Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three and nine-month periods ended September 30, 2023.

Three-Month Periods Ended September 30, 2023 and 2022

  • Net service revenue decreased $1.8 million to $556.2 million compared to $558.0 million in 2022. Prior year included $16.6 million of net service revenue from our personal care business which was divested on March 31, 2023.
  • Net income attributable to Amedisys, Inc. of $26.0 million compared to $25.6 million in 2022.
  • Net income attributable to Amedisys, Inc. per diluted share of $0.79 compared to $0.79 in 2022.

Adjusted Quarterly Results*

  • Adjusted EBITDA of $57.9 million compared to $61.5 million in 2022.
  • Adjusted net service revenue of $556.2 million compared to $558.9 million in 2022. Prior year included $16.6 million of adjusted net service revenue from our personal care business which was divested on March 31, 2023.
  • Adjusted net income attributable to Amedisys, Inc. of $32.2 million compared to $37.4 million in 2022.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $0.98 compared to $1.15 in 2022.

Nine-Month Periods Ended September 30, 2023 and 2022

  • Net service revenue increased $4.5 million to $1,665.6 million compared to $1,661.1 million in 2022. Prior year included $30.5 million of incremental net service revenue from our personal care business which was divested on March 31, 2023.
  • Net loss attributable to Amedisys, Inc. of $29.1 million, which is inclusive of $131.2 million in costs associated with our merger transactions, compared to net income attributable to Amedisys, Inc. of $86.9 million in 2022.
  • Net loss attributable to Amedisys, Inc. per diluted share of $0.89 compared to net income attributable to Amedisys, Inc. per diluted share of $2.66 in 2022.

Adjusted Year to Date Results*

  • Adjusted EBITDA of $190.4 million compared to $202.2 million in 2022.
  • Adjusted net service revenue of $1,665.6 million compared to $1,670.4 million in 2022. Prior year included $30.5 million of incremental adjusted net service revenue from our personal care business which was divested on March 31, 2023.
  • Adjusted net income attributable to Amedisys, Inc. of $109.8 million compared to $125.5 million in 2022.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $3.36 compared to $3.84 in 2022.

* See pages 2 and 14 - 16 for the definition and reconciliations of non-GAAP financial measures to GAAP measures.

The supplemental slides provided in connection with the third quarter 2023 earnings release can be found on the Investor Relations page of our website. In light of the pending merger of the Company with UnitedHealth Group Incorporated, Amedisys will not conduct a quarterly earnings call to discuss the third quarter results.

