Good afternoon, everyone, and thank you for joining us on the third day of JP Morgan Healthcare Conference. My name is Yoojin Nam, and I'm an associate with the JP Morgan Healthcare team. A quick housekeeping item before we proceed to the presentation. At the bottom of your webpage, you will see a blue button that says Ask a question, and that is how you can submit questions throughout the presentation. With that, I am pleased and excited to introduce you to today's speakers from Amedisys. With us today, we have CEO, Paul Kusserow, President and COO, Chris Gerard, and finally, CFO, Scott Ginn. Without further ado, I'll turn it over to you, team. Thanks, Yoojin. Appreciate it. Hi, this is Paul. We're excited to be able to present, and we'll miss the fun times at the St. Francis Hotel, but we're here calling from Nashville. There was some news earlier this week that several people have asked about in our breakout meetings. It's the succession. I'll be retiring as CEO on April 15th, moving on to the chairman role. Happily, Chris Gerard, who's right across the table from me, will be moving and become the President and CEO. A couple people asked about the timing, asked about why this is the right time for succession. A couple of things that I wanted to make sure we emphasize. This has been long planned. Chris has worked with me in the company and has led operations for five years. He's been President of the company; it's almost a year. We looked at transitioning Chris a year ago and started a very planful successioning process. Chris has run about 90% of the company for the last five years, has reported into him as Chief Operating Officer, and about 100% of its revenues. He's well known to the company, to investors, and I think he's gonna have an extraordinarily good run, and I'm looking forward to serving him as the Chairman of the board. I think this is very good news for investors. That the timing is good because, frankly, we believe that all the key elements of the business are running well. We believe that we've assembled fantastic assets that we now need to execute on, and that our strategic direction is quite clear for the next two to three years. Chris is gonna do a phenomenal job making sure all that happens. If you move to the second page, we tried to give you a SOAP, which is strategy on a page. I'll walk through the major plays here. I think what's important is the pandemic. Clearly, we're into almost year two of this. What we've seen is a need for clinical capacity and a need for very sophisticated labor strategies. This is something that we've actually anticipated. This was pre-pandemic, and we've come up with some very unique approaches to labor. If you look at our labor statistics, they've been quite extraordinary. Our turnover rate overall for the company is 18%. Our nurse turnover is much lower than the industry average. The other thing that we started to see is an increase in Medicare Advantage penetration rates. As you know, we mainly deal with Medicare. We've started to develop some risk-based case rate type tools that we're very excited about and have been having very good success with Medicare Advantage. We believe that the best way to deal in this area is to take risk and to move towards risk in the home, and we're looking forward to continuing that process with our Medicare Advantage partners. Longer term, if you look at the demographic, psychographic, regulatory, economic forces at work, these are all extremely positive. We've got baby boomers who are just turning 76. Our average age is 77, 78, so the tsunami of the baby boom is starting to hit. Also these baby boomers want to stay at home. They wanna age in place, and they wanna be taken care of in the home. It's a very good time to be in Home Health business. The other thing that I think is important is we've created a very differentiated company. When I first started, we started off as primarily Home Health company. We're now Home Health, Hospice, Personal Care, Hospital at Home, SNF at Home, Palliative company. We have six lines of business. Three of those lines of business we do them at Home Health, we're starting to move into the risk model. We're very excited by this. We're very excited by our capabilities analytically in terms of quality delivery. We believe that this is really important for us. If you look at the strategic pillars on the lower left, what's really driving our performance, it's a growth in Contessa. We acquired Contessa in August, and we're really excited about what we're seeing there. Very strong demand. This is a leader in the area of hospital at home, SNF at Home, Palliative at Home. These folks are the real deal. They can do it when there's a lot of imitators out there who can't. We're very excited, lots of demand and opening up lots of opportunities. We're continuing. Scott will talk about M&A, but we're continuing. We have a very nice pipeline ready for M&A. We think when the CARES Act money comes down or comes out of the system, that there will be consolidation opportunities, so we're quite excited about that. Then organic growth, we're, you know, we got hit during the pandemic, midpoint last year. What