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HCA Healthcare for home healthcare.

Like a children's hospital that provides continuous, specialized medical care directly in the patient's home.

A skilled nursing facility (SNF) that delivers comprehensive medical, therapeutic, and hospice services to patients in their own homes.

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• Private Duty Nursing: Provides skilled nursing care for medically fragile children and adults in their homes.
• Home Health: Offers skilled nursing, therapy services, and home health aide assistance for adult patients recovering from illness, injury, or surgery.
• Hospice Care: Delivers compassionate end-of-life care focusing on comfort, dignity, and support for patients and their families.
• Medical Solutions (DME/HME): Supplies durable medical equipment and supplies, including enteral nutrition, respiratory services, and incontinence products.

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Major Customers of Aveanna Healthcare (AVAH)

Aveanna Healthcare (AVAH) primarily serves individual patients in their homes. While the company's services are largely reimbursed by government programs (like Medicaid and Medicare) and commercial insurance companies, the direct recipients and beneficiaries of their care are individuals and their families.

Based on its service lines, Aveanna Healthcare serves the following categories of customers:

• Medically Fragile Children and Young Adults: This category primarily includes pediatric and young adult patients with complex medical needs requiring continuous private duty nursing care in their homes. These individuals often have chronic conditions, developmental disabilities, or technology dependencies that necessitate high-acuity care.
• Adult Patients Requiring Skilled Home Health and Hospice Care: This category encompasses adult patients, often seniors, who need skilled nursing, therapy (physical, occupational, speech), or medical social services following a hospital stay, for chronic illness management, or for end-of-life hospice care in their homes.
• Patients Requiring Home Medical Equipment, Supplies, and Nutritional Solutions: This category includes patients of all ages who need durable medical equipment (e.g., respiratory equipment, wheelchairs), various medical supplies (e.g., wound care, incontinence products), and enteral nutrition solutions for their care at home. This often complements their other home care services.

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Jeff Shaner, President and Chief Executive Officer

Jeff Shaner was appointed President and Chief Executive Officer of Aveanna Healthcare in January 2023. He also serves on the Board of Directors. Mr. Shaner is responsible for overseeing the company's three operating divisions: private duty services, medical solutions, and home health and hospice. He has been integral to the formation of Aveanna Healthcare and its strategy to become a leading national provider of homecare. Mr. Shaner brings over 20 years of experience in post-acute healthcare leadership. He began his career in 2000 leading operations at Total Care, Inc. After Total Care was acquired by The Healthfield Group, he led the integration of eight acquired companies into Healthfield, which was subsequently sold to Gentiva Health Services, Inc. in 2006. Following Healthfield's merger with Gentiva, Mr. Shaner held various leadership roles at Gentiva, including President of the Hospice division. After Gentiva's sale to Kindred Healthcare in 2015, Mr. Shaner provided consulting services to Linden Capital Partners and Blue Wolf Capital on post-acute investment opportunities. He joined PSA Healthcare as Chief Operating Officer in 2015 and was instrumental in the formation of Aveanna Healthcare in 2017, a company which is owned by Bain Capital Private Equity and J.H. Whitney Capital Partners.

Matt Buckhalter, Chief Financial Officer and Principal Financial Officer

Matt Buckhalter has more than a decade of financial leadership experience in the healthcare industry. He joined Aveanna in 2016 and is responsible for corporate and operational finance, business intelligence, financial planning and analysis (FP&A), and investor relations. Prior to his current role, Mr. Buckhalter served as Senior Vice President of Finance and led the company's Investor Relations Group. Before joining Aveanna, he was Vice President of Finance for RT Capital and served as a senior financial analyst for Gentiva Health Services. He was appointed Chief Financial Officer, effective January 1, 2024, after serving as Interim Chief Financial Officer and Principal Financial Officer since July 2023.

Rod Windley, Chairman of the Board

Rod Windley has a long and distinguished career in the healthcare industry. He currently serves as Chairman of the Board of Aveanna Healthcare. In 1989, Mr. Windley founded The Healthfield Group, where he served as Chairman and Chief Executive Officer. Healthfield merged with Gentiva Health Services in 2009, and Mr. Windley served as Vice Chairman and later Executive Chairman of Gentiva. Under his leadership, the combined companies grew to over $2 billion in annual revenue. In 2015, he helped guide Gentiva through its merger with Kindred Healthcare, which became the largest sale of homecare assets in the nation's history. Prior to the formation of Aveanna in 2017, Mr. Windley served as Executive Chairman of PSA Healthcare. Aveanna was formed through the merger of Epic Health Services and PSA Healthcare and is owned by private equity firms Bain Capital Private Equity and J.H. Whitney Capital Partners, among other investors. He is a founding member of the National Association for Home Care and Hospice (NAHC).

