AMED - Earnings call transcript Q1 2021

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Operator

Greetings, ladies and gentlemen, and welcome to the Amedisys Q1 2021 Conference Call. [Operator Instructions]. It is now my pleasure to introduce your host, Mr. Nick Muscato. Thank you.

begin. may You

Nick Muscato

supplemental and Investor to operator, ended the investor are press Amedisys XX, filing Form Thank the page with the welcome of results call SEC release, our of discuss A on quarter and of conference related XXXX. X-K the you, available copy to slides Relations the March website. first our

Ginn, Executive will Executive Officer; Financial also call Affairs today's Legal Kusserow, Paul on Operating Chief be Officer; President and from Chief Vice Amedisys Scott Gerard, and Officer. Chris joining and Dave Speaking President us Government and Chief Kemmerly, Chairman And Officer. is Chief

on number statements differ this These These involve actual company's Before to subsequent may or today. as such update than from forward-looking XX-Q include of uncertainties, statements I Litigation available made and statements would forward-looking securities under These we the SEC that other the call, X-K. a to under and results events applicable including risks information Reform our our risks may Amedisys required and filings, cause laws. call statements Act. assumes and information outcomes with obligation on provided which detailed everyone get company our the like call this Private to forward-looking today statements. uncertainties factors materially Securities of are to reflect in are Forms safe started XX-K, to protected harbors on no remind conference The based constitute may

most call Forms I you. and measure be Amedisys' now Regulation Paul will Thank reconciliation to mentioned Kusserow. and G, CEO, our of to GAAP a any And turn In will the measure addition, during our X-K. as the Chairman XX-K, by non-GAAP call over available in XX-Q SEC required comparable

Paul Kusserow

want XX,XXX-plus welcome be for to employees, every First whose Quarter and unwavering our deliver XXXX homes to quarter of thank possible our to And you the nothing our commitment the a strong such would start inspirational. none Amedisys. for Call. good to short in XXXX performance best care patients off one this without to is Amedisys to Thanks, providing their I of Earnings results. Nick, is of helping

and very call performance April through April to us the this music, to be over instead quarter, want turn fortuitous walk for month. have The you the to was few review he developments Chris of Amedisys said I poet usual Scott out heard I to when wrong cruelest Before our our recently occurred. a turned month. T.S. Eliot, who that is has a

and line increase provided over rule proposed business impact given growth substantial top a our rate the our meaningful positive in of hospice in count will it we this very finalized million. represent years. an few rule $X Medicare proposed proposed of expect for proposed We April wage will impact payment be Amedisys rule beneficiaries provided we on X, hospices CMS year First, increase issued line its to in to services XXXX see in on fiscal the for analysis rule, XXXX. our will We don't the they're is X, our not effective and when But serving summer, CMS estimates the before October hospice on rates beginning payments. view update a as index have the Based line updates X.X% favorably with size past incremental the X.X% increase. and hatched. chickens the

Next, XXXX. Medicare of temporary provisions, XX, extends on which, December sequestration suspension among the XX, other Congress through H.R.XXXX, April passed

care access Montgomery to purchase to County. Need XX,XXX including XX-mile we on conduct $XX home a radius area April we to XX, and We allow the within announced County, of definitive of are acquire Certificate to reflect to provide This that Carolina. suspension home updating populist in surrounding Advantage sequestration. operations provides guidance will by enrollees. agreement signed Also, Randolph services a North health million County, Medicare that allows licenses the Randolph us The further us Medicare health service

on We expect close the to XXXX. April transaction XX,

expand As us we ways and for have to for we geographies continuing deploy XXXX. share, market to inorganically said in and look are the to past, our an to important M&A continue throughout grow more is to significant capital tool

increase in these deals expect in small our and represent and geographically bigger do market While active are deals, strong and as are year are they progresses. markets, to presence M&A and more we successful strategic the the

and to to post-acute groups what health an at hospitals, we physician partners for SNF-at-home care. announced of innovative providers, plans, on episodes with Physicians, partner Tuesday Finally, have outcomes Sound a seeking referred transform our to pilot as evening, and post-acute physician we previously leading acute

We such on this high-quality a initiative. industry partner are leader to delighted and be working with

Our in May. pilot launch to is set

be social offering, SDOHs, ADLs, on with living; activities caring them daily health. will for We for on of higher-acuity telemedicine, services the more but home home-based option and care including allowing determinants being cared home robust other in personal care of focused and focused patients, of a the health,

two sites working ready X identified more. to have We locate and and are

we'll the We program, the on are scale. this keep grow acuity learn, and and excited our That's progress news for main updated to you in iterate April. important test, moving up

run-through pentameter, So our performance. laureate, this Chris, do I'll please? you to over iambic poet our in turn for the President first and call Chris a could COO, of Gerard, resident quarter

Christopher Gerard

put I Paul. the moving up Thanks, have to It's now But on. with. things amazing

quality, core look is list. the the we highest things our Always quality. operational frozen Even its care growth. deliver our our If the until follow. we will its do: all data Home Health a to strategic priority people, release, and CMS first are which Let's best good quality, Compare though X at top quarter of results has XXXX as January first, excellence always take delivering to relate pillars, quality what at they

sets have make. frozen, the benchmark is we from data progress using data performance. SHP proud this While extremely I'm continue to our internal we And been of to

of with which X centers care above at our XXX stars, as health In above. benchmark, XXX or XX% fact, centers of and are home X last internal care at stars us our our of puts

perspective, -- on we for frozen reporting has off. For such our proxy This is home a nothing XXXX. is the compare averaged focus paying stars. CMS Much X.X is amazing. This and progress. tremendous teams XXXX, for Congrats health, reporting and home health hospice the resume like short clinical continued in how we performance great in to of quality will metrics

