Addus HomeCare Conference Call Summary Company Overview - **Company**: Addus HomeCare (NasdaqGS:ADUS) - **Industry**: Home healthcare services, primarily focusing on personal care and hospice services Key Points Industry Dynamics - **Medicaid Dependency**: Approximately 75% of Addus's business is derived from Medicaid, making it sensitive to changes in Medicaid regulations and funding [3][4][5] - **Rate Increases**: Significant rate increases have been observed in key states like Texas and Illinois, which have positively impacted revenue growth [4][5][19] Financial Performance - **Growth Targets**: The company aims for a long-term revenue growth of no less than 10% annually, with 3-5% expected from organic growth and the remainder from acquisitions [5][50] - **Recent Growth**: In the third quarter, personal care services experienced about 6.6% organic growth, with expectations to maintain or exceed the 3-5% range in the upcoming quarters [18][19] Hiring and Labor Market - **Hiring Trends**: Strong hiring trends are noted, with the need for 100-105 hires per business day to support growth, particularly in personal care services [9][10][13] - **Labor Market Conditions**: The labor market is showing positive trends, although challenges remain in specific geographies and skilled roles [13][16] Operational Focus - **Census Growth**: The company is focusing on increasing the census in personal care, which is critical for revenue as they are paid by the hour [10][20] - **Technology Utilization**: The rollout of a caregiver app has improved scheduling and service levels, with over 90% adoption in Illinois [22][28] Hospice Services - **Strong Performance**: Hospice services have seen a 19% increase in discharge growth, driven by improved admissions and patient days [30][31] - **Future Expectations**: Anticipated organic revenue growth for hospice is expected to moderate to mid to upper single digits by mid-2026 [34] Home Health Services - **Complementary Role**: Home health services account for less than 10% of total business but are essential for value-based care integration with personal care and hospice [37][39] - **Regulatory Uncertainty**: The company is navigating uncertainties regarding reimbursement rates, with potential impacts estimated at $3 million if proposed cuts are implemented [56] M&A Strategy - **Acquisition Goals**: The company aims to add over $100 million in acquired revenue annually, focusing on personal care and smaller home health acquisitions [50][58] - **Market Conditions**: Current market conditions are described as slower, with expectations for more opportunities in the upcoming year [51][52] Financial Management - **Expense Management**: The company typically runs SG&A in the 20-21% range, with expectations for improvement as revenue grows [59] - **Capital Deployment**: The primary focus remains on M&A, with share repurchases considered a secondary option [68] Future Outlook - **2026 Projections**: The company is optimistic about growth driven by demographic trends, particularly as the elderly population increases [16][18] - **Legislative Monitoring**: Ongoing monitoring of legislative changes and Medicaid funding is crucial for future planning [41][43] Additional Insights - **Community Engagement**: Local recruitment efforts are emphasized, leveraging community ties to enhance hiring effectiveness [12] - **Technology Adoption**: The app's voluntary use by caregivers is seen as a significant factor in improving operational efficiency and caregiver satisfaction [26][28] This summary encapsulates the key insights and strategic directions discussed during the Addus HomeCare conference call, highlighting the company's focus on growth, operational efficiency, and navigating industry challenges.