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 (loss) 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 net income attributable to Amedisys, Inc., defined as net income (loss) attributable to Amedisys, Inc. calculated in accordance with GAAP excluding certain items; and (4) adjusted net income attributable to Amedisys, Inc. per diluted share, defined as net income (loss) attributable to Amedisys, Inc. common stockholders per diluted share calculated in accordance with GAAP 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 and high acuity care services. Amedisys is focused on delivering the care that is best for our patients, whether that is in-patient hospital, palliative and skilled nursing facility ("SNF") care in their homes, home-based recovery and rehabilitation after an operation or injury, care focused on empowering our patients to manage a chronic disease or hospice care at the end of life. More than 3,000 hospitals and 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 18,600 employees in 521 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 455,000 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,” “will,” “could,” “would,” “should” and similar expressions are intended to identify forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements involve a variety of risks and uncertainties that could cause actual results to differ materially from those described therein. These risks and uncertainties include, but are not limited to, the following: disruption from the proposed merger with UnitedHealth Group with patient, payor, provider, referral source, supplier or management and employee relationships; the occurrence of any event, change or other circumstances that could give rise to the termination of the merger agreement with UnitedHealth Group or the inability to complete the proposed transaction on the anticipated terms and timetable; the risk that necessary regulatory approvals for the proposed merger with UnitedHealth Group are delayed, are not obtained or are obtained subject to conditions that are not anticipated; the failure of the conditions to the proposed merger to be satisfied; the costs related to the proposed transaction; the diversion of management time on merger-related issues; the risk that termination fees may be payable by the Company in the event that the merger agreement is terminated under certain circumstances; reputational risk related to the proposed merger; the risk of litigation or regulatory action related to the proposed merger; 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, the case mix of our patients and payment methodologies; 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") 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 SUBSIDIARIESCONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS(Amounts in thousands, except per share data)(Unaudited)
  For the Three-Month Periods Ended September 30,   For the Nine-MonthPeriods Ended September 30,
    2023       2022       2023       2022  
Net service revenue $ 556,237     $ 557,988     $ 1,665,594     $ 1,661,135  
Operating expenses:              
Cost of service, inclusive of depreciation   311,628       322,227       924,093       943,258  
General and administrative expenses:              
Salaries and benefits   129,083       125,550       380,926       376,788  
Non-cash compensation   6,612       3,495       18,968       15,990  
Merger-related expenses   4,980             25,151        
Depreciation and amortization   4,436       5,477       13,604       19,705  
Investment impairment         3,009             3,009  
Other   57,287       59,299       180,467       167,851  
Total operating expenses   514,026       519,057       1,543,209       1,526,601  
Operating income   42,211       38,931       122,385       134,534  
Other income (expense):              
Interest income   1,304       59       2,452       108  
Interest expense   (8,021 )     (4,963 )     (23,040 )     (16,447 )
Equity in earnings (loss) from equity method investments   1,252       302       9,366       (442 )
Merger termination fee               (106,000 )      
Miscellaneous, net   1,201       491       5,262       1,155  
Total other expense, net   (4,264 )     (4,111 )     (111,960 )     (15,626 )
Income before income taxes   37,947       34,820       10,425       118,908  
Income tax expense   (12,331 )     (9,417 )     (40,381 )     (32,755 )
Net income (loss)   25,616       25,403       (29,956 )     86,153  
Net loss attributable to noncontrolling interests   344       239       887       739  
Net income (loss) attributable to Amedisys, Inc. $ 25,960     $ 25,642     $ (29,069 )   $ 86,892  
Basic earnings per common share:              
Net income (loss) attributable to Amedisys, Inc. common stockholders $ 0.80     $ 0.79     $ (0.89 )   $ 2.67  
Weighted average shares outstanding   32,624       32,482       32,587       32,519  
Diluted earnings per common share:              
Net income (loss) attributable to Amedisys, Inc. common stockholders $ 0.79     $ 0.79     $ (0.89 )   $ 2.66  
Weighted average shares outstanding   32,831       32,616       32,587       32,680  

    AMEDISYS, INC. AND SUBSIDIARIESCONDENSED CONSOLIDATED BALANCE SHEETS(Amounts in thousands, except share data)
  September 30, 2023(unaudited)   December 31, 2022
ASSETS      
Current assets:      
Cash and cash equivalents $ 78,112     $ 40,540  
Restricted cash   15,904       13,593  
Patient accounts receivable   319,580       296,785  
Prepaid expenses   20,534       11,628  
Other current assets   33,097       26,415  
Total current assets   467,227       388,961  
Property and equipment, net of accumulated depreciation of $93,909 and $101,364   39,631       16,026  
Operating lease right of use assets   87,834       102,856  
Goodwill   1,244,679       1,287,399  
Intangible assets, net of accumulated amortization of $12,838 and $14,604   103,634       101,167  
Other assets   84,412       79,836  
Total assets $ 2,027,417     $ 1,976,245  
LIABILITIES AND EQUITY      
Current liabilities:      
Accounts payable $ 34,555     $ 43,735  
Payroll and employee benefits   126,989       125,387  
Accrued expenses   139,100       137,390  
Termination fee paid by UnitedHealth Group   106,000        
Current portion of long-term obligations   35,364       15,496  
Current portion of operating lease liabilities   26,111       33,521  
Total current liabilities   468,119       355,529  
Long-term obligations, less current portion   366,853       419,420  
Operating lease liabilities, less current portion   61,878       69,504  
Deferred income tax liabilities   35,398       20,411  
Other long-term obligations   1,651       4,808  
Total liabilities   933,899       869,672  
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; 38,065,853 and 37,891,186 shares issued; 32,633,599 and 32,511,465 shares outstanding   38       38  
Additional paid-in capital   776,880       755,063  
Treasury stock, at cost, 5,432,254 and 5,379,721 shares of common stock   (465,613 )     (461,200 )
Retained earnings   728,603       757,672  
Total Amedisys, Inc. stockholders’ equity   1,039,908       1,051,573  
Noncontrolling interests   53,610       55,000  
Total equity   1,093,518       1,106,573  
Total liabilities and equity $ 2,027,417     $ 1,976,245  

