Sotera Health Company (SHC)
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JPMorgan Healthcare Conference

Jan 10, 2023

Casey Woodring
VP of Equity Research, JPMorgan

All right. Hello, everybody. Thanks for joining us today. My name is Casey Woodring from the Life Sciences Tools and Diagnostics team here at JP Morgan. I'm pleased to be joined here today by Sotera Health. CEO Michael Petras is here to my left. There will be a Q&A portion following the company presentation. With that, Michael.

Michael Petras
Chairman and CEO, Sotera Health

Great. Thanks, Casey. Good afternoon, everybody. Thanks for joining us. We'll get through forward-looking statements. Some of the statements I'll make today may be considered forward-looking statements. Please refer to our SEC filings for a description of the risks and uncertainties that could cause our actual results to differ materially from projected or implied. The company assumes no obligation to update forward-looking statements. During the discussion today, we may talk about certain non-GAAP financial measures, including adjusted EBITDA. You can refer to our SEC filings for reconciliation of these measures as well. What I'll do today is I'll give a brief overview of the company, talk a little bit about the financials as well.

We have a couple things that we pointed out this afternoon that you may or may not have seen in the public markets. We reconfirmed our revenue guidance that we gave at the end of third quarter. We also just within the last hour, announced a settlement for the litigation in Illinois around ethylene oxide. I'll touch upon both of those briefly. I will not get into a lot of details on the fourth quarter or 2023 projections. We will do that on February 28th. First overall overview for the company. We're driven by our mission of safeguarding global health. Many of you may or may not know that the word Sotera comes from the Greek goddess of safety, and that's really what the company stands for.

Safeguarding global health is really our mission. When you look at the company and what we do, for some of you that aren't as familiar with the company, we've got three operating business units, Sterigenics, Nordion and Nelson Labs. In the sterilization services side, we have Sterigenics and Nordion. Sterigenics is the largest business entity that we have, and in this business is where we sterilize medical devices and pharma products. The customers make the products, the big med device pharma companies make the products, package them up, and ship them out to point of care. Before they get to the end use or the point of care, it goes through one of our sterilization facilities around the world, and we do terminal sterilization to make sure there's no microorganisms and the products are safe.

One of the key ways you sterilize is with Cobalt-60. Nordion is the world leader in supplying Cobalt-60 to the sterilization market. They sell to not only Sterigenics but also the competitors of Sterigenics. This is the only one of our businesses of the three business that's a product business. The other two are service businesses. Getting to that point, I'll go to the third business, that's Nelson Labs. Nelson Labs is our microbiological and analytical chemistry testing lab and advisory services business. This is a service business. Similar customers that we have in the sterilization services. In this business, we test products to make sure they meet the regulatory requirements and they're safe. How we do all this is we have customer relationships, blue-chip customer relationships. We do business with the top medical device and pharma companies in the world.

We have a global network of facilities that is in close proximity to our customers. We have over 60 facilities around the world. We have deep expertise, regulatory and technical expertise. You don't just wake up tomorrow morning saying you wanna get in the Cobalt-60 business or sterilization business. There's a lot of complexity, a lot of regulatory requirements, and this is what our team has a lot of breadth and depth in. We have leverage for both organic and inorganic growth, and the foundation of the company is really the values, strong values and accountability and really how we look at our people and what they can bring to the company around customer focus, operational excellence, and how do we make the company better every day, but operating with very high integrity. What does this all lead to?

It leads to a phenomenal business that has had revenue growth every single year since 2005. We've got a TTM through the third quarter. Our adjusted EBITDA margins are greater than 50%. That's 50 as in five-O. 50%-plus adjusted EBITDA margins. We have a $33 billion TAM. This is a business that cash flows several hundreds of millions of dollars a year, and I can tell you it's a very difficult business to replicate. You want exposure to healthcare, this is a great business because we're not tied to payer reimbursement. We don't sell to GPOs. We don't sell into the hospital channel. It's a very unique business. That's just a little bit of an overview.

On this page here, you see all the different kinds of medical devices and pharma products that we come in constant contact with through our medical device sterilization business or in our testing. Same thing with pharma products. We're all the blue-chip customers you know. You know, 40 of the top 50 med device companies in the world, eight of the top 10 global pharma companies in the world are customers of ours. We play a really critical role in supply chain. We're kind of behind the scenes. Not a lot of people know about us and what we do. We play a critical role in making sure these products are safe and getting to market. I mentioned briefly our TAM and SAM.

