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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

 

 

FORM 10-Q

 

 

(MARK ONE)

x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

FOR THE QUARTERLY PERIOD ENDED September 30, 2012

OR

 

¨ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

FOR THE TRANSITION PERIOD FROM              TO             

COMMISSION FILE NUMBER 1-11151

 

 

U.S. PHYSICAL THERAPY, INC.

(EXACT NAME OF REGISTRANT AS SPECIFIED IN ITS CHARTER)

 

 

 

NEVADA   76-0364866

(STATE OR OTHER JURISDICTION OF

INCORPORATION OR ORGANIZATION)

 

(I.R.S. EMPLOYER

IDENTIFICATION NO.)

1300 WEST SAM HOUSTON PARKWAY SOUTH, SUITE 300,

HOUSTON, TEXAS

  77042
(ADDRESS OF PRINCIPAL EXECUTIVE OFFICES)   (ZIP CODE)

REGISTRANT’S TELEPHONE NUMBER, INCLUDING AREA CODE: (713) 297-7000

 

 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  x    No  ¨

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes  x    No  ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act.

 

Large accelerated filer   ¨    Accelerated filer   x
Non-accelerated filer   ¨  (Do not check if a smaller reporting company)    Smaller reporting company   ¨

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ¨    No  x

As of November 8, 2012, the number of shares outstanding (issued less treasury stock) of the registrant's common stock, par value $.01 per share, was: 11,867,065.

 

 

 


PART I — FINANCIAL INFORMATION

  
Item 1.    Financial Statements.      3   
   Consolidated Balance Sheets as of September 30, 2012 and December 31, 2011      3   
   Consolidated Statements of Net Income for the three months and nine months ended September 30, 2012 and 2011      4   
   Consolidated Statements of Cash Flows for the nine months ended September 30, 2012 and 2011      5   
   Consolidated Statement of Shareholders' Equity for the nine months ended September 30, 2012      6   
   Notes to Consolidated Financial Statements      7   
Item 2.    Management’s Discussion and Analysis of Financial Condition and Results of Operations      16   
Item 3.    Quantitative and Qualitative Disclosure About Market Risk      23   
Item 4.    Controls and Procedures      24   
PART II — OTHER INFORMATION   
Item 6.    Exhibits      24   
   Signatures      25   
   Certifications   

 

2


ITEM 1. FINANCIAL STATEMENTS.

U. S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(IN THOUSANDS, EXCEPT SHARE DATA)

 

     September 30,
2012
    December 31,
2011
 
     (unaudited)        

ASSETS

    

Current assets:

    

Cash

   $ 10,683      $ 9,983   

Patient accounts receivable, less allowance for doubtful accounts of $1,687 and $2,154, respectively

     26,784        28,333   

Accounts receivable — other, less allowance for doubtful accounts of $373 and $883, respectively

     1,640        1,614   

Other current assets

     4,956        5,737   
  

 

 

   

 

 

 

Total current assets

     44,063        45,667   

Fixed assets:

    

Furniture and equipment

     35,853        35,103   

Leasehold improvements

     20,598        20,385   
  

 

 

   

 

 

 
     56,451        55,488   

Less accumulated depreciation and amortization

     43,634        42,299   
  

 

 

   

 

 

 
     12,817        13,189   

Goodwill

     99,716        92,750   

Other intangible assets, net

     12,326        9,603   

Other assets

     1,018        2,043   
  

 

 

   

 

 

 
   $ 169,940      $ 163,252   
  

 

 

   

 

 

 

LIABILITIES AND SHAREHOLDERS’ EQUITY

    

Current liabilities:

    

Accounts payable — trade

   $ 1,665      $ 1,809   

Accrued expenses

     12,672        14,082   

Current portion of notes payable

     609        433   
  

 

 

   

 

 

 

Total current liabilities

     14,946        16,324   

Notes payable

     175        284   

Revolving line of credit

     16,100        23,500   

Deferred rent

     894        941   

Other long-term liabilities

     1,434        623   
  

 

 

   

 

 

 

Total liabilities

     33,549        41,672   

Commitments and contingencies

    

Shareholders’ equity:

    

U. S. Physical Therapy, Inc. shareholders’ equity:

    

Preferred stock, $.01 par value, 500,000 shares authorized, no shares issued and outstanding

     —          —     

Common stock, $.01 par value, 20,000,000 shares authorized, 14,081,802 and 13,919,588 shares issued, respectively

     141        139   

Additional paid-in capital

     37,769        36,133   

Retained earnings

     113,112        102,405   

Treasury stock at cost, 2,214,737 shares

     (31,628     (31,628
  

 

 

   

 

 

 

Total U. S. Physical Therapy, Inc. shareholders’ equity

     119,394        107,049   

Noncontrolling interests

     16,997        14,531   
  

 

 

   

 

 

 

Total equity

     136,391        121,580   
  

 

 

   

 

 

 
   $ 169,940      $ 163,252   
  

 

 

   

 

 

 

See notes to consolidated financial statements.

 

3


U. S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF NET INCOME

(IN THOUSANDS, EXCEPT PER SHARE DATA)

(unaudited)

 

     Three Months Ended September 30,     Nine Months Ended September 30,  
             2012                     2011                     2012                     2011          

Net patient revenues

   $ 60,782      $ 57,332      $ 183,333      $ 167,882   

Other revenues

     2,071        2,343        6,061        8,446   
  

 

 

   

 

 

   

 

 

   

 

 

 

Net revenues

     62,853        59,675        189,394        176,328   

Clinic operating costs:

        

Salaries and related costs

     33,376        32,430        98,846        93,189   

Rent, clinic supplies, contract labor and other

     12,844        12,012        38,320        34,695   

Provision for doubtful accounts

     1,259        1,426        3,656        2,554   

Closure costs

     5        13        76        44   
  

 

 

   

 

 

   

 

 

   

 

 

 

Total clinic operating costs

     47,484        45,881        140,898        130,482   
  

 

 

   

 

 

   

 

 

   

 

 

 

Gross margin

     15,369        13,794        48,496        45,846   

Corporate office costs

     5,977        5,142        18,635        17,630   
  

 

 

   

 

 

   

 

 

   

 

 

 

Operating income

     9,392        8,652        29,861        28,216   

Interest and other income, net

     1        4        4        8   

Interest expense

     (142     (149     (449     (331
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before taxes

     9,251        8,507        29,416        27,893   

Provision for income taxes

     2,953        2,654        8,992        8,252   
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income including noncontrolling interests

     6,298        5,853        20,424        19,641   

Less: net income attributable to noncontrolling interests

     (1,735     (1,754     (6,534     (6,896
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to common shareholders

   $ 4,563      $ 4,099      $ 13,890      $ 12,745   
  

 

 

   

 

 

   

 

 

   

 

 

 

Earnings per share attributable to common shareholders:

        

Basic

   $ 0.39      $ 0.35      $ 1.18      $ 1.08   
  

 

 

   

 

 

   

 

 

   

 

 

 

Diluted

   $ 0.38      $ 0.34      $ 1.17      $ 1.06   
  

 

 

   

 

 

   

 

 

   

 

 

 

Shares used in computation:

        

Basic

     11,827        11,886        11,778        11,824   
  

 

 

   

 

 

   

 

 

   

 

 

 

Diluted

     11,928        12,011        11,892        12,007   
  

 

 

   

 

 

   

 

 

   

 

 

 

Dividends declared per common share

   $ 0.09      $ 0.08      $ 0.27      $ 0.24   
  

 

 

   

 

 

   

 

 

   

 

 

 

See notes to consolidated financial statements.

