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Select Medical Holdings Corporation Announces Results for Third Quarter Ended September 30, 2016


News provided by

Select Medical Holdings Corporation

Nov 03, 2016, 04:30 ET

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MECHANICSBURG, Pa., Nov. 3, 2016 /PRNewswire/ -- Select Medical Holdings Corporation ("Select Medical") (NYSE: SEM) today announced results for its third quarter ended September 30, 2016.

For the third quarter ended September 30, 2016, net operating revenues increased 3.2% to $1,053.8 million, compared to $1,021.1 million for the same quarter, prior year.  Income from operations increased 16.5% to $56.2 million for the third quarter ended September 30, 2016, compared to $48.2 million for the same quarter, prior year.  Net income was $4.0 million for the third quarter ended September 30, 2016, which includes a pre-tax non-operating loss of $1.0 million and a pre-tax loss on early retirement of debt of $10.9 million. Net income was $32.8 million for the third quarter ended September 30, 2015, which includes a pre-tax non-operating gain of $29.6 million. 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 third quarter ended September 30, 2016 increased 16.1% to $98.1 million, compared to $84.5 million for the same quarter, prior year.  During the third quarter ended September 30, 2016, we incurred Adjusted EBITDA losses for start-up hospitals of approximately $9.0 million. A reconciliation of net income to Adjusted EBITDA is presented in table VIII of this release. Income per common share for the third quarter ended September 30, 2016 was $0.05 on a fully diluted basis, compared to income per common share of $0.22 for the same period, prior year. Excluding the non-operating loss, loss of early retirement of debt, and related tax effects, adjusted income per common share was $0.06 per diluted share for the third quarter ended September 30, 2016. Excluding the non-operating gain and related tax effect, adjusted income per common share was $0.08 per diluted share for the third quarter ended September 30, 2015. A reconciliation of income per common share to adjusted income per common share for both the third quarters ended September 30, 2016 and 2015 is presented in table IX of this release.

For the nine months ended September 30, 2016, net operating revenues increased 19.8% to $3,239.8 million, compared to $2,703.5 million for the same period, prior year.  Income from operations increased 14.9% to $244.1 million for the nine months ended September 30, 2016, compared to $212.5 million for the same period, prior year.  Net income was $104.8 million for the nine months ended September 30, 2016, which includes a pre-tax non-operating gain of $37.1 million and a pre-tax loss on early retirement of debt of $11.6 million. Net income was $110.1 million for the nine months ended September 30, 2015, which includes a pre-tax non-operating gain of $29.6 million. Adjusted EBITDA for the nine months ended September 30, 2016 increased 23.4% to $368.1 million, compared to $298.3 million for the same period, prior year.  During the nine months ended September 30, 2016, we incurred Adjusted EBITDA losses for start-up hospitals of approximately $19.4 million.  A reconciliation of net income to Adjusted EBITDA is presented in table VIII of this release. Income per common share for the nine months ended September 30, 2016 was $0.72 on a fully diluted basis, compared to income per common share of $0.77 for the same period, prior year. Excluding the non-operating gain, loss of early retirement of debt, and related tax effects, adjusted income per common share was $0.49 per diluted share for the nine months ended September 30, 2016. Excluding the non-operating gain and related tax effect, adjusted income per common share was $0.63 per diluted share for the nine months ended September 30, 2015. A reconciliation of income per common share to adjusted income per common share for both the nine months ended September 30, 2016 and 2015 is presented in table IX of this release.  

Specialty Hospitals Segment

For the third quarter ended September 30, 2016, net operating revenues for the specialty hospitals segment decreased to $544.5 million, compared to $562.3 million for the same quarter, prior year. Income from operations for the specialty hospitals segment decreased to $33.9 million for the third quarter ended September 30, 2016, compared to $39.9 million for the same quarter, prior year.  Adjusted EBITDA for the specialty hospitals segment decreased to $48.3 million for the third quarter ended September 30, 2016, compared to $53.7 million for the same quarter, prior year.  The Adjusted EBITDA margin for the segment was 8.9% for the third quarter ended September 30, 2016, compared to 9.5% for the same quarter, prior year.  The Adjusted EBITDA results for the specialty hospitals segment include Adjusted EBITDA losses for start-up hospitals of approximately $9.0 million for the third quarter ended September 30, 2016, compared to $3.1 million for the same quarter, prior year. Certain specialty hospitals key statistics for both the third quarters ended September 30, 2016 and 2015 are presented in table VI of this release.

