☒
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ANNUAL REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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☐
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TRANSITION REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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Delaware
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20-1764048
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(State or Other Jurisdiction of Incorporation or Organization)
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(I.R.S. Employer Identification Number)
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Title of Each Class
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Trading Symbol(s)
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Name of Each Exchange on Which Registered
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Common Stock, $0.001 par value per share
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SEM
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New York Stock Exchange
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Large accelerated filer
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☒
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Accelerated filer
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☐
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Non-accelerated filer
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☐
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Smaller reporting company
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☐
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Emerging growth company
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☐
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•
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changes in government reimbursement for our services and/or new payment policies may result in a reduction in net operating revenues, an increase in costs, and a reduction in profitability;
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•
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the failure of our Medicare-certified long term care hospitals or inpatient rehabilitation facilities to maintain their Medicare certifications may cause our net operating revenues and profitability to decline;
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•
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the failure of our Medicare-certified long term care hospitals and inpatient rehabilitation facilities operated as “hospitals within hospitals” to qualify as hospitals separate from their host hospitals may cause our net operating revenues and profitability to decline;
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•
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a government investigation or assertion that we have violated applicable regulations may result in sanctions or reputational harm and increased costs;
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•
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acquisitions or joint ventures may prove difficult or unsuccessful, use significant resources, or expose us to unforeseen liabilities;
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•
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our plans and expectations related to our acquisitions and our ability to realize anticipated synergies;
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•
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private third-party payors for our services may adopt payment policies that could limit our future net operating revenues and profitability;
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•
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the failure to maintain established relationships with the physicians in the areas we serve could reduce our net operating revenues and profitability;
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•
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shortages in qualified nurses, therapists, physicians, or other licensed providers could increase our operating costs significantly or limit our ability to staff our facilities;
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•
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competition may limit our ability to grow and result in a decrease in our net operating revenues and profitability;
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•
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the loss of key members of our management team could significantly disrupt our operations;
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•
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the effect of claims asserted against us could subject us to substantial uninsured liabilities;
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•
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a security breach of our or our third-party vendors’ information technology systems may subject us to potential legal and reputational harm and may result in a violation of the Health Insurance Portability and Accountability Act of 1996 or the Health Information Technology for Economic and Clinical Health Act; and
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•
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other factors discussed from time to time in our filings with the Securities and Exchange Commission (the “SEC”), including factors discussed under the heading “Risk Factors” of this annual report on Form 10-K.
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•
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centralizing administrative functions such as accounting, finance, treasury, payroll, legal, operational support, human resources, compliance, and billing and collection;
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•
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standardizing management information systems to assist in capturing the medical record, accounting, billing, collections, and data capture and analysis; and
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•
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centralizing sourcing and contracting to receive discounted prices for pharmaceuticals, medical supplies, and other commodities used in our operations.
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•
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centralizing administrative functions such as accounting, finance, treasury, payroll, legal, operational support, human resources, compliance, and billing and collection;
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•
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standardizing management information systems to assist in capturing the medical record, accounting, billing, collections, and data capture and analysis; and
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•
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centralizing sourcing and contracting to receive discounted prices for pharmaceuticals, medical supplies, and other commodities used in our operations.
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Year Ended December 31,
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|||||||
Net Operating Revenues by Payor Source
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2017
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2018
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2019
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Medicare
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30.1
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%
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26.6
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%
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25.9
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%
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Commercial insurance(1)
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34.4
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%
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31.8
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%
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32.3
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%
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Workers’ Compensation
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17.2
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%
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22.1
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%
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21.4
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%
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Private and other(2)
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15.3
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%
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16.8
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%
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17.5
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%
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Medicaid
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3.0
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%
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2.7
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%
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2.9
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%
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Total
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100.0
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%
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100.0
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%
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100.0
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%
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(1)
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Primarily includes commercial healthcare insurance carriers, health maintenance organizations, preferred provider organizations, and managed care programs.
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(2)
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Primarily includes management services, employer services, self-payors, and non-patient related payments. Self-pay revenues represent less than 1% of total net operating revenues for all periods.
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Year Ended December 31,
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|||||||
Medicare Net Operating Revenues by Segment
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2017
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2018
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2019
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Critical illness recovery hospital
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52.4
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%
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50.9
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%
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49.4
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%
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Rehabilitation hospital
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50.9
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%
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50.3
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%
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49.6
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%
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Outpatient rehabilitation
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15.4
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%
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16.2
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%
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16.4
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%
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Concentra
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0.2
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%
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0.1
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%
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0.1
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%
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Total Company
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30.1
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%
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26.6
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%
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25.9
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%
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Name
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Age
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Position
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Robert A. Ortenzio
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62
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Executive Chairman and Co-Founder
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Rocco A. Ortenzio
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87
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Vice Chairman and Co-Founder
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David S. Chernow
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62
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President and Chief Executive Officer
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Martin F. Jackson
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65
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Executive Vice President and Chief Financial Officer
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John A. Saich
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51
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Executive Vice President and Chief Administrative Officer
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Michael E. Tarvin
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59
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Executive Vice President, General Counsel and Secretary
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Scott A. Romberger
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59
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Senior Vice President, Controller and Chief Accounting Officer
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Robert G. Breighner, Jr.
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50
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Vice President, Compliance and Audit Services and Corporate Compliance Officer
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•
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requires us to dedicate a substantial portion of our cash flow from operations to payments on our indebtedness, reducing the availability of our cash flow to fund working capital, capital expenditures, development activity, acquisitions, and other general corporate purposes;
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•
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increases our vulnerability to adverse general economic or industry conditions;
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•
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limits our flexibility in planning for, or reacting to, changes in our business or the industries in which we operate;
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•
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makes us more vulnerable to increases in interest rates, as borrowings under our senior secured credit facilities are at variable rates;
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•
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limits our ability to obtain additional financing in the future for working capital or other purposes; and
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•
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places us at a competitive disadvantage compared to our competitors that have less indebtedness.
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Critical Illness Recovery Hospitals(1)
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Rehabilitation Hospitals(1)
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Outpatient
Rehabilitation Clinics(1)
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Concentra Occupational Health Centers(2)
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Total
Facilities
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|||||
Alabama
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1
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|
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—
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|
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23
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|
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—
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|
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24
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Alaska
|
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—
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|
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—
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|
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9
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|
|
5
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|
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14
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Arizona
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2
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|
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1
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41
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|
|
17
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|
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61
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Arkansas
|
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2
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|
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—
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|
|
1
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|
|
2
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|
|
5
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California
|
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1
|
|
|
1
|
|
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75
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|
|
100
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|
|
177
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|
Colorado
|
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—
|
|
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—
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|
|
42
|
|
|
23
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|
|
65
|
|
Connecticut
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—
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|
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—
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|
|
59
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|
|
10
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|
|
69
|
|
Delaware
|
|
1
|
|
|
—
|
|
|
13
|
|
|
1
|
|
|
15
|
|
District of Columbia
|
|
—
|
|
|
—
|
|
|
5
|
|
|
—
|
|
|
5
|
|
Florida
|
|
12
|
|
|
2
|
|
|
120
|
|
|
32
|
|
|
166
|
|
Georgia
|
|
5
|
|
|
1
|
|
|
69
|
|
|
16
|
|
|
91
|
|
Hawaii
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1
|
|
|
1
|
|
Illinois
|
|
—
|
|
|
—
|
|
|
68
|
|
|
17
|
|
|
85
|
|
Indiana
|
|
3
|
|
|
—
|
|
|
30
|
|
|
12
|
|
|
45
|
|
Iowa
|
|
2
|
|
|
—
|
|
|
21
|
|
|
3
|
|
|
26
|
|
Kansas
|
|
2
|
|
|
—
|
|
|
14
|
|
|
4
|
|
|
20
|
|
Kentucky
|
|
2
|
|
|
—
|
|
|
64
|
|
|
9
|
|
|
75
|
|
Louisiana
|
|
—
|
|
|
2
|
|
|
3
|
|
|
3
|
|
|
8
|
|
Maine
|
|
—
|
|
|
—
|
|
|
23
|
|
|
7
|
|
|
30
|
|
Maryland
|
|
—
|
|
|
—
|
|
|
65
|
|
|
12
|
|
|
77
|
|
Massachusetts
|
|
—
|
|
|
—
|
|
|
21
|
|
|
2
|
|
|
23
|
|
Michigan
|
|
11
|
|
|
—
|
|
|
36
|
|
|
18
|
|
|
65
|
|
Minnesota
|
|
1
|
|
|
—
|
|
|
32
|
|
|
6
|
|
|
39
|
|
Mississippi
|
|
4
|
|
|
—
|
|
|
1
|
|
|
—
|
|
|
5
|
|
Missouri
|
|
4
|
|
|
3
|
|
|
96
|
|
|
15
|
|
|
118
|
|
Nebraska
|
|
2
|
|
|
—
|
|
|
2
|
|
|
3
|
|
|
7
|
|
Nevada
|
|
—
|
|
|
1
|
|
|
14
|
|
|
7
|
|
|
22
|
|
New Hampshire
|
|
—
|
|
|
—
|
|
|
—
|
|
|
3
|
|
|
3
|
|
New Jersey
|
|
1
|
|
|
4
|
|
|
164
|
|
|
21
|
|
|
190
|
|
New Mexico
|
|
—
|
|
|
—
|
|
|
1
|
|
|
4
|
|
|
5
|
|
North Carolina
|
|
2
|
|
|
—
|
|
|
37
|
|
|
8
|
|
|
47
|
|
Ohio
|
|
16
|
|
|
5
|
|
|
102
|
|
|
17
|
|
|
140
|
|
Oklahoma
|
|
2
|
|
|
—
|
|
|
25
|
|
|
7
|
|
|
34
|
|
Oregon
|
|
—
|
|
|
—
|
|
|
—
|
|
|
4
|
|
|
4
|
|
Pennsylvania
|
|
10
|
|
|
2
|
|
|
232
|
|
|
17
|
|
|
261
|
|
Rhode Island
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2
|
|
|
2
|
|
South Carolina
|
|
2
|
|
|
—
|
|
|
26
|
|
|
4
|
|
|
32
|
|
South Dakota
|
|
1
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1
|
|
Tennessee
|
|
5
|
|
|
—
|
|
|
19
|
|
|
9
|
|
|
33
|
|
Texas
|
|
2
|
|
|
6
|
|
|
128
|
|
|
56
|
|
|
192
|
|
Utah
|
|
—
|
|
|
—
|
|
|
—
|
|
|
6
|
|
|
6
|
|
Vermont
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2
|
|
|
2
|
|
Virginia
|
|
1
|
|
|
1
|
|
|
42
|
|
|
6
|
|
|
50
|
|
Washington
|
|
—
|
|
|
—
|
|
|
9
|
|
|
18
|
|
|
27
|
|
West Virginia
|
|
1
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
1
|
|
Wisconsin
|
|
3
|
|
|
—
|
|
|
8
|
|
|
12
|
|
|
23
|
|
Total Company
|
|
101
|
|
|
29
|
|
|
1,740
|
|
|
521
|
|
|
2,391
|
|
(1)
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Includes managed critical illness recovery hospitals, rehabilitation hospitals, and outpatient rehabilitation clinics, respectively.
|
(2)
|
Our Concentra segment also had operations in New York and Wyoming.
|
|
|
12/31/2014
|
|
12/31/2015
|
|
12/31/2016
|
|
12/31/2017
|
|
12/31/2018
|
|
12/31/2019
|
||||||||||||
Select Medical Holdings Corporation (SEM)
|
|
$
|
100.00
|
|
|
$
|
83.34
|
|
|
$
|
92.71
|
|
|
$
|
123.50
|
|
|
$
|
107.41
|
|
|
$
|
163.31
|
|
S&P Health Care Services Select Industry Index (SPSIHP)
|
|
$
|
100.00
|
|
|
$
|
99.25
|
|
|
$
|
108.74
|
|
|
$
|
129.86
|
|
|
$
|
121.76
|
|
|
$
|
156.92
|
|
S&P 500
|
|
$
|
100.00
|
|
|
$
|
103.08
|
|
|
$
|
94.38
|
|
|
$
|
110.31
|
|
|
$
|
112.91
|
|
|
$
|
133.69
|
|
|
Total Number of
Shares Purchased
|
|
Average Price
Paid Per Share
|
|
Total Number of
Shares Purchased as Part of Publicly Announced Plans or Programs
|
|
Approximate Dollar Value of Shares that
May Yet Be Purchased Under Plans or Programs
|
|
||||||
October 1 - October 31, 2019
|
68,952
|
|
|
$
|
17.70
|
|
|
—
|
|
|
$
|
152,086,459
|
|
|
November 1 - November 30, 2019
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
||
December 1 - December 31, 2019
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
||
Total
|
68,952
|
|
|
$
|
17.70
|
|
|
—
|
|
|
$
|
152,086,459
|
|
|
|
|
For the Year Ended December 31,
|
||||||||||||||||||
|
|
2015
|
|
2016
|
|
2017
|
|
2018
|
|
2019
|
||||||||||
|
|
(In thousands, except per share data)
|
||||||||||||||||||
Statement of Operations Data:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Net operating revenues(1)
|
|
$
|
3,742,736
|
|
|
$
|
4,217,460
|
|
|
$
|
4,365,245
|
|
|
$
|
5,081,258
|
|
|
$
|
5,453,922
|
|
Operating expenses(2)
|
|
3,362,965
|
|
|
3,772,302
|
|
|
3,849,356
|
|
|
4,462,324
|
|
|
4,769,465
|
|
|||||
Depreciation and amortization
|
|
104,981
|
|
|
145,311
|
|
|
160,011
|
|
|
201,655
|
|
|
212,576
|
|
|||||
Income from operations
|
|
274,790
|
|
|
299,847
|
|
|
355,878
|
|
|
417,279
|
|
|
471,881
|
|
|||||
Loss on early retirement of debt(3)
|
|
—
|
|
|
(11,626
|
)
|
|
(19,719
|
)
|
|
(14,155
|
)
|
|
(38,083
|
)
|
|||||
Equity in earnings of unconsolidated subsidiaries
|
|
16,811
|
|
|
19,943
|
|
|
21,054
|
|
|
21,905
|
|
|
24,989
|
|
|||||
Gain (loss) on sale of businesses
|
|
29,647
|
|
|
42,651
|
|
|
(49
|
)
|
|
9,016
|
|
|
6,532
|
|
|||||
Interest expense
|
|
(112,816
|
)
|
|
(170,081
|
)
|
|
(154,703
|
)
|
|
(198,493
|
)
|
|
(200,570
|
)
|
|||||
Income before income taxes
|
|
208,432
|
|
|
180,734
|
|
|
202,461
|
|
|
235,552
|
|
|
264,749
|
|
|||||
Income tax expense (benefit)
|
|
72,436
|
|
|
55,464
|
|
|
(18,184
|
)
|
|
58,610
|
|
|
63,718
|
|
|||||
Net income
|
|
135,996
|
|
|
125,270
|
|
|
220,645
|
|
|
176,942
|
|
|
201,031
|
|
|||||
Less: Net income attributable to non-controlling interests(4)
|
|
5,260
|
|
|
9,859
|
|
|
43,461
|
|
|
39,102
|
|
|
52,582
|
|
|||||
Net income attributable to Select Medical Holdings Corporation
|
|
$
|
130,736
|
|
|
$
|
115,411
|
|
|
$
|
177,184
|
|
|
$
|
137,840
|
|
|
$
|
148,449
|
|
Earnings per common share:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Basic
|
|
$
|
1.00
|
|
|
$
|
0.88
|
|
|
$
|
1.33
|
|
|
$
|
1.02
|
|
|
$
|
1.10
|
|
Diluted
|
|
$
|
0.99
|
|
|
$
|
0.87
|
|
|
$
|
1.33
|
|
|
$
|
1.02
|
|
|
$
|
1.10
|
|
Weighted average common shares outstanding:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Basic
|
|
127,478
|
|
|
127,813
|
|
|
128,955
|
|
|
130,172
|
|
|
130,248
|
|
|||||
Diluted
|
|
127,752
|
|
|
127,968
|
|
|
129,126
|
|
|
130,256
|
|
|
130,276
|
|
|||||
Dividends per share
|
|
$
|
0.10
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
Balance Sheet Data (at end of period):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Cash and cash equivalents
|
|
$
|
14,435
|
|
|
$
|
99,029
|
|
|
$
|
122,549
|
|
|
$
|
175,178
|
|
|
$
|
335,882
|
|
Working capital(5)(6)
|
|
19,869
|
|
|
191,268
|
|
|
315,423
|
|
|
287,338
|
|
|
298,712
|
|
|||||
Total assets(5)(6)
|
|
4,388,678
|
|
|
4,920,626
|
|
|
5,127,166
|
|
|
5,964,265
|
|
|
7,340,288
|
|
|||||
Total debt
|
|
2,385,896
|
|
|
2,698,989
|
|
|
2,699,902
|
|
|
3,293,381
|
|
|
3,445,110
|
|
|||||
Redeemable non-controlling interests
|
|
238,221
|
|
|
422,159
|
|
|
640,818
|
|
|
780,488
|
|
|
974,541
|
|
|||||
Total stockholders’ equity
|
|
859,253
|
|
|
815,725
|
|
|
823,368
|
|
|
803,042
|
|
|
770,972
|
|
(1)
|
For the years ended December 31, 2016, 2017, 2018, and 2019, net operating revenues reflect the adoption of ASC Topic 606, Revenue from Contracts with Customers. Net operating revenues were not retrospectively conformed for the year ended December 31, 2015.
|
(2)
|
Operating expenses include cost of services, general and administrative expenses, bad debt expense, and stock compensation expense.
|
(3)
|
During the year ended December 31, 2016, the Company recognized a loss on early retirement debt of $0.8 million relating to the repayment of series D tranche B term loans under Select’s 2011 senior secured credit facility. Additionally, on September 26, 2016, Concentra Inc. prepaid the term loans outstanding under its second lien credit agreement. The premium plus the expensing of unamortized debt issuance costs and original issuance discount resulted in losses on early retirement of debt of $10.9 million.
|
(4)
|
Reflects interests held by other parties in subsidiaries, limited liability companies and limited partnerships owned and controlled by us.
|
(5)
|
As of December 31, 2016, 2017, 2018, and 2019, the balance sheet data reflects the adoption of ASU 2015-17, Balance Sheet Classification of Deferred Taxes, which requires all deferred tax liabilities and assets be classified as non-current. The balance sheet data was not retrospectively conformed as of December 31, 2015.
|
(6)
|
As of December 31, 2019, the balance sheet data reflects the adoption of ASC Topic 842, Leases, which required the recognition of operating lease right-of-use assets and operating lease liabilities on the balance sheet. Refer to Note 1 – Organization and Significant Accounting Policies of the notes to our consolidated financial statements included elsewhere herein. Prior periods were not adjusted and continue to be reported in accordance with ASC Topic 840, Leases.
