Financial Data and Key Metrics Changes - Total revenue for Q1 2025 was $337.7 million, a 20.3% increase from $280.7 million in Q1 2024 [6] - Adjusted earnings per share rose to $1.42, up 17.4% from $1.21 in Q1 2024 [6] - Adjusted EBITDA increased to $40.6 million, a 25.1% rise from $32.4 million in Q1 2024 [6] - Gross margin percentage improved to 31.9% from 31.4% in Q1 2024 [21] - Adjusted EBITDA margin was 12%, compared to 11.6% in Q1 2024 [22] Business Line Data and Key Metrics Changes - Personal Care segment revenues were $258.3 million, accounting for 76.5% of total revenue, with a same-store revenue growth of 7.4% [20] - Hospice segment revenues were $61.4 million, representing 18.2% of total revenue, with same-store revenue growth of 9.9% [20] - Home Health segment revenues were $18 million, making up 5.3% of total revenue, with a same-store revenue growth of 1.3% [20] Market Data and Key Metrics Changes - Personal Care hiring reached 79 hires per day, an increase from the previous year [7] - Average daily census for hospice increased to 3,515, up 4.6% from 3,359 in Q1 2024 [11] - Same-store hours for Personal Care increased by 2% compared to Q1 2024 [10] Company Strategy and Development Direction - The company aims for a minimum annual revenue growth of 10%, focusing on acquisitions that complement organic growth [13] - The strategy includes expanding personal care services in Texas and evaluating smaller acquisition opportunities [14] - The company is committed to maintaining a conservative approach to valuation and due diligence in acquisitions [14] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the continued demand for home-based care services, which are seen as cost-effective and safe [15] - The company anticipates stable gross margins and consistent cash flow conversion for the full year 2025 [22][24] - Management noted that the clinical hiring environment remains challenging but is improving overall [8][66] Other Important Information - The company utilized approximately $2.5 million in ARPA funding during Q1 2025, with $8.8 million remaining [25] - As of March 31, 2025, the company had cash on hand of approximately $97 million and reduced bank debt by $20 million [6][25] Q&A Session Summary Question: Commentary on hospice cap limitations - Management indicated that cap limitations have not been material, emphasizing a balanced referral mix [28][30] Question: Growth expectations for personal care services - Management acknowledged weather-related impacts in January but expects growth in hours to remain in the 2% to 2.5% range [38] Question: Hospice revenue growth expectations - Management anticipates hospice revenue growth in the 5% to 7% range, likely at the higher end [40] Question: Margin expansion expectations - Management expects 40 to 50 basis points of margin expansion from Q1 to Q2, consistent with historical patterns [46] Question: Impact of ACA expansion rollback - Management stated that potential changes to ACA expansion would likely have no direct impact on the company [50][52] Question: Same-store revenue growth components - Management attributed strong same-store revenue growth to improved scheduling and caregiver assignment practices [56] Question: Industry-wide workforce retention improvements - Management noted improvements in workforce retention across the industry, particularly in personal care [66] Question: Updates on Gentiva's performance - Management reported that Gentiva's bottom line performance has exceeded expectations, while top-line growth has been slightly lighter [76] Question: State budget and rate increase outlook - Management expressed confidence in state budgets and is closely monitoring potential rate increases, particularly in Texas [79]

Core Insights - Addus HomeCare (ADUS) reported revenue of $337.71 million for the quarter ended March 2025, reflecting a year-over-year increase of 20.3% [1] - The earnings per share (EPS) for the quarter was $1.42, up from $1.21 in the same quarter last year, with an EPS surprise of +6.77% compared to the consensus estimate of $1.33 [1] - The reported revenue was slightly below the Zacks Consensus Estimate of $340.01 million, resulting in a revenue surprise of -0.68% [1] Revenue Breakdown - Personal care revenue was $258.29 million, which is a 24.2% increase year-over-year, but below the average estimate of $261.89 million [4] - Home Health revenue reached $17.99 million, exceeding the average estimate of $17.66 million, with a year-over-year growth of 6.6% [4] - Hospice revenue amounted to $61.44 million, surpassing the average estimate of $59.79 million, and showing a year-over-year increase of 10% [4] Stock Performance - Over the past month, Addus HomeCare shares have returned +4.7%, outperforming the Zacks S&P 500 composite, which saw a +0.4% change [3] - The stock currently holds a Zacks Rank 3 (Hold), indicating expected performance in line with the broader market in the near term [3]

