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Almost Family Reports Third Quarter 2016 Results

November 1, 2016

Exhibit 99.1

 

C:\Users\106756\Desktop\Untitled.jpg

 

 

 

 

 

Almost Family, Inc.
Steve Guenthner
(502) 891-1000

 

 

FOR IMMEDIATE RELEASE

November 1, 2016

 

Almost Family Reports Third Quarter 2016 Results

 

Louisville, KY, November 1, 2016 –  Almost Family, Inc. (Nasdaq: AFAM), a leading regional provider of home health nursing and personal care services, announced today its financial results for the quarter ended September 30, 2016.

 

Third Quarter Highlights (1):

·

Record net service revenues of approximately $160.4 million with record revenues in our PC and HCI segments

·

GAAP EPS of $0.52 per diluted share, down $0.27 from a year ago, Adjusted EPS of $0.66, up $0.14 from a year ago

·

GAAP net income of $5.4 million, down $2.4 million from a year ago, Adjusted net income of $6.8 million, up $1.7 million from a year ago

·

Record Adjusted EBITDA of $14.8 million, up 39% from a year ago

·

Healthcare Innovations (HCI) segment recorded Medicare Shared Savings payment success fees from multiple ACOs, while performing over 21,000 in-home assessments and having nearly 122,000 ACO beneficiaries and 15 Accountable Care Organizations under contract

·

Unusually high health insurance claims and a  significant rate cut in Connecticut’s Medicaid-sponsored behavioral health program reduced diluted EPS by $0.06 and $0.05, respectively

·

A change in the Company’s expected effective tax rate recognized in the current quarter increased diluted EPS by $0.02

·

Year to date operating cash flow of  $15.3 million

·

On October 14, 2016, we signed a definitive agreement to acquire a controlling interest in the entity holding the home health and hospice assets of Community Health Systems, Inc.


(1)See Non-GAAP Financial Measures starting on page 12

 

Management Comments

William Yarmuth, Chairman and Chief Executive Officer, commented:  “We’re very pleased with the progress in our core home health business in the quarter where we continue to generate meaningful organic growth, while also working through the integration of our 2015 and 2016

1


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

acquisitions.  In addition, we’re especially pleased to report outstanding record results in our healthcare innovations segment which is drawing increased attention as it makes significant strides in its earnings and developments.  At the same time all of this has been accomplished, we also just recently announced entering into the nation’s largest public company hospital-home health joint venture, enabling us, in a very strategic way, to continue our strong growth trajectory.”

 

Steve Guenthner, President added:  “Although it was somewhat masked by the acquisitions of certain agencies where we did not acquire accounts receivable, we had especially strong operating cash flows in the third quarter reducing days outstanding to 53, the lowest level in quite some time.  Additionally, we were pleased to see the somewhat favorable final rule for Medicare reimbursement in 2017, continuing the comparatively favorable tone of regulators toward home health.”

 

Yarmuth concluded:  “As we move through the balance of 2016 and into 2017 our key focus will be the successful integration of our new strategic home health partnership with CHS, continuing our work on organic volume growth and improving the financial results of all our business units.”

 

The Company noted that the third quarter typically marks the seasonally low-water point of its home health business in terms of admissions and the high point for HCI results due to the timing of accounting recognition for success fees under the Medicare Shared Savings Program for Accountable Care Organizations. 

 

Third Quarter Financial Results

VN segment net revenues increased $10.1 million to $108.4 million from $98.3 million in the prior year and total Medicare admissions grew by 5.3% to 23,030 from 21,876 primarily due to home health agencies acquired in late 2015 and the first half of 2016.  VN segment contribution increased $0.5 million, or 4.5%, to $12.6 million, from $12.1 million in the prior year period.  Contribution margin as a percentage of revenue decreased from 12.3% to 11.6%.  VN results in the current quarter were impacted by unusually high health insurance claims experience of about $1 million which lowered diluted EPS by $0.06.  On a same-store basis, Medicare admissions outside of Florida grew by 3.2%, while Florida was marginally positive.    The Company is continuing its efforts to improve the performance of its Florida business which currently account for approximately one-fourth of VN segment revenues as compared to one-third a year ago and one-half three years ago.

PC segment net revenues increased $10.9 million or 35.2% to a record $41.7 million in 2016 from $30.8 million in 2015 primarily due to acquisitions.  PC segment contribution decreased $0.5 million as compared to the same period of last year, primarily due to a 20% rate cut in the State of Connecticut’s Medicaid-sponsored behavioral health program which generated approximately $2.6 million of revenue in the current quarter as compared to $3.3 million in the same quarter last year on similar volumes.  The Company is currently evaluating the on-going viability of this program under current reimbursement and regulations.

