Home Health Index | 2017 JULY UPDATE

Home Health Index Continues Hot Streak in June

Stoneridge Partners | Home Health Index July 2017: Home health companies continued to see strong returns during June, according to the latest findings of the Home Health Index by Stoneridge Partners.

The index, which tracks the average market values of three of the largest publicly traded home health care companies – Almost Family (Nasdaq: AFAM), Amedisys (Nasdaq: AMED) and LHC Group (Nasdaq: LHCG) – jumped 8.35% compared to the previous month.

The index, on a hot streak, also vastly outpaced the S&P 500, which increased just 0.48%. The June rise was just behind the biggest monthly increase for the index year to date seen in May, when the index rose 9.1%.

“Home health companies, which have been rewarded for their deal making throughout the year, continued to see the ongoing streak of share price gains,” said Rich Tinsley, president and CEO of Stoneridge Partners.

Almost Family, based in Louisville, Kentucky, had strong gains in June, with the company’s stock price rising 7.4%. Year to date, Almost Family’s stock is up 39.8%. The company has been actively pursuing joint venture deals throughout the first half of the year, after completing the nation’s largest public home health-hospital joint venture with Community Health Systems (NYSE: CYH) late in 2016.

Baton Rouge, Louisiana-based Amedisys Inc. also saw its stock price rise in June, albeit at a slower pace. From the previous month, Amedisys’ share price rose 4.82%. Since the start of the year, the stock is up 47.34%. Amedisys agreed to pay $43.8 million to investors during the month in a settlement of a lawsuit that dates back to 2010.

LHC Group, based in Lafayette, Louisiana, saw the highest share price growth in June, soaring 12.77% from the previous month. The stock has also risen the most compared to its peers since the start of the year, jumping 48.56%. The company’s stock has been buoyed by its strong position in joint venture deals, and CEO Keith Myers stated in a June presentation that he predicts LHC Group could double in size with its potential growth opportunities.

Addus HomeCare (Nasdaq: ADUS), which is not tracked on the index because too little of its revenue comes from Medicare, saw marginal gains in June. Its stock price inched up 0.27% last month.

Quote Of The Month 

“I don’t think anybody would say, if you started from scratch and had no system in place, that you would construct the system we have.”

-Steny Hoyer, House Democratic Whip

Read the Full Article Here: Why is Health Care So Complicated?

See It To Believe It!

The Stoneridge Partners Home Health Index (HH Index) is updated monthly and measures the performance of these three publicly traded home health companies, all listed on the NASDAQ:

  • Almost Family (AFAM)
  • LHC Group (LHCG)
  • Amedisys (AMED)

This graph compares the percentage of the Home Health Index to the percentage change in the S&P 500 Index for over 14 years, going back to 2002.

This is a 12 month trailing chart of the HH Index compared to the actual prices of the individual companies that make up the chart.

This graph displays HH Index performance over the past 24 months.

This graph compares the HH Index to the price of Addus stock (non-Medicare).
(Home Health Index July 2017 | Stoneridge Partners)

Here are the results of the stock prices for the past two years:

Company 6/30/17 1 mos change YTD change 6/30/16 6/30/15
Almost Family 61.65 +7.40% +39.80% 42.61 39.91
Amedisys 62.81 +4.82% +47.34% 50.48 39.73
LHC Group 67.89 +12.77% +48.56% 43.28 38.25
HH Index* 64.12 +8.35% +45.25% 45.46 39.30
S&P 500 2423.41 +0.48% +8.24% 2098.86 2063.11
Addus 37.20 +0.27% +6.13% 17.43 27.86

Although we track the performance of Addus, they are not included in our HH Index because very little of their revenue comes from Medicare.


Enterprise Value (EV)

EV (in M) 6/30/17 6/30/16
Almost Family 1009 569
Amedisys 2157 1790
LHC Group 1313 875
HH Index Total 4479 3234
Addus 436 216

Enterprise Value (EV), aka Selling Price, as Percent of Revenue

Company 6/30/17 6/30/16
Almost Family 167% 102%
Amedisys 149% 136%
LHC Group 141% 106%
HH Index Average* 152% 115%
Addus 101% 62%

Multiples of EV/EBITDA

Think of this as selling price as a multiple of EBITDA.

