Amedisys Reports Second Quarter 2018 Financial Results and Updates 2018 Guidance


BATON ROUGE, La., July 31, 2018 (GLOBE NEWSWIRE) -- Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three and six-month period ended June 30, 2018.

Three Month Periods Ended June 30, 2018 and 2017

  • Net service revenue increased $36.7 million to $411.6 million compared to $374.9 million in 2017 (1).
  • Net income attributable to Amedisys, Inc. of $33.3 million compared to $4.5 million in 2017.
  • Net income attributable to Amedisys, Inc. per diluted share of $0.98 per diluted share compared to $0.13 in 2017.

Adjusted Quarterly Results*

  • Adjusted EBITDA of $49.7 million compared to $36.1 million in 2017.
  • Adjusted net service revenue of $413.3 million compared to $374.9 million in 2017.
  • Adjusted net income attributable to Amedisys, Inc. of $34.1 million compared to $21.4 million in 2017.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $1.00 compared to $0.62 in 2017.

Six Month Periods Ended June 30, 2018 and 2017

  • Net service revenue increased $71.3 million to $810.9 million compared to $739.6 million in 2017 (1).
  • Net income attributable to Amedisys, Inc. of $60.5 million compared to $19.6 million in 2017.
  • Net income attributable to Amedisys, Inc. per diluted share of $1.76 per diluted share compared to $0.57 in 2017.

Adjusted Year to Date Results*

  • Adjusted EBITDA of $91.4 million compared to $68.1 million in 2017.
  • Adjusted net service revenue of $812.6 million compared to $739.6 million in 2017.
  • Adjusted net income attributable to Amedisys, Inc. of $61.4 million compared to $37.4 million in 2017.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $1.79 compared to $1.09 in 2017.

*         See pages 12 and 13 for the definition and reconciliations of non-GAAP financial measures to GAAP measures.

(1)        Subsequent to our adoption of Accounting Standards Updates 2014-09 and 2015-14 on January 1, 2018, using the full retrospective method, amounts previously classified as provision for doubtful accounts are now classified as implicit price concessions in determining the transaction price of our net service revenue.

Paul B. Kusserow, President and Chief Executive Officer stated, “I am extremely pleased with the results that our team delivered during the second quarter of 2018. We continued to demonstrate solid growth across all three lines of business, improved upon our quality scores for the thirteenth straight quarter, leveraged our operational platform to drive impressive margin and lowered our turnover; all of which helped deliver significant increases in revenue, EBITDA and earnings per share. A special thank you to all Amedisys employees that continue to provide industry leading care to our patients and help drive significant value to our shareholders. We look forward to continuing to serve more patients and executing upon our strategic pillars during the second half of the year.”

Updated 2018 Guidance

  • Net service revenue is anticipated to be in the range of $1.63 billion to $1.65 billion.
  • Adjusted EBITDA is anticipated to be in the range of $168 million to $172 million.
  • Adjusted diluted earnings per share is anticipated to be in the range of $3.32 to $3.41 based on an estimated 33.50 million shares outstanding.

This guidance excludes the effects of any future acquisitions, if any are made.

We urge caution in considering the current trends and 2018 guidance disclosed in this press release. The home health and hospice industry is highly competitive and subject to intensive regulations, and trends are subject to numerous factors, risks, and uncertainties, some of which are referenced in the cautionary language below and others that are described more fully in our reports filed with the Securities and Exchange Commission (“SEC”) including our Annual Report on Form 10-K for the fiscal year ended December 31, 2017, and subsequent Quarterly Reports on Form 10-Q, and current reports on Form 8-K which can be found on the SEC’s internet website, http://www.sec.gov, and our internet website, http://www.amedisys.com.

Earnings Call and Webcast Information

Amedisys will host a conference call on Wednesday, August 1, 2018, at 11:00 a.m. ET to discuss its second quarter results. To participate on the conference call, please call before 11:00 a.m. ET to either (877) 524-8416 (Toll-Free) or (412) 902-1028 (Toll). A replay of the conference call will be available through September 1, 2018 by dialing (877) 660-6853 (Toll-Free) or (201) 612-7415 (Toll) and entering conference ID #13681543.

