Select Medical Holdings Corporation (NYSE:SEM) Q3 2023 Earnings Conference Call November 3, 2023 9:00 AM ET Company Participants Robert Ortenzio - Executive Chairman & Co-Founder Martin Jackson - EVP & CFO Conference Call Participants Justin Bowers - Deutsche Bank Michael Murray - RBC Capital Markets William Sutherland - The Benchmark Company Operator Good morning, and thank you for joining us today for Select Medical Holdings Corporation's Earnings Conference Call to discuss the Third Quarter 2023 Results ...

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 10-Q (Mark One) ☒ QUARTERLY REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the Quarterly Period Ended September 30, 2023 OR ☐ TRANSITION REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from to Commission file numbers: 001-34465 SELECT MEDICAL HOLDINGS CORPORATION (Exact name of Registrant as specified in its Charter) Delaware 20-1764048 (Stat ...

Financial Data and Key Metrics Changes - Overall revenue grew by 6% year-over-year, with adjusted EBITDA increasing by 21% compared to Q2 of the prior year [10][11] - Total company adjusted EBITDA was $219.5 million compared to $181 million in the prior year, with a consolidated adjusted EBITDA margin of 13.1% for Q2 compared to 11.4% in the prior year [11][27] - Earnings per fully diluted share were $0.61 for the second quarter compared to $0.43 per share in the same quarter of the prior year [27] Business Line Data and Key Metrics Changes - The critical illness recovery hospital division saw a 227% increase in adjusted EBITDA, with a salary, wages, and benefit to revenue ratio of 56.7% [12][19] - The inpatient rehab hospital division experienced a 5% increase in net revenue, with patient volumes increasing by 1% and an adjusted EBITDA margin of 23% [23] - Concentra reported a 6% increase in net revenue driven by a 2% increase in volume and a 6% increase in rate, with an adjusted EBITDA margin of 21.5% [25] - The outpatient rehabilitation division experienced a 6% increase in net revenue, with patient volumes increasing by 11% but a decline in rate from $103 to $100 per visit [26] Market Data and Key Metrics Changes - The critical illness recovery hospital division's occupancy rate increased to 68% from 67% in the prior year [19] - Nursing agency rates decreased by 31% and utilization decreased by 44% compared to the prior year [20] - The inpatient rehab hospital division's occupancy was 84% compared to 86% in the prior year [23] Company Strategy and Development Direction - The company plans to continue focusing on incremental growth in existing markets rather than pursuing larger transactions [44] - There is a strong pipeline of growth opportunities, including new hospital openings and joint ventures [14][15][18] - The company aims to reduce SW&B as a percentage of revenue back to historical rates of 52% through contract negotiations and revenue growth [61] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the sustainability of current volume trends in IRFs and outpatient rehab, indicating that the growth is not solely due to deferred care from the pandemic [70] - The company anticipates continued improvements in labor costs and operational efficiencies [31][62] - Adjusted earnings per share are expected to be in the range of $1.86 to $2.03, with revenue projected between $6.55 billion and $6.7 billion for 2023 [40] Other Important Information - The company completed a refinancing transaction on July 31, extending the maturity of its term loan and revolving credit facility [36] - Capital expenditures are expected to be in the range of $190 million to $210 million for 2023 [41] Q&A Session Summary Question: Clarification on LTAC and upcoming openings - Management confirmed that the next critical illness recovery hospital opening will be in 2024, with no additional announcements for this year [43] Question: Outpatient strategy and appetite for larger transactions - Management indicated no current appetite for larger transactions, focusing instead on incremental growth through joint ventures [44] Question: CapEx and deleveraging strategy - Management expects to reduce debt through free cash flow and anticipates eliminating borrowings on the revolver by the end of 2024 [48] Question: Financial impact of LTAC final rule - Management acknowledged headwinds from the high-cost outlier increase but emphasized strategies to mitigate the impact [51] Question: Rate increases and case mix impact - Management expects Medicare rates to increase by approximately 3.5%, with better increases anticipated on the commercial side [56] Question: Sustainability of volume trends - Management believes the current volume trends are sustainable and not merely a result of pent-up demand from the pandemic [70]

