Amedisys Reports Fourth Quarter and Year End 2019 Financial Results and Issues 2020 Guidance

2/18, 10:15 PM (Source: GlobeNewswire)

BATON ROUGE, La., Feb. 18, 2020 (GLOBE NEWSWIRE) -- Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three month period and year ended December 31, 2019.

Three Month Periods Ended December 31, 2019 and 2018

  • Net service revenue increased $66.3 million to $500.7 million compared to $434.4 million in 2018.
  • Net income attributable to Amedisys, Inc. of $27.7 million compared to $27.5 million in 2018.
  • Net income attributable to Amedisys, Inc. per diluted share of $0.83 compared to $0.84 in 2018.

Adjusted Quarterly Results*

  • Adjusted EBITDA of $52.2 million compared to $43.9 million in 2018.
  • Adjusted net service revenue of $500.7 million compared to $434.4 million in 2018.
  • Adjusted net income attributable to Amedisys, Inc. of $31.1 million compared to $29.8 million in 2018.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $0.94 compared to $0.91 in 2018.

Years Ended December 31, 2019 and 2018

  • Net service revenue increased $293.0 million to $1,955.6 million compared to $1,662.6 million in 2018.
  • Net income attributable to Amedisys, Inc. of $126.8 million compared to $119.3 million in 2018.
  • Net income attributable to Amedisys, Inc. per diluted share of $3.84 compared to $3.55 in 2018.

Adjusted Year End Results*

  • Adjusted EBITDA of $225.3 million compared to $180.6 million in 2018.
  • Adjusted net service revenue of $1,961.6 million compared to $1,664.3 million in 2018.
  • Adjusted net income attributable to Amedisys, Inc. of $145.2 million compared to $122.1 million in 2018.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $4.40 compared to $3.63 in 2018.

*   See pages 12-14 for the definition and reconciliations of non-GAAP financial measures to GAAP measures.

Paul B. Kusserow, Chairman, President and Chief Executive Officer stated, “I am very proud of our fourth quarter and year end results as we continued our trend of outperformance this year. We have stayed true to our mission of providing clinically excellent care to our patients no matter where they call home, and it has once again translated into stellar financial results. None of this would be possible without the unwavering dedication of our over 21,000 employees, and I thank each and every one of you for your continued commitment to our patients. We are set up for a great 2020 as we navigate the waters of PDGM, and I look forward to another year of outperformance.”

2020 Guidance

  • Net service revenue is anticipated to be in the range of $2.115 billion to $2.160 billion.
  • Adjusted EBITDA is anticipated to be in the range of $250 million to $260 million.
  • Adjusted diluted earnings per share is anticipated to be in the range of $4.90 to $5.13 based on an estimated 33.4 million shares outstanding.

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

We urge caution in considering the current trends and 2020 guidance disclosed in this press release. The home health, hospice and personal 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, 2019, and subsequent Quarterly Reports on Form 10-Q, and current reports on Form 8-K which can be found on the SEC’s internet website, http://www.sec.gov, and our internet website, http://www.amedisys.com.

Earnings Call and Webcast Information

Amedisys will host a conference call on Wednesday, February 19, 2020, at 11:00 a.m. ET to discuss its fourth quarter and year end results. To participate on the conference call, please call before 11:00 a.m. ET to either (877) 524-8416 (Toll-Free) or (412) 902-1028 (Toll). A replay of the conference call will be available through March 19, 2020 by dialing (877) 660-6853 (Toll-Free) or (201) 612-7415 (Toll) and entering conference ID #13698548.

