UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10--Q
(Mark One)
x | QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the quarterly period ended June 30, 2009
OR
o | TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the transition period from _______________________ to __________________
Commission file number 0-8527
DIALYSIS CORPORATION OF AMERICA
(Exact name of registrant as specified in its charter)
Florida | 59-1757642 |
(State or other jurisdiction of incorporation | (I.R.S. Employer |
or organization) | Identification No.) |
1302 Concourse Drive, Suite 204, Linthicum, Maryland | 21090 |
(Address of principal executive offices) | (Zip Code) |
(410) 694-0500
(Registrant’s telephone number, including area code)
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15 (d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.
Yes x No o
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).
Yes o No o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer or a smaller reporting company. See definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act.
(Check one):
Large accelerated filer o | Accelerated filer x | Non-accelerated filer o | Smaller reporting company o |
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).
Yes o No x
Common Stock Outstanding
Common Stock, $.01 par value: 9,600,433 shares as of August 7, 2009.
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
INDEX
PART I -- FINANCIAL INFORMATION | 1 | ||
The Consolidated Financial Statements (Unaudited) for the three months and six months ended June 30, 2009 and June 30, 2008, include the accounts of the Registrant and its subsidiaries. | |||
1 | |||
1 | |||
2 | |||
3 | |||
4 | |||
16 | |||
24 | |||
25 | |||
26 | |||
26 | |||
27 | |||
27 |
i
Item 1. Financial Statements
CONSOLIDATED STATEMENTS OF INCOME
(unaudited)
(dollars in thousands, except share and per share amounts)
Three Months Ended | Six Months Ended | |||||||||||||||
June 30, | June 30, | |||||||||||||||
2009 | 2008 | 2009 | 2008 | |||||||||||||
Operating revenues: | ||||||||||||||||
Sales: | ||||||||||||||||
Medical services revenue | $ | 24,461 | $ | 20,519 | $ | 47,629 | $ | 40,714 | ||||||||
Product sales | 252 | 317 | 541 | 607 | ||||||||||||
Total sales revenues | 24,713 | 20,836 | 48,170 | 41,321 | ||||||||||||
Operating costs and expenses: | ||||||||||||||||
Cost of sales revenues: | ||||||||||||||||
Cost of medical services | 15,093 | 12,662 | 29,524 | 25,020 | ||||||||||||
Cost of product sales | 155 | 173 | 315 | 334 | ||||||||||||
Total cost of sales revenues | 15,248 | 12,835 | 29,839 | 25,354 | ||||||||||||
Selling, general and administrative expenses: | ||||||||||||||||
Corporate | 2,896 | 2,447 | 5,886 | 4,835 | ||||||||||||
Facility | 3,478 | 2,999 | 7,079 | 6,081 | ||||||||||||
Total | 6,374 | 5,446 | 12,965 | 10,916 | ||||||||||||
Stock compensation expense | 62 | 81 | 147 | 156 | ||||||||||||
Depreciation and amortization | 756 | 680 | 1,482 | 1,342 | ||||||||||||
Provision for doubtful accounts | 543 | 649 | 1,214 | 1,079 | ||||||||||||
22,983 | 19,691 | 45,647 | 38,847 | |||||||||||||
Operating income | 1,730 | 1,145 | 2,523 | 2,474 | ||||||||||||
Other (expense) income, net | (11 | ) | 13 | (25 | ) | (29 | ) | |||||||||
Income before income taxes | 1,719 | 1,158 | 2,498 | 2,445 | ||||||||||||
Income tax provision | 658 | 305 | 900 | 685 | ||||||||||||
Net income | 1,061 | 853 | 1,598 | 1,760 | ||||||||||||
Less: net income attributable to | ||||||||||||||||
noncontrolling interests | 352 | 190 | 710 | , 648 | ||||||||||||
Net income attributable to the company | $ | 709 | $ | 663 | $ | 888 | $ | 1,112 | ||||||||
Earnings per share: | ||||||||||||||||
Basic | $ | .07 | $ | .07 | $ | .09 | $ | .12 | ||||||||
Diluted | $ | .07 | $ | .07 | $ | .09 | $ | .12 | ||||||||
Weighted average shares outstanding: | ||||||||||||||||
Basic | 9,596,664 | 9,579,766 | 9,593,792 | 9,579,931 | ||||||||||||
Diluted | 9,617,231 | 9,613,663 | 9,612,175 | 9,614,819 | ||||||||||||
See notes to consolidated financial statements.
CONSOLIDATED BALANCE SHEETS
(dollars in thousands, except share and per share amounts)
June 30, | December 31, | |||||||
2009 | 2008(A) | |||||||
ASSETS | (unaudited) | |||||||
Current assets: | ||||||||
Cash and cash equivalents | $ | 5,365 | $ | 6,543 | ||||
Accounts receivable, less allowance | ||||||||
of $3,203 at June 30, 2009; | ||||||||
$2,540 at December 31, 2008 | 21,368 | 21,494 | ||||||
Inventories, less allowance for obsolescence | ||||||||
of $15 at June 30, 2009 and December 31, 2008 | 2,598 | 2,919 | ||||||
Deferred income tax asset | 1,185 | 1,185 | ||||||
Prepaid expenses and other current assets | 1,828 | 2,978 | ||||||
Total current assets | 32,344 | 35,119 | ||||||
Property and equipment: | ||||||||
Land | 1,333 | 1,333 | ||||||
Buildings and improvements | 5,754 | 5,722 | ||||||
Machinery and equipment | 15,524 | 15,143 | ||||||
Leasehold improvements | 10,666 | 10,789 | ||||||
33,277 | 32,987 | |||||||
Less accumulated depreciation and amortization | 15,150 | 14,452 | ||||||
18,127 | 18,535 | |||||||
Goodwill | 16,492 | 16,492 | ||||||
Other assets | 880 | 933 | ||||||
Total other assets | 17,372 | 17,425 | ||||||
$ | 67,843 | $ | 71,079 | |||||
LIABILITIES AND EQUITY | ||||||||
Current liabilities: | ||||||||
Accounts payable | $ | 6,913 | $ | 7,232 | ||||
Accrued expenses | 7,694 | 7,485 | ||||||
Income taxes payable | 109 | 61 | ||||||
Current portion of long-term debt | 77 | 74 | ||||||
Total current liabilities | 14,793 | 14,852 | ||||||
Long-term debt, less current portion | 10,235 | 14,276 | ||||||
Deferred income tax liability | 1,275 | 1,275 | ||||||
Total liabilities | 26,303 | 30,403 | ||||||
Commitments and Contingencies | ||||||||
Equity: | ||||||||
Common stock, $.01 par value, authorized 20,000,000 shares: 9,603,264 shares issued, 9,600,433 shares outstanding at June 30, 2009; 9,579,743 shares issued and outstanding at December 31, 2008 | 96 | 96 | ||||||
Additional paid-in capital | 16,168 | 16,001 | ||||||
Retained earnings | 20,055 | 19,167 | ||||||
Treasury stock at cost (2,831 shares at June 30, 2009) | (14 | ) | --- | |||||
Total company stockholders' equity | 36,305 | 35,264 | ||||||
Noncontrolling interests | 5,235 | 5,412 | ||||||
Total equity | 41,540 | 40,676 | ||||||
$ | 67,843 | $ | 71,079 | |||||
(A) Reference is made to the company’s Annual Report on Form 10-K for the year ended December 31, 2008 filed with the Securities and Exchange Commission in March, 2009.
See notes to consolidated financial statements.
2
CONSOLIDATED STATEMENTS OF CASH FLOWS
(Unaudited)
(dollars in thousands)
Six Months Ended | ||||||||
June 30, | ||||||||
2009 | 2008 | |||||||
Operating activities: | ||||||||
Net income attributable to the company | $ | 888 | $ | 1,112 | ||||
Adjustments to reconcile net income to net cash | ||||||||
provided by (used in) operating activities: | ||||||||
Depreciation and amortization | 1,482 | 1,341 | ||||||
Bad debt expense | 1,214 | 1,079 | ||||||
Stock related compensation expense | 147 | 156 | ||||||
Noncontrolling interest | 710 | 648 | ||||||
Increase (decrease) relating to operating activities from: | ||||||||
Accounts receivable | (1,088 | ) | (1,205 | ) | ||||
Inventories | 321 | (395 | ) | |||||
Prepaid expenses and other current assets | 1,150 | 939 | ||||||
Accounts payable | (319 | ) | (58 | ) | ||||
Accrued expenses | 209 | 109 | ||||||
Income taxes payable | 48 | (33 | ) | |||||
Net cash provided by operating activities | 4,762 | 3,693 | ||||||
Investing activities: | ||||||||
Additions to property and equipment, net of minor disposals | (1,021 | ) | (1,989 | ) | ||||
Payments received on physician affiliate loans | --- | 283 | ||||||
Acquisition of dialysis centers | --- | (1,270 | ) | |||||
Purchase of minority interest in subsidiaries | --- | (25 | ) | |||||
Net cash used in investing activities | (1,021 | ) | (3,001 | ) | ||||
Financing activities: | ||||||||
Line of credit borrowings | --- | 3,500 | ||||||
Line of credit repayments | (4,000 | ) | (2,650 | ) | ||||
Payments on other long-term debt | (38 | ) | (28 | ) | ||||
Exercise of stock options | 20 | --- | ||||||
Repurchase of stock | (14 | ) | --- | |||||
Capital contributions by noncontrolling interests | --- | 450 | ||||||
Distribution to noncontrolling interests | (887 | ) | (720 | ) | ||||
Net cash (used in) provided by financing activities | (4,919 | ) | 552 | |||||
(Decrease) increase in cash and cash equivalents | (1,178 | ) | 1,244 | |||||
Cash and cash equivalents at beginning of period | 6,543 | 2,448 | ||||||
Cash and cash equivalents at end of period | $ | 5,365 | $ | 3,692 | ||||
Supplemental disclosure of cash flow Information: | ||||||||
Interest paid | $ | 245 | $ | 256 | ||||
Incomes taxes paid | 197 | 388 | ||||||
See notes to consolidated financial statements.
