Select Medical Holdings Corporation Announces Results

The following excerpt is from the company's SEC filing.
For Its Second Quarter
Ended June 30, 2022 and Cash Dividend
MECHANICSBURG, PENNSYLVANIA
— August 4, 2022 — Select Medical Holdings Corporation (“Select Medical,” “we,” “us,”
or “our”) (NYSE: SEM) today announced results for its second quarter ended June 30, 2022, and the declaration of a cash
dividend.
For the second quarter ended
June 30, 2022, revenue increased 1.3% to $1,584.7 million, compared to $1,564.0 million for the same quarter, prior year. Income
from operations was $121.0 million for the second quarter ended June 30, 2022, compared to $284.0 million for the same quarter,
prior year. For the second quarter ended June 30, 2022, income from operations included $15.1 million of other operating income
related to the recognition of payments received under the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”)
Public Health and Social Services Emergency Fund, also referred to as the Provider Relief Fund, compared to $98.0 million for the same
quarter, prior year. Net income was $66.3 million for the second quarter ended June 30, 2022, compared to $196.2 million for the
same quarter, prior year. Adjusted EBITDA was $181.0 million for the second quarter ended June 30, 2022, compared to $342.0 million
for the same quarter, prior year. Earnings per common share was $0.43 for the second quarter ended June 30, 2022, compared to $1.22
for the same quarter, prior year. The definition of Adjusted EBITDA and a reconciliation of net income to Adjusted EBITDA are presented
in table IX of this release.
For the six months ended
June 30, 2022, revenue increased 2.4% to $3,184.3 million, compared to $3,110.5 million for the same period, prior year. Income
from operations was $225.0 million for the six months ended June 30, 2022, compared to $486.0 million for the same period, prior
year. For the six months ended June 30, 2022, income from operations included $15.1 million of other operating income related to
the recognition of payments received under the Provider Relief Fund, compared to $114.1 million for the same period, prior year. Net
income was $122.2 million for the six months ended June 30, 2022, compared to $333.4 million for the same period, prior year. Adjusted
EBITDA was $344.8 million for the six months ended June 30, 2022, compared to $600.4 million for the same period, prior year. Earnings
per common share was $0.79 for the six months ended June 30, 2022, compared to $2.04 for the same period, prior year. The definition
of Adjusted EBITDA and a reconciliation of net income to Adjusted EBITDA are presented in table IX of this release.
In addition to providing
key statistics in tables VII and VIII of this release for both the second quarters and six months ended June 30, 2022 and 2021,
Select Medical also provided statistics for the comparable period in 2019. Select Medical believes this additional data provides insight
into how it has performed in comparison to the year prior to the widespread emergence of the coronavirus disease 2019 (“COVID-19”)
in the United States. The effects of the COVID-19 pandemic, including the duration and extent of disruption on our operations, continues
to create uncertainties about Select Medical’s future operating results and financial condition. Please refer to the risk factors
in Item 1A and the section titled “
Effects of the COVID-19 Pandemic on our Results of Operations
” in Item 7 of our
Annual Report on Form 10-K for the year ended December 31, 2021, for further discussion.
Company Overview
Select Medical is one of
the largest operators of critical illness recovery hospitals, rehabilitation hospitals, outpatient rehabilitation clinics, and occupational
health centers in the United States based on number of facilities. Select Medical’s reportable segments include the critical illness
recovery hospital segment, the rehabilitation hospital segment, the outpatient rehabilitation segment, and the Concentra segment. As
of June 30, 2022, Select Medical operated 105 critical illness recovery hospitals in 28 states, 31 rehabilitation hospitals in 12
states, and 1,920 outpatient rehabilitation clinics in 38 states and the District of Columbia. Concentra operated 518 occupational health
centers in 41 states. At June 30, 2022, Select Medical had operations in 46 states and the District of Columbia. Information about
Select Medical is available at
www.selectmedical.com
Critical Illness Recovery Hospital Segment
For the second quarter ended
June 30, 2022, revenue for the critical illness recovery hospital segment increased to $545.9 million, compared to $544.1 million
for the same quarter, prior year. Adjusted EBITDA for the critical illness recovery hospital segment was $20.0 million for the second
quarter ended June 30, 2022, compared to $72.9 million for the same quarter, prior year. The Adjusted EBITDA margin for the critical
illness recovery hospital segment was 3.7% for the second quarter ended June 30, 2022, compared to 13.4% for the same quarter, prior
year. Certain critical illness recovery hospital key statistics are presented in table VII of this release for the second quarters ended
June 30, 2022 and 2021.
