DENVER, July 30, 2020 /PRNewswire/ -- During the second quarter of 2020, DaVita (NYSE: DVA) remained focused on its top priorities, the safety and care of its patients, caregivers, teammates and physician partners. In the face of the novel coronavirus (COVID-19) pandemic, we continue to work collaboratively with the U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention (CDC), the American Society of Nephrology, and dialysis providers nationwide to help ensure the entire dialysis community is able to support our collective patients and each other.

DaVita has made significant investments in workplace safety initiatives, infection control procedures, patient and caregiver COVID-19 testing, and technology and telehealth options for physicians and patients in an effort to ensure that our patients have the ability to maintain continuity of care throughout this crisis, whether in the inpatient, in-center, or home setting.

"The continued efforts of our 65,000 teammates in the face of this crisis while caring for our patients and for each other is truly inspiring," said Javier Rodriguez, CEO of DaVita Inc.  "They are working tirelessly to embody the DaVita name 'to give life' to over 236,000 patients worldwide."

A summary of the company's COVID-19 response to date is included later in this release.

In addition, the Company announced financial and operating results for the quarter ended June 30, 2020.

Financial results for the quarter ended June 30, 2020

Highlights:

• Consolidated revenues of $2.880 billion.
• Operating income of $410 million or 14.2% operating margin and adjusted operating income of $461 million or 16.0% adjusted operating margin.
• Diluted earnings per share from continuing operations of $1.62 and adjusted diluted earnings per share from continuing operations of $1.95.
• Operating cash flow from continuing operations of $651 million and free cash flow from continuing operations of $507 million.
• Issued an aggregate principal amount of $1.750 billion of 4.625% senior notes. The net proceeds from the offering, together with cash on hand, were used to redeem in full our $1.750 billion in aggregate principal amount of outstanding 5.125% senior notes in July.

U.S. dialysis metrics:

Volume: Total U.S. dialysis treatments for the second quarter of 2020 were 7,570,908, or an average of 97,063 treatments per day, representing a per day increase of 0.7% over the second quarter of 2019. Normalized non-acquired treatment growth in the second quarter of 2020 as compared to the second quarter of 2019 was 1.6%.

Primary drivers of the changes in the table above were as follows:

Revenue: The quarter change was primarily due to normal seasonality driven by patients meeting their co-insurance and deductibles, favorable changes in government and commercial payor mix and an increase in Medicare rates due to the temporary suspension of Medicare sequestration, partially offset by a Medicare rate decline related to calcimimetics and a decrease in inpatient dialysis service revenue. The year to date change was primarily due to favorable changes in payor rates and an increase in Medicare rates due to the temporary suspension of Medicare sequestration, partially offset by a decline in Medicare rates related to calcimimetics.

Patient care costs: The quarter change was primarily due to an increase in COVID-19-related costs including compensation and other medical supplies, partially offset by decreases in health benefit expenses, other direct dialysis center operating expense and other pharmaceutical intensity. The year to date change was primarily due to decreases in calcimimetics unit costs, other pharmaceutical unit costs, other direct dialysis center operating expense and health benefit expenses, partially offset by an increase in COVID-19-related costs including compensation and other medical supplies.

General and administrative: The quarter change was primarily due to an increase in compensation costs, including COVID-19-related compensation, as well as increases in legal and consulting costs, partially offset by decreases in travel and entertainment expense, health benefit expenses and long-term incentive compensation expense. The year to date change was primarily due to decreases in travel and entertainment expense, payroll taxes, health benefit expenses and long-term incentive compensation expense partially offset by an increase in compensation costs, including COVID-19-related compensation and an increase in consulting costs.

Certain items impacting the quarter:

Debt transactions: In June 2020, we issued $1.750 billion in aggregate principal amount of 4.625% senior notes due 2030. In July, we used the net proceeds from these 4.625% senior notes, together with cash on hand, to redeem in full all $1.750 billion in aggregate principal amount of our outstanding 5.125% senior notes due 2024, including payment of accrued interest and a redemption premium. Charges associated with this redemption will be recognized in the third quarter.

