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Almost Family Reports Fourth Quarter and Full Year 2008 Results
Date:3/4/2009

Fourth Quarter and Full Year Highlights:

- Fourth quarter net service revenues increased 84% to $66.2 million; full year net service revenues increased 61% to $212.6 million

- Fourth quarter Visiting Nurse (VN) segment net revenues rose 108% to $55.7 million; full year VN net revenues rose 80% to $173.0 million

- Fourth quarter net income increased 151% to $5.2 million; full year net income increased 114% to $16.3 million

- Fourth quarter diluted EPS increased 68% to $0.62 per share on 48% more shares outstanding; full year diluted EPS increased 59% to $2.16 per share on 35% more shares outstanding

LOUISVILLE, Ky., March 4, 2009 /PRNewswire-FirstCall/ -- Almost Family, Inc. (Nasdaq: AFAM), a leading regional provider of home health nursing services, announced today its financial results for the three months and full year ended December 31, 2008.

William Yarmuth, Chief Executive Officer, commented, "By all measures, the fourth quarter of 2008 completes a milestone year for Almost Family. Our success during the quarter was highlighted by 84% total revenue growth and 47% organic growth in our VN segment. We have been extremely successful during the year rolling out our Senior Advocacy Mission to all of our existing and acquired branches. The results are a stronger patient centric organization, a broader platform from which to grow and continued strong financial performance. We are particularly pleased to have substantially completed the integration of Patient Care, the largest acquisition in our history, transitioning its home office functions and systems to our Louisville headquarters. Looking into 2009, we will continue to focus on the major drivers of our revenue growth: educating referral sources on how we can provide the best care for their patients and pursuing start-ups and acquisitions that increase our densification in our existing geographic clusters."

Fourth Quarter Financial Results

Almost Family reported fourth quarter 2008 net service revenues of $66.2 million, an 84% increase from $35.9 million in the fourth quarter of 2007. Net income for the fourth quarter of 2008 increased to 7.9% of net service revenues versus 5.8% for the fourth quarter of 2007.

Net income for the fourth quarter of 2008 was $5.2 million, or $0.62 per diluted share, compared to $2.1 million, or $0.37 per diluted share, in the fourth quarter of 2007. The weighted average shares outstanding for purposes of calculating diluted earnings per share increased 48% between periods.

Fourth Quarter Segment Results

Net revenues in the Visiting Nurse segment for the fourth quarter of 2008 were $55.7 million, a 108% increase from $26.8 million in the fourth quarter of 2007. The total revenue growth of $28.9 million came from a 47% organic growth rate plus $20.1 million from acquired operations. Operating income before corporate expense in the VN segment for the fourth quarter 2008 was $12.6 million, a 145% increase from $5.2 million in the fourth quarter of 2007.

Net revenues in the Personal Care (PC) segment for the fourth quarter of 2008 were $10.5 million, a 16% increase from $9.1 million in the fourth quarter of 2007. Operating income before corporate expense in the PC segment for the fourth quarter of 2008 was $1.4 million, a 67% increase from $819,000 in the fourth quarter of 2007.

Full Year Financial Results

Almost Family reported net service revenues for the twelve month period ended December 31, 2008 of $212.6 million, a 61% increase from $132.1 million in the same period last year. Net income for the twelve month period increased to 7.7% of net service revenues versus 5.9% for the prior year period.

Net income for the twelve month period was $16.3 million, or $2.16 per diluted share, compared to $7.6 million, or $1.36 per diluted share, in the prior year period. The weighted average shares outstanding for purposes of calculating diluted earnings per share increased 35% between periods.

Full Year Segment Results

Net revenues in the Visiting Nurse segment for the twelve month period of 2008 were $173.0 million, an 80% increase from $96.2 million in the same period last year. The total revenue growth of $76.8 million came from a 36% organic growth rate plus $47.4 million from acquired operations. The twelve month results for the period ended 2008 included results from the Apex Home Healthcare acquisition completed in late March 2008, the Patient Care acquisition completed in August 2008 and the Fairfield Ohio Medical Center Home Health Agency acquisition completed in November 2008. The twelve month results from the period ended 2007 included results from the Quality of Life acquisition completed in late October of 2007. Operating income before corporate expense in the VN segment for the twelve month period was $36.6 million, a 99% increase from $18.4 million in the same period last year.

