Addus HomeCare Corp — Call Transcript 2026

Good morning. Welcome back to KeyBanc's Healthcare Forum. My name is Matthew Gillmor, and I lead healthcare equity research coverage for KeyBanc. Joining me on screen is Addus HomeCare CEO Dirk Allison and CFO Brian Poff. Addus is a leading provider of home care services focused on personal care, home health, and hospice. This will be a fireside chat presentation, so I'll lead the Q&A, but feel free to submit questions through the dialogue box, or you can just email me or message me. With that, Dirk and Brian, welcome, and thanks for being here. Thanks a lot. Appreciate it, Matt. I thought we might start off with sort of a state of the union question, a little bit of a review on 2025 and what are you focused on for 2026. So just catch us up on what some of the key performance drivers were for last year. Were there any challenges that emerged that you had to overcome? What are the things you're focused on in 2026 that are new or different compared to last year? Well, you know, one of the things we really started focusing on early in 2025 was our hospice division, our hospice segment. We had made some investments starting in October the previous year and leadership changes and sales and marketing, training. We spent that year really focused on getting that business back to where we thought it was before the pandemic came in. We saw some really good progress in 2025, so we were pretty excited about that. The leadership continues to do a good job. We'll see as we move into 2026 with our hospice division. I think what, you know, if you really wanna talk about 2025 and kind of in focusing on personal care, we saw a couple of things that we have to deal with now. One is, we saw a renewed focus on the need to start growing census. You know, again, I wanna make sure people understand that census itself is not the driver of profitability or performance in our business, it's hours. Really maximizing hours per client is the big driver. There is a point in time where you have to start adding new census to your portfolio. As we look at it, we have to add the right people. That's one of the focus we've looked at. We don't just wanna add census 'cause, you know, if you add somebody with very low hours, that's very difficult to work with and to staff. If you can bring people on with the more normal hours, that's the census you wanna drive. That was a challenge in 2025 that we have worked on and continued to work on in just the beginning of 2026. Then obviously the biggest challenge we probably faced that year was the new Trump administration coming out and deciding that they wanted to look at the Medicaid program and make some changes and try to save some money for their tax reduction bill. Which proved to be, you know, not as much of a challenge for how we're gonna operate going forward and what it's gonna mean to the company, but a challenge to understand it and then to determine how it affected the company and what we do. I think those are the biggest issues we faced in 2025, and we will continue to, you know, talk about those into 2026. Got it. Why don't I follow up on the personal care census topic that you mentioned. You know, I think we're starting to anniversary some of the redetermination pressures that impacted you all last year. Just kinda catch us up in terms of how census growth progressed sequentially through 2025, and any trends you're seeing in your key states to call out, and really just kind of the level of confidence that we'll get back to same-store census growth as we move into 2026. Yeah. That really if you focus on our same-store census growth, there's three markets that make up the biggest move in that particular metric, and that is, Illinois, Texas, and New Mexico are our top three markets. About 70% of our personal care business. Each of those states, at different times and with different results, went through the required Biden redetermination process that started occurring a couple years ago. The states, you know, didn't have a lot of leeway into getting ready for that. It came kinda quickly. I'm not sure they were as prepared as they will be for maybe some of the changes coming up in 2028, 2029 down the road with some of the OBRA changes. What we saw in all three markets at different times were the two key metrics we look at, starts of care and discharges, and what happened to them. Normally, your starts of care exceed your discharges, and that's what leads to your census growth. We saw first in New Mexico and really Texas, probably New Mexico first, followed pretty closely by Texas, where that metric flipped. We were still seeing normal discharges because just the normal lifespan of patients and where they moved continued on without effect. It's bringing new patients in which is dependent on the state to go out and to review the application for the new client and to authorize their hours and then pass them on to us. That is the part that got slowed down pretty dramatically during the redetermination. Both of those went negative in Texas and New Mexico. Starting early last year, New Mexico flipped. We started seeing starts of care get back to where it normally was and discharges staying where they were, and so we started seeing census growth in New Mexico. Texas probably was a few months behind that, but we flipped that probably in, I don't know, Brian, mid-year, third quarter, where Texas, starts of care started exceeding. Then the last one, for whatever reason, you know, obviously Illinois is our biggest market, and it took a little longer in Illinois to get the process more back to what we would consider a normal cadence of growth in the market. For a period of time, even up through the end of the fourth quarter, we saw discharges remain very steady, which was good. At the same time, starts of care were a little delayed in getting back to where they exceeded that particular metric. Coming into the first quarter, we started to see that flip in the first month. I think we mentioned we got hit with a little bit of weather. We were talking earlier about the snow and the ice that went across the country, and we were probably affected for a week or two on a number of our sites. That delayed it. Starting in mid-February and early March so far, we've now seen that metric switch. Illinois has now started to where their starts of care is creeping back over their discharges. Our belief is, by the second quarter, maybe the first quarter, but certainly the second quarter, you ought to see continue to see sequential census growth as we've had up until the fourth quarter when the holidays caused a little blip. Going forward, we'll be coming around on some comps. I think when we talked on our Q&A in the first quarter, when we talked about the last half of 2026, I think that's more of the comps of coming around year-over-year growth versus what we anticipate will continue to be sequential growth until that time. Got it. Then I wanted to flip over to some of the rate environment questions and sort of fold in some of the regulatory topics that you had referenced earlier. Before we get into some of the details, I just wanted to take a step back, and I think we've seen pretty supportive rate increases across your key states. You know, one thing I just wanted to hear from you is how do you all communicate the value that you're delivering to the stakeholders in those states? What's their general view of personal care and the value that personal care delivers to the healthcare system? I'll jump in here and start, Brian, you can add too. You know, one of the things that we've worked for the last 10 years, it's been a long-term effort, not only developing lobbying and relationships with the state, but also the real economic discussion of why home care makes sense. If you think in terms of all states, let's take New York, which we're no longer in, aside because it doesn't apply necessarily for that market. Every other market we're in, if you look at the hours [procured] that we undertake for these home-based care patients, it saves the state money as opposed to going into a nursing home. It's two to 3x the cost to take a patient that can remain at home under personal care. If you take that situation away from them, they are gonna need to go into facility-based care because, you know, again, when you need help with activities of daily living, whether that's dressing, eating, running light errands, you're not, as an elderly patient, if you don't have that this year, you're generally not gonna get that back next year. It's a permanent situation. Same with disabled patients. From our standpoint, one of the things we continue to talk to the states about, and now also with the Medicaid payers out there too, is the value of the service, not only from the standpoint of what the particular person or family want, which is to be in their home, but also from the standpoint of saving the state or the payer money. Because at the end of the day, as I said, if you've got limited Medicaid dollars and you're trying to take care of this high-cost population base, if you can do that in a setting such as personal care, which is much less expensive than SNFs, then it makes sense to do that. That's the message we have talked to. We've talked to Illinois about that for years, and they really appreciate it, and they understand it probably as well as anybody. Then, of course, as we've been in other states and now as we're in Texas, we're doing the same type process, using our lobbyists, using our relationships to talk about the value-based approach we have with that service level. That's great. Why don't we focus on the rates themselves. We know you got a rate update in Texas, I think that started September 1, and then a rate update in Illinois, January 1. What are you seeing in terms of some other states as you're looking out to the next state fiscal year? I think there was some news out of New Mexico, but you know, what are you hearing out of Illinois and sort of where they stand in their budgetary process? Yeah, Matt, I think obviously the larger states are key for us, and we've gotten really good support from them over the years. You know, Texas, as they meet every two years, they've given us a rate increase, you know, each of the last two cycles. Illinois has been pretty consistent. I think last year we didn't necessarily anticipate them giving us an increase, and then we got something right at the end of their session. You know, where they sit today, you know, Governor Pritzker put out his kind of initial budget in February, did not have a rate increase in there for us this year. That's consistent with what we saw from him on the initial budget last year. Their session, what will continue, they usually finalize their budget. They're a July first fiscal, so they usually finalize in the kinda April, May timeframe. We're not necessarily anticipating anything. Obviously, we'll continue to watch. I think in Illinois, one thing that probably works well for us is the union there is usually a pretty good lobbying arm as well. Every year, you know, they do have conversations and push for increases in reimbursement, which will benefit obviously their members. Our understanding is, you know, they're having those conversations again this year, but you know, we'll wait and see what happens. Again, I would say today we would probably not anticipate getting something this year. That probably makes sense from where they are. You know, Texas, we talked about. New Mexico, you know, we did get some information last year. You know, they were talking about a rate increase kinda around the time that OB3 was in flux, and so they decided to hold kinda status quo last year. We were hopeful that meant this year with everything being kinda settled, you know, maybe they would readdress that, and it seems like they did. They've passed a rate increase for us. The governor, I believe, has signed it. We think it'll be around 4% for us. We're still trying to get some of the details, which should be effective July first. That's the New Mexico fiscal year as well. We'll get some support from that, you know, toward the back half of this year. You know, I think generally just talking about the rate environment, particularly in PCS, you know, we've gotten, again, really good strong rate support. We've been saying for the last few years we would expect that cadence to probably slow down some. You know, a lot of states have gotten, you know, to the point where we're able to pay our caregivers nicely ahead of minimum wage, in most markets that we're in today. I think, you know, back to your earlier question with Dirk around, you know, the states and valuing the service, I think we have seen states that have, you know, gone above and beyond in that respect, with the purpose of saying, "Hey, we can give you a additional reimbursement increase. You can pay your caregivers more. That should help with your access to labor and get more people into the program, which should save the state money, because they don't go into an institutional setting. We think states are appreciating that, and we've seen that through some of the rate support over the last few years, and again, all conversations that we'll continue to have, going forward. That's great. I wanna hit on two kind of regulatory topics, and then we'll get back into the fundamentals of the business. I'm sure you're tired of answering some of these questions, but we thought it was important to hit on. The first one was just on some of the fraud, waste, and abuse headlines. I think investors are pretty well aware of these headlines and some of the initiatives that the administration has been talking about. I thought it might be useful for you all just to take a couple and talk about sort of your compliance processes and are there anything you're actually seeing, you know, on the ground level in terms of states increasing audits, that sort of thing? You know, Matt, one of the things we did, again, this goes back to January of 2016, so this is quite a few years back. We came on board as a team and based on our history of operating in healthcare services, one of the things we knew we needed to do at Addus was have a very strong compliance program, which we think is key to operating in any healthcare segment. We today spend multimillion dollars a year on a team who is a very well-versed team. We do a lot of internal audits. We spend a lot of time making sure that what we bill is correct. When we find those instances, which we occasionally do, where maybe some of the paperwork is not as supportive as we think it needs to be to be reimbursed, we will proactively reach out to the state and pay that back. For us, the focus on fraud and abuse, we're very supportive of. We think it makes absolute sense because you think in terms of waste, if we can get rid of whatever fraud abuse, I'm not sure how big it is, but there obviously is some out there, especially if you look at certain states. If we can get that out of the system as much as possible, that gives the states more dollars to pay for truly appropriate services that the Medicaid population really needs. That's why we're very supportive of Medicaid fraud and abuse. It's why we as a company will continue to always make sure we put the proper resources in, following through to make sure that we're doing everything we can to follow the rules. Now, you know, healthcare's complicated, so there are always questions of sometimes there are things you have to make determinations on. We try to be on the side of a little bit conservative to make sure that we've not put ourself at risk. Really if you look at your second part of the question, have we seen any real moves, especially on the personal care side? Just talking about the non-clinical side, we've seen a few states do a few more reviews. Nothing really out of the ordinary. If you go back at various times during the past 10 years, we've seen this cycle occur. I wouldn't say anything has changed in that side of the equation since, you know, the Trump administration started talking about fraud and abuse. Now, on the clinical side, especially as it relates to hospice, there is a lot of attention and has been a lot of attention over the last year plus on long length of stay patients. You know, making sure that the benefit level, which is really for those patients with six months of life left, based on what their physician says, that it's not being abused. That's something we've seen in all the years we've been in hospice, that cycles through. that's, while it is maybe a little higher than it's been over the last two or three years, it's nothing certainly out of the ordinary over the last number of years. nothing that we can point to directly that we've seen a dramatic change. As we're thinking about sort of maybe the derivative implications from this, I think one obvious one is this could put more pressure on smaller providers that then may wanna sell their business to Addus. I was kinda curious if you thought that was reasonable. The other area I was hoping for you to comment on is agency-directed versus self-directed. You know, would states be more interested in pushing people more to the agency-directed model where there's a bit more kinda control versus a self-directed model for personal care? You know, if you really look at one of the states that the federal government's talking about is the state of California. In California, we used to be in an agency-directed model. Back about 12 years ago, the state decided through their Medi-Cal program to really get rid of agencies and go self-directed. The problem with self-directed care, it just allows for potential abuses of the system because now you have no one on the outside that's an independent agency looking to make sure that if you're supposed to provide three hours of care today, that you go in and actually provide it. There's nothing to guarantee that you just don't say you're billing the time and, you know, if you're in a situation where it's in certain situations, the patient may not complain. We firmly believe and have always believed that self-directed care is much more open for abuse than agency-based care and have been supportive of that over our timeframe. I think a lot of states appreciate that. Very few states have gone like California has, where they've really pushed to move totally to self-directed care. For us, having the ability to look at an Addus and say, "Okay, you're gonna be responsible for supervisory visits to make sure these things are happening. We're gonna hold you accountable for that." We're gonna make sure that you're making sure folks are there at the appropriate level of care and following the plan of care. I think those are all very important aspects as it relates to self-directed care. As far as your first part of the question, which talked about what this might mean for smaller providers, I think any time things change, where you're