Financial Data and Key Metrics Changes - Total revenue for Q3 2025 was $362.3 million, a 25% increase from $289.8 million in Q3 2024 [4] - Adjusted earnings per share rose to $1.56, up 20% from $1.30 in Q3 2024 [4] - Adjusted EBITDA increased by 31.6% to $45.1 million compared to $34.3 million in Q3 2024 [5][20] - Gross margin percentage improved to 32.2% from 31.8% in Q3 2024 [20] - Adjusted EBITDA margin was 12.5%, compared to 11.8% for the same quarter last year [22] Business Line Data and Key Metrics Changes - Personal care revenues were $275.8 million, accounting for 76.1% of total revenue, with a same-store revenue growth of 6.6% [20] - Hospice care revenues reached $68.9 million, representing 19% of total revenue, with same-store revenue growth of 19% [20][11] - Home health revenues were $17.6 million, or 4.9% of total revenue, with a same-store revenue decrease of 2.8% [20][12] Market Data and Key Metrics Changes - Texas and Illinois announced rate increases for personal care services, effective October 1, 2025, and January 1, 2026, respectively [6][7] - The Texas rate increase is expected to add approximately $17.7 million in annualized revenue [17] - The Illinois rate increase is projected to add about $17.5 million in annualized revenue [17] Company Strategy and Development Direction - The company continues to pursue strategic acquisitions to enhance geographic coverage and density, with recent acquisitions including Del Cielo HomeCare Services [12][19] - Focus on maintaining a strong balance sheet to support acquisition strategies and organic growth [24][25] - The company aims to leverage the increased demand for home-based care as a growth opportunity [15] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism regarding the favorable reimbursement support from states, which recognizes the value of personal care services [7] - The company anticipates continued growth in hospice and personal care segments, supported by strong hiring trends and rate increases [16][18] - There is caution regarding the home health segment due to potential Medicare payment reductions, but management remains hopeful for improvements [9][41] Other Important Information - The company had cash on hand of approximately $102 million as of September 30, 2025, with net leverage under one times adjusted EBITDA [5][24] - The company is actively working on legislative efforts in various states to advocate for future rate increases [7] Q&A Session Summary Question: Can you provide an update on the Caregiver App rollout in Illinois and New Mexico? - Management noted improvements in fill rates in Illinois and expressed optimism for New Mexico, where the rollout is planned next [28][30] Question: How do you view the hiring trends into 2026 given the strong volume growth? - Management indicated strong hiring momentum with 113 hires per business day, suggesting a positive outlook for organic growth in 2026 [36][39] Question: What is the company's strategy regarding home health and hospice assets? - Management confirmed interest in home health acquisitions that complement personal care and hospice services, while being cautious due to current reimbursement uncertainties [41][42] Question: Can you clarify the impact of overlapping operations in New Mexico and Tennessee on referrals? - Management highlighted the benefits of continuity of care and improved patient outcomes due to the overlap of services [72] Question: What is the outlook for gross margins in Q4 and next year? - Management expects Q4 to be the highest margin quarter, projecting adjusted EBITDA above 13% [54][56] Question: Are there any updates on potential rate increases in New Mexico and Pennsylvania? - Management expressed hope for a rate increase in New Mexico but noted uncertainty regarding Pennsylvania's budget situation [59][60]

Core Insights - The annualized core inflation rate for Bosnia's service sector from January to September is estimated at 4.33% [1] - The consumer price index for the service sector has an annualized increase of 4.84% [1] Inflation Drivers - The most significant impact on September's monthly inflation came from telephone and fax services, although their price increase was too low to affect the overall core inflation trend for the year [1] - Healthcare service prices and hotel and restaurant service prices are the main contributors to the sustained rise in core inflation from January to September [1] - Personal care services also experienced price increases, which had a notable impact on core inflation due to their high price weight [1]

Core Insights - India's Consumer Price Index (CPI) rose by 2.07% year-on-year in August, marking the first increase in 10 months and up from a revised 1.61% in July, signaling a warning for policymakers [1][2] - Despite the rise, inflation remains within the Reserve Bank of India's target range of 2% to 6%, with food prices showing a significant improvement as the decline narrowed to 0.69% from 1.76% in July [1][2] - Core inflation has increased to nearly 4%, driven by rising prices in services such as healthcare and personal care, indicating underlying economic pressures [1][2] Economic Factors - The normal rainfall in India for the 2025 monsoon season has positively impacted agricultural production, stabilizing vegetable prices and alleviating food inflation risks [2] - Strong demand in the service sector, reflected in the Purchasing Managers' Index (PMI) remaining in expansion territory for 16 consecutive months, is contributing to price rigidity in related services [2] - Input cost pressures from geopolitical factors and supply-demand dynamics are gradually affecting consumer prices, particularly in manufacturing sectors [2] Policy Implications - The moderate rise in inflation reflects a delicate balance between stimulating economic recovery and maintaining price stability, complicating policy decisions for the Indian government and central bank [2] - The core inflation increase and sticky service prices are constraining the central bank's ability to maintain an accommodative monetary policy [2] - The Indian government has announced a new round of tax reforms, which has positively impacted market sentiment and may represent a proactive step in addressing inflation concerns [3] Future Considerations - Key variables to monitor include whether food inflation will reverse with the end of the monsoon season and increased festive demand, and if service sector demand can remain robust amid potential interest rate hikes [3] - The current inflation rebound necessitates careful observation beyond seasonal factors to assess the true inflation landscape in India [3]

