EX-99.1 3 exhibit99-2.htm EXHIBIT 99.2 exhibit99-2.htm
1
First Quarter 2010
Earnings Call






Supplemental Slides
Exhibit 99-2
 
 

 
2
The information contained in this presentation includes certain estimates, projections and other forward-
looking information that reflect our current views with respect to future events and financial performance.
These estimates, projections and other forward-looking information are based on assumptions that
HealthSouth believes, as of the date hereof, are reasonable. Inevitably, there will be differences between
such estimates and actual results, and those differences may be material.
There can be no assurance that any estimates, projections or forward-looking information will be realized.
All such estimates, projections and forward-looking information speak only as of the date hereof.
HealthSouth undertakes no duty to publicly update or revise the information contained herein.
You are cautioned not to place undue reliance on the estimates, projections and other forward-looking
information in this presentation as they are based on current expectations and general assumptions and
are subject to various risks, uncertainties and other factors, including those set forth in the Form 10-K for
the year ended December 31, 2009, and our Form 10-Q for the quarter ended March 31, 2010, when filed,
and in other documents we previously filed with the SEC, many of which are beyond our control, that may
cause actual results to differ materially from the views, beliefs and estimates expressed herein.
Note Regarding Presentation of Non-GAAP Financial Measures
The following presentation includes certain “non-GAAP financial measures” as defined in Regulation G
under the Securities Exchange Act of 1934. Schedules are attached that reconcile the non-GAAP financial
measures included in the following presentation to the most directly comparable financial measures
calculated and presented in accordance with Generally Accepted Accounting Principles in the United
States. Our Form 8-K, dated May 4, 2010, to which the following supplemental slides are attached as
Exhibit 99.2, provides further explanation and disclosure regarding our use of non-GAAP financial
measures and should be read in conjunction with these supplemental slides.
Forward-Looking Statements
 
 

 
3
Table of Contents
 
 

 
4
Q1 2010 Highlights
 ü Revenue growth of 3.8%
  Driven by pricing, payor mix, higher patient acuity, and higher discharge
 volume
 ü Discharge growth of 1.1%
  Steep ramp-up in January, due to strong December discharges
  Weather-related disruption to discharge patterns in February
  Strong March discharge growth
 ü High-quality, cost-effective patient care
  Continued disciplined expense management and labor productivity gains
  Continued emphasis on quality outcomes
 ü Leverage ratio reduced to 4.2x (1) from 4.3x at year-end.
  
(1) Based on trailing four quarter Adjusted Consolidated EBITDA of $391.0 million; reconciliation to GAAP provided on slides 29 through 30.
 
 

 
5
FIM Gain
LOS Efficiency
LOS Efficiency = Functional gain
divided by length of stay
Source: UDSmr Database - On Demand
Reports: Q1 2010 Report
FIM Gain = Change in Functional
Independent Measurement (based
on an 18 point assessment) from
Admission to Discharge
** Average = Expected, Risk-adjusted LOS Efficiency
High-Quality Care
 * Average = Expected, Risk-adjusted FIM Change Average
 
 

 
6
Revenues (Q1 2010 vs. Q1 2009)
 Inpatient revenue growth was driven by:
  2.5% Medicare market basket increase effective October 1, 2009
  Discharge growth of 1.1% quarter-over-quarter
  Increase in percentage of Medicare patients treated
 Outpatient revenue declined primarily as a result of 10 fewer outpatient satellite clinics
 quarter over quarter.
 
 

 
7
Expenses (Q1 2010 vs. Q1 2009)
 Disciplined expense management
 Solid labor productivity as reflected in EPOB
 
 

 
8
Adjusted Consolidated EBITDA(1) (Q1 2010 vs. Q1 2009)
(1) Reconciliation to GAAP provided on slides 29 through 30.
In arriving at Adjusted Consolidated EBITDA, the following were excluded from line items:
(2) Restructuring charges associated with closed outpatient satellite clinics of $0.0, $0.0, and $0.3 million, respectively, which reduced occupancy costs.
(3) Stock-based compensation expense of $3.8, $3.7, and $13.4 million, respectively, which reduced general and administrative expenses.
(4) Impairments related to investments of $0.0, $0.7 and $1.4 million, respectively, which increased other income.
(5) Noncontrolling interests related to discontinued operations of $0.0, $0.3 and $0.6 million, respectively, which reduced noncontrolling interests expense.
Adjusted Consolidated EBITDA increased $8.0 million, or 8.1%, Q1 2010 vs. Q1 2009
(Millions)
 
