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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
 
FORM 10-Q
 
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
 
For the Quarterly Period Ended June 30, 2020
OR
TRANSITION REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
 For the transition period from              to              
Commission file numbers: 001-34465
 
SELECT MEDICAL HOLDINGS CORPORATION
(Exact name of Registrant as specified in its Charter)
Delaware20-1764048
(State or Other Jurisdiction of Incorporation or Organization) (I.R.S. Employer Identification Number)
 
4714 Gettysburg Road, P.O. Box 2034
Mechanicsburg, PA 17055
(Address of Principal Executive Offices and Zip code)
(717972-1100
(Registrant’s telephone number, including area code)
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, par value $0.001 per shareSEMNew York Stock Exchange
(NYSE)
Indicate by check mark whether the Registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter periods as such Registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.   Yes  ☒  No ☐
Indicate by check mark whether the Registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the Registrant was required to submit such files).   Yes ☒ No ☐
Indicate by check mark whether the Registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act. (Check one):
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
 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.  ☐
Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).  Yes   No ☒
As of June 30, 2020, Select Medical Holdings Corporation had outstanding 133,970,064 shares of common stock.
Unless the context indicates otherwise, any reference in this report to “Holdings” refers to Select Medical Holdings Corporation and any reference to “Select” refers to Select Medical Corporation, the wholly owned operating subsidiary of Holdings, and any of Select’s subsidiaries. Any reference to “Concentra” refers to Concentra Group Holdings Parent, LLC (“Concentra Group Holdings Parent”) and its subsidiaries, including Concentra Inc. References to the “Company,” “we,” “us,” and “our” refer collectively to Holdings, Select, and Concentra.


Table of Contents
TABLE OF CONTENTS
 
   
 
   
 
   
 
   
 
   
 
   
 
   
   
   
   
   
   
   
   
   
   
   
   
 


Table of Contents
PART I: FINANCIAL INFORMATION
ITEM 1. CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

Select Medical Holdings Corporation
Condensed Consolidated Balance Sheets
(unaudited)
(in thousands, except share and per share amounts)
December 31, 2019June 30, 2020
ASSETS  
Current Assets:  
Cash and cash equivalents$335,882  $509,737  
Accounts receivable762,677  749,245  
Prepaid income taxes18,585  9,204  
Other current assets95,848  95,143  
Total Current Assets1,212,992  1,363,329  
Operating lease right-of-use assets
1,003,986  1,022,721  
Property and equipment, net998,406  959,086  
Goodwill3,391,955  3,391,196  
Identifiable intangible assets, net409,068  398,266  
Other assets323,881  333,860  
Total Assets$7,340,288  $7,468,458  
LIABILITIES AND EQUITY  
Current Liabilities:  
Current operating lease liabilities$207,950  $216,689  
Current portion of long-term debt and notes payable25,167  13,435  
Accounts payable145,731  142,946  
Accrued payroll183,754  125,109  
Accrued vacation124,111  124,624  
Accrued interest33,853  29,610  
Accrued other191,076  204,074  
Government advances (Note 12)  316,992  
Unearned government assistance (Note 12)  45,505  
Income taxes payable2,638  36,985  
Total Current Liabilities914,280  1,255,969  
Non-current operating lease liabilities
852,897  866,097  
Long-term debt, net of current portion3,419,943  3,390,417  
Non-current deferred tax liability148,258  144,697  
Other non-current liabilities101,334  142,861  
Total Liabilities5,436,712  5,800,041  
Commitments and contingencies (Note 11)
Redeemable non-controlling interests974,541  495,987  
Stockholders’ Equity:  
Common stock, $0.001 par value, 700,000,000 shares authorized, 134,328,112 and 133,970,064 shares issued and outstanding at 2019 and 2020, respectively
134  134  
Capital in excess of par491,038  496,785  
Retained earnings279,800  495,964  
Total Stockholders’ Equity770,972  992,883  
Non-controlling interests158,063  179,547  
Total Equity929,035  1,172,430  
Total Liabilities and Equity$7,340,288  $7,468,458  
 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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Select Medical Holdings Corporation
Condensed Consolidated Statements of Operations
(unaudited)
(in thousands, except per share amounts)
 For the Three Months Ended June 30,
 20192020
Net operating revenues$1,361,364  $1,232,718  
Costs and expenses:  
Cost of services, exclusive of depreciation and amortization1,150,150  1,082,456  
General and administrative31,339  33,461  
Depreciation and amortization54,993  52,271  
Total costs and expenses1,236,482  1,168,188  
Other operating income (Note 12)  54,988  
Income from operations124,882  119,518  
Other income and expense:  
Equity in earnings of unconsolidated subsidiaries7,394  8,324  
Gain on sale of businesses  346  
Interest expense(51,464) (37,366) 
Income before income taxes80,812  90,822  
Income tax expense 20,826  23,336  
Net income59,986  67,486  
Less: Net income attributable to non-controlling interests15,170  15,836  
Net income attributable to Select Medical Holdings Corporation$44,816  $51,650  
Earnings per common share (Note 10):  
Basic$0.33  $0.39  
Diluted$0.33  $0.39  
 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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Select Medical Holdings Corporation
Condensed Consolidated Statements of Operations
(unaudited)
(in thousands, except per share amounts)

