Almost Family (AFAM) 8-K Results of Operations and Financial Condition

Exhibit 99.1

Almost Family, Inc. Steve Guenthner (502) 891-1000     The Ruth Group Investor Relations Nick Laudico/Zack Kubow (646) 536-7030/7020 nlaudico@theruthgroup.com zkubow@theruthgroup.com  

Almost Family Reports Third Quarter 2009 Results

Recent Company Highlights:

·   Net service revenues increased 31% to $76.3 million

·   Visiting Nurse (VN) segment net revenues rose 35% to $65.7 million

·   Quarterly operating cash flow of $7.8 million – strongest in the Company’s history

·   Net income increased 31% to $6.2 million

·   Diluted EPS increased 30% to $0.73 per share

·   Raised $28 million in the Company’s Equity Distribution Program -- cash on hand plus bank credit facility make $80 million available to fund acquisitions

Louisville, KY, November 4, 2009 – Almost Family, Inc. (Nasdaq: AFAM), a leading regional provider of home health nursing services, announced today its financial results for the three months ended September 30, 2009.

William Yarmuth, Chief Executive Officer, commented, “We’re very pleased to once again report record operating results, especially in what is seasonally a down quarter in our Florida markets.  Despite the immense amount of noise surrounding Federal health care reform activities, our managers have maintained their focus on our patients and referral sources to achieve these results.  Whatever the outcome of the current health care reform efforts might bring, we are positioning our Company to thrive and grow as a major consolidator in the home health care industry.”

Third Quarter Financial Results

Almost Family reported third quarter 2009 net service revenues of $76.3 million, a 31% increase from $58.4 million in the third quarter of 2008.

Net income for the third quarter of 2009 was $6.2 million, or $0.73 per diluted share, compared to $4.7 million, or $0.56 per diluted share, in the third quarter of 2008.  The weighted average shares outstanding for purposes of calculating diluted earnings per share increased 1% between periods.

Almost Family Reports Third Quarter 2009 Results

Page Two

November 4, 2009

Third Quarter Segment Results

Net revenues in the Visiting Nurse segment for the third quarter of 2009 were $65.7 million, a 35% increase from $48.6 million in the third quarter of 2008.  The total revenue growth of $17.1 million came from a 24% organic growth rate plus $7.1 million from acquired operations.  Organic Medicare admissions growth was 11% and organic Medicare Episodic growth was 25%.  Operating income before corporate expense in the VN segment for the third quarter of 2009 was $13.4 million, a 34% increase from $10.0 million in the third quarter of 2008.

Net revenues in the Personal Care (PC) segment for the third quarter of 2009 were $10.6 million, an 8% increase from $9.8 million in the third quarter of 2008.  Operating income before unallocated corporate expense in the PC segment for the third quarter of 2009 was $1.3 million, a 40% increase from $902,000 in the third quarter of 2008.

The Company also noted that its Visiting Nurse segment operations located in Florida normally experience higher admissions during the first quarter and lower admissions during the third quarter than in the other quarters due to seasonal population fluctuations.

Nine Month Period Ended September 30, 2009

Almost Family reported net service revenues for the nine month period ended September 30, 2009 of $219.8 million, a 51% increase from $145.6 million in the same period of 2008.

Net income for the nine month period of 2009 was $17.8 million, or $2.14 per diluted share, compared to $11.1 million, or $1.52 per diluted share, in the nine month period of 2008.

Nine Month Period Segment Results

Net revenues in the Visiting Nurse segment for the nine month period of 2009 were $188.4 million, a 61% increase from $117.3 million in the nine month period of 2008.  The total revenue growth of $71.1 million came from a 32% organic growth rate plus $39.7 million from acquired operations.  Operating income before corporate expense in the VN segment for the nine month period of 2009 was $38.9 million, a 62% increase from $24.0 million in the same period of 2008.