 

4


U. S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(IN THOUSANDS)

(unaudited)

 

     Nine Months Ended September 30,  
         2012             2011      

OPERATING ACTIVITIES

    

Net income including noncontrolling interests

   $ 20,424      $ 19,641   

Adjustments to reconcile net income including noncontrolling interests to net cash provided by operating activities:

    

Depreciation and amortization

     4,016        4,108   

Provision for doubtful accounts

     3,656        2,554   

Equity-based awards compensation expense

     1,589        1,491   

Loss on sale or abandonment of assets, net

     129        140   

Deferred income tax

     2,535        1,432   

Other

     —          (771

Changes in operating assets and liabilities:

    

Increase in patient accounts receivable

     (1,298     (3,811

Increase in accounts receivable — other

     (482     (1,277

Decrease (increase) in other assets

     471        (2,027

Decrease in accounts payable and accrued expenses

     (1,709     (1,494

Increase in other liabilities

     19        607   
  

 

 

   

 

 

 

Net cash provided by operating activities

     29,350        20,593   

INVESTING ACTIVITIES

    

Purchase of fixed assets

     (2,948     (2,428

Purchase of businesses, net of cash acquired

     (7,402     (8,149

Acquisitions of noncontrolling interests

     (1,314     (18,935

Sale of noncontrolling interests

     239        —     

Net proceeds on sale of fixed assets and business

     58        5   
  

 

 

   

 

 

 

Net cash used in investing activities

     (11,367     (29,507

FINANCING ACTIVITIES

    

Distributions to noncontrolling interests

     (6,850     (7,282

Cash dividends to shareholders

     (3,183     (2,843

Purchase and retirement of common stock

     —          (2,269

Proceeds from revolving line of credit

     55,900        94,000   

Payments on revolving line of credit

     (63,300     (73,100

Payment of notes payable

     (284     (100

Excess tax benefit from stock options exercised

     381        802   

Other

     53        2   
  

 

 

   

 

 

 

Net cash (used in) provided by financing activities

     (17,283     9,210   

Net increase in cash

     700        296   

Cash — beginning of period

     9,983        9,179   
  

 

 

   

 

 

 

Cash — end of period

   $ 10,683      $ 9,475   
  

 

 

   

 

 

 

SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION

    

Cash paid during the period for:

    

Income taxes

   $ 5,200      $ 7,881   

Interest

   $ 538      $ 315   

Non-cash investing and financing transactions during the period:

    

Purchase of business — seller financing portion

   $ 350      $ 200   

Acquisition of noncontrolling interest — seller financing portion

   $ —        $ 367   

See notes to consolidated financial statements.

 

5


U. S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENT OF SHAREHOLDERS’ EQUITY

(IN THOUSANDS)

(unaudited)

 

    U. S. Physical Therapy, Inc.     Noncontrolling
Interests
    Total  
    Common Stock     Additional
Paid-In
Capital
    Retained
Earnings
    Treasury Stock     Total
Shareholders’
Equity
     
    Shares     Amount         Shares     Amount        

Balance December 31, 2011

    13,919      $ 139      $ 36,133      $ 102,405        (2,215   $ (31,628   $ 107,049      $ 14,531      $ 121,580   

Issuance of restricted stock

    81        —          —          —          —          —          —          —          —     

Compensation expense — restricted stock

    —          —          1,589        —          —          —          1,589        —          1,589   

Transfer of compensation liability for certain stock issued pursuant to incentive plans

    —          —          135        —          —          —          135        —          135   

Proceeds from exercise of stock options

    82        2        2        —          —          —          4        —          4   

Excess tax benefit of equity grants

    —          —          381        —          —          —          381        —          381   

Purchase of business

    —          —          —          —          —          —          —          2,892        2,892   

Contribution of non controlling interests partners

    —          —          —          —          —          —          —          49        49   

Acquisition of non controlling interests

    —          —          (705     —          —          —          (705     (164     (869

Sale of non controlling interests

    —          —          234        —          —          —          234        5        239   

Cash dividends to USPT shareholders

    —          —          —          (3,183     —          —          (3,183     —          (3,183

Distributions to noncontrolling interest partners

    —          —          —          —          —          —          —          (6,850     (6,850

Net income

    —          —          —          13,890        —          —          13,890        6,534        20,424   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Balance September 30, 2012

    14,082      $ 141      $ 37,769      $ 113,112        (2,215   $ (31,628   $ 119,394      $ 16,997      $ 136,391   
 

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

See notes to consolidated financial statements.

 

6


U.S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

September 30, 2012

(unaudited)

1. BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

The consolidated financial statements include the accounts of U.S. Physical Therapy, Inc. and its subsidiaries (the “Company”). All significant intercompany transactions and balances have been eliminated. The Company primarily operates through subsidiary clinic partnerships, in which the Company generally owns a 1% general partnership interest and a 64% limited partnership interest. The managing therapist of each clinic owns, directly or indirectly, the remaining limited partnership interest in the majority of the clinics (hereinafter referred to as “Clinic Partnership”). To a lesser extent, the Company operates some clinics, through wholly-owned subsidiaries, under profit sharing arrangements with therapists (hereinafter referred to as “Wholly-Owned Facilities”).

The Company continues to seek to attract physical and occupational therapists who have established relationships with patients and physicians by offering therapists a competitive salary and a share of the profits of the clinic(s) operated by that therapist. The Company has developed satellite clinic facilities of existing clinics, with the result that many Clinic Partnerships and Wholly-Owned Facilities operate more than one clinic location. In addition, the Company has acquired a majority interest in a number of clinics through acquisitions.

During the nine months ended September 30, 2012, the Company acquired 10 clinics as follows:

 

Acquisition

   Date      % Interest
Acquired
    Number of
Clinics
 
       

January 2012 Acquisition

     January 3         100     1   

March 2012 Acquisition

     March 31         65     1   

May 2012 Acquisition

     May 22         70     7   

August 2012 Acquisition

     August 1         65     1   

As of September 30, 2012, the Company operated 423 clinics in 42 states.

The results of operations of the acquired clinics have been included in the Company’s consolidated financial statements since the dates of their respective acquisition.

The Company intends to continue to focus on developing new clinics and on opening satellite clinics where deemed appropriate. The Company will also continue to evaluate acquisition opportunities.

The accompanying unaudited consolidated financial statements were prepared in accordance with accounting principles generally accepted in the United States of America for interim financial information and in accordance with the instructions for Form 10-Q. However, the statements do not include all of the information and footnotes required by accounting principles generally accepted in the United States of America for complete financial statements. Management believes this report contains all necessary adjustments (consisting only of normal recurring adjustments) to present fairly, in all material respects, the Company’s financial position, results of operations and cash flows for the interim periods presented. For further information regarding the Company’s accounting policies, please read the audited financial statements included in the Company’s Form 10-K for the year ended December 31, 2011.

The Company believes, and the Chief Executive Officer, Chief Financial Officer and Corporate Controller have certified, that the financial statements included in this report present fairly, in all material respects, the Company’s financial position, results of operations and cash flows for the interim periods presented.

Operating results for the three months and nine months ended September 30, 2012 are not necessarily indicative of the results the Company expects for the entire year. Please also review the Risk Factors section included in our Form 10-K for the year ended December 31, 2011.

 

7


Clinic Partnerships

For Clinic Partnerships, the earnings and liabilities attributable to the non-controlling interests, typically owned by the managing therapist, directly or indirectly, are recorded within the balance sheets and income statements as non-controlling interests.

Wholly-Owned Facilities

For Wholly-Owned Facilities with profit sharing arrangements, an appropriate accrual is recorded for the amount of profit sharing due to the profit sharing therapists. The amount is expensed as compensation and included in clinic operating costs — salaries and related costs. The respective liability is included in current liabilities — accrued expenses on the balance sheet.

Significant Accounting Policies

Long-Lived Assets

Fixed assets are stated at cost. Depreciation is computed on the straight-line method over the estimated useful lives of the related assets. Estimated useful lives for furniture and equipment range from three to eight years and for software purchased from three to seven years. Leasehold improvements are amortized over the shorter of the related lease term or estimated useful lives of the assets, which is generally three to five years.

Impairment of Long-Lived Assets and Long-Lived Assets to Be Disposed Of

The Company reviews property and equipment and intangible assets with finite lives for impairment upon the occurrence of certain events or circumstances which indicate that the related amounts may be impaired. Assets to be disposed of are reported at the lower of the carrying amount or fair value less costs to sell.

Goodwill

Goodwill represents the excess of the amount paid and fair value of the non-controlling interests over the fair value of the acquired business assets, which include certain intangible assets. Historically, goodwill has been derived from acquisitions and, prior to 2009, from the purchase of some or all of a particular local management’s equity interest in an existing clinic. Effective January 1, 2009, if the purchase price of a non-controlling interest by the Company exceeds or is less than the book value at the time of purchase, any excess or shortfall is recognized as an adjustment to additional paid-in capital.

The fair value of goodwill and other intangible assets with indefinite lives are tested for impairment annually and upon the occurrence of certain events, and are written down to fair value if considered impaired. The Company evaluates goodwill for impairment on at least an annual basis (in its third quarter) by comparing the fair value of its reporting unit to the carrying value of each reporting unit including related goodwill. The Company operates a one segment business which is made up of various clinics within partnerships. The partnerships are components of regions and are aggregated to the operating segment level for the purpose of determining our reporting units when performing our annual goodwill impairment test.

An impairment loss generally would be recognized when the carrying amount of the net assets of a reporting unit, inclusive of goodwill and other intangible assets, exceeds the estimated fair value of the reporting unit. The estimated fair value of a reporting unit is determined using two factors: (i) earnings prior to taxes, depreciation and amortization for the reporting unit multiplied by a price/earnings ratio used in the industry and (ii) a discounted cash flow analysis. A weight is assigned to each factor and the sum of each weight times the factor is considered the estimated fair value. For 2012, the factors (ie., price/earnings ratio, discount rate and residual capitalization rate) were updated to reflect current market conditions. The evaluation in the third quarter of 2012, did not yield any impairment charge.

