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8-K - 8-K - SELECT MEDICAL HOLDINGS CORPa15-12329_18k.htm

Exhibit 99.1

 

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Investor Presentation May 2015

 


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Forward-Looking Statements This presentation may contain forward-looking statements based on current management expectations. Numerous factors, including those related to market conditions and those detailed from time-to-time in the Company’s filings with the Securities and Exchange Commission, may cause results to differ materially from those anticipated in the forward-looking statements. Many of the factors that will determine the Company’s future results are beyond the ability of the Company to control or predict. These statements are subject to risks and uncertainties and, therefore, actual results may differ materially. Readers should not place undue reliance on forward-looking statements, which reflect management’s views only as of the date hereof. The Company undertakes no obligation to revise or update any forward-looking statements, or to make any other forward-looking statements, whether as a result of new information, future events or otherwise. All references to “Select” used throughout this presentation refer to Select Medical Holdings Corporation and its subsidiaries.

 


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Headquartered in Mechanicsburg, Pennsylvania, Select Medical employs approximately 31,900 staff in the United States. SCALE AND EXPERTISE Leading provider of post-acute services with operations in 42 states and D.C. Select Medical Overview Note: (1) See Slide 35 for non-GAAP reconciliation Founded in 1996 $3.1 Billion Net Revenue LTM Q1 2015 $366 Million Adjusted EBITDA LTM Q1 2015(1) 11.8% Adjusted EBITDA Margins

 


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11 2 7 1 3 6 1 14 3 2 3 17 2 1 1 4 24 2 15 2 15 2 20 10 7 93 6 1 2 2 3 19 66 4 3 13 1 11 5 45 33 17 3 16 11 1 57 9 51 2 131 148 1 9 2 44 4 1 3 152 23 1 1 21 2 2 1 21 33 1 42 3 2 4 2 5 5 12 15 2 6 1 24 16 1 2 2 5 3 1 98 53 9 1 Select Medical’s National Footprint 112 Long-Term Acute Care Hospitals (LTACH) (28 States) 17 Inpatient Rehabilitation Hospitals (8 States) 1,028 Outpatient Rehabilitation Clinics (31 States and D.C.) 421 Contract Therapy Locations (28 States and D.C.) As of 03/31/15 12 1 1

 


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Strategy Be the “preferred” provider of post acute care services in our markets Structured relationships to align with patients Partner with academic/major medical institutions Hospital in hospital model in LTACH Experts in our fields – LTACH, Inpatient Rehab, Outpatient Rehab and Occupational Medicine Best in class High quality clinical services Outpatient critical mass

 


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2014 Financial Highlights 2014 FINANCIAL HIGHLIGHTS PRICING/ADMENDMENT TERM LOANS MARCH 2014 $110.0M SR. NOTE ADD-ON @ 101.5 MARCH 2014 SHARE PURCHASES DIVIDEND PAYMENTS 10M shares @ $10.95/share on March 13, 2014 ~1.3M shares @$14.00/share on May 21, 2014 $.10/share on March 10, 2014 $.10/share on May 28, 2014 $.10/share on August 29, 2014 $.10/share on December 1, 2014

 


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2014 Development Highlights Rehabilitation Joint Ventures: LTACHs: 6 Start Ups 1 New Joint Venture Atlanta, GA 56 bed IRF 23 outpatient clinics Harrisburg, PA 55 bed IRF 21 outpatient clinics Cleveland, OH Two 60 bed IRFs (opening late 2015 & 2016) Cincinnati, OH 60 bed IRF (opening 2016) Atlanta, GA 3 LTACHs 88 beds

 


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Long-Term Acute Care Specialty Hospitals

 


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Select Medical LTAC Hospitals 112 Long-Term Acute Care Hospitals (LTACH) (28 States) As of 03/31/15 3 3 2 1 1 2 2 2 10 2 3 3 11 5 16 9 1 1 1 3 2 5 2 6 1 5 1 9

 


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LTACH Overview Major provider of LTACH services in U.S. 112 hospitals 82 hospital-in-hospital (3,091 beds); average size 38 beds 29 freestanding (1,601 beds); average size 55 beds 1 managed hospital Ownership of freestanding LTACHs 17 owned 12 leased

 


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LTACH Legislation LTACH Patient Criteria passed in late December 2013 as part of Budget bill and SGR - effective beginning Q4 2015 LTACH Rates for patients with; 3 day prior short term acute hospital ICU/CCU stay or Ventilation patients for > 96 hours in the LTACH Other patients receive “site neutral” rate which is lesser of; IPPS per diem (capped at the IPPS DRG amount plus outlier payment) or 100% cost Site Neutral payments phased in over 3 years