You know, we've got a $33 billion TAM that we play in. Of that, $11 billion is a serviceable addressable market today. You can see on the right-hand side how it's broken out. You know, over $3 billion is terminal sterilization that Sterigenics and Nordion play in. You've got about $7 billion in testing. That's in the lab testing side for both pharma and med device. This is a really big market, lots of opportunities for growth organically. That's why we're so confident of our ability to continue to grow on the top line year in, year out. Speaking of growth, I'll talk a little bit about the long-term growth and how we see this business playing out in high single-digit organic growth. First, I'll talk about volume and mix.

We're seeing mid-to-high single digits volume and mix across the businesses. If you look at Sterigenics, they in particular in that business is mid-to-high single digit growth on volume and mix. Nordion is on the low-to-mid single digit growth in volume and mix. Nelson Labs is on the mid-to-high single digits in volume and mix. One of the characteristics about this business that's really unique is we get about 3.5%-5% price per year across all three of these businesses. That's right, 3.5%-5% price.

You may have seen in the previous chart I referenced, one of the benefits of this critical, mission-critical service we have is the fact that this is a very small percent of the product cost for the customers. It's less than 5% of the cost. We get 3.5%-5%. Typically, you've got Nelson on the lower end of that range, Sterigenics in the middle of that range, and Nordion on the higher end of that range. When you add that all up, you have a business that grows organically high single digits year in, year out. If you look at our history here, we've been able to expand margins on a consistent basis. There's three opportunities that really help us drive that. It's the operating leverage within the business model and how it plays out.

It's our operational excellence, all the work we're doing with Kaizen and other opportunities to really run more simplified operations. Lastly, the price that I just referenced on the left side of the chart. This delivers high single digits. As I mentioned just moments ago also, we're talking about 50%+ adjusted EBITDA margins. Talk about the financials and a little overview on how the numbers come together in our long-term value creation. If you look at our revenue over the last several years, starting back in 2019, some of you may not be as familiar with the company. We went public in November of 2020. In 2019, we were $778 million of revenue. Through September 30 th 2022, we were at $993 million. You can see consistent revenue growth.

Again, as I mentioned earlier, we have relationships and long-term contracts with the largest global medical device and pharma companies. Our top 25 customers, they have an average tenure of over 10 years with us, and they use multiple facilities of ours around the world because really what's important for them is to have access to our quality systems and the reliable service that we're able to give them, and they're able to rely upon us anywhere in the world. 90%+ of our sterilization sales, or $660 million+, is tied to multiyear contracts. Not only do we have 3.5%-5% price a year, we also have multiyear contracts, typically three to five years in duration.

Over $660 million of our approximately $1 billion in revenue is tied to multiyear contracts. On the adjusted EBITDA, the right-hand side of the chart, you know, we have really differentiated service capabilities that allow us to continue to perform in these highly regulated industries. You see in 2019, we had 48% margin, and through September 30th, we had 50.5% adjusted EBITDA margins. As I mentioned earlier, we get operating leverage, we get price that falls through in operational excellence, but the business continues to perform in margin expansion. I didn't touch upon it on the left-hand side of the chart, but on the price side, you know, we have a pretty good model in being able to offset inflation with the way our contracts are built.

Our business, when you reflect on the past year, when you saw this rapid inflation, we really see inflation in a couple key areas. One would be on wages, that like most companies had wages. The second one would be on our utility spend in some of our facilities. Then the third place would be on construction costs as we continue to expand capacity. Those are the three areas, but we feel very confident in our ability to offset that pricing. There might be a little bit of timing delay between when a contract's coming up for renewal and some of the realized inflation. Overall, we have a pretty strong, solid record of being able to continue to deliver price year in, year out to offset inflation. On capital expenditures, tell you a little bit of this business.

