National Senior Living Operator Bucks Trend; Leads Post-Acute Stocks During Downturn

Home Health Index | 2021 March Update

Home health and post-acute care stockholders are likely glad that February is the shortest month of the year.

Nearly all the companies in the Stoneridge Partners Home Health (HHI) and Post-Acute Care Indices (PAI) took a hit last month – only Brookdale Senior Living Inc. (NYSE: BKD) saw a month-over-month jump in its stock value, thanks to the major home health and hospice deal it announced with HCA Healthcare (NYSE: HCA) on February 24th.

“People have speculated that Brookdale might offload its home health and hospice business to maximize value, and that finally came to fruition in February,” said Stoneridge Partners President Rich Tinsley. “Meanwhile, the other major industry players gave back some of the impressive gains they’ve made over the past year, but I expect that to turn around as our economy begins to grow again and we see deal activity continuing to ramp up.”

The HHI fell by nearly 11% in February as compared to January; the PAI likewise plummeted by almost 21%. Meanwhile, the S&P 500 was up almost 3% for the month.

Home Health Index

The monthly HHI from Stoneridge monitors the stock values of Baton Rouge, Louisiana-based Amedisys, Inc. (Nasdaq: AMED) and Lafayette, Louisiana-based LHC Group, Inc. (Nasdaq: LHCG).

Amedisys stock fell by more than 12% in February as compared to January. LHC Group’s stock fell by almost 9% during the same period after announcing lower than expected projections for the first quarter of 2021. Nevertheless, stock values for both companies are up more than 40% compared to 12 months ago, continuing a trend that has seen both companies’ stock soar over the past five years.

“LHC Group and Amedisys are still riding plenty of tailwinds,” Tinsley said. “Each has talked about setting up innovative models of care to shift patients away from skilled nursing facilities (SNFs), which continues to be a national priority. Each has also made progress in securing stronger contracting positions with payers outside of fee-for-service Medicare. There may be bumps in the road, but overall, I think they’ll continue on their current upward trajectory.”

Post-Acute Care Index

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

Frisco, Texas-based Addus’ stock dropped almost 5% in February – but that’s likely to rebound in March, buoyed by investor interest in the company’s recently announced value-based care arrangement with Presbyterian Health Plan in New Mexico. Meanwhile, Birmingham, Alabama-based Encompass Health saw its stock dip just less than 1% last month, and stock values for Eagle, Idaho-based Pennant dropped by almost 5%.

As for Brookdale, the Brentwood, Tennessee-based company’s stock climbed by nearly 17% in February compared to January.

“Brookdale has been very active in vaccinating residents against the COVID-19 virus, which helps with restoring occupancy,” Tinsley said. “But the agreement with HCA Healthcare also has a lot to do with the surge. Home health and hospice multiples remain incredibly high, so this is a good time for Brookdale to cash in on its health care services segment.”

Brookdale announced toward the end of last month that it’s selling an 80% stake in its health care services business to HCA Healthcare for $400 million, pending all necessary regulatory approvals.

“As we pursued this business opportunity, it was extremely important to find the right strategic partner with the same dedication to care,” Brookdale CEO Lucinda Baier said during her company’s fourth-quarter earnings call. “Our new partnership is designed to deliver value for our shareholders, and it ensures continuity of quality care for our residents and patients while improving access to additional health care services.”

Quote of the Month

“As baby boomers age, we will need to be thinking about how we take care of a population of people that will have some disabilities as they age but are still going to find it attractive to be independent and continue to be as viable as long as they can.” – Grace Terrell, CEO of Eventus Whole Health, an operator of skilled nursing and assisted living facilities in five states across the Southern and Midwestern U.S.

Read the Full Article Here: Home is Where The Care Is

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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 2008.

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 March 2021 | Stoneridge Partners)

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

Company 2/28/21 1 mos change YTD change 2/28/20 2/28/19
Amedisys 253.64 -12.26% -13.53% 174.01 122.65
LHC Group 181.71 -8.74% -14.82% 121.46 106.39
HH Index* 217.68 -10.82% -14.07% 147.74 114.52
S&P 3841 +2.94% +2.26% 2954.22 2796.5
Addus 107.57 -4.53% -8.13% 76.27 66.35

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) 2/28/21 2/28/20 2/28/19
Amedisys 8550 6320 4010
LHC Group 5610 4400 3680
HH Index Total 14160 10720 7690
Addus 1630 1230 761


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

Company 2/28/21 2/28/20 2/28/19
Amedisys 413% 323% 247%
LHC Group 272% 214% 232%
HH Index Average* 343% 269% 240%
Addus 215% 206% 156%


Multiples of EV/EBITDA

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

Company 2/28/21 2/28/20 2/28/19
Amedisys 29.5 26.4 24.39
LHC Group 25.86 22.68 27.61
HH Index Average* 27.68 24.54 26.00
Addus 27.05 31.93 20.31

The Stoneridge Partners Post-Acute Care Index is updated monthly and measures the performance of these six publicly traded post-acute care 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 March 2021 | Stoneridge Partners)

Recent Transactions From Around The Country

  • Private-equity backed hospice and home health provider Charter Heath Group has acquired Serene Care Hospice in Omaha, NE
  • Private-equity backed hospice and home health provider Charter Heath Group has acquired Physmed in Omaha, NE

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

36 item(s) found

Posted 2 weeks ago by Ben B

$9+ million home care agency.  Non-skilled.  99% private pay/LTC Insurance.  65-75% live-ins.  Accredited.  Multiple locations.  Experienced management team.

