Amedisys Reports Third Quarter 2022 Financial Results and Updates 2022 Guidance

Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three and nine-month periods ended September 30, 2022.

BATON ROUGE, La., Oct. 26, 2022 (GLOBE NEWSWIRE) -- Amedisys, Inc., (NASDAQ: AMED) today reported its financial results for the three and nine-month periods ended September 30, 2022.

Three-Month Periods Ended September 30, 2022 and 2021

  • Net service revenue increased $4.5 million to $558.0 million compared to $553.5 million in 2021.
  • Net income attributable to Amedisys, Inc. of $25.6 million compared to $45.0 million in 2021.
  • Net income attributable to Amedisys, Inc. per diluted share of $0.79 compared to $1.37 in 2021.

Adjusted Quarterly Results*

  • Adjusted EBITDA of $61.5 million compared to $72.4 million in 2021.
  • Adjusted net service revenue of $558.9 million compared to $553.5 million in 2021.
  • Adjusted net income attributable to Amedisys, Inc. of $37.4 million compared to $50.5 million in 2021.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $1.15 compared to $1.53 in 2021.

Nine-Month Periods Ended September 30, 2022 and 2021

  • Net service revenue increased $6.3 million to $1,661.1 million compared to $1,654.8 million in 2021.
  • Net income attributable to Amedisys, Inc. of $86.9 million compared to $175.0 million in 2021.
  • Net income attributable to Amedisys, Inc. per diluted share of $2.66 compared to $5.30 in 2021.

Adjusted Year to Date Results*

  • Adjusted EBITDA of $202.2 million compared to $234.8 million in 2021.
  • Adjusted net service revenue of $1,670.4 million compared to $1,648.3 million in 2021.
  • Adjusted net income attributable to Amedisys, Inc. of $125.5 million compared to $157.5 million in 2021.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $3.84 compared to $4.77 in 2021.

* See pages 3 and 15 - 18 for the definition and reconciliations of non-GAAP financial measures to GAAP measures.

Chris Gerard, President and Chief Executive Officer stated, “Although we continue to be impacted by a few headwinds, most of which we believe to be short-term in nature, our enthusiasm for the future outlook of Amedisys has never been stronger. As we await the final rule in Home Health, we have been making progress on a number of key initiatives and partnerships that will help to drive future growth at Amedisys. During the quarter, we signed an innovative case rate arrangement with one of the largest Medicare Advantage health plans in the US – CVS/Aetna. I am extremely excited by this partnership as it shows how more forward thinking payors view home health and the quality of care we provide to their members. We look forward to expanding these types of contracting relationships across more of our business in the coming quarters. We also signed a comprehensive care at home partnership with The University of Arkansas for Medical Science that will offer patients the full spectrum of Amedisys and Contessa services including Hospital at Home, SNF at Home, Primary Care at Home and Home Health. This partnership provides a new standard of care delivery, spanning across the full continuum of at-home care, and represents the first partnership in which both Contessa and Amedisys services have been in scope at the outset. We will continue to seek out and invest in opportunities with similar health systems looking for an operating partner to build out a differentiated and integrated home care offering utilizing this full suite of services. In order to unlock our full growth potential, we know that clinical labor will be key. The clinical labor market has been more challenging than ever before, but Amedisys is superbly positioned to increase our clinical capacity as we decrease our turnover by focusing on what matters most to our clinicians. We are enhancing our benefit packages in 2023, working on flexible scheduling and focusing on centralization and automation to remove the administrative load for both our care givers and our care center leadership. I am confident that as we move past the chop of 2022 and into 2023, Amedisys will return to consistency in performance and industry leading results. Finally, a heartfelt thank you to all of the Amedisys family for your continued hard work, perseverance and compassion for our patients.”

Updated 2022 Guidance

We are updating our previously issued guidance:

  • Adjusted net service revenue is anticipated to be in the range of $2.224 billion to $2.230 billion.
  • Adjusted EBITDA is anticipated to be in the range of $253 million to $258 million.
  • Adjusted diluted earnings per share is anticipated to be in the range of $4.82 to $4.93 based on an estimated 32.7 million shares outstanding.

