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BrightSpring Health Services, Inc. Reports Fourth Quarter and Full Year 2025 Financial Results and Provides Full Year 2026 Guidance

LOUISVILLE, Ky., Feb. 27, 2026 (GLOBE NEWSWIRE) -- BrightSpring Health Services, Inc. (“BrightSpring” or the “Company”) (NASDAQ: BTSG), a leading provider of home and community-based health services for complex populations, today announced financial results for the fourth quarter and full year ended December 31, 2025 and initiated full year 2026 Revenue and Adjusted EBITDA1 guidance.

Fourth Quarter 2025 Financial Highlights
(note: all figures represent continuing operations and exclude the Community Living business)

  • Net revenue of $3,551 million, up 29.3% compared to $2,747 million in the fourth quarter of 2024
  • Gross profit of $413 million, up 21.8% compared to $339 million in the fourth quarter of 2024
  • Net income of $49.6 million compared to net income of $4.3 million in the fourth quarter of 2024
  • Adjusted EBITDA1 of $184 million, up 40.7% compared to $130 million in the fourth quarter of 2024
  • Acquired 107 home health and hospice branches as a part of the Amedisys and LHC acquisition
  • Repurchased 1,500,000 shares of common stock, for approximately $43.2 million, in connection with the October 2025 secondary offering by affiliates of Kohlberg Kravis Roberts & Co. L.P. and certain members of management

Full Year 2025 Financial Highlights
(note: all figures represent continuing operations and exclude the Community Living business)

  • Net revenue of $12,911 million, up 28.2% compared to $10,072 million in full year 2024
  • Gross profit of $1,518 million, up 19.8% compared to $1,266 million in full year 2024
  • Net income of $104.8 million, compared to a net loss of $68.9 million in full year 2024
  • Operating cash flow of $490 million, compared to $24 million in full year 2024
  • Adjusted EBITDA1 of $618 million, up 34.2% compared to $460 million in full year 2024
  • Leverage2 of 2.99x as of December 31, 2025 compared to leverage of 4.16x on December 31, 2024
  • Planned divestiture of Community Living business to Sevita, announced on January 20, 2025, is expected to close by the end of the first quarter of 2026

"In 2025, BrightSpring’s financial performance was driven by ongoing demand for our high-quality and differentiated services and operational capabilities,” said Jon Rousseau, Chairman, President, and Chief Executive Officer of the Company. “I am pleased with our results across the enterprise, underpinned by the people and processes we have in place, which expand the reach and impact of our mission every day. In 2026, we remain focused on delivering superior, timely, and lower-cost coordinated patient care that provides significant value to the healthcare system, the individuals we serve, and our organization.”

1Adjusted EBITDA is a non-GAAP financial measure. Please see “Non-GAAP Financial Information” and the end of this press release for a reconciliation of Adjusted EBITDA to net income (loss) from continuing operations, the most directly comparable financial measure prepared in accordance with GAAP.

2The results of the Community Living business are included in the calculation of our leverage pursuant to the terms of our First Lien Credit Agreement.

Key Financials3 (for BrightSpring continuing operations)
        
 Three Months Ended   Year Ended  
 December 31, (Unaudited)   December 31, (Unaudited)  
  2025  2024 %  2025  2024 %
($ in millions)           
Pharmacy Solutions Revenue$3,157 $2,397 32% $11,446 $8,754 31%
Provider Services Revenue 394  350 13%  1,465  1,318 11%
Total Revenue$3,551 $2,747 29% $12,911 $10,072 28%


 Three Months Ended   Year Ended  
 December 31, (Unaudited)   December 31, (Unaudited)  
  2025   2024  %  2025   2024  %
($ in millions)           
Pharmacy Solutions segment EBITDA$162  $113  44% $544  $395  38%
Provider Services segment EBITDA 64   56  16%  233   205  13%
Total Segment Adjusted EBITDA$227  $168  35% $776  $600  29%
Corporate Costs (43)  (38) -   (159)  (140) - 
Total Company Adjusted EBITDA(1)$184  $130  41% $618  $460  34%

