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      Select Medical Holdings Corporation Announces Results For Its Third Quarter Ended September 30, 2017


      News provided by

      Select Medical Holdings Corporation

      Nov 02, 2017, 16:30 ET

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      MECHANICSBURG, Pa., Nov. 2, 2017 /PRNewswire/ -- Select Medical Holdings Corporation ("Select Medical") (NYSE: SEM) today announced results for its third quarter ended September 30, 2017.

      For the third quarter ended September 30, 2017, net operating revenues increased 4.1% to $1,097.2 million, compared to $1,053.8 million for the same quarter, prior year. Income from operations increased 28.4% to $72.1 million for the third quarter ended September 30, 2017, compared to $56.2 million for the same quarter, prior year. Net income increased to $24.8 million for the third quarter ended September 30, 2017, compared to $4.0 million for the same quarter, prior year. Net income for the third quarter ended September 30, 2016 included a pre-tax loss on early retirement of debt of $10.9 million and a pre-tax non-operating loss of $1.0 million. Adjusted EBITDA increased 18.1% to $115.8 million for the third quarter ended September 30, 2017, compared to $98.1 million for the same quarter, prior year. Income per common share increased to $0.14 on a fully diluted basis for the third quarter ended September 30, 2017, compared to $0.05 for the same quarter, prior year. Excluding the loss on early retirement of debt, non-operating loss, and their related tax effects, adjusted income per common share was $0.06 per diluted share for the third quarter ended September 30, 2016. The definition of Adjusted EBITDA and a reconciliation of net income to Adjusted EBITDA are presented in table VIII of this release. A reconciliation of income per common share to adjusted income per common share is presented in table IX of this release.  

      For the nine months ended September 30, 2017, net operating revenues increased 2.8% to $3,329.2 million, compared to $3,239.8 million for the same period, prior year. Income from operations increased 14.5% to $279.5 million for the nine months ended September 30, 2017, compared to $244.1 million for the same period, prior year. Net income was $99.6 million for the nine months ended September 30, 2017, which includes a pre-tax loss on early retirement of debt of $19.7 million. Net income was $104.8 million for the nine months ended September 30, 2016, which included pre-tax non-operating gains of $37.1 million and pre-tax losses on early retirement of debt of $11.6 million. Adjusted EBITDA increased 12.3% to $413.4 million for the nine months ended September 30, 2017, compared to $368.1 million for the same period, prior year. Income per common share was $0.57 on a fully diluted basis for the nine months ended September 30, 2017, compared to $0.72 for the same period, prior year. Excluding the loss on early retirement of debt and its related tax effects, adjusted income per common share was $0.66 per diluted share for the nine months ended September 30, 2017. Excluding the non-operating gains, losses on early retirement of debt, and their related tax effects, adjusted income per common share was $0.49 per diluted share for the nine months ended September 30, 2016. A reconciliation of net income to Adjusted EBITDA is presented in table VIII of this release. A reconciliation of income per common share to adjusted income per common share is presented in table IX of this release. 

      Specialty Hospitals Segment

      For the third quarter ended September 30, 2017, net operating revenues for the specialty hospitals segment increased 7.5% to $585.3 million, compared to $544.5 million for the same quarter, prior year. Adjusted EBITDA for the specialty hospitals segment increased 43.9% to $69.5 million for the third quarter ended September 30, 2017, compared to $48.3 million for the same quarter, prior year. The Adjusted EBITDA margin for the specialty hospitals segment was 11.9% for the third quarter ended September 30, 2017, compared to 8.9% for the same quarter, prior year. The Adjusted EBITDA results for the specialty hospitals segment include start-up losses of approximately $1.5 million for the third quarter ended September 30, 2017, compared to $9.0 million for the same quarter, prior year. Certain specialty hospitals key statistics for both the third quarters ended September 30, 2017 and 2016 are presented in table VI of this release.

