AVAH

MKT CAP $2.8BP/E 10.3DIV YIELD —FCF YIELD —REV TTM $2.6B +19.5%NET INCOME $274.8M +1380.8%NET DEBT $1.2B52W 6.22 – 14.38SEC XBRL · TTM TO Invalid Date

How AVAH rewrote its risk factors

10-K ITEM 1A · FY2024 → FY2026

Text kept

35%

of sentences unchanged

Added

423

new sentences

Dropped

400

sentences removed

Length

+1,859

words, now 33,944

New in FY2026

Our “fiscal year 2025” refers to the 53-week fiscal year ended on January 3, 2026.
The following table summarizes the revenues generated by each of our segments for the fiscal years ended January 3, 2026 and December 28, 2024: (dollars in thousands) Consolidated PDS HHH MS For the fiscal year ended January 3, 2026 $ 2,433,199 $ 2,001,147 $ 248,557 $ 183,495 Percentage of consolidated revenue % % % For the fiscal year ended December 28, 2024 $ 2,024,506 $ 1,634,609 $ 217,805 $ 172,092 Percentage of consolidated revenue % % % PDS Segment Private Duty Services predominantly includes private duty nursing services (“PDN Services”), as well as pediatric therapy services (“Therapy Services”).
PDN Services patients typically enter our service as children, as our most significant referral sources for new patients are children’s hospitals.
It is common for PDN Services patients to continue to receive our services into adulthood, as approximately 30% of our PDN Services patients are over the age of 18.
PDN Services involve the provision of clinical and non-clinical hourly care to patients in their homes, which is the preferred setting for patient care.
PDN Services typically last four to 24 hours a day, provided by our registered nurses, licensed practical nurses, home health aides, and other non-clinical caregivers who are focused on providing high-quality short-term and long-term clinical care to medically complex children and adults with a wide variety of serious illnesses and conditions.
Patients who typically qualify for PDN Services include those with the following conditions: • Tracheotomies or ventilator dependence; • Dependence on continuous nutritional feeding through a “G-tube” or “NG-tube”; • Dependence on intravenous nutrition; • Oxygen-dependence in conjunction with other medical needs; and • Complex medical needs such as frequent seizures.
PDN Services include: • In-home skilled nursing services to medically complex children and adults; • Nursing services in school settings in which our caregivers accompany patients to school; • Services to patients in our Pediatric Day Healthcare Centers (“PDHC”); and • Non-clinical care, including programs such as support services and personal care services.
Therapy Services provide a valuable multidisciplinary approach that we believe serves all of a child’s therapy needs.
Therapy Services include physical, occupational and speech services.
HHH Segment Our Home Health and Hospice segment predominantly includes home health services (“HH Services”), as well as hospice and specialty program services.
HH Services involve the provision of in-home services to our patients by our clinicians, which may include nurses, therapists, social workers and home health aides.
HH Services include: in-home skilled nursing services; physical, occupational and speech therapy; medical social services and aide services.
Recent Developments Regulatory Developments On June 30, 2025, the Centers for Medicare & Medicaid Services (“CMS”) issued its calendar year 2026 (“CY 2026”) proposed rule for the home health prospective payment system.
CMS estimates the proposed rule would reduce home health payments by 6.4% in CY 2026 relative to 2025.
On November 28, 2025, CMS released the final rule which reduced Medicare reimbursement rates by 1.3%.
This update includes a 3.2% market basket update, reduced by a 0.8% cut for productivity.
