Amedisys Reports Fourth Quarter and Year End 2018 Financial Results Issues 2019 Guidance


BATON ROUGE, La., Feb. 27, 2019 (GLOBE NEWSWIRE) -- Amedisys, Inc. (NASDAQ: AMED) today reported its financial results for the three month period and year ended December 31, 2018.

Three Month Periods Ended December 31, 2018 and 2017

  • Net service revenue increased $36.4 million to $434.4 million compared to $398.0 million in 2017 (1).
  • Net income attributable to Amedisys, Inc. of $27.5 million compared to net loss attributable to Amedisys, Inc. of $3.8 million in 2017.
  • Net income attributable to Amedisys, Inc. per diluted share of $0.84 per diluted share compared to net loss attributable to Amedisys, Inc. of $0.11 in 2017.

Adjusted Quarterly Results*

  • Adjusted EBITDA of $43.9 million compared to $37.1 million in 2017.
  • Adjusted net service revenue of $434.4 million compared to $398.0 million in 2017.
  • Adjusted net income attributable to Amedisys, Inc. of $29.8 million compared to $19.4 million in 2017.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $0.91 compared to $0.56 in 2017.

Years Ended December 31, 2018 and 2017

  • Net service revenue increased $151.3 million to $1,662.6 million compared to $1,511.3 million in 2017 (1).
  • Net income attributable to Amedisys, Inc. of $119.3 million compared to $30.3 million in 2017.
  • Net income attributable to Amedisys, Inc. per diluted share of $3.55 per diluted share compared to $0.88 in 2017.

Adjusted Year End Results*

  • Adjusted EBITDA of $180.6 million compared to $142.2 million in 2017.
  • Adjusted net service revenue of $1,664.3 million compared to $1,517.8 million in 2017.
  • Adjusted net income attributable to Amedisys, Inc. of $122.1 million compared to $75.9 million in 2017.
  • Adjusted net income attributable to Amedisys, Inc. per diluted share of $3.63 compared to $2.21 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 price concessions in determining the transaction price of our net service revenue.

Paul B. Kusserow, President and Chief Executive Officer stated, “Our fourth quarter results are a fitting cap to what has been by all accounts an incredible year for Amedisys. In 2018, we treated approximately 400,000 patients making more than 10 million visits across our three lines of business while continuing to execute and make excellent progress on our strategic pillars of clinical distinction, becoming the employer of choice, operational efficiency and growth. Providing our clinically distinct care to as many patients wherever they call home is, and will always be, our first priority and to that point, our home health and hospice quality measures continue to be at or near the top of the industry. After a year of rebuilding, our home health segment returned to growth and exceeded margin expectations. Hospice continued its stellar performance with another strong quarter and year of ADC growth and we continued to grow our personal care platform, completing two acquisitions during the year. Finally, thanks to our team of over 21,000 employees for continuing to do all that you do to drive such impressive results and provide such incredible care.”

2019 Guidance

  • Net service revenue is anticipated to be in the range of $1.94 billion to $1.98 billion.
  • Adjusted EBITDA is anticipated to be in the range of $205 million to $210 million.
  • Adjusted diluted earnings per share is anticipated to be in the range of $3.98 to $4.09 based on an estimated 33.1 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 2019 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, 2018, 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 Thursday, February 28, 2019, at 10:00 a.m. ET to discuss its fourth quarter and year end results. To participate on the conference call, please call before 10:00 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 March 28, 2019 by dialing (877) 660-6853 (Toll-Free) or (201) 612-7415 (Toll) and entering conference ID #13687280.

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 (loss) 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 (loss) attributable to Amedisys, Inc. excluding certain items; and (4) adjusted net income attributable to Amedisys, Inc. per diluted share, defined as net income (loss) 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. More than 3,000 hospitals and 65,000 physicians nationwide 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 more than 21,000 employees, in 472 care centers within 38 states and the District of Columbia, Amedisys is dedicated to delivering the highest quality of care to the doorsteps of more than 376,000 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, 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 consistently provide high-quality care, 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, our ability to realize the anticipated benefits of the acquisition of Compassionate Care Hospice, 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 MuscatoKendra Kimmons
 Vice President, Strategic FinanceVice President, Marketing & Communications
 (855) 259-2046(225) 299-3720
 IR@amedisys.comkendra.kimmons@amedisys.com


AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF OPERATIONS
(Amounts in thousands, except per share data)