we're seeing with the increase in our sales folks in Hospice and really good performance Home Health and our core businesses, we're seeing good growth, and we're anticipating good growth through next year. On operational efficiency, we always operate as efficiently as possible, and we're focusing on continuing to streamline the organization as well as expand the lines of business. I talked about employer of choice, the name of the game, and all the questions that we're getting right now are around labor and will we have the capacity to keep up with the growth that's out there. As I said, I think we were early in this game, and so we've made some investments in flexible scheduling, in bringing in and expanding our workforce, addressing the gig economy, and we're seeing very good results from that. We think if we continue to innovate in labor, that's what we're basically a staffing company, so human capital is what we deal with. That's our only asset, and we feel we're doing very well that way. Lastly, quality. We're at 4.6 stars on our HHCAHPS surveys, and we're seeing very strong results in Hospice. We believe that this is quite an extraordinary. I'm most proud. As I leave, I'm most proud about what we've achieved in quality. It's really, I never imagined we could be doing this well. What quality does, though, which is interesting, is it drives growth. It also, it's the right thing to do for the patients, but it also drives extraordinary growth. We're excited to continue to take the lead further and further in terms of quality. With that, Chris is gonna be taking this business over and running it. I'll turn it over to Chris, and he can talk about what he's gonna be doing this next year. Yeah. Thanks, Paul. You know, when I talk about our 2022 strategy, just as any other year, you know, when we look at our strategy, we lead with quality. Quality was the last pillar that Paul just spoke about, but that's how we lead every year going into, you know, a new year in terms of what we wanna build around. As Paul mentioned, quality drives growth, it drives retention, it attracts people to the organization, and it's what we're here for. I mean, when you have high quality, you have good patient outcomes. You know, on quality for us, we're now looking into the Value-Based Purchasing that's going nationwide, starting in 2023. A lot of 2022 will be positioning ourselves to be able to participate in the bonus payments related to outcomes from Value-Based Purchasing. A lot of focus and energy around building, continuing to build our clinical quality team in driving better outcomes for our patients on Home Health side. Hospice Care Index will be coming into play in 2022 as well, which will be the first real public quality indicator for Hospices. Just like with star ratings for us over the last several years, where we finally established ourselves at the top in terms of quality, we look to do the same on the Hospice side in terms of the quality Hospice Care Index. A lot of our strategy in some way, shape or form is built around workforce optimization in 2022, and we think that this will actually propel us through this year but also establish, you know, an avenue for continued, outsized growth in 2023 and beyond when you start to look at, you know, the tailwinds, the demographic tailwinds, as Paul mentioned a while ago. For us to do that, we really got to, you know, to fine-tune how we're working and utilizing our staff. It starts with retention. Again, we have, you know, better than industry average retention on our full all of our staff as well as our clinicians, but we're gonna continue to drive more efforts to work that down. We're also gonna be looking at some innovations around, you know, telehealth and utilizing other forms of taking care of patients in the home and using some technology to be able to improve the outcomes and also allow us to expand some of our staff. You know, as always, we still have more room to work on our LPN and PTA utilization. We feel like there's additional opportunity around that as well as some smarter scheduling and some more logistical views that we're looking at and we're implementing throughout this year that we feel like will also build additional capacity in the organization. Workforce optimization is gonna be a critical part of our 2022 strategy. A lot of initiatives that are under that title that we have teams working on that should show up in metrics throughout the organization that we're gonna be excited to report on as we go throughout the year. Paul mentioned Contessa. Part of our, you know, also for us, you know, big investment. It adds another line of business to the organization, integrated technically today. Now it's time to scale the business. Very excited about the team and what we're doing with that and our ability to be able to show the value of Hospital at Home, High Acuity Care in the home, SNF at Home as well. You know, now we have the components of, you know, that start to increase the attractiveness for the Medicare Advantage plans, which are penetrating the senior population at a very fast clip today. You know, from High Acuity, Palliative Home Health Care, Hospice