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      Select Medical Holdings Corporation Announces Results for Fourth Quarter and Year Ended December 31, 2016


      News provided by

      Select Medical Holdings Corporation

      Feb 23, 2017, 15:30 ET

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      MECHANICSBURG, Pa., Feb. 23, 2017 /PRNewswire/ -- Select Medical Holdings Corporation ("Select Medical") (NYSE: SEM) today announced results for its fourth quarter and year ended December 31, 2016.

      For the fourth quarter ended December 31, 2016, net operating revenues increased to $1,046.3 million, compared to $1,039.2 million for the same quarter, prior year.  Income from operations decreased to $55.7 million for the fourth quarter ended December 31, 2016, compared to $62.3 million for the same quarter, prior year. Net income was $20.5 million for the fourth quarter ended December 31, 2016, which includes a pre-tax non-operating gain of $5.6 million. Net income was $25.8 million for the fourth quarter ended December 31, 2015. Earnings excluding interest, income taxes, depreciation and amortization, gain (loss) on early retirement of debt, stock compensation expense, Concentra acquisition costs, Physiotherapy acquisition costs, non-operating gain (loss), and equity in earnings (losses) of unconsolidated subsidiaries ("Adjusted EBITDA") for the fourth quarter ended December 31, 2016 was $97.7 million, compared to $100.8 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, 2016 was $0.15 on a fully diluted basis, compared to $0.22 for the same quarter, prior year. Excluding the non-operating gain and related tax effect, adjusted income per common share was $0.12 per diluted share for the fourth quarter ended December 31, 2016. A reconciliation of income per common share to adjusted income per common share for both the fourth quarters ended December 31, 2016 and 2015 is presented in table IX of this release.  

      For the year ended December 31, 2016, net operating revenues increased 14.5% to $4,286.0 million, compared to $3,742.7 million for the prior year. Income from operations increased 9.1% to $299.8 million for the year ended December 31, 2016, compared to $274.8 million for the prior year. Net income was $125.3 million for the year ended December 31, 2016, which includes a pre-tax non-operating gain of $42.7 million and a pre-tax loss on early retirement on debt of $11.6 million. Net income was $136.0 million for the year ended December 31, 2015, which includes a pre-tax non-operating gain of $29.6 million. Adjusted EBITDA for the year ended December 31, 2016 increased 16.7% to $465.8 million, compared to $399.2 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, 2016 was $0.87 on a fully diluted basis, compared to $0.99 for the prior year. Excluding the non-operating gain, loss of early retirement of debt, and related tax effects, adjusted income per common share was $0.61 per diluted share for the year ended December 31, 2016. Excluding the non-operating gain and related tax effect, adjusted income per common share was $0.85 per diluted share for the year ended December 31, 2015. A reconciliation of income per common share to adjusted income per common share for both the years ended December 31, 2016 and 2015 is presented in table IX of this release.

      Specialty Hospitals Segment

      For the fourth quarter ended December 31, 2016, net operating revenues for the specialty hospitals segment decreased to $560.2 million, compared to $593.3 million for the same quarter, prior year. Adjusted EBITDA for the specialty hospitals segment decreased to $63.8 million for the fourth quarter ended December 31, 2016, compared to $86.0 million for the same quarter, prior year. The Adjusted EBITDA margin for the specialty hospitals segment was 11.4% for the fourth quarter ended December 31, 2016, compared to 14.5% for the same quarter, prior year. The Adjusted EBITDA results for the specialty hospitals segment include start-up losses of approximately $2.4 million for the fourth quarter ended December 31, 2016, compared to $4.9 million for the same quarter, prior year.  Certain specialty hospitals key statistics for both the fourth quarters ended December 31, 2016 and 2015 are presented in table VI of this release.