 For the Six Months Ended June 30,
 20192020
Net operating revenues$2,685,995  $2,647,350  
Costs and expenses:  
Cost of services, exclusive of depreciation and amortization2,282,242  2,282,827  
General and administrative60,016  67,292  
Depreciation and amortization107,131  104,023  
Total costs and expenses2,449,389  2,454,142  
Other operating income (Note 12)  54,988  
Income from operations236,606  248,196  
Other income and expense:  
Equity in earnings of unconsolidated subsidiaries11,760  10,912  
Gain on sale of businesses6,532  7,547  
Interest expense(102,275) (83,473) 
Income before income taxes152,623  183,182  
Income tax expense39,293  45,248  
Net income113,330  137,934  
Less: Net income attributable to non-controlling interests27,680  33,159  
Net income attributable to Select Medical Holdings Corporation$85,650  $104,775  
Earnings per common share (Note 10):  
Basic$0.63  $0.78  
Diluted$0.63  $0.78  
 
The accompanying notes are an integral part of these condensed consolidated financial statements.

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Select Medical Holdings Corporation
Condensed Consolidated Statements of Changes in Equity and Income
(unaudited)
(in thousands)

For the Six Months Ended June 30, 2020
 Total Stockholders’ Equity  
 Common
Stock
Issued
Common
Stock
Par Value
Capital in
Excess
of Par
Retained
Earnings
Total Stockholders’ EquityNon-controlling
Interests
Total
Equity
Balance at December 31, 2019134,328  $134  $491,038  $279,800  $770,972  $158,063  $929,035  
Net income attributable to Select Medical Holdings Corporation53,125  53,125  53,125  
Net income attributable to non-controlling interests—  10,067  10,067  
Issuance of restricted stock2  0  0  —    
Forfeitures of unvested restricted stock(15) 0  0  —    
Vesting of restricted stock6,136  6,136  6,136  
Repurchase of common shares(492) 0  (5,350) (3,341) (8,691) (8,691) 
Issuance of non-controlling interests—  1,679  1,679  
Distributions to and purchases of non-controlling interests(2,726) (2,726) (4,048) (6,774) 
Redemption adjustment on non-controlling interests(10,123) (10,123) (10,123) 
Other(55) (55) 420  365  
Balance at March 31, 2020133,823  $134  $491,824  $316,680  $808,638  $166,181  $974,819  
Net income attributable to Select Medical Holdings Corporation   51,650  51,650  51,650  
Net income attributable to non-controlling interests    —  12,572  12,572  
Issuance of restricted stock200  0  0   —    
Forfeitures of unvested restricted stock(7) 0  0  —    
Vesting of restricted stock6,262  6,262  6,262  
Repurchase of common shares(46) 0  (441) (283) (724) (724) 
Issuance of non-controlling interests—  7  7  
Distributions to and purchases of non-controlling interests  (65) (65) (418) (483) 
Redemption adjustment on non-controlling interests   127,916  127,916  127,916  
Other  (795) 1  (794) 1,205  411  
Balance at June 30, 2020133,970  $134  $496,785  $495,964  $992,883  $179,547  $1,172,430  


The accompanying notes are an integral part of these condensed consolidated financial statements.
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Select Medical Holdings Corporation
Condensed Consolidated Statements of Changes in Equity and Income
(unaudited)
(in thousands)