gonna have as a company, you're gonna put more resources into operating the business, there'll be some folks that can do that and will do that. There'll be others that maybe don't have the resources or maybe, quite frankly, they've been in the business a long time, and it's a real change for them, and they've decided that, maybe it's time to leave the business as opposed to try to make some of these changes that could be affected to their operations. We do expect over time. Right now, it's really early in the process, but as some of these things come through, there may be some potential for some of the smaller mom-and-pops to decide that it's time to get out. Obviously, as Addus has said, we're a, you know, we're certainly an acquirer and would love to look at those. We'll continue to be available if those opportunities arise. Great. Well, let me ask about the Big Beautiful Bill. You know, I think there's been obviously some investor questions around what the implications are from Addus. I think from our perspective, it seems like there's no direct implications at all, whether you're thinking about work requirements or provider tax cuts. There could be some indirect implications, and I think that's what investors are sort of worried about, or that's what's in the back of their mind. I wanted to see if at this point, are you sort of hearing anything from states in terms of if there is funding pressure from lower provider taxes, how that may flow through the system? Maybe that gets back to some of the value prop comments for personal care, but I was just curious whether you're hearing anything or whether you think, you know, we are at least thinking about the big, beautiful bill in the right way? Well, we agree with you the way you think about it. If you look at the provider tax, it really dramatically affects more of those states that expanded their Medicaid population under Obamacare. For us, as far as the big states, that's Illinois. Illinois has been very supportive of the personal care program for the last 40 years. In fact, they're the only state in which we operate that has their own program outside of Medicaid that will pay for some patients to go have personal care service 100% funded by the general fund of the state. We've not heard anything from Illinois as a concern there. The other states are big states. New Mexico and Texas aren't as affected. If you go to the overall thought process of maybe having less dollars eventually, again, you mentioned it plays to our aspect that says that's great because we as a service provider in personal care, we can help you save money for these long, the high-cost patients that we take care of. That to us is not a real issue. You look at work requirements, and we've said we actually think work requirements can be a benefit if you think it through as a company, because we're hiring part-time caregivers. Our average caregivers work 22 hours a week. If you're a Medicaid recipient and, you know, remember, most of our patients are not gonna have to have work requirements. They're either elderly or disabled. A caregiver might. You know, maybe a caregiver, maybe someone is on Medicaid, they're younger, taking care of kids at home, and they're now to go out and get a 20-hour a week job. We're an opportunity as an employer where we're very flexible. They need to work on certain nights because they don't have childcare during the day. If they can only work all weekends, if there are certain specified times that they're available. Generally, we can look to our population base in their market because of our size, and we can find an opportunity for them to be a caregiver for us. We don't expect it to be any issue. We believe, honestly, it can be potentially might be a benefit long term. Okay. All right. Why don't we get off some of the regulatory topics and sort of get back to the business. You know, one of the areas I wanted to touch on was labor. You know, for your business, I've always thought of labor as sometimes being a limiting factor for growth. When you're able to hire, you're able to meet the demand that is out there. Can you talk about the trends that you're seeing in hiring, particularly with personal care, but also non-clinical? Are there any process or tech improvements you've been focused on the last six months or a year to help support the hiring process? Yeah, Matt, I can take that one. I think, you know, on the hiring side, it's been, I think in the personal care environment, you know, pretty positive for us over the last, you know, probably, to be honest, couple of years. I think, you know, typically, you know, we're countercyclical, where unemployment is higher is usually a positive for us. While we're not kind of at, you know, historical highs, it has been ticking up. But I think for us, you know, just the impact of inflation has also probably helped our hiring. Think about the kind of folks that we typically employ. You know, we're competing with retail, hospitality, and those types. But, you know, people need more money. They're looking for, you know, additional work, and I think we've been a great, you know, solution for that. We've been in a pretty positive state. I think, you know, going into Q4, we talked a little bit about the holidays. We were down just a little bit sequentially from Q3. Some of the weather in January probably impacted a little bit at the end of the month. I think February has turned, has been pretty strong. I think we feel like we're in a pretty good trend, a pretty good cadence on the personal care side. Clinical, you know, always has probably just, you know, some pockets, you know, maybe more urban markets where it's a little more difficult, more competitive, to find folks. I think we're, you know, fairly clear of, you know, some of the pressure we all saw coming through COVID and a lot of nurses out there on travel schedules. I think it's gotten back into a more, we would consider historical kind of normal environment. You know, our increases there, you know, we're maybe 4% or 5% kinda coming out of COVID. We're back down to probably, you know, 3%-4% on the clinical side, which is kind of back in line. I think overall, like, we feel like the labor environment has been pretty stable. But second part of your question, just kind of what have we been doing. I think the main thing for us in personal care, if you think about folks that are applying for jobs with us, they're probably applying at, you know, two, three, four other places at the same time. It's really critical that, you know, we get to those individuals quickly and make sure we try everything we can to make their, you know, onboarding process as smooth as possible. I think we've tried to use technology, some AI, actually in there and just responding back to clients or caregivers, I'm sorry, making sure that they get, you know, connections quickly, and they get through our process as seamlessly as possible. I think we've been able to be successful there and kind of seeing the shortening of that overall timeline has probably also been a benefit. That's great. As a quick follow-up, when you all talk about, you know, hires per day, I think in the early part of the quarter you said it was 107 and maybe it ticked down, but now we're back up. What's the type of hiring per day you need to support, you know, the same-store census growth of being north of 2%? Just by way of example, so we have some sort of sense for, you know, how you're tracking. You know, I think what we've looked at is if we can stay just above 105, we're in pretty good shape. We'll meet our growth targets. You know, we've been doing that consistently. I do know we dropped down to 101 during the holidays fourth quarter, but I would expect to see us be able to achieve that 105 in the first quarter going forward so. Got it. That's great. You know, one, I wanted to hit on the caregiver app that you had rolled out to Illinois and then moving out to other states. 'Cause in my mind, one of the real bright spots has been your ability to increase the fill rates and, you know, serve more hours per patient. Maybe just give us some context in terms of how this app works if you're a caregiver and, you know, what's been the impact to fill rates in Illinois and, you know, what are you seeing in sort of the rollout in New Mexico and Texas? Yeah. I think the primary benefit, so if a caregiver you know chooses to download and use the app, we don't make it mandatory. You know, obviously, we definitely promote it and encourage caregivers to use it 'cause it gives them a lot of tools that they otherwise wouldn't have access to. The main thing is they can see what their schedules are. They can see their punches in, their punches out, so they can kinda see what their paycheck's going to look like. You know, if there's something wrong, you know, they can make a correction before their paycheck comes in and it's not the amount that they expect and have to go through that process. It lets them, you know, go in and basically, you know, make edits to their availability, or some of their preferences. So if they're saying, you know, originally they're saying, "I can work on Tuesdays and Thursdays," and that changes, you know, before the app, they would have to try to figure out how to call in, get a hold of somebody, you know, get some updates made in the system. Now they can self-serve in that respect and make some of those changes which should open up and then allow them to take more shifts or maybe see, you know, a higher number of hours which, you know, we hear from a lot of our caregivers that they're looking for. I think the last thing is, you know, we are able to kinda push what we call flex hours out through the app. If they are looking for more work, more hours, you know, we can let them know, "Hey, here are some shifts that are available." Maybe there's, you know, in proximity to maybe where they're, you know, already scheduled for another shift. They can choose to accept that and say, "Yes, I would like to take that shift." That's where really the component on the fill rate comes in, you know, 'cause as you know, our business on that side is largely a logistics business. You know, the number of hours that we're authorized, you know, we wanna try to do everything we can to fill as many of those hours as we can. You know, someone at the state has done an assessment and determined those patients need that level of care. You know, we should try to meet that as much as we can. We'll never be probably at 100%, but, you know, how can we make some improvements there? I think through Illinois and the rollout of the app, you know, we saw those fill rates, which is kinda what we call the difference between, you know, what we serve and what's authorized, you know, we were running in the low 80% range. You know, we saw that move up into the upper 80% range over a period of time. Probably took six, seven, you know, eight months to kinda see us gradually get to that point and kinda plateau, and that's where we've kinda been since. Our hope is if we can, you know, roll out the caregiver app in other markets. We're rolling it out concurrently in New Mexico and Texas, which are our next two largest markets, you know, we'll see a similar impact. You know, those two states were probably similar. They probably hover closer to the 80% range. Can we see them, you know, get up into the mid, maybe even upper 80s? You know, that should be helpful when you kinda look at our hours per census that we report. We've seen some nice improvement there. I think pre-COVID, you know, we were probably in that 80% range. I think through COVID, that definitely dropped. We saw, you know, probably on a consolidated basis, you know, we were probably in the mid- to upper 70s. I think we're now back in, on a consolidated basis, in the low 80s. So we made some improvement, but we think there's still maybe some more headroom and more opportunity there. I thought I heard in the past you make a comment that the way the states are set up, the opportunity in Texas is actually a little bit more than what you see in New Mexico. You know, if I'm not correct, please let me know. Assuming I am, why is it a bigger opportunity in Texas just in terms of how they're structured? Yeah. I think it's just technology. In New Mexico, you know, we're required on electronic visit verification. New Mexico requires all providers to go through their preselected vendor, which is AuthentiCare. So all time communication, everything has to go in and out of that state-run system. So we have to be in sync with that. Probably puts a little bit, you know, of a burden on us. We can't really push the flex hours component out because it can't go through the AuthentiCare system, so it prevents us from doing that. They can still get the rest of the functionality from the app on scheduling, availability, transparency, all of those things. Texas, we're able to use our own EVV system, similar to how we do in Illinois, so the functionality should be exactly the same there. Probably just a little bit less so in New Mexico just because of the nature of what they require us to do on their EVV system. Got it. All right. I don't wanna totally ignore the clinical side of the business. So for hospice and home health, Dirk, you know, can you give us a quick recap in terms of just how those businesses have been performing? Then maybe give us some aspirational comments in terms of what are your goals for the clinical side of the business over the next couple of years? Yeah. You know, hospice itself, as I mentioned earlier in the call, we spent a lot of time getting that back to where it needs to be. We all have hospice backgrounds, and so it's a business that we feel makes a lot of sense for our not only our hospice patients, but the opportunity for our personal care patients that may need that care later to move up to that level of care. So that's been a real focus of ours. I'm very pleased with that process. It's been a little more difficult in home health. We're smaller, but we look at home health a little different maybe than our freestanding home health company. That is, you know, for us, home health is really kind of an add-on to our personal care, which allows us in markets where we're working with payers to do value-based care. It gives us a small clinical component to sit on top of the first in the door non-clinical component to meet the needs of those payers that need value-based care. But also we found in the overlap markets, specifically New Mexico, where we've been there the longest, that 25% of our hospice admissions or so come directly from our home health. If you look at home health itself, it may not be that profitable. I mean, it makes money, but, you know, the growth has not been quite as good in the last year. What it's done, it's really been a nice feeder into the growth on our hospice side. Going forward, I think what you'll see, we'll take the opportunity in those markets that we have personal care to add small home health presence, and really try to lead that into a hospice presence. Right now, we have three markets where we have all three levels of care. We'd like to add to those markets. Right now, the real issue is the valuation in the hospice market. As you probably know, there's some larger private hospice providers coming up for sale later this year. PE firms are willing to pay a lot more money than we are, and so it's difficult for us to get a return as a company that we need, when that is still out there. Now, that tends to change, so eventually maybe that will come back. We were able to get into the hospice business a few years back at probably 12, 13 multiple, which we could make do very well. We'll continue to look at that. You'll probably continue to see us. Right now, we're at 25% clinical. I'd say we'll be between 25% and 30% clinical, but mostly we'll be, you know, our main focus is the non-clinical personal care side. Got it. Maybe the last kind of question here with the last minute. I think, you know, I think your shareholders appreciate just how disciplined you've been on M&A. I know it's an important growth driver given how fragmented. You know, you're always focused on sort of the disciplined approach, I think has been well appreciated. With that said, I'd love to hear just sort of what you're seeing in the pipeline, including on the personal care side. Brian, Dirk, you mentioned a little bit on the hospice side, but any comments in terms of just what's in the market or what do you think will come to market? Yeah, man, I think, you know, I think where we've been kind of seeing the market this year and we've kind of indicated we think probably early part of this year is gonna be more similar type projects than we closed in 2025. Primarily personal care, you know, probably on the smaller side, you know, $10 million-$15 million in revenue are probably the things that we're looking at mostly in markets that we're in. Creating some additional density. We think there's still a lot of opportunity there. You know, those multiples tend to be usually pretty low, you know, mid-single digits, maybe tick up a little bit depending on, you know, size and scale. It's a nicely accretive deals. We've kind of intimated that we are aware of there are a couple of, you know, larger, potentially multi-state, you know, personal care businesses that may be in the market. We think, you know, mid till later this year based on our information, that would be interesting for us. You know, obviously from our perspective, you know, we're sitting in a pretty good spot from a capital, you know, position. We think we are able to be flexible and move very quickly if there are some larger deals that make sense for us. I think a few years ago, you might have seen some similar deals, but they all tended to have, you know, geographies that weren't attractive to us, primarily, you know, New York and those areas. The ones we're kind of looking at that might be available, you know, are not gonna have those kind of issues. Could be something that we definitely would be involved in. I think on the clinical side, you know, if we can find hospice on the smaller side at reasonable multiples, we would love to do those. You know, probably more likely you'll see us if we add more hospice, probably come through maybe a deal that has other service lines involved as well like we did in, you know, Tennessee, and Pennsylvania. You know, on the home health side, you know, if it makes sense where we have personal care and/or hospice, back to Dirk's comments about some of the revenue synergy. You know, if we can find things on the smaller side at good, you know, inexpensive multiples where we have those service lines, those are things that obviously we'll continue to look at as well. Got it. We will certainly stay tuned. Brian and Dirk, really appreciate you being here. Thanks a lot, and I think we can go ahead and conclude it there. Thanks. Appreciate it.