 


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Patient Criteria Phase-In HOSPITALS MOVING TO CRITERIA >>> NOTE: Hospitals as of 5/31/15 2015 2016 3 HOSPITALS 169 BEDS 1 HOSPITAL 45 BEDS 1 HOSPITAL 35 BEDS 106 HOSPITALS 4,432 BEDS Q4 ‘15 Q1 ‘16 Q2 ‘16 Q3 ‘16

 


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Select Impact Positives: Degree of segment certainty with phase-in 25% Rule extension – through cost reporting periods on or after October 1, 2016 Select high CMI HiH Strategy Neutral: Moratorium – on new hospitals and beds (with exceptions) through September 30, 2017 Negatives: Potential loss of volume Reduced rates for site neutral patients

 


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Inpatient Rehabilitation Hospitals Inpatient Rehabilitation Specialty Hospitals

 


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Acquired Kessler Institute in September 2003 The Kessler Rehabilitation network: Three freestanding inpatient rehab hospitals (336 total beds) 88 outpatient rehab clinics Largest licensed rehab hospital in U.S. U.S. News & World Report has recognized Kessler Institute as one of the nation’s best in rehabilitation for the past 20 years. Ranked #2 in the last eight out of nine years One of only eight rehab hospitals in the U.S. to receive dual federal designations as a Model System (brain and spinal cord injury) Inpatient Rehabilitation Hospitals

 


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Operational Joint Ventures Consolidated Joint Ventures: Non-Consolidating Joint Ventures: Dallas, TX 4 IRFs (220 beds) 2 managed units (33 beds) 50 outpatient clinics Scottsdale, AZ 50 bed IRF Columbus, OH 44 bed IRF Atlanta, GA 56 bed IRF 23 outpatient clinics Hershey, PA 76 bed IRF 22 bed TCU St. Louis, MO 2 IRFs (95 beds) 1 managed unit 47 outpatient clinics Additional services San Antonio, TX 42 bed IRF Harrisburg, PA 55 bed IRF 21 outpatient clinics

 


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JVs Under Construction Cleveland, OH Two 60 bed IRFs (opening late 2015 & 2016) Currently managing 3 units with 97 total beds Los Angeles, CA 138 bed IRF (opening late 2015) Cincinnati, OH 60 bed IRF (opening 2016) Currently managing 2 units with 46 total beds

 


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Growing Rehabilitation Network Partner in joint ventures with premier acute care hospitals and systems to build post acute networks 18

 


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Specialty Hospitals Poised for Growth LTACH REHAB 2014 2015 2016 2 new LTACHs 1 new LTACH 3 new LTACHs 1 new LTACH 1 new LTACH Begin phase-in of LTACH patient criteria 6 New IRFs 8 New LTACHs

 


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Outpatient Rehab Clinics Outpatient Rehabilitation

 


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Outpatient Rehabilitation - Industry 1,028 Outpatient Rehabilitation Clinics (31 States and D.C.) Source: Company public filings and websites as of March 31, 2015 Select (1,028) PhysioTherapy Associates (575) USPH (494) ATI (420) 11 7 6 14 2 17 24 15 20 93 1 66 13 45 17 57 9 44 152 1 21 2 21 33 42 12 15 24 3 98 12 131

 


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Payor Mix Outpatient Rehab Clinics 42% 13% 22% 23% YEAR 2010 2011 2012 2013 2014 VISITS (000’s) REVENUE PER VISIT $101 4,567 $103 4,470 $103 4,569 $104 4,781 $103 4,971 LTM Q1 ‘15 $103 5,032 Medicare / Medicaid Commercial / Managed Care Workers’ Comp Managed/ Other

 


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Continued growth in workers’ comp business by illustrating historical ROI benefits of working with Select Payors/Employers Expand hand therapy services to more clinics Expand concussion management program Continued development of start-up clinics 2015 Outpatient Initiatives

 


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Concentra Acquisition Concentra is the leading provider of occupational health with 488 locations across 40 states For the 12 months ended March 31, 2015, Concentra generated $1.0 billion of revenues and $96.0 million of Adjusted EBITDA Three primary service lines: Centers: 300 locations focused primarily on occupational health services, with some consumer health Onsite Clinics: 154 locations at employer customer locations, with comprehensive services, including occupational medicine, primary care and physical therapy CBOCs: 34 Community Based Outpatient Clinics serving Veterans Health Administration patients, including primary, specialty and sub-specialty care, mental health and pharmacy services