This guidance excludes the effects of any future acquisitions and potential share repurchases, if any are made. COVID-19 has impacted the operating metrics typically used to forecast both growth and cost assumptions for both core Amedisys and Contessa. We are basing our guidance on our current operating environment. COVID-19 continues to evolve in its disruptions to the healthcare systems and the economy. Any future regulations or government interventions, extension of the public health emergency, spike in clinicians and business development staff on quarantine, staffing shortages, reduction in elective procedures, change in patient behavior and further decline in senior living occupancy could impact our ability to achieve this guidance.

We urge caution in considering the current trends and 2022 guidance disclosed in this press release. The home health, hospice, personal care and high acuity care industries are highly competitive and subject to intensive regulations, and trends are subject to numerous factors, risks, and uncertainties, some of which are referenced in the cautionary language below and others that are described more fully in our reports filed with the Securities and Exchange Commission (“SEC”) including our Annual Report on Form 10-K for the fiscal year ended December 31, 2021, subsequent Quarterly Reports on Form 10-Q, and current reports on Form 8-K which can be found on the SEC’s internet website, http://www.sec.gov, and our internet website, http://www.amedisys.com.

Earnings Call and Webcast Information

Amedisys will host a conference call on Thursday, October 27, 2022, at 11:00 a.m. Eastern Time to discuss its third quarter results. To participate on the conference call, please call before 11:00 a.m. Eastern Time to either (877) 524-8416 (Toll-Free) or (412) 902-1028 (Toll). A replay of the conference call will be available through November 27, 2022 by dialing (877) 660-6853 (Toll-Free) or (201) 612-7415 (Toll) and entering conference ID #13733130.

A live webcast of the call will be accessible through our website on our Investor Relations section at the following web address: http://investors.amedisys.com.

Non-GAAP Financial Measures

This press release includes reconciliations of the most comparable financial measures calculated and presented in accordance with accounting principles generally accepted in the U.S. (“GAAP”) to non-GAAP financial measures. The non-GAAP financial measures as defined under SEC rules are as follows: (1) adjusted EBITDA, defined as net income attributable to Amedisys, Inc. before net interest expense, provision for income taxes and depreciation and amortization, excluding certain items; (2) adjusted net service revenue, defined as net service revenue excluding certain items; (3) adjusted other operating income, defined as other operating income excluding certain items; (4) adjusted net income attributable to Amedisys, Inc., defined as net income attributable to Amedisys, Inc. excluding certain items; and (5) adjusted net income attributable to Amedisys, Inc. per diluted share, defined as net income attributable to Amedisys, Inc. common stockholders per diluted share excluding certain items. Management believes that these non-GAAP financial measures, when reviewed in conjunction with GAAP financial measures, are useful gauges of our current performance and are also included in internal management reporting. These non-GAAP financial measures should be considered in addition to, and not more meaningful than or as an alternative to the GAAP financial measures presented in this earnings release and the company’s financial statements. Non-GAAP measures as presented herein may not be comparable to similarly titled measures reported by other companies since not all companies calculate these non-GAAP measures consistently.

Additional Information

Amedisys, Inc. (the “Company”) is a leading healthcare at home company delivering personalized home health, hospice, personal care and high acuity care services. Amedisys is focused on delivering the care that is best for our patients, whether that is home-based personal care, inpatient hospital, palliative and skilled nursing facility (“SNF”) care in their homes, recovery and rehabilitation after an operation or injury, care focused on empowering our patients to manage a chronic disease, or hospice care at the end of life. More than 3,000 hospitals and 90,000 physicians nationwide have chosen Amedisys as a partner in post-acute care. With approximately 21,000 employees in 547 care centers within 36 states and the District of Columbia, Amedisys is dedicated to delivering the highest quality of care to the doorsteps of more than 445,000 patients in need every year. For more information about the Company, please visit: www.amedisys.com.

We use our website as a channel of distribution for important company information. Important information, including press releases, investor presentations and financial information regarding our company, is routinely posted on and accessible on the Investor Relations subpage of our website, which is accessible by clicking on the tab labeled “Investors” on our website home page. Visitors to our website can also register to receive automatic e-mail and other notifications alerting them when new information is made available on the Investor Relations subpage of our website.

