Addus HomeCare Announces Fourth Quarter and Year End 2023 Financial Results

Addus HomeCare Corporation (NASDAQ: ADUS), a provider of home care services, today announced its financial results for the fourth quarter and year ended December 31, 2023.

Fourth Quarter 2023 Highlights:

  • Net Service Revenues Grow 11.9% to $276.4 Million
  • Net Income of $19.6 Million, or $1.20 per Diluted Share
  • Adjusted Net Income per Diluted Share Increases 18.9% year-over-year to $1.32
  • Adjusted EBITDA Increases 21.3% year-over-year to $34.3 Million
  • Cash Flow from Operations of $30.0 Million

Overview

Net service revenues were $276.4 million for the fourth quarter of 2023, an 11.9% increase compared with $247.1 million for the fourth quarter of 2022. Net income was $19.6 million for the fourth quarter of 2023, compared with $14.8 million for the fourth quarter of 2022, while net income per diluted share was $1.20 compared with $0.91 for the same period a year ago. Adjusted EBITDA increased 21.3% to $34.3 million for the fourth quarter of 2023 from $28.2 million for the fourth quarter of 2022. Adjusted net income was $21.6 million for the fourth quarter of 2023 compared with $18.1 million for the prior-year period, while adjusted net income per diluted share was $1.32 compared with $1.11 for the fourth quarter of 2022. Adjusted net income per diluted share for the fourth quarter of 2023 excludes the positive impact of retroactive collective bargaining negotiations of $(0.07), acquisition expenses of $0.07 and stock-based compensation expense of $0.12 (See the end of press release for a reconciliation of all non-GAAP and GAAP financial measures.)

For 2023, net service revenues increased 11.3% to $1.06 billion from $951.1 million for the prior-year period. Net income was $62.5 million for 2023 compared with $46.0 million for 2022, and net income per diluted share was $3.83 compared with $2.84 per diluted share. Adjusted EBITDA increased 19.3% to $121.0 million for 2023 from $101.5 million for 2022. Adjusted net income was $74.8 million for 2023 compared with $60.3 million for 2022, while adjusted net income per diluted share was $4.58 compared with $3.73 for the prior-year period.

Commenting on the results, Dirk Allison, Chairman and Chief Executive Officer, said, “Our fourth quarter financial and operating performance marked a strong finish to another record year for Addus. Revenue was up 11.9% and adjusted EBITDA was 21.3% higher for the fourth quarter of 2023 compared with the same period last year. Propelled by the strong momentum in our business throughout 2023, we surpassed $1.0 billion in annual revenues for the first time.

“We continued to benefit from robust demand for home-based care, especially for our personal care services, which accounted for 74.0% of our revenues. We were pleased with our 11.2% organic revenue growth on a same store basis for the quarter, and our annual growth rate of 12.1% was a record for our personal care services. This impressive revenue growth reflects higher volumes, as well as continued rate support for our services.

“Our fourth quarter results included a full three months of operations from Tennessee Quality Care, a provider of home health, hospice, and private duty nursing services, which we acquired August 1, 2023. These acquired operations allowed us to expand our coverage capabilities to all three levels of home-based care in Tennessee, and we are excited about the opportunities to serve more patients in this strategically important market. We will continue to identify additional markets where we can enhance our personal care presence and add clinical care operations, especially where we see potential for growth in value-based contracting models, as payors have expressed interest in both the cost benefits and high quality of our home-based care services.

“Hospice services accounted for 19.8% of revenue for the fourth quarter and included the benefit of a 3.1% rate increase that was effective on October 1, 2023. Hospice revenues were up 3.5% over the fourth quarter of 2022 on a same-store basis, and we were pleased to see further improvement in average daily census and length of stay compared with the same period last year,” said Allison.

Cash and Liquidity

As of December 31, 2023, the Company had cash of $64.8 million and bank debt of $126.4 million, with capacity and availability under its revolving credit facility of $470.0 million and $335.6 million, respectively. Net cash provided by operating activities was $30.0 million for the fourth quarter of 2023, and $112.2 million for the full year 2023, inclusive of a net $7.6 million in ARPA funds utilization.

