Families unable to provide 24-hour care to their kin can at least turn to Kindred Healthcare. As a leading provider of long-term health care, Kindred operates about 225 nursing and rehabilitation centers and some 120 long-term acute care hospitals in 26 states. Its facilities have a combined capacity of more than 36,000 beds. In addition, Kindred's RehabCare business provides contract rehabilitation therapy services at thousands of facilities. The firm also runs sub-acute and inpatient rehabilitation centers, as well as home health and hospice agencies. The company owns many of its facilities, but leases many more facilities from Ventas and other third parties.
Kindred is composed of four divisions including hospital, nursing center, rehabilitation services, and home health and hospice. The hospital division operates its long-term acute care and inpatient rehabilitation hospitals while its nursing center division operates the nursing and (outpatient) rehabilitation centers and a handful of assisted living facilities. The company seriously bulked up its rehabilitation services unit when it acquired RehabCare in 2011. Kindred has grown its home care and hospice business in recent years but that remains the company's smallest division.
The hospital division includes both free-standing long term acute care hospitals and "hospitals-within-hospitals," which are co-located with short-term acute care facilities and sometimes receive patients as they are discharged from the host facility. All of Kindred's hospitals care for patients with complex medical conditions: those who are recovering from major surgery, are experiencing multiple organ failure, or have brain or spinal cord injuries, for instance. The hospital division brings in 45% of Kindred's yearly income. Medicare and Medicaid reimbursements make up more than half of Kindred's revenue.
Kindred Healthcare operates its hospitals and nursing care facilities in over half of the US, but it has the largest numbers of licensed beds in California, Florida, Indiana, Massachusetts, North Carolina, Texas, and Wisconsin.
After several static years, Kindred Healthcare's revenues jumped nearly 26% in 2011 to $5.5 billion as a result of the RehabCare acquisition. However, that same splashy acquisition also affected the company's net income which fell from 2010's nearly $57 million down to some $54 million in 2011.
Kindred's strategy involves dominating the post-acute care sector and it has diversified accordingly. It has clustered its services in certain markets where it can provide rehabilitation services across several possible sites: hospital, inpatient center, outpatient center, or private homes. In those geographic areas, no matter where a patient needs to receive rehabilitation, (or where Medicare is willing to pay for it) Kindred will have a means of providing that care.
To that end, the company paid $1.3 billion in 2011 to acquire post-acute care services provider RehabCare. The purchase added about 35 rehabilitation hospitals, as well as contracts to manage post-acute therapy for another 1,250 facilities.
Kindred's home care and hospice business operates under the PeopleFirst banner. In recent years this part of its business has grown steadily through acquisitions of smaller regional operations. It continued this strategy in 2012 with its acquisition of IntegraCare Holdings. The $71 million price (with up to $4 million more based on earnings) added 47 locations in Texas.
Acquisitions of existing facilities have been Kindred's primary means of growth, though it occasionally opens a new facility. It also regularly sheds underperforming assets. – less