Amedisys Reports Fourth Quarter and Year-End 2022 Financial Results, Issues 2023 Guidance, Announces Sale of Its Personal Care Line of Business and Signs Innovative Palliative Care at Home Partnership With BlueCross BlueShield of Tennessee


BATON ROUGE, La., Feb. 15, 2023 (GLOBE NEWSWIRE) -- Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three-month period and year ended December 31, 2022.

Three-Month Periods Ended December 31, 2022 and 2021

  • Net service revenue increased $2.7 million to $562.0 million compared to $559.3 million in 2021.
  • Net income attributable to Amedisys, Inc. of $31.7 million compared to $34.0 million in 2021.
  • Net income attributable to Amedisys, Inc. per diluted share of $0.97 compared to $1.04 in 2021.

Adjusted Quarterly Results*

  • Adjusted EBITDA of $59.9 million compared to $64.8 million in 2021.
  • Adjusted net service revenue of $562.0 million compared to $559.3 million in 2021.
  • Adjusted net income attributable to Amedisys, Inc. of $38.0 million compared to $38.8 million in 2021.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $1.16 compared to $1.18 in 2021.

Years Ended December 31, 2022 and 2021

  • Net service revenue increased $9.1 million to $2,223.2 million compared to $2,214.1 million in 2021.
  • Net income attributable to Amedisys, Inc. of $118.6 million compared to $209.1 million in 2021.
  • Net income attributable to Amedisys, Inc. per diluted share of $3.63 compared to $6.34 in 2021.

Adjusted Year End Results*

  • Adjusted EBITDA of $262.1 million compared to $299.6 million in 2021.
  • Adjusted net service revenue of $2,232.5 million compared to $2,207.6 million in 2021.
  • Adjusted net income attributable to Amedisys, Inc. of $163.4 million compared to $196.1 million in 2021.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $5.01 compared to $5.95 in 2021.

* See below for the definition and reconciliations of non-GAAP financial measures to GAAP measures.

2023 Guidance

  • Adjusted net service revenue is anticipated to be in the range of $2.244 billion to $2.274 billion.
  • Adjusted EBITDA is anticipated to be in the range of $230 million to $240 million.
  • Adjusted diluted earnings per share is anticipated to be in the range of $4.13 to $4.36 based on an estimated 32.9 million shares outstanding.

This guidance excludes the effects of any future acquisitions and potential share repurchases, if any are made.

Personal Care Divestiture

On February 10, 2023, we signed a definitive agreement to sell our personal care line of business (excluding the Florida operations). The divestment is expected to close during the second quarter of 2023.

BlueCross BlueShield of Tennessee Palliative Care Partnership

We also announced a new agreement between Contessa Health Management, LLC, an Amedisys subsidiary, and BlueCross BlueShield of Tennessee to provide members in Middle Tennessee with palliative care in the comfort of their home.

Paul B. Kusserow, Chairman and Chief Executive Officer stated, "I am very pleased with the way we closed out 2022 and thankful for the efforts of our nearly 20,000 associates who helped to deliver a strong quarter of performance. 2022 was a tumultuous year, but we are building momentum and have started 2023 off on the right foot. Our focus on people, growth, clinical optimization and Contessa will pay dividends as we progress throughout 2023, and our commitment to our patients and the highest quality care will help to further differentiate Amedisys. I am also thrilled to announce that we have signed an innovative partnership with BlueCross BlueShield of Tennessee to provide palliative care at home. This partnership is the first true example of the power of a combined Amedisys and Contessa platform, and we are excited to be able to expand our care continuum to best serve BlueCross BlueShield’s membership. Finally, we announced that we will be divesting our personal care line of business. We are committed to building personal care networks and look forward to the continued engagement with our network partners. 2023 will be an exciting year for Amedisys, and we look forward to consistency in our performance, continued innovation across all our lines of business and expanding our reach so that more patients can receive care where they want it most, their homes."

We urge caution in considering the current trends and 2023 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, 2022, 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 16, 2023, 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 16, 2022 by dialing (877) 660-6853 (Toll-Free) or (201) 612-7415 (Toll) and entering conference ID #13735891.

