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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

FORM 10-Q

     
(Mark One)
 
x   QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES
EXCHANGE ACT OF 1934
     
    For the Quarterly Period Ended June 30, 2003
     
    OR
     
o   TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES
EXCHANGE ACT OF 1934

For the transition period from                     to                    

Commission File No. 0-27640

RENAL CARE GROUP, INC.

(Exact name of registrant as specified in its charter)
     
Delaware
(State or other jurisdiction of
incorporation or organization)
  62-1622383
(I.R.S. Employer Identification No.)

2525 West End Avenue, Suite 600, Nashville, Tennessee 37203
(Address of principal executive offices) (Zip code)

Registrant’s telephone number, including area code: (615) 345-5500

     Indicate by check mark whether the Registrant (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 x     No o

     Indicate by check mark whether the registrant is an accelerated filer (as defined in Exchange Act Rule 12b-2). Yes x     No o

     Indicate the number of shares outstanding of each of the issuer’s classes of common stock as of the latest practicable date.

     
Class   Outstanding at August 6, 2003
Common Stock, $.01 par value   49,198,412

 


TABLE OF CONTENTS

PART I — FINANCIAL INFORMATION
ITEM 1. FINANCIAL STATEMENTS
Condensed Consolidated Balance Sheets
Condensed Consolidated Income Statements
Condensed Consolidated Statements of Cash Flows
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.
RISK FACTORS
ITEM 4. CONTROLS AND PROCEDURES
PART II — OTHER INFORMATION
ITEM 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS.
ITEM 6. EXHIBITS AND REPORTS ON FORM 8-K.
EX-10.17 EMPLOYMENT AGREEMENT
EX-10.18.4 SECOND AMENDMENT TO LOAN AGREEMENT
EX-10.68.1 AMENDMENT NO. 1 TO PLAN AGREEMENT
EX-10.70 STOCK OPTION AGREEMENT
EX-31.1 SECTION 302 CEO CERTIFICATION
EX-31.2 SECTION 302 CFO CERTIFICATION
EX-32.1 SECTION 906 CEO CERTIFICATION
EX-32.2 SECTION 906 CFO CERTIFICATION


Table of Contents

RENAL CARE GROUP, INC.

INDEX

                 
            Page No.
           
PART I — FINANCIAL INFORMATION
Item 1.
  Financial Statements        
 
  Condensed Consolidated Balance Sheets -
       
 
       December 31, 2002 and June 30, 2003 (unaudited)     1  
 
  Condensed Consolidated Income Statements - (unaudited)
       
 
       For the three months and six months ended June 30, 2002 and 2003     2  
 
  Condensed Consolidated Statements of Cash Flows - (unaudited)
       
 
       For the six months ended June 30, 2002 and 2003     3  
 
  Notes to Condensed Consolidated Financial Statements     4  
Item 2.
  Management's Discussion and Analysis of Financial Condition and        
 
       Results of Operations     8  
 
  Risk Factors     12  
Item 4.
  Controls and Procedures     20  
PART II — OTHER INFORMATION
Item 4.
  Submission of Matters to a Vote of Security Holders     21  
Item 6.
  Exhibits and Reports on Form 8-K     21  
 
Note: Item 3 of Part I, and Items 1, 2, 3, and 5 of Part II are omitted because they are not applicable

 


Table of Contents

PART I — FINANCIAL INFORMATION

ITEM 1. FINANCIAL STATEMENTS

RENAL CARE GROUP, INC.
Condensed Consolidated Balance Sheets
(in thousands, except per share data)

                   
      December 31,   June 30,
      2002   2003
     
 
          (unaudited)
ASSETS
               
Current assets:
               
 
Cash and cash equivalents
  $ 38,359     $ 83,344  
 
Accounts receivable, net
    152,440       162,994  
 
Inventories
    23,336       15,209  
 
Prepaid expenses and other current assets
    19,486       21,079  
 
Deferred income taxes
    12,240       12,240  
 
 
   