For the nine months ended September 30, 2016, net operating revenues for the specialty hospitals segment decreased to $1,729.3 million, compared to $1,753.4 million for the same period, prior year. Income from operations for the specialty hospitals segment decreased to $175.7 million for the for nine months ended September 30, 2016, compared to $201.2 million for the same period, prior year. Adjusted EBITDA for the specialty hospitals segment for the nine months ended September 30, 2016 decreased to $217.8 million, compared to $241.6 million for the same period, prior year.  The Adjusted EBITDA margin for the segment was 12.6% for the nine months ended September 30, 2016, compared to 13.8% for the same period, prior year. The Adjusted EBITDA results for the specialty hospitals segment include Adjusted EBITDA losses for start-up hospitals of approximately $19.4 million for the nine months ended September 30, 2016, compared to $11.9 million for the same period, prior year. Certain specialty hospitals key statistics for both the nine months ended September 30, 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 business through March 31, 2016 and Physiotherapy Associates Holdings, Inc. ("Physiotherapy") beginning March 4, 2016.

For the third quarter ended September 30, 2016, net operating revenues for the outpatient rehabilitation segment increased 25.6% to $250.7 million, compared to $199.6 million for the same quarter, prior year.  Income from operations for the outpatient rehabilitation segment increased 25.7% to $25.8 million for the third quarter ended September 30, 2016, compared to $20.6 million for the same quarter, prior year.  Adjusted EBITDA for the segment increased 34.4% to $32.0 million for the third quarter ended September 30, 2016, compared to $23.8 million for the same quarter, prior year.  The Adjusted EBITDA margin for the segment was 12.8% for the third quarter ended September 30, 2016, compared to 11.9% for the same quarter, prior year.  Certain outpatient rehabilitation key statistics for both the third quarters ended September 30, 2016 and 2015 are presented in table VI of this release.

For the nine months ended September 30, 2016, net operating revenues for the outpatient rehabilitation segment increased 23.5% to $745.7 million, compared to $603.8 million for the same period, prior year.  Income from operations for the outpatient rehabilitation segment increased 26.9% to $82.6 million for the nine months ended September 30, 2016, compared to $65.1 million for the same period, prior year.  Adjusted EBITDA for the outpatient rehabilitation segment for the nine months ended September 30, 2016 increased 32.6% to $99.0 million, compared to $74.7 million for the same period, prior year.  The Adjusted EBITDA margin for the segment was 13.3% for the nine months ended September 30, 2016, compared to 12.4% for the same period, prior year.  Certain outpatient rehabilitation key statistics for both the nine months ended September 30, 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 third quarter ended September 30, 2016, net operating revenues for the Concentra segment were $258.5 million, compared to $259.0 million for the same quarter, prior year. Income from operations for the Concentra segment was $25.4 million for the third quarter ended September 30, 2016, compared to $11.5 million for the same quarter, prior year. Adjusted EBITDA for the Concentra segment was $40.9 million for the third quarter ended September 30, 2016, compared to $25.6 million for the same quarter, prior year. The Adjusted EBITDA margin for the Concentra segment was 15.8% for the third quarter ended September 30, 2016, compared to 9.9% for the same quarter, prior year. Certain Concentra key statistics for both the third quarters ended September 30, 2016 and 2015 are presented in table VI of this release.

For the nine months ended September 30, 2016, net operating revenues for the Concentra segment were $764.3 million, compared to $345.8 million for the same period, prior year. Income from operations for the Concentra segment was $71.9 million for the nine months ended September 30, 2016, compared to $13.7 million for the same period, prior year. Adjusted EBITDA for the Concentra segment was $118.1 million for the nine months ended September 30, 2016, compared to $36.8 million for the same period, prior year. The Adjusted EBITDA margin for the Concentra segment was 15.5% for the nine months ended September 30, 2016, compared to 10.6% for the same period, prior year. Certain Concentra key statistics for the nine months ended September 30, 2016 and 2015 are presented in table VII of this release.