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 102,000 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 20,000 employees in 532 care centers within 37 states and the District of Columbia, Amedisys is dedicated to delivering the highest quality of care to the doorsteps of more than 465,000 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: changes in Medicare and other medical payment levels; changes in payments and covered services by federal and state governments; future cost containment initiatives undertaken by third-party payors; changes in the episodic versus non-episodic mix of our payors or payment methodologies; changes in the case mix of our patients; staffing shortages driven by the competitive labor market; our ability to attract and retain qualified personnel; competition in the healthcare industry; our ability to maintain or establish new patient referral sources; 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; 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; changes in estimates and judgments associated with critical accounting policies; our ability to consistently provide high-quality care; our ability to keep our patients and employees safe; our access to financing; our ability to meet debt service requirements and comply with covenants in debt agreements; business disruptions due to natural or man-made disasters, climate change or acts of terrorism, widespread protests or civil unrest; our ability to open care centers, acquire additional care centers and integrate and operate these care centers effectively; our ability to realize the anticipated benefits of acquisitions, investments and joint ventures; our ability to integrate, manage and keep our information systems secure; the impact of inflation; 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 Muscato
 Kendra Kimmons
  Chief Strategy Officer
 Vice President, Marketing & Communications
  (615) 928-5452 (225) 299-3720
  IR@amedisys.com
 kendra.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,
  2022   2021   2022   2021 
 (Unaudited)    
Net service revenue$562,064  $559,317  $2,223,199  $2,214,112 
Other operating income          13,300 
Cost of service, excluding depreciation and amortization 317,167   317,168   1,260,425   1,233,356 
General and administrative expenses:       
Salaries and benefits 132,003   125,185   508,791   474,718 
Non-cash compensation 570   5,949   16,560   23,809 
Other 60,856   53,718   228,707   212,713 
Depreciation and amortization 5,230   9,138   24,935   30,901 
Impairment charge       3,009    
Operating expenses 515,826   511,158   2,042,427   1,975,497 
Operating income 46,238   48,159   180,772   251,915 
Other income (expense):       
Interest income 70      178   49 
Interest expense (5,781)  (2,791)  (22,228)  (9,525)
Equity in earnings (loss) from equity method investments 397   1,017   (45)  4,949 
Gain on equity method investments    6      31,098 
Miscellaneous, net 412   492   1,567   1,745 
Total other (expense) income, net (4,902)  (1,276)  (20,528)  28,316 
Income before income taxes 41,336   46,883   160,244   280,231 
Income tax expense (9,790)  (12,873)  (42,545)  (70,065)
Net income 31,546   34,010   117,699   210,166 
Net loss (income) attributable to noncontrolling interests 171   37   910   (1,094)
Net income attributable to Amedisys, Inc.$31,717  $34,047  $118,609  $209,072 
Basic earnings per common share:       
Net income attributable to Amedisys, Inc. common stockholders$0.98  $1.04  $3.65  $6.41 
Weighted average shares outstanding 32,511   32,594   32,517   32,642 
Diluted earnings per common share:       
Net income attributable to Amedisys, Inc. common stockholders$0.97  $1.04  $3.63  $6.34 
Weighted average shares outstanding 32,602   32,823   32,653   32,972 


AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except share data)