|
|
|
For the Year Ended December 31,
|
|
||||||||||||||||||
|
|
2015
|
|
2016
|
|
2017
|
|
2018
|
|
2019
|
|
||||||||||
|
|
(In thousands)
|
|
||||||||||||||||||
Net income
|
|
$
|
135,996
|
|
|
$
|
125,270
|
|
|
$
|
220,645
|
|
|
$
|
176,942
|
|
|
$
|
201,031
|
|
|
Income tax expense (benefit)
|
|
72,436
|
|
|
55,464
|
|
|
(18,184
|
)
|
|
58,610
|
|
|
63,718
|
|
|
|||||
Interest expense
|
|
112,816
|
|
|
170,081
|
|
|
154,703
|
|
|
198,493
|
|
|
200,570
|
|
|
|||||
Loss (gain) on sale of businesses
|
|
(29,647
|
)
|
|
(42,651
|
)
|
|
49
|
|
|
(9,016
|
)
|
|
(6,532
|
)
|
|
|||||
Equity in earnings of unconsolidated subsidiaries
|
|
(16,811
|
)
|
|
(19,943
|
)
|
|
(21,054
|
)
|
|
(21,905
|
)
|
|
(24,989
|
)
|
|
|||||
Loss on early retirement of debt
|
|
—
|
|
|
11,626
|
|
|
19,719
|
|
|
14,155
|
|
|
38,083
|
|
|
|||||
Income from operations
|
|
274,790
|
|
|
299,847
|
|
|
355,878
|
|
|
417,279
|
|
|
471,881
|
|
|
|||||
Stock compensation expense:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Included in general and administrative
|
|
11,633
|
|
|
14,607
|
|
|
15,706
|
|
|
17,604
|
|
|
20,334
|
|
|
|||||
Included in cost of services
|
|
3,046
|
|
|
2,806
|
|
|
3,578
|
|
|
5,722
|
|
|
6,117
|
|
|
|||||
Depreciation and amortization
|
|
104,981
|
|
|
145,311
|
|
|
160,011
|
|
|
201,655
|
|
|
212,576
|
|
|
|||||
Concentra acquisition costs
|
|
4,715
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
|||||
Physiotherapy acquisition costs
|
|
—
|
|
|
3,236
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
|||||
U.S. HealthWorks acquisition costs
|
|
—
|
|
|
—
|
|
|
2,819
|
|
|
2,895
|
|
|
—
|
|
|
|||||
Adjusted EBITDA
|
|
$
|
399,165
|
|
|
$
|
465,807
|
|
|
$
|
537,992
|
|
|
$
|
645,155
|
|
|
$
|
710,908
|
|
|
|
For the Year Ended December 31, 2019
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Net operating revenues
|
$
|
1,836,518
|
|
|
$
|
670,971
|
|
|
$
|
1,046,011
|
|
|
$
|
1,628,817
|
|
|
$
|
271,605
|
|
|
$
|
5,453,922
|
|
Operating expenses
|
1,581,650
|
|
|
535,114
|
|
|
894,180
|
|
|
1,355,404
|
|
|
403,117
|
|
|
4,769,465
|
|
||||||
Depreciation and amortization
|
50,763
|
|
|
27,322
|
|
|
28,301
|
|
|
96,807
|
|
|
9,383
|
|
|
212,576
|
|
||||||
Income from operations
|
204,105
|
|
|
108,535
|
|
|
123,530
|
|
|
176,606
|
|
|
(140,895
|
)
|
|
471,881
|
|
||||||
Depreciation and amortization
|
50,763
|
|
|
27,322
|
|
|
28,301
|
|
|
96,807
|
|
|
9,383
|
|
|
212,576
|
|
||||||
Stock compensation expense
|
—
|
|
|
—
|
|
|
—
|
|
|
3,069
|
|
|
23,382
|
|
|
26,451
|
|
||||||
Adjusted EBITDA
|
$
|
254,868
|
|
|
$
|
135,857
|
|
|
$
|
151,831
|
|
|
$
|
276,482
|
|
|
$
|
(108,130
|
)
|
|
$
|
710,908
|
|
Adjusted EBITDA margin
|
13.9
|
%
|
|
20.2
|
%
|
|
14.5
|
%
|
|
17.0
|
%
|
|
N/M
|
|
|
13.0
|
%
|
|
For the Year Ended December 31, 2018
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Net operating revenues(1)
|
$
|
1,753,584
|
|
|
$
|
583,745
|
|
|
$
|
995,794
|
|
|
$
|
1,557,673
|
|
|
$
|
190,462
|
|
|
$
|
5,081,258
|
|
Operating expenses(1)
|
1,510,569
|
|
|
474,818
|
|
|
853,789
|
|
|
1,311,474
|
|
|
311,674
|
|
|
4,462,324
|
|
||||||
Depreciation and amortization
|
45,797
|
|
|
24,101
|
|
|
27,195
|
|
|
95,521
|
|
|
9,041
|
|
|
201,655
|
|
||||||
Income from operations
|
197,218
|
|
|
84,826
|
|
|
114,810
|
|
|
150,678
|
|
|
(130,253
|
)
|
|
417,279
|
|
||||||
Depreciation and amortization
|
45,797
|
|
|
24,101
|
|
|
27,195
|
|
|
95,521
|
|
|
9,041
|
|
|
201,655
|
|
||||||
Stock compensation expense
|
—
|
|
|
—
|
|
|
—
|
|
|
2,883
|
|
|
20,443
|
|
|
23,326
|
|
||||||
U.S. HealthWorks acquisition costs
|
—
|
|
|
—
|
|
|
—
|
|
|
2,895
|
|
|
—
|
|
|
2,895
|
|
||||||
Adjusted EBITDA
|
$
|
243,015
|
|
|
$
|
108,927
|
|
|
$
|
142,005
|
|
|
$
|
251,977
|
|
|
$
|
(100,769
|
)
|
|
$
|
645,155
|
|
Adjusted EBITDA margin
|
13.9
|
%
|
|
18.7
|
%
|
|
14.3
|
%
|
|
16.2
|
%
|
|
N/M
|
|
|
12.7
|
%
|
(1)
|
For the year ended December 31, 2018, the financial results of our reportable segments have been changed to remove the net operating revenues and expenses associated with employee leasing services provided to our non-consolidating subsidiaries. These results are now reported as part of our other activities. We lease employees at cost to these non-consolidating subsidiaries.
|
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||
Change in net operating revenues
|
4.7
|
%
|
|
14.9
|
%
|
|
5.0
|
%
|
|
4.6
|
%
|
|
42.6
|
%
|
|
7.3
|
%
|
Change in income from operations
|
3.5
|
%
|
|
28.0
|
%
|
|
7.6
|
%
|
|
17.2
|
%
|
|
(8.2
|
)%
|
|
13.1
|
%
|
Change in Adjusted EBITDA
|
4.9
|
%
|
|
24.7
|
%
|
|
6.9
|
%
|
|
9.7
|
%
|
|
(7.3
|
)%
|
|
10.2
|
%
|
|
For the Year Ended December 31, 2018
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Net operating revenues(1)
|
$
|
1,753,584
|
|
|
$
|
583,745
|
|
|
$
|
995,794
|
|
|
$
|
1,557,673
|
|
|
$
|
190,462
|
|
|
$
|
5,081,258
|
|
Operating expenses(1)
|
1,510,569
|
|
|
474,818
|
|
|
853,789
|
|
|
1,311,474
|
|
|
311,674
|
|
|
4,462,324
|
|
||||||
Depreciation and amortization
|
45,797
|
|
|
24,101
|
|
|
27,195
|
|
|
95,521
|
|
|
9,041
|
|
|
201,655
|
|
||||||
Income from operations
|
197,218
|
|
|
84,826
|
|
|
114,810
|
|
|
150,678
|
|
|
(130,253
|
)
|
|
417,279
|
|
||||||
Depreciation and amortization
|
45,797
|
|
|
24,101
|
|
|
27,195
|
|
|
95,521
|
|
|
9,041
|
|
|
201,655
|
|
||||||
Stock compensation expense
|
—
|
|
|
—
|
|
|
—
|
|
|
2,883
|
|
|
20,443
|
|
|
23,326
|
|
||||||
U.S. HealthWorks acquisition costs
|
—
|
|
|
—
|
|
|
—
|
|
|
2,895
|
|
|
—
|
|
|
2,895
|
|
||||||
Adjusted EBITDA
|
$
|
243,015
|
|
|
$
|
108,927
|
|
|
$
|
142,005
|
|
|
$
|
251,977
|
|
|
$
|
(100,769
|
)
|
|
$
|
645,155
|
|
Adjusted EBITDA margin(1)
|
13.9
|
%
|
|
18.7
|
%
|
|
14.3
|
%
|
|
16.2
|
%
|
|
N/M
|
|
|
12.7
|
%
|
|
For the Year Ended December 31, 2017
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Net operating revenues(1)
|
$
|
1,725,022
|
|
|
$
|
509,108
|
|
|
$
|
960,902
|
|
|
$
|
1,013,224
|
|
|
$
|
156,989
|
|
|
$
|
4,365,245
|
|
Operating expenses(1)
|
1,472,343
|
|
|
419,067
|
|
|
828,369
|
|
|
859,475
|
|
|
270,102
|
|
|
3,849,356
|
|
||||||
Depreciation and amortization
|
45,743
|
|
|
20,176
|
|
|
24,607
|
|
|
61,945
|
|
|
7,540
|
|
|
160,011
|
|
||||||
Income from operations
|
206,936
|
|
|
69,865
|
|
|
107,926
|
|
|
91,804
|
|
|
(120,653
|
)
|
|
355,878
|
|
||||||
Depreciation and amortization
|
45,743
|
|
|
20,176
|
|
|
24,607
|
|
|
61,945
|
|
|
7,540
|
|
|
160,011
|
|
||||||
Stock compensation expense
|
—
|
|
|
—
|
|
|
—
|
|
|
993
|
|
|
18,291
|
|
|
19,284
|
|
||||||
U.S. HealthWorks acquisition costs
|
—
|
|
|
—
|
|
|
—
|
|
|
2,819
|
|
|
—
|
|
|
2,819
|
|
||||||
Adjusted EBITDA
|
$
|
252,679
|
|
|
$
|
90,041
|
|
|
$
|
132,533
|
|
|
$
|
157,561
|
|
|
$
|
(94,822
|
)
|
|
$
|
537,992
|
|
Adjusted EBITDA margin(1)
|
14.6
|
%
|
|
17.7
|
%
|
|
13.8
|
%
|
|
15.6
|
%
|
|
N/M
|
|
|
12.3
|
%
|
(1)
|
For the years ended December 31, 2018 and 2017, the financial results of our reportable segments have been changed to remove the net operating revenues and expenses associated with employee leasing services provided to our non-consolidating subsidiaries. These results are now reported as part of our other activities. We lease employees at cost to these non-consolidating subsidiaries.
|
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||
Change in net operating revenues
|
1.7
|
%
|
|
14.7
|
%
|
|
3.6
|
%
|
|
53.7
|
%
|
|
21.3
|
%
|
|
16.4
|
%
|
Change in income from operations
|
(4.7
|
)%
|
|
21.4
|
%
|
|
6.4
|
%
|
|
64.1
|
%
|
|
(8.0
|
)%
|
|
17.3
|
%
|
Change in Adjusted EBITDA
|
(3.8
|
)%
|
|
21.0
|
%
|
|
7.1
|
%
|
|
59.9
|
%
|
|
(6.3
|
)%
|
|
19.9
|
%
|
|
|
December 31, 2018
|
|
|
December 31, 2019
|
|
||||||||||
Commercial insurance and other
|
|
$
|
551,950
|
|
|
78.1
|
%
|
|
|
$
|
597,663
|
|
|
78.4
|
%
|
|
Medicare and Medicaid
|
|
154,726
|
|
|
21.9
|
%
|
|
|
165,014
|
|
|
21.6
|
%
|
|
||
Total accounts receivable
|
|
$
|
706,676
|
|
|
100.0
|
%
|
|
|
$
|
762,677
|
|
|
100.0
|
%
|
|
|
|
For the Year Ended December 31,
|
|
||||||||||
|
|
2017
|
|
2018
|
|
2019
|
|
||||||
Critical illness recovery hospital data:
|
|
|
|
|
|
|
|
|
|
|
|||
Number of hospitals owned—start of period
|
|
102
|
|
|
99
|
|
|
96
|
|
|
|||
Number of hospitals acquired
|
|
1
|
|
|
—
|
|
|
4
|
|
|
|||
Number of hospital start-ups
|
|
1
|
|
|
1
|
|
|
—
|
|
|
|||
Number of hospitals closed/sold
|
|
(5
|
)
|
|
(4
|
)
|
|
—
|
|
|
|||
Number of hospitals owned—end of period
|
|
99
|
|
|
96
|
|
|
100
|
|
|
|||
Number of hospitals managed—end of period
|
|
1
|
|
|
—
|
|
|
1
|
|
|
|||
Total number of hospitals (all)—end of period
|
|
100
|
|
|
96
|
|
|
101
|
|
|
|||
Available licensed beds(1)
|
|
4,159
|
|
|
4,071
|
|
|
4,265
|
|
|
|||
Admissions(1)(2)
|
|
35,793
|
|
|
36,474
|
|
|
36,774
|
|
|
|||
Patient days(1)(3)
|
|
1,003,161
|
|
|
1,012,368
|
|
|
1,038,361
|
|
|
|||
Average length of stay (days)(1)(4)
|
|
28
|
|
|
28
|
|
|
28
|
|
|
|||
Net revenue per patient day(1)(5)
|
|
$
|
1,704
|
|
|
$
|
1,716
|
|
|
$
|
1,753
|
|
|
Occupancy rate(1)(6)
|
|
66
|
%
|
|
67
|
%
|
|
68
|
%
|
|
|||
Percent patient days—Medicare(1)(7)
|
|
54
|
%
|
|
53
|
%
|
|
51
|
%
|
|
|||
Rehabilitation hospital data:
|
|
|
|
|
|
|
|
||||||
Number of hospitals owned—start of period
|
|
13
|
|
|
16
|
|
|
17
|
|
|
|||
Number of hospitals acquired
|
|
—
|
|
|
—
|
|
|
—
|
|
|
|||
Number of hospital start-ups
|
|
3
|
|
|
1
|
|
|
2
|
|
|
|||
Number of hospitals closed/sold
|
|
—
|
|
|
—
|
|
|
—
|
|
|
|||
Number of hospitals owned—end of period
|
|
16
|
|
|
17
|
|
|
19
|
|
|
|||
Number of hospitals managed—end of period
|
|
8
|
|
|
9
|
|
|
10
|
|
|
|||
Total number of hospitals (all)—end of period
|
|
24
|
|
|
26
|
|
|
29
|
|
|
|||
Available licensed beds(1)
|
|
1,133
|
|
|
1,189
|
|
|
1,309
|
|
|
|||
Admissions(1)(2)
|
|
18,841
|
|
|
21,813
|
|
|
24,889
|
|
|
|||
Patient days(1)(3)
|
|
269,905
|
|
|
315,468
|
|
|
353,031
|
|
|
|||
Average length of stay (days)(1)(4)
|
|
14
|
|
|
14
|
|
|
14
|
|
|
|||
Net revenue per patient day(1)(5)
|
|
$
|
1,577
|
|
|
$
|
1,606
|
|
|
$
|
1,685
|
|
|
Occupancy rate(1)(6)
|
|
72
|
%
|
|
74
|
%
|
|
76
|
%
|
|
|||
Percent patient days—Medicare(1)(7)
|
|
54
|
%
|
|
54
|
%
|
|
52
|
%
|
|
|||
Outpatient rehabilitation data:
|
|
|
|
|
|
|
|
|
|
|
|||
Number of clinics owned—start of period
|
|
1,445
|
|
|
1,447
|
|
|
1,423
|
|
|
|||
Number of clinics acquired
|
|
13
|
|
|
20
|
|
|
31
|
|
|
|||
Number of clinic start-ups
|
|
28
|
|
|
34
|
|
|
57
|
|
|
|||
Number of clinics closed/sold
|
|
(39
|
)
|
|
(78
|
)
|
|
(50
|
)
|
|
|||
Number of clinics owned—end of period
|
|
1,447
|
|
|
1,423
|
|
|
1,461
|
|
|
|||
Number of clinics managed—end of period
|
|
169
|
|
|
239
|
|
|
279
|
|
|
|||
Total number of clinics (all)—end of period
|
|
1,616
|
|
|
1,662
|
|
|
1,740
|
|
|
|||
Number of visits(1)(8)
|
|
8,232,536
|
|
|
8,356,018
|
|
|
8,719,282
|
|
|
|||
Net revenue per visit(1)(9)
|
|
$
|
101
|
|
|
$
|
103
|
|
|
$
|
103
|
|
|
|
|
For the Year Ended December 31,
|
|
||||||||||
|
|
2017
|
|
2018
|
|
2019
|
|
||||||
Concentra data:
|
|
|
|
|
|
|
|
|
|
|
|||
Number of centers owned—start of period
|
|
300
|
|
|
312
|
|
|
524
|
|
|
|||
Number of centers acquired
|
|
11
|
|
|
221
|
|
|
6
|
|
|
|||
Number of center start-ups
|
|
4
|
|
|
—
|
|
|
—
|
|
|
|||
Number of centers closed/sold
|
|
(3
|
)
|
|
(9
|
)
|
|
(9
|
)
|
|
|||
Number of centers owned—end of period
|
|
312
|
|
|
524
|
|
|
521
|
|
|
|||
Number of onsite clinics operated—end of period
|
|
105
|
|
|
124
|
|
|
131
|
|
|
|||
Number of CBOCs owned—end of period
|
|
32
|
|
|
31
|
|
|
32
|
|
|
|||
Number of visits(1)(8)
|
|
7,709,508
|
|
|
11,426,940
|
|
|
12,068,865
|
|
|
|||
Net revenue per visit(1)(9)
|
|
$
|
115
|
|
|
$
|
124
|
|
|
$
|
122
|
|
|
(1)
|
Data excludes locations managed by the Company. For purposes of our Concentra segment, onsite clinics and community-based outpatient clinics are excluded.
|
(2)
|
Represents the number of patients admitted to our hospitals during the periods presented.
|
(3)
|
Each patient day represents one patient occupying one bed for one day during the periods presented.
|
(4)
|
Represents the average number of days in which patients were admitted to our hospitals. Average length of stay is calculated by dividing the number of patient days, as presented above, by the number of patients discharged from our hospitals during the periods presented.
|
(5)
|
Represents the average amount of revenue recognized for each patient day. Net revenue per patient day is calculated by dividing patient service revenues, excluding revenues from certain other ancillary and outpatient services provided at our hospitals, by the total number of patient days.
|
(6)
|
Represents the portion of our hospitals being utilized for patient care during the periods presented. Occupancy rate is calculated using the number of patient days, as presented above, divided by the total number of bed days available during the period. Bed days available is derived by adding the daily number of available licensed beds for each of the periods presented.
|
(7)
|
Represents the portion of our patient days which are paid by Medicare. The Medicare patient day percentage is calculated by dividing the total number of patient days which are paid by Medicare by the total number of patient days, as presented above.
|
(8)
|
Represents the number of visits in which patients were treated at our outpatient rehabilitation clinics and Concentra centers during the periods presented.
|
(9)
|
Represents the average amount of revenue recognized for each patient visit. Net revenue per visit is calculated by dividing patient service revenue, excluding revenues from certain other ancillary services, by the total number of visits. For purposes of this computation for our Concentra segment, patient service revenue does not include onsite clinics and community-based outpatient clinics.