Non-controlling interests

The Company recognizes non-controlling interests as equity in the consolidated financial statements separate from the parent entity’s equity. The amount of net income attributable to non-controlling interests is included in consolidated net income on the face of the income statement. Changes in a parent entity’s ownership interest in a subsidiary that do not result in deconsolidation are treated as equity transactions if the parent entity retains its controlling financial interest. The Company recognizes a gain or loss in net income when a subsidiary is deconsolidated. Such gain or loss is measured using the fair value of the non-controlling equity investment on the deconsolidation date.

 

8


When the purchase price of a non-controlling interest by the Company exceeds or is less than the book value at the time of purchase, any excess or shortfall is recognized as an adjustment to additional paid-in capital. Additionally, operating losses are allocated to non-controlling interests even when such allocation creates a deficit balance for the non-controlling interest partner.

Revenue Recognition

Revenues are recognized in the period in which services are rendered. Net patient revenues (patient revenues less estimated contractual adjustments) are reported at the estimated net realizable amounts from third-party payors, patients and others for services rendered. The Company has agreements with third-party payors that provide for payments to the Company at amounts different from its established rates. The allowance for estimated contractual adjustments is based on terms of payor contracts and historical collection and write-off experience.

The Company determines allowances for doubtful accounts based on the specific agings and payor classifications at each clinic. The provision for doubtful accounts is included in clinic operating costs in the statement of net income. Net accounts receivable, which are stated at the historical carrying amount net of contractual allowances, write-offs and allowance for doubtful accounts, includes only those amounts the Company estimates to be collectible.

Medicare Reimbursement

The Medicare program reimburses outpatient rehabilitation providers based on the Medicare Physician Fee Schedule (“MPFS”). The MPFS rates are automatically updated annually based on a formula, called the sustainable growth rate (“SGR”) formula. The use of the SGR formula has resulted in calculated automatic reductions in rates in every year since 2002; however, for each year through 2012, Centers for Medicare & Medicaid Services (“CMS”) or Congress has taken action to prevent the implementation of SGR formula reductions. The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2011 provided a 2.2% increase to MPFS payment rates, retroactive from June 1, 2011 through November 30, 2011, suspending a 21.3% reduction that briefly became effective on June 1, 2011. The Medicare and Medicaid Extenders Act of 2011 (“MMEA”) prevented a 25.5% reduction in the MPFS payment rates that would have taken effect on January 1, 2011. The Temporary Payroll Tax Cut Continuation Act of 2011 (“TPTC”) delayed application of the SGR for two additional months, through February 29, 2012. The Middle Class Tax Relief and Job Creation Act of 2012 (“MCTRA”) included a measure freezing payment rates at their current level through December 31, 2012.

On November 1, 2012, CMS released the 2013 Medicare Physician Fee Schedule final rule. Under the 2013 Medicare Physician Fee Schedule, CMS has estimated a 26.5% reduction in the outpatient physical therapy payment rates beginning on January 1, 2013, unless Congress again takes legislative action to prevent the SGR formula reductions from going into effect. This reduction would be in addition to any automatic spending reductions being enacted as a result of the Budget Control Act of 2011, which would cut Medicare spending by 2%. If the 26.5% SGR reduction and the 2% cut in Medicare spending are averted by Congress, the projected impact of other changes in the rule on outpatient physical therapy service payments in aggregate is expected to be a 4.0% increase in 2013, primarily due to the continued phase in of new practice expense survey data derived from the Physician Practice Information Survey (“PPIS”). In 2013, when the use of the PPIS data is fully phased in, the impact is expected to be a 6.0% increase for outpatient physical therapy payments. In the final 2012 Medicare Physician Fee Schedule rule, CMS indicated that over the next year it will continue to review whether specific Current Procedural Terminology (“CPT”) codes billed under the fee schedule are overvalued or undervalued, including certain specific CPT codes used by physical therapists.

In the 2013 Medicare Physician Fee Schedule rule, CMS indicated that it will implement a claims-based data collection process to gather additional data on patient function during the course of therapy in order to better understand patient conditions and outcomes. All practice settings that provide outpatient therapy services would be required to include this data on the claim form. Beginning on July 1, 2013, therapists will be required to report new codes and modifiers on the claim form that reflect a patient’s functional limitations and goals at initial evaluation, periodically throughout care, and at discharge. For claims submitted after July 1, 2013, CMS proposes to return claims as unpaid if the required data is not included in the claim.

As a result of the Balanced Budget Act of 1997, the formula for determining the total amount paid by Medicare in any one year for outpatient physical therapy, occupational therapy, and/or speech-language pathology services provided to any Medicare beneficiary (i.e., the “Therapy Cap” or “Limit”) was established. Based on the statutory definitions which constrained how the Therapy Cap would be applied, there is one Limit for Physical Therapy and Speech Language Pathology Services combined, and one Limit for Occupational Therapy. Effective January 1, 2012, the annual Limit on outpatient therapy services is $1,880 for physical therapy and speech language pathology services combined and $1,880 for occupational therapy services. Pursuant to the final MPFS rule for 2013, effective January 1, 2013 the annual Limit on outpatient therapy services is $1,900 for physical therapy and speech language pathology services combined and $1,900 for occupational therapy services. These Therapy Caps are applicable to outpatient therapy services provided in all settings, except for services provided in departments of hospitals. However, pursuant to the MCTRA, beginning no later than October 1, 2012 and expiring on December 31, 2012, these Limits will temporarily apply to therapy services performed in hospital outpatient departments.

In the Deficit Reduction Act of 2005, Congress implemented an exceptions process to the annual Limit for therapy expenses. Under this process, a Medicare enrollee (or person acting on behalf of the Medicare enrollee) is able to request an exception from the therapy caps if the provision of therapy services was deemed to be medically necessary. Therapy cap exceptions have been available automatically for certain conditions and on a case-by-case basis upon submission of documentation of medical necessity. The MCTRA extended the exceptions process for outpatient therapy caps through December 31, 2012. Unless Congress extends the exceptions process, the therapy caps will apply to all outpatient therapy services beginning January 1, 2013, except those services furnished and billed by outpatient hospital departments.

Furthermore, under the MCTRA, starting on October 1, 2012, patients who meet or exceed $3,700 in therapy expenditures will be subject to a manual medical review. The MCTRA designates that this medical review will be similar to the process used following Deficit Reduction Act implementation in 2006. The $3,700 threshold will be applied to the combined physical therapy/speech language pathology cap; a separate $3,700 threshold will be applied to the occupational therapy cap.

 

9


CMS adopted a multiple procedure payment reduction (MPPR) for therapy services in the final update to the MPFS for calendar year 2011. Under MPPR, the Medicare program pays 100% of the practice expense component of the Relative Value Unit (“RVU”) for the therapy procedure with the highest Practive Expense RVU, then reduces the payment for the practice expense component of the RVU for additional procedures. The reduction for these subsequent procedures varies based on the setting, with a 20% reduction for services in an office or other non-institutional setting and 25% in institutional settings. The reduction applies to most therapy services furnished during the same day for the same patient, whether or not the therapy services are furnished in separate sessions. The MPPR was continued in calendar year 2012 and for 2013.

Statutes, regulations, and payment rules governing the delivery of therapy services to Medicare beneficiaries are complex and subject to interpretation. The Company believes that it is in compliance in all material respects with all applicable laws and regulations and is not aware of any pending or threatened investigations involving allegations of potential wrongdoing that would have a material effect on the Company’s financial statements as of September 30, 2012. 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 program.

Physician Services Revenues

Revenues from physician services are generated by franchisee arrangements with third parties, pursuant to which there are multiple deliverables — training and ongoing services — as well as through the two physician services facilities. Each component can be purchased separately. Revenue is recognized over the period the respective services are provided. Physician service revenues are included in “other revenues” in the accompanying Consolidated Statements of Net Income.

Management Contract Revenues

Management contract revenues are derived from contractual arrangements whereby the Company manages a clinic for third party owners. The Company does not have any ownership interest in these clinics. Typically, revenues are determined based on the number of visits conducted at the clinic and recognized when services are performed. Costs, typically salaries for the Company’s employees, are recorded when incurred. Management contract revenues are included in “other revenues” in the accompanying Consolidated Statements of Net Income.