Business Metrics

 Three Months Ended   Year Ended  
 December 31, (Unaudited)   December 31, (Unaudited)  
 2025 2024 % 2025 2024 %
Pharmacy Solutions           
Prescriptions dispensed10,844,786 10,967,463 (1%) 43,367,072 41,816,584 4%
Revenue per script ($)291.07 218.56 33% 263.93 209.35 26%
Gross Profit per script ($)23.52 18.65 26% 21.64 17.83 21%
Provider Services           
Home Health Care average daily census34,593 30,019 15% 31,135 28,532 9%
Rehab Care persons served7,363 6,544 13% 7,127 6,597 8%
Personal Care persons served16,175 15,874 2% 16,079 15,879 1%


1
Adjusted EBITDA is a non-GAAP financial measure. Please see “Non-GAAP Financial Information” and the end of this press release for a reconciliation of Adjusted EBITDA to net income (loss) from continuing operations, the most directly comparable financial measure prepared in accordance with GAAP.

3Financial tables may not foot due to rounding.

Full Year 2026 Financial Guidance

For the full year 2026, BrightSpring is providing Revenue and Adjusted EBITDA guidance, which excludes the Community Living business and the effects of any future closed acquisitions. All growth rates are shown as compared to the full year 2025 Revenue and Adjusted EBITDA results, excluding the Community Living business:

  • Revenues of $14,450 million to $15,000 million, or 11.9% to 16.2% growth.
    • Pharmacy Segment Revenue of $12,600 million to $13,100 million, or 10.1% to 14.5% growth.
    • Provider Segment Revenue of $1,850 million to $1,900 million, or 26.3% to 29.7% growth.
  • Total Adjusted EBITDA4 of $760 million to $790 million, or 23.1% to 27.9% growth.
  • The Amedysis and LHC acquisition is expected to contribute approximately $30 million in Adjusted EBITDA in 2026.

4A reconciliation of the foregoing guidance for the non-GAAP metric of Adjusted EBITDA to GAAP net income (loss) from continuing operations cannot be provided without unreasonable effort because of the inherent difficulty of accurately forecasting the occurrence and financial impact of the various adjusting items necessary for such reconciliation that have not yet occurred, are out of our control, or cannot be reasonably predicted. For the same reasons, the Company is unable to assess the probable significance of the unavailable information, which could have a material impact on its future GAAP financial results.

Webcast and Conference Call Details

The Company will host a conference call today, February 27th at 8:30 a.m. Eastern Time. Investors interested in listening to the conference call are required to register online.

A live and archived webcast of the event will be available on the “Events & Presentations” section of the BrightSpring website at https://ir.brightspringhealth.com/. The Company has posted supplemental information on the fourth quarter and fiscal year 2025 results that it will reference during the conference call. The supplemental information can be found under the “Events & Presentations” on the Company’s investor relations page.

About BrightSpring Health Services

BrightSpring Health Services provides complementary home- and community-based pharmacy and provider health solutions for complex populations in need of specialized and/or chronic care. Through the Company’s service lines, including pharmacy, home health care and primary care, and rehabilitation and behavioral health, we provide comprehensive and integrated care and clinical solutions in all 50 states to over 465,000 customers, clients and patients daily. BrightSpring has consistently demonstrated strong and industry-leading quality metrics across its services lines, while improving the quality of life and health for high-need individuals and reducing overall costs to the healthcare system.

Forward-Looking Statements

This press release contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements reflect our current views with respect to, among other things, our operations and financial performance. Forward-looking statements include all statements that are not historical facts. These forward-looking statements may relate to matters which include, but are not limited to, industries, business strategy, goals and expectations concerning our market position, future operations, margins, profitability, capital expenditures, liquidity and capital resources and other financial and operating information. In some cases, we have used words such as “anticipate,” “assume,” “believe,” “continue,” “could,” “estimate,” “expect,” “intend,” “may,” “plan,” “potential,” “predict,” “project,” “future,” “will,” “seek,” “foreseeable,” “target,” “guidance,” the negative version of these words, or similar terms and phrases to identify these forward-looking statements.

