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 December 31, 2003
OR
| [ ] | 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: 333-94521
IASIS HEALTHCARE CORPORATION
| DELAWARE | 76-0450619 | |
| (State or Other Jurisdiction of | (I.R.S. Employer | |
| Incorporation or Organization) | Identification No.) |
113 SEABOARD LANE, SUITE A-200
FRANKLIN, TENNESSEE 37067
(615) 844-2747
Not Applicable
Indicate by check ü 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 [ü] NO [ ]
Indicate by check mark ü whether the registrant is an accelerated filer (as defined in Rule 12b-2 of the Exchange Act). YES [ ] NO [ü]
As of February 17, 2004, 31,956,113 shares of the Registrants Common Stock were outstanding.
TABLE OF CONTENTS
| PART I - FINANCIAL INFORMATION | 1 | |||||
| Item 1. | Financial Statements | 1 | ||||
| Condensed Consolidated Balance Sheets December 31, 2003 (Unaudited) and September 30, 2003 | 1 | |||||
| Condensed Consolidated Statements of Earnings (Unaudited) Three Months Ended December 31, 2003 and 2002 | 2 | |||||
| Condensed Consolidated Statements of Cash Flows (Unaudited) Three Months Ended December 31, 2003 and 2002 | 3 | |||||
| Notes to Unaudited Condensed Consolidated Financial Statements | 4 | |||||
| Item 2. | Managements Discussion and Analysis of Financial Condition and Results of Operations | 24 | ||||
| Item 3. | Quantitative and Qualitative Disclosures About Market Risk | 32 | ||||
| Item 4. | Controls and Procedures | 33 | ||||
| PART II - OTHER INFORMATION | 33 | |||||
| Item 1. | Legal Proceedings | 33 | ||||
| Item 6. | Exhibits and Reports on Form 8-K | 33 | ||||
PART I
FINANCIAL INFORMATION
Item 1. Financial Statements
IASIS HEALTHCARE CORPORATION
CONDENSED CONSOLIDATED BALANCE SHEETS
(In thousands except share amounts)
| (Unaudited) | ||||||||||||
| December 31, | September 30, | |||||||||||
| 2003 | 2003 | |||||||||||
ASSETS |
||||||||||||
Current assets: |
||||||||||||
Cash and cash equivalents |
$ | 94,970 | $ | 101,070 | ||||||||
Accounts receivable, net of allowance for doubtful accounts of
$71,013 and $47,028, respectively |
161,513 | 153,183 | ||||||||||
Inventories |
23,961 | 23,842 | ||||||||||
Prepaid expenses and other current assets |
15,590 | 16,316 | ||||||||||
Assets held for sale |
11,070 | 11,070 | ||||||||||
Total current assets |
307,104 | 305,481 | ||||||||||
Property and equipment, net |
437,091 | 435,477 | ||||||||||
Goodwill |
252,204 | 252,204 | ||||||||||
Other assets, net |
36,798 | 36,837 | ||||||||||
Total assets |
$ | 1,033,197 | $ | 1,029,999 | ||||||||
LIABILITIES AND STOCKHOLDERS EQUITY |
||||||||||||
Current liabilities: |
||||||||||||
Accounts payable |
$ | 46,337 | $ | 54,172 | ||||||||
Salaries and benefits payable |
25,898 | 29,842 | ||||||||||
Accrued interest payable |
12,617 | 20,978 | ||||||||||
Medical claims payable |
41,290 | 25,767 | ||||||||||
Accrued expenses and other current liabilities |
20,651 | 20,529 | ||||||||||
Current portion of long-term debt and capital lease
obligations |
6,073 | 5,903 | ||||||||||
Total current liabilities |
152,866 | 157,191 | ||||||||||
Long-term debt and capital lease obligations |
656,858 | 658,531 | ||||||||||
Other long-term liabilities |
27,149 | 27,795 | ||||||||||
Minority interest in consolidated entities |
12,007 | 10,383 | ||||||||||
Stockholders equity: |
||||||||||||
Preferred stock $0.01 par value, authorized 5,000,000
shares; no shares issued and outstanding at December 31,
2003 and September 30, 2003 |
| | ||||||||||
Common stock $0.01 par value, authorized 100,000,000 shares;
31,985,029 shares issued and 31,956,113 shares
outstanding at December 31, 2003 and September 30, 2003 |
320 | 320 | ||||||||||
Nonvoting common stock $0.01 par value, authorized
10,000,000 shares; no shares issued and outstanding at
December 31, 2003 and September 30, 2003 |
| | ||||||||||
Additional paid-in capital |
450,720 | 450,720 | ||||||||||
Treasury stock, at cost, 16,306,541 shares at December 31,
2003 and September 30, 2003 |
(155,300 | ) | (155,300 | ) | ||||||||
Accumulated deficit |
(111,423 | ) | (119,641 | ) | ||||||||
Total stockholders equity |
184,317 | 176,099 | ||||||||||
Total liabilities and stockholders equity |
$ | 1,033,197 | $ | 1,029,999 | ||||||||
See accompanying notes.
