Brilliant Acquisition 10-Q 10 Mar 14 2014 Q1 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	3 Months Ended
	Jan. 31, 2014	Mar. 07, 2014
Document and Entity Information	'	'
Entity Registrant Name	'BIO REFERENCE LABORATORIES INC	'
Entity Central Index Key	'0000792641	'
Document Type	'10-Q	'
Document Period End Date	31-Jan-14	'
Amendment Flag	'false	'
Current Fiscal Year End Date	'--10-31	'
Entity Current Reporting Status	'Yes	'
Entity Filer Category	'Accelerated Filer	'
Entity Common Stock, Shares Outstanding	'	27,716,644
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q1	'

CONSOLIDATED_BALANCE_SHEETS

CONSOLIDATED BALANCE SHEETS (USD $)	Jan. 31, 2014	Oct. 31, 2013
In Thousands, unless otherwise specified
CURRENT ASSETS:	'	'
Cash and Cash Equivalents	$14,533	$17,952
Accounts Receivable - Net	217,741	206,261
Inventory	21,742	19,095
Other Current Assets	9,127	9,416
Deferred Tax Assets	36,265	42,154
TOTAL CURRENT ASSETS	299,408	294,878
PROPERTY AND EQUIPMENT - AT COST	139,917	133,599
LESS: Accumulated Depreciation	-72,804	-67,950
PROPERTY AND EQUIPMENT - NET	67,113	65,649
OTHER ASSETS:	'	'
Investments	5,207	5,237
Deposits	1,020	1,017
Goodwill - Net	35,185	35,185
Intangible Assets - Net	16,091	16,320
Other Assets	1,165	1,165
Deferred Tax Assets	2,447	2,077
TOTAL OTHER ASSETS	61,115	61,001
TOTAL ASSETS	427,636	421,528
CURRENT LIABILITIES:	'	'
Accounts Payable	64,055	61,614
Accrued Salaries and Commissions Payable	14,754	19,601
Accrued Taxes and Expenses	17,267	18,292
Other Short Term Acquisition Payable	3,969	2,438
Revolving Note Payable - Bank	29,979	26,139
Current Maturities of Long-Term Debt	501	493
Capital Lease Obligations - Short-Term Portion	5,770	5,185
TOTAL CURRENT LIABILITIES	136,295	133,762
LONG-TERM LIABILITIES:	'	'
Capital Lease Obligations - Long-Term Portion	12,839	10,712
Long Term Debt - Net of Current Portion	3,541	3,670
Long Term Acquisition Payable	'	1,789
TOTAL LONG-TERM LIABILITIES	16,380	16,171
SHAREHOLDERS' EQUITY:	'	'
Preferred Stock, Authorized 1,666,667 shares, including 3,000 shares of Series A Junior Preferred Stock None Issued	'	'
Common Stock, $.01 Par Value; Authorized 35,000,000 shares: Issued and Outstanding 27,710,644 and 27,683,213 at January 31, 2014 and at October 31, 2013, respectively	277	277
Additional Paid-In Capital	39,842	39,430
Retained Earnings	234,842	231,888
TOTAL SHAREHOLDERS' EQUITY	274,961	271,595
TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY	$427,636	$421,528

CONSOLIDATED_BALANCE_SHEETS_Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) (USD $)	Jan. 31, 2014	Oct. 31, 2013
Preferred Stock, Authorized shares, including Series A Junior Preferred Stock	1,666,667	1,666,667
Preferred Stock, Issued shares	0	0
Common Stock, Par Value (in dollars per share)	$0.01	$0.01
Common Stock, Authorized shares	35,000,000	35,000,000
Common Stock, Issued shares	27,710,644	27,683,213
Common Stock, Outstanding shares	27,710,644	27,683,213
Series A Junior Preferred Stock	'	'
Preferred Stock, Authorized shares	3,000	3,000