      For the nine months ended September 30, 2017, net operating revenues for the specialty hospitals segment increased 3.2% to $1,785.0 million, compared to $1,729.3 million for the same period, prior year. Adjusted EBITDA for the specialty hospitals segment increased 17.7% to $256.3 million for the nine months ended September 30, 2017, compared to $217.8 million for the same period, prior year. The Adjusted EBITDA margin for the specialty hospitals segment was 14.4% for the nine months ended September 30, 2017, compared to 12.6% for the same period, prior year. The Adjusted EBITDA results for the specialty hospitals segment include start-up losses of approximately $4.7 million for the nine months ended September 30, 2017, compared to $19.4 million for the same period, prior year. Certain specialty hospitals key statistics for both the nine months ended September 30, 2017 and 2016 are presented in table VII of this release.

      Outpatient Rehabilitation Segment

      For the third quarter ended September 30, 2017, net operating revenues for the outpatient rehabilitation segment were $250.5 million, compared to $250.7 million for the same quarter, prior year. For the third quarter ended September 30, 2017, the outpatient rehabilitation segment experienced a decline in visits within areas affected by Hurricanes Harvey and Irma, which caused an estimated $2.9 million decrease in net operating revenues. Adjusted EBITDA for the outpatient rehabilitation segment was $29.3 million for the third quarter ended September 30, 2017, compared to $32.0 million for the same quarter, prior year. The Adjusted EBITDA margin for the outpatient rehabilitation segment was 11.7% for the third quarter ended September 30, 2017, compared to 12.8% for the same quarter, prior year. Certain outpatient rehabilitation key statistics for both the third quarters ended September 30, 2017 and 2016 are presented in table VI of this release.

      For the nine months ended September 30, 2017, net operating revenues for the outpatient rehabilitation segment increased 2.5% to $764.5 million, compared to $745.7 million for the same period, prior year. Adjusted EBITDA for the outpatient rehabilitation segment increased 3.6% to $102.6 million for the nine months ended September 30, 2017, compared to $99.0 million for the same period, prior year. The Adjusted EBITDA margin for the outpatient rehabilitation segment was 13.4% for the nine months ended September 30, 2017, compared to 13.3% for the same period, prior year. The results for the nine months ended September 30, 2016 include the contract therapy businesses through March 31, 2016 and Physiotherapy Associates Holdings, Inc. ("Physiotherapy") beginning March 4, 2016. Certain outpatient rehabilitation key statistics for both the nine months ended September 30, 2017 and 2016 are presented in table VII of this release.

      Concentra Segment

      For the third quarter ended September 30, 2017, net operating revenues for the Concentra segment increased 1.1% to $261.3 million, compared to $258.5 million for the same quarter, prior year.   For the third quarter ended September 30, 2017, the Concentra segment experienced a decline in visits within areas affected by Hurricanes Harvey and Irma, which caused an estimated $1.2 million decrease in net operating revenues. Adjusted EBITDA for the Concentra segment was $40.0 million for the third quarter ended September 30, 2017, compared to $40.9 million for the same quarter, prior year.  The Adjusted EBITDA margin for the Concentra segment was 15.3% for the third quarter ended September 30, 2017, compared to 15.8% for the same quarter, prior year. Certain Concentra key statistics for both the third quarters ended September 30, 2017 and 2016 are presented in table VI of this release.

      For the nine months ended September 30, 2017, net operating revenues for the Concentra segment increased 1.9% to $779.0 million, compared to $764.3 million for the same period, prior year.   Adjusted EBITDA for the Concentra segment increased 6.4% to $125.7 million for the nine months ended September 30, 2017, compared to $118.1 million for the same period, prior year.  The Adjusted EBITDA margin for the Concentra segment was 16.1% for the nine months ended September 30, 2017, compared to 15.5% for the same period, prior year. Certain Concentra key statistics for both the nine months ended September 30, 2017 and 2016 are presented in table VII of this release.