A live webcast of the call will be accessible through our website on our Investor Relations section at the following web address: http://investors.amedisys.com.

Non-GAAP Financial Measures

This press release includes reconciliations of the most comparable financial measures calculated and presented in accordance with accounting principles generally accepted in the U.S. (“GAAP”) to non-GAAP financial measures. The non-GAAP financial measures as defined under SEC rules are as follows: (1) adjusted EBITDA, defined as net income attributable to Amedisys, Inc. before provision for income taxes, net interest expense and depreciation and amortization, excluding certain items; (2) adjusted net service revenue, defined as net service revenue excluding certain items; (3) adjusted net income attributable to Amedisys, Inc., defined as net income attributable to Amedisys, Inc. excluding certain items; and (4) adjusted net income attributable to Amedisys, Inc. per diluted share, defined as net income attributable to Amedisys, Inc. common stockholders per diluted share excluding certain items. Management believes that these non-GAAP financial measures, when reviewed in conjunction with GAAP financial measures, are useful gauges of our current performance and are also included in internal management reporting. These non-GAAP financial measures should be considered in addition to, and not more meaningful than or as an alternative to the GAAP financial measures presented in this earnings release and the company’s financial statements. Non-GAAP measures as presented herein may not be comparable to similarly titled measures reported by other companies since not all companies calculate these non-GAAP measures consistently.

Additional information

Amedisys, Inc. (the “Company”) is a leading healthcare at home Company delivering personalized home health, hospice and personal care. Amedisys is focused on delivering the care that is best for our patients, whether that is home-based personal care; recovery and rehabilitation after an operation or injury; care focused on empowering them to manage a chronic disease; or hospice care at the end of life. We partner with 3,000 hospitals and 59,000 physicians nationwide who have chosen Amedisys as a partner in post-acute care. Founded in 1982, headquartered in Baton Rouge, LA with an executive office in Nashville, TN, Amedisys is a publicly held company. With 18,300 employees, in 420 care centers in 34 states and the District of Columbia, Amedisys is dedicated to delivering the highest quality of care to the doorsteps of more than 369,000 patients and clients in need every year. For more information about the Company, please visit: www.amedisys.com.

We use our website as a channel of distribution for important company information. Important information, including press releases, investor presentations and financial information regarding our company, is routinely posted on and accessible on the Investor Relations subpage of our website, which is accessible by clicking on the tab labeled “Investors” on our website home page. Visitors to our website can also register to receive automatic e-mail and other notifications alerting them when new information is made available on the Investor Relations subpage of our website.

Forward-Looking Statements

When included in this press release, words like “believes,” “belief,” “expects,” “plans,” “anticipates,” “intends,” “projects,” “estimates,” “may,” “might,” “would,” “should” and similar expressions are intended to identify forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements involve a variety of risks and uncertainties that could cause actual results to differ materially from those described therein. These risks and uncertainties include, but are not limited to the following: changes in Medicare and other medical payment levels, our ability to open care centers, acquire additional care centers and integrate and operate these care centers effectively, changes in or our failure to comply with existing federal and state laws or regulations or the inability to comply with new government regulations on a timely basis, competition in the healthcare industry, our ability to integrate our personal care segment into our business efficiently, changes in the case mix of patients and payment methodologies, changes in estimates and judgments associated with critical accounting policies, our ability to maintain or establish new patient referral sources, our ability to attract and retain qualified personnel, changes in payments and covered services by federal and state governments, future cost containment initiatives undertaken by third-party payors, our access to financing, our ability to meet debt service requirements and comply with covenants in debt agreements, business disruptions due to natural disasters or acts of terrorism, our ability to integrate, manage and keep our information systems secure, our ability to comply with requirements stipulated in our corporate integrity agreement and changes in law or developments with respect to any litigation relating to the Company, including various other matters, many of which are beyond our control.

Because forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified, you should not rely on any forward-looking statement as a prediction of future events. We expressly disclaim any obligation or undertaking and we do not intend to release publicly any updates or changes in our expectations concerning the forward-looking statements or any changes in events, conditions or circumstances upon which any forward-looking statement may be based, except as required by law.