Care, you know, Personal Care, through our network, we have these abilities to provide, you know, a wide range of services in the home that we think will also set us up for, you know, years of, you know, ability to start to create more of a continuum that the patients will benefit from. Contessa integration for us, you know, and performance for us is gonna be a key focus for 2022. The last piece, as Paul mentioned a while ago, you know, we're really now at a point because, you know, labor is gonna be the challenge for our industry for a time to come. It's not just the medicines, it's healthcare as well as post-acute care is gonna create, you know, an avenue and opportunity for us to really think differently with how we're working with Medicare Advantage plans. You know, we're coming up with some new and creative, you know, risk-taking, you know, models that we're willing to and ready to test out with some plans out there. We're having very good dialogue with a number of plans today that we feel like is going to actually, you know, drive value for everybody. Drive value for the plans, get more controlled clock costs, not drive value for us in terms of our ability to improve our margins, but also increase our capacity. Also drive value for the plans by giving plans more access to our labor, and it ultimately driving better outcomes for the patients. You know, we're excited about this year. We've got a lot of work to do. Navigating and managing through the pandemic that changes seems like every day is obviously keeping us on our toes. You know, incredibly proud of what this team's been able to accomplish through these first two years of this. Our positioning is very, very strong for us to be able to have a very successful 2022, with a lot of work to be done, but also more importantly, setting us up for exiting 2022, you know, into 2023 with some tremendous momentum, to be able to really now take on that tsunami, you know, of volume that's gonna be coming to our space, you know, over the next several years. With that, I'll turn it over to Scott to give a little bit of color around, you know, 2022 puts and takes, as well as some of the longer term view of the business. For those of you that aren't following the slides, this is the conclusion. We've skipped through it pretty quickly. Yeah. Sounds good. You caught me off guard. Anyway, yeah, it was just you know starting to you know as we reflect on 2022 you know as we stand here right now very pleased with how we're exiting the year on target on where we wanted to be. Feel good rolling into 2023. As we've said many times, we believe 2022 is a builder for 2023. You know a lot of things going on within the company to make that happen. You know on the positive side we are getting some really nice rate increases 2% on Hospice 3.2% Home Health. you know ordinarily we'd be bridging to you know plus $45 million-$50 million out of the gate here. We'll talk a little about, you know, sequestration's going away, so that's impactful to us. We did get a six-month reprieve on that. Sequestration will be in place at 2% for the Q1 of the year and at 1% for the Q2. A little bit of help there. We do think we'll continue to leverage our and return to normal around our growth rates on Home Health and Hospice. Really excited about where we're landing on our Hospice BDs staffing-wise, and expect you know where we are to really leverage that and really build on that into 2022. Those are some exciting things going on for us. We'll continue to manage you know as Chris said, workforce optimization is kind of our buzzword out here today. You know, as we think about labor pressures that are in place, both around the cost side and just the gathering of people side. A lot of activity there. We'll continue to look at visits per episode, our RN-LPN mix, and we think there's enough levers and opportunities out there to minimize some of that impact. We'll also continue to look at additional investments in this organization. I mean, that's kind of the. As we come out into when we release Q4 and year numbers, we'll talk, you know, of course, on our guidance numbers, and it'll reflect where we feel we wanna invest as in both de novos and other areas of the organization. That's something that we'll finalize as we look at the impact of Omicron, how that's impacted us right now and what we wanna view, our view is going forward. That's certainly all important to us. We're very excited on where we are with Contessa. We'll have an incremental EBITDA, as we've said, a drag related to this, as we've said numerous times this year. Maybe slightly higher than we thought, and that's only indication of how things are going on the top line perspective with a lot of opportunities out there. We'll define that and really make decisions around it, but feel great about that investment. Hospice death rate, we'll continue to monitor that very closely. You know, we saw some normalization there in October, and when I say normalization, not back to 2019 type of levels, but to something that we certainly is more predictable and we believe we can manage through. We're looking at it closely. Medicare Advantage. Excited. You