Future changes in CMS reimbursement methodology, or future decreases in reimbursement rates could have a material adverse effect on our business, financial condition, results of operations, and cash flows.
On July 4, 2025, H.R. 1, also known as the One Big Beautiful Bill Act (“OBBBA”), was enacted into law.
The Congressional Budget Office projects OBBBA will result in a reduction to federal Medicaid spending by an estimated $1.15 trillion over the next ten years.
The changes to Medicaid made by OBBBA include provisions expected to reduce the population of Medicaid recipients through more stringent eligibility requirements, reductions in provider taxes, work (community engagement) requirements, limits on state-directed payments, and other changes.
Most of the applicable provisions have implementation dates of December 31, 2026, or later.
While there were no specific changes to the Medicaid waiver programs that a majority of our patient population qualifies for services under and no provisions that we believe directly impact the reimbursement rates of the services we provide, the resulting reductions to state Medicaid budgets may indirectly impact future rate expansion for certain Medicaid-funded services.
Agreement to Acquire Family First Homecare On March 12, 2026, the Company announced that it had entered into a definitive agreement to acquire Family First Holding, LLC, a scaled, multi-state provider of pediatric home care that primarily provides skilled Private Duty Nursing services with 27 locations in seven states including Florida, Illinois, Iowa, Pennsylvania, South Dakota, Texas, and North Carolina, where it is currently launching operations.
The purchase price for the acquisition is $175.5 million in cash, subject to customary adjustments.
The transaction is expected to close in the second fiscal quarter of 2026, subject to, among other things, customary closing conditions, including the expiration or termination of the waiting period under the Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended.
We intend to fund the acquisition with a combination of cash on hand and borrowings under our Securitization Facility.
We review the number of home health admissions on a daily basis as we believe it is a leading indicator of our growth.
We measure home health admissions by reimbursement structure, separating them into home health episodic admissions, which are reimbursed for a fixed duration of care (typically 30 days), and other admissions, which primarily follow a per-visit reimbursement model.
This allows us to better understand the payor mix of our home health business.
Results of Operations Fiscal Year Ended January 3, 2026 Compared to the Fiscal Year Ended December 28, 2024 The following table summarizes our consolidated results of operations, including Field contribution, which is a non-GAAP measure (see “Non-GAAP Financial Measures” below), for the fiscal years indicated: For the fiscal years ended (dollars in thousands) January 3, 2026 % of Revenue December 28, 2024 % of Revenue Change % Change Revenue $ 2,433,199 100.0 % $ 2,024,506 100.0 % $ 408,693 20.2 % Cost of revenue, excluding depreciation and amortization 1,622,718 66.7 % 1,388,964 68.6 % 233,754 16.8 % Gross margin $ 810,481 33.3 % $ 635,542 31.4 % $ 174,939 27.5 % Branch and regional administrative expenses 374,496 15.4 % 352,814 17.4 % 21,682 6.1 % Field contribution $ 435,985 17.9 % $ 282,728 14.0 % $ 153,257 54.2 % Corporate expenses 163,310 6.7 % 125,402 6.2 % 37,908 30.2 % Depreciation and amortization 10,538 0.4 % 10,778 0.5 % (240 ) -2.2 % Acquisition-related costs 3,813 0.2 % 1,490 0.1 % 2,323 155.9 % Other operating expense 1,861 0.1 % 5,271 0.3 % (3,410 ) -64.7 % Operating income $ 256,463 10.5 % $ 139,787 6.9 % $ 116,676 83.5 % Interest expense, net (137,255 ) (156,104 ) 18,849 -12.1 % Loss on debt extinguishment (5,862 ) - (5,862 ) -100.0 % Other (expense) income (6,398 ) 21,389 (27,787 ) -129.9 % Income tax benefit (expense) 118,086 (16,001 ) 134,087 -838.0 % Net income (loss) $ 225,034 $ (10,929 ) $ 235,963 NM NM = A percentage calculation that is not meaningful due to a percentage change greater than 1000%.
