Amedisys Reports Fourth Quarter and Year End 2021 Financial Results; Issues 2022 Guidance


BATON ROUGE, La., Feb. 23, 2022 (GLOBE NEWSWIRE) -- Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three-month period and year ended December 31, 2021.

Three-Month Periods Ended December 31, 2021 and 2020

  • Net service revenue increased $8.6 million to $559.3 million compared to $550.7 million in 2020.
  • Net income attributable to Amedisys, Inc. of $34.0 million compared to $45.2 million in 2020.
  • Net income attributable to Amedisys, Inc. per diluted share of $1.04 compared to $1.36 in 2020.

Adjusted Quarterly Results*

  • Adjusted EBITDA of $64.8 million compared to $78.1 million in 2020.
  • Adjusted net service revenue of $559.3 million compared to $550.7 million in 2020.
  • Adjusted net income attributable to Amedisys, Inc. of $38.8 million compared to $49.5 million in 2020.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $1.18 compared to $1.49 in 2020.

Years Ended December 31, 2021 and 2020

  • Net service revenue increased $142.6 million to $2,214.1 million compared to $2,071.5 million in 2020.
  • Net income attributable to Amedisys, Inc. of $209.1 million compared to $183.6 million in 2020.
  • Net income attributable to Amedisys, Inc. per diluted share of $6.34 compared to $5.52 in 2020.

Adjusted Year End Results*

  • Adjusted EBITDA of $299.6 million compared to $273.5 million in 2020.
  • Adjusted net service revenue of $2,207.6 million compared to $2,071.5 million in 2020.
  • Adjusted net income attributable to Amedisys, Inc. of $196.1 million compared to $203.3 million in 2020.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $5.95 compared to $6.11 in 2020.

* See pages 2 and 14-16 for the definition and reconciliations of non-GAAP financial measures to GAAP measures.

2022 Guidance

  • Adjusted net service revenue is anticipated to be in the range of $2.330 billion to $2.365 billion.
  • Adjusted EBITDA is anticipated to be in the range of $275 million to $285 million.
  • Adjusted diluted earnings per share is anticipated to be in the range of $5.23 to $5.45 based on an estimated 33.2 million shares outstanding.

This guidance excludes the effects of any future acquisitions and potential share repurchases, if any are made. COVID-19 has continued to impact the operating metrics typically used to forecast both growth and costs assumptions for both core Amedisys and Contessa. We are basing our guidance on our current operating environment. COVID-19 continues to evolve in both the disease itself as well as disruptions to the healthcare systems and the economy. Any future regulations or government interventions, spike in clinicians and business development staff on quarantine, staffing shortages due to current and proposed federal, state and local vaccine mandates, reduction in elective procedures, change in patient behavior and further decline in senior living occupancy could impact our ability to achieve this guidance.

Paul B. Kusserow, Chairman and Chief Executive Officer stated, “I am very pleased with our fourth quarter and full year 2021 results. Though 2021 saw COVID-19 impact all our lines of business, the effort our nearly 21,000 Amedisys employees showed all year is something I am incredibly proud of. While it is hard to predict when the impacts of COVID-19 will truly subside, we remain very excited about all of the opportunity ahead of us. 2022 is a year that will set us up to capitalize on the aging demographics of the U.S. population which will position us for accelerated growth in the future. We continue to lead the industry in quality, are working through new and innovative workforce optimization initiatives and are seeing tremendous interest in what a combined Amedisys and Contessa platform can offer to payors. I am excited to see all the good that Amedisys will do as we work our way through 2022 and am confident that Chris and team will continue to lead this organization to new levels of success.”

We urge caution in considering the current trends and 2022 guidance disclosed in this press release. The home health, hospice, personal care and high acuity care industries are highly competitive and subject to intensive regulations, and trends are subject to numerous factors, risks, and uncertainties, some of which are referenced in the cautionary language below and others that are described more fully in our reports filed with the Securities and Exchange Commission (“SEC”) including our Annual Report on Form 10-K for the fiscal year ended December 31, 2021, and subsequent Quarterly Reports on Form 10-Q, and current reports on Form 8-K which can be found on the SEC’s internet website, http://www.sec.gov, and our internet website, http://www.amedisys.com.

