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8-K - FORM 8-K - AMSURG CORPamsg-8k-2012-07-24.htm

 

 

Exhibit 99

Press Release

 

 

 

Contact:

Claire M. Gulmi

 

 

Executive Vice President and

 

 

Chief Financial Officer

 

 

(615) 665-1283

 

AMSURG’S REPORTS NET EARNINGS FROM CONTINUING OPERATIONS OF $0.51

PER DILUTED SHARE FOR

SECOND-QUARTER 2012

¾¾¾¾¾¾¾¾¾¾¾

SAME-CENTER REVENUES INCREASE 3%

¾¾¾¾¾¾¾¾¾¾¾

AFFIRMS ESTABLISHED FINANCIAL GUIDANCE FOR 2012

 

NASHVILLE, Tenn. ─ (July 24, 2012) ─ Christopher A. Holden, President and Chief Executive Officer of AmSurg Corp. (NASDAQ: AMSG), today announced financial results for the second quarter ended June 30, 2012.  Revenues for the quarter were $231.6 million, a 23% increase from $187.5 million for the second quarter of 2011. Net earnings from continuing operations attributable to AmSurg common shareholders increased to $16.2 million, or $0.51 per diluted share, for the second quarter of 2012 from $12.7 million, or $0.40 per diluted share, for the second quarter of 2011, which included acquisition transaction costs of $0.02 per diluted share. Excluding these costs from the prior year, net earnings from continuing operations per diluted share attributable to AmSurg common shareholders increased 21% to $0.51 for the latest quarter from $0.42 for the second quarter last year.

 

            Revenues for the first six months of 2012 increased 26% to $461.8 million from $365.2 million for the same period in 2011.  Net earnings from continuing operations attributable to AmSurg common shareholders increased to $31.9 million, or $1.01 per diluted share, for the first six months of 2012 from $24.3 million, or $0.78 per diluted share, for the first half of 2011, which included acquisition transaction costs of $0.02 per diluted share.  Excluding these costs from the prior year, net earnings from continuing operations per diluted share attributable to AmSurg common shareholders increased 26% to $1.01 for the first half of 2012 from $0.80 for the comparable 2011 period.

 

            Mr. Holden remarked, “AmSurg’s second-quarter results represent the third consecutive quarter in which our revenues have grown in excess of 20% on a comparable-quarter basis.  For the latest quarter, this growth was driven by a 3% increase in same-center revenue, as well as an expansion in the number of centers in operation to 228 at the quarter’s end from 206 centers at the end of the second quarter last year.  Our centers produced a 14% increase in procedures for the latest quarter compared with the second quarter last year, and revenue per procedure increased 8%, consistent with the growth in multi-specialty centers as a percentage of our center mix since the second quarter last year.

 

 

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AMSG Reports Second-Quarter Results

Page 2

July 24, 2012

            “During the second quarter, we completed the scheduled opening of one de novo center. We also had seven centers under letter of intent at the end of the quarter.  We primarily applied our free cash flow for the quarter to net repayments of long-term debt of $27.9 million, which contributed to an improvement in our ratio of total debt to trailing 12 months EBITDA as calculated under our credit agreement to 2.6 compared with 2.8 and 2.9 at March 31, 2012 and December 31, 2011, respectively.

 

            “Net cash flows from operating activities increased 21% for the second quarter of 2012 to $74.5 million from $61.7 million for the second quarter of 2011.  Excluding distributions to noncontrolling interests, net cash flows from operations grew 17% to $30.7 million from $26.2 million.  Excluding distributions to noncontrolling interests, our cash flow was 1.9 times net earnings from continuing operations attributable to AmSurg common shareholders. 

 

            “In late June, we amended our credit agreements, which increased availability under our revolving credit agreement by $25 million to $475 million, reduced the interest rate on the outstanding borrowings under the agreement and extended its term through June 2017.  At the end of the second quarter, our availability under our revolving credit facility was $159 million, and we had cash and cash equivalents of $37.6 million.  With expectations for continued substantial cash flow during 2012, we believe we are well positioned to fund our planned growth for the year. 

 

            “Based on our performance through the first half of 2012 and our outlook for the remainder of the year, we today affirm our established financial guidance for 2012, while increasing the lower end of the expected range of same-center revenue growth for the year.  We also establish our guidance for the third quarter of 2012, which reflects our more typical seasonality, as well as one less operating day than the second quarter of 2012 and the third quarter last year, as follows:

 

·         Revenues in a range of $905 million to $925 million for 2012.