      For the year ended December 31, 2016, net operating revenues for the specialty hospitals segment decreased to $2,289.5 million, compared to $2,346.8 million for the prior year. Adjusted EBITDA for the specialty hospitals segment decreased to $281.5 million for the year ended December 31, 2016, compared to $327.6 million for the prior year. The Adjusted EBITDA margin for the specialty hospitals segment was 12.3% for the year ended December 31, 2016, compared to 14.0% for the prior year. The Adjusted EBITDA results for the specialty hospitals segment include start-up losses of approximately $21.8 million for the year ended December 31, 2016, compared to $16.8 million for the prior year. Certain specialty hospitals key statistics for both the years ended December 31, 2016 and 2015 are presented in table VII of this release.

      Outpatient Rehabilitation Segment

      The financial results of the outpatient rehabilitation segment include the contract therapy businesses through March 31, 2016 and Physiotherapy Associates Holdings, Inc. ("Physiotherapy") beginning March 4, 2016.

      For the fourth quarter ended December 31, 2016, net operating revenues for the outpatient rehabilitation segment increased 21.1% to $249.7 million, compared to $206.2 million for the same quarter, prior year. Adjusted EBITDA for the outpatient rehabilitation segment increased 30.8% to $30.8 million for the fourth quarter ended December 31, 2016, compared to $23.6 million for the same quarter, prior year. The Adjusted EBITDA margin for the outpatient rehabilitation segment was 12.3% for the fourth quarter ended December 31, 2016, compared to 11.4% for the same quarter, prior year. Certain outpatient rehabilitation key statistics for both the fourth quarters ended December 31, 2016 and 2015 are presented in table VI of this release.

      For the year ended December 31, 2016, net operating revenues for the outpatient rehabilitation segment increased 22.9% to $995.4 million, compared to $810.0 million for the prior year. Adjusted EBITDA for the outpatient rehabilitation segment increased 32.2% to $129.8 million for the year ended December 31, 2016, compared to $98.2 million for the prior year. The Adjusted EBITDA margin for the outpatient rehabilitation segment was 13.0% for the year ended December 31, 2016, compared to 12.1% for the prior year. Certain outpatient rehabilitation key statistics for both the years ended December 31, 2016 and 2015 are presented in table VII of this release. 

      Concentra Segment

      The financial results of Concentra, which is operated through a joint venture subsidiary, are consolidated with Select Medical's commencing on the acquisition date of June 1, 2015.

      For the fourth quarter ended December 31, 2016, net operating revenues for the Concentra segment decreased to $236.4 million, compared to $239.4 million for the same quarter, prior year.   Adjusted EBITDA for the Concentra segment increased 116.4% to $24.9 million for the fourth quarter ended December 31, 2016, compared to $11.5 million for the same quarter, prior year.  The Adjusted EBITDA margin for the Concentra segment was 10.5% for the fourth quarter ended December 31, 2016, compared to 4.8% for the same quarter, prior year. Certain Concentra key statistics for both the fourth quarters ended December 31, 2016 and 2015 are presented in table VI of this release.

      For the year ended December 31, 2016, net operating revenues for the Concentra segment were $1,000.6 million, compared to $585.2 million for the prior year.  Adjusted EBITDA for the Concentra segment was $143.0 million for the year ended December 31, 2016, compared to $48.3 million for the prior year. The Adjusted EBITDA margin for the Concentra segment was 14.3% for the year ended December 31, 2016, compared to 8.3% for the prior year.  Certain Concentra key statistics for both the years ended December 31, 2016 and 2015 are presented in table VII of this release. 

      Stock Repurchase Program

      Select Medical did not repurchase shares during the year ended December 31, 2016 under its authorized $500.0 million stock repurchase program. The program has been extended until December 31, 2017, and will remain in effect until then, unless further extended or earlier terminated by the board of directors.

      Proposed Refinancing

      As announced on January 27, 2017, Select Medical is in negotiations to refinance its senior secured credit facility.  Select Medical expects that its new senior secured credit facility, which will replace the existing senior secured credit facility, will consist of $1,150.0 million of term loans with an interest rate of LIBOR plus 3.50% subject to a 1.00% LIBOR floor and a $450.0 million revolving credit facility with an interest rate of LIBOR plus 3.25%.  The proposed refinancing is subject to customary terms and conditions, including negotiation and execution of definitive documentation.  Select Medical anticipates that the refinancing, if completed, would close in March of 2017.

