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Amedisys Reports Fourth Quarter and Year-End 2022 Financial Results, Issues 2023 Guidance, Announces Sale of Its Personal Care Line of Business and Signs Innovative Palliative Care at Home Partnership With BlueCross BlueShield of Tennessee
المصدر: Nasdaq GlobeNewswire / 15 فبراير 2023 16:10:10 America/New_York
BATON ROUGE, La., Feb. 15, 2023 (GLOBE NEWSWIRE) -- Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three-month period and year ended December 31, 2022.
Three-Month Periods Ended December 31, 2022 and 2021
- Net service revenue increased $2.7 million to $562.0 million compared to $559.3 million in 2021.
- Net income attributable to Amedisys, Inc. of $31.7 million compared to $34.0 million in 2021.
- Net income attributable to Amedisys, Inc. per diluted share of $0.97 compared to $1.04 in 2021.
Adjusted Quarterly Results*
- Adjusted EBITDA of $59.9 million compared to $64.8 million in 2021.
- Adjusted net service revenue of $562.0 million compared to $559.3 million in 2021.
- Adjusted net income attributable to Amedisys, Inc. of $38.0 million compared to $38.8 million in 2021.
- Adjusted net income attributable to Amedisys, Inc. per diluted share of $1.16 compared to $1.18 in 2021.
Years Ended December 31, 2022 and 2021
- Net service revenue increased $9.1 million to $2,223.2 million compared to $2,214.1 million in 2021.
- Net income attributable to Amedisys, Inc. of $118.6 million compared to $209.1 million in 2021.
- Net income attributable to Amedisys, Inc. per diluted share of $3.63 compared to $6.34 in 2021.
Adjusted Year End Results*
- Adjusted EBITDA of $262.1 million compared to $299.6 million in 2021.
- Adjusted net service revenue of $2,232.5 million compared to $2,207.6 million in 2021.
- Adjusted net income attributable to Amedisys, Inc. of $163.4 million compared to $196.1 million in 2021.
- Adjusted net income attributable to Amedisys, Inc. per diluted share of $5.01 compared to $5.95 in 2021.
* See below for the definition and reconciliations of non-GAAP financial measures to GAAP measures.
2023 Guidance
- Adjusted net service revenue is anticipated to be in the range of $2.244 billion to $2.274 billion.
- Adjusted EBITDA is anticipated to be in the range of $230 million to $240 million.
- Adjusted diluted earnings per share is anticipated to be in the range of $4.13 to $4.36 based on an estimated 32.9 million shares outstanding.
This guidance excludes the effects of any future acquisitions and potential share repurchases, if any are made.
Personal Care Divestiture
On February 10, 2023, we signed a definitive agreement to sell our personal care line of business (excluding the Florida operations). The divestment is expected to close during the second quarter of 2023.
BlueCross BlueShield of Tennessee Palliative Care Partnership
We also announced a new agreement between Contessa Health Management, LLC, an Amedisys subsidiary, and BlueCross BlueShield of Tennessee to provide members in Middle Tennessee with palliative care in the comfort of their home.
Paul B. Kusserow, Chairman and Chief Executive Officer stated, "I am very pleased with the way we closed out 2022 and thankful for the efforts of our nearly 20,000 associates who helped to deliver a strong quarter of performance. 2022 was a tumultuous year, but we are building momentum and have started 2023 off on the right foot. Our focus on people, growth, clinical optimization and Contessa will pay dividends as we progress throughout 2023, and our commitment to our patients and the highest quality care will help to further differentiate Amedisys. I am also thrilled to announce that we have signed an innovative partnership with BlueCross BlueShield of Tennessee to provide palliative care at home. This partnership is the first true example of the power of a combined Amedisys and Contessa platform, and we are excited to be able to expand our care continuum to best serve BlueCross BlueShield’s membership. Finally, we announced that we will be divesting our personal care line of business. We are committed to building personal care networks and look forward to the continued engagement with our network partners. 2023 will be an exciting year for Amedisys, and we look forward to consistency in our performance, continued innovation across all our lines of business and expanding our reach so that more patients can receive care where they want it most, their homes."
We urge caution in considering the current trends and 2023 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, 2022, and 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, February 16, 2023, at 11:00 a.m. ET to discuss its fourth quarter and year-end results. To participate on the conference call, please call before 11:00 a.m. ET to either (877) 524-8416 (Toll-Free) or (412) 902-1028 (Toll). A replay of the conference call will be available through March 16, 2022 by dialing (877) 660-6853 (Toll-Free) or (201) 612-7415 (Toll) and entering conference ID #13735891.