Healthcare Innovations (HCI) segment net revenues increased $8.3 million to a record $10.3 million, in 2016 from $2.1 million in 2015.  The Company’s ACO-enablement operations recorded shared savings incentive revenue of $4.3 million from multiple ACOs participating in the Medicare Shared Savings Program.  ACOs managed by the Company saved the Medicare program a total of $25

2


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

million in the measurement period.  The Company’s assessment business acquired in transactions in January 2016 and July 2015 contributed the balance of the revenues.  As a result, operating income for the HCI segment was a record $5.1 million, or $0.15 per share attributable to Almost Family.

Corporate expenses as a percentage of revenue declined to 4.4%, from 4.8% in the prior year period.  Deal, transition and other costs grew to $2.3 million for 2016, primarily as a result of costs related to 2016 and 2015 acquisitions, while the prior year included a one-time $4.2million benefit related to legal settlements.  Borrowings related to acquisitions increased interest expense to $1.4 million, from $0.6 million in the prior year period.

Net cash from operating activities of $4.9 million was generated in the third quarter of 2016.  Home Health accounts receivable days sales outstanding were 53 at the end of the third quarter of 2016 as compared to 58 at the end of the third quarter of 2015.  The Company noted that its late June 2016 acquisition of certain home health agencies from ResCare did not include accounts receivable.  Building normal accounts receivable reduced operating cash flows by about $6 million in the third quarter of 2016.

The effective tax rate for the third quarter of 2016 and 2015 was 37.3% and 21.0%, respectively.  During the quarter the Company lowered its estimated effective tax rate from 40.5% to 39.5% due to lower permanently non-deductible expenses in relation to taxable income.

Year to Date Financial Results

VN segment net revenues increased $33.0 million to a record $328.7 million from $295.6 million in the prior year period and total Medicare admissions grew by 2.4% to 70,021 from 68,380 primarily due to home health agencies acquired in late 2015 and 2016.  VN segment contribution increased $5.9 million, or 16.1%, to $42.9 million, from $37.0 million in the same period last year.  Contribution margin as a percentage of revenue increased to 13.1% from 12.5%.  On a same-store basis, Medicare admissions outside of Florida grew organically by 3% while Florida was down 4%.

PC segment net revenues increased $32.0 million or 35.9% to a record $121.1 million in 2016 from $89.1 million in 2015 primarily due to acquisitions.  PC segment contribution decreased 3.2% or $0.3 million due to rate cuts in certain skilled elements of the Connecticut and Ohio Medicaid programs more than offset earnings from acquisitions.

HCI segment net revenues increased $18.0 million to a record $20.3 million, in 2016 from $2.3 million in 2015, as acquired LTS and Ingenios assessment business revenues were $15.4 million with the remainder due to higher shared savings revenue as multiple Imperium served ACOs received Medicare shared savings payments.  LTS was acquired in January 2016 and Ingenios was acquired in July 2015.  The HCI segment contribution thus improved $5.5 million, as the segment was profitable for year to date 2016.

 

Corporate expenses as a percentage of revenue declined to 4.6%, from 5.2% in the prior year period.  Deal, transition and other costs grew to $7.5 million for 2016, primarily as a result of costs related to 2016 and 2015 acquisitions, while the prior year included a one-time $4.2million benefit related to legal settlements.  Borrowings related to acquisitions increased interest expense to $4.3 million, from $1.5 million in the same period 2015.

3


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

Net cash from operating activities of $15.3 million was generated in 2016, up $2.0 million from the $13.3 million generated in the same period 2015. 

The effective tax rate for 2016 and 2015 was 39.3% and 32.9%, respectively.    

The Company noted that it will continue to pursue quality acquisitions of in-home health care service providers consistent with its stated strategy and the types of services its segments currently provide.

 

Acquisition of the Home Health and Hospice Assets of Community Health Systems, Inc.

On October 14, 2016, the Company signed a definitive agreement to acquire a controlling interest in the entity holding the home health and hospice assets of Community Health Systems, Inc. for $128.0 million, subject to a working capital adjustment. Financing for the transaction has been fully committed by JPMorgan. The transaction is expected to be completed during the fourth quarter, subject to regulatory approvals and the satisfaction of customary closing conditions. The Company expects the transaction will add approximately $200 million in revenue, all of which will be classified in the Company’s VN segment. The transaction will expand the Company’s geographic service territory to a total of 26 states.

 

Medicare Program Developments

On October 31, 2016 the Centers for Medicare and Medicaid Services (CMS) released the final rule for FY2017 home health reimbursement.  The impact table included in the final rule suggests the final rule is slightly more favorable than the preliminary rule published earlier this year.