 As of December 31,
  2022   2021 
ASSETS   
Current assets:   
Cash and cash equivalents$40,540  $42,694 
Restricted cash 13,593   3,075 
Patient accounts receivable 296,785   274,961 
Prepaid expenses 11,628   10,356 
Other current assets 26,415   25,598 
Total current assets 388,961   356,684 
Property and equipment, net of accumulated depreciation of $101,364 and $96,937 16,026   18,435 
Operating lease right of use assets 102,856   101,257 
Goodwill 1,287,399   1,196,090 
Intangible assets, net of accumulated amortization of $14,604 and $19,900 101,167   111,190 
Deferred income tax assets    289 
Other assets 79,836   73,023 
Total assets$1,976,245  $1,856,968 
LIABILITIES AND EQUITY   
Current liabilities:   
Accounts payable$43,735  $38,217 
Payroll and employee benefits 125,387   141,001 
Accrued expenses 137,390   150,836 
Current portion of long-term obligations 15,496   12,995 
Current portion of operating lease liabilities 33,521   31,233 
Total current liabilities 355,529   374,282 
Long-term obligations, less current portion 419,420   432,075 
Operating lease liabilities, less current portion 69,504   69,309 
Deferred income tax liabilities 20,411    
Other long-term obligations 4,808   4,979 
Total liabilities 869,672   880,645 
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; 37,891,186 and 37,674,868 shares issued; and 32,518,278 and 32,509,969 shares outstanding 38   38 
Additional paid-in capital 755,063   728,118 
Treasury stock at cost, 5,372,908 and 5,164,899 shares of common stock (461,200)  (435,868)
Retained earnings 757,672   639,063 
Total Amedisys, Inc. stockholders’ equity 1,051,573   931,351 
Noncontrolling interests 55,000   44,972 
Total equity 1,106,573   976,323 
Total liabilities and equity$1,976,245  $1,856,968 


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,
  2022   2021   2022   2021 
 (Unaudited)    
Cash Flows from Operating Activities:       
Net income$31,546  $34,010  $117,699  $210,166 
Adjustments to reconcile net income to net cash provided by operating activities:       
Depreciation and amortization 5,230   9,138   24,935   30,901 
Non-cash compensation 570   5,949   16,560   23,809 
Amortization and impairment of operating lease right of use assets 11,247   10,183   46,029   40,364 
Loss (gain) on disposal of property and equipment 12   (60)  519   (124)
Gain on equity method investments    (6)     (31,098)
Deferred income taxes 4,346   9,853   23,377   44,582 
Equity in (earnings) loss from equity method investments (397)  (1,017)  45   (4,949)
Amortization of deferred debt issuance costs/debt discount 248   248   991   917 
Return on equity method investments 1,365   1,075   5,163   5,343 
Impairment charge       3,009    
Changes in operating assets and liabilities, net of impact of acquisitions:       
Patient accounts receivable 4,036   (392)  (14,230)  (18,030)
Other current assets 16,404   (5,983)  (3,525)  (12,202)
Other assets 155   (79)  438   (1,017)
Accounts payable (992)  (3,161)  4,894   (4,353)
Accrued expenses (12,592)  (17,552)  (39,382)  (26,915)
Other long-term obligations (9,065)  (27,011)  (8,822)  (28,796)
Operating lease liabilities (10,311)  (9,273)  (41,175)  (36,645)
Operating lease right of use assets (919)  (756)  (3,242)  (3,060)
Net cash provided by operating activities 40,883   5,166   133,283   188,893 
Cash Flows from Investing Activities:       
Proceeds from the sale of deferred compensation plan assets 163   9   252   135 
Proceeds from the sale of property and equipment    4   66   144 
Purchases of property and equipment (1,827)  (1,115)  (6,165)  (6,302)
Investments in technology assets (202)  (272)  (1,050)  (419)
Investment in equity method investee    (200)  (637)  (200)
Purchase of cost method investment    (5,000)  (15,000)  (5,000)
Acquisitions of businesses, net of cash acquired    (5,093)  (71,952)  (269,965)
Net cash used in investing activities (1,866)  (11,667)  (94,486)  (281,607)
Cash Flows from Financing Activities:       
Proceeds from issuance of stock upon exercise of stock options 1,226   348   2,304   2,054 
Proceeds from issuance of stock to employee stock purchase plan 991   946   3,848   3,968 
Shares withheld to pay taxes on non-cash compensation (32)  (204)  (7,981)  (16,898)
Noncontrolling interest contributions 1,401   250   3,501   250 
Noncontrolling interest distributions (136)  (494)  (1,561)  (1,747)
Proceeds from sale of noncontrolling interest 1,876      5,817    
Proceeds from borrowings under term loan          290,312 
Proceeds from borrowings under revolving line of credit 50,500      534,500   500,700 
Repayments of borrowings under revolving line of credit (69,000)     (534,500)  (551,700)
Principal payments of long-term obligations (3,170)  (3,250)  (13,296)  (9,143)
Debt issuance costs          (2,792)
Provider relief fund advance    (58,535)     (60,000)
Purchase of company stock    (14,999)  (17,351)  (99,878)
Payment of accrued contingent consideration       (5,714)   
Net cash (used in) provided by financing activities (16,344)  (75,938)  (30,433)  55,126 
Net increase (decrease) in cash, cash equivalents and restricted cash 22,673   (82,439)  8,364   (37,588)
Cash, cash equivalents and restricted cash at beginning of period 31,460   128,208   45,769   83,357 
Cash, cash equivalents and restricted cash at end of period$54,133  $45,769  $54,133  $45,769 
        
