As we do on each of our earnings call, I will begin with a few overall comments, and then Brian will discuss the second quarter results in more detail. As we announced yesterday afternoon, our total revenue for the second quarter of 2026 was $377.4 million, an increase of 8% as compared to the $349.4 million for the second quarter of 2025. This revenue growth resulted in adjusted earnings per share of $1.73 as compared to adjusted earnings per share for the second quarter of 2025 of $1.49, an increase of 16.1%. Our adjusted EBITDA was $49.2 million, compared to $43.9 million for the second quarter of 2025, an increase of 11.9%.

For the second quarter of 2026, cash flow from operations was $40 million as compared to $22.5 million for the same period in 2025. As we announced on May 1st, we closed on the acquisition of the personal care operation 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 closing this acquisition subject to satisfaction of customary closing conditions, including regulatory review and approval.

The net result is a proposed payment rate increase of 2.1%, compared to last year's rate decrease of 1.3%. While we are pleased with the positive rate increase for 2027, we are concerned about the continuing effect of the temporary adjustment, and we support the industry's ongoing efforts to eliminate these adjustments. The final rate equates to a 2.3% increase versus the 2.4% proposed rate increase. While we are appreciative of this increase, it does reflect an approximate 30-basis-point decrease from the fiscal 2026 final hospice rate increase of 2.6%.

What went well
  • Second-quarter revenue grew 8% year-over-year to $377.4 million, with adjusted EPS up 16.1% to $1.73 and adjusted EBITDA up 11.9% to $49.2 million, lifting adjusted EBITDA margin to 13% from 12.6%.
  • Personal Care Services (78.4% of revenue at $296 million) delivered 6.8% same-store growth on a 2.2% increase in hours per business day, with sequential same-store census up 1.2% and the consolidated fill rate improving into the mid-80s.
  • Hospice grew 11.1% on a same-store basis with average daily census up 6.5% to 3,964 (exceeding 4,000 in July), reflecting a diversified and balanced referral mix.
  • Home Health same-store revenue decline narrowed to 2.8% (from 6.6% in Q1), with same-store new admissions up 9.8% and sequential improvement in revenue, operating income and admissions under new leadership.
  • Generated $40 million of operating cash flow and cut bank debt to $64.3 million (down $30 million sequentially), maintaining a low-leverage balance sheet with $99.6 million of cash and ample revolver availability to pursue larger acquisitions.
  • The Texas caregiver-app rollout ramped ahead of schedule (fill rate into the upper-80s), Illinois app adoption exceeded 90%, and management noted turnover is down slightly; Oregon and Michigan granted rate increases for the coming cycle.
What went wrong
  • Recorded a Medicare hospice cap accrual of a little over $3 million, primarily in the Ohio market (excluded from same-store), which pressured hospice gross margin and flowed through to EBITDA.
  • The final fiscal 2027 hospice rate of 2.3% was below the 2.4% proposed and roughly 30 basis points lower than the fiscal 2026 increase, and the company expects its own rate to come in slightly below the 2.3% national average.
  • The proposed 2027 Home Health rule still includes a negative 3% temporary adjustment, leaving continued uncertainty despite a net proposed 2.1% payment increase.
  • The effective tax rate rose to 26.9% and is expected to stay in the upper-20% range because the Work Opportunity Tax Credit (WOTC) program expired at the end of 2025 without extension.
  • Personal Care in Texas held roughly steady rather than growing, and the company had not yet achieved year-over-year same-store census growth, targeting the second half of 2026 for that inflection.

Guidance Changes

MetricPeriodCurrent guidance
Adjusted EBITDA marginFY2026Expected between 12% and 13%, trending toward the higher end, with Q3 similar to Q2 and a higher Q4
Personal Care same-store revenue growthFY2026Expected to remain at the high end of, or above, the 3%-5% range
Hospice same-store revenue growthFY2026Long-term expectation of upper single digits
Effective tax rateFY2026Expected in the upper-20% range following the WOTC program's expiration
Fiscal 2027 hospice Medicare rateEffective October 1, 2026Final 2.3% increase, with the company's own rate likely a bit below the national average
New Mexico Medicaid rateSecond half 2026Around a 4% increase expected for Addus, being negotiated with the managed-care organizations

Performance Breakdown

MetricYoYNote
Total revenue +8% to $377.4M Personal Care volume and rate growth, Hospice census gains, and the HomeCourt Indiana acquisition (two months).
Personal Care revenue $296.0M (78.4% of revenue); +6.8% same-store Texas (9.9%) and Illinois (3.9%) rate support plus a 2.2% rise in hours per business day and improving fill rates.
Hospice revenue $64.2M (17% of revenue); +11.1% same-store Average daily census up 6.5% to 3,964 and higher revenue per patient day, partly offset by a >$3 million Ohio Medicare cap accrual.
Home Health revenue $17.2M (4.6% of revenue); -2.8% same-store Narrowing decline with same-store new admissions up 9.8% and sequential improvement under new leadership.
Adjusted EBITDA +11.9% to $49.2M (13% margin) Revenue growth and G&A leverage (adjusted G&A 19.2%), despite the hospice cap accrual.
Adjusted EPS +16.1% to $1.73 Revenue growth and margin expansion, partly offset by a higher tax rate from WOTC expiration.
Operating cash flow $40M in quarter Continued strong collections; Illinois Department on Aging DSO fell to 26.8 days from 47.4 days; bank debt cut to $64.3 million.

