Earnings Labs

U.S. Physical Therapy, Inc. (USPH)

Q4 2012 Earnings Call· Thu, Mar 7, 2013

$71.11

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by, and welcome to the U.S. Physical Therapy Fourth Quarter and Year-End 2012 Earnings Conference Call. All lines have been placed on mute to prevent any background noise. After the speakers’ remarks, there will be a question-and-answer session. (Operator Instructions) Thank you. I will now turn the call over to Mr. Chris Reading, Chief Executive Officer. Please go ahead, sir.

Christopher J. Reading

Management

Thank you. Good morning, everyone. Welcome to U.S. Physical Therapy’s fourth quarter and year-end 2012 earnings call. With me here on the office this morning will include, Larry McAfee, our Executive Vice President and Chief Financial Officer; Glenn McDowell, our Chief Operating Officer; Rich Binstein, our Vice President and General Counsel; Jon Bates, our Vice President and Controller. Before we begin today’s call, where we have a lot of material to recover. We first need to review with you a brief disclosure statement. Jon, will you do those honors?

Jon Bates

Management

Thanks, Chris. This presentation contains forward-looking statements, which involve certain risks and uncertainties. And these forward-looking statements are based on the company’s current views and assumptions and the company’s actual results can vary materially from those anticipated. Please see the company’s filings with the Securities and Exchange Commission for more information.

Christopher J. Reading

Management

Thanks, Jon. Okay, we’ll start today by walking through a few highlights from what was another good year. In fact, the sixth straight year, very solid earnings growth, in fact, record growth from operations. Some highlights from the year in the quarter. For the year, we produced same-store revenue growth of 4.4%, which was muted somewhat near years end by the affects of Hurricane Sandy. Despite that, we finished the year as well as the quarter in solid steady fashion. Our net revenue growth for the year increased 6.4% and our corporate cost as a percent of revenue declined just under 10% for the full year, for the first time in the company’s history. 2012 also marked an expansion in our development initiatives to include a program that help our largest partners tuck-in, existing, local and regional practices to further accelerate their growth. This was successful. And then in the second half of the year, we closed on seven of these tuck-ins, following the larger acquisition of a very nice partnership announced earlier in that year. As we begin to walk through our performance for 2012 along with our plans for 2013, I thought it important to create some additional perspective and briefly reflect on a few relevant items that will relate contextually to the path that we will take for 2013 as we work through some of these recently announced federal payer and other challenges that face not us– not just us, but the entire industry. We have detailed a thorough and thoughtful plan to navigate this path as we’ve done repeatedly over these past 9 to 10 years. Over this period, we have successfully worked through previous federal payer rule and reimbursement changes and challenges. We have remodeled an earlier company-owned store initiative, which we needed to significantly…

Lawrance W. McAfee

Management

Thanks, Chris. I’ll begin with a review of the quarter. Net revenue increased 3.3% from $60.7 million to $62.7 million, primarily due to an increase in patient visits of 2.9%. The average net rate for a visit was $106.37 as compared to $105.09 in the year earlier quarter. Total clinic operating cost were 77.5% of revenue in the fourth quarter 2012 versus 75.6% in the 2011 period. The increase was primarily attributable to new clinics opened or acquired. Provision for doubtful accounts was 1.9% versus 2%. Corporate office costs were 9.8% of the revenues versus 11.7% a year earlier. Operating income for the fourth quarter of 2012 was $7.9 million. Net income was $4,043,000 million, adjusted earnings per share were $0.34 in the recent quarter, as compared to $0.29 in the fourth quarter of 2011. The $0.34 in EPS for the quarter was better than the consensus estimate, despite an estimated $0.02 hit we took from Hurricane Sandy. Same-store revenue visits and the average net rate per visit were flat for the period. Visits would have been higher if it were not for Hurricane Sandy, which impacted more than 50 of the company’s clinics. I’ll now review the full year; net revenue increased 6.4% to $252.1 million due to an increase in patient visits of 7%. The average net revenue per visit for the year was $105.57 as compared to $104.72 in 2011. The increase in net revenue was partially offset by a decrease in other revenues of $2.8 million due to a reduction in revenue from physician services. Total clinic operating costs were 75.2% of net revenue in 2012, as compared to 74.4%. The increase was due to increased costs related to the clinics acquired. The provision for doubtful accounts was 1.9% for the year versus 1.6% in 2011.…

Christopher J. Reading

Management

Okay. That’s a lot of a material. I know we will have questions. So operator, why don’t you go ahead and open up the line and we’ll be happy to answer any and all questions.