The following table summarizes our consolidated key performance measures, including Field contribution and Field contribution margin, which are non-GAAP measures (see “Non-GAAP Financial Measures” below), for the fiscal years indicated: For the fiscal years ended (dollars in thousands) January 3, 2026 December 28, 2024 Change % Change Revenue $ 2,433,199 $ 2,024,506 $ 408,693 20.2 % Cost of revenue, excluding depreciation and amortization 1,622,718 1,388,964 233,754 16.8 % Gross margin $ 810,481 $ 635,542 $ 174,939 27.5 % Gross margin percentage 33.3 % 31.4 % 1.9 % (1) Branch and regional administrative expenses 374,496 352,814 21,682 6.1 % Field contribution $ 435,985 $ 282,728 $ 153,257 54.2 % Field contribution margin 17.9 % 14.0 % Corporate expenses $ 163,310 $ 125,402 $ 37,908 30.2 % As a percentage of revenue 6.7 % 6.2 % Operating income $ 256,463 $ 139,787 $ 116,676 83.5 % As a percentage of revenue 10.5 % 6.9 % (1) Represents the change in margin percentage period over period.
The following tables summarize our key performance measures by segment for the fiscal years indicated: PDS For the fiscal years ended (dollars and hours in thousands) January 3, 2026 December 28, 2024 Change % Change Revenue $ 2,001,147 $ 1,634,609 $ 366,538 22.4 % Cost of revenue, excluding depreciation and amortization 1,409,376 1,190,148 219,228 18.4 % Gross margin $ 591,771 $ 444,461 $ 147,310 33.1 % Gross margin percentage 29.6 % 27.2 % 2.4 % (4) Hours 46,123 41,562 4,561 11.0 % Revenue rate $ 43.39 $ 39.33 $ 4.06 11.4 % (1) Cost of revenue rate $ 30.56 $ 28.64 $ 1.92 7.4 % (2) Spread rate $ 12.83 $ 10.69 $ 2.14 22.1 % (3) HHH For the fiscal years ended (dollars and admissions/episodes in thousands) January 3, 2026 December 28, 2024 Change % Change Revenue $ 248,557 $ 217,805 $ 30,752 14.1 % Cost of revenue, excluding depreciation and amortization 114,299 101,310 12,989 12.8 % Gross margin $ 134,258 $ 116,495 $ 17,763 15.2 % Gross margin percentage 54.0 % 53.5 % 0.5 % (4) Home health total admissions (5) 39.6 36.9 2.7 7.3 % Home health episodic admissions (6) 30.4 28.0 2.4 8.6 % Home health total episodes (7) 51.4 46.2 5.2 11.3 % Home health episodic mix (8) 76.8 % 75.9 % 0.9 % (10) Home health revenue per completed episode (9) $ 3,206 $ 3,099 $ 3.5 % MS For the fiscal years ended (dollars and UPS in thousands) January 3, 2026 December 28, 2024 Change % Change Revenue $ 183,495 $ 172,092 $ 11,403 6.6 % Cost of revenue, excluding depreciation and amortization 99,043 97,506 1,537 1.6 % Gross margin $ 84,452 $ 74,586 $ 9,866 13.2 % Gross margin percentage 46.0 % 43.3 % 2.7 % (4) Unique patients served (“UPS”) (4 ) -1.1 % Revenue rate $ 505.50 $ 468.92 $ 36.58 7.7 % (1) Cost of revenue rate $ 272.85 $ 265.68 $ 7.17 2.7 % (2) Spread rate $ 232.65 $ 203.24 $ 29.41 14.3 % (3) (1) Represents the period over period change in revenue rate, plus the change in revenue rate attributable to the change in volume.
(2) Represents the period over period change in cost of patient services rate, plus the change in cost of patient services rate attributable to the change in volume.
(3) Represents the period over period change in spread rate, plus the change in spread rate attributable to the change in volume.
(4) Represents the change in margin percentage period over period.
(5) Represents home health episodic and other admissions.
(6) Represents home health episodic admissions.
(7) Represents episodic admissions and recertifications.
(8) Represents the ratio of home health episodic admissions to home health total admissions.

