Okay. Good morning or afternoon, depending on your geographical location here. Thanks for joining us here for day three of the conference. My name's Matt Larew. I cover healthcare delivery and services here at William Blair. I'm here today with members of the Amedisys management team, including Scott Ginn, the CFO, Chris Gerard, President and COO, Nick Muscato, Investor Relations, and a variety of other folks. I know Paul Kusserow, the Chairman and CEO, will be stepping in to join us here in a minute. As many of you know, Amedisys is one of the largest providers of in-home services in the country and is building really an aging in place infrastructure that we think is particularly interesting. Before we jump into the questions here, I'll just point out from a compliance perspective that for a complete list of disclosures, you can visit our website, which is williamblair.com. To start, Paul, perfect timing. While we're not going to walk through a deck today, I do think it would be nice to have you kick off by just providing a brief update on the business. Maybe give people a sense for how the markets you participate in have evolved over the last couple of years and how the company itself has evolved and really continues to evolve. Sure. I think we feel very good about where we're at, particularly after COVID. The home health business, if we go through the various businesses, the home health business is doing extremely well. I think was hit less hard than hospice was in terms of some of the gyrations that we've had to go through and the machinations that we've had to go through with COVID. We feel very good about where we're at there and the growth, and we're starting to see some of the things we talked about in the beginning of the year in terms of big acceleration of growth in home health. Hospice, we saw extraordinary growth in the third quarter and fourth quarter of last year. Started to see very strong growth, in January. What we saw was a lot of these were short-stay patients, so we saw our ADC, average daily census, the median for that go down to 18 days, and our norm is about between 24 and 26. That's come back. In the process, we've also seen that we have to start to reengage our sales force and start to hire up on some of our sales force to continue to drive some of the growth rates that we've said we'd hit. We're feeling good about hitting our ADC marks, and we're working pretty hard to try to get in the double-digit growth rates in hospice. In personal care, it's hard to hire people, particularly when there's subsidies out there that are going on. We've been doing well in terms of personal care. We tend to use that as our innovation arm, so we feel very good about our pilot with Fresenius. We feel very good about our new pilot that we announced. It's doing SNF at home, moving up the acuity chain, using personal care for all that. We're focused on the future. We anticipate, and we've talked about this, that the home health and hospice and personal care rates will triple over the next three to five years. The baby boomer tsunami is going to hit us. It's going to be quite significant. People want to get taken care of and die in their homes. We want to be able to integrate all these services together. We believe that that's going to occur primarily initially in Medicare Advantage, and we want to move towards taking some risk in that space. With that growth rate that we're starting to see, and we're starting to see the first sort of waves at the shore on that tsunami, is we're really focused on labor. We've been getting a lot of questions on labor. We have kind of preemptively gone after it. Our turnover rate, we brought down 25% just within a quarter, so we're down now to 15%. Our clinical turnover rate, which is with the people we really need to make sure we're bulking up on, that rate has come way down, probably even more than 25%. The recruitment is going very well, so we're recruiting, we're retaining. Now we need to get up to productivity, to make sure that we retain these folks so that we can have the capacity for the growth that we know is coming. We want to innovate. We want to take care of sicker patients. We want to distinguish ourselves from that perspective of saying, we can take care of those SNF patients. We can grow our addressable market. For us, we're really excited. We've got some really good wins under our belt. We expect the year to go well, particularly in the second half of the year, particularly in hospice. We expect the salespeople that we need to bring in, that hiring will largely be finished in June. They'll be kicking in the second half of the year. We expect to do well this year and to deliver and again, to innovate. I think we feel very good about where we're at and where. We feel lucky to be in the industries we're in, actually. Yeah, I think that's a good setup here. I want to ask a couple questions around COVID, which I think has highlighted the strength of the home as a center of care. The first is a bit more near term, which is that both the first quarter results across the space and some of the survey work we've done suggests to us that not only are volumes largely back, maybe with a different mix, but largely back, but the trends have continued to improve throughout May. Obviously, we saw the change in CDC guidance for vaccinated individuals as well. Is that consistent with what you're seeing in terms of this continued gradual improvement? Maybe help us understand if there are areas of your business, either the hospice length of stay, be one perhaps that aren't quite back quite as much. Yeah. I'm going to pitch it to Chris. I think the idea is we've stolen share. During COVID, by being good citizens, one of the things