UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

FORM 10-Q

 

 

 

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

EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 2012March 31, 2013

OR

 

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

EXCHANGE ACT OF 1934

For the transition period from                            to

Commission file number 001-34504

 

 

ADDUS HOMECARE CORPORATION

(Exact name of registrant as specified in its charter)

 

 

 

Delaware 20-5340172

(State or other jurisdiction of

incorporation or organization)

 

(I.R.S. Employer

Identification No.)

2401 South Plum Grove Road

Palatine, Illinois

 60067
(Address of principal executive offices) (Zip code)

(847) 303-5300

(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  x    No   ¨.

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

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

 

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

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

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

Common Stock $0.001 par value

Shares outstanding at July 31, 2012: 10,818,383May 2, 2013: 10,891,438

 

 

 


ADDUS HOMECARE CORPORATION

FORM 10-Q

INDEX

 

PART I.FINANCIAL INFORMATION

  

Item 1. Financial Statements

  

Condensed Consolidated Balance Sheets as of June 30, 2012March 31, 2013 (Unaudited) and December 31, 20112012

   3  

Condensed Consolidated Statements of Income (Unaudited) For the Three and Six Months Ended June  30,March  31, 2013
and 2012 and 2011

   4  

Condensed Consolidated Statement of Stockholders’ Equity (Unaudited) For the SixThree Months Ended June 30, 2012March 31,
2013

   5  

Condensed Consolidated Statements of Cash Flows (Unaudited) For the SixThree Months Ended June 30,March  31, 2013
and 2012 and 2011

   6  

Notes to Condensed Consolidated Financial Statements (Unaudited)

   7  

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

   17  

Item 4. Controls and Procedures

   3731  

PART II.OTHER INFORMATION

   3832  

Item 1. Legal Proceedings

   3832  

Item 1A. Risk Factors

   3832  

Item 6. Exhibits

   4334  

PART I – FINANCIAL INFORMATION

 

Item 1.Financial Statements

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS

As of June 30, 2012March 31, 2013 and December 31, 20112012

(amounts and shares in thousands, except per share data)

(Unaudited)

 

                              
  2012   2011   March 31,
2013
   December 31,
2012
 

Assets

        

Current assets

        

Cash

  $1,493    $2,020    $17,784    $1,737  

Accounts receivable, net of allowances of $5,947 and $7,189 as of June 30, 2012 and December 31, 2011, respectively

   69,141     72,368  

Accounts receivable, net of allowances of $4,361 and $4,466 at March 31, 2013 and December 31, 2012, respectively

   60,640     71,303  

Prepaid expenses and other current assets

   8,418     8,137     5,515     7,293  

Assets held for sale, net

   —       245  

Deferred tax assets

   6,336     6,336     7,258     7,258  
  

 

   

 

   

 

   

 

 

Total current assets

   85,388     88,861     91,197     87,836  
  

 

   

 

   

 

   

 

 

Property and equipment, net of accumulated depreciation and amortization

   2,813     2,490     2,476     2,489  
  

 

   

 

   

 

   

 

 

Other assets

        

Goodwill

   50,615     50,695     50,496     50,536  

Intangibles, net of accumulated amortization

   7,206     8,044     6,030     6,370  

Deferred tax assets

   4,089     4,089     —       2,328  

Investment in joint ventures

   900     —    

Other assets

   399     513     251     298  
  

 

   

 

   

 

   

 

 

Total other assets

   62,309     63,341     57,677     59,532  
  

 

   

 

   

 

   

 

 

Total assets

  $150,510    $154,692    $151,350    $149,857  
  

 

   

 

   

 

   

 

 

Liabilities and stockholders’ equity

        

Current liabilities

        

Accounts payable

  $4,929    $5,266    $4,818    $4,117  

Accrued expenses

   29,286     29,313     35,635     32,717  

Current maturities of long-term debt

   3,527     6,569     —       208  

Deferred revenue

   2,094     2,145     17     2,148  
  

 

   

 

   

 

   

 

 

Total current liabilities

   39,836     43,293     40,470     39,190  
  

 

   

 

   

 

   

 

 

Deferred tax liabilities

   3,097     —    

Long-term debt, less current maturities

   22,000     24,958     —       16,250  
  

 

   

 

   

 

   

 

 

Total liabilities

   61,836     68,251     43,567     55,440  
  

 

   

 

   

 

   

 

 

Commitments, contingencies and other matters

        

Stockholders’ equity

        

Preferred stock—$.001 par value; 10,000 authorized and 0 shares issued and outstanding

   —       —    

Common stock—$.001 par value; 40,000 authorized; 10,818 and 10,775 shares issued and outstanding as of June 30, 2012 and December 31, 2011, respectively

   11     11  

Common stock—$.001 par value; 40,000 authorized and 10,882 and 10,823 shares issued and outstanding as of March 31, 2013 and December 31, 2012, respectively

   11     11  

Additional paid-in capital

   82,577     82,437     82,883     82,778  

Retained earnings

   6,086     3,993     24,889     11,628  
  

 

   

 

   

 

   

 

 

Total stockholders’ equity

   88,674     86,441     107,783     94,417  
  

 

   

 

   

 

   

 

 

Total liabilities and stockholders’ equity

  $150,510    $154,692    $151,350    $149,857  
  

 

   

 

   

 

   

 

 

See accompanying Notes to Unaudited Condensed Consolidated Financial Statements.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTSOF INCOME

For the Three and Six Months Ended June 30,March 31, 2013 and 2012 and 2011

(amounts and shares in thousands, except per share data)

(Unaudited)

 

  For the Three Months Ended June 30,   For the Six Months Ended June 30,   For the Three Months Ended
March 31,
 
  2012   2011   2012 2011   2013 2012 

Net service revenues

  $70,281    $68,252    $138,205   $135,094    $62,998   $58,889  

Cost of service revenues

   49,862     48,142     99,145    95,930     47,200    43,865  
  

 

   

 

   

 

  

 

   

 

  

 

 

Gross profit

   20,419     20,110     39,060    39,164     15,798    15,024  

General and administrative expenses

   17,180     16,493     34,211    32,612     11,510    11,570  

Gain on sale of agency

   —       —       (495  —       —      (495)

Depreciation and amortization

   635     927     1,269    1,856     546    631  
  

 

   

 

   

 

  

 

   

 

  

 

 

Total operating expenses

   17,815     17,420     34,985    34,468     12,056    11,706  
  

 

   

 

   

 

  

 

   

 

  

 

 

Operating income

   2,604     2,690     4,075    4,696  

Interest income

   —       —       (128  —    

Interest expense

   426     668     958    1,381  

Operating income from continuing operations

   3,742    3,318  

Total interest expense

   208    404  
  

 

   

 

   

 

  

 

   

 

  

 

 

Total interest expense, net

   426     668     830    1,381  

Income from continuing operations before income taxes

   3,534    2,914  

Income tax expense

   847    1,168  
  

 

  

 

 

Income before income taxes

   2,178     2,022     3,245    3,315  

Income tax expense

   714     689     1,152    1,129  

Net income from continuing operations

   2,687    1,746  
  

 

  

 

 

Discontinued operations:

   

Loss from home health business, net of tax

   (537  (1,117

Gain on sale of home health business, net of tax

   11,111    —    
  

 

  

 

 

Earnings (losses) from discontinued operations

   10,574    (1,117
  

 

   

 

   

 

  

 

   

 

  

 

 

Net income

  $1,464    $1,333    $2,093   $2,186    $13,261   $629  
  

 

   

 

   

 

  

 

   

 

  

 

 

Income per common share:

       

Net income (loss) per common share

   

Basic and diluted

  $0.14    $0.12    $0.19   $0.20     

Continuing operations

  $0.25   $0.16  

Discontinued operations

   0.98    (0.10
  

 

  

 

 

Basic and diluted income (loss) per share

  $1.23   $0.06  
  

 

   

 

   

 

  

 

   

 

  

 

 

Weighted average number of common shares and potential common shares outstanding:

          

Basic

   10,761     10,746     10,761    10,746     10,778    10,756  
  

 

   

 

   

 

  

 

 

Diluted

   10,785     10,770     10,781    10,762     10,845    10,760  
  

 

   

 

   

 

  

 

 

See accompanying Notes to Unaudited Condensed Consolidated Financial Statements.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTSOF STOCKHOLDERS’ EQUITY

For the SixThree Months Ended June 30, 2012March 31, 2013

(amounts and shares in thousands)

(Unaudited)

 

  Common Stock   

Additional

Paid-In

   Retained   

Total

Stockholders’

   Common Stock   

Additional

Paid-In

   Retained   

Total

Stockholders’

 
  Shares   Amount   Capital   Earnings   Equity   Shares   Amount   Capital   Earnings   Equity 

Balance at December 31, 2011

   10,775    $11    $82,437    $3,993    $86,441  

Balance at December 31, 2012

   10,823    $11    $82,778    $11,628    $94,417  

Issuance of shares of common stock under restricted stock award agreements

   43     —       —       —       —       59     —      —      —      —   

Stock-based compensation

   —       —       140     —       140     —      —      105     —      105  

Net income

   —       —       —       2,093     2,093     —      —      —      13,261     13,261  
  

 

   

 

   

 

   

 

   

 

   

 

   

 

   

 

   

 

   

 

 

Balance at June 30, 2012

   10,818    $11    $82,577    $6,086    $88,674  

Balance at March 31, 2013

   10,882    $11    $82,883    $24,889    $107,783  
  

 

   

 

   

 

   

 

   

 

   

 

   

 

   

 

   

 

   

 

 

See accompanying Notes to Unaudited Condensed Consolidated Financial Statements.Statements

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTSOF CASH FLOWS

For the SixThree Months Ended June 30,March 31, 2013 and 2012 and 2011

(amounts in thousands)

(Unaudited)

 

  For the Six Months Ended June 30,   For the Three Months Ended March 31, 
  2012 2011   2013 2012 

Cash flows from operating activities

      

Net income

  $2,093   $ 2,186    $13,261   $629  

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

      

Depreciation and amortization

   1,269    1,856     546    634  

Deferred income taxes

   5,425    —    

Stock-based compensation

   140    145     105    67  

Amortization of debt issuance costs

   114    110     47    57  

Provision for doubtful accounts

   1,795    2,110     813    850  

Gain on sale of home health business

   (18,838  —   

Gain on sale of agency

   (495)  —       —     (495

Changes in operating assets and liabilities:

      

Accounts receivable

   1,432    17,559     9,850    (2,318

Prepaid expenses and other current assets

   (281)  2,722     1,649    631  

Accounts payable

   (337)  (93   701    (1,546

Accrued expenses

   53    2,316     (391  137  

Deferred revenue

   (51)  187     (143  71  
  

 

  

 

   

 

  

 

 

Net cash provided by operating activities

   5,732    29,098  

Net cash provided by (used in) operating activities

   13,025    (1,283
  

 

  

 

   

 

  

 

 

Cash flows from investing activities

      

Net proceeds from sale of home health business

   19,659    —    

Net proceeds from sale of agency

   495    —       —      495  

Acquisitions of business, net of cash received

   —      (500

Purchases of property and equipment

   (754)  (132   (179  (288
  

 

  

 

   

 

  

 

 

Net cash used in investing activities

   (259)  (632

Net cash provided by investing activities

   19,480    207  
  

 

  

 

   

 

  

 

 

Cash flows from financing activities

      

Payments on term loan

   (1,250)  (1,042

Net payments on term loan

   (208  (625

Net payments on credit facility

   (2,750)  (2,750   (16,250  2000  

Payments on subordinated dividend notes

   (2,000)  (1,000   —     (1,000

Payments on other notes

   —      (366

Debt issuance costs

   —      (19
  

 

  

 

   

 

  

 

 

Net cash used in financing activities

   (6,000)  (5,177

Net cash (used in) provided by financing activities

   (16,458  375  
  

 

  

 

   

 

  

 

 

Net change in cash

   (527)  23,289     16,047    (701

Cash, at beginning of period

   2,020    816     1,737    2,020  
  

 

  

 

   

 

  

 

 

Cash, at end of period

  $1,493   $24,105    $17,784   $1,319  
  

 

  

 

   

 

  

 

 

Supplemental disclosures of cash flow information

      

Cash paid for interest

  $887   $1,291    $213   $371  

Cash paid for income taxes

   1,443    1,139     880    963  

Supplemental disclosures of non-cash investing and financing activities

      

Tax benefit related to the amortization of tax goodwill in excess of book basis

  $80   $79     40    40  

See accompanying Notes to Unaudited Condensed Consolidated Financial Statements.Statements

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements

(amounts and shares in thousands)

(Unaudited)

1. Summary of Significant Accounting Policies

Basis of Presentation and Description of Business

The consolidated financial statements include the accounts of Addus HomeCare Corporation (“Holdings”) and its subsidiaries (together with Holdings, the “Company” or “we”). The Company provides home &and community and home healthbased services through a network of locations throughout the United States. These services are primarily performed in the homes of individuals.the consumers. The Company’s home &and community based services include assistance to the elderly, chronically ill and disabled with bathing, grooming, dressing, personal hygiene and medication reminders, and other activities of daily living. Home &and community based services are primarily performed under agreements with state and local governmental agencies.

Discontinued Operations

On February 7, 2013, subsidiaries of Holdings entered into an Asset Purchase Agreement with LHC Group, Inc. and certain of its subsidiaries (the “Home Health Purchase Agreement”). Pursuant to the Home Health Purchase Agreement, effective March 1, 2013, the purchasers agreed to acquire substantially all the assets of the Company’s home health business in Arkansas, Nevada and South Carolina and 90% of its home health business in California and Illinois, with the Company retaining 10% ownership in such locations, for cash consideration of $20,000.

The Company’s home health services arewere operated through licensed and Medicare certified offices that provideprovided physical, occupational and speech therapy, as well as skilled nursing services to pediatric, adult infirm and elderly patients. Home health services arewere reimbursed from Medicare, Medicaid and Medicaid-waiver programs, commercial insurance and private payors.payors (see note 2).

Principles of Consolidation

All intercompany balances and transactions have been eliminated in consolidation. Our investment in entities with less than 20% ownership or in which the Company does not have the ability to influence the operations of the investee are being accounted for using the cost method and are included in investment in joint ventures.

Revenue Recognition

The Company generates net service revenues by providing home & community services and home health services directly to individuals.consumers. The Company receives payments for providing such services from federal, state and local governmental agencies, commercial insurers and private individuals.

Home & Community

The Our continuing operations, which includes the results of operations previously included in our home &and community segment net service revenuesand three agencies previously included in our home health segment, are principally provided based on authorized hours, determined by the relevant agency, at an hourly rate specified in agreements or fixed by legislation and recognized as revenues at the time services are rendered. Home &and community netbased service revenues are reimbursed by state, local and other governmental programs which are partially funded by Medicaid or Medicaid waiver programs, with the remainder reimbursed through private duty and insurance programs.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

Home Health

The home health segment net service revenues are primarily generated on a per episode or per visit basis. More than half of the home health segment net service revenues consist of Medicare services with the balance being derived from Medicaid, commercial insurers and private duty. Home health net service revenues reimbursed by Medicare are based on episodes of care. Under the Medicare Prospective Payment System (“PPS”), an episode of care is defined as a length of care up to 60 days with multiple continuous episodes allowed per patient. Medicare billings under PPS vary based on the severity of the patient’s condition and are subject to adjustment, both positive and negative, for changes in the patient’s medical condition and certain other reasons. At the inception of each episode of care, a request for anticipated payment (“RAP”) is submitted to Medicare for 50% to 60% of the estimated PPS reimbursement. The Company estimates the net PPS revenues to be earned during an episode of care based on the initial RAP billing, historical trends and other known factors. The net PPS revenues are initially recognized as deferred revenues and subsequently amortized as net service revenues ratably over the 60-day episodic period. At the end of each episode of care, a final billing is submitted to Medicare and any changes between the initial RAP and final billings are recorded as an adjustment to net service revenues. Other non-Medicare services are primarily provided on a per visit basis determinable and recognized as revenues at the time services are rendered.

Laws and regulations governing the MedicareMedicaid and MedicaidMedicare programs are complex and subject to interpretation. As a result, there is at least a reasonable possibility that recorded estimates may change in the near term. The Company believes that it is in compliance in all material respects with all applicable laws and regulations.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

Allowance for Doubtful Accounts

The Company establishes its allowance for doubtful accounts to the extent it is probable that a portion or all of a particular account will not be collected. The Company estimates its provision for doubtful accounts primarily by aging receivables utilizing eight aging categories, and applying its historical collection rates to each aging category, taking into consideration factors that might impact the use of historical collection rates or payor groups, with certain large payors analyzed separately from other payor groups. In the Company’s evaluation of these estimates, it also considers delays in payment trends in individual states due to budget or funding issues, billing conversions related to acquisitions or internal systems, resubmission of bills with required documentation and disputes with specific payors. An allowance for doubtful accounts is maintained at a level management believes is sufficient to cover potential losses. However, actual collections could differ from our estimates.

Goodwill

The Company’s carrying value of goodwill is the residual of the purchase price over the fair value of the net assets acquired from various acquisitions including the acquisition of Addus HealthCare, Inc. (“Addus HealthCare”). In accordance with Accounting Standards Codification TM (“ASC”) Topic 350, “Goodwill and Other Intangible Assets,” goodwill and intangible assets with indefinite useful lives are not amortized. The Company tests goodwill for impairment at the reporting unit level on an annual basis, as of October 1, or whenever potential impairment triggers occur, such as a significant change in business climate or regulatory changes that would indicate that an impairment may have occurred. Goodwill isand indefinite lived intangible assets are required to be tested for impairment at least annually usingannually. The Company may use a qualitative test, known as “Step 0” or a two-step method. The first step in the evaluation of goodwill impairment involves comparing the current fair value of each reporting unit to the recorded value, including goodwill. The Company uses the combination of a discounted cash flow model (“DCF model”) and the market multiple analysisquantitative method to determine whether impairment has occurred. In Step 0, the current fair value of each reporting unit. The DCF model was prepared using revenueCompany can elect to perform an optional qualitative analysis and expense projections based on the Company’s current operating plan. As such, a number of significant assumptions and estimates are involved inresults skip the application of the DCF model to forecast revenue growth, price changes, gross profits, operating expenses and operating cash flows. The cash flows were discounted using a weighted average cost of capital of 14.5%, which was management’s best estimate based on the capital structure oftwo step analysis. In 2012, the Company elected to implement Step 0 and external industry data. As part ofwas not required to conduct the secondremaining two step of this evaluation, if the carrying value of goodwill exceeds its fair value, an impairment loss would be recognized. No impairment charges were recorded in the three and six months ended June 30, 2012 and 2011.analysis.

Intangible Assets

The Company’s identifiable intangible assets consist of customer and referral relationships, trade names, trademarks, state licenses and non-compete agreements. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from two to 25 years.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

ASC Topic 350 requires that the fair value of intangible assets with finiteindefinite lives be estimated and compared to the carrying value. The Company estimates the fair value of these intangible assets using the income approach. The Company recognizes an impairment loss when the estimated fair value of the intangible asset is less than the carrying value. Intangible assets with finite lives are amortized using the estimated economic benefit method over the useful life and assessed for impairment whenever events or changes in circumstances indicate that the carrying amount may not be recoverable.recoverable based on estimated undiscounted cash flows. The Company recognizes an impairment loss when the estimated fair value of the intangible asset is less than the carrying value. No impairment charge was recorded for the three months ended March 31, 2013 or 2012.

The income approach, which the Company uses to estimate the fair value of its reporting units and intangible assets, is dependent on a number of factors including estimates of future market growth and trends, forecasted revenue and costs, expected periods the assets will be utilized, appropriate discount rates and other variables. The Company bases its fair value estimates on assumptions the Company believes to be reasonable but which are unpredictable and inherently uncertain. Actual future results may differ from those estimates. In addition, the Company makes certain judgments about the selection of comparable companies used in the market approach in valuing its reporting units, as well as certain assumptions to allocate shared assets and liabilities to calculate the carrying values for each of the Company’s reporting units. No impairment charges were recorded for the three and six months ended June 30, 2012 and 2011.determining valuation.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

Long-Lived Assets

The Company reviews its long-lived assets and finitedefinite lived intangibles (except goodwill and indefinitefinite lived intangible assets, as described above) for impairment whenever changes in circumstances indicate that the carrying amount of an asset may not be recoverable. To determine if impairment exists, the Company compares the estimated future undiscounted cash flows from the related long-lived assets to the net carrying amount of such assets. If the carrying amount of an asset exceeds its estimated future cash flows, an impairment charge is recognized for the amount by which the carrying amount of the asset exceeds the estimated fair value of the asset, generally determined by discounting the estimated future cash flows. No impairment charges werecharge was recorded infor the three and six months ended June 30, 2012 and 2011.March 31, 2013 or 2012.

