LHC GROUP, INC.
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-Q/A
(Amendment No. 1)
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Quarterly report pursuant to Section 13 or 15 (d) of the Securities Exchange Act of 1934 |
For the quarterly period ended March 31, 2007
or
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Transition Report Pursuant to Section 13 or 15(d) of the Securities Exchange Act of
1934 |
For the transition period from to
Commission file number: 0-8082
LHC GROUP, INC.
(Exact Name of Registrant as Specified in Charter)
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Delaware
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71-0918189 |
(State or Other Jurisdiction of
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(I.R.S. Employer Identification No.) |
Incorporation or Organization) |
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420 West Pinhook Rd, Suite A
Lafayette, LA 70503
(Address of principal executive offices including zip code)
(337) 233-1307
(Registrants telephone number, including area code)
Indicate by check mark whether the issuer (1) has filed all reports required to be filed by
Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for
such shorter period that the registrant was required to file such reports), and (2) has been
subject to such filing requirements for the past 90 days. Yes þ No o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated
filer, or a non-accelerated filer. See definition of accelerated filer and large accelerated
filer in Rule 12b-2 of the Exchange Act. (Check one):
Large accelerated filer o Accelerated Filer þ Non-accelerated filer o
Indicate by check mark whether the registrant is a shell company (as defined in rule 12b-2 of
the Exchange Act). Yes o No þ
Number of shares of common stock, par value $0.01, outstanding as of May 3, 2007: 17,998,246
shares
EXPLANATORY NOTE
We are filing this Amendment No. 1 to Form 10-Q for the quarterly period ended March 31, 2007,
as originally filed with the SEC on May 9, 2007, to restate our Consolidated Balance Sheet and
Statements of Income and Cash Flows and corresponding financial information for the quarterly
period ended March 31, 2007. These financial statements have been restated to include a contractual
adjustment which reduces net service revenue $783,000, and recognize the related income tax benefit
of $305,000.
In an effort to improve our processes and controls in billing and collections, during the
second quarter of 2007 we engaged outside consulting expertise to evaluate the billing process
related to the Long-Term Acute Care Hospitals (LTACHs). The review identified claims which had
been collected, but had remaining claim amounts left on the books. In some cases, these remaining
amounts related to contractual adjustments which had not been recorded or which had been
incorrectly calculated and recorded at discharge. This information led management to determine that
the Company had underestimated its revenue adjustments related to certain commercial payers in our
LTACHs. Therefore the Company has made the following adjustment to the facility-based segment:
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Increased the contractual adjustment in the first quarter by $783,000 pre-tax which
reduces net service revenue. |
Pursuant to Rule 12b-15 under the Securities Exchange Act of 1934, as amended, the complete
text of Item 1 and Item 4 of Part I is set forth below and Item 6 of Part II is amended to contain
updated certifications from our Chief Executive Officer and Chief Financial Officer. This Amendment
No. 1 continues to speak as of the date of the original Form 10-Q for the quarterly period ended
March 31, 2007 and only reflects the changes to Part I and Part II discussed above. We have not
updated or amended the disclosures contained herein to reflect events that have occurred since the
filing of the Form 10-Q, or modified or updated those disclosures in any way other than as
described above. Accordingly, this Amendment No. 1 should be read in conjunction with our filings
made with the SEC subsequent to the filing of the original Form 10-Q on May 9, 2007.
ii
PART I
FINANCIAL INFORMATION
ITEM 1. FINANCIAL STATEMENTS.
LHC GROUP, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
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March 31, |
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December 31, |
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2007 |
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2006 |
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(unaudited) |
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(as restated, see Note 1) |
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(in thousands, except share data) |
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ASSETS |
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Current assets: |
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Cash |
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$ |
20,856 |
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$ |
26,877 |
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Receivables: |
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Patient accounts receivable, less allowance for uncollectible
accounts of $7,378, and $5,769 at March 31, 2007 and December 31,
2006, respectively |
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61,922 |
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50,029 |
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Other receivables |
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2,359 |
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3,367 |
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Employee receivables |
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134 |
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34 |
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Amounts due from governmental entities |
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2,518 |
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2,518 |
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66,933 |
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55,948 |
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Deferred income taxes |
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2,953 |
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1,935 |
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Prepaid expenses and other current assets |
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3,133 |
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4,120 |
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Assets held for sale |
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374 |
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1,171 |
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Total current assets |
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94,249 |
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90,051 |
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Property, building, and equipment, net |
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12,006 |
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11,705 |
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Goodwill |
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44,913 |
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39,681 |
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Intangible assets, net |
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9,294 |
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8,262 |
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Other assets |
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3,559 |
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2,995 |
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Total assets |
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$ |
164,021 |
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$ |
152,694 |
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LIABILITIES AND STOCKHOLDERS EQUITY |
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Current liabilities: |
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Accounts payable and other accrued liabilities |
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$ |
5,268 |
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$ |
5,903 |
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Salaries, wages, and benefits payable |
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12,835 |
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10,572 |
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Amounts due to governmental entities |
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3,162 |
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3,223 |
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Amounts payable under cooperative endeavor agreements |
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56 |
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51 |
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Income taxes payable |
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4,155 |
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1,219 |
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Current portion of capital lease obligations |
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164 |
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211 |
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Current portion of long-term debt |
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430 |
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428 |
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Total current liabilities |
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26,070 |
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21,607 |
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Deferred income taxes, less current portion |
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2,525 |
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2,104 |
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Capital lease obligations, less current portion |
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128 |
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147 |
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Long-term debt, less current portion |
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3,010 |
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3,051 |
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Minority interests subject to exchange contracts and/or put options |
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285 |
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317 |
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Other minority interests |
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3,928 |
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3,579 |
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Stockholders equity: |
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Common stock $0.01 par value: |
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40,000,000 shares authorized; 20,700,211 and 20,682,317 shares
issued and 17,750,142 and 17,732,258 shares outstanding at March
31, 2007 and December 31, 2006, respectively |
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177 |
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177 |
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Treasury stock 2,950,059 shares at cost |
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(2,856 |
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(2,856 |
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Additional paid-in capital |
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80,639 |
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80,273 |
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Retained earnings |
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50,115 |
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44,295 |
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Total stockholders equity |
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128,075 |
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121,889 |
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Total liabilities and stockholders equity |
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$ |
164,021 |
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$ |
152,694 |
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See accompanying notes.