we've done is we've taken share in what was a shrinking pie in certain areas. The other thing, the other phenomena, there's a couple of industry phenomenons that we're seeing. The other one is the decline of SNFs. 43% of all the deaths that occurred in COVID occurred in facilities, in long-term post-acute, generally SNF facilities. We've had over a year now of referral sources pushing towards the home and getting used to that. What we want to continue to do, that's why the SNF at home piece is so important. That's why quality is so important with us, getting those quality scores to the level we've gotten of 99%, four stars and above. We want to continue to show that we have the right employees producing very high quality that can take those sicker patients and then continue to drive more and more of that addressable market into the home, which is where, again, people want to be. I'll turn it over to Chris, and he can talk a bit about some of the volumes. Yeah. Getting specific to volumes, on the home health side, we still see some additional opportunity. Yes, we are back to pre-pandemic levels in terms of our admission volumes, actually ahead of that a little bit. A little bit different segmentation. SNFs and senior living communities is still down roughly 20% versus pre-pandemic levels. Electives has been bouncing week over week to between 90% and 100% of pre-pandemic levels. We do see that that might go north of 100% in the second half of the year, which we see as additional opportunity for us. We're seeing significant growth. We had a nice Q1. It continued into Q2. It'll be outsized kind of looking growth in Q2 just because of the comp. We're encouraged with the fact that we are taking share and there is some additional incremental upside for us to see in the second half of the year. Hospice, as Paul mentioned on the volume side, the rebuilding of our BD staff, that was a little bit of a wobbler for us in Q1 in terms of having a 10% vacancy rate of our reps. We're closing that as we exit Q2. We have 30 reps that'll start this month that have already accepted. We'll hire another 40 this month that will be in play starting in July. That closes the gap. That gets us where we need to be. A little bit more of a delay of seeing the hospice admission trajectory where we want it to be. We expect to see good things in the second half of the year as we execute on the plan. The other thing we're seeing, Chris might want to talk about it, is we're seeing some migration now out of institutions, particularly in the ASCs, that's going to be a pivot point for us. As ASCs take more and more acuity, they take total joints, spine, now cardio. We're going to start to see that, we anticipate we're going to be showing up in the bundles world a lot more as a lot of these types of surgeries that we would normally take care of coming out of hospitals are going to migrate into the ASC environment. We're seeing from a macro perspective, what COVID has done is it's really decentralized a lot of care, it's pushed a lot of that care into the home. It's been interesting. Do you have a sense, to follow up on that, Paul, a sense for the post-acute share for home health versus SNF for ASC procedures relative to similar procedures in the hospital? I would presume there's got to be a low percentage of folks who are going into an ASC and then flipping into a SNF for the post-acute care. It's mainly IRFs. When you see the bundles, the classic thing we would see in bundles is we would see in-hospital IRF to home, and now we're seeing ASC to home, and then split the savings, find out a way to do gain shares, whatever. That way, the plans love it because they get to pay less. The docs love it because they get to do it in their outpatient settings. We love it because then we get to charge more for IRF-like services. Then, maybe Chris or Scott, thinking about the back half or Paul, of course, thinking about the back half of the year a bit more specifically and what the key drivers are of the model here, whether it's the rebuild of hospice, ADC, and the sales folks you brought on. Maybe it's facility access, SNF, assisted living, et cetera, maybe elective procedures. Just as you're thinking about, again, not the second quarter because of the strange comp issue, but just in the back half of the year, what should we be thinking about as the key drivers of your financial model? You notice he skipped me. He didn't want me. No, I added you in. Yeah. I'll have to live with it. Let me talk. Some key drivers again, we touched on a little bit, the electives coming back, just volume still coming back to the industry. We don't think it's fully back, even though our growth rates are in line with what we expect, slightly better in some areas. We expect to be able to see that as that comes back in the second half of the year. On the hospice side, one of the key, if you remember, we had 9% admission growth in Q3, 15% admission growth in Q4, a disappointing 5% growth in admissions in Q1. We did not move the needle on our ADC because we saw the median length of stay come down so much. The fact that that's back, in the last three months, it's been in that 24-26 range. That's an encouraging sign for us to see build on the ADC in the second half of the year. That's going to also be contingent on executing on the BD staff plan, which we are today, and getting the results out of that. That should drive the top line admissions, which will actually build on the ADC in the second half. I think in home health, when you look at Q3, Q4, we got into a full-year about, I think, 9% year-over-year admission growth. I think you'll see that's going to be in line with how those will normalize to that level with normal comps from