UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
FORM 10-K
| (Mark One) | ||
| x |
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
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| For the fiscal year ended December 31, 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 Number: 0-23340
America Service Group Inc.
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Delaware (State or other jurisdiction of incorporation or organization) |
51-0332317 (I.R.S. Employer Identification No.) |
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105 Westpark Drive, Suite 200 Brentwood, Tennessee (Address of principal executive offices) |
37027 (Zip Code) |
Registrants telephone number, including area code: (615) 373-3100
Securities Registered Pursuant to Section 12(b) of the Act:
None
Securities Registered Pursuant to Section 12(g) of the Act:
Common Stock, par value $.01 per share
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 if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to the best of registrants knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K. o
Indicate by check mark whether the registrant is an accelerated filer as defined in Rule 12b-2 of the Act). Yes x No o
The aggregate market value of the Common Stock held by non-affiliates of the registrant as of June 30, 2003 (based on the last reported closing price per share of Common Stock as reported on The Nasdaq National Market on such date) was approximately $112,471,625. The aggregate market value of the Common Stock held by non-affiliates of the registrant as of March 10, 2004 (based on the last reported closing price per share of Common Stock as reported on The Nasdaq National Market on such date) was approximately $239,336,871. As of June 30, 2003 and March 10, 2004, the registrant had 6,333,581 and 7,075,817 shares of Common Stock outstanding, respectively.
Documents Incorporated by Reference
Portions of the Companys Proxy Statement for the 2004 Annual Meeting of Stockholders to be held on June 16, 2004 are incorporated by reference in Part III.
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PART I
Item 1. Business
This Form 10-K contains statements which may constitute forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. Those statements include statements regarding the intent, belief or current expectations of America Service Group Inc. and members of its management team. Prospective investors are cautioned that any such forward-looking statements are not guarantees of future performance and involve a number of risks and uncertainties, and that actual results may differ materially from those contemplated by such forward-looking statements. Important factors currently known to management that could cause actual results to differ materially from those in forward-looking statements are set forth below under the caption Cautionary Statements. Forward-looking statements speak only as of the date they are made, and America Service Group Inc. undertakes no obligation to update or revise forward-looking statements to reflect changed assumptions, the occurrence of unanticipated events or changes to future operating results over time.
General
America Service Group Inc. (ASG or the Company), through its subsidiaries Prison Health Services, Inc. (PHS), EMSA Limited Partnership (EMSA), Correctional Health Services, LLC (CHS) and Secure Pharmacy Plus, LLC (SPP), contracts to provide managed healthcare services, including the distribution of pharmaceuticals, to over 230 correctional facilities throughout the United States. The Company is the leading non-governmental provider of correctional healthcare and pharmacy services in the United States.
ASG was incorporated in 1990 as a holding company for PHS. Unless the context otherwise requires, the terms ASG or the Company refer to ASG and its direct and indirect subsidiaries. ASGs executive offices are located at 105 Westpark Drive, Suite 200, Brentwood, Tennessee 37027. Its telephone number is (615) 373-3100.
Correctional Healthcare Services
The Company contracts with state, county and local governmental agencies to provide healthcare services to inmates of prisons and jails. The Companys revenues from correctional healthcare services are generated primarily by payments from governmental entities, none of which are dependent on third party payment sources. The Company provides a wide range of on-site healthcare programs, as well as off-site hospitalization and specialty outpatient care. The hospitalization and specialty outpatient care is performed through subcontract arrangements with independent doctors and local hospitals. For the year ended December 31, 2003, revenues from correctional healthcare services accounted for 92.6% of the Companys healthcare revenues from continuing operations and discontinued operations combined.
The following table sets forth information regarding the Companys correctional healthcare and pharmacy contracts.
| Historical December 31, |
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| 2003 |
2002 |
2001 |
2000 |
1999 |
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Number of correctional contracts(1) |
120 | 129 | 145 | 130 | 106 | |||||||||||||||
Average number of inmates in all facilities covered
by correctional contracts(2) |
272,175 | 182,327 | 194,137 | 176,563 | 132,304 | |||||||||||||||
| (1) | Indicates the number of contracts in force at the end of the period specified and includes EMSA Military and SPP contracts since acquisition. | |
| (2) | Based on an average number of inmates during the last month of each period specified. The 2003 inmate count also includes inmates under non-comprehensive medical management programs and independent pharmacy distribution contracts which were not included in prior years. |
The Companys target correctional market consists of state prisons and county and local jails. A prison is a facility in which an inmate is incarcerated for an extended period of time (typically one year or longer). A jail is a facility in which the inmate is held for a shorter period of time, often while awaiting trial or sentencing. The higher inmate turnover in jails requires that healthcare be provided to a much larger number of individual inmates over time. Conversely, the costs of chronic healthcare requirements are greater with respect to state prison contracts. State prison contracts often cover a larger number of facilities and often have longer terms than jail contracts.
Services Provided. Generally, the Companys obligation to provide medical services to a particular inmate begins upon the inmates booking into the correctional facility and ends upon the inmates release. Emphasis is placed upon early identification of serious injuries or illnesses so that prompt and clinically-effective treatment is commenced.
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Medical services provided on-site include physical and mental health screening upon intake. Screening includes the compilation of the inmates health history and the identification of any current, chronic or acute healthcare needs. After initial screening, services provided may include regular physical and dental screening and care, psychiatric care, OB-GYN screening and care and diagnostic testing. Hospitalization is provided off-site at acute-care hospitals under contract to the Company. Sick call is regularly conducted and physicians, nurse practitioners, physicians assistants and others are also involved in the delivery of care on a regular basis. Necessary medications are administered by nursing staff.
Medical services provided off-site include specialty outpatient diagnostic testing and care, emergency room care, surgery and hospitalization. In addition, the Company provides administrative support services on-site, at regional offices and at the Companys headquarters. Administrative support services include on-site medical records and management and employee education and licensing. Central and regional offices provide quality assurance, medical audits, credentialing, continuing education and clinical program development activities.
Most of the Companys correctional contracts require it to staff the facilities it serves with nurses 24 hours a day. Doctors at the facilities have regular hours and are generally available on call. In addition, dentists, psychiatrists and other specialists are available on a routine basis at facilities where correctional contracts cover such services. The Company enters into contractual arrangements with independent doctors and local hospitals with respect to more significant off-site procedures and hospitalization. The Company is responsible for all of the costs of these arrangements, unless the relevant contract contains a limit on the Companys obligations in connection with the treatment costs.
The National Commission on Correctional Health Care (the NCCHC) and the American Correctional Association (ACA) set standards for the correctional healthcare industry and offers accreditation to facilities that meet its standards. These standards provide specific guidance related to a service providers operations including administration, personnel, support services such as hospital care, regular services such as sick call, records management and medical and legal issues. Although accreditation is voluntary, many contracts require compliance with NCCHC or ACA standards.
Contract Provisions. The Companys contracts with correctional institutions typically fall into one of three general categories: fixed fee, population based, or cost plus a margin. For fixed fee contracts, the Companys revenues are based on fixed monthly amounts established in the service contract. The Companys revenues for population based contracts are based either on a fixed fee adjusted using a per diem rate for variances in the inmate population from predetermined population levels or on a per diem rate times the average inmate population for the period of service. For cost plus contracts, the Companys revenues are based on actual expenses incurred during the service period plus a contractual margin.
