Aveanna Healthcare Holdings has completed its acquisition of Family First Homecare for $175.5 million in cash, expanding the company’s presence in the pediatric private-duty nursing market and strengthening its position in several key growth states.
The Atlanta-based home healthcare provider said the deal adds 27 Family First Homecare locations across seven states — Florida, Illinois, Iowa, North Carolina, Pennsylvania, South Dakota and Texas — while increasing its scale in the specialized pediatric care segment. The acquisition was funded with cash on hand.
The transaction reflects ongoing consolidation in the home healthcare industry as providers seek greater geographic density, operational scale and access to high-acuity patient populations. Demand for in-home care services continues to grow as healthcare systems and payers increasingly favor lower-cost care settings for medically complex patients.
Family First Homecare specializes primarily in skilled private-duty nursing services for pediatric patients, a market that requires significant clinical expertise and faces persistent workforce shortages. For Aveanna, the acquisition deepens its presence in a category where provider scale and clinician recruitment capabilities can create competitive advantages.
“Family First Homecare is a perfect fit for us,” said Jeff Shaner, CEO of Aveanna, citing the company’s clinical model and established presence in several strategic markets.
Beyond expanding Aveanna’s geographic footprint, the deal increases market density in states where the company already operates, a factor that can improve caregiver utilization, referral relationships and operational efficiency. In home healthcare, scale within individual markets is often as important as national expansion, allowing providers to better manage staffing and service delivery across large patient populations.
The acquisition also contributes immediately to Aveanna’s financial outlook. The company raised its full-year 2026 revenue guidance to between $2.63 billion and $2.65 billion, up from its prior range of $2.56 billion to $2.58 billion. The increase is entirely attributable to Family First Homecare, which is expected to contribute approximately $70 million in revenue during the fiscal year ending January 2, 2027.
Aveanna likewise increased its full-year Adjusted EBITDA guidance to between $338 million and $342 million, compared with its previous forecast of $328 million to $332 million. Family First Homecare is expected to add roughly $10 million in Adjusted EBITDA.
The updated guidance offers a clearer picture of the acquisition’s strategic value. While the deal expands Aveanna’s reach geographically, it also adds earnings and strengthens the company’s position in a segment of home healthcare that benefits from long-term patient relationships and recurring care needs.
The acquisition comes as healthcare providers continue investing in home-based care models amid rising healthcare costs and ongoing efforts to shift treatment away from hospitals and institutional settings. Pediatric private-duty nursing has become an increasingly important component of that transition, enabling medically complex children to receive care at home while reducing reliance on higher-cost facilities.
With the Family First integration now underway, Aveanna is further consolidating its position as one of the largest providers of specialized home healthcare services in the United States, while expanding its ability to serve a growing population of medically complex pediatric patients across multiple regions.