3
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 1--SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Business
We are primarily engaged in kidney dialysis operations which include outpatient hemodialysis services, home dialysis services, inpatient dialysis services and ancillary services associated with dialysis treatments. We own 35 operating dialysis centers located in Georgia, Maryland, New Jersey, Ohio, Pennsylvania, South Carolina and Virginia. We have two Ohio dialysis facilities under development and provide inpatient dialysis treatments to 11 hospitals. Our medical products operations are not a significant component of our operations with operating revenues of $541 during the first half of 2009 and $607 for the same period of the preceding year (1.1% and 1.5%, respectively of operating revenues) and operating income of $69 during the first half of 2009 and $114 for the same period of the preceding year (2.7% and 4.6%, respectively of operating income).
Medical Services Revenue
Our medical services revenues by payor are as follows:
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
2009 | 2008 | 2009 | 2008 | |||||||||||||
Medicare | 47 | % | 48 | % | 47 | % | 47 | % | ||||||||
Medicaid and comparable programs | 8 | 9 | 8 | 9 | ||||||||||||
Hospital inpatient dialysis services | 2 | 4 | 2 | 5 | ||||||||||||
Commercial insurers and other private payors | 43 | 39 | 43 | 39 | ||||||||||||
100 | % | 100 | % | 100 | % | 100 | % |
Our sources of medical services revenue are as follows:
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||||||||||||||||||
2009 | 2008 | 2009 | 2008 | |||||||||||||||||||||||||||||
Outpatient hemodialysis services | $ | 12,302 | 50 | % | $ | 11,098 | 54 | % | $ | 24,425 | 51 | % | $ | 22,088 | 54 | % | ||||||||||||||||
Home and peritoneal dialysis services | 1,081 | 5 | 941 | 5 | 2,039 | 4 | 1,882 | 5 | ||||||||||||||||||||||||
Inpatient hemodialysis services | 581 | 2 | 842 | 4 | 1,195 | 3 | 1,912 | 5 | ||||||||||||||||||||||||
Ancillary services | 10,497 | 43 | 7,638 | 37 | 19,970 | 42 | 14,832 | 36 | ||||||||||||||||||||||||
$ | 24,461 | 100 | % | $ | 20,519 | 100 | % | $ | 47,629 | 100 | % | $ | 40,714 | 100 | % |
Consolidation
The consolidated financial statements include the accounts of Dialysis Corporation of America and its subsidiaries, collectively referred to as the “company.” All material intercompany accounts and transactions have been eliminated in consolidation.
4
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 1--SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES--Continued
Estimates
The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. Actual results could differ from those estimates.
Our principal estimates are for estimated uncollectible accounts receivable as provided for in allowance for doubtful accounts, estimated useful lives of depreciable assets, and estimates for patient revenues from non-contracted payors. Estimates are based on historical experience and assumptions believed to be reasonable given the available evidence at the time of the estimates. Actual results could differ from those estimates.
Vendor Volume Discounts
We have contractual arrangements with certain vendors pursuant to which we receive discounts based on volume of purchases. These discounts are recorded in accordance with paragraph 4 of EITF 02-16, “Accounting by a Customer for Certain Consideration Received from a Vendor,” as a reduction in inventory costs resulting in reduced costs of sales as the related inventory is utilized.
Government Regulation
A substantial portion of our revenues are attributable to payments received under Medicare, which is supplemented by Medicaid or comparable benefits in the states in which we operate.
Reimbursement rates under these programs are subject to regulatory changes and governmental funding restrictions. Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. The company believes that it is in compliance with all applicable laws and regulations. Compliance with such laws and regulations can be subject to government review and interpretation as well as regulatory action including fines, penalties, and exclusion from the Medicare and Medicaid programs.
Cash and Cash Equivalents
We consider all highly liquid investments with a maturity of three months or less when purchased to be cash equivalents. The carrying amounts reported in the balance sheet for cash and cash equivalents approximate their fair values. Although cash and cash equivalents are largely not federally insured, the credit risk associated with these deposits that typically may be redeemed upon demand is considered low due to the high quality of the financial institutions in which they are deposited.
5
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 1--SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES--Continued
Credit Risk
Our primary concentration of credit risk is with accounts receivable, which consist of amounts owed by governmental agencies, insurance companies and private patients. Receivables from Medicare and Medicaid comprised 51% of receivables at June 30, 2009 and 47% at December 31, 2008.
Inventories
Inventories are valued at the lower of cost (first-in, first-out method) or market value and consist of supplies used in dialysis treatments and the finished goods inventory of our medical products division.
Accrued Expenses
Accrued expenses are comprised as follows:
June 30, | December 31, | |||||||
2009 | 2008 | |||||||
Accrued compensation | $ | 2,216 | $ | 1,486 | ||||
Excess insurance liability | 4,194 | 4,687 | ||||||
Other | 1,284 | 1,312 | ||||||
$ | 7,694 | $ | 7,485 | |||||
Excess insurance liability represents amounts paid by insurance companies in excess of the amounts we expect from the insurers. We communicate with the payors regarding these amounts, which can result from duplicate payments, payments in excess of contractual agreements, payments as the primary insurer when payor is secondary, and underbillings by us based on estimated fee schedules. These amounts remain in excess insurance liability until resolution. We identified approximately $1,135 and $1,113 of the excess insurance liability as of June 30, 2009 and December 31, 2008, respectively, as relating to duplicate payments and other amounts that will be refunded. Approximately $3 for the three months and six months ended June 30, 2009 and $17 and $108 for the same periods of the preceding year determined to be nonrefundable that had previously been included in excess insurance liability were recorded in medical services revenues.
We have a self-insured medical and dental insurance plan administered by a third party administrator pursuant to which we are responsible for claims and administrative fees for which the obligation payable was approximately $405 at June 30, 2009 and $341 at December 31, 2008, included in other accrued expenses above.
6
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 1--SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES--Continued
Vendor Concentration
There is only one supplier of erythropoietin (“EPO”) in the United States. This supplier and another manufacturer received FDA approval for alternative products available for dialysis patients, which are indicated to be effective for a longer period than EPO. The alternative drugs also could be administered by the patient’s physician. Accordingly, the use of these drugs could reduce our revenues from our current treatment of anemia, thereby adversely impacting our revenues and profitability. There are no other suppliers of any similar drugs available to dialysis treatment providers. Revenues from the administration of EPO, which amounted to approximately $7,523 and $14,305 for the for the three months and six months ended June 30, 2009 and $5,594 and $11,165 for the same periods of the preceding year, comprised 31% and 30%, respectively for the three months and six months ended June 30, 2009 and 27% for the same periods of the preceding year of medical services revenues.
Property and Equipment
Property and equipment is stated on the basis of cost. Depreciation is computed for book purposes by the straight-line method over the estimated useful lives of the assets, which range from 5 to 34 years for buildings and improvements; 3 to 10 years for machinery, computer and office equipment, and furniture; and 5 to 10 years for leasehold improvements based on the shorter of the minimum lease term or estimated useful life of the property. Replacements and betterments that extend the lives of assets are capitalized. Maintenance and repairs are expensed as incurred. Upon the sale or retirement of assets, the related cost and accumulated depreciation are removed and any gain or loss is recognized.
Revenue Recognition
Net revenue is recognized as services are rendered at the net realizable amount from Medicare, Medicaid, commercial insurers and other third party payors. We occasionally provide dialysis treatments on a charitable basis to patients who cannot afford to pay. The amount is not significant, and we do not record revenues related to these charitable treatments. Product sales are recorded pursuant to stated shipping terms.
Goodwill
Goodwill represents cost in excess of net assets acquired. Pursuant to Statement of Financial Accounting Standards No. 142 (SFAS 142), “Goodwill and Other Intangible Assets,” goodwill and intangible assets with indefinite lives are no longer amortized but are reviewed annually (or more frequently if impairment indicators are present) for impairment, which testing has indicated no impairment for goodwill.
Deferred Expenses
Deferred expenses, except for deferred loan costs, are amortized on the straight-line method over their estimated benefit period with deferred loan costs amortized over the lives of the respective loans. Deferred expenses of approximately $613 at June 30, 2009 and $663 at December 31, 2008 are included in other assets. Amortization expense was approximately $25 and $49 for the three months and six months ended June 30, 2009, and $14 and $28 for the same periods of the preceding year.
7
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 1--SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES--Continued
Income Taxes
Deferred income taxes are determined by applying enacted tax rates applicable to future periods in which the taxes are expected to be paid or recovered to differences between financial accounting and tax basis of assets and liabilities.
We may from time to time be assessed interest or penalties by major tax jurisdictions, although such assessments historically have been minimal and immaterial to our financial results. Our policy is to recognize interest and penalties accrued on any unrecognized tax benefits as a component of income tax expense.
