Cash generation remains inconsistent, evidenced by an OCF/NI ratio that fluctuated from a negative 9.13 in 2024Q2 to a positive 3.04 in 2024Q4, complicating long-term capital deployment strategies.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 | Dec'12 | Dec'11 | Dec'10 | Dec'09 | Dec'08 | Dec'07 | Dec'06 | Dec'05 | Dec'04 | Dec'03 | Dec'02 | Dec'01 | Dec'00 | Dec'99 | Dec'98 | Dec'97 | Dec'96 |
|---|
| Cash from Operations | 161.2M | 144.97M | 30.8M | 43.5M | -8.17M | 37.11M | 217.21M | 93.58M | 80.03M | 7.63M | 41.4M | 63.36M | 57.73M | 32.16M | 60.38M | 32.95M | 37.75M | 38.31M | 16.66M | 25.77M | 16.12M | 24.5M | 19.43M | 16.74M | 16.11M | 12.5M | 7.75M | 1.6M | 3.3M | 5.4M | 8.9M |
| Operating CF Margin % | - | 7.89% | 1.8% | 2.6% | -0.48% | 2.26% | 12.34% | 5.08% | 3.98% | 0.41% | 2.65% | 4.41% | 4.46% | 2.8% | 5.6% | 3.71% | 4.88% | 5.53% | 2.76% | 4.46% | 3.15% | 5.25% | 4.39% | 4.41% | 4.91% | 4.4% | 3.04% | 0.69% | 1.61% | 2.98% | 5.48% |
| Operating CF Growth % | 1636.8% | 370.64% | -29.19% | 632.61% | -122.01% | -82.92% | 132.11% | 16.93% | 948.9% | -81.57% | -34.66% | 9.75% | 79.52% | -46.74% | 83.25% | -12.71% | -1.46% | 129.91% | -35.35% | 59.87% | -34.19% | 26.04% | 16.08% | 3.91% | 28.95% | 61.22% | 384.41% | -51.52% | -38.89% | -39.33% | 50.85% |
| Net Income | 67.89M | 59.06M | 39.47M | 38.39M | 34.63M | 45.86M | 98.68M | 64.58M | 83.52M | 88.23M | 77.4M | 58.02M | 21.85M | 47.13M | 44.21M | 38.16M | 34.44M | 30.34M | 26.61M | 29.58M | 25.45M | 19.1M | 14.7M | 10.86M | 8.63M | 7.04M | 5.59M | 5.5M | 8.9M | 5.9M | 6.9M |
| Depreciation & Amortization | 16.75M | 17.07M | 14.59M | 14.34M | 15.32M | 14.67M | 14.27M | 13.94M | 9.27M | 8.89M | 7.5M | 7.66M | 7.27M | 6.2M | 5.12M | 4.39M | 3.76M | 3.23M | 2.85M | 3M | 2.31M | 1.87M | 1.87M | 1.91M | 2.03M | 2.24M | 2.21M | 2.1M | 2.1M | 2.1M | 2.2M |
| Stock-Based Compensation | 11.03M | 12.01M | 9.16M | 8.98M | 9.21M | 8.83M | 7.87M | 6.87M | 5.9M | 276K | 4.25M | 3.54M | 3.08M | 2.61M | 2.54M | 2.15M | 1.33M | 1.07M | 563K | 291M | 481M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Deferred Taxes | 21.28M | 19.2M | -2.94M | -4.82M | 5.05M | 3.07M | -5.89M | -684K | -13.01M | 1.89M | 20K | 15.97M | -15.06M | -4.92M | -3.49M | 275K | 517K | -2.39M | 1.18M | -759K | -1.39M | -399K | -986K | -174.4K | -1.29M | -1.48M | 200.8K | 0 | -800K | 300K | 700K |
| Other Non-Cash Items | 81.21M | 78.18M | 40.72M | 30.77M | 42.4M | 7.83M | 3.4M | 19.66M | 54.19M | 3.04M | 4.89M | 5.04M | 3.61M | -293K | 1.02M | 4.04M | 2.8M | 1.06M | 5.65M | -284.99M | -480.87M | 4.21M | 5.26M | 5.17M | 6.73M | 5.74M | 3.25M | 7.3M | -100K | -100K | -100K |
| Working Capital Changes | -36.97M | -40.55M | -70.19M | -44.16M | -114.77M | -43.15M | 98.88M | -10.78M | -59.84M | -94.68M | -52.66M | -26.87M | 36.98M | -18.57M | 10.98M | -16.06M | -5.11M | 4.99M | -20.2M | -12.06M | -10.38M | -283K | -1.42M | -1.03M | 7.47K | -1.04M | -3.5M | -13.3M | -9.7M | -3.8M | -2.9M |