·         Same-center revenue increase of 2% to 3% for 2012, up from the prior range of 1% to 3%.

·         Center acquisitions for 2012 that generate annualized operating income in a range of $25 million to $29 million, including approximately $2 million from centers acquired in the first half of 2012.

·         Net cash flow provided by operating activities, less distributions to noncontrolling interests, in a range of $115 million to $120 million for 2012.

·         Net earnings from continuing operations per diluted share attributable to common shareholders for 2012 in a range of $1.97 to $2.01. 

·         Net earnings from continuing operations per diluted share attributable to common shareholders for the third quarter of 2012 in a range of $0.47 to $0.49.”

 

            Mr. Holden concluded, “We are pleased with the improved operating environment evidenced by two consecutive quarters of at least 3% same-center revenue growth, compared with 1% for the first two quarters last year.  While not discounting the potential impact of

 

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AMSG Reports Second-Quarter Results

Page 3

July 24, 2012

uncertain economic conditions and high unemployment, our second-quarter results support our confidence in meeting our guidance of revenue and earnings growth in the mid to high teens for 2012. 

 

            “Beyond 2012, we expect AmSurg’s unique positioning in the free-standing ASC industry to support sustained growth.  In operating the largest number of centers in the country, we are playing a significant role in expanding access to lower cost, high quality healthcare at a time when demand for such access from patients, payers and physicians is expected to steadily grow for the foreseeable future.  In addition to organic growth, we have an unequaled record of expanding our center base through acquisition in an industry that remains highly fragmented.  As the only public company focused on ambulatory care, we believe our access to capital represents a competitive advantage in implementing our center acquisition strategy, in addition to our strong cash flows and financial position.  We further believe that we have built a market-leading position as the physician partner of choice due to our fundamental commitment to differentiating AmSurg through a physician-centric culture.  As a result of our competitive strengths in an industry experiencing favorable long-term growth trends, we are confident of our prospects for producing long-term growth in earnings and shareholder value.”

 

          The information contained in the preceding paragraphs is forward-looking information, and the attainment of these targets is dependent not only on AmSurg’s achievement of its assumptions discussed above, but also on the risks and uncertainties listed below that could cause actual results, performance or developments to differ materially from those expressed or implied by this forward-looking information.

 

            AmSurg Corp. will hold a conference call to discuss this release today at 5:00 p.m. Eastern time.  Investors will have the opportunity to listen to the conference call over the Internet by going to www.amsurg.com and clicking “Investors” or by going to www.earnings.com at least 15 minutes early to register, download, and install any necessary audio software.  For those who cannot listen to the live broadcast, a replay will be available at these sites shortly after the call and continue for 30 days.

 

            This press release contains forward-looking statements.  These statements, which have been included in reliance on the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995, involve risks and uncertainties.  Investors are hereby cautioned that these statements may be affected by important factors, including, but not limited to, the following risks: the risk that payments from third-party payors, including government healthcare programs, may decrease or not increase as the Company’s costs increase; adverse developments affecting the medical practices of the Company’s physician partners; the Company’s ability to maintain favorable relations with its physician partners; the Company’s ability to compete for physician partners, managed care contracts, patients and strategic relationships; the Company’s ability to acquire and develop additional surgery centers on favorable terms; the Company’s ability to grow revenues by increasing procedure volume while maintaining its operating margins and profitability at its existing centers; the Company’s ability to manage the growth in its business; the Company’s ability to obtain sufficient capital resources to complete acquisitions and develop new surgery centers; adverse weather and other factors beyond the Company’s control that may

 

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AMSG Reports Second-Quarter Results

Page 4

July 24, 2012

affect the Company’s surgery centers; adverse impacts on the Company’s business associated with current and future economic conditions; the Company’s failure to comply with applicable laws and regulations; the risk of changes in legislation, regulations or regulatory interpretations that may negatively affect the Company; the risk of becoming subject to federal and state investigation; uncertainties regarding the impact of the Health Reform Law; the risk of regulatory changes that may obligate the Company to buy out interests of physicians who are minority owners of its surgery centers; potential liabilities associated with the Company’s status as a general partner of limited partnerships; liabilities for claims brought against our facilities; the Company’s legal responsibility to minority owners of its surgery centers, which may conflict with its interests and prevent it from acting solely in its best interests; risks associated with the potential write-off of the impaired portion of intangible assets; potential liability relating to the tax deductibility of goodwill; and other risk factors described in AmSurg’s Annual Report on Form 10-K for the fiscal year ended December 31, 2011 and other filings with the Securities and Exchange Commission.  Consequently, actual results, performance or developments may differ materially from the forward-looking statements included above. AmSurg disclaims any intent or obligation to update these forward-looking statements.

