Aveanna is a home-based healthcare services company focused on medically complex patients, and claims to be the largest provider of Private Duty Nursing (PDN) in the U.S. PDN — providing skilled nursing care in the home to children and young adults with serious chronic conditions like respiratory failure, cerebral palsy, or cystic fibrosis — makes up roughly 80% of total revenue. Nurses are deployed in the home for shifts of up to 24 hours a day, and patients often remain on service for years or decades. Aveanna also operates a Home Health & Hospice segment serving primarily elderly Medicare patients, and a Medical Solutions segment distributing enteral nutrition supplies and respiratory equipment, which serves many of the same patients as PDN. Aveanna is paid by government payers — primarily Medicaid and Medicare — for hours of care delivered or units of product. In PDN, the core spread metric is the difference between the reimbursement rate per hour and caregiver labor cost per hour. Aveanna pursues a "preferred payer" strategy, concentrating nursing capacity on MCOs that pay enhanced rates and enter value-based agreements, which drives higher revenue per hour and better staffing fill rates. Aveanna also runs an active government affairs operation targeting Medicaid rate increases across its roughly 29-state footprint. Growth is driven by organic volume expansion, Medicaid rate improvement, preferred payer agreements, and tuck-in M&A — including the acquisition of Thrive Skilled Pediatrics and the announced acquisition of Family First Home Care.