Earnings Labs

U.S. Physical Therapy, Inc. (USPH)

Q2 2010 Earnings Call· Fri, Aug 6, 2010

$71.98

-0.77%

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by. And welcome to the Second Quarter 2010 Earnings Conference Call. All lines have been placed on mute to prevent any background noise. After the speakers' remarks, there will be a question-and-answer session. (Operator Instructions). Thank you. I would now like to turn the conference over to Mr. Chris Reading, President and CEO. Sir, you may begin your conference.

Chris Reading

Management

Thank you very much. Good morning everyone before we start today I would just let you know who is with me in Houston Larry McAfee, our Executive Vice President, Chief Financial Officer; Jon Bates, our Vice President and Controller. Absent today is going Glenn McDowell, our Chief Operating Officer. Glenn is on a very deserved vacation. Somewhere outside to reach of cell phones and so what happened he had chance to take some deserved time off and he will be back next week. Any questions normally for Glenn we will prepare to cover here as well. Before we start I would like to ask Jon to read a brief disclosure statement and then we will begin.

Jon Bates

Management

Chris Reading

Management

Thanks, Jon. For those of you who that are normally on our call, I’m going to handle the call a little bit differently today than normal and go out straight and just talk to you for a little bit today. Then I will ask Glenn to cover the permanent financial details, really want to try to talk and explain what we are as a company, what we are doing and why we are able to achieve some of the results that we have able to achieve this quarter in this year. I also want to tell little bit of a story along the way and highlight some of our partnerships. Right in the call earlier this week with our audit committee to clear the press release in the 10-Q and I think I opened the call by saying that we had a pretty solid quarter at which point I think it probably expanded a couple of people over the call on the team because really we had an outstanding quarter. We always look to try to make it as perfect as we can be and that’s what we should stride for and knowing that we are probably not going to get there one of those areas we have continued work to do always in the same-store area that would have probably made this about as close to a perfect quarter as we could have gotten but it was truly an excellent quarter force we are very happy with the progress we have made since last year and remember last year was a great year for us. Second quarter last year was a record quarter and we moved ahead from where we were second quarter of last year, I think at $0.31 on reported basis up significantly over 20% to $0.38…

Larry McAfee

Management

Thanks, Chris. First, I will review the quarter results and then we will talk about the six months. In a second quarter 2010, net revenue grows by 4.5% to $54.1 million due to an increase in our average net break per visit to about 1.9% to over $105 and an increase of 10,000 in patient visits to 497,000. Our gross margin increased by 100 basis points to 28.7%, as clinic operating cost were reduced as a percent of revenue. Corporate office cost at 10.2% of revenue in second quarter were down from 11.3% same time last year. Our operating income increased by 17.7% to just under $10 million and our operating income margin of 18.5% with a 210 basis point improvement from the second quarter of last year. Our net income rose almost 23% or $4.45 million, our earning per share increased to $0.38 from $0.31. Our same-store revenues for de nova and acquired clinic open a year or more declined by less than percent. The average net rating increased by 1.6% while same store did (inaudible) 2.4. Now I quickly go through the first half year results. Net revenue increased 4.6% to $104.5 million, gross margin for the six months increased by 60 basis points to 26.8%, corporate office cost were 10.8% revenues compared to 11.3% a year ago. Our operating income increased in the first six months by 11.5% to $16,650,000, and our net income for the first half rose by almost 20% to $7.6 million. Earnings per share increased $0.64 to $0.84, we ended in June with 369 products during the six months, we’ve acquired five, opened eight, start up de nova so with the five great joint venture in the first quarter and we closed seven locations. Our cash flow has been really exceptional during the second quarter, notes and bank borrowings were paid down by $7.8 million down a balance of $4.3 million at the end of the quarter. Our cash less debt or net cash position at June 30 was positive; it was $2.8 million or about $0.25 per share. Based on our first-half results, in the earnings today, management raised its earnings guidance for the year, from on the low end $1.14 after $1.17 and on the upper end of the range of $1.20 to $1.22.

