Title of Each Class
of Securities Offered |
Maximum Aggregate
Offering Price |
Amount of
Registration Fee(1)
|
|||||||
4.200% Senior Notes due 2029
|
$ | 500,000,000 | $ | 60,600 |
Per Note
|
Total
|
||
Public offering price(1)
|
99.707%
|
$498,535,000
|
|
Underwriting discount
|
0.65%
|
$3,250,000
|
|
Proceeds, before expenses, to us
|
99.057%
|
$495,285,000
|
Goldman Sachs & Co. LLC
|
Mizuho Securities
|
Morgan Stanley
|
J.P. Morgan |
Wells Fargo Securities |
Credit Agricole CIB
|
MUFG
|
|
Fifth Third Securities |
PNC Capital Markets LLC
|
Prospectus Supplement
|
|
S-1
|
|
S-7
|
|
S-8
|
|
S-11
|
|
S-12
|
|
S-13
|
|
S-32
|
|
S-36
|
|
S-40
|
|
S-40
|
|
S-40
|
|
Prospectus
|
|
ii
|
|
1
|
|
1
|
|
2 |
|
5 |
|
6 |
|
7 |
|
8 |
|
9 |
|
10
|
|
10
|
This summary highlights selected information appearing elsewhere in this prospectus supplement
and may not contain all of the information that is important to you. You should carefully read this prospectus supplement and the accompanying prospectus in their entirety, including the documents incorporated by reference.
Our Company
Quest Diagnostics empowers people to take action to improve health outcomes. We use our extensive database of
clinical lab results to derive diagnostic insights that reveal new avenues to identify and treat disease, inspire healthy behaviors and improve healthcare management. Our diagnostic information services business (“DIS”) provides
information and insights based on the industry-leading menu of routine, non-routine and advanced clinical testing and anatomic pathology testing, and other diagnostic information services. We provide services to a broad range of
customers, including patients, clinicians, hospitals, independent delivery networks, health plans, employers and accountable care organizations. We offer the broadest access in the United States to diagnostic information services through
our nationwide network of laboratories, patient service centers and phlebotomists in physician offices and our connectivity resources, including call centers and mobile paramedics, nurses and other health and wellness professionals. We
are the world’s leading provider of diagnostic information services. We provide interpretive consultation with one of the largest medical and scientific staffs in the industry. Our DIS business makes up approximately 95% of our
consolidated net revenues.
In our Diagnostic Solutions (“DS”) businesses, which represents the balance of our consolidated net revenues, we
offer a variety of solutions for life insurers and healthcare organizations and clinicians. We are the leading provider of risk assessment services for the life insurance industry. In addition, we offer healthcare organizations and
clinicians robust information technology solutions. Prior to the sale of our Focus Diagnostics products business on May 13, 2016, our diagnostics products business manufactured and marketed diagnostic products.
During 2018, we generated net revenues of $7.5 billion and processed approximately 168 million test requisitions
through our extensive laboratory network.
Our principal executive offices are located at 500 Plaza Drive, Secaucus, New Jersey 07094, telephone number:
(973) 520-2700.
|
|
|
|
|
|
|
The Offering
The following is a brief summary of some of the terms of this offering. For a more complete description of
the terms of the notes, see “Description of Notes” in this prospectus supplement and “Description of Senior Debt Securities” in the accompanying prospectus.
|
|
||
|
|
|
|
|
|
Issuer
|
Quest Diagnostics Incorporated.
|
|
|
|
|
|
|
|
|
Notes Offered
|
$500,000,000 aggregate principal amount of 4.200% senior notes due 2029.
|
|
|
|
|
|
|
|
|
Maturity
|
June 30, 2029.
|
|
|
|
|
|
|
|
|
Interest Payment Dates
|
June 30 and December 30, beginning June 30, 2019.
|
|
|
|
|
|
|
|
Ranking |
The notes will be senior unsecured obligations of Quest Diagnostics and will rank equally with Quest Diagnostics’ other existing and future senior
unsecured obligations. The notes will be effectively subordinated to any existing and future secured obligations of Quest Diagnostics as to the assets securing such obligations.
The notes will be structurally subordinated to any existing and future indebtedness and other obligations of Quest Diagnostics’
subsidiaries. Quest Diagnostics’ subsidiaries are not guarantors of the notes; however, under the terms of the indenture governing the notes, certain of Quest Diagnostics’ domestic subsidiaries may be required to become subsidiary guarantors
in the future if they incur any Indebtedness (as defined in the indenture governing the notes), subject to exceptions set forth in the indenture governing the notes, or guarantee any Indebtedness of Quest Diagnostics when the amount of such
Indebtedness, together with any other outstanding Indebtedness of Quest Diagnostics guaranteed by Quest Diagnostics’ subsidiaries that do not guarantee the notes, exceeds $50 million in the aggregate at any time. See “Description of
Notes—Future Subsidiary Guarantors.”
As of December 31, 2018, after giving effect to this offering and the anticipated use of the net proceeds therefrom (as if all of the
foregoing had occurred on that date):
|
|||
● |
Quest Diagnostics would have had debt outstanding of $3,930 million, of which $37 million is secured; and
|
|||
● |
our subsidiaries would have had debt outstanding of $34 million, all of which was secured.
|
|||
For more information, see “Description of Notes,” “Use of Proceeds” and “Capitalization.”
|
||||
Optional Redemption
|
Prior to March 30, 2029 (three months prior to their maturity date, the “par call date”), we may redeem the notes, as a whole at any time or in part
from time to time, at our option, at a redemption price equal to the greater of:
|
|||
● |
100% of the principal amount of the notes to be redeemed, and
|
|||
● |
the sum of the present values of the Remaining Scheduled Payments (as defined in this prospectus supplement) discounted, on a semiannual basis, assuming
a 360-day year consisting of twelve 30-day months, at the Treasury Rate (as defined in this prospectus supplement) plus 25 basis points,
|
|||
plus accrued interest to, but excluding, the date of redemption, which has not been paid. | ||||
On or after the par call date, we may redeem the notes, as a whole at any time or in part from time to time, at our option, at a redemption price equal
to 100% of the principal amount of the notes being redeemed plus accrued interest to, but excluding, the date of redemption, which has not been paid.
