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]

Financial Data and Key Metrics Changes - In Q1 2025, consolidated net revenue was $259.9 million, reflecting a sequential increase of $1.7 million or 0.7% quarter over quarter, but a decrease of $2.5 million or 1% year over year [15] - Consolidated adjusted EBITDA was $26.6 million, an increase of $1.5 million or 6% sequentially, and up $1.3 million or 5.1% year over year, with an overall EBITDA margin of 10.2%, an increase of 60 basis points from the prior year [16] - The leverage ratio improved to 4.4 times, below the covenant of 4.5 times, allowing for better pricing under existing agreements and additional flexibility for acquisitions [22][23] Business Line Data and Key Metrics Changes - Home Health revenue was $200.6 million, a slight increase of $200,000 or 0.1%, with a 3.7% increase in average daily census [16][18] - Hospice revenue reached $59.3 million, reflecting a sequential increase of $1.5 million or 2.6% and a year-over-year increase of $10.1 million or 20.5% [19] - Home Health adjusted EBITDA totaled $38.3 million, reflecting a sequential increase of $2.8 million or 7.9% [18] Market Data and Key Metrics Changes - Non-Medicare admissions increased by 7.4% year over year, driven by payer innovation contracts, with 44% of non-Medicare visits in payer innovation contracts in Q1 2025 [8][9] - Hospice segment admissions grew 8% year over year, with same-store growth of 5.2% [10] - Average daily census in hospice reached 38.09, an improvement of 2.1% sequentially and 12.3% year over year [20] Company Strategy and Development Direction - The company is focusing on payer contract initiatives to drive growth, with a goal to balance admissions and maintain a healthy payer mix [6][26] - A de novo strategy is being implemented, with one new hospice location opened and 13 projects underway [11] - The company is piloting two internally developed apps aimed at improving efficiency and communication [12] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the ability to build capacity and improve average daily census, with expectations of continued growth through the year [29][42] - The company is monitoring labor market conditions and anticipates a return to normal salary inflation rates of 2% to 3% [28] - Management reaffirmed 2025 guidance based on strong Q1 results and business momentum [23] Other Important Information - The company completed the transition to outsourced coding resources, expected to deliver $1.5 million in cost savings for the remainder of 2025 [12] - Free cash flow generated in Q1 was approximately $17 million, with a 63.5% conversion rate [21] Q&A Session Summary Question: Thoughts on volume growth within the non-Medicare book of business - Management noted that payer innovation contracts contributed significantly to positive growth, with a focus on hiring to improve average daily census and admissions [26] Question: Labor market inflation expectations - Management indicated a return to normal inflation rates of 2% to 3%, with some markets experiencing tighter conditions [28] Question: Hospice ADC growth initiatives - Management highlighted the combination of increased referrals and the establishment of regional admissions departments as key drivers of growth [31] Question: Dynamics behind business per episode trends - The use of the Metalogics Pulse tool has been critical in optimizing visits per episode, focusing on higher acuity patients [33] Question: Capacity and productivity in hospice - Management confirmed that they are monitoring capacity at the branch level and do not anticipate changes in growth trajectory [42] Question: Rate increases and inflation protection in payer contracts - Most contracts are 2-3 years in length, with some having escalators tied to quality metrics, and management is actively renegotiating contracts [46] Question: Research recertification rates - Management acknowledged challenges in research due to the growth of Medicare Advantage and emphasized the focus on growing census as a primary driver [49]

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]