      Business Outlook

      Select Medical reaffirms its 2017 business outlook, provided most recently in its January 6, 2017 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 2017 to be in the range of $4.4 billion to $4.6 billion. Select Medical continues to expect Adjusted EBITDA for the full year 2017 to be in the range of $540.0 million to $580.0 million. Select Medical continues to expect fully diluted income per common share for the full year 2017 to be in the range of $0.73 to $0.91. The above business outlook does not take into consideration the effects of the proposed refinancing.

      Conference Call

      Select Medical will host a conference call regarding its fourth quarter and full year ended December 31, 2016 results, as well as its business outlook, on Friday, February 24, 2017, at 9:00am EST. The domestic dial in number for the call is 1-877-430-7741. The international dial in number is 1-615-247-0054. The passcode for the call is 59651514. 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 3, 2017. The replay number is 1-855-859-2056 (domestic) or 1-404-537-3406 (international). The passcode for the replay will be 59651514. 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, outpatient rehabilitation clinics and occupational health centers in the United States based on the number of facilities. As of December 31, 2016, Select Medical operated 103 long term acute care hospitals and 20 acute medical rehabilitation hospitals in 27 states and 1,611 outpatient rehabilitation clinics in 37 states and the District of Columbia. Select Medical's joint venture subsidiary Concentra operated 300 centers in 38 states. Concentra also provides contract services at employer worksites and Department of Veterans Affairs community-based outpatient clinics. At December 31, 2016, 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 established 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 acquisitions of Concentra Inc. and Physiotherapy Associates Holdings, Inc. and our ability to realize anticipated synergies;
      • private third-party payors for our services may adopt payment policies 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 (the "SEC"), including factors discussed under the heading "Risk Factors" of our quarterly reports 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
      [email protected]

      SOURCE: Select Medical Holdings Corporation


       


      I.  Condensed Consolidated Statements of Operations

      For the Three Months Ended December 31, 2015 and 2016

      (In thousands, except per share amounts, unaudited)










      2015


      2016


      % Change








      Net operating revenues


      $    1,039,205


      $    1,046,265


      0.7%








      Costs and expenses:







      Cost of services


      902,328


      909,893


      0.8

      General and administrative


      24,135


      25,701


      6.5

      Bad debt expense


      16,129


      17,502


      8.5

      Depreciation and amortization


      34,313


      37,424


      9.1








      Income from operations


      62,300


      55,745


      (10.5)








      Equity in earnings of unconsolidated subsidiaries


      4,023


      5,477


      36.1

      Non-operating gain


      -


      5,557


             N/M

      Interest expense


      (33,088)


      (42,419)


      28.2








      Income before income taxes


      33,235


      24,360


      (26.7)








      Income tax expense


      7,388


      3,879


      (47.5)








      Net income


      25,847


      20,481


      (20.8)








      Less:  Net income (loss) attributable to non-

           controlling interests


      (3,480)


      309


             N/M








      Net income attributable to Select Medical

            Holdings Corporation


      $        29,327


      $        20,172


      (31.2)%








      Weighted average shares outstanding(1):







           Basic


      127,292


      128,274



           Diluted


      127,464


      128,436










      Income per common share(1):







           Basic


      $0.22


      $0.15



           Diluted


      $0.22


      $0.15




      (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 $0.6 million and $0.9 million for the three months ended December 31, 2016 and 2015, respectively.  Unvested restricted weighted average shares were 4,261 thousand and 4,021 thousand for the three months ended December 31, 2016 and 2015, respectively.