PART I: FINANCIAL INFORMATION [ITEM 1. Condensed Consolidated Financial Statements](index=3&type=section&id=ITEM%201.%20Condensed%20Consolidated%20Financial%20Statements) This section presents the unaudited condensed consolidated financial statements, including balance sheets, statements of operations, and cash flows, reporting **$3.34 billion** revenue and **$177.1 million** net income for the six months ended June 30, 2023 [Condensed Consolidated Financial Statements](index=3&type=section&id=Condensed%20Consolidated%20Financial%20Statements) This section presents the core financial statements, showing total assets of **$7.70 billion**, Q2 2023 revenue of **$1.67 billion**, and **$286.3 million** in operating cash flow for the first six months of 2023 Condensed Consolidated Balance Sheet Data (in thousands) | Account | June 30, 2023 | December 31, 2022 | | :--- | :--- | :--- | | Total Current Assets | $1,304,484 | $1,271,313 | | Total Assets | $7,701,869 | $7,665,293 | | Total Current Liabilities | $1,188,212 | $1,155,151 | | Long-term debt, net | $3,695,341 | $3,835,211 | | Total Liabilities | $6,165,915 | $6,274,686 | | Total Equity | $1,501,579 | $1,356,564 | Condensed Consolidated Statements of Operations (in thousands, except per share amounts) | Metric | Q2 2023 | Q2 2022 | Six Months 2023 | Six Months 2022 | | :--- | :--- | :--- | :--- | :--- | | Revenue | $1,674,528 | $1,584,741 | $3,339,508 | $3,184,288 | | Income from operations | $159,204 | $120,967 | $310,661 | $224,952 | | Net income | $91,860 | $66,262 | $177,117 | $122,188 | | Net income attributable to Holdings | $78,237 | $55,207 | $149,042 | $104,324 | | Basic and diluted EPS | $0.61 | $0.43 | $1.17 | $0.79 | Condensed Consolidated Statements of Cash Flows (in thousands) | Cash Flow Activity | Six Months Ended June 30, 2023 | Six Months Ended June 30, 2022 | | :--- | :--- | :--- | | Net cash provided by operating activities | $286,278 | $178,018 | | Net cash used in investing activities | ($135,875) | ($114,094) | | Net cash used in financing activities | ($147,142) | ($43,565) | | Net increase in cash and cash equivalents | $3,261 | $20,359 | [Notes to Condensed Consolidated Financial Statements](index=9&type=section&id=Notes%20to%20Condensed%20Consolidated%20Financial%20Statements) This section provides detailed disclosures on accounting policies, credit risk, **$3.75 billion** in long-term debt, ongoing legal proceedings, and subsequent events like a dividend declaration and credit facility refinancing - Medicare represents the company's only significant concentration of credit risk, accounting for approximately **19%** of accounts receivable as of both June 30, 2023, and December 31, 2022[32](index=32&type=chunk) - As of June 30, 2023, total long-term debt and notes payable had a carrying value of **$3.75 billion**, a decrease from **$3.88 billion** at the end of 2022[41](index=41&type=chunk) - The company is cooperating with a U.S. Department of Justice investigation into potential False Claims Act violations related to billing for physical therapy services[67](index=67&type=chunk) - Subsequent to the quarter's end, on July 31, 2023, the company refinanced its credit agreement, securing a new **$2.1 billion** term loan and a **$710.0 million** revolving credit facility[69](index=69&type=chunk) - On August 2, 2023, the Board of Directors declared a cash dividend of **$0.125 per share**[68](index=68&type=chunk) [ITEM 2. Management's Discussion and Analysis of Financial Condition and Results of Operations (MD&A)](index=21&type=section&id=ITEM%202.