        


        
 For the Three-Month 
Periods Ended December 31,
 For the Years Ended
December 31,
  2022  2021  2022  2021
 (Unaudited)    
Supplemental Disclosures of Cash Flow Information:       
Cash paid for interest$5,786 $1,812 $14,939 $5,291
Cash paid for Infinity ZPIC interest$1,211 $ $12,755 $
Cash paid for income taxes, net of refunds received$431 $8,615 $24,013 $34,097
Supplemental Disclosures of Non-Cash Activity:       
Accrued contingent consideration$ $ $19,195 $
Noncontrolling interest contribution$ $ $8,900 $
Days revenue outstanding (1) 46.1  43.2  46.1  43.2

(1) Our calculation of days revenue outstanding at December 31, 2022 and 2021 is derived by dividing our ending patient accounts receivable by our average daily patient revenue for the three-month periods ended December 31, 2022 and 2021, 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,
  2022   2021 
Financial Information (in millions):   
Medicare$222.8  $230.1 
Non-Medicare 119.8   107.2 
Net service revenue 342.6   337.3 
Cost of service 195.7   193.1 
Gross margin 146.9   144.2 
Depreciation and amortization 0.7   1.0 
Other general and administrative expenses 89.1   84.7 
Operating income$57.1  $58.5 
Same Store Growth (1):   
Medicare revenue (6%)  1%
Non-Medicare revenue 8%  6%
Total admissions 5%  2%
Total volume (2) 1%  2%
Key Statistical Data - Total (3):   
Admissions 94,365   87,142 
Recertifications 44,546   46,390 
Total volume 138,911   133,532 
    
Medicare completed episodes 75,835   78,693 
Average Medicare revenue per completed episode (4)$2,989  $2,951 
Medicare visits per completed episode (5) 12.5   13.7 
    
Visiting clinician cost per visit$103.83  $98.16 
Clinical manager cost per visit 11.73   10.39 
Total cost per visit$115.56  $108.55 
Visits 1,693,215   1,778,512 


 For the Years Ended
December 31,
  2022   2021 
Financial Information (in millions):   
Medicare$891.3  $914.5 
Non-Medicare 464.2   439.3 
Net service revenue 1,355.5   1,353.8 
Other operating income    7.3 
Cost of service 769.0   756.6 
Gross margin 586.5   604.5 
Depreciation and amortization 4.0   4.3 
Other general and administrative expenses 348.5   328.5 
Operating income$234.0  $271.7 
Same Store Growth (1):   
Medicare revenue (5%)  8%
Non-Medicare revenue 2%  9%
Total admissions 3%  6%
Total volume (2) %  5%
Key Statistical Data - Total (3):   
Admissions 374,631   353,075 
Recertifications 178,101   183,134 
Total volume 552,732   536,209 
    
Medicare completed episodes 304,012   311,531 
Average Medicare revenue per completed episode (4)$3,010  $2,959 
Medicare visits per completed episode (5) 12.9   13.9 
    
Visiting clinician cost per visit$99.90  $93.44 
Clinical manager cost per visit 11.08   9.75 
Total cost per visit$110.98  $103.19 
Visits 6,929,137   7,331,935 

(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 reflects the suspension of sequestration for the period January 1, 2021 through March 31, 2022 and the reinstatement of sequestration at 1% effective April 1, 2022 and at 2% effective July 1, 2022.
(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.