Q1 2010
 
Q1 2009
 
2009
Net operating revenues
 
$ 491.0
 
$ 472.9
 
$ 1,911.1
Operating expenses:
 
 
 
 
 
 
 Salaries and benefits
 
241.9
 
233.3
 
948.8
  Hospital-related expenses:
 
 
 
 
 
 
 Other operating expenses
 
66.9
 
66.9
 
271.4
 Supplies
 
28.3
 
27.4
 
112.4
 Occupancy costs (2)
 
11.6
 
12.0
 
47.3
 Provision for doubtful accounts
 
6.9
 
7.8
 
33.1
 
 
113.7
 
114.1
 
464.2
 General and administrative expenses (3)
 
22.5
 
21.8
 
91.1
Equity in nonconsolidated affiliates
 
2.6
 
2.5
 
4.6
Other income (4)
 
0.7
 
0.5
 
4.8
Noncontrolling interests (5)
 
(9.8)
 
(8.3)
 
(33.4)
Adjusted Consolidated EBITDA
 
$ 106.4
 
$ 98.4
 
$ 383.0
 
 

 
9
Adjusted Income per Diluted Share (1) (Q1 2010 vs. Q1
2009)
(1) Reconciliation to GAAP provided on slides 29 through 30.
 The improvement was driven by:
  Higher Adjusted Consolidated EBITDA
  Lower interest expense as a result of lower debt balances and a lower LIBOR rate
 
 5 million shares were issued on September 30, 2009, related to the 2006 securities
 litigation settlement.
 
 

 
10
(1) Notes on page 30.
Net Cash Provided by Operating Activities (Q1 2010 vs. Q1 2009)
 
 
 

 
11
 
Adjusted Free Cash Flow (Q1 2010 vs. Q1 2009)
 
 
 

 
12
 Debt to EBITDA 6.3x 6.3x 5.3x 4.3x 4.2x (1)
($ Billions)
Year-End 2011 Goal: 3.5x to 4.0x
Liquidity
Debt Outstanding and Liquidity
(1) Based on trailing four quarter Adjusted Consolidated EBITDA of $391.0 million; reconciliation to GAAP provided on slides 29 through 30.
 
 

 
13
2010 Guidance: Adjusted Consolidated EBITDA (1)
Guidance
Based on the results of the first quarter, the Company expects its 2010 full-year
performance will be at the high end of the guidance range.
Considerations
ü IT “pilot” investment
ü Integration of acquisitions
ü Start-up costs at two new hospitals
ü TeamWorks investment
(1) Reconciliation to GAAP provided on slides 29 through 30.
 
 

 
14
2010 Guidance:Adjusted Earnings per Diluted Share(1)
Guidance
Based on the results of the first quarter, the Company expects its 2010 full-year
performance will be at the high-end of the guidance range.
ü $3 million of additional stock-based compensation expense
ü 5 million more diluted shares (Securities Litigation Settlement)
ü 3-month LIBOR
(1) Reconciliation to GAAP provided on slides 29 through 30.
 
 

 
15
Business Outlook
3.5x to 4.0x Debt to EBITDA (by YE 2011)
(Exclusive of any E&Y settlement)
Organic growth through capacity
expansion and de novos
($60+ million in 2010)
IRF acquisitions/joint ventures
Deleveraging
Growth
 
 
Acquisitions of other,
complementary post-acute services
Reform
1.Pricing
2.Bundling
Sector
Regulation
Pilot/Demonstration
Projects
  LTCH: admission criteria; 25% Rule; MMSEA extension
  Home Health: outliers; reimbursement methodology
Deleveraging, Growth, Reform and Sector Regulation
 Market basket minus 25 bps Market basket minus 10 bps
      and productivity adjustment
 2010 2011 2012 2013
 
 