Stock Repurchase Program

Select Medical did not repurchase shares during the nine months ended September 30, 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.

Business Outlook

Select Medical is updating its business outlook following reporting its third quarter 2016 financial performance. Select Medical now expects for the full year of 2016 consolidated net operating revenues to be in the range of $4.25 billion to $4.30 billion, Adjusted EBITDA for the full year of 2016 to be in the range of $460.0 million to $480.0 million and fully diluted income per common share for the full year 2016 to be in the range of $0.80 to $0.90.

Select Medical's business outlook has been updated to include the effects of the revised inpatient rehabilitation joint venture hospital openings, the effects of the long term acute care hospital exchange transaction, and long term acute care hospital closures, as well as the expected effective tax rate for the full year.

Conference Call

Select Medical will host a conference call regarding its third quarter results, as well as its business outlook, on Friday, November 4, 2016, 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 95431213. 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 11, 2016. The replay number is 1-855-859-2056 (domestic) or 1-404-537-3406 (international). The conference ID for the replay will be 95431213. 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, 2016, Select Medical operated 104 long term acute care hospitals and 19 acute medical rehabilitation hospitals in 27 states and 1,603 outpatient rehabilitation clinics in 37 states and the District of Columbia.  Select Medical's joint venture subsidiary Concentra operated 301 centers in 38 states. Concentra also provides contract services at employer worksites and Department of Veterans Affairs community-based outpatient clinics. At September 30, 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 establishes new payment limits for Medicare patients who do not meet specified criteria, may result in a reduction in net operating revenues and profitability of our long term acute care hospitals;
  • the failure of our specialty hospitals to maintain their Medicare certifications may cause our net operating revenues and profitability to decline;
  • the failure of our facilities operated as "hospitals within hospitals" to qualify as hospitals separate from their host hospitals may cause our net operating revenues and profitability to decline;
  • a government investigation or assertion that we have violated applicable regulations may result in sanctions or reputational harm and increased costs;
  • acquisitions or joint ventures may prove difficult or unsuccessful, use significant resources or expose us to unforeseen liabilities;
  • our plans and expectations related to the Concentra and Physiotherapy acquisitions and our inability to realize anticipated synergies;
  • private third-party payors for our services may undertake future cost containment initiatives that could limit our future net operating revenues and profitability;
  • the failure to maintain established relationships with the physicians in the areas we serve could reduce our net operating revenues and profitability;
  • shortages in qualified nurses, therapists, physicians, or other licensed providers could increase our operating costs significantly or limit our ability to staff our facilities;
  • competition may limit our ability to grow and result in a decrease in our net operating revenues and profitability;
  • the loss of key members of our management team could significantly disrupt our operations;
  • the effect of claims asserted against us could subject us to substantial uninsured liabilities; and
  • other factors discussed from time to time in our filings with the Securities and Exchange Commission ("SEC"), including factors discussed under the section entitled, "Risk Factors" in our Annual Report on Form 10-K for the year ended December 31, 2015 as such risk factors may be updated from time to time in our periodic filings with the SEC.

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]

I.  Condensed Consolidated Statements of Operations

For the Three Months Ended September 30, 2015 and 2016

(In thousands, except per share amounts, unaudited)










2015


2016


% Change








Net operating revenues


$    1,021,123


$    1,053,795


3.2%








Costs and expenses:







Cost of services


900,949


915,703


1.6

General and administrative


22,201


27,088


22.0

Bad debt expense


18,287


17,677


(3.3)

Depreciation and amortization


31,472


37,165


18.1








Income from operations


48,214


56,162


16.5








Loss on early retirement of debt


-


(10,853)


      N/M

Equity in earnings of unconsolidated subsidiaries


6,348


5,268


(17.0)

Non-operating gain (loss)


29,647


(1,028)


