Exhibit 99.1
S E L E C TM E D I C A LH O L D I N G SC O R P O R A T I O N A year of resilience 220 A N N U A LR E P O R T |
2SELECT MEDICALI M PROVING QUAL I TY OF LIFE |
AT R I B U T ET OO U RF R O N T L I N E H E A L T HC A R EP R O F E S S I O N A L S 2 0 2 0 A N N U A L R E P O R T3 |
D E A RS T O C K H O L D E R As a Company, we faced incredibly challenging times in 2020 as the coronavirus pandemic took hold in the communities we serve. Yet, we are stronger than ever as our colleagues across all divisions came together to meet the challenge of serving our patients in a healthcare environment that seemed to be changing daily. There were many unknowns, but we learned, collaborated, adapted and innovated daily. We rose to the occasion caring for more than 6,000 recovering COVID-19 patients who came through our hospital doors. Add to that, the thousands of non-COVID-19 patients treated daily across our post-acute care network this year amid the pandemic. Through it all, we strengthened our relationships with joint venture partners, host hospitals and referral sources nationwide. New relationships were also established with acute care hospitals as we answered their calls for help decompressing ICUs in hard hit areas. These achievements were underscored by strong financial performance. Despite the pandemic and its disruption, revenue grew 1.4% year-over-year to more than $5.5 billion, and Adjusted EBITDA grew 12.6% year-over-year to $800.6 million. Our specialty hospitals responded to the extraordinary challenges of the pandemic in each local market by reinforcing short stay hospitals that needed to discharge historically high numbers of patients still requiring acute care services. Our hospitals persevered often by setting up special COVID-19 care units. The critical illness recovery hospitals division had a strong financial performance with an Adjusted EBITDA increase of 34.4%, or $342.4 million for the year. Our inpatient rehabilitation hospitals had their strongest financial performance in the history of the Company with an Adjusted EBITDA increase of 12.8%, or $153.2 million for the year. The Company’s outpatient line of business was negatively impacted by the pandemic’s lockdowns across much of the country. The division posted Adjusted EBITDA of $79.2 million, a 47.9% decrease year-over-year. However, the outpatient division was resilient and by the fourth quarter, the division’s revenue was restored to 94.7% of the level achieved in the same period in 2019. Concentra was also negatively impacted by the pandemic’s lockdowns. Concentra recorded Adjusted EBITDA of $252.9 million, an 8.5% decrease year-over-year. Concentra focused on restoring its business and, by the fourth quarter, its revenue exceeded the level achieved in the same period in 2019. During 2020, Select Medical acquired an additional 30% interest in Concentra and now owns about 78% of Concentra. Following are additional 2020 highlights that define operational and clinical excellence across the organization. Leadership – The Company conducted 116 virtual COVID-19 huddles from March through December bringing together senior operational and clinical leaders across the organization to identify and address obstacles, share clinical developments and shape new protocols and procedures. In December, the American College of Chest Physicians published “Long-Term Acute Care Hospitals Extend ICU Capacity for COVID-19 Response and Recovery,” an article chronicling Select Medical’s response to the national health crisis, clearly defining the critical role of long-term acute care hospitals in the COVID-19 care continuum. Kessler Institute for Rehabilitation was again named one of the best rehabilitation hospitals in the country by U.S. News & World Report, Cleveland Clinic Rehabilitation Hospitals Avon, Beachwood and Edwin Shaw as well as UF Health Rehabilitation Hospital were recognized as the “Best Rehabilitations Centers” in Ohio and Florida, respectively, by Newsweek Magazine. 4S E L E C T M E D I C A LI M P R O V I N G Q U A L I T Y O F L I F E |
Growth – Despite the pandemic, the Company continued to execute its growth strategy. In September, Select Medical formed a new joint venture partnership with RUSH, a top academic health system, that will include critical illness recovery, inpatient rehabilitation and outpatient rehabilitation services. Two new rehabilitation hospitals were opened in Arizona in September and October as part of our Banner Health joint venture partnership. Additionally, 17 outpatient clinics were acquired, further expanding the Company’s national network. Concentra completed several center acquisitions and refocused on its core businesses with the divestiture of its community-based outpatient clinics. Innovation – We responded to COVID-19 by accelerating innovation in 2020. We increased the Company’s telehealth capabilities and usage to ensure that patients maintained access to best-in-class outpatient and occupational medicine care in their time of need, particularly those impacted by compromised immune systems or restricted by stay-at-home orders. Concentra successfully developed COVID-19 testing in its centers and onsite for certain customers. The pandemic also spurred new outpatient clinical advancements such as the Recovery and Reconditioning Program. Developed in partnership with leading physicians, physiatrists and infectious disease specialists, the program helps those continuing to recover from COVID-19 as well as others compromised by debilitating respiratory-related illnesses and conditions. Culture – For the many hardships of 2020, our culture – The Select Medical Way – has never been more formidable. Its guiding principles served as a beacon of inspiration and hope for our 50,000 person workforce amid many dark days. Additionally, ONE Select, our holistic approach regarding how we think, partner and engage with each other across divisions and departments truly galvanized and unified our leaders around one mission, one team and one voice. Above all, however, we learned that when we face and embrace adversity, we will prevail, better and stronger for it. As we enter 2021, we are hopeful for the country, grateful for one another and even more committed to providing exceptional care to the patients and families we serve. Robert Ortenzio 2 0 2 0 A N N U A L R E P O R T5 |
FOR THE YEARS ENDED Revenue Income from operations Net income attributable to Select Medical Holdings Corporation Earnings per common share, fully diluted Cash flow from operations SEGMENT INFORMATION Revenue(1) Critical illness recovery hospital Rehabilitation hospital Outpatient rehabilitation Concentra Other $ 5,531,713 567,657 258,995 1.93 1,028,073 $ 2,077,499 734,673 919,913 1,501,434 298,194 $ 5,453,922 471,881 148,449 1.10 445,182 $ 1,836,518 670,971 1,046,011 1,628,817 271,605 $ 5,081,258 417,279 137,840 1.02 494,194 $ 1,753,584 583,745 995,794 1,557,673 190,462 $ 4,365,245 355,878 177,184 1.33 238,131 $ 1,725,022 509,108 960,902 1,013,224 156,989 $ 4,217,460 299,847 115,411 0.87 346,603 $ 1,756,961 498,100 979,363 982,495 541 Total Revenue $ 5,531,713 $ 5,453,922 $ 5,081,258 $ 4,365,245 $ 4,217,460 Adjusted EBITDA(2) Critical illness recovery hospital $ 342,427 $ 254,868 $ 243,015 $ 252,679 $ 224,609 Rehabilitation hospital 153,203 135,857 108,927 90,041 56,902 Outpatient rehabilitation 79,164 151,831 142,005 132,533 129,830 Concentra(4) 252,892 276,482 251,977 157,561 143,009 Other(4) (27,120) (108,130) (100,769) (94,822) (88,543) Total Adjusted EBITDA $ 800,566 $ 710,908 $ 645,155 $ 537,992 $ 465,807 BALANCE SHEET SNAPSHOT AT YEAR-END Cash and cash equivalents $ 577,061 $ 335,882 $ 175,178 $ 122,549 $ 99,029 Working capital (3) 155,634 298,712 287,338 315,423 191,268 Total assets (3) 7,655,399 7,340,288 5,964,265 5,127,166 4,920,626 Total debt 3,402,019 3,445,110 3,293,381 2,699,902 2,698,989 Stockholders’ equity 1,060,480 770,972 803,042 823,368 815,725 |
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