Operator

Operator

(Operator Instruction) Your first comes from the line of Larry Solow of CJS Securities.

Christopher J. Reading

Management

Hi, Larry. Lawrence Solow – CJS Securities: Hey, guys. Good morning. Anyway you could ballpark the impact of Sandy on visits; quantify it anyway? I know it’s probably difficult, but…

Christopher J. Reading

Management

Yeah, I mean I know we looked at it. We don’t have them here in the room.

Lawrance W. McAfee

Management

We have been tracked it. We don’t have it with us. We did and because we have business discontinuance some insurance, we knew the impact would be – what is our deductible and that’s equivalent to two steps of earnings. Lawrence Solow – CJS Securities: Okay. I noticed that your costs, particularly your SG&A, went up a good amount sequentially and as a percentage of revenue year-over-year. Anything in there non-recurring, or is it just anything that should be worried about there?

Christopher J. Reading

Management

Our new clinic openings were kind of tilted towards the back side of the year. I think Larry, as he outlined in the release, a lot of that was due to the new and acquired facilities that were in just, part of the year. So I don’t think there is anything that’s non-recurring in that group though there.

Lawrance W. McAfee

Management

When you say SG&A, Larry, you’re talk about salaries related? Lawrence Solow – CJS Securities: Yeah, that’s what I meant, exactly.

Lawrance W. McAfee

Management

I mean we had a significant acquisition in July of 2011, is that right? Lawrence Solow – CJS Securities: Right.

Lawrance W. McAfee

Management

That only had what six, five months ending versus 12. So that would have made a difference.

Christopher J. Reading

Management

And then we had another deal in late in the spring.

Lawrance W. McAfee

Management

We have a deal in May and we have clinic openings for more – we have more clinic openings in the second half of the year than the first.

Christopher J. Reading

Management

That’s correct. Lawrence Solow – CJS Securities: Definitely, that’s some temporary excuse there I guess, essentially. And then just last question, I know you guys are not providing guidance now. Two parts, do you plan to inevitably provide guidance? And then the second part is you sort of outlined the MPPR of I think $0.13 to $0.18 and then the additional $0.04 on the further costs from the sequestration. I assume maybe you can’t give me a number, but that those $0.18 and $0.14 are sort of maths targets and hopefully you can offset some of that with your initiatives?

Lawrance W. McAfee

Management

Well, I mean we have a number of initiatives, but the full impact of those combined things $0.22. Lawrence Solow – CJS Securities: Right.

Lawrance W. McAfee

Management

And as to guidance, the reason we didn’t get guidance now as frankly, there wasn’t enough clarity. We came up with some figures, but it would have been such wide range. We didn’t think it would be relevant to the investors. So we’re going to give guidance. We wanted to do with accuracy and hit the number. So we deferred even at this time. We may give it later just in terms on where we are. Lawrence Solow – CJS Securities: And is that wide range driven by the impact or some offsetting impact to this $0.22, or is it wide or is it relate to the weather in Q1, both?

Lawrance W. McAfee

Management

Well, the weather – I don’t have February financials yet, but… Lawrence Solow – CJS Securities: Okay.

Lawrance W. McAfee

Management

The weather will continue to hurt us, so we all know – we know what the impact was in January was significant also in February, but we don’t have the numbers yet. The other thing is due to all the action items we’re taking or just beginning or in midstream… Lawrence Solow – CJS Securities: Okay.

