Start here if you're new
what it is
PACS runs nursing and senior-living facilities, plus the office work that keeps them staffed and paid.
how it gets paid
Last year Pacs made $5.3B in revenue. Skilled nursing care was the main engine at $2.9B, or 55% of sales.
why it's growing
Revenue grew 29.4% last year. Revenue was up 192% vs. prior year, and EPS was up 150%.
what just happened
PACS posted $3.9B in quarterly revenue and $0.80 EPS.
At a glance
n/a balance sheet
27.9x trailing p/e — priced about right
4.7% return on capital — nothing to write home about
$1.22 fy2025 eps est
$6M fy2024 rev est
What they do
PACS runs nursing and senior-living facilities, plus the office work that keeps them staffed and paid.
PACS runs 321 facilities across 17 states and serves 31,700 patients daily. That scale makes your local operator look tiny. It also owns 53 sites, leases 219, and holds 49 partial interests, so leaving means untangling owned buildings, rented buildings, and part-owned stakes.
How they make money
$5.3B
annual revenue · their business grew +29.4% last year
Skilled nursing care
$2.9B
Senior care communities
$1.0B
Assisted living
$0.7B
Independent living
$0.4B
Real estate and support services
$0.3B
The products that matter
runs skilled nursing facilities
Skilled Nursing
$4.5B · 85% of shown revenue
This is the center of gravity. About $4.5B of the $5.29B total shown on this page sits here, so your thesis is mostly a skilled nursing thesis.
85% of revenue
operates residential care sites
Assisted Living
$0.8B · 15% of shown revenue
About $0.8B sits in assisted living. It matters, but it is still the smaller business next to the much larger skilled nursing operation.
secondary segment
shared support and operating functions
Ancillary Services
3.62% net margin
The page does not break out revenue for this bucket. That's thin, and we're saying so. What you can see is the end result: only a 3.62% net margin on $5.29B of revenue leaves very little room for sloppy execution.
thin disclosure
Key numbers
$5.3B
annual revenue
This is the scale number. It tells you PACS is a real operator, not a tiny local chain.
6.9%
operating margin
For every $100 of sales, PACS keeps $6.90 before interest and taxes. That is thin for a business with $3.4B of debt.
4.7%
return on capital
This is the money-it-puts-in number. A 4.7% return says the business is working, but not exactly strutting.
$3.4B
long-term debt
Debt this large turns rate changes into real cash changes. A 1% move is about $34M a year.
Financial health
n/a
strength
- balance sheet grade n/a
- long-term debt $3.4B (38% of capital)
n/a — functional but not a standout on the balance sheet.
Total return vs. market
Return history isn't available for PACS right now.
source: institutional data · return history unavailable
What just happened
beat estimates
PACS posted $3.9B in quarterly revenue and $0.80 EPS.
Revenue was up 192% vs. prior year, and EPS was up 150%. The company is growing fast, but the margin base is still thin.
$3.9B
revenue
$0.80
eps
n/a
n/a
the number that mattered
Revenue was the big number. At $3.9B, it showed the business can grow fast even while margins stay tight.
source: company earnings report, 2026
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What could go wrong
PACS is not a mystery. The risk stack is right in front of you: a premium multiple, thin margins, slower growth, and a balance sheet that looks fine only if operating execution keeps cooperating.
med
premium valuation without premium economics
PACS trades at about 28.6x earnings versus a 22.8x peer average. That is a 29% premium for a business with a 5.6% operating margin and a 4.7% return on capital.
If the margin story does not improve, the stock does not need a disaster to fall. It just needs investors to stop paying ahead of the proof.
med
thin margins in a labor-heavy model
Operating margin is 5.6% and net margin is 3.62%. Those are not large cushions. Wage pressure, occupancy softness, reimbursement changes, or compliance costs have more bite here than they would in a wide-margin business.
At 3.62% net margin, a small miss can do outsized damage to earnings. That's the math you are buying.
med
growth normalization after a fast run
Revenue grew 29.3% last year. The 2026 midpoint of $5.7B implies roughly 8% next. The number itself is still healthy. The contrast is what matters.
When growth decelerates this quickly, the market starts grading the business on quality instead of speed. That raises the bar for every quarter.
med
debt leaves less room for operational mistakes
Long-term debt stands at $3.4B, or 38% of capital. That looks manageable if operations stay steady. It looks heavier if margin improvement stalls while integration, staffing, and compliance demands rise.
You do not need a balance-sheet crisis for this to matter. You just need a few quarters where profit does not scale with revenue.
If PACS reaches roughly $5.7B in 2026 revenue but operating margin stays near 5.6%, you still own a low-margin care operator priced like something better.
source: institutional data · regulatory filings · risk analysis
Pay attention to
margin
the 5.6% operating margin
This is the number that matters. If PACS cannot move it toward Ensign's 8.4%, the premium multiple starts looking rented, not earned.
2026 outlook
the $5.7B midpoint
That target implies roughly 8% growth after a 29.3% year. Watch each quarter for whether the slowdown is orderly or whether growth fades faster than margins improve.
balance sheet
the $3.4B debt load
Debt at 38% of capital is workable until margins get squeezed. In a thin-margin business, debt becomes more visible the moment operations wobble.
management signal
compliance and staffing execution
The December 2025 appointments to compliance and HR tell you where the pressure points are. If those hires lead to cleaner execution, the story gets better. If not, you will see it in margins first.
Analyst rankings
coverage
thin
in human-speak, there is not enough analyst ranking data surfaced on this snapshot to borrow conviction from wall street.
short-term view
unclear
No formal timeliness-style ranking is available here. You are left doing the work yourself, which is inconvenient but often more honest.
consensus quality
limited
When coverage is light, price targets and ranking systems carry less weight. The operating numbers matter more than the labels.
source: institutional data
Institutional activity
institutional ownership data for PACS is being compiled.
source: institutional data
Price targets
3-5 year target range
n/a
n/a
$34
current price
n/a
target midpoint · n/a from current
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