 

4


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

ALMOST FAMILY, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF INCOME

(In thousands, except per share data)

(UNAUDITED)

 

 

 

 

 

 

 

 

 

 

Three months ended

 

Nine months ended

 

September 30, 2016

 

October 2, 2015

 

September 30, 2016

 

October 2, 2015

Net service revenues

$
160,421

 

$
131,232

 

$
470,114

 

$
386,997

Cost of service revenues (excluding depreciation & amortization)

86,074

 

69,475

 

251,998

 

204,134

Gross margin

74,347

 

61,757

 

218,116

 

182,863

General and administrative expenses:

 

 

 

 

 

 

 

Salaries and benefits

42,952

 

36,767

 

126,134

 

108,993

Other

18,167

 

15,598

 

56,323

 

47,772

Deal and transition costs

2,257

 

(1,306)

 

7,455

 

(696)

Total general and administrative expenses

63,376

 

51,059

 

189,912

 

156,069

Operating income

10,971

 

10,698

 

28,204

 

26,794

Interest expense, net

(1,399)

 

(559)

 

(4,335)

 

(1,463)

Income before income taxes

9,572

 

10,139

 

23,869

 

25,331

Income tax expense

(3,194)

 

(2,078)

 

(9,120)

 

(8,458)

Net income

6,378

 

8,061

 

14,749

 

16,873

Net loss - noncontrolling interests

(1,012)

 

(262)

 

(689)

 

330

Net income attributable to Almost Family, Inc.

$
5,366

 

$
7,799

 

$
14,060

 

$
17,203

 

 

 

 

 

 

 

 

Per share amounts-basic:

 

 

 

 

 

 

 

Average shares outstanding

10,172

 

9,604

 

10,150

 

9,432

 

 

 

 

 

 

 

 

Net income attributable to Almost Family, Inc.

$
0.53

 

$
0.81

 

$
1.39

 

$
1.82

 

 

 

 

 

 

 

 

Per share amounts-diluted:

 

 

 

 

 

 

 

Average shares outstanding

10,310

 

9,822

 

10,328

 

9,649

 

 

 

 

 

 

 

 

Net income attributable to Almost Family, Inc.

$
0.52

 

$
0.79

 

$
1.36

 

$
1.78

 

 

 

 

 

 

 

 

 

 

5


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

ALMOST FAMILY, INC. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(In thousands)

 

 

 

 

 

 

 

 

 

 

 

September 30, 2016

 

 

 

 

 

    

(UNAUDITED)

    

January 1, 2016

 

ASSETS

 

 

 

 

 

 

 

CURRENT ASSETS:

 

 

 

 

 

 

 

Cash and cash equivalents

 

$

6,827

 

$

7,522

 

Accounts receivable - net

 

 

95,616

 

 

92,909

 

Prepaid expenses and other current assets

 

 

14,090

 

 

9,033

 

TOTAL CURRENT ASSETS

 

 

116,533

 

 

109,464

 

PROPERTY AND EQUIPMENT - NET

 

 

9,753

 

 

10,000

 

GOODWILL

 

 

320,794

 

 

277,061

 

OTHER INTANGIBLE ASSETS

 

 

69,909

 

 

64,629

 

OTHER ASSETS

 

 

4,143

 

 

3,615

 

TOTAL ASSETS

 

$

521,132

 

$

464,769

 

 

 

 

 

 

 

 

 

LIABILITIES AND STOCKHOLDERS’ EQUITY

 

 

 

 

 

 

 

CURRENT LIABILITIES:

 

 

 

 

 

 

 

Accounts payable

 

$

14,007

 

$

11,297

 

Accrued other liabilities

 

 

36,054

 

 

40,742

 

TOTAL CURRENT LIABILITIES

 

 

50,061

 

 

52,039

 

 

 

 

 

 

 

 

 

LONG-TERM LIABILITIES:

 

 

 

 

 

 

 

Revolving credit facility

 

 

133,824

 

 

113,790

 

Deferred tax liabilities

 

 

18,494

 

 

13,094

 

Seller notes

 

 

12,500

 

 

6,556

 

Other liabilities

 

 

6,335

 

 

5,390

 

TOTAL LONG-TERM LIABILITIES

 

 

171,153

 

 

138,830

 

TOTAL LIABILITIES

 

 

221,214

 

 

190,869

 

 

 

 

 

 

 

 

 

NONCONTROLLING INTEREST - REDEEMABLE -

 

 

 

 

 

 

 

HEALTHCARE INNOVATIONS

 

 

2,256

 

 

3,639

 

 

 

 

 

 

 

 

 

STOCKHOLDERS’ EQUITY:

 

 

 

 

 

 

 

Preferred stock, par value $0.05; authorized 2,000 shares; none issued or outstanding

 

 

 —

 

 

 

Common stock, par value $0.10; authorized 25,000; 10,489 and 10,125 issued and outstanding

 

 

1,050

 

 

1,013

 

Treasury stock, at cost, 116 and 103 shares

 