Lawrance W. McAfee

Management

And it would be premature to try to quantify what the net benefit is going to be. Lawrence Solow – CJS Securities: Gotcha. Okay, fair enough. Thanks, guys.

Operator

Operator

(Operator Instructions) Your next question comes from the line of Brooks O’Neil of Dougherty & Company.

Christopher J. Reading

Management

Hi, Brooks. Brooks O’Neil – Dougherty & Company: Good morning. I was kind of hoping that you might be able to walk us through sort of the modeling impact of the Medicare cuts. I’m just trying to think it through obviously, Medicare is only 20% of your procedures. Help me think about how you came up with this $0.18. I’m not questioning it. I’m just trying to understand.

Lawrance W. McAfee

Management

Yeah, when I initially came out, we ran a model and then also the APDA has a model and, in fact, we put the same assumptions and units in there that their figures and there’s came out almost exactly the same. The impact to us was about an 8% to 10% reduction and our average net rate for Medicare, which is about eight bucks. So and then we took our Medicare visits times the 8 bucks and that’s how you come up with the dollar impact.

Christopher J. Reading

Management

Yeah, it’s actually, I think it layers as well. I think it’s actually a little bit more than eight bucks. When we look at our Medicare reimbursements to begin with we were about $95 of visits. So depending upon the unit selections somewhere in that 8% to 10% range versus in that 8% to 9.50% range, and then on top of that, which just mathematically as we back through our Medicare visits and the real impact on that we end up in $0.18 figure and then the sequester had another 2%. And then as Larry mentioned, as I discussed in this release, we’ve done a lot of things to get through this. Those are revenue impacts. We have to do other things to offset that. Runway is just short in terms of visibility from when these things happened, what we’re doing and we just need a little bit more time.

Lawrance W. McAfee

Management

Sure.

Christopher J. Reading

Management

To get these things in place. Brooks O’Neil – Dougherty & Company: I totally understand that, I think most people do. I think that I recall that historically, Larry said you guys don’t have a pipeline of potential acquisitions. But I sense that you’re in somewhat active pursuit of opportunities all the time. Could you just characterize in a broad general sense? I mean I sort of sense acquisitions could be one way you could begin to offset some of the impact of the cuts. Would it be fair to assume that it’s likely you’re going to try to be more active this year?

Christopher J. Reading

Management

Yeah. So in terms of our growth is kind of a path response on the whole pipeline issue because we don’t announce, certainly people were talking to and we don’t give an estimate ahead of time even after we signed a letter of intent with somebody in terms of a deal until it’s closed. Brooks O’Neil – Dougherty & Company: Yeah.

Christopher J. Reading

Management

We’ve been very active this past year in the market. We’ve had good success and having some very good discussions. We added to our team another seasoned person who will focus his entire day, week, and month, day-in, day-out on prospecting and finding new deals and we expect to be very active as – we expect to be active this year in doing our kinds of deals, good people that want to stick around that have the right kind of values and perspective on the business. And so, we’ll continue to deploy cash in a disciplined way with people that we like and are also interested. Brooks O’Neil – Dougherty & Company: Sure.

Lawrance W. McAfee

Management

The reason we don’t refer to it as a pipeline is, because it’s not groups that we’re contracted with to do the deal yet. Brooks O’Neil – Dougherty & Company: Sure. I understand that and I think it’s a good way to think about it. As I think about the offsets beyond building up the clinic groups, it strikes me that probably it will be a combination of efforts to drive revenue or patient visits higher, combined possibly with some efforts to trim expenses where you think you can do that. Is that a fair way to think about what you’re going to try to do this year?

Christopher J. Reading

Management

Yeah. There are a number of things. So one of those is to improve our efficiencies which our partners understand we have to do. The other is to continue to drive through a variety of different ways, new programs, some of which we discussed; it’s high revenue and more volumes, just to working one of those initiatives and one of the other being the fairly significant expansion of our sales team with these additional part-time folks. We’ve got about 55 people in training right now across our company in typically in facilities that we have and covered with before. So those things combined with some other things that we’re working on, we hope to have an impact. Brooks O’Neil – Dougherty & Company: That’s good. And then pretty clearly, I guess I’m assuming that it’s possible to look at the facilities in the fourth quarter that were impacted by Sandy, and those that weren’t, and kind of assess how your business was in the markets that weren’t really affected, compared to the markets where it was and that may not be the only variable, but…?