Speaker 3: Good morning. Welcome back to KeyBanc's Healthcare Forum. My name is Matthew Gillmor, and I lead healthcare equity research coverage for KeyBanc. Joining me on screen is Addus HomeCare CEO Dirk Allison and CFO Brian Poff. Addus is a leading provider of home care services focused on personal care, home health, and hospice. This will be a fireside chat presentation, so I'll lead the Q&A, but feel free to submit questions through the dialogue box, or you can just email me or message me. With that, Dirk and Brian, welcome, and thanks for being here. Good morning. good morning Welcome back to KeyBanc's Healthcare Forum. welcome back to keybanc's healthcare forum My name is Matthew Gillmor, and I lead healthcare equity research coverage for KeyBanc. my name is matthew gillmor and i lead healthcare equity research coverage for keybanc Joining me on screen is Addus HomeCare CEO Dirk Allison and CFO Brian Poff. joining me on screen is addus homecare ceo dirk allison and cfo brian poff Addus is a leading provider of home care services focused on personal care, home health, and hospice. addus is a leading provider of home care services focused on personal care home health and hospice This will be a fireside chat presentation, so I'll lead the Q&A, but feel free to submit questions through the dialogue box, or you can just email me or message me. this will be a fireside chat presentation so i'll lead the q&a but feel free to submit questions through the dialogue box or you can just email me or message me With that, Dirk and Brian, welcome, and thanks for being here. with that dirk and brian welcome and thanks for being here

Speaker 2: Thanks a lot. Appreciate it, Matt. Thanks a lot. thanks a lot Appreciate it, Matt. appreciate it matt

Speaker 3: I thought we might start off with sort of a state of the union question, a little bit of a review on 2025 and what are you focused on for 2026. So just catch us up on what some of the key performance drivers were for last year. Were there any challenges that emerged that you had to overcome? What are the things you're focused on in 2026 that are new or different compared to last year? I thought we might start off with sort of a state of the union question, a little bit of a review on 2025 and what are you focused on for 2026. i thought we might start off with sort of a state of the union question a little bit of a review on 2025 and what are you focused on for 2026 So just catch us up on what some of the key performance drivers were for last year. so just catch us up on what some of the key performance drivers were for last year Were there any challenges that emerged that you had to overcome? were there any challenges that emerged that you had to overcome What are the things you're focused on in 2026 that are new or different compared to last year? what are the things you're focused on in 2026 that are new or different compared to last year

Speaker 2: Well, you know, one of the things we really started focusing on early in 2025 was our hospice division, our hospice segment. We had made some investments starting in October the previous year and leadership changes and sales and marketing, training. We spent that year really focused on getting that business back to where we thought it was before the pandemic came in. We saw some really good progress in 2025, so we were pretty excited about that. The leadership continues to do a good job. We'll see as we move into 2026 with our hospice division. I think what, you know, if you really wanna talk about 2025 and kind of in focusing on personal care, we saw a couple of things that we have to deal with now. Well, you know, one of the things we really started focusing on early in 2025 was our hospice division, our hospice segment. well you know one of the things we really started focusing on early in 2025 was our hospice division our hospice segment We had made some investments starting in October the previous year and leadership changes and sales and marketing, training. we had made some investments starting in october the previous year and leadership changes and sales and marketing training We spent that year really focused on getting that business back to where we thought it was before the pandemic came in. we spent that year really focused on getting that business back to where we thought it was before the pandemic came in We saw some really good progress in 2025, so we were pretty excited about that. we saw some really good progress in 2025 so we were pretty excited about that The leadership continues to do a good job. the leadership continues to do a good job We'll see as we move into 2026 with our hospice division. we'll see as we move into 2026 with our hospice division I think what, you know, if you really wanna talk about 2025 and kind of in focusing on personal care, we saw a couple of things that we have to deal with now. i think what you know if you really wanna talk about 2025 and kind of in focusing on personal care we saw a couple of things that we have to deal with now One is, we saw a renewed focus on the need to start growing census. You know, again, I wanna make sure people understand that census itself is not the driver of profitability or performance in our business, it's hours. Really maximizing hours per client is the big driver. There is a point in time where you have to start adding new census to your portfolio. As we look at it, we have to add the right people. That's one of the focus we've looked at. We don't just wanna add census 'cause, you know, if you add somebody with very low hours, that's very difficult to work with and to staff. If you can bring people on with the more normal hours, that's the census you wanna drive. One is, we saw a renewed focus on the need to start growing census. one is we saw a renewed focus on the need to start growing census You know, again, I wanna make sure people understand that census itself is not the driver of profitability or performance in our business, it's hours. you know again i wanna make sure people understand that census itself is not the driver of profitability or performance in our business it's hours Really maximizing hours per client is the big driver. really maximizing hours per client is the big driver There is a point in time where you have to start adding new census to your portfolio. there is a point in time where you have to start adding new census to your portfolio As we look at it, we have to add the right people. as we look at it we have to add the right people That's one of the focus we've looked at. that's one of the focus we've looked at We don't just wanna add census 'cause, you know, if you add somebody with very low hours, that's very difficult to work with and to staff. we don't just wanna add census 'cause you know if you add somebody with very low hours that's very difficult to work with and to staff If you can bring people on with the more normal hours, that's the census you wanna drive. if you can bring people on with the more normal hours that's the census you wanna drive That was a challenge in 2025 that we have worked on and continued to work on in just the beginning of 2026. Then obviously the biggest challenge we probably faced that year was the new Trump administration coming out and deciding that they wanted to look at the Medicaid program and make some changes and try to save some money for their tax reduction bill. Which proved to be, you know, not as much of a challenge for how we're gonna operate going forward and what it's gonna mean to the company, but a challenge to understand it and then to determine how it affected the company and what we do. That was a challenge in 2025 that we have worked on and continued to work on in just the beginning of 2026. that was a challenge in 2025 that we have worked on and continued to work on in just the beginning of 2026 Then obviously the biggest challenge we probably faced that year was the new Trump administration coming out and deciding that they wanted to look at the Medicaid program and make some changes and try to save some money for their tax reduction bill. then obviously the biggest challenge we probably faced that year was the new trump administration coming out and deciding that they wanted to look at the medicaid program and make some changes and try to save some money for their tax reduction bill Which proved to be, you know, not as much of a challenge for how we're gonna operate going forward and what it's gonna mean to the company, but a challenge to understand it and then to determine how it affected the company and what we do. which proved to be you know not as much of a challenge for how we're gonna operate going forward and what it's gonna mean to the company but a challenge to understand it and then to determine how it affected the company and what we do I think those are the biggest issues we faced in 2025, and we will continue to, you know, talk about those into 2026. I think those are the biggest issues we faced in 2025, and we will continue to, you know, talk about those into 2026. i think those are the biggest issues we faced in 2025 and we will continue to you know talk about those into 2026

Speaker 3: Got it. Why don't I follow up on the personal care census topic that you mentioned. You know, I think we're starting to anniversary some of the redetermination pressures that impacted you all last year. Just kinda catch us up in terms of how census growth progressed sequentially through 2025, and any trends you're seeing in your key states to call out, and really just kind of the level of confidence that we'll get back to same-store census growth as we move into 2026. Got it. got it Why don't I follow up on the personal care census topic that you mentioned. why don't i follow up on the personal care census topic that you mentioned You know, I think we're starting to anniversary some of the redetermination pressures that impacted you all last year. you know i think we're starting to anniversary some of the redetermination pressures that impacted you all last year Just kinda catch us up in terms of how census growth progressed sequentially through 2025, and any trends you're seeing in your key states to call out, and really just kind of the level of confidence that we'll get back to same-store census growth as we move into 2026. just kinda catch us up in terms of how census growth progressed sequentially through 2025 and any trends you're seeing in your key states to call out and really just kind of the level of confidence that we'll get back to same-store census growth as we move into 2026

Speaker 2: Yeah. That really if you focus on our same-store census growth, there's three markets that make up the biggest move in that particular metric, and that is, Illinois, Texas, and New Mexico are our top three markets. About 70% of our personal care business. Each of those states, at different times and with different results, went through the required Biden redetermination process that started occurring a couple years ago. The states, you know, didn't have a lot of leeway into getting ready for that. It came kinda quickly. I'm not sure they were as prepared as they will be for maybe some of the changes coming up in 2028, 2029 down the road with some of the OBRA changes. Yeah. yeah That really if you focus on our same-store census growth, there's three markets that make up the biggest move in that particular metric, and that is, Illinois, Texas, and New Mexico are our top three markets. that really if you focus on our same-store census growth there's three markets that make up the biggest move in that particular metric and that is illinois texas and new mexico are our top three markets About 70% of our personal care business. about 70% of our personal care business Each of those states, at different times and with different results, went through the required Biden redetermination process that started occurring a couple years ago. each of those states at different times and with different results went through the required biden redetermination process that started occurring a couple years ago The states, you know, didn't have a lot of leeway into getting ready for that. the states you know didn't have a lot of leeway into getting ready for that It came kinda quickly. it came kinda quickly I'm not sure they were as prepared as they will be for maybe some of the changes coming up in 2028, 2029 down the road with some of the OBRA changes. i'm not sure they were as prepared as they will be for maybe some of the changes coming up in 2028 2029 down the road with some of the obra changes What we saw in all three markets at different times were the two key metrics we look at, starts of care and discharges, and what happened to them. Normally, your starts of care exceed your discharges, and that's what leads to your census growth. We saw first in New Mexico and really Texas, probably New Mexico first, followed pretty closely by Texas, where that metric flipped. We were still seeing normal discharges because just the normal lifespan of patients and where they moved continued on without effect. It's bringing new patients in which is dependent on the state to go out and to review the application for the new client and to authorize their hours and then pass them on to us. What we saw in all three markets at different times were the two key metrics we look at, starts of care and discharges, and what happened to them. what we saw in all three markets at different times were the two key metrics we look at starts of care and discharges and what happened to them Normally, your starts of care exceed your discharges, and that's what leads to your census growth. normally your starts of care exceed your discharges and that's what leads to your census growth We saw first in New Mexico and really Texas, probably New Mexico first, followed pretty closely by Texas, where that metric flipped. we saw first in new mexico and really texas probably new mexico first followed pretty closely by texas where that metric flipped We were still seeing normal discharges because just the normal lifespan of patients and where they moved continued on without effect. we were still seeing normal discharges because just the normal lifespan of patients and where they moved continued on without effect It's bringing new patients in which is dependent on the state to go out and to review the application for the new client and to authorize their hours and then pass them on to us. it's bringing new patients in which is dependent on the state to go out and to review the application for the new client and to authorize their hours and then pass them on to us That is the part that got slowed down pretty dramatically during the redetermination. Both of those went negative in Texas and New Mexico. Starting early last year, New Mexico flipped. We started seeing starts of care get back to where it normally was and discharges staying where they were, and so we started seeing census growth in New Mexico. Texas probably was a few months behind that, but we flipped that probably in, I don't know, Brian, mid-year, third quarter, where Texas, starts of care started exceeding. Then the last one, for whatever reason, you know, obviously Illinois is our biggest market, and it took a little longer in Illinois to get the process more back to what we would consider a normal cadence of growth in the market. That is the part that got slowed down pretty dramatically during the redetermination. that is the part that got slowed down pretty dramatically during the redetermination Both of those went negative in Texas and New Mexico. both of those went negative in texas and new mexico Starting early last year, New Mexico flipped. starting early last year new mexico flipped We started seeing starts of care get back to where it normally was and discharges staying where they were, and so we started seeing census growth in New Mexico. we started seeing starts of care get back to where it normally was and discharges staying where they were and so we started seeing census growth in new mexico Texas probably was a few months behind that, but we flipped that probably in, I don't know, Brian, mid-year, third quarter, where Texas, starts of care started exceeding. texas probably was a few months behind that but we flipped that probably in i don't know brian mid-year third quarter where texas starts of care started exceeding Then the last one, for whatever reason, you know, obviously Illinois is our biggest market, and it took a little longer in Illinois to get the process more back to what we would consider a normal cadence of growth in the market. then the last one for whatever reason you know obviously illinois is our biggest market and it took a little longer in illinois to get the process more back to what we would consider a normal cadence of growth in the market For a period of time, even up through the end of the fourth quarter, we saw discharges remain very steady, which was good. At the same time, starts of care were a little delayed in getting back to where they exceeded that particular metric. Coming into the first quarter, we started to see that flip in the first month. I think we mentioned we got hit with a little bit of weather. We were talking earlier about the snow and the ice that went across the country, and we were probably affected for a week or two on a number of our sites. That delayed it. Starting in mid-February and early March so far, we've now seen that metric switch. For a period of time, even up through the end of the fourth quarter, we saw discharges remain very steady, which was good. for a period of time even up through the end of the fourth quarter we saw discharges remain very steady which was good At the same time, starts of care were a little delayed in getting back to where they exceeded that particular metric. at the same time starts of care were a little delayed in getting back to where they exceeded that particular metric Coming into the first quarter, we started to see that flip in the first month. coming into the first quarter we started to see that flip in the first month I think we mentioned we got hit with a little bit of weather. i think we mentioned we got hit with a little bit of weather We were talking earlier about the snow and the ice that went across the country, and we were probably affected for a week or two on a number of our sites. we were talking earlier about the snow and the ice that went across the country and we were probably affected for a week or two on a number of our sites That delayed it. that delayed it Starting in mid-February and early March so far, we've now seen that metric switch. starting in mid-february and early march so far we've now seen that metric switch Illinois has now started to where their starts of care is creeping back over their discharges. Our belief is, by the second quarter, maybe the first quarter, but certainly the second quarter, you ought to see continue to see sequential census growth as we've had up until the fourth quarter when the holidays caused a little blip. Going forward, we'll be coming around on some comps. I think when we talked on our Q&A in the first quarter, when we talked about the last half of 2026, I think that's more of the comps of coming around year-over-year growth versus what we anticipate will continue to be sequential growth until that time. Illinois has now started to where their starts of care is creeping back over their discharges. illinois has now started to where their starts of care is creeping back over their discharges Our belief is, by the second quarter, maybe the first quarter, but certainly the second quarter, you ought to see continue to see sequential census growth as we've had up until the fourth quarter when the holidays caused a little blip. our belief is by the second quarter maybe the first quarter but certainly the second quarter you ought to see continue to see sequential census growth as we've had up until the fourth quarter when the holidays caused a little blip Going forward, we'll be coming around on some comps. going forward we'll be coming around on some comps I think when we talked on our Q&A in the first quarter, when we talked about the last half of 2026, I think that's more of the comps of coming around year-over-year growth versus what we anticipate will continue to be sequential growth until that time. i think when we talked on our q&a in the first quarter when we talked about the last half of 2026 i think that's more of the comps of coming around year-over-year growth versus what we anticipate will continue to be sequential growth until that time