Core Viewpoint - Extendicare Inc. announced the acquisition of Closing the Gap Healthcare Group Inc. by its subsidiary ParaMed Inc. for approximately $75.5 million, enhancing its home health care services in Ontario and Nova Scotia [1][3][4]. Transaction Details - The acquisition is structured on a debt-free, cash-free basis, with an earnout tied to new business revenue generation expected in the first year post-closing [3][8]. - The transaction is subject to customary closing conditions and is anticipated to close in the third quarter of 2025 [2]. Company Background - Closing the Gap has been a leader in home and community healthcare for 35 years, providing a range of services including personal support, nursing, physiotherapy, and social work [5][4]. - In 2024, Closing the Gap delivered over 1.1 million service hours through approximately 1,200 caregivers [5]. Financial Impact - The acquisition is projected to add approximately $84.2 million in revenue to Extendicare's home health care segment for 2024, with similar margins to ParaMed [6]. - The combined service volumes for the home health care segment would reach approximately 12.1 million hours with an average daily volume of 33,164 [7]. - The earnout from the transaction is estimated to be between $3.5 million and $5.5 million, contributing an additional $7.0 to $11.0 million in revenue [8]. Synergies and Growth Potential - The integration of back-office functions is expected to generate approximately $1.1 million in annualized cost synergies in the first year following the closing [8]. - The acquisition is seen as a strategic move to enhance Extendicare's capabilities and market presence in the home health care sector [4].

Core Viewpoint - Aveanna Healthcare Holdings Inc. has announced an agreement to acquire Thrive Skilled Pediatric Care, enhancing its position in the pediatric home care market and expanding its service footprint into two new states [1][2]. Company Overview - Aveanna Healthcare is a diversified home care platform headquartered in Atlanta, Georgia, providing a wide range of healthcare services across 34 states, including nursing, rehabilitation, and therapy services [5]. - Thrive SPC is one of the largest independent providers of pediatric home care, operating 23 locations across seven states, primarily offering skilled Private Duty Nursing services along with Pediatric Therapy and other health aide services [2]. Strategic Implications - The acquisition is expected to close in the second fiscal quarter of 2025, pending regulatory approvals, and is seen as a strategic move to enhance Aveanna's service offerings and geographical reach [1][2]. - The combination of Aveanna and Thrive SPC is anticipated to create a stronger entity focused on delivering high-quality, patient-centered care, reinforcing Aveanna's mission to lead in the home care sector [3]. Financial Aspects - Aveanna plans to fund the acquisition through a mix of common stock and cash from its balance sheet, indicating a strategic financial approach to support growth [3]. Leadership Perspectives - The CEO of Aveanna expressed enthusiasm about the acquisition, highlighting the cultural and geographical fit between the two companies and the shared commitment to high-quality care [3]. - A representative from Summit Partners, which supported Thrive SPC, emphasized the significance of this acquisition in enhancing care for medically fragile children and the alignment of visions between the two companies [3]. Advisory Roles - Edge Healthcare Partners acted as the financial advisor for Aveanna, while Cantor Fitzgerald & Co. served as the financial advisor for Thrive SPC, indicating a structured advisory framework for the transaction [4].