- 1 -
LHC GROUP, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME
(Unaudited)
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Three Months Ended March 31, |
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2007 |
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2006 |
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(as restated, see Note 1) |
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(in thousands, except share and per share data) |
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Net service revenue |
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$ |
69,251 |
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$ |
46,468 |
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Cost of service revenue |
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35,194 |
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24,860 |
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Gross margin |
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34,057 |
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21,608 |
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General and administrative expenses |
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23,038 |
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15,247 |
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Operating income |
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11,019 |
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6,361 |
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Interest expense |
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83 |
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86 |
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Non-operating income, including (gain) on sales of assets |
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(293 |
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(166 |
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Income from continuing operations before income taxes
and minority interest and cooperative endeavor
allocations |
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11,229 |
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6,441 |
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Income tax expense |
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3,634 |
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1,697 |
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Minority interest and cooperative endeavor allocations |
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1,807 |
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995 |
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Income from continuing operations |
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5,788 |
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3,749 |
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Gain (Loss) from discontinued operations (net of income
taxes (benefit) of $(2) and $(129) in the three months
ended March 31, 2007 and 2006, respectively |
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(3 |
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(210 |
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Gain on sale of discontinued operations (net of income
taxes of $365 for the three months ended March 31, 2006) |
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597 |
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Net income |
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5,785 |
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4,136 |
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Redeemable minority interests |
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35 |
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843 |
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Net income available to common stockholders |
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$ |
5,820 |
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$ |
4,979 |
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Earnings per share basic: |
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Income from continuing operations |
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$ |
0.33 |
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$ |
0.23 |
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Gain (Loss) from discontinued operations, net |
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(0.01 |
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Gain on sale of discontinued operations, net |
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0.04 |
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Net income |
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0.33 |
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0.26 |
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Redeemable minority interests |
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0.05 |
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Net income available to common shareholders |
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$ |
0.33 |
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$ |
0.31 |
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Earnings per share diluted: |
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Income from continuing operations |
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$ |
0.33 |
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$ |
0.23 |
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Gain (Loss) from discontinued operations, net |
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(0.01 |
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Gain on sale of discontinued operations, net |
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0.04 |
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Net income |
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0.33 |
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0.26 |
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Redeemable minority interests |
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0.05 |
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Net income available to common shareholders |
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$ |
0.33 |
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$ |
0.31 |
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Weighted average shares outstanding: |
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Basic |
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17,748,369 |
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16,557,828 |
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Diluted |
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17,807,338 |
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16,563,368 |
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See accompanying notes.
- 2 -
LHC GROUP, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)
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Three months Ended |
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March 31, |
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2007 |
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2006 |
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(as restated, see |
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Note 1) |
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(in thousands) |
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Operating activities |
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Net income |
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$ |
5,785 |
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$ |
4,136 |
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Adjustments to reconcile net income to net cash provided by operating activities: |
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Depreciation expense |
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710 |
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532 |
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Provision for bad debts |
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1,816 |
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841 |
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Stock-based compensation expense |
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227 |
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96 |
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Minority interest in earnings of subsidiaries |
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1,756 |
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1,028 |
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Deferred income taxes |
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(596 |
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(290 |
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Gain on divestitures and sale of assets |
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(963 |
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Changes in operating assets and liabilities, net of acquisitions: |
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Receivables |
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(12,801 |
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(2,431 |
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Prepaid expenses, other assets |
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526 |
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63 |
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Accounts payable and accrued expenses |
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4,614 |
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1,963 |
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Net amounts due under cooperative endeavor agreements |
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5 |
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23 |
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Net amounts due governmental entities |
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(61 |
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598 |
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Net cash provided by operating activities |
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1,981 |
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5,596 |
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Investing activities |
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Purchases of property, building, and equipment |
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(716 |
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(991 |
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Proceeds from sale of entities |
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1,200 |
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Cash paid for acquisitions, primarily goodwill and intangible assets |
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(5,865 |
) |
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(3,269 |
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Net cash used in investing activities |
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(6,581 |
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(3,060 |
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Financing activities |
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Principal payments on debt |
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(39 |
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(603 |
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Payments on capital leases |
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(66 |
) |
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(109 |
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Proceeds from employee stock purchase plan |
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88 |
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Minority interest distributions, net |
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(1,404 |
) |
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(1,089 |
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Net cash used in financing activities |
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(1,421 |
) |
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(1,801 |
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Change in cash |
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(6,021 |
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735 |
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Cash at beginning of period |
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26,877 |
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17,398 |
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Cash at end of period |
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$ |
20,856 |
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$ |
18,133 |
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Supplemental disclosures of cash flow information |
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Interest paid |
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$ |
83 |
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$ |
86 |
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Income taxes paid |
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$ |
1,240 |
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$ |
105 |
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See accompanying notes.
- 3 -
LHC GROUP, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
1. Organization
LHC Group, Inc. (the Company) is a healthcare provider specializing in the post-acute
continuum of care primarily for Medicare beneficiaries in rural markets in the southern United
States. The Company provides home-based services, primarily through home nursing agencies and
hospices, and facility-based services, primarily through long-term acute care hospitals and
outpatient rehabilitation clinics. As of the date of this report, the Company, through its wholly
and majority-owned subsidiaries, equity joint ventures, and controlled affiliates, operated in
Louisiana, Alabama, Arkansas, Mississippi, Texas, West Virginia, Kentucky, Florida, Georgia and
Tennessee.
Unaudited Interim Financial Information
The consolidated balance sheet as of March 31, 2007 and the related consolidated statements of
income and cash flows for the three months ended March 31, 2007 and 2006 and related notes (interim
financial information) have been prepared by LHC Group, Inc. and are unaudited. In the opinion of
management, all adjustments (consisting of normal recurring accruals) considered necessary for a
fair presentation in accordance with accounting principles generally accepted in the United States
have been included. Operating results for the three months ended March 31, 2007 are not necessarily
indicative of the results that may be expected for the year ended December 31, 2007.
Certain information and footnote disclosures normally included in financial statements
prepared in accordance with accounting principles generally accepted in the United States have been
condensed or omitted from the interim financial information presented. These consolidated financial
statements should be read in conjunction with the notes to the consolidated financial statements
included in the Companys Consolidated Financial Statements in the Companys Annual Report as filed
with the Securities and Exchange Commission on Form 10-K for the year ended December 31, 2006,
which includes information and disclosures not included herein.
Restatement of Financial Statements
Subsequent to the issuance of the Companys Quarterly Report on Form 10-Q for the period ended
March 31, 2007, management determined that the accounting for certain contractual adjustments
related to the commercial contracts in the LTACHs was in error. The Company previously disclosed in
a Current Report on Form 8-K dated July 31, 2007, that it would restate its financial statements to
correct the accounting for contractual adjustments. The effects of the restatement adjustments on
the Companys originally reported results of operations for the three months ended March 31, 2007
are summarized below.
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1. |
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Consolidated Balance Sheet |
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a. |
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Patient accounts receivable decreased by $783,000 which decreases Total
current assets and Total assets by the same amount. |
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b. |
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Income taxes payable decreased by $305,000 which decreases Total current
liabilities by the same amount. |
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c. |
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Retained earnings decreased by $478,000 which decreases Total
stockholders equity by the same amount. |
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d. |
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Total liabilities and stockholders equity decreased by $783,000. |
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2. |
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Consolidated Statement of Income |
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a. |
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Net service revenue decreased by $783,000 which decreases Gross margin,
Operating income, and Income from continuing operations before income taxes and
minority interest and cooperative endeavor allocations by the same amount. |
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b. |
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Income tax expense decreased by $305,000. |
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c. |
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Income from continuing operations decreased $478,000 which decreases Net
income and Net income available to common stockholders by the same amount. |
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d. |
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Earnings per share decreased $0.02 and fully diluted earnings per share
decreased $0.02. |
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3. |
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Consolidated Statement of Cash Flows |
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a. |
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Net income decreased by $478,000. |
- 4 -
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b. |
|
Changes in operating assets and liabilities, net of acquisitions:
Receivables decreased by $783,000. |
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c. |
|
Changes in operating assets and liabilities, net of acquisitions:
Accounts payable and accrued expenses decreased by $305,000. |
2. Significant Accounting Policies
Use of Estimates
The preparation of financial statements in conformity with accounting principles generally
accepted in the United States requires management to make estimates and assumptions that affect the
reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at
the date of the financial statements and the reported revenue and expenses during the reported
period. Actual results could differ from those estimates.
