Addus HomeCare 2026 Conference Summary Company Overview - **Company**: Addus HomeCare (NasdaqGS:ADUS) - **Industry**: Home care services, focusing on personal care, home health, and hospice [2][4] Key Performance Drivers and Challenges - **2025 Focus**: Significant investments in the hospice division, including leadership changes and enhanced sales and marketing efforts [4][6] - **Census Growth**: Emphasis on maximizing hours per client rather than just increasing census numbers; challenges in adding new clients with adequate hours [5][6] - **Regulatory Challenges**: Adjustments due to the new Trump administration's Medicaid program changes, which required understanding their implications for operations [6][7] Census Growth Insights - **Key Markets**: Illinois, Texas, and New Mexico account for approximately 70% of personal care business; faced challenges with the Biden redetermination process affecting starts of care and discharges [10][11] - **Trends**: New Mexico showed early recovery in census growth, followed by Texas; Illinois lagged but is expected to improve in 2026 [12][14] Rate Environment and Value Communication - **Rate Increases**: Texas and Illinois have provided consistent rate increases; New Mexico is expected to implement a 4% increase effective July [21][23] - **Value Proposition**: Emphasis on the cost-effectiveness of home care versus institutional care, highlighting savings for states [16][19] Compliance and Regulatory Landscape - **Compliance Program**: Strong focus on compliance with a multimillion-dollar investment in internal audits and proactive outreach to states regarding billing issues [27][28] - **Fraud and Abuse**: Support for initiatives to reduce fraud, with no significant changes in audit frequency noted [29][30] Labor Market Trends - **Hiring Trends**: Positive hiring environment, with a focus on quick onboarding processes using technology; average hiring rate of 105 needed to support growth [44][49] - **Caregiver App**: Implementation of a caregiver app has improved fill rates from low 80% to upper 80% in Illinois, with similar expectations for New Mexico and Texas [51][56] Clinical Business Performance - **Hospice and Home Health**: Hospice division is a focus area with growth potential; home health serves as a feeder for hospice admissions [61][62] - **Market Valuation**: Challenges in acquiring hospice businesses due to high valuations; focus remains on non-clinical personal care [63][64] M&A Strategy - **Acquisition Focus**: Targeting smaller personal care businesses with revenues of $10-$15 million; potential interest in larger multi-state businesses later in the year [67][68] - **Clinical Acquisitions**: Interest in smaller hospice acquisitions at reasonable multiples, particularly where there are synergies with existing services [69][70] Conclusion - Addus HomeCare is strategically positioned to leverage its strengths in home care services while navigating regulatory challenges and labor market dynamics. The company remains focused on growth through both organic means and potential acquisitions, particularly in the hospice and personal care sectors.