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, 2010
Or
o TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from to
Commission file numbers:
001-32701
333-127115
EMERGENCY MEDICAL SERVICES CORPORATION
EMERGENCY MEDICAL SERVICES L.P.
(Exact name of Registrants as Specified in their Charters)
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20-3738384 |
Delaware |
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20-2076535 |
(State or other jurisdiction of |
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(IRS Employer |
incorporation or organization) |
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Identification Numbers) |
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6200 S. Syracuse Way, Suite 200 |
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Greenwood Village, CO |
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80111 |
(Address of principal executive offices) |
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(Zip Code) |
Registrants telephone number, including area code: 303-495-1200
Former name, former address and former fiscal year, if changed since last report:
Not applicable
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 o
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 (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). o Yes o 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 definitions of large accelerated filer, accelerated filer, and smaller reporting company in Rule 12b-2 of the Exchange Act.
Large accelerated filer o |
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Accelerated filer x |
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Non-accelerated filer o |
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Smaller reporting company o |
(Do not check if a smaller reporting company) |
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Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange act). Yes o No x
Shares of class A common stock outstanding at October 29, 2010 30,315,886; shares of class B common stock outstanding at October 29, 2010 65,052; LP exchangeable units outstanding at October 29, 2010 13,724,676.
EMERGENCY MEDICAL SERVICES CORPORATION
ON FORM 10-Q
FOR THE THREE AND NINE MONTHS ENDED
SEPTEMBER 30, 2010
3 |
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3 |
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Consolidated Statements of Operations and Comprehensive Income |
3 |
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4 |
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5 |
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6 |
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Managements Discussion and Analysis of Financial Condition and Results of Operations |
20 |
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30 |
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30 |
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31 |
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31 |
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31 |
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32 |
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33 |
EMERGENCY MEDICAL SERVICES CORPORATION
FOR THE THREE AND NINE MONTHS ENDED
SEPTEMBER 30, 2010
ITEM 1. FINANCIAL STATEMENTS (UNAUDITED)
Emergency Medical Services Corporation
Consolidated Statements of Operations and Comprehensive Income
(unaudited; in thousands, except share and per share data)
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Quarter ended |
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Nine months ended |
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September 30, |
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September 30, |
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2010 |
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2009 |
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2010 |
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2009 |
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Net revenue |
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$ |
737,180 |
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$ |
665,056 |
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$ |
2,125,338 |
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$ |
1,915,369 |
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Compensation and benefits |
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523,263 |
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467,625 |
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1,500,023 |
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1,332,787 |
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Operating expenses |
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91,023 |
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85,510 |
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268,138 |
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252,355 |
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Insurance expense |
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25,793 |
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24,845 |
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73,805 |
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75,706 |
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Selling, general and administrative expenses |
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17,742 |
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15,871 |
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52,898 |
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47,186 |
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Depreciation and amortization expense |
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16,528 |
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15,733 |
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48,400 |
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48,658 |
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Income from operations |
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62,831 |
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55,472 |
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182,074 |
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158,677 |
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Interest income from restricted assets |
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717 |
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1,082 |
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2,431 |
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3,468 |
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Interest expense |
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(4,856 |
) |
(10,280 |
) |
(18,182 |
) |
(30,749 |
) |
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Realized gain on investments |
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730 |
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544 |
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879 |
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2,030 |
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Interest and other income |
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277 |
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502 |
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748 |
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1,442 |
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Loss on early debt extinguishment |
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(19,091 |
) |
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Income before income taxes and equity in earnings of unconsolidated subsidiary |
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59,699 |
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47,320 |
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148,859 |
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134,868 |
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Income tax expense |
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(22,990 |
) |
(18,533 |
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(57,355 |
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(53,144 |
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Income before equity in earnings of unconsolidated subsidiary |
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36,709 |
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28,787 |
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91,504 |
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81,724 |
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Equity in earnings of unconsolidated subsidiary |
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53 |
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91 |
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252 |
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244 |
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Net income |
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36,762 |
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28,878 |
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91,756 |
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81,968 |
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Other comprehensive income (loss), net of tax: |
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Unrealized holding gains (losses) during the period |
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364 |
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761 |
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1,907 |
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(1,773 |
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Unrealized gains on derivative financial instruments |
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330 |
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1,105 |
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245 |
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2,372 |
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Comprehensive income |
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$ |
37,456 |
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$ |
30,744 |
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$ |
93,908 |
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$ |
82,567 |
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Basic earnings per common share |
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$ |
0.83 |
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$ |
0.67 |
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$ |
2.09 |
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$ |
1.93 |
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Diluted earnings per common share |
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$ |
0.82 |
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$ |
0.66 |
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$ |
2.06 |
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$ |
1.89 |
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Weighted average common shares outstanding, basic |
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44,100,239 |
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42,809,582 |
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43,896,524 |
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42,366,065 |
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Weighted average common shares outstanding, diluted |
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44,699,169 |
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43,769,788 |
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44,648,135 |
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43,402,818 |
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The accompanying notes are an integral part of these financial statements.
Emergency Medical Services Corporation
(in thousands, except share and per share data)
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September 30, |
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December 31, |
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2010 |
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2009 |
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(Unaudited) |
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Assets |
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Current assets: |
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Cash and cash equivalents |
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$ |
345,716 |
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$ |
332,888 |
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Insurance collateral |
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28,231 |
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24,986 |
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Trade and other accounts receivable, net |
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492,723 |
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459,088 |
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Parts and supplies inventory |
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22,759 |
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22,270 |
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Prepaids and other current assets |
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17,251 |
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19,662 |
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Current deferred tax assets |
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6,323 |
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Total current assets |
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906,680 |
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865,217 |
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Non-current assets: |
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Property, plant and equipment, net |
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126,759 |
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125,855 |
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Intangible assets, net |
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138,641 |
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102,654 |
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Non-current deferred tax assets |
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6,723 |
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13,468 |
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Insurance collateral |
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151,949 |
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143,886 |
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Goodwill |
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388,506 |
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381,951 |
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Other long-term assets |
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18,748 |
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21,676 |
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Total assets |
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$ |
1,738,006 |
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$ |
1,654,707 |
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Liabilities and Equity |
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Current liabilities: |
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Accounts payable |
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$ |
68,239 |
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$ |
70,759 |
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Accrued liabilities |
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264,603 |
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273,704 |
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Current deferred tax liability |
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11,068 |
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Current portion of long-term debt |
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13,953 |
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4,676 |
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Total current liabilities |
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357,863 |
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349,139 |
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Long-term debt |
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410,307 |
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449,254 |
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Insurance reserves and other long-term liabilities |
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166,152 |
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170,227 |
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Total liabilities |
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934,322 |
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968,620 |
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Equity: |
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Preferred stock ($0.01 par value; 20,000,000 shares authorized, 0 issued and outstanding) |
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Class A common stock ($0.01 par value; 100,000,000 shares authorized, 30,294,976 and 29,541,411 issued and outstanding in 2010 and 2009, respectively) |
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303 |
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295 |
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Class B common stock ($0.01 par value; 40,000,000 shares authorized and 65,052 issued and outstanding in 2010 and 2009, respectively) |
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1 |
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1 |
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Class B special voting stock ($0.01 par value; 1 share authorized, issued and outstanding in 2010 and 2009) |
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LP exchangeable units (13,724,676 units issued and outstanding in 2010 and 2009, respectively) |
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90,776 |
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90,776 |
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Treasury stock at cost (23,437 shares in 2010) |
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(1,289 |
) |
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Additional paid-in capital |
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300,286 |
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275,316 |
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Retained earnings |
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410,798 |
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319,042 |
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Accumulated other comprehensive income |
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2,809 |
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657 |
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Total equity |
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803,684 |
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686,087 |
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Total liabilities and equity |
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$ |
1,738,006 |
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$ |
1,654,707 |
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The accompanying notes are an integral part of these financial statements.