Stock-Based Compensation
Pursuant to Statement of Financial Accounting Standards No. 123 (revised), “Share-Based Payment,” we measure compensation cost for stock award compensation arrangements based on grant date fair value to be expensed ratably over the requisite vesting period. Stock compensation expense was approximately $29 and $81 for the three months and six months ended June 30, 2009 and $49 and $99 for the same periods of the preceding year, respectively, with related income tax benefits of $17 for shares vesting during the six months ended June 30, 2009 with no shares vesting during the second quarter of 2009 or during the first half of 2008.
During April, 2007, the company issued an incentive stock option with a total grant date value of $329. This stock option is being expensed over the four-year vesting period for which the expense amounted to approximately $21 and $41 for the three months and six months ended June 30, 2009, and for the same periods of the preceding year. The fair value of this option was estimated at the date of grant using a Black-Scholes option pricing model with the following assumptions: risk free interest rate of 4.61%; no dividend yield; volatility factor of the expected market price of our common stock of 0.666 based on historical volatility for a period coinciding with the expected option life; and an expected life of four years. During February, 2008, the company issued two incentive stock options with a total grant date value of $199. These stock options are being expensed over the four-year vesting period for which the expense amounted to approximately $12 and $25 for the three months and six months ended June 30, 2009, and $12 and $17 for the same periods of the preceding year. The fair value of these options was estimated at the date of grant using a Black-Scholes option pricing model with the following assumptions: risk free interest rate of 2.73%; no dividend yield; volatility factor of the expected market price of our common stock of 0.626 based on historical volatility for a period coinciding with the expected option life; and an expected life of four years. As these are incentive stock options, the related expense is not deductible for tax purposes.
The Black-Scholes option valuation model was developed for use in estimating the fair value of traded options which have no vesting restrictions and are fully transferable. In addition, option valuation models require the input of highly subjective input assumptions including the expected stock price volatility. Because our employee stock options have characteristics significantly different from those of traded options, and because changes in the subjective input assumptions can materially affect the fair value estimate, in management’s opinion, the existing models do not necessarily provide a reliable measure of the fair value of our employee stock options.
8
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 1--SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES--Continued
Earnings Per Share
Diluted earnings per share gives effect to potential common shares that were dilutive and outstanding during the period, such as stock options and contingently issuable shares, calculated using the treasury stock method and average market price.
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
(shares in thousands) | ||||||||||||||||
2009 | 2008 | 2009 | 2008 | |||||||||||||
Net income | $ | 709 | $ | 663 | $ | 888 | $ | 1,112 | ||||||||
Weighted average shares outstanding | 9,597 | 9,580 | 9,594 | 9,580 | ||||||||||||
Weighted average shares outstanding | 9,597 | 9,580 | 9,594 | 9,580 | ||||||||||||
Shares issuable for employee and director stock awards | 18 | 26 | 17 | 26 | ||||||||||||
Weighted average shares diluted computation | 9,615 | 9,606 | 9,611 | 9,606 | ||||||||||||
Effect of dilutive stock options | 2 | 8 | 1 | 9 | ||||||||||||
Weighted average shares, as adjusted diluted computation | 9,617 | 9,614 | 9,612 | 9,615 | ||||||||||||
Earnings per share: | ||||||||||||||||
Basic | $ | .07 | $ | .07 | $ | .09 | $ | .12 | ||||||||
Diluted | $ | .07 | $ | .07 | $ | .09 | $ | .12 | ||||||||
We had various potentially dilutive shares during the periods presented.
Other Income (Expense)
Non-operating:
Other non-operating income (expense) is comprised as follows:
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
2009 | 2008 | 2009 | 2008 | |||||||||||||
Rental income | $ | 102 | $ | 101 | $ | 205 | $ | 202 | ||||||||
Interest income | 4 | 15 | 21 | 46 | ||||||||||||
Interest expense | (118 | ) | (149 | ) | (252 | ) | (336 | ) | ||||||||
Other | 1 | 46 | 1 | 59 | ||||||||||||
Other income (expense), net | $ | (11 | ) | $ | 13 | $ | (25 | ) | $ | (29 | ) |
9
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 1--SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES--Continued
Estimated Fair Value of Financial Instruments
The carrying value of cash, accounts receivable and debt in the accompanying financial statements approximate their fair value because of the short-term maturity of these instruments, and in the case of debt because such instruments either bear variable interest rates which approximate market or have interest rates approximating those currently available to the company for loans with similar terms and maturities.
Reclassification
Certain prior year amounts have been reclassified to conform with the current year’s presentation.
Subsequent Events
We evaluated subsequent events through August 7, 2009, the date of filing of this Form 10-Q.
New Pronouncements
In February, 2008, the Financial Accounting Standards Board (FASB) issued FASB Staff Position FAS 157-2 (FSP FAS 157-2) Effective Date of FASB Statement No. 157, which deferred the effective date of SFAS 157 for nonfinancial assets and liabilities not recognized or disclosed at fair value in an entity’s financial statements on a recurring basis, until January 1, 2009. Implementation of SFAS 157 as it applies to items covered by FSP FAS 157-2 did not have a material impact on our financial statements.
In December, 2007, the FASB issued Statement of Financial Accounting Standards No. 141 (revised 2007) (SFAS 141R), “Business Combinations.” SFAS 141R expands the definitions of a business and business combination and requires all assets and liabilities of an acquired business (for full, partial and step acquisitions) to be recorded at fair values, with limited exceptions. SFAS 141R requires earn-outs and other contingent consideration to be recorded at fair value on acquisition date and contingencies to be recorded at fair value on acquisition date with provision for subsequent remeasurement. SFAS 141R requires acquisitions costs to be expensed as incurred and generally requires restructuring costs to be expensed in periods after the acquisition date. SFAS 141R requires amounts previously called “negative goodwill” which result from a bargain purchase in which acquisition date fair value of identifiable net assets acquired exceeds the fair value of consideration transferred plus any noncontrolling interest in the acquirer to be recognized in earnings as a gain attributable to the acquirer. SFAS 141R became effective for us in 2009. Its effects will depend on the nature and significance of acquisitions subsequent to its adoption.
In December, 2007, the FASB issued Statement of Financial Accounting Standards No. 160 (SFAS 160), “Noncontrolling Interests in Consolidated Financial Statements,” an amendment of ARB 51. SFAS 160 requires noncontrolling interests to be reported in the equity section of consolidated financial statements and requires that consolidated net income include the amounts attributable to both the parent and the noncontrolling interest with disclosure on the face of the consolidated income statement of net income attributable to the parent and to the noncontrolling interests, with any losses attributable to the noncontrolling interests in excess of the noncontrolling interests equity to be allocated to the noncontrolling interests. Calculation of earnings per share amounts in the consolidated financial statements will continue to be based on amounts attributable to the parent. SFAS 160 became effective for us in 2009. Its adoption resulted in presentation differences but did not have a material effect on our consolidated financial statements.
10
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 1--SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES--Continued
In May, 2009, the FASB issued Statement of Financial Accounting Standards No. 165 (SFAS 165), “Subsequent Events.” SFAS165 establishes the accounting and disclosure of events that occur after the balance sheet date but before the issuance of financial statements. SFAS 165 is effective for financial statements for periods ending after June 15, 2009. The adoption of SFAS 165 did not affect our consolidated financial statements.
NOTE 2--INTERIM ADJUSTMENTS
The financial summaries for the three months and six months ended June 30, 2009 and June 30, 2008 are unaudited and include, in the opinion of management of the company, all adjustments (consisting of normal recurring accruals) necessary to present fairly the earnings for such periods. Operating results for the three months and six months ended June 30, 2009 are not necessarily indicative of the results that may be expected for the entire year ending December 31, 2009.
While the company believes that the disclosures presented are adequate to make the information not misleading, it is suggested that these consolidated financial statements be read in conjunction with the financial statements and notes included in the company’s audited financial statements for the year ended December 31, 2008.
NOTE 3--LONG-TERM DEBT
Pursuant to a December 3, 1999 loan agreement through our subsidiary, DCA of Vineland, LLC, we obtained a $700 development loan currently secured by a mortgage on our real property in Easton, Maryland. In May, 2006, the loan was modified to extend the maturity date to May 2, 2026. Monthly payments are approximately $2 plus interest at prime. This loan had an outstanding principal balance of approximately $479 at June 30, 2009 and $495 at December 31, 2008.
In April, 2001, we obtained a $788 five-year mortgage through April, 2006, on our building in Valdosta, Georgia. We refinanced this mortgage in April, 2006 with the new mortgage having an April, 2011, maturity. Interest was at prime with a rate floor of 5.75% and a rate ceiling of 8.00% until September 15, 2008 when the rate floor was revised to 5.00% and the rate ceiling was revised to 7.50%. As of May, 2006, payments are $6 including principal and interest, with a final payment consisting of a balloon payment and any unpaid interest due April, 2011. The remaining principal balance under this mortgage amounted to approximately $532 at June 30, 2009 and $555 at December 31, 2008.
The prime rate was 3.25% at June 30, 2009 and 3.50% at December 31, 2008.
