The call in brief
Read the Q2 2025 earnings summary ↗Chemed reported a Q2 2025 miss at both units, with VITAS net revenue up 5.8% to $396.2 million but pressured by a $16.4 million Medicare cap billing limitation and a 163 bps margin decline, while Roto-Rooter revenue grew just 0.6% and adjusted EBITDA fell 18.7% on tariff-driven April/May weakness, labor inefficiencies, and higher insurance costs. Management cut full-year guidance, projecting $28.2 million in 2025 Medicare cap limitations, but expects the Florida cap to fall to near zero in 2026 via a short-stay mix shift, attrition of the long-stay bubble, and new CON locations. Roto-Rooter residential demand rebounded in June and July, and Chemed reaffirmed its acquisition and buyback strategy.
- VITAS net revenue rose 5.8% to $396.2 million, driven by a 6.1% increase in days of care and an approximately 4.2% Medicare reimbursement rate increase, while average daily census expanded 6.1% to 22,318.
- Hospital-directed admissions grew 9.1%, reflecting the deliberate shift toward shorter-stay patients, and average revenue per patient per day reached $207.03, up 350 basis points year-over-year.
- Excluding prior-year Covenant Health transfers, VITAS admissions increased 4.9%.
- At Roto-Rooter, residential revenue rebounded in June and July closer to internal expectations, water restoration grew 16.9% in residential and 11.7% in commercial, commercial excavation rose 24.4%, and the lead-to-paying-job conversion rate reached nearly 50%, well above historical levels.
- Chemed generated strong cash flow, expects share buyback activity in Q3, and remains confident in the long-term fundamentals of both businesses.
- Both operating units missed second-quarter expectations.
- A $16.4 million Medicare cap billing limitation was accrued at VITAS (including a $9.5 million catch-up for prior periods), and management projects a $19 million Florida billing limitation for the 2025 cap year, with full-year cap limitations of $28.2 million.
- VITAS adjusted EBITDA excluding Medicare cap was essentially flat year-over-year and its margin fell 163 basis points to 16.2% due to the lower-revenue short-stay mix.
- Roto-Rooter revenue grew only 0.6%, with branch revenue up less than 1%, hurt by weak April and May tied to the Liberation Day tariff hit to consumer confidence; total leads fell 7.2%.
- Roto-Rooter adjusted EBITDA dropped 18.7% with margin down 517 basis points to 21.8%, driven by labor inefficiencies from idle technicians, higher commission rates, roughly 220 basis points of higher casualty and workers' compensation costs, and a rising share of more expensive paid-search leads (over 50% of leads versus a historical ~40%).
Management Commentary
Read the Q2 2025 summary ↗Good morning. Our conference call this morning will review the financial results for the second quarter of 2025 ended June 30th, 2025. Before we begin, let me remind you that the safe harbor provisions of the Private Securities Litigation Reform Act of 1995 apply to this conference call.
During the course of this call, the company will make various remarks concerning management's expectations, predictions, plans, and prospects that constitute forward-looking statements. Actual results may differ materially from those projected by these forward-looking statements as a result of a variety of factors, including those identified in the company's news release of July 29th and in various other filings with the SEC. You are cautioned that any forward-looking statements reflect management's current view only and that the company undertakes no obligation to revise or update such statements in the future. In addition, management may also discuss non-GAAP operating performance results during today's call, including earnings before interest, taxes, depreciation, and amortization, or EBITDA and adjusted EBITDA. A reconciliation of these non-GAAP results is provided in the company's press release dated July 29th, which is available on the company's website at chemed.com.
I would now like to introduce our speakers for today: Kevin McNamara, President and Chief Executive Officer of Chemed Corporation, and Mike Witzeman, Chief Financial Officer of Chemed. I will now turn the call over to Kevin McNamara.
Thank you, Holley. Good morning. Welcome to Chemed Corporation's second quarter 2025 conference call. I will begin with highlights for the quarter, then Mike will follow up with additional details. I will then open the call for questions. While the performance of both operating units did not meet our expectations for the second quarter of 2025, we remain confident in the overall fundamentals, growth potential, and strategic direction of both businesses. Admissions and fee costs during the quarter totaled 17,545, which equates to a 1.2% improvement from the same period of 2024. However, it is important to remember that over 600 patients transferred into VITAS in the second quarter of 2024 as a result of our April 2024 acquisition of Covenant Health. Excluding those transfers, admissions increased 4.9% in the second quarter of 2025.