Contact:Investor Contact: Media Contact:
 Amedisys, Inc. Amedisys, Inc.
 Nick Muscato Kendra Kimmons
 Vice President, Strategic Finance Vice President, Marketing & Communications
 (855) 259-2046 (225) 299-3720
 IR@amedisys.com kendra.kimmons@amedisys.com



AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)
(Unaudited)
   
 For the Three-Month
Periods Ended June 30
 
For the Six-Month
Periods Ended June 30
 
  2018    2017    2018    2017   
Net service revenue $411,603 $374,946 $810,865 $739,607 
Cost of service, excluding depreciation and amortization    242,564    220,541    480,873    436,870 
General and administrative expenses:    
Salaries and benefits    77,215    74,943    152,846    149,402 
Non-cash compensation    3,767    4,356    7,811    8,230 
Other    42,104    41,617    83,784    82,034 
Depreciation and amortization    3,125    4,537    6,718    8,954 
Securities Class Action Lawsuit settlement, net    —     28,712    —     28,712 
     
Operating expenses    368,775    374,706    732,032    714,202 
     
Operating income    42,828    240    78,833    25,405 
Other income (expense):    
Interest income    114    41    234    60 
Interest expense    (2,140)   (1,197)   (3,843)   (2,265)
Equity in earnings from equity method investments    2,976    2,355    4,836    2,249 
Miscellaneous, net    359    1,127    960    2,239 
     
Total other income, net   1,309    2,326    2,187    2,283 
     
Income before income taxes    44,137    2,566    81,020    27,688 
Income tax (expense) benefit    (10,596)   1,963    (20,159)   (7,960)
     
Net income    33,541    4,529    60,861    19,728 
Net income attributable to noncontrolling interests    (192)   (68)   (353)   (137)
     
Net income attributable to Amedisys, Inc. $  33,349 $  4,461 $  60,508 $  19,591 
     
Basic earnings per common share:    
Net income attributable to Amedisys, Inc. common stockholders$  1.00 $  0.13 $  1.80 $  0.58 
Weighted average shares outstanding    33,439    33,637    33,705    33,540 
Diluted earnings per common share:    
Net income attributable to Amedisys, Inc. common stockholders$  0.98 $  0.13 $  1.76 $  0.57 
Weighted average shares outstanding    34,179    34,329    34,391    34,203 



AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except share data)
  
 June 30, 2018
(unaudited)
 
December 31,
2017
 
ASSETS  
Current assets:  
Cash and cash equivalents $  25,904 $  86,363 
Patient accounts receivable    197,592    201,196 
Prepaid expenses    10,493    7,329 
Other current assets    24,784    16,268 
   
Total current assets    258,773    311,156 
Property and equipment, net of accumulated depreciation of $101,128 and $146,814    27,998    31,122 
Goodwill    324,145    319,949 
Intangible assets, net of accumulated amortization of $31,864 and $30,610    44,888    46,061 
Deferred income taxes    46,919    56,064 
Other assets, net    50,601    49,130 
   
Total assets $  753,324 $  813,482 
   
LIABILITIES AND EQUITY  
Current liabilities:  
Accounts payable $  29,810 $  25,384 
Payroll and employee benefits    87,239    89,936 
Accrued expenses    96,472    89,104 
Current portion of long-term obligations    668    10,638 
   
Total current liabilities    214,189    215,062 
Long-term obligations, less current portion    123,937    78,203 
Other long-term obligations    6,137    3,791 
   
Total liabilities   344,263    297,056 
   
Equity:  
Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding    —     —  
Common stock, $0.001 par value, 60,000,000 shares authorized; 36,044,177 and 35,747,134 shares issued; and 31,801,357 and 33,964,767 shares outstanding    36    35 
Additional paid-in capital    585,137    568,780 
Treasury stock, at cost 4,242,820 and 1,782,367 shares of common stock   (237,947)   (53,713)
Accumulated other comprehensive income    15    15 
Retained earnings    60,712    204 
   
Total Amedisys, Inc. stockholders’ equity    407,953    515,321 
Noncontrolling interests    1,108    1,105 
   
Total equity    409,061    516,426 
   
Total liabilities and equity $  753,324 $  813,482 
   



AMEDISYS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING
(Amounts in thousands, except statistical information)
(Unaudited)
   