If you look at our three businesses, all three businesses take capital to continue to invest for growth. Over 60% of our CapEx last year was directed towards growth investments. If you look at, you know, 2020 was a little bit slower on investment because of the pandemic and some of the delays that were built within that. If you look at 2022, we've got a pretty healthy record of $152 million of investment in CapEx, and that's really directed towards cobalt development projects with the Nordion team in conjunction with utilities. Significant facility expansions within the Sterigenics business, where we had three capacity expansions go live in 2022. We'll continue those investments in 2023.

We're making significant investments in our ethylene oxide emission controls, and Nelson Labs continues to perform very, very well in the extractables and leachables space. We continue to make investments in that side of the business as well. On the right-hand side, you can see our net leverage reduction. Prior to going public in September of 2020, we had 7.2 times leverage. We've worked our way down as we committed. We've communicated we would be in the two to four times net leverage area as a long-range target. Through September 30th, we are at 9/30/2022. We are at 3.3, I'm sorry, on September 30th of 2022. We're committed to that long-range target. One of the things I do wanna address, I mentioned earlier today, we put out a press release.

One of the things that we've been dealing with as a company is a litigation around ethylene oxide, particularly in Illinois. We reached a global settlement today on resolving approximately 870 claims in Illinois. To date, we had one unfavorable verdict, and we had one favorable verdict. We chose as a company to reach a settlement on this, and it's a global settlement for all the cases, including the ones that we had a runaway verdict on of $360 million. In total, the company has agreed to pay $408 million to resolve all 870+ claimants in Illinois. The settlement agreements are gonna have conditions that have to be met, including opt-in and consent of substantially all the claimants in Illinois.

The plaintiff firms have agreed to a 98.6% participation rate across all the co-complaints. The one thing I wanna make sure is very clear to everybody is all these facilities continue across the Sterigenics platform to operate and compliant in a safe and reliable manner. Okay. There's no mission of liability here. We felt it was the right thing to do to get this litigation behind us because we've been subject to biased media coverage in Chicago market for several years that was not helping the company. We would've been required to put up a $550 million bond to challenge one verdict in the Kamuda trial. It's a lot of money. We had the money to do that, but it's a lot of capital.

Lastly, the number of cases that were still left out there was a lot of capital for us to deploy. We just felt that this was the right decision for all stakeholders, so we could turn the page and continue to move it forward. It's a $408 million settlement for all the cases in Illinois. It helps us avoid the ongoing defense and appellate costs. We will take a charge to 2022 earnings. It'll be going below the line. We do believe this is a tax-deductible action. As I referenced just a moment ago on this chart, we will go ahead and take on some incremental debt in the first half of 2023 to help cover the costs associated with this.

We do have smaller levels of litigation ongoing in Georgia and New Mexico. These are not impacted by this. The majority of our cases we're seeing in Illinois, and that's why we chose to settle this and get this behind us. Kinda wrapping up here about the company, this is a phenomenal company. When you look at... I'm gonna drain this slide a little longer than I typically do because some of you, I don't recognize a lot of the faces in the room, and I wanna make sure people understand how great this company is. It's got a strong financial profile. We've had revenue growth every single year since 2005, greater than 50%+ EBITDA margins. We have excellent visibility in the majority of this company. Significant barriers to entry.

As I mentioned earlier, you can't just walk in, go down the street and say, "Hey, I'm gonna buy a couple containers. I'm gonna get a couple wagons, and I'm gonna start shipping cobalt around the world." Okay? That's not how this works. That is really core competency of that business, as well as all the regulatory requirements and the testing and sterilization side of the business across Nelson Labs and Sterigenics. Significant barriers to entry. We have a large and growing addressable market, a $33 billion TAM. Strong industry dynamics where, you know, our customers rely on us and all the things we do in these essential and highly regulated industries. We're a trusted partner for the 65 facilities we have around the world. One of the other things I didn't talk a lot about is our expert advisory services.

You know, if you haven't had a chance, you ought to go out and look at Sotera Health Academy on the website. There's a lot of customer engagement in that area, where they come to us to help them get through regulatory problems or challenges with different agencies. That's really a strength that helps lead to downstream testing or sterilization services for the company. We have strong operational excellence across the teams in helping expand margins. We've done many acquisitions, two transformational deals with Nelson Labs in 16, Nordion in 14, and we've done nine bolt-on acquisitions. We see lots of opportunity for inorganic growth in addition to the high single-digit organic growth that I referenced earlier. We have an experienced management team. Those are all the prepared remarks I have. Casey, I'm happy to take time and answer any questions.

