Home-Based Care Public Company Roundup Q2 2026
- 2 days ago
- 9 min read
Updated: 14 hours 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 posted revenue of $377.4 million for the quarter, up 8.0% from Q2 2025. Net income was $27.6 million compared with $22.1 million, in the prior year quarter. Adjusted EBITDA rose 11.9% to $49.2 million, with adjusted EBITDA margin of 13.0% compared with 12.6% in the prior year quarter.
Growth was led by the Personal Care segment, which represents 78.4% of the business at $296.0 million and grew same-store revenue 6.8% year-over-year. Same-store hours per business day rose 2.2%, within the company’s target range of 2% to 2.5%, and same-store census increased 1.2% sequentially, with growth returning in Illinois, the company’s largest market.
The Hospice segment, representing 17.0% of quarterly revenue at $64.2 million, grew same-store revenue 11.1% year-over-year, with same-store average daily census increasing 6.5% to 3,964 and a median length of stay of 24 days. Average daily census exceeded 4,000 in July. The company recorded Medicare Cap expense in its Ohio market, which is excluded from the same-store calculation, and management expects no additional cap exposure for the remainder of the year.
The Home Health segment, representing 4.6% of the business at $17.2 million, saw same-store revenue decline 2.8%, an improvement from the 6.6% decline in the first quarter, with sequential gains in revenue, operating income and admissions.
Key Financial Figures
M&A Activity
On May 1, Addus closed the acquisition of the personal care operations of HomeCourt Home Care, based in Fort Wayne, marking the company’s entry into Indiana. CFO Brian Poff said the operation is running slightly ahead of volume expectations and sits close enough to the company’s Illinois, Ohio and Michigan markets to fold under existing regional leadership. A definitive purchase agreement remains in place for a similarly sized personal care operation in the Indianapolis area, which will be combined with HomeCourt once it closes.
Management pointed to a wider set of opportunities reaching the market, noting that “recently, we have begun to see an increasing number of personal care opportunities, which we will be actively pursuing.” CEO Dirk Allison said owners have become comfortable that changes to Medicaid are “not really affecting our business or our industry near as much as people thought” and are now willing to bring businesses to market. He confirmed the company is evaluating scaled assets and has held leverage low in order to act on them.
Guidance
Management continues to expect full-year adjusted EBITDA margin of 12% to 13% and pointed to the higher end of that range, with a step up in the fourth quarter as the hospice rate increase takes effect.
Aveanna Healthcare (Nasdaq: AVAH)
Highlights
Aveanna reported Q2 2026 revenue of $670.5 million, a 13.7% increase over the prior year period, with year-over-year growth in all three operating divisions. Net income was $40.3 million compared with $27.0 million. Adjusted EBITDA rose 8.0% to $95.4 million. Consolidated gross margin was $218.5 million, or 32.6%, compared with 35.8% in the prior year quarter, which included approximately $9 million of non-recurring favorable items in Private Duty Services.
The Private Duty Services segment, representing 83% of the business, grew 14.0% to $553.9 million, driven by a 12.3% volume increase to approximately 12.4 million hours of care and a 1.7% increase in revenue per hour to $44.62. Cost of revenue per hour rose 7.8% to $31.74, leaving spread per hour of $12.88. Segment gross margin was 28.9%.
The Home Health & Hospice segment grew 14.8% to approximately $69.0 million on 10,500 total admissions and 14,700 total episodes of care, up 18.5% from the prior year quarter. Medicare revenue per episode was $3,202 and segment gross margin was 53.9%. Medical Solutions grew 9.4% to $47.5 million on approximately 95,000 unique patients served, up 4.4%.
The company’s preferred payor strategy continued to advance, with three agreements signed in Private Duty Services during the quarter, bringing the total to 37 against a 2026 goal of 38. Preferred payor agreements now account for approximately 64% of total Private Duty Services MCO volumes, up from 60% at the end of the first quarter. In home health, Aveanna reached its full-year goal of 50 preferred payor agreements, while Medical Solutions ended the quarter with 20 against a goal of 25.
