AHCO AdaptHealth Corporation

AdaptHealth Corp. (NASDAQ: AHCO) (“AdaptHealth” or the “Company”), a national leader in providing patient-centered, healthcare-at-home solutions including home medical equipment, medical supplies, and related services, announced today financial results for the first quarter ended March 31, 2024.

First Quarter Results and Highlights

All comparisons are to the quarter ended March 31, 2023.

• Net revenue was $792.5 million compared to $744.6 million, an increase of 6.4%.
• Net loss attributable to AdaptHealth Corp. was $2.1 million compared to net income of $15.7 million.
• Adjusted EBITDA was $158.5 million compared to $134.0 million, an increase of 18.3%.
• Cash flow from operations was $49.0 million, a decrease from $140.2 million, and Free Cash Flow was $(38.9) million, a decrease from $51.1 million, both decreases primarily driven by delayed payments resulting from the Change Healthcare data breach. Since the end of the first quarter, the delayed payments have been largely caught up.

Management Commentary

Richard Barasch, Chairman and Interim CEO of AdaptHealth, commented, “I am pleased to report that AdaptHealth had an excellent first quarter. Our Sleep and Respiratory product lines remained strong and our Diabetes product line is moving in the right direction. We delivered 6.2% non-acquired revenue growth and an 18.3% increase in Adjusted EBITDA driven by Adjusted EBITDA Margin of 20.0%.”

Mr. Barasch continued, “Despite the temporary dislocation caused by the Change Healthcare data breach, our expectations for Free Cash Flow for the first half and for the full year remain unchanged. We have continued to reduce our debt in excess of required payments and expect that we will be below 3x leverage in 2024. As I step away, I am proud of all that our team has accomplished during my tenure as CEO and I am quite confident that our progress will continue under Suzanne Foster’s leadership.”

Conference Call

Management will host a teleconference today, Tuesday, May 7, 2024, at 8:30 am ET to discuss the results and business activities with analysts and investors.

Interested parties may participate in the call by dialing:

• (800) 579-2543 (Domestic) or
• (785) 424-1789 (International)

When prompted, reference Conference ID: AHCO1Q24

Webcast registration: Click Here

Following the live call, a replay will be available for six months on the Company's website, www.adapthealth.com, under "Investor Relations."

About AdaptHealth Corp.

AdaptHealth is a national leader in providing patient-centered, healthcare-at-home solutions including home medical equipment (HME), medical supplies, and related services. The Company provides a full suite of medical products and solutions designed to help patients manage chronic conditions in the home, adapt to challenges in their activities of daily living, and thrive. Product and service offerings include (i) sleep therapy equipment, supplies, and related services (including CPAP and bi PAP services) to individuals suffering from obstructive sleep apnea, (ii) medical devices and supplies to patients for the treatment of diabetes (including continuous glucose monitors and insulin pumps), (iii) HME to patients discharged from acute care and other facilities, (iv) oxygen and related chronic therapy services in the home, and (v) other HME devices and supplies on behalf of chronically ill patients with wound care, urological, incontinence, ostomy and nutritional supply needs. The Company is proud to partner with an extensive and highly diversified network of referral sources, including acute care hospitals, sleep labs, pulmonologists, skilled nursing facilities, and clinics. AdaptHealth services beneficiaries of Medicare, Medicaid, and commercial insurance payors, reaching approximately 4.1 million patients annually in all 50 states through its network of approximately 670 locations in 47 states.

