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EX-31.1 - EX-31.1 - ALMOST FAMILY INCafam-20160401ex3118b35da.htm
EX-31.2 - EX-31.2 - ALMOST FAMILY INCafam-20160401ex3125c202e.htm
EX-32.1 - EX-32.1 - ALMOST FAMILY INCafam-20160401ex3210d02af.htm
EX-32.2 - EX-32.2 - ALMOST FAMILY INCafam-20160401ex322977c61.htm

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 


FORM 10-Q

 


 

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

 

For the quarterly period ended April 1, 2016

 

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  001-09848

 

ETSA-AlmostFamily_1-3x1-no tag line

 

ALMOST FAMILY, INC.

(Exact name of Registrant as specified in its charter)


 

Delaware

 

06-1153720

(State or other jurisdiction of

incorporation or organization)

 

(I.R.S. Employer Identification
Number)

 

9510 Ormsby Station Road, Suite 300, Louisville, Kentucky 40223

(Address of principal executive offices)

 

(502) 891-1000

(Registrant’s telephone number, including area code)

 

Not Applicable

(Former name, former address and former fiscal year, if changed since last report)

 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.  Yes  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 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 definition of “accelerated filer, “large accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act (check one):

 

 

 

 

 

 

 

 

Large accelerated filer

 

Accelerated filer

 

Non-accelerated filer

 

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

 

Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date.

Class of Common Stock    $0.10 par value

Shares outstanding at April 29, 2016     10,376,197

 

 

 


 

ALMOST FAMILY, INC. AND SUBSIDIARIES

 

FORM 10-Q

 

INDEX

 

PART I. 

FINANCIAL INFORMATION

 

 

 

Item 1. 

Financial Statements.  Consolidated Financial Statements and Supplementary Data (unaudited except January 1, 2016 Consolidated Balance Sheet)

 

 

 

 

Consolidated Balance Sheets as of April 1, 2016 and January 1, 2016

 

 

 

 

Consolidated Statements of Income for the Three Month Periods Ended April 1, 2016 and April 3, 2015

 

 

 

 

Consolidated Statements of Cash Flows for the Three Month Periods Ended April 1, 2016 and April 3, 2015

 

 

 

 

Notes to Consolidated Financial Statements

 

 

 

Item 2. 

Management's Discussion and Analysis of Financial Condition and Results of Operations

13 

 

 

 

Item 3. 

Quantitative and Qualitative Disclosures about Market Risk

21 

 

 

 

Item 4. 

Controls and Procedures

21 

 

 

 

PART II. 

OTHER INFORMATION

22 

 

 

 

Item 1. 

Legal Proceedings

22 

 

 

 

Item 1A. 

Risk Factors

22 

 

 

 

Item 2. 

Unregistered Sales of Equity Securities and Use of Proceeds

22 

 

 

 

Item 3. 

Defaults Upon Senior Securities

22 

 

 

 

Item 4. 

Mine Safety Disclosures

22 

 

 

 

Item 5. 

Other Information

23 

 

 

 

Item 6. 

Exhibits

24 

 

 

2


 

PART I — FINANCIAL INFORMATION

Item 1. Financial Statements

 

ALMOST FAMILY, INC. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(In thousands)

 

 

 

 

 

 

 

 

 

 

 

April 1, 2016

 

 

 

 

 

    

(UNAUDITED)

    

January 1, 2016

 

ASSETS

 

 

 

 

 

 

 

CURRENT ASSETS:

 

 

 

 

 

 

 

Cash and cash equivalents

 

$

7,135

 

$

7,522

 

Accounts receivable - net

 

 

94,008

 

 

92,909

 

Prepaid expenses and other current assets

 

 

9,515

 

 

9,033

 

TOTAL CURRENT ASSETS

 

 

110,658

 

 

109,464

 

PROPERTY AND EQUIPMENT - NET

 

 

10,649

 

 

10,000

 

GOODWILL

 

 

315,360

 

 

277,061

 

OTHER INTANGIBLE ASSETS

 

 

66,106

 

 

64,629

 

OTHER ASSETS

 

 

3,885

 

 

3,615

 

TOTAL ASSETS

 

$

506,658

 

$

464,769

 

 

 

 

 

 

 

 

 

LIABILITIES AND STOCKHOLDERS’ EQUITY

 

 

 

 

 

 

 

CURRENT LIABILITIES:

 

 

 

 

 

 

 

Accounts payable

 

$

10,128

 

$

12,297

 

Accrued other liabilities

 

 

43,735

 

 

42,524

 

TOTAL CURRENT LIABILITIES

 

 

53,863

 

 

54,821

 

 

 

 

 

 

 

 

 

LONG-TERM LIABILITIES:

 

 

 

 

 

 

 

Revolving credit facility

 

 

133,211

 

 

113,790

 

Deferred tax liabilities

 

 

15,260

 

 

13,094

 

Seller notes

 

 

12,520

 

 

6,556

 

Other liabilities

 

 

2,968

 

 

2,608

 

TOTAL LONG-TERM LIABILITIES

 

 

163,959

 

 

136,048

 

TOTAL LIABILITIES

 

 

217,822

 

 

190,869

 

 

 

 

 

 

 

 

 

NONCONTROLLING INTEREST - REDEEMABLE -

 

 

 

 

 

 

 

HEALTHCARE INNOVATIONS

 

 

3,639

 

 

3,639

 

 

 

 

 

 

 

 

 

STOCKHOLDERS’ EQUITY:

 

 

 

 

 

 

 

Preferred stock, par value $0.05; authorized 2,000 shares; none issued or outstanding 

 

 

 —

 

 

 

Common stock, par value $0.10; authorized 25,000; 10,490 and 10,125 issued and outstanding 

 

 

1,049

 

 

1,013

 

Treasury stock, at cost, 114 and 103 shares

 

 

(3,126)

 

 

(2,731)

 

Additional paid-in capital

 

 

138,822

 

 

127,253

 

Noncontrolling interest - nonredeemable

 

 

(770)

 

 

(730)

 

Retained earnings

 

 

149,222

 

 

145,456

 

TOTAL STOCKHOLDERS’ EQUITY

 

 

285,197

 

 

270,261

 

TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY

 

$

506,658

 

$

464,769

 

 

See accompanying Notes to Consolidated Financial Statements.

 

3


 

ALMOST FAMILY, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF INCOME

(UNAUDITED)

(In thousands, except per share data)

 

 

 

 

 

 

 

 

 

 

 

 

Three months ended

 

 

 

    

April 1, 2016

    

April 3, 2015

    

 

Net service revenues

 

$

153,698

 

 

128,399

 

 

Cost of service revenues (excluding depreciation and amortization)

 

 

82,232

 

 

68,327

 

 

Gross margin

 

 

71,466

 

 

60,072

 

 

General and administrative expenses:

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

41,676

 

 

36,393

 

 

Other

 

 

19,445

 

 

15,810

 

 

Deal, transition and other costs

 

 

2,609

 

 

406

 

 

Total general and administrative expenses

 

 

63,730

 

 

52,609

 

 

Operating income

 

 

7,736

 

 

7,463

 

 

Interest expense, net

 

 

(1,332)

 

 

(447)

 

 

Income before income taxes

 

 

6,404

 

 

7,016

 

 

Income tax expense

 

 

(2,677)

 

 

(2,987)

 

 

Net income

 

 

3,727

 

 

4,029

 

 

Net loss attributable to noncontrolling interest

 

 

190

 

 

365

 

 

Net income attributable to Almost Family, Inc.

 

$

3,917

 

$

4,394

 

 

 

 

 

 

 

 

 

 

 

Per share amounts-basic:

 

 

 

 

 

 

 

 

Average shares outstanding

 

 

10,089

 

 

9,353

 

 

Net income attributable to Almost Family, Inc.

 

$

0.39

 

$

0.47

 

 

 

 

 

 

 

 

 

 

 

Per share amounts-diluted:

 

 

 

 

 

 

 

 

Average shares outstanding

 

 

10,260

 

 

9,521

 

 

Net income attributable to Almost Family, Inc.

