Kindred Healthcare August 2011 Town Hall Meeting


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Presentation to Kindred Healthcare employees delivered by Paul Diaz and Ben Breier on August 16, 2011

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  • What we want to talk about today: Update you on our continued progress as a company… Our progress on our quality, people and financial goals Progress on RehabCare merger and integration and Thank You ! (Vista, Dallas TCC ’s, Growing Home Health and Hospice Services and Follow-up our Everybody ’s Business communication on the difficult reimbursement environment and what it will and will not mean to us Talk about our exciting path forward together and opportunities to we have to continue to grow
  • Everyday working to improve the lives of our patients and residents and return people home as quickly as possible
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  • In 9 years, the Nursing Center Division has moved from 12 th out of 12 in Quality to Number 1 in Quality compared to our peers
  • RehabCare and our Facility clinical teams are getting our patients home in record numbers, reducing LOS and helping to reducing rehospitalizations in all of our 2,200 sites of service
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  • CMS rule now requires that merit increases range from 0-2%, depending on line of business. 2012 benefits programs incorporate aspects from RehabCare and Kindred to maintain affordable and flexible offerings We are not in the same boat as other rehab and nursing home companies Hospitals in 2006 had a $75 million cut by CMS – we did not overreact
  • People, Quality, Cost Management and Admissions/Contract Growth will always be our Key Drivers of Value Creation Well positioned to succeed long term in a changing post-acute landscape
  • Kindred Healthcare August 2011 Town Hall Meeting

    1. 1. Positioning us for Growth Paul J. Diaz - President & CEO Benjamin A. Breier, Chief Operating Officer Company Update - Webcast
    2. 2. Forward-Looking Statements This presentation includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. All statements regarding Kindred ’s expected future financial position, results of operations, cash flows, financing plans, business strategy, budgets, capital expenditures, competitive positions, growth opportunities, plans and objectives of management and statements containing the words such as “anticipate,” “approximate,” “believe,” “plan,” “estimate,” “expect,” “project,” “could,” “should,” “will,” “intend,” “may” and other similar expressions, are forward-looking statements. Such forward-looking statements are inherently uncertain, and stockholders and other potential investors must recognize that actual results may differ materially from Kindred ’s expectations as a result of a variety of factors, including, without limitation, those discussed below. Such forward-looking statements are based upon management’s current expectations and include known and unknown risks, uncertainties and other factors, many of which Kindred is unable to predict or control, that may cause Kindred’s actual results or performance to differ materially from any future results or performance expressed or implied by such forward-looking statements. These statements involve risks, uncertainties and other factors discussed below and detailed from time to time in Kindred’s filings with the Securities and Exchange Commission (the “SEC”). In addition to the factors set forth above, other factors that may affect Kindred ’ s plans or results include, without limitation, (a) the impact of a final rule issued by CMS on July 29, 2011 providing for a 11.1% reduction in Medicare reimbursement to nursing centers as well as changes in payments for the provision of group rehabilitation therapy services, (b) other potential reimbursement changes resulting from the Budget Control Act of 2011, (c) Kindred ’ s ability to integrate the operations of the acquired hospitals and rehabilitation services operations and realize the anticipated revenues, economies of scale, cost synergies and productivity gains in connection with the RehabCare acquisition and any other acquisitions that may be undertaken during 2011, as and when planned, including the potential for unanticipated issues, expenses and liabilities associated with those acquisitions, (d) the potential for diversion of management time and resources in seeking to integrate RehabCare ’ s operations, (e) the potential failure to retain key employees of RehabCare, (f) the impact of Kindred ’ s significantly increased levels of indebtedness as a result of the RehabCare acquisition on Kindred ’ s funding costs, operating flexibility and ability to fund ongoing operations, development capital expenditures or other strategic acquisitions with additional borrowings, particularly in light of ongoing volatility in the credit and capital markets, (g) the impact of healthcare reform, which will initiate significant reforms to the United States healthcare system, including potential material changes to the delivery of healthcare services and the reimbursement paid for such services by the government or other third party payors. Healthcare reform will impact each of