UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
FORM 10-Q
(Mark One)
þ
|
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 | |
| For the Quarterly Period Ended March 31, 2005 | ||
| 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: 333-117362
IASIS HEALTHCARE LLC
| DELAWARE (State or Other Jurisdiction of Incorporation or Organization) |
20-1150104 (I.R.S. Employer Identification No.) |
DOVER CENTRE
117 SEABOARD LANE, BUILDING E
FRANKLIN, TENNESSEE 37067
(Address of Principal Executive Offices)
(615) 844-2747
(Registrants Telephone Number, Including Area Code)
Not Applicable
(Former Name, Former Address and Former Fiscal Year,
if Changed Since Last Report)
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 þ NO o
Indicate by check mark whether the registrant is an accelerated filer (as defined in Rule 12b-2 of the Exchange Act). YES o NO þ
As of May 9, 2005, 100% of the registrants common interests outstanding (all of which are privately owned and are not traded on any public market) were owned by IASIS Healthcare Corporation, its sole member.
TABLE OF CONTENTS
i
PART I
Item 1. Financial Statements
IASIS HEALTHCARE LLC
| (Unaudited) | September 30, | |||||||
| March 31, 2005 | 2004 | |||||||
| ASSETS | ||||||||
Current assets: |
||||||||
Cash and cash equivalents |
$ | 75,066 | $ | 98,805 | ||||
Accounts receivable, net of allowance for doubtful accounts of
$102,428 and $94,139, respectively |
180,769 | 165,280 | ||||||
Inventories |
27,926 | 26,253 | ||||||
Deferred income taxes |
34,654 | | ||||||
Prepaid expenses and other current assets |
27,907 | 21,297 | ||||||
Total current assets |
346,322 | 311,635 | ||||||
Property and equipment, net |
616,887 | 532,459 | ||||||
Goodwill |
745,350 | 252,204 | ||||||
Other intangible assets, net |
43,500 | | ||||||
Unallocated purchase price |
| 585,013 | ||||||
Other assets, net |
39,996 | 42,850 | ||||||
Total assets |
$ | 1,792,055 | $ | 1,724,161 | ||||
| LIABILITIES AND EQUITY | ||||||||
Current liabilities: |
||||||||
Accounts payable |
$ | 64,518 | $ | 61,295 | ||||
Salaries and benefits payable |
33,669 | 36,463 | ||||||
Accrued interest payable |
17,513 | 13,821 | ||||||
Medical claims payable |
55,699 | 55,421 | ||||||
Other accrued expenses and other current liabilities |
23,740 | 26,142 | ||||||
Current portion of long-term debt and capital lease obligations |
7,378 | 10,728 | ||||||
Total current liabilities |
202,517 | 203,870 | ||||||
Long-term debt and capital lease obligations |
900,518 | 902,026 | ||||||
Deferred income taxes |
35,394 | | ||||||
Other long-term liabilities |
38,631 | 31,596 | ||||||
Minority interest |
12,883 | 12,964 | ||||||
Equity: |
||||||||
Members equity |
602,112 | 573,705 | ||||||
Total liabilities and equity |
$ | 1,792,055 | $ | 1,724,161 | ||||
See accompanying notes.