Earnings Call and Webcast Information

Amedisys will host a conference call on Thursday, February 24, 2022, at 11:00 a.m. ET to discuss its fourth quarter and year end results. To participate on the conference call, please call before 11:00 a.m. ET to either (877) 524-8416 (Toll-Free) or (412) 902-1028 (Toll). A replay of the conference call will be available through March 24, 2022 by dialing (877) 660-6853 (Toll-Free) or (201) 612-7415 (Toll) and entering conference ID #13726704.

A live webcast of the call will be accessible through our website on our Investor Relations section at the following web address: http://investors.amedisys.com.

Non-GAAP Financial Measures

This press release includes reconciliations of the most comparable financial measures calculated and presented in accordance with accounting principles generally accepted in the U.S. (“GAAP”) to non-GAAP financial measures. The non-GAAP financial measures as defined under SEC rules are as follows: (1) adjusted EBITDA, defined as net income attributable to Amedisys, Inc. before net interest expense, provision for income taxes and depreciation and amortization, excluding certain items; (2) adjusted net service revenue, defined as net service revenue excluding certain items; (3) adjusted other operating income, defined as other operating income excluding certain items; (4) adjusted net income attributable to Amedisys, Inc., defined as net income attributable to Amedisys, Inc. excluding certain items; and (5) adjusted net income attributable to Amedisys, Inc. per diluted share, defined as net income attributable to Amedisys, Inc. common stockholders per diluted share excluding certain items. Management believes that these non-GAAP financial measures, when reviewed in conjunction with GAAP financial measures, are useful gauges of our current performance and are also included in internal management reporting. These non-GAAP financial measures should be considered in addition to, and not more meaningful than or as an alternative to the GAAP financial measures presented in this earnings release and the company’s financial statements. Non-GAAP measures as presented herein may not be comparable to similarly titled measures reported by other companies since not all companies calculate these non-GAAP measures consistently.

Additional information

Amedisys, Inc. (the “Company”) is a leading healthcare at home company delivering personalized home health, hospice, personal care and high acuity care services. Amedisys is focused on delivering the care that is best for our patients, whether that is home-based personal care, recovery and rehabilitation after an operation or injury, care focused on empowering our patients to manage a chronic disease, or hospice care at the end of life. Over 3,000 hospitals and 90,000 physicians nationwide have chosen Amedisys as a partner in post-acute care. Founded in 1982, headquartered in Baton Rouge, LA with an executive office in Nashville, TN, Amedisys is a publicly held company. With approximately 21,000 employees in 530 care centers within 38 states and the District of Columbia, Amedisys is dedicated to delivering the highest quality of care to the doorsteps of more than 445,000 patients and clients in need every year. For more information about the Company, please visit: www.amedisys.com.

We use our website as a channel of distribution for important company information. Important information, including press releases, investor presentations and financial information regarding our company, is routinely posted on and accessible on the Investor Relations subpage of our website, which is accessible by clicking on the tab labeled “Investors” on our website home page. Visitors to our website can also register to receive automatic e-mail and other notifications alerting them when new information is made available on the Investor Relations subpage of our website.