 

AmSurg Corp. acquires, develops and operates ambulatory surgery centers in partnership with physician practice groups throughout the United States.  At June 30, 2012, AmSurg owned and operated 228 centers.

 

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AMSG Reports Second-Quarter Results

Page 56 

July 24, 2012 

 

AMSURG CORP.

Unaudited Selected Consolidated Financial and Operating Data

(Dollars in thousands, except per share amounts

 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

For the Three Months

  

For the Six Months

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Ended June 30,

  

Ended June 30,

Statement of Earnings Data:

  

2012 

  

2011 

  

  

2012 

  

  

2011 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Revenues

  

$

 231,581 

  

$

 187,522 

  

$

 461,792 

  

$

 365,248 

Operating expenses:

  

  

  

  

  

  

  

  

  

  

  

  

  

Salaries and benefits

  

  

 70,957 

  

  

 57,127 

  

  

 143,410 

  

  

 112,380 

  

Supply cost

  

  

 33,169 

  

  

 23,938 

  

  

 65,386 

  

  

 46,418 

  

Other operating expenses

  

  

 48,681 

  

  

 40,393 

  

  

 96,090 

  

  

 78,153 

  

Depreciation and amortization

  

  

 7,463 

  

  

 6,133 

  

  

 14,838 

  

  

 12,046 

  

  

Total operating expenses

  

  

 160,270 

  

  

 127,591 

  

  

 319,724 

  

  

 248,997 

Equity in earnings of unconsolidated affiliates

  

  

 316 

  

  

 - 

  

  

 711 

  

  

 - 

  

  

Operating income

  

  

 71,627 

  

  

 59,931 

  

  

 142,779 

  

  

 116,251 

Interest expense

  

  

 4,159 

  

  

 3,631 

  

  

 8,428 

  

  

 7,573 

  

  

Earnings from continuing operations before income taxes

  

  

 67,468 

  

  

 56,300 

  

  

 134,351 

  

  

 108,678 

Income tax expense

  

  

 11,263 

  

  

 8,899 

  

  

 22,204 

  

  

 17,166 

  

  

Net earnings from continuing operations

  

  

 56,205 

  

  

 47,401 

  

  

 112,147 

  

  

 91,512 

Discontinued operations:

  

  

  

  

  

  

  

  

  

  

  

  

  

Earnings (loss) from operations of discontinued interests in surgery centers, net of income tax

  

  

 - 

  

  

 60 

  

  

 (110) 

  

  

 758 

  

Loss on disposal of discontinued interests in surgery centers, net of income tax

  

  

 (660) 

  

  

 (1,084) 

  

  

 (1,553) 

  

  

 (1,265) 

  

  

Net loss from discontinued operations

  

  

 (660) 

  

  

 (1,024) 

  

  

 (1,663) 

  

  

 (507) 

  

  

Net earnings

  

  

 55,545 

  

  

 46,377 

  

  

 110,484 

  

  

 91,005 

Less net earnings attributable to noncontrolling interests:

  

  

  

  

  

  

  

  

  

  

  

  

  

Net earnings from continuing operations

  

  

 40,009 

  

  

 34,718 

  

  

 80,232 

  

  

 67,224 

  

Net earnings (loss) from discontinued operations

  

  

 - 

  

  

 29 

  

  

 (60) 

  

  

 458 

  

  

Total net earnings attributable to noncontrolling interests

  

  

 40,009 

  

  

 34,747 

  

  

 80,172 

  

  

 67,682 

  

  

Net earnings attributable to AmSurg Corp. common shareholders

  

$

 15,536 

  

$

 11,630 

  

$

 30,312 

  

$

 23,323 

Amounts attributable to AmSurg Corp. common shareholders:

  

  

  

  

  

  

  

  

  

  

  

  

  

Earnings from continuing operations, net of income tax

  

$

 16,196 

  

$

 12,683 

  

$

 31,915 

  

$

 24,288 

  

Discontinued operations, net of income tax

  

  

 (660) 

  

  

 (1,053) 

  

  

 (1,603) 

  

  

 (965) 

  

  

Net earnings attributable to AmSurg Corp. common shareholders

  

$

 15,536 

  

$

 11,630 

  

$

 30,312 

  

$

 23,323 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Earnings per share-basic:

  

  

  

  

  

  

  

  

  

  

  

  

  

Net earnings from continuing operations attributable to AmSurg Corp. common shareholders

  

$

 0.53 

  

$

 0.42 

  

$

 1.04 

  

$

 0.80 

  

Net loss from discontinued operations attributable to AmSurg Corp. common shareholders

  

  

 (0.02) 

  

  

 (0.03) 

  

  

 (0.05) 

  

  

 (0.03) 

  

  

Net earnings attributable to AmSurg Corp. common shareholders

  

$

 0.51 

  

$

 0.38 

  

$

 0.99 

  

$

 0.77 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Earnings per share-diluted:

  

  

  

  

  

  

  

  

  

  

  

  

  

Net earnings from continuing operations attributable to AmSurg Corp. common shareholders

  

$

 0.51 

  

$

 0.40 

  

$

 1.01 

  

$

 0.78 

  

Net loss from discontinued operations attributable to AmSurg Corp. common shareholders

  

  

 (0.02) 

  

  

 (0.03) 

  

  

 (0.05) 

  

  

 (0.03) 

  

  

Net earnings attributable to AmSurg Corp. common shareholders

  

$

 0.49 

  

$

 0.37 

  

$

 0.96 

  

$

 0.75 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Weighted average number of shares and share equivalents (000's):

  

  

  

  

  

  

  

  

  

  

  

  

  

Basic

  

  

 30,743 

  

  

 30,415 

  

  

 30,681 

  

  

 30,418 

  

Diluted

  

  

 31,577 

  

  

 31,335 

  

  

 31,489 

  

  

 31,180 

 

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AMSG Reports Second-Quarter Results

Page 66 

July 24, 2012 

 

 

AMSURG CORP.

Unaudited Selected Consolidated Financial and Operating Data, continued

(Dollars in thousands)

 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

For the Three Months

  

For the Six Months

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Ended June 30,

  

Ended June 30,

Operating Data:

  

2012 

  

2011 

  

2012 

  

2011 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Continuing centers in operation at end of period (consolidated)

  

  

 226 

  

  

 206 

  

  

 226 

  

  

 206 

Continuing centers in operation at end of period (unconsolidated)

  

  

 2 

  

  

 - 

  

  

 2 

  

  

 - 

Average number of continuing centers in operation (consolidated)

  

  

 225 

  

  

 206 

  

  

 225 

  

  

 203 

New centers added during the period

  

  

 1 

  

  

 5 

  

  

 2 

  

  

 6 

Centers discontinued during the period

  

  

 - 

  

  

 1 

  

  

 2 

  

  

 2 

Centers under development/not opened at end of period

  

  

 - 

  

  

 1 

  

  

 - 

  

  

 1 

Centers under letter of intent at end of period

  

  

 7 

  

  

 4 

  

  

 7 

  

  

 4 

Average revenue per consolidated center

  

$

 1,028 

  

$

 912 

  

$

 2,054 

  

$

 1,798 

Same center revenues increase

  

  

3%

  

  

1%

  

  

4%

  

  

1%

Procedures performed during the period at consolidated centers

  

  

 385,630 

  

  

 338,331 

  

  

 768,180 

  

  

 656,601 

Income tax expense attributable to noncontrolling interests

  

$

 210 

  

$

 175 

  

$

 422 

  

$

 304 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Reconciliation of net earnings to EBITDA  (1):

  

  

  

  

  

  

  

  

  

  

  

  

  

Net earnings from continuing operations attributable to AmSurg Corp. common shareholders

  

$

 16,196 

  

$

 12,683 

  

$

 31,915 

  

$

 24,288 

  

Add:  income tax expense

  

  

 11,263 

  

  

 8,899 

  

  

 22,204 

  

  

 17,166 

  

Add:  interest expense, net

  

  

 4,159 

  

  

 3,631 

  

  

 8,428 

  

  

 7,573 

  

Add:  depreciation and amortization

  

  

 7,463 

  

  

 6,133 

  

  

 14,838 

  

  

 12,046 

  

  

EBITDA

  

$

 39,081 

  

$

 31,346 

  

$

 77,385 

  

$

 61,073 

 

(1)     EBITDA is defined as earnings before interest, income taxes and depreciation and amortization.  EBITDA should not be considered a measure of financial performance under generally accepted accounting principles.  Items excluded from EBITDA are significant components in understanding and assessing financial performance.  EBITDA is an analytical indicator used by management and the health care industry to evaluate company performance, allocate resources and  measure leverage and debt service capacity.  EBITDA should not be considered in isolation or as an alternative to net income, cash flows generated by operations, investing or financing activities, or other financial statement data presented in the consolidated financial statements as indicators of financial performance or liquidity.  Because EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, EBITDA as presented may not be comparable to other similarly titled measures of other companies.  Net earnings from continuing operations attributable to AmSurg Corp. common shareholders is the financial measure calculated and presented in accordance with generally accepted accounting principles that is most comparable to EBITDA as defined. 

