Document_And_Entity_Informatio
Document And Entity Information (USD $) | 12 Months Ended | ||
Dec. 31, 2013 | Feb. 26, 2014 | Jun. 30, 2013 | |
Document And Entity Information [Abstract] | ' | ' | ' |
Document Type | '10-K | ' | ' |
Amendment Flag | 'false | ' | ' |
Document Period End Date | 31-Dec-13 | ' | ' |
Document Fiscal Year Focus | '2013 | ' | ' |
Document Fiscal Period Focus | 'FY | ' | ' |
Entity Registrant Name | 'AMSURG CORP | ' | ' |
Entity Central Index Key | '0000895930 | ' | ' |
Current Fiscal Year End Date | '--12-31 | ' | ' |
Entity Filer Category | 'Large Accelerated Filer | ' | ' |
Entity Common Stock, Shares Outstanding | ' | 32,487,151 | ' |
Entity Current Reporting Status | 'Yes | ' | ' |
Entity Voluntary Filers | 'No | ' | ' |
Entity Well-known Seasoned Issuer | 'Yes | ' | ' |
Entity Public Float | ' | ' | $1,088,000,000 |
Consolidated_Balance_Sheets
Consolidated Balance Sheets (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Assets | ' | ' |
Cash and cash equivalents | $50,840 | $46,398 |
Accounts receivable, net | 105,072 | 96,752 |
Supplies inventory | 18,414 | 18,406 |
Deferred income taxes | 3,097 | 3,088 |
Prepaid and other current assets | 33,602 | 27,537 |
Total current assets | 211,025 | 192,181 |
Property and equipment, net | 169,895 | 166,612 |
Investments in unconsolidated affiliates and long-term notes receivable | 16,392 | 11,274 |
Goodwill | 1,758,970 | 1,652,002 |
Intangible assets, net | 21,662 | 22,517 |
Total assets | 2,177,944 | 2,044,586 |
Liabilities and Equity | ' | ' |
Current portion of long-term debt | 20,844 | 17,407 |
Accounts payable | 27,501 | 23,509 |
Accrued salaries and benefits | 32,294 | 29,251 |
Other accrued liabilities | 9,231 | 14,246 |
Total current liabilities | 89,870 | 84,413 |
Long-term debt | 583,298 | 620,705 |
Deferred income taxes | 176,020 | 137,648 |
Other long-term liabilities | 25,503 | 25,972 |
Commitments and contingencies | ' | ' |
Noncontrolling interests - redeemable | 177,697 | 175,382 |
Preferred stock, no par value, 5,000 shares authorized, no shares issued or outstanding | 0 | 0 |
Equity: | ' | ' |
Common stock, no par value, 70,000 shares authorized | 185,873 | 183,867 |
Retained earnings | 578,324 | 505,621 |
Total AmSurg Corp. equity | 764,197 | 689,488 |
Noncontrolling interests - non-redeemable | 361,359 | 310,978 |
Total equity | 1,125,556 | 1,000,466 |
Total liabilities and equity | $2,177,944 | $2,044,586 |
Consolidated_Balance_Sheets_Pa
Consolidated Balance Sheets (Parenthetical) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Consolidated Balance Sheets | ' | ' |
Net of allowance on accounts receivable | $27,862 | $22,379 |
Preferred stock, par value | ' | ' |
Preferred stock, shares authorized | 5,000 | 5,000 |
Preferred stock, shares issued | ' | ' |
Preferred stock, shares outstanding | ' | ' |
Common stock, par value | ' | ' |
Common stock, shares authorized | 70,000 | 70,000 |
Common stock, shares outstanding | 32,353 | 31,941 |
Consolidated_Statements_Of_Ear
Consolidated Statements Of Earnings (USD $) | 12 Months Ended | ||
In Thousands, except Per Share data, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Consolidated Statements Of Earnings | ' | ' | ' |
Revenues | $1,079,343 | $923,182 | $772,075 |
Operating expenses: | ' | ' | ' |
Salaries and benefits | 333,190 | 290,063 | 238,738 |
Supply cost | 157,771 | 131,055 | 101,364 |
Other operating expenses | 222,677 | 193,025 | 168,347 |
Depreciation and amortization | 33,028 | 29,850 | 25,645 |
Total operating expenses | 746,666 | 643,993 | 534,094 |
Gain (loss) on deconsolidation | 2,237 | 0 | 0 |
Equity in earnings of unconsolidated affiliates | 3,151 | 1,564 | 613 |
Operating income | 338,065 | 280,753 | 238,594 |
Interest expense | 29,538 | 16,967 | 15,327 |
Earnings from continuing operations before income taxes | 308,527 | 263,786 | 223,267 |
Income tax expense | 49,754 | 42,364 | 34,973 |
Net earnings from continuing operations | 258,773 | 221,422 | 188,294 |
Discontinued operations: | ' | ' | ' |
Earnings (loss) from operations of discontinued interests in surgery centers, net of income tax | 169 | 2,196 | 3,363 |
Gain (loss) on disposal of discontinued interests in surgery centers, net of income tax | 2,602 | 25 | -1,543 |
Net earnings (loss) from discontinued operations | 2,771 | 2,221 | 1,820 |
Net earnings | 261,544 | 223,643 | 190,114 |
Less net earnings attributable to noncontrolling interests: | ' | ' | ' |
Net earnings from continuing operations | 186,120 | 159,187 | 138,269 |
Net earnings (loss) from discontinued operations | 2,721 | 1,893 | 1,848 |
Total net earnings attributable to noncontrolling interests | 188,841 | 161,080 | 140,117 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 72,703 | 62,563 | 49,997 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' | ' |
Earnings from continuing operations, net of income tax | 72,653 | 62,235 | 50,025 |
Discontinued operations, net of income tax | 50 | 328 | -28 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | $72,703 | $62,563 | $49,997 |
Earnings per share-basic: | ' | ' | ' |
Net earnings from continuing operations attributable to AmSurg Corp. common shareholders | $2.32 | $2.02 | $1.64 |
Net earnings (loss) from discontinued operations attributable to AmSurg Corp. common shareholders | $0 | $0.01 | $0 |
Net earnings attributable to AmSurg Corp. common shareholders | $2.32 | $2.03 | $1.64 |
Earnings per share-diluted: | ' | ' | ' |
Net earnings from continuing operations attributable to AmSurg Corp. common shareholders | $2.27 | $1.97 | $1.60 |
Net earnings (loss) from discontinued operations attributable to AmSurg Corp. common shareholders | $0 | $0.01 | $0 |
Net earnings attributable to AmSurg Corp. common shareholders | $2.28 | $1.98 | $1.60 |
Weighted average number of shares and share equivalents outstanding: | ' | ' | ' |
Basic | 31,338 | 30,773 | 30,452 |
Diluted | 31,954 | 31,608 | 31,211 |
Consolidated_Statements_Of_Com
Consolidated Statements Of Comprehensive Income (USD $) | 3 Months Ended | 12 Months Ended | |||||||||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Sep. 30, 2013 | Jun. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2012 | Jun. 30, 2012 | Mar. 31, 2012 | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Consolidated Statements Of Comprehensive Income | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Net earnings | $71,168 | $62,267 | $65,836 | $62,273 | $59,394 | $53,765 | $55,545 | $54,939 | $261,544 | $223,643 | $190,114 |
Other comprehensive income, net of income tax: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Unrealized gain on interest rate swap, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 515 |
Comprehensive income, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 261,544 | 223,643 | 190,629 |
Less comprehensive income attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 188,841 | 161,080 | 140,117 |
Comprehensive income attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | $72,703 | $62,563 | $50,512 |
Consolidated_Statements_Of_Cha
Consolidated Statements Of Changes In Equity (USD $) | Total | Common Stock Including Additional Paid in Capital [Member] | Retained Earnings [Member] | Accumulated Other Comprehensive Loss [Member] | Non-Controlling Interests - Non-Redeemable [Member] | Total Equity (Permanent) [Member] | Non-controlling Interests - Redeemable [Member] |
Balance at Dec. 31, 2010 | ' | $171,522,000 | $393,061,000 | ($515,000) | $12,799,000 | $576,867,000 | $147,740,000 |
Balance (in shares) at Dec. 31, 2010 | ' | 31,040,000 | ' | ' | ' | ' | ' |
Issuance of restricted common stock (in shares) | ' | 277,000 | ' | ' | ' | ' | ' |
Cancellation of restricted common stock | ' | -9,000 | ' | ' | ' | -9,000 | ' |
Cancellation of restricted common stock (in shares) | ' | -1,000 | ' | ' | ' | ' | ' |
Stock options exercised | ' | 6,872,000 | ' | ' | ' | 6,872,000 | ' |
Stock options exercised (in shares) | 374,350 | 374,000 | ' | ' | ' | ' | ' |
Stock repurchased | ' | -10,007,000 | ' | ' | ' | -10,007,000 | ' |
Stock repurchased (in shares) | ' | -406,000 | ' | ' | ' | ' | ' |
Share-based compensation, value | 6,178,000 | 6,178,000 | ' | ' | ' | 6,178,000 | ' |
Tax benefit related to exercise of stock options | ' | 649,000 | ' | ' | ' | 649,000 | ' |
Net earnings | 190,114,000 | ' | 49,997,000 | ' | 10,181,000 | 60,178,000 | 129,936,000 |
Distributions to noncontrolling interests, net of capital contributions | ' | ' | ' | ' | -9,502,000 | -9,502,000 | -129,979,000 |
Purchase of noncontrolling interest, value | ' | 195,000 | ' | ' | -817,000 | -622,000 | -788,000 |
Sale of noncontrolling interest, value | ' | -1,702,000 | ' | ' | 439,000 | -1,263,000 | 1,771,000 |
Acquisitions and other transactions impacting noncontrolling interests | ' | ' | ' | ' | 122,276,000 | 122,276,000 | 21,390,000 |
Disposals and other transactions impacting noncontrolling interests | ' | -511,000 | ' | ' | -3,154,000 | -3,665,000 | 566,000 |
Gain on interest rate swap, net of income tax expense | ' | ' | ' | 515,000 | ' | 515,000 | ' |
Balance at Dec. 31, 2011 | ' | 173,187,000 | 443,058,000 | 0 | 132,222,000 | 748,467,000 | 170,636,000 |
Balance (in shares) at Dec. 31, 2011 | ' | 31,284,000 | ' | ' | ' | ' | ' |
Issuance of restricted common stock (in shares) | ' | 281,000 | ' | ' | ' | ' | ' |
Cancellation of restricted common stock | ' | 0 | ' | ' | ' | 0 | ' |
Cancellation of restricted common stock (in shares) | ' | -2,000 | ' | ' | ' | ' | ' |
Stock options exercised | ' | 18,214,000 | ' | ' | ' | 18,214,000 | ' |
Stock options exercised (in shares) | 841,599 | 842,000 | ' | ' | ' | ' | ' |
Stock repurchased | ' | -13,101,000 | ' | ' | ' | -13,101,000 | ' |
Stock repurchased (in shares) | ' | -464,000 | ' | ' | ' | ' | ' |
Share-based compensation, value | 6,692,000 | 6,692,000 | ' | ' | ' | 6,692,000 | ' |
Tax benefit related to exercise of stock options | ' | 1,834,000 | ' | ' | ' | 1,834,000 | ' |
Net earnings | 223,643,000 | ' | 62,563,000 | ' | 26,303,000 | 88,866,000 | 134,777,000 |
Distributions to noncontrolling interests, net of capital contributions | ' | ' | ' | ' | -26,514,000 | -26,514,000 | -136,356,000 |
Purchase of noncontrolling interest, value | ' | 252,000 | ' | ' | -421,000 | -169,000 | -81,000 |
Sale of noncontrolling interest, value | ' | -2,794,000 | ' | ' | 4,352,000 | 1,558,000 | 0 |
Acquisitions and other transactions impacting noncontrolling interests | ' | ' | ' | ' | 175,036,000 | 175,036,000 | 7,038,000 |
Disposals and other transactions impacting noncontrolling interests | ' | -417,000 | ' | ' | 0 | -417,000 | -632,000 |
Balance at Dec. 31, 2012 | 1,000,466,000 | 183,867,000 | 505,621,000 | 0 | 310,978,000 | 1,000,466,000 | 175,382,000 |
Balance (in shares) at Dec. 31, 2012 | ' | 31,941,000 | ' | ' | ' | ' | ' |
Issuance of restricted common stock (in shares) | ' | 292,000 | ' | ' | ' | ' | ' |
Cancellation of restricted common stock (in shares) | ' | -16,000 | ' | ' | ' | ' | ' |
Stock options exercised | ' | 33,349,000 | ' | ' | ' | 33,349,000 | ' |
Stock options exercised (in shares) | 1,392,366 | 1,393,000 | ' | ' | ' | ' | ' |
Stock repurchased | ' | -45,964,000 | ' | ' | ' | -45,964,000 | ' |
Stock repurchased (in shares) | ' | -1,257,000 | ' | ' | ' | ' | ' |
Share-based compensation, value | 8,321,000 | 8,321,000 | ' | ' | ' | 8,321,000 | ' |
Tax benefit related to exercise of stock options | ' | 7,247,000 | ' | ' | ' | 7,247,000 | ' |
Net earnings | 261,544,000 | ' | 72,703,000 | ' | 49,789,000 | 122,492,000 | 139,052,000 |
Distributions to noncontrolling interests, net of capital contributions | ' | ' | ' | ' | -49,533,000 | -49,533,000 | -134,298,000 |
Purchase of noncontrolling interest, value | ' | 679,000 | ' | ' | -1,926,000 | -1,247,000 | -319,000 |
Sale of noncontrolling interest, value | ' | -1,626,000 | ' | ' | 2,327,000 | 701,000 | 852,000 |
Acquisitions and other transactions impacting noncontrolling interests | ' | ' | ' | ' | 50,041,000 | 50,041,000 | 0 |
Disposals and other transactions impacting noncontrolling interests | ' | 0 | ' | ' | -317,000 | -317,000 | -2,972,000 |
Balance at Dec. 31, 2013 | $1,125,556,000 | $185,873,000 | $578,324,000 | $0 | $361,359,000 | $1,125,556,000 | $177,697,000 |
Balance (in shares) at Dec. 31, 2013 | ' | 32,353,000 | ' | ' | ' | ' | ' |
Consolidated_Statements_Of_Cha1
Consolidated Statements Of Changes In Equity (Parenthetical) (USD $) | 12 Months Ended |
In Thousands, unless otherwise specified | Dec. 31, 2011 |
Consolidated Statements Of Changes In Equity | ' |
Other Comprehensive Income (Loss), Derivatives Qualifying as Hedges, Tax | $332 |
Consolidated_Statements_Of_Cas
Consolidated Statements Of Cash Flows (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Cash flows from operating activities: | ' | ' | ' |
Net earnings (loss) | $261,544 | $223,643 | $190,114 |
Adjustments to reconcile net earnings to net cash flows provided by operating activities: | ' | ' | ' |
Depreciation and amortization | 33,028 | 29,850 | 25,645 |
Net (gain) loss on sale of long-lived assets | -1,468 | -1,065 | -1,518 |
(Gain) loss on deconsolidation | -2,237 | 0 | 0 |
Share-based compensation | 8,321 | 6,692 | 6,178 |
Excess tax benefit from share-based compensation | -7,247 | -1,784 | -977 |
Deferred income taxes | 38,363 | 24,558 | 23,623 |
Equity in earnings of unconsolidated affiliates, net | -3,151 | -1,564 | -613 |
Increase (decrease) in cash and cash equivalents, net of effects of acquisitions and dispositions, due to changes in: | ' | ' | ' |
Accounts receivable, net | -1,297 | 8,061 | -2,122 |
Supplies inventory | 132 | 110 | 168 |
Prepaid and other current assets | -5,308 | -4,651 | 838 |
Accounts payable | 441 | 579 | -2,205 |
Accrued expenses and other liabilities | 6,693 | 7,550 | 2,329 |
Other, net | 5,010 | 3,673 | 1,963 |
Net cash flows provided by operating activities | 332,824 | 295,652 | 243,423 |
Cash flows from investing activities: | ' | ' | ' |
Acquisition of interests in surgery centers and related transactions | -73,594 | -277,388 | -239,223 |
Acquisition of property and equipment | -28,856 | -28,864 | -22,170 |
Proceeds from sale of interests in surgery centers | 3,553 | 7,309 | 7,026 |
Other | 159 | 0 | 0 |
Net cash flows used in investing activities | -98,738 | -298,943 | -254,367 |
Cash flows from financing activities: | ' | ' | ' |
Proceeds from long-term borrowings | 162,204 | 565,566 | 288,869 |
Repayment on long-term borrowings | -202,083 | -394,164 | -129,107 |
Distributions to noncontrolling interests | -184,149 | -162,941 | -138,724 |
Proceeds from issuance of common stock upon exercise of stock options | 33,349 | 18,214 | 6,872 |
Repurchase of common stock | -45,964 | -13,101 | -10,007 |
Capital contributions and ownership transactions by noncontrolling interests | 1,074 | 1,595 | 660 |
Excess tax benefit from share-based compensation | 7,247 | 1,784 | 977 |
Financing cost incurred | -1,322 | -7,982 | -2,025 |
Net cash flows provided by (used in) financing activities | -229,644 | 8,971 | 17,515 |
Net increase in cash and cash equivalents | 4,442 | 5,680 | 6,571 |
Cash and cash equivalents, beginning of year | 46,398 | 40,718 | 34,147 |
Cash and cash equivalents, end of year | $50,840 | $46,398 | $40,718 |
Summary_of_Significant_Account
Summary of Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2013 | |
Summary of Significant Accounting Policies | ' |
Summary of Significant Accounting Policies | ' |
1. Summary of Significant Accounting Policies | |
a. Principles of Consolidation | |
AmSurg Corp. (the “Company”), through its wholly owned subsidiaries, owns interests, primarily 51%, in limited partnerships and limited liability companies (“LLCs”) which own and operate ambulatory surgery centers (“centers”). The Company does not have an ownership interest in a limited partnership or LLC greater than 51% which it does not consolidate. The Company has ownership interests of less than 51% in six limited partnerships and LLCs, three of which it consolidates as the Company has substantive participation rights and three of which it does not consolidate as the Company's rights are limited to protective rights only. The consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries and the consolidated limited partnerships and LLCs. Consolidation of such limited partnerships and LLCs is necessary as the Company's wholly owned subsidiaries have primarily 51% or more of the financial interest, are the general partner or majority member with all the duties, rights and responsibilities thereof, are responsible for the day-to-day management of the limited partnerships and LLCs, and have control of the entities. The responsibilities of the Company's noncontrolling partners (limited partners and noncontrolling members) are to supervise the delivery of medical services, with their rights being restricted to those that protect their financial interests, such as approval of the acquisition of significant assets or the incurrence of debt which they are generally required to guarantee on a pro rata basis based upon their respective ownership interests. Intercompany profits, transactions and balances have been eliminated. All limited partnerships and LLCs and noncontrolling partners are referred to herein as (“partnerships”) and (“partners”), respectively. | |
Ownership interests in consolidated subsidiaries held by parties other than the Company are identified and generally presented in the consolidated financial statements within the equity section but separate from the Company's equity. However, in instances in which certain redemption features that are not solely within the control of the Company are present, classification of noncontrolling interests outside of permanent equity is required. Consolidated net income attributable to the Company and to the noncontrolling interests are identified and presented on the consolidated statements of income; changes in ownership interests are accounted for as equity transactions; and when a subsidiary is deconsolidated, any retained noncontrolling equity investment in the former subsidiary and the gain or loss on the deconsolidation of the subsidiary is measured at fair value. Certain transactions with noncontrolling interests are also classified within financing activities in the consolidated statements of cash flows. | |
As further described in note 14, upon the occurrence of various fundamental regulatory changes, the Company would be obligated, under the terms of certain partnership and operating agreements, to purchase the noncontrolling interests related to a substantial majority of the Company's partnerships. While the Company believes that the likelihood of a change in current law that would trigger such purchases was remote as of December 31, 2013, the occurrence of such regulatory changes is outside the control of the Company. As a result, these noncontrolling interests that are subject to this redemption feature are not included as part of the Company's equity and are classified as noncontrolling interests – redeemable on the Company's consolidated balance sheets. | |
Center profits and losses of consolidated entities are allocated to the Company's partners in proportion to their ownership percentages and reflected in the aggregate as net earnings attributable to noncontrolling interests. The partners of the Company's center partnerships typically are organized as general partnerships, limited partnerships or limited liability companies that are not subject to federal income tax. Each partner shares in the pre-tax earnings of the center in which it is a partner. Accordingly, the earnings attributable to noncontrolling interests in each of the Company's consolidated partnerships are generally determined on a pre-tax basis, and total net earnings attributable to noncontrolling interests are presented after net earnings. However, the Company considers the impact of the net earnings attributable to noncontrolling interests on earnings before income taxes in order to determine the amount of pre-tax earnings on which the Company must determine its tax expense. In addition, distributions from the partnerships are made to both the Company's wholly owned subsidiaries and the partners on a pre-tax basis. | |
Investments in unconsolidated affiliates in which the Company exerts significant influence but does not control or otherwise consolidate are accounted for using the equity method. These investments are included as investments in unconsolidated affiliates and long-term notes receivable in the accompanying consolidated balance sheets. The Company's share of the profits and losses from these investments are reported in equity in earnings of unconsolidated affiliates in the accompanying consolidated statement of earnings and comprehensive income. The Company monitors its investments for other-than-temporary impairment by considering factors such as current economic and market conditions and the operating performance of the companies and records reductions in carrying values when necessary. | |
Each of the Company's centers have similar economic characteristics and are aggregated into a single component. The Company operates this component as one reportable business segment, the ownership and operation of ambulatory surgery centers. | |
b. Cash and Cash Equivalents | |
Cash and cash equivalents are comprised principally of demand deposits at banks and other highly liquid short-term investments with maturities of less than three months when purchased. | |
c. Accounts Receivable | |
The determination of contractual and bad debt allowances constitutes a significant estimate. Some of the factors considered by management in determining the amount of such allowances are the historical trends of the centers' cash collections and contractual and bad debt write-offs, accounts receivable agings, established fee schedules, contracts with payors and procedure statistics. Accordingly, net accounts receivable at December 31, 2013 and 2012 reflect allowances for contractual adjustments of $289,937,000 and $216,363,000, respectively, and allowance for bad debt expense of $27,862,000 and $22,379,000, respectively. | |
d. Supplies Inventory | |
Supplies inventory consists of medical and drug supplies and is recorded at cost on a first-in, first-out basis. | |
e. Prepaid and Other Current Assets | |
At December 31, 2013, prepaid and other current assets were comprised of short-term investments of $13,313,000, other prepaid expenses of $7,099,000, prepaid insurance expense of $5,631,000, other current receivables of $6,126,000 and other current assets of $1,433,000. At December 31, 2012, prepaid and other current assets were comprised of short-term investments of $8,804,000, other prepaid expenses of $6,462,000, prepaid insurance expense of $4,963,000, other current receivables of $5,926,000 and other current assets of $1,382,000. | |
f. Property and Equipment, net | |
Property and equipment are stated at cost. Equipment held under capital leases is stated at the present value of minimum lease payments at the inception of the related leases. Depreciation for buildings and improvements is recognized under the straight-line method over 20 to 40 years or, for leasehold improvements, over the remaining term of the lease plus renewal options for which failure to renew the lease imposes a penalty on the Company in such an amount that a renewal appears, at the inception of the lease, to be reasonably assured. The primary penalty to which the Company is subject is the economic detriment associated with existing leasehold improvements which might be impaired if a decision is made not to continue the use of the leased property. Depreciation for movable equipment and software and software development costs is recognized over useful lives of three to ten years. | |
g. Goodwill | |
The Company evaluates goodwill for impairment at least on an annual basis and more frequently if certain indicators are encountered. Goodwill is to be tested at the reporting unit level, defined as an operating segment or one level below an operating segment (referred to as a component), with the fair value of the reporting unit being compared to its carrying amount, including goodwill. If the fair value of a reporting unit exceeds its carrying amount, goodwill of the reporting unit is not considered to be impaired. The Company has determined that it has one operating, as well as one reportable, segment. For impairment testing purposes, the centers qualify as components of that operating segment. Because they have similar economic characteristics, the components are aggregated and deemed a single reporting unit. The Company completed its annual impairment test as of December 31, 2013, and determined that goodwill was not impaired. | |
h. Intangible Assets | |
Intangible assets consist primarily of deferred financing costs of the Company and certain amortizable and non-amortizable non-compete and customer agreements. Deferred financing costs and amortizable non-compete agreements and customer agreements are amortized over the term of the related debt as interest expense and the contractual term or estimated life (five to ten years) of the agreements as amortization expense, respectively. | |
i. Other Long-Term Liabilities | |
At December 31, 2013, other long-term liabilities are comprised of deferred rent of $14,637,000, tax-effected unrecognized benefits of $6,888,000 (see note 1(k)), unfavorable lease liability of $3,034,000 and other long-term liabilities of $944,000. At December 31, 2012, other long-term liabilities are comprised of deferred rent of $12,134,000, tax-effected unrecognized benefits of $10,113,000 (see note 1(k)), unfavorable lease liability of $3,559,000 and other long-term liabilities of $166,000. | |
j. Revenue Recognition | |
Center revenues consist of billing for the use of the centers' facilities directly to the patient or third-party payor and, at certain of our centers (primarily centers that perform gastrointestinal endoscopy procedures), billing for anesthesia services provided by medical professionals employed or contracted by our centers. Such revenues are recognized when the related surgical procedures are performed. Revenues exclude any amounts billed for physicians' surgical services, which are billed separately by the physicians to the patient or third-party payor. | |
Revenues from centers are recognized on the date of service, net of estimated contractual adjustments from third-party medical service payors including Medicare and Medicaid. During the years ended December 31, 2013, 2012 and 2011, the Company derived approximately 25%, 27% and 29%, respectively, of its revenues from government healthcare programs, primarily Medicare, and managed Medicare programs. Concentration of credit risk with respect to other payors is limited due to the large number of such payors. | |
k. Operating Expenses | |
Substantially all of the Company's operating expenses relate to the cost of revenues and the delivery of care at the Company's surgery centers. Such costs primarily include the surgery centers' clinical and administrative salaries and benefits, supply cost, rent and other variable expenses, such as linen cost, repair and maintenance of equipment, billing fees and bad debt expense. Bad debt expense for continuing operations was approximately $21,947,000, $20,005,000 and $18,230,000 for the years ended December 31, 2013, 2012 and 2011, respectively. | |
l. Income Taxes | |
The Company files a consolidated federal income tax return. Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. | |
The Company applies recognition thresholds and measurement attributes for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return as it relates to accounting for uncertainty in income taxes. In addition, it is the Company's policy to recognize interest accrued and penalties, if any, related to unrecognized benefits as income tax expense in its statement of earnings. The Company does not expect significant changes to its tax positions or liability for tax uncertainties during the next 12 months. | |