      N/M

Interest expense


(33,052)


(44,482)


34.6








Income before income taxes


51,157


5,067


(90.1)








Income tax expense


18,347


1,075


(94.1)








Net income


32,810


3,992


(87.8)








Less:  Net income (loss) attributable to non-

     controlling interests


3,404


(2,479)


      N/M








Net income attributable to Select Medical

      Holdings Corporation


$         29,406


$          6,471


(78.0)%








Weighted average shares outstanding(1):







     Basic


127,386


127,848



     Diluted


127,649


127,989










Income per common share(1):







     Basic


$             0.22


$             0.05



     Diluted


$             0.22


$             0.05










(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 $0.2 million and $0.9 million for the three months ended September 30, 2016 and 2015, respectively.  Unvested restricted weighted average shares were 4,270 thousand and 4,127 thousand for the three months ended September 30, 2016 and 2015, respectively.


N/M = Not Meaningful

II.  Condensed Consolidated Statements of Operations

For the Nine Months Ended September 30, 2015 and 2016

(In thousands, except per share amounts, unaudited)










2015


2016


% Change








Net operating revenues


$    2,703,531


$    3,239,756


19.8%








Costs and expenses:







Cost of services


2,309,213


2,754,950


19.3

General and administrative


67,917


81,226


19.6

Bad debt expense


43,243


51,591


19.3

Depreciation and amortization


70,668


107,887


52.7








Income from operations


212,490


244,102


14.9








Loss on early retirement of debt


-


(11,626)


N/M

Equity in earnings of unconsolidated subsidiaries


12,788


14,466


13.1

Non-operating gain


29,647


37,094


      N/M

Interest expense


(79,728)


(127,662)


60.1








Income before income taxes


175,197


156,374


(10.7)








Income tax expense


65,048


51,585


(20.7)








Net income


110,149


104,789


(4.9)








Less:  Net income attributable to non-

     controlling interests


8,740


9,550


9.3








Net income attributable to Select Medical

      Holdings Corporation


$       101,409


$         95,239


(6.1)%








Weighted average shares outstanding(1):







     Basic


127,541


127,659



     Diluted


127,844


127,804










Income per common share(1):







     Basic


$             0.77


$             0.72



     Diluted


$             0.77


$             0.72










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 $2.9 million for both the nine months ended September 30, 2016 and 2015.  Unvested restricted weighted average shares were 3,941 thousand and 3,788 thousand for the nine months ended September 30, 2016 and 2015, respectively.


N/M = Not Meaningful

III.  Condensed Consolidated Balance Sheets

(In thousands, unaudited)



December 31,
    2015


September 30,
    2016

Assets










Cash


$               14,435


$           68,223






Accounts receivable, net


603,558


592,711






Current deferred tax asset


28,688


50,647






Prepaid income taxes


16,694


11,474






Other current assets


85,779


82,680






Total Current Assets


749,154


805,735






Property and equipment, net


864,124


863,485






Goodwill


2,314,624


2,674,623






Other identifiable intangibles


318,675


338,220






Other assets


142,101


163,342






Total Assets


$           4,388,678


$       4,845,405






Liabilities and Equity










Payables and accruals


$              504,119


$          537,658






Current portion of long-term debt


225,166


12,690






Total Current Liabilities


729,285


550,348






Long-term debt, net of current portion


2,160,730


2,642,115






Non-current deferred tax liability


218,705


210,000






Other non-current liabilities


133,220


136,527






Total Liabilities


3,241,940


3,538,990






Redeemable non-controlling interests


238,221


246,429






Total equity


908,517


1,059,986






Total Liabilities and Equity


$           4,388,678


$       4,845,405

IV.  Condensed Consolidated Statement of Cash Flows


For the Three Months Ended September 30, 2015 and 2016


(In thousands, unaudited)




2015


2016

Operating activities





Net income


$                  32,810


$                     3,992

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





     Distributions from unconsolidated subsidiaries


11,762


4,106

     Depreciation and amortization


31,472


37,165

     Amortization of leasehold interests


-


162

     Provision for bad debts


18,287


17,677

     Equity in earnings of unconsolidated subsidiaries


(6,348)


