EX-99.1 2 a16-5322_1ex99d1.htm EX-99.1

Exhibit 99.1

 

 

 

FOR IMMEDIATE RELEASE

4714 Gettysburg Road

 

Mechanicsburg, PA 17055

 

 

 

NYSE Symbol: SEM

 

Select Medical Holdings Corporation Announces Results for

Fourth Quarter and Year Ended December 31, 2015

 

MECHANICSBURG, PENNSYLVANIA — February 25, 2016 — Select Medical Holdings Corporation (“Select Medical”) (NYSE: SEM) today announced results for its fourth quarter and year ended December 31, 2015.

 

For the fourth quarter ended December 31, 2015, net operating revenues increased 34.7% to $1,039.2 million, compared to $771.6 million for the same quarter, prior year.  Income from operations was $62.3 million for the fourth quarter ended December 31, 2015, compared to $57.8 million for the same quarter, prior year.  Net income attributable to Select Medical was $29.3 million for the fourth quarter ended December 31, 2015, compared to $25.7 million for the same quarter, prior year.  Net income before interest, income taxes, depreciation and amortization, gain (loss) on early retirement of debt, stock compensation expense, Concentra acquisition costs, equity in earnings (losses) of unconsolidated subsidiaries, and gain on sale of equity investment (“Adjusted EBITDA”) for the fourth quarter ended December 31, 2015 was $100.8 million, compared to $78.9 million for the same quarter, prior year.  A reconciliation of net income to Adjusted EBITDA is presented in table VIII of this release. Income per common share for the fourth quarter ended December 31, 2015 was $0.22 on a fully diluted basis compared to income per common share of $0.20 for the same quarter, prior year.

 

For the year ended December 31, 2015, net operating revenues increased 22.1% to $3,742.7 million, compared to $3,065.0 million for the prior year.  Income from operations was $274.8 million for the year ended December 31, 2015, compared to $284.5 million for the prior year. Net income attributable to Select Medical was $130.7 million for the year ended December 31, 2015, compared to $120.6 million for the prior year. Adjusted EBITDA for the year ended December 31, 2015 was $399.2 million, compared to $363.9 million for the prior year.  A reconciliation of net income to Adjusted EBITDA is presented in table VIII of this release.  Income per common share for the year ended December 31, 2015 was $0.99 on a fully diluted basis, compared to income per common share of $0.91 for the year ended December 31, 2014.

 

Specialty Hospitals

 

For the fourth quarter ended December 31, 2015, net operating revenues for the specialty hospitals segment increased 4.8% to $593.3 million, compared to $566.1 million for the same quarter, prior year.  Adjusted EBITDA for the specialty hospitals segment increased 7.6% to $86.0 million for the fourth quarter ended December 31, 2015, compared to $80.0 million for the same quarter, prior year.  The Adjusted EBITDA margin for the segment was 14.5% for the fourth quarter ended December 31, 2015, compared to 14.1% for the same quarter, prior year.  The Adjusted EBITDA results for the specialty hospitals segment include start-up losses of approximately $4.9 million for the fourth quarter ended December 31, 2015 compared to $5.9 million for the same quarter, prior year.  Certain specialty hospitals key statistics for both the fourth quarter ended December 31, 2015 and 2014 are presented in table VI of this release.

 



 

For the year ended December 31, 2015, net operating revenues for the specialty hospitals segment increased 4.5% to $2,346.8 million compared to $2,244.9 million for the prior year.  Adjusted EBITDA for the specialty hospitals segment for the year ended December 31, 2015 decreased to $327.6 million, compared to $341.8 million for the prior year.  The Adjusted EBITDA margin for the segment was 14.0% for the year ended December 31, 2015, compared to 15.2% for the prior year.  The Adjusted EBITDA results for the specialty hospitals segment include start-up losses of approximately $16.8 million for the year ended December 31, 2015, compared to $14.5 million for the prior year.  Certain specialty hospitals key statistics for both the year ended December 31, 2015 and 2014 are presented in table VII of this release.

 

Outpatient Rehabilitation

 

For the fourth quarter ended December 31, 2015, net operating revenues for the outpatient rehabilitation segment increased 0.6% to $206.2 million, compared to $205.0 million for the same quarter, prior year.  Adjusted EBITDA for the segment for the fourth quarter ended December 31, 2015 increased 1.8% to $23.6 million, compared to $23.2 million for the same quarter, prior year.  The Adjusted EBITDA margin for the segment was 11.4% for the fourth quarter ended December 31, 2015, compared to 11.3% for the same quarter, prior year.  Certain outpatient rehabilitation key statistics for both the fourth quarter ended December 31, 2015 and 2014 are presented in table VI of this release.