 

(3,214)

 

 

(2,731)

 

Additional paid-in capital

 

 

140,351

 

 

127,253

 

Noncontrolling interest - nonredeemable

 

 

(766)

 

 

(730)

 

Retained earnings

 

 

160,241

 

 

145,456

 

TOTAL STOCKHOLDERS’ EQUITY

 

 

297,662

 

 

270,261

 

TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY

 

$

521,132

 

$

464,769

 

6


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

ALMOST FAMILY, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(UNAUDITED)

(In thousands)

 

 

 

 

 

 

Nine Months Ended

 

September 30, 2016

 

October 2, 2015

Cash flows of operating activities:

 

 

 

Net income

$
14,749

 

$
16,873

Adjustments to reconcile net income to net cash provided by
operating activities:

 

 

 

Depreciation and amortization

3,020

 

2,625

Provision for uncollectible accounts

10,626

 

9,322

Stock-based compensation

2,013

 

1,455

Deferred income taxes

6,081

 

3,108

 

36,489

 

33,383

Change in certain net assets and liabilities, net of the effects of acquisitions:

 

 

 

Accounts receivable

(12,831)

 

(13,444)

Prepaid expenses and other current assets

(4,451)

 

(4,038)

Other assets

(620)

 

(46)

Accounts payable and accrued expenses

(3,302)

 

(2,535)

Net cash provided by operating activities

15,285

 

13,320

 

 

 

 

Cash flows of investing activities:

 

 

 

Capital expenditures

(4,364)

 

(1,753)

Cost basis investment

 -

 

(1,000)

Acquisitions, net of cash acquired

(31,256)

 

(55,701)

Net cash used in investing activities

(35,620)

 

(58,454)

 

 

 

 

Cash flows of financing activities:

 

 

 

Credit facility borrowings

215,430

 

163,904

Credit facility repayments

(195,396)

 

(118,053)

Debt issuance fees

(102)

 

(1,161)

Proceeds from stock option exercises

(9)

 

141

Purchase of common stock in connection with share awards

(484)

 

(338)

Tax impact of share awards

257

 

227

Payment of special dividend in connection with share awards

 -

 

(50)

Principal payments on notes payable and capital leases

(56)

 

(54)

Net cash provided by financing activities

19,640

 

44,616

 

 

 

 

Net change in cash and cash equivalents

(695)

 

(518)

Cash and cash equivalents at beginning of period

7,522

 

6,886

Cash and cash equivalents at end of period

$
6,827

 

$
6,368

 

 

 

 

 

7


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

ALMOST FAMILY, INC. AND SUBSIDIARIES

RESULTS OF OPERATIONS

(UNAUDITED)

(In thousands)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

 

 

 

 

 

 

 

September 30, 2016

 

October 2, 2015

 

Change

 

 

    

Amount

    

% Rev

    

Amount

    

% Rev

    

Amount

    

%

 

Home Health Operations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net service revenues:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

$

108,425

 

72.2%

 

$

98,344

 

76.1%

 

$

10,081

 

10.3%

 

Personal Care

 

 

41,688

 

27.8%

 

 

30,837

 

23.9%

 

 

10,851

 

35.2%

 

 

 

 

150,113

 

100.0%

 

 

129,181

 

100.0%

 

 

20,932

 

16.2%

 

Operating income before corporate expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

 

12,618

 

11.6%

 

 

12,074

 

12.3%

 

 

544

 

4.5%

 

Personal Care

 

 

2,540

 

6.1%

 

 

3,067

 

9.9%

 

 

(527)

 

-17.2%

 

 

 

 

15,158

 

10.1%

 

 

15,141

 

11.7%

 

 

17

 

0.1%

 

Healthcare Innovations Operations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenue

 

 

10,308

 

100.0%

 

 

2,051

 

100.0%

 

 

8,257

 

402.6%

 

Operating income

 

 

5,051

 

49.0%

 

 

485

 

23.6%

 

 

4,566

 

941.4%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corporate expenses

 

 

6,981

 

4.4%

 

 

6,234

 

4.8%

 

 

747

 

12.0%

 

Deal, transition and other costs

 

 

2,257

 

1.4%

 

 

(1,306)

 

-1.0%

 

 

3,563

 

-272.8%

 

Operating income

 

 

10,971

 

6.8%

 

 

10,698

 

8.2%

 

 

273

 

2.6%

 

Interest expense, net

 

 

(1,399)

 

-0.9%

 

 

(559)

 

-0.4%

 

 

(840)

 

150.3%

 

Income tax expense

 

 

(3,194)

 

-2.0%

 

 

(2,078)

 

-1.6%

 

 

(1,116)

 

53.7%

 

Net income

 

$

6,378

 

4.0%

 

$

8,061

 

6.1%

 

$

(1,683)

 

-20.9%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA (1)

 

$

14,804

 

9.2%

 

$

10,623

 

8.1%

 

$

4,181

 

39.4%

 

Adjusted net income (1)

 

$

7,793

 

4.9%

 

$

5,361

 

4.1%

 

$

2,432

 

45.4%

 

 


(1)

See Non-GAAP Financial Measures starting on page 12.