Forward-Looking Statements

When included in this press release, words like “believes,” “belief,” “expects,” “strategy,” “plans,” “anticipates,” “intends,” “projects,” “estimates,” “may,” “might,” “will,” “could,” “would,” “should” and similar expressions are intended to identify forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements involve a variety of risks and uncertainties that could cause actual results to differ materially from those described therein. These risks and uncertainties include, but are not limited to the following: the impact of the novel coronavirus pandemic (“COVID-19"), including the measures that have been and may be taken by governmental authorities to mitigate it, on our business, financial condition and results of operations; the impact of current and proposed federal, state and local vaccine mandates; staffing shortages driven by the competitive labor market; changes in or our failure to comply with existing federal and state laws or regulations or the inability to comply with new government regulations on a timely basis; changes in Medicare and other medical payment levels; our ability to open care centers, acquire additional care centers and integrate and operate these care centers effectively; competition in the healthcare industry; changes in the case mix of our patients, the episodic versus non-episodic mix of our payors or payment methodologies; changes in estimates and judgments associated with critical accounting policies; our ability to maintain or establish new patient referral sources; our ability to consistently provide high-quality care; our ability to attract and retain qualified personnel; our ability to keep our patients and employees safe; changes in payments and covered services by federal and state governments; future cost containment initiatives undertaken by third-party payors; our access to financing; our ability to meet debt service requirements and comply with covenants in debt agreements; business disruptions due to natural disasters, climate change or acts of terrorism, widespread protests or civil unrest; our ability to integrate, manage and keep our information systems secure; the impact of inflation; our ability to realize the anticipated benefits of acquisitions, investments and joint ventures; and changes in law or developments with respect to any litigation relating to the Company, including various other matters, many of which are beyond our control.

Because forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified, you should not rely on any forward-looking statement as a prediction of future events. We expressly disclaim any obligation or undertaking and we do not intend to release publicly any updates or changes in our expectations concerning the forward-looking statements or any changes in events, conditions or circumstances upon which any forward-looking statement may be based, except as required by law.

Contact: Investor Contact: Media Contact:
Amedisys, Inc. Amedisys, Inc.
Nick Muscato Kendra Kimmons
Chief Strategy Officer Vice President, Marketing & Communications
(615) 928- 5452 (225) 299-3720
IR@amedisys.com kendra.kimmons@amedisys.com

AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)
(Unaudited)

For the Three-Month
Periods Ended September 30,
For the Nine-Month
Periods Ended September 30,
2022 2021 2022 2021
Net service revenue $ 557,988 $ 553,485 $ 1,661,135 $ 1,654,795
Other operating income (4 ) 13,300
Cost of service, excluding depreciation and amortization 322,227 310,294 943,258 916,188
General and administrative expenses:
Salaries and benefits 125,550 119,373 376,788 349,533
Non-cash compensation 3,495 4,397 15,990 17,860
Other 59,299 55,158 167,851 158,995
Depreciation and amortization 5,477 7,487 19,705 21,763
Investment impairment 3,009 3,009
Operating expenses 519,057 496,709 1,526,601 1,464,339
Operating income 38,931 56,772 134,534 203,756
Other income (expense):
Interest income 59 108 49
Interest expense (4,963 ) (2,730 ) (16,447 ) (6,734 )
Equity in earnings (loss) from equity method investments 302 1,444 (442 ) 3,932
Gain on equity method investments 31,092
Miscellaneous, net 491 490 1,155 1,253
Total other (expense) income, net (4,111 ) (796 ) (15,626 ) 29,592
Income before income taxes 34,820 55,976 118,908 233,348
Income tax expense (9,417 ) (10,731 ) (32,755 ) (57,192 )
Net income 25,403 45,245 86,153 176,156
Net loss (income) attributable to noncontrolling interests 239 (239 ) 739 (1,131 )
Net income attributable to Amedisys, Inc. $ 25,642 $ 45,006 $ 86,892 $ 175,025
Basic earnings per common share:
Net income attributable to Amedisys, Inc. common stockholders $ 0.79 $ 1.38 $ 2.67 $ 5.36
Weighted average shares outstanding 32,482 32,607 32,519 32,658
Diluted earnings per common share:
Net income attributable to Amedisys, Inc. common stockholders $ 0.79 $ 1.37 $ 2.66 $ 5.30
Weighted average shares outstanding 32,616 32,899 32,680 33,021

AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except share data)

