Encompass Health Corp - FORM 8-K - EX-99.1 - EXHIBIT 99.1 - March 22, 2010

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Barclays Capital Global
Healthcare Conference
March 23, 2010






Exhibit 99.1
 
 
 
Exhibit 99.1
2
Table of Contents
 
 
 
Exhibit 99.1
3
Note Regarding Forward-Looking Statements
The information contained in this presentation includes certain estimates, projections and other forward-looking information
that reflect our current views with respect to future events and financial performance. These estimates, projections and other
forward-looking information are based on assumptions that HealthSouth believes, as of the date hereof, are reasonable.
Inevitably, there will be differences between such estimates and actual results, and those differences may be material.
There can be no assurance that any estimates, projections or forward-looking information will be realized. All such
estimates, projections and forward-looking information speak only as of the date hereof. HealthSouth undertakes no duty to
publicly update or revise the information contained herein.
This presentation also includes estimates and projections published by the Centers for Medicare and Medicaid Services
(“CMS”). We are not able to verify those estimates or projections or the detailed calculations thereof by CMS which are not
made public. Any changes or errors in those calculations, among other uncertainties such as those referred to below and
changes in CMS’s own rules and policies, could cause actual results to differ materially from CMS’s projections.
Furthermore, we do not believe that CMS numbers are consistent with financial reporting results. CMS data and projections
should not be used as an indication of financial performance.
You are cautioned not to place undue reliance on the estimates, projections and other forward-looking information in this
presentation as they are based on current expectations and general assumptions and are subject to various risks,
uncertainties and other factors, including those set forth in our Form 10-K for the year ended December 31, 2009, and in
other documents we previously filed with the SEC, many of which are beyond our control, that may cause actual results to
differ materially from the views, beliefs and estimates expressed herein.
Note Regarding Presentation of Non-GAAP Financial Measures
The following presentation includes certain “non-GAAP financial measures” as defined in Regulation G under the Securities
Exchange Act of 1934. The Appendix at the end of this presentation includes reconciliations of the non-GAAP financial
measures found in the following presentation to the most directly comparable financial measures calculated and presented in
accordance with Generally Accepted Accounting Principles in the United States. Our Form 8-K, dated March 22, 2010, to
which the following presentation slides are attached, provides further explanation and disclosure regarding our use of non-
GAAP financial measures and should be read in conjunction with these presentation slides.
Cautionary Statements
 
 
 
Exhibit 99.1
4
IRH
LTCH
93  Rehabilitation Hospitals
40  Outpatient Rehabilitation Satellites
 6 Long-Term Acute Care Hospitals
25   Hospital-Based Home
  Health Agencies
Portfolio
Largest Provider of Inpatient Rehabilitative Healthcare Services in the U.S.
Sites under Construction
Exchange (Symbol): NYSE (HLS)
Employees: ~ 22,000 
Corporate Office: Birmingham, AL
 
 
 
Exhibit 99.1
5
“The Basics”: Our Rehabilitation Hospitals
Major Services:
• Physicians: manage and treat medical needs of patients
• Rehabilitation Nursing: oversees treatment program of patient
• Physical Therapy: addresses physical function, mobility, safety
• Occupational Therapy: promotes independence and re-integration
• Speech-Language Therapy: treats communication & swallowing disorders
• Case Managers: coordinate care plan with physician, caregivers, family
• Post-discharge services: outpatient therapy and home health
Note: IRF hospitals are not CAPEX intensive:
ü No Emergency Rooms, ORs, Cath Labs, etc.
 
 
 
Exhibit 99.1
6
“The Basics”: Our Patients
94%
5%
1%
Referral Sources
Acute Care Hospitals
Physician Offices
Skilled Nursing Facilities
All patients are admitted by a physician:
Most Common Cases (2009)
1. Stroke   17.5%
2. Neurological   13.3%
3. Fracture of the lower extremity 11.7%
4. Debility   11.5%
5. Knee/Hip replacement   9.6%
6. Other orthopedic conditions  9.5%
7. Brain injury    7.4%
8. Cardiac conditions   4.7%
9. Spinal cord injury   3.6%
10. All other   11.2%
ü Physicians and acute care hospital case managers are key decision-makers.
ü All IRF patients must meet medical necessity criteria.
ü All IRF patients must be medically stable and have potential to tolerate three hours
 of therapy per day (minimum).
 