Speaker 3: Got it. Then I wanted to flip over to some of the rate environment questions and sort of fold in some of the regulatory topics that you had referenced earlier. Before we get into some of the details, I just wanted to take a step back, and I think we've seen pretty supportive rate increases across your key states. You know, one thing I just wanted to hear from you is how do you all communicate the value that you're delivering to the stakeholders in those states? What's their general view of personal care and the value that personal care delivers to the healthcare system? Got it. got it Then I wanted to flip over to some of the rate environment questions and sort of fold in some of the regulatory topics that you had referenced earlier. then i wanted to flip over to some of the rate environment questions and sort of fold in some of the regulatory topics that you had referenced earlier Before we get into some of the details, I just wanted to take a step back, and I think we've seen pretty supportive rate increases across your key states. before we get into some of the details i just wanted to take a step back and i think we've seen pretty supportive rate increases across your key states You know, one thing I just wanted to hear from you is how do you all communicate the value that you're delivering to the stakeholders in those states? you know one thing i just wanted to hear from you is how do you all communicate the value that you're delivering to the stakeholders in those states What's their general view of personal care and the value that personal care delivers to the healthcare system? what's their general view of personal care and the value that personal care delivers to the healthcare system

Speaker 2: I'll jump in here and start, Brian, you can add too. You know, one of the things that we've worked for the last 10 years, it's been a long-term effort, not only developing lobbying and relationships with the state, but also the real economic discussion of why home care makes sense. If you think in terms of all states, let's take New York, which we're no longer in, aside because it doesn't apply necessarily for that market. Every other market we're in, if you look at the hours [procured] that we undertake for these home-based care patients, it saves the state money as opposed to going into a nursing home. I'll jump in here and start, Brian, you can add too. i'll jump in here and start brian you can add too You know, one of the things that we've worked for the last 10 years, it's been a long-term effort, not only developing lobbying and relationships with the state, but also the real economic discussion of why home care makes sense. you know one of the things that we've worked for the last 10 years it's been a long-term effort not only developing lobbying and relationships with the state but also the real economic discussion of why home care makes sense If you think in terms of all states, let's take New York, which we're no longer in, aside because it doesn't apply necessarily for that market. if you think in terms of all states let's take new york which we're no longer in aside because it doesn't apply necessarily for that market Every other market we're in, if you look at the hours [procured] that we undertake for these home-based care patients, it saves the state money as opposed to going into a nursing home. every other market we're in if you look at the hours [procured] that we undertake for these home-based care patients it saves the state money as opposed to going into a nursing home It's two to 3x the cost to take a patient that can remain at home under personal care. If you take that situation away from them, they are gonna need to go into facility-based care because, you know, again, when you need help with activities of daily living, whether that's dressing, eating, running light errands, you're not, as an elderly patient, if you don't have that this year, you're generally not gonna get that back next year. It's a permanent situation. Same with disabled patients. It's two to 3x the cost to take a patient that can remain at home under personal care. it's two to 3x the cost to take a patient that can remain at home under personal care If you take that situation away from them, they are gonna need to go into facility-based care because, you know, again, when you need help with activities of daily living, whether that's dressing, eating, running light errands, you're not, as an elderly patient, if you don't have that this year, you're generally not gonna get that back next year. if you take that situation away from them they are gonna need to go into facility-based care because you know again when you need help with activities of daily living whether that's dressing eating running light errands you're not as an elderly patient if you don't have that this year you're generally not gonna get that back next year It's a permanent situation. it's a permanent situation Same with disabled patients. same with disabled patients From our standpoint, one of the things we continue to talk to the states about, and now also with the Medicaid payers out there too, is the value of the service, not only from the standpoint of what the particular person or family want, which is to be in their home, but also from the standpoint of saving the state or the payer money. Because at the end of the day, as I said, if you've got limited Medicaid dollars and you're trying to take care of this high-cost population base, if you can do that in a setting such as personal care, which is much less expensive than SNFs, then it makes sense to do that. That's the message we have talked to. From our standpoint, one of the things we continue to talk to the states about, and now also with the Medicaid payers out there too, is the value of the service, not only from the standpoint of what the particular person or family want, which is to be in their home, but also from the standpoint of saving the state or the payer money. from our standpoint one of the things we continue to talk to the states about and now also with the medicaid payers out there too is the value of the service not only from the standpoint of what the particular person or family want which is to be in their home but also from the standpoint of saving the state or the payer money Because at the end of the day, as I said, if you've got limited Medicaid dollars and you're trying to take care of this high-cost population base, if you can do that in a setting such as personal care, which is much less expensive than SNFs, then it makes sense to do that. because at the end of the day as i said if you've got limited medicaid dollars and you're trying to take care of this high-cost population base if you can do that in a setting such as personal care which is much less expensive than snfs then it makes sense to do that That's the message we have talked to. that's the message we have talked to We've talked to Illinois about that for years, and they really appreciate it, and they understand it probably as well as anybody. Then, of course, as we've been in other states and now as we're in Texas, we're doing the same type process, using our lobbyists, using our relationships to talk about the value-based approach we have with that service level. We've talked to Illinois about that for years, and they really appreciate it, and they understand it probably as well as anybody. we've talked to illinois about that for years and they really appreciate it and they understand it probably as well as anybody Then, of course, as we've been in other states and now as we're in Texas, we're doing the same type process, using our lobbyists, using our relationships to talk about the value-based approach we have with that service level. then of course as we've been in other states and now as we're in texas we're doing the same type process using our lobbyists using our relationships to talk about the value-based approach we have with that service level

Speaker 3: That's great. Why don't we focus on the rates themselves. We know you got a rate update in Texas, I think that started September 1, and then a rate update in Illinois, January 1. What are you seeing in terms of some other states as you're looking out to the next state fiscal year? I think there was some news out of New Mexico, but you know, what are you hearing out of Illinois and sort of where they stand in their budgetary process? That's great. that's great Why don't we focus on the rates themselves. why don't we focus on the rates themselves We know you got a rate update in Texas, I think that started September 1, and then a rate update in Illinois, January 1. we know you got a rate update in texas i think that started september 1 and then a rate update in illinois january 1 What are you seeing in terms of some other states as you're looking out to the next state fiscal year? what are you seeing in terms of some other states as you're looking out to the next state fiscal year I think there was some news out of New Mexico, but you know, what are you hearing out of Illinois and sort of where they stand in their budgetary process? i think there was some news out of new mexico but you know what are you hearing out of illinois and sort of where they stand in their budgetary process

Speaker 1: Yeah, Matt, I think obviously the larger states are key for us, and we've gotten really good support from them over the years. You know, Texas, as they meet every two years, they've given us a rate increase, you know, each of the last two cycles. Illinois has been pretty consistent. I think last year we didn't necessarily anticipate them giving us an increase, and then we got something right at the end of their session. You know, where they sit today, you know, Governor Pritzker put out his kind of initial budget in February, did not have a rate increase in there for us this year. That's consistent with what we saw from him on the initial budget last year. Their session, what will continue, they usually finalize their budget. Yeah, Matt, I think obviously the larger states are key for us, and we've gotten really good support from them over the years. yeah matt i think obviously the larger states are key for us and we've gotten really good support from them over the years You know, Texas, as they meet every two years, they've given us a rate increase, you know, each of the last two cycles. you know texas as they meet every two years they've given us a rate increase you know each of the last two cycles Illinois has been pretty consistent. illinois has been pretty consistent I think last year we didn't necessarily anticipate them giving us an increase, and then we got something right at the end of their session. i think last year we didn't necessarily anticipate them giving us an increase and then we got something right at the end of their session You know, where they sit today, you know, Governor Pritzker put out his kind of initial budget in February, did not have a rate increase in there for us this year. you know where they sit today you know governor pritzker put out his kind of initial budget in february did not have a rate increase in there for us this year That's consistent with what we saw from him on the initial budget last year. that's consistent with what we saw from him on the initial budget last year Their session, what will continue, they usually finalize their budget. their session what will continue they usually finalize their budget They're a July first fiscal, so they usually finalize in the kinda April, May timeframe. We're not necessarily anticipating anything. Obviously, we'll continue to watch. I think in Illinois, one thing that probably works well for us is the union there is usually a pretty good lobbying arm as well. Every year, you know, they do have conversations and push for increases in reimbursement, which will benefit obviously their members. Our understanding is, you know, they're having those conversations again this year, but you know, we'll wait and see what happens. Again, I would say today we would probably not anticipate getting something this year. That probably makes sense from where they are. You know, Texas, we talked about. New Mexico, you know, we did get some information last year. They're a July first fiscal, so they usually finalize in the kinda April, May timeframe. they're a july first fiscal so they usually finalize in the kinda april may timeframe We're not necessarily anticipating anything. we're not necessarily anticipating anything Obviously, we'll continue to watch. obviously we'll continue to watch I think in Illinois, one thing that probably works well for us is the union there is usually a pretty good lobbying arm as well. i think in illinois one thing that probably works well for us is the union there is usually a pretty good lobbying arm as well Every year, you know, they do have conversations and push for increases in reimbursement, which will benefit obviously their members. every year you know they do have conversations and push for increases in reimbursement which will benefit obviously their members Our understanding is, you know, they're having those conversations again this year, but you know, we'll wait and see what happens. our understanding is you know they're having those conversations again this year but you know we'll wait and see what happens Again, I would say today we would probably not anticipate getting something this year. again i would say today we would probably not anticipate getting something this year That probably makes sense from where they are. that probably makes sense from where they are You know, Texas, we talked about. you know texas we talked about New Mexico, you know, we did get some information last year. new mexico you know we did get some information last year You know, they were talking about a rate increase kinda around the time that OB3 was in flux, and so they decided to hold kinda status quo last year. We were hopeful that meant this year with everything being kinda settled, you know, maybe they would readdress that, and it seems like they did. They've passed a rate increase for us. The governor, I believe, has signed it. We think it'll be around 4% for us. We're still trying to get some of the details, which should be effective July first. That's the New Mexico fiscal year as well. We'll get some support from that, you know, toward the back half of this year. You know, they were talking about a rate increase kinda around the time that OB3 was in flux, and so they decided to hold kinda status quo last year. you know they were talking about a rate increase kinda around the time that ob3 was in flux and so they decided to hold kinda status quo last year We were hopeful that meant this year with everything being kinda settled, you know, maybe they would readdress that, and it seems like they did. we were hopeful that meant this year with everything being kinda settled you know maybe they would readdress that and it seems like they did They've passed a rate increase for us. they've passed a rate increase for us The governor, I believe, has signed it. the governor i believe has signed it We think it'll be around 4% for us. we think it'll be around 4% for us We're still trying to get some of the details, which should be effective July first. we're still trying to get some of the details which should be effective july first That's the New Mexico fiscal year as well. that's the new mexico fiscal year as well We'll get some support from that, you know, toward the back half of this year. we'll get some support from that you know toward the back half of this year You know, I think generally just talking about the rate environment, particularly in PCS, you know, we've gotten, again, really good strong rate support. We've been saying for the last few years we would expect that cadence to probably slow down some. You know, a lot of states have gotten, you know, to the point where we're able to pay our caregivers nicely ahead of minimum wage, in most markets that we're in today. I think, you know, back to your earlier question with Dirk around, you know, the states and valuing the service, I think we have seen states that have, you know, gone above and beyond in that respect, with the purpose of saying, "Hey, we can give you a additional reimbursement increase. You can pay your caregivers more. You know, I think generally just talking about the rate environment, particularly in PCS, you know, we've gotten, again, really good strong rate support. you know i think generally just talking about the rate environment particularly in pcs you know we've gotten again really good strong rate support We've been saying for the last few years we would expect that cadence to probably slow down some. we've been saying for the last few years we would expect that cadence to probably slow down some You know, a lot of states have gotten, you know, to the point where we're able to pay our caregivers nicely ahead of minimum wage, in most markets that we're in today. you know a lot of states have gotten you know to the point where we're able to pay our caregivers nicely ahead of minimum wage in most markets that we're in today I think, you know, back to your earlier question with Dirk around, you know, the states and valuing the service, I think we have seen states that have, you know, gone above and beyond in that respect, with the purpose of saying, "Hey, we can give you a additional reimbursement increase. i think you know back to your earlier question with dirk around you know the states and valuing the service i think we have seen states that have you know gone above and beyond in that respect with the purpose of saying "hey we can give you a additional reimbursement increase You can pay your caregivers more. you can pay your caregivers more That should help with your access to labor and get more people into the program, which should save the state money, because they don't go into an institutional setting. We think states are appreciating that, and we've seen that through some of the rate support over the last few years, and again, all conversations that we'll continue to have, going forward. That should help with your access to labor and get more people into the program, which should save the state money, because they don't go into an institutional setting. that should help with your access to labor and get more people into the program which should save the state money because they don't go into an institutional setting We think states are appreciating that, and we've seen that through some of the rate support over the last few years, and again, all conversations that we'll continue to have, going forward. we think states are appreciating that and we've seen that through some of the rate support over the last few years and again all conversations that we'll continue to have going forward