Company 6/30/17 6/30/16
Almost Family 21.86 13.30
Amedisys 26.70 22.36
LHC Group 15.80 10.65
HH Index Average* 21.45 15.44
Addus 15.01 9.02

The above calculations are based on selling price being defined as Enterprise Value (EV), with data provided by Capital IQ. Enterprise value is defined as market cap plus debt, minority interest and preferred shares, minus total cash and cash equivalents. EBITDA is calculated using methodology which may differ from that used by a company it’s reporting. (Home Health Index July 2017 | Stoneridge Partners)

Sold by Stoneridge!

  • Superior Home Health Care, Inc. in Baton Rouge, Louisiana was acquired by Hometown Healthcare Management. Ben Bogan and Charles Jantzi provided sell-side advisory services.
  • Home Care Assistance closed on Living Well Assisted Living at Home in Sausalito, California. Rhonda Gronberg provided buy-side advisory services.

Recent Transactions From Around The Country

  • Traditions Hospice of South Houston, a home health and hospice provider in Texas, acquired the Houston-based hospice provider, Hallmark Hospice.
  • The Ensign Group, Inc. closed on several transactions this month. From Brookdale Senior Living, they acquired the real estate and operations of two assisted living facilities in Texas and three assisted living facilities in Wisconsin. In Colorado, the Ensign Group acquired the real estate and operations of two continuing care retirement communities, the Villas at Sunny Acres as well as Medallion Post Acute Rehabilitation and Medallion Villas.
  • Kindred Healthcare struck a deal to sell its skilled nursing business for $700 million in cash to BM Eagle Holdings, a joint venture led by affiliates of BlueMountain Capital Management.

Exclusively Listed For Sale By Stoneridge Partners

Agency Profile
Reference Number
Arizona$2+ million home care agency in Southern Arizona. Diverse payor sources (Medicaid/Private Pay/ W/C. Diverse referral sources. Great reputation. Available
California$4.8 million neuroscience-driving recovery treatment center for traumatic brain injury and SUD. Has helped over 180 professional athletes from the NFL, NHL, NBA and MLB. $1.2 million AEBITDA. Great campus offering full continuum of care. Zero competition in this space.
CaliforniaMedicare certified Home Health agency that was established in 2003. $2 million annual revenue in 2018. PDGM revenue neutral. Located in Southern California. Clean business with no ADR's. Available
CaliforniaGrowing $1.9 million revenue. Private pay. Independently owned. Full staff in place. Available
California$1.6 million Hospice located in Los Angeles County. Consistent census of 25 patients over the last 3 years. Joint commission accredited. Strong bottom line with staff in place. Available
California32 bed detox and residential treatment center. Great location and setup. In network. Large growth with a waiting list. Seeking loan/debt investment. Attractive income option for investor. Available
Connecticut$6 million Medicaid/Medicare agency. Nice growth trend. Stable margins, great surveys.Available
Florida$9.5 million Home Health Agency. Very strong operationally, clinically, and financially. 99% of revenue comes from traditional Medicare. Available
Florida$1.6 million revenue. Pediatric Medicaid agency. Available
FloridaMedicare certified home health agency. $1.4 million annual revenue. 4.5-star & Home Care Elite 2 years running. Accredited. District 3. Motivated Seller. Under Contract
GeorgiaID/DD Services. $1 million revenue. Residential and Day Services. Atlanta Suburb. Available
Illinois$5.5 million accredited Medicare agency located in northeastern Illinois. Strong bottom line. 4 1/2 star rating by CMS.Available