September 30, 2022
(Unaudited)
December 31,
2021
ASSETS
Current assets:
Cash and cash equivalents $ 17,956 $ 42,694
Restricted cash 13,504 3,075
Patient accounts receivable 302,470 274,961
Prepaid expenses 17,011 10,356
Other current assets 37,839 25,598
Total current assets 388,780 356,684
Property and equipment, net of accumulated depreciation of $102,407 and $96,937 17,248 18,435
Operating lease right of use assets 105,843 101,257
Goodwill 1,285,455 1,196,090
Intangible assets, net of accumulated amortization of $11,891 and $19,900 103,678 111,190
Deferred income tax assets 289
Other assets 81,123 73,023
Total assets $ 1,982,127 $ 1,856,968
LIABILITIES AND EQUITY
Current liabilities:
Accounts payable $ 45,527 $ 38,217
Payroll and employee benefits 145,073 141,001
Accrued expenses 130,100 150,836
Current portion of long-term obligations 12,628 12,995
Current portion of operating lease liabilities 33,872 31,233
Total current liabilities 367,200 374,282
Long-term obligations, less current portion 443,431 432,075
Operating lease liabilities, less current portion 72,030 69,309
Deferred income tax liabilities 15,983
Other long-term obligations 13,873 4,979
Total liabilities 912,517 880,645
Equity:
Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding
Common stock, $0.001 par value, 60,000,000 shares authorized; 37,852,059 and 37,674,868 shares issued; and 32,479,475 and 32,509,969 shares outstanding 38 38
Additional paid-in capital 750,914 728,118
Treasury stock, at cost 5,372,584 and 5,164,899 shares of common stock (461,168 ) (435,868 )
Retained earnings 725,955 639,063
Total Amedisys, Inc. stockholders’ equity 1,015,739 931,351
Noncontrolling interests 53,871 44,972
Total equity 1,069,610 976,323
Total liabilities and equity $ 1,982,127 $ 1,856,968

AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING
(Amounts in thousands, except statistical information)
(Unaudited)

