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8-K - 8-K - 21st Century Oncology Holdings, Inc.a12-17901_18k.htm

Exhibit 99.1

 

 

RADIATION THERAPY SERVICES HOLDINGS, INC.

 

Contact:

Bryan J. Carey

Chief Financial Officer

(239) 930-7281

BCarey@rtsx.com

 

Investors:

Amy Glynn / Nick Laudico

The Ruth Group

646-536-7023 / 7030

aglynn@theruthgroup.com

nlaudico@theruthgroup.com

 

RADIATION THERAPY SERVICES REPORTS SECOND QUARTER 2012

FINANCIAL RESULTS

 

Second Quarter 2012 Financial Highlights:

·                  Total company revenues increased 11.1% to $180.3 million

·                  Domestic same practice treatments per day increased 4.1%

·                  Medical Developers’ international cases increased 13.6%

·                  Pro Forma Adjusted EBITDA of $28.1 million

 

Recent Business Highlights:

·                  In May 2012, issued $350.0 million in aggregate principal amount of new 8.875% senior notes due 2017 and entered into new revolving credit facility, allowing for up to $140 million in borrowings

·                  Radiation Therapy focused on providing comments to CMS regarding the Preliminary Physician Fee Schedule for 2013

·                  In August 2012, entered into national contract with major commercial payer to provide radiation therapy services under innovative case rate payment methodology; creates greater alignment and opportunities for strategic growth in several key markets

 

FORT MYERS, FL, August 8, 2012 — Radiation Therapy Services Holdings, Inc (“Radiation Therapy” or “the Company”), a leading operator of radiation therapy centers, today announced financial results for the second quarter ended June 30, 2012.

 

Dr. Daniel Dosoretz, President and Chief Executive Officer, said, “We are pleased with our 4.1% increase in domestic same practice treatments per day as it reflects our continued progress with our integrated cancer care strategy and physician liaison program. We strongly believe that these efforts will serve to enhance Radiation Therapy’s leading position as a provider of advanced cancer care, and ensure that our patients continue to receive the highest level of care. As expected, we did experience some EBITDA margin compression during the quarter primarily as

 



 

a result of our execution of the integrated cancer care strategy, as well as lower Medicare reimbursement.”

 

“On July 6, CMS published its preliminary 2013 Physician Fee Schedule, which included potential cuts for radiation oncology at freestanding centers.  If enacted, we believe the severity of the cuts would result in center closures, particularly in rural areas, thereby limiting important access to treatment for patients with cancer of all diagnoses.  Along with other providers and advocacy groups, our number one priority is to work with CMS, Congress and the Obama Administration to help them to understand the true cost associated with providing appropriate integrated cancer care, and providing them the information necessary to make informed decisions regarding appropriate reimbursement levels. We are hopeful that our efforts will result in these significant cuts being mitigated as part of the Final Rule in late 2012. Concurrently, we are developing contingency plans to offset the impact of possible cuts in 2013,” concluded Dr. Dosoretz.

 

Recent Developments

 

In May 2012, Radiation Therapy issued $350.0 million in aggregate principal amount of its new 8.875% senior secured second lien notes due 2017 (the “Notes”).  Net proceeds from the sale of the Notes were used to repay Radiation Therapy’s existing senior secured revolving credit facility and the Term Loan B portion of its senior secured credit facilities, to pay fees and expenses related to the notes offering and for general corporate purposes.  In connection with the Notes offering, Radiation Therapy also entered into a new 4.5 year $140 million revolving credit facility.  As of August 8, 2012, there were no borrowings under the revolving credit facility.

 

On July 6, 2012, the Centers for Medicare and Medicaid Services (CMS) published the preliminary 2013 Physician Fee Schedule, which included significant proposed cuts which particularly would affect freestanding radiation therapy centers.  The Company, along with other providers and advocacy groups, will be providing comments to CMS and legislators during the 60-day comment period.