 
 
Exhibit 99.1
7
“The Basics”: Our Competitors
Competitors
 • Freestanding IRFs
 • Hospital IRF units
 • Skilled nursing homes
Patients
Total Inpatient Rehabilitation Facilities (IRFs):1,181
Sources: FY 2010 CMS Rate Setting File and MedPAC March 2009 report; Internal HLS reports for HLS data;
 
 
 
Exhibit 99.1
8
Discharges
Consolidated Net Operating Revenues
($ Millions)

+4.5%
+5.4%
Dollar Amounts $928.2 $948.8 $448.9 $464.5 $93.8 $91.1
EPOB (3) 3.62 3.53
30 bps
Improvement
20 bps
Improvement
110 bps
Improvement
Expenses
(1)
(2)
Solid, Sustained Operating Results
(Thousands)
 
 
 
Exhibit 99.1
9
Adjusted Income from Continuing
Operations per Diluted Share (1)
Adjusted Consolidated EBITDA
($ Millions)
 
+12.3%
 
90.8%
(1) Reconciliation to GAAP provided on slides 41 through 42.
Key Drivers:
üIncreased volumes
üImproved labor productivity
üDisciplined expense management
ü2.5% Medicare market basket increase effective October 1, 2009
Solid EBITDA and EPS Growth
 
 
 
Exhibit 99.1
10
(1) Notes on page 42.
Performance Highlights: Strong Free Cash Flow
 
 
 
 
Exhibit 99.1
11
(1) Includes capital expenditures for the hospital refresh program.
(2) Reflects seasonal use of cash related to interest and insurance payments.
 
Performance Highlights: Strong Free Cash Flow
 
 
 
 
Exhibit 99.1
12
(1)  Based on four quarter trailing Adjusted Consolidated EBITDA of $383.0 million; see related debt schedule on slide 37, and reconciliation to
 GAAP on slides 41 through 42.
 Debt to EBITDA 6.3x 6.3x 5.3x 4.3x (1)
Year-End 2011 Goal: 3.5x to 4.0x
Liquidity
Continued Debt Reduction and Deleveraging
Performance Highlights
 
 
 
Exhibit 99.1
13
Business Outlook
3.5x to 4.0x Debt to EBITDA (by YE 2011)
(Exclusive of any E&Y settlement)
Organic growth through capacity
expansion and de novos
(~ $60 million in 2010)
IRF acquisitions/joint ventures
Deleveraging
Growth
 
 
Acquisitions of other,
complementary post-acute services
Reform
1.Pricing
2.Bundling
Sector
Regulation
Pilot/Demonstration
Projects
 • LTCH: admission criteria; 25% Rule; MMSEA extension
 • Home Health: outliers; reimbursement methodology
Deleveraging, Growth, Reform and Sector Regulation
  No change Unknown at this time
 2010 2011 2012 2013
 
 
 
Exhibit 99.1
14
Regulatory Uncertainty
Sources: Senate Reform Bill, CMS Regulatory published rules and MMSEA
 
 
 
Exhibit 99.1
15
2010 Guidance(1)
Guidance Philosophy
Appropriately conservative at beginning of year; consistent
with past practices; does not include acquisitions.
       +4% to +6%
 Considerations:
 üContinued market share gains
 üMedicare pricing
 üIT “pilot” investment
Adjusted EPS(1)(2):   $1.60 to $1.70
      +10% to +17%
 Considerations:
 ü$5 million of additional stock-based compensation expenses
 ü5 million more diluted shares (Securities Litigation Settlement)
 üAssumes LIBOR remains unchanged throughout year
 üTougher “comps”: $0.69 Adjusted EPS growth (+90.8%) 2009 over
 2008
 
Business
Model
+5% to +8%
+15% to +20%
 
 ü Start-up costs at two new
 hospitals
 ü TeamWorks investment
(1) Reconciliation to GAAP provided on slides 41 through 42.
(2) Adjusted income from continuing operations per diluted share.
 
 
 
Exhibit 99.1
16
Q110 Initial Observations
Volume:
ü January - strong December discharges created steeper ramp up in January.
ü February - heavy snow falls affected some markets (e.g. Pennsylvania,
 Virginia, Tennessee, New Jersey and Arkansas).
ü March - volume growth mid-month on track.
 
 
Expenses:
ü Expense management better than expected; improvement over Q109.
 
