The Pennant Group Q2 2026 Earnings Report

The Pennant Group EPS Results

• Actual EPS: $0.36
• Consensus EPS: $0.33
• Beat/Miss: Beat by +$0.03
• One Year Ago EPS: N/A

The Pennant Group Revenue Results

• Actual Revenue: $297.98 million
• Expected Revenue: $288.71 million
• Beat/Miss: Beat by +$9.27 million
• YoY Revenue Growth: N/A

The Pennant Group Announcement Details

• Quarter: Q2 2026
• Date: 8/5/2026
• Time: After Market Closes
• Conference Call Date: Thursday, August 6, 2026
• Conference Call Time: 12:00PM ET

The Pennant Group (NASDAQ:PNTG) (NASDAQ: PNTG) is a publicly traded holding company that provides specialized services to the asset management industry. Through its operating subsidiaries, the company delivers outsourced fund administration, securities lending, prime brokerage, and capital markets solutions designed to support hedge funds, private equity firms, mutual funds and other institutional investors. By leveraging a combination of technology platforms and industry expertise, The Pennant Group helps clients streamline middle- and back-office processes, enhance operational efficiency and manage regulatory requirements.

Key service offerings include fund accounting and reporting, trade settlement and reconciliation, risk monitoring, securities lending programs and execution support across a range of asset classes. The company’s proxy advisory and compliance services assist sponsors in meeting governance and disclosure standards, while its capital introduction team facilitates connections between emerging managers and potential investors. Together, these capabilities enable managers of both traditional and alternative investment vehicles to focus on portfolio performance rather than administrative burdens.

Headquartered in New York City, The Pennant Group was established in the mid-2010s to consolidate several boutique service providers under a unified platform. It operates primarily in the United States, serving a diverse client base that spans domestic and offshore funds. The company’s leadership team comprises professionals with extensive experience in fund operations, securities markets and regulatory oversight, positioning The Pennant Group to address evolving industry challenges and drive growth through strategic partnerships and service innovation.

The Pennant Group Q2 2026 Earnings Call Transcript

Key Takeaways

• Positive Sentiment: Q2 results exceeded expectations, with revenue up 35.8% year over year to $298 million, adjusted EBITDA prior to NCI up 51% to $26.1 million, and adjusted EPS rising 33.3% to $0.36.
• Positive Sentiment: Pennant raised its 2026 guidance to revenue of $1.17 billion–$1.19 billion, adjusted EBITDA prior to NCI of $101.5 million–$105.1 million, and adjusted EPS of $1.34–$1.41, citing strong core operations and progress integrating its Southeast acquisitions.
• Positive Sentiment: Same-store demand remained strong, with hospice admissions up 8.8%, hospice average daily census up 10.8%, and home health Medicare admissions up 13.6%; management also reported a 70-basis-point improvement in same-store home health and hospice margins.
• Positive Sentiment: The company highlighted growth opportunities from seven senior-living acquisitions year to date, its expanded investment in Hartford HealthCare at Home, and a proposed 1.7% effective 2027 home-health reimbursement increase.
• Negative Sentiment: Management cautioned that Southeast integration remains in its largest transition waves through October, while newly acquired senior-living communities may create margin lumpiness in the second half; elevated interest expense, $15 million–$17 million of annual senior-living capital spending, and hospice compliance measures also remain headwinds.

Presentation

[Operator]

Good day, thank you for standing by. Welcome to The Pennant Group second quarter 2026 earnings conference call. At this time, all participants on a listen-only mode. After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press star one one on your telephone. You will hear an automated message advising your hand is raised. Please note that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Kirk Cheney. Please go ahead.

[Kirk Cheney, General Counsel at The Pennant Group]

Thank you, Livia. Welcome everyone, thank you for joining us today. Here with me today, I have Brent Guerisoli, our CEO, John Gochnour, our President and COO, Lynette Walbom, our CFO, and Andy Ryder, our Senior Living President. Before we begin, I have a few housekeeping matters. We filed our earnings press release in 10-Q yesterday. This announcement is available on the investor relations section of our website at www.pennantgroup.com. A replay of this call will also be available on our website until 5:00 P.M. Mountain on August 6th, 2027.

[Kirk Cheney, General Counsel at The Pennant Group]

We want to remind anyone who may be listening to a replay of this call that all statements made are as of today, August 6th, 2026. These statements will not be updated after today's call. Any forward-looking statements made today are based on management's current expectations about our business and the environment in which we operate. These statements are subject to risks and uncertainties that could cause our actual results to materially differ from those expressed or implied on today's call.

[Kirk Cheney, General Counsel at The Pennant Group]

Listeners should not place undue reliance on forward-looking statements and are encouraged to review our SEC filings for a more complete discussion of factors that could impact our results. Except as required by federal securities laws, we do not publicly update or revise any forward-looking statements where changes arise from new information or for any other reason. The Pennant Group Inc. is a holding company with no direct operating assets, employees, or revenues.

[Kirk Cheney, General Counsel at The Pennant Group]

Certain of our independent subsidiaries, collectively referred to as the service center, provide administrative services to the operating companies through contractual relationships. The words Pennant company, we, our, and us refer to The Pennant Group Inc. and its consolidated subsidiaries. Our operating subsidiaries and the service center are operated by separate independent companies that have their own management, employees, and assets.

[Kirk Cheney, General Counsel at The Pennant Group]

References herein to the consolidated company and its assets and activities, as well as use of the terms we, us, our, and similar terms do not imply that The Pennant Group Inc. has direct operating assets, employees or revenues, or that any of the subsidiaries are operated by The Pennant Group. We supplement our GAAP reporting with non-GAAP metrics. When viewed together with our GAAP results, we believe that these measures can provide a more complete understanding of our business, but they should not be relied upon to the exclusion of GAAP reports.