(5,268)

     Loss on early retirement of debt


-


10,853

     Loss on disposal of assets


-


227

     Loss (gain) on sale of assets and businesses


(1,515)


1,269

     Gain on sale of equity investment


(29,647)


(241)

     Stock compensation expense


3,450


4,750

     Amortization of debt discount, premium and issuance costs


2,719


4,768

     Deferred income taxes


(2,497)


198

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





Accounts receivable


40,487


3,320

Other current assets


3,458


1,083

Other assets


972


476

Accounts payable and accrued expenses


26,131


30,464

Due to third party payors


-


11,065

Income taxes


(3,170)


(23,788)

Net cash provided by operating activities


128,371


102,278






Investing activities





Purchases of property and equipment


(45,080)


(38,002)

Proceeds from sale of assets and businesses


1,542


22

Investment in businesses


(848)


(1,550)

Proceeds from sale of equity investment


33,096


1,241

Acquisition of businesses, net of cash acquired


(1,875)


7,288

Net cash used in investing activities


(13,165)


(31,001)






Financing activities





Borrowings on revolving facilities


180,000


100,000

Payments on revolving facilities


(275,000)


(165,000)

Net proceeds from term loans


-


195,217

Payments on term loans


-


(205,193)

Borrowings of other debt


1,451


1,719

Principal payments on other debt


(4,847)


(5,551)

Repayments of bank overdrafts


(3,237)


(6,326)

Proceeds from issuance of common stock


279


831

Proceeds from issuance of non-controlling interest


-


8,743

Repurchase of common stock


(13,622)


(1,433)

Tax benefit from stock based awards


372


245

Purchase of non-controlling interests


-


(236)

Distributions to non-controlling interests


(3,158)


(4,490)

Net cash used in financing activities


(117,762)


(81,474)






Net decrease in cash and cash equivalents


(2,556)


(10,197)






Cash and cash equivalents at beginning of period


25,191


78,420

Cash and cash equivalents at end of period


$                  22,635


$                 68,223







V.  Condensed Consolidated Statement of Cash Flows


For the Nine Months Ended September 30, 2015 and 2016


(In thousands, unaudited)




2015


2016

Operating activities





Net income


$                110,149


$                 104,789

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





     Distributions from unconsolidated subsidiaries


11,814


16,145

     Depreciation and amortization


70,668


107,887

     Amortization of leasehold interests


-


457

     Provision for bad debts


43,243


51,591

     Equity in earnings of unconsolidated subsidiaries


(12,788)


(14,466)

     Loss on early retirement of debt


-


11,626

     Loss on disposal of assets


-


282

     Gain on sale of assets and businesses


(1,264)


(42,192)

     Gain on sale of equity investment


(29,647)


(241)

     Impairment of equity investment


-


5,339

     Stock compensation expense


9,244


12,924

     Amortization of debt discount, premium and issuance costs


6,746


11,845

     Deferred income taxes


(6,925)


(13,088)

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





Accounts receivable


(48,778)


(40,776)

Other current assets


(4,580)


12,094

Other assets


4,540


4,689

Accounts payable and accrued expenses


35,763


35,244

Due to third party payors


-


11,065

Income taxes


15,246


5,033

Net cash provided by operating activities


203,431


280,247






Investing activities





Purchases of property and equipment


(113,992)


(118,260)

Proceeds from sale of assets and businesses


1,542


71,388

Investment in businesses


(1,703)


(3,140)

Proceeds from sale of equity investment


33,096


1,241

Acquisition of businesses, net of cash acquired


(1,049,872)


(414,231)

Net cash used in investing activities


(1,130,929)


(463,002)






Financing activities





Borrowings on revolving facilities


840,000


420,000

Payments on revolving facilities


(675,000)


(545,000)

Net proceeds from term loans


623,575


795,344

Payments on term loans


(26,884)


(434,842)

Borrowings of other debt


11,041


23,801

Principal payments on other debt


(13,167)


(15,477)

Dividends paid to common stockholders


(13,129)


-

Repurchase of common stock


(13,622)