For the six months ended
June 30, 2022, revenue for the critical illness recovery hospital segment increased to $1,147.7 million, compared to $1,138.9 million
for the same period, prior year. Adjusted EBITDA for the critical illness recovery hospital segment was $56.0 million for the six months
ended June 30, 2022, compared to $186.2 million for the same period, prior year. For the six months ended June 30, 2021, Adjusted
EBITDA included $17.9 million of other operating income related to the outcome of litigation with the Centers for Medicare & Medicaid
Services. The Adjusted EBITDA margin for the critical illness recovery hospital segment was 4.9% for the six months ended June 30,
2022, compared to 16.3% for the same period, prior year. Certain critical illness recovery hospital key statistics are presented in table
VIII of this release for the six months ended June 30, 2022 and 2021.
Rehabilitation Hospital Segment
For the second quarter ended
June 30, 2022, revenue for the rehabilitation hospital segment increased 7.6% to $228.9 million, compared to $212.7 million for
the same quarter, prior year. Adjusted EBITDA for the rehabilitation hospital segment was $49.8 million for the second quarter ended
June 30, 2022, compared to $50.8 million for the same quarter, prior year. The Adjusted EBITDA margin for the rehabilitation hospital
segment was 21.8% for the second quarter ended June 30, 2022, compared to 23.9% for the same quarter, prior year. Certain rehabilitation
hospital key statistics are presented in table VII of this release for the second quarters ended June 30, 2022 and 2021.
For the six months ended
June 30, 2022, revenue for the rehabilitation hospital segment increased 6.9% to $449.5 million, compared to $420.5 million for
the same period, prior year. Adjusted EBITDA for the rehabilitation hospital segment was $92.2 million for the six months ended June 30,
2022, compared to $101.3 million for the same period, prior year. The Adjusted EBITDA margin for the rehabilitation hospital segment
was 20.5% for the six months ended June 30, 2022, compared to 24.1% for the same period, prior year. Certain rehabilitation hospital
key statistics are presented in table VIII of this release for the six months ended June 30, 2022 and 2021.
Outpatient Rehabilitation Segment
For the second quarter ended
June 30, 2022, revenue for the outpatient rehabilitation segment increased 2.4% to $287.3 million, compared to $280.4 million for
the same quarter, prior year. Adjusted EBITDA for the outpatient rehabilitation segment was $33.6 million for the second quarter ended
June 30, 2022, compared to $45.6 million for the same quarter, prior year. The Adjusted EBITDA margin for the outpatient rehabilitation
segment was 11.7% for the second quarter ended June 30, 2022, compared to 16.3% for the same quarter, prior year. Certain outpatient
rehabilitation key statistics are presented in table VII of this release for the second quarters ended June 30, 2022 and 2021.
For the six months ended
June 30, 2022, revenue for the outpatient rehabilitation segment increased 5.0% to $559.2 million, compared to $532.4 million for
the same period, prior year. Adjusted EBITDA for the outpatient rehabilitation segment was $60.2 million for the six months ended June 30,
2022, compared to $72.0 million for the same period, prior year. The Adjusted EBITDA margin for the outpatient rehabilitation segment
was 10.8% for the six months ended June 30, 2022, compared to 13.5% for the same period, prior year. Certain outpatient rehabilitation
key statistics are presented in table VIII of this release for the six months ended June 30, 2022 and 2021.
Concentra Segment
For the second quarter ended
June 30, 2022, revenue for the Concentra segment was $441.4 million, compared to $456.4 million for the same quarter, prior year.
Adjusted EBITDA for the Concentra segment was $92.6 million for the second quarter ended June 30, 2022, compared to $137.1 million
for the same quarter, prior year. For the second quarter ended June 30, 2021, Adjusted EBITDA included $32.3 million of other operating
income related to the recognition of payments received under the Provider Relief Fund. The Adjusted EBITDA margin for the Concentra segment
was 21.0% for the second quarter ended June 30, 2022, compared to 30.0% for the same quarter, prior year. Certain Concentra key
statistics are presented in table VII of this release for the second quarters ended June 30, 2022 and 2021.