 

Effective August 1, 2012, Radiation Therapy entered into a national contract with a major commercial payer to provide radiation therapy services under an innovative case rate payment methodology. In line with the efforts of leading healthcare policymakers to fight waste, recognize quality care, encourage coordination across providers, and reduce health care costs, this innovative case rate fee restructuring for radiation oncology provides a single payment to cover the group of procedures performed during a particular course of care.

 

Second Quarter 2012 Results

 

Total revenues for the second quarter of 2012 were $180.3 million, an increase of 11.1% compared to $162.3 million in revenues in the same quarter of 2011. The increase in revenue was principally due to the benefit of acquired integrated cancer care (ICC) practices, the impact of strategic tuck-in acquisitions made in California, North Carolina, Florida and Argentina, the

 



 

value added services agreement with the North Broward Hospital District and organic growth from Medical Developers, the Company’s Latin American operations.

 

Compared to the second quarter of 2011, domestic same practice treatments per day increased 4.1% in the second quarter of 2012, reflecting continued volume improvements, increased referrals from the Company’s physician liaison program and integrated cancer care model, and the impact of the North Broward hospital value added services agreement which is ahead of expectations. Domestic same practice freestanding revenue per treatment decreased 3.5% from the second quarter of 2011, due to reductions in the reimbursement rates announced in the CMS 2012 Physician Fee Schedule, partially offset by improved managed care pricing.

 

Total RVUs per day at same practice domestic freestanding centers, excluding the impact of the Las Vegas capitated contract, decreased 4.8% in the second quarter versus the same period of the prior year principally due to reductions in reimbursement rates included in the CMS 2012 Physician Fee Schedule.

 

Adjusted earnings before interest, taxes, depreciation, amortization, stock-based compensation and other non-cash and pro forma items (“Pro Forma Adjusted EBITDA”) in the second quarter of 2012 was $28.1 million, or 15.6% of total pro forma revenues, compared to $30.0 million, or 18.5% of total pro forma revenues, in the second quarter of 2011. Pro Forma Adjusted EBITDA margins declined in the quarter versus the prior year period primarily due to reductions in Medicare reimbursement rates, growth in integrated cancer care practices, and investments made in key personnel.  A reconciliation of net loss attributable to Radiation Therapy Services Holdings, Inc., determined in accordance with generally accepted accounting principles to Pro Forma Adjusted EBITDA and total revenues, determined in accordance with generally accepted accounting principles, to total pro forma revenues for the quarters ended June 30, 2012 and 2011 is included in the attached supplemental information.

 

Income tax expense in the second quarter of 2012 was $1.4 million, compared to income tax expense of $3.3 million in the second quarter of 2011.  The net loss for the second quarter of 2012 was $19.0 million, compared to a net loss of $4.8 million in the second quarter of 2011.

 

First Six Months of 2012 Results

 

Total revenues for the six months ended June 30, 2012 were $357.7 million, an increase of 12.2% compared to $318.8 million in revenues in the same period of 2011. The increase in revenue was principally due to the benefit of acquired integrated cancer care practices, the impact of strategic tuck-in acquisitions made in California, North Carolina, Florida and Argentina, the value added services agreement with the North Broward Hospital District and organic growth from Medical Developers.

 

Compared to the first six months of 2011, domestic same practice treatments per day increased 3.1% in the first six months of 2012, reflecting continued volume improvements, increased referrals from the Company’s physician liaison program and integrated cancer care model, and the impact of the North Broward value added services agreement which is ahead of expectations.  Domestic same practice therapy revenue per treatment decreased 3.0% from the first six months

 



 

of 2011, due to reductions in reimbursement rates announced in the CMS 2012 Physician Fee Schedule which were partially offset by improved managed care pricing.

 

Total RVUs per day at same practice domestic freestanding centers, excluding the impact of the Las Vegas capitated contract, decreased 5.1% in the first six months versus the same period of the prior year principally due to reductions in reimbursement rates included in the CMS 2012 Physician Fee Schedule.