      Stock Repurchase Program

      Select Medical did not repurchase shares during the nine months ended September 30, 2017 under its authorized $500.0 million stock repurchase program. The program has been extended until December 31, 2018, and will remain in effect until then, unless further extended or earlier terminated by the board of directors. Since the inception of the program through September 30, 2017, Select Medical has repurchased 35,924,128 shares at a cost of approximately $314.7 million, or $8.76 per share, which includes transaction costs.

      Pending U.S. HealthWorks Acquisition

      On October 23, 2017, Select Medical announced that Concentra Group Holdings, LLC ("Group Holdings") entered into an Equity Purchase and Contribution Agreement (the "Purchase Agreement") dated October 22, 2017 with Concentra Inc., Concentra Group Holdings Parent, LLC ("Group Holdings Parent"), U.S. HealthWorks, Inc. ("U.S. HealthWorks"), and Dignity Health Holdings Company ("DHHC").  Pursuant to the terms of the Purchase Agreement, Concentra Inc. will acquire the issued and outstanding shares of stock of U.S. HealthWorks, an occupational medicine and urgent care service provider.

      In connection with the closing of the transaction, it is expected that Group Holdings will redeem certain of its outstanding equity interests from existing minority equity holders and subsequently, Group Holdings and a wholly owned subsidiary of Group Holdings Parent will merge, with Group Holdings surviving the merger and becoming a wholly owned subsidiary of Group Holdings Parent. As a result of the merger, the equity interests of Group Holdings outstanding after the redemption described above will be exchanged for membership interests in Group Holdings Parent. 

      The transaction values U.S. HealthWorks at $753.0 million, subject to certain customary adjustments for working capital, cash, debt, transaction expenses and other items in accordance with the terms of the Purchase Agreement. DHHC, a subsidiary of Dignity Health, will be issued a 20% equity interest in Group Holdings Parent, which is valued at $238.0 million. The remainder of the purchase price will be paid in cash.  Select Medical will retain a majority voting interest in Group Holdings Parent following the closing of the transaction.

      Concentra Inc. expects to finance the transaction and related expenses using a proposed $555.0 million senior secured incremental term facility under its existing credit facility and a proposed $240.0 million second lien term facility, for which JP Morgan Chase, N.A. has provided Concentra Inc. with a debt commitment letter.

      The transaction, which is expected to close in the first quarter of 2018, is subject to a number of closing conditions, including clearance under the Hart-Scott-Rodino Antitrust Improvements Act of 1976, as amended.

      Business Outlook

      Select Medical is updating its business outlook following the reporting of its third quarter results. Select Medical now expects for the full year of 2017 consolidated net operating revenues to be in the range of $4.4 billion to $4.5 billion and Adjusted EBITDA for the full year of 2017 to be in the range of $530.0 million to $550.0 million. Select Medical now expects fully diluted income per common share for the full year 2017 to be in the range of $0.72 to $0.82 and fully diluted adjusted income per common share for the full year 2017 to be in the range of $0.81 to $0.91. Fully diluted adjusted income per common share excludes the non-operating loss and loss on early retirement of debt and their related tax effects. 

      Conference Call

      Select Medical will host a conference call regarding its third quarter results, as well as its business outlook, on Friday, November 3, 2017, at 9:00am EDT. The domestic dial in number for the call is 1-877-430-7741. The international dial in number is 1-615-247-0054. The conference ID for the call is 99499558. 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, November 10, 2017. The replay number is 1-855-859-2056 (domestic) or 1-404-537-3406 (international). The passcode for the replay will be 99499558. 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 September 30, 2017, Select Medical operated 101 long term acute care hospitals and 22 acute medical rehabilitation hospitals in 28 states and 1,604 outpatient rehabilitation clinics in 37 states and the District of Columbia. Select Medical's joint venture subsidiary Concentra operated 312 centers in 38 states. Concentra also provides contract services at employer worksites and Department of Veterans Affairs community-based outpatient clinics. At September 30, 2017, 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 pending acquisition of U.S. HealthWorks 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 for the year ended December 31, 2016.