Contractual Allowances

Contractual allowances result from the differences between the rates charged for services performed and expected reimbursements for such services by both insurance companies and government sponsored healthcare programs. Medicare regulations and the various third party payors and managed care contracts are often complex and may include multiple reimbursement mechanisms payable for the services provided in Company clinics. The Company estimates contractual allowances based on its interpretation of the applicable regulations, payor contracts and historical calculations. Each month the Company estimates its contractual allowance for each clinic based on payor contracts and the historical collection experience of the clinic and applies an appropriate contractual allowance reserve percentage to the gross accounts receivable balances for each payor of the clinic. Based on the Company’s historical experience, calculating the contractual allowance reserve percentage at the payor level is sufficient to allow it to provide the necessary detail and accuracy with its collectibility estimates. However, the services authorized and provided and related reimbursement are subject to interpretation that could result in payments that differ from the Company’s estimates. Payor terms are periodically revised necessitating continual review and assessment of the estimates made by management. The Company’s billing systems may not capture the exact change in its contractual allowance reserve estimate from period to period in order to assess the accuracy of its revenues, and hence, its contractual allowance reserves. Management regularly compares its cash collections to corresponding net revenues measured both in the aggregate and on a clinic-by-clinic basis. In the aggregate, historically the difference between net revenues and corresponding cash collections has generally reflected a difference within approximately 1% of net revenues. Additionally, analysis of subsequent period’s contractual write-offs on a payor basis shows a less than 1% difference between the actual aggregate contractual reserve percentage as compared to the estimated contractual allowance reserve percentage associated with the same period end balance. As a result, the Company believes that a change in the contractual allowance reserve estimate would not likely be more than 1% at September 30, 2012.

 

10


Income Taxes

Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date.

The Company recognizes the financial statement benefit of a tax position only after determining that the relevant tax authority would more likely than not sustain the position following an audit. For tax positions meeting the more-likely-than-not threshold, the amount to be recognized in the financial statements is the largest benefit that has a greater than 50 percent likelihood of being realized upon ultimate settlement with the relevant tax authority.

The Company recognizes accrued interest expense and penalties associated with unrecognized tax benefits as income tax expense. The Company did not have any accrued interest or penalties associated with any unrecognized tax benefits nor was any interest expense recognized during the three months and nine months ended September 30, 2012.

Fair Value of Financial Instruments

The carrying amounts reported in the balance sheet for cash and cash equivalents, accounts receivable, accounts payable and notes payable approximate their fair values due to the short-term maturity of these financial instruments. The carrying amount of the Company’s revolving line of credit approximates its fair value. The interest rate on the revolving line of credit, which is tied to the Eurodollar Rate, is set at various short-term intervals as detailed in the credit agreement.

Segment Reporting

Operating segments are components of an enterprise for which separate financial information is available that is evaluated regularly by chief operating decision makers in deciding how to allocate resources and in assessing performance. The Company identifies operating segments based on management responsibility and believes it meets the criteria for aggregating its operating segments into a single reporting segment.

Use of Estimates

In preparing the Company's consolidated financial statements, management makes certain estimates and assumptions, especially in relation to, but not limited to, purchase accounting, goodwill impairment, allowance for receivables, tax provision and contractual allowances, that affect the amounts reported in the consolidated financial statements and related disclosures. Actual results may differ from these estimates.

Self-Insurance Program

The Company utilizes a self-insurance plan for its employee group health insurance coverage administered by a third party. Predetermined loss limits have been arranged with the insurance company to minimize the Company’s maximum liability and cash outlay. Accrued expenses include the estimated incurred but unreported costs to settle unpaid claims and estimated future claims. Management believes that the current accrued amounts are sufficient to pay claims arising from self insurance claims incurred through September 30, 2012.

Restricted Stock

Restricted stock issued to employees and directors is subject to certain conditions, including continued employment or continued service on the board, respectively. The transfer restrictions for shares granted to employees lapse in equal installments on the following four or five annual anniversaries of the date of grant. Compensation expense for grants of restricted stock is recognized based on the fair value per share on the date of grant amortized over the service period. The restricted stock issued is included in basic and diluted shares for the earnings per share computation.

 

11


Recent Accounting Pronouncements

In July 2011, the Financial Accounting Standards Board (“FASB”) issued ASU 2011-07, “Health Care Entities (Topic 954): Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts and the Allowance for Doubtful Accounts for Certain Health Care Entities” (“ASU 2011-07”). ASU 2011-07 requires certain health care entities to change the presentation in their statement of operations by reclassifying the provision for bad debts associated with patient service revenue that is not subject to an assessment as to the patient’s ability to pay from an operating expense to a deduction from patient service revenue (net of contractual allowances and discounts). Additionally, those health care entities are required to provide enhanced disclosure about their policies for recognizing revenue and assessing bad debts. ASU 2011-07 also requires disclosure of patient service revenue (net of contractual allowances and discounts) as well as qualitative and quantitative information about changes in the allowance for doubtful accounts. The Company has evaluated ASU 2011-07 and concluded that it is not required to change its presentation and disclosure. Substantially all of the Company’s patient revenue is subject to an assessment as to the patient’s ability to pay at the time the related service is provided.

In September 2011, the FASB issued ASU 2011-08, “Intangibles-Goodwill and Other (Topic 350): Testing Goodwill for Impairment” (“ASU 2011-08”), which modifies the impairment test for goodwill intangibles. ASU 2011-08 provides an entity the option to first assess qualitative factors to determine whether the existence of events or circumstances leads to a determination that it is more likely than not (more than 50%) that the fair value of a reporting unit is less than its carrying amount. Such qualitative factors may include the following: macroeconomic conditions; industry and market considerations; cost factors; overall financial performance; and other relevant entity-specific events. If an entity elects to perform a qualitative assessment and determines that an impairment is more likely than not, the entity is then required to perform the existing two-step quantitative impairment test, otherwise no further analysis is required. An entity also may elect not to perform the qualitative assessment and, instead, go directly to the two-step quantitative impairment test. These changes are effective for any goodwill impairment test performed on January 1, 2012 or later, although early adoption was permitted. These changes should not affect the outcome of the impairment analysis of a reporting unit. The Company performs a review of the Company’s goodwill in the third quarter of each fiscal year. The adoption of ASU 2011-08 in 2012 did not have an impact on the Company as it performed its goodwill impairment test using a quantitative approach.

2. EARNINGS PER SHARE

The computations of basic and diluted earnings per share for the Company are as follows (in thousands, except per share data):

 

     Three Months Ended
September 30,
     Nine Months Ended
September 30,
 
     2012      2011      2012      2011  

Numerator:

           

Net income attributable to common shareholders

   $ 4,563       $ 4,099       $ 13,890       $ 12,745   
  

 

 

    

 

 

    

 

 

    

 

 

 

Denominator:

           

Denominator for basic earnings per share — weighted-average shares

     11,827         11,886         11,778         11,824   

Effect of dilutive securities —

           

Stock options

     101         125         114         183   
  

 

 

    

 

 

    

 

 

    

 

 

 

Denominator for diluted earnings per share — adjusted weighted-average shares

     11,928         12,011         11,892         12,007   
  

 

 

    

 

 

    

 

 

    

 

 

 

Earnings per share attributable to common shareholders:

           

Basic

   $ 0.39       $ 0.35       $ 1.18       $ 1.08   
  

 

 

    

 

 

    

 

 

    

 

 

 

Diluted

   $ 0.38       $ 0.34       $ 1.17       $ 1.06   
  

 

 

    

 

 

    

 

 

    

 

 

 

All options to purchase shares were included in the diluted earnings per share calculation for the three months and nine months ended September 30, 2012 and 2011 as the average market price of the common shares was above the exercise prices. The Company’s restricted stock issued is included in basic and diluted shares for the earnings per share computation from the date of grant.

 

12


3. ACQUISITION OF BUSINESSES

The purchase price for the May 2012 Acquisition was $6,090,000 in cash and $250,000 in seller notes, that are payable in two principal installments totaling $125,000 each, plus accrued interest, in May 2013 and 2014. During the first nine months of 2012, the Company acquired three clinics in separate transactions. On January 3, 2012, through a subsidiary, the Company acquired a 100% interest in a clinic for $1.0 million in cash and a note payable of $100,000, effective March 31, 2012, the Company acquired a 65% interest in another clinic for $90,000 and, effective August 1, 2012, the Company acquired a 65% interest in another clinic for $321,000.

The purchase prices have been preliminarily allocated as follows (in thousands):

 

Cash paid, net of cash acquired

   $ 7,402   

Seller notes

     350   
  

 

 

 

Total consideration

   $ 7,752   
  

 

 

 

Estimated fair value of net tangible assets acquired:

  

Total current assets

   $ 363   

Total non-current assets

     423   

Total liabilities

     (290
  

 

 

 

Net tangible assets acquired

   $ 496   

Referral relationships

     57   

Non compete

     25   

Goodwill

     10,066   

Fair value of noncontrolling interest

     (2,892
  

 

 

 
   $ 7,752   
  

 

 

 

The consideration for each transaction was agreed upon through arm’s length negotiations. Funding for the cash portion of the purchase price was derived from proceeds from the Company’s revolving credit facility.

The results of operations of these acquisitions have been included in the Company’s consolidated financial statements since acquired.