 
16
Capacity expansions:
  100+ beds 2010
 De novos:
 Acquisitions/Joint Ventures:
  Acquired the rehabilitation unit in Altoona, PA, through a
 newly formed joint venture and relocated its operations to
 one of our hospitals. (Q4 2009)
  Expanded joint venture with St. Vincent Health System in
 Little Rock, AR, through the purchase of a 23-bed rehabilitation
 unit. (Q1 2010)
  Entered into a definitive agreement to purchase Desert Canyon
 Rehabilitation Hospital, a 50-bed inpatient rehabilitation hospital
 located in southwest Las Vegas, NV. (close Q2 2010)
           
Growth
6 - 7 years (2)
2 - 4 years (1)
(1) Average investment per bed: $100 K to $250 K
(2) Average investment per bed: ~ $450 K.
6 - 7 years
Target Cash pay-back
 
 

 
17
Appendix
 
 

 
18
(1) Data provided by UDSMR, a data gathering and analysis organization for the rehabilitation industry; represents ~ 65-70% of industry, including 90 HealthSouth sites.
(2) Includes 90 consolidated HealthSouth inpatient rehab hospitals and six long-term acute-care hospitals.
Discharge Growth - Historical
HealthSouth vs. Industry
Quarterly Discharges
ü HealthSouth’s volume
 growth has outpaced
 competitors’
ü TeamWorks = standardized
 sales & marketing
ü Capacity expansions will
 help facilitate organic
 growth:
  100+ beds will be added
 in 2010.
 Ÿ 
Trailing 4 quarters
Industry Avg. is 1.0%
(1)
(2)
 
 

 
19
Cost-Effective Care
CMS Fiscal Year 2010 IRF Rate Setting File Analysis (1)
 
Freestanding
(2)
Units (2)
Total
 
HealthSouth
 
Hospitals (2)
Number of IRFs
228
953
1,181
 
94
Average # of Discharges per IRF
649
237
316
 
822
Outlier Payments as % of Total
Payments
1.32%
4.08%
3.00%
 
0.43%
Average Estimated Total Payment
per Discharge for FY 2010
$16,452
$16,741
$16,626
 
$15,996
Average Estimated Cost per
Discharge for FY 2010
$14,021
$17,207
$15,945
 
$12,633
Notes:
(1)  All data provided was filtered and compiled from the Centers for Medicare and Medicaid Services (CMS) Fiscal Year 2010 IRF rate setting final
 rule file found at http://www.cms.hhs.gov/InpatientRehabFacPPS/07_DataFiles.asp#TopOfPage. The data presented was developed entirely by
 CMS and is based on its definitions which are different in form and substance from the criteria HealthSouth uses for external reporting purposes.
 Because CMS does not provide its detailed methodology, HealthSouth is not able to reconstruct the CMS projections or the calculation.
(2) The CMS file contains data for each of the 1,181 inpatient rehabilitation facilities used to estimate the policy updates for the FY 2010 Final IRF-
 PPS Rule. Most of the data represents historical information from the CMS fiscal year 2008 period and does not reflect the same HealthSouth
 hospitals in operation today. The data presented was separated into three categories: Freestanding, Units, and HealthSouth. HealthSouth is a
 subset of Freestanding and the Total.
 
 

 
20
Readmission Rates
Note: Use of home health care and hospice is based on care that starts within three days of discharge. Other PAC care starts within one day of
 discharge. Home health use includes episodes that overlap an inpatient stay.
Source: Medicare Payment Advisory Commission, “A Data Book: Healthcare spending and the Medicare program,” Chart 9-3 (June 2008)
 
 

 
21
Future Regulatory Risk
 
IRF
SNF
LTCH
HH
 
 
 
 
 
 
 1. Re-basing payment system
 
No
Yes; RUGS IV
delayed until 10/01/11
(per PPACA)
No
Yes; would be required as part  of
PPACA starting in 2014
 2. Major outlier payment adjustments
 
No
No
 Yes; will occur when
MMSEA relief expires
(short stay outliers)
Yes; 10% cap per agency; 2.5%
taken out of outlier pool (per
PPACA)
 3. Upcoding adjustments
 
No
Yes; occurring in
FY 2010
 Yes; occurring in FY
2010 and proposed
(-2.5%) for FY 2011
 Yes; occurring in CYs  2010
and 2011
 4. Patient criteria
 