Emergency Medical Services Corporation
Consolidated Statements of Cash Flows
(unaudited; in thousands)
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Quarter ended September 30, |
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Nine months ended September 30, |
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2010 |
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2009 |
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2010 |
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2009 |
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Cash Flows from Operating Activities |
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Net income |
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$ |
36,762 |
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$ |
28,878 |
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$ |
91,756 |
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$ |
81,968 |
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Adjustments to reconcile net income to net cash provided by operating activities: |
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Depreciation and amortization |
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17,165 |
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16,242 |
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50,173 |
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49,983 |
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Loss on disposal of property, plant and equipment |
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6 |
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33 |
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95 |
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69 |
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Equity-based compensation expense |
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2,042 |
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1,121 |
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4,587 |
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2,875 |
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Excess tax benefits from stock-based compensation |
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(479 |
) |
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(13,977 |
) |
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Loss on early debt extinguishment |
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19,091 |
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Equity in earnings of unconsolidated subsidiary |
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(53 |
) |
(91 |
) |
(252 |
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(244 |
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Dividends received |
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403 |
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713 |
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Deferred income taxes |
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(1,102 |
) |
18,061 |
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(262 |
) |
49,989 |
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Changes in operating assets/liabilities, net of acquisitions: |
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Trade and other accounts receivable |
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(10,882 |
) |
7,574 |
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(30,441 |
) |
8,448 |
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Parts and supplies inventory |
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(231 |
) |
41 |
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(318 |
) |
(66 |
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Prepaids and other current assets |
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14,487 |
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(6,270 |
) |
2,271 |
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(1,580 |
) |
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Accounts payable and accrued liabilities |
|
799 |
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(1,007 |
) |
13,898 |
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10,613 |
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Insurance accruals |
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(3,891 |
) |
4,280 |
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2,341 |
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7,033 |
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Net cash provided by operating activities |
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54,623 |
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68,862 |
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139,365 |
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209,801 |
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Cash Flows from Investing Activities |
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Purchases of property, plant and equipment |
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(16,199 |
) |
(13,576 |
) |
(31,367 |
) |
(33,661 |
) |
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Proceeds from sale of property, plant and equipment |
|
12 |
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41 |
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120 |
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101 |
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Acquisition of businesses, net of cash received |
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(183 |
) |
(1,241 |
) |
(51,158 |
) |
(1,374 |
) |
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Net change in insurance collateral |
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(4,140 |
) |
6,002 |
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(9,401 |
) |
4,069 |
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Other investing activities |
|
83 |
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(166 |
) |
11,021 |
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(809 |
) |
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Net cash used in investing activities |
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(20,427 |
) |
(8,940 |
) |
(80,785 |
) |
(31,674 |
) |
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Cash Flows from Financing Activities |
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EMSC issuance of class A common stock |
|
221 |
|
2,437 |
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6,414 |
|
7,160 |
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Class A common stock repurchased as treasury stock |
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(1,289 |
) |
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|
(1,289 |
) |
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Repayments of capital lease obligations and other debt |
|
(3,275 |
) |
(1,214 |
) |
(455,902 |
) |
(3,826 |
) |
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Borrowings under credit facility |
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|
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|
425,000 |
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|
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Debt issue costs |
|
(219 |
) |
|
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(11,968 |
) |
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|
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Payment for debt extinguishment premiums |
|
|
|
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(14,513 |
) |
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Excess tax benefits from stock-based compensation |
|
479 |
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|
|
13,977 |
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|
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Net change in bank overdrafts |
|
2,570 |
|
2,821 |
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(7,471 |
) |
3,471 |
|
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Net cash (used in) provided by financing activities |
|
(1,513 |
) |
4,044 |
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(45,752 |
) |
6,805 |
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Change in cash and cash equivalents |
|
32,683 |
|
63,966 |
|
12,828 |
|
184,932 |
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Cash and cash equivalents, beginning of period |
|
313,033 |
|
267,139 |
|
332,888 |
|
146,173 |
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Cash and cash equivalents, end of period |
|
$ |
345,716 |
|
$ |
331,105 |
|
$ |
345,716 |
|
$ |
331,105 |
|
The accompanying notes are an integral part of these financial statements.
Emergency Medical Services Corporation
Notes to Unaudited Consolidated Financial Statements
(in thousands, except share and per share data)
1. General
Basis of Presentation of Financial Statements
The accompanying interim consolidated financial statements for Emergency Medical Services Corporation (EMSC or the Company) have been prepared in accordance with U.S. generally accepted accounting principles (GAAP) for interim reporting and accordingly, do not include all of the disclosures required for annual financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation have been included. All such adjustments are of a normal, recurring nature. Operating results for the three and nine month periods ended September 30, 2010 are not necessarily indicative of the results that may be expected for the full year ending December 31, 2010. For further information, see the Companys consolidated financial statements, including the accounting policies and notes thereto, included in the Companys Annual Report on Form 10-K for the fiscal year ended December 31, 2009.
The consolidated financial statements of EMSC include those of its direct subsidiary, Emergency Medical Services L.P. (EMS LP), a Delaware limited partnership. The Companys business is conducted primarily through two operating subsidiaries, American Medical Response, Inc. (AMR), its healthcare transportation services segment, and EmCare Holdings Inc. (EmCare), its facility-based physician services segment.
The Company is party to a management agreement with a wholly-owned subsidiary of Onex Corporation, the Companys principal equityholder. In exchange for an annual management fee of $1.0 million, the Onex subsidiary provides the Company with corporate finance and strategic planning consulting services. For each of the three and nine months ended September 30, 2010 and 2009, the Company expensed $250 and $750, respectively, in respect of this fee.
2. Summary of Significant Accounting Policies
Consolidation
The consolidated financial statements include all wholly-owned subsidiaries of EMSC, including AMR and EmCare and their respective subsidiaries. All significant intercompany transactions and balances have been eliminated in consolidation.
Use of Estimates
The preparation of financial statements requires management to make estimates and assumptions relating to the reporting of results of operations, financial condition and related disclosure of contingent assets and liabilities at the date of the financial statements. Actual results may differ from those estimates under different assumptions or conditions.
Insurance
Insurance collateral is comprised principally of government and investment grade securities and cash deposits with third parties and supports the Companys insurance program and reserves. Certain of these investments, if sold or otherwise liquidated, would have to be replaced by other suitable financial assurances and are, therefore, considered restricted.
Insurance reserves are established for automobile, workers compensation, general liability and professional liability claims utilizing policies with both fully-insured and self-insured components. This includes the use of an off-shore captive insurance program through a wholly-owned subsidiary for certain liability programs for both EmCare and AMR. In those instances where the Company has obtained third-party insurance coverage, the Company generally retains liability for the first $1 to $2 million of the loss. Insurance reserves cover known claims and incidents within the level of Company retention that may result in the assertion of additional claims, as well as claims from unknown incidents that may be asserted arising from activities through the balance sheet date.
