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ehc:hospital
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
______________________________
FORM i 10-Q
|
| |
i ☒ | QUARTERLY
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
OR |
| |
i ☐ | TRANSITION
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
______________________________
i Encompass
Health Corporation
(Exact name of Registrant as specified in its Charter)
|
| |
i Delaware | i 63-0860407 |
(State
or Other Jurisdiction of Incorporation or Organization) | (I.R.S. Employer Identification No.) |
| |
i 9001 Liberty Parkway
i Birmingham,
i Alabama i 35242
(Address of Principal Executive Offices)
( i 205)
i 967-7116
(Registrant’s telephone number)
Securities registered pursuant to Section 12(b) of the Act:
|
| | |
Title of each class | Trading Symbol(s) | Name of each exchange on which registered |
i Common
Stock, par value $0.01 per share | i EHC | i New York Stock Exchange |
Indicate by check mark whether the registrant (1) has filed all reports required to
be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. i Yes ý No o
Indicate by check mark whether the registrant
has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). i Yes ý No o
Indicate by check mark whether the registrant is a large accelerated
filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act. |
| | | | | |
i Large accelerated filer | x | Accelerated
filer | o | Non-Accelerated filer | o |
Smaller reporting company | i ☐ | Emerging growth company | i ☐ | | |
If
an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. o Indicate by check mark whether the registrant is a shell company (as defined in Exchange Act Rule 12b-2). Yes i ☐ No ý
NOTE TO READERS
As used in this report, the terms “Encompass Health,” “we,” “us,” “our,” and the “Company” refer to Encompass Health Corporation and its consolidated subsidiaries, unless otherwise stated or indicated by context. This drafting style is suggested by the Securities and Exchange Commission and is not meant to imply that Encompass Health Corporation, the publicly traded parent company, owns or operates any specific asset, business, or property. The hospitals, operations, and businesses described in this filing are primarily owned and operated by subsidiaries of the parent company. In addition, we use the term “Encompass Health
Corporation” to refer to Encompass Health Corporation alone wherever a distinction between Encompass Health Corporation and its subsidiaries is required or aids in the understanding of this filing.
CAUTIONARY STATEMENT REGARDING FORWARD-LOOKING STATEMENTS
This quarterly report contains historical information, as well as forward-looking statements that involve known and unknown risks and relate to, among other things, future events, changes to Medicare reimbursement and other healthcare laws and regulations
from time to time, our business strategy, our dividend and stock repurchase strategies, our financial plans, our growth plans, our future financial performance, our projected business results, or our projected capital expenditures. In some cases, the reader can identify forward-looking statements by terminology such as “may,” “will,” “should,” “could,” “expects,” “plans,” “anticipates,” “believes,” “estimates,” “predicts,” “targets,” “potential,” or “continue” or the negative of these terms or other comparable terminology. Such forward-looking statements are necessarily estimates based upon current information and involve a number of risks and uncertainties, many of which are beyond our control. Any forward-looking statement is based on information current as of the date of this report and speaks only as of the date on which such statement is made. Actual events or results may
differ materially from the results anticipated in these forward-looking statements as a result of a variety of factors. While it is impossible to identify all such factors, factors that could cause, and in the case of the COVID-19 pandemic has already caused, actual results to differ, such as decreases in revenues or increases in costs or charges, materially from those estimated by us include, but are not limited to, the following:
| |
• | each of the factors discussed in Item 1A, Risk Factors, of our Annual Report on Form 10-K for the year ended December 31, 2019, as well as uncertainties and factors, if any, discussed elsewhere
in this Form 10-Q, including in the “Executive Overview—Key Challenges” section of Part I, Item 2, Management’s Discussion and Analysis of Financial Condition and Results of Operations, in our other filings from time to time with the SEC, or in materials incorporated therein by reference; |
| |
• | a pandemic, epidemic, or other widespread outbreak of an infectious disease or other public health crisis, such as the COVID-19 pandemic, which could decrease our patient volumes, pricing, and revenues, lead to staffing and supply shortages and associated cost increases, or otherwise interrupt operations; |
| |
• | state
and local executive actions in response to the COVID-19 pandemic, such as shelter-in-place orders, facility closures and quarantines, which could impair our ability to operate and provide care; |
| |
• | our ability to maintain infectious disease prevention and control efforts that are required and effectively minimize the spread of COVID-19 among patients and employees; |
| |
• | changes in the rules and regulations of the healthcare industry at either or both of the federal and state levels, including those
contemplated now and in the future as part of national healthcare reform and deficit reduction (such as the re-basing of payment systems, the introduction of site neutral payments or case-mix weightings across post-acute settings, the Patient-Driven Groupings Model for home health, the new patient assessment measures, which we refer to as “Section GG functional measures,” for inpatient rehabilitation, and other payment system reforms), which may decrease revenues and increase the costs of complying with the rules and regulations; |
| |
• | reductions or delays in, or suspension of, reimbursement for our services by governmental or private payors, including our ability to obtain and retain favorable arrangements with third-party payors; |
| |
• | restrictive
interpretations of the regulations governing the claims that are reimbursable by Medicare; |
| |
• | our ability to comply with extensive and changing healthcare regulations as well as the increased costs of regulatory compliance and compliance monitoring in the healthcare industry, including the costs of investigating and defending asserted claims, whether meritorious or not; |
| |
• | any adverse outcome of various lawsuits, claims, and legal or regulatory proceedings, including disclosed and undisclosed qui
tam suits; |
| |
• | the use by governmental agencies and contractors of statistical sampling and extrapolation to expand claims of overpayment or noncompliance; |
| |
• | delays in the administrative appeals process associated with denied Medicare reimbursement claims, including from various Medicare audit programs, and our exposure to the related delay or reduction in the receipt of the reimbursement amounts for services previously provided, including through recoupment of ongoing claims reimbursement by CMS; |
| |
• | the
ongoing evolution of the healthcare delivery system, including alternative payment models and value-based purchasing initiatives, which may decrease our reimbursement rate or increase costs associated with our operations; |
| |
• | our ability to attract and retain nurses, therapists, and other healthcare professionals in a highly competitive environment with often severe staffing shortages, including as a result of the COVID-19 pandemic, and the impact on our labor expenses from potential union activity and staffing recruitment and retention; |
| |
• | competitive
pressures in the healthcare industry, including from other providers that may be participating in integrated delivery payment arrangements in which we do not participate, and our response to those pressures; |
| |
• | our ability to successfully complete and integrate de novo developments, acquisitions, investments, and joint ventures consistent with our growth strategy, including realization of anticipated revenues, cost savings, productivity improvements arising from the related operations and avoidance of unanticipated difficulties, costs or liabilities that could arise from acquisitions or integrations; |
| |
• | increased
costs of defending and insuring against alleged professional liability and other claims and the ability to predict the costs related to claims; |
| |
• | potential incidents affecting the proper operation, availability, or security of our or our vendors’ or partners’ information systems, including the patient information stored there; |
| |
• | new or changing quality reporting requirements impacting operational costs or our Medicare reimbursement; |
| |
• | the
price of our common stock as it affects our willingness and ability to repurchase shares and the financial and accounting effects of any repurchases; |
| |
• | our ability and willingness to continue to declare and pay dividends on our common stock, which could be affected by reduced cash flow resulting from the COVID-19 pandemic; |
| |
• | our ability to maintain proper local, state and federal licensing, including compliance with the Medicare conditions of participation and provider enrollment requirements, which is required to participate
in the Medicare program; |
| |
• | our ability to attract and retain key management personnel; |
| |
• | changes in our payor mix or the acuity of our patients affecting reimbursement rates; and |
| |
• | general conditions in the economy and capital markets, including any disruption, instability, or uncertainty related
to armed conflict or an act of terrorism, a governmental impasse over approval of the United States federal budget, an increase to the debt ceiling, an international trade war, a sovereign debt crisis, or a widespread outbreak of an infectious disease such as COVID-19. |
The cautionary statements referred to in this section also should be considered in connection with any subsequent written or oral forward-looking statements that may be issued by us or persons acting on our behalf. We undertake no duty to update these forward-looking statements, even though our situation may change in the future. Furthermore, we cannot guarantee future results, events, levels of activity, performance, or achievements.
PART I.
FINANCIAL INFORMATION
| |
Item 1. | Financial Statements (Unaudited) |
Condensed Consolidated Statements of Comprehensive Income
(Unaudited) |
| | | | | | | |
| |
| 2020 | | 2019 |
| (In Millions, Except Per Share Data) |
Net operating revenues | $ | i 1,182.0 |
| | $ | i 1,124.0 |
|
Operating
expenses: | |
| | |
|
Salaries and benefits | i 679.1 |
| | i 620.8 |
|
Other
operating expenses | i 159.6 |
| | i 150.1 |
|
Occupancy
costs | i 20.2 |
| | i 19.6 |
|
Supplies | i 45.7 |
| | i 40.1 |
|
General
and administrative expenses | i 35.6 |
| | i 53.4 |
|
Depreciation
and amortization | i 58.8 |
| | i 52.5 |
|
Government,
class action, and related settlements | i 2.8 |
| | i — |
|
Total
operating expenses | i 1,001.8 |
| | i 936.5 |
|
Interest
expense and amortization of debt discounts and fees | i 43.2 |
| | i 37.2 |
|
Other
expense (income) | i 1.9 |
| | ( i 3.7 | ) |
Equity
in net income of nonconsolidated affiliates | ( i 0.8 | ) | | ( i 2.5 | ) |
Income
from continuing operations before income tax expense | i 135.9 |
| | i 156.5 |
|
Provision
for income tax expense | i 27.1 |
| | i 30.8 |
|
Income
from continuing operations | i 108.8 |
| | i 125.7 |
|
Loss
from discontinued operations, net of tax | ( i 0.1 | ) | | ( i 0.5 | ) |
Net
and comprehensive income | i 108.7 |
| | i 125.2 |
|
Less:
Net and comprehensive income attributable to noncontrolling interests | ( i 21.7 | ) | | ( i 22.9 | ) |
Net
and comprehensive income attributable to Encompass Health | $ | i 87.0 |
| | $ | i 102.3 |
|
| | | |
Weighted
average common shares outstanding: | |
| | |
|
Basic | i 98.2 |
| | i 98.4 |
|
Diluted | i 99.6 |
| | i 99.7 |
|
Earnings
per common share: | | | |
Basic earnings per share attributable to Encompass Health common shareholders: | | | |
|
Continuing operations | $ | i 0.88 |
| | $ | i 1.05 |
|
Discontinued
operations | i — |
| | ( i 0.01 | ) |
Net
income | $ | i 0.88 |
| | $ | i 1.04 |
|
Diluted
earnings per share attributable to Encompass Health common shareholders: | | | |
Continuing operations | $ | i 0.87 |
| | $ | i 1.04 |
|
Discontinued
operations | i — |
| | ( i 0.01 | ) |
Net
income | $ | i 0.87 |
| | $ | i 1.03 |
|
| | | |
Amounts
attributable to Encompass Health common shareholders: | | | |
|
Income from continuing operations | $ | i 87.1 |
| | $ | i 102.8 |
|
Loss
from discontinued operations, net of tax | ( i 0.1 | ) | | ( i 0.5 | ) |
Net
income attributable to Encompass Health | $ | i 87.0 |
| | $ | i 102.3 |
|
The
accompanying notes to condensed consolidated financial statements are an integral part of these condensed statements.
1
Condensed Consolidated Balance Sheets
(Unaudited)
|
| | | | | | | |
| | | |
| (In Millions) |
Assets | | | |
Current assets: | | | |
Cash
and cash equivalents | $ | i 104.9 |
| | $ | i 94.8 |
|
Restricted
cash | i 56.7 |
| | i 57.4 |
|
Accounts
receivable | i 543.4 |
| | i 506.1 |
|
Other
current assets | i 79.5 |
| | i 97.5 |
|
Total
current assets | i 784.5 |
| | i 755.8 |
|
Property
and equipment, net | i 2,003.3 |
| | i 1,959.3 |
|
Operating
lease right-of-use assets | i 267.9 |
| | i 276.5 |
|
Goodwill | i 2,312.1 |
| | i 2,305.2 |
|
Intangible
assets, net | i 464.7 |
| | i 476.3 |
|
Deferred
income tax assets | i 1.5 |
| | i 2.9 |
|
Other
long-term assets | i 303.7 |
| | i 304.7 |
|
Total
assets(1) | $ | i 6,137.7 |
| | $ | i 6,080.7 |
|
Liabilities
and Shareholders’ Equity | | | |
Current liabilities: | | | |
Current portion of long-term debt | $ | i 40.2 |
| | $ | i 39.3 |
|
Current
operating lease liabilities | i 40.8 |
| | i 40.4 |
|
Accounts
payable | i 98.0 |
| | i 94.6 |
|
Accrued
expenses and other current liabilities | i 407.2 |
| | i 546.7 |
|
Total
current liabilities | i 586.2 |
| | i 721.0 |
|
Long-term
debt, net of current portion | i 3,321.9 |
| | i 3,023.3 |
|
Long-term
operating lease liabilities | i 235.1 |
| | i 243.8 |
|
Other
long-term liabilities | i 163.3 |
| | i 159.9 |
|
| i 4,306.5 |
| | i 4,148.0 |
|
Commitments
and contingencies | i
|
| | i
|
|
Redeemable
noncontrolling interests | i 34.0 |
| | i 239.6 |
|
Shareholders’
equity: | |
| | |
|
Encompass Health shareholders’ equity | i 1,443.9 |
| | i 1,352.2 |
|
Noncontrolling
interests | i 353.3 |
| | i 340.9 |
|
Total
shareholders’ equity | i 1,797.2 |
| | i 1,693.1 |
|
Total
liabilities(1) and shareholders’ equity | $ | i 6,137.7 |
| | $ | i 6,080.7 |
|
| |
(1) | Our
consolidated assets as of March 31, 2020 and December 31, 2019 include total assets of variable interest entities of $ i 222.2 million and $ i 215.0
million, respectively, which cannot be used by us to settle the obligations of other entities. Our consolidated liabilities as of March 31, 2020 and December 31, 2019 include total liabilities of the variable interest entities of $ i 39.3 million and $ i 41.1
million, respectively. See Note 2, Variable Interest Entities. |
The accompanying notes to condensed consolidated financial statements are an integral part of these condensed statements.
2
Condensed Consolidated
Statements of Shareholders’ Equity
(Unaudited)
|
| | | | | | | | | | | | | | | | | | | | | | | | | | |
| |
| (In Millions) |
| Encompass Health Common Shareholders | | | | |
| Number of Common Shares Outstanding | | Common
Stock | | Capital in Excess of Par Value | | Accumulated Deficit | | Treasury Stock | | Noncontrolling Interests | | Total |
Balance
at beginning of period | i 98.6 |
| | $ | i 1.1 |
| | $ | i 2,369.9 |
| | $ | ( i 526.5 | ) | | $ | ( i 492.3 | ) | | $ | i 340.9 |
| | $ | i 1,693.1 |
|
Net
income | — |
| | — |
| | — |
| | i 87.0 |
| | — |
| | i 19.7 |
| | i 106.7 |
|
Receipt
of treasury stock | ( i 0.2 | ) | | — |
| | — |
| | — |
| | ( i 15.6 | ) | | — |
| | ( i 15.6 | ) |
Dividends
declared ($0.28 per share) | — |
| | — |
| | ( i 27.9 | ) | | — |
| | — |
| | — |
| | ( i 27.9 | ) |
Exchange
of Holdings shares | i 0.6 |
| | — |
| | i 27.1 |
| | — |
| | i 19.2 |
| | — |
| | i 46.3 |
|
Stock-based
compensation | — |
| | — |
| | i 7.1 |
| | — |
| | — |
| | — |
| | i 7.1 |
|
Distributions
declared | — |
| | — |
| | — |
| | — |
| | — |
| | ( i 15.5 | ) | | ( i 15.5 | ) |
Capital
contributions from consolidated affiliates | — |
| | — |
| | — |
| | — |
| | — |
| | i 5.8 |
| | i 5.8 |
|
Repurchases
of common stock in open market | ( i 0.1 | ) | | — |
| | — |
| | — |
| | ( i 4.9 | ) | | — |
| | ( i 4.9 | ) |
Other | i 0.5 |
| | — |
| | — |
| | — |
| | ( i 0.3 | ) | | i 2.4 |
| | i 2.1 |
|
Balance
at end of period | i 99.4 |
| | $ | i 1.1 |
| | $ | i 2,376.2 |
| | $ | ( i 439.5 | ) | | $ | ( i 493.9 | ) | | $ | i 353.3 |
| | $ | i 1,797.2 |
|
|
| | | | | | | | | | | | | | | | | | | | | | | | | | |
| |
| (In Millions) |
| Encompass Health Common Shareholders | | | | |
| Number of Common Shares Outstanding | | Common
Stock | | Capital in Excess of Par Value | | Accumulated Deficit | | Treasury Stock | | Noncontrolling Interests | | Total |
Balance at beginning of period | i 98.9 |
| | $ | i 1.1 |
| | $ | i 2,588.7 |
| | $ | ( i 885.2 | ) | | $ | ( i 427.9 | ) | | $ | i 280.3 |
| | $ | i 1,557.0 |
|
Net
income | — |
| | — |
| | — |
| | i 102.3 |
| | — |
| | i 18.9 |
| | i 121.2 |
|
Receipt
of treasury stock | ( i 0.3 | ) | | — |
| | — |
| | — |
| | ( i 15.9 | ) | | — |
| | ( i 15.9 | ) |
Dividends
declared ($0.27 per share) | — |
| | — |
| | ( i 26.9 | ) | | — |
| | — |
| | — |
| | ( i 26.9 | ) |
Stock-based
compensation | — |
| | — |
| | i 7.0 |
| | — |
| | — |
| | — |
| | i 7.0 |
|
Distributions
declared | — |
| | — |
| | — |
| | — |
| | — |
| | ( i 15.3 | ) | | ( i 15.3 | ) |
Capital
contributions from consolidated affiliates | — |
| | — |
| | — |
| | — |
| | — |
| | i 7.1 |
| | i 7.1 |
|
Fair
value adjustments to redeemable noncontrolling interests | — |
| | — |
| | ( i 20.3 | ) | | — |
| | — |
| | — |
| | ( i 20.3 | ) |
Repurchases
of common stock in open market | ( i 0.2 | ) | | — |
| | — |
| | — |
| | ( i 11.0 | ) | | — |
| | ( i 11.0 | ) |
Other | i 0.7 |
| | — |
| | i 2.8 |
| | — |
| | ( i 0.4 | ) | | i 11.2 |
| | i 13.6 |
|
Balance
at end of period | i 99.1 |
| | $ | i 1.1 |
| | $ | i 2,551.3 |
| | $ | ( i 782.9 | ) | | $ | ( i 455.2 | ) | | $ | i 302.2 |
| | $ | i 1,616.5 |
|
The
accompanying notes to condensed consolidated financial statements are an integral part of these condensed statements.
3
Condensed Consolidated Statements of Cash Flows
(Unaudited)
|
| | | | | | | |
| |
| 2020 | | 2019 |
| (In Millions) |
Cash flows from operating activities: | | | |
Net income | $ | i 108.7 |
| | $ | i 125.2 |
|
Loss
from discontinued operations, net of tax | i 0.1 |
| | i 0.5 |
|
Adjustments
to reconcile net income to net cash provided by operating activities— | |
| | |
|
Depreciation and amortization | i 58.8 |
| | i 52.5 |
|
Stock-based
compensation | i 7.1 |
| | i 19.4 |
|
Deferred
tax expense | i 1.4 |
| | i 2.6 |
|
Other,
net | i 7.7 |
| | ( i 0.8 | ) |
Change
in assets and liabilities, net of acquisitions— | | | |
|
Accounts receivable | ( i 36.6 | ) | | ( i 29.6 | ) |
Other
assets | i 15.8 |
| | ( i 3.8 | ) |
Accrued
payroll | ( i 24.0 | ) | | ( i 14.8 | ) |
Other
liabilities | ( i 109.6 | ) | | i 11.7 |
|
Net
cash used in operating activities of discontinued operations | ( i 0.1 | ) | | ( i 3.0 | ) |
Total
adjustments | ( i 79.5 | ) | | i 34.2 |
|
Net
cash provided by operating activities | i 29.3 |
| | i 159.9 |
|
Cash
flows from investing activities: | | | |
Purchases of property and equipment | ( i 83.5 | ) | | ( i 72.3 | ) |
Acquisitions
of businesses, net of cash acquired | ( i 1.1 | ) | | ( i 13.7 | ) |
Other,
net | i 1.6 |
| | ( i 5.5 | ) |
Net
cash used in investing activities | ( i 83.0 | ) | | ( i 91.5 | ) |
Cash
flows from financing activities: | | | |
Borrowings on revolving credit facility | i 330.0 |
|
| i 25.0 |
|
Payments
on revolving credit facility | ( i 25.0 | ) |
| ( i 30.0 | ) |
Dividends
paid on common stock | ( i 29.0 | ) | | ( i 28.3 | ) |
Purchase
of equity interests in consolidated affiliates | ( i 162.3 | ) | | i — |
|
Distributions
paid to noncontrolling interests of consolidated affiliates | ( i 19.1 | ) | | ( i 19.5 | ) |
Taxes
paid on behalf of employees for shares withheld | ( i 15.6 | ) | | ( i 15.9 | ) |
Other,
net | ( i 7.9 | ) | | ( i 13.0 | ) |
Net
cash provided by (used in) financing activities | i 71.1 |
| | ( i 81.7 | ) |
Increase
(decrease) in cash, cash equivalents, and restricted cash | i 17.4 |
| | ( i 13.3 | ) |
Cash,
cash equivalents, and restricted cash at beginning of period | i 159.6 |
| | i 133.5 |
|
Cash,
cash equivalents, and restricted cash at end of period | $ | i 177.0 |
| | $ | i 120.2 |
|
| | | |
Reconciliation
of Cash, Cash Equivalents, and Restricted Cash | | | |
Cash and cash equivalents at beginning of period | $ | i 94.8 |
| | $ | i 69.2 |
|
Restricted
cash at beginning of period | i 57.4 |
| | i 59.0 |
|
Restricted
cash included in other long-term assets at beginning of period | i 7.4 |
| | i 5.3 |
|
Cash,
cash equivalents, and restricted cash at beginning of period | $ | i 159.6 |
| | $ | i 133.5 |
|
| | | |
Cash
and cash equivalents at end of period | $ | i 104.9 |
| | $ | i 56.1 |
|
Restricted
cash at end of period | i 56.7 |
| | i 59.0 |
|
Restricted
cash included in other long-term assets at end of period | i 15.4 |
| | i 5.1 |
|
Cash,
cash equivalents, and restricted cash at end of period | $ | i 177.0 |
| | $ | i 120.2 |
|
| | | |
Supplemental
schedule of noncash financing activity: | | | |
Adoption of ASC 842 | $ | i — |
| | $ | i 349.4 |
|
The
accompanying notes to condensed consolidated financial statements are an integral part of these condensed statements.