 No; 60% Rule
already in place
No
Study dictated as
part of MMSEA
PPACA requires a “face-to-face”
encounter between physicians (or
clinicians working with them) and
patients before HH services are
prescribed
 5. Healthcare Reform
 
 
 
 
 
 Market basket update reductions
 
 Known
 Known
 Known
 Known
 Productivity adjustments
 
 Begins 2012
 Begins 2012
 Begins 2012
 Begins 2015
 Bundling
 
 Pilot to be
 established by 2013
 Pilot to be
 established by 2013
 Pilot to be
 established by 2013
 Pilot to be
 established by 2013
 Independent Medicare Advisory Board
 
 FY 2019
 FY 2015
 FY 2019
 CY 2015
 New quality reporting requirements
 
 Begins 2014
 N/A
 Begins 2014
 N/A
 Value based purchasing
 
 Pilot begins 2016
 Post 2012
 Pilot begins 2016
 Post 2012
 6. Other
 
N/A
N/A
25% Rule will be
reinstituted when MMSEA
moratorium expires
N/A
Regulatory Uncertainty
Sources: Healthcare Reform Bill (PPACA, HERA),CMS Regulatory published rules and MMSEA
 
 

 
22
Payment Sources (Q1 2010 vs. Q1 2009)
(1) Managed Medicare revenues represent ~ 7% and 8% of total revenues for Q1 2010 and Q1 2009, respectively, and are included in
 “Managed care and other discount plans.”
 
 

 
23
Expenses (Sequential)
 
 

 
24
Operational and Labor Metrics (1)
(1) Numbers have been reclassified to reflect current continuing operations.
(2) Represents discharges from HealthSouth’s 90 consolidated hospitals and 6 LTCHs.
(3) Excludes approximately 400 full-time equivalents, who are considered part of corporate overhead with their salaries and benefits included in
 general and administrative expenses in the Company’s consolidated statements of operations. Full-time equivalents included in the above table
 represent HealthSouth employees who participate in or support the operations of the Company’s hospitals.
(4) Employees per occupied bed, or “EPOB,” is calculated by dividing the number of full-time equivalents, including an estimate of full-time
 equivalents from the utilization of contract labor, by the number of occupied beds during each period. The number of occupied beds is determined
 by multiplying the number of licensed beds by the Company’s occupancy percentage.
 
 

 
 
25
4 i A.D. u r e O u A
Debt Profile
Debt Maturities
As of March 31, 2010
= Term Loan maturities
= 10.75% Fixed
= 8.125% Fixed
= Capital leases & term
 loan amortization
(1) The Company had $116.8 million in cash and cash equivalents as of March 31, 2010.
(2) Based on trailing four quarter Adjusted Consolidated EBITDA of $391.0 million; reconciliation to GAAP provided on slides 29 through 30.
3 month
LIBOR
plus
225 bps
3 month
LIBOR
plus
375 bps
 
 

 
26
Interest Rate Swaps
(Millions)
(1) In October 2009, the credit agreement was amended. The maturity for $300 million of the term loan has been extended to 2015. The extended
 portion of the term loan will bear an interest rate of Libor plus 375.
(2) Cash settlements flow through investing activities.
(3) In June 2009, we entered into a receive-fixed rate swap as a mirror offset to $100.0 million of the $1,056 million interest rate swap.
(4) Forward-starting interest rate swaps (designated as cash flow hedges). Cash settlements will flow through operating activities as part of interest
 expense.
Floating Rate Debt Balances
Mar. 31,
2010
 
Floating
Interest Rate
 
 
 
 
 
 
 
Advances under $400 million revolving credit
facility
$ -
 
Libor plus 300
 
 
 
 
 
 
 
Term Loan facility due 2013
 450.9
 
Libor plus 225
 
 
 
 
 
 
 
Term Loan facility due 2015 (1)
 298.5
 
Libor plus 375 (1)
 
 
 
 
 
 
Total
$ 749.4
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notional
Amount
 
Cash payment if LIBOR = 0.30%
 
 
 
2010
 
2011
Swap Settlement
 
 
Q1
Q2
Q3
Q4
 
Q1
Q2
Q3
Q4
Does not Qualify for Hedge Accounting (2)
 