|
|
|
For the Year Ended December 31,
|
|
|||||||
|
|
2017
|
|
2018
|
|
2019
|
|
|||
Net operating revenues
|
|
100.0
|
%
|
|
100.0
|
%
|
|
100.0
|
%
|
|
Cost of services, exclusive of depreciation and amortization(1)
|
|
85.6
|
|
|
85.4
|
|
|
85.1
|
|
|
General and administrative
|
|
2.6
|
|
|
2.4
|
|
|
2.4
|
|
|
Depreciation and amortization
|
|
3.6
|
|
|
4.0
|
|
|
3.8
|
|
|
Income from operations
|
|
8.2
|
|
|
8.2
|
|
|
8.7
|
|
|
Loss on early retirement of debt
|
|
(0.5
|
)
|
|
(0.3
|
)
|
|
(0.7
|
)
|
|
Equity in earnings of unconsolidated subsidiaries
|
|
0.5
|
|
|
0.4
|
|
|
0.5
|
|
|
Gain (loss) on sale of businesses
|
|
(0.0
|
)
|
|
0.2
|
|
|
0.1
|
|
|
Interest expense
|
|
(3.6
|
)
|
|
(3.9
|
)
|
|
(3.7
|
)
|
|
Income before income taxes
|
|
4.6
|
|
|
4.6
|
|
|
4.9
|
|
|
Income tax expense (benefit)
|
|
(0.5
|
)
|
|
1.1
|
|
|
1.2
|
|
|
Net income
|
|
5.1
|
|
|
3.5
|
|
|
3.7
|
|
|
Net income attributable to non-controlling interests
|
|
1.0
|
|
|
0.8
|
|
|
1.0
|
|
|
Net income attributable to Select Medical Holdings Corporation
|
|
4.1
|
%
|
|
2.7
|
%
|
|
2.7
|
%
|
|
(1)
|
Cost of services includes salaries, wages and benefits, operating supplies, lease and rent expense, and other operating costs.
|
|
|
Year Ended December 31,
|
|
|
|
|
|
||||||||||||
|
|
2017(1)
|
|
2018(1)
|
|
2019
|
|
% Change
2017 - 2018
|
|
% Change
2018 - 2019
|
|
||||||||
Net operating revenues:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
Critical illness recovery hospital
|
|
$
|
1,725,022
|
|
|
$
|
1,753,584
|
|
|
$
|
1,836,518
|
|
|
1.7
|
%
|
|
4.7
|
%
|
|
Rehabilitation hospital
|
|
509,108
|
|
|
583,745
|
|
|
670,971
|
|
|
14.7
|
|
|
14.9
|
|
|
|||
Outpatient rehabilitation
|
|
960,902
|
|
|
995,794
|
|
|
1,046,011
|
|
|
3.6
|
|
|
5.0
|
|
|
|||
Concentra(2)
|
|
1,013,224
|
|
|
1,557,673
|
|
|
1,628,817
|
|
|
53.7
|
|
|
4.6
|
|
|
|||
Other(3)
|
|
156,989
|
|
|
190,462
|
|
|
271,605
|
|
|
21.3
|
|
|
42.6
|
|
|
|||
Total Company
|
|
$
|
4,365,245
|
|
|
$
|
5,081,258
|
|
|
$
|
5,453,922
|
|
|
16.4
|
%
|
|
7.3
|
%
|
|
Income (loss) from operations:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Critical illness recovery hospital
|
|
$
|
206,936
|
|
|
$
|
197,218
|
|
|
$
|
204,105
|
|
|
(4.7
|
)%
|
|
3.5
|
%
|
|
Rehabilitation hospital
|
|
69,865
|
|
|
84,826
|
|
|
108,535
|
|
|
21.4
|
|
|
28.0
|
|
|
|||
Outpatient rehabilitation
|
|
107,926
|
|
|
114,810
|
|
|
123,530
|
|
|
6.4
|
|
|
7.6
|
|
|
|||
Concentra(2)
|
|
91,804
|
|
|
150,678
|
|
|
176,606
|
|
|
64.1
|
|
|
17.2
|
|
|
|||
Other(3)
|
|
(120,653
|
)
|
|
(130,253
|
)
|
|
(140,895
|
)
|
|
(8.0
|
)
|
|
(8.2
|
)
|
|
|||
Total Company
|
|
$
|
355,878
|
|
|
$
|
417,279
|
|
|
$
|
471,881
|
|
|
17.3
|
%
|
|
13.1
|
%
|
|
Adjusted EBITDA:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
Critical illness recovery hospital
|
|
$
|
252,679
|
|
|
$
|
243,015
|
|
|
$
|
254,868
|
|
|
(3.8
|
)%
|
|
4.9
|
%
|
|
Rehabilitation hospital
|
|
90,041
|
|
|
108,927
|
|
|
135,857
|
|
|
21.0
|
|
|
24.7
|
|
|
|||
Outpatient rehabilitation
|
|
132,533
|
|
|
142,005
|
|
|
151,831
|
|
|
7.1
|
|
|
6.9
|
|
|
|||
Concentra(2)
|
|
157,561
|
|
|
251,977
|
|
|
276,482
|
|
|
59.9
|
|
|
9.7
|
|
|
|||
Other(3)
|
|
(94,822
|
)
|
|
(100,769
|
)
|
|
(108,130
|
)
|
|
(6.3
|
)
|
|
(7.3
|
)
|
|
|||
Total Company
|
|
$
|
537,992
|
|
|
$
|
645,155
|
|
|
$
|
710,908
|
|
|
19.9
|
%
|
|
10.2
|
%
|
|
Adjusted EBITDA margins:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Critical illness recovery hospital
|
|
14.6
|
%
|
|
13.9
|
%
|
|
13.9
|
%
|
|
|
|
|
|
|||||
Rehabilitation hospital
|
|
17.7
|
|
|
18.7
|
|
|
20.2
|
|
|
|
|
|
|
|
|
|||
Outpatient rehabilitation
|
|
13.8
|
|
|
14.3
|
|
|
14.5
|
|
|
|
|
|
|
|
|
|||
Concentra(2)
|
|
15.6
|
|
|
16.2
|
|
|
17.0
|
|
|
|
|
|
|
|
|
|||
Other(3)
|
|
N/M
|
|
|
N/M
|
|
|
N/M
|
|
|
|
|
|
|
|
|
|||
Total Company
|
|
12.3
|
%
|
|
12.7
|
%
|
|
13.0
|
%
|
|
|
|
|
|
|
|
|||
Total assets:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Critical illness recovery hospital
|
|
$
|
1,848,783
|
|
|
$
|
1,771,605
|
|
|
$
|
2,099,833
|
|
|
|
|
|
|
||
Rehabilitation hospital
|
|
868,517
|
|
|
894,192
|
|
|
1,127,028
|
|
|
|
|
|
|
|
|
|||
Outpatient rehabilitation
|
|
954,661
|
|
|
1,002,819
|
|
|
1,289,190
|
|
|
|
|
|
|
|
|
|||
Concentra(2)
|
|
1,340,919
|
|
|
2,178,868
|
|
|
2,372,187
|
|
|
|
|
|
|
|
|
|||
Other(3)
|
|
114,286
|
|
|
116,781
|
|
|
452,050
|
|
|
|
|
|
|
|
|
|||
Total Company
|
|
$
|
5,127,166
|
|
|
$
|
5,964,265
|
|
|
$
|
7,340,288
|
|
|
|
|
|
|
|
|
Purchases of property and equipment:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
Critical illness recovery hospital
|
|
$
|
49,720
|
|
|
$
|
40,855
|
|
|
$
|
45,573
|
|
|
|
|
|
|
||
Rehabilitation hospital
|
|
96,477
|
|
|
42,389
|
|
|
27,216
|
|
|
|
|
|
|
|
|
|||
Outpatient rehabilitation
|
|
27,721
|
|
|
30,553
|
|
|
33,628
|
|
|
|
|
|
|
|
|
|||
Concentra(2)
|
|
28,912
|
|
|
42,205
|
|
|
44,101
|
|
|
|
|
|
|
|
|
|||
Other(3)
|
|
30,413
|
|
|
11,279
|
|
|
6,608
|
|
|
|
|
|
|
|
|
|||
Total Company
|
|
$
|
233,243
|
|
|
$
|
167,281
|
|
|
$
|
157,126
|
|
|
|
|
|
|
|
|
(1)
|
For the years ended December 31, 2017 and 2018, the financial results of our reportable segments have been changed to remove the net operating revenues and expenses associated with employee leasing services provided to our non-consolidating subsidiaries. These results are now reported as part of our other activities. We lease employees at cost to these non-consolidating subsidiaries.
|
(2)
|
The Concentra segment includes the operating results of U.S. HealthWorks beginning February 1, 2018.
|
(3)
|
Other includes our corporate administration and shared services, as well as employee leasing services with our non-consolidating subsidiaries. Total assets include certain non-consolidating joint ventures and minority investments in other healthcare related businesses.
|
|
|
For the Year Ended December 31,
|
|
||||||||||
|
|
2017
|
|
2018
|
|
2019
|
|
||||||
Cash flows provided by operating activities
|
|
$
|
238,131
|
|
|
$
|
494,194
|
|
|
$
|
445,182
|
|
|
Cash flows used in investing activities
|
|
(192,965
|
)
|
|
(697,137
|
)
|
|
(316,729
|
)
|
|
|||
Cash flows provided by (used in) financing activities
|
|
(21,646
|
)
|
|
255,572
|
|
|
32,251
|
|
|
|||
Net increase in cash and cash equivalents
|
|
23,520
|
|
|
52,629
|
|
|
160,704
|
|
|
|||
Cash and cash equivalents at beginning of period
|
|
99,029
|
|
|
122,549
|
|
|
175,178
|
|
|
|||
Cash and cash equivalents at end of period
|
|
$
|
122,549
|
|
|
$
|
175,178
|
|
|
$
|
335,882
|
|
|
|
|
Total
|
|
2020
|
|
2021 - 2023
|
|
2024 - 2025
|
|
After 2025
|
|
||||||||||
|
|
(in thousands)
|
|
||||||||||||||||||
Debt(1)
|
|
$
|
3,447,221
|
|
|
$
|
25,167
|
|
|
$
|
62,784
|
|
|
$
|
2,122,584
|
|
|
$
|
1,236,686
|
|
|
Interest(2)
|
|
1,160,004
|
|
|
201,391
|
|
|
597,726
|
|
|
296,000
|
|
|
64,887
|
|
|
|||||
Letters of credit outstanding(1)
|
|
52,662
|
|
|
—
|
|
|
14,319
|
|
|
38,343
|
|
|
—
|
|
|
|||||
Purchase obligations(3)
|
|
142,330
|
|
|
58,955
|
|
|
66,990
|
|
|
16,385
|
|
|
—
|
|
|
|||||
Construction contracts(4)
|
|
16,196
|
|
|
16,196
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
|||||
Operating leases(5)
|
|
1,415,215
|
|
|
263,085
|
|
|
558,133
|
|
|
195,286
|
|
|
398,711
|
|
|
|||||
Total contractual cash obligations(6)
|
|
$
|
6,233,628
|
|
|
$
|
564,794
|
|
|
$
|
1,299,952
|
|
|
$
|
2,668,598
|
|
|
$
|
1,700,284
|
|
|
(1)
|
See Note 9 – Long-Term Debt and Notes Payable of the notes to our consolidated financial statements included herein.
|
(2)
|
The interest obligation for the Select credit facilities was calculated using the average interest rate of 5.7% for the Select term loan at December 31, 2019. The interest obligation for the 6.250% senior notes was calculated using the stated interest rate. The weighted average interest rate of our other debt obligations was 4.7% at December 31, 2019.
|
(3)
|
Amounts represent purchase commitments that are not presented as construction contract commitments. Our purchase obligations primarily relate to software licensing and support.
|
(4)
|
See Note 16 – Commitments and Contingencies of the notes to our consolidated financial statements included herein.
|
(6)
|
Workers’ compensation and professional malpractice liability insurance liabilities of $99.7 million, which are included as components of other non-current liabilities on the consolidated balance sheet at December 31, 2019, have been excluded from the table above as we cannot reasonably estimate the amounts or periods in which these liabilities will be paid.
|
Plan Category
|
|
Number of securities to be issued upon exercise of outstanding options, warrants and rights (a)
|
|
Weighted-average exercise price of outstanding options, warrants and rights (b)
|
|
Number of securities remaining available for future issuance under equity compensation plans (excluding securities reflected in column (a))(c)
|
|
|||
Equity compensation plans approved by security holders:
|
|
|
|
|
|
|
|
|
|
|
Select Medical Holdings Corporation 2005 Equity Incentive Plan
|
|
—
|
|
|
—
|
|
|
—
|
|
(1)
|
Select Medical Holdings Corporation 2011 Equity Incentive Plan
|
|
—
|
|
|
—
|
|
|
—
|
|
(2)
|
Director Equity Incentive Plan
|
|
—
|
|
|
—
|
|
|
—
|
|
(2)
|
Select Medical Holdings Corporation 2016 Equity Incentive Plan
|
|
—
|
|
|
—
|
|
|
1,727,405
|
|
|
Equity compensation plans not approved by security holders
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(1)
|
In connection with the approval of the Select Medical Holdings Corporation 2011 Equity Incentive Plan, we no longer issue awards under the Select Medical Holdings Corporation 2005 Equity Incentive Plan.
|
(2)
|
In connection with the approval of the Select Medical Holdings Corporation 2016 Equity Incentive Plan, as amended, we no longer issue awards under the Select Medical Holdings 2011 Equity Incentive Plan and the Director Equity Incentive Plan.
|
a.
|
The following documents are filed as part of this report:
|
i.
|
Financial Statements: See Index to Financial Statements appearing on page F-1 of this report.
|
ii.
|
Financial Statement Schedule: See Schedule II—Valuation and Qualifying Accounts appearing on page F-38 of this report.
|
iii.
|
The following exhibits are filed as part of, or incorporated by reference into, this report:
|
Number
|
|
Description
|
|
2.1
|
|
|
|
3.1
|
|
|
|
3.2
|
|
|
|
3.3
|
|
|
|
3.4
|
|
|
|
4.1
|
|
|
|
4.2
|
|
|
|
4.3
|
|
|
|
10.1
|
|
|
|
10.2
|
|
|
|
10.3
|
|
|
|
10.4
|
|
|
|
10.5
|
|
|
|
10.6
|
|
|
|
10.7
|
|
|
Number
|
|
Description
|
|
10.8
|
|
|
|
10.9
|
|
|
|
10.10
|
|
|
|
10.11
|
|
|
|
10.12
|
|
|
|
10.13
|
|
|
|
10.14
|
|
|
|
10.15
|
|
|
|
10.16
|
|
|
|
10.17
|
|
|
|
10.18
|
|
|
|
10.19
|
|
|
|
10.20
|
|
|
|
10.21
|
|
|
|
10.22
|
|
|
|
10.23
|
|
|
|
10.24
|
|
|
|
10.25
|
|
|
|
10.26
|
|
|
Number
|
|
Description
|
|
10.27
|
|
|
|
10.28
|
|
|
|
10.29
|
|
|
|
10.30
|
|
|
|
10.31
|
|
|
|
10.32
|
|
|
|
10.33
|
|
|
|
10.34
|
|
|
|
10.35
|
|
|
|
10.36
|
|
|
|
10.37
|
|
|
|
10.38
|
|
|
|
10.39
|
|
|
|
10.40
|
|
|
|
10.41
|
|
|
|
10.42
|
|
|
|
10.43
|
|
|
Number
|
|
Description
|
|
10.44
|
|
|
|
10.45
|
|
|
|
10.46
|
|
|
|
10.47
|
|
|
|
10.48
|
|
|
|
10.49
|
|
|
|
10.50
|
|
|
|
10.51
|
|
|
|
10.52
|
|
|
|
10.53
|
|
|
|
10.54
|
|
|
|
10.55
|
|
|
|
10.56
|
|
|
|
10.57
|
|
|
|
10.58
|
|
|
Number
|
|
Description
|
|
10.59
|
|
|
|
10.60
|
|
|
|
10.61
|
|
|
|
10.62
|
|
|
|
10.63
|
|
|
|
10.64
|
|
|
|
10.65
|
|
|
|
10.66
|
|
|
|
10.67
|
|
|
|
10.68
|
|
|
|
10.69
|
|
|
|
10.70
|
|
|
Number
|
|
Description
|
|
10.71
|
|
|
|
10.72
|
|
|
|
10.73
|
|
|
|
10.74
|
|
|
|
10.75
|
|
|
|
21.1
|
|
|
|
23
|
|
|
|
31.1
|
|
|
|
31.2
|
|
|
|
32.1
|
|
|
|
101.INS
|
|
|
XBRL Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
|
101.SCH
|
|
|
XBRL Taxonomy Extension Schema Document.
|
101.CAL
|
|
|
XBRL Taxonomy Extension Calculation Linkbase Document.
|
101.DEF
|
|
|
XBRL Taxonomy Extension Definition Linkbase Document.
|
101.LAB
|
|
|
XBRL Taxonomy Extension Label Linkbase Document.
|
101.PRE
|
|
|
XBRL Taxonomy Extension Presentation Linkbase Document.
|
|
SELECT MEDICAL HOLDINGS CORPORATION
|
|
|
|
|
|
By:
|
/s/ MICHAEL E. TARVIN
Michael E. Tarvin
(Executive Vice President, General Counsel and Secretary)
|
|
|
/s/ ROCCO A. ORTENZIO
Rocco A. Ortenzio
Director, Vice Chairman and Co-Founder
|
/s/ ROBERT A. ORTENZIO
Robert A. Ortenzio
Director, Executive Chairman and Co-Founder
|
/s/ DAVID S. CHERNOW
David S. Chernow
President and Chief Executive Officer (principal executive officer)
|
/s/ MARTIN F. JACKSON
Martin F. Jackson
Executive Vice President and Chief Financial Officer (principal financial officer)
|
/s/ SCOTT A. ROMBERGER
Scott A. Romberger
Senior Vice President, Controller and Chief Accounting Officer (principal accounting officer)
|
/s/ RUSSELL L. CARSON
Russell L. Carson
Director
|
/s/ BRYAN C. CRESSEY
Bryan C. Cressey
Director
|
/s/ WILLIAM H. FRIST, M.D.
William H. Frist, M.D.