Forward-Looking Statements

When included in this press release, words like “believes,” “belief,” “expects,” “strategy,” “plans,” “anticipates,” “intends,” “projects,” “estimates,” “may,” “might,” “could,” “would,” “should” and similar expressions are intended to identify forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements involve a variety of risks and uncertainties that could cause actual results to differ materially from those described therein. These risks and uncertainties include, but are not limited to the following: the impact of the novel coronavirus pandemic (“COVID-19”), including the measures that have been and may be taken by governmental authorities to mitigate it, on our business, financial condition and results of operations; the impact of current and proposed federal, state and local vaccine mandates, including potential staffing shortages; changes in or our failure to comply with existing federal and state laws or regulations or the inability to comply with new government regulations on a timely basis; changes in Medicare and other medical payment levels; our ability to open care centers, acquire additional care centers and integrate and operate these care centers effectively; competition in the healthcare industry; changes in the case mix of patients and payment methodologies; changes in estimates and judgments associated with critical accounting policies; our ability to maintain or establish new patient referral sources; our ability to consistently provide high-quality care; our ability to attract and retain qualified personnel; our ability to keep our patients and employees safe; changes in payments and covered services by federal and state governments; future cost containment initiatives undertaken by third-party payors; our access to financing; our ability to meet debt service requirements and comply with covenants in debt agreements; business disruptions due to natural disasters or acts of terrorism, widespread protests or civil unrest; our ability to integrate, manage and keep our information systems secure; our ability to realize the anticipated benefits of acquisitions, investments and joint ventures; and changes in laws or developments with respect to any litigation relating to the Company, including various other matters, many of which are beyond our control.

Because forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified, you should not rely on any forward-looking statement as a prediction of future events. We expressly disclaim any obligation or undertaking and we do not intend to release publicly any updates or changes in our expectations concerning the forward-looking statements or any changes in events, conditions or circumstances upon which any forward-looking statement may be based, except as required by law.

Contact:Investor Contact:Media Contact:
 Amedisys, Inc.Amedisys, Inc.
 Nick MuscatoKendra Kimmons
 Senior Vice President, FinanceVice President, Marketing & Communications
 (615) 928-5452(225) 299-3720
 IR@amedisys.comkendra.kimmons@amedisys.com
   


 
AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)
   
 For the Three-Month
Periods Ended December 31,
 For the Years Ended
December 31,
 2021
 2020
 2021
 2020
        
 (Unaudited)
      
Net service revenue$559,317  $550,705  $2,214,112  $2,071,519 
Other operating income    6,780   13,300   34,372 
Cost of service, excluding depreciation and amortization 317,168   306,736   1,233,356   1,185,369 
General and administrative expenses:    
Salaries and benefits 125,185   119,119   474,718   449,448 
Non-cash compensation 5,949   6,972   23,809   26,730 
Other 53,718   49,506   212,713   192,122 
Depreciation and amortization 9,138   8,847   30,901   28,802 
Asset impairment charge    4,152      4,152 
Operating expenses 511,158   495,332   1,975,497   1,886,623 
Operating income 48,159   62,153   251,915   219,268 
Other income (expense):    
Interest income    34   49   292 
Interest expense (2,791)  (2,363)  (9,525)  (11,038)
Equity in earnings from equity method investments 1,017   1,567   4,949   3,966 
Gain (loss) on equity method investments 6      31,098   (2,980)
Miscellaneous, net 492   649   1,745   1,311 
Total other (expense) income, net (1,276)  (113)  28,316   (8,449)
Income before income taxes 46,883   62,040   280,231   210,819 
Income tax expense (12,873)  (16,460)  (70,065)  (25,635)
Net income 34,010   45,580   210,166   185,184 
Net loss (income) attributable to noncontrolling interests 37   (429)  (1,094)  (1,576)
Net income attributable to Amedisys, Inc.$34,047  $45,151  $209,072  $183,608 
Basic earnings per common share:               
Net income attributable to Amedisys, Inc. common stockholders$1.04  $1.38  $6.41  $5.64 
Weighted average shares outstanding 32,594   32,825   32,642   32,559 
Diluted earnings per common share:    
Net income attributable to Amedisys, Inc. common stockholders$1.04  $1.36  $6.34  $5.52 
Weighted average shares outstanding 32,823   33,243   32,972   33,268 
                


 
AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except share data)
  
