BATON ROUGE, La., April 28, 2021 (GLOBE NEWSWIRE) -- Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three-month period ended March 31, 2021.
Three-Month Periods Ended March 31, 2021 and 2020
- Net service revenue increased $45.4 million to $537.1 million compared to $491.7 million in 2020.
- Net income attributable to Amedisys, Inc. of $49.9 million compared to $31.8 million in 2020.
- Net income attributable to Amedisys, Inc. per diluted share of $1.50 compared to $0.96 in 2020.
Adjusted Quarterly Results*
- Adjusted EBITDA of $78.6 million compared to $53.3 million in 2020.
- Adjusted net income attributable to Amedisys, Inc. of $51.1 million compared to $34.8 million in 2020.
- Adjusted net income attributable to Amedisys, Inc. per diluted share of $1.54 compared to $1.05 in 2020.
* See pages 11 and 12 for the definition and reconciliations of non-GAAP financial measures to GAAP measures.
Paul B. Kusserow, Chairman and Chief Executive Officer stated, “I am proud of our first quarter results and our continued performance in our four strategic pillars. Home Health has carried its strong momentum exiting 2020 into the first quarter of 2021, and though Hospice continues to see the impact of COVID-19 on average daily census, we are performing ahead of our projections and expect to continue to make good progress throughout 2021. We are also innovating close-to-the-core, growing inorganically, generating a prodigious amount of cash flow and remain in a position of very low leverage. We are excited about the growth opportunity both organically and inorganically this year and beyond and expect to be at the forefront of industry consolidation. Our industry leading quality, innovations mindset and payor orientation have materially differentiated Amedisys and have helped us take incremental steps towards being the leading aging-in-place, chronic care management company. A special thank you to all of our clinical staff and teams whose unwavering dedication to providing best-in-class clinical care has once again translated into strong financial results.”
Updated 2021 Guidance
Revenue, adjusted EBITDA and adjusted diluted earnings per share guidance ranges for 2021 updated to reflect the extension of the suspension of sequestration through December 31, 2021.
- Net service revenue is anticipated to be in the range of $2.302 billion to $2.342 billion.
- Adjusted EBITDA is anticipated to be in the range of $342 million to $352 million.
- Adjusted diluted earnings per share is anticipated to be in the range of $6.85 to $7.07 based on an estimated 33.4 million shares outstanding.
This guidance excludes the effects of any future acquisitions, if any are made.
We urge caution in considering the current trends and 2021 guidance disclosed in this press release. The home health, hospice and personal care industries are highly competitive and subject to intensive regulations, and trends are subject to numerous factors, risks, and uncertainties, some of which are referenced in the cautionary language below and others that are described more fully in our reports filed with the Securities and Exchange Commission (“SEC”) including our Annual Report on Form 10-K for the fiscal year ended December 31, 2020, subsequent Quarterly Reports on Form 10-Q, and current reports on Form 8-K which can be found on the SEC’s internet website, http://www.sec.gov, and our internet website, http://www.amedisys.com.
Earnings Call and Webcast Information
Amedisys will host a conference call on Thursday, April 29, 2021, at 11:00 a.m. ET to discuss its first quarter results. To participate on the conference call, please call before 11:00 a.m. ET to either (877) 524-8416 (Toll-Free) or (412) 902-1028 (Toll). A replay of the conference call will be available through May 29, 2021 by dialing (877) 660-6853 (Toll-Free) or (201) 612-7415 (Toll) and entering conference ID #13718528.
A live webcast of the call will be accessible through our website on our Investor Relations section at the following web address: http://investors.amedisys.com.