Chris Reading

Management

Thanks Larry. With that operator I’d like to ask you to go ahead and open it up for questions.

Operator

Operator

(Operator Instructions). Your first question comes from Larry Solow of CJS Securities. Larry Solow – CJS Securities: You mentioned little bit like just the one negative is same store visits and it looks like they were down 2.5% this quarter or more than last quarter, anymore color on that and just any underlying trends there?

Larry McAfee

Management

Larry, I will give you some I am slipping through a couple of my pages. I will give you a couple of thing, it’s been kind of mix around the country so it isn’t located to one part of the country are very capable long-term partnerships are actually for the most part doing pretty well. Where we struggled over the last two years when the market’s gotten tougher which we continue to struggle a little bit, we tried to augment that with some sales efforts and some other things. When I look at, kind of find new quarter. When I look at our business per clinic per day for quarter we are actually up just very slightly from what we were at this time last year. So I think we are shifting a little bit and we sold some facilities in the quarter earlier this year and that’s impacted us a little bit because those numbers come out and they were around before we had the flood. But in general I would say that the environment is a little bit tough right now. We had an excellent June, I think from the volume standpoint and from what I've seen. We don’t have certainly any financials for July but July has been very solid as well. I don’t know when we are going to see absolute time in same-store. I think probably in some combination while we continue to fight for it very hard, it is going to take a little time until the economy improves a little but more. It is not bad. Larry Solow – CJS Securities: Would you sell those businesses doesn’t that come out of same-store comp or is there fixed there.

Larry McAfee

Management

They came out with the once we sold we are actually clinics that we growing at a pretty good cliff. So it hurt the numbers. Larry Solow – CJS Securities: Got you then any reason why you would sell better performing clinic or was it?

Larry McAfee

Management

Yes we made a lot of money of them.

Chris Reading

Management

There was an opportunity in the market which it’s a little bit of a long story. But it was a partnership that needed to, that needed to go at different direction and it was a good opportunity for us to sell and we made decisions to do that.

Larry McAfee

Management

Yes. It was an unusual situation that was a joint venture and we all buy and sell agreement with our partners there so that at least really got where we need to either buy them out or buy them now. Larry Solow – CJS Securities: You mentioned Chris some of the CMS proposals out there that you guys don’t particularly agree with. This proposal to lower reimbursement on multiple services have performed and we have therapy, would that impact you guys?

Chris Reading

Management

Yes, MPPR, Multiple Procedure Payment Reduction plan would impact us if it goes through I mean it will impact hospital providers, it will impact out patient providers as well. We have done any analysis on that. We have folks on the ground in Washington who are very connected with the folks at CMS; there is the common period that extends to the end of this month. A number of alliance industry groups working in collaboration on this directly a very focused grass roots effort. It seems a little disconnected when you get a 2. Whatever percent increase becomes one week from Congress because they recognize that we are in the value end of this proposition, we are getting patients better and holding much more expensive procedures and then the next week CMS comes out with something that’s totally out of our field. In some discussion with them, I think there is some methodology question in terms of how they come up with their assessment and I think at this point in time anything could happen but I think there is at least the possibility that some of this has the potential to change before install. That said, we are working on the business like we are working on the business like we always do and if doesn't change we do our very best to deal with that and grow the company as we have in the past. We are just going to have continued to be creative as we have been. Larry Solow – CJS Securities: And how it will be implemented in 2011 I guess?

Chris Reading

Management

As it's proposed right now that's correct.

Larry McAfee

Management

In our 10-Q we got, they are identical notes but we have two things in the Q filed today. Talked about the proposal what our Medicare business is, the potential impact etcetera. I think in all probability what we have in there which is what our CMS has laid out initially will probably not be where it ends up the problem is, it seems like every time they come out with proposal gets modified one way or another but we have some information about it in the Q today.

