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AdaptHealth Corp.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 24 February 2026: press release. Guidance figures: 3 new. The quarter’s numbers.

Key takeaways

  • Full-year revenue slightly lower: Full-year 2025 net revenue was $3,244.9 million, down 0.5%. Fourth quarter net revenue was $846.3 million, down 1.2% from $856.6 million. Source
  • Net loss against prior-year net income: Net loss attributable to AdaptHealth was $70.8 million for the year and $102.8 million for the fourth quarter. Both 2024 periods showed net income. Source
  • Adjusted EBITDA declined year on year: Full-year Adjusted EBITDA was $616.7 million, down 10.5% from $688.7 million. Fourth quarter Adjusted EBITDA was $163.1 million, down 18.7% from $200.6 million. Source
  • Census records in three segments: Patient census reached records in Sleep Health, Respiratory Health and Wellness at Home. Diabetes Health set a patient retention record in the quarter. Source
  • Fourth quarter hit by legal and onboarding: The release cites a $14.5 million legal settlement expense and over $10 million of onboarding investments in the fourth quarter. The Adjusted EBITDA reconciliation lists $1.0 million of litigation settlement expense for the quarter. Source
  • Operating cash flow and free cash flow: Full-year operating cash flow was $601.8 million, up from $541.8 million. Full-year free cash flow was $219.4 million, down from $235.8 million. Source
  • Debt reduced by $250 million: The company reduced debt by $25 million in the fourth quarter and by $250 million for full-year 2025. Source
  • Capitated contract start dates secured: The company made significant investments in critical infrastructure and nearly 500 dedicated employees to secure the first start dates of the new key capitated agreement. Source

“2025 was a tremendous year of transition in which we made significant strides toward building a stronger operational and financial foundation,”

Suzanne Foster, Chief Executive Officer

Guidance

AreaPeriodFigureAgainst last quarter
Net revenue Sourcefiscal year 2026$3.44 billion to $3.51 billionNew
Adjusted EBITDA Sourcefiscal year 2026$680 million to $730 millionNew
Free cash flow Sourcefiscal year 2026$175 million to $225 millionNew

What changed from last quarter

  • New guidance: The company issued its first fiscal year 2026 financial guidance. The prior release gave fiscal year 2025 guidance. Source
  • New: The company acquired a leading home medical equipment provider in Hawaii, its first operations in a 48th state. Source
  • New: S&P and Moody's upgraded the company's credit ratings. Source
  • Ended: The 2025 full-year results include gains from disposing of incontinence and infusion businesses within the Wellness at Home segment. Source

Results and growth drivers

  • Full-year revenue slightly lower: Full-year 2025 net revenue was $3,244.9 million, down 0.5%. Fourth quarter net revenue was $846.3 million, down 1.2% from $856.6 million. Source
  • Organic growth held at 1.7%: Organic revenue growth was 1.7% for both the full year and the fourth quarter of 2025. Source
  • Net loss against prior-year net income: Net loss attributable to AdaptHealth was $70.8 million for the year and $102.8 million for the fourth quarter. Both 2024 periods showed net income. Source
  • Adjusted EBITDA declined year on year: Full-year Adjusted EBITDA was $616.7 million, down 10.5% from $688.7 million. Fourth quarter Adjusted EBITDA was $163.1 million, down 18.7% from $200.6 million. Source

Segments and regions

  • Census records in three segments: Patient census reached records in Sleep Health, Respiratory Health and Wellness at Home. Diabetes Health set a patient retention record in the quarter. Source
  • Network now spans 48 states: The company reports about 640 locations in 48 states. The prior release reported 47 states. Source
  • Four reportable segments by product: The four reportable segments are Sleep Health, Respiratory Health, Diabetes Health and Wellness at Home, aligned with product categories. Source

“We closed the largest capitated contract in the industry's history.”

Suzanne Foster, Chief Executive Officer

Products, customers and digital engagement

  • MyApp users more than doubled: myApp users reached 327,300, more than doubling from the fourth quarter of 2024. The prior release reported 271,000 registered users at the third quarter. Source
  • Payer mix of Medicare and Medicaid: The company services beneficiaries of Medicare, Medicaid and commercial insurance payors. Source
  • Broad referral source network: The company describes its referral sources as an extensive and highly diversified network, including acute care hospitals, sleep labs, pulmonologists, skilled nursing facilities and clinics. Source

Costs, margins and one-time items

  • Fourth quarter hit by legal and onboarding: The release cites a $14.5 million legal settlement expense and over $10 million of onboarding investments in the fourth quarter. The Adjusted EBITDA reconciliation lists $1.0 million of litigation settlement expense for the quarter. Source
  • General and administrative costs rose: General and administrative expenses were $107.9 million in the fourth quarter, against $83.5 million a year earlier. Full-year G&A was $382.3 million, against $359.2 million. Source
  • Cost of net revenue increased: Cost of net revenue was $674.1 million in the fourth quarter, against $664.4 million. Full-year cost of net revenue was $2,635.7 million, against $2,579.9 million. Source

“And we strengthened our balance sheet by paying down debt while generating cash flow that exceeded expectations.”

Suzanne Foster, Chief Executive Officer

Cash flow, capital and debt

  • Operating cash flow and free cash flow: Full-year operating cash flow was $601.8 million, up from $541.8 million. Full-year free cash flow was $219.4 million, down from $235.8 million. Source
  • Fourth quarter cash flow higher: Fourth quarter operating cash flow was $183.2 million, against $150.4 million. Fourth quarter free cash flow was $79.3 million, against $73.1 million. Source
  • Capital spending on equipment rose: Purchases of equipment and other fixed assets were $103.9 million in the fourth quarter, against $77.3 million. Full-year purchases were $382.4 million, against $306.1 million. Source
  • Debt reduced by $250 million: The company reduced debt by $25 million in the fourth quarter and by $250 million for full-year 2025. Source

Strategy and operating model

  • Capitated contract start dates secured: The company made significant investments in critical infrastructure and nearly 500 dedicated employees to secure the first start dates of the new key capitated agreement. Source
  • Underlying earnings power intact: Management says the underlying earnings power of the business remains intact, despite the fourth quarter legal settlement and onboarding investments. Source
  • Operating model transformed: The chief executive says the company transformed its operating model to position it for sustained growth. Source

Figures management reported

FigureReported
Patient volumes Sourceapproximately 4.3 million patients annually

Risks management discussed

  • Financial: A non-cash goodwill impairment charge of $128.0 million relates to the Diabetes Health reporting unit, whose fair value fell below its carrying value. Source
  • Regulatory: The company expects to fund an estimated amount relating to a previously disclosed securities settlement. Source

Earlier plans management reported on

  • Not stated: The prior release cited a 2.50x net leverage target against a 2.68x ratio at September 30, 2025. The fourth quarter release does not state a leverage ratio.
  • Not stated: The company made investments in infrastructure and about 500 dedicated employees to secure the first start dates. The release does not state whether those start dates have begun. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.