Welcome to HealthStream’s Second Quarter 2021 Earnings Conference Call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question-and-answer session. please be advised that today's conference is being recorded. [Operator instructions] I'd now like to hand the conference over to your speaker today Mollie Condra, Vice President, Investor Relations and Communications. Ms. Condra, you may begin.

Thank you and good morning. Thank you for joining us today to discuss our second quarter 2021 results. Also in the conference call with me today are Robert A. Frist Jr., CEO and Chairman of HealthStream; and Scotty Roberts, CFO and Senior Vice President. I'd also like to remind you that this conference call may contain forward-looking statements regarding future events and the future performance of HealthStream that involve risk and uncertainties that could cause the actual results to differ materially from those projected in the forward-looking statements. Information concerning these risks and other factors that could cause the results to differ materially from those forward-looking statements are contained in the company's filings with the SEC, including Forms 10-K, 10-Q and our earnings release. Additionally, we may reference measures such as adjusted EBITDA, which is a non-GAAP financial measure. A table providing supplemental information on adjusted EBITDA and reconciling to net income attributable to HealthStream is included in the earnings release that we issued yesterday and may refer to in this call. So with that in mind, at this time, I'll turn the call over to Bobby Frist.

Thank you, Mollie. Good morning, everyone and welcome to our second quarter 2021 earnings call. A lot to cover there, but I think first contact is important and I want to remind everybody that as the nation moves forward through the pandemic, it's clear that this long journey has grown bumpier in the recent rise of the Delta variant which is causing the 36% increase in the number of hospitalizations. According to the CDC, nearly half of adults in the US have been fully vaccinated and as that number rises we at HealthStream remain hopeful that progress towards beating the pandemic will continue, but we must keep in mind that as our customers are customers are one on the front lines responding to this new spike in the cases. We started today's call, I can tell you that our commitment to helping them improve the quality of healthcare has never been stronger. We were trying to align our interest in energies with our hospital customers and our continuing customers. I'll comment on branch performance for the quarter and the first half of the year. We remain laser focused on growing the company, which is why we were able to deliver another strong quarter with topline revenues increasing 7% and adjusted EBITDA increasing 20% over the same period last year to a record $14.5 million and based on those results, we have updated our financial guidance. We wanted to hit that early in the conference call. We now expect revenue for the full-year 2021 to be in the range of $253 million to $257 million. For context the midpoint of the new range is $5 million higher than the midpoint of the previous range. I believe one of the most remarkable things about this guidance is that we are projecting revenue…

Okay. Thanks Bobby and good morning, everyone. I'd like to begin my discussion with the highlight of the quarter, which is our achievement of a new record adjusted EBITDA of $14.5 million, which is after setting the previous record at $13.6 million during the first quarter. Having set back to back records of adjusted EBITDA, or raising the full year guidance to now range between $48 million and $50 million, which is up from the previous range of $40 million to $44 million. Before I go over that data guidance in more detail though, let me first speak to the results for the quarter. Revenues were $64.8 million, which is up 7% over last year and included balanced growth within both segments. Revenues for 2021 were impacted by $1.2 million reduction associated with deferred revenue write-downs, which is primarily from acquisitions that we completed during the fourth quarter of last year. Operating income was $3.4 million were down 20%, net income was $2.4 million or down 29% and EPS was $0.08 per diluted share down from $0.11 per deleted share in the prior year. While these GAAP based financial measures experienced declines, our non-GAAP performance measure adjusted EBITDA improved a $14.5 million, which was up 20%. Both of our business segments are contributing to the revenue growth over the prior year. Workforce Solutions revenues were $52.2 million and were up 6.7% and revenues from Provider Solutions were $12.7 million and were up 8.5%. We overcame a nearly $10 million headwind from the Legacy Resuscitation business during the quarter and delivered year-over-year growth of 7%. Revenues from recent acquisitions and organic growth from both segments contributed to this year-over-year improvement. Workforce revenues included $1 million of Legacy Resuscitation in the quarter and also benefited from some non-recurring software license and professional…

Thanks Scotty. What I'd like to do is talk a little bit about our plan investments and kind of flossing approach to building the scheduling and capacity management business, which is right now the result of three recent acquisitions and so a little lesson from history, if we look back and think about what we've been able to do creating the VerityStream application suite through four acquisitions over eight years and if you think back six years ago, we took these for VerityStream, we took these four standalone companies, we combined them into a new business group. We essentially created a new platform of fifth application sets to migrate those customers to and it's a multiyear journey and it's a story of time and investment that's required to take these wholly separate assets and involve them something that is market-leading and more than the sum of their parts. And so we have a very successful playbook for doing that and if you look at the five-year trajectory of VerityStream and we're really excited to see it emerging out of that kind of storming and forming phase and into a market-leading phase and of course we hope to repeat that with our capacity management and scheduling business. We've recently acquired three businesses really during the pandemic, three of them just I'd say 12 months and we've appointed a leadership team. They've begun identifying where they want to invest. So we didn’t acquire to cut, we acquired to innovate and invest and so we're fortunate to have a team at VerityStream that has created a playbook a detailed playbook on how to make this work and we think we can do it now with our scheduling capacity management business more quickly. But it is important to remind everybody that over the journey,…

Thank you, sir. The question-and-answer session will begin at this time.[Operator Instructions]. Your first question comes from the line of Richard Close with Canaccord Genuity.

