Select Medical Holdings Corporation Announces Results For Its Third Quarter Ended September 30, 2020

Select Medical Holdings Corporation (“Select Medical,” “we,” “us,” or “our”) (NYSE: SEM) today announced results for its third quarter ended September 30, 2020

 

MECHANICSBURG, Pa., Oct. 29, 2020 /PRNewswire/ -- Select Medical Holdings Corporation ("Select Medical," "we," "us," or "our") (NYSE: SEM) today announced results for its third quarter ended September 30, 2020.

For the third quarter ended September 30, 2020, net operating revenues increased 2.2% to $1,423.9 million, compared to $1,393.3 million for the same quarter, prior year. Income from operations increased 27.0% to $156.1 million for the third quarter ended September 30, 2020, compared to $122.9 million for the same quarter, prior year. Income from operations included a net reduction of $1.2 million related to payments received under the Provider Relief Fund, as described below. Net income increased 137.2% to $104.5 million for the third quarter ended September 30, 2020, compared to $44.0 million for the same quarter, prior year. Net income included pre-tax gains on sales of businesses of $5.1 million for the third quarter ended September 30, 2020. Net income included pre-tax losses on early retirement of debt of $18.6 million for the third quarter ended September 30, 2019. Adjusted EBITDA increased 16.7% to $213.2 million for the third quarter ended September 30, 2020, compared to $182.7 million for the same quarter, prior year. Earnings per common share was $0.57 on a fully diluted basis for the third quarter ended September 30, 2020, compared to $0.23 for the same quarter, prior year. Adjusted earnings per common share was $0.56 on a fully diluted basis for the third quarter ended September 30, 2020, compared to $0.33 for the same quarter, prior year. Adjusted earnings per common share excludes the gains on sales of businesses and related tax effects for the third quarter ended September 30, 2020. Adjusted earnings per common share excludes the losses on early retirement of debt and related costs, and their related tax effects, for the third quarter ended September 30, 2019. The definition of Adjusted EBITDA and a reconciliation of net income to Adjusted EBITDA are presented in table IX of this release. A reconciliation of earnings per common share to adjusted earnings per common share is presented in table X of this release.

For the nine months ended September 30, 2020, net operating revenues were $4,071.2 million, compared to $4,079.3 million for the same period, prior year. Income from operations increased 12.5% to $404.3 million for the nine months ended September 30, 2020, compared to $359.5 million for the same period, prior year. For the nine months ended September 30, 2020, income from operations included other operating income of $53.8 million related to the recognition of payments received under the Provider Relief Fund, as described below, for loss of revenue and health care related expenses attributable to coronavirus disease 2019 ("COVID-19"). Net income increased 54.0% to $242.4 million for the nine months ended September 30, 2020, compared to $157.4 million for the same period, prior year. Net income included pre-tax gains on sales of businesses of $12.7 million for the nine months ended September 30, 2020. Net income included pre-tax losses on early retirement of debt of $18.6 million and a pre-tax gain on sale of businesses of $6.5 million for the nine months ended September 30, 2019. Adjusted EBITDA increased 7.5% to $579.3 million for the nine months ended September 30, 2020, compared to $539.0 million for the same period, prior year. Earnings per common share was $1.35 on a fully diluted basis for the nine months ended September 30, 2020, compared to $0.86 for the same period, prior year. Adjusted earnings per common share was $1.31 on a fully diluted basis for the nine months ended September 30, 2020, compared to $0.93 for the same period, prior year. Adjusted earnings per common share excludes the gains on sales of businesses and related tax effects for the nine months ended September 30, 2020. Adjusted earnings per common share excludes the losses on early retirement of debt and related costs, gain on sale of businesses, and their related tax effects for the nine months ended September 30, 2019. The definition of Adjusted EBITDA and a reconciliation of net income to Adjusted EBITDA are presented in table IX of this release. A reconciliation of earnings per common share to adjusted earnings per common share is presented in table X of this release.

Please refer to "Effects of the COVID-19 Pandemic on Select Medical's Results of Operations" below for further discussion.

Company Overview

Select Medical is one of the largest operators of critical illness recovery hospitals, rehabilitation hospitals, outpatient rehabilitation clinics, and occupational health centers in the United States based on number of facilities.   Select Medical's reportable segments include the critical illness recovery hospital segment, the rehabilitation hospital segment, the outpatient rehabilitation segment, and the Concentra segment. As of September 30, 2020, Select Medical operated 100 critical illness recovery hospitals in 28 states, 29 rehabilitation hospitals in 12 states, and 1,777 outpatient rehabilitation clinics in 37 states and the District of Columbia. Select Medical's joint venture subsidiary Concentra operated 523 occupational health centers in 41 states. At September 30, 2020, Select Medical had operations in 46 states and the District of Columbia. Information about Select Medical is available at www.selectmedical.com.

CARES Act Provider Relief Fund

On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") was enacted. The CARES Act provided additional waivers, reimbursement, grants and other funds to assist health care providers during the COVID-19 pandemic, including $100.0 billion in appropriations for the Public Health and Social Services Emergency Fund, also referred to as the Provider Relief Fund, to be used for preventing, preparing, and responding to the coronavirus, and for reimbursing eligible health care providers for lost revenues and health care related expenses that are attributable to COVID-19.

For the three and nine months ended September 30, 2020, Select Medical recognized payments received under the Provider Relief Fund for loss of revenue and health care related expenses attributable to COVID-19 as other operating income. For the three months ended September 30, 2020, other operating income of $0.4 million is included within the operating results of our Select Medical's Concentra segment, and a reduction to other operating income of $1.5 million is included within the operating results of its other activities. The reduction in other operating income resulted from changes in the terms and conditions associated with the acceptance of the Provider Relief Fund payments; these terms and conditions have changed from those which existed upon receipt of the payments. For the nine months ended September 30, 2020, $52.7 million and $1.1 million of other operating income is included within the operating results of Select Medical's other activities and its Concentra segment, respectively.

Critical Illness Recovery Hospital Segment

For the third quarter ended September 30, 2020, net operating revenues for the critical illness recovery hospital segment increased 12.2% to $519.5 million, compared to $462.9 million for the same quarter, prior year. Adjusted EBITDA for the critical illness recovery hospital segment increased 55.2% to $88.8 million for the third quarter ended September 30, 2020, compared to $57.2 million for the same quarter, prior year. The Adjusted EBITDA margin for the critical illness recovery hospital segment was 17.1% for the third quarter ended September 30, 2020, compared to 12.4% for the same quarter, prior year. Certain critical illness recovery hospital key statistics are presented in table VII of this release for both the third quarters ended September 30, 2020 and 2019.

For the nine months ended September 30, 2020, net operating revenues for the critical illness recovery hospital segment increased 11.4% to $1,539.6 million, compared to $1,381.6 million for the same period, prior year. Adjusted EBITDA for the critical illness recovery hospital segment increased 37.4% to $267.1 million for the nine months ended September 30, 2020, compared to $194.4 million for the same period, prior year. The Adjusted EBITDA margin for the critical illness recovery hospital segment was 17.4% for the nine months ended September 30, 2020, compared to 14.1% for the same period, prior year. Certain critical illness recovery hospital key statistics are presented in table VIII of this release for both the nine months ended September 30, 2020 and 2019.