 As of December 31,
 2021
 2020
ASSETS       
Current assets:  
Cash and cash equivalents$42,694  $81,808 
Restricted cash 3,075   1,549 
Patient accounts receivable 274,961   255,145 
Prepaid expenses 10,356   10,217 
Other current assets 25,598   13,265 
Total current assets 356,684   361,984 
Property and equipment, net of accumulated depreciation of $96,937 and $95,024 18,435   23,719 
Operating lease right of use assets 101,257   93,440 
Goodwill 1,196,090   932,685 
Intangible assets, net of accumulated amortization of $19,900 and $22,973 111,190   74,183 
Deferred income taxes 289   47,987 
Other assets 73,023   33,200 
Total assets$1,856,968  $1,567,198 
        
LIABILITIES AND EQUITY       
Current liabilities:       
Accounts payable$38,217  $42,674 
Payroll and employee benefits 141,001   146,929 
Accrued expenses 150,836   166,192 
Provider relief fund advance    60,000 
Current portion of long-term obligations 12,995   10,496 
Current portion of operating lease liabilities 31,233   30,046 
Total current liabilities 374,282   456,337 
Long-term obligations, less current portion 432,075   204,511 
Operating lease liabilities, less current portion 69,309   61,987 
Other long-term obligations 4,979   33,622 
Total liabilities 880,645   756,457 
Equity:       
Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding     
Common stock, $0.001 par value, 60,000,000 shares authorized; 37,674,868 and 37,470,212 shares issued; and 32,509,969 and 32,814,278 shares outstanding 38   38 
Additional paid-in capital 728,118   698,287 
Treasury stock at cost, 5,164,899 and 4,655,934 shares of common stock (435,868)  (319,092)
Retained earnings 639,063   429,991 
Total Amedisys, Inc. stockholders’ equity 931,351   809,224 
Noncontrolling interests 44,972   1,517 
Total equity 976,323   810,741 
Total liabilities and equity$1,856,968  $1,567,198 
        


 
AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING
(Amounts in thousands, except statistical information)
    
 For the Three-Month
Periods Ended December 31,
 For the Years Ended
December 31,
 2021 2020 2021 2020
 (Unaudited)
   
Cash Flows from Operating Activities:    
Net income$34,010  $45,580  $210,166  $185,184 
Adjustments to reconcile net income to net cash provided by operating activities:               
Depreciation and amortization 9,138   8,847   30,901   28,802 
Non-cash compensation 5,949   6,972   23,809   26,730 
Amortization and impairment of operating lease right of use assets 10,183   9,991   40,364   39,140 
(Gain) loss on disposal of property and equipment (60)  47   (124)  (30)
(Gain) loss on equity method investments (6)     (31,098)  2,980 
Write-off of other comprehensive income          (15)
Deferred income taxes 9,853   (23,798)  44,582   (26,560)
Equity in earnings from equity method investments (1,017)  (1,567)  (4,949)  (3,966)
Amortization of deferred debt issuance costs/debt discount 248   216   917   869 
Return on equity method investments 1,075   1,525   5,343   5,444 
Asset impairment charge    4,152      4,152 
Changes in operating assets and liabilities, net of impact of acquisitions:               
Patient accounts receivable (392)  (4,372)  (18,030)  2,114 
Other current assets (5,983)  21,036   (12,202)  (7,181)
Other assets (79)  122   (1,017)  31 
Accounts payable (3,161)  3,568   (4,353)  1,941 
Accrued expenses (17,552)  14,245   (26,915)  39,839 
Other long-term obligations (27,011)  (10,764)  (28,796)  27,717 
Operating lease liabilities (9,273)  (9,119)  (36,645)  (34,695)
Operating lease right of use assets (756)  (769)  (3,060)  (3,544)
Net cash provided by operating activities 5,166   65,912   188,893   288,952 
Cash Flows from Investing Activities:               
Proceeds from the sale of deferred compensation plan assets 9   7   135   101 
Proceeds from the sale of property and equipment 4      144   80 
Purchases of property and equipment (1,115)  (2,337)  (6,302)  (5,332)
Investments in technology assets (272)     (419)   
Purchase of investment (5,200)     (5,200)  (875)
Proceeds from sale of equity method investment          17,876 
Acquisitions of businesses, net of cash acquired (5,093)  765   (269,965)  (298,958)
Net cash used in investing activities (11,667)  (1,565)  (281,607)  (287,108)
Cash Flows from Financing Activities:               
Proceeds from issuance of stock upon exercise of stock options 348   255   2,054   6,325 
Proceeds from issuance of stock to employee stock purchase plan 946   962   3,968   3,562 
Shares withheld to pay taxes on non-cash compensation (204)  (321)  (16,898)  (54,493)
Noncontrolling interest contributions 250      250    
Noncontrolling interest distributions (494)  (450)  (1,747)  (1,122)
Proceeds from borrowings under term loan       290,312    
Proceeds from borrowings under revolving line of credit    252,200   500,700   684,200 
Repayments of borrowings under revolving line of credit    (346,200)  (551,700)  (703,200)
Principal payments of long-term obligations (3,250)  (2,889)  (9,143)  (10,249)
Debt issuance costs       (2,792)   
Provider relief fund advance (58,535)     (60,000)  60,000 
Purchase of company stock (14,999)     (99,878)   
Net cash (used in) provided by financing activities (75,938)  (96,443)  55,126   (14,977)
Net decrease in cash, cash equivalents and restricted cash (82,439)  (32,096)  (37,588)  (13,133)
Cash, cash equivalents and restricted cash at beginning of period 128,208   115,453   83,357   96,490 
Cash, cash equivalents and restricted cash at end of period$45,769  $83,357  $45,769  $83,357 
Supplemental Disclosures of Cash Flow Information:               
Cash paid for interest$1,812  $1,305  $5,291  $6,207 
Cash paid for income taxes, net of refunds received$8,615  $20,431  $34,097  $50,721 
Days revenue outstanding (1) 43.2   40.2   43.2   40.2 