Net revenues in the Personal Care segment for the twelve month period were $39.6 million, a 10% increase from $35.9 million in the same period last year. Operating income before corporate expense in the PC segment for the twelve month period was $3.8 million, a 12% increase from $3.4 million in the same period last year.

Recent Corporate Developments

On October 14, 2008, Almost Family announced that it had been ranked No. 24 in Forbes' 2008 listing of the 200 Best Small Companies in America, rising from its No. 77 ranking in 2007.

On November 5, 2008 Almost Family filed with the Securities and Exchange Commission a shelf registration statement on Form S-3 which increased the amount of capital the Company could raise from approximately $30 million to $150 million to provide financing flexibility for development plans.

On November 14, 2008, Almost Family acquired the assets of the Medicare-certified home health agency owned by Fairfield Medical Center located near Columbus OH. The agency generated approximately $1.2 million of Medicare revenue in 2007.

On November 26, 2008, Almost Family acquired the Kentucky Certificate of Need and home health license of the Medicare-certified home health agency formerly operated by Hardin Memorial Hospital in Elizabethtown, KY. The certificate will enable Almost Family to expand its service territory into four additional counties south of the metro Louisville area.

On Friday, February 20, 2009 Almost Family was added to the S&P SmallCap 600 Index. Introduced in 1994, S&P SmallCap 600 is a U.S. benchmark index made up of the securities of 600 companies with a market capitalization of $200 million to $1 billion.

Conference Call

A conference call to review the results will begin at 11:00 a.m. ET on March 4, 2009, and will be hosted by William Yarmuth, Chief Executive Officer, and Steve Guenthner, Chief Financial Officer. To participate in the conference call, please dial 1-877-407-0789 (USA) or 1-201-689-8562 (International). In addition, a dial-up replay of the conference call will be available beginning March 4, 2009 at 2:00 p.m. ET and ending on March 18, 2009. The replay telephone number is 1-877-660-6853 (USA) or 1-201-612-7415 (International). Account Number: 3055 and Passcode: 313364.

A live Web cast of the call will also be available from the Investor Relations section of the corporate Web site at http://www.almostfamily.com. A Web cast replay can be accessed on the corporate Web site beginning March 4, 2009 at approximately 2:00 p.m. ET and will remain available until April 4, 2009.

                       ALMOST FAMILY, INC. AND SUBSIDIARIES
                         CONSOLIDATED STATEMENTS OF INCOME
                                    (UNAUDITED)
                                                        Three months ended
                                                            December 31,
                                                        ------------------
                                                            2008         2007
                                                            ----         ----
    Net service revenues                             $66,167,274  $35,876,385
    Cost of service revenue                           30,427,520   17,239,541
                                                      ----------   ----------
    Gross margin                                      35,739,754   18,636,844
                                                      ----------   ----------
    General and administrative expenses:
      Salaries and benefits                           18,241,445    9,399,181
      Other                                            8,220,775    5,414,355
                                                       ---------    ---------
    Total general and administrative expenses         26,462,220   14,813,536
                                                      ----------   ----------
    Operating income                                   9,277,534    3,823,308
    Interest expense, net                               (413,584)    (186,503)
                                                        --------     --------
     Income from continuing operations before
      income taxes                                     8,863,950    3,636,805
    Income tax expense                                (3,658,122)  (1,560,737)
                                                      ----------   ----------
    Net income from continuing operations              5,205,828    2,076,068
    Discontinued operations, net of tax benefit of
     $5,915 and $92,290                                   (9,135)      (5,986)
                                                          ------       ------
    Net income                                        $5,196,693   $2,070,082
                                                      ==========   ==========


    Per share amounts-basic:
      Average shares outstanding                       8,136,723    5,504,484
      Income from continued operations                     $0.64        $0.38
      Loss from discontinued operations                        -            -
                                                       ---------    ---------
    Net income                                             $0.64        $0.38
                                                           =====        =====