For a more detailed description, see “Description of Notes—Optional Redemption.”
|
||||
Repurchase Upon a Change of Control
|
Upon the occurrence of a Change of Control Triggering Event (as defined in this prospectus supplement), we will be required to make an offer to purchase
the notes at a price equal to 101% of their principal amount plus accrued and unpaid interest to, but excluding, the date of repurchase. See “Description of Notes—Change of Control.”
|
|||
Covenants
|
The indenture governing the notes will contain covenants that, among other things, will limit our ability and/or the ability of our restricted
subsidiaries to:
|
|||
● |
create certain liens;
|
|||
● |
enter into certain sale and leaseback transactions;
|
|||
● |
consolidate, merge or transfer all or substantially all of our assets; and
|
|||
● |
incur indebtedness of non-guarantor subsidiaries.
|
|||
These covenants are subject to important exceptions and qualifications, which are described in this prospectus supplement. For a more detailed
description, see “Description of Notes.”
|
||||
Use of Proceeds
|
We estimate that the net proceeds from this offering of notes after deducting underwriting discounts but before deducting other expenses of the offering
will be approximately $495,285,000. We intend to use the net proceeds to repay outstanding indebtedness, which includes the $300 million aggregate principal amount of our senior notes due April 2019, and indebtedness under our secured
receivables credit facility, and for general corporate purposes. See “Use of Proceeds.”
|
|||
Conflicts of Interest
|
One or more of the underwriters or their affiliates may receive 5% or more of the net proceeds of this offering by
reason of the repayment of amounts due under our secured receivables credit facility. Accordingly, such underwriters will be deemed to have a “conflict of interest” within the meaning of Rule 5121 of the Financial Industry Regulatory Authority,
and this offering will be conducted in accordance with Rule 5121. See “Underwriting (Conflicts of Interest)—Conflicts of Interest.”
|
|||
Risk Factors
|
See “Risk Factors” and the other information in this prospectus supplement and in our Annual Report on Form 10-K for the fiscal year ended December 31,
2018, which is incorporated by reference into this prospectus supplement, for a discussion of factors you should carefully consider before deciding to invest in the notes.
|
|||
Governing Law
|
The indenture and the notes will be governed by, and construed in accordance with, the laws of the State of New York without application of principles
of conflicts of law thereunder.
|
|||
Trustee
|
The Bank of New York Mellon.
|
|||
Summary Financial Data
The following table presents summary historical financial data at the dates and for each of the periods presented. We
derived the summary historical operations and other data for the years ended December 31, 2018, 2017 and 2016 and the summary historical balance sheet data at December 31, 2018 and 2017 from our audited consolidated financial statements
incorporated by reference herein. We derived the summary historical balance sheet data at December 31, 2016 from our audited consolidated financial statements not incorporated by reference herein.
You should not take historical results as necessarily indicative of the results that may be expected for any
future period. The summary historical financial data presented below is only a summary and should be read together with our audited consolidated financial statements and related notes and management’s discussion and analysis of financial
condition and results of operations included in our Annual Report on Form 10-K for the year ended December 31, 2018, which is incorporated by reference into this prospectus supplement.
|
|||
Year Ended December 31,
|
||||||||||||||
2018
|
2017
|
2016
|
||||||||||||
(dollars in millions)
|
||||||||||||||
Operations Data:
|
(a) (b) (c)
|
(a) (d) (e)
|
(a) (f) (g)
|
|||||||||||
Net revenues
|
$
|
7,531
|
$
|
7,402
|
$
|
7,214
|
||||||||
Operating income
|
1,101
|
1,165
|
1,277
|
|||||||||||
Net income
|
788
|
824
|
696
|
|||||||||||
Less: Net income attributable to noncontrolling interests
|
52
|
52
|
51
|
|||||||||||
Net income attributable to Quest Diagnostics
|
736
|
772
|
645
|
|||||||||||
Balance Sheet Data:
|
||||||||||||||
(at end of period):
|
||||||||||||||
Cash and cash equivalents
|
$
|
135
|
$
|
137
|
$
|
359
|
||||||||
Total assets
|
11,003
|
10,503
|
10,100
|
|||||||||||
Long-term debt
|
3,429
|
3,748
|
3,728
|
|||||||||||
Total debt
|
3,893
|
3,784
|
3,734
|
|||||||||||
Redeemable noncontrolling interest
|
77
|
80
|
77
|
|||||||||||
Other Data:
|
||||||||||||||
Net cash provided by operating activities
|
$
|
1,200
|
$
|
1,175
|
$
|
1,116
|
||||||||
Net cash used in investing activities
|
(801
|
)
|
(830
|
)
|
(127
|
)
|
||||||||
Net cash (used in) provided by financing activities
|
(401
|
)
|
(592
|
)
|
(738
|
)
|
||||||||
Capital expenditures
|
383
|
252
|
293
|
|||||||||||
Purchases of treasury stock
|
322
|
465
|
590
|
|||||||||||
Dividends paid
|
266
|
247
|
223
|
(a) |
Net revenues for the years ended December 31, 2017 and 2016 have been restated to reflect the impact of new revenue recognition rules that became
effective January 1, 2018 and were adopted on a retrospective basis; Cash flow data for the years ended December 31, 2017 and 2016 have been restated to reflect the impact of the adoption of two new accounting standards that clarify
presentation and classification in the statement of cash flows on a retrospective basis. See Note 2 to the consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2018, for further details
on the adoption of new accounting standards.
|
||||
(b) |
On February 1, 2018, we completed the acquisition of Mobile Medical Examination Services, LLC. (“MedXM”). On June 18, 2018, we completed the acquisition
of the outreach laboratory service business of Cape Cod Healthcare, Inc. On September 19, 2018, we completed the acquisition of ReproSource, Inc. (“ReproSource”). On November 6, 2018, we completed the acquisition of the U.S. laboratory
service business of Oxford Immunotec, Inc. (“Oxford”). Consolidated operating results for 2018 include the results of operations of MedXM, the outreach laboratory service business of Cape Cod Healthcare, Inc., ReproSource and Oxford subsequent
to the closing of the applicable acquisition. For further details regarding our acquisitions, see Note 6 to the consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2018.
|
||||
(c) |
Operating income included (for 2018):
|
||||
● |
pre-tax charges of $122 million, primarily associated with workforce reductions, systems conversions and integration incurred in connection with further
restructuring and integrating our business; and
|
||||
● |
pre-tax charges of $2 million, primarily associated with costs incurred related to certain legal matters and a loss on the sale of a foreign subsidiary
partially offset by a gain associated with the decrease in the fair value of the contingent consideration accrual associated with our MedXM acquisition and an insurance claim for hurricane related losses.
|
||||
In addition to the items included in operating income, income from continuing operations included:
|
|||||
● |
excess tax benefits associated with stock-based compensation arrangements of $18 million; and
|
||||
● |
income tax benefit of $14 million primarily associated with a change in a tax return accounting method that enabled our Company to accelerate the
deduction of certain expenses on its 2017 tax return at the federal corporate statutory tax rate in effect during 2017 partially offset by an income tax expense associated with finalizing the impact of the enactment of the Tax Cuts and Jobs Act
(“TCJA”).
