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Almost Family Reports Second Quarter 2016 Results

LOUISVILLE, Ky., Aug. 03, 2016 (GLOBE NEWSWIRE) -- Almost Family, Inc. (Nasdaq:AFAM), a leading regional provider of home health nursing and personal care services, announced today its financial results for the quarter ended July 1, 2016.

Second Quarter Highlights (1):

  • Record net service revenues of approximately $156.0 million with record revenues in all three segments
  • GAAP EPS of $0.46 per diluted share, down $0.06 from a year ago, Adjusted EPS of $0.61, up $0.07 from a year ago 
  • GAAP net income of $4.8 million, down $0.2 million from a year ago, Adjusted net income of $6.3 million, up $1.2 million from a year ago
  • Record Adjusted EBITDA of $13.8 million, up 34% from a year ago
  • Healthcare Innovations (HCI) segment contributed $0.03 in earnings per share, while performing nearly 20,000 in-home assessments and having nearly 122,000 ACO beneficiaries and 15 Accountable Care Organizations under contract
  • Year to date operating cash flow of $10.4 million
  • On June 18, 2016, we completed the previously announced acquisition of certain home health agencies in Wisconsin, Connecticut and Kentucky

___________

(1) See Non-GAAP Financial Measures starting on page 12.

Management Comments
William Yarmuth, Chairman and Chief Executive Officer, commented:  “We are pleased with our quarterly results as we produced record revenues and solid performance while continuing with the integration of recent significant acquisition activity.  This is the first quarter in which our HCI segment has generated positive earnings without an ACO shared savings payment.  In only two years since its inception, the HCI segment has established a meaningful business presence with an expectation of on-going profitability.  Over the balance of 2016 we will continue to integrate our recent acquisitions, focus on the operation and growth of our existing operations and seek additional acquisition opportunities.”

Steve Guenthner, President added:  “We remain optimistic about the future and comparatively favorable capital market and regulatory conditions.  The recently released 2017 preliminary rule on Medicare home health reimbursement marks the last of four years of rebasing of home health rates.  We feel CMS’ recently announced pre-claim review process, which may initially be somewhat burdensome, if properly implemented should serve to reduce real and perceived payment error rates and help build a relationship of trust between the Program and providers that is critical to home health achieving its real potential in the health care delivery system.  We support CMS’ program integrity efforts and will continue to work with them to find the best approaches to implementation.”

Yarmuth concluded:  “The knowledge we are gaining from our HCI investments and their overall role in various models to control costs through well managed care only reinforces our overarching thesis that home health care is essential to the future of and will play an ever growing part in our health care delivery system. We will build on this, and our accomplishments to date, as we seek to maintain our growth trajectory.  I want to thank our 14,000+ employees for their continued commitment to our important mission-based work and express my confidence in our ability to continue to be a leader in the industry.”

Second Quarter Financial Results
VN segment net revenues increased $12.9 million to a record $110.7 million from $97.7 million in the prior year and total Medicare admissions grew by 5% to 23,920 from 22,782 primarily due to home health agencies acquired in late 2015 and early 2016.  VN segment contribution increased $2.8 million, or 22.7%, to $15.3 million, from $12.5 million in the prior year period.  Contribution margin as a percentage of revenue increased to 13.8% from 12.8%.  On a same-store basis, Medicare admissions outside of Florida grew by 3.1%.  The Company is continuing its efforts to improve the performance of its Florida business, however, with its growth and acquisition activity outside of the state, the impact of Florida performance on the Company’s operating results is lessening.  Florida operations currently account for approximately one-fourth of VN segment revenues as compared to one-third a year ago and one-half three years ago.

PC segment net revenues increased $10.2 million or 34.6% to a record $39.7 million in 2016 from $29.5 million in 2015 primarily due to acquisitions.  PC segment contribution decreased $0.6 million as compared to the same period of last year, primarily due to rate reductions in certain skilled elements of the Ohio Medicaid program as well as higher provision for bad debts in two Medicaid managed care states.

HCI segment net revenues increased $5.5 million to a record $5.6 million, in 2016 from $0.1 million in 2015.  The HCI segment earned $0.03 EPS in its first quarter of profitability without an ACO-related shared savings payment.  The HCI segment is expected to be profitable for the balance of 2016.