    Per share amounts-diluted:
      Average shares outstanding                       8,367,865    5,668,916
      Income from continued operations                     $0.62        $0.37
      Loss from discontinued operations                        -            -
                                                       ---------    ---------
    Net income                                             $0.62        $0.37
                                                           =====        =====



    ALMOST FAMILY, INC. AND SUBSIDIARIES
    CONSOLIDATED STATEMENTS OF INCOME
    (UNAUDITED)
                                                      Year ended December 31,
                                                      -----------------------
                                                           2008          2007
                                                           ----          ----
    Net service revenues                           $212,600,271  $132,130,056
    Cost of service revenue                          98,959,401    63,874,381
                                                     ----------    ----------
    Gross margin                                    113,640,870    68,255,675
                                                    -----------    ----------
    General and administrative expenses:
      Salaries and benefits                          58,182,889    35,945,657
      Other                                          27,251,997    18,380,418
                                                     ----------    ----------
     Total general and
      administrative expenses                        85,434,886    54,326,075
                                                     ----------    ----------
    Operating income                                 28,205,984    13,929,600
    Interest expense, net                            (1,147,417)     (836,911)
                                                     ----------      --------
      Income from continuing
       operations before income
       taxes                                         27,058,567    13,092,689
    Income tax expense                              (10,654,393)   (5,272,149)
                                                    -----------    ----------
    Net income from continuing
     operations                                      16,404,174     7,820,540
    Discontinued operations, net of tax
     benefit of $69,577 and $138,148                  (111,291)     (216,981)
                                                       --------      --------
    Net income                                      $16,292,883    $7,603,559
                                                    ===========    ==========


    Per share amounts-basic:
      Average shares outstanding                      7,368,968     5,435,615
      Income from continued operations                    $2.23         $1.44
      Loss from discontinued operations                   (0.02)        (0.04)
                                                          -----         -----
    Net income                                            $2.21         $1.40
                                                          =====         =====

    Per share amounts-diluted:
      Average shares outstanding                      7,572,333     5,599,476
      Income from continued operations                    $2.17         $1.40
      Loss from discontinued operations                   (0.01)        (0.04)
                                                          -----         -----
    Net income                                            $2.16         $1.36
                                                          =====         =====



                      ALMOST FAMILY, INC. AND SUBSIDIARIES
                           CONSOLIDATED BALANCE SHEETS
                                   (UNAUDITED)
                                                    Year ended December 31,
    ASSETS                                                 2008        2007
                                                           ----        ----
    CURRENT ASSETS:
    Cash and cash equivalents                        $1,301,178    $473,222
    Accounts receivable - net                        34,760,021  16,965,316
    Prepaid expenses and other current assets         3,113,737   1,203,454
    Deferred tax assets                               4,437,979   1,829,895
                                                      ---------   ---------
    TOTAL CURRENT ASSETS                             43,612,915  20,471,887

    PROPERTY AND EQUIPMENT - NET                      4,199,067   1,458,844

    GOODWILL                                         92,170,091  42,667,244

    OTHER INTANGIBLE ASSETS                          16,715,369   2,488,056

    DEFERRED TAX ASSETS                               3,576,275           -

    OTHER ASSETS                                        518,317     274,359
                                                        -------     -------
    TOTAL ASSETS                                   $160,792,034 $67,360,390
                                                   ============ ===========

    LIABILITIES AND STOCKHOLDERS' EQUITY
    CURRENT LIABILITIES:
    Accounts payable                                 $5,320,763  $3,943,555
    Accrued other liabilities                        22,436,430  10,369,346
    Current portion - capital leases and notes
     payable                                          4,774,249     653,891
    Current deferred tax liabilities                  4,792,091           -
                                                     ----------  ----------
    TOTAL CURRENT LIABILITIES                        37,323,533  14,966,792
                                                     ----------  ----------