Q3 and Q4 of last year. All right. Very good. Paul, something you mentioned on the labor side. You've noted in the past that labor supply is a main governor of growth. You alluded to some of the metrics you're seeing in terms of turnover. Maybe you could just dig a little bit more into that, how you're using predictive analytics to improve employee retention, recruiting. I think as you alluded to, with the rates, the demand for your business expected to really accelerate here over the next several years. I just wanted to dig in a bit more on what you're doing to improve recruiting and retention. Yeah, when we did our strategy plan last October, thanks to Nick, who put all this stuff together, we said, "Oh, my God, this is phenomenal." We go, "Oh, my God, we need a ton of folks to make this work." We did the modeling, we found that this year was going to be fine with what we normally did. Middle of next year, if we don't start to retain better than what we were doing, if we didn't start to up the recruitment, we would not be able to have the capacity that we need to just allow the market to push us along. Plus, we're generally about two points, three points above the market. When you're talking home health going from 2% to 6%, and then two points above that, 8%-9%, which is what Chris has been talking about. When you talk about the hospice market getting up to 8%, and then two points above 10% or more, you realize. Remember, 85% of our costs are people. We're fundamentally in the staffing business. Ultimately, in order for us to continue to drive that incredible growth that we've been showing. Also to continue to move up the acuity level and show that we're differentiated and to take care of sicker and sicker, more complex patients, we have to have really good employees bringing them in, and then we have to keep them there, train them up, and then give them all these incredible opportunities. We've done a really good job. The turnover has been really impressive. To go from 20% down to 15% is extraordinary. The most important one of those is clinicians, though. The clinicians tend to run, they were running in the high 20s during COVID. There was a lot of disruption there. They're down now to about 20%. That's very good, but we still need to do better. We should be the only place people want to work. We also expect, frankly, when all the artificial supports that are going on out there with the CARES Act, when all that becomes due, we expect there to be consolidation in the industry between 20% and 30% of the industry, we think will be in serious trouble. We have to be out there, again, building great labor, going to these people, being the place they want to come to. We think there will be tremendous opportunity there, as well as there's tremendous tumult, actually, with some of the top players in our industry. With Kindred and Compassus, there's a lot of instability and then people coming out. It's very interesting from our perspective because we're relatively stable, and we're going to be with all this consolidation and some of the tumult that's going on with the top competitors, it's going to be an interesting place to be. Yeah, Was there a follow-up there at all from Chris, or? No, just to build. Go ahead, Matt. All right. Fair enough. I want to touch on a number of those topics in a bit, but that raises one of my other questions. Last one I'll ask about COVID, which is, perhaps the improvements in labor retention recruiting wasn't specifically tied to COVID, but it occurred during COVID. To me, that's something that long term potentially improves the margin profile because as you retain people better, you're spending less to recruit them. Just curious if there are other things over the last year or so that you've learned or implemented that you think could make this business a more efficient, higher margin business over time? Yeah. I think in general, advertisement. We just got named Modern Healthcare's Best Places to Work, which in our business is a very big deal. Our retention shows it. We're a very strong brand. Our quality scores have been very effective in attracting high-quality people. We feel very, very good about where we are. Our stability as a company, the fact that we've been successful as a company in the last six years has been quite extraordinary. You're seeing a lot of dissatisfaction out there, particularly in SNFs, where you have people leaving, and some of the institutions in general, you have a lot more interest in the home. I think that a lot of the clinicians, the hospitals, while they're paying people exorbitant rates now, they cut everybody and furloughed everybody for a while, then they hired them back at extraordinary rates. We're seeing a lot of people that are sick of the ebb and the flow of all this stuff. I think, and again, when you look at consolidation that's going to occur, I think we'll be a very good brand, high-quality employer for people to come. I'm very confident when we get that message out that we will continue to attract really good people. As you said, home's the place. It's where it's going. I think a lot of clinicians are out there recognizing that if they're in this business, they're going to be very busy, and that's what they want. They want stability, high quality, great tools, and that's all we focus on. Following up on that point around consolidation here, I think you've noted in the last couple of calls that the suspension of sequestration likely pushed deal activity maybe into the back half of the year, just curious, maybe can you give a sense for the size of deals you're looking at, what the pipeline looks like between home health and hospice? I'll take that. I'll say, it's a pretty broad range. You can