1
IASIS HEALTHCARE CORPORATION
CONDENSED CONSOLIDATED STATEMENTS OF EARNINGS (UNAUDITED)
(In thousands)
| Three Months Ended | ||||||||||
| December 31, | ||||||||||
| 2003 | 2002 | |||||||||
Net revenue: |
||||||||||
Net acute care revenue |
$ | 249,390 | $ | 217,817 | ||||||
Premium revenue |
68,714 | 36,948 | ||||||||
Total net revenue |
318,104 | 254,765 | ||||||||
Costs and expenses: |
||||||||||
Salaries and benefits |
99,416 | 88,799 | ||||||||
Supplies |
40,279 | 35,683 | ||||||||
Medical claims |
57,771 | 30,901 | ||||||||
Other operating expenses |
55,828 | 46,513 | ||||||||
Provision for bad debts |
25,098 | 19,711 | ||||||||
Interest, net |
13,891 | 13,317 | ||||||||
Depreciation and amortization |
16,731 | 12,851 | ||||||||
Total costs and expenses |
309,014 | 247,775 | ||||||||
Earnings before gain on sale of assets,
minority interests and income taxes |
9,090 | 6,990 | ||||||||
Gain on sale of assets, net |
(151 | ) | (780 | ) | ||||||
Minority interests |
991 | 278 | ||||||||
Earnings before income taxes |
8,250 | 7,492 | ||||||||
Income tax expense |
32 | | ||||||||
Net earnings |
$ | 8,218 | $ | 7,492 | ||||||
See accompanying notes.
2
IASIS HEALTHCARE CORPORATION
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED)
(In thousands)
| Three Months Ended | |||||||||||
| December 31, | |||||||||||
| 2003 | 2002 | ||||||||||
Cash flows from operating activities: |
|||||||||||
Net earnings |
$ | 8,218 | $ | 7,492 | |||||||
Adjustments to reconcile net earnings to
net cash provided by operating activities: |
|||||||||||
Depreciation and amortization |
16,731 | 12,851 | |||||||||
Minority interests |
991 | 278 | |||||||||
Gain on sale of assets, net |
(151 | ) | (780 | ) | |||||||
Changes in operating assets and liabilities,
net of disposals: |
|||||||||||
Accounts receivable |
(8,330 | ) | (1,069 | ) | |||||||
Inventories, prepaid expenses and other
current assets |
607 | (1,041 | ) | ||||||||
Accounts payable and other accrued liabilities |
(5,138 | ) | (9,471 | ) | |||||||
Net cash provided by operating activities |
12,928 | 8,260 | |||||||||
Cash flows from investing activities: |
|||||||||||
Purchases of property and equipment |
(17,362 | ) | (14,415 | ) | |||||||
Proceeds from sale of assets |
151 | 2,463 | |||||||||
Change in other assets |
(946 | ) | (861 | ) | |||||||
Net cash used in investing activities |
(18,157 | ) | (12,813 | ) | |||||||
Cash flows from financing activities: |
|||||||||||
Proceeds from debt borrowings |
| 62,200 | |||||||||
Payment of debt and capital leases |
(1,504 | ) | (57,347 | ) | |||||||
Distribution of minority interests |
(1,343 | ) | (300 | ) | |||||||
Proceeds from hospital syndication |
1,976 | | |||||||||
Net cash (used in) provided by financing activities |
(871 | ) | 4,553 | ||||||||
Decrease in cash and cash equivalents |
(6,100 | ) | | ||||||||
Cash and cash equivalents at beginning of period |
101,070 | | |||||||||
Cash and cash equivalents at end of period |
$ | 94,970 | $ | | |||||||
Supplemental disclosure of cash flow information: |
|||||||||||
Cash paid for interest |
$ | 23,097 | $ | 18,720 | |||||||
Cash paid for income taxes |
$ | 21 | $ | | |||||||
Supplemental schedule of noncash investing and financing activities: |
|||||||||||
Capital lease obligations incurred to acquire
equipment |
$ | | $ | 3,318 | |||||||
See accompanying notes.
