Investor Presentation
First Quarter 2009
Exhibit 99
1
n $468 mm - 61% of revenue
n 1,063 skilled nursing facility (SNF)
programs in 37 states
programs in 37 states
n 7.7 million annual patient visits
n Polaris Group - consulting for
long-term care facilities
n VTA Management Services - therapy
and nurse staffing for New York
and nurse staffing for New York
Skilled Nursing Rehabilitation Services (SRS) Div.
Hospital Rehabilitation Services (HRS) Division
n $169 mm - 22% of revenue
n 158 hospital-based programs
n 32 states
n 46,400 inpatient rehabilitation facility
(IRF) and skilled nursing unit
discharges/year
(IRF) and skilled nursing unit
discharges/year
n 1 million annual outpatient visits
Hospital Division (HD)
Healthcare Management Consulting
n $8.7 mm - 1% of revenue
n Phase 2 Consulting - - consulting for
hospitals and health systems
hospitals and health systems
$764 mm consolidated revenues for 12 months ending 3/31/09
1 Not included in consolidated revenues
2 These statistics include the minority-owned rehab hospital
RehabCare at a glance
Operating divisions
Operating divisions
2
n RehabCare delivers services across the post-acute continuum of care, providing the most appropriate
discharge destination for acute patients in need of restorative care
discharge destination for acute patients in need of restorative care
n Less capital intensive/more flexible business model built around partnering with hospitals, SNFs and health
systems through management contracts and joint ventures (where RehabCare has majority interest)
systems through management contracts and joint ventures (where RehabCare has majority interest)
SNF/IRF/LTACH
No post
acute care
acute care
Hospice/Home Health
Source: MedPAC, equity research estimates
1 Of the $21bn SNF market size, $6bn is the market potential for SRS
Patient Discharge Destination
Overview of post-acute settings
65%
13%
Acute care hospital
RehabCare at a glance
The back door to acute care providers
The back door to acute care providers
3
n Manages rehab programs for SNFs
n Each Medicare certified SNF is required to provide physical, speech and occupational therapy, but many lack the
management know-how and/or scale to effectively manage a program
n RehabCare provides a compelling value proposition to our SNF partners
n Access to advanced technology platform that provides for more efficient utilization of therapists and management
resources, improved patient outcomes and increased SNF reimbursement
n Broader array of services
n Better access to scarce therapist labor pool
n Market size¹
n 15,800 Medicare certified skilled nursing facilities
Source: Information available from public filings or from company websites
¹ Source: MedPAC and Congressional Budget Office
Competitive Landscape — # of facilities served
Self-
operated
11,000+
1,063
935
700
661
425
400
300
189
Skilled Nursing Rehabilitation Services
Division overview
Division overview
4
n Strong track record of profitable growth
n Operating earnings decline due to Symphony acquisition in 2006
n Margin recovery with completion of Symphony integration in 2007
YOY growth: 30.9% 35.5% 49.9% 24.4% 5.6% 0.9% 9.5%
Same store: 9.9% 8.4% 1.0%¹ 7.1%¹ 12.4% 12.6% 11.5%
Revenue ($mm)
Note: Includes Symphony acquisition as of July 1, 2006
¹Same store analysis does not include Symphony
% Margin: 6.0% 5.5% (0.3%) 1.7% 5.6% 3.7% 8.5%
Operating Earnings ($mm)
Skilled Nursing Rehabilitation Services
Performance
Performance
5
n Manages hospital-based IRFs and outpatient therapy programs on a contract basis, providing
our partners with:
n Improved clinical outcomes
n Ability to attract ~30% admissions from external sources
n Broader clinical programming (brain, stroke, spinal dysfunction)
n Better access to scarce therapist labor pool
n Better compliance (60% rule, RAC, 3-hour rule)
— Enhanced denial management
Source: Information available from public filings or from company websites
Competitive Landscape
Hospital Rehabilitation Services
Division overview
Division overview
6
n RehabCare offers acute care providers opportunity to
expand post-acute services and deliver a more
coordinated continuum of care for their patient population
expand post-acute services and deliver a more
coordinated continuum of care for their patient population
n Collaborative agreement with West Penn Allegheny Health
System (WPAHS) in October 2008 is an example of this
model
System (WPAHS) in October 2008 is an example of this
model
n Benefits for WPAHS:
n Enhanced clinical services for ever-growing post-acute
population
population
n Improved market share / decreased outmigration
n Improved patient outcomes / creation of “centers of excellence”
n Seamless integration of post-acute services and patient care
coordination through CareNexus
coordination through CareNexus
WPAHS agreement
A continuum of care model
A continuum of care model
7
n Revenue and operating earnings declined due to implementation of the 75% Rule in 2004
n Clear runway to growth given freeze of 75% Rule at 60% starting January 2008
n Revenue and operating earnings rebounded during the second half of 2008 with further growth expected in 2009
YOY growth: 2.6% (0.5%) (5.3%) (8.7%) 0.9% (7.1%) 7.2%
IRFs: 113 120 115 107 113 107 113
Revenue ($mm)