For the six months ended
June 30, 2022, revenue for the Concentra segment was $864.8 million, compared to $879.2 million for the same period, prior year.
Adjusted EBITDA for the Concentra segment was $182.1 million for the six months ended June 30, 2022, compared to $219.1 million
for the same period, prior year. For the six months ended June 30, 2021, Adjusted EBITDA included $32.3 million of other operating
income related to the recognition of payments received under the Provider Relief Fund. The Adjusted EBITDA margin for the Concentra segment
was 21.1% for the six months ended June 30, 2022, compared to 24.9% for the same period, prior year. Certain Concentra key statistics
are presented in table VIII of this release for the six months ended June 30, 2022 and 2021.
On August 2, 2022,
Select Medical’s board of directors declared a cash dividend of $0.125 per share. The dividend will be payable on or about September 2,
2022, to stockholders of record as of the close of business on August 16, 2022.
There is no assurance that
future dividends will be declared. The declaration and payment of dividends in the future are at the discretion of Select Medical’s
board of directors after taking into account various factors, including, but not limited to, Select Medical’s financial condition,
operating results, available cash and current and anticipated cash needs, the terms of Select Medical’s indebtedness, and other
factors Select Medical’s board of directors may deem to be relevant.
Stock Repurchase Program
The board of directors of
Select Medical has authorized a common stock repurchase program to repurchase up to $1.0 billion worth of shares of its common stock.
The common stock repurchase program will remain in effect until December 31, 2023, unless further extended or earlier terminated
by the board of directors. Stock repurchases under this program may be made in the open market or through privately negotiated transactions,
and at times and in such amounts as Select Medical deems appropriate. Select Medical funds this program with cash on hand and borrowings
under its revolving credit facility.
During the six months ended
June 30, 2022, Select Medical repurchased 7,567,433 shares at a cost of approximately $177.6 million, or $23.47 per share,
which includes transaction costs. Since the inception of the common stock repurchase program through June 30, 2022, Select Medical
has repurchased 47,919,061 shares at a cost of approximately $592.8 million, or $12.37 per share, which includes transaction costs.
Business Outlook for Revenue
Select Medical reaffirms
its 2022 business outlook for revenue, which was provided most recently in its May 5, 2022, press release. Select Medical continues to
expect consolidated revenue to be in the range of $6.25 billion to $6.40 billion for the full year of 2022. Select Medical is also reaffirming
its previously issued three-year compound annual growth rate target for revenue only, which is expected to be in the range of 4% to 6%
for 2021 through 2023.
Select Medical intends to
address its business outlook and target compound annual growth rates for Adjusted EBITDA and earnings per common share when the labor
climate stabilizes.
Conference Call
Select Medical will host
a conference call regarding its second quarter results, as well as its business ou
tlook for revenue
and the
impact of the COVID-19 pandemic on each of its reportable segments, on Friday, August 5, 2022, at 9:00am ET. The conference
call will be a live webcast and can be accessed at Select Medical Holding Corporation’s website at
www.selectmedicalholdings.com
.
A replay of the webcast will be available shortly after the call through the same link.
For listeners wishing to
dial-in via telephone, or participate in the question and answer session, you may pre-register for the call at
Select Medical Earnings
Call Registration
to obtain your dial-in number and unique passcode.
Certain statements contained
herein that are not descriptions of historical facts are “forward-looking” statements (as such term is defined in the Private
Securities Litigation Reform Act of 1995), including statements related to Select Medical’s 2022 and long-term business outlook.