We have set historically item on outperformed the all our performance. strive hospice to and industry improve average continually measures

to collecting will publicly that and been data has They star in class. spring, replicating reporting are Seeing the our structure, Next segment CMS our home coming, for we analytics currently this hospice propelled release. initial home health report scores. have best health

up in us and we are should look being preparation to public perform top home set health. and true the well, by forward in we focus at as having Our benchmarks

quality a without and one that I'm Keeping have energized great develop having can't people our helping driving. committed you our and them by people. and and grow personally Next, great challenge, great to next is

revenue. time initiate to and As a job our than nearly our productive. do effort are When recruit stated XX% time company to are and in bring has is staff them Paul higher again, our It who demand takes talent, and RNs top we keep time clinical Further, of of fulfilled it people. ever. in we

initiative performance turnover within organization. reductions results Making effort very the the effect organization in to down in comp. XX.X% the end during how XX.X%, quarter, continue down turnover is the turnover throughout is all turnover and a business. QX pandemic QX at year. this an that improve It's have phenomenal of I'm reductions in statistics all kind both was QX, board turnover throughout the We XXXX center of report has clinical total nearly across for proud behind Keep and and to forward we to our pleased to really saw I'm of of in home significant which in leadership of and was a our come. XXXX. is pre-pandemic voluntary turnover about both the entire mind, this our quickly RN has story. This improvement lines look care people. So saw health a the in amazing the clinical hospice this the trickle-down staff put from

excellence. operational is Next

the we've per strong in X.X visits our performed sequentially X.X remain with scores. very quality XX.X visits comfortable episode, visits seen For year-over-year. We increases our as levels we quarter, down and VPE

we per we episode, visits stated impact we in quality that And never on improvement will our anything delivering utilization. our achieved with XX.X% consistently to given do promise. a utilization decreased continued in along we're LPN scores. On QX, reminder, home mix, As and that PTA health quality, clinical XX.X%

has our to ability per LPN utilization more come increase As challenging. episode become down, visits have

However, improvement. some there's room still for

future increase growth our Increased our to We visits will And productivity, staff growth. nearly visits in finally, per key our be saw health capacity, FTE episode, with decreased combined year-over-year which home improvements as will X%. increased our also per clinical opportunities. productivity

an total For admissions health, X%, X% impressive we and the volume grew quarter respectively. home in same-store and

growing and weather in tremendous health Our our line growth see Medicare home job quarter. momentum our strong through significant a about of admit the by has business in continued X%. did operations pandemic the which disruption impacted We in first February, that done

XXXX was reminder, significantly most impacted a COVID-XX. the As QX of by

for large that year health So expecting in admissions. number our a we're growth of year-over-year home 'XX guided full target will total growth X% put us QX line in

weather less our event throughout our with in hospice. strong admissions in of admissions working QX growth resulting X% caused growth opportunity We approximately Though increasingly growth. unprecedented XX% saw rate to in mid-February. reaching and sequentially, X%, The a weather QX. lost office was day a admit in Moving X closures, significant same-store XXXX, 'XX of severe increased

our 'XX. 'XX impacted admit COVID-XX volume QX and QX Additionally, in

COVID occurring highest Excluding XXX declined at the the helping cases. in ADC, in growth same-store digits those our single admits volume our with in of length impacting on which net admits, admits of also of initial were the stay 'XX, a that Keep we less COVID peak number 'XX XXXX, This mind basis. in half XXX many back in QX than during XX% these the saw in of with to were January. pandemic, negatively of QX nearly COVID

hire improvements 'XX; we in especially after beneficial in FTEs. to admits a low rates, be in reaching has will continue reaching and of throughout BD our of in point of ability which shorter the see hospice to ADC COVID year. an COVID-XX decline, remainder our As train discharge length stay and target the had length-of-stay median on our impact to our patients, also January

in $X.X Page shows our increase should deck the year. of performing that. catalysts move we training lifted, versus increasing. We to in productivity of of reps forecast, are plan. should the seeing admits our In up million count, we're more our and able of programs and be network BD have staff, hospice in consistency both vaccinated of through the revenue rates, pace working and and plans sources. supplemental are drove XXX% people XX how with referral throughout the roll conversion And we out forecasted restrictions drive second just and stick more volume more COVID-XX home our but increase to the Care, Personal is head we're place, slide approximately our but are year-over-year. the The the the normally population in Small, to at which more network. front XXXX we're as health as for which skeptical combined our ADC in graphically hockey we're increase be half still in access improvements in segments, to in get and is However, our

aide very sick the support and are also responsible Aging for providing services This between signed reimbursement This Massachusetts prove a Services homes. Point organizations, dialysis care cared received patients. have personal element personal we economically Amedisys to how provide home. in dialysis will a and partnership consistent this of care services be of this that services for Medical in we an Medicaid. are for to interventions. Massachusetts progressing dialysis-focused a training on shows care for to to an Care to A and specialized Sound the include patients we several execute dialysis Medicaid and Fresenius services for reimbursing ASAPs mentioned, Physicians innovative for services bundle and We further activities partnership, daily personal care ASAPs Paul home-based can has performed be of Through home our programming Access The ASAPs, providers in supportive is key health dialysis-focused the the needs is will of of their utilizing and coordinate by partnership with patient. routine piece in dialysis finally, as X-way waiver refined personal the And care for to living higher-acuity a pilot have service requirements. short. the focused program more patient our patients be overseeing care expanded home in of that essential who

will assets network our we And initial utilizing expand, Personal for be We markets. our owned pilot Personal engaged. Care Care as will be our

new are they're we'll pilots view business ways initially a as and ways. to representation a our great these of Personal incubator, services small, and Personal differentiating trying While Care. in service Personal Care deploy Care use of innovative we're We the and to continue new line delivery

As can of our carry core quarter. positive from you into momentum see, business we first much the XXXX

financial Our focus of efficiency take us through turn with more our but for financially, for performance on to I'll the clinical choice, Scott? distinction, importantly, who growth it continues Scott, a that, quarter. to off employer over detailed and will And operational of our more patients. review pay