Income Taxes

The Company accounts for income taxes under the provisions of ASC Topic 740, “Income Taxes.” The objective of accounting for income taxes is to recognize the amount of taxes payable or refundable for the current year and deferred tax liabilities and assets for the future tax consequences of events that have been recognized in its financial statements or tax returns. Deferred taxes, resulting from differences between the financial and tax basis of the Company’s assets and liabilities, are also adjusted for changes in tax rates and tax laws when changes are enacted. ASC Topic 740 also requires that deferred tax assets be reduced by a valuation allowance if it is more likely than not that some portion or all of the deferred tax asset will not be realized. ASC Topic 740, also prescribes a recognition threshold and measurement process for recording in the financial statements uncertain tax positions taken or expected to be taken in a tax return. In addition, ASC Topic 740 provides guidance on derecognition, classification, accounting in interim periods and disclosure requirements for uncertain tax positions.

Stock-based Compensation

The Company has two stock incentive plans, the 2006 Stock Incentive Plan (the “2006 Plan”) and the 2009 Stock Incentive Plan (the “2009 Plan”) that provide for stock-based employee compensation. The Company accounts for stock-based compensation in accordance with ASC Topic 718, “Stock Compensation.” Compensation expense is recognized on a graded method under the 2006 Plan and on a straight-line basis under the 2009 Plan over the vesting period of the awards based on the fair value of the options and restricted stock awards. Under the 2006 Plan, the Company historically used the Black-Scholes option pricing model to estimate the fair value of its stock based payment awards, but beginning October 28, 2009 under its 2009 Plan it began using an enhanced Hull-White Trinomial model. The determination of the fair value of stock-based payments utilizing the Black-Scholes model and the Enhanced Hull-White Trinomial model is affected by Holdings’ stock price and a number of assumptions, including expected volatility, risk-free interest rate, expected term, expected dividends yield, expected forfeiture rate, expected turn-over rate, and the expected exercise multiple.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

 

Net Income Per Common Share

Net income (loss) per common share, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The Company’s outstanding securities that may potentially dilute the common stock are stock options and restricted stock awards.

Included in the Company’s calculation for the three and six months ended June 30, 2012March 31, 2013 were 791715 stock options of which 716 stock options517 were out-of-the money forand therefore anti-dilutive and 95 restricted stock awards with 18 included in the weighted diluted shares outstanding.

For the three and six months ended June 30,March 31, 2012 and therefore anti-dilutive. Included in the Company’s calculation for the three and six months ended June 30, 2011 were 762Company had 775 stock options, all of which 571 and 597 stock options were out-of-the money for the three and six months ended June 30, 2011, respectively, and therefore anti-dilutive.anti-dilutive and 19 restricted stock awards with 4 included in the weighted diluted shares outstanding.

Estimates

The financial statements are prepared by management in conformity with GAAP and include estimated amounts and certain disclosures based on assumptions about future events. Accordingly, actual results could differ from those estimates.

Recent Accounting Pronouncements

In September 2011, the FASB issued Accounting Standards Update, Intangibles—Goodwill and Other (Topic 350): Testing Goodwill for Impairment (the revised standard). The revised standard is intended to reduce the cost and complexity of the annual goodwill impairment test by providing entities an option to perform a “qualitative” assessment to determine whether further impairment testing is necessary. If an entity believes, as a result of its qualitative assessment, that it is more-likely-than-not that the fair value of a reporting unit is less than its carrying amount, the quantitative impairment test is required. Otherwise, no further testing is required. The revised standard is effective for annual and interim goodwill impairment tests performed for fiscal years beginning after December 15, 2011. The Company will implement the new standard in its 2012 annual goodwill impairment testing. This guidance isdoes not expected tobelieve any recently issued, but not yet effective, accounting standards will have a material effect on the Company’s consolidated financial condition orposition, results of operations.operations, or cash flows.

2. Discontinued Operations

During December 2012, in anticipation of the sale of substantially all of the assets used in its home health business (the “Home Health Business”), the Company reported the operating results of the Home Health Business as discontinued operations in accordance with ASC 360-10-45 “Impairment or Disposal of Long-Lived Assets.” On February 7, 2013, the Company entered into the Home Health Purchase Agreement, pursuant to which subsidiaries of LHC Group, Inc. agreed to acquire substantially all the assets of the Home Health Business in Arkansas, Nevada and South Carolina and 90% of the Home Health Business in California and Illinois, with the Company retaining 10% ownership in such locations, for cash consideration of $20,000. The transaction was consummated effective March 1, 2013. In addition, the results of discontinued operations include one home health agency being held for sale and one home health agency that closed in January of 2013.

The Company has included the financial results of the Home Health Business in discontinued operations for all periods presented. Assets sold to the purchasers are presented as assets held for sale, net, on the accompanying consolidated balance sheet as of December 31, 2012. In connection with the discontinued operations presentation, certain financial statement footnotes have also been updated to reflect the impact of discontinued operations.

The following table presents the net service revenues and earnings attributable to discontinued operations, which include the financial results for the three months ended March 31, 2013 and 2012:

   For the Three Months ended
March 31,
 
   2013  2012 

Net service revenues

  $6,476   $9,035  
  

 

 

  

 

 

 

Loss before income taxes

   (911  (1,847

Income tax benefit

   (374  (730
  

 

 

  

 

 

 

Net loss from discontinued operations

  $(537 $(1,117
  

 

 

  

 

 

 

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

The following table presents the net gain on the sale of the Home Health Business, which was recorded March 1, 2013.

Gain before income taxes

  $18,838  

Income tax expenses

   7,727  
  

 

 

 

Net income (loss) from discontinued operations

  $11,111  
  

 

 

 

The only class of assets for discontinued operations reflected as assets held for sale, net, as of December 31, 2012 was as follows:

   December 31,
2012
 

Property and equipment, net of accumulated depreciation and amortization

  $245  

Pursuant to the Home Health Purchase Agreement, the Company retained $4,115 and $7,123 of accounts receivable, net as of March 31, 2013 and December 31, 2012. In addition, the Company retained the related accrued expenses and accounts payable associated with the Home Health Business as of December 31, 2012.

3. Sale of Agency

During February 2012, the Company completed its sale of a home health agency located in Portland, OR for approximately $525 with net proceeds of approximately $495 after the payment of closing related expenses. The Company recorded a $495 pre-tax gain on the sale of the agency.

3. Details4. Goodwill and Intangible Assets

The Company’s carrying value of Certain Balance Sheet Accounts

Prepaid expenses and other current assets consistedgoodwill is the residual of the following:purchase price over the fair value of the net assets acquired from various acquisitions including the acquisition of Addus HealthCare. In accordance with Accounting Standards Codification (“ASC”) Topic 350, “Goodwill and Other Intangible Assets,” goodwill and intangible assets with indefinite useful lives are not amortized. The Company tests goodwill for impairment on an annual basis, as of October 1, or whenever potential impairment triggers occur, such as a significant change in business climate or regulatory changes that would indicate that impairment may have occurred.

Goodwill is required to be tested for impairment at least annually. The Company can elect to perform Step-0 an optional qualitative analysis and based on the results skip the remaining two steps. In 2012, the Company elected to implement Step 0 and was not required to conduct the remaining two step analysis.

In performing its goodwill assessment for 2012, the Company evaluated the following factors that affect future business performance: macroeconomic conditions, industry and market considerations, cost factors, overall financial performance, entity-specific events and company stock price. As a result of the assessment of these qualitative factors, the Company has concluded that it is more likely than not that the fair value of the Company as of December 31, 2012 exceeded its carrying value. Accordingly, the first and second steps of the goodwill impairment test as described in FASB ASC 350-20-35, which includes estimating the fair value of the Company, are not considered necessary for the Company.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

 

   June 30,
2012
   December 31,
2011
 

Prepaid health insurance

  $       3,441    $       3,672  

Prepaid workers’ compensation and liability insurance

   1,765     1,354  

Prepaid rent

   176     192  

Workers’ compensation insurance receivable

   1,815     1,866  

Other

   1,221     1,053  
  

 

 

   

 

 

 
  $8,418    $8,137  
  

 

 

   

 

 

 

Accrued expenses consistedThe Company did not record any impairment charges for the three months ended March 31, 2013 or 2012. The Company will perform its annual impairment test for fiscal 2013 during the fourth quarter of 2013.

The following is a summary of the following:goodwill activity for the three months ended March 31, 2013:

 

    June 30,
2012
   December 31,
2011
 

Accrued payroll

  $10,558    $11,547  

Accrued workers’ compensation insurance

   11,219     10,173  

Accrued payroll taxes

   2,330     1,811  

Accrued health insurance

   3,002     3,039  

Accrued interest

   58     100  

Contingent earn-out obligation

   683     683  

Other

   1,436     1,960  
  

 

 

   

 

 

 
  $29,286    $29,313  
  

 

 

   

 

 

 

Goodwill, at December 31, 2012

  $50,536  

Adjustments to previously recorded goodwill

   (40
  

 

 

 

Goodwill, at March 31, 2013

  $50,496  
  

 

 

 

The Company’s identifiable intangible assets consist of customer and referral relationships, trade names, trademarks, state licenses and non-compete agreements. Amortization is computed using straight-line and accelerated methods based upon the estimated useful lives of the respective assets, which range from two to 25 years.

The Company also has indefinite-lived assets that are not subject to amortization expense such as certificates of need and licenses to conduct specific operations within geographic markets. The Company has concluded that certificates of need and licenses have indefinite lives, as management has determined that there are no legal, regulatory, contractual, economic or other factors that would limit the useful life of these intangible assets and the Company intends to renew and operate the certificates of need and licenses indefinitely. The certificates of need and licenses are tested annually for impairment using the cost approach. Under this method assumptions are made about the cost to replace the certificates of need. No impairment charges were recorded in the three months ended March 31, 2013 and 2012.

The Company will perform its annual impairment test for fiscal 2013 during the fourth quarter of 2013.

The following is a summary of the intangible assets and indefinite-lived asset activity as of March 31, 2013:

                                             
   Gross
Carrying
Amount
   Accumulated
Amortization
   Net Carrying
Amount
 

Customer and referral relationships

  $24,908    $20,318    $4,590  

Trade names and trademarks

   4,081     2,833     1,248  

State licenses

   150     —      150  

Non-competition agreements

   408     366     42  
  

 

 

   

 

 

   

 

 

 
  $29,547    $23,517    $6,030  
  

 

 

   

 

 

   

 

 

 

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

 

4.5. Details of Certain Balance Sheet Accounts

Prepaid expenses and other current assets consisted of the following:

                              
   March 31,
2013
   December 31,
2012
 

Prepaid health insurance

  $2,110    $4,062  

Prepaid workers’ compensation and liability insurance

   515     1,056  

Prepaid rent

   186     181  

Workers’ compensation insurance receivable

   1,531     953  

Other

   1,173     1,041  
  

 

 

   

 

 

 
  $5,515    $7,293  
  

 

 

   

 

 

 

Accrued expenses consisted of the following:

                              
   March 31,
2013
   December 31,
2012
 

Accrued payroll

  $9,591    $11,539  

Accrued workers’ compensation insurance

   13,527     12,452  

Accrued payroll taxes

   2,418     1,481  

Accrued health insurance

   2,167     3,469  

Accrued amounts to purchaser

   1,988     —    

Accrued taxes

   3,078     1,223  

Accrued interest

   —       51  

Current portion of contingent earn-out obligation (1)

   689     689  

Other

   2,177     1,813  
  

 

 

   

 

 

 
  $35,635    $32,717  
  

 

 

   

 

 

 

(1)The Company acquired certain assets of Advantage Health Systems, Inc. (“Advantage”) in July 2010. The purchase agreement for the acquisition of Advantage contained a provision for earn-out payments contingent upon the achievement of certain performance targets. The sellers of Advantage disagree with the Company’s calculation of the earn-out payment and the parties have agreed to have an arbitrator determine the amount of the second earn-out payment. The final earn-out payment is expected to be made during the second quarter of 2013.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

6. Long-Term Debt

Long-term debt consisted of the following:

 

                                    
  June 30,
2012
 December 31,
2011
   March 31,
2013
   December 31,
2012
 

Revolving credit loan

  $     22,000   $     24,750    $—      $16,250  

Term loan

   1,458    2,708     —       208  

Subordinated dividend notes bearing interest at 10.0%

   2,069    4,069  
  

 

  

 

   

 

   

 

 

Total

   25,527    31,527     —       16,458  

Less current maturities

   (3,527  (6,569)   —       (208
  

 

  

 

   

 

   

 

 

Long-term debt

  $22,000   $24,958    $—      $16,250  
  

 

  

 

   

 

   

 

 

Senior Secured Credit Facility

On March 18, 2010,The Company’s credit facility provides a $55.0 million revolving line of credit expiring November 2, 2014, includes a $15.0 million sublimit for the Company entered into an amendment (the “First Amendment”) to itsissuance of letters of credit and included a $5.0 million term loan that matured and was paid on January 5, 2013. Substantially all of the subsidiaries of Holdings are co-borrowers, and Holdings has guaranteed the borrowers’ obligations under the credit facility. The First Amendment (i) increasedcredit facility is secured by a first priority security interest in all of Holdings’ and the maximum aggregate amountborrowers’ current and future tangible and intangible assets, including the shares of revolving loans available to the Company by $5,000 to $55,000, (ii) modified the Company’s maximum senior leverage ratio from 2.75 to 1.0 to 3.00 to 1.0 for each twelve month period ending on the last of day of each fiscal quarter thereafter and (iii) increased the advance multiple used to determine the amountstock of the borrowing base from 2.75 to 1.0 to 3.0 to 1.0.borrowers.

On July 26, 2010, the Company entered into the Second Amendmentan amendment to its credit facility. The Second Amendmentfacility, which provided for a new term loan component of the credit facility in the aggregate principal amount of $5,000 with a maturity date of January 5, 2013. The requisite lenders also consented to the acquisition, effective July 25, 2010, of certain assets of Advantage Health Systems, Inc. (“Advantage”) by the Company, pursuant to an Asset Purchase Agreement entered into on July 26, 2010. The term loan will bewas repaid in 24 equal monthly installments which commenced February 2011. Interestwhen due on the term loan under the credit facility is payable either at a floating rate equal to the 30-day LIBOR, plus an applicable margin of 4.6% or the LIBOR rate for term periods of one, two, three or six months plus a margin of 4.6%. Interest will be paid monthly or at the end of the relevant interest period. The credit facility contains customary affirmative, negative and financial covenants with which the Company was in compliance at June 30, 2012.

On May 24, 2011, the Company entered into a Joinder, Consent and Amendment No. 3 to its credit facility to include Addus HealthCare (Delaware) Inc., a newly-formed, wholly-owned subsidiary of Addus HealthCare, as an additional borrower under the credit facility.January 5, 2013.

On July 26, 2011, the Company entered into a fourthanother amendment (the “Fourth Amendment”) to its credit facility. The Fourth Amendmentfacility, which modified the Company’s maximum senior leverage ratio from 3.00 to 1.00 to 3.25 to 1.00 for each twelve month period ending on the last of day of each fiscal quarter beginning with the twelve month period ended June 30, 2011 and increased the advance multiple used to determine the amount of the borrowing base from 3.0 to 1.0 to 3.25 to 1.0. The Fourth Amendment resulted in an increase in the Company’s available borrowings under the credit facility.

On March 2, 2012, the Company entered into a fifth amendment (the “Fifth Amendment”) to its credit facility. The Fifth Amendment includes technical changes that are intended to comply with rules promulgated by the Centers for Medicare and Medicaid Services (“CMS”) that restrict lenders from exercising any rights of set-off of funds on deposit in any lockboxes established for receiving payments from governmental authorities.

During the fourth quarter of 2011, the lenders under the Company’s credit facility permitted the Company to add back approximately $1,800 to adjusted EBITDA for the purpose of determining availability under the credit facility. The effect of the add back was to increase availability by approximately $5,800 until March 1, 2012. On March 1, 2012, the add back allowance was reduced by $200 and will continue to bewas reduced by $200 on the first day of each month thereafter until the add back iswas eliminated, which will resultresulted in a reduction in availability of $650 on the first day of each month thereafter until the add back iswas eliminated.

The add-back was eliminated on December 1, 2012. During the second quarter of 2012, the lenders under the Company’s credit facility agreed to a modified interpretation of the credit facility as it relates to the calculation of the fixed charge ratio, which provides the Company with increased flexibility in meeting this covenant. The credit facility contains customary affirmative, negative and financial covenants with which the Company was in compliance at March 31, 2013.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

The availability of funds under the revolving credit portion of the credit facility, as amended, is based on the lesser of (i) the product of adjusted EBITDA, as defined in the credit facility agreement, for the most recent 12-month period for which financial statements have been delivered under the credit facility agreement multiplied by the specified advance multiple, up to 3.25, less the outstanding senior indebtedness and letters of credit, and (ii) $55,000 less the outstanding revolving loans and letters of credit. Interest on the amounts outstanding under the revolving credit portion of the credit facility is payable either at a floating rate equal to the 30-day LIBOR, plus an applicable margin of 4.6% or the LIBOR rate for term periods of one, two, three or six months plus a margin of 4.6%. Interest will be paid monthly or at the end of the relevant interest period, as determined in accordance with the credit facility

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

agreement. The borrowers will pay a fee equal to 0.5% per annum of the unused portion of the revolving portion of the credit facility. Issued stand-by letters of credit will be charged at a rate of 2.0% per annum payable monthly. On June 30, 2012March 31, 2013 the interest rate on the revolving credit loan facility was 4.8% (30 day LIBOR rate was 0.2%). The total availability under the revolving credit loan facility was $16,237$47,590 at June 30, 2012March 31, 2013 compared to $21,810$27,137 at December 31, 2011.2012.

Subordinated Dividend Notes7. Income Taxes

The dividend notes are subordinated and junior to all obligations underA reconciliation of the Company’s credit facility. Interest on the outstanding dividend notes accrues at acontinuing operations statutory federal tax rate of 10% per annum, compounded annually. Interest on35% and 34% for the unpaid principal balance of the dividend notesthree months ended March 31, 2013 and 2012 is due and payable quarterly in arrears together with each payment of principal.summarized as follows:

On March 18, 2010, the Company amended its subordinated dividend notes. Pursuant to the amendments, the dividend notes were amended to (i) extend the maturity date of the dividend notes from September 30, 2011 to December 31, 2012, (ii) modify the amortization schedule of the dividend notes to reduce the annual principal payment amounts from $4,468 to $1,250 in 2010; from $3,351 to $2,500 in 2011; and amended total payments in 2012 to $4,069, and (iii) permit, based on the Company’s leverage ratio, the prepayment of all or a portion of the principal amount of the dividend notes, together with interest on the principal amount.

   Three Months Ended
March  31,
 
   2013  2012 

Federal income tax a statutory rate

   35.0  34.0

State and local taxes, net of federal benefit

   6.1    5.9  

Jobs tax credits, net (1)

   (18.9  —    

Nondeductible meals and entertainment, other

   1.8    0.2  
  

 

 

  

 

 

 

Long-term debt

   24.0  40.1
  

 

 

  

 

 

 

(1)Included in the jobs tax credit for the three months ended March 31, 2013 was a one time benefit of 14.7% reduction in our statutory tax rate for the jobs tax credits earned in 2012 but not recorded until 2013. The Federal employment opportunity tax credits were reinstated in 2013 and were not an allowable deduction in 2012.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

 

5.8. Segment Data

The Company provideshas historically segregated its results into two distinct reporting segments: the home & community segment and the home health services primarilysegment. As a result of the sale of the Home Health Business, the Company has reported the operating results for the Home Health Business in discontinued operations. Therefore, all of the homes of individuals. The Company’s locations and operations are organized principally along these lines of service. The home & community and home health services lines have been identifiedreported as reportable segments applying the criteria in ASC Topic 280, “Disclosure about Segments of an Enterprise and Related Information.” The accounting policies of the segments are the same as those described in the Summary of Significant Accounting Policies. Intersegment net service revenues are not significant. All services are provided in the United States.

The Company evaluates the performance of its segments throughone operating income which excludes corporate depreciation and general corporate expenses. General corporate expenses consist principally of accounting and finance, information systems, billing and collections, human resources and national sales and marketing administration.