[Kirk Cheney, General Counsel at The Pennant Group]

A GAAP to non-GAAP reconciliation is available in yesterday's press release and is available in our 10-Q. With that, I'll turn the call over to Brent Guerisoli, our CEO. Brent?

[Brent Guerisoli, CEO at The Pennant Group]

Thanks, Kirk, and welcome everyone to our second quarter 2026 earnings call. We are pleased to report another strong quarter, which put us on pace to surpass the top end of our original guidance range. Our momentum is the product of diligent focus on operational excellence, along with effective transitions at recently acquired operations. In Q2, we generated revenue of $298 million, an increase of $78.5 million or 35.8% over the prior year quarter. Adjusted EBITDA of $24.3 million, an increase of $7.9 million or 48.2% over the prior year quarter.

[Brent Guerisoli, CEO at The Pennant Group]

Adjusted EBITDA prior to NCI of $26.1 million, an increase of $8.8 million or 51% over the prior year quarter, and adjusted diluted earnings per share of $0.36, an increase of $0.09 or 33.3% over the prior year quarter. I'm incredibly proud of our local leaders and teams. Heading into this year, we outlined two critical initiatives that would create success in 2026. First, we would rigorously pursue operational excellence across all of our business lines, looking at every lever to increase efficiencies and improve results.

[Brent Guerisoli, CEO at The Pennant Group]

Second, after a period of significant investment, we would focus sufficient resources and attention on integrating those operations, especially our sizable recent acquisition in the Southeast, to ensure that they were transitioned quickly and effectively. As a testament to the strength of our operating model, we have experienced remarkable progress in organic growth across our core operations, even as we have outperformed internal expectations thus far in the transition of the largest acquisition in our history. This has been the story of Pennant's year thus far.

[Brent Guerisoli, CEO at The Pennant Group]

Before the recent announcement of the 2027 proposed home health rule, home health reimbursement had been in a down cycle, with annual base rate cuts for four consecutive years. We made the best of this challenging environment by rigorously innovating and optimizing our operations and delivering exceptional clinical care more efficiently. Throughout this period, we continued to invest in home health at attractive valuations and reaffirmed our bullish view and long-term commitment to these services, even as we have expanded our hospice and senior living businesses.

[Brent Guerisoli, CEO at The Pennant Group]

We know, and we believe the government also knows, that home health services are a vital component of America's healthcare strategy, and their importance will only increase as more seniors age into the services and governmental leaders look for solutions to reduce the nation's overall healthcare spend. The silver wave will continue to unfold over the next decade and beyond. Each year, more than four million Americans turn 65. As the share of the U.S. population over 65 increases and life expectancy continues to expand, we anticipate growing demand for our services.

[Brent Guerisoli, CEO at The Pennant Group]

Our home health and hospice services will continue to be critical, lowest cost solutions to address these demographic changes. Healthcare reimbursement is cyclical. It appears now that the payment pendulum is moving in a better direction, with a 2.4% increase in the 2027 proposed rule, which we're modeling as a 1.7% increase as applied to our operations. We see this as a positive signal and welcome the opportunity to collaborate with CMS and Congress on a more stable home health rate environment that aligns reimbursement with the increasing costs of delivering high-quality care.

[Brent Guerisoli, CEO at The Pennant Group]

As payers and CMS increasingly focus on rewarding quality outcomes and value-based care, we are well-positioned to be a solution in the healthcare continuum. As announced in yesterday's press release, we are raising annual guidance based on the momentum in the business, the progress we have made in transitioning new acquisitions in the Southeast, and the significant upside that remains in our existing operations. We anticipate full year revenue in the range of $1.17 billion-$1.19 billion, adjusted EBITDA prior to NCI of $101.5 million-$105.1 million, and adjusted earnings per share in the range of $1.34-$1.41.

[Brent Guerisoli, CEO at The Pennant Group]

With solid performance across the portfolio, a pipeline of potential growth opportunities, and a robust balance sheet, we are excited for the remainder of 2026 and beyond. With that, I'll turn the call over to John to provide more details on our second quarter operational results.

[John Gochnour, President and COO at The Pennant Group]

Thank you, Brent, and good morning, everyone. Pennant's local leaders continued to drive inspiring clinical and operational results in their communities. We are pleased to see strong performance in our mature operations, even as we are onboarding these new acquisitions. In our home health and hospice segment, exemplary clinical and cultural performance continues to create financial momentum. Top line segment revenue in the second quarter was $237.8 million, an increase of $71.8 million or 43.2%.

[John Gochnour, President and COO at The Pennant Group]

Adjusted EBITDA was $37.7 million, an increase of $12.3 million or 48.2%, and adjusted EBITDA prior to NCI of $39.6 million, an increase of $13.2 million or 50% each over the prior year quarter. Our growth in adjusted EBITDA prior to NCI reflects not only the addition of new operations, but also our focus on operational excellence, as same-store margin improved 70 basis points year-over-year. Our hospice business continues to excel. Hospice revenue in Q2 was $103.6 million, an increase of $29.8 million or 40.4% over the prior year quarter.

[John Gochnour, President and COO at The Pennant Group]

Hospice admits increased 38.4%, and average daily census increased 40.1%. While this increase reflects the impact of our investment in the Southeast, our same-store trends reflect that the community is responding to our locally driven approach and clinical excellence. For the second quarter, same-store hospice admissions increased 8.8% and ADC grew 10.8% each over the prior year quarter. In July, CMS released the 2027 Hospice Final Payment rule, which includes a 2.3% increase in revenue per day, along with several program integrity measures primarily intended to increase rigor relating to hospice enrollment.