      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 September 30, 2016 and 2017

      (In thousands, except per share amounts, unaudited)










      2016


      2017


      % Change








      Net operating revenues


      $     1,053,795


      $     1,097,166


      4.1%








      Costs and expenses:







      Cost of services


      915,703


      938,910


      2.5

      General and administrative


      27,088


      27,065


      (0.1)

      Bad debt expense


      17,677


      20,321


      15.0

      Depreciation and amortization


      37,165


      38,772


      4.3








      Income from operations


      56,162


      72,098


      28.4








      Loss on early retirement of debt


      (10,853)


      —


      N/M 

      Equity in earnings of unconsolidated subsidiaries


      5,268


      4,431


      (15.9)

      Non-operating loss


      (1,028)


      —


      N/M 

      Interest expense


      (44,482)


      (37,688)


      (15.3)








      Income before income taxes


      5,067


      38,841


      666.5








      Income tax expense


      1,075


      14,017


      1,203.9








      Net income


      3,992


      24,824


      521.8








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


      (2,479)


      6,362


      (356.6)








      Net income attributable to Select Medical 
           
      Holdings Corporation


      $            6,471


      $          18,462


      185.3%








      Weighted average shares outstanding(1):







           Basic


      127,848


      129,142



           Diluted


      127,989


      129,322










      Income per common share(1):







           Basic


      $              0.05


      $             0.14



           Diluted


      $              0.05


      $             0.14










      (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 $0.2 million for the three months ended September 30, 2017 and 
                  2016, respectively. Unvested restricted weighted average shares were 4,395 thousand and 4,270 thousand for the 
                  three months ended September 30, 2017 and 2016, respectively.


      N/M = Not Meaningful

      II.  Condensed Consolidated Statements of Operations

      For the Nine Months Ended September 30, 2016 and 2017

      (In thousands, except per share amounts, unaudited)










      2016


      2017


      % Change








      Net operating revenues


      $      3,239,756


      $      3,329,202


      2.8%








      Costs and expenses:







      Cost of services


      2,754,950


      2,787,497


      1.2

      General and administrative


      81,226


      83,415


      2.7

      Bad debt expense


      51,591


      59,120


      14.6

      Depreciation and amortization


      107,887


      119,644


      10.9








      Income from operations


      244,102


      279,526


      14.5








      Loss on early retirement of debt


      (11,626)


      (19,719)


      N/M

      Equity in earnings of unconsolidated subsidiaries


      14,466


      15,618


      8.0

      Non-operating gain (loss)


      37,094


      (49)


      N/M

      Interest expense


      (127,662)


      (116,196)


      (9.0)








      Income before income taxes


      156,374


      159,180


      1.8








      Income tax expense


      51,585


      59,593


      15.5








      Net income


      104,789


      99,587


      (5.0)








      Less: Net income attributable to 
           non-controlling interests


      9,550


      23,200


      142.9








      Net income attributable to Select Medical 
           
      Holdings Corporation


      $           95,239


      $           76,387


      (19.8)%








      Weighted average shares outstanding(1):







           Basic


      127,659


      128,745



           Diluted


      127,804


      128,916










      Income per common share(1):







           Basic


      $              0.72


      $              0.57



           Diluted


      $              0.72


      $              0.57










      (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 $2.5 million and $2.9 million for the nine months ended September 30, 2017 and 
                  2016, respectively. Unvested restricted weighted average shares were 4,291 thousand and 3,941 thousand for the 
                  nine months ended September 30, 2017 and 2016, respectively.