The Company and its subsidiaries file income tax returns in the U.S. federal jurisdiction and various state jurisdictions. With few exceptions, the Company is no longer subject to U.S. federal or state income tax examinations for years prior to 2010. | |
m. Earnings Per Share | |
Basic earnings per share is computed by dividing net earnings attributable to AmSurg Corp. common shareholders by the combined weighted average number of common shares, while diluted earnings per share is computed by dividing net earnings attributable to AmSurg Corp. common shareholders by the weighted average number of such common shares and dilutive share equivalents. | |
n. Share-Based Compensation | |
Transactions in which the Company receives employee and non-employee services in exchange for the Company's equity instruments or liabilities that are based on the fair value of the Company's equity securities or may be settled by the issuance of these securities are accounted using a fair value method. The Company applies the Black-Scholes method of valuation in determining share-based compensation expense. | |
Benefits of tax deductions in excess of recognized compensation cost are reported as a financing cash flow, thus reducing the Company's net operating cash flows and increasing its financing cash flows by $7,247,000, $1,784,000 and $977,000 for the years ended December 31, 2013, 2012 and 2011, respectively. | |
The Company examines its concentrations of holdings, its historical patterns of award exercises and forfeitures as well as forward-looking factors, in an effort to determine if there were any discernible employee populations. From this analysis, the Company has identified three employee populations, consisting of senior executives, officers and all other recipients. The expected volatility rate applied was estimated based on historical volatility. The expected term assumption applied is based on contractual terms, historical exercise and cancellation patterns and forward-looking factors where present for each population identified. The risk-free interest rate used is based on the U.S. Treasury yield curve in effect at the time of the grant. The pre-vesting forfeiture rate is based on historical rates and forward-looking factors for each population identified. The Company will adjust the estimated forfeiture rate to its actual experience. The Company intends to retain its earnings to finance growth and development of the business and does not expect to disclose or pay any cash dividends in the foreseeable future. | |
o. Use of 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 reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. | |
p. Reclassifications | |
Certain prior year amounts in the accompanying consolidated financial statements and these notes have been reclassified to reflect the impact of additional discontinued operations as further discussed in note 3. |
Acquisitions_and_Investments_i
Acquisitions and Investments in Unconsolidated Affiliates | 12 Months Ended | ||||||||
Dec. 31, 2013 | |||||||||
Acquisitions and Investments in Unconsolidated Affiliates | ' | ||||||||
Acquisitions and Investments in Unconsolidated Affiliates | ' | ||||||||
2. Acquisitions and Investments in Unconsolidated Affiliates | |||||||||
As a significant part of its growth strategy, the Company primarily acquires controlling interests in centers. The Company accounts for its business combinations under the fundamental requirements of the acquisition method of accounting and under the premise that an acquirer be identified for each business combination. The acquirer is the entity that obtains control of one or more businesses in the business combination and the acquisition date is the date the acquirer achieves control. The assets acquired, liabilities assumed and any noncontrolling interests in the acquired business at the acquisition date are recognized at their fair values as of that date, and the direct costs incurred in connection with the business combination are recorded and expensed separately from the business combination. Acquisitions in which the Company is able to exert significant influence but does not have control are accounted for using the equity method. Equity method investments are initially recorded at cost, unless such investments are a result of the Company entering into a transaction whereby the Company loses control of a previously controlled entity but retains a noncontrolling interest. Such transactions, which result in the deconsolidation of a previously consolidated entity, are measured at fair value. | |||||||||
During 2013 and 2012, the Company, through a wholly owned subsidiary, acquired a controlling interest in five centers and 17 centers, respectively. One of the centers acquired during 2012 was immediately merged into an existing center. | |||||||||
The aggregate amount paid for the centers acquired and for settlement of purchase price payable obligations during December 31, 2013 and 2012 was approximately $73,594,000 and $277,388,000, respectively, and was paid in cash and funded by a combination of operating cash flow and borrowings under the Company's revolving credit facility. The total fair value of an acquisition includes an amount allocated to goodwill, which results from the centers' favorable reputations in their markets, their market positions and their ability to deliver quality care with high patient satisfaction consistent with the Company's business model. | |||||||||
In conjunction with the Company's acquisition of 17 centers from National Surgical Care, Inc. (“NSC”) on September 1, 2011, the Company agreed to pay as additional consideration an amount up to $7,500,000 based on a multiple of the excess earnings over the targeted earnings of the acquired centers, if any, from the period of January 1, 2012 to December 31, 2012. At December 31, 2012, the Company had a contingent purchase price obligation of $2,744,000, which was paid during 2013 as final settlement of the additional consideration due in accordance with the purchase agreement. | |||||||||
The acquisition date fair value of the total consideration transferred and acquisition date fair value of each major class of consideration for the acquisitions completed during 2013 and 2012, including post acquisition date adjustments recorded to finalize purchase price allocations, are as follows (in thousands): | |||||||||
2013 | 2012 | ||||||||
Accounts receivable | $ | 4,011 | $ | 11,572 | |||||
Supplies inventory, prepaid and other current assets | 2,014 | 4,750 | |||||||
Property and equipment | 6,894 | 23,546 | |||||||
Goodwill | 116,243 | 429,504 | |||||||
Other intangible assets | - | 800 | |||||||
Accounts payable | -2,214 | -3,199 | |||||||
Other accrued liabilities | -532 | -2,387 | |||||||
Long-term debt | -3,028 | -6,954 | |||||||
Other long-term liabilities | -254 | - | |||||||
Total fair value | 123,134 | 457,632 | |||||||
Less: Fair value attributable to noncontrolling interests | 49,792 | 182,073 | |||||||
Acquisition date fair value of total consideration transferred | $ | 73,342 | $ | 275,559 | |||||
Fair value attributable to noncontrolling interests is based on significant inputs that are not observable in the market. Key inputs used to determine the fair value include financial multiples used in the purchase of noncontrolling interests in centers. Such multiples, based on earnings, are used as a benchmark for the discount to be applied for the lack of control or marketability. The fair value of noncontrolling interests for acquisitions where the purchase price allocation is not finalized may be subject to adjustment as the Company completes its initial accounting for acquired intangible assets. During 2013 and 2012, approximately $70,147,000 and $260,547,000, respectively, of goodwill recorded was deductible for tax purposes. Associated with the transactions discussed above, the Company incurred and expensed in other operating expenses in the accompanying consolidated statements of earnings approximately $300,000 and $700,000 in acquisition related costs during 2013 and 2012, respectively. | |||||||||
Revenues and net earnings included in the years ended December 31, 2013 and 2012 associated with these acquisitions are as follows (in thousands): | |||||||||
2013 | 2012 | ||||||||
Revenues | $ | 15,616 | $ | 11,247 | |||||
Net earnings | 4,596 | 3,441 | |||||||
Less: Net earnings attributable to noncontrolling interests | 2,603 | 1,977 | |||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 1,993 | $ | 1,464 | |||||
The unaudited consolidated pro forma results for the years ended December 31, 2013 and 2012, assuming all 2013 acquisitions had been consummated on January 1, 2012 and all 2012 acquisitions had been consummated on January 1, 2011, are as follows (in thousands, except per share data): | |||||||||
2013 | 2012 | ||||||||
Revenues | $ | 1,108,686 | $ | 1,116,214 | |||||
Net earnings | 269,903 | 261,251 | |||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||
Net earnings from continuing operations | 75,411 | 76,893 | |||||||
Net earnings | 75,461 | 77,221 | |||||||
Net earnings from continuing operations per common share: | |||||||||
Basic | $ | 2.41 | $ | 2.5 | |||||
Diluted | $ | 2.36 | $ | 2.43 | |||||
Net earnings: | |||||||||
Basic | $ | 2.41 | $ | 2.51 | |||||
Diluted | $ | 2.36 | $ | 2.44 | |||||
Weighted average number of shares and share equivalents: | |||||||||
Basic | 31,338 | 30,773 | |||||||
Diluted | 31,954 | 31,608 | |||||||
During 2013, the Company entered into a transaction whereby it contributed cash plus a controlling interest in one center in exchange for a noncontrolling interest in an entity that, after the completion of the transaction, controls the contributed center and one additional center. Management of the Company believes this structure provides both economies of scale and potential future growth opportunities in the market. As a result of the transaction, the Company recorded in the accompanying consolidated balance sheets the fair value of the noncontrolling interest in the entity which now controls the contributed centers of approximately $5,201,000 as a component of investments in unconsolidated affiliates and long term notes receivable. The Company also recognized a gain on deconsolidation in the accompanying consolidated statements of earnings and comprehensive income of approximately $2,237,000. Such gain was determined based on the difference between the fair value of the Company's noncontrolling interest in the new entity and the carrying value of both the tangible and intangible assets of the contributed center immediately prior to the transaction. The fair value of the Company's noncontrolling interest was based on various estimates of the expected future earnings under likely scenarios which were weighted by the probability of each outcome using a range of expected probability of 5% to 30%. Subsequent to the completion of this transaction, the center contributed by the Company was merged into the acquired center. |
Dispositions
Dispositions | 12 Months Ended | ||||||||
Dec. 31, 2013 | |||||||||
Dispositions | ' | ||||||||
Dispositions | ' | ||||||||
3. Dispositions | |||||||||
The Company initiated the dispositions of certain of its centers primarily due to management's assessment of the limited growth opportunities at these centers and as a result of certain market driven strategies. Results of operations of the centers discontinued for the years ended December 31, 2013, 2012 and 2011, are as follows (in thousands): | |||||||||
2013 | 2012 | 2011 | |||||||
Cash proceeds from disposal | $ | 3,553 | $ | 7,309 | $ | 7,026 | |||
Net earnings from discontinued operations | 2,771 | 2,221 | 1,820 | ||||||
Net gain (loss) from discontinued operations attributable to AmSurg Corp. | 50 | 328 | -28 | ||||||
The results of operations of discontinued centers have been classified as discontinued operations in all periods presented. Results of operations of the combined discontinued surgery centers for the years ended December 31, 2013, 2012 and 2011 are as follows (in thousands): | |||||||||
2013 | 2012 | 2011 | |||||||
Revenues | $ | 3,224 | $ | 10,975 | $ | 18,814 | |||
Earnings before income taxes | 227 | 2,724 | 4,318 | ||||||
Net earnings | 169 | 2,196 | 3,363 |
Property_and_Equipment
Property and Equipment | 12 Months Ended | ||||||
Dec. 31, 2013 | |||||||
Property, Plant and Equipment | ' | ||||||
Property, Plant and Equipment | ' | ||||||
4. Property and Equipment | |||||||
Property and equipment at December 31, 2013 and 2012 were as follows (in thousands): | |||||||
2013 | 2012 | ||||||
Building and improvements | $ | 161,805 | $ | 151,270 | |||
Movable equipment and software | 228,212 | 208,541 | |||||
Construction in progress | 2,321 | 2,313 | |||||
392,338 | 362,124 | ||||||
Less accumulated depreciation | -222,443 | -195,512 | |||||
Property and equipment, net | $ | 169,895 | $ | 166,612 | |||
The Company capitalized interest in the amount of $24,000, $43,000 and $85,000 for the years ended December 31, 2013, 2012 and 2011, respectively. At December 31, 2013, the Company and its partnerships had unfunded construction and equipment purchases of approximately $953,000 in order to complete construction in progress. Depreciation expense for continuing and discontinued operations for the years ended December 31, 2013, 2012 and 2011 was $32,974,000, $30,072,000 and $26,068,000, respectively. | |||||||
Goodwill_And_Intangible_Assets
Goodwill And Intangible Assets | 12 Months Ended | |||||||||||||||||||||
Dec. 31, 2013 | ||||||||||||||||||||||
Goodwill And Intangible Assets | ' | |||||||||||||||||||||
Goodwill And Intangible Assets | ' | |||||||||||||||||||||
5. Goodwill and Intangible Assets | ||||||||||||||||||||||
The changes in the carrying amount of goodwill for the years ended December 31, 2013 and 2012 are as follows (in thousands): | ||||||||||||||||||||||
2013 | 2012 | |||||||||||||||||||||
Balance, beginning of period | $ | 1,652,002 | $ | 1,229,298 | ||||||||||||||||||
Goodwill acquired, including post acquisition adjustments | 112,951 | 429,504 | ||||||||||||||||||||
Goodwill disposed, including impact of deconsolidation transaction | -5,983 | -6,800 | ||||||||||||||||||||
Balance, end of period | $ | 1,758,970 | $ | 1,652,002 | ||||||||||||||||||
Amortizable intangible assets at December 31, 2013 and 2012 consisted of the following (in thousands): | ||||||||||||||||||||||
2013 | 2012 | |||||||||||||||||||||
Gross | Gross | |||||||||||||||||||||
Carrying | Accumulated | Carrying | Accumulated | |||||||||||||||||||
Amount | Amortization | Net | Amount | Amortization | Net | |||||||||||||||||
Deferred financing cost | $ | 15,814 | $ | -4,953 | $ | 10,861 | $ | 14,523 | $ | -3,029 | $ | 11,494 | ||||||||||
Agreements, contracts and other intangible assets | 3,448 | -2,472 | 976 | 3,448 | -2,250 | 1,198 | ||||||||||||||||
Total amortizable intangible assets | $ | 19,262 | $ | -7,425 | $ | 11,837 | $ | 17,971 | $ | -5,279 | $ | 12,692 | ||||||||||
Amortization of intangible assets for the years ended December 31, 2013, 2012 and 2011 was $2,178,000, $1,415,000 and $1,472,000, respectively. During 2012, deferred financing costs increased approximately $6,200,000 related to the issuance of the senior unsecured notes. Estimated amortization of intangible assets for the five years and thereafter subsequent to December 31, 2013, with a weighted average amortization period of 5.7 years, is $2,243,000, $2,242,000, $2,242,000, $1,988,000, $1,424,000 and $1,698,000. | ||||||||||||||||||||||
At December 31, 2013 and 2012, other non-amortizable intangible assets related to restrictive covenant arrangements were $9,825,000, respectively. | ||||||||||||||||||||||
LongTerm_Debt
Long-Term Debt | 12 Months Ended | |||||||
Dec. 31, 2013 | ||||||||
Long-Term Debt | ' | |||||||
Long-Term Debt | ' | |||||||
6. Long-term Debt | ||||||||
Long-term debt at December 31, 2013 and 2012 was comprised of the following (in thousands): | ||||||||
2013 | 2012 | |||||||
Revolving credit agreement (average rate of 2.1%) | $ | 252,500 | $ | 279,780 | ||||
Senior Unsecured Notes due 2020 (5.625%) | 250,000 | 250,000 | ||||||
Senior Secured Notes due 2020 (8.04%) | 69,643 | 75,000 | ||||||
Other debt at an average rate of 3.6%, due through 2025 | 21,149 | 21,350 | ||||||
Capitalized lease arrangements at an average rate of 5.3%, due through 2026 | 10,850 | 11,982 | ||||||
604,142 | 638,112 | |||||||
Less current portion | 20,844 | 17,407 | ||||||
Long-term debt | $ | 583,298 | $ | 620,705 | ||||
Principal payments required on the Company's long-term debt and capital leases in the five years and thereafter subsequent to December 31, 2013 are $20,844,000, $17,751,000, $14,903,000, $13,422,000, $265,037,000, and $272,185,000. | ||||||||
a. Credit Facility | ||||||||
On June 29, 2012, the Company amended its revolving credit agreement to increase the borrowing capacity and adjust the interest rate spreads. On November 7, 2012, the Company further amended its revolving credit agreement to allow for the Company's issuance of the 5.625% senior unsecured notes (discussed below), which resulted in certain adjustments to the existing covenants. On June 14, 2013, the Company amended its revolving credit agreement to adjust the interest rate spreads and extend the maturity date by one year. The revolving credit agreement, as amended, permits the Company to borrow up to $475,000,000 at an interest rate equal to, at the Company's option, the base rate plus 0.25% to 1.00% or LIBOR plus 1.25% to 2.00%, or a combination thereof; provides for a fee of 0.25% to 0.40% of unused commitments; and contains certain covenants relating to the ratio of debt to operating performance measurements, interest coverage ratios and minimum net worth. Borrowings under the revolving credit agreement mature in June 2018 and are secured by a pledge of the stock of the Company's wholly-owned subsidiaries and the Company's partnership and membership interests in the limited partnerships and limited liability companies. The Company was in compliance with the covenants contained in the revolving credit agreement at December 31, 2013. | ||||||||
b. Senior Unsecured Notes | ||||||||
On November 20, 2012, the Company completed a private offering of $250,000,000 aggregate principal amount of 5.625% senior unsecured notes due 2020 (the “Senior Unsecured Notes”). The net proceeds from the issuance of the Senior Unsecured Notes were used to reduce the outstanding indebtedness under the Company's existing revolving credit agreement. In connection with the issuance of the Senior Unsecured Notes, the Company entered into a registration rights agreement, dated November 20, 2012 (the “Registration Rights Agreement”). On May 2, 2013, under the terms of the Registration Rights Agreement, the Company commenced an offer to exchange the outstanding Senior Unsecured Notes for an equal amount of such notes that are registered under the Securities Act of 1933, as amended. The exchange offer was completed on May 31, 2013 and all holders of the Senior Unsecured Notes participated in the exchange. The Senior Unsecured Notes are general unsecured obligations of the Company and are guaranteed by its existing and subsequently acquired or organized wholly owned domestic subsidiaries. The Senior Unsecured Notes are pari passu in right of payment with all the existing and future senior debt of the Company and senior to all existing and future subordinated debt of the Company. Interest on the Senior Unsecured Notes accrues at the rate of 5.625% per annum and is payable semi-annually in arrears on May 30 and November 30, through the maturity date of November 30, 2020. | ||||||||
Prior to November 30, 2015, the Company may redeem up to 35% of the aggregate principal amount of the Senior Unsecured Notes at a redemption price of 105.625% of the principal amount thereof, plus accrued and unpaid interest and liquidated damages, if any, using proceeds of one or more equity offerings. On or after November 30, 2015, the Company may redeem the Senior Unsecured Notes in whole or in part. The redemption price for such a redemption (expressed as percentages of principal amount) is set forth below, plus accrued and unpaid interest and liquidated damages, if any, if redeemed during the twelve-month period beginning on November 30 of the years indicated below: | ||||||||
Period | Redemption Price | |||||||
2015 | 104.22% | |||||||
2016 | 102.81% | |||||||
2017 | 101.41% | |||||||
2018 and thereafter | 100.00% | |||||||
The Senior Unsecured Notes contain certain covenants which, among other things, limit, but may not restrict the Company's ability to enter into or guarantee additional borrowings, sell preferred stock, pay dividends and repurchase stock. The Company was in compliance with the covenants contained in the indenture relating to the Senior Unsecured Notes at December 31, 2013. | ||||||||
c. Senior Secured Notes | ||||||||
The Company issued $75,000,000 principal amount of senior secured notes (the “Senior Secured Notes”) on May 28, 2010 pursuant to a note purchase agreement. The Senior Secured Notes mature on May 28, 2020. The Senior Secured Notes, which were originally issued with a stated interest rate of 6.04%, were amended on November 7, 2012 to allow for the Company's issuance of the Senior Unsecured Notes, which resulted in an increase in the annual interest rate of 2.00% to 8.04%, and included certain other adjustments to the existing covenants. The Senior Secured Notes are pari passu with the indebtedness under the Company's revolving credit agreement and the Senior Unsecured Notes and principal payments began in August 2013. The note purchase agreement governing the Senior Secured Notes contains covenants similar to the covenants in the revolving credit agreement and includes a make whole provision in the event of any prepayment of principle. The Company was in compliance with the covenants contained in the note purchase agreement relating to the Senior Secured Notes at December 31, 2013. | ||||||||
d. Other Debt | ||||||||
Certain partnerships included in the Company's consolidated financial statements have loans with local lending institutions, included above in other debt, which are collateralized by certain assets of the centers with a book value of approximately $74,150,000. The Company and the partners have guaranteed payment of the loans in proportion to the relative partnership interests. |
Derivative_Instruments
Derivative Instruments | 12 Months Ended |
Dec. 31, 2013 | |
Derivative Instruments | ' |
Derivative Instruments | ' |
7. Derivative Instruments | |
The Company entered into an interest rate swap agreement in April 2006, the objective of which was to hedge exposure to the variability of the future expected cash flows attributable to the variable interest rate of a portion of the Company's outstanding balance under its revolving credit agreement. The interest rate swap matured in April 2011. Prior to April 2011, the interest rate swap had a notional amount of $50,000,000. The Company paid to the counterparty a fixed rate of 5.365% of the notional amount of the interest rate swap and received a floating rate from the counterparty based on LIBOR. In the opinion of management and as permitted by Accounting Standards Codification Topic 815, Derivatives and Hedging (“ASC 815”), the interest rate swap (as a cash flow hedge) was a fully effective hedge. Payments or receipts of cash under the interest rate swap were shown as a part of operating cash flows, consistent with the interest expense incurred pursuant to the revolving credit agreement. An increase in the fair value of the interest rate swap, net of tax, of $515,000 was included in other comprehensive income in the year ended December 31, 2011. |
Fair_Value_Measurements
Fair Value Measurements | 12 Months Ended | ||||||||
Dec. 31, 2013 | |||||||||
Fair Value Measurements | ' | ||||||||
Fair Value Measurements | ' | ||||||||
8. Fair Value Measurements | |||||||||
The fair value of a financial instrument is the amount at which the instrument could be exchanged in an orderly transaction between market participants to sell the asset or transfer the liability. The inputs used by the Company to measure fair value are classified into the following fair value hierarchy: | |||||||||
Level 1: Quoted prices in active markets for identical assets or liabilities. | |||||||||
Level 2: Inputs other than quoted prices included in Level 1 that are observable for the asset or liability through corroboration with market data at the measurement date. | |||||||||
Level 3: Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date. | |||||||||
In determining the fair value of assets and liabilities that are measured on a recurring basis at December 31, 2013 and 2012, with the exception of the contingent purchase price payable, the Company utilized Level 2 inputs to perform such measurements methods which were commensurate with the market approach. The Company utilized Level 3 inputs, which utilizes unobservable data, to measure the fair value of the contingent purchase price payable (in thousands): | |||||||||
2013 | 2012 | ||||||||
Assets: | |||||||||
Supplemental executive retirement savings plan investments - Level 2 | $ | 13,313 | $ | 8,804 | |||||
Liabilities: | |||||||||
Contingent purchase price payable - Level 3 (see note 2) | $ | - | $ | 2,744 | |||||
The fair value of the supplemental executive and director retirement savings plan investments, which are included in prepaid and other current assets, was determined using the calculated net asset values obtained from the plan administrator and observable inputs of similar public mutual fund investments. The fair value of the contingent purchase price payable related to the centers acquired from NSC as of December 31, 2012, was determined utilizing the actual earnings of those centers during the earnout period, January 1, 2012 to December 31, 2012, in accordance with the purchase agreement. During the year ended December 31, 2013, the Company paid $2,744,000 as final settlement of the contingent purchase price payable using its revolving credit facility. There were no transfers to or from Levels 1 and 2 during the year ended December 31, 2013. | |||||||||
Cash and cash equivalents, receivables and payables are reflected in the financial statements at cost, which approximates fair value. The fair value of fixed rate long-term debt, with a carrying value of $348,958,000, was approximately $364,349,000 at December 31, 2013. The fair value of variable-rate long-term debt approximates its carrying value of $255,184,000 at December 31, 2013. The fair value of fixed rate long-term debt, with a carrying value of $354,105,000, was approximately $379,036,000 at December 31, 2012. The fair value of variable-rate long-term debt approximates its carrying value of $284,007,000 at December 31, 2012.With the exception of the Company's Senior Unsecured Notes, the fair value of fixed rate debt (Level 2) is determined based on an estimation of discounted future cash flows of the debt at rates currently quoted or offered to the Company for similar debt instruments of comparable maturities by its lenders. The fair value of the Company's Senior Unsecured Notes (Level 1) is determined based on quoted prices in an active market. | |||||||||
Leases
Leases | 12 Months Ended | |||||||
Dec. 31, 2013 | ||||||||
Leases | ' | |||||||
Leases | ' | |||||||
9. Leases | ||||||||
The Company has entered into various building and equipment capital and operating leases for its surgery centers in operation and under development and for office space, expiring at various dates through 2033. Future minimum lease payments, including payments during expected renewal option periods, at December 31, 2013 were as follows (in thousands): | ||||||||
Capitalized | Operating | |||||||
Year Ended December 31, | Equipment Leases | Leases | ||||||
2014 | $ | 2,040 | $ | 47,704 | ||||
2015 | 1,673 | 46,557 | ||||||
2016 | 1,404 | 45,772 | ||||||
2017 | 1,184 | 45,174 | ||||||
2018 | 1,000 | 43,718 | ||||||
Thereafter | 7,003 | 354,087 | ||||||
Total minimum rentals | 14,304 | $ | 583,012 | |||||