Rehabilitation Hospital Segment

For the third quarter ended September 30, 2020, net operating revenues for the rehabilitation hospital segment increased 8.5% to $188.1 million, compared to $173.4 million for the same quarter, prior year. Adjusted EBITDA for the rehabilitation hospital segment increased 21.4% to $44.6 million for the third quarter ended September 30, 2020, compared to $36.8 million for the same quarter, prior year. The Adjusted EBITDA margin for the rehabilitation hospital segment was 23.7% for the third quarter ended September 30, 2020, compared to 21.2% for the same quarter, prior year. Certain rehabilitation hospital key statistics are presented in table VII of this release for both the third quarters ended September 30, 2020 and 2019.

For the nine months ended September 30, 2020, net operating revenues for the rehabilitation hospital segment increased 10.3% to $538.8 million, compared to $488.3 million for the same period, prior year. Adjusted EBITDA for the rehabilitation hospital segment increased 19.7% to $110.8 million for the nine months ended September 30, 2020, compared to $92.5 million for the same period, prior year. The Adjusted EBITDA margin for the rehabilitation hospital segment was 20.6% for the nine months ended September 30, 2020, compared to 19.0% for the same period, prior year. For the nine months ended September 30, 2019, the Adjusted EBITDA results for the rehabilitation hospital segment included start-up losses of approximately $8.8 million. Certain rehabilitation hospital key statistics are presented in table VIII of this release for both the nine months ended September 30, 2020 and 2019.

Outpatient Rehabilitation Segment

For the third quarter ended September 30, 2020, net operating revenues for the outpatient rehabilitation segment were $240.0 million, compared to $265.3 million for the same quarter, prior year. Adjusted EBITDA for the outpatient rehabilitation segment was $30.6 million for the third quarter ended September 30, 2020, compared to Adjusted EBITDA of $40.0 million for the same quarter, prior year. The Adjusted EBITDA margin for the outpatient rehabilitation segment was 12.8% for the third quarter ended September 30, 2020, compared to 15.1% for the same quarter, prior year. Certain outpatient rehabilitation key statistics are presented in table VII of this release for both the third quarters ended September 30, 2020 and 2019.

For the nine months ended September 30, 2020, net operating revenues for the outpatient rehabilitation segment were $662.4 million, compared to $774.1 million for the same period, prior year. Adjusted EBITDA for the outpatient rehabilitation segment was $51.5 million for the nine months ended September 30, 2020, compared to $111.6 million for the same period, prior year. The Adjusted EBITDA margin for the outpatient rehabilitation segment was 7.8% for the nine months ended September 30, 2020, compared to 14.4%  for the same period, prior year. Certain outpatient rehabilitation key statistics are presented in table VIII of this release for both the nine months ended September 30, 2020 and 2019.

Concentra Segment

For the third quarter ended September 30, 2020, net operating revenues for the Concentra segment were $391.9 million, compared to $421.9 million for the same quarter, prior year. Adjusted EBITDA for the Concentra segment increased 3.7% to $80.5 million for the third quarter ended September 30, 2020, compared to $77.7 million for the same quarter, prior year. The Adjusted EBITDA margin for the Concentra segment was 20.6% for the third quarter ended September 30, 2020, compared to 18.4% for the same quarter, prior year. Certain Concentra key statistics are presented in table VII of this release for both the third quarters ended September 30, 2020 and 2019.

For the nine months ended September 30, 2020, net operating revenues for the Concentra segment were $1,102.7 million, compared to $1,231.7 million for the same period, prior year. Adjusted EBITDA for the Concentra segment was $183.5 million for the nine months ended September 30, 2020, compared to $220.0 million for the same period, prior year. The Adjusted EBITDA margin for the Concentra segment was 16.6% for the nine months ended September 30, 2020, compared to 17.9% for the same period, prior year. Certain Concentra key statistics are presented in table VIII of this release for both the nine months ended September 30, 2020 and 2019.

Effects of the COVID-19 Pandemic on Select Medical's Results of Operations

The continuing implications of the COVID-19 pandemic on Select Medical's results of operations and overall financial performance remain uncertain. Select Medical has provided net operating revenues and certain operating statistics to assist readers in understanding how the COVID-19 pandemic impacted each of its segments during the three and nine months ended September 30, 2020.

Critical Illness Recovery Hospital Segment.  Select Medical's critical illness recovery hospitals are a key component of the inpatient hospital continuum of care. Both the Centers for Medicare & Medicaid Services ("CMS") and Congress acted to temporarily suspend certain regulations concerning length of stay requirements, which apply to Select Medical's critical illness recovery hospitals, in order to facilitate the transfer of patients from general acute care hospitals. This was done in order to expand hospital bed capacity to care for COVID-19 patients. COVID-19 has been prevalent in certain markets that Select Medical serves; as a result, Select Medical's critical illness recovery hospitals have admitted patients with COVID-19 and have faced the challenging task of treating those patients while also taking measures to protect their patients and staff members who do not have COVID-19. The pandemic has caused, and may continue to cause, disruptions in Select Medical's critical illness recovery hospitals, which include, in some cases, the addition or reduction of beds, the creation of isolated units and spaces, temporary increases or restrictions on admissions, the incurrence of additional costs, staff illnesses, and the increased use of contract clinical labor.

The following table shows the trend in net operating revenues, patient day volume, and occupancy rates for each of the periods presented, as well as the number of critical illness recovery hospitals Select Medical owned at the end of each period.

   

Net Operating Revenues

   

Patient Days

   

Occupancy Rate

   

Number of
Hospitals Owned(1)

   

2019

 

2020

 

% Change

   

2019

 

2020

 

% Change

   

2019

 

2020

   

2019

 

2020

   

(in thousands, except percentages)

                         

January

 

$

149,799

   

$

163,238

   

9.0%

   

86,238

 

90,783

 

5.3%

   

69%

 

69%

   

96

 

100

February

 

145,586

   

165,375

   

13.6%

   

80,806

 

87,844

 

8.7%

   

71%

 

72%

   

96

 

100

March

 

162,149

   

171,908

   

6.0%

   

91,085

 

91,831

 

0.8%

   

73%

 

70%

   

96

 

100

Three Months Ended March 31

 

$

457,534

   

$

500,521

   

9.4%

   

258,129

 

270,458

 

4.8%

   

71%

 

70%

   

96

 

100

                                               

April

 

$

156,231

   

$

171,445

   

9.7%

   

88,357

 

90,710

 

2.7%

   

70%

 

71%

   

99

 

100

May

 

156,422

   

178,223

   

13.9%

   

89,350

 

95,191

 

6.5%

   

69%

 

72%

   

99

 

100

June

 

148,490

   

169,958

   

14.5%

   

85,153

 

90,988

 

6.9%

   

68%

 

71%

   

99

 

100

Three Months Ended June 30

 

$

461,143

   

$

519,626

   

12.7%

   

262,860

 

276,889

 

5.3%

   

69%

 

72%

   

99

 

100

Six Months Ended June 30

 

$

918,677

   

$

1,020,147

   

11.0%

   

520,989

 

547,347

 

5.1%

   

70%

 

71%

   

99

 

100

                                               

July

 

$

151,416

   

$

175,253

   

15.7%

   

87,143

 

94,144

 

8.0%

   

67%

 

71%

   

99

 

99

August

 

155,485

   

173,967

   

11.9%

   

86,553

 

93,964

 

8.6%

   

66%

 

71%

   

99

 

99

September

 

155,991

   

170,234

   

9.1%

   

84,393

 

90,955

 

7.8%

   

67%

 

71%

   

99

 

99

Three Months Ended September 30

 

$

462,892

   

$

519,454

   

12.2%

   

258,089

 

279,063

 

8.1%

   

67%

 

71%

   

99

 

99

Nine Months Ended September 30

 

$

1,381,569

   

$

1,539,601

   

11.4%

   

779,078

 

826,410

 

6.1%

   

69%

 

71%

   

99

 

99

                                               
 

_______________________________________________________________________________

(1)

Represents the number of hospitals owned at the end of each period presented.  