4
Notes to Condensed Consolidated Financial Statements
| |
1. | i Basis
of Presentation |
Encompass Health Corporation, incorporated in Delaware in 1984, including its subsidiaries, is one of the nation’s largest providers of post-acute healthcare services, offering both facility-based and home-based patient services in i 37 states and Puerto Rico through its network of inpatient rehabilitation hospitals, home health agencies, and hospice
agencies. We manage our operations and disclose financial information using i two reportable segments: (1) inpatient rehabilitation and (2) home health and hospice. See also Note 10, Segment Reporting. The accompanying unaudited condensed consolidated financial statements of Encompass Health Corporation and Subsidiaries
should be read in conjunction with the consolidated financial statements and accompanying notes contained in Encompass Health’s Annual Report on Form 10-K filed with the United States Securities and Exchange Commission on February 27, 2020 (the “2019 Form 10‑K”). The unaudited condensed consolidated financial statements have been prepared in accordance with the rules and regulations of the SEC applicable to interim financial information. Certain information and note disclosures included in financial statements prepared in accordance with generally accepted accounting principles in the United States of America have been omitted in these interim statements, as allowed by such SEC rules and regulations. The condensed consolidated balance sheet as of December 31,
2019 has been derived from audited financial statements, but it does not include all disclosures required by GAAP. However, we believe the disclosures are adequate to make the information presented not misleading. The unaudited results of operations for the interim periods shown in these financial statements are not necessarily indicative of operating results for the entire year. In our opinion, the accompanying condensed consolidated financial statements recognize all adjustments of a normal recurring nature considered necessary to fairly state the financial position, results of operations, and cash flows for each interim period presented.
Net Operating Revenues—
i Our
Net operating revenues disaggregated by payor source and segment are as follows (in millions):
|
| | | | | | | | | | | | | | | | | | | | | | | |
| Inpatient Rehabilitation | | Home
Health and Hospice | | Consolidated |
| Three Months Ended March 31, | | Three Months Ended March 31, | | |
| 2020 | | 2019 | | 2020 | | 2019 | | 2020 | | 2019 |
Medicare | $ | i 641.9 |
| | $ | i 638.9 |
| | $ | i 226.2 |
| | $ | i 214.8 |
| | $ | i 868.1 |
| | $ | i 853.7 |
|
Medicare
Advantage | i 111.5 |
| | i 85.2 |
| | i 29.4 |
| | i 25.5 |
| | i 140.9 |
| | i 110.7 |
|
Managed
care | i 90.2 |
| | i 83.5 |
| | i 12.1 |
| | i 8.4 |
| | i 102.3 |
| | i 91.9 |
|
Medicaid | i 30.7 |
| | i 26.2 |
| | i 4.2 |
| | i 4.3 |
| | i 34.9 |
| | i 30.5 |
|
Other
third-party payors | i 11.0 |
| | i 10.0 |
| | i — |
| | i — |
| | i 11.0 |
| | i 10.0 |
|
Workers’
compensation | i 6.9 |
| | i 8.2 |
| | i 0.3 |
| | i 0.2 |
| | i 7.2 |
| | i 8.4 |
|
Patients | i 5.5 |
| | i 6.1 |
| | i 0.4 |
| | i 0.4 |
| | i 5.9 |
| | i 6.5 |
|
Other
income | i 11.5 |
| | i 12.0 |
| | i 0.2 |
| | i 0.3 |
| | i 11.7 |
| | i 12.3 |
|
Total | $ | i 909.2 |
| | $ | i 870.1 |
| | $ | i 272.8 |
| | $ | i 253.9 |
| | $ | i 1,182.0 |
| | $ | i 1,124.0 |
|
/ See
Note 1, Summary of Significant Accounting Policies, to the consolidated financial statements accompanying the
2019 Form 10-K for our policy related to Net operating revenues.
Risks and Uncertainties—
The novel coronavirus disease 2019 (“COVID-19”) pandemic has caused a disruption to our nation’s healthcare system. Such disruption includes reductions in the availability of personal protective equipment (“PPE”) to prevent spread of the disease during patient treatment and increases
in the cost of PPE. Generally, elective procedures were postponed by physicians and acute-care hospitals in order to prepare for the expected volume of COVID-19 patients and reduce the risk of
Notes to Condensed Consolidated Financial Statements
exposure to COVID-19. In March, we experienced decreased volumes in both segments which we believe resulted from a number of conditions related to the COVID-19 pandemic including: lower acute-care hospital censuses due to the deferral of elective surgeries and shelter-in-place
orders, restrictive visitation policies in place at acute-care hospitals that have served to severely limit access to patients and caregivers by our clinical rehabilitation liaisons and care transition coordinators, lock down of assisted living facilities, and heightened anxiety among patients and their family members regarding the risk of exposure to COVID-19 during acute-care and post-acute care treatment.
In March and April 2020, the federal government began to undertake numerous legislative and regulatory initiatives designed to provide relief to the healthcare industry during the COVID-19 pandemic. A specific initiative impacting us is the Coronavirus Aid, Relief, and Economic Security Act of 2020 (the “CARES Act”) which temporarily suspends the automatic 2% reduction of Medicare program payments known as “sequestration”
for the period of May 1 through December 31, 2020 and authorizes the cash distribution of relief funds from the United States Department of Health and Human Services (“HHS”) to healthcare providers in response to the COVID-19 pandemic. On April 10, 2020, we began to receive the CARES Act relief fund payments, for which we did not apply, from HHS. To date, our inpatient rehabilitation hospitals and home health and hospice agencies have received in aggregate approximately $ i 238
million. On May 7, 2020, we informed HHS we would not accept any of the CARES Act relief funds. We are currently seeking direction on how to process the repayment of those funds. Additionally, the CARES Act and a series of waivers and guidance issued by the Centers for Medicare and Medicaid Services (“CMS”) suspend various Medicare patient coverage criteria and documentation and care requirements in an effort to provide regulatory relief. For inpatient rehabilitation, the regulatory relief includes the temporary suspension of the requirement that patients must be able to tolerate a minimum of 3 hours of therapy per day for 5 days per week, waiver of the requirement that at least 60% of a facility’s patients must have a diagnosis from at least 1 of 13 specified medical conditions that typically require intensive therapy and supervision, and
waiver of the requirement for a physician to conduct and document a post-admission evaluation. In addition, the requirement of physician face-to-face visits at least 3 days a week may be fulfilled using telehealth. For home health, the relief includes the allowance of nurse practitioners and physician assistants under certain conditions to certify, establish and periodically review the plan of care, as well as supervise the provision of items and services for beneficiaries under the Medicare home health benefit and expands the use of telehealth. For hospice, the relief includes the temporary waiver of the requirement to use volunteers and to conduct a nurse visit every two weeks to evaluate aides, as well as the expanded use of telehealth for routine services and patient recertification.
As discussed in Note 3, Long-term Debt, in April 2020, we amended our credit agreement primarily
to provide covenant relief due to business disruptions from the COVID-19 pandemic. The amendment included, among other things, the carve-out of the COVID-19 pandemic from the definition of material adverse effect for 364 days and modifications to the interest coverage and leverage ratios under the agreement.
The foregoing and other disruptions to our business as a result of the COVID-19 pandemic have had and are likely to continue to have an adverse effect on our business and could have a material adverse effect on our business, results of operations, financial condition and cash flows.
i Recently
Adopted Accounting Pronouncements—
In June 2016, the FASB issued ASU 2016-13, “Financial Instruments – Credit Losses (Topic 326),” which provides guidance for accounting for credit losses on financial instruments. The new guidance introduces an approach based on expected losses to estimate credit losses on certain types of financial instruments and modifies the impairment model for available-for-sale debt securities. The new guidance was effective for us beginning January 1, 2020. The adoption of this guidance resulted in an immaterial change to our condensed consolidated financial statements. In August 2018, the FASB issued ASU 2018-15, “Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That
Is a Service Contract.” The update helps entities evaluate the accounting for fees paid by a customer in a cloud computing arrangement (hosting arrangement), by providing guidance in determining when the arrangement includes a software license. It requires entities to account for such costs consistent with the guidance on capitalizing costs associated with developing or obtaining internal-use software. The new guidance was effective for us beginning January 1, 2020. The adoption of this guidance did not have a material impact to our condensed consolidated financial statements. Recent Accounting Pronouncements Not Yet Adopted—
In December 2019, the FASB issued ASU 2019-12, “Income Taxes (Topic 740): Simplifying
the Accounting for Income Taxes.” The standard removes certain exceptions to the general principles of ASC 740 and simplifies other areas such as accounting for outside basis differences of equity method investments. Either prospective or retrospective transition of this
Notes to Condensed Consolidated Financial Statements
standard is dependent upon the specific amendments. The new guidance is effective for us beginning January 1, 2021, including interim periods within
that reporting period. Early adoption is permitted. We continue to review the requirements of this standard and any potential impact it may have on our condensed consolidated financial statements. We do not believe any other recently issued, but not yet effective, accounting standards will have a material effect on our condensed consolidated financial position, results of operations, or cash flows.
| |
2. | i Variable
Interest Entities |
As of March 31, 2020 and December 31, 2019, we consolidated i nine and i eight,
respectively, limited partnership-like entities that are variable interest entities (“VIEs”) and of which we are the primary beneficiary. Our ownership percentages in these entities range from i 50.0% to i 75.0%
as of March 31, 2020. Through partnership and management agreements with or governing each of these entities, we manage all of these entities and handle all day-to-day operating decisions. Accordingly, we have the decision making power over the activities that most significantly impact the economic performance of our VIEs and an obligation to absorb losses or receive benefits from the VIE that could potentially be significant to the VIE. These decisions and significant activities include, but are not limited to, marketing efforts, oversight of patient admissions, medical training, nurse and therapist scheduling, provision of healthcare services, billing, collections, and creation and maintenance of medical records. The terms of the agreements governing each of our VIEs prohibit us from using the assets of each VIE to satisfy the obligations of other entities. i The
carrying amounts and classifications of the consolidated VIEs’ assets and liabilities, which are included in our consolidated balance sheet, are as follows (in millions):
|
| | | | | | | |
| | | |
Assets | | | |
Current
assets: | | | |
Cash and cash equivalents | $ | i 1.1 |
| | $ | i 0.2 |
|
Accounts
receivable | i 31.3 |
| | i 29.3 |
|
Other
current assets | i 7.7 |
| | i 6.4 |
|
Total
current assets | i 40.1 |
| | i 35.9 |
|
Property
and equipment, net | i 120.9 |
| | i 122.6 |
|
Operating
lease right-of-use assets | i 5.8 |
| | i 6.0 |
|
Goodwill | i 19.2 |
| | i 15.9 |
|
Intangible
assets, net | i 4.8 |
| | i 3.3 |
|
Other
long-term assets | i 31.4 |
| | i 31.3 |
|
Total
assets | $ | i 222.2 |
| | $ | i 215.0 |
|
Liabilities | | | |
Current
liabilities: | | | |
Current portion of long-term debt | $ | i 0.9 |
| | $ | i 0.8 |
|
Current
operating lease liabilities | i 1.5 |
| | i 1.4 |
|
Accounts
payable | i 5.6 |
| | i 6.7 |
|
Accrued
expenses and other current liabilities | i 16.6 |
| | i 17.0 |
|
Total
current liabilities | i 24.6 |
| | i 25.9 |
|
Long-term
debt, net of current portion | i 10.3 |
| | i 10.5 |
|
Long-term
operating lease liabilities | i 4.4 |
| | i 4.7 |
|
Total
liabilities | $ | i 39.3 |
| | $ | i 41.1 |
|
/
Notes to Condensed Consolidated Financial Statements
i Our long-term debt outstanding consists of the following (in millions):
|
| | | | | | | |
| | | |
Credit Agreement— | | | |
Advances under revolving credit facility | $ | i 350.0 |
| | $ | i 45.0 |
|
Term
loan facilities | i 261.9 |
| | i 265.2 |
|
Bonds
payable— | | | |
5.125% Senior Notes due 2023 | i 297.5 |
| | i 297.3 |
|
5.75%
Senior Notes due 2024 | i 697.5 |
| | i 697.3 |
|
5.75%
Senior Notes due 2025 | i 345.8 |
| | i 345.6 |
|
4.50%
Senior Notes due 2028 | i 491.9 |
| | i 491.7 |
|
4.75%
Senior Notes due 2030 | i 491.8 |
| | i 491.7 |
|
Other
notes payable | i 44.5 |
| | i 44.7 |
|
Finance
lease obligations | i 381.2 |
| | i 384.1 |
|
| i 3,362.1 |
| | i 3,062.6 |
|
Less:
Current portion | ( i 40.2 | ) | | ( i 39.3 | ) |
Long-term
debt, net of current portion | $ | i 3,321.9 |
| | $ | i 3,023.3 |
|
/ Borrowings
under our revolving credit facility as of March 31, 2020 were primarily used for the purchase of equity and vested stock appreciation rights from management investors of our home health and hospice segment. For additional information see Note 4, Redeemable Noncontrolling Interests, and Note 6, Share-Based Payments. In April 2020, we amended our existing credit agreement. The following are the changes made to the material
provisions of the credit agreement:
| |
1. | Amendment of the financial covenants to update the applicable interest coverage
ratio and leverage ratio included in that covenant. The revised applicable ratios are set forth below. |
i |
| |
Fiscal Quarters Ending | Interest Coverage Ratio |
| 3.00
to 1.00 |
June 30, 2020, September 30, 2020, December 31, 2020, March 31, 2021, June 30, 2021, September 30, 2021 and December 31, 2021 | 2.00 to 1.00 |
| 3.00 to 1.00 |
|
| |
Fiscal
Quarters Ending | Leverage Ratio |
| 4.50 to 1.00 |
| 4.75 to 1.00 |
| 5.50 to 1.00 |
| 6.50
to 1.00 |
| 6.50 to 1.00 |
| 6.00 to 1.00 |
| 5.50 to 1.00 |
| 5.00 to 1.00 |
| 4.25 to 1.00 |
Notes to Condensed Consolidated Financial Statements
| |
2. | Amendment of the definition of “Material Adverse Effect” to carve out the direct and indirect impacts of COVID-19 and the related legislative,
regulatory and executive actions on us from that definition for a period of 364 days; and |
| |
3. | Amendment of the investment limitation covenant and the restricted payment limitation covenant, to add to each a leverage ratio condition (not in excess of 4.50x) to the provisions allowing unlimited investments and restricted payments in the event certain conditions are met including a senior secured leverage ratio (not in excess of 2:00x) and the existence of no events of default in addition to the new leverage ratio condition. |
All other material terms of the existing credit agreement remain the same and are described in Note 10, Long-term
Debt, to the consolidated financial statements accompanying the 2019 Form 10‑K.
| |
4. | i Redeemable Noncontrolling Interests |
i The
following is a summary of the activity related to our Redeemable noncontrolling interests during the three months ended March 31, 2020 and 2019 (in millions): |
| | | | | | | |
| |
| 2020 | | 2019 |
Balance
at beginning of period | $ | i 239.6 |
| | $ | i 261.7 |
|
Net
income attributable to noncontrolling interests | i 2.0 |
| | i 4.0 |
|
Distributions
declared | ( i 2.1 | ) | | ( i 1.8 | ) |
Contribution
to joint venture | i 3.1 |
| | i — |
|
Reclassification
to noncontrolling interests | i — |
| | ( i 11.2 | ) |
Purchase
of redeemable noncontrolling interests | ( i 162.3 | ) | | i — |
|
Exchange
transaction | ( i 46.3 | ) | | i — |
|
Change
in fair value | i — |
| | i 20.3 |
|
Balance
at end of period | $ | i 34.0 |
| | $ | i 273.0 |
|
/ i The
following table reconciles the net income attributable to nonredeemable Noncontrolling interests, as recorded in the shareholders’ equity section of the condensed consolidated balance sheets, and the net income attributable to Redeemable noncontrolling interests, as recorded in the mezzanine section of the condensed consolidated balance sheets, to the Net and comprehensive income attributable to noncontrolling interests presented in the condensed consolidated statements of comprehensive income for the three months ended March 31, 2020 and 2019 (in millions): |
| | | | | | | |
| |
| 2020 | | 2019 |
Net income attributable to nonredeemable noncontrolling interests | $ | i 19.7 |
| | $ | i 18.9 |
|
Net
income attributable to redeemable noncontrolling interests | i 2.0 |
| | i 4.0 |
|
Net
income attributable to noncontrolling interests | $ | i 21.7 |
| | $ | i 22.9 |
|
/ On
December 31, 2014, we acquired i 83.3% of our home health and hospice business when we purchased EHHI Holdings, Inc. (“EHHI”). In the acquisition, we acquired all of the issued and outstanding equity interests of EHHI, other than equity interests contributed to Encompass Health Home Health Holdings, Inc. (“Holdings”),
a subsidiary of Encompass Health and an indirect parent of EHHI, by certain sellers in exchange for shares of common stock of Holdings. Those sellers were members of EHHI management, and they contributed a portion of their shares of common stock of EHHI, valued at approximately $ i 64 million on the acquisition date, in exchange for approximately i 16.7%
of the outstanding shares of common stock of Holdings. At any time after December 31, 2017, each management investor had the right (but not the obligation) to have his or her shares of Holdings stock repurchased by Encompass Health for a cash purchase price per share equal to the fair
Notes to Condensed Consolidated Financial Statements
value. In February 2018, each management investor exercised the right to sell one-third of his or her shares of Holdings stock to Encompass Health,
representing approximately i 5.6% of the outstanding shares of the common stock of Holdings. On February 21, 2018, Encompass Health settled the acquisition of those shares upon payment of approximately $ i 65
million in cash. In July 2019, we received additional exercise notices, representing approximately i 5.6% of the outstanding shares of the common stock of Holdings. In September 2019, Encompass Health settled the acquisition of those shares upon payment of approximately $ i 163
million in cash. In January 2020, we received additional exercise notices, representing approximately i 4.3% of the outstanding shares of the common stock of Holdings. On February 18, 2020, Encompass Health settled the acquisition of those shares upon payment of approximately $ i 162
million in cash. Upon settlement of these exercises, approximately $ i 46 million of the shares of Holdings held by two management investors remained outstanding. On February 20, 2020, Encompass Health entered into exchange agreements (each, an “Exchange Agreement”) with these two management investors, pursuant to
which they had the right to exchange all of the remaining shares of Holdings held by them for shares of common stock of Encompass Health (the “EHC Shares”). Each of the Exchange Agreements provided that the management investor must deliver a written exchange notice (an “Exchange Notice”) to Encompass Health in order to exchange his or her remaining shares of Holdings for EHC Shares. Each Exchange Agreement further provided that the number of EHC Shares to be delivered to the management investor was to be determined by dividing the fair value of the shares of Holdings held by the management investor on the date of the Exchange Agreement by the last reported sales price of Encompass Health’s common stock on the New York Stock Exchange (the “NYSE”) on the date of delivery of the Exchange Notice. On February 20, 2020, Encompass Health received an Exchange Notice
from each of the management investors. Based on the last sales price of Encompass Health’s common stock on the NYSE on February 20, 2020, Encompass Health delivered an aggregate i 560,957 EHC Shares to the management investors. The total number of EHC Shares issued pursuant to the exchange agreements on March 6, 2020 represented less than i 0.6%
of the outstanding shares of Encompass Health common stock. Encompass Health issued the EHC Shares from its treasury shares. Encompass Health now owns i 100% of Holdings and EHHI. See also Note 5, Fair Value Measurements.
| |
5. | i Fair
Value Measurements |
i Our financial assets and liabilities that are measured at fair value on a recurring basis are as follows (in millions):
|
| | | | | | | | | | | | | | | | | |
| | | Fair
Value Measurements at Reporting Date Using |
| Fair Value | | Quoted Prices in Active Markets for Identical Assets (Level 1) | | Significant Other Observable Inputs (Level 2) | | Significant Unobservable Inputs (Level 3) | | Valuation
Technique (1) |
Other long-term assets: | | | | | | | | | |
Equity securities | $ | i 61.8 |
| | $ | i — |
| | $ | i 61.8 |
| | $ | i — |
| | M |
Debt
securities | i 9.4 |
| | i 9.4 |
| | i — |
| | i — |
| | M |
Redeemable
noncontrolling interests | i 34.0 |
| | i — |
| | i — |
| | i 34.0 |
| | I |
| | | | | | | | | |
Other long-term assets: | | | | | | | | | |
Equity
securities | $ | i 63.5 |
| | $ | i — |
| | $ | i 63.5 |
| | $ | i — |
| | M |
Debt
securities | i 12.6 |
| | i 12.6 |
| | i — |
| | i — |
| | M |
Redeemable
noncontrolling interests | i 239.6 |
| | i — |
| | i — |
| | i 239.6 |
| | I |
(1) The
three valuation techniques are: market approach (M), cost approach (C), and income approach (I).