Director
|
/s/ JAMES S. ELY III
James S. Ely III
Director
|
/s/ LEOPOLD SWERGOLD
Leopold Swergold
Director
|
/s/ THOMAS A. SCULLY
Thomas A. Scully
Director
|
/s/ DANIEL J. THOMAS
Daniel J. Thomas
Director
|
/s/ MARILYN B. TAVENNER
Marilyn B. Tavenner
Director
|
|
|
|
|
|
F-2
|
|
|
F-4
|
|
|
F-5
|
|
|
F-6
|
|
|
F-7
|
|
|
F-8
|
|
|
F-38
|
|
December 31, 2018
|
|
December 31, 2019
|
|
||||
ASSETS
|
|
|
|
|
|
|
||
Current Assets:
|
|
|
|
|
|
|
||
Cash and cash equivalents
|
$
|
175,178
|
|
|
$
|
335,882
|
|
|
Accounts receivable
|
706,676
|
|
|
762,677
|
|
|
||
Prepaid income taxes
|
20,539
|
|
|
18,585
|
|
|
||
Other current assets
|
90,131
|
|
|
95,848
|
|
|
||
Total Current Assets
|
992,524
|
|
|
1,212,992
|
|
|
||
Operating lease right-of-use assets
|
—
|
|
|
1,003,986
|
|
|
||
Property and equipment, net
|
979,810
|
|
|
998,406
|
|
|
||
Goodwill
|
3,320,726
|
|
|
3,391,955
|
|
|
||
Identifiable intangible assets, net
|
437,693
|
|
|
409,068
|
|
|
||
Other assets
|
233,512
|
|
|
323,881
|
|
|
||
Total Assets
|
$
|
5,964,265
|
|
|
$
|
7,340,288
|
|
|
LIABILITIES AND EQUITY
|
|
|
|
|
|
|
||
Current Liabilities:
|
|
|
|
|
|
|
||
Overdrafts
|
$
|
25,083
|
|
|
$
|
—
|
|
|
Current operating lease liabilities
|
—
|
|
|
207,950
|
|
|
||
Current portion of long-term debt and notes payable
|
43,865
|
|
|
25,167
|
|
|
||
Accounts payable
|
146,693
|
|
|
145,731
|
|
|
||
Accrued payroll
|
172,386
|
|
|
183,754
|
|
|
||
Accrued vacation
|
110,660
|
|
|
124,111
|
|
|
||
Accrued interest
|
12,137
|
|
|
33,853
|
|
|
||
Accrued other
|
190,691
|
|
|
191,076
|
|
|
||
Income taxes payable
|
3,671
|
|
|
2,638
|
|
|
||
Total Current Liabilities
|
705,186
|
|
|
914,280
|
|
|
||
Non-current operating lease liabilities
|
—
|
|
|
852,897
|
|
|
||
Long-term debt, net of current portion
|
3,249,516
|
|
|
3,419,943
|
|
|
||
Non-current deferred tax liability
|
153,895
|
|
|
148,258
|
|
|
||
Other non-current liabilities
|
158,940
|
|
|
101,334
|
|
|
||
Total Liabilities
|
4,267,537
|
|
|
5,436,712
|
|
|
||
Commitments and contingencies (Note 16)
|
|
|
|
|
|
|
||
Redeemable non-controlling interests
|
780,488
|
|
|
974,541
|
|
|
||
Stockholders’ Equity:
|
|
|
|
|
|
|
||
Common stock, $0.001 par value, 700,000,000 shares authorized, 135,265,864 and 134,328,112 shares issued and outstanding at 2018 and 2019, respectively
|
135
|
|
|
134
|
|
|
||
Capital in excess of par
|
482,556
|
|
|
491,038
|
|
|
||
Retained earnings
|
320,351
|
|
|
279,800
|
|
|
||
Total Stockholders’ Equity
|
803,042
|
|
|
770,972
|
|
|
||
Non-controlling interests
|
113,198
|
|
|
158,063
|
|
|
||
Total Equity
|
916,240
|
|
|
929,035
|
|
|
||
Total Liabilities and Equity
|
$
|
5,964,265
|
|
|
$
|
7,340,288
|
|
|
|
For the Year Ended December 31,
|
|
||||||||||
|
2017
|
|
2018
|
|
2019
|
|
||||||
Net operating revenues
|
$
|
4,365,245
|
|
|
$
|
5,081,258
|
|
|
$
|
5,453,922
|
|
|
Costs and expenses:
|
|
|
|
|
|
|
|
|
|
|||
Cost of services, exclusive of depreciation and amortization
|
3,735,309
|
|
|
4,341,056
|
|
|
4,641,002
|
|
|
|||
General and administrative
|
114,047
|
|
|
121,268
|
|
|
128,463
|
|
|
|||
Depreciation and amortization
|
160,011
|
|
|
201,655
|
|
|
212,576
|
|
|
|||
Total costs and expenses
|
4,009,367
|
|
|
4,663,979
|
|
|
4,982,041
|
|
|
|||
Income from operations
|
355,878
|
|
|
417,279
|
|
|
471,881
|
|
|
|||
Other income and expense:
|
|
|
|
|
|
|
|
|
|
|||
Loss on early retirement of debt
|
(19,719
|
)
|
|
(14,155
|
)
|
|
(38,083
|
)
|
|
|||
Equity in earnings of unconsolidated subsidiaries
|
21,054
|
|
|
21,905
|
|
|
24,989
|
|
|
|||
Gain (loss) on sale of businesses
|
(49
|
)
|
|
9,016
|
|
|
6,532
|
|
|
|||
Interest expense
|
(154,703
|
)
|
|
(198,493
|
)
|
|
(200,570
|
)
|
|
|||
Income before income taxes
|
202,461
|
|
|
235,552
|
|
|
264,749
|
|
|
|||
Income tax expense (benefit)
|
(18,184
|
)
|
|
58,610
|
|
|
63,718
|
|
|
|||
Net income
|
220,645
|
|
|
176,942
|
|
|
201,031
|
|
|
|||
Less: Net income attributable to non-controlling interests
|
43,461
|
|
|
39,102
|
|
|
52,582
|
|
|
|||
Net income attributable to Select Medical Holdings Corporation
|
$
|
177,184
|
|
|
$
|
137,840
|
|
|
$
|
148,449
|
|
|
Earnings per common share (Note 15):
|
|
|
|
|
|
|
||||||
Basic
|
$
|
1.33
|
|
|
$
|
1.02
|
|
|
$
|
1.10
|
|
|
Diluted
|
$
|
1.33
|
|
|
$
|
1.02
|
|
|
$
|
1.10
|
|
|
|
|
|
|
|
|
|
Total Stockholders’ Equity
|
|
|
|
|
|
|||||||||||||||||||||
|
|
Redeemable
Non-controlling
interests
|
|
|
Common
Stock
Issued
|
|
Common
Stock
Par Value
|
|
Capital in
Excess
of Par
|
|
Retained
Earnings
|
|
Total
Stockholders’
Equity
|
|
Non-controlling
Interests
|
|
Total
Equity
|
|
|||||||||||||||
Balance at December 31, 2016
|
|
$
|
422,159
|
|
|
|
132,597
|
|
|
$
|
132
|
|
|
$
|
443,908
|
|
|
$
|
371,685
|
|
|
$
|
815,725
|
|
|
$
|
90,176
|
|
|
$
|
905,901
|
|
|
Net income attributable to Select Medical Holdings Corporation
|
|
|
|
|
|
|
|
|
|
|
|
|
177,184
|
|
|
177,184
|
|
|
|
|
177,184
|
|
|
||||||||||
Net income attributable to non-controlling interests
|
|
35,639
|
|
|
|
|
|
|
|
|
|
|
|
|
—
|
|
|
7,822
|
|
|
7,822
|
|
|
||||||||||
Issuance of restricted stock
|
|
|
|
|
|
1,598
|
|
|
2
|
|
|
(2
|
)
|
|
|
|
—
|
|
|
|
|
—
|
|
|
|||||||||
Forfeitures of unvested restricted stock
|
|
|
|
|
(27
|
)
|
|
0
|
|
|
0
|
|
|
|
|
—
|
|
|
|
|
—
|
|
|
||||||||||
Vesting of restricted stock
|
|
|
|
|
|
|
|
|
18,291
|
|
|
|
|
18,291
|
|
|
|
|
18,291
|
|
|
||||||||||||
Repurchase of common shares
|
|
|
|
|
|
(280
|
)
|
|
0
|
|
|
(2,666
|
)
|
|
(2,087
|
)
|
|
(4,753
|
)
|
|
|
|
(4,753
|
)
|
|
||||||||
Exercise of stock options
|
|
|
|
|
|
227
|
|
|
0
|
|
|
2,017
|
|
|
|
|
2,017
|
|
|
|
|
2,017
|
|
|
|||||||||
Issuance of non-controlling interests
|
|
|
|
|
|
|
|
|
|
|
1,951
|
|
|
|
|
1,951
|
|
|
16,329
|
|
|
18,280
|
|
|
|||||||||
Distributions to and purchases of non-controlling interests
|
|
(5,334
|
)
|
|
|
|
|
|
|
|
|
|
|
7
|
|
|
7
|
|
|
(5,293
|
)
|
|
(5,286
|
)
|
|
||||||||
Redemption adjustment on non-controlling interests
|
|
187,506
|
|
|
|
|
|
|
|
|
|
|
(187,506
|
)
|
|
(187,506
|
)
|
|
|
|
(187,506
|
)
|
|
||||||||||
Other
|
|
848
|
|
|
|
|
|
|
|
|
|
|
|
452
|
|
|
452
|
|
|
202
|
|
|
654
|
|
|
||||||||
Balance at December 31, 2017
|
|
$
|
640,818
|
|
|
|
134,115
|
|
|
$
|
134
|
|
|
$
|
463,499
|
|
|
$
|
359,735
|
|
|
$
|
823,368
|
|
|
$
|
109,236
|
|
|
$
|
932,604
|
|
|
Net income attributable to Select Medical Holdings Corporation
|
|
|
|
|
|
|
|
|
|
|
|
137,840
|
|
|
137,840
|
|
|
|
|
137,840
|
|
|
|||||||||||
Net income attributable to non-controlling interests
|
|
27,775
|
|
|
|
|
|
|
|
|
|
|
|
|
—
|
|
|
11,327
|
|
|
11,327
|
|
|
||||||||||
Issuance of restricted stock
|
|
|
|
|
|
1,491
|
|
|
1
|
|
|
(1
|
)
|
|
|
|
—
|
|
|
|
|
—
|
|
|
|||||||||
Forfeitures of unvested restricted stock
|
|
|
|
|
(168
|
)
|
|
0
|
|
|
0
|
|
|
|
|
—
|
|
|
|
|
—
|
|
|
||||||||||
Vesting of restricted stock
|
|
|
|
|
|
|
|
|
20,443
|
|
|
|
|
20,443
|
|
|
|
|
20,443
|
|
|
||||||||||||
Repurchase of common shares
|
|
|
|
|
|
(357
|
)
|
|
0
|
|
|
(3,728
|
)
|
|
(3,109
|
)
|
|
(6,837
|
)
|
|
|
|
(6,837
|
)
|
|
||||||||
Exercise of stock options
|
|
|
|
|
|
185
|
|
|
0
|
|
|
1,722
|
|
|
|
|
1,722
|
|
|
|
|
1,722
|
|
|
|||||||||
Issuance and exchange of non-controlling interests
|
|
163,659
|
|
|
|
|
|
|
|
|
1,553
|
|
|
74,341
|
|
|
75,894
|
|
|
1,921
|
|
|
77,815
|
|
|
||||||||
Distributions to and purchases of non-controlling interests
|
|
(217,570
|
)
|
|
|
|
|
|
|
|
(932
|
)
|
|
(83,617
|
)
|
|
(84,549
|
)
|
|
(10,839
|
)
|
|
(95,388
|
)
|
|
||||||||
Redemption adjustment on non-controlling interests
|
|
164,476
|
|
|
|
|
|
|
|
|
|
|
(164,476
|
)
|
|
(164,476
|
)
|
|
|
|
(164,476
|
)
|
|
||||||||||
Other
|
|
1,330
|
|
|
|
|
|
|
|
|
|
|
|
(363
|
)
|
|
(363
|
)
|
|
1,553
|
|
|
1,190
|
|
|
||||||||
Balance at December 31, 2018
|
|
$
|
780,488
|
|
|
|
135,266
|
|
|
$
|
135
|
|
|
$
|
482,556
|
|
|
$
|
320,351
|
|
|
$
|
803,042
|
|
|
$
|
113,198
|
|
|
$
|
916,240
|
|
|
Net income attributable to Select Medical Holdings Corporation
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
148,449
|
|
|
148,449
|
|
|
|
|
148,449
|
|
|
||||||||
Net income attributable to non-controlling interests
|
|
25,956
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
—
|
|
|
26,626
|
|
|
26,626
|
|
|
|||||||
Issuance of restricted stock
|
|
|
|
|
|
1,500
|
|
|
2
|
|
|
(2
|
)
|
|
|
|
|
—
|
|
|
|
|
—
|
|
|
||||||||
Forfeitures of unvested restricted stock
|
|
|
|
|
(43
|
)
|
|
0
|
|
|
0
|
|
|
|
|
—
|
|
|
|
|
—
|
|
|
||||||||||
Vesting of restricted stock
|
|
|
|
|
|
|
|
|
23,382
|
|
|
|
|
23,382
|
|
|
|
|
23,382
|
|
|
||||||||||||
Repurchase of common shares
|
|
|
|
|
|
(2,500
|
)
|
|
(3
|
)
|
|
(22,565
|
)
|
|
(15,963
|
)
|
|
(38,531
|
)
|
|
|
|
(38,531
|
)
|
|
||||||||
Exercise of stock options
|
|
|
|
|
|
105
|
|
|
0
|
|
|
964
|
|
|
|
|
|
964
|
|
|
|
|
964
|
|
|
||||||||
Issuance of non-controlling interests
|
|
|
|
|
|
|
|
|
|
|
|
6,499
|
|
|
|
|
|
6,499
|
|
|
31,622
|
|
|
38,121
|
|
|
|||||||
Distributions to and purchases of non-controlling interests
|
|
(6,205
|
)
|
|
|
|
|
|
|
|
|
204
|
|
|
|
|
|
204
|
|
|
(15,065
|
)
|
|
(14,861
|
)
|
|
|||||||
Redemption adjustment on non-controlling interests
|
|
172,915
|
|
|
|
|
|
|
|
|
|
|
|
|
(172,915
|
)
|
|
(172,915
|
)
|
|
|
|
(172,915
|
)
|
|
||||||||
Other
|
|
1,387
|
|
|
|
|
|
|
|
|
|
|
|
|
(122
|
)
|
|
(122
|
)
|
|
1,682
|
|
|
1,560
|
|
|
|||||||
Balance at December 31, 2019
|
|
$
|
974,541
|
|
|
|
134,328
|
|
|
$
|
134
|
|
|
$
|
491,038
|
|
|
$
|
279,800
|
|
|
$
|
770,972
|
|
|
$
|
158,063
|
|
|
$
|
929,035
|
|
|
|
|
For the Year Ended December 31,
|
|
||||||||||
|
|
2017
|
|
2018
|
|
2019
|
|
||||||
Operating activities
|
|
|
|
|
|
|
|
|
|
|
|||
Net income
|
|
$
|
220,645
|
|
|
$
|
176,942
|
|
|
$
|
201,031
|
|
|
Adjustments to reconcile net income to net cash provided by operating activities:
|
|
|
|
|
|
|
|
|
|
|
|||
Distributions from unconsolidated subsidiaries
|
|
20,006
|
|
|
15,721
|
|
|
20,222
|
|
|
|||
Depreciation and amortization
|
|
160,011
|
|
|
201,655
|
|
|
212,576
|
|
|
|||
Provision for bad debts
|
|
1,133
|
|
|
(103
|
)
|
|
3,038
|
|
|
|||
Equity in earnings of unconsolidated subsidiaries
|
|
(21,054
|
)
|
|
(21,905
|
)
|
|
(24,989
|
)
|
|
|||
Loss on extinguishment of debt
|
|
6,527
|
|
|
2,999
|
|
|
22,130
|
|
|
|||
Gain on sale of assets and businesses
|
|
(10,349
|
)
|
|
(9,168
|
)
|
|
(6,321
|
)
|
|
|||
Stock compensation expense
|
|
19,284
|
|
|
23,326
|
|
|
26,451
|
|
|
|||
Amortization of debt discount, premium and issuance costs
|
|
11,130
|
|
|
13,112
|
|
|
11,566
|
|
|
|||
Deferred income taxes
|
|
(72,324
|
)
|
|
7,217
|
|
|
(7,435
|
)
|
|
|||
Changes in operating assets and liabilities, net of effects of business combinations:
|
|
|
|
|
|
|
|
|
|
|
|||
Accounts receivable
|
|
(118,833
|
)
|
|
54,575
|
|
|
(57,991
|
)
|
|
|||
Other current assets
|
|
1,597
|
|
|
(4,152
|
)
|
|
(4,259
|
)
|
|
|||
Other assets
|
|
(886
|
)
|
|
7,857
|
|
|
6,122
|
|
|
|||
Accounts payable
|
|
3,903
|
|
|
(1,778
|
)
|
|
5,743
|
|
|
|||
Accrued expenses
|
|
17,341
|
|
|
27,896
|
|
|
37,298
|
|
|
|||
Net cash provided by operating activities
|
|
238,131
|
|
|
494,194
|
|
|
445,182
|
|
|
|||
Investing activities
|
|
|
|
|
|
|
|
|
|
|
|||
Business combinations, net of cash acquired
|
|
(27,390
|
)
|
|
(523,134
|
)
|
|
(93,705
|
)
|
|
|||
Purchases of property and equipment
|
|
(233,243
|
)
|
|
(167,281
|
)
|
|
(157,126
|
)
|
|
|||
Investment in businesses
|
|
(12,682
|
)
|
|
(13,482
|
)
|
|
(66,090
|
)
|
|
|||
Proceeds from sale of assets and businesses
|
|
80,350
|
|
|
6,760
|
|
|
192
|
|
|
|||
Net cash used in investing activities
|
|
(192,965
|
)
|
|
(697,137
|
)
|
|
(316,729
|
)
|
|
|||
Financing activities
|
|
|
|
|
|
|
|
|
|
|
|||
Borrowings on revolving facilities
|
|
970,000
|
|
|
595,000
|
|
|
700,000
|
|
|
|||
Payments on revolving facilities
|
|
(960,000
|
)
|
|
(805,000
|
)
|
|
(720,000
|
)
|
|
|||
Proceeds from term loans
|
|
1,139,487
|
|
|
779,823
|
|
|
1,208,106
|
|
|
|||
Payments on term loans
|
|
(1,179,442
|
)
|
|
(11,500
|
)
|
|
(1,618,170
|
)
|
|
|||
Proceeds from 6.250% senior notes
|
|
—
|
|
|
—
|
|
|
1,244,987
|
|
|
|||
Payment on 6.375% senior notes
|
|
—
|
|
|
—
|
|
|
(710,000
|
)
|
|
|||
Revolving facility debt issuance costs
|
|
(4,392
|
)
|
|
(1,639
|
)
|
|
(310
|
)
|
|
|||
Borrowings of other debt
|
|
46,621
|
|
|
42,218
|
|
|
24,225
|
|
|
|||
Principal payments on other debt
|
|
(20,647
|
)
|
|
(25,242
|
)
|
|
(30,604
|
)
|
|
|||
Repurchase of common stock
|
|
(4,753
|
)
|
|
(6,837
|
)
|
|
(38,531
|
)
|
|
|||
Proceeds from exercise of stock options
|
|
2,017
|
|
|
1,722
|
|
|
964
|
|
|
|||
Decrease in overdrafts
|
|
(9,899
|
)
|
|
(4,380
|
)
|
|
(25,083
|
)
|
|
|||
Proceeds from issuance of non-controlling interests
|
|
9,982
|
|
|
2,926
|
|
|
18,447
|
|
|
|||
Distributions to and purchases of non-controlling interests
|
|
(10,620
|
)
|
|
(311,519
|
)
|
|
(21,780
|
)
|
|
|||
Net cash provided by (used in) financing activities
|
|
(21,646
|
)
|
|
255,572
|
|
|
32,251
|
|
|
|||
Net increase in cash and cash equivalents
|
|
23,520
|
|
|
52,629
|
|
|
160,704
|
|
|
|||
Cash and cash equivalents at beginning of period
|
|
99,029
|
|
|
122,549
|
|
|
175,178
|
|
|
|||
Cash and cash equivalents at end of period
|
|
$
|
122,549
|
|
|
$
|
175,178
|
|
|
$
|
335,882
|
|
|
Supplemental information:
|
|
|
|
|
|
|
|
|
|
|
|||
Cash paid for interest
|
|
$
|
149,156
|
|
|
$
|
193,406
|
|
|
$
|
182,992
|
|
|
Cash paid for taxes
|
|
64,991
|
|
|
48,153
|
|
|
70,592
|
|
|
|||
Non-cash investing and financing activities:
|
|
|
|
|
|
|
|
||||||
Liabilities for purchases of property and equipment
|
|
$
|
30,043
|
|
|
$
|
29,134
|
|
|
$
|
28,760
|
|
|
Non-cash equity exchange for acquisition of U.S. HealthWorks
|
|
—
|
|
|
238,000
|
|
|
—
|
|
|
1.