The following is a summary of segment information for the three and six months ended June 30, 2012 and 2011:

   Three Months Ended
June 30,
  Six Months Ended
June 30,
 
   2012  2011  2012  2011 

Net service revenue

     

Home & Community

  $58,656   $55,009   $115,579   $109,152  

Home Health

   11,625    13,243    22,626    25,942  
  

 

 

  

 

 

  

 

 

  

 

 

 
  $70,281   $68,252   $138,205   $135,094  
  

 

 

  

 

 

  

 

 

  

 

 

 

Operating income (loss)

     

Home & Community

  $7,078   $6,020   $13,498   $11,345  

Home Health

   (47)  840    (1,210)  1,538  

General corporate expenses & corporate depreciation

   (4,427  (4,170  (8,213  (8,187
  

 

 

  

 

 

  

 

 

  

 

 

 
  $2,604   $2,690   $4,075   $4,696  
  

 

 

  

 

 

  

 

 

  

 

 

 

Depreciation and amortization

     

Home & Community

  $461   $609   $927   $1,219  

Home Health

   4    129    7    257  

Corporate

   170    189    335    380  
  

 

 

  

 

 

  

 

 

  

 

 

 
  $635   $927   $1,269   $1,856  
  

 

 

  

 

 

  

 

 

  

 

 

 

ADDUS HOMECARE CORPORATIONsegment.

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

6.9. Commitments and Contingencies

Legal Proceedings

The Company is a party to legal and/or administrative proceedings arising in the ordinary course of its business. It is the opinion of management that the outcome of such proceedings will not have a material effect on the Company’s financial position and results of operations.

Indemnification Obligations

Pursuant to the Home Health Purchase Agreement, the Company is obligated to indemnify the purchasers for, among other things, (i) penalties, fines, judgments and settlement amounts arising from a violation of certain specified statutes, including the False Claims Act, the 19 Civil Monetary Penalties Law, the federal Anti-Kickback Statute, the Ethics in Patient Referral Act or any state law equivalent in connection with the operation of the Home Health Business prior to the closing, and (ii) any liability related to the failure of any reimbursement claim submitted to certain government programs for services rendered by the Home Health Business prior to the closing to meet the requirements of such government programs, or any violation prior to the closing of any health care laws. Such liabilities include amounts to be recouped by, or repaid to, such government programs as a result of improperly submitted claims for reimbursement or those discovered as a result of audits by investigative agencies. All services that the Company has provided that have been or may be reimbursed by Medicare are subject to retroactive adjustments and/or total denial of payments received from Medicare under various review and audit provisions included in the program regulations. The review period is generally described as six years from the date the services are provided but could be expanded to ten years under certain circumstances if fraud is found to have existed at the time of original billing. In the event that there are adjustments relating to the period prior to the closing, the Company may be required to reimburse the purchasers or the government for the amount of such adjustments, which could adversely affect the Company’s business and financial condition. The Company has not established a liability reserve for these obligations and at this time cannot determine the probability of requiring the reserve nor the estimated value of such reserve.

Employment Agreements

The Company has entered into employment agreements with certain members of senior management. The terms of these agreements are up to four years and include non-compete and nondisclosure provisions, as well as provide for defined severance payments in the event of termination.

ADDUS HOMECARE CORPORATION

AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements—(Continued)

(amounts and shares in thousands)

(Unaudited)

7.10. Significant Payors

A substantial portion of the Company’s net service revenues and accounts receivables are derived from services performed for federal, state and local governmental agencies. Medicare and oneOne state governmental agency accounted for 11.0%59.5% and 48.8%55.1% of the Company’s net service revenues for the three months ended June 30,March 31, 2013 and 2012, respectively, and 12.9% and 42.2% of the Company’s net service revenues for the three months ended June 30, 2011, respectively. Medicare and one state governmental agency accounted for 10.5% and 48.3% of the Company’s net service revenues for the six months ended June 30, 2012, respectively, and 12.7% and 41.8% of the Company’s net service revenues for the six months ended June 30, 2011, respectively

The related receivables due from Medicare and the state agency represented 9%5% and 62%68%, respectively, of the Company’s accounts receivable at June 30, 2012,March 31, 2013, and 11%7% and 58%69%, respectively, of the Company’s accounts receivable at December 31, 2011.2012.

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

You should read the following discussion together with our unaudited condensed consolidated financial statements and the related notes. This discussion contains forward-looking statements about our business and operations. Our actual results may differ materially from those we currently anticipate.

Overview

We are a comprehensive provider of home-basedhome and community based services, which are primarily social in nature and medical servicesare provided in the home, focused on the elderly who are enrolled in both Medicare and Medicaid, also known as dual eligibles.eligible population. Our services include personal care and assistance with activities of daily living, skilled nursing and rehabilitative therapies, and adult day care. TheOur consumers are individuals with special needs who receive our services may beare at risk of hospitalization or institutionalization, such as the elderly, chronically ill and disabled. Our payor clients include federal, state and local governmental agencies, commercial insurers and private individuals. We provide ourhome and community based services through 117over 96 locations across 19 states to over 26,000 individuals.25,000 consumers.

Effective March 1, 2013, we sold substantially all of the assets used in our home health business (the “Home Health Business”) in Arkansas, Nevada and South Carolina, and 90% of the Home Health Business in California and Illinois, to subsidiaries of LHC Group, Inc. (the “Purchasers”) for a cash purchase price of approximately $20 million. We operateretained a 10% ownership interest in the Home Health Business in California and Illinois. The assets sold included 19 home health agencies and two hospice agencies in five states. Through these home health agencies, we previously provided physical, occupational and speech therapy, as well as skilled nursing services, to pediatric, adult infirm and elderly patients. We are also holding as an asset for sale an agency located in Pennsylvania and we closed an agency in Idaho in January 2013. The results of the Home Health Business sold or held for sale are reflected as discontinued operations for all periods presented herein. Continuing operations include the results of operations previously included in our business through two segments, home & community servicessegment and three agencies previously included in our home health services. Oursegment. Following the sale of the Home Health Business, we manage and internally report our business in one segment.

We believe the sale of the Home Health Business substantially positions us for future growth. The sale allows us to focus both management and financial resources to address changes in the home &and community based services industry and to address the needs of managed care organizations as they become responsible for state sponsored programs. We have improved our financial performance by lowering our administrative costs and concentrating our efforts on the business that is growing and providing all of our profitability and disposing of the business that was unprofitable. We have improved our overall financial position by eliminating our debt and adding substantial amounts in cash reserves to our balance sheet. A summary of our results for the three months ended March 31, 2013 and 2012 are provided in the table below:

   For the Three Months Ended
March 31,
    
   2013  2012  Percent Change 

Net service revenues – continuing operations

  $62,998   $58,889    7.0

Net service revenues – discontinued operations

   6,476    9,035    (28.3)% 

Net income from continuing operations

   2,687    1,746    53.9

Gain on sale of Home Health Business

   11,111    —      N/A  

Loss from discontinued operations

   (537  (1,117  (51.9
  

 

 

  

 

 

  

Net income

  $13,261   $629    N/A  
  

 

 

  

 

 

  

The home and community based services we provide are primarily social or non-medical, in nature and include assistance with bathing, grooming, dressing, personal hygiene and medication reminders, and other activities of daily living. We provide home & communitythese services on a long-term, continuous basis, with an average duration of approximately 2017 months per individual.consumer. Our home healthadult day centers provide a comprehensive program of skilled and support services are primarilyand designated medical services for adults in naturea community-based group setting. Services provided by our adult day centers include social activities, transportation services to and include physical, occupationalfrom the centers, the provision of meals and speech therapy,snacks, personal care and therapeutic activities such as well as skilled nursing. We generally provide home health services on a short-term, intermittent or episodic basis to individuals recovering from an acute medical condition, with an average length of care of approximately 80 days.exercise and cognitive interaction.

We utilize a coordinated care model that is designed to enhance individualconsumer outcomes and satisfaction as well as reduce service duplication and lower the cost of and/or prevent acute care treatment.treatment and reduce service duplication. Through our coordinated care model, we utilize our social serviceshome care aides to observe and report changes in the condition of individualsour consumers for the purpose of early intervention in the disease process, thereby preventing or reducing the cost of medical services by avoiding emergency room visits, and/or institutionalization.

reducing the need of hospitalization. These changes in condition are evaluated by appropriately trained managers and referred to appropriate medical personnel including the primary care physicians and managed care plans for treatment and follow-up. We also utilize an integrated service delivery model, in markets where we operate both home & communitywill coordinate the services and homeprovided by our team with those of selected health services,whichmaximizescare agencies. We believe this approach to the long-term relationship we have with individuals in our home & community segment through on-going monitoring and possible provision of our home health servicescare to this same population as their needs warrant. Our care and service coordinators work with our caregivers, consumers and their medicalthe integration of our services into the broader healthcare industry is particularly attractive to managed care providers to review our consumers’ current and anticipated service needs and, based on this continuous review, identify coordination and/or integration opportunities including the possible provision of home & community services to our home health individuals and the referral sources in that segment. This provides us with an additional source of revenue, enables individuals to access both social and medical services from one homecare provider and appeals to referral sourcesothers who are seeking a single providerultimately responsible for the healthcare needs of our consumers and over time will increase our business with a breadth of services.them.

Our ability to grow our net service revenues is directly related toclosely correlated with the number of individualsconsumers to whom we provide our services. Our continued growth depends on our ability to maintain our existing payor client relationships, establish relationships with new payors, enter into new contracts and increase our referral sources. Our continued growth is also dependent upon the authorization by state agencies of new individualsconsumers to receive our services. We believe there are several market opportunities for growth. The U.S. population of persons aged 65 and older is growing, and the U.S. Census Bureau estimates that this population will more than double by 2050.

Additionally, we believe the overwhelming majority of individuals in need of care generally prefer to receive care in their homes or community-based settings. Finally, we believe the provision of home &and community based services is more effective and cost-efficientcost-effective than the provision of similar services in an institutional setting for long-term care.

We also believe payorshave historically grown our business primarily through organic growth, complemented with selective acquisitions. Our acquisitions have historically been focused on facilitating entry into new states.

On July 26, 2010, we entered into an Asset Purchase Agreement (the “Purchase Agreement”), pursuant to which we acquired the operations and governmental agencies are increasingly recognizingcertain assets of Advantage Health Systems, Inc., a South Carolina corporation (“Advantage”). Advantage is a provider of home and community based services in South Carolina and Georgia, which expanded our services across 19 states. The total consideration payable pursuant to the benefitsPurchase Agreement was $8.3 million, comprised of providing care$5.1 million in cash, common stock consideration with a sub-acute settingdeemed value of $1.2 million resulting in the home whereissuance of 248,000 common shares, a maximum of $2.0 million in future cash consideration subject to the achievement of certain performance targets set forth in an earn-out agreement and the assumption of certain specified liabilities. In April 2011, we also believepaid the overwhelming majorityfirst earn-out payment of individuals prefer$0.5 million to receive care especiallythe sellers of Advantage. During the fourth quarter of 2011 we completed a revaluation of the remaining contingent earn-out obligation and recorded a reduction of approximately $0.5 million with a remaining obligation of $0.7 million as an alternativeof December 31, 2012. The sellers of Advantage disagree with our calculation of the second earn-out payment. The dispute has been submitted to an institutional long-term care setting.arbitrator and the final payment is expected to be made during the second quarter of 2013.

With the passageBusiness

The results of the Home Health Reform Act, discussed below,Business sold are reflected as discontinued operations for all periods presented herein. Continuing operations include the states and the federal government are proposing to combine the administrative activities for benefits provided to dual eligibles. Several states in which we are doing business are currently in the process of requesting proposals from various managed care insurance providers for the administration of these programs. We are in active discussions with several of these managed care providers to be a core provider of services to more effectively manage this population.

In March 2010, the President signed into law the Patient Protection and Affordable Care Act and the Healthcare and Education Reconciliation Act of 2010 (collectively, both laws are referred to herein as the “Health Reform Act”). The Health Reform Act includes several provisions that may affect reimbursement for home health agencies. The Health Reform Act is broad, sweeping reform, and is subject to change, including through the adoption of related regulations, the way in which its provisions are interpreted and the manner in which it is enforced. We cannot assure you that the provisions of the Health Reform Act will not adversely impact our business, results of operations or financial position. We may be unable to mitigate any adverse effects resulting from the Health Reform Act.

On July 14, 2010, the Office for Civil Rights of the U.S. Department of Health and Human Services (“OCR”) published proposed regulations to implement the Health Information Technology for Economic and Clinical Health Act (the “HITECH Act”). The HITECH Act imposed additional privacy and security requirements on health care providers and on their business associates. Failure to comply with the Health Insurance Portability and Accountability Act, or HIPAA, could resultpreviously included in fines and penalties that could have a material adverse effect on the Company. Recently, the OCR has imposed substantial financial and other penalties on covered entities that improperly disclosed individuals’ health information.

In November 2010, CMS released its Home Health Prospective Payment System Update for Calendar Year 2011. It included a 1.1% market basket increase for 2011 (after application of the mandated 1% reduction) and a mandated 3.79% rate reduction. The rate reduction resulted from the CMS determination that there had been a general increase in case mix that CMS believed was unwarranted. CMS believed that this “case-mix creep” was due to improved coding, coding practice changes, and other behavioral responses to the change in reimbursement that went in to effect in 2009, including greater use of high therapy treatment plans above what CMS believed was related to an increase in patient acuity. CMS warned that it would continue to monitor changes in case-mix. If new data identifies additional increases in case-mix, CMS would immediately impose further reductions. The final 2011 payment base rate reflected a 0.3% decrease from the proposed market basket rate in July 2010. CMS announced that it was postponing its proposed 3.79% reduction in home health rates for calendar year 2012 pending its further monitoring of case-mix changes. Home health agencies that did not submit required quality data would be subject to a 2% reduction in the market basket update.

On August 2, 2011 the President signed into law the Budget Control Act of 2011, which raised the debt ceiling and put into effect a series of actions for deficit reduction. The Budget Control Act created a Congressional Joint Select Committee on Deficit Reduction that was tasked with proposing additional deficit reduction of at least $1.5 trillion. The committee was unsuccessful which triggered automatic across the board reductions in spending of $1.2 trillion. Medicare is subject to these reductions but Medicare reductions are capped at 2%.

As mandated by the Health Reform Act, on October 20, 2011, CMS released final regulations for the Medicare Shared Savings Program. Although the Health Reform Act mandates that the program be established no later than January 1, 2012, CMS set start dates of April 1, 2011 and July 1, 2011. The Medicare Shared Savings Program is designed to give financial incentives to healthcare providers and suppliers that meet criteria established by the U.S. Department of Health and Human Services (“DHHS”) that work together to manage and coordinate care through Accountable Care Organizations (“ACOs”) for fee-for-service Medicare beneficiaries assigned to the ACO by CMS to increase quality of care and reduce costs. On December 19, 2011, CMS announced 32 pilot “pioneer ACOs”. In proposed regulations published April 7, 2011, CMS requested comments on a number of issues including the range of providers and suppliers that could participate in an ACO. Reaction to the proposed regulations issued on April 7, 2011 was generally negative especially with regard to start up costs, retroactive assignment of beneficiaries, antitrust issues, the proposed quality measures (both the number and complexity), and the lack of a model that only includes shared savings. The final regulations addressed several but not all of these concerns. The final regulations set a “savings-only model” where providers share any savings over a threshold amount but do not share any losses, as well as a two sided model where the ACO shares in the savings but is also at risk for losses. The number of quality measures is reduced by almost one half, and beneficiaries are assigned prospectively. The first performance period began on January 1, 2012. On April 10, 2012, CMS announced the selection of the first 27 ACOs to participate in the Medicare Shared Savings Program. On July 9, 2012, CMS announced 88 additional ACOs bringing the total to 147 ACOs.

In connection with the ACO rules, also on October 20, 2011, the Federal Trade Commission (“FTC”) and the Department of Justice (“DOJ”) released a joint antitrust policy statement, the Internal Revenue Service released a fact sheet, and the Office of Inspector General (“OIG”) released an interim final rule with five fraud waivers (waiving prosecution under the federal anti-kickback statute applicable to federal and state healthcare programs, the federal Ethics in Patient Referral Act or physician referral law and the Civil Monetary Penalty Law and laws regarding gain sharing arrangements). The FTC and the DOJ antitrust policy statement addressed some but not all antitrust concerns. The OIG waivers set forth who would be protected by the waivers and under what circumstances. A home health agency cannot qualify for a waiver for activities during ACO pre-participation, which would include activities in the start-up period until an application is accepted but which CMS states could also occur during the participation period. Post-acute care facilities, such as skilled nursing facilities (“SNFs”) and inpatient rehabilitation facilities (“IRFs”), can qualify for pre-participation waivers. Without a pre-participation waiver, it may be difficult for home health agencies, such as ours, to participate in the planning process for formation of an ACO and this may put us at a disadvantage in negotiating sharing of savings if we were to participate in an ACO. In addition, because other post-acute care providers, such as SNFs and IRFs, can participate in the planning process they may more readily participate in ACOs and may attract referrals that otherwise would have been made to us. Although provider and supplier participation in an ACO is voluntary, participation by our competitors in some markets may force us to participate as well, or if we do not participate, result in loss of business. Also, where we do not participate we will need to be mindful of quality measure criteria and if we are unable to meet those criteria we could be at risk for losing Medicare referrals. In addition, other savings programs similar to ACOs may be adopted by government and commercial payors to control costs and reduce hospital readmissions in which we could be financially at risk. We cannot predict what effect, if any, ACOs will have on our company.

On July 15, 2011, DHHS published two sets of proposed regulations relating to health insurance exchanges established under the Health Reform Act providing guidance and options to states on how to structure their exchanges. On September 30, 2011, DHHS extended the date for public comment from September 28 to October 31, 2011. CMS published final regulations on March 27, 2012. On December 16, 2011, CMS issued an “Essential Benefits Bulletin,” which provided a broad outline of benefit categories, including habilitative and rehabilitative services, but left the definition of essential benefits to the states, to be defined in a benchmark plan selected by each state. The benchmark plan is supposed to reflect the scope of services and limits in a plan offered by a typical employer in the state. At this point it is uncertain what services will be mandated for coverage by exchanges or at what level services will be paid or what impact the exchanges will have on other payors.

In the Final Home Health Prospective Payment System Update for Calendar Year 2012 CMS imposed a 5.1% reduction to the national standardized 60-day episode rates that is being phased in over 2 years. The reduction in calendar year 2012 is 3.8% and the remaining 1.3% will be applied for calendar year 2013. After offset of the reduction for calendar year 2012, the market basket update is 1.4%, which results in a 2012 rate that is less than the 2011 rate. Home health agencies that do not meet quality data reporting requirements have a market basket update of 0.6%. CMS also implemented several other changes. It removed two codes for hypertension from the home health PPS case-mix model’s hypertension group. In addition, CMS revised payment weights, lowering the relative weights, and thus payments, for home health episodes with a high number of therapy visits and increasing the weights, and payments, for episodes with little or no therapy.

CMS also reported that it plans to do further analysis of the costs for providing therapy visits and the use of therapy assistants for future rulemaking and plans to make further rate adjustments in accordance with its findings. In its March 2012 Report to Congress, the Medicare Payment Advisory Commission, or MedPAC, an independent congressional agency that advises Congress on issues involving the Medicare program, reiterated its belief that home health agency margins are too high and its recommendation that payments for 2013 should be rebased.

On July 13, 2012, CMS published the proposed Medicare 2013 Home Health update. CMS proposes a 1.5% payment update reduced by 1.32% to offset what it views as case mix “creep”. CMS also proposes additional methods to enforce compliance with home health conditions of participation and the imposition of alternative sanctions for home health agencies with deficiencies, including civil monetary penalties.

Reductions in Medicare home health agency payments, whether through rebasing or otherwise, would decrease our revenue, which would have a negative effect on our profits and liquidity.

Segments

We operate our business through two segments, home & community servicessegment and three agencies previously included in our home health services. We have organizedsegment. Following the sale of the Home Health Business, we manage and internally report our internal management reports to align with these segment designations. As such, we have identified two reportable segments, home & community and home health, applying the criteriabusiness in ASC 280, “Disclosure about Segments of an Enterprise and Related Information”. The following table presents our locations by segment, setting forth acquisitions, start-ups and closures for the period January 1, 2012 to June 30, 2012:one segment.

   Home &
Community
  Home
Health
  Total 

Total at December 31, 2011

   89    29    118  

Merged/Sold

   (1  (1)  (2)

Start-up

   1    —      1  
  

 

 

  

 

 

  

 

 

 

Total at June 30, 2012

   89    28    117  
  

 

 

  

 

 

  

 

 

 

As of June 30, 2012, weWe provided our home and community based services through 117over 96 locations across 19 states.states as of March 31, 2013 and December 31, 2012.