Key Financial Figures
M&A Activity
Aveanna closed the acquisition of Family First Homecare, a Florida-based provider of in-home pediatric care, in early June, funding the purchase and closing costs with cash on hand. Shaner described the integration as in its front third, with the back office and EMR transitions still ahead, and expects the work to be complete late in the fourth quarter. He said the transaction strengthened the company in Florida and improved service distribution in Iowa, South Dakota and Illinois.
Looking forward, Shaner said “we think the majority of our M&A activity moving forward will be in the adult space,” with home health and hospice the focus now that most Private Duty Services states are filled in.
Guidance
Management raised full-year 2026 guidance to revenue of greater than $2.68 billion, from a range of $2.63 billion to $2.65 billion, and adjusted EBITDA of greater than $365 million, from a range of $338 million to $342 million.
The Pennant Group, Inc. (Nasdaq: PNTG)
Highlights
Pennant Group reported total revenue of $298.0 million for the quarter, an increase of $78.5 million or 35.8% over the prior year quarter. Adjusted EBITDA grew 48.2% to $24.3 million, or $26.1 million prior to non-controlling interests, up 51.0%.
The Home Health and Hospice segment delivered revenue of $237.8 million, an increase of $71.8 million or 43.2%, with segment adjusted EBITDA of $37.7 million, up 48.2%. Same-store segment margin improved 70 basis points year-over-year.
Hospice revenue grew 40.4% to $103.6 million, with admissions up 38.4% and average daily census up 40.1% to 5,477. Same-store hospice admissions grew 8.8% and same-store average daily census grew 10.8% to 4,089. The company recorded approximately $1.3 million of Medicare Cap in the quarter, approximately $0.5 million below the prior year level, with most of the exposure in California.
Home health revenue grew 50.8% to $119.4 million, with total admissions up 62.3% and total Medicare admissions up 70.7%. Same-store home health admissions grew 9.7% and same-store Medicare admissions grew 13.6%.
Key Financial Figures
M&A Activity
The transition of the home health, hospice and home care operations acquired from UnitedHealthcare in Tennessee, Alabama and Georgia is three of five waves complete, with the fourth nearing completion and the fifth, one of the largest, started August 1. Management expects the process to be finished by the middle of the fourth quarter and said margins are trending ahead of internal expectations, with volumes holding above the levels at the time of acquisition.
In senior living, Pennant has completed seven acquisitions year to date. In May the company acquired the operations and real estate of Copper Canyon Memory Care, a 40-unit community in Tucson. On June 1 it assumed operations of Memory Care of Contra Costa, a 46-unit memory care community in Pleasant Hill, California, and on August 1 it acquired the operations and real estate of River Center Assisted Living, a 63-unit community in Tucson. The additions bring the company’s real estate portfolio to nine properties, five of which were acquired in the last 12 months.
On June 4, Pennant announced an equity investment in Hartford HealthCare at Home, which it has managed since 2024 and serves more than 30,000 patients from nine locations in Connecticut.
Guidance
Management raised full-year 2026 guidance to total revenue of $1,171.1 million to $1,190.1 million, adjusted diluted earnings per share of $1.34 to $1.41 and adjusted EBITDA of $94.4 million.
BrightSpring Health Services, Inc. (NASDAQ: BTSG)
Highlights
BrightSpring posted total revenue of $3.9 billion for the quarter, up 23.0% year-over-year, with adjusted EBITDA of $206 million, a 44% increase, and adjusted EBITDA margin of 5.3%, an 80-basis point improvement. Net income was $87 million, compared with $9 million in the prior year quarter. Results reflect continuing operations and exclude the Community Living business divested on March 30.
Pharmacy Solutions grew revenue 22% to $3.4 billion, with segment adjusted EBITDA of $180 million, up 44%. Specialty and infusion revenue grew 30% to $2.9 billion on 31% script growth, driven by the branded oncology limited distribution drug portfolio, new LDD wins, wraparound fee-for-service programs and brand-to-generic conversions. The company added two ultra-narrow network LDDs in the quarter, bringing its total to 155, and has launched 12 year to date, four as exclusive partner and eight ultra-narrow.