¹includes $1.2 mm pretax charge from a bad debt write-down related to an outpatient
transaction
transaction
Operating Earnings ($mm)
% Margin: 17.3% 11.9% 13.2% 14.0% 13.3% 11.5% 14.6%
1
Hospital Rehabilitation Services
Performance
Performance
8
n Market Size:
n 215+ IRFs
Freestanding IRFs
LTACHs
Competitive Landscape
n Market Size:
n 460+ LTACHs
Source: Information available from public filings or from company websites
¹ Includes minority-owned hospital
Centerre
Hospital Division
Market overview
Market overview
9
n 11 existing hospitals, 2 in development, 2 expansions; one scheduled opening in Q309
n Strategy of partnering with real estate investors/joint venture partners to build hospitals in a capital-
efficient, high ROI fashion
efficient, high ROI fashion
Wholly Owned
Joint Venture
Growing portfolio of post-acute hospitals
10
Revenue ($mm) and discharges
1Includes a $1.5 mm pretax charge related to the cancellation of a planned
acquisition and development project
acquisition and development project
¹
Hospital Division
Performance
Performance
11
Net Earnings ($mm)
Revenue ($mm)
EPS: $0.42 $0.731 $1.052 $0.25 $0.48
¹includes a $0.17 per diluted share impairment charge on an intangible asset
²includes $0.09 per diluted share in charges related to a bad debt write-down of an
outpatient transaction and cancellation of a planned acquisition and development project
outpatient transaction and cancellation of a planned acquisition and development project
Consolidated financial summary
12
n Cash position increased by $10.8 mm in Q109 to provide greater liquidity during credit crisis (net debt
fell from $30 mm at FYE 2008 to $19 mm at 3/31/09)
fell from $30 mm at FYE 2008 to $19 mm at 3/31/09)
n Days sales outstanding improved from 66 days at FYE 2008 to 64 days at 3/31/09
Cash and Cash Equivalents
Total Assets
Total Debt
Stockholders’ Equity
Percent of Debt to Total Capital
Percent of Net Debt (debt less cash) to Total
Capital
Capital
($mm)
$ 27.4
438.4
57.0
267.8
18%
9%
$ 38.2
452.5
57.0
277.4
17%
6%
12/31/08
3/31/09
n Continued strong operating cash flow expected in 2009 with DSO of approximately 66 days
n Capital expenditures anticipated to be approximately $11 million for the remainder of 2009,
primarily related to information systems investments
2009 Outlook:
Consolidated balance sheet
13
LTACHs
IRFs
SNFs
n The Extension Act contained LTACH
-specific provisions through
December 31, 2010, including
stoppage of both the 25% rule and a
short-stay outlier payment provision.
It also instituted a moratorium on
development of new LTACHs.
-specific provisions through
December 31, 2010, including
stoppage of both the 25% rule and a
short-stay outlier payment provision.
It also instituted a moratorium on
development of new LTACHs.
n For FY2009, CMS implemented a
2.7% increase in rates
2.7% increase in rates
n LTACH proposed rule for FY2010
provides a net 0.6% increase
provides a net 0.6% increase
n Prior legislation requires CMS to
report by July 2009 the results of an
LTACH study related to admission
criteria
report by July 2009 the results of an
LTACH study related to admission
criteria
n The SCHIP Extension Act of 2007
eliminated a market basket update
through FY2009
eliminated a market basket update
through FY2009
n IRF proposed rule provides for a
2.4% payment rate update for
FY2010
2.4% payment rate update for
FY2010
n Prior legislation requires CMS to
report by July 2009 the results of an
IRF study related to patient access
report by July 2009 the results of an
IRF study related to patient access
n CMS issued a 3.4% industry rate
increase for FY2009, which became
effective on October 1, 2008
increase for FY2009, which became
effective on October 1, 2008
n SNF proposed rule for FY2010
Medicare reimbursement calls for a
net 1.2% decrease
Medicare reimbursement calls for a
net 1.2% decrease
n Part B therapy cap exceptions
process and physician fee schedule
increase are set to expire December
31, 2009
process and physician fee schedule
increase are set to expire December
31, 2009
Current reimbursement environment
14
Summary
n Under a bundled payment model, a single provider would receive a bundled payment
intended to cover the full cost of care, from hospitalization to 30 days post-discharge
intended to cover the full cost of care, from hospitalization to 30 days post-discharge
n The Senate’s Policy Option paper, issued on April 29, 2009, highlights post-acute
care with discussions on both hospital readmissions and bundling of payments
care with discussions on both hospital readmissions and bundling of payments
n The paper calls for initial implementation of a readmission policy in FY2010 and a
bundled payment system to be phased in beginning FY2015
bundled payment system to be phased in beginning FY2015
n Provides CMS the option to directly pay qualified post-acute providers, as long as the
acute care hospital is involved
acute care hospital is involved
n We believe a bundled payment system will produce a more cost-efficient delivery system
with better patient outcomes
with better patient outcomes
n Also eliminates the need for arbitrary regulations such as the 60% Rule, 25-day LTACH
length-of-stay requirement and the 3-day hospital admission requirement for SNFs
length-of-stay requirement and the 3-day hospital admission requirement for SNFs