Kristy Rohwedder, Chief Operating Officer

Kristy Rohwedder oversees both the Private Duty Services Division and the Medical Solutions Division at Aveanna. Prior to joining Aveanna Healthcare, Kristy was the Chief Executive Officer of Florida Autism Center/Fusion Autism Center, where she led rapid expansion efforts. She later served as Chief Operating Officer at BlueSprig Pediatrics after the company was acquired. Ms. Rohwedder also brings extensive experience from her fourteen years at PSA Healthcare, where she held a variety of roles. At Aveanna, she has held key leadership positions, including President of Private Duty Nursing.

Jerry Perchik, Chief Legal Officer and Secretary

Jerry Perchik serves as Aveanna's Chief Legal Officer and Secretary, acting as the primary legal advisor to the Chief Executive Officer, the senior management team, and the Board of Directors. He has over fifteen years of experience in corporate law and the healthcare industry. Before joining Aveanna, Mr. Perchik most recently served as Chief Legal Officer for MedQuest Associates. He has also previously held various corporate leadership roles and legal capacities for both publicly traded and private equity-sponsored healthcare companies.

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Key Risks to Aveanna Healthcare (AVAH)

Aveanna Healthcare (AVAH) faces several critical risks to its business operations and financial outlook, with the most significant challenges stemming from labor market dynamics and government reimbursement policies.

1. Labor Shortages and Wage Inflation: The most significant risk to Aveanna Healthcare is the ongoing challenge of labor shortages, particularly in nursing, coupled with wage inflation. This persistently pressures the margins of the company's core Private Duty Services segment. The company's ability to offer competitive pay to caregivers is heavily dependent on Medicaid rate negotiations, making reimbursement uncertain in key states.
2. Medicaid and Medicare Rate Uncertainty and Regulatory Risks: Aveanna Healthcare generates a substantial portion of its revenue from government programs, with 23% from Medicaid and 10% from Medicare as of the first quarter of 2025. Therefore, reductions in Medicare and Medicaid rates, changes in payment methods, or broader regulatory shifts in healthcare laws could materially and adversely affect the company's revenue stability and profitability.
3. High Variable-Rate Debt and Interest Rate Risk: Aveanna Healthcare is exposed to significant interest rate risk due to its substantial variable-rate debt. This debt structure could lead to increased borrowing costs and strain financial flexibility, especially if industry or macroeconomic conditions worsen, or if interest rates continue to rise.

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The clear emerging threat for Aveanna Healthcare (AVAH) is the aggressive consolidation and integration of home healthcare services by large, technologically advanced healthcare conglomerates and payers, such as UnitedHealth Group's Optum and CVS Health.

These entities possess significant capital, existing patient populations, and robust technological infrastructure. By acquiring major home health providers (e.g., Optum's acquisitions of LHC Group and Amedisys, which are direct competitors to Aveanna), these conglomerates are building highly integrated, data-driven, and efficient care delivery networks that span insurance, pharmacy, primary care, and home care. This strategy allows them to achieve economies of scale, leverage advanced analytics for better outcomes, and offer more comprehensive and potentially lower-cost solutions to patients and payers. This trend directly threatens Aveanna's ability to compete on scale, technology, pricing, and access to patient populations as a standalone provider, mirroring the disruption of traditional businesses by new, integrated, and technologically superior models.