 For the Three-Month
Period Ended December 31
  For the Year Ended
December 31
   
   
  2018   2017   2018   2017 
                
 (Unaudited)  
Net service revenue$434,378  $397,961  $1,662,578  $1,511,272 
Cost of service, excluding depreciation and amortization 262,251   239,238   992,863   903,377 
General and administrative expenses:    
Salaries and benefits 84,309   79,406   316,522   305,938 
Non-cash compensation 5,234   4,507   17,887   16,295 
Other 42,778   39,757   166,897   159,980 
Depreciation and amortization 3,379   3,984   13,261   17,123 
Asset impairment charge    1,323      1,323 
Securities Class Action Lawsuit settlement, net          28,712 
Operating expenses 397,951   368,215   1,507,430   1,432,748 
Operating income 36,427   29,746   155,148   78,524 
Other income (expense):    
Interest income 15   54   278   158 
Interest expense (1,536)  (1,431)  (7,370)  (5,031)
Equity in earnings from equity method investments 1,231   232   7,692   3,381 
Miscellaneous, net 458   487   3,240   3,769 
Total other income (expense), net 168   (658)  3,840   2,277 
Income before income taxes 36,595   29,088   158,988   80,801 
Income tax expense (8,875)  (32,794)  (38,859)  (50,118)
Net income (loss) 27,720   (3,706)  120,129   30,683 
Net income attributable to noncontrolling interests (259)  (142)  (783)  (382)
Net income (loss) attributable to Amedisys, Inc.$27,461  $(3,848) $119,346  $30,301 
                
Basic earnings per common share:    
Net income (loss) attributable to Amedisys, Inc. common stockholders$0.86  $(0.11) $3.64  $0.90 
Weighted average shares outstanding 31,916   33,898   32,791   33,704 
Diluted earnings per common share:    
Net income (loss) attributable to Amedisys, Inc. common stockholders$0.84  $(0.11) $3.55  $0.88 
Weighted average shares outstanding 32,805   33,898   33,609   34,304 
                

AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(Amounts in thousands, except share data)

 As of December 31,
  2018   2017 
ASSETS  
Current assets:  
Cash and cash equivalents$20,229  $86,363 
Patient accounts receivable 188,972   201,196 
Prepaid expenses 7,568   7,329 
Other current assets 7,349   16,268 
Total current assets 224,118   311,156 
Property and equipment, net of accumulated depreciation of $95,472 and $146,814 29,449   31,122 
Goodwill 329,480   319,949 
Intangible assets, net of accumulated amortization of $33,050 and $30,610 44,132   46,061 
Deferred income taxes 35,794   56,064 
Other assets 54,145   49,130 
Total assets$717,118  $813,482 
        
   
LIABILITIES AND EQUITY  
Current liabilities:  
Accounts payable$28,531  $25,384 
Payroll and employee benefits 92,858   89,936 
Accrued expenses 99,475   89,104 
Current portion of long-term obligations 1,612   10,638 
Total current liabilities 222,476   215,062 
Long-term obligations, less current portion 5,775   78,203 
Other long-term obligations 6,234   3,791 
Total liabilities 234,485   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; 36,252,280 and 35,747,134 shares issued; and 31,973,505 and 33,964,767 shares outstanding 36   35 
Additional paid-in capital 603,666   568,780 
Treasury stock at cost 4,278,775 and 1,782,367 shares of common stock (241,685)  (53,713)
Accumulated other comprehensive income 15   15 
Retained earnings 119,550   204 
Total Amedisys, Inc. stockholders’ equity 481,582   515,321 
Noncontrolling interests 1,051   1,105 
Total equity 482,633   516,426 
Total liabilities and equity$717,118  $813,482 
        
   

AMEDISYS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS AND DAYS REVENUE OUTSTANDING
(Amounts in thousands, except statistical information)

 For the Three-Month
Period Ended December 31
  For the Year
Ended December 31

   
  2018   2017   2018   2017 
                
 (Unaudited)  
Cash Flows from Operating Activities:    
Net income (loss)$27,720  $(3,706) $120,129  $30,683 
Adjustments to reconcile net income (loss) to net cash provided by operating activities:    
Depreciation and amortization 3,379   3,984   13,261   17,123 
Non-cash compensation 5,234   4,507   17,887   16,295 
401(k) employer match 2,042   2,207   8,976   8,754 
(Gain) loss on disposal of property and equipment (24)  22   714    
Deferred income taxes 5,355   34,950   20,271   52,178 
Equity in earnings from equity method investments (1,231)  (232)  (7,692)  (3,381)
Amortization of deferred debt issuance costs/debt discount 201   180   797   735 
Return on equity investment 1,785   665   6,158   5,321 
Asset impairment charge    1,323      1,323 
Changes in operating assets and liabilities, net of impact of acquisitions:    
Patient accounts receivable 6,058   (23,826)  12,224   (34,672)
Other current assets 8,711   956   8,679   (4,940)
Other assets 2,221   (547)  2,947   (12,749)
Accounts payable 3,835   2,587   3,165   (2,843)
Accrued expenses (1,234)  9,259   13,524   31,843 
Other long-term obligations (19)  (140)  2,443   61 
                