 


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Concentra Transaction Overview On March 23, 2015, Select Medical and Welsh Carson Anderson & Stowe (“WCAS”) announced the purchase of Concentra for $1,055 million. The transaction will be structured as a joint venture partnership Debt financing will be non-recourse to both Select and WCAS The transaction is expected to be financed through: $700 million Senior Credit Facilities @ Concentra $50 million R/C Facility (undrawn at close) $450 million 1st lien Term Loan $200 million 2nd lien Term Loan $435 million of new cash equity with: 50.1% contributed by SEM 49.9% contributed by WCAS

 


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Concentra Investment Rationale Business well known by both WCAS and Select Complementary to Select’s outpatient rehabilitation business Significant geographic overlap of Concentra centers and Select outpatient clinics Select’s track record of successful acquisitions combined with WCAS’s historical knowledge of Concentra provides meaningful opportunity to increase margins Strategically aligned partners, platform for synergies, and compelling value proposition

 


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Financial Overview

 


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Financial Metric Trends Net Revenue Adjusted EBITDA CAGR 6.3% CAGR 4.2% Adjusted EPS CAGR 17.1% $2,390 $2,805 $2,949 $2,976 $3,065 $307 $386 $406 $373 $364 ($ in millions) ($ in millions) $3,098 $366 $0.48 $0.84 $1.07 $ 0.90 $ 0.92 $0.94 2010 2011 2012 2013 2014 LTM Q1 2015 2010 2011 2012 2013 2014 LTM Q1 2015 Hospitals Outpatient 2010 2011 2012 2013 2014 LTM Q1 2015 Hospitals Outpatient

 


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($ in millions) Annual Capital Expenditures Accelerated development spending expected 2014-2015 $52 $46 $68 $74 $95 $0 $25 $50 $75 $100 2010 2011 2012 2013 2014 LTM Q1 '15 Maintenance Development $96

 


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($ in millions) Note: Free Cash Flow calculated as Net Cash Provided by Operating Activities less Purchases of Property and Equipment See Slide 35 for non-GAAP reconciliation Free Cash Flow Focus on Free Cash Flow Generation $93 $171 $231 $119 $75 $128 2010 2011 2012 2013 2014 LTM Q1 '15

 


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Debt Maturities ($ in millions) $280 $5 $568 $710 $0 $200 $400 $600 $800 2015 2016 2017 2018 2019 2020 2021 Revolver (L + 3.75%) Term Loan E (L + 2.75% - 1% floor) Term Loan D (L + 2.75%) Senior Notes 6.375%

 


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Use of Capital - Opportunistic USE OF CAPITAL (OPPORTUNISTIC) STOCK BUYBACK DEBT REPAYMENT Acquisition payments $176M since 2010 $.10/share on December 1, 2014 DIVIDENDS ACQUISITIONS Investments in businesses $73M since 2011 Special dividend $1.50/share @ 12/2012 Dividend payments totaling $.30/share in 2013 Dividend payments totaling $.40/share in 2014 - $129.5M in 2011-13 (avg. price $7.75) - $127.5M in 2014 (10M, 1.3M share blocks) - Net leverage of 4.2x @ 03/31/15

 


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Net Revenue $3,100M - $3,200M Adjusted EBITDA $370M - $385M Adjusted EPS $0.84 - $0.90 2015 Financial Guidance

 


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Appendix: Additional Materials

 


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Non-GAAP Reconciliation ($ in millions) 2010 2011 2012 2013 2014 Q1 ‘14 Q1 ‘15 LTM Q1 ’15 Net Income $82 $113 $154 $123 $128 $35 $38 $131 (+) Income tax 42 71 90 75 76 22 23 77 (+/-) Equity in losses/(earnings) of unconsolidated subsidiaries 1 (3) (8) (2) (7) (1) (3) (9) (+/-) Other expense / (income) (1) - - - - - - - (+) Interest expense, net 112 99 95 87 86 21 21 86 (-/+) (Gain) / Loss on debt retirement - 31 6 19 2 2 - - (+) Depreciation and Amortization 69 71 63 64 68 16 18 70 (+) Stock Based Compensation 2 4 6 7 11 2 2 11 Adjusted EBITDA $307 $386 $406 $373 $364 $97 $99 $366 Net Cash Provided by Operating Activities $145 $217 $299 $193 $170 $(16) $38 $224 (-) Purchase of Property and Equipment 52 46 68 74 95 27 28 96 Free Cash Flow $93 $171 $231 $119 $75 $(43) $10 $128

 


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