Critical Accounting Policies
The most critical accounting policies relate to the principles of consolidation, revenue
recognition, accounts receivable and allowances for uncollectible accounts, and accounting for
goodwill and intangible assets.
Principles of Consolidation
The consolidated financial statements include all subsidiaries and entities controlled by the
Company. Control is generally defined by the Company as ownership of a majority of the voting
interest of an entity. The consolidated financial statements include entities in which the Company
absorbs a majority of any losses, receives a majority of any residual returns, or both, as a result
of ownership, contractual or other financial interests in the entity.
All significant inter-company accounts and transactions have been eliminated in consolidation.
Business combinations, which are accounted for as purchases, have been included in the consolidated
financial statements from the respective dates of acquisition.
- 5 -
The following describes the Companys consolidation policy with respect to its various
ventures excluding wholly-owned subsidiaries:
Equity Joint Ventures
The Companys joint ventures are structured as limited liability companies in which the
Company typically owns a majority equity interest ranging from 51% to 99%. Each member of all but
one of the Companys equity joint ventures participates in profits and losses in proportion to
their equity interests. The Company has one joint venture partner whose participation in losses is
limited. The Company consolidates these entities as the Company absorbs a majority of any losses,
receives a majority of any residual returns and generally has voting control over the entity.
Cooperative Endeavors
The Company has arrangements with certain partners that involve the sharing of profits and
losses. Unlike the equity joint ventures, the Company owns 100% of the equity in these cooperative
endeavors. In these cooperative endeavors, the Company possesses interests in the net profits and
losses ranging from 67% to 70%. The Company has one cooperative endeavor partner whose
participation in losses is limited. The Company consolidates these entities as the Company owns
100% of the outstanding equity and the Company absorbs a majority of any losses and receives a
majority of any residual returns.
License Leasing Arrangements
The Company, through wholly-owned subsidiaries, leases home health licenses necessary to
operate certain of its home nursing agencies. As with wholly-owned subsidiaries, the Company owns
100% of the equity of these entities and consolidates them based on such ownership as well as the
Companys right to receive a majority of any residual returns and the Companys obligation to
absorb a majority of any losses.
Management Services
The Company has various management services agreements under which the Company manages certain
operations of agencies and facilities. The Company does not consolidate these agencies or
facilities, as the Company does not have an ownership interest and does not have a right to receive
a majority of any residual returns or an obligation to absorb a majority of any losses.
The following table summarizes the percentage of net service revenue earned by type of
ownership or relationship the Company had with the operating entity:
|
|
|
|
|
|
|
|
|
|
|
Three Months |
|
|
Ended March 31, |
|
|
2007 |
|
2006 |
Wholly-owned subsidiaries |
|
|
45.2 |
% |
|
|
38.3 |
% |
Equity joint ventures |
|
|
41.1 |
|
|
|
47.5 |
|
Cooperative endeavors |
|
|
1.2 |
|
|
|
1.7 |
|
License leasing arrangements |
|
|
9.7 |
|
|
|
11.1 |
|
Management services |
|
|
2.8 |
|
|
|
1.4 |
|
|
|
|
|
|
|
|
|
|
|
|
|
100.0 |
% |
|
|
100.0 |
% |
|
|
|
|
|
|
|
|
|
Revenue Recognition
The Company reports net service revenue at the estimated net realizable amount due from
Medicare, Medicaid, commercial insurance, managed care payors, patients, and others for services
rendered. Under Medicare, the Companys home nursing patients are classified into a group referred
to as a home health resource group prior to the receipt of services. Based on this home health
resource group, the Company is entitled to receive a prospective Medicare payment for delivering
care over a 60-day period referred to as an episode. Medicare adjusts these prospective payments
based on a variety of factors, such as low utilization, patient transfers, changes in condition and
the level of services provided. In calculating the Companys reported net service revenue from home
nursing services, the Company adjusts the prospective Medicare payments by an estimate of the
adjustments. The Company calculates the adjustments based on a historical average of these types of
adjustments. For home nursing services, the Company recognizes revenue based on the number of days
elapsed during the episode of care.
- 6 -
For the Companys long-term acute care hospitals, revenue is recognized as services are
provided. Under Medicare, patients in the Companys long-term acute care facilities are classified
into long-term diagnosis-related groups. Based on this classification, the Company is then entitled
to receive a fixed payment from Medicare. This fixed payment is also subject to adjustment by
Medicare due to factors such as short stays. In calculating reported net service revenue for
services provided in the Companys long-term acute care hospitals, the Company reduces the
prospective payment amounts by an estimate of the adjustments. The Company calculates the
adjustment based on a historical average of these types of adjustments for claims paid.
For hospice services, the Company is paid by Medicare under a per diem payment system. The
Company receives one of four predetermined daily or hourly rates based upon the level of care the
Company furnished. The Company records net service revenue from hospice services based on the daily
or hourly rate. The Company recognizes revenue for hospice as services are provided.
Under Medicare, the Company is reimbursed for rehabilitation services based on a fee schedule
for services provided adjusted by the geographical area in which the facility is located. The
Company recognizes revenue as these services are provided.
The Companys Medicaid reimbursement is based on a predetermined fee schedule applied to each
service provided. Therefore, revenue is recognized for Medicaid services as services are provided
based on this fee schedule. The Companys managed care payors reimburse the Company under the terms
of the related contracts. Accordingly, the Company recognizes revenue from managed care payors
consistent with those terms.
The Company records management services revenue as services are provided in accordance with
the various management services agreements to which the Company is a party. The agreements
generally call for the Company to provide billing, management, and other consulting services suited
to and designed for the efficient operation of the applicable home nursing agency, hospice, or
inpatient rehabilitation facility. The Company is responsible for the costs associated with the
locations and personnel required for the provision of the services. The Company is generally
compensated based on a percentage of net billings or an established base fee. In addition, for
certain of the management agreements, the Company may earn incentive compensation.
Net service revenue was comprised of the following:
|
|
|
|
|
|
|
|
|
|
|
Three Months |
|
|
Ended March 31, |
|
|
2007 |
|
2006 |
Home-based services |
|
|
79.5 |
% |
|
|
69.8 |
% |
Facility-based services |
|
|
20.5 |
|
|
|
30.2 |
|
|
|
|
|
|
|
|
|
|
|
|
|
100.0 |
% |
|
|
100.0 |
% |
|
|
|
|
|
|
|
|
|
The following table sets forth the percentage of net service revenue earned by category of
payor:
|
|
|
|
|
|
|
|
|
|
|
Three Months |
|
|
Ended March 31, |
|
|
2007 |
|
2006 |
Payor: |
|
|
|
|
|
|
|
|
Medicare |
|
|
81.7 |
% |
|
|
86.1 |
% |
Medicaid |
|
|
6.1 |
|
|
|
5.2 |
|
Other |
|
|
12.2 |
|
|
|
8.7 |
|
|
|
|
|
|
|
|
|
|
|
|
|
100.0 |
% |
|
|
100.0 |
% |
|
|
|
|
|
|
|
|
|
Home-Based Services
Home Nursing Services. The Company receives a standard prospective Medicare payment for
delivering care. The base payment, established through federal legislation, is a flat rate that is
adjusted upward or downward based upon differences in the expected resource needs of individual
patients as indicated by clinical severity, functional severity, and service utilization. The
magnitude of the adjustment is determined by each patients categorization into one of 80 payment
groups, known as home health resource groups, and the costliness of care for patients in each group
relative to the average patient. The Companys payment is also adjusted for differences in local
prices using the hospital wage index. The Company performs payment variance analyses to verify the
models utilized in projecting total net service revenue are accurately reflecting the payments to
be received.
