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Aveanna Healthcare Holdings, Inc.: Q4 FY2026 earnings call

What management said about Q4 FY2026, from the documents filed with the SEC on 19 March 2026: press release. Guidance figures: 2 kept. The quarter’s numbers.

Key takeaways

  • Fourth-quarter revenue rose 27.4%: Fourth-quarter revenue was $662.5 million, up $142.6 million from $519.9 million. PDS added $118.5 million, HHH $14.9 million and MS $9.2 million. Source
  • Adjusted EBITDA rose 74.8% for year: Full-year Adjusted EBITDA was $320.9 million, or 13.2% of revenue, up from $183.6 million or 9.1%. Fourth-quarter Adjusted EBITDA was $85.0 million, 12.8% of revenue, up 54.0%. Source
  • PDS revenue and hours grew: PDS fourth-quarter revenue was $540.7 million, up 28.1%, on hours up 17.9% to 12,361 thousand. Full-year PDS revenue was $2,001.1 million, up 22.4%. Source
  • Field contribution margin rose: Field contribution margin was 17.5% in the fourth quarter, against 16.0%, and 17.9% for the year, against 14.0%. Full-year field contribution was $436.0 million. Source
  • Free cash flow of $131.0 million: Free cash flow was $131.0 million for the year, from net cash provided by operating activities of $125.9 million. Source
  • Thrive integration reported complete: The company said the integration of Thrive Skilled Pediatric Care is finished, and that it is positioned for further acquisitions. Source

“The strength and momentum of all three operating divisions can be seen in our fourth quarter results as we complete the third year of our Strategic Transformation.”

Jeff Shaner, Chief Executive Officer

Guidance

AreaPeriodFigureAgainst last quarter
Revenue SourceFiscal year 2026 (year ending January 2, 2027)$2.54 billion to $2.56 billionKept
Adjusted EBITDA SourceFiscal year 2026 (year ending January 2, 2027)$318 million to $322 millionKept

What changed from last quarter

  • New: The company agreed on March 12, 2026 to acquire Family First Holding, LLC, a pediatric home care provider with 27 locations in seven states, for $175.5 million. Source
  • Guidance kept: Full-year 2026 revenue and Adjusted EBITDA guidance were maintained rather than changed. Source
  • Ended: The preliminary fiscal 2025 figures given in January were replaced by reported results for the fiscal year ended January 3, 2026.

Results and growth drivers

  • Fourth-quarter revenue rose 27.4%: Fourth-quarter revenue was $662.5 million, up $142.6 million from $519.9 million. PDS added $118.5 million, HHH $14.9 million and MS $9.2 million. Source
  • Full-year revenue rose 20.2%: Full-year revenue was $2,433.2 million, up $408.7 million from $2,024.5 million, with PDS contributing $366.5 million of the increase. Source
  • Adjusted EBITDA rose 74.8% for year: Full-year Adjusted EBITDA was $320.9 million, or 13.2% of revenue, up from $183.6 million or 9.1%. Fourth-quarter Adjusted EBITDA was $85.0 million, 12.8% of revenue, up 54.0%. Source
  • Net income positive after prior loss: Full-year net income was $225.0 million, against a net loss of $10.9 million. Diluted EPS was $1.05, against $(0.06). Adjusted diluted EPS was $0.60. Source
  • Tax benefit added to net income: The previous release said the income tax benefit reflected an anticipated partial release of a deferred tax asset valuation allowance. The fourth-quarter benefit was $139.5 million.

Segments and service lines

  • PDS revenue and hours grew: PDS fourth-quarter revenue was $540.7 million, up 28.1%, on hours up 17.9% to 12,361 thousand. Full-year PDS revenue was $2,001.1 million, up 22.4%. Source
  • PDS gross margin fell: PDS fourth-quarter gross margin was 27.7%, against 29.3%. The cost of revenue rate rose 13.0% to $31.62, against a 10.2% rise in the revenue rate to $43.74. Source
  • HHH admissions and episodes rose: HHH fourth-quarter revenue was $69.3 million, up 27.3%. Total admissions rose 22.4% to 10.4 thousand, and total episodes rose 25.0% to 14.0 thousand. Source
  • HHH margin and rate per episode: HHH full-year revenue was $248.6 million, up 14.1%, with gross margin of 54.0% against 53.5%. Revenue per completed episode was $3,206, up 3.5%. Source
  • MS gross margin rose: MS fourth-quarter revenue was $52.5 million, up 21.3%, and gross margin was 50.0% against 44.3%. Full-year unique patients served fell 1.1% to 363 thousand. Source

“In line with customary practice, we have not included our pending acquisition in our full-year 2026 guidance.”