Operator

Operator

The next question comes from Brian Tanquilut of Jefferies & Company Brian Tanquilut - Jefferies & Company: Chris, thank you for all that color that you gave us on your partnerships and all the development things that you're doing. Just wanted to hear from you what your view is on the current pipeline for the year, both for acquisitions and de novos? What should we expect in terms of deal flow this year?

Chris Reading

Management

I am not going to give you any hard numbers. I will tell you that for this current quarter our organic development looks very good and we have had this year a lot of good discussions. There were some very good partnerships around the country in terms of acquisition. We've got some things working on that may or may not happen. But it's been a very active for us and I think over some period of time we are seeing number of those things come to fruition. Brian Tanquilut - Jefferies & Company: Okay and then on the Medicare comments that you just made earlier, I mean, Medicare is a pretty small percentage of your business but what are you guys thinking in terms of what you can do to your business to adapt let’s just say this proposal goes through in its current form?

Chris Reading

Management

Number one, Medicare is you know what is the percentage count?

Larry McAfee

Management

In terms of absolute receipts we get from them is 20.4%.

Chris Reading

Management

Okay so Medicare is 20.4%, I don’t know if it’s small or not but we are working and it will take some time. But we are working on some comp related initiatives which give us annual with industry which helps to drive both volume and is also pretty solid in terms of our rate. We’ve been able this year to get some expansion of rate whether that can continue or not sure but we remain focused on those things. And then really it comes down to figure we got to figure out how to continue to be more efficient as the environment changes and still deliver an excellent clinical product and that’s happening slowly but I think our people understand that the environment is not static and we can’t be static either and so I think there is more opportunity there where we are and where the rest of the industry is, its enough from the delta between now we’ve got continued progress to make. I think the team has done an excellent job in these last two years taking up cost from our leases that we had one of the very detailed numbers of our audit committee pointed out the fact that we’ve had some pretty nice reduction in some of the categories in our cost structure. We have some very good negotiators here who work to take out contract cost in a variety of different areas. We brought on some new partners in our equipment, in our supply areas. And have negotiated some great deals there and so, its not just on the labor side, we are looking at every available facet of our business seem to be honest two years ago I thought we run in good bid without and we found some more. So it is not just one thing. It is a combination but we are working on all those things to try to overcome whether it is employment or CMS with Olympia proposal that maybe not happen, I think we are going to be okay.

Larry McAfee

Management

Brian I gave you the wrong number, I gave you the Q1 number, our Medicare as percentage of actual revenues in the second quarter was 19.7%. It is actually come down. Brian Tanquilut - Jefferies & Company: Coming down, yes. And, Chris, you talked about your view two years ago about expenses. I mean where you stand today? Do you feel like with all the stuff that you guys have done in the last couple of years and as I look at your P&L on a dollar basis, a lot of your costs are holding firm, do you think there is more that you can squeeze in terms of cost?

Chris Reading

Management

I think the answer I think there is some more, the real answer is we are not going to get people cheaper and we are not going to look for a lesser quality person. But I think over time as we provide more resources and more tools as we’ve tried doing, on a very focused way these last few years. We will get more efficient, that’s all I think that the relative for the delivery for the visits and the units were able to drive I think will go down.

Larry McAfee

Management

If you look at the earnings growth in the most recent quarter, we have some gross margin improvement. We also have operating margin improvement. There are 10 basis points and a big chunk of that, which we said from the beginning when our corporate cost use to be about 14%, our goal was to get it to 10% invested revenues. Now we are real close the much recent quarter, but there is some important improvement as we continue to add businesses, we don’t have to add costs incorporate at the same pace. Brian Tanquilut - Jefferies & Company: Okay. And then, Chris, sorry, one more question here. As it's relates to pricing in other areas of healthcare outside of Medicare, we're obviously hearing about commercial pricing pressure and all that kind of stuff. So I'm just wondering if you're seeing any of that in your industry right now.