1
IASIS HEALTHCARE LLC
| Predecessor | Predecessor | |||||||||||||||
| Three Months | Three Months | Six Months | Six Months | |||||||||||||
| Ended | Ended | Ended | Ended | |||||||||||||
| March 31, 2005 | March 31, 2004 | March 31, 2005 | March 31, 2004 | |||||||||||||
Net revenue: |
||||||||||||||||
Acute care revenue |
$ | 302,719 | $ | 286,213 | $ | 586,493 | $ | 535,603 | ||||||||
Premium revenue |
87,538 | 69,302 | 173,739 | 138,016 | ||||||||||||
Total net revenue |
390,257 | 355,515 | 760,232 | 673,619 | ||||||||||||
Costs and expenses: |
||||||||||||||||
Salaries and benefits |
112,725 | 110,487 | 219,234 | 209,903 | ||||||||||||
Supplies |
49,289 | 46,301 | 94,655 | 86,580 | ||||||||||||
Medical claims |
75,433 | 57,880 | 148,768 | 115,651 | ||||||||||||
Rents and leases |
7,991 | 7,766 | 15,850 | 15,566 | ||||||||||||
Other operating expenses |
54,205 | 50,701 | 107,240 | 98,728 | ||||||||||||
Provision for bad debts |
30,715 | 32,169 | 62,970 | 57,268 | ||||||||||||
Interest expense, net |
14,007 | 13,878 | 28,677 | 27,769 | ||||||||||||
Depreciation and amortization |
17,659 | 17,248 | 35,883 | 33,979 | ||||||||||||
Management fees |
963 | | 1,921 | | ||||||||||||
Write-off of debt issue costs |
| 8,850 | | 8,850 | ||||||||||||
Total costs and expenses |
362,987 | 345,280 | 715,198 | 654,294 | ||||||||||||
Earnings before gain (loss) on
sale of assets, minority
interests and income taxes |
27,270 | 10,235 | 45,034 | 19,325 | ||||||||||||
Gain (loss) on sale of assets, net |
(9 | ) | 3,602 | (82 | ) | 3,753 | ||||||||||
Minority interests |
(1,141 | ) | (1,033 | ) | (2,274 | ) | (2,024 | ) | ||||||||
Earnings before income taxes |
26,120 | 12,804 | 42,678 | 21,054 | ||||||||||||
Income tax expense |
10,324 | 953 | 16,921 | 985 | ||||||||||||
Net earnings |
$ | 15,796 | $ | 11,851 | $ | 25,757 | $ | 20,069 | ||||||||
See accompanying notes.
2
IASIS HEALTHCARE LLC
| Predecessor | ||||||||
| Six Months | Six Months | |||||||
| Ended March 31, | Ended March 31, | |||||||
| 2005 | 2004 | |||||||
Cash flows from operating activities: |
||||||||
Net earnings |
$ | 25,757 | $ | 20,069 | ||||
Adjustments to reconcile net earnings to net
cash provided by operating activities: |
||||||||
Depreciation and amortization |
35,883 | 33,979 | ||||||
Minority interests |
2,274 | 2,024 | ||||||
Deferred income taxes |
16,148 | | ||||||
Loss (gain) on sale of assets |
82 | (3,753 | ) | |||||
Write-off of debt issue costs |
| 8,850 | ||||||
Changes in operating assets and liabilities: |
||||||||
Accounts receivable |
(15,489 | ) | (12,388 | ) | ||||
Establishment of accounts receivable of
recent acquisition |
| (10,338 | ) | |||||
Inventories, prepaid expenses and other
current assets |
(8,283 | ) | (3,645 | ) | ||||
Accounts payable and other accrued
liabilities |
3,684 | 28,439 | ||||||
Net cash provided by operating activities |
60,056 | 63,237 | ||||||
Cash flows from investing activities: |
||||||||
Purchase of property and equipment |
(75,611 | ) | (51,524 | ) | ||||
Cash paid for acquisition |
(410 | ) | (23,032 | ) | ||||
Proceeds from sale of assets |
| 14,928 | ||||||
Change in other assets |
(75 | ) | (1,761 | ) | ||||
Net cash used in investing activities |
(76,096 | ) | (61,389 | ) | ||||
Cash flows from financing activities: |
||||||||
Proceeds from debt borrowings |
2,274 | | ||||||
Payment of debt and capital leases |
(7,132 | ) | (3,083 | ) | ||||
Debt financing costs incurred |
(487 | ) | (1,024 | ) | ||||
Distribution of minority interests |
(2,354 | ) | (1,817 | ) | ||||
Proceeds received from hospital syndication |
| 1,801 | ||||||
Net cash used in financing activities |
(7,699 | ) | (4,123 | ) | ||||
Decrease in cash and cash equivalents |
(23,739 | ) | (2,275 | ) | ||||
Cash and cash equivalents at beginning of period |
98,805 | 101,070 | ||||||
Cash and cash equivalents at end of period |
$ | 75,066 | $ | 98,795 | ||||
Supplemental disclosure of cash flow information: |
||||||||
Cash paid for interest |
$ | 28,032 | $ | 30,553 | ||||
Cash paid for income taxes, net |
$ | 1,881 | $ | 21 | ||||
Supplemental schedule of noncash investing
activities: |
||||||||
Capital lease obligations incurred to acquire
equipment |
$ | | $ | 1,419 | ||||
Property and equipment in accounts payable |
$ | 14,904 | $ | 3,186 | ||||
See accompanying notes.