    LONG-TERM LIABILITIES:
    Revolving credit facility                        23,998,428  12,386,783
    Capital Lease Obligations                           111,002           -
    Notes payable                                     3,100,000   4,000,000
    Long-term deferred tax liabilities                        -     776,672
    Other liabilities                                 1,476,843     388,230
                                                      ---------     -------
    TOTAL LONG-TERM LIABILITIES                      28,686,273  17,551,685
                                                     ----------  ----------
    TOTAL LIABILITIES                                66,009,806  32,518,477
                                                     ----------  ----------

    STOCKHOLDERS' EQUITY:
    Preferred stock, par value $0.05; authorized
      2,000,000 shares; none issued or outstanding            -           -
    Common stock, par value $0.10; authorized
      25,000,000 and 10,000,000 shares; 8,136,723
      and 7,808,819 issued and outstanding              813,672     780,882
    Treasury stock, at cost, 2,276,898 shares                 -  (8,877,641)
    Additional paid-in capital                       64,935,673  30,198,671
    Retained earnings                                29,032,883  12,740,001
                                                     ----------  ----------
    TOTAL STOCKHOLDERS' EQUITY                       94,782,228  34,841,913
                                                     ----------  ----------
    TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY     $160,792,034 $67,360,390
                                                   ============ ===========



                       ALMOST FAMILY, INC. AND SUBSIDIARIES
                      CONSOLIDATED STATEMENTS OF CASH FLOWS
                                   (UNAUDITED)
                                                     Year ended December 31,
                                                            2008        2007
                                                            ----        ----
    Cash flows from operating activities:
      Net income                                     $16,292,883  $7,603,559
        Loss from discontinued operations               (111,291)   (216,981)
                                                        --------    --------
    Income from continuing operations                 16,404,174   7,820,540
    Adjustments to reconcile income
     from continuing operations to
      net cash provided by operating activities:
     Depreciation and amortization                     1,330,185     842,201
     Provision for uncollectible accounts              2,964,561   1,546,284
     Stock-based compensation                            687,543     362,510
     Deferred income taxes                             1,364,259     911,211
                                                       ---------     -------
                                                      22,750,722  11,482,746
    Change in certain net current assets, net
      of the effects of acquisitions:
     (Increase) decrease in:
     Accounts receivable                             (14,283,621) (4,785,292)
     Prepaid expenses and other current assets          (992,557)   (302,908)
     Other assets                                        (34,369)    (78,804)
    Increase (decrease) in:
     Accounts payable and accrued expenses             2,145,571   1,048,344
                                                       ---------   ---------
    Net cash provided by operating activities          9,585,746   7,364,086
                                                       ---------   ---------

    Cash flows from investing activities:
     Capital expenditures                            (1,475,905)    (590,839)
     Acquisitions, net of cash acquired             (59,797,388)  (9,075,054)
                                                     -----------  ----------
    Net cash used in investing activities            (61,273,293) (9,665,893)
                                                     -----------  ----------

    Cash flows from financing activities:
     Net revolving credit facility repayments         11,610,708   3,921,785
     Proceeds from stock option exercises                 52,797      77,521
     Purchase of common stock in connection with
      option exercises                                        -   (3,645,776)
     Tax benefit from non-qualified stock
      option exercises                                   86,594      704,294
     Proceeds from stock offering                    41,820,500            -
     Principal payments on capital leases and
      notes payable                                    (943,805)  (2,322,612)
                                                        --------   ----------
    Net cash provided by (used in)
     financing activities                             52,626,794  (1,264,788)
                                                      ----------  ----------

    Cash flows from discontinued operations
     Operating Activities                               (111,291)   (351,658)
     Investing Activities                                      -     265,883
     Financing Activities                                      -           -
                                                        --------     -------
    Net cash used in discontinued operations            (111,291)    (85,775)
                                                        --------     -------

    Net increase (decrease) in cash and
     cash equivalents                                    827,956  (3,652,370)
    Cash and cash equivalents at
     beginning of period                                 473,222   4,125,592
                                                         -------   ---------
    Cash and cash equivalents at end of period        $1,301,178    $473,222
                                                      ==========    ========