On October 24, 2005, we entered into a revolving line of credit with a maturity date, as amended, of November 4, 2011 and total availability of $25,000. Each of our wholly-owned subsidiaries has guaranteed this credit facility, as will future wholly-owned subsidiaries. Further, the obligation under the revolving line of credit is secured by our pledge of our ownership in our subsidiaries. The credit facility, which has provisions for both base rate and LIBOR loans, is intended to provide funds for the development and acquisition of new dialysis facilities, to meet general working capital requirements, and for other general corporate purposes. Up to $3,000 has been allocated for the repurchase of company stock under the stock repurchase program management established in April, 2009, provided the company continues to be in compliance with the financial covenants of the credit facility after giving effect to such stock repurchases. Borrowings under the revolving line of credit accrue interest at the base rate for base rate loans and at LIBOR for LIBOR loans, plus the applicable margin, as those terms are defined in the agreement.
11
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 3--LONG-TERM DEBT--Continued
The LIBOR applicable to a LIBOR loan is determined by the interest period selected by the company for that particular loan, which represents the duration of the loan. We have the right to convert a base rate loan to a LIBOR loan, and vice versa. The agreement contains customary reporting and financial covenant requirements for this type of credit facility. We are in compliance with the requirements of this credit facility at June 30, 2009 and December 31, 2008. Outstanding borrowings under our line of credit were $9,300 at June 30, 2009 and $13,300 at December 31, 2008. As of June 30, 2009, there were two outstanding LIBOR loans of $3,500 and $5,800 with one month terms with interest rates of 3.375% and 3.3125%, respectively, which includes LIBOR at issuance plus an applicable margin of 3.0%. The individual LIBOR loans outstanding at June 30, 2009 are renewable at the end of their respective one month terms.
Our two mortgage agreements contain certain restrictive covenants that, among other things, limit the payment of dividends, require lenders’ approval for a merger, sale of substantially all of our assets, or other business combination to which we are a party, and require maintenance of certain financial ratios. The company was in compliance with the debt covenants at June 30, 2009 and December 31, 2008.
NOTE 4--INCOME TAXES
Deferred income taxes reflect the net tax effect of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes.
No valuation allowance was recorded for deferred tax assets at June 30, 2009 or December 31, 2008, due to the company’s anticipated prospects for future taxable income in an amount sufficient to realize the deferred tax assets.
NOTE 5--STOCK OPTIONS AND STOCK AWARDS
In June, 2004, the board of directors granted 160,000 stock options to officers, directors and a key employee exercisable at $4.02 per share through June 6, 2009. The four remaining grants for 18,750 shares were exercised during June, 2009, with one 5,000 share grant exercised for approximately $20 cash proceeds and three grants for a total of 13,750 shares exercised through a cashless exercise with approximately $55 exercise price satisfied through payment of 13,750 shares resulting in an additional 8,896 shares outstanding after the exercise.
On June 27, 2006, we granted stock awards of 64,000 shares to officers and key employees with the awards vesting in equal yearly increments over four years commencing December 31, 2006. Of these stock awards, 36,000 shares were cancelled, 8,500 shares vested at the end of 2006, 6,500 shares vested at the end of 2007 and at the end of 2008, with the balance of 6,500 shares to vest at the end of 2009.
In April, 2007, the board of directors granted a five-year option to our Vice President of Operations for 50,000 shares exercisable at $12.18 through April 15, 2012. The option vests in equal increments of 12,500 shares every 12 months commencing April 15, 2008. The grant date fair value of $329 is being expensed over the four-year vesting period with approximately $21 and $41 expense recorded during the three months and six months ended June 30, 2009 and for the same periods of the preceding year.
On January 10, 2008, the board of directors granted stock awards for 13,500 shares to non-executive management personnel with the awards to vest over four years in 25% equal increments commencing on January 9, 2009. One award for 1,000 shares was cancelled due to resignation of an employee leaving awards for 12,500 shares outstanding.
12
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 5--STOCK OPTIONS AND STOCK AWARDS--Continue
On February 29, 2008, the board of directors granted a five year option to our newly appointed Chief Financial Officer for 50,000 shares exercisable at $12.18 through February 28, 2013, and a five year option to a key employee for 10,000 shares, each of the options vesting in equal increments totaling 15,000 shares every 12 months commencing February 28, 2009. The grant date fair value of approximately $199 is being expensed over the four-year vesting period with approximately $12 and $25 expense recorded during the three months and six months ended June 30, 2009 and $12 and $17 for the same periods of the preceding year.
On February 27, 2009 we granted stock awards for 5,000 shares to our four non-employee directors. These awards vested immediately resulting in an expense of $28 at the time of grant.
On June 11, 2009 we granted stock awards for 10,000 shares to our four non-employee directors. The awards vest one year from the date of issuance. The expense of $55 will be recorded over the one year period until the awards vest.
NOTE 6--COMMITMENTS
We have entered into a three-year grant agreement with the University of Cincinnati, College of Medicine, under which we will provide $265 per year for three years to support basic and clinical research and education relating to kidney disease. We will provide the University with the amounts due under the grant at the end of the first quarter of each of the three years of the agreement, with the first $265 grant paid to the University effective for 2009.
NOTE 7--ACQUISITIONS
Our various acquisitions were made either on the basis of existing profitability or expectation of future profitability for the interest acquired based on our analysis of the potential for each acquisition, and the value of the relationship with the physician affiliated with the selling entity. Each acquisition was intended to either strengthen our market share within a geographic area or provide us with the opportunity to enter a new geographic area and market. Management also reviews the purchase price and any resulting goodwill based on established current valuations for dialysis centers. Also considered are the anticipated synergistic effects of a potential acquisition, including potential costs integration and the effect of the acquisition on our overall valuation. Certain of the acquisition transactions were of minority interests held by medical directors of certain of our dialysis facilities.
These transactions resulted in an aggregate of approximately $16,492 of goodwill, representing the excess of the purchase price over the fair value of the net assets acquired, including net goodwill of $7,916 from 2008 acquisitions as further described below. The goodwill is being amortized for tax purposes over a 15-year period with the exception of $1,358 goodwill from a stock acquisition which is not amortizable for tax purposes. We have determined there is no impairment of goodwill related to any of our acquisitions.
Pursuant to a call option which was exercised on January 11, 2007, one of our subsidiaries acquired, effective January 1, 2008, the assets of a Georgia dialysis facility that we had been managing pursuant to a management services agreement. Effective January 1, 2008, we have an 80% interest in the facility, which is operated through our subsidiary with the former owner having a 20% interest. The purchase price included the 20% noncontrolling interest and approximately $2,541, one half of which was paid at closing with the remaining portion subject to a one year promissory note payable to the seller with interest at prime plus 1% which was paid in December, 2008. This transaction resulted in approximately $2,311 of goodwill amortizable over 15 years for tax purposes.
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DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 7--ACQUISITIONS--Continued
Effective March 1, 2008, we acquired the remaining 20% noncontrolling interest in DCA of Chesapeake, LLC and DCA of North Baltimore, LLC for $25. This transaction resulted in a reduction of the existing goodwill on these subsidiaries by $159.
On December 31, 2008, we acquired a Maryland dialysis center for approximately $6,627, including acquisition costs, resulting in approximately $5,715 of goodwill, the excess of the net purchase price over the estimated fair value of net assets acquired, including the valuation of a ten year non-competition agreement that will be amortized over the life of the agreement. The goodwill is amortizable for tax purposes over 15 years. The initial allocation of purchase cost at fair value was based upon available information and will be finalized as any contingent purchase amounts are resolved and estimated fair values of assets are finalized. We began recording the results of operations for the acquired company in our consolidated results of operations as of January 1, 2009.
Pro forma results of operations as if the Maryland acquisition had completed as of January 1, 2008 are as follows:
Three Months Ended | Six Months Ended | |||||||
June 30, 2008 | June 30, 2008 | |||||||
Operating revenues | $ | 22,154 | $ | 43,798 | ||||
Net income | $ | 758 | $ | 1,236 | ||||
Earnings per share: | ||||||||
Basic | $ | .08 | $ | .13 | ||||
Diluted | $ | .08 | $ | .13 |
NOTE 8--EQUITY
The changes in equity for the six months ended June 30, 2009 are summarized as follows:
Stockholders | ||||||||||||||||||||||||||||
Common Stock | Additional Paid-in Capital | Retained Earnings | Treasury Stock | Total | Noncontrolling Interests | Total | ||||||||||||||||||||||
Balance December 31, 2008 | $ | 96 | $ | 16,001 | $ | 19,167 | $ | --- | $ | 35,264 | $ | 5,412 | $ | 40,676 | ||||||||||||||
Stock related compensation expense | --- | 147 | --- | --- | 147 | --- | 147 | |||||||||||||||||||||
Distributions to noncontrolling interests | --- | --- | --- | --- | ---- | (887 | ) | (887 | ) | |||||||||||||||||||
Stock option exercises | --- | 20 | --- | --- | 20 | --- | 20 | |||||||||||||||||||||
Stock repurchases | --- | --- | --- | (14 | ) | (14 | ) | --- | (14 | ) | ||||||||||||||||||
Net income | --- | --- | 888 | --- | 888 | 710 | 1,598 | |||||||||||||||||||||
Balance June 30, 2009 | $ | 96 | $ | 16,168 | $ | 20,055 | $ | (14 | ) | $ | 36,305 | $ | 5,235 | $ | 41,540 |
14
DIALYSIS CORPORATION OF AMERICA AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2009
(unaudited)
(dollars in thousands, except per share amounts)
NOTE 9--SHARE REPURCHASE PROGRAM
On April 13, 2009, we announced that our board of directors has approved a stock repurchase program pursuant to which we are authorized to repurchase up to $3,000 of our outstanding shares. Stock purchases will be made from available cash in open market transactions at the prevailing market price or in privately negotiated transactions. We may suspend or discontinue the program at any time. Repurchases of 2,831 shares at a cost of approximately $14 were made during June, 2009.