Non-GAAP Financial Measures
This press release includes reconciliations of the most comparable financial measures calculated and presented in accordance with accounting principles generally accepted in the U.S. (“GAAP”) to non-GAAP financial measures. The non-GAAP financial measures as defined under SEC rules are as follows: (1) adjusted EBITDA, defined as net income attributable to Amedisys, Inc. before net interest expense, provision for income taxes and depreciation and amortization, excluding certain items; (2) adjusted other operating income, defined as other operating income excluding certain items; (3) adjusted net income attributable to Amedisys, Inc., defined as net income attributable to Amedisys, Inc. excluding certain items; and (4) adjusted net income attributable to Amedisys, Inc. per diluted share, defined as net income attributable to Amedisys, Inc. common stockholders per diluted share excluding certain items. Management believes that these non-GAAP financial measures, when reviewed in conjunction with GAAP financial measures, are useful gauges of our current performance and are also included in internal management reporting. These non-GAAP financial measures should be considered in addition to, and not more meaningful than or as an alternative to the GAAP financial measures presented in this earnings release and the company’s financial statements. Non-GAAP measures as presented herein may not be comparable to similarly titled measures reported by other companies since not all companies calculate these non-GAAP measures consistently.
Additional Information
Amedisys, Inc. (the “Company”) is a leading healthcare at home company delivering personalized home health, hospice and personal care. Amedisys is focused on delivering the care that is best for our patients, whether that is home-based personal care; recovery and rehabilitation after an operation or injury; care focused on empowering our patients to manage a chronic disease; or hospice care at the end of life. More than 2,900 hospitals and 78,000 physicians nationwide have chosen Amedisys as a partner in post-acute care. Founded in 1982, headquartered in Baton Rouge, LA with an executive office in Nashville, TN, Amedisys is a publicly held company. With approximately 21,000 employees in 514 care centers within 39 states and the District of Columbia, Amedisys is dedicated to delivering the highest quality of care to the doorsteps of more than 418,000 patients and clients in need every year. For more information about the Company, please visit: www.amedisys.com.
We use our website as a channel of distribution for important company information. Important information, including press releases, investor presentations and financial information regarding our company, is routinely posted on and accessible on the Investor Relations subpage of our website, which is accessible by clicking on the tab labeled “Investors” on our website home page. Visitors to our website can also register to receive automatic e-mail and other notifications alerting them when new information is made available on the Investor Relations subpage of our website.
Forward-Looking Statements
When included in this press release, words like “believes,” “belief,” “expects,” “strategy,” “plans,” “anticipates,” “intends,” “projects,” “estimates,” “may,” “might,” “could,” “would,” “should” and similar expressions are intended to identify forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements involve a variety of risks and uncertainties that could cause actual results to differ materially from those described therein. These risks and uncertainties include, but are not limited to the following: the impact of the novel coronavirus pandemic (“COVID-19”), including the measures that have been and may be taken by governmental authorities to mitigate it, on our business, financial condition and results of operations, changes in or our failure to comply with existing federal and state laws or regulations or the inability to comply with new government regulations on a timely basis, changes in Medicare and other medical payment levels, our ability to open care centers, acquire additional care centers and integrate and operate these care centers effectively, competition in the healthcare industry, changes in the case mix of patients and payment methodologies, changes in estimates and judgments associated with critical accounting policies, our ability to maintain or establish new patient referral sources, our ability to consistently provide high-quality care, our ability to attract and retain qualified personnel, our ability to keep our patients and employees safe, changes in payments and covered services by federal and state governments, future cost containment initiatives undertaken by third-party payors, our access to financing, our ability to meet debt service requirements and comply with covenants in debt agreements, business disruptions due to natural disasters or acts of terrorism, widespread protests or civil unrest, our ability to integrate, manage and keep our information systems secure, our ability to realize the anticipated benefits of acquisitions, changes in law or developments with respect to any litigation relating to the Company, including various other matters, many of which are beyond our control.