Forward-Looking Statements

This press release includes certain statements that are not historical facts but are forward-looking statements for purposes of the safe harbor provisions under the United States Private Securities Litigation Reform Act of 1995. Forward-looking statements generally are accompanied by words such as “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” “should,” “would,” “plan,” “predict,” “potential,” “seem,” “seek,” “future,” “outlook,” and similar expressions that predict or indicate future events or trends or that are not statements of historical matters. These forward-looking statements include, but are not limited to, statements regarding projections, estimates and forecasts of revenue and other financial and performance metrics and projections of market opportunity and expectations and the Company’s acquisition pipeline. These statements are based on various assumptions and on the current expectations of AdaptHealth management and are not predictions of actual performance. These forward-looking statements are provided for illustrative purposes only and are not intended to serve as, and must not be relied on, by any investor as, a guarantee, an assurance, a prediction or a definitive statement of fact or probability. Actual events and circumstances are difficult or impossible to predict and will differ from assumptions. Many actual events and circumstances are beyond the control of the Company.

These forward-looking statements are subject to a number of risks and uncertainties, including the outcome of judicial and administrative proceedings to which the Company may become a party or governmental investigations to which the Company may become subject that could interrupt or limit the Company’s operations, result in adverse judgments, settlements or fines and create negative publicity; changes in the Company’s customers’ preferences, prospects and the competitive conditions prevailing in the healthcare sector. A further description of such risks and uncertainties can be found in the Company’s filings with the Securities and Exchange Commission. If the risks materialize or assumptions prove incorrect, actual results could differ materially from the results implied by these forward-looking statements. There may be additional risks that the Company presently knows or that the Company currently believes are immaterial that could also cause actual results to differ from those contained in the forward-looking statements. In addition, forward-looking statements reflect the Company’s expectations, plans or forecasts of future events and views as of the date of this press release. The Company anticipates that subsequent events and developments will cause the Company’s assessments to change. However, while the Company may elect to update these forward-looking statements at some point in the future, the Company specifically disclaims any obligation to do so. These forward-looking statements should not be relied upon as representing the Company’s assessments as of any date subsequent to the date of this press release. Accordingly, undue reliance should not be placed upon the forward-looking statements.

Use of Non-GAAP Financial Information

The Company uses EBITDA, Adjusted EBITDA, Adjusted EBITDA Margin and Free Cash Flow, which are financial measures that are not in accordance with generally accepted accounting principles in the United States, or U.S. GAAP, to analyze its financial results and believes that they are useful to investors, as a supplement to U.S. GAAP measures. In addition, the Company’s ability to incur additional indebtedness and make investments under its existing credit agreement is governed, in part, by its ability to satisfy tests based on a variation of Adjusted EBITDA.

The Company believes Adjusted EBITDA and Adjusted EBITDA Margin are useful to investors in evaluating the Company’s financial performance. The Company uses Adjusted EBITDA as the profitability measure in its incentive compensation plans that have a profitability component and to evaluate acquisition opportunities, where it is most often used for purposes of contingent consideration arrangements.

EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin should not be considered as measures of financial performance under U.S. GAAP, and the items excluded from EBITDA and Adjusted EBITDA are significant components in understanding and assessing financial performance. Accordingly, these key business metrics have limitations as an analytical tool. They should not be considered as an alternative to net income or any other performance measures derived in accordance with U.S. GAAP or as an alternative to cash flows from operating activities as a measure of the Company’s liquidity.

The Company uses free cash flow, which is a financial measure that is not in accordance with U.S. GAAP, in its operational and financial decision-making and believes free cash flow is useful to investors because similar measures are frequently used by securities analysts, investors, ratings agencies and other interested parties to evaluate the Company's competitors and to measure the ability of companies to service their debt. The Company's presentation of free cash flow should not be construed as a measure of liquidity or discretionary cash available to the Company to fund its cash needs, including investing in the growth of its business and meeting its obligations.

Free cash flow should not be considered as a measure of financial performance under U.S. GAAP. Accordingly, this key business metric has limitations as an analytical tool. It should not be considered as an alternative to any performance measures derived in accordance with U.S. GAAP or as an alternative to cash flows from operating activities as a measure of AdaptHealth’s liquidity.

ADAPTHEALTH CORP.

