Finvest
CHE Healthcare Services · Hospice · Home services · Thesis updated July 14, 2026

VITAS is healing while Roto-Rooter leaks

01 Running thesis

Hospice strength meets search-cost pain

Chemed's story improved after Q1 2026. VITAS, the hospice business, beat expectations and raised full-year guidance. It also looks like the Florida Medicare Cap issue from 2025 is mostly behind it. The Medicare Cap is a limit on how much Medicare will pay a hospice provider for a group of patients over a year.

The bull case is simple. VITAS keeps adding care capacity, grows patient days, and uses new Certificates of Need, or state approvals needed to open or expand hospice service in some markets. In Q1 2026, VITAS net revenue reached $420.0 million, up 3.1%, with days-of-care up 2.2%. That is steady, not explosive, but it is moving in the right direction.

The bear case sits mostly inside Roto-Rooter. The plumbing brand finally showed life, with residential plumbing and residential sewer and drain revenue both growing for the first time since Q4 2022. But the way customers find Roto-Rooter has changed. Free leads from Google search fell almost 16%, and paid advertisements made up 53.4% of total leads. That can keep margins lower even if sales recover.

The next test is the second half of 2026. Investors should watch whether Roto-Rooter can keep core plumbing volume growing and whether centralized billing lifts revenue per water restoration job. If those do not work, VITAS may not be enough to make the whole company look better.

Apr 2026The Q1 2026 Form 10-Q confirmed the earnings update. VITAS grew, Roto-Rooter slipped slightly, and the filing did not add a new material risk.
Apr 2026Q1 2026 improved the thesis because VITAS beat expectations and full-year guidance moved higher. Roto-Rooter also showed its first core residential service growth since Q4 2022, though paid search costs remained a major drag.
Feb 2026The 2025 Form 10-K confirmed the Roto-Rooter lead-generation risk and noted that AI use by customers can make marketing harder. It also supported the view that the Florida Medicare Cap issue was being reduced.
Feb 2026Q4 2025 missed expectations at both subsidiaries. VITAS was hurt by the Florida Medicare Cap response, and Roto-Rooter was hit by water restoration write-offs tied to AI-driven insurance review.
Oct 2025The Q3 2025 Form 10-Q backed the existing view. VITAS kept growing, while Roto-Rooter stayed sluggish as drain cleaning weakness offset gains in other services.
Oct 2025Q3 2025 showed better Roto-Rooter margin direction and clearer confidence that the 2025 Florida Medicare Cap problem would not repeat in 2026.
Jul 2025The Q2 2025 Form 10-Q confirmed margin pressure at Roto-Rooter, including a gross margin decline tied partly to higher casualty insurance expense. The filing also added tariff-related demand risk for non-emergency services.
Jul 2025Q2 2025 made the thesis more cautious. Roto-Rooter margins contracted sharply, paid search dependence grew, and VITAS confirmed a $19 million Florida Medicare Cap billing limitation for 2025.
02 Business model

Two service businesses, two rulebooks

Chemed makes money through two wholly owned subsidiaries. VITAS provides hospice and palliative care, mostly paid through Medicare. Roto-Rooter provides plumbing, drain cleaning, excavation, water restoration, and related services to homes and businesses.

VITAS grows when it serves more patient days, hires enough clinical staff, earns Medicare rate increases, and expands into new regions. In Q1 2026, VITAS grew days-of-care by 2.2%, helped by a geographically weighted average Medicare reimbursement rate increase of about 2.6%. The weak spot is regulation, because Medicare rules and audits can change economics quickly.

Roto-Rooter has a more consumer-driven model. Management typically targets 5% to 6% long-term top-line growth, helped by annual price increases and housing demand. The problem is that demand now costs more to capture. Search engine changes and customer use of AI platforms can make marketing more expensive and less predictable.

Chemed also returns capital through buybacks and dividends, but the balance sheet moved a bit more levered in Q1 2026. Long-term debt rose by $91.2 million, mainly due to acquisitions and stock repurchases. The company still said it had about $313.3 million of unused credit available at March 31, 2026.

03 Product portfolio

Care beds and clogged drains

Steady

VITAS routine homecare

This is the core hospice service, delivered where patients live. It was $371.1 million of Q1 2026 VITAS revenue before cap and other adjustments.