 

For the year ended December 31, 2015, net operating revenues for the outpatient rehabilitation segment decreased to $810.0 million, compared to $819.4 million for the prior year.  Adjusted EBITDA for the segment for the year ended December 31, 2015 increased 0.7% to $98.2 million, compared to $97.6 million for the prior year.  The Adjusted EBITDA margin for the segment was 12.1% for the year ended December 31, 2015, compared to 11.9% for the prior year.  Certain outpatient rehabilitation key statistics for both the year ended December 31, 2015 and 2014 are presented in table VII of this release.

 

Concentra Segment

 

On June 1, 2015, MJ Acquisition Corporation, a joint venture that Select Medical created with Welsh, Carson, Anderson & Stowe XII, L.P. (“WCAS”), consummated the acquisition of Concentra Inc. (“Concentra”), which provides occupational health, consumer health, physical therapy, and veteran’s healthcare services throughout the United States. Select Medical owns 50.1% of the voting interests of Concentra Group Holdings, LLC, the indirect parent of Concentra. Concentra’s financial results are consolidated with Select Medical’s effective June 1, 2015.

 

For the fourth quarter ended December 31, 2015, net operating revenues for the Concentra segment were $239.4 million.  Adjusted EBITDA for the Concentra segment was $11.5 million for the fourth quarter ended December 31, 2015.  The Adjusted EBITDA margin for the Concentra segment was 4.8% for the fourth quarter ended December 31, 2015. Concentra’s net operating revenues, Adjusted EBITDA and Adjusted EBITDA margin for the third quarter ended September 30, 2015 were $259.0 million, $25.6 million and 9.9% respectively.  The reduction in Adjusted EBITDA and Adjusted EBITDA margin is attributable to a seasonal reduction in the business that occurs in the fourth quarter and additional costs incurred related to integration activities.  Certain Concentra key statistics for the fourth quarter ended December 31, 2015 are presented in table VI of this release.

 

All Concentra financial information and statistics for the year ended December 31, 2015 are for the period beginning June 1, 2015 through December 31, 2015. For the year ended December 31, 2015, net operating revenues for the Concentra segment were $585.2 million.  Adjusted EBITDA for the Concentra segment was $48.3 million for the year ended December 31, 2015.  The Adjusted EBITDA margin for the Concentra segment was 8.3% for the year ended December 31, 2015.  Certain Concentra key statistics for the year ended December 31, 2015 are presented in table VII of this release.

 



 

Stock Repurchase Program

 

Select Medical did not repurchase shares during the fourth quarter ended December 31, 2015 under the authorized $500.0 million stock repurchase program. The program will remain in effect until December 31, 2016, unless extended or earlier terminated by the board of directors. Stock repurchases under this program may be made in the open market or through privately negotiated transactions, and at times and in such amounts as Select Medical deems appropriate.  Select Medical is funding this program with cash on hand and borrowings under Select’s revolving facility.

 

During the year ended December 31, 2015, Select Medical repurchased 1,032,334 shares at an aggregate cost of approximately $13.6 million, an average cost per share of $13.20, which includes transaction costs. Since the inception of the program through December 31, 2015, Select Medical has repurchased 35,924,128 shares at an aggregate cost of approximately $314.7 million, or $8.76 per share, which includes transaction costs.

 

Pending Physiotherapy Acquisition

 

On January 25, 2016, Select Medical announced that its wholly owned subsidiary, Select Medical Corporation, has entered into a Merger Agreement to acquire Physiotherapy Associates Holdings, Inc. for $400.0 million in cash, subject to certain adjustments in accordance with the terms set forth in the Merger Agreement. The transaction, which is expected to close in the first half of 2016, is subject to a number of closing conditions.

 

Business Outlook

 

Select Medical reaffirms its prior business outlook, provided most recently in its January 11, 2016 press release, for net operating revenues, Adjusted EBITDA and fully diluted income per common share. Select Medical continues to expect consolidated net operating revenues for the full year 2016 to be in the range of $4.0 billion to $4.2 billion. Select Medical continues to expect Adjusted EBITDA for the full year 2016 to be in the range of $470 million to $510 million. Select Medical continues to expect fully diluted income per common share for the full year 2016 to be in the range of $0.72 to $0.91.

 

This business outlook does not take into consideration the pending acquisition of Physiotherapy described above.

 

Conference Call

 

Select Medical will host a conference call regarding its fourth quarter and full year ended December 31, 2015 results, as well as its business outlook, on Friday, February 26, 2016, at 9:00am EST. The domestic dial in number for the call is 1-877-703-6105. The international dial in number is 1-857-244-7304. The passcode for the call is 67220955. The conference call will be webcast simultaneously and can be accessed at Select Medical Holdings Corporation’s website www.selectmedicalholdings.com.