Because these acquisitions occurred during the nine months ended September 30, 2012, the purchase price plus the fair value of the noncontrolling interest was allocated to the fair value of the assets acquired and liabilities assumed based on the preliminary estimates of the fair values at the acquisition date, with the amount exceeding the estimated fair values being recorded as goodwill. The Company is in the process of completing its formal valuation analysis to identify and determine the fair value of tangible and intangible assets acquired and the liabilities assumed. Thus, the final allocation of the purchase price may differ from the preliminary estimates used at September 30, 2012 based on additional information obtained. Changes in the estimated valuation of the tangible and intangible assets acquired and the completion by the Company of the identification of any unrecorded pre-acquisition contingencies, where the liability is probable and the amount can be reasonably estimated, will likely result in adjustments to goodwill.

On July 25, 2011, the Company acquired a 51% interest in a 20 clinic multi-partner physical therapy group for $8.2 million in cash and a seller note of $200,000 payable in two principal installments of $100,000 each plus any accrued interest, in July 2012 and July 2013 (“July 2011 Acquisition”). During the nine months ended September 30, 2012, the Company finalized the purchase price allocation related to the July 2011 Acquisition.

 

13


The purchase price was allocated as follows:

 

Cash paid, net of cash acquired

   $ 7,930   

Seller notes

     200   
  

 

 

 

Total consideration

   $ 8,130   
  

 

 

 

Estimated fair value of net tangible assets acquired:

  

Total current assets

   $ 1,341   

Total non-current assets

     902   

Total liabilities

     (581
  

 

 

 

Net tangible assets acquired

   $ 1,662   

Tradename

     1,900   

Referral relationships

     1,100   

Non compete

     300   

Goodwill

     11,263   

Fair value of noncontrolling interest

     (8,095
  

 

 

 
   $ 8,130   
  

 

 

 

For the July 2011 Acquisition, the purchase price was allocated to the fair value of the assets acquired including tradename, non compete agreements and referral relationships, and to the liabilities assumed based on estimates of the fair values at the acquisition date, with the amount exceeding the fair value being recorded as goodwill. The values assigned to the referral relationships and non compete agreements are being amortized to expense equally over the respective estimated life of 13 years and six years, respectively. The values assigned to goodwill and tradenames are tested annually for impairment. Approximately, $5.8 million of the goodwill is tax deductible.

In April 2012, the Company sold 1% of its interest acquired in the July 2011 Acquisition to the limited partners. The Company now owns a 50% interest in the July 2011 Acquisition, consisting of 1% as a general partner interest and 49% as a limited partner interest. See Footnote 4 — Acquisitions and Sales of Non-Controlling Interests- for further details.

Unaudited proforma consolidated financial information for acquisitions occurring in 2012 and the July 2011 Acquisition has not been included as the results were not material to current operations.

4. ACQUISITIONS AND SALES OF NON-CONTROLLING INTERESTS

In ten separate transactions during the nine months ended September 30, 2012, the Company purchased partnership interests in ten partnerships. The interests in the partnerships purchased ranged from 10% to 35%. The aggregate of the purchase prices paid was $1,314,000, which included $164,000 of undistributed earnings. The remaining purchase price of $1,150,000, less future tax benefits of $445,000, was recognized as an adjustment to additional paid-in capital. During the nine months ended September 30, 2012, the Company sold partnership interests in the range of .64% to 1% in three partnerships for an aggregate price of $239,000. This amount less related undistributed earnings of $5,000 was credited to additional paid-in capital.

5. GOODWILL

The changes in the carrying amount of goodwill consisted of the following (in thousands):

 

     Nine Months
Ended
September 30,
2012
 

Beginning balance

   $ 92,750   

Goodwill acquired during the period

     10,066   

Goodwill allocated to specific assets for business acquired in 2011

     (3,300

Goodwill adjustments for purchase price allocation of business acquired in 2011

     200   
  

 

 

 

Ending balance

   $ 99,716   
  

 

 

 

 

14


6. NOTES PAYABLE AND REVOLVING CREDIT AGREEMENT

Notes payable as of September 30, 2012 and December 31, 2011 consisted of the following ($ in thousands):

 

     2012     2011  

Revolving credit agreement
average effective interest rate of 3.7% inclusive of unused fee

   $ 16,100      $ 23,500   

Promissory note payable in annual installments of $100 plus accrued interest through December 31, 2012, interest accrues at 3.25% per annum

     100        100   

Promissory note payable in annual installments of $50 plus accrued interest through December 21, 2012, interest accrues at 4.00% per annum

     50        50   

Promissory note payable in annual installments of $184 plus accrued interest through June 30, 2013, interest accrues at 3.25% per annum

     184        367   

Promissory note payable in annual installments of $100 plus accrued interest through July 25, 2013, interest accrues at 3.25% per annum

     100        200   

Promissory note payable in annual installments of $50 plus accrued interest through January 3, 2014, interest accrues at 3.25% per annum

     100        —     

Promissory notes payable in aggregate annual installments of $125 plus accrued interest through May 22, 2014, interest accrues at 3.25% per annum

     250        —     
  

 

 

   

 

 

 
     16,884        24,217   

Less current portion

     (609     (433
  

 

 

   

 

 

 
   $ 16,275      $ 23,784   
  

 

 

   

 

 

 

Effective August 27, 2007, the Company entered into a credit agreement with a commitment for a $30.0 million revolving credit facility which was increased to $50.0 million effective June 4, 2008 (“Credit Agreement”). Effective March 18, 2009, the Credit Agreement was amended to permit the purchase up to $15,000,000 of the Company’s common stock subject to compliance with certain covenants, including the requirement that after giving effect to any stock purchase, the Company’s consolidated leverage ratio (as defined in the Credit Agreement) be less than 1.0 to 1.0 and that any stock repurchased be retired within seven days of purchase. Effective October 13, 2010, the Credit Agreement was amended to extend the maturity date from August 31, 2011 to August 31, 2015. In addition, the Credit Agreement was amended to adjust the pricing grid which is based on the Company’s consolidated leverage ratio with the applicable spread over LIBOR ranging from 1.6% to 2.5% or the applicable spread over the Base Rate ranging from .1% to 1%. On July 14, 2011, the Credit Agreement was amended to increase the commitment from $50.0 million to $75.0 million. Effective October 24, 2012, the Credit Agreement was amended to permit the Company to purchase, commencing on October 24, 2012 and at all times thereafter, up to $15,000,000 of its common stock subject to compliance with covenants. The Credit Agreement is unsecured and has loan covenants, including requirements that the Company comply with a consolidated fixed charge coverage ratio and consolidated leverage ratio. Proceeds from the Credit Agreement may be used for working capital, acquisitions, purchases of the Company’s common stock, dividend payments to the Company’s common stockholders, capital expenditures and other corporate purposes. Fees under the Credit Agreement include an unused commitment fee ranging from .1% to .25% depending on the Company’s consolidated leverage ratio and the amount of funds outstanding under the Credit Agreement. On September 30, 2012, $16.1 million was outstanding on the revolving credit facility resulting in $58.9 million of availability. As of September 30, 2012, the Company was in compliance with all of the covenants thereunder.

The Company generally enters into various notes payable as a means of financing a portion of its acquisitions and purchases of non controlling interests. In conjunction with the May 2012 Acquisition, the Company entered into seller notes, that are payable in two aggregate principal installments of $125,000 each, plus accrued interest, in May 2013 and 2014. In January 2012, the Company, in conjunction with the purchase of a clinic, entered into a note payable in the amount of $100,000 payable in two equal annual installments of $50,000 plus accrued and unpaid interest. Interest accrues at 3.25% per annum.

Aggregate annual payments of principal required pursuant to the revolving credit facility and the above notes payable subsequent to September 30, 2012 are as follows:

 

During the twelve months ended September 30, 2013

   $ 609   

During the twelve months ended September 30, 2014

     175   

During the twelve months ended September 30, 2015

     16,100   
  

 

 

 

.

   $ 16,884   
  

 

 

 

 

15


7. COMMON STOCK

From September 2001 through December 31, 2008, the Board of Directors ("Board") authorized the Company to purchase, in the open market or in privately negotiated transactions, up to 2,250,000 shares of the Company’s common stock. In March 2009, the Board authorized the repurchase of up to 10% or approximately 1,200,000 shares of its common stock (“March 2009 Authorization”). In connection with the March 2009 Authorization, the Company amended its bank credit agreement to permit share repurchases of up to $15,000,000. The Company is required to retire shares purchased under the March 2009 Authorization.

Under the March 2009 Authorization, the Company has purchased a total of 859,499 shares. Since there is no expiration date for the share repurchase program, and since effective October 24, 2012, the Credit Agreement was further amended to permit the Company to purchase, commencing on October 24, 2012 and at all times thereafter, up to $15,000,000 of its common stock subject to compliance with certain covenants, there are currently an additional estimated 340,501 shares that may be purchased from time to time in the open market or private transactions depending on price, availability and the Company’s cash position. The Company did not purchase any shares of its common stock during the three months and nine months ended September 30, 2012.