/
Notes to Condensed Consolidated Financial Statements
The decrease in Redeemable noncontrolling interests from December 31, 2019 to March, 31, 2020 primarily
resulted from the final purchase of equity interests in Holdings from management investors discussed in Note 4, Redeemable Noncontrolling Interests. The fair values of our financial assets and liabilities are determined as follows:
| |
• | Equity and Debt securities - The fair values of our equity and debt securities are determined based on quoted market prices in active markets or quoted prices, dealer quotations, or alternative pricing sources supported by observable inputs in markets that are not considered to be active. |
| |
• | Redeemable
noncontrolling interests - The fair value of the Redeemable noncontrolling interests related to our home health segment was determined using the product of a twelve-month adjusted EBITDA measure and a specified median market price multiple based on a basket of public home health companies and transactions, after adding cash and deducting indebtedness that included the outstanding principal balance under any intercompany notes. To determine the fair value of the Redeemable noncontrolling interests in our joint venture hospitals, we use the applicable hospitals’ projected operating results and cash flows discounted using a rate that reflects market participant assumptions for the applicable facilities. The projected operating results use management’s best estimates of economic and market conditions over the forecasted periods including assumptions for pricing
and volume, operating expenses, and capital expenditures. |
In addition, there are assets and liabilities that are not required to be measured at fair value on a recurring basis. However, these assets may be recorded at fair value as a result of impairment charges or other adjustments made to the carrying value of the applicable assets. During the three months ended March 31, 2020 and March 31, 2019, we did not record any material gains or losses related to these assets. As discussed in Note 1, Summary of Significant
Accounting Policies, “Fair Value Measurements,” to the consolidated financial statements accompanying the 2019 Form 10‑K, the carrying value equals fair value for our financial instruments that are not included in the table below and are classified as current in our condensed consolidated balance sheets. i The carrying amounts and estimated fair values for all of our other financial instruments are presented in the following
table (in millions):
|
| | | | | | | | | | | | | | | |
| | | |
| Carrying
Amount | | Estimated Fair Value | | Carrying Amount | | Estimated Fair Value |
Long-term debt: | |
| | |
| | |
| | |
|
Advances
under revolving credit facility | $ | i 350.0 |
| | $ | i 350.0 |
| | $ | i 45.0 |
| | $ | i 45.0 |
|
Term
loan facilities | i 261.9 |
| | i 263.3 |
| | i 265.2 |
| | i 266.6 |
|
5.125%
Senior Notes due 2023 | i 297.5 |
| | i 298.5 |
| | i 297.3 |
| | i 306.6 |
|
5.75%
Senior Notes due 2024 | i 697.5 |
| | i 703.5 |
| | i 697.3 |
| | i 708.8 |
|
5.75%
Senior Notes due 2025 | i 345.8 |
| | i 344.3 |
| | i 345.6 |
| | i 369.7 |
|
4.50%
Senior Notes due 2028 | i 491.9 |
| | i 491.3 |
| | i 491.7 |
| | i 519.4 |
|
4.75%
Senior Notes due 2030 | i 491.8 |
| | i 496.1 |
| | i 491.7 |
| | i 520.0 |
|
Other
notes payable | i 44.5 |
| | i 44.5 |
| | i 44.7 |
| | i 44.7 |
|
Financial
commitments: | | | | | | | |
Letters of credit | i — |
| | i 36.7 |
| | i — |
| | i 38.9 |
|
Fair
values for our long-term debt and financial commitments are determined using inputs, including quoted prices in nonactive markets, that are observable either directly or indirectly, or Level 2 inputs within the fair value hierarchy. See Note 1, Summary of Significant Accounting Policies, “Fair Value Measurements,” to the consolidated financial statements accompanying the 2019 Form 10‑K.
Notes
to Condensed Consolidated Financial Statements
| |
6. | i Share-Based Payments |
In the first quarter of 2020, we issued a total of i 0.4
million restricted stock awards to members of our management team and our board of directors. Approximately i 0.2 million of these awards contain only a service condition, while the remainder contain both a service
and a performance condition. For the awards that include a performance condition, the number of shares that will ultimately be granted to employees may vary based on the Company’s performance during the applicable two year performance measurement period. Additionally, we granted i 0.1
million stock options to members of our management team. The fair value of these awards and options was determined using the policies described in Note 1, Summary of Significant Accounting Policies, and Note 14, Share-Based Payments, to the consolidated financial statements accompanying the 2019 Form 10‑K. In conjunction with the EHHI acquisition discussed in Note 4, Redeemable Noncontrolling Interests, we granted stock appreciation rights (“SARs”) based on Holdings common stock to certain members of EHHI management at closing. Half of the SARs vested on December 31,
2018 and the remainder vested on December 31, 2019. Upon exercise, each SAR must be settled for cash in the amount by which the per share fair value of Holdings’ common stock on the exercise date exceeds the per share fair value on the grant date. As of December 31, 2019, the fair value of the remaining i 115,545
SARs was approximately $ i 101 million, all of which was included in Accrued expenses and other current liabilities in the condensed consolidated balance sheet. In January 2020, members of the management team exercised the remaining SARs, and in February 2020, we settled those awards upon payment of approximately $ i 101
million in cash. For additional information, see Note 14, Share-Based Payments, to the consolidated financial statements accompanying the 2019 Form 10‑K.
Our Provision for income tax expense of $ i 27.1 million and $ i 30.8
million for the three months ended March 31, 2020 and March 31, 2019, respectively, primarily resulted from the application of our estimated effective blended federal and state income tax rate offset by tax benefits resulting from share-based compensation windfalls.
Notes
to Condensed Consolidated Financial Statements
8. i Earnings per Common Share
i The following table sets forth the computation of basic
and diluted earnings per common share (in millions, except per share amounts):
|
| | | | | | | |
| |
| 2020 | | 2019 |
Basic: | | | |
Numerator: | | | |
Income
from continuing operations | $ | i 108.8 |
| | $ | i 125.7 |
|
Less:
Net income attributable to noncontrolling interests included in continuing operations | ( i 21.7 | ) | | ( i 22.9 | ) |
Less:
Income allocated to participating securities | ( i 0.3 | ) | | ( i 0.4 | ) |
Income
from continuing operations attributable to Encompass Health common shareholders | i 86.8 |
| | i 102.4 |
|
Loss
from discontinued operations, net of tax, attributable to Encompass Health common shareholders | ( i 0.1 | ) | | ( i 0.5 | ) |
Net
income attributable to Encompass Health common shareholders | $ | i 86.7 |
| | $ | i 101.9 |
|
Denominator: | | | |
Basic
weighted average common shares outstanding | i 98.2 |
| | i 98.4 |
|
Basic
earnings per share attributable to Encompass Health common shareholders: | | | |
Continuing operations | $ | i 0.88 |
| | $ | i 1.05 |
|
Discontinued
operations | i — |
| | ( i 0.01 | ) |
Net
income | $ | i 0.88 |
| | $ | i 1.04 |
|
| | | |
Diluted: | | | |
Numerator: | | | |
Income
from continuing operations | $ | i 108.8 |
| | $ | i 125.7 |
|
Less:
Net income attributable to noncontrolling interests included in continuing operations | ( i 21.7 | ) | | ( i 22.9 | ) |
Income
from continuing operations attributable to Encompass Health common shareholders | i 87.1 |
| | i 102.8 |
|
Loss
from discontinued operations, net of tax, attributable to Encompass Health common shareholders | ( i 0.1 | ) | | ( i 0.5 | ) |
Net
income attributable to Encompass Health common shareholders | $ | i 87.0 |
| | $ | i 102.3 |
|
Denominator: | | | |
Diluted
weighted average common shares outstanding | i 99.6 |
| | i 99.7 |
|
Diluted
earnings per share attributable to Encompass Health common shareholders: | | | |
Continuing operations | $ | i 0.87 |
| | $ | i 1.04 |
|
Discontinued
operations | i — |
| | ( i 0.01 | ) |
Net
income | $ | i 0.87 |
| | $ | i 1.03 |
|
/
Notes to Condensed Consolidated Financial Statements
i The following table sets forth the reconciliation between basic weighted average common shares outstanding and diluted weighted average common shares outstanding (in millions):
|
| | | | | |
| |
| 2020 | | 2019 |
Basic weighted average common shares outstanding | i 98.2 |
| | i 98.4 |
|
Restricted
stock awards, dilutive stock options, and restricted stock units | i 1.4 |
| | i 1.3 |
|
Diluted
weighted average common shares outstanding | i 99.6 |
| | i 99.7 |
|
/ See
Note 17, Earnings per Common Share, to the consolidated financial statements accompanying the 2019 Form 10‑K for additional information related to our common stock.
| |
9. | i Contingencies
and Other Commitments |
We operate in a highly regulated industry in which healthcare providers are routinely subject to litigation. As a result, various lawsuits, claims, and legal and regulatory proceedings have been and can be expected to be instituted or asserted against us. The resolution of any such lawsuits, claims, or legal and regulatory proceedings could materially and adversely affect our financial position, results of operations, and cash flows in a given period.
Nichols Litigation—
We were named as a defendant in a lawsuit filed March 28, 2003 by several individual stockholders in the Circuit Court of Jefferson County, Alabama, captioned Nichols v. HealthSouth Corp. In July 2019, we entered into settlement
agreements with all but one plaintiff and paid those settling plaintiffs an aggregate amount of cash less than $ i 0.1 million. The remaining plaintiff alleges that we, some of our former officers, and our former investment bank engaged in a scheme to overstate and misrepresent our earnings and financial position. The plaintiff is seeking compensatory and punitive damages. This
case was stayed in the circuit court on August 8, 2005. However, the complaint has been amended from time to time, including to request certification as a class action. Additionally, one of the former officers named as a defendant has repeatedly attempted to remove the case to federal district court. We filed our latest motion to remand the case back to state court on January 10, 2013. On September 27, 2013, the federal court remanded the case back to state court. On December 10, 2014, we filed a motion to dismiss on the grounds the plaintiffs lacked standing because their claims were derivative in nature, and the claims were time-barred by the statute of limitations. On May 26, 2016, the trial court granted our motion to
dismiss. On appeal, the Supreme Court of Alabama reversed the trial court’s dismissal on March 23, 2018. On April 6, 2018, we filed an application for rehearing with the Alabama Supreme Court. On March 22, 2019, the Alabama Supreme Court denied our application for rehearing and remanded the case to the trial court for further proceedings. The trial court recently vacated its original scheduling order, so we do not currently know when this trial will begin. We intend to vigorously defend ourselves in this case against the sole remaining plaintiff. Based on the stage of litigation, review of the current facts and circumstances as we understand them, the nature of the underlying claim, the results of the proceedings to date, and the nature and scope of the defense we continue to
mount, we do not believe an adverse judgment or settlement is probable in this matter, and it is also not possible to estimate an amount of loss, if any, or range of possible loss that might result from an adverse judgment or settlement of this case.
Other Matters—
The False Claims Act allows private citizens, called “relators,” to institute civil proceedings on behalf of the United States alleging violations of the False Claims Act. These lawsuits, also known as “whistleblower” or “qui tam” actions, can involve significant monetary damages, fines, attorneys’ fees and the award of bounties to the relators who successfully prosecute or bring these suits to the government. Qui tam cases are sealed at the time of filing, which means knowledge of the information contained in the
complaint typically is limited to the relator, the federal government, and the presiding court. The defendant in a qui tam action may remain unaware of the existence of a sealed complaint for years. While the complaint is under seal, the government reviews the merits of the case and may conduct a broad investigation and seek discovery from the defendant and other parties before deciding whether to intervene in the case and take the lead on litigating the claims. The court
Notes to Condensed Consolidated Financial Statements
lifts
the seal when the government makes its decision on whether to intervene. If the government decides not to intervene, the relator may elect to continue to pursue the lawsuit individually on behalf of the government. It is possible that qui tam lawsuits have been filed against us, which suits remain under seal, or that we are unaware of such filings or precluded by existing law or court order from discussing or disclosing the filing of such suits. We may be subject to liability under one or more undisclosed qui tam cases brought pursuant to the False Claims Act.
It is our obligation as a participant in Medicare and other federal healthcare programs to routinely conduct audits and reviews of the accuracy of our billing systems and other regulatory compliance matters. As a result of these reviews, we have made, and will continue to make,
disclosures to the United States Department of Health and Human Services Office of Inspector General and CMS relating to amounts we suspect represent over-payments from these programs, whether due to inaccurate billing or otherwise. Some of these disclosures have resulted in, or may result in, Encompass Health refunding amounts to Medicare or other federal healthcare programs.
Our internal financial reporting and management structure is focused on the major types of services provided by Encompass Health. We manage our operations using i two operating segments which are also our reportable segments: (1) inpatient rehabilitation and (2) home health and hospice. These reportable operating segments are consistent with information used by our chief executive officer, who is our chief operating decision maker, to assess performance and allocate
resources. The following is a brief description of our reportable segments:
| |
• | Inpatient Rehabilitation - Our national network of inpatient rehabilitation hospitals stretches across i 33 states and Puerto Rico, with
a concentration of hospitals in the eastern half of the United States and Texas. As of March 31, 2020, we operate i 134 inpatient rehabilitation hospitals. We are the sole owner of i 87
of these hospitals. We retain i 50.0% to i 97.5%
ownership in the remaining i 47 jointly owned hospitals. In addition, we manage i three
inpatient rehabilitation units through management contracts. We provide specialized rehabilitative treatment on both an inpatient and outpatient basis. Our inpatient rehabilitation hospitals provide a higher level of rehabilitative care to patients who are recovering from conditions such as stroke and other neurological disorders, cardiac and pulmonary conditions, brain and spinal cord injuries, complex orthopedic conditions, and amputations. |
| |
• | Home Health and Hospice - As of March 31, 2020, we provide home health services in i 245
locations and hospice services in i 83 locations across i 31
states with concentrations in the Southeast and Texas. In addition, i one of these home health agencies operates as a joint venture which we account for using the equity method of accounting. We are the sole owner of i 320
of these locations. We retain i 50.0% to i 81.0%
ownership in the remaining i eight jointly owned locations. Our home health services include a comprehensive range of Medicare-certified home nursing services to adult patients in need of care. These services include, among others, skilled nursing, physical, occupational, and speech therapy, medical social work, and home health aide services. Our hospice services include in-home services to terminally ill patients
and their families to address patients’ physical needs, including pain control and symptom management, and to provide emotional and spiritual support. |
The accounting policies of our reportable segments are the same as those described in Note 1, Summary of Significant Accounting Policies, to the consolidated financial statements accompanying the 2019 Form 10‑K. All revenues for our services are generated through external customers. See Note 1, Basis of Presentation, “Net Operating Revenues,” for the disaggregation of our revenues. No corporate overhead is allocated to either of our reportable segments. Our chief operating decision maker evaluates the performance of
our segments and allocates resources to them based on adjusted earnings before interest, taxes, depreciation, and amortization (“Segment Adjusted EBITDA”).
Notes to Condensed Consolidated Financial Statements
i Selected
financial information for our reportable segments is as follows (in millions):
|
| | | | | | | | | | | | | | | |
| Inpatient Rehabilitation | | Home Health and Hospice |
| Three
Months Ended March 31, | | |
| 2020 | | 2019 | | 2020 | | 2019 |
Net operating revenues | $ | i 909.2 |
| | $ | i 870.1 |
| | $ | i 272.8 |
| | $ | i 253.9 |
|
Operating
expenses: | | | | | | | |
Inpatient rehabilitation: | | | | | | | |
Salaries
and benefits | i 482.3 |
| | i 445.0 |
| | — |
| | — |
|
Other
operating expenses | i 134.7 |
| | i 127.6 |
| | — |
| | — |
|
Supplies | i 39.6 |
| | i 35.6 |
| | — |
| | — |
|
Occupancy
costs | i 15.3 |
| | i 15.8 |
| | — |
| | — |
|
Home
health and hospice: | | | | | | | |
Cost of services sold (excluding depreciation and amortization) | — |
| | — |
| | i 130.9 |
| | i 116.5 |
|
Support
and overhead costs | — |
| | — |
| | i 100.2 |
| | i 88.8 |
|
| i 671.9 |
| | i 624.0 |
| | i 231.1 |
| | i 205.3 |
|
Other
expense (income) | i 1.6 |
| | ( i 2.8 | ) | | i — |
| | i — |
|
Equity
in net income of nonconsolidated affiliates | ( i 0.6 | ) | | ( i 2.1 | ) | | ( i 0.2 | ) | | ( i 0.4 | ) |
Noncontrolling
interests | i 20.8 |
| | i 21.0 |
| | i 0.9 |
| | i 2.7 |
|
Segment
Adjusted EBITDA | $ | i 215.5 |
| | $ | i 230.0 |
| | $ | i 41.0 |
| | $ | i 46.3 |
|
| | | | | | | |
Capital
expenditures | $ | i 83.3 |
| | $ | i 70.4 |
| | $ | i 1.5 |
| | $ | i 4.5 |
|
/ |
| | | | | | | | | | | |
| Inpatient
Rehabilitation | | Home Health and Hospice | | Encompass Health Consolidated |
| | | | | |
Total assets | $ | i 4,558.8 |
| | $ | i 1,639.2 |
| | $ | i 6,137.7 |
|
Investments
in and advances to nonconsolidated affiliates | i 1.8 |
| | i 3.9 |
| | i 5.7 |
|
| | | | | |
Total assets | $ | i 4,501.4 |
| | $ | i 1,612.8 |
| | $ | i 6,080.7 |
|
Investments
in and advances to nonconsolidated affiliates | i 2.0 |
| | i 5.4 |
| | i 7.4 |
|
Notes to Condensed Consolidated Financial Statements
i Segment reconciliations (in millions): |
| | | | | | | |
| |
| 2020 | | 2019 |
Total Segment Adjusted EBITDA | $ | i 256.5 |
| | $ | i 276.3 |
|
General
and administrative expenses | ( i 35.6 | ) | | ( i 53.4 | ) |
Depreciation
and amortization | ( i 58.8 | ) | | ( i 52.5 | ) |
Loss
on disposal of assets | ( i 0.1 | ) | | ( i 1.1 | ) |
Government,
class action, and related settlements | ( i 2.8 | ) | | i — |
|
Interest
expense and amortization of debt discounts and fees | ( i 43.2 | ) | | ( i 37.2 | ) |
Net
income attributable to noncontrolling interests | i 21.7 |
| | i 22.9 |
|
SARs
mark-to-market impact on noncontrolling interests | i — |
| | i 0.8 |
|
Change
in fair market value of equity securities | ( i 2.5 | ) | | i 0.9 |
|
Gain
on consolidation of Treasure Coast | i 2.2 |
| | i — |
|
Payroll
taxes on SARs exercise | ( i 1.5 | ) | | ( i 0.2 | ) |
Income
from continuing operations before income tax expense | $ | i 135.9 |
| | $ | i 156.5 |
|
/ i |
| | | | | | | |
| | | |
Total assets for reportable segments | $ | i 6,198.0 |
| | $ | i 6,114.2 |
|
Reclassification
of deferred income tax liabilities to net deferred income tax assets | ( i 60.3 | ) | | ( i 33.5 | ) |
Total
consolidated assets | $ | i 6,137.7 |
| | $ | i 6,080.7 |
|
/ i Additional
detail regarding the revenues of our operating segments by service line follows (in millions):
|
| | | | | | | |
| |
| 2020 | | 2019 |
Inpatient rehabilitation: | | | |
Inpatient | $ | i 890.0 |
| | $ | i 847.6 |
|
Outpatient
and other | i 19.2 |
| | i 22.5 |
|
Total
inpatient rehabilitation | i 909.2 |
| | i 870.1 |
|
Home
health and hospice: | | | |
Home health | i 224.8 |
| | i 219.5 |
|
Hospice | i 48.0 |
| | i 34.4 |
|
Total
home health and hospice | i 272.8 |
| | i 253.9 |
|
Total
net operating revenues | $ | i 1,182.0 |
| | $ | i 1,124.0 |
|
/
Notes to Condensed Consolidated Financial Statements
| |
11. | i Condensed
Consolidating Financial Information |
The accompanying condensed consolidating financial information has been prepared and presented pursuant to SEC Regulation S-X, Rule 3-10, “Financial Statements of Guarantors and Issuers of Guaranteed Securities Registered or Being Registered.” Each of the subsidiary guarantors is i 100% owned by Encompass Health. Those subsidiary guarantors guarantee the indebtedness under our credit agreement and our senior
unsecured notes, and all guarantees are full and unconditional and joint and several, subject to certain customary conditions for release. Encompass Health’s investments in its consolidated subsidiaries, as well as guarantor subsidiaries’ investments in nonguarantor subsidiaries and nonguarantor subsidiaries’ investments in guarantor subsidiaries, are presented under the equity method of accounting with the related investment presented within the line items Intercompany receivable and investments
in consolidated affiliates and Intercompany payable in the accompanying condensed consolidating balance sheets. The terms of our credit agreement allow us to declare and pay cash dividends on our common stock so long as: (1) we are not in default under our credit agreement, (2) our senior secured leverage ratio (as defined in our credit agreement) remains less than or equal to i 2x, and (3) our leverage ratio
(as defined in our credit agreement) remains less than or equal to 4.5x. The terms of our senior note indenture allow us to declare and pay cash dividends on our common stock so long as (1) we are not in default, (2) the consolidated coverage ratio (as defined in the indenture) exceeds i 2x or we are otherwise allowed under the indenture
to incur debt, and (3) we have capacity under the indenture’s restricted payments covenant to declare and pay dividends. See Note 10, Long-term Debt, to the consolidated financial statements accompanying the 2019 Form 10‑K. Periodically, certain wholly owned subsidiaries of Encompass Health make dividends or distributions of available cash and/or intercompany receivable balances to their parents. In addition, Encompass Health makes contributions to certain wholly owned subsidiaries. When made, these dividends, distributions,
and contributions impact the Intercompany receivable and investments in consolidated affiliates, Intercompany payable, and Encompass Health shareholders’ equity line items in the accompanying condensed consolidating balance sheet but have no impact on the consolidated financial statements of Encompass Health Corporation. The “Holdings” column in the condensed consolidating financial statements below represents Holdings and its wholly-owned subsidiaries. As discussed in Note 4, Redeemable Noncontrolling Interests, Holdings had i 5.5%
noncontrolling interest as of December 31, 2019, and accordingly, Holdings and its wholly-owned subsidiaries were not guarantors of our debt. In February 2020, we acquired for cash all but i 1.2% of the remaining noncontrolling interest in Holdings following the most recent exercise of the put option
by the management investors. On February 20, 2020, Encompass Health Corporation and each of the two remaining management investors agreed to exchange the remaining shares representing the noncontrolling interest for an equal value of shares of common stock of Encompass Health Corporation. We settled the exchanges on March 6, 2020 and now own 100% of Holdings. Pursuant to the terms of our credit agreement and our senior note indentures, we executed joinders for Holdings and its wholly-owned subsidiaries on April 23, 2020 at which time they became guarantors of the indebtedness under the credit agreement and our senior note indentures.