 

Pro Forma Adjusted EBITDA in the first six months of 2012 was $57.6 million, or 15.8% of total pro forma revenues, compared to $62.0 million, or 18.8% of total pro forma revenues, in the first six months of 2011. Pro Forma Adjusted EBITDA margins declined in the period versus the prior year period primarily due to reductions in Medicare reimbursement rates, growth in integrated care practices and investments made in key personnel.  A reconciliation of net loss attributable to Radiation Therapy Services Holdings, Inc., determined in accordance with generally accepted accounting principles to Pro Forma Adjusted EBITDA and total revenues, determined in accordance with generally accepted accounting principles, to total pro forma revenues for the six-month periods ended June 30, 2012 and 2011 is included in the attached supplemental information.

 

Income tax expense in the first six months of 2012 was $1.5 million, compared to income tax expense of $5.8 million in the first six months of 2011.  The net loss for the first six months of 2012 was $27.4 million, compared to a net loss of $7.9 million in the first six months of 2011.

 

Conference Call

 

Management will host a conference call Thursday, August 9, 2012 at 11 a.m. ET to discuss financial results, other developments and business conditions. The dial-in numbers are (877) 407-0789 for domestic callers and (201) 689-8562 for international callers.  In addition, a telephonic replay of the call will be available until August 23, 2012.  The replay dial-in numbers are (877) 870-5176 for domestic callers and (858) 384-5517 for international callers.  Please use the conference ID number 397867 to access the replay.

 

A live webcast and webcast replay of the call will also be available from the Investor Relations section on the corporate web site at www.rtsx.com.

 

About Radiation Therapy Services Holdings, Inc.

 

Radiation Therapy is a leading provider of advanced radiation therapy and other services to cancer patients in the United States and Latin America.  The Company offers a comprehensive range of radiation treatment alternatives, focused on delivering academic quality, cost-effective patient care in a personal and convenient setting. In total, the Company operates 126 treatment centers, including 95 centers located in 15 U.S. states, strategically clustered in 28 local markets. The Company also operates 30 centers located in six countries in Latin America and 1 center located in India.  The Company holds market leading positions in most of its domestic local markets and abroad.

 



 

Forward-Looking Statements

 

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Act of 1934, as amended.  Statements preceded by, followed by or that otherwise include the words “believes”, “expects”, “anticipates”, “intends”, “projects”, “estimates”, “plans”, “may increase”, “forecast” and similar expressions or future or conditional verbs such as “will”, “should”, “would”, “may” and “could” are generally forward-looking in nature and not historical facts. Forward-looking statements are based on management’s current expectations or beliefs about the Company’s future plans, expectations and objectives, including, but not limited to, the Company’s expected financial results and estimates for 2012 and beyond.  These forward-looking statements are not historical facts and are subject to risks and uncertainties that could cause the actual results to differ materially from those projected in these forward-looking statements including, but not limited to reductions in Medicare reimbursement, healthcare reform, decreases in payments by managed care organizations and other commercial payers and other risk factors that may be described from time to time in the Company’s filings with the Securities and Exchange Commission.  Readers of this release are cautioned not to place undue reliance on forward-looking statements contained herein, which speak only as of the date stated, or if no date is stated, as of the date of this press release. The Company undertakes no obligation to publicly update or revise the forward-looking statements contained herein to reflect changed events or circumstances after the date of this release, unless required by law.

 

Financial Tables on Following Pages

 



 

RADIATION THERAPY SERVICES HOLDINGS, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(in thousands, except share and per share amounts)

 

 

 

June 30,

 

December 31,

 

 

 

2012

 

2011

 

 

 

(unaudited)

 

 

 

ASSETS

 

 

 

 

 

Current assets:

 

 

 

 

 

Cash and cash equivalents

 

$

28,425

 

$

10,177

 

Accounts receivable, net

 

95,489

 

87,094

 

Prepaid expenses

 

5,051

 

5,731

 

Inventories

 

5,260

 

4,308

 

Deferred income taxes

 

3,258

 

2,969

 

Other

 

5,995

 

6,025

 

Total current assets

 

143,478

 

116,304

 

 

 

 

 

 

 

Equity investments in joint ventures

 

