Post-Acute Care Sector Rebounds to Finish 2021 on a High Note

The last month of 2021 finally brought some good news for home health and post-acute care providers, with stock values rebounding after months of volatility caused by the ongoing effects of the COVID-19 pandemic.

“The HHI fell sharply in mid-Q4, then bounced back in December prior to year-end,” said Brian Bruenderman, Managing Partner of national mergers and acquisitions advisory firm Stoneridge Partners. “Home health fared better than the post-acute industry overall, but all care segments are likely to face an uncertain start to the new year as the Omicron variant continues to spread.”

With Omicron surging across the country – comprising 73% of COVID cases as of the week ending Dec. 18 – hospitals have once again approached maximum capacity. That has increased demand for post-acute care services, but with fewer labor resources available to meet the need, providers continue to decline referrals due to workforce shortages.

Home Health Index

Despite staffing shortages and COVID-19-related operating challenges, home health companies are bullish about the future as demand for their services continues to grow.

The Stoneridge Partners Home Health Index (HHI), which tracks the stock prices of national home health providers Amedisys, Inc. (Nasdaq: AMED) and LHC Group, Inc. (Nasdaq: LHCG), rose nearly 18% in December, strongly outpacing S&P gains of 4%. LHC Group’s share price rose by 20%, while Amedisys saw an increase of 16%.

The 2022 outlook for Amedisys will not only be shaped by Omicron in 2022, but also by changes at the very top of the organization. The company announced in early January that chairman and CEO Paul Kusserow will retire as CEO on April 15, with current president and COO Chris Gerard stepping into the role.

Post-Acute Care Index

Post-acute care providers saw more modest gains during December, with the Post-Acute Care Index (PAI) rising nearly 2%.

Almost all companies in the PAI — which combines stock performance for Addus HomeCare Corporation (Nasdaq: ADUS), Brookdale Senior Living Inc. (NYSE: BKD), Encompass Health Corp. (NYSE: EHC) and The Pennant Group, Inc. (Nasdaq: PNTG) with results for Amedisys and LHC Group — saw increases in their share prices. The sole exception was Brookdale, which saw its share price fall nearly 12%.

While COVID-19, and the Omicron surge in particular, continues to impact the entire care landscape, many experts anticipate cases will soon fall as sharply as they rose during December and early January. This outlook is supporting a positive perspective for care providers as 2022 continues.

“With the strong demand for home-based care and pent-up demand that post-acute providers will experience in the near term, the market should see a bright future in the year ahead,” Bruenderman said.

Quote of the Month

“We’ve seen home care workers provide essential frontline care during the pandemic, but the reality is, they have been providing this type of care all along, but often not recognized for it.” – Dr. Madeline Sterling, Assistant Professor of Medicine at Weill Cornell Medicine

Read the Full Article Here: Paid Home Care Workers Go Well Beyond Standard Duties

Articles Featuring Stoneridge

Brian Bruenderman and Tom Lillis recently led a webinar for the National Association for Home Care & Hospice called “The State of the Market: From Valuations to Volume in 2022 and Beyond”, which was featured in the McKnight’s Home Care article, Home Care Sets Deal-Making Record in 2021 with 166 Transactions.

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)

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

Company 12/31/21 1 mos change YTD change 12/31/20 12/31/19
Amedisys 161.88 +15.92% -44.81% 293.33 166.2
LHC Group 137.23 +19.62% -35.67% 213.32 137.76
HH Index* 149.56 +4.36% -40.96% 253.33 151.98
S&P 4766.18 +4.36% +26.89% 3756.07 3230.78
Addus 93.51 +7.21% -20.14% 117.09 97.22

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) 2021 2020 2019
Amedisys 5240 9920 5690
LHC Group 4220 6610 4750
HH Index Total 9460 16530 10440
Addus 1460 1780 1340



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

Company 2021 2020 2019
Amedisys 257% 491% 301%
LHC Group 215% 320% 231%
HH Index Average* 236% 406% 266%
Addus 188% 234% 224%

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 January 2022 | 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

Hospice agency.  6 counties in northern California.  Moratorium in place.  Minimal census.  Accredited.