see we closed on two relatively small deals, and we'll continue to do that. You kind of look at those as really extensions of our de novo process and looking to get in the markets. It's going to be kind of the same approach to hospice, small, medium, type of a large deal out there. We just had to be certainly more proactive in going seeking targets. To your point, those targets didn't come to us like we initially thought. We spent a lot of time in the back half of last year identifying where we wanted to go with our portfolio, identified the top targets in each area, and looked for where did we have relationships that we could push. It's been a little bit more challenging there, I would say. We still think we'll get them done. We're less, as I use the example from a timing perspective. We certainly have said, look, we have the ability to spend $300 million- $350 million. Can't always predict timing on home health. Home health deals, which to answer another question, that's mainly what's in our pipeline right now. They tend to be a little bit more difficult to get through diligence than hospice, which has certainly made that somewhat of a challenge. Certainly, we look at a lot of deals. I use the term we kiss a lot of frogs through this process. We're happy with where we are. We'll keep pushing to get the right deals done. We kicked off hospice in February 2018, said we wanted to start doing acquisitions. We didn't close our first one until February 1st of 2019. Sometimes they'll be lumpy, and they'll come together all at once, it'll seem like. We feel good about our ability to push. We do think we'll get help as the sequestration subsides, as monies get paid back towards the back half of the year. You're feeling it in cash flows. You saw the impact of the no-pay RAP in cash flows in Q1. It's going to accumulate. It's just the timing's been not exactly as we would've thought. I feel very good about where we're at, Matt, just because, if you look at it, we spent almost $700 million buying ourselves from the eighth largest hospice to the third largest hospice. AseraCare, our last deal, closed basically about a year ago. You look at the deals that are getting done now, they're easily twice what we paid for those deals. Easily. What we did is we got into hospice, I wouldn't say early, but I would say at a really good time. The prices that are going on for now that we see, and we've been at the table for a lot of these things that are being announced now, and they're just undoable for us. The multiples are way north of 20. What we do do is we still have our proprietary engine working where we're out there and we're engaged in some very good conversations preemptively that will hopefully bring in some deals without an auction process. If they go to auction, it's going to be ugly. That means because there's crazy private equity, there's some folks that are desperate to move into the home health space and the hospice space. At that point, I'd say our odds are very poor of getting those deals. That's why we're very preemptive. Again, our reputation has gotten very good at we do what we say, we're good on diligence. We get in there, we get out, we pay fairly. That's the way we're going to stick to. That model, we believe, has got us a good pipeline, but you probably won't see us paying 25 times for a hospice deal or 20 times for a home health deal. Just can't make that math work. No, that's good to hear. You've spoken about obviously some of the organic acceleration. You spoke about the M&A opportunity. I think maybe the third piece about the outlook moving forward is that at least from the outside looking in, the regulatory landscape feels about as positive as it has been in some time. Emerging from PDGM, which is the largest reimbursement change you've had in two decades with things like the Choose Home legislation, a variety of other either formal bills or discussions around support in the home. Maybe, Paul, just give us a sense for how you're feeling about the legislative landscape, how you'd handicap the success of some of these various initiatives, and how that plays into the strategy about building this integrated provider. Yeah. No, I think the way you characterize it, Matt, I think is exactly right. I think for the 10 years that we just hit, and at the end of it was the culmination of PDGM, was a culmination of what was about 18% cuts cumulatively across 10 years. Now what we see forward, Nick has done some really nice work on this, we see about another 13% in gains over the next five to seven years. We think that we're in for a period now. When you have the Bipartisan Budget Act of 2018 that's there, that mandates budget neutrality on home health spend, that's a very good place. We've seen good increases in hospice. Again, the economics of hospice for end-of-life care, there's nothing better. Hospice is awfully hard to go cut. It's a tough thing for a legislator or a regulatory agent to do. We feel we're in kind of the 2%-3% range for the next five to seven years. We like the Choose Home. Don't know what the probability of that happening. The one negative we see out there is a hospice carve-in. With Humana shedding their hospice asset, we don't know if they're going to have the political will to push for that. What's the point? We think that that's something that we're working with the rest of the hospice players out there to get the carve-in killed. We like value-based in the waning years of the Trump administration. Brad Smith did everybody a favor and said this can happen nationwide now. Again, that favors high-quality players for bonuses. We think that's the way to play in value-based. I think the key thing for us is still in a fee-for-service world, to