 

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AMSG Reports Second-Quarter Results

Page 76 

July 24, 2012 

 

 

AMSURG CORP.

Unaudited Selected Consolidated Financial and Operating Data, continued

(Dollars in thousands

 

  

  

  

  

  

  

  

  

  

June 30,

  

December 31,

Balance Sheet Data:

  

2012 

  

2011 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Assets

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Current assets:

  

  

  

  

  

  

  

Cash and cash equivalents

  

$

 37,649 

  

$

 40,718 

  

Accounts receivable, net of allowance of $23,009 and $18,844, respectively

  

  

 90,446 

  

  

 93,454 

  

Supplies inventory

  

  

 14,741 

  

  

 15,039 

  

Deferred income taxes

  

  

 2,478 

  

  

 2,129 

  

Prepaid and other current assets

  

  

 21,813 

  

  

 21,875 

  

  

Total current assets

  

  

 167,127 

  

  

 173,215 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Property and equipment, net

  

  

 143,830 

  

  

 144,558 

Investments in unconsolidated affiliates and long-term notes receivable

  

  

 11,851 

  

  

 10,522 

Goodwill

  

  

 1,240,422 

  

  

 1,229,298 

Intangible assets, net

  

  

 16,248 

  

  

 15,425 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Total assets

  

$

 1,579,478 

  

$

 1,573,018 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Liabilities and Equity

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Current liabilities:

  

  

  

  

  

  

  

Current portion of long-term debt

  

$

 10,018 

  

$

 10,800 

  

Accounts payable

  

  

 17,442 

  

  

 19,746 

  

Current income taxes payable

  

  

 - 

  

  

 1,796 

  

Accrued salaries and benefits

  

  

 22,576 

  

  

 22,224 

  

Other accrued liabilities

  

  

 9,664 

  

  

 9,088 

  

  

Total current liabilities

  

  

 59,700 

  

  

 63,654 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Long-term debt

  

  

 409,726 

  

  

 447,963 

Deferred income taxes

  

  

 125,853 

  

  

 114,167 

Other long-term liabilities

  

  

 28,480 

  

  

 28,131 

Commitments and contingencies

  

  

  

  

  

  

Noncontrolling interests - redeemable

  

  

 171,412 

  

  

 170,636 

Preferred stock, no par value, 5,000,000 shares authorized, no shares issued or outstanding

  

  

 - 

  

  

 - 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Equity:

  

  

  

  

  

  

  

Common stock, no par value, 70,000,000 shares authorized, 31,624,480 and 31,283,772 shares outstanding, respectively

  

  

 174,690 

  

  

 173,187 

  

Retained earnings

  

  

 473,370 

  

  

 443,058 

  

  

Total AmSurg Corp. equity

  

  

 648,060 

  

  

 616,245 

  

  

Noncontrolling interests - non-redeemable

  

  

 136,247 

  

  

 132,222 

  

  

Total equity

  

  

 784,307 

  

  

 748,467 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Total liabilities and equity

  

$

 1,579,478 

  

$

 1,573,018 

 

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AMSG Reports Second-Quarter Results

Page 86 

July 24, 2012 

 

AMSURG CORP.

Unaudited Selected Consolidated Financial and Operating Data, continued

(Dollars in thousands

 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

For the Three Months

  

For the Six Months

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Ended June 30,

  

Ended June 30,

Statement of Cash Flow Data:

  

2012 

  

2011 

  

2012 

  

2011 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Cash flows from operating activities:

  

  

  

  

  

  

  

  

  

  

  

  

  

Net earnings

  

$

 55,545 

  

$

 46,377 

  

$

 110,484 

  

$

 91,005 

  

Adjustments to reconcile net earnings to net cash flows provided by operating activities:

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Depreciation and amortization

  

  

 7,463 

  

  

 6,133 

  

  

 14,838 

  

  

 12,046 

  

  

Net (gain) loss on sale of long-lived assets

  

  

 - 

  

  

 (465) 

  

  

 599 

  