 
 
 
 
 
 
 
 
 
 
Net notional amount of interest rate swaps (3)
$ 884.0
 
11.9
11.2
11.1
11.0
 
10.9
-
-
-
Receive 3 month Libor and pay 5.22% fixed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Does Qualify for Hedge Accounting (4)
 
 
 
 
 
 
 
 
 
 
 
Notional amount of the interest rate swap
$ 100.0
 
 
-
-
-
 
 
0.6
0.6
0.6
Receive 3 month Libor and pay 2.6% fixed
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notional amount of the interest rate swap
$ 100.0
 
 
-
-
-
 
 
0.7
0.7
0.7
Receive 3 month Libor and pay 2.9% fixed
 
 
 
 
 
 
 
 
 
 
 
 
 

 
27
Non-Operating Cash/Tax Position
Cash Refunds as of Mar. 31, 2010
 Federal tax recoveries virtually complete.
 State tax refunds in progress.
  Approx. $6.5 million received in Q1
 2010.
  Approx. $1.1 million net receivable on
  the balance sheet.
Future Cash Tax Payments
 Expect to pay about $5-7 million per year of income
 tax.
  State income tax.
  Alternative Minimum Tax (AMT).
 The Company does not expect to pay significant
 federal income taxes for the next 10-12 years, due
 to approximately $905 million in deferred tax assets
 as of 12/31/09 outlined in the 2009 Form 10-K. The
 majority of the deferred tax assets is related to
 NOLs.
  At this time, we do not believe the use
  of NOLs will be limited before they
  expire, however, no assurances can
  be provided.
 HealthSouth is not currently subject to an annual
 use limitation (AUL) under the Internal Revenue
 Code section 382.
 If we experienced a “change of ownership” as
 defined by the Internal Revenue Code section 382,
 we would be subject to an AUL, which is equal to
 the value of the company at the time of the “change
 of ownership” multiplied by the long-term tax exempt
 rate.
GAAP Considerations
 HealthSouth’s balance sheet currently
 reflects a valuation allowance for the
 potential value of NOLs and future
 deductions. The valuation allowance is
 approximately $893 million.
 
 GAAP tax rate will net to small amount for
 foreseeable future as there will be a
 reduction in the valuation allowance when
 NOLs are utilized.
 
 

 
28
Outstanding Share Summary
(Millions)
Notes:
(1) Completed an equity offering for 8.8 million shares on June 27, 2008.
(2)  Does not include 2.0 million warrants issued in connection with a January 2004 loan repaid to Credit Suisse First Boston. In connection with this
 transaction, we issued warrants to the lender to purchase two million shares of our common stock. Each warrant has a term of ten years from the
 date of issuance and an exercise price of $32.50 per share. The warrants were not assumed exercised for dilutive shares outstanding because
 they were antidilutive in the periods presented.
(3) The agreement to settle our class action securities litigation received final court approval in January 2007. These shares of common stock and
 warrants were issued on September 30, 2009. The 5.0 million of common shares are now included in the outstanding shares. The warrants at a
 strike price of $41.40 were not assumed exercised for the dilutive shares outstanding because they are anti-dilutive in the periods presented.
(4) The difference between the basic and diluted shares outstanding is primarily related to our convertible perpetual preferred stock.
 
 

 
29
Three Months Reconciliation of Net Income to Adjusted Income from
Continuing Operations and Adjusted Consolidated EBITDA
(1) (3) (4)
(1) (2) (3) (4) - Notes on page 30.
 
 
 
 
 
 
 
 
 
Q1 2010
 
Q1 2009
 
2009
(In Millions, Except per Share Data)
 
 
Per Share (2)
 
 
 
Per Share (2)
 
 
 
Per Share (2)
Net income
 
$ 50.5
 
$ 0.54
 
$ 53.5
 
$ 0.61
 
$ 128.8
 
$ 1.45
Loss (income) from discontinued operations, net of tax,
 
 
 
 
 
 
 
 
 
 
 
attributable to HealthSouth
 3.1
 
$ 0.03
 
 3.0
 
 0.03
 
 (1.5)
 
 (0.02)
Net income attributable to noncontrolling interests
 (9.8)
 
 (0.11)
 
 (8.6)
 