Because forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified, you should not rely on any forward-looking statement as a prediction of future events. We expressly disclaim any obligation or undertaking and we do not intend to release publicly any updates or changes in our expectations concerning the forward-looking statements or any changes in events, conditions or circumstances upon which any forward-looking statement may be based, except as required by law.
| Contact: | Investor Contact: | Media Contact: |
| Amedisys, Inc. | Amedisys, Inc. | |
| Nick Muscato | Kendra Kimmons | |
| Senior Vice President, Finance | Vice President, Marketing & Communications | |
| (855) 259-2046 | (225) 299-3720 | |
| IR@amedisys.com | kendra.kimmons@amedisys.com |
AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)
(Unaudited)
| For the Three-Month Periods Ended March 31, | ||||||
| 2021 | 2020 | |||||
| Net service revenue | $ | 537,144 | $ | 491,685 | ||
| Other operating income | 8,701 | — | ||||
| Cost of service, excluding depreciation and amortization | 297,203 | 285,737 | ||||
| General and administrative expenses: | ||||||
| Salaries and benefits | 115,825 | 101,566 | ||||
| Non-cash compensation | 7,307 | 5,909 | ||||
| Other | 49,106 | 49,265 | ||||
| Depreciation and amortization | 7,555 | 5,338 | ||||
| Operating expenses | 476,996 | 447,815 | ||||
| Operating income | 68,849 | 43,870 | ||||
| Other income (expense): | ||||||
| Interest income | 24 | 13 | ||||
| Interest expense | (2,072 | ) | (3,231 | ) | ||
| Equity in earnings from equity method investments | 1,118 | 477 | ||||
| Miscellaneous, net | 288 | 263 | ||||
| Total other expense, net | (642 | ) | (2,478 | ) | ||
| Income before income taxes | 68,207 | 41,392 | ||||
| Income tax expense | (17,915 | ) | (9,346 | ) | ||
| Net income | 50,292 | 32,046 | ||||
| Net income attributable to noncontrolling interests | (422 | ) | (244 | ) | ||
| Net income attributable to Amedisys, Inc. | $ | 49,870 | $ | 31,802 | ||
| Basic earnings per common share: | ||||||
| Net income attributable to Amedisys, Inc. common stockholders | $ | 1.52 | $ | 0.98 | ||
| Weighted average shares outstanding | 32,780 | 32,331 | ||||
| Diluted earnings per common share: | ||||||
| Net income attributable to Amedisys, Inc. common stockholders | $ | 1.50 | $ | 0.96 | ||
| Weighted average shares outstanding | 33,190 | 33,234 | ||||
AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except share data)
| March 31, 2021 (unaudited) | December 31, 2020 | |||||
| ASSETS | ||||||
| Current assets: | ||||||
| Cash and cash equivalents | $ | 77,344 | $ | 81,808 | ||
| Restricted cash | 1,000 | 1,549 | ||||
| Patient accounts receivable | 275,632 | 255,145 | ||||
| Prepaid expenses | 15,449 | 10,217 | ||||
| Other current assets | 11,025 | 13,265 | ||||
| Total current assets | 380,450 | 361,984 | ||||
| Property and equipment, net of accumulated depreciation of $97,698 and $95,024 | 21,679 | 23,719 | ||||
| Operating lease right of use assets | 94,620 | 93,440 | ||||
| Goodwill | 933,207 | 932,685 | ||||
| Intangible assets, net of accumulated amortization of $12,738 and $22,973 | 69,764 | 74,183 | ||||
| Deferred income taxes | 40,576 | 47,987 | ||||
| Other assets | 32,913 | 33,200 | ||||
| Total assets | $ | 1,573,209 | $ | 1,567,198 | ||
| LIABILITIES AND EQUITY | ||||||
| Current liabilities: | ||||||
| Accounts payable | $ | 38,865 | $ | 42,674 | ||
| Payroll and employee benefits | 150,887 | 146,929 | ||||
| Accrued expenses | 170,954 | 166,192 | ||||