     
 
Total current assets
    245,861       294,866  
Property, plant and equipment, net
    202,972       215,519  
Intangible assets, net
    12,110       12,730  
Other assets
    3,514       3,232  
Goodwill
    275,666       279,490  
 
 
   
     
 
Total assets
  $ 740,123     $ 805,837  
 
 
   
     
 
LIABILITIES AND STOCKHOLDERS’ EQUITY
               
Current liabilities:
               
 
Accounts payable and accrued expenses
  $ 101,213     $ 86,623  
 
Due to third-party payors
    32,611       40,656  
 
Income taxes payable
    1,423       6,334  
 
Current portion of long-term debt
    133       357  
 
 
   
     
 
Total current liabilities
    135,380       133,970  
Long-term debt, net of current portion
    10,161       2,697  
Other long-term liabilities
          4,792  
Deferred income taxes
    19,288       19,288  
Minority interest
    31,406       31,637  
 
 
   
     
 
Total liabilities
    196,235       192,384  
 
 
   
     
 
Commitments and contingencies
               
Stockholders’ equity:
               
 
Preferred stock, $0.01 par value, 10,000 shares authorized, none issued
           
 
Common stock, $0.01 par value, 90,000 shares authorized, 51,176 and 52,201 shares issued at December 31, 2002 and June 30, 2003, respectively
    512       522  
 
Treasury stock, 2,983 and 3,135 shares of common stock at December 31, 2002 and June 30, 2003, respectively
    (93,953 )     (98,333 )
 
Additional paid-in capital
    309,355       335,725  
 
Retained earnings
    327,974       375,539  
 
 
   
     
 
Total stockholders’ equity
    543,888       613,453  
 
 
   
     
 
Total liabilities and stockholders’ equity
  $ 740,123     $ 805,837  
 
 
   
     
 

See accompanying notes to condensed consolidated financial statements.

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RENAL CARE GROUP, INC.
Condensed Consolidated Income Statements
(in thousands, except per share data)
(unaudited)

                                   
      Three Months Ended   Six Months Ended
      June 30,   June 30,
     
 
      2002   2003   2002   2003
     
 
 
 
Net revenue
  $ 222,169     $ 247,061     $ 428,847     $ 489,204  
Operating costs and expenses:
                               
 
Patient care costs
    145,750       159,998       280,462       317,475  
 
General and administrative expenses
    18,787       21,187       36,347       47,475  
 
Provision for doubtful accounts
    5,736       6,468       11,220       12,880  
 
Depreciation and amortization
    9,933       11,579       19,295       21,877  
 
   
     
     
     
 
Total operating costs and expenses
    180,206       199,232       347,324       399,707  
 
   
     
     
     
 
Income from operations
    41,963       47,829       81,523       89,497  
Interest expense, net
    138       165       311       450  
 
   
     
     
     
 
Income before minority interest and income taxes
    41,825       47,664       81,212       89,047  
Minority interest
    5,307       6,029       10,017       12,337  
 
   
     
     
     
 
Income before income taxes
    36,518       41,635       71,195       76,710  
Provision for income taxes
    13,876       15,822       27,060       29,145  
 
   
     
     
     
 
Net income
  $ 22,642     $ 25,813     $ 44,135     $ 47,565  
 
   
     
     
     
 
Net income per share:
                               
 
Basic
  $ 0.46     $ 0.53     $ 0.89     $ 0.98  
 
   
     
     
     
 
 
Diluted
  $ 0.44     $ 0.52     $ 0.86     $ 0.96  
 
   
     
     
     
 
Weighted average shares outstanding:
                               
 
Basic
    49,474       48,537       49,450       48,359  
 
   
     
     
     
 
 
Diluted
    51,369       49,931       51,296       49,681  
 
   
     
     
     
 

See accompanying notes to condensed consolidated financial statements.

