HCSG February 11, 2026

Healthcare Services Group, Inc. Fourth Quarter 2025 Earnings Call - Upgraded Contracts and $75M Buyback Power Mid-Single-Digit 2026 Growth

Summary

HCSG closed 2025 with better-than-expected revenue, margins, and cash generation, leaning on contract upgrades and operational execution. Revenue was $466.7 million, up 6.6% year over year, gross margin benefited from service execution gains, and the company ended the year with more than $200 million in cash and marketable securities while keeping its $300 million revolver undrawn.

Management is explicit about the playbook for 2026: mid-single-digit organic revenue growth driven by pipeline conversion, management candidate development, and retention; continued cost discipline with a target ~86% cost of services and SG&A in the 9.5% to 10.5% near-term range; an effective tax rate moving toward ~25%; and an aggressive capital return push with a $75 million repurchase plan alongside a readiness to pursue M&A backed by a fortified balance sheet.

Key Takeaways

  • Revenue of $466.7 million in Q4 2025, up 6.6% year over year.
  • Net income of $31.2 million and diluted EPS of $0.44, each including an $8.3 million ($0.12/sh) tax benefit tied to ERC receipts.
  • Cost of services reported at 84.6% in Q4, with a 2026 target to manage cost of services around 86%.
  • Adjusted SG&A of $45.8 million, or 9.8% of revenue; 2026 goal is 9.5% to 10.5% with a longer-term aim toward 8.5% to 9.5%.
  • HCSG completed a $50 million repurchase program early and announced a new $75 million repurchase plan for the next 12 months; board also authorized repurchase of up to 10 million shares.
  • Cash and marketable securities ended the year at $203.9 million; $300 million revolver remains undrawn aside from letters of credit.
  • Company upgraded contract terms toward service-day-based billing, faster pass-throughs for cost increases, and increased payment frequency; result is better margin visibility and lower DSOs.
  • Service-day billing introduces a Q4 to Q1 day-count dynamic, with Q4 2025 at 92 service days and Q1 2026 at 90 days, a difference that equates to over $10 million on the Q4 base if taken in isolation.
  • Management expects mid-single-digit revenue growth for full-year 2026, with Q1 revenue guidance of $460 to $465 million and sequential strength in H2 2026.
  • Campus division surpassed $100 million in revenue, split roughly evenly between CSG and Meriwether Godsey brands, and management plans targeted M&A plus organic expansion to scale campuses.
  • Operational improvements drove margin expansion, aided by workers' comp and general liability efficiencies, better collections, and lower bad debt in Q4.
  • Cash flow from operations reported at $17.4 million, and adjusted to $36.4 million after removing a $19 million payroll accrual decrease; management says net income is the best proxy for cash flow ex payroll accrual changes.
  • Primary growth algorithm remains execution-based: develop management candidates, convert pipeline opportunities, and retain existing facility business; biggest internal constraint is hiring and retaining management talent.
  • Effective tax rate for 2026 expected around 25% after including prior ERC-related items; 2025 year effective tax rate was 13% including the ERC benefit.
  • Balance sheet posture is defensive but flexible: significant cash cushion plus an undrawn revolver, positioned to pursue organic investments, opportunistic acquisitions, and buybacks without obvious liquidity strain.

Full Transcript

Conference Call Moderator: Thank you for standing by and welcome to the Healthcare Services Group, Inc.’s fourth quarter 2025 earnings conference call. The matters discussed on today’s conference call include forward-looking statements about the business prospects of Healthcare Services Group, Inc. For Healthcare Services Group, Inc.’s most recent forward-looking statement notice, please refer to the press release issued this morning, which can be found on our website, www.hcsg.com. Actual results may differ materially from those expressed or implied as a result of various risks, uncertainties, and important factors, including those discussed in the Risk Factors, MD&A, and other sections of the annual report on Form 10-K and Healthcare Services Group, Inc.’s other SEC filings, and as indicated in our most recent forward-looking statements notice. Additionally, management will be discussing certain non-GAAP financial measures. A reconciliation of these items to U.S. GAAP can be found in this morning’s press release.