Kindred ’ s businesses in some manner. Due to the substantial regulatory changes that will need to be implemented by CMS and others, and the numerous processes required to implement these reforms, Kindred cannot predict which healthcare initiatives will be implemented at the federal or state level, the timing of any such reforms, or the effect such reforms or any other future legislation or regulation will have on Kindred ’ s business, financial position, results of operations and liquidity, (h) changes in the reimbursement rates or the methods or timing of payment from third party payors, including commercial payors and the Medicare and Medicaid programs, changes arising from and related to the Medicare prospective payment system for LTAC hospitals, including potential changes in the Medicare payment rules, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, and changes in Medicare and Medicaid reimbursements for nursing centers, and the expiration of the Medicare Part B therapy cap exception process, (i) the effects of additional legislative changes and government regulations, interpretation of regulations and changes in the nature and enforcement of regulations governing the healthcare industry, (j) Kindred ’ s ability to successfully pursue its development activities, including through acquisitions, and successfully integrate new operations, including the realization of anticipated revenues, economies of scale, cost savings and productivity gains associated with such operations, (k) the impact of the Medicare, Medicaid and SCHIP Extension Act of 2007 (the “ SCHIP Extension Act ” ), including the ability of Kindred ’ s hospitals to adjust to potential LTAC certification, medical necessity reviews and the moratorium on future hospital development, (l) the impact of the expiration of several moratoriums under the SCHIP Extension Act which could impact the short stay rules, the budget neutrality adjustment as well as implement the policy known as the “ 25 Percent Rule, ” which would limit certain patient admissions, (m) failure of Kindred ’ s facilities to meet applicable licensure and certification requirements, (n) the further consolidation and cost containment efforts of managed care organizations and other third party payors, (o) Kindred ’ s ability to meet its rental and debt service obligations, (p) Kindred ’ s ability to operate pursuant to the terms of its debt obligations and its master lease agreements with Ventas, Inc. (NYSE:VTR), (q) the condition of the financial markets, including volatility and weakness in the equity, capital and credit markets, which could limit the availability and terms of debt and equity financing sources to fund the requirements of Kindred ’ s businesses, or which could negatively impact Kindred ’ s investment portfolio, (r) national and regional economic, financial, business and political conditions, including their effect on the availability and cost of labor, credit, materials and other services, (s) Kindred ’ s ability to control costs, particularly labor and employee benefit costs, (t) increased operating costs due to shortages in qualified nurses, therapists and other healthcare personnel, (u) Kindred ’ s ability to attract and retain key executives and other healthcare personnel, (v) the increase in the costs of defending and insuring against alleged professional liability and other claims and the ability to predict the estimated costs related to such claims, including the impact of differences in actuarial assumptions and estimates compared to eventual outcomes, (w) Kindred ’ s ability to successfully reduce (by divestiture of operations or otherwise) its exposure to professional liability and other claims, (x) Kindred ’ s ability to successfully dispose of unprofitable facilities, (y) events or circumstances which could result in the impairment of an asset or other charges, (z) changes in generally accepted accounting principles ( “ GAAP ” ) or practices, and changes in tax accounting or tax laws (or authoritative interpretations relating to any of these matters), and (aa) Kindred ’ s ability to maintain an effective system of internal control over financial reporting. Many of these factors are beyond Kindred ’ s control. Kindred cautions investors that any forward-looking statements made by Kindred are not guarantees of future performance. Kindred disclaims any obligation to update any such factors or to announce publicly the results of any revisions to any of the forward-looking statements to reflect future events or developments. The information being provided today is as of this date only and Kindred disclaims any obligation to update any such factors or to announce publicly the results of any revisions to any of the forward-looking statements to reflect future events or developments. Additional information concerning Kindred, including our SEC filings and a copy of this presentation, is available on our website , under the heading “Investor Information.” Reconciliation of non-GAAP Financial Measures Our website also includes reconciliations of any non-GAAP financial measures we mention in our presentations to their corresponding GAAP measures. These reconciliations may be found at under the heading “Investor Information.”