Non-GAAP adjustments to operating income:

Loss on changes in ownership interest, net: During the second quarter of 2020 we sold Lifeline, our vascular access business, and recognized a loss of $16 million.

Accruals for legal matters: During the second quarter of 2020 we recorded accruals for legal matters and recognized a net charge of $35 million which is included in general and administrative expenses.

Financial and operating metrics:

Center activity: As of June 30, 2020, we provided dialysis services to a total of approximately 236,800 patients at 3,082 outpatient dialysis centers, of which 2,795 centers were located in the United States and 287 centers were located in ten countries outside of the United States. During the second quarter of 2020, we opened a total of 28 new dialysis centers, acquired one center and closed six dialysis centers in the United States. We also acquired three dialysis centers and opened two new dialysis centers outside of the United States during the second quarter of 2020.

Outlook:

The following forward-looking measures and the underlying assumptions involve significant risks and uncertainties, including those described below, and actual results may vary materially from these forward-looking measures. In particular, the widespread impact of the COVID-19 pandemic continues to generate significant risk and uncertainty, and as a result, our future results could vary materially from the guidance provided below. We do not provide guidance for diluted net income from continuing operations per share attributable to DaVita Inc., effective income tax rate on income from continuing operations or free cash flow from continuing operations on a basis consistent with United States generally accepted accounting principles (GAAP) nor a reconciliation of forward-looking non-GAAP financial measures to the most directly comparable GAAP financial measures on a forward-looking basis because we are unable to predict certain items contained in the GAAP measures without unreasonable efforts. These non-GAAP financial measures do not include certain items, including loss on changes in ownership interests, accruals for legal matters, refinancing charges and foreign currency fluctuations, which may be significant. The guidance for our effective income tax rate on adjusted income from continuing operations attributable to DaVita Inc. also excludes the amount of third party owners' income and related taxes attributable to non-tax paying entities.

We will be holding a conference call to discuss our results for the second quarter ended June 30, 2020, on July 30, 2020, at 5:00 p.m. Eastern Time. To join the conference call, please dial (877) 918-6630 from the U.S. or (517) 308-9042 from outside the U.S., and provide the operator the password 'Earnings'. A replay of the conference call will be available on our website at investors.davita.com for the following 30 days.

DaVita COVID-19 Response to Date

DaVita implemented a Prepare, Prevent and Respond protocol and is working in lockstep with the CDC on infection control and clinical best practices in response to COVID-19. Additionally, we have made many investments to support our patients and teammates and the broader community. Our COVID-19 response includes:

Caring for our patients

• Collaborating with dialysis providers across the nation to develop a nationwide contingency plan with a goal of maintaining continuity of care for dialysis patients by creating isolation cohort capacity that can be accessed by other dialysis providers.
• Requiring proactive screenings to evaluate everyone who enters our outpatient dialysis centers for COVID-19-like symptoms and exposure.
• Early cohorting of patients who have or are suspected of having COVID-19 to help keep our other dialysis patients and frontline caregivers safe.
• Restricting visitors who are not necessary for patient care.
• Onsite testing of patients and teammates for COVID-19 at select facilities.
• Implementing a mask policy for all individuals—patients, teammates, essential visitors—at all times in our centers early in the COVID-19 outbreak.
• Providing all necessary personal protective equipment (e.g., masks, gowns, shields, hand sanitizer) for teammates' safety.
• Updating our sick leave policy to align with CDC guidance for health care professionals.
• Offering telehealth options to our physicians in all of our locations to help protect our patients, teammates, and physician partners from potential virus exposure while maintaining continuity of care.
• Continuing to offer home dialysis to over 28,000 patients through over 1,750 DaVita locations across the United States with options for home remote monitoring and a dedicated HIPAA-compliant home dialysis telehealth platform.
• Sending nearly 100 clinicians who volunteered to travel from their home center to other states to support clinics and acute care hospitals providing dialysis to patients in COVID-19 hotspots.

