Literature Review

‘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. 

New Day Healthcare acquires Intrepid USA’s Missouri, Texas hospice assets Hospice News; by Holly Vossel; 11/11/24 Texas-based New Day Healthcare LLC on Monday announced its acquisition of Intrepid USA’s hospice operations in Missouri and in its home state. The transaction expands the home-based service provider’s existing presence in those markets. The deal includes Intrepid’s hospice assets in Joplin and Springfield, Missouri, as well as its locations in Beaumont, Texas. New Day Healthcare has additional strategic growth plans in store once the acquisition completes, with more deals on the near horizon in coming months according to CEO and Founder G. Scott Herman.

Arrest warrant issued gor a California hospice care executive PRLog - Press Release Distribution, Los Angeles, CA; 11/8/24 The Superior Court of California in Los Angeles has issued a Bench Warrant for the arrest of Darline Singh, owner of Zola Hospice LLC, and associated with numerous other hospice companies throughout the state. Singh failed to appear in court on 9/12/2024 and on 10/24/2024 for a judgment debtor exam stemming from a $15MM judgment against Singh, Zola Hospice LLC, and E&E Hospice, LLC. Darline Singh's resume indicates she has a degree in Chemical engineering from UC Davis, AI Machine learning at MIT, as well as Harvard University. Her work experience highlights consulting and executive roles at Brookdale Senior Living, ACE Hospice, Suncrest Healthcare, Vitas Healthcare, Kindred Healthcare, and Bridge Hospice. In March of 2022 Acting California State Auditor, Michael S. Tilden, reported in a letter to the Governor, "my office conducted an audit of the State's licensure and oversight of hospice agencies and found that the State's weak controls have created the opportunity for large-scale fraud and abuse. We identified numerous indicators of such fraud and abuse by hospice agencies."

Enhabit to shutter handful of home health locations, ‘close’ to new deal with UnitedHealthcare Home Health Care News; by Andrew Donlan; 11/7/24 Enhabit Inc. (NYSE: EHAB) has a new CFO and a somewhat new strategy. It still faces a lot of the same problems. On Thursday, CEO Barb Jacobsmeyer said the company would be closing or consolidating certain locations that are underperforming, specifically when it comes to traditional Medicare business in home health care. While its payer innovation strategy is still intact, that’s largely a departure from its goal of moving more toward Medicare Advantage (MA) revenue over the last couple of years. Specifically, the company has been trying to diversify its revenue mix to become a better partner to referral sources and adjust to a more MA-dominated future. But now, after a strategic review and a battle with the activist investor AREX Capital, it seems to be re-focusing on fee-for-service revenue from traditional Medicare. ...

The Pennant Group to seek more hospice, home health deals in 2025 Hospice News; by Jim Parker; 11/7/24 The Pennant Group (Nasdaq: PNTG) has a “robust pipeline” of potential acquisitions in the wings for 2025 across its home health and hospice and senior living business segments. For prospective deals, Pennant scouts for agencies that show strong promise for organic growth that have “talented” local leaders or entrepreneurs in place, according to CEO Brent Guerisoli. Pennant then leverages the resources in its platform to foster growth. “Developing local leaders remains at the heart of our operating model,” Guerisoli said in a Q3 earnings call. “As the talent and experience operations and clusters deepens with strong portfolio companies, our efforts throughout our footprint, we are able to more quickly improve new acquisitions and grow seasoned operations, thus the significant investment we have made in our leadership and development programs is the catalyst for enduring momentum.” Pennant is the holding company for a cluster of independent hospice, home health and senior living providers located across 13 states. Year to date, the company has added more than 60 CEOs to its portfolio agencies as well as 40 internal clinical leaders.

Arden Home Health and Hospice partners with ADP to formally announce opening of Hattiesburg offices Accesswire; by Arden Home Health & Hospice; 11/4/24 Arden Home Health and Hospice is excited to announce the formal opening of its new corporate headquarters in Hattiesburg, Mississippi. This marks a key milestone in the company's growth and success. The celebration, held on Friday, November 1, 2024, featured a ribbon-cutting ceremony in partnership with the Area Development Partnership (ADP). Under the leadership of Founder and CEO Abb Payne, Arden has experienced tremendous growth, having doubled the size of its workforce in just 11 short months. Payne emphasized the importance of this expansion, particularly for South Mississippi: "The opening of our Hattiesburg headquarters is more than just a brick-and-mortar event; it symbolizes a year of incredible growth and success. Our family's goal has always been to keep jobs in South Mississippi, and this new office represents our commitment to this region."