 

For those unable to participate in the conference call, a replay will be available until 11:59pm EST, March 4, 2016. The replay number is 1-888-286-8010 (domestic) or 1-617-801-6888 (international). The passcode for the replay will be 63449153. The replay can also be accessed at Select Medical Holdings Corporation’s website, www.selectmedicalholdings.com.

 

*   *   *   *   *

 



 

Select Medical began operations in 1997 and has grown to be one of the largest operators of specialty hospitals and outpatient rehabilitation clinics in the United States based on number of facilities.  As of December 31, 2015, Select Medical operated 109 long term acute care hospitals and 18 acute medical rehabilitation hospitals in 28 states, and 1,038 outpatient rehabilitation clinics in 31 states and the District of Columbia.  Select Medical’s subsidiary, Concentra, provides occupational health, consumer health, physical therapy, and veteran’s healthcare services throughout the United States.  As of December 31, 2015, Concentra operated 300 centers in 38 states.  Concentra also provides contract services at employer worksites and Department of Veterans Affairs community-based outpatient clinics.  Select Medical’s contract therapy business provides medical rehabilitation services on a contracted basis to nursing homes, hospitals, assisted living and senior care centers, schools, and work sites.  As of December 31, 2015, Select Medical had operations in 46 states and the District of Columbia.  Information about Select Medical is available at www.selectmedical.com.

 

Certain statements contained herein that are not descriptions of historical facts are “forward-looking” statements (as such term is defined in the Private Securities Litigation Reform Act of 1995).  Because such statements include risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements due to factors including the following:

 

·                       changes in government reimbursement for our services due to the implementation of healthcare reform legislation, deficit reduction measures, and/or new payment policies (including, for example, the expiration of the moratorium limiting the full application of the 25 Percent Rule that would reduce our Medicare payments for those patients admitted to a long term acute care hospital from a referring hospital in excess of an applicable percentage admissions threshold) may result in a reduction in net operating revenues, an increase in costs and a reduction in profitability;

 

·                       the impact of the Bipartisan Budget Act of 2013, which establishes new payment limits for Medicare patients who do not meet specified criteria, may result in a reduction in net operating revenues and profitability of our long term acute care hospitals;

 

·                    the failure of our specialty hospitals to maintain their Medicare certifications may cause our net operating revenues and profitability to decline;

 

·                    the failure of our facilities operated as “hospitals within hospitals” to qualify as hospitals separate from their host hospitals may cause our net operating revenues and profitability to decline;

 

·                    a government investigation or assertion that we have violated applicable regulations may result in sanctions or reputational harm and increased costs;

 

·                    acquisitions or joint ventures may prove difficult or unsuccessful, use significant resources or expose us to unforeseen liabilities;

 

·                    our plans and expectations related to the Concentra acquisition, including expectations regarding the expected capital expenditures related to the acquisition, and our ability to realize anticipated synergies;

 

·                    private third-party payors for our services may undertake future cost containment initiatives that could limit our future net operating revenues and profitability;

 

·                    the failure to maintain established relationships with the physicians in the areas we serve could reduce our net operating revenues and profitability;

 

·                    shortages in qualified nurses, therapists, physicians, or other licensed providers could increase our operating costs significantly or limit our ability to staff our facilities;

 



 

·                    competition may limit our ability to grow and result in a decrease in our net operating revenues and profitability;

 

·                    the loss of key members of our management team could significantly disrupt our operations;

 

·                    the effect of claims asserted against us could subject us to substantial uninsured liabilities; and

 

·                    other factors discussed from time to time in our filings with the Securities and Exchange Commission (“SEC”), including factors discussed under the heading “Risk Factors” of our quarterly report on Form 10-Q and of the annual report on Form 10-K.

 

Except as required by applicable law, including the securities laws of the United States and the rules and regulations of the SEC, we are under no obligation to publicly update or revise any forward-looking statements, whether as a result of any new information, future events or otherwise. You should not place undue reliance on our forward-looking statements. Although we believe that the expectations reflected in forward-looking statements are reasonable, we cannot guarantee future results or performance.

