On March 19, Aveanna Healthcare Holdings Inc. (NASDAQ: AVAH), a leading, diversified home care platform focused on providing care to medically complex, high-cost patient populations, announced financial results for the three-month period and fiscal year ended January 3, 2026.
Jeff Shaner, chief executive officer (pictured at top), commented, “The strength and momentum of all three operating divisions can be seen in our fourth quarter results as we complete the third year of our Strategic Transformation. Fourth quarter results are headlined by revenue and adjusted EBITDA growth of 27.4% and 54.0%, respectively, when compared to the prior year period. With the integration of Thrive Skilled Pediatric Care completed, we are well-positioned for further acquisition activity, including the recently announced Family First Homecare transaction. Our confirmed guidance underscores the strength of our core business model as we continue to provide high quality and cost-effective care to our patients in their preferred care setting – the home. These results reflect the extraordinary efforts and the determination of our entire team at Aveanna, who deliver on our mission of exceptional care every day.”
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, 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.
Details on the Fourth-Quarter Results
Revenue was $662.5 million for the three-month period ended January 3, 2026, as compared to $519.9 million for the three-month period ended December 28, 2024, an increase of $142.6 million, or 27.4%. The overall increase in revenue was attributable to a $118.5 million increase in PDS segment revenue, a $14.9 million increase in HHH segment revenue, and a $9.2 million increase in MS segment revenue compared to the fourth quarter of 2024.
Gross margin was $213.3 million, or 32.2% of revenue, for the three-month period ended January 3, 2026, as compared to $171.7 million, or 33.0% of revenue, for the three-month period ended December 28, 2024, an increase of $41.6 million, or 24.2%.
Net income was $178.8 million for the three-month period ended January 3, 2026, as compared to net income of $29.2 million for the three-month period ended December 28, 2024. Net income per diluted share was $0.80 for the three-month period ended January 3, 2026, as compared to net income per diluted share of $0.14 for the three-month period ended December 28, 2024. Adjusted net income per diluted share was $0.17 for the three-month period ended January 3, 2026, as compared to adjusted net income per diluted share of $0.05 for the three-month period ended December 28, 2024.
Adjusted EBITDA was $85.0 million, or 12.8% of revenue, for the three-month period ended January 3, 2026, as compared to $55.2 million, or 10.6% of revenue, for the three-month period ended December 28, 2024, an increase of $29.8 million or 54%.
Year Ended January 3, 2026 and December 28, 2024
Revenue was $2,433.2 million for the fiscal year ended January 3, 2026, as compared to $2,024.5 million for the fiscal year ended December 28, 2024, an increase of $408.7 million, or 20.2%. The overall increase in revenue was attributable to a $366.5 million increase in PDS segment revenue, a $30.8 million increase in HHH segment revenue, and a $11.4 million increase in MS segment revenue compared to the fiscal year 2024.
Gross margin was $810.5 million, or 33.3% of revenue, for the fiscal year ended January 3, 2026, as compared to $635.5 million, or 31.4% of revenue, for the fiscal year ended December 28, 2024, an increase of $174.9 million, or 27.5%.
Net income was $225.0 million for the fiscal year ended January 3, 2026, as compared to net loss of $10.9 million for the fiscal year ended December 28, 2024. Net income per diluted share was $1.05 for the fiscal year ended January 3, 2026, as compared to net loss per diluted share of $(0.06) for the fiscal year ended December 28, 2024. Adjusted net income per diluted share was $0.60 for the fiscal year ended January 3, 2026, as compared to adjusted net income per diluted share of $0.06 for the fiscal year ended December 28, 2024.
Adjusted EBITDA was $320.9 million, or 13.2% of revenue, for the fiscal year ended January 3, 2026, as compared to $183.6 million, or 9.1% of revenue, for the fiscal year ended December 28, 2024, an increase of $137.3 million or 74.8%.
Liquidity, Cash Flow, and Debt
As of January 3, 2026, we had cash of $193.3 million and incremental borrowing capacity of $110.0 million under our securitization facility. Our revolver was undrawn, with approximately $225.5 million of borrowing capacity and approximately $24.5 million of outstanding letters of credit. The pending acquisition, which is being funded with a combination of cash on hand and borrowings under our securitization facility, is expected to reduce our liquidity upon the closing of the transaction.
2025 net cash provided by operating activities was $125.9 million. Free cash flow was $131.0 million for the fiscal year ended January 3, 2026. See “Non-GAAP Financial Measures – Free cash flow” below.
As of January 3, 2026 we had total indebtedness of $1,486.7 million. Our interest rate exposure under our credit facilities is currently hedged with the following instruments:
$520.0 million notional amount of interest rate swaps that convert variable rate debt to a fixed rate, and
$880.0 million notional amount of interest rate caps that cap our exposure to SOFR at 2.96%
Matt Buckhalter, chief financial officer, commented, “2025 was a monumental year for Aveanna. Our team delivered exceptional performance across the business, generating annual revenue growth of 20.2% and Adjusted EBITDA growth of 74.8%. These results reflect the strength of our clinical model, the dedication of our caregivers, and the disciplined execution of our strategy across each of our segments. We also generated $131.0 million in free cash flow during the year, further strengthening our balance sheet and providing additional flexibility to invest in the continued growth at Aveanna. In line with customary practice, we have not included our pending acquisition in our full-year 2026 guidance. We continue to maintain our guidance for 2026 of revenue between $2.54 and $2.56 billion and Adjusted EBITDA between $318 and $322 million.”
