Looking back on senior health, home health & hospice stocks’ Q4 earnings, we examine this quarter’s best and worst performers, including BrightSpring Health Services (NASDAQ: BTSG) and its peers.

The senior health, home care, and hospice care industries provide essential services to aging populations and patients with chronic or terminal conditions. These companies benefit from stable, recurring revenue driven by relationships with patients and families that can extend many months or even years. However, the labor-intensive nature of the business makes it vulnerable to rising labor costs and staffing shortages, while profitability is constrained by reimbursement rates from Medicare, Medicaid, and private insurers. Looking ahead, the industry is positioned for tailwinds from an aging population, increasing chronic disease prevalence, and a growing preference for personalized in-home care. Advancements in remote monitoring and telehealth are expected to enhance efficiency and care delivery. However, headwinds such as labor shortages, wage inflation, and regulatory uncertainty around reimbursement could pose challenges. Investments in digitization and technology-driven care will be critical for long-term success.

The 7 senior health, home health & hospice stocks we track reported a slower Q4. As a group, revenues beat analysts’ consensus estimates by 1.1%.

Amidst this news, share prices of the companies have had a rough stretch. On average, they are down 7.7% since the latest earnings results.

Best Q4: BrightSpring Health Services (NASDAQ: BTSG)

Founded in 1974, BrightSpring Health Services (NASDAQ: BTSG) offers home health care, hospice, neuro-rehabilitation, and pharmacy services.

BrightSpring Health Services reported revenues of $3.55 billion, up 16.3% year on year. This print exceeded analysts’ expectations by 5%. Overall, it was a strong quarter for the company with a solid beat of analysts’ revenue estimates and full-year EBITDA guidance exceeding analysts’ expectations.

"In 2025, BrightSpring’s financial performance was driven by ongoing demand for our high-quality and differentiated services and operational capabilities,” said Jon Rousseau, Chairman, President, and Chief Executive Officer of the Company.

BrightSpring Health Services pulled off the biggest analyst estimates beat but had the weakest full-year guidance update of the whole group. Unsurprisingly, the stock is up 4.9% since reporting and currently trades at $42.09.

Is now the time to buy BrightSpring Health Services? Access our full analysis of the earnings results here, it’s free.

The Pennant Group (NASDAQ: PNTG)

Spun off from The Ensign Group in 2019 to focus on non-skilled nursing healthcare services, Pennant Group (NASDAQ: PNTG) operates home health, hospice, and senior living facilities across 13 western and midwestern states, serving patients of all ages including seniors.

The Pennant Group reported revenues of $288 million, up 52.6% year on year, outperforming analysts’ expectations by 4.6%. The business had a satisfactory quarter with an impressive beat of analysts’ revenue estimates but a slight miss of analysts’ full-year EPS guidance estimates.

The Pennant Group scored the fastest revenue growth among its peers. However, the results were likely priced into the stock as it’s traded sideways since reporting. Shares currently sit at $33.04.

Is now the time to buy The Pennant Group? Access our full analysis of the earnings results here, it’s free.

Weakest Q4: Chemed (NYSE: CHE)

With a unique business model combining end-of-life care and household services, Chemed (NYSE: CHE) operates two distinct businesses: VITAS, which provides hospice care for terminally ill patients, and Roto-Rooter, which offers plumbing and water restoration services.

Chemed reported revenues of $639.3 million, flat year on year, falling short of analysts’ expectations by 3%. It was a disappointing quarter as it posted a significant miss of analysts’ full-year EPS guidance estimates and a significant miss of analysts’ revenue estimates.

Chemed delivered the weakest performance against analyst estimates in the group. As expected, the stock is down 15.2% since the results and currently trades at $395.82.

Read our full analysis of Chemed’s results here.

Brookdale (NYSE: BKD)

With a network of over 650 communities serving approximately 59,000 residents across 41 states, Brookdale Senior Living (NYSE: BKD) operates senior living communities across the United States, offering independent living, assisted living, memory care, and continuing care retirement communities.

Brookdale reported revenues of $754.1 million, down 3.4% year on year. This result missed analysts’ expectations by 1.7%. It was a slower quarter as it also recorded a miss of analysts’ revenue estimates and full-year EBITDA guidance meeting analysts’ expectations.

Brookdale had the slowest revenue growth among its peers. The stock is down 14.2% since reporting and currently trades at $14.21.

Read our full, actionable report on Brookdale here, it’s free.

Addus HomeCare (NASDAQ: ADUS)

Serving approximately 66,000 clients across 22 states with a focus on "dual eligible" Medicare and Medicaid beneficiaries, Addus HomeCare (NASDAQ: ADUS) provides in-home personal care, hospice, and home health services to elderly, chronically ill, and disabled individuals.

Addus HomeCare reported revenues of $373.1 million, up 25.6% year on year. This number was in line with analysts’ expectations. Zooming out, it was a mixed quarter as it failed to impress in some other areas of the business.

The stock is down 13.7% since reporting and currently trades at $101.52.

Read our full, actionable report on Addus HomeCare here, it’s free.

Want to invest in winners with rock-solid fundamentals? Check out our Hidden Gem Stocks and add them to your watchlist. These companies are poised for growth regardless of the political or macroeconomic climate.