For the Three-Month
Periods Ended September 30,
For the Nine-Month
Periods Ended September 30,
2022 2021 2022 2021
Cash Flows from Operating Activities:
Net income $ 25,403 $ 45,245 $ 86,153 $ 176,156
Adjustments to reconcile net income to net cash (used in) provided by operating activities:
Depreciation and amortization 5,477 7,487 19,705 21,763
Non-cash compensation 3,495 4,397 15,990 17,860
Amortization and impairment of operating lease right of use assets 12,319 10,479 34,782 30,181
(Gain) loss on disposal of property and equipment (24 ) (72 ) 507 (64 )
Gain on equity method investments (31,092 )
Deferred income taxes 13,028 12,013 19,031 34,729
Equity in (earnings) loss from equity method investments (302 ) (1,444 ) 442 (3,932 )
Amortization of deferred debt issuance costs/debt discount 248 237 743 669
Return on equity method investments 1,370 1,585 3,798 4,268
Investment impairment 3,009 3,009
Changes in operating assets and liabilities, net of impact of acquisitions:
Patient accounts receivable 3,078 5,149 (18,266 ) (17,638 )
Other current assets (15,461 ) (9,779 ) (19,929 ) (6,219 )
Other assets 63 (886 ) 283 (938 )
Accounts payable 1,388 5,338 5,886 (1,192 )
Accrued expenses (56,319 ) (7,736 ) (26,790 ) (9,363 )
Other long-term obligations 466 (49 ) 243 (1,785 )
Operating lease liabilities (10,207 ) (9,417 ) (30,864 ) (27,372 )
Operating lease right of use assets (661 ) (780 ) (2,323 ) (2,304 )
Net cash (used in) provided by operating activities (13,630 ) 61,767 92,400 183,727
Cash Flows from Investing Activities:
Proceeds from the sale of deferred compensation plan assets 61 101 89 126
Proceeds from the sale of property and equipment 29 98 66 140
Purchases of property and equipment (1,556 ) (2,244 ) (4,338 ) (5,187 )
Investments in technology assets (289 ) (147 ) (848 ) (147 )
Investment in equity method investee (637 ) (637 )
Purchase of cost method investment (15,000 )
Acquisitions of businesses, net of cash acquired 1,359 (262,369 ) (71,952 ) (264,872 )
Net cash used in investing activities (1,033 ) (264,561 ) (92,620 ) (269,940 )
Cash Flows from Financing Activities:
Proceeds from issuance of stock upon exercise of stock options 306 1,083 1,078 1,706
Proceeds from issuance of stock to employee stock purchase plan 966 1,061 2,857 3,022
Shares withheld to pay taxes on non-cash compensation (3,187 ) (9,750 ) (7,949 ) (16,694 )
Noncontrolling interest contributions 1,148 2,100
Noncontrolling interest distributions (450 ) (459 ) (1,425 ) (1,253 )
Proceeds from sale of noncontrolling interest 3,941 3,941
Proceeds from borrowings under term loan 290,312 290,312
Proceeds from borrowings under revolving line of credit 185,500 111,500 484,000 500,700
Repayments of borrowings under revolving line of credit (182,000 ) (141,500 ) (465,500 ) (551,700 )
Principal payments of long-term obligations (3,151 ) (501 ) (10,126 ) (5,893 )
Debt issuance costs (2,792 ) (2,792 )
Purchase of company stock (10,805 ) (17,351 ) (84,879 )
Payment of accrued contingent consideration (5,714 ) (5,714 )
Provider relief fund advance 207 (1,465 )
Net cash (used in) provided by financing activities (2,641 ) 238,356 (14,089 ) 131,064
Net (decrease) increase in cash, cash equivalents and restricted cash (17,304 ) 35,562 (14,309 ) 44,851
Cash, cash equivalents and restricted cash at beginning of period 48,764 92,646 45,769 83,357
Cash, cash equivalents and restricted cash at end of period $ 31,460 $ 128,208 $ 31,460 $ 128,208
For the Three-Month
Periods Ended September 30,
For the Nine-Month
Periods Ended September 30,
2022 2021 2022 2021
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest $ 4,664 $ 1,565 $ 9,153 $ 3,479
Cash paid for Infinity ZPIC interest $ 11,544 $ $ 11,544 $
Cash paid for income taxes, net of refunds received $ 605 $ 16,815 $ 23,582 $ 25,482
Cash paid for operating lease liabilities $ 10,868 $ 10,197 $ 33,187 $ 29,676
Cash paid for finance lease liabilities $ 339 $ 492 $ 1,074 $ 1,509
Supplemental Disclosures of Non-Cash Activity:
Right of use assets obtained in exchange for operating lease liabilities $ 10,390 $ 14,192 $ 36,980 $ 34,881
Right of use assets obtained in exchange for finance lease liabilities $ 530 $ 287 $ 1,846 $ 814
Reductions to right of use assets resulting from reductions to operating lease liabilities $ 624 $ 279 $ 3,387 $ 1,183
Reductions to right of use assets resulting from reductions to finance lease liabilities $ 564 $ $ 564 $
Accrued contingent consideration $ $ $ 19,195 $
Noncontrolling interest contribution $ $ $ 8,900 $
Days revenue outstanding (1) 47.3 43.5 47.3 43.5

(1) Our calculation of days revenue outstanding at September 30, 2022 and 2021 is derived by dividing our ending patient accounts receivable by our average daily patient revenue for the three-month periods ended September 30, 2022 and 2021, respectively.

AMEDISYS, INC. AND SUBSIDIARIES
SEGMENT INFORMATION
(Amounts in millions, except statistical information)
(Unaudited)
Segment Information - Home Health

For the Three-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Medicare $ 222.4 $ 228.2
Non-Medicare 114.8 110.4
Net service revenue 337.2 338.6
Cost of service 195.3 190.1
Gross margin 141.9 148.5
Other operating expenses 88.3 82.4
Depreciation and amortization 0.9 1.1
Operating income $ 52.7 $ 65.0
Same Store Growth (1):
Medicare revenue (6 %) 2 %
Non-Medicare revenue (1 %) 6 %
Total admissions 5 % 1 %
Total volume (2) 1 % 1 %
Key Statistical Data - Total (3):
Admissions 94,992 86,732
Recertifications 44,985 46,919
Total volume 139,977 133,651
Medicare completed episodes 75,891 78,318
Average Medicare revenue per completed episode (4) $ 2,989 $ 2,969
Medicare visits per completed episode (5) 12.7 13.8
Visiting clinician cost per visit $ 101.22 $ 94.24
Clinical manager cost per visit 11.33 9.85
Total cost per visit $ 112.55 $ 104.09
Visits 1,735,015 1,826,505