| Change in Receivables | -12.18M | 5.23M | -61.81M | -74.56M | -78.71M | -37.19M | 38.08M | -29.53M | -44.36M | -121.64M | -61.05M | -18.85M | -13.49M | -50.88M | -11.63M | 1.06B | 0 | -1.93B | 67.8M | 1.96B | 764.85M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Change in Inventory | 1.38M | -48K | 1.73M | 2.69M | 4.85M | 5.6M | 4.93M | 4.76M | 950K | -1.87M | -1.49M | -846K | -3.02M | -3.77M | -3.53M | -4.53M | -3.64M | -620K | -963K | -2.48M | -840K | -714K | -560K | -1.79M | -681.53K | 439.76K | 196.22K | -800K | -500K | 100K | -200K |
| Change in Payables | -2.06M | -12.06M | -9.74M | 7.43M | -13.75M | 10.24M | -7.25M | -9.53M | -9.14M | 11.2M | -4.25M | 2.4M | 492K | 25.96M | 13.66M | -1.08B | 0 | 1.93B | -85M | -2.13B | -774M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Cash from Investing | -8.08M | -11M | 6.05M | -3.29M | 2.58M | -22.99M | -36.84M | -16.46M | -9.59M | -14.97M | -6.45M | -62.31M | -6.46M | 605K | 5.69M | 4.51M | 3.08M | -10.23M | -49.86M | -1.85M | -11.44M | -1.81M | -2.07M | -2.09M | -1.71M | -1.74M | -1.36M | -1.8M | -2.4M | -1.5M | -2.1M |
| Capital Expenditures | -5.47M | -5.82M | -6.34M | -5.41M | -5.21M | -5.69M | -4.34M | -4.37M | -4.94M | -5.4M | -5.44M | -5M | -5.79M | -3.76M | -3.48M | -5.54M | -4.17M | -2.15M | -1.58M | -1.5M | -1.85M | -1.9M | -2.39M | -2.31M | -1.86M | -2.05M | -1.8M | -2.9M | -2.8M | -1.8M | -2.4M |
| CapEx % of Revenue | 0.3% | 0.32% | 0.37% | 0.32% | 0.31% | 0.35% | 0.25% | 0.24% | 0.25% | 0.29% | 0.35% | 0.35% | 0.45% | 0.33% | 0.32% | 0.62% | 0.54% | 0.31% | 0.26% | 0.26% | 0.36% | 0.41% | 0.54% | 0.61% | 0.57% | 0.72% | 0.71% | 1.25% | 1.37% | 0.99% | 1.48% |
| Acquisitions | 249K | -7.15M | -2.75M | 0 | -114K | -23.88M | 0 | 199K | 640K | -4.58M | 275K | 267K | 0 | -5M | 0 | -1M | 0 | -4.61M | 0 | -477K | -9.74M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | -4.56M | 105K | 211K | 121K | 393K | 211K | 274K | 0 | 640K | 338K | 275K | 267K | 83K | 158K | 26K | 22K | 44K | 2K | 157K | 132K | 151K | 85K | 321K | 221.03K | 152.11K | 313.21K | 439.85K | 1.1M | 400K | 300K | 300K |
| Cash from Financing | -81.23M | -63.33M | -31.05M | -12.15M | -38.93M | -82.65M | -68.37M | -75.82M | -53.98M | -6.96M | -44.28M | -43.14M | -40.15M | -37.56M | -35.75M | -38.52M | -32.44M | -34.27M | -21.76M | -4.46M | -22.69M | -6.53M | -6.7M | 1.21M | -343.21K | 659.99K | -743.57K | 200K | -1.5M | -8.7M | -400K |
| Debt Issued (Net) | 0 | 0 | -25M | 0 | 25M | 0 | -10M | -20M | -5.38M | 35.38M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -4.72M | 0 | 0 | -6.16M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Equity Issued (Net) | -77.07M | -61.59M | -5.02M | -11.28M | 106K | -21.44M | 93K | 3.72M | 89K | 95K | 109K | 113K | 110K | 107K | 118K | 128K | 121K | 88K | -4.65M | 5.46M | -5.15M | 1.55M | -2.1M | 2.69M | -343K | 659.99K | -743.57K | 200K | -1.5M | -8.7M | -400K |