 

8


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nine Months Ended

 

 

 

 

 

 

 

 

September 30, 2016

 

October 2, 2015

 

Change

 

 

    

Amount

    

% Rev

    

Amount

    

% Rev

    

Amount

    

%

 

Home Health Operations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net service revenues:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

$

328,697

 

73.1%

 

$

295,627

 

76.8%

 

$

33,070

 

11.2%

 

Personal Care

 

 

121,074

 

26.9%

 

 

89,086

 

23.2%

 

 

31,988

 

35.9%

 

 

 

 

449,771

 

100.0%

 

 

384,713

 

100.0%

 

 

65,058

 

16.9%

 

Operating income before corporate expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

 

42,905

 

13.1%

 

 

36,956

 

12.5%

 

 

5,949

 

16.1%

 

Personal Care

 

 

9,273

 

7.7%

 

 

9,580

 

10.8%

 

 

(307)

 

-3.2%

 

 

 

 

52,178

 

11.6%

 

 

46,536

 

12.1%

 

 

5,642

 

12.1%

 

Healthcare Innovations Operations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenue

 

 

20,343

 

100.0%

 

 

2,284

 

100.0%

 

 

18,059

 

790.7%

 

Operating income (loss)

 

 

5,098

 

25.1%

 

 

(434)

 

-19.0%

 

 

5,532

 

NM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corporate expenses

 

 

21,617

 

4.6%

 

 

20,004

 

5.2%

 

 

1,613

 

8.1%

 

Deal, transition and other costs

 

 

7,455

 

1.6%

 

 

(696)

 

-0.2%

 

 

8,151

 

-1171.1%

 

Operating income

 

 

28,204

 

6.0%

 

 

26,794

 

6.9%

 

 

1,410

 

5.3%

 

Interest expense, net

 

 

(4,335)

 

-0.9%

 

 

(1,463)

 

-0.4%

 

 

(2,872)

 

196.3%

 

Income tax expense

 

 

(9,120)

 

-1.9%

 

 

(8,458)

 

-2.2%

 

 

(662)

 

7.8%

 

Net income

 

$

14,749

 

3.1%

 

$

16,873

 

4.4%

 

$

(2,124)

 

-12.6%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA (1)

 

$

40,486

 

8.6%

 

$

29,962

 

7.7%

 

$

10,524

 

35.1%

 

Adjusted net income (1)

 

$

19,259

 

4.1%

 

$

14,536

 

3.8%

 

$

4,723

 

32.5%

 


(1)

See Non-GAAP Financial Measures starting on page 12.

9


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

VISITING NURSE SEGMENT OPERATING METRICS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

 

 

 

 

 

 

 

September 30, 2016

 

October 2, 2015

 

Change

 

 

 

Amount

    

%

    

Amount

    

%

    

Amount

    

%

 

Average number of locations

 

 

169

 

 

 

 

164

 

 

 

 

5

 

3.0%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

All payors:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Patient months

 

 

88,396

 

 

 

 

80,940

 

 

 

 

7,456

 

9.2%

 

Admissions

 

 

25,788

 

 

 

 

24,759

 

 

 

 

1,029

 

4.2%

 

Billable visits

 

 

711,998

 

 

 

 

645,589

 

 

 

 

66,409

 

10.3%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions

 

 

23,030

 

89%

 

 

21,876

 

88%

 

 

1,154

 

5.3%

 

Revenue (in thousands)

 

$

101,383

 

94%

 

$

92,033

 

94%

 

$

9,350

 

10.2%

 

Revenue per admission

 

$

4,402

 

 

 

$

4,207

 

 

 

$

195

 

4.6%

 

Billable visits

 

 

630,089

 

88%

 

 

580,709

 

90%

 

 

49,380

 

8.5%

 

Recertifications

 

 

12,639

 

 

 

 

11,966

 

 

 

 

673

 

5.6%

 

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Traditional Medicare Episodic

 

 

84.0%

 

 

 

 

84.6%

 

 

 

 

-0.6%

 

 

 

Replacement Plans Paid Episodically

 

 

5.9%

 

 

 

 

4.1%

 

 

 

 

1.8%

 

 

 

Replacement Plans Paid Per Visit

 

 

10.1%

 

 

 

 

11.3%

 

 

 

 

-1.2%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions

 

 

2,758

 

11%

 

 

2,883

 

12%

 

 

$
(125)

 