| Provider relief fund advance | 55,000 | 60,000 | ||||
| Current portion of long-term obligations | 10,329 | 10,496 | ||||
| Current portion of operating lease liabilities | 30,047 | 30,046 | ||||
| Total current liabilities | 456,082 | 456,337 | ||||
| Long-term obligations, less current portion | 231,380 | 204,511 | ||||
| Operating lease liabilities, less current portion | 63,359 | 61,987 | ||||
| Other long-term obligations | 32,814 | 33,622 | ||||
| Total liabilities | 783,635 | 756,457 | ||||
| Equity: | ||||||
| Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding | — | — | ||||
| Common stock, $0.001 par value, 60,000,000 shares authorized; 37,538,837 and 37,470,212 shares issued; and 32,567,712 and 32,814,278 shares outstanding | 38 | 38 | ||||
| Additional paid-in capital | 707,006 | 698,287 | ||||
| Treasury stock, at cost 4,971,125 and 4,655,934 shares of common stock | (398,752 | ) | (319,092 | ) | ||
| Retained earnings | 479,861 | 429,991 | ||||
| Total Amedisys, Inc. stockholders’ equity | 788,153 | 809,224 | ||||
| Noncontrolling interests | 1,421 | 1,517 | ||||
| Total equity | 789,574 | 810,741 | ||||
| Total liabilities and equity | $ | 1,573,209 | $ | 1,567,198 | ||
AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING
(Amounts in thousands, except statistical information)
(Unaudited)
| For the Three-Month Periods Ended March 31, | ||||||
| 2021 | 2020 | |||||
| Cash Flows from Operating Activities: | ||||||
| Net income | $ | 50,292 | $ | 32,046 | ||
| Adjustments to reconcile net income to net cash provided by operating activities: | ||||||
| Depreciation and amortization | 7,555 | 5,338 | ||||
| Non-cash compensation | 7,307 | 5,909 | ||||
| Amortization and impairment of operating lease right of use assets | 9,850 | 9,058 | ||||
| Loss on disposal of property and equipment | 14 | 55 | ||||
| Write-off of other comprehensive income | — | (15 | ) | |||
| Deferred income taxes | 7,411 | 1,228 | ||||
| Equity in earnings from equity method investments | (1,118 | ) | (477 | ) | ||
| Amortization of deferred debt issuance costs/debt discount | 216 | 220 | ||||
| Return on equity investment | 1,500 | 2,369 | ||||
| Changes in operating assets and liabilities, net of impact of acquisitions: | ||||||
| Patient accounts receivable | (20,448 | ) | (25,459 | ) | ||
| Other current assets | (2,874 | ) | (5,756 | ) | ||
| Other assets | (115 | ) | 417 | |||
| Accounts payable | (3,374 | ) | (2,673 | ) | ||
| Accrued expenses | 8,370 | (10,336 | ) | |||
| Other long-term obligations | (808 | ) | 3,060 | |||
| Operating lease liabilities | (9,014 | ) | (8,132 | ) | ||
| Operating lease right of use assets | (762 | ) | (817 | ) | ||
| Net cash provided by operating activities | 54,002 | 6,035 | ||||
| Cash Flows from Investing Activities: | ||||||
| Proceeds from sale of deferred compensation plan assets | 19 | 16 | ||||
| Proceeds from the sale of property and equipment | 42 | 12 | ||||
| Purchases of property and equipment | (1,618 | ) | (1,434 | ) | ||
| Acquisitions of businesses, net of cash acquired | — | (69,349 | ) | |||
| Net cash used in investing activities | (1,557 | ) | (70,755 | ) | ||
| Cash Flows from Financing Activities: | ||||||
| Proceeds from issuance of stock upon exercise of stock options | 364 | 1,184 | ||||
| Proceeds from issuance of stock to employee stock purchase plan | 1,048 | 860 | ||||
| Shares withheld to pay taxes on non-cash compensation | (6,774 | ) | (4,050 | ) | ||
| Noncontrolling interest distribution | (518 | ) | (360 | ) | ||