|
Organization and Significant Accounting Policies
|
1.
|
Organization and Significant Accounting Policies (Continued)
|
(i)
|
Net income attributable to the Company is reduced by the amount of dividends declared and by the contractual amount of dividends that must be paid for the current period for each class of stock, if any.
|
(ii)
|
The remaining undistributed net income of the Company is then equally allocated to its common stock and unvested restricted stock awards, as if all of the earnings for the period had been distributed. The total net income allocated to each security is determined by adding both distributed and undistributed net income for the period.
|
(iii)
|
The net income allocated to each security is then divided by the weighted average number of outstanding shares for the period to determine the EPS for each security considered in the two-class method.
|
1.
|
Organization and Significant Accounting Policies (Continued)
|
1.
|
Organization and Significant Accounting Policies (Continued)
|
Land improvements
|
5 – 25 years
|
Leasehold improvements
|
1 – 20 years
|
Buildings
|
40 years
|
Building improvements
|
5 – 40 years
|
Furniture and equipment
|
1 – 20 years
|
1.
|
Organization and Significant Accounting Policies (Continued)
|
Customer relationships
|
5 – 17 years
|
Non-compete agreements
|
1 – 15 years
|
1.
|
Organization and Significant Accounting Policies (Continued)
|
1.
|
Organization and Significant Accounting Policies (Continued)
|
2.
|
Acquisitions
|
Accounts receivable
|
$
|
68,934
|
|
Other current assets
|
10,810
|
|
|
Property and equipment
|
69,712
|
|
|
Identifiable intangible assets
|
140,406
|
|
|
Other assets
|
25,435
|
|
|
Goodwill
|
540,067
|
|
|
Total assets
|
855,364
|
|
|
Accounts payable and other current liabilities
|
49,925
|
|
|
Deferred income taxes and other long-term liabilities
|
51,851
|
|
|
Total liabilities
|
101,776
|
|
|
Consideration given
|
$
|
753,588
|
|
|
Fair Value
|
|
Weighted Average
Amortization Period
|
||
|
(in thousands)
|
|
(in years)
|
||
Customer relationships
|
$
|
135,000
|
|
|
15 years
|
Trademark
|
5,000
|
|
|
1 year
|
|
Favorable leasehold interests
|
406
|
|
|
3 years
|
|
Identifiable intangible assets
|
$
|
140,406
|
|
|
|
2.
|
Acquisitions (Continued)
|
|
For the Year Ended December 31,
|
||||||
|
2017
|
|
2018
|
||||
|
(in thousands, except per share amounts)
|
||||||
Net operating revenues
|
$
|
4,903,612
|
|
|
$
|
5,128,838
|
|
Net income attributable to the Company
|
170,689
|
|
|
140,488
|
|
3.
|
Variable Interest Entities
|
3.
|
Variable Interest Entities (Continued)
|
4.
|
Leases
|
|
For the Year Ended December 31, 2019
|
||||||||||
|
Unrelated Parties
|
|
Related Parties
|
|
Total
|
||||||
Operating lease cost
|
$
|
271,799
|
|
|
$
|
5,498
|
|
|
$
|
277,297
|
|
Finance lease cost:
|
|
|
|
|
|
||||||
Amortization of right-of-use assets
|
258
|
|
|
—
|
|
|
258
|
|
|||
Interest on lease liabilities
|
812
|
|
|
—
|
|
|
812
|
|
|||
Short-term lease cost
|
2,171
|
|
|
—
|
|
|
2,171
|
|
|||
Variable lease cost
|
43,096
|
|
|
553
|
|
|
43,649
|
|
|||
Sublease income
|
(9,822
|
)
|
|
—
|
|
|
(9,822
|
)
|
|||
Total lease cost
|
$
|
308,314
|
|
|
$
|
6,051
|
|
|
$
|
314,365
|
|
Cash paid for amounts included in the measurement of lease liabilities:
|
|
||
Operating cash flows for operating leases
|
$
|
274,095
|
|
Operating cash flows for finance leases
|
777
|
|
|
Financing cash flows for finance leases
|
225
|
|
|
Right-of-use assets obtained in exchange for lease liabilities:
|
|
||
Operating leases(1)
|
1,275,575
|
|
|
Finance leases
|
9,102
|
|
(1)
|
Includes the right-of-use assets obtained in exchange for lease liabilities of $1,057.0 million which were recognized upon adoption of ASC Topic 842 at January 1, 2019.
|
4.
|
Leases (Continued)
|
|
Operating Leases
|
||||||||||
|
Unrelated Parties
|
|
Related Parties
|
|
Total
|
||||||
Operating lease right-of-use assets
|
$
|
971,382
|
|
|
$
|
32,604
|
|
|
$
|
1,003,986
|
|
|
|
|
|
|
|
||||||
Current operating lease liabilities
|
$
|
202,506
|
|
|
$
|
5,444
|
|
|
$
|
207,950
|
|
Non-current operating lease liabilities
|
826,049
|
|
|
26,848
|
|
|
852,897
|
|
|||
Total operating lease liabilities
|
$
|
1,028,555
|
|
|
$
|
32,292
|
|
|
$
|
1,060,847
|
|
|
Finance Leases
|
||||||||||
|
Unrelated Parties
|
|
Related Parties
|
|
Total
|
||||||
Property and equipment, net
|
$
|
4,965
|
|
|
$
|
—
|
|
|
$
|
4,965
|
|
|
|
|
|
|
|
||||||
Current portion of long-term debt and notes payable
|
$
|
195
|
|
|
$
|
—
|
|
|
$
|
195
|
|
Long-term debt, net of current portion
|
13,088
|
|
|
—
|
|
|
13,088
|
|
|||
Total finance lease liabilities
|
$
|
13,283
|
|
|
$
|
—
|
|
|
$
|
13,283
|
|
Weighted average remaining lease term (in years):
|
|
|
Operating leases
|
8.0
|
|
Finance leases
|
34.4
|
|
Weighted average discount rate:
|
|
|
Operating leases
|
5.9
|
%
|
Finance leases
|
7.3
|
%
|
|
Operating Leases
|
|
Finance Leases
|
|
Total
|
||||||
2020
|
$
|
263,085
|
|
|
$
|
1,182
|
|
|
$
|
264,267
|
|
2021
|
227,202
|
|
|
1,193
|
|
|
228,395
|
|
|||
2022
|
187,053
|
|
|
1,203
|
|
|
188,256
|
|
|||
2023
|
143,878
|
|
|
1,214
|
|
|
145,092
|
|
|||
2024
|
110,835
|
|
|
1,225
|
|
|
112,060
|
|
|||
Thereafter
|
483,162
|
|
|
30,404
|
|
|
513,566
|
|
|||
Total undiscounted cash flows
|
1,415,215
|
|
|
36,421
|
|
|
1,451,636
|
|
|||
Less: Imputed interest
|
354,368
|
|
|
23,138
|
|
|
377,506
|
|
|||
Total discounted lease liabilities
|
$
|
1,060,847
|
|
|
$
|
13,283
|
|
|
$
|
1,074,130
|
|
4.
|
Leases (Continued)
|
2019
|
$
|
267,846
|
|
2020
|
231,711
|
|
|
2021
|
193,155
|
|
|
2022
|
150,155
|
|
|
2023
|
107,759
|
|
|
Thereafter
|
484,038
|
|
|
|
$
|
1,434,664
|
|
5.
|
Property and Equipment
|
|
December 31,
|
||||||
|
2018
|
|
2019
|
||||
|
(in thousands)
|
||||||
Land
|
$
|
87,358
|
|
|
$
|
95,549
|
|
Leasehold improvements
|
498,520
|
|
|
543,934
|
|
||
Buildings
|
481,375
|
|
|
553,701
|
|
||
Furniture and equipment
|
609,805
|
|
|
670,050
|
|
||
Construction-in-progress
|
67,333
|
|
|
52,467
|
|
||
Total property and equipment
|
1,744,391
|
|
|
1,915,701
|
|
||
Accumulated depreciation
|
(764,581
|
)
|
|
(917,295
|
)
|
||
Property and equipment, net
|
$
|
979,810
|
|
|
$
|
998,406
|
|
6.
|
Intangible Assets
|
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Total
|
||||||||||
|
(in thousands)
|
||||||||||||||||||
Balance as of January 1, 2018
|
$
|
1,045,220
|
|
|
$
|
415,528
|
|
|
$
|
647,522
|
|
|
$
|
674,542
|
|
|
$
|
2,782,812
|
|
Acquired
|
—
|
|
|
1,118
|
|
|
4,309
|
|
|
537,424
|
|
|
542,851
|
|
|||||
Measurement period adjustment
|
—
|
|
|
—
|
|
|
—
|
|
|
4,472
|
|
|
4,472
|
|
|||||
Sold
|
—
|
|
|
—
|
|
|
(9,409
|
)
|
|
—
|
|
|
(9,409
|
)
|
|||||
Balance as of December 31, 2018
|
1,045,220
|
|
|
416,646
|
|
|
642,422
|
|
|
1,216,438
|
|
|
3,320,726
|
|
|||||
Acquired
|
33,149
|
|
|
14,254
|
|
|
12,970
|
|
|
18,299
|
|
|
78,672
|
|
|||||
Measurement period adjustment
|
435
|
|
|
—
|
|
|
—
|
|
|
(2,249
|
)
|
|
(1,814
|
)
|
|||||
Sold
|
—
|
|
|
—
|
|
|
(5,629
|
)
|
|
—
|
|
|
(5,629
|
)
|
|||||
Balance as of December 31, 2019
|
$
|
1,078,804
|
|
|
$
|
430,900
|
|
|
$
|
649,763
|
|
|
$
|
1,232,488
|
|
|
$
|
3,391,955
|
|
|
December 31,
|
||||||||||||||||||||||
|
2018
|
|
2019
|
||||||||||||||||||||
|
Gross
Carrying
Amount
|
|
Accumulated
Amortization
|
|
Net
Carrying
Amount
|
|
Gross
Carrying
Amount
|
|
Accumulated
Amortization
|
|
Net
Carrying
Amount
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Indefinite-lived intangible assets:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
Trademarks
|
$
|
166,698
|
|
|
$
|
—
|
|
|
$
|
166,698
|
|
|
$
|
166,698
|
|
|
$
|
—
|
|
|
$
|
166,698
|
|
Certificates of need
|
19,174
|
|
|
—
|
|
|
19,174
|
|
|
17,157
|
|
|
—
|
|
|
17,157
|
|
||||||
Accreditations
|
1,857
|
|
|
—
|
|
|
1,857
|
|
|
1,874
|
|
|
—
|
|
|
1,874
|
|
||||||
Finite-lived intangible assets:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
Trademarks
|
5,000
|
|
|
(4,583
|
)
|
|
417
|
|
|
5,000
|
|
|
(5,000
|
)
|
|
—
|
|
||||||
Customer relationships
|
280,710
|
|
|
(61,900
|
)
|
|
218,810
|
|
|
287,373
|
|
|
(87,346
|
)
|
|
200,027
|
|
||||||
Favorable leasehold interests(1)
|
13,553
|
|
|
(6,064
|
)
|
|
7,489
|
|
|
—
|
|
|
—
|
|
|
—
|
|
||||||
Non-compete agreements
|
29,400
|
|
|
(6,152
|
)
|
|
23,248
|
|
|
32,114
|
|
|
(8,802
|
)
|
|
23,312
|
|
||||||
Total identifiable intangible assets
|
$
|
516,392
|
|
|
$
|
(78,699
|
)
|
|
$
|
437,693
|
|
|
$
|
510,216
|
|
|
$
|
(101,148
|
)
|
|
$
|
409,068
|
|
(1)
|
Favorable leasehold interests are a component of the operating lease right-of-use assets upon adoption of ASC Topic 842, Leases.
|
6.
|
Intangible Assets (Continued)
|
|
2020
|
|
2021
|
|
2022
|
|
2023
|
|
2024
|
||||||||||
|
(in thousands)
|
||||||||||||||||||
Amortization expense
|
$
|
26,943
|
|
|
$
|
26,624
|
|
|
$
|
26,295
|
|
|
$
|
26,019
|
|
|
$
|
18,057
|
|
7.
|
Equity Method Investments
|
BIR JV, LLP
|
49.0
|
%
|
OHRH, LLC
|
49.0
|
%
|
GlobalRehab—Scottsdale, LLC
|
49.0
|
%
|
Rehabilitation Institute of Denton, LLC
|
50.0
|
%
|
ES Rehabilitation, LLC
|
49.0
|
%
|
Coastal Virginia Rehabilitation, LLC
|
49.0
|
%
|
BHSM Rehabilitation, LLC
|
49.0
|
%
|
Vibra Hospital of San Diego, LLC
|
39.0
|
%
|
|
|
December 31,
|
||||||
|
|
2018
|
|
2019
|
||||
|
|
(in thousands)
|
||||||
Current assets
|
|
$
|
125,435
|
|
|
$
|
178,674
|
|
Non-current assets
|
|
118,270
|
|
|
317,332
|
|
||
Total assets
|
|
$
|
243,705
|
|
|
$
|
496,006
|
|
Current liabilities
|
|
$
|
43,792
|
|
|
$
|
107,400
|
|
Non-current liabilities
|
|
16,338
|
|
|
127,976
|
|
||
Equity
|
|
183,575
|
|
|
260,630
|
|
||
Total liabilities and equity
|
|
$
|
243,705
|
|
|
$
|
496,006
|
|
7.
|
Equity Method Investments (Continued)
|
|
|
For the Year Ended December 31,
|
||||||||||
|
|
2017
|
|
2018
|
|
2019
|
||||||
|
|
(in thousands)
|
||||||||||
Revenues
|
|
$
|
336,349
|
|
|
$
|
393,034
|
|
|
$
|
536,464
|
|
Cost of services and other operating expenses
|
|
289,224
|
|
|
342,603
|
|
|
476,182
|
|
|||
Net income
|
|
45,648
|
|
|
48,535
|
|
|
58,519
|
|
8.
|
Insurance Risk Programs
|
9.
|
Long-Term Debt and Notes Payable
|
|
Principal Outstanding
|
|
Unamortized
Premium (Discount)
|
|
Unamortized
Issuance Costs |
|
Carrying
Value |
|
|
Fair Value
|
||||||||||
Select 6.250% senior notes
|
$
|
1,225,000
|
|
|
$
|
39,988
|
|
|
$
|
(19,944
|
)
|
|
$
|
1,245,044
|
|
|
|
$
|
1,322,020
|
|
Select credit facilities:
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
Select term loan
|
2,143,280
|
|
|
(10,411
|
)
|
|
(11,348
|
)
|
|
2,121,521
|
|
|
|
2,145,959
|
|
|||||
Other debt, including finance leases
|
78,941
|
|
|
—
|
|
|
(396
|
)
|
|
78,545
|
|
|
|
78,545
|
|
|||||
Total debt
|
$
|
3,447,221
|
|
|
$
|
29,577
|
|
|
$
|
(31,688
|
)
|
|
$
|
3,445,110
|
|
|
|
$
|
3,546,524
|
|
|
2020
|
|
2021
|
|
2022
|
|
2023
|
|
2024
|
|
Thereafter
|
|
Total
|
||||||||||||||
Select 6.250% senior notes
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
1,225,000
|
|
|
$
|
1,225,000
|
|
Select credit facilities:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
Select term loan
|
11,150
|
|
|
11,150
|
|
|
11,150
|
|
|
11,150
|
|
|
11,150
|
|
|
2,087,530
|
|
|
2,143,280
|
|
|||||||
Other debt, including finance leases
|
14,017
|
|
|
7,255
|
|
|
18,715
|
|
|
3,364
|
|
|
23,550
|
|
|
12,040
|
|
|
78,941
|
|
|||||||
Total debt
|
$
|
25,167
|
|
|
$
|
18,405
|
|
|
$
|
29,865
|
|
|
$
|
14,514
|
|
|
$
|
34,700
|
|
|
$
|
3,324,570
|
|
|
$
|
3,447,221
|
|
9.
|
Long-Term Debt and Notes Payable (Continued)
|
|
Principal Outstanding
|
|
Unamortized
Premium (Discount)
|
|
Unamortized
Issuance
Costs
|
|
Carrying
Value
|
|
|
Fair Value
|
||||||||||
Select 6.375% senior notes
|
$
|
710,000
|
|
|
$
|
550
|
|
|
$
|
(4,642
|
)
|
|
$
|
705,908
|
|
|
|
$
|
706,450
|
|
Select credit facilities:
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
Select revolving facility
|
20,000
|
|
|
—
|
|
|
—
|
|
|
20,000
|
|
|
|
18,400
|
|
|||||
Select term loan
|
1,129,875
|
|
|
(9,690
|
)
|
|
(9,321
|
)
|
|
1,110,864
|
|
|
|
1,076,206
|
|
|||||
Concentra-JPM credit facilities:
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
Concentra term loans
|
1,414,175
|
|
|
(2,765
|
)
|
|
(18,648
|
)
|
|
1,392,762
|
|
|
|
1,357,802
|
|
|||||
Other debt, including finance leases
|
64,331
|
|
|
—
|
|
|
(484
|
)
|
|
63,847
|
|
|
|
63,847
|
|
|||||
Total debt
|
$
|
3,338,381
|
|
|
$
|
(11,905
|
)
|
|
$
|
(33,095
|
)
|
|
$
|
3,293,381
|
|
|
|
$
|
3,222,705
|
|
9.
|
Long-Term Debt and Notes Payable (Continued)
|
9.
|
Long-Term Debt and Notes Payable (Continued)
|
9.
|
Long-Term Debt and Notes Payable (Continued)
|
10.
|
Stock Repurchase Program
|
11.
|
Segment Information
|
11.