    3. 3. is to promote healing, provide hope, preserve dignity and produce value for each patient, resident, family member, customer, employee and shareholder we serve . Kindred Healthcare ’s Mission
    4. 4. Premier Provider of Rehabilitation Services and Post-Acute Care in the United States (1) (1) Ranking based on revenues. (2) Pro forma revenues for the twelve months ended June 30, 2011. (3) As of June 30, 2011. (4) Ranking provided by TMP, Inc. 2,213 (3) sites of service, 453 facilities in 46 states 76,300 (3) dedicated employees, making Kindred a top-150 private employer in the U.S. (4) 56,300 (3) patients and residents per day $6 billion (2) consolidated revenues
    5. 5.
    6. 6. <ul><li>Provide superior clinical outcomes and quality care with an approach which is patient-centered, disciplined and transparent </li></ul><ul><li>Lower cost by reducing lengths of stay in acute care hospitals and transition patients home at the highest possible level of function </li></ul><ul><li>Reduce re-hospitalization through our integrated and interdisciplinary care management teams and protocols </li></ul>KINDRED ’S VALUE PROPOSITION AND OUR “ CONTINUE THE CARE ” CAMPAIGN
    7. 7. KINDRED ’S MANAGEMENT PHILOSOPHY Commitment to Mission and Values Taking Care of Our People Focus on Quality and Customer Service Disciplined and Balanced Approach to Our Key Success Factors
    9. 9. Hospital Division • Balanced Scorecard June 2011 YTD
    10. 10. Nursing Center Division • Balanced Scorecard June 2011 YTD
    11. 11. RehabCare Division 1 • Balanced Scorecard June 2011 YTD 1 Legacy
    12. 12. Nursing Center Division <ul><li>Nursing Center Division #1 in Quality/Rankings as measured by Standard Surveys </li></ul><ul><li>American Healthcare Association Quality Awards </li></ul><ul><ul><li>1 Gold Award (Only 10 Gold Award Winners in the United States) </li></ul></ul><ul><ul><li>22 Silver Award Winners </li></ul></ul><ul><ul><li>208 Bronze Award Winners </li></ul></ul><ul><ul><ul><ul><ul><li>208 out of a total of 224 Facilities ! </li></ul></ul></ul></ul></ul>
    13. 13. Nursing Center Division *Based on eight Standard Survey categories derived from CASPER data by TSI Healthcare Solutions thru Jun 30, 2011 Standard Survey Rank among Top Ten Largest Providers Selected Corporation Actual Rank Average Rank* Centers Beds Kindred Healthcare 1 3.38 232 27661 Company A 2 4.38 305 30974 Company B 3 6.50 201 24909 Company C 4 6.63 176 12905 Company D 5 7.13 166 17116 Company E 6 7.13 218 28661 Company F 7 7.38 180 21560 Company G 8 7.50 281 37401 Company H 9 9.25 187 21212 Company I 10 10.00 84 9810
    14. 14. Hospital Division 2011 Results are YTD through June Per 1000 Patient Days Per 1000 Central Line Days Per 1000 Urinary Catheter Days Per 1000 Patient Days Quality  Consistently the Best ! 2007 2008 2009 2010 2011
    15. 15. Hospital Division 2011 Results are YTD through June Customer Service  Consistent Year over Year Improvement
    16. 16. Improving % of Patients Discharged to Home <ul><li>Discharge to Home up year over year </li></ul>RehabCare -
    17. 17. <ul><li>Key Systems & Infrastructure </li></ul><ul><li>Payroll conversion successfully executed </li></ul><ul><li>1 st full month end and quarter end financial close successfully completed </li></ul><ul><li>Synergy Realization </li></ul><ul><li>Moving forward with implementation efforts on $55m of identified synergies </li></ul><ul><li>People </li></ul><ul><li>Overall employee retention on track with retention of key senior management </li></ul><ul><li>Maintaining levels of patient care and quality </li></ul><ul><li>2012 Benefits program being developed </li></ul>RehabCare Integration Update Overall Status Full integration of organizations and systems are on track with go-forward focus on business operationalization and synergy realization