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 provision for income taxes, net interest expense and depreciation and amortization, excluding certain items; (2) adjusted net service revenue, defined as net service revenue excluding certain items; (3) adjusted net income attributable to Amedisys, Inc., defined as net income attributable to Amedisys, Inc. excluding certain items; and (4) 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 and personal care. 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 them to manage a chronic disease; or hospice care at the end of life. More than 2,600 hospitals and 67,000 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 more than 21,000 employees in 479 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 415,000 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,” “would,” “should” and similar expressions are intended to identify forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements involve a variety of risks and uncertainties that could cause actual results to differ materially from those described therein. These risks and uncertainties include, but are not limited to the following: changes in 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, 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, our ability to integrate, manage and keep our information systems secure, our ability to realize the anticipated benefits of the acquisition of Compassionate Care Hospice (“CCH”), our ability to comply with requirements stipulated in the CCH corporate integrity agreement, and 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 MuscatoKendra Kimmons
 Vice President, Strategic FinanceVice President, Marketing & Communications
 (855) 259-2046(225) 299-3720
 IR@amedisys.comkendra.kimmons@amedisys.com
   


 
AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)
     
 For the Three-Month
Period Ended December 31

 For the Year Ended
December 31
 2019 2018 2019 2018
        
 (Unaudited)  
Net service revenue$500,678  $434,378  $1,955,633  $1,662,578 
Cost of service, excluding depreciation and amortization 295,603   262,251   1,150,337   992,863 
General and administrative expenses:               
Salaries and benefits 101,325   84,309   394,452   316,522 
Non-cash compensation 6,589   5,234   25,040   17,887 
Other 48,150   42,778   188,434   166,897 
Depreciation and amortization 5,988   3,379   18,428   13,261 
Asset impairment charge 1,470      1,470    
Operating expenses 459,125   397,951   1,778,161   1,507,430 
Operating income 41,553   36,427   177,472   155,148 
Other income (expense):               
Interest income 19   15   78   278 
Interest expense (3,056)  (1,536)  (14,515)  (7,370)
Equity in earnings from equity method investments 1,218   1,231   5,338   7,692 
Miscellaneous, net (367)  458   2,037   3,240 
Total other (expense) income, net (2,186)  168   (7,062)  3,840 
Income before income taxes 39,367   36,595   170,410   158,988 
Income tax expense (11,398)  (8,875)  (42,503)  (38,859)
Net income 27,969   27,720   127,907   120,129 
Net income attributable to noncontrolling interests (314)  (259)  (1,074)  (783)
Net income attributable to Amedisys, Inc.$27,655  $27,461  $126,833  $119,346 
Basic earnings per common share:               
Net income attributable to Amedisys, Inc. common stockholders$0.86  $0.86  $3.95  $3.64 
Weighted average shares outstanding 32,278   31,916   32,142   32,791 
Diluted earnings per common share:               
Net income attributable to Amedisys, Inc. common stockholders$0.83  $0.84  $3.84  $3.55 
Weighted average shares outstanding 33,123   32,805   32,990   33,609 
                


 
AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except share data)
   
 As of December 31,
 2019 2018
ASSETS       
Current assets:       
Cash and cash equivalents$30,294  $20,229 
Restricted cash 66,196    
Patient accounts receivable 237,596   188,972 
Prepaid expenses 8,243   7,568 
Other current assets 8,225   7,349 
Total current assets 350,554   224,118 
Property and equipment, net of accumulated depreciation of $96,137 and $95,472 28,113   29,449 
Operating lease right of use assets 84,791    
Goodwill 658,500   329,480 
Intangible assets, net of accumulated amortization of $7,044 and $693 64,748   44,132 
Deferred income taxes 21,427   35,794 
Other assets 54,612   54,145 
Total assets$1,262,745  $717,118 
        
