Document_And_Entity_Informatio
Document And Entity Information | 3 Months Ended | |
Mar. 31, 2014 | Apr. 30, 2014 | |
Document And Entity Information [Abstract] | ' | ' |
Document Type | '10-Q | ' |
Amendment Flag | 'false | ' |
Document Period End Date | 31-Mar-14 | ' |
Document Fiscal Year Focus | '2014 | ' |
Document Fiscal Period Focus | 'Q1 | ' |
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 | ' | 32,531,056 |
Consolidated_Balance_Sheets
Consolidated Balance Sheets (USD $) | Mar. 31, 2014 | Dec. 31, 2013 |
Assets | ' | ' |
Cash and cash equivalents | $47,116,000 | $50,840,000 |
Accounts receivable, net | 106,209,000 | 105,072,000 |
Supplies inventory | 18,433,000 | 18,414,000 |
Deferred income taxes | 1,026,000 | 3,097,000 |
Prepaid and other current assets | 37,151,000 | 33,602,000 |
Total current assets | 209,935,000 | 211,025,000 |
Property and equipment, net | 169,006,000 | 169,895,000 |
Investments in unconsolidated affiliates and other | 19,484,000 | 16,392,000 |
Goodwill | 1,764,623,000 | 1,758,970,000 |
Intangible assets, net | 21,093,000 | 21,662,000 |
Total assets | 2,184,141,000 | 2,177,944,000 |
Liabilities and Equity | ' | ' |
Current portion of long-term debt | 20,285,000 | 20,844,000 |
Accounts payable | 25,359,000 | 27,501,000 |
Accrued salaries and benefits | 26,218,000 | 32,294,000 |
Other accrued liabilities | 12,387,000 | 9,231,000 |
Total current liabilities | 84,249,000 | 89,870,000 |
Long-term debt | 564,937,000 | 583,298,000 |
Deferred income taxes | 185,882,000 | 176,020,000 |
Other long-term liabilities | 25,753,000 | 25,503,000 |
Commitments and contingencies | ' | ' |
Noncontrolling interests - redeemable | 177,683,000 | 177,697,000 |
Preferred stock, no par value, 5,000,000 shares authorized, no shares issued or outstanding | 0 | 0 |
Equity: | ' | ' |
Common stock, no par value, 70,000,000 shares authorized | 186,894,000 | 185,873,000 |
Retained earnings | 595,519,000 | 578,324,000 |
Total AmSurg Corp. equity | 782,413,000 | 764,197,000 |
Noncontrolling interests - non-redeemable | 363,224,000 | 361,359,000 |
Total equity | 1,145,637,000 | 1,125,556,000 |
Total liabilities and equity | $2,184,141,000 | $2,177,944,000 |
Consolidated_Balance_Sheets_Pa
Consolidated Balance Sheets (Parenthetical) (USD $) | Mar. 31, 2014 | Dec. 31, 2013 |
In Thousands, except Share data, unless otherwise specified | ||
Consolidated Balance Sheets | ' | ' |
Net of allowance on accounts receivable | $29,120 | $27,862 |
Preferred stock, par value | ' | ' |
Preferred stock, shares authorized | 5,000,000 | 5,000,000 |
Preferred stock, shares issued | 0 | 0 |
Preferred stock, shares outstanding | 0 | 0 |
Common stock, par value | ' | ' |
Common stock, shares authorized | 70,000,000 | 70,000,000 |
Common stock, shares outstanding | 32,505,000 | 32,353,000 |
Consolidated_Statements_Of_Ear
Consolidated Statements Of Earnings (USD $) | 3 Months Ended | |
In Thousands, except Per Share data, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Consolidated Statements Of Earnings | ' | ' |
Revenues | $263,107 | $258,189 |
Operating expenses: | ' | ' |
Salaries and benefits | 83,194 | 80,958 |
Supply cost | 38,720 | 37,213 |
Other operating expenses | 55,269 | 52,727 |
Depreciation and amortization | 8,374 | 8,008 |
Total operating expenses | 185,557 | 178,906 |
Gain (loss) on deconsolidation | 2,045 | 2,237 |
Equity in earnings of unconsolidated affiliates | 764 | 402 |
Operating income | 80,359 | 81,922 |
Interest expense | 6,963 | 7,542 |
Earnings from continuing operations before income taxes | 73,396 | 74,380 |
Income tax expense | 13,057 | 12,269 |
Net earnings from continuing operations | 60,339 | 62,111 |
Discontinued operations: | ' | ' |
Earnings (loss) from operations of discontinued interests in surgery centers, net of income tax | 137 | 162 |
Gain (loss) on disposal of discontinued interests in surgery centers, net of income tax | -362 | 0 |
Net earnings (loss) from discontinued operations | -225 | 162 |
Net earnings and comprehensive income | 60,114 | 62,273 |
Less net earnings and comprehensive income attributable to noncontrolling interests: | ' | ' |
Net earnings from continuing operations | 42,835 | 44,361 |
Net earnings (loss) from discontinued operations | 84 | 101 |
Total net earnings and comprehensive income attributable to noncontrolling interests | 42,919 | 44,462 |
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | 17,195 | 17,811 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' |
Earnings from continuing operations, net of income tax | 17,504 | 17,750 |
Discontinued operations, net of income tax, attributable to AmSurg Corp. | -309 | 61 |
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $17,195 | $17,811 |
Earnings per share-basic: | ' | ' |
Net earnings from continuing operations attributable to AmSurg Corp. common shareholders | $0.55 | $0.57 |
Net earnings (loss) from discontinued operations attributable to AmSurg Corp. common shareholders | ($0.01) | $0 |
Net earnings attributable to AmSurg Corp. common shareholders | $0.54 | $0.57 |
Earnings per share-diluted: | ' | ' |
Net earnings from continuing operations attributable to AmSurg Corp. common shareholders | $0.55 | $0.56 |
Net earnings (loss) from discontinued operations attributable to AmSurg Corp. common shareholders | ($0.01) | $0 |
Net earnings attributable to AmSurg Corp. common shareholders | $0.54 | $0.56 |
Weighted average number of shares and share equivalents outstanding: | ' | ' |
Basic | 31,716 | 31,217 |
Diluted | 32,120 | 31,881 |
Consolidated_Statements_Of_Cha
Consolidated Statements Of Changes In Equity (USD $) | Total | Common Stock Including Additional Paid in Capital [Member] | Retained Earnings [Member] | Non-Controlling Interests - Non-Redeemable [Member] | Total Equity (Permanent) [Member] | Non-controlling Interests - Redeemable [Member] |
Balance at Dec. 31, 2012 | ' | $183,867,000 | $505,621,000 | $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) | ' | 263,000 | ' | ' | ' | ' |
Cancellation of restricted common stock (in shares) | ' | -14,000 | ' | ' | ' | ' |
Stock options exercised | ' | 5,691,000 | ' | ' | 5,691,000 | ' |
Stock options exercised (in shares) | ' | 237,000 | ' | ' | ' | ' |
Stock repurchased | ' | -16,758,000 | ' | ' | -16,758,000 | ' |
Stock repurchased (in shares) | ' | -528,000 | ' | ' | ' | ' |
Share-based compensation, value | 2,050,000 | 2,050,000 | ' | ' | 2,050,000 | ' |
Tax benefit related to exercise of stock options | ' | 1,630,000 | ' | ' | 1,630,000 | ' |
Net earnings and comprehensive income | 62,273,000 | ' | 17,811,000 | 12,232,000 | 30,043,000 | 32,230,000 |
Distributions to noncontrolling interests, net of capital contributions | ' | ' | ' | -11,891,000 | -11,891,000 | -31,823,000 |
Purchase of noncontrolling interest, value | ' | -304,000 | ' | -133,000 | -437,000 | -316,000 |
Sale of noncontrolling interest, value | ' | -644,000 | ' | 1,419,000 | 775,000 | 236,000 |
Acquisitions and other transactions impacting noncontrolling interests | ' | ' | ' | 266,000 | 266,000 | 0 |
Disposals and other transactions impacting noncontrolling interests | ' | 0 | ' | -317,000 | -317,000 | ' |
Balance at Mar. 31, 2013 | ' | 175,532,000 | 523,432,000 | 312,554,000 | 1,011,518,000 | 175,709,000 |
Balance (in shares) at Mar. 31, 2013 | ' | 31,899,000 | ' | ' | ' | ' |
Balance at Dec. 31, 2013 | 1,125,556,000 | 185,873,000 | 578,324,000 | 361,359,000 | 1,125,556,000 | 177,697,000 |
Balance (in shares) at Dec. 31, 2013 | ' | 32,353,000 | ' | ' | ' | ' |
Issuance of restricted common stock (in shares) | ' | 200,000 | ' | ' | ' | ' |
Stock options exercised | ' | 488,000 | ' | ' | 488,000 | ' |
Stock options exercised (in shares) | 19,921 | 20,000 | ' | ' | ' | ' |
Stock repurchased | ' | -2,857,000 | ' | ' | -2,857,000 | ' |
Stock repurchased (in shares) | ' | -68,000 | ' | ' | ' | ' |
Share-based compensation, value | 2,458,000 | 2,458,000 | ' | ' | 2,458,000 | ' |
Tax benefit related to exercise of stock options | ' | 1,727,000 | ' | ' | 1,727,000 | ' |
Net earnings and comprehensive income | 60,114,000 | ' | 17,195,000 | 12,219,000 | 29,414,000 | 30,700,000 |
Distributions to noncontrolling interests, net of capital contributions | ' | ' | ' | -12,753,000 | -12,753,000 | -30,441,000 |
Purchase of noncontrolling interest, value | ' | 286,000 | ' | -286,000 | 0 | 0 |
Sale of noncontrolling interest, value | ' | -1,081,000 | ' | 1,665,000 | 584,000 | 0 |
Acquisitions and other transactions impacting noncontrolling interests | ' | ' | ' | 3,976,000 | 3,976,000 | ' |
Disposals and other transactions impacting noncontrolling interests | ' | ' | ' | -2,956,000 | -2,956,000 | -273,000 |
Balance at Mar. 31, 2014 | $1,145,637,000 | $186,894,000 | $595,519,000 | $363,224,000 | $1,145,637,000 | $177,683,000 |
Balance (in shares) at Mar. 31, 2014 | ' | 32,505,000 | ' | ' | ' | ' |
Consolidated_Statements_Of_Cas
Consolidated Statements Of Cash Flows (USD $) | 3 Months Ended | |
In Thousands, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Cash flows from operating activities: | ' | ' |
Net earnings (loss) | $60,114 | $62,273 |
Adjustments to reconcile net earnings to net cash flows provided by operating activities: | ' | ' |
Depreciation and amortization | 8,374 | 8,008 |
Net (gain) loss on sale of long-lived assets | 604 | 0 |
(Gain) loss on deconsolidation | -2,045 | -2,237 |
Share-based compensation | 2,458 | 2,050 |
Excess tax benefit from share-based compensation | -1,727 | -288 |
Deferred income taxes | 11,933 | 12,929 |
Equity in earnings of unconsolidated affiliates, net | -764 | -402 |
Increase (decrease) in cash and cash equivalents, net of effects of acquisitions and dispositions, due to changes in: | ' | ' |
Accounts receivable, net | -1,651 | -1,705 |
Supplies inventory | -245 | -201 |
Prepaid and other current assets | -3,638 | 17 |
Accounts payable | -3,578 | -3,040 |
Accrued expenses and other liabilities | -606 | -4,101 |
Other, net | 590 | 562 |
Net cash flows provided by operating activities | 69,819 | 73,865 |
Cash flows from investing activities: | ' | ' |
Acquisition of interests in surgery centers and related transactions | -5,038 | -252 |
Acquisition of property and equipment | -7,038 | -6,110 |
Proceeds from sale of interests in surgery centers | 1,111 | 0 |
Other | -418 | 0 |
Net cash flows used in investing activities | -11,383 | -6,362 |
Cash flows from financing activities: | ' | ' |
Proceeds from long-term borrowings | 31,945 | 30,870 |
Repayment on long-term borrowings | -50,853 | -48,211 |
Distributions to noncontrolling interests | -43,194 | -43,914 |
Proceeds from issuance of common stock upon exercise of stock options | 488 | 5,691 |
Repurchase of common stock | -2,857 | -16,758 |
Capital contributions and ownership transactions by noncontrolling interests | 584 | 559 |
Excess tax benefit from share-based compensation | 1,727 | 288 |
Financing cost incurred | 0 | -13 |
Net cash flows provided by (used in) financing activities | -62,160 | -71,488 |
Net increase (decrease) in cash and cash equivalents | -3,724 | -3,985 |
Cash and cash equivalents, beginning of period | 50,840 | 46,398 |
Cash and cash equivalents, end of period | $47,116 | $42,413 |
Basis_of_Presentation
Basis of Presentation | 3 Months Ended |
Mar. 31, 2014 | |
Accounting Policies [Abstract] | ' |
Basis of Presentation | ' |
AmSurg Corp. | |
Notes to the Unaudited Consolidated Financial Statements | |
(1) Basis of Presentation | |
AmSurg Corp. (the “Company”), through its wholly owned subsidiaries, owns interests, primarily 51%, in limited partnerships (“LPs”) and limited liability companies (“LLCs”) which own and operate ambulatory surgery centers (“centers”). The Company does not have an ownership interest in a LP or LLC greater than 51% which it does not consolidate. The Company has ownership interests of less than 51% in seven LPs and LLCs, three of which it consolidates as the Company has substantive participation rights and four 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 LPs and LLCs. Consolidation of such LPs 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 LPs and LLCs, and have control of the entities. The responsibilities of the Company’s noncontrolling partners (LPs 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 LPs 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, with 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 face of the consolidated statements of earnings and comprehensive 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 statements of cash flows. | |
As further described in note 11, 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 March 31, 2014, 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, LPs or LLCs 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 other 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. | |
These unaudited consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial reporting and in accordance with Rule 10-01 of Regulation S-X. In the opinion of management, the unaudited interim consolidated financial statements contained in this report reflect all adjustments, consisting of only normal recurring accruals, which are necessary for a fair presentation of the financial position and the results of operations for the interim periods presented. The results of operations for any interim period are not necessarily indicative of results for the full year. | |