Some contracts provide for annual increases in the fixed fee based upon the regional medical care component of the Consumer Price Index. In all other contracts that extend beyond one year, the Company utilizes a projection of the future inflation rate of its costs of services when bidding and negotiating the fixed fee for future years. The Company often bears the risk of increased or unexpected costs, which could result in reduced profits or cause it to sustain losses when costs are higher than projected and increased profits when costs are lower than projected. Certain contracts also contain financial penalties when performance or staffing criteria are not achieved.
Normally, contracts will also include additional provisions which mitigate a portion of the Companys risk related to cost increases. Off-site utilization risk is mitigated in certain of the Companys contracts through aggregate pools for off-site expenses, stop loss provisions, cost plus fee arrangements or the entire exclusion of off-site service costs. Pharmacy expense risk is similarly mitigated in certain of the Companys contracts. Typically under the terms of such provisions, the Companys revenue under the contract increases to offset increases in specified cost categories such as utilization or pharmaceutical costs. While such provisions serve to mitigate the Companys exposure to losses resulting from cost fluctuations in the specified cost categories, the Company will still experience variances in its margin percentage on these contracts as the additional revenue under these contract provisions is typically equal to the additional costs incurred by the Company. Many contracts contain termination clause provisions which allow the Company to terminate the contract under agreed-upon notice periods. The ability to terminate a contract serves to mitigate the Companys risk of increasing costs of services being provided. Contracts accounting for approximately 98% of the Companys correctional healthcare services revenues from continuing operations for the year ended December 31, 2003 contain one or more of the risk-mitigating provisions.
Contracts accounting for approximately 32% of the Companys correctional healthcare services revenues from continuing operations for the year ended December 31, 2003 contain no limits on the Companys exposure for treatment costs related to catastrophic illnesses or injuries to inmates. However, only 12% of the Companys correctional healthcare services revenues from continuing operations for the year ended December 31, 2003 results from such contracts which do not contain a termination clause provision which allows the Company to terminate the contract under agreed-upon notice periods.
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When preparing bid proposals, the Company estimates the extent of its exposure to cost increases, severe individual cases and catastrophic events and attempts to compensate for its exposure in the pricing of its bids. The Companys management has experience in evaluating these risks for bidding purposes and maintains an extensive database of historical experience. Nonetheless, increased or unexpected costs against which the Company is not protected could render a contract unprofitable. In an effort to manage risk of catastrophic illness or injury of inmates under contracts that do not limit the Companys exposure to such risk, the Company maintains stop loss insurance from an unaffiliated insurer covering 100% of its exposure with respect to catastrophic illnesses or injuries for annual amounts in excess of $500,000 per inmate up to an annual per inmate cap of $2.0 million.
The average length of a contract for services is one to three years, with subsequent renewal options. In general, contracts may be terminated by the governmental agency, and often by the Company as well, without cause at any time upon proper notice. The required notice period for such contracts ranges from one day to one year, but is typically between 30 and 90 days. Governmental agencies may be subject to political influences that could lead to termination of a contract through no fault of the Company. As with other governmental contracts, the Companys contracts are subject to adequate budgeting and appropriation of funds by the governing legislature or administrative body.
Administrative Systems. The Company has centralized its administrative systems in order to enhance economies of scale and to provide management with accurate, up-to-date field data for forecasting purposes. These systems also enable the Company to refine its bids and help the Company reduce the costs associated with the delivery of consistent healthcare.
The Company maintains a utilization review system to monitor the extent and duration of most healthcare services required by inmates on an inpatient and outpatient basis. The current automated utilization review program is an integral part of the services provided at each facility. The system is designed to ensure that the medical care rendered is medically necessary and is provided safely in a clinically appropriate setting while maintaining traditional standards of quality of care. The system provides for determinations of medical necessity by medical professionals through a process of pre-authorization and concurrent review of the appropriateness of any hospital stay. The system seeks to identify the maximum capability of on-site healthcare units to allow for a more timely discharge from the hospital back to the correctional facility. The utilization review staff consists of doctors and nurses who are supported by medical directors at the regional and corporate levels.
The Company has developed a variety of customized databases to facilitate and improve operational review including (i) a claims management tracking system that monitors current outpatient charges and inpatient stays, (ii) a comprehensive cost review system that analyzes the Companys average costs per inmate at each facility including pharmaceutical utilization and trend analysis available from SPP and (iii) a daily operating report to manage staffing and off-site utilization.
Bid Process. Contracts with governmental agencies are obtained primarily through a competitive bidding process, which is governed by applicable state and local statutes and ordinances. Although practices vary, typically a formal request for proposal (RFP) is issued by the governmental agency, stating the scope of work to be performed, length of contract, performance bonding requirements, minimum qualifications of bidders, selection criteria and the format to be followed in the bid or proposal. Usually, a committee appointed by the governmental agency reviews bids and makes an award determination. The committee may award the contract to a particular bidder or decide not to award the contract. The committees consider a number of factors, including the technical quality of the proposal, the bid price and the reputation of the bidder for providing quality care. The award of a contract may be subject to formal or informal protest by unsuccessful bidders through a governmental appeals process. If the committee does not award a contract, the correctional agency will continue to provide healthcare services to its inmates with its own personnel.
Certain RFPs for significant contracts require the bidder to post a bid bond or performance bond. These bonding requirements may cover one year or up to the length of the contract and, at December 31, 2003, generally ranged between 10% and 100% of the annual contract fee.
A successful bidder must often agree to comply with numerous of additional requirements regarding record-keeping and accounting, non-discrimination in the hiring of personnel, safety, safeguarding confidential information, management qualifications, professional licensing requirements, emergency healthcare needs of corrections employees and other matters. If a violation of the terms of an applicable contractual or statutory provision occurs, a contractor may be debarred or suspended from obtaining future contracts for specified periods of time in the applicable location. The Company has never been debarred or suspended in any jurisdiction.
Marketing. The Company gathers, monitors and analyzes relevant information on potential jail and prison systems which meet predefined new business criteria. These criteria include facility size, location, revenue and margin potential and exposure to risk. The Company then devotes the necessary resources in securing new business.
The Company is the largest provider of healthcare services to county/municipal jails and detention centers. The Company will continue to focus its business development efforts on these facilities where stabilization and treatment of the population is the primary
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mission. The Company will also continue to pursue certain opportunities at state prison systems, where in many cases, services are provided to a larger system with a more permanent population. Due to the more permanent population at the state prison facilities, the primary healthcare mission shifts to disease management and treatment.
The Company maintains a staff of sales and marketing representatives assigned to specific projects, geographic areas or markets. In addition, the Company uses consultants to help identify marketing opportunities, to determine the needs of specific potential customers and to engage customers on the Companys behalf. The Company uses paid advertising and promotion to reach prospective clients as well as to reinforce its image with existing clients.
Management believes that the constitutional requirement to provide healthcare to inmates, an increasing inmate population and medical Consumer Price Index, combined with public sector budget deficits, will continue the trend towards privatization of correctional healthcare and present opportunities for revenue growth for the Company.