The forward-looking statements are based on management’s current expectations and are not historical facts or guarantees of future performance. The forward-looking statements relate to the future and are therefore subject to various risks, uncertainties, assumptions, or changes in circumstances that are difficult to predict or quantify. Our expectations, beliefs, and projections are expressed in good faith and we believe there is a reasonable basis for them. However, there can be no assurance that management’s expectations, beliefs, and projections will result or be achieved. Actual results may differ materially from these expectations due to changes in global, regional, or local economic, business, competitive, market, regulatory, and other factors, many of which are beyond our control. We believe that these factors include but are not limited to the following:

  • our operation in a highly competitive industry;
  • our inability to maintain relationships with existing patient referral sources or establish new referral sources;
  • changes to Medicare and Medicaid rates or methods governing Medicare and Medicaid payments for our services;
  • cost containment initiatives of third-party payors, including post-payment audits;
  • the implementation of alternative payment models and the transition of Medicaid and Medicare beneficiaries to managed care organizations may limit our market share and could adversely affect our revenues;
  • changes in the case mix of patients, as well as payor mix and payment methodologies, and decisions and operations of third-party organizations;
  • our reliance on federal and state spending, budget decisions, and continuous governmental operations which may fluctuate under different political conditions;
  • changes in drug utilization and/or pricing, PBM contracts, and Medicare Part D/Medicaid reimbursement, which may negatively impact our profitability;
  • changes in our relationships with pharmaceutical suppliers, including changes in drug availability or pricing;
  • reliance on the continual recruitment and retention of nurses, pharmacists, therapists, caregivers, direct support professionals, and other qualified personnel, including senior management;
  • compliance with or changes to federal, state, and local laws and regulations that govern our employment practices, including minimum wage, living wage, and paid time-off requirements;
  • fluctuation of our results of operations on a quarterly basis;
  • harm caused by labor relation matters;
  • limitations in our ability to control reimbursement rates received for our services if we are unable to maintain or reduce our costs to provide such services;
  • delays in collection or non-collection of our accounts receivable, particularly during the business integration process;
  • failure to manage our growth effectively, which may inhibit our ability to execute our business plan, maintain high levels of service and satisfaction or adequately address competitive challenges;
  • our ability to identify, successfully complete and manage acquisitions, joint ventures, divestitures and other significant transactions and strategic initiatives;
  • our ability to continue to provide consistently high quality of care;
  • maintenance of our corporate reputation or the emergence of adverse publicity, including negative information on social media or changes in public perception of our services;
  • contract continuance, expansion and renewal with our existing customers, including renewals at lower fee levels, customers declining to purchase additional services from us, or reduction in the services received from us pursuant to those contracts;
  • effective investment in, implementation of improvements to and proper maintenance of the uninterrupted operation and data integrity of our information technology and other business systems;
  • security breaches, loss of data, and other disruptions, which could compromise sensitive business or patient information; cause a loss of confidential patient data, employee data or personal information; or prevent access to critical information and thereby expose us to liability, litigation, and federal and state governmental inquiries and damage our reputation and brand;
  • risks related to credit card payments and other payment methods;
  • potential substantial malpractice or other similar claims;
  • various risks related to governmental inquiries, regulatory actions, and whistleblower and other lawsuits, which may not be entirely covered by insurance;
  • our current insurance program, which may expose us to unexpected costs, particularly if we incur losses not covered by our insurance or if claims or losses differ from our estimates;
  • factors outside of our control, including those listed, which have required and could in the future require us to record an asset impairment of goodwill;
  • a pandemic, epidemic, or outbreak of an infectious disease;
  • inclement weather, natural disasters, acts of terrorism, riots, civil insurrection or social unrest, looting, protests, strikes, or street demonstrations;
  • our inability to adequately protect our intellectual property rights;
  • risks related to our compliance with our regulatory framework;
  • the significant interests of KKR Stockholder may conflict with our stockholders’ interests in the future;
  • our substantial indebtedness;
  • significant changes in tax or trade policies, tariffs, or trade relations between the United States and other countries, such as the imposition of unilateral tariffs on imported products, including impacts on imported drug products, which could result in supply chain disruptions and significant increases in costs; and
  • fluctuations in the amount and frequency of repurchases of our common stock.

The forward-looking statements included in this press release are made only as of the date of this press release, and we undertake no obligation to publicly update or revise any forward-looking statement, whether as a result of new information, future developments, or otherwise, except as required by law. These factors should not be construed as exhaustive, and should one or more of these risks or uncertainties materialize, or should any of our assumptions prove incorrect, our actual results may vary in material respects from those projected in these forward-looking statements. Factors or events that could cause our actual results to differ may emerge from time to time, and it is not possible for us to predict all of them. We may not actually achieve the plans, intentions, or expectations disclosed in our forward-looking statements and you should not place undue reliance on our forward-looking statements. Our forward- looking statements do not reflect the potential impact of any future acquisitions, mergers, dispositions, joint ventures, investments, or other strategic transactions we may make.