| Proceeds from borrowings under revolving line of credit | 215,200 | 187,500 | ||||
| Repayments of borrowings under revolving line of credit | (186,200 | ) | (37,500 | ) | ||
| Principal payments of long-term obligations | (2,692 | ) | (1,592 | ) | ||
| Purchase of company stock | (72,886 | ) | — | |||
| Provider relief fund advance | (5,000 | ) | — | |||
| Net cash (used in) provided by financing activities | (57,458 | ) | 146,042 | |||
| Net (decrease) increase in cash, cash equivalents and restricted cash | (5,013 | ) | 81,322 | |||
| Cash, cash equivalents and restricted cash at beginning of period | 83,357 | 96,490 | ||||
| Cash, cash equivalents and restricted cash at end of period | $ | 78,344 | $ | 177,812 | ||
| Supplemental Disclosures of Cash Flow Information: | ||||||
| Cash paid for interest | $ | 1,011 | $ | 1,755 | ||
| Cash paid for income taxes, net of refunds received | $ | 971 | $ | 5,272 | ||
| Cash paid for operating lease liabilities | $ | 9,776 | $ | 8,949 | ||
| Cash paid for finance lease liabilities | $ | 503 | $ | 499 | ||
| Supplemental Disclosures of Non-Cash Activity: | ||||||
| Right of use assets obtained in exchange for operating lease liabilities | $ | 10,548 | $ | 6,437 | ||
| Right of use assets obtained in exchange for finance lease liabilities | $ | 177 | $ | 254 | ||
| Reductions to right of use assets resulting from reductions to operating lease liabilities | $ | 279 | $ | 159 | ||
| Days revenue outstanding (1) | 43.9 | 46.6 | ||||
(1) Our calculation of days revenue outstanding, net is derived by dividing our ending patient accounts receivable at March 31, 2021 and 2020 by our average daily net patient service revenue for the three-month periods ended March 31, 2021 and 2020, respectively.
AMEDISYS, INC. AND SUBSIDIARIES
SEGMENT INFORMATION
(Amounts in millions, except statistical information)
(Unaudited)
Segment Information - Home Health
| For the Three-Month Periods Ended March 31, | ||||||
| 2021 | 2020 | |||||
| Financial Information (in millions): | ||||||
| Medicare | $ | 221.4 | $ | 203.9 | ||
| Non-Medicare | 107.2 | 99.7 | ||||
| Net service revenue | 328.6 | 303.6 | ||||
| Other operating income | 5.0 | — | ||||
| Cost of service | 183.0 | 179.8 | ||||
| Gross margin | 150.6 | 123.8 | ||||
| Other operating expenses | 81.1 | 76.7 | ||||
| Operating income | $ | 69.5 | $ | 47.1 | ||
| Same Store Growth (1): | ||||||
| Medicare revenue | 9 | % | (4 | %) | ||
| Non-Medicare revenue | 8 | % | 3 | % | ||
| Total admissions | 5 | % | 3 | % | ||
| Total volume (2) | 6 | % | 1 | % | ||
| Key Statistical Data—Total (3): | ||||||
| Admissions | 89,830 | 85,975 | ||||
| Recertifications (6) | 43,808 | 39,867 | ||||
| Total volume (6) | 133,638 | 125,842 | ||||
| Medicare completed episodes | 75,332 | 75,636 | ||||
| Average Medicare revenue per completed episode (4) | $ | 2,931 | $ | 2,734 | ||
| Medicare visits per completed episode (5) | 13.9 | 15.8 | ||||
| Visiting Clinician Cost per Visit | $ | 90.32 | $ | 84.01 | ||
| Clinical Manager Cost per Visit | $ | 9.50 | $ | 8.97 | ||
| Total Cost per Visit | $ | 99.82 | $ | 92.98 | ||
| Visits | 1,832,912 | 1,933,445 | ||||
(1) Same store information represents the percent change in our Medicare, Non-Medicare and Total revenue, admissions or volume for the period as a percent of the Medicare, Non-Medicare and Total revenue, admissions or volume of the prior period. Same store is defined as care centers that we have operated for at least the last twelve months and startups that are an expansion of a same store care center.