|
||||
Pursuant to the TCJA, among other changes to U.S. corporate income tax laws, the federal corporate statutory income tax rate was reduced from 35% to 21%
effective for 2018.
|
|||||
(d) |
On May 1, 2017, we completed the acquisition of the outreach laboratory service business of PeaceHealth Laboratories (“PHL”). On July 14, 2017, we
completed the acquisition of Med Fusion, LLC and Clearpoint Diagnostic Laboratories, LLC (“Med Fusion”). On September 28, 2017, we completed the acquisition of the outreach laboratory service businesses of two hospitals of Hartford HealthCare
Corporation (“HHC”), The William W. Backus Hospital and The Hospital of Central Connecticut. On December 1, 2017, we completed the acquisition of Cleveland HeartLab, Inc. (“CHL”). On December 7, 2017, we completed the acquisition of certain
assets of the clinical and anatomic pathology laboratory business of Shiel Holdings, LLC (“Shiel”). Consolidated operating results for 2017 include the results of operations of PHL, Med Fusion, HHC, CHL and Shiel subsequent to the closing of
the applicable acquisition. For further details regarding our acquisitions, see Note 6 to the consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2018.
|
||||
(e) |
Operating income included (for 2017):
|
||||
● |
pre-tax charges of $105 million, primarily associated with systems conversions, integration and workforce reductions incurred in connection with further
restructuring and integrating our business; and
|
||||
● |
pre-tax charges of $12 million, primarily a result of non-cash asset impairment charges and incremental costs incurred as a result of hurricanes and
costs incurred related to certain legal matters.
|
||||
In addition to the items included in operating income, income from continuing operations included:
|
|||||
● |
a net pre-tax gain of $2 million, primarily a result of a gain on the sale of an interest in an equity method investment partially offset by non-cash
asset impairment charges associated with an investment;
|
||||
● |
$1 million of pre-tax restructuring and integration charges associated with our Q2 Solutions joint venture;
|
||||
● |
a provisional estimated income tax benefit of $106 million associated with the TCJA, including a deferred income tax benefit of $115 million primarily
due to the remeasurement of our net deferred tax liabilities and reserves at the new combined federal and state tax rate, partially offset by $9 million of current tax expense primarily due to the mandatory repatriation toll charge on
undistributed foreign earnings and profits;
|
||||
● |
excess tax benefits associated with stock-based compensation arrangements of $37 million; and
|
||||
● | income tax expense of $3 million primarily a result of recording a valuation allowance against certain net operating loss carryforwards in a geography impacted by hurricanes. | ||||
Net cash provided by operating activities benefited from a decrease in tax payments associated with the realization of a $62 million deferred tax
benefit.
|
|||||
(f) |
On February 29, 2016, we completed the acquisition of the outreach laboratory service business of Clinical Laboratory Partners, LLC (“CLP”), a
wholly-owned subsidiary of HHC. Consolidated operating results for 2016 include the results of operations of CLP subsequent to the closing of the acquisition. On May 13, 2016, we completed the sale of our Focus Diagnostics products business
(“Focus Sale”). Our Focus Diagnostics products business has not been classified as a discontinued operation. For further details regarding dispositions, see Note 7 to the consolidated financial statements included in our Annual Report on Form
10-K for the year ended December 31, 2018.
|
||||
(g) |
Operating income included (for 2016):
|
||||
● |
a pre-tax gain of $118 million associated with the Focus Sale;
|
||||
● |
pre-tax charges of $78 million, primarily associated with systems conversions and integration incurred in connection with further restructuring and
integrating our business; and
|
||||
● |
a net pre-tax gain of $7 million, primarily a result of a non-taxable gain on an escrow recovery associated with an acquisition, partially offset by
costs associated with winding down subsidiaries, non-cash asset impairment charges and costs incurred related to certain legal matters.
|
||||
In addition to the items included in operating income, income from continuing operations included:
|
|||||
● |
income tax expense of $84 million associated with the Focus Sale, consisting of $91 million of current income tax expense and a deferred income tax
benefit of $7 million;
|
||||
● |
$48 million of pre-tax charges on the retirement of debt associated with the March 2016 cash tender offer and the related income tax benefit of $18
million;
|
||||
● |
non-cash asset impairment charges of $7 million associated with certain investments;
|
||||
● |
$4 million of pre-tax restructuring and integration charges associated with our Q2 Solutions joint venture; and
|
||||
● |
excess tax benefits associated with stock-based compensation arrangements of $9 million.
|
||||
Net cash provided by operating activities included:
|
|||||
● |
a $17 million cash tax benefit on the retirement of debt associated with the March 2016 cash tender offer;
|
||||
● |
$54 million of proceeds received from the termination of interest rate swap agreements; and
|
||||
● |
$91 million of income taxes paid in connection with the Focus Sale.
|
||||
Net cash used in investing activities included proceeds from the sale of businesses of $295 million, principally related to the Focus Sale.
Net cash used in financing activities included $43 million of pre-tax cash charges on the retirement of debt associated with the March 2016
cash tender offer, principally comprised of premiums paid to retire the debt.
|
|||||
|
(a) |
Heightened competition from commercial clinical testing companies, hospitals, physicians and others.
|
(b) |
Increased pricing pressure from customers, including payers and patients.
|
(c) |
A decline in economic conditions.
|
(d) |
Impact of changes in payment mix, including increased patient financial responsibility and any shift from fee-for-service to discounted, capitated or bundled
fee arrangements.
|
(e) |
Adverse actions by government or other third-party payers, including healthcare reform that focuses on reducing healthcare costs but does not recognize the
value and importance to healthcare of clinical testing or innovative solutions, unilateral reduction of fee schedules payable to us, unilateral recoupment of amounts allegedly owed and competitive bidding.
|
(f) |
The impact upon our testing volume and collected revenue or general or administrative expenses resulting from compliance with policies and requirements
imposed by Medicare, Medicaid and other third-party payers. These include:
|
(1) |
the requirements of government and other payers to provide diagnosis codes and other information for many tests;
|
(2) |
inability to obtain from patients a valid advance consent form for tests that cannot be billed without prior receipt of the form;
|
(3) |
the impact of additional or expanded limited coverage policies and limits on the allowable number of test units or ordering frequency of same; and
|
(4) |
the impact of increased prior authorization programs.