3
IASIS HEALTHCARE CORPORATION
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
1. Basis of Presentation
The unaudited condensed consolidated financial statements include the accounts of IASIS Healthcare Corporation (IASIS or the Company) and all subsidiaries and entities under common control of the Company and have been prepared in accordance with accounting principles generally accepted in the United States for interim financial reporting and in accordance with Rule 10-01 of Regulation S-X. Accordingly, they do not include all of the information and notes required by accounting principles generally accepted in the United States for complete financial statements. The condensed and consolidated balance sheet at September 30, 2003 has been derived from the audited consolidated financial statements at that date but does not include all of the information and footnotes required by accounting principles generally accepted in the United States for complete financial statements. For further information, refer to the consolidated financial statements and footnotes thereto included in the Companys Annual Report on Form 10-K for the fiscal year ended September 30, 2003.
In the opinion of management, the accompanying unaudited condensed consolidated financial statements contain all material adjustments (consisting of normal recurring items) necessary for a fair presentation of results for the interim periods presented. The results of operations for any interim period are not necessarily indicative of results for the full year.
The preparation of the financial statements in conformity with accounting principles generally accepted in the United States requires management to make estimates and assumptions that affect the amounts reported in the accompanying unaudited condensed consolidated financial statements and notes. Actual results could differ from those estimates.
IASIS owns and operates medium-sized acute care hospitals in high-growth urban and suburban markets. At December 31, 2003, the Company owned or leased 14 acute care hospitals, with a total of 2,024 beds in service, located in four regions:
| - | Salt Lake City, Utah; | ||
| - | Phoenix, Arizona; | ||
| - | Tampa-St. Petersburg, Florida; and | ||
| - | four cities in Texas, including San Antonio. |
The Company also owns and operates a behavioral health center in Phoenix and has an ownership interest in three ambulatory surgery centers. In addition, the Company owns and operates a Medicaid managed health plan in Phoenix called Health Choice Arizona, Inc. (Health Choice or the Plan), serving over 90,000 members at December 31, 2003. As more fully described in note 10, the Company acquired Lake Mead Hospital Medical Center in Las Vegas, Nevada on February 1, 2004.
2. Recently Issued Accounting Pronouncements
In November 2002, the Financial Accounting Standards Board, (the FASB) issued Interpretation No. 45, Guarantors Accounting and Disclosure Requirements for Guarantees (FIN 45). FIN 45 requires a guarantor to recognize, at the inception of a guarantee, a liability for the fair value of the obligation it has undertaken in issuing the guarantee. The Company will apply FIN 45 to guarantees, if any, issued or modified after December 31, 2002. The adoption of FIN 45 did not have a material effect on the Companys consolidated financial position or results of operations.
In January 2003, the FASB issued Interpretation No. 46, Consolidation of Variable Interest Entities (VIEs), an Interpretation of Accounting Research Bulletin No. 51 (FIN 46). FIN 46 requires certain VIEs to be consolidated by the primary beneficiary of the entity if the equity investors in the entity do not have the characteristics of a controlling financial interest or do not have sufficient equity at risk for the equity for the entity to finance its activities without additional subordinated financial support from other parties. FIN 46 is effective for all new VIEs created or acquired after January 31, 2003. For VIEs created or acquired prior to February 1, 2003, the
4
IASIS HEALTHCARE CORPORATION
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
provisions of FIN 46 must be applied for the first interim or annual period ending after December 15, 2003. The adoption of FIN 46 did not have a material effect on the Companys results of operations or financial position.