The accompanying unaudited consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in the Company’s 2013 Annual Report on Form 10-K. 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 5. | |
Use_of_Estimates
Use of Estimates | 3 Months Ended |
Mar. 31, 2014 | |
Accounting Policies [Abstract] | ' |
Use of Estimates | ' |
(2) Use of Estimates | |
The preparation of financial statements in conformity with GAAP 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. | |
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 March 31, 2014 and December 31, 2013 reflect allowances for contractual adjustments of $280,582,000 and $289,937,000, respectively, and allowances for bad debt expense of $29,120,000 and $27,862,000, respectively. For the three months ended March 31, 2014 and 2013, bad debt expense from continuing operations was approximately $5,208,000 and $5,900,000, respectively, and is included in other operating expenses in the accompanying consolidated statements of earnings and comprehensive income. |
Revenue_Recognition
Revenue Recognition | 3 Months Ended |
Mar. 31, 2014 | |
Revenue Recognition | ' |
Revenue Recognition | ' |
(3) 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 the Company’s centers (primarily centers that perform gastrointestinal endoscopy procedures), billing for anesthesia services provided by medical professionals employed or contracted by the Company’s 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 each of the three months ended March 31, 2014 and 2013, the Company derived approximately 25% of its revenues from governmental 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. |
Acquisitions
Acquisitions | 3 Months Ended | ||||||||
Mar. 31, 2014 | |||||||||
Business Combinations [Abstract] | ' | ||||||||
Acquisitions | ' | ||||||||
(4) 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 the three months ended March 31, 2014 the Company, through a wholly owned subsidiary, acquired a controlling interest in one center. The aggregate amount paid for the center acquired during the three months ended March 31, 2014 was approximately $5,038,000, net of cash acquired, 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. During the three months ended March 31, 2013, the Company paid NSC $2,744,000 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 acquisition completed in the three months ended March 31, 2014 and 2013, including post acquisition date adjustments recorded to finalize purchase price allocations, are as follows (in thousands): | |||||||||
Three Months Ended March 31, | |||||||||
2014 | 2013 | ||||||||
Accounts receivable | $ | 417 | $ | - | |||||
Supplies, inventory, prepaid and other current assets | 81 | - | |||||||
Property and equipment | 429 | - | |||||||
Goodwill | 8,260 | - | |||||||
Accounts payable | -125 | - | |||||||
Other accrued liabilities | -39 | - | |||||||
Total fair value | 9,023 | - | |||||||
Less: Fair value attributable to noncontrolling interests | 3,985 | - | |||||||
Acquisition date fair value of total consideration transferred | $ | 5,038 | $ | - | |||||
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. For the three months ended March 31, 2014 approximately $4,670,000 of goodwill recorded was deductible for tax purposes. The acquisition related costs incurred by the Company were not significant for the three months ended March 31, 2014 and 2013, respectively. | |||||||||
Revenues and net earnings included in the three months ended March 31, 2014 and 2013 associated with this acquisition are as follows (in thousands): | |||||||||
Three Months Ended March 31, | |||||||||
2014 | 2013 | ||||||||
Revenues | $ | 1,031 | $ | - | |||||
Net earnings | 245 | - | |||||||
Less: Net earnings attributable to noncontrolling interests | 151 | - | |||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 94 | $ | - | |||||
The unaudited consolidated pro forma results for the three months ended March 31, 2014 and 2013, assuming all 2014 acquisitions had been consummated on January 1, 2013 and all 2013 acquisitions had been consummated on January 1, 2012, are as follows (in thousands, except per share data): | |||||||||
Three Months Ended March 31, | |||||||||
2014 | 2013 | ||||||||
Revenues | $ | 263,107 | $ | 270,371 | |||||
Net earnings | 60,114 | 65,385 | |||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||
Net earnings from continuing operations | 17,504 | 18,830 | |||||||
Net earnings | 17,195 | 18,891 | |||||||
Net earnings from continuing operations per common share: | |||||||||
Basic | $ | 0.55 | $ | 0.6 | |||||
Diluted | $ | 0.54 | $ | 0.59 | |||||
Net earnings: | |||||||||
Basic | $ | 0.54 | $ | 0.61 | |||||
Diluted | $ | 0.54 | $ | 0.59 | |||||
Weighted average number of shares and share equivalents: | |||||||||
Basic | 31,716 | 31,217 | |||||||
Diluted | 32,120 | 31,881 | |||||||
During the three months ended March 31, 2014, the Company entered into a transaction whereby it contributed a controlling interest in one center in exchange for $600,000 and a noncontrolling interest in an entity jointly owned by a hospital that, after the completion of the transaction, controls the contributed center. During the three months ended March 31, 2013, the Company entered into a transaction whereby it contributed cash of $252,000 plus a controlling interest in one center in exchange for a noncontrolling interest in an entity jointly owned by a hospital that, after the completion of the transaction, controlled the contributed center and one additional center. Management of the Company believes these structures provide both economies of scale and potential future growth opportunities in the markets in which the centers are located. As a result of these transactions, the Company recorded in the accompanying consolidated balance sheets as a component of investments in unconsolidated affiliates and other, the fair value of the noncontrolling interest in the entities which control the contributed centers of approximately $1,238,000 and $5,200,000 as of the three months ended March 31, 2014 and 2013, respectively. Accordingly, during the three months ended March 31, 2014 and 2013, the Company recognized a gain on deconsolidation in the accompanying consolidated statements of earnings and comprehensive income of approximately $2,045,000 and $2,237,000, respectively. In each of these transactions, the gain on deconsolidation 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 centers immediately prior to each transaction. |
Dispositions
Dispositions | 3 Months Ended | |||||
Mar. 31, 2014 | ||||||
Dispositions | ' | |||||
Dispositions | ' | |||||
(5) Dispositions | ||||||
During the three months ended March 31, 2014 and the year ended December 31, 2013, the Company initiated the disposition of certain of its centers due to management’s assessment of the Company’s strategy in the market and due to the limited growth opportunities at these centers. Results of operations (net of income tax) of the centers discontinued for the three months ended March 31, 2014 and 2013 are as follows (in thousands): | ||||||
Three Months Ended March 31, | ||||||
2014 | 2013 | |||||
Cash proceeds from disposal | $ | 1,147 | $ | - | ||
Net (loss) earnings from discontinued operations | -225 | 162 | ||||
Net (loss) earnings from discontinued operations attributable to AmSurg Corp. | -309 | 61 | ||||
The results of operations of discontinued centers have been classified as discontinued operations in all periods presented. Results of operations of the combined discontinued centers for the three months ended March 31, 2014 and 2013 are as follows (in thousands): | ||||||
Three Months Ended March 31, | ||||||
2014 | 2013 | |||||
Revenues | $ | 1,048 | $ | 1,872 | ||
Earnings before income taxes | 172 | 209 | ||||
Net earnings | 137 | 162 |
Goodwill_And_Intangible_Assets
Goodwill And Intangible Assets | 3 Months Ended | ||||||||||||||||||
Mar. 31, 2014 | |||||||||||||||||||
Goodwill And Intangible Assets | ' | ||||||||||||||||||
Goodwill And Intangible Assets | ' | ||||||||||||||||||
(6) Goodwill and Intangible Assets | |||||||||||||||||||
The changes in the carrying amount of goodwill for the three months ended March 31, 2014 are as follows (in thousands): | |||||||||||||||||||
Balance as of December 31, 2013 | $ | 1,758,970 | |||||||||||||||||
Goodwill acquired, including post acquisition adjustments | 8,328 | ||||||||||||||||||
Goodwill disposed, including impact of deconsolidation transaction | -2,675 | ||||||||||||||||||
Balance as of March 31, 2014 | $ | 1,764,623 | |||||||||||||||||
Amortizable intangible assets at March 31, 2014 and December 31, 2013 consisted of the following (in thousands): | |||||||||||||||||||
31-Mar-14 | 31-Dec-13 | ||||||||||||||||||
Gross | Gross | ||||||||||||||||||
Carrying | Accumulated | Carrying | Accumulated | ||||||||||||||||
Amount | Amortization | Net | Amount | Amortization | Net | ||||||||||||||
Deferred financing cost | $ | 15,814 | $ | -5,452 | $ | 10,362 | $ | 15,814 | $ | -4,953 | $ | 10,861 | |||||||
Agreements, contracts and other intangible assets | 3,448 | -2,542 | 906 | 3,448 | -2,472 | 976 | |||||||||||||
Total amortizable intangible assets | $ | 19,262 | $ | -7,994 | $ | 11,268 | $ | 19,262 | $ | -7,425 | $ | 11,837 | |||||||
Amortization of intangible assets for the three months ended March 31, 2014 and 2013 was $569,000 and $545,000, respectively. Estimated amortization of intangible assets for the remainder of 2014 and the following five years and thereafter is $1,682,000, $2,241,000, $2,240,000, $1,986,000, $1,423,000, $859,000 and $837,000, respectively. The Company expects to recognize amortization of intangible assets over a weighted average period of 5.5 years with no expected residual values. | |||||||||||||||||||
At March 31, 2014 and December 31, 2013, other non-amortizable intangible assets related to restrictive covenant arrangements were $9,825,000, respectively. |
LongTerm_Debt
Long-Term Debt | 3 Months Ended | |||||||
Mar. 31, 2014 | ||||||||
Long-Term Debt | ' | |||||||
Long-Term Debt | ' | |||||||
(7) Long-term Debt | ||||||||
Long-term debt at March 31, 2014 and December 31, 2013 was comprised of the following (in thousands): | ||||||||
March 31, | December 31, | |||||||
2014 | 2013 | |||||||
Revolving credit agreement | $ | 237,500 | $ | 252,500 | ||||
Senior Unsecured Notes due 2020 (5.625%) | 250,000 | 250,000 | ||||||
Senior Secured Notes due 2020 (8.04%) | 66,964 | 69,643 | ||||||
Other debt due through 2025 | 20,193 | 21,149 | ||||||
Capitalized lease arrangements due through 2026 | 10,565 | 10,850 | ||||||
585,222 | 604,142 | |||||||
Less current portion | 20,285 | 20,844 | ||||||
Long-term debt | $ | 564,937 | $ | 583,298 | ||||
a. Credit Facility | ||||||||
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 primarily by a pledge of the stock of the Company’s wholly-owned subsidiaries and the Company’s partnership and membership interests in the LPs and LLCs. The Company was in compliance with the covenants contained in the revolving credit agreement at March 31, 2014. | ||||||||
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”). On May 31, 2013 the Company completed 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 net proceeds from the issuance of the Senior Unsecured Notes were used to reduce the outstanding indebtedness under the Company’s revolving credit agreement. 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 March 31, 2014. | ||||||||
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 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 March 31, 2014. |
Fair_Value_Measurements
Fair Value Measurements | 3 Months Ended |
Mar. 31, 2014 | |
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 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 March 31, 2014 and December 31, 2013, the Company utilized Level 2 inputs to perform such measurements methods, which were commensurate with the market approach. As of March 31, 2014 and December 31, 2013, the fair value of the supplemental executive and director retirement savings plan investments, which are included in prepaid and other current assets in the accompanying consolidated balance sheets, was $16,175,000 and $13,313,000, respectively. The fair values were determined using the calculated net asset values obtained from the plan administrator and observable inputs of similar public mutual fund investments (Level 2). There were no transfers to or from Levels 1 and 2 during the three months ended March 31, 2014. | |
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 $345,253,000, was $365,111,000 at March 31, 2014. The fair value of variable rate long-term debt approximates its carrying value of $239,969,000 at March 31, 2014. 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. |
Shareholders_Equity
Shareholders' Equity | 3 Months Ended | ||||||||||
Mar. 31, 2014 | |||||||||||
Shareholders' Equity | ' | ||||||||||
Shareholders' Equity | ' | ||||||||||