%20MANAGEMENT%27S%20DISCUSSION%20AND%20ANALYSIS%20OF%20FINANCIAL%20CONDITION%20AND%20RESULTS%20OF%20OPERATIONS) Management discusses financial performance, highlighting a **5.7% revenue increase** and **21.3% Adjusted EBITDA rise** for Q2 2023, driven by reduced labor costs and detailing segment performance, regulatory changes, and liquidity [Overview and Regulatory Changes](index=22&type=section&id=Overview%20and%20Regulatory%20Changes) This section outlines the company's operational footprint and details significant regulatory changes, including the end of the COVID-19 public health emergency and updates to Medicare payment rates for LTCHs and IRFs - As of June 30, 2023, the company operated **108 critical illness recovery hospitals**, **32 rehabilitation hospitals**, **1,944 outpatient rehabilitation clinics**, and **540 occupational health centers** across 46 states and the District of Columbia[77](index=77&type=chunk) - The COVID-19 public health emergency ended on May 11, 2023, terminating most related Medicare waivers, including the waiver of the IRF 60% Rule and site-neutral payment requirements for LTCHs[95](index=95&type=chunk)[96](index=96&type=chunk) - For fiscal year 2024, CMS finalized an increase in the LTCH standard federal payment rate to **$48,117** (from **$46,433**) and the IRF standard payment conversion factor to **$18,541** (from **$17,878**)[102](index=102&type=chunk)[106](index=106&type=chunk) [Results of Operations](index=29&type=section&id=Results%20of%20Operations) This section analyzes Q2 2023 financial results, showing **5.7% revenue growth** and **31.6% income from operations increase**, with Critical Illness Recovery Hospital segment's Adjusted EBITDA surging **227.2%** due to reduced labor costs Q2 2023 vs Q2 2022 Performance Changes | Segment | Revenue Change | Adj. EBITDA Change | | :--- | :--- | :--- | | Critical Illness Recovery Hospital | +5.3% | +227.2% | | Rehabilitation Hospital | +5.2% | +9.7% | | Outpatient Rehabilitation | +5.5% | -2.2% | | Concentra | +5.8% | +8.4% | | **Total** | **+5.7%** | **+21.3%** | - The Critical Illness Recovery Hospital segment's Adjusted EBITDA margin improved dramatically from **3.7% to 11.4%** YoY for the quarter, primarily due to a significant decrease in labor costs, with total contract labor costs falling by approximately **62%** due to lower utilization and rates[130](index=130&type=chunk) - The Outpatient Rehabilitation segment's Adjusted EBITDA margin decreased from **11.7% to 10.8%** YoY for the quarter, primarily due to increased labor costs and a decrease in revenue per visit from **$103 to $100**[124](index=124&type=chunk)[132](index=132&type=chunk) - The Concentra segment's revenue increased **5.8%** YoY for the quarter, driven by a **5.5%** increase in revenue per visit to **$134**, while revenue from COVID-19 screening and testing services was nil in Q2 2023, compared to **$7.7 million** in Q2 2022[125](index=125&type=chunk) [Liquidity and Capital Resources](index=40&type=section&id=Liquidity%20and%20Capital%20Resources) The company's liquidity is strong, with operating cash flow increasing to **$286.3 million** for the first six months of 2023, supported by **$101.2 million** cash and **$248.8 million** revolving credit facility availability - Net cash provided by operating activities for the first six months of 2023 was **$286.3 million**, a significant increase from **$178.0 million** in the same period of 2022, which included a **$77.3 million** repayment of Medicare advance payments[160](index=160&type=chunk) - As of June 30, 2023, the company had **$101.2 million** in cash and cash equivalents and **$248.8 million** of availability under its revolving facility[171](index=171&type=chunk) - The company maintains a **$1.0 billion** stock repurchase program, effective until December 31, 2023, with no shares repurchased under this program during the six months ended June 30, 2023[169](index=169&type=chunk) [ITEM 3. Quantitative and Qualitative Disclosures About Market Risk](index=41&type=section&id=ITEM%203.%20QUANTITATIVE%20AND%20QUALITATIVE%20DISCLOSURES%20ABOUT%20MARKET%20RISK) The company's primary market risk is interest rate exposure on variable-rate debt, mitigated by an interest rate cap on **$2.0 billion** of its term loan, with a **0.25%** rate increase impacting annual interest expense by **$1.1 million** - The company is exposed to interest rate risk on its variable-rate debt, primarily its term loan and revolving credit facility indexed to SOFR[177](index=177&type=chunk) - An interest rate cap agreement mitigates risk by limiting the variable interest rate to **1.0%** on **$2.0 billion** of the term loan's principal through September 30, 2024[179](index=179&type=chunk) - A hypothetical **0.25%** increase in market interest rates would impact the company's annual interest expense by approximately **$1.1 million** on its unhedged variable-rate debt[180](index=180&type=chunk) [ITEM 4. Controls and Procedures](index=41&type=section&id=ITEM%204.