 

Investor inquiries:

Joel T. Veit

Senior Vice President and Treasurer

717-972-1100

ir@selectmedical.com

 

SOURCE: Select Medical Holdings Corporation

 



 

I.  Condensed Consolidated Statements of Operations

 

For the Three Months Ended December 31, 2014 and 2015

(In thousands, except per share amounts, unaudited)

 

 

 

2014

 

2015

 

% Change

 

 

 

 

 

 

 

 

 

Net operating revenues

 

$

771,608

 

$

1,039,205

 

34.7

%

 

 

 

 

 

 

 

 

Costs and expenses:

 

 

 

 

 

 

 

Cost of services

 

656,303

 

902,328

 

37.5

%

General and administrative

 

28,028

 

24,135

 

(13.9

)%

Bad debt expense

 

12,110

 

16,129

 

33.2

%

Depreciation and amortization

 

17,345

 

34,313

 

97.8

%

 

 

 

 

 

 

 

 

Income from operations

 

57,822

 

62,300

 

7.7

%

 

 

 

 

 

 

 

 

Equity in earnings of unconsolidated subsidiaries

 

2,909

 

4,023

 

38.3

%

Interest expense

 

(21,414

)

(33,088

)

54.5

%

 

 

 

 

 

 

 

 

Income before income taxes

 

39,317

 

33,235

 

(15.5

)%

 

 

 

 

 

 

 

 

Income tax expense

 

11,799

 

7,388

 

(37.4

)%

 

 

 

 

 

 

 

 

Net income

 

27,518

 

25,847

 

(6.1

)%

 

 

 

 

 

 

 

 

Less: Net income (loss) attributable to non- controlling interests

 

1,806

 

(3,480

)

N/M

 

 

 

 

 

 

 

 

 

Net income attributable to Select Medical Holdings Corporation

 

$

25,712

 

$

29,327

 

14.1

%

 

 

 

 

 

 

 

 

Weighted average shares outstanding(1):

 

 

 

 

 

 

 

Basic

 

127,007

 

127,292

 

 

 

Diluted

 

127,358

 

127,464

 

 

 

 

 

 

 

 

 

 

 

Income per common share(1):

 

 

 

 

 

 

 

Basic

 

$

0.20

 

$

0.22

 

 

 

Diluted

 

$

0.20

 

$

0.22

 

 

 

 

 

 

 

 

 

 

 

Dividends per share

 

$

0.10

 

 

 

 

 


N/M — Not Meaningful

 

(1)         Under the two-class method for calculating income per common share, unvested restricted stock is a separate, participating class.  Income per common share and weighted average common shares outstanding exclude amounts attributed to the unvested restricted class of stockholders.  Net income allocated to the unvested restricted stockholders was $0.9 million and $0.8 million for the three months ended December 31, 2015 and 2014, respectively.  Unvested restricted weighted average shares were 4,021 thousand and 4,069 thousand for the three months ended December 31, 2015 and 2014, respectively.

 



 

II.  Condensed Consolidated Statements of Operations

 

For the Years Ended December 31, 2014 and 2015

(In thousands, except per share amounts, unaudited)

 

 

 

2014

 

2015

 

% Change

 

 

 

 

 

 

 

 

 

Net operating revenues

 

$

3,065,017

 

$

3,742,736

 

22.1

%

 

 

 

 

 

 

 

 

Costs and expenses:

 

 

 

 

 

 

 

Cost of services

 

2,582,340

 

3,211,541

 

24.4

%

General and administrative

 

85,247

 

92,052

 

8.0

%

Bad debt expense

 

44,600

 

59,372

 

33.1

%

Depreciation and amortization

 

68,354

 

104,981

 

53.6

%

 

 

 

 

 

 

 

 

Income from operations

 

284,476

 

274,790

 

(3.4

)%

 

 

 

 

 

 

 

 

Loss on early retirement of debt

 

(2,277

)

 

N/M

 

Equity in earnings of unconsolidated subsidiaries

 

7,044

 

16,811

 

138.7

%

Gain on sale of equity investment

 

 

29,647

 

N/M

 

Interest expense

 

(85,446

)

(112,816

)

32.0

%

 

 

 

 

 

 

 

 

Income before income taxes

 

203,797

 

208,432

 

2.3

%

 

 

 

 

 

 

 

 

Income tax expense

 

75,622

 

72,436

 

(4.2

)%

 

 

 

 

 

 

 

 

Net income

 

128,175

 

135,996

 

6.1

%

 

 

 

 

 

 

 

 

Less: Net income attributable to non- controlling interests

 

7,548

 

5,260

 

(30.3

)%

 

 

 

 

 

 

 

 

Net income attributable to Select Medical Holdings Corporation

 

$

120,627

 

$

130,736

 

8.4

%

 

 

 

 

 

 

 

 

Weighted average shares outstanding(1):

 

 

 

 

 

 

 

Basic

 

129,026

 

127,478

 

 

 

Diluted

 

129,465

 

127,752

 

 

 

 

 

 

 

 

 

 

 

Income per common share(1):

 

 

 

 

 

 

 

Basic

 

$

0.91

 

$

1.00

 

 

 

Diluted

 

$

0.91

 

$

0.99

 

 

 

 

 

 

 

 

 

 

 

Dividends per share

 

$

0.40

 

$

0.10

 

 

 

 


N/M = Not Meaningful

 

(1)         Under the two-class method for calculating income per common share, unvested restricted stock is a separate, participating class.  Income per common share and weighted average common shares outstanding exclude amounts attributed to the unvested restricted class of stockholders.  Net income allocated to the unvested restricted stockholders was $3.8 million and $3.3 million for the years ended December 31, 2015 and 2014, respectively.  Unvested restricted weighted average shares were 3,847 thousand and 3,671 thousand for the years ended December 31, 2015 and 2014, respectively.