Notes to Condensed Consolidated Financial Statements
Condensed Consolidating Statement of Comprehensive Income
i i |
| | | | | | | | | | | | | | | | | | | | | | | |
| |
| Encompass Health Corporation | | | | | | Holdings | | Eliminating
Entries | | Encompass Health Consolidated |
| (In Millions) |
Net operating revenues | $ | i 4.6 |
| | $ | i 622.5 |
| | $ | i 323.3 |
| | $ | i 266.8 |
| | $ | ( i 35.2 | ) | | $ | i 1,182.0 |
|
Operating
expenses: | |
| | |
| | |
| | | | |
| | |
Salaries
and benefits | i 16.7 |
| | i 309.8 |
| | i 164.2 |
| | i 193.3 |
| | ( i 4.9 | ) | | i 679.1 |
|
Other
operating expenses | i 9.6 |
| | i 86.9 |
| | i 52.0 |
| | i 24.1 |
| | ( i 13.0 | ) | | i 159.6 |
|
Occupancy
costs | i 0.6 |
| | i 25.4 |
| | i 6.7 |
| | i 4.8 |
| | ( i 17.3 | ) | | i 20.2 |
|
Supplies | i — |
| | i 26.5 |
| | i 13.2 |
| | i 6.0 |
| | i — |
| | i 45.7 |
|
General
and administrative expenses | i 34.7 |
| | i — |
| | i — |
| | i 0.9 |
| | i — |
| | i 35.6 |
|
Depreciation
and amortization | i 5.3 |
| | i 28.7 |
| | i 15.0 |
| | i 9.8 |
| | i — |
| | i 58.8 |
|
Government,
class action, and related settlements | i 2.8 |
| | i — |
| | i — |
| | i — |
| | i — |
| | i 2.8 |
|
Total
operating expenses | i 69.7 |
| | i 477.3 |
| | i 251.1 |
| | i 238.9 |
| | ( i 35.2 | ) | | i 1,001.8 |
|
Interest
expense and amortization of debt discounts and fees | i 35.8 |
| | i 6.3 |
| | i 1.4 |
| | i 4.9 |
| | ( i 5.2 | ) | | i 43.2 |
|
Other
(income) expense | ( i 2.3 | ) | | ( i 0.4 | ) | | i 1.6 |
| | ( i 2.2 | ) | | i 5.2 |
| | i 1.9 |
|
Equity
in net income of nonconsolidated affiliates | i — |
| | ( i 0.5 | ) | | ( i 0.1 | ) | | ( i 0.2 | ) | | i — |
| | ( i 0.8 | ) |
Equity
in net income of consolidated affiliates | ( i 122.2 | ) | | ( i 17.8 | ) | | i — |
| | i — |
| | i 140.0 |
| | i — |
|
Management
fees | ( i 42.0 | ) | | i 30.2 |
| | i 11.8 |
| | i — |
| | i — |
| | i — |
|
Income
from continuing operations before income tax (benefit) expense | i 65.6 |
| | i 127.4 |
| | i 57.5 |
| | i 25.4 |
| | ( i 140.0 | ) | | i 135.9 |
|
Provision
for income tax (benefit) expense | ( i 21.5 | ) | | i 33.0 |
| | i 9.1 |
| | i 6.5 |
| | i — |
| | i 27.1 |
|
Income
from continuing operations | i 87.1 |
| | i 94.4 |
| | i 48.4 |
| | i 18.9 |
| | ( i 140.0 | ) | | i 108.8 |
|
Loss
from discontinued operations, net of tax | ( i 0.1 | ) | | i — |
| | i — |
| | i — |
| | i — |
| | ( i 0.1 | ) |
Net
and comprehensive income | i 87.0 |
| | i 94.4 |
| | i 48.4 |
| | i 18.9 |
| | ( i 140.0 | ) | | i 108.7 |
|
Less:
Net and comprehensive income attributable to noncontrolling interests | i — |
| | i — |
| | ( i 21.2 | ) | | ( i 0.5 | ) | | i — |
| | ( i 21.7 | ) |
Net
and comprehensive income attributable to Encompass Health | $ | i 87.0 |
| | $ | i 94.4 |
| | $ | i 27.2 |
| | $ | i 18.4 |
| | $ | ( i 140.0 | ) | | $ | i 87.0 |
|
/ /
Notes to Condensed Consolidated Financial Statements
Condensed Consolidating Statement of Comprehensive Income
|
| | | | | | | | | | | | | | | | | | | | | | | |
| |
| Encompass Health Corporation | | | | | | Holdings | | Eliminating
Entries | | Encompass Health Consolidated |
| (In Millions) |
Net operating revenues | $ | i 5.1 |
| | $ | i 606.5 |
| | $ | i 296.5 |
| | $ | i 249.5 |
| | $ | ( i 33.6 | ) | | $ | i 1,124.0 |
|
Operating
expenses: | |
| | |
| | |
| | | | |
| | |
Salaries
and benefits | i 15.9 |
| | i 288.9 |
| | i 148.0 |
| | i 173.1 |
| | ( i 5.1 | ) | | i 620.8 |
|
Other
operating expenses | i 10.3 |
| | i 84.7 |
| | i 46.8 |
| | i 20.8 |
| | ( i 12.5 | ) | | i 150.1 |
|
Occupancy
costs | i 0.5 |
| | i 24.9 |
| | i 6.5 |
| | i 3.7 |
| | ( i 16.0 | ) | | i 19.6 |
|
Supplies | i — |
| | i 24.0 |
| | i 11.6 |
| | i 4.5 |
| | i — |
| | i 40.1 |
|
General
and administrative expenses | i 39.9 |
| | i — |
| | i — |
| | i 13.5 |
| | i — |
| | i 53.4 |
|
Depreciation
and amortization | i 5.0 |
| | i 26.3 |
| | i 13.1 |
| | i 8.1 |
| | i — |
| | i 52.5 |
|
Total
operating expenses | i 71.6 |
| | i 448.8 |
| | i 226.0 |
| | i 223.7 |
| | ( i 33.6 | ) | | i 936.5 |
|
Interest
expense and amortization of debt discounts and fees | i 30.1 |
| | i 6.2 |
| | i 1.3 |
| | i 6.4 |
| | ( i 6.8 | ) | | i 37.2 |
|
Other
income | ( i 7.7 | ) | | ( i 0.3 | ) | | ( i 2.5 | ) | | i — |
| | i 6.8 |
| | ( i 3.7 | ) |
Equity
in net income of nonconsolidated affiliates | i — |
| | ( i 2.0 | ) | | ( i 0.1 | ) | | ( i 0.4 | ) | | i — |
| | ( i 2.5 | ) |
Equity
in net income of consolidated affiliates | ( i 130.2 | ) | | ( i 17.1 | ) | | i — |
| | i — |
| | i 147.3 |
| | i — |
|
Management
fees | ( i 39.8 | ) | | i 29.5 |
| | i 10.3 |
| | i — |
| | i — |
| | i — |
|
Income
from continuing operations before income tax (benefit) expense | i 81.1 |
| | i 141.4 |
| | i 61.5 |
| | i 19.8 |
| | ( i 147.3 | ) | | i 156.5 |
|
Provision
for income tax (benefit) expense | ( i 21.7 | ) | | i 37.8 |
| | i 10.2 |
| | i 4.5 |
| | i — |
| | i 30.8 |
|
Income
from continuing operations | i 102.8 |
| | i 103.6 |
| | i 51.3 |
| | i 15.3 |
| | ( i 147.3 | ) | | i 125.7 |
|
Loss
from discontinued operations, net of tax | ( i 0.5 | ) | | i — |
| | i — |
| | i — |
| | i — |
| | ( i 0.5 | ) |
Net
and comprehensive income | i 102.3 |
| | i 103.6 |
| | i 51.3 |
| | i 15.3 |
| | ( i 147.3 | ) | | i 125.2 |
|
Less:
Net and comprehensive income attributable to noncontrolling interests | i — |
| | i — |
| | ( i 21.2 | ) | | ( i 1.7 | ) | | i — |
| | ( i 22.9 | ) |
Net
and comprehensive income attributable to Encompass Health | $ | i 102.3 |
| | $ | i 103.6 |
| | $ | i 30.1 |
| | $ | i 13.6 |
| | $ | ( i 147.3 | ) | | $ | i 102.3 |
|
Notes to Condensed Consolidated Financial Statements
Condensed Consolidating Balance Sheet
i |
| | | | | | | | | | | | | | | | | | | | | | | |
| |
| Encompass Health Corporation | | | | | | Holdings | | Eliminating
Entries | | Encompass Health Consolidated |
| (In Millions) |
Assets | | | | | | | | | | | |
Current
assets: | | | | | | | | | | | |
Cash and cash equivalents | $ | i 79.0 |
| | $ | i 3.7 |
| | $ | i 7.8 |
| | $ | i 14.4 |
| | $ | i — |
| | $ | i 104.9 |
|
Restricted
cash | i — |
| | i — |
| | i 56.7 |
| | i — |
| | i — |
| | i 56.7 |
|
Accounts
receivable | i — |
| | i 270.8 |
| | i 131.6 |
| | i 141.0 |
| | i — |
| | i 543.4 |
|
Other
current assets | i 79.8 |
| | i 34.7 |
| | i 45.1 |
| | i 7.2 |
| | ( i 87.3 | ) | | i 79.5 |
|
Total
current assets | i 158.8 |
| | i 309.2 |
| | i 241.2 |
| | i 162.6 |
| | ( i 87.3 | ) | | i 784.5 |
|
Property
and equipment, net | i 138.5 |
| | i 1,268.0 |
| | i 567.4 |
| | i 29.4 |
| | i — |
| | i 2,003.3 |
|
Operating
lease right-of-use assets | i 9.7 |
| | i 158.0 |
| | i 80.1 |
| | i 43.2 |
| | ( i 23.1 | ) | | i 267.9 |
|
Goodwill | i — |
| | i 912.2 |
| | i 329.0 |
| | i 1,070.9 |
| | i — |
| | i 2,312.1 |
|
Intangible
assets, net | i 15.8 |
| | i 98.9 |
| | i 64.8 |
| | i 285.2 |
| | i — |
| | i 464.7 |
|
Deferred
income tax assets | i 52.6 |
| | i 11.1 |
| | i 0.1 |
| | i — |
| | ( i 62.3 | ) | | i 1.5 |
|
Other
long-term assets | i 51.7 |
| | i 86.8 |
| | i 152.9 |
| | i 12.3 |
| | i — |
| | i 303.7 |
|
Intercompany
receivable and investments in consolidated affiliates | i 4,245.7 |
| | i 657.6 |
| | i — |
| | i 7.5 |
| | ( i 4,910.8 | ) | | i — |
|
Total
assets | $ | i 4,672.8 |
| | $ | i 3,501.8 |
| | $ | i 1,435.5 |
| | $ | i 1,611.1 |
| | $ | ( i 5,083.5 | ) | | $ | i 6,137.7 |
|
Liabilities
and Shareholders’ Equity | |
| | |
| | |
| | | | |
| |
|
|
Current
liabilities: | |
| | |
| | |
| | | | |
| |
|
|
Current
portion of long-term debt | $ | i 17.0 |
| | $ | i 10.8 |
| | $ | i 3.9 |
| | $ | i 8.5 |
| | $ | i — |
| | $ | i 40.2 |
|
Current
operating lease liabilities | i 1.4 |
| | i 19.2 |
| | i 14.2 |
| | i 13.6 |
| | ( i 7.6 | ) | | i 40.8 |
|
Accounts
payable | i 12.5 |
| | i 57.2 |
| | i 25.0 |
| | i 3.3 |
| | i — |
| | i 98.0 |
|
Accrued
expenses and other current liabilities | i 171.5 |
| | i 110.4 |
| | i 134.0 |
| | i 78.6 |
| | ( i 87.3 | ) | | i 407.2 |
|
Total
current liabilities | i 202.4 |
| | i 197.6 |
| | i 177.1 |
| | i 104.0 |
| | ( i 94.9 | ) | | i 586.2 |
|
Long-term
debt, net of current portion | i 2,973.0 |
| | i 302.5 |
| | i 40.6 |
| | i 5.8 |
| | i — |
| | i 3,321.9 |
|
Long-term
operating lease liabilities | i 8.6 |
| | i 143.5 |
| | i 69.1 |
| | i 29.6 |
| | ( i 15.7 | ) | | i 235.1 |
|
Other
long-term liabilities | i 44.9 |
| | i 12.0 |
| | i 105.0 |
| | i 63.6 |
| | ( i 62.2 | ) | | i 163.3 |
|
Intercompany
payable | i — |
| | i — |
| | i 66.0 |
| | i — |
| | ( i 66.0 | ) | | i — |
|
| i 3,228.9 |
| | i 655.6 |
| | i 457.8 |
| | i 203.0 |
| | ( i 238.8 | ) | | i 4,306.5 |
|
Commitments
and contingencies | i
|
| | i
|
| | i
|
| | i
|
| | i
|
| | i
|
|
Redeemable
noncontrolling interests | i — |
| | i — |
| | i 34.0 |
| | i — |
| | i — |
| | i 34.0 |
|
Shareholders’
equity: | |
| | |
| | |
| | | | |
| |
|
|
Encompass
Health shareholders’ equity | i 1,443.9 |
| | i 2,846.2 |
| | i 590.4 |
| | i 1,408.1 |
| | ( i 4,844.7 | ) | | i 1,443.9 |
|
Noncontrolling
interests | i — |
| | i — |
| | i 353.3 |
| | i — |
| | i — |
| | i 353.3 |
|
Total
shareholders’ equity | i 1,443.9 |
| | i 2,846.2 |
| | i 943.7 |
| | i 1,408.1 |
| | ( i 4,844.7 | ) | | i 1,797.2 |
|
Total
liabilities and shareholders’ equity | $ | i 4,672.8 |
| | $ | i 3,501.8 |
| | $ | i 1,435.5 |
| | $ | i 1,611.1 |
| | $ | ( i 5,083.5 | ) | | $ | i 6,137.7 |
|
/
Notes to Condensed Consolidated Financial Statements
Condensed Consolidating Balance Sheet
|
| | | | | | | | | | | | | | | | | | | | | | | |
| |
| Encompass Health Corporation | | | | | | Holdings | | Eliminating
Entries | | Encompass Health Consolidated |
| (In Millions) |
Assets | | | | | | | | | | | |
Current
assets: | | | | | | | | | | | |
Cash and cash equivalents | $ | i 53.7 |
| | $ | i 5.2 |
| | $ | i 6.0 |
| | $ | i 29.9 |
| | $ | i — |
| | $ | i 94.8 |
|
Restricted
cash | i — |
| | i — |
| | i 57.4 |
| | i — |
| | i — |
| | i 57.4 |
|
Accounts
receivable | i — |
| | i 280.4 |
| | i 125.6 |
| | i 100.1 |
| | i — |
| | i 506.1 |
|
Other
current assets | i 64.3 |
| | i 35.4 |
| | i 9.3 |
| | i 7.8 |
| | ( i 19.3 | ) | | i 97.5 |
|
Total
current assets | i 118.0 |
| | i 321.0 |
| | i 198.3 |
| | i 137.8 |
| | ( i 19.3 | ) | | i 755.8 |
|
Property
and equipment, net | i 133.4 |
| | i 1,246.0 |
| | i 551.2 |
| | i 28.7 |
| | i — |
| | i 1,959.3 |
|
Operating
lease right-of-use assets | i 10.1 |
| | i 171.5 |
| | i 86.5 |
| | i 43.7 |
| | ( i 35.3 | ) | | i 276.5 |
|
Goodwill | i — |
| | i 912.2 |
| | i 323.0 |
| | i 1,070.0 |
| | i — |
| | i 2,305.2 |
|
Intangible
assets, net | i 17.7 |
| | i 101.7 |
| | i 65.3 |
| | i 291.6 |
| | i — |
| | i 476.3 |
|
Deferred
income tax assets | i 27.2 |
| | i 11.1 |
| | i 0.1 |
| | i — |
| | ( i 35.5 | ) | | i 2.9 |
|
Other
long-term assets | i 53.6 |
| | i 85.4 |
| | i 151.6 |
| | i 14.1 |
| | i — |
| | i 304.7 |
|
Intercompany
notes receivable | i 737.8 |
| | i — |
| | i — |
| | i — |
| | ( i 737.8 | ) | | i — |
|
Intercompany
receivable and investments in consolidated affiliates | i 3,155.4 |
| | i 523.6 |
| | i — |
| | i — |
| | ( i 3,679.0 | ) | | i — |
|
Total
assets | $ | i 4,253.2 |
| | $ | i 3,372.5 |
| | $ | i 1,376.0 |
| | $ | i 1,585.9 |
| | $ | ( i 4,506.9 | ) | | $ | i 6,080.7 |
|
Liabilities
and Shareholders’ Equity | |
| | |
| | |
| | | | |
| |
|
|
Current
liabilities: | |
| | |
| | |
| | | | |
| |
|
|
Current
portion of long-term debt | $ | i 17.0 |
| | $ | i 10.4 |
| | $ | i 3.8 |
| | $ | i 8.1 |
| | $ | i — |
| | $ | i 39.3 |
|
Current
operating lease liabilities | i 1.3 |
| | i 21.9 |
| | i 16.0 |
| | i 12.1 |
| | ( i 10.9 | ) | | i 40.4 |
|
Accounts
payable | i 9.8 |
| | i 56.5 |
| | i 24.3 |
| | i 4.0 |
| | i — |
| | i 94.6 |
|
Accrued
expenses and other current liabilities | i 147.4 |
| | i 108.7 |
| | i 109.2 |
| | i 200.7 |
| | ( i 19.3 | ) | | i 546.7 |
|
Total
current liabilities | i 175.5 |
| | i 197.5 |
|
| i 153.3 |
|
| i 224.9 |
| | ( i 30.2 | ) | | i 721.0 |
|
Long-term
debt, net of current portion | i 2,670.6 |
| | i 305.4 |
| | i 41.6 |
| | i 5.7 |
| | i — |
| | i 3,023.3 |
|
Long-term
operating lease liabilities | i 9.0 |
| | i 153.9 |
| | i 73.6 |
| | i 31.9 |
| | ( i 24.6 | ) | | i 243.8 |
|
Intercompany
notes payable | i — |
| | i — |
| | i — |
| | i 737.8 |
| | ( i 737.8 | ) | | i — |
|
Other
long-term liabilities | i 45.9 |
| | i 12.2 |
| | i 100.3 |
| | i 37.0 |
| | ( i 35.5 | ) | | i 159.9 |
|
Intercompany
payable | i — |
| | i — |
| | i 66.0 |
| | i 4.4 |
| | ( i 70.4 | ) | | i — |
|
| i 2,901.0 |
| | i 669.0 |
|
| i 434.8 |
|
| i 1,041.7 |
| | ( i 898.5 | ) | | i 4,148.0 |
|
Commitments
and contingencies | i
|
| | i
|
| | i
|
| | i
|
| | i
|
| | i
|
|
Redeemable
noncontrolling interests | i — |
| | i — |
| | i 31.4 |
| | i 208.2 |
| | i — |
| | i 239.6 |
|
Shareholders’
equity: | |
| | |
| | |
| | | | |
| |
|
|
Encompass
Health shareholders’ equity | i 1,352.2 |
| | i 2,703.5 |
| | i 568.9 |
| | i 336.0 |
| | ( i 3,608.4 | ) | | i 1,352.2 |
|
Noncontrolling
interests | i — |
| | i — |
| | i 340.9 |
| | i — |
| | i — |
| | i 340.9 |
|
Total
shareholders’ equity | i 1,352.2 |
| | i 2,703.5 |
|
| i 909.8 |
|
| i 336.0 |
| | ( i 3,608.4 | ) | | i 1,693.1 |
|
Total
liabilities and shareholders’ equity | $ | i 4,253.2 |
| | $ | i 3,372.5 |
|
| $ | i 1,376.0 |
|
| $ | i 1,585.9 |
| | $ | ( i 4,506.9 | ) | | $ | i 6,080.7 |
|
Notes to Condensed Consolidated Financial Statements
Condensed Consolidating Statement of Cash Flows
i |
| | | | | | | | | | | | | | | | | | | | | | | |
| |
| Encompass Health Corporation | | | | | | Holdings | | Eliminating
Entries | | Encompass Health Consolidated |
| (In Millions) |
Net cash (used in) provided by operating activities | $ | ( i 31.2 | ) | | $ | i 117.7 |
| | $ | i 56.8 |
| | $ | ( i 114.0 | ) | | $ | i — |
| | $ | i 29.3 |
|
Cash
flows from investing activities: | |
| | |
| | |
| | | | |
| | |
|
Purchases
of property and equipment | ( i 9.3 | ) | | ( i 49.5 | ) | | ( i 23.4 | ) | | ( i 1.3 | ) | | i — |
| | ( i 83.5 | ) |
Acquisitions
of businesses, net of cash acquired | i — |
| | i — |
| | i — |
| | ( i 1.1 | ) | | i — |
| | ( i 1.1 | ) |
Funding
of intercompany note receivable | ( i 15.0 | ) | | i — |
| | i — |
| | i — |
| | i 15.0 |
| | i — |
|
Other,
net | ( i 2.8 | ) | | i 0.7 |
| | i 3.9 |
| | ( i 0.2 | ) | | i — |
| | i 1.6 |
|
Net
cash used in investing activities | ( i 27.1 | ) | | ( i 48.8 | ) |
| ( i 19.5 | ) |
| ( i 2.6 | ) |
| i 15.0 |
| | ( i 83.0 | ) |
Cash
flows from financing activities: | |
| | |
| | |
| | | | |
| |
|
|
Principal
borrowings on intercompany note payable | i — |
| | i — |
| | i — |
| | i 15.0 |
| | ( i 15.0 | ) | | i — |
|
Borrowings
on revolving credit facility | i 330.0 |
| | i — |
| | i — |
| | i — |
| | i — |
| | i 330.0 |
|
Payments
on revolving credit facility | ( i 25.0 | ) | | i — |
| | i — |
| | i — |
| | i — |
| | ( i 25.0 | ) |
Dividends
paid on common stock | ( i 28.9 | ) | | i — |
| | i — |
| | ( i 0.1 | ) | | i — |
| | ( i 29.0 | ) |
Purchase
of equity interests in consolidated affiliates | ( i 162.3 | ) | | i — |
| | i — |
| | i — |
| | i — |
| | ( i 162.3 | ) |
Distributions
paid to noncontrolling interests of consolidated affiliates | i — |
| | i — |
| | ( i 19.1 | ) | | i — |
| | i — |
| | ( i 19.1 | ) |
Taxes
paid on behalf of employees for shares withheld | ( i 14.6 | ) | | i — |
| | i — |
| | ( i 1.0 | ) | | i — |
| | ( i 15.6 | ) |
Other,
net | ( i 8.5 | ) | | ( i 2.5 | ) | | i 5.0 |
| | ( i 1.9 | ) | | i — |
| | ( i 7.9 | ) |
Change
in intercompany advances | ( i 7.1 | ) | | ( i 67.9 | ) | | ( i 14.1 | ) | | i 89.1 |
| | i — |
| | i — |
|
Net
cash provided by (used in) financing activities | i 83.6 |
| | ( i 70.4 | ) |
| ( i 28.2 | ) |
| i 101.1 |
|
| ( i 15.0 | ) | | i 71.1 |
|
Increase
(decrease) in cash, cash equivalents, and restricted cash | i 25.3 |
| | ( i 1.5 | ) |
| i 9.1 |
|
| ( i 15.5 | ) |
| i — |
| | i 17.4 |
|
Cash,
cash equivalents, and restricted cash at beginning of period | i 53.7 |
| | i 5.2 |
| | i 70.8 |
| | i 29.9 |
| | i — |
| | i 159.6 |
|
Cash,
cash equivalents, and restricted cash at end of period | $ | i 79.0 |
| | $ | i 3.7 |
|
| $ | i 79.9 |
|
| $ | i 14.4 |
|
| $ | i — |
| | $ | i 177.0 |
|
| | | | | | | | | | | |
Reconciliation
of Cash, Cash Equivalents, and Restricted Cash | | | | | | | | | | | |
Cash and cash equivalents at beginning of period | $ | i 53.7 |
| | $ | i 5.2 |
| | $ | i 6.0 |
| | $ | i 29.9 |
| | $ | i — |
| | $ | i 94.8 |
|
Restricted
cash at beginning of period | i — |
| | i — |
| | i 57.4 |
| | i — |
| | i — |
| | i 57.4 |
|
Restricted
cash included in other long term assets at beginning of period | i — |
| | i — |
| | i 7.4 |
| | i — |
| | i — |
| | i 7.4 |
|
Cash,
cash equivalents, and restricted cash at beginning of period | $ | i 53.7 |
| | $ | i 5.2 |
| | $ | i 70.8 |
|
| $ | i 29.9 |
| | $ | i — |
| | $ | i 159.6 |
|
| | | | | | | | | | | |
Cash
and cash equivalents at end of period | $ | i 79.0 |
| | $ | i 3.7 |
| | $ | i 7.8 |
| | $ | i 14.4 |
| | $ | i — |
| | $ | i 104.9 |
|
Restricted
cash at end of period | i — |
| | i — |
| | i 56.7 |
| | i — |
| | i — |
| | i 56.7 |
|
Restricted
cash included in other long-term assets at end of period | i — |
| | i — |
| | i 15.4 |
| | i — |
| | i — |
| | i 15.4 |
|
Cash,
cash equivalents, and restricted cash at end of period | $ | i 79.0 |
| | $ | i 3.7 |
| | $ | i 79.9 |
|
| $ | i 14.4 |
| | $ | i — |
| | $ | i 177.0 |
|
| | | | | | | | | | | |
Supplemental
schedule of noncash financing activity: | | | | | | | | | | | |
Capital contribution of intercompany note | $ | i 853.0 |
| | $ | i — |
| | $ | i — |
| | ( i 853.0 | ) | | $ | i — |
| | $ | i — |
|
/
Notes to Condensed Consolidated Financial Statements
Condensed Consolidating Statement of Cash Flows
|
| | | | | | | | | | | | | | | | | | | | | | | |
| |
| Encompass Health Corporation | | | | | | Holdings | | Eliminating
Entries | | Encompass Health Consolidated |
| (In Millions) |
Net cash provided by operating activities | $ | i 18.6 |
| | $ | i 89.6 |
| | $ | i 42.4 |
| | $ | i 9.3 |
| | $ | i — |
| | $ | i 159.9 |
|
Cash
flows from investing activities: | |
| | |
| | |
| | | | |
| | |
|
Purchases
of property and equipment | ( i 6.8 | ) | | ( i 32.5 | ) | | ( i 29.4 | ) | | ( i 3.6 | ) | | i — |
| | ( i 72.3 | ) |
Acquisitions
of businesses, net of cash acquired | i — |
| | i — |
| | i — |
| | ( i 13.7 | ) | | i — |
| | ( i 13.7 | ) |
Funding
of intercompany note receivable | ( i 8.0 | ) | | i — |
| | i — |
| | i — |
| | i 8.0 |
| | i — |
|
Proceeds
from repayment of intercompany note receivable | i 5.0 |
| | i — |
| | i — |
| | i — |
| | ( i 5.0 | ) | | i — |
|
Other,
net | ( i 4.0 | ) | | ( i 0.1 | ) | | ( i 0.7 | ) | | ( i 0.7 | ) | | i — |
| | ( i 5.5 | ) |
Net
cash used in investing activities | ( i 13.8 | ) | | ( i 32.6 | ) | | ( i 30.1 | ) |
| ( i 18.0 | ) | | i 3.0 |
| | ( i 91.5 | ) |
Cash
flows from financing activities: | |
| | |
| | |
| | | | |
| |
|
|
Principal
borrowings on intercompany note payable | i — |
| | i — |
| | i — |
| | i 8.0 |
| | ( i 8.0 | ) | | i — |
|
Principal
payments on intercompany note payable | i — |
| | i — |
| | i — |
| | ( i 5.0 | ) | | i 5.0 |
| | i — |
|
Borrowings
on revolving credit facility | i 25.0 |