Net cash provided by operating activities 64,033   32,189   223,483   105,731 
                
Cash Flows from Investing Activities:    
Proceeds from sale of deferred compensation plan assets 152      715   622 
Proceeds from the sale of property and equipment 3   131   54   249 
Purchases of property and equipment (874)  (1,633)  (6,558)  (10,707)
Investments in equity method investees (3,667)  (40)  (7,144)  (476)
Acquisitions of businesses, net of cash acquired (5,186)  (9,587)  (9,260)  (33,715)
                
Net cash used in investing activities (9,572)  (11,129)  (22,193)  (44,027)
                
     
Cash Flows from Financing Activities:    
Proceeds from issuance of stock upon exercise of stock options 3,204   340   5,953   4,554 
Proceeds from issuance of stock to employee stock purchase plan 642   584   2,429   2,382 
Shares withheld upon stock vesting (1,149)  (485)  (6,570)  (6,939)
Non-controlling interest distribution (560)     (1,090)  (216)
Proceeds from borrowings under revolving line of credit 10,500      138,000    
Repayments of borrowings under revolving line of credit (60,500)     (130,500)   
Principal payments of long-term obligations (379)  (1,250)  (91,450)  (5,319)
Debt issuance costs       (2,433)   
Purchase of company stock       (181,402)   
Repurchase of noncontrolling interest       (361)   
Net cash used in financing activities (48,242)  (811)  (267,424)  (5,538)
Net increase (decrease) in cash and cash equivalents 6,219   20,249   (66,134)  56,166 
Cash and cash equivalents at beginning of period 14,010   66,114   86,363   30,197 
                
Cash and cash equivalents at end of period$20,229  $86,363  $20,229  $86,363 
                
Supplemental Disclosures of Cash Flow Information:    
Cash paid for interest$533  $509  $3,522  $2,697 
                
Cash paid for income taxes, net of refunds received$3,261  $  $14,278  $315 
                
Supplemental Disclosures of Non-Cash Financing Activities:    
Note payable issued for software licenses$  $  $418  $ 
                
Capital leases$929  $  $2,936  $ 
                
Days revenue outstanding (1) 38.0   44.0   38.0   44.0 
                

(1) Our calculation of days revenue outstanding at December 31, 2018 and 2017 is derived by dividing our ending patient accounts receivable by our average daily patient revenue for the three month periods ended December 31, 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 Period
Ended December 31,
  2018   2017 
Financial Information  (in millions):  
Medicare$211.5  $205.0 
Non-Medicare 92.5   76.9 
        
Net service revenue 304.0   281.9 
Cost of service 189.4   174.9 
        
Gross margin 114.6   107.0 
Asset impairment charge    1.3 
Other operating expenses 72.2   71.3 
        
Operating income$42.4  $34.4 
        
Same Store Growth (1):  
Medicare revenue 3%  2%
Non-Medicare revenue 20%  24%
Total admissions 6%  3%
Total volume (2) 6%  7%
Total Episodic admissions (3) 5%  2%
Total Episodic volume (4) 5%  5%
Key Statistical Data - Total (5):  
Medicare:  
Admissions 47,864   46,421 
Recertifications 28,555   27,896 
        
Total volume 76,419   74,317 
Completed episodes 75,497   73,037 
Visits 1,328,025   1,273,435 
Average revenue per completed episode (6)$2,891  $2,858 
Visits per completed episode (7) 17.7   17.6 
Non-Medicare:  
Admissions 30,092   27,421 
Recertifications 14,874   12,415 
        
Total volume 44,966   39,836 
Visits 722,677   619,745 
Total (5):  
Visiting Clinician Cost per Visit$84.27  $83.88 
Clinical Manager Cost per Visit 8.09   8.49 
        