After the speaker’s remarks, there will be a question-and-answer session. If you’d like to ask a question during this time, simply press followed by the number 1 on your telephone keypad. I’d now like to turn the call over to Ted Wahl, President and CEO. You may begin.

Ted Wahl, President and CEO, Healthcare Services Group, Inc.: Good morning, everyone, and welcome to HCSG’s fourth quarter 2025 earnings call. With me today are Matt McKee, our Chief Communications Officer, and Vikas Singh, our Chief Financial Officer. Earlier this morning we released our fourth quarter results and plan on filing our 10-K by the end of the week. Today, in my opening remarks, I’ll discuss our 2025 highlights, share our perspective on the general business environment, discuss our strategic priorities for the year ahead, and provide details on our new $75 million share repurchase plan. Matt will then provide a more detailed discussion on our Q4 results, and then Vikas will provide an update on our more recent contract enhancements, liquidity position, and capital allocation progression. We will then open up the call for Q&A. So with that overview, I’d like to now discuss our 2025 highlights.

I am extremely pleased with our fourth quarter performance, which capped a strong year for Healthcare Services Group. Against the backdrop of solid industry fundamentals, we exceeded our initial 2025 expectations for revenue, earnings, and cash flow, driven by disciplined execution of our strategic priorities. Year-over-year revenue was up over 7%, with our campus division reaching a significant milestone in its growth journey, achieving over $100 million in revenue. We successfully managed costs of services and SG&A within our targeted ranges, and we generated significant free cash flow. We also returned over $60 million of capital through our share repurchase program and ended the year with a strong balance sheet and ROIC profile, underscoring our focus on value-creating capital deployment. I’d like to now share our perspective on the general business environment.

Industry fundamentals continue to gain strength, highlighted by the multi-decade demographic tailwind that is now beginning to work its way into the long-term and post-acute care system. In 2026, the first baby boomers will turn 80 years old, and by the year 2030, all 70 million-plus boomers will be over the age of 65, with the oldest being in their mid-80s, the primary age cohort for long-term and post-acute care utilization. We expect that the demand and opportunities for service providers in this space, especially for those with compelling value propositions, durable business models, and market-leading positions, to only increase in the months and years ahead. The most recent industry operating trends remain positive as well, highlighted by steady occupancy, increasing workforce availability, and a stable reimbursement environment.

We remain optimistic that the administration will continue to prioritize the rationalization of regulations and policy to better align with the changing and expanding needs of our nation’s most vulnerable and the provider communities we service. Looking ahead to 2026, our top three strategic priorities remain: driving growth by developing management candidates, converting sales pipeline opportunities, and retaining our existing facility business; managing cost through field-based operational execution and prudent spend management at the enterprise level; and optimizing cash flow with increased customer payment frequency, enhanced contract terms, and disciplined working capital management. We are optimistic about our trajectory and expect mid-single-digit revenue growth in the year ahead. We remain confident that continuing to execute on our strategic priorities, supported by our robust business fundamentals, will enable us to drive growth while delivering sustainable, profitable results.

Finally, in conjunction with our earnings release, we announced the completion of our $50 million 12-month share repurchase plan, five months ahead of schedule. We also announced plans to further accelerate the pace of our share buybacks in 2026 and intend to repurchase $75 million of our common stock over the next 12 months. Over the past few years, we have continued to strengthen our balance sheet and expect strong cash flow generation over the next 12 months and beyond. We have demonstrated a prudent and balanced approach to capital allocation, including first and foremost investing in our growth initiatives. The current valuation of our shares relative to our long-term growth potential presents a compelling opportunity to return meaningful capital to shareholders through the buyback. So with those introductory comments, I’ll turn the call over to Matt.