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, 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. Over 3,000 hospitals and 102,000 physicians nationwide have chosen Amedisys as a partner in post-acute care. Founded in 1982, headquartered in Baton Rouge, LA with an executive office in Nashville, TN, Amedisys is a publicly held company. With approximately 20,000 employees in 532 care centers within 37 states and the District of Columbia, Amedisys is dedicated to delivering the highest quality of care to the doorsteps of more than 465,000 patients and clients 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,” “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: changes in Medicare and other medical payment levels; changes in payments and covered services by federal and state governments; future cost containment initiatives undertaken by third-party payors; changes in the episodic versus non-episodic mix of our payors or payment methodologies; changes in the case mix of our patients; staffing shortages driven by the competitive labor market; our ability to attract and retain qualified personnel; competition in the healthcare industry; our ability to maintain or establish new patient referral sources; 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; 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; changes in estimates and judgments associated with critical accounting policies; our ability to consistently provide high-quality care; our ability to keep our patients and employees safe; our access to financing; our ability to meet debt service requirements and comply with covenants in debt agreements; business disruptions due to natural or man-made disasters, climate change or acts of terrorism, widespread protests or civil unrest; our ability to open care centers, acquire additional care centers and integrate and operate these care centers effectively; our ability to realize the anticipated benefits of acquisitions, investments and joint ventures; our ability to integrate, manage and keep our information systems secure; the impact of inflation; and changes in laws 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
CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)For the Three-Month
Periods Ended December 31,For the Years Ended
December 31,2022 2021 2022 2021 (Unaudited) Net service revenue $ 562,064 $ 559,317 $ 2,223,199 $ 2,214,112 Other operating income — — — 13,300 Cost of service, excluding depreciation and amortization 317,167 317,168 1,260,425 1,233,356 General and administrative expenses: Salaries and benefits 132,003 125,185 508,791 474,718 Non-cash compensation 570 5,949 16,560 23,809 Other 60,856 53,718 228,707 212,713 Depreciation and amortization 5,230 9,138 24,935 30,901 Impairment charge — — 3,009 — Operating expenses 515,826 511,158 2,042,427 1,975,497 Operating income 46,238 48,159 180,772 251,915 Other income (expense): Interest income 70 — 178 49 Interest expense (5,781 ) (2,791 ) (22,228 ) (9,525 ) Equity in earnings (loss) from equity method investments 397 1,017 (45 ) 4,949 Gain on equity method investments — 6 — 31,098 Miscellaneous, net 412 492 1,567 1,745 Total other (expense) income, net (4,902 ) (1,276 ) (20,528 ) 28,316 Income before income taxes 41,336 46,883 160,244 280,231 Income tax expense (9,790 ) (12,873 ) (42,545 ) (70,065 ) Net income 31,546 34,010 117,699 210,166 Net loss (income) attributable to noncontrolling interests 171 37 910 (1,094 ) Net income attributable to Amedisys, Inc. $ 31,717 $ 34,047 $ 118,609 $ 209,072 Basic earnings per common share: Net income attributable to Amedisys, Inc. common stockholders $ 0.98 $ 1.04 $ 3.65 $ 6.41 Weighted average shares outstanding 32,511 32,594 32,517 32,642 Diluted earnings per common share: Net income attributable to Amedisys, Inc. common stockholders $ 0.97 $ 1.04 $ 3.63 $ 6.34 Weighted average shares outstanding 32,602 32,823 32,653 32,972 AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except share data)As of December 31, 2022 2021 ASSETS Current assets: Cash and cash equivalents $ 40,540 $ 42,694 Restricted cash 13,593 3,075 Patient accounts receivable 296,785 274,961 Prepaid expenses 11,628 10,356 Other current assets 26,415 25,598 Total current assets 388,961 356,684 Property and equipment, net of accumulated depreciation of $101,364 and $96,937 16,026 18,435 Operating lease right of use assets 102,856 101,257 Goodwill 1,287,399 1,196,090 Intangible assets, net of accumulated amortization of $14,604 and $19,900 101,167 111,190 Deferred income tax assets — 289 Other assets 79,836 73,023 Total assets $ 1,976,245 $ 1,856,968 LIABILITIES AND EQUITY Current liabilities: Accounts payable $ 43,735 $ 38,217 Payroll and employee benefits 125,387 141,001 Accrued expenses 137,390 150,836 Current portion of long-term obligations 15,496 12,995 Current portion of operating lease liabilities 33,521 31,233 Total current liabilities 355,529 374,282 Long-term obligations, less current portion 419,420 432,075 Operating lease liabilities, less current portion 69,504 69,309 Deferred income tax liabilities 20,411 — Other long-term obligations 4,808 4,979 Total liabilities 869,672 880,645 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; 37,891,186 and 37,674,868 shares issued; and 32,518,278 and 32,509,969 shares outstanding 38 38 Additional paid-in capital 755,063 728,118 Treasury stock at cost, 5,372,908 and 5,164,899 shares of common stock (461,200 ) (435,868 ) Retained earnings 757,672 639,063 Total Amedisys, Inc. stockholders’ equity 1,051,573 931,351 Noncontrolling interests 55,000 44,972 Total equity 1,106,573 976,323 Total liabilities and equity $ 1,976,245 $ 1,856,968 AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING
(Amounts in thousands, except statistical information)For the Three-Month
Periods Ended December 31,For the Years Ended
December 31,2022 2021 2022 2021 (Unaudited) Cash Flows from Operating Activities: Net income $ 31,546 $ 34,010 $ 117,699 $ 210,166 Adjustments to reconcile net income to net cash provided by operating activities: Depreciation and amortization 5,230 9,138 24,935 30,901 Non-cash compensation 570 5,949 16,560 23,809 Amortization and impairment of operating lease right of use assets 11,247 10,183 46,029 40,364 Loss (gain) on disposal of property and equipment 12 (60 ) 519 (124 ) Gain on equity method investments — (6 ) — (31,098 ) Deferred income taxes 4,346 9,853 23,377 44,582 Equity in (earnings) loss from equity method investments (397 ) (1,017 ) 45 (4,949 ) Amortization of deferred debt issuance costs/debt discount 248 248 991 917 Return on equity method investments 1,365 1,075 5,163 5,343 Impairment charge — — 3,009 — Changes in operating assets and liabilities, net of impact of acquisitions: Patient accounts receivable 4,036 (392 ) (14,230 ) (18,030 ) Other current assets 16,404 (5,983 ) (3,525 ) (12,202 ) Other assets 155 (79 ) 438 (1,017 ) Accounts payable (992 ) (3,161 ) 4,894 (4,353 ) Accrued expenses (12,592 ) (17,552 ) (39,382 ) (26,915 ) Other long-term obligations (9,065 ) (27,011 ) (8,822 ) (28,796 ) Operating lease liabilities (10,311 ) (9,273 ) (41,175 ) (36,645 ) Operating lease right of use assets (919 ) (756 ) (3,242 ) (3,060 ) Net cash provided by operating activities 40,883 5,166 133,283 188,893 Cash Flows from Investing Activities: Proceeds from the sale of deferred compensation plan assets 163 9 252 135 Proceeds from the sale of property and equipment — 4 66 144 Purchases of property and equipment (1,827 ) (1,115 ) (6,165 ) (6,302 ) Investments in technology assets (202 ) (272 ) (1,050 ) (419 ) Investment in equity method investee — (200 ) (637 ) (200 ) Purchase of cost method investment — (5,000 ) (15,000 ) (5,000 ) Acquisitions of businesses, net of cash acquired — (5,093 ) (71,952 ) (269,965 ) Net cash used in investing activities (1,866 ) (11,667 ) (94,486 ) (281,607 ) Cash Flows from Financing Activities: Proceeds from issuance of stock upon exercise of stock options 1,226 348 2,304 2,054 Proceeds from issuance of stock to employee stock purchase plan 991 946 3,848 3,968 Shares withheld to pay taxes on non-cash compensation (32 ) (204 ) (7,981 ) (16,898 ) Noncontrolling interest contributions 1,401 250 3,501 250 Noncontrolling interest distributions (136 ) (494 ) (1,561 ) (1,747 ) Proceeds from sale of noncontrolling interest 1,876 — 5,817 — Proceeds from borrowings under term loan — — — 290,312 Proceeds from borrowings under revolving line of credit 50,500 — 534,500 500,700 Repayments of borrowings under revolving line of credit (69,000 ) — (534,500 ) (551,700 ) Principal payments of long-term obligations (3,170 ) (3,250 ) (13,296 ) (9,143 ) Debt issuance costs — — — (2,792 ) Provider relief fund advance — (58,535 ) — (60,000 ) Purchase of company stock — (14,999 ) (17,351 ) (99,878 ) Payment of accrued contingent consideration — — (5,714 ) — Net cash (used in) provided by financing activities (16,344 ) (75,938 ) (30,433 ) 55,126 Net increase (decrease) in cash, cash equivalents and restricted cash 22,673 (82,439 ) 8,364 (37,588 ) Cash, cash equivalents and restricted cash at beginning of period 31,460 128,208 45,769 83,357 Cash, cash equivalents and restricted cash at end of period $ 54,133 $ 45,769 $ 54,133 $ 45,769 For the Three-Month
Periods Ended December 31,For the Years Ended
December 31,2022 2021 2022 2021 (Unaudited) Supplemental Disclosures of Cash Flow Information: Cash paid for interest $ 5,786 $ 1,812 $ 14,939 $ 5,291 Cash paid for Infinity ZPIC interest $ 1,211 $ — $ 12,755 $ — Cash paid for income taxes, net of refunds received $ 431 $ 8,615 $ 24,013 $ 34,097 Supplemental Disclosures of Non-Cash Activity: Accrued contingent consideration $ — $ — $ 19,195 $ — Noncontrolling interest contribution $ — $ — $ 8,900 $ — Days revenue outstanding (1) 46.1 43.2 46.1 43.2 (1) Our calculation of days revenue outstanding at December 31, 2022 and 2021 is derived by dividing our ending patient accounts receivable by our average daily patient revenue for the three-month periods ended December 31, 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 December 31,2022 2021 Financial Information (in millions): Medicare $ 222.8 $ 230.1 Non-Medicare 119.8 107.2 Net service revenue 342.6 337.3 Cost of service 195.7 193.1 Gross margin 146.9 144.2 Depreciation and amortization 0.7 1.0 Other general and administrative expenses 89.1 84.7 Operating income $ 57.1 $ 58.5 Same Store Growth (1): Medicare revenue (6 %) 1 % Non-Medicare revenue 8 % 6 % Total admissions 5 % 2 % Total volume (2) 1 % 2 % Key Statistical Data - Total (3): Admissions 94,365 87,142 Recertifications 44,546 46,390 Total volume 138,911 133,532 Medicare completed episodes 75,835 78,693 Average Medicare revenue per completed episode (4) $ 2,989 $ 2,951 Medicare visits per completed episode (5) 12.5 13.7 Visiting clinician cost per visit $ 103.83 $ 98.16 Clinical manager cost per visit 11.73 10.39 Total cost per visit $ 115.56 $ 108.55 Visits 1,693,215 1,778,512 For the Years Ended
December 31,2022 2021 Financial Information (in millions): Medicare $ 891.3 $ 914.5 Non-Medicare 464.2 439.3 Net service revenue 1,355.5 1,353.8 Other operating income — 7.3 Cost of service 769.0 756.6 Gross margin 586.5 604.5 Depreciation and amortization 4.0 4.3 Other general and administrative expenses 348.5 328.5 Operating income $ 234.0 $ 271.7 Same Store Growth (1): Medicare revenue (5 %) 8 % Non-Medicare revenue 2 % 9 % Total admissions 3 % 6 % Total volume (2) — % 5 % Key Statistical Data - Total (3): Admissions 374,631 353,075 Recertifications 178,101 183,134 Total volume 552,732 536,209 Medicare completed episodes 304,012 311,531 Average Medicare revenue per completed episode (4) $ 3,010 $ 2,959 Medicare visits per completed episode (5) 12.9 