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Aveanna Healthcare (AVAH) operates in several key segments within the home healthcare market, primarily in the United States. The addressable markets for their main products and services are as follows:

• Private Duty Services (PDS)
  • U.S. Pediatric Home Healthcare: The U.S. pediatric home healthcare market size was estimated at approximately USD 13.50 billion in 2024, with projections to reach USD 21.24 billion by 2030, growing at a Compound Annual Growth Rate (CAGR) of 7.85% from 2024 to 2030. Another estimate placed the U.S. pediatric home healthcare market at USD 20.1 billion in 2024, anticipated to grow at a CAGR of 6.5% between 2025 and 2034.
  • U.S. Private Nursing Services (including adult and pediatric): The U.S. private nursing services market generated a revenue of approximately USD 1.84 billion in 2023 and is expected to reach USD 2.69 billion by 2030, with a CAGR of 5.6% from 2024 to 2030.
• Home Health & Hospice (HHH)
  • U.S. Home Healthcare: The U.S. home healthcare market size was approximately USD 194.24 billion in 2024. It is projected to reach around USD 222.61 billion by 2025 and is expected to be worth around USD 644.37 billion by 2034, expanding at a CAGR of 12.74% from 2025 to 2034. Another report estimated the U.S. home healthcare market size at USD 162.35 billion in 2024, with an expectation to reach USD 381.40 billion by 2033, growing at a CAGR of 10.00% from 2025 to 2033.
  • U.S. Hospice Care: The U.S. hospice market size was approximately USD 30.25 billion in 2024 and is projected to reach around USD 47.52 billion by 2034, with a CAGR of 4.62% during the forecast period from 2025 to 2034.
• Medical Solutions (MS)
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Aveanna Healthcare (AVAH) is anticipated to drive future revenue growth over the next 2-3 years through several key strategies:

1. Rate Increases and Favorable Reimbursement Environments: Aveanna Healthcare expects continued revenue growth from rate increases, particularly through an improved payer rate environment and successful negotiation of adequate reimbursement rates from payer and government partners. The company anticipates ongoing "wage pass-through" in late 2025 and into 2026, and is targeting double-digit rate wins in 2026, though individual wins are expected to be smaller than in previous years.
2. Expansion of Preferred Payer Agreements: A significant driver is the expansion of preferred payer agreements across its segments. Aveanna has been actively adding new preferred payer agreements, including five in Q3 2025 alone, and focuses on aligning caregiver capacity with payers offering episodic reimbursement, which has led to positive year-over-year growth and improved outcomes. The company aims to double its number of preferred payers and expand national enteral presence and payer partnerships.
3. Growth in Patient Volume and Service Utilization: Increased demand for home healthcare services, driven by an aging population and the rising prevalence of chronic diseases, is leading to higher patient volumes and hours of care. Aveanna has seen volume increases in its Private Duty Services and Home Health & Hospice segments, and is optimistic about attracting caregivers to meet this demand when favorable reimbursement rates are secured.
4. Strategic Acquisitions and Integration: The integration of strategic acquisitions, such as Thrive Skilled Pediatric Care, is contributing to Aveanna's revenue growth. These tuck-in opportunities in key states are part of the company's growth strategy.
5. Expansion to New Medicaid States: Aveanna is focused on expanding its presence in Medicaid states. The company currently operates in 29 Medicaid states and is targeting expansion to 38-40 states, indicating a strategy to grow its market reach and customer base.

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Share Issuance

• Aveanna Healthcare completed its Initial Public Offering (IPO) in April 2021, generating total net proceeds of $477.6 million. This included the sale of 38.2 million shares at $12.00 per share and an additional 4.0 million shares from the underwriters' overallotment option.
• In October 2025, the company completed a follow-on equity offering, issuing 10,000,000 shares of common stock for $90 million to increase available capital. [cite: 14 in original search, 16 in original search]

Outbound Investments

• Aveanna Healthcare acquired Five Points Healthcare for $64.4 million in October 2020.
• In November 2021, Aveanna acquired Accredited Nursing Care for $180 million.
• The company acquired Comfort Care Home Health Services, LLC for $346.5 million in December 2021, a transaction financed by a $415 million loan. [cite: 7, 23 in original search]
• In April 2025, Aveanna acquired Thrive Skilled Pediatric Care for $75 million, which expanded its private duty services offerings and market presence, including new states like Arizona and Kansas.

Capital Expenditures

• Aveanna Healthcare is investing in digital modernization to upgrade its scheduling, billing, and care coordination systems, aiming to reduce administrative costs and enhance field contribution margins. [cite: 20 in original search]
• The company is focusing on the modernization of its Medical Solutions division, with this initiative anticipated to drive growth in 2026 and 2027. [cite: 18 in original search]
• Capitalized expenses decreased in 2023, contributing to a reduction in depreciation and amortization as older assets became fully depreciated.