 Home Care /  New Jersey / 17 views

Posted 4 weeks ago by Ben B

Medicare/Medicare certified Home Health agency.  Accredited.  Minimal Census.

 Home Health /  Virginia / 31 views

Posted 1 month ago by Ted Cohen

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

 Home Health /  Massachusetts / 40 views

Posted 2 months ago by Coley M

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

 Home Health /  Tennessee / 87 views

Posted 3 months ago by Luci

Substance use disorder treatment center, PHP, IOP, co-occurring disorders.  2019 EBITDA of $400k, 2020 revenue trend nearly $2 million and growing.  Average daily census of...

 Behavioral Health /  Mountain West / 79 views

Posted 3 months ago by Ben B

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

 Home Care /  Northeast / 121 views

Posted 4 months ago by Joe L

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

 Home Health /  Minnesota / 93 views

Posted 4 months ago by Ben B

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

 Home Care /  California / 134 views

Posted 6 months ago by Brian B

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

 Home Care /  Minnesota / 196 views

Posted 6 months ago by Brian H

$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 / 196 views

Posted 6 months ago by Partners

$4.2 million home health agency in Houston, Texas.  17.5% bottom line.  Large coverage area.  Diverse referral network.  Fully staffed with no clinical issues.

 Home Health /  Texas / 200 views

Posted 7 months ago by Joe L

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

 Hospice /  Texas / 206 views

Posted 7 months ago by Joe L

Fast growing private pay home care agency in northeast Tennessee.  $1.2+ million in revenue.  Quality focused and very profitable.

 Home Care /  Tennessee / 215 views

Posted 7 months ago by Brian H

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

 ID/DD /  Midwest / 210 views

Posted 7 months ago by Partners

$2.1 million revenue.  Dallas/Ft. Worth based Medicaid pediatric therapy business.  16% EBITDA margin.  More than 300 patients.  Also services San Antonio and surrounding areas.

 Home Health /  Texas / 200 views

Posted 8 months ago by Partners

$12 million Medicaid home care business.  Experienced management team in place.  Strong financials, long-term consistent growth.  EBITDA over $1 million.

 Home Care /  Pennsylvania / 227 views

Posted 8 months ago by Ted Cohen

$1+ million non-skilled home care agency.  20% AEBITDA.  90% of revenue from Medicaid Waiver program.  Includes Medicare-certified, ACHC accredited home health license.  Management team in...

 Home Care /  Michigan / 239 views

Posted 9 months ago by Jacob L

Three locations in southeastern US.  Real estate is also for sale.  Residential, PHP, IOP and sober living programs; detox is outsourced through BioCore.  More than...

 Behavioral Health /  Southeast / 304 views

Posted 9 months ago by Partners

$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 / 305 views

Posted 10 months ago by Partners

$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 / 323 views

Posted 10 months ago by Coley M

$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 / 317 views

Posted 10 months ago by Partners

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...

 Behavioral Health /  Kentucky / 332 views

Posted 10 months ago by Partners

Ohio ID/DD provider with $1.1 million revenues. A high-quality operation with existing staff to manage the transition to new ownership.

 ID/DD /  Ohio / 308 views

Posted 11 months ago by Jacob L

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...

 Other / 307 views

Posted 11 months ago by Joe L

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...

 Home Health /  Southwest / 355 views

Posted 11 months ago by Ben B

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

 Hospice /  Texas / 357 views

Posted 11 months ago by Ted Cohen

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 / 343 views

Posted 11 months ago by Jacob L

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 / 338 views

Posted 11 months ago by Ted Cohen

$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....

 Hospice /  Oklahoma / 349 views

Posted 11 months ago by Brian H

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

 ID/DD /  North Carolina / 301 views

Posted 11 months ago by Ben B

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

 Home Health /  New Mexico / 307 views

Posted 11 months ago by Brian H

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

 Michigan / 306 views

Posted 11 months ago by Ted Cohen

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 / 354 views

Posted 11 months ago by Jacob L

Boutique full-service clinical laboratory specializing in preventative diagnostic testing. Medicare- and Medicaid- certified, with insurance contracts in more than 20 southeastern states.

 South / 309 views

Posted 11 months ago by Brian H

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

 ID/DD /  Georgia / 319 views

Posted 11 months ago by Ted Cohen

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....

 Home Health /  Florida / 369 views

Home Health Index March 2021 | 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