Chris Reading

Management

I'll characterize it this way, in the last two or three years we haven't felt a big change. So we remain very focused on where we have density I give you an example in Nashville when we did start deals, coming up on three years now. We did that deal; their net rate was $87 a visit through local efforts and efforts here, their net right now is right out of $100 a visit. Now we can't give that everywhere but we are able to get at Nashville. So, we are able to go and look and where we have density and opportunistically where we have relationships and other things and little by little we made some decent progress. Brian Tanquilut - Jefferies & Company: Okay. And then, Larry, last question. As we look at our model for the year, is there any seasonality factor that we should be baking into the back half of the year?

Larry McAfee

Management

Yes, by far the second quarter is our best quarter. Things normally slow down pretty dramatically in the summer, Chris mentioned June was surprisingly good, but certainly July and August are normally slower and then when kids get back in school in September or October gets back up so the third quarter is a good quarter and in the fourth quarter really primarily around the times of the holidays week, Thanks giving and the week before and after Christmas through the New Year really slow. The fourth quarter is absolutely normally our slowest quarter of the year.

Operator

Operator

Next question comes from Mike Petusky of Noble Research.

Unidentified Analyst

Analyst

This is actually Terry Baker in for Mike this morning. Nice quarter. I just have a few housekeeping questions for you. I know you said the Medicare mix was 19.7%; could you break out the rest of the payer mix for this quarter?

Larry McAfee

Management

I want to explain historically this is long before Chris and I got here. The company has always reported, if you look at our investor presentation and pie chart there in terms of the payers. What the charges were as people familiar with medical billing know what you bill or what you get paid are two different things. So we are going to start reporting what we actually get paid as a percentage of revenues by the different payers. And it's slightly different than what the charges are. So I give you for example, I get to Medicare what the charges were versus what we get paid. These are charge numbers and we are going to update our investor presentation in other information so these going forward. Private pay which are really primarily PPS and those type indemnity plans, it's all insurance related was 25.6%; managed care was HMOs requested the field etcetera is 31.9%. So those two combined which is really your insurance reimburse business and the copaid's from those. It's 57.5%. Workers' comp, which historically we report at a lower percentage because the charges as a percent lower of the payments are actually higher, workers' comp is 16.5% of revenue or actual receipt in the second quarter. Medicare was 19.7% of revenue and by comparison it was 22.8% of billings. So it represents about 23% of billings with less than 20% of revenues. Medicaid which we don’t normally breakout but I am going to do it in this case to see that if the board was 1.9% and that our other payers who constituted 4.4% of revenues.

Unidentified Analyst

Analyst

Okay, thanks. Do you have the number for the visits per full-time employee for this quarter?

Chris Reading

Management

Yeah. I have got it; it was an 11.22% for the quarter.

Larry McAfee

Management

Which is up from 11.1% in Q1.

Unidentified Analyst

Analyst

Okay, thanks. And then I just have a few quick questions about sales and sales coverage. Could you just tell me how many sales reps you had at the end of this quarter, what the ratio was for commission versus traditional sales reps?

Chris Reading

Management

This is Glen's area and he left me some crib notes. So we have 78 total sales reps and that includes the commission only reps covering about 275 locations.

Larry McAfee

Management

And we have 50 what we call traditional reps. So we have 20, 38 commissions.

Chris Reading

Management

Right and so right now we have 14 or 15 full and part time sales reps that we are looking to fill, we are looking to again double up on some of our bigger markets where we have 8 to 10 locations also looking to fill in with some part time people. And we will keep the commission sales rep program going as long as we can it's still producing very good results although we continue to have some in flow and out flow there. But there is no reason to discontinue that at this point certainly but we will see that some reps over the course of the next six months.