know, Paul talks a lot about this and our relationships with Medicare Advantage plans. We're having some great dialogues with that. That penetration is increasing, so that's something we'll continue to watch as it impacts our business. You know, as we've all learned from the COVID-19, it's the gift that keeps on giving. We continue to monitor the impacts of testing costs, quarantine costs. That's something that'll still be with us as we move forward. We've talked a ton about the vaccine mandate, which is there. We're pleased with where we are from a workforce perspective. Certainly how things pan out around that will be something we have to manage through in 2022. Of course, the increased labor costs. Generally, we run 2%-3%, but we think that'll be in the 4%-5% range, and that's why workforce optimization is so important to us. Longer term, very bullish on where we are. We see significant growth in this sector. The baby boomers, they continue to age into our, you know, the age range that really utilize our services. That's certainly an upside for us. We know that's where the baby boomers wanna be. 90%, you know, they want to age in place at home. That's very important, Home Health continues to be the lowest cost area for taking care of people. A lot of great things for us. We know our Value-Based Purchasing, as that comes into play, our quality will mean a lot. We continue to be tops there, and it'll continue to be a focus of this organization. We believe just overall, our platform is a differentiator. As Paul talked about all the different offerings we have Home Health, Hospice, Hospital at Home, SNF at Home, Palliative Care, Personal Care, really gives us the offerings we need to really be a leader in this space. You know, going forward, we think industry consolidation is certainly an opportunity. We've talked a lot about that. We think this labor dynamic is an additional, you know, headwind to folks that we believe we can win even more going forward. Look forward to some excitement in 2022. Thank you. Thanks, everyone, for the presentation. Now we can move on to the Q&A portion. We've got some great engagement questions from the audience. Some of these might have already been answered by your presentation, but just to make sure that, we give you an opportunity to expand upon, I'll just read through all the questions that we've gotten so far. Is that okay? Sure. The first question we have is, in light of Omicron, could you please speak to how Q4 is trending in terms of nursing shortage and wage pressure? You want them? Q4 actually, you know, Omicron didn't really become an impact until late in December and early this year over the last few weeks. What we actually saw throughout Q4 was improved labor, you know, situations or environment all the way, you know, progressively throughout the quarter. Hiring was good, retention was good, clinical capacity was good, and quarantines came down all the way up into the last, you know, week and a half of the year in December. You know, now it's at a, you know, pretty high level today. The good news there is that, you know, we're typically cycling in and out employees onto quarantine quicker with the newer CDC guidelines of five days of quarantine. It's not necessarily impacting our ability to take on patients and serve our patients, but it is, you know, it is rapidly moving. You know, I think I see that actually as a good sign. Overall, for Q4, actually, we saw the labor environment improve throughout the quarter, as we, you know, when we exited Q3 going into Q4. Chris, admissions are going well. We have some folks in quarantine, but we're able to take those admissions until this hopefully bottoms out at the end of the month. Yes. Yeah. Yeah. Good. It's very fluid. Very fluid. Right now, it's not impacting our ability to admit patients. Building on from that, what kind of labor vacancy rates are you seeing now, and inflation in wages do you expect for 2022? Yeah. We saw, you know, when we reported Q3, we had around 6% year-over-year wage inflation. We talked a lot about that at the time. You know, a couple of dynamics. One, you know, early retiring nurses and nurses leaving the industry altogether, as well as some clinicians also moving to more gig work, and taking, you know, and chasing the dollars there to create a pretty tough environment. But what we've seen is the ability to, you know, for that to start. We saw that start to slow down a little bit throughout Q4 of last year. What we focused on is really, you know, rather than raising our wages and our base wages, you know, focus more on multi-year retention bonuses for our current employees where needed or, multi-year sign-on bonuses to attract new clinicians. To offset that labor wage inflation, which we thought could be, you know, anywhere 4%-6% in 2022. We think we can bring that down more in the 3%-4%, by, you know, just pulling on these workforce optimization levers that I just mentioned. I mentioned a few of about a dozen things that we're doing this year that should help drive down or hold down our actual cost per visit on Home Health side and our cost per day on the Hospice side. I'm feeling