 

Condensed Consolidated Balance Sheets (Unaudited)

 

(in thousands)

 

March 31, 2024

 

December 31, 2023

Assets

 

 

 

 

Current assets:

 

 

 

 

Cash

 

$

79,566

 

$

77,132

Accounts receivable

 

 

429,558

 

 

388,910

Inventory

 

 

108,585

 

 

113,642

Prepaid and other current assets

 

 

38,272

 

 

69,338

Total current assets

 

 

655,981

 

 

649,022

Equipment and other fixed assets, net

 

 

501,892

 

 

495,101

Operating lease right-of-use assets

 

 

111,232

 

 

110,465

Finance lease right-of-use assets

 

 

30,427

 

 

31,962

Goodwill

 

 

2,718,428

 

 

2,724,958

Identifiable intangible assets, net

 

 

124,591

 

 

130,160

Other assets

 

 

20,001

 

 

21,128

Deferred tax assets

 

 

341,141

 

 

345,854

Total Assets

 

$

4,503,693

 

$

4,508,650

Liabilities and Stockholders' Equity

 

 

 

 

Current liabilities:

 

 

 

 

Accounts payable and accrued expenses

 

$

340,234

 

$

391,994

Current portion of long-term debt

 

 

40,000

 

 

53,368

Current portion of operating lease obligations

 

 

31,530

 

 

29,270

Current portion of finance lease obligations

 

 

9,245

 

 

9,122

Contract liabilities

 

 

34,040

 

 

38,570

Warrant liability

 

 

11,474

 

 

4,021

Other liabilities

 

 

26,169

 

 

10,654

Total current liabilities

 

 

492,692

 

 

536,999

Long-term debt, less current portion

 

 

2,159,161

 

 

2,094,614

Operating lease obligations, less current portion

 

 

84,115

 

 

85,529

Finance lease obligations, less current portion

 

 

21,057

 

 

22,746

Other long-term liabilities

 

 

275,639

 

 

302,093

Total Liabilities

 

 

3,032,664

 

 

3,041,981

Total Stockholders' Equity

 

 

1,471,029

 

 

1,466,669

Total Liabilities and Stockholders' Equity

 

$

4,503,693

 

$

4,508,650

 

 

 

 

 

ADAPTHEALTH CORP.

 

Consolidated Statements of Operations (Unaudited)

 

 

Three Months Ended

(in thousands, except share and per share data)

March 31,

 

2024

 

2023

Net revenue

$

792,497

 

 

$

744,626

 

Costs and expenses:

 

 

 

Cost of net revenue

 

675,693

 

 

 

655,396

 

General and administrative expenses

 

48,378

 

 

 

47,521

 

Depreciation and amortization, excluding patient equipment depreciation

 

11,365

 

 

 

15,532

 

Goodwill impairment

 

6,530

 

 

 

—

 

Total costs and expenses

 

741,966

 

 

 

718,449

 

Operating income

 

50,531

 

 

 

26,177

 

Interest expense, net

 

32,472

 

 

 

31,955

 

Change in fair value of warrant liability

 

7,453

 

 

 

(21,914

)

Other loss, net

 

5,105

 

 

 

1,175

 

Income before income taxes

 

5,501

 

 

 

14,961

 

Income tax expense (benefit)

 

6,610

 

 

 

(1,714

)

Net (loss) income

 

(1,109

)

 

 

16,675

 

Income attributable to noncontrolling interest

 

1,025

 

 

 

968

 

Net (loss) income attributable to AdaptHealth Corp.

$

(2,134

)

 

$

15,707

 

 

 

 

 

Weighted average common shares outstanding - basic

 

132,914

 

 

 

134,525

 

Weighted average common shares outstanding - diluted

 

132,914

 

 

 

135,976

 

 

 

 

 

Basic net (loss) income per share

$

(0.02

)

 

$

0.11

 

Diluted net loss per share

$

(0.02

)

 

$

(0.06

)

 

ADAPTHEALTH CORP.