Corporate expenses as a percentage of revenue declined to 4.5%, from 5.4% in the prior year period.  Deal, transition and other costs grew to $2.6 million for 2016, primarily as a result of costs related to 2016 and 2015 acquisitions.  Borrowings related to acquisitions increased interest expense to $1.6 million, from $0.5 million in the prior year period.

Net cash from operating activities of $4.9 million was generated in the second quarter of 2016.  Home Health accounts receivable days sales outstanding were 56 at the end of the second quarter of 2016 as compared to 59 at the end of the second quarter of 2015.

The effective tax rate for the second quarter of 2016 and 2015 was 40.5% and 40.3%, respectively. 

Year to Date Financial Results
VN segment net revenues increased $23.0 million to a record $220.3 million from $197.3 million in the prior year period and total Medicare admissions grew by 1.3% to 47,105 from 46,504 primarily due to home health agencies acquired in late 2015 and 2016.  VN segment contribution increased $5.4 million, or 21.7%, to $30.3 million, from $24.9 million in the first half of last year.  Contribution margin as a percentage of revenue increased to 13.7% from 12.6%.  On a same-store basis, Medicare admissions outside of Florida grew organically by 2.8%.  Within Florida, same store Medicare admissions in Florida in the first half of 2016 were 7.6% below the first half of 2015 which represented a high-water mark for Florida Medicare admissions. 

PC segment net revenues increased $21.1 million or 36.3% to a record $79.4 million in 2016 from $58.2 million in 2015 primarily due to acquisitions.  PC segment contribution increased 3.4% or $0.2 million as compared to the first half of last year.

HCI segment net revenues increased $9.8 million to a record $10.0 million in 2016 from $0.2 million in 2015.  The HCI segment contribution improved $1.0 million over the first half of 2015.

Corporate expenses as a percentage of revenue declined to 4.7%, from 5.4% in the prior year period.  Deal, transition and other costs grew to $5.2 million for 2016, primarily as a result of costs related to 2016 and 2015 acquisitions.  Borrowings related to acquisitions increased interest expense to $2.9 million, from $0.9 million in the first half of 2015.

Net cash from operating activities of $10.4 million was generated in the first half of 2016, more than double the $5.1 million generated in the first half of 2015. 

The effective tax rate for the second quarter of 2016 and 2015 was 40.5% and 40.4%, respectively. 

The Company noted that it will continue to pursue quality acquisitions of in-home health care service providers consistent with its stated strategy and the types of services its segments currently provide.

Medicare Program Developments
On June 27, 2016, the Centers for Medicare and Medicaid Services (CMS) issued its proposed rule for 2017.  CMS is proposing a 1.0% rate cut consisting of a 2.8% market basket update minus a 0.5% productivity adjustment, a 2.3% rebasing cut, and a 0.97% case mix adjustment.  The proposed rule, which also proposes certain refinements to the Home Health Value-based Purchasing Model is currently open for comment.  The final rule is expected to be released in late October 2016.

On June 8, 2016, CMS announced the “Pre-Claim Review Demonstration of Home Health Services” which seeks to demonstrate that a review of selected documentation prior to payment of claims can decrease “improper payments because of insufficient documentation”.  According to the CMS announcement, the pre-claim review demonstration will help educate HHAs on what documentation is required and encourage them to submit the correct documentation, while still allowing the HHA to begin providing services and receive initial payments prior to the pre-claim review decision.  The pre-claim review demonstration will begin in Illinois no earlier than August 1, 2016 and the remaining states of Florida, Texas, Michigan and Massachusetts will phase in over 2016 and 2017.  The Company is currently unable to predict what impact, if any, this demonstration program may have on its results of operations or financial position.