Allison added, “In 2023 we generated strong cash flow from operations, bolstered by higher revenues and consistent payments from our various payors. Combined with our disciplined balance sheet management, we were able to fully fund our acquisitions during 2023 and still lower our revolver balance by $8.5 million from the end of the prior year. Importantly, we have the financial flexibility to continue to invest in our business and pursue our strategic growth initiatives, including acquisitions and other potential development opportunities. We are optimistic that we will see attractive acquisition opportunities in 2024 as market conditions continue to improve.

“As we look to 2024, we will continue to build on our momentum and capitalize on the growing demand for our home-based care. Addus offers a strong value proposition with high-quality and cost-effective care for patients in the preferred home setting. We are fortunate to have a dedicated team of caregivers across our markets who advance our mission to provide outstanding care and support for increasing numbers of patients and families. We continue to look for ways to improve the way we deliver care with enhanced training and investments in applications that support our caregivers with more efficient scheduling and overall service. With this capable team representing Addus, we are confident in our ability to extend our market reach in 2024 and deliver greater value to our shareholders.”

Non-GAAP Financial Measures

The information provided in this release includes adjusted net income, adjusted EBITDA, adjusted net income per diluted share and adjusted net service revenue, which are non-GAAP financial measures. The Company defines adjusted net income as net income before acquisition expenses, stock-based compensation expenses, restructure and other non-recurring costs, gain or loss on the sale of assets, retroactive rate increases from New York, and the retroactive impact from collective bargaining negotiations. The Company defines adjusted EBITDA as earnings before interest expense, other non-operating income, taxes, depreciation, amortization, acquisition expense, stock-based compensation expense, restructure and other non-recurring costs, gain or loss on the sale of assets, retroactive rate increases from New York, and the retroactive impact from collective bargaining negotiations. The Company defines adjusted net income per diluted share as net income per share, adjusted for acquisition expenses, stock-based compensation expense, restructure and other non-recurring costs, gain or loss on the sale of assets, retroactive rate increases from New York, and the retroactive impact from collective bargaining negotiations. The Company defines adjusted net service revenues as revenue adjusted for the closure of certain sites. The Company has provided, in the financial statement tables included in this press release, a reconciliation of adjusted net income to net income, a reconciliation of adjusted EBITDA to net income, a reconciliation of adjusted diluted net income per share to net income per share, and a reconciliation of adjusted net service revenues to net service revenues, in each case, the most directly comparable GAAP measure. Management believes that adjusted net income, adjusted EBITDA, adjusted diluted net income per share, and adjusted net service revenues are useful to investors, management and others in evaluating the Company’s operating performance, to provide investors with insight and consistency in the Company’s financial reporting and to present a basis for comparison of the Company’s business operations among periods, and to facilitate comparison with the results of the Company’s peers.

Conference Call

Addus will host a conference call on Tuesday, February 27, 2024, at 9:00 a.m. Eastern time. To access the live call, dial (833) 629-0620 (international dial-in number is (412) 317-1805) and ask to join the Addus HomeCare earnings call. A telephonic replay of the conference call will be available through midnight on March 5, 2024, by dialing (877) 344-7529 (international dial-in number is (412) 317-0088) and entering pass code 1856114.

A live broadcast of Addus HomeCare’s conference call will be available under the Investor Relations section of the Company’s website: www.addus.com. An online replay will also be available on the Company’s website for one month, beginning approximately two hours following the conclusion of the live broadcast.

Forward-Looking Statements

Certain matters discussed in this press release constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Such forward-looking statements may be identified by words such as “preliminary,” “continue,” “expect,” and similar expressions. These forward-looking statements are based on our current expectations and beliefs concerning future developments and their potential effect on us. Forward-looking statements involve a number of risks and uncertainties that may cause actual results to differ materially from those expressed or implied by such forward-looking statements, including discretionary determinations by government officials, the consummation and integration of acquisitions, transition to managed care providers, our ability to successfully execute our growth strategy, unexpected increases in SG&A and other expenses, expected benefits and unexpected costs of acquisitions and dispositions, management plans related to dispositions, the possibility that expected benefits may not materialize as expected, the failure of the business to perform as expected, changes in reimbursement, changes in government regulations, changes in Addus HomeCare’s relationships with referral sources, increased competition for Addus HomeCare’s services, changes in the interpretation of government regulations, the uncertainty regarding the outcome of discussions with managed care organizations, changes in tax rates, the impact of adverse weather, higher than anticipated costs, lower than anticipated cost savings, estimation inaccuracies in future revenues, margins, earnings and growth, whether any anticipated receipt of payments will materialize, any security breaches, cyber-attacks, loss of data or cybersecurity threats or incidents, and other risks set forth in the Risk Factors section in Addus HomeCare’s Annual Report on Form 10-K filed with the Securities and Exchange Commission on February 28, 2023, which is available at www.sec.gov. The financial information described herein and the periods to which they relate are preliminary estimates that are subject to change and finalization. There is no assurance that the final amounts and adjustments will not differ materially from the amounts described above, or that additional adjustments will not be identified, the impact of which may be material. Addus HomeCare undertakes no obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. In addition, these forward-looking statements necessarily depend upon assumptions, estimates and dates that may be incorrect or imprecise and involve known and unknown risks, uncertainties, and other factors. Accordingly, any forward-looking statements included in this press release do not purport to be predictions of future events or circumstances and may not be realized. (Unaudited tables and notes follow).