- 7 -
Medicare rates are subject to change. Due to the length of the Companys episodes of care, a
situation may arise where Medicare rate changes affect a prior periods net service revenue. In the
event that Medicare rates experience change, the net effect of that change will be reflected in the
current reporting period.
Final payments from Medicare may reflect one of five retroactive adjustments to ensure the
adequacy and effectiveness of the total reimbursement: (a) an outlier payment if the patients care
was unusually costly; (b) a low utilization adjustment if the number of visits was fewer than five;
(c) a partial payment if the patient transferred to another provider before completing the episode;
(d) a change-in-condition adjustment if the patients medical status changes significantly,
resulting in the need for more or less care; or (e) a payment adjustment based upon the level of
therapy services required in the population base. Management estimates the impact of these payment
adjustments based on historical experience and records this estimate during the period the services
are rendered.
Hospice Services. The Companys Medicare hospice reimbursement is based on an annually-updated
prospective payment system. Hospice payments are also subject to two caps. One cap relates to
individual programs receiving more than 20% of their total Medicare reimbursement from inpatient
care services. The second cap relates to individual programs receiving reimbursements in excess of
a cap amount, calculated by multiplying the number of beneficiaries during the period by a
statutory amount that is indexed for inflation. The determination for each cap is made annually
based on the 12-month period ending on October 31 of each year. This limit is computed on a
program-by-program basis. None of the Companys hospices exceeded either cap during the three
months ended March 31, 2007 or 2006.
Facility-Based Services
Long-Term Acute Care Services. The Company is reimbursed by Medicare for services provided
under the long-term acute care hospital prospective payment system, which was implemented on
October 1, 2002. Each patient is assigned a long-term care diagnosis-related group. The Company is
paid a predetermined fixed amount applicable to that particular group. This payment is intended to
reflect the average cost of treating a Medicare patient classified in that particular long-term
care diagnosis-related group. For selected patients, the amount may be further adjusted based on
length of stay and facility-specific costs, as well as in instances where a patient is discharged
and subsequently readmitted, among other factors. Similar to other Medicare prospective payment
systems, the rate is also adjusted for geographic wage differences.
Outpatient Rehabilitation Services. Outpatient therapy services are reimbursed on a fee
schedule, subject to annual limitations. Outpatient therapy providers receive a fixed fee for each
procedure performed, adjusted by the geographical area in which the facility is located. The
Company recognizes revenue as the services are provided. There are also annual per Medicare
beneficiary caps that limit Medicare coverage for outpatient rehabilitation services.
Accounts Receivable and Allowances for Uncollectible Accounts
The Company reports accounts receivable net of estimated allowances for uncollectible accounts
and adjustments. Accounts receivable are uncollateralized and primarily consist of amounts due from
third-party payors and patients. To provide for accounts receivable that could become uncollectible
in the future, the Company establishes an allowance for uncollectible accounts to reduce the
carrying amount of such receivables to their estimated net realizable value. The credit risk for
other concentrations of receivables is limited due to the significance of Medicare as the primary
payor. The Company does not believe that there are any other significant concentrations of
receivables from any particular payor that would subject it to any significant credit risk in the
collection of accounts receivable.
The amount of the provision for bad debts is based upon the Companys assessment of historical
and expected net collections, business and economic conditions, and trends in government
reimbursement. Uncollectible accounts are written off when the Company has determined the account
will not be collected.
A portion of the estimated Medicare prospective payment system reimbursement from each
submitted home nursing episode is received in the form of a request for accelerated payment (RAP).
The Company submits a RAP for 60% of the estimated reimbursement for the initial episode at the
start of care. The full amount of the episode is billed after the episode has been completed. The
RAP received for that particular episode is deducted from the final payment. If a final bill is not
submitted within the greater of 120 days from the start of the episode, or 60 days from the date
the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other
claims
- 8 -
in process for that particular provider. The RAP and final claim must then be re-submitted.
For any subsequent episodes of care contiguous with the first episode for a particular patient, the
Company submits a RAP for 50% instead of 60% of the estimated reimbursement. The Company has earned
net service revenue in excess of billings rendered to Medicare. Only a nominal portion of the
amounts due to the Medicare program represent cash collected in advance of providing services.
Our Medicare population is paid at a prospectively set amount that can be determined at the
time services are rendered. Our Medicaid reimbursement is based on a predetermined fee schedule
applied to each individual service we provide. Our managed care contracts are structured similar to
either the Medicare or Medicaid payment methodologies. Because of our payor mix, we are able to
calculate our actual amount due at the patient level and adjust the gross charges down to the
actual amount at the time of billing. This negates the need for an estimated contractual allowance
to be booked at the time we report net service revenue for each reporting period.
At March 31, 2007, our allowance for uncollectible accounts, as a percentage of patient
accounts receivable, was approximately 10.5%. For the three months ended March 31, 2007, the
provision for doubtful accounts increased to 2.6% of net service revenue compared to 1.8% of net
service revenue for the same period in 2006. Adverse changes in general economic conditions,
billing operations, payor mix, or trends in federal or state governmental coverage could affect our
collection of accounts receivable, cash flows and results of operations.
The following table sets forth our aging of accounts receivable (based on the billing date) as
of March 31, 2007:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Payor |
|
0-30 |
|
|
31-60 |
|
|
61-90 |
|
|
91-120 |
|
|
121-150 |
|
|
151+ |
|
|
Total |
|
|
|
(in thousands) |
|
Medicare |
|
$ |
20,383 |
|
|
$ |
4,736 |
|
|
$ |
2,548 |
|
|
$ |
1,202 |
|
|
$ |
1,888 |
|
|
$ |
9,103 |
|
|
$ |
39,860 |
|
Medicaid |
|
|
1,348 |
|
|
|
1,512 |
|
|
|
543 |
|
|
|
377 |
|
|
|
640 |
|
|
|
3,921 |
|
|
|
8,341 |
|
Other |
|
|
4,745 |
|
|
|
3,049 |
|
|
|
1,822 |
|
|
|
695 |
|
|
|
1,297 |
|
|
|
9,491 |
|
|
|
21,099 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
$ |
26,476 |
|
|
$ |
9,297 |
|
|
$ |
4,913 |
|
|
$ |
2,274 |
|
|
$ |
3,825 |
|
|
$ |
22,515 |
|
|
$ |
69,300 |
|
Goodwill and Intangible Assets
Goodwill and other intangible assets with indefinite lives are reviewed annually for
impairment or more frequently if circumstances indicate impairment may have occurred.