Less amounts representing interest at rates ranging from 2.9% to 11.8% | 3,454 | |||||||
Capital lease obligations | $ | 10,850 | ||||||
At December 31, 2013, buildings and equipment with a cost of approximately $13,950,000 and accumulated depreciation of approximately $3,635,000 were held under capital leases. The Company and the partners in the partnerships have guaranteed payment of certain of these leases. Rental expense for continuing and discontinued operations for operating leases for the years ended December 31, 2013, 2012 and 2011 was approximately $52,641,000, $47,278,000 and $42,413,000, respectively. |
Shareholders_Equity
Shareholders' Equity | 12 Months Ended | ||||||||||
Dec. 31, 2013 | |||||||||||
Shareholders' Equity | ' | ||||||||||
Shareholders' Equity | ' | ||||||||||
10. Shareholders' Equity | |||||||||||
a. Common Stock | |||||||||||
On April 24, 2012, the Board of Directors authorized a stock purchase program for up to $40,000,000 of the Company's shares of common stock. The Company completed this repurchase program in August 2013. On August 9, 2013, the Board of Directors authorized a stock purchase program for up to $40,000,000 of the Company's shares of common stock to be purchased through February 9, 2015. As of December 31, 2013, there was approximately $27,100,000 available under the stock repurchase program. | |||||||||||
During the year ended 2013, the Company purchased 1,154,378 shares of the Company's common stock for approximately $42,652,000, at an average price of $36.93 per share, in order to mitigate the dilutive effect of shares issued upon the exercise of stock options pursuant to the Company's stock incentive plans. During the year ended 2012, the Company purchased 415,084 shares of the Company's common stock for approximately $11,838,000, at an average price of $28.50 per share. In addition, during 2013 and 2012, the Company repurchased 102,252 shares and 48,139 shares, respectively, of common stock for approximately $3,312,000 and $1,263,000, respectively, to cover payroll withholding taxes in connection with the vesting of restricted stock awards in accordance with the restricted stock agreements. | |||||||||||
b. Stock Incentive Plans | |||||||||||
In May 2006, the Company adopted the AmSurg Corp. 2006 Stock Incentive Plan. The Company also has options outstanding under the AmSurg Corp. 1997 Stock Incentive Plan, under which no additional awards may be granted. Under these plans, the Company has granted restricted stock and non-qualified options to purchase shares of common stock to employees and outside directors from its authorized but unissued common stock. At December 31, 2013, 2,760,250 shares were authorized for grant under the 2006 Stock Incentive Plan and 895,822 shares were available for future equity grants, including 733,704 shares available for issuance as restricted stock. Restricted stock granted to outside directors prior to 2012 vested over a two year period and restricted stock granted to outside directors in 2012 and 2013 vest over a one year period. Shares held by outside directors are subject to certain holding restrictions. Restricted stock granted to employees during 2010 and thereafter vests over four years in three equal installments beginning on the second anniversary of the date of grant. Restricted stock granted to employees prior to 2010 vests at the end of four years from the date of grant. Shares held by the Company's senior management are subject to certain holding restrictions. The fair value of restricted stock is determined based on the closing bid price of the Company's common stock on the grant date. | |||||||||||
No options have been issued subsequent to 2008 and all outstanding options are fully vested. Options were granted at market value on the date of the grant and vested over four years. Outstanding options have a term of ten years from the date of grant. | |||||||||||
Other information pertaining to share-based activity for the years ended December 31, 2013, 2012 and 2011 was as follows (in thousands): | |||||||||||
2013 | 2012 | 2011 | |||||||||
Share-based compensation expense | $ | 8,321 | $ | 6,692 | $ | 6,178 | |||||
Fair value of shares vested | 11,742 | 6,425 | 7,356 | ||||||||
Cash received from option exercises | 33,349 | 18,214 | 6,872 | ||||||||
Tax benefit from option exercises | 7,247 | 1,784 | 977 | ||||||||
As of December 31, 2013, the Company had total unrecognized compensation cost of approximately $7,426,000 related to non-vested awards, which the Company expects to recognize through 2017 and over a weighted-average period of 1.0 year. | |||||||||||
Average outstanding share-based awards to purchase approximately 20,000 and 923,000 shares of common stock that had an exercise price in excess of the average market price of the common stock during the years ended December 31, 2012 and 2011, respectively, were not included in the calculation of diluted securities under the treasury method for purposes of determining diluted earnings per share due to their anti-dilutive impact. During the year ended December 31, 2013, there were no options that were anti-dilutive. | |||||||||||
A summary of the status of and changes for non-vested restricted shares for the three years ended December 31, 2013, is as follows: | |||||||||||
Weighted | |||||||||||
Number | Average | ||||||||||
of | Grant | ||||||||||
Shares | Price | ||||||||||
Non-vested shares at January 1, 2011 | 664,909 | $ | 22.16 | ||||||||
Shares granted | 276,869 | 21.78 | |||||||||
Shares vested | -208,949 | 23.11 | |||||||||
Shares forfeited | -417 | 24.75 | |||||||||
Non-vested shares at December 31, 2011 | 732,412 | $ | 21.91 | ||||||||
Shares granted | 281,429 | 26.78 | |||||||||
Shares vested | -183,019 | 25.98 | |||||||||
Shares forfeited | -2,136 | 26.26 | |||||||||
Non-vested shares at December 31, 2012 | 828,686 | $ | 22.5 | ||||||||
Shares granted | 291,863 | 31.66 | |||||||||
Shares vested | -360,337 | 21.55 | |||||||||
Shares forfeited | -16,343 | 23.11 | |||||||||
Non-vested shares at December 31, 2013 | 743,869 | $ | 26.54 | ||||||||
A summary of stock option activity for the three years ended December 31, 2013 is summarized as follows: | |||||||||||
Weighted | |||||||||||
Average | |||||||||||
Weighted | Remaining | ||||||||||
Number | Average | Contractual | |||||||||
of | Exercise | Term | |||||||||
Shares | Price | (in years) | |||||||||
Outstanding at January 1, 2011 | 2,901,989 | $ | 22.49 | 4.5 | |||||||
Options exercised with total intrinsic value of $2,482,000 | -374,350 | 18.36 | |||||||||
Options terminated | -17,585 | 25.42 | |||||||||
Outstanding at December 31, 2011 | 2,510,054 | $ | 23.09 | 3.4 | |||||||
Options exercised with total intrinsic value of $6,287,000 | -841,599 | 21.64 | |||||||||
Options terminated | -5,625 | 21.85 | |||||||||
Outstanding at December 31, 2012 | 1,662,830 | $ | 23.82 | 2.9 | |||||||
Options exercised with total intrinsic value of $33,349,000 | -1,392,366 | 23.95 | |||||||||
Outstanding at December 31, 2013 with aggregate intrinsic value of $6,156,000 | 270,464 | $ | 23.16 | 2.5 | |||||||
Vested or expected to vest at December 31, 2013 with total intrinsic value of $6,156,000 | 270,464 | $ | 23.16 | 2.5 | |||||||
Exercisable at December 31, 2013 with total intrinsic value of $6,156,000 | 270,464 | $ | 23.16 | 2.5 | |||||||
The aggregate intrinsic value represents the total pre-tax intrinsic value received by the option holders on the exercise date or that would have been received by the option holders had all holders of in-the-money outstanding options at December 31, 2013 exercised their options at the Company's closing stock price on December 31, 2013. | |||||||||||
c. Earnings per Share | |||||||||||
The following is a reconciliation of the numerator and denominators of basic and diluted earnings per share (in thousands, except per share amounts): | |||||||||||
Per | |||||||||||
Earnings | Shares | Share | |||||||||
(Numerator) | (Denominator) | Amount | |||||||||
For the year ended December 31, 2013: | |||||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (basic) | $ | 72,653 | 31,338 | $ | 2.32 | ||||||
Effect of dilutive securities options and non-vested shares | - | 616 | |||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (diluted) | $ | 72,653 | 31,954 | $ | 2.27 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 72,703 | 31,338 | $ | 2.32 | ||||||
Effect of dilutive securities options and non-vested shares | - | 616 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 72,703 | 31,954 | $ | 2.28 | ||||||
For the year ended December 31, 2012: | |||||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (basic) | $ | 62,235 | 30,773 | $ | 2.02 | ||||||
Effect of dilutive securities options and non-vested shares | - | 835 | |||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (diluted) | $ | 62,235 | 31,608 | $ | 1.97 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 62,563 | 30,773 | $ | 2.03 | ||||||
Effect of dilutive securities options and non-vested shares | - | 835 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 62,563 | 31,608 | $ | 1.98 | ||||||
For the year ended December 31, 2011: | |||||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (basic) | $ | 50,025 | 30,452 | $ | 1.64 | ||||||
Effect of dilutive securities options and non-vested shares | - | 759 | |||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (diluted) | $ | 50,025 | 31,211 | $ | 1.6 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 49,997 | 30,452 | $ | 1.64 | ||||||
Effect of dilutive securities options and non-vested shares | - | 759 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 49,997 | 31,211 | $ | 1.6 |
Income_Taxes
Income Taxes | 12 Months Ended | |||||||||
Dec. 31, 2013 | ||||||||||
Income Taxes | ' | |||||||||
Income Taxes | ' | |||||||||
11. Income Taxes | ||||||||||
Total income taxes expense (benefit) for the years ended December 31, 2013, 2012 and 2011 was included within the following sections of the consolidated financial statements as follows (in thousands): | ||||||||||
2013 | 2012 | 2011 | ||||||||
Income from continuing operations | $ | 49,754 | $ | 42,364 | $ | 34,973 | ||||
Discontinued operations | -1,091 | 1,574 | 3,032 | |||||||
Shareholders’ equity | -7,381 | -1,581 | -649 | |||||||
Other comprehensive income | - | - | 332 | |||||||
Total | $ | 41,282 | $ | 42,357 | $ | 37,688 | ||||
Income tax expense from continuing operations for the years ended December 31, 2013, 2012 and 2011 was comprised of the following (in thousands): | ||||||||||
2013 | 2012 | 2011 | ||||||||
Current: | ||||||||||
Federal | $ | 8,437 | $ | 15,326 | $ | 11,671 | ||||
State | 3,724 | 4,974 | 3,541 | |||||||
Deferred: | ||||||||||
Federal | 31,909 | 18,488 | 17,502 | |||||||
State | 5,684 | 3,576 | 2,259 | |||||||
Income tax expense | $ | 49,754 | $ | 42,364 | $ | 34,973 | ||||
Income tax expense from continuing operations for the years ended December 31, 2013, 2012 and 2011 differed from the amount computed by applying the U.S. federal income tax rate of 35% to earnings before income taxes as a result of the following (in thousands): | ||||||||||
2013 | 2012 | 2011 | ||||||||
Statutory federal income tax | $ | 107,984 | $ | 92,325 | $ | 78,143 | ||||
Less federal income tax assumed directly by noncontrolling interests | -65,142 | -55,715 | -48,394 | |||||||
State income taxes, net of federal income tax benefit | 5,539 | 5,309 | 3,642 | |||||||
Increase in valuation allowances | 924 | 419 | 1,622 | |||||||
Interest related to unrecognized tax benefits | -155 | -109 | -83 | |||||||
Other | 604 | 135 | 43 | |||||||
Income tax expense | $ | 49,754 | $ | 42,364 | $ | 34,973 | ||||
The Company recognizes interest and penalties related to unrecognized tax benefits in income tax expense. Decreases in interest obligations of $189,000, $132,000 and $109,000 were recognized in the consolidated statement of earnings for the years ended December 31, 2013, 2012 and 2011, respectively, resulting in a total recognition of interest obligations of approximately $943,000 and $1,132,000 in the consolidated balance sheet at December 31, 2013 and 2012, respectively. No amounts for penalties have been recorded. | ||||||||||
The Company primarily has unrecognized tax benefits that represent an amortization deduction which is temporary in nature. A reconciliation of the beginning and ending amount of the liability associated with unrecognized tax benefits for the years ended December 31, 2013, 2012 and 2011 is as follows (in thousands): | ||||||||||
2013 | 2012 | 2011 | ||||||||
Balance at beginning of year | $ | 9,235 | $ | 7,252 | $ | 7,144 | ||||
Additions for tax positions of current year | 46 | 119 | 342 | |||||||
Increases (decreases) for tax positions taken during a prior period | - | 1,985 | -190 | |||||||
Lapse of statute of limitations | -2,951 | -121 | -44 | |||||||
Balance at end of year | $ | 6,330 | $ | 9,235 | $ | 7,252 | ||||
The Company believes that the total amount of increases in unrecognized tax benefits within the next 12 months will not be significant. The total amount of unrecognized tax benefits that would affect the Company's effective tax rate if recognized is approximately $150,000. | ||||||||||
The tax effects of temporary differences that give rise to significant portions of the deferred tax assets and deferred tax liabilities at December 31, 2013 and 2012 were as follows (in thousands): | ||||||||||
2013 | 2012 | |||||||||
Deferred tax assets: | ||||||||||
Allowance for uncollectible accounts | $ | 897 | $ | 884 | ||||||
Accrued assets and other | 5,292 | 5,212 | ||||||||
Valuation allowances | -2,021 | -2,084 | ||||||||
Total current deferred tax assets | 4,168 | 4,012 | ||||||||
Share-based compensation | 7,635 | 9,500 | ||||||||
Interest on unrecognized tax benefits | 230 | 363 | ||||||||
Accrued liabilities and other | 3,629 | 3,077 | ||||||||
Operating and capital loss carryforwards | 9,185 | 9,169 | ||||||||
Valuation allowances | -7,665 | -7,265 | ||||||||
Total non-current deferred tax assets | 13,014 | 14,844 | ||||||||
Total deferred tax assets | 17,182 | 18,856 | ||||||||
Deferred tax liabilities: | ||||||||||
Prepaid expenses | 1,071 | 925 | ||||||||
Property and equipment, principally due to differences in depreciation | 4,137 | 3,997 | ||||||||
Goodwill, principally due to differences in amortization | 184,897 | 148,494 | ||||||||
Total deferred tax liabilities | 190,105 | 153,416 | ||||||||
Net deferred tax liabilities | $ | 172,923 | $ | 134,560 | ||||||
The net deferred tax liabilities at December 31, 2013 and 2012 were recorded as follows (in thousands): | ||||||||||
2013 | 2012 | |||||||||
Current deferred income tax assets | $ | 3,097 | $ | 3,088 | ||||||
Non-current deferred income tax liabilities | 176,020 | 137,648 | ||||||||
Net deferred tax liabilities | $ | 172,923 | $ | 134,560 | ||||||
The Company has provided valuation allowances on its gross deferred tax assets to the extent that management does not believe that it is more likely than not that such asset will be realized. Capital loss carryforwards will begin to expire in 2014, and state net operating losses will begin to expire in 2015. |
Related_Party_Transactions
Related Party Transactions | 12 Months Ended | ||||||||
Dec. 31, 2013 | |||||||||
Related Party Transactions | ' | ||||||||
Related Party Transactions Disclosure | ' | ||||||||
12. Related Party Transactions | |||||||||
Certain surgery centers lease space from entities affiliated with their physician partners at negotiated rates that management believes were equal to fair market value at the inception of the leases based on relevant market data. Certain surgery centers reimburse their physician partners for salaries and benefits and billing fees related to time spent by employees of their practices on activities of the centers at current market rates. In addition, certain centers compensate at market rates their physician partners for physician advisory services provided to the surgery centers, including medical director and performance improvement services. | |||||||||
Related party payments for the years ended December 31, 2013, 2012 and 2011 were as follows (in thousands): | |||||||||
2013 | 2012 | 2011 | |||||||
Operating leases | $ | 29,240 | $ | 29,079 | $ | 29,137 | |||
Salaries and benefits | 72,892 | 65,908 | 64,830 | ||||||
Billing fees | 11,591 | 11,126 | 11,240 | ||||||
Medical advisory services | 2,993 | 2,671 | 2,575 | ||||||
The Company also reimburses their physician partners for operating expenses paid by the physician partners to third party providers on the behalf of the surgery center. The Company believes that the foregoing transactions are reasonably expected to benefit the Company and that the amount of reimbursed expenses included in other operating expenses in the accompanying consolidated statements of earnings for each of the years ended December 31, 2013, 2012 and 2011 were not significant. | |||||||||
It is the Company's policy that all transactions by the Company with officers, directors, five percent shareholders and their affiliates be entered into only if such transactions are on terms no less favorable to the Company than could be obtained from unaffiliated third parties, are reasonably expected to benefit the Company and are approved by the Nominating and Corporate Governance Committee of the Company's Board of Directors. | |||||||||
Employee_Benefit_Programs
Employee Benefit Programs | 12 Months Ended |
Dec. 31, 2013 | |
Compensation and Retirement Disclosure [Abstract] | ' |
Employee Benefit Plans | ' |
13. Employee Benefit Programs | |
The Company maintains the AmSurg 401(k) Plan and Trust. This plan is a defined contribution plan covering substantially all employees of the Company and provides for voluntary contributions by these employees, subject to certain limits. Company contributions are based on specified percentages of employee compensation. The Company funds contributions as accrued. The Company's contributions for the years ended December 31, 2013, 2012 and 2011 were approximately $1,095,000, $1,031,000 and $594,000, respectively, and vest immediately or incrementally over five years, depending on the tenures of the respective employees for which the contributions were made. | |
The Company maintains the Supplemental Executive and Director Retirement Savings Plan. This plan is a defined contribution plan covering all officers of the Company and provides for voluntary contributions of up to 50% of employee annual compensation. Company contributions are at the discretion of the Compensation Committee of the Board of Directors and vest incrementally over five years. The employee and employer contributions are placed in a Rabbi Trust and recorded in the accompanying consolidated balance sheets in prepaid and other current assets. Employer contributions to this plan for the years ended December 31, 2013, 2012 and 2011 were approximately $2,338,000, $1,693,000 and $915,000, respectively. On December 30, 2011, this plan was amended to allow non-employee directors to voluntarily contribute up to 100% of annual director cash compensation to the plan. | |
Commitments_And_Contingencies
Commitments And Contingencies | 12 Months Ended |
Dec. 31, 2013 | |
Commitments And Contingencies | ' |
Commitments And Contingencies | ' |
14. Commitments and Contingencies | |
The Company and its subsidiaries are insured with respect to medical malpractice risk on a claims-made basis. The Company also maintains insurance for general liability, director and officer liability and property. Certain policies are subject to deductibles. In addition to the insurance coverage provided, the Company indemnifies its officers and directors for actions taken on behalf of the Company and its subsidiaries. Management is not aware of any claims against it or its subsidiaries which would have a material financial impact on the Company. | |
Certain of the Company's wholly owned subsidiaries, as general partners in the limited partnerships, are responsible for all debts incurred but unpaid by the limited partnership. As manager of the operations of the limited partnerships, the Company has the ability to limit potential liabilities by curtailing operations or taking other operating actions. | |
In the event of a change in current law that would prohibit the physicians' current form of ownership in the partnerships, the Company would be obligated to purchase the physicians' interests in a majority of the Company's partnerships. The purchase price to be paid in such event would be determined by a predefined formula, as specified in the partnership agreements. The Company believes the likelihood of a change in current law, which would trigger such purchases, was remote as of December 31, 2013. | |
On December 27, 2012, the Company entered into a lease agreement with an initial term of 15 years plus renewal options, pursuant to which the Company has agreed to lease an approximately 110,000 square foot building to be constructed in Nashville, Tennessee. The Company intends that the building will serve as its corporate headquarters beginning in 2015. Prior to taking possession, the Company may terminate the agreement if the landlord fails to satisfy certain construction milestones. The Company's annual rental obligation at the inception of the lease, which will occur upon completion of construction currently estimated to occur in late 2014, is approximately $2,300,000 and increases by 1.9% annually thereafter during the initial term. In addition to base rent, the Company will pay additional rent consisting of, among other things, operating expenses, real estate taxes and insurance costs. The landlord will provide the Company with an allowance of approximately $4,400,000 for certain interior tenant improvements. |
Supplemental_Cash_Flow_Informa
Supplemental Cash Flow Information | 12 Months Ended | |||||||||||||
Dec. 31, 2013 | ||||||||||||||
Supplemental Cash Flow Information | ' | |||||||||||||
Supplemental Cash Flow Information | ' | |||||||||||||
15. Supplemental Cash Flow Information | ||||||||||||||
Supplemental cash flow information for the years ended December 31 2013, 2012 and 2011 is as follows (in thousands): | ||||||||||||||
2013 | 2012 | 2011 | ||||||||||||
Cash paid during the period for: | ||||||||||||||
Interest | $ | 28,378 | $ | 14,786 | $ | 13,815 | ||||||||
Income taxes, net of refunds | 7,756 | 19,615 | 10,232 | |||||||||||
Non-cash investing and financing activities: | ||||||||||||||
Increase in accounts payable associated with acquisition of property and equipment | 884 | 248 | 659 | |||||||||||
Capital lease obligations | 738 | 1,096 | 466 |
Guarantor
Guarantor | 12 Months Ended | ||||||||||||||||||
Dec. 31, 2013 | |||||||||||||||||||
Condensed Consolidating Financial Information | ' | ||||||||||||||||||
Condensed Consolidating Financial Information | ' | ||||||||||||||||||
16. Financial Information for the Company and Its Subsidiaries | |||||||||||||||||||
The Senior Unsecured Notes, issued in 2012, are senior unsecured obligations of the Company and are guaranteed by the Company and certain of its existing and subsequently acquired or organized wholly owned domestic subsidiaries. The Senior Unsecured Notes are guaranteed on a full and unconditional and joint and several basis, with limited exceptions considered customary for such guarantees, including the release of the guarantee when a subsidiary's assets are sold. The following condensed consolidating financial statements present the Company (as parent issuer), the subsidiary guarantors, the subsidiary non-guarantors and consolidating adjustments. These condensed consolidating financial statements have been prepared and presented in accordance with SEC Regulation S-X Rule 3-10 "Financial Statements of Guarantors and Issuers of Guaranteed Securities Registered or Being Registered." The operating and investing activities of the separate legal entities are fully interdependent and integrated. Accordingly, the results of the separate legal entities are not representative of what the operating results would be on a stand-alone basis. | |||||||||||||||||||
Condensed Consolidating Balance Sheet - December 31, 2013 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Assets | |||||||||||||||||||
Current assets: | |||||||||||||||||||
Cash and cash equivalents | $ | 6,710 | $ | - | $ | 44,130 | $ | - | $ | 50,840 | |||||||||
Accounts receivable, net | - | - | 105,072 | - | 105,072 | ||||||||||||||
Supplies inventory | 33 | - | 18,381 | - | 18,414 | ||||||||||||||
Deferred income taxes | 3,097 | - | - | - | 3,097 | ||||||||||||||
Prepaid and other current assets | 23,993 | - | 13,971 | -4,362 | 33,602 | ||||||||||||||
Total current assets | 33,833 | - | 181,554 | -4,362 | 211,025 | ||||||||||||||
Property and equipment, net | 9,829 | - | 160,066 | - | 169,895 | ||||||||||||||
Investments in unconsolidated affiliates and long-term notes receivable | 1,484,974 | 1,453,596 | - | -2,922,178 | 16,392 | ||||||||||||||
Goodwill and other intangible assets, net | 20,684 | - | 978 | 1,758,970 | 1,780,632 | ||||||||||||||
Total assets | $ | 1,549,320 | $ | 1,453,596 | $ | 342,598 | $ | -1,167,570 | $ | 2,177,944 | |||||||||
Liabilities and Equity | |||||||||||||||||||
Current liabilities: | |||||||||||||||||||
Current portion of long-term debt | $ | 10,714 | $ | - | $ | 10,130 | $ | - | $ | 20,844 | |||||||||
Accounts payable | 1,972 | - | 29,487 | -3,958 | 27,501 | ||||||||||||||
Other accrued liabilities | 27,419 | - | 14,510 | -404 | 41,525 | ||||||||||||||
Total current liabilities | 40,105 | - | 54,127 | -4,362 | 89,870 | ||||||||||||||
Long-term debt | 561,429 | - | 53,246 | -31,377 | 583,298 | ||||||||||||||
Deferred income taxes | 176,020 | - | - | - | 176,020 | ||||||||||||||
Other long-term liabilities | 7,569 | - | 17,934 | - | 25,503 | ||||||||||||||
Noncontrolling interests – redeemable | - | - | 63,704 | 113,993 | 177,697 | ||||||||||||||
Equity: | |||||||||||||||||||
Total AmSurg Corp. equity | 764,197 | 1,453,596 | 114,671 | -1,568,267 | 764,197 | ||||||||||||||
Noncontrolling interests – non-redeemable | - | - | 38,916 | 322,443 | 361,359 | ||||||||||||||
Total equity | 764,197 | 1,453,596 | 153,587 | -1,245,824 | 1,125,556 | ||||||||||||||
Total liabilities and equity | $ | 1,549,320 | $ | 1,453,596 | $ | 342,598 | $ | -1,167,570 | $ | 2,177,944 | |||||||||
Condensed Consolidating Balance Sheet - December 31, 2012 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Assets | |||||||||||||||||||
Current assets: | |||||||||||||||||||
Cash and cash equivalents | $ | 7,259 | $ | - | $ | 39,139 | $ | - | $ | 46,398 | |||||||||
Accounts receivable, net | - | - | 96,752 | - | 96,752 | ||||||||||||||
Supplies inventory | - | - | 18,406 | - | 18,406 | ||||||||||||||
Deferred income taxes | 3,088 | - | - | - | 3,088 | ||||||||||||||
Prepaid and other current assets | 19,342 | - | 13,160 | -4,965 | 27,537 | ||||||||||||||
Total current assets | 29,689 | - | 167,457 | -4,965 | 192,181 | ||||||||||||||
Property and equipment, net | 9,199 | - | 157,413 | - | 166,612 | ||||||||||||||
Investments in unconsolidated affiliates and long-term notes receivable | 1,413,061 | 1,381,596 | - | -2,783,383 | 11,274 | ||||||||||||||
Goodwill and other intangible assets, net | 21,311 | - | 1,206 | 1,652,002 | 1,674,519 | ||||||||||||||
Total assets | $ | 1,473,260 | $ | 1,381,596 | $ | 326,076 | $ | -1,136,346 | $ | 2,044,586 | |||||||||
Liabilities and Equity | |||||||||||||||||||
Current liabilities: | |||||||||||||||||||
Current portion of long-term debt | $ | 5,357 | $ | - | $ | 12,050 | $ | - | $ | 17,407 | |||||||||
Accounts payable | 1,379 | - | 26,035 | -3,905 | 23,509 | ||||||||||||||
Other accrued liabilities | 29,380 | - | 15,177 | -1,060 | 43,497 | ||||||||||||||
Total current liabilities | 36,116 | - | 53,262 | -4,965 | 84,413 | ||||||||||||||
Long-term debt | 599,423 | - | 52,747 | -31,465 | 620,705 | ||||||||||||||
Deferred income taxes | 137,648 | - | - | - | 137,648 | ||||||||||||||
Other long-term liabilities | 10,585 | - | 15,387 | - | 25,972 | ||||||||||||||
Noncontrolling interests – redeemable | - | - | 61,939 | 113,443 | 175,382 | ||||||||||||||