367

 

692

 

Property and equipment, net

 

241,057

 

236,411

 

Real estate subject to finance obligation

 

14,961

 

13,719

 

Goodwill

 

568,418

 

556,547

 

Intangible assets, net

 

42,284

 

42,393

 

Other assets

 

38,451

 

32,526

 

Total assets

 

$

1,049,016

 

$

998,592

 

 

 

 

 

 

 

LIABILITIES AND EQUITY

 

 

 

 

 

 

 

 

 

 

 

Current liabilities:

 

 

 

 

 

Accounts payable

 

$

25,177

 

$

27,748

 

Accrued expenses

 

49,200

 

42,596

 

Income taxes payable

 

4,764

 

5,310

 

Current portion of long-term debt

 

13,178

 

13,945

 

Current portion of finance obligation

 

180

 

161

 

Other current liabilities

 

6,609

 

6,615

 

Total current liabilities

 

99,108

 

96,375

 

Long-term debt, less current portion

 

741,828

 

665,088

 

Finance obligation, less current portion

 

15,490

 

14,105

 

Other long-term liabilities

 

21,233

 

22,659

 

Deferred income taxes

 

10,100

 

10,343

 

Total liabilities

 

887,759

 

808,570

 

 

 

 

 

 

 

Noncontrolling interests - redeemable

 

12,793

 

12,728

 

 

 

 

 

 

 

Commitments and Contingencies

 

 

 

 

 

 

 

 

 

 

 

Equity:

 

 

 

 

 

Common stock, $0.01 par value, 1,025 shares authorized, issued and outstanding

 

 

 

Additional paid-in capital

 

651,590

 

648,703

 

Retained deficit

 

(513,568

)

(483,815

)

Notes receivable from shareholder

 

 

(125

)

Accumulated other comprehensive loss, net of tax

 

(6,976

)

(4,890

)

Total Radiation Therapy Services Holdings, Inc. shareholder’s equity

 

131,046

 

159,873

 

Noncontrolling interests - nonredeemable

 

17,418

 

17,421

 

Total equity

 

148,464

 

177,294

 

Total liabilities and equity

 

$

1,049,016

 

$

998,592

 

 



 

RADIATION THERAPY SERVICES HOLDINGS, INC.

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS

(in thousands)

(unaudited)

 

 

 

Three Months Ended

 

Six Months Ended

 

 

 

June 30,

 

June 30,

 

 

 

2012

 

2011

 

2012

 

2011

 

Revenues:

 

 

 

 

 

 

 

 

 

Net patient service revenue

 

$

178,499

 

$

160,887

 

$

354,047

 

$

315,970

 

Other revenue

 

1,755

 

1,369

 

3,652

 

2,823

 

Total revenues

 

180,254

 

162,256

 

357,699

 

318,793

 

 

 

 

 

 

 

 

 

 

 

Expenses:

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

95,166

 

80,114

 

189,009

 

161,013

 

Medical supplies

 

16,639

 

13,164

 

32,099

 

25,655

 

Facility rent expense

 

9,925

 

8,311

 

19,515

 

16,134

 

Other operating expenses

 

9,961

 

8,380

 

18,662

 

15,838

 

General and administrative expenses

 

21,301

 

21,469

 

40,983

 

39,305

 

Depreciation and amortization

 

16,247

 

12,998

 

31,443

 

25,453

 

Provision for doubtful accounts

 

4,800

 

3,721

 

9,861

 

7,522

 

Interest expense, net

 

19,600

 

15,314

 

37,155

 

29,807

 

Early extinguishment of debt

 

4,473

 

 

4,473

 

 

Gain on fair value adjustment of previously held equity investment

 

 

 

 

(234

)

Foreign currency transaction loss (gain)

 

45

 

(11

)

94

 

(1

)

(Gain) loss on foreign currency derivative contracts

 

(374

)

283

 

220

 

399

 

Total expenses

 

197,783

 

163,743

 

383,514

 

320,891

 

 

 

 

 

 

 

 

 

 

 