      N/M = Not Meaningful


       

      II.  Condensed Consolidated Statements of Operations

      For the Years Ended December 31, 2015 and 2016

      (In thousands, except per share amounts, unaudited)










      2015


      2016


      % Change








      Net operating revenues


      $   3,742,736


      $    4,286,021


      14.5%








      Costs and expenses:







      Cost of services


      3,211,541


      3,664,843


      14.1

      General and administrative


      92,052


      106,927


      16.2

      Bad debt expense


      59,372


      69,093


      16.4

      Depreciation and amortization


      104,981


      145,311


      38.4








      Income from operations


      274,790


      299,847


      9.1








      Loss on early retirement of debt


      -


      (11,626)


         N/M  

      Equity in earnings of unconsolidated subsidiaries


      16,811


      19,943


      18.6

      Non-operating gain


      29,647


      42,651


         N/M  

      Interest expense


      (112,816)


      (170,081)


      50.8








      Income before income taxes


      208,432


      180,734


      (13.3)








      Income tax expense


      72,436


      55,464


      (23.4)








      Net income


      135,996


      125,270


      (7.9)








      Less:  Net income attributable to non-

           controlling interests


      5,260


      9,859


      87.4








      Net income attributable to Select Medical

            Holdings Corporation


      $      130,736


      115,411


      (11.7)%








      Weighted average shares outstanding(1):







           Basic


      127,478


      127,813



           Diluted


      127,752


      127,968










      Income per common share(1):







           Basic


      $1.00


      $0.88



           Diluted


      $0.99


      $0.87










      Dividends paid per share


      $0.10


      -










      (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 $3.5 million and $3.8 million for the years ended December 31, 2016 and 2015, respectively.  Unvested restricted weighted average shares were 4,022 thousand and 3,847 thousand for the years ended December 31, 2016 and 2015, respectively.

       

      N/M = Not Meaningful


      III.  Condensed Consolidated Balance Sheets

      (In thousands, unaudited)



      December 31,
      2015


      December 31,
      2016

      Assets










      Cash


      $        14,435


      $        99,029






      Accounts receivable, net


      603,558


      573,752






      Current deferred tax asset


      28,688


      45,165






      Other current assets


      102,473


      90,122






      Total Current Assets


      749,154


      808,068






      Property and equipment, net


      864,124


      892,217






      Goodwill


      2,314,624


      2,751,000






      Other identifiable intangibles, net


      318,675


      340,562






      Other assets


      142,101


      152,548






      Total Assets


      $   4,388,678


      $    4,944,395






      Liabilities and Equity










      Payables and accruals


      $      504,119


      $      557,979






      Current portion of long-term debt and notes payable


      225,166


      13,656






      Total Current Liabilities


      729,285


      571,635






      Long-term debt, net of current portion


      2,160,730


      2,685,333






      Non-current deferred tax liability


      218,705


      222,847






      Other non-current liabilities


      133,220


      136,520






      Total Liabilities


      3,241,940


      3,616,335






      Redeemable non-controlling interests


      238,221


      422,159






      Total equity


      908,517


      905,901






      Total Liabilities and Equity


      $   4,388,678


      $   4,944,395

















      IV.  Condensed Consolidated Statements of Cash Flows


      For the Three Months Ended December 31, 2015 and 2016
      (In thousands, unaudited)




      2015


      2016

      Operating activities





      Net income


      $    25,847


      $   20,481

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





      Distributions from unconsolidated subsidiaries


      2,155


      4,331

            Depreciation and amortization


      34,313


      37,424

            Provision for bad debts


      16,129


      17,502

      Equity in earnings of unconsolidated subsidiaries


      (4,023)


      (5,477)

            Loss (gain) on sale of assets and businesses


      166


      (4,578)

      Gain on sale of equity investment


      -


      (2,538)

            Stock compensation expense


      5,741


      4,489

            Amortization of debt discount, premium and issuance costs


      2,797


      3,811

            Deferred income taxes


      4,867


      497

            Changes in operating assets and liabilities, net of effects of business combinations:





      Accounts receivable


      (43,794)


      1,456

      Other current assets


      2,077


      5,356

      Other assets


      173


      4,144

      Accounts payable and accrued expenses


      (41,464)


      (21,056)

      Net cash provided by operating activities


      4,984


      65,842






      Investing activities





      Acquisition of businesses, net of cash acquired


      (11,756)