-4.3%

 

Revenue (in thousands)

 

$

7,042

 

6%

 

$

6,311

 

6%

 

$

731

 

11.6%

 

Revenue per admission

 

$

2,553

 

 

 

$

2,189

 

 

 

$

364

 

16.6%

 

Billable visits

 

 

81,909

 

12%

 

 

64,880

 

10%

 

 

17,029

 

26.2%

 

Recertifications

 

 

1,233

 

 

 

 

774

 

 

 

 

459

 

59.3%

 

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicaid & other governmental

 

 

25.9%

 

 

 

 

30.6%

 

 

 

 

-4.7%

 

 

 

Private payors

 

 

74.1%

 

 

 

 

69.4%

 

 

 

 

4.7%

 

 

 

 

PERSONAL CARE SEGMENT OPERATING METRICS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

 

 

 

 

 

 

 

September 30, 2016

 

October 2, 2015

 

Change

 

 

    

Amount

    

 

    

Amount

    

 

    

Amount

    

%

 

Average number of locations

 

 

80

 

 

 

 

66

 

 

 

 

14

 

21.2%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions

 

 

2,638

 

 

 

 

1,725

 

 

 

 

913

 

52.9%

 

Patient months of care

 

 

43,562

 

 

 

 

25,419

 

 

 

 

18,143

 

71.4%

 

Billable hours

 

 

1,919,931

 

 

 

 

1,384,466

 

 

 

 

535,465

 

38.7%

 

Revenue per billable hour

 

$

21.71

 

 

 

$

22.27

 

 

 

$

(0.56)

 

-2.5%

 

 

 

10


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VISITING NURSE SEGMENT OPERATING METRICS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nine Months Ended

 

 

 

 

 

 

 

 

September 30, 2016

 

 

 

October 2, 2015

 

Change

 

 

    

Amount

    

%

    

Amount

    

%

    

Amount

    

%

 

Average number of locations

 

 

165

 

 

 

 

162

 

 

 

 

3

 

1.9%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

All payors:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Patient months

 

 

270,880

 

 

 

 

242,989

 

 

 

 

27,891

 

11.5%

 

Admissions

 

 

81,574

 

 

 

 

75,958

 

 

 

 

5,616

 

7.4%

 

Billable visits

 

 

2,174,980

 

 

 

 

1,926,660

 

 

 

 

248,320

 

12.9%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions

 

 

70,021

 

86%

 

 

68,380

 

90%

 

 

1,641

 

2.4%

 

Revenue (in thousands)

 

$

308,055

 

94%

 

$

280,827

 

95%

 

$

27,228

 

9.7%

 

Revenue per admission

 

$

4,399

 

 

 

$

4,107

 

 

 

$

293

 

7.1%

 

Billable visits

 

 

1,921,796

 

88%

 

 

1,745,856

 

91%

 

 

175,940

 

10.1%

 

Recertifications

 

 

37,777

 

 

 

 

35,473

 

 

 

 

2,304

 

6.5%

 

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Traditional Medicare Episodic

 

 

82.5%

 

 

 

 

83.9%

 

 

 

 

-1.4%

 

 

 

Replacement Plans Paid Episodically

 

 

5.2%

 

 

 

 

4.0%

 

 

 

 

1.2%

 

 

 

Replacement Plans Paid Per Visit

 

 

12.3%

 

 

 

 

12.1%

 

 

 

 

0.2%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions

 

 

11,553

 

14%

 

 

7,578

 

10%

 

 

3,975

 

52.5%

 

Revenue (in thousands)

 

$

20,642

 

6%

 

$

14,800

 

5%

 

$

5,842

 

39.5%

 

Revenue per admission

 

$

1,787

 

 

 

$

1,953

 

 

 

$

(166)

 

-8.5%

 

Billable visits

 

 

253,184

 

12%

 

 

180,804

 

9%

 

 

72,380

 

40.0%

 

Recertifications

 

 

3,517

 

 

 

 

1,485

 

 

 

 

2,032

 

136.8%

 

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicaid & other governmental

 

 

41.1%

 

 

 

 

32.4%

 

 

 

 

8.7%

 

 

 

Private payors

 

 

58.9%

 

 

 

 

67.6%

 

 

 

 

-8.7%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONAL CARE OPERATING METRICS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nine Months Ended

 

 

 

 

 

 

 

 

September 30, 2016

 

October 2, 2015

 

Change

 

 

    

Amount

    

 

    

Amount

    

 

    

Amount

    

%

 

Average number of locations

 

 

74

 

 

 

 

64

 

 

 

 

10

 

15.6%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions

 

 

7,675

 

 

 

 

4,803

 

 

 

 

2,872

 

59.8%

 

Patient months of care

 

 

122,380

 

 

 

 

71,907

 