(9) 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 March 31, 2014, there was approximately $27,100,000 available under the stock repurchase program. | |||||||||||
During the three months ended March 31, 2014, the Company did not purchase any shares under the stock repurchase program. During the three months ended March 31, 2013, the Company purchased 438,668 shares of the Company’s common stock for approximately $13,943,000, at an average price of $31.76 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. | |||||||||||
In addition, the Company repurchases shares to cover payroll withholding taxes in connection with the vesting of restricted stock awards in accordance with the restricted stock agreements. During the three months ended March 31, 2014, and 2013, the Company repurchased 68,014 shares and 89,788 shares, respectively, of common stock for approximately $2,857,000 and $2,815,000, respectively. | |||||||||||
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 March 31, 2014, 2,760,250 shares were authorized for grant under the 2006 Stock Incentive Plan and 763,445 shares were available for future equity grants, including 601,327 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 during 2012 and after vest over a one year period. 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. The fair value of restricted stock is determined based on the closing bid price of the Company’s common stock on the grant date. Under Company policy, shares held by outside directors and senior management are subject to certain holding restrictions. | |||||||||||
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 during the three months ended March 31, 2014 and 2013 was as follows (in thousands): | |||||||||||
Three Months Ended March 31, | |||||||||||
2014 | 2013 | ||||||||||
Share-based compensation expense | $ | 2,458 | $ | 2,050 | |||||||
Fair value of shares vested | 9,175 | 9,182 | |||||||||
Cash received from option exercises | 488 | 5,691 | |||||||||
Tax benefit from option exercises | 1,727 | 288 | |||||||||
As of March 31, 2014, the Company had total unrecognized compensation cost of approximately $13,227,000 related to non-vested awards, which the Company expects to recognize through 2018 and over a weighted average period of 1.2 years. | |||||||||||
For the period ended March 31, 2014 and 2013, there were no options that were anti-dilutive. | |||||||||||
A summary of the status of non-vested restricted shares at March 31, 2014 and changes during the three months ended March 31, 2014 is as follows: | |||||||||||
Weighted | |||||||||||
Number | Average | ||||||||||
of Shares | Grant Price | ||||||||||
Non-vested shares at December 31, 2013 | 743,869 | $ | 26.54 | ||||||||
Shares granted | 200,391 | 42.38 | |||||||||
Shares vested | -218,405 | 21.62 | |||||||||
Non-vested shares at March 31, 2014 | 725,855 | $ | 32.4 | ||||||||
A summary of stock option activity for the three months ended March 31, 2014 is summarized as follows: | |||||||||||
Weighted | |||||||||||
Average | |||||||||||
Weighted | Remaining | ||||||||||
Number | Average | Contractual | |||||||||
of Shares | Exercise Price | Term (in years) | |||||||||
Outstanding at December 31, 2013 | 270,464 | $ | 23.16 | 2.5 | |||||||
Options exercised with total intrinsic value of $488,000 | -19,921 | 24.49 | |||||||||
Outstanding at March 31, 2014 with aggregate intrinsic value of $6,020,000 | 250,543 | $ | 23.05 | 2.2 | |||||||
Vested at March 31, 2014 with aggregate intrinsic value of $6,020,000 | 250,543 | $ | 23.05 | 2.2 | |||||||
Exercisable at March 31, 2014 with aggregate intrinsic value of $6,020,000 | 250,543 | $ | 23.05 | 2.2 | |||||||
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 March 31, 2014 exercised their options at the Company’s closing stock price on March 31, 2014. | |||||||||||
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): | |||||||||||
Three Months Ended March 31, | |||||||||||
Earnings | Shares | Per Share | |||||||||
(Numerator) | (Denominator) | Amount | |||||||||
2014:00:00 | |||||||||||
Net earnings from continuing operations attributable to AmSurg Corp. per common share (basic) | $ | 17,504 | 31,716 | $ | 0.55 | ||||||
Effect of dilutive securities options and non-vested shares | - | 404 | |||||||||
Net earnings from continuing operations attributable to AmSurg Corp. per common share (diluted) | $ | 17,504 | 32,120 | $ | 0.55 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 17,195 | 31,716 | $ | 0.54 | ||||||
Effect of dilutive securities options and non-vested shares | - | 404 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 17,195 | 32,120 | $ | 0.54 | ||||||
2013:00:00 | |||||||||||
Net earnings from continuing operations attributable to AmSurg Corp. per common share (basic) | $ | 17,750 | 31,217 | $ | 0.57 | ||||||
Effect of dilutive securities options and non-vested shares | - | 664 | |||||||||
Net earnings from continuing operations attributable to AmSurg Corp. per common share (diluted) | $ | 17,750 | 31,881 | $ | 0.56 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 17,811 | 31,217 | $ | 0.57 | ||||||
Effect of dilutive securities options and non-vested shares | - | 664 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 17,811 | 31,881 | $ | 0.56 |
Income_Taxes
Income Taxes | 3 Months Ended |
Mar. 31, 2014 | |
Income Taxes | ' |
Income Taxes | ' |
(10) 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 consolidated statement of earnings and comprehensive income. 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 U.S. federal and various state tax returns. With few exceptions, the Company is no longer subject to U.S. federal or state income tax examinations for years prior to 2010. |
Commitments_And_Contingencies
Commitments And Contingencies | 3 Months Ended |
Mar. 31, 2014 | |
Commitments And Contingencies | ' |
Commitments And Contingencies | ' |
(11) 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, workers’ compensation liability and property damage. 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 LPs, are responsible for all debts incurred but unpaid by the LPs. As manager of the operations of the LPs, 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 substantial 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 that would trigger such purchases was remote as of March 31, 2014. | |
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. |
Recent_Accounting_Pronouncemen
Recent Accounting Pronouncements | 3 Months Ended |
Mar. 31, 2014 | |
Recent Accounting Pronouncements [Abstract] | ' |
Description of New Accounting Pronouncements Not yet Adopted [Text Block] | ' |
(12) Recent Accounting Pronouncements | |
In April 2014, the Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) 2014-08 “Presentation of Financial Statements and Property, Plant and Equipment” which raised the threshold for a disposal to qualify as a discontinued operation and requires certain new disclosures for individually material disposals that do not meet the new definition of a discontinued operation. The ASU’s intent is to reduce the number of disposals reported as discontinued operations by focusing on strategic shifts that have or will have a major effect on the Company’s operations and financial results rather than routine disposals that are not a change in the Company’s strategy. The guidance is effective for interim and annual periods beginning after December 15, 2014, with earlier adoption permitted. From time to time, the Company will dispose of certain of its centers due to management’s assessment of the Company’s strategy in the market and due to limited growth opportunities at those centers. Historically, these dispositions were classified as discontinued operations and recorded separately from continuing operations. When adopted, this ASU will require the Company to record the results of operations and the associated gain or loss from similar dispositions as a component of continuing operations. The Company does not believe this ASU will have a material impact on the Company’s consolidated financial position or cash flows. |
Supplemental_Cash_Flow_Informa
Supplemental Cash Flow Information | 3 Months Ended | |||||||
Mar. 31, 2014 | ||||||||
Supplemental Cash Flow Information | ' | |||||||
Supplemental Cash Flow Information | ' | |||||||
(13) Supplemental Cash Flow Information | ||||||||
Supplemental cash flow information for the three months ended March 31, 2014 and 2013 is as follows (in thousands): | ||||||||
Three Months Ended March 31, | ||||||||
2014 | 2013 | |||||||
Cash paid during the period for: | ||||||||
Interest | $ | 3,132 | $ | 3,547 | ||||
Income taxes, net of refunds | 65 | 69 | ||||||
Non-cash investing and financing activities: | ||||||||
Increase (decrease) in accounts payable associated with acquisition of property and equipment | 1,111 | -675 | ||||||
Capital lease obligations | 116 | - |
Guarantor
Guarantor | 3 Months Ended | ||||||||||||||||||
Mar. 31, 2014 | |||||||||||||||||||
Condensed Consolidating Financial Information | ' | ||||||||||||||||||
Condensed Consolidating Financial Information | ' | ||||||||||||||||||
(14) Financial Information for the Company and Its Subsidiaries | |||||||||||||||||||
The Senior Unsecured Notes are senior 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 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 - March 31, 2014 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Assets | |||||||||||||||||||
Current assets: | |||||||||||||||||||
Cash and cash equivalents | $ | 5,562 | $ | - | $ | 41,554 | $ | - | $ | 47,116 | |||||||||
Accounts receivable, net | - | - | 106,209 | - | 106,209 | ||||||||||||||
Supplies inventory | 52 | - | 18,381 | - | 18,433 | ||||||||||||||
Deferred income taxes | 1,026 | - | - | - | 1,026 | ||||||||||||||
Prepaid and other current assets | 28,618 | - | 13,350 | -4,817 | 37,151 | ||||||||||||||
Total current assets | 35,258 | - | 179,494 | -4,817 | 209,935 | ||||||||||||||
Property and equipment, net | 10,129 | - | 158,877 | - | 169,006 | ||||||||||||||
Investments in unconsolidated affiliates and other | 1,489,635 | 1,458,185 | - | -2,928,336 | 19,484 | ||||||||||||||
Goodwill and intangible assets, net | 20,185 | - | 909 | 1,764,622 | 1,785,716 | ||||||||||||||
Total assets | $ | 1,555,207 | $ | 1,458,185 | $ | 339,280 | $ | -1,168,531 | $ | 2,184,141 | |||||||||
Liabilities and Equity | |||||||||||||||||||
Current liabilities: | |||||||||||||||||||
Current portion of long-term debt | $ | 10,714 | $ | - | $ | 9,571 | $ | - | $ | 20,285 | |||||||||
Accounts payable | 1,014 | - | 28,972 | -4,627 | 25,359 | ||||||||||||||
Accrued liabilities | 24,092 | - | 14,703 | -190 | 38,605 | ||||||||||||||
Total current liabilities | 35,820 | - | 53,246 | -4,817 | 84,249 | ||||||||||||||
Long-term debt | 543,750 | - | 52,009 | -30,822 | 564,937 | ||||||||||||||
Deferred income taxes | 185,882 | - | - | - | 185,882 | ||||||||||||||
Other long-term liabilities | 7,342 | - | 18,411 | - | 25,753 | ||||||||||||||
Noncontrolling interests – redeemable | - | - | 63,691 | 113,992 | 177,683 | ||||||||||||||
Equity: | |||||||||||||||||||
Total AmSurg Corp. equity | 782,413 | 1,458,185 | 113,448 | -1,571,633 | 782,413 | ||||||||||||||
Noncontrolling interests – non-redeemable | - | - | 38,475 | 324,749 | 363,224 | ||||||||||||||
Total equity | 782,413 | 1,458,185 | 151,923 | -1,246,884 | 1,145,637 | ||||||||||||||
Total liabilities and equity | $ | 1,555,207 | $ | 1,458,185 | $ | 339,280 | $ | -1,168,531 | $ | 2,184,141 | |||||||||
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 other | 1,484,974 | 1,453,596 | - | -2,922,178 | 16,392 | ||||||||||||||
Goodwill and 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 | ||||||||||||||
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 Statement of Earnings and Comprehensive Income - For the Three Months Ended March 31, 2014 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 6,127 | $ | - | $ | 261,589 | $ | -4,609 | $ | 263,107 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 14,485 | - | 68,830 | -121 | 83,194 | ||||||||||||||
Supply cost | - | - | 38,720 | - | 38,720 | ||||||||||||||
Other operating expenses | 4,166 | - | 55,591 | -4,488 | 55,269 | ||||||||||||||
Depreciation and amortization | 825 | - | 7,549 | - | 8,374 | ||||||||||||||
Total operating expenses | 19,476 | - | 170,690 | -4,609 | 185,557 | ||||||||||||||
Gain on deconsolidation | 2,045 | 2,045 | - | -2,045 | 2,045 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 48,052 | 48,052 | - | -95,340 | 764 | ||||||||||||||
Operating income | 36,748 | 50,097 | 90,899 | -97,385 | 80,359 | ||||||||||||||
Interest expense | 6,452 | - | 511 | - | 6,963 | ||||||||||||||
Earnings from continuing operations before income taxes | 30,296 | 50,097 | 90,388 | -97,385 | 73,396 | ||||||||||||||
Income tax expense | 12,704 | - | 353 | - | 13,057 | ||||||||||||||
Net earnings from continuing operations | 17,592 | 50,097 | 90,035 | -97,385 | 60,339 | ||||||||||||||
Net earnings (loss) from discontinued operations | -397 | - | 172 | - | -225 | ||||||||||||||
Net earnings and comprehensive income | 17,195 | 50,097 | 90,207 | -97,385 | 60,114 | ||||||||||||||