|
(g) |
Adverse results from pending or future government investigations, lawsuits or private actions. These include, in particular, monetary damages, loss or
suspension of licenses, and/or suspension or exclusion from the Medicare and Medicaid programs and/or criminal penalties.
|
(h) |
Failure to efficiently integrate acquired businesses and to manage the costs related to any such integration, or to retain key technical, professional or
management personnel.
|
(i) |
Denial, suspension or revocation of Clinical Laboratory Improvement Act (“CLIA”) certification or other licenses for any of our clinical laboratories under
the CLIA standards, revocation or suspension of the right to bill the Medicare and Medicaid programs or other adverse regulatory actions by federal, state and local agencies.
|
(j) |
Changes in and complexity of federal, state or local laws or regulations, including changes that result in new or increased federal or state regulation of
commercial clinical laboratories, tests developed by commercial clinical laboratories or other products or services that we offer or activities in which we are engaged, including regulation by the U.S. Food and Drug Administration.
|
(k) |
Inability to achieve expected benefits from our acquisitions of other businesses.
|
(l) |
Inability to achieve additional benefits from our business performance tools and efficiency initiatives.
|
(m) |
Adverse publicity and news coverage about the diagnostic information services industry or us.
|
(n) |
Failure of the Company to maintain, defend and secure its financial, accounting, technology, customer data and other operational systems from cyberattacks,
information technology system outages, telecommunications failures, malicious human acts and failure of the systems of third parties upon which the Company relies.
|
(o) |
Development of technologies that substantially alter the practice of clinical testing, including technology changes that lead to the development of more
convenient or cost-effective testing, or testing to be performed outside of a commercial clinical laboratory, such as (1) point-of-care testing that can be performed by physicians in their offices, (2) advanced testing that can be
performed by hospitals in their own laboratories or (3) home testing that can be carried out without requiring the services of clinical laboratories.
|
(p) |
Negative developments regarding intellectual property and other property rights that could prevent, limit or interfere with our ability to develop, perform or
sell our tests or operate our business. These include:
|
(1)
|
Issuance of patents or other property rights to our competitors or others; and
|
(2) |
Inability to obtain or maintain adequate patent or other proprietary rights for our products and services or to successfully enforce our proprietary rights.
|
(q) |
Development of tests by our competitors or others which we may not be able to license, or usage of our technology or similar technologies or our trade secrets
or other intellectual property by competitors, any of which could negatively affect our competitive position.
|
(r) |
Regulatory delay or inability to commercialize newly developed or licensed tests or technologies or to obtain appropriate reimbursements for such tests.
|
(s) |
The complexity of billing and revenue recognition for clinical laboratory testing.
|
(t) |
Changes in interest rates and changes in our credit ratings from S&P Global, Moody’s Investor Services or Fitch Ratings causing an unfavorable impact on
our cost of and access to capital.
|
(u) |
Inability to hire or retain qualified or key senior management personnel.
|
(v) |
Terrorist and other criminal activities, hurricanes, earthquakes or other natural disasters, and health pandemics, which could affect our customers,
transportation or systems, or our facilities, and for which insurance may not adequately reimburse us.
|
(w) |
Difficulties and uncertainties in the discovery, development, regulatory environment and/or marketing of new services or solutions or new uses of existing
tests.
|
(x) |
Failure to adapt to changes in the healthcare system (including the medical laboratory testing market) and healthcare delivery, including those stemming from
the Affordable Care Act (or its repeal, amendment or replacement), Protecting Access to Medicare Act, trends in utilization of the healthcare system and increased patient financial responsibility for services.
|
(y) |
Results and consequences of governmental inquiries.
|
(z) |
Difficulty in implementing, or lack of success with, our strategic plan.
|
(aa) |
The impact of informatics on our industry and the ability of our Company to adapt to that impact.
|
(bb) |
Failure to adequately operationalize appropriate controls around use of our data, including risk of non-compliance with privacy law requirements.
|
December 31, 2018
|
||||||||
Actual
|
As Adjusted
|
|||||||
(in millions)
|
||||||||
Cash and cash equivalents
|
$
|
135
|
$
|
170
|
(a)
|
|||
Debt (including current maturities):
|
||||||||
Secured receivables credit facility (3.39%)
|
$
|
160
|
$
|
—
|
||||
Senior unsecured revolving credit facility
|
—
|
—
|
||||||
2.70% senior notes due 2019
|
300
|
—
|
||||||
4.75% senior notes due 2020
|
507
|
507
|
||||||
2.50% senior notes due 2020
|
300
|
300
|
||||||
4.70% senior notes due 2021
|
557
|
557
|
||||||
4.25% senior notes due 2024
|
299
|
299
|
||||||
3.50% senior notes due 2025
|
562
|
562
|
||||||
3.45% senior notes due 2026
|
469
|
469
|
||||||
6.95% senior notes due 2037
|
175
|
175
|
||||||
5.75% senior notes due 2040
|
244
|
244
|
||||||
4.70% senior notes due 2045
|
300
|
300
|
||||||
Senior notes offered hereby
|
—
|
499 |
(b)
|
|||||
Other
|
37
|
37
|
||||||
Debt issuance costs
|
(17
|
)
|
(20
|
)
|
||||
Total debt
|
$
|
3,893
|
$
|
3,929
|
||||
Stockholders’ equity:
|
||||||||
Quest Diagnostics stockholders’ equity
|
5,216
|
5,216
|
||||||
Noncontrolling interests
|
51
|
51
|
||||||
Total stockholders’ equity
|
5,267
|
5,267
|
||||||
Total capitalization
|
$
|
9,160
|
$
|
9,196
|
(a) |
Cash and cash equivalents, as adjusted, reflects the net proceeds from this offering of approximately $495 million, which will be used as described in the “Use
of Proceeds” section in this prospectus supplement. Cash and cash equivalents, as adjusted, also reflects net repayment of $160 million outstanding under the secured receivables credit facility and repayment of the 2.7% senior notes
due 2019.
|
(b) |
Consists of $500,000,000 of 4.200% senior notes due 2029 issued at 99.707%. The original issue discount of approximately $1 million is reflected as a
reduction to the carrying amount of the debt.
|
● |
100% of principal amount of the Notes to be redeemed, and
|
● |
the sum of the present values of the Remaining Scheduled Payments (as defined below) discounted, on a semiannual basis, assuming a 360-day year
consisting of twelve 30-day months, at the Treasury Rate (as defined below) plus 25 basis points,
|
● |
the average of four Reference Treasury Dealer Quotations for that redemption date, after excluding the highest and lowest of such Reference Treasury Dealer
Quotations; or
|
● |
if Quest Diagnostics obtains fewer than four Reference Treasury Dealer Quotations, the average of all quotations obtained by Quest Diagnostics.