Yeah. Thanks for the time and taking the question. Congratulations on the results. Just curious on the hiring, investing in hiring and you guys discussing turnover as well little bit higher than we're expecting in the first half. Can you talk a little bit about the hiring environment? Obviously specifically here in Nashville, I assume you guys are looking for technology people, it seems like a pretty competitive marketplace, a lot of tech moving into the city here, with Amazon and eventually Oracle and, and whatnot, but just curious in terms of, if that's increasing the wages that you guys would typically bring on tech people here in Nashville?

Sure, sure. Glad to comment on that. And so you're right to observe that we're subject to the same macro forces that everyone seems to be discussing. And what I think is happening and we look at our own workforces, everyone is kind of now right in their head up after 16 months of this new work style and some just want a change for the sake of change. And, and we have people saying, we love HealthStream, but we want to try something new. And, we've had a lot of people leave and come back over the last decade. So we're, we're encouraging people to find places that they really like. And so we are seeing an increased turnover rate that -- that said, we're the benefactor, because I think we have this fruitful culture that people read about and want to be a part of. And so we've been able to also win hearts and minds of lots of new employees. That's kind of the net additions haven't been as high because the turnover. And so it's just an interesting dynamic. We're getting all these new, highly energetic employees coming into the company while some of our employees are also seeking new and exciting experiences for themselves. So we have been able to net add meaning more, obviously more people coming in and going out. But it has been a little bit more tumultuous than, than in past really decades. And we think it's just a natural outcropping of, of kind of the nature of the last 16 months that people want to look at new and fresh horizons. That said, we think we have this wonderful, attractive culture that people come through now. And the cost sample we were talking about this what's really fascinating is right…

Okay. And just a couple of questions maybe for Scotty with respect to the comment on the $6 million travel and trade show expense in the pre-COVID world and you're talking about second half. Some of that's going to come back. Is there any way to ballpark that? I mean, are you going to be at half of that $6 million or?

Also just, I don't know about the trade shows yet, but we were talking about trap and we've budgeted essentially a very incremental return. So for example, I think we have about 250,000 in the third quarter and about $0.50 million in the fourth quarter. So you can see there kind of a growing run rate, we could be way off, we could convene all of our employees in November and then that could cost more. But -- but you see going from kind of nearly zero and zero or the first half, I think it was sub a hundred thousand, the whole first half and travel alone returning to now kind of our targeted budget would be around [indiscernible] 250 in the third quarter, 500 in the fourth quarter. So, again those are kind of budget placeholders and we don't know exactly what the new normal is. And eventually I expect travel budget to exceed where they were because the new mobile workforce, we may require employees to commute in, to one of these resource center slash headquarters to have strategic planning retreats and that could be more costly. And --and, but hopefully the offsetting a reduced rent we'll, we'll help pay for that. So that's what we mean by kind of scaling it up in the second half. And -- and again, those are just kind of placeholder numbers, but we wanted to give you, I wanted to give you a sense for where we're headed or what we're thinking. And --and of course, we'll, we'll tell you if we end up spending more or less than that, but-- but that's kind of where our heads are right now.

Okay. That's helpful. And then Scotty, I think mentioned some sort of shift in expenses up into cost of services. If, if you guys could just go over that again. And was that something that happened in the second quarter? I'm just trying to understand why the gross margin was a little bit higher, 66ish. If I'm not mistaken in the first quarter and then take down to the 65, obviously 65 is-- is great and all that, but was it that shift in expenses that, you know, was the primary contributor to that?

I'll, let you know now that on the head, Richard, that -- that's kind of exactly what happened. There's a kind of allocation of expenses from G&A to cost of revenues.

And what specifically was that?

[Indiscernible]

Software. Okay.

Software, isn't it? I think we kind of covered it as production environment related, not for licenses.

Okay. That's helpful. That's helpful. Thank you. I'll jump back in the queue.

Your next question comes from Ryan Daniels with William Blair.

