Good Moderate Growth, page-5

I think you're seeing the effects of relatively expensive acquisitions funded by debt, and surprisingly low organic growth (the latter not LHC specific but an industry issue, given the health thematic). What has surprised me is the lack of earnings per share growth, given they haven't really issued issues and relied on debt, but perhaps this has more to do with the acquisition prices. Your observation on declining EBITDA margins is also important and it is unclear whether they have been impacted by exchange rates which could reverse.