%20CONTROLS%20AND%20PROCEDURES) Management concluded that disclosure controls and procedures were effective as of June 30, 2023, with no material changes to internal control over financial reporting during Q2 2023 - Based on an evaluation as of June 30, 2023, the principal executive officer and principal financial officer concluded that the company's disclosure controls and procedures are effective[181](index=181&type=chunk) - No changes in internal control over financial reporting were identified during the second quarter of 2023 that have materially affected, or are reasonably likely to materially affect, these controls[182](index=182&type=chunk) PART II: OTHER INFORMATION [ITEM 1. Legal Proceedings](index=42&type=section&id=ITEM%201.%20Legal%20Proceedings) This section refers to Note 13 for details on ongoing legal proceedings, including governmental audits and Department of Justice investigations related to billing practices - The report directs readers to Note 13 – Commitments and Contingencies for information on legal proceedings, detailing ongoing investigations by the Department of Justice regarding billing practices[184](index=184&type=chunk)[65](index=65&type=chunk)[67](index=67&type=chunk) [ITEM 1A. Risk Factors](index=42&type=section&id=ITEM%201A.%20Risk%20Factors) There have been no material changes to the risk factors previously disclosed in the Annual Report on Form 10-K for the year ended December 31, 2022 - There have been no material changes from the risk factors set forth in the Annual Report on Form 10-K for the year ended December 31, 2022[185](index=185&type=chunk) [ITEM 2. Unregistered Sales of Equity Securities and Use of Proceeds](index=42&type=section&id=ITEM%202.%20Unregistered%20Sales%20of%20Equity%20Securities%20and%20Use%20of%20Proceeds) The company maintains a **$1.0 billion** stock repurchase program, with **$399.7 million** remaining available, and acquired **49,370 shares** in Q2 2023 for tax withholding purposes, not under the public plan - The company has a common stock repurchase program authorized for up to **$1.0 billion**, which remains in effect until December 31, 2023[186](index=186&type=chunk) Equity Purchases in Q2 2023 | Month | Total Shares Purchased | Average Price Paid Per Share | Remaining Program Value | | :--- | :--- | :--- | :--- | | April 2023 | 49,370 | $30.50 | $399,677,961 | | May 2023 | 0 | N/A | $399,677,961 | | June 2023 | 0 | N/A | $399,677,961 | - The shares purchased during the quarter were surrendered by employees to satisfy tax withholding obligations and were not part of the publicly announced repurchase plan[188](index=188&type=chunk) [Other Items (3, 4, 5, 6)](index=42&type=section&id=Other%20Items) This section confirms no defaults on senior securities, non-applicability of mine safety disclosures, no Rule 10b5-1 plan changes by officers, and lists filed exhibits - Item 3 (Defaults Upon Senior Securities) and Item 4 (Mine Safety Disclosures) are not applicable[189](index=189&type=chunk)[190](index=190&type=chunk) - During the quarter, no directors or executive officers adopted or terminated any Rule 10b5-1 trading plans[191](index=191&type=chunk) - Item 6 lists exhibits filed with the report, including Amendment No. 7 to the Credit Agreement and required CEO/CFO certifications[192](index=192&type=chunk)

Select Medical Holdings Corporation (NYSE:SEM) Q1 2023 Earnings Conference Call May 5, 2023 9:00 AM ET Company Participants Robert Ortenzio - Executive Chairman and Co-Founder Martin Jackson - EVP and CFO Conference Call Participants Justin Bowers - Deutsche Bank Nabil Gutierrez - Bank of America Ben Hendrix - RBC Capital Markets A.J. Rice - Credit Suisse Bill Sutherland - The Benchmark Company Operator Good morning, and thank you for joining us today for Select Medical Holdings Corporation's Earnings Confe ...