      (57,975)

      Purchases of property and equipment


      (68,650)


      (43,373)

      Investment in businesses


      (644)


      (1,583)

      Proceeds from sale of equity investment


      -


      2,538

      Proceeds from sale of assets and businesses


      225


      9,075

      Net cash used in investing activities


      (80,825)


      (91,318)






      Financing activities





      Borrowings on revolving facilities


      295,000


      155,000

      Payments on revolving facilities


      (220,000)


      (110,000)

      Payments on term loans


      (1,125)


      (3,192)

      Borrowings of other debt


      2,333


      3,920

      Principal payments on other debt


      (6,094)


      (5,924)

      Proceeds from bank overdrafts


      4,516


      19,210

      Repurchase of common stock


      (2,205)


      (990)

      Proceeds from exercise of stock options


      45


      184

      Tax benefit from stock based awards


      1,463


      -

      Purchase of non-controlling interests


      (1,095)


      (569)

      Distributions to non-controlling interests


      (5,197)


      (1,357)

      Net cash provided by financing activities


      67,641


      56,282






      Net increase (decrease) in cash and cash equivalents


      (8,200)


      30,806






      Cash and cash equivalents at beginning of period


      22,635


      68,223

      Cash and cash equivalents at end of period


      $    14,435


      $     99,029






      Supplemental Information





           Cash paid for interest


      $    43,229


      $     49,712

           Cash paid for taxes


      $    23,515


      $     10,819








       


      V.  Condensed Consolidated Statements of Cash Flows


      For the Years Ended December 31, 2015 and 2016
      (In thousands, unaudited)




      2015


      2016

      Operating activities





      Net income


      $    135,996


      $   125,270

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





      Distributions from unconsolidated subsidiaries


      13,969


      20,476

      Depreciation and amortization


      104,981


      145,311

      Provision for bad debts


      59,372


      69,093

      Equity in earnings of unconsolidated subsidiaries


      (16,811)


      (19,943)

      Loss on early retirement of debt


      -


      11,626

      Gain on sale of assets and businesses


      (1,098)


      (46,488)

      Gain on sale of equity investment


      (29,647)


      (2,779)

      Impairment of equity investment


      -


      5,339

      Stock compensation expense


      14,985


      17,413

      Amortization of debt discount, premium, and issuance costs


      9,543


      15,656

            Deferred income taxes


      (2,058)


      (12,591)

            Changes in operating assets and liabilities, net of effects of business combinations:





      Accounts receivable


      (92,572)


      (39,320)

      Other current assets


      (2,503)


      17,450

      Other assets


      4,713


      9,290

      Accounts payable and accrued expenses


      9,545


      30,800

      Net cash provided by operating activities


      208,415


      346,603






      Investing activities





      Acquisition of businesses, net of cash acquired


      (1,061,628)


      (472,206)

      Purchases of property and equipment


      (182,642)


      (161,633)

      Investment in businesses


      (2,347)


      (4,723)

      Proceeds from sale of equity investment


      33,096


      3,779

      Proceeds from sale of assets and businesses


      1,767


      80,463

      Net cash used in investing activities


      (1,211,754)


      (554,320)






      Financing activities





      Borrowings on revolving facilities


      1,135,000


      575,000

      Payments on revolving facilities


      (895,000)


      (655,000)

      Net proceeds from term loans


      623,575


      795,344

      Payments on term loans


      (29,134)


      (438,034)

      Borrowings of other debt


      13,374


      27,721

      Principal payments on other debt


      (18,136)


      (21,401)

      Proceeds from bank overdrafts


      6,869


      10,746

      Dividends paid to common stockholders


      (13,129)


      -

      Repurchase of common stock


      (15,827)


      (2,929)

      Proceeds from exercise of stock options


      1,649


      1,672

      Tax benefit from stock based awards


      1,846


      -

      Proceeds from issuance of non-controlling interests


      217,065


      11,846

      Purchase of non-controlling interests


      (1,095)