Less net earnings and comprehensive income attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 42,835 | - | 42,835 | ||||||||||||||
Net earnings from discontinued operations | - | - | 84 | - | 84 | ||||||||||||||
Total net earnings and comprehensive income attributable to noncontrolling interests | - | - | 42,919 | - | 42,919 | ||||||||||||||
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $ | 17,195 | $ | 50,097 | $ | 47,288 | $ | -97,385 | $ | 17,195 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 17,592 | $ | 50,097 | $ | 47,200 | $ | -97,385 | $ | 17,504 | |||||||||
Discontinued operations, net of income tax | -397 | - | 88 | - | -309 | ||||||||||||||
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $ | 17,195 | $ | 50,097 | $ | 47,288 | $ | -97,385 | $ | 17,195 | |||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income - For the Three Months Ended March 31, 2013 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 5,716 | $ | - | $ | 256,711 | $ | -4,238 | $ | 258,189 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 15,421 | - | 65,650 | -113 | 80,958 | ||||||||||||||
Supply cost | - | - | 37,213 | - | 37,213 | ||||||||||||||
Other operating expenses | 5,060 | - | 51,792 | -4,125 | 52,727 | ||||||||||||||
Depreciation and amortization | 772 | - | 7,236 | - | 8,008 | ||||||||||||||
Total operating expenses | 21,253 | - | 161,891 | -4,238 | 178,906 | ||||||||||||||
Gain on deconsolidation | 2,237 | 2,237 | - | -2,237 | 2,237 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 49,955 | 49,955 | - | -99,508 | 402 | ||||||||||||||
Operating income | 36,655 | 52,192 | 94,820 | -101,745 | 81,922 | ||||||||||||||
Interest expense | 6,923 | - | 619 | - | 7,542 | ||||||||||||||
Earnings from continuing operations before income taxes | 29,732 | 52,192 | 94,201 | -101,745 | 74,380 | ||||||||||||||
Income tax expense | 11,877 | - | 392 | - | 12,269 | ||||||||||||||
Net earnings from continuing operations | 17,855 | 52,192 | 93,809 | -101,745 | 62,111 | ||||||||||||||
Net earnings (loss) from discontinued operations | -44 | - | 206 | - | 162 | ||||||||||||||
Net earnings and comprehensive income | 17,811 | 52,192 | 94,015 | -101,745 | 62,273 | ||||||||||||||
Less net earnings and comprehensive income attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 44,361 | - | 44,361 | ||||||||||||||
Net earnings from discontinued operations | - | - | 101 | - | 101 | ||||||||||||||
Total net earnings and comprehensive income attributable to noncontrolling interests | - | - | 44,462 | - | 44,462 | ||||||||||||||
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $ | 17,811 | $ | 52,192 | $ | 49,553 | $ | -101,745 | $ | 17,811 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 17,855 | $ | 52,192 | $ | 49,448 | $ | -101,745 | $ | 17,750 | |||||||||
Discontinued operations, net of income tax | -44 | - | 105 | - | 61 | ||||||||||||||
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $ | 17,811 | $ | 52,192 | $ | 49,553 | $ | -101,745 | $ | 17,811 | |||||||||
Condensed Consolidating Statement of Cash Flows - For the Three Months Ended March 31, 2014 (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 | $ | 18,482 | $ | 48,096 | $ | 96,257 | $ | -93,016 | $ | 69,819 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | - | -5,082 | - | 44 | -5,038 | ||||||||||||||
Acquisition of property and equipment | -1,237 | - | -5,801 | - | -7,038 | ||||||||||||||
Proceeds from sale of interests in surgery centers | - | 1,111 | - | - | 1,111 | ||||||||||||||
Other | -629 | 211 | - | - | -418 | ||||||||||||||
Net cash flows used in investing activities | -1,866 | -3,760 | -5,801 | 44 | -11,383 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 30,000 | - | 1,945 | - | 31,945 | ||||||||||||||
Repayment on long-term borrowings | -47,679 | - | -3,174 | - | -50,853 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | -44,920 | -91,290 | 93,016 | -43,194 | ||||||||||||||
Changes in intercompany balances with affiliates, net | 556 | - | -556 | - | - | ||||||||||||||
Other financing activities, net | -641 | 584 | 43 | -44 | -58 | ||||||||||||||
Net cash flows used in financing activities | -17,764 | -44,336 | -93,032 | 92,972 | -62,160 | ||||||||||||||
Net decrease in cash and cash equivalents | -1,148 | - | -2,576 | - | -3,724 | ||||||||||||||
Cash and cash equivalents, beginning of period | 6,710 | - | 44,130 | - | 50,840 | ||||||||||||||
Cash and cash equivalents, end of period | $ | 5,562 | $ | - | $ | 41,554 | $ | - | $ | 47,116 | |||||||||
Condensed Consolidating Statement of Cash Flows - For the Three Months Ended March 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 | $ | 23,940 | $ | 49,577 | $ | 99,411 | $ | -99,063 | $ | 73,865 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | - | -242 | - | -10 | -252 | ||||||||||||||
Acquisition of property and equipment | -853 | - | -5,257 | - | -6,110 | ||||||||||||||
Net cash flows used in investing activities | -853 | -242 | -5,257 | -10 | -6,362 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 29,700 | - | 1,170 | - | 30,870 | ||||||||||||||
Repayment on long-term borrowings | -45,024 | - | -3,187 | - | -48,211 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | -49,486 | -93,491 | 99,063 | -43,914 | ||||||||||||||
Changes in intercompany balances with affiliates, net | 533 | - | -533 | - | - | ||||||||||||||
Other financing activities, net | -10,792 | 151 | 398 | 10 | -10,233 | ||||||||||||||
Net cash flows used in financing activities | -25,583 | -49,335 | -95,643 | 99,073 | -71,488 | ||||||||||||||
Net decrease in cash and cash equivalents | -2,496 | - | -1,489 | - | -3,985 | ||||||||||||||
Cash and cash equivalents, beginning of period | 7,259 | - | 39,139 | - | 46,398 | ||||||||||||||
Cash and cash equivalents, end of period | $ | 4,763 | $ | - | $ | 37,650 | $ | - | $ | 42,413 |
Subsequent_Events
Subsequent Events | 3 Months Ended |
Mar. 31, 2014 | |
Subsequent Events | ' |
Subsequent Events | ' |
(15) Subsequent Events | |
The Company assessed events occurring subsequent to March 31, 2014 for potential recognition and disclosure in the unaudited consolidated financial statements. No events have occurred that would require adjustment to or disclosure in the unaudited consolidated financial statements. |
Basis_of_Presentation_Policies
Basis of Presentation (Policies) | 3 Months Ended |
Mar. 31, 2014 | |
Accounting Policies [Abstract] | ' |
Principles of Consolidation | ' |
AmSurg Corp. (the “Company”), through its wholly owned subsidiaries, owns interests, primarily 51%, in limited partnerships (“LPs”) and limited liability companies (“LLCs”) which own and operate ambulatory surgery centers (“centers”). The Company does not have an ownership interest in a LP or LLC greater than 51% which it does not consolidate. The Company has ownership interests of less than 51% in seven LPs and LLCs, three of which it consolidates as the Company has substantive participation rights and four 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 LPs and LLCs. Consolidation of such LPs 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 LPs and LLCs, and have control of the entities. The responsibilities of the Company’s noncontrolling partners (LPs 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 LPs 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, with 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 face of the consolidated statements of earnings and comprehensive 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 statements of cash flows. | |
As further described in note 11, 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 March 31, 2014, 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, LPs or LLCs 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 other 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. | |
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 5. | |
Use_of_Estimates_Policies
Use of Estimates (Policies) | 3 Months Ended |
Mar. 31, 2014 | |
Accounting Policies [Abstract] | ' |
Use of Estimates | ' |
The preparation of financial statements in conformity with GAAP 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. | |
Revenue_Recognition_Policies
Revenue Recognition (Policies) | 3 Months Ended |
Mar. 31, 2014 | |
Accounting Policies [Abstract] | ' |
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 the Company’s centers (primarily centers that perform gastrointestinal endoscopy procedures), billing for anesthesia services provided by medical professionals employed or contracted by the Company’s 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 each of the three months ended March 31, 2014 and 2013, the Company derived approximately 25% of its revenues from governmental 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. |
Acquisition_Policies
Acquisition (Policies) | 3 Months Ended |
Mar. 31, 2014 | |
Accounting Policies [Abstract] | ' |
Acquisition 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. | |
Income_Taxes_Policies
Income Taxes (Policies) | 3 Months Ended |
Mar. 31, 2014 | |
Accounting Policies [Abstract] | ' |
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 consolidated statement of earnings and comprehensive income. 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 U.S. federal and various state tax returns. With few exceptions, the Company is no longer subject to U.S. federal or state income tax examinations for years prior to 2010. |
Acquisitions_Tables
Acquisitions (Tables) | 3 Months Ended | ||||||||
Mar. 31, 2014 | |||||||||
Business Combinations [Abstract] | ' | ||||||||
Fair Value Of Total Consideration Transferred And Major Class Of Consideration | ' | ||||||||
Three Months Ended March 31, | |||||||||
2014 | 2013 | ||||||||
Accounts receivable | $ | 417 | $ | - | |||||
Supplies, inventory, prepaid and other current assets | 81 | - | |||||||
Property and equipment | 429 | - | |||||||
Goodwill | 8,260 | - | |||||||
Accounts payable | -125 | - | |||||||
Other accrued liabilities | -39 | - | |||||||
Total fair value | 9,023 | - | |||||||
Less: Fair value attributable to noncontrolling interests | 3,985 | - | |||||||
Acquisition date fair value of total consideration transferred | $ | 5,038 | $ | - | |||||
Revenues And Net Earnings Associated With Acquisitions | ' | ||||||||
Three Months Ended March 31, | |||||||||
2014 | 2013 | ||||||||
Revenues | $ | 1,031 | $ | - | |||||
Net earnings | 245 | - | |||||||
Less: Net earnings attributable to noncontrolling interests | 151 | - | |||||||
Net earnings attributable to AmSurg Corp. common shareholders | $ | 94 | $ | - | |||||
Consolidated Pro Forma Results Of Acquisition | ' | ||||||||
Three Months Ended March 31, | |||||||||
2014 | 2013 | ||||||||
Revenues | $ | 263,107 | $ | 270,371 | |||||
Net earnings | 60,114 | 65,385 | |||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||
Net earnings from continuing operations | 17,504 | 18,830 | |||||||
Net earnings | 17,195 | 18,891 | |||||||
Net earnings from continuing operations per common share: | |||||||||
Basic | $ | 0.55 | $ | 0.6 | |||||
Diluted | $ | 0.54 | $ | 0.59 | |||||
Net earnings: | |||||||||
Basic | $ | 0.54 | $ | 0.61 | |||||
Diluted | $ | 0.54 | $ | 0.59 | |||||
Weighted average number of shares and share equivalents: | |||||||||
Basic | 31,716 | 31,217 | |||||||
Diluted | 32,120 | 31,881 |
Dispositions_Tables
Dispositions (Tables) | 3 Months Ended | |||||
Mar. 31, 2014 | ||||||
Dispositions | ' | |||||
Results Of Operations Of Centers Discontinued | ' | |||||
Three Months Ended March 31, | ||||||
2014 | 2013 | |||||
Cash proceeds from disposal | $ | 1,147 | $ | - | ||
Net (loss) earnings from discontinued operations | -225 | 162 | ||||
Net (loss) earnings from discontinued operations attributable to AmSurg Corp. | -309 | 61 | ||||
Results Of Operations Of Combined Discontinued Surgery Centers | ' | |||||
Three Months Ended March 31, | ||||||
2014 | 2013 | |||||
Revenues | $ | 1,048 | $ | 1,872 | ||
Earnings before income taxes | 172 | 209 | ||||
Net earnings | 137 | 162 |
Goodwill_And_Intangible_Assets1
Goodwill And Intangible Assets (Tables) | 3 Months Ended | ||||||||||||||||||
Mar. 31, 2014 | |||||||||||||||||||
Goodwill And Intangible Assets | ' | ||||||||||||||||||
Changes In Carrying Amount Of Goodwill | ' | ||||||||||||||||||
Balance as of December 31, 2013 | $ | 1,758,970 | |||||||||||||||||
Goodwill acquired, including post acquisition adjustments | 8,328 | ||||||||||||||||||
Goodwill disposed, including impact of deconsolidation transaction | -2,675 | ||||||||||||||||||
Balance as of March 31, 2014 | $ | 1,764,623 | |||||||||||||||||
Schedule of Finite-Lived Intangible Assets | ' | ||||||||||||||||||
31-Mar-14 | 31-Dec-13 | ||||||||||||||||||
Gross | Gross | ||||||||||||||||||
Carrying | Accumulated | Carrying | Accumulated | ||||||||||||||||
Amount | Amortization | Net | Amount | Amortization | Net | ||||||||||||||
Deferred financing cost | $ | 15,814 | $ | -5,452 | $ | 10,362 | $ | 15,814 | $ | -4,953 | $ | 10,861 | |||||||
Agreements, contracts and other intangible assets | 3,448 | -2,542 | 906 | 3,448 | -2,472 | 976 | |||||||||||||
