November Leads to Mixed Results for Home Health, Post-Acute Care Stocks

Last month saw a reversal of fortune for the post-acute care providers tracked by the Stoneridge Partners Home Health (HHI) and Post-Acute Care (PAI) Indices.

The HHI – which has mostly made steady progress over the past several months – took a hit in November, falling by more than 7% compared to October’s results. In contrast, the PAI jumped up by almost 5% in November after months of struggles related to the COVID-19 pandemic. The S&P 500 similarly saw healthy gains last month, up almost 12% over October.

“November was a bit of a mixed bag for providers in the post-acute care space,” said Stoneridge Partners President Rich Tinsley. “The companies in the HHI have largely withstood much of 2020’s economic chaos, while the PAI companies have really struggled. But last month, the PAI made some significant progress after a punishing year. Let’s hope that means more good things to come for all of them in 2021.”

Home Health Index

The Stoneridge Partners HHI follows the stock value of Amedisys, Inc. (Nasdaq: AMED) and LHC Group, Inc. (Nasdaq: LHCG), two of the largest home health, hospice and personal care service providers in the U.S.

After months of almost consistent gains, stock values for Baton Rouge, Louisiana-based Amedisys dropped by nearly 6% last month. Lafayette, Louisiana-based LHC Group saw an even sharper decline over the same period, dropping more than 10% on a month-over-month basis.

LHC Group announced an expansion of its hospice business in November through the purchase of Grace Hospice in Oklahoma. The company also announced the acquisition of East Valley Hospice and East Valley Palliative Care in Arizona.

“LHC Group has been clear about its mission to expand into hospice, ideally tri-locating all of its services in key markets,” Tinsley said. “This is a continuation of that strategy.”

Even with November’s losses, year-to-date the HHI is still up by more than 45% over last year.

Post-Acute Care Index

The PAI combines Amedisys’ and LHC Group’s stock values with values for Addus HomeCare Corporation (Nasdaq: ADUS), The Pennant Group, Inc. (Nasdaq: PNTG), Encompass Health Corp. (NYSE: EHC) and Brookdale Senior Living Inc. (NYSE: BKD).

November marked an impressive turnaround for the additional providers making up the PAI, all of which have faced an uphill climb in 2020 due to the challenges posed by COVID-19 for companies operating in the congregate senior living space. Addus, Pennant, Brookdale and Encompass Health all recorded gains last month.

Values for Brentwood, Tennessee-based Brookdale were up nearly 31% in November compared to October, while Birmingham, Alabama-based Encompass Health was also up by a large margin during that time — almost 24%. Encompass’ growth has been fueled by collaboration between its home health, hospice and in-patient rehabilitation service lines; still, the company recently announced it was exploring strategic alternatives for its home health and hospice segment, likely in an effort to develop untapped value for its shareholders.

Meanwhile, Pennant stock was up by almost 18% in November, and Addus recorded nearly a 2% gain.

“I’m glad to see these companies seem to have turned a corner,” Tinsley said. “As the COVID-19 vaccine rolls out, I think we’ll continue to see positive gains for these providers whose work has been in the spotlight all year.”

Quote of the Month

“This study is important because it demonstrates that investing in disease-specific training among home care workers – for example, in cardiovascular disease – may be a way to improve their experience caring for patients. These findings support the need for additional training requirements for those home care workers caring for patients with complex clinical conditions, like heart failure.”- Dr. Madeline Sterling, a health services researcher in the Division of General Internal Medicine at Weill Cornell Medicine

Read the Full Article Here: Disease-Specific Training for Home-Based Care Workers Can Improve Staffing, Boost Quality

Articles Featuring Stoneridge

View our quarterly M&A webinars on current valuation trends, deal flow, and pertinent regulatory changes in home health, home care, hospice, ID/DD, and behavioral health industries. Visit the Speaker Series Webinar Library on our website.

See It To Believe It!

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

  • 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 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 since 2002.

This graph compares the HH Index to the price of Addus stock (non-Medicare).

(Home Health Index December 2020 | Stoneridge Partners)

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

Company 11/30/20 1 mos change YTD change 11/30/19 11/30/18
Amedisys 244.79 -5.49% +47.29% 162.96 137.93
LHC Group 196.32 -9.34% +42.51% 133.40 105.43
HH Index* 220.56 -7.24% +45.12% 148.18 121.68
S&P 3660.25 +11.94% +13.29% 3140.98 2739.67
Addus 99.25 +1.72% +2.09% 93.21 75.45

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) 11/30/20 11/30/19 11/30/18
Amedisys 8190 5560 4060
LHC Group 6140 4200 3400
HH Index Total 14330 9760 7460
Addus 1450 1280 834


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

Company 11/30/20 11/30/19 11/30/18
Amedisys 405% 294% 250%
LHC Group 298% 224% 214%
HH Index Average* 352% 259% 232%
Addus 191% 213% 171%


Multiples of EV/EBITDA

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

Company 11/30/20 11/30/19 11/30/18
Amedisys 31.03 29.55 24.71
LHC Group 28.28 21.49 25.47
HH Index Average* 29.66 25.52 25.09
Addus 24.09 30.30 22.27

The Stoneridge Partners Post-Acute Care Index is updated monthly and measures the performance of these two publicly traded home health companies, all listed on the NASDAQ:

  • LHC Group (LHCG)
  • Amedisys (AMED)
  • Addus (ADUS)
  • The Pennant Group, Inc. (PNTG)
  • Encompass Health (EHC)
  • Brookdale Senior Living Inc. (BKD)

This graph displays Post-Acute Care Index performance starting late 2019.