Casey Woodring
VP of Equity Research, JPMorgan

Great. Thank you. That was a great overview.

Michael Petras
Chairman and CEO, Sotera Health

Maybe I'll sit down. I had knee surgery. My body parts at 50 are all wearing out I'm realizing. The warranty goes. I'll take a minute and sit.

Casey Woodring
VP of Equity Research, JPMorgan

Yeah. Go for it.

Michael Petras
Chairman and CEO, Sotera Health

Yeah, Casey. Go ahead.

Casey Woodring
VP of Equity Research, JPMorgan

Now we'll start the Q&A session. If anybody has a question, please feel free to raise your hand, and we have a mic runner in the room, to take your question. If anybody's listening on the webcast, please feel free to submit a question via the conference portal. Michael, yeah, just to get started here, a few on the recent announcement. Can you just explain the settlement in a little more detail? Is this a final settlement, or is it a proposal? Can you just walk us through what the next steps are for a full resolution and the timelines behind them?

Michael Petras
Chairman and CEO, Sotera Health

Yeah. We signed a binding term sheet with the plaintiff executive committee. There's 873 cases. What we'll do is they now will go out. We're gonna first go to the courts today or tomorrow morning, probably more likely tomorrow morning based on the East Coast time or Central Time. The courts will go stay on all the existing litigation in Illinois. The plaintiff's firm will appoint a claims administrator, and the claims administrator will take about 90 days to go ahead and evaluate all the cases and assign a value to them for each of the plaintiffs. The plaintiffs have approximately 30 days after getting that value to opt in or opt out. Once all those are accumulated, they come back to us for final 15 days to review that.

We have to fund a settlement fund by May first, which we're prepared to do, to deliver $408 million. They have a small ability, as I referenced earlier, to opt out some of the plaintiffs, approximately 12. It's about 98.6% of the plaintiffs have to opt in. If they don't, we can walk back from that.

Casey Woodring
VP of Equity Research, JPMorgan

Have you done any sort of analysis to see what percentage of plaintiffs would opt in or opt out? How confident are you that this is a final resolution, and is that 98.6% number achievable?

Michael Petras
Chairman and CEO, Sotera Health

Yeah. We feel pretty confident based on the representations from the plaintiff firms representing the plaintiffs.

Casey Woodring
VP of Equity Research, JPMorgan

You know, you mentioned that you can elect to not proceed with the settlement if any of the plaintiffs who opt out meet certain criteria. What is that criteria? Is there any risk there?

Michael Petras
Chairman and CEO, Sotera Health

Yeah. We'll have a more detailed filing in the 8-K tomorrow morning on this, but because it just happened after the deadlines tonight. Basically, there's a couple paths that we could walk away if we felt, and they would be if 12 people opt out. Also, we had some conditions, you know, certain kinds of cancers of close proximity to the facility that if someone was a half a mile away, and they chose to opt out, we have an ability to walk away from this as well. In addition to that, if the claims administrator finds that 40 of the plaintiffs do not have legitimate claims, that gives us an opportunity to reevaluate as well. Also, if the courts do not approve the settlement. Again, we feel confident that this will get resolved based on the representations from the plaintiff firms.

Casey Woodring
VP of Equity Research, JPMorgan

I'll just pause here for any audience questions. I think we got a mic coming to you. Thanks.

Speaker 3

Michael, you just talked about New Mexico and Georgia, and you were comfortable with where they stood, but why would there not be more sort of similar, even if lesser settlements in those states?

Michael Petras
Chairman and CEO, Sotera Health

Yeah. Each of these jurisdictions are a little bit different. I mean, I look at Illinois, when you factor in the media coverage and the politicized nature of that, you factor in the Illinois court system and some of the requirements there, about causation, expert defense that you're able to put on, it's a different standard. Particularly in Georgia, there's a very different standard. I would tell you another point around besides, you know, causation requirements to experts. The last thing I would also tell you in Georgia is there's a cap on punitive damages there as well. It's just the different jurisdictions. Many of us know the Illinois system is a little challenging, and we feel pretty good about where we're sitting in Georgia. There's about 300 cases approximately there, but again, there's some significant differences in that, the standards required there.

