Good morning. Is it good afternoon yet? No? Nova Leap Health. Cool. Good morning. Going to get started now. Perfect. Now presenting Chris Dobbin with Nova Leap Health.
Thanks very much, everybody. Appreciate everybody attending in person or on the webcast. Recognize a couple of faces in here. I tend to do a couple of things with these presentations. The first is to give a bit of an overview in terms of how we came about and what we've been up to. The second is to try to give a little sense of what we're planning for the future. It is with that in mind that I'll get started. Nova Leap Health Corp is traded on the venture exchange TSXV: NLH, not to be confused with NHL for those that are following the hockey playoffs. I get that quite a bit. We're an in-home care company. What that means is that we're generally going into an individual's home, so normally a senior, and we're looking after them in their own home.
Think about a mom or dad that has dementia, perhaps somebody that is towards the end of their life, they've had some sort of terminal illness, we'll look after them. Could be a spouse that lost a loved one and they want companionship. That's often what we do. I'd say about 75% of our clients live with some form of dementia. There could be Alzheimer's, Lewy body, Parkinson's. There's something that's causing a challenge to the family. Basically, we're in there to provide support within the home. We also provide one-on-one care within facilities. While the bulk of our work is within someone's house, we would also go into facilities. It could be independent living, assisted living, nursing homes, and we also provide one-on-one care there.
The scenario that we would get called in, again, is an adult child goes home at a certain time of the year. Maybe it's Christmas time or something, and they realize, "Okay, something's a little off here with mom or dad," and maybe they need some assistance. A lot of times these days, the adult children are sort of living away. They don't realize the challenges that have sort of or the changes that have happened until they're actually home. Usually, they'll pick up the phone and call us. They'll do a Google search, and that's how they get a hold of us. We would then send someone in that has a senior care background. Could be an RN or an LPN, social worker, perhaps. Somebody from our office would go and do an in-home assessment.
They would assess the situation, speak to the family members, understand what's going on, do a safety check around the house, and so on. That's how we would build a care plan. From that care plan, we would then assign a caregiver, perhaps, if it's a 3 or 4-hour shift, or a series of caregivers that are rotating through the home if it's 24/7 care. Okay? We would do, it could be as low as a one-hour shift all the way to 24/7. We handle it all. Okay? That's generally how it works. We're in what's called the private pay space. In the U.S., you think about sort of Medicaid, Medicare reimbursement. That's not really the space we play in. We're private pay. It's out of pocket to the seniors we provide the care to or their adult children. Okay?
That would be the bulk of how we're reimbursed. There is some Veteran Affairs work that we do, which is government-funded, or it could be long-term care insurance. But we're primarily private payer, not in the Medicare or Medicaid space. Okay? I've broken down here between non-medical and home health just because those are two sort of distinct terms that are used. The non-medical side or home care, often what you'll do is medication reminders, the dementia care, transportation, errands, light housekeeping, meal prep. That's on the non-medical side. The home health side is typically under the direction of a nurse, LPN or an RN, maybe in concert with a physician. That would be medication administration as an example. Those are two distinct differences. One is specifically on the medical side of things with administration of medicine.
The other side is non-medical, which is the bulk of our work. Okay? I'm not going to spend a lot of time on the home care industry. I think everybody has a good understanding of the demographics. There is an aging demographic that started after World War II. We see that every day with an aging population. I think the stats have seen the U.S., 10,000 people turning the age of 65 every day. Basically, for the next 30-40 years, we have an aging demographic before it starts to level off. That is what we're in. There is also a movement more towards home care. If you look at the surveys that are done, 90%-95% of the people that are surveyed would indicate they would prefer to stay in their home if they can. They can't always do it.
Sometimes they may be better off in a facility depending on the circumstances. The bulk of folks want to stay in their home. If you look at, particularly in Medicare and Medicaid, the cost of providing the service, it's a lower cost in the home than it is in a large facility where there's much larger overhead. For some of you who've heard the movement to hospital in the home, that is a real movement. It's not obtained near the traction I thought it would at this point. That's not the space we're in. I think there's a lot of energy moving towards the home. That definitely is the space we're in, again, primarily on the non-medical side, but to some extent on the medical side. Where are we? I'm based up in Halifax, Nova Scotia, Canada. We have offices in Nova Scotia.
I think we have five offices in Nova Scotia now. We've made a number of acquisitions over the years, which I'll take you through. I founded the business back in 2016. We made our first acquisition in New Hampshire, I think, at that time. We've since expanded to Rhode Island, Vermont, more in New Hampshire. Massachusetts, we have, I think, five offices now. Oklahoma, Arkansas, Texas, South Carolina, and recently to Florida. I'd say between the end of 2017, probably until the end of 2021, we were averaging about 4 acquisitions a year, so one a quarter. Didn't always work out that way. At the end of 2021, we actually made 3 over a period of 2 weeks. The average was generally about one per quarter. We were hit by COVID, which I'll take you through here in a bit.