13.9 Visiting clinician cost per visit $ 99.90 $ 93.44 Clinical manager cost per visit 11.08 9.75 Total cost per visit $ 110.98 $ 103.19 Visits 6,929,137 7,331,935 (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 December 31,2022 2021 Financial Information (in millions): Medicare $ 186.3 $ 193.9 Non-Medicare 11.3 11.0 Net service revenue 197.6 204.9 Cost of service 103.3 110.8 Gross margin 94.3 94.1 Depreciation and amortization 0.6 0.7 Other general and administrative expenses 51.3 54.0 Operating income $ 42.4 $ 39.4 Same Store Growth (1): Medicare revenue (4 %) — % Hospice admissions (8 %) (1 %) Average daily census (2 %) (4 %) Key Statistical Data - Total (2): Hospice admissions 12,629 13,857 Average daily census 12,878 13,237 Revenue per day, net $ 166.82 $ 168.24 Cost of service per day $ 87.21 $ 91.01 Average discharge length of stay 94 90 For the Years Ended
December 31,2022 2021 Financial Information (in millions): Medicare $ 744.1 $ 750.1 Non-Medicare 43.7 41.7 Net service revenue 787.8 791.8 Other operating income — 6.0 Cost of service 426.5 425.2 Gross margin 361.3 372.6 Depreciation and amortization 2.3 2.7 Other general and administrative expenses 203.3 198.4 Operating income $ 155.7 $ 171.5 Same Store Growth (1): Medicare revenue (1 %) — % Hospice admissions (1 %) 2 % Average daily census (1 %) (4 %) Key Statistical Data - Total (2): Hospice admissions 52,656 53,507 Average daily census 13,091 13,271 Revenue per day, net $ 164.88 $ 163.47 Cost of service per day $ 89.26 $ 87.77 Average discharge length of stay 91 94 (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 December 31,2022 2021 Financial Information (in millions): Medicare $ — $ — Non-Medicare 15.9 15.1 Net service revenue 15.9 15.1 Cost of service 12.3 11.7 Gross margin 3.6 3.4 Depreciation and amortization — — Other general and administrative expenses 2.3 2.4 Operating income $ 1.3 $ 1.0 Key Statistical Data - Total: Billable hours 453,644 500,546 Clients served 7,720 7,867 Shifts 193,220 215,167 Revenue per hour $ 35.07 $ 30.09 Revenue per shift $ 82.34 $ 69.99 Hours per shift 2.3 2.3 For the Years Ended
December 31,2022 2021 Financial Information (in millions): Medicare $ — $ — Non-Medicare 61.4 65.0 Net service revenue 61.4 65.0 Cost of service 46.7 49.1 Gross margin 14.7 15.9 Depreciation and amortization 0.1 0.2 Other general and administrative expenses 9.2 11.2 Operating income $ 5.4 $ 4.5 Key Statistical Data - Total: Billable hours 1,851,563 2,275,511 Clients served 10,448 12,074 Shifts 791,596 974,409 Revenue per hour $ 33.15 $ 28.54 Revenue per shift $ 77.55 $ 66.66 Hours per shift 2.3 2.3 Segment Information - High Acuity Care
For the Three-Month Periods
Ended December 31,2022 2021 Financial Information(in millions): Medicare $ 1.9 $ — Non-Medicare 4.0 2.0 Net service revenue 5.9 2.0 Cost of service 5.9 1.6 Gross margin — 0.4 Depreciation and amortization 0.9 0.8 Other general and administrative expenses 8.3 6.1 Operating loss $ (9.2 ) $ (6.5 ) Key Statistical Data - Total: Full risk admissions 108 61 Limited risk admissions 374 225 Total admissions 482 286 Full risk revenue per episode $ 12,282 $ 11,565 Limited risk revenue per episode $ 5,545 $ 5,740 Number of admitting joint ventures (1) 8 7 For the Years Ended December 31, 2022 2021 Financial Information (in millions): Medicare $ 5.2 $ — Non-Medicare 13.3 3.5 Net service revenue 18.5 3.5 Cost of service 18.2 2.5 Gross margin 0.3 1.0 Depreciation and amortization 3.3 1.3 Impairment charge 3.0 — Other general and administrative expenses 33.1 10.0 Operating loss $ (39.1 ) $ (10.3 ) Key Statistical Data - Total: Full risk admissions 448 107 Limited risk admissions 1,142 413 Total admissions 1,590 520 Full risk revenue per episode $ 11,273 $ 10,457 Limited risk revenue per episode $ 5,553 $ 5,693 Number of admitting joint ventures (1) 8 7 (1) Prior year count has been recast to include admitting joint ventures only.