Rehabilitation Hospital Segment.  Select Medical's rehabilitation hospitals receive most of their admissions from general acute care hospitals. Both CMS and Congress acted to temporarily suspend certain regulations that govern admissions into rehabilitation hospitals in order to facilitate the transfer of patients from general acute care hospitals and critical illness recovery hospitals. This was done in order to expand hospital bed capacity to care for COVID-19 patients. COVID-19 has been prevalent in certain markets that Select Medical serves; as a result, Select Medical's rehabilitation hospitals have admitted patients with COVID-19 and have faced the challenging task of treating those patients while also taking measures to protect their patients and staff members who do not have COVID-19. The pandemic has caused, and will continue to cause, disruptions in Select Medical's rehabilitation hospitals, which include, in some cases, the addition or reduction of beds, the creation of isolated units and spaces, temporary restrictions on admissions, the incurrence of additional costs, staff illnesses, and the increased use of contract clinical labor. At the beginning of the pandemic, elective surgeries at hospitals and other facilities were suspended, which reduced the need for inpatient rehabilitation services. Beginning in May, state governments and health departments began to ease these restrictions and hospitals began to perform elective surgeries again, which has since increased the need for the services provided by Select Medical's rehabilitation hospitals.

The following table shows the trend in net operating revenues, patient day volume, and occupancy rates for each of the periods presented, as well as the number of rehabilitation hospitals Select Medical owned at the end of each period.

   

Net Operating Revenues

   

Patient Days

   

Occupancy Rate

   

Number of
Hospitals Owned(1)

   

2019

 

2020

 

% Change

   

2019

 

2020

 

% Change

   

2019

 

2020

   

2019

 

2020

   

(in thousands, except percentages)

                                 

January

 

$

50,615

   

$

61,673

   

21.8%

   

27,434

 

32,111

 

17.0%

   

74%

 

79%

   

17

 

19

February

 

48,080

   

60,690

   

26.2%

   

25,442

 

31,813

 

25.0%

   

76%

 

84%

   

17

 

19

March

 

55,863

   

59,656

   

6.8%

   

29,940

 

30,644

 

2.4%

   

78%

 

76%

   

18

 

19

Three Months Ended March 31

 

$

154,558

   

$

182,019

   

17.8%

   

82,816

 

94,568

 

14.2%

   

76%

 

79%

   

18

 

19

                                               

April

 

$

51,991

   

$

45,878

   

(11.8)%

   

28,266

 

23,553

 

(16.7)%

   

76%

 

61%

   

18

 

19

May

 

56,019

   

57,815

   

3.2%

   

29,730

 

29,787

 

0.2%

   

75%

 

73%

   

19

 

19

June

 

52,364

   

64,974

   

24.1%

   

28,529

 

30,741

 

7.8%

   

73%

 

78%

   

19

 

19

Three Months Ended June 30

 

$

160,374

   

$

168,667

   

5.2%

   

86,525

 

84,081

 

(2.8)%

   

75%

 

71%

   

19

 

19

Six Months Ended June 30

 

$

314,932

   

$

350,686

   

11.4%

   

169,341

 

178,649

 

5.5%

   

76%

 

75%

   

19

 

19

                                               

July

 

$

57,077

   

$

62,312

   

9.2%

   

30,054

 

31,986

 

6.4%

   

75%

 

81%

   

19

 

18

August

 

58,072

   

63,673

   

9.6%

   

30,228

 

32,518

 

7.6%

   

75%

 

83%

   

19

 

18

September

 

58,220

   

62,090

   

6.6%

   

29,172

 

31,176

 

6.9%

   

75%

 

82%

   

19

 

18

Three Months Ended September 30

 

$

173,369

   

$

188,075

   

8.5%

   

89,454

 

95,680

 

7.0%

   

75%

 

82%

   

19

 

18

Nine Months Ended September 30

 

$

488,301

   

$

538,761

   

10.3%

   

258,795

 

274,329

 

6.0%

   

75%

 

77%

   

19

 

18

 

_______________________________________________________________________________

(1)

Represents the number of hospitals owned at the end of each period presented.  

Outpatient Rehabilitation Segment.  Beginning in mid-March, state governments began implementing mandatory closures of non-essential or non-life sustaining businesses, restricting travel and individual activities outside of the home, closing schools, and mandating other social distancing measures. Additionally, hospitals and other facilities began to suspend elective surgeries. As a result, Select Medical's outpatient rehabilitation clinics experienced significantly less patient visit volume due to a decline in patient referrals from physicians, a reduction in workers' compensation injury visits resulting from the temporary closure of businesses, and the suspension of elective surgeries which would have required outpatient rehabilitation services. Beginning in May, state governments began to ease restrictions imposed on individuals and businesses. Further, most physician offices have reopened for routine office visits and hospitals and other facilities have begun to perform elective surgeries again, which has since increased the need for services provided by Select Medical's outpatient rehabilitation clinics.

The following table shows the trend in net operating revenues and patient visit volume for each of the periods presented, as well as the number of working days for each period.

   

Net Operating Revenues

   

Visits

   

Working Days(1)

 
   

2019

 

2020

 

% Change

   

2019

 

2020

 

% Change

   

2019

 

2020

 
   

(in thousands, except percentages)

                         

January

 

$

83,185

   

$

90,924

   

9.3%

   

687,007

 

757,171

 

10.2%

   

22

 

22

 

February

 

78,573

   

88,239

   

12.3%

   

658,610

 

739,061

 

12.2%

   

20

 

20

 

March

 

85,147

   

76,086

   

(10.6)%

   

708,866

 

626,433

 

(11.6)%

   

21

 

22

 

Three Months Ended March 31

 

$

246,905

   

$

255,249

   

3.4%

   

2,054,483

 

2,122,665

 

3.3%

   

63

 

64

 
                                       

April

 

$

90,230

   

$

49,084

   

(45.6)%

   

762,914

 

386,108

 

(49.4)%

   

22

 

22

 

May

 

90,272

   

51,186

   

(43.3)%

   

759,829

 

409,703

 

(46.1)%

   

22

 

20

 

June

 

81,389

   

66,868

   

(17.8)%

   

680,762

 

546,456

 

(19.7)%

   

20

 

22

 

Three Months Ended June 30

 

$

261,891

   