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RENAL CARE GROUP, INC.
Condensed Consolidated Statements of Cash Flows
(in thousands)
(unaudited)

                     
        Six Months Ended
        June 30,
       
        2002   2003
       
 
OPERATING ACTIVITIES
               
Net income
  $ 44,135     $ 47,565  
Adjustments to reconcile net income to net cash provided by operating activities:
               
 
Depreciation and amortization
    19,295       21,877  
 
Loss on disposal of property and equipment
          312  
 
Distributions to minority shareholders
    (3,425 )     (12,381 )
 
Income applicable to minority interest
    10,017       12,337  
 
Changes in operating assets and liabilities, net of effects from acquisitions
    6,669       5,404  
 
   
     
 
   
Net cash provided by operating activities
    76,691       75,114  
INVESTING ACTIVITIES
               
Purchases of property and equipment
    (30,250 )     (34,517 )
Cash paid for acquisitions, net of cash acquired
    (18,932 )     (5,492 )
Change in other assets
    (2,190 )     (780 )
 
   
     
 
   
Net cash used in investing activities
    (51,372 )     (40,789 )
FINANCING ACTIVITIES
               
Net payments of debt
    (1,536 )     (7,240 )
Net proceeds from issuance of common stock
    8,339       22,280  
Investment by joint venture partner
    2,896        
Repurchase of treasury shares
    (22,223 )     (4,380 )
 
   
     
 
   
Net cash (used in) provided by financing activities
    (12,524 )     10,660  
 
   
     
 
Increase in cash and cash equivalents
    12,795       44,985  
Cash and cash equivalents at beginning of period
    27,423       38,359  
 
   
     
 
Cash and cash equivalents at end of period
  $ 40,218     $ 83,344  
 
   
     
 

See accompanying notes to condensed consolidated financial statements.

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RENAL CARE GROUP, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
JUNE 30, 2003
(dollars in thousands, except per share data)
(unaudited)

1. Basis of Presentation

Overview

     Renal Care Group, Inc. provides dialysis services to patients with chronic kidney failure, also known as end-stage renal disease (ESRD). As of June 30, 2003, the Company provided dialysis and ancillary services to over 21,100 patients through 278 owned outpatient dialysis centers in 27 states, in addition to providing acute dialysis services at approximately 120 hospitals.

     Renal Care Group’s net revenue has been derived primarily from the following sources:

    outpatient hemodialysis services;
 
    ancillary services associated with dialysis, primarily the administration of erythropoietin (also known as Epogen® or EPO);
 
    home dialysis services;
 
    inpatient hemodialysis services provided to acute care hospitals and skilled nursing facilities;
 
    laboratory services; and
 
    management contracts with hospital-based and medical university dialysis programs.

     Most patients with end-stage renal disease receive three dialysis treatments each week in an outpatient setting. Reimbursement for these services is provided primarily by the Medicare ESRD program based on rates established by the Centers for Medicare and Medicaid Services (CMS). For the six months ended June 30, 2003, approximately 55% of the Company’s net revenue was derived from reimbursement under the Medicare and Medicaid programs. Medicare reimbursement is subject to rate and other legislative changes by Congress and periodic changes in regulations, including changes that may reduce payments under the ESRD program. Neither Congress nor CMS approved an increase in the composite rate for either 2002 or 2003.

     The Medicare composite rate applies to a designated group of outpatient dialysis services, including the dialysis treatment, supplies used for the treatment, certain laboratory tests and medications, and most of the home dialysis services provided by Renal Care Group. The Company receives separate reimbursement outside the composite rate for some other services, drugs, including specific drugs such as EPO, and some physician-ordered tests, including laboratory tests, provided to dialysis patients.

     If a patient has private health insurance, that patient’s treatment is typically reimbursed at rates significantly higher than Medicare during the first 30 months of care. After that period Medicare becomes the primary payor. Reimbursement for dialysis services provided pursuant to a hospital contract is negotiated with the individual hospital and is usually higher than the Medicare composite rate. Because dialysis is a life-sustaining therapy to treat a chronic disease, utilization is predictable and is not subject to seasonal fluctuations.