Segment Information - Hospice

 For the Three-Month Periods
Ended December 31,
  2022   2021 
Financial Information (in millions):   
Medicare$186.3  $193.9 
Non-Medicare 11.3   11.0 
Net service revenue 197.6   204.9 
Cost of service 103.3   110.8 
Gross margin 94.3   94.1 
Depreciation and amortization 0.6   0.7 
Other general and administrative expenses 51.3   54.0 
Operating income$42.4  $39.4 
Same Store Growth (1):   
Medicare revenue (4%)  %
Hospice admissions (8%)  (1%)
Average daily census (2%)  (4%)
Key Statistical Data - Total (2):   
Hospice admissions 12,629   13,857 
Average daily census 12,878   13,237 
Revenue per day, net$166.82  $168.24 
Cost of service per day$87.21  $91.01 
Average discharge length of stay 94   90 


 For the Years Ended
December 31,
  2022   2021 
Financial Information (in millions):   
Medicare$744.1  $750.1 
Non-Medicare 43.7   41.7 
Net service revenue 787.8   791.8 
Other operating income    6.0 
Cost of service 426.5   425.2 
Gross margin 361.3   372.6 
Depreciation and amortization 2.3   2.7 
Other general and administrative expenses 203.3   198.4 
Operating income$155.7  $171.5 
Same Store Growth (1):   
Medicare revenue (1%)  %
Hospice admissions (1%)  2%
Average daily census (1%)  (4%)
Key Statistical Data - Total (2):   
Hospice admissions 52,656   53,507 
Average daily census 13,091   13,271 
Revenue per day, net$164.88  $163.47 
Cost of service per day$89.26  $87.77 
Average discharge length of stay 91   94 

(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,
  2022  2021
Financial Information (in millions):   
Medicare$ $
Non-Medicare 15.9  15.1
Net service revenue 15.9  15.1
Cost of service 12.3  11.7
Gross margin 3.6  3.4
Depreciation and amortization   
Other general and administrative expenses 2.3  2.4
Operating income$1.3 $1.0
Key Statistical Data - Total:   
Billable hours 453,644  500,546
Clients served 7,720  7,867
Shifts 193,220  215,167
Revenue per hour$35.07 $30.09
Revenue per shift$82.34 $69.99
Hours per shift 2.3  2.3


 For the Years Ended
December 31,
  2022  2021
Financial Information (in millions):   
Medicare$ $
Non-Medicare 61.4  65.0
Net service revenue 61.4  65.0
Cost of service 46.7  49.1
Gross margin 14.7  15.9
Depreciation and amortization 0.1  0.2
Other general and administrative expenses 9.2  11.2
Operating income$5.4 $4.5
Key Statistical Data - Total:   
Billable hours 1,851,563  2,275,511
Clients served 10,448  12,074
Shifts 791,596  974,409
Revenue per hour$33.15 $28.54
Revenue per shift$77.55 $66.66
Hours per shift 2.3  2.3


Segment Information - High Acuity Care

 For the Three-Month Periods
Ended December 31,
  2022   2021 
Financial Information(in millions):   
Medicare$1.9  $ 
Non-Medicare 4.0   2.0 
Net service revenue 5.9   2.0 
Cost of service 5.9   1.6 
Gross margin    0.4 
Depreciation and amortization 0.9   0.8 
Other general and administrative expenses 8.3   6.1 
Operating loss$(9.2) $(6.5)
Key Statistical Data - Total:   
Full risk admissions 108   61 
Limited risk admissions 374   225 
Total admissions 482   286 
    
Full risk revenue per episode$12,282  $11,565 
Limited risk revenue per episode$5,545  $5,740 
      
Number of admitting joint ventures (1) 8   7 


 For the Years Ended December 31,
  2022   2021 
Financial Information (in millions):   
Medicare$5.2  $ 
Non-Medicare 13.3   3.5 
Net service revenue 18.5   3.5 
Cost of service 18.2   2.5 
Gross margin 0.3   1.0 
Depreciation and amortization 3.3   1.3 
Impairment charge 3.0    
Other general and administrative expenses 33.1   10.0 
Operating loss$(39.1) $(10.3)
Key Statistical Data - Total:   
Full risk admissions 448   107 
Limited risk admissions 1,142   413 
Total admissions 1,590   520 
    
Full risk revenue per episode$11,273  $10,457 
Limited risk revenue per episode$5,553  $5,693 
    
Number of admitting joint ventures (1) 8   7 

(1) Prior year count has been recast to include admitting joint ventures only.