 
Earnings:
ü Reaffirm 2010 guidance
 
 
 
 
 
Exhibit 99.1
17
Summary
ü Industry Leader: Largest provider in attractive healthcare segment.
ü Strong Cash Flows: Directed toward debt reduction and growth.
ü Continued Deleveraging: Reduce leverage to between 3.5x and 4.0x
 no later than YE 2011.
ü Solid Organic Growth: Volume growth + expense management.
ü Opportunistic, Disciplined Expansion: Capacity expansion and new
 hospitals coming online over next three years.
ü Well Positioned: High-quality + cost-effective provider; proven track
 record of adapting to regulatory changes.
Value Proposition
 
 
 
Exhibit 99.1
18
Appendix
 
 
 
Exhibit 99.1
19
(1) Data provided by UDSMR, a data gathering and analysis organization for the rehabilitation industry; represents ~ 65-70% of industry, including 90 HealthSouth sites.
(2) Includes 90 consolidated HealthSouth inpatient rehab hospitals and six long-term acute-care hospitals.
Operational Excellence: Sustained Market Share Gains
HealthSouth vs. Industry
Quarterly Discharges
ü HealthSouth’s volume growth
 has outpaced competitors’
ü TeamWorks = standardized
 sales & marketing
ü Capacity expansions will help
 facilitate organic growth:
 Ÿ ~ 100 new beds 2009
 Ÿ ~ 100 new beds 2010
 
 
 
Exhibit 99.1
20
FIM Gain
LOS Efficiency
LOS Efficiency = Functional gain
divided by length of stay
Source: UDSmr Database - On Demand
Reports 2009 Year End Report
FIM Gain = Change in Functional
Independent Measurement (based
on an 18 point assessment) from
Admission to Discharge
** Average = Expected, Risk-adjusted LOS Efficiency
Operational Excellence = “High-Quality” Care
 * Average = Expected, Risk-adjusted FIM Change Average
 
 
 
Exhibit 99.1
21
Operational Excellence = “Cost-Effective” Care
CMS Fiscal Year 2010 IRF Rate Setting File Analysis (1)
 
Freestanding
(2)
Units (2)
Total
 
HealthSouth
 
Hospitals (2)
Number of IRFs
228
953
1,181
 
94
Average # of Discharges per IRF
649
237
316
 
822
Outlier Payments as % of Total
Payments
1.32%
4.08%
3.00%
 
0.43%
Average Estimated Total Payment
per Discharge for FY 2010
$16,452
$16,741
$16,626
 
$15,996
Average Estimated Cost per
Discharge for FY 2010
$14,021
$17,207
$15,945
 
$12,633
Notes:
(1)  All data provided was filtered and compiled from the Centers for Medicare and Medicaid Services (CMS) Fiscal Year 2010 IRF rate setting final
 rule file found at http://www.cms.hhs.gov/InpatientRehabFacPPS/07_DataFiles.asp#TopOfPage. The data presented was developed entirely by
 CMS and is based on its definitions which are different in form and substance from the criteria HealthSouth uses for external reporting purposes.
 Because CMS does not provide its detailed methodology, HealthSouth is not able to reconstruct the CMS projections or the calculation.
(2) The CMS file contains data for each of the 1,181 inpatient rehabilitation facilities used to estimate the policy updates for the FY 2010 Final IRF-
 PPS Rule. Most of the data represents historical information from the CMS fiscal year 2008 period and does not reflect the same HealthSouth
 hospitals in operation today. The data presented was separated into three categories: Freestanding, Units, and HealthSouth. HealthSouth is a
 subset of Freestanding and the Total.
 
 
 
Exhibit 99.1
22
Capacity expansions:
 • Approximately 100 beds to be added in 2010.
 • Average investment per bed including renovation:
 – $100K to $250K
 De novos:
 • Expanded joint venture with St. Vincent Health System in Little Rock, AR, through the
 purchase of a 23-bed rehabilitation unit.
 • Acquired the rehabilitation unit in Altoona, PA, through a newly formed joint venture and
 relocated its operations to one of our hospitals.
Organic Growth
Cash pay-back:
6 - 7 years
Cash pay-back:
2 - 4 years
 
 
 
Exhibit 99.1
23
IRFs have Lower Readmission Rates
Note: Use of home health care and hospice is based on care that starts within three days of discharge. Other PAC care starts within one day of
 discharge. Home health use includes episodes that overlap an inpatient stay.
Source: Medicare Payment Advisory Commission, “A Data Book: Healthcare spending and the Medicare program,” Chart 9-3 (June 2008)
 