In May 2003, the FASB Issued Statement of Financial Accounting Standards No. 149, Amendment of Statement 133 on Derivative Instruments and Hedging Activities (SFAS 149). SFAS 149 amends and clarifies financial accounting and reporting for derivative instruments, including certain derivative instruments embedded in other contracts (collectively referred to as derivatives) and for hedging activities under FASB Statement No. 133, Accounting for Derivative Instruments and Hedging Activities. Most provisions of SFAS 149 are effective for contracts entered into or modified after June 30, 2003, and for hedging relationships designated after June 30, 2003. SFAS 149 is not expected to have a material effect on the Companys financial statements. The Company held no derivative instruments as of and for the three months ended December 31, 2003.
In May 2003, the FASB issued Statement of Financial Accounting Standards No. 150, Accounting for Certain Financial Instruments with Characteristics of both Liabilities and Equity (SFAS 150). SFAS 150 establishes standards for how an issuer classifies and measures in its statement of financial position certain financial instruments with characteristics of both liabilities and equity. It requires that an issuer classify a financial instrument that is within its scope as a liability (or an asset in some circumstances) because that financial instrument embodies an obligation of the issuer. SFAS 150 is effective for financial instruments entered into or modified after May 31, 2003, and otherwise is effective at the beginning of the first interim period beginning after June 15, 2003. The adoption of this Statement did not have a material effect on the Companys financial position or results of operations.
3. Long-Term Debt and Capital Lease Obligations
Long-term debt and capital lease obligations consist of the following (in thousands):
| December 31, | September 30, | |||||||
| 2003 | 2003 | |||||||
Bank facilities |
$ | 322,000 | $ | 322,875 | ||||
Senior subordinated notes |
330,000 | 330,000 | ||||||
Capital lease obligations and other |
10,931 | 11,559 | ||||||
| 662,931 | 664,434 | |||||||
Less current maturities |
6,073 | 5,903 | ||||||
| $ | 656,858 | 658,531 | ||||||
Bank Facilities
On February 7, 2003, the Company completed the refinancing of its credit facility to provide for a new $475.0 million credit facility in the form of a $350.0 million, six year term B loan and a $125.0 million, five year revolving credit facility (the 2003 credit facility). Proceeds from the 2003 credit facility were used to refinance amounts outstanding under the 1999 credit facility and to fund closing and other transaction related costs of $10.9 million incurred in connection with the refinancing. The $125.0 million revolving credit facility is available for working capital and other general corporate purposes. Principal payments on the term B loan are due in quarterly installments of $875,000 until maturity. The 2003 credit facility is also subject to mandatory prepayment under specific circumstances including a portion of excess cash flow and the net proceeds from an initial public offering, asset sales, debt issuances and specified casualty events, each subject to various exceptions. The 2003 credit facility included a 1% prepayment penalty on voluntary prepayments under the term loan, which lapsed on February 7, 2004.
The 2003 credit facility was amended on June 6, 2003 to allow for the issuance of the Companys 8½% senior subordinated notes, as discussed below. On February 9, 2004, the 2003 credit facility was further amended
5
IASIS HEALTHCARE CORPORATION
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
to, among other things, reduce the applicable margin on the term loans by 150 basis points and increase the annual capital expenditure limitations beginning in fiscal year 2005.
The 2003 credit facility requires that the Company comply with various other financial ratios and tests and contains covenants limiting the Companys ability to, among other things, incur debt, engage in acquisitions or mergers, sell assets, make investments or capital expenditures, make distributions or stock repurchases and pay dividends.
The 2003 credit facility is guaranteed by all of the Companys material subsidiaries (the Subsidiary Guarantors) and these guaranties are secured by a pledge of substantially all of the Subsidiary Guarantors assets. Substantially all of the Companys outstanding common stock is pledged for the benefit of the Companys lenders as security for the Companys obligations under the 2003 credit facility.
At December 31, 2003, there was $322.0 million outstanding under the six-year term B loan and no amounts outstanding under the revolving credit facility. The revolving credit facility includes a $75.0 million sub-limit for letters of credit that may be issued. At December 31, 2003, the Company had issued $40.3 million in letters of credit. The loans under the credit facilities accrued interest at variable rates at specified margins above either the agent banks alternate base rate or its reserve-adjusted Eurodollar rate. The weighted average interest rate of outstanding borrowings under the 2003 credit facility was approximately 5.40% for the three months ended December 31, 2003. The Company pays a commitment fee equal to 0.5% of the average daily amount available under the revolving credit facility.