Christopher J. Reading

Management

Yeah. The business was fine in the fourth quarter. I mean, we had a very strong fourth quarter going late into the year. And the only impact really for us was Sandy.

Lawrance W. McAfee

Management

Yeah. Brooks O’Neil – Dougherty & Company: Yeah. And then in the first quarter with the weather and the flu, that almost certainly is much more broadly disbursed around the United States, obviously not many snowstorms in the warm-weather areas, but is that a fair way to think about it, that it’s pretty much across the United States?

Christopher J. Reading

Management

Yeah, it’s pretty board. Flu was everywhere and we even had storms in North Texas that were – in Oklahoma that was significant this year. So it’s not been a kind winter season. But we’re going to be out of it soon, and we’re doing everything that we can. And the team did a great job driving new patients, new referrals into the facility. In fact, we were on plan both January and February, and things are picking up, so. Brooks O’Neil – Dougherty & Company: That’s good. Let me just ask one last question. I’m curious your philosophy in thinking about raising the dividend at this point. Obviously, I’m guessing it’s a message that you think the long-term prospects for the business are good, but can you just tell us what you and the Board thought about as you thought about raising the dividend right now?

Lawrance W. McAfee

Management

Yeah, well, since we initiated the dividend, we set up along. Our plan was to business permitting that continue to increase it. Our free cash flow has been exceptional, even after paying a special dividend in the fourth quarter, $0.40 of share. We’ve reduced our debt very, very quickly after that thus far in the first quarter. So we’re in a great place. Balance sheet was – we had ability to not only pay a dividend, but to grow internally and externally and when it’s opportunistic to even continue to buy in shares. Brooks O’Neil – Dougherty & Company: That’s great. Thanks a lot. I appreciate all the color.

Christopher J. Reading

Management

Thanks Brooks.

Operator

Operator

Your next question comes from the line of Mike Petusky of Noble Financial.

Christopher J. Reading

Management

Hey, Mike. Michael Petusky – Noble Financial Capital Markets: Good morning guys. I guess a few questions somewhat related to a couple of the questions Brooks was asking. On the M&A front, I would assume with kind of the double hit the MPPR and then the sequestration hit, hip up, obviously, as much as it impacts you guys, it’s got to impact smaller operators even more. Have you guys noticed more calls coming in, unsolicited kind of looking for an exit strategy? Have you guys noticed anything in terms of that at this point?

Christopher J. Reading

Management

Yeah, I don’t know that I can relate it directly to MPPR. I think quite honestly, some groups are still trying to digest what the impact is and what it means to them. We’ve seen an increase in activity, I’d say over the last six or nine months with usually calls from smaller groups who are looking for some shelter. The bigger groups, the guys that we’re talking to, we usually are very well positioned until they look at some of these headwinds and challenges, often times setting what we do as a potential opportunity. The question often is, whether they want to go alone or they want to kind of combine forces. And so, we’ve talked to some good people and we’re going to continue to do these tuck-ins into our stronger partnerships, and we’ll continue to grow organically. And you’re right, these challenges are affecting everybody. And some groups have less resources to be able to deal with it than others. We’re fortunate to have strong resources and a very good balance sheet. Michael Petusky – Noble Financial Capital Markets: Okay. I would assume I know the answer to this, but I’m going to ask it anyway. Does this in anyway, these challenges this year in terms of some of what you’re facing out of Washington. Does that change in any way your thinking about de novos? You guys have always been pretty consistent over the years in how you think about that, but does any of this change that?