About Addus HomeCare

Addus HomeCare is a provider of home care services that primarily include personal care services that assist with activities of daily living, as well as hospice and home health services. Addus HomeCare’s consumers are primarily persons who, without these services, are at risk of hospitalization or institutionalization, such as the elderly, chronically ill and disabled. Addus HomeCare’s payor clients include federal, state, and local governmental agencies, managed care organizations, commercial insurers, and private individuals. Addus HomeCare currently provides home care services to over 49,000 consumers through 217 locations across 22 states. For more information, please visit www.addus.com.

ADDUS HOMECARE CORPORATION AND SUBSIDIARIES
Condensed Consolidated Statements of Income
(amounts and shares in thousands, except per share data)
(Unaudited)
 
Income Statement Information:

For the Three Months

Ended December 31,

 

For the Twelve Months

Ended December 31,

 

2023

 

 

 

2022

 

 

 

2023

 

 

 

2022

 

 
Net service revenues

$

276,351

 

$

247,050

 

$

1,058,651

 

$

951,120

 

Cost of service revenues

 

183,938

 

 

168,281

 

 

718,775

 

 

651,381

 

 
Gross profit

 

92,413

 

 

78,769

 

 

339,876

 

 

299,739

 

 

33.4

%

 

31.9

%

 

32.1

%

 

31.5

%

General and administrative expenses

 

60,766

 

 

54,466

 

 

234,794

 

 

216,942

 

Depreciation and amortization

 

3,677

 

 

3,489

 

 

14,126

 

 

14,060

 

Total operating expenses

 

64,443

 

 

57,955

 

 

248,920

 

 

231,002

 

 
Operating income

 

27,970

 

 

20,814

 

 

90,956

 

 

68,737

 

 
Total interest expense, net

 

2,616

 

 

2,537

 

 

9,630

 

 

8,566

 

 
Income before income taxes

 

25,354

 

 

18,277

 

 

81,326

 

 

60,171

 

Income tax expense

 

5,776

 

 

3,515

 

 

18,810

 

 

14,146

 

 
Net income

$

19,578

 

$

14,762

 

$

62,516

 

$

46,025

 

 
Net income per diluted share:

$

1.20

 

$

0.91

 

$

3.83

 

$

2.84

 

 
 
Weighted average number of common shares outstanding:
Diluted

 

16,307

 

 

16,258

 

 

16,311

 

 

16,181

 

 
 
 
 
Cash Flow Information:

For the Three Months

Ended December 31,

 

For the Twelve Months

Ended December 31,

 

2023

 

 

 

2022

 

 

 

2023

 

 

 

2022

 

 
Net cash provided by operating activities

$

30,049

 

$

24,292

 

$

112,247

 

$

105,110

 

Net cash (used in) investing activities

 

(5,302

)

 

(19,236

)

 

(119,236

)

 

(106,590

)

Net cash (used in) financing activities

 

(39,706

)

 

(30,739

)

 

(8,181

)

 

(87,454

)

 
Net change in cash

 

(14,959

)

 

(25,683

)

 

(15,170

)

 

(88,934

)

Cash at the beginning of the period

 

79,750

 

 

105,644

 

 

79,961

 

 

168,895

 

Cash at the end of the period

$

64,791

 

$

79,961

 

$

64,791

 

$

79,961

 