 



 

III.  Condensed Consolidated Balance Sheets

(In thousands, unaudited)

 

 

 

December 31, 2014

 

December 31, 2015

 

Assets

 

 

 

 

 

 

 

 

 

 

 

Cash

 

$

3,354

 

$

14,435

 

 

 

 

 

 

 

Accounts receivable, net

 

444,269

 

603,558

 

 

 

 

 

 

 

Current deferred tax asset

 

15,991

 

28,688

 

 

 

 

 

 

 

Other current assets

 

64,030

 

102,473

 

 

 

 

 

 

 

Total Current Assets

 

527,644

 

749,154

 

 

 

 

 

 

 

Property and equipment, net

 

542,310

 

864,124

 

 

 

 

 

 

 

Goodwill

 

1,642,083

 

2,314,624

 

 

 

 

 

 

 

Other identifiable intangibles

 

72,519

 

318,675

 

 

 

 

 

 

 

Other assets

 

140,253

 

180,089

 

 

 

 

 

 

 

Total Assets

 

$

2,924,809

 

$

4,426,666

 

 

 

 

 

 

 

Liabilities and Equity

 

 

 

 

 

 

 

 

 

 

 

Payables and accruals

 

$

383,550

 

$

504,119

 

 

 

 

 

 

 

Current portion of long-term debt

 

10,874

 

233,570

 

 

 

 

 

 

 

Total Current Liabilities

 

394,424

 

737,689

 

 

 

 

 

 

 

Long-term debt, net of current portion

 

1,542,102

 

2,190,314

 

 

 

 

 

 

 

Non-current deferred tax liability

 

109,203

 

218,705

 

 

 

 

 

 

 

Other non-current liabilities

 

92,855

 

133,220

 

 

 

 

 

 

 

Total Liabilities

 

2,138,584

 

3,279,928

 

 

 

 

 

 

 

Redeemable non-controlling interests

 

10,985

 

238,221

 

 

 

 

 

 

 

Total equity

 

775,240

 

908,517

 

 

 

 

 

 

 

Total Liabilities and Equity

 

$

2,924,809

 

$

4,426,666

 

 



 

IV.  Condensed Consolidated Statement of Cash Flows

For the Three Months Ended December 31, 2014 and 2015

(In thousands, unaudited)

 

 

 

2014

 

2015

 

Operating Activities

 

 

 

 

 

Net Income

 

$

27,518

 

$

25,847

 

Adjustments to reconcile net income to net cash provided by operating activities:

 

 

 

 

 

Distributions from unconsolidated subsidiaries

 

15

 

2,155

 

Depreciation and amortization

 

17,345

 

34,313

 

Provision for bad debts

 

12,110

 

16,129

 

Equity in earnings of unconsolidated subsidiaries

 

(2,909

)

(4,023

)

Loss on sale of assets and businesses

 

188

 

166

 

Stock compensation expense

 

3,795

 

5,741

 

Amortization of debt discount, premium and issuance costs

 

1,902

 

2,797

 

Deferred income taxes

 

11,467

 

4,867

 

Changes in operating assets and liabilities, net of effects from acquisition of businesses:

 

 

 

 

 

Accounts receivable

 

(44,878

)

(43,794

)

Other current assets

 

(2,220

)

2,077

 

Other assets

 

2,164

 

173

 

Accounts payable

 

3,721

 

(702

)

Accrued expenses

 

(11,819

)

(40,762

)

Net cash provided by operating activities

 

18,399

 

4,984

 

 

 

 

 

 

 

Investing activities

 

 

 

 

 

Purchases of property and equipment

 

(21,896

)

(68,650

)

Proceeds from sale of assets

 

 

225

 

Investment in businesses

 

(1,499

)

(644

)

Acquisition of businesses, net of cash acquired

 

 

(11,756

)

Net cash used in investing activities

 

(23,395

)

(80,825

)

 

 

 

 

 

 

Financing activities

 

 

 

 

 

Borrowings on revolving facilities

 

235,000

 

295,000

 

Payments on revolving facilities

 

(215,000

)

(220,000

)

Payments on term loans

 

 

(1,125

)

Borrowings of other debt

 

2,040

 

2,333

 

Principal payments on other debt

 

(2,977

)

(6,094

)