 

 

 

50,473

 

70.2%

 

Billable hours

 

 

5,575,254

 

 

 

 

3,989,328

 

 

 

 

1,585,926

 

39.8%

 

Revenue per billable hour

 

$

21.72

 

 

 

$

22.33

 

 

 

$

(0.61)

 

-2.8%

 

11


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

HEALTHCARE INNOVATIONS SUPPLEMENTAL DATA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

 

 

 

 

 

 

 

September 30, 2016

 

October 2, 2015

 

 

Change

 

 

    

Amount

    

Amount

 

    

Amount

    

%

 

In-home Assessments

 

 

21,019

 

 

1,962

 

 

19,057

 

NM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare ACO enrollees under management

 

 

121,881

 

 

83,133

 

 

38,748

 

46.6%

 

ACOs under contract

 

 

15

 

 

11

 

 

4

 

36.4%

 

Assets

 

$

64,556

 

 

11,070

 

$

53,486

 

NM

 

Liabilities

 

$

23,118

 

 

1,124

 

$

21,994

 

NM

 

Non-controlling interest - redeemable

 

$

2,256

 

 

3,639

 

$

(1,383)

 

-38.0%

 

Non-controlling interest - nonredeemable

 

$

1,060

 

 

417

 

$

643

 

154.2%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nine Months Ended

 

 

 

 

 

 

 

 

September 30, 2016

 

October 2, 2015

 

 

Change

 

 

    

Amount

    

Amount

 

    

Amount

    

%

 

In-home Assessments

 

 

79,017

 

 

1,962

 

 

77,055

 

NM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare enrollees under management

 

 

121,881

 

 

83,133

 

 

38,748

 

46.6%

 

ACOs under contract

 

 

15

 

 

11

 

 

4

 

36.4%

 

 

 

Non-GAAP Financial Measures

The information provided in some of the tables in this release includes certain non-GAAP financial measures as defined under SEC rules.  In accordance with SEC rules, the Company has provided, in the supplemental information, a reconciliation of those measures to the most directly comparable GAAP measures.

 

Adjusted Net Income and Adjusted Earnings Per Share 

Adjusted net income and adjusted earnings per share is not a measure of financial performance under accounting principles generally accepted in the United States of America.  It should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles. The presentation of adjusted net income and adjusted earnings per share provides investors with pertinent information to enable comparison of financial performance between periods by excluding certain items that the Company believes are not representative of its ongoing operations due to the nature of the items. 

 

The following tables set forth a reconciliation of net income attributable to Almost Family, Inc. to adjusted net income:

12


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

ALMOST FAMILY, INC. AND SUBSIDIARIES

RECONCILIATION OF ADJUSTED NET INCOME AND ADJUSTED EARNINGS PER SHARE

 (In thousands)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

(in thousands)

    

September 30, 2016

    

October 2, 2015

    

September 30, 2016

    

October 2, 2015

 

Net income

 

$

6,378

 

$

8,061

 

$

14,749

 

$

16,873

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Addbacks:

 

 

 

 

 

 

 

 

 

 

 

 

 

Deal, transition and other, net of tax

 

 

1,415

 

 

(2,700)

 

 

4,510

 

 

(2,337)

 

Adjusted net income

 

 

7,793

 

 

5,361

 

 

19,259

 

 

14,536

 

Non-controlling interest

 

 

(1,012)

 

 

(262)

 

 

(689)

 

 

330

 

Adjusted net income attributable to Almost Family, Inc.

 

$

6,781

 

$

5,099

$

 

18,570

 

$

14,866

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Per share amounts-diluted:

 

 

 

 

 

 

 

 

 

 

 

 

 

Average shares outstanding

 

 

10,310

 

 

9,822

 

 

10,328

 

 

9,649

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net income

 

 

0.62

 

 

0.82

 

 

1.43

 

 

1.75

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Addbacks:

 

 

 

 

 

 

 

 

 

 

 

 

 

Deal, transition and other, net of tax

 

 

0.14

 

 

(0.27)

 

 

0.44

 

 

(0.24)

 

Adjusted earnings per share

 

 

0.76

 

 

0.55

 

 

1.86

 

 

1.51

 

Non-controlling interest

 

 

(0.10)

 

 

(0.03)

 

 

(0.07)

 

 

0.03

 

Adjusted net income attributable to Almost Family, Inc.

 

$

0.66

 

$

0.52

 

$

1.80

 

$

1.54

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA

Adjusted earnings before interest, income tax, depreciation and amortization, amortization of stock-based compensation, deal, transition and other (Adjusted EBTIDA) is not a measure of financial performance under accounting principles generally accepted in the United States of America.  It should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.  The items excluded from Adjusted EBITDA Operations are significant components in understanding and evaluating financial performance and liquidity.  Management routinely calculates and communicates Adjusted EBITDA Operations and believes that it is useful to investors because it provides a common analytical indicator within our industry to evaluate performance, measure leverage capacity and debt service ability, and to estimate current or prospective enterprise value.  Adjusted EBITDA is also used in certain covenants contained in our credit agreement.

