Dave Williams
Analyst · RBC Capital Markets. Your line is open
Thanks, Kevin. I first need to take care of some housekeeping matters. As most of you are aware, effective January 1, 2018, the Financial Accounting Standards Board or FASB mandated certain changes in revenue recognition under Generally Accepted Accounting Principles, otherwise referred to as GAAP. For Chemed, this accounting standard mandates the reclassification of certain costs within the 2018 income statement when compared to prior-year formats. These reclassifications have zero impact on EBITDA, adjusted EBITDA, pretax income or net income; these reclassified expenses do impact comparative analysis between years on certain metrics such as gross margin since this accounting standard was adopted on a modified retrospective basis. Our 2017 operating results were not restated and are reported using historical revenue recognition accounting standards. This resulted in the reclassification of net room and board expenses associated with certain Medicaid patients residing in nursing homes to be reclassified from cost of services to revenue, effectively reducing VITAS revenue and cost of sales by approximately $2.6 million in 2018. In addition, uncollectable accounts receivable, commonly referred to as bad debt expense has historically been included in selling, general and administrative expenses for both VITAS and Roto-Rooter, and these are now netted in service revenue and sales or a contract revenue account. This reduced revenue in selling, general and administrative expenses by approximately $4.6 million in the quarter. The discussion and analysis of operating results on this conference call, as well as in our first quarter 2018 earnings release narrative does reclassify net 2017 room and board and estimated uncollectable receivables to facilitate analysis of operating results in the format consistent with the 2018 revenue recognition accounting standard. With that said, let's talk about the quarter. In the first quarter of 2018, VITAS net revenue was $292 million, which is an increase of 5.5% when compared to the prior-year period. This revenue increase is comprised primarily of geographically weighted average Medicare reimbursement rate increase of approximately 0.7%, a 6.1% increase in average daily census, and a reduction in Medicare Cap that increased revenue 0.6%. This growth is partially offset by acuity mix shift that negatively impacted revenue growth by 1.8 percentage points when compared to the prior-year period. In the first quarter of 2018, VITAS reversed $1.8 million in Medicare Cap billing limitations recorded in the fourth quarter of 2017 all of which relates to the 2018 Medicare Cap billing period. At March 31, 2018, VITAS had 30 Medicare provider numbers, two of which have a current estimated 2018 Medicare Cap billing limitation of approximately $616,000. Of VITAS's 30 unique Medicare provider numbers, 27 of these provider numbers have a Medicare Cap cushion of 10% or greater, one provider number has a cap cushion between 5% and 10% of revenue, and two provider numbers have a Medicare Cap billing limitations for the 2018 Medicare Cap period. VITAS's average revenue per patient per day in the quarter was $189.76, which is 1.2% below the prior-year period. Our routine home care reimbursement and high acuity care averaged $163.53 and $706.24 respectively. During the quarter, high acuity days of care were 4.8% of total days of care, and this is a 60 basis points reduction when you look at the prior year quarter. The first quarter of 2018 gross margin, excluding Medicare Cap was 21.7%, which is a 97 basis point improvement when compared to the first quarter of 2017. In our routine home care direct patient care, gross margin was 52.1% in the quarter which is an increase of 80 basis points when compared to the first quarter of 2017. Direct inpatient margin in the quarter was 7.5% and compared to a margin of 5.9% in the prior year. Occupancy of our 28 dedicated inpatient units averaged 72.2% in the quarter and compares to 71.4% occupancy in the first quarter of 2017. Continuous Care had a direct gross margin of 17.7%, an increase of 210 basis points when compared to the prior year. Average hours billed for a day of continuous care was 17.2 in the quarter which is a slight decrease compared to the 17.7 average hours billed for a day of continuous care in the first quarter of 2017. Now let's take a look at the Roto-Rooter segment. Roto-Rooter's plumbing and drain cleaning business generated sales of $147 million for the first quarter of 2018, an increase of $24.7 million or 20.2% over the prior year. Revenue from water restoration totaled $27.7 million, which is an increase of $9.6 million, or 53.3% compared to the prior year. Commercial drain clean revenue increased 7.7%, commercial plumbing and excavation increased 15.3%, and commercial water restoration grew 40.7%. And overall, our commercial revenue increased 13.4%. Residential drain cleaning increased 13.6%, plumbing and excavation increased 22.7%, and residential water restoration expanded 55.5%. Overall, aggregate residential sales increased 26.3%. Our first quarter 2018 operating results did outperform our internal projections. However, we are reiterating our earnings guidance issued in February 2018 and we'll provide an updated guidance when we report our second quarter 2018 operating results. I'll now turn this call over to Nick Westfall, Chief Executive Officer of VITAS.