CONSOLIDATED_STATEMENTS_OF_OPE

CONSOLIDATED STATEMENTS OF OPERATIONS (USD $)	3 Months Ended
In Thousands, except Share data, unless otherwise specified	Jan. 31, 2014	Jan. 31, 2013
CONSOLIDATED STATEMENTS OF OPERATIONS	'	'
NET REVENUES:	$181,270	$161,256
COST OF SERVICES:	'	'
Depreciation	4,575	3,538
Employee Related Expenses	49,110	40,059
Reagents and Lab Supplies	37,231	31,703
Other Cost of Services	18,200	15,034
TOTAL COST OF SERVICES	109,116	90,334
GROSS PROFIT ON REVENUES	72,154	70,922
General and Administrative Expenses:	'	'
Depreciation and Amortization	1,114	909
Other General and Administrative Expenses	49,586	41,641
Bad Debt Expense	15,574	12,613
TOTAL GENERAL AND ADMIN. EXPENSES	66,274	55,163
OPERATING INCOME	5,880	15,759
OTHER (INCOME) EXPENSES:	'	'
Interest Expense	609	300
Interest Income	-14	-34
Other Income	30	120
TOTAL OTHER (INCOME) EXPENSES - NET	625	386
INCOME BEFORE INCOME TAXES	5,255	15,373
Provision for Income Taxes	2,301	6,708
NET INCOME	$2,954	$8,665
NET INCOME PER SHARE - BASIC: (in dollars per share)	$0.11	$0.31
WEIGHTED AVERAGE NUMBER OF SHARES BASIC: (in shares)	27,700,167	27,716,336
NET INCOME PER SHARE - DILUTED: (in dollars per share)	$0.11	$0.31
WEIGHTED AVERAGE NUMBER OF SHARES - DILUTED: (in shares)	27,848,492	27,912,327

CONSOLIDATED_STATEMENTS_OF_CAS

CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Jan. 31, 2014	Jan. 31, 2013
OPERATING ACTIVITIES:	'	'
Net Income	$2,954	$8,665
Adjustments to Reconcile Net Income to Cash Provided by Operating Activities:	'	'
Depreciation and Amortization	5,689	4,447
Deferred Income Taxes (Benefit)	5,519	222
Stock Based Compensation	290	290
Loss (Gain) on Disposal of Fixed Assets	38	56
Undistributed Equity Method (Income) Loss	30	120
(Increase) Decrease in:	'	'
Accounts Receivable	2,166	-6,669
Provision for Doubtful Accounts	-13,646	-1,373
Inventory	-2,647	-1,229
Other Current Assets	289	445
Other Assets	'	-49
Deposits	-3	-31
Increase (Decrease) in:	'	'
Accounts Payable and Accrued Liabilities	-3,431	2,720
NET CASH - OPERATING ACTIVITIES	-2,752	7,614
INVESTING ACTIVITIES:	'	'
Acquisition of Equipment and Leasehold Improvements	-2,771	-4,821
Business Acquisitions Related Costs	-258	-7,139
NET CASH - INVESTING ACTIVITIES	-3,029	-11,960
FINANCING ACTIVITIES:	'	'
Payments of Long-Term Debt	-121	-75
Payments of Capital Lease Obligations	-1,479	-1,098
Increase (Decrease) in Revolving Line of Credit	3,840	6,684
Proceeds from Exercise of Options	122	8
NET CASH - FINANCING ACTIVITIES	2,362	5,519
NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS	-3,419	1,173
CASH AND CASH EQUIVALENTS AT BEGINNING OF PERIODS	17,952	25,143
CASH AND CASH EQUIVALENTS AT END OF PERIODS	14,533	26,316
Cash paid during the period for:	'	'
Interest	583	255
Income Taxes	2,813	2,874
SUPPLEMENTAL SCHEDULE OF NON-CASH INVESTING AND FINANCING ACTIVITIES:	'	'
Capital Leases	4,191	626
Write-off of property and equipment	644	1,953
Contingent liability	'	$1,250

Basis_of_Presentation

Basis of Presentation	3 Months Ended
	Jan. 31, 2014
Basis of Presentation	'
Basis of Presentation	'
	[1] Basis of Presentation
	The accompanying unaudited consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America and the instructions to Form 10-Q and, therefore, do not include all information and footnotes necessary for complete audited financial statements. However, in the opinion of the management of the Company, all adjustments necessary for a fair presentation of the financial position and operating results have been included in these statements. Interim results are not necessarily indicative of results for a full year. Reference is made to the October 31, 2013 audited consolidated financial statements of Bio-Reference Laboratories, Inc. (“BRLI”) contained in its Annual Report on Form 10-K for the year ended October 31, 2013.
	The consolidated financial statements and notes thereto should be read in conjunction with the audited consolidated financial statements and notes for the year ended October 31, 2013 as filed with the Securities and Exchange Commission in the Company’s Annual Report on Form 10-K. Significant accounting policies followed by the Company are set forth in Note 2 to the Company’s 2013 Annual Report on Form 10-K.