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     Renal Care Group derives a significant portion of its net revenue and net income from the administration of EPO. EPO is manufactured by a single company, Amgen Inc. In April 2002, Amgen implemented its third EPO price increase of 3.9% in as many years. Because the Company was already under contract with Amgen through 2002, this price increase did not affect its results of operations during 2002. Key components of the 2002 pricing formula were maintained in the Company’s 2003 contract with Amgen. Therefore, while the 2002 price increases have had and will continue to have an adverse affect on the Company’s 2003 results of operations, the Company believes it will be able to mitigate approximately 80% of the increase.

Interim Financial Statements

     In the opinion of management, the information contained in this quarterly report on Form 10-Q reflects all adjustments necessary to make the results of operations for the interim periods a fair representation of such operations. All such adjustments are of a normal recurring nature. Operating results for interim periods are not necessarily indicative of results that may be expected for the year as a whole. The Company suggests that persons read these financial statements in conjunction with the consolidated financial statements and the related notes thereto included in the Company’s Form 10-K, as filed with the SEC on March 18, 2003.

2. Net Income per Share

     The following table sets forth the computation of basic and diluted net income per share (shares in thousands):

                                     
        Three Months Ended   Six Months Ended
        June 30,   June 30,
       
 
        2002   2003   2002   2003
       
 
 
 
Numerator:
                               
 
Numerator for basic and diluted net income per
share — net income
  $ 22,642     $ 25,813     $ 44,135     $ 47,565  
Denominator:
                               
 
Denominator for basic net income per share —
weighted-average shares
    49,474       48,537       49,450       48,359  
 
Effect of dilutive securities:
                               
   
Stock options
    1,798       1,394       1,749       1,322  
   
Warrants
    97             97        
 
   
     
     
     
 
 
Denominator for diluted net income per share — adjusted weighted-average shares and assumed conversions
    51,369       49,931       51,296       49,681  
 
   
     
     
     
 
Net income per share:
                               
   
Basic
  $ 0.46     $ 0.53     $ 0.89     $ 0.98  
 
   
     
     
     
 
   
Diluted
  $ 0.44     $ 0.52     $ 0.86     $ 0.96  
 
   
     
     
     
 

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3. Stock-Based Compensation

     The Company accounts for stock-based compensation to employees and directors using the intrinsic value method in accordance with the provisions of Accounting Principles Board Opinion No. 25, Accounting for Stock Issued to Employees, and related Interpretations. In accordance with that opinion, the Company recognizes no compensation expense when it grants fixed options to employees and directors, because the exercise price of the stock options equals or exceeds the market price of the underlying stock on the dates of grant. Option grants to medical directors and non-vested stock grants are expensed over their vesting periods.

     The following table represents the pro forma effect on net income and net income per share as if the Company had applied the fair value based method and recognition provisions of Statement of Financial Accounting Standards No. 123, Accounting for Stock-Based Compensation, (SFAS No. 123) to stock-based compensation to employees and directors:

                                   
      Three Months Ended   Six Months Ended
      June 30,   June 30,
     
 
      2002   2003   2002   2003
     
 
 
 
Net income, as reported
  $ 22,642     $ 25,813     $ 44,135     $ 47,565  
Add: stock-based compensation expense, net of related tax effects, included in the determination of net income as reported
    95       283       190       344  
Less: stock-based compensation expense, net of related tax effects, determined by the fair value-based method
    (1,884 )     (2,276 )     (3,724 )     (4,763 )
 
   
     
     
     
 
Pro forma net income
  $ 20,853     $ 23,820     $ 40,601     $ 43,146  
 
   
     
     
     
 
Net income per share:
                               
 
Basic, as reported
  $ 0.46     $ 0.53     $ 0.89     $ 0.98  
 
   
     
     
     
 
 
Basic, pro forma
  $ 0.42     $ 0.49     $ 0.82     $ 0.89