      N/M = Not Meaningful

      III.  Condensed Consolidated Balance Sheets

      (In thousands, unaudited)



      December 31,
      2016


      September 30,
      2017

      Assets










      Cash


      $                99,029


      $             107,300






      Accounts receivable, net


      573,752


      716,426






      Other current assets


      90,122


      80,324






      Total Current Assets


      762,903


      904,050






      Property and equipment, net


      892,217


      946,063






      Goodwill


      2,751,000


      2,767,896






      Identifiable intangible assets, net


      340,562


      331,036






      Other assets


      173,944


      174,762






      Total Assets


      $            4,920,626


      $           5,123,807






      Liabilities and Equity










      Payables and accruals


      $               557,979


      $             561,976






      Current portion of long-term debt and notes payable


      13,656


      37,560






      Total Current Liabilities


      571,635


      599,536






      Long-term debt, net of current portion


      2,685,333


      2,752,742






      Non-current deferred tax liability


      199,078


      191,441






      Other non-current liabilities


      136,520


      138,118






      Total Liabilities


      3,592,566


      3,681,837






      Redeemable non-controlling interests


      422,159


      621,515






      Total equity


      905,901


      820,455






      Total Liabilities and Equity


      $            4,920,626


      $          5,123,807
















      IV.  Condensed Consolidated Statements of Cash Flows


      For the Three Months Ended September 30, 2016 and 2017


      (In thousands, unaudited)




      2016


      2017

      Operating activities





      Net income


      $         3,992


      $       24,824

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





           Distributions from unconsolidated subsidiaries


      4,106


      3,609

           Depreciation and amortization


      37,165


      38,772

           Provision for bad debts


      17,677


      20,321

           Equity in earnings of unconsolidated subsidiaries


      (5,268)


      (4,431)

           Loss on extinguishment of debt


      10,853


      —

           Loss on sale or disposal of assets and businesses


      1,496


      24

           Gain on sale of equity investment


      (241)


      —

           Stock compensation expense


      4,750


      4,957

           Amortization of debt discount, premium and issuance costs


      4,768


      2,572

           Deferred income taxes


      198


      (4,652)

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





      Accounts receivable


      3,320


      (22,511)

      Other current assets


      1,083


      2,880

      Other assets


      638


      (3,214)

      Accounts payable and accrued expenses


      30,464


      26,739

      Due to third party payors


      11,065


      —

      Income taxes


      (23,543)


      (258)

      Net cash provided by operating activities


      102,523


      89,632






      Investing activities





      Purchases of property and equipment


      (38,002)


      (68,498)

      Investment in businesses


      (1,550)


      (1,500)

      Business combinations, net of cash acquired


      7,288


      (863)

      Proceeds from sale of assets, businesses, and equity investment


      1,263


      3

      Net cash used in investing activities


      (31,001)


      (70,858)






      Financing activities





      Borrowings on revolving facilities


      100,000


      175,000

      Payments on revolving facilities


      (165,000)


      (155,000)

      Proceeds from term loans


      195,217


      —

      Payments on term loans


      (205,193)


      (2,875)

      Borrowings of other debt


      1,719


      18,127

      Principal payments on other debt


      (5,551)


      (4,675)

      Repurchase of common stock


      (1,433)


      (3,003)

      Proceeds from exercise of stock options


      831


      671

      Repayments of overdrafts


      (6,326)


      (15,211)

      Proceeds from issuance of non-controlling interests


      8,743


      5,433

      Purchase of non-controlling interests


      (236)


      —

      Distributions to non-controlling interests


      (4,490)


      (3,740)

      Net cash provided by (used in) financing activities


      (81,719)


      14,727






      Net increase (decrease) in cash and cash equivalents


      (10,197)


      33,501






      Cash and cash equivalents at beginning of period


      78,420


      73,799

      Cash and cash equivalents at end of period


      $        68,223


      $    107,300






      Supplemental Information





           Cash paid for interest


      $        23,613


      $       24,691

           Cash paid for taxes


      $        24,419


      $       18,927


      V.  Condensed Consolidated Statements of Cash Flows


      For the Nine Months Ended September 30, 2016 and 2017


      (In thousands, unaudited)