      (2,099)

      Distributions to non-controlling interests


      (12,637)


      (10,555)

      Net cash provided by financing activities


      1,014,420


      292,311






      Net increase in cash and cash equivalents


      11,081


      84,594






      Cash and cash equivalents at beginning of period


      3,354


      14,435

      Cash and cash equivalents at end of period


      $      14,435


      $      99,029






      Supplemental Information





           Cash paid for interest


      $    103,166


      $    142,640

           Cash paid for taxes


      $      79,420


      $      70,756

      VI.  Key Statistics

      For the Three Months Ended December 31, 2015 and 2016

       (unaudited)






      2015


      2016


      % Change

      Specialty Hospitals







      Number of hospitals – end of period:







      Long term acute care hospitals (a)


      109


      103



      Rehabilitation hospitals (a)


      18


      20



      Total specialty hospitals


      127


      123










      Net operating revenues (,000)


      $    593,336


      $    560,221


      (5.6)%








      Number of patient days (b)


      339,614


      306,776


      (9.7)%








      Number of admissions (b)


      14,218


      12,840


      (9.7)%








      Net revenue per patient day (b)(c)


      $        1,588


      $        1,651


      4.0%








      Adjusted EBITDA (,000)


      $      86,048


      $      63,752


      (25.9)%








      Adjusted EBITDA margin


      14.5%


      11.4%










      Outpatient Rehabilitation







      Number of clinics – end of period (d)


      1,038


      1,611










      Net operating revenues (,000)


      $    206,178


      $    249,654


      21.1%








      Number of visits (e)


      1,339,123


      2,047,646


      52.9%








      Revenue per visit (e)(f)


      $           103


      $           102


      (1.0)%








      Adjusted EBITDA (,000)


      $      23,558


      $      30,824


      30.8%








      Adjusted EBITDA margin


      11.4%


      12.3%










      Concentra







      Number of centers – end of period (g)


      300


      300










      Net operating revenues (,000)


      $    239,424


      $    236,372


      (1.3)%








      Number of visits (g)


      1,782,647


      1,731,446


      (2.9)%








      Revenue per visit (g)(h)


      $           115


      $           119


      3.5%








      Adjusted EBITDA (,000)


      $      11,518


      $      24,929


      116.4%








      Adjusted EBITDA margin


      4.8%


      10.5%










      (a)     Includes managed hospitals.

      (b)     Excludes managed hospitals.

      (c)     Net revenue per patient day is calculated by dividing specialty hospitals 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, 2015 and 2016

       (unaudited)






      2015


      2016


      % Change

      Specialty Hospitals







      Number of hospitals – end of period:







      Long term acute care hospitals (a)


      109


      103



      Rehabilitation hospitals (a)


      18


      20



      Total specialty hospitals


      127


      123










      Net operating revenues (,000)


      $  2,346,781


      $  2,289,482


      (2.4)%








      Number of patient days (b)


      1,373,780


      1,258,068


      (8.4)%








      Number of admissions (b)


      56,570


      52,381


      (7.4)%








      Net revenue per patient day (b)(c)


      $         1,569


      $         1,651


      5.2%








      Adjusted EBITDA (,000)


      $     327,623


      $     281,511


      (14.1)%








      Adjusted EBITDA margin


      14.0%


      12.3%










      Outpatient Rehabilitation







      Number of clinics – end of period: (d)


      1,038


      1,611










      Net operating revenues (,000)


      $     810,009


      $     995,374


      22.9%








      Number of visits (e)


      5,218,532


      7,799,208


      49.5%








      Revenue per visit (e)(f)


      $            103


      $            102


      (1.0)%








      Adjusted EBITDA (,000)


      $       98,220


      $     129,830


      32.2%








      Adjusted EBITDA margin


      12.1%


      13.0%










      Concentra







      Number of centers – end of period (g)


      300


      300










      Net operating revenues (,000)


      $     585,222


      $  1,000,624


      N/M








      Number of visits (g)


      4,436,977


      7,373,751


      N/M








      Revenue per visit (g)(h)


      $            114


      $            118


      3.5%








      Adjusted EBITDA (,000)


      $       48,301


      $     143,009


      N/M








      Adjusted EBITDA margin


      8.3%


      14.3%










      (a)     Includes managed hospitals.