We sort of paused the acquisitions and really worked internally on operations. Came out of that in a pretty strong financial position. Then started going back to acquisitions, I'd say, mid-last year. Made another one in Massachusetts. Made an acquisition mid-December in Florida. Picked up a couple of locations in Nova Scotia mid-January. We're back on the acquisition front. What do we look for? We look at Canada and the U.S. The furthest west we've gone in the U.S. has been Texas. We're not going to go any further west than that right now. We do look in Canada, but again, all of our acquisitions and expansion have been in Nova Scotia thus far. We'll make further expansion at some point in Canada. These are small businesses, so the mom-and-pop. Within the home care industry, there are thousands of these mom-and-pop businesses.
Mom-and-pop, they were started by a single founder, perhaps a couple. Right? They've been around for 10 or 15 years. That's generally what we're looking for. They're probably doing just under $2 million of revenue. Really tiny businesses. There are a lot of them. What we look to do is cash flow positive and a good, so what you get with a business is basically an office team that could be 3 or 4 people, and then caregivers that are out in the field, people's homes or facilities, which maybe they're 40-50 depending on the size of the acquisition. That's typically what you get with an acquisition and the local brand and sort of the referral sources and so on that come along with that.
We're really looking at the team within the office in particular to make sure that the team that we get is staying. All the acquisitions that we've made thus far, it's been more of a succession plan. The founder has been there 10 or 15 years, and they're looking for an exit. Sometimes it's listed by a broker. Sometimes we reach out because we say, "Hey, we're looking to come into your market. Is there an opportunity to make an acquisition?" Those are the ways that we get our deals. Direct outreach, brokers that know us because we've made so many acquisitions, some industry conferences I'll speak to, people come up to me after the conference. Assuming that the sellers had a good experience with us, they'll tell their network about it, and then we'll get some opportunities from that as well.
Those are probably the four primary ways that we get acquisition opportunities. We're really focused on one and two of the growth strategy, organic growth and acquisitions. A little bit less than joint venture partners. We're always keeping our eyes open and talk to people within the industry to see if there's opportunities for JVs, but we really haven't come across the right opportunity. I'll focus on the first two a little bit. Here's our financial profile. Again, founded the business back in 2016. I think these are in USD , by the way. I think we had $40,000 in revenue in 2016. We finished just over $25 million, almost $26 million last year U.S. You could look, I think, at our business in sort of three phases.
The initial phase from 2016 until basically the end of 2019, pre-COVID, where we were making a lot of acquisitions, significant growth, sort of go, go, go. We got hit by COVID for probably a period of 2-3 years that set us back. We really focused more internally as opposed to going and making acquisitions, which is why when we came out, you'll see, I think, in the bottom right corner, the quarterly adjusted EBITDA, that's I think we have, what, seven quarters of very, very consistent cash flow. If you look at our financial statements from last year, we are profitable. We are cash flow positive. We've just started to take on some acquisition-related debt. We didn't have any debt towards the end of 2024 before we made our acquisition in Florida. We haven't done a financing, I don't think, in probably three years now.
We don't need money. This is an awareness trip I make every year. We're not looking for capital. We don't need it. We're a good, stable business. If I don't remember, remind me at the end because there's sort of a profile that I think fits us in terms of what we're looking for as a company from investors. There's a profile we think fits for us that's a good investor profile. I'm happy to share that with you if you're interested after. I think we're not for everybody. We're not for the quick flippers, the folks that are trading. It's a very difficult stock to trade. It's thinly traded. As I go through, for those that don't know us, over 40% is insider-owned. Right? Management is really aligned with shareholders.
There are a few key things I just think you have to be aware of before you'd ever consider making an investment in Nova Leap. The primary one is you have to be thinking long-term because that's the way we view this business. We're steady. We're growing. We're stable. You'll start to see because we've just made acquisitions, we should be approaching, certainly over the next couple of quarters, $30 million of revenue, which will sort of take us to the next level. I think from an EBITDA perspective, we've just invested and are investing in a number of new resources in terms of people. I think there's going to be some fluctuations in that. I don't think you're immediately going to see some uptick there. Again, we're sort of stable business right now. Again, cash flow positive, no need for capital.