Equity: | |||||||||||||||||||
Total AmSurg Corp. equity | 689,488 | 1,381,596 | 108,412 | -1,490,008 | 689,488 | ||||||||||||||
Noncontrolling interests – non-redeemable | - | - | 34,329 | 276,649 | 310,978 | ||||||||||||||
Total equity | 689,488 | 1,381,596 | 142,741 | -1,213,359 | 1,000,466 | ||||||||||||||
Total liabilities and equity | $ | 1,473,260 | $ | 1,381,596 | $ | 326,076 | $ | -1,136,346 | $ | 2,044,586 | |||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income - Year Ended December 31, 2013 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 24,167 | $ | - | $ | 1,072,694 | $ | -17,518 | $ | 1,079,343 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 61,038 | - | 272,619 | -467 | 333,190 | ||||||||||||||
Supply cost | - | - | 157,771 | - | 157,771 | ||||||||||||||
Other operating expenses | 22,660 | - | 217,068 | -17,051 | 222,677 | ||||||||||||||
Depreciation and amortization | 3,186 | - | 29,842 | - | 33,028 | ||||||||||||||
Total operating expenses | 86,884 | - | 677,300 | -17,518 | 746,666 | ||||||||||||||
Gain on deconsolidation | 2,237 | 2,237 | - | -2,237 | 2,237 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 204,962 | 204,962 | - | -406,773 | 3,151 | ||||||||||||||
Operating income | 144,482 | 207,199 | 395,394 | -409,010 | 338,065 | ||||||||||||||
Interest expense | 27,282 | - | 2,256 | - | 29,538 | ||||||||||||||
Earnings from continuing operations before income taxes | 117,200 | 207,199 | 393,138 | -409,010 | 308,527 | ||||||||||||||
Income tax expense | 48,239 | - | 1,515 | - | 49,754 | ||||||||||||||
Net earnings from continuing operations | 68,961 | 207,199 | 391,623 | -409,010 | 258,773 | ||||||||||||||
Net earnings (loss) from discontinued operations | 3,742 | - | -971 | - | 2,771 | ||||||||||||||
Net earnings | 72,703 | 207,199 | 390,652 | -409,010 | 261,544 | ||||||||||||||
Less net earnings attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 186,120 | - | 186,120 | ||||||||||||||
Net earnings from discontinued operations | - | - | 2,721 | - | 2,721 | ||||||||||||||
Total net earnings attributable to noncontrolling interests | - | - | 188,841 | - | 188,841 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 72,703 | $ | 207,199 | $ | 201,811 | $ | -409,010 | $ | 72,703 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 68,961 | $ | 207,199 | $ | 205,503 | $ | -409,010 | $ | 72,653 | |||||||||
Discontinued operations, net of income tax | 3,742 | - | -3,692 | - | 50 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 72,703 | $ | 207,199 | $ | 201,811 | $ | -409,010 | $ | 72,703 | |||||||||
Net earnings and comprehensive income, net of income tax | $ | 72,703 | $ | 207,199 | $ | 390,652 | $ | -409,010 | $ | 261,544 | |||||||||
Less comprehensive income attributable to noncontrolling interests | - | - | 188,841 | - | 188,841 | ||||||||||||||
Comprehensive income attributable to AmSurg Corp. | |||||||||||||||||||
common shareholders | $ | 72,703 | $ | 207,199 | $ | 201,811 | $ | -409,010 | $ | 72,703 | |||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income - Year Ended December 31, 2012 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 19,907 | $ | - | $ | 918,176 | $ | -14,901 | $ | 923,182 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 54,895 | - | 235,618 | -450 | 290,063 | ||||||||||||||
Supply cost | - | - | 131,055 | - | 131,055 | ||||||||||||||
Other operating expenses | 20,499 | - | 186,977 | -14,451 | 193,025 | ||||||||||||||
Depreciation and amortization | 2,860 | - | 26,990 | - | 29,850 | ||||||||||||||
Total operating expenses | 78,254 | - | 580,640 | -14,901 | 643,993 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 178,137 | 178,137 | - | -354,710 | 1,564 | ||||||||||||||
Operating income | 119,790 | 178,137 | 337,536 | -354,710 | 280,753 | ||||||||||||||
Interest expense | 14,803 | - | 2,164 | - | 16,967 | ||||||||||||||
Earnings from continuing operations before income taxes | 104,987 | 178,137 | 335,372 | -354,710 | 263,786 | ||||||||||||||
Income tax expense | 40,810 | - | 1,554 | - | 42,364 | ||||||||||||||
Net earnings from continuing operations | 64,177 | 178,137 | 333,818 | -354,710 | 221,422 | ||||||||||||||
Net (loss) earnings from discontinued operations | -1,614 | - | 3,835 | - | 2,221 | ||||||||||||||
Net earnings | 62,563 | 178,137 | 337,653 | -354,710 | 223,643 | ||||||||||||||
Less net earnings attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 159,187 | - | 159,187 | ||||||||||||||
Net earnings from discontinued operations | - | - | 1,893 | - | 1,893 | ||||||||||||||
Total net earnings attributable to noncontrolling interests | - | - | 161,080 | - | 161,080 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 62,563 | $ | 178,137 | $ | 176,573 | $ | -354,710 | $ | 62,563 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 64,177 | $ | 178,137 | $ | 174,631 | $ | -354,710 | $ | 62,235 | |||||||||
Discontinued operations, net of income tax | -1,614 | - | 1,942 | - | 328 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 62,563 | $ | 178,137 | $ | 176,573 | $ | -354,710 | $ | 62,563 | |||||||||
Net earnings and comprehensive income, net of income tax | $ | 62,563 | $ | 178,137 | $ | 337,653 | $ | -354,710 | $ | 223,643 | |||||||||
Less comprehensive income attributable to noncontrolling interests | - | - | 161,080 | - | 161,080 | ||||||||||||||
Comprehensive income attributable to AmSurg Corp. | |||||||||||||||||||
common shareholders | $ | 62,563 | $ | 178,137 | $ | 176,573 | $ | -354,710 | $ | 62,563 | |||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income - Year Ended December 31, 2011 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 11,253 | $ | - | $ | 768,823 | $ | -8,001 | $ | 772,075 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 42,739 | - | 196,358 | -359 | 238,738 | ||||||||||||||
Supply cost | - | - | 101,364 | - | 101,364 | ||||||||||||||
Other operating expenses | 19,468 | - | 156,521 | -7,642 | 168,347 | ||||||||||||||
Depreciation and amortization | 2,487 | - | 23,158 | - | 25,645 | ||||||||||||||
Total operating expenses | 64,694 | - | 477,401 | -8,001 | 534,094 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 152,409 | 152,409 | - | -304,205 | 613 | ||||||||||||||
Operating income | 98,968 | 152,409 | 291,422 | -304,205 | 238,594 | ||||||||||||||
Interest expense | 13,195 | - | 2,132 | - | 15,327 | ||||||||||||||
Earnings from continuing operations before income taxes | 85,773 | 152,409 | 289,290 | -304,205 | 223,267 | ||||||||||||||
Income tax expense | 33,806 | - | 1,167 | - | 34,973 | ||||||||||||||
Net earnings from continuing operations | 51,967 | 152,409 | 288,123 | -304,205 | 188,294 | ||||||||||||||
Net (loss) earnings from discontinued operations | -1,970 | - | 3,790 | - | 1,820 | ||||||||||||||
Net earnings | 49,997 | 152,409 | 291,913 | -304,205 | 190,114 | ||||||||||||||
Less net earnings attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 138,269 | - | 138,269 | ||||||||||||||
Net earnings from discontinued operations | - | - | 1,848 | - | 1,848 | ||||||||||||||
Total net earnings attributable to noncontrolling interests | - | - | 140,117 | - | 140,117 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 49,997 | $ | 152,409 | $ | 151,796 | $ | -304,205 | $ | 49,997 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 51,967 | $ | 152,409 | $ | 149,854 | $ | -304,205 | $ | 50,025 | |||||||||
Discontinued operations, net of income tax | -1,970 | - | 1,942 | - | -28 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 49,997 | $ | 152,409 | $ | 151,796 | $ | -304,205 | $ | 49,997 | |||||||||
Net earnings | $ | 49,997 | $ | 152,409 | $ | 291,913 | $ | -304,205 | $ | 190,114 | |||||||||
Other comprehensive income, net of income tax: | |||||||||||||||||||
Unrealized gain on interest rate swap, net of income tax | 515 | - | - | - | 515 | ||||||||||||||
Comprehensive income, net of income tax | 50,512 | 152,409 | 291,913 | -304,205 | 190,629 | ||||||||||||||
Less comprehensive income attributable to noncontrolling interests | - | - | 140,117 | - | 140,117 | ||||||||||||||
Comprehensive income attributable to AmSurg Corp. | |||||||||||||||||||
common shareholders | $ | 50,512 | $ | 152,409 | $ | 151,796 | $ | -304,205 | $ | 50,512 | |||||||||
Condensed Consolidating Statement of Cash Flows - Year Ended December 31, 2013 (In thousands) | |||||||||||||||||||
Parent | Guarantor | Non-Guarantor | Consolidating | Total | |||||||||||||||
Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||
Net cash flows provided by operating activities | $ | 45,127 | $ | 208,773 | $ | 426,572 | $ | -347,648 | $ | 332,824 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | - | -74,288 | - | 694 | -73,594 | ||||||||||||||
Acquisition of property and equipment | -3,693 | - | -25,163 | - | -28,856 | ||||||||||||||
Proceeds from sale of interests in surgery centers | - | 3,553 | - | - | 3,553 | ||||||||||||||
Other | - | 159 | - | - | 159 | ||||||||||||||
Net cash flows used in investing activities | -3,693 | -70,576 | -25,163 | 694 | -98,738 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 152,700 | - | 9,504 | - | 162,204 | ||||||||||||||
Repayment on long-term borrowings | -188,081 | - | -14,002 | - | -202,083 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | -138,875 | -392,922 | 347,648 | -184,149 | ||||||||||||||
Changes in intercompany balances with affiliates, net | 88 | - | -88 | - | - | ||||||||||||||
Other financing activities, net | -6,690 | 678 | 1,090 | -694 | -5,616 | ||||||||||||||
Net cash flows used in financing activities | -41,983 | -138,197 | -396,418 | 346,954 | -229,644 | ||||||||||||||
Net increase (decrease) in cash and cash equivalents | -549 | - | 4,991 | - | 4,442 | ||||||||||||||
Cash and cash equivalents, beginning of year | 7,259 | - | 39,139 | - | 46,398 | ||||||||||||||
Cash and cash equivalents, end of year | $ | 6,710 | $ | - | $ | 44,130 | $ | - | $ | 50,840 | |||||||||
Condensed Consolidating Statement of Cash Flows - Year Ended December 31, 2012 (In thousands) | |||||||||||||||||||
Parent | Guarantor | Non-Guarantor | Consolidating | Total | |||||||||||||||
Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||
Net cash flows provided by (used in) operating activities | $ | -83,605 | $ | 182,851 | $ | 379,257 | $ | -182,851 | $ | 295,652 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | -90,029 | -280,189 | - | 92,830 | -277,388 | ||||||||||||||
Acquisition of property and equipment | -3,681 | - | -25,183 | - | -28,864 | ||||||||||||||
Proceeds from sale of interests in surgery centers | - | 7,309 | - | - | 7,309 | ||||||||||||||
Net cash flows used in investing activities | -93,710 | -272,880 | -25,183 | 92,830 | -298,943 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 560,000 | - | 5,566 | - | 565,566 | ||||||||||||||
Repayment on long-term borrowings | -381,220 | - | -12,944 | - | -394,164 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | - | -345,792 | 182,851 | -162,941 | ||||||||||||||
Capital contributions | - | 90,029 | - | -90,029 | - | ||||||||||||||
Changes in intercompany balances with affiliates, net | -2,666 | - | 2,666 | - | - | ||||||||||||||
Other financing activities, net | -70 | - | 3,381 | -2,801 | 510 | ||||||||||||||
Net cash flows provided by (used in) financing activities | 176,044 | 90,029 | -347,123 | 90,021 | 8,971 | ||||||||||||||
Net increase (decrease) in cash and cash equivalents | -1,271 | - | 6,951 | - | 5,680 | ||||||||||||||
Cash and cash equivalents, beginning of year | 8,530 | - | 32,188 | - | 40,718 | ||||||||||||||
Cash and cash equivalents, end of year | $ | 7,259 | $ | - | $ | 39,139 | $ | - | $ | 46,398 | |||||||||
Condensed Consolidating Statement of Cash Flows - Year Ended December 31, 2011 (In thousands) | |||||||||||||||||||
Parent | Guarantor | Non-Guarantor | Consolidating | Total | |||||||||||||||
Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||
Net cash flows provided by (used in) operating activities | $ | -67,911 | $ | 151,558 | $ | 311,334 | $ | -151,558 | $ | 243,423 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | -84,597 | -243,429 | - | 88,803 | -239,223 | ||||||||||||||
Acquisition of property and equipment | -2,858 | - | -19,312 | - | -22,170 | ||||||||||||||
Proceeds from sale of interests in surgery centers | - | 7,274 | -248 | - | 7,026 | ||||||||||||||
Net cash flows used in investing activities | -87,455 | -236,155 | -19,560 | 88,803 | -254,367 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 281,100 | - | 7,769 | - | 288,869 | ||||||||||||||
Repayment on long-term borrowings | -118,100 | - | -11,007 | - | -129,107 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | - | -290,282 | 151,558 | -138,724 | ||||||||||||||
Capital contributions | - | 84,597 | - | -84,597 | - | ||||||||||||||
Changes in intercompany balances with affiliates, net | -178 | - | 178 | - | - | ||||||||||||||
Other financing activities, net | -3,609 | - | 4,292 | -4,206 | -3,523 | ||||||||||||||
Net cash flows provided by (used in) financing activities | 159,213 | 84,597 | -289,050 | 62,755 | 17,515 | ||||||||||||||
Net increase in cash and cash equivalents | 3,847 | - | 2,724 | - | 6,571 | ||||||||||||||
Cash and cash equivalents, beginning of year | 4,683 | - | 29,464 | - | 34,147 | ||||||||||||||
Cash and cash equivalents, end of year | $ | 8,530 | $ | - | $ | 32,188 | $ | - | $ | 40,718 |
Subsequent_Events
Subsequent Events | 12 Months Ended |
Dec. 31, 2013 | |
Subsequent Events | ' |
Subsequent Events | ' |
17. Subsequent Events | |
The Company assessed events occurring subsequent to December 31, 2013 for potential recognition and disclosure in the consolidated financial statements. In January 2014, the Company, through a wholly owned subsidiary, acquired a majority interest in a surgery center for a purchase price of approximately $5,100,000. Other than as previously described, no events have occurred that would require adjustment to or disclosure in the consolidated financial statements. | |
Quarterly_Financial_Data_Unaud
Quarterly Financial Data Unaudited | 12 Months Ended | ||||||||||||||||||||||||
Dec. 31, 2013 | |||||||||||||||||||||||||
Quarterly Financial Data Abstract | ' | ||||||||||||||||||||||||
Quarterly Financial Information Text Block | ' | ||||||||||||||||||||||||
Quarterly Statement of Earnings Data (Unaudited) | |||||||||||||||||||||||||
The following table presents certain quarterly statement of earnings data for the years ended December 31, 2013 and 2012. The quarterly statement of earnings data set forth below was derived from the Company's unaudited financial statements and includes all adjustments, consisting of normal recurring adjustments, which the Company considers necessary for a fair presentation thereof. Results of operations for any particular quarter are not necessarily indicative of results of operations for a full year or predictive of future periods. | |||||||||||||||||||||||||
2013 | 2012 | ||||||||||||||||||||||||
Q1 | Q2 | Q3 | Q4 | Q1 | Q2 | Q3 | Q4 | ||||||||||||||||||
(In thousands, except per share data) | |||||||||||||||||||||||||
Revenues | $ | 259,043 | $ | 268,099 | $ | 267,631 | $ | 284,570 | $ | 227,567 | $ | 228,955 | $ | 223,885 | $ | 242,775 | |||||||||
Earnings from continuing operations | |||||||||||||||||||||||||
before income taxes | 74,496 | 78,398 | 73,989 | 81,644 | 66,110 | 66,611 | 63,211 | 67,854 | |||||||||||||||||
Net earnings from continuing operations | 62,203 | 65,640 | 62,562 | 68,368 | 55,349 | 55,541 | 53,148 | 57,384 | |||||||||||||||||
Net earnings (loss) from | |||||||||||||||||||||||||
discontinued operations (1) | 70 | 196 | -295 | 2,800 | -410 | 4 | 617 | 2,010 | |||||||||||||||||
Net earnings | 62,273 | 65,836 | 62,267 | 71,168 | 54,939 | 55,545 | 53,765 | 59,394 | |||||||||||||||||
Net earnings (loss) attributable to | |||||||||||||||||||||||||
AmSurg Corp. common shareholders: | |||||||||||||||||||||||||
Continuing | 17,785 | 18,489 | 17,056 | 19,323 | 15,488 | 15,939 | 15,196 | 15,612 | |||||||||||||||||
Discontinued | 26 | 74 | -285 | 235 | -712 | -403 | 241 | 1,202 | |||||||||||||||||
Net earnings | $ | 17,811 | $ | 18,563 | $ | 16,771 | $ | 19,558 | $ | 14,776 | $ | 15,536 | $ | 15,437 | $ | 16,814 | |||||||||
Diluted net earnings from | |||||||||||||||||||||||||
continuing operations per common share | $ | 0.56 | $ | 0.58 | $ | 0.53 | $ | 0.6 | $ | 0.49 | $ | 0.5 | $ | 0.48 | $ | 0.49 | |||||||||
Diluted net earnings per common share | $ | 0.56 | $ | 0.58 | $ | 0.52 | $ | 0.61 | $ | 0.47 | $ | 0.49 | $ | 0.49 | $ | 0.53 | |||||||||
(1) Certain previously reported amounts have been reclassified for current year presentation for discontinued operations. |
Schedule_II_Valuation_and_Qual
Schedule II Valuation and Qualifying Accounts | 12 Months Ended | |||||||||||||||
Dec. 31, 2013 | ||||||||||||||||
Valuation And Qualifying Accounts Abstract | ' | |||||||||||||||
Schedule Of Valuation And Qualifying Accounts Disclosure Text Block | ' | |||||||||||||||
AmSurg Corp. | ||||||||||||||||
Schedule II – Valuation and Qualifying Accounts | ||||||||||||||||
For the Years Ended December 31, 2013, 2012 and 2011 | ||||||||||||||||
(In thousands) | ||||||||||||||||
Additions | Deductions | |||||||||||||||
Balance at | Charged to | Charged to | Charge-off | Balance | ||||||||||||
Beginning | Cost and | Other | Against | at End of | ||||||||||||
of Period | Expenses | Accounts (1) | Allowances | Period | ||||||||||||
Allowance for uncollectible accounts included under | ||||||||||||||||
the balance sheet caption “Accounts receivable”: | ||||||||||||||||
Year ended December 31, 2013 | $ | 22,379 | $ | 21,983 | $ | 6,410 | $ | -22,910 | $ | 27,862 | ||||||
Year ended December 31, 2012 | $ | 18,844 | $ | 20,340 | $ | 4,561 | $ | -21,366 | $ | 22,379 | ||||||
Year ended December 31, 2011 | $ | 13,070 | $ | 18,501 | $ | 3,967 | $ | -16,694 | $ | 18,844 | ||||||
-1 | ||||||||||||||||
Valuation of allowance for uncollectible accounts as of the acquisition date of physician practice-based surgery centers, net of dispositions. See “Item 8. Financial Statements and Supplementary Data – Notes to the Consolidated Financial Statements – Note 2.” |
Summary_of_Significant_Account1
Summary of Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2013 | |
Summary of Significant Accounting Policies | ' |
Principles of Consolidation | ' |
a. Principles of Consolidation | |
AmSurg Corp. (the “Company”), through its wholly owned subsidiaries, owns interests, primarily 51%, in limited partnerships and limited liability companies (“LLCs”) which own and operate ambulatory surgery centers (“centers”). The Company does not have an ownership interest in a limited partnership or LLC greater than 51% which it does not consolidate. The Company has ownership interests of less than 51% in six limited partnerships and LLCs, three of which it consolidates as the Company has substantive participation rights and three of which it does not consolidate as the Company's rights are limited to protective rights only. The consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries and the consolidated limited partnerships and LLCs. Consolidation of such limited partnerships and LLCs is necessary as the Company's wholly owned subsidiaries have primarily 51% or more of the financial interest, are the general partner or majority member with all the duties, rights and responsibilities thereof, are responsible for the day-to-day management of the limited partnerships and LLCs, and have control of the entities. The responsibilities of the Company's noncontrolling partners (limited partners and noncontrolling members) are to supervise the delivery of medical services, with their rights being restricted to those that protect their financial interests, such as approval of the acquisition of significant assets or the incurrence of debt which they are generally required to guarantee on a pro rata basis based upon their respective ownership interests. Intercompany profits, transactions and balances have been eliminated. All limited partnerships and LLCs and noncontrolling partners are referred to herein as (“partnerships”) and (“partners”), respectively. | |
Ownership interests in consolidated subsidiaries held by parties other than the Company are identified and generally presented in the consolidated financial statements within the equity section but separate from the Company's equity. However, in instances in which certain redemption features that are not solely within the control of the Company are present, classification of noncontrolling interests outside of permanent equity is required. Consolidated net income attributable to the Company and to the noncontrolling interests are identified and presented on the consolidated statements of income; changes in ownership interests are accounted for as equity transactions; and when a subsidiary is deconsolidated, any retained noncontrolling equity investment in the former subsidiary and the gain or loss on the deconsolidation of the subsidiary is measured at fair value. Certain transactions with noncontrolling interests are also classified within financing activities in the consolidated statements of cash flows. | |
As further described in note 14, upon the occurrence of various fundamental regulatory changes, the Company would be obligated, under the terms of certain partnership and operating agreements, to purchase the noncontrolling interests related to a substantial majority of the Company's partnerships. While the Company believes that the likelihood of a change in current law that would trigger such purchases was remote as of December 31, 2013, the occurrence of such regulatory changes is outside the control of the Company. As a result, these noncontrolling interests that are subject to this redemption feature are not included as part of the Company's equity and are classified as noncontrolling interests – redeemable on the Company's consolidated balance sheets. | |
Center profits and losses of consolidated entities are allocated to the Company's partners in proportion to their ownership percentages and reflected in the aggregate as net earnings attributable to noncontrolling interests. The partners of the Company's center partnerships typically are organized as general partnerships, limited partnerships or limited liability companies that are not subject to federal income tax. Each partner shares in the pre-tax earnings of the center in which it is a partner. Accordingly, the earnings attributable to noncontrolling interests in each of the Company's consolidated partnerships are generally determined on a pre-tax basis, and total net earnings attributable to noncontrolling interests are presented after net earnings. However, the Company considers the impact of the net earnings attributable to noncontrolling interests on earnings before income taxes in order to determine the amount of pre-tax earnings on which the Company must determine its tax expense. In addition, distributions from the partnerships are made to both the Company's wholly owned subsidiaries and the partners on a pre-tax basis. | |
Investments in unconsolidated affiliates in which the Company exerts significant influence but does not control or otherwise consolidate are accounted for using the equity method. These investments are included as investments in unconsolidated affiliates and long-term notes receivable in the accompanying consolidated balance sheets. The Company's share of the profits and losses from these investments are reported in equity in earnings of unconsolidated affiliates in the accompanying consolidated statement of earnings and comprehensive income. The Company monitors its investments for other-than-temporary impairment by considering factors such as current economic and market conditions and the operating performance of the companies and records reductions in carrying values when necessary. | |
Each of the Company's centers have similar economic characteristics and are aggregated into a single component. The Company operates this component as one reportable business segment, the ownership and operation of ambulatory surgery centers. | |
Cash and Cash Equivalents | ' |
b. Cash and Cash Equivalents | |
Cash and cash equivalents are comprised principally of demand deposits at banks and other highly liquid short-term investments with maturities of less than three months when purchased. | |
Accounts Receivable | ' |
c. Accounts Receivable | |
The determination of contractual and bad debt allowances constitutes a significant estimate. Some of the factors considered by management in determining the amount of such allowances are the historical trends of the centers' cash collections and contractual and bad debt write-offs, accounts receivable agings, established fee schedules, contracts with payors and procedure statistics. Accordingly, net accounts receivable at December 31, 2013 and 2012 reflect allowances for contractual adjustments of $289,937,000 and $216,363,000, respectively, and allowance for bad debt expense of $27,862,000 and $22,379,000, respectively. | |
Supplies Inventory | ' |
d. Supplies Inventory | |
Supplies inventory consists of medical and drug supplies and is recorded at cost on a first-in, first-out basis. | |
Prepaids and Other Current Assets | ' |
e. Prepaid and Other Current Assets | |
At December 31, 2013, prepaid and other current assets were comprised of short-term investments of $13,313,000, other prepaid expenses of $7,099,000, prepaid insurance expense of $5,631,000, other current receivables of $6,126,000 and other current assets of $1,433,000. At December 31, 2012, prepaid and other current assets were comprised of short-term investments of $8,804,000, other prepaid expenses of $6,462,000, prepaid insurance expense of $4,963,000, other current receivables of $5,926,000 and other current assets of $1,382,000. | |
Property and Equipment, net | ' |
f. Property and Equipment, net | |
Property and equipment are stated at cost. Equipment held under capital leases is stated at the present value of minimum lease payments at the inception of the related leases. Depreciation for buildings and improvements is recognized under the straight-line method over 20 to 40 years or, for leasehold improvements, over the remaining term of the lease plus renewal options for which failure to renew the lease imposes a penalty on the Company in such an amount that a renewal appears, at the inception of the lease, to be reasonably assured. The primary penalty to which the Company is subject is the economic detriment associated with existing leasehold improvements which might be impaired if a decision is made not to continue the use of the leased property. Depreciation for movable equipment and software and software development costs is recognized over useful lives of three to ten years. | |
Goodwill | ' |
g. Goodwill | |
The Company evaluates goodwill for impairment at least on an annual basis and more frequently if certain indicators are encountered. Goodwill is to be tested at the reporting unit level, defined as an operating segment or one level below an operating segment (referred to as a component), with the fair value of the reporting unit being compared to its carrying amount, including goodwill. If the fair value of a reporting unit exceeds its carrying amount, goodwill of the reporting unit is not considered to be impaired. The Company has determined that it has one operating, as well as one reportable, segment. For impairment testing purposes, the centers qualify as components of that operating segment. Because they have similar economic characteristics, the components are aggregated and deemed a single reporting unit. The Company completed its annual impairment test as of December 31, 2013, and determined that goodwill was not impaired. | |
Intangible Assets | ' |
h. Intangible Assets | |
Intangible assets consist primarily of deferred financing costs of the Company and certain amortizable and non-amortizable non-compete and customer agreements. Deferred financing costs and amortizable non-compete agreements and customer agreements are amortized over the term of the related debt as interest expense and the contractual term or estimated life (five to ten years) of the agreements as amortization expense, respectively. | |