Scott Ginn

quarter financial first Thanks, I'm Chris. our pleased very results. with

net $X.XX share $XX million revenue to on XXXX. of quarter or compared delivered in income X% first $XXX of the or a revenue, million of we a GAAP diluted basis, per increase For XXXX,

a reminder, service. CARES to we majority associated COVID-XX. funds chosen are of costs only direct have Act As our cost costs of in The apply included with these to

the adjustment in provides nature. statement and were GAAP results our impacts. as the impacted income characterized XX of each these slides expense our onetime that noncore, items adjusting items or items results Slide For temporary our we income the quarter, line have or supplemental detail regarding by

You note and that the adjustments recognition direct COVID-XX. associated costs with include CARES Act will funds our of

results million acquisition XXX as in contributed $X.XX quarter and or clinician grew or revenue our consolidated to $XX suspension expansion increased EBITDA items and basis, impacting to and For million. percentage increased of million. per the health revenue gross $XX a home margin. to Improvement points, substantial And increases of as EPS follows. on XX% margin. to gross million and added increased a $XX $XX of XXXX basis sequestration The episode first million $XXX Significant as adjusted QX utilization AseraCare XX% are results Revenue were $XX EBITDA X% revenue $X.XX an or follows. per our our drove in million rate the revenue. share.

XXXX our prior X%. home turning pre-corporate million adjusted $XXX same-store by sequestration million, half $XX in and a driven first of volume X% episode segment revenue increase of per growth is was total was the by EBITDA and was mind, billing fewer of growth to was rate mix other functional up X%, and X% health, to increase, $XXX Revenue performance. result of total half the suspension Now allocation. segment-level improvements case or quarter up year lost impairment Keep driven the and In the scores. of periods in our and or admissions compared

visits per driven and improve Our utilization COVID-XX, insurance and to year. impact on costs the care by on visit inclement fixed growth Visiting weather implementation costs. health episode, increase a quality by contract reduction of our clinicians driven over pay, in in planned while the per X% lower significant to increased Medalogix volume led rates cost higher X.X wage connection increases, of of a we continue visit has was increase scores. of The prior

by points Our improvement in driven increase segment administration up lower gross from margin our raises; benefited despite costs; by Segment were XXX improved sequestration spend. increased driven the and The approximately staffing which higher resources mainly our was increases cost investments of EBITDA and progress offset travel utilization; was in $XX to a -- insurance increase; lower basis which with which XXX and basis and higher care variable business by million, of from volumes significant the mix offset by EBITDA and and basis center $X staff; a per by XXX related million, up driven clinical improvement. was point on point impact relief increase million development PDGM, Sequentially, rate million business costs. XX.X%, representing rate X% the visit. nature reimbursement. health training G&A XXXX and EBITDA health $X.X and margin an $XX model,

total Our X% sequentially. increased admits

revenue episodes completion per the of lower of impacted and revenue. weather timing However, episode,

segment to turning hospice results. Now our

the million, For into X, which was hospice rate the X.X% of $XXX.XX X, by per day acquisition, over XXXX. up year, on the revenue was first sequestration that suspension and which closed went increase to effect the driven XXXX. XX%, includes revenue quarter, an up $XXX Net increase prior addition of June million X% October $XX AseraCare

offset related restrictions, per decline utilization in discussed, performed admissions Chris and $X.XX delay board our grew COVID-XX-related Hospice hospice decreased in to lower shorter the X% the visits and onto to As day primarily by million million $X.X a rested million acquisition. was price into to and of access the ADC employees raises the room performance as the timing $X coming X%, of $XX -- million, G&A segment's cost $XX resulted hourly increase and lower quarter. service stay. partially due ADC. declined of anticipated AseraCare and $X acquisition discharge rate EBITDA in patients revenue length million The of EBITDA mainly added by by million, decline for of costs. health EBITDA AseraCare $X.X driven approximately and an increased in Sequentially, concessions, by insurance segment decreased XX%. up driven

million Turning and of million in is million includes total On $XX year-over-year, general adjusted administrative in million segment revenue, expenses. AseraCare corporate. and G&A $X related to million additional $XXX to an our basis, increase or an the which our costs XX.X% of total and acquisition, hospice was $X $X

incentive development approximately $X raises, operational Additionally, comp and resources business for account health additional million. costs, insurance accruals, support

tax in the from February. operations in strong operations. in the due payments of quarter, ahead collections internal due We first projections $XX producing flow inclement million federal an continued is the cash to to cash extension from impressive Cash generate weather flow flow of and to cash

forecasted X days from X.X our days. versus increase of increased DSO Our year-end

net X.Xx. was flow, health active. quarter the and priority, and capital leverage our and both end at deals the home of is main continued of M&A pipeline deployment result a strong ratio As remains our our of our cash full hospice

we signing operations announced the regulatory of assets Carolina. Randolph the to our expand definitive County, North mentioned, Paul recently a in health As home to acquire agreement

expanding plan tool in to in as footprint, We also de XX our use a novos with planned XXXX.

opportunistically During positioning for authorization. $XXX million $XXX in million inorganic growth. the well repurchase, quarter, repurchase continued have Even we our this approximately deployed million our liquidity, $XX us with over share of we

reflect ranges can you as slide of deck, sequestration our Page suspension. Finally, guidance the updating to XX see supplemental extension on our XXXX of for we're the

Our billion sequential facilities both million; our billion; in hospices visit of and access EPS to approximately still ADC We EBITDA Paul anticipate adjusted $X our We're homes increase quarterly adjusted a aides is million to in Paul? guidance to in $X.X to LPNs. and return to $X to now million to and of our climbing in of conclude. we out ranges patients $X.XX revenue to QX. new The as $XXX The an of $X.XX of QX. impact keep mind to are: turn seeing from over for back We're move into $XXX health decline and as items $X.XX. call pre-COVID million. the million $X their we workers' compensation insurance levels. increase I'll

Paul Kusserow

love I Scott. poetry April. in financial Thanks,

open all exciting vested in performance very our another can position a future. This advantageous you and increased and Operator, a demographic, quarter operational tailwinds please As as call ends the for remain market. ever-changing point We have see, strong our questions. in our prepared we an We remarks. regulatory to psychographic, ranges. guidance very delivered expectations of