15
Management's Discussion and Analysis of Financial Condition and Results of Operations |
Cautionary Notice Regarding Forward-Looking Information
The statements contained in this quarterly report on Form 10-Q for the quarter ended June 30, 2009, that are not historical are forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934 (the “Exchange Act”). In addition, from time to time, we or our representatives have made or may make forward looking statements, orally or in writing, and in press releases. The Private Securities Litigation Reform Act of 1995 contains certain safe harbors for forward-looking statements. Certain of the forward-looking statements include management’s expectations, intentions, beliefs and strategies regarding the growth of our company and our future operations, the character and development of the dialysis industry, anticipated revenues, our need for and sources of funding for expansion opportunities and construction, expenditures, costs and income, our business strategies and plans for future operations, potential business combinations, and similar expressions concerning matters that are not considered historical facts. Forward-looking statements also include our statements regarding liquidity, anticipated cash needs and availability, and anticipated expense levels in this Item 2, “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” commonly known as MD&A. Words such as “anticipate,” “estimate,” “expect,” “project,” “intend,” “plan” and “belief,” and words and terms of similar substance used in connection with any discussions of future operating or financial performance identify forward-looking statements. Such forward-looking statements, like all statements about expected future events, are based on assumptions and are subject to substantial risks and uncertainties that could cause actual results to materially differ from those expressed in the statements, including the general economic and market conditions which substantially deteriorated over the last 18 months, and continue in a global economic decline to date, business opportunities pursued or not pursued, competition, changes in federal and state laws or regulations affecting the company and our operations, and other factors discussed periodically in our filings. Many of the foregoing factors are beyond our control. Among the factors that could cause actual results to differ materially are the factors detailed in the risks discussed in Item 1A, “Risk Factors,” beginning on page 20 of our Annual Report on Form 10-K for the year ended December 31, 2008. If any of such events occur or circumstances arise that we have not assessed, they could have a material adverse effect upon our revenues, earnings, financial condition and business, as well as the trading price of our common stock, which could adversely affect your investment in our company. Accordingly, readers are cautioned not to place too much reliance on such forward-looking statements. All subsequent written and oral forward-looking statements attributable to us or persons acting on our behalf are expressly qualified in their entirety by the cautionary statements contained in this quarterly report. You should read this quarterly report on Form 10-Q, with any of the exhibits attached and the documents incorporated by reference, completely and with the understanding that the company’s actual results may be materially different from what we expect.
The forward-looking statements speak only as of the date of this quarterly report, and except as required by law, we undertake no obligation to rewrite or update such statements to reflect subsequent events.
MD&A is our attempt to provide a narrative explanation of our financial statements, and to provide our shareholders and investors with the dynamics of our business as seen through our eyes as management. Generally, MD&A is intended to cover expected effects of known or reasonably expected uncertainties, expected effects of known trends on future operations, and prospective effects of events that have had a material effect on past operating results.
Our discussion of MD&A should be read in conjunction with our consolidated financial statements (unaudited), including the notes, included elsewhere in this report on Form 10-Q.
Overview
We provide dialysis services, primarily kidney dialysis treatments through 35 outpatient dialysis centers, to patients with chronic kidney failure, also known as end-stage renal disease or ESRD. We provide dialysis treatments to dialysis patients of 11 hospitals and medical centers through acute inpatient dialysis services agreements with those entities. We also provide homecare services, including home peritoneal dialysis. We engage in medical product sales, which is not a significant part of our business.
16
Quality Clinical Results
Our goal is to provide consistent quality clinical care to our patients from caring and qualified doctors, nurses, patient care technicians, social workers and dieticians. We have demonstrated an unwavering commitment to quality renal care through our continuous quality improvement initiatives. We strive to maintain a leadership position as a quality provider in the dialysis industry and often set our goals to exceed the national average standards.
Kt/V is a formula that measures the amount of dialysis delivered to the patient, based on the removal of urea, an end product of protein metabolism. Kt/V provides a means to determine an individual dialysis prescription and to monitor the effectiveness or adequacy of the dialysis treatment as delivered to the patient. We believe it is critical to achieve a Kt/V level of greater than 1.2 for as many patients as possible. Approximately 98% of our patients had a Kt/V level greater than 1.2 for the second quarter ended June 30, 2009, compared to approximately 97% for the first quarter ended March 31, 2009.
Anemia is a shortage of oxygen-carrying red blood cells. Because red blood cells bring oxygen to all the cells in the body, untreated anemia can cause severe fatigue, heart disorders, difficulty concentrating, reduced immune function, and other problems. Anemia is common among renal patients, caused by insufficient erythropoietin, iron deficiency, repeated blood losses, and other factors. Anemia can be detected with a blood test for hemoglobin or hematocrit. It is ideal to have as many patients as possible with hemoglobin levels above 11. Approximately 81% of our patients had a hemoglobin level greater than 11 for the second quarter ended June 30, 2009, and for the first quarter ended March 31, 2009.
Vascular access is the site on a patient’s body where blood is removed and returned during dialysis. The Center for Medicare and Medicaid Services, CMS has indicated that fistulas are the “gold standard” for establishing access to a patient’s circulatory system in order to provide life sustaining dialysis. Approximately 60% of our patients were dialyzed with a fistula during the second quarter ended June 30, 2009, compared to approximately 57% for the first quarter ended March 31, 2009.
Patient Treatments
The following table shows the number of in-center, home and peritoneal and acute inpatient treatments performed by us through the dialysis centers we operate, and in those hospitals and medical centers with which we have inpatient acute service agreements for the periods presented:
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||||||
2009 | 2008 | 2009 | 2008 | |||||||||||||
In center | 68,308 | 61,783 | 134,445 | 120,535 | ||||||||||||
Home and peritoneal | 4,127 | 3,987 | 7,985 | 7,695 | ||||||||||||
Acute | 1,492 | 2,251 | 2,987 | 5,112 | ||||||||||||
73,927 | 68,021 | 145,417 | 133,342 |
Same Center Growth
We endeavor to increase same center growth by adding quality staff and management and attracting new patients to our existing facilities. We seek to accomplish this objective by rendering high caliber patient care in convenient, safe and pleasant conditions. We believe that we have adequate space and stations within our facilities to accommodate greater patient volume and maximize our treatment potential. We experienced approximately a 2% increase in dialysis treatments for the first half of 2009 at centers that were operable during the entire first half of the preceding year compared to a 6% increase for the first half of 2008.
17
New Business Development
Our future growth depends primarily on the availability of suitable dialysis centers for development or acquisition in appropriate and acceptable areas, and our ability to manage the development costs for these potential dialysis centers while competing with larger companies, some of which are public companies or divisions of public companies with greater numbers of personnel and financial resources available for acquiring and/or developing dialysis centers in areas targeted by us. Additionally, there is intense competition for qualified nephrologists who would serve as medical directors of dialysis facilities. We currently have two dialysis facilities under development. There is no assurance as to when any new dialysis centers or inpatient service contracts with hospitals will be implemented, or the number of stations, or patient treatments such center or service contract may involve, or if such center or service contract will ultimately be profitable.
Start-up Losses
It has been our experience that newly established dialysis centers, although contributing to increased revenues, have adversely affected our results of operations in the short term due to start-up costs and expenses and a smaller patient base. These losses are typically a result of several months of pre-opening costs, and six to eighteen months of post opening costs, in excess of revenues. We consider new dialysis centers to be “start-up centers” through their initial 12 months of operations, or when they achieve consistent profitability, whichever is sooner. For the three months and six months ended June 30, 2009, we incurred an aggregate of approximately $133,000 and $194,000 in pre-tax losses for start-up centers compared to $62,000 and $238,000 for the same period of the preceding year.
EPO Utilization
We also provide ancillary services associated with dialysis treatments, including the administration of EPO for the treatment of anemia in our dialysis patients. EPO is a bio-engineered protein that stimulates the production of red blood cells. A deteriorating kidney loses its ability to regulate the red blood cell counts, which typically results in anemia. EPO is currently available from only one manufacturer. If our available supply of EPO were reduced, either by the manufacturer or due to excessive demand, our revenues and net income would be adversely affected. The manufacturer of EPO could implement price increases which would adversely affect our net income.
ESRD patients must either obtain a kidney transplant or obtain regular dialysis treatments for the rest of their lives. Due to a lack of suitable donors and the possibility of transplanted organ rejection, the most prevalent form of treatment for ESRD patients is hemodialysis through a kidney dialysis machine. Hemodialysis patients usually receive three treatments each week with each treatment lasting between three and five hours on an outpatient basis. Although not as common as hemodialysis in an outpatient facility, home peritoneal dialysis is an available treatment option, representing the third most common type of ESRD treatment after outpatient hemodialysis and kidney transplantation.
Reimbursement
Approximately 55% of our medical services revenues for the first half of 2009 were derived from Medicare and Medicaid reimbursement with rates established by CMS, and which rates are subject to legislative changes. Dialysis is typically reimbursed at higher rates from private payors, such as a patient’s insurance carrier, as well as higher payments received under negotiated contracts with hospitals for acute inpatient dialysis services. The breakdown of our revenues by type of payor and the breakdown of our medical services revenues (in thousands) derived from our primary revenue sources and the percentage of total medical services revenue represented by each source for the periods presented are provided in Note 1 to “Notes to Consolidated Financial Statements.”