(1,939)

Proceeds from issuance of common stock


1,604


1,488

Proceeds from issuance of non-controlling interest


217,065


11,846

Proceeds from (repayments of) bank overdrafts


2,353


(8,464)

Tax benefit from stock based awards


383


514

Purchase of non-controlling interests


-


(1,530)

Distributions to non-controlling interests


(7,440)


(9,198)

Net cash provided by financing activities


946,779


236,543






Net increase in cash and cash equivalents


19,281


53,788






Cash and cash equivalents at beginning of period


3,354


14,435

Cash and cash equivalents at end of period


$                  22,635


$                 68,223







VI.  Key Statistics

For the Three Months Ended September 30, 2015 and 2016
(unaudited)





2015


2016


% Change

Specialty Hospitals







Number of hospitals – end of period:







Long term acute care hospitals (a)


110


104



Rehabilitation hospitals (a)


17


19



Total specialty hospitals


127


123










Net operating revenues (,000)


$  562,328


$ 544,491


(3.2)%








Number of patient days (b)


338,412


296,202


(12.5)%








Number of admissions (b)


13,927


12,586


(9.6)%








Net revenue per patient day (b)(c)


$      1,522


$    1,642


7.9%








Adjusted EBITDA (,000)


$    53,656


$  48,264


(10.0)%








Adjusted EBITDA margin


9.5%


8.9%










Outpatient Rehabilitation







Number of clinics – end of period (d)


1,033


1,603










Net operating revenues (,000)


$  199,593


$ 250,710


25.6%








Number of visits (e)


1,306,637


2,052,678


57.1%








Revenue per visit (e)(f)


$         103


$        102


(1.0)%








Adjusted EBITDA (,000)


$    23,807


$   31,995


34.4%








Adjusted EBITDA margin


11.9%


12.8%










Concentra







Number of centers – end of period (g)


300


301










Net operating revenues (,000)


$  258,969


$ 258,507


(0.2)%








Number of visits (g)


1,980,496


1,906,242


(3.7)%








Revenue per visit (g)(h)


$         114


$       119


4.4%








Adjusted EBITDA (,000)


$    25,584


$  40,888


59.8%








Adjusted EBITDA margin


9.9%


15.8%










(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 clinic revenue 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












VII.  Key Statistics

For the Nine Months Ended September 30, 2015 and 2016
(unaudited)



2015


2016


% Change

Specialty Hospitals







Number of hospitals – end of period:







Long term acute care hospitals (a)


110


104



Rehabilitation hospitals (a)


17


19



Total specialty hospitals


127


123










Net operating revenues (,000)


$  1,753,445


$   1,729,261


(1.4)%








Number of patient days (b)


1,034,166


951,262


(8.0)%








Number of admissions (b)


42,352


39,541


(6.6)%








Net revenue per patient day (b)(c)


$         1,563


$          1,651


5.6%








Adjusted EBITDA (,000)


$     241,575


$      217,759


(9.9)%








Adjusted EBITDA margin


13.8%


12.6%










Outpatient Rehabilitation







Number of clinics – end of period: (d)


1,033


1,603










Net operating revenues (,000)


$    603,831


$     745,720


23.5%








Number of visits (e)


3,879,409


5,751,562


48.3%








Revenue per visit (e)(f)


$           103


$            102


(1.0)%








Adjusted EBITDA (,000)


$      74,662


$       99,006


32.6%








Adjusted EBITDA margin


12.4%


13.3%










Concentra







Number of centers – end of period (g)


300


301










Net operating revenues (,000)


$   345,798


$   764,252


N/M








Number of visits (g)


2,654,330


5,642,305


N/M








Revenue per visit (g)(h)


$          114


$          118


3.5%








Adjusted EBITDA (,000)


$     36,783


$   118,080


N/M








Adjusted EBITDA margin


10.6%


15.5%










(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. 