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 10-Q (Mark One) ☒ QUARTERLY REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the Quarterly Period Ended March 31, 2023 OR ☐ TRANSITION REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from to Commission file numbers: 001-34465 SELECT MEDICAL HOLDINGS CORPORATION (Exact name of Registrant as specified in its Charter) Delaware 20-1764048 (State or ...

Select Medical Holdings Corporation (NYSE:SEM) Q4 2022 Earnings Conference Call February 24, 2023 9:00 AM ET Company Participants Robert Ortenzio - Executive Chairman and Co-Founder Martin Jackson - EVP and CFO Conference Call Participants Justin Bowers - Deutsche Bank Ben Hendrix - RBC Capital Markets Bill Sutherland - Benchmark Company Miles Highsmith - Deutsche Bank Operator Good morning, and thank you for joining us today for Select Medical Holdings Corporation's Earnings Conference Call to discuss the ...

Use these links to rapidly review the document TABLE OF CONTENTS UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 Form 10-K INDEX TO FINANCIAL STATEMENTS ☒ ANNUAL REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 Table of Contents 1 For fiscal year ended December 31, 2022 OR ☐ TRANSITION REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from to Commission file numbers: 001-34465 SELECT MEDICAL HOLDINGS C ...

Select Medical Holdings Corporation (NYSE:SEM) Q3 2022 Earnings Conference Call November 4, 2022 9:00 AM ET Company Participants Robert Ortenzio - Executive Chairman & Co-Founder Martin Jackson - Executive Vice President & Chief Financial Officer Conference Call Participants Justin Bowers - Deutsche Bank Joanna Gajuk - Bank of America Ben Hendrix - RBC Capital Markets Bill Sutherland - The Benchmark Company Miles Highsmith - Deutsche Bank A.J. Rice - Credit Suisse Operator Good morning and thank you for joi ...

Financial Performance - For the nine months ended September 30, 2022, the company reported total revenue of $4,752.1 million, with approximately 35% from the critical illness recovery hospital segment, 14% from the rehabilitation hospital segment, 18% from the outpatient rehabilitation segment, and 28% from the Concentra segment [74]. - Adjusted EBITDA for the nine months ended September 30, 2022, was $497.954 million, a decrease from $808.939 million in the same period of 2021 [78]. - Net income for the three months ended September 30, 2022, was $38.126 million, down from $100.217 million in the same period of 2021 [78]. - Total revenue for the company reached $1.57 billion for the three months ended September 30, 2022, up 2.2% from $1.53 billion in the same period of 2021 [84]. - Net income for the nine months ended September 30, 2022, was $160.3 million, down from $433.6 million for the same period in 2021 [87]. - Adjusted EBITDA for the company was $153.1 million in Q3 2022, reflecting a decrease of 26.6% compared to $208.6 million in Q3 2021 [85]. - Total revenue for the three months ended September 30, 2022, increased by 2.2% to $1,567.8 million compared to $1,534.2 million for the same period in 2021 [124]. - Total revenue for the nine months ended September 30, 2022, was $4,752.1 million, a 2.3% increase from $4,644.7 million in the same period of 2021 [87]. Segment Performance - The company operated 105 critical illness recovery hospitals, 31 rehabilitation hospitals, and 1,933 outpatient rehabilitation clinics as of September 30, 2022 [73]. - The company’s rehabilitation hospital segment generated approximately 14% of total revenue, highlighting its role in the overall business [74]. - Revenue for Critical Illness Recovery Hospital was $524.6 million for the three months ended September 30, 2022, a decrease of 1.1% compared to $530.6 million in the same period of 