Chemed Corporation (CHE, formerly Roto-Rooter, Inc.) is headquartered in Cincinnati, Ohio. Publicly traded since 1971, Chemed currently operates in the healthcare field through its Vitas Healthcare Corporation (Vitas) subsidiary, and in the residential and commercial repair and maintenance service industry under the name Roto-Rooter. The company has evolved since its incorporation in 1970 through numerous acquisitions and divestments of diversified businesses. The most significant recent transaction involved the acquisition of the remaining 63% of common stock in previously privately held Vitas not already owned by Chemed, completed on February 24, 2004, and the more recent disposal of the company's Service America subsidiary on December 29, 2004. The Service America subsidiary, located throughout Florida and in Phoenix, Arizona, was divested through an asset sale to employees of Service America.
Vitas Healthcare Corporation (Vitas), based in Miami, Florida, is the nation's largest provider of hospice services with about a 7% share of the U.S. hospice market. Vitas commenced operations in 1978 and incorporated in 1983 as a for-profit organization. Vitas Healthcare currently provides services to almost 9,000 patients from 44 hospice programs in 11 states. These areas include: California, Connecticut, Delaware, Florida, Georgia, Illinois, New Jersey, Ohio, Pennsylvania, Texas and Wisconsin. Over half of Vitas' patients receive care in their homes. Approximately 40% of patients receive care in skilled nursing and assisted living facilities. The organization classifies its services based on location and type of care provided. The major classifications are: Home Care, Continuous Care, and Inpatient Care. Home Care refers to routine care provided to patients and their families residing at home or in a nursing facility, where the provider is paid the routine home care rate for each day per patient. Continuous care is the care provided to patients while they are at home during periods of crisis involving intensive monitoring and care. Inpatient care refers to short-term care provided in a participating hospice inpatient unit, hospital, or skilled nursing facility. All of Vitas' operations, including clinical operations, billing and collections, accounts payable and claims processing, financial reporting, human resources, and compliances are supported by the company's proprietary information systems.
The capital required to establish a single hospice facility is currently estimated at between $300,000 and $500,000. As a result, competition notwithstanding the not-for-profit providers, which constitute more than 72% of all hospices, is significant (albeit highly fragmented). A large number of hospice programs are owned by, or are part of, a larger healthcare delivery system, typically not-for-profit hospitals. In addition to not-for-profit service providers, the industry is also characterized by a high number of small regional operators. However, nine of the top 10 providers, as measured by average daily census (ADC), are for-profit. Average daily census refers to the total number of patients, regardless of the level of service. The major publicly traded hospice industry players, which include Vitas, Odyssey, VistaCare, and Manor Care, collectively only account for approximately 15% of the market. While the relatively low absolute capital requirements represent a low barrier to entry, the regulatory complexity associated with establishing a Medicare-licensed hospice location remains a significant barrier. In addition, hospice referral sources are largely dependent on relationships and reputations established over time through the provision of high-quality care and service.
Roto-Rooter, Inc. was founded in Des Moines, Iowa, in 1935 by Samuel Blanc, and is currently the largest provider of plumbing and drain cleaning services in North America. Roto-Rooter operates through more than 100 company-owned branches, independent contractors, and 500 franchisees. Either directly or indirectly via franchising, the total Roto-Rooter system is available to more than 90% of the U.S. population and approximately 40% of the Canadian population. Roto-Rooter also has licensed master franchisees in China, including Hong Kong, Indonesia, Japan, Mexico, the Philippines, and the United Kingdom. In 1980, the Blanc family sold Roto-Rooter to Cincinnati-based Chemed Corporation and subsequently moved its corporate headquarters to Cincinnati. In 1986, Roto-Rooter was spun off as a public company, with Chemed retaining majority ownership. In August 1996, Roto-Rooter again became a wholly owned subsidiary when Chemed bought back all outstanding shares. The U.S. residential/light commercial plumbing repair/replace market is valued at nearly $8 billion, comprising more than 50,000 small regional plumbing companies. The competitive landscape for the drain and plumbing services industry is intense at a local level. Points of differentiation amongst participants include brand/name recognition, speed and quality of customer service, service guarantees, and pricing.