pretty good about that. Thank you. Next question we have is, Hospice ADC was one of the larger headwinds in 2021. Could you please talk about how that has trended in the back half of the year? Hospice ADC declined in January, kinda hit the bottom point mid-February to late February of 2021, and we really stayed relatively flat the entire year, plus or minus maybe 100, 150 ADC every month. A lot of that fluctuation early on was driven around admission volumes due to the BD staff that we talked about a lot last year. We fully have got that addressed. We exited the year with 540 reps. Productivity is in line with what we're expecting. The other driver of ADC fluctuation has been the discharge rates and the median length of stay that has been impacted by the pandemic. We still are finding that, you know, a little bit really more related to where the pandemic is raging. We see more hospital referrals to Hospice, which are typically lower length of stay. That's still kind of a headwind that we're working through. What we built into our plan for 2022, though, is what I would consider conservative around assumptions on discharge rate and median length of stay. We're about to lap kinda that significant decline in ADC. We should start to be looking into sequential and year-over-year ADC growth as we move throughout this year. In the event that the median length of stay and the discharge rate kinda reverts back to pre-pandemic levels, throughout this year, if that does happen, we see based on the volume, numbers that we're expecting on the admission side, significant kinda ramp in ADC, in the back half of the year. Going further into this topic, could you comment on Hospice death rates in November and December? Could you potentially provide any, kind of sizing estimates of the testing and quarantine costs in 2022 versus 2021? You wanna? Yeah. For the testing and quarantine type cost, I mean, we you know we consider that you know kind of that Q3 run rate kinda where we expect to see that, but what we called out in those numbers. You know, those items will probably continue, and we'll talk a little bit more about this when we give guidance. Continue to call those out separately around quarantine and testing. Too much uncertainty around the timing of quarantine. Omicron has certainly taught us that lesson very quickly here. Testing with the mandate, you know, we're continuing to implement, but you know, there's still some finalization that's to happen. Those will be called out. I would say the piece that'll continue to be something that we'll go ahead and let feed through our numbers next year will be around the contract utilizations, that excess labor rate. I think Q3 is a good proxy for how those numbers deliver to go forward. Excuse me. Yeah. On the death rates, I'd start by saying, in November and December of 2020, over November and December of 2019, our death rates on Hospice were about roughly 4%-5% higher in 2020 than in 2019. In 2021, they were 1%-2% higher than 2020. Still elevated over 2020, but much, you know, considerably elevated over the 2019 rates. Since my comments a while ago, if we do revert back to those 2019 rates, we should start to see, you know, more significant ramp in our ADC. We're still looking at elevated death rates, you know, that we feel like is related to the pandemic, either directly from COVID patients, indirectly from patients delaying care, diagnostic testing, seeking end-of-life care, you know, coming on services later in the dying process, which is also impacting the median length of stay. You know, there also is typical, you know, kind of acceleration of death rates over the holiday, you know, months. That's a phenomenon that's been existing in Hospice forever, that was not out of the ordinary this year. It's about in line with what we were expecting. Is the elevated death rate having any impact on the census and the volumes? Not on the volumes, but census is again, with the volumes we're generating today, under a normal death rate, we should see more significant ADC growth. Instead, we're still seeing ADC sideways, you know. We should start to see the death rate just from seasonality come down as we move throughout Q1. Volumes are very good, so that should, you know, result in sequential and eventually year-over-year growth as we start to lap some of those lower ADC quarters from last year. I think it's important to add that at the worst, we had 18 days median length of stay. It's now between 2021, 2022 and- 2022. The norm is about 2026. Yeah. It's not like the dark days of a year ago. Yeah. The only other color I'd add is in parts of the country where median length of stay has reverted back to pre-pandemic levels, we are seeing very predictable and consistent admission growth and ADC growth that's in line with what we're expecting. The disruption around the timing of patients coming onto service, and that being related to the pandemic is what's impacting, you know, the ability to grow census today. Yeah. It's a better situation now. Thank you. Could you also paint a picture of how Contessa will be integrated with the base business? Do you wanna? Go ahead. Variety of ways. We're