Pharmaceutical Distribution Services
The Company, through its wholly owned subsidiary, SPP, contracts with federal, state and local governments and certain private entities to distribute pharmaceuticals and certain medical supplies to inmates of correctional facilities. SPPs contracts typically cover one year with renewals upon agreement of both parties. SPP utilizes a packaging and distribution center to fill prescriptions and ship pharmaceuticals to over 370 sites in 33 states covering over 235,000 inmates.
SPP provides clinical pharmacy services in concert with their systematic delivery process. SPPs clinical pharmacological management adds therapeutic value to services as well as fiscal responsibility to its clients. In addition, SPPs medical supply service creates additional value for its clients, as the packaging and delivery mode on certain products is specific to the corrections environment.
SPP is the largest non-governmental provider of correctional pharmacy services in the United States with 2003 revenues of approximately $76 million, $33 million of which relates to services provided for Company-contracted sites, which are eliminated in consolidation. For the year ended December 31, 2003, revenues from correctional pharmacy services, excluding revenues eliminated in consolidation, accounted for approximately 7.4% of the Companys healthcare revenues from continuing operations and discontinued operations combined.
Risk Management
For contracts where the Companys exposure to the risk of inmates catastrophic illness or injury is not limited, the Company maintains stop loss insurance to cover 100% of the Companys exposure with respect to hospitalization for annual amounts in excess of $500,000 per inmate up to an annual per inmate cap of $2.0 million. The Company believes this insurance mitigates its exposure to unanticipated expenses of catastrophic hospitalization. See Correctional Healthcare Services Contract Provisions.
Employees and Independent Contractors
The services provided by the Company require an experienced staff of healthcare professionals and facilities administrators. In particular, a nursing staff with experience in correctional healthcare and specialized skills in all necessary areas contributes significantly to the Companys ability to provide efficient service. In addition to nurses, the Companys staff of employees or independent contractors includes physicians, dentists, psychologists and other healthcare professionals.
As of December 31, 2003, the Company had approximately 6,350 employees, including approximately 800 doctors and 3,050 nurses. The Company also had under contract approximately 300 independent contractors, including physicians, dentists, psychiatrists and psychologists. Of the Companys employees, approximately 1,150 are represented by labor unions. The Company believes that its employee relations are good.
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Competition
The business of providing correctional healthcare services to governmental entities is highly competitive. The Company is in direct competition with local, regional and national correctional healthcare providers. The Company estimates that it has approximately 9.3% of the combined privatized and non-privatized market, based on estimates of national aggregate annual expenditures on correctional healthcare services. Its primary competitors are Correctional Medical Services, which the Company estimates has approximately 7.7% of the combined privatized and non-privatized market, and Wexford Health Sources, Inc., which the Company estimates has approximately 2.1% of such market. As the private market for providing correctional healthcare matures, the Companys competitors may gain additional experience in bidding and administering correctional healthcare contracts. In addition, new competitors, some of whom may have extensive experience in related fields or greater financial resources than the Company, may enter the market.
Major Contracts
The Companys operating revenue with respect to its correctional healthcare operations is derived primarily from contracts with state, county and local governmental entities. The Companys Rikers Island, New York contract accounted for approximately 15.2% of the healthcare revenues from continuing and discontinued operations for the year ended December 31, 2003 on a combined basis. No other contract accounted for 10.0% or more of such revenues during the year ended December 31, 2003.
Rikers Island Contract. The Company, through its subsidiary, PHS, entered into a contract with the New York City Health and Hospitals Corporation (HHC), effective January 1, 2001, to provide, among other things, medical healthcare services to inmates held by the Commissioner of the New York City Department of Corrections. The original term of the contract was three years, with HHC having the option to extend the term for an additional year. During 2003, HHC exercised its option to extend the contract for an additional year through December 31, 2004. Also during 2003, HHC assigned this contract to the New York City Department of Health and Mental Hygiene (NYCDOH). For the Companys services, NYCDOH pays the Company the cost of providing the services rendered under the contract plus 4.25% of reimbursable costs. The Company is subject to mandatory staffing requirements under the contract. NYCDOH is required to indemnify the Company and its employees and independent contractors for damages for personal injuries and/or death alleged to have been sustained by an inmate by reason of malpractice, except where the Companys employees or independent contractors have engaged in intentional misconduct or a criminal act. Either party may terminate the contract without cause at any time on 12 months notice. Either party may terminate on ten days notice for a material breach of the contract subject to certain cure provisions.
Maryland Department of Public Safety and Correctional Services. The Company through PHS, entered into the present Maryland contract with the Maryland Department of Public Safety and Correctional Services (DPS) on July 1, 2000, to provide comprehensive medical services to four regions of the Maryland prison system. The initial term of the contract was for three years ending June 20, 2003, with DPS having the ability to renew the contract for two additional one year terms. The contract is presently in its first renewal term. DPS pays PHS a flat fee per month with certain limited cost sharing adjustments for staffing costs, primarily nurses, and the cost of medications related to certain specific illnesses. The contract also contains provisions that allow DPS to assess penalties if certain staffing or performance criteria are not maintained. The flat fee paid to PHS is increased annually based on a portion of the consumer price index. DPS may terminate the contract by giving notice at least ninety days before the end of a yearly term. PHS does not have a similar ability to terminate the contract. Under the terms of the contract the Company must maintain a performance bond.
Commonwealth of Pennsylvania Department of Corrections. The Company, through PHS, entered into a new contract with the Commonwealth of Pennsylvania Department of Corrections (DOC) on September 1, 2003, for a period of five years for medical services exclusive of mental health and pharmacy. The contract covers the entire 27 Pennsylvania prison system facilities. The DOC pays PHS a flat rate per month, which is adjusted for changes in inmate population levels. Under the terms of the contract, the Company is reimbursed for the costs of the medical malpractice insurance related to this contract and its exposure to off-site medical costs related to this contract is limited to a specified maximum amount. The DOC may terminate the contract on six months notice. After the first eighteen months, PHS may terminate the contract without cause subject to a nine month notice to the DOC.
Cautionary Statements
All statements made by the Company that are not historical facts are based on current expectations. These statements are forward looking in nature and involve a number of risks and uncertainties. Actual results may differ materially from current expectations. Significant factors that could cause actual results to differ materially are the following: termination or expiration of contracts; losses from contracts that the Company cannot terminate; changes in performance bonding requirements; the complexity of and potential changes in government contracting procedures; the risk of debarment or suspension from obtaining future contracts; general business and economic conditions; the results of ongoing litigation or investigations; and the other risk factors described in the Companys reports filed from time to time with the Securities and Exchange Commission. Certain of these factors are described in greater detail below.
Dependence on Client Contracts. The Companys operating revenue is derived almost exclusively from contracts with state, county and local governmental agencies. Generally, contracts may be terminated by the governmental agency at will and without cause upon proper notice (typically between 30 and 90 days). Governmental agencies may be subject to political influences that could lead to termination of a contract through no fault of the Company. Although the Company generally attempts to renew or renegotiate contracts at or prior to their termination, contracts that are put out for bid are subject to intense competition. As a result, the Companys portfolio of contracts is subject to change. The changes in the Companys portfolio of contracts are largely unpredictable, which creates uncertainties about the amount of its total revenues from period to period. The Company must engage in competitive bidding for new business to replace contracts that expire or are terminated. The Company, therefore, has no assurance that it will be able to replace contracts that expire or are terminated.