 
ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME
(In thousands, except per share data)
(UNAUDITED)
 
  Three month period ended   Six months ended
  July 1, 2016   July 3, 2015   July 1, 2016   July 3, 2015
Net service revenues $ 155,996     $ 127,366     $ 309,694     $ 255,765  
Cost of service revenues (excluding depreciation & amortization)    83,692        66,343        165,924        134,659  
Gross margin    72,304        61,023        143,770        121,106  
General and administrative expenses:              
Salaries and benefits    41,502        35,832        83,182        72,225  
Other    18,715        16,356        38,156        32,175  
Deal and transition costs    2,589        203        5,198        609  
Total general and administrative expenses    62,806        52,391        126,536        105,009  
Operating income    9,498        8,632        17,234        16,097  
Interest expense, net    (1,604 )      (457 )      (2,936 )      (905 )
Income before income taxes    7,894        8,175        14,298        15,192  
Income tax expense    (3,250 )      (3,393 )      (5,927 )      (6,381 )
Net income    4,644        4,782        8,371        8,811  
Net loss - noncontrolling interests    133        228        323        592  
Net income attributable to Almost Family, Inc. $ 4,777     $ 5,010     $ 8,694     $ 9,403  
               
Per share amounts-basic:              
Average shares outstanding    10,158        9,393        10,125        9,377  
               
Net income attributable to Almost Family, Inc. $ 0.47     $ 0.53     $ 0.86     $ 1.00  
               
Per share amounts-diluted:              
Average shares outstanding    10,322        9,569        10,311        9,554  
               
Net income attributable to Almost Family, Inc. $ 0.46     $ 0.52     $ 0.84     $ 0.98  
                               

 

ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(In thousands)
 
   
    July 1, 2016        
    (UNAUDITED)   January 1, 2016  
ASSETS              
CURRENT ASSETS:              
Cash and cash equivalents   $   5,914     $   7,522    
Accounts receivable - net       95,623         92,909    
Prepaid expenses and other current assets       9,853         9,033    
TOTAL CURRENT ASSETS       111,390         109,464    
PROPERTY AND EQUIPMENT - NET       8,626         10,000    
GOODWILL       321,539         277,061    
OTHER INTANGIBLE ASSETS       69,811         64,629    
OTHER ASSETS       4,086         3,615    
TOTAL ASSETS   $   515,452     $   464,769    
               
LIABILITIES AND STOCKHOLDERS’ EQUITY              
CURRENT LIABILITIES:              
Accounts payable   $   13,937     $   12,297    
Accrued other liabilities       39,280         42,524    
TOTAL CURRENT LIABILITIES       53,217         54,821    
               
LONG-TERM LIABILITIES:              
Revolving credit facility        135,175          113,790    
Deferred tax liabilities        17,094          13,094    
Seller notes        12,500          6,556    
Other liabilities        3,330          2,608    
TOTAL LONG-TERM LIABILITIES        168,099          136,048    
TOTAL LIABILITIES        221,316          190,869    
               
NONCONTROLLING INTEREST - REDEEMABLE -              
HEALTHCARE INNOVATIONS        3,639          3,639    
               
STOCKHOLDERS’ EQUITY:              
Preferred stock, par value $0.05; authorized 2,000 shares; none issued or outstanding                  
Common stock, par value $0.10; authorized 25,000; 10,490 and 10,125 issued and outstanding        1,049          1,013    
Treasury stock, at cost, 116 and 103 shares        (3,214 )        (2,731 )  
Additional paid-in capital        139,565          127,253    
Noncontrolling interest - nonredeemable        (718 )        (730 )  
Retained earnings        153,815          145,456    
TOTAL STOCKHOLDERS’ EQUITY        290,497          270,261    
TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY   $    515,452     $    464,769    
                       

 

ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(UNAUDITED)
(In thousands)
 
  Six months ended
  July 1, 2016   July 3, 2015
Cash flows of operating activities:      
Net income $ 8,371     $ 8,811  
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization    1,984        1,780  
Provision for uncollectible accounts    7,859        4,821  
Stock-based compensation    1,402        1,005  
Deferred income taxes    4,236        1,639  
     23,852        18,056  
Change in certain net assets and liabilities, net of the effects of acquisitions:      
Accounts receivable    (10,081 )      (12,522 )
Prepaid expenses and other current assets    (511 )      3,538  
Other assets    (492 )      46  
Accounts payable and accrued expenses    (2,363 )      (4,062 )
Net cash provided by operating activities    10,405        5,056  
       
Cash flows of investing activities:      
Capital expenditures    (2,275 )      (1,147 )
Cost basis investment    -        (1,000 )
Acquisitions, net of cash acquired    (30,754 )      (3,000 )
Net cash used in investing activities    (33,029 )      (5,147 )
       