Loss before income taxes

 

(17,529

)

(1,487

)

(25,815

)

(2,098

)

Income tax expense

 

1,439

 

3,295

 

1,549

 

5,761

 

 

 

 

 

 

 

 

 

 

 

Net loss

 

(18,968

)

(4,782

)

(27,364

)

(7,859

)

 

 

 

 

 

 

 

 

 

 

Net income attributable to noncontrolling interests- redeemable and non-redeemable

 

(1,236

)

(1,068

)

(2,389

)

(2,507

)

 

 

 

 

 

 

 

 

 

 

Net loss attributable to Radiation Therapy Services Holdings, Inc. shareholder

 

(20,204

)

(5,850

)

(29,753

)

(10,366

)

 

 

 

 

 

 

 

 

 

 

Other comprehensive (loss) income:

 

 

 

 

 

 

 

 

 

Unrealized gain (loss) on derivative interest rate swap agreements

 

 

804

 

(333

)

2,100

 

Unrealized loss on foreign currency translation

 

(2,492

)

(196

)

(3,020

)

(351

)

Other comprehensive (loss) income:

 

(2,492

)

608

 

(3,353

)

1,749

 

 

 

 

 

 

 

 

 

 

 

Comprehensive loss:

 

(21,460

)

(4,174

)

(30,717

)

(6,110

)

Comprehensive income attributable to noncontrolling interests- redeemable and non-redeemable

 

(903

)

(1,060

)

(2,080

)

(2,471

)

Comprehensive loss attributable to Radiation Therapy Services Holdings, Inc. shareholder

 

$

(22,363

)

$

(5,234

)

$

(32,797

)

$

(8,581

)

 



 

RADIATION THERAPY SERVICES HOLDINGS, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(in thousands)

(unaudited)

 

 

 

Six Months Ended

 

 

 

June 30,

 

 

 

2012

 

2011

 

Cash flows from operating activities

 

 

 

 

 

Net loss

 

$

(27,364

)

$

(7,859

)

Adjustments to reconcile net loss to net cash provided by operating activities:

 

 

 

 

 

Depreciation

 

25,637

 

21,936

 

Amortization

 

5,806

 

3,517

 

Deferred rent expense

 

549

 

601

 

Deferred income taxes

 

(702

)

3,917

 

Stock-based compensation

 

3,012

 

940

 

Provision for doubtful accounts

 

9,861

 

7,522

 

Loss on the sale/disposal of property and equipment

 

22

 

12

 

Amortization of termination of interest rate swap

 

958

 

 

Write-off of loan costs

 

525

 

 

 

Early extinguishment of debt

 

4,473

 

 

Termination of derivative interest rate swap agreements

 

(972

)

 

Gain on fair value adjustment of previously held equity investment

 

 

(234

)

Loss on foreign currency transactions

 

18

 

44

 

Loss on foreign currency derivative contracts

 

220

 

399

 

Amortization of debt discount

 

417

 

401

 

Amortization of loan costs

 

2,609

 

2,111

 

Equity interest in net loss of joint ventures

 

539

 

525

 

Distribution received from unconsolidated joint ventures

 

9

 

 

Changes in operating assets and liabilities:

 

 

 

 

 

Accounts receivable and other receivables

 

(18,102

)

(15,053

)

Income taxes payable

 

(441

)

(1,515

)

Inventories

 

(713

)

(2,059

)

Prepaid expenses

 

1,111

 

1,556

 

Accounts payable and other current liabilities

 

(2,701

)

(3,044

)

Accrued deferred compensation

 

602

 

 

Accrued expenses / other long-term liabilities

 

6,314

 

1,068

 

 

 

 

 

 

 

Net cash provided by operating activities

 

11,687

 

14,785

 

 

 

 

 

 

 

Cash flows from investing activities

 

 

 

 

 

Purchase of property and equipment

 

(16,298

)

(22,471

)

Acquisition of medical practices

 

(23,742

)

(42,293

)

Proceeds from the sale of property and equipment

 

27

 

5

 

