Aveanna Healthcare (AVAH) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue reached $662.5 million, up 27.4% year-over-year, with Adjusted EBITDA of $85 million, up 54%, and net income of $178.8 million, up from $29.2 million in the prior year period.

• Full year 2025 revenue was $2,433.2 million, up 20.2%, with Adjusted EBITDA of $320.9 million, up 74.8%, and net income of $225 million versus a net loss of $10.9 million in 2024.

• Strategic transformation over three years led to growth across all divisions, with a focus on preferred payer and government strategies.

• Integration of Thrive Skilled Pediatric Care completed; agreement to acquire Family First Homecare announced.

• Strong demand for home and community-based care, with improved caregiver hiring and retention trends.

Financial highlights

• Q4 consolidated gross margin was $213.3 million (32.2%), with all three divisions showing double-digit revenue growth.

• Full year gross margin was $810.5 million (33.3% of revenue), up 27.5%.

• Adjusted net income per diluted share for Q4 was $0.17; for the year, $0.60.

• Free cash flow for the year was $131 million.

• Operating cash flow for 2025 was $125.9 million.

Outlook and guidance

• 2026 revenue guidance is $2.54–$2.56 billion, with Adjusted EBITDA of $318–$322 million, excluding the impact of the Family First acquisition.

• Organic revenue growth is expected in the 5–7% range, with EBITDA growth in the high single digits.

• Preferred payer agreements in Private Duty Services targeted to grow from 30 to 38 in 2026; Home Health preferred payer agreements expected to exceed 50.

• Medical Solutions expected to return to double-digit growth by year-end 2026, with gross margins normalizing to 43–45%.