      2016


      2017

      Operating activities





      Net income


      $     104,789


      $        99,587

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





           Distributions from unconsolidated subsidiaries


      16,145


      14,542

           Depreciation and amortization


      107,887


      119,644

           Provision for bad debts


      51,591


      59,120

           Equity in earnings of unconsolidated subsidiaries


      (14,466)


      (15,618)

           Loss on extinguishment of debt


      11,626


      6,527

           Gain on sale or disposal of assets and businesses


      (41,910)


      (9,499)

           Gain on sale of equity investment


      (241)


      —

           Impairment of equity investment


      5,339


      —

           Stock compensation expense


      12,924


      14,227

           Amortization of debt discount, premium and issuance costs


      11,845


      8,546

           Deferred income taxes


      (13,088)


      (6,126)

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





      Accounts receivable


      (40,776)


      (201,514)

      Other current assets


      12,094


      (2,677)

      Other assets


      5,146


      1,407

      Accounts payable and accrued expenses


      35,244


      22,665

      Due to third party payors


      11,065


      —

      Income taxes


      5,547


      19,141

      Net cash provided by operating activities


      280,761


      129,972






      Investing activities





      Purchases of property and equipment


      (118,260)


      (173,800)

      Investment in businesses


      (3,140)


      (11,374)

      Business combinations, net of cash acquired


      (414,231)


      (19,371)

      Proceeds from sale of assets, businesses, and equity investment


      72,629


      34,555

      Net cash used in investing activities


      (463,002)


      (169,990)






      Financing activities





      Borrowings on revolving facilities


      420,000


      805,000

      Payments on revolving facilities


      (545,000)


      (705,000)

      Proceeds from term loans


      795,344


      1,139,487

      Payments on term loans


      (434,842)


      (1,176,567)

      Debt issuance costs


      —


      (4,392)

      Borrowings of other debt


      23,801


      27,571

      Principal payments on other debt


      (15,477)


      (15,112)

      Repurchase of common stock


      (1,939)


      (3,603)

      Proceeds from exercise of stock options


      1,488


      1,634

      Repayments of overdrafts


      (8,464)


      (20,439)

      Proceeds from issuance of non-controlling interests


      11,846


      8,986

      Purchase of non-controlling interests


      (1,530)


      (120)

      Distributions to non-controlling interests


      (9,198)


      (9,156)

      Net cash provided by financing activities


      236,029


      48,289






      Net increase in cash and cash equivalents


      53,788


      8,271






      Cash and cash equivalents at beginning of period


      14,435


      99,029

      Cash and cash equivalents at end of period


      $       68,223


      $     107,300






      Supplemental Information





           Cash paid for interest


      $       92,928


      $     101,341

           Cash paid for taxes


      $       59,937


      $       46,553







      VI.  Key Statistics

      For the Three Months Ended September 30, 2016 and 2017

      (unaudited)






      2016


      2017


      % Change

      Specialty Hospitals







      Number of hospitals – end of period:







      Long term acute care hospitals (a)


      104


      101



      Rehabilitation hospitals (a)


      19


      22



      Total specialty hospitals


      123


      123










      Net operating revenues (,000)


      $      544,491


      $      585,288


      7.5%








      Number of patient days (b)


      296,202


      316,170


      6.7%








      Number of admissions (b)


      12,586


      13,728


      9.1%








      Net revenue per patient day (b)(c)


      $          1,642


      $          1,676


      2.1%








      Adjusted EBITDA (,000)


      $        48,264


      $        69,454


      43.9%








      Adjusted EBITDA margin


      8.9%


      11.9%










      Outpatient Rehabilitation







      Number of clinics – end of period (d)


      1,603


      1,604










      Net operating revenues (,000)


      $     250,710


      $     250,527


      (0.1)%








      Number of visits (e)


      2,052,678


      1,986,213


      (3.2)%








      Revenue per visit (e)(f)