 
 
Exhibit 99.1
24
Revenues (Q4 2009 vs. Q4 2008)
• Inpatient revenue growth was driven by strong discharge volumes in Q4 2009 despite tough
 comparisons in Q4 2008.
 – Volume growth was driven by the sustained sales and marketing effort.
 – Same store discharge growth was 4.2%.
 – Pricing reflects 2.5% Medicare market basket increase effective October 1, 2009.
• Outpatient revenue declined as a result of 10 fewer outpatient satellites quarter over quarter.
 
 
 
Exhibit 99.1
25
• Salaries and benefits increased as a result of an October 1, 2009, 2.3% merit increase.
 – Continued improvement on labor productivity demonstrated by lower EPOB.
• Hospital-related expenses increased as a result of higher discharge volume.
 
 
 
Exhibit 99.1
26
Adjusted Consolidated EBITDA (1)
(Millions)
(1) Reconciliation to GAAP provided on slides 41 through 42.
• Improvements driven by:
 – Increased volumes
 – Improved labor productivity
 – Disciplined expense management
 – 2.5% Medicare market basket increase effective October 1, 2009
 
 
 
Exhibit 99.1
27
Adjusted Income per Diluted Share (4Q 2009)
 
(1) Reconciliation to GAAP provided on slides 41 through 42.
• The improvement in adjusted earnings per share, driven by higher Adjusted
 Consolidated EBITDA and lower interest expense, was offset by a $15.6 million loss on
 early extinguishment of debt.
 – Interest expense was lower as a result of lower debt balances and a lower LIBOR rate.
 
 
 
Exhibit 99.1
28
(1) Reconciliation to GAAP provided on slides 41 through 42.
 
 
 
Exhibit 99.1
29
Revenues (Year-End)
 
 
 
Exhibit 99.1
30
Expenses (Year-End)
 
 
 
Exhibit 99.1
31
Revenues (Sequential)
 
 
 
Exhibit 99.1
32
Expenses (Sequential)
 
 
 
Exhibit 99.1
33
Operational and Labor Metrics (1)
(2) Represents discharges from HealthSouth’s 90 consolidated hospitals, which includes Mesa, Arizona starting in Q3 2009.
(3) Excludes approx. 400 full-time equivalents, who are considered part of corporate overhead with their salaries and benefits included in general
 and administrative expenses in the Company’s condensed consolidated statements of operations. Full-time equivalents included in the above
 table represent HealthSouth employees who participate in or support the operations of the Company’s hospitals.
(4) Employees per occupied bed, or “EPOB,” is calculated by dividing the number of full-time equivalents, including an estimate of full-time
 equivalents from the utilization of contract labor, by the number of occupied beds during each period. The number of occupied beds is determined
 by multiplying the number of licensed beds by the Company’s occupancy percentage.
 
 
 
Exhibit 99.1
34
Payment Sources
(1) Managed Medicare revenues represent ~ 8% and 6% of total revenues for 2009 and 2008, respectively, and are included in “Managed care
 and other discount plans.”
 
 
 
Exhibit 99.1
35
Debt Maturities: No Near-Term Financing Needs
(Millions)
= Term Loan maturities
= 10.75% Fixed
= 8.125% Fixed
= Capital leases and term
 loan amortization
As of December 31, 2009
 
 
 
Exhibit 99.1
36
Interest Rate Swaps
(Millions)
(1) In October 2009, the credit agreement was amended. The maturity for $300 million of the term loan has been extended to 2015. The extended
 portion of the term loan will bear an interest rate of Libor plus 375.
(2) Cash settlements flow through investing activities.
(3) In June 2009, we entered into a receive-fixed rate swap as a mirror offset to $100.0 million of the $1,056 million interest rate swap.
(4) Forward-starting interest rate swaps (designated as cash flow hedges). Cash settlements will flow through operating activities as part of interest
 expense.
 