and 383 more.

Gone since FY2024

Our “fiscal year 2022” refers to the 52-week fiscal year ended on December 31, 2022.
The following table summarizes the revenues generated by each of our segments for the fiscal years ended December 28, 2024 and December 30, 2023: (dollars in thousands) Consolidated PDS HHH MS For the fiscal year ended December 28, 2024 $ 2,024,506 $ 1,634,609 $ 217,805 $ 172,092 Percentage of consolidated revenue % % % For the fiscal year ended December 30, 2023 $ 1,895,209 $ 1,518,811 $ 218,628 $ 157,770 Percentage of consolidated revenue % % % PDS Segment Private Duty Services predominantly includes private duty nursing (“PDN”) services, as well as pediatric therapy services.
Our PDN patients typically enter our service as children, as our most significant referral sources for new patients are children’s hospitals.
It is common for our PDN patients to continue to receive our services into adulthood, as approximately 30% of our PDN patients are over the age of 18.
Our PDN services involve the provision of clinical and non-clinical hourly care to patients in their homes, which is the preferred setting for patient care.
PDN services typically last four to 24 hours a day, provided by our registered nurses, licensed practical nurses, home health aides, and other non-clinical caregivers who are focused on providing high-quality short-term and long-term clinical care to medically fragile children and adults with a wide variety of serious illnesses and conditions.
Patients who typically qualify for our PDN services include those with the following conditions: • Tracheotomies or ventilator dependence; • Dependence on continuous nutritional feeding through a “G-tube” or “NG-tube”; • Dependence on intravenous nutrition; • Oxygen-dependence in conjunction with other medical needs; and • Complex medical needs such as frequent seizures.
Our PDN services include: • In-home skilled nursing services to medically fragile children and adults; • Nursing services in school settings in which our caregivers accompany patients to school; • Services to patients in our Pediatric Day Healthcare Centers (“PDHC”); and • Non-clinical care, including programs such as support services and personal care services.
Through our pediatric therapy services, we provide a valuable multidisciplinary approach that we believe serves all of a child’s therapy needs.
Our therapy services include physical, occupational and speech services.
HHH Segment Our Home Health and Hospice segment predominantly includes home health services, as well as hospice and specialty program services.
Our home health services involve the provision of in-home services to our patients by our clinicians, who may include nurses, therapists, social workers and home health aides.
Our home health services include: in-home skilled nursing services; physical, occupational and speech therapy; medical social services and aide services.
We review the number of home health admissions on a daily basis because we believe it is a leading indicator of our growth.
We measure home health admissions by reimbursement structure, separating them into home health episodic admissions and fee-for-service admissions (other admissions), which allows us to better understand the payer mix of our home health business.
Results of Operations Fiscal Year Ended December 28, 2024 Compared to the Fiscal Year Ended December 30, 2023 The following table summarizes our consolidated results of operations for the fiscal years indicated: For the fiscal years ended (dollars in thousands) December 28, 2024 % of Revenue December 30, 2023 % of Revenue Change % Change Revenue $ 2,024,506 100.0 % $ 1,895,209 100.0 % $ 129,297 6.8 % Cost of revenue, excluding depreciation and amortization 1,388,964 68.6 % 1,299,777 68.6 % 89,187 6.9 % Gross margin $ 635,542 31.4 % $ 595,432 31.4 % $ 40,110 6.7 % Branch and regional administrative expenses 352,814 17.4 % 360,978 19.0 % (8,164 ) -2.3 % Corporate expenses 125,402 6.2 % 113,034 6.0 % 12,368 10.9 % Goodwill impairment - 0.0 % 105,136 5.5 % (105,136 ) -100.0 % Depreciation and