      (b)     Excludes managed hospitals.

      (c)     Net revenue per patient day is calculated by dividing specialty hospitals 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. 

      N/M = Not Meaningful









      VIII. Net Income to Adjusted EBITDA Reconciliation

      For the Three Months and Years Ended December 31, 2015 and 2016

      (In thousands, unaudited)


      The presentation of Adjusted EBITDA income (loss) 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 to evaluate financial performance and determine resource allocation for each of Select Medical's operating units. Adjusted EBITDA is not a measure of financial performance under generally accepted accounting principles ("GAAP"). 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, income from operations, 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 GAAP and is thus susceptible to varying calculations, Adjusted EBITDA as presented may not be comparable to other similarly titled measures of other companies.


      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 earnings excluding interest, income taxes, depreciation and amortization, gain (loss) on early retirement of debt, stock compensation expense, Concentra acquisition costs, Physiotherapy acquisition costs, non-operating gain (loss), and equity in earnings (losses) of unconsolidated subsidiaries.

      Non-GAAP Measure Reconciliation


      Three Months Ended

      December 31,


      Year Ended

      December 31,



      2015


      2016


      2015


      2016

      Net income


      $      25,847


      $       20,481


      $    135,996


      $    125,270

      Income tax expense


      7,388


      3,879


      72,436


      55,464

      Interest expense


      33,088


      42,419


      112,816


      170,081

      Non-operating gain


      -


      (5,557)


      (29,647)


      (42,651)

      Equity in earnings of unconsolidated subsidiaries


      (4,023)


      (5,477)


      (16,811)


      (19,943)

      Loss on early retirement of debt


      -


      -


      -


      11,626

      Income from operations


      62,300


      55,745


      274,790


      299,847

      Stock compensation expense:









         Included in general and administrative


      3,560


      3,836


      11,633


      14,607

         Included in cost of services


      644


      653


      3,046


      2,806

      Depreciation and amortization


      34,313


      37,424


      104,981


      145,311

      Physiotherapy acquisition costs


      -


      -


      -


      3,236

      Concentra acquisition costs


      -


      -


      4,715


      -

      Adjusted EBITDA


      $     100,817


      $       97,658


      $   399,165


      $     465,807










      Specialty hospitals


      $       86,048


      $       63,752


      $   327,623


      $      281,511

      Outpatient rehabilitation


      23,558


      30,824


      98,220


      129,830

      Concentra


      11,518


      24,929


      48,301


      143,009

      Other (a)


      (20,307)


      (21,847)


      (74,979)


      (88,543)

      Adjusted EBITDA


      $     100,817


      $       97,658


      $   399,165


      $      465,807










      (a)     Other primarily includes general and administrative costs.

      IX. Reconciliation of Income per Common Share to Adjusted Income per Common Share 

      For the Three Months and Years Ended December 31, 2015 and 2016

      (In thousands, except per share amounts, unaudited)


      Adjusted net income available to common stockholders and adjusted income per common share – diluted shares are not measures of financial performance under GAAP.  Items excluded from adjusted net income available to common stockholders and adjusted income per common share – diluted shares are significant components in understanding and assessing financial performance. The Company believes that the presentation of adjusted net income available to common stockholders and adjusted income per common share – diluted shares is important to investors because it is reflective of the financial performance of our ongoing operations and provides better comparability of our results of operations between periods. Adjusted net income available to common stockholders and adjusted income per common share – diluted shares 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 net income available to common stockholders and adjusted income per common share – diluted shares is not a measurement determined in accordance with GAAP and is thus susceptible to varying calculations, adjusted net income available to common stockholders and adjusted income per common share – diluted shares as presented may not be comparable to other similarly titled measures of other companies. 