I run a business out of Halifax. He's a CFO. We have someone that runs our operations here in the U.S., Melissa Anderson. Again, this is all available on our corporate text available on our website if you want to reflect it after. There are 6 of us on the board, 5 of whom are independent. I have direct home care experience. We owned a home care agency privately for a decade. My wife and I did with a partner, Anne Whelan, who's the second one from the bottom. We actually just bought her business out of Florida in December. We got a couple of people on the board to have home care experience. The rest of them are either entrepreneurs or executives of publicly traded companies. Our cap table, about 87 million shares outstanding.
Again, about just you'll see insider ownership in the bottom left there, just under 42%. Share price has really not done much for, I'd say, 12 months. It's been pretty consistent over the last year. Fully diluted, 95 million. No one covering us right now. Usually, those that have covered us in the past, we have had analyst coverage in the past, but because we haven't been raising money, they don't cover us anymore. Typically, the analyst leads into investment banking work, but we don't have any investment banking work to give. That's it. That's a little bit of a snapshot of our company. I saw a post on LinkedIn that I thought actually described us pretty well. It wasn't referring to us, but I'll see if I can pick it up and share it.
With all the political stuff going back and forth, sometimes it's hard to see business things on LinkedIn these days. It was a post by Matt Symes, a guy I know well on the East Coast. He's involved in strategy and execution and scaling. I've known him for probably the better part of a decade. He made this post, which again, I thought resonated well with our company. I prefer the Camel Way. The Camel Way emphasizes sustainable, profitable growth over rapid, unsustainable expansion, focusing on efficiency, resilience, and long-term viability rather than a growth at any cost mentality. It should work in the short term and in the long term. Build a model for tomorrow and today. I actually thought that spoke pretty well about Nova Leap. Personally, I like the story of the tortoise and the hare.
I don't know if you guys know that one from years and years ago. Slow and steady wins the race. I think that's been us. I mean, Nova Leap is an easy company to understand. We provide home care services to seniors. It's an easy market to understand. Everybody, I think, realizes that we're an aging demographic. We have pricing power because we have the ability to charge market-prevailing rates, whereas you don't have the same pricing power, Medicare and Medicaid. That's evident by the fact we've had increasing gross margins over the last few years. Pre-COVID, they were in around 33%. Post-COVID, they've been upwards of 38%-39%. Again, demonstrating our pricing power. We've made 20+ acquisitions. We're back in acquisition mode.
You should continue to see an increase in revenue and a catch-up in EBITDA once we've sort of internalized the last couple of acquisitions that we've made. There are thousands of opportunities in the coming years just because you have folks that have started their business over the last decade that have been looking to exit the home care space. We love the tailwinds. We love where we operate. We know we're making a huge difference to the families we're providing service to. Again, profitable, cash flow positive business that's easy to understand. We think we're in a very, very good position, a position from strength. That's the story of Nova Leap. I'm happy to take any questions you might have.
Sure. Go ahead. Yeah. The question is around competition.
Is it competition for deals, or is it competition actually at the service level of the local area? Yeah. I would describe this industry as very competitive. There are actually a lot of providers within the local market. If you look at the larger players, those would be usually private equity-backed franchises. Home Instead, which would be the largest global home care franchise in the world, they recently sold out. BrightStar recently did a deal with a PE firm, Comfort Keepers, Nurse Next Door out of Vancouver, BC, Canada. The list goes on. I think there are a lot of franchises that are out there. Then you have these small mom-and-pop independents, non-franchise ones, which is what we're interested in. It is a highly competitive industry. There's really not a lot of barriers to entry.
In the investment community, you always talk about moats and stuff like that. I mean, our ability to scale and to hire really, really good people, that's not something that somebody at the local level has the ability to do. If they're generating 1,000 hours a week, and they're making $1.2 million of revenue, and you have your office team and so on, they're not making a lot of money. Their ability to sort of work on the business is restricted, right? They're really in the business all the time. Our scale provides a competitive advantage as we continue to grow. We can hire and attract good people. Sometimes those are sales personnel. Sometimes they're experienced executives. We've hired both.
I can tell you the things that I was doing in 2016 and 2017, from literally in the snowstorm, driving a caregiver to get to someone's condo an hour away to make sure that that person had service. I'm not doing that stuff now, right? I mean, we have multiple locations across two countries. The only way to be successful in that type of a setup is to have people that you trust and that are really, really good. I'd say every year as we've grown, we've added more experienced people. The team that we have now is the strongest team we've ever had in our history. Yeah. Yeah. Yeah. The end of 2021, part of the reason that there was a blip there was because we'd made three acquisitions in December. That carried on into 2022.