ITEM 2. MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.

EXECUTIVE SUMMARY

Our Business

We operate outpatient physical and/or occupational therapy clinics that provide preventive and post-operative care for a variety of orthopedic-related disorders and sports-related injuries, treatment for neurologically-related injuries and rehabilitation of injured workers. As of September 30, 2012, we operated 423 clinics in 42 states, including two physician services facilities.

We also manage physical therapy facilities for third parties, primarily physicians, with 15 third-party facilities under management as of September 30, 2012.

Revenues from physician services are generated by franchisee arrangements with third parties, pursuant to which there are multiple deliverables — training and ongoing services — as well as through the two physician services facilities. Each deliverable can be purchased separately.

On May 22, 2012, we acquired a 70% interest in a seven-clinic practice (“May 2012 Acquisition”) and, during the first nine months of 2012, acquired three clinics in three separate transactions. On January 3, 2012, we acquired a 100% interest in a clinic, effective March 31, 2012, we acquired a 65% interest in another clinic and effective August 1, 2012, we acquired a 65% interest in another clinic. In July 2011, the Company acquired a 51% interest in a 20 clinic multi-partner physical therapy group (“July 2011 Acquisition”).

The results of operations of the acquired clinics have been included in our consolidated financials since the dates of their acquisition.

 

16


Selected Operating and Financial Data

The following table presents selected operating and financial data that we believe are key indicators of our operating performance.

 

     For the Three Months
Ended September 30,
     For the Nine Months
Ended September 30,
 
     2012      2011      2012      2011  

Number of clinics, at the end of period

     423         420         423         420   

Working days

     63         64         191         192   

Average visits per day per clinic

     21.7         20.8         21.9         20.8   

Total patient visits

     574,893         548,991         1,740,887         1,605,134   

Net patient revenue per visit

   $ 105.73       $ 104.43       $ 105.31       $ 104.59   

RESULTS OF OPERATIONS

Three Months Ended September 30, 2012 Compared to the Three Months Ended September 30, 2011

 

   

Net revenues increased to $62.9 million for the three months ended September 30, 2012 (“2012 Third Quarter”) from $59.7 million for the three months ended September 30, 2011 (“2011 Third Quarter”) primarily due to an increase in patient visits from 549,000 to 575,000. The average net patient revenue per visit for the 2012 Third Quarter was $105.73 as compared to $104.43 in the 2011 Third Quarter. The increase in net revenues from our core physical therapy operations was partially offset by a decrease in other revenues of $300,000 due to a reduction in revenue from physician services. There were 63 operating days in the 2012 Third Quarter and 64 operating days in the 2011 Third Quarter.

 

   

Net income attributable to our common shareholders for the 2012 Third Quarter was $4.6 million versus $4.1 million for the 2011 Third Quarter. Net income was $0.38 per diluted share for the 2012 Third Quarter and $0.34 per diluted share for the 2011 Third Quarter. Total diluted shares were 11.9 million for the 2012 Third Quarter and 12.0 million for the 2011 Third Quarter.

Net Patient Revenues

 

   

Net patient revenues increased to $60.8 million for the 2012 Third Quarter from $57.3 million for the 2011 Third Quarter, an increase of $3.5 million, or 6.0%, due to an increase in patient visits from 549,000 to 575,000, and an increase in the net patient revenue per visit of $1.30.

 

   

The growth in patient visits was primarily attributable to 21,000 visits in clinics opened or acquired between October 1, 2011 and September 30, 2012 (“New Clinics”). For clinics opened or acquired prior to October 1, 2011 (“Mature Clinics”), patient visits increased by 5,000 in the 2012 Third Quarter as compared to the 2011 Third Quarter.

 

   

Net patient revenues related to New Clinics amounted to $2.3 million for the 2012 Third Quarter and net patient revenues for Mature Clinics increased by $1.2 million for the 2012 Third Quarter as compared to the 2011 Third Quarter.

Net patient revenues are based on established billing rates less allowances and discounts for patients covered by contractual programs and workers’ compensation. Net patient revenues are after contractual and other adjustments relating to patient discounts from certain payors. Payments received under these programs are based on predetermined rates and are generally less than the established billing rates.

Other Revenues

Other revenues decreased by $0.3 million from $2.4 million to $2.1 million due to lower revenues from physician services.

 

17


Clinic Operating Costs

Clinic operating costs as a percentage of net revenues were 75.5% for the 2012 Third Quarter and 76.9% for the 2011 Third Quarter.

Clinic Operating Costs — Salaries and Related Costs

Salaries and related costs increased to $33.4 million for the 2012 Third Quarter from $32.4 million for the 2011 Third Quarter, an increase of $1.0 million, or 2.9%. Salaries and related costs for New Clinics amounted to $1.5 million for the 2012 Third Quarter. Salaries and related costs for Mature Clinics decreased by $0.5 million for the 2012 Third Quarter as compared to the 2011 Third Quarter. Salaries and related costs as a percentage of net revenues were 53.1% for the 2012 Third Quarter and 54.3% for the 2011 Third Quarter.

Clinic Operating Costs — Rent, Clinic Supplies, Contract Labor and Other

Rent, clinic supplies, contract labor and other were $12.8 million for the 2012 Third Quarter and $12.0 million for the 2011 Third Quarter. For New Clinics, rent, clinic supplies, contract labor and other amounted to $0.7 million for the 2012 Third Quarter. For Mature Clinics, rent, clinic supplies, contract labor and other increased by $100,000 in the 2012 Third Quarter compared to the 2011 Third Quarter. Rent, clinic supplies, contract labor and other as a percentage of net revenues was 20.4% for the 2012 Third Quarter and 20.1% for the 2011 Third Quarter.

Clinic Operating Costs — Provision for Doubtful Accounts

The provision for doubtful accounts was $1.3 million for the 2012 Third Quarter and $1.4 million for the 2011 Third Quarter. Of the $1.3 million, $180,000 related to other accounts receivable, and of the $1.4 million, $780,000 related to other accounts receivable. The provision for doubtful accounts for patients accounts receivable as a percentage of net patient revenues was 1.8% for the 2012 Third Quarter and 1.1% for the 2011 Third Quarter.

Our allowance for doubtful accounts for patient accounts receivable as a percentage of total patient accounts receivable was 5.9% at September 30, 2012, as compared to 7.1% at December 31, 2011. Our days sales outstanding was reduced to 42 days at September 30, 2012 as compared to 48 days at December 31, 2011.

Corporate Office Costs

Corporate office costs, consisting primarily of salaries and benefits of corporate office personnel, rent, insurance costs, depreciation and amortization, travel, legal, professional, and recruiting fees, were $6.0 million for the 2012 Third Quarter and $5.1 million for the 2011 Third Quarter. As a percentage of net revenues, corporate office costs were 9.5% for the 2012 Third Quarter and 8.6% for the 2011 Third Quarter.

Interest Expense

Interest expense decreased to $142,000 in the 2012 Third Quarter compared to $149,000 in the 2011 Third Quarter. At September 30, 2012, $16.1 million was outstanding under our revolving credit facility.

Provision for Income Taxes

The provision for income taxes was $3.0 million for the 2012 Third Quarter and $2.7 million for the 2011 Third Quarter. During the 2012 and 2011 Third Quarters, the Company accrued state and federal income taxes at an effective tax rate (provision for taxes divided by the difference between income before taxes and net income attributable to non-controlling interests) of 39.3%.

Non-controlling Interests

Net income attributable to non-controlling interests was $1.7 million for the 2012 Third Quarter and $1.8 million for the 2011 Third Quarter. Net income attributable to non-controlling interests as a percentage of operating income before corporate office costs was 11.3% for the 2012 Third Quarter and 12.7% for the 2011 Third Quarter.

 

18


Nine Months Ended September 30, 2012 Compared to the Nine Months Ended September 30, 2011

 

   

Net revenues increased to $189.4 million for the nine months ended September 30, 2012 (“2012 Nine Months”) from $176.3 million for the nine months ended September 30, 2011 (“2011 Nine Months”) primarily due to an increase in patient visits from 1,605,000 to 1,741,000. The average net patient revenue per visit for the 2012 Nine Months was $105.31 as compared to $104.59 in the 2011 Nine Months. The increase in net revenues from our core physical therapy operations was partially offset by a decrease in other revenues of $2,300,000 due to a reduction in revenue from physician services. The 2012 Nine Months included 191 operating days and the 2011 Nine Months included 192 days.