      The following table reconciles net income available to common stockholders and income per common share – diluted shares to adjusted net income available to common stockholders and adjusted income per common share – diluted shares for Select Medical.  Adjusted net income available to common stockholders is defined as net income available to common shareholders before non-operating gain (loss) and gain (loss) on early retirement of debt.


      Three Months Ended December 31,


      2015

      Per share (a)


      2016

      Per share (a)

      Net income attributable to Select Medical Holdings Corporation

      $     29,327



      $      20,172


      Earnings allocated to unvested  restricted stockholders

      898



      649


      Net income available to common stockholders

      28,429

      $            0.22


      19,523

      $            0.15







      Adjustments:






         Non-operating gains

      -



      (5,557)


      Estimated income tax expense (b)

      -



      941


      Earnings allocated to unvested restricted stockholders

      -



      148


      Adjusted net income available to common stockholders

      $      28,429

      $             0.22


      $      15,055

      $           0.12

      Adjustment for dilution


      (0.00)



      (0.00)

      Adjusted income per common share – diluted shares


      $             0.22



      $           0.12







      Weighted average common shares outstanding:






          Basic


      127,292



      128,274

          Diluted


      127,464



      128,436







      (a)       Per share amounts for each period presented are basic weighted average common shares outstanding for all amounts except adjusted income per common share - diluted shares, which is based on diluted shares outstanding.

      (b)    Represents the estimated tax expense on the adjustments to net income.

      Refer to Reconciliation of Income per Common Share to Adjusted Income per Common Share for the years ended December 31, 2015 and 2016 on the next page. 


      Year Ended December 31,


      2015

      Per share (a)


      2016

      Per share (a)

      Net income attributable to Select Medical Holdings Corporation

      $     130,736



      $    115,411


      Earnings allocated to unvested restricted stockholders

      3,830



      3,521


      Net income available to common  stockholders

      126,906

      $           1.00


      111,890

      $           0.88







      Adjustments:






         Non-operating gain:






            Gain on sale of contract therapy

      -



      (33,933)


            Other non-operating gains

      (29,647)



      (8,705)


         Loss on early retirement of debt (b)

      -



      6,211


      Estimated income tax expense (c)

      11,419



      1,273


      Earnings allocated to unvested restricted stockholders

      534



      1,072


      Adjusted net income available to common stockholders

      $    109,212

      $            0.86


      $      77,808

      $            0.61

      Adjustment for dilution


      (0.01)



      (0.00)

      Adjusted income per common share – diluted shares


      $            0.85



      $            0.61







      Weighted average common shares outstanding:






          Basic


      127,478



      127,813

          Diluted


      127,752



      127,968


      (a)    Per share amounts for each period presented are basic weighted average common shares outstanding for all amounts except adjusted income per common share - diluted shares, which is based on diluted shares outstanding.

      (b)    Includes the loss on early retirement of Concentra's debt, net of non-controlling interest.

      (c)    Represents the estimated tax expense on the adjustments to net income.

      X.  Net Income to Adjusted EBITDA Reconciliation

      Business Outlook for the Year Ending December 31, 2017

      (In millions, unaudited)


      The following is a reconciliation of full year 2017 Adjusted EBITDA expectations as computed at the low and high points of the range to the closest comparable GAAP financial measure. Refer to table VIII for the definition of Adjusted EBITDA and a discussion of the Company's use of Adjusted EBITDA in evaluating financial performance and determining resource allocation. Each item of expense presented in the table is an estimation of full year 2017 expectations.



      Range

      Non-GAAP Measure Reconciliation


      Low


      High

      Net income


      $                   135


      $                    159

      Income tax expense


      90


      106

      Interest expense


      173


      173

      Equity in earnings of unconsolidated subsidiaries


      (23)


      (23)

      Income from operations


      $                   375


      $                   415

      Stock compensation expense


      15


      15

      Depreciation and amortization


      150


      150

      Adjusted EBITDA


      $                   540


      $                   580






      SOURCE Select Medical Holdings Corporation

      Modal title

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