$

167,138

   

(36.2)%

   

2,203,505

 

1,342,267

 

(39.1)%

   

64

 

64

 

Six Months Ended June 30

 

$

508,796

   

$

422,387

   

(17.0)%

   

4,257,988

 

3,464,932

 

(18.6)%

   

127

 

128

 
                                       

July

 

$

89,267

   

$

77,793

   

(12.9)%

   

754,102

 

636,826

 

(15.6)%

   

22

 

22

 

August

 

90,687

   

79,034

   

(12.8)%

   

743,813

 

651,738

 

(12.4)%

   

22

 

21

 

September

 

85,376

   

83,215

   

(2.5)%

   

706,413

 

694,808

 

(1.6)%

   

20

 

21

 

Three Months Ended September 30

 

$

265,330

   

$

240,042

   

(9.5)%

   

2,204,328

 

1,983,372

 

(10.0)%

   

64

 

64

 

Nine Months Ended September 30

 

$

774,126

   

$

662,429

   

(14.4)%

   

6,462,316

 

5,448,304

 

(15.7)%

   

191

 

192

 
 

_______________________________________________________________________________

(1)

Represents the number of days in which normal business operations were conducted during the periods presented. 

Concentra Segment.  Beginning in mid-March, state governments began placing significant restrictions on businesses and mandating closures of non-essential or non-life sustaining businesses, causing many employers to furlough their workforce and temporarily cease or significantly reduce their operations. These actions have had significant effects on Select Medical's patient visit volumes. Beginning in May, state governments began to ease restrictions imposed on businesses and employers began to increase their workforce, which has since resulted in an increased need for occupational health services.

The following table shows the trend in net operating revenues and patient visit volume for each of the periods presented, as well as the number of working days for each period.

   

Net Operating Revenues

   

Visits

   

Working Days(1)

 
   

2019

 

2020

 

% Change

   

2019

 

2020

 

% Change

   

2019

 

2020

 
   

(in thousands, except percentages)

                         

January

 

$

133,507

   

$

141,236

   

5.8%

   

985,598

 

1,032,069

 

4.7%

   

22

 

22

 

February

 

126,309

   

133,690

   

5.8%

   

919,065

 

965,741

 

5.1%

   

20

 

20

 

March

 

136,505

   

123,609

   

(9.4)%

   

1,006,944

 

879,585

 

(12.6)%

   

21

 

22

 

Three Months Ended March 31

 

$

396,321

   

$

398,535

   

0.6%

   

2,911,607

 

2,877,395

 

(1.2)%

   

63

 

64

 
                                       

April

 

$

140,050

   

$

91,178

   

(34.9)%

   

1,040,543

 

610,555

 

(41.3)%

   

22

 

22

 

May

 

143,183

   

99,228

   

(30.7)%

   

1,073,763

 

674,629

 

(37.2)%

   

22

 

20

 

June

 

130,218

   

121,932

   

(6.4)%

   

988,783

 

865,896

 

(12.4)%

   

20

 

22

 

Three Months Ended June 30

 

$

413,451

   

$

312,338

   

(24.5)%

   

3,103,089

 

2,151,080

 

(30.7)%

   

64

 

64

 

Six Months Ended June 30

 

$

809,772

   

$

710,873

   

(12.2)%

   

6,014,696

 

5,028,475

 

(16.4)%

   

127

 

128

 
                                       

July

 

$

142,385

   

$

132,465

   

(7.0)%

   

1,057,809

 

930,427

 

(12.0)%

   

22

 

22

 

August

 

144,452

   

130,291

   

(9.8)%

   

1,087,165

 

933,555

 

(14.1)%

   

22

 

21

 

September

 

135,063

   

129,103

   

(4.4)%

   

1,005,929

 

963,065

 

(4.3)%

   

20

 

21

 

Three Months Ended September 30

 

$

421,900

   

$

391,859

   

(7.1)%

   

3,150,903

 

2,827,047

 

(10.3)%

   

64

 

64

 

Nine Months Ended September 30

 

$

1,231,672

   

$

1,102,732

   

(10.5)%

   

9,165,599

 

7,855,522

 

(14.3)%

   

191

 

192

 
 

_______________________________________________________________________________

(1)

Represents the number of days in which normal business operations were conducted during the periods presented. 

Stock Repurchase Program

The board of directors of Select Medical has authorized a common stock repurchase program to repurchase up to $500.0 million worth of shares of its common stock. The program has been extended until December 31, 2021, and will remain in effect until then, unless further extended or earlier terminated by the board of directors. Stock repurchases under this program may be made in the open market or through privately negotiated transactions, and at times and in such amounts as Select Medical deems appropriate. Select Medical funds this program with cash on hand and borrowings under its revolving credit facility.

Select Medical did not repurchase shares during the quarter ended September 30, 2020. Since the inception of the program through September 30, 2020, Select Medical has repurchased 38,580,908 shares at a cost of approximately $356.6 million, or $9.24 per share, which includes transaction costs.

Business Outlook

Select Medical is issuing an updated business outlook following the reporting of its third quarter 2020 results. Select Medical now expects for the full year of 2020 consolidated net operating revenues to be in the range of $5.44 billion to $5.50 billion and Adjusted EBITDA for the full year of 2020 to be in the range of $745.0 million to $765.0 million. Select Medical now expects fully diluted earnings per common share for the full year 2020 to be in the range of $1.65 to $1.75 and adjusted earnings per common share for the full year 2020 to be in the range of $1.61 to $1.71. Adjusted earnings per common share excludes the gains on sales of businesses and their related tax effects. Reconciliations of net income to Adjusted EBITDA and diluted earnings per common share to adjusted earnings per common share for the full year of 2020 are presented in table XI of this release.

Conference Call

Select Medical will host a conference call regarding its third quarter results, as well as its business outlook and the impact of the COVID-19 pandemic on each of its reporting segments, on Friday, October 30, 2020, at 9:00am ET. The domestic dial in number for the call is 1-866-440-2669. The international dial in number is 1-409-220-9844. The conference ID for the call is 6297066. 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 11:00am ET, November 6, 2020. The replay number is 1-855-859-2056 (domestic) or 1-404-537-3406 (international). The conference ID for the replay will be 6297066. The replay can also be accessed at Select Medical Holdings Corporation's website, www.selectmedicalholdings.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:

  • developments related to the COVID-19 pandemic including, but not limited to, the duration and severity of the pandemic, additional measures taken by government authorities and the private sector to limit the spread of COVID-19, and further legislative and regulatory actions which impact healthcare providers, including actions that may impact the Medicare program;
  • changes in government reimbursement for our services and/or new payment policies may result in a reduction in net operating revenues, an increase in costs, and a reduction in profitability;
  • the failure of our Medicare-certified long term care hospitals or inpatient rehabilitation facilities to maintain their Medicare certifications may cause our net operating revenues and profitability to decline;
  • the failure of our Medicare-certified long term care hospitals and inpatient rehabilitation 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 our acquisitions 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, or the inability to attract or retain healthcare professionals due to the heightened risk of infection related to the COVID-19 pandemic, 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;
  • a security breach of our or our third-party vendors' information technology systems may subject us to potential legal and reputational harm and may result in a violation of the Health Insurance Portability and Accountability Act of 1996 or the Health Information Technology for Economic and Clinical Health Act; 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 the quarterly reports on Form 10-Q and of the annual report on Form 10-K for the year ended December 31, 2019.