[John Gochnour, President and COO at The Pennant Group]

The hospice industry is currently the subject of intense scrutiny because of the significant fraud and abuse issues perpetrated by bad actors in California and elsewhere. While they have created new administrative costs, we understand and support the need for program integrity measures that will help lawmakers and regulators pinpoint and punish fraudsters. We are working closely with regulators to narrowly tailor regulations and enforcement in ways that improve patient care and increase trust in the industry.

[John Gochnour, President and COO at The Pennant Group]

By identifying and isolating bad actors, funds can be redirected to providers like Pennant, who deliver great care in a compliant manner. In short, we are well equipped to thrive through this dynamic regulatory environment. On the home health side, our operations continue to grow and perform well. Home health revenue increased to $119.4 million, an increase of $40.3 million or 50.8% over the prior year quarter. Total home health admissions increased 62.3%, and Medicare admissions increased 70.7% each over the prior year quarter.

[John Gochnour, President and COO at The Pennant Group]

Revenue per episode decreased by 1.9% over the prior year, as we anticipated based on our significant growth in the Southeast. These markets have lower CMS wage indexes and thus lower revenue per episode, offset by lower actual wages and overall cost of service. Consistent with our hospice results, our same-store strength illustrates our foundation of quality care, with total same-store home health admissions increasing 9.7% and same-store Medicare admissions increasing 13.6%.

[John Gochnour, President and COO at The Pennant Group]

The transition of new operations in the Southeast continues to roll forward on schedule. Though we see significant variability and much opportunity to improve individual operations, we are pleased with their overall performance and transition progress to date. Financially, margins in this business are trending ahead of internal expectations. Clinically, where we have successfully transitioned to Pennant's EMR instance and implemented our technology stack and clinical best practices, we are seeing outcomes improve, including star ratings and potentially preventable hospitalization scores.

[John Gochnour, President and COO at The Pennant Group]

That said, we are currently in the thick of our largest transition waves, which will continue through October. This will naturally cause some ongoing disruption. In the long term, we see so much potential in these operations and their local leaders and teams. We expect them to thrive in Pennant's unique operating model for many years to come. Clinical excellence is the foundation of all we do. Our quality scores remain excellent, with an average CMS star rating of 4.1, compared to the national average of 3.0, and a potentially preventable hospitalization rate of 10%, which compares favorably to the national average of 10.8%.

[John Gochnour, President and COO at The Pennant Group]

We also continue to benefit from CMS's Home Health Value-Based Purchasing program, in which our mature operations have experienced positive revenue impacts on average. These favorable adjustments helped our same-store revenue per episode increase by 40 basis points over the prior year quarter, despite the impact of Medicare base rate cuts. Our senior living segment continued its significant growth in the second quarter as revenue improved to $60.2 million, an increase of $6.7 million or 12.6% over the prior year quarter.

[John Gochnour, President and COO at The Pennant Group]

Segment adjusted EBITDA increased to $5.8 million, a $0.7 million or 13.2% increase over the prior year quarter. In Q2, average all-store monthly revenue per occupied unit rose to $5,392, an increase of $204 or 3.9% over the prior year quarter. Same-store monthly revenue per occupied unit rose to $5,413, an increase of $282 or 5.5% over the prior year quarter. Same-store occupancy ticked up 150 basis points versus the prior year quarter to 81.6%, even as we have consistently strengthened our revenue quality year-after-year.

[John Gochnour, President and COO at The Pennant Group]

We are pleased with the broad-based stability and leadership in our senior living business, which has enabled us to be active acquirers with seven deals closed year to date. As we have discussed previously, in Q3 and Q4, we anticipate some lumpiness in senior living margin as we integrate these newly acquired communities, many of which have low occupancy, but compelling long-term potential that we are excited to unlock. Turning to acquisitions more specifically, Q2 produced a steady stream of senior living deals.

[John Gochnour, President and COO at The Pennant Group]

On our Q1 call, we discussed our April and May acquisitions of two communities in Arizona and two in Wisconsin, constituting 262 units. Later in May, we acquired the operations and real estate of Copper Canyon Memory Care, a 40-unit community in Tucson, Arizona. On June 1st, Pennant assumed operations of a senior living community in Pleasant Hill, California, known as Memory Care of Contra Costa, including 46 memory care units. These acquisitions reflect Pennant's commitment to high acuity senior living care, which is embedded in our DNA as a clinical company.

[John Gochnour, President and COO at The Pennant Group]

We believe that our ability to accept and serve more clinically complex residents positions us well for the demographic trends ahead. On August 1st, we acquired the operations and real estate associated with River Centre Assisted Living, a 63-unit community in Tucson, Arizona. The addition of River Centre and Copper Canyon increases our growing real estate portfolio to nine properties, including five acquired in the last 12 months. It also strengthens our robust care continuum in Tucson, which includes multiple home health, hospice, and senior living operations.

[John Gochnour, President and COO at The Pennant Group]

On the home health and hospice side, we made an investment in Hartford HealthCare at Home that we are excited to discuss. On June 4th, we announced the next evolution of our partnership with Hartford HealthCare, which began more than two years ago. In 2024, we commenced management of Hartford HealthCare at Home, which now provides home health and hospice services to more than 30,000 patients annually from nine locations throughout the state of Connecticut.

[John Gochnour, President and COO at The Pennant Group]

In June, we made an investment in the future of Hartford HealthCare at Home that allows us to share in the profits or losses recognized in connection with our management of the business. These now appear as income from equity method investments in our financial statements, and more details are available in our 10-Q. We are pleased that since we began working with Hartford, we have expanded patient access, improved clinical outcomes, and brought financial stability to Hartford HealthCare at Home.