    Supplemental disclosures of cash flow
     information:
     Cash payment of interest, net of
      amounts capitalized                               $871,000    $915,000
     Cash payment of taxes                            $9,308,088  $3,176,000

    Summary of non-cash investing and
     financing activities:
     Capital expenditures financed under
      capital leases                                    $967,023          $-
     Acquisitions funded by notes payable             $3,100,000          $-
     Acquisitions funded by stock                     $1,000,000  $2,000,000
     Value of stock option shares withheld in lieu
      of payroll taxes                                    $6,979  $3,725,533



    ALMOST FAMILY, INC. AND SUBSIDIARIES
    RESULTS OF OPERATIONS
    (UNAUDITED)

                                Three months ended December 31,
                                --------------------------------

                         2008               2007               Change
                       ------------------------------------------------------
                       Amount    % Rev    Amount     % Rev     Amount       %
                       ------------------------------------------------------
     Net service
      revenues
        Visiting
         Nurse     $55,660,271   84.1% $26,798,810   74.7% $28,861,461 107.7%
        Personal
         Care       10,507,004   15.9%   9,077,575   25.3%   1,429,429  15.7%
                    ----------           ---------           ---------
                    66,167,275  100.0%  35,876,385  100.0%  30,290,890  84.4%
                    ----------          ----------          ----------
    Operating
     income
        Visiting
         Nurse      12,608,579   22.7%   5,155,714   19.2%   7,452,865 144.6%
        Personal
         Care        1,368,406   13.0%     819,372    9.0%     549,034  67.0%
                     ---------             -------             -------
    Operating
     income
     before
     unallocated
     corporate
     expenses       13,976,985   21.1%   5,975,086   16.7%   8,001,899 133.9%
    Corporate
     expenses        4,699,451    7.1%   2,151,778    6.0%   2,547,673 118.4%
                     ---------           ---------           ---------
    Operating
     income          9,277,534   14.0%   3,823,308   10.7%   5,454,226 142.7%
    Interest
     expense, net     (413,584)   0.6%    (186,503)   0.5%     227,081 121.8%
    Income taxes    (3,658,122)   5.5%  (1,560,737)   4.4%   2,097,385 134.4%
                    ----------          ----------           ---------
    Net income
     from
     continuing
     operations     $5,205,828    7.8%  $2,076,068    5.8%  $3,129,760 150.8%
                    ==========          ==========          ==========

    EBITDA from
     continuing
     operations     $9,616,714   14.5%  $4,069,451   11.3%  $5,547,263 136.3%



                        ALMOST FAMILY, INC. AND SUBSIDIARIES
                               RESULTS OF OPERATIONS

                                       Year ended December 31,
                                       -----------------------

                         2008                2007              Change
                       ------------------------------------------------------
                       Amount    % Rev     Amount    % Rev     Amount       %
                       ------------------------------------------------------
    Net service
     revenues
        Visiting
         Nurse    $172,977,478   81.4% $96,187,044   72.8% $76,790,434  79.8%
        Personal
         Care       39,622,793   18.6%  35,943,012   27.2%   3,679,781  10.2%
                    ----------          ----------           ---------
                   212,600,271  100.0% 132,130,056  100.0%  80,470,215  60.9%
                   -----------         -----------          ----------
    Operating
     income
        Visiting
         Nurse      36,644,987   21.2%  18,382,333   19.1%  18,262,654  99.3%
        Personal
         Care        3,849,180    9.7%   3,444,913    9.6%     404,267  11.7%
                     ---------           ---------             -------
    Operating
     income
     before
     unallocated
     corporate
     expenses       40,494,167   19.0%  21,827,246   16.5%  18,666,921  85.5%
    Corporate
     expenses       12,288,183    5.8%   7,897,646    6.0%   4,390,537  55.6%
                    ----------           ---------           ---------
    Operating
     income         28,205,984   13.3%  13,929,600   10.5%  14,276,384 102.5%
    Interest
     expense,
     net            (1,147,417)   0.5%    (836,911)   0.6%     310,506  37.1%
    Income
     taxes         (10,654,393)   5.0%  (5,272,149)   4.0%   5,382,244 102.1%
                   -----------          ----------           ---------
    Net income
     from
     continuing
     operations    $16,404,174    7.7%  $7,820,540    5.9%  $8,583,634 109.8%
                   ===========          ==========          ==========