Dependence on Government Funding. The Companys cash flow is subject to the receipt of sufficient funding of, and timely payment by, the government entities with which it contracts. If a government entity does not receive sufficient funding to cover its obligations under a healthcare services contract, the contract may be terminated or payment for the Companys services could be delayed. The termination of contracts or a significant delay in payment could adversely affect the Companys results of operations or cash flows.
Privatization of Government Services, Competition and Correctional Population. The Companys future revenue growth will depend in part on continued privatization by state, county and local governmental agencies of healthcare services for correctional
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facilities. The Company believes that more than $55 million in annualized correctional healthcare contract revenues were newly privatized in 2003 by governmental agencies either for the first time or as a result of the expansion of existing contracted services to encompass additional or expanded services. There can be no assurance that this market will continue to grow at historical rates or at all, or that existing contracts will continue to be made available to the private sector. Revenue growth could also be adversely affected by material decreases in the inmate population of correctional facilities. Any of these results could cause the Companys revenue to decline and harm its business and operating results.
Competition. The business of providing correctional healthcare services to governmental agencies is highly competitive. The Company is in direct competition with local, regional and national correctional healthcare providers. The Company estimates that it has approximately 9.3% of the combined privatized and non-privatized market, based on national aggregate annual expenditures on correctional healthcare services. Its primary competitors are Correctional Medical Services, which the Company estimates has approximately 7.7% of the combined privatized and non-privatized market, and Wexford Health Sources, Inc., which the Company estimates has approximately 2.1% of such market. As the private market for providing correctional healthcare matures, the Companys competitors may gain additional experience in bidding and administering correctional healthcare contracts. Competitors may use the additional experience to underbid the Company. In addition, new competitors, some of whom may have extensive experience in related fields or greater financial resources than the Company, may enter the market. Increased competition could result in a loss of contracts and market share. Any of these results could seriously harm its business and operating results.
Acquisitions. The Companys expansion strategy involves both internal growth and, as opportunities become available, acquisitions. The Company took significant steps toward implementing this strategy with the EMSA acquisition in January 1999 and the acquisitions of CHS, SPP and certain assets of Correctional Physician Services, Inc. (CPS) during 2000. The Company previously had limited experience acquiring businesses and integrating them into its operations and the inability to successfully integrate future acquisitions would seriously harm the Companys business or operating revenues.
Exposure to Catastrophic Events. Contracts accounting for approximately 32% of the Companys correctional healthcare services revenues from continuing operations for the year ended December 31, 2003 contain no limits on the Companys exposure for treatment costs related to catastrophic illnesses or injuries to inmates. However, only 12% of the Companys correctional healthcare services revenues from continuing operations for the year ended December 31, 2003 results from such contracts which do not contain a termination clause provision which allows the Company to terminate the contract under agreed-upon notice periods. Although the Company attempts to compensate for the increased financial risk when pricing contracts that do not contain catastrophic limits and has not had any catastrophic illnesses or injuries to inmates that exceeded its insurance coverage in the past, there can be no assurance that the Company will not experience a catastrophic illness or injury of a patient that exceeds its coverage in the future. The occurrence of severe individual cases outside of those catastrophic limits could render contracts unprofitable and could have a material adverse effect on the Companys financial condition and results of operations.
Dependence on Key Personnel. The success of the Company depends in large part on the ability and experience of its senior management. The loss of services of one or more key employees could adversely affect the Companys business and operating results. The Company has employment contracts with Michael Catalano, Chairman, President and Chief Executive Officer; Richard D. Wright, Vice Chairman of Operations; Lawrence H. Pomeroy, Senior Vice President and Chief Development Officer; and Michael W. Taylor, Senior Vice President and Chief Financial Officer, as well as certain other key personnel. The Company does not maintain key man life insurance for any member of its senior management.
Dependence on Healthcare Personnel. The Companys success depends on its ability to attract and retain highly skilled healthcare personnel. A shortage of trained and competent employees and/or independent contractors may result in overtime costs or the need to hire less efficient and more costly temporary staff. Attracting qualified nurses at a reasonable cost in some markets has been and continues to be of concern to the Company. Approximately 36% of the Companys contracts contain financial deductions that apply when performance or staffing criteria are not achieved. For the year ended December 31, 2003, the Company incurred revenue deductions related to these criteria totaling approximately $2.1 million, 0.4% of the Companys healthcare revenues from continuing operations and discontinued operations combined. If the Company is not successful in attracting and retaining a sufficient number of qualified healthcare personnel in the future, it may not be able to perform under its contracts, which could lead to the loss of existing contracts or its ability to gain new contracts.
Corporate Exposure to Professional Liability. The Company periodically becomes involved in medical malpractice claims with the attendant risk of substantial damage awards. The most significant source of potential liability in this regard is the risk of suits brought by inmates alleging lack of timely or adequate healthcare services. The Company may be vicariously liable for the negligence of healthcare professionals with whom it contracts. The Companys contracts generally provide for the Company to indemnify the governmental agency for losses incurred related to healthcare provided by the Company and its agents. The Company maintains professional and general liability insurance under which it is subject to substantial self-insurance risks resulting from the use of large deductible policies in 2000 and 2001 and the use of adjustable premium policies in 2002 and 2003. Management establishes reserves for the estimated losses that will be incurred under these insurance policies using internal and external evaluations of the merits of the
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individual claims, analysis of claim history and the estimated reserves assigned by the Companys third-party administrator. The Company requires its independent contractors to maintain professional liability insurance in amounts deemed appropriate by management based upon the Companys claims history and the nature and risks of its business. However, there can be no assurance that a future claim or claims will not exceed managements loss estimates or the limits of available insurance coverage.
Recently, the cost of malpractice and other liability insurance has risen significantly. Adequate levels of insurance may not continue to be available at a reasonable price. The Company is dependent on the financial health of the insurance carriers with whom it has insurance policies. Failure to obtain sufficient levels of professional liability insurance or a deterioration in an insurance carriers financial health may expose the Company to significant losses.
Dependence on Credit Facility. The Companys debt consists of a credit facility dated October 31, 2002 with CapitalSource Finance LLC. The credit facility requires the Company to meet certain financial covenants related to minimum levels of earnings. The financial covenants contained in the credit facility are described in Managements Discussion and Analysis of Financial Condition and Results of Operations Liquidity and Capital Resources contained in this Annual Report on Form 10-K.
The Company is dependent on the availability of borrowings pursuant to this credit facility to meet its working capital needs, capital expenditure requirements and other cash flow requirements during 2004. However, should the Company fail to meet its projected results or fail to remain in compliance with the terms of the credit facility, it may be forced to seek alternative sources of financing in order to fund its working capital needs. No assurances can be made that the Company can obtain alternative financing arrangements on terms acceptable to it, or at all.
Legislative changes. The Administrative Simplification Provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) require the use of uniform electronic data transmission standards for health care claims and payment transactions submitted or received electronically. These provisions are intended to encourage electronic commerce in the health care industry. HIPAA includes regulations on standards to protect the security and privacy of health-related information. The privacy regulations will extensively regulate the use and disclosure of individually identifiable health-related information, whether communicated electronically, on paper or orally. The Company does not electronically file at present, but may do so in the future, subjecting it to regulations of HIPAA.