Our average daily census, or ADC, expanded to 22,318, an increase of 6.1% when compared to the prior year quarter. In the quarter, hospital-directed admissions increased 9.1%. Home-based patient admissions declined 6.2%. Nursing home admissions declined 2.9%, and assisted living facilities admissions declined 1.4% when compared to the prior year period. We currently estimate that the consolidated Florida program will end the 2025 Medicare cap year with a $19 million billing limitation. As was discussed in our June 27th press release, we were on track to mitigate the Florida Medicare billing limitation risk as of the end of the first quarter of 2025. Admissions in Florida were weaker than anticipated in April and May. Accordingly, our Medicare cap projection was revised. June and July admissions in Florida are within our expected range but will not be enough to offset the overall billing limitation for the 2025 cap year.
Management does not expect a significant level of Medicare cap billing limitation in our Florida program for the 2026 cap year. There are a number of initiatives underway that contribute to that expectation, including continued efforts on admitting short-stay patients, mainly through higher hospital admissions, quick ramp-up of the CON startup locations in Marion and Pinellas counties, and other cap management strategies. The current projection for the 2026 cap year assumes that the rate differential that occurred for the 2025 cap year does not recur. The detailed rate information related to the reimbursement increase in Florida for the 2026 cap year will become available during the third quarter. We intend to update our assumptions regarding rates and overall outlook for the 2026 Medicare cap year in Florida in the third quarter earnings release. Now let's turn to Roto-Rooter.
Roto-Rooter revenue increased 0.6% in the second quarter of 2025 compared to the same period of 2024, falling short of our internal expectations. Branch revenue, in particular, was softer than anticipated, with less than 1% growth compared to the prior year. We continue to execute on the strategies implemented in 2024 that resulted in improved fourth quarter of 2024 and the first quarter of 2025 revenue trends. Despite these efforts, April and May were particularly weak. Other large consumer-facing companies have discussed the chilling effect that the Liberation Day tariff announcement had on consumer confidence and consumer spending in April and May. We believe that Roto-Rooter suffered from that issue as well. June and July residential revenue has rebounded to a level that is much closer to our internal expectations. Total leads were down 7.2% in the second quarter of 2025 compared with the same period of 2024.
This is a slight improvement compared to the trend we saw in the first quarter of 2025. While the second quarter of 2025 resulted in disappointing operating results, we remain optimistic about the overall prospects for both businesses. VITAS is in the process of adjusting their patient mix in Florida to ensure Medicare cap issues do not persist past 2025. This will cause some disruption in VITAS' operating metrics but positions them to return to a consistent higher growth rate for the long term. Roto-Rooter remains the most recognized brand in the plumbing and drain cleaning industry. We remain confident that the competitive advantages enjoyed by Roto-Rooter will return its financial performance to a steadier growth trajectory. With that, I would like to turn the teleconference over to Mike.
Thank you, Kevin. VITAS net revenue was $396.2 million in the second quarter of 2025, which is an increase of 5.8% when compared to the prior year period. This revenue increase is comprised primarily of a 6.1% increase in days of care and a geographically weighted average Medicare reimbursement rate increase of approximately 4.2%. The acuity mix shift negatively impacted revenue growth 71 basis points in the quarter when compared to the prior year revenue and level of care mix. The combination of Medicare cap and other contra-revenue changes negatively impacted revenue growth by approximately 379 basis points. The $16.4 million Medicare cap billing limitation accrued in the second quarter of 2025 is comprised of three components.
First, a catch-up entry of $9.5 million was required to recognize the Medicare cap billing limitation in Florida related to the first six months of the 2025 Medicare cap year, which includes our fourth quarter of 2024 and first quarter of 2025. Second, $4.8 million was recorded related to the Medicare cap billing limitation for the current quarter of 2025 related to our Florida combined program. Third, $2.1 million was recognized for the current quarter of 2025 related to all other VITAS programs, mainly in California. The amount recognized for all other VITAS programs is in line with the historical run rate for these programs and our original projections for 2025. Average revenue per patient per day in the second quarter of 2025 was $207.03, which is 350 basis points above the prior year period.
During the quarter, high acuity days of care were 2.5% of total days of care, a decline of 15 basis points when compared to the prior year quarter. Average length of stay in the quarter was 137.1 days. This compares to 100.6 days in the second quarter of 2024. It is important to remember that length of stay statistics are calculated based on discharged patients, not active patients. This increase in average length of stay between quarters represents the effect of the patients admitted during our community access initiative, which was designed to identify appropriate patients earlier in their disease trajectory being discharged. Our median length of stay was 20 days in the second quarter of 2025 compared to 18 days in the same period of 2024. Adjusted EBITDA, excluding Medicare cap, totaled $66.8 million in the quarter, which is essentially flat with the second quarter of 2024.