 

Consolidated Statements of Cash Flows (Unaudited)

 

 

 

Three Months Ended

March 31,

(in thousands)

 

2024

 

2023

Cash flows from operating activities:

 

 

 

 

Net (loss) income

 

$

(1,109

)

 

$

16,675

 

Adjustments to reconcile net (loss) income to net cash provided by operating activities:

 

 

 

 

Depreciation and amortization, including patient equipment depreciation

 

 

92,876

 

 

 

93,813

 

Goodwill impairment

 

 

6,530

 

 

 

—

 

Equity-based compensation

 

 

4,533

 

 

 

5,916

 

Change in fair value of warrant liability

 

 

7,453

 

 

 

(21,914

)

Reduction in the carrying amount of operating lease right-of-use assets

 

 

10,730

 

 

 

8,486

 

Reduction in the carrying amount of finance lease right-of-use assets

 

 

2,255

 

 

 

427

 

Deferred income tax expense (benefit)

 

 

4,389

 

 

 

(2,327

)

Change in fair value of interest rate swaps, net of reclassification adjustment

 

 

(367

)

 

 

(579

)

Amortization of deferred financing costs

 

 

1,309

 

 

 

1,309

 

Payment of contingent consideration from an acquisition

 

 

(1,850

)

 

 

—

 

Changes in operating assets and liabilities, net of effects from acquisitions:

 

 

 

 

Accounts receivable

 

 

(40,647

)

 

 

5,920

 

Inventory

 

 

5,056

 

 

 

(8,149

)

Prepaid and other assets

 

 

33,610

 

 

 

(4,503

)

Operating lease obligations

 

 

(10,653

)

 

 

(9,451

)

Operating liabilities

 

 

(65,080

)

 

 

54,625

 

Net cash provided by operating activities

 

 

49,035

 

 

 

140,248

 

Cash flows from investing activities:

 

 

 

 

Purchases of equipment and other fixed assets

 

 

(87,891

)

 

 

(89,120

)

Payments for business acquisitions, net of cash acquired

 

 

—

 

 

 

(447

)

Net cash used in investing activities

 

 

(87,891

)

 

 

(89,567

)

Cash flows from financing activities:

 

 

 

 

Proceeds from borrowings on lines of credit

 

 

75,000

 

 

 

50,000

 

Repayments on long-term debt and lines of credit

 

 

(25,000

)

 

 

(30,000

)

Repayments of finance lease obligations

 

 

(2,291

)

 

 

(981

)

Payments for shares purchased under share repurchase program

 

 

—

 

 

 

(9,224

)

Proceeds from the exercise of stock options

 

 

545

 

 

 

—

 

Proceeds received in connection with employee stock purchase plan

 

 

607

 

 

 

1,021

 

Payments relating to the Tax Receivable Agreement

 

 

(1,432

)

 

 

(3,202

)

Payments for tax withholdings from restricted stock vesting

 

 

(1,139

)

 

 

(2,492

)

Payments of contingent consideration and deferred purchase price from acquisitions

 

 

(5,000

)

 

 

(674

)

Net cash provided by financing activities

 

 

41,290

 

 

 

4,448

 

Net increase in cash

 

 

2,434

 

 

 

55,129

 

Cash at beginning of period

 

 

77,132

 

 

 

46,272

 

Cash at end of period

 

$

79,566

 

 

$

101,401

 

 

 

 

 

 

Non-GAAP Financial Measures

EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin

This press release presents AdaptHealth’s EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin for the three months ended March 31, 2024 and 2023.

AdaptHealth defines EBITDA as net income (loss) attributable to AdaptHealth Corp., plus net income (loss) attributable to noncontrolling interests, interest expense, net, income tax expense (benefit), and depreciation and amortization, including patient equipment depreciation.

AdaptHealth defines Adjusted EBITDA as EBITDA (as defined above), plus equity-based compensation expense, change in fair value of the warrant liability, goodwill impairment, litigation settlement expense, and certain other non-recurring items of expense or income.