For additional information on these and other factors that could cause BrightSpring’s actual results to differ materially from expected results, please see our filings with the Securities and Exchange Commission (the “SEC”), which are accessible on the SEC’s website at www.sec.gov.

Non-GAAP Financial Measures

This press release contains “non-GAAP financial measures,” including “EBITDA,” “Adjusted EBITDA,” and “Adjusted EPS,” which are financial measures that either exclude or include amounts that are not excluded or included in the most directly comparable measures calculated and presented in accordance with accounting principles generally accepted in the United States, or GAAP.

EBITDA, Adjusted EBITDA, and Adjusted EPS have been presented in this release as supplemental measures of financial performance that are not required by, or presented in accordance with, GAAP, because we believe they assist investors and analysts in comparing our operating performance across reporting periods on a consistent basis by excluding items that we do not believe are indicative of our core operating performance. Management also believes that these measures are useful to investors in highlighting trends in our operating performance, while other measures can differ significantly depending on long-term strategic decisions regarding capital structure, the tax jurisdictions in which we operate and capital investments. Management uses EBITDA, Adjusted EBITDA, and Adjusted EPS to supplement GAAP measures of performance in the evaluation of the effectiveness of our business strategies, to make budgeting decisions, to establish and award discretionary annual incentive compensation, and to compare our performance against that of other peer companies using similar measures.

Management supplements GAAP results with non-GAAP financial measures to provide a more complete understanding of the factors and trends affecting the business than GAAP results alone. EBITDA, Adjusted EBITDA, and Adjusted EPS are not GAAP measures of our financial performance and should not be considered as an alternative to net income (loss) as a measure of financial performance or any other performance measures derived in accordance with GAAP. Additionally, these measures are not intended to be a measure of free cash flow available for management’s discretionary use as they do not consider certain cash requirements such as tax payments, debt service requirements, total capital expenditures, and certain other cash costs that may recur in the future.

Management defines EBITDA as net income (loss) from continuing operations before income tax expense (benefit), interest expense, net and depreciation and amortization. Management also defines Adjusted EBITDA as EBITDA, further adjusted to exclude non-cash share-based compensation, acquisition, integration and transaction-related costs, restructuring and divestiture-related and other costs, legal costs and settlements associated with certain historical matters for PharMerica, significant projects, and management fees.

The presentations of these measures have limitations as analytical tools and should not be considered in isolation, or as a substitute for analysis of our results as reported under GAAP. Because not all companies use identical calculations, the presentations of these measures may not be comparable to other similarly titled measures of other companies and can differ significantly from company to company. Please see the end of this press release for reconciliations of non-GAAP financial measures to the most directly comparable financial measure prepared in accordance with GAAP.

BrightSpring Contact:

Investor Relations:                                        Media Contact:
David Deuchler, CFA                                       Leigh White
Gilmartin Group LLC                                       leigh.white@brightspringhealth.com
ir@brightspringhealth.com                              502.630.7412

BrightSpring Health Services, Inc. and Subsidiaries
Consolidated Balance Sheets
December 31, 2025 and 2024
(In thousands, except share and per share data)
(Unaudited)
 