amortization 10,778 0.5 % 13,778 0.7 % (3,000 ) -21.8 % Acquisition-related costs 1,490 0.1 % 0.0 % 1,024 219.7 % Other operating expense (income) 5,271 0.3 % (6,032 ) -0.3 % 11,303 -187.4 % Operating income $ 139,787 6.9 % $ 8,072 0.4 % $ 131,715 NM Interest expense, net (156,104 ) (152,919 ) (3,185 ) 2.1 % Other income 21,389 5,851 15,538 265.6 % Income tax (expense) benefit (16,001 ) 4,472 (20,473 ) -457.8 % Net loss $ (10,929 ) $ (134,524 ) $ 123,595 -91.9 % The following table summarizes our consolidated key performance measures, including Field contribution and Field contribution margin, which are non-GAAP measures (see “Non-GAAP Financial Measures” below), for the fiscal years indicated: For the fiscal years ended (dollars in thousands) December 28, 2024 December 30, 2023 Change % Change Revenue $ 2,024,506 $ 1,895,209 $ 129,297 6.8 % Cost of revenue, excluding depreciation and amortization 1,388,964 1,299,777 89,187 6.9 % Gross margin $ 635,542 $ 595,432 $ 40,110 6.7 % Gross margin percentage 31.4 % 31.4 % Branch and regional administrative expenses 352,814 360,978 (8,164 ) -2.3 % Field contribution $ 282,728 $ 234,454 $ 48,274 20.6 % Field contribution margin 14.0 % 12.4 % Corporate expenses $ 125,402 $ 113,034 $ 12,368 10.9 % As a percentage of revenue 6.2 % 6.0 % Operating income $ 139,787 $ 8,072 $ 131,715 NM As a percentage of revenue 6.9 % 0.4 % The following tables summarize our key performance measures by segment for the fiscal years indicated: PDS For the fiscal years ended (dollars and hours in thousands) December 28, 2024 December 30, 2023 Change % Change Revenue $ 1,634,609 $ 1,518,811 $ 115,798 7.6 % Cost of revenue, excluding depreciation and amortization 1,190,148 1,095,091 95,057 8.7 % Gross margin $ 444,461 $ 423,720 $ 20,741 4.9 % Gross margin percentage 27.2 % 27.9 % -0.7 % (4) Hours 41,562 39,818 1,744 4.4 % Revenue rate $ 39.33 $ 38.14 $ 1.19 3.2 % (1) Cost of revenue rate $ 28.64 $ 27.50 $ 1.14 4.3 % (2) Spread rate $ 10.69 $ 10.64 $ 0.05 0.5 % (3) HHH For the fiscal years ended (dollars and admissions/episodes in thousands) December 28, 2024 December 30, 2023 Change % Change Revenue $ 217,805 $ 218,628 $ (823 ) -0.4 % Cost of revenue, excluding depreciation and amortization 101,310 113,762 (12,452 ) -10.9 % Gross margin $ 116,495 $ 104,866 $ 11,629 11.1 % Gross margin percentage 53.5 % 48.0 % 5.5 % (4) Home health total admissions (5) 36.9 40.1 (3.2 ) -8.0 % Home health episodic admissions (6) 28.0 28.6 (0.6 ) -2.1 % Home health total episodes (7) 46.2 45.5 0.7 1.5 % Home health episodic mix (8) 75.9 % 71.3 % 4.6 % Home health revenue per completed episode (9) $ 3,099 $ 3,032 $ 2.2 % MS For the fiscal years ended (dollars and UPS in thousands) December 28, 2024 December 30, 2023 Change % Change Revenue $ 172,092 $ 157,770 $ 14,322 9.1 % Cost of revenue, excluding depreciation and amortization 97,506 90,924 6,582 7.2 % Gross margin $ 74,586 $ 66,846 $ 7,740 11.6 % Gross margin percentage 43.3 % 42.4 % 0.9 % (4) Unique patients served (“UPS”) 5.5 % Revenue rate $ 468.92 $ 453.36 $ 15.56 3.6 % (1) Cost of revenue rate $ 265.68 $ 261.28 $ 4.40 1.7 % (2) Spread rate $ 203.24 $ 192.08 $ 11.16 6.1 % (3) 1.
Represents the period over period change in revenue rate, plus the change in revenue rate attributable to the change in volume. 2.
Represents the period over period change in cost of patient services rate, plus the change in cost of patient services rate attributable to the change in volume. 3.
Represents the period over period change in spread rate, plus the change in spread rate attributable to the change in volume. 4.
Represents the change in margin percentage year over year. 5.
Represents home health episodic and fee-for-service admissions. 6.
Represents home health episodic admissions. 7.
Represents episodic admissions and recertifications. 8.
Represents the ratio of home health episodic admissions to home health total admissions. 9.
Represents Medicare revenue per completed episode.