(1) Our calculation of days revenue outstanding at December 31, 2021 and 2020 is derived by dividing our ending patient accounts receivable by our average daily patient revenue for the three-month periods ended December 31, 2021 and 2020, respectively.


AMEDISYS, INC. AND SUBSIDIARIES
SEGMENT INFORMATION
(Amounts in millions, except statistical information)
(Unaudited)

Segment Information - Home Health

 For the Three-Month Periods
Ended December 31,
 2021
 2020
Financial Information (in millions):       
Medicare$230.1  $228.3 
Non-Medicare 107.2   101.1 
Net service revenue 337.3   329.4 
Other operating income    2.5 
Cost of service 193.1   186.1 
Gross margin 144.2   145.8 
Depreciation and amortization 1.0   1.0 
Asset impairment charge    3.4 
Other operating expenses 84.7   80.5 
Operating income$58.5  $60.9 
Same Store Growth (1):       
Medicare revenue 1%  6%
Non-Medicare revenue 6%  %
Total admissions 2%  6%
Total volume (2)(6) 2%  5%
Key Statistical Data - Total (3):       
Admissions 87,142   85,474 
Recertifications (6) 46,390   44,820 
Total volume (6) 133,532   130,294 
        
Medicare completed episodes 78,693   80,008 
Average Medicare revenue per completed episode (4)$2,951  $2,906 
Medicare visits per completed episode (5) 13.7   14.0 
        
Visiting Clinician Cost per Visit$98.16  $92.62 
Clinical Manager Cost per Visit$10.39  $9.38 
Total Cost per Visit$108.55  $102.00 
Visits 1,778,512   1,824,557 


 For the Years Ended
December 31,
 2021
 2020
Financial Information (in millions):       
Medicare$914.5  $847.3 
Non-Medicare 439.3   401.9 
Net service revenue 1,353.8   1,249.2 
Other operating income 7.3   20.2 
Cost of service 756.6   729.9 
Gross margin 604.5   539.5 
Depreciation and amortization 4.3   3.9 
Asset impairment charge    3.4 
Other operating expenses 328.5   307.2 
Operating income$271.7  $225.0 
Same Store Growth (1):       
Medicare revenue 8%  (1%)
Non-Medicare revenue 9%  1%
Total admissions 6%  1%
Total volume (2)(6) 5%  2%
Key Statistical Data - Total (3):       
Admissions 353,075   331,354 
Recertifications (6) 183,134   177,631 
Total volume (6) 536,209   508,985 
        