  December 31, 2025  December 31, 2024 
Assets      
Current assets:      
Cash and cash equivalents $88,370  $60,954 
Accounts receivable, net of allowance for credit losses  989,719   902,782 
Inventories  815,180   636,561 
Prepaid expenses and other current assets  118,592   161,310 
Current assets held for sale  882,189   131,447 
Total current assets  2,894,050   1,893,054 
Property and equipment, net of accumulated depreciation of $404,878 and $339,892
at December 31, 2025 and 2024, respectively
  204,689   180,570 
Goodwill  2,545,673   2,363,884 
Intangible assets, net of accumulated amortization  557,555   595,224 
Operating lease right-of-use assets, net  171,632   161,032 
Deferred income taxes, net     5,288 
Other assets  39,712   39,128 
Non-current assets held for sale     687,960 
Total assets $6,413,311  $5,926,140 
Liabilities, Redeemable Noncontrolling Interests, and Equity      
Current liabilities:      
Trade accounts payable $1,217,946  $923,926 
Accrued expenses  333,024   295,746 
Current portion of obligations under operating leases  42,936   38,910 
Current portion of obligations under financing leases  6,794   3,463 
Current portion of long-term debt  52,340   48,725 
Current liabilities held for sale  195,994   117,563 
Total current liabilities  1,849,034   1,428,333 
Obligations under operating leases, net of current portion  135,420   129,467 
Obligations under financing leases, net of current portion  14,544   6,530 
Long-term debt, net of current portion  2,455,204   2,561,858 
Deferred income taxes, net  6,178    
Long-term liabilities  66,565   71,190 
Non-current liabilities held for sale     77,177 
Total liabilities  4,526,945   4,274,555 
Redeemable noncontrolling interests  11,227   3,730 
Shareholders’ equity:      
Common stock, $0.01 par value, 1,500,000,000 shares authorized, 192,124,125 and
174,245,990 shares issued and outstanding at December 31, 2025 and 2024, respectively
 $1,921  $1,742 
Preferred stock, $0.01 par value, 250,000,000 authorized, no shares issued and
outstanding at December 31, 2025 and 2024
      
Additional paid-in capital  1,954,482   1,866,850 
Accumulated deficit  (74,647)  (222,155)
Accumulated other comprehensive (loss) income  (6,691)  1,418 
Total shareholders’ equity  1,875,065   1,647,855 
Noncontrolling interest  74    
Total equity  1,875,139   1,647,855 
Total liabilities, redeemable noncontrolling interests, and equity $6,413,311  $5,926,140 


BrightSpring Health Services, Inc. and Subsidiaries
Consolidated Statements of Operations
For the three and twelve months ended December 31, 2025 and 2024
(In thousands, except per share amounts)
(Unaudited)
 
  For the Three Months Ended
December 31,
  For the Years Ended
December 31,
 
  2025  2024  2025  2024 
Revenues:            
Products $3,156,539  $2,397,059  $11,445,777  $8,754,282 
Services  394,092   349,906   1,464,787   1,317,932 
Total revenues  3,550,631   2,746,965   12,910,564   10,072,214 
Cost of goods  2,901,500   2,192,520   10,507,431   8,008,501 
Cost of services  236,583   215,777   885,356   797,286 
Gross profit  412,548   338,668   1,517,777   1,266,427 
Selling, general, and administrative expenses  304,435   283,129   1,222,525   1,158,473 
Operating income  108,113   55,539   295,252   107,954 
Loss on extinguishment of debt           12,726 
Interest expense, net  38,535   46,180   157,311   190,546 
Income (loss) from continuing operations before income taxes  69,578   9,359   137,941   (95,318)
Income tax expense (benefit)  20,027   5,077   33,145   (26,387)
Income (loss) from continuing operations, net of income taxes  49,551   4,282   104,796   (68,931)
Income from discontinued operations, net of income taxes  27,769   11,122   84,317   48,410 
Net income (loss)  77,320   15,404   189,113   (20,521)
Net income (loss) attributable to noncontrolling interests included in
continuing operations
  240   (595)  (1,553)  (2,459)
Net income (loss) attributable to BrightSpring Health Services, Inc.
and subsidiaries
 $77,080  $15,999  $190,666  $(18,062)
             
Net income (loss) per common share:            
Basic income (loss) per share attributable to common shareholders:            
Continuing operations $0.24  $0.02  $0.53  $(0.34)
Discontinued operations $0.14  $0.06  $0.41  $0.25 
Net income (loss) per share $0.38  $0.08  $0.94  $(0.09)
Diluted income (loss) per share attributable to common shareholders:            
Continuing operations $0.23  $0.02  $0.48  $(0.34)
Discontinued operations $0.12  $0.06  $0.39  $0.25 
Net income (loss) per share $0.35  $0.08  $0.87  $(0.09)
Weighted average shares outstanding:            
Basic  203,702   200,312   202,564   192,997 
Diluted  218,417   213,160   219,774   192,997 


BrightSpring Health Services, Inc. and Subsidiaries
Consolidated Statements of Cash Flows
For the three and twelve months ended December 31, 2025 and 2024
(In thousands)
(Unaudited)
 