    EBITDA from
     continuing
     operations    $30,223,712   14.2% $15,134,311   11.5% $15,089,401  99.7%



    ALMOST FAMILY, INC. AND SUBSIDIARIES
    VISITING NURSE SEGMENT OPERATING METRICS

                                   Three months ended December 31,
                                ----------------------------------------
                                 2008         2007        Change
                                Amount       Amount       Amount       %
                                ----------------------------------------

    Average number of
     locations                        64           46           18  39.1%

    All payors:
    Admissions                    11,535        7,571        3,964  52.4%
    Billable Visits              344,823      169,287      175,536 103.7%

    Medicare Statistics:
    Revenue                  $49,104,895  $24,845,800  $24,259,095  97.6%
       Percentage of total
        revenues                    88.2%        92.7%
      Billable Visits            297,649      153,658      143,991  93.7%
      Admissions                  10,497        6,663        3,834  57.5%
      Episodes started            16,290        9,003        7,287  80.9%

      Revenue per completed
       episode                    $3,203       $3,011         $192   6.4%
      Visits per episode            17.7         16.5          1.2   7.3%



    ALMOST FAMILY, INC. AND SUBSIDIARIES
    PERSONAL CARE SEGMENT OPERATING METRICS

                                Three months ended December 31,
                                 ---------------------------
                                   2008       2007    Change
                                 Amount     Amount    Amount      %
                                 ----------------------------------
    Average number of locations      23         22         1    4.5%

    Admissions                      870        769       101   13.1%
    Patient Days of Care        142,011    134,225     7,786    5.8%
    Billable Hours              580,101    518,343    61,758   11.9%

    Revenue per billable hours   $18.11     $17.51     $0.60    3.4%



    ALMOST FAMILY, INC. AND SUBSIDIARIES
    VISITING NURSE SEGMENT OPERATING METRICS

                                       Year ended December 31,
                                       -----------------------
                                 2008         2007         Change
                                Amount        Amount       Amount      %
                                ----------------------------------------

    Average number of locations      62           47          15    31.9%

    All payors:
    Admissions                   39,666       29,338       10,328   35.2%
    Billable Visits           1,077,477      600,913      476,564   79.3%

    Medicare Statistics:
    Revenue                $156,892,495  $89,142,173  $67,750,322   76.0%
       Percentage of total
        revenues                  90.7%        92.7%
      Billable Visits           952,188      545,732      406,456   74.5%
      Admissions                 36,195       26,199        9,996   38.2%
      Episodes started           53,687       33,169       20,518   61.9%

       Revenue per completed
        episode                  $3,171       $2,911         $260    8.9%
      Visits per episode           17.3         16.0          1.3    8.1%



    ALMOST FAMILY, INC. AND SUBSIDIARIES
    PERSONAL CARE SEGMENT OPERATING METRICS

                                     Year ended December 31,
                                     -----------------------
                                    2008        2007     Change
                                  Amount      Amount     Amount     %
                                  -----------------------------------
    Average number of locations        23          22         1   4.5

    Admissions                      3,671       3,544       127   3.6%
    Patient Days of Care          558,681     526,540    32,141   6.1%
    Billable Hours              2,225,213   2,042,226   182,987   9.0%

    Revenue per billable hours     $17.81      $17.60     $0.21   1.2%

Non-GAAP Financial Measure

The information provided in the tables in this release includes certain non-GAAP financial measures as defined under Securities and Exchange Commission (SEC) rules. In accordance with SEC rules, the Company has provided, in the supplemental information and the footnotes to the tables, a reconciliation of those measures to the most directly comparable GAAP measures.

EBITDA:

EBITDA is defined as income before depreciation and amortization, net interest expense and income taxes. EBITDA is not a measure of financial performance under accounting principles generally accepted in the United States of America. It should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles. The items excluded from EBITDA are significant components in understanding and evaluating financial performance and liquidity. Management routinely calculates and communicates EBITDA and believes that it is useful to investors because it is commonly used as an analytical indicator within our industry to evaluate performance, measure leverage capacity and debt service ability, and to estimate current or prospective enterprise value. EBITDA is also used in certain covenants contained in our credit agreement.

