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Section 1: 8-K (8-K)

8-K

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

FORM 8-K

 

 

CURRENT REPORT

PURSUANT TO SECTION 13 OR 15(D)

OF THE SECURITIES EXCHANGE ACT OF 1934

DATE OF REPORT (DATE OF EARLIEST EVENT REPORTED): JANUARY 10, 2018

Commission File Number: 0-24260

 

 

LOGO

 

 

AMEDISYS, INC.

(Exact Name of Registrant as specified in its Charter)

 

 

 

Delaware   11-3131700

(State or other jurisdiction of

incorporation or organization)

 

(I.R.S. Employer

Identification No.)

3854 American Way, Suite A, Baton Rouge, LA 70816

(Address of principal executive offices, including zip code)

(225) 292-2031 or (800) 467-2662

(Registrant’s telephone number, including area code)

 

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

 

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).

Emerging growth company  ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  ☐

 

 

 


SECTION 7 – REGULATION FD

ITEM 7.01. REGULATION FD DISCLOSURE

As of January 10, 2018 representatives of Amedisys, Inc. (the “Company”) will begin making presentations at investor conferences using slides containing the information attached to this Current Report on Form 8-K as Exhibit 99.1. The Company expects to use these slides, in whole or in part, and possibly with modifications, in connection with presentations to investors, analysts and others during 2018.

By filing this report on Form 8-K and furnishing this information, the Company makes no admission as to the materiality of any information in this report.

The information contained in the slides is summary information that is intended to be considered in the context of the Company’s Securities and Exchange Commission (“SEC”) filings and other public announcements that it may make, by press release or otherwise, from time to time. The Company undertakes no duty or obligation to publicly update or revise the information contained in this report, although it may do so from time to time as its management believes is warranted. Any such updating may be made through the filing of other reports or documents with the SEC, through press releases or through other public disclosure.

In accordance with General Instruction B.2 of Form 8-K, the information presented herein, including the slides attached hereto as Exhibit 99.1, shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, except as previously set forth by specific reference in such a filing.

Use of our Website to Distribute Material Company Information

Our company website address is 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.

Certain Forward-Looking Statements

When included in this report and Exhibit 99.1 hereto, words like “believes,” “belief,” “expects,” “plans,” “anticipates,” “intends,” “projects,” “estimates,” “may,” “might,” “will,” “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.

 

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SECTION 9 – FINANCIAL STATEMENTS AND EXHIBITS

ITEM 9.01. FINANCIAL STATEMENTS AND EXHIBITS

(d) Exhibits.

 

99.1    Investor Relations Slide Show in use beginning January 10, 2018 (furnished only)

 

3


Signatures

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

AMEDISYS, INC.

(Registrant)

By:  

/s/ Scott G. Ginn

  Scott G. Ginn
 

Chief Financial Officer

(Principal Accounting Officer)

DATE: January 10, 2018

 

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Section 2: EX-99.1 (EX-99.1)

EX-99.1

Slide 1

Amedisys Presentation J.P. Morgan Health Care Conference 2018 Exhibit 99.1


Slide 2

This presentation may include forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements are based upon current expectations and assumptions about our business that are subject to a variety of risks and uncertainties that could cause actual results to differ materially from those described in this presentation. You should not rely on forward-looking statements as a prediction of future events. Additional information regarding factors that could cause actual results to differ materially from those discussed in any forward-looking statements are described in reports and registration statements we file with the SEC, including our Annual Report on Form 10-K and subsequent Quarterly Reports on Form 10-Q and Current Reports on Form 8-K, copies of which are available on the Amedisys internet website http://www.amedisys.com or by contacting the Amedisys Investor Relations department at (225) 292-2031. We disclaim any obligation to update any 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. www.amedisys.com NASDAQ: AMED We encourage everyone to visit the Investors Section of our website at www.amedisys.com, where we have posted additional important information such as press releases, profiles concerning our business and clinical operations and control processes, and SEC filings. Forward-looking statements


Slide 3

The Home Health and Hospice Industries Continue to Grow We continue to see steady growth in both Home Health and Hospice driven by favorable demographic trends, growing acceptance of each benefit and an increased recognition of our ability to drive cost out of higher cost settings while delivering high quality care Source: Medicare Payment Advisory Commission Reports to Congress – June 2017 data book Note: Enrollment numbers are based on Part A enrollment only. Beneficiaries enrolled only in Part B are not included *Share of all decedents = share of Medicare patients who passed away on Hospice Home Health Number of Users (millions) Share of FFS Beneficiaries Who Used Home Health Home Health Episodes (millions) Hospice Beneficiaries (millions) Medicare Payments (billions) Share of All Decedents Using Hospice* Historic Projected Enrollment in Medicare is Projected to Grow Rapidly in the Next 25 Years