 

AMEDISYS, INC. AND SUBSIDIARIESCONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING(Amounts in thousands, except statistical information)(Unaudited)
  For the Three-MonthPeriods Ended September 30,   For the Nine-MonthPeriods Ended September 30,
    2023       2022       2023       2022  
Cash Flows from Operating Activities:              
Net income (loss) $ 25,616     $ 25,403     $ (29,956 )   $ 86,153  
Adjustments to reconcile net income (loss) to net cash (used in) provided by operating activities:              
Depreciation and amortization (inclusive of depreciation included in cost of service)   6,063       5,477       17,956       19,705  
Non-cash compensation   7,243       3,495       19,624       15,990  
Amortization and impairment of operating lease right of use assets   8,456       12,319       25,427       34,782  
(Gain) loss on disposal of property and equipment   (10 )     (24 )     346       507  
Loss on personal care divestiture               2,186        
Merger termination fee               106,000        
Deferred income taxes   7,313       13,028       15,417       19,031  
Equity in (earnings) loss from equity method investments   (1,252 )     (302 )     (9,366 )     442  
Amortization of deferred debt issuance costs   248       248       743       743  
Return on equity method investments   1,556       1,370       4,309       3,798  
Investment impairment         3,009             3,009  
Changes in operating assets and liabilities, net of impact of acquisitions:              
Patient accounts receivable   (40,796 )     3,078       (32,934 )     (18,266 )
Other current assets   (17,123 )     (15,461 )     (15,434 )     (19,929 )
Operating lease right of use assets   (866 )     (661 )     (2,803 )     (2,323 )
Other assets   29       63       273       283  
Accounts payable   (4,108 )     1,388       (8,839 )     5,886  
Accrued expenses   5,565       (56,319 )     10,340       (26,790 )
Other long-term obligations   23       466       (3,156 )     243  
Operating lease liabilities   (7,800 )     (10,207 )     (23,256 )     (30,864 )
Net cash (used in) provided by operating activities   (9,843 )     (13,630 )     76,877       92,400  
Cash Flows from Investing Activities:              
Proceeds from the sale of deferred compensation plan assets         61       25       89  
Proceeds from the sale of property and equipment         29       100       66  
Purchases of property and equipment   (984 )     (1,556 )     (3,728 )     (4,338 )
Investments in technology assets   (214 )     (289 )     (6,881 )     (848 )
Investment in equity method investee         (637 )           (637 )
Purchase of cost method investment                     (15,000 )
Return of investment   150             150        
Proceeds from personal care divestiture               47,787        
Acquisitions of businesses, net of cash acquired         1,359       (350 )     (71,952 )
Net cash (used in) provided by investing activities   (1,048 )     (1,033 )     37,103       (92,620 )
Cash Flows from Financing Activities:              
Proceeds from issuance of stock upon exercise of stock options   25       306       100       1,078  
Proceeds from issuance of stock under employee stock purchase plan   848       966       2,602       2,857  
Shares withheld to pay taxes on non-cash compensation   (925 )     (3,187 )     (4,413 )     (7,949 )
Noncontrolling interest contributions   856       1,148       1,232       2,100  
Noncontrolling interest distributions   (902 )     (450 )     (1,614 )     (1,425 )
Proceeds from sale of noncontrolling interest         3,941             3,941  
Proceeds from borrowings under revolving line of credit         185,500       23,000       484,000  
Repayments of borrowings under revolving line of credit         (182,000 )     (23,000 )     (465,500 )
Principal payments of long-term obligations   (6,120 )     (3,151 )     (67,113 )     (10,126 )
Purchase of company stock                     (17,351 )
Payment of accrued contingent consideration   (36 )     (5,714 )     (4,091 )     (5,714 )
Purchase of noncontrolling interest               (800 )      
Net cash used in financing activities   (6,254 )     (2,641 )     (74,097 )     (14,089 )
Net (decrease) increase in cash, cash equivalents and restricted cash   (17,145 )     (17,304 )     39,883       (14,309 )
Cash, cash equivalents and restricted cash at beginning of period   111,161       48,764       54,133       45,769  
Cash, cash equivalents and restricted cash at end of period $ 94,016     $ 31,460     $ 94,016     $         31,460  
               
