Home-Based Care Public Company Roundup Q1 2025
- Emin Beganovic
- May 23
- 8 min read
Updated: 12 minutes ago
Mertz Taggart follows the publicly traded home-based care companies and reports on their earnings calls each quarter. As a group, public company performance and share price serve as a proxy for industry performance and investor sentiment, respectively. Historically seen as the “ultimate consolidators”, the publicly traded home-based care trading multiples have a downstream effect on lower middle market home-based care M&A.
Addus Homecare (Nasdaq: ADUS)
Highlights
Addus reported a surge in total revenue by 20.3% year-over-year to $337.7 million, primarily fueled by strong organic growth and contributions from recent acquisitions, notably the Gentiva personal care operations.
Adjusted EBITDA rose 25.1% to $40.6 million, and net income increased 34% to $21.2 million compared to Q1 2024, reflecting robust operational execution and profitability.
The Personal Care segment, accounting for approximately 76.5% of total revenue, delivered a 7.4% organic revenue increase year-over-year, driven by higher volumes and a 5.5% rate increase in Illinois, the company’s largest personal care market.
Home Health services represented 5.3% of total revenue, with organic revenue growth of 1.3% over the prior year, while Hospice services contributed $61.4 million, or 18.2% of revenue.
Cash on hand stood at $97 million as of March 31, 2025, with net leverage under one-time adjusted EBITDA, providing ample flexibility for future strategic acquisitions.
Key Financial Figures
M&A Activity
Addus’ major M&A activity in 2025 was the completion and integration of its $350 million acquisition of Gentiva’s personal care operations, which expanded its presence into seven states (including Texas and Missouri as new markets) and made it the largest personal care provider in Texas, adding approximately $280 million in annualized revenues.
“Now that we have a strong presence in Texas following our Gentiva acquisition, our team has started to look for both clinical and non-clinical acquisition opportunities to increase both the density and geographic scope of our personal care service offerings in Texas and to add complementary clinical services to achieve our goal of broad coverage across the state for all three levels of home care,” CEO Dirk Allison commented.
Guidance
Management reaffirmed a minimum annual revenue growth target of 10% and expects same-store personal care hour growth of at least 2% per year.
Adjusted EBITDA margin is projected to remain above 12% for the full year, with continued focus on operational and technological improvements.
The company is monitoring potential rate changes in key markets, including Texas, and remains committed to selective, accretive acquisitions.
Aveanna Healthcare (Nasdaq: AVAH)
Highlights
Aveanna reported total revenue of $559.2 million, up 14.0% from $490.7 million in Q1 2024. This result exceeded analyst expectations and was driven by growth in the Private Duty Services segment, which contributed $38.0 million of the increase. Home Health & Hospice revenue increased by $2.1 million.
Gross margin rose 25.9% to $183.6 million, representing 32.8% of revenue (up from 29.7% in Q1 2024), reflecting improved operational efficiency and cost management.
The Private Duty Services segment delivered approximately 10.9 million hours of care, a 6.1% volume increase, and revenue per hour rose 10.4% year-over-year, driven by preferred payer volume growth and rate enhancements.
CEO Jeff Shaner highlighted the quarter as a reflection of continued positive momentum and strategic transformation, with all three operating divisions contributing to growth and improved profitability.
Key Financial Figures
M&A Activity
Aveanna is actively re-engaging in M&A activity in 2025, with a primary focus on acquiring companies in the Private Duty Services (PDS) and Home Health & Hospice segments.
The company announced an agreement to acquire Thrive Skilled Pediatric Care, with the transaction expected to close in Q2 2025.
On the Thrive deal, CEO Jeff Shaner stated, “This is the perfect acquisition for Aveanna. I’ve told other folks it checks all the boxes. Our missions are very alike. What we do every day in both Aveanna and Thrive fit each other like hand in glove. So that’s, for us, most important. From a cultural and clinical standpoint, do we both think alike? And the answer is yes, we do.”