| Dividends Paid | 0 | 0 | 0 | 0 | -63.37M | -62.23M | -60.7M | -58.95M | -57.2M | -55.24M | -53.34M | -51.38M | -49.08M | -46.71M | -44.09M | -42.23M | -39.28M | -32.25M | -24.98M | -17.74M | -12.63M | -8.08M | -4.6M | -1.49M | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Share Repurchases | -78.51M | -61.59M | -5.02M | -11.28M | 0 | -21.54M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -4.65M | 0 | -8.49M | -4.03M | -6.03M | -164K | -2.13M | -824.94K | -761.88K | -200K | -3.5M | -10.9M | -500K |
| Other Financing | -4.16M | -1.74M | -1.03M | -871K | -661K | 1.01M | 2.25M | -587K | 8.52M | 12.81M | 8.95M | 8.12M | 8.82M | 9.04M | 8.22M | 3.58M | 6.73M | 2.6M | 7.88M | 7.82M | 1.25M | 0 | 0 | 1.02K | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Net Change in Cash | 71.89M | 70.64M | 5.8M | 28.05M | -44.52M | -68.54M | 112M | 1.3M | 16.47M | -14.3M | -9.34M | -42.09M | 11.13M | -4.79M | 30.31M | -1.05M | 8.39M | -6.2M | -54.96M | 19.46M | -18.01M | 16.16M | 10.67M | 15.86M | 14.06M | 11.42M | 5.64M | 0 | -1.5M | -8.7M | -400K |
| Free Cash Flow | 155.72M | 139.15M | 24.47M | 38.09M | -13.38M | 31.42M | 212.87M | 89.21M | 75.09M | 2.23M | 35.96M | 58.36M | 51.94M | 28.4M | 56.89M | 27.4M | 33.57M | 36.15M | 15.09M | 24.27M | 14.27M | 22.6M | 17.05M | 14.43M | 14.25M | 10.44M | 5.95M | -1.3M | 500K | 3.6M | 6.5M |
| FCF Margin % | 8.41% | 7.57% | 1.43% | 2.28% | -0.79% | 1.91% | 12.09% | 4.85% | 3.74% | 0.12% | 2.3% | 4.06% | 4.02% | 2.47% | 5.28% | 3.08% | 4.34% | 5.22% | 2.5% | 4.2% | 2.79% | 4.85% | 3.85% | 3.8% | 4.34% | 3.68% | 2.34% | -0.56% | 0.24% | 1.98% | 4% |
| FCF Growth % | 98.49% | 468.75% | -35.77% | 384.76% | -142.57% | -85.24% | 138.61% | 18.81% | 3262.79% | -93.79% | -38.39% | 12.38% | 82.9% | -50.09% | 107.61% | -18.38% | -7.14% | 139.66% | -37.83% | 70.1% | -36.87% | 32.56% | 18.11% | 1.27% | 36.45% | 75.64% | 557.44% | -360% | -86.11% | -44.62% | 103.13% |
| FCF per Share | 2.19 | 1.91 | 0.33 | 0.51 | -0.18 | 0.42 | 2.85 | 1.20 | 1.01 | 0.03 | 0.49 | 0.80 | 0.73 | 0.41 | 0.83 | 0.41 | 0.50 | 0.54 | 0.23 | 0.37 | 0.22 | 0.35 | 0.27 | 0.24 | 0.24 | 0.19 | 0.11 | -0.02 | 0.01 | 0.06 | 0.11 |
| FCF Conversion (FCF/Net Income) | 2.29x | 2.45x | 0.78x | 1.13x | -0.24x | 0.76x | 2.20x | 1.45x | 0.96x | 0.09x | 0.53x | 1.09x | 2.64x | 0.68x | 1.37x | 0.86x | 1.10x | 1.26x | 0.63x | 0.87x | 0.63x | 1.28x | 1.32x | 1.54x | 1.87x | 1.78x | 1.39x | 0.29x | 0.37x | 0.92x | 1.29x |
| Interest Paid | 1.68M | 0 | 6.49M | 7.81M | 2.82M | 1.39M | 1.37M | 3.46M | 3.09M | 1.36M | 574K | 258K | 156K | 4K | 3K | 2K | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Taxes Paid | 0 | 0 | 15.23M | 5.58M | 3.31M | 21.23M | 44.87M | 20.03M | 37.68M | 35.37M | 32.53M | 7.9M | 25.08M | 21.69M | 24.68M | 14.61M | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Client credit and labor volatility
Based on reported financial data, HCSG exhibits significant volatility in its cash conversion, with the OCF/NI ratio swinging from a negative 9.13 in 2024Q2 to a positive 3.04 in 2024Q4, indicating that net income is a poor proxy for the company's actual cash-generating capacity.