Net revenues in the Personal Care (PC) segment for the nine month period of 2009 were $31.4 million, an 11% increase from $28.3 million in the nine month period of 2008.  Operating income before unallocated corporate expense in the PC segment for the nine month period of 2009 was $3.6 million, a 48% increase from $2.4 million in the nine month period of 2008.

Stock Offering

In the quarter ended September 30, 2009, the Company sold 967,556 shares of its common stock in a series of open market transactions at a weighted average price of $29.71.  Net proceeds of approximately $28 million were used to repay obligations under the Company’s bank credit facility.  As of September 30, 2009, the Company had approximately $10 million in cash on hand.   

Almost Family Reports Third Quarter 2009 Results

Page Three

November 4, 2009

Conference Call

A conference call to review the results will begin at 11:00 a.m. ET on November 4, 2009, and will be hosted by William Yarmuth, Chief Executive Officer, and Steve Guenthner, Chief Financial Officer. To participate in the conference call, please dial 1-877-407-0789 (USA) or 1-201-689-8562 (International).  In addition, a dial-up replay of the conference call will be available beginning November 4, 2009 at 2:00 p.m. ET and ending on November 18, 2009. The replay telephone number is 1-877-660-6853 (USA) or 1-201-612-7415 (International). Account Number: 3055 and Passcode: 335866.

A live Web cast of the call will also be available from the Investor Relations section of the corporate Web site at http://www.almostfamily.com. A Web cast replay can be accessed on the corporate Web site beginning November 4, 2009 at approximately 2:00 p.m. ET and will remain available until December 4, 2009.

Almost Family Reports Third Quarter 2009 Results

Page Four

November 4, 2009

ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME
(UNAUDITED)
	Three months ended September 30,
	2009			2008
Net service revenues	$	76,294,375		$	58,437,365
Cost of service revenues		35,779,006			26,953,672
Gross margin		40,515,369			31,483,693
General and administrative expenses:
Salaries and benefits		20,799,942			16,352,793
Other		9,378,248			7,262,549
Total general and administrative expenses		30,178,190			23,615,342
Operating income		10,337,179			7,868,351
Interest expense, net		(156,326	)		(355,077	)
Income from continuing operations before income taxes		10,180,853			7,513,274
Income tax expense		(3,985,767	)		(2,729,479	)
Net income from continuing operations		6,195,086			4,783,795
Discontinued operations, net of tax benefits of $18,384 and $12,759		(28,624	)		(79,039	)
Net income	$	6,166,462		$	4,704,756
Per share amounts-basic:
Average shares outstanding		8,282,209			8,137,326
Income from continued operations	$	0.75		$	0.59
Loss from discontinued operations		-			(0.01	)
Net income	$	0.75		$	0.58
Per share amounts-diluted:
Average shares outstanding		8,457,329			8,357,332
Income from continued operations	$	0.73		$	0.57
Loss from discontinued operations		-			(0.01	)
Net income	$	0.73		$	0.56

Almost Family Reports Third Quarter 2009 Results

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November 4, 2009

ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME
(UNAUDITED)
	Nine months ended September 30,
	2009			2008
Net service revenues	$	219,828,607		$	145,621,947
Cost of service revenues		102,494,108			67,995,016
Gross margin		117,334,499			77,626,931
General and administrative expenses:
Salaries and benefits		60,469,972			39,805,479
Other		26,840,565			18,875,416
Total general and administrative expenses		87,310,537			58,680,895
Operating income		30,023,962			18,946,036
Interest expense, net		(673,186	)		(733,833	)
Income from continuing operations before income taxes		29,350,776			18,212,203
Income tax expense		(11,488,120	)		(6,996,271	)
Net income from continuing operations		17,862,656			11,215,932
Discontinued operations, net of tax benefits of $27,061 and $63,661		(106,999	)		(119,165	)
Net income	$	17,755,657		$	11,096,767
Per share amounts-basic:
Average shares outstanding		8,164,360			7,111,182
Income from continued operations	$	2.19		$	1.58
Loss from discontinued operations		(0.01	)		(0.02	)
Net income	$	2.18		$	1.56
Per share amounts-diluted:
Average shares outstanding		8,318,411			7,298,718
Income from continued operations	$	2.15		$	1.54
Loss from discontinued operations		(0.01	)		(0.02	)
Net income	$	2.14		$	1.52