  For the Three Months Ended
December 31,
  For the Years Ended
December 31,
 
  2025  2024  2025  2024 
Operating activities:            
Net income (loss) $77,320  $15,404  $189,113  $(20,521)
Adjustments to reconcile net income (loss) to cash provided
by operating activities:
            
Depreciation and amortization  39,524   54,881   164,277   204,482 
Impairment of long-lived assets  6,102   5,454   12,628   10,235 
Change in fair value of contingent consideration, net     2,261   (1,266)  2,261 
Payment of contingent consideration in excess of acquisition date fair value     (2,351)  (6,170)  (2,351)
Provision for credit losses  7,504   12,102   56,227   33,998 
Amortization of deferred debt issuance costs  2,858   2,631   11,242   12,108 
Share-based compensation  14,366   13,980   70,099   69,174 
Deferred income taxes, net  (3,424)  1,867   14,842   (25,914)
Loss on extinguishment of debt           12,726 
Loss on disposition of fixed assets  573   156   2,076   101 
Other  (2,518)  (1,492)  (4,356)  (2,451)
Change in operating assets and liabilities, net of acquisitions:            
Accounts receivable  31,402   (15,044)  (131,287)  (179,040)
Prepaid expenses and other current assets  5,812   10,065   30,669   7,595 
Inventories  (175,627)  (162,249)  (177,906)  (236,514)
Trade accounts payable  221,335   147,646   264,171   303,209 
Accrued expenses  14,791   5,452   32,003   (144,580)
Other assets and liabilities  (8,459)  (151)  (36,193)  (20,744)
Net cash provided by operating activities $231,559  $90,612  $490,169  $23,774 
Investing activities:            
Purchases of property and equipment $(37,665) $(15,311) $(95,484) $(80,913)
Acquisitions of businesses, net of cash acquired  (196,256)  (42)  (204,564)  (59,797)
Other  37   (427)  (5,031)  473 
Net cash used in investing activities $(233,884) $(15,780) $(305,079) $(140,237)
Financing activities:            
Long-term debt borrowings $  $  $  $2,566,000 
Long-term debt repayments  (12,342)  (11,701)  (50,275)  (3,396,334)
Proceeds from issuance of common stock on initial public offering, net           656,485 
Proceeds from issuance of tangible equity units, net           389,000 
(Repayments) borrowings of the Revolving Credit Facility, net     (33,800)  (63,300)  12,600 
Payment of debt issuance costs     (3,857)     (47,045)
Repurchase of shares of common stock  (43,173)     (43,173)  (650)
Proceeds from shares issued under share-based compensation plan  10,600   1,004   25,281   1,535 
Payment of taxes related to net share settlement of equity awards  (1,971)  (1,196)  (7,554)  (1,196)
Payment of contingent consideration up to acquisition date fair value  (200)  2,351   (200)  (1,805)
Purchase of redeemable noncontrolling interest        (5,100)  (2,316)
Payment of financing lease obligations  (3,412)  (2,353)  (13,545)  (11,629)
Net cash (used in) provided by financing activities $(50,498) $(49,552) $(157,866) $164,645 
Net (decrease) increase in cash and cash equivalents  (52,823)  25,280   27,224   48,182 
Cash and cash equivalents at beginning of period  141,300   35,973   61,253   13,071 
Cash and cash equivalents at end of period $88,477  $61,253  $88,477  $61,253 
Cash and cash equivalents included in assets held for sale at end of period  107   299   107   299 
Cash and cash equivalents included in continuing operations at end of period $88,370  $60,954  $88,370  $60,954 



BrightSpring Health Services, Inc. and Subsidiaries
Reconciliation of EBITDA and Adjusted EBITDA
For the three and twelve months ended December 31, 2025 and 2024
(Unaudited)
 
The following table reconciles net income (loss) from continuing operations to EBITDA and Adjusted EBITDA:
 