Matt McKee, Chief Communications Officer, Healthcare Services Group, Inc.: Thanks, Ted, and good morning, everyone. Revenue was reported at $466.7 million, a 6.6% increase over the prior year. Segment revenues and margins for environmental services were reported at $210.8 million and 12.6%. Segment revenues and margins for dietary services were reported at $255.9 million and 7.2%. As far as the cadence of our 2026 growth, while we don’t provide full-year revenue guidance broken out by quarter, our 2026 growth plans are oriented as follows: Q1 revenue in the $460-$465 million range, with a step up in Q2 revenue and then sequential revenue growth in the second half of the year compared to the first half of the year, culminating in mid-single-digit revenue growth for the full year 2026. Cost of services was reported at $394.6 million or 84.6%. Cost of services benefited from strong service execution, workers’ comp, and general liability efficiencies, and lower bad debt expense.

Our 2026 goal is to manage the cost of services in the 86% range. SG&A was reported at $46.2 million, but after adjusting for the $0.4 million increase in deferred compensation, SG&A was $45.8 million or 9.8%. Our 2026 goal is to manage SG&A in the 9.5%-10.5% range based on investments that we’ve made and spoken about in previous quarters, with the longer-term goal of managing those costs into the 8.5%-9.5% range. The effective tax rate for the fourth quarter was reported as a 9.4% benefit, and the effective tax rate for the year was reported as a 13% expense. The effective tax rates include an $8.3 million or $0.12 per share benefit related to the treatment of certain ERC receipts recognized in the third quarter. The company, in consultation with third-party experts, has determined its tax position with respect to these receipts.

We expect our 2026 effective tax rate to be approximately 25%. Net income and diluted earnings per share were reported at $31.2 million and $0.44 per share. Net income and diluted earnings per share included an $8.3 million or $0.12 per share benefit related to the tax treatment of certain ERC receipts, as previously mentioned. Cash flow from operations was reported at $17.4 million. After adjusting for the $19 million decrease in the payroll accrual, cash flow from operations was $36.4 million. I’d now like to turn the call over to Vikas.

Vikas Singh, Chief Financial Officer, Healthcare Services Group, Inc.: Thank you, Matt, and good morning, everyone. Before reviewing our liquidity position and capital allocation priorities, I’ll first highlight the favorable evolution of our contracts and the resulting impact on the business. Over the past few years, we have deliberately and systematically upgraded our contracts to improve both pricing mechanics and cash flow. These changes were designed to pass through cost increases with greater certainty and speed, increase payment frequency relative to monthly collections, and shift from fixed monthly billings to billings based on the number of service days, the last being a particular area of focus over the past 12 months. As a result, we’ve seen several meaningful benefits, including improved margin visibility and stronger collection trends, which have contributed to lower days sales outstanding.

One implication of the move to service-day-based billing is that revenue is now more directly influenced by the number of days in a given quarter. While this has been largely beneficial, it has introduced a Q4 to Q1 dynamic that was not as pronounced historically. For example, Q4 2025 had 92 service days, while Q1 2026 has 90 days. Applied to our Q4 2025 revenue base, that difference would equate to more than $10 million. Our Q1 revenue range reflects performance above what the day-count dynamic alone would imply. That’s fueled by sustained momentum across the business. This outlook extends our pattern of consistent year-over-year quarterly growth and reinforces our conviction in delivering full-year growth in the mid-single digits for 2026. The service-day impact is not expected to be a factor in the remaining quarters of the year.

Given the number of days per quarter are more evenly distributed, they’re also balanced by offsetting events. So overall, while the Q4 to Q1 dynamic is a relatively recent result of contract changes that have been a strategic priority for us, we are very pleased with the overall impact these actions have had on the business and believe they position us well with a more durable and sustainable model going forward. Our primary sources of liquidity are cash flow from operating activities, cash and cash equivalents, and our revolving credit facility. We wrapped up 2025 with cash and marketable securities of $203.9 million, and our credit facility of $300 million was undrawn, with utilization limited to LCs only. This strong position was driven by top-line growth combined with robust collections throughout the year that enabled us to reduce our receivable balance and bring down our DSOs.

