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
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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|
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|
|HH Index Total||4479||3234|
Enterprise Value (EV), aka Selling Price, as Percent of Revenue
|HH Index Average*||152%||115%|
Multiples of EV/EBITDA
Think of this as selling price as a multiple of EBITDA.
|HH Index Average*||21.45||15.44|
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
|State||Agency Profile||Status||Reference Number
|California||$11 million multi-location addiction treatment center. Located in Southern California. 21% bottom line. Strong growth trends. JCAHO-accredited.||Available|
|California||Medicare-certified home health agency established in 2003. $2 million annual revenue in 2018. PDGM revenue-neutral. Located in Southern California. Clean business with no ADRs.||Available|
|Florida||Medicare-certified home health agency. Approximately $3.8 million in revenue with 17% bottom line. Located in Districts 9 and 10. Revenues split evenly between districts. Accredited. 4.5-star quality of patient care rating.||Available|
|Georgia||ID/DD service provider with $1 million in revenue. Residential and day services offered, located in Atlanta suburb.||Available|
|Illinois||$5.5 million accredited Medicare agency located in northeastern Illinois. Strong bottom line. 4.5-star rating by CMS.||Available|
|Louisiana||Boutique full-service clinical laboratory specializing in preventative diagnostic testing. Medicare- and Medicaid- certified, with insurance contracts in more than 20 southeastern states.||Available|
|Massachusetts||Medicare- and Medicaid-certified home health agency. |
$13+ million in annual revenue with continued growth. Diverse payor mix. Strong management in place. Accredited.
|Michigan||Medicare home health and hospice agency. $10 million in annual revenue with numerous referral relationships.||Available|
|Michigan||$2 million ID/DD agency in the Detroit area. Profitable service provider with existing management team in place.||Available|
|Mid-Atlantic||$10+ million non-skilled home care agency. Primarily Medicaid reimbursed with 20% EBITDA margins. Strong management team in place.||Available|
|Nevada||Medicare-certified home health agency in Las Vegas area. Approximately $1 million in annual revenue. Accredited.||Available|
|New Mexico||$2.5 million New Mexico home health agency. 87% Medicare. Long history in the community and existing staff in place.||Available|
|North Carolina||$1 million ID/DD agency with real estate. Long-term client base, additional growth potential and strong margins.||Available|
|Oklahoma||Medicare-certified home health agency with $9.6 million in annual revenue. 98% traditional Medicare and other PPS payors. Medicare- and Medicaid-certified with multiple locations.||Available|
|Oklahoma||$5+ million home health, home care, case management, and hospice company. Approximately 15% revenue from hospice, other service line revenues distributed relatively evenly. Multiple locations. Diverse payor sources. Hospice accreditation. Projected PDGM impact of 30%+ for home health.||Available|
|South||Treatment center with 28 beds, intensive outpatient program capacity of 40, full continuum of substance use disorder services and dual diagnosis treatment capability. JCAHO accreditation pending. $4+ million in revenue, highly competitive in-network contracts. Average census of 30. Existing relationships with county, parole, local hospitals, churches and universities. Solid business in desirable location with little area competition.||Available|
|South||Full continuum, JCAHO-accredited substance use disorder treatment center on 100+ acre horse ranch. Dual diagnosis treatment capability with 16 beds and 22 staff. $1.5 million EBITDA on $3.5 million in revenue. In-network with great contracts/rates and strong census.||Available|
|South||Partial hospitalization treatment program/intensive outpatient program seeking strategic partner. Strong census and revenue growth. No direct competition for niche market.||Available|
|Southwest||$5+ million 37-bed outpatient treatment center. Fully accredited and recently revamped to increase growth and margin. Great census, UR, acquisition and solid numbers. Out of network but transitioning to some in-network.||Available|
|Southwest||64 bed full continuum 64-bed full continuum treatment center in two southwestern US metropolitan cities. JCAHO-accredited and in-network. $4 million pro forma EBITDA run rate based on 30% occupancy with significant growth expected. Strong infrastructure to support growth trajectory.||Available|
|South-Atlantic||Home health agency and adult day care center with $12+ million in annual revenue. Home health represents 85% of revenue while adult day represents 15% of revenue. Home health is primarily a Medicaid business but is Medicare-certified. Accredited.||Available|