keep getting disproportionate fee-for-service and then find ways in Medicare Advantage to build gain share so we can get almost close to fee-for-service pay for Medicare Advantage business by driving really good results. That's our big challenge over the next, I'd say two to three years, is getting Medicare Advantage to where they should be and where their mouths are, but they aren't walking the talk yet. That's where we're spending a lot of our time. Yep. Then we'll try to take in two more questions in the last couple of minutes. The first is, again, a high-level question. Paul, you alluded to HCA's acquisition of Brookdale, Humana's Kindred decision. I think oftentimes from the outside looking in, investors ask about competition for some of these larger assets that come in and try to own home care assets, whether it's a payer provider. Any change to your view on the value of an independent, large-scale provider and maybe just a broader thought on payer involvement in the space and given your background obviously with Humana? I think it's a validation. I think certainly to have a high-quality provider, the highest quality provider like HCA to come in and say, we have to have some understanding in the home. The Brookdale asset, we'll see how they do with it. It covers some good space in terms of Florida and Texas, I think that'll be good for them. It'll be a good way for them to experiment with integrated care. We have a wonderful overlap with HCA. We're a preferred provider for HCA in most places. They're really good operators, but it's a completely different business. We've offered to help them because in those markets, I wouldn't mind being number two. They turn out so much volume, and then there's a lot of places where they don't play. I think Humana, again, has validated the fact that the baby boomer consumers who are now 76 year old, they want to stay in the home. The way they're going to attract members and the way they're going to keep those members happy and do it at a low cost, those chronically ill members, is keeping them at home. If they have that skill set, they'll differentiate themselves from all their competition, and those baby boomers will sign up for somebody who say, "I can allow you to age in place." I think it's validation. I feel very good about it, and we want it to work at these places. If it doesn't work, that's worse for us than it. This will take several years to play itself out. I'm very encouraged by it. It's competition in terms of some of the assets, but I prefer the validation, and we're confident enough in our ability to acquire where we need to that we prefer the validation and are not really afraid of the competition. Got it. We've got about one minute left here. I just want to ask about ESG briefly. I'm hoping you can highlight the ESG attributes of Amedisys and what criteria you think are most important as investors think about evaluating Amedisys on an ESG basis. Yeah, sure. We can do this quickly, Matt, but ESG has been something that's been kind of fundamental to our thought process here at Amedisys for a number of years, although we may just not have called it ESG. As the investing theme has picked up momentum, we've done a better and better job about reporting all the good that we've been doing internally for those years. I think for our space and our business specifically, the S and the G are probably the most important. If you look at what's the fundamental nature of our business is we're providing care and the highest quality care, if you look at star scores, to a very vulnerable patient population in their home. From a social perspective, I think we check a lot of boxes. Also, if you talk about labor management, you heard Paul talk a lot about what we're doing from a turnover perspective, all that we've done for our employees through the time period of the pandemic and pre and post that. From a governance perspective, the board's structured in such a way where they have ultimate oversight around all kind of ESG measures. We have an internal ESG committee, furthered by kind of the diversity and inclusion council. The board is divided up into committees that are focused on a lot of ESG measures, quality and compliance being two of them. It's something that has been foundational to our business. We recognize that it's kind of an infinite journey on the ESG path. We'll always continue to do better. If you look at just the way in which we've talked about what we're doing internally over the last year, how it resulted in a rating improvement from MSCI, and so now we're a double A-rated company, so very proud of that, but recognize that that journey will always be continuing, and we will always look to better ourselves. I think the one thing I've been focused on, Matt, just quickly, is making sure our management team, which unfortunately is not reflective here, but making sure our board and our management team reflects our employee population and our patient population. 85% of our employees are women, and 30% of them are people of color. Our board now is majority women. There's been a McKinsey study which shows in our top 100 people in our company that run this company, 65% of them are women and 25% are people of color. We are reflective of that, and there's been a very well-known McKinsey study which says if your governance and your management teams looks like the folks you're serving and like your employees, you're going to do a lot better. We've seen that in spades. It's been great. We're very excited with that. Well, fantastic. That's great to hear and thanks for all the updates. Nick, Chris, Scott and Paul, thank you all very much for your time. Thanks to the audience for being with us. Everyone have a nice day.