PACS Raises 2026 Adjusted EBITDA Outlook After Florida Entry

The Tip Desk · November 3, 2026 · 3 min read

The post-acute operator lifted full-year Adjusted EBITDA guidance to $685 million to $695 million after third-quarter Adjusted EBITDA of $175.7 million.

PACS Group, Inc. (PACS), one of the largest post-acute healthcare companies in the United States, raised its full-year 2026 Adjusted EBITDA outlook to a range of $685 million to $695 million, up from $640 million to $660 million, after third-quarter Adjusted EBITDA of $175.7 million, which the company said represented approximately 37% growth over 2025 at the midpoint.

Revenue was $1.50 billion, an increase of 11.5% from a year earlier, after 9.1% growth in the second quarter. Adjusted EBITDA rose 33.6% from $131.5 million a year earlier, after 24.6% growth in the second quarter. Chief Financial Officer Carey Hendrickson said the quarter showed Adjusted EBITDA growth significantly outpacing revenue growth.

Net income was $60.8 million, up 16.2% from $52.3 million in the prior-year period. Diluted earnings were $0.37 a share. Adjusted earnings were $0.63 a share, up 37.0% from a year earlier. Adjusted EBITDAR was $273.9 million.

On a same-store basis covering the 284 skilled nursing facilities operated at the start of 2025, SNF revenue increased 6.4% from a year earlier, after 5.8% growth in the second quarter. Same-store occupancy improved to 91.3% from 89.3% a year earlier. Overall skilled mix increased to 29.1%, an improvement of 90 basis points from 28.2% a year earlier, which the company attributed to continued improvement in its Ramping facilities cohort. Mature facilities skilled mix was 31.3%.

Overall occupancy was 90.2%, compared with an industry average of 80.2%. Mature facilities occupancy was 93.1%. The company said 250 facilities, or 78.9%, of its skilled nursing portfolio achieved a 4- or 5-star CMS Quality Measure Star rating, with its 196 mature facilities averaging 4.5 as of September 30, 2026. That share of 4- or 5-star facilities was lower than the 83.6% reported in the second quarter.

Subsidiaries closed acquisitions of the operations of 11 Texas facilities, including 10 skilled nursing facilities and one assisted living facility, and of 32 skilled nursing facilities across Florida comprising 4,049 beds, marking the company’s entry into that state. The company deployed $213.0 million in capital for M&A in the third quarter, bringing first-nine-months M&A investment to $403.8 million. The portfolio comprised 398 healthcare operations across 21 states.

Cash provided by operating activities was $583.1 million for the nine months ended September 30, 2026. Available liquidity was $707.4 million, including $115.3 million of cash and cash equivalents, with net leverage of 0.2x at quarter-end. Cash and cash equivalents were $115.3 million at September 30, 2026.

Hendrickson said the company is increasing revenue guidance to $5.95 billion to $6.05 billion, up from $5.75 billion to $5.85 billion. The company said the new Adjusted EBITDA guidance reflects approximately $5 million of EBITDA contribution from retroactive quality incentive payments in Ohio received in October. Hendrickson said the company continues to see a robust pipeline of acquisition opportunities.