Almost Family Reports Third Quarter 2009 Results

Page Six

 November 4, 2009

ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
	September 30, 2009
ASSETS	(UNAUDITED)		December 31, 2008
CURRENT ASSETS:
Cash and cash equivalents	$	10,072,590	$	1,301,178
Accounts receivable - net		38,404,378		34,760,021
Prepaid expenses and other current assets		2,930,547		3,113,737
Deferred tax assets		7,098,046		4,437,979
TOTAL CURRENT ASSETS		58,505,561		43,612,915
PROPERTY AND EQUIPMENT - NET		4,095,383		4,199,067
GOODWILL		98,179,505		92,170,091
OTHER INTANGIBLE ASSETS		14,613,918		16,715,369
OTHER ASSETS		576,137		518,317
	$	175,970,505	$	157,215,759
LIABILITIES AND STOCKHOLDERS' EQUITY
CURRENT LIABILITIES:
Accounts payable	$	5,293,798	$	5,320,763
Accrued other liabilities		19,502,196		22,436,430
Current portion - capital leases and notes payable		493,210		4,774,249
TOTAL CURRENT LIABILITIES		25,289,204		32,531,442
LONG-TERM LIABILITIES:
Revolving credit facility		-		23,998,428
Capital lease obligations		-		111,002
Notes payable		4,300,000		3,100,000
Deferred tax liabilities		3,218,179		1,215,816
Other liabilities		1,149,412		1,476,843
TOTAL LONG-TERM LIABILITIES		8,667,591		29,902,089
TOTAL LIABILITIES		33,956,795		62,433,531
STOCKHOLDERS' EQUITY:
Preferred stock, par value $0.05; authorized
2,000,000 shares; none issued or outstanding		-		-
Common stock, par value $0.10; authorized
25,000,000; 9,146,295 and 8,136,723
issued and outstanding		914,630		813,672
Additional paid-in capital		94,310,539		64,935,673
Retained earnings		46,788,541		29,032,883
TOTAL STOCKHOLDERS' EQUITY		142,013,710		94,782,228
	$	175,970,505	$	157,215,759

Almost Family Reports Third Quarter 2009 Results

Page Seven

November 4, 2009

ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(UNAUDITED)
	Nine months ended September 30,
	2009			2008
Cash flows from operating activities:
Net income	$	17,755,657		$	11,096,767
Loss from discontinued operations		(106,999	)		(119,165	)
Income from continuing operations		17,862,656			11,215,932
Adjustments to reconcile income from continuing operations to
net cash provided by operating activities:
Depreciation and amortization		1,752,952			1,151,087
Provision for uncollectible accounts		3,164,030			2,375,792
Stock-based compensation		1,218,909			527,462
Deferred income taxes		(657,704	)		(1,152,716	)
		23,340,843			14,117,557
Change in certain net assets, net of the effects of acquisitions:
(Increase) decrease in:
Accounts receivable		(6,642,774	)		(11,716,548	)
Prepaid expenses and other current assets		183,190			(789,821	)
Other assets		(57,821	)		(26,455	)
Increase (decrease) in:
Accounts payable and accrued expenses		(22,981	)		2,154,591
Net cash provided by operating activities		16,800,457			3,739,324
Cash flows from investing activities:
Capital expenditures		(1,382,133	)		(621,360	)
Acquisitions, net of cash acquired		(6,406,358	)		(58,593,323	)
Net cash used in investing activities		(7,788,491	)		(59,214,683	)
Cash flows from financing activities:
Net revolving credit facility (repayments) borrowings		(23,998,428	)		14,096,873
Proceeds from stock option exercises		78,110			54,876
Tax benefit from non-qualified stock option exercises		211,417			84,448
Proceeds from stock offering, net		27,967,387			41,820,562
Principal payments on capital leases and notes payable		(4,392,041	)		(200,086	)
Net cash (used in) provided by financing activities		(133,555	)		55,856,673
Cash flows from discontinued operations:
Operating activities		(106,999	)		(119,165	)
Investing activities		-			-
Financing activities		-			-
Net cash used in discontinued operations		(106,999	)		(119,165	)
Net increase in cash and cash equivalents		8,771,412			262,149
Cash and cash equivalents at beginning of period		1,301,178			473,222
Cash and cash equivalents at end of period	$	10,072,590		$	735,371
Summary of non-cash investing and financing activities:
Acquisitions funded by notes payable	$	1,200,000		$	3,000,000
Acquisitions funded by stock	$	-		$	1,000,000