Slide 4

2018 Strategic Landscape Amedisys is well positioned for success in 2018 LHCG & AFAM Merger of Equals On November 16, 2017, LHC Group and Almost Family announced that they have agreed to combine in an all-stock merger of equals transaction: Almost Family shareholders will receive 0.9150 shares of LHC Group for each existing Almost Family share Upon closing, LHC shareholders will own 58.5% and Almost Family shareholders will own 41.5% of the combined company HUM, TPG, WCAS Acquire KND On December 19, 2017, Kindred Healthcare announced its sale to TPG and Welsh Carson for $9.00 per share, representing a ~$4.1 billion transaction enterprise value Simultaneously with the acquisition by sponsors, Kindred at Home will be separated, and Humana will acquire a 40% stake in that business for $800 million in cash AMED Positioned for Growth Recent acquisition activity makes Amedisys one of only two publicly traded, pure-play, Home Health and Hospice companies of scale Our 2018 focus continues to be organic growth and inorganic expansion in all three lines of business The Home Health and Hospice industries remain very fragmented with the combined market share of the top five players in each space amounting to less than 20% Strong capital position allows for both large and small inorganic opportunities We will remain focused on our four core strategic pillars: Clinical Distinction Employer of Choice Operational Excellence and Efficiency Driving Growth Outstanding Outcomes For our Patients


Slide 5

What we Accomplished and Where we are Going 2018 2017 Realized the $46M annualized savings we promised Delivered on our goal of clinical distinction, reaching 4.21 stars average in the Jan 2018 HHC preview with 88% of our providers at 4+ Stars Lowered BD vacancy rate to 1.1% at the end of 3Q’17 from 8.6% in April 2017 Grew Hospice ADC to ~7,000 at the end of 3Q’17 Signed three Personal Care acquisitions making Amedisys the largest provider of Personal Care services Mass. Lowered voluntary turnover to ~22%, down from ~29% Improving productivity via increased proficiency in HCHB, Productivity Staffing Tool and standardized scheduling processes Home Health Reorg will be complete Feb 1st driving $7M - $9M in run-rate savings Portfolio optimization – focusing on margin improvement in underperforming care centers 4. Enhanced leadership training to drive improvement in turnover, onboarding, scheduling, episode management and employee engagement Continuation of Business Development staffing strategy Opportunistic M&A and balance sheet optimization What we Accomplished Where we are Going


Slide 6

Status Category Update Ongoing Initiative Quality ratings (Stars & VBP) Amedisys maintains above a 4-Star average (4.21) in the Jan 2018 HHC preview with 88% of providers at 4+ Stars; focusing on readmission reduction; Hospice quality metrics initially released Clinical Initiatives & Readmissions Create innovative industry-leading, clinical programs and define, develop and implement standardized care protocols at point of care. Heart program rolled out in Feb. 2017, COPD on-track BD Staffing / Turnover We exited September with 770 BD FTE’s and are on pace to reach our next target of 775 BD FTE’s by 4Q’17; significantly slowed turnover of productive staff that was occurring in late 2016 Clinical Staffing & Turnover During the third quarter, we filled over 1,300 clinical positions, building capacity for planned volume growth HCHB 2.0 Re-training the field to become system “super-users” or drive more efficiencies and organizational standardization Cost Initiatives / Margin We will deliver the run rate savings opportunities of $46M by 4Q’17; delivered on margin opportunity despite rate cuts (margin adjusted for rate cuts and Personal Care is ~12% in 3Q’17) Accounts Receivable DSO remained steady at 40.7. DSO excluding impact of FL ZPIC and Tenet acquisition was 38.0. Expect to reduce DSO to more normalized levels by end of year Home Health Same store episodic admissions ex. FL closures and hurricane up +3%. Same store total episodic volume growth +5% (admissions + recertifications) [ex. FL closures and hurricane] Hospice Hospice performance continues to be stellar. Same store Hospice admissions +7% and SS ADC growth +14% Personal Care Billable hours/quarter: +37%. Highly efficient integration process. Realizing synergies from HomeStaff acquisition. Targeting additional acquisitions and efficiency as platform is built out M&A Valuations remain high. Continue focus on Hospice, Personal Care and strategic Home Health acquisitions but will remain disciplined. Pipeline full Reimbursement Impact of rate cut ~$4M in 3Q’17, offset by $2M due to patient acuity levels. 2018 reimbursement for AMED (1.4%), half of the impact is due to the expiration of the rural add on (0.7%) How we’re tracking (3Q’17) Clinical Distinction Employer of Choice Operational Excellence & Efficiency Driving Growth Outstanding Outcomes for Our Patients In Their Homes Care Centers & Clinical Teams Continued focus on driving down 30 and 60 day readmissions rates, key value proposition for Medicare and other payors Continued focus on retention through engagement and development opportunities. Increased emphasis on HH BD staffing and retention paying dividends Home Health has realized impact of new BD FTE’s in 3Q’17 Targeting total episodic growth of 4-6% in 4Q (ex. Florida closures) Focusing M&A efforts on Hospice and Personal Care, while maintaining price discipline 2018 Home Health Final Rule did not include HHGM Focus of 2H’17 has shifted to HCHB 2.0 training – proof will be in productivity gains Aside from disruptions to A/R from Florida ZPIC and Tenet acquisition, making progress on reducing DSO