Operator

[Operator Instructions].

first comes question Tanquilut Brian line Jefferies. from Our of the with

Brian Tanquilut

recovery you're has for first -- right, the Congrats. to sequester, only only in your buyback in Scott. I you're seems the that? think clarify, adjusting an QX at of question as right nothing to for terms the my changed of guidance despite in about that to I but Scott, guidance just earlier-than-expected think so the be or acceleration kind about what the assumptions to QX Is adjustment, pace guess the is hospitals? like way

Scott Ginn

That's right, Brian.

impact get only to around kind of sequestration, reassess waiting we -- for QX I'm so guidance. adjusting sticking our to of yes, to to the So plan

not you're And EPS So sticking from anything we're buyback, perspective. would say from with the seeing an that. I impact

full impact year that somewhere is $X.XX. around a I of think

So minimal. it's

Brian Tanquilut

Got it.

Paul, in-house? I But for don't you plan then, And Okay. Chris, what have is. hospice in deck. question. on you And mind throw thinking and you I there? impact us Humana you through does they're guess are it how just Kindred the that the you know if your slide turnaround from action chart guess doing thoughts Since about just so now the guidance I turnaround, walking they've there? Home your operationalizing second days, what brought I'll How a at

Paul Kusserow

you on in seesawing we're Chris, the why don't seeing Sure. hospice. take

focused seesawing. is for And in been we've bit -- beneficial it's to But That's our out just pre-COVID. March important saying, about is ADC. equal which bottomed most, where of January, Chris think preview very we're I on to a we're what this length March focused last little stay, us.

But we're good very seesaw. So feeling that. I'll let Chris about describe the

Christopher Gerard

admission you that with It yes, the go what patients either of kind pandemic a as admission of we this moved only to or off. in in that. end a I we out as January after Brian, really discharging imagine end saw saw can of was have big growth what hospice, December, most Yes. COVID-related the of came related through that through strong strong the really On growth in and is some ADC gates at saw declines January hospitals came XX% growth of we QX. day. -- that every And that while

than we stay moved and of news what our or our percent service QX, both XX of model. are those So as in our the you are days had a through that less. median pace numbers good metrics really in positive watching is, of length patients direction we're internal a little move a on at closely very quicker for The

this to and and last the median of low January XX compared year, we that's January stay of point in in XX -- length on year. hit So of of

end street. and around standards, looking disappointing by really there kind in in good. do and we the the the saw signs had making have feet QX we that, admission a that tick-up stabilization little our have really are Unfortunately, mainly a just to So work of of positive right number month a stay of length from on around sure bit around turnover of deploy sales aggressive right of we plan we're have an around. of particularly done that we we be that month arms that hospice now that generate should on feel next that for by kind in our to numbers makes middle team me our on of be the have And good got able now we'll We committed we of to our some hard the XXXX. track

Paul Kusserow

And it's with in Brian, terms I ex-Humana people Humana room the ex-Humana an in I'm of great. Humana and as of mean acquisition Kindred, person, X folks. sitting the --

it's for going payviders the Medicare home. rate X:X. which Medicare payers, signing be to going going Advantage, baby that a going growing Xx that Advantage into up move that the think in for care, boomers wants are -- service of is if they're fee the the to of particularly the is demographics home for idea the to be to at I managed the are That's where are validation

And very a for so think smart move them. I it's

I home think to but like or it's to Center Anyway, something smart renaming they're that. Care be health. it in

Home, works terms very saw we found Humana there, we and As home when very, savings. health were your sick in for well your sickest we started members we using when involved of got cost all that at of

think overlap Kindred, all revenues, with Humana I interesting is have -- business whether the on think they Kindred to thing they'll then that and of that will cost it so, whether go folks, be the if we where seems good of savings will generating talked versus will -- about And business are. we Kindred, means that Kindred more provide opportunity quality how is us used of capacity one for for if if I that scores fee-for-service against compete by business has that things Humana us. our an think the high like up

-- compete where isn't, So did partners a -- It We announce we're I I hospice they Kindred they will us. they're happens and And them. with it's guess spinning we to we for work see be good think care. interesting good if them. think sign with what where I -- personal off will

a is a not So plan do. of hospice I part for to very health think commitment think that I home And to should be good payer.

So me. it's for happy all news

Operator

the question line comes Larew William from Matt Our of Blair. next with

Matthew Larew

we'd turnover, the With per think partly right because lower and have adds episode increased the last Medalogix demand. of record you And referral have capacity. source XX even low more record do months, your over visits you've now with had we

make you being is that referral source do increased sure all that, how fully So really and capacity you that utilized have opportunities? new capturing these

Paul Kusserow

our Chris, first, Matt deck through we the demographic to about the growth do -- described think you I natural how and rates, we January that want growth. referrals have Well, then and take incremental JPMorgan in in talks the

So going in issue significant be we're get for one a and by industry, to yes, capacity that's is to making front have of entire trying the sure we very turnover. low

walk to So him do want that? you yes, Chris, through

Christopher Gerard

Thanks, Matt. Yes. Yes.

referring accounts, we business refer not to XX home in kind the accounts in in added a another from Those health did referral previous accounts X,XXX are QX. of So that months. growth us

deeper the sales to into our We we're is, those be home go BD on have that maintain accounts a to able force growing around strategy pretty accounts. and health aggressively those side

with off. paid while So our a that It's about it's definitely for been one good and strategy. we we've feel now,

but living another our still think year-over-year, at thing as it's at which looking I business, up QX. home and look business XX% senior nursing is And skilled growth to to we're sequentially going our down QX, X% X% those, well the I'm rehab as of know right that there include you now, segmentation from it's on in even in health. with

see come to utilize while a So starting that that as we see that capacity for we're ago. back, that to and that's upside an us you mentioned should opportunity

there back, We're as level. well we grow to of get as room have electives. seen have still still XX% XX% around we above now. that really So those back business come pre-pandemic not comes the as those And communities

-- as signs, those we see come the of on good see X we as couple those a So to things strategy. we continue as