Performance bonds. The Company is required under certain contracts to provide a performance bond. At December 31, 2003, the Company has outstanding performance bonds totaling $27.9 million. The performance bonds are renewed on an annual basis. The market for performance bonds was severely impacted by certain recent corporate failures and the events of September 11, 2001 and continues to be impacted by general economic conditions. Consequently, the sureties for the Companys performance bond program may require additional collateral to issue or renew performance bonds in support of certain contracts. The letters of credit which the Company utilizes as collateral for its performance bonds reduce availability under the Companys credit facility and limit funds available for debt service and working capital. The Company is also dependant on the financial health of the surety companies that it relies on to issue its performance bonds. An inability to obtain new or renew existing performance bonds could result in limitations on the Companys ability to bid for new or renew existing contracts which could have a material adverse effect on the Companys financial condition and results of operations.
Outcome of Florida Attorney General Investigation. The Company is in discussions with the Florida Attorney Generals office related to allegations that the Company may have played an indirect role in the improper billing of Medicaid by independent providers treating incarcerated patients (see discussion under Item 3. Legal Proceedings). It is possible that this matter could result in a material impact on the Companys financial results as a result of ongoing legal fees related to the matter, potential litigation by the Florida Attorney Generals office or a potential negotiated settlement.
Other Available Information
The Company files its annual report on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K, and all amendments to those reports with the Securities & Exchange Commission (SEC). You may obtain copies of these documents by visiting the SECs Public Reference Room at 450 Fifth Street, NW, Washington, DC 20549, by calling the SEC at 1-800-SEC-0330 or by accessing the SECs website at http://www.sec.gov. In addition, as soon as reasonably practicable, after such materials are filed with or furnished to the SEC, the Company makes copies of these documents available to the public free of charge through its web site at http://www.asgr.com or by contacting its Corporate Secretary at its principal offices, which are located at 105 Westpark Drive, Suite 200, Brentwood, Tennessee 37027, telephone number (615) 373-3100.
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Item 2. Properties
The Company occupies approximately 33,528 square feet of leased office space in Brentwood, Tennessee, where it maintains its corporate headquarters. The Companys lease on its current headquarters expires in April 2009. The Company leases additional office facilities in Franklin, Tennessee; Baltimore and Jessup, Maryland; Alameda, California; Topeka, Kansas; Sunrise, Florida; Verona, New Jersey; Boise, Idaho; Indianapolis, Indiana; Richmond, Virginia; Whitestone, New York; East Pennsboro Township, Pennsylvania; Montgomery, Alabama; and Concordville, Pennsylvania. While the Company may open additional offices to meet the local needs of future contracts awarded in new areas, management believes that its current facilities are adequate for its existing contracts for the foreseeable future.
Item 3. Legal Proceedings
Polk County matter. During 2003, the Company was successful on its appeal of a previous summary judgment granted against it in January 2002 on an indemnification claim by the insurer of a client. The case has now been remanded to the lower court in accordance with the appelate courts opinion as discussed below. In December 1995, the Florida Association of Counties Trust (FACT), as the insurer for the Polk County Sheriffs Office, and the Sheriff of Polk County, Florida, brought an action against PHS in the Circuit Court, 10th Judicial Circuit, Polk County, Florida seeking indemnification for $1.0 million paid on behalf of the plaintiffs for settlement of a lawsuit brought against the Sheriffs Office. The recovery is sought for amounts paid in settlement of a wrongful death claim brought by the estate of an inmate who died as a result of injuries sustained from a beating from several corrections officers employed by the Sheriffs Office. In addition, the Sheriffs Office released the Company from liability for this claim subsequent to filing the lawsuit. The plaintiffs contend that an indemnification provision in the contract between PHS and the Sheriffs Office obligates the Company to indemnify the Sheriffs Office against losses caused by its own wrongful acts. The Company was represented by counsel provided by Reliance Insurance Company (Reliance), the Companys insurer. In April 2001, FACTs motion for summary judgment on the question of liability for indemnity was denied, but on rehearing in July 2001 the prior denial was reversed and summary judgment was granted. In October 2001, Reliance filed for receivership. In January 2002, the court entered final judgment in favor of FACT for approximately $1.7 million at a hearing at which the Company was not represented, as counsel provided by Reliance had simultaneously filed a motion to withdraw. The Company retained new counsel in February 2002 and obtained a reversal of the summary judgment motion on October 31, 2003. In the fourth quarter of 2003, the Companys appeal bond in the amount of $2.0 million was released. At December 31, 2002, the amount paid for the appeal bond was classified as a deposit and included in prepaid expenses and other current assets on the Companys Consolidated Balance Sheets. The case has been remanded to the trial court to determine if the actions of the officers, for which some of them were indicted and convicted, were intentional and whether the claims for which indemnity was sought arose out of the provision of medical services and not the actions of the officers. The Company believes it will be successful at the trial court level. However, in the event that the Company is not successful at the trial court level, an adverse judgment could have a material adverse effect on the Companys financial position and its quarterly or annual results of operations. The Company has entered into possible settlement negotiations with the plaintiffs. As of December 31, 2003, the Company has reserved approximately $500,000 related to probable costs associated with this proceeding.
Florida Attorney General investigation. Two of the Companys operating subsidiaries, EMSA and PHS, have been involved in a sporadic investigation by the Florida Attorney Generals office related to Medicaid reimbursement issues from December 1, 1998 to the present. The Company acquired EMSA in early 1999. Although neither the Company nor its subsidiaries have ever billed Medicaid for reimbursement, the Florida Attorney Generals office has been investigating allegations, first raised related to EMSA in 1997, that correctional healthcare providers may have played an indirect role in the submission by independent healthcare providers of unallowable Medicaid claims for the treatment of inmates. The Company and its subsidiaries are cooperating fully with the investigation. Based upon recent discussions with the Florida Attorney Generals office, the Company believes that the Florida Attorney Generals office intends to pursue a claim against the Company as part of the States industry-wide investigation of billing practices for inmate healthcare in Florida.
As part of these ongoing discussions, the Company requested the medical claims data from the Florida Attorney Generals office that formed the basis for such allegations. This data identifies approximately $3.25 million of Medicaid payments to independent providers from December 1998 through 2003. The Company is currently in the process of reviewing the data and comparing it with its own and other publicly available records to determine the best course of action to resolve this matter. Subject to further analysis of the data by the Company and the Florida Attorney Generals office, the total value of the Medicaid payments in question to independent providers may be more or less than $3.25 million. Should a settlement of this matter become necessary, the Company is not able to predict whether the amount of a settlement would be more or less than $3.25 million. In addition to restitution of amounts ultimately identified as the responsibility of the Company, some portion or all of such Medicaid payments may be subject to additional fines and penalties. The Company will continue to cooperate with the Florida Attorney Generals office to seek a prompt, appropriate resolution. It is possible that this matter could result in a material impact on the Companys financial results as a result of ongoing legal fees related to the matter, potential litigation by the Florida Attorney Generals office or a potential negotiated settlement. At
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this time, the Company cannot quantify or predict the actual impact of this matter on the Companys financial results. Given the uncertain financial resolution of this matter, no contingent liability has been accrued at this time.