Core Viewpoint - Addus HomeCare (ADUS) has been upgraded to a Zacks Rank 1 (Strong Buy), indicating a positive outlook on its earnings estimates, which is a significant factor influencing stock prices [1][3]. Earnings Estimates and Stock Performance - The Zacks rating system tracks the Zacks Consensus Estimate, which reflects EPS estimates from sell-side analysts for the current and following years, highlighting the importance of earnings revisions in stock price movements [1][4]. - A strong correlation exists between changes in earnings estimates and near-term stock price movements, with institutional investors using these estimates to determine fair value [4][6]. Company Performance Indicators - Addus HomeCare is projected to earn $6.04 per share for the fiscal year ending December 2025, representing a year-over-year increase of 14.8% [8]. - Over the past three months, the Zacks Consensus Estimate for Addus HomeCare has increased by 5.2%, indicating a positive trend in earnings expectations [8]. Zacks Rating System - The Zacks Rank system classifies stocks into five groups based on earnings estimates, with Zacks Rank 1 stocks historically generating an average annual return of +25% since 1988 [7]. - The upgrade of Addus HomeCare to Zacks Rank 1 places it in the top 5% of Zacks-covered stocks, suggesting potential for market-beating returns in the near term [10].

Financial Data and Key Metrics Changes - Revenue for Q4 2024 was approximately $520 million, representing an 8.6% increase year-over-year [5][16] - Full year 2024 revenue was approximately $2.024 billion, a 6.8% increase over the prior year [5] - Adjusted EBITDA for Q4 was $55.2 million, a 42.6% increase year-over-year, primarily due to improved payer rates and cost reduction efforts [5][16] - Full year 2024 adjusted EBITDA was $183.5 million, a 31.8% increase over the prior year [5] Business Line Data and Key Metrics Changes - Private Duty Services (PDS) revenue for Q4 was approximately $422.2 million, a 10.1% increase, driven by a volume increase of 4% [17] - Home Health and Hospice segment revenue for Q4 was approximately $54.4 million, a 0.6% increase, with 76% of admissions being episodic [19][21] - Medical Solutions segment revenue for Q4 was approximately $43.3 million, a 4.8% increase, with revenue per unique patient served at approximately $486, up 5.9% [22] Market Data and Key Metrics Changes - Preferred payer agreements accounted for approximately 50% of total PDS Managed Care Organization (MCO) volumes in Q4, up from 47% in Q3 [10] - The episodic payer mix for home health was 76% in Q4, exceeding the goal of 70% [10][11] Company Strategy and Development Direction - The company continues to focus on enhancing partnerships with government partners and preferred payers to create additional capacity and growth [14] - The strategic plan for 2025 includes identifying cost efficiencies, modernizing the medical solutions business, and managing capital structure while producing positive free cash flow [14] - The company aims to increase the number of preferred payer agreements in PDS from 22 to 30 by the end of 2025 [35][74] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the labor market improving and the demand for home and community-based care remaining strong [6][13] - The initial outlook for 2025 anticipates revenue in the range of $2.1 billion to $2.12 billion and adjusted EBITDA between $190 million and $194 million [14][27] - Management highlighted the importance of aligning clinical capacity with preferred payers to improve clinical outcomes and financial performance [12][52] Other Important Information - The company secured 12 private duty services state rate increases for the full year 2024, with significant improvements in Georgia and Massachusetts [8] - The company had liquidity of approximately $260 million at the end of Q4, providing ample room to operate and invest in growth [25] Q&A Session Summary Question: Guidance on top line growth and EBITDA margins - Management characterized their guidance as prudent, expecting continued momentum in 2025 with solid rate increases and preferred payer execution [31][32] Question: M&A pipeline focus - The company is focused on tuck-in acquisitions in home health and private duty services, planning to stay within its capital structure [34][35] Question: PDS segment rate growth and gross margin progression - Management indicated confidence in PDS growth rates, with expectations for spread per hour to normalize between $10 and $10.5 [40][41] Question: Capital allocation and leverage comfort - The company aims to continue deleveraging while maintaining a strong cash flow position, with a focus on organic growth and potential M&A opportunities [43][48] Question: Medical solutions payer strategy and contract conversions - The company is aligning clinical capacity with preferred payers and expects to see improved clinical outcomes and margin expansion in the Medical Solutions segment [51][52] Question: Medicaid regulatory changes and policy discussions - Management expressed confidence in being a cost saver for government programs and is well-positioned to adapt to potential changes in Medicaid [57][68] Question: Revenue guidance for PDS revenue growth - The guidance implies a total revenue growth of 3% to 5% in the PDS segment, with a focus on increasing preferred payer volumes [72][74]