For the Nine-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Medicare $ 668.4 $ 684.4
Non-Medicare 344.4 332.1
Net service revenue 1,012.8 1,016.5
Other operating income 7.3
Cost of service 573.3 563.5
Gross margin 439.5 460.3
Other operating expenses 259.3 243.8
Depreciation and amortization 3.3 3.3
Operating income $ 176.9 $ 213.2
Same Store Growth (1):
Medicare revenue (5 %) 10 %
Non-Medicare revenue % 10 %
Total admissions 2 % 8 %
Total volume (2) % 6 %
Key Statistical Data - Total (3):
Admissions 280,266 265,933
Recertifications 133,555 136,744
Total volume 413,821 402,677
Medicare completed episodes 228,177 232,838
Average Medicare revenue per completed episode (4) $ 3,017 $ 2,962
Medicare visits per completed episode (5) 13.0 14.0
Visiting clinician cost per visit $ 98.63 $ 91.94
Clinical manager cost per visit 10.87 9.54
Total cost per visit $ 109.50 $ 101.48
Visits 5,235,922 5,553,423

(1) Same store information represents the percent change in our Medicare, Non-Medicare and Total revenue, admissions or volume for the period as a percent of the Medicare, Non-Medicare and Total revenue, admissions or volume of the prior period. Same store is defined as care centers that we have operated for at least the last twelve months and startups that are an expansion of a same store care center.
(2) Total volume includes all admissions and recertifications.
(3) Total includes acquisitions, start-ups and denovos.
(4) Average Medicare revenue per completed episode is the average Medicare revenue earned for each Medicare completed episode of care. Average Medicare revenue per completed episode reflects the suspension of sequestration for the period January 1, 2021 through March 31, 2022 and the reinstatement of sequestration at 1% effective April 1, 2022 and at 2% effective July 1, 2022.
(5) Medicare visits per completed episode are the home health Medicare visits on completed episodes divided by the home health Medicare episodes completed during the period.

Segment Information - Hospice

For the Three-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Medicare $ 187.8 $ 187.8
Non-Medicare 10.9 9.7
Net service revenue 198.7 197.5
Cost of service 109.4 107.6
Gross margin 89.3 89.9
Other operating expenses 49.1 49.5
Depreciation and amortization 0.5 0.7
Operating income $ 39.7 $ 39.7
Same Store Growth (1):
Medicare revenue % (1 %)
Hospice admissions (3 %) 1 %
Average daily census 1 % (5 %)
Key Statistical Data - Total (2):
Hospice admissions 12,782 13,292
Average daily census 13,314 13,272
Revenue per day, net $ 162.24 $ 161.74
Cost of service per day $ 89.36 $ 88.06
Average discharge length of stay 92 94

For the Nine-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Medicare $ 557.8 $ 556.2
Non-Medicare 32.4 30.7
Net service revenue 590.2 586.9
Other operating income 6.0
Cost of service 323.2 314.4
Gross margin 267.0 278.5
Other operating expenses 152.1 144.4
Depreciation and amortization 1.7 2.0
Operating income $ 113.2 $ 132.1
Same Store Growth (1):
Medicare revenue % %
Hospice admissions 1 % 3 %
Average daily census (1 %) (4 %)
Key Statistical Data - Total (2):
Hospice admissions 40,027 39,650
Average daily census 13,163 13,282
Revenue per day, net $ 164.24 $ 161.87
Cost of service per day $ 89.94 $ 86.68
Average discharge length of stay 90 95

(1) Same store information represents the percent change in our Medicare revenue, Hospice admissions or average daily census for the period as a percent of the Medicare revenue, Hospice admissions or average daily census of the prior period. Same store is defined as care centers that we have operated for at least the last twelve months and startups that are an expansion of a same store care center.
(2) Total includes acquisitions and denovos.