 

$

0.38

 

$

0.46

 

 

 

See accompanying Notes to Consolidated Financial Statements.

4


 

ALMOST FAMILY, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(UNAUDITED)

(In thousands)

 

 

 

 

 

 

 

 

 

 

 

Three months ended

 

 

    

April 1, 2016

    

April 3, 2015

 

Cash flows from operating activities:

 

 

 

 

 

 

 

Net income before NCI

 

$

3,727

 

$

4,029

 

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

 

 

 

 

 

 

 

Depreciation and amortization

 

 

1,050

 

 

918

 

Provision for uncollectible accounts

 

 

3,845

 

 

1,865

 

Stock-based compensation

 

 

717

 

 

520

 

Deferred income taxes

 

 

2,166

 

 

1,031

 

 

 

 

11,505

 

 

8,363

 

Change in certain net assets and liabilities, net of the effects of acquisitions:

 

 

 

 

 

 

 

Change in:

 

 

 

 

 

 

 

Accounts receivable

 

 

(3,571)

 

 

(11,961)

 

Prepaid expenses and other current assets

 

 

(257)

 

 

3,653

 

Other assets

 

 

(334)

 

 

17

 

Accounts payable and accrued expenses

 

 

(1,735)

 

 

(3,853)

 

Net cash provided by (used in) operating activities

 

 

5,608

 

 

(3,781)

 

Cash flows from investing activities:

 

 

 

 

 

 

 

Capital expenditures

 

 

(969)

 

 

(401)

 

Cost basis investment

 

 

 —

 

 

(1,000)

 

Acquisitions, net of cash acquired

 

 

(24,229)

 

 

(3,000)

 

Net cash used in investing activities

 

 

(25,198)

 

 

(4,401)

 

Cash flows from financing activities:

 

 

 

 

 

 

 

Credit facility borrowings

 

 

78,011

 

 

47,813

 

Credit facility repayments

 

 

(58,590)

 

 

(39,161)

 

Debt issuance fees

 

 

 —

 

 

(1,158)

 

Proceeds from stock option exercises

 

 

 —

 

 

23

 

Purchase of common stock in connection with share awards

 

 

(396)

 

 

(276)

 

Tax impact of share awards

 

 

214

 

 

88

 

Payment of special dividend

 

 

 —

 

 

(50)

 

Principal payments on notes payable and capital leases

 

 

(36)

 

 

(23)

 

Net cash provided by financing activities

 

 

19,203

 

 

7,256

 

Net decrease in cash and cash equivalents

 

 

(387)

 

 

(926)

 

Cash and cash equivalents at beginning of period

 

 

7,522

 

 

6,886

 

Cash and cash equivalents at end of period

 

$

7,135

 

$

5,960

 

 

See accompanying Notes to Consolidated Financial Statements.

5


 

ALMOST FAMILY, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

(Unless otherwise indicated, all dollars and share amounts are in thousands, except per share data)

 

1.Accounting Policies

 

Basis of Presentation

 

The accompanying unaudited consolidated financial statements for the periods ended April 1, 2016 and April 3, 2015, have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (SEC).  Certain information and footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States have been omitted pursuant to such rules and regulations.  Accordingly, the reader of this Form 10-Q is referred to Almost Family, Inc.’s (the “Company”) Annual Report on Form 10-K for the year ended January 1, 2016 for further information.  In the opinion of management of the Company, the accompanying unaudited consolidated financial statements reflect all adjustments (consisting of normal recurring adjustments) necessary to present fairly the financial position at April 1, 2016, and the results of operations and cash flows for the periods ended April 1, 2016 and April 3, 2015.  The results of operations for the period ended April 1, 2016 are not necessarily indicative of the operating results for the year.

 

Effective with the first quarter of 2015 the Company adopted a 52-53 week fiscal reporting calendar under which it will report its annual results going forward in four equal 13-week quarters.  Due to the Company’s use of the 52-53 week calendar, the first quarter of 2015 includes the 13 week and 2 day period from January 1, 2015 to April 3, 2015 which is 2 more days than each 13 week quarter to be reported in the future.  For prospective comparison, the 2 days (New Year’s Day and the day after) had a one-time effect of increasing revenue by $2.3 million, while lowering EPS by $0.02 due to the effect of the holiday. The first quarter of 2016 started on January 2, 2016, excluding the 2016 New Year’s Day holiday. 

 

Use of Estimates

 

The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of revenues and expenses during the reporting period.  Actual results could differ from those estimates.

 

Recently Issued Accounting Pronouncements

 

The Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606), during the second quarter of 2014.  Topic 606 affects virtually all aspects of an entity’s revenue recognition, including determining the measurement of revenue and the timing of when it is recognized for the transfer of goods or services to customers.  Topic 606 is effective for annual reporting periods beginning after December 15, 2017.  The Company is currently evaluating the effect of the adoption of Topic 606 on its financial position and results of operations.

 

In April 2015, the FASB issued ASU No. 2015-03, Interest – Imputation of Interest (Subtopic 835-30):  Simplifying the Presentation of Debt Issuance Costs.  In certain instances, Subtopic 835-30 requires that debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability.  Subtopic 835-30 is effective for annual and interim periods beginning after December 15, 2015.  With the adoption of ASU No. 2015-03, amortization of debt issuance costs were reclassified from amortization expense to interest expense.

 

In April 2015, the FASB issued ASU No. 2015-05, Intangibles – Goodwill and Other – Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Fees Paid in a Cloud Computing Arrangement.  Subtopic 350-40 provides guidance that all software licenses included in cloud computing arrangement be accounted for consistent with other licenses of intangible assets.  However, if a cloud computing arrangement does not include a software license, the arrangement should be accounted for as a service contract, the accounting for which did not change.  Subtopic 350-40 is effective for

6


 

annual and interim periods beginning after December 15, 2015. The adoption of ASU No. 2015-05 did not affect the Company’s financial position and results of operations.

 

In February 2016, the FASB issued ASU 2016-02, Leases. ASU 2016-02 requires lessees to recognize assets and liabilities on their balance sheet related to the rights and obligations created by most leases, while continuing to recognize expenses on their income statements over the lease term. It will also require disclosures designed to give financial statement users information regarding the amount, timing, and uncertainty of cash flows arising from leases. The guidance is effective for annual reporting periods beginning after December 15, 2018, and interim periods within those years. Early adoption is permitted for all entities. The Company is currently evaluating the impact ASU 2016-02 will have on its consolidated financial statements and associated disclosures.

 

In March 2016, the FASB issued ASU 2016-09, Compensation – Stock Compensation. ASU 2016-09 is intended to simplify several aspects of the accounting for share-based payments. The guidance will be effective for fiscal years beginning after December 15, 2016, including interim periods within that year. The Company is in the process of evaluating the impacts of the adoption of this ASU.

 

2.Segment Data

 

The Company has two divisions, Home Health Care and Healthcare Innovations.  The Home Health Care division is comprised of two reportable segments, Visiting Nurse Services (VN or Visiting Nurse) and Personal Care Services (PC or Personal Care).  Healthcare Innovations (HCI)  is also a reportable segment.  Reportable segments have been identified based upon how management has organized the business by services provided to customers and how the chief operating decision maker manages the business and allocates resources, consistent with the criteria in ASC 280, Segment Reporting

 

Consistent with information given to the chief operating decision maker, the Company does not allocate certain expenses to the reportable segments.  The Company evaluates the performance of its business segments based on operating income.  Intercompany and intersegment transactions have been eliminated.

 

The VN segment provides skilled medical services in patients’ homes largely to enable recipients to reduce or avoid periods of hospitalization and/or nursing home care.  Approximately 94% of the VN segment revenues are generated from the Medicare program while the balance is generated from Medicaid and private insurance programs.  VN Medicare revenues include revenues from all Medicare sources including traditional Medicare and Medicare Advantage, whether paid on a per episode basis or a per visit basis.

