Addus HomeCare Corp. (Nasdaq: ADUS) is set to acquire Gentiva’s personal care assets for about $350 million.
Those assets amount to over 16,000 home care patients per day, in Arizona, Arkansas, California, Missouri, North Carolina, Tennessee and Texas. Addus – which just left the state of New York – will fund the acquisition through its existing revolving credit facility.
“We believe this acquisition is a great strategic fit for Addus, and we are excited about the opportunity to expand our personal care market coverage in seven states, including Texas and Missouri, which are new markets for Addus,” Addus CEO Dirk Allison said. “Notably, Gentiva is the largest provider of personal care services in the state of Texas, where we currently have no personal care operations. This acquisition fits squarely into our growth strategy to leverage our strong personal care experience to build scale in existing markets as well as enter select new markets where we can immediately establish a significant presence.”
Addus currently provides home care, home health care and hospice services to over 49,000 consumers through 214 locations spanning 22 states.
On its end, the Atlanta-based Gentiva is a provider of home care, hospice and palliative care services. It has more than 590 locations across 38 states. The company was born out of Humana’s (NYSE: HUM) divestment of Kindred at Home’s home care and hospice assets to Clayton, Dubilier & Rice (CD&R). Once Humana fully acquired Kindred at Home – turning it into CenterWell Home Health – it only kept the Medicare-certified home health care.
Since, Gentiva – led by CEO David Causby, the former CEO of Kindred at Home – has mostly focused on hospice and palliative care. The company acquired ProMedica’s home health, palliative care and hospice assets for $710 million last year.
Causby told Home Health Care News last year that he believed the company was going to turn a historical loss leader in palliative care into a “game changer.”
“One of the things that we’re really trying to build out is an advanced palliative care model,” Causby said. “Palliative care is very difficult today. It’s built on the physician Part B schedule. It’s a loss leader. There’s just not very good reimbursement. But we personally feel that’s one of the greatest needs. One of the biggest spends in the health care system today are those patients that sit in that middle bucket that don’t qualify for home health and don’t qualify for hospice. That’s really where palliative should sit.”
Now, the company will be able to focus solely on palliative and hospice care.
“A recognized leader in personal care services, Addus is the right home for our personal care division and our teammates who provide care to these important clients,” Causby said in a statement. “This will ensure continued growth for that segment under proven leadership and will allow us to sharpen our focus on our industry-leading core hospice and palliative businesses, where we have the greatest opportunity to deliver the compassionate care that defines who we are, to those who need us the most.”
Addus, on the other hand, has repeatedly said it wants to continue to acquire personal care assets across the country, and then ideally layer home health services on top of that to boost value-based care capabilities.
Gentiva’s seven-state footprint was a perfect opportunity to do the former.
“Acquisitions remain an important part of our growth strategy, and we will continue to pursue strategic acquisitions that meet our criteria and are accretive to our operations,” Allison continued. “Fortunately, our strong capital structure supports our strategy, and we look forward to additional opportunities ahead for Addus.”
Looking ahead
After leaving New York, Addus has now entered an array of new states. As mentioned above, it will now be one of the largest personal care providers in Texas, where it previously only had a hospice footprint.
That now gives it the opportunity to add home health care there as well, which would turn it into a possible value-based care market for the company.
It also will expand its footprint in Arkansas, where it only had three locations, and in Missouri and North Carolina, where it did not have a footprint at all.
In Tennessee, Addus will further its scope in a state where it already made a significant leap last year. The company acquired Tennessee Quality Care in 2023 for $106 million.
On the other hand, Gentiva now has the opportunity to narrow its focus. Hospice has generally been a positive area of investment for home-based care companies over the last few years.
While palliative care has not been, Gentiva and others are bullish on what that kind of care can do in value-based care arrangements.
“We’re going on a PMPM basis arrangement and a risk-sharing basis to where we can take these patients during that five-year journey and provide services,” Causby said last year. “We believe that we have the data, and the partners we’re working with believe that there’s no doubt that, over that five-year journey between home health and hospice, we’ll be able to majorly impact those patients to ensure that they have decreased re-hospitalizations, … and we’ll help the payers in managing those patients.”
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