3
IASIS HEALTHCARE LLC
1. Organization and Basis of Presentation
On June 22, 2004, an investor group led by Texas Pacific Group acquired IASIS Healthcare Corporation (IAS or the Predecessor) through a merger (the Merger). In order to consummate the Merger, the investor group established IASIS Investment LLC, a Delaware limited liability company (IASIS Investment), and capitalized it with cash and shares of IASs common stock. The initial capital contributed by the investor group was contributed by IASIS Investment to a wholly owned subsidiary of IASIS Investment, which merged with and into IAS. In the Merger, IAS issued shares of common and preferred stock to IASIS Investment, which became the sole stockholder of IAS after giving effect to the Merger.
Prior to the Merger, IAS contributed substantially all of its assets and liabilities to IASIS Healthcare LLC, a newly formed Delaware limited liability company (IASIS LLC), in exchange for all of the equity interests in IASIS LLC. As a result, IAS is a holding company and IASs operations are conducted by IASIS LLC and its subsidiaries. References herein to the Company are to IASIS LLC and its subsidiaries and, unless indicated otherwise or the context requires, include the Predecessor.
For a discussion of the Merger and related financing transactions, see Notes 3 and 4 to these unaudited condensed consolidated financial statements. The Merger, the related financing transactions and the use of the proceeds from the financing transactions are referred to herein as the Transactions.
The accompanying unaudited condensed consolidated financial statements for the three and six months ended March 31, 2004 reflect the results of operations and cash flows of the Predecessor. The unaudited condensed consolidated financial statements as of and for the three and six months ended March 31, 2005 reflect the financial position, results of operations and cash flows of IASIS LLC.
The Merger has been accounted for as a purchase in accordance with Statement of Financial Accounting Standards (SFAS) No. 141, Business Combinations. Because of this accounting treatment the consolidated financial statements of IASIS LLC reflect a step-up in basis of related net assets upon the allocation of the purchase price.
IASIS LLC owns and operates medium-sized acute care hospitals in high-growth urban and suburban markets. At March 31, 2005, the Company owned or leased 15 acute care hospitals and one behavioral health hospital, with a total of 2,232 beds in service, located in five regions:
| | Salt Lake City, Utah; | |||
| | Phoenix, Arizona; | |||
| | Tampa-St. Petersburg, Florida; | |||
| | Las Vegas, Nevada; and | |||
| | four cities in Texas, including San Antonio. | |||
On April 16, 2005, the Company opened a new hospital in Port Arthur, Texas. Substantially all of the operations of Mid-Jefferson Hospital in Nederland, Texas, and Park Place Medical Center in Port Arthur, Texas, moved to the new hospital. As a result, the Company currently operates 14 acute care hospitals. The Company also owns and operates a Medicaid managed health plan in Phoenix called Health Choice Arizona, Inc. (Health Choice or the Plan), serving over 112,000 members at March 31, 2005. In addition, the Company has an ownership interest in three ambulatory surgery centers.