18
Compliance
The healthcare industry is subject to extensive regulation by federal and state authorities. There are a variety of fraud and abuse measures to combat waste, including Anti-Kickback regulations and extensive prohibitions relating to self-referrals, violations of which are punishable by criminal or civil penalties, including exclusion from Medicare and other governmental programs. Unanticipated changes in healthcare programs or laws could require us to restructure our business practices which, in turn, could materially adversely affect our business, operations and financial condition. We have a Compliance Program to assure that we provide the highest level of patient care and services in a professional and ethical manner consistent with applicable federal and state laws and regulations. Our Compliance Program also relates to claims submission, cost report preparation, initial audit and human resources.
Results of Operations
The following table shows our results of operations (in thousands):
Three Months Ended | Six Months Ended | |||||||||||||||
June 30 | June 30, | |||||||||||||||
2009 | 2008 | 2009 | 2008 | |||||||||||||
Medical service revenue | $ | 24,461 | $ | 20,519 | $ | 47,629 | $ | 40,714 | ||||||||
Product sales | 252 | 317 | 541 | 607 | ||||||||||||
Total sales | 24,713 | 20,836 | 48,170 | 41,321 | ||||||||||||
Cost of medical services | 15,093 | 12,662 | 29,524 | 25,020 | ||||||||||||
Cost of product sales | 155 | 173 | 315 | 334 | ||||||||||||
Total cost of sales | 15,248 | 12,835 | 29,839 | 25,354 | ||||||||||||
Corporate selling, general and administrative | 2,896 | 2,447 | 5,886 | 4,835 | ||||||||||||
Facility selling, general and administrative | 3,478 | 2,999 | 7,079 | 6,081 | ||||||||||||
Total, selling, general and administrative | 6,374 | 5,446 | 12,965 | 10,916 | ||||||||||||
Stock compensation expense | 62 | 81 | 147 | 156 | ||||||||||||
Depreciation and amortization | 756 | 680 | 1,482 | 1,342 | ||||||||||||
Provision for doubtful accounts | 543 | 649 | 1,214 | 1,079 | ||||||||||||
Total operating costs and expenses | 22,983 | 19,691 | 45,647 | 38,847 | ||||||||||||
Operating income | 1,730 | 1,145 | 2,523 | 2,474 | ||||||||||||
Other (expense) income, net | (11 | ) | 13 | (25 | ) | (29 | ) | |||||||||
Income before income taxes | 1,719 | 1,158 | 2,498 | 2,445 | ||||||||||||
Income tax provision | 658 | 305 | 900 | 685 | ||||||||||||
Net income | 1,061 | 853 | 1,598 | 1,760 | ||||||||||||
Less: net income attributable to | ||||||||||||||||
noncontrolling interests | 352 | 190 | 710 | 648 | ||||||||||||
Net income attributable to the company | $ | 709 | $ | 663 | $ | 888 | $ | 1,112 |
19
Medical services revenue increased approximately $3,942,000 (19%) and $6,915,000 (17%) for the three months and six months ended June 30, 2009 compared to the same periods of the preceding year. Medical services revenue for the three months and six months ended June 30, 2009 includes approximately $3 of amounts previously included in excess insurance liability that was determined to be non-refundable compared to approximately $17,000 and $108,000 during the same periods of the preceding year. Dialysis treatments performed increased from 68,021 during the second quarter of 2008 to 73,927 during the second quarter of 2009, a 9% increase and from 133,342 during the first half of 2008 to 145,417 during the first half of 2009, a 9% increase. Approximately $1,498,000 and $2,676,000 of the increase in medical service revenues and 4,721 and 9,386 of the increase in treatments for the three months and six months ended June 30, 2009 compared to the same periods of the preceding year are attributable to the Maryland dialysis center we acquired December 31, 2008.
Some of our patients carry commercial insurance which may require an out of pocket co-pay by the patient, which is often uncollectible by us. This co-pay is typically limited, and therefore may lead to our under-recognition of revenue at the time of service. We routinely recognize these revenues as we become aware that these limits have been met. We record contractual adjustments based on fee schedules for a patient’s insurance plan except in circumstances where the schedules are not readily determinable, in which case rates are estimated based on similar insurance plans and subsequently adjusted when actual rates are determined. Out-of-network providers generally do not provide fee schedules and coinsurance information and, consequently, represent the largest portion of contractual adjustment changes. Based on historical data we do not anticipate that a change in estimates would have a significant impact on our financial condition, results of operations or cash flows.
Operating income increased approximately $585,000 (51%) and $50,000 (2%) for the three months and six months ended June 30, 2009 compared to the same periods of the preceding year. First quarter 2009 results included our 2009 grant obligation of $265,000 to the University of Cincinnati, College of Medicine pursuant to our three year grant agreement to support basic and clinical research and education relating to kidney disease. Operating income has been negatively impacted primarily during the first quarter of 2009 by transitional costs associated with the Maryland center we acquired December 31, 2008. Start-up costs associated with our new centers was approximately $133,000 and $194,000 for the three months ended June 30, 2009 compared to $62,000 and $238,000 for the same periods of the preceding year.
Cost of medical services sales as a percentage of sales amounted to 62% for the three months and six months ended June 30, 2009 compared to 62% and 61% for the same periods of the preceding year, which includes an increase in supply costs as a percentage of medical service sales that was largely offset by decreased payroll costs as a percentage of sales revenues.
Approximately 31% and 30% of our medical services revenue for the three months and six months ended June 30, 2009 and 27% for the same periods of the preceding year derived from the administration of EPO to our dialysis patients.
Our medical products operation represents a minor portion of our operations with operating revenues of $252,000 and $541,000 for the three months and six months ended June 30, 2009 and $317,000 and $607,000 for the same periods of the preceding year (1.0% and 1.1% of operating revenues for the three months and six months ended June 30, 2009 compared to 1.5% for the same periods of the preceding year). Operating income for the medical products operation was $16,000 and $69,000 for the three months and six months ended June 30, 2009 compared to $69,000 and $114,000 for the same periods of the preceding year (.9% and2.7% of operating income for the three months and six months ended June 30, 2009 compared to 6.0% and 4.6% for the same periods of the preceding year).
Cost of sales for our medical products operation amounted to 62% and 58% of sales for the three months and six months ended June 30, 2009 compared to 55% for the same periods of the preceding year. Cost of sales for this operation is largely related to product mix.
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Selling, general and administrative expenses, those corporate and facility costs not directly related to the care of patients, including, among others, administration, accounting and billing, increased by approximately $928,000 (17%) for the three months and 2,048,000 (19%) for the six months ended June 30, 2009 compared to the same periods of the preceding year. This increase includes the Maryland dialysis center we acquired December 31, 2008, the $265,000 University of Cincinnati, College of Medicine grant during the first quarter of 2009, increased support activities resulting from expanded operations, ongoing investments in our infrastructure, and the cost of development activities. Selling, general and administrative expenses as a percentage of medical services revenue amounted to approximately 26% and 27% for the three months and six months ended June 30, 2009, and 26% for the same periods of the preceding year.
Provision for doubtful accounts decreased approximately $106,000 for the three months ended June 30, 2009 and increased approximately $134,000 for the six months ended June 30, 2009, compared to the same periods of the preceding year, which includes an increase in the commercial patient portion of our payor mix and a reduction in Medicare bad debt recoveries for the three months and six months ended June 30, 2009 compared to the same periods of the preceding year. The provision amounted to 2% and 3% of medical services revenue for the three months and six months ended June 30, 2009 and 3% for the same periods of preceding year. Medicare bad debt recoveries of $167,000 and $222,000 were recorded during the three months and six months ended June 30, 2009, compared to approximately $48,000 and $162,000 for the same periods of the preceding year. Without the effect of the Medicare bad debt recoveries, the provision for doubtful accounts would have amounted to 3% of medical services revenue for the three months and six months ended June 30, 2009 and for the same periods of the preceding year. The provision for doubtful accounts reflects our collection experience with the impact of that experience included in accounts receivable presently reserved, plus recovery of accounts previously considered uncollectible from our Medicare cost report filings. The provision for doubtful accounts is determined under a variety of criteria, primarily aging of the receivables and payor mix. Accounts receivable are estimated to be uncollectible based upon various criteria including the age of the receivable, historical collection trends and our understanding of the nature and collectibility of the receivables, and are reserved for in the allowance for doubtful accounts until they are written off.
Days’ sales outstanding were 80 as of June 30, 2009, compared to 84 as of December 31, 2008. Days’ sales outstanding are impacted by the expected and typical slower receivable turnover at our new centers opened and by payor mix. Based on our collection experience with the different payor groups comprising our accounts receivable, our analysis indicates that our allowance for doubtful accounts reasonably estimates the amount of accounts receivable that we will ultimately not collect.
After a patient’s insurer has paid the applicable coverage for the patient, the patient is billed for the applicable co-payment or balance due. If payment is not received from the patient for his applicable portion, collection letters and billings are sent to that patient until such time as the patient’s account is determined to be uncollectible, at which time the account will be charged against the allowance for doubtful accounts. Patient accounts that remain outstanding four months after initial collection efforts are generally considered uncollectible.