For the Six Months Ended June 30, 2019
 Total Stockholders’ Equity  
 Common
Stock
Issued
Common
Stock
Par Value
Capital in
Excess
of Par
Retained
Earnings
Total Stockholders’ EquityNon-controlling
Interests
Total
Equity
Balance at December 31, 2018135,266  $135  $482,556  $320,351  $803,042  $113,198  $916,240  
Net income attributable to Select Medical Holdings Corporation40,834  40,834  40,834  
Net income attributable to non-controlling interests—  4,810  4,810  
Issuance of restricted stock21  0  0  —    
Forfeitures of unvested restricted stock(24) 0  0  —    
Vesting of restricted stock5,488  5,488  5,488  
Issuance of non-controlling interests—  6,837  6,837  
Distributions to and purchases of non-controlling interests259  259  (2,739) (2,480) 
Redemption adjustment on non-controlling interests(47,470) (47,470) (47,470) 
Other(122) (122) 413  291  
Balance at March 31, 2019135,263  $135  $488,303  $313,593  $802,031  $122,519  $924,550  
Net income attributable to Select Medical Holdings Corporation44,816  44,816  44,816  
Net income attributable to non-controlling interests—  3,663  3,663  
Issuance of restricted stock187  0  0  —    
Vesting of restricted stock5,591  5,591  5,591  
Repurchase of common shares(936) 0  (8,164) (5,456) (13,620) (13,620) 
Exercise of stock options50  0  459  459  459  
Issuance of non-controlling interests6,366  6,366  24,761  31,127  
Distributions to and purchases of non-controlling interests14  14  (1,430) (1,416) 
Redemption adjustment on non-controlling interests270  270  270  
Other82  82  428  510  
Balance at June 30, 2019134,564  $135  $492,569  $353,305  $846,009  $149,941  $995,950  
The accompanying notes are an integral part of these condensed consolidated financial statements.
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Select Medical Holdings Corporation
Condensed Consolidated Statements of Cash Flows
(unaudited)
(in thousands)

 For the Six Months Ended June 30,
 20192020
Operating activities  
Net income$113,330  $137,934  
Adjustments to reconcile net income to net cash provided by operating activities:  
Distributions from unconsolidated subsidiaries11,148  11,223  
Depreciation and amortization107,131  104,023  
Provision for expected credit losses1,958  253  
Equity in earnings of unconsolidated subsidiaries(11,760) (10,912) 
Gain on sale of assets and businesses(6,354) (7,881) 
Stock compensation expense12,613  13,866  
Amortization of debt discount, premium and issuance costs6,326  1,093  
Deferred income taxes(6,290) (3,416) 
Changes in operating assets and liabilities, net of effects of business combinations:  
Accounts receivable(85,873) 13,179  
Other current assets(9,236) 713  
Other assets(939) 11,504  
Accounts payable2,670  4,251  
Accrued expenses(18,156) 4,028  
Government advances  316,992  
Unearned government assistance  45,505  
Income taxes16,346  43,743  
Net cash provided by operating activities132,914  686,098  
Investing activities  
Business combinations, net of cash acquired(86,062) (6,961) 
Purchases of property and equipment(89,285) (71,253) 
Investment in businesses(52,257) (14,749) 
Proceeds from sale of assets and businesses125  12,401  
Net cash used in investing activities(227,479) (80,562) 
Financing activities  
Borrowings on revolving facilities635,000  470,000  
Payments on revolving facilities(460,000) (470,000) 
Payments on term loans(132,685) (39,843) 
Borrowings of other debt14,230  31,487  
Principal payments on other debt(12,680) (35,733) 
Repurchase of common stock(13,620) (9,415) 
Proceeds from exercise of stock options459    
Increase in overdrafts2,176    
Proceeds from issuance of non-controlling interests18,288  1,686  
Distributions to and purchases of non-controlling interests(7,745) (13,660) 
Purchase of membership interests of Concentra Group Holdings Parent (Note 4)  (366,203) 
Net cash provided by (used in) financing activities43,423  (431,681) 
Net increase (decrease) in cash and cash equivalents(51,142) 173,855  
Cash and cash equivalents at beginning of period175,178  335,882  
Cash and cash equivalents at end of period$124,036  $509,737  
Supplemental Information  
Cash paid for interest$97,909  $86,124  
Cash paid for taxes29,241  4,920  
Operating lease right-of-use assets obtained in exchange for lease liabilities, excluding adoption impact of ASC Topic 842 at January 1, 201966,977  132,125  
 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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SELECT MEDICAL HOLDINGS CORPORATION
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