Total Cost per Visit$92.36  $92.37 
Visits 2,050,702   1,893,180 


 For the Year
Ended December 31,
  2018   2017 
Financial Information  (in millions):  
Medicare$830.8  $793.3 
Non-Medicare 343.7   290.6 
Net service revenue 1,174.5   1,083.9 
Cost of service 722.1   670.9 
Gross margin 452.4   413.0 
Asset impairment charge    1.3 
Other operating expenses 279.8   281.9 
Operating income$172.6  $129.8 
        
Same Store Growth (1):  
Medicare revenue 6%  (4%)
Non-Medicare revenue 18%  17%
Total admissions 5%  2%
Total volume (2) 7%  4%
Total Episodic admissions (3) 4%  1%
Total Episodic volume (4) 5%  3%
Key Statistical Data - Total (5):  
Medicare:  
Admissions 190,748   190,132 
Recertifications 112,773   106,774 
Total volume 303,521   296,906 
Completed episodes 296,223   290,227 
Visits 5,261,315   5,067,436 
Average revenue per completed episode (6)$2,854  $2,823 
Visits per completed episode (7) 17.6   17.3 
Non-Medicare:  
Admissions 118,577   107,665 
        
Recertifications 55,736   46,364 
Total volume 174,313   154,029 
Visits 2,772,339   2,347,363 
Total (5):  
Visiting Clinician Cost per Visit$81.88  $82.04 
Clinical Manager Cost per Visit 8.01   8.44 
Total Cost per Visit$89.89  $90.48 
Visits 8,033,654   7,414,799 

(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 Period

Ended December 31,
  2018   2017 
Financial Information  (in millions):  
Medicare$103.5  $92.7 
Non-Medicare 5.3   5.2 
Net service revenue 108.8   97.9 
Cost of service 56.8   50.6 
Gross margin 52.0   47.3 
Other operating expenses 23.2   20.8 
Operating income$28.8  $26.5 
        
Same Store Growth (1):  
Medicare revenue 11%  14%
Non-Medicare revenue 5%  131%
Hospice admissions 12%  8%
Average daily census 9%  12%
Key Statistical Data - Total (2):  
Hospice admissions 7,152   6,371 
Average daily census 7,809   7,162 
Revenue per day, net$151.46  $148.62 
Cost of service per day$79.02  $76.81 
Average discharge length of stay 103   96 


 For the Year
Ended December 31,
  2018   2017 
Financial Information  (in millions):  
Medicare$390.2  $350.7 
Non-Medicare 20.7   17.1 
Net service revenue 410.9   367.8 
Cost of service 212.0   187.5 
Gross margin 198.9   180.3 
Other operating expenses 85.7   77.5 
Operating income$113.2  $102.8 
        
Same Store Growth (1):  
Medicare revenue 11%  17%
Non-Medicare revenue 21%  20%
Hospice admissions 8%  11%
Average daily census 11%  15%
Key Statistical Data - Total (2):  
Hospice admissions 27,596   25,381 
Average daily census 7,588   6,820 
Revenue per day, net$148.36  $147.75 
Cost of service per day$76.53  $75.31 
Average discharge length of stay 100   93 

(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 Period
Ended December 31,
 2018 2017
Financial Information  (in millions):  
Medicare$ $
Non-Medicare 21.6  18.1
      
   
Net service revenue 21.6  18.1
Cost of service 16.1  13.7
   
Gross margin 5.5  4.4
Other operating expenses 3.4  3.1
   
Operating income$2.1 $1.3
   
Key Statistical Data:  
Billable hours 890,696  782,140
Clients served 13,054  12,646
Shifts 406,119  365,360
Revenue per hour$24.24 $23.07
Revenue per shift$53.16 $49.39
Hours per shift 2.2  2.1
  
 For the Year
Ended December 31,
 2018 2017
Financial Information (in  millions):  
Medicare$ $
Non-Medicare 77.2  59.6
   
Net service revenue 77.2  59.6
Cost of service 58.8  45.0
   
Gross margin 18.4  14.6
Other operating expenses 13.1  9.7
   
Operating income$5.3 $4.9
   
Key Statistical Data:  
Billable hours 3,248,304  2,604,794
Clients served 17,981  16,774
Shifts 1,468,541  1,195,511
Revenue per hour$23.75 $22.86
Revenue per shift$52.54 $49.80
Hours per shift 2.2  2.2
      

Segment Information - Corporate

 For the Three-
Month Period
Ended December 31,
 2018 2017
Financial Information  (in millions):  
Other operating expenses$35.0 $29.6
Depreciation and amortization 1.9  2.9
      