  

 (363) 

  

  

Share-based compensation

  

  

 1,620 

  

  

 1,578 

  

  

 3,412 

  

  

 3,171 

  

  

Excess tax benefit from share-based compensation

  

  

 (450) 

  

  

 (61) 

  

  

 (529) 

  

  

 (463) 

  

  

Deferred income taxes

  

  

 4,666 

  

  

 5,814 

  

  

 13,388 

  

  

 11,460 

  

  

Equity in earnings of unconsolidated affiliates, net

  

  

 (316) 

  

  

 - 

  

  

 (711) 

  

  

 - 

  

  

Increase (decrease) in cash and cash equivalents, net of effects

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

of acquisition and dispositions, due to changes in:

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Accounts receivable, net

  

  

 4,054 

  

  

 (290) 

  

  

 2,935 

  

  

 (1,534) 

  

  

  

  

Supplies inventory

  

  

 156 

  

  

 141 

  

  

 333 

  

  

 67 

  

  

  

  

Prepaid and other current assets

  

  

 302 

  

  

 1,144 

  

  

 (331) 

  

  

 2,506 

  

  

  

  

Accounts payable

  

  

 2,594 

  

  

 (1,590) 

  

  

 901 

  

  

 (3,737) 

  

  

  

  

Accrued expenses and other liabilities

  

  

 (1,631) 

  

  

 2,666 

  

  

 (2,616) 

  

  

 (1,866) 

  

  

  

  

Other, net

  

  

 476 

  

  

 298 

  

  

 921 

  

  

 733 

  

  

  

  

  

Net cash flows provided by operating activities

  

  

 74,479 

  

  

 61,745 

  

  

 143,624 

  

  

 113,025 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Cash flows from investing activities:

  

  

  

  

  

  

  

  

  

  

  

  

  

Acquisition of interest in surgery centers and related transactions

  

  

 (115) 

  

  

 (41,979) 

  

  

 (9,972) 

  

  

 (45,674) 

  

Acquisition of property and equipment

  

  

 (8,523) 

  

  

 (5,959) 

  

  

 (14,569) 

  

  

 (10,303) 

  

Proceeds from the sale of interests in surgery centers

  

  

 - 

  

  

 3 

  

  

 - 

  

  

 3,369 

  

  

  

  

  

Net cash flows used in investing activities

  

  

 (8,638) 

  

  

 (47,935) 

  

  

 (24,541) 

  

  

 (52,608) 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Cash flows from financing activities:

  

  

  

  

  

  

  

  

  

  

  

  

  

Proceeds from long-term borrowings

  

  

 13,778 

  

  

 57,364 

  

  

 33,378 

  

  

 72,984 

  

Repayment on long-term borrowings

  

  

 (41,640) 

  

  

 (40,076) 

  

  

 (72,517) 

  

  

 (64,852) 

  

Distributions to noncontrolling interests

  

  

 (43,750) 

  

  

 (35,497) 

  

  

 (82,759) 

  

  

 (67,360) 

  

Distributions received from unconsolidated affiliates

  

  

 400 

  

  

 - 

  

  

 400 

  

  

 - 

  

Proceeds from issuance of common stock upon exercise of stock options

  

  

 4,151 

  

  

 891 

  

  

 6,672 

  

  

 4,628 

  

Repurchase of common stock

  

  

 (4,396) 

  

  

 - 

  

  

 (7,219) 

  

  

 (6,185) 

  

Capital contributions and ownership transactions by noncontrolling interests

  

  

 250 

  

  

 675 

  

  

 1,119 

  

  

 698 

  

Excess tax benefit from share-based compensation

  

  

 450 

  

  

 61 

  

  

 529 

  

  

 463 

  

Financing cost incurred

  

  

 (1,755) 

  

  

 (1,982) 

  

  

 (1,755) 

  

  

 (1,986) 

  

  

  

  

  

Net cash flows used in financing activities

  

  

 (72,512) 

  

  

 (18,564) 

  

  

 (122,152) 

  

  

 (61,610) 

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

  

Net decrease in cash and cash equivalents

  

  

 (6,671) 

  

  

 (4,754) 

  

  

 (3,069) 

  

  

 (1,193) 

Cash and cash equivalents, beginning of period

  

  

 44,320 

  

  

 37,708 

  

  

 40,718 

  

  

 34,147 

Cash and cash equivalents, end of period

  

$

 37,649 

  

$

 32,954 

  

$

 37,649 

  

$

 32,954 

 

 

-END-