Provider Services grew revenue 30% to $466 million, with segment adjusted EBITDA of $75 million, up 33%, and a margin of 16.1%. Home Health grew 51% to $278 million on 54% average daily census growth, de novo expansion and the integration of acquired branches. The Amedisys and LHC branches contributed approximately $78 million of revenue and approximately $8 million of adjusted EBITDA in the quarter. Rehab grew 12% to $82 million and Personal Care grew 7% to $107 million.
Key Financial Figures
M&A Activity
Management described a full pipeline, with several small tuck-ins and geographic expansions signed during the quarter and further transactions possible in the second half. Rousseau said geographically adjacent tuck-ins remain the core of the strategy, that larger transactions for BrightSpring are typically below $30 million to $40 million of EBITDA, and that the company is considering adding to its sevenperson M&A team.
Integration of the acquired Amedisys and LHC branches is complete on the company’s home-based platform, and management raised the expected 2026 adjusted EBITDA contribution from those assets to approximately $35 million from approximately $30 million.
Guidance
Management raised full-year 2026 guidance to total revenue of $15.1 billion to $15.425 billion, including Pharmacy Solutions revenue of $13.2 billion to $13.5 billion and Provider Services revenue of $1.9 billion to $1.925 billion. Total adjusted EBITDA is now expected to be in the range of $820 million to $845 million, reflecting 32.8% to 36.8% growth over full-year 2025 excluding Community Living in both years, and includes approximately $35 million from the Amedisys and LHC branches.
Option Care Health, Inc. (NASDAQ: OPCH)
Highlights
Option Care posted second quarter revenue of $1.4 billion, up 1.9% compared with the prior year and 7% sequentially, ahead of management’s expectations. Adjusted EBITDA of $117.5 million rose 3.0% year-over-year and 12% sequentially, and adjusted earnings per share of $0.45 increased 9.8%, including a three-cent uplift from share repurchases. GAAP net income was $53.9 million, up 6.7%, or $0.35 per diluted share.
Acute therapy revenue grew in the high single digits, with sequential and year-over-year growth across all key therapeutic categories and in the number of patients served. Chronic therapy revenue was in line with the prior year and grew in the high single digits sequentially, led by the IG and neurology portfolio.
In the chronic inflammatory disease portfolio, management said the company “began to stabilize our portfolio coming out of the first quarter reset and saw our second quarter patient census rise sequentially,” and expects to build census further through the year. The company continues to expect a full-year revenue headwind of approximately 600 basis points and a gross profit headwind of $55 million from that portfolio and continues to expect Stelara and related biosimilars to represent less than 1% of 2026 net revenue and gross profit. The rare and orphan portfolio grew sequentially and yearover-year, with several newly added therapies not going live until late 2026 or early 2027.
Ambulatory infusion clinic utilization continued to increase, with five facilities added in the quarter, more than 190 locations now in the network and visits growing more than 20% year-over-year. The company conducted more than 35% of its nursing visits in one of its suites or clinics during the quarter and continues to add to a portfolio of more than 600 therapies.
Key Financial Figures
M&A Activity
Capital allocation priorities begin with organic investments to drive revenue growth, capacity and cost structure optimization, followed by periodic share buybacks, with acquisitions focused on adjacencies and tuck-ins last. CFO Meenal Sethna said guidance does not include any new or prospective repurchases beyond the $150 million completed in the second quarter.
Guidance
Management maintained full-year net revenue guidance of $5.675 billion to $5.775 billion and narrowed adjusted EBITDA guidance to a range of $480 million to $495 million and adjusted earnings per share to $1.85 to $1.92. Operating cash flow is still expected to be at least $320 million, with net interest expense of $50 million to $55 million and a full-year tax rate of 26% to 28%.
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