Total amortizable intangible assets | $ | 19,262 | $ | -7,994 | $ | 11,268 | $ | 19,262 | $ | -7,425 | $ | 11,837 |
LongTerm_Debt_Tables
Long-Term Debt (Tables) | 3 Months Ended | |||||||
Mar. 31, 2014 | ||||||||
Long-Term Debt | ' | |||||||
Components Of Long-Term Debt | ' | |||||||
March 31, | December 31, | |||||||
2014 | 2013 | |||||||
Revolving credit agreement | $ | 237,500 | $ | 252,500 | ||||
Senior Unsecured Notes due 2020 (5.625%) | 250,000 | 250,000 | ||||||
Senior Secured Notes due 2020 (8.04%) | 66,964 | 69,643 | ||||||
Other debt due through 2025 | 20,193 | 21,149 | ||||||
Capitalized lease arrangements due through 2026 | 10,565 | 10,850 | ||||||
585,222 | 604,142 | |||||||
Less current portion | 20,285 | 20,844 | ||||||
Long-term debt | $ | 564,937 | $ | 583,298 | ||||
Redemption Price Percentage | ' | |||||||
Period | Redemption Price | |||||||
2015 | 104.22% | |||||||
2016 | 102.81% | |||||||
2017 | 101.41% | |||||||
2018 and thereafter | 100.00% |
Shareholders_Equity_Tables
Shareholders' Equity (Tables) | 3 Months Ended | ||||||||||
Mar. 31, 2014 | |||||||||||
Shareholders' Equity | ' | ||||||||||
Share-Based Activity | ' | ||||||||||
Three Months Ended March 31, | |||||||||||
2014 | 2013 | ||||||||||
Share-based compensation expense | $ | 2,458 | $ | 2,050 | |||||||
Fair value of shares vested | 9,175 | 9,182 | |||||||||
Cash received from option exercises | 488 | 5,691 | |||||||||
Tax benefit from option exercises | 1,727 | 288 | |||||||||
Schedule Of Changes In Non-Vested Restricted Shares | ' | ||||||||||
Weighted | |||||||||||
Number | Average | ||||||||||
of Shares | Grant Price | ||||||||||
Non-vested shares at December 31, 2013 | 743,869 | $ | 26.54 | ||||||||
Shares granted | 200,391 | 42.38 | |||||||||
Shares vested | -218,405 | 21.62 | |||||||||
Non-vested shares at March 31, 2014 | 725,855 | $ | 32.4 | ||||||||
Schedule Of Stock Option Activity | ' | ||||||||||
Weighted | |||||||||||
Average | |||||||||||
Weighted | Remaining | ||||||||||
Number | Average | Contractual | |||||||||
of Shares | Exercise Price | Term (in years) | |||||||||
Outstanding at December 31, 2013 | 270,464 | $ | 23.16 | 2.5 | |||||||
Options exercised with total intrinsic value of $488,000 | -19,921 | 24.49 | |||||||||
Outstanding at March 31, 2014 with aggregate intrinsic value of $6,020,000 | 250,543 | $ | 23.05 | 2.2 | |||||||
Vested at March 31, 2014 with aggregate intrinsic value of $6,020,000 | 250,543 | $ | 23.05 | 2.2 | |||||||
Exercisable at March 31, 2014 with aggregate intrinsic value of $6,020,000 | 250,543 | $ | 23.05 | 2.2 | |||||||
Schedule Of Reconciliation Of Numerator And Denominators Of Basic And Diluted Earnings Per Share | ' | ||||||||||
Three Months Ended March 31, | |||||||||||
Earnings | Shares | Per Share | |||||||||
(Numerator) | (Denominator) | Amount | |||||||||
2014:00:00 | |||||||||||
Net earnings from continuing operations attributable to AmSurg Corp. per common share (basic) | $ | 17,504 | 31,716 | $ | 0.55 | ||||||
Effect of dilutive securities options and non-vested shares | - | 404 | |||||||||
Net earnings from continuing operations attributable to AmSurg Corp. per common share (diluted) | $ | 17,504 | 32,120 | $ | 0.55 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 17,195 | 31,716 | $ | 0.54 | ||||||
Effect of dilutive securities options and non-vested shares | - | 404 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 17,195 | 32,120 | $ | 0.54 | ||||||
2013:00:00 | |||||||||||
Net earnings from continuing operations attributable to AmSurg Corp. per common share (basic) | $ | 17,750 | 31,217 | $ | 0.57 | ||||||
Effect of dilutive securities options and non-vested shares | - | 664 | |||||||||
Net earnings from continuing operations attributable to AmSurg Corp. per common share (diluted) | $ | 17,750 | 31,881 | $ | 0.56 | ||||||
Net earnings attributable to AmSurg Corp. per common share (basic) | $ | 17,811 | 31,217 | $ | 0.57 | ||||||
Effect of dilutive securities options and non-vested shares | - | 664 | |||||||||
Net earnings attributable to AmSurg Corp. per common share (diluted) | $ | 17,811 | 31,881 | $ | 0.56 |
Supplemental_Cash_Flow_Informa1
Supplemental Cash Flow Information (Tables) | 3 Months Ended | |||||||
Mar. 31, 2014 | ||||||||
Supplemental Cash Flow Information | ' | |||||||
Summary Of Supplemental Cash Flow Information | ' | |||||||
Three Months Ended March 31, | ||||||||
2014 | 2013 | |||||||
Cash paid during the period for: | ||||||||
Interest | $ | 3,132 | $ | 3,547 | ||||
Income taxes, net of refunds | 65 | 69 | ||||||
Non-cash investing and financing activities: | ||||||||
Increase (decrease) in accounts payable associated with acquisition of property and equipment | 1,111 | -675 | ||||||
Capital lease obligations | 116 | - |
Guarantor_Tables
Guarantor (Tables) | 3 Months Ended | ||||||||||||||||||
Mar. 31, 2014 | |||||||||||||||||||
Condensed Consolidating Financial Information | ' | ||||||||||||||||||
Condensed Balance Sheet | ' | ||||||||||||||||||
Condensed Consolidating Balance Sheet - March 31, 2014 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Assets | |||||||||||||||||||
Current assets: | |||||||||||||||||||
Cash and cash equivalents | $ | 5,562 | $ | - | $ | 41,554 | $ | - | $ | 47,116 | |||||||||
Accounts receivable, net | - | - | 106,209 | - | 106,209 | ||||||||||||||
Supplies inventory | 52 | - | 18,381 | - | 18,433 | ||||||||||||||
Deferred income taxes | 1,026 | - | - | - | 1,026 | ||||||||||||||
Prepaid and other current assets | 28,618 | - | 13,350 | -4,817 | 37,151 | ||||||||||||||
Total current assets | 35,258 | - | 179,494 | -4,817 | 209,935 | ||||||||||||||
Property and equipment, net | 10,129 | - | 158,877 | - | 169,006 | ||||||||||||||
Investments in unconsolidated affiliates and other | 1,489,635 | 1,458,185 | - | -2,928,336 | 19,484 | ||||||||||||||
Goodwill and intangible assets, net | 20,185 | - | 909 | 1,764,622 | 1,785,716 | ||||||||||||||
Total assets | $ | 1,555,207 | $ | 1,458,185 | $ | 339,280 | $ | -1,168,531 | $ | 2,184,141 | |||||||||
Liabilities and Equity | |||||||||||||||||||
Current liabilities: | |||||||||||||||||||
Current portion of long-term debt | $ | 10,714 | $ | - | $ | 9,571 | $ | - | $ | 20,285 | |||||||||
Accounts payable | 1,014 | - | 28,972 | -4,627 | 25,359 | ||||||||||||||
Accrued liabilities | 24,092 | - | 14,703 | -190 | 38,605 | ||||||||||||||
Total current liabilities | 35,820 | - | 53,246 | -4,817 | 84,249 | ||||||||||||||
Long-term debt | 543,750 | - | 52,009 | -30,822 | 564,937 | ||||||||||||||
Deferred income taxes | 185,882 | - | - | - | 185,882 | ||||||||||||||
Other long-term liabilities | 7,342 | - | 18,411 | - | 25,753 | ||||||||||||||
Noncontrolling interests – redeemable | - | - | 63,691 | 113,992 | 177,683 | ||||||||||||||
Equity: | |||||||||||||||||||
Total AmSurg Corp. equity | 782,413 | 1,458,185 | 113,448 | -1,571,633 | 782,413 | ||||||||||||||
Noncontrolling interests – non-redeemable | - | - | 38,475 | 324,749 | 363,224 | ||||||||||||||
Total equity | 782,413 | 1,458,185 | 151,923 | -1,246,884 | 1,145,637 | ||||||||||||||
Total liabilities and equity | $ | 1,555,207 | $ | 1,458,185 | $ | 339,280 | $ | -1,168,531 | $ | 2,184,141 | |||||||||
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 other | 1,484,974 | 1,453,596 | - | -2,922,178 | 16,392 | ||||||||||||||
Goodwill and 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 | ||||||||||||||
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 Income Statement | ' | ||||||||||||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income - For the Three Months Ended March 31, 2014 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 6,127 | $ | - | $ | 261,589 | $ | -4,609 | $ | 263,107 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 14,485 | - | 68,830 | -121 | 83,194 | ||||||||||||||
Supply cost | - | - | 38,720 | - | 38,720 | ||||||||||||||
Other operating expenses | 4,166 | - | 55,591 | -4,488 | 55,269 | ||||||||||||||
Depreciation and amortization | 825 | - | 7,549 | - | 8,374 | ||||||||||||||
Total operating expenses | 19,476 | - | 170,690 | -4,609 | 185,557 | ||||||||||||||
Gain on deconsolidation | 2,045 | 2,045 | - | -2,045 | 2,045 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 48,052 | 48,052 | - | -95,340 | 764 | ||||||||||||||
Operating income | 36,748 | 50,097 | 90,899 | -97,385 | 80,359 | ||||||||||||||
Interest expense | 6,452 | - | 511 | - | 6,963 | ||||||||||||||
Earnings from continuing operations before income taxes | 30,296 | 50,097 | 90,388 | -97,385 | 73,396 | ||||||||||||||
Income tax expense | 12,704 | - | 353 | - | 13,057 | ||||||||||||||
Net earnings from continuing operations | 17,592 | 50,097 | 90,035 | -97,385 | 60,339 | ||||||||||||||
Net earnings (loss) from discontinued operations | -397 | - | 172 | - | -225 | ||||||||||||||
Net earnings and comprehensive income | 17,195 | 50,097 | 90,207 | -97,385 | 60,114 | ||||||||||||||
Less net earnings and comprehensive income attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 42,835 | - | 42,835 | ||||||||||||||
Net earnings from discontinued operations | - | - | 84 | - | 84 | ||||||||||||||
Total net earnings and comprehensive income attributable to noncontrolling interests | - | - | 42,919 | - | 42,919 | ||||||||||||||
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $ | 17,195 | $ | 50,097 | $ | 47,288 | $ | -97,385 | $ | 17,195 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 17,592 | $ | 50,097 | $ | 47,200 | $ | -97,385 | $ | 17,504 | |||||||||
Discontinued operations, net of income tax | -397 | - | 88 | - | -309 | ||||||||||||||
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $ | 17,195 | $ | 50,097 | $ | 47,288 | $ | -97,385 | $ | 17,195 | |||||||||
Condensed Consolidating Statement of Earnings and Comprehensive Income - For the Three Months Ended March 31, 2013 (In thousands) | |||||||||||||||||||
Guarantor | Non-Guarantor | Consolidating | Total | ||||||||||||||||
Parent Issuer | Subsidiaries | Subsidiaries | Adjustments | Consolidated | |||||||||||||||
Revenues | $ | 5,716 | $ | - | $ | 256,711 | $ | -4,238 | $ | 258,189 | |||||||||
Operating expenses: | |||||||||||||||||||
Salaries and benefits | 15,421 | - | 65,650 | -113 | 80,958 | ||||||||||||||
Supply cost | - | - | 37,213 | - | 37,213 | ||||||||||||||
Other operating expenses | 5,060 | - | 51,792 | -4,125 | 52,727 | ||||||||||||||
Depreciation and amortization | 772 | - | 7,236 | - | 8,008 | ||||||||||||||
Total operating expenses | 21,253 | - | 161,891 | -4,238 | 178,906 | ||||||||||||||
Gain on deconsolidation | 2,237 | 2,237 | - | -2,237 | 2,237 | ||||||||||||||
Equity in earnings of unconsolidated affiliates | 49,955 | 49,955 | - | -99,508 | 402 | ||||||||||||||
Operating income | 36,655 | 52,192 | 94,820 | -101,745 | 81,922 | ||||||||||||||
Interest expense | 6,923 | - | 619 | - | 7,542 | ||||||||||||||
Earnings from continuing operations before income taxes | 29,732 | 52,192 | 94,201 | -101,745 | 74,380 | ||||||||||||||
Income tax expense | 11,877 | - | 392 | - | 12,269 | ||||||||||||||
Net earnings from continuing operations | 17,855 | 52,192 | 93,809 | -101,745 | 62,111 | ||||||||||||||
Net earnings (loss) from discontinued operations | -44 | - | 206 | - | 162 | ||||||||||||||
Net earnings and comprehensive income | 17,811 | 52,192 | 94,015 | -101,745 | 62,273 | ||||||||||||||
Less net earnings and comprehensive income attributable to noncontrolling interests: | |||||||||||||||||||
Net earnings from continuing operations | - | - | 44,361 | - | 44,361 | ||||||||||||||
Net earnings from discontinued operations | - | - | 101 | - | 101 | ||||||||||||||
Total net earnings and comprehensive income attributable to noncontrolling interests | - | - | 44,462 | - | 44,462 | ||||||||||||||
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $ | 17,811 | $ | 52,192 | $ | 49,553 | $ | -101,745 | $ | 17,811 | |||||||||
Amounts attributable to AmSurg Corp. common shareholders: | |||||||||||||||||||
Earnings from continuing operations, net of income tax | $ | 17,855 | $ | 52,192 | $ | 49,448 | $ | -101,745 | $ | 17,750 | |||||||||
Discontinued operations, net of income tax | -44 | - | 105 | - | 61 | ||||||||||||||
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $ | 17,811 | $ | 52,192 | $ | 49,553 | $ | -101,745 | $ | 17,811 | |||||||||
Condensed Cash Flow Statement | ' | ||||||||||||||||||
Condensed Consolidating Statement of Cash Flows - For the Three Months Ended March 31, 2014 (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 | $ | 18,482 | $ | 48,096 | $ | 96,257 | $ | -93,016 | $ | 69,819 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | - | -5,082 | - | 44 | -5,038 | ||||||||||||||
Acquisition of property and equipment | -1,237 | - | -5,801 | - | -7,038 | ||||||||||||||
Proceeds from sale of interests in surgery centers | - | 1,111 | - | - | 1,111 | ||||||||||||||
Other | -629 | 211 | - | - | -418 | ||||||||||||||
Net cash flows used in investing activities | -1,866 | -3,760 | -5,801 | 44 | -11,383 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 30,000 | - | 1,945 | - | 31,945 | ||||||||||||||
Repayment on long-term borrowings | -47,679 | - | -3,174 | - | -50,853 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | -44,920 | -91,290 | 93,016 | -43,194 | ||||||||||||||