The unaudited condensed consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles 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 U.S. generally accepted accounting principles for complete financial statements. The condensed consolidated balance sheet of the Company at September 30, 2004 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
4
IASIS HEALTHCARE LLC
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
statements and footnotes thereto included in the Companys Annual Report on Form 10-K for the fiscal year ended September 30, 2004.
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 U.S. generally accepted accounting principles 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.
The unaudited condensed consolidated financial statements include all subsidiaries and entities under common control of the Company. Control is generally defined by the Company as ownership of a majority of the voting interest of an entity. Significant intercompany transactions have been eliminated. Investments in entities that the Company does not control, but in which it has a substantial ownership interest and can exercise significant influence, are accounted for using the equity method.
The majority of the Companys expenses are cost of revenue items. Costs that could be classified as general and administrative by the Company include the IASIS LLC corporate office costs, which were $9.5 million and $8.1 million for the three months ended March 31, 2005 and 2004 and $18.3 million and $16.4 million for the six months ended March 31, 2005 and 2004, respectively.
2. Recently Issued Accounting Pronouncements
In December 2004, the Financial Accounting Standards Board (the FASB) issued SFAS No. 123 (revised 2004), Share-Based Payment (SFAS 123(R)), which is a revision of SFAS No. 123, Accounting for Stock-Based Compensation (SFAS 123). SFAS 123(R) supersedes APB Opinion No. 25, Accounting for Stock Issued to Employees (APB 25), and amends SFAS No. 95, Statement of Cash Flows. Generally, the approach in SFAS 123(R) is similar to the approach described in SFAS 123. However, SFAS 123(R) requires all share-based payments to employees, including grants of employee stock options, to be recognized in the income statement based on their fair values. Pro forma disclosure is no longer an alternative. Under SFAS No. 123(R) the Company must determine the appropriate fair value model to be used for valuing share-based payments, the amortization method for compensation cost and the transition method to be used at the date of adoption. The transition alternatives include prospective and retroactive adoption methods. The Company expects to adopt SFAS 123(R) on October 1, 2006. The Company is evaluating the requirements of SFAS No. 123(R), as well as related guidance recently issued by the SEC. Management of the Company has not yet determined the method of adoption or the effect of adopting the new standard.
3. Long-Term Debt and Capital Lease Obligations
Long-term debt and capital lease obligations consist of the following (in thousands):
| March 31, | September 30, | |||||||
| 2005 | 2004 | |||||||
Senior secured credit facilities |
$ | 421,813 | $ | 423,938 | ||||
Senior subordinated notes |
475,000 | 478,500 | ||||||
Capital lease obligations and other |
11,083 | 10,316 | ||||||
| 907,896 | 912,754 | |||||||
Less current maturities |
7,378 | 10,728 | ||||||
| $ | 900,518 | $ | 902,026 | |||||
5
IASIS HEALTHCARE LLC
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
Senior Secured Credit Facilities
As part of the Transactions, the Company entered into an amended and restated senior credit agreement with various lenders and Bank of America, N.A., as administrative agent, and repaid all outstanding indebtedness under IASs existing bank credit facility.
The senior secured credit facilities consist of a senior secured term loan of $425.0 million (the Term Facility) and a senior secured revolving credit facility of $250.0 million (the Revolving Facility). The Term Facility has a maturity of seven years, with principal due in 24 consecutive equal quarterly installments in an aggregate annual amount equal to 1.0% of the original principal amount of the Term Facility during the first six years thereof, with the balance payable in four equal installments in year seven. Unless terminated earlier, the Revolving Facility has a single maturity of six years. The senior secured credit facilities are also subject to mandatory prepayment under specific circumstances, including a portion of excess cash flow, a portion of the net proceeds from an initial public offering, asset sales, debt issuances and specified casualty events, each subject to various exceptions.