Because such statements include risks and uncertainties, actual results may differ materially from those expressed or implied by such
forward-looking statements due to factors including the following:
developments related to the COVID-19
pandemic including, but not limited to, the duration and severity of the pandemic, additional
measures taken by government authorities and the private sector to limit the spread of COVID-19,
and further legislative and regulatory actions which impact healthcare providers, including
actions that may impact the Medicare program;
changes in government reimbursement for
our services and/or new payment policies may result in a reduction in revenue, an increase
in costs, and a reduction in profitability;
the failure of our Medicare-certified
long term care hospitals or inpatient rehabilitation facilities to maintain their Medicare
certifications may cause our revenue and profitability to decline;
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 revenue and profitability to decline;
a government investigation or assertion
that we have violated applicable regulations may result in sanctions or reputational harm
and increased costs;
acquisitions or joint ventures may prove
difficult or unsuccessful, use significant resources or expose us to unforeseen liabilities;
our plans and expectations related to
our acquisitions and our ability to realize anticipated synergies;
private third-party payors for our services
may adopt payment policies that could limit our future revenue and profitability;
the failure to maintain established relationships
with the physicians in the areas we serve could reduce our revenue and profitability;
shortages in qualified nurses, therapists,
physicians, or other licensed providers, or the inability to attract or retain healthcare
professionals due to the heightened risk of infection related to the COVID-19 pandemic, could
increase our operating costs significantly or limit our ability to staff our facilities;
competition may limit our ability to
grow and result in a decrease in our revenue and profitability;
the loss of key members of our management
team could significantly disrupt our operations;
the effect of claims asserted against
us could subject us to substantial uninsured liabilities;
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
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 the quarterly
reports on Form 10-Q and of the annual report on Form 10-K for the year ended December 31,
2021.
Except as required by applicable
law, including the securities laws of the United States and the rules and regulations of the SEC, we are under no obligation to publicly
update or revise any forward-looking statements, whether as a result of any new information, future events, or otherwise. You should
not place undue reliance on our forward-looking statements. Although we believe that the expectations reflected in forward-looking statements
are reasonable, we cannot guarantee future results or performance.
Investor inquiries:
Joel T. Veit
Senior Vice President and Treasurer
717-972-1100
ir@selectmedical.com
SOURCE: Select Medical Holdings Corporation
I. Condensed Consolidated Statements of Operations
For the Three Months Ended June 30, 2021 and 2022
(In thousands, except per share amounts, unaudited)
% Change
1,564,020
1,584,741
Costs and expenses:
Cost of services, exclusive of depreciation and amortization
1,291,448
1,390,550
General and administrative
35,737
37,268
Depreciation and amortization
50,954
51,081
Total costs and expenses
1,378,139
1,478,899
Other operating income
98,087
15,125
Income from operations
283,968
120,967
Other income and expense:
Equity in earnings of unconsolidated subsidiaries
11,809
Interest expense
(33,888
(41,052
Income before income taxes
261,889
86,082
Income tax expense
65,681
19,820
196,208
66,262
Less: Net income attributable to non-controlling interests
31,314
11,055
Net income attributable to Select Medical
164,894
55,207
Basic and diluted earnings per common share:
Refer to table III for calculation of earnings
per common share.
Not meaningful.
II. Condensed Consolidated Statements of Operations
For the Six Months Ended June 30, 2021 and 2022
3,110,483
3,184,288
2,584,897
2,797,560
71,140
74,781
100,574
102,120
2,756,611
2,974,461
132,108
485,980
224,952
21,728
11,564
Interest income
(68,290
(76,566
444,167
159,950
110,745
37,762
333,422
122,188
57,982
17,864
275,440
104,324
Refer to table III for calculation of earnings per common share.
III. Earnings per Share
For the Three and Six Months Ended June 30,
2021 and 2022
Select Medical’s capital
structure includes common stock and unvested restricted stock awards. To compute earnings per share (“EPS”), Select Medical
applies the two-class method because its unvested restricted stock awards are participating securities which are entitled to participate
equally with its common stock in undistributed earnings.
The following table sets
forth the net income attributable to Select Medical, its common shares outstanding, and its participating securities outstanding for the
three and six months ended June 30, 2021 and 2022:
Basic and Diluted EPS
June 30,
Less: net income attributable to non-controlling interests
Less: net income attributable to participating securities
Net income attributable to common shares
159,334
53,287
266,190
100,766
The following tables set
forth the computation of EPS under the two-class method for the three and six months ended June 30, 2021 and 2022:
Three Months Ended June 30,
Net Income
Allocation
Shares
Common shares
130,396
124,897
Participating securities
Six Months Ended June 30,
130,362
126,942
(1)       Represents
the weighted average share count outstanding during the period.