Proceeds from (repayment of) bank overdrafts

 

(1,064

)

4,516

 

Dividends paid to common stockholders

 

(13,109

)

 

Repurchase of common stock

 

(1,677

)

(2,205

)

Proceeds from issuance of common stock

 

1,810

 

45

 

Tax benefit from stock based awards

 

3,119

 

1,463

 

Purchase of non-controlling interests

 

(9,961

)

(1,095

)

Distributions to non-controlling interests

 

(860

)

(5,197

)

Net cash provided by (used in) financing activities

 

(2,679

)

67,641

 

 

 

 

 

 

 

Net decrease in cash and cash equivalents

 

(7,675

)

(8,200

)

 

 

 

 

 

 

Cash and cash equivalents at beginning of period

 

11,029

 

22,635

 

Cash and cash equivalents at end of period

 

$

3,354

 

$

14,435

 

 

 

 

 

 

 

Supplemental Cash Flow Information

 

 

 

 

 

Cash paid for interest

 

$

31,030

 

$

43,229

 

Cash paid for taxes

 

$

12,587

 

$

23,515

 

 



 

V.  Condensed Consolidated Statement of Cash Flows

For the Years Ended December 31, 2014 and 2015

(In thousands, unaudited)

 

 

 

2014

 

2015

 

Operating Activities

 

 

 

 

 

Net Income

 

$

128,175

 

$

135,996

 

Adjustments to reconcile net income to net cash provided by operating activities:

 

 

 

 

 

Distributions from unconsolidated subsidiaries

 

11,954

 

13,969

 

Depreciation and amortization

 

68,354

 

104,981

 

Provision for bad debts

 

44,600

 

59,372

 

Equity in earnings of unconsolidated subsidiaries

 

(7,044

)

(16,811

)

Gain on sale of assets and businesses

 

(1,048

)

(1,098

)

Gain on sale of equity investment

 

 

(29,647

)

Loss on early retirement of debt

 

2,277

 

 

Stock compensation expense

 

11,186

 

14,985

 

Amortization of debt discount, premium, and issuance costs

 

7,553

 

9,543

 

Deferred income taxes

 

14,311

 

(2,058

)

Changes in operating assets and liabilities, net of effects from acquisition of businesses:

 

 

 

 

 

Accounts receivable

 

(97,802

)

(92,572

)

Other current assets

 

(1,729

)

(2,503

)

Other assets

 

(103

)

4,713

 

Accounts payable

 

5,997

 

2,345

 

Accrued expenses

 

(16,039

)

7,200

 

Net cash provided by operating activities

 

170,642

 

208,415

 

 

 

 

 

 

 

Investing activities

 

 

 

 

 

Purchases of property and equipment

 

(95,246

)

(182,642

)

Proceeds from sale of assets

 

 

1,767

 

Investment in businesses

 

(4,634

)

(2,347

)

Proceeds from sale of equity investment

 

 

33,096

 

Acquisition of businesses, net of cash acquired

 

(1,211

)

(1,061,628

)

Net cash used in investing activities

 

(101,091

)

(1,211,754

)

 

 

 

 

 

 

Financing activities

 

 

 

 

 

Borrowings on revolving facilities

 

910,000

 

1,135,000

 

Payments on revolving facilities

 

(870,000

)

(895,000

)

Proceeds from term loans, net of discounts

 

 

646,875

 

Payments on term loans

 

(33,994

)

(29,134

)

Issuance of 6.375% senior notes, includes premium

 

111,650

 

 

Borrowings of other debt

 

9,076

 

13,374

 

Principal payments on other debt

 

(14,673

)

(18,136

)

Proceeds from bank overdrafts

 

9,240

 

6,869

 

Debt issuance costs

 

(4,434

)

(23,300

)

Dividends paid to common stockholders

 

(53,366

)

(13,129

)

Repurchase of common stock

 

(130,734

)

(15,827

)

Proceeds from issuance of common stock

 

7,355

 

1,649

 

Tax benefit from stock based awards

 

3,119

 

1,846

 

Purchase of non-controlling interests

 

(9,961

)

(1,095

)

Proceeds from issuance of non-controlling interests

 

185

 

217,065

 

Distributions to non-controlling interests

 

(3,979

)

(12,637

)

Net cash provided by (used in) financing activities

 

(70,516

)

1,014,420

 

 

 

 

 

 

 

Net increase (decrease) in cash and cash equivalents

 

(965

)

11,081

 

 

 

 

 

 

 

Cash and cash equivalents at beginning of period

 

4,319

 

3,354

 

Cash and cash equivalents at end of period

 

$

3,354

 

$

14,435

 

 

 

 

 

 

 

Supplemental Cash Flow Information

 

 

 

 

 