The term loans under the Term Facility bear interest at a rate equal to LIBOR plus 2.25% per annum or, at the Companys option, the base rate plus 1.25% per annum. As of March 31, 2005, loans under the Revolving Facility bear interest at a rate equal to LIBOR plus 2.25% per annum or, at the Companys option, the base rate plus 1.25% per annum, and may increase or decrease by 0.25% based on the Companys total leverage ratio.
All of the obligations under the senior secured credit facilities are guaranteed by IAS and the Companys existing and subsequently acquired or organized domestic subsidiaries (except Health Choice and Biltmore Surgery Center Limited Partnership).
The senior secured credit facilities are secured by first priority security interests in substantially all assets of the Company and the guarantors thereunder. In addition, the senior secured credit facilities are secured by a first priority security interest in 100% of the common interests of the Company and 100% of the capital stock of each of the Companys present and future domestic subsidiaries to the extent owned by the Company or a guarantor, and all intercompany debt owed to the Company or any guarantor.
The senior secured credit facilities contain a number of covenants that, among other things, limit the Companys ability and the ability of its subsidiaries to (i) dispose of assets; (ii) incur additional indebtedness; (iii) incur guarantee obligations; (iv) repay other indebtedness; (v) pay certain restricted payments and dividends; (vi) create liens on assets or prohibit liens securing the new senior secured credit facilities; (vii) make investments, loans or advances; (viii) restrict distributions to the Company; (ix) make certain acquisitions; (x) engage in mergers or consolidations; (xi) enter into sale and leaseback transactions; (xii) engage in certain transactions with subsidiaries and affiliates; or (xiii) amend the terms of the 8 3/4% notes, and otherwise restrict corporate activities. In addition, under the senior secured credit facilities, the Company is required to comply with specified financial ratios and tests, including a minimum interest coverage ratio, a maximum leverage ratio and maximum capital expenditures.
At March 31, 2005, $421.8 million was outstanding under the Term Facility and no amounts were outstanding under the Revolving Facility. The Term Facility includes a $75.0 million sublimit for letters of credit that may be issued. At March 31, 2005, the Company had $38.3 million in letters of credit outstanding. The Company pays a commitment fee equal to 0.5% of the average daily amount available under the Revolving Facility. The weighted average interest rate of outstanding borrowings under the Term Facility was approximately 4.8% and 4.5% for the three and six months ended March 31, 2005, respectively.
6
IASIS HEALTHCARE LLC
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
13% Senior Subordinated Notes and 8 1/2% Senior Subordinated Notes
On October 13, 1999, IAS issued $230.0 million of 13% senior subordinated notes due 2009. On May 25, 2000, IAS exchanged all of its outstanding 13% senior subordinated notes due 2009 for 13% senior subordinated exchange notes due 2009 registered under the Securities Act of 1933, as amended (the 13% notes).
On June 6, 2003, IAS issued $100.0 million of 8 1/2% senior subordinated notes due 2009. On August 14, 2003, IAS exchanged all of its outstanding 8 1/2% senior subordinated notes due 2009 for 8 1/2% senior subordinated notes due 2009 registered under the Securities Act (the 8 1/2% notes).
In connection with the Transactions, on May 6, 2004, IAS commenced a cash tender offer to purchase any and all of the 13% notes and the 8 1/2% notes. IAS also commenced a solicitation of consents to proposed amendments to the indentures governing the notes that would amend or eliminate substantially all of the restrictive covenants contained in the indentures. As of the consent payment deadline, holders of approximately 98.5% of the outstanding principal amount of the 13% notes and 100% of the outstanding principal amount of the 8 1/2% notes tendered their notes and consented to the applicable proposed amendments. In October 2004, the remaining $3.5 million of the 13% notes were retired. This amount is included in current liabilities on the Companys condensed consolidated balance sheet at September 30, 2004.