Guidance
Aveanna raised its 2025 outlook, now expecting revenue to exceed $2.15 billion and adjusted EBITDA to surpass $207 million, driven by strong Q1 results and continued growth in Private Duty Services. The company remains focused on operational efficiencies, strategic acquisitions, and strengthening payer partnerships to support long-term profitability.
Key 2025 initiatives include strengthening partnerships, improving efficiency, and integrating acquisitions for long-term growth.
The Pennant Group, Inc. (Nasdaq: PNTG)
Highlights
Pennant Group reported total revenue of $209.8 million for Q1 2025, a 33.7% increase over the prior year quarter, and significantly beating analyst expectations.
The Home Health and Hospice segment delivered a standout quarter, with revenue up 37.2% year-over-year to $159.9 million while home health admissions jumped 28.9% to 18,878, and hospice average daily census increased 28.1% to 3,794.
The Senior Living segment also grew, with revenue rising 23.6% to $50 million and average monthly revenue per occupied unit up 11.3% to $5,193, though occupancy remained flat at 78.5%.
Total admissions grew to 18,878, an increase of 4,229 or 28.9%. Medicare admissions rose 19.7%, and Medicare revenue per episode increased by 9.3% each over the prior year quarter.
Key Financial Figures
M&A Activity
In August 2024, PNTG completed the first phase of its $80 million acquisition of Signature Healthcare at Home’s Washington and Idaho assets. In Q1 2025, it finalized the two-stage acquisition, closing on Signature’s Oregon assets. The Company claims to have successfully integrated these operations ahead of schedule, with many new sites already outperforming expectations.
President and COO John Gochnour commented, “We continue to evaluate a strong pipeline of acquisition opportunities in both segments. As always, we will approach these opportunities with discipline, pursuing only those we believe we have the leadership capacity and operational strength to support.
Guidance
PNTG continued with the full-year 2025 guidance as follows:
Revenue: Range of $800 million to $865 million
Adjusted EBITDA: Range of $63.1 million to $68.2 million
Adjusted EPS: $1.03 to $1.11
The company also indicated it is trending toward the upper end of this guidance range based on strong Q1 performance and momentum.
Enhabit Home Health & Hospice (Nasdaq: EHAB)
Highlights
Enhabit’s Q1 2025 net service revenue was $259.9 million, down 1% from the prior year, but the company delivered strong profitability with net income of $17.8 million-boosted by a $14.7 million after-tax gain on an investment sale.
The home health segment faced a 5.9% revenue decline to $200.6 million yet saw sequential improvement with a 3.7% increase in average daily census and nearly 1% year-over-year admissions growth, while cost per patient day dropped 2.4% because of operational efficiencies and productivity gains.
Hospice operations were a standout, with revenue surging 20.5% year-over-year to $59.3 million, average daily census climbing 12.3%, and admissions up 8%.
Enhabit reduced its bank debt by $25 million during the quarter, bringing total debt to $489.8 million and lowering its leverage ratio to 4.4x.
Key Financial Figures
M&A Activity
Enhabit has not announced any M&A deals but remains open to a sale, merger, or other strategic options.
The company met its Net Leverage Ratio requirement (as per credit agreement with Wells Fargo) for June 2025 one quarter ahead of schedule, bringing it below the 4.5x threshold. This early compliance will now allow the company to benefit from better credit terms and financial and operational flexibility including the capability to pursue acquisitions one quarter earlier than expected.
Guidance
Enhabit reaffirmed its guidance for full-year 2025 as follows:
Revenue: Range of $1.05 billion to $1.08 billion
Adjusted EBITDA: Range of $101 million to $107 million
Adjusted EPS: Range of $0.41 to $0.51
This guidance reflects its long-term growth strategy in home health and hospice. Stabilized Medicare census, a renegotiated national contract, and a growing hospice segment highlight its strengthened market position. These developments reinforce its commitment to operational and financial improvement in 2025.