Christopher J. Reading

Management

It changes it very suddenly in this way. We’re going to continue to do, I think that we’re going to try to do as many de novos as we can, that we can do predictably. We’ve shifted some resources out of going into brand new markets where we’re going to put a single dot with a brand new unknown partner to a great extent towards further developing our existing partner network through the addition of satellites. So I think what you’ll see in this year and we continue to take the temperature of what we need to do to make adjustments. But you’ll see more satellites, which are very predictable for us in terms of their performance, maybe less brand new partners and more resources shifted between the satellite expansion and the acquisitions. And so we’re moving some things around. The organic expansion that we’ve had over the last few years, much of that not all, but a lot of it, a big chunk has come as a result of our acquired partnerships, who have robust teams that are very strong and we’re working with along with our seasoned organic partners to continue to grow organically within all of those partnership. So I think as we acquire more and do more deals, you’ll see that organic flow continue to be very steady. Michael Petusky – Noble Financial Capital Markets: Okay, great. That was great color, and I’m glad I asked the question. In terms of your commentary around sales reps. And I didn’t catch it if you said this, how many sales reps do you guys have now?

Lawrance W. McAfee

Management

Well, we currently have 75 sales reps covering 306 locations. Michael Petusky – Noble Financial Capital Markets: And did I hear you right saying that there’s 55 in training?

Lawrance W. McAfee

Management

That is separate from – separately 75 sales reps that we have are traditional full time and part time sales reps that are trained sales reps. The 55 number that Chris was talking about are employees that we have working in the clinic either in our business office or as athletic trainers and others that we are training to assist in sales and marketing, that have a finite group of docs that they have relationships with that then can go out and continue to benefit. Michael Petusky – Noble Financial Capital Markets: I actually should think of those folks as augmenting or assisting the 75 that you traditionally have had in that ballpark, right or no?

Christopher J. Reading

Management

Correct, I would not add that to the 75 there assisting in a sales and marketing effort.

Christopher J. Reading

Management

Yeah. But Mike, just to be clear, they don’t always exist in a facility where we have a full turnaround. So when we say they are assisting, they’re assisting the company and broadening our sales efforts. They’re not necessarily by degree a trained sales person. We are giving them the training that they need to be able to go out and call on a focused group. But it is broadening our sales effort across a greater number of facilities. Michael Petusky – Noble Financial Capital Markets: Yeah. So if my takeaway was you guys are making a material effort to kind of muscle up in that area that would be a reasonable takeaway, right?

Christopher J. Reading

Management

I like that description. Michael Petusky – Noble Financial Capital Markets: Okay. All right and then just last question. Around your initiative on the orthopaedic home care, where I guess you’re doing a first few visits in the home, and then that leads to some clinic visits. Do you guys expect that over time, and I’m not talking about 2013, I’m talking about over the next few years that that initiative could have a material impact, or is that more just a little bit of incremental business that you guys could pick up?

Glenn McDowell

Management

At this point in time, we would say that it would be incremental. We think that there is an opportunity for this to open up some doors with orthopedic groups in areas that we’ve not been in yet; so at this point, with the incremental that we’re looking for, but we are getting some very positive response back from our partners and from physicians that we’re talking to about it.

Christopher J. Reading

Management

And Mike, I would agree with Glenn. I would characterize this as being a little early to say whether or not we can get enough steam into this more to be a material change. When you look at the size of our clinics averaging somewhere in the low 20 visits for clinic per day range, if we can pick up a few visits a day, whether or not you consider that incremental or material, it’s kind of a decent needle mover. And so where this won’t necessarily go in every facility, we’re beginning the rollout process and we think it will have a positive impact.

Lawrance W. McAfee

Management

And one thing I want to make sure that nobody think this is home healthcare, it’s not. And it’s an outpatient physical therapy visit, which in this case should have been done in the clinic, it’s done one or two times maybe three in somebody’s home after they’ve had major surgery even they can’t get to the clinic yet.

Christopher J. Reading

Management

And so to Larry’s point, the reimbursement is the same as we would typically be paid for, it’s no different than in clinic Medicare visit. It’s not classified truly as the home health business. Michael Petusky – Noble Financial Capital Markets: Okay, great. And actually let me ask one more question unrelated, and if you’ve commented on this, forgive me. But did you guys make any comments around your physician sales business, and I didn’t catch anything if you mentioned of early, just crack it there?