  For the Three-Month Periods Ended September 30,   For the Nine-Month Periods Ended September 30,
    2023       2022       2023       2022  
Supplemental Disclosures of Cash Flow Information:              
Cash paid for interest $ 6,756     $ 4,664     $ 19,787     $ 9,153  
Cash paid for Infinity ZPIC interest $     $ 11,544     $     $ 11,544  
Cash paid for income taxes, net of refunds received $ 8,498     $ 605     $ 24,318     $ 23,582  
Cash paid for operating lease liabilities $ 8,665     $ 10,868     $ 26,059     $ 33,187  
Cash paid for finance lease liabilities $ 3,141     $ 339     $ 8,462     $ 1,074  
Supplemental Disclosures of Non-Cash Activity:              
Right of use assets obtained in exchange for operating lease liabilities $ 10,459     $ 10,390     $ 25,261     $ 36,980  
Right of use assets obtained in exchange for finance lease liabilities $ 7,020     $ 530     $ 34,964     $ 1,846  
Reductions to right of use assets resulting from reductions to operating lease liabilities $     $ 624     $ 15,135     $ 3,387  
Reductions to right of use assets resulting from reductions to finance lease liabilities $ 315     $ 564     $ 1,209     $ 564  
Accrued contingent consideration $     $     $     $ 19,195  
Noncontrolling interest contribution $     $     $     $ 8,900  
Days revenue outstanding (1)   49.8       47.3       49.8       47.3  
(1) Our calculation of days revenue outstanding at September 30, 2023 and 2022 is derived by dividing our ending patient accounts receivable by our average daily patient revenue for the three-month periods ended September 30, 2023 and 2022, respectively.
AMEDISYS, INC. AND SUBSIDIARIESSEGMENT INFORMATION(Amounts in millions, except statistical information)(Unaudited)
Segment Information - Home Health
  For the Three-Month PeriodsEnded September 30,
    2023       2022  
Financial Information (in millions) (6):      
Medicare $ 217.9     $ 225.6  
Non-Medicare   133.7       113.6  
Net service revenue   351.6       339.2  
Cost of service, inclusive of depreciation   201.6       196.7  
Gross margin   150.0       142.5  
General and administrative expenses   91.4       89.1  
Depreciation and amortization   1.8       0.9  
Operating income $ 56.8     $ 52.5  
Same Store Growth(1):      
Medicare revenue   (2 %)     (6 %)
Non-Medicare revenue   17 %     (1 %)
Total admissions   4 %     5 %
Total volume(2)   3 %     1 %
Key Statistical Data - Total(3)(6):      
Admissions   98,527       95,566  
Recertifications   45,693       45,098  
Total volume   144,220       140,664  
       
Medicare completed episodes   72,714       76,334  
Average Medicare revenue per completed episode(4) $ 3,015     $ 2,992  
Medicare visits per completed episode(5)   12.4       12.7  
       