Matt Buckhalter, Chief Financial Officer

Costs, margins and field results

  • Fourth-quarter gross margin declined: Fourth-quarter gross margin was $213.3 million, or 32.2% of revenue, against 33.0%. Full-year gross margin was 33.3%, up from 31.4%. Source
  • Field contribution margin rose: Field contribution margin was 17.5% in the fourth quarter, against 16.0%, and 17.9% for the year, against 14.0%. Full-year field contribution was $436.0 million. Source
  • Corporate expenses as share of revenue: Full-year corporate expenses were $163.3 million, or 6.7% of revenue, against 6.2%. Fourth-quarter corporate expenses were 5.9% of revenue, against 6.4%. Source
  • Operating income rose: Full-year operating income was $256.5 million, or 10.5% of revenue, against $139.8 million or 6.9%. Fourth-quarter operating income was $71.0 million, or 10.7% of revenue. Source
  • Interest expense declined: Full-year interest expense was $140.1 million, against $156.6 million. Fourth-quarter interest expense was $32.6 million, against $38.1 million. Source

Cash, debt and hedging

  • Free cash flow of $131.0 million: Free cash flow was $131.0 million for the year, from net cash provided by operating activities of $125.9 million. Source
  • Cash and undrawn revolver: Cash was $193.3 million at January 3, 2026, against $84.3 million a year earlier. The revolver was undrawn, with about $225.5 million of borrowing capacity. Source
  • Total debt and interest rates: Total indebtedness was $1,486.7 million at January 3, 2026. Term loans of $1,321.7 million bear SOFR plus 3.75%, and $165.0 million was drawn on the securitization facility. Source
  • Interest rate exposure hedged: Interest rate exposure under the credit facilities is hedged with $520.0 million of swaps converting variable debt to fixed, and $880.0 million of caps at SOFR of 2.96%. Source
  • Investing cash outflow increased: Net cash used in investing activities was $22.3 million for the year, against $6.3 million for the prior year. Source

“With the integration of Thrive Skilled Pediatric Care completed, we are well-positioned for further acquisition activity, including the recently announced Family First Homecare transaction.”

Jeff Shaner, Chief Executive Officer

Strategy and integration

  • Thrive integration reported complete: The company said the integration of Thrive Skilled Pediatric Care is finished, and that it is positioned for further acquisitions. Source
  • Integration and acquisition costs rose: Integration costs were $6.95 million for the year, against $1.21 million. Acquisition-related costs were $3.8 million, against $1.5 million. Source
  • Adjusted EBITDA excludes deal costs: Acquisition and integration costs are excluded from Adjusted EBITDA, which management said gives a normalized view of core operations after acquired companies are integrated. Source

Legal, adjustments and debt costs

  • Legal reserve released: A legal reserve for an accrued settlement was released during the year, and the other legal matters adjustment was a reduction of $5.9 million. Source
  • Adjusted net income rose: Adjusted net income was $129.8 million for the year, or $0.60 per diluted share, against $12.5 million or $0.06. Fourth-quarter adjusted diluted EPS was $0.17, against $0.05. Source
  • Debt modification fees added back: Fees related to debt modifications were $15.9 million for the year, and the loss on debt extinguishment was $5.9 million. Both were added back to reach Adjusted EBITDA. Source

Coming up, as management said on 19 March 2026

  • Family First closing expected second quarter: The company expects the Family First Homecare acquisition to close in the second fiscal quarter of 2026, subject to customary conditions and the Hart-Scott-Rodino waiting period. Source

Figures management reported

FigureReported
Unique patients served (UPS), MS segment, fourth quarter Source92 thousand, up 3.4% from 89 thousand
Home health total admissions, HHH, fourth quarter Source10.4 thousand, up 22.4% from 8.5 thousand
Home health total episodes, HHH, fourth quarter Source14.0 thousand, up 25.0% from 11.2 thousand
Home health episodic mix, HHH, fourth quarter Source77.9%, against 76.5%
PDS hours, fourth quarter Source12,361 thousand, up 17.9% from 10,488 thousand

Risks management discussed

  • Financial: Funding the Family First acquisition from cash and securitization borrowings is expected to lower liquidity when the deal closes. Source
  • Regulatory: Legal and forensic costs relate to responding to a Department of Justice grand jury subpoena about nurse wages and hiring, linked to a terminated transaction. Source
  • Operational: Integrating acquired companies brings transitionary costs, including closing overlapping markets, lease termination and terminating legacy contracts and systems. Source

Earlier plans management reported on

  • Not stated: Reported fiscal 2025 revenue was $2,433.2 million, within the January range; the January figures were described as preliminary.
  • Met: Management said the integration of Thrive Skilled Pediatric Care has been completed. Source
  • Not stated: Management said it continues to maintain the 2026 revenue and Adjusted EBITDA guidance given in January. 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.