Matthew Larew

of there And build a And for to in Physicians, give Sound endpoint anything might an partners? eventually there want make in line other tests metrics interesting with there. tracking? you terms provide of what convene? a kind here iterate? to partnership us is where sort of that pilot you stage versus you are it's even the kind an ultimately time call do you What then of On broadly more what and potentially that terms expand of can Is does

Paul Kusserow

Yes.

all, idea extraordinarily proud Sound I with quality working think just -- known we're there them is, good. inception, their a group one first such and Physicians, be since of they're the to of very

a health, if XX% belief that what we and into that for So they're other you lowest they get and there's diet, to can mentioned: with the personal to SNFs -- I can in, of what with outcomes that is that I these And want they of that provide. home variety that services combined into the a potentially is we go they're for to we're The cost. in business looking there's goes basically transportation, things the other side. do think optimize capitated. XX% home looking areas, care we're go combined they at and able phenomenal provide execution work what mean all telemedicine, on

higher market because acuity important idea we to it this scale, the environments. is start I increases very is addressable think in tremendously, for mean, I the up to work our So us move as acuity

care I then the traditional compared adherence, going what the to do referred are they if patient per admissions; traditional drives which they an cost more terms think and of customer into normally taken making satisfaction; of so the it's it do quality institutional in What things, sure med we outcomes, often would readmissions can setting. of; to be things.

much I put running know, pretty front the Scott's that us. the we are in of innovation. those So don't benchmarks

the of I did miss benchmarks? So any Scott,

Scott Ginn

No. all readmission. them. be mean, Paul, is. where That's you've it's Matt, to the mostly got going I cost around

patient. the that can for keep better it's of days end keep huge in then satisfaction day. will So them be at How And the many the the patient up. of we home, days number

normal measure perspective. be think to I talk some that from about, we and the then So able financial items we'll a of

Paul Kusserow

areas that they We lot need to then Matt, we benchmarks. associated partner. a we're jumping Yes. Obviously, the in methodology that this, the a overlap them doing iterate, set great with build I in of our really United. in job some is Sound, mean, process we're with. a Sound's value successful Sound. to -- iterate, this deliver iterate We but until is Again, with with up of XX-plus

opportunities beyond our really at this, good to with So expand there's particularly United. some friends

Operator

comes Our line A.J. the Credit Suisse. question next Rice with of from

A.J. Rice

shifting you catch up? is, I from are and know the your -- COVID about about direct a professional the and call still -- business first that have in you're stands. you. are up and So Just do to it, -- directly there come much SNFs to or from coming at elective baseline or rebound been you some appreciate to sense below may referrals now where But that think and par the how now may broadly still running? business if have But what like pre-pandemic patients, much comments you want have come hospitals where whatever know looked to you, SNFs potentially of to is or I you've the where coming in business I that you're picked there's that the how

Paul Kusserow

because address A.J. should a stolen -- SNF question, we've to been. where share Yes. we mean it's I good still the share to the equal But decline. area, in that. won't it's we've not Chris Clearly,

see percentage do of where post? to in Chris, pre-pandemic versus you but growth -- talk want terms So about we things of

Christopher Gerard

referrals and the physician would also pre-pandemic ahead is growing business and I say fully Hospitals physician A.J., we're the pretty are of back because Yes. as well. because partly of our significantly. partly market is growing, levels back back base

as with upside centers, do kind and of other ambulatory other medsurg they're So could we with going create patients are those strong electives happen that what some of more have move types fill to to is, hospitals patients incremental we opportunity starting surgery to relationships. think beds hospital will very where

our So mix. exact XX.X% excited and skilled about down the makes of again, almost business that. XX% year-over-year, QX. be rehab that about senior admission community, XX% living talk is I for When and that up nursing And about to

we don't feel that we've we those. where see taken like and lost opportunities the share actually in share So we those, like in feel we've is --

to growth So markets levels expect I getting see is where beyond pre-pandemic opportunity. to significant back and those in would

A.J. Rice

that little $XXX a just in potentially other delay done whether I priority for Okay. sequestration know seen acquisition the seeing think front. terms $XXX things out regional may players got and little that deals We've the We've you million of pricing, a was the on sequestration small things bit. by like a you. rebuilding move remains will what couple revenue. the target. million Can Great. I M&A of bit of talked you deals, the of acquisitions, you Xx stretch were that And about north quickly a tell activity? so the And on think you're year, into us coming maybe to spent

Paul Kusserow

the And are the feeling the a -- Carolina we're think about about very year. I I the M&A pipeline end because CON have the is not pipeline. going I'll A.J., Yes. think North we and in -- Scott talk front good where to on

been on pretty we there So that that we've out competitors the from the assets proactive. The our they're pipeline, good largely perplexing some seen have pricing has a of acquiring. deals for particularly

proactive going up books. highly last lot to of if been of done. going have they're get move SPAC think home to A people but to a something get public going we after health? they're some Have to if on in assets prices that there's along continue for So that, seen a not or doing high-quality or the move home and I crazy But like a hospice, their health prices. at try the in that crazy; deals hospice, being we're little reasonable

the before. using of on to the out about And I you there, want the so with some particularly do assets pipe -- inflation feel we've these how a assets that talk seen some capital don't know, and Scott, of some we up that's we're we're that a generating? lot bit doing causing of

Scott Ginn

pipe A.J., we that's good out feel about the Yes. so there.

As we've talked about, health. focus been our home has

a And there. I right on. got we've you're So think those lot of out

sequestration I made think has it. the

that from want incoming, we've for to not in pushing that still areas we those targets assessment, I think be the identify our really out. from You're But in seeing delays we'll active that. and and we the do a be laid geography perspective

go different start So we while some routes, try head for and wait these to off. processes of certainly to

about and an push through we'll be M&A we year and to good rest successful we move the continue are, as where perspective. from So of to feel looking the

Paul Kusserow

the opportunities answered I do mom-and-pop deals of that think delay Yes. sequestration with are industries, A.J., there. your I think will delay roll-up specifically. to But question midsized out larger don't I not the

the sequestration opportunities do I think will be delayed gets So roll-up reimplemented. until

Operator

[Operator Instructions].

question of Bank the with Gajuk America. comes from line of next Joanna Our

Joanna Gajuk

the follow-up, still visits episode. First a one? have short per a So I on can

about this the And talked that there. thing say do want reductions year per terms per first about I episode? for talked you of in visits of You expect foot And to happen? to I kind is this when previously, you the target the in episode. reduction the what guess, visits

Paul Kusserow

Sure.

