Robert Ortenzio
Analyst · BoA Merrill Lynch. Your line is now open
Thank you, operator. Good morning, everyone. And thanks for joining us for Select Medical’s Fourth Quarter and Full Year Earnings Conference Call for 2017. Before I outline our operational metrics, I’d like to provide you with some summary comments and updates since we reported last quarter. Our LTACs, Inpatient Rehab Hospitals and Concentra business segments had a very good quarter with strong double-digit adjusted EBITDA growth on a same-quarter year-over-year basis. We also realized nice volume increases in both patient days and visits as well as increased pricing. We continue to be pleased with the progress our LTAC operators are making since the transition to patient criteria. The fourth quarter was the first full quarter of comparable year-over-year results since all of our LTACs were operating under patient criteria. For the quarter, our admissions increased 4.2% compared to the same quarter last year. Our occupancy rate in our LTACs was 65.2% in the quarter, up from 62.6% in the same quarter last year. Our occupancy rate on a same-store basis was 66.4%. Our improved occupancy and continued focus on managing cost has resulted in a 240 basis point year-over-year improvement in adjusted EBITDA margin in our LTACs. Our LTAC’s adjusted EBITDA this quarter was up 24.9% compared to the same quarter last year. Our Inpatient Rehab segment continues to experience significant growth in terms of both revenue and adjusted EBITDA. On a same-quarter year-over-year basis, revenue grew 24.7% and adjusted EBITDA increased 65.1%. Our JV pipeline remains strong. Just after the first of the year, we announced the signing of a new joint venture partnership with Banner Health in Arizona. The joint venture with Banner will consist of both inpatient and outpatient rehab, with the ultimate, building of 3 new rehab hospitals in the market. In addition, as I mentioned on our last earnings call, we opened 1 additional rehab hospital in our Cleveland Clinic joint venture in October and an additional hospital with Cleveland Clinic in Akron opened in November. The Cleveland Clinic joint venture now has 3 hospitals with 180 total beds in operation. Later this quarter, we expect to open our joint venture rehab hospital in New Orleans with Ochsner; and some time later this year, our joint venture rehabilitation hospital in Las Vegas with Dignity. Concentra continues to exceed expectations with same-quarter year-over-year strong top line adjusted EBITDA growth of 7.9% and 28%, respectively. We should continue to see significant growth in the business segment over the next couple of years as we recently announced the completion of the acquisition of U.S. HealthWorks and the related financing transaction on February 1. This partnership enables us to expand our regional and national platform and build upon our success in occupational health. Our Outpatient Rehab legacy business continues to perform well with net revenue up 6.4% and adjusted EBITDA up 7% in the quarter compared to the same quarter last year. As we mentioned the last couple of quarters, we continue to experience some headwinds with several of the acquired physiotherapy markets as a result of changes we have implemented. Overall, the quarter, net revenue on our Outpatient segment is up 2.7% and adjusted EBITDA is down 2.8% to $30 million. As I’ve mentioned previously, we’re confident our operators will improve the performance of Physio assets during 2018. I’m sure many of you have noticed in our most recent earnings press release, we are now reporting separately our LTAC and Inpatient Rehabilitation Hospital businesses. Previously, these operations were combined as our Specialty Hospital segment. Our Outpatient Rehab and Concentra segments remain the same. Let me next take you through some of the operational highlights for the fourth quarter and full year. Net revenue for the fourth quarter increased $68 million to $1.1 billion compared to same quarter last year. Net revenue for the full year increased $158 million to $4.4 billion compared to last year. Net revenue on our LTAC segment in the fourth quarter increased 2.1% to $432 million compared to $423 million in the same quarter last year. Net revenue per patient day increased to $1,724 in the fourth quarter compared to $1,689 the same quarter last year. Patient days increased 1% to 249,000 days compared to 246,000 patient days the same quarter last year. For the full year, net revenue in our LTAC segment decreased $29 million to $1.76 billion compared to $1.79 billion last year. The decline in net revenue for the year was primarily related to decrease in patient days as a result of hospital closures. Patient days decreased 3.6% to just over 1 million patient days compared to last year. Net revenue per patient day increased 2.7% to $1,735 for the year compared to $1,690 per patient day last year. The higher net revenue per patient day was primarily due to a higher-acuity patient population resulting from full implementation of patient criteria. Net revenue in our Inpatient Rehab segment for the fourth quarter increased 24.7% to $171 million compared to $137 million same quarter last year. Patient days increased 22.3% to just under 74,000 patient days compared to 60,000 days the same quarter last year. Net revenue per patient day increased to $1,667 in the fourth quarter compared to $1,500 per day same quarter last year. For the full year, net revenue in the Inpatient Rehab segment increased $127 million to $632 million compared to $504 million last year. The increase in net revenue is related to several new hospitals that we opened in 2016 and 2017. Our patient days increased 24.4% to just under 270,000 patient days compared to 217,000 patient days last year. Net revenue per patient day increased 9.8% to $1,609 for the year compared to $1,465 per patient day last year. Net revenue on our Outpatient Rehab segment for the fourth quarter increased 2.7% to $256.4 million compared to $249.7 million the same quarter last year. Patient visits increased to 2.06 million visits in the fourth quarter compared to 2.05 million visits the same quarter last year. Net revenue per visit was $104 in the fourth quarter compared to $102 per visit same quarter last year. For the full year, net revenue in our Outpatient Rehab segment increased 2.6% to $1 billion compared to $995 million last year. The acquisition of Physiotherapy on March 4, 2016, was the primary driver in the increase in net revenues compared to last year. These increases were partially offset by the sale of our contract therapy business on March 31, 2016. Patient