      $            102


      $            104


      2.0%








      Adjusted EBITDA (,000)


      $       31,995


      $       29,298


      (8.4)%








      Adjusted EBITDA margin


      12.8%


      11.7%










      Concentra







      Number of centers – end of period (g)


      301


      312










      Net operating revenues (,000)


      $     258,507


      $     261,295


      1.1%








      Number of visits (g)


      1,906,242


      1,979,481


      3.8%








      Revenue per visit (g)(h)


      $            119


      $            116


      (2.5)%








      Adjusted EBITDA (,000)


      $       40,888


      $       40,003


      (2.2)%








      Adjusted EBITDA margin


      15.8%


      15.3%










      (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. 

      VII.  Key Statistics

      For the Nine Months Ended September 30, 2016 and 2017

      (unaudited)






      2016


      2017


      % Change

      Specialty Hospitals







      Number of hospitals – end of period:







      Long term acute care hospitals (a)


      104


      101



      Rehabilitation hospitals (a)


      19


      22



      Total specialty hospitals


      123


      123










      Net operating revenues (,000)


      $   1,729,261


      $   1,785,035


      3.2%








      Number of patient days (b)


      951,292


      950,419


      (0.1)%








      Number of admissions (b)


      39,541


      41,314


      4.5%








      Net revenue per patient day (b)(c)


      $          1,651


      $          1,707


      3.4%








      Adjusted EBITDA (,000)


      $      217,759


      $      256,291


      17.7%








      Adjusted EBITDA margin


      12.6%


      14.4%










      Outpatient Rehabilitation







      Number of clinics – end of period (d)


      1,603


      1,604










      Net operating revenues (,000)


      $      745,720


      $     764,450


      2.5%








      Number of visits (e)


      5,751,562


      6,168,763


      7.3%








      Revenue per visit (e)(f)


      $             102


      $            103


      1.0%








      Adjusted EBITDA (,000)


      $        99,006


      $     102,575


      3.6%








      Adjusted EBITDA margin


      13.3%


      13.4%










      Concentra







      Number of centers – end of period (g)


      301


      312










      Net operating revenues (,000)


      $      764,252


      $     779,030


      1.9%








      Number of visits (g)


      5,642,305


      5,848,551


      3.7%








      Revenue per visit (g)(h)


      $             118


      $            117


      (0.8)%








      Adjusted EBITDA (,000)


      $      118,080


      $     125,656


      6.4%








      Adjusted EBITDA margin


      15.5%


      16.1%










      (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. 

      VIII. Net Income to Adjusted EBITDA Reconciliation

      For the Three and Nine Months Ended September 30, 2016 and 2017

      (In thousands, unaudited)


      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
      to evaluate financial performance and determine resource allocation for each of Select Medical's operating
      segments. 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, Physiotherapy acquisition costs, non-operating gain (loss), and equity in earnings (losses) of
      unconsolidated subsidiaries.


      Three Months Ended September 30,


      Nine Months Ended September 30,


      2016


      2017


      2016


      2017

      Net income

      $            3,992


      $          24,824


      $       104,789


      $          99,587

      Income tax expense

      1,075


      14,017


      51,585


      59,593

      Interest expense

      44,482


      37,688


      127,662


      116,196

      Non‑operating loss (gain)

      1,028


      —


      (37,094)


      49

      Equity in earnings of unconsolidated subsidiaries

      (5,268)


      (4,431)


      (14,466)


      (15,618)

      Loss on early retirement of debt

      10,853


      —


      11,626


      19,719

      Income from operations

      56,162


      72,098


      244,102


      279,526

      Stock compensation expense:








      Included in general and administrative

      3,932


      4,079


      10,771


      11,603

      Included in cost of services

      818


      878


      2,153


      2,624

      Depreciation and amortization

      37,165


      38,772


      107,887


      119,644

      Physiotherapy acquisition costs

      —


      —


      3,236


      —

      Adjusted EBITDA

      $          98,077


      $        115,827


      $        368,149


      $        413,397









      Specialty hospitals

      $          48,264


      $          69,454


      $        217,759


      $        256,291

      Outpatient rehabilitation

      31,995


      29,298


      99,006


      102,575

      Concentra

      40,888


      40,003


      118,080


      125,656

      Other (a)

      (23,070)


      (22,928)


      (66,696)


      (71,125)

      Adjusted EBITDA

      $          98,077


      $        115,827


      $        368,149


      $        413,397









      (a)     Other primarily includes general and administrative costs.