|South Texas||Hospice with $3.5 million in annual revenue. Accredited. No cap or regulatory issues.||Available|
|South Tennessee||Very rare opportunity in a CON state. Located in Davidson County in Nashville, TN. Projected 2019 revenue in excess of $800,000.||Available|
|Texas||$5.3 million Medicaid agency in San Antonio, TX. 16.5% EBITDA. CHAP-accredited. Staff can remain in place for a smooth transition.||Available|
|Texas||Home health and hospice covering 10 counties in west Texas/eastern New Mexico with $5 million in revenue. No clinical issues, under CAP. Very profitable. Easily separated.||Available|
|Texas||$3.5 million all-Medicaid home care company located in Houston, TX. 20%+ year-over-year revenue growth since 2016.||Available|
|Texas||Home health agency located in Arlington, TX with $2.3 million in revenue. Growing and profitable company. Managed staff in place. No compliance issues.||Available|
|Texas||$1.7 million Medicare home health agency located in Southwest Houston. Well-established with predictable referral sources and revenues.||Available|
|Texas||$1 million Medicare-certified agency licensed in seven counties in the Houston area. 80% traditional Medicare.||Available|
|USA||New software application helping build social connections among patients in recovery and giving them increased access to therapists. Potential investment opportunity. Facilitates total successful recovery and gathers important helpful data.||Available|
|Virginia||$6 million Medicare-certified agency in Northern Virginia.||Available|
|Virginia||Physical therapy and wellness operation with $2.3 million in revenue. 95% cash payors. Potential to franchise nationwide. 2018 EBITDA was $257,000.||Available|
|West||Premier provider of primary mental health services for adolescents aged 13-18 with two locations. Currently growing in-network contracts.||Available|
|Colorado||Opportunity to establish Medicare home health agency. Denver market. ACHC accreditation until 2022.||Under Contract||
|Florida||$9.5 million home health agency with strong management, clinical and financial operations. 99% of revenue comes from traditional Medicare.||Under Contract||
|Florida||South Florida staffing agency. $2 million + revenue. Approximately 30% gross margin. Licensed to service entire state of Florida. Systems and staff in place.||Under Contract||
|Kentucky||Medication-assisted treatment center. Suboxone only. Strategic location between Louisville and Lexington, Kentucky. Great reputation with strong clinical team in place. 110 clients with room to grow. In-network contracts. Clients pay $150 per visit for counseling twice per month. Owners are near retirement and will help with the transition.||Under Contract||
|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.||Under Contract||
|Mid-west||$5 million Midwest-based ABA provider. Day supports and counseling. Highly profitable and respected. CARF accredited. Contracted with state and insurance companies.||Under Contract||
|Multi-State||Well-established pediatric provider. Revenue more than $40 million. Medicaid and insurance accepted.||Under Contract||
|New Mexico||Home health and hospice with $15 million in annual revenue. Revenue split is 2/3 home health and 1/3 hospice. Medicare- and Medicaid-certified. Accredited.||Under Contract||
|New York||Licensed home care services agency with services in five boroughs. Approximately $20 million in revenue and a long-standing history in the community.||Under Contract||
|North Carolina||$5 million Medicaid agency. $5 million Medicaid agency. CAP/PCS services. Long history of providing quality services.||Under Contract||
|Pacific Northwest||Full continuum substance use disorder, mental health and gambling addiction treatment center in Washington state with $3,625,000 in revenue and $1,100,000 EBITDA. 40 bed facility with 40 employees. Strong census, full outpatient program and Medicaid payors.||Under Contract||
|Southwest||Provider of waiver and intermediate care facility ID/DD services with $25 million in annual revenue. Statewide platform with a strong management team and excellent reputation for quality services.||Under Contract||
|Texas||Three Hospice companies with Three hospice companies with affiliated home health and $6 million in total revenue. Locations in south, southcentral, and southeast Texas.||Under Contract||
|Texas||$4.2 million home health agency. 17.5% bottom line. Located in Houston, TX. Large coverage area. Diverse referral network. Fully staffed with no clinical issues.||Under Contract||
|Texas||$3.5 million Medicare certified $3.5 million Medicare certified home health agency located in San Antonio, TX. Fully staffed and CHAP-accredited. Branch office is included in sale.||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.
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