2021 [84]. - Rehabilitation Hospital revenue increased by 8.0% to $229.4 million in Q3 2022 from $212.4 million in Q3 2021 [85]. - Outpatient Rehabilitation revenue rose by 3.8% to $285.0 million in Q3 2022 compared to $274.5 million in Q3 2021 [85]. - Revenue from the Critical Illness Recovery Hospital segment decreased by 1.1% to $524.6 million, with revenue per patient day declining to $1,878 from $1,931 [125]. - Revenue for the Rehabilitation Hospital Segment increased by 7.3% to $678.9 million for the nine months ended September 30, 2022, with patient days rising by 3.7% to 321,690 [147]. - Revenue for the Outpatient Rehabilitation Segment rose by 4.6% to $844.2 million for the nine months ended September 30, 2022, driven by a 4.6% increase in patient visits to 7,165,866 [148]. - Concentra Segment's revenue was $1,309.4 million for the nine months ended September 30, 2022, down from $1,321.4 million in 2021, primarily due to a decline in COVID-19 screening revenue [149]. Operational Challenges - The company faced challenges due to the COVID-19 pandemic, impacting future operating results and financial condition [79]. - The company is subject to various risks, including changes in government reimbursement policies and competition, which could affect revenue and profitability [69]. - The company experienced a significant decline in income from operations, with a 50.3% decrease overall, and a notable drop of 89.4% in the Critical Illness Recovery Hospital segment [88]. - The company is navigating regulatory changes due to the COVID-19 pandemic, which may impact future financial performance [90]. - The company is focused on adapting to ongoing healthcare regulatory changes that may affect reimbursement and operational strategies [90]. Cost and Expenses - Operating expenses increased to $4,305.6 million, or 90.6% of revenue, for the nine months ended September 30, 2022, compared to $3,991.6 million, or 85.9% of revenue, for the same period in 2021 [151]. - The cost of services as a percentage of revenue increased from 84.6% in Q3 2021 to 88.9% in Q3 2022 [116]. - Total operating expenses for the three months ended September 30, 2022, were $1,433.3 million, representing 91.4% of revenue, up from 87.1% in the prior year [130]. Cash Flow and Dividends - Cash flows from operating activities were $272.3 million for the nine months ended September 30, 2022, down from $461.9 million in the same period of 2021 [168]. - The company had cash and cash equivalents of $108.2 million as of September 30, 2022, with $213.5 million available under its revolving facility [177]. - Cash dividends declared were $0.125 per share, with total cash dividends paid amounting to $16.7 million, $16.1 million, and $15.9 million in March, June, and September 2022 respectively [82]. - The board of directors declared a cash dividend of $0.125 per share on November 2, 2022, payable on or about November 29, 2022 [179]. Share Repurchase and Debt - The company repurchased 7,883,195 shares at a cost of approximately $185.1 million during the nine months ended September 30, 2022, as part of a $1.0 billion stock repurchase program [175]. - As of September 30, 2022, Select had outstanding borrowings of $2,103.4 million under a term loan and $380.0 million under a revolving facility [184]. - The company entered into an interest rate cap transaction to limit the 1-month LIBOR rate to 1.0% on $2.0 billion of principal outstanding under its term loan, effective through September 30, 2024 [185]. - As of September 30, 2022, the 1-month LIBOR rate was 3.14%, with $103.4 million of term loan borrowings subject to variable interest rates [185]. - Each 0.25% increase in market interest rates will impact the interest expense on Select's variable rate debt by $1.2 million [186].