| | i — |
| | i — |
| | i — |
| | i — |
| | i 25.0 |
|
Payments
on revolving credit facility | ( i 30.0 | ) | | i — |
| | i — |
| | i — |
| | i — |
| | ( i 30.0 | ) |
Dividends
paid on common stock | ( i 28.2 | ) | | i — |
| | i
|
| | ( i 0.1 | ) | | i — |
| | ( i 28.3 | ) |
Distributions
paid to noncontrolling interests of consolidated affiliates | i — |
| | i — |
| | ( i 19.5 | ) | | i — |
| | i — |
| | ( i 19.5 | ) |
Taxes
paid on behalf of employees for shares withheld | ( i 14.7 | ) | | i — |
| | i — |
| | ( i 1.2 | ) | | i — |
| | ( i 15.9 | ) |
Other,
net | ( i 14.7 | ) | | ( i 2.1 | ) | | i 5.6 |
| | ( i 1.8 | ) | | i — |
| | ( i 13.0 | ) |
Change
in intercompany advances | i 51.0 |
| | ( i 54.4 | ) | | i 2.1 |
| | i 1.3 |
| | i — |
| | i — |
|
Net
cash used in financing activities | ( i 11.6 | ) | | ( i 56.5 | ) | | ( i 11.8 | ) |
| i 1.2 |
| | ( i 3.0 | ) | | ( i 81.7 | ) |
(Decrease)
increase in cash, cash equivalents, and restricted cash | ( i 6.8 | ) | | i 0.5 |
| | i 0.5 |
|
| ( i 7.5 | ) | | i — |
| | ( i 13.3 | ) |
Cash,
cash equivalents, and restricted cash at beginning of period | i 41.5 |
| | i 3.0 |
| | i 69.4 |
| | i 19.6 |
| | i — |
| | i 133.5 |
|
Cash,
cash equivalents, and restricted cash at end of period | $ | i 34.7 |
| | $ | i 3.5 |
| | $ | i 69.9 |
|
| $ | i 12.1 |
| | $ | i — |
| | $ | i 120.2 |
|
| | | | | | | | | | | |
Reconciliation
of Cash, Cash Equivalents, and Restricted Cash | | | | | | | | | | | |
Cash and cash equivalents at beginning of period | $ | i 41.5 |
| | $ | i 3.0 |
| | $ | i 5.1 |
| | $ | i 19.6 |
| | $ | i — |
| | $ | i 69.2 |
|
Restricted
cash at beginning of period | i — |
| | i — |
| | i 59.0 |
| | i — |
| | i — |
| | i 59.0 |
|
Long
term restricted cash at beginning of period | i — |
| | i — |
| | i 5.3 |
| | i — |
| | i — |
| | i 5.3 |
|
Cash,
cash equivalents, and restricted cash at beginning of period | $ | i 41.5 |
| | $ | i 3.0 |
| | $ | i 69.4 |
|
| $ | i 19.6 |
| | $ | i — |
| | $ | i 133.5 |
|
| | | | | | | | | | | |
Cash
and cash equivalents at end of period | $ | i 34.7 |
| | $ | i 3.5 |
| | $ | i 5.8 |
| | $ | i 12.1 |
| | $ | i — |
| | $ | i 56.1 |
|
Restricted
cash at end of period | i — |
| | i — |
| | i 59.0 |
| | i — |
| | i — |
| | i 59.0 |
|
Long
term restricted cash at end of period | i — |
| | i — |
| | i 5.1 |
| | i — |
| | i — |
| | i 5.1 |
|
Cash,
cash equivalents, and restricted cash at end of period | $ | i 34.7 |
| | $ | i 3.5 |
| | $ | i 69.9 |
|
| $ | i 12.1 |
| | $ | i — |
| | $ | i 120.2 |
|
| |
Item 2. | Management’s Discussion and Analysis of Financial Condition and Results of Operations |
The following Management’s Discussion and Analysis of Financial Condition and Results of Operations (“MD&A”) relates to Encompass Health Corporation and its subsidiaries and should be read in conjunction with our condensed consolidated financial statements included under Part I, Item 1,
Financial Statements (Unaudited), of this report. In addition, the following MD&A should be read in conjunction with our audited consolidated financial statements for the year ended December 31, 2019, Part II, Item 7, Management’s Discussion and Analysis of Financial Condition and Results of Operations, Part I, Item 1, Business, and Item 1A, Risk Factors, included in our Annual Report on Form 10-K for the year ended December 31, 2019 filed on February 27, 2020 (collectively, the “2019
Form 10‑K”). This MD&A is designed to provide the reader with information that will assist in understanding our condensed consolidated financial statements, the changes in certain key items in those financial statements from period to period, and the primary factors that accounted for those changes, as well as how certain accounting principles affect our condensed consolidated financial statements. See “Cautionary Statements Regarding Forward-Looking Statements” on page i of this report for a description of important factors that could cause actual results to differ from expected results. See also Item 1A, Risk Factors, of this report and to the 2019 Form 10‑K.
Executive
Overview
Our Business
We are a national leader in integrated healthcare services, offering both facility-based and home-based patient care through our network of inpatient rehabilitation hospitals, home health agencies, and hospice agencies. As of March 31, 2020, our national footprint includes 37 states and Puerto Rico. As discussed in this Item, “Segment Results of Operations,” we manage our operations in two operating segments which are also our reportable segments: (1) inpatient rehabilitation and (2) home health and hospice. For additional information about our business, see Item 1, Business, of the 2019 Form 10‑K. Inpatient
Rehabilitation
We are the nation’s largest owner and operator of inpatient rehabilitation hospitals in terms of patients treated and discharged, revenues, and number of hospitals. We provide specialized rehabilitative treatment on both an inpatient and outpatient basis. We operate hospitals in 33 states and Puerto Rico, with concentrations in the eastern half of the United States and Texas. As of March 31, 2020, we operate 134 inpatient rehabilitation hospitals and manage three inpatient rehabilitation units through management contracts. Our inpatient rehabilitation segment represents approximately 77%
of our Net operating revenues for the three months ended March 31, 2020. Home Health and Hospice
Our home health business is the nation’s fourth largest provider of Medicare-certified skilled home health services in terms of revenues. Our home health services include a comprehensive range of Medicare-certified home nursing services to adult patients in need of care. These services include, among others, skilled nursing, physical, occupational, and speech therapy, medical social work, and home health aide services. Our hospice business is the nation’s eleventh largest provider of Medicare-certified hospice services in terms of revenues. We provide hospice services to terminally ill patients and
their families that address patients’ physical needs, including pain control and symptom management, and to provide emotional and spiritual support. As of March 31, 2020, we provide home health services in 245 locations and provide hospice services in 83 locations across 31 states, with concentrations in the Southeast and Texas. In addition, one of these home health agencies operates as a joint venture that we account for using the equity method of accounting. Our home health and hospice segment represents approximately 23% of our Net operating revenues for the three
months ended March 31, 2020. 2020 Overview
During the three months ended March 31, 2020, Net operating revenues increased 5.2% over the same period of 2019 due primarily to volume and pricing growth in our inpatient rehabilitation segment and volume growth in our home health and hospice segment. As discussed in the “Results of Operations” section, through February 2020 both of our segments were experiencing strong volume growth. In March, we began to experience declines in volume due to conditions resulting from the novel coronavirus disease 2019 (“COVID-19”)
pandemic. Within our inpatient rehabilitation segment, discharge growth of 4.7% coupled with a 0.3% increase in net patient revenue per discharge in the first quarter of 2020 generated 4.5% growth in inpatient revenue compared to the first quarter of 2019. Discharge growth included a 2.4% increase in same-store discharges. Within our home health and hospice segment, home health admission growth of 11.9% and hospice admission growth of 25.6% contributed to 7.4% growth in home health and hospice revenue compared to the
first quarter of 2019. Home health admission
growth included a 0.2% increase in same-store admissions. See the “Results of Operations” and “Segment Results of Operations” sections of this Item.
Our growth efforts thus far in 2020 related to our inpatient rehabilitation segment have included the following:
| |
• | began
operating our new 50-bed inpatient rehabilitation hospital in Murrieta, California in February 2020; |
| |
• | continued our capacity expansions by adding 23 new beds to existing hospitals; and |
| |
• | announced or continued the development of the following hospitals: |
|
| | |
| Number
of New Beds |
| 2020(1) | 2021(1) |
De novos: | | |
Sioux Falls, South Dakota | 40 | — |
Toledo, Ohio | 40 | — |
Cumming,
Georgia | — | 50 |
North Tampa, Florida | — | 50 |
Stockbridge, Georgia | — | 50 |
Greenville, South Carolina | — | 40 |
Pensacola, Florida | — | 40 |
Shreveport,
Louisiana | — | 40 |
Waco, Texas | — | 40 |
Joint ventures: | | |
Coralville, Iowa | 40 | — |
San Angelo, Texas | — | 40 |
(1)
Certain development projects may be delayed due to the COVID-19 pandemic.
We also continued our growth efforts in our home health and hospice segment. We acquired one home health location in Lynchburg, Virginia and began accepting patients at our new hospice location in Allen, Texas.
We continued our shareholder distributions during the three months ended March 31, 2020 by paying a quarterly cash dividend of $0.28 per share on our common stock in January and April. On May 6, 2020, our board of directors declared a cash dividend of $0.28 per share, payable on July 15, 2020, to holders of record on July 1, 2020.
In addition, we repurchased 0.1 million shares of our common stock in the open market for approximately $4.9 million during the three months ended March 31, 2020. Repurchases were suspended in mid-March 2020. For additional information see the “Liquidity and Capital Resources” section of this Item. COVID-19 Pandemic
The rapid onset of the COVID-19 outbreak in the United States has resulted in significant changes to our operating environment. The willingness and ability of patients to seek healthcare services has been negatively affected by restrictive measures, such as travel bans, social distancing, quarantines, and shelter-in-place orders. Acute-care hospitals and physician practices have also significantly reduced the volume of elective procedures. Patients recovering from elective
surgeries have historically represented approximately 15% of our home health admissions. While not a significant percentage of our inpatient rehabilitation population, we treat patients recovering from elective surgery with multiple comorbidities that qualify for inpatient rehabilitation care. These changes to the healthcare environment, along with the factors noted in the “Results of Operations” section of this Item, caused decreased patient volumes in both our inpatient rehabilitation and home health and hospice segments beginning in mid-March and continuing into April and May. We are also experiencing supply chain disruptions as a result of the COVID-19 pandemic, including increased procurement timelines, and we have experienced and are likely to continue to experience significant price increases in medical supplies, particularly personal protective equipment (“PPE”). Beginning in March 2020, we experienced increased supply expenses due to higher utilization
of PPE and increased purchasing of other medical supplies and cleaning and sanitization materials. The federal government began to undertake numerous legislative and regulatory initiatives designed to provide relief to the healthcare industry during the COVID-19
pandemic as described below in the “Key Challenges” section. These initiatives have given our hospitals and agencies the types of enhanced flexibilities they need to care for our patients and assist acute-care hospitals in maintaining hospital capacity in the current environment. The COVID-19 pandemic is still rapidly evolving and much of its impact remains unknown and difficult to predict, with the impact on our operations and financial
performance being dependent on numerous factors, including the nature of the COVID-19 pandemic, such as its rate of spread, duration, and geographic coverage; the legal, regulatory, and administrative developments related to the pandemic at federal, state, and local levels; and our infectious disease prevention and control efforts.
While the operating environment for healthcare providers is continuously changing during this pandemic, we have taken the following steps to ensure the safety and well-being of our patients and employees:
|
| |
ü | Staying current with the Centers for Disease Control and Prevention’s (the “CDC”) guidance on the use of PPE,
which is frequently updated |
ü | Limiting visitors in our hospitals to primary caregivers who require training in order to safely discharge a patient home |
ü | Screening everyone entering our hospitals and self-screening all home health and hospice employees |
ü | Performing pre-visit telephone calls to assess risk factors within the home, including patient and caregiver health status |
ü | Following social distancing recommendations in our therapy
gyms and performing therapy in patient rooms, if needed |
ü | Suspended all hospital-based outpatient services |
ü | Implemented work-at-home policies for home office and certain field personnel |
ü | Halted all non-essential travel |
We also continue to take actions to enhance our operational and financial flexibility and ensure our long-term sustainability. Recently, our executive team voluntarily reduced their base compensation for six months. In addition, we have:
|
| |
ü | secured
secondary sources of PPE and other medical supplies, at times paying premium prices; |
ü | aligned staffing with patient demand; |
ü | amended our senior credit facility in April 2020 (primarily provided covenant relief due to disruptions from the COVID-19 pandemic); |
ü | developed plans for reducing capital expenditures; and |
ü | suspended our authorized share repurchase program in mid-March. |
After
lengthy consideration, we developed plans to manage labor costs in response to lower patient volumes via furloughs, changes to compensation structures and workforce reductions.
Given the rapidly changing operating conditions related to the COVID-19 pandemic, we cannot accurately estimate the effects it may have on our full-year 2020 financial results.
Business Outlook
Notwithstanding the current impacts from the COVID-19 pandemic, we remain optimistic regarding the intermediate and long-term prospects for both of our business segments. Demographic trends, such as population aging, should continue to increase long-term demand for the services we provide. While we treat patients of all ages, most of our patients are 65 and older, and the number of Medicare enrollees is expected to grow approximately 3% per year for the foreseeable future.
Even more specifically, the average age of our patients is approximately 76, and the population group ranging in ages from 75 to 79 is expected to grow at approximately 5% per year through 2026. We believe the demand for the services we provide will continue to increase as the U.S. population ages. We believe these factors align with our strengths in, and focus on, post-acute services. In addition, we believe we can address the demand for facility-based and home-based post-acute care services in markets where we currently do not have a presence by constructing or acquiring new hospitals and by acquiring or opening home health and hospice agencies in those extremely fragmented industries.
We are a leading provider of integrated healthcare services, offering both facility-based and home-based patient care through our network of inpatient rehabilitation hospitals, home health agencies, and hospice agencies. We are committed to
delivering high-quality, cost-effective, integrated patient care across the healthcare continuum with a primary focus on the post-
acute sector. As the nation’s largest owner and operator of inpatient rehabilitation hospitals in terms of patients treated and discharged, revenues, and number of hospitals, we believe we differentiate ourselves from our competitors based on the quality of our clinical outcomes, our cost-effectiveness, our financial strength, and our extensive application of technology. As the fourth largest provider of Medicare-certified skilled home health services in terms of revenues, we believe we differentiate ourselves from our competitors by the application of a highly integrated
technology platform, our ability to manage a variety of care pathways, and a proven track record of consummating and integrating acquisitions.
Although the healthcare industry is currently engaged in addressing the healthcare crisis caused by the COVID-19 pandemic, the industry also faces the prospect of ongoing efforts to transform the healthcare system to coordinated care delivery and payment models. The nature, timing and extent of that transformation remains uncertain, as the development and implementation of new care delivery and payment systems will require significant time and resources. Our short-term goal is to serve our communities and provide the best care possible during the COVID-19 pandemic. Our long-term goal is to position the Company in a prudent manner to be responsive to industry shifts. We have invested in our core business
and created an infrastructure that enables us to provide high-quality care on a cost-effective basis. We have been disciplined in creating a capital structure that is flexible with no significant debt maturities prior to 2023. We continue to have a strong, well-capitalized balance sheet, including a substantial portfolio of owned real estate and significant availability under our revolving credit facility. For these and other reasons, we believe we will be able to adapt to changes in reimbursement, sustain our business model, and grow through acquisition and consolidation opportunities as they arise. See also Item 1, Business, “Competitive Strengths” and “Strategy and 2020 Strategic Priorities” in the 2019 Form 10‑K. Key Challenges
Healthcare is a highly-regulated industry
facing many well-publicized regulatory and reimbursement challenges. The industry also is facing uncertainty associated with the efforts to identify and implement workable coordinated care and integrated delivery payment models as well as post-acute site neutrality in Medicare reimbursement. The Medicare reimbursement systems for both inpatient rehabilitation and home health are undergoing significant changes. The future of many aspects of healthcare regulation remains uncertain. Successful healthcare providers are those able to adapt to changes in the regulatory and operating environments, build strategic relationships across the healthcare continuum, and consistently provide high-quality, cost-effective care. We believe we have the necessary capabilities — change agility, strategic relationships, quality of patient outcomes, cost effectiveness, and ability to capitalize on growth opportunities — to adapt to and succeed in a dynamic, highly regulated industry, and we
have a proven track record of doing so. For a detailed discussion of the challenges we face, see Item 7, Management’s Discussion and Analysis of Financial Condition and Results of Operations, “Executive Overview-Key Challenges” to the 2019 Form 10-K.