Fair_Value_Measurements

Fair Value Measurements	3 Months Ended
	Jan. 31, 2014
Fair Value Measurements.	'
Fair Value Measurements.	'
	[2] Fair Value Measurements.
	As of January 31, 2014, the Company’s financial instruments primarily consist of cash, short-term trade receivables and payables for which their carrying amounts approximate fair values, and long term debt, for which based on the borrowing rates currently available to the Company for bank loans with similar terms and average maturities, its carrying amount approximates its fair value.
	The Company has evaluated subsequent events through the date the financial statements are issued as evidenced by the date of filing of this report with the Securities and Exchange Commission. No such events have occurred.

New_Accounting_Pronouncements_

New Accounting Pronouncements, Reclassifications and Other Matters	3 Months Ended
	Jan. 31, 2014
New Accounting Pronouncements, Reclassifications and Other Matters	'
New Accounting Pronouncements, Reclassifications and Other Matters	'
	[3] New Accounting Pronouncements, Reclassifications and Other Matters
	Certain prior year amounts may have been reclassified to conform to the current year presentation.

Revenue_Recognition_and_Contra

Revenue Recognition and Contractual Adjustments	3 Months Ended
	Jan. 31, 2014
Revenue Recognition and Contractual Adjustments	'
Revenue Recognition and Contractual Adjustments	'
	[4] Revenue Recognition and Contractual Adjustments
	Service revenues are principally generated from laboratory testing services including chemical diagnostic tests such as blood analysis, urine analysis and genetic testing among others. Service revenues are recognized at the time the testing services are performed and are reported at their estimated net realizable amounts.
	Service revenues before provision for bad debts are determined utilizing gross service revenues net of contractual adjustments and discounts.  Even though it is the responsibility of the patient to pay for laboratory service bills, most individuals in the United States have an agreement with a third party payor such as Medicare, Medicaid or a commercial insurance provider to pay all or a portion of their healthcare expenses; the majority of services provided by Bio-Reference Laboratories, Inc. are to patients covered under a third party payor contract.  In certain cases, the individual has no insurance or does not provide insurance information and in other cases tests are performed under contract to a professional organization (such as physicians, hospitals, and clinics) which reimburse BRLI directly; in the remainder of the cases, BRLI is provided the third party billing information and seeks payment from the third party under the terms and conditions of the third party payor for health service providers like BRLI.  Each of these third party payors may differ not only with regard to rates, but also with regard to terms and conditions of payment and providing coverage (reimbursement) for specific tests.  Estimated revenues are established based on a series of highly complex procedures and judgments that require industry specific healthcare experience and an understanding of payor methods and trends. We review our calculations on a monthly basis in order to make certain that we are properly allowing for the uncollectable portion of our gross billings due to the contractual adjustments and discounts and that our estimates remain sensitive to variances and changes within our payor groups.  The contractual allowance calculation is made on the basis of historical allowance rates for the various specific payor groups on a monthly basis with a greater weight being given to the most recent trends; this process is adjusted based on recent changes in underlying contract provisions and shifts in the testing being performed.  This calculation is routinely analyzed by BRLI on the basis of actual allowances issued by payors and the actual payments made to determine what adjustments, if any, are needed.  The chart below shows the adjustments made to gross service revenues to arrive at net revenues, the amount reported on our statement of operations.
		($)
		Three Months Ended January 31
		[Unaudited]
		2014	2013
	Gross Service Revenues	909,879	798,709
	Contractual Adjustments and Discounts:
	Medicare/Medicaid Portion	88,919	81,827
	All Other Third Party Payors*	624,145	543,285
	Total Contractual Adjustments and Discounts	713,064	625,112
	Service Revenues Net of Contractual Adjustments and Discounts	196,815	173,597
	Patient Service Revenue Provision for Bad Debts**	15,545	12,341
	Net Revenues	181,270	161,256
	* All Other Third Party and Direct Payors consists of almost eight hundred distinct payors, including commercial health insurers and administrators as well as professionally billed accounts such as physicians, hospitals, clinics and other direct billed accounts.
	** Represents the amount of Bad Debt Expense that is now required to be presented as a deduction from patient service revenue (net of contractual allowances and discounts) pursuant to ASU No. 2011-7.
	When new business is received by BRLI, service revenues net of contractual adjustments and discounts are calculated by reducing gross service revenues by the estimated contractual allowance. The Patient Service Revenue Provision for Bad Debts represents the amount of bad debt expense expected to occur on patient service revenue based upon our experience.  The remaining bad debt expense is presented as part of operating expenses.  The bad debt expense presented as part of operating expense represents the bad debt expense related to receivables from service revenues determined after taking into account our ability to collect on such revenue.
	BRLI recognized the amounts in subsequent periods for actual allowances/discounts to gross service revenue; bad debt may have been adjusted over the same periods of time to maintain an accurate balance between net revenues and actual revenues. Management has reviewed the allowances/discounts recognized in subsequent periods and believes the amounts to be immaterial. A number of proposals for legislation or regulation continue to be under discussion which could have the effect of substantially reducing Medicare reimbursements for clinical laboratories or introducing cost sharing to beneficiaries. Depending upon the nature of regulatory action, if any, which is taken and the content of legislation, if any, which is adopted, the Company could experience a significant decrease in revenues from Medicare and Medicaid, which could have a material adverse effect on the Company. The Company is unable to predict, however, the extent to which such actions will be taken.