Earnings Call Themes & Trends

TopicPrevious mentionCurrent periodTrend
M&A pipeline accelerationTwo or three larger processes beginningAn increasing number of personal care opportunities plus renewed home health deal interest following the improved 2027 proposed rule; the company is actively pursuing and remains interested in Gentiva-scale, well-scaled assets while preserving its low-leverage balance sheet.
Personal Care census inflectionIllinois turned positive in Q1Illinois and New Mexico show good momentum while Texas holds steady; management targets a return to year-over-year same-store census growth in the second half of 2026 alongside continued sequential gains.
Caregiver app (Addus Connect)Rolled out to all three big statesIllinois adoption over 90% with fill rate driving turnover slightly lower; Texas ramped faster than expected into the upper-80s; New Mexico slower due to the state's EVV system.
Hospice Medicare cap managementOccasional isolated cap exposureA >$3 million Ohio cap accrual was recorded, with mitigation strategies expected to prevent further cap expense this year; management emphasizes maintaining a balanced long/short-stay referral mix.
Bridge Program & EMR consolidationNew Mexico and Tennessee, now IllinoisBridge Program referrals from Home Health to Hospice exceed 25% in New Mexico and Tennessee; Personal Care conversion to Homecare Homebase is on track to complete by the end of Q1 2027, enabling a full-continuum bridge, with ~$1 million of Gentiva EMR synergies expected in 2027.
Fraud, waste and abuse / state fundingSupportive of scrutinyFederal payment withholding tied to audits (e.g., Minnesota, California) has not affected Addus's markets; states that have finalized budgets maintained rates, with Oregon and Michigan granting increases, and Illinois flat this cycle.

Q&A Summary

Stephens (Raj Kumar) asked about back-half census trajectory in the big three states and the caregiver-app rollout status.
Poff said Illinois and New Mexico show nice census momentum while Texas is holding steady; the consolidated fill rate rose to 84%-85%, driven by a faster-than-expected Texas app ramp into the upper-80s, with New Mexico slower due to the state EVV system.
RBC (Ben Hendrix) asked about the hospice cap issue and how the 2.3% final rate translates to Addus.
Poff said the ~$3 million cap accrual was primarily Ohio with mitigation expected to prevent further exposure this year; the actual rate will be a bit below the 2.3% national average based on wage index, without changing the cap outlook.
KeyBanc (Matthew Gillmor) asked about the M&A uptick and state budget outcomes, especially Illinois.
Allison said personal care owners are more comfortable selling as Medicaid changes prove less impactful than feared, and home health optimism grew after the proposed rule; Poff noted finalized state budgets maintained rates, with Oregon and Michigan increases and Illinois flat.
BMO (Sean Dodge) asked about the caregiver app's impact on retention and adoption in Illinois.
Poff said Illinois adoption exceeds 90%; Allison said turnover is down slightly, which he partly attributes to the app, helping sustain hiring around 104-106 per business day and PCS growth targets.
Jefferies (Brian Tanquilut) asked about federal Medicaid payment withholding and appetite for platform/larger deals.
Allison said the withholding issues (Minnesota, California) do not affect Addus's markets and reiterated support for fraud-and-abuse scrutiny; the disciplined balance sheet leaves the company very interested in scaled assets that come to market.
Bank of America (Joanna Gajuk) asked to quantify the hospice cap accrual and the outlook for average rate increases into next year.
Poff quantified the accrual at a little over $3 million and said rate support will be state-by-state and cycle-by-cycle - New Mexico around 4% being negotiated with MCOs, Texas not meeting until 2027, and Illinois flat - likely tempering the high-end increases of recent years.
Barclays (Andrew Mok) asked which markets have not yet reached census growth and what is driving the 9.8% home health admissions jump.
Allison said New Mexico turned over a year ago and Illinois more recently, with Texas the last to inflect, targeting second-half year-over-year growth; new Home Health leadership is driving the admissions improvement.
UBS (A.J. Rice) asked about underlying Personal Care supply-demand and evolving managed-care relationships.
Allison said demand is strong as baby boomers age into prime personal-care years, with caregiver availability the main growth constraint - well-supported by state rates except the exited New York market - and said Addus's larger scale post-Gentiva makes it a more important partner to managed-care payers.

More on Addus HomeCare Corp

Reported 2026-08-04 · figures from the Addus HomeCare Corp Q2 2026 earnings call.

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