Amedisys Reports Third Quarter 2021 Financial Results Updates 2021 Guidance

BATON ROUGE, La., Nov. 02, 2021 (GLOBE NEWSWIRE) -- Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three and nine-month periods ended September 30, 2021.

Three-Month Periods Ended September 30, 2021 and 2020

• Net service revenue increased $9.4 million to $553.5 million compared to $544.1 million in 2020.
• Net income attributable to Amedisys, Inc. of $45.0 million compared to $72.0 million (inclusive of a $24.0 million income tax benefit related to executive stock option exercise) in 2020.
• Net income attributable to Amedisys, Inc. per diluted share of $1.37 compared to $2.16 (inclusive of $0.72 income tax benefit related to executive stock option exercise) in 2020.

Adjusted Quarterly Results*

• Adjusted EBITDA of $72.4 million compared to $75.7 million in 2020.
• Adjusted net service revenue of $553.5 million compared to $544.1 million in 2020.
• Adjusted net income attributable to Amedisys, Inc. of $50.5 million compared to $74.6 million (inclusive of a $24.0 million income tax benefit related to executive stock option exercise) in 2020.
• Adjusted net income attributable to Amedisys, Inc. per diluted share of $1.53 compared to $2.24 (inclusive of $0.72 income tax benefit related to executive stock option exercise) in 2020.

Nine-Month Periods Ended September 30, 2021 and 2020

• Net service revenue increased $134.0 million to $1,654.8 million compared to $1,520.8 million in 2020.
• Net income attributable to Amedisys, Inc. of $175.0 million compared to $138.5 million (inclusive of a $24.0 million income tax benefit related to executive stock option exercise) in 2020.
• Net income attributable to Amedisys, Inc. per diluted share of $5.30 compared to $4.16 (inclusive of $0.72 income tax benefit related to executive stock option exercise) in 2020.

Adjusted Year to Date Results*

• Adjusted EBITDA of $234.8 million compared to $195.4 million in 2020.
• Adjusted net service revenue of $1,648.3 million compared to $1,520.8 million in 2020.
• Adjusted net income attributable to Amedisys, Inc. of $157.5 million compared to $153.9 million (inclusive of a $24.0 million income tax benefit related to executive stock option exercise) in 2020.
• Adjusted net income attributable to Amedisys, Inc. per diluted share of $4.77 compared to $4.63 (inclusive of $0.72 income tax benefit related to executive stock option exercise) in 2020.

* See pages 3 and 16 - 18 for the definition and reconciliations of non-GAAP financial measures to GAAP measures.

Updated 2021 Guidance

COVID-19 has continued to impact the operating metrics typically used to forecast both growth and cost 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.

Based upon the above discussion, our updated 2021 guidance is as follows:

• Adjusted net service revenue is anticipated to be in the range of $2.200 billion to $2.205 billion.
• Adjusted EBITDA is anticipated to be in the range of $296 million to $298 million.
• Adjusted diluted earnings per share is anticipated to be in the range of $5.88 to $5.93 based on an estimated 33.0 million shares outstanding.

This guidance excludes the effects of any future acquisitions, if any are made.

Paul B. Kusserow, Chairman and Chief Executive Officer stated, “Though COVID-19 continues to impact all of our lines of business, I am very proud of the efforts of the nearly 21,000 Amedisys employees and thank them for their continued dedication and tireless work throughout this quarter and for the results their work produced. Our operating environment continues to change in real-time and yet we have been able to grow Home Health and Hospice admissions. We have made significant progress on recovering our Hospice Business Development staff and remain very confident in our ability to continue to expand this group, translating into further admissions growth. Though 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. We are well positioned to capitalize on the aging demographics of the U.S. population; our industry leading quality scores make us a provider of choice for those that want to be cared for in their homes; and via our acquisition of Contessa, we have assembled a group of assets that truly differentiate Amedisys from our peers. It is a time unlike any other to be in our spaces and tackling the challenges of COVID-19 has, and continues to, energize our entire organization. My enthusiasm for the future of Amedisys has never been stronger.”