The Company estimates the fair value of its identified reporting units and compares those
estimates against the related carrying value. For each of the reporting units, the estimated fair
value is determined based on a multiple of earnings before interest, taxes, depreciation, and
amortization or on the estimated fair value of assets in situations when it is readily
determinable.
Included in intangible assets, net are other intangible assets such as licenses to operate
home-based and/or facility-based services and trade names. The Company has valued these intangible
assets separately from goodwill for each acquisition completed after January 1, 2006. The Company
has concluded that these licenses and trade names have indefinite lives, as management has
determined that there are no legal, regulatory, contractual, economic or other factors that would
limit the useful life of these intangible assets and the Company intends to renew and operate the
licenses and use these trade names indefinitely. Prior to January 1, 2006, the Company elected to
recognize the fair value of indefinite-lived licenses and trade names together with goodwill as a
single asset for financial reporting purposes.
Components of the Companys home nursing operating segment are generally represented by
individual subsidiaries or joint ventures with individual licenses to conduct specific operations
within geographic markets as limited by the terms of each license. Components of the Companys
facility-based services are represented by individual operating entities. Effective January 1,
2004, management aggregates the components of these two segments into two reporting units for
purposes of evaluating impairment.
Other Significant Accounting Policies
Due to/from Governmental Entities
The Companys critical access hospital and long-term acute care hospitals are reimbursed for
certain activities based on tentative rates. Final reimbursement is determined based on submission
of annual cost reports and audits
- 9 -
by the fiscal intermediary. Adjustments are accrued on an estimated basis in the period the
related services are rendered and further adjusted as final settlements are determined. These
adjustments are accounted for as changes in estimates. There have been no significant changes in
estimates during the three months ended March 31, 2007 and 2006.
Property, Building, and Equipment
Property, building, and equipment are stated at cost. Depreciation is computed using the
straight-line method over the estimated useful lives of the individual assets, generally ranging
from three to ten years and up to thirty-nine years on buildings. Depreciation expense for the
three months ended March 31, 2007 and 2006 was $710,000 and $532,000, respectively.
Capital leases are included in equipment. Capital leases are recorded at the present value of
the future rentals at lease inception and are amortized over the shorter of the applicable lease
term or the useful life of the equipment. Amortization of assets under the capital lease
obligations is included in depreciation and amortization expense.
Long-Lived Assets
The Company reviews the recoverability of long-lived assets whenever events or circumstances
occur which indicate recorded costs may not be recoverable. If the expected future cash flows
(undiscounted) are less than the carrying amount of such assets, the Company recognizes an
impairment loss for the difference between the carrying amount of the assets and their estimated
fair value.
Income Taxes
The Company accounts for income taxes using the liability method. Under the liability method,
deferred taxes are determined based on differences between the financial reporting and tax bases of
assets and liabilities, and are measured using the enacted tax laws that will be in effect when the
differences are expected to reverse. Management provides a valuation allowance for any net deferred
tax assets when it is more likely than not that a portion of such net deferred tax assets will not
be recovered.
Minority Interest and Cooperative Endeavor Agreements
The interest held by third parties in subsidiaries owned or controlled by the Company is
reported on the consolidated balance sheets as minority interest. Minority interest reported in the
consolidated statements of income reflects the respective interests in the income or loss of the
subsidiaries attributable to the other parties, the effect of which is removed from the Companys
consolidated results of operations.
Several of the Companys home health agencies have cooperative endeavor agreements with third
parties that allow the third parties to be paid or recover a fee based on the profits or losses of
the respective agencies. The Company accrues for the settlement of the third partys profits or
losses during the period the amounts are earned. Under the agreements, the Company has incurred net
amounts due to the third parties of $56,000 and $65,000 for the three months ended March 31, 2007
and 2006, respectively. The cooperative endeavor agreements have terms expiring at the end of June
2008.
For agreements where the third party is a healthcare institution, the agreements typically
require the Company to lease building and equipment and receive housekeeping and maintenance from
the healthcare institutions. Ancillary services related to these arrangements are also typically
provided by the healthcare institution.
Minority Interest Subject to Exchange Contracts and/or Put Options
The Company has a put option agreement with the minority interest holders of a majority-owned
subsidiary, St. Landry Extended Care Hospital, LLC (St. Landry), which allows the minority
interest holders to redeem their minority interests for cash. As of March 31, 2007, approximately
76.5% of the doctors have converted their minority interests to cash.
There were no redemptions in the three months ended March 31, 2007. In the three months ended
March 31, 2007, the Company recorded a mark-to-market charge of $35,000 for these redeemable
minority interests. Included
- 10 -
in minority interests subject to exchange contracts and/or put options liability at March 31,
2007 and December 31, 2006 is $279,000 and $314,000, respectively, related to these redeemable
minority interests.
Stock-based Compensation
The Company has two stock option plans that are administered by the Compensation Committee of
the Board of Directors, which selects persons eligible to receive awards and determines the number
of shares and/or options subject to each award, the terms, conditions, performance measures and
other provisions of the award. Readers should refer to note 6 of the Companys consolidated
financial statements in its Annual Report on Form 10-K for the year ended December 31, 2006 for
additional information related to these stock-based compensation plans.
The Company accounts for its stock-based compensation plans using the fair value recognition
provisions of Statement of Financial Accounting Standards.
Earnings Per Share
Basic per share information is computed by dividing the item by the weighted-average number of
shares outstanding during the period. Diluted per share information is computed by dividing the
item by the weighted-average number of shares outstanding plus dilutive potential shares.
The following table sets forth shares used in the computation of basic and diluted per share
information:
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended |
|
|
|
March 31, |
|
|
|
2007 |
|
|
2006 |
|
Weighted average number of shares outstanding for basic per share calculation |
|
|
17,748,369 |
|
|
|
16,557,828 |
|
Effect of dilutive potential shares: |
|
|
|
|
|
|
|
|
Options |
|
|
4,789 |
|
|
|
940 |
|
Restricted stock |
|
|
54,180 |
|
|
|
4,600 |
|
|
|
|
|
|
|
|
Adjusted weighted average shares for diluted per share calculation |
|
|
17,807,338 |
|
|
|
16,563,368 |
|
|
|
|
|
|
|
|
Recently Issued Accounting Pronouncements
In September 2006, the FASB issued SFAS No. 157, Fair Value Measurements (SFAS No. 157),
which defines fair value, establishes a framework for measuring fair value in GAAP and expands
disclosures about fair value measurements. SFAS No. 157 will be effective for financial statements
issued for fiscal years beginning after November 15, 2007, and interim periods within those fiscal
years. The Company is currently evaluating the requirements of this new standard and has not
concluded its analysis on the impact to the Companys consolidated financial position or results of
operations.
In February 2007, the Financial Accounting Standards Board (FASB) issued Statement of
Financial Accounting (SFAS) No. 159, The Fair Value Option for Financial Assets and Financial
Liabilities Including an Amendment to FASB Statement No. 115 (SFAS No. 159), which permits
entities to choose to measure many financial instruments and certain other items at fair value.