Almost Family Reports Third Quarter 2009 Results

Page Eight

 November 4, 2009

ALMOST FAMILY, INC. AND SUBSIDIARIES
RESULTS OF OPERATIONS
	Three months ended September 30,
	2009						2008						Change
	Amount			% Rev			Amount			% Rev			Amount			%
Net service revenues:
Visiting Nurse	$	65,738,993			86.2	%	$	48,621,039			83.2	%	$	17,117,954			35.2	%
Personal Care		10,555,382			13.8	%		9,816,326			16.8	%		739,056			7.5	%
		76,294,375			100.0	%	$	58,437,365			100.0	%		17,857,010			30.6	%
Operating income:
Visiting Nurse		13,418,391			20.4	%	$	10,000,146			20.6	%		3,418,245			34.2	%
Personal Care		1,263,325			12.0	%		901,983			9.2	%		361,342			40.1	%
		14,681,716			19.2	%		10,902,129			18.7	%		3,779,587			34.7	%
Corporate expenses		4,344,538			5.7	%		3,033,778			5.2	%		1,310,759			43.2	%
Operating income		10,337,178			13.5	%		7,868,351			13.5	%		2,468,828			31.4	%
Interest expense, net		(156,326	)		0.2	%		(355,077	)		0.6	%		(198,751	)		-56.0	%
Income tax expense		(3,985,767	)		5.2	%		(2,729,479	)		4.7	%		1,256,288			46.0	%
Net income from continuing operations	$	6,195,086			8.1	%	$	4,783,795			8.2	%	$	1,411,290			29.5	%
EBITDA from continuing operations	$	11,385,337			14.9	%	$	8,571,218			14.7	%	$	2,814,119			32.8	%

ALMOST FAMILY, INC. AND SUBSIDIARIES
RESULTS OF OPERATIONS
	Nine months ended September 30,
	2009						2008						Change
	Amount			% Rev			Amount			% Rev			Amount			%
Net service revenues:
Visiting Nurse	$	188,443,726			85.7	%	$	117,317,207			80.6	%	$	71,126,519			60.6	%
Personal Care		31,384,881			14.3	%		28,304,740			19.4	%		3,080,141			10.9	%
		219,828,607			100.0	%	$	145,621,947			100.0	%		74,206,660			51.0	%
Operating income:
Visiting Nurse		38,902,918			20.6	%	$	24,037,766			20.5	%		14,865,152			61.8	%
Personal Care		3,597,234			11.5	%		2,425,635			8.6	%		1,171,599			48.3	%
Operating income before unallocated            corporate expenses		42,500,152			19.3	%		26,463,401			18.2	%		16,036,751			60.6	%
Corporate expenses		12,476,189			5.7	%		7,517,365			5.2	%		4,958,824			66.0	%
Operating income		30,023,962			13.7	%		18,946,036			13.0	%		11,077,927			58.5	%
Interest expense, net		(673,186	)		0.3	%		(733,833	)		0.5	%		(60,647	)		-8.3	%
Income taxes		(11,488,120	)		5.2	%		(6,996,271	)		4.8	%		4,491,849			64.2	%
Net income from continuing operations	$	17,862,656			8.1	%	$	11,215,932			7.7	%	$	6,646,725			59.3	%
EBITDA from continuing operations	$	32,995,823			15.0	%	$	20,624,585			14.2	%	$	12,371,238			60.0	%