Accounts_Receivable_Allowances

Accounts Receivable Allowances	3 Months Ended
	Jan. 31, 2014
Accounts Receivable Allowances	'
Accounts Receivable Allowances	'
	[5] Accounts Receivable Allowances
	It is typically the responsibility of the patient to pay for laboratory service bills. Most individuals in the United States have an agreement with a third party payor such as Medicare, Medicaid or commercial insurance to pay all or a portion of their healthcare expenses; this represents the major portion of payment for all services provided to BRLI. In certain cases, the individual has no insurance or does not provide insurance information; in the remainder of the cases, BRLI is provided the third party billing information, usually by the referring physician, and seeks payment from the third party under the terms and conditions of the third party payor for health service providers like BRLI. Each of these third party payors may differ not only with regard to rates, but also with regard to terms and conditions of payment and coverage of specific tests. BRLI routinely reviews the reimbursement policies and subsequent payments and collection rates from these different types of payors. Contractual adjustments and discounts are recorded as reductions to gross service revenues and are collectively referred to as the contractual allowance. BRLI has not been required to record an adjustment in a subsequent period related to revenue recorded in a prior period which was material in nature. Aging of accounts receivable is monitored by billing personnel and follow-up activities including collection efforts are conducted as necessary.  BRLI writes off receivables against the allowance for doubtful accounts when they are deemed uncollectible. For client billing, accounts are written off when all reasonable collection efforts prove to be unsuccessful. Patient accounts, where the patient is directly responsible for all or a remainder portion of the account after partial payment or denial by a third party payor, are written off after the normal dunning cycle has occurred, although these may be subsequently transferred to a third party collection agency after being written off. Third party payor accounts are written off when they exceed the payer’s timely filing limits. Accounts Receivable on the balance sheet is net of the following amounts for contractual credits and doubtful accounts:
		($)
		[Unaudited]
		January 31,	October 31,
		2014	2013
	Contractual Credits/Discounts	375,535	342,297
	Doubtful Accounts	75,615	89,261
	Total Allowance	451,150	431,558