Other matters. In addition to the matters discussed above, the Company is a party to various legal proceedings incidental to its business. Certain claims, suits and complaints arising in the ordinary course of business have been filed or are pending against the Company. An estimate of the amounts payable on existing claims for which the liability of the Company is probable is included in accrued expenses at December 31, 2003. The Company is not aware of any material unasserted claims and, based on its past experience, would not anticipate that potential future claims would have a material adverse effect on its consolidated financial position or results of operations.
Item 4. Submission of Matters to a Vote of Security Holders
None.
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PART II
Item 5. Market For Registrants Common Stock, Related Stockholder Matters and Issuer Purchases of Equity Securities
The Companys common stock is traded on The Nasdaq Stock Markets National Market System under the symbol ASGR. As of March 10, 2004, there were approximately 36 registered holders of record of the Companys common stock. The high and low bid prices of the Companys common stock as reported on The Nasdaq Stock Market during each quarter from January 1, 2002 through December 31, 2003 are shown below:
| Quarter Ended |
High |
Low |
||||||
March 31, 2002 |
$ | 8.11 | $ | 3.75 | ||||
June 30, 2002 |
13.00 | 6.75 | ||||||
September 30, 2002 |
13.25 | 8.98 | ||||||
December 31, 2002 |
17.00 | 9.30 | ||||||
March 31, 2003 |
17.22 | 10.70 | ||||||
June 30, 2003 |
18.13 | 11.85 | ||||||
September 30, 2003 |
21.25 | 16.42 | ||||||
December 31, 2003 |
35.78 | 20.65 | ||||||
The Company did not pay cash dividends on its common stock during the years ended December 31, 2003 and 2002. The Company does not presently intend to pay cash dividends on its common stock because, under the terms of its credit facility, the Company is prohibited from paying cash dividends on its common stock.
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Item 6. Selected Financial Data
| For the Year Ended December 31, |
||||||||||||||||||||
| 2003 |
2002 |
2001 |
2000 |
1999 |
||||||||||||||||
| (In thousands, except per share data) | ||||||||||||||||||||
Statement of Operations Data: |
||||||||||||||||||||
Healthcare revenues |
$ | 549,257 | $ | 433,781 | $ | 416,096 | $ | 269,316 | $ | 209,567 | ||||||||||
Income (loss) from continuing operations before income taxes |
15,996 | 4,074 | (27,970 | ) | 3,948 | 2,670 | ||||||||||||||
Income (loss) from continuing operations |
15,115 | 3,743 | (26,118 | ) | 2,190 | 1,603 | ||||||||||||||
Income (loss) from discontinued operations, net of taxes |
(3,240 | ) | 8,158 | (18,725 | ) | 5,617 | 3,037 | |||||||||||||
Net income (loss) attributable to common shares |
11,875 | 11,901 | (45,006 | ) | 7,159 | 2,328 | ||||||||||||||
Net income (loss) per common share basic: |
||||||||||||||||||||
Income (loss) from continuing operations |
2.36 | 0.67 | (4.97 | ) | 0.40 | (0.20 | ) | |||||||||||||
Income (loss) from discontinued operations, net of taxes |
(0.50 | ) | 1.45 | (3.53 | ) | 1.46 | 0.84 | |||||||||||||
Net income (loss) |
1.86 | 2.12 | (8.50 | ) | 1.86 | 0.64 | ||||||||||||||
Net income (loss) per common share diluted: |
||||||||||||||||||||
Net income (loss) from continuing operations |
2.29 | 0.65 | (4.97 | ) | 0.39 | (0.20 | ) | |||||||||||||
Net income (loss) from discontinued operations, net of taxes |
(0.49 | ) | 1.43 | (3.53 | ) | 1.01 | 0.84 | |||||||||||||
Net income (loss) |
1.80 | 2.08 | (8.50 | ) | 1.40 | 0.64 | ||||||||||||||
Weighted average common shares outstanding basic |
6,398 | 5,603 | 5,292 | 3,854 | 3,613 | |||||||||||||||
Weighted average common shares outstanding diluted |
6,604 | 5,718 | 5,292 | 5,587 | 3,613 | |||||||||||||||
Cash dividends per share |
| | | | | |||||||||||||||
See Managements Discussion and Analysis of Financial Condition and Results of Operations and Notes to Consolidated Financial Statements describing the reclassification from continuing operations to discontinued operations of contracts terminating during 2002 and 2003, the financial impact for 2003 and 2002 of adjustments to the loss contract reserve and for 2001 of charges related to goodwill impairment, loss contracts and additional medical claims accruals. During 2000, the Company acquired certain assets of SPP and CPS and purchased all of the outstanding common stock of CHS in three separate purchase transactions. During 1999, the Company purchased all of the outstanding stock of EMSA Government Services, Inc. These acquisitions were accounted for under the purchase method of accounting and the results of operations of the acquired entities have been included in the Companys consolidated operating results since the respective acquisition dates.
| As of December 31, |
||||||||||||||||||||
| 2003 |
2002 |
2001 |
2000 |
1999 |
||||||||||||||||
| (in thousands) | ||||||||||||||||||||
Balance Sheet Data: |
||||||||||||||||||||
Working capital (deficit) |
$ | (19,887 | ) | $ | (38,395 | ) | $ | (3,826 | ) | $ | 15,573 | $ | 9,498 | |||||||
Total assets |
158,423 | 176,048 | 160,380 | 161,402 | 98,727 | |||||||||||||||
Long-term debt, including current portion |
3,559 | 45,996 | 58,100 | 56,800 | 25,500 | |||||||||||||||
Mandatory redeemable preferred stock |
| | | 12,397 | 12,375 | |||||||||||||||
Mandatory redeemable common stock |
| | | | 1,842 | |||||||||||||||
Stockholders equity (deficit) |
38,957 | 14,325 | (3,554 | ) | 28,965 | 16,723 | ||||||||||||||
The working capital deficit as of December 31, 2003, reflects the timing of receipt of revenues versus the payment for healthcare services provided under correctional healthcare services contracts. The working capital deficit as of December 31, 2003 and 2002, includes $365,000 and $41.1 million, respectively, of borrowings outstanding under the Companys revolving credit facility. This revolving credit facility has a maturity date of October 31, 2005; however, due to the presence of a typical material adverse effect clause in the loan agreement combined with the existence of a mandatory lock-box agreement, borrowings outstanding under the revolving credit facility have been classified as a current liability in accordance with the guidance in the Financial Accounting Standard Boards Emerging Issues Task Force Consensus 95-22, Balance Sheet Classification of Borrowings Outstanding Under Revolving Credit Agreements that Include Both a Subjective Acceleration Clause and a Lock-Box Arrangement. For further discussion, see Managements Discussion and Analysis of Financial Condition and Results of Operations Liquidity and Capital Resources or Note 11 to the Companys Consolidated Financial Statements included in this Annual Report.
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Item 7. Managements Discussion and Analysis of Financial Condition and Results of Operations
The following discussion should be read in conjunction with the consolidated financial statements provided under Part II, Item 8 of this Annual Report on Form 10-K.