|
● |
accept for payment all Notes or portions of Notes properly tendered pursuant to the Change of Control Offer;
|
● |
deposit with the paying agent an amount equal to the Change of Control Payment in respect of all Notes or portions of Notes properly tendered; and
|
● |
deliver or cause to be delivered to the trustee the Notes properly accepted together with an Officers’ Certificate stating the aggregate principal amount of
Notes or portions of Notes being repurchased.
|
● |
Liens existing on the date of the issuance of the Notes;
|
● |
Liens securing only the Notes;
|
● |
Liens in favor of only Quest Diagnostics or any Restricted Subsidiary;
|
● |
Liens on property or shares of stock or indebtedness of a Person existing at the time such Person becomes a Restricted Subsidiary or is merged into or
consolidated with, or its assets are acquired by, Quest Diagnostics or any Restricted Subsidiary (provided that such Lien was not
incurred in anticipation of such transaction and was in existence prior to such transaction) so long as such Lien does not extend to any other property and the Indebtedness so secured is not increased;
|
● |
Liens on property existing immediately prior to the acquisition thereof (provided that such Lien was not incurred in anticipation of such transaction and was in existence prior to such transaction) so long as such Lien does not extend to any other property and the Indebtedness
so secured is not increased;
|
● |
Liens to secure Indebtedness incurred for the purpose of financing all or any part of a property’s purchase price or cost of construction or additions,
repairs, alterations, or other improvements; provided that (1) the principal amount of any Indebtedness secured by such Lien does
not exceed 100% of such property’s purchase price or cost, (2) such Lien does not extend to or cover any other property other than the property so purchased, constructed or on which such additions, repairs, alterations or other
improvements were so made, and (3) such Lien is incurred prior to or within 270 days after the acquisition of such property or the completion of construction or such additions, repairs, alterations or other improvements and the full
operation of such property thereafter;
|
● |
Liens in favor of the United States or any state thereof, or any instrumentality of either, to secure certain payments pursuant to any contract or statute;
|
● |
Liens for taxes or assessments or other governmental charges or levies which are being contested in good faith and for which adequate reserves are being
maintained, to the extent required by generally accepted accounting principles;
|
● |
title exceptions, easements and other similar Liens that are not consensual and that do not materially impair the use of the property subject thereto;
|
● |
Liens to secure obligations under workmen’s compensation laws, unemployment compensation, old-age pensions and other social security benefits or similar
legislation, including Liens with respect to judgments which are not currently dischargeable;
|
● |
Liens arising out of legal proceedings, including Liens arising out of judgments or awards;
|
● |
warehousemen’s, materialmen’s and other similar Liens for sums being contested in good faith and for which adequate reserves are being maintained, to the
extent required by generally accepted accounting principles;
|
● |
Liens incurred to secure the performance of statutory obligations, surety or appeal bonds, performance or return-of-money bonds or other obligations of a like
nature incurred in the ordinary course of business; or
|
● |
Liens to secure any extension, renewal, refinancing or refunding (or successive extensions, renewals, refinancings or refundings), in whole or in part, of any
Indebtedness secured by Liens referred to in the foregoing bullets or liens created in connection with any amendment, consent or waiver relating to such Indebtedness, so long as such Lien does not extend to any other property and the
Indebtedness so secured does not exceed the fair market value (as determined by our board of directors) of the assets subject to such Liens at the time of such extension, renewal, refinancing or refunding, or such amendment, consent or
waiver, as the case may be.
|
● |
the Sale and Leaseback Transaction is solely with Quest Diagnostics or a domestic Subsidiary that has guaranteed the obligations of Quest Diagnostics pursuant
to the terms of the Indenture; or
|
● |
the lease is for a period not in excess of five years, including renewal rights; or
|
● |
Quest Diagnostics or the Restricted Subsidiary, prior to or within 270 days after the sale of such Principal Property in connection with the Sale and
Leaseback Transaction is completed, applies the net cash proceeds of the sale of the Principal Property leased to:
|
(1) |
the retirement of the Notes or debt ranking equally with the Notes of Quest Diagnostics or any Restricted Subsidiary, or
|
(2) |
the acquisition of different property, facilities or equipment or the expansion of Quest Diagnostics’ existing business, including the acquisition of other
businesses.
|
● |
the outstanding Indebtedness secured by such Liens (not including any Liens permitted under “— Limitation on Liens” which amount does not include any Liens
permitted under the provisions of this “—Exempted Liens and Sale and Leaseback Transactions”); plus
|
● |
all Attributable Debt in respect of such Sale and Leaseback Transaction entered into (not including any Sale and Leaseback Transactions permitted under
“—Limitation on Sale and Leaseback Transactions” which amount does not include any Sale and Leaseback Transactions permitted under the provisions of this “—Exempted Liens and Sale and Leaseback Transactions”),
|
● |
Indebtedness outstanding on the date of the Indenture;
|
● |
Indebtedness representing the assumption by one Subsidiary of Indebtedness of another Subsidiary;
|
● |
Indebtedness outstanding under any Receivables Credit Facility;
|
● |
Indebtedness secured by a Lien incurred for the purpose of financing all or any part of a property’s purchase price or cost of construction or additions,
repairs, alterations or other improvements, provided that such Indebtedness and Lien is incurred prior to or within 270 days after
the acquisition of such property or the completion of construction or such additions, repairs, alterations or other improvements and the full operation of such property thereafter;
|
● |
Indebtedness of any Subsidiary of Quest Diagnostics, the proceeds of which are used to renew, extend, refinance or refund outstanding Indebtedness of such
Subsidiary; provided that such Indebtedness is scheduled to mature no earlier than the Indebtedness being renewed, extended,
refinanced or refunded; provided further that such Indebtedness shall be permitted hereunder only to the extent that the aggregate
principal amount of such Indebtedness (or, if such Indebtedness is issued at a price less than the principal amount thereof, the aggregate amount of gross proceeds therefrom) does not exceed the aggregate principal amount then
outstanding under the Indebtedness being renewed, extended, refinanced or refunded (or if the Indebtedness being renewed, extended, refinanced or refunded, was issued at a price less than the principal amount thereof, then not in excess
of the amount of liability in respect thereof determined in accordance with generally accepted accounting principles) plus the lesser of (A) the stated amount of any premium or other payment required to be paid in connection with such a
refinancing pursuant to the terms of the Indebtedness being refinanced or (B) the amount of premium or other payment actually paid at such time to refinance the Indebtedness, plus, in either case, the amount of expenses of such
Subsidiary incurred in connection with such refinancing;
|
● |
Indebtedness of a Subsidiary of Quest Diagnostics to Quest Diagnostics or to another Subsidiary of Quest Diagnostics;
|
● |
any Indebtedness resulting from a Sale and Leaseback Transaction which is permitted by the “—Limitation on Sale and Leaseback Transactions” covenant (but not
including any Sale and Leaseback Transaction which is permitted by the “—Exempted Liens and Sale and Leaseback Transactions” provisions relating thereto);
|
● |
any Permitted Acquired Indebtedness;
|
● |
any guarantee of Indebtedness of Quest Diagnostics by any Subsidiary of Quest Diagnostics in anticipation of such Subsidiary guaranteeing the obligations of
Quest Diagnostics pursuant to the terms of the Indenture;
|
● |
Preferred Stock to the extent that the aggregate liquidation preference of Preferred Stock, outstanding at any one time, does not exceed 5% of Consolidated
Total Assets;
|
● |
shares of Preferred Stock held by Quest Diagnostics or a subsidiary of Quest Diagnostics; or
|
● |
any Indebtedness, including any Acquired Indebtedness that is not Permitted Acquired Indebtedness, the outstanding aggregate principal amount of which does
not at any one time exceed the greater of (1) 10% of Consolidated Total Assets or (2) $200 million, measured in each case at the time such Indebtedness is incurred.
