Literature Review

ONA accuses Providence of trying to sidestep state regulators as it partners with private equity Oregon Nurses Association; by ONA; 12/12/24 The Oregon Nurses Association (ONA) sent a letter to the Oregon Health Authority asking them to intervene in the recently proposed joint venture between Providence Health and private equity-backed Compassus to manage Providence’s home health and hospice program. The full letter is included below. Providence announced the so-called joint venture in October but has failed to file the proper paperwork with Oregon’s Healthcare Market Oversight (HCMO) to allow state regulators time to review the sale. Concerns from patients and caregivers have already been raised about transparency, patient care, and the potential negative effects on health outcomes in Oregon’s vulnerable communities with this joint venture.

New Day Healthcare acquires Good Samaritan Society’s hospice operations Hospice News; by Holly Vossel; 12/11/24 Texas-based New Day Healthcare LLC has announced its acquisition of Good Samaritan Society’s hospice operations in its home state. The financial terms of the deal were undisclosed. The transaction includes Good Samaritan’s hospice assets in El Paso, Texas, expanding New Day’s existing presence in that market. The deal marks an important strategic move as New Day Healthcare ramps up M&A activity in the near future, according to CEO and Founder G. Scott Herman.

CareTrust REIT expands in the Midwest with $97M deal Modern Healthcare; by Diane Eastabrook; 12/10/24 CareTrust REIT has acquired a 46-facility skilled nursing and senior housing portfolio in the Midwest for $97 million. The San Clemente, California-based real estate investment trust said in a Monday news release the facilities include more than 3,800 beds and were purchased through a bankruptcy sale of the assets from an unnamed debtor. It did not disclose the names or specific locations of the facilities.

Court rules against former Encompass Health officers in lawsuitHomeCare, Dallas, TX and Birmingham, AL; 12/9/24 The Delaware Court of Chancery ruled in the lawsuit against Encompass Health, a national home health and hospice provider, and Enhabit Home Health and Hospice, an owner and operator of rehabilitation hospitals. The lawsuit related to breaches of fiduciary duty by former company executives within Emcompass Health's former home health and hospice division, which is now Enhabit Home Health and Hospice. The court awarded judgment against VitalCaring Group, a home health and hospice business, as well as the private equity firms Vistria Group and Nautic Partners for aiding and abetting “the egregious breaches of the duty of loyalty” by former Encompass Health CEO April Anthony, former chief strategy officer Luke James and former chief financial officer Chris Walker. The court found that while employed by Encompass Health, Anthony, James and Walker usurped acquisition opportunities falling within Encompass Health’s line of business, used Encompass Health’s confidential information and swayed key Encompass Health employees to join them, with the promise of equity in the home health and hospice competitor that Anthony now heads, VitalCaring Group. 

Creach Family Holdings announces acquisition of HealthRev Partners EIN Presswire, Stuart, FL; by Careficient, Inc.; 12/3/24 Creach Family Holdings announces acquisition of HealthRev Partners Expanding Healthcare Technology Solutions for Home Health and Hospice Providers. Creach Family Holdings, a privately held investment firm focused on healthcare technology and tech-enabled services, announces the acquisition of HealthRev Partners, a provider of technology-driven revenue cycle management (RCM) solutions serving the home health and hospice market. This acquisition complements Creach Family Holdings’ portfolio, including Careficient, a leading electronic medical record (EMR) provider for home health and hospice agencies. By combining HealthRev Partners’ RCM expertise with Careficient’s EMR platform, Creach Family Holdings aims to provide an integrated suite of solutions that streamline operations, optimize revenue cycles, and improve patient care. 

Addus closes $350M Gentiva Personal Care deal Hospice News; by Jim Parker; 12/2/24 Addus HomeCare Corporation (Nasdaq: ADUS) has closed its $350 million acquisition of Gentiva’s personal care business. Gentiva’s personal care segment brings in annual revenues of close to $280.0 million. Post-transaction, Addus will continue with a leverage ratio of less than 3x, with the ability to further that amount with the influx of revenue resulting from this deal, Addus Chairman and CEO Dirk Allision said in a statement. ... Addus provides personal care, home health and hospice to more than 48,500 patients across 22 states. Its total revenue reached $289.8 million in the Q3 of 2024, a 7% year-over-year increase. Its personal care revenues reached $215.4 million that period.

Transactions: Elevance Health’s home-based care bet; Eden Health, Mission Health expand hospice footprints Home Health Care News; by Andrew Donlan; 11/26/24...will fall under Elevance’s Carelon arm. Eden Health acquires A Plus Hospice Care Eden Health of Northern Nevada has acquired A Plus Hospice Care. The deal was official as of Nov. 1. [Full access to the article might require a subscription.]