8 3/4% Senior Subordinated Notes
In connection with the Transactions, on June 22, 2004, the Company and IASIS Capital Corporation, a wholly owned subsidiary of IASIS LLC formed solely for the purpose of serving as a co-issuer (IASIS Capital) (IASIS LLC and IASIS Capital referred to collectively as the Issuers), issued $475.0 million aggregate principal amount of 8 3/4% senior subordinated notes due 2014.
On December 15, 2004, the Issuers exchanged all of their outstanding 8 3/4% senior subordinated notes due 2014 for 8 3/4% senior subordinated notes dues 2014 registered under the Securities Act (the 8 3/4% 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 November 12, 2004.
The 8 3/4% notes are general unsecured senior subordinated obligations and are subordinated in right of payment to all existing and future senior debt of the Company. The Companys existing domestic subsidiaries, other than non-guarantor subsidiaries which include Health Choice and the Companys non-wholly owned subsidiaries, are guarantors of the 8 3/4% notes. The 8 3/4% notes are effectively subordinated to all of the Issuers and the guarantors secured debt to the extent of the value of the assets securing the debt and are structurally subordinated to all liabilities and commitments (including trade payables and lease obligations) of the Companys subsidiaries that are not guarantors of the 8 3/4% notes.
4. Acquisition of IASIS Healthcare Corporation
As previously discussed in Note 1, an investor group led by Texas Pacific Group acquired IAS through the Merger on June 22, 2004. The Merger has been accounted for as a purchase in accordance with SFAS No. 141, Business Combinations. During the three months ended March 31, 2005, the Company substantially completed the allocation of the Merger purchase price, resulting in the recognition of $493.1 million of additional goodwill and $45.0 million of other intangible assets. The Company intends to finalize the purchase price allocation during the third fiscal quarter of 2005 upon final determination of the assignment of goodwill within our acute care business segment. The purchase price allocation is based on estimates of the fair value of the assets acquired and liabilities assumed as determined by an independent appraiser. The purchase price for IAS, including direct transaction costs, was $1.5 billion and has been allocated as reflected in the table below. Goodwill resulting from the purchase price allocation did not result in additional deductible goodwill for tax purposes.
7
IASIS HEALTHCARE LLC
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
The following table summarizes the purchase price allocation to reflect the fair values of the net assets acquired and liabilities assumed at the date of acquisition.
| (in millions) | ||||
Current assets, net |
$ | 123 | ||
Property and equipment |
547 | |||
Non-current assets, net |
6 | |||
Goodwill |
764 | |||
Other
intangible assets |
45 | |||
Total assets acquired |
$ | 1,485 | ||
The $45.0 million of acquired intangible assets consists solely of Health Choices contract with the Arizona Health Care Cost Containment System (AHCCCS). The contract intangible is being amortized over a period of 15 years which approximates the contracts estimated useful life, including assumed renewal periods. Amortization of the contract intangible for the three and six months ended March 31, 2005 was $750,000 and $1.5 million, respectively. Accumulated amortization at March 31, 2005 equaled $1.5 million.
Goodwill as of March 31, 2005 was $745.0 million net of a $19.0 million cumulative reduction to goodwill resulting from changes in deferred taxes subsequent to the Merger. In the application of the purchase method of accounting, the Company reduces goodwill, not income tax expenses, upon the reduction of the Companys deferred tax valuation allowance.
5. Stock Benefit Plans
Although IASIS LLC has no stock option plan or outstanding stock options, the Company, through its parent, IAS, grants stock options for a fixed number of common shares to employees. SFAS 123 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 APB 25 and, accordingly, 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. See Note 2 Recently Issued Accounting Pronouncements.