 For the Three-Month
Periods Ended June 30  
For the Six-Month
Periods Ended June 30
 
  2018    2017    2018    2017   
Cash Flows from Operating Activities:    
Net income $  33,541 $  4,529 $  60,861 $19,728 
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization    3,125    4,537    6,718    8,954 
Non-cash compensation    3,767    4,356    7,811    8,230 
401(k) employer match    2,327    2,140    4,894    4,367 
Loss on disposal of property and equipment    87    163    650    147 
Deferred income taxes    6,200    (1,863)   9,145    7,582 
Equity in earnings from equity method investments    (2,976)   (2,355)   (4,836)   (2,249)
Amortization of deferred debt issuance costs    177    185    355    370 
Write off of deferred debt issuance costs    38    —     38    —  
Return on equity investment    1,579    3,266    2,204    3,416 
Changes in operating assets and liabilities, net of impact of acquisitions:    
Patient accounts receivable    (4,656)   (681)   3,604    (6,833)
Other current assets    (4,698)   (3,489)   (11,680)   (6,892)
Other assets    642    (158)   688    (1,148)
Accounts payable    5,146    1,000    3,623    1,093 
Securities Class Action Lawsuit settlement accrual, net    —     28,712    —     28,712 
Accrued expenses    6,355    (4,129)   4,548    (2,743)
Other long-term obligations    (1)   31    2,347    607 
     
Net cash provided by operating activities    50,653    36,244    90,970    63,341 
     
Cash Flows from Investing Activities:    
Proceeds from sale of deferred compensation plan assets    9    —     471    565 
Proceeds from the sale of property and equipment    6    —     11    —  
Purchase of investment    —     (180)   —     (436)
Purchases of property and equipment    (149)   (3,064)   (1,611)   (7,449)
Acquisitions of businesses, net of cash acquired    (1,824)   (20,029)   (4,074)   (24,128)
     
Net cash used in investing activities   (1,958)   (23,273)   (5,203)   (31,448)
     
Cash Flows from Financing Activities:    
Proceeds from issuance of stock upon exercise of stock options and warrants    2,484    3,550    2,609    4,203 
Proceeds from issuance of stock to employee stock purchase plan    560    575    1,157    1,187 
Shares withheld upon stock vesting   (1,527)   (4,968)   (2,832)   (5,726)
Non-controlling interest distribution   (322)   (48)   (350)   (90)
Proceeds from borrowings under revolving line of credit    127,500    —     127,500    —  
Principal payments of long-term obligations   (87,656)   (1,250)   (90,475)   (2,500)
Debt issuance costs    (2,433)   —     (2,433)   —  
Purchase of company stock    (181,402)   —     (181,402)   —  
     
Net cash used in financing activities    (142,796)   (2,141)   (146,226)   (2,926)
     
Net (decrease) increase in cash and cash equivalents    (94,101)   10,830    (60,459)   28,967 
Cash and cash equivalents at beginning of period    120,005    48,334    86,363    30,197 
     
Cash and cash equivalents at end of period $  25,904 $59,164 $  25,904 $59,164 
     
Supplemental Disclosures of Cash Flow Information:    
Cash paid for interest $  1,015 $  466 $  2,080 $  1,172 
     
Cash paid for income taxes, net of refunds received $  3,336 $  —  $  6,149 $  284 
     
Days revenue outstanding (1)    41.1    40.2    41.1    40.2 

(1)      Our calculation of days revenue outstanding at June 30, 2018 and 2017 is derived by dividing our ending patient accounts receivable by our average daily patient revenue for the three month periods ended June 30, 2018 and 2017, respectively.




