Home Health, Post-Acute Care Stocks Down Across the Board

In a variable year characterized by almost monthly swings in stock performance, August resulted in tough blows for both the Home Health and Post-Acute Care Indices tracked by national healthcare mergers and acquisitions firm Stoneridge Partners.

Thanks to America’s rapidly aging population and the overall demand for senior care services, home health and post-acute care companies have seen far more ups than downs when it comes to the stock market over the past several years – and even with August’s downturn, their trajectory over time remains impressive. But a host of factors, including staff shortages due to the COVID-19 pandemic that continue to limit growth, are keeping providers on their heels.

“Nearly all the home health and post-acute care companies we track saw their stock prices drop last month,” Stoneridge Partners President and CEO Rich Tinsley says. “There’s no single reason for the across-the-board downturn – a combination of factors is at play, including the ongoing pandemic, which has made a pre-existing staff shortage grow even larger.”

Home Health and Post-Acute Care Indices

The Home Health (HHI) and Post-Acute Care (PAI) Indices were both down in August compared to the previous month. The HHI fell more than 22%, while the PAI dropped more than 14%.

Both indices underperformed the S&P 500, which was up nearly 3% in August compared to July.

Home Health Index

The Stoneridge Partners HHI follows the stock values of Amedisys, Inc. (Nasdaq: AMED) and LHC Group, Inc. (Nasdaq: LHCG).

Amedisys saw its stock fall almost 30% in August compared to July, marking the Baton Rouge, Louisiana-based company’s worst-performing month in recent history. Because of the dip in August, Amedisys’ stock is now down more than 24% compared to 12 months ago.

LHC Group also saw its stock drop more than 13% on a month-over-month basis. The Lafayette, Louisiana-based provider’s price is down more than 10% over the last 12 months.

Amedisys, which adjusted its 2021 guidance after releasing second-quarter financial results, has attributed operational struggles to the company’s large hospice segment.

“While our performance in the first half of 2021 has produced strong EBITDA and expanded margins, our Hospice segment is behind in both admission and average daily census growth,” Amedisys noted in a press release on its Q2 results. “The COVID-19 pandemic has put pressure on our ability to hire and retain business development employees at a level needed to achieve our internal growth targets.”

LHC Group affirmed its 2021 guidance for revenue and adjusted EBITDA.

Post-Acute Care Index

In addition to Amedisys and LHC Group, Stoneridge tracks the stock performance of Addus HomeCare Corporation (Nasdaq: ADUS), Brookdale Senior Living Inc. (NYSE: BKD), Encompass Health Corp. (NYSE: EHC) and The Pennant Group, Inc. (Nasdaq: PNTG) in its PAI.

Of those companies, only Frisco, Texas-based Addus posted a gain in August, with stock prices up almost 4% month over month.

“Addus announced that it doubled its credit facility to $600 million in August, and the company has suggested much of that will go toward its M&A pipeline,” said Tinsley. “Addus has mostly worked in the Medicaid personal care space, but it’s steadily building out its home health and hospice footprints as well.”

Meanwhile, Eagle, Idaho-based Pennant saw its stock drop nearly 11% in August compared to July, and Encompass Health saw its stock decline by almost 6% month over month. Brentwood, Tennessee-based Brookdale, which sold 80% of its home health and hospice segment to HCA Healthcare, Inc. (NYSE: HCA) earlier this summer, saw its stock fall nearly 3% in August.

“Brookdale had a difficult time with its health care services segment for a few quarters, but they were able to cash in on the strong demand for home health and hospice with the HCA sale,” Tinsley said.

Quote of the Month

“This workforce is in extremely high demand, driven primarily by the growing population of older adults. We’ve seen this workforce add millions of jobs over the past decade, and we can expect a million more in the next decade — more new jobs than any other occupation.” – Stephen McCall, a PHI data and policy analyst

Read the Full Article Here: Home Care Workforce Still Facing Widespread Economic Instability

Articles Featuring Stoneridge

Stoneridge Buy-Side Associate Partner Jenna Schwartz Helps to Find Your “Diamond in the Rough”. Click here to view the article.

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 2010.

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 September 2021 | Stoneridge Partners)

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

Company 8/31/21 1 mos change YTD change 8/31/20 8/31/19
Amedisys 183.45 -29.61% -37.46% 241.9 128.71
LHC Group 186.76 -26.56% -12.45% 208.44 118.5
HH Index* 185.11 -22.19% -26.93% 225.17 123.61
S&P 4522.68 +2.90% +20.41% 3505 2926.46
Addus 89.92 +3.61% -23.20% 93.66 87.98

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) 8/31/21 8/31/20 8/31/19
Amedisys 5940 8210 4490
LHC Group 5750 6440 4130
HH Index Total 11690 14650 8620
Addus 1540 1390 1150


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

Company 8/31/21 8/31/20 8/31/19
Amedisys 271% 416% 248%
LHC Group 269% 308% 203%
HH Index Average* 270% 362% 226%
Addus 189% 188% 203%


Multiples of EV/EBITDA

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

Company 8/31/21 8/31/20 8/31/19
Amedisys 15.54 33.92 24.92
LHC Group 24.19 30.79 20.33
HH Index Average* 19.87 32.36 22.63
Addus 22.69 24.93 27.74

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 September 2021 | Stoneridge Partners)

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 September 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