LIABILITIES AND EQUITY       
Current liabilities:       
Accounts payable$31,259  $28,531 
Payroll and employee benefits 120,877   92,858 
Accrued expenses 137,111   99,475 
Current portion of long-term obligations 9,927   1,612 
Current portion of operating lease liabilities 27,769    
Total current liabilities 326,943   222,476 
Long-term obligations, less current portion 232,256   5,775 
Operating lease liabilities, less current portion 56,128    
Other long-term obligations 5,905   6,234 
Total liabilities 621,232   234,485 
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; 36,638,021 and 36,252,280 shares issued; and 32,284,051 and 31,973,505 shares outstanding 37   36 
Additional paid-in capital 645,256   603,666 
Treasury stock at cost 4,353,970 and 4,278,775 shares of common stock (251,241)  (241,685)
Accumulated other comprehensive income 15   15 
Retained earnings 246,383   119,550 
Total Amedisys, Inc. stockholders’ equity 640,450   481,582 
Noncontrolling interests 1,063   1,051 
Total equity 641,513   482,633 
Total liabilities and equity$1,262,745  $717,118 
        


 
AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING
(Amounts in thousands, except statistical information)
    
 For the Three-Month
Period Ended December 31

 For the Year Ended
December 31
 2019 2018 2019 2018
        
 (Unaudited)       
Cash Flows from Operating Activities:    
Net income$27,969  $27,720  $127,907  $120,129 
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 5,988   3,379   18,428   13,261 
Non-cash compensation 6,589   5,234   25,040   17,887 
401(k) employer match 2,964   2,042   10,509   8,976 
Amortization and impairment of operating lease right of use assets 8,891      35,905    
Loss (gain) on disposal of property and equipment 135   (24)  141   714 
Deferred income taxes (4,332)  5,355   13,466   20,271 
Equity in earnings from equity method investments (1,218)  (1,231)  (5,338)  (7,692)
Amortization of deferred debt issuance costs/debt discount 220   201   873   797 
Return on equity investment 1,228   1,785   4,955   6,158 
Asset impairment charge 1,470      1,470    
Changes in operating assets and liabilities, net of impact of acquisitions:    
Patient accounts receivable 15,323   6,058   (24,146)  12,224 
Other current assets 7,512   8,711   (2,682)  8,679 
Other assets 630   2,221   832   2,947 
Accounts payable (3,184)  3,835   (11,329)  3,165 
Accrued expenses 14,193   (1,234)  42,096   13,524 
Other long-term obligations (98)  (19)  (329)  2,443 
Operating lease liabilities (8,179)     (32,295)   
Operating lease right of use assets (881)     (3,503)   
Net cash provided by operating activities 75,220   64,033   202,000   223,483 
Cash Flows from Investing Activities:               
Proceeds from sale of deferred compensation plan assets 161   152   448   715 
Proceeds from the sale of property and equipment 4   3   162   54 
Purchases of property and equipment (1,551)  (874)  (7,888)  (6,558)
Investments in equity method investees    (3,667)  (210)  (7,144)
Acquisitions of businesses, net of cash acquired    (5,186)  (345,460)  (9,260)
Net cash used in investing activities (1,386)  (9,572)  (352,948)  (22,193)
Cash Flows from Financing Activities:               
Proceeds from issuance of stock upon exercise of stock options 223   3,204   3,611   5,953 
Proceeds from issuance of stock to employee stock purchase plan 803   642   3,187   2,429 
Shares withheld upon stock vesting (171)  (1,149)  (9,556)  (6,570)
Non-controlling interest distribution (152)  (560)  (1,062)  (1,090)
Proceeds from borrowings under term loan       175,000    
Proceeds from borrowings under revolving line of credit 70,000   10,500   262,500   138,000 
Repayments of borrowings under revolving line of credit (67,000)  (60,500)  (200,000)  (130,500)
Principal payments of long-term obligations (1,804)  (379)  (5,624)  (91,450)
Debt issuance costs       (847)  (2,433)
Purchase of company stock          (181,402)
Repurchase of noncontrolling interest          (361)
Net cash provided by (used in) financing activities 1,899   (48,242)  227,209   (267,424)
Net increase (decrease) in cash, cash equivalents and restricted cash 75,733   6,219   76,261   (66,134)
Cash, cash equivalents and restricted cash at beginning of period 20,757   14,010   20,229   86,363 
Cash, cash equivalents and restricted cash at end of period$96,490  $20,229  $96,490  $20,229 
Supplemental Disclosures of Cash Flow Information:               
Cash paid for interest$1,872  $533  $9,628  $3,522 
Cash paid for income taxes, net of refunds received$11,866  $3,261  $29,522  $14,278 
Supplemental Disclosures of Non-Cash Financing Activities:               
Note payable issued for software licenses$  $  $  $418 
Days revenue outstanding (1) 40.9   38.0   40.9   38.0 
                

