From Struggling Conglomerate to Hospice Powerhouse
Kevin McNamara's 2001 turnaround plan was radical but logical: exit non-core businesses (pet supply distribution, carpet cleaning), double down on VITAS Healthcare (acquired 1999), and treat Roto-Rooter as a defensive cash generator. The hospice bet paid off spectacularly—aging Baby Boomers (10,000 Americans turn 65 daily) created sustained 8-10% annual demand growth, Medicare reimbursement proved stable (90%+ of VITAS revenue), and regulatory barriers limited competition. By 2025, VITAS serves 19,000+ patients daily (vs. 8,000 in 2005), operates 50+ hospice programs across 15 states, and generates $2B+ revenue with 12-14% operating margins. Roto-Rooter complements perfectly: plumbing emergencies (clogged drains, sewer backups) occur regardless of economic conditions, brand recognition drives premium pricing, and franchise model enables low-capex expansion. Together, CHE generates $2.5B revenue, $412M EBITDA, and consistent 20%+ ROE.
Business Model: Hospice + Plumbing = Recession-Proof
- •VITAS Healthcare (80% revenue): Hospice care for terminally ill patients (<6 months life expectancy); Medicare reimburses ~$200/day per patient; 90%+ revenue from Medicare/Medicaid (government-backed, predictable)
- •Roto-Rooter (20% revenue): Plumbing, drain cleaning, water damage restoration; 80+ franchisees + company-owned locations; brand recognition enables 20-30% pricing premium vs. local plumbers
- •Revenue Mix: VITAS generates $2B+ (growing 8-10%/year), Roto-Rooter $500M+ (growing 3-5%/year); combined operating margin 12%
- •Competitive Moats: VITAS: regulatory licensing (barriers to entry), Medicare relationships, scale advantages. Roto-Rooter: 90+ year brand, national footprint, franchise model enables rapid expansion
- •Recession Resistance: Hospice demand immune to economic cycles (demographic-driven); plumbing emergencies non-discretionary
Financial Performance: Boring Profitability
- •Revenue: $2.53B TTM (+3.1% YoY); VITAS growth accelerating as Boomers age, Roto-Rooter steady 3-5%
- •Profitability: 11% profit margin, 12% operating margin; $412M EBITDA, 24.1% ROE (excellent capital efficiency)
- •Earnings: EPS $18.89, Trailing PE 22.78 (fair for quality), Forward PE 17.61 (attractive vs. healthcare peers)
- •Cash Flow: Free cash flow $300M+ annually; supports dividends ($2.10/share, 0.49% yield) + share buybacks
- •Balance Sheet: Net debt $1B (1.5x EBITDA), manageable; investment-grade credit rating enables low-cost financing
Growth Catalysts
- •Aging Demographics: 10,000 Americans turn 65 daily through 2030; hospice utilization rate rising from 50% to 60%+ (TAM expansion $5B+)
- •VITAS Expansion: Targeting 5-7 new hospice programs annually; each program generates $30-50M revenue at maturity
- •Medicare Reimbursement Increases: Annual 2-3% CPI adjustments; potential hospice payment reform could add 5-10% reimbursement
- •Roto-Rooter Geographic Expansion: Adding 10-15 franchise territories annually; targeting $1B revenue by 2028
- •M&A Optionality: CHE generates $300M+ free cash flow; potential bolt-on hospice acquisitions (regional players) or adjacent services (home health, palliative care)
Risks & Challenges
- •Medicare Reimbursement Cuts: Federal budget pressures could reduce hospice payments 5-10%; eliminates $100M+ EBITDA
- •Regulatory Risk: Hospice industry faces heightened Medicare fraud scrutiny; compliance violations = fines, license suspensions
- •Competition Intensifying: Private equity rolling up hospice providers (Compassus, Kindred); market share erosion possible
- •Roto-Rooter Commoditization: Digital platforms (Angi, HomeAdvisor) reduce brand moat; pricing power eroding 2-3%/year
- •Valuation Risk: Trading at 28% discount to highs but still PE 22.78; if earnings decline, stock could correct to $350-380 (22% downside)
Competitive Landscape
| Company | Focus | Revenue | Market Cap |
|---|---|---|---|
| Chemed (CHE) | Hospice + Plumbing | $2.53B | $6.1B |
| Encompass Health (EHC) | Rehab hospitals | $5.2B | $7.8B |
| Amedisys (AMED) | Home health + hospice | $2.3B | $3.5B (acquired) |
| LHC Group (acquired) | Home health | $2.4B | Acquired by UHS |
| Gentiva (private) | Hospice | $1.8B | PE-owned |
VITAS competes in fragmented $25B+ hospice market where top 5 players control ~30% share. Amedisys (recently acquired by UnitedHealth) and LHC Group (acquired by UHS) validate hospice consolidation thesis—large healthcare systems acquiring scale players for vertical integration. CHE's $6.1B market cap makes it acquisition target for Humana, CVS Health, or UnitedHealth seeking Medicare Advantage hospice capabilities. Roto-Rooter faces competition from Angi, local plumbers, and franchise alternatives (Mr. Rooter, Benjamin Franklin), but 90+ year brand recognition and national footprint provide durable moat.
Who Is This Stock Suitable For?
Perfect For
- ✓Defensive income + growth investors seeking recession-resistant healthcare exposure
- ✓Baby Boomer demographic thematic investors with 5-7 year horizon
- ✓Low-volatility portfolios (beta 0.465, consistent earnings)
- ✓Contrarian value buyers accumulating quality stocks at 28% discount
Less Suitable For
- ✗Growth-at-any-price investors (3-5% revenue growth is boring)
- ✗High-yield income seekers (0.49% dividend yield too low)
- ✗Short-term traders (low volume, slow-moving)
- ✗ESG-focused investors uncomfortable with hospice/end-of-life exposure
Investment Thesis
Chemed Corp exemplifies boring, profitable healthcare at a reasonable price. Kevin McNamara's 24-year tenure has created two recession-resistant franchises: VITAS (largest U.S. hospice, growing 8-10%/year on aging demographics) and Roto-Rooter (national plumbing brand, steady 3-5% growth). At $447.55 (down 28% from highs), CHE trades at PE 17.61 (forward) with 24.1% ROE, 11% profit margins, and ultra-low beta (0.465). The investment case hinges on demographics: 10,000 Americans turn 65 daily through 2030, hospice utilization is rising from 50% to 60%+, and Medicare reimbursement remains stable. Analysts target $578.50 (29% upside), reflecting confidence in demographic tailwinds.
The bull case is straightforward: hospice demand accelerates 10%+ annually as Boomers age, VITAS adds 7-10 programs/year generating $300M+ incremental revenue, Roto-Rooter hits $1B revenue milestone, and CHE becomes acquisition target for UnitedHealth/CVS at $650-700/share (45-56% premium). At 17.61 forward PE with 8-10% organic growth, CHE is undervalued vs. 20-25x PE healthcare peers. The bear case is equally clear: Medicare cuts hospice reimbursement 10% (eliminates $200M EBITDA), regulatory scrutiny intensifies forcing compliance costs up 15-20%, and Roto-Rooter faces commoditization as Angi/HomeAdvisor erode pricing. At PE 22.78, stock corrects to $350-380 if earnings decline. At current levels, risk/reward skews positive for defensive portfolios seeking quality at reasonable prices.