Medicare completed episodes 311,531   301,856 
Average Medicare revenue per completed episode (4)$2,959  $2,836 
Medicare visits per completed episode (5) 13.9   14.9 
        
Visiting Clinician Cost per Visit$93.44  $89.62 
Clinical Manager Cost per Visit$9.75  $9.17 
Total Cost per Visit$103.19  $98.79 
Visits 7,331,935   7,388,549 

(1) Same store information represents the percent change in our Medicare, Non-Medicare and Total revenue, admissions or volume for the period as a percent of the Medicare, Non-Medicare and Total revenue, admissions or volume of the prior period. Same store is defined as care centers that we have operated for at least the last twelve months and startups that are an expansion of a same store care center.
(2) Total volume includes all admissions and recertifications.
(3) Total includes acquisitions, start-ups and denovos.
(4) Average Medicare revenue per completed episode is the average Medicare revenue earned for each Medicare completed episode of care. Average Medicare revenue per completed episode for the years ended December 31, 2021 and 2020 reflects the transition to PDGM effective January 1, 2020 and the suspension of sequestration effective May 1, 2020.
(5) Medicare visits per completed episode are the home health Medicare visits on completed episodes divided by the home health Medicare episodes completed during the period.
(6) Prior year amounts have been recast to conform to the current year calculation.

Segment Information - Hospice

 For the Three-Month Periods
Ended December 31,
 2021 2020
Financial Information (in millions):       
Medicare$193.9  $193.5 
Non-Medicare 11.0   10.4 
Net service revenue 204.9   203.9 
Other operating income    4.2 
Cost of service 110.8   107.5 
Gross margin 94.1   100.6 
Depreciation and amortization 0.7   0.5 
Asset impairment    0.8 
Other operating expenses 54.0   48.0 
Operating income$39.4  $51.3 
Same Store Growth (1):       
Medicare revenue %  4%
Hospice admissions (1%)  15%
Average daily census (4%)  %
Key Statistical Data - Total (2):       
Hospice admissions 13,857   13,939 
Average daily census 13,237   13,793 
Revenue per day, net$168.24  $160.72 
Cost of service per day$91.01  $84.72 
Average discharge length of stay 90   102 


 For the Years Ended
December 31,
 2021
 2020
Financial Information (in millions):       
Medicare$750.1  $710.0 
Non-Medicare 41.7   40.1 
Net service revenue 791.8   750.1 
Other operating income 6.0   13.1 
Cost of service 425.2   400.6 
Gross margin 372.6   362.6 
Depreciation and amortization 2.7   2.2 
Asset impairment    0.8 
Other operating expenses 198.4   175.4 
Operating income$171.5  $184.2 
Same Store Growth (1):       
Medicare revenue %  4%
Hospice admissions 2%  6%
Average daily census (4%)  1%
Key Statistical Data - Total (2):       
Hospice admissions 53,507   49,694 
Average daily census 13,271   13,081 
Revenue per day, net$163.47  $156.69 
Cost of service per day$87.77  $83.67 
Average discharge length of stay 94   99 

(1) Same store information represents the percent change in our Medicare revenue, Hospice admissions or average daily census for the period as a percent of the Medicare revenue, Hospice admissions or average daily census of the prior period. Same store is defined as care centers that we have operated for at least the last twelve months and startups that are an expansion of a same store care center.
(2) Total includes acquisitions and denovos.