(1) Our calculation of days revenue outstanding at December 31, 2019 and 2018 is derived by dividing our ending patient accounts receivable by our average daily patient revenue for the three month periods ended December 31, 2019 and 2018, respectively.

 
AMEDISYS, INC. AND SUBSIDIARIES
SEGMENT INFORMATION
(Amounts in millions, except statistical information)
(Unaudited)
   
Segment Information - Home Health  
 For the
Three-Month Period
Ended December 31,
 2019 2018
    
Financial Information (in millions):  
Medicare$215.2  $211.5 
Non-Medicare 101.0   92.5 
Net service revenue 316.2   304.0 
Cost of service 191.7   189.4 
Gross margin 124.5   114.6 
Asset impairment charge 1.5    
Other operating expenses 77.4   72.2 
Operating income$45.6  $42.4 
Same Store Growth (1):       
Medicare revenue 2%  3%
Non-Medicare revenue 10%  20%
Total admissions 4%  6%
Total volume (2) 4%  6%
Key Statistical Data - Total (3):  
Medicare:  
Admissions 48,028   47,864 
Recertifications 27,909   28,555 
Total volume 75,937   76,419 
Completed episodes 75,916   75,497 
Visits 1,272,381   1,328,025 
Average revenue per completed episode (4)$2,916  $2,891 
Visits per completed episode (5) 17.0   17.7 
Non-Medicare:  
Admissions 32,996   30,092 
Recertifications 16,163   14,874 
Total volume 49,159   44,966 
Visits 762,169   722,677 
Total (3):  
Visiting Clinician Cost per Visit$85.82  $84.27 
Clinical Manager Cost per Visit 8.44   8.09 
Total Cost per Visit$94.26  $92.36 
Visits 2,034,550   2,050,702 
        


   
 For the Year
Ended December 31,
 2019 2018
    
Financial Information (in millions):  
Medicare$859.2  $830.8 
Non-Medicare 397.2   343.7 
Net service revenue 1,256.4   1,174.5 
Cost of service 754.1   722.1 
Gross margin 502.3   452.4 
Asset impairment charge 1.5    
Other operating expenses 301.4   279.8 
Operating income$199.4  $172.6 
Same Store Growth (1):       
Medicare revenue 4%  6%
Non-Medicare revenue 16%  18%
Total admissions 7%  5%
Total volume (2) 5%  7%
Key Statistical Data - Total (3):  
Medicare:  
Admissions 195,513   190,748 
Recertifications 110,460   112,773 
Total volume 305,973   303,521 
Completed episodes 300,551   296,223 
Visits 5,207,563   5,261,315 
Average revenue per completed episode (4)$2,920  $2,854 
Visits per completed episode (5) 17.3   17.6 
Non-Medicare:  
Admissions 133,180   118,577 
Recertifications 62,108   55,736 
Total volume 195,288   174,313 
Visits 3,065,745   2,772,339 
Total (3):  
Visiting Clinician Cost per Visit$83.11  $81.88 
Clinical Manager Cost per Visit 8.04   8.01 
Total Cost per Visit$91.15  $89.89 
Visits 8,273,308   8,033,654 
        

(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. Effective July 1, 2019, 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 and de novos.
(4) Average Medicare revenue per completed episode is the average Medicare revenue earned for each Medicare completed episode of care.
(5) Medicare visits per completed episode are the home health Medicare visits on completed episodes divided by the home health Medicare episodes completed during the period.