As we continue to execute our business plan, the following are some of the challenges we face.
| |
• | Operating in a Highly Regulated Industry. We are required to comply with extensive and complex laws and regulations at the federal, state, and local government levels. More specifically, because Medicare comprises a significant portion of our Net operating revenues,
failure to comply with the laws and regulations governing the Medicare program and related matters could materially and adversely affect us. These rules and regulations have affected, or could in the future affect, our business activities by having an impact on the reimbursement we receive for services provided or the costs of compliance, mandating new documentation standards, requiring additional licensure or certification, regulating our relationships with physicians and other referral sources, regulating the use of our properties, and limiting our ability to enter new markets or add new capacity to existing hospitals and agencies. Ensuring continuous compliance with extensive laws and regulations is an operating requirement for all healthcare providers. See Item 1, Business, “Regulation,” Item 1A, Risk Factors, and Item 7, Management’s Discussion
and Analysis of Financial Condition and Results of Operations, “Executive Overview-Key Challenges,” to the 2019 Form 10‑K for detailed discussions of the most important regulations we face and our programs intended to ensure we comply with those regulations. |
| |
• | Changes to Our Operating Environment Resulting from the COVID-19 pandemic. In March 2020, the federal government began to undertake numerous legislative and regulatory initiatives designed to provide relief to the healthcare industry during the COVID-19 pandemic. |
Temporary suspension of the automatic 2% reduction of Medicare program payments, known as “sequestration”
On
August 2, 2011, President Obama signed into law the Budget Control Act of 2011, which provided for an automatic 2% reduction of Medicare program payments for all healthcare providers. This automatic reduction, known as “sequestration,” began affecting payments received after April 1, 2013 and, as a result of subsequent legislation, will continue through fiscal year 2030. On March 27, 2020, President Trump signed into law the
Coronavirus Aid, Relief, and Economic Security Act of 2020 (the “CARES Act”), which temporarily suspends the automatic
2% reduction of Medicare claim reimbursements for the period of May 1 through December 31, 2020. At this time, we cannot reasonably estimate the impact of the suspension of sequestration on our revenues due to the ongoing volume volatility in both segments (see “Results of Operations” section of this Item). Payment of relief funds directly to healthcare providers
The CARES Act also authorized the cash distribution of relief funds from the Department of Health and Human Services (“HHS”) to healthcare providers. To date, our inpatient rehabilitation hospitals and home health and hospice agencies have received in aggregate approximately $238 million. HHS requires providers to submit an attestation accepting certain terms and conditions. If a provider does not wish to comply
with these terms and conditions, the provider must remit the full payment to HHS. On May 7, 2020, we informed HHS we would not accept any of the CARES Act relief funds. We are currently seeking direction on how to process the repayment of those funds. Temporary suspension of certain patient coverage criteria and documentation and care requirements
The CARES Act and a series of waivers and guidance issued by the Centers for Medicare and Medicaid Services (“CMS”) suspend various Medicare patient coverage criteria and documentation and care requirements. These efforts to provide regulatory relief help to ensure patients continue to have adequate access to care notwithstanding the burdens being placed on healthcare providers by the COVID-19 pandemic.
Inpatient Rehabilitation.
Medicare pays our inpatient rehabilitation hospitals a fixed payment reimbursement amount per discharge under the inpatient rehabilitation facility prospective payment system (the “IRF-PPS”) based on the patient’s rehabilitation impairment category established by CMS and other characteristics and conditions identified by the attending clinicians. In order to qualify for reimbursement under the IRF-PPS, our hospitals must comply with various Medicare rules and regulations including documentation and coverage requirements, or specifications as to what conditions must be met to qualify for reimbursement. These requirements relate to, among other things, pre-admission screening, post-admission evaluations, and individual treatment planning that all delineate the role of physicians in ordering and overseeing patient care. The CARES Act regulatory relief includes the temporary suspension of the requirement that patients must be able to tolerate a minimum of 3 hours
of therapy per day for 5 days per week, waiver of the requirement that at least 60% of a facility’s patients must have a diagnosis from at least 1 of 13 specified medical conditions that typically require intensive therapy and supervision, and waiver of the requirement for a physician to conduct and document a post-admission evaluation. In addition, the requirement of physician face-to-face visits at least 3 days a week may be fulfilled using telehealth.
Home Health and Hospice. Medicare pays home health benefits for patients discharged from a hospital or patients otherwise suffering from chronic conditions that require ongoing but intermittent skilled care. As a condition of participation under Medicare, patients must be homebound (meaning unable to leave their home without a considerable and taxing effort), require intermittent skilled nursing, physical therapy or speech therapy services, or have a
continuing need for occupational therapy, and receive treatment under a plan of care established and periodically reviewed by a physician. A physician must document that he or she or a qualifying nurse practitioner has had a face-to-face encounter with the patient and then certify to CMS that a patient meets the eligibility requirements for the home health benefit. The CARES Act includes a provision allowing nurse practitioners and physician assistants under certain conditions to certify, establish and periodically review the plan of care, as well as supervise the provision of items and services for beneficiaries under the Medicare home health benefit and expands the use of telehealth.
Medicare pays hospice benefits for patients with life expectancies of six months or less, as documented by the patient’s physician(s). Medicare hospice reimbursements to each provider are subject to a number of conditions of participation. These
conditions require, among others, the use of volunteers and onsite visits to evaluate aids. Volunteers provide day-to-day administrative and/or direct patient care services in an amount that, at a minimum, equals five percent of the total patient care hours of all paid hospice employees and contract staff. A nurse or other professional conducts an onsite visit every two weeks to evaluate if aides are providing care consistent with the care plan. The CARES Act includes the temporary waiver of the requirement to use volunteers and to conduct a nurse visit every two weeks to evaluate aides, as well as the expanded use of telehealth.
On
March 30, 2020, CMS announced a pause of certain claims processing requirements for the Home Health Review Choice Demonstration (“RCD”) in Illinois, Ohio, and Texas until the Public Health Emergency for the COVID-19 pandemic has ended. In addition, the demonstration will not begin in North Carolina and Florida in May 2020 as previously scheduled. CMS has also offered home health agencies the option of continuing their participation in the RCD, which we have elected to do at this point in time. We operate agencies (representing approximately 44% of our home health Medicare claims) in these five states. On March 30th, CMS also suspended most medical reviews, including pre-payment medical reviews by Medicare Administrative Contractors (“MACs”) under the Targeted Probe and Educate (“TPE”) initiative
and post-payment reviews conducted by MACs, Supplemental Medical Review Contractors and Recovery Audit Contractors until the Public Health Emergency for the COVID-19 pandemic has ended.
These regulatory actions provide flexibility to our hospitals and agencies to care for patients and assist acute-care hospitals in maintaining hospital capacity during the COVID-19 pandemic when the otherwise applicable rules would likely have constrained our ability to do so.
| |
• | Changes to Our Operating Environment Resulting from Healthcare Reform. On April 16, 2020, CMS released its Notice of Proposed Rulemaking for Fiscal Year 2021 for inpatient rehabilitation
facilities under the inpatient rehabilitation facility prospective payment system (the “2021 Proposed IRF Rule”). The 2021 Proposed IRF Rule would implement a net 2.5% market basket increase (market basket update of 2.9% reduced by a productivity adjustment of 0.4%) effective for discharges between October 1, 2020 and September 30, 2021. The 2021 Proposed IRF Rule also includes changes that impact our hospital-by-hospital base rate for Medicare reimbursement. Such changes include, but are not limited to, revisions to the wage index and labor-related share values. The 2021 Proposed IRF Rule would update case-mix group relative weights and average lengths of stay values. The 2021 Proposed IRF Rule would also remove the post-admission physician evaluation requirement for all IRF discharges beginning on or after October
1, 2020, codify certain inpatient rehabilitation coverage documentation requirements, and, under certain conditions, allow the use of non-physician practitioners to perform the IRF services and documentation requirements currently required to be performed by the rehabilitation physician. Based on our analysis that utilizes, among other things, the acuity of our patients over the six-month period prior to the 2021 Proposed IRF Rule’s release, our experience with outlier payments over this same time frame, and other factors, we believe the 2021 Proposed IRF Rule will result in a net increase to our Medicare payment rates of approximately 2.4% effective October 1, 2020. |
| |
• | Maintaining Strong
Volume Growth. In addition to the factors described in our 2019 Form 10-K, beginning in March, we experienced decreased volumes in both segments which we believe resulted from a number of conditions related to the COVID-19 pandemic which are expected to continue as discussed in the “Results of Operations” section of this Item. |
| |
• | Recruiting and Retaining High-Quality Personnel. See Item 1A, Risk Factors, to the 2019 Form 10‑K for a discussion of competition for staffing, shortages of qualified personnel, and other factors that may increase our labor costs. Additionally, our operations may be adversely
affected by staffing shortages where employees must self-quarantine due to exposure to COVID-19 or where employees are unavailable due to a lack of childcare or care for elderly family. |
We remain confident in the prospects of both of our business segments based on the increasing demands for the services we provide to an aging population. This confidence is further supported by our strong financial foundation and the substantial investments we have made in our businesses. We have a proven track record of working through difficult situations, and we believe in our ability to overcome current and future challenges.
Results
of Operations
Payor Mix
We derived consolidated Net operating revenues from the following payor sources:
|
| | | | | |
| |
| 2020 | | 2019 |
Medicare | 73.4 | % | | 76.0 | % |
Medicare
Advantage | 11.9 | % | | 9.8 | % |
Managed care | 8.7 | % | | 8.2 | % |
Medicaid | 3.0 | % | | 2.7 | % |
Other
third-party payors | 0.9 | % | | 0.9 | % |
Workers’ compensation | 0.6 | % | | 0.7 | % |
Patients | 0.5 | % | | 0.6 | % |
Other
income | 1.0 | % | | 1.1 | % |
Total | 100.0 | % | | 100.0 | % |
For additional information regarding our payors, see the “Sources of Revenues” section of Item 1, Business,
of the 2019 Form 10‑K.
Our Results
For the three months ended March 31, 2020 and 2019, our consolidated results of operations were as follows: |
| | | | | | | | | | |
| Three
Months Ended March 31, | | Percentage Change |
| 2020 | | 2019 | | 2020 vs. 2019 |
| (In Millions, Except Percentage Change) |
Net operating revenues | $ | 1,182.0 |
| | $ | 1,124.0 |
| | 5.2 | % |
Operating
expenses: | |
| | |
| | |
|
Salaries and benefits | 679.1 |
| | 620.8 |
| | 9.4 | % |
Other
operating expenses | 159.6 |
| | 150.1 |
| | 6.3 | % |
Occupancy costs | 20.2 |
| | 19.6 |
| | 3.1 | % |
Supplies | 45.7 |
| | 40.1 |
| | 14.0 | % |
General
and administrative expenses | 35.6 |
| | 53.4 |
| | (33.3 | )% |
Depreciation and amortization | 58.8 |
| | 52.5 |
| | 12.0 | % |
Government,
class action, and related settlements | 2.8 |
| | — |
| | N/A |
|
Total operating expenses | 1,001.8 |
| | 936.5 |
| | 7.0 | % |
Interest
expense and amortization of debt discounts and fees | 43.2 |
| | 37.2 |
| | 16.1 | % |
Other expense (income) | 1.9 |
| | (3.7 | ) | | (151.4 | )% |
Equity
in net income of nonconsolidated affiliates | (0.8 | ) | | (2.5 | ) | | (68.0 | )% |
Income from continuing operations before income tax expense | 135.9 |
| | 156.5 |
| | (13.2 | )% |
Provision
for income tax expense | 27.1 |
| | 30.8 |
| | (12.0 | )% |
Income from continuing operations | 108.8 |
| | 125.7 |
| | (13.4 | )% |
Loss
from discontinued operations, net of tax | (0.1 | ) | | (0.5 | ) | | (80.0 | )% |
Net income | 108.7 |
| | 125.2 |
| | (13.2 | )% |
Less:
Net income attributable to noncontrolling interests | (21.7 | ) | | (22.9 | ) | | (5.2 | )% |
Net income attributable to Encompass Health | $ | 87.0 |
| | $ | 102.3 |
| | (15.0 | )% |
Operating Expenses as a % of Net Operating Revenues |
| | | | | |
| |
| 2020 | | 2019 |
Operating
expenses: | | | |
Salaries and benefits | 57.5 | % | | 55.2 | % |
Other operating expenses | 13.5 | % | | 13.4 | % |
Occupancy
costs | 1.7 | % | | 1.7 | % |
Supplies | 3.9 | % | | 3.6 | % |
General and administrative expenses | 3.0 | % | | 4.8 | % |
Depreciation
and amortization | 5.0 | % | | 4.7 | % |
Government, class action, and related settlements | 0.2 | % | | — | % |
Total operating expenses | 84.8 | % | | 83.3 | % |
In
the discussion that follows, we use “same-store” comparisons to explain the changes in certain performance metrics and line items within our financial statements. We calculate same-store comparisons based on hospitals and home health and hospice locations open throughout both the full current periods and prior periods presented. These comparisons include the financial results of market consolidation transactions in existing markets, as it is difficult to determine, with precision, the incremental impact of these transactions on our results of operations.
Net Operating Revenues
Our consolidated Net operating revenues increased in the three months ended March 31, 2020 over the same period of 2019
primarily due to volume and pricing growth in our inpatient rehabilitation segment and volume growth in our home health and hospice segment. See additional discussion in the “Segment Results of Operations” section of this Item. During January and February 2020, both segments were exhibiting strong year-over-year volume growth as shown in the table below. Beginning in mid-March, we experienced decreased volumes in both segments which we believe resulted from a number of conditions related to the COVID-19 pandemic including: lower acute-care hospital censuses due to the deferral of elective surgeries and shelter-in-place orders, restrictive visitation policies in place at acute-care hospitals that have served to severely limit access to patients and caregivers by our clinical rehabilitation liaisons and care transition coordinators, lock down of assisted living facilities, and heightened anxiety among patients and their
family members regarding the risk of exposure to COVID-19 during acute-care and post-acute care treatment. We believe these factors have contributed to a decline in new patients for all of our business lines, a lower length of stay in the inpatient rehabilitation segment, and fewer visits per episode in home health. For the two-month period of January and February and the month of March, year-over-year volume results were as follows:
|
| | | |
| 2020 vs. 2019 |
| January - February | | March |
Inpatient
Rehabilitation | | | |
Total discharges | 7.7% | | (1.0)% |
| | | |
Home Health and Hospice | | | |
Home
health total admissions | 18.5% | | (0.5)% |
Hospice total admissions | 31.5% | | 13.9% |
We continued to experience lower volumes in April and May than we did in January and February. Certain volume results for April
and May, including certain year-over-year volume growth information for the month of April, are included below.
|
| |
| April 2020 vs. April 2019 |
Inpatient Rehabilitation | |
Total discharges | (20.9)% |
| |
Home Health
and Hospice | |
Home health total admissions | (23.5)% |
Hospice total admissions | 27.8% |
|
| | | | |
Inpatient Rehabilitation - Patient Census Information |
| | (Easter Weekend) | | |
6,782 | 5,342 | 5,139 | 5,989 | 6,119 |
|
| | | | |
Home
Health - Starts of Episodes (Includes Starts of Care and Recertifications) |
Week Ended | Week Ended | Week Ended | Week Ended | Week Ended |
4,950 | 4,778 | 4,120 | 4,283 | 4,628 |
|
| | | | |
Hospice - Admissions |
Week Ended | Week Ended | Week Ended | Week Ended | Week Ended |
259 | 197 | 236 | 239 | 242 |
Salaries
and Benefits
Salaries and benefits increased during the three months ended March 31, 2020 compared to the same period of 2019 primarily due to salary increases for our employees, increased benefit costs, and increased patient volumes, including an increase in the number of full-time equivalents as a result of our development activities. As a percent of Net operating revenues, Salaries and benefits increased during the three months ended March 31, 2020 compared to the same period of 2019
primarily as a result of higher salary and benefit cost increases compared to revenue pricing increases. See additional discussion in the “Segment Results of Operations” section of this Item. Additionally, as announced on April 6, 2020, we initiated a program for eligible frontline employees to earn additional paid time off in recognition of their outstanding efforts responding to the COVID-19 pandemic. With more than 21,000 employees potentially benefiting from this additional paid time off, we estimate this investment will be up to $50 million in the second quarter of 2020. Other Operating Expenses
Other operating expenses increased during the three months ended March 31,
2020 compared to the same period of 2019 primarily due to increased patient volumes. As a percent of Net operating revenues, Other operating expenses increased during the three months ended March 31, 2020 compared to the same period of 2019 primarily due to higher repairs and maintenance expense, including demolition costs for development projects. Supplies
Supplies increased in terms of dollars and as a percent of revenue during the three months ended March 31,
2020 compared to the same period of 2019 primarily due to increased utilization and cost of medical supplies, including personal protective equipment (“PPE”), beginning in March 2020 due to the COVID-19 pandemic. We expect to continue to see increased utilization and cost of medical supplies in 2020 as a result of the COVID-19 pandemic.
General and Administrative Expenses
General and administrative expenses decreased in terms of dollars and as a percent of revenue during the three months ended March 31,
2020 compared to the same period of 2019 primarily due to decreased expenses associated with stock appreciation rights as well as the $4.4 million year-over-year change in the mark-to-market adjustment on our non-qualified 401(k) liability. For additional information on stock appreciation rights, see Note 6, Share-Based Payments, to the accompanying condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited), of this report, and Note 14, Share-Based Payments, to the consolidated financial statements accompanying the 2019 Form 10‑K.
Depreciation and Amortization
Depreciation and amortization increased during the three months ended March 31, 2020 compared to the same period of 2019 due to our capital investments. Other Expense (Income)
Other expense (income) decreased during the three months ended March 31, 2020 compared to the same period of 2019 primarily due to the $4.4 million year-over-year
change in the mark-to-market adjustment on our non-qualified 401(k) liability offset by a $2.2 million gain as a result of our consolidation of the Treasure Coast home health location and the remeasurement of our previously held equity interest at fair value. Income from Continuing Operations Before Income Tax Expense
Our pre-tax income from continuing operations decreased during the three months ended March 31, 2020 compared to the same period of 2019 primarily due to the decrease in earnings, as discussed in the “Segment Results of Operations” section of this Item. Provision for Income Tax Expense
Our
Provision for income tax expense decreased during the three months ended March 31, 2020 compared to the same period of 2019 primarily due to lower Income from Continuing Operations Before Income Tax Expense. At this time, we cannot reasonably estimate how much our cash payments for income taxes will be in 2020 due to the impact of the COVID-19 pandemic discussed above and in the “Executive Overview” section of this Item.
In certain jurisdictions, we do not expect to generate sufficient income to use all of the available state net operating losses and other credits prior to their expiration. This determination is based on
our evaluation of all available evidence in these jurisdictions including results of operations during the preceding three years, our forecast of future earnings, and prudent tax planning strategies. It is possible we may be required to increase or decrease our valuation allowance at some future time if our forecast of future earnings varies from actual results on a consolidated basis or in the applicable tax jurisdiction, if the timing of future tax deductions differs from our expectations, or pursuant to changes in state tax laws and rates.
We recognize the financial statement effects of uncertain tax positions when it is more likely than not, based on the technical merits, a position will be sustained upon examination by and resolution with the taxing authorities. Total remaining unrecognized tax benefits were $0.4 million as of March 31,
2020 and December 31, 2019. See Note 7, Income Taxes, to the condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited), of this report and Note 16, Income Taxes, to the consolidated financial statements accompanying the 2019 Form 10‑K.
Segment Results of Operations
Our internal
financial reporting and management structure is focused on the major types of services provided by Encompass Health. We manage our operations using two operating segments which are also our reportable segments: (1) inpatient rehabilitation and (2) home health and hospice. For additional information regarding our business segments, including a detailed description of the services we provide, financial data for each segment, and a reconciliation of total segment Adjusted EBITDA to income from continuing operations before income tax expense, see Note 10, Segment Reporting, to the condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited), of this report.
Inpatient
Rehabilitation
Our inpatient rehabilitation segment derived its Net operating revenues from the following payor sources:
|
| | | | | |
| |
| 2020 | | 2019 |
Medicare | 70.5 | % | | 73.5 | % |
Medicare
Advantage | 12.3 | % | | 9.8 | % |
Managed care | 9.9 | % | | 9.6 | % |
Medicaid | 3.4 | % | | 3.0 | % |
Other
third-party payors | 1.2 | % | | 1.1 | % |
Workers’ compensation | 0.8 | % | | 0.9 | % |
Patients | 0.6 | % | | 0.7 | % |
Other
income | 1.3 | % | | 1.4 | % |
Total | 100.0 | % | | 100.0 | % |
Additional information regarding our inpatient rehabilitation segment’s operating results for the three months
ended March 31, 2020 and 2019 is as follows: |
| | | | | | | | | | |
| Three Months Ended March 31, | | Percentage Change |
| 2020 | | 2019 | | 2020
vs. 2019 |
| (In Millions, Except Percentage Change) |
Net operating revenues: | | | | |
|
Inpatient | $ | 890.0 |
| | $ | 847.6 |
| | 5.0 | % |
Outpatient
and other | 19.2 |
| | 22.5 |
| | (14.7 | )% |
Inpatient rehabilitation segment revenues | 909.2 |
| | 870.1 |
| | 4.5 | % |
Operating
expenses: | | | | | |
Salaries and benefits | 482.3 |
| | 445.0 |
| | 8.4 | % |
Other
operating expenses | 134.7 |
| | 127.6 |
| | 5.6 | % |
Supplies | 39.6 |
| | 35.6 |
| | 11.2 | % |
Occupancy
costs | 15.3 |
| | 15.8 |
| | (3.2 | )% |
Other expense (income) | 1.6 |
| | (2.8 | ) | | (157.1 | )% |
Equity
in net income of nonconsolidated affiliates | (0.6 | ) | | (2.1 | ) | | (71.4 | )% |
Noncontrolling interests | 20.8 |
| | 21.0 |
| | (1.0 | )% |
Segment
Adjusted EBITDA | $ | 215.5 |
| | $ | 230.0 |
| | (6.3 | )% |
| | | | | |
| (Actual
Amounts) |
Discharges | 47,750 |
| | 45,609 |
| | 4.7 | % |
Net patient revenue per discharge | $ | 18,639 |
| | $ | 18,584 |
| | 0.3 | % |
Outpatient
visits | 69,743 |
| | 102,028 |
| | (31.6 | )% |
Average length of stay (days) | 12.7 |
| | 12.8 |
| | (0.8 | )% |
Occupancy
% | 71.3 | % | | 72.3 | % | | (1.4 | )% |
# of licensed beds | 9,322 |
| | 8,941 |
| | 4.3 | % |
Full-time
equivalents* | 22,318 |
| | 21,345 |
| | 4.6 | % |
Employees per occupied bed | 3.38 |
| | 3.34 |
| | 1.2 | % |
| |
* | Full-time
equivalents included in the above table represent our employees who participate in or support the operations of our hospitals and exclude an estimate of full-time equivalents related to contract labor. |
We actively manage the productive portion of our Salaries and benefits utilizing certain metrics, including employees per occupied bed, or “EPOB.” This metric is determined 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 our occupancy percentage. Operating Expenses as a % of Net Operating Revenues
|
| | | | | |
| |
| 2020 | | 2019 |
Operating
expenses: | | | |
Salaries and benefits | 53.0 | % | | 51.1 | % |
Other operating expenses | 14.8 | % | | 14.7 | % |
Supplies | 4.4 | % | | 4.1 | % |
Occupancy
costs | 1.7 | % | | 1.8 | % |
Total operating expenses | 73.9 | % | | 71.7 | % |
Net Operating Revenues
Revenue growth during the three months ended March 31,
2020 compared to the same period of 2019 resulted from volume growth and an increase in net patient revenue per discharge. Discharge growth from new stores resulted from our joint ventures in Lubbock, Texas (May 2019) and Boise, Idaho (July 2019) and wholly owned hospitals in Katy, Texas (September 2019) and Murrieta, California (February 2020). New-store growth also resulted from a joint venture hospital in Yuma, Arizona changing from the equity method of accounting to a consolidated entity effective July 1, 2019. Growth in net patient revenue per discharge primarily resulted from an increase in reimbursement rates offset by prior period cost report adjustments. Revenue reserves were lower during the three months ended March 31, 2020
compared to the same period of 2019 primarily due to the continued favorable resolution of medical claims reviews. See Note 1, Summary of Significant Accounting Policies, “Net Operating Revenues,” to the consolidated financial statements accompanying the 2019 Form 10‑K for information regarding claims reviews. The decrease in outpatient and other revenue during the three months ended March 31, 2020 compared to the same period of 2019 resulted from the suspension of hospital-based outpatient services in mid-March 2020 and the closure of certain hospital-based outpatient
programs in 2019. See Note 2, Business Combinations, and Note 9, Investments in and Advances to Nonconsolidated Affiliates, to the consolidated financial statements accompanying the 2019 Form 10‑K for information regarding the joint ventures discussed above.