Almost Family Reports Third Quarter 2009 Results

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November 4, 2009

ALMOST FAMILY, INC. AND SUBSIDIARIES
VISITING NURSE SEGMENT OPERATING METRICS
	Three months ended September 30,
	2009			2008			Change
	Amount			Amount			Amount			%
Average number of locations		82			64			18			28.1	%
All payors:
Admissions		12,878			10,339			2,539			24.6	%
Billable visits		416,328			309,183			107,145			34.7	%
Medicare statistics:
Revenue	$	59,380,507		$	43,374,706		$	16,005,801			36.9	%
Percentage of total revenues		90.3	%		89.2	%
Billable visits		360,681			261,426			99,255			38.0	%
Admissions		11,616			9,479			2,137			22.5	%
Episodes started		19,479			14,562			4,917			33.8	%
Revenue per completed episode	$	3,002		$	2,926		$	76			2.6	%
Visits per episode		17.8			17.4			0.4			2.4	%
ALMOST FAMILY, INC. AND SUBSIDIARIES
PERSONAL CARE SEGMENT OPERATING METRICS
	Three months ended September 30,
		2009			2008		Change
	Amount			Amount			Amount			%
Average number of locations		23			22			1			4.5	%
Admissions		804			861			(57	)		-6.6	%
Patient days of care		152,272			137,878			14,394			10.4	%
Billable hours		590,662			544,512			46,150			8.5	%
Revenue per billable hours	$	17.87		$	18.03		$	(0.16	)		-0.9	%

Almost Family Reports Third Quarter 2009 Results

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November 4, 2009

ALMOST FAMILY, INC. AND SUBSIDIARIES
VISITING NURSE SEGMENT OPERATING METRICS
	Nine months ended September 30,
	2009			2008			Change
	Amount			Amount			Amount			%
Average number of locations		78			58			20			34.5	%
All payors:
Admissions		38,532			28,149			10,383			36.9	%
Billable visits		1,194,139			737,318			456,821			62.0	%
Medicare statistics:
Revenue	$	169,098,518		$	107,772,323		$	61,326,195			56.9	%
Percentage of total revenues		89.7	%		91.9	%
Billable visits		1,025,210			654,542			370,668			56.6	%
Admissions		34,968			25,702			9,266			36.0	%
Episodes started		56,703			37,401			19,302			51.6	%
Revenue per completed episode	$	2,943		$	2,832		$	111			3.9	%
Visits per episode		17.5			17.2			0.3			1.9	%
ALMOST FAMILY, INC. AND SUBSIDIARIES
PERSONAL CARE SEGMENT OPERATING METRICS
	Nine months ended September 30,
		2009			2008		Change
	Amount			Amount			Amount			%
Average number of locations		22			22			-			-
Admissions		2,445			2,586			(141	)		-5.5	%
Patient days of care		448,331			401,539			46,792			11.7	%
Billable hours		1,756,498			1,563,377			193,121			12.4	%
Revenue per billable hours	$	17.87		$	18.10		$	(0.23	)		-1.3	%

Non-GAAP Financial Measure

The information provided in the tables in this release includes certain non-GAAP financial measures as defined under Securities and Exchange Commission (SEC) rules.  In accordance with SEC rules, the Company has provided, in the supplemental information and the footnotes to the tables, a reconciliation of those measures to the most directly comparable GAAP measures.