Option

VITAS inpatient and continuous care

These are higher-acuity hospice services for patients who need more intense care. Continuous care revenue fell 26.4% in Q1 2026, so mix can move results.

Growth engine

Hospice expansion through CONs

Certificates of Need are state approvals that can limit new competitors and open growth paths. Execution on newly awarded CONs is part of the bull case.

Cash cow

Roto-Rooter plumbing

Plumbing is a core Roto-Rooter service for homes and businesses. Q1 2026 plumbing revenue rose 7.7%, helped by price and service mix.

Steady

Roto-Rooter drain cleaning

Drain cleaning is a high-recognition service tied to urgent customer needs. Q1 2026 drain cleaning revenue rose 0.3%, with price and mix offsetting lower job count.

Option

Roto-Rooter water restoration

Water restoration can be attractive when jobs bill cleanly, but it is under pressure. Q1 2026 water restoration revenue fell 11.7%, and insurers are using AI to challenge billing.

04 Business segments

VITAS carries the mix

VITAS Healthcare64%modest
Roto-Rooter36%flat

Segment shares use Q1 2026 service revenues and sales from Chemed's Form 10-Q for the three months ended March 31, 2026. VITAS was $420.0 million and Roto-Rooter was $237.5 million of the $657.5 million total.

05 Risk factors

What could break the story

Paid-search margin trap

High impact · High odds

Roto-Rooter depends more on paid leads because free search leads fell almost 16% after Google algorithm changes. Paid advertisements made up 53.4% of total leads in Q1 2026. If this is permanent, revenue can grow while margins stay squeezed.

We watchPaid leads as a share of total leads, free search lead growth, and Roto-Rooter EBITDA margin.

Water restoration billing pushback

Medium impact · Medium odds

Insurance companies are using AI to review water restoration bills line by line. That raised write-offs in 2025 and remains a headwind. Centralized billing is meant to improve revenue per job, but the fix still needs proof.

We watchWater restoration revenue growth, write-offs, credit memos, and management comments on centralized billing.

Hospice reimbursement and audit risk

High impact · Medium odds

VITAS depends heavily on Medicare, so CMS, the Medicare regulator, matters. The Florida Medicare Cap issue looks mostly solved for 2026, but hospice remains a politically sensitive area. Fraud campaigns aimed at unrelated rogue providers can still bring wider scrutiny to the sector.

We watchMedicare cap accruals, CMS rule changes, audit activity, and VITAS margin.

Roto-Rooter volume false start

Medium impact · Medium odds

The quarter showed a green shoot, but the base is not fully healthy. Overall Roto-Rooter net revenue still fell 0.9% in Q1 2026, and branch residential revenue declined 1.5%. If job counts keep falling, price increases may not be enough.

We watchResidential plumbing job count, drain cleaning job count, branch residential revenue, and commercial revenue.

Consumer and cost pressure

Medium impact · Medium odds

Roto-Rooter can be hurt when consumers delay non-emergency work. Chemed also flagged inflation, tariffs, fuel prices, and other macro pressures as items that may hurt future sales and profitability. The company does not expect a material negative effect for the rest of fiscal 2026, but 2027 planning is still under review.

We watchNon-emergency service demand, fuel costs, tariff commentary, and Roto-Rooter gross margin.
06 Quick answers

In one breath

What does Chemed Corporation do?

Chemed owns two main businesses: VITAS Healthcare and Roto-Rooter. VITAS provides hospice and palliative care, while Roto-Rooter provides plumbing, drain cleaning, excavation, and water restoration services.

Is Chemed more healthcare or plumbing?

By Q1 2026 revenue, Chemed is more healthcare. VITAS made up about 64% of service revenues and sales, while Roto-Rooter made up about 36%.

Why is Roto-Rooter a problem for Chemed?

Roto-Rooter is facing higher marketing costs because free search leads are down and paid ads are a larger share of leads. Water restoration billing is also under pressure as insurers use AI to review claims more closely.

What is the key thing to watch next for Chemed?

Watch whether VITAS keeps growing patient days without a new Medicare Cap problem. Also watch whether Roto-Rooter can hold the recovery in plumbing and drain revenue while improving margins.