Adjusted EBITDA
The decrease in Adjusted EBITDA during the three months ended March 31, 2020 compared to the same period of 2019 primarily resulted from higher Salaries and benefits and Supplies
expenses. Expense ratios for three months ended March 31, 2020 benefited from a decrease in revenue reserves as discussed above. Salaries and benefits increased as a percent of revenue primarily due to the ramp up of new stores, overtime paid to employees as a result of increased volumes early in the first quarter, and declining employee productivity in March. The employee productivity decrease primarily was the result of COVID-19 pandemic conditions including performing more individual therapy in patient rooms, donning and doffing of PPE, and screenings of everyone entering the hospital. Supplies increased as a percent of revenue primarily due to increased purchase and use of medical supplies in March 2020 due to the COVID-19 pandemic.
Other expense (income) within the segment decreased $4.4 million primarily due to the year-over-year change in the mark-to-market adjustment on our non-qualified 401(k) liability, which is offset in General and administrative expenses. Lower revenues and higher expense trends resulting from the COVID-19 pandemic have continued into April and May and could lead to a significant reduction in inpatient rehabilitation segment Adjusted EBITDA.
Home Health and Hospice
Our home health and hospice segment derived its Net operating revenues
from the following payor sources:
|
| | | | | |
| |
| 2020 | | 2019 |
Medicare | 83.0 | % | | 84.6 | % |
Medicare
Advantage | 10.8 | % | | 10.0 | % |
Managed care | 4.4 | % | | 3.3 | % |
Medicaid | 1.5 | % | | 1.7 | % |
Workers’
compensation | 0.1 | % | | 0.1 | % |
Patients | 0.1 | % | | 0.2 | % |
Other income | 0.1 | % | | 0.1 | % |
Total | 100.0 | % | | 100.0 | % |
Additional
information regarding our home health and hospice segment’s operating results for the three months ended March 31, 2020 and 2019 is as follows: |
| | | | | | | | | | |
| Three Months Ended March 31, | | Percentage
Change |
| 2020 | | 2019 | | 2020 vs. 2019 |
| (In Millions, Except Percentage Change) |
Net operating revenues: | | | | | |
Home
health | $ | 224.8 |
| | $ | 219.5 |
| | 2.4 | % |
Hospice | 48.0 |
| | 34.4 |
| | 39.5 | % |
Home
health and hospice segment revenues | 272.8 |
| | 253.9 |
| | 7.4 | % |
Operating expenses: | | | | | |
Cost
of services sold (excluding depreciation and amortization) | 130.9 |
| | 116.5 |
| | 12.4 | % |
Support and overhead costs | 100.2 |
| | 88.8 |
| | 12.8 | % |
Equity
in net income of nonconsolidated affiliates | (0.2 | ) | | (0.4 | ) | | (50.0 | )% |
Noncontrolling interests | 0.9 |
| | 2.7 |
| | (66.7 | )% |
Segment
Adjusted EBITDA | $ | 41.0 |
| | $ | 46.3 |
| | (11.4 | )% |
| | | | | |
| (Actual
Amounts) |
Home health: | | | | | |
Admissions | 42,476 |
| | 37,944 |
| | 11.9 | % |
Recertifications | 26,553 |
| | 28,282 |
| | (6.1 | )% |
Episodes | 68,652 |
| | 63,626 |
| | 7.9 | % |
Revenue
per episode | $ | 2,909 |
| | $ | 3,057 |
| | (4.8 | )% |
Episodic visits per episode | 16.3 |
| | 17.7 |
| | (7.9 | )% |
Total
visits | 1,306,230 |
| | 1,308,610 |
| | (0.2 | )% |
Cost per visit | $ | 81 |
| | $ | 75 |
| | 8.0 | % |
Hospice: | | | | |
|
Admissions | 2,986 |
| | 2,378 |
| | 25.6 | % |
Patient
days | 334,545 |
| | 239,022 |
| | 40.0 | % |
Average daily census | 3,676 |
| | 2,656 |
| | 38.4 | % |
Revenue
per day | $ | 144 |
| | $ | 144 |
| | — | % |
Operating
Expenses as a % of Net Operating Revenues
|
| | | | | |
| |
| 2020 | | 2019 |
Operating expenses: | | | |
Cost
of services sold (excluding depreciation and amortization) | 48.0 | % | | 45.9 | % |
Support and overhead costs | 36.7 | % | | 35.0 | % |
Total operating expenses | 84.7 | % | | 80.9 | % |
Net
Operating Revenues
Revenue growth during the three months ended March 31, 2020 compared to the same period of 2019 primarily was driven by volume growth. Volume growth included a 0.2% increase in home health same-store admissions. New-store admission growth was primarily due to the acquisition of Alacare on July 1, 2019. Revenue per episode decreased primarily due to implementation of the Patient Driven Groupings Model (the “PDGM”) on January 1, 2020 and the patient mix of the former Alacare locations. The effects of PDGM were exacerbated by the COVID-19 pandemic, including an increase in low utilization payment adjustments, or “LUPAs.”
Revenue per episode during the three months ended March 31, 2020 benefited from the reversal of a $1.6 million reserve for a Zone Program Integrity Contractor audit. Hospice revenue increased during the three months ended March 31, 2020 compared to the same period of 2019 by 39.5%, with approximately 75% of the increase resulting from the acquisition of Alacare. See Note 2, Business Combinations, to the consolidated financial statements accompanying the 2019 Form 10‑K for information regarding the acquisition
discussed above.
Adjusted EBITDA
The decrease in Adjusted EBITDA during the three months ended March 31, 2020 compared to the same period of 2019 primarily resulted from a decrease in Medicare reimbursement rates primarily related to the implementation of PDGM and an increase in Cost of services and Support and overhead costs as a percent of revenues. Cost of services as percent of revenues for the three months ended March 31, 2020
increased primarily due to COVID-19 pandemic related impacts on patient volumes, staff productivity and medical supplies, as well as an increase in salaries and wages per full-time equivalent. Support and overhead costs as a percent of revenues for the three months ended March 31, 2020 increased primarily due to increased administrative costs associated with the implementation of PDGM and the Review Choice Demonstration Program, as well as an increase in sales force full-time equivalents. Lower revenues and higher expense trends resulting from the COVID-19 pandemic have continued into April and May and could lead to a significant reduction in home health and hospice segment Adjusted EBITDA. Liquidity
and Capital Resources
Our primary sources of liquidity are cash on hand, cash flows from operations, and borrowings under our revolving credit facility.
The objectives of our capital structure strategy are to ensure we maintain adequate liquidity and flexibility. Pursuing and achieving those objectives allow us to support the execution of our operating and strategic plans and weather temporary disruptions in the capital markets and general business environment. Maintaining adequate liquidity is a function of our unrestricted Cash and cash equivalents and our available borrowing capacity. Maintaining flexibility in our capital structure is a function of, among other things, the amount of debt maturities in any given year, the options for debt prepayments without onerous penalties, and limiting restrictive terms and maintenance covenants
in our debt agreements.
To further enhance our liquidity and ensure availability under our credit agreement, in April 2020, we amended our credit agreement primarily to provide covenant relief due to business disruptions from the COVID-19 pandemic. The amendment included, among other things, the carve-out of the COVID-19 pandemic from the definition of material adverse effect for 364 days and modifications to the interest coverage and leverage ratios under the agreement. For additional information see Note 3, Long-term Debt, to the accompanying condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited), of this report,
We have been disciplined in creating a capital structure that is flexible with no
significant debt maturities prior to 2023. We continue to have a strong, well-capitalized balance sheet, including a substantial portfolio of owned real estate, and
we have significant availability under our revolving credit facility. We continue to generate cash flows from operations and we have significant flexibility with how we choose to invest our cash and return capital to shareholders.
For additional information see Note 3, Long-term Debt, to the accompanying condensed consolidated financial statements included in Part I, Item 1, Financial
Statements (Unaudited), of this report, and Note 10, Long-term Debt, to the consolidated financial statements accompanying the 2019 Form 10‑K.
Current Liquidity
As of March 31, 2020, we had $104.9 million in Cash and cash equivalents. This amount excludes $72.1 million in restricted cash ($56.7 million included in Restricted cash and $15.4 million included in Other
long-term assets in our condensed consolidated balance sheet) and $71.2 million of restricted marketable securities (included in Other long-term assets in our condensed consolidated balance sheet). Our restricted assets pertain primarily to obligations associated with our captive insurance company, as well as obligations we have under agreements with joint venture partners. See Note 4, Cash and Marketable Securities, to the consolidated financial statements accompanying the 2019 Form 10‑K. In addition to Cash and cash equivalents, as of March 31, 2020, we had approximately
$613.3 million available to us under our revolving credit facility. Our credit agreement governs the substantial majority of our senior secured borrowing capacity and contains a leverage ratio and an interest coverage ratio as financial covenants. Our leverage ratio is defined in our credit agreement as the ratio of consolidated total debt (less up to $300 million of cash on hand) to Adjusted EBITDA for the trailing four quarters. In calculating the leverage ratio under our credit agreement, we are permitted to use pro forma Adjusted EBITDA, the calculation of which includes historical income statement items and pro forma adjustments resulting from (1) the dispositions and repayments or incurrence of debt and (2) the investments, acquisitions, mergers, amalgamations, consolidations and operational changes from acquisitions to the extent such items or effects are not yet reflected in our trailing four-quarter financial statements.
Our interest coverage ratio is defined in our credit agreement as the ratio of Adjusted EBITDA to consolidated interest expense, excluding the amortization of financing fees, for the trailing four quarters. As of March 31, 2020, the maximum leverage ratio requirement per our credit agreement was 4.50x and the minimum interest coverage ratio requirement was 3.0x, and we were in compliance with these covenants. Based on Adjusted EBITDA for the trailing four quarters and the interest rate in effect under our credit agreement during the three-month period ended March 31, 2020, if we had drawn on the first day and maintained the maximum amount of outstanding draws under our revolving credit facility for that entire period, we would still be in compliance with the maximum leverage ratio
and minimum interest coverage ratio requirements. We do not face near-term refinancing risk, as the amounts outstanding under our credit agreement do not mature until 2024, and our bonds all mature in 2023 and beyond. See the “Contractual Obligations” section below for information related to our contractual obligations as of March 31, 2020. We acquired a significant portion of our home health and hospice business when we purchased EHHI Holdings, Inc (“EHHI”) on December 31, 2014. In the acquisition, we acquired all of the issued and outstanding equity interests of EHHI, other than equity interests contributed to Encompass Health Home Health Holdings, Inc. (“Holdings”),
a subsidiary of Encompass Health and an indirect parent of EHHI, by certain sellers in exchange for shares of common stock of Holdings. Those sellers were members of EHHI management, and they contributed a portion of their shares of common stock of EHHI, valued at approximately $64 million on the acquisition date, in exchange for approximately 16.7% of the outstanding shares of common stock of Holdings. At any time after December 31, 2017, each management investor had the right (but not the obligation) to have his or her shares of Holdings stock repurchased by Encompass Health for a cash purchase price per share equal to the fair value. The fair value was determined using the product of the trailing twelve-month adjusted EBITDA measure for Holdings and a specified median market price multiple based on a basket of public home health companies and transactions, after adding cash and deducting indebtedness that included
the outstanding principal balance under any intercompany notes. In February 2018, each management investor exercised the right to sell one-third of his or her shares of Holdings stock to Encompass Health, representing approximately 5.6% of the outstanding shares of the common stock of Holdings. On February 21, 2018, Encompass Health settled the acquisition of those shares upon payment of approximately $65 million in cash. In July 2019, we received additional exercise notices, representing approximately 5.6% of the outstanding shares of the common stock of Holdings. In September 2019, Encompass Health settled the acquisition of those shares upon payment of approximately $163 million in cash. As of December 31, 2019, the fair value of those outstanding shares of Holdings owned by management investors was approximately $208 million. In January 2020, we received additional
exercise notices, representing approximately 4.3% of the outstanding shares of the common stock of Holdings. In February 2020, Encompass Health settled the acquisition of those shares upon payment of approximately $162 million in cash. Upon settlement of these exercises, approximately $46 million of the shares of Holdings held by two management investors remained outstanding.
On February 20, 2020, Encompass Health entered into exchange agreements (each, an “Exchange Agreement”) with these two management investors, pursuant to which they had the right to exchange all of the remaining shares of Holdings held by them for shares of common stock
of Encompass Health (the “EHC Shares”). Each of the Exchange Agreements provided that the management investor must deliver a written exchange notice (an “Exchange Notice”) to Encompass Health in order to exchange his or her remaining shares of Holdings for EHC Shares. Each Exchange Agreement further provided that the number of EHC Shares to be delivered to the management investor was to be determined by dividing the fair value of the shares of Holdings held by the management investor on the date of the Exchange Agreement by the last reported sales price of Encompass Health’s common stock on the New York Stock Exchange (the “NYSE”) on the date of delivery of the Exchange Notice. On February 20, 2020, Encompass Health received an Exchange Notice from each of the management investors. Based on the last sales price of Encompass Health’s common stock on the
NYSE on February 20, 2020, Encompass Health delivered an aggregate 560,957 EHC Shares to the management investors. The total number of EHC Shares issued pursuant to the exchange agreements on March 6, 2020 represented less than 0.6% of the outstanding shares of Encompass Health common stock. Encompass Health issued the EHC Shares from its treasury shares. Encompass Health now owns 100% of Holdings and EHHI. See also Note 4, Redeemable Noncontrolling Interests, to the condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited), of this report. In conjunction with the EHHI acquisition, we granted stock appreciation rights (“SARs”) based on
Holdings common stock to certain members of EHHI management at closing. Half of the SARs vested on December 31, 2018 and the remainder vested on December 31, 2019. Upon exercise, each SAR must be settled for cash in the amount by which the per share fair value of Holdings’ common stock on the exercise date exceeds the per share fair value on the grant date. As of December 31, 2019, the fair value of the remaining 115,545 SARs was approximately $101 million, all of which was included in Accrued expenses and other current liabilities in the condensed consolidated balance sheet. In January 2020, members of the management team exercised the remaining SARs and in February 2020, we settled
those awards upon payment of approximately $101 million in cash. See also Note 6, Share-Based Payments, to the accompanying condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited), of this report. For a discussion of risks and uncertainties facing us see Item 1A, Risk Factors, under Part II, Other Information, of this report and Item 1A, Risk Factors, of the 2019 Form 10‑K.
Sources and Uses of Cash
The following table shows the cash flows provided by or used in operating, investing, and financing activities
for the three months ended March 31, 2020 and 2019 (in millions): |
| | | | | | | |
| |
| 2020 | | 2019 |
Net
cash provided by operating activities | $ | 29.3 |
| | $ | 159.9 |
|
Net cash used in investing activities | (83.0 | ) | | (91.5 | ) |
Net
cash provided by (used in) financing activities | 71.1 |
| | (81.7 | ) |
Increase (decrease) in cash, cash equivalents, and restricted cash | $ | 17.4 |
| | $ | (13.3 | ) |
Operating
activities. The decrease in Net cash provided by operating activities for the three months ended March 31, 2020 compared to the same period of 2019 primarily resulted from the payment to management investors of our home health and hospice segment of approximately $101 million for vested stock appreciation rights. For additional information, see Note 6,
Share-Based Payments, to the condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited), of this report. Investing activities. The decrease in Net cash used in investing activities during the three months ended March 31, 2020 compared to the same period of 2019 primarily
resulted from acquisitions during the first quarter of 2019 offset by an increase in purchases of property and equipment during the first quarter of 2020. See Note 2, Business Combinations, to the consolidated financial statements accompanying the 2019 Form 10‑K. Financing activities. The increase in Net cash provided by financing activities during the three months ended March 31, 2020 compared to the same period of 2019
primarily resulted from the net borrowings on our revolving credit facility offset by cash used for the purchase of equity interests held by the home health and hospice management team during the first quarter of 2020. For additional information, see Note 3, Long-term Debt, and Note 4, Redeemable Noncontrolling
Interests, to the accompanying condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited),
of this report.
Contractual Obligations
Our consolidated contractual obligations as of March 31, 2020 are as follows (in millions): |
| | | | | | | | | | | | | | | | | | | |
| Total | | | | 2021 - 2022 | | 2023 - 2024 | | 2025 and thereafter |
Long-term debt obligations: | | | | | |
| | |
| | |
Long-term
debt, excluding revolving credit facility and finance lease obligations (a) | $ | 2,630.9 |
| | $ | 14.7 |
| | $ | 41.5 |
| | $ | 1,237.2 |
| | $ | 1,337.5 |
|
Revolving
credit facility | 350.0 |
| | — |
| | — |
| | 350.0 |
| | — |
|
Interest
on long-term debt (b) | 840.3 |
| | 107.4 |
| | 284.0 |
| | 244.2 |
| | 204.7 |
|
Finance
lease obligations (c) | 630.3 |
| | 38.3 |
| | 96.2 |
| | 90.2 |
| | 405.6 |
|
Operating
lease obligations (d) | 372.0 |
| | 42.0 |
| | 100.6 |
| | 75.9 |
| | 153.5 |
|
Purchase
obligations (e) | 138.3 |
| | 51.4 |
| | 61.7 |
| | 18.9 |
| | 6.3 |
|
Other
long-term liabilities (f)(g) | 3.3 |
| | 0.2 |
| | 0.5 |
| | 0.4 |
| | 2.2 |
|
Total | $ | 4,965.1 |
| | $ | 254.0 |
| | $ | 584.5 |
| | $ | 2,016.8 |
| | $ | 2,109.8 |
|
| |
(a) | Included
in long-term debt are amounts owed on our bonds payable and other notes payable. These borrowings are further explained in Note 3, Long-term Debt, accompanying the condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited), of this report, and Note 10, Long-term Debt, to the consolidated financial statements accompanying the 2019 Form 10‑K. |
| |
(b) | Interest on our fixed rate
debt is presented using the stated interest rate. Interest expense on our variable rate debt is estimated using the rate in effect as of March 31, 2020. Interest pertaining to our credit agreement and bonds is included to their respective ultimate maturity dates. Interest related to finance lease obligations is excluded from this line. Amounts exclude amortization of debt discounts, amortization of loan fees, or fees for lines of credit that would be included in interest expense in our consolidated statements of comprehensive income. |
| |
(c) | Amounts include interest portion of future minimum finance lease payments. |
| |
(d) | Our
inpatient rehabilitation segment leases approximately 14% of its hospitals as well as other property and equipment under operating leases in the normal course of business. Our home health and hospice segment leases relatively small office spaces in the localities it serves, space for its corporate office, and other equipment under operating leases in the normal course of business. Amounts include interest portion of future minimum operating lease payments. For more information, see Note 7, Leases, to the consolidated financial statements accompanying the 2019 Form 10‑K. |
| |
(e) | Purchase
obligations include agreements to purchase goods or services that are enforceable and legally binding on Encompass Health and that specify all significant terms, including: fixed or minimum quantities to be purchased; fixed, minimum, or variable price provisions; and the approximate timing of the transaction. Purchase obligations exclude agreements that are cancelable without penalty. Our purchase obligations primarily relate to software licensing and support and medical equipment. Purchase obligations are not recognized in our condensed consolidated balance sheet. |
| |
(f) | Because their future cash outflows are uncertain, the following noncurrent liabilities are excluded from the table above: general liability, professional
liability, and workers' compensation risks, noncurrent amounts related to third-party billing audits, and deferred income taxes. For more information, see Note 11, Self-Insured Risks, Note 16, Income Taxes, and Note 18, Contingencies and Other Commitments, to the consolidated financial statements accompanying the 2019 Form 10‑K and Note 7, Income Taxes, to the condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited),
of this report. |
| |
(g) | The table above does not include Redeemable noncontrolling interests of $34.0 million because of the uncertainty surrounding the timing and amounts of any related cash outflows. See Note 4, Redeemable Noncontrolling Interests, to the condensed consolidated financial statements included in Part
I, Item 1, Financial Statements (Unaudited), of this report. |
Our capital expenditures include costs associated with our hospital refresh program, de novo projects, capacity expansions, technology initiatives, and building and equipment upgrades and purchases. During the three months ended March 31, 2020, we made capital expenditures of approximately $85 million for property and equipment and capitalized software. These expenditures are exclusive of approximately $1 million in net cash related to our acquisition activity. At this time, we cannot reasonably estimate how much we expect to spend on capital expenditures in 2020 due to
the impact of the COVID-19 pandemic discussed in the “Executive Overview” section of this Item. Authorizations for Returning Capital to Stakeholders
In October 2019 and February 2020, our board of directors declared cash dividends of $0.28 per share that were paid in January 2020 and April 2020, respectively. On May 6, 2020, our board of directors declared a cash dividend of $0.28 per share, payable on July 15, 2020, to holders of record on July 1, 2020. We expect quarterly dividends to be paid in January, April, July, and October. However, the actual declaration of any future cash dividends, and the setting of record and payment dates as well as the per share amounts, will be at
the discretion of our board of directors after consideration of various factors, including our capital position and alternative uses of funds. Cash dividends are expected to be funded using cash flows from operations, cash on hand, and availability under our revolving credit facility. On February 14, 2014, our board of directors approved an increase in our existing common stock repurchase authorization from $200 million to $250 million. On July 24, 2018, our board approved resetting the aggregate common stock repurchase authorization to $250 million. As of March 31, 2020, approximately $199 million remained under this authorization. The repurchase authorization does not require the repurchase of a specific number of shares, has an
indefinite term, and is subject to termination at any time by our board of directors. Subject to certain terms and conditions, including a maximum price per share and compliance with federal and state securities and other laws, the repurchases may be made from time to time in open market transactions, privately negotiated transactions, or other transactions, including trades under a plan established in accordance with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended. During the three months ended March 31, 2020, we repurchased 0.1 million shares of our common stock in the open market for approximately $4.9 million under this repurchase authorization using cash on hand. We suspended stock repurchases in mid-March 2020 in response to the uncertainty resulting from the COVID-19 pandemic. Adjusted EBITDA
Management
believes Adjusted EBITDA as defined in our credit agreement is a measure of our ability to service our debt and our ability to make capital expenditures. We reconcile Adjusted EBITDA to Net income and to Net cash provided by operating activities.