The Company establishes reserves for claims based upon an assessment of actual claims and claims incurred but not reported. The reserves are established based on quarterly consultation with third-party independent actuaries using actuarial principles and assumptions that consider a number of factors, including historical claim payment patterns (including legal costs), changes in case reserves and the assumed rate of inflation in healthcare costs and property damage repairs.
The Companys most recent actuarial valuation was completed in September 2010. As a result of this actuarial valuation, the Company recorded an increase of $0.1 million in its provision for insurance liabilities related to reserves for losses in prior years during the three months ended September 30, 2010. A total increase of $0.2 million was recorded during the nine
months ended September 30, 2010. As a result of the actuarial valuation completed in September 2009, the Company recorded a decrease of $0.9 million in its provision for insurance liabilities during the three months ended September 30, 2009. A total increase of $4.3 million was recorded during the nine months ended September 30, 2009.
The long-term portion of insurance reserves was $155.2 million and $143.6 million as of September 30, 2010 and December 31, 2009, respectively.
Trade and Other Accounts Receivable, net
The Company determines its allowances based on payor reimbursement schedules, historical write-off experience and other economic data. The allowances for contractual discounts and uncompensated care are reviewed monthly. Account balances are charged off against the uncompensated care allowance when it is probable the receivable will not be recovered. Write-offs to the contractual allowance occur when payment is received. The allowance for uncompensated care is related principally to receivables recorded for self-pay patients. The Companys accounts receivable and allowances are as follows:
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September 30, |
|
December 31, |
|
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Gross trade accounts receivable |
|
$ |
2,068,202 |
|
$ |
1,955,152 |
|
Allowance for contractual discounts |
|
1,088,277 |
|
1,001,285 |
|
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Allowance for uncompensated care |
|
576,683 |
|
572,015 |
|
||
Net trade accounts receivable |
|
403,242 |
|
381,852 |
|
||
Other receivables, net |
|
89,481 |
|
77,236 |
|
||
Net accounts receivable |
|
$ |
492,723 |
|
$ |
459,088 |
|
Other receivables represent EmCare hospital subsidies and fees and AMR fees for stand-by and special events and subsidies from community organizations.
AMR contractual allowances are determined primarily on payor reimbursement schedules that are included and regularly updated in the billing systems, and by historical collection experience. The billing systems calculate the difference between payor specific gross billings and contractually agreed to, or governmentally driven, reimbursement rates. The allowance for uncompensated care at AMR is related principally to receivables recorded for self-pay patients. AMRs allowances on self-pay accounts receivable are estimated on claim level, historical write-off experience.
Accounts receivable allowances at EmCare are estimated based on cash collection and write-off experience at a facility level contract and facility specific payor mix. These allowances are reviewed and adjusted monthly through revenue provisions. In addition, a look-back analysis is done, typically after 15 months, to compare actual cash collected on a date of service basis to the revenue recorded for that period. Any adjustment necessary for an overage or deficit in these allowances based on actual collections is recorded through a revenue adjustment in the current period.
Revenue Recognition
Revenue is recognized at the time of service and is recorded net of provisions for contractual discounts and estimated uncompensated care. Provisions for estimated contractual discounts are related principally to differences between gross charges and specific payor, including governmental, reimbursement schedules. Provisions for estimated uncompensated care are related principally to the number of self-pay patients treated in the period. Provisions for contractual discounts and estimated uncompensated care as a percentage of gross revenue and as a percentage of gross revenue less provision for contractual discounts are as follows:
|
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Quarter ended |
|
Nine months ended |
|
||||
|
|
2010 |
|
2009 |
|
2010 |
|
2009 |
|
Gross revenue |
|
100.0 |
% |
100.0 |
% |
100.0 |
% |
100.0 |
% |
Provision for contractual discounts |
|
52.3 |
% |
49.2 |
% |
52.5 |
% |
48.9 |
% |
Revenue net of contractual discounts |
|
47.7 |
% |
50.8 |
% |
47.5 |
% |
51.1 |
% |
Provision for uncompensated care as a percentage of gross revenue |
|
19.0 |
% |
20.3 |
% |
18.7 |
% |
20.1 |
% |
Provision for uncompensated care as a percentage of gross revenue less contractual discounts |
|
39.9 |
% |
39.9 |
% |
39.3 |
% |
39.3 |
% |
Healthcare reimbursement is complex and may involve lengthy delays. Third-party payors are continuing their efforts to control expenditures for healthcare, including proposals to revise reimbursement policies. The Company has from time to time experienced delays in reimbursement from third-party payors. In addition, third-party payors may disallow, in whole or in part, claims for reimbursement based on determinations that certain amounts are not reimbursable under plan coverage, determinations of medical necessity, or the need for additional information. Laws and regulations governing the Medicare and Medicaid programs are very complex and subject to interpretation. Revenue is recognized on an estimated basis in the period which related services are rendered. As a result, there is a reasonable possibility that recorded estimates will change materially in the short-term. Such amounts, including adjustments between provisions for contractual discounts and uncompensated care, are adjusted in future periods, as adjustments become known. These adjustments were less than 1% of net revenue for the three and nine month periods ending September 30, 2010 and 2009.
The Company also provides services to patients who have no insurance or other third-party payor coverage. In certain circumstances, federal law requires providers to render services to any patient who requires emergency care regardless of their ability to pay.
Equity Structure
On December 21, 2005, the Company effected a reorganization and issued 8.1 million shares of class A common stock in an initial public offering. Pursuant to the reorganization, EMS LP, the former top-tier holding company of AMR and EmCare, became the consolidated subsidiary of EMSC, a newly formed corporation. To effect the reorganization, the holders of the capital stock of the sole general partner of EMS LP contributed that capital stock to the Company in exchange for class B common stock; the general partner was merged into the Company and the Company became the sole general partner of EMS LP. Concurrently, the holders of class B units of EMS LP contributed their units to the Company in exchange for shares of the Companys class A common stock, and the holders of certain class A units of EMS LP contributed their units to the Company in exchange for shares of the Companys class B common stock.
As of September 30, 2010, the Company holds 68.8% of the equity interests in EMS LP. LP exchangeable units, held by persons affiliated with the Companys principal equity holder, represent the balance of the EMS LP equity. The LP exchangeable units are exchangeable at any time, at the option of the holder, for shares of the Companys class B common stock on a one-for-one basis. The holders of the LP exchangeable units have the right to vote, through the trustee holder of the Companys class B special voting stock, at all stockholder meetings at which holders of the Companys class B common stock or class B special voting stock are entitled to vote.
In the EMS LP partnership agreement, the Company has agreed to maintain the economic equivalency of the LP exchangeable units and the class B common stock, and the holders of the LP exchangeable units have no general voting rights. The LP exchangeable units, when considered with the class B special voting stock, have the same rights, privileges and characteristics of the Companys class B common stock. The LP exchangeable units are intended to be economically equivalent to the class B common stock of the Company in that the LP exchangeable units carry the right to vote (by virtue of the class B special voting stock) with the holders of class B common stock as one class, and entitle holders to receive distributions only if the equivalent dividends are declared on the Companys class B common stock. Accordingly, the Company accounts for the LP exchangeable units as if the LP exchangeable units were shares of its common stock, including reporting the LP exchangeable units in the equity section of the Companys balance sheet and including the number of outstanding LP exchangeable units in both its basic and diluted earnings per share calculations.