Non-operating expense amounted to approximately $11,000 and $25,000 for the three months and six months ended June 30, 2009 compared to non-operating income of $13,000 for the three months ended June 30, 2008 and non-operating expense of $29,000 for the six months ended June 30, 2008 which included an increase in rental income of $2,000 and $3,000, a decrease in interest income of $11,000 and $25,000 from lower interest rates on invested funds and lower average invested funds, a decrease in interest expense of $31,000 and $84,000 resulting from lower interest rates on borrowed funds and a decrease in miscellaneous other income of $45,000 and $58,000 for the three months and six months ended June 30, 2009 compared to the same periods of the preceding year.
Although operations of additional centers result in additional revenues, while these centers are in the start-up stage, their operating results adversely impact our overall results of operations until they achieve a patient count sufficient to sustain profitable operations. We had one center in the start-up stage during the first half of 2009.
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Noncontrolling interests represents the proportionate equity interests of noncontrolling owners in our subsidiaries whose financial results are included in our consolidated results.
Liquidity and Capital Resources
Working capital totaled approximately $17,551,000 at June 30, 2009, which reflected a decrease of $2,715,000 during the six months ended June 30, 2009. Included in the changes in components of working capital was a decrease in cash and cash equivalents of $1,178,000, which included net cash provided by operating activities of $4,762,000; net cash used in investing activities of $1,021,000 (consisting primarily of additions to property and equipment); and net cash used in financing activities of $4,919,000 (including repayments of $4,000,000 on our line of credit, other debt payments of $38,000, and distributions to noncontrolling interests of $887,000).
Net cash provided by operating activities consists of net income attributable to the company before non-cash items which for the first half of 2009 consisted of depreciation and amortization of $1,482,000, provision for doubtful accounts of $1,214,000, income applicable to noncontrolling interests of $710,000, and non-cash stock and stock option compensation expense of $147,000, as adjusted for changes in components of working capital. Significant changes in components of working capital, in addition to the $1,178,000 decrease in cash, included an increase in accounts receivable of $126,000, a decrease in inventories of $321,000, a decrease in prepaid expenses and other current assets of $1,150,000, including a reduction of approximately $650,000 in prepaid income taxes as a result of application of tax prepayments to tax liabilities and a decrease of approximately $150,000 in estimated medicare bad debt recoveries, a decrease in accounts payable of $319,000, and an increase in accrued expenses of 209,000. The major uses of cash in operating activities are supply costs, payroll, independent contractor costs, and costs for our leased facilities.
Our Easton, Maryland building has a mortgage to secure a subsidiary development loan. This loan had a remaining principal balance of $479,000 at June 30, 2009 and $495,000 at December 31, 2008. Our mortgage on our building in Valdosta, Georgia due in April, 2011 had an outstanding principal balance of approximately $532,000 at June 30, 2009 and $555,000 at December 31, 2008.
We are in the process of developing two new Ohio dialysis centers.
Capital is needed primarily for the development of outpatient dialysis centers. The construction of a 15 station facility, typically the size of our dialysis facilities, costs in the range of $1,000,000 to $1,500,000, depending on location, size and related services to be provided, which includes equipment and initial working capital requirements. Acquisition of an existing dialysis facility is more expensive than construction, although acquisition would provide us with an immediate ongoing operation, which most likely would be generating income. Although our expansion strategy focuses primarily on construction of new centers, we have expanded through acquisition of dialysis facilities and continue to review potential acquisitions. Development of a dialysis facility to initiate operations takes four to six months and usually up to 12 months or longer to generate earnings. We consider some of our centers to be in the developmental stage since they have not developed a patient base sufficient to generate and sustain earnings.
We are seeking to expand our outpatient dialysis treatment facilities and inpatient dialysis care and are presently in different phases of negotiations with physicians and others for the development or acquisition of additional outpatient centers. Such expansion requires capital. We have been funding our expansion through internally generated cash flow and a revolving line of credit with KeyBank National Association. To assist with our future expansion we have a $25,000,000 revolving line of credit with KeyBank National Association maturing November 4, 2011. We had outstanding borrowings of $9,300,000 under this credit facility as of June 30, 2009 and $13,300,000 as of December 31, 2008. No assurance can be given that we will be successful in implementing our growth strategy or that available financing will be adequate to support our expansion.
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New Accounting Pronouncements
In February, 2008, the FASB issued Staff Position FAS 157-2 (FSP FAS 157-2) Effective Date of FASB Statement No. 157, which deferred the effective date of SFAS 157 for nonfinancial assets and liabilities not recognized or disclosed at fair value in an entity’s financial statements on a recurring basis, until January 1, 2009. Implementation of SFAS 157 as it applies to items covered by FSP FAS 157-2 did not have a material impact on our financial statements.
In December, 2007, the FASB issued Statement of Financial Accounting Standards No. 141 (revised 2008) (SFAS 141R), “Business Combinations.” SFAS 141R expands the definitions of a business and a business combination and requires all assets and liabilities of an acquired business (for full, partial and step acquisitions) to be recorded at fair values, with limited exceptions. SFAS 141R became effective for us in 2009. Its effects will depend on the nature and significance of acquisitions subsequent to its adoption.
In December, 2007, the FASB issued Statement of Financial Accounting Standards No. 160 (SFAS 160), “Noncontrolling Interests in Consolidated Financial Statements,” an amendment of ARB 51. SFAS 160 requires noncontrolling interests to be reported in the equity section of consolidated financial statements and requires that consolidated net income include the amounts attributable to both the parent and noncontrolling interests with these amounts disclosed on the face of the consolidated income statement and requires any losses attributable to the noncontrolling interests in excess of noncontrolling interests in equity to be allocated to the noncontrolling interests. SFAS 160 became effective for us in 2009. Its adoption resulted in presentation differences but did not have a material effect on our consolidated financial statements.
In May, 2009, the FASB issued Statement of Financial Accounting Standards No. 165 (SFAS 165), “Subsequent Events,” that became effective for us in June, 2009. SFAS 165, which establishes the accounting and disclosure of events that occur after the balance sheet date but before financial statements are issued, did not affect our financial statements.
Critical Accounting Policies and Estimates
The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make judgments and estimates. On an on-going basis, we evaluate our estimates, the most significant of which include establishing allowances for doubtful accounts, a valuation allowance for our deferred tax assets and determining the recoverability of our long-lived assets. The basis for our estimates are historical experience and various assumptions that are believed to be reasonable under the circumstances, given the available information at the time of the estimate, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily available from other sources. Actual results may differ from the amounts estimated and recorded in our financial statements.
We believe the following critical accounting policies affect our more significant judgments and estimates used in the preparation of our consolidated financial statements.
Revenue Recognition: Revenues are recognized net of contractual provisions at the expected collectable amount. We receive payments through reimbursement from Medicare and Medicaid for our outpatient dialysis treatments coupled with patients’ private payments, individually and through private third-party insurers. A substantial portion of our revenues are derived from the Medicare ESRD program, which outpatient reimbursement rates are fixed under a composite rate structure, which includes the dialysis services and certain supplies, drugs and laboratory tests. Certain of these ancillary services are reimbursable outside of the composite rate. Medicaid reimbursement is similar and supplemental to the Medicare program. Our acute inpatient dialysis operations are paid under contractual arrangements, usually at higher contractually established rates, as are certain of the private
pay insurers for outpatient dialysis. We have a sophisticated information and computerized coding system, but due to the complexity of the payor mix and regulations, we sometimes receive more or less than the amount expected when the services are provided. We reconcile any differences at least quarterly.
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In those situations where a patient’s insurance fee schedule cannot be readily determined, which typically occurs with out of network providers, we estimate fees based on our knowledge base of historical data for patients with similar insurance plans. Our internal controls, including an ongoing review and follow-up on estimated fees, allow us to make necessary changes to estimated fees on a timely basis. When the actual fee schedule is determined, we adjust the amounts originally estimated, and then use the actual fees to estimate fees for similar future situations. We adhere to the guidelines of SAB Topic 13 in regard to recording reasonable estimates of revenue based on our historical experience and identifying on a timely basis necessary changes to estimates.
Allowance for Doubtful Accounts: We maintain an allowance for doubtful accounts for estimated losses resulting from the inability of our patients or their insurance carriers to make required payments. Based on historical information, we believe that our allowance is adequate. Changes in general economic, business and market conditions could result in an impairment in the ability of our patients and the insurance companies to make their required payments, which would have an adverse effect on cash flows and our results of operations. The allowance for doubtful accounts is reviewed monthly and changes to the allowance are updated based on actual collection experience. We use a combination of percentage of sales and the aging of accounts receivable to establish an allowance for losses on accounts receivable. We adhere to the guidelines of Statement of Financial Accounting Standards No. 5, “Accounting for Contingencies” in determining reasonable estimates of accounts for which uncollectibility is possible.
Valuation Allowance for Deferred Tax Assets: The carrying value of deferred tax assets assumes that we will be able to generate sufficient future taxable income to realize the deferred tax assets based on estimates and assumptions. If these estimates and assumptions change in the future, we may be required to adjust our valuation allowance for deferred tax assets which could result in additional income tax expense.
Long-Lived Assets: We state our property and equipment at acquisition cost and compute depreciation for book purposes by the straight-line method over estimated useful lives of the assets. In accordance with Statement of Financial Accounting Standards No. 144, “Accounting for the Impairment or Disposal of Long-Lived Assets,” long-lived assets are reviewed for impairment whenever events or changes in circumstances indicate the carrying amount of the asset may not be recoverable. Recoverability of assets to be held and used is measured by comparison of the carrying amount of an asset to the future cash flows expected to be generated by the asset. If the carrying amount of the asset exceeds its estimated future cash flows, an impairment charge is recognized to the extent the carrying amount of the asset exceeds the fair value of the asset. These computations are complex and subjective.