We use Adjusted EBITDA on a consolidated basis as a liquidity measure. We believe this financial measure on a consolidated basis is important in analyzing our liquidity because it is the key component of certain material covenants contained within our credit agreement, which is discussed in more detail in Note 10, Long-term Debt, to the consolidated financial statements accompanying the 2019 Form 10‑K. These covenants are material terms of the credit
agreement. Noncompliance with these financial covenants under our credit agreement—our interest coverage ratio and our leverage ratio—could result in our lenders requiring us to immediately repay all amounts borrowed. If we anticipated a potential covenant violation, we would seek relief from our lenders, which would have some cost to us, and such relief might be on terms less favorable to us than those in our existing credit agreement. In addition, if we cannot satisfy these financial covenants, we would be prohibited under our credit agreement from engaging in certain activities, such as incurring additional indebtedness, paying common stock dividends, making certain payments, and acquiring and disposing of assets. Consequently, Adjusted EBITDA is critical to our assessment of our liquidity.
In general terms, the credit agreement definition of Adjusted EBITDA, therein referred to as “Adjusted Consolidated
EBITDA,”
allows us to add back to consolidated Net income interest expense, income taxes, and depreciation and amortization and then add back to consolidated Net income (1) all unusual or nonrecurring items reducing consolidated Net income (of which only up to $10 million in a year may be cash expenditures), (2) any losses from discontinued operations, (3) non-ordinary course fees, costs and expenses incurred with respect to any litigation or settlement, (4) share-based compensation expense, (5) costs and expenses associated with changes in the fair value of marketable securities, (6) costs and expenses associated with the issuance or prepayment debt and acquisitions, and (7) any restructuring charges not in excess of
20% of Adjusted Consolidated EBITDA. We also subtract from consolidated Net income all unusual or nonrecurring items to the extent they increase consolidated Net income.
Under the credit agreement, the Adjusted EBITDA calculation does not require us to deduct net income attributable to noncontrolling interests or gains on fair value adjustments of hedging and equity instruments, disposal of assets, and development activities. It also does not allow us to add back losses on fair value adjustments of hedging instruments or unusual or nonrecurring cash expenditures in excess of $10 million. These items and amounts, in addition to the items falling within the credit agreement’s “unusual
or nonrecurring” classification, may occur in future periods, but can vary significantly from period to period and may not directly relate to, or be indicative of, our ongoing liquidity or operating performance. Accordingly, the Adjusted EBITDA calculation presented here includes adjustments for them.
Adjusted EBITDA is not a measure of financial performance under generally accepted accounting principles in the United States of America, and the items excluded from Adjusted EBITDA are significant components in understanding and assessing financial performance. Therefore, Adjusted EBITDA should not be considered a substitute for Net income or cash flows from operating, investing, or financing activities. Because Adjusted EBITDA is not a measurement determined in accordance with GAAP and is thus susceptible to varying calculations, Adjusted EBITDA, as presented, may not be comparable
to other similarly titled measures of other companies. Revenues and expenses are measured in accordance with the policies and procedures described in Note 1, Summary of Significant Accounting Policies, to the consolidated financial statements accompanying the 2019 Form 10‑K.
Our Adjusted EBITDA for the three months ended March 31, 2020 and 2019 was as follows (in millions): Reconciliation of Net Income to Adjusted EBITDA
|
| | | | | | | |
| |
| 2020 | | 2019 |
Net income | $ | 108.7 |
| | $ | 125.2 |
|
Loss
from discontinued operations, net of tax, attributable to Encompass Health | 0.1 |
| | 0.5 |
|
Net income attributable to noncontrolling interests | (21.7 | ) | | (22.9 | ) |
Provision
for income tax expense | 27.1 |
| | 30.8 |
|
Interest expense and amortization of debt discounts and fees | 43.2 |
| | 37.2 |
|
Government, class action, and
related settlements | 2.8 |
| | — |
|
Loss on disposal of assets | 0.1 |
| | 1.1 |
|
Depreciation and amortization | 58.8 |
| | 52.5 |
|
Stock-based
compensation expense | 7.1 |
| | 19.4 |
|
Transaction costs | — |
| | 0.6 |
|
Gain on consolidation of Treasure Coast | (2.2 | ) | | — |
|
SARs
mark-to-market impact on noncontrolling interests | — |
| | (0.8 | ) |
Change in fair market value of equity securities | 2.5 |
| | (0.9 | ) |
Payroll taxes on SARs exercise | 1.5 |
| | 0.2 |
|
Adjusted
EBITDA | $ | 228.0 |
| | $ | 242.9 |
|
Reconciliation of Net Cash Provided by Operating Activities to Adjusted EBITDA
|
| | | | | | | |
| |
| 2020 | | 2019 |
Net cash provided by operating activities | $ | 29.3 |
| | $ | 159.9 |
|
Interest
expense and amortization of debt discounts and fees | 43.2 |
| | 37.2 |
|
Equity in net income of nonconsolidated affiliates | 0.8 |
| | 2.5 |
|
Net income attributable
to noncontrolling interests in continuing operations | (21.7 | ) | | (22.9 | ) |
Amortization of debt-related items | (1.4 | ) | | (1.0 | ) |
Distributions from nonconsolidated affiliates | (1.0 | ) | | (2.1 | ) |
Current
portion of income tax expense | 25.7 |
| | 28.2 |
|
Change in assets and liabilities | 154.4 |
| | 36.5 |
|
Cash used in operating activities of discontinued operations | 0.1 |
| | 3.0 |
|
Transaction
costs | — |
| | 0.6 |
|
SARs mark-to-market impact on noncontrolling interests | — |
| | (0.8 | ) |
Change in fair market value of equity securities | 2.5 |
| | (0.9 | ) |
Payroll
taxes on SARs exercise | 1.5 |
| | 0.2 |
|
Other | (5.4 | ) | | 2.5 |
|
Adjusted EBITDA | $ | 228.0 |
| | $ | 242.9 |
|
For
additional information see the “Results of Operations” and “Segment Results of Operations” sections of this Item.
Recent Accounting Pronouncements
For information regarding recent accounting pronouncements, see Note 1, Basis of Presentation, to our condensed consolidated financial statements included under Part I, Item 1, Financial Statements (Unaudited), of this report.
| |
Item 3. | Quantitative and Qualitative
Disclosures about Market Risk |
Our primary exposure to market risk is to changes in interest rates on our variable rate long-term debt. We use sensitivity analysis models to evaluate the impact of interest rate changes on our variable rate debt. As of March 31, 2020, our primary variable rate debt outstanding related to $350.0 million in advances under our revolving credit facility and $261.9 million under our term loan facilities. Assuming outstanding balances were to remain the same, a 1% increase in interest rates would result in an incremental negative cash flow of approximately $5.5 million over the next 12 months, while a 1% decrease in interest rates would result in an incremental
positive cash flow of approximately $5.0 million over the next 12 months. See Note 3, Long-term Debt, and Note 5, Fair Value Measurements, to the condensed consolidated financial statements included in Part I, Item 1, Financial Statements (Unaudited), of this report, for additional information regarding our long-term debt.
| |
Item 4. | Controls
and Procedures |
Evaluation of Disclosure Controls and Procedures
As of the end of the period covered by this report, an evaluation was carried out by our management, including our chief executive officer and chief financial officer, of the effectiveness of our disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) of the Securities Exchange Act of 1934, as amended. Based on our evaluation, our chief executive officer and chief financial officer concluded that our disclosure controls and procedures were effective as of the end of the period covered by this report.
Changes in Internal Control Over Financial Reporting
There have been no changes in our Internal Control over Financial Reporting during the quarter ended March 31,
2020 that have a material effect on our Internal Control over Financial Reporting.
PART II. OTHER INFORMATION
We
provide services in the highly regulated healthcare industry. In the ordinary course of our business, we are a party to various legal actions, proceedings, and claims as well as regulatory and other governmental audits and investigations. These matters could potentially subject us to sanctions, damages, recoupments, fines, and other penalties. Some of these matters have been material to us in the past, and others in the future may, either individually or in the aggregate, be material and adverse to our business, financial position, results of operations, and liquidity. We do not believe any of our pending legal proceedings are material to us, but there can be no assurance our assessment will not change based on future developments.
Additionally, the False Claims Act (the “FCA”)
allows private citizens, called “relators,” to institute civil proceedings on behalf of the United States alleging violations of the FCA. These lawsuits, also known as “qui tam” actions, are common in the healthcare industry and can involve significant monetary damages, fines, attorneys’ fees and the award of bounties to the relators who successfully prosecute or bring these suits to the government. It is possible that qui tam lawsuits have been filed against us, which suits remain under seal, or that we are unaware of such filings or precluded by existing law or court order from discussing or disclosing the filing of such suits. Therefore, from time to time, we may be party to one or more undisclosed qui tam cases brought pursuant to the FCA.
Information
relating to certain legal proceedings in which we are involved is included in Note 9, Contingencies and Other Commitments, to the condensed consolidated financial statements contained in Part I, Item 1, Financial Statements (Unaudited), of this report and should be read in conjunction with the related disclosure previously reported in our Annual Report on Form 10‑K for the year ended December 31, 2019 (the “2019 Form 10‑K”). Except as set forth below, there have been no material changes from the risk factors disclosed in Part I, Item 1A, Risk Factors, of the 2019 Form 10-K. Certain information in those risk factors has been updated by the discussion in the “Executive Overview—Key Challenges” section of Part I, Item 2, Management’s Discussion and Analysis of Financial Condition and Results of Operations, of this report, which section is incorporated by reference herein. The novel coronavirus disease 2019 (“COVID-19”) pandemic has begun to significantly affect our operations, business, and financial condition,
and our liquidity could be negatively impacted, particularly if the operations of acute-care hospitals and physician practices remain disrupted for a significant amount of time.
The COVID-19 pandemic has begun to significantly affect our facilities, employees, business operations, and financial performance, as well as the United States economy and financial markets. The COVID-19 pandemic is still rapidly evolving and much of its impact remains unknown and difficult to predict, with the impact on our operations and financial performance being dependent on numerous factors, including the rate of spread, duration, and geographic coverage of the COVID-19 pandemic; the legal, regulatory, and administrative developments related to the pandemic at federal, state, and local levels; and the infectious disease prevention and control efforts of the
Company, governments, and third parties. We began experiencing a negative impact on our operations and financial results in March 2020, which has continued into the second quarter, and it is likely the COVID-19 pandemic will significantly affect our financial performance for at least the second and third quarters of 2020.
The willingness and ability of patients to seek healthcare services has been negatively affected by restrictive measures, such as travel bans, social distancing, quarantines, and shelter-in-place orders. Acute-care hospitals and physician practices have also significantly reduced the volume of elective procedures. This deferral of elective surgeries, along with the factors noted below, have caused decreased patient volumes in both our inpatient rehabilitation (“IRF”) and home health and hospice segments beginning in mid-March
and continuing into April and May. Other factors related to the COVID-19 pandemic that have led to decreasing patient volumes in our facilities include restrictive visitation policies in place at acute-care hospitals that have served to severely limit access to patients and caregivers by our clinical rehabilitation liaisons and care transition coordinators and heightened anxiety among patients and caregivers regarding the risk of exposure to COVID-19 during acute and post-acute care treatment. Significant outbreaks of COVID-19 in our markets, hospitals or large acute-care referral sources could further increase patient anxiety and unwillingness to seek treatment from us. These factors have contributed, and could in the future contribute, to a decline in new patients for both of our operating segments as well as a lower length of stay of patients in the IRF segment and fewer visits per episode in home health, both of which negatively affect pricing and revenue.
We are experiencing supply chain disruptions as a result of the COVID-19 pandemic, including shortages and delays, and we have experienced, and are likely to continue to experience, significant price increases in equipment, pharmaceuticals and medical supplies, particularly personal protective equipment, or “PPE.” Beginning in March 2020, we experienced increased supply expenses due to higher utilization of PPE and increased purchasing of other medical supplies and cleaning and sanitization materials as well as higher prices for supplies in shortage. Shortages of essential equipment, pharmaceutical, and medical supplies may also limit our ability to admit and treat patients.
Our operations and financial results may be adversely
affected by staffing shortages where employees must self-quarantine due to exposure to COVID-19 or where employees are unavailable due to a lack of childcare or care for elderly family members (social distancing, quarantines and shelter-in-place orders). In addition to staffing shortages, significant outbreaks in our markets or hospitals may reduce employee morale or create labor unrest or other workforce disruptions. Staffing shortages or employee relations issues related to COVID-19 may lead to increased compensation expenses. In April, we initiated a program for eligible frontline employees to earn additional paid time off in recognition of their outstanding efforts responding to the COVID-19 pandemic. We estimate this program will result in up to $50 million of additional Salaries and benefits expense in the second quarter of 2020. We may also experience additional benefit costs related to increased workers’ compensation
claims and group health insurance expenses as a result of the COVID-19 pandemic.
Our operations and financial results may be further adversely affected by future federal or state laws, regulations, orders, or other governmental or regulatory actions addressing the current COVID-19 pandemic or the United States healthcare system, which, if adopted, could result in direct or indirect restrictions on our business, potentially adversely affecting our financial condition, results of operations and cash flow. State and local executive actions in response to the COVID-19 pandemic, such as shelter-in-place orders, facility closures and quarantines, could impair our ability to operate or prevent people from seeking care from us. For example, local health departments have restricted our ability to take patients in certain markets for periods of time in reaction to perceived COVID-19 outbreaks.
We may also be subject to lawsuits from patients, employees and others exposed to COVID-19 at our facilities. Such actions may involve large damage claims as well as substantial defense costs. Our professional and general liability insurance may not cover all claims against us.
Additionally, the Coronavirus Aid, Relief, and Economic Security Act of 2020 (the “CARES Act”), signed into law on March 27, 2020, authorized the cash distribution of relief funds to healthcare providers in response to the COVID-19 pandemic. On April 10, 2020, we began to receive the CARES Act relief fund payments, for which we did not apply,
from the United States Department of Health and Human Services (“HHS”). To date, our inpatient rehabilitation hospitals and home health and hospice agencies have received in aggregate approximately $238 million. On May 7, 2020, we informed HHS we would not accept any of the CARES Act relief funds. We are currently seeking direction on how to process the repayment of those funds.
The foregoing and other disruptions to our business as a result of the COVID-19 pandemic have had and are likely to continue to have an adverse effect on our business and could have a material adverse effect on our business, results of operations, financial condition and cash flows. Furthermore, assessing the CARES Act and numerous regulatory changes and formulating our response to the COVID-19 pandemic have required our management team to devote
extensive resources and are likely to continue to do so in the near future, which negatively affects our ability to implement our business plan and respond to opportunities. To the extent the COVID-19 pandemic adversely affects our business, results of operations, financial condition and cash flows, it may also have the effect of heightening many of the other risks described in this report and the risk factors disclosed in Part I, Item 1A, Risk Factors, of the 2019 Form 10-K.
| |
Item 2. | Unregistered Sales
of Equity Securities and Use of Proceeds |
Unregistered Sales of Equity Securities
As previously disclosed, at the time that Encompass Health acquired its home health and hospice business through the purchase of EHHI Holdings, Inc. (“EHHI”) in December 2014, certain sellers of EHHI who were members of EHHI management (the “Management Investors”) contributed a portion of their shares of EHHI common stock, valued at approximately $64 million on the acquisition date, to a subsidiary of Encompass Health (“Holdings”) that was formed in order to complete the acquisition and that is an indirect parent of EHHI, in exchange for approximately 16.7% of the outstanding shares of common stock of Holdings (the “Rollover Shares”). Pursuant to a stockholders agreement entered into among Encompass Health, Holdings and the Management Investors, the Management
Investors had the right (but not the obligation) after December 31, 2017 to have their Rollover Shares purchased by Encompass Health for a cash purchase price per share equal to their fair value. As of February 20, 2020, the Management Investors had put to Encompass Health for cash all Rollover
Shares except for (i) approximately $45 million worth of the Rollover Shares held by HCHB Consulting, Inc. (“HCHB”), an entity in which April Anthony, the chief executive officer of EHHI and an executive officer of Encompass Health, has a material interest, and (ii) approximately $1 million worth of the
Rollover Shares held by another Management Investor (together with HCHB, the “Subsidiary Shareholders” and, each, a “Subsidiary Shareholder”).
On February 20, 2020, Encompass Health entered into an exchange agreement (each, an “Exchange Agreement”) with each of the Subsidiary Shareholders, pursuant to which they had the right to exchange all of the remaining Rollover Shares held by them for shares of common stock of Encompass Health (the “EHC Shares”). Each of the Exchange Agreements provided that the Subsidiary Shareholder must deliver a written exchange notice (an “Exchange Notice”) to Encompass Health in order to exchange his or her remaining Rollover Shares for EHC Shares. Each Exchange Agreement further provided that the number of EHC Shares to be delivered to the Subsidiary Shareholder
was to be determined by dividing the fair value of the Rollover Shares held by the Subsidiary Shareholder on the date of the Exchange Agreement by the last reported sales price of Encompass Health’s common stock on the New York Stock Exchange (the “NYSE”) on the date of delivery of the Exchange Notice.
On February 20, 2020, Encompass Health received an Exchange Notice from each of the Subsidiary Shareholders. Based on the last sales price of the Company’s common stock on the NYSE on February 20, 2020, the Company delivered an aggregate of 560,957 EHC Shares to the Subsidiary Shareholders on March
6, 2020. The total number of EHC Shares issued from treasury stock to the Subsidiary Shareholders pursuant to the Exchange Agreements represented less than 0.6% of the total number of outstanding shares of the Company’s common stock. The EHC Shares issued to the Subsidiary Shareholders are being issued in a transaction exempt from registration under the Securities Act of 1933, as amended (the “Securities Act”) pursuant to Section 4(a)(2) of the Securities Act.
The foregoing description of the terms of the Exchange Agreements is not intended to be complete and is qualified in its entirety by reference to the Exchange Agreement with HCHB, a copy of which is attached hereto as Exhibit 10.1 and is incorporated herein by reference.
Purchases
of Equity Securities
The following table summarizes our repurchases of equity securities during the three months ended March 31, 2020: |
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Period | | Total Number of Shares (or Units) Purchased(1) | | Average
Price Paid per Share (or Unit) ($) | | Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs | | Maximum Number (or Approximate Dollar Value) of Shares That May Yet Be Purchased Under the Plans or Programs(2) |
January 1 through | | 601 |
| | $ | 79.27 |
| | — |
| | $ | 204,120,171 |
|
| | 54,472 |
| | 82.61 |
| | — |
| | 204,120,171 |
|
March
1 through | | 80,534 |
|
| 67.72 |
| | 80,304 |
| | 199,253,887 |
|
Total | | 135,607 |
| | 73.75 |
| | 80,304 |
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|
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(1) | Except
as noted in the following sentence, the number of shares reported in this column includes the shares purchased under the plan or program as reported in the third column of this table and the shares tendered by employees as payments of the tax liabilities incident to the vesting of previously awarded shares of restricted stock and the exercise price and tax liability incident to the net settlement of an option exercise. In January, 601 shares were purchased pursuant to our Directors’ Deferred Stock Investment Plan. This plan is a nonqualified deferral plan allowing non-employee directors to make advance elections to defer a fixed percentage of their director fees. The plan administrator acquires the shares in the open market which are then held in a rabbi trust. The plan also provides that dividends paid on the shares held for the accounts of the directors will be reinvested in shares of our common stock which will also be held in the trust. The directors’ rights to all
shares in the trust are nonforfeitable, but the shares are only released to the directors after departure from our board. |
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(2) | On October 28, 2013, we announced our board of directors authorized the repurchase of up to $200 million of our common stock. On February 14, 2014, our board approved an increase in this common stock repurchase authorization from $200 million to $250 million. On July 24, 2018, our board approved resetting the aggregate common stock repurchase authorization to $250 million. The repurchase authorization does not require the repurchase of a specific |
number of shares, has an indefinite term, and is subject to termination at any time by our board of directors. Subject to certain terms and conditions, including a maximum price per share and compliance with federal and state securities and other laws, the repurchases may be made from time to time in open market transactions, privately negotiated transactions, or other transactions, including trades under a plan established in accordance with Rule 10b5-1 under the Securities Exchange Act of 1934, as amended.
See
the Exhibit Index immediately following the signature page of this report.
SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this Report to be signed on its behalf by the undersigned thereunto duly authorized. |
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| ENCOMPASS
HEALTH CORPORATION |
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| By: | |
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| | Executive
Vice President and Chief Financial Officer |
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| Date: | |
The exhibits required by Regulation S-K are set forth in the following list and are filed by attachment to this report unless otherwise noted. |
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No. | | Description |
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101 | | Sections of the Encompass Health Corporation Quarterly Report on Form 10-Q for the quarter ended March 31, 2020, formatted in XBRL (eXtensible Business Reporting Language), submitted in the following files: |
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| | 101.INS | | XBRL
Instance Document (the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document) |
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| | 101.SCH | | XBRL Taxonomy Extension Schema Document |
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| | 101.CAL | | XBRL
Taxonomy Extension Calculation Linkbase Document |
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| | 101.DEF | | XBRL Taxonomy Extension Definition Linkbase Document |
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| | 101.LAB | | XBRL
Taxonomy Extension Label Linkbase Document |
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| | 101.PRE | | XBRL Taxonomy Extension Presentation Linkbase Document |
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104 | | | | Cover
Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101) |
+ Management contract or compensatory plan or arrangement.