Cash flows of financing activities:      
Credit facility borrowings    145,538        87,747  
Credit facility repayments    (124,153 )      (86,743 )
Debt issuance fees    (102 )      (1,161 )
Proceeds from stock option exercises    16        68  
Purchase of common stock in connection with share awards    (484 )      (338 )
Tax impact of share awards    256        210  
Payment of special dividend in connection with share awards    -        (50 )
Principal payments on notes payable and capital leases    (55 )      (30 )
Net cash provided by (used in) financing activities    21,016        (297 )
       
Net change in cash and cash equivalents    (1,608 )      (388 )
Cash and cash equivalents at beginning of period    7,522        6,886  
Cash and cash equivalents at end of period $ 5,914     $ 6,498  
               

 

ALMOST FAMILY, INC. AND SUBSIDIARIES
RESULTS OF OPERATIONS
(UNAUDITED)
(In thousands)
 
   
    Three months ended            
    July 1, 2016   July 3, 2015   Change  
    Amount   % Rev   Amount   % Rev   Amount   %  
Home Health Operations                                
Net service revenues:                                
Visiting Nurse   $    110,658       73.6 %   $    97,748       76.8 %   $   12,910       13.2 %  
Personal Care        39,694       26.4 %        29,488       23.2 %       10,206       34.6 %  
         150,352       100.0 %        127,236       100.0 %       23,116       18.2 %  
Operating income before corporate expenses:                                
Visiting Nurse        15,310       13.8 %        12,482       12.8 %       2,828       22.7 %  
Personal Care        3,008       7.6 %        3,604       12.2 %       (596 )     -16.5 %  
         18,318       12.2 %        16,086       12.6 %       2,232       13.9 %  
Healthcare Innovations Operations                                
Revenue        5,644       100.0 %        130       100.0 %       5,514       4241.5 %  
Operating income (loss)        720       12.8 %        (402 )     -309.2 %       1,122       279.1 %  
                                 
Corporate expenses        6,951       4.5 %        6,849       5.4 %       102       1.5 %  
Deal, transition and other costs        2,589       1.7 %       203       0.2 %       2,386       1175.4 %  
Operating income        9,498       6.1 %        8,632       6.8 %       866       10.0 %  
Interest expense, net        (1,604 )     -1.0 %        (457 )     -0.4 %       (1,147 )     251.0 %  
Income tax expense        (3,250 )     -2.1 %        (3,393 )     -2.7 %       143       -4.2 %  
Net income   $    4,644       3.0 %   $    4,782       3.8 %   $    (138 )     -2.9 %  
                                 
Adjusted EBITDA (1)   $    13,768       8.8 %   $    10,345       8.1 %   $    3,423       33.1 %  
Adjusted net income (1)   $    6,317       4.0 %   $    5,131       4.0 %   $    1,187       23.1 %  
__________________  
(1) See Non-GAAP Financial Measures starting on page 12.  

 

    Six months ended            
    July 1, 2016   July 3, 2015   Change  
    Amount   % Rev   Amount   % Rev   Amount   %  
Home Health Operations                                
Net service revenues:                                
Visiting Nurse   $    220,271       73.5 %   $    197,283       77.2 %   $   22,988       11.7 %  
Personal Care        79,387       26.5 %        58,249       22.8 %       21,138       36.3 %  
         299,658       100.0 %        255,532       100.0 %       44,126       17.3 %  
Operating income before corporate expenses:                                
Visiting Nurse        30,287       13.7 %        24,883       12.6 %       5,404       21.7 %  
Personal Care        6,732       8.5 %        6,513       11.2 %       219       3.4 %  
         37,019       12.4 %        31,396       12.3 %       5,623       17.9 %  
Healthcare Innovations Operations                                
Revenue        10,036       100.0 %        233       100.0 %       9,803       4207.3 %  
Operating income (loss)        47       0.5 %        (919 )     -394.4 %       966     NM  
                                 
Corporate expenses        14,634       4.7 %        13,771       5.4 %       863       6.3 %  
Deal, transition and other costs        5,198       1.7 %        609       0.2 %       4,589       753.5 %  
Operating income        17,234       5.6 %        16,097       6.3 %       1,137       7.1 %  
Interest expense, net        (2,936 )     -0.9 %        (905 )     -0.4 %       (2,031 )     224.4 %  
Income tax expense        (5,927 )     -1.9 %        (6,381 )     -2.5 %       454       -7.1 %  
Net income   $    8,371       2.7 %   $    8,811       3.4 %   $   (440 )     -5.0 %  
                                 
Adjusted EBITDA (1)   $    26,006       8.4 %   $    19,931       7.8 %   $    6,075       30.5 %  
Adjusted net income (1)   $    11,787       3.8 %   $    9,765       3.8 %   $    2,021       20.7 %  
__________________  
(2) See Non-GAAP Financial Measures starting on page 12.  