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

      For the Three and Nine Months Ended September 30, 2016 and 2017

      (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. Select Medical believes that the presentation of adjusted net
      income available to common stockholders and adjusted income per common share – diluted shares are important to
      investors because they are reflective of the financial performance of our ongoing operations and provide 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 alternatives to, or
      substitutes 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 are not measurements determined in accordance with GAAP and are 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 tables reconcile net income available to common stockholders and income per common
      share 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 September 30,


      2016

      Per share (a)


      2017

      Per share (a)

      Net income attributable to Select Medical Holdings Corporation

      $        6,471



      $      18,462


      Earnings allocated to unvested  restricted stockholders

      (209)



      (608)


      Net income available to common stockholders

      6,262

      $            0.05


      17,854

      $            0.14







      Adjustments:






      Non-operating losses:






      Other non-operating losses

      1,049



      —


      Loss on early retirement of debt (b)

      5,437



      —


      Estimated income tax benefit (c)

      (5,405)



      —


      Earnings allocated to unvested restricted stockholders

      (35)



      —


      Adjusted net income available to common stockholders

      $        7,308

      $           0.06


      $       17,854

      $           0.14

      Adjustment for dilution


      (0.00)



      (0.00)

      Adjusted income per common share – diluted shares


      $           0.06



      $           0.14







      Weighted average common shares outstanding:






          Basic


      127,848



      129,142

          Diluted


      127,989



      129,322







      (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)      For the three months ended September 30, 2016, the loss on early retirement of Concentra's debt is net of non-controlling 
                 interest.

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


      Nine Months Ended September 30,


      2016

      Per share (a)


      2017

      Per share (a)

      Net income attributable to Select Medical Holdings Corporation

      $      95,239



      $       76,387


      Earnings allocated to unvested  restricted stockholders

      (2,852)



      (2,464)


      Net income available to common stockholders

      92,387

      $            0.72


      73,923

      $            0.57







      Adjustments:






      Non-operating losses (gains):






      Gain on sale of contract therapy

      (33,933)



      —


      Other non-operating losses (gains)

      (3,148)



      49


      Loss on early retirement of debt (b)

      6,211



      19,719


      Estimated income tax expense (benefit) (c)

      330



      (7,796)


      Earnings allocated to unvested restricted stockholders

      915



      (385)


      Adjusted net income available to common stockholders

      $      62,762

      $            0.49


      $      85,510

      $            0.66

      Adjustment for dilution


      (0.00)



      (0.00)

      Adjusted income per common share – diluted shares


      $            0.49



      $            0.66







      Weighted average common shares outstanding:






          Basic


      127,659



      128,745

          Diluted


      127,804



      128,916







      (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)       For the nine months ended September 30, 2016, the loss on early retirement of Concentra's debt is net of non-controlling 
                  interest.

      (c)       Represents the estimated tax expense (benefit) 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 Select Medical'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


      $                    124


      $                    136

      Income tax expense


      76


      84

      Interest expense


      155


      155

      Equity in earnings of unconsolidated subsidiaries


      (22)


      (22)

      Loss on early retirement of debt


      20


      20

      Income from operations


      353


      373

      Stock compensation expense


      19


      19

      Depreciation and amortization


      158


      158

      Adjusted EBITDA


      $                    530


      $                    550






      SOURCE Select Medical Holdings Corporation

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