Almost Family Reports Third Quarter 2009 Results

Page Eleven

November 4, 2009

EBITDA:

EBITDA is defined as income before depreciation and amortization, net interest expense and income taxes. EBITDA is not a measure of financial performance under accounting principles generally accepted in the United States of America. It should not be considered in isolation or as a substitute for net income,  operating income,  cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles. The items excluded from EBITDA are significant components in understanding and evaluating financial performance and liquidity. Management routinely calculates and communicates EBITDA and believes that it is useful to investors because it is commonly used as an analytical indicator within our industry to evaluate performance, measure leverage capacity and debt service ability, and to estimate current or prospective enterprise value. EBITDA is also used in certain covenants contained in our credit agreement.

The following tables set forth a reconciliation of Continuing Operations Net Income to EBITDA:

ALMOST FAMILY, INC. AND SUBSIDIARIES
RECONCILIATION OF EBITDA
	Three months ended September 30,
	2009		2008
Net income from continuing operations	$	6,195,086	$	4,783,795
Add back:
Interest expense		156,326		355,077
Income tax expense		3,985,767		2,729,479
Depreciation and amortization		600,936		508,737
Amortization of stock-based compensation		447,222		194,130
Earnings before interest, income taxes,
depreciation and amortization (EBITDA)
from continuing operations	$	11,385,337	$	8,571,218

ALMOST FAMILY, INC. AND SUBSIDIARIES
RECONCILIATION OF EBITDA
	Nine months ended September 30,
	2009		2008
Net income from continuing operations	$	17,862,656	$	11,215,932
Add back:
Interest expense		673,186		733,833
Income tax expense		11,488,120		6,996,271
Depreciation and amortization		1,752,952		1,151,087
Amortization of stock-based compensation		1,218,909		527,462
Earnings before interest, income taxes,
depreciation and amortization (EBITDA)
from continuing operations	$	32,995,823	$	20,624,585

About Almost Family

Almost Family, Inc., founded in 1976, is a leading regional provider of home health nursing services, with branch locations in Florida, Kentucky, Connecticut, New Jersey, Ohio, Massachusetts,   Alabama,   Missouri,   Illinois,   Pennsylvania,  and Indiana (in order of revenue significance). Almost Family, Inc. and its subsidiaries operate a Medicare-certified visiting nurse segment and a personal care segment. Altogether, Almost Family operates over 100 branch locations in 11 U.S. states.

Almost Family Reports Third Quarter 2009 Results

Page Twelve

November 4, 2009

Forward Looking Statements

All statements, other than statements of historical facts, included in this news release are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may be identified by the use of forward-looking terminology such as "may," "will," "expect," "believe," "estimate," "project," "anticipate," "continue," or similar terms, variations of those terms or the negative of those terms. These forward-looking statements are based on the Company's current plans, expectations and projections about future events.

Because forward-looking statements involve risks and uncertainties, the Company's actual results could differ materially from any future results, performance or achievements expressed or implied by such forward-looking statements. The potential risks and uncertainties which could cause actual results to differ materially include: regulatory approvals or third party consents may not be obtained, the impact of further changes in healthcare reimbursement systems, including the ultimate outcome of potential changes to Medicare reimbursement for home health services and to Medicaid reimbursement due to state budget shortfalls; the ability of the Company to maintain its level of operating performance and achieve its cost control objectives; changes in our relationships with referral sources; the ability of the Company to integrate acquired operations; government regulation; health care reform; pricing pressures from Medicare, Medicaid and other third-party payers; changes in, or failure to comply with, laws and interpretations of laws relating to the healthcare industry; and the Company’s self-insurance risks.  For a more complete discussion regarding these and other factors which could affect the Company's financial performance, refer to the Company's various filings with the Securities and Exchange Commission, including its filing on Form 10-K for the year ended December 31, 2008, in particular information under the headings "Special Caution Regarding Forward-Looking Statements" and “Risk Factors.” The Company undertakes no obligation to update or revise its forward-looking statements.