Chris specific X while per numbers, episode centers, above. our jumps the health, one of the in with XX% care XXX, Before I'll the out stars them is, visits thing in did XXX go health, home home of say down and were

concert quality visits increased. our in So with what were we look first our we actually that reducing to quality, sustained. -- per is thing Actually, of always these sure some episode, is the always make

talk done specifics. So that company. let as we've a Chris something is I'm that, what I'll to the of really about me, proud

Christopher Gerard

Yes.

of well XX.XX, that we'll to around impacted as QX, which the kind earlier like are as from the could XX.X. XX.X year. expect Where year much on around feel be for nurses -- than did better both was year around access QX XX.X. of think So to shaped by particularly little will we'd today had for pandemic, We the QX. in facilities, that I than a up XXs, to for out land went a on get a they less about quarantine be low as We the the modeled bit little out. in to were what we full do modeled I XX.X ramp get

we'll to we be. where normalized the suggest get now of year closer XX.X exit where we more are think that's as a data we I than right environment. into should Medalogix

it anticipate I I'd And look around range. at So wouldn't further. it going XX.XX as any down

Joanna Gajuk

gap question of the home business. in rates in Can of I That's kind penetration, on And on the plans and updates my talk the at-risk Medicare any didn't the Okay. there in you rates, increasing the more structures topic, or yet terms value-based-type which of guess helpful. about health to get we or I pricing was of MA with this the closing plans? terms guess, the Advantage

Paul Kusserow

do you all you that's what there. Chris,

Christopher Gerard

more gap to for we for in rate very a Yes. us the of name a Nothing but based but continue of quality still We also significant basis. Yes. more we're the get remains still appetite renew. typically The give we're had still last that reasonable to in to from of story. It's is quarter. the same pay on kind strong. a game able us metrics. The And kind have rate, fee fair groundbreaking go -- a couple some update, service a plans contracts Medicare of that per-visit doing the earn upside breaking

has we per able that bringing blended net visit actual component. what be new to episode revenue per any in That's the visit or -- revenues episodic per we're and math, being with an we're significant since driving from our revenue contracts So much particularly visits But as pretty renewal up unfortunately, well. get gap in our per would world, seeing down. the by come pure we're up episode still

So but the nothing getting narrow, nominal, plans, rate getting gap rate but better -- not is it's are more we from more not -- it's any -- any the significant.

Paul Kusserow

think that's and have as conveners that higher the pressured are as work desire some over And of the to I the acquired. folks Joanna, higher with to quality folks been the the change, -- going plans years quality

capacity There get quality outcomes. be folks contract of limitation. conveners will pressured Some the to a are better higher to with

be So with limitations, capacity price increases. going there's to

Again, that based to we're on But show extra. risk continue looking continue to high-quality can what and is going at which readmissions portion So in like, deliver risk book try that I about go focus we we XX% plans sure the rate MA on which just really We're to them. a our versus paid try of Advantage to very average it's delivering Yes, if think for good we're is metrics other risk quality, now, we increasing. Right shape. on business. $XXX good make the about the to at reductions; about Medicare get outcomes on $XXX on fee-for-service.

Operator

Our with Ransom next John the James. line question comes of from Raymond

John Ransom

share of the kind on market question is gains. So my just

between How with me but if kind some that's using I think math? volume share math. your down of other that of X% gain. points we in growth, of the disconnect sort help mean, how share electives least Just should trying volumes XX growth? to XQ you triangulate then But that offset we Scott, can -- of organic at think the about do your with we totality mean I market XX%, maybe, -- sources, versus about gains

Scott Ginn

that. to to fall to what's perspective going on behind don't backed Yes. I John, perspective. I come some as really through you that from of your But move, think But bit, specific mean, always think -- electives thought think, I we're kind of Chris, you I see in mean us some know where a Chris, you haven't going little I I have those process. if I

Christopher Gerard

Yes.

hospital share I being think think taking. up with volume pure year-over-year, I market that's

raw that's pre-pandemic all sets new within back are levels. above those and that. we're sits about share I We're the up. kind in of full volume. Even the though about like in is X% having as think for physician market not SNF back referral living year-over-year bypass hospitals to well volume, community now admission It's the fully and feel rehab those around Year-over-year volume senior as But opportunity skill, It's are some and in still all X% nursing Year-over-year, -- XX%. of volumes there. Physicians well. year. the be are because growth skilled there on kind is right could still some down, up that QX our sources. also

be well. just haven't upside happening upside Really for adding could strategy: us. year. area that of of to can us as home, actually referral ground a through additional electives that SNF we as We be to attention that out. really strategy what's come but selling the on and to competitors, But we're down with to sure the Now significant for we does then sales sources, in hit some on reps, that that an then be come adding those think quality. it kind we going and making It pretty growth move been around this penciled accounted haven't there's the straightforward this the paid to our

Paul Kusserow

And trying think is And smoke -- think to what smart, bounce yes, you're is. saying. I Yes. out on, is John, what the it is I where is the we're us which than bigger

following more the think business calculate. lot for have places. example, we're And also, I a lot we've we going of There's stolen a these really ASCs, to lot than tried share I than with think better a most.

in places, to We COVID some getting some has of I that's around as proposition of these try the whack-a-mole. business facile to It's have So we've our can we learning. as do been like we're figure out work with involved is. been where the where value whack-a-mole on fairly business figuring bundlers. is. out -- That's the think at but being adept And like to moving I still think terms