Our payor clients are principally federal, state and local governmental agencies. The federal, state and local programs under which they operate are subject to legislative, budgetary and other risks that can influence reimbursement rates. Our commercial insurance carrier payor clients are typically for profit companies and are continuously seeking opportunities to control costs. We are seeking to grow our private duty business in both of our segments.business.

For the three and six months ended June 30,March 31, 2013 and 2012 and 2011, our payor revenue mix by segment was as follows:for continuing operations was:

 

  Home & Community 
  For the Three
Months Ended
June 30,
 For the Six
Months Ended
June 30,
   For the Three Months ended
March 31,
 
  2012 2011 2012 2011   2013 2012 

State, local and other governmental programs

   95.3  94.5  95.4  94.5   95.0  95.3

Commercial

   1.0    0.9    0.9    0.8     1.1    0.9  

Private duty

   3.7    4.6    3.7    4.7     3.9    3.8  
  

 

  

 

  

 

  

 

   

 

  

 

 
   100.0  100.0  100.0  100.0   100.0  100.0
  

 

  

 

  

 

  

 

   

 

  

 

 
  Home Health 
  For the Three
Months Ended
June 30,
 For the Six
Months Ended
June 30,
 
  2012 2011 2012 2011 

Medicare

   66.4  66.3  64.4  65.9

State, local and other governmental programs

   17.8    18.2    19.0    18.4  

Commercial

   11.4    9.9    11.9    10.0  

Private duty

   4.4    5.6    4.7    5.7  
  

 

  

 

  

 

  

 

 
   100.0  100.0  100.0  100.0
  

 

  

 

  

 

  

 

 

We derive a significant amount of our net service revenues from our continuing operations in Illinois, which represented 65.5% and 61.9% of our total net service revenues from continuing operations for the three months ended March 31, 2013 and 2012, respectively.

A significant amount of our net service revenues from continuing operations are derived from one payor client, the Illinois Department on Aging, which accounted for 59.5% and 55.1% of our total net service revenues from continuing operations for the three months ended March 31, 2013 and 2012, respectively.

We also measure the performance of each segmentour business using a number of different metrics. For our home & community segment, weWe consider billable hours, billable hours per business day, revenues per billable hour and the number of consumers, or census. For our home health segment, we consider

On April 2, 2013, the Centers for Medicare admissions, non-Medicare admissions, and Medicare revenues per episode completed.

We derive a significant amountMedicaid Services published final regulations for implementation of our net service revenues from our operations in Illinois and California, which represented 61.8% and 9.6%; and 55.3% and 10.5%, of our total net service revenuesthe increased Federal Medical Assistance Percentage (“FMAP”) payments for the three months ended June 30,Medicaid program under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2012 (collectively, both laws are referred to herein as the “Health Reform Act”). Under the Health Reform Act, the FMAP to states to cover individuals who are “newly eligible” is 100% for calendar years 2014-2016 and 2011, respectively. Net service revenues from our operationsgradually decreases by 2020 to 90%. States that already covered individuals who otherwise became eligible for Medicaid under the Health Reform Act (“Expansion States”) will receive a much lower 2.2% FMAP increase. Expansion States will receive the enhanced FMAP payment for those individuals who previously did not qualify for Medicaid. The final rule, among other things, establishes methodologies for states to determine who is newly eligible. Thus, we expect that not all states in Illinois and California represented 61.0% and 9.6%; and 54.9% and 10.6%, of our total net service revenues for the six months ended June 30, 2012 and 2011, respectively.

A significant amount of our net service revenues are derived from two specific payor clients. The Illinois Department on Aging, in the home & community segment, and Medicare, in the home health segment, which accounted for 48.8% and 11.0%; and 42.2% and 12.9% of our total net service revenues for the three months ended June 30, 2012 and 2011, respectively. The Illinois Department on Aging and Medicare accounted for 48.3% and 10.5%; and 41.8% and 12.7% of our total net service revenues for the six months ended June 30, 2012 and 2011, respectively.we do business will receive enhanced FMAP payments or substantial enhanced FMAP payments.

Components of our Statements of IncomeOperations

Net Service Revenues

We generate net service revenues from continuing operations by providing our home & community services and home health services directly to individuals. We receive payment for providing such services from our payor clients, including federal, state and local governmental agencies, commercial insurers and private individuals.

Home & community segmentNet service revenues from continuing operations are typically generated based on services rendered and reimbursed on an hourly basis. Our home & community segmentnet service revenues from continuing operations were generated principally through reimbursements by state, local and other governmental programs which are partially funded by Medicaid programs, and to a lesser extent from private duty and insurance programs. Net service revenues for our home & community segmentfrom continuing operations are principally provided based on authorized hours, determined by the relevant agency, at an hourly rate, which is either contractual or fixed by legislation, and recognized as net service revenues at the time services are rendered.

Home health segment revenues are primarily generated on a per episode or visit basis rather than on a flat fee or an hourly basis. Our home health segment revenues are generated principally through reimbursements by the Medicare program, and to a lesser extent from Medicaid programs, commercial insurers and private duty. Net service revenues from home health payors, other than Medicare, are readily determinable and recognized as net service revenues at the time the services are rendered. Medicare reimbursements are based on 60-day episodes of care. The anticipated net service revenues from an episode are initially recognized as accounts receivable and deferred revenues and subsequently amortized as net service revenues ratably over the 60-day episodic period. At the end of each episode of care, a final billing is submitted to Medicare and any changes between the initial anticipated net service revenues and final billings are recorded as an adjustment to net service revenues. For open episodes, we estimate net service revenues based on historical data and adjust for the difference between the initial anticipated net service revenues and the ultimate final claim amount.

Cost of Service Revenues

We incur direct care wages, payroll taxes and benefit-related costs from continuing operations in connection with our employees providing our home & community and home health services. We also provide workers’ compensation and general liability coverage for these employees.

Employees are also reimbursed for their travel time and related travel costs. For home health services, we provide medical supplies and occasionally hire contract labor services to supplement existing staffing in order to meet our consumers’ needs.

General and Administrative Expenses

Our general and administrative expenses from continuing operations consist of expenses incurred in connection with our segments’ activities and as part of our central administrative functions.

Our general and administrative expenses for home & community and home health servicesfrom continuing operations consist principally of supervisory personnel, care coordination and office administration costs. Our general and administrative expenses for home health also include additional staffing for clinical and admissions processing. These expenses consist principally ofinclude wages, payroll taxes and benefit-related costs; facility rent; operating costs such as utilities, postage, telephone and office expenses; and bad debt expense. The Company hasWe have initiated efforts to centralize administrative tasks currently conducted at the branch locations. The costs related to these initiatives are included in the general and administrative expenses for each division.

Our corporate general and administrativefrom continuing operations. Other centralized expenses cover the centralizedfrom continuing operations include administrative departments of accounting, information systems, human resources, billing and collections and contract administration, as well as national program coordination efforts for marketing and private duty. These expenses primarily consist of compensation, including stock-based compensation, payroll taxes, and related benefits; legal, accounting and other professional fees; rents and related facility costs; and other operating costs such as software application costs, software implementation costs, travel, general insurance and bank account maintenance fees.

Depreciation and Amortization Expenses

We amortize our intangible assets with finite lives, consisting of customer and referral relationships, trade names, trademarks and non-compete agreements, principally on accelerated methods based upon their estimated useful lives. Depreciable assets at the segment level consist

principally of furniture and equipment, and for the home & community segment, also include vehicles for our adult day centers.

A substantial portion of our capital expenditures is infrastructure-related or for our corporate office. Corporate asset purchases consist primarily of network administration and telephone equipment, and operating system software, furniture and equipment.software. Depreciable and leasehold assets are depreciated or amortized on a straight-line method over their useful lives or, if less and if applicable, their lease terms.

Interest Income

Legislation enacted in Illinois entitles designated service program providers to receive a prompt payment interest penalty based on qualifying services approved for payment that remain unpaid after a designated period of time. As the amount and timing of the receipt of these payments are not certain, the interest income is recognized when received and reported in the income statement caption, interest income. While we may be owed additional prompt payment interest, the amount and timing of receipt of such payments remains uncertain and we have determined that we will continue to recognize prompt payment interest income when received. The state amended its prompt payment interest terms, effective July 1, 2011, which changed the measurement period for outstanding invoices from a 60-day to a 90-day outstanding period. We believe this change in terms will reduce future amounts paid for prompt payment interest.

Interest Expense

Interest expense from continuing operations consists of interest costs on our credit facility and other debt instruments.

Income Tax Expense

All of our income from continuing operations is from domestic sources. We incur state and local taxes in states in which we operate. The differences from the federal statutory rate of 34%35% are principally due to state taxes and the use of federal employment tax credits.

Gain on Sale of the Home Health Business, Net of Tax

Gain on sale of the home health business, net of tax consists of the results of the gain, net of tax we recorded for selling our Home Health Business effective March 1, 2013.

Discontinued Operations

Discontinued operations consists of the results of operations, net of tax for our Home Health Business that was sold effective March 1, 2013 and the results of operations of assets held for sale.

Results of Operations

Three Months Ended June 30, 2012March 31, 2013 Compared to Three Months Ended June 30, 2011March 31, 2012

The following table sets forth, for the periods indicated, our unaudited consolidated results of operations.

 

   Three Months Ended
June 30, 2012
  Three Months Ended
June 30, 2011
  Change 
   Amount  % of
Net Service
Revenues
  Amount   % of
Net Service
Revenues
  Amount  % 
   (in thousands, except percentages) 

Net service revenues:

        

Home & Community

  $58,656    83.5 $55,009     80.6% $3,647    6.6

Home Health

   11,625    16.5    13,243     19.4    (1,618  (12.2
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Total

   70,281    100.0    68,252     100.0    2,029    3.0  

Operating income before corporate expenses:

        

Home & Community

   7,078    12.1    6,020     10.9    1,058    17.6  

Home Health

   (47  (0.4  840     6.3    (887  (105.6
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Total segment operating income

   7,031    10.0    6,860     10.1    171    2.5  

Corporate general and administrative expenses

   4,257    6.1    3,981     5.8    276    6.9  

Corporate depreciation and amortization

   170    0.2    189     0.3    (19  (10.1
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Total operating income

   2,604    3.7    2,690     4.0    (86  (3.2

Interest expense

   426    0.6    668     1.0    (242  (36.2
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Income from operations before taxes

   2,178    3.1    2,022     3.0    156    7.7  

Income tax expense

   714    1.0    689     1.0    25    3.6  
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Net income

  $1,464    2.1 $1,333     2.0% $131    9.8
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Our net service revenues increased by $2.0 million, or 3.0%, to $70.3 million for the three months ended June 30, 2012 compared to $68.3 million for the same period in 2011. This net increase represents 6.6% growth in home & community net service revenues partially offset by a 12.2% decline in home health net service revenues. Home & community revenue growth was driven by an increase in average census and related increase in billable hours partially offset by a decrease in the rate per billable hour. Our home health revenue decline in the second quarter of 2012 was primarily due to a decrease in Medicare and non-Medicare admissions from on-going operations and a loss of revenues from agencies that were closed or sold.

Total operating income, expressed as a percentage of net service revenues, for the three months ended June 30, 2012 and 2011, was 3.7% and 4.0%, respectively. Corporate general and administrative expenses increased by $0.3 million to 6.1% of net service revenues for the three months ended June 30, 2012.

                The decrease of $0.1 million in operating income for the three months ended June 30, 2012 consists of an operating income increase of $1.1 million in our home & community segment due primarily to an increase in billable hours and improved gross profit percentage offset by a $0.9 million decrease in operating income in our home health segment primarily due to a decrease in admissions and a decline in gross margin percentage. In addition, our corporate costs increased by $0.3 million in 2012 primarily due to an increase in corporate wage related costs as a result of an increase in our corporate infrastructure and an increase in other corporate administrative expenses.

Total segment operating income, expressed as a percentage of net service revenues, for the three months ended June 30, 2012 and 2011, was 10.0% and 10.1% respectively. Corporate general and administrative expenses increased to 6.1% of net service revenues for the three months ended June 30, 2012, from 5.8% for the same period in 2011.

Home & Community Segment

The following table sets forth, for the periods indicated, a summary of our home & community segment’s unaudited results of operations through operating income, before corporate expenses:

   For the Three Months Ended March 31,    
   2013  2012  Change 
   Amount  % of
Net Service
Revenues
  Amount  % of
Net Service
Revenues
  Amount  % 
   (in thousands, except percentages) 

Net service revenues

  $62,998    100.0 $58,889    100.0 $4,109    7.0

Cost of service revenues

   47,200    74.9    43,865    74.5    3,335    7.6  
  

 

 

   

 

 

   

 

 

  

Gross profit

   15,798    25.1    15,024    25.5    774    5.2  

General and administrative expenses

   11,510    18.3    11,570    19.6    (60  (0.5

Gain on sale of agency

   —      —      (495  (0.8  495    (100.0

Depreciation and amortization

   546    0.9    631    1.1    (85  (13.5
  

 

 

   

 

 

   

 

 

  

Total operating expenses

   12,056    19.1    11,706    19.9    350    3.0  
  

 

 

   

 

 

   

 

 

  

Operating income from continuing operations

   3,742    5.9    3,318    5.6    424    12.8  

Total interest expense

   208    0.3    404    0.7    (196  (48.5
  

 

 

   

 

 

   

 

 

  

Income from continuing operations before income taxes

   3,534    5.6    2,914    4.9    620    21.3  

Income tax expense

   847    1.3    1,168    2.0    (321  (27.5
  

 

 

   

 

 

   

 

 

  

Net income from continuing operations

   2,687    4.3    1,746    3.0    941    53.9  
  

 

 

   

 

 

   

 

 

  

Discontinued operations:

       

Loss from home health business, net of tax

   (537  (0.9  (1,117  (1.9  580    (51.9

Gain on sale of the home health business, net of tax

   11,111    17.6    —      —      11,111    *  
  

 

 

   

 

 

   

 

 

  

Net income from discontinued operations

   10,574    16.8    (1,117  (1.9  11,691    *  
  

 

 

   

 

 

   

 

 

  

Net income

  $13,261    21.0 $629    1.1 $12,632    *
  

 

 

   

 

 

   

 

 

  

Business Metrics

       

Average billable census

   25,817     24,525     1,292    5.3

Billable hours (in thousands)

   3,714     3,470     244    7.0  

Average Billable hours per census per month

   48     47     1    2.1  

Billable hours per business day

   58,031     53,354     4,677    8.8  

Revenues per billable hour

  $16.96    $16.97    $(0.01  (0.1)% 

 

   Three Months Ended
June 30, 2012
  Three Months Ended
June 30, 2011
  Change 
   Amount   % of Net
Service
Revenues
  Amount   % of Net
Service
Revenues
  Amount  % 
   (in thousands, except percentages) 

Net service revenues

  $58,656     100.0% $55,009     100.0% $3,647    6.6

Cost of service revenues

   43,532     74.2    41,076     74.7    2,456    6.0  
  

 

 

   

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Gross profit

   15,124     25.8    13,933     25.3    1,191    8.5  

General and administrative expenses

   7,585     12.9    7,304     13.3    281    3.8  

Depreciation and amortization

   461     0.8    609     1.1    (148  (24.3
  

 

 

   

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Operating income

  $7,078     12.1% $6,020     10.9% $1,058    17.6
  

 

 

   

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Segment Data:

         

Billable hours (in thousands)

   3,477      3,229      248    7.7

Billable hours per business day

   54,334      50,456      3,878    7.7

Revenues per billable hour

  $16.86     $17.03     $(0.17  (1.0)% 

Average census

   23,714      22,753      961    4.2
*Percentage information not meaningful

Net service revenues from state, local and other governmental programs accounted for 95.0% and 95.3% and 94.5% of home & community net service revenues for the three months ended June 30,March 31, 2013 and 2012, and 2011, respectively. Private duty and, to a lesser extent, commercial payors accounted for the remainder of net service revenues.

Net service revenues increased $3.7$4.1 million, or 6.6%7.0%, to $58.7$63.0 million for the second quarter of 2012three months ended March 31, 2013 compared to $55.0$58.9 million for the same period in 2011.2012. The increase was primarily due to a 4.2%5.3% increase in average census increase and a related 7.7%7.0% increase in billable hours partially offset by a slight decrease in the average revenues per billable hour by 1.0%.hours.

Gross profit, expressed as a percentage of net service revenues, increaseddecreased to 25.8%25.1% for the second quarterthree months ended March 31, 2013, from 25.5% in 2012. This decrease as a percent of 2012, from 25.3% for the same period in 2011. This increaserevenue of 0.5%0.4% is primarily due to a continued focus onan increase in auto claim expenses, partially offset by an increase in the average billed hours per census per month while leveraging the fixed wage cost for field staff productivity and management of service costs.staff.

General and administrative expenses, expressed as a percentage of net service revenues decreased to 12.9%19.1% for the three months ended June 30, 2012,March 31, 2013, from 13.3%19.9% for the three months ended June 30, 2011.March 31, 2012. General and administrative expenses increased by $0.3 milliondecreased to $7.6$11.5 million as compared to $7.3$11.6 million for the three months ended June 30,March 31, 2013 and 2012, respectively. The decrease in general and 2011, respectively. This increase of $0.3 million is primarilyadministrative expenses was due to an increasea decrease in administrative wages and telecom related costs partially offset by reductions inour bad debt expense duefor the three months ended 2013 as compared to our continued focus on collections.2012.

Depreciation and amortization, expressed as a percentage of net service revenues, decreased to 0.8% for the second quarter of 2012,0.9% from 1.1% for the same period in 2011.three months ended March 31, 2013 and 2012, respectively. Amortization of intangibles, which are principally amortized using accelerated methods, totaled $0.4$0.3 million and $0.6$0.4 million for the three months ended June 30,March 31, 2013 and 2012, and 2011, respectively.

Home Health Segment

The following table sets forth, for the periods indicated, a summary of our home health segment’s unaudited results of operations through operating income, before corporate expenses:

   Three Months Ended
June 30, 2012
  Three Months Ended
June 30, 2011
  Change 
   Amount  % of Net
Service
Revenues
  Amount   % of Net
Service
Revenues
  Amount  % 
   (in thousands, except percentages) 

Net service revenues

  $11,625    100.0% $13,243     100.0% $(1,618  (12.2)% 

Cost of service revenues

   6,330    54.5    7,066     53.4    (736  (10.4
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Gross profit

   5,295    45.5    6,177     46.6    (882  (14.3

General and administrative expenses

   5,338    45.9    5,208     39.3    130    2.5  

Depreciation and amortization

   4    0.0    129     1.0    (125  (96.9
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Operating (loss) income

  $(47  (0.4)% $840     6.3% $(887  (105.6)% 
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Segment Data:

        

Medicare admissions

   2,012     2,274      (262  (11.5)% 

Non-Medicare admissions

   1,236     1,707      (471  (27.6)% 

Medicare revenues per episode completed

  $2,551    $2,517     $34    1.4

Net service revenues from Medicare accounted for 66.4% and 66.3% of home health net service revenues for the three months ended June 30, 2012 and 2011, respectively. Non-Medicare net service revenues, in order of significance, include Medicaid and other governmental programs, commercial insurers and private duty payors.

Net service revenues decreased $1.6 million, or 12.2%, to $11.6 million for the second quarter of 2012, compared to $13.2 million in the same period of 2011. Our home health revenue decline in the second quarter of 2012 was primarily due to an 18.4% decrease in admissions and a loss of revenues from agencies that were closed or sold.

Gross profit, expressed as a percentage of net service revenues, decreased to 45.5% for the three months ended June 30, 2012, from 46.6% in the same period of 2011. This decrease of 1.1% in gross margin percentage is primarily due to the reduction in 2012 Medicare payment base rates and a decrease in field staff productivity.

General and administrative expenses, expressed as a percentage of net service revenues, increased to 45.9% for the second quarter of 2012, from 39.3% for the same period in 2011. General and administrative expenses increased by $0.1 million to $5.3 million as compared to $5.2 million for the three months ended June 30, 2012 and 2011, respectively. This increase of $0.1 million was due to an increase in management and administrative staffing costs and an increase in bad debt expense partially offset by a reduction in consulting expenses.

Total operating (loss) income expressed as a percentage of net service revenues, for the three months ended June 30, 2012 and 2011, was (0.4)% and 6.3%, respectively.

Depreciation and amortization, expressed as a percentage of net service revenues, decreased by 96.9% for the three months ended June 30, 2012. This decrease is due to the write-off of all intangible assets in the third quarter of 2011 as a result of an impairment analysis completed.