AMEDISYS, INC. AND SUBSIDIARIES
SEGMENT INFORMATION
(Amounts in millions, except statistical information)
(Unaudited)
 
Segment Information - Home Health
  
 For the Three-
Month Periods
Ended June 30,
 
  2018    2017   
Financial Information (in millions):  
Medicare $  206.3 $  198.3 
Non-Medicare    85.2    72.0 
   
Net service revenue    291.5    270.3 
Cost of service    176.5    164.8 
   
Gross margin    115.0    105.5 
Other operating expenses    69.2    69.9 
   
Operating income $  45.8 $  35.6 
   
Same Store Growth (1):  
Medicare revenue    6%   (5%)
Non-Medicare revenue    18%   14%
Total admissions   6%   — %
Total volume (2)    8%   2%
Total Episodic admissions (3)    5%   (1%)
Total Episodic volume (4)   6%   2%
Key Statistical Data - Total (5):  
Medicare:  
Admissions    47,058    47,260 
Recertifications    28,431    26,839 
   
Total volume    75,489    74,099 
Completed episodes    74,776    73,872 
Visits    1,318,074    1,271,747 
Average revenue per completed episode (6) $  2,874 $  2,829 
Visits per completed episode (7)    17.8    17.5 
Non-Medicare:  
Admissions    29,271    26,225 
Recertifications    13,891    11,462 
   
Total volume    43,162    37,687 
Visits    690,548    579,328 
Total (5):  
Visiting Clinician Cost per Visit $  80.07 $  80.61 
Clinical Manager Cost per Visit $  7.76 $  8.44 
   
Total Cost per Visit $  87.83 $  89.05 
Visits    2,008,622    1,851,075 


 For the Six-
Month Periods
Ended June 30,
 
  2018    2017   
Financial Information (in millions):  
Medicare $  411.3 $  397.0 
Non-Medicare    164.3    140.9 
   
Net service revenue    575.6    537.9 
Cost of service    350.9    327.8 
   
Gross margin    224.7    210.1 
Other operating expenses    138.0    138.8 
   
Operating income $  86.7 $  71.3 
   
Same Store Growth (1):  
Medicare revenue    5%   (4%)
Non-Medicare revenue    16%   12%
Total admissions   5%   1%
Total volume (2)    7%   2%
Total Episodic admissions (3)    4%   1%
Total Episodic volume (4)   6%   2%
Key Statistical Data - Total (5):  
Medicare:  
Admissions    96,513    96,888 
Recertifications    55,667    51,882 
   
Total volume    152,180    148,770 
Completed episodes    147,612    145,736 
Visits    2,632,200    2,534,845 
Average revenue per completed episode (6) $  2,833 $  2,806 
Visits per completed episode (7)    17.5    17.2 
Non-Medicare:  
Admissions    59,160    53,558 
Recertifications    26,323    21,686 
   
Total volume    85,483    75,244 
Visits    1,351,481    1,134,876 
Total (5):  
Visiting Clinician Cost per Visit $  80.20 $  80.84 
Clinical Manager Cost per Visit $  7.88 $  8.49 
   
Total Cost per Visit $  88.08 $  89.33 
Visits    3,983,681    3,669,721 

(1)      Same store information represents the percent increase (decrease) in our Medicare, Non-Medicare, Total and Episodic revenue, admissions or volume for the period as a percent of the Medicare, Non-Medicare, Total and Episodic revenue, admissions or volume of the prior period.
(2)      Total volume includes all admissions and recertifications.
(3)      Total Episodic admissions includes admissions for Medicare and Non-Medicare payors that bill on a 60-day episode of care basis.
(4)      Total Episodic volume includes admissions and recertifications for Medicare and Non-Medicare payors that bill on a 60-day episode of care basis.
(5)      Total includes acquisitions.
(6)      Average Medicare revenue per completed episode is the average Medicare revenue earned for each Medicare completed episode of care.
(7)      Medicare visits per completed episode are the home health Medicare visits on completed episodes divided by the home health Medicare episodes completed during the period.

Segment Information - Hospice

 For the Three-
Month Periods
Ended June 30,
 
  2018    2017   
Financial Information (in millions):  
Medicare $  96.9 $  85.8 
Non-Medicare    4.5    4.5 
   
Net service revenue    101.4    90.3 
Cost of service    51.7    45.4 
   
Gross margin    49.7    44.9 
Other operating expenses    20.6    19.3 
   
Operating income $  29.1 $  25.6 
   
Same Store Growth (1):  
Medicare revenue    13%   19%
Non-Medicare revenue    (1%)   8%
Hospice admissions    7%   11%
Average daily census    12%   16%
Key Statistical Data - Total (2):  
Hospice admissions    6,746    6,248 
Average daily census    7,554    6,717 
Revenue per day, net $147.58 $147.74 
Cost of service per day $  75.20 $  74.34 
Average discharge length of stay    97    89 
  