Slide 7

Our Key Areas of Focus Home Health: Rebuild of BD staff continues. BD FTE ramp helped us achieve our 3Q total episodic admit growth (+3% ex FL closures and hurricane). On track to achieve 4Q total episodic admit growth rate (ex. FL closures) of 4-6%. Same store episodic volume growth +5% Hospice: Continued growth at high single / low double digit pace (Admissions +7%, ADC +14%) Personal Care: Double digit growth in billable hours / quarter +37% 1 Organic Growth Amedisys improves STARS scores to 4.21 (Jan’18 preview) with 88% of providers at 4+ STAR rating STAR score improvement for the tenth consecutive quarter (from initial July’15 release to Jan’18 preview) 19 Amedisys providers (representing 29 care centers) rated at 5-Stars in the Jan’18 Preview Readmissions & clinical turnover Palliative care programs 3 Clinical Initiatives Continued training on productivity tool optimization will help to impact RN / LPN & PT / PTA ratio and give field leaders better insight into capacity by clinician providing more clarity around staffing needs Since Jan. 1, 2017, clinician productivity has increased in the range of 5% (partially due to increased volume being available) – helping to drive down CPV 4 Impact Capacity and Productivity Preference to acquire assets in: Hospice; Personal Care tuck-in’s, and opportunistic regional acquisitions in Home Health Unlevered balance sheet (0.2x) gives us access to capital and lots of options Pipeline strong but price expectations challenging 5 M&A 2 BD Recruiting / Retention Focus on BD recruiting and retention payoff as BD FTEs at the end of Sept. at 770 projected to be 775 by 4Q’17 (increase of 58 FTEs vs. 4Q16) BD vacancy rate at end of September: 1.1%, down from 8.6% in April Targeting industry leading employee retention amongst all employee categories 6 Regulatory Home Health 2018 rule finalized on 11/1 HHGM not included for implementation Working through details of final rule; final rule impacts AMED by (1.4%), half of this cut is due to rural add-on expiration 2018 Hospice rate increase of 1% effective 10/1/17 Work with CMS on future payment reform


Slide 8

Highlights and Summary Financial Results (Adjusted): 3Q 2017(1) Same store Home Health Episodic admissions up (+3%) excluding Florida closures and hurricane impact. Hospice (+7% same store admissions) and Personal Care (+37% billable hours) continue their strong growth. Cost containment initiatives performing very well driving 3Q EBITDA, EPS and cash flows Amedisys Consolidated Revenue Growth: +7% EBITDA: $37M (+44%) EBITDA Margin: 9.5% EPS: $0.56 (+56%) 3Q’17 Net debt: $25.9 Leverage ratio: 0.2x (net) CFFO: $10.2M ($38.9M ex. Legal Settlements) Free cash flow (5) : $8.3M ($37.0M) ex. Legal Settlements) Balance Sheet & Cash Flow 3Q’17 Same Store Admissions (2): Episodic (3): +3% Non-Episodic: +3% Same Store Volume (4): Episodic: +5% Other Statistics: Total cost per visit: (1%) Recert Rate: +300 bps Home Health Growth Metrics (6): Billable hours/quarter: +37% Clients served: +14% Personal Care Same Store Volume: Admissions: +7% ADC: +14% Other Statistics: Cost per day: (1%) Hospice 3Q’17 3Q’17 3Q’17 Adjusted Financial Results 3Q’17 The financial results for the three-month periods ended September 30, 2016 and September 30, 2017 are adjusted for certain items and should be considered a non-GAAP financial measure. A reconciliation of these non-GAAP financial measures is included in the corresponding 8-K detailing quarterly results for each respective reporting period. Same store admissions exclude 7 closed and consolidated care centers in FL and impact of hurricane. Episodic admissions – Includes Medicare and non-Medicare payors that bill on a 60-day episode of care basis. Same Store Episodic volume – Includes admissions and recertifications (ex. Florida closures and impact of hurricane). Free cash flow defined as cash flow from operations less routine capital expenditures and required debt repayments. Includes acquisitions and full 3Q’16 impact of AHC (deal closed in March 2016).


