Strong Top-Line Growth
Q4 revenue of $662.5M, up 27.4% year-over-year; full-year 2025 revenue of $2.433B, up 20.2% versus prior year (results benefitted from a 53rd week).
Substantial EBITDA Expansion
Q4 adjusted EBITDA of $85M, up 54% YoY; full-year 2025 adjusted EBITDA of $320.8M, up 74.8% YoY.
Segment Growth — Private Duty Services (PDS)
PDS Q4 revenue ~ $541M, +28.1% YoY; care volume ~12.4M hours, +17.9% YoY; revenue per hour $43.74, +10.2% YoY; Q4 PDS gross margin 27.7% with a spread per hour of $12.12.
Segment Growth — Home Health & Hospice
Q4 revenue $69.3M, +27.3% YoY; 10,400 admissions (+22.4% YoY) and 14,000 episodes (+25% YoY); episodic payer mix 78% (goal >70%); Medicare revenue per episode $3,223 (+3% YoY); Q4 gross margin 53.7%.
Segment Growth — Medical Solutions
Q4 revenue $52.5M, +21.3% YoY; ~92,000 unique patients served (+3.4% YoY); revenue per UPS ~$570, +17.9% YoY; Q4 gross margin 50% (noting a reserve release boosted results).
Preferred Payer Momentum
PDS added 8 preferred payer agreements in 2025 (total 30); preferred payer volumes ~57% of PDS MCO volumes in Q4 (target low-60% in 2026). Home health ended 2025 with 45 preferred payers (target >50 in 2026). Medical Solutions at 18 preferred payers end-2025 (target 25 in 2026).
Liquidity and Cash Generation
Quarter-end liquidity $529M (cash ~$193M, $110M securitization availability, $226M undrawn revolver); operating cash flow $125.9M and free cash flow $131M for 2025.
M&A — Family First Acquisition
Announced acquisition of Family First Home Care for $175.5M (~7.5x post-synergy EBITDA), ~ $120M revenue (two-thirds in Florida); expected close in Q2 2026; funded with cash and securitization facility and projected to have minimal near-term leverage impact.
Conservative 2026 Guidance
Full-year 2026 revenue guidance $2.54B–$2.56B and adjusted EBITDA $318M–$322M (guidance excludes Family First), reflecting prudence given remaining headwinds.