We did have a couple of underperforming assets that we did say divest if we closed down. They were smaller, but they were not making money. If I look back at the history of our company, most of the acquisitions we made have been cash flow positive. There is one that we took on early on in 2017 that was not. My view at the time was that was just a math problem, meaning that based on the revenue they were doing, they had too many office staff. Actually, mathematically, it was impossible for them to make money. Their gross margin was great. It was about 40%. We actually were making really, really good headway up until COVID hit. We could not get the headway we wanted. Given the impact it was having on our overall business, we decided to close it down.
We had a couple of things like that at that point in time. That is really the reason for the drop. It is just a loss of hours. Again, I would have to go back to COVID, but a lot of it had to do with schools shutting down and the impact that had on that. The availability of labor was very difficult at that period of time. Those are all things that have changed over the last couple of years that are much better than where they were a couple of years ago. That is the reason for it. Yeah. Yeah. Go. Price per day. Price? Yeah. I mean, we might bill $35 an hour, for example. Someone could get an hour shift, which might be higher, a different premium rate, like $40 or so, but it could be 24/7.
It just depends on the hours that someone needs. Utilization in terms of staff utilization. Yeah. I can tell you what our range is. Typically, our target's between 90%-110% of what they want. A caregiver comes in, and they will tell us the hours that they're willing to work. That's how we know how to schedule them depending on their experience with the families. Sorry, what was your last question? What are we looking for in an investor? Yeah. I got two minutes left, right? One minute? You're going to tell me one minute? Three minutes. All right. Okay. Six things. Here's the ideal—this is my work on the plane on the way through here. The ideal investor, I think, for Nova Leap, one's long-term oriented, right? I mean, that's how we think.
I mean, I don't think about people ask me, "When are you going to exit?" I don't think about exiting. I think about, "How do I build a company and how do I leave that so that my kids still benefit from this in perpetuity?" Two, you've got to believe in the healthcare as a defensive growth sector, right? I mean, obviously, you have to understand healthcare and believe that no matter sort of how the economy is doing and so on, that it'll continue to be a good industry to invest in. Three, appreciates roll-up and consolidation strategies. I think there's a lot of roll-ups that have failed. I think a lot of people have had bad experience with roll-ups. We're not trying to be a bad experience as a roll-up. There are some excellent ones out there.
Constellation Software is one I'd hold up as being phenomenal based out of Canada. I mean, multi-billion dollar company now that was a roll-up. I started as a private equity-backed company. Values alignment with management. Again, we have almost 42% insider ownership. You have to sort of view that as a positive thing. I heard somebody make a comment one day at a previous conference saying that they thought over 40% was bad. That was kind of shocking. I said, "We put our money where our mouth is," right? I mean, almost 42% insider ownership. Obviously, you have to look at micro-cap or nano-cap. The last I'd say is sort of patient but ambitious. When I talk about long-term, it doesn't mean that you're not going to see returns for the long-term.
It means that we're building and we're making decisions that are long-term oriented. If you call me next month and say, "I didn't like your quarter," it's irrelevant to me. I don't care because I'm not thinking about the next quarter. I am thinking 5 years out, right? I am thinking about the impact that AI is going to have on our business and all the efficiencies that we could get and the problems it can create and how we utilize that, right? I am thinking about the fact that with our aging demographic, we also have an aging caregiver base. What impact will that have on us a decade out, right? Those are risk areas that we think about or opportunities that we think about that are irrelevant for the next quarter. When we're making decisions, again, we're not looking to raise money.
I don't have to come here and sort of promote the stock and say, "Hey, we got to bump this up to do a discount for our financing." It doesn't matter. We want people that we have investors that are CEOs now of publicly traded companies or that have run corporate development arms of publicly traded companies or that have been directors of publicly traded companies, have been successful entrepreneurs that have invested in publicly traded companies. And they've done that, and they've been investors for a decade plus in those companies. We love those investors. I spend time talking to those investors because they can relate to what we're doing, and they can share their experience of how they did it because their experience often mirrors what we're going through. Those are the type of investors.
We have some funds that have been with us since really early days. I love long-term oriented investors. Very difficult to find them. Very difficult to find truly long-term oriented investors. When we find them, we find we get great value from them. I got 30 seconds? Thirty seconds. Yeah. Last question. The most expensive one that we've done. I talk multiple or actually total dollars? Multiple. I think the most expensive one we did is 6 and 3 quarters. The lowest one we've done has been under 3 . Think 3-5 . Actually, think 4-5 . I said probably a little bit narrow. Think four to five. That's what we look for. Yeah. Okay. All right. I got to wrap. I told you I got to wrap it up. I appreciate everybody coming out.
Really, really appreciate your time and learning a little bit more about us and enjoy the rest of the conference. Thank you.