($ in thousands) For the Three Months Ended  For The Twelve Months Ended 
  December 31,  December 31, 
  2025  2024  2025  2024 
Net income (loss) from continuing operations $49,551  $4,282  $104,796  $(68,931)
Income tax expense (benefit)  20,027   5,077   33,145   (26,387)
Interest expense, net  38,535   46,180   157,311   190,546 
Depreciation and amortization  39,524   42,675   162,948   162,144 
EBITDA $147,637  $98,214  $458,200  $257,372 
Non-cash share-based compensation(1)  13,009   11,543   59,164   61,336 
Acquisition, integration, and transaction-related costs(2)  5,613   6,625   40,424   31,953 
Restructuring and divestiture-related and other costs(3)  17,289   14,046   59,782   61,688 
Legal costs and settlements(4)           21,886 
Significant projects(5)           2,604 
Management fees(6)           23,381 
Total adjustments $35,911  $32,214  $159,370  $202,848 
Adjusted EBITDA $183,548  $130,428  $617,570  $460,220 


(1) Represents non-cash share-based compensation to certain members of our management and other full-time employees. The year ended December 31, 2024 includes $15.0 million of previously unrecognized share-based compensation expense related to performance-vesting options under the 2017 Stock Plan, a portion of which vested upon completion of the IPO.

(2) Represents transaction costs incurred in connection with planned, completed, or terminated acquisitions, which include investment banking fees, legal diligence and related documentation costs, finance and accounting diligence and documentation; costs associated with the integration of acquisitions, including any facility consolidation, integration travel, or severance; and costs associated with other planned, completed, or terminated non-routine transactions. The years ended December 31, 2025 and 2024 included other non-routine transaction costs of $26.8 million and $5.8 million, respectively.

(3) Represents costs associated with restructuring-related activities, including closure costs, and related license impairment, and severance expenses associated with certain enterprise-wide or significant business line cost-savings measures. These costs included $23.4 million and $23.7 million of costs that did not meet the criteria for discontinued operations related to the Community Living divestiture for the years ended December 31, 2025 and 2024, respectively. These costs also included $12.7 million of unamortized debt issuance costs associated with the extinguishment of our Second Lien Facility in the year ended December 31, 2024.

(4) Represents settlement and defense costs associated with certain historical PharMerica litigation matters, including the Silver matter, all of which were finalized in 2024.

(5) Represents costs associated with certain transformational projects and for the periods presented primarily included general ledger system implementation, pharmacy billing system implementation, and ransomware attack response costs, all of which were finalized in 2024.

(6) Represents annual management fees payable to the Managers under the Monitoring Agreement through the date of the IPO, and $22.7 million of termination fees resulting from the Monitoring Agreement being terminated upon completion of the IPO Offerings. All management fees ceased following the completion of the IPO in 2024.

BrightSpring Health Services, Inc. and Subsidiaries
Reconciliation of Adjusted EPS
For the three and twelve months ended December 31, 2025 and 2024
(Unaudited)
 
The following table reconciles diluted EPS to Adjusted EPS:
 
(shares in thousands) For the Three Months Ended  For The Twelve Months Ended 
  December 31,  December 31, 
  2025  2024  2025  2024 
Diluted EPS $0.23  $0.02  $0.48  $(0.34)
Non-cash share-based compensation(1)  0.06   0.05   0.27   0.30 
Acquisition, integration, and transaction-related costs(1)  0.03   0.03   0.18   0.16 
Restructuring and divestiture-related and other costs(1)  0.08   0.07   0.27   0.31 
Legal costs and settlements(1)           0.11 
Significant projects(1)           0.01 
Management fee(1)           0.12 
Income tax impact on adjustments(2)  (0.07)  (0.04)  (0.20)  (0.32)
Adjusted EPS $0.33  $0.13  $1.00  $0.35 
             
Weighted average common shares outstanding used in
calculating diluted U.S. GAAP net income (loss) per share
  218,417   213,160   219,774   192,997 
Weighted average common shares outstanding used in
calculating diluted Non-GAAP earnings per share
  218,417   213,160   219,774   202,106 



(1) This adjustment reflects the per share impact of the adjustment reflected within the definition of Adjusted EBITDA.

(2) The income tax impact of non-GAAP adjustments is calculated using the estimated tax rate for the respective non-GAAP adjustment. For the year ended December 31, 2024, the income tax impact on adjustments is inclusive of a discrete tax benefit related to the Silver matter that was finalized in connection with the signing of the settlement agreement during the second fiscal quarter of 2024. For all periods presented, the income tax impact on adjustments is inclusive of a discrete tax benefit related to share-based compensation.


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