Segment Information - Corporate

 For the Three-Month Periods
Ended December 31,
  2022  2021
Financial Information (in millions):   
Other general and administrative expenses$42.3 $37.6
Depreciation and amortization 3.0  6.6
Total operating expenses$45.3 $44.2


 For the Years Ended
December 31,
  2022  2021
Financial Information (in millions):   
Other general and administrative expenses$160.0 $163.1
Depreciation and amortization 15.2  22.4
Total operating expenses$175.2 $185.5


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,
  2022  2021   2022   2021 
Net income attributable to Amedisys, Inc.$31,717 $34,047  $118,609  $209,072 
Add:       
Income tax expense 9,790  12,873   42,545   70,065 
Interest expense, net 5,711  2,791   22,050   9,476 
Depreciation and amortization 5,230  9,138   24,935   30,901 
Certain items (1) 7,441  6,412   58,361   (18,028)
Interest component of certain items (1)   (451)  (4,445)  (1,888)
Adjusted EBITDA (2) (7)$59,889 $64,810  $262,055  $299,598 


Adjusted Net Service Revenue Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
  2022  2021  2022  2021 
Net service revenue$562,064 $559,317 $2,223,199 $2,214,112 
Add:       
Certain items (1)     9,305  (6,541)
Adjusted net service revenue (3) (7)$562,064 $559,317 $2,232,504 $2,207,571 


Adjusted Other Operating Income Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
  2022  2021  2022  2021 
Other operating income$ $ $ $13,300 
Add:       
Certain items (1)       (13,300)
Adjusted other operating income (4) (7)$ $ $ $ 


Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:

 For the Three-Month Periods
Ended December 31,
 For the Years Ended
December 31,
  2022  2021  2022  2021 
Net income attributable to Amedisys, Inc.$31,717 $34,047 $118,609 $209,072 
Add:       
Certain items (1) 6,251  4,764  44,838  (12,923)
Adjusted net income attributable to Amedisys, Inc. (5) (7)$37,968 $38,811 $163,447 $196,149 


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,
  2022  2021  2022  2021 
Net income attributable to Amedisys, Inc. common stockholders per diluted share$0.97 $1.04 $3.63 $6.34 
Add:       
Certain items (1) 0.19  0.15  1.37  (0.39)
Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share (6) (7)$1.16 $1.18 $5.01 $5.95 

(1) The following details the certain items for the three-month periods and years ended December 31, 2022 and 2021:

Certain Items:

 For the Three-Month Period
Ended December 31, 2022
 For the Year Ended
December 31, 2022
 (Income) Expense (Income) Expense
Certain Items Impacting Net Service Revenue:   
Contingency accrual$ $9,305 
Certain Items Impacting Cost of Service:   
COVID-19 costs 1,510  8,747 
Clinical optimization and reorganization costs 33  1,382 
Fuel supplement 261  3,576 
Integration costs   1,712 
Certain Items Impacting General and Administrative Expenses:   
Acquisition and integration costs 1,443  11,298 
COVID-19 costs 107  503 
Executive Board of Directors transition award   3,500 
Severance 993  993 
Legal fees - non-routine   241 
Clinical optimization and reorganization costs 2,247  5,792 
Legal settlement   (1,058)
Fuel supplement 33  251 
Investment impairment   3,009 
Certain Items Impacting Total Other Income (Expense):   
Interest component of certain items   4,445 
Other (income) expense, net 814  4,665 
Total$7,441 $58,361 
Net of tax$6,251 $44,838 
Diluted EPS$0.19 $1.37 


 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 funds   (13,300)
Certain Items Impacting Cost of Service:   
COVID-19 costs 4,323  20,780 
Certain Items Impacting General and Administrative 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)

(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.