Cash paid for interest

 

$

78,812

 

$

103,166

 

Cash paid for taxes

 

$

77,771

 

$

79,420

 

 



 

VI.  Key Statistics

For the Three Months Ended December 31, 2014 and 2015

(unaudited)

 

 

 

2014

 

2015

 

% Change

 

Specialty Hospitals

 

 

 

 

 

 

 

Number of hospitals — end of period:

 

 

 

 

 

 

 

Long term acute care hospitals (a)

 

113

 

109

 

 

 

Rehabilitation hospitals (a)

 

16

 

18

 

 

 

Total specialty hospitals

 

129

 

127

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues (,000)

 

$

566,106

 

$

593,336

 

4.8

%

 

 

 

 

 

 

 

 

Number of patient days (b)

 

336,457

 

339,614

 

0.9

%

 

 

 

 

 

 

 

 

Number of admissions (b)

 

14,057

 

14,218

 

1.1

%

 

 

 

 

 

 

 

 

Net revenue per patient day (b)(c)

 

$

1,546

 

$

1,588

 

2.7

%

 

 

 

 

 

 

 

 

Adjusted EBITDA (,000)

 

$

79,999

 

$

86,048

 

7.6

%

 

 

 

 

 

 

 

 

Adjusted EBITDA margin

 

14.1

%

14.5

%

 

 

 

 

 

 

 

 

 

 

Outpatient Rehabilitation

 

 

 

 

 

 

 

Number of clinics — end of period (d)

 

1,023

 

1,038

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues (,000)

 

$

205,029

 

$

206,178

 

0.6

%

 

 

 

 

 

 

 

 

Number of visits (e)

 

1,266,220

 

1,339,123

 

5.8

%

 

 

 

 

 

 

 

 

Revenue per visit (e)(f)

 

$

103

 

$

103

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA (,000)

 

$

23,151

 

$

23,558

 

1.8

%

 

 

 

 

 

 

 

 

Adjusted EBITDA margin

 

11.3

%

11.4

%

 

 

 

 

 

 

 

 

 

 

Concentra

 

 

 

 

 

 

 

Number of centers — end of period (g)

 

 

 

300

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues (,000)

 

 

 

$

239,424

 

 

 

 

 

 

 

 

 

 

 

Number of visits (g)

 

 

 

1,782,647

 

 

 

 

 

 

 

 

 

 

 

Revenue per visit (g)(h)

 

 

 

$

115

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA (,000)

 

 

 

$

11,518

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA margin

 

 

 

4.8

%

 

 

 


(a)         Includes managed hospitals.

(b)         Excludes managed hospitals.

(c)          Net revenue per patient day is calculated by dividing specialty hospital direct patient service revenue by the total number of patient days.

(d)         Includes managed clinics.

(e)          Excludes managed clinics.

(f)           Net revenue per visit is calculated by dividing outpatient rehabilitation clinic direct patient service revenue by the total number of visits.  For purposes of this computation, outpatient rehabilitation clinic direct patient service revenue does not include managed clinics or contract therapy revenue.

(g)          Excludes onsite clinics and community-based outpatient clinics.

(h)         Net revenue per visit is calculated by dividing center direct patient service revenue by the total number of center visits. 

 



 

VII.  Key Statistics

For the Years Ended December 31, 2014 and 2015

(unaudited)

 

 

 

2014

 

2015

 

% Change

 

Specialty Hospitals

 

 

 

 

 

 

 

Number of hospitals — end of period:

 

 

 

 

 

 

 

Long term acute care hospitals (a)

 

113

 

109

 

 

 

Rehabilitation hospitals (a)

 

16

 

18

 

 

 

Total specialty hospitals

 

129

 

127

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues (,000)

 

$

2,244,899

 

$

2,346,781

 

4.5

%

 

 

 

 

 

 

 

 

Number of patient days (b)

 

1,340,506

 

1,373,780

 

2.5

%

 

 

 

 

 

 

 

 

Number of admissions (b)

 

55,581

 

56,570

 

1.8

%

 

 

 

 

 

 

 

 

Net revenue per patient day (b)(c)

 

$

1,546

 

$

1,569

 

1.5

%

 

 

 

 

 

 

 

 

Adjusted EBITDA (,000)

 

$

341,787

 

$

327,623

 

(4.1

)%

 

 

 

 

 

 

 

 

Adjusted EBITDA margin

 

15.2

%

14.0

%

 

 

 

 

 

 

 

 

 

 

Outpatient Rehabilitation

 

 

 

 

 

 

 

Number of clinics — end of period: (d)

 

1,023

 

1,038

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues (,000)

 

$

819,397

 

$

810,009

 

(1.1

)%

 

 

 

 

 

 

 

 

Number of visits (e)