Casey Woodring
VP of Equity Research, JPMorgan

Does this settlement prevent future plaintiffs from bringing lawsuits against Sotera in Illinois, or would this completely resolve the Willowbrook?

Michael Petras
Chairman and CEO, Sotera Health

No. If somebody's newly diagnosed today, they could bring new claims, yes.

Speaker 4

Hi. I have a follow-up question on that. Could you talk about the possibility or likelihood of future plaintiffs from other states besides Georgia and Illinois?

Michael Petras
Chairman and CEO, Sotera Health

Yeah. Again, One thing to keep in mind, all these facilities are operating in a safe and compliant manner. All right? We've got litigation in Georgia, a very different kind of nature, as I've just mentioned. We're gonna continue to operate these facilities in a safe and compliant manner. This is a broader industry. We're looking forward to the new requirements coming out in 2023. The government has informed us that we'll see new standards in 2023, so we're hopeful for that. It'll also help reinforce the compliance and the improvements we've been putting in these facilities. I'm sorry. I don't know if you have another... It's hard to see you back there with the light, but did I... Okay. I didn't know if you had another question. I'm sorry.

Casey Woodring
VP of Equity Research, JPMorgan

Any other questions from the audience about this one?

Speaker 5

Yeah. Thanks. Just to help you get off the subject of litigation maybe. On your strategy, at the end of your introduction there, you mentioned, I think, some of the sort of regulatory services you have within your Nelson Labs, I think it was you said, I guess, on things like quality, compliance, these sort of areas. Is that a focus of your strategy going forward to grow that, or is that just a sort of peripheral-

Michael Petras
Chairman and CEO, Sotera Health

Oh, no.

Speaker 5

service offering?

Michael Petras
Chairman and CEO, Sotera Health

Thank you for the question. We have our expert advisory services. We also made an acquisition of RCA, Regulatory Compliance Associates. This is an area that is very important to us. We've put the resources across the company together at Sterigenics and Nelson to go service that market, and we can help with many different facets of our services in helping customers get through regulatory requirements and also helping them with some of their facilities and some of their processes. Yes, this is an area that's been growing for us, and we see that continuing in the future.

Casey Woodring
VP of Equity Research, JPMorgan

Looks like we have another question from back there.

Speaker 6

Two questions. One, can you just confirm that the first case, the $360 million, that is a part of the $400 million? The second question is, how many lawyers did you solicit feedback from, and how many cases do those lawyers represent?

Michael Petras
Chairman and CEO, Sotera Health

Yes, the answer to your first question is the Kamuda verdict of approximately $360 million is part of the $408 million settlement. The second question you asked was about the plaintiffs. There's a plaintiff executive committee or executive council that represents the vast majority, I think it's 85%-90%, approximately the case of the plaintiffs that were representing the negotiation, because there were so many lawyers involved that they picked and put a committee together to represent in the negotiation.

Speaker 6

Got it. Does that assume that the full $360 million is paid, meaning that the residual plaintiffs get around $50,000 on average?

Michael Petras
Chairman and CEO, Sotera Health

You know, we're not getting into the details of what plaintiffs are getting what amount. That's something ultimately that'll be agreed to by the plaintiff firms with their plaintiffs in the complaints. I would assume that, you know, that large verdict had an outsized number, if you will, relative to others. One thing I wanna make sure is clear, though, that everybody understands, because of the fact we reached a settlement, I wanna make sure we understand there's no evidence that these facilities cause cancer. There's no science that supports the belief that these facilities cause cancer. That was very apparent in the trial of Ms. Fornek as well.

Casey Woodring
VP of Equity Research, JPMorgan

I guess just talking about the liquidity options, that you talked about earlier, considering moving above the two to 4x leverage range, is there a maximum leverage ratio in any of your covenants, or is there anything you've committed to that would prohibit additional debt capacity here?

Michael Petras
Chairman and CEO, Sotera Health

Yeah.

Casey Woodring
VP of Equity Research, JPMorgan

Potentially.