Illinois$2.8 million Home Health agency. 100% Medicare. Loyal caregiver and patient base. Available
IllinoisHospice. Census in mid-70's. Accredited. Chicago area.Available
LouisianaBoutique full service clinical laboratory specializing in preventative diagnostic testing.
Medicare & Medicaid certified, and insurance contracts in over 20 Southeast States. Several unique programs and innovative technologies.
Maryland/DC/VirginiaLarge Medicare & Medicaid home care agency. Poised for continued growth.Available
MassachusettsMedicare and Medicaid certified Home Health agency.
$13+ million in annual revenue and growing. Diverse payor mix. Strong Management in place. Accredited.
Michigan$1.5 million private duty home health agency in eastern Michigan. Profitable and well positioned for additional growth. Self-sufficient staff in place. 82 long-term clients. Available
Minnesota$9 million Medicaid agency. Consistent growth & profitability. Recent rate increase. Attractive Medicaid margin. Available
New YorkAnnualizing at $1.3 million revenue. 40% Non-Medicare/Private Insurance skilled nursing. 45% Managed LTC. Southern New York. Joint Commission Accreditation.Available
New Mexico$2.5 million New Mexico home health agency. 87% Medicare. Long history in the community. Staff in place.Available
North Carolina$1 million ID/DD Agency. Long-term client base. Growth potential with real estate. Strong margins. Available
OhioSoutheastern Ohio. $3.5 million annual revenue. Diverse referral source mix.Available
Oklahoma$1.7 million ID/DD agency. Long history in the community. Profitable/recent rate increase. Available
Pacific NorthwestFull continuum in Washington State. $3,625,000. revenue with $1,100,000 EBITDA. States has moved from BHO to MCO for Medicaid. Co-occurring, Medicaid paid, 40 bed facility, 40 employees, census is very strong.
Outpatient is full. Opportunity for marketing. SUD mental health gambling. Equine therapy and other perks.
South28 bed, IOP capacity of 40, full continuum SUD treatment center, dual diagnosis, pending JCAHO. $4+ million revenue, highly competitive in network contracts, average census of 30. Existing marketing relationships with county, parole, local hospitals, churches and universities. Solid business in desirable location, little competition, good opportunity. Available
SouthNational growth opportunity. No direct competition for niche market. Unique program and strong branding. PHP/IOP with census and revenue growth. Seeking strategic partnerAvailable
Southwest$25 million in annual revenue. Provider of Waiver and ICF ID/DD Services. Statewide Platform. Strong management team. Excellent reputation for quality services. Available
Southwest$5+ million outpatient treatment center. Fully accredited. 37 beds. Recently revamped to increase growth and margin. Great census, UR, acquisition and solid numbers. Out of network and transitioning some in network.Available
Southwest64 bed full continuum treatment center in 2 Southwest US metropolitan cities.
JCAHO accredited.
$4 million pro forma EBITDA run rate. 3rd location set to open May 2019. Run rate based on 30% occupancy with significant growth expected. Strong infrastructure to support growth trajectory.
South-Atlantic$12+ million in annual revenue. Home Health Agency (HHA) and Adult Day Care Center (ADC). HHA (represents 85% of revenue). ADC (represents 15% of revenue). HHA is primarily Medicaid business but is Medicare-certified. Accredited. Available
South TexasHospice. $3.5 million in annual revenue. Accredited. Clean: No cap or regulatory issues. Available
Texas$2.6 million revenue Home Health agency in East Texas. Great local reputation, with strong financials. 2018 adjusted EBITDA $606,000. Has second license with minimal census available.Available
Texas$2 million Medicare home health agency in Austin, TX. Offers outstanding reputation and strong management & clinical teams. CHAP accredited & consistently Top 100 or Top 500 Home Care Elite for past 8 years. Available
Texas$1.7 million Medicare home health agency. Located in Southwest Houston. Well-established with predictable referral sources. Very profitable. Available
Texas48 bed full continuum treatment campus, all in-network. Established management team, 3-year CARF Accredited. $1.7 million of AEBITDA on $6 million of revenue. Major metropolitan market. Great asset for a strategic buyer.