Critical Accounting Policies And Estimates
General
The Companys discussion and analysis of its financial condition and results of operations are based upon its consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States. The preparation of these financial statements requires the Company to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses, and related disclosure of contingent assets and liabilities. On an on-going basis, the Company evaluates its estimates, including, but not limited to, those related to:
| | revenue and cost recognition (including estimated medical claims), | |||
| | loss contracts, | |||
| | professional and general liability self-insurance retention, | |||
| | other self-funded insurance reserves, | |||
| | legal contingencies, | |||
| | impairment of intangible assets and goodwill, and | |||
| | income taxes. | |||
The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates under different assumptions or conditions.
The Company believes the following critical accounting policies are affected by its more significant judgments and estimates used in the preparation of its consolidated financial statements.
Revenue and Cost Recognition
The Companys contracts with correctional institutions are principally fixed price contracts adjusted for census fluctuations. Such contracts typically have a term of one to three years with subsequent renewal options and generally may be terminated by the correctional institution at will and without cause upon proper notice. The contracts typically contain certain risk sharing arrangements, such as stop-loss provisions and aggregate limits for off-site or pharmaceutical costs. Revenues earned under contracts with correctional institutions are recognized in the period that services are rendered. Cash received in advance for future services is recorded as deferred revenue and recognized as income when the service is performed.
Revenues are calculated based on the specific contract terms and fall into one of three general categories: fixed fee, population based, or cost plus a margin. For fixed fee contracts, revenues are recorded based on fixed monthly amounts established in the service contract. Revenue for population based contracts is calculated either as a fixed fee adjusted using a per diem rate for variances in the inmate population from predetermined population levels or by a per diem rate times the average inmate population for the period of service. For cost plus contracts, revenues are calculated based on actual expenses incurred during the service period plus a contractual margin. For contracts which include provisions limiting the Companys exposure to off-site medical services utilization or pharmacy utilization, the Company recognizes the additional revenue that would be due from clients based on contract to date utilization compared to the corresponding pro rata contractual limit for such costs. Under all contracts, the Company records revenues net of any estimated contractual allowances for potential adjustments resulting from performance or staffing related criteria. If necessary, the Company revises its estimates for such adjustments in future periods when the actual amount of the adjustment is determined.
Revenues for the distribution of pharmaceutical and medical supplies are recognized upon delivery of the related products.
Healthcare expenses include the compensation of physicians, nurses and other healthcare professionals including any related benefits and all other direct costs of providing the managed care including the costs of professional and general liability insurance and other self-funded insurance reserves discussed more fully below. The cost of healthcare services provided or contracted for are recognized in the period in which they are provided based in part on estimates, including an accrual for estimated unbilled medical services rendered through the balance sheet date. The Company estimates the accrual for unbilled medical services using a claims payment lag methodology based upon historical payment patterns using actual utilization data including hospitalization, one day
13
surgeries, physician visits and emergency room and ambulance visits and their corresponding costs. For contracts which have sufficient claims payment history, an actuarial analysis is also prepared monthly by an independent actuary to evaluate the adequacy of the accrual. The analysis takes into account historical claims experience (including the average historical costs and billing lag time for such services) and other actuarial data.
Actual payments and future reserve requirements will differ from the Companys current estimates. The differences could be material if significant adverse fluctuations occur in the healthcare cost structure or the Companys future claims experience. Changes in estimates of claims resulting from such fluctuations and differences between actuarial estimates and actual claims payments are recognized in the period in which the estimates are changed or the payments are made.
Loss Contracts
The Company accrues losses under its fixed price contracts when it is probable that a loss has been incurred and the amount of the loss can be reasonably estimated. The Company performs this loss accrual analysis on a specific contract basis taking into consideration such factors as future contractual revenue, projected future healthcare and maintenance costs, projected future stop-loss insurance recoveries and each contracts specific terms related to future revenue increases as compared to increased healthcare costs. The projected future healthcare and maintenance costs are estimated based on historical trends and managements estimate of future cost increases. These estimates are subject to the same adverse fluctuations and future claims experience as previously noted.
On a quarterly basis, the Company performs a review of its portfolio of contracts for the purpose of identifying loss contracts and developing a contract loss reserve for succeeding periods. As a result of its fourth quarter 2001 review, the Company identified five non-cancelable contracts that, based upon managements projections, were expected to continue to incur negative gross margins over their remaining terms. In December 2001, the Company recorded a charge of $18.3 million to establish a reserve for future losses under these non-cancelable contracts. The five contracts covered by the charge had expiration dates ranging from June 30, 2002 through June 30, 2005. Ninety percent of the charge related to the State of Kansas Department of Corrections (the Kansas DOC) contract, which was to expire on June 30, 2005, and the City of Philadelphia contract, which was renewable annually, at the clients option, through June 30, 2004.
In June 2002, the Company and the City of Philadelphia reached a mutual agreement that the contract between PHS and the City of Philadelphia would expire effective June 30, 2002. As a result of the earlier than anticipated expiration of this loss contract, the Company recorded a gain of $3.3 million, in the second quarter of 2002, to reduce its reserve for loss contracts. From July 1, 2002 to September 30, 2002, the Company provided services to the City of Philadelphia under a transition arrangement. Subsequent to September 30, 2002, the Company is continuing to provide healthcare services to the City of Philadelphia under modified contract terms.
During the quarter ended June 30, 2003, the Company utilized its loss contract reserve at a rate greater than previously anticipated due to an unexpected increase in healthcare expenses associated with the Companys contract to provide services to the Kansas DOC. The primary causes for the increase in healthcare expenses in this contract were hospitalization and outpatient costs. The Company increased its reserve for loss contracts by $4.5 million, as of June 30, 2003, to cover estimated future losses under the Kansas DOC contract, which was to expire in June 2005.
During the second and third quarters of 2003, the Company participated in active discussions with the Kansas DOC related to a proposal from the Company that would significantly reduce the remaining length of the current contract. In response to the proposal, the Kansas DOC solicited and received proposals from several other vendors to provide healthcare services to the Kansas DOC. After the Kansas DOCs evaluation of the proposals from the other vendors, in August 2003, the Company began discussions with Health Cost Solutions, Inc. (HCS) and the Kansas DOC related to a proposal pursuant to which HCS would assume the Companys performance obligation under the Kansas DOC contract.
On August 22, 2003, the Company entered into an assignment and novation agreement with the Kansas DOC to assign the Kansas DOC contract to HCS effective October 1, 2003. The Company also entered into a general assignment, novation and assumption agreement with HCS to transfer the Kansas DOC contract to HCS, effective October 1, 2003. Beginning October 1, 2003, HCS became solely responsible for the performance of the Kansas DOC contract, and the Company has no obligation to the Kansas DOC or to HCS related to HCS performance of the contract. Under the terms of the Companys agreement with HCS, the Company agreed to pay HCS net consideration of $5.6 million in 21 monthly installments, commencing October 31, 2003 and continuing through June 30, 2005. The net consideration of $5.6 million is comprised of payments of $6.5 million to assume the Companys obligations under the Kansas DOC contract, less $0.9 million related to fixed assets and inventory purchased from the Company by HCS.