Other Long-Term Liabilities | ' |
i. Other Long-Term Liabilities | |
At December 31, 2013, other long-term liabilities are comprised of deferred rent of $14,637,000, tax-effected unrecognized benefits of $6,888,000 (see note 1(k)), unfavorable lease liability of $3,034,000 and other long-term liabilities of $944,000. At December 31, 2012, other long-term liabilities are comprised of deferred rent of $12,134,000, tax-effected unrecognized benefits of $10,113,000 (see note 1(k)), unfavorable lease liability of $3,559,000 and other long-term liabilities of $166,000. | |
Revenue Recognition | ' |
j. Revenue Recognition | |
Center revenues consist of billing for the use of the centers' facilities directly to the patient or third-party payor and, at certain of our centers (primarily centers that perform gastrointestinal endoscopy procedures), billing for anesthesia services provided by medical professionals employed or contracted by our centers. Such revenues are recognized when the related surgical procedures are performed. Revenues exclude any amounts billed for physicians' surgical services, which are billed separately by the physicians to the patient or third-party payor. | |
Revenues from centers are recognized on the date of service, net of estimated contractual adjustments from third-party medical service payors including Medicare and Medicaid. During the years ended December 31, 2013, 2012 and 2011, the Company derived approximately 25%, 27% and 29%, respectively, of its revenues from government healthcare programs, primarily Medicare, and managed Medicare programs. Concentration of credit risk with respect to other payors is limited due to the large number of such payors. | |
Operating Expenses | ' |
k. Operating Expenses | |
Substantially all of the Company's operating expenses relate to the cost of revenues and the delivery of care at the Company's surgery centers. Such costs primarily include the surgery centers' clinical and administrative salaries and benefits, supply cost, rent and other variable expenses, such as linen cost, repair and maintenance of equipment, billing fees and bad debt expense. Bad debt expense for continuing operations was approximately $21,947,000, $20,005,000 and $18,230,000 for the years ended December 31, 2013, 2012 and 2011, respectively. | |
Income Taxes | ' |
l. Income Taxes | |
The Company files a consolidated federal income tax return. Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. | |
The Company applies recognition thresholds and measurement attributes for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return as it relates to accounting for uncertainty in income taxes. In addition, it is the Company's policy to recognize interest accrued and penalties, if any, related to unrecognized benefits as income tax expense in its statement of earnings. The Company does not expect significant changes to its tax positions or liability for tax uncertainties during the next 12 months. | |
The Company and its subsidiaries file income tax returns in the U.S. federal jurisdiction and various state jurisdictions. With few exceptions, the Company is no longer subject to U.S. federal or state income tax examinations for years prior to 2010. | |
Earnings Per Share | ' |
m. Earnings Per Share | |
Basic earnings per share is computed by dividing net earnings attributable to AmSurg Corp. common shareholders by the combined weighted average number of common shares, while diluted earnings per share is computed by dividing net earnings attributable to AmSurg Corp. common shareholders by the weighted average number of such common shares and dilutive share equivalents. | |
Share-Based Compensation | ' |
n. Share-Based Compensation | |
Transactions in which the Company receives employee and non-employee services in exchange for the Company's equity instruments or liabilities that are based on the fair value of the Company's equity securities or may be settled by the issuance of these securities are accounted using a fair value method. The Company applies the Black-Scholes method of valuation in determining share-based compensation expense. | |
Benefits of tax deductions in excess of recognized compensation cost are reported as a financing cash flow, thus reducing the Company's net operating cash flows and increasing its financing cash flows by $7,247,000, $1,784,000 and $977,000 for the years ended December 31, 2013, 2012 and 2011, respectively. | |
The Company examines its concentrations of holdings, its historical patterns of award exercises and forfeitures as well as forward-looking factors, in an effort to determine if there were any discernible employee populations. From this analysis, the Company has identified three employee populations, consisting of senior executives, officers and all other recipients. The expected volatility rate applied was estimated based on historical volatility. The expected term assumption applied is based on contractual terms, historical exercise and cancellation patterns and forward-looking factors where present for each population identified. The risk-free interest rate used is based on the U.S. Treasury yield curve in effect at the time of the grant. The pre-vesting forfeiture rate is based on historical rates and forward-looking factors for each population identified. The Company will adjust the estimated forfeiture rate to its actual experience. The Company intends to retain its earnings to finance growth and development of the business and does not expect to disclose or pay any cash dividends in the foreseeable future. | |
Use of Estimates | ' |
o. Use of 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 reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. | |
Reclassifications | ' |
p. Reclassifications | |
Certain prior year amounts in the accompanying consolidated financial statements and these notes have been reclassified to reflect the impact of additional discontinued operations as further discussed in note 3. |
Acquisitions_Policies
Acquisitions (Policies) | 12 Months Ended |
Dec. 31, 2013 | |
Acquisitions and Investments in Unconsolidated Affiliates | ' |
Business Combinations | ' |
The Company accounts for its business combinations under the fundamental requirements of the acquisition method of accounting and under the premise that an acquirer be identified for each business combination. The acquirer is the entity that obtains control of one or more businesses in the business combination and the acquisition date is the date the acquirer achieves control. The assets acquired, liabilities assumed and any noncontrolling interests in the acquired business at the acquisition date are recognized at their fair values as of that date, and the direct costs incurred in connection with the business combination are recorded and expensed separately from the business combination. Acquisitions in which the Company is able to exert significant influence but does not have control are accounted for using the equity method. Equity method investments are initially recorded at cost, unless such investments are a result of the Company entering into a transaction whereby the Company loses control of a previously controlled entity but retains a noncontrolling interest. Such transactions, which result in the deconsolidation of a previously consolidated entity, are measured at fair value. |
Related_Party_Policies
Related Party (Policies) | 12 Months Ended |
Dec. 31, 2013 | |
Related Party Transactions | ' |
Related Party | ' |
It is the Company's policy that all transactions by the Company with officers, directors, five percent shareholders and their affiliates be entered into only if such transactions are on terms no less favorable to the Company than could be obtained from unaffiliated third parties, are reasonably expected to benefit the Company and are approved by the Nominating and Corporate Governance Committee of the Company's Board of Directors. | |
Acquisitions_Tables
Acquisitions (Tables) | 12 Months Ended | ||||||||
Dec. 31, 2013 | |||||||||
Acquisitions and Investments in Unconsolidated Affiliates | ' | ||||||||
Fair Value Of Total Consideration Transferred And Major Class Of Consideration | ' | ||||||||
2013 | 2012 | ||||||||
Accounts receivable | $ | 4,011 | $ | 11,572 | |||||
Supplies inventory, prepaid and other current assets | 2,014 | 4,750 | |||||||
Property and equipment | 6,894 | 23,546 | |||||||
Goodwill | 116,243 | 429,504 | |||||||
Other intangible assets | - | 800 | |||||||
Accounts payable | -2,214 | -3,199 | |||||||
Other accrued liabilities | -532 | -2,387 | |||||||
Long-term debt | -3,028 | -6,954 | |||||||
Other long-term liabilities | -254 | - | |||||||
Total fair value | 123,134 | 457,632 | |||||||
Less: Fair value attributable to noncontrolling interests | 49,792 | 182,073 | |||||||
Acquisition date fair value of total consideration transferred | $ | 73,342 | $ | 275,559 | |||||
Revenues And Net Earnings Associated With Acquisitions | ' | ||||||||
2013 | 2012 | ||||||||
Revenues | $ | 15,616 | $ | 11,247 | |||||
Net earnings | 4,596 | 3,441 | |||||||
Less: Net earnings attributable to noncontrolling interests | 2,603 | 1,977 | |||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 1,993 | $ | 1,464 | |||||
Consolidated Pro Forma Results Of Acquisition | ' | ||||||||
2013 | 2012 | ||||||||
Revenues | $ | 1,108,686 | $ | 1,116,214 | |||||
Net earnings | 269,903 | 261,251 | |||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||
Net earnings from continuing operations | 75,411 | 76,893 | |||||||
Net earnings | 75,461 | 77,221 | |||||||
Net earnings from continuing operations per common share: | |||||||||
Basic | $ | 2.41 | $ | 2.5 | |||||
Diluted | $ | 2.36 | $ | 2.43 | |||||
Net earnings: | |||||||||
Basic | $ | 2.41 | $ | 2.51 | |||||
Diluted | $ | 2.36 | $ | 2.44 | |||||
Weighted average number of shares and share equivalents: | |||||||||
Basic | 31,338 | 30,773 | |||||||
Diluted | 31,954 | 31,608 |
Dispositions_Tables
Dispositions (Tables) | 12 Months Ended | ||||||||
Dec. 31, 2013 | |||||||||
Dispositions | ' | ||||||||
Results Of Operations Of Centers Discontinued | ' | ||||||||
2013 | 2012 | 2011 | |||||||
Cash proceeds from disposal | $ | 3,553 | $ | 7,309 | $ | 7,026 | |||
Net earnings from discontinued operations | 2,771 | 2,221 | 1,820 | ||||||
Net gain (loss) from discontinued operations attributable to AmSurg Corp. | 50 | 328 | -28 | ||||||
Results Of Operations Of Combined Discontinued Surgery Centers | ' | ||||||||
2013 | 2012 | 2011 | |||||||
Revenues | $ | 3,224 | $ | 10,975 | $ | 18,814 | |||
Earnings before income taxes | 227 | 2,724 | 4,318 | ||||||
Net earnings | 169 | 2,196 | 3,363 |
Property_and_Equipment_Tables
Property and Equipment (Tables) | 12 Months Ended | ||||||
Dec. 31, 2013 | |||||||
Property, Plant and Equipment | ' | ||||||
Property, Plant and Equipment Schedule | ' | ||||||
2013 | 2012 | ||||||
Building and improvements | $ | 161,805 | $ | 151,270 | |||
Movable equipment and software | 228,212 | 208,541 | |||||
Construction in progress | 2,321 | 2,313 | |||||
392,338 | 362,124 | ||||||
Less accumulated depreciation | -222,443 | -195,512 | |||||
Property and equipment, net | $ | 169,895 | $ | 166,612 |
Goodwill_And_Intangible_Assets1
Goodwill And Intangible Assets (Tables) | 12 Months Ended | |||||||||||||||||||||
Dec. 31, 2013 | ||||||||||||||||||||||
Goodwill And Intangible Assets | ' | |||||||||||||||||||||
Changes In Carrying Amount Of Goodwill | ' | |||||||||||||||||||||
2013 | 2012 | |||||||||||||||||||||
Balance, beginning of period | $ | 1,652,002 | $ | 1,229,298 | ||||||||||||||||||
Goodwill acquired, including post acquisition adjustments | 112,951 | 429,504 | ||||||||||||||||||||
Goodwill disposed, including impact of deconsolidation transaction | -5,983 | -6,800 | ||||||||||||||||||||
Balance, end of period | $ | 1,758,970 | $ | 1,652,002 | ||||||||||||||||||
Schedule of Finite-Lived Intangible Assets | ' | |||||||||||||||||||||
2013 | 2012 | |||||||||||||||||||||
Gross | Gross | |||||||||||||||||||||
Carrying | Accumulated | Carrying | Accumulated | |||||||||||||||||||
Amount | Amortization | Net | Amount | Amortization | Net | |||||||||||||||||
Deferred financing cost | $ | 15,814 | $ | -4,953 | $ | 10,861 | $ | 14,523 | $ | -3,029 | $ | 11,494 | ||||||||||
Agreements, contracts and other intangible assets | 3,448 | -2,472 | 976 | 3,448 | -2,250 | 1,198 | ||||||||||||||||
Total amortizable intangible assets | $ | 19,262 | $ | -7,425 | $ | 11,837 | $ | 17,971 | $ | -5,279 | $ | 12,692 |
LongTerm_Debt_Tables
Long-Term Debt (Tables) | 12 Months Ended | |||||||
Dec. 31, 2013 | ||||||||
Long-Term Debt | ' | |||||||
Components Of Long-Term Debt | ' | |||||||
2013 | 2012 | |||||||
Revolving credit agreement (average rate of 2.1%) | $ | 252,500 | $ | 279,780 | ||||
Senior Unsecured Notes due 2020 (5.625%) | 250,000 | 250,000 | ||||||
Senior Secured Notes due 2020 (8.04%) | 69,643 | 75,000 | ||||||
Other debt at an average rate of 3.6%, due through 2025 | 21,149 | 21,350 | ||||||
Capitalized lease arrangements at an average rate of 5.3%, due through 2026 | 10,850 | 11,982 | ||||||
604,142 | 638,112 | |||||||
Less current portion | 20,844 | 17,407 | ||||||
Long-term debt | $ | 583,298 | $ | 620,705 | ||||
Redemption Price Percentage | ' | |||||||
Period | Redemption Price | |||||||
2015 | 104.22% | |||||||
2016 | 102.81% | |||||||
2017 | 101.41% | |||||||
2018 and thereafter | 100.00% |
Fair_Value_Measurements_Tables
Fair Value Measurements (Tables) | 12 Months Ended | ||||||||
Dec. 31, 2013 | |||||||||
Fair Value Measurements | ' | ||||||||
Fair Value Of Assets And Liabilities Measured On A Recurring Basis | ' | ||||||||
2013 | 2012 | ||||||||
Assets: | |||||||||
Supplemental executive retirement savings plan investments - Level 2 | $ | 13,313 | $ | 8,804 | |||||
Liabilities: | |||||||||
Contingent purchase price payable - Level 3 (see note 2) | $ | - | $ | 2,744 |
Leases_Tables
Leases (Tables) | 12 Months Ended | |||||||
Dec. 31, 2013 | ||||||||
Leases | ' | |||||||
Future Minimum Lease Payment Schedule | ' | |||||||
Capitalized | Operating | |||||||
Year Ended December 31, | Equipment Leases | Leases | ||||||
2014 | $ | 2,040 | $ | 47,704 | ||||
2015 | 1,673 | 46,557 | ||||||
2016 | 1,404 | 45,772 | ||||||
2017 | 1,184 | 45,174 | ||||||
2018 | 1,000 | 43,718 | ||||||
Thereafter | 7,003 | 354,087 | ||||||
Total minimum rentals | 14,304 | $ | 583,012 | |||||
Less amounts representing interest at rates ranging from 2.9% to 11.8% | 3,454 | |||||||
Capital lease obligations | $ | 10,850 |
Shareholders_Equity_Tables
Shareholders' Equity (Tables) | 12 Months Ended | ||||||||||
Dec. 31, 2013 | |||||||||||
Shareholders' Equity | ' | ||||||||||
Share-Based Activity | ' | ||||||||||
2013 | 2012 | 2011 | |||||||||
Share-based compensation expense | $ | 8,321 | $ | 6,692 | $ | 6,178 | |||||
Fair value of shares vested | 11,742 | 6,425 | 7,356 | ||||||||
Cash received from option exercises | 33,349 | 18,214 | 6,872 | ||||||||
Tax benefit from option exercises | 7,247 | 1,784 | 977 | ||||||||
Schedule Of Changes In Non-Vested Restricted Shares | ' | ||||||||||
Weighted | |||||||||||
Number | Average | ||||||||||
of | Grant | ||||||||||
Shares | Price | ||||||||||
Non-vested shares at January 1, 2011 | 664,909 | $ | 22.16 | ||||||||
Shares granted | 276,869 | 21.78 | |||||||||
Shares vested | -208,949 | 23.11 | |||||||||
Shares forfeited | -417 | 24.75 | |||||||||
Non-vested shares at December 31, 2011 | 732,412 | $ | 21.91 | ||||||||
Shares granted | 281,429 | 26.78 | |||||||||
Shares vested | -183,019 | 25.98 | |||||||||
Shares forfeited | -2,136 | 26.26 | |||||||||
Non-vested shares at December 31, 2012 | 828,686 | $ | 22.5 | ||||||||
Shares granted | 291,863 | 31.66 | |||||||||
Shares vested | -360,337 | 21.55 | |||||||||
Shares forfeited | -16,343 | 23.11 | |||||||||
Non-vested shares at December 31, 2013 | 743,869 | $ | 26.54 | ||||||||
Schedule Of Stock Option Activity | ' | ||||||||||
Weighted | |||||||||||
Average | |||||||||||
Weighted | Remaining | ||||||||||
Number | Average | Contractual | |||||||||
of | Exercise | Term | |||||||||
Shares | Price | (in years) | |||||||||
Outstanding at January 1, 2011 | 2,901,989 | $ | 22.49 | 4.5 | |||||||
Options exercised with total intrinsic value of $2,482,000 | -374,350 | 18.36 | |||||||||
Options terminated | -17,585 | 25.42 | |||||||||
Outstanding at December 31, 2011 | 2,510,054 | $ | 23.09 | 3.4 | |||||||
Options exercised with total intrinsic value of $6,287,000 | -841,599 | 21.64 | |||||||||
Options terminated | -5,625 | 21.85 | |||||||||
Outstanding at December 31, 2012 | 1,662,830 | $ | 23.82 | 2.9 | |||||||
Options exercised with total intrinsic value of $33,349,000 | -1,392,366 | 23.95 | |||||||||
Outstanding at December 31, 2013 with aggregate intrinsic value of $6,156,000 | 270,464 | $ | 23.16 | 2.5 | |||||||
Vested or expected to vest at December 31, 2013 with total intrinsic value of $6,156,000 | 270,464 | $ | 23.16 | 2.5 | |||||||
Exercisable at December 31, 2013 with total intrinsic value of $6,156,000 | 270,464 | $ | 23.16 | 2.5 | |||||||
Schedule Of Reconciliation Of Numerator And Denominators Of Basic And Diluted Earnings Per Share | ' | ||||||||||
Per | |||||||||||
Earnings | Shares | Share | |||||||||
(Numerator) | (Denominator) | Amount | |||||||||
For the year ended December 31, 2013: | |||||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (basic) | $ | 72,653 | 31,338 | $ | 2.32 | ||||||
Effect of dilutive securities options and non-vested shares | - | 616 | |||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (diluted) | $ | 72,653 | 31,954 | $ | 2.27 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 72,703 | 31,338 | $ | 2.32 | ||||||
Effect of dilutive securities options and non-vested shares | - | 616 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 72,703 | 31,954 | $ | 2.28 | ||||||
For the year ended December 31, 2012: | |||||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (basic) | $ | 62,235 | 30,773 | $ | 2.02 | ||||||
Effect of dilutive securities options and non-vested shares | - | 835 | |||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (diluted) | $ | 62,235 | 31,608 | $ | 1.97 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 62,563 | 30,773 | $ | 2.03 | ||||||
Effect of dilutive securities options and non-vested shares | - | 835 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 62,563 | 31,608 | $ | 1.98 | ||||||
For the year ended December 31, 2011: | |||||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (basic) | $ | 50,025 | 30,452 | $ | 1.64 | ||||||
Effect of dilutive securities options and non-vested shares | - | 759 | |||||||||
Net earnings from continuing operations attributable to | |||||||||||
AmSurg Corp. per common share (diluted) | $ | 50,025 | 31,211 | $ | 1.6 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 49,997 | 30,452 | $ | 1.64 | ||||||
Effect of dilutive securities options and non-vested shares | - | 759 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 49,997 | 31,211 | $ | 1.6 |
Income_Taxes_Tables
Income Taxes (Tables) | 12 Months Ended | |||||||||
Dec. 31, 2013 | ||||||||||
Income Taxes | ' | |||||||||
Schedule Of Total Income Tax Expense | ' | |||||||||
2013 | 2012 | 2011 | ||||||||
Income from continuing operations | $ | 49,754 | $ | 42,364 | $ | 34,973 | ||||
Discontinued operations | -1,091 | 1,574 | 3,032 | |||||||
Shareholders’ equity | -7,381 | -1,581 | -649 | |||||||
Other comprehensive income | - | - | 332 | |||||||
Total | $ | 41,282 | $ | 42,357 | $ | 37,688 | ||||
Schedule of Components of Income Tax Expense (Benefit) | ' | |||||||||
2013 | 2012 | 2011 | ||||||||
Current: | ||||||||||
Federal | $ | 8,437 | $ | 15,326 | $ | 11,671 | ||||
State | 3,724 | 4,974 | 3,541 | |||||||
Deferred: | ||||||||||
Federal | 31,909 | 18,488 | 17,502 | |||||||
State | 5,684 | 3,576 | 2,259 | |||||||
Income tax expense | $ | 49,754 | $ | 42,364 | $ | 34,973 | ||||
Schedule of Effective Income Tax Rate Reconciliation | ' | |||||||||
2013 | 2012 | 2011 | ||||||||
Statutory federal income tax | $ | 107,984 | $ | 92,325 | $ | 78,143 | ||||
Less federal income tax assumed directly by noncontrolling interests | -65,142 | -55,715 | -48,394 | |||||||
State income taxes, net of federal income tax benefit | 5,539 | 5,309 | 3,642 | |||||||
Increase in valuation allowances | 924 | 419 | 1,622 | |||||||
Interest related to unrecognized tax benefits | -155 | -109 | -83 | |||||||
Other | 604 | 135 | 43 | |||||||
Income tax expense | $ | 49,754 | $ | 42,364 | $ | 34,973 | ||||
Summary of Income Tax Contingencies | ' | |||||||||
2013 | 2012 | 2011 | ||||||||
Balance at beginning of year | $ | 9,235 | $ | 7,252 | $ | 7,144 | ||||
Additions for tax positions of current year | 46 | 119 | 342 | |||||||
Increases (decreases) for tax positions taken during a prior period | - | 1,985 | -190 | |||||||
Lapse of statute of limitations | -2,951 | -121 | -44 | |||||||
Balance at end of year | $ | 6,330 | $ | 9,235 | $ | 7,252 | ||||
Schedule of Deferred Tax Assets and Liabilities | ' | |||||||||
2013 | 2012 | |||||||||
Deferred tax assets: | ||||||||||
Allowance for uncollectible accounts | $ | 897 | $ | 884 | ||||||
Accrued assets and other | 5,292 | 5,212 | ||||||||
Valuation allowances | -2,021 | -2,084 | ||||||||
Total current deferred tax assets | 4,168 | 4,012 | ||||||||
Share-based compensation | 7,635 | 9,500 | ||||||||
Interest on unrecognized tax benefits | 230 | 363 | ||||||||
Accrued liabilities and other | 3,629 | 3,077 | ||||||||
Operating and capital loss carryforwards | 9,185 | 9,169 | ||||||||
Valuation allowances | -7,665 | -7,265 | ||||||||
Total non-current deferred tax assets | 13,014 | 14,844 | ||||||||
Total deferred tax assets | 17,182 | 18,856 | ||||||||
Deferred tax liabilities: | ||||||||||
Prepaid expenses | 1,071 | 925 | ||||||||
Property and equipment, principally due to differences in depreciation | 4,137 | 3,997 | ||||||||
Goodwill, principally due to differences in amortization | 184,897 | 148,494 | ||||||||
Total deferred tax liabilities | 190,105 | 153,416 | ||||||||
Net deferred tax liabilities | $ | 172,923 | $ | 134,560 | ||||||
Schedule Of Deferred Tax Assets And Liabilities, Net [Table Text Block] | ' | |||||||||
2013 | 2012 | |||||||||
Current deferred income tax assets | $ | 3,097 | $ | 3,088 | ||||||
Non-current deferred income tax liabilities | 176,020 | 137,648 | ||||||||
Net deferred tax liabilities | $ | 172,923 | $ | 134,560 |
Related_Party_Transactions_Tab
Related Party Transactions (Tables) | 12 Months Ended | ||||||||
Dec. 31, 2013 | |||||||||
Related Party Transactions | ' | ||||||||
Schedule of Related Party Payments | ' | ||||||||
2013 | 2012 | 2011 | |||||||
Operating leases | $ | 29,240 | $ | 29,079 | $ | 29,137 | |||
Salaries and benefits | 72,892 | 65,908 | 64,830 | ||||||
Billing fees | 11,591 | 11,126 | 11,240 | ||||||
Medical advisory services | 2,993 | 2,671 | 2,575 |
Supplemental_Cash_Flow_Informa1
Supplemental Cash Flow Information (Tables) | 12 Months Ended | |||||||||||||
Dec. 31, 2013 | ||||||||||||||
Supplemental Cash Flow Information | ' | |||||||||||||
Summary Of Supplemental Cash Flow Information | ' | |||||||||||||
2013 | 2012 | 2011 | ||||||||||||
Cash paid during the period for: | ||||||||||||||
Interest | $ | 28,378 | $ | 14,786 | $ | 13,815 | ||||||||
Income taxes, net of refunds | 7,756 | 19,615 | 10,232 | |||||||||||
Non-cash investing and financing activities: | ||||||||||||||
Increase in accounts payable associated with acquisition of property and equipment | 884 | 248 | 659 | |||||||||||
Capital lease obligations | 738 | 1,096 | 466 |
Guarantor_Tables
Guarantor (Tables) | 12 Months Ended | ||||||||||||||||||
Dec. 31, 2013 | |||||||||||||||||||
Condensed Consolidating Financial Information | ' | ||||||||||||||||||
Condensed Consolidating Balance Sheet | ' | ||||||||||||||||||
Condensed Consolidating Balance Sheet - December 31, 2013 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Assets | |||||||||||||||||||
Current assets: | |||||||||||||||||||
Cash and cash equivalents | $ | 6,710 | $ | - | $ | 44,130 | $ | - | $ | 50,840 | |||||||||
Accounts receivable, net | - | - | 105,072 | - | 105,072 | ||||||||||||||
Supplies inventory | 33 | - | 18,381 | - | 18,414 | ||||||||||||||
Deferred income taxes | 3,097 | - | - | - | 3,097 | ||||||||||||||
Prepaid and other current assets | 23,993 | - | 13,971 | -4,362 | 33,602 | ||||||||||||||
Total current assets | 33,833 | - | 181,554 | -4,362 | 211,025 | ||||||||||||||
Property and equipment, net | 9,829 | - | 160,066 | - | 169,895 | ||||||||||||||
Investments in unconsolidated affiliates and long-term notes receivable | 1,484,974 | 1,453,596 | - | -2,922,178 | 16,392 | ||||||||||||||
Goodwill and other intangible assets, net | 20,684 | - | 978 | 1,758,970 | 1,780,632 | ||||||||||||||
Total assets | $ | 1,549,320 | $ | 1,453,596 | $ | 342,598 | $ | -1,167,570 | $ | 2,177,944 | |||||||||
Liabilities and Equity | |||||||||||||||||||
Current liabilities: | |||||||||||||||||||
Current portion of long-term debt | $ | 10,714 | $ | - | $ | 10,130 | $ | - | $ | 20,844 | |||||||||
Accounts payable | 1,972 | - | 29,487 | -3,958 | 27,501 | ||||||||||||||
Other accrued liabilities | 27,419 | - | 14,510 | -404 | 41,525 | ||||||||||||||
Total current liabilities | 40,105 | - | 54,127 | -4,362 | 89,870 | ||||||||||||||
Long-term debt | 561,429 | - | 53,246 | -31,377 | 583,298 | ||||||||||||||
Deferred income taxes | 176,020 | - | - | - | 176,020 | ||||||||||||||
Other long-term liabilities | 7,569 | - | 17,934 | - | 25,503 | ||||||||||||||
Noncontrolling interests – redeemable | - | - | 63,704 | 113,993 | 177,697 | ||||||||||||||
Equity: | |||||||||||||||||||
Total AmSurg Corp. equity | 764,197 | 1,453,596 | 114,671 | -1,568,267 | 764,197 | ||||||||||||||
Noncontrolling interests – non-redeemable | - | - | 38,916 | 322,443 | 361,359 | ||||||||||||||
Total equity | 764,197 | 1,453,596 | 153,587 | -1,245,824 | 1,125,556 | ||||||||||||||
Total liabilities and equity | $ | 1,549,320 | $ | 1,453,596 | $ | 342,598 | $ | -1,167,570 | $ | 2,177,944 | |||||||||
Condensed Consolidating Balance Sheet - December 31, 2012 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Assets | |||||||||||||||||||
Current assets: | |||||||||||||||||||
Cash and cash equivalents | $ | 7,259 | $ | - | $ | 39,139 | $ | - | $ | 46,398 | |||||||||
Accounts receivable, net | - | - | 96,752 | - | 96,752 | ||||||||||||||
Supplies inventory | - | - | 18,406 | - | 18,406 | ||||||||||||||
Deferred income taxes | 3,088 | - | - | - | 3,088 | ||||||||||||||
Prepaid and other current assets | 19,342 | - | 13,160 | -4,965 | 27,537 | ||||||||||||||
Total current assets | 29,689 | - | 167,457 | -4,965 | 192,181 | ||||||||||||||
Property and equipment, net | 9,199 | - | 157,413 | - | 166,612 | ||||||||||||||
Investments in unconsolidated affiliates and long-term notes receivable | 1,413,061 | 1,381,596 | - | -2,783,383 | 11,274 | ||||||||||||||
Goodwill and other intangible assets, net | 21,311 | - | 1,206 | 1,652,002 | 1,674,519 | ||||||||||||||
Total assets | $ | 1,473,260 | $ | 1,381,596 | $ | 326,076 | $ | -1,136,346 | $ | 2,044,586 | |||||||||
Liabilities and Equity | |||||||||||||||||||
Current liabilities: | |||||||||||||||||||
Current portion of long-term debt | $ | 5,357 | $ | - | $ | 12,050 | $ | - | $ | 17,407 | |||||||||
Accounts payable | 1,379 | - | 26,035 | -3,905 | 23,509 | ||||||||||||||
Other accrued liabilities | 29,380 | - | 15,177 | -1,060 | 43,497 | ||||||||||||||
Total current liabilities | 36,116 | - | 53,262 | -4,965 | 84,413 | ||||||||||||||
Long-term debt | 599,423 | - | 52,747 | -31,465 | 620,705 | ||||||||||||||
Deferred income taxes | 137,648 | - | - | - | 137,648 | ||||||||||||||
Other long-term liabilities | 10,585 | - | 15,387 | - | 25,972 | ||||||||||||||
Noncontrolling interests – redeemable | - | - | 61,939 | 113,443 | 175,382 | ||||||||||||||
Equity: | |||||||||||||||||||
Total AmSurg Corp. equity | 689,488 | 1,381,596 | 108,412 | -1,490,008 | 689,488 | ||||||||||||||
Noncontrolling interests – non-redeemable | - | - | 34,329 | 276,649 | 310,978 | ||||||||||||||