finding that there's a lot of coordination and overlap between them. I mean, I think the reason Contessa chose us over other places where they probably could have done better in terms of price is that we're good at finding nurses and finding the types of folks that is gonna enable them to grow at the rate they're gonna grow. What we've seen and what's been really interesting to us is when we've gotten a lot of work where we do a lot of the work with hospitals, and what we've seen is that these hospitals wanna bring in other services. We're having a lot of good conversations with hospital systems now, relatively large ones, that are looking at us and saying, "Well, if you're doing this really well with Contessa, you know, maybe you should take over Home Health and Hospice assets." I also think there's a play with Contessa, with payers. We now have six lines of business. Again, I'd argue that three of those lines are unique to us. We have a whole full breadth of in-home care to be able to deliver, particularly on the High Acuity level. We're taking risk again in High Acuity, and we're looking to take risk in home. We think it's pretty interesting. You wanna comment on the- Yeah. I think you know just to piggyback on our pipeline certainly is filled up and a lot of opportunities and great conversations when we get around the table with some of these hospital systems that are giving us opportunities that we didn't you know really have in front of us as much before. You know that's something that's you know we felt good about our pipeline. I think it's only been additive and continue to generate some more and more conversations that we think will be able to leverage from an acquisition perspective going forward. I guess the bottom line is we're delighted with Contessa. We're delighted and surprised by some of the new opportunities and more so than we expected that are coming in through Contessa. We anticipate that it's gonna grow. Very well. We're excited by it. Thank you. The next question we have is, can you commit to at least growing EBITDA in 2022 or could EBITDA be down in 2022 versus 2021 levels? Yes. We haven't put out our final numbers, so you know, we talked a lot about the puts and takes. We felt confident in our ability to grow that, you know, from a base business perspective. We still feel strong about that. We're still gonna finalize our decisions around investments in the organization as we come out. I think that's you know, we're gonna have to have some decisional items, and we'll lay that out you know, what's core and what's not. You know, we're watching things closely here with Omicron coming out, which will impact our numbers. We still feel good about the business going into 2022 and as it leverages into 2023. More to come. Thank you. The next question goes: Should we think of the additional benefit of sequestration extension as going to fund the de novo and Contessa investments? You know, when we kind of given numbers before, it certainly can be a piece of that. I think that's a good way to look at additional use of Contessa as we move that forward and as those EBITDA numbers grow. You know, that certainly can be viewed as an offset to that. Thank you. Those are all the questions we had from the audience. I believe we still have a few minutes left, for the time allotted. I'll give it back to the Amedisys team in case there is anything else that you would like to cover. We can also give the audience a little bit more time, if they wanna submit more questions. Yeah, I think, Scott, could you talk a little bit about M&A and where our pipeline is, that sort of thing, potential for consolidation in the industry? Yeah, no. We certainly had some questions around that and Paul. We, you know, we've been pretty bullish on the ability to consolidate this industry coming out of 2019 when PDGM came into place. We still see that coming. We do think the wage and labor pressures are gonna make that really even more opportunistic for us. We're ready for it. Our pipeline is as good as it's been, and we think we'll have some actionable things coming up pretty soon. It's strong out there. I would say that, you know, we get a lot of questions around where our preference is to spend our M&A dollars. That still remains Home Health. that's our number one priority. We do have Hospices, really small type of Hospice in our pipeline that we would still transact on if it was the right geography, and are comfortable where we are, and especially as we're seeing some positives with our BD staffing as well as we see some normalization in the death rates, that'll only make us feel more comfortable with that. Great. I think we're feeling very good about where we are as a company. We have a great team, great leadership coming on, and very unique assets with extraordinary executional ability. We're viewing next year as exciting to get to outperform as we always have done. We're very much looking to 2023. Look forward to talking to you then. Thanks again. We haven't received any more new questions, so we can wrap this up here. Thank you for the presentation and thanks everyone for joining today. Thanks again. I appreciate it.