[John Gochnour, President and COO at The Pennant Group]

We have also established a service center in Connecticut, invested in strong operational and resource leaders, and created a foundation from which we can grow in the Northeast. With that, I'll hand it over to Lynette for a review of the financials. Lynette?

[Lynette Walbom, CFO at The Pennant Group]

Thank you, John, good morning, everyone. Detailed financial results for the three months ended June 30th, 2026 are contained in our 10-Q and press release filed yesterday. For the quarter ended June 30th, 2026, we reported total GAAP revenue of $298 million, an increase of $78.5 million or 35.8% over the prior year quarter. Adjusted EBITDA of $24.3 million, an increase of $7.9 million or 48.2% over the prior year quarter. Adjusted EBITDA prior to NCI of $26.1 million, an increase of $8.8 million or 51% over the prior year quarter.

[Lynette Walbom, CFO at The Pennant Group]

GAAP diluted earnings per share of $0.25, and adjusted diluted earnings per share of $0.36. Our year-to-date results put us on pace to exceed the top end of our full year guidance. Accordingly, we are revising and raising our full year 2026 guidance as follows. Full year total revenue is anticipated to be between $1.17 billion and $1.19 billion. Full year adjusted diluted earnings per share is anticipated to be between $1.34 and $1.41. Full year adjusted EBITDA is anticipated to be between $94.4 million and $98 million.

[Lynette Walbom, CFO at The Pennant Group]

Full year adjusted EBITDA prior to NCI is anticipated to be between $101.5 million and $105.1 million. This updated guidance incorporates current operations and organic growth, diluted weighted average shares outstanding of approximately 37 million, and a 26% effective tax rate. It anticipates continued strong operating performance through the end of the year, hospice reimbursement rate adjustments, elevated interest expense, and the contributions from our joint ventures and management agreements.

[Lynette Walbom, CFO at The Pennant Group]

It excludes unannounced acquisitions, startups, share-based compensation, acquisition-related costs, and one-time implementation and unusual items. Key metrics as of June 30th, 2026 include $201.9 million outstanding under our credit facility and $15.3 million cash on hand at quarter end. 1.96x net debt to adjusted EBITDA and cash flows provided from operations of $18.4 million year to date. I would now like to spotlight a few leaders in our organization who have achieved exceptional results.

[Lynette Walbom, CFO at The Pennant Group]

Their stories demonstrate the remarkable progress that can occur when local leaders build strong culture and develop high-performing teams of C-level leaders in their operations. At Emblem Hospice in Tucson, Arizona, CEO Tobias Emes, CCO Adriana Treit, future CCO Itzel Erickson, and future CMO Chelsea Conn have created a culture that makes Emblem a vital contributor to the Tucson market. Emblem's leaders have intently focused on cultural excellence, creating a supportive environment where employees feel aligned with the organization's goals and ownership over results.

[Lynette Walbom, CFO at The Pennant Group]

This has resulted in a caregiver satisfaction score of 95%. This alignment has also allowed Emblem to become a consistent provider of choice in the Tucson market as the team works collaboratively to respond quickly and communicate effectively with referral sources and families. Emblem has developed an outstanding clinical reputation, highlighted by their strong scores for visiting patients in the last days of their life. As a result of these efforts, average daily hospice census has grown 43% year-over-year.

[Lynette Walbom, CFO at The Pennant Group]

Financial results have followed suit as Emblem's revenue has increased 75% and EBITDA has increased 315%, each over the prior year. Emblem is a valued partner in the robust care continuum that Pennant has developed to serve Tucson and the surrounding community. At Signature Healthcare at Home in Eugene, Oregon, CEO Samantha Moose, CCO Lucy Arbo, and future CMO Millie Sage have demonstrated how local leaders and teams can transition and thrive in Pennant's unique operating model, adding tremendous value to their local communities.

[Lynette Walbom, CFO at The Pennant Group]

Since its acquisition by Pennant in January 2025, Samantha and Lucy have embraced CAPLICO and our unique locally driven model. Signature's rigorous focus on operational excellence has resulted in exceptional clinical and cultural outcomes, including a real-time star rating of 4.5, a potentially preventable hospitalization score of 7.2%, single-digit turnover, and Home Health Value-Based Purchasing score significantly better than the national and state average.

[Lynette Walbom, CFO at The Pennant Group]

As a result of this clinical excellence and workforce stability, census has increased nearly 30% since acquisition, and EBITDA has doubled versus the prior year. Samantha, Lucy, and team are helping to set the bar and elevate care in Oregon. On the senior living side, CEO Ryan Weaver, CCO Abigail Santos, and CMO Charlie Wolf have created a community of choice at Desert View Senior Living in Las Vegas, Nevada. With a special focus on caring for our nation's military veterans, Desert View benefits the lives of a deserving elderly population.

[Lynette Walbom, CFO at The Pennant Group]

Desert View's occupancy has consistently been above 95% over the past four years, demonstrating that it is an in-demand community. By creating a comfortable and caring environment, Desert View has grown revenue 10% year-over-year and EBITDA 29% year-over-year. Desert View's story exemplifies how established leaders in a stable, mature operation can drive steady organic growth year-after-year and benefit the lives of a vulnerable population. With that, I'll turn the call back over to Brent for concluding comments.

[Brent Guerisoli, CEO at The Pennant Group]

Thanks, Lynette. Before we transition to questions, I want to thank our employees whose daily efforts create the results we share on these calls. With that, we'll open it up for questions. Livia, can you please instruct the audience on the Q&A procedure?

[Operator]

Certainly. Ladies and gentlemen, to ask a question at this time, you will need to press star one one on your telephone and wait for your name to be announced. Please stand by while we compile a Q&A roster. Our first question coming from the line of Raj Kumar with Stephens. Your line is now open.