Summary Operating Results Operating Income Operating income was $139.8 million, or 6.9% of revenue, for the fiscal year ended December 28, 2024, as compared to an operating income of $8.1 million, or 0.4% of revenue, for the fiscal year ended December 30, 2023, an increase of $131.7 million.
The change in operating income for fiscal year 2024 primarily resulted from the $105.1 million in non-cash impairment charges recorded during fiscal year 2023, and a $48.3 million, or 20.6%, increase in Field contribution as compared to fiscal year 2023.
The $48.3 million increase in Field contribution resulted from a $129.3 million, or 6.8%, increase in consolidated revenue and a 1.6% improvement in Field contribution margin to 14.0% for fiscal year 2024 from 12.4% for fiscal year 2023.
The primary drivers of our higher Field contribution margin over the comparable fiscal year period was a 1.6% decrease in branch and regional administrative expense as a percentage of revenue to 17.4% for fiscal year 2024 from 19.0% for fiscal year 2023.
Net Loss The $123.6 million decrease in net loss over the comparable fiscal year periods, was primarily driven by the following: • the previously discussed $131.7 million increase in operating income; and • an aggregate $15.7 million decrease in valuation losses on interest rate derivatives and increase in net settlements received from interest rate derivative counterparties over the comparable periods; offset by • a $20.5 million increase in income tax expense; and • a $3.2 million increase in interest expense, net of interest income.
Revenue Revenue was $2,024.5 million for the fiscal year ended December 28, 2024 as compared to $1,895.2 million for the fiscal year ended December 30, 2023, an increase of $129.3 million, or 6.8%.
This increase resulted from the following segment activity: • a $115.8 million, or 7.6% increase in PDS revenue; • a $0.8 million, or 0.4%, decrease in HHH revenue; and • a $14.3 million, or 9.1%, increase in MS revenue.
Our PDS segment revenue growth of $115.8 million, or 7.6%, for the fiscal year ended December 28, 2024 was attributable to an increase in volume of 4.4% and an increase in revenue rate of 3.2%.
The increase in PDS volume on a year over year basis was attributable to growth in demand for non-clinical services.
The 3.2% increase in PDS revenue rate for the fiscal year ended December 28, 2024, as compared to the fiscal year ended December 30, 2023, resulted primarily from reimbursement rate increases issued by various state Medicaid programs and managed Medicaid payers and increases in value-based payments, offset by increases in implicit price concessions.
Our HHH segment revenue decline of $0.8 million, or 0.4%, for the fiscal year ended December 28, 2024 resulted primarily from a decline in non-episodic volumes over the comparable fiscal year period.
While home health total admissions declined 8.0% over the comparable period, total segment revenue declined by a lower rate primarily due to the 4.6% improvement in home health episodic mix.
Our MS segment revenue growth of $14.3 million, or 9.1%, for the fiscal year ended December 28, 2024, as compared to the fiscal year ended December 30, 2023, was attributable to 5.5% volume growth combined with an increase in revenue rate of 3.6% over the comparable period .
Cost of Revenue, Excluding Depreciation and Amortization Cost of revenue, excluding depreciation and amortization, was $1,389.0 million for the fiscal year ended December 28, 2024, as compared to $1,299.8 million for the fiscal year ended December 30, 2023, an increase of $89.2 million, or 6.9%.
This increase resulted from the following segment activity: • a $95.1 million, or 8.7%, increase in PDS cost of revenue; • a $12.5 million, or 10.9%, decrease in HHH cost of revenue; and • a $6.6 million, or 7.2%, increase in MS cost of revenue.

and 360 more.

Sentence-level comparison of Item 1A in the two most recent 10-Ks (FY2024 ↗, FY2026 ↗). A reworded sentence counts as one dropped and one added, so heavy edits read as low “kept”. Headings and page furniture are stripped; nothing is summarised by a model.

Watch AVAH. Know when insiders buy.

One email the day a filing lands. Free.