Amedisys (AMED)

Risks

• Federal and state changes to reimbursement and other aspects of Medicare and Medicaid could have a material adverse effect on our business and consolidated financial condition, results of operations and cash flows.
• Quality reporting requirements may negatively impact Medicare reimbursement.
• Value-based purchasing may negatively impact Medicare reimbursement.
• Any economic downturn, deepening of an economic downturn, continued deficit spending by the Federal Government or state budget pressures may result in a reduction in payments and covered services.
• Future cost containment initiatives undertaken by private third party payors may limit our future revenue and profitability.
• Our business may be materially adversely affected by the ongoing COVID-19 pandemic.
• A shortage of qualified registered nursing staff and other clinicians, such as therapists and nurse practitioners, could materially impact our ability to attract, train and retain qualified personnel and could increase operating costs.
• Because we are limited in our ability to control rates received for our services, our business and consolidated financial condition, results of operations and cash flows could be materially adversely affected if we are not able to maintain or reduce our costs to provide such services.
• If we are unable to provide consistently high quality of care, our business will be adversely impacted.
• If we are unable to maintain relationships with existing patient referral sources, our business and consolidated financial condition, results of operations and cash flows could be materially adversely affected.
• Possible changes in the case mix of patients, as well as payor mix and payment methodologies, could have a material adverse effect on our business and consolidated financial condition, results of operations and cash flows.
• Our failure to negotiate favorable managed care contracts, or our loss of existing favorable managed care contracts, could have a material adverse effect on our business and consolidated financial condition, results of operations and cash flows.
• Our industry is highly competitive, with few barriers to entry in certain states.
• Our business depends on our information systems. A cyber-attack, security breach or our inability to effectively integrate, manage and keep our information systems secure and operational could disrupt our operations.
• Our insurance liability coverage may not be sufficient for our business needs.
• We may be subject to substantial malpractice or other similar claims.
• If we are unable to maintain our corporate reputation, our business may suffer.
• A write off of a significant amount of intangible assets or long-lived assets could have a material adverse effect on our consolidated financial condition and results of operations.
• Our operations could be impacted by natural disasters and climate change.
• Our growth strategy depends on our ability to acquire additional care centers and integrate and operate these care centers effectively, make investments and enter into joint ventures and other strategic relationships. If our growth strategy is unsuccessful or we are not able to successfully integrate newly acquired care centers into our existing operations, our business and consolidated financial condition, results of operations and cash flows could be materially adversely affected.
• The indemnification provisions of acquisition agreements by which we have acquired companies may not fully protect us and as a result we may face unexpected liabilities.
• State efforts to regulate the establishment or expansion of health care providers could impair our ability to expand our operations.
• Federal regulation may impair our ability to consummate acquisitions or open new care centers.
• Divestitures or other dispositions could negatively impact our business, and contingent liabilities from businesses that we have sold could adversely affect our business and consolidated financial condition, results of operations and cash flows.
• We are subject to extensive government regulation. Any changes to the laws and regulations governing our business, or to the interpretation and enforcement of those laws or regulations, could have a material adverse effect on our business and consolidated financial condition, results of operations and cash flows.
• We face periodic and routine reviews, audits and investigations under our contracts with federal and state government agencies and private payors, and these audits could have adverse findings that may negatively impact our business.
• If a care center fails to comply with the conditions of participation in the Medicare program, that care center could be subjected to sanctions or terminated from the Medicare program.
• We are subject to federal and state laws that govern our financial relationships with physicians and other health care providers, including potential or current referral sources.
• We may face significant uncertainty in the industry due to government health care reform.
• Delays in payment may cause liquidity problems.
• Changes in units of payment for home health agencies could reduce our Medicare home health reimbursement levels.
• The volatility and disruption of the capital and credit markets and adverse changes in the United States and global economies could impact our ability to access both available and affordable financing, and without such financing, we may be unable to achieve our objectives for strategic acquisitions and internal growth.
• Our indebtedness could impact our financial condition and impair our ability to fulfill other obligations.
• The agreements governing our indebtedness contain various covenants that limit our discretion in the operation of our business and our failure to satisfy requirements in these agreements could have a material adverse effect on our business and consolidated financial condition, results of operations and cash flows.
• The price of our common stock may be volatile, which could lead to securities litigation brought against us or cause investors to lose the value of their investment.
• Our Board of Directors may use anti-takeover provisions or issue stock to discourage a change of control.
• Our Bylaws designate the Court of Chancery of the State of Delaware or, if the Court of Chancery does not have jurisdiction, the federal court for the District of Delaware, as the sole and exclusive forum for certain types of actions and proceedings that may be initiated by our stockholders, which could discourage lawsuits against us and our directors, officers, employees and stockholders.