IV. Condensed Consolidated Balance Sheets
(In thousands, unaudited)
December 31, 2021
June 30, 2022
Assets
Current Assets:
Cash and cash equivalents
74,310
94,669
Accounts receivable
889,303
921,623
Other current assets
175,826
204,756
Total Current Assets
1,139,439
1,221,048
Operating lease right-of-use assets
1,078,754
1,136,678
Property and equipment, net
961,467
955,752
Goodwill
3,448,912
3,476,213
Identifiable intangible assets, net
374,879
366,222
Other assets
356,720
395,745
Total Assets
7,360,171
7,551,658
Liabilities and Equity
Current Liabilities:
Payables and accruals
942,288
956,756
Government advances
83,790
Unearned government assistance
Current operating lease liabilities
229,334
233,917
Current portion of long-term debt and notes payable
17,572
44,009
Total Current Liabilities
1,273,077
1,241,739
Non-current operating lease liabilities
916,540
974,657
Long-term debt, net of current portion
3,556,385
3,723,734
Non-current deferred tax liability
142,792
157,892
Other non-current liabilities
106,442
107,738
Total Liabilities
5,995,236
6,205,760
Redeemable non-controlling interests
39,033
42,197
Total equity
1,325,902
1,303,701
Total Liabilities and Equity
V. Condensed Consolidated Statements of Cash
Flows
Operating activities
Adjustments to reconcile net income to net cash provided by operating activities:
Distributions from unconsolidated subsidiaries
Provision for expected credit losses
(11,809
(6,167
Loss (gain) on sale or disposal of assets
(1,453
Stock compensation expense
Amortization of debt discount, premium and issuance costs
Deferred income taxes
(7,426
(2,385
Changes in operating assets and liabilities, net of effects of business combinations:
28,391
19,794
(8,431
(12,945
(1,411
Accounts payable and accrued expenses
45,288
40,369
(73,703
(14,391
(97,716
Income taxes
(1,642
Net cash provided by operating activities
123,138
171,681
Investing activities
Business combinations, net of cash acquired
(3,767
(14,055
Purchases of property and equipment
(36,723
(46,332
Investment in businesses
(4,614
(3,653
Proceeds from sale of assets
Net cash used in investing activities
(35,660
(58,763
Financing activities
Borrowings on revolving facilities
285,000
Payments on revolving facilities
(275,000
Borrowings of other debt
Principal payments on other debt
(5,972
(7,686
Dividends paid to common stockholders
(16,876
(16,108
Repurchase of common stock
(1,610
(126,947
Decrease in overdrafts
(3,447
Proceeds from issuance of non-controlling interests
Distributions to and purchases of non-controlling interests
(15,489
(8,368
Net cash used in financing activities
(34,259
(149,130
Net increase (decrease) in cash and cash equivalents
53,219
(36,212
Cash and cash equivalents at beginning of period
750,274
130,881
Cash and cash equivalents at end of period
803,493
Supplemental information
Cash paid for interest
14,485
20,700
Cash paid for taxes
74,751
15,500
VI. Condensed Consolidated Statements of Cash
Flows
19,384
11,140
(21,728
(11,564
(1,476
13,808
17,769
(8,323
(1,965
(31,751
(32,431
(12,856
(2,128
(11,984
89,915
25,367
(77,319
(78,509
42,976
23,315
363,026
178,018
(10,081
(19,241
(76,442
(93,177
(11,185
(6,990
(88,245
(114,094
565,000
(375,000
17,494
(15,314
(16,874
(32,799
(178,623
(11,055
(29,152
(18,663
(48,349
(43,565
Net increase in cash and cash equivalents
226,432
20,359
577,061
66,955
74,217
76,094
16,423
VII. Key Statistics
For the Three Months Ended June 30, 2019, 2021, and 2022
(unaudited)
Number of hospitals operated – end of period
Revenue (,000)
461,143
544,059
545,908
Number of patient days
(b)(c)
262,860
272,981
273,133
Number of admissions
(b)(d)
Revenue per patient day
(b)(e)
Occupancy rate
(b)(f)
Adjusted EBITDA (,000)
64,138
72,904
20,019
160,374
212,666
228,887
86,525
104,948
108,812
29,968
50,768
49,845
Number of clinics operated – end of period
Working days
261,891
280,409
287,258
Number of visits
(b)(h)
2,203,505
2,404,861
2,450,912
Revenue per visit
(b)(i)
42,584
45,633
33,601
Number of centers operated – end of period
413,451
456,372
441,357
3,103,089
3,030,078
3,214,512
76,087
137,060
92,607
Includes managed locations.