13% Senior Subordinated Notes
On October 13, 1999, the Company issued $230.0 million of 13% senior subordinated notes due 2009. On May 25, 2000, the Company exchanged all of its outstanding 13% senior subordinated notes due 2009 for 13% senior subordinated exchange notes due 2009 that have been registered under the Securities Act of 1933, as amended (the 1999 Notes). Terms and conditions of the exchange offer were as set forth in the registration statement on Form S-4 filed with the Securities and Exchange Commission that became effective on April 17, 2000. The 1999 Notes are unsecured obligations and are subordinated in right of payment to all existing and future senior indebtedness of the Company. Interest on the 1999 Notes is payable semi-annually on April 15 and October 15.
Except with respect to a change of control, the Company is not required to make mandatory redemption or sinking fund payments with respect to the 1999 Notes. The Company may redeem the 1999 Notes, in whole or in part, at any time from October 15, 2004 to October 14, 2008 at redemption prices ranging from 106.500% to 101.625%, plus accrued and unpaid interest. Thereafter, the Company may redeem the 1999 Notes at a 100% redemption price plus accrued and unpaid interest. The 1999 Notes are guaranteed, fully and unconditionally, jointly and severally, by the Subsidiary Guarantors. The Company is a holding company with no independent assets or operations apart from its ownership of the Subsidiary Guarantors. At December 31, 2003, all of the Subsidiary Guarantors fully and unconditionally guaranteed the 1999 Notes and, with the exception of Odessa Regional Hospital, LP, Jordan Valley Hospital, LP, The Medical Center of Southeast Texas, LP and Davis Hospital & Medical Center, LP, all were 100% owned by the Company. The indenture for the 1999 Notes contains certain covenants, including but not limited to, restrictions on new indebtedness, asset sales, capital expenditures, dividends and the Companys ability to merge or consolidate.
8½% Senior Subordinated Notes
On June 6, 2003, the Company issued $100.0 million of 8-1/2% senior subordinated notes due 2009. On August 14, 2003, the Company exchanged all of its outstanding 8-1/2% senior subordinated notes due 2009 for 8-1/2% senior subordinated notes due 2009 that have been registered under the Securities Act of 1933, as amended (the 2003 Notes). Terms and conditions of the exchange offer were as set forth in the registration statement on Form S-4 filed with the Securities and Exchange Commission that became effective on July 16, 2003. The 2003 Notes are unsecured obligations and are subordinated in right of payment to all existing and future senior indebtedness of the Company. Interest on the 2003 Notes is payable semi-annually on April 15 and October 15.
6
IASIS HEALTHCARE CORPORATION
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
Except with respect to a change of control, the Company is not required to make mandatory redemption or sinking fund payments with respect to the 2003 Notes. Subject to certain conditions, at any time prior to June 15, 2006, the Company may on any one or more occasions redeem up to 35.0% of the aggregate principal amount of 2003 Notes at a redemption price of 108.5% of the principal amount thereof, plus accrued and unpaid interest to the redemption date, with the net cash proceeds of one or more equity offerings. The Company may redeem the 2003 Notes, in whole or in part, at any time from June 15, 2006 to June 14, 2008 at redemption prices ranging from 104.250% to 102.125%, plus accrued and unpaid interest. Thereafter, the Company may redeem the 2003 Notes at a 100% redemption price plus accrued and unpaid interest. The 2003 Notes are guaranteed, fully and unconditionally, jointly and severally, by the Subsidiary Guarantors, except Health Choice Arizona, Inc. The indenture for the 2003 Notes contains certain covenants, including but not limited to, restrictions on new indebtedness, asset sales, capital expenditures, dividends and the Companys ability to merge or consolidate.