Corporate General and Administrative Expense

Corporate general and administrative expenses increased $0.3 million, or 6.9%, to $4.3 million for the three months ended June 30, 2012, from $4.0 million for the same period in 2011. This increase was primarily due to an increase in wage related costs and an increase in telecom and data related expenses partially offset by a decrease in legal expenses. These expenses, expressed as a percentage of net service revenues, were 6.1% and 5.8% for the second quarter of 2012 and 2011, respectively.

Interest Income

Legislation enacted in Illinois entitles designated service program providers to receive a prompt payment interest penalty based on qualifying services approved for payment that remain unpaid after a designated period of time. As the amount and timing of the receipt of these payments are not certain, the interest income is recognized when received and reported in the income statement caption, interest income. We did not receive any prompt payment interest in the three months ended June 30, 2012 and 2011. While we may be owed additional prompt payment interest, the amount and timing of receipt of such payments remains uncertain and we have determined that we will continue to recognize prompt payment interest income when received. The state amended its prompt payment interest terms, effective July 1, 2011, which changed the measurement period for outstanding invoices from a 60-day to a 90-day outstanding period. We believe this change in terms will reduce future amounts paid for prompt payment interest. We did not receive any prompt payment interest income for the three months ended March 31, 2013 or 2012.

Interest Expense

Interest expense was $0.4$0.2 million and $0.7$0.4 million for the three months ended June 30,March 31, 2013 and 2012, and 2011, respectively. Interest expense decreased $0.3$0.2 million primarily due to a reduction in outstanding debt.

Income Tax Expense (Benefit)

Our effective tax rates from continuing operations for the three months ended June 30,March 31, 2013 and 2012 were 24.0% and 2011 were 32.8% and 34.1%40.1%, respectively. The principal difference between the Federal and stateState statutory rates and our effective tax rate is the use of Federal employment opportunity tax credits. The decrease in our second quarter 2012 effective tax rate to 32.8% from 41.0% in the first quarter of 2012 is principally due to a change in estimate relating to the recognition of 2011 Federal employment opportunity tax credits processedwere reinstated in 2013 and earnedwere not an allowable deduction in 2012. Our effective tax rate for 2012 does not include any earned 2012 Federal employment opportunity tax credits and will not be recognized until such time that the Federal employment opportunity tax credits are reinstated.

Results ofDiscontinued Operations

Six Months Ended June 30,During the fourth quarter of fiscal year 2012, Comparedwe announced that we were pursuing strategic alternatives for our Home Health Business, and in February 2013, we entered into the Home Health Purchase Agreement. Following the sale, we have segregated the Home Health Business operating results and presented them separately as discontinued operations for all periods presented (see note 2 – “Discontinued Operations” of the Notes to Six Months Ended June 30, 2011the Consolidated Financial Statements included herein).

The following table sets forth, forbelow depicts the periods indicated, our unaudited consolidated results of discontinued operations.

 

   Six Months Ended
June 30, 2012
  Six Months Ended
June 30, 2011
  Change 
   Amount  % of
Net Service
Revenues
  Amount   % of
Net Service
Revenues
  Amount  % 
   (in thousands, except percentages) 

Net service revenues:

        

Home & Community

  $115,579    83.6 $ 109,152     80.8 $6,427    5.9

Home Health

   22,626    16.4    25,942     19.2    (3,316)  (12.8
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Total

   138,205    100.0    135,094     100.0    3,111    2.3  
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Operating income (loss) before corporate expenses:

        

Home & Community

   13,498    11.7    11,345     10.4    2,153    19.0  

Home Health

   (1,210)  (5.3  1,538     5.9    (2,748)  (178.7
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Total segment operating income

   12,288    8.9    12,883     9.6    (595)  (4.6

Corporate general and administrative expenses

   8,373    6.1    7,807     5.8    566    7.2  

Gain on sale of agency

   (495)  (0.4  —       —      (495)  *  

Corporate depreciation and amortization

   335    0.2    380     0.3    (45)  (11.8
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Total operating income

   4,075    2.9    4,696     3.5    (621)  (13.2

Interest income

   (128  (0.1  —       —      (128  *  

Interest expense

   958    0.7    1,381     1.0    (423)  (30.6
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Income from operations before taxes

   3,245    2.3    3,315     2.5    (70)  (2.1

Income tax expense

   1,152    0.8    1,129     0.9    23    2.0  
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Net income

  $2,093    1.5 $2,186     1.6% $(93)  (4.3)% 
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 
   For the Three Months Ended March 31,    
   2013  2012  Change 
   Amount  % of Net
Service
Revenues
  Amount  % of Net
Service
Revenues
  Amount  % 
   (in thousands, except percentages) 

Net service revenues

  $6,476    100.0 $9,035    100.0 $(2,559  (28.3)% 

Cost of service revenues

   3,713    57.3    5,418    60.0    (1,705  (31.5
  

 

 

   

 

 

   

 

 

  

Gross profit

   2,763    42.7    3,617    40.0    (854  (23.6

General and administrative expenses

   3,674    56.7    5,461    60.4    (1,787  (32.7

Depreciation and amortization

   —      —     3    0.0    (3  (100.0
  

 

 

   

 

 

   

 

 

  

Operating income (loss) from discontinued operations

   (911  (14.1  (1,847  (20.4  936    (50.7
  

 

 

   

 

 

   

 

 

  

Income tax (benefit)

   (374  (5.8  (730  (8.1  356    (48.8
  

 

 

   

 

 

   

 

 

  

Loss from home health business, net of tax

  $(537  (8.3)%  $(1,117  (12.4)%  $580    (51.9)% 
  

 

 

   

 

 

   

 

 

  

*Percent information not meaningful

Our net service revenues increased by $3.1 million, or 2.3%, to $138.2 million for the six months ended June 30, 2012 compared to $135.1 million for the same period in 2011. This net increase represents 5.9% growth in home & community net service revenues partially offset by a 12.8% decline in home health net service revenues. Home & community revenue growth was driven by an increase in average census and related increase in billable hours partially offset by a slight decrease in the average revenues per billable hour. Our home health revenue declined in the six months ended June 30, 2012The losses were primarily due to an adjustmentreduced sales, higher costs to treat consumers and our inability to reduce estimates of accrued Medicare revenues of approximately $0.9 million that was recorded in the first quarter of 2012, a decrease in admissions and a loss of revenues from agencies that were closed or sold.

Total segment operating income, expressed as a percentage of net service revenues, for the six months ended June 30, 2012 and 2011, was 8.9% and 9.6%, respectively. Corporatefixed general and administrative expenses increased to 6.1% of net service revenues for the six months ended June 30, 2012, from 5.8% for the same period in 2011.

Home & Community Segment

The following table sets forth, for the periods indicated,costs at a summary of our home & community segment’s unaudited results of operations through operating income, before corporate expenses:

   Six Months Ended
June 30, 2012
  Six Months Ended
June 30, 2011
  Change 
   Amount   % of Net
Service
Revenues
  Amount   % of Net
Service
Revenues
  Amount  % 
   (in thousands, except percentages) 

Net service revenues

  $115,579     100.0% $109,152     100.0 $6,427    5.9

Cost of service revenues

   86,161     74.5    81,853     75.0    4,308    5.3  
  

 

 

   

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Gross profit

   29,418     25.5    27,299     25.0    2,119    7.8  

General and administrative expenses

   14,993     13.0    14,735     13.5    258    1.8  

Depreciation and amortization

   927     0.8    1,219     1.1    (292  (24.0
  

 

 

   

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Operating income

  $13,498     11.7% $11,345     10.4 $2,153    19.0
  

 

 

   

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Segment Data:

         

Billable hours (in thousands)

   6,851      6,414      437    6.8

Billable hours per business day

   53,522      50,506      3,016    6.0

Revenues per billable hour

  $16.86     $17.02     $(0.16  (0.9)% 

Average census

   23,447      22,629      818    3.6

Net service revenues from state, local and other governmental programs accounted for 95.4% and 94.5% of home & community net service revenues for the six months ended June 30, 2012 and 2011, respectively. Private duty and, to a lesser extent, commercial payors accounted for the remainder of net service revenues.

Net service revenues increased $6.4 million, or 5.9%, to $115.6 million for the six months ended June 30, 2012 compared to $109.2 million for the same period in 2011. The increase was primarily due to a 3.6% increase in average census and a related 6.8% increase in billable hours partially offset by a slight decrease in the average revenues per billable hour by 0.9%.

Gross profit, expressed as a percentage of net service revenues, increased to 25.5% for the six months ended June 30, 2012, from 25.0% for the same period in 2011. This increase is primarily due to a continued focus on field staff productivity and management of service costs.

General and administrative expenses, expressed as a percentage of net service revenues decreased to 13.0% for the six months ended June 30, 2012, from 13.5% for the six months ended June 30, 2011. General and administrative expenses increased by $0.3 million to $15.0 million as compared to $14.7 million for the six months ended June 30, 2012 and 2011, respectively. This increase of $0.3 million is primarily due to an increase in telecom and data related costs and an increase in management bonus expense partially offset by reductions in bad debt expense due to our continued focus on collections.

Depreciation and amortization, expressed as a percentage of net service revenues, decreased to 0.8% for the six months ended June 30, 2012, from 1.1% for the same period in 2011. Amortization of intangibles, which are principally amortized using accelerated methods, totaled $0.8 million and $1.1 million for the six months ended June 30, 2012 and 2011, respectively.

Home Health Segment

The following table sets forth, for the periods indicated, a summary of our home health segment’s unaudited results of operations through operating income, before corporate expenses:

   Six Months Ended
June 30, 2012
  Six Months Ended
June 30, 2011
  Change 
   Amount  % of Net
Service
Revenues
  Amount   % of Net
Service
Revenues
  Amount  % 
   (in thousands, except percentages) 

Net service revenues

  $22,626    100.0 $25,942     100.0% $(3,316  (12.8)% 

Cost of service revenues

   12,984    57.4    14,077     54.3    (1,093  (7.8
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Gross profit

   9,642    42.6    11,865     45.7    (2,223  (18.7

General and administrative expenses

   10,845    47.9    10,070     38.8    775    7.7  

Depreciation and amortization

   7    0.0    257     1.0    (250  (97.3
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Operating (loss) income

  $(1,210  (5.3)%  $1,538     5.9% $(2,748  (178.7)% 
  

 

 

  

 

 

  

 

 

   

 

 

  

 

 

  

 

 

 

Segment Data:

        

Medicare admissions

   4,183     4,547      (364  (8.0)% 

Non-Medicare admissions

   2,596     3,321      (725  (21.8)% 

Medicare revenues per episode completed

  $2,565    $2,528     $37    1.5

Net service revenues from Medicare accounted for 64.4% and 65.9% of home health net service revenues for the six months ended June 30, 2012 and 2011, respectively. Non-Medicare net service revenues, in order of significance, include Medicaid and other governmental programs, commercial insurers and private duty payors.

Net service revenues decreased $3.3 million, or 12.8%, to $22.6 million for the six months ended June 30, 2012, compared to $25.9 million in the same period of 2011. Our home healthrate consistent with revenue decline was due to a reduction of estimates of accrued Medicare revenues of approximately $0.9 million that was recorded in the first quarter of 2012, a decrease in admissions and a loss of revenues from agencies that were closed or sold.

Gross profit, expressed as a percentage of net service revenues, decreased to 42.6% for the six months ended June 30, 2012, from 45.7% in the same period of 2011. Excluding the reduction of estimates of accrued Medicare revenues, gross profit, expressed as a percentage of net service revenues decreased to 44.3% for the six months ended June 30, 2012. The decrease in gross margin is primarily due to the reduction in 2012 Medicare payment base rates and a decrease in field staff productivity.

General and administrative expenses, expressed as a percentage of net service revenues increased to 47.9% for the six months ended June 30, 2012, from 38.8% for the same period in 2011. General and administrative expenses increased by $0.8 million for the six months ended June 30, 2012 to $10.8 million as compared to $10.0 million for the six months ended June 30, 2011. This increase was due to an increase in management and administrative staffing costs and related travel costs, an increase in bad debt expense and other net administrative expenses partially offset by a decrease in consulting expenses.

Total operating (loss) income expressed as a percentage of net service revenues, for the six months ended June 30, 2012 and 2011, was (5.3)% and 5.9%, respectively. Excluding the reduction of estimates of accrued Medicare revenues discussed above, total operating loss, expressed as a percentage of net service revenues was (2.0)% for the six months ended June 30, 2012.

Depreciation and amortization, expressed as a percentage of net service revenues, decreased by 97.3% for the six months ended June 30, 2012. This decrease is due to the write-off of all intangible assets in the third quarter of 2011 as a result of an impairment analysis completed.

Corporate General and Administrative Expense

Corporate general and administrative expenses increased $0.6 million, or 7.2%, to $8.4 million for the six months ended June 30, 2012, from $7.8 million for the same period in 2011. This increase was primarily due to an increase in wage related costs and an increase in telecom and data related expenses partially offset by a decrease in legal expenses. These expenses, expressed as a percentage of net service revenues, were 6.1% and 5.8% for the six months ended June 30, 2012 and 2011, respectively.

Interest Income

Legislation enacted in Illinois entitles designated service program providers to receive a prompt payment interest penalty based on qualifying services approved for payment that remain unpaid after a designated period of time. As the amount and timing of the receipt of these payments are not certain, the interest income is recognized when received and reported in the income statement caption, interest income. We received approximately $0.1 million in prompt payment interest for the six months ended June 30, 2012. We did not receive any prompt payment interest in the six months ended June 30, 2011. While we may be owed additional prompt payment interest, the amount and timing of receipt of such payments remains uncertain and we have determined that we will continue to recognize prompt payment interest income when received. The state amended its prompt payment interest terms, effective July 1, 2011, which changed the measurement period for outstanding invoices from a 60-day to a 90-day outstanding period. We believe this change in terms will reduce future amounts paid for prompt payment interest.

Interest Expense

Interest expense was $1.0 million and $1.4 million for the six months ended June 30, 2012 and 2011, respectively. Interest expense decreased $0.4 million primarily due to a reduction in outstanding debt.

Income Tax Expense

Our effective tax rates for the six months ended June 30, 2012 and 2011 were 35.5% and 34.1%, respectively. The principal difference between the Federal and state statutory rates and our effective tax rate is the use of Federal employment opportunity tax credits. The increase is primarily due to our estimate of recognizing less tax credits in 2012 as compared to the tax credits realized in 2011. Our effective tax rate for 2012 does not include any earned 2012 Federal employment opportunity tax credits and will not be recognized until such time that the Federal employment opportunity tax credits are reinstated.declines.

Liquidity and Capital Resources

Overview

Our primary sources of liquidity are cash from operations and borrowings under our credit facility. At June 30, 2012March 31, 2013 and December 31, 2011,2012, we had cash balances of $1.5$17.8 million and $2.0$1.7 million, respectively. The increase in cash balance between December 31, 2012 and March 31, 2013 is primarily attributable to the cash received from the purchasers for our Home Health Business and increased collections on outstanding accounts receivable which were offset by payments on our line of credit and term loan.

Cash flows from operating activities represent the inflow of cash from our payor clients and the outflow of cash for payroll and payroll taxes, operating expenses, interest and taxes. Due to its revenue deficiencies and financing issues, the State of Illinois has reimbursed us on a delayed basis with respect to our various agreements including with our largest payor, the Illinois Department on Aging. The open receivable balance from the State of Illinois increaseddecreased by $1.9$8.0 million, to $45.2 million as of March 31, 2013 from $47.4$53.2 million as of December 31, 2011 to $49.3 million as of June 30, 2012.

The State of Illinois continues to reimburse us on a delayed basis. These payment delays have adversely impacted, and may further adversely impact, our liquidity, and may result in the need to increase borrowings under our credit facility. Delayed reimbursements from our other state payors have also contributed to the increase in our receivable balances.

Our credit facility provides a $55.0 million revolving line of credit expiring November 2, 2014, includes a $15.0 million sublimit for the issuance of letters of credit and previously included a $5.0 million term loan that matured and was paid on January 5, 2013. Substantially all of the subsidiaries of Holdings are co-borrowers, and Holdings has guaranteed the borrowers’ obligations under the credit facility. The credit facility is secured by a first priority security interest in all of Holdings’ and the borrowers’ current and future tangible and intangible assets, including the shares of stock of the borrowers.

Our credit facility provides (i) maximum aggregate amount of revolving loans available to us of $55.0 million, (ii) maximum senior debt leverage ratio of 3.00 to 1.0 for the twelve (12) month period ending March 31, 2010 and each twelve (12) month period ending on the last day of each fiscal quarter thereafter and (iii) advance multiple of 3.25 used to determine the amount of the borrowing base.

On March 18, 2010, we entered into the first amendment (the “First Amendment”) to our credit facility. The First Amendment (i) increased the maximum aggregate amount of revolving loans available to us by $5.0 million to $55.0 million, (ii) modified our maximum senior debt leverage ratio from 2.75 to 1.0 to 3.00 to 1.0 for the twelve (12) month period ending March 31, 2010 and each twelve (12) month period ending on the last day of each fiscal quarter thereafter and (iii) increased the advance multiple used to determine the amount of the borrowing base from 2.75 to 3.00.

On March 18, 2010, we also amended our subordinated dividend notes that we issued on November 2, 2009 in the aggregate original principal amount of $12.9 million. Pursuant to the amendments, the dividend notes were amended to (i) extend the maturity date of the notes from September 30, 2011 to December 31, 2012, (ii) modify the amortization schedule of the notes to reduce the annual principal payment amounts from $4.5 million to $1.3 million in 2010; from $3.3 million to $2.5 million in 2011; and provide for total payments in 2012 of $4.0 million and (iii) permit, based on our leverage ratio, the prepayment of all or a portion of the principal amount of the notes, together with interest on the principal amount.

On July 26, 2010, we entered into a secondan amendment (the “Second Amendment”) to our credit facility. The Second Amendmentfacility, which provided for a $5.0 millionnew term loan component of the credit facility in the proceedsaggregate principal amount of which were used to finance a portion of the purchase price payable in connection$5,000 with our acquisition of certain assets of Advantage effective July 25, 2010. The term loan will be repaid in 24 equal monthly installments, which commenced February 2011. Interest on the new term loan under the credit facility is payable either at a floating rate equal to the 30-day LIBOR, plus an applicable margin of 4.6% or the LIBOR rate for term periods of one, two, three or six months plus a margin of 4.6%. Interest will be paid monthly or at the end of the relevant interest period. The term loan has a maturity date of January 5, 2013. The total consideration payable pursuant to the Purchase Agreementterm loan was $8.3 million, comprised of $5.1 million in cash, common stock consideration with a deemed value of $1.2 million resulting in the issuance of 248,000 common shares, a maximum of $2.0 million in future cash consideration subject to the achievement of certain performance targets set forth in an earn-out agreement and the assumption of certain specified liabilities. In April 2011, we paid the first earn-out payment of $0.5 million to the sellers of Advantage. The second earn-out payment obligation was reviewed during the fourth quarter of 2011 and it was revalued at approximately $0.7 million. The final payment is expected to be made during the third quarter of 2012.

On May 24, 2011, we entered into a Joinder, Consent and Amendment No. 3 to our credit facility to include Addus HealthCare (Delaware) Inc., a wholly-owned subsidiary of Addus HealthCare, as an additional borrower under our credit facility.repaid when due on January 5, 2013.

On July 26, 2011, we entered into a fourthanother amendment (the “Fourth Amendment”) to our credit facility. The Fourth Amendment (i)facility, which modified our maximum senior leverage ratio from 3.00 to 1.00 to 3.25 to 1.00 for each twelve month period ending on the last of day of each fiscal quarter beginning with the twelve month period ended June 30, 2011 and (ii) increased the advance multiple used to determine the amount of the borrowing base from 3.0 to 1.0 to 3.25 to 1.0. The Fourth Amendment resulted in an increase in the available borrowings under our credit facility.

On March 2, 2012, we entered into a fifth amendment (the “Fifth Amendment”) to our credit facility. The Fifth Amendment includes technical changes that are intended to comply with rules promulgated by CMS that restrict lenders from exercising any rights of set-off of funds on deposit in any lockboxes established for receiving payments from governmental authorities.

During the fourth quarter of 2011, the lenders under our credit facility permitted us to add back approximately $1.8 million to adjusted EBITDA for the purpose of determining availability under the credit facility. The effect of the add back was to increase availability by approximately $5.8 million until March 1, 2012. On March 1, 2012, the add back allowance was reduced by $0.2 million and will continue to bewas reduced by $0.2 million on the first day of each month thereafter until the add back iswas eliminated, which will resultresulted in a reduction in availability of $0.65 million on the first day of each month thereafter until the add back iswas eliminated. The add-back was eliminated on December 1, 2012.

