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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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)
(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
$2M revenue home care agency. 100% private pay. Primarily non-medical. Skilled designation, not Medicare-certified. W-2 caregivers. Region 8. Accredited.
Profitable private-duty home health agency in Northern Virginia. $1.5M in revenue. 20+ years in the community.
Profitable home care franchise with consistent sales growth. Revenue of $1.3M. Great reputation within the community.
$40M+ home care agency with 20+% AEBITDA. Primarily private-duty, non-medical (90%). Medicaid waiver programs. 40% family caregivers. Multiple locations.
Colorado Springs and surrounding areas. Opportunity to grow existing small hospice. Motivated Seller
Medicare-certified home health agency. Houston/Kingwood area. Approximately $600k in revenue. Accredited.
I/DD provider offering SCL & FHP services. $3M in revenue. Recent rate increase.
Hospice. 30+ADC. No CAP or regulatory issues.
Behavioral Health/Suboxone Clinic. $900k in revenue. 21 years in business with stellar reputation. Single office, great opportunities for expansion. All cash paying patient base.
I/DD residential services. $11M in revenue. Highly profitable agency with long-standing reputation. Community Residential Services (CRS) 4-bed model & Integrated Community Supports (ICS) apartment settings.
Well established home health agency. $4M in revenue. Fully staffed. Profitable. Good history of compliance.
Home Health CON in Montgomery County. Profitable agency generating over $1.3M in revenue. 95%+ Medicare. Built in marketing relationship and growth potential.
Skilled Home Health & Private Duty. $4.4 million in revenue. 22% census increase over last year. Established over 23 years.
Medicare/Medicaid Home Health agency. $8 million in revenue. Long history in the community.
86 patient hospice located Northeast of Houston, TX. $4M+ in revenue with 20% + adjusted EBITDA. Full staff in place. Excellent record of compliance.
Medicare-certified home health agency. District 7. Census of approximately 30 patients. Accredited.
Hospice. 150 ADC. Strong growth. Expertly run with administrative team willing to stay involved. No CAP or regulatory issues.
Mental Health Treatment Center. $1.1M in revenue. Long-established, profitable practice. Full spectrum of medical treatment and therapy services.
Medical Staffing Agency. $4.6M in revenue. Established over 25 years. Excellent rapport with regional hospital network.
Medicare home health agency. Health system relationship. Rare KY CON opportunity, multiple counties
Large, established franchise territory. $2.5 million revenue. Two offices with strong leadership teams in place.
Home health with $8M in revenue. Medicare/Medicaid-certified. 90+% traditional Medicare/episodic. Services central Texas and licensed for entire state. Strong management team in place.
Medicare-certified home health agency. Houston-area. Minimal census.
Medicare-certified home health agency. $1M+ in revenue. Long-established agency with excellent community rapport.
$19.5M large home care franchisee. 89% Medicaid. Well-established company operating more than 20 years. Phenomenal year-over-year revenue growth.
Well-established and profitable franchisee. Revenue of $4.9M. Medicaid and private pay.
Home Health Index March 2021 | Stoneridge Partners
From Rich Tinsley, Publisher of “Home Health Index.” Rich can be reached at [email protected] 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