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#Thank you, <UNK>.
Good morning.
Welcome to Chemed Corporation's First Quarter 2018 Conference Call.
I will begin with highlights for the quarter, and <UNK> and Nick will follow up with additional operating detail.
I will then open the call up for questions.
What a great start to the year.
Our first quarter of 2018 had excellent operational performance, margin improvement and overall financial results in both of our operating segments.
In the quarter, Chemed generated $439 million of revenue, an increase of 8.2%.
Our consolidated net income in the quarter, excluding certain discrete items, generated adjusted per diluted share of $2.72, an increase of 49.5%.
Both VITAS and Roto-Rooter performed well, exceeding the high end of our key operational and financial estimates.
VITAS admissions, excluding the Alabama site closure in 2017, increased 4.7% in the quarter.
And an Average Daily Census expanded to 6.6%.
And our adjusted EBITDA, excluding the benefit from Medicare Cap, increased 11.6%.
Roto-Rooter continues to show excellent results in our core plumbing and drain cleaning service segments as well as strong growth in water restoration.
This resulted in Roto-Rooter having record first quarter 2018 revenue and profitability.
With that, I'd like to turn this teleconference over to <UNK> <UNK>, our Chief Financial Officer.
Thanks, <UNK>.
First, I need to take care of some housekeeping matters.
As most of you are aware, effective January 1, 2018, the Financial Accounting Standards Board, or FASB, mandated certain changes in revenue recognition under Generally Accepted Accounting Principles, otherwise referred to as GAA<UNK>
For Chemed, this accounting standard mandates the reclassification of certain costs within the 2018 income statement when compared to prior-year formats.
These reclassifications have zero impact on EBITDA, adjusted EBITDA, pretax income or net income.
These reclassified expenses do impact comparative analysis between years on certain metrics, such as gross margin, since these accounting standard ---+ this accounting standard was adopted on a modified retrospective basis.
Our 2017 operating results were not restated and are reported using historical revenue recognition accounting standards.
This resulted in the reclassification of net room and board expenses, associated with certain Medicaid patients residing in nursing homes to be reclassified from cost of services to revenue, effectively reducing VITAS revenue and cost of sales by approximately $2.6 million in 2018.
In addition, uncollectible accounts receivable, commonly referred to as bad debt expense, has historically been included in selling, general and administrative expenses for both VITAS and Roto-Rooter, and these are now netted in service revenue and sales or a contra revenue account.
This reduced revenue and selling, general and administrative expenses by approximately $4.6 million in the quarter.
The discussion and analysis of operating results on this conference call as well as in our first quarter 2018 earnings release narrative does reclassify net 2017 room and board and estimated uncollectible receivables to facilitate analysis of operating results in a format consistent with the 2018 revenue recognition accounting standard.
With that said, let's talk about the quarter.
In the first quarter of 2018, VITAS net revenue was $292 million, which is an increase of 5.5%, when compared to the prior year period.
This revenue increase is comprised primarily of geographically weighted average Medicare reimbursement rate increase of approximately 0.7%, a 6.1% increase in Average Daily Census and a reduction in Medicare Cap that increased revenue 0.6%.
This growth is partially offset by acuity mix shift that negatively impacted revenue growth by 1.8 percentage points, when compared to the prior year period.
In the first quarter of 2018, VITAS reversed $1.8 million in Medicare Cap billing limitations recorded in the fourth quarter of 2017, all of which relates to the 2018 Medicare Cap billing period.
At March 31, 2018, VITAS had 30 Medicare provider numbers, 2 of which have a current estimated 2018 Medicare Cap billing limitation of approximately $616,000.
Of VITAS's 30 unique Medicare provider numbers, 27 of these provider numbers have a Medicare Cap cushion of 10% or greater, 1 provider number has a cap cushion between 5% and 10% of revenue and 2 provider numbers have a Medicare Cap billing limitations for the 2018 Medicare Cap period.
VITAS's average revenue per patient per day in the quarter was $189.76, which is 1.2% below the prior year period.
Our routine home care reimbursement and high acuity care averaged $163.53 and $706.24, respectively.
During the quarter, high acuity days of care were 4.8% of total days of care, and this is a 60 basis point reduction, when you look at the prior year quarter.
The first quarter of 2018 gross margin, excluding Medicare Cap, was 21.7%, which is a 97 basis point improvement, when compared to the first quarter of 2017.
And our routine home care direct patient care gross margin was 52.1% in the quarter, which is an increase of 80 basis points when compared to the first quarter of 2017.
Direct inpatient margin in the quarter was 7.5% and compares to a margin of 5.9% in the prior year.
Occupancy of our 28 dedicated inpatient units averaged 72.2% in the quarter and compares to 71.4% occupancy in the first quarter of 2017.
Continuous care had a direct gross margin of 17.7%, an increase of 210 basis points when compared to the prior year.
Average hours billed for a day of continuous care was 17.2 in the quarter, which is a slight decrease compared to the 17.7 average hours billed for a day of continuous care in the first quarter of 2017.
Now let's take a look at the Roto-Rooter segment.
Roto-Rooter's plumbing and drain cleaning business generated sales of $147 million for the first quarter of 2018, an increase of $24.7 million, or 20.2%, over the prior year.
Revenue from water restoration totaled $27.7 million, which is an increase of $9.6 million, or 53.3%, compared to the prior year.