AdaptHealth defines Adjusted EBITDA Margin as Adjusted EBITDA (as defined above) as a percentage of net revenue.

The following unaudited table presents the reconciliation of net (loss) income attributable to AdaptHealth Corp. to EBITDA and Adjusted EBITDA, and the reconciliation of net (loss) income attributable to AdaptHealth Corp. as a percentage of net revenue to Adjusted EBITDA Margin, for the three months ended March 31, 2024 and 2023:

 

Three Months Ended March 31,

 

2024

 

2023

(in thousands, except percentages)

Dollars

Revenue

Percentage

 

Dollars

Revenue

Percentage

Net (loss) income attributable to AdaptHealth Corp.

$

(2,134

)

(0.3

)%

 

$

15,707

 

2.1

%

Income attributable to noncontrolling interest

 

1,025

 

0.1

%

 

 

968

 

0.1

%

Interest expense, net

 

32,472

 

4.1

%

 

 

31,955

 

4.3

%

Income tax expense (benefit)

 

6,610

 

0.8

%

 

 

(1,714

)

(0.2

)%

Depreciation and amortization, including patient equipment depreciation

 

92,876

 

11.7

%

 

 

93,813

 

12.6

%

EBITDA

 

130,849

 

16.5

%

 

 

140,729

 

18.9

%

Equity-based compensation expense (a)

 

4,533

 

0.6

%

 

 

5,916

 

0.8

%

Change in fair value of warrant liability (b)

 

7,453

 

0.9

%

 

 

(21,914

)

(2.9

)%

Goodwill impairment (c)

 

6,530

 

0.8

%

 

 

—

 

—

%

Litigation settlement expense (d)

 

5,105

 

0.6

%

 

 

—

 

—

%

Other non-recurring expenses, net (e)

 

4,015

 

0.5

%

 

 

9,233

 

1.2

%

Adjusted EBITDA

$

158,485

 

20.0

%

 

$

133,964

 

18.0

%

Adjusted EBITDA Margin

 

20.0

%

 

 

18.0

%

(a)

Represents equity-based compensation expense for awards granted to employees and non-employee directors.

(b)

Represents a non-cash charge or gain for the change in the estimated fair value of the warrant liability.

(c)

Represents a non-cash goodwill impairment charge relating to an immaterial business disposal during 2024.

(d)

Represents a $4.2 million charge for the change in fair value of shares expected to be issued in connection with the settlement of a previously disclosed securities class action lawsuit, as well as an expense of $0.9 million to settle a shareholder derivative complaint. The proposed settlements remain subject to final court approval and other customary closing conditions.

(e)

The 2024 period consists of $1.2 million of expenses associated with litigation, $1.0 million of consulting expenses associated with systems implementation activities, a $0.7 million write-down of assets, and $1.1 million of other non-recurring expenses. The 2023 period consists of $7.1 million of expenses associated with litigation, $1.2 million of consulting expenses associated with systems implementation activities, and $0.9 million of other non-recurring expenses.

Free Cash Flow

This press release presents AdaptHealth’s Free Cash Flow for the three months ended March 31, 2024 and 2023.

AdaptHealth defines Free Cash Flow as net cash provided by operating activities less cash paid for purchases of equipment and other fixed assets.

The following unaudited table reconciles net cash provided by operating activities to the free cash flow measure for the three months ended March 31, 2024 and 2023:

 

 

Three months ended

(in thousands)

 

March 31,

 

 

2024

 

2023

Net cash provided by operating activities

 

$

49,035

 

 

$

140,248

 

Purchases of equipment and other fixed assets

 

 

(87,891

)

 

 

(89,120

)

Free cash flow

 

$

(38,856

)

 

$

51,128

 

 

View source version on businesswire.com: https://www.businesswire.com/news/home/20240507034319/en/

AdaptHealth Corp. Jason Clemens, CFA Chief Financial Officer IR@adapthealth.com