Operator

Operator

Your next question comes from Mitra Ramgopal of Sidoti & Company. Mitra Ramgopal - Sidoti & Company: Good morning, first question I just wanted to follow up, I know you mentioned couple of the difficulties you're seeing is pressure on same store from higher unemployment and potential CMS reimbursement risk. Now will that make you more inclined to be more aggressive in terms clinic expansion?

Chris Reading

Management

I think we are inclined to be aggressive in terms of clinic expansion anywhere. I don’t know if it creates a further spur, I think the spur is pretty much there, it doesn’t make me anymore disinclined to do acquisition to open new facilities. We always look for portfolio position so I wouldn’t for instance. We wouldn’t have before and we won’t now do an acquisition that’s predominantly federal funded. And nor will we do a start up in an area that was predominantly probably federally funded. That said I think we are going to continue to be very focused on development we got the cash to do it. We got the people to do it and we got a nice model that works and so I think that challenges today, I think in one hand I think do creates some opportunity because I don’t think of companies are looking to expand as much as we are right now. I think we are good home, and I think we will continue to be for credit people and so we are going to continue to try to grow aggressively. Mitra Ramgopal - Sidoti & Company: And I am getting if you look at the number of clinics you had at the end of this quarter I think was 369, was versus say 366 a year ago. Should we expect sort a more acceleration in that sort of, not necessarily reduced closures etcetera.

Larry McAfee

Management

I think closures are going to be higher for a year then we initially thought they were much higher for quarter than I anticipated lets say as you can see form the financials, when the closed those it didn’t cost us any money, so we don’t worry so much about the clinic count we also sold five which helped mature the comparative numbers.

Chris Reading

Management

I look at this as kind of a pruning of things that no longer contribute to the health of the organization and done in a thoughtful, deliberate way that allows the overall function to be stronger. I think that the clinics that we have closed, we haven't missed because they were either drag or non-contributor and I think conversely the clinics we have opened then acquired have been great contributors, and I think we will always have some that over some period of time change and will necessitate that we close but we are going to continue to these focus on development. I'm not caught up on clinic count per say, I'm caught up on growing earnings we all are and value for the share holders and there is certainly development that goes into that and that will continue but I'm not going to hesitate to close a clinic if it needs to be closed. Mitra Ramgopal - Sidoti & Company: Okay, thanks. And again if we look at the net revenue per visit, it's the highest I think we've ever seen, and the last few years, you've consistently been able to increase that number. As we look out again to next couple of years, is there a reason why we shouldn't see sort of similar increases?

Chris Reading

Management

No, my crystal ball things are changing rapidly sometimes unexpectedly, we made some big progress last year and everybody said well can you do it again next year and we didn’t make any big predictions, we just trying to stay focused on what we do. My honest answer is I don’t know if we can continue to get rate expansion of this magnitude year-over-year. What I do know if you look historically we kind of figured out a way to get some growth in there even during tough times. There may be a point where we can't do that anymore. But right now we are still making progress.

Larry McAfee

Management

Yes, I am in the company's 20 year history I don't think we've ever had a down year to that rate. Now that's not because we haven't done pressure from time to time whether from the government or the state, the insurance companies you can name it. We normally try to find a way to offset that and mitigate the impact from it. Part of it, it is not just pricing, our pricing has been increases historically been modest at best. Some of this is small increase in units per visit, the combination of things. And that ultimately even if the rates are same if you increase your visits or therapist visits for FTE in each major corporate cost over larger base you can still continue drive increased profit. Mitra Ramgopal - Sidoti & Company: I know it's just been a tremendous number given the environment. And finally, Larry, on the guidance, does it include a $0.03 gain in the first quarter?

Larry McAfee

Management

Yes, that's actually end forecast. So it includes the gain from the sale on the first quarter.

Operator

Operator

The next question comes from Alex Gait of Castle Peak Asset Management.

Alex Gait - Castle Peak Asset Management

Analyst

Just one question for you. Plenty of guys may have gone over this already. But could you maybe say something about the main growth drivers going forward, say, like do you expect a number of new qualified therapists entering the market to increase anytime soon?