Slide 9

Home Health and Hospice Segment (Adjusted) – 3Q 2017(1) Overall same store episodic admissions ex. FL closures and volume impact of hurricane +3% Total same store episodic volume growth +5% (admissions plus recertifications) [ex. Florida closures and hurricane] Expected total episodic admissions growth in 4Q (ex. FL closures): 4-6% Y/Y CPV decrease of (1%) Home Health Highlights Same store average daily census (ADC) up 14% Net revenue per day up 2% y/y; gross margin expanded 160 basis points Cost per day down 1%; segment EBITDA contribution up 13% Only one provider over cap as of Q3’17, less than $200k liability Hospice Highlights The financial results for the three-month periods ended September 30, 2016 and September 30, 2017 are adjusted for certain items and should be considered a non-GAAP financial measure. A reconciliation of these non-GAAP financial measures is included in the corresponding 8-K detailing quarterly results for each respective reporting period. Segment EBITDA does not include any corporate G&A expenses. Same store episodic admissions exclude 7 closed and consolidated care centers in FL and impact of hurricane. Home health same store episodic volume up; Hospice continues to outperform


Slide 10

General & Administrative Expenses – Adjusted (1,2) Notes: Year over year total G&A as a percentage of revenue decreased 270 basis points Home Health segment G&A: 120 bps y/y decrease as % of revenue Hospice segment G&A: 150 bps decrease y/y as % of revenue Personal Care segment G&A: 50 bps increase y/y as % of revenue Corporate G&A: 130 bps decrease y/y as % of total revenue G&A has decreased $2.2M in 3Q17 vs. 3Q16 Home Health restructuring plan will further reduce G&A beginning in Q4’17 The financial results for the three-month periods ended September 30, 2016, December 31, 2016, March 31, 2017, June 30, 2017 and September 30, 2017 are adjusted for certain items and should be considered a non-GAAP financial measure. A reconciliation of these non-GAAP financial measures is included in the corresponding 8-K detailing quarterly results for each respective reporting period. Adjusted G&A expenses do not include bad debt expense or depreciation and amortization. Impact of G&A cost control materializing as operational efficiencies are realized


Slide 11

Our Stars scores have continued to trend upwards and are amongst industry leaders Note: Top Competitor Avg weighted by CCN count and include LHC, Kindred, AFAM, HLS and BKD Metric APR 17 Release OCT 17 Release JAN 18 Preview Quality of Patient Care 4.03 4.13 4.21 Entities at 4+ Stars 75% 81% 88% Metric Apr 17 Release Jul 17 Release OCT 17 Release Patient Satisfaction Star 3.82 4.08 3.56* Performance Over Industry +5% +8% +6% Quality of Patient Care (QPC)* Patient Satisfaction (PS) QPC Industry Performance PS Industry Performance *Scoring methodology changed dropped entire industry’s PS STAR scores Amedisys maintains a 4-Star average in the Jan 2018 HHC release with 88% of our providers at 4+ Stars STAR score improvement for the eighth consecutive quarter (from initial Jul 15 release to Jan 18 preview)** Nineteen Amedisys providers (representing 29 care centers) rated at 5-Stars in the January 2018 preview Industry impacted by calculation methodology change resulting in industry wide Patient Satisfaction drop * *JUL 17 and OCT 17 release periods use same OASIS data time frame. JUL 17 release excluded from this view to show improvement progression