Fair Value Measurement
The Company classifies its financial instruments that are reported at fair value based on a hierarchal framework which ranks the level of market price observability used in measuring financial instruments at fair value. Market price observability is impacted by a number of factors, including the type of instrument and the characteristics specific to the instrument. Instruments with readily available active quoted prices or for which fair value can be measured from actively quoted prices generally will have a higher degree of market price observability and a lesser degree of judgment used in measuring fair value.
Financial instruments measured and reported at fair value are classified and disclosed in one of the following categories:
Level 1 Quoted prices are available in active markets for identical assets or liabilities as of the reporting date. The Company does not adjust the quoted price for these assets or liabilities.
Level 2 Pricing inputs are other than quoted prices in active markets, which are either directly or indirectly observable as of the reporting date, and fair value is determined through the use of models or other valuation methodologies.
Level 3 Pricing inputs are unobservable as of the reporting date and reflect the Companys own assumptions about the
fair value of the asset or liability.
The following table summarizes the valuation of EMSCs financial instruments by the above fair value hierarchy levels as of September 30, 2010:
Description |
|
Total |
|
Level 1 |
|
Level 2 |
|
Level 3 |
|
||||
Assets: |
|
|
|
|
|
|
|
|
|
||||
Securities |
|
$ |
62,152 |
|
$ |
49,608 |
|
$ |
12,544 |
|
$ |
|
|
Derivatives |
|
$ |
571 |
|
$ |
|
|
$ |
571 |
|
$ |
|
|
Recent Accounting Pronouncements
In August 2010, the FASB further defined the requirements for measurement and disclosure of charity care provided. The amendments require that cost, both direct and indirect, be used as the measurement basis for charity care disclosure purposes. These amendments will be effective for the Company beginning January 1, 2011. Management does not expect the adoption of this guidance to have a material effect on the Companys consolidated financial statements and related disclosures.
Also in August 2010, the FASB clarified that healthcare entities should not net insurance recoveries against a related claim liability. These amendments will be effective for the Company beginning January 1, 2011. Management does not expect the adoption of this guidance to have a material effect on the Companys consolidated financial statements and related disclosures.
3. Acquisitions
During the three months ended March 31, 2010, the Company made a purchase price allocation adjustment related to the acquisition of the management services entity of Pinnacle Anesthesia Consultants, P.A. and Pinnacle Consultants Mid-Atlantic, L.L.C. (together, the Pinnacle Acquisition) which closed in December 2009. Based on an independent valuation analysis completed during the first quarter of 2010, $31.1 million was reclassified from goodwill to intangible assets, and amortized accordingly.
On May 28, 2010, the Company completed the acquisition of V.I.P. Professional Services, Inc., the parent of Gold Coast Ambulance Service, which provides emergency and non-emergency ambulance services in southwest Ventura County, California. On June 4, 2010, an affiliate of the Company completed the acquisition of professional entities which provide anesthesiology services for Clinical Partners Management Company, an existing subsidiary of the Company. On June 30, 2010, the Company completed its acquisition of Affilion, Inc., which provides emergency department physician staffing and related management services to hospitals in Arizona, New Mexico and Texas. Also on June 30, 2010, an affiliate of the Company completed its acquisition of Fredericksburg Anesthesia Consultants, PLLC, a provider of anesthesia services to facilities in south Texas. The total cost of these and other smaller acquisitions was $51.2 million and the Company has recorded $35.7 million of goodwill, which amount is subject to adjustment based upon completion of purchase price allocations.
4. Accrued Liabilities
Accrued liabilities were as follows at September 30, 2010 and December 31, 2009:
|
|
September 30, |
|
December 31, |
|
||
Accrued wages and benefits |
|
$ |
113,355 |
|
$ |
92,721 |
|
Accrued paid time-off |
|
27,422 |
|
24,290 |
|
||
Current portion of self-insurance reserves |
|
53,593 |
|
62,832 |
|
||
Accrued restructuring |
|
165 |
|
181 |
|
||
Current portion of compliance and legal |
|
7,253 |
|
2,814 |
|
||
Accrued billing and collection fees |
|
3,800 |
|
4,093 |
|
||
Accrued incentive compensation |
|
20,253 |
|
34,000 |
|
||
Accrued interest |
|
1,003 |
|
9,773 |
|
||
Accrued income taxes payable |
|
|
|
5,454 |
|
||
Other |
|
37,759 |
|
37,546 |
|
||
Total accrued liabilities |
|
$ |
264,603 |
|
$ |
273,704 |
|
5. Long-Term Debt
On April 8, 2010, the Company completed the financing of new senior secured credit facilities consisting of a $425 million term loan and a $150 million revolving credit facility. The term loan bears interest at LIBOR, plus a margin of 3.00%, and requires quarterly principal repayments until maturity in 2015. The revolving facility bears interest at LIBOR, plus a margin of 3.00%, and is repayable at maturity in 2015. The senior secured credit facilities can be expanded and the interest rate margins stepped down to 2.75% upon achieving certain leverage ratios. Substantially all of EMS LPs domestic assets are pledged as collateral under the new senior secured credit facilities. The revolving facility is also subject to an annual commitment fee of 0.5% on unutilized commitments.
In conjunction with completing the financing under the new credit facilities, the Company repaid the balance outstanding on the previous senior secured term loan and redeemed the Companys 10% senior subordinated notes. During the three months ended June 30, 2010, the Company recorded a loss on early debt extinguishment of $19.1 million which included certain unamortized debt issuance costs as well as costs associated with the redemption of the senior subordinated notes.
Long-term debt consisted of the following at September 30, 2010 and December 31, 2009:
|
|
September 30, |
|
December 31, |
|
||
Senior subordinated notes |
|
$ |
|
|
$ |
250,000 |
|
Senior secured term loan due 2015 (3.28% at September 30, 2010) |
|
422,344 |
|
199,765 |
|
||
Notes due at various dates from 2010 to 2022 with interest rates from 6% to 10% |
|
1,115 |
|
1,249 |
|
||
Capital lease obligations due at various dates from 2010 to 2018 (see note 7) |
|
801 |
|
2,916 |
|
||
|
|
424,260 |
|
453,930 |
|
||
Less current portion |
|
(13,953 |
) |
(4,676 |
) |
||
Total long-term debt |
|
$ |
410,307 |
|
$ |
449,254 |
|
6. Derivative Instruments and Hedging Activities
The Company manages its exposure to changes in market interest rates and fuel prices and from time to time uses highly effective derivative instruments to manage well-defined risk exposures. The Company monitors its positions and the credit ratings of its counterparties and does not anticipate non-performance by the counterparties. The Company does not use derivative instruments for speculative purposes.
At September 30, 2010, the Company was party to a series of fuel hedge transactions with a major financial institution under one master agreement. Each of the transactions effectively fixes the cost of diesel fuel at prices ranging from $3.00 to $3.29 per gallon. The Company purchases the diesel fuel at the market rate and periodically settles with its counterparty for the difference between the national average price for the period published by the Department of Energy and the agreed upon fixed price. The transactions fix the price for a total of 5.9 million gallons, which represent approximately 32% of the Companys total estimated usage over the hedge period, and are spread over periods from October 2010 through June 2012. As of September 30, 2010, the Company recorded, as a component of other comprehensive income before applicable tax impacts, an asset associated with the fair value of the fuel hedge of $0.6 million, compared to $0.2 million as of December 31, 2009. The net additional payments made or received under these hedge agreements did not have a material impact on operating expenses during the nine months ended September 30, 2010.