During the second quarter of 2012, the lenders under our credit facility agreed to a modified interpretation of the credit facility as it relates to the calculation of the fixed charge ratio, which provides us with increased flexibility in meeting this covenant. The credit facility contains customary affirmative, negative and financial covenants with which we were in compliance at March 31, 2013.

As of June 30, 2012March 31, 2013 we had $22.0 millionno outstanding amount on our revolving credit facility.facility other than letters of credit. After giving effect to the amount drawn on our credit facility, approximately $7.4 million of outstanding letters of credit, borrowing limits based on an advanced multiple of adjusted EBITDA and the Fourth Amendment, we had $16.2$47.6 million available for borrowing under the credit facility as of June 30, 2012.March 31, 2013. In order to obtain consent from our lender for the sale of the Home Health Business we agreed to work in good faith to negotiate and enter into an amendment to the credit facility to amend certain provisions including a reduction in the maximum revolving loan limit and revolving loan commitment.

We believe the available borrowings under our credit facility which, when taken together with existing cash reserves and cash from operations, will be sufficient to cover our working capital needs for at least the next 12 months and provide resources, subject to any necessary lender consent, to enter into and complete select acquisitions. While our growth plan is not dependent on the completion of acquisitions, if we do not have sufficient cash resources or availability under our credit facility, or we are otherwise prohibited from making acquisitions, our growth could be limited unless we obtain additional equity or debt financing or unless we obtain the necessary consents from our lenders. We believe the available borrowings under our credit facility which, when taken together with cash from operations, will be sufficient to cover our working capital needs for at least the next 12 months.

Cash Flows

The following table summarizes our cash flows for the sixthree months ended June 30, 2012March 31, 2013 and 2011:2012:

 

   Six Months Ended
June 30,
 
   2012  2011 
   (unaudited) 

Net cash provided by operating activities

  $5,732   $29,098  

Net cash used in investing activities

   (259)  (632)

Net cash used in financing activities

   (6,000)  (5,177)

   Three Months Ended
March 31,
 
   2013  2012 

Net cash provided by (used in) operating activities

  $13,025   $(1,283

Net cash provided by investing activities

   19,480    207  

Net cash (used in) provided by financing activities

   (16,458  375  

SixThree Months Ended June 30, 2012March 31, 2013 Compared to SixThree Months Ended June 30, 2011March 31, 2012

Net cash provided by operating activities was $5.7$13.0 million for the sixthree months ended June 30, 2012,March 31, 2013, compared to $29.1cash used in operations of $(1.3) million for the same period in 2011.2012. This decreaseincrease in operating cash provided by operations was primarily due to delayed paymentsan increase in accounts receivable resultingcash from changes in a year-over-year cash decrease of $16.4 million from accounts receivable. The remainingnet working capital and an increase in operating income before depreciation and amortization generated for the three months ended March 31, 2013 as compared to the same period in 2012.

Net cash provided by operations of $7.0 million was driven by changes in other working capital accounts.

Net cash used in investing activities was $0.3$19.5 million for the sixthree months ended June 30, 2012.March 31, 2013. Our investing activities for the sixthree months ended June 30,March 31, 2013 were $19.7 million in net proceeds received from the sale of the Home Health Business and the purchase of $0.2 million of property and equipment. Our investing activities for the three months ended March 31, 2012 were $0.5 million in net proceeds received for the sale of a home healthan agency and the purchase of $0.8$0.3 million of property and equipment. Our investing activities for the six months ended June 30, 2011 were $0.1 million forin capital expenditures and a $0.5 million earn-out payment for Advantage.expenditures.

Net cash used in financing activities was $6.0$16.5 million for the sixthree months ended June 30, 2012March 31, 2013 as compared to net cash used of $5.2provided by financing activities $0.4 million for the sixthree months ended June 30, 2011.March 31, 2012. Our financing activities for the sixthree months ended June 30, 2012March 31, 2013 were primarily driven by net payments of $2.8$16.2 million on the revolving credit portion of our credit facility, $2.0 million in payments on our subordinated dividend notes and $1.2$0.2 million in payments on our term loan. Our financing activities for the sixthree months ended June 30, 2011March 31, 2012 were primarily driven by $2.8$2.0 million in paymentsborrowings on the revolving credit portion of our credit facility, offset by $1.0 million in payments on subordinated dividend notes, $1.0and $0.6 million in payments on our term loan, and $0.4 million in payments on other notes.loan.

Outstanding Accounts Receivable

Outstanding accounts receivable, net of the allowance for doubtful accounts, decreased by $3.2$10.7 million as of June 30, 2012March 31, 2013 as compared to December 31, 2011.2012. The decrease in accounts receivable is primarily attributable to the consistent payments we received from the State of Illinois during the first quarter of 2013 and to a lesser extent the winding down of our Home Health Business.

We establish our allowance for doubtful accounts to the extent it is probable that a portion or all of a particular account will not be collected. Our provision for doubtful accounts is estimated and recorded primarily by aging receivables utilizing eight aging categories and applying our historical collection rates to each aging category, taking into consideration factors that might impact the use of historical collection rates or payor groups, with certain large payors analyzed separately from other payor groups. In our evaluation of these estimates, we also consider other factors including: delays in payment trends in individual states due to budget or funding issues, billing conversions related to acquisitions or internal systems, regulatory requirements for submitting Medicare billing including face-to-face and physical therapy documentation, resubmission of bills with required documentation and disputes with specific payors.

Our collection procedures include review of account agings and direct contact with our payors. We have historically not used collection agencies. An uncollectible amount, not governed by amount or aging, is written off to the allowance account only after reasonable collection efforts have been exhausted.

The following tables detail our accounts receivable before reserves by payor category, showing Illinois governmental payors separately, and segment and the related allowance amount at June 30, 2012March 31, 2013 and December 31, 2011:2012:

   June 30, 2012 
   0-90 Days  91-180 Days  181-365 Days  Over
365  Days
  Total 
   (in thousands, except percentages) 

Home & Community

      

Illinois governmental based programs

  $36,613   $10,985   $693   $451   $48,742  

Other state, local and other governmental programs

   9,762    893    755    716    12,126  

Private duty and commercial

   1,663    244    355    713    2,975  
  

 

 

  

 

 

  

 

 

  

 

 

  

 

 

 
   48,038    12,122    1,803    1,880    63,843  
  

 

 

  

 

 

  

 

 

  

 

 

  

 

 

 

Home Health

      

Medicare

   4,715    1,875    326    —      6,916  

Other state, local and other governmental programs

   1,480    116    189    161    1,946  

Private duty and commercial

   1,326    263    203    61    1,853  

Illinois governmental based programs

   173    180    151    26    530  
  

 

 

  

 

 

  

 

 

  

 

 

  

 

 

 
   7,694    2,434    869    248    11,245  
  

 

 

  

 

 

  

 

 

  

 

 

  

 

 

 

Total

  $55,732   $14,556   $2,672   $2,128   $75,088  
  

 

 

  

 

 

  

 

 

  

 

 

  

 

 

 

Related aging %

   74.2  19.4  3.6  2.8 

Allowance for doubtful accounts

      $5,947  

Reserve as % of gross accounts receivable

       7.9

 

  December 31, 2011   March 31, 2013 
  0-90 Days 91-180 Days 181-365 Days Over
365  Days
 Total   0-90 Days 91-180 Days 181-365 Days Over
365 Days
 Total 
  (in thousands, except percentages)   (in thousands, except percentages) 

Home & Community

      

Continuing operations

      

Illinois governmental based programs

  $33,233   $11,969   $416   $1,110   $46,728    $39,098   $3,484   $1,341   $911   $44,834  

Other state, local and other governmental programs

   10,106    1,077    901    1,720    13,804     10,541    888    543    231    12,203  

Private duty and commercial

   1,454    482    569    920    3,425     1,874    449    214    335    2,872  
  

 

  

 

  

 

  

 

  

 

   

 

  

 

  

 

  

 

  

 

 
   44,793    13,528    1,886    3,750    63,957     51,513    4,821    2,098    1,477    59,909  
  

 

  

 

  

 

  

 

  

 

   

 

  

 

  

 

  

 

  

 

 

Home Health

      

Aging % continuing operations

   86.0  8.0  3.5  2.5 

Discontinued operations

      

Medicare

   6,109    2,991    991    17    10,108     2,309    1,050    164    —     3,523  

Other state, local and other governmental programs

   1,617    310    259    251    2,437     303    41    25    4    373  

Private duty and commercial

   1,459    412    369    146    2,386     521    192    135    14    862  

Illinois governmental based programs

   241    249    119    60    669     125    121    38    50    334  
  

 

  

 

  

 

  

 

  

 

   

 

  

 

  

 

  

 

  

 

 
   9,426    3,962    1,738    474    15,600     3,258    1,404    362    68    5,092  
  

 

  

 

  

 

  

 

  

 

   

 

  

 

  

 

  

 

  

 

 

Total

  $54,219   $17,490   $3,624   $4,224   $79,557    $54,771   $6,225   $2,460   $1,545   $65,001  
  

 

  

 

  

 

  

 

  

 

   

 

  

 

  

 

  

 

  

 

 

Related aging %

   68.2%  22.0%  4.6%  5.2% 

Aging % of total

   84.2  9.6  3.8  2.4 

Allowance for doubtful accounts

      $7,189        $4,361  

Reserve as % of gross accounts receivable

       9.0%       6.7
  December 31, 2012 
  0-90 Days 91-180 Days 181-365 Days Over
365 Days
 Total 
  (in thousands, except percentages) 

Continuing operations

      

Illinois governmental based programs

  $38,339   $13,374   $1,076   $126   $52,915  

Other state, local and other governmental programs

   10,248    845    610    329    12,032  

Private duty and commercial

   1,936    360    127    401    2,824  
  

 

  

 

  

 

  

 

  

 

 
   50,523    14,579    1,813    856    67,771  
  

 

  

 

  

 

  

 

  

 

 

Aging % continuing operations

   74.5  21.5  2.7  1.3 

Discontinued operations

      

Medicare

   4,751    955    188    —     5,894  

Other state, local and other governmental programs

   340    109    58    —     507  

Private duty and commercial

   965    211    164    30    1,370  

Illinois governmental based programs

   128    19    35    45    227  
  

 

  

 

  

 

  

 

  

 

 
   6,184    1,294    445    75    7,998  
  

 

  

 

  

 

  

 

  

 

 

Total

  $56,707   $15,873   $2,258   $931   $75,769  
  

 

  

 

  

 

  

 

  

 

 

Aging % of total

   74.9  20.9  3.0  1.2 

Allowance for doubtful accounts

      $4,466  

Reserve as % of gross accounts receivable

       5.9

We calculate our continuing operations days sales outstanding (“DSO”) by taking the accounts receivable outstanding net of the allowance for doubtful accounts and deducting deferred revenues at the end of the period, divided by the total net service revenues for the last quarter, multiplied by the number of days in that quarter. The adjustment for deferred revenues relates to Medicare receivables which are recorded at the inception of each 60 day episode of care at the full requested anticipated payment (“RAP”) amount. Our DSOs from continuing operations were 8781 days and 9492 days at June 30, 2012March 31, 2013 and December 31, 2011,2012, respectively. The DSOs for our largest payor, the Illinois Department on Aging, at June 30, 2012March 31, 2013 and December 31, 20112012 were 12399 days and 125122 days, respectively.

Indebtedness

Credit Facility

Our credit facility most recently amended on March 2, 2012, provides a $55.0 million revolving line of credit expiring November 2, 2014, and a $5.0 million term loan maturing January 5, 2013, and includes a $15.0 million sublimit for the issuance of letters of credit.credit and previously included a $5.0 million term loan that matured and was paid on January 5, 2013. Substantially all of the subsidiaries of Holdings are co-borrowers, and Holdings has guaranteed the borrowers’ obligations under the credit facility. The credit facility is secured by a first priority security interest in all of Holdings’ and the borrowers’ current and future tangible and intangible assets, including the shares of stock of the borrowers.

The availability of funds under the revolving credit portion of the credit facility, as amended, is based on the lesser of (i) the product of adjusted EBITDA, as defined, for the most recent 12-month period for which financial statements have been delivered under the credit facility agreement multiplied by the specified advance multiple, up to 3.25, less the outstanding senior indebtedness and letters of credit, and (ii) $55.0 million less the outstanding revolving loans and letters of credit. Interest on the revolving line of credit and term loan amounts outstanding under the credit facility is payable either at a floating rate equal to the 30-day LIBOR, plus an applicable margin of 4.6% or the LIBOR rate for term periods of one, two, three or six months plus a margin of 4.6%. Interest on the credit facility will be paid monthly on or at the end of the relevant interest period, as determined in accordance with the credit facility agreement. The borrowers will pay a fee equal to 0.5% per annum of the unused portion of the revolving portion of the credit facility. Issued stand-by letters of credit will be charged at a rate of 2.0% per annum payable monthly. A balance of $22.0 million wasWe did not have any amounts outstanding on our credit facility as of June 30, 2012March 31, 2013 and the total availability under the revolving credit loan facility was $16.2 million at June 30, 2012.$47.6 million.

The credit facility contains customary affirmative covenants regarding, among other things, the maintenance of records, compliance with laws, maintenance of permits, maintenance of insurance and property and payment of taxes. The credit facility also contains certain customary financial covenants and negative covenants that, among other things, include a requirement to maintain a minimum fixed charge coverage ratio, a requirement to stay below a maximum senior leverage ratio and a requirement to stay below a maximum permitted amount of capital expenditures, as well as restrictions on guarantees, indebtedness, liens, dividends, distributions, investments and loans, subject to customary carve outs, restrictions on Holdings’ and the borrowers’ ability to enter into transactions other than in the ordinary course of business, a restriction on the ability to consummate more than three acquisitions in any calendar year, or for the purchase price of any one acquisition to exceed $0.5 million, in each case without the consent of the lenders, restrictions on mergers, transfers of assets, acquisitions, equipment, subsidiaries and affiliate transactions, subject to customary carve outs, and restrictions on fundamental changes and lines of business. We were in compliance with all of our credit facility covenants at June 30, 2012.

During the fourth quarter of 2011, the lenders under our credit facility permitted us to add back approximately $1.8 million to adjusted EBITDA for the purpose of determining availability under the credit facility. The effect of the add back was to increase availability by approximately $5.8 million until March 1, 2012. On March 1, 2012, the add back allowance was reduced by $0.2 million and will continue to be reduced by $0.2 million on the first day of each month thereafter until the add back is eliminated, which will result in a reduction in availability of $0.65 million on the first day of each month thereafter until the add back is eliminated.31, 2013.

During the second quarter of 2012, the lenders under our credit facility agreed to a modified interpretation of the credit facility as it relates to the calculation of the fixed charge ratio, which provides us with increased flexibility in meeting this covenant. In order to obtain consent from our lender for the sale of the Home Health Business we agreed to work in good faith to negotiate and enter into an amendment to the credit facility to amend certain provisions including a reduction in the maximum revolving loan limit and revolving loan commitment.

Dividend Notes

On March 18, 2010,Prior to the completion of our IPO, we amendedhad 37,750 shares of series A preferred stock issued and outstanding, all of which were converted into shares of our common stock on November 2, 2009. Shares of our series A preferred stock accumulated dividends each quarter at a rate of 10%, compounded annually. We accrued these undeclared dividends because the holders had the option to convert their shares of series A preferred stock into common stock at any time with the accumulated dividends payable in cash or a note payable. Our series A preferred stock was converted into 4,077,000 shares of common stock in connection with the completion of our IPO on November 2, 2009. We paid $0.2 million of the $13.1 million outstanding accumulated dividends as of November 2, 2009 with the remaining $12.9 million being converted into 10% junior subordinated promissory notes, which we refer to as the dividend notes. PursuantThe dividends notes were subordinated and junior to the amendments, theall obligations under our credit facility. Our dividend notes were amended to (i) extendrepaid in full during the maturity datefourth quarter of the dividend notes from September 30, 2011 to December 31, 2012, (ii) modify the amortization schedule of the dividend notes to reduce the annual principal payment amounts from $4.5 million to $1.3 million in 2010; from $3.4 million to $2.5 million in 2011; and amended total payments in 2012 to $4.1 million, and (iii) permit, based on our leverage ratio, the prepayment of all or a portion of the principal amount of the dividend notes, together with interest on the principal amount. A balance of $2.0 million was outstanding on the dividend notes as of June 30, 2012.

Off-Balance Sheet Arrangements

As of June 30, 2012,March 31, 2013, we did not have any off-balance sheet guarantees or arrangements with unconsolidated entities.

Critical Accounting Policies and Estimates

The discussion and analysis of our financial condition and results of operations are based on our consolidated financial statements prepared in accordance with accounting principles generally accepted in the United States. The preparation of the financial statements requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities, revenues and expense and related disclosures. We base our estimates and judgments on historical experience and other sources and factors that we believe to be reasonable under the circumstances; however, actual results may differ from these estimates. We consider the items discussed below to be critical because of their impact on operations and their application requires our judgment and estimates.

Revenue Recognition

The majority of our home & community segment revenues for the three months ended March 31, 2013 and 2012 from continuing operations are derived from Medicaid and Medicaid waiver programs under agreements with various state and local authorities. These agreements provide for a service term from one year to an indefinite term. Services are provided based on authorized hours, determined by the relevant state or local agency, at an hourly rate specified in the agreement or fixed by legislation. Services to other payors, such as private or commercial clients, are provided at negotiated hourly rates and recognized in net service revenues as services are provided. We provide for appropriate allowances for uncollectible amounts at the time the services are rendered.

More than half of our home health segment revenues are derived from Medicare. Home health services are reimbursed by Medicare basedThe Illinois Department on episodes of care. UnderAging initiated technical changes to the Medicare Prospective Payment System, or PPS, an episode of care is defined as a length of care up to 60 days per patient with multiple continuous episodes allowed. Billings per episode under PPS vary based on the severity of the patient’s condition and are subject to adjustment, both higher and lower,method for changes in the patient’s medical condition and certain other reasons. At the inception of each episode of care, we submit a request for anticipated payment, or RAP, to Medicare for 50% to 60% of the estimated PPS reimbursement.reimbursing providers effective May 1, 2013. We estimate the net PPS revenues to be earned during an episode of care based on the initial RAP billing, historical trends and other known factors. The net PPS revenues are initially recognized as deferredthat first quarter net service revenues and subsequently amortized as netwould have been reduced by approximately $0.6 million with no corresponding reduction in the cost of service revenues, ratably over the 60-day episodic period. At the end of each episode of care, a final billing is submitted to Medicare and anyif such changes between the initial RAP and final billings are recorded as an adjustment to net service revenues. For open episodes, we estimate net revenues based on historical data, and adjust net service revenues for the difference, if any, between the initial RAP and ultimate final claim amount.

The remaining revenueshad been in our home health segment are from state and local governmental agencies, commercial insurers and private individuals. Services are primarily provided to these payors on a per visit basis based on negotiated rates. As such, net service revenues are readily determinable and recognized at the time the services are rendered. We provide for appropriate allowances for uncollectible amounts at the time the services are rendered.effect beginning January 1, 2013.

Accounts Receivable and Allowance for Doubtful Accounts

We are paid for our services primarily by state and local agencies under Medicaid or Medicaid waiver programs, Medicare, commercial insurance companies and private individuals. While our accounts receivable are uncollateralized, our credit risk is somewhat limited due to the significance of Medicare and state agencygovernmental payors to our results of operations. Laws and regulations governing the Medicaid and Medicaregovernmental programs in which we participate are complex and subject to interpretation. Amounts collected may be different than amounts billed due to client eligibility issues, insufficient or incomplete documentation, services at levels other than authorized and other reasons unrelated to credit risk.

Legislation enacted in Illinois entitles designated service program providers to receive a prompt payment interest penalty based on qualifying services approved for payment that remain unpaid after a designated period of time. As the amount and timing of the receipt of these payments are not certain, the interest income is recognized when received and reported in the income statement caption, interest income. We did not receive any prompt payment interest in the three months ended March 31, 2013 and 2012, respectively. While we may be owed additional prompt payment interest, the amount and timing of receipt of such payments remains uncertain and we have determined that we will continue to recognize prompt payment interest income when received. The state amended its prompt payment interest terms, effective July 1, 2011, which changed the measurement period for outstanding invoices from a 60-day to a 90-day outstanding period. We believe this change in terms will reduce future amounts paid for prompt payment interest.