John Ransom

more. rehab I a or mean I days health joint really X/X total a at understood the in a comment never episodes my nursing XX for home editorial home couple versus cost of is

the fact I -- difficulties there's make perhaps lapping comparison is staffing to to pandemic more that that and but obvious with My sequester big respect be the -- people. look sort take I gains. question So some going Medalogix guess these of we 'XX, at to as second the away you'll

trying you M&A, as air else are I big not is of we thinking but have pocket there's look the the about other -- thinking answer a obvious to guys there forward? So is mean how -- team any about how

Paul Kusserow

do to one? take that Scott, want you

Scott Ginn

right John, full that's just you're of year, that. right -- $XX I'll a Yes. about million. kind roughly now, Sequestration

but you for normal So we'll year, mean, of we've I good then issue. get we and half us -- first pattern. us, -- you we'll good walk first, comps the to got saw PDGM year-over-year got that to year, gains, really deal a with the to into think think, as a see next in the then I from

run course of some will levers time. its in have those So at that point

see continued acquisitions. accelerated for how then you'll I on our -- built model, I look think this we you think growth

us XXXX. into that's to then think will some help give pour try into what we'll M&A. And more to I juice continue

we'll think closely. follow kind -- I that's of rates

think that I productivity around right, for as clinicians, will be get our certainly us. I that think we helpful

have few we I staffing we moving But levers get into difficulties the yes, contractors. as there next more that's I versus think our some think in some of year.

Operator

line Markets. comes RBC the Capital Our next question Frank of Morgan with from

Frank Morgan

RAP a it. be clinical this side, of curious, business had it down turnover, influence. finally, is And -- there. care. side? that that's the I health Is you side targets the always are is to just do think maybe I things on the it And hospice just would wanted on talked the I bigger not a care for kicking is prevalent? about you thought have effect But being the you but the both? on there. think growth of that I sequestration? just or would by when able more home more turnover then maybe in offset the elimination, That's update go what in then the Or -- with I'm the of year, the about and of slowing health the that the pushout -- an some pace to of roll-up this do your than business development more reach home side that back, think see

Paul Kusserow

I think, RAC, no-pay quite is The Yes. severe.

but come turned to we've would were We be, X.X. that. X-day it I anticipating think, think, a increase out in how Scott again, showed through I it DSOs, be

against I well performed think we So that. very

results the I on very mixed industry we're know, that? in working don't out Scott, anything -- industry. is think seeing the I

Scott Ginn

No.

but right. how I CARES well think that sequestration, that's up think dollars. prop it, in I we've think depending on Act mean, still some you done still have I funded, I

now. You pocket funds your in those right got

So to in more and gives it I hit that RAP early year. that this kind challenging, the feel ability them makes it withstand of

bit still out, it shakes makes more think it difficult. I but it think we So a little

Paul Kusserow

in people say we're COVID, going bit due to hospice. and the make the on Chris transition on talk side, side, And We up. to lost that But Yes. it's a some it. I'd BD BD hospice let I'll in about the

turnover much we're up think May. to generally that -- make end Chris pretty BD take we've it with I of by And good. so We've we'll BD. turnover -- May our going is that to mentioned, but reduced

what and do us back to fast then the Chris, how growth So for ADC any in and buildup terms an that's going of get track? admits comments then on

Christopher Gerard

Yes. Yes.

got This So to X.X%. hospice Home a Frank, is a vacancy rate XX% on clearly issue. hospice up we side. the about health is about

that was shape we're there. on filled good in have had it a sizable since in and And combination that a vacancies couple So turnover QX. addressed of kind onboarded. and some we us the of fairly had spiked regions been leadership of And

really hiring a I'm there. around on of reps. the months. has shift for increased bit So And of down Focus last couple we've been turnover driving bringing new resources that little our a and comfortable BD in over us

XX% deployed. and Back clinical relatively to And field that we'll organization and hires we've and get nursing We're high I range, as this the back out driven has clinical to think I your get turnover So be proud was just our the significantly. question. getting turnover, in them us of the track on believe, we XX%, the in soon, how down again, responded mentioned retaining a we're that that XX.X%, the in year. down in our down to focusing to last on people. turnover good sign organization, my drive continuing which and for And is drove as even and our good for we total right real we're prepared for which XX%, a things, feat was QX I around remarks, it great And further. QX, we're this

Operator

of Deutsche line Bank. question Bowers with from the Our comes next Justin

Justin Bowers

strategic demand So grow your with in on little ability home going just it talk terms can of bit quickly, issue about stuff you able of with a -- being landscape electives in versus the like more health, staff on? And then up. the Is kind some competitive thoughts to terms activity back that fair a supply in institutional sounds it's like to characterization? of a the and of than a of issue, the just coming

Paul Kusserow

say it's in be supply regions. Yes. -- question, be your certain supply your say I'd our going issue. to a of of to issue latter getting It's a on I'd part

think we're post X growth we for we is we'll what's I the don't year or next So ahead we don't -- up staff, that next able if road, certainly post year again, keep well clinical saw to and staff actually which we this on the the and our to clinical are excellent be have anticipating seeing productive the and think -- years.

of it's is a of validation of with particularly are supply largely a telling issue, Brookdale asset. So we're plans to perspective, for the seeing so guess to landscape with be the then the fact that, ways, think, very, out are home boomers, the probably moving demographics Yes, into and referring provide buying my going it's demand the very, turnover. on that's in and you're very why we're and lot a are HCA's From I out things there's demand care. competitive there Kindred home-based that acquisition -- us of strong to baby very Humana's that strong a focused the

that validating respected know the think of we out players got moving the most there you've into X basically all So home. things I what are

both capacity I you there. particularly hospice, is to know, quality as -- able There's highly supply don't not palliative execute to win. care, fragmented And and So be going think -- the to the I think being also of industry a it's personal going winner care. there. any is in services competitive worried about to I I'm have And issues home health,

what we'll their up these something take and core will day and And probably occur. come we every better And integration might So particularly to concerned doing think keep I better out I'm that folks with. these X little be about folks will integrate companies a and figuring do better. how getting not what with while and