[Raj Kumar, Analyst at Stephens]

Hey, good morning. Maybe kind of focusing on home health and the strong organic growth that you guys are seeing there Fee-for-Service, pretty healthy, and MA kind of right behind it. So as I think about some of the dynamics underlying that, this year, MA has kind of been tempered from a growth perspective. Might kind of rebound next year. How should we be thinking about just the kind of profile of the business and the underlying stability? If there are certain population shifts across the Fee-for-Service or MA kind of insurance backdrop.

[John Gochnour, President and COO at The Pennant Group]

Yeah. Good morning, Raj. Thank you for the question. I think one thing that is unique about our business is our locally driven models impact on how we make referral and acceptance of referral decisions. Each of those decisions is made at the local level by leaders and teams who understand sort of both sides of the equation. They understand what their staffing looks like, they understand what their reimbursement looks like. They're really well-positioned to make those decisions in a way that benefits patients and the community and the organization as a whole.

[John Gochnour, President and COO at The Pennant Group]

I think one of the things that your question highlights is we've had incredible success in driving organic growth across the platform. 13.6% increase in Medicare referrals, a 9.9% increase in total admissions, sort of reflects that the communities that we serve are choosing us. Because we've been able to staff, because we've been able to take volume in those more in-demand communities, it's positioned us to sort of choose which referrals to accept. I think we believe that there will continue to be growth on both sides of the ledger.

[John Gochnour, President and COO at The Pennant Group]

As Brent highlighted, there's just going to be more patients that need services and more demand for the services we provide. Certainly, we expect that there's going to be more growth in Medicare Advantage and commercial plans. We're investing strategically within the service center to make sure that we have the best team possible, to present the compelling Pennant story from a clinical outcome standpoint, from an efficiency of care delivery standpoint, so that we can make sure that we have the rate that's necessary to take that volume.

[John Gochnour, President and COO at The Pennant Group]

I think you'll continue to see growth in both fee-for-service patients and in MA patients. We believe that being a solution to the community is critical to our overall success as a company. That's how we're intending to approach it.

[Raj Kumar, Analyst at Stephens]

Got it. Maybe following up on thinking about senior living and I think the kind of uniqueness of your portfolio with the Medicaid exposure. Just curious on the waiver programs there, the sustainability of that, just underlying the backdrop around constrained Medicaid funding overall under this administration. Curious on what offers advantage or stability from that standpoint with your Medicaid-weighted business as you think about the senior living business long term.

[Andy Ryder, Senior Living President at The Pennant Group]

Thanks, Raj. This is Andy. Yeah, we have developed really meaningful relationships with the managed payers in the states where we serve higher density on the Medicaid population side. We're pretty particular about the states where we're expanding that offering versus not, and we're thoughtful about how we grow that business. In case of those specific programs, we see stability where we have that density and believe that we need to create an offering for all, but also it has to be in a way that protects margin.

[Andy Ryder, Senior Living President at The Pennant Group]

In those states where we have those relationships, because we're providing a lot of value, and we're working with those managed care payers, we continue to be able to negotiate and work with them to create not just an offering from kind of a community standpoint, but one that does have a viable margin and gives us hope for the future. In terms of the rate pressure, we continue to monitor that situation, but haven't felt large effects in any of our major density areas.

[Raj Kumar, Analyst at Stephens]

Great. Appreciate the color. Thank you.

[John Gochnour, President and COO at The Pennant Group]

Thanks, Raj.

[Operator]

Our next question in queue coming from the line of David MacDonald with Truist. Your line is now open. David, your line is now open. Please check your mute button. All right, we'll go to the next person in queue. David, please re-queue again if you can. Our next question coming from the line of Brian Tanquilut with Jefferies. Your line is now open.

[Brian Tanquilut, Analyst at Jefferies]

Hey, good morning, guys. Congrats on a solid quarter. Maybe my first question, as I think about the Amedisys assets, if you can share with us just the progress of that integration. It seems like there's still waves to be done, but any color you can share with us in terms of the strength in that business that you're seeing as you evaluate the new market in Tennessee?

[John Gochnour, President and COO at The Pennant Group]

Brian, thanks for the question. I would start with the people. There's amazing people that we inherited in these operations. It's been fun to see them embrace our unique operating model. Anytime you go into a new community with 46 new assets in Tennessee, multiple assets in Alabama and Georgia, there's that question of how people are going to respond. It's been really exciting to see them embrace the Pennant model, and how quickly and effectively they've worked through the difficulties that are inherent in any transition.

[John Gochnour, President and COO at The Pennant Group]

We're currently, we've completed three waves. We are approaching the end of wave four, which was one of the larger waves, and then we've still got one of the largest waves, which is wave five, that just started August 1st. As I mentioned in the call, I think we are on schedule from a timing standpoint. Our service center team and our operations teams that have been supporting these assets have done a remarkable job of working through the implementation of new brands, training and developing the existing leaders and some new leaders to step in and lead these operations in our model.

[John Gochnour, President and COO at The Pennant Group]

Then, of course, implementing our instance of Homecare Homebase, our technology stack, and ultimately, and this process will take longer, the implementation of our clinical best practices. All of that is proceeding on schedule, and we're excited about it. I think Brent mentioned we feel like we're a little bit ahead of schedule with regard to how the assets are performing. We've seen volume sort of stay well and really above where we expected it to be through the transition, through the brand change, through the leadership change.

[John Gochnour, President and COO at The Pennant Group]

That's a sign of the need in these communities for high-quality providers. That's exactly what we have in these assets. We're just really excited about the future of what we can build in the Southeast, in the quality of these assets, and most importantly, in the quality of the people, and the way that they can impact the remainder of the year, but more importantly, how they impact the future of Pennant.