Speaker 3: That's great. I wanna hit on two kind of regulatory topics, and then we'll get back into the fundamentals of the business. I'm sure you're tired of answering some of these questions, but we thought it was important to hit on. The first one was just on some of the fraud, waste, and abuse headlines. I think investors are pretty well aware of these headlines and some of the initiatives that the administration has been talking about. I thought it might be useful for you all just to take a couple and talk about sort of your compliance processes and are there anything you're actually seeing, you know, on the ground level in terms of states increasing audits, that sort of thing? That's great. that's great I wanna hit on two kind of regulatory topics, and then we'll get back into the fundamentals of the business. i wanna hit on two kind of regulatory topics and then we'll get back into the fundamentals of the business I'm sure you're tired of answering some of these questions, but we thought it was important to hit on. i'm sure you're tired of answering some of these questions but we thought it was important to hit on The first one was just on some of the fraud, waste, and abuse headlines. the first one was just on some of the fraud waste and abuse headlines I think investors are pretty well aware of these headlines and some of the initiatives that the administration has been talking about. i think investors are pretty well aware of these headlines and some of the initiatives that the administration has been talking about I thought it might be useful for you all just to take a couple and talk about sort of your compliance processes and are there anything you're actually seeing, you know, on the ground level in terms of states increasing audits, that sort of thing? i thought it might be useful for you all just to take a couple and talk about sort of your compliance processes and are there anything you're actually seeing you know on the ground level in terms of states increasing audits that sort of thing

Speaker 2: You know, Matt, one of the things we did, again, this goes back to January of 2016, so this is quite a few years back. We came on board as a team and based on our history of operating in healthcare services, one of the things we knew we needed to do at Addus was have a very strong compliance program, which we think is key to operating in any healthcare segment. We today spend multimillion dollars a year on a team who is a very well-versed team. We do a lot of internal audits. We spend a lot of time making sure that what we bill is correct. You know, Matt, one of the things we did, again, this goes back to January of 2016, so this is quite a few years back. you know matt one of the things we did again this goes back to january of 2016 so this is quite a few years back We came on board as a team and based on our history of operating in healthcare services, one of the things we knew we needed to do at Addus was have a very strong compliance program, which we think is key to operating in any healthcare segment. we came on board as a team and based on our history of operating in healthcare services one of the things we knew we needed to do at addus was have a very strong compliance program which we think is key to operating in any healthcare segment We today spend multimillion dollars a year on a team who is a very well-versed team. we today spend multimillion dollars a year on a team who is a very well-versed team We do a lot of internal audits. we do a lot of internal audits We spend a lot of time making sure that what we bill is correct. we spend a lot of time making sure that what we bill is correct When we find those instances, which we occasionally do, where maybe some of the paperwork is not as supportive as we think it needs to be to be reimbursed, we will proactively reach out to the state and pay that back. For us, the focus on fraud and abuse, we're very supportive of. We think it makes absolute sense because you think in terms of waste, if we can get rid of whatever fraud abuse, I'm not sure how big it is, but there obviously is some out there, especially if you look at certain states. If we can get that out of the system as much as possible, that gives the states more dollars to pay for truly appropriate services that the Medicaid population really needs. When we find those instances, which we occasionally do, where maybe some of the paperwork is not as supportive as we think it needs to be to be reimbursed, we will proactively reach out to the state and pay that back. when we find those instances which we occasionally do where maybe some of the paperwork is not as supportive as we think it needs to be to be reimbursed we will proactively reach out to the state and pay that back For us, the focus on fraud and abuse, we're very supportive of. for us the focus on fraud and abuse we're very supportive of We think it makes absolute sense because you think in terms of waste, if we can get rid of whatever fraud abuse, I'm not sure how big it is, but there obviously is some out there, especially if you look at certain states. we think it makes absolute sense because you think in terms of waste if we can get rid of whatever fraud abuse i'm not sure how big it is but there obviously is some out there especially if you look at certain states If we can get that out of the system as much as possible, that gives the states more dollars to pay for truly appropriate services that the Medicaid population really needs. if we can get that out of the system as much as possible that gives the states more dollars to pay for truly appropriate services that the medicaid population really needs That's why we're very supportive of Medicaid fraud and abuse. It's why we as a company will continue to always make sure we put the proper resources in, following through to make sure that we're doing everything we can to follow the rules. Now, you know, healthcare's complicated, so there are always questions of sometimes there are things you have to make determinations on. We try to be on the side of a little bit conservative to make sure that we've not put ourself at risk. Really if you look at your second part of the question, have we seen any real moves, especially on the personal care side? Just talking about the non-clinical side, we've seen a few states do a few more reviews. That's why we're very supportive of Medicaid fraud and abuse. that's why we're very supportive of medicaid fraud and abuse It's why we as a company will continue to always make sure we put the proper resources in, following through to make sure that we're doing everything we can to follow the rules. it's why we as a company will continue to always make sure we put the proper resources in following through to make sure that we're doing everything we can to follow the rules Now, you know, healthcare's complicated, so there are always questions of sometimes there are things you have to make determinations on. now you know healthcare's complicated so there are always questions of sometimes there are things you have to make determinations on We try to be on the side of a little bit conservative to make sure that we've not put ourself at risk. we try to be on the side of a little bit conservative to make sure that we've not put ourself at risk Really if you look at your second part of the question, have we seen any real moves, especially on the personal care side? really if you look at your second part of the question have we seen any real moves especially on the personal care side Just talking about the non-clinical side, we've seen a few states do a few more reviews. just talking about the non-clinical side we've seen a few states do a few more reviews Nothing really out of the ordinary. If you go back at various times during the past 10 years, we've seen this cycle occur. I wouldn't say anything has changed in that side of the equation since, you know, the Trump administration started talking about fraud and abuse. Now, on the clinical side, especially as it relates to hospice, there is a lot of attention and has been a lot of attention over the last year plus on long length of stay patients. You know, making sure that the benefit level, which is really for those patients with six months of life left, based on what their physician says, that it's not being abused. That's something we've seen in all the years we've been in hospice, that cycles through. Nothing really out of the ordinary. nothing really out of the ordinary If you go back at various times during the past 10 years, we've seen this cycle occur. if you go back at various times during the past 10 years we've seen this cycle occur I wouldn't say anything has changed in that side of the equation since, you know, the Trump administration started talking about fraud and abuse. i wouldn't say anything has changed in that side of the equation since you know the trump administration started talking about fraud and abuse Now, on the clinical side, especially as it relates to hospice, there is a lot of attention and has been a lot of attention over the last year plus on long length of stay patients. now on the clinical side especially as it relates to hospice there is a lot of attention and has been a lot of attention over the last year plus on long length of stay patients You know, making sure that the benefit level, which is really for those patients with six months of life left, based on what their physician says, that it's not being abused. you know making sure that the benefit level which is really for those patients with six months of life left based on what their physician says that it's not being abused That's something we've seen in all the years we've been in hospice, that cycles through. that's something we've seen in all the years we've been in hospice that cycles through that's, while it is maybe a little higher than it's been over the last two or three years, it's nothing certainly out of the ordinary over the last number of years. nothing that we can point to directly that we've seen a dramatic change. that's, while it is maybe a little higher than it's been over the last two or three years, it's nothing certainly out of the ordinary over the last number of years. nothing that we can point to directly that we've seen a dramatic change. that's while it is maybe a little higher than it's been over the last two or three years it's nothing certainly out of the ordinary over the last number of years nothing that we can point to directly that we've seen a dramatic change

Speaker 3: As we're thinking about sort of maybe the derivative implications from this, I think one obvious one is this could put more pressure on smaller providers that then may wanna sell their business to Addus. I was kinda curious if you thought that was reasonable. The other area I was hoping for you to comment on is agency-directed versus self-directed. You know, would states be more interested in pushing people more to the agency-directed model where there's a bit more kinda control versus a self-directed model for personal care? As we're thinking about sort of maybe the derivative implications from this, I think one obvious one is this could put more pressure on smaller providers that then may wanna sell their business to Addus. as we're thinking about sort of maybe the derivative implications from this i think one obvious one is this could put more pressure on smaller providers that then may wanna sell their business to addus I was kinda curious if you thought that was reasonable. i was kinda curious if you thought that was reasonable The other area I was hoping for you to comment on is agency-directed versus self-directed. the other area i was hoping for you to comment on is agency-directed versus self-directed You know, would states be more interested in pushing people more to the agency-directed model where there's a bit more kinda control versus a self-directed model for personal care? you know would states be more interested in pushing people more to the agency-directed model where there's a bit more kinda control versus a self-directed model for personal care

Speaker 2: You know, if you really look at one of the states that the federal government's talking about is the state of California. In California, we used to be in an agency-directed model. Back about 12 years ago, the state decided through their Medi-Cal program to really get rid of agencies and go self-directed. The problem with self-directed care, it just allows for potential abuses of the system because now you have no one on the outside that's an independent agency looking to make sure that if you're supposed to provide three hours of care today, that you go in and actually provide it. There's nothing to guarantee that you just don't say you're billing the time and, you know, if you're in a situation where it's in certain situations, the patient may not complain. You know, if you really look at one of the states that the federal government's talking about is the state of California. you know if you really look at one of the states that the federal government's talking about is the state of california In California, we used to be in an agency-directed model. in california we used to be in an agency-directed model Back about 12 years ago, the state decided through their Medi-Cal program to really get rid of agencies and go self-directed. back about 12 years ago the state decided through their medi-cal program to really get rid of agencies and go self-directed The problem with self-directed care, it just allows for potential abuses of the system because now you have no one on the outside that's an independent agency looking to make sure that if you're supposed to provide three hours of care today, that you go in and actually provide it. the problem with self-directed care it just allows for potential abuses of the system because now you have no one on the outside that's an independent agency looking to make sure that if you're supposed to provide three hours of care today that you go in and actually provide it There's nothing to guarantee that you just don't say you're billing the time and, you know, if you're in a situation where it's in certain situations, the patient may not complain. there's nothing to guarantee that you just don't say you're billing the time and you know if you're in a situation where it's in certain situations the patient may not complain We firmly believe and have always believed that self-directed care is much more open for abuse than agency-based care and have been supportive of that over our timeframe. I think a lot of states appreciate that. Very few states have gone like California has, where they've really pushed to move totally to self-directed care. For us, having the ability to look at an Addus and say, "Okay, you're gonna be responsible for supervisory visits to make sure these things are happening. We're gonna hold you accountable for that." We're gonna make sure that you're making sure folks are there at the appropriate level of care and following the plan of care. I think those are all very important aspects as it relates to self-directed care. We firmly believe and have always believed that self-directed care is much more open for abuse than agency-based care and have been supportive of that over our timeframe. we firmly believe and have always believed that self-directed care is much more open for abuse than agency-based care and have been supportive of that over our timeframe I think a lot of states appreciate that. i think a lot of states appreciate that Very few states have gone like California has, where they've really pushed to move totally to self-directed care. very few states have gone like california has where they've really pushed to move totally to self-directed care For us, having the ability to look at an Addus and say, "Okay, you're gonna be responsible for supervisory visits to make sure these things are happening. for us having the ability to look at an addus and say "okay you're gonna be responsible for supervisory visits to make sure these things are happening We're gonna hold you accountable for that." We're gonna make sure that you're making sure folks are there at the appropriate level of care and following the plan of care. we're gonna hold you accountable for that." we're gonna make sure that you're making sure folks are there at the appropriate level of care and following the plan of care I think those are all very important aspects as it relates to self-directed care. i think those are all very important aspects as it relates to self-directed care As far as your first part of the question, which talked about what this might mean for smaller providers, I think any time things change, where you're gonna have as a company, you're gonna put more resources into operating the business, there'll be some folks that can do that and will do that. There'll be others that maybe don't have the resources or maybe, quite frankly, they've been in the business a long time, and it's a real change for them, and they've decided that, maybe it's time to leave the business as opposed to try to make some of these changes that could be affected to their operations. We do expect over time. As far as your first part of the question, which talked about what this might mean for smaller providers, I think any time things change, where you're gonna have as a company, you're gonna put more resources into operating the business, there'll be some folks that can do that and will do that. as far as your first part of the question which talked about what this might mean for smaller providers i think any time things change where you're gonna have as a company you're gonna put more resources into operating the business there'll be some folks that can do that and will do that There'll be others that maybe don't have the resources or maybe, quite frankly, they've been in the business a long time, and it's a real change for them, and they've decided that, maybe it's time to leave the business as opposed to try to make some of these changes that could be affected to their operations. there'll be others that maybe don't have the resources or maybe quite frankly they've been in the business a long time and it's a real change for them and they've decided that maybe it's time to leave the business as opposed to try to make some of these changes that could be affected to their operations We do expect over time. we do expect over time Right now, it's really early in the process, but as some of these things come through, there may be some potential for some of the smaller mom-and-pops to decide that it's time to get out. Obviously, as Addus has said, we're a, you know, we're certainly an acquirer and would love to look at those. We'll continue to be available if those opportunities arise. Right now, it's really early in the process, but as some of these things come through, there may be some potential for some of the smaller mom-and-pops to decide that it's time to get out. right now it's really early in the process but as some of these things come through there may be some potential for some of the smaller mom-and-pops to decide that it's time to get out Obviously, as Addus has said, we're a, you know, we're certainly an acquirer and would love to look at those. obviously as addus has said we're a you know we're certainly an acquirer and would love to look at those We'll continue to be available if those opportunities arise. we'll continue to be available if those opportunities arise