We urge caution in considering the current trends and 2021 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, 2020, 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 Wednesday, November 3, 2021, at 11:00 a.m. ET to discuss its third quarter 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 December 3, 2021 by dialing (877) 660-6853 (Toll-Free) or (201) 612-7415 (Toll) and entering conference ID #13724253.

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. More than 2,900 hospitals and 78,000 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 527 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 418,000 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,” “will,” “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 staff 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, changes in law 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
	Senior Vice President, Finance	Vice President, Marketing & Communications
	(615) 928- 5452	(225) 299-3720
	IR@amedisys.com	kendra.kimmons@amedisys.com

AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)
(Unaudited)

	For the Three-Month Periods Ended September 30,								For the Nine-Month Periods Ended September 30,
		2021				2020				2021				2020
Net service revenue	$	553,485			$	544,070			$	1,654,795			$	1,520,814
Other operating income		(4	)			4,812				13,300				27,592
Cost of service, excluding depreciation and amortization		310,294				297,668				916,188				878,633
General and administrative expenses:
Salaries and benefits		119,373				123,146				349,533				330,329
Non-cash compensation		4,397				7,124				17,860				19,758
Other		55,158				49,348				158,995				142,616
Depreciation and amortization		7,487				8,283				21,763				19,955
Operating expenses		496,709				485,569				1,464,339				1,391,291
Operating income		56,772				63,313				203,756				157,115
Other income (expense):
Interest income		—				31				49				258
Interest expense		(2,730	)			(2,692	)			(6,734	)			(8,675	)
Equity in earnings from equity method investments		1,444				1,435				3,932				2,399
Gain (loss) on equity method investments		—				—				31,092				(2,980	)
Miscellaneous, net		490				122				1,253				662
Total other (expense) income, net		(796	)			(1,104	)			29,592				(8,336	)
Income before income taxes		55,976				62,209				233,348				148,779
Income tax (expense) benefit		(10,731	)			10,202				(57,192	)			(9,175	)
Net income		45,245				72,411				176,156				139,604
Net income attributable to noncontrolling interests		(239	)			(430	)			(1,131	)			(1,147	)
Net income attributable to Amedisys, Inc.	$	45,006			$	71,981			$	175,025			$	138,457
Basic earnings per common share:
Net income attributable to Amedisys, Inc. common stockholders	$	1.38			$	2.20			$	5.36			$	4.26
Weighted average shares outstanding		32,607				32,662				32,658				32,469
Diluted earnings per common share:
Net income attributable to Amedisys, Inc. common stockholders	$	1.37			$	2.16			$	5.30			$	4.16
Weighted average shares outstanding		32,899				33,260				33,021				33,267

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

	September 30, 2021 (unaudited)				December 31, 2020
ASSETS
Current assets:
Cash and cash equivalents	$	124,458			$	81,808
Restricted cash		3,750				1,549
Patient accounts receivable		274,570				255,145
Prepaid expenses		16,080				10,217
Other current assets		14,024				13,265
Total current assets		432,882				361,984
Property and equipment, net of accumulated depreciation of $100,407 and $95,024		20,381				23,719
Operating lease right of use assets		100,028				93,440
Goodwill		1,188,054				932,685
Intangible assets, net of accumulated amortization of $20,309 and $22,973		118,084				74,183
Deferred income taxes		10,111				47,987
Other assets		68,105				33,200
Total assets	$	1,937,645			$	1,567,198
LIABILITIES AND EQUITY
Current liabilities:
Accounts payable	$	41,649			$	42,674
Payroll and employee benefits		155,123				146,929
Accrued expenses		154,264				166,192
Provider relief fund advance		58,535				60,000
Current portion of long-term obligations		13,225				10,496
Current portion of operating lease liabilities		31,553				30,046
Total current liabilities		454,349				456,337
Long-term obligations, less current portion		434,781				204,511
Operating lease liabilities, less current portion		67,723				61,987
Other long-term obligations		31,991				33,622
Total liabilities		988,844				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; 37,659,284 and 37,470,212 shares issued; and 32,590,775 and 32,814,278 shares outstanding		38				38
Additional paid-in capital		720,875				698,287
Treasury stock, at cost 5,068,509 and 4,655,934 shares of common stock		(420,665	)			(319,092	)
Retained earnings		605,016				429,991
Total Amedisys, Inc. stockholders’ equity		905,264				809,224
Noncontrolling interests		43,537				1,517
Total equity		948,801				810,741
Total liabilities and equity	$	1,937,645			$	1,567,198

AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING
(Amounts in thousands, except statistical information)
(Unaudited)

	For the Three-Month Periods Ended September 30,								For the Nine-Month Periods Ended September 30,
		2021				2020				2021				2020
Cash Flows from Operating Activities:
Net income	$	45,245			$	72,411			$	176,156			$	139,604
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		7,487				8,283				21,763				19,955
Non-cash compensation		4,397				7,124				17,860				19,758
Amortization and impairment of operating lease right of use assets		10,479				10,591				30,181				29,149
(Gain) loss on disposal of property and equipment		(72	)			17				(64	)			(77	)
(Gain) loss on equity method investments		—				—				(31,092	)			2,980
Write-off of other comprehensive income		—				—				—				(15	)
Deferred income taxes		12,013				1,274				34,729				(2,762	)
Equity in earnings from equity method investments		(1,444	)			(1,435	)			(3,932	)			(2,399	)
Amortization of deferred debt issuance costs/debt discount		237				216				669				653
Return on equity method investments		1,585				1,175				4,268				3,919
Changes in operating assets and liabilities, net of impact of acquisitions:
Patient accounts receivable		5,149				(2,511	)			(17,638	)			6,486
Other current assets		(9,779	)			(24,748	)			(6,219	)			(28,217	)
Other assets		(886	)			584				(938	)			(91	)
Accounts payable		5,338				4,825				(1,192	)			(1,627	)
Accrued expenses		(7,736	)			(2,396	)			(9,363	)			25,594
Other long-term obligations		(49	)			17,735				(1,785	)			38,481
Operating lease liabilities		(9,417	)			(9,211	)			(27,372	)			(25,576	)
Operating lease right of use assets		(780	)			(851	)			(2,304	)			(2,775	)
Net cash provided by operating activities		61,767				83,083				183,727				223,040
Cash Flows from Investing Activities:
Proceeds from sale of deferred compensation plan assets		101				73				126				94
Proceeds from sale of property and equipment		98				—				140				80
Purchases of property and equipment		(2,244	)			(1,294	)			(5,187	)			(2,995	)
Investments in technology assets		(147	)			—				(147	)			—
Investments in equity method investees		—				—				—				(875	)
Proceeds from sale of equity method investment		—				—				—				17,876
Acquisitions of businesses, net of cash acquired		(262,369	)			—				(264,872	)			(299,723	)
Net cash used in investing activities		(264,561	)			(1,221	)			(269,940	)			(285,543	)
Cash Flows from Financing Activities:
Proceeds from issuance of stock upon exercise of stock options		1,083				3,123				1,706				6,070
Proceeds from issuance of stock to employee stock purchase plan		1,061				914				3,022				2,600
Shares withheld to pay taxes on non-cash compensation		(9,750	)			(47,788	)			(16,694	)			(54,172	)
Noncontrolling interest distribution		(459	)			(300	)			(1,253	)			(672	)
Proceeds from borrowings under term loan		290,312				—				290,312				—
Proceeds from borrowings under revolving line of credit		111,500				7,500				500,700				432,000
Repayments of borrowings under revolving line of credit		(141,500	)			(97,500	)			(551,700	)			(357,000	)
Principal payments of long-term obligations		(501	)			(2,685	)			(5,893	)			(7,360	)
Debt issuance costs		(2,792	)			—				(2,792	)			—
Purchase of company stock		(10,805	)			—				(84,879	)			—
Provider relief fund advance		207				(10,000	)			(1,465	)			60,000
Net cash provided by (used in) financing activities		238,356				(146,736	)			131,064				81,466
Net increase (decrease) in cash, cash equivalents and restricted cash		35,562				(64,874	)			44,851				18,963
Cash, cash equivalents and restricted cash at beginning of period		92,646				180,327				83,357				96,490
Cash, cash equivalents and restricted cash at end of period	$	128,208			$	115,453			$	128,208			$	115,453
Supplemental Disclosures of Cash Flow Information:
Cash paid for interest	$	1,565			$	1,610			$	3,479			$	4,902
Cash paid for income taxes, net of refunds received	$	16,815			$	22,137			$	25,482			$	30,290
Cash paid for operating lease liabilities	$	10,197			$	10,062			$	29,676			$	28,351
Cash paid for finance lease liabilities	$	492			$	497			$	1,509			$	1,483
Supplemental Disclosures of Non-Cash Activity:
Right of use assets obtained in exchange for operating lease liabilities	$	14,192			$	10,982			$	34,881			$	29,876
Right of use assets obtained in exchange for finance lease liabilities	$	287			$	335			$	814			$	822
Reductions to right of use assets resulting from reductions to operating lease liabilities	$	279			$	360			$	1,183			$	767
Days revenue outstanding		43.5				40.0				43.5				40.0