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

Investor inquiries:

Joel T. Veit
Senior Vice President and Treasurer
717-972-1100
ir@selectmedical.com

 

I.  Condensed Consolidated Statements of Operations

For the Three Months Ended September 30, 2019 and 2020

(In thousands, except per share amounts, unaudited)

 
 

2019

 

2020

 

% Change

Net operating revenues

$

1,393,343

   

$

1,423,869

   

2.2

%

Costs and expenses:

         

Cost of services, exclusive of depreciation and amortization

1,183,111

   

1,180,951

   

(0.2)

 

General and administrative

34,385

   

35,516

   

3.3

 

Depreciation and amortization

52,941

   

50,110

   

(5.3)

 

Total costs and expenses

1,270,437

   

1,266,577

   

(0.3)

 

Other operating income

   

(1,160)

   

N/M

 

Income from operations

122,906

   

156,132

   

27.0

 

Other income and expense:

         

Loss on early retirement of debt

(18,643)

   

   

N/M

 

Equity in earnings of unconsolidated subsidiaries

6,950

   

8,765

   

26.1

 

Gain on sale of businesses

   

5,143

   

N/M

 

Interest expense

(54,336)

   

(34,026)

   

(37.4)

 

Income before income taxes

56,877

   

136,014

   

139.1

 

Income tax expense

12,847

   

31,557

   

145.6

 

Net income

44,030

   

104,457

   

137.2

 

Less: Net income attributable to non-controlling interests

13,298

   

27,511

   

106.9

 

Net income attributable to Select Medical

$

30,732

   

$

76,946

   

150.4

%

Diluted earnings per common share:(1)

$

0.23

   

$

0.57

     
 

_______________________________________________________________________________

(1)

Refer to table III for calculation of earnings per common share.

   

N/M

Not Meaningful

 

II.  Condensed Consolidated Statements of Operations

For the Nine Months Ended September 30, 2019 and 2020

(In thousands, except per share amounts, unaudited)

 
 

2019

 

2020

 

% Change

Net operating revenues

$

4,079,338

   

$

4,071,219

   

(0.2)

%

Costs and expenses:

         

Cost of services, exclusive of depreciation and amortization

3,465,353

   

3,463,778

   

0.0

 

General and administrative

94,401

   

102,808

   

8.9

 

Depreciation and amortization

160,072

   

154,133

   

(3.7)

 

Total costs and expenses

3,719,826

   

3,720,719

   

0.0

 

Other operating income

   

53,828

   

N/M

 

Income from operations

359,512

   

404,328

   

12.5

 

Other income and expense:

         

Loss on early retirement of debt

(18,643)

   

   

N/M

 

Equity in earnings of unconsolidated subsidiaries

18,710

   

19,677

   

5.2

 

Gain on sale of businesses

6,532

   

12,690

   

N/M

 

Interest expense

(156,611)

   

(117,499)

   

(25.0)

 

Income before income taxes

209,500

   

319,196

   

52.4

 

Income tax expense

52,140

   

76,805

   

47.3

 

Net income

157,360

   

242,391

   

54.0

 

Less: Net income attributable to non-controlling interests

40,978

   

60,670

   

48.1

 

Net income attributable to Select Medical

$

116,382

   

$

181,721

   

56.1

%

Diluted earnings per common share:(1)

$

0.86

   

$

1.35

     
 

_______________________________________________________________________________

(1)

Refer to table III for calculation of earnings per common share.

   

N/M

Not meaningful

 

III.  Earnings per Share

For the Three and Nine Months Ended September 30, 2019 and 2020

(In thousands, except per share amounts, unaudited)

 

Select Medical's capital structure includes common stock and unvested restricted stock awards. To compute earnings per share ("EPS"), Select Medical applies the two-class method because its unvested restricted stock awards are participating securities which are entitled to participate equally with its common stock in undistributed earnings.

 

The following table sets forth the net income attributable to Select Medical, its common shares outstanding, and its participating securities outstanding for the three and nine months ended September 30, 2019 and 2020:

 
   

Diluted EPS

   

Three Months Ended
September 30,

 

Nine Months Ended
September 30,

   

2019

 

2020

 

2019

 

2020

Net income

 

$

44,030

   

$

104,457

   

$

157,360

   

$

242,391

 

Less: net income attributable to non-controlling interests

 

13,298

   

27,511

   

40,978

   

60,670

 

Net income attributable to Select Medical

 

30,732

   

76,946

   

116,382

   

181,721

 

Less: net income attributable to participating securities

 

1,052

   

2,666

   

3,888

   

6,254

 

Net income attributable to common shares

 

$

29,680

   

$

74,280

   

$

112,494

   

$

175,467

 

 

The following tables set forth the computation of EPS under the two-class method for the three and nine months ended September 30, 2019 and 2020:

 
   

Three Months Ended September 30,

   

2019

   

2020

   

Net Income
Allocation

 

Shares(1)

 

Diluted EPS

   

Net Income
Allocation

 

Shares(1)

 

Diluted EPS

Common shares

 

$

29,680

   

130,007

   

$

0.23

     

$

74,280

   

129,882

   

$

0.57

 

Participating securities

 

1,052

   

4,607

   

$

0.23

     

2,666

   

4,662

   

$

0.57

 

Total

 

$

30,732

             

$

76,946

         
 
 
   

Nine Months Ended September 30,

   

2019

   

2020

   

Net Income
Allocation

 

Shares(1)

 

Diluted EPS

   

Net Income
Allocation

 

Shares(1)

 

Diluted EPS

Common shares

 

$

112,494

   

130,474

   

$

0.86

     

$

175,467

   

129,616

   

$

1.35

 

Participating securities

 

3,888

   

4,509

   

$

0.86

     

6,254

   

4,620

   

$

1.35

 

Total

 

$

116,382

             

$

181,721

         
 

_______________________________________________________________________________

(1)

Represents the weighted average share count outstanding during the period.

 

IV.  Condensed Consolidated Balance Sheets

(In thousands, unaudited)

 
   

December 31, 2019

 

September 30, 2020

Assets

       

Current Assets:

       

Cash and cash equivalents

 

$

335,882

   

$

639,800

 

Accounts receivable

 

762,677

   

842,615

 

Other current assets

 

114,433

   

141,719

 

Total Current Assets

 

1,212,992

   

1,624,134

 

Operating lease right-of-use assets

 

1,003,986

   

1,005,689

 

Property and equipment, net

 

998,406

   

927,975

 

Goodwill

 

3,391,955

   

3,369,009

 

Identifiable intangible assets, net

 

409,068

   

392,506

 

Other assets

 

323,881

   

340,564

 

Total Assets

 

$

7,340,288

   

$

7,659,877

 

Liabilities and Equity

       

Current Liabilities:

       

Payables and accruals

 

$

681,163

   

$

734,166

 

Government advances

 

   

318,116

 

Unearned government assistance

 

   

66,938

 

Current operating lease liabilities

 

207,950

   

215,235

 

Current portion of long-term debt and notes payable

 