 

The PC segment services are also provided in patients’ homes. These services (generally provided by paraprofessional staff such as home health aides) are generally of a custodial rather than skilled nature.  PC revenues are generated on an hourly basis.  Approximately 78% of the PC segment revenues are generated from Medicaid and other government programs while the balance is generated from insurance programs and private pay patients.

 

The Company’s HCI business segment was created to house and separately report on our developmental activities outside the traditional home health business platform.  These activities are intended ultimately, whether directly or indirectly, to benefit the Company’s patients and payors through the enhanced provision of home health services.  The activities all share a common goal of improving patient experiences and quality outcomes, while lowering costs.  They include, but are not limited to, items such as: technology, information, population health management, risk-sharing, care-

7


 

coordination and transitions, clinical advancements, enhanced patient engagement and informed clinical decision and technology enabled in-home clinical assessments.

 

 

 

 

 

 

 

 

 

 

 

 

Three months ended

 

 

Consolidated

    

April 1, 2016

    

April 3, 2015

    

 

Home Health Operations

 

 

 

 

 

 

 

 

Net service revenues:

 

 

 

 

 

 

 

 

Visiting Nurse

 

$

109,613

 

$

99,535

 

 

Personal Care

 

 

39,693

 

 

28,761

 

 

 

 

 

149,306

 

 

128,296

 

 

Operating income before corporate expenses:

 

 

 

 

 

 

 

 

Visiting Nurse

 

 

14,975

 

 

12,400

 

 

Personal Care

 

 

3,737

 

 

2,898

 

 

 

 

 

18,712

 

 

15,298

 

 

Healthcare Innovations Operations

 

 

 

 

 

 

 

 

Revenue

 

 

4,392

 

 

103

 

 

Operating income (loss) before noncontrolling interest

 

 

(673)

 

 

(517)

 

 

Corporate expenses

 

 

7,694

 

 

6,912

 

 

Deal, transition and other costs

 

 

2,609

 

 

406

 

 

Operating income

 

 

7,736

 

 

7,463

 

 

Interest expense, net (1)

 

 

(1,332)

 

 

(447)

 

 

Income tax expense

 

 

(2,677)

 

 

(2,987)

 

 

Net income

 

$

3,727

 

$

4,029

 

 

 

 


(1)  Allocation of interest for 2016 was $358,  $358, and $378 to Visiting Nurse, Personal Care and Healthcare Innovations, respectively.  Substantially all interest in 2015 was in the Visiting Nurse segment.

 

3.Capitalized Software Development Costs

 

The Company capitalizes the cost of internally generated computer software developed for the Company’s own use.  Software development costs of approximately $272 and $72 were capitalized in the three month periods ended April 1, 2016 and April 3, 2015, respectively.  Capitalized software development costs are amortized over the estimated useful life, generally three years, once the software is ready for its intended use.

 

4.Goodwill and Other Intangible Assets

 

The Company conducts annual reviews for impairment, or more frequently if circumstances indicate impairment may have occurred.  Other intangible assets consist of certificates of need and licenses, trade names and non-compete agreements.  Finite-lived intangible assets are amortized on a straight-line basis over their estimated useful lives. Licenses, provider numbers, certificates of need and trade names have indefinite lives and are reviewed at least annually for possible impairment, or whenever events or changes in circumstances indicate that carrying amounts may not be recoverable.  The Company completed its most recent annual impairment test of goodwill and other indefinite-lived intangible assets as of January 1, 2016 and determined that no impairment existed.

 

8


 

The following table summarizes the activity related to goodwill and other intangible assets for 2016:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Intangible Assets

 

 

 

 

 

Certificates

 

 

 

 

 

 

 

 

 

 

 

 

of Need and

 

Trade

 

Non-compete

 

 

 

 

 

    

Goodwill

    

Licenses

    

 Names

    

Agreements

    

Total

 

Balances at December 31, 2014

 

$

192,523

 

$

39,611

 

$

14,771

 

$

20

 

$

54,402

 

Acquisitions

 

 

84,538

 

 

6,433

 

 

3,640

 

 

180

 

 

10,253

 

Amortization

 

 

 —

 

 

 —

 

 

(10)

 

 

(16)

 

 

(26)

 

Balances at January 1, 2016

 

$

277,061

 

$

46,044

 

$

18,401

 

$

184

 

$

64,629

 

Acquisitions

 

 

38,299

 

 

1,484

 

 

 —

 

 

 —

 

 

1,484

 

Amortization

 

 

 —

 

 

 —

 

 

(3)

 

 

(4)

 

 

(7)

 

Balances at April 1, 2016

 

$

315,360

 

$

47,528

 

$

18,398

 

$

180

 

$

66,106

 

 

Acquisitions in the table relate to the acquisitions discussed further in Note 9, “Acquisitions.

 

The following table summarizes the Company’s goodwill and other intangible assets by segment:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other Intangible Assets

 

 

 

 

 

Certificates

 

 

 

 

 

 

 

 

 

 

 

of Need and

 

Trade

 

Non-compete

 

 

 

 

    

Goodwill

    

Licenses

    

Names

    

Agreements

    

Total

 

Visiting Nurse

 

$

189,103

 

 

44,368

 

 

13,203

 

 

90

 

$

57,661

 

Personal Care

 

 

72,860

 

 

3,160

 

 

5,195

 

 

90

 

 

8,445

 

Healthcare Innovations

 

 

53,397

 

 

 —

 

 

 —

 

 

 —

 

 

 —

 

April 1, 2016 balance

 

$

315,360

 

$

47,528

 

$

18,398

 

$

180

 

$

66,106

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.Revolving Credit Facility

 

The Company has a senior secured revolving credit facility with JP Morgan Chase Bank, NA, as Administrative Agent, Bank of America, as Syndication Agent, and certain other lenders (the “Facility”).  The Facility consists of a $175 million credit line with a maturity date of November 15, 2020 and an “accordion” feature providing for potential future expansion of the Facility to $250 million.  Borrowings (other than letters of credit) under the credit facility generally will bear interest at a rate varying from the London Interbank Offered Rate (LIBOR) plus 1.75% to LIBOR rate plus 3.00%,  depending on leverage.  The Facility is secured by substantially all of the Company’s assets and the stock of its subsidiaries.  Debt issuance costs of $1.2 million incurred in connection with the credit facility are recorded in prepaid and other assets and are being amortized to interest expense through November 15, 2020.

 

Borrowings under the Facility are subject to various covenants including a multiple of 3.5 times earnings before interest, taxes, depreciation and amortization (“EBITDA”). “EBITDA” may include “Acquired EBITDA” from pro-forma acquisitions as defined. Borrowings under the Facility may be used for general corporate purposes, including acquisitions.  Application of the Facility’s borrowing formula as of April 1, 2016, permitted an additional $18.0 million to be used. The Company had irrevocable letters of credit totaling $11.3 million outstanding in connection with the Company’s self-insurance programs, which resulted in a total of $6.7 million being available for use at April 1, 2016.  As of April 1, 2016, the Company was in compliance with the various financial covenants.  Under the most restrictive of its covenants, the Company was required to maintain minimum net worth of at least $179.5 million at April 1, 2016.  At such date, the Company’s net worth was approximately $285.2 million.

 

The effective interest rates on the Company’s borrowings were 3.31% and 2.67% for the three month periods ended April 1, 2016 and April 3, 2015, respectively.

 

9


 

6.Fair Value Measurements

 

The Company’s financial instruments consist of cash, accounts receivable, payables and debt instruments.  The carrying values of cash, accounts receivable and payables are considered representative of their respective fair values due to the short-term nature of these instruments.  The fair value of the Company’s debt instruments approximates their carrying values as substantially all of such debt instruments have rates which fluctuate with changes in market rates.  The Company does not have any assets or liabilities carried at fair value that are measured on a recurring basis.