|
● |
The merger, consolidation or sale of assets must not cause an event of default. See “—Events of Default.” An event of default for this purpose would also
include any event that would be an event of default if the notice or time requirements were disregarded;
|
● |
If Quest Diagnostics is not the surviving entity, the Person we would merge or consolidate with, or sell all or substantially all of our assets to, must be
organized under the laws of the United States or any state thereof;
|
● |
If Quest Diagnostics is not the surviving entity, the Person we would merge or consolidate with, or sell all or substantially all of our assets to, must
expressly assume by supplemental indenture all of our obligations under the Notes and the Indenture; and
|
● |
Quest Diagnostics must deliver specific certification and documents to the trustee.
|
● |
Quest Diagnostics or any domestic Subsidiary that guarantees the obligations of Quest Diagnostics pursuant to the terms of the Indenture does not pay the
principal of or any premium on the Notes on its due date;
|
● |
Quest Diagnostics or any domestic Subsidiary that guarantees the obligations of Quest Diagnostics pursuant to the terms of the Indenture does not pay interest
on the Notes within 30 days of its due date whether at maturity, upon redemption or upon acceleration;
|
● |
Quest Diagnostics or any domestic Subsidiary that guarantees the obligations of Quest Diagnostics pursuant to the terms of the Indenture remains in breach of
a covenant in respect of the Notes for 60 days after it receives a written notice of default stating it is in breach and requiring that it remedy the breach. The notice must be sent by either the trustee or holders of 25% of the
aggregate principal amount of the Notes;
|
● |
An event of default under any indenture or instrument evidencing or under which Quest Diagnostics or any domestic Subsidiary that guarantees the obligations
of Quest Diagnostics pursuant to the terms of the Indenture then has outstanding any Indebtedness shall occur and be continuing and either:
|
(1) |
such event of default results from the failure to pay the principal of such Indebtedness in excess of $200 million at final maturity of such Indebtedness,
individually or in the aggregate; or
|
(2) |
as a result of such event of default the maturity of such Indebtedness shall have been accelerated so that the same shall be or become due and payable prior
to the date on which the same would otherwise have become due and payable and the principal amount of such Indebtedness, together with the principal of any other Indebtedness of Quest Diagnostics or such Subsidiary in default, or the
maturity of which has been accelerated, aggregates at least $200 million, individually or in the aggregate;
|
● |
Any domestic Subsidiary that guarantees the obligations of Quest Diagnostics pursuant to the terms of the Indenture repudiates its obligations under its
guarantee of the Notes or, other than by reason of the termination of the Indenture or the release of any such guarantee in accordance with the Indenture, any such guarantee ceases to be in full force and effect or is declared null and
void and such condition shall have continued for a period of 30 days after written notice of such failure requiring Quest Diagnostics or such Subsidiary to remedy the same shall have been given to Quest Diagnostics by the trustee or to
Quest Diagnostics and the trustee by the holders of 25% in aggregate principal amount of the Notes then outstanding; or
|
● |
Quest Diagnostics or any domestic Subsidiary that guarantees the obligations of Quest Diagnostics pursuant to the terms of the Indenture files for bankruptcy
or certain other events of bankruptcy, insolvency or reorganization occur.
|
● |
You must give the trustee written notice that an event of default has occurred and remains uncured;
|
● |
The holders of at least 25% in principal amount of the outstanding Notes must make a written request that the trustee take action because of the default and
must offer the trustee indemnity reasonably satisfactory to it against the cost and other liabilities of taking that action;
|
● |
The trustee must not have taken action for 60 days after receipt of the above notice and offer of indemnity; and
|
● |
Holders of a majority in principal amount of the Notes must not have given the trustee a direction inconsistent with the above notice.
|
● |
We must deposit in trust for your benefit and the benefit of all other registered holders of the Notes a combination of money and U.S. government or U.S.
government agency notes or bonds that will generate enough cash to make interest, principal and any other payments on the Notes on their various due dates including, possibly, their earliest redemption date.
|
● |
In order for us to effect a full defeasance, we must deliver to the trustee a legal opinion confirming that you will not recognize income, gain or loss for
U.S. federal income tax purposes as a result of the defeasance and that you will not be taxed on the Notes any differently than if the defeasance had not occurred.
|
● |
We must deposit in trust for your benefit and the benefit of all other registered holders of the Notes a combination of money and U.S. government or U.S.
government agency notes or bonds that will generate enough cash to make interest, principal and any other payments on the Notes on their various due dates.
|
● |
We must deliver to the trustee a legal opinion confirming that under current U.S. federal income tax law you will not recognize income, gain or loss for U.S.
federal income tax purposes as a result of the covenant defeasance and that you will not be taxed on the Notes any differently than if the covenant defeasance had not occurred.
|
● |
any promises of any domestic Subsidiary that guarantees our obligations pursuant to the terms of the Indenture relating to its guarantees, the conduct of its
business and any other covenants applicable to the Notes;
|
● |
our promises regarding conduct of our business and other matters and any other covenants applicable to the Notes; and
|
● |
the definition of an event of default as a breach of such covenants.