[Brian Tanquilut, Analyst at Jefferies]

That's good. When I think about the same-store performance for the quarter, I mean, really strong, right? When I think through the drivers of that, obviously, the market for home health and post-acute as a whole is growing. How are you thinking about market share gains and the ability to sustain that level of same-store performance?

[John Gochnour, President and COO at The Pennant Group]

I think there's a couple things I would highlight with regard to our same-store home health and hospice performance. One of them, obviously is the strong organic growth numbers, which really play into your question about market share. That comes back to what I stated when responding to Raj's question. I think our local approach allows us to diversify our offering based on the needs of the community. That includes everything from the clinical programs we design, some of which are designed at the service center, but then implemented according to the needs of the local community.

[John Gochnour, President and COO at The Pennant Group]

It also allows us to be super responsive to referral sources because decision-makers are housed there in the local community. We've just seen that resonate with people. I also think that it's resonating with staff, and that's the big question of the future. There is so much demand. The big question is who will be the best at recruiting, retaining, and creating a life-changing opportunity for clinicians? I think our leaders are doing a good job of that. I think our turnover shows it that as that has declined, I think our headcount growth shows that our recruiting has improved.

[John Gochnour, President and COO at The Pennant Group]

Overall, we're better meeting that need. When you look out and say, Is this sustainable? I think, we have traditionally cited that mid to high single digits as where we think our mature organic growth is going to lie. We've been performing above that for a number of quarters in a row, and I think that reflects the increasing demand and our ability to take market share. The other thing that I would highlight is, just as I called it out in the call, even as we've been going through this growth, we improved margin at our same-store operations by 50 basis points year-over-year.

[John Gochnour, President and COO at The Pennant Group]

Actually, 70 basis points year-over-year. When you think about that, I think that reflects sort of this element of our model where owners are supporting other owners, cluster partners are supporting other cluster partners in driving improved operational outcomes. I think that is sustainable because it's such a focus and because of the way our model ties people together to support each other.

[Operator]

Thank you. I see David MacDonald's back in queue. David, your line is now open.

[David MacDonald, Analyst at Truist]

Yes. Can you guys hear me?

[Brent Guerisoli, CEO at The Pennant Group]

Yep. We can hear you.

[David MacDonald, Analyst at Truist]

Okay. Sorry about that. Guys, just two quick questions. One, we hear a lot in terms of providers talking about automation, talking about AI, talking about a lot of the things that are changing the market a little bit. Can you guys just talk about, obviously, you've got a staff that deals with a lot of clinical paperwork, a lot of things where there's potentially an opportunity to drive some efficiencies. Just kind of how you're thinking about that relative to your employee base, and any opportunities there over the next, let's say, 12-24 months.

[Brent Guerisoli, CEO at The Pennant Group]

Yeah, David, appreciate the question. It's certainly something we haven't spent a lot of time talking about on past calls. I will say this, it is a key focus area for us. We recognize and acknowledge that moving forward, technology advancements and specifically related to using AI and the tools available there are going to be critical to delivering more effective, more efficient care. We've spent a significant amount of money and investment in driving and elevating the performance from a technology standpoint.

[Brent Guerisoli, CEO at The Pennant Group]

A lot of this stuff is in development. There's a huge opportunity to do a few things. First of all, we think a lot about our clinicians and the experiences they have in patient homes and in just the work that they do. A lot of that is tied into documentation time. We're really focused on coming up with solutions and piloting different solutions that will allow our clinicians to be more efficient and effective in the care that they provide. Frankly, just provide a better experience for them in general, because we know if they can do that.

[Brent Guerisoli, CEO at The Pennant Group]

They will be more productive, we'll be able to increase the number of patients that we can care for. It should also ensure that the care that the patients are getting is increasing and improving. The other side of this is on the back office automation piece, and there's a lot of procedures or manual processes that currently is just part of what we do. A lot of these AI tools are going to allow us to eliminate many of those processes and really reduce the indirect spend. I could elaborate for an extended period of time on all of this.

[Brent Guerisoli, CEO at The Pennant Group]

I'll just say this, we are very focused on this. We believe it's a part of our future. We look forward to maybe speaking about it more as some of these pilot programs and these trials continue to show progress. Ultimately, we would expect to see improved quality outcomes and improved financial outcomes as a result of the investments that we're making on the technology front.

[David MacDonald, Analyst at Truist]

Okay. Then just one quick follow-up. I wanted to just jump off what Brian was asking about, just in terms of the market share and the underlying trends. This is probably a little bit hard to parse, but I'm just curious, do you guys think that some of the noise around waste, fraud, and abuse has potentially started to accelerate some market share shift towards some of the larger, more sophisticated folks? Are you guys benefiting from some of that share shift?

[John Gochnour, President and COO at The Pennant Group]

Yeah, it's a great question. What we believe we've seen, particularly on the hospice side, is that it is a fundamentally different enforcement environment than it has been over the last few years. The result of that is there's these things, these payment suspensions, these audits, all of these different things that are causing providers and referral sources to question how they move forward. That has allowed us to step into a place where we've had more opportunities to provide life-changing care because of those changing dynamics in the industry.

[John Gochnour, President and COO at The Pennant Group]

Our robust internal compliance program, our strong ability to navigate and manage through audit activity and the enforcement activity that exists, that has positioned us in a place of trust in a lot of these communities and allowed us to accept patients that were maybe looking for a home or work with referral sources who maybe previously had worked with others, but now are focused on those kind of things. So I do think that there is an impact.