Michael Petras
Chairman and CEO, Sotera Health

We're not concerned about running any of our debt covenants. We feel that we'll be slightly above the four times longer range target, the two to four times longer range target, but we're comfortable within that. As you also saw, this business operated in the high sevens before when we were a private company, 7.2 just prior to the IPO, but we don't anticipate going anywhere near that. It'll be more in the two to four times, slightly above that in the short term. We don't see an impact to covenants.

Casey Woodring
VP of Equity Research, JPMorgan

Got it. Maybe we can touch on the base business here, moving away from the litigation. Just the reiteration of your 2022 guide. Just kind of curious if anything has changed in terms of your assumptions for FX or inflation that you talked about last quarter.

Michael Petras
Chairman and CEO, Sotera Health

No. We, you know, as we mentioned on the call, we saw inflation kinda settle in, and I'd say that's pretty consistent where we sit today. We reconfirmed our guide of $995 million-$1.5 billion. You know, and we'll give more details at the end of February.

Casey Woodring
VP of Equity Research, JPMorgan

You know, part of the 3Q guide down for the year was on Nelson Labs. You'd highlighted that you had not seen a recovery in demand for certain testing services there. Can you just elaborate on what testing services specifically saw a slower recovery in that quarter? How have those tracked in 4Q, and if there's anything to call out there in terms of underlying demand within Nelson?

Michael Petras
Chairman and CEO, Sotera Health

Yeah. I won't get into specifics on fourth quarter, but one of the things that we communicated in the third quarter was we had built capacity, which is people. You know, the markets were a little challenging the first half of 2022, as many people experienced. It was important for us to bring the employees in, get them trained and really help with the service equation. What ultimately happened is we overhired a little bit. The volumes did improve as the year went on. They just didn't improve to the rate that we had hoped. We had a little bit more labor capacity than we had planned for, which suffered a little bit on the margins. Really comfortable with that decision, especially what we're seeing on the Net Promoter Score and the customer sat ratings all returning to historical levels.

We're comfortable with that decision and, we think volumes will continue to improve. You asked where the softness was. I'm sorry, that was one other point in your question. You gotta ask me, like, these single questions, not these, like, three-stage questions. On the volumes, our routine testing, was pretty consistent and stable. It was the more validation, the more complex testing on some of the new product stuff that was a little slower. That's something we'll have to continue to watch as the markets and where companies are in R&D as you move into 23.

Casey Woodring
VP of Equity Research, JPMorgan

You know, following up on what you were talking about there with overstaffing in Nelson, how has that dynamic kinda trended currently? Have you cut back on staffing at all, or have volumes kind of improved to where, you know, that increase in staffing?

Michael Petras
Chairman and CEO, Sotera Health

Yeah. I'll address fourth quarter in the beginning of, you know, on the February 28th call, what I would tell you is we're comfortable with our labor spot and our customer service metrics and our Net Promoter Scores continue to rise. And we're confident, and we have not had a cutback on employees.

Casey Woodring
VP of Equity Research, JPMorgan

Okay. I'll pause here if there's any audience questions. All right.

Michael Petras
Chairman and CEO, Sotera Health

Notice the only one asked about litigation. You're asking all the business, they only wanna talk about the litigation one.

Casey Woodring
VP of Equity Research, JPMorgan

We can ask some more litigation if you want.

Michael Petras
Chairman and CEO, Sotera Health

No, no.

Casey Woodring
VP of Equity Research, JPMorgan

you know, turning to Nordion cobalt supply, you were able to navigate through 2022 and the Russian situation without really any impact. Don't believe any of your suppliers were sanctioned this year. How should we think about 2023 supply? I think last quarter you called out some lumpiness there in Nordion for 2023, but that's not necessarily different from the historical nature of, you know, that business. Just curious to hear your thoughts there.

Michael Petras
Chairman and CEO, Sotera Health

Yeah. First of all, I gotta commend the Nordion leadership team, Riaz and that whole team, and what they did. You know, if you saw how the sausage was made and what they were doing every day to move cobalt around the world to take care of the global healthcare supply chain, it was pretty unbelievable. They did an outstanding job in 2022. You know, Russia will continue to be a geopolitical challenge. The team will continue to work to navigate through the waters of getting cobalt to the customers around the world. I feel confident in their ability to do that.