25,167

   

11,031

 

Total Current Liabilities

 

914,280

   

1,345,486

 

Non-current operating lease liabilities

 

852,897

   

852,555

 

Long-term debt, net of current portion

 

3,419,943

   

3,390,945

 

Non-current deferred tax liability

 

148,258

   

131,423

 

Other non-current liabilities

 

101,334

   

178,967

 

Total Liabilities

 

5,436,712

   

5,899,376

 

Redeemable non-controlling interests

 

974,541

   

541,856

 

Total equity

 

929,035

   

1,218,645

 

Total Liabilities and Equity

 

$

7,340,288

   

$

7,659,877

 

 

V.  Condensed Consolidated Statements of Cash Flows

For the Three Months Ended September 30, 2019 and 2020

(In thousands, unaudited)

 
   

2019

 

2020

Operating activities

       

Net income

 

$

44,030

   

$

104,457

 

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

       

Distributions from unconsolidated subsidiaries

 

2,461

   

10,497

 

Depreciation and amortization

 

52,941

   

50,110

 

Provision for expected credit losses

 

386

   

28

 

Equity in earnings of unconsolidated subsidiaries

 

(6,950)

   

(8,765)

 

Loss on extinguishment of debt

 

10,160

   

 

Loss (gain) on sale of assets and businesses

 

5

   

(16,842)

 

Stock compensation expense

 

6,818

   

6,962

 

Amortization of debt discount, premium and issuance costs

 

3,143

   

542

 

Deferred income taxes

 

(957)

   

(11,140)

 

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

       

Accounts receivable

 

(7,552)

   

(104,592)

 

Other current assets

 

3,220

   

(23,528)

 

Other assets

 

2,198

   

4,831

 

Accounts payable and accrued expenses

 

39,251

   

133,748

 

Government advances

 

   

1,124

 

Unearned government assistance

 

   

21,433

 

Income taxes

 

(15,428)

   

(34,328)

 

Net cash provided by operating activities

 

133,726

   

134,537

 

Investing activities

       

Business combinations, net of cash acquired

 

(207)

   

(7,115)

 

Purchases of property and equipment

 

(34,671)

   

(34,319)

 

Investment in businesses

 

(8,411)

   

(11,108)

 

Proceeds from sale of assets and businesses

 

58

   

70,919

 

Net cash provided by (used in) investing activities

 

(43,231)

   

18,377

 

Financing activities

       

Borrowings on revolving facilities

 

65,000

   

 

Payments on revolving facilities

 

(260,000)

   

 

Proceeds from term loans

 

593,683

   

 

Payments on term loans

 

(242,399)

   

 

Proceeds from 6.250% senior notes

 

539,176

   

 

Payment on 6.375% senior notes

 

(710,000)

   

 

Revolving facility debt issuance costs

 

(310)

   

 

Borrowings of other debt

 

5,052

   

3,599

 

Principal payments on other debt

 

(9,948)

   

(7,087)

 

Repurchase of common stock

 

(23,689)

   

(4,827)

 

Proceeds from exercise of stock options

 

413

   

 

Decrease in overdrafts

 

(27,259)

   

 

Distributions to and purchases of non-controlling interests

 

(8,287)

   

(14,536)

 

Net cash used in financing activities

 

(78,568)

   

(22,851)

 

Net increase in cash and cash equivalents

 

11,927

   

130,063

 

Cash and cash equivalents at beginning of period

 

124,036

   

509,737

 

Cash and cash equivalents at end of period

 

$

135,963

   

$

639,800

 

Supplemental information

       

Cash paid for interest

 

$

51,181

   

$

54,050

 

Cash paid for taxes

 

29,231

   

77,025

 

 

VI.  Condensed Consolidated Statements of Cash Flows

For the Nine Months Ended September 30, 2019 and 2020

(In thousands, unaudited)

 
   

2019

 

2020

Operating activities

       

Net income

 

$

157,360

   

$

242,391

 

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

       

Distributions from unconsolidated subsidiaries

 

13,609

   

21,720

 

Depreciation and amortization

 

160,072

   

154,133

 

Provision for expected credit losses

 

2,344

   

281

 

Equity in earnings of unconsolidated subsidiaries

 

(18,710)

   

(19,677)

 

Loss on extinguishment of debt

 

10,160

   

 

Gain on sale of assets and businesses

 

(6,349)

   

(24,723)

 

Stock compensation expense

 

19,431

   

20,828

 

Amortization of debt discount, premium and issuance costs

 

9,469

   

1,635

 

Deferred income taxes

 

(7,247)

   

(14,556)

 

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

       

Accounts receivable

 

(93,425)

   

(91,413)

 

Other current assets

 

(6,016)

   

(22,815)

 

Other assets

 

1,259

   

16,335

 

Accounts payable and accrued expenses

 

23,765

   

142,027

 

Government advances

 

   

318,116

 

Unearned government assistance

 

   

66,938

 

Income taxes

 

918

   

9,415

 

Net cash provided by operating activities

 

266,640

   

820,635

 

Investing activities

       

Business combinations, net of cash acquired

 

(86,269)

   

(14,076)

 

Purchases of property and equipment

 

(123,956)

   

(105,572)

 

Investment in businesses

 

(60,668)

   

(25,857)

 

Proceeds from sale of assets and businesses

 

183

   

83,320

 

Net cash used in investing activities

 

(270,710)

   

(62,185)

 

Financing activities

       

Borrowings on revolving facilities

 

700,000

   

470,000

 

Payments on revolving facilities

 

(720,000)

   

(470,000)

 

Proceeds from term loans

 

593,683

   

 

Payments on term loans

 

(375,084)

   

(39,843)

 

Proceeds from 6.250% senior notes

 

539,176

   

 

Payment on 6.375% senior notes

 

(710,000)

   

 

Revolving facility debt issuance costs

 

(310)

   

 

Borrowings of other debt

 

19,282

   

35,086

 

Principal payments on other debt

 

(22,628)

   

(42,820)

 

Repurchase of common stock

 

(37,309)

   

(14,242)

 

Proceeds from exercise of stock options

 

872

   

 

Decrease in overdrafts

 

(25,083)

   

 

Proceeds from issuance of non-controlling interests

 

18,288

   

1,686

 

Distributions to and purchases of non-controlling interests

 

(16,032)

   

(28,196)

 

Purchase of membership interests of Concentra Group Holdings Parent

 

   

(366,203)

 

Net cash used in financing activities

 

(35,145)

   

(454,532)

 

Net increase (decrease) in cash and cash equivalents

 

(39,215)

   

303,918

 

Cash and cash equivalents at beginning of period

 

175,178

   

335,882

 

Cash and cash equivalents at end of period

 

$

135,963

   

$

639,800

 

Supplemental information

       

Cash paid for interest

 

$

149,090

   

$

140,174

 

Cash paid for taxes

 

58,472

   

81,945

 

 

VII.  Key Statistics

For the Three Months Ended September 30, 2019 and 2020

(unaudited)

 
   

2019

 

2020

 

% Change

Critical Illness Recovery Hospital

           

Number of hospitals – end of period(a)

 

100

   

100

     

Net operating revenues (,000)

 

$

462,892

   

$

519,454

   