(2) Total volume includes all admissions and recertifications.
(3) Total includes acquisitions, start-ups and denovos.
(4) Average Medicare revenue per completed episode is the average Medicare revenue earned for each Medicare completed episode of care. Average Medicare revenue per completed episode reflects the transition to PDGM effective January 1, 2020 and the suspension of sequestration effective May 1, 2020.
(5) Medicare visits per completed episode are the home health Medicare visits on completed episodes divided by the home health Medicare episodes completed during the period.
(6) Prior year amounts have been recast to conform to the current year calculation.
Segment Information - Hospice
| For the Three-Month Periods Ended March 31, | ||||||
| 2021 | 2020 | |||||
| Financial Information (in millions): | ||||||
| Medicare | $ | 181.5 | $ | 160.5 | ||
| Non-Medicare | 10.0 | 8.9 | ||||
| Net service revenue | 191.5 | 169.4 | ||||
| Other operating income | 3.7 | — | ||||
| Cost of service | 101.6 | 91.8 | ||||
| Gross margin | 93.6 | 77.6 | ||||
| Other operating expenses | 47.1 | 39.3 | ||||
| Operating income | $ | 46.5 | $ | 38.3 | ||
| Same Store Growth (1): | ||||||
| Medicare revenue | (2 | %) | 5 | % | ||
| Hospice admissions | 5 | % | 1 | % | ||
| Average daily census | (4 | %) | 4 | % | ||
| Key Statistical Data - Total (2): | ||||||
| Hospice admissions | 13,683 | 11,318 | ||||
| Average daily census | 13,321 | 12,046 | ||||
| Revenue per day, net | $ | 159.76 | $ | 154.55 | ||
| Cost of service per day | $ | 84.80 | $ | 83.78 | ||
| Average discharge length of stay | 94 | 98 | ||||
(1) Same store information represents the percent change in our Medicare revenue, Hospice admissions or average daily census for the period as a percent of the Medicare revenue, Hospice admissions or average daily census of the prior period. Same store is defined as care centers that we have operated for at least the last twelve months and startups that are an expansion of a same store care center.
(2) Total includes acquisitions, start-ups and denovos.
Segment Information - Personal Care
| For the Three-Month Periods Ended March 31, | |||||
| 2021 | 2020 | ||||
| Financial Information (in millions): | |||||
| Medicare | $ | — | $ | — | |
| Non-Medicare | 17.0 | 18.7 | |||
| Net service revenue | 17.0 | 18.7 | |||
| Other operating income | — | — | |||
| Cost of service | 12.6 | 14.1 | |||
| Gross margin | 4.4 | 4.6 | |||
| Other operating expenses | 3.1 | 3.4 | |||
| Operating income | $ | 1.3 | $ | 1.2 | |
| Key Statistical Data - Total (1): | |||||
| Billable hours | 607,437 | 752,077 | |||
| Clients served | 9,759 | 11,770 | |||
| Shifts | 257,609 | 333,464 | |||
| Revenue per hour | $ | 27.95 | $ | 24.87 | |
| Revenue per shift | $ | 65.92 | $ | 56.09 | |
| Hours per shift | 2.4 | 2.3 | |||
(1) Total includes acquisitions, start-ups and denovos.