We establish our allowance for doubtful accounts to the extent it is probable that a portion or all of a particular account will not be collected. Our allowance for doubtful accounts is estimated and recorded primarily by aging receivables utilizing eight aging categories and applying our historical collection rates to each aging category, taking into consideration factors that might impact the use of historical collection rates or payor groups, with certain large payors analyzed separately from other payor groups. In our evaluation of these estimates, we also consider delays in payment trends in individual states due to budget or funding issues, billing conversions related to acquisitions or internal systems, resubmission of bills with required documentation and disputes with specific payors. Historically, we have not experienced any write-off of accounts as a result of a state operating with budget deficits. While we regularly monitor state budget and funding developments for the states in which we operate, we consider losses due to state credit risk on outstanding balances as remote. We believe that our recorded allowance for doubtful accounts is sufficient to cover potential losses; however, actual collections in subsequent periods may require changes to our estimates.

Goodwill and Other Intangible Assets

Our carrying value of goodwill is the residual of the purchase price over the fair value of the net assets acquired from various acquisitions, including the acquisition of Addus HealthCare.HealthCare, Inc. (“Addus HealthCare”). In accordance with ASC Topic 350, “Goodwill and Other Intangible Assets,,” goodwill and intangible assets with indefinite useful lives are not amortized. Goodwill and indefinite lived intangible assets are required to be tested for impairment at least annually. We test goodwill for impairment at the reporting unit level on an annual basis, as of October 1, or whenever potential impairment triggers occur, such as a significant change in business climate or regulatory changes that would indicate that an impairment may have occurred. Goodwill is required to be tested for

impairment at least annually usingWe may use a qualitative test, known as “Step 0” or a two-step method. The first step in the evaluation of goodwill impairment involves comparing the current fair value of each reporting unit to the recorded value, including goodwill. We use the combination of a discounted cash flow model (“DCF model”) and the market multiple analysisquantitative method to determine the current fair value of each reporting unit. The DCF model was prepared using revenuewhether impairment has occurred. We can elect to perform Step-0 an optional qualitative analysis and expense projections based on our current operating plan. As such, a number of significant assumptionsthe results skip the remaining two steps. In 2012, we elected to implement Step 0 and estimates are involved inwere not required to conduct the application of the DCF model to forecast revenue growth, price changes, gross profits, operating expenses and operating cash flows. The cash flows were discounted using a weighted average cost of capital of 14.5%, which was management’s best estimate based on our capital structure and external industry data. As part of the secondremaining two step of this evaluation, if the carrying value of goodwill exceeds its fair value, ananalysis.

We did not record any impairment loss would be recognized.

Based on updates to our business projections and forecasts, and other factors in 2011, we determined that the estimated fair value of our home health reporting unit was less than the net book value indicating that its allocated goodwill was impaired. The preliminary assessment for our home & community reportable unit indicated that its fair value was greater than its net book value with no initial indication of goodwill impairment.

As permitted by ASC Topic 350, when an impairment indicator arises toward the end of an interim reporting period, we may recognize our best estimate of that impairment loss. Based on our preliminary analysis prepared as of June 30, 2011, we determined that all of the $13.1 million allocated to goodwillcharges for the home health reportable unit as of September 30, 2011 was impairedthree months ended March 31, 2013 and we recorded a goodwill impairment loss in the third quarter of 2011. The goodwill impairment charge was noncash in nature and did not affect our liquidity or cash flows from operating activities. Additionally, the goodwill impairment had no effect on our borrowing availability or covenants under our credit facility agreement.2012.

The preliminary analysis prepared as of June 30, 2011 was subject to the completion of our annual impairment test as of October 1, 2011. We completed our annual impairment test of goodwill as of October 1, 2011 and determined that no additional impairment charges or adjustments were required. Our home & community segment had fair values in excess of carrying amounts of approximately $9.1 million, or 8.9% as of October 1, 2011.

Long-Lived Assets

We review our long-lived assets and finiteindefinite lived intangibles for impairment whenever changes in circumstances indicate that the carrying amount of an asset may not be recoverable. To determine if impairment exists, we compare the estimated future undiscounted cash flows from the related long-lived assets to the net carrying amount of such assets. If the carrying amount of an asset exceeds its estimated future cash flows, an impairment charge is recognized for the amount by which the carrying amount of the asset exceeds the estimated fair value of the asset, generally determined by discounting the estimated future cash flows. In connection with our assessment of fair value discussed above, we determined that all ofNo impairments were recorded for the $2.3 million allocated to home health finite lived intangibles were impairedthree months ended March 31, 2013 and recorded an impairment loss of $2.3 million in the third quarter of 2011.

We also have indefinite-lived assets that are not subject to amortization expense such as certificates of need and licenses to conduct specific operations within geographic markets. Our management has concluded that certificates of need and licenses have indefinite lives, as management has determined that there are no legal, regulatory, contractual, economic or other factors that would limit the useful life of these intangible assets and we intend to renew and operate the certificates of need and licenses indefinitely. The certificates of need and licenses are tested annually for impairment. In connection with our assessment of fair value discussed above, we determined that all of the $0.6 million allocated to home health certificates of need and licenses were impaired and recorded an impairment loss for 2011.2012.

Workers’ Compensation Program

Our workers’ compensation insurance program has a $350,000$0.35 million deductible component. We recognize our obligations associated with this program in the period the claim is incurred. The cost of both the claims reported and claims incurred but not reported, up to the deductible, have been accrued based on historical claims experience, industry statistics and an actuarial analysis performed by an independent third party. We monitor our claims quarterly and adjust our reserves accordingly. These costs are recorded primarily in the cost of services caption in the consolidated statement of income. Under the agreement pursuant to which we acquired Addus HealthCare, claims under our workers’ compensation insurance program that relate to December 31, 2005 or earlier are the responsibility of the selling shareholders in the acquisition, subject to certain limitations. In August 2010, the FASB issued Accounting Standards Update No 2010-24, Health Care Entities (Topic 954), “Presentation of Insurance Claims and Related Insurance Recoveries” (“ASU 2010-24”), which clarifies that companies should not net insurance recoveries against a related claim liability. Additionally, the amount of the claim liability should be determined without consideration of insurance recoveries. As of June 30, 2012March 31, 2013 and December 31, 2011,2012, we recorded $1.8$1.5 and $1.0 million in workers’ compensation insurance recovery receivables and a corresponding increase in its workers’ compensation liability. The workers’ compensation insurance recovery receivable is included in our prepaid expenses and other current assets on the balance sheet.

Income Taxes

We account for income taxes under the provisions of ASC Topic 740, “Accounting for Income Taxes.” The objective of accounting for income taxes is to recognize the amount of taxes payable or refundable for the current year and deferred tax liabilities and assets for the future tax consequences of events that have been recognized in our financial statements or tax returns. Deferred taxes, resulting from differences between the financial and tax basis of our assets and liabilities, are also adjusted for changes in tax rates and tax laws when changes are enacted. ASC 740 also requires that deferred tax assets be reduced by a valuation allowance if it is more likely than not that some portion or all of the deferred tax asset will not be realized.

 

ITEM 4.CONTROLS AND PROCEDURES

Evaluation of Disclosure Controls and Procedures

Our management, with the participation of our Chief Executive Officer and our Chief Financial Officer, evaluated the effectiveness of our disclosure controls and procedures as of June 30, 2012.March 31, 2013. The term “disclosure controls and procedures,” as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), means controls and other procedures of a company that are designed to ensure that information required to be disclosed by a company in the reports that it files or submits under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the SEC’s rules and forms. Disclosure controls and procedures include, without limitation, controls and procedures designed to ensure that information required to be disclosed by a company in the reports that it files or submits under the Exchange Act is accumulated and communicated to the company’s management, including its principal executive and principal financial officers, as appropriate to allow timely decisions regarding required disclosure. Management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving their objectives and management necessarily applies its judgment in evaluating the cost-benefit relationship of possible controls and procedures. Based on the evaluation of our disclosure controls and procedures as of June 30, 2012,March 31, 2013, our Chief Executive Officer and Chief Financial Officer concluded that, as of such date, our disclosure controls and procedures were effective.

Changes in Internal Control over Financial Reporting

There was no change in our internal control over financial reporting identified in connection with the evaluation required by Rule 13a-15(d) and 15d-15(d) of the Exchange Act that occurred during the period covered by this report that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

Given the recent increase in our share price, it is likely that we will be required to comply with Section 404 of the Sarbanes-Oxley Act during 2013.

PART II – OTHER INFORMATION

 

Item 1.Legal Proceedings

Legal Proceedings

The Company is a party to legal and/or administrative proceedings arising in the ordinary course of its business. It is the opinion of management that the outcome of such proceedings will not have a material effect on the Company’s financial position and results of operations.

 

Item 1A.Risk Factors

Investing in our common stock involves a high degree of risk. In addition to the other information set forth in this quarterly report on Form 10-Q, you should carefully consider the risk factors discussed under the caption “Risk Factors” set forth in Part I, Item 1A, of our Annual Report on Form 10-K for the year ended December 31, 2011 and Part II, Item 1A of our Quarterly Report on Form 10-Q for the quarter ended March 31, 2012. Except as set forth below, there have been no material changes to the risk factors previously disclosed under the caption “Risk Factors” in our Annual Report on Form 10-K. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially adversely affect our business, financial condition or operating results.

Changes to Medicaid, Medicaid waiver or other state and local medical and social programs could adversely affect our net service revenues and profitability.

For the year ended December 31, 2011,2012, we derived approximately 80%95% of our net service revenues from continuing operations from agreements that are directly or indirectly paid for by state and local governmental agencies, such as Medicaid funded programs and Medicaid waiver programs. Governmental agencies generally condition their agreements with us upon a sufficient budgetary appropriation. If a governmental agency does not receive an appropriation sufficient to cover its contractual obligations with us, it may terminate an agreement or defer or reduce the amount of the reimbursement we receive. Almost all the states in which we operate are facing budgetary shortfalls due to the current economic downturn and the rising costs of health care, and as a result, have made, are considering or may consider making changes in their Medicaid, Medicaid waiver or other state and local medical and social programs. The Deficit Reduction Act of 2005 permits states to make benefit cuts to their Medicaid programs, which could affect the services for which states contract with us. Changes that states have made or may consider making to address their budget deficits include:

 

limiting increases in, or decreasing, reimbursement rates;

 

redefining eligibility standards or coverage criteria for social and medical programs or the receipt of homecarehome and community based services under those programs;

 

increasing the consumer’s share of costs or co-payment requirements;

 

decreasing the number of authorized hours for recipients;

 

slowing payments to providers;

 

increasing utilization of self-directed care alternatives or “all inclusive” programs; or

 

shifting beneficiaries to managed care programs.

Certain of these measures have been implemented by, or are proposed in, states in which we operate. For example, California has considered a number of proposals, including potential changes in eligibility standards or hours utilization and Illinois has delayed payments to providers. In 2011,2012, we derived approximately 56%64% of our total net service revenues from continuing operations from services provided in Illinois, 10%7% of our total net service revenues from continuing operations from services provided in California and 7% of our total net service revenues from continuing operations from services provided in Washington. Because a substantial portion of our business is concentrated in these states, any significant reduction in expenditures that pay for our services in these states and other states in which we do business may have a disproportionately negative impact on our future operating results. Provisions in the Health Reform Act increase eligibility for Medicaid, which may cause a reallocation of Medicaid funding. It is difficult to predict at this time what the effect of these changes would be on our business. If changes in Medicaid policy result in a reduction in available funds for the services we offer, our net service revenues could be negatively impacted.

Further, in an effort to control escalating Medicaid costs, states are increasingly requiring Medicaid beneficiaries to enroll in managed care plans. Under a health reform bill signed into

law in January 2012, Illinois set a goal to increase the percentage of Medicaid beneficiaries in Medicaid managed care plans from the current 8% to 50% by 2015. The difficulty of getting healthcare providers to agree to sign up for the plans, however, has proved to be a stumbling block to managed care enrollment. States are also increasingly requiring Medicaid beneficiaries to work with case managers.

All states currently benefit from

On April 2, 2013, the Centers for Medicare and Medicaid Services published final regulations for implementation of the increased federal medical assistance percentage (“FMAP”) grantedFMAP payments for the Medicaid program under the American Recovery and ReinvestmentHealth Reform Act. Under the Health Reform Act, (“ARRA”), which increases the share of federal dollars paidFMAP to states to cover individuals who are “newly eligible” is 100% for servicescalendar years 2014-2016 and gradually decreases by 2020 to Medicaid beneficiaries.90%. Expansion States will receive a much lower 2.2% FMAP increase. Expansion States will receive the enhanced FMAP payment for those individuals who previously did not qualify for Medicaid. The final rule, among other things, establishes methodologies for states to determine who is newly eligible. Thus, we expect that not all states in which we do business will receive enhanced percentages were setFMAP payments or substantial enhanced FMAP payments. We are not able at this time to expire as of December 31, 2010 which would have occurred in the middle of most states’ 2011 fiscal year (July 2010 to June 2011). On August 10, 2010, President Obama signed into law a six-month FMAP extension through June 2011. The law scaled back the FMAP increase from the initial 6.2% to 3.2% for the first quarter (January 2011 through March 2011) and 1.2% for the second quarter (April 2011 through June 2011). It is difficult to estimatedetermine the impact lower FMAP increases is havingthese changes will have on state budgets and particularly funding of Medicaid, Medicaid waiver or other state and local medical and social programs during the extension period and any subsequent changes to FMAP upon the expiration of the extension in June 2011. our business.

The Governor of Illinois has reported that state revenue is not sufficient to keep up with pension and Medicaid obligations. On February 22, 2012, the Governor of Illinois released his proposed budget for fiscal year 2013. He called for a $2.7 billion cut to the state’s $14 billion Medicaid program. Options to reach that goal include rate reduction and reform, eliminating some services, implementing utilization controls, and restricting Medicaid eligibility so that fewer people can qualify. On March 7, 2013 the Illinois Department on Aging released a letter to all providers notifying them that it was projecting it would run out of appropriations for home and community based services by March 15, 2013. We were notified shortly thereafter that substantially all billings for our services beginning on March 1, 2013 would be held for approval pending additional appropriations. While there are bills drafted to provide supplemental appropriation to the Illinois Department on Aging, those bills have not been introduced. The Governor’s budget for fiscal year 2014 was introduced on March 6, 2013 and included funding for the Illinois Department on Aging. It is not clear whether fiscal year 2013 bills will be payable with fiscal year 2014 appropriations. Absent passage of the supplemental appropriation or approval of the fiscal year 2014 budget by the General Assembly, we are at risk of not being reimbursed for services provided from March 1, 2013 through June 30, 2013. Because a substantial portion of our business is concentrated in these programs, any significant reduction in expenditures that pay for our services maywould have a disproportionately negative impact on our future operating results.

In February 2012, CMS agreed to allow Illinois to move forward on at least one of two efforts to combat Medicaid fraud. According toIn January 2013, Illinois began a letter from CMS to the Illinois Department of Healthcare and Family Services, state health officials will be permittedprogram to verify annually the income and residency of Medicaid applicants to prevent non-residents from fraudulently obtaining health benefits intended for Illinois residents. Illinois had also requested to be permitted to verify income for qualification, but CMS’s letter did not address that. On April 19, 2012, the governor of Illinois announced a plan to cover the $2.7 billion shortfall for Medicaid, which includes reducing Medicaid spending by $2 billion. The Medicaid reductions would be accomplished by rate reductions to providers and “cuts, reductions and efficiencies,” which include enhanced eligibility verification; annual maximums for occupational therapy, physical therapy and adult speech hearing and language therapy (and reimbursement for therapies only through home health agencies), a 10% reduction in home health through utilization controls; and implementation of RAC audits. On May 24, 2012, the Illinois General Assembly passed a Medicaid reform bill that cut Medicaid spending by $1.6 billion. In response, the Illinois Department of Human Services issued a combination of emergency and proposed rules on July 13, 2012 increasing the score needed in order to qualify for the community care program and the home services program, increasing co-payments for some home health services, eliminating coverage for home health and homemaker services under the Medicaid hospice benefit, eliminating General Assistance and related medical benefits, and limiting eligibility for FamilyCare to families with income at or below 133% of the federal poverty level and incorporating the expected reductions outlined above. Another regulation would authorize the collection of interest overpayments to vendors. Home health service providers must be Medicare certified, the Medicare face-to-face rule will apply to the provision of Medicaid home health, and home health services only may be provided after a hospital admission. In addition, the Illinois Department of Human Services has the authority to reduce payment rates.

beneficiaries. If Illinois identifies nonresidentnon-resident Medicaid beneficiaries and removes them from the Medicaid rolls or prevents non-resident individuals from becoming Medicaid beneficiaries, the number of consumers we serve in Illinois could be reduced, which could negatively affect our results of operations. Similarly,or if CMS allows Illinois to verify income for Medicaid qualification and Illinois identifies Medicaid applicants or Medicaid beneficiaries who do not meet income requirements and prevents them from becoming Medicaid beneficiaries or removes beneficiaries from the Medicaid rolls, the number of consumers we serve in Illinois could similarly be reduced, which could also negatively affect our business.business and results of operations.

Changes to eligibility requirements or methods of reimbursement for home health aides in the Illinois Medicaid program could adversely affect our net service revenues and profitability.

We derived approximately 46% of our 2011 revenue from the Illinois Medicaid program. On January 25, 2011, the governor of Illinois signed into law a comprehensive Medicaid reform law that is expected to achieve savings of $624 to $774 million over five years. Among other things, subject toThe federal government approval the law expands requirementsimplemented in March 2013 certain budgetary reductions commonly known as sequestration. Reimbursement or authorizations for coordination of care for Medicaid beneficiaries, tightens the Medicaid eligibility process by requiring greater documentation to establish eligibilityservices under our programs with federal and requiring annual redetermination of eligibility. The law also establishes a moratorium on eligibility expansion and phasing out of permitting unpaid bills from one fiscal year to be paid in the following fiscal year. The law also will permit the state to move long-term care patients from institutional settings to less expensive community-based care. As previously indicated, the Illinois General Assembly passed a Medicaid reform bill that cut Medicaid spending. See the risk factor titled“Changes to Medicaid, Medicaid waiver or other state and local medical and social programs could adversely affect our net service revenues and profitability.” It is difficult to ascertain at this time what impact, if any, the new law will have on our business. If the law results in individuals having more difficulty in qualifying for the Medicaid program or results in fewer Medicaid beneficiaries qualifying for our services it would adversely affect our service revenues and profitability.

Our profitability could be negatively affected by a reduction in reimbursement from Medicare or other payors.

For the year ended December 31, 2011, we received approximately 12% of our net service revenues from Medicare. We generally receive fixed payments from Medicare for our services based on a projection of the services required by our consumers, which is generally based on acuity. For our Medicare consumers, we typically receive a 60-day episodic-based payment. Although Medicare currently provides for an annual adjustment of payment rates based on the increase or decrease of the medical care expenditure category of the Consumer Price Index, these rate increasescontracts may be less than actual inflation or costs, and could be eliminated or reduced in any given year. The base episode rate for home health services is also subject to an annual market basket adjustment. A market basket is a fixed-weight index that measures the cost of a specified mix of goods and services as compared to a base period. The home health market basket, which is used to adjust annually the Medicare base episodic rate for home health services, measures inflation or deflation in the prices of a mix of home health goods and services. This annual adjustment could also be eliminated or reduced in any given year. The Health Reform Act mandates a 1% reduction in the market basket update for 2011 and 2012 and a market basket productivity adjustment for 2015 and subsequent years. The market basket reductions may result in a negative adjustment. Medicare has in the past reclassified home health resource groups. As a result of reclassifications, we could receive lower reimbursement rates depending on the consumer’s case mix and services provided. Medicare reimbursement rates could also decline due to the imposition of co-payments or other mechanisms that shift responsibility for a portion of the amount payable to beneficiaries. Rates could also decline due to adjustments to the wage index. Changes could also occur in the therapy payment thresholds, or in reimbursement for specific thresholds, such as the changes to home health episodes with varying levels of therapy visits. Our profitability for Medicare reimbursed services largely depends upon our ability to manage the cost of providing these services. If we receive lower reimbursement rates, or if our cost of providing services increases by more than the annual Medicare price adjustment, our profitability could be adversely impacted.

The amount of reimbursement based on the home health market basket may be reduced with respect to an agency seeking reimbursement if certain requirements are not met. Reduction in the payments and cost limits for the identified basket of goods based on deflation or failure to meet certain requirements is referred to in the industry as a market basket reduction. The home health market basket increase is reduced by two percentage points to zero if an agency fails to submit certain required quality data. The required quality data consists of a set of data elements that are used to assess outcomes for adult homecare patients,actions, which include, among other things, improvements in ambulation, bathing and surgical wound status.