BrightSpring Health Services, Inc. (NASDAQ: BTSG)
Highlights
BrightSpring Health Services delivered a strong Q1 2025, with net revenue rising 25.9% year-over-year to $2.88 billion, driven by robust growth in both Pharmacy Solutions (up 28% to $2.53 billion) and Provider Services (up 12% to $346 million).
The company achieved a major turnaround in profitability, posting net income from continuing operations of $9.2 million compared to a $56 million loss in Q1 2024.
Pharmacy Solutions was the primary growth engine, benefiting from BrightSpring’s scale and focus on specialty pharmacy for chronic and complex conditions, while Provider Services saw higher home health care volumes and average daily census.
Provider Services saw notable gains, particularly in Home Health Care (up 20.9%), with average daily census rising 11.6% to 30,241 patients, though the segment’s EBITDA margin dipped slightly to 14.8%.
Gross profit increased 15.7% to $338 million, reflecting not just revenue growth but also improved operational efficiency and cost discipline.
Key Financial Figures
M&A Activity
In Q1 2025, the Company acquired a Provider Services business for approximately $6.8 million to expand its service offerings and geographic footprint. The transaction resulted in $6.4 million of goodwill and a $0.4 million non-compete intangible asset. The acquisition contributed $0.8 million in revenue and $0.3 million in operating income for the quarter.
Further, the company continues to pursue strategic tuck-in acquisitions. CEO Jon Rousseau mentioned, “We continue to execute on our disciplined M&A strategy, focusing on acquiring complementary businesses that align with our core services and expand our geographic footprint.”
Guidance
BTSG has provided revenue and Adjusted EBITDA guidance for the full year 2025 as follows:
Revenue: Range of $12.0 billion to $12.5 billion
Adjusted EBITDA: Range of $570 million to $585 million
This guidance underscores confidence in continued robust growth across its core pharmacy and provider service lines in 2025.
Option Care Health, Inc. (NASDAQ: OPCH)
Highlights
Option Care Health reported Q1 2025 revenue of $1.33 billion, a 16.3% increase from $1.14 billion in Q1 2024, driven by balanced growth across both acute and chronic therapy portfolios and continued expansion in alternate site infusion services.
Gross profit was $263.1 million, or 19.7% of net revenue, up 10.3% from $238.5 million in Q1 2024, though gross margin declined from 20.8% last year due to higher operating expenses, which rose 8.5% to $183.9 million.
Net income increased to $46.7 million, compared to $44.8 million in Q1 2024, and adjusted EBITDA increased by 13.7% to $111.8 million, reflecting strong operational performance and profitability.
The company significantly improved cash flow from operating, using only $7.2 million versus $68.8 million in the prior year, and repurchased approximately $100 million of its own stock during the quarter, signaling confidence in its growth trajectory.
Key Financial Figures
M&A Activity
Option Care Health continued emphasizing mergers and acquisitions as a core pillar of its growth strategy in Q1 2025, with management reiterating commitment to deploying capital for accretive acquisitions and expanding the company’s national footprint.
In January 2025, Option Care closed it’s $117 million acquisition of Intramed Plus, a South Carolina-based infusion provider. This deal was aimed at broadening Option Care’s advanced practitioner model and enhancing its clinical capabilities, particularly in complex infusion therapies.
Option Care Health maintains a strong pipeline of potential acquisitions and continues to evaluate both tuck-in and larger deals, supported by its solid balance sheet and healthy cash flow, which provide flexibility for future M&A, share repurchases, and internal investments.
Guidance
OPCH has now updated their guidance for the full year 2025 as follows:
Revenue: Range of $5.4 billion to $5.6 billion
Adjusted EBITDA: Range of $455 million to $470 million
Adjusted EPS: Range of $1.61 - $1.70
Key drivers for the raised guidance are strong Q1 results, operational improvements, and continued expansion, signaling confidence in sustained growth for the remainder of the year.
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