The frequent divergence between net income and operating cash flow suggests that non-cash items and accrual adjustments, likely related to bad debt provisions and insurance reserves, heavily distort reported earnings. Investors should view the company's bottom-line profitability with caution, as the cash flow statement reveals a much more erratic operational reality than the income statement implies.
As reported in quarterly filings, HCSG's free cash flow margins have fluctuated wildly, ranging from a negative 6.7% in 2024Q1 to a peak of 15.1% in 2025Q3, demonstrating that the company's ability to generate sustainable excess cash is highly sensitive to operational and client-side disruptions.
This inconsistency in free cash flow generation complicates the company's ability to maintain a predictable capital allocation strategy. The sharp swings suggest that the business model lacks the operational leverage required to smooth out cash flow during periods of increased client credit risk or rising labor costs.
According to the cash flow statements, working capital changes have been a major source of volatility, with a $50 million outflow in 2024Q1 followed by a $21.6 million inflow in 2023Q4, highlighting the company's vulnerability to the payment cycles of its skilled nursing facility client base.
These dramatic shifts in working capital suggest that HCSG is frequently acting as a de facto lender to its clients by absorbing delayed payments. The reliance on these fluctuations to manage liquidity warrants close monitoring, as persistent working capital outflows may indicate deteriorating credit quality among the firm's primary service recipients.
Based on recent financial statements, HCSG has prioritized share repurchases, utilizing $24 million in 2026Q1 alone, despite the underlying volatility in operating cash flow, which suggests a management preference for returning capital to shareholders even when operational cash generation remains inconsistent and unpredictable.
The decision to aggressively buy back shares while operating cash flow remains erratic may limit the company's financial buffer against future regulatory or labor-related shocks. This capital allocation strategy appears to prioritize short-term equity support over the preservation of liquidity, which could prove problematic if client solvency issues intensify.
Quick answers to the most common questions about buying HCSG stock.
Healthcare Services Group, Inc. (HCSG) generated $145.0M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Healthcare Services Group, Inc. (HCSG) generated $139.2M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
Healthcare Services Group, Inc. (HCSG) spent $5.8M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.
In 2025, Healthcare Services Group, Inc. (HCSG) spent $61.6M on share repurchases. This shows the company's commitment to returning capital to its equity investors.