 

 

7.Earnings per Common Share

 

A reconciliation of the weighted average shares outstanding used in the calculation of basic and diluted earnings per common share is as follows:

 

 

 

 

 

 

 

 

 

 

Three months ended

 

 

 

    

April 1, 2016

    

April 3, 2015

 

 

Basic weighted average outstanding shares

 

10,089

 

9,353

 

 

Add common equivalent shares representing shares issuable upon exercise of dilutive awards

 

171

 

168

 

 

Diluted weighted average number of shares

 

10,260

 

9,521

 

 

 

 

 

 

 

 

 

Anti-dilutive shares excluded from calculation

 

77

 

104

 

 

 

 

8.Commitments and Contingencies

 

Insurance Programs

 

The Company bears significant insurance risk under its large-deductible workers’ compensation insurance program and its self-insured employee health program.  Under the workers’ compensation insurance program, the Company bears risk up to $400 per incident, after which stop-loss coverage is maintained.  The Company purchases stop-loss insurance for the employee health plan that places a specific limit, generally $300, on its exposure for any individual covered life.

 

Malpractice and general patient liability claims for incidents which may give rise to litigation have been asserted against the Company by various claimants.  The claims are in various stages of processing and some may ultimately be brought to trial.  The Company is aware of incidents that have occurred through April 1, 2016 that may result in the assertion of additional claims.  The Company currently carries professional and general liability insurance coverage (on a claims made basis) for this exposure with no deductible.  The Company also carries D&O coverage (also on a claims made basis) for potential claims against the Company’s directors and officers, including securities actions, with deductibles ranging from $175 to $500 per claim.

 

The Company records estimated liabilities for its insurance programs based on information provided by the third-party plan administrators, historical claims experience, the life cycle of claims, expected costs of claims incurred but not paid, and expected costs to settle unpaid claims.  The Company monitors its estimated insurance-related liabilities and recoveries, if any, on a monthly basis and records amounts due under insurance policies in other current assets, while recording the estimated carrier liability in other current liabilities.  As facts change, it may become necessary to make adjustments that could be material to the Company’s results of operations and financial condition.

 

Legal Proceedings

 

The Company is currently, and from time to time, subject to claims and suits arising in the ordinary course of its business, including claims for damages for personal injuries.  In the opinion of management, after discussions with legal counsel, the ultimate resolution of any of these ordinary course pending claims and legal proceedings will not have a material effect on the Company’s financial position or results of operations.

 

 

10


 

9.Acquisitions

 

2016 Acquisitions

 

On January 5, 2016, the Company acquired 100% of the equity of Long Term Solutions, Inc. (“LTS”).  LTS is a provider of in-home nursing assessments for the long-term care insurance industry.  LTS provides assessments in all 50 U.S. states and a number of foreign countries.  The purchase price of $37 million was funded through borrowings on the Company’s bank credit facility, seller notes and issuance of the Company’s common stock.  LTS’s post acquisition operating results are reported in the Company’s HCI business segment.

 

On January 5, 2016, the Company purchased the assets of a Medicare-certified home health agency owned by Bayonne Visiting Nurse Association (Bayonne) located in New Jersey.  The purchase price was $4.0 million.  Bayonne’s post acquisition operating results are reported in the Company’s VN segment.

 

2015 Acquisitions

 

On November 5, 2015, the Company acquired the stock of Black Stone Operations, LLC (“Black Stone”).  Black Stone is a provider of in-home personal care and skilled home health services in western Ohio and operates under the name “Home Care by Black Stone.”  The purchase price of $40 million was funded through borrowings on the Company’s bank credit facility, seller notes and issuance of the Company’s common stock.  Black Stone’s post acquisition operating results are primarily reported in the VN and PC segments.

 

On August 29, 2015 the Company acquired 100% of the equity of Bracor, Inc. (dba WillCare).  The purchase price for the New York and Connecticut operations was $50.8 million.  The transaction was funded by borrowings under the Company’s bank credit facility.  On March 1, 2015, the Company acquired the stock of WillCare’s Ohio operations for $3.0 million.  WillCare’s post acquisition operating results are reported in the VN and PC segments.

 

On July 22, 2015, the Company acquired 100% of the equity of Ingenios Health Co. (Ingenios) for $11.4 million of the Company’s common stock plus $2.0 million in cash.  Ingenios is a leading provider of technology enabled in-home clinical assessments for Medicare Advantage, Managed Medicaid and Commercial Exchange lives in 7 states and Washington, D.C.  The operating results of Ingenios are reported in the HCI business segment.

 

On January 29, 2015, the Company acquired a noncontrolling interest in a development stage analytics and software company, NavHealth, Inc. (NavHealth).  The investment is an asset of the Company’s HCI segment.

 

11


 

The following table summarizes the preliminary fair value estimates as of the respective acquisition dates of the assets acquired and liabilities assumed for the Willcare, Ingenios, Black Stone, LTS and Bayonne acquisitions:

 

 

 

 

 

 

 

 

 

 

 

Preliminary Purchase

 

 

 

    

    

Price Allocation

    

 

Accounts receivable 

    

 

$

14,412

 

 

Property, plant & equipment

 

 

 

5,375

 

 

Other assets

 

 

 

2,033

 

 

Goodwill

 

 

 

122,675

 

 

Other intangibles

 

 

 

12,270

 

 

Assets acquired

 

 

 

156,765

 

 

Liabilities assumed

 

 

 

(9,301)

 

 

Net assets acquired

 

 

$

147,464

 

 

 

Deal and transition costs incurred in conjunction with the 2015 and 2016 acquisitions were $2.3 million for the quarter ended April 1, 2016.  Similar amounts for the prior year periods were $406 related to 2014 acquisitions.  Such amounts are included in Deal, transition and other costs in the Consolidated Statements of Income.

 

10.Income Taxes

 

The Company’s effective income tax rate for the period ended April 1, 2016 and April 3, 2015  was approximately 40.5%

 

Accounting principles generally accepted in the United States prescribe a recognition threshold and measurement attribute for the accounting and financial statement disclosure of tax positions taken or expected to be taken in a tax return.  The evaluation of a tax position is a two-step process.  The first step requires the Company to determine whether it is more likely than not that a tax position will be sustained upon examination based on the technical merits of the position.  The second step requires the Company to recognize in the financial statements each tax position that meets the more likely than not criteria, measured at the amount of benefit that has a greater than 50% likelihood of being realized.  The Company had $2.5 million of unrecognized tax benefits at April 1, 2016, the total amount of which, if recognized, would affect the tax rate.  The Company includes the full amount of unrecognized tax benefits in other liabilities in the Consolidated Balance Sheets.  Additionally, the Company may from time to time be assessed interest and penalties by tax jurisdictions.  Any such assessments historically have been immaterial to the Company’s financial results and are classified as other general and administrative expenses in the consolidated statements of income.

 

11.Subsequent Events

 

Management has evaluated all events and transactions that occurred after April 1, 2016.  During this period, the Company had no material subsequent events requiring recognition in the consolidated financial statements.

 

 

12


 

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

 

The Company

 

Almost Family, Inc. and subsidiaries (collectively “Almost Family”) is a leading regionally focused provider of home health nursing services. In this report, the terms “Company,” “we,” “us” or “our” mean Almost Family, Inc. and all subsidiaries included in our consolidated financial statements.

 

Cautionary Statements - Forward Outlook and Risks

 

Certain statements contained in this quarterly report on Form 10-Q, including, without limitation, statements containing the words “believes,” “anticipates,” “intends,” “expects,” “assumes,” “trends” and similar expressions, constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995.  Forward-looking statements are based upon the Company’s current plans, expectations and projections about future events.  However, such statements involve known and unknown risks, uncertainties and other factors that may cause the actual results, performance or achievements of the Company to be materially different from any future results, performance or achievements expressed or implied by such forward-looking statements.  These factors include, among others, the following:

 

·

general economic and business conditions;

·

demographic changes;

·

changes in, or failure to comply with, existing governmental regulations;

·

legislative proposals for healthcare reform;

·

changes in Medicare and Medicaid reimbursement levels;

·

changes in laws and regulations with respect to Accountable Care Organizations;

·

changes in the marketplace and regulatory environment for Health Risk Assessments;

·

effects of competition in the markets in which the Company operates;

·

liability and other claims asserted against the Company;

·

potential audits and investigations by government and regulatory agencies, including the impact of any negative publicity or litigation;

·

ability to attract and retain qualified personnel;

·

availability and terms of capital;

·

loss of significant contracts or reduction in revenues associated with major payor sources;

·

ability of customers to pay for services;

·

business disruption due to natural disasters or terrorist acts;

·

ability to effectively integrate, manage and keep secure our information systems;

·

ability to successfully integrate the operations of acquired businesses and achieve expected synergies and operating efficiencies from the acquisition, in each case within expected time-frames or at all;

·

significant deterioration in economic conditions and significant market volatility;

·

effect on liquidity of the Company's financing arrangements; and

·

changes in estimates and judgments associated with critical accounting policies and estimates.