ADDUS HOMECARE CORPORATION AND SUBSIDIARIES
Condensed Consolidated Balance Sheets
(Amounts in thousands)
(Unaudited)
   
   
   

December 31,

 

2023

 

 

 

2022

 
Assets  
   
Current assets  
Cash

$

64,791

 

$

79,961

Accounts receivable, net

 

115,499

 

 

125,501

Prepaid expenses and other current assets

 

19,714

 

 

17,345

   
Total current assets

 

200,004

 

 

222,807

   
Property and equipment, net

 

24,011

 

 

21,182

   
Other assets  
Goodwill

 

662,995

 

 

582,837

Intangible assets, net

 

91,983

 

 

72,188

Operating lease assets

 

45,433

 

 

38,980

Total other assets

 

800,411

 

 

694,005

   
Total assets

$

1,024,426

 

$

937,994

   
Liabilities and stockholders' equity  
   
Current liabilities  
Accounts payable

$

26,183

 

$

22,092

Accrued payroll

 

56,551

 

 

44,937

Accrued expenses

 

33,236

 

 

27,507

Operating lease liabilities - current portion

 

11,339

 

 

10,801

Government stimulus advance

 

5,765

 

 

12,912

Accrued workers compensation

 

12,043

 

 

12,897

Total current liabilities

 

145,117

 

 

131,146

   
Long-term debt, less current portion, net of debt issuance costs

 

124,132

 

 

131,772

Long-term lease liability, less current portion

 

39,711

 

 

35,479

Other long-term liabilities

 

8,772

 

 

6,057

Total long-term liabilities

 

172,615

 

 

173,308

   
Total liabilities

 

317,732

 

 

304,454

   
Total stockholders' equity

 

706,694

 

 

633,540

   
Total liabilities and stockholders' equity

$

1,024,426

 

$

937,994

ADDUS HOMECARE CORPORATION AND SUBSIDIARIES
Net Service Revenue by Segment
(Amounts in thousands)
(Unaudited)
 

For the Three Months

Ended December 31,

 

For the Twelve Months

Ended December 31,

 

2023

 

 

2022

 

 

2023

 

 

2022

Net Service Revenues by Segment
 
Personal Care

$

204,491

$

183,365

$

794,718

$

706,507

Hospice

 

54,741

 

50,612

 

207,155

 

201,772

Home Health

 

17,119

 

13,073

 

56,778

 

42,841

Total Revenue

$

276,351

$

247,050

$

1,058,651

$

951,120

 
ADDUS HOMECARE CORPORATION AND SUBSIDIARIES
Key Statistical and Financial Data (Unaudited)
   

For the Three Months

Ended December 31,

 

For the Twelve Months

Ended December 31,

 

2023

 

 

2022

 

 

 

2023

 

 

2022

   
   
Personal Care  
   
States served at period end

 

-

 

 

-

 

 

 

21

 

 

21

Locations at period end

 

-

 

 

-

 

 

 

156

 

 

156

Average billable census - same store (1)

 

37,993

 

 

38,169

 

 

 

38,430

 

 

37,482

Average billable census - acquisitions

 

85

 

 

-

 

 

 

91

 

 

-

Average billable census total

 

38,078

 

 

38,169

 

 

 

38,521

 

 

37,482

Billable hours (in thousands)

 

7,694

 

 

7,465

 

 

 

30,658

 

 

29,412

Average billable hours per census per month

 

67.2

 

 

65.0

 

 

 

66.2

 

 

65.1

Billable hours per business day

 

118,366

 

 

114,849

 

 

 

117,915

 

 

113,122

Revenues per billable hour

$

26.53

 

$

24.48

 

 

$

25.86

 

$

23.91

Organic growth  
- Revenue

 

11.2

%

 

7.9

%

 

 

12.1

%

 

4.6

%

   
Hospice  
   
Locations served at period end

 

-

 

 

-

 

 

 

39

 

 

33

Admissions

 

3,326

 

 

3,393

 

 

 

12,902

 

 

13,171

Average daily census (2)

 

3,381

 

 

3,213

 

 

 

3,415

 

 

3,279

Average discharge length of stay

 

97.8

 

 

90.2

 

 

 

94.4

 

 

87.7

Patient days

 

311,015

 

 

295,619

 

 

 

1,203,522

 

 

1,176,193

Revenue per patient day

$

176.01

 

$

171.21

 

 