As you mentioned, lumpiness, one of the challenges for some of you that aren't as familiar with the business. Remember, these are nuclear utilities that are generating electricity, and one of the projects and part of their social license is generating cobalt for us. It's a very small portion of their business, so we're at the mercy of their shutdowns or maintenance cycles and when they're gonna harvest the cobalt. We really can't call them and say, "Hey, I need it February first. Can you shut down all the utility generation to give me these little cobalt slugs?" It doesn't work that way. You know, what's happening is we've got to work on their schedule when they're gonna do maintenance on their facilities, and that's when we harvest the cobalt.

What happens is, during the course of the year, they might have heavier loading, heavier harvesting in the first quarter. They might not do any in the second, they might not do any in the third, they might do a lot in the fourth. It creates this lumpiness because we don't hold the inventory. What comes in goes out in a very short order. We've seen lumpiness where, as I just described, some quarters you won't get cobalt, all right? We anticipate that continuing in 2023 as well.

That's just the nature of the business, we're planning for that. We communicate with our customers, we make sure, particularly Sterigenics, who has to get cobalt, because as you remember, one of the beauties of this business model, that cobalt decays at about 12% a year, okay? It's a melting ice cube. You need to replenish it. And that's one of the things that, you know, Sterigenics has to plan for as well as any other Nordion customers.

Casey Woodring
VP of Equity Research, JPMorgan

Just following up on that last point, is there a way that you can quantify what the trickle-down impact to Sterigenics would look like if there were to be a Nordion supply, you know, supply situation?

Michael Petras
Chairman and CEO, Sotera Health

Yeah. Last year, we gave broad guidance to the impact of Sterigenics revenue of 0%-3%, you know, based at the beginning of the year. I envision us probably giving a similar type of guidance. I don't know if it's gonna be 0%-3% or what it'll look like in 2023, but that is all inclusive of both the impact of Nordion and Sterigenics. Last year, just in the magnitude, it was 0%-3%. As the year went on, we continued to get Russia cobalt, that number got smaller and smaller.

Casey Woodring
VP of Equity Research, JPMorgan

Got it. That's helpful. Any questions from the audience? All right, we can keep going here. Just maybe staying on Sterigenics. You know, 57% outsourcing penetration in across all the modalities there. How much runway do you see for penetration rates to grow, in Sterigenics-

Michael Petras
Chairman and CEO, Sotera Health

You know.

Casey Woodring
VP of Equity Research, JPMorgan

-modalities?

Michael Petras
Chairman and CEO, Sotera Health

What you're referencing is about 57% of the business is outsourced, 43% is insourced. That means the med device or pharma companies may be doing in-house sterilization. I think that, you know, that's. It doesn't move 10 points in a year or anything like that. It moves a couple points over the last several years. We think that there's a good probability that'll continue to shift over time, especially as more regulations come in and make it more challenging. People wanna focus on their core business. We are not seeing in-house. In very rare instances, we're seeing in-house med device companies shut down their sterilization and say, "Hey, I wanna move it all to you guys." I have. I've been here since 2016, I've seen that a couple times.

What's more likely is when the customer needs additional capacity, they're gonna say, "Hey, we're not gonna put it in ourselves, is we're growing with new products and new opportunities. We'll give it to you guys as an opportunity 'cause you have the capacity and the facilities to do this, and it's your core business." I think it'll continue over time.

Casey Woodring
VP of Equity Research, JPMorgan

You know, for Sterigenics, you've talked about capacity expansion plans. They're not necessarily a reaction to immediate near-term demand, but more planning for the long-term trajectory of that business. What gives you confidence that the demand will be there for the new capacity you're building? Yeah, just any color around new capacity expansion projects for next year.

Michael Petras
Chairman and CEO, Sotera Health

Yeah. As a general guide, we try to get about 40% commitment of that facility's capacity before we put a shovel in the ground. One of the things that we've seen as capacity gets tighter and tighter, we have something called take-or-pay. The customers are actually paying us for this capacity, even if they don't use it, because they want the surety of supply in our capability. Those things are all helpful to us as we make these capital decisions. We've had great returns. We target 15%-20% IRR in these investments, and we've been very successful with that.

Casey Woodring
VP of Equity Research, JPMorgan

One that just came in over email. It's sort of a follow-up to one of the audience questions. Just around California EO facilities.