The increase in our cash position also reflects ERC receipts received during the year. However, we did not receive or recognize any ERC proceeds in the fourth quarter. Moreover, there can be no certainty regarding future receipts. On the capital allocation front, our 2026 priorities remain unchanged. We will continue to prioritize direct investments towards organic growth, strategic acquisitions, and opportunistic share repurchases. As Ted referenced earlier, we completed our 50 million share repurchase program in January 2026, well ahead of the original 12-month timeline. Those share repurchases included $19.6 million of buybacks during the fourth quarter, which contributed to our $61.6 million of share repurchases in 2025. Additionally, in February 2026, our board of directors authorized the repurchase of up to 10 million outstanding shares of common stock.

Alongside that authorization, we announced plans to accelerate our share repurchase activity and expect to repurchase 75 million of our common stock over the next 12 months. With that, we will conclude our opening remarks and open up the call for Q&A.

Conference Call Moderator: Thank you. We will now begin the question and answer session. If you would like to ask a question, please press star one in your telephone keypad. If you would like to withdraw your question, simply press star one again. Your first question today comes from the line of AJ Rice from UBS. Your line is open.

James, Analyst, UBS: Hi, this is James on for AJ. Maybe if I could just start with how you guys are potentially thinking about the revenue upside opportunity. I know mid-single digits you’ve been talking about for a while for this year, but just given the strong underlying fundamentals of the nursing home sector, plus the cross-sell opportunities and also the growth opportunity in campus, just wanted to get your thoughts there.

Ted Wahl, President and CEO, Healthcare Services Group, Inc.: Sure, James, and good morning to you. Overall, we’ve continued to successfully execute on our organic growth strategy, largely by developing management candidates, converting sales pipeline opportunities, and retaining our existing facility business. That’s really our growth algorithm. Since we operate in a largely untapped market where the demand for the services is greater than what we’re capable of managing, our growth is largely execution-based. So we do, in many respects, retain control of that growth. Our pipeline is robust and growing. We have a highly structured sales process from prospecting all the way through closing, and the demand for the services is as strong as ever. So for us, as we look out over the next 12-18 months, James, the growth rate limiting factor is really our ability to successfully hire, develop, and retain the next generation of management candidates.

More than any other factor, that’s going to be the catalyst for us in sustaining the new business momentum we’ve seen over the past year or two, as well as related to any potential upside opportunity.

James, Analyst, UBS: Got it. That’s helpful. Thank you. Maybe just one more, if I could. It looked like margins in both segments had some nice expansion. Maybe just what are your thoughts on where those could end up in 2026?

Matt McKee, Chief Communications Officer, Healthcare Services Group, Inc.: Yeah, good morning, James. You’re right. Certainly, we saw a nice output in margins, and obviously, that was reflected in cost of services as well. And really, that comes down to what we’ve talked about consistently and previously, which is the primary driver being overall service execution and the recent positive service execution trends in customer experience, systems adherence, regulatory compliance, budget discipline. All of those are near-term margin drivers, and they carried into Q4, and the expectation is that they’ll carry forward into 2026 as well. So that’s why we’re confident in our ability to continue managing cost of services in that 86% range. That said, there’s always going to be month-to-month and quarter-to-quarter movement, and the timing of certain items certainly had a positive impact on Q4 results in cost of services. And of course, that feeds through into the segment margins as well.

You think about workers’ comp and general liability efficiencies that continue to be driven by our focus and commitment to training and safety protocol that have been implemented out in the facilities. Lower bad debt expense, which we’ve noted will likely be a bit inconsistent in the near term but is favorably impacted by the strong cash collection efforts and the scarcity of customer bankruptcies and reorgs during the quarter. But ultimately, you bring it back, and it’s ultimately far outweighed by that operational execution and some of those other factors. So we’ve got a firm commitment to 86% as the right cost of service target, and as we mentioned, that will ultimately feed into the segment margins as well.

James, Analyst, UBS: Great. Thank you for taking my questions.

Conference Call Moderator: Your next question comes from the line of Sean Dodge from BMO Capital Markets. Your line is open.