$

175.43

 

$

171.55

Organic growth  
- Revenue

 

3.5

%

 

(4.9

)%

 

 

2.0

%

 

0.4

%

- Average daily census

 

(1.1

)%

 

(0.9

)%

 

 

0.3

%

 

1.9

%

   
Home Health  
   
Locations served at period end

 

-

 

 

-

 

 

 

24

 

 

13

New Admissions

 

4,654

 

 

4,081

 

 

 

16,251

 

 

14,452

Recertifications

 

3,214

 

 

1,631

 

 

 

9,030

 

 

5,838

Total Volume

 

7,868

 

 

5,712

 

 

 

25,281

 

 

20,290

Visits

 

104,161

 

 

88,046

 

 

 

344,919

 

 

293,381

Organic growth  
- Revenue

 

(17.8

)%

 

8.3

%

 

 

(7.1

)%

 

8.2

%

- New admissions

 

(10.3

)%

 

(12.8

)%

 

 

(9.8

)%

 

16.4

%

- Volume

 

(9.2

)%

 

(1.8

)%

 

 

(7.2

)%

 

18.7

%

   
Percentage of Revenues by Payor:  
   
Personal Care  
   
State, local and other governmental programs

 

50.5

%

 

49.3

%

 

 

50.4

%

 

49.3

%

Managed care organizations

 

46.4

 

 

46.7

 

 

 

46.2

 

 

46.3

Private duty

 

1.9

 

 

2.5

 

 

 

2.0

 

 

2.6

Commercial

 

0.8

 

 

0.9

 

 

 

0.8

 

 

1.1

Other

 

0.4

%

 

0.6

%

 

 

0.6

%

 

0.7

%

   
Hospice  
   
Medicare

 

89.3

%

 

91.3

%

 

 

89.9

%

 

90.9

%

Commercial

 

6.3

 

 

4.5

 

 

 

6.0

 

 

5.0

Managed care organizations

 

3.7

 

 

3.7

 

 

 

3.4

 

 

3.6

Other

 

0.7

%

 

0.5

%

 

 

0.7

%

 

0.5

%

   
Home Health  
   
Medicare

 

68.8

%

 

74.9

%

 

 

72.3

%

 

73.5

%

Managed care organizations

 

25.5

 

 

18.9

 

 

 

22.2

 

 

20.3

Commercial

 

4.4

 

 

6.0

 

 

 

4.4

 

 

6.0

Other

 

1.3

%

 

0.2

%

 

 

1.1

%

 

0.2

%

   
   
(1) Exited sites would have reduced same store census for the three and twelve months ended December 31, 2022 by 3 and 24, respectively.
(2) Exited sites would have reduced average daily census for the three and twelve months ended December 31, 2022 by 6 and 27, respectively.
ADDUS HOMECARE CORPORATION AND SUBSIDIARIES
Reconciliation of Non-GAAP Financial Measures
(Amounts in thousands, except per share data)
(Unaudited) (1)
 

For the Three Months

Ended December 31,

 

For the Twelve Months

Ended December 31,

 

2023

 

 

 

2022

 

 

 

2023

 

 

 

2022

 

Reconciliation of Adjusted EBITDA to Net Income: (1)
 
Net income

$

19,578

 

$

14,762

 

$

62,516

 

$

46,025

 

 
Interest expense, net

 

2,616

 

 

2,537

 

 

9,630

 

 

8,566

 

(Gain) Loss on sale of assets

 

3

 

 

(33

)

 

(2

)

 

(60

)

Income tax expense

 

5,776

 

 

3,515

 

 

18,810

 

 

14,146

 

Depreciation and amortization

 

3,677

 

 

3,489

 

 

14,126

 

 

14,060

 

Impact of retroactive New York rate increase

 

-

 

 

-

 

 

(868

)

 

-

 

Impact of retroactive collective bargaining negotiations

 

(1,338

)

 

-

 

 

-

 

 

-

 

Acquisition expenses

 

1,428

 

 

1,155

 

 

6,220

 

 

7,657

 

Stock-based compensation expense

 

2,488

 

 

2,680

 

 

10,319

 

 

10,625

 

Restructure and other non-recurring costs

 

27

 

 

143

 

 

269

 

 

461

 

Adjusted EBITDA

$

34,255

 

$

28,248

 

$

121,020

 