Changes in intercompany balances with affiliates, net | 556 | - | -556 | - | - | ||||||||||||||
Other financing activities, net | -641 | 584 | 43 | -44 | -58 | ||||||||||||||
Net cash flows used in financing activities | -17,764 | -44,336 | -93,032 | 92,972 | -62,160 | ||||||||||||||
Net decrease in cash and cash equivalents | -1,148 | - | -2,576 | - | -3,724 | ||||||||||||||
Cash and cash equivalents, beginning of period | 6,710 | - | 44,130 | - | 50,840 | ||||||||||||||
Cash and cash equivalents, end of period | $ | 5,562 | $ | - | $ | 41,554 | $ | - | $ | 47,116 | |||||||||
Condensed Consolidating Statement of Cash Flows - For the Three Months Ended March 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 | $ | 23,940 | $ | 49,577 | $ | 99,411 | $ | -99,063 | $ | 73,865 | |||||||||
Cash flows from investing activities: | |||||||||||||||||||
Acquisition of interests in surgery centers and related transactions | - | -242 | - | -10 | -252 | ||||||||||||||
Acquisition of property and equipment | -853 | - | -5,257 | - | -6,110 | ||||||||||||||
Net cash flows used in investing activities | -853 | -242 | -5,257 | -10 | -6,362 | ||||||||||||||
Cash flows from financing activities: | |||||||||||||||||||
Proceeds from long-term borrowings | 29,700 | - | 1,170 | - | 30,870 | ||||||||||||||
Repayment on long-term borrowings | -45,024 | - | -3,187 | - | -48,211 | ||||||||||||||
Distributions to owners, including noncontrolling interests | - | -49,486 | -93,491 | 99,063 | -43,914 | ||||||||||||||
Changes in intercompany balances with affiliates, net | 533 | - | -533 | - | - | ||||||||||||||
Other financing activities, net | -10,792 | 151 | 398 | 10 | -10,233 | ||||||||||||||
Net cash flows used in financing activities | -25,583 | -49,335 | -95,643 | 99,073 | -71,488 | ||||||||||||||
Net decrease in cash and cash equivalents | -2,496 | - | -1,489 | - | -3,985 | ||||||||||||||
Cash and cash equivalents, beginning of period | 7,259 | - | 39,139 | - | 46,398 | ||||||||||||||
Cash and cash equivalents, end of period | $ | 4,763 | $ | - | $ | 37,650 | $ | - | $ | 42,413 |
Basis_of_Presentation_Details
Basis of Presentation (Details) | Mar. 31, 2014 |
Centers | |
Ownership Interests [Line Items] | ' |
Number Of Centers Owned Less Than 51 Percent | 7 |
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 | 4 |
Use_of_Estimates_Details
Use of Estimates (Details) (USD $) | 3 Months Ended | ||
Mar. 31, 2014 | Mar. 31, 2013 | Dec. 31, 2013 | |
Use Of Estimates [Abstract] | ' | ' | ' |
Allowances for contractual adjustments | $280,582,000 | ' | $289,937,000 |
Allowances for accounts receivable | 29,120,000 | ' | 27,862,000 |
Bad debt expense included in other operating expenses | $5,208,000 | $5,900,000 | ' |
Revenue_Recognition_Details
Revenue Recognition (Details) | 3 Months Ended | |
Mar. 31, 2014 | Mar. 31, 2013 | |
Revenue Recognition | ' | ' |
Percentage of revenues from governmental healthcare programs | 25.00% | 25.00% |
Acquisitions_Narrative_Details
Acquisitions (Narrative) (Details) (USD $) | 3 Months Ended | 3 Months Ended | 0 Months Ended | ||||||||
Mar. 31, 2014 | Mar. 31, 2013 | Dec. 31, 2013 | Mar. 31, 2014 | Mar. 31, 2013 | Mar. 31, 2014 | Mar. 31, 2013 | Sep. 01, 2011 | Mar. 31, 2013 | Mar. 31, 2014 | Mar. 31, 2013 | |
Centers | Centers | Noncontrolling Interest Number Of Centers [Member] | Noncontrolling Interest Number Of Centers [Member] | Controlling Interest [Member] | Controlling Interest [Member] | Acquired Nsc Centers [Member] | Acquired Nsc Centers [Member] | Current Year Acquisitions [Member] | Current Year Acquisitions [Member] | ||
Centers | Centers | Centers | Centers | Centers | |||||||
Business Acquisition [Line Items] | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Equity Method Investments | $19,484,000 | ' | $16,392,000 | ' | ' | ' | ' | ' | ' | $1,238,000 | $5,200,000 |
Gain (loss) on deconsolidation | 2,045,000 | 2,237,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Number of business acquisitions | ' | ' | ' | 1 | 1 | 1 | 0 | 17 | ' | ' | ' |
Payments to Acquire Businesses, Net of Cash Acquired | 5,038,000 | 252,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High | ' | ' | ' | ' | ' | ' | ' | 7,500,000 | ' | ' | ' |
Contingent Purchase Price Obligation, Settlement Amount | ' | ' | ' | ' | ' | ' | ' | ' | 2,744,000 | ' | ' |
Goodwill deductible for tax purposes | 4,670,000 | 0 | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Proceeds from Divestiture of Interest in Consolidated Subsidiaries | $600,000 | ' | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Number Of Consolidated Centers Contributed To Joint Venture | 1 | 1 | ' | ' | ' | ' | ' | ' | ' | ' | ' |
Acquisitions_Fair_Value_Of_Tot
Acquisitions (Fair Value Of Total Consideration Transferred And Major Class Of Consideration) (Details) (USD $) | Mar. 31, 2014 | Dec. 31, 2013 | Mar. 31, 2014 | Mar. 31, 2013 |
In Thousands, unless otherwise specified | Series of Individually Immaterial Business Acquisitions [Member] | Series of Individually Immaterial Business Acquisitions [Member] | ||
Business Acquisition [Line Items] | ' | ' | ' | ' |
Accounts receivable | ' | ' | $417 | $0 |
Supplies, inventory, prepaid and other current assets | ' | ' | 81 | 0 |
Property and equipment | ' | ' | 429 | 0 |
Goodwill | 1,764,623 | 1,758,970 | 8,260 | 0 |
Accounts payable | ' | ' | -125 | 0 |
Other accrued liabilities | ' | ' | -39 | 0 |
Total fair value | ' | ' | 9,023 | 0 |
Less: Fair value attributable to noncontrolling interests | ' | ' | 3,985 | 0 |
Acquisition date fair value of total consideration transferred | ' | ' | $5,038 | $0 |
Acquisitions_Revs_and_Earnings
Acquisitions (Revs and Earnings) (Details) (USD $) | 3 Months Ended | |
In Thousands, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Business Acquisition [Line Items] | ' | ' |
Net earnings (loss) | $60,114 | $62,273 |
Less: Net earnings attributable to noncontrolling interests | 42,919 | 44,462 |
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | 17,195 | 17,811 |
Series of Individually Immaterial Business Acquisitions [Member] | ' | ' |
Business Acquisition [Line Items] | ' | ' |
Revenues | 1,031 | 0 |
Net earnings (loss) | 245 | 0 |
Less: Net earnings attributable to noncontrolling interests | 151 | 0 |
Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders | $94 | $0 |
Acquisitions_Consolidated_Pro_
Acquisitions (Consolidated Pro Forma Results Of Acquisition) (Details) (USD $) | 3 Months Ended | |
In Thousands, except Per Share data, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Business Combinations [Abstract] | ' | ' |
Revenues | $263,107 | $270,371 |
Net earnings | 60,114 | 65,385 |
Amounts Attributable To Common Shareholders | ' | ' |
Net earnings from continuing operations | 17,504 | 18,830 |
Net earnings | $17,195 | $18,891 |
Net earnings from continuing operations per common share: Basic | $0.55 | $0.60 |
Net earnings from continuing operations per common share: Diluted | $0.54 | $0.59 |
Net earnings: Basic | $0.54 | $0.61 |
Net earnings: Diluted | $0.54 | $0.59 |
Weighted average number of shares and share equivalents: Basic | 31,716 | 31,217 |
Weighted average number of shares and share equivalents: Diluted | 32,120 | 31,881 |
Dispositions_Results_Of_Operat
Dispositions (Results Of Operations Of Centers Discontinued) (Details) (USD $) | 3 Months Ended | |
In Thousands, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Dispositions | ' | ' |
Cash proceeds from disposal | $1,147 | $0 |
Net earnings (loss) from discontinued operations | -225 | 162 |
Net (loss) gain from discontinued operations attributable to AmSurg Corp. | ($309) | $61 |
Dispositions_Results_Of_Operat1
Dispositions (Results Of Operations Of Combined Discontinued Surgery Centers) (Details) (USD $) | 3 Months Ended | |
In Thousands, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Dispositions | ' | ' |
Revenues | $1,048 | $1,872 |
Earnings before income taxes | 172 | 209 |
Net earnings | $137 | $162 |
Goodwill_And_Intangible_Assets2
Goodwill And Intangible Assets (Narrative) (Details) (USD $) | 3 Months Ended | ||
Mar. 31, 2014 | Mar. 31, 2013 | Dec. 31, 2013 | |
Goodwill And Intangible Assets | ' | ' | ' |
Amortization of Intangible Assets | $569,000 | $545,000 | ' |
Finite-Lived Intangible Assets, Amortization Expense, Remainder of Fiscal Year | 1,682,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Next Twelve Months | 2,241,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Year Two | 2,240,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Year Three | 1,986,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Year Four | 1,423,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, Year Five | 859,000 | ' | ' |
Finite-Lived Intangible Assets, Amortization Expense, after Year Five | 837,000 | ' | ' |
Finite-Lived Intangible Asset, Useful Life | '5 years 6 months 0 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 $) | 3 Months Ended |
In Thousands, unless otherwise specified | Mar. 31, 2014 |
Goodwill And Intangible Assets | ' |
Balance, beginning of period | $1,758,970 |
Goodwill acquired, including post acquisition adjustments | 8,328 |
Disposals | -2,675 |
Balance, end of period | $1,764,623 |
Goodwill_And_Intangible_Assets4
Goodwill And Intangible Assets (Summary Of Amortizable Intangible Assets) (Details) (USD $) | Mar. 31, 2014 | Dec. 31, 2013 |
In Thousands, unless otherwise specified | ||
Finite-Lived Intangible Assets [Line Items] | ' | ' |
Gross Carrying Amount | $19,262 | $19,262 |
Accumulated Amortization | -7,994 | -7,425 |
Net | 11,268 | 11,837 |
Deferred Financing Cost [Member] | ' | ' |
Finite-Lived Intangible Assets [Line Items] | ' | ' |
Gross Carrying Amount | 15,814 | 15,814 |
Accumulated Amortization | -5,452 | -4,953 |
Net | 10,362 | 10,861 |
Customer And Non Compete Agreements [Member] | ' | ' |
Finite-Lived Intangible Assets [Line Items] | ' | ' |
Gross Carrying Amount | 3,448 | 3,448 |
Accumulated Amortization | -2,542 | -2,472 |
Net | $906 | $976 |
LongTerm_Debt_Narrative_Detail
Long-Term Debt (Narrative) (Details) (USD $) | Mar. 31, 2014 | Dec. 31, 2013 | Mar. 31, 2014 | Mar. 31, 2014 | Mar. 31, 2014 | 28-May-10 | Mar. 31, 2014 | Mar. 31, 2014 | Mar. 31, 2014 | Mar. 31, 2014 |
Line of Credit [Member] | Unsecured Debt [Member] | Secured Debt [Member] | Secured Debt [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] | |||||||
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 | ' | ' | ' | ' | ' |
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 | $66,964,000 | $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 | ' | ' | ' | ' | ' |
LongTerm_Debt_Components_Of_Lo
Long-Term Debt (Components Of Long-Term Debt) (Details) (USD $) | Mar. 31, 2014 | Dec. 31, 2013 |
In Thousands, unless otherwise specified | ||
Long-Term Debt | ' | ' |
Revolving credit agreement | $237,500 | $252,500 |
Senior Unsecured Notes | 250,000 | 250,000 |
Senior Secured Notes | 66,964 | 69,643 |
Other debt | 20,193 | 21,149 |
Capitalized lease arrangements | 10,565 | 10,850 |
Long-term debt, gross | $585,222 | $604,142 |
Long_Term_Debt_Current_Noncurr
Long Term Debt (Current & Noncurrent Breakout) (Details) (USD $) | Mar. 31, 2014 | Dec. 31, 2013 |
In Thousands, unless otherwise specified | ||
Debt Disclosure Current [Abstract] | ' | ' |
Long-term debt | $564,937 | $583,298 |
Less current portion | 20,285 | 20,844 |
Long-term debt, gross | $585,222 | $604,142 |
LongTerm_Debt_Redemption_Price
Long-Term Debt (Redemption Price) (Details) (Unsecured Debt [Member]) | Mar. 31, 2014 |
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% |
Fair_Value_Measurements_Narrat
Fair Value Measurements (Narrative) (Details) (USD $) | Mar. 31, 2014 | Dec. 31, 2013 |
Long-term Debt gross | $585,222,000 | $604,142,000 |
Fixed Interest Rate [Member] | ' | ' |
Long-term Debt gross | 345,253,000 | ' |
Long-term Debt, Fair Value | 365,111,000 | ' |
Variable Interest Rate [Member] | ' | ' |
Long-term Debt gross | 239,969,000 | ' |
Long-term Debt, Fair Value | 239,969,000 | ' |
Fair Value, Inputs, Level 2 [Member] | Fair Value, Measurements, Recurring [Member] | ' | ' |
Supplemental executive retirement savings plan investments - Level 2 | $16,175,000 | $13,313,000 |
Shareholders_Equity_Narrative_
Shareholder's Equity (Narrative) (Details) (USD $) | 0 Months Ended | 3 Months Ended | ||
Aug. 09, 2013 | Apr. 24, 2012 | Mar. 31, 2014 | Mar. 31, 2013 | |
M | Y | |||
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 | ' | ' |
Amount remaining under stock repurchase plan | ' | ' | 27,100,000 | ' |
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 | ' | ' | 763,445 | ' |
Unrecognized compensation cost on non vested awards | ' | ' | 13,227,000 | ' |
Employee Service Share-based Compensation, Nonvested Awards | ' | ' | '1 year 2 months 12 days | ' |
Share based payment award shares purchased for award | ' | ' | 0 | 0 |
Stock Repurchased Under Repurchase Program [Member] | ' | ' | ' | ' |
Common Stock: | ' | ' | ' | ' |
Repurchase of common stock, shares | ' | ' | 0 | 438,668 |
Repurchase of common stock | ' | ' | 0 | 13,943,000 |
Average price per share | ' | ' | $0 | 31.76 |