Segment Information - Corporate
For the Three-Month Periods Ended March 31, | ||||
| 2021 | 2020 | |||
| Financial Information (in millions): | ||||
| Other operating expenses | $ | 42.6 | $ | 39.0 |
| Depreciation and amortization | 5.9 | 3.7 | ||
| Total operating expenses | $ | 48.5 | $ | 42.7 |
AMEDISYS, INC. AND SUBSIDIARIES
RECONCILIATION OF NON-GAAP FINANCIAL MEASURES TO GAAP MEASURES
(Amounts in thousands)
(Unaudited)
Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization (“Adjusted EBITDA”) Reconciliation:
| For the Three-Month Periods Ended March 31, | ||||||
| 2021 | 2020 | |||||
| Net income attributable to Amedisys, Inc. | $ | 49,870 | $ | 31,802 | ||
| Add: | ||||||
| Income tax expense | 17,915 | 9,346 | ||||
| Interest expense, net | 2,048 | 3,218 | ||||
| Depreciation and amortization | 7,555 | 5,338 | ||||
| Certain items (1) | 1,712 | 4,036 | ||||
| Interest component of certain items (1) | (517 | ) | (446 | ) | ||
| Adjusted EBITDA (2) (6) | $ | 78,583 | $ | 53,294 | ||
Adjusted Other Operating Income Reconciliation:
| For the Three-Month Periods Ended March 31, | |||||
| 2021 | 2020 | ||||
| Other operating income | $ | 8,701 | $ | — | |
| Add: | |||||
| Certain items (1) | (8,701 | ) | — | ||
| Adjusted other operating income (3) (6) | $ | — | $ | — | |
Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:
| For the Three-Month Periods Ended March 31, | |||||
| 2021 | 2020 | ||||
| Net income attributable to Amedisys, Inc. | $ | 49,870 | $ | 31,802 | |
| Add: | |||||
| Certain items (1) | 1,267 | 2,987 | |||
| Adjusted net income attributable to Amedisys, Inc. (4) (6) | $ | 51,137 | $ | 34,789 | |
Adjusted Net Income Attributable to Amedisys, Inc. per Diluted Share Reconciliation:
| For the Three-Month Periods Ended March 31, | ||||
| 2021 | 2020 | |||
| Net income attributable to Amedisys, Inc. common stockholders per diluted share | $ | 1.50 | $ | 0.96 |
| Add: | ||||
| Certain items (1) | 0.04 | 0.09 | ||
| Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share (5) (6) | $ | 1.54 | $ | 1.05 |
(1) The following details the certain items for the three-month periods ended March 31, 2021 and 2020:
Certain Items:
| For the Three-Month Periods Ended March 31, | |||||
| 2021 | 2020 | ||||
| (Income) Expense | (Income) Expense | ||||
| Certain Items Impacting Other Operating Income: | |||||
| CARES Act & State COVID-19 grants | $ | (8,701 | ) | $ | — |
| Certain Items Impacting Cost of Service: | |||||
| COVID-19 costs | 8,480 | 1,017 | |||
| Certain Items Impacting Operating Expenses: | |||||
| Acquisition and integration costs | 1,199 | 2,336 | |||
| COVID-19 costs | 217 | 12 | |||
| Certain Items Impacting Total Other Income (Expense): | |||||
| Interest component of certain items | 517 | 446 | |||
| Other (income) expense, net | — | 225 | |||
| Total | $ | 1,712 | $ | 4,036 | |
| Net of tax | 1,267 | 2,987 | |||
| Diluted EPS | $ | 0.04 | $ | 0.09 | |
(2) Adjusted EBITDA is defined as net income attributable to Amedisys, Inc. before net interest expense, provision for income taxes and depreciation and amortization, excluding certain items as described in footnote 1.
(3) Adjusted other operating income is defined as other operating income excluding certain items as described in footnote 1.
(4) Adjusted net income attributable to Amedisys, Inc. is defined as net income attributable to Amedisys, Inc. calculated in accordance with GAAP excluding certain items as described in footnote 1.
(5) Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share is defined as diluted income per share calculated in accordance with GAAP excluding the earnings per share effect of certain items as described in footnote 1.
(6) Adjusted EBITDA, adjusted other operating income, adjusted net income attributable to Amedisys, Inc. and adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share should not be considered as an alternative to, or more meaningful than, income before income taxes or other measures calculated in accordance with GAAP. These calculations may not be comparable to a similarly titled measure reported by other companies, since not all companies calculate these non-GAAP financial measures in the same manner.