If the Company had measured compensation cost for the stock options granted under the fair value based method prescribed by SFAS 123, net earnings would have been changed to the pro forma amounts set forth below (in thousands):
| Three Months Ended March 31, | Six Months Ended March 31, | |||||||||||||||
| 2005 | 2004 | 2005 | 2004 | |||||||||||||
Net earnings as reported |
$ | 15,796 | $ | 11,851 | $ | 25,757 | $ | 20,069 | ||||||||
Deduct: Total stock
based employee
compensation determined
under fair value based
method for all awards,
net of related tax
effects |
(696 | ) | (373 | ) | (933 | ) | (747 | ) | ||||||||
Pro forma net earnings |
$ | 15,100 | $ | 11,478 | $ | 24,824 | $ | 19,322 | ||||||||
The effect of applying SFAS 123 for providing pro forma disclosure may not to be representative of the effect on reported net earnings for future years.
6. 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
8
IASIS HEALTHCARE LLC
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
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.
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. However, some claims may exceed the scope of coverage in effect. Plaintiffs in these matters may request punitive or other damages that may potentially 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 March 31, 2005 and September 30, 2004, the Companys professional and general liability accrual for asserted and unasserted claims was approximately $34.8 million and $28.8 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 AHCCS. 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 March 31, 2005, the Company 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 $5.0 million and an intercompany demand note with the Company. The amount of the performance guaranty is based in part upon the membership in the Plan and the related capitation revenue paid to Health Choice.
Capital Expenditure Commitments
The Company completed construction of its new hospital in Port Arthur, Texas, which opened April 16, 2005. In addition, the Company is expanding and renovating some of its existing facilities to permit additional patient volume and provide a greater variety of services. The Company had incurred approximately $103.2 million in uncompleted projects as of March 31, 2005, which is included in property and equipment in the accompanying unaudited condensed consolidated balance sheet at that date. At March 31, 2005, the Company had various construction and other projects in progress with an estimated additional cost to complete and equip of approximately $65.2 million.
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
9
IASIS HEALTHCARE LLC
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
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 IAS 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 IAS. IAS has informed Tenet that IAS has no obligation or liability for any of the matters described in the complaint and that IAS is entitled to indemnification if any damages or relief were to be sought against IAS in connection with the proceeding. Tenet has accepted service of process on behalf of these hospitals and has agreed to indemnify IAS.
The Company believes it is in material compliance with all applicable laws and regulations. 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.
7. 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 (2) its Medicaid managed health plan, Health Choice. The following is a financial summary by business segment for the periods indicated:
10
IASIS HEALTHCARE LLC
NOTES TO UNAUDITED CONDENSED CONSOLIDATED
FINANCIAL STATEMENTS
| For the Three Months Ended March 31, 2005 | ||||||||||||||||
| Acute Care | Health Choice | Eliminations | Consolidated | |||||||||||||
Net acute care revenue |
$ | 302,719 | $ | | $ | | $ | 302,719 | ||||||||
Premium revenue |
| 87,538 | | 87,538 | ||||||||||||
Revenue between segments |
2,273 | | (2,273 | ) | | |||||||||||
Net revenue |
304,992 | 87,538 | (2,273 | ) | 390,257 | |||||||||||
Salaries and benefits |
109,928 | 2,797 | | 112,725 | ||||||||||||
Supplies |
49,243 | 46 | | 49,289 | ||||||||||||
Medical claims |
| 77,706 | (2,273 | ) | 75,433 | |||||||||||
Rents and Leases |
7,773 | 218 | | 7,991 | ||||||||||||
Other operating expenses |
51,511 | 2,694 | | 54,205 | ||||||||||||
Provision for bad debts |
30,715 | | | 30,715 | ||||||||||||
Adjusted EBITDA(1) |
55,822 | 4,077 | | 59,899 | ||||||||||||
Interest expense, net |
14,007 | | | 14,007 | ||||||||||||
Depreciation and amortization |
16,798 | 861 | | 17,659 | ||||||||||||
Management fees |
963 | | | 963 | ||||||||||||
Earnings before loss on sale of
assets, minority interests and
income taxes |
$ | 24,054 | $ | 3,216 | $ | | $ | 27,270 | ||||||||