Texas$1.4 million revenue pediatric therapy business. Company provides Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST) to disadvantaged and disabled children in near a major metropolitan city in Texas and the surrounding counties. Positive reputation for providing quality help in an environment comfortable to the child. Founded in January 2008 as an investment for the owner. Average census is 190 patients with a goal of 225 for calendar year 2019.
Texas$1 million revenue. Very clean and well established home health agency in the heart of West Texas. Fully staffed and ready for a new owner to step right in.Available
Texas$1 million Medicare certified agency. Licensed in 7 counties in the Houston area. 80% is traditional Medicare. Available
Texas$650,000 revenue. Medicare certified. Licensed in 6 counties North of Dallas, TX.Available
TexasPediatric therapy company in Houston, TX. Census of 165. 75% Medicaid reimbursed. Systems and staff in place. Available
TexasHome Health agency in Texas. Near Sam Houston National Forest. Clean license with minimal census and minimal revenue. Available
TexasClean hospice provider number. Located in West Texas.Available
USANew software application. Potential investment opportunity. Great test results.
Helps connect those in recovery socially. Helps connect therapists to patients. Facilitates total successful recovery and gathers important helpful data.
Virginia$2.3 million revenue Physical Therapy and Wellness operation. 95% cash pay. Potential to franchise Nationwide. 2018 EBITDA $257,000. Available
Florida$3.5 million private duty home health agency on Florida's east coast. CHAP accredited. 26 years of outstanding service. Diversified pay mix; Private duty, Workers comp, Private pay, and Long-term care insurance. Strong management and support staff. Under Contract
FloridaMedicare/Medicaid certified home health agency. $2.5 million annual revenue. 5-star. Accredited. District 10.Under Contract
Florida$1.5 million non-skilled private duty home health business. Strong management team in place. District 1.Under Contract
KentuckyMedication-assisted clinic. IOP counseling for substance abuse and co-occurring disorders. Profitable with strong team in place. 150 clients. 95% Medicaid. Under Contract
New York$13 million revenue LHCSA. 30-year history. Licensed in all 5 boroughs.Under Contract
OklahomaHome Care Agency. Approximately $1.5 million in annual revenue. Predominantly private pay with some LTC, VA, and WC. Outstanding clinical. Great reputation. Under Contract
Pennsylvania$4.3 million revenue. Home health, home care and hospice agency. 18% bottom line. Under Contract
Texas$3.6 million Hospice, home health and palliative care agency. 90% Traditional Medicare. Service area in 13 counties around Harris County. CHAP accredited. Staff in place. Under Contract
Texas$3.5 million all Medicaid Home Care company located in Houston, TX. 20%+ year over year revenue growth since 2016. Nice bottom line.Under Contract
Texas$3+ million hospice agency based in Dallas/Fort Worth. Well established. Clinically clean and growing. Full staff in place. Under Contract
Texas$2.2 million Dallas-area Medicare home health agency. 22% bottom line. Well-established with a very clean compliance record. Full management team in place. Under Contract
Virginia$6 million Medicare certified agency in Northern Virginia. Under Contract

Do you know of any acquisitions that have taken place?  We are interested in your comments.  At the top of this column is a “Contact Tab” with a section for comments.  These can be sent anonymously and the return email address can be left blank.


Another Cartoon Favorite from the New Yorker

HHI Lars


Stoneridge Partners | Home Health Index July 2017

Webinar: The Current Home Care Market – An M&A Perspective

Presented by: Rich Tinsley, President & CEO of Stoneridge Partners

July 14th at 12:00 p.m. (EDT)

Cost: $39


For more information and to register visit:

The Current Home Care Market: An M&A Perspective


Stoneridge Partners | Home Health Index July 2017

From Rich Tinsley, Publisher of “Home Health Index”. Rich can be reached at rich@stoneridgepartners.com or (239) 561-0826 and toll-free 800-218-3944

Previous editions of this monthly newsletter can be searched for at the bottom of the home page of the Home Health Index. Links to Google Finance: Almost Family | Amedisys | LHC Group

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