Christopher J. Reading

Management

The one thing I should have mentioned is, I get – I made it generic comment about strengthening our resource group here. We brought back somebody who have been with us for a number of years moves outside the company to increase a major hospital systems, physician practice, expansion initiative you did that for a few years, came back to us. He is now the lead person of our physician services group and we’re working through that, transition as we speak real-time, so… Michael Petusky – Noble Financial Capital Markets: So, I mean, currently, I mean your outlook for that business in 2013, is it going to be kind of a transitional year with hopefully more growth in 2014, or how do you just think about I guess the next year or two in that business?

Christopher J. Reading

Management

Yeah, I think this will continue to be a transition year. We hope to make progress this year. We have a number of things that we’re adding and we’re working through some steps from the past. But we’ve got a good leadership group and they’re working hard on it right now. Michael Petusky – Noble Financial Capital Markets: Right. Thanks, guys.

Operator

Operator

(Operator Instructions) Your next question comes from the line of Kevin Leary of Spitfire Capital. Kevin Leary – Spitfire Capital: Just a couple of questions around the Medicare rate going from sort of this mid 90s level to the mid 80s level. I know historically for the Medicare, it’s a good business, because Medicare patients can come in the middle of the day when the rest of us are up funding Medicare.

Christopher J. Reading

Management

Good way to put it. Kevin Leary – Spitfire Capital: Two questions; first, (inaudible) and then second, if it is still true, at what rate do your practitioners start grumbling about covering a fixed cost and God forbid turning away Medicare patients?

Christopher J. Reading

Management

We’re not in danger I don’t think anywhere turning away Medicare patients. I mean, the nice thing about our company still is we’ve got a pretty good portfolio. So most of these Medicare doesn’t make up the bulk of what we do. And you’re right. They are able to often to come in and have more flexibility in terms of time. I wouldn’t speculate at what rate. We’re making some changes in our company, in our efficiencies, in our other things, which adopt to improve our cost structure. I’m certainly hoping that we’re not, in the near future going to see additional costs because this is a pretty onerous year in terms of a Medicare focus. On a group generally seen as saving the healthcare system cost. So I’m not anticipating at least further reductions anytime in the near future. So we haven’t done that math. But you’re first question, we either had a blip in our phone or yours and we didn’t hear it, so if could repeat that. Kevin Leary – Spitfire Capital: Actually, you’ve answered it. I was just making sure that it’s still good business. Second questions, on the other peer groups, do you private payers and your workers comp payers look at this reduction as an opportunity to maybe get some slippage in your other payer sources?

Lawrance W. McAfee

Management

I think it’s uncertain right now. I mean when MPPR came out, initially couples years ago, two, three years ago, we had a couple of payers I think as not being one that adopted to be MPPR and Medicare alike payment mechanism. I think to guess, I would imagine that there maybe some, but I think it’s still a little early. We didn’t see a ground slow when the initial MPPR came out. I don’t expect to see it now. Most of commercial payers now are dealing with whatever they’re dealing with. They have a system in place. They have a utilization management system. Now they have their guidelines in terms of what percentage of their premiums they have the pay up to providers. And so, I’m personally not expecting to see a ground slow movement in that direction. Kevin Leary – Spitfire Capital: Great, that’s helpful. Good luck in 2013 guys.

Lawrance W. McAfee

Management

Thanks.

Operator

Operator

(Operator Instructions) At this time, we have no further questions. I’ll now return the call to management for any closing remarks.

Christopher J. Reading

Management

Okay. Listen, I thank you for your time and attention. This was a little bit of a long call. Management team will be here to answer questions today or through the rest of the weeks if you have any. And again, we appreciate your attention and your support. Thank you.

Operator

Operator

Thank you. That does conclude the U.S. Physical Therapy Fourth Quarter and Year-End 2012 earnings conference call. You may now disconnect.