SFAS No. 159 is effective as of the beginning of an entitys first fiscal year that begins after
November 15, 2007. The Company is currently evaluating the requirements of this new standard and
has not concluded its analysis on the impact to the Companys consolidated financial position or
results of operations.
3. Acquisitions and Divestitures
The following acquisitions were completed pursuant to the Companys strategy of becoming the
leading provider of post-acute healthcare services to Medicare patients in selected rural markets
in the southern United States. The purchase price of each acquisition was determined based on the
Companys analysis of comparable acquisitions and target markets potential cash flows. Goodwill
generated from the acquisitions was recognized based on the expected contributions of each
acquisition to the overall corporate strategy. The Company expects the goodwill recognized in
connection with the acquisition of existing operations to be fully tax deductible.
- 11 -
2007 Acquisitions
During the three month period ended March 31, 2007, the Company acquired the existing
operations of four entities for $5,298,000 in cash and $439,000 in acquisition costs. Goodwill of
$4.8 million and other intangibles of $1.0 million were assigned to the home based services
segment.
2007 Divestitures
The Company has reclassified the operations of one long-term acute care hospital out of
discontinued operations in the three months ended March 31, 2007 and 2006. The facility had
previously been identified as held for sale and accounted for in discontinued operations throughout
the year ended December 31, 2006. Goodwill of $402,000 and other assets related to this hospital
were classified as assets held for sale at December 31, 2006. The operating results for the three
months ended March 31, 2006, previously disclosed in discontinued operations, have been
reclassified to continuing operations in the statement of income.
The Company has identified one pharmacy operation as held for sale as of March 31, 2007. The
assets related to this operation are classified as assets held for sale on the balance sheet.
The following table summarizes the operating results of divestitures which have been presented
as loss from discontinued operations in the accompanying consolidated statements of income:
|
|
|
|
|
|
|
|
|
|
|
Three Months |
|
|
|
Ended |
|
|
|
March 31, |
|
|
|
2007 |
|
|
2006 |
|
Net service revenue |
|
$ |
542 |
|
|
$ |
1,594 |
|
Costs, expenses and minority interest and cooperative endeavor allocations |
|
|
547 |
|
|
|
1,933 |
|
|
|
|
|
|
|
|
Gain (Loss) from discontinued operations before income taxes |
|
|
(5 |
) |
|
|
(339 |
) |
Income taxes (benefit) |
|
|
(2 |
) |
|
|
(129 |
) |
|
|
|
|
|
|
|
Gain (Loss) from discontinued operations |
|
$ |
(3 |
) |
|
$ |
(210 |
) |
|
|
|
|
|
|
|
The changes in recorded goodwill by segment for the three month period ended March 31, 2007
were as follows:
|
|
|
|
|
|
|
Three months |
|
|
|
Ended |
|
|
|
March 31, |
|
|
|
2007 |
|
|
|
(in thousands) |
|
Home-based services segment: |
|
|
|
|
Balance at December 31, 2006 |
|
$ |
35,740 |
|
Goodwill acquired during the period from acquisitions |
|
|
4,830 |
|
|
|
|
|
Balance at March 31, 2007 |
|
$ |
40,570 |
|
|
|
|
|
Facility-based services segment: |
|
|
|
|
Balance at December 31, 2006 |
|
$ |
3,941 |
|
Goodwill classified as held for sale at December 31, 2006 |
|
|
402 |
|
|
|
|
|
Balance at March 31, 2007 |
|
$ |
4,343 |
|
|
|
|
|
The above transactions were considered to be immaterial individually and in the aggregate.
Accordingly, no supplemental pro forma information is required.
- 12 -
4. Credit Arrangements
Long-Term Debt
Long-term debt consisted of the following:
|
|
|
|
|
|
|
|
|
|
|
March 31, |
|
|
December 31, |
|
|
|
2007 |
|
|
2006 |
|
|
|
(in thousands) |
|
Notes payable: |
|
|
|
|
|
|
|
|
Due in yearly installments of $50,000 through August 2010 at 6.25% |
|
$ |
190 |
|
|
$ |
190 |
|
Due in monthly installments of $20,565 through October 2015 at LIBOR
plus 225 basis points (7.57% at March 31, 2007) |
|
|
2,891 |
|
|
|
2,898 |
|
Due in monthly installments of $12,500 through November 2009 at 3.08% |
|
|
359 |
|
|
|
391 |
|
|
|
|
|
|
|
|
|
|
|
3,440 |
|
|
|
3,479 |
|
Less current portion of long-term debt |
|
|
430 |
|
|
|
428 |
|
|
|
|
|
|
|
|
|
|
$ |
3,010 |
|
|
$ |
3,051 |
|
|
|
|
|
|
|
|
In August 2005, the Company entered into a promissory note with Bancorp Equipment Finance,
Inc. to purchase an airplane, for a principal amount of $2,975,000 with interest on any outstanding
principal balance at the one month LIBOR rate plus 225 basis points (7.57% at March 31, 2007). The
note is collateralized by the Companys airplane and is payable in 119 monthly installments of
$20,565 followed by one balloon installment in the amount of $1,920,565.
In August 2005, the Company entered into a promissory note with the seller of A-1 Nursing
Registry, Inc. (A-1) in conjunction with the purchase of the assets of A-1. The principal amount
of the note is $250,000 and it bears interest at 6.25%.
Certain of the Companys loan agreements contain certain restrictive covenants, including
limitations on indebtedness and the maintenance of certain financial ratios. At March 31, 2007 and
at December 31, 2006, the Company was in compliance with all covenants.
Other Credit Arrangements
The Company maintains a revolving-debt arrangement. Under the terms of this arrangement, the
Company may be advanced funds up to a defined limit of eligible accounts receivable not to exceed
the borrowing limit. At March 31, 2007 and December 31, 2006, the borrowing limit was $22,500,000,
and no amounts were outstanding. Interest accrues on any outstanding amounts at a varying rate and
is based on the Wells Fargo Bank, N.A. prime rate plus 1.5% (9.75% at March 31, 2007). The annual
facility fee is 0.5% of the total availability. The agreement expires on April 15, 2010.
5. Income Taxes
The Company adopted the provisions of FASB Interpretation No. 48 Accounting for Uncertainty
in Income Taxes (FIN 48) effective January 1, 2007. The adoption did not have a material effect
on the consolidated financial position or results of operations of the Company. At the date of
adoption, the Company had no unrecognized tax benefits. The Company recognizes interest and
penalties related to uncertain tax positions in interest expense and general and administrative
expenses, respectively. As of March 31, 2007, there were no accrued interest or penalties relating
to unrecognized income tax benefits recognized in the statement of operations. There was no accrued
liability for interest or penalties related to unrecognized income tax benefits recognized in the
statement of financial position at March 31, 2007.
The Company is subject to both federal and state income tax for jurisdictions within which it
operates. Within these jurisdictions, the Company is open to examination for tax years ended after
December 31, 2002.