VISITING NURSE SEGMENT OPERATING METRICS  
   
    Three months ended            
    July 1, 2016   July 3, 2015   Change  
    Amount   %   Amount   %   Amount   %  
Average number of locations        163              162              1       0.6 %  
                                 
All payors:                                
Patient months        90,737              81,067              9,670       11.9 %  
Admissions        27,410              24,920              2,490       10.0 %  
Billable visits        735,138              638,479              96,659       15.1 %  
                                 
Medicare:                                
Admissions        23,920       87 %        22,782       91 %        1,138       5.0 %  
Revenue (in thousands)   $    103,514       94 %   $    93,673       96 %   $    9,841       10.5 %  
Revenue per admission   $    4,328         $    4,112         $    216       5.2 %  
Billable visits        647,490       88 %        580,709       91 %        66,781       11.5 %  
Recertifications        12,579              11,580              999       8.6 %  
Payor mix % of Admissions                                
Traditional Medicare Episodic       83.2 %           82.9 %           0.3 %      
Replacement Plans Paid Episodically       4.8 %           3.9 %           0.9 %      
Replacement Plans Paid Per Visit       12.0 %           13.2 %           -1.2 %      
                                 
Non-Medicare:                                
Admissions        3,490       13 %        2,138       9 %        1,352       63.2 %  
Revenue (in thousands)   $    7,144       6 %   $    4,075       4 %   $    3,069       75.3 %  
Revenue per admission   $    2,047         $    1,906         $    141       7.4 %  
Billable visits        87,648       12 %        57,770       9 %        29,878       51.7 %  
Recertifications        1,153              480              673       140.2 %  
Payor mix % of Admissions                                
Medicaid & other governmental       25.8 %           36.8 %           -11.0 %      
Private payors       74.2 %           63.2 %           11.0 %      


PERSONAL CARE SEGMENT OPERATING METRICS  
   
    Three months ended            
    July 1, 2016   July 3, 2015   Change  
    Amount   Amount   Amount   %  
Average number of locations      71      62        9       14.5 %  
                         
Admissions      2,591      1,651        940       56.9 %  
Patient months of care      39,758      23,722        16,036       67.6 %  
Billable hours      1,833,784      1,317,978        515,806       39.1 %  
Revenue per billable hour   $  21.65   $  22.37   $    (0.73 )     -3.3 %  

      

VISITING NURSE SEGMENT OPERATING METRICS  
                                 
    Six months ended            
    July 1, 2016       July 3, 2015   Change  
    Amount   %   Amount   %   Amount   %  
Average number of locations        163              162             1       0.6 %  
                                 
All payors:                                
Patient months        182,695              162,049              20,646       12.7 %  
Admissions        55,911              51,199              4,712       9.2 %  
Billable visits        1,467,380              1,281,071              186,309       14.5 %  
                                 
Medicare:                                
Admissions        47,105       84 %        46,504       91 %        601       1.3 %  
Revenue (in thousands)   $    206,672       94 %   $    188,794       96 %   $    17,878       9.5 %  
Revenue per admission   $    4,387         $    4,060         $   328       8.1 %  
Billable visits        1,295,836       88 %        1,165,147       91 %        130,689       11.2 %  
Recertifications        25,170              23,507              1,663       7.1 %  
Payor mix % of Admissions                                
Traditional Medicare Episodic       81.8 %           83.5 %           -1.7 %      
Replacement Plans Paid Episodically       4.9 %           4.0 %           0.9 %      
Replacement Plans Paid Per Visit       13.3 %           12.5 %           0.8 %      
                                 