 

   

Net income attributable to our common shareholders for the 2012 Nine Months was $13.9 million versus $12.7 million for the 2011 Nine Months. Net income was $1.17 per diluted share for the 2012 Nine Months and $1.06 for the 2011 Nine Months. Total diluted shares were 11.9 million for the 2012 Nine Months and 12.0 million for the 2011 Nine Months.

Net Patient Revenues

 

   

Net patient revenues increased to $183.3 million for the 2012 Nine Months from $167.9 million for the 2011 Nine Months, an increase of $15.4 million, or 9.2%, due to an increase in patient visits from 1,605,000 to 1,741,000, and an increase in the net patient revenue per visit of $0.72.

 

   

The growth in patient visits was primarily attributable to 37,000 visits from clinics opened or acquired between October 1, 2011 and September 30, 2012 (“New Clinics”). For clinics opened or acquired prior to October 1, 2011 (“Mature Clinics”), patient visits increased by 99,000 in the 2012 Nine Months as compared to the 2011 Nine Months.

 

   

Net patient revenues related to New Clinics amounted to $4.1 million for the 2012 Nine Months and net patient revenues for Mature Clinics increased by $11.3 million for the 2012 Nine Months as compared to the 2011 Nine Months primarily due to net patient revenues of the July 2011 Acquisition which for 2012 Nine Months included nine months of operations and two months in the 2011 Nine Months.

Net patient revenues are based on established billing rates less allowances and discounts for patients covered by contractual programs and workers’ compensation. Net patient revenues are after contractual and other adjustments relating to patient discounts from certain payors. Payments received under these programs are based on predetermined rates and are generally less than the established billing rates of the clinics.

Other Revenues

Other revenues decreased by $2.3 million from $8.4 million to $6.1 million due to lower revenues from physician services.

Clinic Operating Costs

Clinic operating costs as a percentage of net revenues were 74.4% for the 2012 Nine Months and 74.0% for the 2011 Nine Months.

Clinic Operating Costs — Salaries and Related Costs

Salaries and related costs increased to $98.8 million for the 2012 Nine Months from $93.2 million for the 2011 Nine Months, an increase of $5.6 million, or 6.1%. Salaries and related costs for New Clinics amounted to $2.6 million for the 2012 Nine Months. Salaries and related costs for Mature Clinics increased by $3.0 million for the 2012 Nine Months as compared to the 2011 Nine Months primarily due to the July 2011 Acquisition as discussed above. Salaries and related costs as a percentage of net revenues were 52.2% for the 2012 Nine Months and 52.8% for the 2011 Nine Months.

 

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Clinic Operating Costs — Rent, Clinic Supplies, Contract Labor and Other

Rent, clinic supplies, contract labor and other were $38.3 million for the 2012 Nine Months and $34.7 million for the 2011 Nine Months. For New Clinics, rent, clinic supplies, contract labor and other amounted to $1.4 million for the 2012 Nine Months. For Mature Clinics, rent, clinic supplies, contract labor and other increased by $2.2 million in the 2012 Nine Months compared to the 2011 Nine Months. Rent, clinic supplies, contract labor and other as a percentage of net revenues was 20.2% for the 2012 Nine Months and 19.7% for the 2011 Nine Months.

Clinic Operating Costs — Provision for Doubtful Accounts

The provision for doubtful accounts was $3.7 million for the 2012 Nine Months and $2.6 million for the 2011 Nine Months. Of the $3.7 million, $500,000 related to other accounts receivable, and of the $2.6 million, $800,000 related to other accounts receivable. The provision for doubtful accounts for patients accounts receivable as a percentage of net patient revenues was 1.7% for the 2012 Nine Months and 1.0% for the 2011 Nine Months.

Our allowance for doubtful accounts for patient accounts receivable as a percentage of total patient accounts receivable was 5.9% at September 30, 2012, as compared to 7.1% at December 31, 2011. Our days sales outstanding was reduced to 42 days at September 30, 2012 as compared to 48 days at December 31, 2011.

Corporate Office Costs

Corporate office costs, consisting primarily of salaries and benefits of corporate office personnel, rent, insurance costs, depreciation and amortization, travel, legal, professional, and recruiting fees, were $18.6 million for the 2012 Nine Months and $17.6 million for the 2011 Nine Months. As a percentage of net revenues, corporate office costs were 9.8% for the 2012 Nine Months and 10.0% for the 2011 Nine Months.

Interest Expense

Interest expense increased to $449,000 in the 2012 Nine Months compared to $331,000 in the 2011 Nine Months due to an increase in the average borrowings outstanding under our revolving credit facility during the 2012 period compared to the 2011 period. At September 30, 2012, $16.1 million was outstanding under our revolving credit facility.

Provision for Income Taxes

The provision for income taxes was $9.0 million for the 2012 Nine Months and $8.3 million for the 2011 Nine Months. During the 2012 and 2011 Nine Months, the Company accrued state and federal income taxes at an effective tax rate (provision for taxes divided by the difference between income before taxes and net income attributable to non-controlling interests) of 39.3%.

Non-controlling Interests

Net income attributable to non-controlling interests was $6.5 million for the 2012 Nine Months and $6.9 million for the 2011 Nine Months. The reduction is attributable to the Company’s increased ownership interest in certain physical therapy partnerships. Net income attributable to non-controlling interests as a percentage of operating income before corporate office costs was 13.5% for the 2012 Nine Months and 15.0% for the 2011 Nine Months.

LIQUIDITY AND CAPITAL RESOURCES

We believe that our business is generating sufficient cash flow from operating activities to allow us to meet our short-term and long-term cash requirements, other than those with respect to future acquisitions. At September 30, 2012, we had $10.7 million in cash compared to cash of $10.0 million at December 31, 2011. We believe that our cash and unused availability under our $75.0 million revolving credit facility are sufficient to fund the working capital needs of our operating subsidiaries, corporate costs, dividends, purchases of our common stock, accrued clinic closure costs, future clinic development and investments through at least September 2013. Significant acquisitions of clinics and/or non-controlling interests would likely require financing under our existing revolving credit agreement (defined below).

During the 2012 Nine Months, $29.4 million was provided by operations, $0.2 million was derived from proceeds from the sale of noncontrolling interests and $0.4 million was obtained from the exercise of stock options and related tax benefits and contributions of capital from a limited partner. The major uses of cash included: purchase of businesses ($7.4 million), distributions to non-controlling interest partners ($6.9 million), net reduction of our revolving line of credit ($7.4 million), payments of cash dividends to our shareholders ($3.2 million), purchases of fixed assets ($2.9 million), payments for acquisitions of non-controlling interests ($1.3 million) and payments on notes payable ($0.3 million).

 

20


Effective August 27, 2007, we entered into a credit agreement with a commitment for a $30.0 million revolving credit facility which was increased to $50.0 million effective June 4, 2008 (“Credit Agreement”). Effective March 18, 2009, we amended the Credit Agreement to permit us to purchase up to $15,000,000 of our common stock subject to compliance with certain covenants, including the requirement that after giving effect to any stock purchase, our consolidated leverage ratio (as defined in the Credit Agreement) be less than 1.0 to 1.0 and that any stock repurchased be retired within seven days of purchase. Effective October 13, 2010, we amended the Credit Agreement to extend the maturity date from August 31, 2011 to August 31, 2015. In addition, the Credit Agreement was amended to adjust the pricing grid which is based on our consolidated leverage ratio with the applicable spread over LIBOR ranging from 1.6% to 2.5% or the applicable spread over the Base Rate ranging from .1% to 1%. On July 14, 2011, we amended the Credit Agreement to increase the commitment from $50.0 million to $75.0 million. Effective October 24, 2012, we amended the Credit Agreement to permit us to purchase, commencing on October 24, 2012 and at all times thereafter, up to $15,000,000 of our common stock subject to compliance with covenants. The Credit Agreement is unsecured and has loan covenants, including requirements that we comply with a consolidated fixed charge coverage ratio and consolidated leverage ratio. Proceeds from the Credit Agreement may be used for working capital, acquisitions, purchases of our common stock, dividend payments to our common stockholders, capital expenditures and other corporate purposes. Fees under the Credit Agreement include an unused commitment fee ranging from .1% to .25% depending on our consolidated leverage ratio and the amount of funds outstanding under the Credit Agreement. On September 30, 2012, $16.1 million was outstanding on the revolving credit facility resulting in $58.9 million of availability, and we were in compliance with all of the covenants thereunder.

Historically, we have generated sufficient cash from operations to fund our development activities and to cover operational needs. We plan to continue developing new clinics and making additional acquisitions. We also from time to time purchase the non-controlling interests in our Clinic Partnerships. Generally, any acquisition or purchase of non-controlling interests is expected to be accomplished using a combination of cash and financing. Any large acquisition would likely require financing.