7. Commitments and Contingencies
Lease Commitments
The Company leases various facilities and equipment under operating lease agreements.
The Company also leases certain leasehold improvements under capital leases. Assets under capital leases are capitalized using inherent interest rates at the inception of each lease. Capital leases are collateralized by the underlying assets.
Purchase Commitment
Beginning in March 2009, AMR entered into a series of forward purchase contracts which fixed the price for a portion of its total monthly diesel fuel usage from April 1, 2009 through June 30, 2010. Based on the terms of the contracts, the Company has concluded they do not qualify as derivatives. There was no material impact to operating expenses related to
these contracts during the three and nine month periods ended September 30, 2010 and 2009.
Services
The Company is subject to the Medicare and Medicaid fraud and abuse laws which prohibit, among other things, any false claims, or any bribe, kickback or rebate in return for the referral of Medicare and Medicaid patients. Violation of these prohibitions may result in civil and criminal penalties and exclusion from participation in the Medicare and Medicaid programs. Management has implemented policies and procedures that management believes will assure that the Company is in substantial compliance with these laws and regulations but there can be no assurance the Company will not be found to have violated certain of these laws and regulations. From time to time, the Company receives requests for information from government agencies pursuant to their regulatory or investigational authority. Such requests can include subpoenas or demand letters for documents to assist the government in audits or investigations. The Company is cooperating with the government agencies conducting these investigations and is providing requested information to the government agencies. Other than the proceedings described below, management believes that the outcome of any of these investigations would not have a material adverse effect on the Company.
Other Legal Matters
On December 13, 2005, a lawsuit purporting to be a class action was commenced against AMR in Spokane, Washington in Washington State Court, Spokane County. The complaint alleged that AMR billed patients and third party payors for transports it conducted between 1998 and 2005 at higher rates than contractually permitted. The court has certified a class in this case which is comprised of approximately 15,000 Spokane County residents. In September 2010, the Company and class representatives reached an agreement to resolve the claims for approximately $1.1 million, which amount includes all remaining refunds due to class members and attorneys fees for the plaintiffs counsel. The settlement is expected to be approved and finalized by the court by the end of January 2011.
In December 2006, AMR received a subpoena from the Department of Justice (DOJ). The subpoena requested copies of documents for the period from January 2000 through the present. The subpoena required AMR to produce a broad range of documents relating to the operations of certain AMR affiliates in New York. The Company produced documents responsive to the subpoena. The government has identified claims for reimbursement that the government believes lack support for the level billed, and invited the Company to respond to the identified areas of concern. The Company reviewed the information provided by the government, provided its response, and is currently in discussions with the DOJ and the Office of the Inspector General of Health and Human Services regarding resolution of this matter. During the three months ended June 30, 2010, the Company recorded a $3.1 million reserve for its estimate of likely exposure in this matter.
Four different lawsuits purporting to be class actions have been filed against AMR and certain subsidiaries in California alleging violations of California wage and hour laws. On April 16, 2008, Lori Bartoni commenced a suit in the Superior Court for the State of California, County of Alameda; on July 8, 2008, Vaughn Banta filed suit in the Superior Court of the State of California, County of Los Angeles; on January 22, 2009, Laura Karapetian filed suit in the Superior Court of the State of California, County of Los Angeles; and on March 11, 2010, Melanie Aguilar filed suit in the Superior Court of the State of California County of Los Angeles. The Banta and Karapetian cases have been coordinated with the Bartoni case in the Superior Court for the State of California, County of Alameda. At the present time, the courts have not certified classes in any of these cases. Plaintiffs allege principally that the AMR entities failed to pay daily overtime charges pursuant to California law, and failed to provide required meal breaks or pay premium compensation for missed meal breaks. Plaintiffs are seeking to certify the classes and are seeking lost wages, punitive damages, attorneys fees and other sanctions permitted under California law for violations of wage hour laws. The Company is unable at this time to estimate the amount of potential damages, if any.
The Company is involved in other litigation arising in the ordinary course of business. Management believes the outcome of these legal proceedings will not have a material adverse impact on its financial condition, results of operations or liquidity.
8. Equity Based Compensation
The Companys stock options are valued using the Black-Scholes valuation model on the date of grant. Equity based compensation has been issued under the plans described below.
Equity Option Plan
Under the Companys Equity Option Plan, key employees were granted options that permit the individuals to purchase class A common shares and vest ratably generally over a period of four years. In addition, certain performance measures must be met for 50% of the options to become exercisable; these performance measures were satisfied during 2009 with respect to
the options granted under the Equity Option Plan. As the vesting period for these options was completed prior to 2010, the Company did not record a compensation charge during each of the three and nine months ended September 30, 2010 as well as during the three months ended September 30, 2009. A compensation charge of $97 was recorded for the nine months ended September 30, 2009. Options are no longer granted under the Equity Option Plan, but rather under the Companys Second Amended and Restated Long-Term Incentive Plan described below.
Long-Term Incentive Plan
The Companys original 2007 Long-Term Incentive Plan was approved by stockholders in May 2007, amended and restated in May 2008, and a Second Amended and Restated Long-Term Incentive Plan (the Plan) was approved by stockholders in May 2010. The Plan provides for the grant of long-term incentives, including various equity-based incentives, to those persons with responsibility for the success and growth of the Company and its subsidiaries. Options granted under the Plan vest and become exercisable ratably over a period of four years from the date of grant and have a maximum term of ten years. In addition, for options granted under the Plan prior to January 1, 2009, certain performance measures were required to be met for 50% of these options to become exercisable; these performance measures were satisfied during the first quarter of 2010. The Company also grants shares of restricted stock under the Plan, which currently lapse ratably over a period of three years from the date of grant. In addition, with respect to grants of restricted stock in May 2010 to the Companys named executive officers and persons deemed covered employees under section 162(m) of the Internal Revenue Code of 1986, as amended, certain profitability-based performance measures must be met within that three-year period for restricted stock grants to lapse.
The Company recorded a compensation charge of $1,859 and $996 during the three months ended September 30, 2010 and 2009, respectively, and $4,135 and $2,403 during the nine months ended September 30, 2010 and 2009, respectively, in connection with the Plan.
Non-Employee Director Compensation Plan
The Non-Employee Director Compensation Plan, approved in May 2007, is available to non-employee directors of the Company, other than the Chair of the Compliance Committee. Under this plan, eligible directors are granted Restricted Stock Units (RSUs) following each annual stockholder meeting with each RSU representing one share of the Companys class A common stock. As of May 2010, eligible directors now receive a grant of RSUs having a fair market value of $133 on the date of grant based on the closing price of the Companys class A common stock on the business day immediately preceding the grant date. The Non-Employee Director Compensation Plan allows directors to defer income from the grant of RSUs, which vest immediately prior to the election of directors at the next annual stockholder meeting. In connection with this plan, the Company granted 2,324 RSUs per director after the Companys 2010 annual stockholder meeting, plus an additional prorated amount of 1,854 RSUs to a director upon his election to the board of directors in July 2010. The Company granted 3,018 RSUs per director in 2009. The Company expensed $183 and $125 during the three month periods ended September 30, 2010 and 2009, respectively, and $452 and $375 during the nine month periods ended September 30, 2010 and 2009, respectively.
