PACS Group (PACS) Q4 2025 earnings summary

Executive summary

• Achieved record 2025 performance with $5.29 billion revenue (up 29–29.3%), $191.5–$191.6 million net income, and $505 million adjusted EBITDA, reflecting successful integration of 2024 acquisitions and disciplined execution.

• Expanded to 321–323 facilities across 17 states, serving over 31,700 patients daily with approximately 47,000 team members.

• Added 8 operating facilities and 7 real estate purchases in 2025, increasing local scale and owned real estate footprint.

• Maintained strong liquidity with $197 million in cash and a net leverage ratio of 0.3x at year-end.

• 207 skilled nursing facilities (73.4%) rated 4 or 5 stars by CMS; mature facilities averaged 4.4 stars and 94.9% occupancy.

Financial highlights

• Full year 2025 revenue: $5.29 billion (up 29–29.3%); net income: $191.5–$191.6 million; diluted EPS: $1.22.

• Adjusted EBITDA for 2025: $505 million (up 81%); adjusted EBITDAR: $883.9 million.

• Q4 2025 revenue: $1.36 billion (up 12–12.4%); net income: $59.8 million.

• Operating cash flow for 2025: $404.2 million; cash and cash equivalents at year-end: $197 million.

• Cost of services rose 25% and G&A expenses increased 21% year-over-year, aligned with platform growth.

Outlook and guidance

• 2026 revenue guidance: $5.65–$5.75 billion (midpoint ~8% growth); adjusted EBITDA: $555–$575 million (midpoint ~12% growth).

• Guidance assumes steady organic growth, margin expansion, stable reimbursement, and disciplined capital allocation.

• Pipeline includes about 5 facility acquisitions per quarter in 2026, with nominal initial revenue and margin.

• Portfolio now includes 323 healthcare operations, with ongoing evaluation of acquisition opportunities.