 For the Six-
Month Periods
Ended June 30,
 
  2018    2017   
Financial Information (in millions):  
Medicare $  188.7 $  166.5 
Non-Medicare    10.0    7.4 
   
Net service revenue    198.7    173.9 
Cost of service    101.8    88.4 
   
Gross margin    96.9    85.5 
Other operating expenses    40.8    37.5 
   
Operating income $  56.1 $  48.0 
   
Same Store Growth (1):  
Medicare revenue    12%   18%
Non-Medicare revenue    33%   (7%)
Hospice admissions    6%   15%
Average daily census    12%   16%
Key Statistical Data - Total (2):  
Hospice admissions    13,679    12,753 
Average daily census    7,385    6,542 
Revenue per day, net $148.66 $146.89 
Cost of service per day $  76.15 $  74.68 
Average discharge length of stay    97    90 


(1)      Same store information represents the percent increase (decrease) in our Medicare and Non-Medicare revenue, Hospice admissions or average daily census for the period as a percent of the Medicare and Non-Medicare revenue, Hospice admissions or average daily census of the prior period.
(2)      Total includes acquisitions.

Segment Information - Personal Care

 For the Three-
Month Periods
Ended June 30,
 
  2018   2017  
Financial Information (in millions):  
Medicare $  — $  — 
Non-Medicare    18.7   14.3
   
Net service revenue    18.7   14.3
Cost of service    14.4   10.3
   
Gross margin    4.3   4.0
Other operating expenses    3.3   3.0
   
Operating income $  1.0$  1.0
   
Key Statistical Data:  
Billable hours    797,228   618,401
Clients served    12,683   8,270
Shifts    356,874   283,130
Revenue per hour $  23.48$  23.12
Revenue per shift$  52.45$  50.50
Hours per shift    2.2   2.2
  
 For the Six-
Month Periods
Ended June 30,
 
  2018   2017  
Financial Information (in millions):  
Medicare $  — $  — 
Non-Medicare    36.6   27.8
   
Net service revenue    36.6   27.8
Cost of service    28.2   20.7
   
Gross margin    8.4   7.1
Other operating expenses    6.6   6.3
   
Operating income $  1.8$  0.8
   
Key Statistical Data:  
Billable hours    1,547,181   1,206,618
Clients served    14,350   9,845
Shifts    705,040   548,247
Revenue per hour $  23.66$  23.04
Revenue per shift$  51.91$  50.72
Hours per shift    2.2   2.2


Segment Information - Corporate

 For the Three-
Month Periods
Ended June 30,
 
  2018   2017  
Financial Information (in millions):  
Other operating expenses $31.1$30.0
Depreciation and amortization    2.0   3.3
   
Total operating expenses before Securities Class Action Lawsuit settlement, net    33.1   33.3
Securities Class Action Lawsuit settlement, net    —    28.7
   
Total operating expenses $33.1$62.0
   
  
 For the Six-
Month Periods
Ended June 30,
 
  2018   2017  
Financial Information (in millions):  
Other operating expenses $61.3$59.5
Depreciation and amortization    4.5   6.5
   
Total operating expenses before Securities Class Action Lawsuit settlement, net    65.8   66.0
Securities Class Action Lawsuit settlement, net    —    28.7
   
Total operating expenses $65.8$94.7
   




AMEDISYS, INC. AND SUBSIDIARIES
RECONCILIATION OF NON-GAAP FINANCIAL MEASURES TO GAAP MEASURES
(Amounts in thousands)
(Unaudited)
 
Adjusted Earnings Before Interest, Taxes, Depreciation and Amortization (“Adjusted EBITDA”):
   
 For the Three-
Month Period
Ended June 30,  
For the Six-
Month Period
Ended June 30,
 