We make reasonable and appropriate efforts to collect accounts receivable, including applicable deductible and co-payment amounts, in a consistent manner for all payor types. Claims are submitted to payors daily, weekly or monthly in accordance with our policy or payor’s requirements. When possible, we submit our claims electronically. The collection process is time consuming and typically involves the submission of claims to multiple payors whose payment of claims may be dependent upon the payment of another payor. Claims under litigation and vehicular incidents can take a year or longer to collect. Medicare and other payor claims relating to new clinics awaiting Medicare Rehab Agency status approval initially may not be submitted for six months or more. When all reasonable internal collection efforts have been exhausted, accounts are written off prior to sending them to outside collection firms. With managed care, commercial health plans and self-pay payor type receivables, the write-off generally occurs after the account receivable has been outstanding for at least 120 days.

We generally enter into various notes payable as a means of financing our acquisitions. Our presently outstanding notes payable relate to acquisitions that occurred in 2012, 2011 and 2010. At September 30, 2012, the balance on these notes payable was $784,000.

In conjunction with acquisitions that occurred in 2010, 2011 and 2012, in the event that a limited minority partner’s employment ceases at any time after three years from the acquisition date, we have agreed to repurchase that individual’s non-controlling interest at a predetermined multiple of earnings before interest and taxes.

From September 2001 through December 31, 2008, the Board of Directors ("Board") authorized us to purchase, in the open market or in privately negotiated transactions, up to 2,250,000 shares of our common stock. In March 2009, the Board authorized the repurchase of up to 10% or approximately 1,200,000 shares of our common stock (“March 2009 Authorization”). In connection with the March 2009 Authorization, we amended our bank credit agreement to permit share repurchases of up to $15,000,000. We are required to retire shares purchased under the March 2009 Authorization.

Under the March 2009 Authorization, we purchased a total of 859,499 shares. Since there is no expiration date for the share repurchase program, and since effective October 24, 2012, the Credit Agreement was further amended to permit us to purchase, commencing on October 24, 2012 and at all times thereafter, up to $15,000,000 of our common stock subject to compliance with covenants, there are currently an additional estimated 340,501 shares that may be purchased from time to time in the open market or private transactions depending on price, availability and our cash position. We did not purchase any shares of our common stock during the three months and nine months ended September 30, 2012.

 

21


FACTORS AFFECTING FUTURE RESULTS

The risks related to our business and operations include:

 

   

The uncertain economic conditions and the historically high unemployment rate in the United States may have material adverse impacts on our business and financial condition that we currently cannot predict.

 

   

We depend upon reimbursement by third-party payors including Medicare and Medicaid.

 

   

Changes as a result of healthcare reform legislation may affect our business.

 

   

We depend upon the cultivation and maintenance of relationships with the physicians in our markets.

 

   

We also depend upon our ability to recruit and retain experienced physical and occupational therapists.

 

   

Our revenues may fluctuate due to weather.

 

   

Our operations are subject to extensive regulation.

 

   

We operate in a highly competitive industry.

 

   

We may incur closure costs and losses.

 

   

Future acquisitions may use significant resources, may be unsuccessful and could expose us to unforeseen liabilities.

 

   

Certain of our internal controls, particularly as they relate to billings and cash collections, are largely decentralized at our clinic locations.

See Risk Factors in Item 1A of our Annual Report on Form 10-K for the year ended December 31, 2011.

 

22


FORWARD LOOKING STATEMENTS

Forward-Looking Statements

We make statements in this report that are considered to be forward-looking within the meaning under Section 21E of the Securities Exchange Act of 1934. These statements contain forward-looking information relating to the financial condition, results of operations, plans, objectives, future performance and business of our Company. These statements (often using words such as “believes”, “expects”, “intends”, “plans”, “appear”, “should” and similar words) involve risks and uncertainties that could cause actual results to differ materially from those we project. Included among such statements are those relating to opening new clinics, availability of personnel and the reimbursement environment. The forward-looking statements are based on our current views and assumptions and actual results could differ materially from those anticipated in such forward-looking statements as a result of certain risks, uncertainties, and factors, which include, but are not limited to:

 

   

changes in Medicare guidelines and reimbursement or failure of our clinics to maintain their Medicare certification status,

 

   

revenue and earnings expectations;

 

   

general economic conditions;

 

   

business and regulatory conditions including federal and state regulations;

 

   

changes as the result of government enacted national healthcare reform;

 

   

availability and cost of qualified physical and occupational therapists;

 

   

personnel productivity;

 

   

competitive, economic or reimbursement conditions in our markets which may require us to reorganize or close certain clinics and thereby incur losses and/or closure costs including the possible write-down or write-off of goodwill and other intangible assets;

 

   

changes in reimbursement rates or payment methods from third party payors including government agencies and deductibles and co-pays owed by patients;

 

   

maintaining adequate internal controls;

 

   

availability, terms, and use of capital;

 

   

acquisitions, purchase of non-controlling interests (minority interests) and the successful integration of the operations of the acquired businesses; and

 

   

weather and other seasonal factors.

Many factors are beyond our control. Given these uncertainties, you should not place undue reliance on our forward-looking statements. Please see our periodic reports filed with the Securities and Exchange Commission (the "SEC") for more information on these factors. Our forward-looking statements represent our estimates and assumptions only as of the date of this report. Except as required by law, we are under no obligation to update any forward-looking statement, regardless of the reason the statement is no longer accurate.

ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK.

We do not maintain any derivative instruments, interest rate swap arrangements, hedging contracts, futures contracts or the like. The Company’s primary market risk exposure is the changes in interest rates obtainable on our revolving credit agreement. The interest on our revolving credit agreement is based on a variable rate. At September 30, 2012, $16.1 million was outstanding on our revolving credit facility. Based on the balance of the revolving credit facility at September 30, 2012, any change in the interest rate of 1% would yield a decrease or increase in annual interest expense of $161,000.

 

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ITEM 4. CONTROLS AND PROCEDURES.

(a) Evaluation of Disclosure Controls and Procedures

As of the end of the period covered by this report, the Company’s management completed an evaluation, under the supervision and with the participation of our principal executive officer and principal financial officer, of the effectiveness of our disclosure controls and procedures. Based on this evaluation, our principal executive officer and principal financial officer concluded (i) that our disclosure controls and procedures are designed to ensure that information required to be disclosed in the reports that we file or submit under the Securities Exchange Act of 1934 is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms and that such information is accumulated and communicated to our management, including our principal executive officer and principal financial officer, or persons performing similar functions, as appropriate to allow timely decisions regarding required disclosure and (ii) that our disclosure controls and procedures are effective.

(b) Changes in Internal Control Over Financial Reporting

There have been no changes in our internal control over financial reporting during the period covered by this report that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

PART II — OTHER INFORMATION

ITEM 6. EXHIBITS.

 

Exhibit Number    Description
31.1*    Rule 13a-14(a)/15d-14(a) Certification of Chief Executive Officer.
31.2*    Rule 13a-14(a)/15d-14(a) Certification of Chief Financial Officer.
31.3*    Rule 13a-14(a)/15d-14(a) Certification of Corporate Controller.
32*    Certification Pursuant to 18 U.S.C 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
101.INS*    XBRL Instance Document
101.SCH*    XBRL Taxonomy Extension Schema Document
101.CAL*    XBRL Taxonomy Extension Calculation Linkbase Document
101.DEF*    XBRL Taxonomy Extension Definition Linkbase Document
101.LAB*    XBRL Taxonomy Extension Label Linkbase Document
101.PRE*    XBRL Taxonomy Extension Presentation Linkbase Document

* Filed herewith

 

24


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on our behalf by the undersigned thereunto duly authorized.

 

    U.S. PHYSICAL THERAPY, INC.  

Date: November 9, 2012

    By:  

  /s/ LAWRANCE W. MCAFEE

 
     

  Lawrance W. McAfee

  Chief Financial Officer

 
     

  (duly authorized officer and principal financial and accounting officer)

 
    By:  

  /s/ JON C. BATES

 
     

  Jon C. Bates

  Vice President/Corporate Controller

 

 

25


INDEX OF EXHIBITS

 

Exhibit Number

  

Description

31.1*    Rule 13a-14(a)/15d-14(a) Certification of Chief Executive Officer.
31.2*    Rule 13a-14(a)/15d-14(a) Certification of Chief Financial Officer.
31.3*    Rule 13a-14(a)/15d-14(a) Certification of Corporate Controller.
32*    Certification Pursuant to 18 U.S.C 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
101.INS*    XBRL Instance Document
101.SCH*    XBRL Taxonomy Extension Schema Document
101.CAL*    XBRL Taxonomy Extension Calculation Linkbase Document
101.DEF*    XBRL Taxonomy Extension Definition Linkbase Document
101.LAB*    XBRL Taxonomy Extension Label Linkbase Document
101.PRE*    XBRL Taxonomy Extension Presentation Linkbase Document

 

* Filed herewith

 

26