 (0.10)
 
 (34.0)
 
 (0.38)
Income from continuing operations attributable to HealthSouth
 43.8
 
 0.47
 
 47.9
 
 0.55
 
 93.3
 
 1.05
 
 
 
 
 
 
 
 
 
 
 
 
 
Government, class action, and related settlements
 -
 
 -
 
 (15.9)
 
 (0.18)
 
 36.7
 
 0.41
Professional fees - accounting, tax, and legal
 2.9
 
 0.03
 
 4.8
 
 0.05
 
 8.8
 
 0.10
Gain on early extinguishment of debt
 -
 
 -
 
 (1.8)
 
 (0.02)
 
 -
 
 -
Loss on interest rate swaps
 4.3
 
 0.05
 
 5.0
 
 0.06
 
 19.6
 
 0.22
Adjustment for prior period amounts in tax provision
 0.9
 
 0.01
 
 (0.3)
 
 (0.00)
 
 (8.8)
 
 (0.10)
Adjusted income from continuing operations
 51.9
 
 0.56
 
 39.7
 
 0.45
 
 149.6
 
 1.68
Adjustment for dilution
 
 
 (0.08)
 
 
 
 (0.06)
 
 
 
 (0.23)
Adjusted income from continuing operations per diluted share
 
 
$ 0.48
 
 
 
$ 0.39
 
 
 
$ 1.45
 
 
 
 
 
 
 
 
 
 
 
 
 
Current period amounts in tax provision
 1.6
 
 
 
 1.5
 
 
 
 5.6
 
 
Interest expense and amortization of debt discounts and fees
 30.5
 
 
 
 34.4
 
 
 
 125.8
 
 
Depreciation and amortization
 18.3
 
 
 
 17.4
 
 
 
 70.9
 
 
 
 
 102.3
 
 
 
 93.0
 
 
 
 351.9
 
 
Other adjustments per the Company's credit agreement:
 
 
 
 
 
 
 
 
 
 
 
Impairment charges, including investments
 -
 
 
 
 0.7
 
 
 
 1.4
 
 
Net noncash loss on disposal of assets
 -
 
 
 
 1.0
 
 
 
 3.5
 
 
Loss on early extinguishment of debt
 0.3
 
 
 
 -
 
 
 
 12.5
 
 
Stock-based compensation expense
 3.8
 
 
 
 3.7
 
 
 
 13.4
 
 
Other
 
 -
 
 
 
 -
 
 
 
 0.3
 
 
Adjusted Consolidated EBITDA
$ 106.4
 
 
 
$ 98.4
 
 
 
$ 383.0
 
 
Weighted average common shares outstanding:
 
 
 
 
 
 
 
 
 
 
 
Basic
 
 
 
 92.7
 
 
 
 87.5
 
 
 
 88.8
Diluted
 
 
 
 108.0
 
 
 
 100.9
 
 
 
 103.3
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
30
Reconciliation Notes
1. Adjusted income from continuing operations and Adjusted Consolidated EBITDA are
 non-GAAP financial measures. The Company’s leverage ratio (Total Consolidated Debt
 to Adjusted Consolidated EBITDA for the trailing four quarters) is, likewise, a non-GAAP
 financial measure. Management and some members of the investment community
 utilize adjusted income from continuing operations as a financial measure and Adjusted
 Consolidated EBITDA and leverage ratio as liquidity measures on an ongoing basis.
 These measures are not recognized in accordance with GAAP and should not be
 viewed as an alternative to GAAP measures of performance or liquidity. In evaluating
 these adjusted measures, the reader should be aware that in the future HealthSouth
 may incur expenses similar to the adjustments set forth above.
2. Per share amounts for each period presented are based on basic weighted average
 common shares outstanding for all amounts except adjusted income from continuing
 operations per diluted share, which is based on diluted weighted average shares
 outstanding. The difference in shares between the basic and diluted shares outstanding
 is primarily related to our convertible perpetual preferred stock.
3. Adjusted income from continuing operations per diluted share and Adjusted
 Consolidated EBITDA are two components of our guidance.
4. The Company’s Credit Agreement allows certain other items to be added to arrive at
 Adjusted Consolidated EBITDA, and there may be certain other deductions required.