Addus HomeCare NASDAQ: ADUS reported first-quarter 2026 revenue of $363.6 million, up 7.7% from $337.7 million in the prior-year quarter, as growth in personal care and hospice offset continued pressure in home health. Chairman and CEO Dirk Allison said the quarter produced adjusted earnings per share of $1.62, up from $1.42 a year earlier, while adjusted EBITDA increased 9.7% to $44.5 million.
Allison noted that cash flow from operations rose to $52.4 million from $18.9 million in the year-ago quarter. As of March 31, 2026, the company had about $103 million of cash and reduced bank debt to $94.3 million, which Allison said left Addus with “the financial flexibility to consider larger acquisitions.”
Weather headwind and segment performance
Management said revenue in late January was affected by a widespread weather event, which led to missed personal care visits that could not all be rescheduled. Allison estimated the storm-related impact at approximately $1.5 million of lost revenue, adding that February and March returned to normalized expectations.
Chief Financial Officer Brian Poff said personal care services accounted for 77.3% of first-quarter revenue. Segment revenue rose 8.8% to $281.1 million, including 6.5% same-store growth. Poff attributed growth to a mix of acquisitions, volume increases, and rate support in key states, including the 3.9% personal care rate increase in Illinois effective January 1, 2026, and a 9.9% increase in Texas effective September 1, 2025.
Hospice represented 18.1% of revenue. Hospice revenue was $65.8 million, and same-store revenue rose 7.7% year over year, supported by average daily census (ADC) growth. Allison said hospice ADC increased to 3,804 from 3,515 in the first quarter of 2025, and that median length of stay was 23 days versus 19 days in the year-ago quarter and 25 days in the fourth quarter of 2025.
Home health was 4.6% of revenue at $16.7 million. Allison said home health same-store revenue declined versus the prior-year quarter, but operating income improved both year over year and sequentially. President and COO Heather Dixon said the company has made leadership and sales changes in home health and is now focused on volume after achieving target margins. Dixon said new admissions, total volume, and total visits improved sequentially versus the fourth quarter of 2025.
Indiana expansion and M&A pipeline
Addus announced two personal care transactions in Indiana. Allison said the company closed on May 1 the acquisition of the personal care operations of HomeCourt Home Care in Fort Wayne, marking Addus’ entry into the state adjacent to its largest personal care market, Illinois. Poff said HomeCourt serves about 240 clients and has annual revenue of approximately $9.7 million. Addus also signed a definitive agreement to acquire another personal care operation of similar size in Indiana, which management expects to close later in 2026 subject to regulatory approvals.
On the call, management described Indiana as increasingly attractive due to rate support over recent years and the presence of managed Medicaid. Poff said completing two acquisitions in close proximity creates a better footprint than a single deal would, and Allison said Indiana’s rates are “a little higher than some of the Midwestern states,” though Illinois remains the company’s highest-rate market.
Allison also told analysts Addus is seeing larger opportunities emerge in the M&A pipeline. In response to a question about deal size, he said the company is looking at opportunities “similar in size” to the Gentiva personal care transaction, and that the increase in larger processes has become more noticeable in the last three months.
Operations: hiring trends, census, and Addus Connect
Allison said personal care hiring trends remained positive, with 108 hires per business day in the first quarter, up from 103 in the fourth quarter of 2025 and consistent with the first quarter of 2025. Dixon added that candidate flow has been strong across markets and that wage inflation has returned to a more typical range of roughly 3%.
On personal care volume, Allison said same-store hours increased 2.2% year over year and the percentage of authorized hours served was consistent with the fourth quarter of 2025. Dixon attributed a slight sequential decline in personal care census partly to weather, but said census improved through the quarter and that March exceeded January and February. She also said Illinois saw starts of care exceed discharges throughout the quarter, supporting sequential improvement in the state.
Management highlighted progress on Addus Connect, the company’s caregiver app. Dixon said the platform has been deployed in Addus’ three largest states—Illinois, New Mexico (in stages due to nuances with the state’s EVV system), and Texas, where rollout began during the first quarter. In Texas, Dixon said more than 10% of caregivers adopted the app within the first days to a week. Allison said Addus Connect supports improving the “% of hours served” by helping caregivers track remaining authorized hours and also improves caregiver engagement by offering visibility into schedules, hours, and the ability to pick up additional shifts.
Margins, cash flow, and balance sheet
Poff said gross margin was 31.9%, consistent with the year-ago quarter, and reiterated that the first quarter is typically impacted by annual merit increases and payroll tax resets. He said adjusted G&A expense was 19.6% of revenue versus 19.9% a year earlier, reflecting leverage from a growing revenue base. Adjusted EBITDA margin was 12.2% compared with 12.0% a year ago, and Poff said the company expects full-year 2026 adjusted EBITDA margin to remain above 12%.
Poff said adjusted EPS of $1.62 excluded $0.06 of acquisition expenses and $0.20 of non-cash stock-based compensation, including accelerated vesting related to the retirement of the former president and COO. He said the stock-based compensation increase was not expected to be a continuing run rate.
The company’s cash generation contributed to debt reduction. Poff said Addus ended the quarter with $103.1 million of cash and availability under its revolving credit facility of $547.8 million, and that bank debt fell by $30 million from the end of the fourth quarter of 2025. He added the company paid down an additional $10 million on the revolver in the second quarter to date.
Regulatory and reimbursement commentary
Allison said Addus believes the 80/20 provision of the CMS Medicaid Access Rule will be eliminated and that recent communications indicate this portion is expected to be removed this year, though implementation would be years away and has “no current impact” on the business. He also said New Mexico’s legislature included $10 million of increased funding for home and community-based services in the upcoming fiscal-year budget, and the company is awaiting details on how the funds will be allocated.
On hospice cap exposure, Poff said Addus does not have cap concerns at the moment and believes it is managing referral mix and patient base well. On revenue per patient day, Poff said results were influenced by a reversion of an implicit price concession adjustment to more historical norms, with some additional impact from mix.
Management also addressed scrutiny of self-directed personal care programs and broader fraud, waste, and abuse (FWA) enforcement. Allison said Addus primarily operates in agency-directed models and believes increased focus on ensuring services are actually delivered should benefit compliant providers. He said Addus invests “millions of dollars” in compliance and welcomed the administration’s attention to FWA across home-based care.
About Addus HomeCare NASDAQ: ADUS
Addus HomeCare NASDAQ: ADUS is a leading provider of home and community-based care services for elderly, disabled, and medically complex individuals across the United States. Through a network of company-owned and franchise locations, the company delivers a broad spectrum of non-medical personal care and licensed home health services designed to support clients' independence and quality of life.
The company's core offerings include personal care assistance—covering daily living activities, medication reminders, and light housekeeping—and skilled home health services delivered under the supervision of registered nurses and licensed therapists.
Featured Articles
This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to contact@marketbeat.com.
Before you consider Addus HomeCare, you'll want to hear this.
MarketBeat keeps track of Wall Street's top-rated and best performing research analysts and the stocks they recommend to their clients on a daily basis. MarketBeat has identified the five stocks that top analysts are quietly whispering to their clients to buy now before the broader market catches on... and Addus HomeCare wasn't on the list.
While Addus HomeCare currently has a Moderate Buy rating among analysts, top-rated analysts believe these five stocks are better buys.
View The Five Stocks Here
Market downturns give many investors pause, and for good reason. Wondering how to offset this risk? Click the link to learn more about using beta to protect your portfolio.
Get This Free Report