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 for its reporting. (Home Health Index December 2020 | Stoneridge Partners)

Recent Transactions From Around The Country

  • Hospice provider The Care Team has acquired InTeliCare Home Health & Hospice in Michigan
  • Texas-based Silverstone Hospice has acquired Comfort Care Hospice in the Dallas-Fort Worth region

Exclusively Listed For Sale By Stoneridge Partners


Do you know of any acquisitions that have taken place? We are interested in your comments. Contact us; Stoneridge Partners

Central Ohio based home health company with private pay.  $2.3 million in revenue.  13.5% EBITDA.  Strong growth trends, full staff in place.

 Home Health /  Ohio

Large home care franchisee.  $6.5 million in revenue.  Private duty.  Attractive market with great growth potential.

 Home Care /  Florida

Non-medical home care franchisor.  Platform opportunity with national footprint.  Systemwide revenues more than $12 million.  Franchise locations in 16 states.

 Home Care /  Texas

$2+ million private pay.  Profitable with great reputation.

 Home Health /  Pennsylvania

Profitable hospice agency with $600,000 in revenue.  Ready to grow with full complement of staff in place.

 Hospice /  Pennsylvania

Medicare/Medicaid agency with $3.5 million in revenue.  Established 20+ years.  Great reputation in eastern Michigan.

 Michigan

$1.5 million home health agency.  Approximately 70% traditional Medicare.  Single location.  Reputation for clinical excellence.  Experienced administrative team.

 Home Health /  Ohio

CHAP-accredited private duty business.  $2.8 million projected 2021 revenue.  Workers' compensation primary source of revenue.  Regions 9, 10 and 11.

 Home Health /  Florida

$4 million I/DD provider.  Great reputation and long history of profitability.

 ID/DD /  Kentucky

$25+ million home health agency.  Medicaid/Medicare-certified.  95%+ Medicaid.  Multiple locations.  Experienced management team.

 Home Health /  Massachusetts

Very rare opportunity in a CON state.  Located in Davidson County in Nashville, TN.  2020 revenue in excess of $650,000.

 Home Health /  Tennessee

Non-skilled home care company.  $10+ million in annual revenue.  Predominantly Medicaid.  Highly profitable.  Accredited.  Strong management team in place.

 Home Care /  Northeast

$1 million Medicare home health agency in northwest Minnesota.  Well-established.  Diverse referral sources.  Long history of excellent care.

 Home Health /  Minnesota

Non-skilled licensed home care organization.  Approximately $2 million in annual revenue.  Strong management team in place.  Southern California.

 Home Care /  California

$10 million Medicaid personal care provider.  Large consumer-direct component.  History of steady growth.

 Home Care /  Minnesota

$50 million ID/DD platform opportunity.  Multi-state, Midwest.  Tenured management team to stay in place.  Double digit year over year organic growth.  Significant future opportunities for...

 ID/DD /  Midwest

Clean and accredited hospice provider number in the coveted San Antonio marketplace.  Current license is valid until the end of May 2022.

 Hospice /  Texas

$8 million Midwest ID/DD agency.  Highly profitable.  Consistent staff and clients.

 ID/DD /  Midwest

$4.9 million Medicare home health agency located in Phoenix, Arizona.  Showing strong year over year revenue growth since 2018.  Diverse referral sources, well run with...

 Home Health /  Arizona

$5 million Midwest-based ABA provider. Day supports and counseling. Highly profitable and respected. CARF accredited. Contracted with state and insurance companies.

 Behavioral Health /  Midwest

$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.

 Home Health /  Michigan

Hospice with $3.5 million in annual revenue. Accredited. No cap or regulatory issues.

 Hospice /  Texas

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%...

 Home Health /  South Atlantic

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...

 Behavioral Health /  Texas

$1 million ID/DD agency with real estate. Long-term client base, additional growth potential and strong margins.

 ID/DD /  North Carolina

$2.5 million New Mexico home health agency. 87% Medicare. Long history in the community and existing staff in place.

 Home Health /  New Mexico

$2 million ID/DD agency in the Detroit area. Profitable service provider with existing management team in place.

 Michigan

Medicare and Medicaid certified home health agency.  $16.5 million in annual revenue with continued growth. 90%+ Medicaid.   Strong management in place. Accredited.

 Home Health /  Massachusetts

ID/DD service provider with $1 million in revenue. Residential and day services offered, located in Atlanta suburb.

 ID/DD /  Georgia

Home Health Index December 2020 | Stoneridge Partners

From Rich Tinsley, Publisher of “Home Health Index.” Rich can be reached at rich@stoneridgepartners.com or (239) 561-0826, and toll-free at 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: Amedisys | LHC Group