  2018    2017    2018    2017  
Net income attributable to Amedisys, Inc. $33,349 $  4,461 $60,508 $19,591
Add:    
Income tax expense (benefit)   10,596    (1,963)   20,159    7,960
Interest expense, net   2,026    1,156    3,609    2,205
Depreciation and amortization    3,125    4,537    6,718    8,954
Certain items (1)    1,035    27,958    1,224    29,424
Interest component of certain items (1)    (446)   —     (829)   — 
     
Adjusted EBITDA (2) (6) $49,685 $36,149 $91,389 $68,134
     

Adjusted Net Service Revenue Reconciliation:

 For the Three-
Month Period
Ended June 30,  
For the Six-
Month Period
Ended June 30,
 
  2018   2017   2018   2017  
Net service revenue $411,603$374,946$810,865$739,607
Add:    
Certain items (1)    1,687   —    1,687   — 
     
Adjusted net service revenue (3) (6)$413,290$374,946$812,552$739,607
     

Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:

 For the Three-
Month Period
Ended June 30,  
For the Six-
Month Period
Ended June 30,
 
  2018   2017   2018   2017  
Net income attributable to Amedisys, Inc. $33,349$  4,461$60,508$19,591
Add:    
Certain items (1)    766   16,915   906   17,802
     
Adjusted net income attributable to Amedisys, Inc. (4) (6) $34,115$21,376$61,414$37,393
     

Adjusted Net Income Attributable to Amedisys, Inc. per Diluted Share:

 For the Three-
Month Period
Ended June 30,  
For the Six-
Month Period
Ended June 30,
 
  2018   2017   2018   2017  
Net income attributable to Amedisys, Inc. common stockholders per diluted share$0.98$0.13$1.76$0.57
Add:    
Certain items (1)    0.02   0.49   0.03   0.52
     
Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share (5) (6) $1.00$0.62$1.79$1.09
     


(1)      The following details the certain items for the three and six month periods ended June 30, 2018 and 2017:

Certain Items:

 For the Three-
Month Period
Ended June 30, 2018  
For the Six-
Month Period
Ended June 30, 2018
 
 (Income) Expense  (Income) Expense  
Certain Items Impacting Net Service Revenue:  
Florida self-audit (pre-acquisition) $  1,687 $  1,687 
Certain Items Impacting Operating Expenses:  
Acquisition costs    440    875 
Legal fees - non-routine    543    1,105 
Certain Items Impacting Total Other Income (Expense):  
Miscellaneous, other (income) expense, net    (1,635)   (2,443)
   
Total $  1,035 $  1,224 
   
Net of tax $  766 $  906 
   
Diluted EPS $  0.02 $  0.03 
   
   
 For the Three-
Month Period
Ended June 30, 2017  
For the Six-
Month Period
Ended June 30, 2017
 
 (Income) Expense  (Income) Expense  
Certain Items Impacting Operating Expenses:  
Acquisition costs $  294 $  976 
Legal fees - non-routine    1,111    1,234 
Securities Class Action Lawsuit settlement accrual, net    28,712    28,712 
Data center relocation    226    940 
Certain Items Impacting Total Other Income (Expense):  
Legal settlements   (693)   (1,367)
Miscellaneous, other (income) expense, net    (1,692)   (1,071)
   
Total $  27,958 $  29,424 
   
Net of tax $  16,915 $  17,802 
   
Diluted EPS $  0.49 $  0.52 
   

(2)      Adjusted EBITDA is defined as net income attributable to Amedisys, Inc. before provision for income taxes, net interest expense and depreciation and amortization, excluding certain items as described in footnote 1.
(3)      Adjusted net service revenue is defined as net service revenue plus certain items as described in footnote 1.
(4)      Adjusted net income attributable to Amedisys, Inc. is defined as net income attributable to Amedisys, Inc. calculated in accordance with GAAP excluding certain items as described in footnote 1.
(5)      Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share is defined as diluted income per share calculated in accordance with GAAP excluding the earnings per share effect of certain items as described in footnote 1.
(6)      Adjusted EBITDA, adjusted net service revenue, adjusted net income attributable to Amedisys, Inc. and adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share should not be considered as an alternative to, or more meaningful than, income before income taxes or other measure calculated in accordance with GAAP. These calculations may not be comparable to a similarly titled measure reported by other companies, since not all companies calculate these non-GAAP financial measures in the same manner.