 

For a detailed discussion of these and other factors that could cause the Company’s actual results to differ materially from the results contemplated by the forward-looking statements, please refer to Item 1A. “Risk Factors” and Item 7. “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in the Company’s Annual Report on Form 10-K for year ended January 1, 2016 and this Form 10-Q.  The reader should not place undue reliance on forward-looking statements, which speak only as of the date of this report.  Except as required by law, the Company assumes no responsibility for updating forward-looking statements to reflect unforeseen or other events after the date of this report. The Company has provided a detailed discussion of risk factors in its Form 10-K and various filings with the Securities and Exchange Commission (SEC).  The reader is encouraged to review these risk factors and filings.

 

13


 

Critical Accounting Policies

 

Refer to the “Critical Accounting Policies” section of Item 7. “Management’s Discussion and Analysis of Financial Condition and Results of Operations” included in our Form 10-K for the year ended January 1, 2016 for a detailed discussion of our critical accounting policies.  There have been no material changes to our critical accounting policies and estimates as described therein.

 

Fiscal Year End

 

As a result of the change in the fiscal reporting calendar in the first quarter of 2015 to the use of the 52-53 week calendar, the first quarter of 2015 includes the 13 week and 2 day period from January 1, 2015 to April 3, 2015 which is 2 more days than each 13 week quarter to be reported in the future.  For prospective comparison, the 2 days (New Year’s Day and the day after) had a one-time effect of increasing revenue by $2.3 million, while lowering EPS by $0.02 due to the effect of the holiday. The first quarter of 2016 started on January 2, 2016, excluding the 2016 New Year’s Day holiday. 

 

Operating Segments

 

The Company has two divisions, Home Health Care and Healthcare Innovations.  The Home Health Care division is comprised of two reportable segments, Visiting Nurse Services (VN or Visiting Nurse) and Personal Care Services (PC or Personal Care).  Our Healthcare Innovations (HCI) division is also a reporting segment.  Reportable segments have been identified based upon how management has organized the business by services provided to customers and how the chief operating decision maker manages the business and allocates resources, consistent with the criteria in ASC 280, Segment Reporting. 

 

Our VN segment provides skilled medical services in patients’ homes largely to enable recipients to reduce or avoid periods of hospitalization and/or nursing home care.  VN Medicare revenues include revenues from all Medicare sources including traditional Medicare and Medicare Advantage, whether paid on a per episode basis or a per visit basis.  Approximately 94% of the VN segment revenues are generated from the Medicare program while the balance is generated from Medicaid and private insurance programs.

 

Our PC segment services are also provided in patients’ homes.  These services (generally provided by paraprofessional staff such as home health aides) are generally of a custodial rather than skilled nature.  PC revenues are typically generated on an hourly basis.  Approximately 78% of the PC segment revenues are generated from Medicaid and other government programs while the balance is generated from insurance programs and private pay patients.

 

Our HCI business segment was created to separately report on our developmental activities outside our traditional home health business platform.   These activities are intended ultimately, whether directly or indirectly, to benefit our patients and our payers through the enhanced provision of home health services.   Our activities all share a common goal of improving patient experiences and quality outcomes while lowering costs.   They include, but are not limited to, items such as: technology, information, population health management, risk-sharing, care coordination and transitions, clinical advancements, enhanced patient engagement and informed clinical decision and technology enabled in-home clinical assessments. 

 

Certain general and administrative expenses incurred at the corporate level have not been allocated to the segments. 

 

Acquisitions

 

On January 5, 2016, we acquired 100% of the equity of Long Term Solutions, Inc. (“LTS”).  LTS is a provider of in-home nursing assessments for the long-term care insurance industry.  LTS provides assessments in all 50 U.S. states and a number of foreign countries.  The purchase price of $37 million was funded through borrowings on the Company’s bank credit facility, seller notes and issuance of the Company’s common stock.  LTS’s post acquisition operating results are reported in our HCI business segment.

 

14


 

On January 5, 2016, we purchased the assets of a Medicare-certified home health agency owned by Bayonne Visiting Nurse Association (‘Bayonne”) located in New Jersey.  The purchase price was $4.1 million.  Bayonne’s post acquisition operating results are reported in our VN segment.

 

On November 5, 2015, the Company acquired the stock of Black Stone Operations, LLC (“Black Stone”).  Black Stone is a provider of in-home personal care and skilled home health services in western Ohio and operates under the name “Home Care by Black Stone.”  The purchase price of $40 million was funded through borrowings on the Company’s bank credit facility, seller notes and issuance of the Company’s common stock.  Black Stone’s post acquisition operating results are primarily reported in the VN and PC segments.

 

On August 29, 2015, the Company acquired 100% of the equity of Bracor, Inc. (d/b/a WillCare).  The purchase price for the New York and Connecticut operations was $50.8 million.  The transaction was funded by borrowings under the Company’s bank credit facility.  On March 1, 2015, the Company acquired the stock of WillCare’s Ohio operations for $3.0 million.  WillCare’s post acquisition operating results are reported in the VN and PC segments.

 

On July 22, 2015, the Company acquired 100% of the equity of Ingenios Health Co. (Ingenios) for $11.4 million of the Company’s common stock plus $2.0 million in cash.  Ingenios is a leading provider of technology enabled in-home clinical assessments for Medicare Advantage, Managed Medicaid and Commercial Exchange lives in 7 states and Washington, D.C.  The operating results of Ingenios are reported in the HCI business segment.

 

On January 29, 2015, the Company acquired a noncontrolling interest in a development stage analytics and software company, NavHealth, Inc. (NavHealth).  The investment is an asset of the Company’s HCI segment.

 

Health Care Reform Legislation and Medicare Regulations

 

The reader is encouraged to review our detailed discussion of Health Care Reform Legislation and Medicare Regulations in the similarly titled section in Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” along with the discussion under “Government Regulation” in Part I, Item 1, “Business” including but not limited to Item 1A. “Risk Factors” in the Company’s Annual Report on Form 10-K for year ended January 1, 2016

 

Seasonality

 

Our VN segment operations in Florida, where nearly 20% of that segment’s revenues are generated, normally experience higher admissions during the first quarter and lower admissions during the third quarter than in the other quarters due to seasonal population fluctuations. 