Adjusted EBITDA margin in the quarter, excluding Medicare cap, was 16.2%, which is 163 basis points below the prior year period. The lower EBITDA margin in the quarter reflects the impact of admitting more short-stay patients. While this is the right thing to do to mitigate Medicare cap billing limitations, it has the effect of slowing revenue growth and reducing overall margin. VITAS management is currently reviewing expenses at all levels of the organization to reduce costs wherever possible to help offset the lower EBITDA margin. Now let's turn to Roto-Rooter. Roto-Rooter branch residential revenue in the quarter totaled $156.4 million, an increase of 0.9% from the prior year period. The residential revenue increase was driven by a 16.9% increase in water restoration, offset by declines in drain cleaning, plumbing, and excavation revenue.
Roto-Rooter branch commercial revenue in the quarter totaled $53.2 million, an increase of 4.4% from the prior year. The commercial revenue increase was driven by a 24.4% increase in excavation and an 11.7% increase in water restoration, offset by slight declines in plumbing and drain cleaning revenue. Revenue from our independent contractors declined 4.4% in the second quarter of 2025 as compared to the same period of 2024. Our independent contractors are generally smaller operations in middle-market cities. In most instances, they do not have the capability to perform the add-on business that is currently the primary driver of revenue growth at Roto-Rooter branches. Adjusted EBITDA for Roto-Rooter in the second quarter of 2025 totaled $48.6 million, a decrease of 18.7% compared to the prior year quarter. The adjusted EBITDA margin in the quarter was 21.8%.
The second quarter adjusted EBITDA margin represents a 517 basis point decline from the second quarter of 2024. The EBITDA and EBITDA margin decline was the result of a number of factors. Based on the improved revenue results seen in late 2024 and early 2025, Roto-Rooter began to selectively increase its productive workforce in certain high-performing branches. With the sudden weakness in residential revenue seen in April and May, margins suffered from inefficiencies within the labor force. Technicians were sitting idle more than expected. This has a few effects in addition to the impact of inefficient labor use. First, when a technician knows they may only have one or two opportunities for commission on a daily basis, they are more likely to provide discounts to secure the paying job. Second, Roto-Rooter routes jobs to its highest performing technicians first. The highest performing technicians generally have higher commission rates.
As a result, commissions as a percentage of total revenue were higher than they have historically run. These issues should moderate as revenue rebounds in the third quarter. Higher casualty and workers' compensation costs negatively impacted margins by approximately 220 basis points, due mainly to actuarial estimates, assuming significantly increasing costs of settling claims. Finally, as discussed in prior quarters, our cost per click for internet marketing leads has continued to decline. However, a much greater percentage of our leads are currently coming from paid searches as compared to unpaid searches. Paid searches in the second quarter of 2025 represent over 50% of all leads during the quarter. Paid searches have historically represented closer to 40% of all leads. This has the effect of increasing costs as a percentage of revenue for our internet marketing program.
Roto-Rooter management is also reviewing expenses at all levels of the organization to reduce costs wherever possible to help improve adjusted EBITDA margins going forward. Now let's turn to the revised guidance for the remainder of 2025. VITAS full-year 2025 revenue prior to Medicare cap is estimated to increase 7.5%-8.5% when compared to 2024. Full-year adjusted EBITDA margin prior to Medicare cap is estimated to be 18.2%-18.7%. We are currently estimating $28.2 million in Medicare cap billing limitations in calendar 2025. This is comprised of $19 million related to the Florida combined program and $9.2 million for all other VITAS Healthcare Corporation programs. There's no Medicare cap billing limitation in the fourth quarter included in the guidance related to the Florida combined program. This expectation assumes that the rate differential that occurred for the 2025 cap year does not recur in 2026.
The detailed rate information related to the reimbursement increase in Florida for 2026 will become available during the third quarter. We intend to update our assumptions regarding rates and the overall outlook for the 2026 Medicare cap in Florida in the third quarter earnings release. Roto-Rooter is forecasted to have a 1.25%-1.75% revenue increase in 2025 compared to 2024. Roto-Rooter's adjusted EBITDA margin for 2025 is expected to be 23.5%-24.5%. Based on the above, full-year 2025 earnings per diluted share, excluding non-cash expenses for stock options, tax benefits from stock option exercises, costs related to litigation, and other discrete items, is estimated to be in the range of $22-$22.30. This guidance assumes an effective tax rate of 25.3% and a diluted share count of 14.7 million shares. Chemed's previously issued 2025 guidance range was $24.95-$25.45.
Chemed's 2024 reported adjusted earnings per diluted share was $23.13. I will now turn this call back over to Kevin.
Thank you, Mike. I will now open this teleconference to questions.
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