(1) Our calculation of days revenue outstanding, net is derived by dividing our ending patient accounts receivable at September 30, 2021 and 2020 by our average daily net patient service revenue for the three-month periods ended September 30, 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 September 30,
		2021				2020
Financial Information (in millions):
Medicare	$	228.2			$	222.2
Non-Medicare		110.4				103.8
Net service revenue		338.6				326.0
Other operating income		—				2.6
Cost of service		190.1				180.0
Gross margin		148.5				148.6
Other operating expenses		82.4				78.8
Depreciation and amortization		1.1				1.0
Operating income	$	65.0			$	68.8
Same Store Growth (1):
Medicare revenue		2	%			5	%
Non-Medicare revenue		6	%			4	%
Total admissions		1	%			5	%
Total volume (2) (6)		1	%			6	%
Key Statistical Data - Total (3):
Admissions		86,732				85,578
Recertifications (6)		46,919				46,186
Total volume (6)		133,651				131,764
Medicare completed episodes		78,318				77,552
Average Medicare revenue per completed episode (4)	$	2,969			$	2,886
Medicare visits per completed episode (5)		13.8				14.4
Visiting Clinician Cost per Visit	$	94.24			$	89.10
Clinical Manager Cost per Visit	$	9.85			$	8.91
Total Cost per Visit	$	104.09			$	98.01
Visits		1,826,505				1,836,895
	For the Nine-Month Periods Ended September 30,
		2021				2020
Financial Information (in millions):
Medicare	$	684.4			$	619.0
Non-Medicare		332.1				300.8
Net service revenue		1,016.5				919.8
Other operating income		7.3				17.7
Cost of service		563.5				543.8
Gross margin		460.3				393.7
Other operating expenses		243.8				226.7
Depreciation and amortization		3.3				2.9
Operating income	$	213.2			$	164.1
Same Store Growth (1):
Medicare revenue		10	%			(4	%)
Non-Medicare revenue		10	%			2	%
Total admissions		8	%			(1	%)
Total volume (2)(6)		6	%			1	%
Key Statistical Data - Total (3):
Admissions		265,933				245,880
Recertifications (6)		136,744				132,811
Total volume (6)		402,677				378,691
Medicare completed episodes		232,838				221,848
Average Medicare revenue per completed episode (4)	$	2,962			$	2,811
Medicare visits per completed episode (5)		14.0				15.2
Visiting Clinician Cost per Visit	$	91.94			$	88.64
Clinical Manager Cost per Visit	$	9.54			$	9.10
Total Cost per Visit	$	101.48			$	97.74
Visits		5,553,423				5,563,992