    18. 18. <ul><li>Maintain active employee engagement and communications – Combining Our Strengths </li></ul><ul><li>Continue moving forward with synergy realization efforts </li></ul><ul><li>Launch IT Phase 2 Integration efforts </li></ul><ul><li>Move forward with Hospital Clinical Systems (ProTouch) Implementation Plan </li></ul>Integration Next Steps
    19. 19. Financial, Reimbursement and Legislative Update <ul><li>Reported Strong Second Quarter Results of $0.53 per share as a combined company </li></ul><ul><li>Operating Cash flows strong and Balance Sheet (Debt) remains at conservative levels </li></ul><ul><li>CMS issued final Medicare rules that will negatively impact our Nursing and Rehabilitation Centers and RehabCare by $105 - $125 Million </li></ul>
    20. 20. <ul><li>Maintain quality and staffing levels in our facilities and rehab departments and protect jobs - our number one focus </li></ul><ul><li>Continue with merit increases to be a competitive employer </li></ul><ul><ul><li>Target will be lower than hoped, ranging from 0-2% </li></ul></ul><ul><li>Continue to provide health insurance and other benefits </li></ul><ul><ul><li>Premiums and Plan designs will continue to be adjusted over time in the context of healthcare reform and increasing healthcare cost </li></ul></ul><ul><li>2012 benefits programs will incorporate aspects from RehabCare and Kindred to maintain affordable and flexible offerings </li></ul>Impact of Reimbursement Cuts? We Will…
    21. 21. <ul><li>Continue to Provide a Wellness Program (lower Healthy Rewards rates) for employees committing to a healthy lifestyle </li></ul><ul><ul><li>Consider moving to Consumer Choice plan to further lower health insurance contributions </li></ul></ul><ul><ul><li>Last year, 1,600 people successfully completed weight, stress or tobacco programs and 91% of those who quit smoking were smoke-free after 6 months </li></ul></ul><ul><ul><li>96% of those who graduated from weight management maintained a BMI <30 after 6 months </li></ul></ul>We Will… Impact of Reimbursement Cuts?
    22. 22. <ul><li>Continue to Offer a 401K plan </li></ul><ul><ul><li>In 2012, we will reinstate a basic 401K match and continue profit-based contributions </li></ul></ul><ul><li>PTO </li></ul><ul><ul><li>In general, PTO program will be same or better than current </li></ul></ul><ul><li>Next step .....two year plan to have smoke-free campuses </li></ul>We Will… Impact of Reimbursement Cuts?
    23. 23. <ul><li>Have big layoffs or do anything that jeopardizes our Mission </li></ul><ul><li>Stop investing in our people and the quality of our services </li></ul><ul><li>Stop capital spending </li></ul><ul><ul><li>Information technology </li></ul></ul><ul><ul><li>Facility upgrades </li></ul></ul><ul><ul><li>Cluster Market Development e.g., TCC ’s, IRF’s, LTAC’s, Home Health </li></ul></ul>We Will Not… Impact of Reimbursement Cuts?
    24. 24. CLOSING THOUGHTS <ul><ul><li>Track record for operational success based on commitment to quality, service excellence and a demonstrated ability to adapt to change </li></ul></ul><ul><ul><li>We are in a strong financial position and have the flexibility to continue to grow and weather the current reimbursement head-winds </li></ul></ul><ul><ul><li>People, Quality, Cost Management and Admissions/Contract Growth will always be our Key Drivers of Value Creation </li></ul></ul><ul><ul><li>Well positioned to succeed long term in a changing post-acute landscape </li></ul></ul>