Caring for our teammates

• Providing relief reimbursement to eligible teammates.
• Implementing double overtime pay as extra compensation for eligible teammates who worked over 40 hours per work week, during a period of time in the quarter ended June 30, 2020.
• Making paid time off (PTO) policy changes, including:
• Giving PTO advances for teammates who get sick and need time off.
• Allowing teammates to continue to accrue PTO without limitation through June 27.
• Establishing a donation platform for teammates to give PTO and financial support to other teammates in need.
• Sending care packages with helpful resources to frontline teammates.
• Transitioning central business office teammates to work remotely without disruption in service levels.
• Offering 10 days of free emergency backup child or elder care to our teammates through Bright Horizons.
• Providing no-cost resources to help teammates and their families to cope with stress and to enhance mental and emotional well-being through our Employee Assistance Program.
• Providing regular communications and updates to teammates on COVID-19-related issues.

Caring for our communities and physician partners

• Continuing to provide outpatient dialysis to nearly 70% of patients with suspected and confirmed COVID-19, which helps maintain continuity of care and reduces the burden on hospitals.
• Returning approximately $250 million of CARES Act provider relief funding to the federal government so it could be allocated to providers in greater need of emergency relief.
• Committing millions in charitable donations for initiatives to enhance social justice.
• Continuing the DaVita Way of Giving program which allows teammates to direct donations to local nonprofits across the U.S.

DaVita Inc. and its representatives may from time to time make written and oral forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 ("PSLRA"), including statements in this release, filings with the Securities and Exchange Commission ("SEC"), reports to stockholders and in meetings with investors and analysts. All statements in this release, during the related presentation or other meetings, other than statements of historical fact, are forward-looking statements and as such are intended to be covered by the safe harbor for "forward-looking statements" provided by the PSLRA. These forward-looking statements could include, among other things, DaVita's response to and the expected future impacts of COVID-19, including statements about our balance sheet and liquidity, our expenses, revenues and future results, potential need, ability or willingness to use any funds under the CARES Act or other government programs, availability of supplies, treatment volumes, number or percentage of patients and overall impact on our patients, as well as statements related to our guidance and expectations for future periods and the assumptions underlying any such projections. Without limiting the foregoing, statements including the words "expect," "intend," "will," "could," "plan," "anticipate," "believe," and similar expressions are intended to identify forward-looking statements. These forward-looking statements are based on DaVita's current expectations and are based solely on information available as of the date of this release. DaVita undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of changed circumstances, new information, future events or otherwise. Actual future events and results could differ materially from any forward-looking statements due to numerous factors that involve substantial known and unknown risks and uncertainties. These risks and uncertainties include, among other things:

• the continuing impact of the dynamic and rapidly evolving COVID-19 pandemic, including, without limitation, on our patients, teammates, physician partners, suppliers, business, operations, reputation, financial condition and results of operations, the government's response to the COVID-19 pandemic, and the consequences of an extended economic downturn resulting from the impacts of COVID-19, any of which may also have the effect of heightening many of the other risks and uncertainties discussed below;
• our need, ability and willingness to utilize any funds received under the CARES Act or subsequent legislation, and the consequences of our decisions with respect thereto;
• the concentration of profits generated by higher-paying commercial payor plans for which there is continued downward pressure on average realized payment rates, and a reduction in the number or percentage of our patients under such plans, including without limitation as a result of restrictions or prohibitions on the use and/or availability of charitable premium assistance, which may result in the loss of revenues or patients, or our making incorrect assumptions about how our patients will respond to any change in financial assistance from charitable organizations;
• noncompliance by us or our business associates with any privacy or security laws or any security breach by us or a third party involving the misappropriation, loss or other unauthorized use or disclosure of confidential information;
• the extent to which the ongoing implementation of healthcare reform, or changes in or new legislation, regulations or guidance, enforcement thereof or related litigation result in a reduction in coverage or reimbursement rates for our services, a reduction in the number of patients enrolled in higher-paying commercial plans or that are enrolled in or select Medicare Advantage plans, or other material impacts to our business; or our making incorrect assumptions about how our patients will respond to any such developments;
• a reduction in government payment rates under the Medicare End Stage Renal Disease program or other government-based programs and the impact of the Medicare Advantage benchmark structure;
• risks arising from potential and proposed federal and/or state legislation, regulation, ballot, executive action or other initiatives, including such initiatives related to healthcare and/or labor matters, such as Proposition 23 in California;
• the impact of the upcoming election cycle, the political environment and related developments on the current healthcare marketplace and on our business, including with respect to the future of the Affordable Care Act, the exchanges and many other core aspects of the current healthcare marketplace;
• our ability to successfully implement our strategy with respect to home-based dialysis, including maintaining our existing business and further developing our capabilities in a complex and highly regulated environment;
• changes in pharmaceutical practice patterns, reimbursement and payment policies and processes, or pharmaceutical pricing, including with respect to calcimimetics;
• legal and compliance risks, such as our continued compliance with complex government regulations;
• continued increased competition from dialysis providers and others, and other potential marketplace changes;
• our ability to maintain contracts with physician medical directors, changing affiliation models for physicians, and the emergence of new models of care introduced by the government or private sector that may erode our patient base and reimbursement rates, such as accountable care organizations, independent practice associations and integrated delivery systems;
• our ability to complete acquisitions, mergers or dispositions that we might announce or be considering, on terms favorable to us or at all, or to integrate and successfully operate any business we may acquire or have acquired, or to successfully expand our operations and services in markets outside the United States, or to businesses outside of dialysis;
• uncertainties related to potential payments and/or adjustments under certain provisions of the equity purchase agreement for the sale of our DaVita Medical Group (DMG) business, such as post-closing adjustments and indemnification obligations;
• the variability of our cash flows, including without limitation any extended billing or collections cycles; the risk that we may not be able to generate or access sufficient cash in the future to service our indebtedness or to fund our other liquidity needs; and the risk that we may not be able to refinance our indebtedness as it becomes due, on terms favorable to us or at all;
• factors that may impact our ability to repurchase stock under our stock repurchase program and the timing of any such stock repurchases;
• risks arising from the use of accounting estimates, judgments and interpretations in our financial statements;
• impairment of our goodwill, investments or other assets; and
• uncertainties associated with the other risk factors set forth in DaVita Inc.'s Annual Report on Form 10-K for the year ended December 31, 2019 and Quarterly Report on Form 10-Q for the quarter ended March 31, 2020, and the risks and uncertainties discussed in any subsequent reports that DaVita has filed or furnished with the SEC from time to time.

The financial information presented in this release is unaudited and is subject to change as a result of subsequent events or adjustments, if any, arising prior to the filing of the Company's Quarterly Report on Form 10-Q for the quarter ended June 30, 2020.

DAVITA INC.
SUPPLEMENTAL FINANCIAL DATA-continued
(unaudited)
(dollars in thousands)

Note 1: Calculation of the Leverage Ratio

Under our new senior secured credit facilities (the New Credit Agreement) dated August 12, 2019 and our prior senior secured credit facilities (the Prior Credit Agreement), the leverage ratio is defined as all funded debt plus the face amount of all letters of credit issued, minus cash and cash equivalents, not to exceed certain limits under the New Credit Agreement, including short-term investments, divided by "Consolidated EBITDA". The leverage ratio determines the interest rate margin payable by the Company for its new Term Loan A and new revolving line of credit under the New Credit Agreement by establishing the margin over the base interest rate (LIBOR) that is applicable. The following leverage ratios were calculated using "Consolidated EBITDA" and "Consolidated net debt" as defined in the credit agreement that was in effect at the end of each period. The calculation below is based on the last twelve months of "Consolidated EBITDA", as of the end of the reported period and pro forma for acquisitions or divestitures that occurred during the period. The Company's management believes the presentation of "Consolidated EBITDA" is useful to users to enhance their understanding of the Company's leverage ratio under its credit agreement in effect at that time. The leverage ratio calculated by the Company is a non-GAAP measure and should not be considered a substitute for debt to net income attributable to DaVita Inc., net income attributable to DaVita Inc. or total debt as determined in accordance with United States generally accepted accounting principles (GAAP). The Company's calculation of its leverage ratio might not be calculated in the same manner as, and thus might not be comparable to, similarly titled measures by other companies.