Non-Medicare:                                
Admissions        8,806       16 %        4,695       9 %        4,111       87.6 %  
Revenue (in thousands)   $    13,599       6 %   $    8,489       4 %   $    5,110       60.2 %  
Revenue per admission   $    1,544         $    1,808         $    (264 )     -14.6 %  
Billable visits        171,544       12 %        115,924       9 %        55,620       48.0 %  
Recertifications        2,284              907              1,377       151.8 %  
Payor mix % of Admissions                                
Medicaid & other governmental       45.9 %           33.5 %           12.4 %      
Private payors       54.1 %           66.5 %           -12.4 %      


PERSONAL CARE OPERATING METRICS  
                                 
    Six months ended            
    July 1, 2016   July 3, 2015   Change  
    Amount   %   Amount   %   Amount   %  
Average number of locations      71          62            9       14.5 %  
                                 
Admissions      5,037          3,078            1,959       63.6 %  
Patient months of care      78,818          46,488            32,330       69.5 %  
Billable hours      3,655,323          2,604,862            1,050,461       40.3 %  
Revenue per billable hour   $ 21.72       $ 22.36       $   (0.64 )     -2.9 %  


HEALTHCARE INNOVATIONS SUPPLEMENTAL DATA  
   
    Three months ended            
    July 1, 2016   July 3, 2015     Change  
    Amount   Amount     Amount   %  
In-home Assessments        19,820          -          19,820     NM  
                         
Medicare ACO enrollees under management        121,881          83,133          38,748       46.6 %  
ACOs under contract        15          11          4       36.4 %  
Assets   $    62,050     $    9,428     $    52,622       558.1 %  
Liabilities   $    28,395     $    226     $    28,169       12464.2 %  
Non-controlling interest - redeemable   $    3,639     $    3,639     $    -       0.0 %  
Non-controlling interest - nonredeemable   $    (184 )   $    (155 )   $    (29 )     18.7 %  


    Six months ended            
    July 1, 2016   July 3, 2015     Change  
    Amount   Amount     Amount   %  
In-home Assessments      36,766      -      36,766   NM  
                         
Medicare enrollees under management      121,881      83,133      38,748     46.6 %  
ACOs under contract      15      11      4     36.4 %  
                             

Non-GAAP Financial Measures
The information provided in some of the tables in this release includes certain non-GAAP financial measures as defined under SEC rules.  In accordance with SEC rules, the Company has provided, in the supplemental information, a reconciliation of those measures to the most directly comparable GAAP measures.

Adjusted Net Income and Adjusted Earnings Per Share
Adjusted net income and adjusted earnings per share are not measures of financial performance under accounting principles generally accepted in the United States of America.  They should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles. The presentation of adjusted net income and adjusted earnings per share provides investors with pertinent information to enable comparison of financial performance between periods by excluding certain items that the Company believes are not representative of its ongoing operations due to the nature of the items. 

The following tables set forth a reconciliation of net income attributable to Almost Family, Inc. to adjusted net income:

   
ALMOST FAMILY, INC. AND SUBSIDIARIES
RECONCILIATION OF ADJUSTED NET INCOME AND ADJUSTED EARNINGS PER SHARE
 (In thousands)
 
   
    Three month period ended   Six months ended  
(in thousands)   July 1, 2016   July 3, 2015   July 1, 2016   July 3, 2015  
Net income attributable to Almost Family, Inc.   $  4,777   $    5,010     $    8,694     $    9,403    
                           
Addbacks:                          
Deal, transition and other, net of tax      1,540        121          3,093          362    
Adjusted net income   $  6,317   $    5,131     $    11,787     $    9,765    
                           
Per share amounts-diluted:                          
Average shares outstanding      10,322        9,569          10,311          9,554    
                           
Net income attributable to Almost Family, Inc.   $  0.46   $    0.52     $    0.84     $    0.98    
                           
Addbacks:                          
Deal, transition and other, net of tax      0.15        0.02          0.30          0.04    
Adjusted earnings per share   $  0.61   $    0.54     $    1.14     $    1.02    
                                       
Adjusted earnings per share:                                      
Home health operations   $  0.58   $    0.55     $    1.16     $    1.06    
Healthcare Innovations      0.03        (0.01 )        (0.02 )        (0.04 )  
Total   $  0.61   $    0.54     $    1.14     $    1.02    
                                       

Adjusted EBITDA 
Adjusted earnings before interest, income tax, depreciation and amortization, amortization of stock-based compensation, deal, transition and other (Adjusted EBITDA) is not a measure of financial performance under accounting principles generally accepted in the United States of America.  It should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.  The items excluded from Adjusted EBITDA Operations are significant components in understanding and evaluating financial performance and liquidity.  Management routinely calculates and communicates Adjusted EBITDA Operations and believes that it is useful to investors because it provides a common analytical indicator within our industry to evaluate performance, measure leverage capacity and debt service ability, and to estimate current or prospective enterprise value.  Adjusted EBITDA is also used in certain covenants contained in our credit agreement.