|
Segment Information (Continued)
|
|
For the Year Ended December 31, 2017
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Net operating revenues(1)
|
$
|
1,725,022
|
|
|
$
|
509,108
|
|
|
$
|
960,902
|
|
|
$
|
1,013,224
|
|
|
$
|
156,989
|
|
|
$
|
4,365,245
|
|
Adjusted EBITDA
|
252,679
|
|
|
90,041
|
|
|
132,533
|
|
|
157,561
|
|
|
(94,822
|
)
|
|
537,992
|
|
||||||
Total assets
|
1,848,783
|
|
|
868,517
|
|
|
954,661
|
|
|
1,340,919
|
|
|
114,286
|
|
|
5,127,166
|
|
||||||
Capital expenditures
|
49,720
|
|
|
96,477
|
|
|
27,721
|
|
|
28,912
|
|
|
30,413
|
|
|
233,243
|
|
|
For the Year Ended December 31, 2018
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra(2)
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Net operating revenues(1)
|
$
|
1,753,584
|
|
|
$
|
583,745
|
|
|
$
|
995,794
|
|
|
$
|
1,557,673
|
|
|
$
|
190,462
|
|
|
$
|
5,081,258
|
|
Adjusted EBITDA
|
243,015
|
|
|
108,927
|
|
|
142,005
|
|
|
251,977
|
|
|
(100,769
|
)
|
|
645,155
|
|
||||||
Total assets
|
1,771,605
|
|
|
894,192
|
|
|
1,002,819
|
|
|
2,178,868
|
|
|
116,781
|
|
|
5,964,265
|
|
||||||
Capital expenditures
|
40,855
|
|
|
42,389
|
|
|
30,553
|
|
|
42,205
|
|
|
11,279
|
|
|
167,281
|
|
|
For the Year Ended December 31, 2019
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospitals
|
|
Rehabilitation Hospitals
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Net operating revenues
|
$
|
1,836,518
|
|
|
$
|
670,971
|
|
|
$
|
1,046,011
|
|
|
$
|
1,628,817
|
|
|
$
|
271,605
|
|
|
$
|
5,453,922
|
|
Adjusted EBITDA
|
254,868
|
|
|
135,857
|
|
|
151,831
|
|
|
276,482
|
|
|
(108,130
|
)
|
|
710,908
|
|
||||||
Total assets
|
2,099,833
|
|
|
1,127,028
|
|
|
1,289,190
|
|
|
2,372,187
|
|
|
452,050
|
|
|
7,340,288
|
|
||||||
Capital expenditures
|
45,573
|
|
|
27,216
|
|
|
33,628
|
|
|
44,101
|
|
|
6,608
|
|
|
157,126
|
|
|
For the Year Ended December 31, 2017
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Adjusted EBITDA
|
$
|
252,679
|
|
|
$
|
90,041
|
|
|
$
|
132,533
|
|
|
$
|
157,561
|
|
|
$
|
(94,822
|
)
|
|
|
|
|
Depreciation and amortization
|
(45,743
|
)
|
|
(20,176
|
)
|
|
(24,607
|
)
|
|
(61,945
|
)
|
|
(7,540
|
)
|
|
|
|
||||||
Stock compensation expense
|
—
|
|
|
—
|
|
|
—
|
|
|
(993
|
)
|
|
(18,291
|
)
|
|
|
|
||||||
U.S. HealthWorks acquisition costs
|
—
|
|
|
—
|
|
|
—
|
|
|
(2,819
|
)
|
|
—
|
|
|
|
|||||||
Income (loss) from operations
|
$
|
206,936
|
|
|
$
|
69,865
|
|
|
$
|
107,926
|
|
|
$
|
91,804
|
|
|
$
|
(120,653
|
)
|
|
$
|
355,878
|
|
Loss on early retirement of debt
|
|
|
|
|
|
|
|
|
|
|
(19,719
|
)
|
|||||||||||
Equity in earnings of unconsolidated subsidiaries
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
21,054
|
|
|||||||
Loss on sale of businesses
|
|
|
|
|
|
|
|
|
|
|
(49
|
)
|
|||||||||||
Interest expense
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(154,703
|
)
|
|||||||
Income before income taxes
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$
|
202,461
|
|
11.
|
Segment Information (Continued)
|
|
For the Year Ended December 31, 2018
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra(2)
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Adjusted EBITDA
|
$
|
243,015
|
|
|
$
|
108,927
|
|
|
$
|
142,005
|
|
|
$
|
251,977
|
|
|
$
|
(100,769
|
)
|
|
|
|
|
Depreciation and amortization
|
(45,797
|
)
|
|
(24,101
|
)
|
|
(27,195
|
)
|
|
(95,521
|
)
|
|
(9,041
|
)
|
|
|
|
||||||
Stock compensation expense
|
—
|
|
|
—
|
|
|
—
|
|
|
(2,883
|
)
|
|
(20,443
|
)
|
|
|
|
||||||
U.S. HealthWorks acquisition costs
|
—
|
|
|
—
|
|
|
—
|
|
|
(2,895
|
)
|
|
—
|
|
|
|
|
||||||
Income (loss) from operations
|
$
|
197,218
|
|
|
$
|
84,826
|
|
|
$
|
114,810
|
|
|
$
|
150,678
|
|
|
$
|
(130,253
|
)
|
|
$
|
417,279
|
|
Loss on early retirement of debt
|
|
|
|
|
|
|
|
|
|
|
(14,155
|
)
|
|||||||||||
Equity in earnings of unconsolidated subsidiaries
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
21,905
|
|
|||||||
Gain on sale of businesses
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
9,016
|
|
|||||||
Interest expense
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(198,493
|
)
|
|||||||
Income before income taxes
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$
|
235,552
|
|
|
For the Year Ended December 31, 2019
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Adjusted EBITDA
|
$
|
254,868
|
|
|
$
|
135,857
|
|
|
$
|
151,831
|
|
|
$
|
276,482
|
|
|
$
|
(108,130
|
)
|
|
|
|
|
Depreciation and amortization
|
(50,763
|
)
|
|
(27,322
|
)
|
|
(28,301
|
)
|
|
(96,807
|
)
|
|
(9,383
|
)
|
|
|
|
||||||
Stock compensation expense
|
—
|
|
|
—
|
|
|
—
|
|
|
(3,069
|
)
|
|
(23,382
|
)
|
|
|
|
||||||
Income (loss) from operations
|
$
|
204,105
|
|
|
$
|
108,535
|
|
|
$
|
123,530
|
|
|
$
|
176,606
|
|
|
$
|
(140,895
|
)
|
|
$
|
471,881
|
|
Loss on early retirement of debt
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(38,083
|
)
|
|||||||
Equity in earnings of unconsolidated subsidiaries
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
24,989
|
|
|||||||
Gain on sale of businesses
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
6,532
|
|
|||||||
Interest expense
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(200,570
|
)
|
|||||||
Income before income taxes
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
$
|
264,749
|
|
(1)
|
Prior to 2019, the financial results of employee leasing services provided to related parties affiliated through the Company’s equity method investments were included with the Company’s reportable segments. These results are now reported as part of the Company’s other activities. For the years ended December 31, 2017 and 2018, net operating revenues were conformed to reflect the current presentation.
|
12.
|
Revenue from Contracts with Customers
|
|
For the Year Ended December 31, 2017
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Patient service revenues:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
Medicare
|
$
|
903,503
|
|
|
$
|
259,221
|
|
|
$
|
148,403
|
|
|
$
|
2,128
|
|
|
$
|
—
|
|
|
$
|
1,313,255
|
|
Non-Medicare
|
810,723
|
|
|
207,196
|
|
|
739,531
|
|
|
1,002,787
|
|
|
—
|
|
|
2,760,237
|
|
||||||
Total patient services revenues
|
1,714,226
|
|
|
466,417
|
|
|
887,934
|
|
|
1,004,915
|
|
|
—
|
|
|
4,073,492
|
|
||||||
Other revenues
|
10,796
|
|
|
42,691
|
|
|
72,968
|
|
|
8,309
|
|
|
156,989
|
|
|
291,753
|
|
||||||
Total net operating revenues
|
$
|
1,725,022
|
|
|
$
|
509,108
|
|
|
$
|
960,902
|
|
|
$
|
1,013,224
|
|
|
$
|
156,989
|
|
|
$
|
4,365,245
|
|
|
For the Year Ended December 31, 2018
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Patient service revenues:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
Medicare
|
$
|
893,429
|
|
|
$
|
293,913
|
|
|
$
|
161,054
|
|
|
$
|
2,168
|
|
|
$
|
—
|
|
|
$
|
1,350,564
|
|
Non-Medicare
|
847,447
|
|
|
254,215
|
|
|
762,247
|
|
|
1,545,852
|
|
|
—
|
|
|
3,409,761
|
|
||||||
Total patient services revenues
|
1,740,876
|
|
|
548,128
|
|
|
923,301
|
|
|
1,548,020
|
|
|
—
|
|
|
4,760,325
|
|
||||||
Other revenues
|
12,708
|
|
|
35,617
|
|
|
72,493
|
|
|
9,653
|
|
|
190,462
|
|
|
320,933
|
|
||||||
Total net operating revenues
|
$
|
1,753,584
|
|
|
$
|
583,745
|
|
|
$
|
995,794
|
|
|
$
|
1,557,673
|
|
|
$
|
190,462
|
|
|
$
|
5,081,258
|
|
|
For the Year Ended December 31, 2019
|
||||||||||||||||||||||
|
Critical Illness Recovery Hospital
|
|
Rehabilitation Hospital
|
|
Outpatient
Rehabilitation
|
|
Concentra
|
|
Other
|
|
Total
|
||||||||||||
|
(in thousands)
|
||||||||||||||||||||||
Patient service revenues:
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
Medicare
|
$
|
907,963
|
|
|
$
|
332,514
|
|
|
$
|
171,690
|
|
|
$
|
1,965
|
|
|
$
|
—
|
|
|
$
|
1,414,132
|
|
Non-Medicare
|
916,650
|
|
|
300,113
|
|
|
794,288
|
|
|
1,615,529
|
|
|
—
|
|
|
3,626,580
|
|
||||||
Total patient services revenues
|
1,824,613
|
|
|
632,627
|
|
|
965,978
|
|
|
1,617,494
|
|
|
—
|
|
|
5,040,712
|
|
||||||
Other revenues
|
11,905
|
|
|
38,344
|
|
|
80,033
|
|
|
11,323
|
|
|
271,605
|
|
|
413,210
|
|
||||||
Total net operating revenues
|
$
|
1,836,518
|
|
|
$
|
670,971
|
|
|
$
|
1,046,011
|
|
|
$
|
1,628,817
|
|
|
$
|
271,605
|
|
|
$
|
5,453,922
|
|
13.
|
Stock-based Compensation
|
|
Shares
|
|
Weighted Average
Grant Date
Fair Value
|
|||
|
(share amounts in thousands)
|
|||||
Unvested balance, January 1, 2019
|
4,450
|
|
|
$
|
15.68
|
|
Granted
|
1,500
|
|
|
16.60
|
|
|
Vested
|
(1,300
|
)
|
|
11.97
|
|
|
Forfeited
|
(43
|
)
|
|
16.09
|
|
|
Unvested balance, December 31, 2019
|
4,607
|
|
|
$
|
17.03
|
|
|
For the Year Ended December 31,
|
||||||||||
|
2017
|
|
2018
|
|
2019
|
||||||
|
(in thousands)
|
||||||||||
Stock compensation expense:
|
|
|
|
|
|
|
|
|
|||
Included in general and administrative
|
$
|
15,706
|
|
|
$
|
17,604
|
|
|
$
|
20,334
|
|
Included in cost of services
|
3,578
|
|
|
5,722
|
|
|
6,117
|
|
|||
Total
|
$
|
19,284
|
|
|
$
|
23,326
|
|
|
$
|
26,451
|
|
|
2020
|
|
2021
|
|
2022
|
|
2023
|
|
2024
|
||||||||||
|
(in thousands)
|
||||||||||||||||||
Stock compensation expense
|
$
|
24,381
|
|
|
$
|
16,031
|
|
|
$
|
8,117
|
|
|
$
|
1,267
|
|
|
$
|
19
|
|
14.
|
Income Taxes
|
|
For the Year Ended December 31,
|
||||||||||
|
2017
|
|
2018
|
|
2019
|
||||||
|
(in thousands)
|
||||||||||
Current income tax expense:
|
|
|
|
|
|
|
|
|
|||
Federal
|
$
|
45,809
|
|
|
$
|
36,072
|
|
|
$
|
55,822
|
|
State and local
|
8,331
|
|
|
15,321
|
|
|
15,331
|
|
|||
Total current income tax expense
|
54,140
|
|
|
51,393
|
|
|
71,153
|
|
|||
Deferred income tax expense (benefit)
|
(72,324
|
)
|
|
7,217
|
|
|
(7,435
|
)
|
|||
Total income tax expense (benefit)
|
$
|
(18,184
|
)
|
|
$
|
58,610
|
|
|
$
|
63,718
|
|
|
For the Year Ended December 31,
|
|||||||
|
2017
|
|
2018
|
|
2019
|
|||
Federal income tax at statutory rate
|
35.0
|
%
|
|
21.0
|
%
|
|
21.0
|
%
|
State and local income taxes, less federal income tax benefit
|
3.7
|
|
|
5.0
|
|
|
4.2
|
|
Permanent differences
|
1.7
|
|
|
2.1
|
|
|
1.7
|
|
Valuation allowance
|
(7.3
|
)
|
|
0.5
|
|
|
0.5
|
|
Uncertain tax positions
|
(0.6
|
)
|
|
(0.8
|
)
|
|
(0.1
|
)
|
Non-controlling interest
|
0.5
|
|
|
(2.1
|
)
|
|
(2.9
|
)
|
Stock-based compensation
|
(1.3
|
)
|
|
(2.2
|
)
|
|
(0.7
|
)
|
Deferred income taxes - state income tax rate adjustment
|
(2.8
|
)
|
|
0.4
|
|
|
0.8
|
|
Deferred income taxes - tax legislation rate adjustment
|
(37.5
|
)
|
|
—
|
|
|
—
|
|
Other
|
(0.4
|
)
|
|
1.0
|
|
|
(0.4
|
)
|
Effective income tax rate
|
(9.0
|
)%
|
|
24.9
|
%
|
|
24.1
|
%
|
14.
|
Income Taxes (Continued)
|
|
December 31,
|
||||||
|
2018
|
|
2019
|
||||
|
(in thousands)
|
||||||
Deferred tax assets
|
|
|
|
|
|
||
Allowance for doubtful accounts
|
$
|
10,313
|
|
|
$
|
13,097
|
|
Compensation and benefit-related accruals
|
51,900
|
|
|
55,300
|
|
||
Professional malpractice liability insurance
|
13,644
|
|
|
13,753
|
|
||
Deferred revenue
|
209
|
|
|
274
|
|
||
Federal and state net operating loss and state tax credit carryforwards
|
40,163
|
|
|
38,933
|
|
||
Interest limitation carryforward
|
4,675
|
|
|
4,943
|
|
||
Stock awards
|
5,695
|
|
|
6,251
|
|
||
Equity investments
|
2,055
|
|
|
2,914
|
|
||
Operating lease liabilities
|
—
|
|
|
267,513
|
|
||
Other
|
3,271
|
|
|
2,344
|
|
||
Deferred tax assets
|
$
|
131,925
|
|
|
$
|
405,322
|
|
Valuation allowance
|
(17,893
|
)
|
|
(18,461
|
)
|
||
Deferred tax assets, net of valuation allowance
|
$
|
114,032
|
|
|
$
|
386,861
|
|
Deferred tax liabilities
|
|
|
|
|
|
||
Deferred income
|
$
|
(13,891
|
)
|
|
$
|
(9,190
|
)
|
Investment in unconsolidated affiliates
|
(5,653
|
)
|
|
(7,498
|
)
|
||
Depreciation and amortization
|
(217,950
|
)
|
|
(225,079
|
)
|
||
Deferred financing costs
|
(8,324
|
)
|
|
(6,250
|
)
|
||
Operating lease right-of-use assets
|
—
|
|
|
(263,818
|
)
|
||
Other
|
(3,488
|
)
|
|
(3,546
|
)
|
||
Deferred tax liabilities
|
$
|
(249,306
|
)
|
|
$
|
(515,381
|
)
|
Deferred tax liabilities, net of deferred tax assets
|
$
|
(135,274
|
)
|
|
$
|
(128,520
|
)
|
|
December 31,
|
||||||
|
2018
|
|
2019
|
||||
|
(in thousands)
|
||||||
Other assets
|
$
|
18,621
|
|
|
$
|
19,738
|
|
Non-current deferred tax liability
|
(153,895
|
)
|
|
(148,258
|
)
|
||
|
$
|
(135,274
|
)
|
|
$
|
(128,520
|
)
|
14.
|
Income Taxes (Continued)
|
|
State Net Operating Losses
|
|
Gross Valuation Allowance
|
||||
|
(in thousands)
|
||||||
2020
|
$
|
17,297
|
|
|
$
|
14,100
|
|
2021
|
11,772
|
|
|
8,806
|
|
||
2022
|
39,319
|
|
|
33,790
|
|
||
2023
|
20,743
|
|
|
15,367
|
|
||
Thereafter through 2038
|
630,506
|
|
|
413,916
|
|
15.
|
Earnings per Share
|
|
|
Basic EPS
|
|
Diluted EPS
|
|
||||||||||||||||||||
|
|
For the Year Ended December 31,
|
|
For the Year Ended December 31,
|
|
||||||||||||||||||||
|
|
2017
|
|
2018
|
|
2019
|
|
2017
|
|
2018
|
|
2019
|
|
||||||||||||
|
|
(in thousands)
|
|
||||||||||||||||||||||
Net income
|
|
$
|
220,645
|
|
|
$
|
176,942
|
|
|
$
|
201,031
|
|
|
$
|
220,645
|
|
|
$
|
176,942
|
|
|
$
|
201,031
|
|
|
Less: net income attributable to non-controlling interests
|
|
43,461
|
|
|
39,102
|
|
|
52,582
|
|
|
43,461
|
|
|
39,102
|
|
|
52,582
|
|
|
||||||
Net income attributable to the Company
|
|
177,184
|
|
|
137,840
|
|
|
148,449
|
|
|
177,184
|
|
|
137,840
|
|
|
148,449
|
|
|
||||||
Less: net income attributable to participating securities
|
|
5,758
|
|
|
4,551
|
|
|
4,995
|
|
|
5,751
|
|
|
4,548
|
|
|
4,994
|
|
|
||||||
Net income attributable to common shares
|
|
$
|
171,426
|
|
|
$
|
133,289
|
|
|
$
|
143,454
|
|
|
$
|
171,433
|
|
|
$
|
133,292
|
|
|
$
|
143,455
|
|
|
15.