Choice Health at Home announces new credit facilities and the strategic acquisition of Accentra Home Health and Hospice News Channel Nebraska Southeast; Press Release; 11/6/24 Choice Health at Home (“Choice”), a leading multi-state operator of home health, hospice, private duty, and rehabilitation services providing care throughout the Southwestern US, is proud to announce the company’s most recent acquisition and newly expanded credit facilities for the future growth of the organization. On the transaction front, Choice announced its acquisition of Accentra Home Health and Hospice (“Accentra”), a multi-agency home health and hospice organization in the state of Oklahoma. The merger of Accentra with Choice’s already significant existing Oklahoma home health and hospice agencies will dramatically strengthen the company’s presence in Oklahoma and provide the infrastructure for a long-term strategic plan to cover more than 90% of the state’s urban and rural geographies.

Longer hospice stays among dementia patients save Medicare dollars Hospice News; by Holly Vossel; 11/4/24 Hospice utilization has tripled among patients diagnosed with Alzheimer’s disease and related dementias (ADRD) during the past two decades. The trend has ignited concerns about these patients’ lengths of stay, as well as praise for hospices’ cost-savings potential. Massachusetts Institute of Technology (MIT) researchers analyzed Medicare fee-for-service claims spanning between 1999 and 2019, including data on hospice billing, patient enrollment, hospitalizations, health costs and chronic condition indicators. Roughly 14.7% of ADRD patients utilized hospices services in 2019, nearly triple the 4.4% of patients who received this care in 1999, according to the research, which was published in the National Bureau of Economic Research. The research compared billing claims among nonprofit and for-profit providers to explore spending associated with longer hospice stays among dementia patients. ...

Mission Health Services acquires Angel’s Crossing Home Hospice Hospice News; by Jim Parker; 11/4/24 The long term care company Mission Health Services has acquired Utah-based Angel’s Crossing Home Hospice. Mission is a nonprofit provider of nursing home, assisted living, short term care, memory care and therapy services. The M&A advisory firm Agenda Health facilitated the transaction. Financial terms were undisclosed. The deal marks Mission’s first foray into the hospice space. “The sellers made the strategic decision to divest their business to pursue a new venture. Their goal was to reallocate their time, energy and resources towards founding a hospice in a different region of the country,” Stephen Walters, senior director for Agenda Health, told Hospice News in an email. 

Cigna considers Humana acquisition – What it means for the stocks MarketBeat; by Jea Yu; 10/29/24 There has been speculation of a massive merger in the medical sector between two massive health insurers. Specifically, the rumor is The Cigna Group NYSE: CI is interested in acquiring Humana Inc. NYSE: HUM. The conjecture caused both stocks to react, as Cigna stock fell 10% as the rumored surfaced on Oct. 18, 2024, and Humana stock remained relatively flat. Based on the reactions, the market doesn't see this as a favorable merger, and for good reason. While there are many potential synergies in a merger, assuming it passes the regulatory antitrust sniff test (which is a big "if"), there is also a major sticking point that sinks any possibility of it coming to fruition called Medicare Advantage (MA). 

Vitas, Big Bend, Heart to Heart, Family Hospice unveil new locations Hospice News; by Holly Vossel; 10/25/24 

Healthcare trends & transactions Q3 2024 Bass, Berry & Sims; by Bass, Berry & Sims, PLC; 10/21/24 In the healthcare mergers and acquisitions (M&A) market, while deal volumes varied across different sectors, by and large the sure and steady pace of deal volume in Q2 continued into Q3. Moreover, several positive developments in Q3—namely, the Federal Reserve (finally) cutting interest rates, the courts striking down the Federal Trade Commission’s (FTC) national ban on non-competes, and California Governor Newsom’s vetoing Assembly Bill 3129—may serve as the catalysts needed to boost activity as we head into the final stretch of 2024.

Gentiva reaches $19.4 million False Claims Act Settlement Policy & Medicine; by Thomas Sullivan; 10/15/24 Gentiva – formerly known as Kindred at Home – reached a $19.4 million settlement with the United States, resolving allegations that it violated the False Claims Act by holding on to overpayments for hospice services provided to patients who were ineligible to receive hospice benefits under various federal health care programs. Kindred is made up of entities that were previously part of an enterprise that did business through various subsidiaries as Kindred at Home. Kindred provided health care services, including hospice services, using various business names during the time periods relevant to the settlement. The settlement resolves allegations brought by the United States and the State of Tennessee against certain Kindred entities alleging that from 2010 until February 2020, the entities knowingly submitted (or caused to be submitted) false claims for hospice services to hospice patients in Tennessee and other states who were ineligible for Medicare or Medicaid hospice benefit because they were not terminally ill. The settlement further resolved allegations that the defendants improperly concealed or otherwise avoided the obligation to repay the hospice claims at issue. The settlement also resolves allegations that SouthernCare New Beacon – a subsidiary – allegedly violated the Anti-Kickback Statute by willfully paying remuneration to a consulting physician to induce Medicare beneficiary hospice referrals.