(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 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 September 30,
		2021				2020
Financial Information (in millions):
Medicare	$	187.8			$	189.0
Non-Medicare		9.7				10.7
Net service revenue		197.5				199.7
Other operating income		—				1.7
Cost of service		107.6				104.1
Gross margin		89.9				97.3
Other operating expenses		49.5				47.8
Depreciation and amortization		0.7				0.6
Operating income	$	39.7			$	48.9
Same Store Growth (1):
Medicare revenue		(1	%)			3	%
Hospice admissions		1	%			9	%
Average daily census		(5	%)			—	%
Key Statistical Data - Total (2):
Hospice admissions		13,292				13,026
Average daily census		13,272				13,953
Revenue per day, net	$	161.74			$	155.57
Cost of service per day	$	88.06			$	81.05
Average discharge length of stay		94				101
	For the Nine-Month Periods Ended September 30,
		2021				2020
Financial Information (in millions):
Medicare	$	556.2			$	516.5
Non-Medicare		30.7				29.7
Net service revenue		586.9				546.2
Other operating income		6.0				8.9
Cost of service		314.4				293.1
Gross margin		278.5				262.0
Other operating expenses		144.4				127.4
Depreciation and amortization		2.0				1.7
Operating income	$	132.1			$	132.9
Same Store Growth (1):
Medicare revenue		—	%			4	%
Hospice admissions		3	%			3	%
Average daily census		(4	%)			1	%
Key Statistical Data - Total (2):
Hospice admissions		39,650				35,755
Average daily census		13,282				12,841
Revenue per day, net	$	161.87			$	155.23
Cost of service per day	$	86.68			$	83.29
Average discharge length of stay		95				98

(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, start-ups and denovos.

Segment Information - Personal Care

	For the Three-Month Periods Ended September 30,
		2021			2020
Financial Information (in millions):
Medicare	$	—		$	—
Non-Medicare		15.9			18.4
Net service revenue		15.9			18.4
Other operating income		—			0.5
Cost of service		11.7			13.5
Gross margin		4.2			5.4
Other operating expenses		2.6			3.2
Depreciation and amortization		0.1			—
Operating income	$	1.5		$	2.2
Key Statistical Data - Total:
Billable hours		558,227			673,161
Clients served		8,697			10,153
Shifts		240,736			280,470
Revenue per hour	$	28.44		$	27.33
Revenue per shift	$	65.95		$	65.59
Hours per shift		2.3			2.4

	For the Nine-Month Periods Ended September 30,
		2021			2020
Financial Information (in millions):
Medicare	$	—		$	—
Non-Medicare		49.9			54.8
Net service revenue		49.9			54.8
Other operating income		—			1.0
Cost of service		37.4			41.7
Gross margin		12.5			14.1
Other operating expenses		8.8			9.5
Depreciation and amortization		0.2			0.1
Operating income	$	3.5		$	4.5
Key Statistical Data - Total:
Billable hours		1,774,965			2,067,958
Clients served		11,597			14,057
Shifts		759,242			896,141
Revenue per hour	$	28.11		$	26.51
Revenue per shift	$	65.71		$	61.18
Hours per shift		2.3			2.3

Segment Information - High Acuity Care

	For the Three-Month Periods Ended September 30,
		2021				2020
Financial Information (in millions):
Medicare	$	—			$	—
Non-Medicare		1.5				—
Net service revenue		1.5				—
Other operating income		—				—
Cost of service		0.9				—
Gross margin		0.6				—
Other operating expenses		3.9				—
Depreciation and amortization		0.5				—
Operating income	$	(3.8	)		$	—
Key Statistical Data - Total:
Full risk admissions		46				—
Limited risk admissions		188				—
Total admissions		234				—
Direct medical loss ratio		52.6	%			—
Number of joint ventures		8				—
Market penetration		31	%			—
Patient satisfaction		92	%			—
	For the Nine-Month Periods Ended September 30,
		2021				2020
Financial Information (in millions):
Medicare	$	—			$	—
Non-Medicare		1.5				—
Net service revenue		1.5				—
Other operating income		—				—
Cost of service		0.9				—
Gross margin		0.6				—
Other operating expenses		3.9				—
Depreciation and amortization		0.5				—
Operating income	$	(3.8	)		$	—
Key Statistical Data - Total:
Full risk admissions		46				—
Limited risk admissions		188				—
Total admissions		234				—
Direct medical loss ratio		52.6	%			—
Number of joint ventures		8				—
Market penetration		31	%			—
Patient satisfaction		92	%			—

Segment Information - Corporate

	For the Three-Month Periods Ended September 30,
		2021			2020
Financial Information (in millions):
Other operating expenses	$	40.5		$	49.9
Depreciation and amortization		5.1			6.7
Total operating expenses	$	45.6		$	56.6

	For the Nine-Month Periods Ended September 30,
		2021			2020
Financial Information (in millions):
Other operating expenses	$	125.5		$	129.2
Depreciation and amortization		15.8			15.2
Total operating expenses	$	141.3		$	144.4