12.2

%

Number of patient days(b)(c)

 

258,089

   

279,063

   

8.1

%

Number of admissions(b)(d)

 

9,051

   

9,380

   

3.6

%

Net revenue per patient day(b)(e)

 

$

1,773

   

$

1,845

   

4.1

%

Adjusted EBITDA (,000)

 

$

57,247

   

$

88,830

   

55.2

%

Adjusted EBITDA margin

 

12.4

%

 

17.1

%

   

Rehabilitation Hospital

           

Number of hospitals – end of period(a)

 

29

   

29

     

Net operating revenues (,000)

 

$

173,369

   

$

188,075

   

8.5

%

Number of patient days(b)(c)

 

89,454

   

95,680

   

7.0

%

Number of admissions(b)(d)

 

6,400

   

6,443

   

0.7

%

Net revenue per patient day(b)(e)

 

$

1,724

   

$

1,775

   

3.0

%

Adjusted EBITDA (,000)

 

$

36,780

   

$

44,637

   

21.4

%

Adjusted EBITDA margin

 

21.2

%

 

23.7

%

   

Outpatient Rehabilitation

           

Number of clinics – end of period(a)

 

1,707

   

1,777

     

Net operating revenues (,000)

 

$

265,330

   

$

240,042

   

(9.5)

%

Number of visits(b)

 

2,204,328

   

1,983,372

   

(10.0)

%

Revenue per visit(b)(f)

 

$

103

   

$

104

   

1.0

%

Adjusted EBITDA (,000)

 

$

40,040

   

$

30,623

   

(23.5)

%

Adjusted EBITDA margin

 

15.1

%

 

12.8

%

   

Concentra

           

Number of centers – end of period(b)

 

523

   

523

     

Net operating revenues (,000)

 

$

421,900

   

$

391,859

   

(7.1)

%

Number of visits(b)

 

3,150,903

   

2,827,047

   

(10.3)

%

Revenue per visit(b)(f)

 

$

120

   

$

121

   

0.8

%

Adjusted EBITDA (,000)

 

$

77,679

   

$

80,547

   

3.7

%

Adjusted EBITDA margin

 

18.4

%

 

20.6

%

   
 

_______________________________________________________________________________

(a) 

Includes managed locations.

   

(b) 

Excludes managed locations. For purposes of the Concentra segment, onsite clinics and community-based outpatient clinics are excluded.

   

(c)

Each patient day represents one patient occupying one bed for one day during the periods presented.

   

(d)  

Represents the number of patients admitted to our hospitals during the periods presented.

   

(e)

Represents the average amount of revenue recognized for each patient day. Net revenue per patient day is calculated by dividing patient service revenues, excluding revenues from certain other ancillary and outpatient services provided at our hospitals, by the total number of patient days.

   

(f) 

Represents the average amount of revenue recognized for each patient visit. Net revenue per visit is calculated by dividing patient service revenue, excluding revenues from certain other ancillary services, by the total number of visits.

 

VIII.  Key Statistics

For the Nine Months Ended September 30, 2019 and 2020

(unaudited)

 
   

2019

 

2020

 

% Change

Critical Illness Recovery Hospital

           

Number of hospitals – end of period(a)

 

100

   

100

     

Net operating revenues (,000)

 

$

1,381,569

   

$

1,539,601

   

11.4

%

Number of patient days(b)(c)

 

779,078

   

826,410

   

6.1

%

Number of admissions(b)(d)

 

27,679

   

28,080

   

1.4

%

Net revenue per patient day(b)(e)

 

$

1,757

   

$

1,850

   

5.3

%

Adjusted EBITDA (,000)

 

$

194,383

   

$

267,143

   

37.4

%

Adjusted EBITDA margin

 

14.1

%

 

17.4

%

   

Rehabilitation Hospital

           

Number of hospitals – end of period(a)

 

29

   

29

     

Net operating revenues (,000)

 

$

488,301

   

$

538,761

   

10.3

%

Number of patient days(b)(c)

 

258,795

   

274,329

   

6.0

%

Number of admissions(b)(d)

 

18,253

   

18,489

   

1.3

%

Net revenue per patient day(b)(e)

 

$

1,665

   

$

1,777

   

6.7

%

Adjusted EBITDA (,000)

 

$

92,545

   

$

110,811

   

19.7

%

Adjusted EBITDA margin

 

19.0

%

 

20.6

%

   

Outpatient Rehabilitation

           

Number of clinics – end of period(a)

 

1,707

   

1,777

     

Net operating revenues (,000)

 

$

774,126

   

$

662,429

   

(14.4)

%

Number of visits(b)

 

6,462,316

   

5,448,304

   

(15.7)

%

Revenue per visit(b)(f)

 

$

103

   

$

105

   

1.9

%

Adjusted EBITDA (,000)

 

$

111,615

   

$

51,463

   

(53.9)

%

Adjusted EBITDA margin

 

14.4

%

 

7.8

%

   

Concentra

           

Number of centers – end of period(b)

 

523

   

523

     

Net operating revenues (,000)

 

$

1,231,672

   

$

1,102,732

   

(10.5)

%

Number of visits(b)

 

9,165,599

   

7,855,522

   

(14.3)

%

Revenue per visit(b)(f)

 

$

122

   

$

123

   

0.8

%

Adjusted EBITDA (,000)

 

$

220,024

   

$

183,510

   

(16.6)

%

Adjusted EBITDA margin

 

17.9

%

 

16.6

%

   
 

_______________________________________________________________________________

(a)

Includes managed locations.

   

(b) 

Excludes managed locations. For purposes of the Concentra segment, onsite clinics and community-based outpatient clinics are excluded.

   

(c) 

Each patient day represents one patient occupying one bed for one day during the periods presented.

   

(d)  

Represents the number of patients admitted to our hospitals during the periods presented.

   

(e)  

Represents the average amount of revenue recognized for each patient day. Net revenue per patient day is calculated by dividing patient service revenues, excluding revenues from certain other ancillary and outpatient services provided at our hospitals, by the total number of patient days.

   

(f)  

Represents the average amount of revenue recognized for each patient visit. Net revenue per visit is calculated by dividing patient service revenue, excluding revenues from certain other ancillary services, by the total number of visits.

 

IX. Net Income to Adjusted EBITDA Reconciliation

For the Three and Nine Months Ended September 30, 2019 and 2020

(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 definitions, 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, gain (loss) on sale of businesses, and equity in earnings (losses) of unconsolidated subsidiaries.