(Loans to) repayments from employees

 

(115

)

200

 

Contribution of capital to joint venture entities

 

(225

)

 

Distribution received from joint venture entities

 

 

616

 

Proceeds from the sale of equity interest in a joint venture

 

 

312

 

Payment of foreign currency derivative contracts

 

(432

)

(746

)

Premiums on life insurance policies

 

(518

)

 

Change in other assets and other liabilities

 

7

 

(142

)

 

 

 

 

 

 

Net cash used in investing activities

 

(41,296

)

(64,519

)

 



 

RADIATION THERAPY SERVICES HOLDINGS, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(in thousands)

(unaudited)

 

 

 

Six Months Ended

 

 

 

June 30,

 

 

 

2012

 

2011

 

Cash flows from financing activities

 

 

 

 

 

Proceeds from issuance of debt (net of original issue discount of $1.7 million and $625,000, respectively)

 

434,061

 

57,294

 

Principal repayments of debt

 

(369,903

)

(6,123

)

Repayments of finance obligation

 

(53

)

(47

)

Proceeds from equity contribution

 

 

3

 

Payments of notes receivable from shareholder

 

 

50

 

Cash distributions to noncontrolling interest holders - redeemable and non-redeemable

 

(2,018

)

(2,092

)

Payments of loan costs

 

(14,225

)

(1,637

)

 

 

 

 

 

 

Net cash provided by financing activities

 

47,862

 

47,448

 

 

 

 

 

 

 

Effect of exchange rate changes on cash and cash equivalents

 

(5

)

(7

)

 

 

 

 

 

 

Net increase (decrease) in cash and cash equivalents

 

18,248

 

(2,293

)

Cash and cash equivalents, beginning of period

 

10,177

 

13,977

 

 

 

 

 

 

 

Cash and cash equivalents, end of period

 

$

28,425

 

$

11,684

 

 

 

 

 

 

 

Supplemental disclosure of noncash transactions

 

 

 

 

 

Recorded finance obligation related to real estate projects

 

$

1,457

 

$

4,974

 

Recorded capital lease obligations related to the purchase of equipment

 

$

696

 

$

 

Recorded accounts payable related to acceptance and delivery of medical equipment

 

$

 

$

358

 

Recorded issuance of Parent equity units related to the acquisition of medical practices

 

$

 

$

16,250

 

Recorded issuance of senior subordinated notes related to the acquisition of medical practices

 

$

 

$

16,047

 

Recorded earn-out accrual related to the acquisition of medical practices

 

$

 

$

2,340

 

Recorded noncash dividend declared to noncontrolling interest

 

$

 

$

624

 

Recorded property and equipment related to the North Broward Hospital District license agreement

 

$

4,260

 

$

 

Recorded capital lease obligations related to the acquisition of medical practices

 

$

5,746

 

$

 

 



 

RADIATION THERAPY SERVICES HOLDINGS, INC.

Supplemental Financial Information (Unaudited)

Reconciliation of Total Pro-forma Revenue and Pro-forma Adjusted EBITDA to Net Loss Attributable

to Radiation Therapy Services Holdings, Inc. Shareholder

 

 

 

Three Months Ended

 

Six Months Ended

 

 

 

June 30,

 

June 30,

 

(in thousands):

 

2012

 

2011

 

2012

 

2011

 

 

 

 

 

 

 

 

 

 

 

Total revenues

 

$

180,254

 

$

162,256

 

$

357,699

 

$

318,793

 

Pro-forma full period effect of acquisitions (a)

 

 

 

7,557

 

11,942

 

Total pro-forma revenues

 

$

180,254

 

$

162,256

 

$

365,256

 

$

330,735

 

 

 

 

 

 

 

 

 

 

 

Net loss attributable to Radiation Therapy Services Holdings, Inc. shareholder

 

$

(20,204

)

$

(5,850

)

$

(29,753

)

$

(10,366

)

Income tax epense

 

1,439

 

3,295

 

1,549

 

5,761

 

Interest expense, net

 

19,600

 

15,314

 

37,155

 