Stock Repurchased To Cover Employee Tax Withholdings [Member] | ' | ' | ' | ' |
Common Stock: | ' | ' | ' | ' |
Repurchase of common stock, shares | ' | ' | 68,014 | 89,788 |
Repurchase of common stock | ' | ' | $2,857,000 | 2,815,000 |
Stock Options | ' | ' | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' |
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period | ' | ' | '4 years | ' |
Options term | ' | ' | 10 | ' |
Restricted Stock [Member] | ' | ' | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' |
Shares available for future grants/issuance under stock incentive plan | ' | ' | 601,327 | ' |
Outside Directors [Member] | Restricted Stock [Member] | Period from January 1, 2012 thru current period | ' | ' | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' |
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period | ' | ' | '1 year | ' |
Outside Directors [Member] | Restricted Stock [Member] | Period prior to January 1, 2012 | ' | ' | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' |
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period | ' | ' | '2 years | ' |
Employees [Member] | Restricted Stock [Member] | Period from January 1, 2010 thru current period | ' | ' | ' | ' |
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 | ' |
Employees [Member] | Restricted Stock [Member] | Period prior to January 1, 2010 | ' | ' | ' | ' |
Stock Incentive Plans: | ' | ' | ' | ' |
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period | ' | ' | '4 years | ' |
Shareholders_Equity_ShareBased
Shareholders' Equity (Share-Based Activity) (Details) (USD $) | 3 Months Ended | |
In Thousands, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Shareholders' Equity | ' | ' |
Share-based compensation expense | $2,458 | $2,050 |
Fair value of shares vested | 9,175 | 9,182 |
Cash received from option exercises | 488 | 5,691 |
Tax benefit from option exercises | $1,727 | $288 |
Shareholders_Equity_Schedule_O
Shareholders Equity (Schedule Of Changes In Non-Vested Restricted Shares) (Details) (USD $) | 3 Months Ended |
Mar. 31, 2014 | |
Shareholders' Equity | ' |
Non-vested shares at beginning of period, Number of Shares | 743,869 |
Non-vested shares at beginning of period, Weighted Average Grant Price | $26.54 |
Shares granted, Number of Shares | 200,391 |
Shares granted, Weighted Average Grant Price | $42.38 |
Shares vested, net of shares repurchased to cover tax withholding requirements,, Number of Shares | -218,405 |
Shares vested, net of shares repurchased to cover tax withholding requirements, , Weighted Average Grant Price | $21.62 |
Shares forfeited, Number of Shares | 0 |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeitures, Weighted Average Grant Date Fair Value | $0 |
Non-vested shares at end of period, Number of Shares | 725,855 |
Non-vested shares at end of period, Weighted Average Grant Price | $32.40 |
Recovered_Sheet1
Shareholder's Equity (Schedule of Stock Option Activity (Details) (USD $) | 3 Months Ended | 12 Months Ended |
Mar. 31, 2014 | Dec. 31, 2013 | |
Shareholders' Equity | ' | ' |
Outstanding at beginning of period, Number of Shares | 270,464 | ' |
Options exercised, Number of Shares | -19,921 | ' |
Options terminated, Number of Shares | 0 | ' |
Outstanding at end of period, Number of Shares | 250,543 | 270,464 |
Vested or expected to vest at end of period, Number of Shares | 250,543 | ' |
Exercisable at end of period, Number of Shares | 250,543 | ' |
Outstanding at beginning of period, Weighted Average Exercise Price | $23.16 | ' |
Share-based Compensation Arrangements by Share-based Payment Award, Options, Exercises in Period, Weighted Average Exercise Price | $24.49 | ' |
Share-based Compensation Arrangements by Share-based Payment Award, Options, Forfeitures in Period, Weighted Average Exercise Price | $0 | ' |
Outstanding at end of period, Weighted Average Exercise Price | $23.05 | $23.16 |
Vested or expected to vest at end of period, weighted average exercise price | $23.05 | ' |
Exercisable at end of period, Weighted Average Exercise Price | $23.05 | ' |
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term, Period Start | '2 years 2 months 12 days | '2 years 6 months 0 days |
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term, Period End | '2 years 2 months 12 days | '2 years 6 months 0 days |
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Outstanding, Weighted Average Remaining Contractual Term | '2 years 2 months 12 days | ' |
Share-based Compensation Arrangement by Share-based Payment Award, Options, Vested and Expected to Vest, Exercisable, Weighted Average Remaining Contractual Term | '2 years 2 months 12 days | ' |
Shareholders_Equity_Schedule_o1
Shareholder's Equity (Schedule of Stock Option Activity (Parenthetical) (Details) (USD $) | 3 Months Ended |
Mar. 31, 2014 | |
Shareholders' Equity | ' |
Total intrinsic value with options exercised | $488,000 |
Aggregate intrinsic value of options outstanding | 6,020,000 |
Total intrinsic value of options vested or expected to vest | 6,020,000 |
Total Intrinsic value of options exercisable | $6,020,000 |
Recovered_Sheet2
Shareholder's Equity (Schedule Of Reconciliation Of Numerator And Denominators Of Basic And Diluted Earnings Per Share) (Details) (USD $) | 3 Months Ended | |
In Thousands, except Per Share data, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Shareholders' Equity | ' | ' |
Net earnings from continuing operations attributable to AmSurg Corp., Earnings (Numerator) | $17,504 | $17,750 |
Net earnings attributable to AmSurg Corp., Earnings (Numerator) | $17,195 | $17,811 |
Net earnings from continuing operations attributable to AmSurg Corp. (Basic), Shares (Denominator) | 31,716 | 31,217 |
Net earnings from continuing operations attributable to AmSurg Corp. (Diluted), Shares (Denominator) | 32,120 | 31,881 |
Dilutive Securities, Effect on Basic Earnings Per Share | 404 | 664 |
Net earnings from continuing operations attributable to AmSurg Corp. per common share (Basic), Per Share Amount | $0.55 | $0.57 |
Net earnings from continuing operations attributable to AmSurg Corp. per common share (Diluted), Per Share Amount | $0.55 | $0.56 |
Net earnings attributable to AmSurg Corp. per common share (Basic), Per Share Amount | $0.54 | $0.57 |
Net earnings attributable to AmSurg Corp. per common share (Diluted), Per Share Amount | $0.54 | $0.56 |
Commitments_and_Contingencies_
Commitments and Contingencies (Details) (USD $) | 3 Months Ended |
Mar. 31, 2014 | |
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 $) | 3 Months Ended | |
In Thousands, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Cash Paid During The Period For | ' | ' |
Interest | $3,132 | $3,547 |
Income taxes, net of refunds | 65 | 69 |
Noncash Investing and Financing Activities | ' | ' |
Increase (decrease) in accounts payable associated with acquisition of property and equipment | 1,111 | -675 |
Capital lease obligations | $116 | $0 |
Guarantor_Balance_Sheets_Detai
Guarantor (Balance Sheets) (Details) (USD $) | Mar. 31, 2014 | Dec. 31, 2013 | Mar. 31, 2013 | Dec. 31, 2012 |
Assets | ' | ' | ' | ' |
Cash and cash equivalents | $47,116,000 | $50,840,000 | $42,413,000 | $46,398,000 |
Accounts receivable, net | 106,209,000 | 105,072,000 | ' | ' |
Supplies inventory | 18,433,000 | 18,414,000 | ' | ' |
Deferred income taxes | 1,026,000 | 3,097,000 | ' | ' |
Prepaid and other current assets | 37,151,000 | 33,602,000 | ' | ' |
Total current assets | 209,935,000 | 211,025,000 | ' | ' |
Property and equipment, net | 169,006,000 | 169,895,000 | ' | ' |
Investments in unconsolidated affiliates and other | 19,484,000 | 16,392,000 | ' | ' |
Total assets | 2,184,141,000 | 2,177,944,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Current portion of long-term debt | 20,285,000 | 20,844,000 | ' | ' |
Total current liabilities | 84,249,000 | 89,870,000 | ' | ' |
Long-term debt | 564,937,000 | 583,298,000 | ' | ' |
Deferred income taxes | 185,882,000 | 176,020,000 | ' | ' |
Other long-term liabilities | 25,753,000 | 25,503,000 | ' | ' |
Noncontrolling interests - redeemable | 177,683,000 | 177,697,000 | ' | ' |
Equity: | ' | ' | ' | ' |
Total AmSurg Corp. equity | 782,413,000 | 764,197,000 | ' | ' |
Noncontrolling interests - non-redeemable | 363,224,000 | 361,359,000 | ' | ' |
Total equity | 1,145,637,000 | 1,125,556,000 | ' | ' |
Total liabilities and equity | 2,184,141,000 | 2,177,944,000 | ' | ' |
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 | -4,817,000 | -4,362,000 | ' | ' |
Total current assets | -4,817,000 | -4,362,000 | ' | ' |
Property and equipment, net | 0 | 0 | ' | ' |
Investments in unconsolidated affiliates and other | -2,928,336,000 | -2,922,178,000 | ' | ' |
Goodwill and other intangible assets, net | 1,764,622,000 | 1,758,970,000 | ' | ' |
Total assets | -1,168,531,000 | -1,167,570,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Current portion of long-term debt | 0 | 0 | ' | ' |
Accounts payable | -4,627,000 | -3,958,000 | ' | ' |
Other accrued liabilities | -190,000 | -404,000 | ' | ' |
Total current liabilities | -4,817,000 | -4,362,000 | ' | ' |
Long-term debt | -30,822,000 | -31,377,000 | ' | ' |
Deferred income taxes | 0 | 0 | ' | ' |
Other long-term liabilities | 0 | 0 | ' | ' |
Noncontrolling interests - redeemable | 113,992,000 | 113,993,000 | ' | ' |
Equity: | ' | ' | ' | ' |
Total AmSurg Corp. equity | -1,571,633,000 | -1,568,267,000 | ' | ' |
Noncontrolling interests - non-redeemable | 324,749,000 | 322,443,000 | ' | ' |
Total equity | -1,246,884,000 | -1,245,824,000 | ' | ' |
Total liabilities and equity | -1,168,531,000 | -1,167,570,000 | ' | ' |
Parent Company [Member] | ' | ' | ' | ' |
Assets | ' | ' | ' | ' |
Cash and cash equivalents | 5,562,000 | 6,710,000 | 4,763,000 | 7,259,000 |
Accounts receivable, net | 0 | 0 | ' | ' |
Supplies inventory | 52,000 | 33,000 | ' | ' |
Deferred income taxes | 1,026,000 | 3,097,000 | ' | ' |
Prepaid and other current assets | 28,618,000 | 23,993,000 | ' | ' |
Total current assets | 35,258,000 | 33,833,000 | ' | ' |
Property and equipment, net | 10,129,000 | 9,829,000 | ' | ' |
Investments in unconsolidated affiliates and other | 1,489,635,000 | 1,484,974,000 | ' | ' |
Goodwill and other intangible assets, net | 20,185,000 | 20,684,000 | ' | ' |
Total assets | 1,555,207,000 | 1,549,320,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Current portion of long-term debt | 10,714,000 | 10,714,000 | ' | ' |
Accounts payable | 1,014,000 | 1,972,000 | ' | ' |
Other accrued liabilities | 24,092,000 | 27,419,000 | ' | ' |
Total current liabilities | 35,820,000 | 40,105,000 | ' | ' |
Long-term debt | 543,750,000 | 561,429,000 | ' | ' |
Deferred income taxes | 185,882,000 | 176,020,000 | ' | ' |
Other long-term liabilities | 7,342,000 | 7,569,000 | ' | ' |
Noncontrolling interests - redeemable | 0 | 0 | ' | ' |
Equity: | ' | ' | ' | ' |
Total AmSurg Corp. equity | 782,413,000 | 764,197,000 | ' | ' |
Noncontrolling interests - non-redeemable | 0 | 0 | ' | ' |
Total equity | 782,413,000 | 764,197,000 | ' | ' |
Total liabilities and equity | 1,555,207,000 | 1,549,320,000 | ' | ' |
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 other | 1,458,185,000 | 1,453,596,000 | ' | ' |
Goodwill and other intangible assets, net | 0 | 0 | ' | ' |
Total assets | 1,458,185,000 | 1,453,596,000 | ' | ' |
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 | 1,458,185,000 | 1,453,596,000 | ' | ' |
Noncontrolling interests - non-redeemable | 0 | 0 | ' | ' |
Total equity | 1,458,185,000 | 1,453,596,000 | ' | ' |
Total liabilities and equity | 1,458,185,000 | 1,453,596,000 | ' | ' |
Non-Guarantor Subsidiaries [Member] | ' | ' | ' | ' |
Assets | ' | ' | ' | ' |
Cash and cash equivalents | 41,554,000 | 44,130,000 | 37,650,000 | 39,139,000 |
Accounts receivable, net | 106,209,000 | 105,072,000 | ' | ' |
Supplies inventory | 18,381,000 | 18,381,000 | ' | ' |
Deferred income taxes | 0 | 0 | ' | ' |
Prepaid and other current assets | 13,350,000 | 13,971,000 | ' | ' |
Total current assets | 179,494,000 | 181,554,000 | ' | ' |
Property and equipment, net | 158,877,000 | 160,066,000 | ' | ' |
Investments in unconsolidated affiliates and other | 0 | 0 | ' | ' |
Goodwill and other intangible assets, net | 909,000 | 978,000 | ' | ' |
Total assets | 339,280,000 | 342,598,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Current portion of long-term debt | 9,571,000 | 10,130,000 | ' | ' |
Accounts payable | 28,972,000 | 29,487,000 | ' | ' |
Other accrued liabilities | 14,703,000 | 14,510,000 | ' | ' |
Total current liabilities | 53,246,000 | 54,127,000 | ' | ' |
Long-term debt | 52,009,000 | 53,246,000 | ' | ' |
Deferred income taxes | 0 | 0 | ' | ' |
Other long-term liabilities | 18,411,000 | 17,934,000 | ' | ' |
Noncontrolling interests - redeemable | 63,691,000 | 63,704,000 | ' | ' |
Equity: | ' | ' | ' | ' |
Total AmSurg Corp. equity | 113,448,000 | 114,671,000 | ' | ' |
Noncontrolling interests - non-redeemable | 38,475,000 | 38,916,000 | ' | ' |
Total equity | 151,923,000 | 153,587,000 | ' | ' |
Total liabilities and equity | 339,280,000 | 342,598,000 | ' | ' |
Consolidated Entities [Member] | ' | ' | ' | ' |
Assets | ' | ' | ' | ' |