 

4,970,724

 

5,218,532

 

5.0

%

 

 

 

 

 

 

 

 

Revenue per visit (e)(f)

 

$

103

 

$

103

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA (,000)

 

$

97,584

 

$

98,220

 

0.7

%

 

 

 

 

 

 

 

 

Adjusted EBITDA margin

 

11.9

%

12.1

%

 

 

 

 

 

 

 

 

 

 

Concentra

 

 

 

 

 

 

 

Number of centers — end of period (g)

 

 

 

300

 

 

 

 

 

 

 

 

 

 

 

Net operating revenues (,000)

 

 

 

$

585,222

 

 

 

 

 

 

 

 

 

 

 

Number of visits (g)

 

 

 

4,436,977

 

 

 

 

 

 

 

 

 

 

 

Revenue per visit (g)(h)

 

 

 

$

114

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA (,000)

 

 

 

$

48,301

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA margin

 

 

 

8.3

%

 

 

 


(a)         Includes managed hospitals.

(b)         Excludes managed hospitals.

(c)          Net revenue per patient day is calculated by dividing specialty hospital direct patient service revenue by the total number of patient days.

(d)         Includes managed clinics.

(e)          Excludes managed clinics.

(f)           Net revenue per visit is calculated by dividing outpatient rehabilitation clinic direct patient service revenue by the total number of visits.  For purposes of this computation, outpatient rehabilitation clinic direct patient service revenue does not include managed clinics or contract therapy revenue.

(g)          Excludes onsite clinics and community-based outpatient clinics.

(h)         Net revenue per visit is calculated by dividing center direct patient service revenue by the total number of center visits. 

 



 

VIII.  Net Income to Adjusted EBITDA Reconciliation

For the Three Months and Years Ended December 31, 2014 and 2015

(In thousands, unaudited)

 

The following table reconciles net income to Adjusted EBITDA for Select Medical.  Adjusted EBITDA is used by Select Medical to report its segment performance.  Adjusted EBITDA is defined as net income before interest, income taxes, depreciation and amortization, gain (loss) on early retirement of debt, stock compensation expense, Concentra acquisition costs, equity in earnings (losses) of unconsolidated subsidiaries, and gain on sale of equity investment. The Company believes that the presentation of Adjusted EBITDA is important to investors because Adjusted EBITDA is commonly used as an analytical indicator of performance by investors within the healthcare industry.  Adjusted EBITDA is used by management to evaluate financial performance and determine resource allocation for each of its operating units.

 

Adjusted EBITDA is not a measure of financial performance under generally accepted accounting principles.  Items excluded from Adjusted EBITDA are significant components in understanding and assessing financial performance.  Adjusted EBITDA should not be considered in isolation or as an alternative to, or substitute for, net income, cash flows generated by operations, investing or financing activities, or other financial statement data presented in the consolidated financial statements as indicators of financial performance or liquidity.  Because Adjusted EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, Adjusted EBITDA as presented may not be comparable to other similarly titled measures of other companies.

 

 

 

Three Months Ended
December 31,

 

Year Ended
December 31,

 

 

 

2014

 

2015

 

2014

 

2015

 

Net income

 

$

27,518

 

$

25,847

 

$

128,175

 

$

135,996

 

Income tax expense

 

11,799

 

7,388

 

75,622

 

72,436

 

Loss on early retirement of debt

 

 

 

2,277

 

 

Interest expense

 

21,414

 

33,088

 

85,446

 

112,816

 

Equity in earnings of unconsolidated subsidiaries

 

(2,909

)

(4,023

)

(7,044

)

(16,811

)

Gain on sale of equity investment

 

 

 

 

(29,647

)

Stock compensation expense:

 

 

 

 

 

 

 

 

 

Included in general and administrative

 

3,187

 

3,560

 

9,027

 

11,633

 

Included in cost of services

 

536

 

644

 

2,015

 

3,046

 

Depreciation and amortization

 

17,345

 

34,313

 

68,354

 

104,981

 

Concentra acquisition costs

 

 

 

 

4,715

 

Adjusted EBITDA

 

$

78,890

 

$

100,817

 

$

363,872

 

$

399,165

 

 

 

 

 

 

 

 

 

 

 

Specialty hospitals

 

$

79,999

 

$

86,048

 

$

341,787

 

$

327,623

 

Outpatient rehabilitation

 

23,151

 

23,558

 

97,584

 

98,220

 

Concentra

 

 

11,518

 

 

48,301

 

Other (a)

 

(24,260

)

(20,307

)

(75,499

)

(74,979

)

Adjusted EBITDA

 

$

78,890

 

$

100,817

 

$

363,872

 

$

399,165

 

 


(a)         Other primarily includes general and administrative costs.