Stock Purchase Plan/Employee Stock Purchase Plan
During the second quarter of 2010, the Company commenced an offering of its class A common stock to eligible employees and independent contractors associated with the Company and its subsidiaries pursuant to the Companys Stock Purchase Plan and Employee Stock Purchase Plan (together, the SPPs). The purchases of stock under the SPPs occurred in October 2010 at a 5% discount to the closing price of the Companys class A common stock on October 15, 2010, and as such no compensation charge was recorded for these plans during the nine months ended September 30, 2010.
9. Segment Information
The Company is organized around two separately managed business units: healthcare transportation services and facility-based physician services, which have been identified as operating segments. The healthcare transportation services reportable segment focuses on providing a full range of medical transportation services from basic patient transit to the most advanced emergency care and pre-hospital assistance. The facility-based physician services reportable segment provides physician services to hospitals primarily for emergency departments and urgent care centers, as well as for hospitalist/ inpatient, radiology, teleradiology and anesthesiology services. The Chief Executive Officer has been identified as the chief operating decision maker (CODM) as he assesses the performance of the business units and decides how to allocate resources to the business units.
Net income before equity in earnings of unconsolidated subsidiary, income tax expense, loss on early debt extinguishment, interest and other income, realized gain on investments, interest expense and depreciation and amortization (Adjusted
EBITDA) is the measure of profit and loss that the CODM uses to assess performance, measure liquidity and make decisions. The accounting policies for reported segments are the same as for the Company as a whole.
|
|
Quarter ended September 30, |
|
Nine months ended September 30, |
|
||||||||
|
|
2010 |
|
2009 |
|
2010 |
|
2009 |
|
||||
Healthcare Transportation Services |
|
|
|
|
|
|
|
|
|
||||
Net Revenue |
|
$ |
352,226 |
|
$ |
338,768 |
|
$ |
1,033,347 |
|
$ |
1,010,718 |
|
Segment Adjusted EBITDA |
|
31,449 |
|
31,838 |
|
95,611 |
|
98,151 |
|
||||
Facility-Based Physician Services |
|
|
|
|
|
|
|
|
|
||||
Net Revenue |
|
384,954 |
|
326,288 |
|
1,091,991 |
|
904,651 |
|
||||
Segment Adjusted EBITDA |
|
48,627 |
|
40,449 |
|
137,294 |
|
112,652 |
|
||||
Total |
|
|
|
|
|
|
|
|
|
||||
Total Net Revenue |
|
737,180 |
|
665,056 |
|
2,125,338 |
|
1,915,369 |
|
||||
Total Adjusted EBITDA |
|
80,076 |
|
72,287 |
|
232,905 |
|
210,803 |
|
||||
Reconciliation of Adjusted EBITDA to Net Income |
|
|
|
|
|
|
|
|
|
||||
Adjusted EBITDA |
|
$ |
80,076 |
|
$ |
72,287 |
|
$ |
232,905 |
|
$ |
210,803 |
|
Depreciation and amortization expense |
|
(16,528 |
) |
(15,733 |
) |
(48,400 |
) |
(48,658 |
) |
||||
Interest expense |
|
(4,856 |
) |
(10,280 |
) |
(18,182 |
) |
(30,749 |
) |
||||
Realized gain on investments |
|
730 |
|
544 |
|
879 |
|
2,030 |
|
||||
Interest and other income |
|
277 |
|
502 |
|
748 |
|
1,442 |
|
||||
Loss on early debt extinguishment |
|
|
|
|
|
(19,091 |
) |
|
|
||||
Income tax expense |
|
(22,990 |
) |
(18,533 |
) |
(57,355 |
) |
(53,144 |
) |
||||
Equity in earnings of unconsolidated subsidiary |
|
53 |
|
91 |
|
252 |
|
244 |
|
||||
Net income |
|
$ |
36,762 |
|
$ |
28,878 |
|
$ |
91,756 |
|
$ |
81,968 |
|
A reconciliation of Adjusted EBITDA to cash flows provided by operating activities is as follows:
|
|
Quarter ended September 30, |
|
Nine months ended September 30, |
|
||||||||
|
|
2010 |
|
2009 |
|
2010 |
|
2009 |
|
||||
Adjusted EBITDA |
|
$ |
80,076 |
|
$ |
72,287 |
|
$ |
232,905 |
|
$ |
210,803 |
|
Interest paid |
|
(4,195 |
) |
(9,773 |
) |
(16,385 |
) |
(29,424 |
) |
||||
Change in accounts receivable |
|
(10,882 |
) |
7,574 |
|
(30,441 |
) |
8,448 |
|
||||
Change in other operating assets/liabilities |
|
11,164 |
|
(2,956 |
) |
18,192 |
|
16,000 |
|
||||
Equity based compensation |
|
2,042 |
|
1,121 |
|
4,587 |
|
2,875 |
|
||||
Excess tax benefits from stock-based compensation |
|
(479 |
) |
|
|
(13,977 |
) |
|
|
||||
Income tax expense, net of change in deferred taxes |
|
(24,092 |
) |
(472 |
) |
(57,617 |
) |
(3,155 |
) |
||||
Other |
|
989 |
|
1,081 |
|
2,101 |
|
4,254 |
|
||||
Cash flows provided by operating activities |
|
$ |
54,623 |
|
$ |
68,862 |
|
$ |
139,365 |
|
$ |
209,801 |
|
10. Guarantors of Debt
EMS LPs wholly-owned subsidiaries, AMR HoldCo, Inc. and EmCare HoldCo, Inc., are the borrowers under the senior secured credit facility, which includes a full, unconditional and joint and several guarantee by EMSC, EMS LP and EMSCs domestic subsidiaries. The senior secured credit facility does not include a guarantee by the Companys captive insurance subsidiary and only limited guarantees from any future non-domestic subsidiaries. All of the operating income and cash flow of EMSC, EMS LP, AMR HoldCo, Inc. and EmCare HoldCo, Inc. is generated by AMR, EmCare and their subsidiaries. As a result, funds necessary to meet the debt service obligations under the senior secured credit facility are provided by the distributions or advances from the subsidiary companies, AMR and EmCare. Investments in subsidiary operating companies are accounted for on the equity method. Accordingly, entries necessary to consolidate EMSC, EMS LP, AMR HoldCo, Inc., EmCare HoldCo, Inc. and all of their subsidiaries are reflected in the Eliminations/Adjustments column. Separate complete financial statements of the borrowers, EMS LP and subsidiary guarantors would not provide additional material information that would be useful in assessing the financial composition of the borrowers, EMS LP or the subsidiary guarantors. The condensed consolidating financial statements for EMSC,EMS LP, the borrowers, the guarantors and the non-guarantor are as follows:
Consolidating Statement of Operations
For the quarter ended September 30, 2010
|
|
|
|
|
|
Issuer |
|
Issuer |
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
AMR |
|
EmCare |
|
Subsidiary |
|
Subsidiary |
|
Eliminations/ |
|
|
|
||||||||
|
|
EMSC |
|
EMS LP |
|
HoldCo, Inc. |
|
HoldCo, Inc. |
|
Guarantors |
|
Non-Guarantor |
|
Adjustments |
|
Total |
|
||||||||
Net revenue |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
737,180 |
|
$ |
19,164 |
|
$ |
(19,164 |
) |
$ |
737,180 |
|
Compensation and benefits |
|
|
|
|
|
|
|
|
|
523,263 |
|
|
|
|
|
523,263 |
|
||||||||
Operating expenses |
|
|
|
|
|
|
|
|
|
91,023 |
|
|
|
|
|
91,023 |
|
||||||||
Insurance expense |
|
|
|
|
|
|
|
|
|
24,586 |
|
20,371 |
|
(19,164 |
) |
25,793 |
|
||||||||
Selling, general and administrative expenses |
|
|
|
|
|
|
|
|
|
17,742 |
|
|
|
|
|
17,742 |
|
||||||||
Depreciation and amortization expense |
|
|
|
|
|
|
|
|
|
16,528 |
|
|
|
|
|
16,528 |
|
||||||||
Income (loss) from operations |
|
|
|
|
|
|
|
|
|
64,038 |
|
(1,207 |
) |
|
|
62,831 |
|
||||||||
Interest income from restricted assets |
|
|
|
|
|
|
|
|
|
240 |
|
477 |
|
|
|
717 |
|
||||||||
Interest expense |
|
|
|
|
|
|
|
|
|
(4,856 |
) |
|
|
|
|
(4,856 |
) |
||||||||
Realized gain on investments |
|
|
|
|
|
|
|
|
|
|
|
730 |
|
|
|
730 |
|
||||||||
Interest and other income |
|
|
|
|
|
|
|
|
|
277 |
|
|
|
|
|
277 |
|
||||||||
Income before income taxes |
|
|
|
|
|
|
|
|
|
59,699 |
|
|
|
|
|
59,699 |
|
||||||||
Income tax expense |
|
|
|
|
|
|
|
|
|
(22,990 |
) |
|
|
|
|
(22,990 |
) |
||||||||
Income before equity in earnings of unconsolidated subsidiaries |
|
|
|
|
|
|
|
|
|
36,709 |
|
|
|
|
|
36,709 |
|
||||||||
Equity in earnings of unconsolidated subsidiaries |
|
36,762 |
|
36,762 |
|
10,567 |
|
26,195 |
|
53 |
|
|
|
(110,286 |
) |
53 |
|
||||||||
Net income |
|
$ |
36,762 |
|
$ |
36,762 |
|
$ |
10,567 |
|
$ |
26,195 |
|
$ |
36,762 |
|
$ |
|
|
$ |
(110,286 |
) |
$ |
36,762 |
|
Consolidating Statement of Operations
For the quarter ended September 30, 2009
|
|
|
|
|
|
Issuer |
|
Issuer |
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
AMR |
|
EmCare |
|
Subsidiary |
|
Subsidiary |
|
Eliminations/ |
|
|
|
||||||||
|
|
EMSC |
|
EMS LP |
|
HoldCo, Inc. |
|
HoldCo, Inc. |
|
Guarantors |
|
Non-Guarantor |
|
Adjustments |
|
Total |
|
||||||||
Net revenue |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
665,056 |
|
$ |
7,226 |
|
$ |
(7,226 |
) |
$ |
665,056 |
|
Compensation and benefits |
|
|
|
|
|
|
|
|
|
467,625 |
|
|
|
|
|
467,625 |
|
||||||||
Operating expenses |
|
|
|
|
|
|
|
|
|
85,510 |
|
|
|
|
|
85,510 |
|
||||||||
Insurance expense |
|
|
|
|
|
|
|
|
|
23,714 |
|
8,357 |
|
(7,226 |
) |
24,845 |
|
||||||||
Selling, general and administrative expenses |
|
|
|
|
|
|
|
|
|
15,871 |
|
|
|
|
|
15,871 |
|
||||||||
Depreciation and amortization expense |
|
|
|
|
|
|
|
|
|
15,733 |
|
|
|
|
|
15,733 |
|
||||||||
Income (loss) from operations |
|
|
|
|
|
|
|
|
|
56,603 |
|
(1,131 |
) |
|
|
55,472 |
|
||||||||
Interest income from restricted assets |
|
|
|
|
|
|
|
|
|
495 |
|
587 |
|
|
|
1,082 |
|
||||||||
Interest expense |
|
|
|
|
|
|
|
|
|
(10,280 |
) |
|
|
|
|
(10,280 |
) |
||||||||
Realized gain on investments |
|
|
|
|
|
|
|
|
|
|
|
544 |
|
|
|
544 |
|
||||||||
Interest and other income |
|
|
|
|
|
|
|
|
|
502 |
|
|
|
|
|
502 |
|
||||||||
Income before income taxes |
|
|
|
|
|
|
|
|
|
47,320 |
|
|
|
|
|
47,320 |
|
||||||||
Income tax expense |
|
|
|
|
|
|
|
|
|
(18,533 |
) |
|
|
|
|
(18,533 |
) |
||||||||
Income before equity in earnings of unconsolidated subsidiaries |
|
|
|
|
|
|
|
|
|
28,787 |
|
|
|
|
|
28,787 |
|
||||||||
Equity in earnings of unconsolidated subsidiaries |
|
28,878 |
|
28,878 |
|
8,409 |
|
20,469 |
|
91 |
|
|
|
(86,634 |
) |
91 |
|
||||||||
Net income |
|
$ |
28,878 |
|
$ |
28,878 |
|
$ |
8,409 |
|
$ |
20,469 |
|
$ |
28,878 |
|
$ |
|
|
$ |
(86,634 |
) |
$ |
28,878 |
|
Consolidating Statement of Operations
For the nine months ended September 30, 2010
|
|
|
|
|
|
Issuer |
|
Issuer |
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
AMR |
|
EmCare |
|
Subsidiary |
|
Subsidiary |
|
Eliminations/ |
|
|
|
||||||||
|
|
EMSC |
|
EMS LP |
|
HoldCo, Inc. |
|
HoldCo, Inc. |
|
Guarantors |
|
Non-Guarantor |
|
Adjustments |
|
Total |
|
||||||||
Net revenue |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
2,125,338 |
|
$ |
45,265 |
|
$ |
(45,265 |
) |
$ |
2,125,338 |
|
Compensation and benefits |
|
|
|
|
|
|
|
|
|
1,500,023 |
|
|
|
|
|
1,500,023 |
|
||||||||
Operating expenses |
|
|
|
|
|
|
|
|
|
268,138 |
|
|
|
|
|
268,138 |
|
||||||||
Insurance expense |
|
|
|
|
|
|
|
|
|
71,423 |
|
47,647 |
|
(45,265 |
) |
73,805 |
|
||||||||
Selling, general and administrative expenses |
|
|
|
|
|
|
|
|
|
52,898 |
|
|
|
|