Total equity | 689,488 | 1,381,596 | 142,741 | -1,213,359 | 1,000,466 | ||||||||||||||
Total liabilities and equity | $ | 1,473,260 | $ | 1,381,596 | $ | 326,076 | $ | -1,136,346 | $ | 2,044,586 | |||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income | ' | ||||||||||||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income - Year Ended December 31, 2013 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 24,167 | $ | - | $ | 1,072,694 | $ | -17,518 | $ | 1,079,343 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 61,038 | - | 272,619 | -467 | 333,190 | ||||||||||||||
Supply cost | - | - | 157,771 | - | 157,771 | ||||||||||||||
Other operating expenses | 22,660 | - | 217,068 | -17,051 | 222,677 | ||||||||||||||
Depreciation and amortization | 3,186 | - | 29,842 | - | 33,028 | ||||||||||||||
Total operating expenses | 86,884 | - | 677,300 | -17,518 | 746,666 | ||||||||||||||
Gain on deconsolidation | 2,237 | 2,237 | - | -2,237 | 2,237 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 204,962 | 204,962 | - | -406,773 | 3,151 | ||||||||||||||
Operating income | 144,482 | 207,199 | 395,394 | -409,010 | 338,065 | ||||||||||||||
Interest expense | 27,282 | - | 2,256 | - | 29,538 | ||||||||||||||
Earnings from continuing operations before income taxes | 117,200 | 207,199 | 393,138 | -409,010 | 308,527 | ||||||||||||||
Income tax expense | 48,239 | - | 1,515 | - | 49,754 | ||||||||||||||
Net earnings from continuing operations | 68,961 | 207,199 | 391,623 | -409,010 | 258,773 | ||||||||||||||
Net earnings (loss) from discontinued operations | 3,742 | - | -971 | - | 2,771 | ||||||||||||||
Net earnings | 72,703 | 207,199 | 390,652 | -409,010 | 261,544 | ||||||||||||||
Less net earnings attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 186,120 | - | 186,120 | ||||||||||||||
Net earnings from discontinued operations | - | - | 2,721 | - | 2,721 | ||||||||||||||
Total net earnings attributable to noncontrolling interests | - | - | 188,841 | - | 188,841 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 72,703 | $ | 207,199 | $ | 201,811 | $ | -409,010 | $ | 72,703 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 68,961 | $ | 207,199 | $ | 205,503 | $ | -409,010 | $ | 72,653 | |||||||||
Discontinued operations, net of income tax | 3,742 | - | -3,692 | - | 50 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 72,703 | $ | 207,199 | $ | 201,811 | $ | -409,010 | $ | 72,703 | |||||||||
Net earnings and comprehensive income, net of income tax | $ | 72,703 | $ | 207,199 | $ | 390,652 | $ | -409,010 | $ | 261,544 | |||||||||
Less comprehensive income attributable to noncontrolling interests | - | - | 188,841 | - | 188,841 | ||||||||||||||
Comprehensive income attributable to AmSurg Corp. | |||||||||||||||||||
common shareholders | $ | 72,703 | $ | 207,199 | $ | 201,811 | $ | -409,010 | $ | 72,703 | |||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income - Year Ended December 31, 2012 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 19,907 | $ | - | $ | 918,176 | $ | -14,901 | $ | 923,182 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 54,895 | - | 235,618 | -450 | 290,063 | ||||||||||||||
Supply cost | - | - | 131,055 | - | 131,055 | ||||||||||||||
Other operating expenses | 20,499 | - | 186,977 | -14,451 | 193,025 | ||||||||||||||
Depreciation and amortization | 2,860 | - | 26,990 | - | 29,850 | ||||||||||||||
Total operating expenses | 78,254 | - | 580,640 | -14,901 | 643,993 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 178,137 | 178,137 | - | -354,710 | 1,564 | ||||||||||||||
Operating income | 119,790 | 178,137 | 337,536 | -354,710 | 280,753 | ||||||||||||||
Interest expense | 14,803 | - | 2,164 | - | 16,967 | ||||||||||||||
Earnings from continuing operations before income taxes | 104,987 | 178,137 | 335,372 | -354,710 | 263,786 | ||||||||||||||
Income tax expense | 40,810 | - | 1,554 | - | 42,364 | ||||||||||||||
Net earnings from continuing operations | 64,177 | 178,137 | 333,818 | -354,710 | 221,422 | ||||||||||||||
Net (loss) earnings from discontinued operations | -1,614 | - | 3,835 | - | 2,221 | ||||||||||||||
Net earnings | 62,563 | 178,137 | 337,653 | -354,710 | 223,643 | ||||||||||||||
Less net earnings attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 159,187 | - | 159,187 | ||||||||||||||
Net earnings from discontinued operations | - | - | 1,893 | - | 1,893 | ||||||||||||||
Total net earnings attributable to noncontrolling interests | - | - | 161,080 | - | 161,080 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 62,563 | $ | 178,137 | $ | 176,573 | $ | -354,710 | $ | 62,563 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 64,177 | $ | 178,137 | $ | 174,631 | $ | -354,710 | $ | 62,235 | |||||||||
Discontinued operations, net of income tax | -1,614 | - | 1,942 | - | 328 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 62,563 | $ | 178,137 | $ | 176,573 | $ | -354,710 | $ | 62,563 | |||||||||
Net earnings and comprehensive income, net of income tax | $ | 62,563 | $ | 178,137 | $ | 337,653 | $ | -354,710 | $ | 223,643 | |||||||||
Less comprehensive income attributable to noncontrolling interests | - | - | 161,080 | - | 161,080 | ||||||||||||||
Comprehensive income attributable to AmSurg Corp. | |||||||||||||||||||
common shareholders | $ | 62,563 | $ | 178,137 | $ | 176,573 | $ | -354,710 | $ | 62,563 | |||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income - Year Ended December 31, 2011 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 11,253 | $ | - | $ | 768,823 | $ | -8,001 | $ | 772,075 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 42,739 | - | 196,358 | -359 | 238,738 | ||||||||||||||
Supply cost | - | - | 101,364 | - | 101,364 | ||||||||||||||
Other operating expenses | 19,468 | - | 156,521 | -7,642 | 168,347 | ||||||||||||||
Depreciation and amortization | 2,487 | - | 23,158 | - | 25,645 | ||||||||||||||
Total operating expenses | 64,694 | - | 477,401 | -8,001 | 534,094 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 152,409 | 152,409 | - | -304,205 | 613 | ||||||||||||||
Operating income | 98,968 | 152,409 | 291,422 | -304,205 | 238,594 | ||||||||||||||
Interest expense | 13,195 | - | 2,132 | - | 15,327 | ||||||||||||||
Earnings from continuing operations before income taxes | 85,773 | 152,409 | 289,290 | -304,205 | 223,267 | ||||||||||||||
Income tax expense | 33,806 | - | 1,167 | - | 34,973 | ||||||||||||||
Net earnings from continuing operations | 51,967 | 152,409 | 288,123 | -304,205 | 188,294 | ||||||||||||||
Net (loss) earnings from discontinued operations | -1,970 | - | 3,790 | - | 1,820 | ||||||||||||||
Net earnings | 49,997 | 152,409 | 291,913 | -304,205 | 190,114 | ||||||||||||||
Less net earnings attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 138,269 | - | 138,269 | ||||||||||||||
Net earnings from discontinued operations | - | - | 1,848 | - | 1,848 | ||||||||||||||
Total net earnings attributable to noncontrolling interests | - | - | 140,117 | - | 140,117 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 49,997 | $ | 152,409 | $ | 151,796 | $ | -304,205 | $ | 49,997 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 51,967 | $ | 152,409 | $ | 149,854 | $ | -304,205 | $ | 50,025 | |||||||||
Discontinued operations, net of income tax | -1,970 | - | 1,942 | - | -28 | ||||||||||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 49,997 | $ | 152,409 | $ | 151,796 | $ | -304,205 | $ | 49,997 | |||||||||
Net earnings | $ | 49,997 | $ | 152,409 | $ | 291,913 | $ | -304,205 | $ | 190,114 | |||||||||
Other comprehensive income, net of income tax: | |||||||||||||||||||
Unrealized gain on interest rate swap, net of income tax | 515 | - | - | - | 515 | ||||||||||||||
Comprehensive income, net of income tax | 50,512 | 152,409 | 291,913 | -304,205 | 190,629 | ||||||||||||||
Less comprehensive income attributable to noncontrolling interests | - | - | 140,117 | - | 140,117 | ||||||||||||||
Comprehensive income attributable to AmSurg Corp. | |||||||||||||||||||
common shareholders | $ | 50,512 | $ | 152,409 | $ | 151,796 | $ | -304,205 | $ | 50,512 | |||||||||
Condensed Consolidating Cash Flow Statement | ' | ||||||||||||||||||
Condensed Consolidating Statement of Cash Flows - Year Ended December 31, 2013 (In thousands) | |||||||||||||||||||
Parent | Guarantor | Non-Guarantor | Consolidating | Total | |||||||||||||||
Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||
Net cash flows provided by operating activities | $ | 45,127 | $ | 208,773 | $ | 426,572 | $ | -347,648 | $ | 332,824 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | - | -74,288 | - | 694 | -73,594 | ||||||||||||||
Acquisition of property and equipment | -3,693 | - | -25,163 | - | -28,856 | ||||||||||||||
Proceeds from sale of interests in surgery centers | - | 3,553 | - | - | 3,553 | ||||||||||||||
Other | - | 159 | - | - | 159 | ||||||||||||||
Net cash flows used in investing activities | -3,693 | -70,576 | -25,163 | 694 | -98,738 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 152,700 | - | 9,504 | - | 162,204 | ||||||||||||||
Repayment on long-term borrowings | -188,081 | - | -14,002 | - | -202,083 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | -138,875 | -392,922 | 347,648 | -184,149 | ||||||||||||||
Changes in intercompany balances with affiliates, net | 88 | - | -88 | - | - | ||||||||||||||
Other financing activities, net | -6,690 | 678 | 1,090 | -694 | -5,616 | ||||||||||||||
Net cash flows used in financing activities | -41,983 | -138,197 | -396,418 | 346,954 | -229,644 | ||||||||||||||
Net increase (decrease) in cash and cash equivalents | -549 | - | 4,991 | - | 4,442 | ||||||||||||||
Cash and cash equivalents, beginning of year | 7,259 | - | 39,139 | - | 46,398 | ||||||||||||||
Cash and cash equivalents, end of year | $ | 6,710 | $ | - | $ | 44,130 | $ | - | $ | 50,840 | |||||||||
Condensed Consolidating Statement of Cash Flows - Year Ended December 31, 2012 (In thousands) | |||||||||||||||||||
Parent | Guarantor | Non-Guarantor | Consolidating | Total | |||||||||||||||
Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||
Net cash flows provided by (used in) operating activities | $ | -83,605 | $ | 182,851 | $ | 379,257 | $ | -182,851 | $ | 295,652 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | -90,029 | -280,189 | - | 92,830 | -277,388 | ||||||||||||||
Acquisition of property and equipment | -3,681 | - | -25,183 | - | -28,864 | ||||||||||||||
Proceeds from sale of interests in surgery centers | - | 7,309 | - | - | 7,309 | ||||||||||||||
Net cash flows used in investing activities | -93,710 | -272,880 | -25,183 | 92,830 | -298,943 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 560,000 | - | 5,566 | - | 565,566 | ||||||||||||||
Repayment on long-term borrowings | -381,220 | - | -12,944 | - | -394,164 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | - | -345,792 | 182,851 | -162,941 | ||||||||||||||
Capital contributions | - | 90,029 | - | -90,029 | - | ||||||||||||||
Changes in intercompany balances with affiliates, net | -2,666 | - | 2,666 | - | - | ||||||||||||||
Other financing activities, net | -70 | - | 3,381 | -2,801 | 510 | ||||||||||||||
Net cash flows provided by (used in) financing activities | 176,044 | 90,029 | -347,123 | 90,021 | 8,971 | ||||||||||||||
Net increase (decrease) in cash and cash equivalents | -1,271 | - | 6,951 | - | 5,680 | ||||||||||||||
Cash and cash equivalents, beginning of year | 8,530 | - | 32,188 | - | 40,718 | ||||||||||||||
Cash and cash equivalents, end of year | $ | 7,259 | $ | - | $ | 39,139 | $ | - | $ | 46,398 | |||||||||
Condensed Consolidating Statement of Cash Flows - Year Ended December 31, 2011 (In thousands) | |||||||||||||||||||
Parent | Guarantor | Non-Guarantor | Consolidating | Total | |||||||||||||||
Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Cash flows from operating activities: | |||||||||||||||||||
Net cash flows provided by (used in) operating activities | $ | -67,911 | $ | 151,558 | $ | 311,334 | $ | -151,558 | $ | 243,423 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | -84,597 | -243,429 | - | 88,803 | -239,223 | ||||||||||||||
Acquisition of property and equipment | -2,858 | - | -19,312 | - | -22,170 | ||||||||||||||
Proceeds from sale of interests in surgery centers | - | 7,274 | -248 | - | 7,026 | ||||||||||||||
Net cash flows used in investing activities | -87,455 | -236,155 | -19,560 | 88,803 | -254,367 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 281,100 | - | 7,769 | - | 288,869 | ||||||||||||||
Repayment on long-term borrowings | -118,100 | - | -11,007 | - | -129,107 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | - | -290,282 | 151,558 | -138,724 | ||||||||||||||
Capital contributions | - | 84,597 | - | -84,597 | - | ||||||||||||||
Changes in intercompany balances with affiliates, net | -178 | - | 178 | - | - | ||||||||||||||
Other financing activities, net | -3,609 | - | 4,292 | -4,206 | -3,523 | ||||||||||||||
Net cash flows provided by (used in) financing activities | 159,213 | 84,597 | -289,050 | 62,755 | 17,515 | ||||||||||||||
Net increase in cash and cash equivalents | 3,847 | - | 2,724 | - | 6,571 | ||||||||||||||
Cash and cash equivalents, beginning of year | 4,683 | - | 29,464 | - | 34,147 | ||||||||||||||
Cash and cash equivalents, end of year | $ | 8,530 | $ | - | $ | 32,188 | $ | - | $ | 40,718 |
Quarterly_Financial_Data_Unaud1
Quarterly Financial Data Unaudited (Tables) | 12 Months Ended | ||||||||||||||||||||||||
Dec. 31, 2013 | |||||||||||||||||||||||||
Quarterly Financial Data Abstract | ' | ||||||||||||||||||||||||
Schedule of Quarterly Financial Information [Table Text Block] | ' | ||||||||||||||||||||||||
2013 | 2012 | ||||||||||||||||||||||||
Q1 | Q2 | Q3 | Q4 | Q1 | Q2 | Q3 | Q4 | ||||||||||||||||||
(In thousands, except per share data) | |||||||||||||||||||||||||
Revenues | $ | 259,043 | $ | 268,099 | $ | 267,631 | $ | 284,570 | $ | 227,567 | $ | 228,955 | $ | 223,885 | $ | 242,775 | |||||||||
Earnings from continuing operations | |||||||||||||||||||||||||
before income taxes | 74,496 | 78,398 | 73,989 | 81,644 | 66,110 | 66,611 | 63,211 | 67,854 | |||||||||||||||||
Net earnings from continuing operations | 62,203 | 65,640 | 62,562 | 68,368 | 55,349 | 55,541 | 53,148 | 57,384 | |||||||||||||||||
Net earnings (loss) from | |||||||||||||||||||||||||
discontinued operations (1) | 70 | 196 | -295 | 2,800 | -410 | 4 | 617 | 2,010 | |||||||||||||||||
Net earnings | 62,273 | 65,836 | 62,267 | 71,168 | 54,939 | 55,545 | 53,765 | 59,394 | |||||||||||||||||
Net earnings (loss) attributable to | |||||||||||||||||||||||||
AmSurg Corp. common shareholders: | |||||||||||||||||||||||||
Continuing | 17,785 | 18,489 | 17,056 | 19,323 | 15,488 | 15,939 | 15,196 | 15,612 | |||||||||||||||||
Discontinued | 26 | 74 | -285 | 235 | -712 | -403 | 241 | 1,202 | |||||||||||||||||
Net earnings | $ | 17,811 | $ | 18,563 | $ | 16,771 | $ | 19,558 | $ | 14,776 | $ | 15,536 | $ | 15,437 | $ | 16,814 | |||||||||
Diluted net earnings from | |||||||||||||||||||||||||
continuing operations per common share | $ | 0.56 | $ | 0.58 | $ | 0.53 | $ | 0.6 | $ | 0.49 | $ | 0.5 | $ | 0.48 | $ | 0.49 | |||||||||
Diluted net earnings per common share | $ | 0.56 | $ | 0.58 | $ | 0.52 | $ | 0.61 | $ | 0.47 | $ | 0.49 | $ | 0.49 | $ | 0.53 |
Schedule_II_Valuation_and_Qual1
Schedule II Valuation and Qualifying Accounts (Tables) | 12 Months Ended | |||||||||||||||
Dec. 31, 2013 | ||||||||||||||||
Valuation And Qualifying Accounts Abstract | ' | |||||||||||||||
Schedule Of Valuation And Qualifying Accounts Disclosure | ' | |||||||||||||||
Additions | Deductions | |||||||||||||||
Balance at | Charged to | Charged to | Charge-off | Balance | ||||||||||||
Beginning | Cost and | Other | Against | at End of | ||||||||||||
of Period | Expenses | Accounts (1) | Allowances | Period | ||||||||||||
Allowance for uncollectible accounts included under | ||||||||||||||||
the balance sheet caption “Accounts receivable”: | ||||||||||||||||
Year ended December 31, 2013 | $ | 22,379 | $ | 21,983 | $ | 6,410 | $ | -22,910 | $ | 27,862 | ||||||
Year ended December 31, 2012 | $ | 18,844 | $ | 20,340 | $ | 4,561 | $ | -21,366 | $ | 22,379 | ||||||
Year ended December 31, 2011 | $ | 13,070 | $ | 18,501 | $ | 3,967 | $ | -16,694 | $ | 18,844 |
Summary_of_Significant_Account2
Summary of Significant Accounting Policies (Details) (USD $) | 12 Months Ended | ||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | |
Centers | |||
Accounts Receivable, Net [Abstract] | ' | ' | ' |
Allowances for contractual adjustments | $289,937,000 | $216,363,000 | ' |
Allowances for accounts receivable | 27,862,000 | 22,379,000 | ' |
Income Taxes | ' | ' | ' |
Open Tax Year | '2010 | ' | ' |
Operating Expenses [Abstract] | ' | ' | ' |
Bad debt expense included in other operating expenses | 21,947,000 | 20,005,000 | 18,230,000 |
Other Long Term Liabilities | ' | ' | ' |
Deferred Rent Credit, Noncurrent | 14,637,000 | 12,134,000 | ' |
Liability for Uncertain Tax Positions, Noncurrent | 6,888,000 | 10,113,000 | ' |
Off-market Lease, Unfavorable | 3,034,000 | 3,559,000 | ' |
Other long-term liabilities | 944,000 | 166,000 | ' |
Prepaid Expense and Other Current Assets | ' | ' | ' |
Short-term Investments | 13,313,000 | 8,804,000 | ' |
Other Prepaid Expense, Current | 7,099,000 | 6,462,000 | ' |
Prepaid Insurance | 5,631,000 | 4,963,000 | ' |
Accounts and Other Receivables, Net, Current | 6,126,000 | 5,926,000 | ' |
Other Assets, Current | 1,433,000 | 1,382,000 | ' |
Ownership Interests [Line Items] | ' | ' | ' |
Number Of Centers Owned Less Than 51 Percent | 6 | ' | ' |
Ownership Interest In Unconsolidated Minority Owned Partnerships | 20.00% | ' | ' |
Revenue Recognition | ' | ' | ' |
Percentage of revenues from governmental healthcare programs | 25.00% | 27.00% | 29.00% |
Finite-Lived Intangible Assets [Line Items] | ' | ' | ' |
Finite-Lived Intangible Asset, Useful Life | '5 years 8 months 12 days | ' | ' |
Share-based Compensation [Abstract] | ' | ' | ' |
Excess Tax Benefit from Share-based Compensation, Financing Activities | $7,247,000 | $1,784,000 | $977,000 |
Maximum [Member] | ' | ' | ' |
Finite-Lived Intangible Assets [Line Items] | ' | ' | ' |
Finite-Lived Intangible Asset, Useful Life | '10 years | ' | ' |
Maximum [Member] | Building and Building Improvements [Member] | ' | ' | ' |
Property, Plant and Equipment [Line Items] | ' | ' | ' |
Property, Plant and Equipment, Useful Life | '40 years | ' | ' |
Maximum [Member] | Machinery and Equipment [Member] | ' | ' | ' |
Property, Plant and Equipment [Line Items] | ' | ' | ' |
Property, Plant and Equipment, Useful Life | '10 years | ' | ' |
Minimum [Member] | ' | ' | ' |
Finite-Lived Intangible Assets [Line Items] | ' | ' | ' |
Finite-Lived Intangible Asset, Useful Life | '5 years | ' | ' |
Minimum [Member] | Building and Building Improvements [Member] | ' | ' | ' |
Property, Plant and Equipment [Line Items] | ' | ' | ' |
Property, Plant and Equipment, Useful Life | '20 years | ' | ' |
Minimum [Member] | Machinery and Equipment [Member] | ' | ' | ' |
Property, Plant and Equipment [Line Items] | ' | ' | ' |
Property, Plant and Equipment, Useful Life | '3 years | ' | ' |
Consolidated [Member] | ' | ' | ' |
Ownership Interests [Line Items] | ' | ' | ' |
Number Of Centers Owned Less Than 51 Percent | 3 | ' | ' |
Nonconsolidated [Member] | ' | ' | ' |
Ownership Interests [Line Items] | ' | ' | ' |
Number Of Centers Owned Less Than 51 Percent | 3 | ' | ' |
Number Of Centers Owned Greater Than 51 Percent | 0 | ' | ' |
Acquisitions_and_Investments_i1
Acquisitions and Investments in Unconsolidated Affiliates (Narrative) (Details) (USD $) | 12 Months Ended | 0 Months Ended | ||||||||||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2012 | Sep. 01, 2011 | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2013 | |
Minimum [Member] | Maximum [Member] | Noncontrolling Interest Number Of Centers [Member] | Controlling Interest [Member] | Controlling Interest [Member] | Acquired Nsc Centers [Member] | Acquired Nsc Centers [Member] | Acquired Nsc Centers [Member] | Current Year Acquisitions [Member] | ||||
Centers | Centers | Centers | Centers | |||||||||
Business Acquisition [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Equity Method Investments | $16,392,000 | $11,274,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | $5,201,000 |
Gain (loss) on deconsolidation | 2,237,000 | 0 | 0 | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Estimated Probability Of Fair Value Variables Range | ' | ' | ' | 5.00% | 30.00% | ' | ' | ' | ' | ' | ' | ' |
Number of Businesses Acquired | ' | ' | ' | ' | ' | 1 | 5 | 17 | 17 | ' | ' | ' |
Payments to Acquire Businesses, Net of Cash Acquired | 73,594,000 | 277,388,000 | 239,223,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Purchase Price Payable Commitment | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | 2,744,000 | ' |
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High | ' | ' | ' | ' | ' | ' | ' | ' | 7,500,000 | ' | ' | ' |
Contingent Purchase Price Obligation, Settlement Amount | 2,744,000 | ' | ' | ' | ' | ' | ' | ' | ' | 2,744,000 | ' | ' |
Goodwill deductible for tax purposes | 70,147,000 | 260,547,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Other operating expenses in acquisition related costs, primarily attorney fees | $300,000 | $700,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Acquisitions_Fair_Value_Of_Tot
Acquisitions (Fair Value Of Total Consideration Transferred And Major Class Of Consideration) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
In Thousands, unless otherwise specified | |||
Business Acquisition [Line Items] | ' | ' | ' |
Goodwill | $1,758,970 | $1,652,002 | $1,229,298 |
Series of Individually Immaterial Business Acquisitions [Member] | ' | ' | ' |
Business Acquisition [Line Items] | ' | ' | ' |
Accounts receivable | 4,011 | 11,572 | ' |
Supplies, inventory, prepaid and other current assets | 2,014 | 4,750 | ' |
Property and equipment | 6,894 | 23,546 | ' |
Goodwill | 116,243 | 429,504 | ' |
Other intangible assets | 0 | 800 | ' |
Accounts payable | -2,214 | -3,199 | ' |
Other accrued liabilities | -532 | -2,387 | ' |
Long-term debt | -3,028 | -6,954 | ' |
Other long-term liabililties | -254 | 0 | ' |
Total fair value | 123,134 | 457,632 | ' |
Less: Fair value attributable to noncontrolling interests | 49,792 | 182,073 | ' |
Acquisition date fair value of total consideration transferred | $73,342 | $275,559 | ' |
Acquisitions_Revs_and_Earnings
Acquisitions (Revs and Earnings) (Details) (USD $) | 3 Months Ended | 12 Months Ended | |||||||||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Sep. 30, 2013 | Jun. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2012 | Jun. 30, 2012 | Mar. 31, 2012 | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Business Acquisition [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Net earnings | $71,168 | $62,267 | $65,836 | $62,273 | $59,394 | $53,765 | $55,545 | $54,939 | $261,544 | $223,643 | $190,114 |
Less: Net earnings attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 188,841 | 161,080 | 140,117 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 19,558 | 16,771 | 18,563 | 17,811 | 16,814 | 15,437 | 15,536 | 14,776 | 72,703 | 62,563 | 49,997 |
Series of Individually Immaterial Business Acquisitions [Member] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Business Acquisition [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Revenues | ' | ' | ' | ' | ' | ' | ' | ' | 15,616 | 11,247 | ' |
Net earnings | ' | ' | ' | ' | ' | ' | ' | ' | 4,596 | 3,441 | ' |
Less: Net earnings attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 2,603 | 1,977 | ' |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | $1,993 | $1,464 | ' |
Acquisitions_Consolidated_Pro_
Acquisitions (Consolidated Pro Forma Results Of Acquisition) (Details) (USD $) | 12 Months Ended | |
In Thousands, except Per Share data, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 |
Acquisitions and Investments in Unconsolidated Affiliates | ' | ' |
Revenues | $1,108,686 | $1,116,214 |
Net earnings | 269,903 | 261,251 |
Amounts Attributable To Common Shareholders | ' | ' |
Net earnings from continuing operations | 75,411 | 76,893 |
Net earnings | $75,461 | $77,221 |
Net earnings from continuing operations per common share: Basic | $2.41 | $2.50 |
Net earnings from continuing operations per common share: Diluted | $2.36 | $2.43 |
Net earnings: Basic | $2.41 | $2.51 |
Net earnings: Diluted | $2.36 | $2.44 |
Weighted average number of shares and share equivalents: Basic | 31,338 | 30,773 |
Weighted average number of shares and share equivalents: Diluted | 31,954 | 31,608 |
Dispositions_Results_Of_Operat
Dispositions (Results Of Operations Of Centers Discontinued) (Details) (USD $) | 3 Months Ended | 12 Months Ended | |||||||||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Sep. 30, 2013 | Jun. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2012 | Jun. 30, 2012 | Mar. 31, 2012 | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Dispositions | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Cash proceeds from disposal | ' | ' | ' | ' | ' | ' | ' | ' | $3,553 | $7,309 | $7,026 |
Net earnings (loss) from discontinued operations | 2,800 | -295 | 196 | 70 | 2,010 | 617 | 4 | -410 | 2,771 | 2,221 | 1,820 |
Net gain (loss) from discontinued operations attributable to AmSurg Corp. | $235 | ($285) | $74 | $26 | $1,202 | $241 | ($403) | ($712) | $50 | $328 | ($28) |
Dispositions_Results_Of_Operat1
Dispositions (Results Of Operations Of Combined Discontinued Surgery Centers) (Details) (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Dispositions | ' | ' | ' |
Revenues | $3,224 | $10,975 | $18,814 |
Earnings (loss) before income taxes | 227 | 2,724 | 4,318 |
Net earnings (loss) | $169 | $2,196 | $3,363 |
Property_and_Equipment_Narrati
Property and Equipment (Narrative) (Details) (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Property, Plant and Equipment | ' | ' | ' |
Capitalized Interest | $24,000 | $43,000 | $85,000 |
Unfunded ConstructionAnd Equipment Purchases | 953,000 | ' | ' |
Depreciation Expense | $32,974,000 | $30,072,000 | $26,068,000 |
Property_and_Equipment_PPE_Sch
Property and Equipment (PPE Schedule) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Property, Plant and Equipment | ' | ' |
Buildings and improvements | $161,805 | $151,270 |
Movable equipment and software | 228,212 | 208,541 |
Construction in Progress | 2,321 | 2,313 |
Property, Plant and Equipment, Gross | 392,338 | 362,124 |
Less accumulated depreciation | -222,443 | -195,512 |
Property, Plant and Equipment, Net | $169,895 | $166,612 |
Goodwill_And_Intangible_Assets2
Goodwill And Intangible Assets (Narrative) (Details) (USD $) | 12 Months Ended | ||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | |
Goodwill And Intangible Assets | ' | ' | ' |
Amortization of Intangible Assets | $2,178,000 | $1,415,000 | $1,472,000 |
Deferred Financing Costs, Increase (Decrease) | 6,200,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Next Twelve Months | 2,243,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Year Two | 2,242,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Year Three | 2,242,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Year Four | 1,988,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Year Five | 1,424,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, after Year Five | 1,698,000 | ' | ' |
Finite-Lived Intangible Asset, Useful Life | '5 years 8 months 12 days | ' | ' |
Restrictive Covenant Agreements | $9,825,000 | $9,825,000 | ' |
Goodwill_And_Intangible_Assets3
Goodwill And Intangible Assets (Changes In Carrying Amount Of Goodwill) (Details) (USD $) | 12 Months Ended | |
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 |
Goodwill And Intangible Assets | ' | ' |
Balance, beginning of period | $1,652,002 | $1,229,298 |
Goodwill acquired, including post acquisition adjustments | 112,951 | 429,504 |
Goodwill disposed, including impact of deconsolidation transaction | -5,983 | -6,800 |
Balance, end of period | $1,758,970 | $1,652,002 |