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 September 30,								For the Nine- Month Periods Ended September 30,
		2021				2020				2021				2020
Net income attributable to Amedisys, Inc.	$	45,006			$	71,981			$	175,025			$	138,457
Add:
Income tax expense (benefit)		10,731				(10,202	)			57,192				9,175
Interest expense, net		2,730				2,661				6,685				8,417
Depreciation and amortization		7,487				8,283				21,763				19,955
Certain items (1)		6,858				3,494				(24,440	)			20,843
Interest component of certain items (1)		(451	)			(558	)			(1,437	)			(1,450	)
Adjusted EBITDA (2) (7)	$	72,361			$	75,659			$	234,788			$	195,397

Adjusted Net Service Revenue Reconciliation:

	For the Three- Month Periods Ended September 30,						For the Nine- Month Periods Ended September 30,
		2021			2020			2021				2020
Net service revenue	$	553,485		$	544,070		$	1,654,795			$	1,520,814
Add:
Certain items (1)		—			—			(6,541	)			—
Adjusted net service revenue (3) (7)	$	553,485		$	544,070		$	1,648,254			$	1,520,814

Adjusted Other Operating Income Reconciliation:

	For the Three- Month Periods Ended September 30,								For the Nine- Month Periods Ended September 30,
		2021				2020				2021				2020
Other operating income	$	(4	)		$	4,812			$	13,300			$	27,592
Add:
Certain items (1)		4				(4,812	)			(13,300	)			(27,592	)
Adjusted other operating income (4) (7)	$	—			$	—			$	—			$	—

Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:

	For the Three- Month Periods Ended September 30,						For the Nine- Month Periods Ended September 30,
		2021			2020			2021				2020
Net income attributable to Amedisys, Inc.	$	45,006		$	71,981		$	175,025			$	138,457
Add:
Certain items (1)		5,474			2,585			(17,495	)			15,424
Adjusted net income attributable to Amedisys, Inc. (5) (7)	$	50,480		$	74,566		$	157,530			$	153,881

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

	For the Three- Month Periods Ended September 30,						For the Nine- Month Periods Ended September 30,
		2021			2020			2021				2020
Net income attributable to Amedisys, Inc. common stockholders per diluted share	$	1.37		$	2.16		$	5.30			$	4.16
Add:
Certain items (1)		0.17			0.08			(0.53	)			0.46
Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share (6) (7)	$	1.53		$	2.24		$	4.77			$	4.63

(1) The following details the certain items for the three and nine-month periods ended September 30, 2021 and 2020:

Certain Items:

	For the Three-Month Period Ended September 30, 2021				For the Nine-Month Period Ended September 30, 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		4				(13,300	)
Certain Items Impacting Cost of Service:
COVID-19 costs		3,513				16,457
Certain Items Impacting Operating Expenses:
Acquisition and integration costs		2,757				6,249
COVID-19 costs		199				576
Pre-acquisition legal settlement		—				1,825
Certain Items Impacting Total Other Income (Expense):
Interest component of certain items		451				1,437
Other (income) expense, net		(66	)			(31,143	)
Total	$	6,858			$	(24,440	)
Net of tax	$	5,474			$	(17,495	)
Diluted EPS	$	0.17			$	(0.53	)

	For the Three-Month Period Ended September 30, 2020				For the Nine-Month Period Ended September 30, 2020
	(Income) Expense				(Income) Expense
Certain Items Impacting Other Operating Income:
CARES Act & State COVID-19 grants	$	(4,812	)		$	(27,592	)
Certain Items Impacting Cost of Service:
COVID-19 costs		4,389				27,399
Severance - reductions in staffing levels		(550	)			4,633
Certain Items Impacting Operating Expenses:
Acquisition and integration costs		3,626				9,561
COVID-19 costs		322				1,385
Severance - reductions in staffing levels		—				271
Certain Items Impacting Total Other Income (Expense):
Interest component of certain items		558				1,450
Other (income) expense, net		(39	)			3,736
Total	$	3,494			$	20,843
Net of tax	$	2,585			$	15,424
Diluted EPS	$	0.08			$	0.46

(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.