   
Segment Information - Hospice  
 For the
Three-Month Period
Ended December 31,
 2019 2018
    
Financial Information (in millions):  
Medicare$156.6  $103.5 
Non-Medicare 8.0   5.3 
Net service revenue 164.6   108.8 
Cost of service 89.2   56.8 
Gross margin 75.4   52.0 
Other operating expenses 38.2   23.2 
Operating income$37.2  $28.8 
Same Store Growth (1):       
Medicare revenue 9%  11%
Hospice admissions 1%  12%
Average daily census 8%  9%
Key Statistical Data - Total (2):  
Hospice admissions 10,139   7,152 
Average daily census 11,660   7,809 
Revenue per day, net$153.42  $151.46 
Cost of service per day$83.13  $79.02 
Average discharge length of stay 100   103 
        


   
 For the Year
Ended December 31,
 2019 2018
    
Financial Information (in millions):  
Medicare$586.6  $390.2 
Non-Medicare 30.6   20.7 
Net service revenue 617.2   410.9 
Cost of service 335.1   212.0 
Gross margin 282.1   198.9 
Other operating expenses 139.1   85.7 
Operating income$143.0  $113.2 
Same Store Growth (1):       
Medicare revenue 7%  11%
Hospice admissions 4%  8%
Average daily census 7%  11%
Key Statistical Data - Total (2):  
Hospice admissions 40,194   27,596 
Average daily census 11,164   7,588 
Revenue per day, net$151.47  $148.36 
Cost of service per day$82.24  $76.53 
Average discharge length of stay 98   100 
        

(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. Effective July 1, 2019, same store is defined as care centers that we have operated for at least the last twelve months and startups that are an expansion of a same store care center.
(2) Total includes acquisitions and denovos.

  
Segment Information - Personal Care 
 For the
Three-Month Period
Ended December 31,
 2019  
 2018  
    
    
    
Financial Information (in millions):  
Medicare$  $ 
Non-Medicare 19.9   21.6 
Net service revenue 19.9   21.6 
Cost of service 14.7   16.1 
Gross margin 5.2   5.5 
Other operating expenses 3.0   3.4 
Operating income$2.2  $2.1 
Key Statistical Data:       
Billable hours 802,225   890,696 
Clients served 12,300   13,054 
Shifts 359,255   406,119 
Revenue per hour$24.88  $24.24 
Revenue per shift$55.56  $53.16 
Hours per shift 2.2   2.2 
  
  
 For the Year
Ended December 31,
 2019  
 2018  
    
    
    
Financial Information (in millions):  
Medicare$  $ 
Non-Medicare 82.0   77.2 
Net service revenue 82.0   77.2 
Cost of service 61.1   58.8 
Gross margin 20.9   18.4 
Other operating expenses 12.5   13.1 
Operating income$8.4  $5.3 
Key Statistical Data:       
Billable hours 3,308,338   3,248,304 
Clients served 17,364   17,981 
Shifts 1,488,175   1,468,541 
Revenue per hour$24.80  $23.75 
Revenue per shift$55.13  $52.54 
Hours per shift 2.2   2.2 
        


  
Segment Information - Corporate 
 For the
Three-Month Period
Ended December 31,
 2019  
 2018  
    
Financial Information (in millions):  
Other operating expenses$38.9  $35.0 
Depreciation and amortization 4.5   1.9 
Total operating expenses$43.4  $36.9 
        
  
 For the Year
Ended December 31,
 2019
 2018
    
Financial Information (in millions):  
Other operating expenses$160.9  $127.6 
Depreciation and amortization 12.4   8.4 
Total operating expenses$173.3  $136.0 
        