Slide 12

Assuming a normalized level of BD productivity (~25 monthly admits / BD FTE) and meeting hiring and retention goals, we expect to achieve episodic growth of 4-6% for 4Q’17 excluding Florida closures On Target to Reach 775 BD FTEs by End of 4Q’17 Vacancy Rate goal of 6% by YE 2017 achieved and surpassed BD recruiting SWAT team responsible for the significant ramp in BD FTEs BD FTE impact will help us achieve 4-6% episodic growth in 4Q’17, excluding FL closures


Slide 13

We are on track to realize the $46M annualized savings we promised by Q4’17 – Additional Home Health restructure will put us over our original projections and help deliver improved margins despite reimbursement cuts $46 million in Targeted Savings by Q4 2017 In early 2015, we discussed a plan to deliver $46M in annualized run rate savings by the end of this year and have achieved much of this to date, which has driven improved margins Unanticipated rate cuts in home health, a cumulative 3% as of Q3’17 have impacted margins. Adjusting for these rate cuts and Personal Care, expected to deliver margins in the 12% range


Slide 14

Components 3Q’16 2Q’17 3Q’17 YoY Variance Detail Mitigation Plan Salaries $62.34 $60.34 $61.65 ($0.69) YoY decrease driven by increased productivity. Sequential increase due to planned salary increases and impact of additional holiday Staffing mix optimization, productivity and scheduling improvement initiatives in place helped us overcome planned salary increases Contractors $2.61 $2.58 $2.81 $0.20 Sequential increase due to slight increase in clinician turnover and increasing volumes Contractor utilization decreases as clinician capacity increases post HCHB; increases due to increased volume in quarter Benefits $10.94 $10.83 $11.12 $0.18 Health insurance driving increase. Q3 and Q4 are the highest claim volume Focus on cost containment and spend optimization Transportation & Supplies $6.97 $6.86 $6.95 ($0.02) Sequential increase primarily due to supply costs Initiatives underway including more effective medical supply contracting and optimized scheduling to reduce travel costs *Visiting Staff CPV $82.86 $80.61 $82.53 ($0.33) Clinical Managers $8.72 $8.44 $8.30 ($0.42) Fixed cost associated with non-visiting clinicians Unit cost reduced as volume increases Total CPV $91.58 $89.05 $90.83 ($0.75) Operational Excellence: Cost Per Visit (CPV) CPV decreased year-over-year despite planned salary increases, increased volume of visits has lowered our overall unit cost in several areas *Note: Direct comparison with industry competitors CPV calculation $82.86 $80.61 $82.53


Slide 15

Driving Top Line Growth: Metrics Across Business Segments Solid growth in Hospice and Personal Care; Medicare episodic growth improving 234 Opportunities Prospected 45 Opportunities Under Review 13 Active Processes Personal Care Total Hours / Quarter* * Includes acquisitions - AMED closed AHC acquisition in March of 2016 15


Slide 16

Debt and Liquidity Metrics Our debt levels remain very low (0.2x) providing us ample flexibility and available liquidity for strategic initiatives and inorganic growth opportunities Net debt defined as total debt outstanding ($92M) less cash balance ($66M). Leverage ratio (net) is defined as net debt divided by last twelve months adjusted EBITDA ($136M). Liquidity defined as the sum of cash balance and available revolving line of credit. Credit facility and cash provide significant capital for accretive acquisitions and/or other capital deployment options


Slide 17

Adjusted EBITDA to Free Cash Flow Reconciliation (1,2) Cash flow from operations impacted by Securities Class Action Lawsuit Settlement (net ~$29M) The financial results for the three-month periods ended September 30, 2016, December 31, 2016 , March 31, 2017, June 30, 2017 and September 30, 2017 are adjusted for certain items and should be considered a non-GAAP financial measure. A reconciliation of these non-GAAP financial measures is included in the corresponding 8-K detailing quarterly results for each respective reporting period. Free cash flow defined as cash flow from operations less routine capital expenditures and required debt repayments.


Slide 18

Income Statement Adjustments (1) Amount of non-GAAP adjustments, excluding Florida ZPIC audit and legal settlements, have substantially decreased. Trend to continue throughout 4Q’17. The financial results for the three-month periods ended September 30, 2016, December 31, 2016, March 31, 2017, June 30, 2017 and September 30, 2017 are adjusted for certain items and should be considered a non-GAAP financial measure. A reconciliation of these non-GAAP financial measures is included in the corresponding 8-K detailing quarterly results for each respective reporting period.

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