Stoneridge Partners | Home Health Index May 2012: It was kind of a blah month for the stock market in general and a little worse for our home health index (HH Index). After a great first quarter, the S&P 500 was down 0.75% in April. (Please note: Graphs and charts May 2012 are no longer available, but the data can still be seen in the recent issues of the Home Health Index.)

But after four straight months of terrific increases (up 44% in the first quarter alone), our HH Index lost about 4% in April….2% of which was on the final day of the month.

Our HH Index now sits at 16.27. The high was set in September, 2008 at 41.75. The only company that showed an increase in their stock price was Amedisys, closing out the month at 14.73, up 1.87%.

April Results:

Almost Family, down 6.3%
Amedisys, up 1.9%
Gentiva, down 5.4%
LHC Group, down 4.4%
Home Health Index, down 3.9%
S&P 500 down 0.7%

We also note that Addus HealthCare’s stock, after a 37.5% increase in March,  closed out April down 6.7%.  They are a public company (NASDAQ:ADUS), but not in our HH Index.



Headline Florida: On May 2nd the feds charged 107 suspects with submitting $452 million in false bills to Medicare in seven U.S. cities. In Miami alone, 59 of those defendants — including three nurses and two therapists — were accused of trying to steal $137 million from the taxpayer-funded healthcare program.

Not surprisingly, “South Florida has the lion’s share of the cases,” U.S. Attorney Wifredo Ferrer told reporters after 22 indictments were unsealed in Miami federal court.

This follows up on last month’s announcement of the arrest of a Dallas physician, his office manager, and five owners of home health agencies who were arrested on charges related to their alleged participation in a nearly $375 million health care fraud scheme involving fraudulent claims for home health service.

Earnings Season:  All four public companies will be announcing their 1st quarter earning this week.  Almost Family led with their announcement on May 2.  Genitva and LHC Group are next next up on May 3rd, then Amedisys on May 8.

To listen to their reports you can go to their websites (links below) for dial-in information.  We will be giving a summary in next month’s update.

Revenue Growth: For the fourth quarter of 2011, we totaled the revenue for all four HH Index public companies and compared that to the third quarter.   According to their earnings reports, total revenue for all four companies in the 4th quarter, 2011 equaled $1.067B  compared to third quarter of $1.063B, which works out to the plus side a very modest $4M or 0.37%.

Revenue run rate based on the fourth quarter annualized follows, along with their market capitalization as of March 31, 2012 as published in Yahoo Finance:

Annual Run Rate (M) Market Cap (M)
Almost Family 357.3 243.6
Amedisys 1,483.0 433.8
Gentiva 1,796.8 270.1
LHC Group 630.8 348.7


“THE PARTNERSHIP FOR QUALITY HOME HEALTH CARE” is a consortium of home health care providers including the large public companies and NAHC.  Previously they put forth a proposal to limit “Outliers”, which was adopted and is reported to have produced savings to the Medicare program of $860 million.

The Partnership has made additional proposals to CMS for further controls.  According to the Almost Family earnings report, “The Partnership couldn’t be more aligned with the government to put controls in place that will be effective in impacting fraud and abuse”.

THE SENATE FINANCE COMMITTEE met again last week for a hearing on Medicare fraud and abuse.  Daniel Levinson, head of the Office of the Inspector General gave testimony that home health is an important ingredient in both delivering  medical care and saving money.  He went on to say that the government needs to develop better analytics to detect fraud, and to better regulate and monitor those that do get in.


There have not been any announcements from these public companies regarding any acquisition activity at all.  The market appears to be a little muddied as buyers factor in future decreases in Medicare reimbursement, whiles Sellers want 2009 prices.

We believe this will soon change as there has been very little in the way of organic growth among these public companies.  Acquisitions are an engine that can provide growth!

Announcements in the news:

Ancor Capital Partners sold Tritax Healthcare Services, a DFW home healthcare services provider to Jordan Health Services.  Ancor will now focus on pediatric care.

Home Health International, Inc. (PINKSHEETS: HHI) announced that is has entered into a letter of intent to acquire Mount Aubern, Inc. dba Associated Home Health, a Medicare-certified home health agency based in Florida.

Hospice Advantage, a Michigan based hospice, announced its acquisition of HC Healthcare (formerly Hospice Complete) located in Alabama.  Hospice Advantage now has over 50 locations nationwide.

Millenium Home Health Care, Broomall, PA announced that Saints Home Healthcare, a Medicare-certified home health care provider in Smyrna, Delaware is now part of their family of providers.

The Ensign Group, Inc. (NASDAQ:ENSG) announced their acquisition of Zion’s Way Home Health & Hospice based in St. George, Utah.

UPDATE: April, 2012 Results

For the month of April, the S&P 500 was down 0.75% while the Home Health Index was down 3.91%.

Percentage change in stock prices for these public companies for the month of April and Year to Date (YTD) follows:

Company April YTD
Almost Family -6.27% +47.04%
Amedisys +1.87% +35.01%
Gentiva -5.37% +22.67%
LHC Group -4.43% +38.04%
Home Health Index -3.91% +38.30%
S&P 500 -0.75% +11.16%
Company Multiple of EBITDA
Almost Family 5.9
Amedisys 2.8
Gentiva 1.3

Multiples of EBITDA based upon the earnings results for the year 2011with the stock prices as of April 30, 2012.


Stoneridge Partners | Home Health Index May 2012 Cartoon

Stoneridge Partners | Home Health Index May 2012

Quote: “A government that robs Peter to pay Paul can always depend on the support of Paul”. – George Bernard Shaw

Stoneridge Partners | Home Health Index May 2012: This Home Health Index (HH Index) measures the performance of four publicly traded home health companies, all listed on the NASDAQ — Almost Family (AFAM), LHC Group (LHCG), Gentiva (GTIV) and Amedisys (AMED). This index is updated monthly. If you would like to receive a monthly e-mail of this update, please e-mail us your name and e-mail address to [email protected].