As we do on each of our quarterly earnings calls, I will begin with a few overall comments, Brian will discuss the first quarter results in more detail. As we announced yesterday afternoon, our total revenue for the first quarter of 2026 was $363.6 million, an increase of 7.7% as compared to $337.7 million for the first quarter of 2025. This revenue growth resulted in an adjusted earnings per share of $1.62 as compared to adjusted earnings per share for the first quarter of 2025 of $1.42, an increase of 14.1%. Our adjusted EBITDA was $44.5 million compared to $40.6 million for the first quarter of 2025, an increase of 9.7%.
For the first quarter of 2026, cash flow from operation was $52.4 million as compared to $18.9 million for the same period in 2025. During the first quarter, we saw an impact on revenue due to the widespread weather event that occurred towards the end of January. While the amount of the revenue was immaterial to our company overall, we did see a loss of revenue of approximately $1.5 million as a result of these storms. As we announced on May 1, we closed on the acquisition of the personal care operations of HomeCourt Home Care based in Fort Wayne, Indiana.
This acquisition marks our entry into an attractive state which is adjacent to our largest personal care market of Illinois. We anticipate that this additional Indiana acquisition should close in the coming months, subject to customary regulatory approvals. As we mentioned on our last earnings call, the State of Illinois increased our rates in personal care service effective on January 1, 2026, adding approximately $17.5 million in annualized revenues. This most recent rate increase continues to show the important support we are receiving from our state partners as we continue to provide these much-needed services to our elderly and disabled clients.
| Metric | Period | Current guidance |
|---|---|---|
| Adjusted EBITDA margin | FY2026 | Expected to remain above 12% for the full year |
| Personal Care same-store revenue growth | FY2026 | Expected at the high end of, or above, the normal 3%-5% range for the remainder of the year |
| Hospice same-store revenue growth | FY2026 | Long-term expectation of upper single digits, not the double-digit rates of 2025 |
| Same-store hours per business day | FY2026 | Targeting a 2.0%-2.5% range going forward |
| Effective tax rate | FY2026 | Expected in the mid-20% range for the full year |
| Metric | YoY | Note |
|---|---|---|
| Total revenue | +7.7% to $363.6M | Personal Care volume and rate growth plus acquisitions, partly offset by winter-weather impact and two fewer business days. |
| Personal Care revenue | $281.1M (77.3% of revenue); +8.8% total / +6.5% same-store | Illinois (3.9%) and Texas (9.9%) rate support plus higher volumes; Gentiva now in the same-store base. |
| Hospice revenue | $65.8M (18.1% of revenue); +7.7% same-store | Higher average daily census (8.2% to 3,804), partly offset by lower revenue per patient day as implicit price concessions normalized. |
| Home Health revenue | $16.7M (4.6% of revenue); -6.6% same-store | Volume weakness, though operating income improved year-over-year and sequentially and admissions/visits rose sequentially. |
| Adjusted EBITDA | +9.7% to $44.5M (12.2% margin) | Revenue growth and G&A leverage (adjusted G&A 19.6%). |
| Adjusted EPS | +14.1% to $1.62 | Revenue growth, margin leverage and a lower effective tax rate (22.7%) from an excess stock-comp tax benefit. |
| Operating cash flow | $52.4M (vs $18.9M) | Strong collections and resolution of year-end payment-cycle timing; Illinois Department on Aging DSO improved to 47.4 days from 54.7 days. |
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Personal Care census inflection | Census soft in 2025 | Illinois turned to growth with starts of care exceeding discharges; management believes all three big states (Illinois, Texas, New Mexico) are positioned to grow census in 2026, though it emphasizes billable hours over raw census. | — |
| Indiana market entry | - | HomeCourt Home Care (closed May 1) plus a signed second deal mark entry into Indiana, an attractive, less-competitive market adjacent to Illinois with good rate support since ~2023 and strong managed-Medicaid relationships. | — |
| Larger M&A pipeline | Mostly small tuck-ins | Two or three Gentiva-sized personal care processes have begun in the last few months; the clean, low-leverage balance sheet is being preserved specifically to execute larger deals as debt is paid down. | — |
| Caregiver app (Addus Connect) | Illinois and New Mexico | Now deployed across all three largest states; Texas rollout in Q1 saw over 10% adoption within days, expected to lift service percentage as the year progresses. | — |
| 80/20 Medicaid Access Rule | Expected repeal | Recent communications indicate the 80/20 provision is expected to be eliminated this year, an encouraging signal for the industry. | — |
| Self-directed care scrutiny | - | CMS skepticism of self-directed care (e.g., New York, California) is viewed as favorable for Addus's agency-directed, compliance-heavy model. | — |