 

15


 

RESULTS OF OPERATIONS

FIRST QUARTER

Consolidated

(In thousands)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three months ended

 

 

 

 

 

 

 

 

April 1, 2016

 

April 3, 2015

 

Change

 

Consolidated

    

Amount

    

% Rev

    

Amount

    

% Rev

    

Amount

    

%  

 

Home Health Operations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Net service revenues:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

$

109,613

 

73.4%

 

$

99,535

 

77.6%

 

$

10,078

 

10.1

%

Personal Care

 

 

39,693

 

26.6%

 

 

28,761

 

22.4%

 

 

10,932

 

38.0

%

 

 

 

149,306

 

100.0%

 

 

128,296

 

100.0%

 

 

21,010

 

16.4

%

Operating income before corporate expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

 

14,975

 

13.7%

 

 

12,400

 

12.5%

 

 

2,575

 

20.8

%

Personal Care

 

 

3,737

 

9.4%

 

 

2,898

 

10.1%

 

 

839

 

29.0

%

 

 

 

18,712

 

12.5%

 

 

15,298

 

11.9%

 

 

3,414

 

22.3

%

Healthcare Innovations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenue

 

 

4,392

 

100.0%

 

 

103

 

100.0%

 

 

4,289

 

4164.1

%

Operating income before noncontrolling interest

 

 

(673)

 

-15.3%

 

 

(517)

 

-501.9%

 

 

(156)

 

30.2

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corporate expenses

 

 

7,694

 

5.0%

 

 

6,912

 

5.4%

 

 

782

 

11.3

%

Deal, transition and other costs

 

 

2,609

 

1.7%

 

 

406

 

0.3%

 

 

2,203

 

542.6

%

Operating income

 

 

7,736

 

5.0%

 

 

7,463

 

5.8%

 

 

273

 

3.7

%

Interest expense, net

 

 

(1,332)

 

-0.9%

 

 

(447)

 

-0.3%

 

 

(885)

 

198.0

%

Income tax expense

 

 

(2,677)

 

-1.7%

 

 

(2,987)

 

-2.3%

 

 

310

 

-10.4

%

Net income

 

$

3,727

 

2.4%

 

$

4,029

 

3.1%

 

$

(302)

 

-7.5

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA-HHO (1)

 

$

13,151

 

8.8%

 

$

10,203

 

8.0%

 

$

2,948

 

28.9

%

Adjusted Earnings-HHO (1)

 

$

6,032

 

4.0%

 

$

4,825

 

3.8%

 

$

1,208

 

25.0

%

 


(1)See Page 20 for GAAP reconciliation of Adjusted EBITDA from home health operations and Adjusted earnings from home health operations.

 

Home Health revenue increased year over year by $21.0 million primarily as a result of our acquisition of WillCare and Black Stone.  Refer to VN and PC segment discussions for further operating performance details.  Refer to “Fiscal Year End” related to our 52-53 week reporting calendar conversion. 

 

Healthcare Innovations (HCI) segment net revenues increased $4.3 million to a record $4.4 million, in 2016 from $0.1 million in 2015, as acquired LTS and Ingenios assessment business revenues were $4.1 million.  The first quarter of the year has historically been seasonably lower than the other three quarters.  LTS was acquired in January 2016 and Ingenios was acquired in July 2015.

 

Corporate expenses as a percentage of revenue declined to 5.0%, from 5.4% in the prior year period as a result of acquired revenue out pacing corporate cost additions, while deal, transition and other costs grew to $2.6 million for 2016, primarily as a result of costs related to our 2016 and 2015 acquisitions.  Borrowings related to our acquisition activity in late 2015 and early 2016 also increased our interest expense to $1.3 million, from $0.4 million in the prior year period.

 

Our effective tax rate for the first quarter of 2016 and 2015 was 40.5%.

 

16


 

Visiting Nurse Segment

(In thousands, except for statistics)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three months ended

 

 

 

 

 

 

 

 

April 1, 2016

 

April 3, 2015

 

Change

 

 

    

Amount

    

% Rev

    

Amount

    

% Rev

    

Amount

    

%

 

Net service revenues

 

$

109,613

 

100.0

%  

$

99,535

 

100.0

%  

$

10,078

 

10.1

%

Cost of service revenues

 

 

52,625

 

48.0

%  

 

48,084

 

48.3

%  

 

4,541

 

9.4

%

Gross margin

 

 

56,988

 

52.0

%  

 

51,451

 

51.7

%  

 

5,537

 

10.8

%

General and administrative expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

30,318

 

27.7

%  

 

28,702

 

28.8

%  

 

1,616

 

5.6

%

Other

 

 

11,695

 

10.7

%  

 

10,349

 

10.4

%  

 

1,346

 

13.0

%

Total general and administrative expenses

 

 

42,013

 

38.3

%  

 

39,051

 

39.2

%  

 

2,962

 

7.6

%

Operating income before corporate expenses

 

$

14,975

 

13.7

%  

$

12,400

 

12.5

%  

$

2,575

 

20.8

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Average number of locations

 

 

164

 

 

 

 

160

 

 

 

 

4

 

2.5

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

All payors:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Patients Months

 

 

91,881

 

 

 

 

80,982

 

 

 

 

10,899

 

13.5

%

Admissions

 

 

28,455

 

 

 

 

26,279

 

 

 

 

2,176

 

8.3

%

Billable Visits

 

 

737,871

 

 

 

 

642,592

 

 

 

 

95,279

 

14.8

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions (1)

 

 

25,205

 

88.6

%  

 

23,722

 

90.3

%  

 

1,483

 

6.3

%

Revenue (in thousands)

 

$

103,158

 

94.1

%  

$

95,122

 

95.6

%  

$

8,036

 

8.4

%

Revenue per admission

 

$

4,093

 

 

 

$

4,010

 

 

 

$

83

 

2.1

%

Billable visits (1)

 

 

652,118

 

88.4

%  

 

584,438

 

91.0

%  

 

67,680

 

11.6

%

Recertifications

 

 

12,273

 

 

 

 

11,927

 

 

 

 

346

 

2.9

%

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Traditional Medicare Episodic

 

 

82.0

%  

 

 

 

84.1

%  

 

 

 

(2.1)

%  

 

 

Replacement Plans Paid Episodically

 

 

4.6

%  

 

 

 

4.0

%  

 

 

 

0.6

%  

 

 

Replacement Plans Paid Per Visit

 

 

13.4

%  

 

 

 

11.9

%  

 

 

 

1.5

%  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions (1)

 

 

3,250

 

11.4

%  

 

2,557

 

9.7

%  

 

693

 

27.1

%

Revenue (in thousands)

 

$

6,455

 

5.9

%  

$

4,413

 

4.4

%  

$

2,042

 

46.3

%

Revenue per admission

 

$

1,986

 

 

 

$

1,726

 

 

 

$

260

 

15.1

%

Billable visits (1)

 

 

85,753

 

11.6

%  

 

58,154

 

9.0

%  

 

27,599

 

47.5

%

Recertifications

 

 

1,131

 

 

 

 

427

 

 

 

 

704

 

164.9

%

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicaid & other governmental

 

 

32.6

%  

 

 

 

30.8

%  

 

 

 

1.8

%  

 

 

Private payors

 

 

67.4

%  

 

 

 

69.2

%  

 

 

 

(1.8)

%  

 

 

 


(1)Percentages pertain to percentage of total admissions or total billable visits, as applicable.

 

VN segment net revenues increased $10.1 million to a record $109.6 million from $99.5 million in the prior year and total Medicare admissions grew by 6% to 25,205 from 23,722 primarily due to home health agencies acquired in late 2015 and early 2016 (WillCare, Black Stone and Bayonne acquisitions).  The more rapid growth in Non-Medicare business was driven by the business mix of our acquisitions.

 

Gross margin as a percentage of revenue increased to 52.0% from 51.7% primarily due to lower labor costs per visit from improved monitoring and managementTotal general and administrative expenses declined as a percentage of revenue to 38.3% in the first quarter of 2016 from 39.2% in the prior year quarter primarily from the effect of acquired operations plus the closing of selected underperforming smaller branches.

 

17


 

As a result, VN segment operating income before corporate expenses increased $2.6 million, or 20.8%, to $15.0 million, from $12.4 million in the prior year period, while VN segment operating income as percentage of revenue increased to 13.7% from 12.5% in the prior year period. 

