Guardian Raises 2026 Outlook After Profit Expansion

The Tip Desk · November 11, 2026 · 3 min read

The long-term care pharmacy operator lifted full-year adjusted EBITDA guidance to $136 million–$138 million after third-quarter adjusted EBITDA of $33.9 million.

Guardian Pharmacy Services (GRDN), a long-term care pharmacy operator, raised its 2026 outlook a third time this year after third-quarter adjusted EBITDA of $33.9 million, up 24% from a year earlier, even as reported revenue slipped on Inflation Reduction Act pricing.

The company now expects full-year revenue of $1.44 billion to $1.46 billion and adjusted EBITDA of $136 million to $138 million, up from the $1.43 billion to $1.45 billion and $129 million to $131 million ranges it issued in August. The guidance excludes future acquisitions.

Reported revenue for the three months ended September 30, 2026 was $371.1 million, down 2% from a year earlier, after second-quarter revenue of $351.8 million, up 2%, and first-quarter revenue of $336.6 million, also up 2%. President and Chief Executive Officer Fred Burke said that absent IRA price reductions, revenues would have been up high single digits versus the third quarter of 2025, mostly from organic growth.

Residents served ended the quarter at approximately 218,000, up 7% year-over-year, after 210,000 (up 8%) at June 30 and 207,000 (up 10%) at March 31.

Gross profit was $85.2 million on that revenue, versus $74.7 million on $377.4 million a year earlier. Operating income was $25.1 million, compared with $16.4 million. Adjusted EBITDA margin was 9.1% of revenue. Burke said the margin improvement showed scalability of the operating model and progress in profitability and leverage across the growing resident base.

Net income was $19.1 million, compared with $9.6 million in the prior-year quarter. Diluted EPS was $0.29 and adjusted EPS $0.33. The second quarter’s net income of $22.1 million had included an $8.5 million payor-reimbursement settlement; that cash payment was recorded in the nine months ended September 30, 2026, not the third quarter.

Cash and cash equivalents totaled $119.7 million at quarter-end, with no long-term debt outstanding under the credit facility, after $89.8 million at June 30 and $64.9 million at March 31.

Guardian completed the July acquisition of Wellness Concepts, a long-term care pharmacy in Virginia’s Shenandoah Valley, and certain assets of Nautilus, an assisted-living mail-order pharmacy across 14 states. The company said it transitioned the Nautilus resident base to 18 existing pharmacies. Subsequent to quarter-end it added a small pharmacy in Sioux City, Iowa, and completed the acquisition of Van’s Institutional Pharmacy in western Tennessee and Kentucky, increasing its Tennessee footprint to five locations. The previously announced Lexington, Kentucky greenfield pharmacy is now operational, with further Texas and Alabama expansions planned.

On September 27, 2026, approximately 13.5 million Class B shares converted into Class A, completing the two-year conversion process that began with the September 2024 reorganization tied to the IPO. About 29.9 million Class A shares, representing about 80% of Class A shares held by founders, executive officers, and other pre-IPO employee shareholders, remain subject to lock-up through September 14, 2027.

The company said it continues to strengthen regional leadership and operational coordination while preserving the locally managed model. It operates more than 63 licensed pharmacies, 57 of which are full-service.

Burke said the third-quarter performance, together with the positive outlook for the remainder of the year, supported the decision to raise full-year guidance.