Matt McKee, Chief Communications Officer, Healthcare Services Group, Inc.: Yeah, thanks. Good morning. Congratulations on the quarter and on the year. Ted, you mentioned campus services reaching $100 million of revenue. How’s that split between environmental services and the Meriwether Godsey side? And just how should we be thinking about you’ve been incubating this. You’ve gotten comfortable with it. Is there anything left to do there before you can really begin to accelerate and scale it? And I guess what’s the timeline around when we start to see campus services really become kind of a more meaningful factor in your growth?

Ted Wahl, President and CEO, Healthcare Services Group, Inc.: It’s split pretty evenly, Sean, between our CSG brand and the Meriwether Godsey brand you referenced. So we’re pleased with that. It provides a strong platform for future growth. And the organic growth element is going to be critical for us. We continue to see accelerated organic growth in both of those brands. And with the concentration primarily in the Northeast, Southeast, through the Mid-Atlantic, and the beginning stages of a Midwest expansion, that will be, we anticipate, fueled over the next 12-18 months by very strategic, very intentional M&A to be able to land and expand. So to find those brands that we’ve talked about before that meet our criteria in a specific market, complement the growth strategy that we’ve laid out, and then organically grow those brands with the support and the supplementation from the home office here. So we’re very well positioned.

That milestone is a critical milestone as we think about it, reinforces our conviction in the model and the niche we’ve carved out. So we’re expecting continued accelerated growth in the year ahead and then beyond. Really, the possibilities are very compelling and powerful.

Matt McKee, Chief Communications Officer, Healthcare Services Group, Inc.: Okay. And then on cash from operations, you had a great performance in 2025, even after you strip out the ERC payments. How should we be thinking about cash from ops trajectory for 2026? You said mid-singles revenue growth. You gave some margin targets. You’ve talked before about cash from ops approximating net income. Is that still kind of the message, the expectation for 2026?

Vikas Singh, Chief Financial Officer, Healthcare Services Group, Inc.: Yeah, Sean, that’s spot on. I think our expectation continues to be that net income is the best proxy for cash flow from operations, excluding the change in payroll accrual. And again, I think it goes back to the indication we are suggesting for the year to follow, which is mid-single-digit revenue growth, margins consistent with what we’ve said in the past, which is 86% cost of sales, 10% SG&A at the midpoint of our short-term target range, and an effective tax rate of, give or take, 25%, which is what we’ve done historically, and overall collections matching revenue. And that leads to an outcome where net income will be the best proxy for what our cash flows will be going forward.

Matt McKee, Chief Communications Officer, Healthcare Services Group, Inc.: Okay. And then just last on the buyback, the plan to repurchase $75 million of stock over the next 12 months, maybe just balancing that against the M&A opportunity. Buying back that amount of stock, how much does that or how much room does that give you to still do M&A?

Vikas Singh, Chief Financial Officer, Healthcare Services Group, Inc.: Yeah. So Sean, what we’ve done over the last few quarters is prime our balance sheet for all our capital allocation priorities. So you would see in 2025, we’ve gone through the year without drawing on our line of credit. We’ve built up our cash balance, and now we’re sitting at a balance of $200 million plus in terms of securities and cash, which is substantial. We have an undrawn line of credit. And as we think about all the priorities, focusing on organic growth, M&A, share buyback, we feel very comfortable with our liquidity position and feel confident and comfortable that we can go after all the 3 priorities without having to worry about liquidity. I think we’ve put our balance sheet in a spot where all those priorities can be moved forward without one compromising the other.

Now, that said, if we ever find ourselves in the happy spot of finding a substantial M&A, the line of credit gives us a lot of cushion. So long way of saying that we don’t really see a conflict between the priorities and our liquidity.

Matt McKee, Chief Communications Officer, Healthcare Services Group, Inc.: Okay. Super helpful. Thanks and congratulations again.

Vikas Singh, Chief Financial Officer, Healthcare Services Group, Inc.: Thank you.

Conference Call Moderator: Your next question comes from a line of Ryan Daniels from William Blair. Your line is open.