Speaker 3: Great. Well, let me ask about the Big Beautiful Bill. You know, I think there's been obviously some investor questions around what the implications are from Addus. I think from our perspective, it seems like there's no direct implications at all, whether you're thinking about work requirements or provider tax cuts. There could be some indirect implications, and I think that's what investors are sort of worried about, or that's what's in the back of their mind. I wanted to see if at this point, are you sort of hearing anything from states in terms of if there is funding pressure from lower provider taxes, how that may flow through the system? Great. great Well, let me ask about the Big Beautiful Bill. well let me ask about the big beautiful bill You know, I think there's been obviously some investor questions around what the implications are from Addus. you know i think there's been obviously some investor questions around what the implications are from addus I think from our perspective, it seems like there's no direct implications at all, whether you're thinking about work requirements or provider tax cuts. i think from our perspective it seems like there's no direct implications at all whether you're thinking about work requirements or provider tax cuts There could be some indirect implications, and I think that's what investors are sort of worried about, or that's what's in the back of their mind. there could be some indirect implications and i think that's what investors are sort of worried about or that's what's in the back of their mind I wanted to see if at this point, are you sort of hearing anything from states in terms of if there is funding pressure from lower provider taxes, how that may flow through the system? i wanted to see if at this point are you sort of hearing anything from states in terms of if there is funding pressure from lower provider taxes how that may flow through the system Maybe that gets back to some of the value prop comments for personal care, but I was just curious whether you're hearing anything or whether you think, you know, we are at least thinking about the big, beautiful bill in the right way? Maybe that gets back to some of the value prop comments for personal care, but I was just curious whether you're hearing anything or whether you think, you know, we are at least thinking about the big, beautiful bill in the right way? maybe that gets back to some of the value prop comments for personal care but i was just curious whether you're hearing anything or whether you think you know we are at least thinking about the big beautiful bill in the right way

Speaker 2: Well, we agree with you the way you think about it. If you look at the provider tax, it really dramatically affects more of those states that expanded their Medicaid population under Obamacare. For us, as far as the big states, that's Illinois. Illinois has been very supportive of the personal care program for the last 40 years. In fact, they're the only state in which we operate that has their own program outside of Medicaid that will pay for some patients to go have personal care service 100% funded by the general fund of the state. We've not heard anything from Illinois as a concern there. The other states are big states. New Mexico and Texas aren't as affected. Well, we agree with you the way you think about it. well we agree with you the way you think about it If you look at the provider tax, it really dramatically affects more of those states that expanded their Medicaid population under Obamacare. if you look at the provider tax it really dramatically affects more of those states that expanded their medicaid population under obamacare For us, as far as the big states, that's Illinois. for us as far as the big states that's illinois Illinois has been very supportive of the personal care program for the last 40 years. illinois has been very supportive of the personal care program for the last 40 years In fact, they're the only state in which we operate that has their own program outside of Medicaid that will pay for some patients to go have personal care service 100% funded by the general fund of the state. in fact they're the only state in which we operate that has their own program outside of medicaid that will pay for some patients to go have personal care service 100% funded by the general fund of the state We've not heard anything from Illinois as a concern there. we've not heard anything from illinois as a concern there The other states are big states. the other states are big states New Mexico and Texas aren't as affected. new mexico and texas aren't as affected If you go to the overall thought process of maybe having less dollars eventually, again, you mentioned it plays to our aspect that says that's great because we as a service provider in personal care, we can help you save money for these long, the high-cost patients that we take care of. That to us is not a real issue. You look at work requirements, and we've said we actually think work requirements can be a benefit if you think it through as a company, because we're hiring part-time caregivers. Our average caregivers work 22 hours a week. If you're a Medicaid recipient and, you know, remember, most of our patients are not gonna have to have work requirements. They're either elderly or disabled. A caregiver might. If you go to the overall thought process of maybe having less dollars eventually, again, you mentioned it plays to our aspect that says that's great because we as a service provider in personal care, we can help you save money for these long, the high-cost patients that we take care of. if you go to the overall thought process of maybe having less dollars eventually again you mentioned it plays to our aspect that says that's great because we as a service provider in personal care we can help you save money for these long the high-cost patients that we take care of That to us is not a real issue. that to us is not a real issue You look at work requirements, and we've said we actually think work requirements can be a benefit if you think it through as a company, because we're hiring part-time caregivers. you look at work requirements and we've said we actually think work requirements can be a benefit if you think it through as a company because we're hiring part-time caregivers Our average caregivers work 22 hours a week. our average caregivers work 22 hours a week If you're a Medicaid recipient and, you know, remember, most of our patients are not gonna have to have work requirements. if you're a medicaid recipient and you know remember most of our patients are not gonna have to have work requirements They're either elderly or disabled. they're either elderly or disabled A caregiver might. a caregiver might You know, maybe a caregiver, maybe someone is on Medicaid, they're younger, taking care of kids at home, and they're now to go out and get a 20-hour a week job. We're an opportunity as an employer where we're very flexible. They need to work on certain nights because they don't have childcare during the day. If they can only work all weekends, if there are certain specified times that they're available. Generally, we can look to our population base in their market because of our size, and we can find an opportunity for them to be a caregiver for us. We don't expect it to be any issue. We believe, honestly, it can be potentially might be a benefit long term. You know, maybe a caregiver, maybe someone is on Medicaid, they're younger, taking care of kids at home, and they're now to go out and get a 20-hour a week job. you know maybe a caregiver maybe someone is on medicaid they're younger taking care of kids at home and they're now to go out and get a 20-hour a week job We're an opportunity as an employer where we're very flexible. we're an opportunity as an employer where we're very flexible They need to work on certain nights because they don't have childcare during the day. they need to work on certain nights because they don't have childcare during the day If they can only work all weekends, if there are certain specified times that they're available. if they can only work all weekends if there are certain specified times that they're available Generally, we can look to our population base in their market because of our size, and we can find an opportunity for them to be a caregiver for us. generally we can look to our population base in their market because of our size and we can find an opportunity for them to be a caregiver for us We don't expect it to be any issue. we don't expect it to be any issue We believe, honestly, it can be potentially might be a benefit long term. we believe honestly it can be potentially might be a benefit long term

Speaker 3: Okay. All right. Why don't we get off some of the regulatory topics and sort of get back to the business. You know, one of the areas I wanted to touch on was labor. You know, for your business, I've always thought of labor as sometimes being a limiting factor for growth. When you're able to hire, you're able to meet the demand that is out there. Can you talk about the trends that you're seeing in hiring, particularly with personal care, but also non-clinical? Are there any process or tech improvements you've been focused on the last six months or a year to help support the hiring process? Okay. okay All right. all right Why don't we get off some of the regulatory topics and sort of get back to the business. why don't we get off some of the regulatory topics and sort of get back to the business You know, one of the areas I wanted to touch on was labor. you know one of the areas i wanted to touch on was labor You know, for your business, I've always thought of labor as sometimes being a limiting factor for growth. you know for your business i've always thought of labor as sometimes being a limiting factor for growth When you're able to hire, you're able to meet the demand that is out there. when you're able to hire you're able to meet the demand that is out there Can you talk about the trends that you're seeing in hiring, particularly with personal care, but also non-clinical? can you talk about the trends that you're seeing in hiring particularly with personal care but also non-clinical Are there any process or tech improvements you've been focused on the last six months or a year to help support the hiring process? are there any process or tech improvements you've been focused on the last six months or a year to help support the hiring process

Speaker 1: Yeah, Matt, I can take that one. I think, you know, on the hiring side, it's been, I think in the personal care environment, you know, pretty positive for us over the last, you know, probably, to be honest, couple of years. I think, you know, typically, you know, we're countercyclical, where unemployment is higher is usually a positive for us. While we're not kind of at, you know, historical highs, it has been ticking up. But I think for us, you know, just the impact of inflation has also probably helped our hiring. Think about the kind of folks that we typically employ. You know, we're competing with retail, hospitality, and those types. But, you know, people need more money. Yeah, Matt, I can take that one. yeah matt i can take that one I think, you know, on the hiring side, it's been, I think in the personal care environment, you know, pretty positive for us over the last, you know, probably, to be honest, couple of years. i think you know on the hiring side it's been i think in the personal care environment you know pretty positive for us over the last you know probably to be honest couple of years I think, you know, typically, you know, we're countercyclical, where unemployment is higher is usually a positive for us. i think you know typically you know we're countercyclical where unemployment is higher is usually a positive for us While we're not kind of at, you know, historical highs, it has been ticking up. while we're not kind of at you know historical highs it has been ticking up But I think for us, you know, just the impact of inflation has also probably helped our hiring. but i think for us you know just the impact of inflation has also probably helped our hiring Think about the kind of folks that we typically employ. think about the kind of folks that we typically employ You know, we're competing with retail, hospitality, and those types. you know we're competing with retail hospitality and those types But, you know, people need more money. but you know people need more money They're looking for, you know, additional work, and I think we've been a great, you know, solution for that. We've been in a pretty positive state. I think, you know, going into Q4, we talked a little bit about the holidays. We were down just a little bit sequentially from Q3. Some of the weather in January probably impacted a little bit at the end of the month. I think February has turned, has been pretty strong. I think we feel like we're in a pretty good trend, a pretty good cadence on the personal care side. Clinical, you know, always has probably just, you know, some pockets, you know, maybe more urban markets where it's a little more difficult, more competitive, to find folks. They're looking for, you know, additional work, and I think we've been a great, you know, solution for that. they're looking for you know additional work and i think we've been a great you know solution for that We've been in a pretty positive state. we've been in a pretty positive state I think, you know, going into Q4, we talked a little bit about the holidays. i think you know going into q4 we talked a little bit about the holidays We were down just a little bit sequentially from Q3. we were down just a little bit sequentially from q3 Some of the weather in January probably impacted a little bit at the end of the month. some of the weather in january probably impacted a little bit at the end of the month I think February has turned, has been pretty strong. i think february has turned has been pretty strong I think we feel like we're in a pretty good trend, a pretty good cadence on the personal care side. i think we feel like we're in a pretty good trend a pretty good cadence on the personal care side Clinical, you know, always has probably just, you know, some pockets, you know, maybe more urban markets where it's a little more difficult, more competitive, to find folks. clinical you know always has probably just you know some pockets you know maybe more urban markets where it's a little more difficult more competitive to find folks I think we're, you know, fairly clear of, you know, some of the pressure we all saw coming through COVID and a lot of nurses out there on travel schedules. I think it's gotten back into a more, we would consider historical kind of normal environment. You know, our increases there, you know, we're maybe 4% or 5% kinda coming out of COVID. We're back down to probably, you know, 3%-4% on the clinical side, which is kind of back in line. I think overall, like, we feel like the labor environment has been pretty stable. But second part of your question, just kind of what have we been doing. I think we're, you know, fairly clear of, you know, some of the pressure we all saw coming through COVID and a lot of nurses out there on travel schedules. i think we're you know fairly clear of you know some of the pressure we all saw coming through covid and a lot of nurses out there on travel schedules I think it's gotten back into a more, we would consider historical kind of normal environment. i think it's gotten back into a more we would consider historical kind of normal environment You know, our increases there, you know, we're maybe 4% or 5% kinda coming out of COVID. you know our increases there you know we're maybe 4% or 5% kinda coming out of covid We're back down to probably, you know, 3%-4% on the clinical side, which is kind of back in line. we're back down to probably you know 3%-4% on the clinical side which is kind of back in line I think overall, like, we feel like the labor environment has been pretty stable. i think overall like we feel like the labor environment has been pretty stable But second part of your question, just kind of what have we been doing. but second part of your question just kind of what have we been doing I think the main thing for us in personal care, if you think about folks that are applying for jobs with us, they're probably applying at, you know, two, three, four other places at the same time. It's really critical that, you know, we get to those individuals quickly and make sure we try everything we can to make their, you know, onboarding process as smooth as possible. I think we've tried to use technology, some AI, actually in there and just responding back to clients or caregivers, I'm sorry, making sure that they get, you know, connections quickly, and they get through our process as seamlessly as possible. I think we've been able to be successful there and kind of seeing the shortening of that overall timeline has probably also been a benefit. I think the main thing for us in personal care, if you think about folks that are applying for jobs with us, they're probably applying at, you know, two, three, four other places at the same time. i think the main thing for us in personal care if you think about folks that are applying for jobs with us they're probably applying at you know two three four other places at the same time It's really critical that, you know, we get to those individuals quickly and make sure we try everything we can to make their, you know, onboarding process as smooth as possible. it's really critical that you know we get to those individuals quickly and make sure we try everything we can to make their you know onboarding process as smooth as possible I think we've tried to use technology, some AI, actually in there and just responding back to clients or caregivers, I'm sorry, making sure that they get, you know, connections quickly, and they get through our process as seamlessly as possible. i think we've tried to use technology some ai actually in there and just responding back to clients or caregivers i'm sorry making sure that they get you know connections quickly and they get through our process as seamlessly as possible I think we've been able to be successful there and kind of seeing the shortening of that overall timeline has probably also been a benefit. i think we've been able to be successful there and kind of seeing the shortening of that overall timeline has probably also been a benefit