Segment Information - Personal Care

For the Three-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Medicare $ $
Non-Medicare 16.6 15.9
Net service revenue 16.6 15.9
Cost of service 12.2 11.7
Gross margin 4.4 4.2
Other operating expenses 2.4 2.6
Depreciation and amortization 0.1
Operating income $ 2.0 $ 1.5
Key Statistical Data - Total:
Billable hours 474,365 558,227
Clients served 7,771 8,697
Shifts 202,638 240,736
Revenue per hour $ 34.98 $ 28.44
Revenue per shift $ 81.89 $ 65.95
Hours per shift 2.3 2.3

For the Nine-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Medicare $ $
Non-Medicare 45.5 49.9
Net service revenue 45.5 49.9
Other operating income
Cost of service 34.5 37.4
Gross margin 11.0 12.5
Other operating expenses 6.8 8.8
Depreciation and amortization 0.1 0.2
Operating income $ 4.1 $ 3.5
Key Statistical Data - Total:
Billable hours 1,397,919 1,774,965
Clients served 9,530 11,597
Shifts 598,376 759,242
Revenue per hour $ 32.53 $ 28.11
Revenue per shift $ 76.00 $ 65.71
Hours per shift 2.3 2.3

Segment Information - High Acuity Care

For the Three-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Medicare $ 1.6 $
Non-Medicare 3.9 1.5
Net service revenue 5.5 1.5
Cost of service 5.3 0.9
Gross margin 0.2 0.6
Other operating expenses 8.8 3.9
Depreciation and amortization 0.8 0.5
Investment impairment 3.0
Operating loss $ (12.4 ) $ (3.8 )
Key Statistical Data - Total:
Full risk admissions 130 46
Limited risk admissions 300 188
Total admissions 430 234
Full risk revenue per episode $ 11,615 $ 9,191
Limited risk revenue per episode $ 5,580 $ 5,524
Number of admitting joint ventures 8 8

For the Nine-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Medicare $ 3.3 $
Non-Medicare 9.3 1.5
Net service revenue 12.6 1.5
Other operating income
Cost of service 12.3 0.9
Gross margin 0.3 0.6
Other operating expenses 24.7 3.9
Depreciation and amortization 2.4 0.5
Investment impairment 3.0
Operating loss $ (29.8 ) $ (3.8 )
Key Statistical Data - Total:
Full risk admissions 339 46
Limited risk admissions 768 188
Total admissions 1,107 234
Full risk revenue per episode $ 11,018 $ 9,191
Limited risk revenue per episode $ 5,556 $ 5,524
Number of admitting joint ventures 8 8

Segment Information - Corporate

For the Three-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Other operating expenses $ 39.8 $ 40.5
Depreciation and amortization 3.3 5.1
Total operating expenses $ 43.1 $ 45.6

For the Nine-Month Periods
Ended September 30,
2022 2021
Financial Information(in millions):
Other operating expenses $ 117.7 $ 125.5
Depreciation and amortization 12.2 15.8
Total operating expenses $ 129.9 $ 141.3

AMEDISYS, INC. AND SUBSIDIARIES
RECONCILIATION OF NON-GAAP FINANCIAL MEASURES TO GAAP MEASURES
(Amounts in thousands)
(Unaudited)

Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization (“Adjusted EBITDA”) Reconciliation:

For the Three-Month Periods
Ended September 30,
For the Nine-Month Periods
Ended September 30,
2022 2021 2022 2021
Net income attributable to Amedisys, Inc. $ 25,642 $ 45,006 $ 86,892 $ 175,025
Add:
Income tax expense 9,417 10,731 32,755 57,192
Interest expense, net 4,904 2,730 16,339 6,685
Depreciation and amortization 5,477 7,487 19,705 21,763
Certain items (1) 15,861 6,858 50,920 (24,440 )
Interest component of certain items (1) 207 (451 ) (4,445 ) (1,437 )
Adjusted EBITDA (2) (7) $ 61,508 $ 72,361 $ 202,166 $ 234,788

Adjusted Net Service Revenue Reconciliation:

For the Three-Month Periods
Ended September 30,
For the Nine-Month Periods
Ended September 30,
2022 2021 2022 2021
Net service revenue $ 557,988 $ 553,485 $ 1,661,135 $ 1,654,795
Add:
Certain items (1) 931 9,305 (6,541 )
Adjusted net service revenue (3) (7) $ 558,919 $ 553,485 $ 1,670,440 $ 1,648,254

Adjusted Other Operating Income Reconciliation:

For the Three-Month Periods
Ended September 30,
For the Nine-Month Periods
Ended September 30,
2022 2021 2022 2021
Other operating income $ $ (4 ) $ $ 13,300
Add:
Certain items (1) 4 (13,300 )
Adjusted other operating income (4) (7) $ $ $ $

Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:

For the Three-Month Periods
Ended September 30,
For the Nine-Month Periods
Ended September 30,
2022 2021 2022 2021
Net income attributable to Amedisys, Inc. $ 25,642 $ 45,006 $ 86,892 $ 175,025
Add:
Certain items (1) 11,740 5,474 38,587 (17,495 )
Adjusted net income attributable to Amedisys, Inc. (5) (7) $ 37,382 $ 50,480 $ 125,479 $ 157,530

Adjusted Net Income Attributable to Amedisys, Inc. per Diluted Share Reconciliation:

For the Three-Month Periods
Ended September 30,
For the Nine-Month Periods
Ended September 30,
2022 2021 2022 2021
Net income attributable to Amedisys, Inc. common stockholders per diluted share $ 0.79 $ 1.37 $ 2.66 $ 5.30
Add:
Certain items (1) 0.36 0.17 1.18 (0.53 )
Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share (6) (7) $ 1.15 $ 1.53 $ 3.84 $ 4.77

(1) The following details the certain items for the three and nine-month periods ended September 30, 2022 and 2021:

Certain Items:

For the Three-Month Periods
Ended September 30, 2022
For the Nine-Month Periods
Ended September 30, 2022
(Income) Expense (Income) Expense
Certain Items Impacting Net Service Revenue:
Contingency accrual $ 931 $ 9,305
Certain Items Impacting Cost of Service:
COVID-19 costs 1,701 7,237
Centralization and reorganization costs 1,154 1,349
Fuel supplement 1,962 3,315
Integration costs 311 1,712
Certain Items Impacting Operating Expenses:
Acquisition and integration costs 3,154 9,855
COVID-19 costs 159 396
Executive Board of Directors transition award 3,500
Legal fees - non-routine 241
Centralization and reorganization costs 2,676 3,545
Legal settlement (1,058 )
Fuel supplement 218 218
Investment impairment 3,009 3,009
Certain Items Impacting Total Other Income (Expense):
Interest component of certain items (207 ) 4,445
Other expense, net 793 3,851
Total $ 15,861 $ 50,920
Net of tax $ 11,740 $ 38,587
Diluted EPS $ 0.36 $ 1.18

For the Three-Month Periods
Ended September 30, 2021
For the Nine-Month Periods
Ended September 30, 2021
(Income) Expense (Income) Expense
Certain Items Impacting Net Service Revenue:
Contingency accrual $ $ (6,541 )
Certain Items Impacting Other Operating Income:
CARES Act funds 4 (13,300 )
Certain Items Impacting Cost of Service:
COVID-19 costs 3,513 16,457
Certain Items Impacting Operating Expenses:
Acquisition and integration costs 2,757 6,249
COVID-19 costs 199 576
Pre-acquisition legal settlement 1,825
Certain Items Impacting Total Other Income (Expense):
Interest component of certain items 451 1,437
Other income, net (66 ) (31,143 )
Total $ 6,858 $ (24,440 )
Net of tax $ 5,474 $ (17,495 )
Diluted EPS $ 0.17 $ (0.53 )

(2) Adjusted EBITDA is defined as net income attributable to Amedisys, Inc. before net interest expense, provision for income taxes and depreciation and amortization, excluding certain items as described in footnote 1.
(3) Adjusted net service revenue is defined as net service revenue excluding certain items as described in footnote 1.
(4) Adjusted other operating income is defined as other operating income excluding certain items as described in footnote 1.
(5) Adjusted net income attributable to Amedisys, Inc. is defined as net income attributable to Amedisys, Inc. calculated in accordance with GAAP excluding certain items as described in footnote 1.
(6) Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share is defined as diluted income per share calculated in accordance with GAAP excluding the earnings per share effect of certain items as described in footnote 1.
(7) Adjusted EBITDA, adjusted net service revenue, adjusted other operating income, adjusted net income attributable to Amedisys, Inc. and adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share should not be considered as an alternative to, or more meaningful than, income before income taxes or other measures calculated in accordance with GAAP. These calculations may not be comparable to a similarly titled measure reported by other companies, since not all companies calculate these non-GAAP financial measures in the same manner.


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