 
 
Exhibit 99.1
37
Debt Schedule
(Millions)
(1) The Company had $80.9 million in cash and cash equivalents as of December 31, 2009.
(2) Based on four quarter trailing Adjusted Consolidated EBITDA of $383.0 million and $341.2 million respectively. See reconciliation to GAAP
 on slides 41 through 42.
 Debt to EBITDA(2)  4.3x  5.3x
 
 
 
 
Exhibit 99.1
38
Credit Ratings
 
 
 
Exhibit 99.1
39
Non-Operating Cash/Tax Position
Cash Refunds as of Dec. 31, 2009
• Federal tax recoveries virtually complete.
 – Approx. $43 million received.
• State tax refunds in progress.
 – Approx. $21 million received.
 – Approx. $10 million net receivable on
  the balance sheet.
Future Cash Tax Payments
• Expect to pay about $5-7 million per year of income
 tax.
 – State income tax.
 – Alternative Minimum Tax (AMT).
• The Company does not expect to pay significant
 federal income taxes for the next 10-12 years, due
 to approximately $905 million in deferred tax assets
 as of 12/31/09 outlined in the Form 10-K to be filed
 with the SEC. The majority of the deferred tax asset
 is related to net operating losses (NOLs).
 – At this time, we do not believe the use
  of NOLs will be limited before they
  expire, however, no assurances can
  be provided.
• HealthSouth is not currently subject to an annual
 use limitation (AUL) under the Internal Revenue
 Code section 382.
• If we experienced a “change of ownership” as
 defined by the Internal Revenue Code section 382,
 we would be subject to an AUL, which is equal to
 the value of the company at the time of the “change
 of ownership” multiplied by the long-term tax exempt
 rate.
GAAP Considerations
• HealthSouth’s balance sheet currently
 reflects a valuation allowance for the
 potential value of NOLs and future
 deductions. The valuation allowance is
 approximately $893 million.
 
• GAAP tax rate will net to small amount for
 foreseeable future as there will be a
 reduction in the valuation allowance when
 NOLs are utilized.
 
 
 
Exhibit 99.1
40
Outstanding Share Summary
(Millions)
Notes:
(1) Completed an equity offering for 8.8 million shares on June 27, 2008.
(2)  Does not include 2.0 million warrants issued in connection with a January 2004 loan repaid to Credit Suisse First Boston. In connection with this
 transaction, we issued warrants to the lender to purchase two million shares of our common stock. Each warrant has a term of ten years from the
 date of issuance and an exercise price of $32.50 per share. The warrants were not assumed exercised for dilutive shares outstanding because
 they were antidilutive in the periods presented.
(3) The agreement to settle our class action securities litigation received final court approval in January 2007. These shares of common stock and
 warrants were issued on September 30, 2009. The 5.0 million of common shares are now included in the outstanding shares. The warrants at a
 strike price of $41.40 were not assumed exercised for the dilutive shares outstanding because they are anti-dilutive in the periods presented.
(4) The difference between the basic and diluted shares outstanding is primarily related to our convertible perpetual preferred stock.
 
 
 
Exhibit 99.1
41
Three & Twelve Months Reconciliation of Net Income to Adjusted Income
from Continuing Operations and Adjusted Consolidated EBITDA (1) (3)
(1) (2) (3) (4) - Notes on page 42.
 
 
 
Exhibit 99.1
42
Reconciliation Notes
1. Adjusted income from continuing operations and Adjusted Consolidated EBITDA are
 non-GAAP financial measures. The Company’s leverage ratio (Total Consolidated Debt
 to Adjusted Consolidated EBITDA for the trailing four quarters) is, likewise, a non-GAAP
 financial measure. Management and some members of the investment community
 utilize adjusted income from continuing operations as a financial measure and Adjusted
 Consolidated EBITDA and leverage ratio as liquidity measures on an ongoing basis.
 These measures are not recognized in accordance with GAAP and should not be
 viewed as an alternative to GAAP measures of performance or liquidity. In evaluating
 these adjusted measures, the reader should be aware that in the future HealthSouth
 may incur expenses similar to the adjustments set forth above.
2. Per share amounts for each period presented are based on basic weighted average
 common shares outstanding for all amounts except adjusted income from continuing
 operations per diluted share, which is based on diluted weighted average shares
 outstanding. The difference in shares between the basic and diluted shares outstanding
 is primarily related to our convertible perpetual preferred stock.
3. Adjusted income from continuing operations per diluted share and Adjusted
 Consolidated EBITDA are two components of our guidance.
4. The Company’s Credit Agreement allows certain other items to be added to arrive at
 Adjusted Consolidated EBITDA, and there may be certain other deductions required.

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