Inflation Data - The US April CPI increased by 0.2% month-on-month, lower than the expected 0.3%, and year-on-year it rose by 2.3%, slightly below the expected 2.4%[4] - Core CPI also rose by 0.2% month-on-month, matching expectations, and year-on-year it remained stable at 2.8%[4] Inflation Trends - Energy prices were the main driver behind the inflation decline, with a 0.7% month-on-month increase, primarily from natural gas and electricity, offsetting gasoline price drops[5] - Housing prices contributed over half of the April inflation, rising by 0.3% month-on-month[5] Seasonal Patterns - The period from March to July is traditionally a low inflation season, with April's month-on-month increase in goods prices at 0.1%, higher than March[6] - The impact of tariffs on inflation is expected to be moderate due to a 90-day pause in the US-China tariff war, allowing for a recovery in shipping[6] Market Outlook - The outlook for US equities is cautiously optimistic in the short term, with a neutral long-term perspective, as the delay in tariff policies allows companies to stock up[7] - The probability of a recession in the US has decreased, although inflation levels may see a slight increase due to foundational tariffs[7]

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 [9] - Adjusted earnings per share rose to $1.42, up 17.4% from $1.21 in Q1 2024 [9] - Adjusted EBITDA increased to $40.6 million, a 25.1% rise from $32.4 million in Q1 2024 [9] - Gross margin percentage improved to 31.9% from 31.4% in Q1 2024 [24] - Adjusted EBITDA margin was 12%, compared to 11.6% in Q1 2024 [25] Business Line Data and Key Metrics Changes - Personal Care segment revenues were $258.3 million, accounting for 76.5% of total revenue, with a 7.4% organic revenue growth [23] - Hospice same store revenue increased by 9.9%, with average daily census rising to 3,515, a 4.6% increase year-over-year [14][21] - Home Health segment revenues were $18 million, representing 5.3% of total revenue, with a 1.3% organic revenue growth [22] Market Data and Key Metrics Changes - Personal Care services received favorable reimbursement support, including a 5.5% rate increase in Illinois effective January 1, 2025 [12] - Same store hours in Personal Care increased by 2% compared to Q1 2024, marking the largest year-over-year volume growth in recent quarters [13] - The company experienced solid caregiver hiring success, with 79 hires per day in Personal Care, up from 78 in 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 [17] - The Gentiva acquisition added approximately $280 million in annualized revenues, significantly expanding market coverage [22] - The company is actively pursuing additional acquisition opportunities to enhance density in existing markets and add clinical services [23][28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the continued demand for home-based care, viewing it as a growth opportunity [18] - The company anticipates stable gross margins and consistent cash flow conversion in line with historical averages [25][27] - Management noted that the clinical hiring environment remains challenging, but improvements have been observed in the personal care segment [11][67] Other Important Information - The company utilized approximately $2.5 million in ARPA funding during Q1 2025, with $8.8 million remaining [28] - As of March 31, 2025, the company had cash on hand of approximately $97 million and reduced bank debt by $20 million [9][28] Q&A Session Summary Question: Commentary on hospice cap limitations - Management indicated that cap limitations have not been material, with effective management of referral mix [33][34] Question: Impact of weather on personal care services - Management confirmed weather events affected January but noted a rebound in February and March, expecting hours growth to remain in the 2% to 2.5% range [40][41] Question: Hospice revenue growth expectations - Management projected hospice revenue growth in the 5% to 7% range, leaning towards the upper end [44] Question: Margin expansion expectations - Management expects typical margin expansion of 40 to 50 basis points into Q2, with Q1 usually being the low point [50][51] Question: Impact of Medicaid changes - Management stated that potential changes to Medicaid would likely have no direct impact on the company, as its patient base is primarily elderly and disabled [54][56] Question: Performance of Gentiva post-acquisition - Management reported that Gentiva's bottom line performance has exceeded expectations, while top line growth was slightly lighter than anticipated [77] Question: Update on home health services - Management noted stability in Medicare rates and improvements in contracting with Medicare Advantage plans, with discounts narrowing from 40% to 15-20% [106]