INVESTOR PRESENTATION May 21 2020 Forward Looking Statements
- Slides: 33
INVESTOR PRESENTATION May 21, 2020
Forward Looking Statements This presentation contains forward-looking statements, which involve numerous risks and uncertainties. Included are statements relating to opening of new clinics, availability of personnel and reimbursement environment. The forward-looking statements are based on the Company’s current views and assumptions and the Company’s actual results could differ materially from those anticipated as a result of certain risks, uncertainties, and factors, which include, but are not limited to: general economic, business, and regulatory conditions; competition; reimbursement conditions; federal and state regulation; acquisitions; clinic closures, availability, terms, and use of capital; availability and cost of skilled physical and occupational therapists; and weather. 2 2
Investment Highlights Established Company • 554 outpatient physical and occupational therapy clinics across 39 states • One of the largest owner/operator of PT clinics • Only publicly-traded, pure play provider Attractive Market Dynamics • US rehab market > $30 B in annual revenue • Highly fragmented; No company with >10% market share • Favorable demographics – aging and active population Proven Business Model • Partner with experienced physical therapists • Driven by organic growth and acquisitions • Approximately one-half of clinics were de novo start-ups Solid Financial Position 3 • Diversified payor mix, only 28% of revenue from Medicare • Strong cash flow and balance sheet
Large and Growing Market Opportunity • $30 B+ U. S. rehab market with projected growth • Favorable demographics – physically active, aging and obese population segments • Healthcare delivery shifting towards lower cost, high quality outpatient providers 4
Focused Business Model • Specialize in trauma, sports, work-related and pre and post surgical cases • Partner with experienced physical therapists – Drive volume via referrals – Augment sales with marketing reps • Historical focus on organic growth via lower cost de novo (start-up) clinics • Strategic acquisitions structured like de novos as partnerships with significant ownership retained by founders 5
Competitive Landscape • Highly fragmented U. S. outpatient rehab market with 18, 000 + clinics • No company with >10% market share • USPh ranks third nationally – Select Medical/Physio – ATI 894 Clinics – USPh 554 Clinics Note: Owned Clinics 6 1740 Clinics
Growth Strategy Drive organic growth through de novo PT/OT clinic openings, utilize true partnership model Maximize profits of existing facilities by growing patient volume; realize efficiencies through higher clinical productivity Augment organic growth through strategic acquisitions 7
USPH Partnership Advantages Less Administrative Burden 8 Accounting HR Real Estate Construction Purchasing Marketing Compliance Legal IT More Resources Access to Capital for Development of Additional Clinics No Personal Financial Risk Unlimited Earnings Potential Full Benefit Package Ongoing Guidance within Semi-Autonomous Work Environment
National Footprint 9
10 10
Acquisition Strategy • Completed 34 acquisitions since 2005 • Range in size from 3 to 52 clinics • Acquisition criteria: Owner therapists continue to operate clinics and retain significant equity interest Immediately accretive to earnings Further de novo growth opportunities 11
New Clinics / Brands 2019 12
Executive Management • Chris Reading – Chief Executive Officer – – – Joined USPh as COO in November 2003 Promoted to CEO and Board in November 2004 Previously Senior Vice President of Operations with Health. South, managed over 200 facilities including OP, ASC, DX Imaging and rehab hospital operations. – BS Physical Therapy Larry Mc. Afee – Chief Financial Officer – Joined USPh as CFO in September 2003 – Promoted to EVP and Board in November 2004 – Previously served as CFO and President of both public and private companies – BBA & MBA Glenn Mc. Dowell – Chief Operating Officer – Central/West Regions – Joined USPh as Vice President - West Region in October 2003 – Promoted to COO in January 2005 – Previously Vice President of Operations with Health. South, managed 165 facilities including ASC, DX Imaging, OP and occupational medicine facilities. – BS & Masters Physical Therapy Graham Reeve – Chief Operating Officer – East Region – Joined USPh in March 2018 – Previously President & Chief Executive Officer of Baptist Health System in San Antonio, TX. Managed six hospitals with a $1. 32 B annual operating budget. – BS Physical Therapy & MBA • • • 13
USPH Physical Therapy Net Revenue Mix 14