Yeah. Good morning. This is Jared Haase on for Ryan. Thanks for taking my questions. I'm just wondering to stick with this theme of headwinds on the hiring and retaining front. And I imagine specifically that that's a similar theme within your client base in terms of hospitals having kind of the same issue around attracting or retaining talent as well. So just curious if there've been any changes from HealthStreams perspective, either you know, thinking from a product development side or maybe on the marketing side with how you message your value proposition to hospitals that, you know, trying to help them deal with, you know, hiring issues or maybe provider burnout, some of those themes?

Yeah, I think it's a great point. I mean, we are positioned as being supportive of developing and retaining and the, the workforce. And so we, we believe and try to demonstrate that our products and services result in higher engagement employees and that we also believe fundamentally that offering health systems that offer their employees kind of career development and new skills and capabilities and assessment tools will be favored employers. So some of them are seeing that light and beginning to invest in and invest back in their employees through their develop continued development. We also see opportunities maybe around things that are focused on the psychological wellbeing and have some products in that category that are kind of newly offered related to, to helping employers. The hospitals and health systems and home health and a continuum of care providers that we have in our customer base build their relationship with their employees through their continued development. And so we, we do use that as a form of positioning and we believe that our products have those impacts.

Got it. Yeah, that makes sense. And, and I think I just want to another quick follow-up in Scotty, I think you mentioned in your prepared remarks you know, kind of calling out an improvement both in, in bookings, as well as renewals. I'm curious, would you kind of characterize that as sort of market-based girl sort of along that theme of hospitals looking for solutions like this or do you feel like that's more indicative of maybe some competitive takeaways or you know, maybe some big, you know, a more competitive solution on the marketplace, just given all the investments that you've made over the past couple of years?

I think it's probably all the above. I mean, it's you know, I think we did experience some growth over last year, but last year you got to keep in mind was, was in the beginning of COVID the second quarter of last year. So the comparisons are, are difficult to interpret because of that, you know, COVID factor. But we had some nice wins in the quarterly announced that, you know, in our press release a nice American red cross win with prime healthcare. So I think we're still seeing some, some good wins across the board, but, you know, things, we were looking at comparisons or still kind of getting back into the pre COVID levels of sales production.

Okay. Thanks. That makes sense. I'll hop back in the queue.

Your next question comes from the line of Matt Hewitt with Craig-Hallum Capital.

Good morning and congratulations on the quarter a few different topics. I got a couple of questions on first up regarding the guidance that the revenue guidance for the year, I'm looking at the first half of the year, your guidance, essentially at the high end implies that it's basically flat second half versus first half, so not seeing a lot of lift. Is that a function of where we're at with the pandemic and the Delta variant and everything that's going on and maybe hospitals not being able to hire at the pace? But as we look at next year, I would assume that hospitals are going to need to start hiring again, and then hopefully are able to find the employees so that in its self should drive some incremental growth. Is that a fair way to think about it?

No matter I would probably say, you know, one of the factors that's going to result in some of the levelling is just those declines that we discussed. There's the legacy resuscitation. That was $2.8 million. We know pretty confidently. That's not going to be anywhere near that. It's going to be almost zero in the second half of the year. And then we also have some, non-recurring what we call one-time revenues from the scheduling and capacity management business that we just don't have enough history of kind of projecting some of those one-time software sales, which are almost immediate revenue recognition as they're delivered to the customer. So that's some of the, kind of the, the change in some of our second half outlook. I think, you know, some of the factors that you mentioned more broadly speaking about customer, you know, turnover and some other challenges I don't know if that's factored into kind of the way we're projecting our sales production necessarily, but it could be something that either could be a detriment or a benefit to us, depending on which direction and challenges they face.

Okay. Fair enough. And then Jane, it sounds like you had a really good quarter with the number of new additions. I'm just curious if you could update us on the pipeline there. Obviously that's been years in development and seeing that starting to ramp as is pretty exciting. So any update on there on Jane that is?

I don't know if you'd want to take that question?

Matt. I don't know if Bobby is on, but I think, just --just the, kind of the story there as we continue to see, you know about one sale a week that has been our objective you know, deal sizes vary, you know, we had a nice win and Q1 wouldn't say that we had a repeat of that in Q2, but we continued to gain traction. We'd like to see more adoption and penetration of it, but it's one of those products that I would put in that discretionary bucket. And so I mentioned that know, we still see delayed purchasing decisions from customers, kind of in that type of category. It's not mandatory, it's not required. And so we still see some hesitancy in some of the buying decisions there, and I put that product in that category, but even with that, as a challenge, we're still able to accomplish our objective of one sale a week.

Okay. That's great and then one last one for me, as you were talking about some of the incremental expenses coming back at you, you talked about the travel given the new workforce environment. But I'm curious as you start to think about conferences historically HealthStream has held a pretty big user event there in Nashville, maybe not so much this year, maybe it will, but more likely in fiscal '22, if we get some somewhat back to normal, would, would you expect that in what quarter would that would that fall in? And I only asked because it is typically a larger expense that kind of stands out?