|
Earnings per Share (Continued)
|
|
|
For the Year Ended December 31, 2017
|
|||||||||||||||||||||
|
|
Net Income Allocation
|
|
Shares(1)
|
|
Basic EPS
|
|
|
Net Income Allocation
|
|
Shares(1)
|
|
Diluted EPS
|
||||||||||
|
|
(in thousands, except for per share amounts)
|
|||||||||||||||||||||
Common shares
|
|
$
|
171,426
|
|
|
128,955
|
|
|
$
|
1.33
|
|
|
|
$
|
171,433
|
|
|
129,126
|
|
|
$
|
1.33
|
|
Participating securities
|
|
5,758
|
|
|
4,332
|
|
|
1.33
|
|
|
|
5,751
|
|
|
4,332
|
|
|
1.33
|
|
||||
Total Company
|
|
$
|
177,184
|
|
|
|
|
|
|
|
$
|
177,184
|
|
|
|
|
|
|
|
For the Year Ended December 31, 2018
|
|||||||||||||||||||||
|
|
Net Income Allocation
|
|
Shares(1)
|
|
Basic EPS
|
|
|
Net Income Allocation
|
|
Shares(1)
|
|
Diluted EPS
|
||||||||||
|
|
(in thousands, except for per share amounts)
|
|||||||||||||||||||||
Common shares
|
|
$
|
133,289
|
|
|
130,172
|
|
|
$
|
1.02
|
|
|
|
$
|
133,292
|
|
|
130,256
|
|
|
$
|
1.02
|
|
Participating securities
|
|
4,551
|
|
|
4,444
|
|
|
1.02
|
|
|
|
4,548
|
|
|
4,444
|
|
|
1.02
|
|
||||
Total Company
|
|
$
|
137,840
|
|
|
|
|
|
|
|
$
|
137,840
|
|
|
|
|
|
|
|
For the Year Ended December 31, 2019
|
|||||||||||||||||||||
|
|
Net Income Allocation
|
|
Shares(1)
|
|
Basic EPS
|
|
|
Net Income Allocation
|
|
Shares(1)
|
|
Diluted EPS
|
||||||||||
|
|
(in thousands, except for per share amounts)
|
|||||||||||||||||||||
Common shares
|
|
$
|
143,454
|
|
|
130,248
|
|
|
$
|
1.10
|
|
|
|
$
|
143,455
|
|
|
130,276
|
|
|
$
|
1.10
|
|
Participating securities
|
|
4,995
|
|
|
4,535
|
|
|
$
|
1.10
|
|
|
|
4,994
|
|
|
4,535
|
|
|
$
|
1.10
|
|
||
Total Company
|
|
$
|
148,449
|
|
|
|
|
|
|
|
$
|
148,449
|
|
|
|
|
|
16.
|
Commitments and Contingencies
|
16.
|
Commitments and Contingencies (Continued)
|
16.
|
Commitments and Contingencies (Continued)
|
17.
|
Subsequent Events
|
18.
|
Selected Quarterly Financial Data (Unaudited)
|
|
First
Quarter
|
|
Second
Quarter
|
|
Third
Quarter
|
|
Fourth
Quarter
|
||||||||
|
(in thousands, except per share amounts)
|
||||||||||||||
For the year ended December 31, 2018
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net operating revenues
|
$
|
1,252,964
|
|
|
$
|
1,296,210
|
|
|
$
|
1,267,401
|
|
|
$
|
1,264,683
|
|
Cost of services, exclusive of depreciation and amortization
|
1,065,813
|
|
|
1,094,731
|
|
|
1,087,062
|
|
|
1,093,450
|
|
||||
Depreciation and amortization
|
46,771
|
|
|
51,724
|
|
|
50,527
|
|
|
52,633
|
|
||||
Income from operations
|
108,598
|
|
|
120,561
|
|
|
99,837
|
|
|
88,283
|
|
||||
Net income
|
43,982
|
|
|
60,559
|
|
|
42,679
|
|
|
29,722
|
|
||||
Net income attributable to Select Medical Holdings Corporation
|
33,739
|
|
|
46,511
|
|
|
32,917
|
|
|
24,673
|
|
||||
Earnings per common share:(1)
|
|
|
|
|
|
|
|
|
|
|
|
||||
Basic
|
$
|
0.25
|
|
|
$
|
0.35
|
|
|
$
|
0.24
|
|
|
$
|
0.18
|
|
Diluted
|
$
|
0.25
|
|
|
$
|
0.35
|
|
|
$
|
0.24
|
|
|
$
|
0.18
|
|
|
First
Quarter
|
|
Second
Quarter
|
|
Third
Quarter
|
|
Fourth
Quarter
|
||||||||
|
(in thousands, except per share amounts)
|
||||||||||||||
For the year ended December 31, 2019
|
|
|
|
|
|
|
|
|
|
|
|
||||
Net operating revenues
|
$
|
1,324,631
|
|
|
$
|
1,361,364
|
|
|
$
|
1,393,343
|
|
|
$
|
1,374,584
|
|
Cost of services, exclusive of depreciation and amortization
|
1,132,092
|
|
|
1,150,150
|
|
|
1,183,111
|
|
|
1,175,649
|
|
||||
Depreciation and amortization
|
52,138
|
|
|
54,993
|
|
|
52,941
|
|
|
52,504
|
|
||||
Income from operations
|
111,724
|
|
|
124,882
|
|
|
122,906
|
|
|
112,369
|
|
||||
Net income
|
53,344
|
|
|
59,986
|
|
|
44,030
|
|
|
43,671
|
|
||||
Net income attributable to Select Medical Holdings Corporation
|
40,834
|
|
|
44,816
|
|
|
30,732
|
|
|
32,067
|
|
||||
Earnings per common share:(1)
|
|
|
|
|
|
|
|
|
|
|
|
||||
Basic
|
$
|
0.30
|
|
|
$
|
0.33
|
|
|
$
|
0.23
|
|
|
$
|
0.24
|
|
Diluted
|
$
|
0.30
|
|
|
$
|
0.33
|
|
|
$
|
0.23
|
|
|
$
|
0.24
|
|
(1)
|
Due to rounding, the summation of quarterly earnings per common share balances may not equal year to date equivalents.
|
|
|
Balance at
Beginning
of Year
|
|
Charged to
Cost and
Expenses
|
|
Acquisitions(1)
|
|
Deductions
|
|
Balance at
End of Year
|
||||||||||
|
|
(in thousands)
|
||||||||||||||||||
Income Tax Valuation Allowance
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
Year ended December 31, 2019
|
|
$
|
17,893
|
|
|
$
|
568
|
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
18,461
|
|
Year ended December 31, 2018
|
|
$
|
12,986
|
|
|
$
|
1,032
|
|
|
$
|
3,875
|
|
|
$
|
—
|
|
|
$
|
17,893
|
|
Year ended December 31, 2017
|
|
$
|
26,421
|
|
|
$
|
(13,435
|
)
|
|
$
|
—
|
|
|
$
|
—
|
|
|
$
|
12,986
|
|
(1)
|
Includes valuation allowance reserves resulting from business combinations.
|
NAME
|
|
Jurisdiction of Organization
|
AbsoluteCVO, Inc.
|
|
Michigan
|
ACC Capital, LLC
|
|
Delaware
|
Actra Rehabilitation Associates, Inc.
|
|
Wisconsin
|
Advantage Rehabilitation Clinics, Inc.
|
|
Massachusetts
|
Alexandria Sports, Inc.
|
|
New York
|
Allevant Solutions, LLC
|
|
Delaware
|
Ambulatory Care Solutions of Arkansas LLC
|
|
Arkansas
|
Ambulatory Care Solutions of Ohio LLC
|
|
Ohio
|
Ambulatory Care Solutions, LLC
|
|
Indiana
|
American Current Care of Arizona, P.A.
|
|
Arizona
|
American Current Care of Arkansas, P.A.
|
|
Arkansas
|
American Current Care of California, A Medical Corporation
|
|
California
|
American Current Care of Delaware, P.A.
|
|
Delaware
|
American Current Care of Hawaii, Prof. Corp.
|
|
Hawaii
|
American Current Care of Illinois, P.C.
|
|
Illinois
|
American Current Care of Kansas, P.A.
|
|
Kansas
|
American Current Care of Massachusetts, P.C.
|
|
Massachusetts
|
American Current Care of Michigan, P.C.
|
|
Michigan
|
American Current Care of Minnesota, P.C.
|
|
Minnesota
|
American Current Care of Missouri, P.C.
|
|
Missouri
|
American Current Care of Nebraska, P.C.
|
|
Nebraska
|
American Current Care of New Jersey PA
|
|
New Jersey
|
American Current Care of North Carolina, P.C.
|
|
North Carolina
|
American Current Care of Ohio, P.A., Co.
|
|
Ohio
|
American Current Care of Washington, P.S.
|
|
Washington
|
American Current Care, P.A.
|
|
Texas
|
American Transitional Hospitals, LLC
|
|
Delaware
|
Archer Rehabilitation, LLC
|
|
Delaware
|
Argosy Health, LLC
|
|
Delaware
|
Benchmark Acquisition Corp.
|
|
Delaware
|
Benchmark Medical Management Company
|
|
Delaware
|
Benchmark O&P Holdings, Inc.
|
|
Delaware
|
Benchmark Orthotics & Prosthetics, Inc.
|
|
Delaware
|
BHSM ES, Inc.
|
|
Delaware
|
BHSM Rehabilitation, LLC
|
|
Delaware
|
BIR JV, LLP
|
|
Texas
|
Blue Hen Physical Therapy, Inc.
|
|
Delaware
|
California Rehab Institute Medical Group
|
|
California
|
California Rehabilitation Institute, LLC
|
|
Delaware
|
Cape Prosthetics-Orthotics, Inc.
|
|
Missouri
|
Caritas Rehab Services, LLC
|
|
Kentucky
|
Carrollton Physical Therapy Clinic, Inc.
|
|
Texas
|
Central Iowa Physio, LLC
|
|
Iowa
|
Cleveland Clinic Rehabilitation Hospitals, LLC
|
|
Delaware
|
CM Occupational Health, Limited Liability Company
|
|
Maine
|
Coastal Virginia ES, LLC
|
|
Delaware
|
Coastal Virginia Rehabilitation, LLC
|
|
Virginia
|
Concentra Akron, L.L.C.
|
|
Delaware
|
Concentra Arkansas, L.L.C.
|
|
Delaware
|
Concentra Group Holdings Parent, LLC
|
|
Delaware
|
Concentra Group Holdings, LLC
|
|
Delaware
|
Concentra Health Services, Inc.
|
|
Delaware
|
Concentra Holdings, Inc.
|
|
Delaware
|
Concentra Inc.
|
|
Delaware
|
Concentra Integrated Services, Inc.
|
|
Massachusetts
|
Concentra Laboratory, L.L.C.
|
|
Delaware
|
Concentra Occupational Health Research Institute
|
|
Texas
|
Concentra Occupational Healthcare Harrisburg, L.P.
|
|
Pennsylvania
|
Concentra Operating Corporation
|
|
Delaware
|
Concentra Primary Care of California, a Medical Corporation
|
|
California
|
Concentra Primary Care of New Jersey PA
|
|
New Jersey
|
Concentra Primary Care of Ohio, P.A., Co.
|
|
Ohio
|
Concentra Primary Care, P.A.
|
|
Texas
|
Concentra Solutions, Inc.
|
|
Delaware
|
Concentra South Carolina, L.L.C.
|
|
Delaware
|
Concentra St. Louis, L.L.C.
|
|
Delaware
|
Concentramark, Inc.
|
|
Delaware
|
Concentra-UPMC, L.L.C.
|
|
Delaware
|
ContinuityRx, Inc.
|
|
Arizona
|
CRI ES, Inc.
|
|
Delaware
|
Crowley Physical Therapy Clinic, Inc.
|
|
Louisiana
|
Dade Prosthetics & Orthotics, Inc.
|
|
Florida
|
DG Physical Therapy, P.C.
|
|
Massachusetts
|
Dignity Select Nevada, LLC
|
|
Delaware
|
Douglas Avery & Associates, Ltd.
|
|
Virginia
|
Eagle Rehab Corporation
|
|
Delaware
|
Eden Sports, Inc.
|
|
New York
|
Elizabethtown Physical Therapy, P.S.C.
|
|
Kentucky
|
ES LTACH, LLC
|
|
Georgia
|
ES Rehabilitation, LLC
|
|
Georgia
|
FC Select II, LLC
|
|
Delaware
|
FC Select, LLC
|
|
Delaware
|
Fine, Bryant & Wah, Inc.
|
|
Maryland
|
Frederick Orthopedic Rehabilitation, Inc.
|
|
Maryland
|
Freedom Management Services, LLC
|
|
Pennsylvania
|
Georgia Physical Therapy, Inc.
|
|
Georgia
|
GH General, LLC
|
|
Texas
|
GH General-San Antonio, LLC
|
|
Texas
|
GlobalRehab — Fort Worth, LP
|
|
Texas
|
GlobalRehab — San Antonio, LP
|
|
Texas
|
GlobalRehab — Scottsdale, LLC
|
|
Arizona
|
GlobalRehab, LP
|
|
Texas
|
GP Therapy, L.L.C.
|
|
Georgia
|
GR General-Scottsdale, LLC
|
|
Texas
|
Great Lakes Specialty Hospital—Hackley, LLC
|
|
Delaware
|
Great Lakes Specialty Hospital—Oak, LLC
|
|
Delaware
|
GRSH ES, Inc.
|
|
Delaware
|
Gulf Breeze Physical Therapy, Inc.
|
|
Florida
|
Hospital Holdings Corporation
|
|
Delaware
|
Indiana Rehabilitation Services, LLC
|
|
Delaware
|
Indianapolis Physical Therapy and Sports Medicine, Inc.
|
|
Indiana
|
Integrity Physical Therapy, Inc.
|
|
Delaware
|
Intensiva Healthcare Corporation
|
|
Delaware
|
Intensiva Hospital of Greater St. Louis, Inc.
|
|
Missouri
|
Jeffersontown Physical Therapy, LLC
|
|
Kentucky
|
Johnson Physical Therapy, Inc.
|
|
Ohio
|
Joyner Sportsmedicine Institute, Inc.
|
|
Pennsylvania
|
Kentucky Orthopedic Rehabilitation, LLC
|
|
Delaware
|
Kentucky Rehabilitation Services, Inc.
|
|
Kentucky
|
Kessler Hudson County Rehabilitation, LLC
|
|
Delaware
|
Kessler Institute for Rehabilitation, Inc.
|
|
New Jersey
|
Kessler Orthotic & Prosthetic Services, Inc.
|
|
Delaware
|
Kessler Pediatric Therapy, Inc.
|
|
Delaware
|
Kessler Professional Services, LLC
|
|
Delaware
|
Kessler Rehab Centers, Inc.
|
|
Delaware
|
Kessler Rehabilitation Corporation
|
|
Delaware
|
Kessler Rehabilitation Services, Inc.
|
|
New Jersey
|
Keystone Rehabilitation Systems of McMurray
|
|
Pennsylvania
|
Keystone Rehabilitation Systems, Inc.
|
|
Pennsylvania
|
KORT Kentuckiana, LLC
|
|
Delaware
|
KORT Rehabilitation at Home, LLC
|
|
Delaware
|
Leesburg Sports, Inc.
|
|
New York
|
LifeBridge Sports Medicine and Rehabilitation, LLC
|
|
Maryland
|
LifeSigns Management, Inc.
|
|
Michigan
|
Louisville Physical Therapy, P.S.C.
|
|
Kentucky
|
LTACH @ Riverside, LLC
|
|
Virginia
|
Madison Rehabilitation Center, Inc.
|
|
Connecticut
|
Matrix Healthcare Services, LLC
|
|
Delaware
|
Matrix Rehabilitation, Inc.
|
|
Delaware
|
Matrix Rehabilitation-Delaware, Inc.
|
|
Delaware
|
Matrix Rehabilitation-Georgia, Inc.
|
|
Delaware
|
Matrix Rehabilitation-Ohio, Inc.
|
|
Delaware
|
Matrix Rehabilitation-South Carolina, Inc.
|
|
Delaware
|
Matrix Rehabilitation-Texas, Inc.
|
|
Delaware
|
Metro Rehabilitation Services, Inc.
|
|
Michigan
|
Morris Area Rehabilitation Association, Inc.
|
|
New Jersey
|
National Healthcare Resources, Inc.
|
|
Delaware
|
North Dallas Physical Therapy Associates, Inc.
|
|
Texas
|
Northstar Health Service, Inc.
|
|
Delaware
|
NovaCare Occupational Health Services, Inc.
|
|
Delaware
|
NovaCare Outpatient Rehabilitation East, Inc.
|
|
Delaware
|
NovaCare Outpatient Rehabilitation, Inc.
|
|
Kansas
|
NovaCare Rehabilitation of Ohio, Inc.
|
|
Ohio
|
NSR ES, Inc.
|
|
Delaware
|
Occspecialists Corp., A Medical Corporation
|
|
California
|
Occupational Health + Rehabilitation LLC
|
|
Delaware
|
Occupational Health Centers of Arkansas, P.A.
|
|
Arkansas
|
Occupational Health Centers of California, a Medical Corporation
|
|
California
|
Occupational Health Centers of Delaware, P.A.
|
|
Delaware
|
Occupational Health Centers of Georgia, P.C.
|
|
Georgia
|
Occupational Health Centers of Illinois, P.C.
|
|
Illinois
|
Occupational Health Centers Of Kansas, P.A.
|
|
Kansas
|
Occupational Health Centers of Louisiana, a Professional Corporation
|
|
Louisiana
|
Occupational Health Centers of Michigan, P.C.
|
|
Michigan
|
Occupational Health Centers of Minnesota, P.C.
|
|
Minnesota
|
Occupational Health Centers of Nebraska, P.C.
|
|
Nebraska
|
Occupational Health Centers of New Jersey, P.A.
|
|
New Jersey
|
Occupational Health Centers of New York, P.A.
|
|
New York
|
Occupational Health Centers of North Carolina, P.C.
|
|
North Carolina
|
Occupational Health Centers of Ohio, P.A., Co.
|
|
Ohio
|
Occupational Health Centers of The Southwest, P.A. (AZ)
|
|
Arizona
|
Occupational Health Centers of The Southwest, P.A. (TX)
|
|
Texas
|
Occupational Health Centers of Washington, P.S.
|
|
Washington
|
OHC of Hawaii, Inc.
|
|
Hawaii
|
OHR/Baystate, LLC
|
|
Massachusetts
|
OHR/MMC, Limited Liability Company
|
|
Maine
|
OHRH, LLC
|
|
Ohio
|
OHRH ES, Inc.
|
|
Delaware
|
OHRH Select, Inc.
|
|
Delaware
|
OHRH Subsidiaries, LLC
|
|
Delaware
|
OMP Insurance Company, Ltd.
|
|
Cayman Islands
|
OnSite OccMed, P.A.
|
|
Texas
|
OSR Louisiana, LLC
|
|
Delaware
|
OSR Property Ventures, LLC
|
|
Delaware
|
P&O Services, Inc.
|
|
Michigan
|
Pacific Rehabilitation & Sports Medicine, Inc.
|
|
Delaware
|
Penn State Hershey Rehabilitation, LLC
|
|
Delaware
|
Philadelphia Occupational Health, P.C.
|
|
Pennsylvania
|
PHS Physical Therapy, LLC
|
|
Delaware
|
Physio at Hammonds Centre, LLC
|
|
Georgia
|
PhysioKids, Inc.
|
|
Delaware
|
PhysioLink Corporation
|
|
Delaware
|
Physiotherapy Associates Holdings, Inc.
|
|
Delaware
|
Physiotherapy Associates NRH Rehab, LLC
|
|
Maryland
|
Physiotherapy Associates Union Rehab, LLC
|
|
Maryland
|
Physiotherapy Associates, Inc.
|
|
Michigan
|
Physiotherapy Corporation
|
|
Delaware
|
Physiotherapy-BMHI Holdings, Inc.