visits in our Outpatient Rehab clinics increased 5.6% to 8.2 million compared to 7.8 million last year. Net revenue per visit was $103 this year compared to $102 last year. Net revenue in our Concentra segment for the fourth quarter increased 7.9% to $255 million compared to $236 million in the same quarter last year. For the fourth quarter, revenue from our centers was $222 million and the balance of approximately $333 million was generated from on-site clinics, community-based outpatient clinics and other services. For the centers, patient visits were 1.86 million and net revenue per visit was $120 for the fourth quarter compared to 1.73 million visits and $119 per visit in the same quarter last year. For the full year, net revenue in our Concentra segment increased 3.3% to $1.03 billion compared to $1 billion last year. For the year, revenue from our centers was $904 million and the balance of approximately $113 million was generated from on-site clinics, community-based outpatient clinics and other services. For the centers, patient visits were 7.7 million and net revenue per visit was $117 for the year compared to 7.4 million visits and $118 per visit last year. Total adjusted EBITDA for the fourth quarter grew 27.6% to $124.6 million compared to $97.7 million same quarter last year with consolidated adjusted EBITDA margin at 11.2% for the fourth quarter compared to 9.3% the same quarter last year. For the full year, total adjusted EBITDA grew 15.5% to $538 million compared to $165.8 million last year. adjusted EBITDA margin at 12.1% for the year compared to 10.9% last year. As previously mentioned, our LTAC segment adjusted EBITDA increased 24.9% in the fourth quarter to $58.4 million compared to $46.8 million the same quarter last year. Adjusted EBITDA margin for the LTAC segment improved 240 basis points to 13.5% from the fourth quarter compared to 11.1% in the same quarter last year. The adjusted EBITDA results for the LTAC segment includes startup losses of approximately $400,000 for the fourth quarter this year. For the full year, LTAC segment adjusted EBITDA increased 12.5% to $252.7 million compared to $224.6 million last year. Adjusted EBITDA margin for the LTAC segment improved 180 basis points to 14.4% compared to 12.6% last year. The increase in adjusted EBITDA margin for the year are primarily due to an increase in our net revenue per patient day while maintaining a consistent cost structure. The adjusted EBITDA results for the LTAC segment includes startup losses of approximately $600,000 this year. Inpatient Rehab adjusted EBITDA increased 65.1% in the fourth quarter to $28 million compared to $17 million in the same quarter last year. Adjusted EBITDA margin for Inpatient Rehab segment improved 400 basis points to 16.4% in the fourth quarter compared to 12.4% same quarter last year. Adjusted EBITDA results for the Inpatient segment include startup losses of approximately $3 million for the fourth quarter compared to $2.4 million same quarter last year. For the full year, Inpatient Rehab adjusted EBITDA increased 58.2% to $90 million compared to $56.9 million last year. Adjusted EBITDA margin for Inpatient Rehab segment improved 300 basis points to 14.3% compared to 11.3% last year. The increase in adjusted EBITDA margin were primarily the result of improved performance in the new hospitals that we opened in 2016 and 2017. Adjusted EBITDA startup losses were $7.5 million for the year compared to $21.8 million last year. Outpatient Rehab adjusted EBITDA for the fourth quarter was $30 million compared to $30.8 million the same quarter last year. Adjusted EBITDA margin in the Outpatient segment was 11.7% in the fourth quarter compared to 12.3% same quarter last year. As I mentioned, continue to experience operational challenges in a few of our Physio clinic markets, which is a primary driver of the decline in adjusted EBITDA and margin in the quarter compared to the same quarter last year. For the full year, Outpatient Rehab adjusted EBITDA was $132.5 million compared to $129.8 million last year with Adjusted EBITDA margin for the Outpatient segment was 13% both this year and last year. Concentra adjusted EBITDA for the fourth quarter was $31.9 million compared to $24.9 million same quarter last year. Adjusted EBITDA margin improved 200 basis points to 12.5% compared to 10.5% in the same quarter last year. For the full year, Concentra adjusted EBITDA was $157.6 million compared to $143 million last year. Adjusted EBITDA margin improved 90 basis points in 2017 to 15.2% compared to 14.3% in 2016. Earnings per fully diluted share was $0.75 for the fourth quarter compared to $0.15 for the same quarter last year. Adjusted earnings per fully diluted share was $0.31 per fully diluted share for the fourth quarter compared to $0.12 per diluted share for the same quarter last year. Adjusted earnings per fully diluted share excludes the effects resulting from federal tax reform legislation for the fourth quarter of 2017 and a nonoperating gain and its related tax effects for the fourth quarter of 2016. For the full year, earnings per fully diluted share was $1.33 compared to $0.87 last year. Adjusted earnings per fully diluted share was $0.97 per diluted share for the year compared to $0.61 per diluted share last year. Adjusted earnings per fully diluted share in 2017 excludes the effects resulting from federal tax reform legislation and loss on early retirement of debt and its related tax effects for the year. Adjusted earnings per fully diluted share in 2016 excludes the nonoperating gain and loss on early retirement of debt and their related tax effects last year. Before I conclude, I wanted to note that the Bipartisan Budget Act of 2018 included some provisions related to LTAC hospitals and outpatient rehab that I thought I should mention. For the LTAC, the act included a provision for the continuation of blended payments for site-neutral patients for an additional two years. The continuation of the blended payments is being paid for via reduction of the IPPS, or short-term acute care per diem rate, used as part of the blended payment calculation. Because Select is focused on taking criteria- eligible patients only, this rule change does not really impact the company, and Select remained at neutral on support for the rule. For Outpatient Rehab, the act also included a provision for the repeal of the therapy caps on Outpatient Rehab services. Select was supportive of this legislative change that was seen as long overdue by the industry. I’ll now turn the call over to Marty Jackson for some additional financial details before we open the call for questions.