The following tables set forth a reconciliation of net income from continuing operations to Adjusted EBITDA from Home Health Operations:

   
ALMOST FAMILY, INC. AND SUBSIDIARIES
RECONCILIATION OF ADJUSTED EBITDA
 (In thousands)
 
   
    Three month period ended   Six months ended  
(in thousands)   July 1, 2016   July 3, 2015   July 1, 2016     July 3, 2015  
Net income   $  4,777   $    5,010     $  8,694     $    9,403    
Add back:                            
Interest expense      1,604        457        2,936          905    
Income tax expense      3,250        3,393        5,927          6,381    
Depreciation and amortization      864        797        1,849          1,628    
Stock-based compensation      684        485        1,402          1,005    
Deal and transition costs      2,589        203        5,198          609    
Adjusted EBITDA   $  13,768   $    10,345     $  26,006     $    19,931    
                             
Adjusted EBITDA:                            
Home health operations   $  12,147   $    10,818     $  24,714     $    21,021    
Healthcare Innovations      1,621        (473 )      1,292          (1,090 )  
Total   $  13,768   $    10,345     $  26,006     $    19,931    
                                     

About Almost Family, Inc.
Almost Family, Inc., founded in 1976, is a leading regional provider of home health nursing services, with branch locations in Florida, Ohio, Tennessee, New York, Connecticut, Kentucky, New Jersey, Massachusetts, Pennsylvania, Georgia, Wisconsin, Indiana, Missouri, Illinois, Mississippi and Alabama (in order of revenue significance).  Almost Family, Inc. and its subsidiaries operate a Medicare-certified segment, a personal care segment and a healthcare innovations segment.  Almost Family operates over 240 branch locations in sixteen U.S. states.

Forward Looking Statements
All statements, other than statements of historical facts, included in this news release are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may be identified by the use of forward-looking terminology such as “may,” “will,” “expect,” “believe,” “estimate,” “project,” “anticipate,” “continue,” or similar terms, variations of those terms or the negative of those terms. These forward-looking statements are based on the Company's current plans, expectations and projections about future events.

Because forward-looking statements involve risks and uncertainties, the Company's actual results could differ materially from any future results, performance or achievements expressed or implied by such forward-looking statements. The potential risks and uncertainties which could cause actual results to differ materially include: regulatory approvals or third party consents may not be obtained; the impact of further changes in healthcare reimbursement systems, including the ultimate outcome of potential changes to Medicare reimbursement for home health services and to Medicaid reimbursement due to state budget shortfalls; the ability of the Company to maintain its level of operating performance and achieve its cost control objectives; changes in our relationships with referral sources; the ability of the Company to integrate acquired operations including obtaining synergies, integration objectives and anticipated timelines; government regulation; health care reform; pricing pressures from Medicare, Medicaid and other third-party payers; changes in laws and interpretations of laws relating to the healthcare industry; the ability of the Company to integrate, manage and keep secure our information systems; changes in the marketplace and regulatory environment for Health Risk Assessments and the Company’s self-insurance risks.  For a more complete discussion regarding these and other factors which could affect the Company's financial performance, refer to the Company's various filings with the Securities and Exchange Commission, including its filing on Form 10-K for the fiscal year ended January 1, 2016, in particular information under the headings "Special Caution Regarding Forward-Looking Statements" and “Risk Factors.” With regard to the Company’s investment in development-stage enterprises in its Healthcare Innovations segment, there can be no assurance that its operational and developmental objectives will be realized or that the Company’s investments will result in future returns.  The Company undertakes no obligation to update or revise its forward-looking statements.

Almost Family, Inc.
Steve Guenthner
(502) 891-1000

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