|
|
Delaware
|
Pinnacle Health Select Rehabilitation, LLC
|
|
Delaware
|
PR Acquisition Corporation
|
|
California
|
Pro Active Therapy of North Carolina, Inc.
|
|
North Carolina
|
Pro Active Therapy of South Carolina, Inc.
|
|
South Carolina
|
Pro Active Therapy of Virginia, Inc.
|
|
Virginia
|
Pro Active Therapy, Inc.
|
|
North Carolina
|
Professional Rehab Associates, Inc.
|
|
Pennsylvania
|
Professional Therapeutic Services, Inc.
|
|
Ohio
|
Professional Therapy Systems, Inc.
|
|
Tennessee
|
Progressive Therapy, Services, Inc.
|
|
Ohio
|
PSHR Physical Therapy, LLC
|
|
Delaware
|
PTSMA, Inc.
|
|
Connecticut
|
R.S. Network, Inc.
|
|
Illinois
|
RCI (Michigan), Inc.
|
|
Delaware
|
RCI (WRS), Inc.
|
|
Delaware
|
Rebound Oklahoma, Inc.
|
|
Oklahoma
|
Regency Hospital Company of Macon, LLC
|
|
Delaware
|
Regency Hospital Company of Meridian, L.L.C.
|
|
Delaware
|
Regency Hospital Company of South Carolina, L.L.C.
|
|
Delaware
|
Regency Hospital Company, L.L.C.
|
|
Delaware
|
Regency Hospital of Atlanta, LLC
|
|
Delaware
|
Regency Hospital of Columbus, LLC
|
|
Delaware
|
Regency Hospital of Fort Worth Holdings, LLC
|
|
Delaware
|
Regency Hospital of Fort Worth, LLLP
|
|
Delaware
|
Regency Hospital of Greenville, LLC
|
|
Delaware
|
Regency Hospital of Jackson, LLC
|
|
Delaware
|
Regency Hospital of Kansas City, LLC
|
|
Delaware
|
Regency Hospital of Minneapolis, LLC
|
|
Delaware
|
Regency Hospital of North Central Ohio, LLC
|
|
Delaware
|
Regency Hospital of North Dallas Holdings, LLC
|
|
Delaware
|
Regency Hospital of North Dallas II, LLLP
|
|
Delaware
|
Regency Hospital of Northwest Arkansas, LLC
|
|
Delaware
|
Regency Hospital of Northwest Indiana, LLC
|
|
Delaware
|
Regency Hospital of Portland, LLC
|
|
Delaware
|
Regency Hospital of Rhode Island, LLC
|
|
Delaware
|
Regency Hospital of Rockford, LLC
|
|
Delaware
|
Regency Hospital of Southern Mississippi, LLC
|
|
Delaware
|
Regency Hospital of Toledo, LLC
|
|
Delaware
|
Regency Hospitals, LLC
|
|
Delaware
|
Regency Management Company, Inc.
|
|
Delaware
|
Rehab Associates of Jackson Hospital, LLC
|
|
Alabama
|
Rehab Associates, L.L.C.
|
|
Alabama
|
Rehab Colorado, LLC
|
|
Alabama
|
Rehab Missouri, LLC
|
|
Alabama
|
Rehab Provider Network of Colorado, Inc.
|
|
Colorado
|
Rehab Provider Network of New Mexico, Inc.
|
|
New Mexico
|
Rehab Provider Network of North Carolina, Inc.
|
|
North Carolina
|
Rehab Provider Network of South Carolina, Inc.
|
|
Delaware
|
Rehab Provider Network of Virginia, Inc.
|
|
Virginia
|
Rehab Provider Network—East I, Inc.
|
|
Delaware
|
Rehab Provider Network—East II, Inc.
|
|
Maryland
|
Rehab Provider Network—Indiana, Inc.
|
|
Indiana
|
Rehab Provider Network—Ohio, Inc.
|
|
Ohio
|
Rehab Provider Network—Pennsylvania, Inc.
|
|
Pennsylvania
|
Rehab Xcel, LLC
|
|
Alabama
|
RehabClinics (PTA), Inc.
|
|
Delaware
|
RehabClinics (SPT), Inc.
|
|
Delaware
|
RehabClinics, Inc.
|
|
Delaware
|
Rehabilitation Center of Washington, D.C., Inc.
|
|
Delaware
|
Rehabilitation Consultants, Inc.
|
|
Delaware
|
Rehabilitation Hospital of Vancouver, LLC
|
|
Delaware
|
Rehabilitation Institute of Denton, LLC
|
|
Delaware
|
Rehabilitation Institute of North Texas, LLC
|
|
Delaware
|
RPN of NC, Inc.
|
|
Delaware
|
S.T.A.R.T., Inc.
|
|
Massachusetts
|
Saco Bay Orthopedic and Sports Physical Therapy, Inc.
|
|
Maine
|
SCRI, LLC
|
|
Delaware
|
Select Cleveland Hospitals, LLC
|
|
Delaware
|
Select Employment Services, Inc.
|
|
Delaware
|
Select Hospital Investors, LP
|
|
Delaware
|
Select Kentuckiana, Inc.
|
|
Delaware
|
Select LifeCare Western Michigan, LLC
|
|
Delaware
|
Select Medical Corporation
|
|
Delaware
|
Select Medical International (US), Inc.
|
|
Delaware
|
Select Medical International Limited
|
|
Cyprus
|
Select Medical of Kentucky, Inc.
|
|
Delaware
|
Select Medical of Maryland, Inc.
|
|
Delaware
|
Select Medical of New York, Inc.
|
|
Delaware
|
Select Medical Patient Safety and Quality Institute, LLC
|
|
Delaware
|
Select Medical Property Ventures, LLC
|
|
Delaware
|
Select Medical Rehabilitation Clinics, Inc.
|
|
Delaware
|
Select NovaCare—KOP, Inc.
|
|
Nevada
|
Select NovaCare—PBG, Inc.
|
|
New York
|
Select NovaCare—PIT, Inc.
|
|
Arizona
|
Select Physical Therapy Holdings, Inc.
|
|
Delaware
|
Select Physical Therapy Network Services, Inc.
|
|
Delaware
|
Select Physical Therapy of Albuquerque, Ltd.
|
|
Alabama
|
Select Physical Therapy of Blue Springs Limited Partnership
|
|
Alabama
|
Select Physical Therapy of Chicago, Inc.
|
|
Illinois
|
Select Physical Therapy of Colorado Springs Limited Partnership
|
|
Alabama
|
Select Physical Therapy of Connecticut Limited Partnership
|
|
Alabama
|
Select Physical Therapy of Denver, Ltd.
|
|
Alabama
|
Select Physical Therapy of Illinois Limited Partnership
|
|
Alabama
|
Select Physical Therapy of Kendall, Ltd.
|
|
Alabama
|
Select Physical Therapy of Portola Valley Limited Partnership
|
|
Alabama
|
Select Physical Therapy of St. Louis Limited Partnership
|
|
Alabama
|
Select Physical Therapy of West Denver Limited Partnership
|
|
Alabama
|
Select Physical Therapy Limited Partnership for Better Living
|
|
Delaware
|
Select Physical Therapy Orthopedic Services, Inc.
|
|
Delaware
|
Select Physical Therapy Texas Limited Partnership
|
|
Alabama
|
Select Rehabilitation Hospital—Hershey, Inc.
|
|
Delaware
|
Select Software Ventures, LLC
|
|
Delaware
|
Select Specialty Hospital—Akron, LLC
|
|
Delaware
|
Select Specialty Hospital—Ann Arbor, Inc.
|
|
Missouri
|
Select Specialty Hospital—Arizona, Inc.
|
|
Delaware
|
Select Specialty Hospital—Augusta, Inc.
|
|
Delaware
|
Select Specialty Hospital—Beech Grove, Inc.
|
|
Missouri
|
Select Specialty Hospital—Belhaven, LLC
|
|
Delaware
|
Select Specialty Hospital—Broward, Inc.
|
|
Delaware
|
Select Specialty Hospital—Central Pennsylvania, L.P.
|
|
Delaware
|
Select Specialty Hospital—Charleston, Inc.
|
|
Delaware
|
Select Specialty Hospital—Cincinnati, Inc.
|
|
Missouri
|
Select Specialty Hospital—Cleveland, LLC
|
|
Delaware
|
Select Specialty Hospital—Colorado Springs, Inc.
|
|
Delaware
|
Select Specialty Hospital—Columbus, Inc.
|
|
Delaware
|
Select Specialty Hospital—Dallas, Inc.
|
|
Delaware
|
Select Specialty Hospital—Danville, Inc.
|
|
Delaware
|
Select Specialty Hospital—Daytona Beach, Inc.
|
|
Delaware
|
Select Specialty Hospital—Denver, Inc.
|
|
Delaware
|
Select Specialty Hospital—Des Moines, Inc.
|
|
Delaware
|
Select Specialty Hospital—Durham, Inc.
|
|
Delaware
|
Select Specialty Hospital—Erie, Inc.
|
|
Delaware
|
Select Specialty Hospital—Evansville, Inc.
|
|
Missouri
|
Select Specialty Hospital—Evansville, LLC
|
|
Delaware
|
Select Specialty Hospital—Flint, Inc.
|
|
Missouri
|
Select Specialty Hospital—Fort Myers, Inc.
|
|
Delaware
|
Select Specialty Hospital—Fort Smith, Inc.
|
|
Missouri
|
Select Specialty Hospital—Fort Wayne, Inc.
|
|
Missouri
|
Select Specialty Hospital—Gainesville, LLC
|
|
Delaware
|
Select Specialty Hospital—Greensboro, Inc.
|
|
Delaware
|
Select Specialty Hospital—Gulf Coast, Inc.
|
|
Missouri
|
Select Specialty Hospital—Houston, L.P.
|
|
Delaware
|
Select Specialty Hospital—Jackson, Inc.
|
|
Delaware
|
Select Specialty Hospital—Johnstown, Inc.
|
|
Missouri
|
Select Specialty Hospital—Kalamazoo, Inc.
|
|
Delaware
|
Select Specialty Hospital—Kansas City, Inc.
|
|
Missouri
|
Select Specialty Hospital—Laurel Highlands, Inc.
|
|
Delaware
|
Select Specialty Hospital—Lexington, Inc.
|
|
Delaware
|
Select Specialty Hospital—Lincoln, Inc.
|
|
Delaware
|
Select Specialty Hospital—Little Rock, Inc.
|
|
Delaware
|
Select Specialty Hospital—Longview, Inc.
|
|
Delaware
|
Select Specialty Hospital—Macomb County, Inc.
|
|
Missouri
|
Select Specialty Hospital—Madison, Inc.
|
|
Delaware
|
Select Specialty Hospital—McKeesport, Inc.
|
|
Delaware
|
Select Specialty Hospital—Memphis, Inc.
|
|
Delaware
|
Select Specialty Hospital—Miami Lakes, Inc.
|
|
Delaware
|
Select Specialty Hospital—Milwaukee, Inc.
|
|
Delaware
|
Select Specialty Hospital—Nashville, Inc.
|
|
Delaware
|
Select Specialty Hospital—North Atlanta, Inc.
|
|
Delaware
|
Select Specialty Hospital—North Knoxville, Inc.
|
|
Missouri
|
Select Specialty Hospital—Northeast New Jersey, Inc.
|
|
Delaware
|
Select Specialty Hospital—Northeast Ohio, Inc.
|
|
Missouri
|
Select Specialty Hospital—Northern Kentucky, LLC
|
|
Delaware
|
Select Specialty Hospital—Oklahoma City, Inc.
|
|
Delaware
|
Select Specialty Hospital—Omaha, Inc.
|
|
Missouri
|
Select Specialty Hospital—Orlando, Inc.
|
|
Delaware
|
Select Specialty Hospital—Oshkosh, Inc.
|
|
Delaware
|
Select Specialty Hospital—Palm Beach, Inc.
|
|
Delaware
|
Select Specialty Hospital—Panama City, Inc.
|
|
Delaware
|
Select Specialty Hospital—Pensacola, Inc.
|
|
Delaware
|
Select Specialty Hospital—Phoenix, Inc.
|
|
Delaware
|
Select Specialty Hospital—Pittsburgh/UPMC, Inc.
|
|
Delaware
|
Select Specialty Hospital—Quad Cities, Inc.
|
|
Delaware
|
Select Specialty Hospitals, Inc.
|
|
Delaware
|
Select Specialty Hospital—Saginaw, Inc.
|
|
Delaware
|
Select Specialty Hospital—San Antonio, Inc.
|
|
Delaware
|
Select Specialty Hospital—Savannah, Inc.
|
|
Delaware
|
Select Specialty Hospital—Sioux Falls, Inc.
|
|
Missouri
|
Select Specialty Hospital—South Dallas, Inc.
|
|
Delaware
|
Select Specialty Hospital—Springfield, Inc.
|
|
Delaware
|
Select Specialty Hospital—Tallahassee, Inc.
|
|
Delaware
|
Select Specialty Hospital—The Villages, Inc.
|
|
Delaware
|
Select Specialty Hospital—Topeka, Inc.
|
|
Missouri
|
Select Specialty Hospital—TriCities, Inc.
|
|
Delaware
|
Select Specialty Hospital—Tulsa, Inc.
|
|
Delaware
|
Select Specialty Hospital—Tulsa/Midtown, LLC
|
|
Delaware
|
Select Specialty Hospital—Western Michigan, Inc.
|
|
Missouri
|
Select Specialty Hospital—Wichita, Inc.
|
|
Missouri
|
Select Specialty Hospital—Wilmington, Inc.
|
|
Missouri
|
Select Specialty Hospital—Winston-Salem, Inc.
|
|
Delaware
|
Select Specialty Hospital—Youngstown, Inc.
|
|
Missouri
|
Select Specialty Hospital—Zanesville, Inc.
|
|
Delaware
|
Select Specialty—Downriver, LLC
|
|
Delaware
|
Select Subsidiaries, Inc.
|
|
Pennsylvania
|
Select Synergos, Inc.
|
|
Delaware
|
Select Transport, Inc.
|
|
Delaware
|
Select Unit Management, Inc.
|
|
Delaware
|
SelectMark, Inc.
|
|
Delaware
|
SemperCare, Inc.
|
|
Delaware
|
SLMC Finance Corporation
|
|
Delaware
|
SMR Banyan Tree, Inc.
|
|
New York
|
SN Kentuckiana Rehab, LLC
|
|
Delaware
|
Special Care Hospital, LLC
|
|
Delaware
|
Sports Orthopedic Rehabilitation Services, Inc.
|
|
Florida
|
SSM Select Rehab St. Louis, LLC
|
|
Delaware
|
St. Mary’s Medical Park Pharmacy, Inc.
|
|
Arizona
|
Susquehanna Physical Therapy Associates, Inc.
|
|
Pennsylvania
|
Swanson Orthotic and Prosthetic Center, Inc.
|
|
Ohio
|
The Parks Physical Therapy and Work Hardening Center, Inc.
|
|
Texas
|
The Rehab Center
|
|
Pennsylvania
|
Theraphysics Partners of Colorado, Inc.
|
|
Delaware
|
Theraphysics Partners of Texas, Inc.
|
|
Delaware
|
Therapy Associates of Martinsville, Inc.
|
|
Virginia
|
Therapy Centers of South Carolina, P.A.
|
|
South Carolina
|
Therapy Centers of The Southwest I, P.A.
|
|
Texas
|
TheraWorks, Inc.
|
|
Texas
|
TJ Corporation I, LLC
|
|
Delaware
|
TriHealth Rehabilitation, LLC
|
|
Delaware
|
Trumbull P.T. Corp.
|
|
Connecticut
|
U.S. HealthWorks Medical Group of Alaska, L.L.C.
|
|
Alabama
|
U.S. HealthWorks Medical Group of Indiana, P.C.
|
|
Indiana
|
U.S. HealthWorks Medical Group of Kansas City, P.A.
|
|
Kansas
|
U.S. HealthWorks Medical Group of New Jersey, P.C.
|
|
New Jersey
|
U.S. HealthWorks Medical Group of Ohio, Inc.
|
|
Ohio
|
U.S. HealthWorks Medical Group of Pennsylvania, PC
|
|
Pennsylvania
|
U.S. HealthWorks Medical Group of Tennessee, P.C.
|
|
Tennessee
|
U.S. HealthWorks Medical Group of Texas, Inc.
|
|
Texas
|
U.S. HealthWorks Medical Group, Prof. Corp.
|
|
California
|
U.S. HealthWorks of New Jersey, Inc.
|
|
New Jersey
|
U.S. HealthWorks of Pennsylvania, Inc.
|
|
Pennsylvania
|
U.S. HealthWorks of Washington, Inc.
|
|
Washington
|
U.S. HealthWorks, Inc.
|
|
Delaware
|
USHW of California, Inc.
|
|
California
|
USHW of Texas, Inc.
|
|
Texas
|
U.S. Medgroup of Arkansas, P.A.
|
|
Arkansas
|
U.S. Medgroup of Delaware, P.A.
|
|
Delaware
|
U.S. Medgroup of Illinois, P.C.
|
|
Illinois
|
U.S. Medgroup Of Kansas, P.A.
|
|
Kansas
|
U.S. Medgroup of Massachusetts, P.C.
|
|
Massachusetts
|
U.S. Medgroup of Michigan, P.C.
|
|
Michigan
|
U.S. Medgroup of Minnesota, P.C.
|
|
Minnesota
|
U.S. Medgroup of New Jersey, P.A.
|
|
New Jersey
|
U.S. Medgroup of North Carolina, P.C.
|
|
North Caroline
|
U.S. Medgroup of Ohio, P.A., Co.
|
|
Ohio
|
U.S. Medgroup of Washington, P.S.
|
|
Washington
|
U.S. Medgroup, P.A. (AZ)
|
|
Arizona
|
U.S. Medgroup, P.A. (TX)
|
|
Texas
|
U.S. Regional Occupational Health II of NJ, P.C.
|
|
New Jersey
|
U.S. Regional Occupational Health II, P.C.
|
|
Pennsylvania
|
Valor Healthcare, Inc.
|
|
Delaware
|
VHSD ES, Inc.
|
|
Delaware
|
Vibra Hospital of San Diego, LLC
|
|
Delaware
|
Victoria Healthcare, Inc.
|
|
Florida
|
West Gables Rehabilitation Hospital, LLC
|
|
Delaware
|
Wisconsin Prosthetics & Orthotics, Inc.
|
|
Wisconsin
|
WWLTACH, LLC
|
|
Delaware
|
4.
|
The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
|
5.
|
The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
|
Date: February 20, 2020
|
/s/ David S. Chernow
|
|
David S. Chernow
|
|
President and Chief Executive Officer
|
1.
|
I have reviewed this annual report on Form 10-K of Select Medical Holdings Corporation;
|
2.
|
Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
|
3.
|
Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
|
4.
|
The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
|
5.
|
The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
|
Date: February 20, 2020
|
/s/ Martin F. Jackson
|
|
Martin F. Jackson
|
|
Executive Vice President and Chief Financial Officer
|
(1)
|
The Report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934; and
|
/s/ David S. Chernow
|
|
David S. Chernow
|
|
President and Chief Executive Officer
|
|
|
|
|
|
/s/ Martin F. Jackson
|
|
Martin F. Jackson
|
|
Executive Vice President and Chief Financial Officer
|
|