29,807

 

Depreciation and amortization

 

16,247

 

12,998

 

31,443

 

25,453

 

Gain on fair value adjustment of previously held equity investment

 

 

 

 

(234

)

(Gain) loss on foreign currency derivative contracts

 

(374

)

283

 

220

 

399

 

Early extinguishment of debt

 

4,473

 

 

4,473

 

 

Management fees (b)

 

328

 

341

 

541

 

618

 

Non-cash expenses (c)

 

3,323

 

921

 

3,925

 

2,263

 

Sale-lease back adjustments (d)

 

(246

)

(242

)

(490

)

(438

)

Acquisition-related costs (e)

 

1,101

 

1,349

 

1,744

 

2,997

 

Other expenses (f)

 

437

 

111

 

894

 

432

 

Litigation settlement (g)

 

590

 

938

 

1,100

 

938

 

Costs associated with the provision for income taxes (h)

 

532

 

544

 

532

 

544

 

Tradename / rebranding initiative (i)

 

317

 

 

317

 

 

Expenses associated with idle / closed treatment facilities (j)

 

529

 

 

1,478

 

 

Pro-forma full period effect of acquisition EBITDA (a)

 

 

 

2,433

 

3,844

 

 

 

 

 

 

 

 

 

 

 

Pro-forma Adjusted EBITDA (1)

 

$

28,092

 

$

30,002

 

$

57,561

 

$

62,018

 

 

 

 

 

 

 

 

 

 

 

Pro-forma Adjusted EBITDA as a percentage of total pro-forma revenues

 

15.6

%

18.5

%

15.8

%

18.8

%

 



 


(1) Pro-forma Adjusted EBITDA is defined as income (loss) before interest expense (net of interest income), income taxes, depreciation and amortization, foreign currency derivative contract loss, gain on fair value adjustment of previously held equity investment, early extinguishment of debt, management fees from our sponsor, non-cash expenses including costs relating to stock compensation, amortization of straigh-line rent and amortization of capital expenditures relating to repairs and maintenance, sale-lease back adjustments, acquisition-related costs, other expenses including loss on sale of assets, severance payments related to termination of employee staff reductions, tail premiums on termed physicians, and franchise taxes, litigation settlements with physicians, costs associated with the provision for income taxes, costs associated with tradename and rebranding initiatives, expenses associated with idle / closed radiation therapy treatment facilities and pro-forma full period effect of acquisition EBITDA.

 

(a) Pro-forma amounts related to adjustments to total revenues and Pro-forma Adjusted EBITDA to reflect the full period effect of our acquisitions completed during 2011 and 2012.  The adjustments reflect the impact to our total revenues and Pro-forma Adjusted EBITDA as if the acquisitions had occurred at the beginning of the year.

 

(b) Management fees are fees paid to our sponsor, Vestar Capital Partners.

 

(c) Non-cash expenses including costs relating to stock compensation, amortization of straight-line rent and amortization of capital expenditures relating to warranty arrangements amortized to repairs and maintenance.

 

(d) Sale-lease back adjustments relates to the adjustment of benefit derived from the classification of operating leases as finance obiligations reflecting a reclassification of interest expense and depreciation and amortization expense as rent expense.

 

(e) Acquisition related costs associated with the adoption of ASC 805, Business Combinations, requiring prior capitalized costs be expensed, including professional fees and due diligence costs relating to the acquisition of physician practices.

 

(f) Other expenses include loss on sale of assets, severance payments related to termination of employee staff reductions, tail premiums paid on terminated physicians and franchise taxes.

 

(g) Litigation settlement relates to costs associated with the termination of physicians during 2011 and 2012.

 

(h) Expenses related to the costs associated with process improvements in the provision for income taxes.

 

(i) Expeses related to the costs associated with the Company’s tradename and rebranding initiatives.

 

(j) Expenses associated with idle / closed radiation therapy treatment facilities.