[John Gochnour, President and COO at The Pennant Group]

We think that our biggest opportunity is to continue to focus rigorously, from an eligibility criteria standpoint, from a compliance standpoint, in delivering life-changing care in each community we serve, that that's going to give us opportunities to continue to grow market share.

[David MacDonald, Analyst at Truist]

Okay. Thank you very much.

[Operator]

Thank you. Our next question coming from the line of Ben Hendrix with RBC Capital Markets. Your line is now open.

[Ben Hendrix, Analyst at RBC Capital Markets]

Hey, guys. Thank you very much. Just wanted to move to the hospice segment real quick. I know I ask you guys a lot about cap, but we get a lot of client focus on it, especially I think one of your peers put up a cap accrual this quarter in a market we don't typically think of high wage index. Just given this strong organic census growth still outpacing admissions, just want to get your thoughts on how that management process is going, how you guys think about balance and if there's anything kind of emerging either in your new markets or in your same store markets regarding cap accrual. Thanks.

[John Gochnour, President and COO at The Pennant Group]

Thanks, Ben. It's one of the things that we constantly focus on. The Medicare cap, particularly in California, as we've discussed on previous calls, requires us to sort of manage our census because patients are eligible for a longer period of time than the cap allows them to receive services. I think you saw us record about $1.3 million in the quarter. We're still about half a million behind where we were last year. That has come from, we approach cap like we approach every other operational thing.

[John Gochnour, President and COO at The Pennant Group]

When we notice a problem, and we're tracking this constantly. Our finance team has developed sophisticated tools that project cap over multiple years, and they present that data to our operators on a monthly basis so that they know how they're trending. That data also works in census growth and admissions growth and kind of how that plays into cap management. Our operators understand that the mix of patients that they receive, whether it's from hospitals, whether it's from dialysis, that they've got to manage that length of stay, particularly in those higher reimbursement states.

[John Gochnour, President and COO at The Pennant Group]

As a rule, most of our cap continues to come from California. We feel pretty comfortable with the way that we're managing it. From time to time, you'll see an individual operation where there's cap liability. Again, we focus on that with an individualized plan based on the needs of that community and the way we feel like we can better serve that community by working with referral sources where we traditionally receive shorter length of stay patients. Overall, I think we're managing it well. We'd always like to have no cap.

[John Gochnour, President and COO at The Pennant Group]

The reality is our most important obligation is to provide service to eligible patients. In states like California, that may result in cap from time to time.

[Ben Hendrix, Analyst at RBC Capital Markets]

Great. Thank you.

[John Gochnour, President and COO at The Pennant Group]

Thanks, Ben.

[Operator]

Thank you. Our next question in queue coming from the line of Jared Haase with William Blair & Company. Your line is now open.

[Jared Haase, Analyst at William Blair & Company]

Hi, guys. Thanks for taking the questions. I wanted to ask about the partnership expansion with Hartford. Just wanted to hear a little bit more about what led you guys to sort of want to take more of an equity stake here with that partnership. I guess, any other thoughts around potential growth or expansion or maybe taking that a step further, are you thinking about that as kind of a beachhead to give you more expansion opportunities throughout the Northeast region?

[John Gochnour, President and COO at The Pennant Group]

Yeah, thanks for the question, Jared. I'll take the first part and Brent will jump in on the second part. I think what attracted us to the opportunity at Hartford is honestly the excellence of Hartford HealthCare and their commitment to in-home care. They had built Hartford HealthCare at Home as the largest provider of home health and hospice services in Connecticut. They recognized that they needed a partner from an operational standpoint to be able to deliver the best quality care most efficiently and make sure that there was financial stability and patient access in that business.

[John Gochnour, President and COO at The Pennant Group]

We started two years ago as a manager, with those sort of twin obligations and goals. As we succeeded in driving improvement in each of those areas, we felt like we reached the time where we both felt like we should invest in the partnership on a go-forward basis. That together, both as owners, we would have an opportunity to build something even more special to serve the residents of Connecticut and those who need home health and hospice services. We're just thrilled with the opportunity.

[John Gochnour, President and COO at The Pennant Group]

We're thrilled to partner with Hartford HealthCare. We're thrilled to operate the largest home health and hospice provider in Connecticut. That won't consolidate into our revenue, you'll see it a little bit differently in our financials. We believe it's a great opportunity for Pennant, and for the residents of Hartford and actually the whole state of Connecticut.

[Brent Guerisoli, CEO at The Pennant Group]

Yeah, sort of to that point, what John has shared and to your question, we looked at this certainly from an incredible opportunity to partner with a high-quality provider out on the East Coast. It also allowed us to have a pretty sizable platform to build off of. Our intention going in was to really help stabilize and grow this business, eventually have the support invest in service center, we have a service center location out there on the East Coast, to recruit leaders that could develop that business, also expand beyond that.

[Brent Guerisoli, CEO at The Pennant Group]

In many ways, it's similar to the way we think about the Southeast. That is the beginning stage. With some size, it allows us to really make strategic investments, demonstrate in these broader markets that we're a viable operation. Now we're essentially becoming a national company that can operate. Historically, we've been primarily in the West, but now we're in the Southeast and in the Northeast. That really is beneficial in a couple of different ways. One is, from a relationship with payer standpoint, we can become a much broader solution.

[Brent Guerisoli, CEO at The Pennant Group]

That really helps in our negotiations from a rate standpoint. It opens up other doors to potentially expand into additional markets where we aren't currently operating. We're excited about that deal because of the opportunity to continue it to expand, and we see it sort of as this continuing step in the progression of our relationships with healthcare systems, joint ventures, etc. We now have four meaningful relationships that kind of dot the country. There's certainly an opportunity to expand in our relationships with healthcare systems going forward as well.