Segment Information - Corporate
For the Three-Month Periods
Ended December 31,2022 2021 Financial Information (in millions): Other general and administrative expenses $ 42.3 $ 37.6 Depreciation and amortization 3.0 6.6 Total operating expenses $ 45.3 $ 44.2 For the Years Ended
December 31,2022 2021 Financial Information (in millions): Other general and administrative expenses $ 160.0 $ 163.1 Depreciation and amortization 15.2 22.4 Total operating expenses $ 175.2 $ 185.5 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 December 31,For the Years Ended
December 31,2022 2021 2022 2021 Net income attributable to Amedisys, Inc. $ 31,717 $ 34,047 $ 118,609 $ 209,072 Add: Income tax expense 9,790 12,873 42,545 70,065 Interest expense, net 5,711 2,791 22,050 9,476 Depreciation and amortization 5,230 9,138 24,935 30,901 Certain items (1) 7,441 6,412 58,361 (18,028 ) Interest component of certain items (1) — (451 ) (4,445 ) (1,888 ) Adjusted EBITDA (2) (7) $ 59,889 $ 64,810 $ 262,055 $ 299,598 Adjusted Net Service Revenue Reconciliation:
For the Three-Month Periods
Ended December 31,For the Years Ended
December 31,2022 2021 2022 2021 Net service revenue $ 562,064 $ 559,317 $ 2,223,199 $ 2,214,112 Add: Certain items (1) — — 9,305 (6,541 ) Adjusted net service revenue (3) (7) $ 562,064 $ 559,317 $ 2,232,504 $ 2,207,571 Adjusted Other Operating Income Reconciliation:
For the Three-Month Periods
Ended December 31,For the Years Ended
December 31,2022 2021 2022 2021 Other operating income $ — $ — $ — $ 13,300 Add: Certain items (1) — — — (13,300 ) Adjusted other operating income (4) (7) $ — $ — $ — $ — Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:
For the Three-Month Periods
Ended December 31,For the Years Ended
December 31,2022 2021 2022 2021 Net income attributable to Amedisys, Inc. $ 31,717 $ 34,047 $ 118,609 $ 209,072 Add: Certain items (1) 6,251 4,764 44,838 (12,923 ) Adjusted net income attributable to Amedisys, Inc. (5) (7) $ 37,968 $ 38,811 $ 163,447 $ 196,149 Adjusted Net Income Attributable to Amedisys, Inc. per Diluted Share Reconciliation:
For the Three-Month Periods
Ended December 31,For the Years Ended
December 31,2022 2021 2022 2021 Net income attributable to Amedisys, Inc. common stockholders per diluted share $ 0.97 $ 1.04 $ 3.63 $ 6.34 Add: Certain items (1) 0.19 0.15 1.37 (0.39 ) Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share (6) (7) $ 1.16 $ 1.18 $ 5.01 $ 5.95 (1) The following details the certain items for the three-month periods and years ended December 31, 2022 and 2021:
Certain Items:
For the Three-Month Period
Ended December 31, 2022For the Year Ended
December 31, 2022(Income) Expense (Income) Expense Certain Items Impacting Net Service Revenue: Contingency accrual $ — $ 9,305 Certain Items Impacting Cost of Service: COVID-19 costs 1,510 8,747 Clinical optimization and reorganization costs 33 1,382 Fuel supplement 261 3,576 Integration costs — 1,712 Certain Items Impacting General and Administrative Expenses: Acquisition and integration costs 1,443 11,298 COVID-19 costs 107 503 Executive Board of Directors transition award — 3,500 Severance 993 993 Legal fees - non-routine — 241 Clinical optimization and reorganization costs 2,247 5,792 Legal settlement — (1,058 ) Fuel supplement 33 251 Investment impairment — 3,009 Certain Items Impacting Total Other Income (Expense): Interest component of certain items — 4,445 Other (income) expense, net 814 4,665 Total $ 7,441 $ 58,361 Net of tax $ 6,251 $ 44,838 Diluted EPS $ 0.19 $ 1.37 For the Three-Month Period
Ended December 31, 2021For the Year Ended
December 31, 2021(Income) Expense (Income) Expense Certain Items Impacting Net Service Revenue: Contingency accrual $ — $ (6,541 ) Certain Items Impacting Other Operating Income: CARES Act funds — (13,300 ) Certain Items Impacting Cost of Service: COVID-19 costs 4,323 20,780 Certain Items Impacting General and Administrative Expenses: Acquisition and integration costs 1,310 7,559 COVID-19 costs 140 716 Pre-acquisition legal settlement — 1,825 Certain Items Impacting Total Other Income (Expense): Interest component of certain items 451 1,888 Other (income) expense, net 188 (30,955 ) Total $ 6,412 $ (18,028 ) Net of tax $ 4,764 $ (12,923 ) Diluted EPS $ 0.15 $ (0.39 ) (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.