Commercial drain cleaning revenue increased 7.7%, commercial plumbing and excavation revenue increased 15.3%, and commercial water restoration grew 40.7%.
And overall, our commercial revenue increased 13.4%.
Residential drain cleaning increased 13.6%, plumbing and excavation increased 22.7%, and residential water restoration expanded 55.5%.
Overall, aggregate residential sales increased 26.3%.
Our first quarter 2018 operating results did outperform our internal projections.
However, we are reiterating our earnings guidance issued in February 2018, and we'll provide an updated guidance when we report our second quarter 2018 operating results.
I'll now turn this call over to Nick <UNK>, Chief Executive Officer of VITAS.
Thanks, <UNK>.
VITAS continued our solid performance in the first quarter, both financially and operationally.
Our Average Daily Census in the first quarter of 2018 was 17,209 patients, an increase of 6.6%, excluding Alabama, over the prior year.
Total admissions in the quarter, excluding Alabama, were 18,279, an increase of 4.7%, when compared to the first quarter of 2017.
During the quarter, admissions generated from hospitals, which typically represent roughly 50% of our admissions, increased 0.7%.
Home-based admissions increased 11.3%.
Nursing home admissions increased 2.9% and assisted living facility admissions increased 3.6% in the quarter.
Our per patient per day ancillary costs, which include durable medical equipment, supplies and pharmaceutical costs, averaged $14.47, and are 4.4% favorable when compared to the $15.14 that we had for the cost of these items in the prior year quarter.
At the end of the first quarter, our inpatient care consists of 26 active units as well as contract beds.
We evaluate inpatient capacity on a market-by-market basis to ensure these facilities are appropriately positioned to meet the needs of our patients in every community we serve.
We currently have a few new units in development as well as few a new contract bed arrangements, where we plan on servicing patients in 2018.
As Dave mentioned, we were able to continue our general inpatient margin performance in the quarter with a 160 basis point improvement over the prior year.
Within continuous care, we continue to focus on labor management, specifically related to appropriate nursing to aide staffing assignments and the appropriate utilization of outside nursing agencies based upon the patient's location and individual needs.
These efforts improved our continuous care margins 210 basis points when compared to the first quarter of 2017.
VITAS's average length of stay in the quarter was 87.9 days and compares to 88.7 days in the first quarter of 2017.
Medium length of stay was 15 days in the quarter and is equal to the prior year quarter.
Medium length of stay is a key indicator of our penetration into the high acuity sector of the market.
With that, I'd like to turn this call back over to <UNK>.
Thank you, Nick.
I will now open this teleconference to questions.
<UNK>, this is Dave <UNK>.
It exceeded our expectations.
I think the Street was a little light overall.
I mean, we ---+ when we gave our guidance for 2018 in February, I think everyone ---+ most of the analysts moved up their numbers, but probably not enough.
And then from our standpoint, we really hit it out of the park operationally in terms of the metrics, in terms of our call volume, our Roto-Rooter, job count increase across commercial, residential plumbing and drain cleaning.
So yes, that was strong across the board, and VITAS just did a phenomenal job of both growing census more than we thought they could, admissions more than we thought they could and a great cost-control quarter.
It would ---+ I would say equally spread, but for us, the (inaudible) there were no misses in the quarter.
Everything showed strong sustainable growth on the areas that we care about that exceeded our high end of the expectations.
<UNK>, it's going to have a few thoughts on this.
But what I would say is water restoration continues to show strength as we continue to hire feet on the Street to respond almost on a triage basis when there is a water problem at a customer's home and that's giving us continued outside ---+ outsized growth as we convert plumbing and drain cleaning jobs into additional water-restoration work.
At some point, there has to be a precipitous drop in that growth rate, but right now, we don't see it.
And <UNK>, what I would say, one way of what Dave is saying is because of the fast growth rate through the last year at water restoration, almost by definition, our budget was a little front-loaded, particularly on Roto-Rooter, just for ---+ if you just do the math on a company that grew as fast as water restoration did last year.
But the answer to your point, it's hard to say.
At the end of the second quarter, what we use is trend analysis.
And if the ---+ so if the current trends are the same, it will be certainly a number north of 11, let's put it that way.
And $11 a share that is.
But until we get there, we like to be accurate.
We got ---+ we over the last 3 years in a row, I think, we ---+ 4 years in a row, we revised guidance at the end of the second quarter.
And that's allowed us to come within much narrower parameters.
So that's what ---+ that's the answer I would suggest.
Yes, no problem.
<UNK>, this is Nick.
I'll take that one.
I would say there isn't anything we're necessarily seeing out in the market itself.
I think some of our methodical approaches towards improving not only our admission processes, but also some of our sales and marketing processes and really, the education and messaging we're starting to see and reap some of the results associated with that.
We've talked about it a few quarters occasionally.
Admissions is a barometer related to the business, but sometimes it receives, to a certain extent, an unnecessary amount of attention.
One of the things we want to continue to look on ---+ look at is continued senses growth corresponding with some of those admissions, because, as you are aware, many of those patients that come on could have a very large range of discrepancy regarding total length of stay for those types of patients.
So we feel comfortable with the continued performance.
It's a result of a methodical approach for continued improvement.
And would expect a degree of consistency inside of this range consistent with our guidance.
Thank you all for your attention.
And we're excited here after a good quarter like that.
And we'll expect another similar call 3 months from now.
Thank you.