 

13


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

The following tables set forth a reconciliation of net income from continuing operations to Adjusted EBITDA from Home Health Operations:

 

ALMOST FAMILY, INC. AND SUBSIDIARIES

RECONCILIATION OF ADJUSTED EBITDA

 (In thousands)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three Months Ended

 

Nine Months Ended

 

(in thousands)

    

September 30, 2016

    

October 2, 2015

    

September 30, 2016

    

    

October 2, 2015

 

Net income

 

$

6,378

 

$

8,061

 

$

14,749

 

 

$

16,873

 

Add back:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Interest expense

 

 

1,399

 

 

559

 

 

4,335

 

 

 

1,463

 

Income tax expense

 

 

3,194

 

 

2,078

 

 

9,120

 

 

 

8,458

 

Depreciation and amortization

 

 

964

 

 

781

 

 

2,814

 

 

 

2,409

 

Stock-based compensation

 

 

612

 

 

450

 

 

2,013

 

 

 

1,455

 

Deal and transition costs

 

 

2,257

 

 

(1,306)

 

 

7,455

 

 

 

(696)

 

Adjusted EBITDA

 

$

14,804

 

$

10,623

 

$

40,486

 

 

$

29,962

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

About Almost Family, Inc.

Almost Family, Inc., founded in 1976, is a leading regional provider of home health nursing services, with branch locations in Florida, Ohio, Tennessee, New York, Connecticut, Kentucky, New Jersey, Massachusetts, Pennsylvania, Georgia, Wisconsin, Indiana, Missouri, Illinois, Mississippi and Alabama (in order of revenue significance and prior to the acquisition of Community Health Systems, Inc. home health and hospice operations).  Almost Family, Inc. and its subsidiaries operate a Medicare-certified segment, a personal care segment and a healthcare innovations segment.  Almost Family operates over 250 branch locations in sixteen U.S. states.

14


 

Almost Family Reports Third Quarter 2016 Results

November 1, 2016

Forward Looking Statements

All statements, other than statements of historical facts, included in this news release are forward looking statements within the meaning of the Private Securities Litigation Reform Act of 1995.  Forward-looking statements may be identified by the use of forward-looking terminology such as “may,” “will,” “expect,” “believe,” “estimate,” “project,” “anticipate,” “continue,” or similar terms, variations of those terms or the negative of those terms.  These forward-looking statements are based on the Company's current plans, expectations and projections about future events.  Statements about the Company’s or CHS Home Health’s past financial results do not, and are not meant to, predict future results.  The Company can provide no assurance that such results and performance will continue. 

Because forward-looking statements involve risks and uncertainties, the Company's actual results could differ materially from any future results, performance or achievements expressed or implied by such forward-looking statements. The potential risks and uncertainties which could cause actual results to differ materially include: the satisfaction of the conditions precedent to the consummation of the proposed transaction, including, without limitation, the receipt of regulatory approvals or third party consents on the terms desired or anticipated; the Company’s ability to obtain financing on the anticipated terms and schedule; disruptions of the Company’s and CHS Home Health’s current plans, operations and relationships caused by the announcement and pendency of the proposed transaction; the impact of further changes in healthcare reimbursement systems, including the ultimate outcome of potential changes to Medicare reimbursement for home health services and to Medicaid reimbursement due to state budget shortfalls; the ability of the Company to maintain its level of operating performance and achieve its cost control objectives; changes in our relationships with referral sources; unanticipated difficulties or expenditures relating to the proposed transaction, including, without limitation, difficulties that result in the failure to achieve expected synergies, efficiencies and cost savings from the proposed transaction within the expected time period (if at all); government regulation; health care reform; pricing pressures from Medicare, Medicaid and other third-party payers; changes in laws and interpretations of laws relating to the healthcare industry; the ability of the Company to integrate, manage and keep secure our information systems; changes in the marketplace and regulatory environment for Health Risk Assessments and the Company’s self-insurance risks.  For a more complete discussion regarding these and other factors which could affect the Company's financial performance, refer to the Company's various filings with the Securities and Exchange Commission, including its filing on Form 10-K for the fiscal year ended January 1, 2016, in particular information under the headings "Special Caution Regarding Forward-Looking Statements" and “Risk Factors.”  With regard to the Company’s investment in development-stage enterprises in its Healthcare Innovations segment, there can be no assurance that its operational and developmental objectives will be realized or that the Company’s investments will result in future returns.  The Company undertakes no obligation to update or revise its forward-looking statements.

 

15