1.               Basis of Presentation
The unaudited condensed consolidated financial statements of Select Medical Holdings Corporation (“Holdings”) include the accounts of its wholly owned subsidiary, Select Medical Corporation (“Select”). Holdings conducts substantially all of its business through Select and its subsidiaries. Holdings and Select and its subsidiaries are collectively referred to as the “Company.” The unaudited condensed consolidated financial statements of the Company as of June 30, 2020, and for the three and six month periods ended June 30, 2019 and 2020, have been prepared pursuant to the rules and regulations of the Securities Exchange Commission (the “SEC”) for interim reporting and accounting principles generally accepted in the United States of America (“GAAP”). Accordingly, certain information and disclosures required by GAAP, which are normally included in the notes to consolidated financial statements, have been condensed or omitted pursuant to those rules and regulations, although the Company believes the disclosure is adequate to make the information presented not misleading. In the opinion of management, such information contains all adjustments, which are normal and recurring in nature, necessary for a fair statement of the financial position, results of operations and cash flow for such periods. All significant intercompany transactions and balances have been eliminated.
The results of operations for the three and six months ended June 30, 2020, are not necessarily indicative of the results to be expected for the full fiscal year ending December 31, 2020. These unaudited condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto for the year ended December 31, 2019, contained in the Company’s Annual Report on Form 10-K filed with the SEC on February 20, 2020.
2. Accounting Policies
Use of Estimates
The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, including disclosure of contingencies, at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.
Recently Adopted Accounting Pronouncements
Financial Instruments
On January 1, 2020, the Company adopted Accounting Standards Update (“ASU”) 2016-13, Financial Instruments - Credit Losses: Measurement of Credit Losses on Financial Instruments (Topic 326), which replaced the incurred loss approach for recognizing credit losses on financial instruments with an expected loss approach. The expected loss approach is subject to management judgments using assessments of incurred credit losses, assessments of current conditions, and forecasts using reasonable and supportable assumptions. The standard was required to be applied using the modified retrospective approach with a cumulative-effect adjustment to retained earnings, if any, upon adoption.
The Company’s primary financial instrument subject to the standard is its accounts receivable derived from contracts with patients. Historically, the Company has experienced infrequent, immaterial credit losses related to its accounts receivable and, based on its experience, believes the risk of material defaults is low. The Company experienced credit losses of $1.1 million for the year ended December 31, 2017, credit loss recoveries of $0.1 million for the year ended December 31, 2018, and credit losses of $3.0 million for the year ended December 31, 2019. The Company’s historical credit losses have been infrequent and immaterial largely because the Company’s accounts receivable are typically paid for by highly-solvent, creditworthy payors such as Medicare, other governmental programs, and highly-regulated commercial insurers, on behalf of the patient. The Company believes it has moderate credit risk related to defaults on self-pay amounts in accounts receivable; however, these amounts represented less than 1.0% of the Company’s accounts receivable at January 1, 2020.
In estimating the Company’s expected credit losses under Topic 326, the Company considers its incurred loss experience and adjusts for known and expected events and other circumstances, identified using periodic assessments implemented by the Company, which management believes are relevant in assessing the collectability of its accounts receivable. Because of the infrequent and insignificant nature of the Company’s historical credit losses, forecasts of expected credit losses are generally unnecessary. Expected credit losses are recognized by the Company through an allowance for credit losses and related credit loss expense.
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As of January 1, 2020, the Company completed its expected credit loss assessment for its financial instruments subject to Topic 326. The Company’s estimate of expected credit losses as of January 1, 2020, resulted in no adjustments to the allowance for credit losses and no cumulative-effect adjustment to retained earnings on the adoption date of the standard.
3.  Credit Risk Concentrations
Financial instruments that potentially subject the Company to concentrations of credit risk consist primarily of cash balances and accounts receivables. The Company’s excess cash is held with large financial institutions. The Company grants unsecured credit to its patients, most of whom reside in the service area of the Company’s facilities and are insured under third-party payor agreements. The Company’s general policy is to verify insurance coverage prior to the date of admission for patients admitted to its critical illness recovery hospitals and rehabilitation hospitals. Within the Company’s outpatient rehabilitation clinics, insurance coverage is verified prior to the patient’s visit. Within the Company’s Concentra centers, insurance coverage is verified or an authorization is received from the patient’s employer prior to the patient’s visit.