Visiting clinician cost per visit $ 105.06     $ 101.33  
Clinical manager cost per visit   11.98       11.44  
Total cost per visit $ 117.04     $ 112.77  
Visits   1,723,289       1,744,385  
  For the Nine-Month PeriodsEnded September 30,
    2023       2022  
Financial Information (in millions) (6):      
Medicare $ 653.1     $ 671.7  
Non-Medicare   391.6       345.1  
Net service revenue   1,044.7       1,016.8  
Cost of service, inclusive of depreciation   593.1       576.6  
Gross margin   451.6       440.2  
General and administrative expenses   270.5       261.1  
Depreciation and amortization   4.3       3.3  
Operating income $ 176.8     $ 175.8  
Same Store Growth(1):      
Medicare revenue   (3 %)     (5 %)
Non-Medicare revenue   13 %     %
Total admissions   5 %     2 %
Total volume(2)   3 %     %
Key Statistical Data - Total(3)(6):      
Admissions   297,943       281,393  
Recertifications   134,826       133,775  
Total volume   432,769       415,168  
       
Medicare completed episodes   221,125       229,098  
Average Medicare revenue per completed episode(4) $ 2,998     $ 3,019  
Medicare visits per completed episode(5)   12.4       13.0  
       
Visiting clinician cost per visit $ 101.55     $ 98.72  
Clinical manager cost per visit   11.41       10.99  
Total cost per visit $ 112.96     $ 109.71  
Visits   5,250,944       5,256,207  
(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, startups and de novos.
(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 at 2% and 1% for the three-month periods ended March 31, 2022 and June 30, 2022, respectively, and the reinstatement of sequestration 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.
(6) Prior year has been recast to conform to the current year presentation.

Segment Information - Hospice

  For the Three-Month Periods Ended September 30,
    2023       2022  
Financial Information (in millions):      
Medicare $ 188.9     $ 187.8  
Non-Medicare   11.3       10.9  
Net service revenue   200.2       198.7  
Cost of service, inclusive of depreciation   104.2       109.4  
Gross margin   96.0       89.3  
General and administrative expenses   48.4       49.1  
Depreciation and amortization   0.8       0.5  
Operating income $ 46.8     $ 39.7  
Same Store Growth(1):      
Medicare revenue   1 %     %
Hospice admissions   (6 %)     (3 %)
Average daily census   (2 %)     1 %
Key Statistical Data - Total(2):      
Hospice admissions   11,968       12,782  
Average daily census   12,943       13,314  
Revenue per day, net $ 168.11     $ 162.24  
Cost of service per day $ 87.48     $ 89.36  
Average discharge length of stay   94       92  
  For the Nine-Month Periods Ended September 30,
    2023       2022  
Financial Information (in millions):      
Medicare $ 559.8     $ 557.8  
Non-Medicare   33.0       32.4  
Net service revenue   592.8       590.2  
Cost of service, inclusive of depreciation   304.4       323.2  
Gross margin   288.4       267.0  
General and administrative expenses   144.1       152.1  
Depreciation and amortization   2.2       1.7  
Operating income $ 142.1     $ 113.2  
Same Store Growth(1):      
Medicare revenue   %     %
Hospice admissions   (6 %)     1 %
Average daily census   (2 %)     (1 %)
Key Statistical Data - Total(2):      
Hospice admissions   37,361       40,027  
Average daily census   12,864       13,163  
Revenue per day, net $ 168.80     $ 164.24  
Cost of service per day $ 86.66     $ 89.94  
Average discharge length of stay   91       90  
(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 de novos.

Segment Information - Personal Care (1)