Thank you, Bobby and tackle. Somehow I got booted out, but that conference, we actually stopped having pre pre-pandemic and went to smaller, more regionalized conferences or meetings of different scale. And so and spread them out more over the year and across our different business lines and business solution groups. So we, we have, we abandoned that singular large conference model, even pre pandemic, and don't currently have any plans to return to it. And it built into our marketing budgets. I guess I'd call smaller regional conferences and, and, and what we call a user group meetings. So we kind of strategically shifted several years ago and don't plan to return to the single large conference model. Regard to other costs I wanted to kind of update my thinking on the cost of turnover and new positions, because I don't want to understate it. I characterize it as slight increases in pay. I guess I'd changed that to moderate and want to think about it in certain roles different forms of compensation than, than we've had. So for example, in our sales organizations we're finding that other people are paying higher basis. We don't think that they're going to make more money because we have strong commission plans, but we have had the purchase in sales reporting higher base salaries than we pay at HealthStream. Again our sales teams typically delivered great sales results and their total compensation based on variables, on commissions has always been really strong. So we actually doubt they will make more money going to new roles but have heard reports of that. And then I'd just say, I'd upgrade from slight to moderate increased pressure on hiring everywhere else on cost and it is true that we did discuss this over the last 100 hires. We have largely been able to fill most of those roles within a similar band of costs as we had previously had in staff and so that statement remains true, but I would upgrade my pressure on pay to go from slight to moderate and I would say that in some areas we're experiencing maybe a changing nature of compensation may be less variable comp and more base where the market is headed in sales structure. So we'll see how that plays out and we always think again our team they have been well rewarded in total compensation based on those strong commission earnings, but we'll see where the market takes us on that. So hope that helps this contextualize the questions around labor and labor force because I don’t want to understate it. There's a lot more turmoil in the market with people just generally getting up and looking for new experiences. We think HealthStream is going to be a net benefit factor, benefit from those trends but still it's hard to ignore the amount of people they are looking for kind of new trajectory in life.

Your next question comes from the line of Steve Pointer with Cantor Fitzgerald.

Hi. Good morning, just a housekeeping question, you talked about $2 million of one-time software license that was in the first half correct? Can you give us what the impact was in the quarter?

Steve, the $2 million reference is combination of software licenses and some larger professional services projects that had milestones completed in the first half. Looking at the split between Q1 and Q2, it's pretty evenly split to almost a million in each quarter.

[Operator instructions] Your next question comes from the line of Vince Colicchio with Barrington Research.

Yeah Bobby are you seeing any signs or pockets of the caution on spending due to the new variant or is it too early to see that?

It's too early we've heard reports of course of the spikes and we heard that they're getting busier. What I would say is the larger health systems and hospital systems, universities, they've learnt to operate in the crisis mode and have learned to resource better and so it's not like the first few ways where all surgeries were shut down. So while there is disruption with a surge or a spike I don't think it's the same as was round one and two when there were surges that through people out of operating mode and shutting down elective surgery. So while we have plainly see some deferred purchasing, a little less focus on elective things, products from vendors. I'd just say in general, people are trying to define the new norm or the new norm includes handling surges in patient cases related to COVID. That doesn't mean there won't be pockets of the country that are overwhelmed by it. I do think that will happen. Some are not as prepared as others to handle it and so we will see some that will have to shift their full attention, but broadly I'd say particularly the bigger health system, the university health systems are much more prepared to handle spikes in COVID cases.

And a couple of questions on Jane. You had said I think that Jane is largely used for nursing. Is it solely used for nursing, that's one clarification and then where does some of the other opportunity you talked about with Jane?

Well, I think you just hit it. It is largely focused on nursing skilled, nursing careers, different departments of nursing help them transition from one department to another. There are other assessments and tools built into Jane, but expanding and to cover other types of positions I'll say home health aides would be kind of expansion opportunity. But in addition expanding to handle more of the other functionality that could be important versus reminding them of their schedule to do so many things we can do with Jane and the technology we've built around it as a kind of an open platform, open framework that we can extend that adding new types of assessments in new categories for new types of employees would be more of immediate ideas for expanding Jane capability. It is largely and most appropriate for nursing workforce, which has represented about 40% plus of the subscriptions in our HealthStream network.

Okay. That's my last question. Nice quarter.

Thank you.

There are no further questions at this time. I'd now like to turn the conference back to management.

Thank you. Look forward to reporting these operational updates in the near future and thanks to our employees for delivering a great first half result.

This concludes today's conference call. Thank you for participating. You may now disconnect.