Justin Bowers

Is -- just any early as dynamics. issue. recently XQ? move quarter? we the pressure of from of Okay. has just Yes, notable you of XQ kind that all factors the on kind eased in to supply And what that more then kind And labor versus lastly, saw swing at then

Paul Kusserow

hospital fundamentally, in except -- capacity caught urban -- people see but can't management we're inflated sure through labor it's perspective, when much -- a like where we had see from organization, we go when -- focused we that which had inflation, labor the don't say heavy record. make we and we so And of general, market demanding. contractor, being you're is but sounding high human COVID side market seeing see a the get I'd see -- we on -- we have a to to pockets, the to you capital for we it contractors. business. that, in have market sorry, a Again, why again we don't have with That's is COVID in in issue. supply admissions that's going our But broken enough to we're we the the don't what I'm quality, like

will patient to that right the want and have quality, and quality, quality, we high not things go XX% You you. they said, I who's X and seem an And delivers All just equal, recruiting, the with compromise will work that -- come stars want don't for for pockets big urban head for the it. in as some to things things above, on that people HR do for to do here, being have employer the high charge problems of therefore, actually that of where my right tough employee. there's I everybody. have except it's to

So did that get I right?

Sharon Brunecz

Yes.

You did.

Paul Kusserow

Okay. on me thumbs I the labor? Good. missed up. Sharon Chris, anything gave

Christopher Gerard

No.

all. got You it

Paul Kusserow

good. We're Okay.

Operator

line Steven of Barclays. question from Our the with next comes Valiquette

Steven Valiquette

feeling easiest think mentioned line admissions And on same-store the you when just the year could maybe do full we the in slightly just XQ points to home in that's to are but just growth you're result in this with seems be question way. summary and you So guidance of Yes, Personal growth that the I coming more softer; talking a staged and a little or of unchanged, little correlate 'XX but on same lot that tying X% XQ this touched on just about viewing the hospice want at health XQ we for together. and I sort Care, And guess, relatively guidance. around quarter X% X% call? better direction either of last the key with you metrics. to same everything just confirm based around that about cautious Maybe the that X% trend with that, talked bit strongest seasonal XQ, XQ, a whether it on comp; on then too, bit,

are that. thing So feeling for billable summarize hospice, the to on on all XX% just number Care, you hours the there, same? about better the the or Personal And XX% or worse same

Paul Kusserow

runs unless Yes. Chris can him We number. balance the most is ADC. since comfortable And the answer. responsible hospice general, say otherwise. we businesses, feel ADC is in Chris But with important Chris? numbers I'll for and let our

Christopher Gerard

Yes.

a lot this to continuing plan. coming of action in as line and I in just the living us up. is into based on with area say, going we that the some shaping just be on quarter, of how upon to going So our first slightly senior year are your back going things home feel share kind And of would health, well than better dependent on the questions and taking our

in better but feel I about X%, I that, come could that. it strong So about feel than good the

the XX% growth ADC side, of We're we On it lap get on length a X%. that the got about the that. But I I exit I've going pretty -- the I back of soft feel And deliver tailwinds a the kind commitments our a here admission the good the have of stay about to getting able do and up financial into I think build bit just of like coming half side. will year in on we've QX I'll faster X% to build to say than little feel given hospice second of modeled. strong XXXX. -- than growth really be But the got feel I we QX. of and hospice we're track, had to should we better going

lingering On to is have effects has to been even And continue it side, Personal when issues the Care it at labor the struggle still that wage has the that level. that pandemic we you really the business. pandemic most grow -- one, because gone, of

is of spiked last significantly. our month, that number turnover new and checks a example applications So out went stimulus good dropped our

have you -- growing caregivers. Massachusetts, is little of be get a to to to got our still difficult work most labor through headwinds. labor a difficult We able as state. our also bit some where of which we're We market and So to is business in got

As soon our a growth for can we trajectory base, caregiver business. we as the be will grow on

which look through working there, caregivers. today, at of the some half So I is second still of to still challenges momentum access kind kind

Paul Kusserow

that to in just Personal a in again, that personal faster. the I'll assets using Physicians growing Steve, And is with to that's Personal something, real show of comment, proud grow state, so day in And Care provides guess I partnership is our happy it home-based SNF-at-home with that fantastic. Sound we business. that a national that I'm Medicaid. we're that fact And Massachusetts. that's the the Care able Care of. nicely, building Yes. fact assets mainly network care care. something project want We on every something Personal That's we're personal do learning in fact can The Personal coverage. our to the although we're we drive to a and tough I'm We're Care. -- But we're be -- dialysis, use add

So business. very -- and small it's a

an learning combination As But when be all care about that, of million provide can the $XX these think beneficial you to services we're about business. how, patients them doing together, know, value you they I all and it's the just put and along continuum. tremendous really

we're Care committed to the Personal business, So way. very in innovative particularly I think that an

that's I'd on that. So say what

Nick Muscato

queue? Jen, do in have anyone we else

Paul Kusserow

Should reading off? T.S. Are Jen? Eliot, we I start

Nick Muscato

are No. Operator, there? you

Paul Kusserow

the queue. more have in I think two we questions

Nick Muscato

for So going the call guys to technical queue, it. we in We're difficulties. apologize

Paul Kusserow

Yes.

folks. we've we're and call got we'll I think going X it, to -- I think

I think John had a circle queue. Bill was around and the then in

to people, great day, Like call you employees we progress call you who Until ever-evolving on delivered afterwards. wonderful to up most. and great I day, joined Take doing, work care. Please to updating all call hope a thanks look thank keep on on progress. you us wonderful our who we you're our forward happen. have who earnings to next -- us that We patients then, this again We want value this what need We the wonderful Bye. shouldn't has and July. to right this for care doing the have apologize we'll everyone forward and today. a in results. purposeful But quarterly our we this. as of and incredible look take So our talking everyone to

Amedisys (AMED) 2 May 212021 Q1 Earnings call transcript