  For the Three-Month Periods Ended September 30,
    2023     2022
Financial Information (in millions):      
Medicare $   $
Non-Medicare       16.6
Net service revenue       16.6
Cost of service, inclusive of depreciation       12.2
Gross margin       4.4
General and administrative expenses       2.4
Depreciation and amortization      
Operating income $   $ 2.0
Key Statistical Data - Total:      
Billable hours       474,365
Clients served       7,771
Shifts       202,638
Revenue per hour $   $ 34.98
Revenue per shift $   $ 81.89
Hours per shift       2.3
  For the Nine-Month Periods Ended September 30,
    2023     2022
Financial Information (in millions):      
Medicare $   $
Non-Medicare   15.0     45.5
Net service revenue   15.0     45.5
Cost of service, inclusive of depreciation   11.1     34.5
Gross margin   3.9     11.0
General and administrative expenses   2.3     6.8
Depreciation and amortization       0.1
Operating income $ 1.6   $ 4.1
Key Statistical Data - Total:      
Billable hours   440,464     1,397,919
Clients served   7,892     9,530
Shifts   191,379     598,376
Revenue per hour $ 33.97   $ 32.53
Revenue per shift $ 78.19   $ 76.00
Hours per shift   2.3     2.3
(1) We completed the sale of our personal care business on March 31, 2023.

Segment Information - High Acuity Care

  For the Three-Month Periods Ended September 30,
    2023       2022  
Financial Information (in millions) (1):      
Medicare $     $  
Non-Medicare   4.4       3.5  
Net service revenue   4.4       3.5  
Cost of service, inclusive of depreciation   5.8       3.9  
Gross margin   (1.4 )     (0.4 )
General and administrative expenses   5.3       5.2  
Depreciation and amortization   0.7       0.8  
Investment impairment         3.0  
Operating loss $ (7.4 )   $ (9.4 )
Key Statistical Data - Total:      
Full risk admissions   150       130  
Limited risk admissions   430       300  
Total admissions   580       430  
       
Full risk revenue per episode $ 10,168     $ 11,615  
Limited risk revenue per episode $ 6,242     $ 5,580  
       
Number of admitting joint venture markets   11       8  
  For the Nine-Month Periods Ended September 30,
    2023       2022  
Financial Information (in millions) (1):      
Medicare $     $    —  
Non-Medicare   13.1       8.6  
Net service revenue   13.1       8.6  
Cost of service, inclusive of depreciation   15.5       9.0  
Gross margin   (2.4 )     (0.4 )
General and administrative expenses   15.0       14.6  
Depreciation and amortization   2.3       2.4  
Investment impairment         3.0  
Operating loss $ (19.7 )   $ (20.4 )
Key Statistical Data - Total:      
Full risk admissions   468       339  
Limited risk admissions   1,263       768  
Total admissions   1,731       1,107  
       
Full risk revenue per episode $ 10,783     $ 11,018  
Limited risk revenue per episode $ 5,881     $ 5,556  
       
Number of admitting joint venture markets   11       8  
(1) Prior year has been recast to conform to the current year presentation.

Segment Information - Corporate

  For the Three-Month PeriodsEnded September 30,
    2023     2022
Financial Information (in millions) (1):      
General and administrative expenses $ 52.9   $ 42.6
Depreciation and amortization   1.1     3.3
Total operating expenses $ 54.0   $ 45.9
  For the Nine-Month PeriodsEnded September 30,
    2023     2022
Financial Information (in millions) (1):      
General and administrative expenses $ 173.6   $ 126.0
Depreciation and amortization   4.8     12.2
Total operating expenses $ 178.4   $ 138.2
(1) Prior year has been recast to conform to the current year presentation.
    AMEDISYS, INC. AND SUBSIDIARIESRECONCILIATION 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 PeriodsEnded September 30,   For the Nine-Month PeriodsEnded September 30,
    2023     2022     2023       2022  
Net income (loss) attributable to Amedisys, Inc. $ 25,960   $ 25,642   $ (29,069 )   $ 86,892  
Add:              
Income tax expense   12,331     9,417     40,381       32,755  
Interest expense, net   6,717     4,904     20,588       16,339  
Depreciation and amortization   6,063     5,477     17,956       19,705  
Certain items(1)   6,807     15,861     140,498       50,920  
Interest component of certain items(1)       207           (4,445 )
Adjusted EBITDA(2)(6) $ 57,878   $ 61,508   $ 190,354     $ 202,166  

Adjusted Net Service Revenue Reconciliation:

  For the Three-Month PeriodsEnded September 30,   For the Nine-Month PeriodsEnded September 30,
    2023     2022     2023     2022
Net service revenue $ 556,237   $ 557,988   $ 1,665,594   $ 1,661,135
Add:              
Certain items(1)       931         9,305
Adjusted net service revenue(3) (6) $ 556,237   $ 558,919   $ 1,665,594   $ 1,670,440

Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:

  For the Three-Month PeriodsEnded September 30,   For the Nine-Month PeriodsEnded September 30,
    2023     2022     2023       2022
Net income (loss) attributable to Amedisys, Inc. $ 25,960   $ 25,642   $ (29,069 )   $ 86,892
Add:              
Certain items(1)   6,242     11,740     138,884       38,587
Adjusted net income attributable to Amedisys, Inc.(4)(6) $ 32,202   $ 37,382   $ 109,815     $ 125,479

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

  For the Three-Month PeriodsEnded September 30,   For the Nine-Month PeriodsEnded September 30,
    2023     2022     2023       2022
Net income (loss) attributable to Amedisys, Inc. common stockholders per diluted share $ 0.79   $ 0.79   $ (0.89 )   $ 2.66
Add:              
Certain items(1)   0.19     0.36     4.25       1.18
Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share(5)(6) $ 0.98   $ 1.15   $ 3.36     $ 3.84
(1) The following details the certain items for the three and nine-month periods ended September 30, 2023 and 2022:

Certain Items (in thousands):

  For the Three-Month PeriodsEnded September 30, 2023   For the Nine-Month PeriodsEnded September 30, 2023
  (Income) Expense   (Income) Expense
Certain Items Impacting Cost of Service, Inclusive of Depreciation:      
Clinical optimization and reorganization costs $ 282     $ 396
Certain Items Impacting General and Administrative Expenses:      
Acquisition and integration costs   338       3,106
CEO transition   1,094       5,279
Merger-related expenses   4,980       25,151
Clinical optimization and reorganization costs   466       4,203
Personal care divestiture         525
Certain Items Impacting Total Other Income (Expense):      
Other (income) expense, net (includes $106,000 merger termination fee)   (353 )     101,838
Total $ 6,807     $ 140,498
Net of tax $ 6,242     $ 138,884
Diluted EPS $ 0.19     $ 4.25
  For the Three-Month PeriodsEnded September 30, 2022   For the Nine-Month PeriodsEnded September 30, 2022
  (Income) Expense   (Income) Expense
Certain Items Impacting Net Service Revenue:      
Contingency accrual $ 931     $ 9,305  
Certain Items Impacting Cost of Service:      
COVID-19 costs   1,701       7,237  
Clinical optimization and reorganization costs   1,154       1,349  
Fuel supplement   1,962       3,315  
Integration costs   311       1,712  
Certain Items Impacting General and Administrative Expenses:      
Acquisition and integration costs   3,154       9,855  
COVID-19 costs   159       396  
CEO transition         3,500  
Legal fees - non-routine         241  
Clinical optimization and reorganization costs   2,676       3,545  
Legal settlement         (1,058 )
Fuel supplement   218       218  
Investment impairment   3,009       3,009  
Certain Items Impacting Total Other Income (Expense):      
Interest component of certain items   (207 )     4,445  
Other expense, net   793       3,851  
Total $ 15,861     $ 50,920  
Net of tax $ 11,740     $ 38,587  
Diluted EPS $ 0.36     $ 1.18  
(2) Adjusted EBITDA is defined as net income (loss) 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 net income attributable to Amedisys, Inc. is defined as net income (loss) attributable to Amedisys, Inc. calculated in accordance with GAAP excluding certain items as described in footnote 1.
(5) 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.
(6) Adjusted EBITDA, adjusted net service revenue, adjusted net income attributable to Amedisys, Inc. and adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share should not be considered as an alternative to, or more meaningful than, income before income taxes or other measures calculated in accordance with GAAP. These calculations may not be comparable to a similarly titled measure reported by other companies, since not all companies calculate these non-GAAP financial measures in the same manner.

   

 

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