N/M = Not Meaningful











VIII. Net Income to Adjusted EBITDA Reconciliation
For the Three and Nine Months Ended September 30, 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
September 30,


Nine Months Ended
September 30,



2015


2016


2015


2016

Net income


$     32,810


$       3,992


$     110,149


$    104,789

Income tax expense


18,347


1,075


65,048


51,585

Interest expense


33,052


44,482


79,728


127,662

Non-operating loss (gain)


(29,647)


1,028


(29,647)


(37,094)

Equity in earnings of unconsolidated subsidiaries


(6,348)


(5,268)


(12,788)


(14,466)

Loss on early retirement of debt


-


10,853


-


11,626

Income from operations


48,214


56,162


212,490


244,102

Stock compensation expense:









   Included in general and administrative


3,433


3,932


8,073


10,771

   Included in cost of services


1,392


818


2,402


2,153

Depreciation and amortization


31,472


37,165


70,668


107,887

Physiotherapy acquisition costs


-


-


-


3,236

Concentra acquisition costs


-


-


4,715


-

Adjusted EBITDA


$     84,511


$     98,077


$     298,348


$     368,149










Specialty hospitals


$     53,656


$     48,264


$     241,575


$     217,759

Outpatient rehabilitation


23,807


31,995


74,662


99,006

Concentra


25,584


40,888


36,783


118,080

Other (a)


(18,536)


(23,070)


(54,672)


(66,696)

Adjusted EBITDA


$     84,511


$     98,077


$    298,348


$     368,149










(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, 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 generally accepted accounting principles.  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 generally accepted accounting principles 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 September 30,


2015

Per share (a)


2016

Per share (a)

Net income attributable to Select Medical Holdings Corporation

$     29,406



$        6,471


Earnings allocated to unvested  restricted stockholders

(923)



(209)


Net income available to common stockholders

28,483

$            0.22


6,262

$             0.05







Adjustments:






Non-operating loss (gain)

(29,647)



1,049


Loss on early retirement of debt (b)

-



5,437


Estimated income tax expense (benefit) (c)

11,419



(5,405)


Earnings allocated to unvested restricted stockholders

572



(35)


Adjusted net income available to common stockholders

$     10,827

$             0.08


$        7,308

$            0.06

Adjustment for dilution


(0.00)



(0.00)

Adjusted income per common share – diluted shares


$             0.08



$            0.06







Weighted average common shares outstanding:






    Basic


127,386



127,848

    Diluted


127,649



127,989







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

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


Refer to Reconciliation of Income per Common Share to Adjusted Income per Common Share for the nine months ended September 30, 2015 and 2016 on the next page.  


Nine Months Ended September 30,


2015

Per share (a)


2016

Per share (a)

Net income attributable to Select Medical Holdings Corporation

$    101,409



$      95,239


Earnings allocated to unvested restricted stockholders

(2,925)



(2,852)


Net income available to common  stockholders

98,484

$             0.77


92,387

$            0.72







Adjustments:






Non-operating gain:






   Gain on sale of contract therapy

-



(33,933)


   Other non-operating gains

(29,647)



(3,148)


Loss on early retirement of debt (b)

-



6,211


Estimated income tax expense (c)

11,419



330


Earnings allocated to unvested restricted stockholders

526



915


Adjusted net income available to common stockholders

$      80,782

$            0.63


$      62,762

$            0.49

Adjustment for dilution


(0.00)



(0.00)

Adjusted income per common share – diluted shares


$            0.63



$            0.49







Weighted average common shares outstanding:






    Basic


127,541



127,659

    Diluted


127,844



127,804


(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, 2016
(In millions, unaudited)

The following is a reconciliation of full year 2016 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 2016 expectations.



Range

Non-GAAP Measure Reconciliation


Low


High

Net income


$    115


$    128

Income tax expense


56


63

Interest expense


170


170

Non-operating gain


(37)


(37)

Equity in earnings of unconsolidated subsidiaries


(20)


(20)

Loss on early retirement of debt


12


12

Income from operations


$    296


$    316

Stock compensation expense


16


16

Depreciation and amortization


145


145

Physiotherapy acquisition costs


3


3

Adjusted EBITDA


$    460


$    480






SOURCE Select Medical Holdings Corporation

Related Links

http://www.selectmedicalholdings.com

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