Intangible_Assets

Intangible Assets	3 Months Ended
	Jan. 31, 2014
Intangible Assets	'
Intangible Assets	'
	[6] Intangible Assets
	The following disclosures present certain information on the Company’s intangible assets as of January 31, 2014 (Unaudited) and October 31, 2013. All intangible assets are being amortized over their estimated useful lives, as indicated below, with no estimated residual value.
	January 31, 2014
		Weighted-Average		Accumulated	Net of
		Amortization Period			Accumulated
	Intangible Asset	Years	Cost ($)	Amortization ($)	Amortization ($)
	Customer Lists	20	8,738	2,978	5,760
	Covenants Not-to-Compete	5	11,131	4,604	6,527
	Patents and Licenses	17	5,297	1,493	3,804
	Totals		25,166	9,075	16,091
	October 31, 2013
		Weighted-Average		Accumulated	Net of
		Amortization Period			Accumulated
	Intangible Asset	Years	Cost ($)	Amortization ($)	Amortization ($)
	Customer Lists	20	8,738	2,878	5,860
	Covenants Not-to-Compete	5	11,131	4,560	6,571
	Patents and Licenses	17	5,297	1,408	3,889
	Totals		25,166	8,846	16,320
	The aggregate intangible amortization expense for the three months ended January 31, 2014 and 2013 was $229 and $140, respectively.  The estimated intangible asset amortization expense for the remainder of the fiscal year ending October 31, 2014 and for the four subsequent years is as follows:
	October 31,	($)
	2014	1,703
	2015	1,852
	2016	1,540
	2017	1,063
	2018	946
	Thereafter	8,987
	Total	16,091

Revolving_Note_Payable_Bank

Revolving Note Payable - Bank	3 Months Ended
	Jan. 31, 2014
Revolving Note Payable - Bank	'
Revolving Note Payable - Bank	'
	[7] Revolving Note Payable - Bank
	On February 3, 2014, the Company entered into an amended revolving note payable loan agreement with PNC Bank, N.A. (“PNC Bank Credit Line”).  This amendment increased the maximum credit line to $70,000.  The maximum amount of the credit line available to the Company pursuant to the loan agreement is the lesser of (i) $70,000 or (ii) 50% of the Company’s qualified accounts receivable, as defined in the agreement.  The amendment to the Loan and Security Agreement provides for an interest rate on advances to be subject, at the election of the Company, to either the bank’s base rate or the Eurodollar rate of interest plus, in certain instances, an additional interest percentage.  The additional interest percentage charge on bank’s base rate borrowings and on Eurodollar rate borrowings ranges from 1% to 4% and is determined based upon certain financial ratios achieved by the Company.  At January 31, 2014, the Company elected to have all of the total advances outstanding to be subject to the bank’s base rate of interest of 3.50%.  The credit line is collateralized by substantially all of the Company’s assets. The line of credit is available through October 2016 and may be extended for annual periods by mutual consent, thereafter.  The terms of this agreement contain, among other provisions, requirements for maintaining defined levels of capital expenditures and fixed charge coverage, and the prohibition of the payment of cash dividends by the Company. As of January 31, 2014, the Company utilized $29,979 of the available credit under this revolving note payable loan agreement.

LongTerm_Debt_Bank

Long-Term Debt - Bank	3 Months Ended
	Jan. 31, 2014
Long-Term Debt - Bank	'
Long-Term Debt - Bank	'
	[8] Long-Term Debt - Bank
	In December 2010, the Company issued a seven year term note for $5,408 at the rate of interest of 6.12% per annum for the financing of new equipment.  The note is payable in 84 equal monthly installments commencing on January 29, 2011 of $61 including principal and interest followed by a balloon payment of the principal and interest outstanding on the loan repayment date of December 29, 2017.  The balance on this note as of January 31, 2014 is approximately $4,042.

Provision_for_Income_Taxes

Provision for Income Taxes	3 Months Ended
	Jan. 31, 2014
Provision for Income Taxes	'
Provision for Income Taxes	'
	[9] Provision for Income Taxes
	The provision for income taxes for the three months ended January 31, 2014 consists of a current tax benefit of $3,218 and a deferred tax provision of $5,519. At January 31, 2014, the Company had a current deferred tax asset of $36,265 included in other current assets and a long-term deferred tax asset of $2,447 included in other assets.  The provision for income taxes for the three months ended January 31, 2013 consists of a current tax provision of $6,486 and a deferred tax provision of $221. At January 31, 2013, the Company had a current deferred tax asset of $24,385 included in other current assets and a long-term deferred tax asset of $2,583 included in other assets.