Michael Petras
Chairman and CEO, Sotera Health

Mm-hmm.

Casey Woodring
VP of Equity Research, JPMorgan

There's been several investigations into a couple of your facilities out there. just to confirm, there aren't any pending lawsuits in California?

Michael Petras
Chairman and CEO, Sotera Health

There are none.

Casey Woodring
VP of Equity Research, JPMorgan

Can you just maybe shed some light on what those investigations were brought up for and if they've been resolved? Yeah.

Michael Petras
Chairman and CEO, Sotera Health

Yeah, yeah. California has always been very good, thorough regulators. For years and years, we've been out in the facilities. We've got multiple facilities throughout the state of California. You know, we're working with L.A. County as well as Ontario to put additional controls in which, as we've said to many of our investors over the last couple of years, we're putting additional ethylene oxide emission controls in. What we agreed to with California is they asked us to solidify exactly what that means for their facilities, what the timelines are. We've got agreements in place with the two L.A. facilities on an approved timeline by the regulators and us of when we're gonna put those improvements in, that we're progressing on very rapidly, and we're going the same direction on Ontario. Those facilities continue to operate and play a really critical role in healthcare.

Casey Woodring
VP of Equity Research, JPMorgan

Maybe shifting over to pricing for this year. You know, you talked about realizing price significantly above that 3% to 5% annual escalator in a lot of your contracts. Should we expect this to normalize in 2023? Or do you have more levers to pull on price next year?

Michael Petras
Chairman and CEO, Sotera Health

Yeah. Just to be a bit clear, I'm not sure what points you're referencing, but 3.5%-5% is our typical price. In 2022, we're through three quarters, we're running a little higher, because of our ability to push through price, you know, to reflect the inflation offsets. There's a little lag in that, but we feel confident of our ability to continue to do that in an inflationary environment and even without an inflationary environment, being able to maintain 3.5%-5%.

Casey Woodring
VP of Equity Research, JPMorgan

The long-term top-line guide is high single digits. You know, that's including M&A. Is it safe to say now, you know, assuming that the Illinois litigation will be behind you here and towards the end of the year, that you'll get back to, you know, looking at bolt-ons?

Michael Petras
Chairman and CEO, Sotera Health

We've stated that we'll grow high single digits organically with our revenue guide. I think that's 7%-8% in 2022. We feel comfortable with that. You know, we continue to look at M&A as an opportunity. We looked at several deals in 2022. For a host of reasons, they didn't come through, some of them being valuations that we just didn't feel comfortable with. We'll continue to be very inquisitive and pursue. We've got a healthy list of opportunities that we're pursuing across all three businesses.

Casey Woodring
VP of Equity Research, JPMorgan

Great. Maybe last one here. Just where do you see the most opportunity for margin expansion over the long term?

Michael Petras
Chairman and CEO, Sotera Health

You know, all three of our businesses have margin opportunity, margin expansion, you know, with the great operating leverage you have in the businesses. I will, while you're talking about margins, comment a little bit about Nelson. You know, the Nelson business got into the mid-40s in margin rate and EBITDA. That's a little hotter than normal, that was really a factor of the PPE testing that came in during COVID. That business sells in more in the 35%-40% range, is kinda where I'd see it. That's the lowest of our three businesses, but I still see opportunities for all three business to continue to perform.

Casey Woodring
VP of Equity Research, JPMorgan

Gotcha. Maybe just sneak in one more in.

Michael Petras
Chairman and CEO, Sotera Health

All right.

Casey Woodring
VP of Equity Research, JPMorgan

How much extra CapEx do you expect to spend on site improvements ahead of NESHAP? Is there any kind of runway left there or?

Michael Petras
Chairman and CEO, Sotera Health

We mentioned that we're gonna continue to invest in controls and improvements in the U.S. We've made great progress. Several facilities are completed. We will complete additional facilities in 23. We'll probably be in a point when we talk about our CapEx for 23 to give you a little bit more color on that.

Casey Woodring
VP of Equity Research, JPMorgan

Great. Well, looks like we're out of time. Thank you, everybody, for joining us. Thank you, Michael.

Michael Petras
Chairman and CEO, Sotera Health

Thanks, Casey. Good to see you, and thanks everybody for joining us today. All right. Have a great day.

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