 

Personal Care Segment

(In thousands, except for statistics)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Three months ended

 

 

 

 

 

 

 

 

April 1, 2016

 

April 3, 2015

 

Change

 

 

    

Amount

    

% Rev

    

Amount

    

% Rev

    

Amount

    

%

 

Net service revenues

 

$

39,693

 

100.0

%  

$

28,761

 

100.0

%  

$

10,932

 

38.0

%

Cost of service revenues

 

 

27,177

 

68.5

%  

 

20,197

 

70.2

%  

 

6,980

 

34.6

%

Gross margin

 

 

12,516

 

31.5

%  

 

8,564

 

29.8

%  

 

3,952

 

46.1

%

General and administrative expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

 

5,666

 

14.3

%  

 

3,874

 

13.5

%  

 

1,792

 

46.3

%

Other

 

 

3,113

 

7.8

%  

 

1,792

 

6.2

%  

 

1,321

 

73.7

%

Total general and administrative expenses

 

 

8,779

 

22.1

%  

 

5,666

 

19.7

%  

 

3,113

 

54.9

%

Operating income before corporate expenses

 

$

3,737

 

9.4

%  

$

2,898

 

10.1

%  

$

839

 

29.0

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Average number of locations

 

 

71

 

 

 

 

61

 

 

 

 

10

 

16.4

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions

 

 

2,446

 

 

 

 

1,427

 

 

 

 

1,019

 

71.4

%

Patient months of care

 

 

39,060

 

 

 

 

22,766

 

 

 

 

16,294

 

71.6

%

Billable hours

 

 

1,821,539

 

 

 

 

1,286,884

 

 

 

 

534,655

 

41.5

%

Revenue per billable hour

 

$

21.79

 

 

 

$

22.35

 

 

 

$

(0.56)

 

-2.5

%

 

PC segment net revenues increased $10.9 million or 38.0% to a record $39.7 million in 2016 from $28.8 million in 2015 primarily due to acquisitions.  Changes in cost of service revenues and general and administrative expenses as a percent of revenue are primarily due to mix changes from acquired operations.  Acquired operations likewise increased PC segment contribution to 29.0%, or $0.8 million, as compared to the same period of last year.

 

Liquidity and Capital Resources

 

Revolving Credit Facility

 

We have a senior secured revolving credit facility with JP Morgan Chase Bank, NA, as Administrative Agent, Bank of America, as Syndication Agent, and certain other lenders (the “Facility”).  The Facility consists of a $175 million credit line with a maturity date of November 15, 2020 and an “accordion” feature providing for potential future expansion of the Facility to $250 million.  Borrowings (other than letters of credit) under the credit facility generally will bear interest at a rate varying from the London Interbank Offered Rate (LIBOR) plus 1.75% to LIBOR rate plus 3.00%, depending on leverage.  The Facility is secured by substantially all of our assets and the stock of our subsidiaries.  Debt issuance costs of $1.2 million incurred in connection with the credit facility is recorded in prepaid and other assets and is being amortized through November 15, 2020.

 

Borrowings under the Facility are subject to various covenants including a multiple of 3.5 times earnings before interest, taxes, depreciation and amortization (“EBITDA”). “EBITDA” may include “Acquired EBITDA” from pro-forma acquisitions as defined. Borrowings under the Facility may be used for general corporate purposes, including acquisitions.  Application of the Facility’s borrowing formula as of April 1, 2016, permitted $18.0 million to be used.  We had irrevocable letters of credit totaling $11.3 million outstanding in connection with our self-insurance programs, which resulted in a total of $6.7 million being available for use at April 1, 2016.  As of April 1, 2016, we were in compliance with the various financial covenants.  Under the most restrictive of the Facility’s covenants, we were required to maintain minimum net worth of at least $179.5 million at April 1, 2016.  At such date, our net worth was approximately $285.2 million.

 

18


 

We believe that this facility plus cash on hand will be sufficient to fund our operating needs and expansion plans for at least the next year.  We will continue to evaluate additional capital, including possible debt and equity investments in the Company, to support a more rapid development of the business than would be possible with internal funds.

 

Cash Flows

 

Key elements to the Consolidated Statements of Cash Flows for the three month period ended April 1, 2016 were:

 

 

 

 

 

 

 

 

 

Net Change in Cash and Cash Equivalents (in thousands)

    

2016

    

2015

 

Provided by (used in):

 

 

 

 

 

 

 

Operating activities

 

$

5,608

 

$

(3,781)

 

Investing activities

 

 

(25,198)

 

 

(4,401)

 

Financing activities

 

 

19,203

 

 

7,256

 

Net increase (decrease) in cash and cash equivalents

 

$

(387)

 

$

(926)

 

 

2016

 

Net cash provided by operating activities resulted primarily from current period net income of $3.7 million plus certain non-cash items, net of changes in accounts receivable, accounts payable and accrued expenses.  Accounts receivable days sales outstanding, which were 56 at April 1, 2016 and 62 at April 3, 2015,  decreased due to improved collections in both the VN and PC segments due to focused collection efforts in each segment

 

Cash used in investing activities was primarily due to our January 5, 2016 acquisition of LTS for $20.5 million and Bayonne for $3.7 million.

 

Cash provided by financing activities resulted from $19.4 million of new borrowings on the revolving credit facility to fund acquisitions.

 

2015

 

Net cash provided by operating activities resulted primarily from period net income of $4.0 million plus certain non-cash items, net of changes in accounts receivable, accounts payable and accrued expenses.  Accounts receivable days sales outstanding, which were 62 at April 3, 2015 increased due to collection delays, primarily in the PC segment, due to changes in patient enrollment and billing requirements enacted by the Medicaid managed care providers in Tennessee

 

Cash used in investing activities was primarily due to our March 1, 2015 acquisition of the stock of WillCare’s Ohio operations for $3.0 million and a $1.0 million cost basis investment.

 

Cash provided by financing activities resulted from $8.7 million of new borrowings on the revolving credit facility and $1.2 million of debt issuance costs incurred with the new five year $175 million credit facility.

 

Impact of Inflation

 

Management does not believe that inflation has had a material effect on income during the past several years.

 

Non-GAAP Financial Measures

 

The information provided in some of the tables use certain non-GAAP financial measures as defined under SEC rules. In accordance with SEC rules, the Company has provided, in the supplemental information below, a reconciliation of those measures to the most directly comparable GAAP measures.

 

Adjusted Earnings from Home Health Operations

 

Adjusted earnings from home health operations (Adjusted Earnings-HHO) is not a measure of financial performance under accounting principles generally accepted in the United States of America (US GAAP).  It should not be considered

19


 

in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.  We believe the use of non-GAAP measures on a consolidated and business segment basis assists investors in understanding the ongoing operating performance by presenting comparable financial results between periods.  The non-GAAP information provided is used by us and may not be determined in a manner consistent with the methodologies used by other companies. 

 

 

 

 

 

 

 

 

 

 

 

 

Three months ended

 

 

(in thousands)

    

April 1, 2016

    

April 3, 2015

    

 

Net income attributable to Almost Family, Inc.

 

$

3,917

 

$

4,394

 

 

Addbacks:

 

 

 

 

 

 

 

 

Deal, transition and other, net of tax

 

 

1,552

 

 

242

 

 

Adjusted earnings

 

 

5,469

 

 

4,636

 

 

Healthcare Innovations operating loss after NCI, net of tax

 

 

563

 

 

189

 

 

Adjusted Earnings-HHO

 

$

6,032

 

$

4,825

 

 

Per share amounts-basic:

 

 

 

 

 

 

 

 

Average shares outstanding

 

 

10,089

 

 

9,353

 

 

Net income attributable to Almost Family, Inc.

 

$

0.39

 

$

0.47

 

 

Addbacks:

 

 

 

 

 

 

 

 

Deal, transition and other, net of tax

 

 

0.15

 

 

0.03

 

 

Adjusted earnings

 

 

0.54

 

 

0.50

 

 

Healthcare Innovations operating loss after NCI, net of tax

 

 

0.06

 

 

0.02

 

 

Adjusted Earnings-HHO

 

$

0.60

 

$

0.52

 

 

Per share amounts-diluted:

 

 

 

 

 

 

 

 

Average shares outstanding

 

 

10,260

 

 

9,521

 

 

Net income attributable to Almost Family, Inc.