Total operating expenses$36.9 $32.5
      
  
 For the Year
Ended December 31,
 2018 2017
Financial Information (in  millions):  
Other operating expenses$127.6 $117.8
Depreciation and amortization 8.4  12.5
      
Total operating expenses before Securities Class Action Lawsuit settlement, net 136.0  130.3
Securities Class Action Lawsuit settlement, net   28.7
Total operating expenses$136.0 $159.0
   

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 December 31,
  For the Year Ended
December 31,
  2018   2017   2018   2017 
Net income (loss) attributable to Amedisys, Inc.$27,461  $(3,848) $119,346  $30,301 
Add:    
Income tax expense 8,875   32,794   38,859   50,118 
Interest expense, net 1,521   1,377   7,092   4,873 
Depreciation and amortization 3,379   3,984   13,261   17,123 
Certain items (1) 3,124   24,414   3,739   61,429 
Interest component of certain items (1) (451)  (168)  (1,731)  (263)
Tax component of certain items (1)    (21,424)     ( 21,424)
Adjusted EBITDA (2) (6)$43,909  $37,129  $180,566  $142,157 
                
     

Adjusted Net Service Revenue Reconciliation:

 For the Three-
Month Period
Ended December 31,
  For the Year Ended
December 31,
 2018 2017  2018 2017
Net service revenue$434,378 $397,961 $1,662,578 $1,511,272
Add:    
Certain items (1)     1,687  6,506
            
Adjusted net service revenue (3) (6)$434,378 $397,961 $1,664,265 $1,517,778
            
     

Adjusted Net Income Attributable to Amedisys, Inc Reconciliation:

 For the Three-
Month Period
Ended December 31,
  
For the Year Ended
December 31,

  2018   2017    2018   2017 
             
Net income (loss) attributable to Amedisys, Inc.$27,461 $(3,848) $119,346 $30,301
Add:    
Certain items (1) 2,312  23,233   2,767  45,627
Adjusted net income attributable to Amedisys, Inc. (4) (6)$29,773 $19,385  $122,113 $75,928
     

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

 For the Three-
Month Period
Ended December 31,
  For the Year Ended
December 31,
  2018  2017   2018  2017
Net income (loss) attributable to Amedisys, Inc. common stockholders per diluted share$0.84 $(0.11) $3.55 $0.88
Add:    
Certain items (1) 0.07  0.67   0.08  1.33
Adjusted net income attributable to Amedisys, Inc. common stockholders per diluted share (5) (6)$0.91 $0.56  $3.63 $2.21
     

(1)      The following details the certain items for the three month periods and years ended December 31, 2018 and 2017:

Certain Items:

 For the Three-Month Period
Ended December 31, 2018
 For the Year Ended
December 31, 2018

 (Income) Expense (Income) Expense
Certain Items Impacting Net Service  Revenue:  
Florida self-audit (pre-acquisition)$  $1,687 
Certain Items Impacting Operating Expenses:  
Acquisition costs 1,025   2,757 
Legal fees - non-routine 56   1,465 
Indemnity receivable adjustment 2,143   2,143 
Certain Items Impacting Total Other Income (Expense):  
Legal settlements    (1,437)
Miscellaneous, other (income) expense, net (100)  (2,876)
Total$3,124  $3,739 
Net of tax$2,312  $2,767 
Diluted EPS$0.07  $0.08 
        
   


 For the Three-Month Period
Ended December 31, 2017
 
For the Year Ended
December 31, 2017

 (Income) Expense (Income) Expense
Certain Items Impacting Net Service  Revenue:  
Florida ZPIC audit$ $6,506 
Certain Items Impacting Operating Expenses:  
Acquisition costs 48  1,025 
Legal fees - non-routine 358  1,768 
Securities Class Action Lawsuit settlement, net   28,712 
Restructuring activity 648  2,318 
Data center relocation   940 
Asset impairment 1,323  1,323 
Certain Items Impacting Total Other Income (Expense):  
Legal settlements   (2,014)
Miscellaneous, other (income) expense, net 613  (573)
Certain Items Impacting Income Tax Expense:  
Remeasurement of deferred tax assets and liabilities 21,424  21,424 
Total$24,414 $61,429 
Net of tax$23,233 $45,627 
Diluted EPS$0.67 $1.33 
   

(2)      Adjusted EBITDA is defined as net income (loss) 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 (loss) 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 (loss) 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 measures 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.