 Hospice /  California

Medicare home health agency.  Health system relationship.  Rare KY CON opportunity, multiple counties

 Home Health /  Kentucky

Opportunity to establish a Houston-based hospice.  Low-census provider licensed for regions 3, 4, 5 and 6.

 Hospice /  Texas

Opportunity to establish a Medicare hospice and Medicare home health agency.  Greater Salt Lake city area.  Clean provider number with management and field staff in...

 Home Health /  Utah

Large, established franchise territory.  $2.5 million revenue.  Two offices with strong leadership teams in place.

 Home Care /  Michigan

ABA in-home and community-based autism treatment for children and families.  Located in Northeastern VA.  $1M in revenue.  Completely self-sufficient staff to remain.

 Other /  Virginia

Home health with $8+M in revenue.  Medicare/Medicaid-certified.  90+% traditional Medicare/episodic.  Services central Texas and licensed for entire state.  Strong management team in place.

 Home Health /  Texas

Home care franchisee.  $8.4M in revenue.  Highly profitable agency.  Medicaid/private pay.

 Home Care /  Kentucky

Skilled home health agency.  JCAHO accredited, zero deficiencies.  Excellent reputation and referral relationships.  $400k in revenue, impressive growth potential.

 Home Health /  Colorado

Medicare-certified home health agency.  Houston-area.  Minimal census.

 Home Health /  Texas

Medicare-certified home health agency.  $1M+ in revenue.  Long-established agency with excellent community rapport.

 Home Health /  Texas

In-home DME manufacturer.  Patented mobility system.  $7.7M+ in revenue.  GSA/VA contract.  Strong industry supplier partnerships.

 Other /  California

$1M in revenue.  Small Medicare home health agency.  Region 5.

 Home Health /  Florida

Private pay home care.  $1.6M in revenue.  Profitable, great reputation.  Tenured staff.

 Home Care /  Illinois

Medicare-certified home health agency.  District 3.  Approximately $700k in revenue.  Accredited.

 Home Health /  Florida

Medicare-certified home health agency.  District 5.  Minimal census.  Accredited.

 Home Health /  Florida

$19.5M large home care franchisee.  89% Medicaid.  Well-established company operating more than 20 years.  Phenomenal year-over-year revenue growth.

 Home Care /  Illinois

$27M highly profitable, tech-enabled health care staffing company.  Provides on-demand workers for LTC facilities.  Impressive growth trends with extraordinary upside

 Other /  Midwest

Well-established and profitable franchisee.  Revenue of $4.9M.  Medicaid and private pay.

 Home Care /  Southwest

ABA in-home autism therapy for children.  $2.4M in revenue.  Strong growth and bottom line.

 Other /  California

Opportunity to acquire a Medicare-certified home health agency. JCAHO-accredited.  Zero deficiencies.  Region 9.

 Home Health /  Florida

Opportunity to acquire a Medicare-certified home health agency.  JACHO-accredited.  Zero deficiencies.  Minimal census.

 Home Health /  Pennsylvania

Opportunity to acquire a Medicare-certified home health agency.  Zero deficiencies.  Minimal census.

 Home Health /  Kansas

Rare southern hospice/home health CON opportunity.  $3.5M in revenue, 60+ hospice ADC.  Strong staff recruiting and retention.

 Home Health /  South

Medicaid/private pay, Medicare-certified.  $3 million in revenue.  CHAP-accredited.

 Massachusetts

4-star home health agency.  $2.5 million revenue.  Experienced management team.  Strong financials with outstanding local reputation.  Huge growth opportunities.

 Home Health /  Michigan

$1.5 million revenue chiropractic/physical therapy business.  High profit margin/low operating costs.  Diverse referral sources.

 Other /  Maryland

$3.3 million in revenue.  Autism center providing ABA, OT, PT and ST.  In-clinic and in-home services.

 Other /  Michigan

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

 Home Care /  California

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

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

 Hospice /  Texas / Popular

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

 Home Health /  New Mexico

Home Health Index January 2022 | Stoneridge Partners

From Brian Bruenderman, Publisher of “Home Health Index.” Brian 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