Financial Data and Key Metrics Changes - Total revenue for Q4 2024 was $297.1 million, an increase of 7.5% compared to $276.4 million in Q4 2023 [20] - Adjusted earnings per share for Q4 2024 was $1.38, up 4.6% from $1.32 in Q4 2023 [20] - Adjusted EBITDA for Q4 2024 was $37.8 million, a 10.3% increase from $34.3 million in Q4 2023 [20] - For the full year 2024, total revenue was $1.2 billion, a 9.1% increase from $1.1 billion in 2023 [21] - Adjusted EBITDA for 2024 was $140.3 million, up 15.9% from $121 million in 2023 [21] Business Line Data and Key Metrics Changes - Personal care revenues for Q4 2024 were $216.9 million, accounting for 73.8% of total revenue [52] - Hospice care revenues were $59 million, representing 20.1% of total revenue [52] - Home health revenues were $17.8 million, making up 6.1% of total revenue [52] - Same store revenue growth for personal care was 5.8% in Q4 2024 compared to Q4 2023 [35] - Hospice same store revenue increased by 7.8% year-over-year [37] - Home health segment returned to positive growth with a 1.6% increase compared to Q4 2023 [39] Market Data and Key Metrics Changes - Illinois enacted a 5.5% rate increase for personal care services effective January 1, 2025, expected to contribute approximately $23 million in annualized revenue [34][47] - The company experienced solid caregiver hiring success, with personal care hiring at 76 hires per day, up from 74 hires per day in Q4 2023 [30] Company Strategy and Development Direction - The company is focused on expanding services related to home care, which is seen as valuable to both states and Congress [18] - The Gentiva acquisition is a significant part of the growth strategy, adding approximately $280 million in annualized revenues [50] - The company aims for a targeted minimum annual revenue growth of 10% despite the larger revenue base [40] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism regarding the potential impact of Medicaid program changes, believing that their services reduce overall costs to state Medicaid programs [16][19] - The company is well-positioned to handle potential changes in Medicaid funding due to its low-cost provider status [99] - Management anticipates continued growth in personal care services, aiming for a revenue increase of 3% to 5% in 2025 [72] Other Important Information - The company had cash on hand of approximately $100 million as of the end of 2024 [22] - A one-time write-off of approximately $4.9 million was taken in Q4 2024 related to excess corporate office space [29] - The company maintains a conservative leverage position at just under one times Adjusted EBITDA, allowing flexibility for strategic acquisitions [23] Q&A Session Summary Question: Average revenue per hour in Q4 and its impact - The average revenue per hour is expected to be slightly down due to the Gentiva deal and the lower reimbursement rate in Texas [67] Question: Organic volume growth in personal care - Organic volume growth in personal care was slightly up, with expectations to reach the higher end of the 3% to 5% growth range in 2025 [72][74] Question: Impact of work requirements on business - The majority of clients served are elderly and disabled, so work requirements would have negligible direct effects, potentially increasing caregiver availability [83] Question: Integration of Gentiva and its impact on cash flow - The integration of Gentiva is progressing smoothly, with no significant impact on cash flow conversion expected [119] Question: Expected margin decline from Q4 to Q1 - A 200 basis point margin decline is anticipated, primarily due to the mix shift from Gentiva and annual resets of payroll taxes [54][109]

Table of Contents BrightSpring Health Services, Inc. (Exact name of registrant as specified in its charter) As filed with the Securities and Exchange Commission on January 2, 2024 Registration No. 333- UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM S-1 REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933 (State or other jurisdiction of incorporation or organization) Delaware 8082 82-2956404 (Primary Standard Industrial Classification Code Number) (I.R.S. Employer Identificat ...