Caregiver Desires For 40-Hour Weeks Shape Addus’ Personal Care Census Strategy

Addus HomeCare reported a year-over-year decline in its personal care census for the third quarter of 2026, with the drop concentrated among clients needing fewer hours, CEO Dirk Allison said. The company is expanding its caregiver scheduling app and refining which cases it accepts as it tries to match workers seeking fuller schedules with client needs and authorized care hours.

Allison said on the earnings call that higher-hour cases increased year over year, while lower-hour cases accounted for most of the census decline. He said improved service levels, together with the shift toward higher-hour cases, contributed to an increase in same-store personal care hours. Addus did not provide a numerical census figure in the supplied report.

The company’s first response is to expand Addus Connect, an app that lets caregivers check schedules, change their work hours and availability, and view patient information. Allison said the app performed well in Illinois. Addus is rolling it out in Texas and plans to introduce it in New Mexico next. He said the technology is intended to help the company serve more of the hours authorized by states.

Addus is also being more selective about new cases, Allison said, with the aim of taking on clients whose needs can be staffed effectively. He stressed that the company will continue serving lower-hour clients, while working to organize those cases in ways that better fit caregivers’ preferred schedules. Addus’ personal care services generated $301 million in third-quarter revenue, up 9% year over year, according to the report.

Staffing Pressure Shapes Case Selection

The change illustrates how caregiver availability can affect which home care hours a provider can deliver, even when clients have state-authorized services. Allison attributed the census decline to caregivers increasingly wanting 40-hour work weeks; cases with only a few hours of work can be harder to staff under that preference. The company’s approach may improve its ability to cover scheduled hours, but the report does not establish that the app or more selective referrals have already resolved the staffing challenge.

For clients and referral sources, Addus’ stated commitment to keep serving lower-hour cases matters alongside its focus on higher-hour work. Its decisions could affect how efficiently it matches caregivers to clients, while the company’s results will depend on whether it can balance workforce preferences with the service needs of people requiring fewer hours.

Growth Plans and AccentCare Deal

Addus, based in Frisco, Texas, provides personal care, home health and hospice services. The company serves about 62,500 people across 263 locations in 24 states, according to the source report. Its personal care census strategy comes as it pursues a substantial expansion through an agreement to acquire personal care assets from AccentCare.

Announced on Sept. 14, the proposed acquisition covers assets in 10 states and about 13,700 clients in average daily census, for approximately $275 million. Addus expects the transaction to close in the first quarter of 2027. Allison estimated that it would increase the company’s revenue base by about 19%. The deal would bring Addus into Colorado, Georgia, Minnesota, Pennsylvania, Tennessee and Washington, among other states covered by the assets.

Across the business, Addus reported third-quarter net revenue of $387.7 million, up 7% year over year, and adjusted EBITDA of $51.2 million, up 13.5%. Home health accounted for 4.6% of quarterly revenue. Allison said the segment recorded its first positive year-over-year revenue quarter in years, with $17.7 million in revenue, up 0.36%. Those results provide company-wide context but do not change the reported decline in personal care census.

“The slight decline in our personal care census over the prior year has primarily been in our lower hour cases, as our higher hour cases have increased year over year.”

— Dirk Allison, Addus HomeCare CEO, during the third-quarter earnings call

Limits of the Staffing Strategy

The source report does not give the personal care census totals, the number of lower-hour cases affected, or a quantified measure of the app’s effect on staffing and service completion. It is also not yet clear how quickly Addus Connect will roll out beyond Illinois and Texas, or whether it will materially increase the share of authorized hours the company delivers.

The company has not said how its case-selection approach will affect access for clients needing fewer hours. Allison said Addus intends to continue serving those clients, but the report provides no targets or measures for how it will balance that commitment with caregivers’ preferences for fuller work weeks. The AccentCare acquisition is also pending, so its expected scale and timing remain subject to closing.

App Rollout and Acquisition Milestones

Addus plans to continue its caregiver app rollout in Texas and then New Mexico, while monitoring whether it can serve more state-authorized hours. The company also expects to keep refining how it staffs lower-hour cases and balances those referrals with caregiver schedules, though Allison did not provide a timetable or specific performance goals.

The next major corporate milestone is the planned closing of the AccentCare personal care asset acquisition in Q1 2027. Until then, the deal remains an agreement rather than a completed expansion. Addus’ subsequent operating results should show whether higher-hour cases, app adoption and staffing changes can support personal care growth while the company continues to accept lower-hour clients.

Key Questions

Why did Addus’ personal care census decline?

CEO Dirk Allison said the year-over-year decline was primarily among lower-hour cases. He attributed the staffing difficulty to caregivers’ increasing preference for 40-hour work weeks.

What is Addus doing to address the staffing challenge?

Addus is expanding its Addus Connect caregiver app and taking a more selective approach to cases it accepts. Allison said the company will still serve clients who need fewer hours and is trying to staff them more effectively.

Where is Addus Connect available or planned?

Allison said the app performed well in Illinois. Addus is rolling it out in Texas and plans to introduce it in New Mexico next.

What is the AccentCare acquisition and when could it close?

Addus agreed to acquire AccentCare personal care assets for about $275 million, covering 10 states and about 13,700 clients in average daily census. The company expects the deal to close in Q1 2027; it has not yet been completed.

Source: homehealthcarenews.com