As a result of the financial terms of the Companys agreement with HCS, in the third quarter of 2003, the Company reclassified $6.5 million of its reserve for loss contracts to accounts payable and recorded a gain of $1.7 million, to reduce its reserve for loss contracts. This reduction in the reserve, as well as the second quarter increase in the reserve of $4.5 million, are reflected as
14
components of income (loss) from discontinued operations, net of tax, in the Companys statements of operations. At December 31, 2003, the Companys payable to HCS totals $5.0 million, with $3.3 million classified as accounts payable and $1.7 million classified as a non-current liability on the Companys Consolidated Balance Sheets.
As of December 31, 2003, the Company had a loss contract reserve totaling $0.7 million, which relates to a county contract that expires on June 30, 2005. Negative gross margin and overhead costs charged against the loss contract reserve related to loss contracts, including contracts classified as discontinued operations, totaled $4.6 million and $6.0 million for the years ended December 31, 2003 and 2002, respectively. The amounts charged against the loss contract reserve during 2002 represented losses associated with all five of the contracts that were identified during 2001. The amounts charged against the loss contract reserve during 2003 relate only to the Kansas DOC contract discussed above and the remaining loss contract, a county contract, which expires on June 30, 2005.
In the course of performing its quarterly review in future periods, the Company might identify additional contracts which have become loss contracts due to a change in circumstances. Circumstances that might change and result in the identification of a contract as a loss contract in a future period include unanticipated adverse changes in the healthcare cost structure or the utilization of outside medical services in a contract where such changes are not offset by increased revenue. Should a contract be identified as a loss contract in a future period, the Company would record, in the period in which such identification is made, a reserve for the estimated future losses that would be incurred under the contract. Such a reserve could have a material adverse effect on the Companys results of operations in the period in which it is recorded.
Professional and General Liability Self-insurance Retention
As a healthcare provider, the Company is subject to medical malpractice claims and lawsuits. The most significant source of potential liability in this regard is the risk of suits brought by inmates alleging lack of timely or adequate healthcare services. The Company may also be liable, as employer, for the negligence of healthcare professionals it employs or the healthcare professionals it engages as independent contractors. The Companys contracts generally require it to indemnify the governmental agency for losses incurred related to healthcare provided by the Company or its agents.
To mitigate a portion of this risk, the Company maintains its primary professional liability insurance program, principally on a claims made basis. However, the Company assumes significant self-insurance risks resulting from the use of large deductibles in 2000 and 2001 and the use of adjustable premium policies in 2002 and 2003. For 2002 and 2003, the Company is covered by separate policies each of which contains a 42-month retro-premium with adjustment based on actual losses after 42 months. The Companys ultimate premium for its 2002 policy and its 2003 policy will depend on the final incurred losses related to each of these separate policy periods. Reserves for estimated losses related to known claims are provided for on an undiscounted basis using internal and external evaluations of the merits of the individual claims, analysis of claim history and the estimated reserves assigned by the Companys third-party administrator. Any adjustments resulting from the review are reflected in current earnings.
In addition to its reserves for known claims, the Company maintains a reserve for incurred but not reported claims. The reserve for incurred but not reported claims is recorded on an undiscounted basis. The Companys estimates of this reserve are supported by an independent actuarial analysis, which is obtained on a quarterly basis.
At December 31, 2003, the Companys reserves for known and incurred but not reported claims totaled $18.3 million. Reserves for medical malpractice liability fluctuate because the number of claims and the severity of the underlying incidents change from one period to the next. Furthermore, payments with respect to previously estimated liabilities frequently differ from the estimated liability. Changes in estimates of losses resulting from such fluctuations and differences between actuarial estimates and actual loss payments are recognized by an adjustment to the reserve for medical malpractice liability in the period in which the estimates are changed or payments are made. The reserves can also be affected by changes in the financial health of the third-party insurance carriers used by the Company. Changes in reserve requirements resulting from a change in the financial health of a third-party insurance carrier are recognized in the period in which such factor becomes known.
Other Self-funded Insurance Reserves
At December 31, 2003, the Company has approximately $6.8 million in accrued liabilities for employee health and workers compensation claims. The Company is significantly self-insured for employee health and workers compensation claims. As such, its insurance expense is largely dependent on claims experience and the ability to control claims. The Company accrues the estimated liability for employee health insurance based on its history of claims experience and the time lag between the incident date and the date of actual claim payment. The Company accrues the estimated liability for workers compensation claims based on internal and external evaluations of the merits of the individual claims, analysis of claim history and the estimated reserves assigned by the Companys third-party administrator. These estimates could change in the future.
15
Legal Contingencies
In addition to professional and general liability claims, the Company is also subject to other legal proceedings in the ordinary course of business. Such proceedings generally relate to labor, employment or contract matters. When estimable, the Company accrues an estimate of the probable costs for the resolution of these claims. Such estimates are developed in consultation with outside counsel handling the Companys defense in these matters and is based upon an estimated range of potential results, assuming a combination of litigation and settlement strategies. Other than the potential impact of the two Florida matters discussed above in Item 3 Legal Proceedings, the Company does not believe these proceedings will have a material adverse effect on its consolidated financial position. However, it is possible that future results of operations for any particular quarterly or annual period could be materially affected by changes in assumptions, new developments or changes in approach, such as a change in settlement strategy in dealing with such litigation.
Intangible Assets and Goodwill
The Company adopted Statement of Financial Accounting Standards No. 142, Goodwill and Other Intangible Assets, (SFAS 142) on January 1, 2002, at which time it ceased amortization of goodwill. In accordance with SFAS 142, goodwill acquired is reviewed for impairment on an annual basis or more frequently whenever events or circumstances indicate that the carrying value may not be recoverable. The Company performed its annual review as of December 31, 2003. Based on the results of this annual review, management has determined that goodwill is not impaired as of December 31, 2003. Future events could cause the Company to conclude that impairment indicators exist and that goodwill is impaired. Any resulting impairment loss could have a material adverse impact on the Companys financial condition and results of operations.
The Companys other identifiable intangible assets, such as customer contracts acquired in acquisitions and covenants not to compete, are amortized on the straight-line method over their estimated useful lives. The Company also assesses the impairment of its other identifiable intangibles whenever events or changes in circumstances indicate that the carrying value may not be recoverable.
Important factors taken into consideration when evaluating the need for an impairment review include the following:
| | significant underperformance or loss of key contracts relative to expected historical or projected future operating results; | |||
| | significant changes in the manner of use of the Companys assets or in the Companys overall business strategy; and | |||
| | significant negative industry or economic trends. | |||
If the Company determines that the carrying value of goodwill may be impaired based upon the existence of one or more of the above indicators of impairment or as a result of its annual impairment review, any impairment is measured using a fair-value-based goodwill impairment test as required under the provisions of SFAS 142. Fair value is the amount at which the asset could be bought or sold in a current transaction between willing parties and may be estimated using a number of techniques, including quoted market prices or valuations by third parties, present value techniques based on estimates of cash flows, or multiples of earnings or revenues. The fair value of the asset could be different using different estimates and assumptions in these valuation techniques.
When the Company determines that the carrying value of other intangible assets may not be recoverable based upon the existence of one or more of the above indicators of impairment, any impairment is measured using an estimate of the assets fair value based on the projected net cash flows expected to result from that asset, including eventual disposition.
Future events could cause the Company to conclude that impairment indic