4. Stock Benefit Plans
The Company, from time to time, grants stock options for a fixed number of common shares to employees. Statement of Financial Accounting Standards (SFAS) No. 123, Accounting for Stock-Based Compensation, encourages, but does not require, companies to record compensation cost for stock-based employee compensation plans at fair value. The Company has chosen to account for employee stock option grants in accordance with Accounting Principles Board Opinion No. 25, Accounting for Stock Issued to Employees, and, accordingly, uses the intrinsic method to value options and recognizes no compensation expense for the stock option grants when the exercise price of the options equals, or is greater than, the market value of the underlying stock on the date of grant. Pro forma information regarding interim net earnings is required by SFAS No. 148, Accounting for Stock-Based Compensation Transition and Disclosure, and has been determined as if the Company had accounted for its employee stock options under the fair value method. If the Company had measured compensation cost for the stock options granted under the fair value based method prescribed by SFAS No. 123, the Companys net earnings (loss) would have been changed to the pro forma amounts set forth below (in thousands):
| Three months ended, | ||||||||
| December 31, | December 31, | |||||||
| 2003 | 2002 | |||||||
Net earnings, as reported |
$ | 8,218 | $ | 7,492 | ||||
Less: stock-based compensation expense
determined under fair value based method |
(375 | ) | (372 | ) | ||||
Pro forma net earnings |
$ | 7,843 | $ | 7,120 | ||||
The effect of applying SFAS No. 123 for providing pro forma disclosure is not likely to be representative of the effect on reported net earnings for future years.
5. Contingencies
Net Revenue
The calculation of appropriate payments from the Medicare and Medicaid programs as well as terms governing agreements with other third party payors are complex and subject to interpretation. Final determination of amounts earned under the Medicare and Medicaid programs often occurs subsequent to the year in which services are rendered because of audits by the programs, rights of appeal and the application of numerous technical provisions. As a result, there is at least a reasonable possibility that recorded estimates will change by a material amount in the near term. In the opinion of management, adequate provision has been made for adjustments that may result from such routine audits and appeals.
7
IASIS HEALTHCARE CORPORATION
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
Professional, General and Workers Compensation Liability Risks
The Company is subject to claims and legal actions in the ordinary course of business, including claims relating to patient treatment and personal injuries. To cover these types of claims, the Company maintains general liability and professional liability insurance in excess of self-insured retentions through a commercial insurance carrier in amounts that the Company believes to be sufficient for its operations, although, potentially, some claims may exceed the scope of coverage in effect. Plaintiffs in these matters may request punitive or other damages that may not be covered by insurance. The Company is currently not a party to any such proceedings that, in the Companys opinion, would have a material adverse effect on the Companys business, financial condition or results of operations. The Company expenses an estimate of the costs it expects to incur under the self-insured retention exposure for general and professional liability claims using historical claims data, demographic factors, severity factors, current incident logs and other actuarial analysis. As of December 31, 2003 and September 30, 2003, the Companys professional and general liability accrual for asserted and unasserted claims was approximately $23.8 million and $24.3 million, respectively, which is included within other long-term liabilities in the accompanying condensed consolidated balance sheets.
The Company is subject to claims and legal actions in the ordinary course of business relative to workers compensation and other labor and employment matters. To cover these types of claims, the Company maintains workers compensation insurance coverage with a self-insured retention. The Company accrues costs of workers compensation claims based upon estimates derived from its claims experience.
Health Choice
Health Choice has entered into a capitated contract whereby the Plan provides healthcare services in exchange for fixed periodic and supplemental payments from AHCCCS. These services are provided regardless of the actual costs incurred to provide these services. The Company receives reinsurance and other supplemental payments from AHCCCS to cover certain costs of healthcare services that exceed certain thresholds. The Company believes the capitated payments, together with reinsurance and other supplemental payments are sufficient to pay for the services Health Choice is obligated to deliver. As of December 31, 2003, the Company has provided a performance guaranty in the form of a letter of credit in the amount of $20.6 million for the benefit of AHCCCS to support its obligations under the Health Choice contract to provide and pay for the healthcare services. Additionally, Health Choice maintains a cash balance of $5 million and an intercompany demand note with the Company. The amount of the performance guaranty is based upon the membership in the plan and the related capitation revenue paid to us.
Capital Expenditure Commitments
The Company is expanding and renovating some of its facilities to permit additional patient volume and to provide a greater variety of services. At December 31, 2003, the Company had various projects under construction with an estimated additional cost to complete and equip of approximately $109.8 million.