Industrial Injury Prevention & Worker’s Comp • Both internally and through acquisition, USPh has expanded its industry focused Industrial Injury Prevention and Worker’s Comp business. • In March 2017, April 2018 and April 2019 USPh acquired leading providers of Industrial Injury Prevention services. • Industrial Injury Prevention (Briotix Health) services provided include rehabilitation, performance optimization and ergonomic assessments. Services are performed onsite at more than 600 client locations. • Worker’s Comp (Fit 2 WRK) Services provided in our physical therapy clinics include job specific rehabilitation, work hardening/conditioning, post-offer pre-employment screening and functional capacity evaluations (“FCE”). National approach with local care delivery, 1 -800 -centralized scheduling-fast, easy and convenient. • Industrial Injury Prevention and Worker’s Comp combined presently account for 21% of USPH’s total revenue for the year ended December 31, 2019. 15
USPH Total Revenue 16
USPH Physical Therapy Growth Drivers Each driver showed robust growth historically +8. 5%/Year (2012 -19 CAGR) 17
USPH Physical Therapy Volume & Revenue 18
USPH Physical Therapy Clinic Level Margin 19
Year End 2019 Highlights • • Total gross profit grew (in spite of 30 clinic partnership sale) by 10. 6% Gross margin increased 90 bps to 23. 3% PT gross margins increased 90 bps to 23. 6% Best same store (maybe ever) at 5. 8% for visits and 6. 3% for revenue PT management contracts margin increased 270 bps IIP gross margins increased 200 bps to 22. 4% Operating income increased 11. 8% Operating margin increased 70 bps to 14% 20
Dividend • In 2011 initiated quarterly dividend • Increased dividend every year • Paid special dividend in 2012 • Raised dividend in February 2020 by 12. 3% for the year as compared to 2019. • Dividends do not impact ability to continue to grow internally through de novo clinic development and externally through acquisitions • Dividend seen as additional way to increase returns to shareholders as Company is under leveraged and has excellent net free cash flow • Temporarily suspended quarterly dividend after Q 1 2020 due to uncertainty associated with COVID pandemic. 21
COVID • With the March onset of the pandemic the Company took a number of actions to preserve cash and mitigate losses including laying off staff and closing some clinics. • 70 out of 585 clinics were closed. 30 temporarily and 40 permanently based on the presumption of lower patient volumes for a sustained period of time. • Approximately 2, 150 out of 5, 500 Company employees were furloughed or terminated. • In the corporate office across the board salary reductions of 20% to 25% were implemented and 35% to 40% for executives. Salary reductions were instituted at a number of clinic partnerships as well. • In the first quarter, management estimates approximately $8 million in contribution margin was lost as the result of a reduction in patient visits due to the virus. 22
COVID • In March, management announced that the Company was rescinding 2020 earnings guidance and that after the first quarter did not anticipate paying a quarterly dividend for the reminder of 2020. • In April, patient volumes bottomed out at approximately 45% of normal. • In May, patient volumes began to recover. New patient referrals are now increasing at double digit rates and patient volume nationally now averages 70% of normal. • The Company anticipates incurring losses for a number of months to come. • Cash flow has been better than anticipated, with the Company’s current cash balance exceeding $100 million. • The Company currently has $125 million drawn under it’s bank credit agreement and is not in violation of any loan covenants. 23
Strong Cash Flow and Balance Sheet • Both de novo clinics and acquisitions financed primarily through free cash flow • USPH year ended December 31, 2019 adjusted EBITDA of $67. 3 million. (1) Adjusted EBITDA is defined as net income contributable to USPh shareholders before interest income, interest expense, taxes, depreciation, amortization, equity-based awards compensation expense, derecognition of debt and gain on sale of partnership expense. 24
Strong Return to Shareholders Total Cumulative Return through December 31, 2019 including dividends is $108. 24. Total Cumulative Return Percentage is 887%. Market Cap Increase during time period is from $154. 7 million to $1. 5 billion or by $1. 3 billion or by 844% 25
Year Results Year Ended December 31, 2019 December 31, 2018 Change Revenue $ 482. 0 M $ 453. 9 M Gross Margin $ 112. 5 M $ 101. 7 M 10. 6% Operating Income $ 67. 4 M $ 60. 3 M Net Income (GAAP) $ 40. 0 M $ 34. 9 M 14. 8% Operating Results $ 36. 0 M $ 33. 5 M 7. 3% EPS (Operating Results)* $ 2. 82 $ 2. 65 6. 6% EPS (GAAP) $ 2. 45 $ 1. 31 87. 0% Adjusted EBITDA** $ 67. 3 M $ 62. 0 M 6. 2% 11. 8% 8. 5% *Operating Results is defined as USPH’s net income attributable to common shareholders per the consolidated statement of net income and excludes the impact of the gain on the sale of a partnership interest and gain on derecognition of debt, both net of tax. **Adjusted EBITDA is defined as net income contributable to USPh shareholders before interest income, interest expense, taxes, depreciation, amortization, equity-based awards compensation expense, gain on sale of partnership interest and gain on derecognition of debt, . 26