Goodwill and other intangible assets, net | 1,785,716,000 | 1,780,632,000 | ' | ' |
Liabilities and Equity | ' | ' | ' | ' |
Accounts payable | 25,359,000 | 27,501,000 | ' | ' |
Other accrued liabilities | $38,605,000 | $41,525,000 | ' | ' |
Guarantor_Income_Statements_De
Guarantor (Income Statements) (Details) (USD $) | 3 Months Ended | |
In Thousands, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Condensed Financial Statements, Captions [Line Items] | ' | ' |
Revenues | $263,107 | $258,189 |
Operating expenses: | ' | ' |
Salaries and benefits | 83,194 | 80,958 |
Supply cost | 38,720 | 37,213 |
Other operating expenses | 55,269 | 52,727 |
Depreciation and amortization | 8,374 | 8,008 |
Total operating expenses | 185,557 | 178,906 |
Gain (loss) on deconsolidation | 2,045 | 2,237 |
Equity in earnings of unconsolidated affiliates | 764 | 402 |
Operating income | 80,359 | 81,922 |
Interest expense | 6,963 | 7,542 |
Earnings from continuing operations before income taxes | 73,396 | 74,380 |
Income tax expense | 13,057 | 12,269 |
Net earnings from continuing operations | 60,339 | 62,111 |
Net earnings (loss) from discontinued operations | -225 | 162 |
Net earnings (loss) | 60,114 | 62,273 |
Less net earnings and comprehensive income attributable to noncontrolling interests: | ' | ' |
Net earnings from continuing operations | 42,835 | 44,361 |
Net earnings (loss) from discontinued operations | 84 | 101 |
Total net earnings attributable to noncontrolling interests | 42,919 | 44,462 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 17,195 | 17,811 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' |
Earnings from continuing operations, net of income tax | 17,504 | 17,750 |
Discontinued operations, net of income tax, attributable to AmSurg Corp. | -309 | 61 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 17,195 | 17,811 |
Consolidation, Eliminations [Member] | ' | ' |
Condensed Financial Statements, Captions [Line Items] | ' | ' |
Revenues | -4,609 | -4,238 |
Operating expenses: | ' | ' |
Salaries and benefits | -121 | -113 |
Supply cost | 0 | 0 |
Other operating expenses | -4,488 | -4,125 |
Depreciation and amortization | 0 | 0 |
Total operating expenses | -4,609 | -4,238 |
Gain (loss) on deconsolidation | -2,045 | -2,237 |
Equity in earnings of unconsolidated affiliates | -95,340 | -99,508 |
Operating income | -97,385 | -101,745 |
Interest expense | 0 | 0 |
Earnings from continuing operations before income taxes | -97,385 | -101,745 |
Income tax expense | 0 | 0 |
Net earnings from continuing operations | -97,385 | -101,745 |
Net earnings (loss) from discontinued operations | 0 | 0 |
Net earnings (loss) | -97,385 | -101,745 |
Less net earnings and comprehensive income attributable to noncontrolling interests: | ' | ' |
Net earnings from continuing operations | 0 | 0 |
Net earnings (loss) from discontinued operations | 0 | 0 |
Total net earnings attributable to noncontrolling interests | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | -97,385 | -101,745 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' |
Earnings from continuing operations, net of income tax | -97,385 | -101,745 |
Discontinued operations, net of income tax, attributable to AmSurg Corp. | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | -97,385 | -101,745 |
Parent Company [Member] | ' | ' |
Condensed Financial Statements, Captions [Line Items] | ' | ' |
Revenues | 6,127 | 5,716 |
Operating expenses: | ' | ' |
Salaries and benefits | 14,485 | 15,421 |
Supply cost | 0 | 0 |
Other operating expenses | 4,166 | 5,060 |
Depreciation and amortization | 825 | 772 |
Total operating expenses | 19,476 | 21,253 |
Gain (loss) on deconsolidation | 2,045 | 2,237 |
Equity in earnings of unconsolidated affiliates | 48,052 | 49,955 |
Operating income | 36,748 | 36,655 |
Interest expense | 6,452 | 6,923 |
Earnings from continuing operations before income taxes | 30,296 | 29,732 |
Income tax expense | 12,704 | 11,877 |
Net earnings from continuing operations | 17,592 | 17,855 |
Net earnings (loss) from discontinued operations | -397 | -44 |
Net earnings (loss) | 17,195 | 17,811 |
Less net earnings and comprehensive income attributable to noncontrolling interests: | ' | ' |
Net earnings from continuing operations | 0 | 0 |
Net earnings (loss) from discontinued operations | 0 | 0 |
Total net earnings attributable to noncontrolling interests | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 17,195 | 17,811 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' |
Earnings from continuing operations, net of income tax | 17,592 | 17,855 |
Discontinued operations, net of income tax, attributable to AmSurg Corp. | -397 | -44 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 17,195 | 17,811 |
Guarantor Subsidiaries [Member] | ' | ' |
Condensed Financial Statements, Captions [Line Items] | ' | ' |
Revenues | 0 | 0 |
Operating expenses: | ' | ' |
Salaries and benefits | 0 | 0 |
Supply cost | 0 | 0 |
Other operating expenses | 0 | 0 |
Depreciation and amortization | 0 | 0 |
Total operating expenses | 0 | 0 |
Gain (loss) on deconsolidation | 2,045 | 2,237 |
Equity in earnings of unconsolidated affiliates | 48,052 | 49,955 |
Operating income | 50,097 | 52,192 |
Interest expense | 0 | 0 |
Earnings from continuing operations before income taxes | 50,097 | 52,192 |
Income tax expense | 0 | 0 |
Net earnings from continuing operations | 50,097 | 52,192 |
Net earnings (loss) from discontinued operations | 0 | 0 |
Net earnings (loss) | 50,097 | 52,192 |
Less net earnings and comprehensive income attributable to noncontrolling interests: | ' | ' |
Net earnings from continuing operations | 0 | 0 |
Net earnings (loss) from discontinued operations | 0 | 0 |
Total net earnings attributable to noncontrolling interests | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 50,097 | 52,192 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' |
Earnings from continuing operations, net of income tax | 50,097 | 52,192 |
Discontinued operations, net of income tax, attributable to AmSurg Corp. | 0 | 0 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 50,097 | 52,192 |
Non-Guarantor Subsidiaries [Member] | ' | ' |
Condensed Financial Statements, Captions [Line Items] | ' | ' |
Revenues | 261,589 | 256,711 |
Operating expenses: | ' | ' |
Salaries and benefits | 68,830 | 65,650 |
Supply cost | 38,720 | 37,213 |
Other operating expenses | 55,591 | 51,792 |
Depreciation and amortization | 7,549 | 7,236 |
Total operating expenses | 170,690 | 161,891 |
Gain (loss) on deconsolidation | 0 | 0 |
Equity in earnings of unconsolidated affiliates | 0 | 0 |
Operating income | 90,899 | 94,820 |
Interest expense | 511 | 619 |
Earnings from continuing operations before income taxes | 90,388 | 94,201 |
Income tax expense | 353 | 392 |
Net earnings from continuing operations | 90,035 | 93,809 |
Net earnings (loss) from discontinued operations | 172 | 206 |
Net earnings (loss) | 90,207 | 94,015 |
Less net earnings and comprehensive income attributable to noncontrolling interests: | ' | ' |
Net earnings from continuing operations | 42,835 | 44,361 |
Net earnings (loss) from discontinued operations | 84 | 101 |
Total net earnings attributable to noncontrolling interests | 42,919 | 44,462 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | 47,288 | 49,553 |
Amounts attributable to AmSurg Corp. common shareholders: | ' | ' |
Earnings from continuing operations, net of income tax | 47,200 | 49,448 |
Discontinued operations, net of income tax, attributable to AmSurg Corp. | 88 | 105 |
Net earnings (loss) attributable to AmSurg Corp. common shareholders | $47,288 | $49,553 |
Guarantor_Cash_Flow_Statements
Guarantor (Cash Flow Statements) (Details) (USD $) | 3 Months Ended | |
In Thousands, unless otherwise specified | Mar. 31, 2014 | Mar. 31, 2013 |
Cash flows from operating activities: | ' | ' |
Net cash flows provided by operating activities | $69,819 | $73,865 |
Cash flows from investing activities: | ' | ' |
Acquisition of interests in surgery centers and related transactions | -5,038 | -252 |
Acquisition of property and equipment | -7,038 | -6,110 |
Proceeds from sale of interests in surgery centers | 1,111 | 0 |
Other | -418 | 0 |
Net cash flows used in investing activities | -11,383 | -6,362 |
Cash flows from financing activities: | ' | ' |
Proceeds from long-term borrowings | 31,945 | 30,870 |
Repayment on long-term borrowings | -50,853 | -48,211 |
Distributions to noncontrolling interests | -43,194 | -43,914 |
Net cash flows provided by (used in) financing activities | -62,160 | -71,488 |
Net increase (decrease) in cash and cash equivalents | -3,724 | -3,985 |
Cash and cash equivalents, beginning of period | 50,840 | 46,398 |
Cash and cash equivalents, end of period | 47,116 | 42,413 |
Consolidation, Eliminations [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net cash flows provided by operating activities | -93,016 | -99,063 |
Cash flows from investing activities: | ' | ' |
Acquisition of interests in surgery centers and related transactions | 44 | -10 |
Acquisition of property and equipment | 0 | 0 |
Proceeds from sale of interests in surgery centers | 0 | 0 |
Other | 0 | 0 |
Net cash flows used in investing activities | 44 | -10 |
Cash flows from financing activities: | ' | ' |
Proceeds from long-term borrowings | 0 | 0 |
Repayment on long-term borrowings | 0 | 0 |
Distributions to noncontrolling interests | 93,016 | 99,063 |
Capital contributions | 0 | ' |
Changes In Intercompany Balances | 0 | 0 |
Other financing activities, net | -44 | 10 |
Net cash flows provided by (used in) financing activities | 92,972 | 99,073 |
Net increase (decrease) in cash and cash equivalents | 0 | 0 |
Cash and cash equivalents, beginning of period | 0 | 0 |
Cash and cash equivalents, end of period | 0 | 0 |
Parent Company [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net cash flows provided by operating activities | 18,482 | 23,940 |
Cash flows from investing activities: | ' | ' |
Acquisition of interests in surgery centers and related transactions | 0 | 0 |
Acquisition of property and equipment | -1,237 | -853 |
Proceeds from sale of interests in surgery centers | 0 | 0 |
Other | -629 | 0 |
Net cash flows used in investing activities | -1,866 | -853 |
Cash flows from financing activities: | ' | ' |
Proceeds from long-term borrowings | 30,000 | 29,700 |
Repayment on long-term borrowings | -47,679 | -45,024 |
Distributions to noncontrolling interests | 0 | 0 |
Capital contributions | 0 | ' |
Changes In Intercompany Balances | 556 | 533 |
Other financing activities, net | -641 | -10,792 |
Net cash flows provided by (used in) financing activities | -17,764 | -25,583 |
Net increase (decrease) in cash and cash equivalents | -1,148 | -2,496 |
Cash and cash equivalents, beginning of period | 6,710 | 7,259 |
Cash and cash equivalents, end of period | 5,562 | 4,763 |
Guarantor Subsidiaries [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net cash flows provided by operating activities | 48,096 | 49,577 |
Cash flows from investing activities: | ' | ' |
Acquisition of interests in surgery centers and related transactions | -5,082 | -242 |
Acquisition of property and equipment | 0 | 0 |
Proceeds from sale of interests in surgery centers | 1,111 | 0 |
Other | 211 | 0 |
Net cash flows used in investing activities | -3,760 | -242 |
Cash flows from financing activities: | ' | ' |
Proceeds from long-term borrowings | 0 | 0 |
Repayment on long-term borrowings | 0 | 0 |
Distributions to noncontrolling interests | -44,920 | -49,486 |
Capital contributions | 0 | ' |
Changes In Intercompany Balances | 0 | 0 |
Other financing activities, net | 584 | 151 |
Net cash flows provided by (used in) financing activities | -44,336 | -49,335 |
Net increase (decrease) in cash and cash equivalents | 0 | 0 |
Cash and cash equivalents, beginning of period | 0 | 0 |
Cash and cash equivalents, end of period | 0 | 0 |
Non-Guarantor Subsidiaries [Member] | ' | ' |
Cash flows from operating activities: | ' | ' |
Net cash flows provided by operating activities | 96,257 | 99,411 |
Cash flows from investing activities: | ' | ' |
Acquisition of interests in surgery centers and related transactions | 0 | 0 |
Acquisition of property and equipment | -5,801 | -5,257 |
Proceeds from sale of interests in surgery centers | 0 | 0 |
Other | 0 | 0 |
Net cash flows used in investing activities | -5,801 | -5,257 |
Cash flows from financing activities: | ' | ' |
Proceeds from long-term borrowings | 1,945 | 1,170 |
Repayment on long-term borrowings | -3,174 | -3,187 |
Distributions to noncontrolling interests | -91,290 | -93,491 |
Capital contributions | 0 | ' |
Changes In Intercompany Balances | -556 | -533 |
Other financing activities, net | 43 | 398 |
Net cash flows provided by (used in) financing activities | -93,032 | -95,643 |
Net increase (decrease) in cash and cash equivalents | -2,576 | -1,489 |
Cash and cash equivalents, beginning of period | 44,130 | 39,139 |
Cash and cash equivalents, end of period | 41,554 | 37,650 |
Consolidated Entities [Member] | ' | ' |
Cash flows from financing activities: | ' | ' |
Changes In Intercompany Balances | 0 | 0 |
Other financing activities, net | ($58) | ($10,233) |