Tax Sharing Agreement
The Company and some of its subsidiaries are included in JLL Healthcare, LLCs consolidated group for U.S. federal income tax purposes as well as in some consolidated, combined or unitary groups which include JLL Healthcare, LLC for state, local and foreign income tax purposes. The Company and JLL Healthcare, LLC entered into a tax sharing agreement in connection with the capitalization of the Company. The tax sharing agreement requires the Company to make payments to JLL Healthcare, LLC such that, with respect to tax returns for any taxable period in which the Company or any of its subsidiaries is included in JLL Healthcare, LLCs consolidated group or any combined group, including JLL Healthcare, LLC, the amount of taxes to be paid by the Company will be determined, subject to some adjustments, as if the Company and each of its subsidiaries included in JLL Healthcare, LLCs consolidated group or a combined group including JLL Healthcare, LLC filed their own consolidated, combined or unitary tax return.
8
IASIS HEALTHCARE CORPORATION
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
Each member of a consolidated group for U.S. federal income tax purposes is jointly and severally liable for the federal income tax liability of each other member of the consolidated group. Accordingly, although the tax sharing agreement allocates tax liabilities between the Company and JLL Healthcare, LLC, for any period in which the Company is included in JLL Healthcare, LLCs consolidated group, the Company could be liable in the event that any federal tax liability was incurred, but not discharged, by any other member of JLL Healthcare, LLCs consolidated group.
Acquisitions
The Company may choose to acquire businesses with prior operating histories. If acquired, such companies may have unknown or contingent liabilities, including liabilities for failure to comply with healthcare laws and regulations, such as billing and reimbursement, fraud and abuse and similar anti-referral laws. Although the Company has policies designed to conform business practices to its policies following the completion of any acquisitions, there can be no assurance that the Company will not become liable for previous activities of prior owners that may later be asserted to be improper by private plaintiffs or government agencies. Although the Company generally would seek to obtain indemnification from prospective sellers covering such matters, there can be no assurance that any such matter will be covered by indemnification, or if covered, that such indemnification will be adequate to cover potential losses and fines.
Other
The Company has been advised that its hospital in San Antonio, Texas, Southwest General Hospital, is a subject of an investigation relating to the provision of hyperbaric oxygen therapy services. In a letter dated February 11, 2003, the U.S. Attorney for the Western District of Texas stated that the investigation relates to certain billing practices for these services since 1998. The Company is cooperating with the U.S. Attorneys office with respect to this investigation. Based on information currently available, the Company believes the investigation relates primarily to the period when Tenet Healthcare Corporation (Tenet) owned the hospital. Although the Company is unable to predict the outcome of this investigation, management does not currently believe it will have a material adverse effect on the Companys business, financial condition or results of operations.
Tenet and its affiliates are defendants in a civil action brought on January 9, 2003 in the U.S. District Court for the Central District of California by the United States for the improper assignment of diagnostic codes and submitting false claims to Medicare. The litigation stems from an investigation by the U.S. Department of Justice, in conjunction with the Office of Inspector General, of certain hospital billings to Medicare for inpatient stays reimbursed pursuant to diagnosis related groups 79 (pneumonia), 415 (operating room procedure for infectious and parasitic diseases), 416 (septicemia) and 475 (respiratory system diagnosis with mechanical ventilator). Although hospitals that the Company acquired from Tenet are referenced in the complaint, all of the actions complained of occurred prior to December 31, l998 and thus before the hospitals acquisition by the Company. The Company has informed Tenet that the Company has no obligation or liability for any of the matters described in the complaint and that the Company is entitled to indemnification if any damages or relief were to be sought against IASIS in connection with the proceeding. Tenet has accepted service of process on behalf of these hospitals and has agreed to indemnify the Company.
The Company believes 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 that it believes would have a material effect on its financial statements. 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 and Medicaid programs.
6. Segment and Geographic Information
The Companys acute care hospitals and related healthcare businesses are similar in their activities and the economic environments in which they operate (i.e., urban and suburban markets). Accordingly, the Companys reportable operating segments consist of (1) acute care hospitals and related healthcare businesses, collectively, and
9
IASIS HEALTHCARE CORPORATION
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
(2) its Medicaid managed health plan, Health Choice and a related entity (collectively referred to as Health Choice). The following is a financial summary by business segment for the periods indicated:
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IASIS HEALTHCARE CORPORATION
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
| For the Three Months Ended December 31, 2003 | |||||||||||||||||
| Acute Care | Health Choice | Eliminations | Consolidated | ||||||||||||||
Net acute care revenue |
$ | 249,390 | $ | | $ | | $ | 249,390 | |||||||||
Premium revenue |
| 68,714 | |||||||||||||||