Because of the diversity in the Company’s non-governmental third-party payor base, as well as their geographic dispersion, patient accounts receivable which are due from the Medicare program represent the Company’s only significant concentration of credit risk. Approximately 15% and 13% of the Company’s accounts receivable is from Medicare at December 31, 2019, and June 30, 2020, respectively.
4.  Redeemable Non-Controlling Interests
The ownership interests held by outside parties in subsidiaries, limited liability companies, and limited partnerships controlled by the Company are classified as non-controlling interests. Some of the Company’s non-controlling ownership interests consist of outside parties that have certain redemption rights that, if exercised, require the Company to purchase the parties’ ownership interests. These interests are classified and reported as redeemable non-controlling interests and have been adjusted to their approximate redemption values.
On January 1, 2020, Select acquired approximately 17.2% of the outstanding membership interests of Concentra Group Holdings Parent on a fully diluted basis from Welsh, Carson, Anderson & Stowe XII, L.P. (“WCAS”), Dignity Health Holding Corporation (“DHHC”), and certain other sellers in exchange for an aggregate purchase price of approximately $338.4 million. On February 1, 2020, Select acquired an additional 1.4% of the outstanding membership interests of Concentra Group Holdings Parent on a fully diluted basis from WCAS, DHHC, and certain other sellers in exchange for an aggregate purchase price of approximately $27.8 million. These purchases were in lieu of, and are considered to be, the exercise of the first put right provided to certain equity holders under the terms of the Amended and Restated Limited Liability Company Agreement of Concentra Group Holdings Parent, dated as of February 1, 2018, as amended (the “Concentra LLC Agreement”).
Following these purchases, Select owns approximately 66.6% of the outstanding membership interests of Concentra Group Holdings Parent on a fully diluted basis and approximately 68.8% of the outstanding Class A membership interests of Concentra Group Holdings Parent.
The changes in redeemable non-controlling interests are as follows (in thousands):
Six Months Ended June 30,
20192020
Balance as of January 1$780,488  $974,541  
Net income attributable to redeemable non-controlling interests7,700  7,256  
Distributions to and purchases of redeemable non-controlling interests(2,771) (5,687) 
Purchase of membership interests of Concentra Group Holdings Parent  (366,203) 
Redemption adjustment on redeemable non-controlling interests47,470  10,123  
Other354  347  
Balance as of March 31$833,241  $620,377  
Net income attributable to redeemable non-controlling interests11,507  3,264  
Distributions to and purchases of redeemable non-controlling interests(395) (30) 
Redemption adjustment on redeemable non-controlling interests(270) (127,916) 
Other339  292  
Balance as of June 30$844,422  $495,987  
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5.  Variable Interest Entities
Concentra does not own many of its medical practices, as certain states prohibit the “corporate practice of medicine,” which restricts business corporations from practicing medicine through the direct employment of physicians or from exercising control over medical decisions by physicians. In these states, Concentra typically enters into long-term management agreements with professional corporations or associations that are owned by licensed physicians, which, in turn, employ or contract with physicians who provide professional medical services in Concentra’s occupational health centers.
The management agreements have terms that provide for Concentra to conduct, supervise, and manage the day-to-day non-medical operations of the occupational health centers and provide all management and administrative services. Concentra receives a management fee for these services, which is based, in part, on the performance of the professional corporation or association. Additionally, the outstanding voting equity interests of the professional corporations or associations are typically owned by licensed physicians appointed at Concentra’s discretion. Concentra has the ability to direct the transfer of ownership of the professional corporation or association to a new licensed physician at any time.
The total assets of Concentra’s variable interest entities, which are comprised principally of accounts receivable, were $178.4 million and $153.2 million at December 31, 2019, and June 30, 2020, respectively. The total liabilities of Concentra’s variable interest entities, which are comprised principally of accounts payable, accrued expenses, and obligations payable for services received under the aforementioned management agreements, were $176.7 million and $151.9 million at December 31, 2019, and June 30, 2020, respectively.
6.  Intangible Assets
Goodwill
The following table shows changes in the carrying amounts of goodwill by reporting unit for the six months ended June 30, 2020:
 Critical Illness Recovery HospitalRehabilitation HospitalOutpatient
Rehabilitation
ConcentraTotal
 (in thousands)
Balance as of December 31, 2019$1,078,804  $430,900  $649,763  $1,232,488  $3,391,955  
Acquired    728  4,567  5,295  
Sold    (6,034)   (6,034) 
Measurement period adjustment      (20) (20) 
Balance as of June 30, 2020$1,078,804  $430,900  $644,457  $1,237,035  $3,391,196  
Identifiable Intangible Assets
The following table provides the gross carrying amounts, accumulated amortization, and net carrying amounts for the Company’s identifiable intangible assets:
 December 31, 2019