First Quarter Results Three Months Ended March 31, 2020 March 31, 2019 Change Revenue $ 112. 7 M $ 116. 2 M Gross Margin $ 15. 7 M $ 26. 7 M 41. 3% Operating Income $ 4. 0 M $ 15. 4 M 74. 0% Net Income (GAAP) $ 1. 0 M $ 8. 4 M 88. 0% Operating Results* $ 3. 9 M $ 8. 4 M 54. 0% EPS (Operating Results)* $ 0. 30 $ 0. 66 54. 4% EPS (GAAP) $ 0. 20 $ 0. 39 48. 7% Adjusted EBITDA** $ 8. 0 M $ 15. 6 M 3. 0% 48. 5% *Operating Results a non-GAAP measure, equals net income attributable to USPH shareholders per the consolidated statement of net income plus charges incurred for the closure costs and CFO search, both net of tax. The earnings per share from Operating Results also excludes the impact of the revaluation of redeemable non-controlling interest. **Adjusted EBITDA is defined as net income attributable to USPH shareholders before interest income, interest expense, taxes, depreciation, amortization, equity-based awards compensation expense and write-off of goodwill related to clinic closures. 27
Summary Only publicly-traded, pure play operator of rehab clinics Proven business model, driven by organic growth and acquisitions Significant scale with national footprint Large and growing market/favorable demographics Strong cash flow and balance sheet 28
Reconciliation of Non-GAAP Financial Measures – Adjusted EBITDA Three Months Ended March 31, (amounts in 000’s) 2020 Net revenues Net Income attributable to U. S. Physical Therapy Depreciation and amortization $ Interest income Closure costs – write-off of goodwill Derecognition of debt Interest expense – debt and other Equity grant expense Provision for income taxes Adjusted EBITDA* 122, 717 1, 016 2, 607 2019 $ 116, 231 8, 443 2, 400 (43) 1, 859 427 1, 886 292 $ 8, 044 (16) 358 1, 728 2, 708 $ 15, 621 *Adjusted EBITDA is defined as net income attributable to USPH shareholders before interest income, interest expense, taxes, depreciation, amortization, equity-based awards compensation expense and write-off of goodwill related to clinic closures. 29
Reconciliation of Non-GAAP Financial Measures – Adjusted EBITDA Year Ended December 31, (amounts in 000’s) 2019 Net revenues Net Income attributable to U. S. Physical Therapy $ 481, 969 40, 039 2018 $ 453, 911 34, 873 Adjustments: Depreciation & amortization Interest income Gain on sale of partnership interest Derecognition of debt 10, 095 (46) (5, 514) - 9, 755 (93) (1, 846) Interest expense – debt and other Equity grant expense Provision for income taxes 2, 079 6, 985 13, 647 2, 042 5, 939 11, 369 Adjusted EBITDA $ 67, 285 $ Adjusted EBITDA is defined as net income contributable to USPh shareholders before interest income, interest expense, taxes, depreciation, amortization, equity-based awards compensation expense, gain on sale of partnership interest and derecognition of debt. 30 62, 039
Reconciliation of Non-GAAP Financial Measures – Operating Results Three Months Ended March 31 (in 000’s, except per share data) Computation of earnings per share – USPH shareholders Net Income attributable to USPh Shareholders Charges to retained earnings: 2020 $ 1, 016 2019 $ 2, 129 Revaluation of redeemable non-controlling interest Tax effect at statutory rate (federal and state) of 26. 25% 8, 443 (4, 661) (559) 1, 224 $ 2, 586 $ 5, 006 $ 0. 20 $ 0. 39 Charges incurred for CFO search $ 133 $ - Closure Costs $ 3, 752 $ - Revaluation of redeemable non-controlling interest $ (2, 129) Tax effect at statutory rate (federal and state) of 26. 25% Operating results* $ (461) 3, 881 Earnings per share (basic and diluted) Adjustments: Basic and diluted operating results per share Shares used in computation - basic and diluted $ 0. 66 4, 661 $ (1, 224) 8, 443 0. 30 $ 12, 796 12, 707 *Operating Results a non-GAAP measure, equals net income attributable to USPH shareholders per the consolidated statement of net income plus charges incurred for the closure costs and CFO search, both net of tax. The earnings per share from Operating Results also excludes the impact of the revaluation of redeemable non-controlling interest. 31
Reconciliation of Non-GAAP Financial Measures – Twelve Months Operating Results Ended December 31 (in thousand’s, except per share data) 2019 Computation of earnings per share – USPH shareholders Net Income attributable to USPh Shareholders Charges to retained earnings: $ Revaluation of redeemable non-controlling interest Tax effect at statutory rate (federal and state) of 26. 25% 40, 039 2018 $ 34, 873 (11, 893) (24, 770) 3, 121 6, 502 $ 31, 267 $ 16, 605 $ 2. 45 $ 1. 31 Gain on sale of partnership interest $ $ (5, 514) $ $ (1, 846) - Revaluation of redeemable non-controlling interest $ 11, 893 24, 770 $ (1, 674) 35, 972 (6, 018) 33, 511 Basic and diluted per share Adjustments: Gain on derecognition of debt Tax effect at statutory rate (federal and state) of 26. 25% and 39. 25%, respectively Operating results Basic and diluted operating results per share Shares used in computation: Basic and diluted $ 2. 65 $ 2. 82 $ 12, 756 12, 666 *Operating Results is defined as USPH’s net income attributable to common shareholders per the consolidated statement of net income and excludes the impact of the adjustment to the gain on sale of a partnership interest and the gain in derecognition of debt, both net of tax. 32
NYSE: USPH
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