- 13 -
6. Stockholders Equity
The following table summarizes the activity in stockholders equity for the three month period
ended March 31, 2007 (amounts in thousands, except per share data):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Common Stock |
|
|
Additional |
|
|
|
|
|
|
|
|
|
Issued |
|
|
Treasury |
|
|
Paid-In |
|
|
Retained |
|
|
|
|
|
|
Amount |
|
|
Shares |
|
|
Amount |
|
|
Shares |
|
|
Capital |
|
|
Earnings |
|
|
Total |
|
Balances at December 31, 2006 |
|
$ |
177 |
|
|
|
20,682,317 |
|
|
$ |
(2,856 |
) |
|
|
2,950,059 |
|
|
$ |
80,273 |
|
|
$ |
44,295 |
|
|
$ |
121,889 |
|
Net income |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5,785 |
|
|
|
5,785 |
|
Issuance of 1,167 shares of vested restricted stock |
|
|
|
|
|
|
1,167 |
|
|
|
|
|
|
|
|
|
|
|
33 |
|
|
|
|
|
|
|
33 |
|
Nonvested stock compensation |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
194 |
|
|
|
|
|
|
|
194 |
|
Issuance of vested restricted stock |
|
|
|
|
|
|
13,477 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Excess tax benefits from issuance of nonvested stock |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
51 |
|
|
|
|
|
|
|
51 |
|
Issuance of common stock under Employee Stock
Purchase Plan |
|
|
|
|
|
|
3,240 |
|
|
|
|
|
|
|
|
|
|
|
88 |
|
|
|
|
|
|
|
88 |
|
Recording minority interest in joint venture at
redemption value |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
35 |
|
|
|
35 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balances at March 31, 2007 |
|
$ |
177 |
|
|
|
20,700,201 |
|
|
$ |
(2,856 |
) |
|
|
2,950,059 |
|
|
$ |
80,639 |
|
|
$ |
50,115 |
|
|
$ |
128,075 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Share Based Compensation
On January 20, 2005, the board of directors and stockholders of the Company approved the 2005
Long Term Incentive Plan (the Incentive Plan). The Incentive Plan provides for 1,000,000 shares
of common stock that may be issued or transferred pursuant to awards made under the plan. A variety
of discretionary awards for employees, officers, directors and consultants are authorized under the
Incentive Plan, including incentive or non-qualified statutory stock options and restricted stock.
All awards must be evidenced by a written award certificate which will include the provisions
specified by the compensation committee of the board of directors. The compensation committee will
determine the exercise price for non-statutory stock options. The exercise price for any option
cannot be less than the fair market value of our common stock as of the date of grant.
Also on January 20, 2005, the 2005 Director Compensation Plan was adopted. The shares issued
under our 2005 Director Compensation Plan are issued from the 1,000,000 shares reserved for
issuance under our Incentive Plan.
Stock Options
At March 31, 2007, 21,000 options were issued and exercisable. No options were exercised or
forfeited during the three months ended March 31, 2007. There were no options granted during the
three months ended March 31, 2007. There were no options exercised, forfeited or granted during the
three month period ended March 31, 2006.
Nonvested Stock
During the three months ended March 31, 2007, 12,600 nonvested shares of stock were granted to
our independent directors under the 2005 Director Compensation Plan. Of these 12,600 shares, 9,100
shares vest in one year, while the remaining 3,500 shares vest one third immediately, and the
remaining two-thirds vest over the two year period following the grant date. During the three
months ended March 31, 2007, 109,425 nonvested shares were granted to employees pursuant to the
2005 Long-Term Incentive Plan. Of these 109,425 shares, 2,000 shares vest over a three year period
while the remaining 107,425 shares vest over a five year period. The fair value of nonvested shares
is determined based on the closing trading price of the Companys shares on the grant date. The
weighted average grant date fair values of nonvested shares granted during the three month period
ended March 31, 2007 were $30.30.
- 14 -
The following table represents the nonvested stock activity for the three months ended March
31, 2007:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average |
|
|
|
|
grant date fair |
|
|
Number of Shares |
|
value |
Nonvested shares outstanding at December 31, 2006 |
|
|
86,716 |
|
|
$ |
18.29 |
|
Granted |
|
|
122,025 |
|
|
|
30.30 |
|
Vested |
|
|
(14,644 |
) |
|
|
18.96 |
|
Forfeited |
|
|
|
|
|
|
|
|
Nonvested shares outstanding at March 31, 2007 |
|
|
194,097 |
|
|
$ |
25.58 |
|
As of March 31, 2007, there was $4.8 million of total unrecognized compensation cost related
to nonvested shares granted. That cost is expected to be recognized over the weighted average
period of 4.1 years. The total fair value of shares vested in the three month periods ended March
31, 2007 was $397,000. No shares vested in the three months ended March 31, 2006. The Company
records compensation expense related to nonvested share awards at the grant date for shares that
are awarded fully vested, and over the vesting term on a straight line basis for shares that vest
over time. The Company has recorded $227,000 and $96,000 in compensation expense related to
nonvested stock grants in the periods ended March 31, 2007 and 2006 respectively.
Employee Stock Purchase Plan
The Company has a plan whereby eligible employees may purchase the Companys common stock at
95% of the market price on the last day of the calendar quarter. There are 250,000 shares reserved
for the plan. The Company issued 3,240 shares of common stock under the plan at a per share price
of $27.08 during the three months ended March 31, 2007. At March 31, 2007 there were 239,664 shares
available for future issuance.
7. Commitments and Contingencies
Contingencies
The terms of several joint venture operating agreements grant a buy/sell option that would
require the Company to either purchase or sell the existing membership interest in the joint
venture within 30 days of the receipt of the notice to exercise the provision. Either the Company
or its joint venture partner has the right to exercise the buy/sell option. The party receiving the
exercise notice has the right to either purchase the interests held by the other party or sell its
interests to the other party. The purchase price formula for the interests is set forth in the
joint venture agreement and is typically based on a multiple of the earnings before income taxes,
depreciation and amortization of the joint venture. Total revenue earned by the Company from joint
ventures subject to these arrangements was $3.8 million and $3.5 million for the three months ended
March 31, 2007 and 2006, respectively. The Company has not received notice from any joint venture
partners of their intent to exercise the buy/sell option nor has the Company notified any joint
venture partners of any intent to exercise the buy/sell option.
The Company is involved in various legal proceedings arising in the ordinary course of
business. Although the results of litigation cannot be predicted with certainty, management
believes the outcome of pending litigation will not have a material adverse effect, after
considering the effect of the Companys insurance coverage, on the Companys consolidated financial
statements.
Compliance
The laws and regulations governing the Companys operations, along with the terms of
participation in various government programs, regulate how the Company does business, the services
offered, and interactions with patients and the public. These laws and regulations, and their
interpretations, are subject to frequent change. Changes in existing laws or regulations, or their
interpretations, or the enactment of new laws or regulations could materially and adversely affect
the Companys operations and financial condition.
The Company is subject to various routine and non-routine governmental reviews, audits, and
investigations. In recent years, federal and state civil and criminal enforcement agencies have
heightened and coordinated their oversight efforts related to the healthcare industry, including
with respect to referral practices, cost reporting, billing practices, joint ventures, and other
financial relationships among healthcare providers. Violation of the laws governing the Companys
operations, or changes in the interpretation of those laws, could result in the imposition of
- 15 -
fines, civil or criminal penalties, termination of the Companys rights to participate in
federal and state-sponsored programs, and suspension or revocation of the Companys licenses.