Chris Reading

Management

I will tell you that the job market in general, in other worlds our ability to attract good people, fill open positions from a staffing standpoint. I think definitely has improved over this difficult period I think we have we are seeing I think is a pretty good home as a good stable place and on our time to fill positions and number of open positions have gone down much of that entirely answers your question. On the partners side I think we continue to look for exceptional people. Those people don’t grow on trees so we have to look hard and we are very selective about who we will work with but that continues to go well and we’ve continued to find very good people in our traffic to our ongoing client website is up and we continue to do things to drive people and so the interest seems to be very good right now.

Larry McAfee

Management

On our macro basis that there is any big influences in there.

Chris Reading

Management

I think the schools continue to be pretty steady. The educational requirements have been steady the last few years. It’s pretty much a doctors degree now and that’s not going to get any worse and it’s not going to get any better and so I think that’s been static and maybe that’s helpful because they are for a while, there was a migration for masters to doctor programs and so that probably created a little bit of a drag. So right now the environment it's not easy from a hiring perspective but its better and we are doing okay.

Operator

Operator

(Operator Instructions) Your next question comes from Larry Solow of CJS Securities.

Larry Solow - CJS Securities

Analyst

Did you guys give the visits or lets see did you give out the units build per visit, the change in that do you have that?

Larry McAfee

Management

4.22 again its in Q1.

Chris Reading

Management

Yeah I think that’s a typo that’s Q2, its 4.22.

Larry McAfee

Management

We are looking Glenn’s notes. So it was about the same as Q1. Q1 was 4.20; Q2 is 4.22, so not much of a change.

Larry Solow - CJS Securities

Analyst

And you know one last one, I should probably go find that too.

Larry McAfee

Management

Yeah, it was 4.21.

Larry Solow - CJS Securities

Analyst

So it was similar, and just you sound like you are still obviously aggressively trying to increase, clinics, that’s in the acquisition environment and potentially gain something done over the next six months.

Larry McAfee

Management

We are talking to lot more people right now than we were this time last year.

Chris Reading

Management

And we have some we have some interest that we have expressed a few places and thing that we are working on, so yeah if you give me over the next six months I feel pretty confident we will get some things done and we will have some leverage.

Larry Solow - CJS Securities

Analyst

And then just lastly maybe more your queue I know you mentioned in the queue, but in this (inaudible) reading therapies. Anywhere to quantify I mean if 20% of your services are Medicaid or Medicare about that I mean how much not really that too many how many is it generally a patient goes in there receives more than one service or.

Larry McAfee

Management

Typical patients they are given about typical manicure patients is about 3.5 units from especially can determine and you can see the foot note I am looking on page 22 it is in there somewhere else too but we did a sample of that actually over a 100 actual bills for Medicare patients. We estimated positioning in (inaudible) saying that other people published that the reduction to us in terms of range would be about 10 to 12%.

Chris Reading

Management

That’s net of the 2% increase that we had this year.

Larry McAfee

Management

So if you looked at what the current reimbursement is and what it would be what they promote remains unchanged if we have a 10% to 12% rate reduction on Medicare patients. Again that’s a preliminary number it is given common period there are lot of people that are worked up about this, there is some other public companies in addition to a lot of stuff on that.

Larry Solow - CJS Securities

Analyst

Right, but in theory if that came out it will be 10% on your 20% portion of your business obviously which would impact obviously revenue per visit that would be right out of the figure revenue per patient summarizing I guess?

Larry McAfee

Management

Right.

Operator

Operator

At this time there are no further questions. I'll now turn the call back over to management for any closing remarks.

Chris Reading

Management

Okay, well I just want to say thank you one more time we appreciate your interest. Larry and I are here for the rest of the day and the week entering, remaining questions you might have offline and again we thank you, hope you have a great day.

Operator

Operator

Thank you. This concludes your conference. You may now disconnect.