Goodwill_And_Intangible_Assets4
Goodwill And Intangible Assets (Summary Of Amortizable Intangible Assets) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Finite-Lived Intangible Assets [Line Items] | ' | ' |
Gross Carrying Amount | $19,262 | $17,971 |
Accumulated Amortization | -7,425 | -5,279 |
Net | 11,837 | 12,692 |
Deferred financing cost [Member] | ' | ' |
Finite-Lived Intangible Assets [Line Items] | ' | ' |
Gross Carrying Amount | 15,814 | 14,523 |
Accumulated Amortization | -4,953 | -3,029 |
Net | 10,861 | 11,494 |
Agreements, contracts and other intangible assets | ' | ' |
Finite-Lived Intangible Assets [Line Items] | ' | ' |
Gross Carrying Amount | 3,448 | 3,448 |
Accumulated Amortization | -2,472 | -2,250 |
Net | $976 | $1,198 |
LongTerm_Debt_Narrative_Detail
Long-Term Debt (Narrative) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2013 | Dec. 31, 2013 |
Line of Credit [Member] | Unsecured Debt [Member] | Secured Debt [Member] | Capital Lease Obligations [Member] | Other Debt Obligations [Member] | Maximum [Member] | Minimum [Member] | Period from current report date to November 30, 2015 | Period from January 1, 2012 through November 7, 2012 | |||
Line of Credit [Member] | Line of Credit [Member] | Unsecured Debt [Member] | Secured Debt [Member] | ||||||||
Long-term Debt, by Maturity [Abstract] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Repayments of Principal in Next Twelve Months | $20,844,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Repayments of Principal after Year Five | 272,185,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Long-term Debt, Maturing in Years Two and Three [Abstract] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Repayments of Principal in Year Two | 17,751,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Repayments of Principal in Year Three | 14,903,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Long-term Debt, Maturing in Years Four and Five [Abstract] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Repayments of Principal in Year Four | 13,422,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Repayments of Principal in Year Five | 265,037,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Credit Facility | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Borrowing capacity of new revolving credit agreement | ' | ' | 475,000,000 | ' | ' | ' | ' | ' | ' | ' | ' |
Line of Credit Facility, Expiration Date | ' | ' | 1-Jun-18 | ' | ' | ' | ' | ' | ' | ' | ' |
Debt instruments interest rate base rate plus | ' | ' | ' | ' | ' | ' | ' | 1.00% | 0.25% | ' | ' |
Debt instruments interest rate Libor plus | ' | ' | ' | ' | ' | ' | ' | 2.00% | 1.25% | ' | ' |
Unused capacity commitment fee, percentage | ' | ' | ' | ' | ' | ' | ' | 0.40% | 0.25% | ' | ' |
Senior Unsecured Debt | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Unsecured Debt | 250,000,000 | 250,000,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Debt Instrument, Interest Rate, Stated Percentage | ' | ' | ' | 5.63% | 8.04% | ' | ' | ' | ' | ' | 6.04% |
Debt Instrument, Maturity Date | ' | ' | ' | 30-Nov-20 | 28-May-20 | 31-Dec-26 | 30-Nov-25 | ' | ' | ' | ' |
Redeemable Principal Percentage | ' | ' | ' | 35.00% | ' | ' | ' | ' | ' | ' | ' |
Future Redemption Price of Debt During Eligibility Period, as a Percentage of Principal Amount | ' | ' | ' | ' | ' | ' | ' | ' | ' | 105.63% | ' |
Senior Secured Debt | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Senior Secured Notes | 69,643,000 | 75,000,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Debt Instrument, Interest Rate, Stated Percentage | ' | ' | ' | 5.63% | 8.04% | ' | ' | ' | ' | ' | 6.04% |
Debt Instrument, Maturity Date | ' | ' | ' | 30-Nov-20 | 28-May-20 | 31-Dec-26 | 30-Nov-25 | ' | ' | ' | ' |
Debt Instrument, Interest Rate Increase | ' | ' | ' | ' | 2.00% | ' | ' | ' | ' | ' | ' |
Other Long-term Debt [Abstract] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Book Value of Collateralized By Certain Assets | ' | ' | ' | ' | ' | ' | $74,150,000 | ' | ' | ' | ' |
LongTerm_Debt_Components_Of_Lo
Long-Term Debt (Components Of Long-Term Debt) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Long-Term Debt | ' | ' |
Revolving credit agreement | $252,500 | $279,780 |
Senior Unsecured Notes | 250,000 | 250,000 |
Senior Secured Notes | 69,643 | 75,000 |
Other debt | 21,149 | 21,350 |
Capitalized lease arrangements | 10,850 | 11,982 |
Long-term debt, gross | $604,142 | $638,112 |
Long_Term_Debt_Current_Noncurr
Long Term Debt (Current & Noncurrent Breakout) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Long-term Debt, Current and Noncurrent [Abstract] | ' | ' |
Long-term debt | $583,298 | $620,705 |
Less current portion | 20,844 | 17,407 |
Long-term debt, gross | $604,142 | $638,112 |
Long_Term_Debt_Parenthetical_D
Long Term Debt (Parenthetical) (Details) | 12 Months Ended |
Dec. 31, 2013 | |
Line of Credit [Member] | ' |
Debt Instrument [Line Items] | ' |
Long-term Debt, Weighted Average Interest Rate | 2.10% |
Unsecured Debt [Member] | ' |
Debt Instrument [Line Items] | ' |
Debt Instrument, Maturity Date | 30-Nov-20 |
Debt Instrument, Interest Rate, Stated Percentage | 5.63% |
Secured Debt [Member] | ' |
Debt Instrument [Line Items] | ' |
Debt Instrument, Maturity Date | 28-May-20 |
Debt Instrument, Interest Rate, Stated Percentage | 8.04% |
Capital Lease Obligations [Member] | ' |
Debt Instrument [Line Items] | ' |
Debt Instrument, Maturity Date | 31-Dec-26 |
Long-term Debt, Weighted Average Interest Rate | 5.30% |
Other Debt Obligations [Member] | ' |
Debt Instrument [Line Items] | ' |
Debt Instrument, Maturity Date | 30-Nov-25 |
Long-term Debt, Weighted Average Interest Rate | 3.60% |
LongTerm_Debt_Redemption_Price
Long-Term Debt (Redemption Price) (Details) (Unsecured Debt [Member]) | Dec. 31, 2013 |
Period from November 30, 2015 to November 29, 2016 | ' |
Future Redemption Price of Debt During Eligibility Period, as a Percentage of Principal Amount | 104.22% |
Period from November 30, 2016 to November 29, 2017 | ' |
Future Redemption Price of Debt During Eligibility Period, as a Percentage of Principal Amount | 102.81% |
Period from November 30, 2017 to November 29, 2018 | ' |
Future Redemption Price of Debt During Eligibility Period, as a Percentage of Principal Amount | 101.41% |
Period from November 30, 2018 to November 30, 2020 | ' |
Future Redemption Price of Debt During Eligibility Period, as a Percentage of Principal Amount | 100.00% |
Derivative_Instruments_Narrati
Derivative Instruments (Narrative) (Details) (USD $) | 12 Months Ended | |||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | Apr. 30, 2011 | |
Derivative Instruments | ' | ' | ' | ' |
Derivative, Notional Amount | ' | ' | ' | $50,000,000 |
Percentage of interest rate swap pays to counterparty | ' | ' | ' | 5.37% |
Unrealized gain on interest rate swap, net of income tax | $0 | $0 | $515,000 | ' |
Fair_Value_Measurements_Narrat
Fair Value Measurements (Narrative) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
Fair Value Measurements | ' | ' |
Business Acquisition, Preacquisition Contingency, Amount of Settlement | $2,744,000 | ' |
Debt Instrument [Line Items] | ' | ' |
Long-term Debt gross | 604,142,000 | 638,112,000 |
Fixed Interest Rate [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Long-term Debt gross | 348,958,000 | 354,105,000 |
Long-term Debt, Fair Value | 364,349,000 | 379,036,000 |
Variable Interest Rate [Member] | ' | ' |
Debt Instrument [Line Items] | ' | ' |
Long-term Debt gross | 255,184,000 | 284,007,000 |
Long-term Debt, Fair Value | $255,184,000 | $284,007,000 |
Fair_Value_Measurements_Fair_V
Fair Value Measurements (Fair Value Of Assets And Liabilities Measured On A Recurring Basis) (Details) (Fair Value, Measurements, Recurring [Member], USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Fair Value, Inputs, Level 2 [Member] | ' | ' |
Supplemental executive retirement savings plan investments - Level 2 | $13,313 | $8,804 |
Fair Value, Inputs, Level 3 [Member] | ' | ' |
Contingent purchase price payable - Level 3 | $0 | $2,744 |
Leases_Narrative_Details
Leases (Narrative) (Details) (USD $) | 12 Months Ended | ||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | |
Leases | ' | ' | ' |
Lease Expiration Date | 31-Dec-33 | ' | ' |
Capital Leased Assets, Gross | $13,950,000 | ' | ' |
Capital Leases, Lessee Balance Sheet, Assets by Major Class, Accumulated Depreciation | 3,635,000 | ' | ' |
Operating Leases, Rent Expense, Net | $52,641,000 | $47,278,000 | $42,413,000 |
Leases_Future_Min_Schedule_Det
Leases (Future Min Schedule) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Leases | ' | ' |
Capital Leases, Future Minimum Payments Due, Current | $2,040 | ' |
Capital Leases, Future Minimum Payments Due in Two Years | 1,673 | ' |
Capital Leases, Future Minimum Payments Due in Three Years | 1,404 | ' |
Capital Leases, Future Minimum Payments Due in Four Years | 1,184 | ' |
Capital Leases, Future Minimum Payments Due in Five Years | 1,000 | ' |
Capital Leases, Future Minimum Payments Due Thereafter | 7,003 | ' |
Total minimum rentals | 14,304 | ' |
Less amounts representing interest | 3,454 | ' |
Capital Lease Obligations, Total | 10,850 | 11,982 |
Operating Leases, Future Minimum Payments Due, Current | 47,704 | ' |
Operating Leases, Future Minimum Payments, Due in Two Years | 46,557 | ' |
Operating Leases, Future Minimum Payments, Due in Three Years | 45,772 | ' |
Operating Leases, Future Minimum Payments, Due in Four Years | 45,174 | ' |
Operating Leases, Future Minimum Payments, Due in Five Years | 43,718 | ' |
Operating Leases, Future Minimum Payments, Due Thereafter | 354,087 | ' |
Total minimum rentals | $583,012 | ' |
Leases_Parenthetical_Details
Leases (Parenthetical) (Details) | 12 Months Ended |
Dec. 31, 2013 | |
Maximum [Member] | ' |
Capital Lease Interest Rate Range [Line Items] | ' |
Capital Lease Interest Rates | 11.80% |
Minimum [Member] | ' |
Capital Lease Interest Rate Range [Line Items] | ' |
Capital Lease Interest Rates | 2.90% |
Shareholders_Equity_Narrative_
Shareholder's Equity (Narrative) (Details) (USD $) | 0 Months Ended | 12 Months Ended | |||
Aug. 09, 2013 | Apr. 24, 2012 | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | |
M | M | ||||
Common Stock: | ' | ' | ' | ' | ' |
Stock repurchased program authorized by the board of directors | $40,000,000 | $40,000,000 | ' | ' | ' |
Period of stock repurchase program, months | 18 | 18 | ' | ' | ' |
Average price per share | ' | ' | $36.93 | $28.50 | ' |
Amount remaining under stock repurchase plan | ' | ' | 27,100,000 | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' | ' |
Unrecognized compensation cost on non vested awards | ' | ' | 7,426,000 | ' | ' |
Employee Service Share-based Compensation, Nonvested Awards | ' | ' | '1 year 0 months 0 days | ' | ' |
Share based payment award shares purchased for award | ' | ' | 0 | 20,000 | 923,000 |
Stock Repurchased Under Repurchase Program [Member] | ' | ' | ' | ' | ' |
Common Stock: | ' | ' | ' | ' | ' |
Repurchase of common stock, shares | ' | ' | 1,154,378 | 415,084 | ' |
Repurchase of common stock | ' | ' | 42,652,000 | 11,838,000 | ' |
Stock Repurchased To Cover Employee Tax Withholdings [Member] | ' | ' | ' | ' | ' |
Common Stock: | ' | ' | ' | ' | ' |
Repurchase of common stock, shares | ' | ' | 102,252 | 48,139 | ' |
Repurchase of common stock | ' | ' | $3,312,000 | $1,263,000 | ' |
Outside Directors [Member] | ' | ' | ' | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' | ' |
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period | ' | ' | '1 year | '1 year | ' |
Employees [Member] | ' | ' | ' | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' | ' |
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period | ' | ' | '4 years | ' | ' |
Number of installments in restricted stock granted. | ' | ' | 3 | ' | ' |
Options term | ' | ' | 10 | ' | ' |
Stock Options [Member] | ' | ' | ' | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' | ' |
Number of shares authorized for grant under share incentive plan | ' | ' | 2,760,250 | ' | ' |
Shares available for future grants/issuance under stock incentive plan | ' | ' | 895,822 | ' | ' |
Restricted Stock [Member] | ' | ' | ' | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' | ' |
Shares available for future grants/issuance under stock incentive plan | ' | ' | 733,718 | ' | ' |
Shareholders_Equity_ShareBased
Shareholders' Equity (Share-Based Activity) (Details) (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Shareholders' Equity | ' | ' | ' |
Share-based compensation expense | $8,321 | $6,692 | $6,178 |
Fair value of shares vested | 11,742 | 6,425 | 7,356 |
Cash received from option exercises | 33,349 | 18,214 | 6,872 |
Tax benefit from option exercises | $7,247 | $1,784 | $977 |
Shareholders_Equity_Schedule_O
Shareholders Equity (Schedule Of Changes In Non-Vested Restricted Shares) (Details) (USD $) | 12 Months Ended | ||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | |
Shareholders' Equity | ' | ' | ' |
Non-vested shares at beginning of period, Number of Shares | 828,686 | 732,412 | 664,909 |
Shares granted, Number of Shares | 291,863 | 281,429 | 276,869 |
Shares vested, Number of Shares | -360,337 | -183,019 | -208,949 |
Shares forfeited, Number of Shares | -16,343 | -2,136 | -417 |
Non-vested shares at end of period, Number of Shares | 743,869 | 828,686 | 732,412 |
Non-vested shares at beginning of period, Weighted Average Grant Price | $22.50 | $21.91 | $22.16 |
Shares granted, Weighted Average Grant Price | $31.66 | $26.78 | $21.78 |
Shares vested, Weighted Average Grant Price | $21.55 | $25.98 | $23.11 |
Shares forfeited, Weighted Average Grant Price | $23.11 | $26.26 | $24.75 |
Non-vested shares at end of period, Weighted Average Grant Price | $26.54 | $22.50 | $21.91 |
Recovered_Sheet1
Shareholder's Equity (Schedule of Stock Option Activity (Details) (USD $) | 12 Months Ended | |||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | Dec. 31, 2010 | |
Shareholders' Equity | ' | ' | ' | ' |
Outstanding at beginning of period, Number of Shares | 1,662,830 | 2,510,054 | 2,901,989 | ' |
Options exercised, Number of Shares | -1,392,366 | -841,599 | -374,350 | ' |
Options terminated, Number of Shares | ' | -5,625 | -17,585 | ' |
Outstanding at end of period, Number of Shares | 270,464 | 1,662,830 | 2,510,054 | 2,901,989 |
Vested or expected to vest at end of period, Number of Shares | 270,464 | ' | ' | ' |
Exercisable at end of period, Number of Shares | 270,464 | ' | ' | ' |
Outstanding at beginning of period, Weighted Average Exercise Price | $23.82 | $23.09 | $22.49 | ' |
Options exercised, Weighted Average Grant Price | $23.95 | $21.64 | $18.36 | ' |
Options terminated, Weighted Average Grant Price | ' | $21.85 | $25.42 | ' |
Outstanding at end of period, Weighted Average Exercise Price | $23.16 | $23.82 | $23.09 | $22.49 |
Vested or expected to vest at end of period, Weighted Average Exercise Price price | $23.16 | ' | ' | ' |
Exercisable at end of period, Weighted Average Exercise Price | $23.16 | ' | ' | ' |
Weighted Average Remaining Contractual Term, Period Start | '2 years 6 months 0 days | '2 years 10 months 24 days | '3 years 4 months 24 days | '4 years 6 months 0 days |
Weighted Average Remaining Contractual Term, Period End | '2 years 6 months 0 days | '2 years 10 months 24 days | '3 years 4 months 24 days | '4 years 6 months 0 days |
Weighted Average Remaining Contractual Term, Vested or expected to vest | '2 years 6 months 0 days | ' | ' | ' |
Weighted Average Remaining Contractual Term, Exercisable | '2 years 6 months 0 days | ' | ' | ' |
Shareholders_Equity_Schedule_o1
Shareholder's Equity (Schedule of Stock Option Activity (Parenthetical) (Details) (USD $) | 12 Months Ended | ||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | |
Shareholders' Equity | ' | ' | ' |
Total intrinsic value with options exercised | $33,349,000 | $6,287,000 | $2,482,000 |
Aggregate intrinsic value of options outstanding | 6,156,000 | ' | ' |
Total intrinsic value of options vested or expected to vest | 6,156,000 | ' | ' |
Total intrinsic value of options exercisable | $6,156,000 | ' | ' |
Recovered_Sheet2
Shareholder's Equity (Schedule Of Reconciliation Of Numerator And Denominators Of Basic And Diluted Earnings Per Share) (Details) (USD $) | 3 Months Ended | 12 Months Ended | |||||||||
In Thousands, except Per Share data, unless otherwise specified | Dec. 31, 2013 | Sep. 30, 2013 | Jun. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2012 | Jun. 30, 2012 | Mar. 31, 2012 | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Shareholders' Equity | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Net earnings from continuing operations attributable to AmSurg Corp., Earnings (Numerator) | $19,323 | $17,056 | $18,489 | $17,785 | $15,612 | $15,196 | $15,939 | $15,488 | $72,653 | $62,235 | $50,025 |
Net earnings attributable to AmSurg Corp., Earnings (Numerator) | $19,558 | $16,771 | $18,563 | $17,811 | $16,814 | $15,437 | $15,536 | $14,776 | $72,703 | $62,563 | $49,997 |
Net earnings from continuing operations attributable to AmSurg Corp. (Basic), Shares (Denominator) | ' | ' | ' | ' | ' | ' | ' | ' | 31,338 | 30,773 | 30,452 |
Effect of dilutive securities options and non-vested shares | ' | ' | ' | ' | ' | ' | ' | ' | 616 | 835 | 759 |
Net earnings from continuing operations attributable to AmSurg Corp. (Diluted), Shares (Denominator) | ' | ' | ' | ' | ' | ' | ' | ' | 31,954 | 31,608 | 31,211 |
Net earnings from continuing operations attributable to AmSurg Corp. per common share (Basic), Per Share Amount | ' | ' | ' | ' | ' | ' | ' | ' | $2.32 | $2.02 | $1.64 |
Net earnings from continuing operations attributable to AmSurg Corp. per common share (Diluted), Per Share Amount | $0.60 | $0.53 | $0.58 | $0.56 | $0.49 | $0.48 | $0.50 | $0.49 | $2.27 | $1.97 | $1.60 |
Net earnings attributable to AmSurg Corp. per common share (Basic), Per Share Amount | ' | ' | ' | ' | ' | ' | ' | ' | $2.32 | $2.03 | $1.64 |
Net earnings attributable to AmSurg Corp. per common share (Diluted), Per Share Amount | $0.61 | $0.52 | $0.58 | $0.56 | $0.53 | $0.49 | $0.49 | $0.47 | $2.28 | $1.98 | $1.60 |
Income_Taxes_Narrative_Details
Income Taxes (Narrative) (Details) (USD $) | 12 Months Ended | ||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | |
Income Taxes | ' | ' | ' |
Change in interest related to unrecognized tax benefits | ($189,000) | ($132,000) | ($109,000) |
Unrecognized Tax Benefits, Interest on Income Taxes Accrued | 943,000 | 1,132,000 | ' |
Unrecognized Tax Benefits, Income Tax Penalties Expense | 0 | 0 | 0 |
Unrecognized Tax Benefits that Would Impact Effective Tax Rate | $150,000 | ' | ' |
Operating Loss Carryforwards [Line Items] | ' | ' | ' |
Operating Loss Carryforwards, Expiration Dates | 31-Dec-14 | ' | ' |
State and Local Jurisdiction [Member] | ' | ' | ' |
Operating Loss Carryforwards [Line Items] | ' | ' | ' |
Operating Loss Carryforwards, Expiration Dates | 31-Dec-15 | ' | ' |
Income_Taxes_Total_Income_Tax_
Income Taxes (Total Income Tax Expense) (Details) (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Income Taxes | ' | ' | ' |
Income from continuing operations | $49,754 | $42,364 | $34,973 |
Discontinued operations | -1,091 | 1,574 | 3,032 |
Shareholders' equity | -7,381 | -1,581 | -649 |
Other comprehensive income | 0 | 0 | 332 |
Total | $41,282 | $42,357 | $37,688 |
Income_Taxes_Income_Tax_Expens
Income Taxes (Income Tax Expense from Cont. Ops) (Details) (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Current: | ' | ' | ' |
Federal | $8,437 | $15,326 | $11,671 |
State | 3,724 | 4,974 | 3,541 |
Deferred: | ' | ' | ' |
Federal | 31,909 | 18,488 | 17,502 |
State | 5,684 | 3,576 | 2,259 |
Income tax expense | $49,754 | $42,364 | $34,973 |
Income_Taxes_Income_Tax_Expens1
Income Taxes (Income Tax Expense Reconciliation to Federal Rate) (Details) (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Income Tax Expense (Benefit), Continuing Operations, Income Tax Reconciliation [Abstract] | ' | ' | ' |
Statutory federal income tax | $107,984 | $92,325 | $78,143 |
Less federal income tax assumed directly by noncontrolling interests | -65,142 | -55,715 | -48,394 |
State income taxes, net of federal income tax benefit | 5,539 | 5,309 | 3,642 |
Increase in valuation allowances | 924 | 419 | 1,622 |
Interest related to unrecognized tax benefits | -155 | -109 | -83 |
Other | 604 | 135 | 43 |
Income tax expense | $49,754 | $42,364 | $34,973 |
Income_Taxes_Unrecognized_Tax_
Income Taxes (Unrecognized Tax Liability Rec) (Details) (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward] | ' | ' | ' |
Balance at beginning of year | $9,235 | $7,252 | $7,144 |
Additions for tax positions of current year | 46 | 119 | 342 |
Increases for tax positions taken during a prior period | 0 | 1,985 | ' |
Decreases for tax positions taken during a prior period | ' | ' | -190 |
Lapse of statute of limitations | -2,951 | -121 | -44 |
Balance at end of year | $6,330 | $9,235 | $7,252 |
Income_Taxes_Deferred_Assets_a
Income Taxes (Deferred Assets and Liabilities) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Deferred Taxes Assets [Abstract] | ' | ' |
Allowance for uncollectible accounts | $897 | $884 |
Accrued assets and other | 5,292 | 5,212 |
Valuation allowances | -2,021 | -2,084 |
Total current deferred tax assets | 4,168 | 4,012 |
Share-based compensation | 7,635 | 9,500 |
Interest on unrecognized tax benefits | 230 | 363 |
Accrued liabilities and other | 3,629 | 3,077 |
Operating and capital loss carryforwards | 9,185 | 9,169 |
Valuation allowances | -7,665 | -7,265 |
Total non-current deferred tax assets | 13,014 | 14,844 |
Total deferred tax assets | 17,182 | 18,856 |
Deferred Tax Liabilities [Abstract] | ' | ' |
Prepaid expenses | 1,071 | 925 |
Property and equipment, principally due to differences in depreciation | 4,137 | 3,997 |
Goodwill, principally due to differences in amortization | 184,897 | 148,494 |
Total deferred tax liabilities | 190,105 | 153,416 |
Total deferred tax liabilities | $172,923 | $134,560 |
Income_Taxes_Deferred_Tax_Liab
Income Taxes (Deferred Tax Liability Schedule) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 |
In Thousands, unless otherwise specified | ||
Deferred Tax Assets (Liabilities), Net [Abstract] | ' | ' |
Current deferred income tax assets | $3,097 | $3,088 |
Deferred income taxes | 176,020 | 137,648 |
Total deferred tax liabilities | $172,923 | $134,560 |
Related_Party_Transactions_Rel
Related Party Transactions (Related Party Payments) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
In Thousands, unless otherwise specified | |||
Related Party Transactions | ' | ' | ' |
Operating leases | $29,240 | $29,079 | $29,137 |
Salaries and benefits | 72,892 | 65,908 | 64,830 |
Billing fees | 11,591 | 11,126 | 11,240 |
Medical advisory services | $2,993 | $2,671 | $2,575 |
Employee_Benefit_Programs_Deta
Employee Benefit Programs (Details) (USD $) | 12 Months Ended | ||
Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | |
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items] | ' | ' | ' |
SERP contribution | $2,338,000 | $1,693,000 | $915,000 |
Defined Contribution Pension and Other Postretirement Plans Disclosure [Abstract] | ' | ' | ' |
Employer contributions | $1,095,000 | $1,031,000 | $594,000 |
Board of Director's [Member] | ' | ' | ' |
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items] | ' | ' | ' |
SERP contribution percentage | 100.00% | ' | ' |
Officer's [Member] | ' | ' | ' |
Deferred Compensation Arrangement with Individual, Postretirement Benefits [Line Items] | ' | ' | ' |
SERP contribution percentage | 50.00% | ' | ' |
SERP Vesting Period | '5 | ' | ' |
Commitments_and_Contingencies_
Commitments and Contingencies (Details) (USD $) | 12 Months Ended |
Dec. 31, 2013 | |
Y | |
Business Combination, Contingent Consideration Arrangements [Abstract] | ' |
Contractual Obligation Term | 15 |
Contractual Obligation Lease Square Footage | 110,000 |
Contractual Obligation Annual Rental Payment | $2,300,000 |
Contractual Obligation Annual Rental Payment Increase | 1.90% |
Contractual Obligation Maximum Tenant Allowance | $4,400,000 |
Supplemental_Cash_Flow_Informa2
Supplemental Cash Flow Information (Summary Of Supplemental Cash Flow Information) (Details) (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Cash Paid During The Period For | ' | ' | ' |
Interest | $28,378 | $14,786 | $13,815 |
Income taxes, net of refunds | 7,756 | 19,615 | 10,232 |
Noncash Investing and Financing Activities | ' | ' | ' |
Increase (decrease) in accounts payable associated with acquisition of property and equipment | 884 | 248 | 659 |
Capital lease obligations | $738 | $1,096 | $466 |
Guarantor_Balance_Sheets_Detai
Guarantor (Balance Sheets) (Details) (USD $) | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 | Dec. 31, 2010 |
Assets | ' | ' | ' | ' |
Cash and cash equivalents | $50,840,000 | $46,398,000 | $40,718,000 | $34,147,000 |
Accounts receivable, net | 105,072,000 | 96,752,000 | ' | ' |
Supplies inventory | 18,414,000 | 18,406,000 | ' | ' |
Deferred income taxes | 3,097,000 | 3,088,000 | ' | ' |
Prepaid and other current assets | 33,602,000 | 27,537,000 | ' | ' |
Total current assets | 211,025,000 | 192,181,000 | ' | ' |
Property and equipment, net | 169,895,000 | 166,612,000 | ' | ' |
Investments in unconsolidated affiliates and long-term notes receivable | 16,392,000 | 11,274,000 | ' | ' |
Total assets | 2,177,944,000 | 2,044,586,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Current portion of long-term debt | 20,844,000 | 17,407,000 | ' | ' |
Accounts payable | 27,501,000 | 23,509,000 | ' | ' |
Total current liabilities | 89,870,000 | 84,413,000 | ' | ' |
Long-term debt | 583,298,000 | 620,705,000 | ' | ' |
Deferred income taxes | 176,020,000 | 137,648,000 | ' | ' |
Other long-term liabilities | 25,503,000 | 25,972,000 | ' | ' |
Noncontrolling interests - redeemable | 177,697,000 | 175,382,000 | ' | ' |
Equity: | ' | ' | ' | ' |
Total AmSurg Corp. equity | 764,197,000 | 689,488,000 | ' | ' |
Noncontrolling interests - non-redeemable | 361,359,000 | 310,978,000 | ' | ' |
Total equity | 1,125,556,000 | 1,000,466,000 | ' | ' |
Total liabilities and equity | 2,177,944,000 | 2,044,586,000 | ' | ' |
Consolidation, Eliminations [Member] | ' | ' | ' | ' |
Assets | ' | ' | ' | ' |
Cash and cash equivalents | 0 | 0 | 0 | 0 |
Accounts receivable, net | 0 | 0 | ' | ' |
Supplies inventory | 0 | 0 | ' | ' |
Deferred income taxes | 0 | 0 | ' | ' |
Prepaid and other current assets | -4,362,000 | -4,965,000 | ' | ' |
Total current assets | -4,362,000 | -4,965,000 | ' | ' |
Property and equipment, net | 0 | 0 | ' | ' |
Investments in unconsolidated affiliates and long-term notes receivable | -2,922,178,000 | -2,783,383,000 | ' | ' |
Goodwill and other intangible assets, net | 1,758,970,000 | 1,652,002,000 | ' | ' |
Total assets | -1,167,570,000 | -1,136,346,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Current portion of long-term debt | 0 | 0 | ' | ' |
Accounts payable | -3,958,000 | -3,905,000 | ' | ' |
Other accrued liabilities | -404,000 | -1,060,000 | ' | ' |
Total current liabilities | -4,362,000 | -4,965,000 | ' | ' |
Long-term debt | -31,377,000 | -31,465,000 | ' | ' |
Deferred income taxes | 0 | 0 | ' | ' |
Other long-term liabilities | 0 | 0 | ' | ' |
Noncontrolling interests - redeemable | 113,993,000 | 113,443,000 | ' | ' |
Equity: | ' | ' | ' | ' |
Total AmSurg Corp. equity | -1,568,267,000 | -1,490,008,000 | ' | ' |
Noncontrolling interests - non-redeemable | 322,443,000 | 276,649,000 | ' | ' |
Total equity | -1,245,824,000 | -1,213,359,000 | ' | ' |
Total liabilities and equity | -1,167,570,000 | -1,136,346,000 | ' | ' |
Parent Company [Member] | ' | ' | ' | ' |
Assets | ' | ' | ' | ' |
Cash and cash equivalents | 6,710,000 | 7,259,000 | 8,530,000 | 4,683,000 |
Accounts receivable, net | 0 | 0 | ' | ' |
Supplies inventory | 33,000 | 0 | ' | ' |
Deferred income taxes | 3,097,000 | 3,088,000 | ' | ' |
Prepaid and other current assets | 23,993,000 | 19,342,000 | ' | ' |
Total current assets | 33,833,000 | 29,689,000 | ' | ' |