 
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 Period
Ended December 31,
 For the Year Ended
December 31,
 2019 2018 2019 2018
Net income attributable to Amedisys, Inc.$27,655  $27,461  $126,833  $119,346 
Add:    
Income tax expense 11,398   8,875   42,503   38,859 
Interest expense, net 3,037   1,521   14,437   7,092 
Depreciation and amortization 5,988   3,379   18,428   13,261 
Certain items (1) 4,618   3,124   24,877   3,739 
Interest component of certain items (1) (451)  (451)  (1,789)  (1,731)
Adjusted EBITDA (2) (6)$52,245  $43,909  $225,289  $180,566 
                
Adjusted Net Service Revenue Reconciliation:
    
 For the Three-
Month Period
Ended December 31,
 For the Year Ended
December 31,
 2019 2018 2019 2018
Net service revenue$500,678  $434,378  $1,955,633  $1,662,578 
Add:    
Certain items (1) 6      5,999   1,687 
Adjusted net service revenue (3) (6)$500,684  $434,378  $1,961,632  $1,664,265 
                


Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:
  
 For the Three-
Month Period
Ended December 31,
 For the Year Ended
December 31,
 2019  
 2018  
 2019  
 2018  
        
Net income attributable to Amedisys, Inc.$27,655  $27,461  $126,833  $119,346 
Add:    
Certain items (1) 3,417   2,312   18,409   2,767 
Adjusted net income attributable to Amedisys, Inc. (4) (6)$31,072  $29,773  $145,242  $122,113 
                
Adjusted Net Income Attributable to Amedisys, Inc. per Diluted Share Reconciliation:
  
 For the Three-
Month Period
Ended December 31,
 For the Year Ended
December 31,
 2019  
 2018  
 2019  
 2018  
        
Net income attributable to Amedisys, Inc. common stockholders per diluted share$0.83  $0.84  $3.84  $3.55 
Add:    
Certain items (1) 0.10   0.07   0.56   0.08 
Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share (5) (6)$0.94  $0.91  $4.40  $3.63 
                

(1) The following details the certain items for the three month periods and years ended December 31, 2019 and 2018:

Certain Items:  
 For the Three-Month Period
Ended December 31, 2019
 For the Year Ended
December 31, 2019
 (Income) Expense
 (Income) Expense
Certain Items Impacting Net Service Revenue:  
Contingency accrual$  $6,541 
Planned closures (7) 6   (542)
Certain Items Impacting Cost of Service:  
Planned closures (7) 2   1,174 
Certain Items Impacting Operating Expenses:  
Planned closures (7) 2   187 
Acquisition and integration costs 1,718   16,111 
Legal fees - non-routine 604   977 
Asset impairment 1,470   1,470 
Certain Items Impacting Total Other Income (Expense):  
Legal settlements    (1,437)
Other (income) expense, net 816   396 
Total$4,618  $24,877 
Net of tax$3,417  $18,409 
Diluted EPS$0.10  $0.56 
        
   
 For the Three-Month Period
Ended December 31, 2018
 For the Year Ended
December 31, 2018
 (Income) Expense
 (Income) Expense
Certain Items Impacting Net Service Revenue:  
Florida self-audit (pre-acquisition)$  $1,687 
Certain Items Impacting Operating Expenses:  
Acquisition costs 1,025   2,757 
Legal fees - non-routine 56   1,465 
Indemnity receivable adjustment 2,143   2,143 
Certain Items Impacting Total Other Income (Expense):  
Legal settlements    (1,437)
Other (income) expense, net (100)  (2,876)
Total$3,124  $3,739 
Net of tax$2,312  $2,767 
Diluted EPS$0.07  $0.08 
        

(2) Adjusted EBITDA is defined as net income attributable to Amedisys, Inc. before provision for income taxes, net interest expense and depreciation and amortization, excluding certain items as described in footnote 1.
(3) Adjusted net service revenue is defined as net service revenue plus certain items as described in footnote 1.
(4) 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.
(5) 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.
(6) Adjusted EBITDA, adjusted net service revenue, 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.
(7) Planned closures consist of in-patient units acquired from Compassionate Care Hospice whose operations ceased in April 2019.

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