Business_Combinations

Business Combinations	3 Months Ended
	Jan. 31, 2014
Business Combinations	'
Business Combinations	'
	[10] Business Combinations
	On December 21, 2012, we entered into an agreement pursuant to which we agreed to purchase all of the authorized, issued and outstanding shares of Meridian Clinical Laboratory, Corp. ( “MCL”), a Florida corporation.  More information about MCL and the agreement may be found in the Form 8-K the Company filed on December 27, 2012.
	On December 31, 2012, we entered into an agreement pursuant to which we agreed to purchase all of the authorized, issued and outstanding shares of Florida Clinical Laboratory, Inc. (“FCL”), a Florida corporation.  More information about FCL and the agreement may be found in the Form 8-K we filed on January 4, 2013.
	The following table sets forth these final allocations.
		($)
		FCL	MCL	Totals:
	Accounts Receivable	1,008	232	1,240
	Autos	137	48	185
	Medical Equipment	225	3	228
	Computer Equipment	21	—	21
	Leasehold Improvements	53	—	53
	Other Non-Current Assets	3	—	3
	Non-Compete Agreement	747	43	790
	Deposits	—	2	2
	Customer Relationships in Place	3,235	930	4,165
	Goodwill	1,905	673	2,578
	Accounts Payable	118	83	201
	Long Term Debt (Auto-Loans)	200	0	200
	Short Term Acquisition Payable	1,000	250	1,250

Revenue_Recognition_and_Contra1

Revenue Recognition and Contractual Adjustments (Tables)	3 Months Ended
	Jan. 31, 2014
Revenue Recognition and Contractual Adjustments	'
Schedule of adjustments made to gross service revenues to arrive at net revenues	'
		($)
		Three Months Ended January 31
		[Unaudited]
		2014	2013
	Gross Service Revenues	909,879	798,709
	Contractual Adjustments and Discounts:
	Medicare/Medicaid Portion	88,919	81,827
	All Other Third Party Payors*	624,145	543,285
	Total Contractual Adjustments and Discounts	713,064	625,112
	Service Revenues Net of Contractual Adjustments and Discounts	196,815	173,597
	Patient Service Revenue Provision for Bad Debts**	15,545	12,341
	Net Revenues	181,270	161,256
	* All Other Third Party and Direct Payors consists of almost eight hundred distinct payors, including commercial health insurers and administrators as well as professionally billed accounts such as physicians, hospitals, clinics and other direct billed accounts.
	** Represents the amount of Bad Debt Expense that is now required to be presented as a deduction from patient service revenue (net of contractual allowances and discounts) pursuant to ASU No. 2011-7.

Accounts_Receivable_Allowances1

Accounts Receivable Allowances (Tables)	3 Months Ended
	Jan. 31, 2014
Accounts Receivable Allowances	'
Schedule of amounts for contractual credits and doubtful accounts	'
		($)
		[Unaudited]
		January 31,	October 31,
		2014	2013
	Contractual Credits/Discounts	375,535	342,297
	Doubtful Accounts	75,615	89,261
	Total Allowance	451,150	431,558

Intangible_Assets_Tables

Intangible Assets (Tables)	3 Months Ended
	Jan. 31, 2014
Intangible Assets	'
Schedule of information on intangible assets	'
	January 31, 2014
		Weighted-Average		Accumulated	Net of
		Amortization Period			Accumulated
	Intangible Asset	Years	Cost ($)	Amortization ($)	Amortization ($)
	Customer Lists	20	8,738	2,978	5,760
	Covenants Not-to-Compete	5	11,131	4,604	6,527
	Patents and Licenses	17	5,297	1,493	3,804
	Totals		25,166	9,075	16,091
	October 31, 2013
		Weighted-Average		Accumulated	Net of
		Amortization Period			Accumulated
	Intangible Asset	Years	Cost ($)	Amortization ($)	Amortization ($)
	Customer Lists	20	8,738	2,878	5,860
	Covenants Not-to-Compete	5	11,131	4,560	6,571
	Patents and Licenses	17	5,297	1,408	3,889
	Totals		25,166	8,846	16,320
Schedule of estimated amortization expense related to remaining intangible assets	'
	October 31,	($)
	2014	1,703
	2015	1,852
	2016	1,540
	2017	1,063
	2018	946
	Thereafter	8,987
	Total	16,091

Business_Combinations_Tables

Business Combinations (Tables) (FCL and MCL)	3 Months Ended
	Jan. 31, 2014
FCL and MCL	'
Acquisitions	'
Schedule of final purchase allocations	'
		($)
		FCL	MCL	Totals:
	Accounts Receivable	1,008	232	1,240
	Autos	137	48	185
	Medical Equipment	225	3	228
	Computer Equipment	21	—	21
	Leasehold Improvements	53	—	53
	Other Non-Current Assets	3	—	3
	Non-Compete Agreement	747	43	790
	Deposits	—	2	2
	Customer Relationships in Place	3,235	930	4,165
	Goodwill	1,905	673	2,578
	Accounts Payable	118	83	201
	Long Term Debt (Auto-Loans)	200	0	200
	Short Term Acquisition Payable	1,000	250	1,250