|
● |
a limited-purpose trust company organized under the laws of the State of New York;
|
● |
a “banking organization” within the meaning of the New York State Banking Law;
|
● |
a member of the Federal Reserve System;
|
● |
a “clearing corporation” within the meaning of the New York Uniform Commercial Code, as amended; and
|
● |
a “clearing agency” registered pursuant to Section 17A of the Exchange Act.
|
● |
upon deposit of each global note, DTC will credit, on its book-entry registration and transfer system, the accounts of participants designated by the
underwriters with an interest in that global note; and
|
● |
ownership of beneficial interests in the global notes will be shown on, and the transfer of ownership interests in the global notes will be effected only
through, records maintained by DTC (with respect to the interests of participants) and by participants and indirect participants (with respect to the interests of persons other than participants).
|
● |
changing the stated maturity of the principal of or interest on the Notes;
|
● |
reducing any amounts due on the Notes or payable upon acceleration of the maturity of the security following a default;
|
● |
adversely affecting any right of repayment at the holder’s option;
|
● |
changing the place (except as otherwise described in this prospectus supplement) or currency of payment on the Notes;
|
● |
impairing your right to sue for payment or to convert or exchange Notes;
|
● |
modifying the Notes to subordinate the Notes to other indebtedness;
|
● |
reducing the percentage of holders of Notes whose consent is needed to modify or amend the Indenture;
|
● |
reducing the percentage of holders of Notes whose consent is needed to waive compliance with certain provisions of the Indenture or to waive certain defaults;
|
● |
reducing the requirements for quorum or voting with respect to the Notes;
|
● |
modifying any other aspect of the provisions of the Indenture dealing with modification and waiver except to increase the voting requirements; and
|
● |
change in any of our obligations to pay additional amounts to holders with respect to taxes imposed on such holders in certain circumstances.
|
● |
all Notes not previously delivered to the trustee for cancellation have become due and payable or will become due and payable at their stated maturity or on a
redemption date within one year;
|
● |
we deposit with the trustee, in trust, funds sufficient to pay the entire indebtedness on the Notes that had not been previously delivered for cancellation,
for the principal and interest to the date of the deposit (for Notes that have become due and payable) or to the stated maturity or the redemption date, as the case may be (for Notes that have not become due and payable);
|
● |
we have paid or caused to be paid all other sums payable under the Indenture; and
|
● |
we have delivered to the trustee an Officer’s Certificate and opinion of counsel, each stating that all these conditions have been complied with.
|
● |
an individual who is a citizen or resident of the United States;
|
● |
a corporation (or other entity taxable as a corporation) created or organized in or under the laws of the United States, any state thereof or the District of
Columbia;
|
● |
an estate, the income of which is subject to U.S. federal income tax regardless of its source; or
|
● |
a trust, if a U.S. court can exercise primary supervision over the administration of the trust and one or more U.S. persons can control all substantial trust
decisions, or if the trust was in existence on August 20, 1996 and has elected to continue to be treated as a U.S. person.
|
● |
fails to furnish its taxpayer identification number (“TIN”), which, for an individual, ordinarily is his or her social security number;
|
● |
furnishes an incorrect TIN;
|
● |
is notified by the IRS that the U.S. Holder has failed to properly report payments of interest or dividends; or
|
● |
fails to certify, under penalties of perjury, that the U.S. Holder is a U.S. person, has furnished a correct TIN and that the IRS has not notified the U.S.
Holder that it is subject to backup withholding.
|
● |
such non-U.S. Holder does not directly or indirectly, actually or constructively, own 10% or more of the total combined voting power of all of our classes of
stock;
|
● |
such non-U.S. Holder is not a controlled foreign corporation that is related to us through sufficient direct or indirect stock ownership;
|
● |
such interest is not effectively connected with a trade or business conducted by the non-U.S. Holder within the United States; and
|
● |
(1) the non-U.S. Holder provides the applicable withholding agent with a properly completed IRS Form W-8BEN or W-8BEN-E (or other applicable form), which
includes its name and address and a certification, under penalties of perjury, that the non-U.S. Holder is not a “United States person” within the meaning of the Code, or (2) a securities clearing organization, bank or other financial
institution that holds customers’ securities in the ordinary course of its trade or business and holds the notes on behalf of the non-U.S. Holder certifies to the applicable withholding agent under penalties of perjury that it, or the
financial institution between it and the non-U.S. Holder, has received from the non-U.S. Holder a properly completed IRS Form W-8BEN or W-8BEN-E (or other applicable form), which includes a statement, under penalties of perjury, that
such non-U.S. Holder is not a “United States person” and provides the applicable withholding agent with a copy of this statement.
|
Underwriter
|
Principal Amount of Notes
|
|||
Goldman Sachs & Co. LLC
|
$
|
112,500,000
|
||
Mizuho Securities USA LLC
|
112,500,000
|
|||
Morgan Stanley & Co. LLC
|
112,500,000
|
|||
J.P. Morgan Securities LLC
|
45,000,000
|
|||
Wells Fargo Securities, LLC
|
45,000,000
|
|||
Credit Agricole Securities (USA) Inc.
|
27,500,000
|
|||
MUFG Securities Americas Inc.
|
20,000,000
|
|||
Fifth Third Securities, Inc.
|
12,500,000
|
|||
PNC Capital Markets LLC
|
12,500,000
|
|||
Total
|
$
|
500,000,000
|
|
Per Note |
Total
|
|||
Public offering price(1)
|
99.707%
|
$
|
498,535,000
|
||
Underwriting discount
|
0.65%
|
$
|
3,250,000
|
||
Proceeds, before expenses, to us
|
99.057%
|
$
|
495,285,000
|
(1) |
Plus accrued interest from March 12, 2019, if settlement occurs after that date.
|
● |
it has only communicated or caused to be communicated and will only communicate or cause to be communicated an invitation or inducement to engage in
investment activity (within the meaning of Section 21 of the FSMA) received by it in connection with the issue or sale of the notes in circumstances in which Section 21(1) of the FSMA does not apply to us; and
|
● |
it has complied and will comply with all applicable provisions of the FSMA with respect to anything done by it in relation to the notes in, from or otherwise
involving the United Kingdom.
|
1. |
Our Annual Report on Form 10-K for the fiscal year ended December 31, 2018;
|
2. |
Our proxy statement on Schedule 14A filed with the SEC on April 4, 2018;
|
3. |
Our Current Report on Form 8-K, filed on February 22, 2019; and
|
4. |
Our Current Report on Form 8-K, filed on March 4, 2019.