Speaker 3: That's great. As a quick follow-up, when you all talk about, you know, hires per day, I think in the early part of the quarter you said it was 107 and maybe it ticked down, but now we're back up. What's the type of hiring per day you need to support, you know, the same-store census growth of being north of 2%? Just by way of example, so we have some sort of sense for, you know, how you're tracking. That's great. that's great As a quick follow-up, when you all talk about, you know, hires per day, I think in the early part of the quarter you said it was 107 and maybe it ticked down, but now we're back up. as a quick follow-up when you all talk about you know hires per day i think in the early part of the quarter you said it was 107 and maybe it ticked down but now we're back up What's the type of hiring per day you need to support, you know, the same-store census growth of being north of 2%? what's the type of hiring per day you need to support you know the same-store census growth of being north of 2% Just by way of example, so we have some sort of sense for, you know, how you're tracking. just by way of example so we have some sort of sense for you know how you're tracking

Speaker 2: You know, I think what we've looked at is if we can stay just above 105, we're in pretty good shape. We'll meet our growth targets. You know, we've been doing that consistently. I do know we dropped down to 101 during the holidays fourth quarter, but I would expect to see us be able to achieve that 105 in the first quarter going forward so. You know, I think what we've looked at is if we can stay just above 105, we're in pretty good shape. you know i think what we've looked at is if we can stay just above 105 we're in pretty good shape We'll meet our growth targets. we'll meet our growth targets You know, we've been doing that consistently. you know we've been doing that consistently I do know we dropped down to 101 during the holidays fourth quarter, but I would expect to see us be able to achieve that 105 in the first quarter going forward so. i do know we dropped down to 101 during the holidays fourth quarter but i would expect to see us be able to achieve that 105 in the first quarter going forward so

Speaker 3: Got it. That's great. You know, one, I wanted to hit on the caregiver app that you had rolled out to Illinois and then moving out to other states. 'Cause in my mind, one of the real bright spots has been your ability to increase the fill rates and, you know, serve more hours per patient. Maybe just give us some context in terms of how this app works if you're a caregiver and, you know, what's been the impact to fill rates in Illinois and, you know, what are you seeing in sort of the rollout in New Mexico and Texas? Got it. got it That's great. that's great You know, one, I wanted to hit on the caregiver app that you had rolled out to Illinois and then moving out to other states. 'Cause in my mind, one of the real bright spots has been your ability to increase the fill rates and, you know, serve more hours per patient. you know one i wanted to hit on the caregiver app that you had rolled out to illinois and then moving out to other states 'cause in my mind one of the real bright spots has been your ability to increase the fill rates and you know serve more hours per patient Maybe just give us some context in terms of how this app works if you're a caregiver and, you know, what's been the impact to fill rates in Illinois and, you know, what are you seeing in sort of the rollout in New Mexico and Texas? maybe just give us some context in terms of how this app works if you're a caregiver and you know what's been the impact to fill rates in illinois and you know what are you seeing in sort of the rollout in new mexico and texas

Speaker 1: Yeah. I think the primary benefit, so if a caregiver you know chooses to download and use the app, we don't make it mandatory. You know, obviously, we definitely promote it and encourage caregivers to use it 'cause it gives them a lot of tools that they otherwise wouldn't have access to. The main thing is they can see what their schedules are. They can see their punches in, their punches out, so they can kinda see what their paycheck's going to look like. You know, if there's something wrong, you know, they can make a correction before their paycheck comes in and it's not the amount that they expect and have to go through that process. Yeah. yeah I think the primary benefit, so if a caregiver you know chooses to download and use the app, we don't make it mandatory. i think the primary benefit so if a caregiver you know chooses to download and use the app we don't make it mandatory You know, obviously, we definitely promote it and encourage caregivers to use it 'cause it gives them a lot of tools that they otherwise wouldn't have access to. you know obviously we definitely promote it and encourage caregivers to use it 'cause it gives them a lot of tools that they otherwise wouldn't have access to The main thing is they can see what their schedules are. the main thing is they can see what their schedules are They can see their punches in, their punches out, so they can kinda see what their paycheck's going to look like. they can see their punches in their punches out so they can kinda see what their paycheck's going to look like You know, if there's something wrong, you know, they can make a correction before their paycheck comes in and it's not the amount that they expect and have to go through that process. you know if there's something wrong you know they can make a correction before their paycheck comes in and it's not the amount that they expect and have to go through that process It lets them, you know, go in and basically, you know, make edits to their availability, or some of their preferences. So if they're saying, you know, originally they're saying, "I can work on Tuesdays and Thursdays," and that changes, you know, before the app, they would have to try to figure out how to call in, get a hold of somebody, you know, get some updates made in the system. Now they can self-serve in that respect and make some of those changes which should open up and then allow them to take more shifts or maybe see, you know, a higher number of hours which, you know, we hear from a lot of our caregivers that they're looking for. It lets them, you know, go in and basically, you know, make edits to their availability, or some of their preferences. it lets them you know go in and basically you know make edits to their availability or some of their preferences So if they're saying, you know, originally they're saying, "I can work on Tuesdays and Thursdays," and that changes, you know, before the app, they would have to try to figure out how to call in, get a hold of somebody, you know, get some updates made in the system. so if they're saying you know originally they're saying "i can work on tuesdays and thursdays," and that changes you know before the app they would have to try to figure out how to call in get a hold of somebody you know get some updates made in the system Now they can self-serve in that respect and make some of those changes which should open up and then allow them to take more shifts or maybe see, you know, a higher number of hours which, you know, we hear from a lot of our caregivers that they're looking for. now they can self-serve in that respect and make some of those changes which should open up and then allow them to take more shifts or maybe see you know a higher number of hours which you know we hear from a lot of our caregivers that they're looking for I think the last thing is, you know, we are able to kinda push what we call flex hours out through the app. If they are looking for more work, more hours, you know, we can let them know, "Hey, here are some shifts that are available." Maybe there's, you know, in proximity to maybe where they're, you know, already scheduled for another shift. They can choose to accept that and say, "Yes, I would like to take that shift." That's where really the component on the fill rate comes in, you know, 'cause as you know, our business on that side is largely a logistics business. I think the last thing is, you know, we are able to kinda push what we call flex hours out through the app. i think the last thing is you know we are able to kinda push what we call flex hours out through the app If they are looking for more work, more hours, you know, we can let them know, "Hey, here are some shifts that are available." Maybe there's, you know, in proximity to maybe where they're, you know, already scheduled for another shift. if they are looking for more work more hours you know we can let them know "hey here are some shifts that are available." maybe there's you know in proximity to maybe where they're you know already scheduled for another shift They can choose to accept that and say, "Yes, I would like to take that shift." That's where really the component on the fill rate comes in, you know, 'cause as you know, our business on that side is largely a logistics business. they can choose to accept that and say "yes i would like to take that shift." that's where really the component on the fill rate comes in you know 'cause as you know our business on that side is largely a logistics business You know, the number of hours that we're authorized, you know, we wanna try to do everything we can to fill as many of those hours as we can. You know, someone at the state has done an assessment and determined those patients need that level of care. You know, we should try to meet that as much as we can. We'll never be probably at 100%, but, you know, how can we make some improvements there? I think through Illinois and the rollout of the app, you know, we saw those fill rates, which is kinda what we call the difference between, you know, what we serve and what's authorized, you know, we were running in the low 80% range. You know, we saw that move up into the upper 80% range over a period of time. You know, the number of hours that we're authorized, you know, we wanna try to do everything we can to fill as many of those hours as we can. you know the number of hours that we're authorized you know we wanna try to do everything we can to fill as many of those hours as we can You know, someone at the state has done an assessment and determined those patients need that level of care. you know someone at the state has done an assessment and determined those patients need that level of care You know, we should try to meet that as much as we can. you know we should try to meet that as much as we can We'll never be probably at 100%, but, you know, how can we make some improvements there? we'll never be probably at 100% but you know how can we make some improvements there I think through Illinois and the rollout of the app, you know, we saw those fill rates, which is kinda what we call the difference between, you know, what we serve and what's authorized, you know, we were running in the low 80% range. i think through illinois and the rollout of the app you know we saw those fill rates which is kinda what we call the difference between you know what we serve and what's authorized you know we were running in the low 80% range You know, we saw that move up into the upper 80% range over a period of time. you know we saw that move up into the upper 80% range over a period of time Probably took six, seven, you know, eight months to kinda see us gradually get to that point and kinda plateau, and that's where we've kinda been since. Our hope is if we can, you know, roll out the caregiver app in other markets. We're rolling it out concurrently in New Mexico and Texas, which are our next two largest markets, you know, we'll see a similar impact. You know, those two states were probably similar. They probably hover closer to the 80% range. Can we see them, you know, get up into the mid, maybe even upper 80s? You know, that should be helpful when you kinda look at our hours per census that we report. We've seen some nice improvement there. Probably took six, seven, you know, eight months to kinda see us gradually get to that point and kinda plateau, and that's where we've kinda been since. probably took six seven you know eight months to kinda see us gradually get to that point and kinda plateau and that's where we've kinda been since Our hope is if we can, you know, roll out the caregiver app in other markets. our hope is if we can you know roll out the caregiver app in other markets We're rolling it out concurrently in New Mexico and Texas, which are our next two largest markets, you know, we'll see a similar impact. we're rolling it out concurrently in new mexico and texas which are our next two largest markets you know we'll see a similar impact You know, those two states were probably similar. you know those two states were probably similar They probably hover closer to the 80% range. they probably hover closer to the 80% range Can we see them, you know, get up into the mid, maybe even upper 80s? can we see them you know get up into the mid maybe even upper 80s You know, that should be helpful when you kinda look at our hours per census that we report. you know that should be helpful when you kinda look at our hours per census that we report We've seen some nice improvement there. we've seen some nice improvement there I think pre-COVID, you know, we were probably in that 80% range. I think through COVID, that definitely dropped. We saw, you know, probably on a consolidated basis, you know, we were probably in the mid- to upper 70s. I think we're now back in, on a consolidated basis, in the low 80s. So we made some improvement, but we think there's still maybe some more headroom and more opportunity there. I think pre-COVID, you know, we were probably in that 80% range. i think pre-covid you know we were probably in that 80% range I think through COVID, that definitely dropped. i think through covid that definitely dropped We saw, you know, probably on a consolidated basis, you know, we were probably in the mid- to upper 70s. we saw you know probably on a consolidated basis you know we were probably in the mid- to upper 70s I think we're now back in, on a consolidated basis, in the low 80s. i think we're now back in on a consolidated basis in the low 80s So we made some improvement, but we think there's still maybe some more headroom and more opportunity there. so we made some improvement but we think there's still maybe some more headroom and more opportunity there

Speaker 3: I thought I heard in the past you make a comment that the way the states are set up, the opportunity in Texas is actually a little bit more than what you see in New Mexico. You know, if I'm not correct, please let me know. Assuming I am, why is it a bigger opportunity in Texas just in terms of how they're structured? I thought I heard in the past you make a comment that the way the states are set up, the opportunity in Texas is actually a little bit more than what you see in New Mexico. i thought i heard in the past you make a comment that the way the states are set up the opportunity in texas is actually a little bit more than what you see in new mexico You know, if I'm not correct, please let me know. you know if i'm not correct please let me know Assuming I am, why is it a bigger opportunity in Texas just in terms of how they're structured? assuming i am why is it a bigger opportunity in texas just in terms of how they're structured

Speaker 1: Yeah. I think it's just technology. In New Mexico, you know, we're required on electronic visit verification. New Mexico requires all providers to go through their preselected vendor, which is AuthentiCare. So all time communication, everything has to go in and out of that state-run system. So we have to be in sync with that. Probably puts a little bit, you know, of a burden on us. We can't really push the flex hours component out because it can't go through the AuthentiCare system, so it prevents us from doing that. They can still get the rest of the functionality from the app on scheduling, availability, transparency, all of those things. Texas, we're able to use our own EVV system, similar to how we do in Illinois, so the functionality should be exactly the same there. Yeah. yeah i I think it's just technology. i think it's just technology In New Mexico, you know, we're required on electronic visit verification. in new mexico you know we're required on electronic visit verification New Mexico requires all providers to go through their preselected vendor, which is AuthentiCare. new mexico requires all providers to go through their preselected vendor which is authenticare So all time communication, everything has to go in and out of that state-run system. so all time communication everything has to go in and out of that state-run system So we have to be in sync with that. so we have to be in sync with that Probably puts a little bit, you know, of a burden on us. probably puts a little bit you know of a burden on us We can't really push the flex hours component out because it can't go through the AuthentiCare system, so it prevents us from doing that. we can't really push the flex hours component out because it can't go through the authenticare system so it prevents us from doing that They can still get the rest of the functionality from the app on scheduling, availability, transparency, all of those things. they can still get the rest of the functionality from the app on scheduling availability transparency all of those things Texas, we're able to use our own EVV system, similar to how we do in Illinois, so the functionality should be exactly the same there. texas we're able to use our own evv system similar to how we do in illinois so the functionality should be exactly the same there Probably just a little bit less so in New Mexico just because of the nature of what they require us to do on their EVV system. Probably just a little bit less so in New Mexico just because of the nature of what they require us to do on their EVV system. probably just a little bit less so in new mexico just because of the nature of what they require us to do on their evv system