n Our bundled payment position paper and rule elimination summary are available for
viewing at www.rehabcare.com
viewing at www.rehabcare.com
n Prompts acute care hospitals to have a post-acute care strategy, which creates
opportunity for new RHB hospital contracts and joint venture partnerships
opportunity for new RHB hospital contracts and joint venture partnerships
Potential Impact
Bundled payment proposal
Impact on post-acute care
Impact on post-acute care
15
§ Strong consolidated revenue and net earnings growth for the full year, with quarterly operating
earnings impacted less by hospital start-up/ramp-up losses than in 2008
earnings impacted less by hospital start-up/ramp-up losses than in 2008
§ In the Skilled Nursing Rehabilitation Services division, 6.5% - 7.5% operating earnings margins for
the remainder of 2009, driven by 6% - 8% year-over-year same store revenue growth; flat to
modest unit growth
the remainder of 2009, driven by 6% - 8% year-over-year same store revenue growth; flat to
modest unit growth
§ For the Hospital Rehabilitation Services division,14% - 16% operating earnings margin, 3% - 5%
year-over-year growth in IRF same store discharges and a stable to modest net increase in units,
with most unit growth occurring in the second half of the year
year-over-year growth in IRF same store discharges and a stable to modest net increase in units,
with most unit growth occurring in the second half of the year
§ In the Hospital division, total year operating losses of $8.4 - $9.4 million, a reduction of $4.5 - $5.5
million compared to fiscal year 2008. Revenue of $145 - $155 million for the full year, driven by
strong growth in mature and de novo hospitals and assuming implementation of the proposed
FY2010 market basket increase for IRFs and a minimal increase for LTACHs. Breakeven
operating earnings in the first half of 2010.
million compared to fiscal year 2008. Revenue of $145 - $155 million for the full year, driven by
strong growth in mature and de novo hospitals and assuming implementation of the proposed
FY2010 market basket increase for IRFs and a minimal increase for LTACHs. Breakeven
operating earnings in the first half of 2010.
2009 Outlook
16
The Post-Acute Continuum
Hospital Division
IT Roadmap
Therapist Solutions
Long-term strategic plan
17
Why RehabCare?
One of the longest tenured post-acute providers (established in 1982)
n Increasing market demand
n Expenditures for post-acute services:
n Grew $20.4 billion from 2000-2007
n Projected to increase 150% by 2016
n Represents 15% of Medicare fee-for-service spending
n First wave of baby boomers enter Medicare in 2011
n Post-acute continuum capabilities
n Offers flexible solutions to clients and partners
n Gives us the ability to withstand market
pressures in any one segment
pressures in any one segment
n Positions us to capitalize on proposed bundled
or episodic payment system
or episodic payment system
18
Why RehabCare?
ü PPS
ü 60% Rule
2 Total debt less cash
ü Part B Therapy Caps
ü LTACH 25% rule
2006-08
10.2%
21.3%
n Enhances competitive advantage in economic
downturns
downturns
n Greater flexibility with potential partners
searching for capital resources
searching for capital resources
n Allows continued evaluation of growth
opportunities
opportunities
Note: Includes Symphony acquisition as of July 1, 2006
¹ Includes $2.7mm in charges related to a bad debt write-down of an outpatient transaction and
cancellation of a planned acquisition and development project in FY2008
cancellation of a planned acquisition and development project in FY2008
FY2006 | FY2007 | FY2008 | Q12009 | |
DSO | 78 | 72 | 66 | 64 |
CFFO | $19 | $52 | $49 | $9 |
Net Debt2 | $111 | $64 | $30 | $19 |
19
Forward-looking statements have been provided pursuant to the safe harbor provisions of
the Private Securities Litigation Reform Act of 1995. Such statements are based on the
Company’s current expectations and could be affected by numerous factors, risks and
uncertainties discussed in the Company’s filings with the Securities and Exchange
Commission, including its most recent annual report on Form 10-K, subsequent quarterly
reports on Form 10-Q and current reports on Form 8-K. Do not rely on forward looking
statements as the Company cannot predict or control many factors that may affect its ability
to achieve the results estimated. The Company makes no promise to update any forward
looking statements whether as a result of changes in underlying factors, new information,
future events or otherwise.
the Private Securities Litigation Reform Act of 1995. Such statements are based on the
Company’s current expectations and could be affected by numerous factors, risks and
uncertainties discussed in the Company’s filings with the Securities and Exchange
Commission, including its most recent annual report on Form 10-K, subsequent quarterly
reports on Form 10-Q and current reports on Form 8-K. Do not rely on forward looking
statements as the Company cannot predict or control many factors that may affect its ability
to achieve the results estimated. The Company makes no promise to update any forward
looking statements whether as a result of changes in underlying factors, new information,
future events or otherwise.
Safe Harbor