Matthew Mardula, Analyst, William Blair: Hello. This is Matthew Mardula on for Ryan Daniels. Thank you so much for taking our questions. I know new business adds were a large part of the growth in 2025. When thinking about the setup for this year, do you believe or maybe even anticipate an even larger amount of new businesses added throughout the year? I know the timing of new businesses can vary between even months or quarters. Given the improvement in the industry and the potential of it continuing, any color into how you are thinking about new businesses adds and the drivers of that throughout this year?

Ted Wahl, President and CEO, Healthcare Services Group, Inc.: Sure, Matthew. And good morning to you. We highlighted that in 2026, we’re expecting mid-single digit revenue growth along the lines of the cadence that Matt described in his opening remarks. And you referenced timing, but as always is the case, the timing of new business adds is a factor, and that can be fluid quarter to quarter, knowing there’s always a subset of opportunities intra-quarter that could be pushed out or pulled forward. You think about the difference between starting a new opportunity on March 1st as opposed to April 1st, maybe insignificant on a year-over-year basis, but that could be meaningful to a given quarter. Again, that’s why our mid-single digit guidance is really based off annual growth expectations, whereas our quarter-to-quarter estimates are ranges that are intended to provide that additional near-term visibility.

So again, in terms of driving that organic growth, I referenced it earlier, but our growth algorithm is very straightforward. It’s execution-based. And with the pipeline that we’ve built, which is robust, and the retention trends that we’re seeing in that 90%+ range, the key for us in driving organic growth is going to be executing on that management development strategy, hiring, developing, retaining, and then making sure that there’s balance throughout the organization. Each of those components I referenced is supported by best-in-class leadership systems, procedures in each of the divisions, as well as the service center providing administrative support here. But the execution is region by region, area by area.

We’re more convinced than ever that the decentralized approach puts us in the best position to, in a very bottoms-up type of way, deliver on that mid-single-digit growth expectation, certainly over the next 12 months, but perhaps most importantly, over the next 3-5 years as we think about the longer-term outlook.

Matthew Mardula, Analyst, William Blair: Got it. Thank you for that. And then how have the services you have performed in the skilled nursing facilities compared to the other facilities you have performed at this year? Are just all types of facilities performing better than expectations, or are there any certain ones performing better than others that you could call out from last year? And then also just kind of looking ahead to 2026, do you expect similar trends to persist or any changes in growth regarding facility types, especially with any color with the skilled nursing facilities?

Matt McKee, Chief Communications Officer, Healthcare Services Group, Inc.: Yeah. I would say, Matthew, from the previous comments that I made with respect to the strong performance in cost of services and the impact that that’s had on gross margin, our service execution across really all service segments and customer types, inclusive of facility types, remained remarkably consistent throughout the course of 2025. That’s absolutely our expectation going forward in 2026 as well. We certainly don’t take that for granted.

There’s a heck of a lot of effort that goes into implementing our systems and, most importantly, adhering to our systems at the facility level to not only deliver relative to budget and to deliver the margin and cost of services that we’re anticipating, but more importantly, to do so within a framework that allows for a high degree of operational execution, client satisfaction, and all of those other really important elements that are critical to our success at the facility level. So really strong performance across all verticals and segments. And the expectation is absolutely that that continues throughout the course of 2026 and beyond as well.

Matthew Mardula, Analyst, William Blair: Great. Thank you so much for all that.

Conference Call Moderator: We have reached the end of our question and answer session. I will now turn the call back over to Ted Wahl for closing remarks.

Ted Wahl, President and CEO, Healthcare Services Group, Inc.: Okay. Great. Thank you, Rob. As we enter 2026, our 50th anniversary, the company’s underlying fundamentals are more robust than ever. Our leadership and management team, our enhanced value proposition, our business model, and the visibility we have into that model, our training and learning platforms, our KPIs and key business trends, and our strong balance sheet. And with the industry at the beginning of a multi-decade demographic tailwind, we are incredibly well positioned to capitalize on the abundance of opportunities that lie ahead and deliver meaningful long-term shareholder value. So on behalf of Matt, Vikas, and all of us at Healthcare Services Group, Rob, thank you for hosting the call today. And thank you again, everyone, for participating.

Conference Call Moderator: This concludes today’s conference call. Thank you for your participation. You may now disconnect.