|
52,898 |
|
||||||||
Depreciation and amortization expense |
|
|
|
|
|
|
|
|
|
48,400 |
|
|
|
|
|
48,400 |
|
||||||||
Income (loss) from operations |
|
|
|
|
|
|
|
|
|
184,456 |
|
(2,382 |
) |
|
|
182,074 |
|
||||||||
Interest income from restricted assets |
|
|
|
|
|
|
|
|
|
928 |
|
1,503 |
|
|
|
2,431 |
|
||||||||
Interest expense |
|
|
|
|
|
|
|
|
|
(18,182 |
) |
|
|
|
|
(18,182 |
) |
||||||||
Realized gain on investments |
|
|
|
|
|
|
|
|
|
|
|
879 |
|
|
|
879 |
|
||||||||
Interest and other income |
|
|
|
|
|
|
|
|
|
748 |
|
|
|
|
|
748 |
|
||||||||
Loss on early extinguishment of debt |
|
|
|
|
|
|
|
|
|
(19,091 |
) |
|
|
|
|
(19,091 |
) |
||||||||
Income before income taxes |
|
|
|
|
|
|
|
|
|
148,859 |
|
|
|
|
|
148,859 |
|
||||||||
Income tax expense |
|
|
|
|
|
|
|
|
|
(57,355 |
) |
|
|
|
|
(57,355 |
) |
||||||||
Income before equity in earnings of unconsolidated subsidiaries |
|
|
|
|
|
|
|
|
|
91,504 |
|
|
|
|
|
91,504 |
|
||||||||
Equity in earnings of unconsolidated subsidiaries |
|
91,756 |
|
91,756 |
|
24,087 |
|
67,669 |
|
252 |
|
|
|
(275,268 |
) |
252 |
|
||||||||
Net income |
|
$ |
91,756 |
|
$ |
91,756 |
|
$ |
24,087 |
|
$ |
67,669 |
|
$ |
91,756 |
|
$ |
|
|
$ |
(275,268 |
) |
$ |
91,756 |
|
Consolidating Statement of Operations
For the nine months ended September 30, 2009
|
|
|
|
|
|
Issuer |
|
Issuer |
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
AMR |
|
EmCare |
|
Subsidiary |
|
Subsidiary |
|
Eliminations/ |
|
|
|
||||||||
|
|
EMSC |
|
EMS LP |
|
HoldCo, Inc. |
|
HoldCo, Inc. |
|
Guarantors |
|
Non-Guarantor |
|
Adjustments |
|
Total |
|
||||||||
Net revenue |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
1,915,369 |
|
$ |
21,256 |
|
$ |
(21,256 |
) |
$ |
1,915,369 |
|
Compensation and benefits |
|
|
|
|
|
|
|
|
|
1,332,787 |
|
|
|
|
|
1,332,787 |
|
||||||||
Operating expenses |
|
|
|
|
|
|
|
|
|
252,355 |
|
|
|
|
|
252,355 |
|
||||||||
Insurance expense |
|
|
|
|
|
|
|
|
|
71,693 |
|
25,269 |
|
(21,256 |
) |
75,706 |
|
||||||||
Selling, general and administrative expenses |
|
|
|
|
|
|
|
|
|
47,186 |
|
|
|
|
|
47,186 |
|
||||||||
Depreciation and amortization expense |
|
|
|
|
|
|
|
|
|
48,658 |
|
|
|
|
|
48,658 |
|
||||||||
Income (loss) from operations |
|
|
|
|
|
|
|
|
|
162,690 |
|
(4,013 |
) |
|
|
158,677 |
|
||||||||
Interest income from restricted assets |
|
|
|
|
|
|
|
|
|
1,485 |
|
1,983 |
|
|
|
3,468 |
|
||||||||
Interest expense |
|
|
|
|
|
|
|
|
|
(30,749 |
) |
|
|
|
|
(30,749 |
) |
||||||||
Realized gain on investments |
|
|
|
|
|
|
|
|
|
|
|
2,030 |
|
|
|
2,030 |
|
||||||||
Interest and other income |
|
|
|
|
|
|
|
|
|
1,442 |
|
|
|
|
|
1,442 |
|
||||||||
Income before income taxes |
|
|
|
|
|
|
|
|
|
134,868 |
|
|
|
|
|
134,868 |
|
||||||||
Income tax expense |
|
|
|
|
|
|
|
|
|
(53,144 |
) |
|
|
|
|
(53,144 |
) |
||||||||
Income before equity in earnings of unconsolidated subsidiaries |
|
|
|
|
|
|
|
|
|
81,724 |
|
|
|
|
|
81,724 |
|
||||||||
Equity in earnings of unconsolidated subsidiaries |
|
81,968 |
|
81,968 |
|
26,344 |
|
55,624 |
|
244 |
|
|
|
(245,904 |
) |
244 |
|
||||||||
Net income |
|
$ |
81,968 |
|
$ |
81,968 |
|
$ |
26,344 |
|
$ |
55,624 |
|
$ |
81,968 |
|
$ |
|
|
$ |
(245,904 |
) |
$ |
81,968 |
|
Consolidating Balance Sheet
As of September 30, 2010
|
|
|
|
|
|
Issuer |
|
Issuer |
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
AMR |
|
EmCare |
|
Subsidiary |
|
Subsidiary |
|
Eliminations/ |
|
|
|
||||||||
|
|
EMSC |
|
EMS LP |
|
HoldCo, Inc. |
|
HoldCo, Inc. |
|
Guarantors |
|
Non-Guarantor |
|
Adjustments |
|
Total |
|
||||||||
Assets |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
Current assets: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
Cash and cash equivalents |
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
|
|
$ |
329,461 |
|
$ |
16,255 |
|
$ |
|
|
$ |
345,716 |
|
Insurance collateral |
|
|
|
|
|
|
|
|
|
8,681 |
|
32,053 |
|
(12,503 |
) |
28,231 |
|
||||||||
Trade and other accounts receivable, net |
|
|
|
|
|
|
|
|
|
492,234 |
|
489 |
|
|
|
492,723 |
|
||||||||
Parts and supplies inventory |
|
|
|
|
|
|
|
|
|
22,759 |
|
|
|
|
|
22,759 |
|
||||||||
Prepaids and other current assets |
|
|
|
|
|
|
|
|
|
24,854 |
|
329 |
|
(7,932 |
) |
17,251 |
|
||||||||
Current deferred tax assets |
|
|
|
|
|
|
|
|
|
(3,834 |
) |
3,834 |
|
|
|
|
|
||||||||
Current assets |
|
|
|
|
|
|
|
|
|
874,155 |
|
52,960 |
|
(20,435 |
) |
906,680 |
|
||||||||
Non-current assets: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
Property, plant, and equipment, net |
|
|
|
|
|
|
|
|
|
126,759 |
|
|
|
|
|
126,759 |
|
||||||||
Intercompany receivable |
|
|
|
|
|
284,948 |
|
126,640 |
|
|
|
|
|
(411,588 |
) |
|
|
||||||||
Intangible assets, net |
|
|
|
|
|
|
|
|
|
138,641 |
|
|
|
|
|
138,641 |
|
||||||||
Non-current deferred tax assets |
|
|
|
|
|
|
|
|
|
10,849 |
|
(6,120 |
) |
1,994 |
|
6,723 |
|
||||||||
Insurance collateral |
|
|
|
|
|
|
|
|
|
30,977 |
|
124,889 |
|
(3,917 |
) |
151,949 |
|
||||||||
Goodwill |
|
|
|
|
|
|
|
|
|
388,048 |
|
458 |
|
|
|
388,506 |
|
||||||||
Other long-term assets |
|
|
|
|
|
8,273 |
|
3,500 |
|
6,975 |
|
|
|
|
|
18,748 |
|
||||||||
Investment and advances in subsidiaries |
|
803,684 |
|
803,684 |
|
430,943 |
|
372,728 |
|
35,799 |
|
|
|
(2,446,838 |
) |
|
|
||||||||
Assets |
|
$ |
803,684 |
|
$ |
803,684 |
|
$ |
724,164 |
|
$ |
502,868 |
|
$ |
1,612,203 |
|
$ |