Revenue_Recognition_and_Contra2

Revenue Recognition and Contractual Adjustments (Details) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Jan. 31, 2014	Jan. 31, 2013
	item
Revenue Recognition and Contractual Adjustments	'	'
Gross Service Revenues	$909,879	$798,709
Contractual Adjustments and Discounts:	'	'
Medicare/Medicaid Portion	88,919	81,827
All Other Third Party Payors	624,145	543,285
Total Contractual Adjustments and Discounts	713,064	625,112
Service Revenues Net of Contractual Adjustments and Discounts	196,815	173,597
Patient Service Revenue Provision for Bad Debts	15,545	12,341
Net Revenues	$181,270	$161,256
Number of distinct payors included in all other third party and Direct	800	'

Accounts_Receivable_Allowances2

Accounts Receivable Allowances (Details) (USD $)	Jan. 31, 2014	Oct. 31, 2013
In Thousands, unless otherwise specified
Allowances	'	'
Total Allowance	$451,150	$431,558
Contractual Credits/Discounts	'	'
Allowances	'	'
Total Allowance	375,535	342,297
Doubtful Accounts	'	'
Allowances	'	'
Total Allowance	$75,615	$89,261

Intangible_Assets_Details

Intangible Assets (Details) (USD $)	3 Months Ended			3 Months Ended	12 Months Ended	3 Months Ended	12 Months Ended	3 Months Ended	12 Months Ended
In Thousands, unless otherwise specified	Jan. 31, 2014	Jan. 31, 2013	Oct. 31, 2013	Jan. 31, 2014	Oct. 31, 2013	Jan. 31, 2014	Oct. 31, 2013	Jan. 31, 2014	Oct. 31, 2013
				Customer Lists	Customer Lists	Covenants Not-to-Compete	Covenants Not-to-Compete	Patents and Licenses	Patents and Licenses
Intangible assets	'	'	'	'	'	'	'	'	'
Weighted-Average Amortization Period	'	'	'	'20 years	'20 years	'5 years	'5 years	'17 years	'17 years
Cost	$25,166	'	$25,166	$8,738	$8,738	$11,131	$11,131	$5,297	$5,297
Accumulated Amortization	9,075	'	8,846	2,978	2,878	4,604	4,560	1,493	1,408
Net of Accumulated Amortization	16,091	'	16,320	5,760	5,860	6,527	6,571	3,804	3,889
Estimated residual value	0	'	'	0	'	0	'	0	'
Amortization expenses	229	140	'	'	'	'	'	'	'
Estimated amortization expense related to intangible assets	'	'	'	'	'	'	'	'	'
2014	1,703	'	'	'	'	'	'	'	'
2015	1,852	'	'	'	'	'	'	'	'
2016	1,540	'	'	'	'	'	'	'	'
2017	1,063	'	'	'	'	'	'	'	'
2018	946	'	'	'	'	'	'	'	'
Thereafter	8,987	'	'	'	'	'	'	'	'
Net of Accumulated Amortization	$16,091	'	$16,320	$5,760	$5,860	$6,527	$6,571	$3,804	$3,889