Segment Information - Personal Care

 For the Three-Month Periods
Ended December 31,
 2021
 2020
Financial Information (in millions):       
Medicare$  $ 
Non-Medicare 15.1   17.4 
Net service revenue 15.1   17.4 
Other operating income    0.1 
Cost of service 11.7   13.2 
Gross margin 3.4   4.3 
Depreciation and amortization    0.1 
Other operating expenses 2.4   2.9 
Operating income$1.0  $1.3 
Key Statistical Data - Total:       
Billable hours 500,546   662,163 
Clients served 7,867   10,057 
Shifts 215,167   281,445 
Revenue per hour$30.09  $26.24 
Revenue per shift$69.99  $61.74 
Hours per shift 2.3   2.4 


 For the Years Ended
December 31,
 2021
 2020
Financial Information (in millions):       
Medicare$  $ 
Non-Medicare 65.0   72.2 
Net service revenue 65.0   72.2 
Other operating income    1.1 
Cost of service 49.1   54.9 
Gross margin 15.9   18.4 
Depreciation and amortization 0.2   0.2 
Other operating expenses 11.2   12.4 
Operating income$4.5  $5.8 
Key Statistical Data - Total:       
Billable hours 2,275,511   2,730,121 
Clients served 12,074   15,019 
Shifts 974,409   1,177,586 
Revenue per hour$28.54  $26.45 
Revenue per shift$66.66  $61.31 
Hours per shift 2.3   2.3 
        

Segment Information - High Acuity Care

 For the Three-Month Periods
Ended December 31,
 2021
 2020
Financial Information (in millions):       
Medicare$  $ 
Non-Medicare 2.0    
Net service revenue 2.0    
Other operating income     
Cost of service 1.6    
Gross margin 0.4    
Depreciation and amortization 0.8    
Other operating expenses 6.1    
Operating loss$(6.5) $ 
Key Statistical Data - Total:       
Full risk admissions 61    
Limited risk admissions 225    
Total admissions 286    
Direct medical loss ratio 54.6%   
Number of joint ventures 8    
Market penetration 31%   
Patient satisfaction 97%   


 For the Years Ended
December 31,
 2021
 2020
Financial Information (in millions):       
Medicare$  $ 
Non-Medicare 3.5    
Net service revenue 3.5    
Other operating income     
Cost of service 2.5    
Gross margin 1.0    
Depreciation and amortization 1.3    
Other operating expenses 10.0    
Operating loss$(10.3) $ 
Key Statistical Data - Total:       
Full risk admissions 107    
Limited risk admissions 413    
Total admissions 520    
Direct medical loss ratio 54.0%   
Number of joint ventures 8    
Market penetration 31%   
Patient satisfaction 97%   
        

Segment Information - Corporate

 For the Three-Month Periods
Ended December 31,
 2021 
 2020
Financial Information (in millions):       
Other operating expenses$37.6  $44.0 
Depreciation and amortization 6.6   7.3 
Total operating expenses$44.2  $51.3 


 For the Years Ended
December 31,
 2021
 2020
Financial Information (in millions):       
Other operating expenses$163.1  $173.2 
Depreciation and amortization 22.4   22.5 
Total operating expenses$185.5  $195.7 
        


AMEDISYS, INC. AND SUBSIDIARIES
RECONCILIATION OF NON-GAAP FINANCIAL MEASURES TO GAAP MEASURES
(Amounts in thousands)
(Unaudited)

Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization (“Adjusted EBITDA”) Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
 2021
 2020
 2021
 2020
Net income attributable to Amedisys, Inc.$34,047  $45,151  $209,072  $183,608 
Add:    
Income tax expense 12,873   16,460   70,065   25,635 
Interest expense, net 2,791   2,329   9,476   10,746 
Depreciation and amortization 9,138   8,847   30,901   28,802 
Certain items (1) 6,412   5,815   (18,028)  26,658 
Interest component of certain items (1) (451)  (464)  (1,888)  (1,914)
Adjusted EBITDA (2) (7)$64,810  $78,138  $299,598  $273,535 
                

Adjusted Net Service Revenue Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
 2021
 2020
 2021
 2020
Net service revenue$559,317  $550,705  $2,214,112  $2,071,519 
Add:               
Certain items (1)       (6,541)   
Adjusted net service revenue (3) (7)$559,317  $550,705  $2,207,571  $2,071,519 
                