Property and equipment, net | 9,829,000 | 9,199,000 | ' | ' |
Investments in unconsolidated affiliates and long-term notes receivable | 1,484,974,000 | 1,413,061,000 | ' | ' |
Goodwill and other intangible assets, net | 20,684,000 | 21,311,000 | ' | ' |
Total assets | 1,549,320,000 | 1,473,260,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Current portion of long-term debt | 10,714,000 | 5,357,000 | ' | ' |
Accounts payable | 1,972,000 | 1,379,000 | ' | ' |
Other accrued liabilities | 27,419,000 | 29,380,000 | ' | ' |
Total current liabilities | 40,105,000 | 36,116,000 | ' | ' |
Long-term debt | 561,429,000 | 599,423,000 | ' | ' |
Deferred income taxes | 176,020,000 | 137,648,000 | ' | ' |
Other long-term liabilities | 7,569,000 | 10,585,000 | ' | ' |
Noncontrolling interests - redeemable | 0 | 0 | ' | ' |
Equity: | ' | ' | ' | ' |
Total AmSurg Corp. equity | 764,197,000 | 689,488,000 | ' | ' |
Noncontrolling interests - non-redeemable | 0 | 0 | ' | ' |
Total equity | 764,197,000 | 689,488,000 | ' | ' |
Total liabilities and equity | 1,549,320,000 | 1,473,260,000 | ' | ' |
Guarantor Subsidiaries [Member] | ' | ' | ' | ' |
Assets | ' | ' | ' | ' |
Cash and cash equivalents | 0 | 0 | 0 | 0 |
Accounts receivable, net | 0 | 0 | ' | ' |
Supplies inventory | 0 | 0 | ' | ' |
Deferred income taxes | 0 | 0 | ' | ' |
Prepaid and other current assets | 0 | 0 | ' | ' |
Total current assets | 0 | 0 | ' | ' |
Property and equipment, net | 0 | 0 | ' | ' |
Investments in unconsolidated affiliates and long-term notes receivable | 1,453,596,000 | 1,381,596,000 | ' | ' |
Goodwill and other intangible assets, net | 0 | 0 | ' | ' |
Total assets | 1,453,596,000 | 1,381,596,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Current portion of long-term debt | 0 | 0 | ' | ' |
Accounts payable | 0 | 0 | ' | ' |
Other accrued liabilities | 0 | 0 | ' | ' |
Total current liabilities | 0 | 0 | ' | ' |
Long-term debt | 0 | 0 | ' | ' |
Deferred income taxes | 0 | 0 | ' | ' |
Other long-term liabilities | 0 | 0 | ' | ' |
Noncontrolling interests - redeemable | 0 | 0 | ' | ' |
Equity: | ' | ' | ' | ' |
Total AmSurg Corp. equity | 1,453,596,000 | 1,381,596,000 | ' | ' |
Noncontrolling interests - non-redeemable | 0 | 0 | ' | ' |
Total equity | 1,453,596,000 | 1,381,596,000 | ' | ' |
Total liabilities and equity | 1,453,596,000 | 1,381,596,000 | ' | ' |
Non-Guarantor Subsidiaries [Member] | ' | ' | ' | ' |
Assets | ' | ' | ' | ' |
Cash and cash equivalents | 44,130,000 | 39,139,000 | 32,188,000 | 29,464,000 |
Accounts receivable, net | 105,072,000 | 96,752,000 | ' | ' |
Supplies inventory | 18,381,000 | 18,406,000 | ' | ' |
Deferred income taxes | 0 | 0 | ' | ' |
Prepaid and other current assets | 13,971,000 | 13,160,000 | ' | ' |
Total current assets | 181,554,000 | 167,457,000 | ' | ' |
Property and equipment, net | 160,066,000 | 157,413,000 | ' | ' |
Investments in unconsolidated affiliates and long-term notes receivable | 0 | 0 | ' | ' |
Goodwill and other intangible assets, net | 978,000 | 1,206,000 | ' | ' |
Total assets | 342,598,000 | 326,076,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Current portion of long-term debt | 10,130,000 | 12,050,000 | ' | ' |
Accounts payable | 29,487,000 | 26,035,000 | ' | ' |
Other accrued liabilities | 14,510,000 | 15,177,000 | ' | ' |
Total current liabilities | 54,127,000 | 53,262,000 | ' | ' |
Long-term debt | 53,246,000 | 52,747,000 | ' | ' |
Deferred income taxes | 0 | 0 | ' | ' |
Other long-term liabilities | 17,934,000 | 15,387,000 | ' | ' |
Noncontrolling interests - redeemable | 63,704,000 | 61,939,000 | ' | ' |
Equity: | ' | ' | ' | ' |
Total AmSurg Corp. equity | 114,671,000 | 108,412,000 | ' | ' |
Noncontrolling interests - non-redeemable | 38,916,000 | 34,329,000 | ' | ' |
Total equity | 153,587,000 | 142,741,000 | ' | ' |
Total liabilities and equity | 342,598,000 | 326,076,000 | ' | ' |
Consolidated Entities [Member] | ' | ' | ' | ' |
Assets | ' | ' | ' | ' |
Goodwill and other intangible assets, net | 1,780,632,000 | 1,674,519,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Accounts payable | 27,501,000 | 23,509,000 | ' | ' |
Other accrued liabilities | $41,525,000 | $43,497,000 | ' | ' |
Guarantor_Income_Statements_De
Guarantor (Income Statements) (Details) (USD $) | 3 Months Ended | 12 Months Ended | |||||||||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Sep. 30, 2013 | Jun. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2012 | Jun. 30, 2012 | Mar. 31, 2012 | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Condensed Financial Statements, Captions [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Revenues | $284,570 | $267,631 | $268,099 | $259,043 | $242,775 | $223,885 | $228,955 | $227,567 | $1,079,343 | $923,182 | $772,075 |
Operating expenses: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Salaries and benefits | ' | ' | ' | ' | ' | ' | ' | ' | 333,190 | 290,063 | 238,738 |
Supply cost | ' | ' | ' | ' | ' | ' | ' | ' | 157,771 | 131,055 | 101,364 |
Other operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | 222,677 | 193,025 | 168,347 |
Depreciation and amortization | ' | ' | ' | ' | ' | ' | ' | ' | 33,028 | 29,850 | 25,645 |
Total operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | 746,666 | 643,993 | 534,094 |
Gain (loss) on deconsolidation | ' | ' | ' | ' | ' | ' | ' | ' | 2,237 | 0 | 0 |
Equity in earnings of unconsolidated affiliates | ' | ' | ' | ' | ' | ' | ' | ' | 3,151 | 1,564 | 613 |
Operating income | ' | ' | ' | ' | ' | ' | ' | ' | 338,065 | 280,753 | 238,594 |
Interest expense | ' | ' | ' | ' | ' | ' | ' | ' | 29,538 | 16,967 | 15,327 |
Earnings from continuing operations before income taxes | 81,644 | 73,989 | 78,398 | 74,496 | 67,854 | 63,211 | 66,611 | 66,110 | 308,527 | 263,786 | 223,267 |
Income tax expense | ' | ' | ' | ' | ' | ' | ' | ' | 49,754 | 42,364 | 34,973 |
Net earnings from continuing operations | 68,368 | 62,562 | 65,640 | 62,203 | 57,384 | 53,148 | 55,541 | 55,349 | 258,773 | 221,422 | 188,294 |
Net earnings (loss) from discontinued operations | 2,800 | -295 | 196 | 70 | 2,010 | 617 | 4 | -410 | 2,771 | 2,221 | 1,820 |
Net earnings (loss) | 71,168 | 62,267 | 65,836 | 62,273 | 59,394 | 53,765 | 55,545 | 54,939 | 261,544 | 223,643 | 190,114 |
Less net earnings attributable to noncontrolling interests: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Net earnings from continuing operations | ' | ' | ' | ' | ' | ' | ' | ' | 186,120 | 159,187 | 138,269 |
Net earnings (loss) from discontinued operations | ' | ' | ' | ' | ' | ' | ' | ' | 2,721 | 1,893 | 1,848 |
Total net earnings attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 188,841 | 161,080 | 140,117 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 19,558 | 16,771 | 18,563 | 17,811 | 16,814 | 15,437 | 15,536 | 14,776 | 72,703 | 62,563 | 49,997 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Earnings from continuing operations, net of income tax | 19,323 | 17,056 | 18,489 | 17,785 | 15,612 | 15,196 | 15,939 | 15,488 | 72,653 | 62,235 | 50,025 |
Discontinued operations, net of income tax | 235 | -285 | 74 | 26 | 1,202 | 241 | -403 | -712 | 50 | 328 | -28 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 19,558 | 16,771 | 18,563 | 17,811 | 16,814 | 15,437 | 15,536 | 14,776 | 72,703 | 62,563 | 49,997 |
Other comprehensive income, net of income tax: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Unrealized gain on interest rate swap, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 515 |
Comprehensive income, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 261,544 | 223,643 | 190,629 |
Less comprehensive income attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 188,841 | 161,080 | 140,117 |
Comprehensive income attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | 72,703 | 62,563 | 50,512 |
Consolidation, Eliminations [Member] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Condensed Financial Statements, Captions [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Revenues | ' | ' | ' | ' | ' | ' | ' | ' | -17,518 | -14,901 | -8,001 |
Operating expenses: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Salaries and benefits | ' | ' | ' | ' | ' | ' | ' | ' | -467 | -450 | -359 |
Supply cost | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Other operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | -17,051 | -14,451 | -7,642 |
Depreciation and amortization | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Total operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | -17,518 | -14,901 | -8,001 |
Gain (loss) on deconsolidation | ' | ' | ' | ' | ' | ' | ' | ' | -2,237 | ' | ' |
Equity in earnings of unconsolidated affiliates | ' | ' | ' | ' | ' | ' | ' | ' | -406,773 | -354,710 | -304,205 |
Operating income | ' | ' | ' | ' | ' | ' | ' | ' | -409,010 | -354,710 | -304,205 |
Interest expense | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Earnings from continuing operations before income taxes | ' | ' | ' | ' | ' | ' | ' | ' | -409,010 | -354,710 | -304,205 |
Income tax expense | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings from continuing operations | ' | ' | ' | ' | ' | ' | ' | ' | -409,010 | -354,710 | -304,205 |
Net earnings (loss) from discontinued operations | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) | ' | ' | ' | ' | ' | ' | ' | ' | -409,010 | -354,710 | -304,205 |
Less net earnings attributable to noncontrolling interests: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Net earnings from continuing operations | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) from discontinued operations | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Total net earnings attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | -409,010 | -354,710 | -304,205 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Earnings from continuing operations, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | -409,010 | -354,710 | -304,205 |
Discontinued operations, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | -409,010 | -354,710 | -304,205 |
Other comprehensive income, net of income tax: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Unrealized gain on interest rate swap, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | 0 |
Comprehensive income, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | -409,010 | -354,710 | -304,205 |
Less comprehensive income attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Comprehensive income attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | -409,010 | -354,710 | -304,205 |
Parent Company [Member] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Condensed Financial Statements, Captions [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Revenues | ' | ' | ' | ' | ' | ' | ' | ' | 24,167 | 19,907 | 11,253 |
Operating expenses: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Salaries and benefits | ' | ' | ' | ' | ' | ' | ' | ' | 61,038 | 54,895 | 42,739 |
Supply cost | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Other operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | 22,660 | 20,499 | 19,468 |
Depreciation and amortization | ' | ' | ' | ' | ' | ' | ' | ' | 3,186 | 2,860 | 2,487 |
Total operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | 86,884 | 78,254 | 64,694 |
Gain (loss) on deconsolidation | ' | ' | ' | ' | ' | ' | ' | ' | 2,237 | ' | ' |
Equity in earnings of unconsolidated affiliates | ' | ' | ' | ' | ' | ' | ' | ' | 204,962 | 178,137 | 152,409 |
Operating income | ' | ' | ' | ' | ' | ' | ' | ' | 144,482 | 119,790 | 98,968 |
Interest expense | ' | ' | ' | ' | ' | ' | ' | ' | 27,282 | 14,803 | 13,195 |
Earnings from continuing operations before income taxes | ' | ' | ' | ' | ' | ' | ' | ' | 117,200 | 104,987 | 85,773 |
Income tax expense | ' | ' | ' | ' | ' | ' | ' | ' | 48,239 | 40,810 | 33,806 |
Net earnings from continuing operations | ' | ' | ' | ' | ' | ' | ' | ' | 68,961 | 64,177 | 51,967 |
Net earnings (loss) from discontinued operations | ' | ' | ' | ' | ' | ' | ' | ' | 3,742 | -1,614 | -1,970 |
Net earnings (loss) | ' | ' | ' | ' | ' | ' | ' | ' | 72,703 | 62,563 | 49,997 |
Less net earnings attributable to noncontrolling interests: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Net earnings from continuing operations | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) from discontinued operations | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Total net earnings attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | 72,703 | 62,563 | 49,997 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Earnings from continuing operations, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 68,961 | 64,177 | 51,967 |
Discontinued operations, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 3,742 | -1,614 | -1,970 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | 72,703 | 62,563 | 49,997 |
Other comprehensive income, net of income tax: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Unrealized gain on interest rate swap, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | 515 |
Comprehensive income, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 72,703 | 62,563 | 50,512 |
Less comprehensive income attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Comprehensive income attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | 72,703 | 62,563 | 50,512 |
Guarantor Subsidiaries [Member] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Condensed Financial Statements, Captions [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Revenues | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Operating expenses: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Salaries and benefits | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Supply cost | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Other operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Depreciation and amortization | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Total operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Gain (loss) on deconsolidation | ' | ' | ' | ' | ' | ' | ' | ' | 2,237 | ' | ' |
Equity in earnings of unconsolidated affiliates | ' | ' | ' | ' | ' | ' | ' | ' | 204,962 | 178,137 | 152,409 |
Operating income | ' | ' | ' | ' | ' | ' | ' | ' | 207,199 | 178,137 | 152,409 |
Interest expense | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Earnings from continuing operations before income taxes | ' | ' | ' | ' | ' | ' | ' | ' | 207,199 | 178,137 | 152,409 |
Income tax expense | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings from continuing operations | ' | ' | ' | ' | ' | ' | ' | ' | 207,199 | 178,137 | 152,409 |
Net earnings (loss) from discontinued operations | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) | ' | ' | ' | ' | ' | ' | ' | ' | 207,199 | 178,137 | 152,409 |
Less net earnings attributable to noncontrolling interests: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Net earnings from continuing operations | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) from discontinued operations | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Total net earnings attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | 207,199 | 178,137 | 152,409 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Earnings from continuing operations, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 207,199 | 178,137 | 152,409 |
Discontinued operations, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | 207,199 | 178,137 | 152,409 |
Other comprehensive income, net of income tax: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Unrealized gain on interest rate swap, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | 0 |
Comprehensive income, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 207,199 | 178,137 | 152,409 |
Less comprehensive income attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Comprehensive income attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | 207,199 | 178,137 | 152,409 |
Non-Guarantor Subsidiaries [Member] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Condensed Financial Statements, Captions [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Revenues | ' | ' | ' | ' | ' | ' | ' | ' | 1,072,694 | 918,176 | 768,823 |
Operating expenses: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Salaries and benefits | ' | ' | ' | ' | ' | ' | ' | ' | 272,619 | 235,618 | 196,358 |
Supply cost | ' | ' | ' | ' | ' | ' | ' | ' | 157,771 | 131,055 | 101,364 |
Other operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | 217,068 | 186,977 | 156,521 |
Depreciation and amortization | ' | ' | ' | ' | ' | ' | ' | ' | 29,842 | 26,990 | 23,158 |
Total operating expenses | ' | ' | ' | ' | ' | ' | ' | ' | 677,300 | 580,640 | 477,401 |
Gain (loss) on deconsolidation | ' | ' | ' | ' | ' | ' | ' | ' | 0 | ' | ' |
Equity in earnings of unconsolidated affiliates | ' | ' | ' | ' | ' | ' | ' | ' | 0 | 0 | 0 |
Operating income | ' | ' | ' | ' | ' | ' | ' | ' | 395,394 | 337,536 | 291,422 |
Interest expense | ' | ' | ' | ' | ' | ' | ' | ' | 2,256 | 2,164 | 2,132 |
Earnings from continuing operations before income taxes | ' | ' | ' | ' | ' | ' | ' | ' | 393,138 | 335,372 | 289,290 |
Income tax expense | ' | ' | ' | ' | ' | ' | ' | ' | 1,515 | 1,554 | 1,167 |
Net earnings from continuing operations | ' | ' | ' | ' | ' | ' | ' | ' | 391,623 | 333,818 | 288,123 |
Net earnings (loss) from discontinued operations | ' | ' | ' | ' | ' | ' | ' | ' | -971 | 3,835 | 3,790 |
Net earnings (loss) | ' | ' | ' | ' | ' | ' | ' | ' | 390,652 | 337,653 | 291,913 |
Less net earnings attributable to noncontrolling interests: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Net earnings from continuing operations | ' | ' | ' | ' | ' | ' | ' | ' | 186,120 | 159,187 | 138,269 |
Net earnings (loss) from discontinued operations | ' | ' | ' | ' | ' | ' | ' | ' | 2,721 | 1,893 | 1,848 |
Total net earnings attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 188,841 | 161,080 | 140,117 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | 201,811 | 176,573 | 151,796 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Earnings from continuing operations, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 205,503 | 174,631 | 149,854 |
Discontinued operations, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | -3,692 | 1,942 | 1,942 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | 201,811 | 176,573 | 151,796 |
Other comprehensive income, net of income tax: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Unrealized gain on interest rate swap, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | 0 |
Comprehensive income, net of income tax | ' | ' | ' | ' | ' | ' | ' | ' | 390,652 | 337,653 | 291,913 |
Less comprehensive income attributable to noncontrolling interests | ' | ' | ' | ' | ' | ' | ' | ' | 188,841 | 161,080 | 140,117 |
Comprehensive income attributable to AmSurg Corp. common shareholders | ' | ' | ' | ' | ' | ' | ' | ' | $201,811 | $176,573 | $151,796 |
Guarantor_Cash_Flow_Statements
Guarantor (Cash Flow Statements) (Details) (USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Cash flows from operating activities: | ' | ' | ' |
Net cash flows provided by operating activities | $332,824 | $295,652 | $243,423 |
Cash flows from investing activities: | ' | ' | ' |
Acquisition of interests in surgery centers and related transactions | -73,594 | -277,388 | -239,223 |
Acquisition of property and equipment | -28,856 | -28,864 | -22,170 |
Proceeds from sale of interests in surgery centers | 3,553 | 7,309 | 7,026 |
Other | 159 | 0 | 0 |
Net cash flows used in investing activities | -98,738 | -298,943 | -254,367 |
Cash flows from financing activities: | ' | ' | ' |
Proceeds from long-term borrowings | 162,204 | 565,566 | 288,869 |
Repayment on long-term borrowings | -202,083 | -394,164 | -129,107 |
Distributions to noncontrolling interests | -184,149 | -162,941 | -138,724 |
Net cash flows provided by (used in) financing activities | -229,644 | 8,971 | 17,515 |
Net increase (decrease) in cash and cash equivalents | 4,442 | 5,680 | 6,571 |
Cash and cash equivalents, beginning of year | 46,398 | 40,718 | 34,147 |
Cash and cash equivalents, end of year | 50,840 | 46,398 | 40,718 |
Consolidation, Eliminations [Member] | ' | ' | ' |
Cash flows from operating activities: | ' | ' | ' |
Net cash flows provided by operating activities | -347,648 | -182,851 | -151,558 |
Cash flows from investing activities: | ' | ' | ' |
Acquisition of interests in surgery centers and related transactions | 694 | 92,830 | 88,803 |
Acquisition of property and equipment | 0 | 0 | 0 |
Proceeds from sale of interests in surgery centers | 0 | 0 | 0 |
Other | 0 | ' | ' |
Net cash flows used in investing activities | 694 | 92,830 | 88,803 |
Cash flows from financing activities: | ' | ' | ' |
Proceeds from long-term borrowings | 0 | 0 | 0 |
Repayment on long-term borrowings | 0 | 0 | 0 |
Distributions to noncontrolling interests | 347,648 | 182,851 | 151,558 |
Capital contributions | ' | -90,029 | -84,597 |
Changes in intercompany balances with affiliates, net | 0 | 0 | 0 |
Other financing activities, net | -694 | -2,801 | -4,206 |
Net cash flows provided by (used in) financing activities | 346,954 | 90,021 | 62,755 |
Net increase (decrease) in cash and cash equivalents | 0 | 0 | 0 |
Cash and cash equivalents, beginning of year | 0 | 0 | 0 |
Cash and cash equivalents, end of year | 0 | 0 | 0 |
Parent Company [Member] | ' | ' | ' |
Cash flows from operating activities: | ' | ' | ' |
Net cash flows provided by operating activities | 45,127 | -83,605 | -67,911 |
Cash flows from investing activities: | ' | ' | ' |
Acquisition of interests in surgery centers and related transactions | 0 | -90,029 | -84,597 |
Acquisition of property and equipment | -3,693 | -3,681 | -2,858 |
Proceeds from sale of interests in surgery centers | 0 | 0 | 0 |
Other | 0 | ' | ' |
Net cash flows used in investing activities | -3,693 | -93,710 | -87,455 |
Cash flows from financing activities: | ' | ' | ' |
Proceeds from long-term borrowings | 152,700 | 560,000 | 281,100 |
Repayment on long-term borrowings | -188,081 | -381,220 | -118,100 |
Distributions to noncontrolling interests | 0 | 0 | 0 |
Capital contributions | ' | 0 | 0 |
Changes in intercompany balances with affiliates, net | 88 | -2,666 | -178 |
Other financing activities, net | -6,690 | -70 | -3,609 |
Net cash flows provided by (used in) financing activities | -41,983 | 176,044 | 159,213 |
Net increase (decrease) in cash and cash equivalents | -549 | -1,271 | 3,847 |
Cash and cash equivalents, beginning of year | 7,259 | 8,530 | 4,683 |
Cash and cash equivalents, end of year | 6,710 | 7,259 | 8,530 |
Guarantor Subsidiaries [Member] | ' | ' | ' |
Cash flows from operating activities: | ' | ' | ' |
Net cash flows provided by operating activities | 208,773 | 182,851 | 151,558 |
Cash flows from investing activities: | ' | ' | ' |
Acquisition of interests in surgery centers and related transactions | -74,288 | -280,189 | -243,429 |
Acquisition of property and equipment | 0 | 0 | 0 |
Proceeds from sale of interests in surgery centers | 3,553 | 7,309 | 7,274 |
Other | 159 | ' | ' |
Net cash flows used in investing activities | -70,576 | -272,880 | -236,155 |
Cash flows from financing activities: | ' | ' | ' |
Proceeds from long-term borrowings | 0 | 0 | 0 |
Repayment on long-term borrowings | 0 | 0 | 0 |
Distributions to noncontrolling interests | -138,875 | 0 | 0 |
Capital contributions | ' | 90,029 | 84,597 |
Changes in intercompany balances with affiliates, net | 0 | 0 | 0 |
Other financing activities, net | 678 | 0 | 0 |
Net cash flows provided by (used in) financing activities | -138,197 | 90,029 | 84,597 |
Net increase (decrease) in cash and cash equivalents | 0 | 0 | 0 |
Cash and cash equivalents, beginning of year | 0 | 0 | 0 |
Cash and cash equivalents, end of year | 0 | 0 | 0 |
Non-Guarantor Subsidiaries [Member] | ' | ' | ' |
Cash flows from operating activities: | ' | ' | ' |
Net cash flows provided by operating activities | 426,572 | 379,257 | 311,334 |
Cash flows from investing activities: | ' | ' | ' |
Acquisition of interests in surgery centers and related transactions | 0 | 0 | 0 |
Acquisition of property and equipment | -25,163 | -25,183 | -19,312 |
Proceeds from sale of interests in surgery centers | 0 | 0 | -248 |
Other | 0 | ' | ' |
Net cash flows used in investing activities | -25,163 | -25,183 | -19,560 |
Cash flows from financing activities: | ' | ' | ' |
Proceeds from long-term borrowings | 9,504 | 5,566 | 7,769 |
Repayment on long-term borrowings | -14,002 | -12,944 | -11,007 |
Distributions to noncontrolling interests | -392,922 | -345,792 | -290,282 |
Capital contributions | ' | 0 | 0 |
Changes in intercompany balances with affiliates, net | -88 | 2,666 | 178 |
Other financing activities, net | 1,090 | 3,381 | 4,292 |
Net cash flows provided by (used in) financing activities | -396,418 | -347,123 | -289,050 |
Net increase (decrease) in cash and cash equivalents | 4,991 | 6,951 | 2,724 |
Cash and cash equivalents, beginning of year | 39,139 | 32,188 | 29,464 |
Cash and cash equivalents, end of year | 44,130 | 39,139 | 32,188 |
Consolidated Entities [Member] | ' | ' | ' |
Cash flows from financing activities: | ' | ' | ' |
Other financing activities, net | ($5,616) | $510 | ($3,523) |
Subsequent_Events_Details
Subsequent Events (Details) (USD $) | 12 Months Ended |
Dec. 31, 2013 | |
Centers | |
Aggregate purchase price of surgery centers | $5,100,000 |
Number of business units | 1 |
Quarterly_Financial_Data_Unaud2
Quarterly Financial Data Unaudited (Details) (USD $) | 3 Months Ended | 12 Months Ended | |||||||||
In Thousands, except Per Share data, unless otherwise specified | Dec. 31, 2013 | Sep. 30, 2013 | Jun. 30, 2013 | Mar. 31, 2013 | Dec. 31, 2012 | Sep. 30, 2012 | Jun. 30, 2012 | Mar. 31, 2012 | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Quarterly Financial Data Abstract | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Revenues | $284,570 | $267,631 | $268,099 | $259,043 | $242,775 | $223,885 | $228,955 | $227,567 | $1,079,343 | $923,182 | $772,075 |
Earnings from continuing operations before income taxes | 81,644 | 73,989 | 78,398 | 74,496 | 67,854 | 63,211 | 66,611 | 66,110 | 308,527 | 263,786 | 223,267 |
Net earnings from continuing operations | 68,368 | 62,562 | 65,640 | 62,203 | 57,384 | 53,148 | 55,541 | 55,349 | 258,773 | 221,422 | 188,294 |
Net earnings (loss) from discontinued operations | 2,800 | -295 | 196 | 70 | 2,010 | 617 | 4 | -410 | 2,771 | 2,221 | 1,820 |
Net earnings | 71,168 | 62,267 | 65,836 | 62,273 | 59,394 | 53,765 | 55,545 | 54,939 | 261,544 | 223,643 | 190,114 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Earnings from continuing operations, net of income tax | 19,323 | 17,056 | 18,489 | 17,785 | 15,612 | 15,196 | 15,939 | 15,488 | 72,653 | 62,235 | 50,025 |
Discontinued operations, net of income tax | 235 | -285 | 74 | 26 | 1,202 | 241 | -403 | -712 | 50 | 328 | -28 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | $19,558 | $16,771 | $18,563 | $17,811 | $16,814 | $15,437 | $15,536 | $14,776 | $72,703 | $62,563 | $49,997 |
Net earnings from continuing operations attributable to AmSurg Corp. common shareholders | $0.60 | $0.53 | $0.58 | $0.56 | $0.49 | $0.48 | $0.50 | $0.49 | $2.27 | $1.97 | $1.60 |
Net earnings attributable to AmSurg Corp. common shareholders | $0.61 | $0.52 | $0.58 | $0.56 | $0.53 | $0.49 | $0.49 | $0.47 | $2.28 | $1.98 | $1.60 |
Schedule_II_Valuation_and_Qual2
Schedule II Valuation and Qualifying Accounts (Details) (Allowance for Doubtful Accounts [Member], USD $) | 12 Months Ended | ||
In Thousands, unless otherwise specified | Dec. 31, 2013 | Dec. 31, 2012 | Dec. 31, 2011 |
Allowance for Doubtful Accounts [Member] | ' | ' | ' |
Valuation and Qualifying Accounts Disclosure [Line Items] | ' | ' | ' |
Valuation Allowances and Reserves, Balance, Beginning Balance | $22,379 | $18,844 | $13,070 |
Charged to Cost and Expenses | 21,983 | 20,340 | 18,501 |
Charged to Other Accounts | 6,410 | 4,561 | 3,967 |
Charge-off Against Allowances | -22,910 | -21,366 | -16,694 |
Valuation Allowances and Reserves, Balance, Ending Balance | $27,862 | $22,379 | $18,844 |