Why the DOJ’s lawsuit against the UGH-Amedisys merger may not go anywhere MedCityNews; by Marissa Plescia; 11/21/24 Experts aren’t sure what the outcome of the DOJ’s recent lawsuit against the proposed UnitedHealth Group/Amedisys merger will be under the incoming Trump administration. The Biden administration has focused more on supporting clinicians, while the previous Trump administration favored corporations. ...  But even aside from the differences in governing philosophy, one expert noted that the main reason for antitrust lawsuits — prices would rise as a result of the transaction, hurting consumers and patients — seems to be missing from the equation here. That’s because of the outsized role Medicare and Medicaid play in the home health industry. ... By acquiring Amedisys, UHG would grow its home health and hospice footprint to five more states, as well as receive 500 additional locations across 32 states it already operates in. The deal would also give UHG control of at least 30% of the home health or hospice services in eight states. ... Will the DOJ succeed? It's hard to say for sure what the outcome of the DOJ’s lawsuit will be, particularly with the change in administration. ... 

Pursuit of quick profits makes hospice care worse, new research says Ohio Capital Journal; by Marty Schladen; 11/20/24 Private equity firms — high-dollar investors known for aggressively seeking profit — and publicly traded health conglomerates have been buying up businesses that provide hospice care. But when it comes to caring for patients facing the end of their lives, those businesses perform worst, according to a research letter published Monday in the Journal of the American Medical Association. ...  Publicly traded behemoths such as UnitedHealth Group and CVS Health are already the subject of investigations and lawsuits by federal and state government over allegedly anticompetitive actions as drug middlemen. At the same time, both provide hospice care. Meanwhile, the business practices of private equity groups have been coming under increasing scrutiny over the past decade. They often buy businesses in deals structured so they can quickly recoup their investment, identify the most profitable assets, sell them and then sell the resulting business or declare bankruptcy. ... The firms also have been accused of being predatory toward consumers.

Cigna ends Humana merger talks, prioritizes share buybacks Modern Healthcare - Insurance; by John Lauerman, Bloomberg; 11/11/24 Cigna Group said it won’t pursue a combination with rival insurer Humana Inc. after reports the two companies had renewed discussions of a deal. The company “remains committed to its established M&A criteria and would only consider acquisitions that are strategically aligned, financially attractive, and have a high probability to close,” according to a statement Monday. Cigna shares jumped by 8% in premarket trading, while shares in Humana dropped by 7%. The two health insurance giants, with a combined market value of roughly $125 billion, held talks about a deal last year, but Cigna walked away after the two companies failed to agree on a price, Bloomberg News reported in December.   

‘Everything is lining up’: Home-based care M&A expected to soar in near-term future Home Health News; by Audrie Martin; 11/11/24 Home health, home care and hospice M&A was historically high in 2021, with high valuations serving sellers and solid return on investment serving buyers. Transactions plummeted after that, but recent signs suggest M&A is beginning to pick back up across sectors. ... Sellers should expect questions about employee retention, the company’s track record of growth after M&A and whether their leadership has done due diligence before entering the race. ... Experts predict that large, founder-led home health and hospice businesses will be in high demand in the coming year. Larger home care companies, especially those that are Medicaid-funded, will also be in demand. 

Eden Health acquires A Plus Hospice Care Hospice News; by Jim Parker; 11/11/24 Eden Health of Northern Nevada, dba Eden Hospice, has acquired A Plus Hospice Care in its home state. Financial terms were undisclosed. Through the transaction, A Plus Hospice Care patients will have access to Eden Health’s additional services, including home health, home care and palliative care. The M&A advisory firm Agenda Health consulted on the deal. Cultural alignment, proximity to its existing footprint and the seller’s strong track record on compliance were factors in Eden’s decision to acquire, Jamie Brown, the company’s COO, told Hospice News in an email. ... Eden Health is a 100% employee-owned company operating in Washington state, Nevada, California, Idaho, Montana, Wyoming and Arizona.

Aveanna revs hospice, home health M&A engine Hospice News; by Holly Vossel; 11/7/24 Aveanna Healthcare Holdings (Nasdaq: AVAH) is ramping up its merger and acquisition activity in the home health and hospice space heading into next year. The Atlanta-headquartered company has set its strategic sights on both private duty nursing and hospice and home health, according to Aveanna CEO Jeff Shaner. The company has been quiet on the M&A front in recent years, taking a cautious approach to growth, Shaner said during an earnings call on Thursday. Aveanna is in the process of reviewing a few potential acquisitions, which could close in 2025, he indicated.