If the Companys long-term acute care hospitals fail to meet or maintain the standards for
Medicare certification as long-term acute care hospitals, such as average minimum length of patient
stay, they will receive payments under the prospective payment system applicable to general acute
care hospitals rather than payment under the system applicable to long-term acute care hospitals.
Payments at rates applicable to general acute care hospitals would likely result in the Company
receiving less Medicare reimbursement than currently received for patient services. Moreover, all
of the Companys long-term acute care hospitals are subject to additional Medicare criteria because
they operate as separate hospitals located in space leased from, and located in, a general acute
care hospital, known as a host hospital. This is known as a hospital within a hospital model.
These additional criteria include requirements concerning financial and operational separateness
from the host hospital.
The Company anticipates there may be changes to the standard episode-of-care payment from
Medicare in the future. Due to the uncertainty of the revised payment amount, the Company cannot
estimate the impact that changes in the payment rate, if any, will have on its future financial
statements. In August 2004, the Centers for Medicare and Medicaid Services, or CMS, adopted new
regulations that implement significant changes affecting long-term acute care hospitals. Among
other things, these new regulations, which became effective in October 2004, implemented new rules
that provide long-term acute care hospitals operating in the hospital within a hospital model with
lower rates of reimbursement for Medicare admissions from their host hospitals that are in excess
of specified percentages.
These new rules also reclassified certain long-term acute care hospital diagnosis related
groups, which could result in a decrease in reimbursement rates. Further, the new rules kept in
place the financial penalties associated with the failure to limit to 5% the total number of
Medicare patients discharged to the host hospital and subsequently readmitted to a long-term acute
care hospital located within the host hospital.
The Company believes that it is in material compliance with all applicable laws and
regulations and is not aware of any pending or threatened investigations involving allegations of
potential wrongdoing. While no such regulatory inquiries have been made, compliance with such laws
and regulations can be subject to future government review and interpretation as well as
significant regulatory action, including fines, penalties, and exclusion from the Medicare program.
- 16 -
8. Segment Information
The Companys segments consist of (a) home-based services and (b) facility-based services.
Home-based services include home nursing services and hospice services. Facility-based services
include long-term acute care services and outpatient rehabilitation services. The accounting
policies of the segments are the same as those described in the summary of significant accounting
policies.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended March 31, 2007 (as restated) |
|
|
Home-Based |
|
Facility-Based |
|
|
|
|
Services |
|
Services |
|
Total |
|
|
(in thousands) |
Net service revenue |
|
$ |
55,066 |
|
|
$ |
14,185 |
|
|
$ |
69,251 |
|
Cost of service revenue |
|
|
26,028 |
|
|
|
9,166 |
|
|
|
35,194 |
|
General and administrative expenses |
|
|
17,835 |
|
|
|
5,203 |
|
|
|
23,038 |
|
Operating income (loss) |
|
|
11,203 |
|
|
|
(184 |
) |
|
|
11,019 |
|
Interest expense |
|
|
54 |
|
|
|
29 |
|
|
|
83 |
|
Non-operating income, including gain on sale of assets |
|
|
(204 |
) |
|
|
(89 |
) |
|
|
(293 |
) |
Income from continuing operations before income taxes and
minority interest and cooperative endeavor allocations |
|
|
11,353 |
|
|
|
(124 |
) |
|
|
11,229 |
|
Minority interest and cooperative endeavor allocations |
|
|
1,421 |
|
|
|
386 |
|
|
|
1,807 |
|
Income (loss) from continuing operations before income taxes |
|
|
9,932 |
|
|
|
(510 |
) |
|
|
9,422 |
|
Total assets |
|
$ |
128,165 |
|
|
$ |
35,856 |
|
|
$ |
164,021 |
|
|
|
|
Three Months Ended March 31, 2006 |
|
|
Home-Based |
|
Facility-Based |
|
|
|
|
Services |
|
Services |
|
Total |
|
|
(in thousands) |
Net service revenue |
|
$ |
32,421 |
|
|
$ |
14,047 |
|
|
|
46,468 |
|
Cost of service revenue |
|
|
16,233 |
|
|
|
8,627 |
|
|
|
24,860 |
|
General and administrative expenses |
|
|
11,321 |
|
|
|
3,926 |
|
|
|
15,247 |
|
Operating income |
|
|
4,867 |
|
|
|
1,494 |
|
|
|
6,361 |
|
Interest expense |
|
|
54 |
|
|
|
32 |
|
|
|
86 |
|
Non-operating income, including gain on sale of assets |
|
|
(111 |
) |
|
|
(55 |
) |
|
|
(166 |
) |
Income from continuing operations before income taxes
and minority interest and cooperative endeavor
allocations |
|
|
4,924 |
|
|
|
1,517 |
|
|
|
6,441 |
|
Minority interest and cooperative endeavor allocations |
|
|
557 |
|
|
|
438 |
|
|
|
995 |
|
Income from continuing operations before income taxes |
|
|
4,367 |
|
|
|
1,079 |
|
|
|
5,446 |
|
Total assets |
|
$ |
76,185 |
|
|
$ |
33,952 |
|
|
$ |
110,137 |
|
- 17 -
ITEM 4. CONTROLS AND PROCEDURES
Evaluation of Disclosure Controls and Procedures
On March 31, 2007, LHC Group, Inc. (the Company) management, including the Companys
principal executive and principal financial officers, evaluated the Companys disclosure controls
and procedures and concluded that its disclosure controls and procedures were effective. Subsequent
to that date and in connection with the filing of this Amendment No. 1 to the Companys Form 10-Q
to restate the Companys financial statements and corresponding financial information for the three
months ended March 31, 2007, the Companys management re-evaluated the effectiveness of the
Companys disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the
Securities Exchange Act of 1934, as amended (the Exchange Act)), as of March 31, 2007. As a
result of a material weakness in internal control over financial reporting related to the Companys
procedure for recording contractual adjustments related to commercial contracts in the Long-Term
Acute Care Hospitals (LTACH), the Companys management, including the Companys principal
executive and principal financial officers, has concluded that the Companys disclosure controls
and procedures were not effective as of March 31, 2007. To address the material weakness described
above, the Company has implemented additional manual controls and procedures over the recording of
contractual adjustments related to commercial contracts in the
LTACHs. The Company will work with
outside consultants to continue identifying additional methods of ensuring these controls and
procedures may not be circumvented in the future.
Changes in Internal Controls
Other than the matter described in this Item 4, there have been no significant changes in the
Companys internal control over financial reporting that have materially affected, or are
reasonably likely to materially affect, the Companys internal control over financial reporting. At
the time of the filing of this Amendment No. 1 to Form 10-Q, management is in the process of
remediating the material weakness surrounding the recording of contractual adjustments related to
commercial contracts in the LTACHs noted above through the implementation of manual controls.
- 18 -
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused
this report to be signed on its behalf by the undersigned thereunto duly authorized.
|
|
|
|
|
|
|
LHC GROUP, INC. |
|
|
|
|
|
|
|
Date August 8, 2007
|
|
/s/ Barry E. Stewart |
|
|
|
|
|
|
|
|
|
Barry E. Stewart |
|
|
|
|
Executive Vice President and Chief Financial
Officer |
|
|
- 19 -