Extendicare expands by acquiring CBI Home Health

MARKHAM, Ont. – Extendicare Inc. announced that its wholly owned home-healthcare subsidiary, ParaMed Inc., has entered into an agreement to acquire all the equity interests of CBI Home Health LP and CBI (GP) 3 Inc. and their respective subsidiaries. The acquisition will be completed for a cash purchase price of $570 million, subject to customary adjustments, plus approximately $13.6 million in estimated lease liabilities.

Acquisition highlights

• CBI Home Health is a national home health care company, delivering over 10 million hours of care annually across seven provinces, anchored by sizeable Ontario and Alberta operations.
• Diversifies ParaMed’s geographic footprint and establishes a sizeable presence in the Alberta market.
• Enhances ParaMed’s capabilities through innovative care models, including service partnerships with hospitals and specialized community services.
• Highly complementary to Extendicare’s home health platform, adding scale to ParaMed’s technology platform to drive operating performance and significant IT and other cost synergies.

“Home care services play an important role in relieving pressure on the rest of the healthcare system. The combination of ParaMed and CBI Home Health brings together two outstanding teams to enhance access to community-based care across the country,” said Dr. Michael Guerriere (pictured), president and CEO of Extendicare.

He added, “This acquisition accelerates the growth trajectory of our home healthcare segment, significantly enhancing our presence in Western Canada and adding innovative care models to broaden our service offerings. The deep bench of talent and scale of our combined operations will allow us to support more Canadians to live independently at home, while leveraging our technology platform to drive outstanding customer experience and significant cost synergies to deliver strong value for our customers and shareholders.”

CBI Home Health is the home healthcare subsidiary of CBI Health LP. It provides services in seven provinces and delivered over 10 million hours of care in 2024 (average daily volume of approximately 28,000 hours).

CBI Home Health’s team of approximately 8,500 provide a comprehensive suite of publicly funded home healthcare services, including innovative care models such as hospital to home programs, integrated care provided by interdisciplinary teams and specialized community support services, in addition to the more traditional provincially funded home healthcare services.

CBI Home Health’s standalone financial performance for the twelve months ended July 31, 2025, generated revenue of approximately $477.9 million and adjusted EBITDA of approximately $61.9 million (or approximately 12.9% adjusted EBITDA margin).

Based on these results, the purchase price of $570 million and approximately $13.6 million in estimated lease liabilities in accordance with IFRS 16, represents an estimated purchase price multiple of 9.4x CBI Home Health’s Adjusted EBITDA.

Extendicare expects to realize annualized run-rate synergies of approximately $7.4 million related to the integration of IT platforms and other cost synergies over the two-year period following closing of the acquisition.

Including the effect of these synergies, the implied purchase price multiple would be approximately 8.4x of CBI Home Health’s adjusted EBITDA.

Given the complementary nature of ParaMed’s and CBI Home Health’s operations, Extendicare expects to realize further annualized run-rate synergies of approximately $5.0 to $7.0 million over a longer period of time as the company deploys enhanced technology solutions to drive productivity gains in areas such as automated scheduling and front-line employee experience once CBI Home Health’s business has been fully integrated.

Closing of the acquisition is subject to customary closing conditions, including receipt of consents from third parties, including Ontario Health atHome and Assisted Living Alberta, and regulatory approval pursuant to the Competition Act (Canada), and is not conditional on financing or due diligence.

The acquisition is anticipated to close in the first quarter of 2026.