 
 

Three Months Ended
September 30,

 

Nine Months Ended
September 30,

 

2019

 

2020

 

2019

 

2020

Net income

$

44,030

   

$

104,457

   

$

157,360

   

$

242,391

 

Income tax expense

12,847

   

31,557

   

52,140

   

76,805

 

Interest expense

54,336

   

34,026

   

156,611

   

117,499

 

Gain on sale of businesses

   

(5,143)

   

(6,532)

   

(12,690)

 

Equity in earnings of unconsolidated subsidiaries

(6,950)

   

(8,765)

   

(18,710)

   

(19,677)

 

Loss on early retirement of debt

18,643

   

   

18,643

   

 

Income from operations

122,906

   

156,132

   

359,512

   

404,328

 

Stock compensation expense:

             

Included in general and administrative

5,305

   

5,600

   

14,849

   

16,488

 

Included in cost of services

1,513

   

1,362

   

4,582

   

4,340

 

Depreciation and amortization

52,941

   

50,110

   

160,072

   

154,133

 

Adjusted EBITDA

$

182,665

   

$

213,204

   

$

539,015

   

$

579,289

 
               

Critical illness recovery hospital

$

57,247

   

$

88,830

   

$

194,383

   

$

267,143

 

Rehabilitation hospital

36,780

   

44,637

   

92,545

   

110,811

 

Outpatient rehabilitation

40,040

   

30,623

   

111,615

   

51,463

 

Concentra(a)

77,679

   

80,547

   

220,024

   

183,510

 

Other(a)(b)

(29,081)

   

(31,433)

   

(79,552)

   

(33,638)

 

Adjusted EBITDA

$

182,665

   

$

213,204

   

$

539,015

   

$

579,289

 
 

_______________________________________________________________________________

(a)

For the three and nine months ended September 30, 2020, Select Medical recognized payments received under the Provider Relief Fund for loss of revenue and health care related expenses attributable to COVID-19 as other operating income. Refer to "CARES Act Provider Relief Fund" for further discussion.

   

(b) 

Other primarily includes general and administrative costs.

 

X. Reconciliation of Earnings per Common Share to Adjusted Earnings per Common Share

For the Three and Nine Months Ended September 30, 2019 and 2020

(In thousands, except per share amounts, unaudited)

 

Adjusted net income attributable to common shares and adjusted earnings per common share are not measures of financial performance under GAAP.  Items excluded from adjusted net income attributable to common shares and adjusted earnings per common share are significant components in understanding and assessing financial performance. Select Medical believes that the presentation of adjusted net income attributable to common shares and adjusted earnings per common share are important to investors because they are reflective of the financial performance of Select Medical's ongoing operations and provide better comparability of its results of operations between periods. Adjusted net income attributable to common shares and adjusted earnings per common share 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 attributable to common shares and adjusted earnings per common share are not measurements determined in accordance with GAAP and are thus susceptible to varying calculations, adjusted net income attributable to common shares and adjusted earnings per common share as presented may not be comparable to other similarly titled measures of other companies.

 

The following tables reconcile net income attributable to common shares and earnings per common share on a fully diluted basis to adjusted net income attributable to common shares and adjusted earnings per common share on a fully diluted basis.

 
 

Three Months Ended September 30,

 

2019

 

Per Share(a)

 

2020

 

Per Share(a)

Net income attributable to common shares(a)

$

29,680

   

$

0.23

   

$

74,280

   

$

0.57

 

Adjustments:(b)

             

Loss on early retirement of debt and related costs(c)

12,777

   

0.10

   

   

 

Gain on sale of businesses

   

   

(1,189)

   

(0.01)

 

Adjusted net income attributable to common shares

$

42,457

   

$

0.33

   

$

73,091

   

$

0.56

 
 
 
 

Nine Months Ended September 30,

 

2019

 

Per Share(a)

 

2020

 

Per Share(a)

Net income attributable to common shares(a)

$

112,494

   

$

0.86

   

$

175,467

   

$

1.35

 

Adjustments:(b)

             

Loss on early retirement of debt and related costs(c)

12,777

   

0.10

   

   

 

Gain on sale of businesses

(4,543)

   

(0.03)

   

(5,089)

   

(0.04)

 

Adjusted net income attributable to common shares

$

120,728

   

$

0.93

   

$

170,378

   

$

1.31

 
 

______________________________________________________________________________

(a) 

Net income attributable to common shares and earnings per common share are calculated based on the diluted weighted average common shares outstanding, as presented in table III.

   

(b)  

Adjustments to net income attributable to common shares include estimated income tax and non-controlling interest impacts and are calculated based on the diluted weighted average common shares outstanding.

   
 

The estimated income tax impact, which is determined using tax rates based on the nature of the adjustment and the jurisdiction in which the adjustment occurred, includes both current and deferred income tax expense or benefit.

   
 

For the three months ended September 30, 2019, the adjustments to net income attributable to common shares include an estimated income tax benefit of approximately $5.9 million. For the three months ended September 30, 2020, the adjustments to net income attributable to common shares include an estimated income tax benefit of approximately $0.2 million.

   
 

For the nine months ended September 30, 2019, the adjustments to net income attributable to common shares include an estimated income tax benefit of approximately $4.0 million. For the nine months ended September 30, 2020, the adjustments to net income attributable to common shares include estimated income tax expense of approximately $3.3 million.

   

(c)

For the three and nine months ended September 30, 2019, the loss on early retirement of debt and related costs adjustment includes expenses related to the amendment to the Select credit agreement, the amendment to the Concentra-JPM first lien credit agreement, the repayment of term loans outstanding under the Concentra-JPM second lien credit agreement, and the redemption of the 6.375% senior notes.

   
 

The redemption of the 6.375% senior notes occurred on August 30, 2019, while the issuance of the $550.0 million 6.250% senior notes occurred on August 1, 2019. As a result, Select Medical recognized interest expense on both the 6.250% senior notes and the 6.375% senior notes during August 2019. The adjustment to net income attributable to common shares for the loss on early retirement of debt and related costs includes the interest expense recognized on the 6.375% senior notes during August 2019 and its related tax effects.

 

XI. Net Income to Adjusted EBITDA and Earnings per Common Share to Adjusted Earnings per Common Share Reconciliations

Business Outlook for the Year Ending December 31, 2020

(In millions, unaudited)

 

The following are reconciliations of full year 2020 Adjusted EBITDA and adjusted earnings per common share expectations as computed at the low and high points of the range to the closest comparable GAAP financial measure.  Refer to table IX and table X for a discussion of Select Medical's use of Adjusted EBITDA and adjusted earnings per common share in evaluating financial performance. Refer to table IX for the definition of Adjusted EBITDA. Each item presented in the below tables are estimations of full year 2020 expectations.

 
 

Range

Non-GAAP Measure Reconciliation

Low

 

High

Net income attributable to Select Medical

$

221

   

$

235

 

Net income attributable to non-controlling interests

75

   

75

 

Net income

296

   

310

 

Income tax expense

98

   

104

 

Interest expense

154

   

154

 

Gain on sale of businesses

(13)

   

(13)

 

Equity in earnings of unconsolidated subsidiaries

(27)

   

(27)

 

Income from operations

508

   

528

 

Stock compensation expense

29

   

29

 

Depreciation and amortization

208

   

208

 

Adjusted EBITDA

$

745

   

$

765

 
 
 
 

Range

Non-GAAP Measure Reconciliation

Low

 

High

Diluted earnings per common share

$

1.65

   

$

1.75

 

Adjustments:

     

Gain on sale of businesses

(0.04)

   

(0.04)

 

Adjusted earnings per common share

$

1.61

   

$

1.71

 

 

Cision View original content:http://www.prnewswire.com/news-releases/select-medical-holdings-corporation-announces-results-for-its-third-quarter-ended-september-30-2020-301163426.html

SOURCE Select Medical Holdings Corporation

 
 
Company Codes: NYSE:SEM
 
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