 

We believe the Pro-forma Adjusted EBITDA provides useful information about our financial performance to investors, lenders, financial analysts and rating agencies since these groups have historically used EBITDA-related measures in the healthcare industry, along with other measures, to estimate the value of a company, to make informed investment decisions, to evaluate a company’s leverage capacity and its ability to meet its debt service requirements.  Pro-forma Adjusted EBITDA eliminates the uneven effect of non-cash depreciation of tangibles assets and amortization of intangible assets, much of which results from acquisitions accounted for under the purchase method of accounting.  Pro-forma Adjusted EBITDA is also used by us to measure individual performance for incentive compensation purposes and as an analytical indicator for purposes of allocating resources to our operating business and assessing their performance, both internally and relative to our peers, as well as to evaluate the performance of our operating management teams, and for purposes in the calculation of debt covenants and related disclosures.

 

Pro-forma Adjusted EBITDA is not intended as a substitute for net income (loss) attributable to Radiation Therapy Services Holdings, Inc. shareholder, operating cash flows or other cash flow data determined in accordance with accounting principles generally accepted in the United States. Due to varying methods of calculation, Pro-forma Adjusted EBITDA as presented may not be comparable to similarly titled measures of other companies.

 



 

RADIATION THERAPY SERVICES HOLDINGS, INC.

KEY OPERATING STATISTICS

(unaudited)

 

 

 

Three Months Ended

 

 

 

Six Months Ended

 

 

 

 

 

June 30,

 

%

 

June 30,

 

%

 

Domestic U.S.

 

2012

 

2011 *

 

Change

 

2012

 

2011 *

 

Change

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number of treatment days

 

64

 

64

 

 

 

128

 

128

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total RVU’s - freestanding centers

 

2,969,204

 

3,138,665

 

-5.4

%

5,902,036

 

6,348,006

 

-7.0

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RVU’s per day - freestanding centers

 

46,394

 

49,042

 

-5.4

%

46,110

 

49,594

 

-7.0

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Percentage change in RVU’s per day - freestanding centers - same practice basis

 

-4.8

%

10.5

%

 

 

-5.1

%

8.9

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total treatments - freestanding centers

 

128,005

 

119,274

 

7.3

%

253,321

 

241,830

 

4.8

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Treatments per day - freestanding centers

 

2,000

 

1,864

 

7.3

%

1,979

 

1,889

 

4.8

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Percentage change in revenue per treatment - freestanding centers - same practice basis

 

-3.5

%

5.7

%

 

 

-3.0

%

4.5

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Percentage change in treatments per day - freestanding centers - same practice basis

 

4.1

%

-0.1

%

 

 

3.1

%

-0.9

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number of regions at period end (global)

 

9

 

9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number of local markets at period end

 

28

 

28

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Treatment centers - freestanding (global)

 

121

 

112

 

8.0

%

 

 

 

 

 

 

Treatment centers - hospital / other groups (global)

 

5

 

7

 

-28.6

%

 

 

 

 

 

 

 

 

126

 

119

 

5.9

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Days sales outstanding at quarter end

 

40

 

43

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Percentage change in freestanding revenues - same practice basis

 

0.5

%

5.5

%

 

 

0.0

%

4.3

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net patient service revenue - professional services only (in thousands)

 

$

52,293

 

$

40,437

 

 

 

$

101,827

 

$

82,534

 

 

 

 


* Excludes the impact of the termination of a capitated contract in Las Vegas, Nevada

 

 

 

Three Months Ended

 

 

 

Six Months Ended

 

 

 

 

 

June 30,

 

%

 

June 30,

 

%

 

International

 

2012

 

2011

 

Change

 

2012

 

2011 **

 

Change

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Number of new cases

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2-D cases

 

1,091

 

1,295

 

 

 

2,450

 

2,649

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3-D cases

 

2,304

 

1,677

 

 

 

4,327

 

3,265

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IMRT / IGRT cases

 

343

 

319

 

 

 

779

 

631

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

3,738

 

3,291

 

13.6

%

7,556

 

6,545

 

15.4

%

 


** includes full period operating statistics, including period prior to our acquisition on March 1, 2011

 

###