[Jared Haase, Analyst at William Blair & Company]

Okay. That's very helpful. As a follow-up, I wanted to just turn to cash flow on the balance sheet. It looks like CapEx was a little bit elevated, which I think is something you guys had talked about previously in regards to some investments on the senior living side. I guess just more broadly, could you remind us kind of your thoughts on cash flow from here? It looks like debt came up a little bit this quarter, which I think was attributable to the investment in Hartford that you made.

[Jared Haase, Analyst at William Blair & Company]

I guess just as you think about the opportunities to drive cash flow, how are you thinking about prioritizing maybe paying down some of that debt versus maintaining some flexibility for growth investments?

[Lynette Walbom, CFO at The Pennant Group]

Yeah. From a cash flow perspective, I think we're on track to be where we have guided to, which is a $45 million-$55 million in operating cash flows. With that kind of going up as we've raised guidance to about $58 million, on the high end. There will be some extra noise as we go through these transitions. There's some collections pieces as we go through any transition from an acquisition. There'll be some extra noise there. From a cash outflow, looking at that CapEx piece, we do have some acquisitions that we've done on the senior living side towards the end of 2025 that are having larger CapEx expenditures for those buildings.

[Lynette Walbom, CFO at The Pennant Group]

They were significantly distressed buildings that we acquired. We're spending money to get them up to the standards that we would like them to be at. There's more cash expenditure that has happened related to those, and we anticipate that cash expenditure to be probably in that $15 million-$17 million on a year basis for CapEx spend on that line item on the cash flow statement. The debt side did go up. That mainly was driven by the acquisition for Hartford, what we just talked about, Hartford HealthCare at Home and acquiring an interest in that.

[Lynette Walbom, CFO at The Pennant Group]

That piece, we will continue to work on paying down through our operating cash flows, that outstanding balance. We want to make sure we're maintaining the ability for us to continue to acquire when we have acquisitions that come along that fit our acquisition profile.

[Jared Haase, Analyst at William Blair & Company]

Okay. All makes sense. Thank you.

[Operator]

Thank you. Our next question coming from the line of Stephen Baxter with Wells Fargo. Your line is now open.

[Stephen Baxter, Analyst at Wells Fargo]

Hi. Thanks. I wanted to ask about the senior living business and the acquisition pace you're doing. I'd love to hear a little bit about what's the same-store margins look like in that business? I think you cited the same-store margins for the home health and hospice business earlier, but I'm not sure I heard them for senior living. Just trying to understand the progress you're making there, because it seems like the occupancy and the rate growth are going in the right direction to drive same-store margin improvement that might just be offset by some of the new store activity you have.

[Andy Ryder, Senior Living President at The Pennant Group]

Appreciate the question. On the same-store side, we continue to see stability and progress from a margin standpoint. Most of that impact is really driven by these new store adds that we've had. The stability, and I think John and Brent outlined this in the call, the stability in the same-store business has been consistent, and we expect that to be ongoing.

[Stephen Baxter, Analyst at Wells Fargo]

Okay. I'd love to just hear a little bit about the improved guidance. Is there reason to think that that's driven by home health and hospice perhaps, a little bit more so than senior living, given some of the progress that you've discussed on the call today? How should we think about the composition of the improvement and where that sits within the segments? Thank you.

[Andy Ryder, Senior Living President at The Pennant Group]

Yeah. Just to add a little bit on the senior living side, most of the lumpiness that's going to be coming in Q3 and Q4, as I said, is driven by that new store challenge. On the same-store side, just pulled up the numbers. I want to just add a little bit more color there. Same-store improved from 10% to 10.5% year-over-year. I'll let the team answer the second part of that question.

[Brent Guerisoli, CEO at The Pennant Group]

Yeah, on the guidance, I think you're just seeing the progress in the acquisition in Tennessee or in the Southeast, also just the continuing performance of our current operations. I started kind of talking about this at the beginning of my remarks, it's pretty remarkable the progress that has been made on core operations, even in light of this pretty intense transition period. We're just really encouraged. Obviously, at the beginning of the year, as we project out and we anticipate the challenges related to any sort of transition, let alone the largest transition in our history.

[Brent Guerisoli, CEO at The Pennant Group]

We're naturally going to be conservative to ensure that we're accounting for any lumpiness in results or any fluctuations that may come and things that we just don't know what to expect. The team has talked about the incredible contributions of our local leaders and teams and the ability to maintain and even improve performance consistently over time. We're ahead of schedule up to now on the transition, but we're also making meaningful progress on our key initiatives across our core operations as well.

[Brent Guerisoli, CEO at The Pennant Group]

That's really what's led to the increase in the guidance, because we're performing better than we anticipated at the beginning of the year. We hope that that will continue, but we're also cautiously optimistic, recognizing that there's still work to be done and there's still a lot of progress to be made. We anticipate a continuing improvement going forward.

[Operator]

Thank you. I'm showing no further questions in the queue at this time. I will now turn the call back over to Mr. Brent Guerisoli for any closing remarks.

[Brent Guerisoli, CEO at The Pennant Group]

All right. Thank you, Livia, thank you everyone for joining us on the call today.

[Operator]

Ladies and gentlemen, this concludes today's conference call. Thank you for your participation. You may now disconnect.

Participants

Executives

• Kirk Cheney, General Counsel
• Brent Guerisoli, CEO
• John Gochnour, President and COO
• Lynette Walbom, CFO
• Andy Ryder, Senior Living President

Analysts

• Raj Kumar, Analyst at Stephens
• Brian Tanquilut, Analyst at Jefferies
• David MacDonald, Analyst at Truist
• Ben Hendrix, Analyst at RBC Capital Markets
• Jared Haase, Analyst at William Blair & Company
• Stephen Baxter, Analyst at Wells Fargo