Revolving_Note_Payable_Bank_De

Revolving Note Payable - Bank (Details) (USD $)	Jan. 31, 2014	Oct. 31, 2013	Feb. 28, 2014	Jan. 31, 2014	Feb. 28, 2014	Jan. 31, 2014	Feb. 28, 2014	Feb. 28, 2014	Feb. 28, 2014	Feb. 28, 2014	Feb. 28, 2014
In Thousands, unless otherwise specified			Revolving note payable - bank	Revolving note payable - bank	Revolving note payable - bank	Revolving note payable - bank	Revolving note payable - bank	Revolving note payable - bank	Revolving note payable - bank	Revolving note payable - bank	Revolving note payable - bank
					Bank's base rate	Bank's base rate	Bank's base rate	Bank's base rate	Eurodollar rate	Eurodollar rate	Eurodollar rate
							Minimum	Maximum		Minimum	Maximum
Revolving note payable - Bank	'	'	'	'	'	'	'	'	'	'	'
Maximum amount of the credit line available pursuant to the loan agreement	'	'	$70,000	'	'	'	'	'	'	'	'
Maximum credit line available as percentage of accounts receivable	'	'	50.00%	'	'	'	'	'	'	'	'
Variable rate basis	'	'	'	'	'base rate	'	'	'	'Eurodollar rate	'	'
Percentage of additional interest	'	'	'	'	'	'	1.00%	4.00%	'	1.00%	4.00%
Variable rate of interest (as a percent)	'	'	'	'	'	3.50%	'	'	'	'	'
Amount of credit utilized	$29,979	$26,139	'	$29,979	'	'	'	'	'	'	'

LongTerm_Debt_Bank_Details

Long-Term Debt - Bank (Details) (Seven-year term note, USD $)	1 Months Ended	3 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2010	Jan. 31, 2014
		item
Seven-year term note	'	'
Long-term debt	'	'
Term of debt	'7 years	'
Debt issued	$5,408	'
Debt instrument interest rate (as a percent)	'	6.12%
Number of equal monthly installments	'	84
Monthly installment including principal and interest	'	61
Debt outstanding	'	$4,042

Provision_for_Income_Taxes_Det

Provision for Income Taxes (Details) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Jan. 31, 2014	Jan. 31, 2013	Oct. 31, 2013
Provision for Income Taxes	'	'	'
Current tax provision (benefit)	$3,218	$6,486	'
Deferred tax provision	5,519	222	'
Current deferred tax asset	36,265	24,385	42,154
Long-term deferred tax asset	$2,447	$2,583	$2,077

Business_Combinations_Details

Business Combinations (Details) (USD $)

Jan. 31, 2014

Oct. 31, 2013

Jan. 31, 2014

Jan. 31, 2014

Jan. 31, 2014

Jan. 31, 2014

Jan. 31, 2014

Jan. 31, 2014

Jan. 31, 2014

Dec. 31, 2012

Dec. 31, 2012

Dec. 31, 2012

Dec. 31, 2012

Dec. 31, 2012

Dec. 31, 2012

Dec. 31, 2012

Dec. 21, 2012

Dec. 21, 2012

Dec. 21, 2012

Dec. 21, 2012

Dec. 21, 2012

In Thousands, unless otherwise specified

FCL and MCL

FCL and MCL

FCL and MCL

FCL and MCL

FCL and MCL

FCL and MCL

FCL and MCL

FCL

FCL

FCL

FCL

FCL

FCL

FCL

MCL

MCL

MCL

MCL

MCL

Autos

Medical Equipment

Computer Equipment

Leasehold improvements

Non-Compete Agreement

Customer Relationships in Place

Autos

Medical Equipment

Computer Equipment

Leasehold improvements

Non-Compete Agreement

Customer Relationships in Place

Autos

Medical Equipment

Non-Compete Agreement

Customer Relationships in Place

Acquisitions

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

'

Accounts Receivable

'

'

$1,240

'

'

'

'

'

'

$1,008

'

'

'

'

'

'

$232

'

'

'

'

Property, plant and equipment

'

'

'

185

228

21

53

'

'

'

137

225

21

53

'

'

'

48

3

'

'

Other Non-Current Assets

'

'

3

'

'

'

'

'

'

3

'

'

'

'

'

'

'

'

'

'

'

Intangible assets

'

'

'

'

'

'

'

790

4,165

'

'

'

'

'

747

3,235

'

'

'

43

930

Deposits

'

'

2

'

'

'

'

'

'

'

'

'

'

'

'

'

2

'

'

'

'

Goodwill

35,185

35,185

2,578

'

'

'

'

'

'

1,905

'

'

'

'

'

'

673

'

'

'

'

Accounts Payable

'

'

201

'

'

'

'

'

'

118

'

'

'

'

'

'

83

'

'

'

'

Long Term Debt (Auto-Loans)

'

'

200

'

'

'

'

'

'

200

'

'

'

'

'

'

'

'

'

'

'

Short Term Acquisition Payable

'

'

$1,250

'

'

'

'

'

'

$1,000

'

'

'

'

'

'

$250

'

'

'

'