 

 

0.38

 

$

0.46

 

 

Addbacks:

 

 

 

 

 

 

 

 

Deal, transition and other, net of tax

 

 

0.15

 

 

0.03

 

 

Adjusted earnings

 

 

0.53

 

 

0.49

 

 

Healthcare Innovations operating loss after NCI, net of tax

 

 

0.05

 

 

0.02

 

 

Adjusted Earnings-HHO

 

$

0.59

 

$

0.51

 

 

 

Adjusted EBITDA from Home Health Operations

 

Adjusted earnings before interest, income tax, depreciation, amortization, amortization of stock-based compensation, Healthcare Innovations operating loss and deal, transition and other from Home Health Operations (Adjusted EBITDA-HHO) is not a measure of financial performance under U.S. GAAP.  It should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.  The items excluded from Adjusted EBITDA-HHO are significant components in understanding and evaluating financial performance and liquidity.  Management routinely calculates and communicates Adjusted EBITDA-HHO and believes that it is useful to investors because it is commonly used as an analytical indicator within our industry to evaluate performance, measure leverage capacity and debt service ability, and to estimate current or prospective enterprise value. Adjusted EBITDA is used in certain covenants contained in our Credit Facility.

 

20


 

The following table sets forth a reconciliation of net income to Adjusted EBITDA-HHO as of April 1, 2016:

 

 

 

 

 

 

 

 

 

 

 

 

Three months ended

 

 

(in thousands)

    

April 1, 2016

    

April 3, 2015

    

 

Net income attributable to Almost Family, Inc.

 

$

3,917

 

$

4,394

 

 

Add back:

 

 

 

 

 

 

 

 

Interest expense, net

 

 

1,332

 

 

447

 

 

Income tax expense

 

 

2,677

 

 

2,987

 

 

Depreciation and amortization

 

 

985

 

 

831

 

 

Stock-based compensation

 

 

717

 

 

520

 

 

Deal, transition and other costs

 

 

2,609

 

 

406

 

 

Adjusted EBITDA

 

 

12,237

 

 

9,585

 

 

Healthcare Innovations operating loss

 

 

914

 

 

618

 

 

Adjusted EBITDA-HHO

 

$

13,151

 

$

10,203

 

 

 

 

ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

 

Derivative Instruments

 

The Company does not use derivative instruments.

 

Market Risk of Financial Instruments

 

Our primary market risk exposure with regard to financial instruments is to changes in interest rates on long-term obligations.

 

At April 1, 2016, a hypothetical 100 basis point increase in short-term interest rates would result in a reduction of approximately $1.3 million in our quarter pre-tax earnings.

 

ITEM 4. CONTROLS AND PROCEDURES.

 

Disclosure Controls and Procedures – As of April 1, 2016, the Company’s management, with participation of the Company’s Chief Executive Officer and Principal Financial Officer, evaluated the effectiveness of the Company’s disclosure controls and procedures as defined in Exchange Act Rules 13a-15(e).  Based on that evaluation, the Chief Executive Officer and Principal Financial Officer concluded that the Company’s disclosure controls and procedures were effective as of April 1, 2016

 

Changes in Internal Control Over Financial Reporting - There were no changes in the Company’s internal control over financial reporting during the first quarter of 2016, that have materially affected, or are reasonably likely to materially affect the Company’s internal control over financial reporting.

21


 

PART II - OTHER INFORMATION

 

ITEM 1. LEGAL PROCEEDINGS

 

From time to time, we are subject to various legal actions arising in the ordinary course of our business, including claims for damages for personal injuries.  In our opinion, after discussion with legal counsel, the ultimate resolution of any of these pending ordinary course claims and legal proceedings will not have a material effect on our financial position or results of operations.    Refer to our Form 10-K for the year ended January 1, 2016 in Part I, Item 3. Legal Proceedings.

 

 

ITEM 1A. RISK FACTORS

 

Information regarding risk factors appears in our Form 10-K for the year ending January 1, 2016, under the heading “Special Caution Regarding Forward – Looking Statements” and in the Form 10-K Part I, Item 1A. Risk Factors.  There have been no material changes from the risk factors disclosed in our Form 10-K.

 

ITEM 2.  UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(d) Maximum Number

 

 

(a) Total

 

 

 

 

(c) Total Number of

 

(or Approximate Dollar

 

 

Number of

 

(b) Average

 

Shares (or Units)

 

Value) of Shares (or

 

 

Shares (or

 

Price Paid

 

Purchased as Part of

 

Units) that May Yet Be

 

 

Units)

 

per Share

 

Publicly Announced

 

Purchased Under the

Period

    

Purchased (1)

    

(or Unit)

    

Plans or Programs

    

Plans or Programs

January 2, 2016 – January 29, 2016

 

 —

 

$

 —

 

 —

 

 —

January 30, 2016 – February 26, 2016

 

 —

 

 

 —

 

 —

 

 —

February 27, 2016 – April 1, 2016

 

10,478

 

 

37.76

 

 —

 

 —

Total

 

10,478

 

$

37.76

 

 —

 

 —

 

 

 

 

 

 

 

 

 

 

 


(1) Shares were submitted by employees in lieu of tax withholding that would have otherwise been due on vesting of restricted shares approved by the Company's Board of Directors.

 

 

ITEM 3. DEFAULTS UPON SENIOR SECURITIES

 

 

None.

 

ITEM 4. MINE SAFETY DISCLOSURES

 

Not applicable

22


 

ITEM 5. OTHER INFORMATION

 

Submission of Matters to a Vote of Security Holders

 

At the Annual Meeting of Stockholders of Almost Family, Inc. (the “Company”) held on May 2, 2016, the stockholders elected each of the Company’s nominees for director to serve for terms of one year and until their successors are elected and qualified.  Stockholders also (i) ratified the appointment of independent auditors, Ernst & Young LLP, for the year ended December 30, 2016, and (ii) approved, on an advisory basis, the compensation of the Company’s named executive officers as disclosed in the Company’s proxy statement.

 

The following table shows the final voting results for the Annual Meeting of Stockholders:

 

Proposals and Vote Tabulations

 

Proposal 1: Election of Directors to hold office for a one-year term expiring at the annual meeting in 2017:

 

 

 

Director

Votes Received

Votes Withheld

 

 

 

William B. Yarmuth

7,709,108

91,544 

Steven B. Bing

7,515,493

285,159 

Donald G. McClinton

7,572,186

228,466 

Tyree G. Wilburn

7,566,285

234,367 

Jonathan D. Goldberg

7,329,039

471,613 

W. Earl Reed, III

7,708,884

91,768 

Henry M. Altman, Jr.

5,774,656

2,025,996 

 

There were 1,328,989 broker non-votes for each director nominee.

Proposal 2: The ratification of Ernst & Young LLP as the Company’s Independent Registered Public Accounting Firm for the fiscal year ending December 30, 2016:

9,009,521

 

For:

9,009,521 

Against:

111,787 

Abstained:

8,333 

Broker Non-Votes:

 

 Proposal 3: The advisory vote to approve executive compensation:

 

 

 

For:

7,550,391 

Against:

203,382 

Abstained:

46,879 

Broker Non-Votes:

1,328,989 

 

23


 

ITEM 6. EXHIBITS

 

31.1

Certifications of Chief Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

 

31.2

Certifications of Principal Financial Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

 

32.1

Certifications of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

 

32.2

Certifications of Principal Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

 

101

Financial statements from the quarterly report on Form 10-Q of Almost Family, Inc. for the quarter ended April 1, 2016, filed on May 5, 2016, formatted in XBRL:  (i) Consolidated Balance Sheets, (ii) Consolidated Statements of Income, (iii) Consolidated Statements of Cash Flows, and (iv) the Notes to Consolidated Financial Statements.

 

24


 

SIGNATURES

 

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

 

 

ALMOST FAMILY, INC.

 

 

 

Date  May 5, 2016

By:

/s/ William B. Yarmuth

William B. Yarmuth

 

 

 

 

Chairman of the Board and

Chief Executive Officer

 

 

 

 

 

 

 

 

 

By:

/s/ C. Steven Guenthner

 

 

C. Steven Guenthner

 

 

President and

 

 

Principal Financial Officer

 

25