Speaker 3: Got it. All right. I don't wanna totally ignore the clinical side of the business. So for hospice and home health, Dirk, you know, can you give us a quick recap in terms of just how those businesses have been performing? Then maybe give us some aspirational comments in terms of what are your goals for the clinical side of the business over the next couple of years? Got it. got it All right. all right I don't wanna totally ignore the clinical side of the business. i don't wanna totally ignore the clinical side of the business So for hospice and home health, Dirk, you know, can you give us a quick recap in terms of just how those businesses have been performing? so for hospice and home health dirk you know can you give us a quick recap in terms of just how those businesses have been performing Then maybe give us some aspirational comments in terms of what are your goals for the clinical side of the business over the next couple of years? then maybe give us some aspirational comments in terms of what are your goals for the clinical side of the business over the next couple of years

Speaker 2: Yeah. You know, hospice itself, as I mentioned earlier in the call, we spent a lot of time getting that back to where it needs to be. We all have hospice backgrounds, and so it's a business that we feel makes a lot of sense for our not only our hospice patients, but the opportunity for our personal care patients that may need that care later to move up to that level of care. So that's been a real focus of ours. I'm very pleased with that process. It's been a little more difficult in home health. We're smaller, but we look at home health a little different maybe than our freestanding home health company. Yeah. yeah You know, hospice itself, as I mentioned earlier in the call, we spent a lot of time getting that back to where it needs to be. you know hospice itself as i mentioned earlier in the call we spent a lot of time getting that back to where it needs to be We all have hospice backgrounds, and so it's a business that we feel makes a lot of sense for our not only our hospice patients, but the opportunity for our personal care patients that may need that care later to move up to that level of care. we all have hospice backgrounds and so it's a business that we feel makes a lot of sense for our not only our hospice patients but the opportunity for our personal care patients that may need that care later to move up to that level of care So that's been a real focus of ours. so that's been a real focus of ours I'm very pleased with that process. i'm very pleased with that process It's been a little more difficult in home health. it's been a little more difficult in home health We're smaller, but we look at home health a little different maybe than our freestanding home health company. we're smaller but we look at home health a little different maybe than our freestanding home health company That is, you know, for us, home health is really kind of an add-on to our personal care, which allows us in markets where we're working with payers to do value-based care. It gives us a small clinical component to sit on top of the first in the door non-clinical component to meet the needs of those payers that need value-based care. But also we found in the overlap markets, specifically New Mexico, where we've been there the longest, that 25% of our hospice admissions or so come directly from our home health. If you look at home health itself, it may not be that profitable. I mean, it makes money, but, you know, the growth has not been quite as good in the last year. That is, you know, for us, home health is really kind of an add-on to our personal care, which allows us in markets where we're working with payers to do value-based care. that is you know for us home health is really kind of an add-on to our personal care which allows us in markets where we're working with payers to do value-based care It gives us a small clinical component to sit on top of the first in the door non-clinical component to meet the needs of those payers that need value-based care. it gives us a small clinical component to sit on top of the first in the door non-clinical component to meet the needs of those payers that need value-based care But also we found in the overlap markets, specifically New Mexico, where we've been there the longest, that 25% of our hospice admissions or so come directly from our home health. but also we found in the overlap markets specifically new mexico where we've been there the longest that 25% of our hospice admissions or so come directly from our home health If you look at home health itself, it may not be that profitable. if you look at home health itself it may not be that profitable I mean, it makes money, but, you know, the growth has not been quite as good in the last year. i mean it makes money but you know the growth has not been quite as good in the last year What it's done, it's really been a nice feeder into the growth on our hospice side. Going forward, I think what you'll see, we'll take the opportunity in those markets that we have personal care to add small home health presence, and really try to lead that into a hospice presence. Right now, we have three markets where we have all three levels of care. We'd like to add to those markets. Right now, the real issue is the valuation in the hospice market. As you probably know, there's some larger private hospice providers coming up for sale later this year. PE firms are willing to pay a lot more money than we are, and so it's difficult for us to get a return as a company that we need, when that is still out there. What it's done, it's really been a nice feeder into the growth on our hospice side. what it's done it's really been a nice feeder into the growth on our hospice side Going forward, I think what you'll see, we'll take the opportunity in those markets that we have personal care to add small home health presence, and really try to lead that into a hospice presence. going forward i think what you'll see we'll take the opportunity in those markets that we have personal care to add small home health presence and really try to lead that into a hospice presence Right now, we have three markets where we have all three levels of care. right now we have three markets where we have all three levels of care We'd like to add to those markets. we'd like to add to those markets Right now, the real issue is the valuation in the hospice market. right now the real issue is the valuation in the hospice market As you probably know, there's some larger private hospice providers coming up for sale later this year. as you probably know there's some larger private hospice providers coming up for sale later this year PE firms are willing to pay a lot more money than we are, and so it's difficult for us to get a return as a company that we need, when that is still out there. pe firms are willing to pay a lot more money than we are and so it's difficult for us to get a return as a company that we need when that is still out there Now, that tends to change, so eventually maybe that will come back. We were able to get into the hospice business a few years back at probably 12, 13 multiple, which we could make do very well. We'll continue to look at that. You'll probably continue to see us. Right now, we're at 25% clinical. I'd say we'll be between 25% and 30% clinical, but mostly we'll be, you know, our main focus is the non-clinical personal care side. Now, that tends to change, so eventually maybe that will come back. now that tends to change so eventually maybe that will come back We were able to get into the hospice business a few years back at probably 12, 13 multiple, which we could make do very well. we were able to get into the hospice business a few years back at probably 12 13 multiple which we could make do very well We'll continue to look at that. we'll continue to look at that You'll probably continue to see us. you'll probably continue to see us Right now, we're at 25% clinical. right now we're at 25% clinical I'd say we'll be between 25% and 30% clinical, but mostly we'll be, you know, our main focus is the non-clinical personal care side. i'd say we'll be between 25% and 30% clinical but mostly we'll be you know our main focus is the non-clinical personal care side

Speaker 3: Got it. Maybe the last kind of question here with the last minute. I think, you know, I think your shareholders appreciate just how disciplined you've been on M&A. I know it's an important growth driver given how fragmented. You know, you're always focused on sort of the disciplined approach, I think has been well appreciated. With that said, I'd love to hear just sort of what you're seeing in the pipeline, including on the personal care side. Brian, Dirk, you mentioned a little bit on the hospice side, but any comments in terms of just what's in the market or what do you think will come to market? Got it. Ma ybe the last kind of question here with the last minute. got it. ma ybe the last kind of question here with the last minute I think, you know, I think your shareholders appreciate just how disciplined you've been on M&A. i think you know i think your shareholders appreciate just how disciplined you've been on m&a I know it's an important growth driver given how fragmented. i know it's an important growth driver given how fragmented You know, you're always focused on sort of the disciplined approach, I think has been well appreciated. you know you're always focused on sort of the disciplined approach i think has been well appreciated With that said, I'd love to hear just sort of what you're seeing in the pipeline, including on the personal care side. with that said i'd love to hear just sort of what you're seeing in the pipeline including on the personal care side Brian, Dirk, you mentioned a little bit on the hospice side, but any comments in terms of just what's in the market or what do you think will come to market? brian dirk you mentioned a little bit on the hospice side but any comments in terms of just what's in the market or what do you think will come to market

Speaker 1: Yeah, man, I think, you know, I think where we've been kind of seeing the market this year and we've kind of indicated we think probably early part of this year is gonna be more similar type projects than we closed in 2025. Primarily personal care, you know, probably on the smaller side, you know, $10 million-$15 million in revenue are probably the things that we're looking at mostly in markets that we're in. Creating some additional density. We think there's still a lot of opportunity there. You know, those multiples tend to be usually pretty low, you know, mid-single digits, maybe tick up a little bit depending on, you know, size and scale. It's a nicely accretive deals. Yeah, man, I think, you know, I think where we've been kind of seeing the market this year and we've kind of indicated we think probably early part of this year is gonna be more similar type projects than we closed in 2025. yeah man i think you know i think where we've been kind of seeing the market this year and we've kind of indicated we think probably early part of this year is gonna be more similar type projects than we closed in 2025 Primarily personal care, you know, probably on the smaller side, you know, $10 million-$15 million in revenue are probably the things that we're looking at mostly in markets that we're in. primarily personal care you know probably on the smaller side you know $10 million-$15 million in revenue are probably the things that we're looking at mostly in markets that we're in Creating some additional density. creating some additional density We think there's still a lot of opportunity there. we think there's still a lot of opportunity there You know, those multiples tend to be usually pretty low, you know, mid-single digits, maybe tick up a little bit depending on, you know, size and scale. you know those multiples tend to be usually pretty low you know mid-single digits maybe tick up a little bit depending on you know size and scale It's a nicely accretive deals. it's a nicely accretive deals We've kind of intimated that we are aware of there are a couple of, you know, larger, potentially multi-state, you know, personal care businesses that may be in the market. We think, you know, mid till later this year based on our information, that would be interesting for us. You know, obviously from our perspective, you know, we're sitting in a pretty good spot from a capital, you know, position. We think we are able to be flexible and move very quickly if there are some larger deals that make sense for us. I think a few years ago, you might have seen some similar deals, but they all tended to have, you know, geographies that weren't attractive to us, primarily, you know, New York and those areas. We've kind of intimated that we are aware of there are a couple of, you know, larger, potentially multi-state, you know, personal care businesses that may be in the market. we've kind of intimated that we are aware of there are a couple of you know larger potentially multi-state you know personal care businesses that may be in the market We think, you know, mid till later this year based on our information, that would be interesting for us. we think you know mid till later this year based on our information that would be interesting for us You know, obviously from our perspective, you know, we're sitting in a pretty good spot from a capital, you know, position. you know obviously from our perspective you know we're sitting in a pretty good spot from a capital you know position We think we are able to be flexible and move very quickly if there are some larger deals that make sense for us. we think we are able to be flexible and move very quickly if there are some larger deals that make sense for us I think a few years ago, you might have seen some similar deals, but they all tended to have, you know, geographies that weren't attractive to us, primarily, you know, New York and those areas. i think a few years ago you might have seen some similar deals but they all tended to have you know geographies that weren't attractive to us primarily you know new york and those areas The ones we're kind of looking at that might be available, you know, are not gonna have those kind of issues. Could be something that we definitely would be involved in. I think on the clinical side, you know, if we can find hospice on the smaller side at reasonable multiples, we would love to do those. You know, probably more likely you'll see us if we add more hospice, probably come through maybe a deal that has other service lines involved as well like we did in, you know, Tennessee, and Pennsylvania. You know, on the home health side, you know, if it makes sense where we have personal care and/or hospice, back to Dirk's comments about some of the revenue synergy. The ones we're kind of looking at that might be available, you know, are not gonna have those kind of issues. the ones we're kind of looking at that might be available you know are not gonna have those kind of issues Could be something that we definitely would be involved in. could be something that we definitely would be involved in I think on the clinical side, you know, if we can find hospice on the smaller side at reasonable multiples, we would love to do those. i think on the clinical side you know if we can find hospice on the smaller side at reasonable multiples we would love to do those You know, probably more likely you'll see us if we add more hospice, probably come through maybe a deal that has other service lines involved as well like we did in, you know, Tennessee, and Pennsylvania. you know probably more likely you'll see us if we add more hospice probably come through maybe a deal that has other service lines involved as well like we did in you know tennessee and pennsylvania You know, on the home health side, you know, if it makes sense where we have personal care and/or hospice, back to Dirk's comments about some of the revenue synergy. you know on the home health side you know if it makes sense where we have personal care and/or hospice back to dirk's comments about some of the revenue synergy You know, if we can find things on the smaller side at good, you know, inexpensive multiples where we have those service lines, those are things that obviously we'll continue to look at as well. You know, if we can find things on the smaller side at good, you know, inexpensive multiples where we have those service lines, those are things that obviously we'll continue to look at as well. you know if we can find things on the smaller side at good you know inexpensive multiples where we have those service lines those are things that obviously we'll continue to look at as well

Speaker 3: Got it. We will certainly stay tuned. Brian and Dirk, really appreciate you being here. Thanks a lot, and I think we can go ahead and conclude it there. Got it. got it We will certainly stay tuned. we will certainly stay tuned Brian and Dirk, really appreciate you being here. brian and dirk really appreciate you being here Thanks a lot, and I think we can go ahead and conclude it there. thanks a lot and i think we can go ahead and conclude it there

Speaker 2: Thanks. Thanks. thanks

Speaker 3: Appreciate it. Appreciate it. appreciate it