NHC Acquires Remaining Interest in Caris Healthcare, Plans to Expand Senior Care Continuum

National Healthcare Corporation (NHC), a publicly traded senior care company listed on the NYSE American stock exchange, has acquired its outstanding stake in Caris Healthcare. Financial terms of the deal were not disclosed.

Headquartered in Murfreesboro, Tennessee, NHC bills itself as one of the nation’s oldest publicly traded senior care companies. As an overall organization, NHC and its affiliates operate 75 skilled nursing facilities (SNFs) with 9,463 beds, along with 24 assisted living communities, five independent living communities and one behavioral health hospital.

Outside of its portfolio of senior care facilities, NHC has 35 home health agencies and 28 hospice agencies. Its home health footprint stretches across Tennessee, South Carolina and Florida, a company spokesperson told Home Health Care News in an email.

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“While NHC is sometimes recognized as a SNF operator, we have been and are a senior care provider with a full continuum of related health care services,” the spokesperson said. “NHC has been an owner in Caris for many years, but taking full ownership gives us further opportunities to expand our continuum of care for seniors and to strategically grow in states where NHC and Caris operate — and elsewhere.”

Caris, meanwhile, is a provider of hospice and palliative care services in Georgia, Missouri, South Carolina, Tennessee and Virginia. The organization — founded in 2003 — delivers care to more than 1,200 patients per day across 28 total locations.

“Caris has been a premier hospice and palliative care provider for many years,” NHC CEO Steve Flatt said in a press release. “We are honored to continue to provide these critical, compassionate services for patients and their families during such a challenging time in their lives.”

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NHC acquired the remaining interest in Caris from its founder and managing director, Norman McRae, and McRae Investment Company. NHC already owned a majority stake in Caris prior to the purchase.

The transaction is effective as of June 11. Broadly, the deal is “a strategic advancement of NHC’s growth of a continuum of care to seniors” in its operational footprint,” according to the company.

“We are always interested in growing all aspects of our continuum of care for seniors, including home care,” the spokesperson said. “We believe there may be specific opportunities for the growth of home care and related services, such as hospice, post-pandemic, and we hope to use those opportunities to optimize care for our patients.”

As a result of the purchase, Caris will be a wholly owned and consolidated subsidiary of NHC.

Beyond home health, hospice and its previously aforementioned facilities, NHC’s other services include Alzheimer’s and memory care units, plus pharmacy services and a rehabilitation services company. NHC also provides management and accounting services to third-party post-acute care operators.

For the first quarter ended March 31, 2021, NHC reported net operating revenues and CARES Act income of about $251 million. That total was a roughly 2% decrease compared to $256 million NHC reported for the same period a year prior.

The company’s home health revenue for the first quarter was about $13.6 million, a slight increase compared to $13.1 million in Q1 2020.

NHC provides nursing, rehab and other in-home care services across the Medicare, Medicaid, managed care and private-insurance reimbursement landscapes. Maintaining a full SNF census has been a key challenge for NHC during the COVID-19 public health emergency, the company noted in a May 6 financial filing.

“Due to the pandemic, as well as the increased availability of assisted living facilities and home- and community-based services, the challenge of maintaining desirable patient census levels has been amplified,” the company wrote. “Management has undertaken a number of steps in order to best position our current and future health care facilities.”

Those steps include working internally “to examine and improve systems to be most responsive to referral sources and payers.”

Additionally, NHC — founded by Dr. Carl Adams in 1971 — is in various stages of partnerships with hospital systems, payers and other post-acute networks to better position itself moving forward.

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