|
ABOUT THIS PROSPECTUS
|
ii
|
QUEST DIAGNOSTICS INCORPORATED
|
1
|
WHERE YOU CAN FIND MORE INFORMATION
|
1
|
CAUTIONARY STATEMENT FOR PURPOSES OF THE “SAFE HARBOR” PROVISIONS OF THE PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995
|
2 |
USE OF PROCEEDS
|
5 |
RATIO OF EARNINGS TO FIXED CHARGES
|
6 |
SECURITIES WE MAY ISSUE
|
7 |
DESCRIPTION OF SENIOR DEBT SECURITIES
|
8 |
PLAN OF DISTRIBUTION
|
9 |
VALIDITY OF THE SECURITIES
|
10
|
EXPERTS
|
10
|
1. |
Our current report on Form 8-K, filed with the SEC on March 2, 2016;
|
2. |
Our quarterly report on Form 10-Q for the quarter ended March 31, 2016; and
|
3. |
Our annual report on Form 10-K for the fiscal year ended December 31, 2015 (including information specifically incorporated by reference into the annual
report on Form 10-K from our proxy statement on Schedule 14A filed with the SEC on April 7, 2016).
|
(a) |
Heightened competition from commercial clinical testing companies, hospitals, physicians and others.
|
(b) |
Increased pricing pressure from customers and payers.
|
(c) |
A decline in economic conditions.
|
(d) |
Impact of changes in payer mix, including any shift from fee-for-service to discounted or capitated fee arrangements.
|
(e) |
Adverse actions by government or other third-party payers, including healthcare reform that focuses on reducing healthcare costs but does not recognize the
value and importance to healthcare of clinical testing, unilateral reduction of fee schedules payable to us, competitive bidding, and an increase in the practice of negotiating for exclusive arrangements that involve aggressively
priced capitated or fee-for-service payments by health insurers or other payers.
|
(f) |
The impact upon our testing volume and collected revenue or general or administrative expenses resulting from our compliance with Medicare and Medicaid
administrative policies and requirements of third-party payers. These include:
|
(1) |
the requirements of Medicare carriers to provide diagnosis codes for many commonly ordered tests and the possibility that third-party payers will
increasingly adopt similar requirements;
|
(2) |
inability to obtain from patients a valid advance beneficiary notice form for tests that cannot be billed without prior receipt of the form;
|
(3) |
increased challenges in operating as a non-contracted provider with respect to health plans;
|
(4) |
the impact of additional or expanded limited coverage policies and limits on the allowable number of test units; and
|
(5) |
the impact of increased prior authorization programs for clinical testing.
|
(g) |
Adverse results from pending or future government investigations, lawsuits or private actions. These include, in particular, monetary damages, loss or
suspension of licenses, and/or suspension or exclusion from the Medicare and Medicaid programs and/or criminal penalties.
|
(h) |
Failure to efficiently integrate acquired businesses and to manage the costs related to any such integration, or to retain key technical, professional or
management personnel.
|
(i) |
Denial, suspension or revocation of CLIA certification or other licenses for any of our clinical laboratories under the CLIA standards, revocation or
suspension of the right to bill the Medicare and Medicaid programs or other adverse regulatory actions by federal, state and local agencies.
|
(j) |
Changes in federal, state or local laws or regulations, including changes that result in new or increased federal or state regulation of commercial clinical
laboratories, tests developed by commercial clinical laboratories or other products or services that we offer or activities in which we are engaged, including regulation by the FDA.
|
(k) |
Inability to achieve expected benefits from our acquisitions of other businesses.
|
(l) |
Inability to achieve additional benefits from our business performance tools and efficiency initiatives.
|
(m) |
Adverse publicity and news coverage about the clinical testing industry or us.
|
(n) |
Computer or other IT system failures that affect our ability to perform testing, report test results or properly bill customers, or result in the disclosure
of confidential information, including potential failures resulting from implementing common IT systems and other system conversions, telecommunications failures, malicious human acts (such as electronic break-ins or computer viruses)
or natural disasters.
|
(o) |
Development of technologies that substantially alter the practice of clinical testing, including technology changes that lead to the development of more
convenient or cost-effective testing, or testing to be performed outside of a commercial clinical laboratory, such as (1) point-of-care testing that can be performed by physicians in their offices, (2) esoteric testing that can be
performed by hospitals in their own laboratories or (3) home testing that can be carried out without requiring the services of clinical laboratories.
|
(p) |
Negative developments regarding intellectual property and other property rights that could prevent, limit or interfere with our ability to develop, perform
or sell our tests or operate our business. These include:
|
(1) |
Issuance of patents or other property rights to our competitors or others; and
|
(2) |
Inability to obtain or maintain adequate patent or other proprietary rights for our products and services or to successfully enforce our proprietary rights.
|
(q) |
Development of tests by our competitors or others which we may not be able to license, or usage of our technology or similar technologies or our trade
secrets or other intellectual property by competitors, any of which could negatively affect our competitive position.
|
(r) |
Regulatory delay or inability to commercialize newly developed or licensed tests or technologies or to obtain appropriate reimbursements for such tests.
|
(s) |
Inability to properly bill for our services or to obtain appropriate payments for services that we do bill.
|
(t) |
Changes in interest rates and changes in our credit ratings from Standard & Poor’s, Moody’s Investor Services or Fitch Ratings causing an unfavorable
impact on our cost of and access to capital.
|
(u) |
Inability to hire and retain qualified personnel or the loss of the services of one or more of our key senior management personnel.
|
(v) |
Terrorist and other criminal activities, hurricanes, earthquakes or other natural disasters, and health pandemics, which could affect our customers,
transportation or systems, or our facilities, and for which insurance may not adequately reimburse us.
|
(w) |
Difficulties and uncertainties in the discovery, development, regulatory environment and/or marketing of new services or solutions or new uses of existing
tests.
|
(x) |
Failure to adapt to changes in the healthcare system and healthcare delivery, including those stemming from the 2010 federal healthcare reform legislation.
|
(y) |
Results and consequences of governmental inquiries.
|
(z) |
Trends in utilization of the healthcare system.
|
(aa) |
Increased patient financial responsibility for services.
|
(bb) |
Difficulty in implementing, or lack of success with, our strategic plan.
|
(cc) |
Inability to adapt to diverse and dynamic non-U.S. markets.
|
(dd) |
The impact of informatics on our industry and the ability of our Company to adapt to that impact.
|
THREE MONTHS ENDED MARCH 31,
|
YEARS ENDED DECEMBER 31,
|
|||||||||||||||||||||||
2016
|
2015
|
2014
|
2013
|
2012
|
2011
|
|||||||||||||||||||
Ratio of earnings to fixed charges
|
4.3
|
x
|
5.9
|
x
|
4.4
|
x
|
6.7
|
x
|
5.5
|
x
|
4.5
|
x
|