Adjusted Other Operating Income Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
 2021
 2020
 2021
 2020
Other operating income$  $6,780  $13,300  $34,372 
Add:               
Certain items (1)    (6,780)  (13,300)  (34,372)
Adjusted other operating income (4) (7)$  $  $  $ 
                

Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
 2021
 2020
 2021
 2020
Net income attributable to Amedisys, Inc.$34,047  $45,151  $209,072  $183,608 
Add:               
Certain items (1) 4,764   4,303   (12,923)  19,727 
Adjusted net income attributable to Amedisys, Inc. (5) (7)$38,811  $49,454  $196,149  $203,335 
                

Adjusted Net Income Attributable to Amedisys, Inc. per Diluted Share Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
 2021
 2020
 2021
 2020
Net income attributable to Amedisys, Inc. common stockholders per diluted share$1.04  $1.36  $6.34  $5.52 
Add:               
Certain items (1) 0.15   0.13   (0.39)  0.59 
Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share (6) (7)$1.18  $1.49  $5.95  $6.11 
                

(1) The following details the certain items for the three-month periods and years ended December 31, 2021 and 2020:

Certain Items:

 For the Three-Month Period
Ended December 31, 2021
 For the Year Ended
December 31, 2021
 (Income) Expense
 (Income) Expense
Certain Items Impacting Net Service Revenue:   
Contingency accrual$  $(6,541)
Certain Items Impacting Other Operating Income:   
CARES Act & State COVID-19 grants    (13,300)
Certain Items Impacting Cost of Service:   
COVID-19 costs 4,323   20,780 
Certain Items Impacting Operating Expenses:   
Acquisition and integration costs 1,310   7,559 
COVID-19 costs 140   716 
Pre-acquisition legal settlement    1,825 
Certain Items Impacting Total Other Income (Expense):   
Interest component of certain items 451   1,888 
Other (income) expense, net 188   (30,955)
Total$6,412  $(18,028)
Net of tax$4,764  $(12,923)
Diluted EPS$0.15  $(0.39)
    


 For the Three-Month Period
Ended December 31, 2020
 For the Year Ended
December 31, 2020
 (Income) Expense
 (Income) Expense
Certain Items Impacting Other Operating Income:   
CARES Act & State COVID-19 grants$(6,780) $(34,372)
Certain Items Impacting Cost of Service:   
COVID-19 costs 6,568   33,967 
Severance - reductions in staffing levels    4,633 
Certain Items Impacting Operating Expenses:   
Acquisition and integration costs 1,234   10,795 
COVID-19 costs 177   1,562 
Severance - reductions in staffing levels    271 
Asset impairment 4,152   4,152 
Certain Items Impacting Total Other Income (Expense):   
Interest component of certain items 464   1,914 
Other (income) expense, net    3,736 
Total$5,815  $26,658 
Net of tax$4,303  $19,727 
Diluted EPS$0.13  $0.59 

(2) Adjusted EBITDA is defined as net income attributable to Amedisys, Inc. before net interest expense, provision for income taxes and depreciation and amortization, excluding certain items as described in footnote 1.
(3) Adjusted net service revenue is defined as net service revenue excluding certain items as described in footnote 1.
(4) Adjusted other operating income is defined as other operating income excluding certain items as described in footnote 1.
(5) Adjusted net income attributable to Amedisys, Inc. is defined as net income attributable to Amedisys, Inc. calculated in accordance with GAAP excluding certain items as described in footnote 1.
(6) Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share is defined as diluted income per share calculated in accordance with GAAP excluding the earnings per share effect of certain items as described in footnote 1.
(7) Adjusted EBITDA, adjusted net service revenue, adjusted other operating income, adjusted net income attributable to Amedisys, Inc. and adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share should not be considered as an alternative to, or more meaningful than, income before income taxes or other measures calculated in accordance with GAAP. These calculations may not be comparable to a similarly titled measure reported by other companies, since not all companies calculate these non-GAAP financial measures in the same manner.