Excludes managed locations. For purposes of the Concentra segment, onsite clinics and community-based
outpatient clinics are excluded.
Each patient day represents one patient occupying one bed for one day during the periods presented.
Represents the number of patients admitted to Select Medical’s hospitals during the periods presented.
Represents the average amount of revenue recognized for each patient day. Revenue per patient day is calculated
by dividing patient service revenues, excluding revenues from certain other ancillary and outpatient services provided at Select Medical’s
hospitals, by the total number of patient days.
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.
Represents the number of days in which normal business operations were conducted during the periods presented.
Represents the number of visits in which patients were treated at Select Medical’s outpatient rehabilitation
clinics and Concentra centers during the periods presented.
Represents the average amount of revenue recognized for each patient visit. 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 the Concentra segment, patient service revenue does not include onsite clinics.
VIII. Key Statistics
For the Six Months Ended June 30, 2019, 2021, and 2022
918,677
1,138,931
1,147,663
520,989
566,099
562,350
18,628
18,885
18,263
137,136
186,176
55,986
314,932
420,470
449,521
169,341
207,387
212,614
11,853
14,491
14,632
55,765
101,302
92,224
508,796
532,370
559,198
4,257,988
4,505,015
4,760,998
71,575
71,962
60,197
809,772
879,212
864,780
6,014,696
5,825,652
6,331,410
142,345
219,075
182,076
IX. Net Income to Adjusted EBITDA Reconciliation
For the Three and Six Months Ended June 30, 2019, 2021 and 2022

The presentation of Adjusted
EBITDA is important to investors because Adjusted EBITDA is commonly used as an analytical indicator of performance by investors within
the healthcare industry. Adjusted EBITDA is used by management to evaluate financial performance and determine resource allocation for
each of Select Medical’s segments. Adjusted EBITDA is not a measure of financial performance under accounting principles generally
accepted in the United States of America (“GAAP”). Items excluded from Adjusted EBITDA are significant components in understanding
and assessing financial performance. Adjusted EBITDA should not be considered in isolation or as an alternative to, or substitute for,
net income, income from operations, cash flows generated by operations, investing or financing activities, or other financial statement
data presented in the consolidated financial statements as indicators of financial performance or liquidity. Because Adjusted EBITDA is
not a measurement determined in accordance with GAAP and is thus susceptible to varying definitions, Adjusted EBITDA as presented may
not be comparable to other similarly titled measures of other companies.
The following table reconciles
net income to Adjusted EBITDA for Select Medical. Adjusted EBITDA is used by Select Medical to report its segment performance. Adjusted
EBITDA is defined as earnings excluding interest, income taxes, depreciation and amortization, gain (loss) on early retirement of debt,
stock compensation expense, gain (loss) on sale of businesses, and equity in earnings (losses) of unconsolidated subsidiaries.
59,986
113,330
20,826
39,293
51,464
102,275
(4,749
Gain on sale of businesses
(6,532
(7,394
(11,760
124,882
236,606
Stock compensation expense:
Included in general and administrative
11,080
13,995
Included in cost of services
54,993
107,131
186,233
342,021
180,994
356,350
600,362
344,841
Critical illness recovery hospital
Rehabilitation hospital
Outpatient rehabilitation
(c)(d)
(26,544
35,656
(15,078
(50,471
21,847
(45,642
For the six months ended June 30, 2021, Adjusted EBITDA included other operating income of $17.9
million. The other operating income is related to the outcome of litigation with the Centers for Medicare & Medicaid Services.
For both the three and six months ended June 30, 2021, Adjusted EBITDA included other operating income
of $32.3 million. The other operating income is related to the recognition of payments received under the Provider Relief Fund.
For both the three and six months ended June 30, 2022, Adjusted EBITDA included other operating income
of $15.1 million related to the recognition of payments received under the Provider Relief Fund. For the three and six months ended June 30,
2021, Adjusted EBITDA included other operating income of $65.8 million and $81.9 million, respectively. The other operating income is
related to the recognition of payments received under the Provider Relief Fund.
Other primarily includes general and administrative costs and other operating income, as discussed further
above.

The above information was disclosed in a filing to the SEC. To see the filing, click here.

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