The following tables set forth a reconciliation of Continuing Operations Net Income to EBITDA:

    ALMOST FAMILY, INC. AND SUBSIDIARIES
    RECONCILIATION OF EBITDA




                                                   Three months ended
    RECONCILIATION OF EBITDA:                         December 31,
                                                   ------------------
                                                     2008        2007
                                                     ----         ----
    Net income from continuing operations      $5,205,828   $2,076,068
    Add back:
      Interest expense                            413,584      186,503
      Income taxes                              3,658,122    1,560,737
      Depreciation and amortization               179,098      216,501
      Amortization of stock-based compensation    160,081       29,642
                                                  -------       ------
    Earnings before interest, income taxes,
    depreciation and amortization (EBITDA)
    from continuing operations                 $9,616,713   $4,069,451
                                               ==========   ==========



    ALMOST FAMILY, INC. AND SUBSIDIARIES
    RECONCILIATION OF EBITDA




                                                Year ended December 31,
    RECONCILIATION OF EBITDA:                  -----------------------
                                                      2008        2007
                                                      ----        ----
    Net income from continuing operations      $16,404,174  $7,820,540
    Add back:
      Interest expense                           1,147,417     836,911
      Income taxes                              10,654,393   5,272,149
      Depreciation and amortization              1,330,185     842,201
      Amortization of stock-based compensation     687,543     362,510
                                                   -------     -------
    Earnings before interest, income taxes,
    depreciation and amortization (EBITDA)
    from continuing operations                 $30,223,712 $15,134,311
                                               =========== ===========

About Almost Family

Almost Family, Inc., founded in 1976, is a leading regional provider of home health nursing services, with branch locations in Florida, Kentucky, Connecticut, New Jersey, Ohio, Massachusetts, Alabama, Missouri, Illinois, Pennsylvania, and Indiana (in order of revenue significance). Almost Family, Inc. and its subsidiaries operate a Medicare-certified segment and a personal care segment. Altogether, Almost Family operates over 90 branch locations in 11 U.S. states.

Forward Looking Statements

All statements, other than statements of historical facts, included in this news release are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may be identified by the use of forward-looking terminology such as "may," "will," "expect," "believe," "estimate," "project," "anticipate," "continue," or similar terms, variations of those terms or the negative of those terms. These forward-looking statements are based on the Company's current plans, expectations and projections about future events.

Because forward-looking statements involve risks and uncertainties, the Company's actual results could differ materially from any future results, performance or achievements expressed or implied by such forward-looking statements. The potential risks and uncertainties which could cause actual results to differ materially include: regulatory approvals or third party consents may not be obtained, the impact of further changes in healthcare reimbursement systems, including the ultimate outcome of potential changes to Medicare reimbursement for home health services and to Medicaid reimbursement due to state budget shortfalls; the ability of the Company to maintain its level of operating performance and achieve its cost control objectives; changes in our relationships with referral sources; the ability of the Company to integrate acquired operations; government regulation; health care reform; pricing pressures from Medicare, Medicaid and other third-party payers; changes in laws and interpretations of laws relating to the healthcare industry; and the Company's self-insurance risks. For a more complete discussion regarding these and other factors which could affect the Company's financial performance, refer to the Company's various filings with the Securities and Exchange Commission, including its filing on Form 10-K for the year ended December 31, 2007, in particular information under the headings "Special Caution Regarding Forward-Looking Statements" and "Risk Factors." The Company undertakes no obligation to update or revise its forward-looking statements.

    Almost Family, Inc.
    Steve Guenthner
    (502) 891-1000

    The Ruth Group
    Investor Relations
    Nick Laudico/Zack Kubow
    (646) 536-7030/7020
    nlaudico@theruthgroup.com
    zkubow@theruthgroup.com


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SOURCE Almost Family, Inc.
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