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NAHC 28th Annual
Meeting and Exposition
               October 12, 2009
             Los Angeles, California

 Homecare Va...
Overview

•Concepts of Value
•Value Drivers
•Capitalization of Earnings
Method
•Case Studies


         Healthcare Advisor...
Concepts of Value
•Market Capitalization
•Book Value
•Goodwill
•Enterprise Value




        Healthcare Advisory Partners
...
Enterprise Value

•Comparables
•Buyers’ Perspective
•Sellers’ Perspective




         Healthcare Advisory Partners
      ...
Value Drivers
•Determine Premium or
Discount

•Qualitative Value Drivers

•Quantitative Value Drivers


         Healthcar...
Qualitative Value
       Drivers
•Business Mix
•Geography
•Management Depth




        Healthcare Advisory Partners
     ...
Quantitative Value
      Drivers
•Size
•Trends
•Margins




           Healthcare Advisory Partners
            Copyright ...
Financial Statements

•Transparent Financial Reporting
     GAAP
•Accrual Basis Financial Statements
•Break Out Direct and...
Capitalization of
   Earnings Method
•Service Companies use
Income Approach
•Boil Complexity Down to
Single Number
•Enterp...
EBITDA
•Reproducible Cash Flow
•Reliable # for Any Buyer’s
Model
•Adjusted EBITDA




         Healthcare Advisory Partner...
Adjusted EBITDA

•Nonrecurring Expenses
•Owners’ Compensation
•Personal Expenses
•Add Backs & Subtractions



        Heal...
No Magic Formula
•EBITDA Multiplier
•3-5x Adjusted EBITDA
•Transaction Structure
•Convention Due to Historical
Pattern: No...
Real World Context

•Market Conditions
•Regulatory Environment
•Financing




        Healthcare Advisory Partners
       ...
Formulas Must be Applied
    with Intelligence
 •Analyze within Context of
 Industry and Individual
 Benchmarks

 •Is Oper...
Case Study:
 Small Transactions
•Very Common but Formulas
Least Applicable

•Licensure
•Small but Viable
•The Overachiever...
Case Study:
Medium Transactions
•$2 - $15 Million
•Standard from which Formula
is Derived
•Formula is Most Applicable
•Pre...
Case Study:
 Large Transactions
•$15-$25+ Million
•Platform Investment
•Size Premium May Exceed
5xEBITDA Ceiling
•Strategi...
Case Study:
Largest Transactions

•Exceptional Cases
•Often Publicly Traded
•Often Exceed 5xEBITDA
•Apria/ResCare/Healthfi...
Conclusions
•Formulas Reflect Market
Parameters
•Formulas Must be Applied
Intelligently
•Market is Active and Robust
•Good...
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NAHC '09

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Homecare Valuations in the Real World: Putting Theory into Practice

Consolidation in the homecare industry continues at a torrid pace as larger operators continue to grow through acquisitions and private equity investors look for platform opportunities to enter the space. Valuation methods are easy to talk about, but harder to apply to real-world situations. This
presentation examines what makes a homecare agency valuable and how to articulate that value in a practical way that makes sense to both buyers and sellers.

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NAHC '09

  1. 1. NAHC 28th Annual Meeting and Exposition October 12, 2009 Los Angeles, California Homecare Valuations in the Real World: Putting Theory into Practice Jack J. Eskenazi, Jr. , Managing Partner Healthcare Advisory Partners Brian Bruenderman, Director of Development ResCare Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  2. 2. Overview •Concepts of Value •Value Drivers •Capitalization of Earnings Method •Case Studies Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  3. 3. Concepts of Value •Market Capitalization •Book Value •Goodwill •Enterprise Value Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  4. 4. Enterprise Value •Comparables •Buyers’ Perspective •Sellers’ Perspective Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  5. 5. Value Drivers •Determine Premium or Discount •Qualitative Value Drivers •Quantitative Value Drivers Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  6. 6. Qualitative Value Drivers •Business Mix •Geography •Management Depth Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  7. 7. Quantitative Value Drivers •Size •Trends •Margins Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  8. 8. Financial Statements •Transparent Financial Reporting GAAP •Accrual Basis Financial Statements •Break Out Direct and Administrative Expenses Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  9. 9. Capitalization of Earnings Method •Service Companies use Income Approach •Boil Complexity Down to Single Number •Enterprise Value is Expression of Earning Power of Investment Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  10. 10. EBITDA •Reproducible Cash Flow •Reliable # for Any Buyer’s Model •Adjusted EBITDA Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  11. 11. Adjusted EBITDA •Nonrecurring Expenses •Owners’ Compensation •Personal Expenses •Add Backs & Subtractions Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  12. 12. No Magic Formula •EBITDA Multiplier •3-5x Adjusted EBITDA •Transaction Structure •Convention Due to Historical Pattern: Not Prescriptive •Typically between 1xGP and 1xRevs Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  13. 13. Real World Context •Market Conditions •Regulatory Environment •Financing Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  14. 14. Formulas Must be Applied with Intelligence •Analyze within Context of Industry and Individual Benchmarks •Is Operation Reproducible? •Guideline – Not Prescriptive Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  15. 15. Case Study: Small Transactions •Very Common but Formulas Least Applicable •Licensure •Small but Viable •The Overachiever Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  16. 16. Case Study: Medium Transactions •$2 - $15 Million •Standard from which Formula is Derived •Formula is Most Applicable •Premium •Discount Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  17. 17. Case Study: Large Transactions •$15-$25+ Million •Platform Investment •Size Premium May Exceed 5xEBITDA Ceiling •Strategic Buyer •Financial Buyer Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  18. 18. Case Study: Largest Transactions •Exceptional Cases •Often Publicly Traded •Often Exceed 5xEBITDA •Apria/ResCare/Healthfield/Addus Healthcare Advisory Partners Copyright 2009 All Rights Reserved
  19. 19. Conclusions •Formulas Reflect Market Parameters •Formulas Must be Applied Intelligently •Market is Active and Robust •Good Companies Available for Premium •Weaker Companies Available for Discount Healthcare Advisory Partners Copyright 2009 All Rights Reserved

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