$

101,480

 

 
 
Reconciliation of Adjusted Net Income to Net Income: (2)
 
Net income

$

19,578

 

$

14,762

 

$

62,516

 

$

46,025

 

 
(Gain) Loss on sale of assets

 

3

 

 

(33

)

 

(2

)

 

(60

)

Impact of retroactive New York rate increase

 

-

 

 

-

 

 

(868

)

 

-

 

Impact of retroactive collective bargaining negotiations

 

(1,338

)

 

-

 

 

-

 

 

-

 

Acquisition expenses

 

1,428

 

 

1,155

 

 

6,220

 

 

7,657

 

Stock-based compensation expense

 

2,488

 

 

2,680

 

 

10,319

 

 

10,625

 

Restructure and other non-recurring costs

 

27

 

 

143

 

 

269

 

 

461

 

Tax effect

 

(594

)

 

(652

)

 

(3,694

)

 

(4,393

)

 
Adjusted Net Income

$

21,592

 

$

18,055

 

$

74,760

 

$

60,315

 

 
 
Reconciliation of Net Income per Diluted Share to Adjusted Net Income per Diluted Share: (3)
 
Net income per diluted share

$

1.20

 

$

0.91

 

$

3.83

 

$

2.84

 

 
Impact of retroactive New York rate increase per diluted share

 

-

 

 

-

 

 

(0.04

)

 

-

 

Impact of retroactive collective bargaining negotiations per diluted share

 

(0.07

)

 

-

 

 

-

 

 

-

 

Acquisition expenses per diluted share

 

0.07

 

 

0.06

 

 

0.29

 

 

0.36

 

Restructure and other non-recurring costs per diluted share

 

-

 

 

0.01

 

 

0.01

 

 

0.02

 

Stock-based compensation expense per diluted share

 

0.12

 

 

0.13

 

 

0.49

 

 

0.51

 

 
Adjusted net income per diluted share

$

1.32

 

$

1.11

 

$

4.58

 

$

3.73

 

 
Reconciliation of Net Service Revenues to Adjusted Net Service Revenues: (4)
 
Net service revenues

$

276,351

 

$

247,050

 

$

1,058,651

 

$

951,120

 

 
Revenues associated with the closure of certain sites

 

(0

)

 

(722

)

 

(1,325

)

 

(4,339

)

 
Adjusted net service revenues

$

276,351

 

$

246,328

 

$

1,057,326

 

$

946,781

 

Footnotes:
 
(1) We define Adjusted EBITDA as earnings before net interest expense, income tax expense, depreciation and amortization, acquisition expenses, stock-based compensation expense, restructure expenses and other non-recurring costs, gain or loss on the sale of assets, retroactive rate increases from New York and the retroactive impact of collective bargaining negotiations. Adjusted EBITDA is a performance measure used by management that is not calculated in accordance with generally accepted accounting principles in the United States (GAAP). It should not be considered in isolation or as a substitute for net income, operating income or any other measure of financial performance calculated in accordance with GAAP.
(2) We define Adjusted Net Income as net income before acquisition expenses, stock-based compensation expense, restructure and other non-recurring costs, gain or loss on the sale of assets, retroactive rate increases from New York and the retroactive impact of collective bargaining negotiations. Adjusted Net Income is a performance measure used by management that is not calculated in accordance with generally accepted accounting principles in the United States (GAAP). It should not be considered in isolation or as a substitute for net income, operating income or any other measure of financial performance calculated in accordance with GAAP.
(3) We define Adjusted diluted earnings per share as earnings per share, adjusted for acquisition expenses, stock-based compensation expense and restructure and other non-recurring costs, gain or loss on the sale of asset, retroactive rate increases from New York and the retroactive impact of collective bargaining negotiations. Adjusted diluted earnings per share is a performance measure used by management that is not calculated in accordance with generally accepted accounting principles in the United States (GAAP). It should not be considered in isolation or as a substitute for net income, operating income or any other measure of financial performance calculated in accordance with GAAP.
(4) We define Adjusted net service revenues as revenue adjusted for the closure of certain sites. Adjusted net service revenues is a performance measure used by management that is not calculated in accordance with generally accepted accounting principles in the United States (GAAP). It should not be considered in isolation or as a substitute for net income, operating income or any other measure of financial performance calculated in accordance with GAAP.

 

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