In November 2010, CMS released the Final 2011 Home Health PPS Update. CMS made some revisions to its proposed regulations regarding face-to-face-encounters. The physician or non-physician practitioner must have a face-to-face encounter with the patient within 90 days of the home health start date. If there is no face-to-face encounter within the 90 day period or if the encounter did not relate to the reason for home health, a face-to-face encounter must occur within 30 days after the home health start date. CMS emphasized that the certification must be dated by the physician (not the home health agency) and the patient must be under the care of a physician while receiving home health services. However, the face-to-face encounter is only required for the initial certification. The certifying physician may not be the home health agency medical director and the physician or non-physician practitioner may not have a financial relationship with the home health agency. CMS also

required that for therapy services, a qualified therapist (not a therapy assistant) must assess the patient, measure progress, and document progress toward therapy goals at least once every 30 days. For patients requiring 13 or 19 therapy visits, the qualified therapist must perform this evaluation at the 13th and 19th therapy visit. The requirement was relaxed for patients in rural areas, requiring the qualified therapist evaluation any time after the 10th visit and not later than the 13th visit, and after the 16th therapy visit but not later than the 19th visit. If more than one therapy is furnished, an evaluation must be made by a qualified therapist for each therapy. The Final 2011 Home Health PPS Update set an effective date for the face-to-face encounter requirement of January 1, 2011. After pleas from home health and hospice provider associations, physician groups and others, CMS suspended the requirement until April 1, 2011.

CMS also announced that it is going to assess a variety of home health issues, including the then current therapy threshold reimbursement. CMS also clarified its rules regarding change of ownership of home health agencies and the 36-month rule. If there is a change of ownership within 36 months of enrollment in Medicare or within 36 months of a prior change of ownership, the home health agency must undergo a new survey. CMS clarified that indirect ownership changes are not subject to the 36-month rule. There are also several exceptions to the 36-month rule but in order to qualify, the home health agency must have submitted two or more consecutive cost reports (excluding low utilization cost reports or no cost report). Exceptions to the 36-month rule include death of an owner and changes in business structure as long as ownership remains the same.

In its March 2011 report to Congress, MedPAC made several recommendations that could adversely affect the home health industry and potentially our business, including recommendations that Congress rebase the payment system in a manner that would increase payments for non-therapy services and decrease payments for therapy services and a recommendation to impose a beneficiary copayment for individuals that do not begin home health services following an inpatient stay or a stay in a post acute care facility. The Health Reform Act requires CMS to rebase payments for home health services, reducing payments beginning in 2013 with a four-year phase-in and full implementation in 2016. On July 23, 2010, CMS published the Proposed 2011 Home Health PPS Update. A proposed overall reduction in the home health payment base rate of 4.9% included a reduction for each 60-day episode and the conversion factor for NRS of 3.79%. The 3.79% decrease, which also is imposed in 2012, is a result of the CMS determination that there has been a general increase in case mix that CMS believes is unwarranted. CMS believes that this “case-mix creep” is due to improved coding, coding practice changes, and other behavioral responses to the change in reimbursement that went into effect in 2009, including greater use of high therapy treatment plans above what CMS believes is any increase in patient acuity. CMS warned that it will continue to monitor changes in case-mix. If new data identifies additional increases in case-mix, CMS will impose further reductions that will not be phased in over multiple years.

On July 12, 2011, CMS also published proposed regulations that would require physicians or their designee to have a face-to-face encounter with a beneficiary in order to certify the beneficiary for home health services reimbursed by Medicaid. The Medicaid face-to-face requirements are essentially the same as those imposed for Medicare. The face-to-face requirement may make it more difficult for Medicaid patients to obtain certification for home health services which could result in a reduction in demand for our services.

As mandated by the Health Reform Act, on October 20, 2011, CMS released final regulations for the Medicare Shared Savings Program. Although the Health Reform Act mandates that the program be established no later than January 1, 2012, CMS set start dates of April 1, 2011 and July 1, 2011. The Medicare Shared Savings Program is designed to give financial incentives to healthcare providers and suppliers that meet criteria established by DHHS that work together to manage and coordinate care through ACOs for fee-for-service Medicare beneficiaries assigned to the ACO by CMS to increase quality of care and reduce costs. Participating providers and suppliers would share in the savings generated and, in one of two plans, bear the risk of losses. In proposed regulations published April 7, 2011, CMS requested comments on a number of issues including the range of providers and suppliers that could participate in an ACO. Reaction to the proposed regulations issued on April 7, 2011 was generally negative especially with regard to start up costs, retroactive assignment of beneficiaries, antitrust issues, the proposed quality measures (both the number and complexity), and the lack of a model that only includes shared savings. The final regulations addressed several but not all of these concerns. The final regulations set a “savings-only model” where providers share any savings over a threshold amount but do not share any losses, as well as a two sided model where the ACO shares in the savings but is also at risk for losses. The number of quality measures is reduced by almost one half, and beneficiaries are assigned prospectively. In connection with the ACO rules, also on October 20, 2011, the FTC and the DOJ released a joint antitrust policy statement, the IRS released a fact sheet, and the OIG released an interim final rule with five fraud waivers (waiving prosecution under the Anti-Kickback Law, the Stark Law and the CMPL and laws regarding gain sharing arrangements.) The FTC and the DOJ antitrust policy statement addressed some but not all antitrust concerns. The OIG waivers set forth who would be protected by the waivers and under what circumstances. A home health agency cannot qualify for a waiver for activities during ACO pre-participation, which would include activities in the start-up period until an application is accepted but which CMS states could also occur during the participation period. Post-acute care facilities, such as SNFs and IRFs, can qualify for pre-participation waivers. Without a pre-participation waiver, it may be difficult for home health agencies, such as ours, to participate in the planning process for formation of an ACO and this may put us at a disadvantage in negotiating sharing of savings if we were to participate in an ACO. In addition, because other post-acute care providers, such as SNFs and IRFs, can participate in the planning process they may more readily participate in ACOs and may attract referrals that otherwise would have been made to us. On December 19, 2011, CMS announced 32 pilot “pioneer ACOs.” The first performance period began on January 1, 2012. Although provider and supplier participation in an ACO is voluntary, participation by our competitors in some markets may force us to participate as well, or if we do not participate, result in loss of business. Also, where we do not participate we will need to be mindful of quality measure criteria and if we are unable to meet those criteria we could be at risk for losing Medicare referrals. In addition, other savings programs similar to ACOs may be adopted by government and commercial payors to control costs and reduce hospital readmissions in which we could be financially at risk. We cannot predict what effect, if any, ACOs will have on our company.

Pursuant to the Final 2012 Home Health PPS Update, CMS finalized a 5.06% reduction to the national standardized 60-day episode rates to account for its perceived nominal case-mix growth since the inception of the home health PPS through 2009, phasing in the reduction over 2 years. The reduction in calendar year 2012 is 3.79% and the remaining 1.32% will be applied for calendar year 2013. The effective market basket update for calendar year 2012 is 1.4% (resulting from a market basket update of 2.4% less the required reduction of 1.0%). Home health agencies that do not meet quality data reporting requirements have a market basket update of -0.6%. After applying the 3.79% reduction, the 60-day episode rate for calendar year 2012 is lower than the rate for calendar year 2011. CMS also implemented several other changes that it had proposed in its notice of proposed rulemaking in July 2011. First, CMS removed two codes for hypertension from the home health PPS case-mix model’s hypertension group. Second, CMS revised payment weights to provide what it believes are more accurate case-mix payments, lowering the relative weights for home health episodes with a high number of therapy visits and increasing the weights for episodes with little or no therapy. The effect is to lower payments for home health episodes with high numbers of therapy visits and increase payments to episodes with little or no therapy. Third, CMS increased payments for episodes of care with three to five therapy visits so that these episodes have higher payment to cost ratios and reduced payments for episodes with 20 or just higher than 20 therapy visits so that episodes with approximately 20 therapy visits have more reasonable payment to cost ratio. Episodes with three to five therapy visits have a higher payment to cost ratio and receive higher payments and episodes of 20 or just over 20 visits have lower cost ratios. All changes were to be made in a budget neutral way. In addition, CMS clarified the definition of “confined to the home” (homebound status) for qualification for home health services and relaxed the requirement for initial physician certification for home health services permitting the patient’s attending physician at a hospital or post acute care facility to conduct the face-to-face encounter and inform the certifying physician of his or her findings. CMS also reported that for future rulemaking it plans to do further analysis of the costs for providing therapy visits and the use of therapy assistants and plans to make further rate adjustments in accordance with its findings.

On February 13, 2012, the President submitted his 2013 fiscal year budget to Congress. The budget includes a co-payment of $100 per episode of care for individuals using home health services not preceded by a hospitalization to begin in 2017. Individuals that have first dollar coverage for Medicare copayments would be assessed a Part B premium surcharge. The President’s budget is a recommendation to Congress by the President. It is not possible to know at this time whether Congress will enact into law the President’s budget proposals regarding home health services.

In its March 2012 Report to Congress, MedPAC reiterated its recommendation that Home Health reimbursement should be rebased to reduce payments.

On July 13, 2012, CMS published the proposed Medicare 2013 Home Health update. CMS proposes a 1.5% payment update reduced by 1.32% to offset what it views as case mix “creep”. CMS also proposes additional methods to enforce compliance with home health conditions of participation and the imposition of alternative sanctions for home health agencies with deficiencies, including civil monetary penalties.

Any reduction in Medicare and Medicaid reimbursements or imposition of copayments that dissuade beneficiary use of our services would materially adversely affect our profitability.

Private payors, including commercial insurance companies, could also reduce reimbursement. Any reduction in reimbursement from private payors would adversely affect our profitability.

We are subject to extensive government regulation. Changes to the laws and regulations governing our business could negatively impact our profitability and any failure to comply with these regulations could adversely affect our business.

The federal governmentbusiness and the states in which we operate regulate our industry extensively. The laws and regulations governing our operations, along with the termsresults of participation in various government programs, impose certain requirements on the way in which we do business, the services we offer, and our interactions with consumers and the public. These requirements include matters related to:operations.

 

Item 2.Unregistered Sales of Equity Securities and Use of Proceeds

licensure and certification;

adequacy and quality of health care services;

qualifications and training of health care and support personnel;

confidentiality, maintenance and security issues associated with medical records and claims processing;

relationships with physicians and other referral sources;

operating policies and procedures;

addition of facilities and services; and

billing for services.

These laws and regulations, and their interpretations, are subject to frequent change. These changes could reduce our profitability by increasing our liability, increasing our administrative and other costs, increasing or decreasing mandated services, forcing us to restructure our relationships with referral sources and providers or requiring us to implement additional or different programs and systems. Failure to comply could lead to the termination of rights to participate in federal and state-sponsored programs, the suspension or revocation of licenses and other civil and criminal penalties and a delay in our ability to bill and collect for services provided.

The Health Reform Act includes several provisions that may affect reimbursement for home health agencies. Congress directed the Secretary of DHHS to develop a program for value-based purchasing program for payments to home health agencies. The Health Reform Act also creates within CMS a Center for Medicare and Medicaid Innovation, or CMMI, to test payment and service delivery systems to reduce program expenditures. Among the issues that are to be addressed by CMMI are: allowing the states to test new models of care for individuals dually eligible for Medicare and Medicaid, supporting “continuing care hospitals” that offer post acute care during the 30 days following discharge, funding home health providers that offer chronic care management services, and establishing pilot programs that bundle acute care hospital services with physician services and post-acute care services, including home health services for patients with certain selected conditions. We may have difficulty negotiating for a fair share of the bundled payment. In addition, we may be unfairly penalized if a consumer is readmitted to the hospital within 30 days of discharge for reasons beyond our control. The Health Reform Act also requires CMS to rebase payments for home health services, reducing payments beginning 2013 with a four-year phase-in and full implementation in 2016. Reductions may not exceed 3.5% of the reimbursement in effect on March 23, 2010. The Health Reform Act mandates a 1% reduction in the market basket update for 2011 and 2012 and a market basket productivity adjustment for 2015 and subsequent years. The market basket reductions may result in a negative adjustment. The Health Reform Act reduces total payments for all home health agencies for outliers from 5% to 2.5%, and, in addition, caps payments to any one home health agency to no more than 10% of the payments received by the home health agency in a year. The Health Reform Act provides for the appointment of a 15-member Independent Medicare Advisory Board, or IMAB, that will have authority to recommend cost cutting measures to Congress to control the growth of Medicare spending, reducing expenditures to certain targeted amounts and other changes to the Medicare program. The IMAB would be appointed by the President. Congress will be severely limited in its ability to debate or modify recommendations of the IMAB, giving the IMAB broad powers to reduce Medicare spending and modify the program.

The Health Reform Act is broad, sweeping reform, and is subject to change, including through the adoption of related regulations, the way in which its provisions are interpreted and the manner in which it is enforced. The Health Reform Act is currently the subject of more than 20 constitutional challenges in federal courts. Some federal courts have upheld the constitutionality of the Health Reform Act or dismissed cases on procedural grounds. Others have held that the requirement that individuals maintain health insurance or pay a penalty to be unconstitutional, although none of the orders has enjoined its operation. On June 28, 2012, the Supreme Court issued its opinion in challenges to the Health Reform Act. The Court upheld the constitutionality of the individual mandate under Congress’ taxing power. But, the Court held that states must be able to choose whether to participate in the program of expanded eligibility for Medicaid. Several states have indicated that they may not participate.

In addition, there have been efforts in Congress to repeal or amend the Health Reform Act. It is difficult to predict the impact of the Health Reform Act due to its complexity, lack of implementing regulations or interpretive guidance, gradual or potentially delayed implementation, pending court challenges and possible amendment or repeal, as well as our inability to foresee how individuals and businesses will respond to the choices afforded them by the law. We cannot assure you, however, that the provisions described above, or that any other provisions of the Health Reform Act, will not adversely impact our business, results of operations or financial results. We may be unable to mitigate any adverse effects resulting from the Health Reform Act.

The HITECH Act established certain health information security breach notification requirements. A covered entity must notify any individual whose protected health information is breached. While we believe that we protect individuals’ health information, if our information systems are breached, we may experience reputational harm that could adversely affect our business. Recently, the OCR, which is charged with enforcement of HIPAA, has imposed substantial fines and compliance requirements on covered entities whose employees improperly disclosed individuals’ health information. Failure to comply with HIPAA and the HITECH Act could result in fines and penalties that could have a material adverse effect on us.

MedPAC made the following recommendations to Congress:None

 

Item 5.Other Information

DHHS, with the OIG, should conduct medical review activities in counties that have aberrant home health utilization;

DHHS should implement the new authorities to suspend payment and the enrollment of new providers if they indicate significant fraud;

Congress should direct the DHHS to begin a two-year rebasing of home health rates in 2013 and eliminate the market basket update for 2012;

DHHS should revise the home health case-mix system to rely on patient characteristics to set payment for therapy and nontherapy services and should no longer use the number of therapy visits as a payment factor; and

Congress should direct DHHS to establish a per episode copay for home health episodes that are not preceded by hospitalization or post-acute care use.

Many of the recommendations made by MedPAC in its March 2011 report to Congress could adversely affect the home health industry and potentially our business.None

Item 6. Exhibits

 

3.1  Amended and Restated Certificate of Incorporation of the Company dated as of November 2, 2009 (filed on November 20, 2009 as Exhibit 3.1 to the Company’s Quarterly Report on Form 10-Q and incorporated by reference herein)
3.2  Amended and Restated Bylaws of the Company, (filed on September 21, 2009 as Exhibit 3.5 toamended by the First Amendment No. 2 to the Company’s Registration Statement on Form S-1Amended and incorporated by reference herein)Restated Bylaws*
4.1  Form of Common Stock Certificate (filed on October 2, 2009 as Exhibit 4.1 to Amendment No. 4 to the Company’s Registration Statement on Form S-1 and incorporated by reference herein)
10.1  The Executive Nonqualified “Excess” Plan AdoptionAsset Purchase Agreement, dated as of February 7, 2013, by and among Addus HealthCare, Inc., dated April 1, 2012its subsidiaries identified therein, LHC Group, Inc. and its subsidiaries identified therein (filed on April 5, 2012March 6, 2013 as Exhibit 99.1 to Addus HomeCare Corporation’sthe Company’s Current Report on Form 8-K and incorporated by reference herein)
10.2The Executive Nonqualified Excess Plan Document, dated April 1, 2012 (filed on April 5, 2012 as Exhibit 99.2 to Addus HomeCare Corporation’s Current Report on Form 8-K and incorporated herein by reference)
10.3Employment Agreement, effective June 18, 2012, by and between Addus Healthcare, Inc. and Inna Berkovich (filed on June 20, 2012 as Exhibit 99.1 to Addus HomeCare Corporation’s Current Report on Form 8-K and incorporated herein by reference)8-K)
31.1  Certification of Chief Executive Officer Pursuant to Rule 13-14(a) of the Securities Exchange Act of 1934 as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002*
31.2  Certification of Chief Financial Officer Pursuant to Rule 13-14(a) of the Securities Exchange Act of 1934 as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002*
32.1  Certification 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  Certification of Chief 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 Addus HomeCare Corporation for the quarter ended JuneSeptember 30, 2012, filed on August 9,November 1, 2012, formatted in XBRL: (i) Consolidated Balance Sheets, (ii) Consolidated Statements of Income, (iii) Consolidated Statements of Stockholders’ Equity, (iv) Consolidated Statements of Cash Flows, and (v) the Notes to Condensed Consolidated Financial Statements, tagged as blocks of text.

 

*Filed herewith
**Furnished herewith

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.

 

  ADDUS HOMECARE CORPORATION

Date: AugustMay 9, 2012

2013
 By: 

/S/ MARK S. HEANEY

  

Mark S. Heaney

President and Chief Executive Officer

(As Principal Executive Officer)

Date: AugustMay 9, 2012

2013
 By: 

/S/ DENNIS B. MEULEMANS

  

Dennis B. Meulemans

Chief Financial Officer

(As Principal Financial Officer)

EXHIBIT INDEX

Item 6.Exhibits

 

3.1  Amended and Restated Certificate of Incorporation of the Company dated as of November 2, 2009 (filed on November 20, 2009 as Exhibit 3.1 to the Company’s Quarterly Report on Form 10-Q and incorporated by reference herein)
3.2  Amended and Restated Bylaws of the Company, (filed on September 21, 2009 as Exhibit 3.5 toamended by the First Amendment No. 2 to the Company’s Registration Statement on Form S-1Amended and incorporated by reference herein)Restated Bylaws*
4.1  Form of Common Stock Certificate (filed on October 2, 2009 as Exhibit 4.1 to Amendment No. 4 to the Company’s Registration Statement on Form S-1 and incorporated by reference herein)
10.1  The Executive Nonqualified “Excess” Plan AdoptionAsset Purchase Agreement, dated as of February 7, 2013, by and among Addus HealthCare, Inc., dated April 1, 2012its subsidiaries identified therein, LHC Group, Inc. and its subsidiaries identified therein (filed on April 5, 2012March 6, 2013 as Exhibit 99.1 to Addus HomeCare Corporation’sthe Company’s Current Report on Form 8-K and incorporated by reference herein)
10.2The Executive Nonqualified Excess Plan Document, dated April 1, 2012 (filed on April 5, 2012 as Exhibit 99.2 to Addus HomeCare Corporation’s Current Report on Form 8-K and incorporated herein by reference)
10.3Employment Agreement, effective June 18, 2012, by and between Addus Healthcare, Inc. and Inna Berkovich (filed on June 20, 2012 as Exhibit 99.1 to Addus HomeCare Corporation’s Current Report on Form 8-K and incorporated herein by reference)8-K)
31.1  Certification of Chief Executive Officer Pursuant to Rule 13-14(a) of the Securities Exchange Act of 1934 as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002*
31.2  Certification of Chief Financial Officer Pursuant to Rule 13-14(a) of the Securities Exchange Act of 1934 as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002*
32.1  Certification 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  Certification of Chief 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 Addus HomeCare Corporation for the quarter ended JuneSeptember 30, 2012, filed on August 9,November 1, 2012, formatted in XBRL: (i) Consolidated Balance Sheets, (ii) Consolidated Statements of Income, (iii) Consolidated Statements of Stockholders’ Equity, (iv) Consolidated Statements of Cash Flows, and (v) the Notes to Condensed Consolidated Financial Statements, tagged as blocks of text.

 

*Filed herewith
**Furnished herewith

 

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