Goodwill and Intangible Asset Impairment: In assessing the recoverability of our goodwill and other intangibles we must make assumptions regarding estimated future cash flows and other factors to determine the fair value of the respective assets. This impairment test requires the determination of the fair value of the intangible asset. If the fair value of the intangible asset is less than its carrying value, an impairment loss will be recognized in an amount equal to the difference. If these estimates or their related assumptions change in the future, we may be required to record impairment charges for these assets. According to Statement of Financial Accounting Standards No. 142, “Goodwill and Other Intangible Assets,” we analyze goodwill and indefinite lived intangible assets for impairment on at least an annual basis or when conditions warrant.
Quantitative and Qualitative Disclosures About Market Risk |
We do not consider our exposure to market risks, principally changes in interest rates, to be significant.
Sensitivity of results of operations to interest rate risks on our investments is managed by conservatively investing funds in liquid interest bearing accounts of which we held approximately $5,098,000 at June 30, 2009.
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Interest rate risk on debt is managed by negotiation of appropriate rates for equipment financing and other fixed rate obligations based on current market rates. There is an interest rate risk associated with our variable rate debt obligations, which totaled approximately $10,312,000 at June 30, 2009.
We have exposure to both rising and falling interest rates. Due to the global financial crisis and the correspondingly exceedingly low interest rates on invested funds, there was no substantial risk of a decrease in interest income as a result of decreased yields at June 30, 2009. Assuming a relative 15% increase in rates on our period-end variable rate debt would have resulted in a negative impact of approximately $10,000 on our results of operations for the six months ended June 30, 2009.
We do not utilize financial instruments for trading or speculative purposes and do not currently use interest rate derivatives.
Controls and Procedures |
Effectiveness of Disclosure Controls and Procedures.
As of the end of the period of this quarterly report on Form 10-Q for the second quarter ended June 30, 2009, management carried out an evaluation, under the supervision and with the participation of our President and Chief Executive Officer, and our Vice President of Finance and Chief Financial Officer, of the effectiveness of the design and operation of our disclosure controls and procedures pursuant to Rule 13a-15(b) of the Securities Exchange Act of 1934 (the “Exchange Act”). These disclosure controls and procedures are designed to provide reasonable assurance that, among other things, information is accumulated and communicated to our management, including our President and Chief Executive Officer, and our Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure. Based upon such evaluation, our President and Chief Executive Officer, and our Chief Financial Officer, have concluded that, as of the end of such period, our disclosure controls and procedures are effective in providing reasonable assurance that information required to be disclosed by our company in the reports that it files under the Exchange Act is recorded, processed, summarized and reported within required time periods specified by the SEC’s rules and forms.
Internal Control Over Financial Reporting.
There were no changes in our internal control over financial reporting that occurred during our most recent fiscal quarter ended June 30, 2009 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
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OTHER INFORMATION
Unregistered Sales of Equity Securities and Use of Proceeds |
(a) Four options granted in June, 2004 for 18,750 shares of common stock were exercised at the $4.02 per share exercise price. Three of these options for 5,000 shares each had been registered under the Securities Act of 1933, as amended (the “Securities Act”) and held by the independent directors of the Company. The fourth option for 3,750 shares was held by a former President of the Company which option shares were not registered. One director exercised his option for cash for $20,100. The remaining options were exercised with option shares at the fair market value on the date of exercise of approximately $5.60 per share resulting in 9,854 option shares aggregating approximately $55,000 being paid to the Company. Shares issued by the Company as a result of these exercises amounted to 7,834 shares of common stock, all of which were previously included in a registration statement for issuance to the directors, and 1,062 shares issued under a non-public offering exemption of Section 4(2) (a private placement) from the registration requirements of the Securities Act to the former President of the Company, who is knowledgeable of the Company.
(b) In June, 2009, the Company effected its first repurchases of its common stock under its stock repurchase program announced in April, 2009, pursuant to which it may purchase up to $3,000,000 of its outstanding common stock. Based on the $5.01 closing price on June 30, 2009 would result in the potential repurchase of approximately 598,800 shares of common stock.
Issuer Purchases of Equity Securities
(a) | (b) | (c) | (d) | |||||||||||||
Period | Total No. of Shares (or Units) Purchased | Average Price Paid per Share (or Unit) | Total No. of Shares (or Units) Purchased as Part of Publicly Announced Plans or Programs | Maximum No. (or Approximate Dollar Value) of Shares (or Units) That May Yet Be Purchased Under the Plans or Programs | ||||||||||||
April 1 – 30 | --- | --- | --- | --- | ||||||||||||
May 1 – 31 | --- | --- | --- | --- | ||||||||||||
June 1 – 30 | 2,831 | $ | 4.97 | 2,831 | $ | 2,986,000 | ||||||||||
Repurchases are effected through open market transactions at the prevailing market prices, as were the June, 2009 transactions referred to in the above table, or in privately negotiated transactions. The repurchase program is continuing, although we may suspend or discontinue the program at any time.
Although not part of the repurchase program, certain of our affiliates purchased common stock in open market transactions during the second quarter, 2009, at prevailing market prices, to wit:
May, 2009
Thomas Carey, V.P., Operations, 3,500 shares at approximately $4.44
Stephen W. Everett, President & CEO, 1,500 shares at $4.55
Joanne Zimmerman, V.P., Clinical Services & Compliance Officer, 700 shares at $4.38
June, 2009
Joanne Zimmerman, V.P., Clinical Services & Compliance Officer, 1,000 shares at $4.60
For information with respect to acquisitions pursuant to option exercises, see subparagraph (a) above.
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The declaration and issuance of cash dividends are subject to the covenants in the KeyBank National Association credit facility, which precludes the payment of dividends (other than stock dividends). We also have a mortgage with Ameris Bank on our property in Valdosta, Georgia which restricts the payment of dividends above 25% of our net worth. See Note 3, “Long Term Debt,” to “Notes to Consolidated Financial Statements” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” under “Liquidity and Capital Resources” of Part I of this Quarterly Report.
Submission of Matters to a Vote of Security Holders |
On June 11, 2009, the company held its annual meeting of shareholders to vote on three matters: (i) the election of five directors; (ii) approval and adoption of the Dialysis Corporation of America 2009 Omnibus Incentive Plan (the “Plan”); and (iii) to ratify the appointment of MSPC Certified Public Accountants and Advisors, P.C. (“MSPC”), as independent auditors of the company for the 2009 fiscal year. All directors were elected, the Plan was approved and adopted by the shareholders, and the appointment of the independent auditors was ratified. The voting tabulations were as follows:
Election of Directors:
For | Withheld | Total | |||
Thomas K. Langbein | 7,557,271 | 607,620 | = | 8,164,891 | |
Stephen W. Everett | 7,709,803 | 455,088 | = | 8,164,891 | |
Peter D. Fischbein | 7,622,393 | 542,498 | = | 8,164,891 | |
Robert W. Trause | 7,493,846 | 671,045 | = | 8,164,891 | |
Kenneth J. Bock | 7,643,320 | 521,571 | = | 8,164,891 |
Approval and adoption of the Plan
For | Against | Abstain | Total | ||
4,467,727 | 1,763,941 | 59,752 | = | 6,291,420 |
Ratification of appointment of MSPC as the company’s independent auditors for fiscal 2009:
For | Against | Abstain | Total | ||
7,991,797 | 160,413 | 12,681 | = | 8,164,891 |
Exhibits |
31 | Rule 13a-14(a)/15d-14(a) Certifications | ||
31.1 | Certification of the Chief Executive Officer pursuant to Rule 13a-14(a) of the Securities Exchange Act of 1934. | ||
31.2 | Certification of the Chief Financial Officer pursuant to Rule 13a-14(a) of the Securities Exchange Act of 1934. | ||
32 | Section 1350 Certifications | ||
32.1* | Certifications of the Chief Executive Officer and the Chief Financial Officer pursuant to Rule 13a-14(b) of the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350. |
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_______________
* | In accordance with Release No. 34-47551, this exhibit is furnished to the SEC as an accompanying document and is not deemed to be “filed” for the purposes of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that Section, and the document will not be deemed incorporated by reference into any filing under the Securities Act of 1933. |
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.
DIALYSIS CORPORATION OF AMERICA | |||
By: | /s/ ANDREW JEANNERET | ||
ANDREW JEANNERET, Vice President, Finance and | |||
Chief Financial Officer |
Dated: August 7, 2009
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EXHIBIT INDEX
Exhibit No. | |||
31 | Rule 13a-14(a)/15d-14(a) Certifications | ||
31.1 | Certification of the Chief Executive Officer pursuant to Rule 13a-14(a) of the Securities Exchange Act of 1934. | ||
31.2 | Certification of the Chief Financial Officer pursuant to Rule 13a-14(a) of the Securities Exchange Act of 1934. | ||
32 | Section 1350 Certifications | ||
32.1* | Certifications of the Chief Executive Officer and the Chief Financial Officer pursuant to Rule 13a-14(b) of the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350. |
_______________
* | In accordance with Release No. 34-47551, this exhibit is furnished to the SEC as an accompanying document and is not deemed to be “filed” for the purposes of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that Section, and the document will not be deemed incorporated by reference into any filing under the Securities Act of 1933. |
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