Document and Entity Information
Document and Entity Information - shares | 6 Months Ended | |
Jun. 30, 2018 | Jul. 27, 2018 | |
Document And Entity Information [Abstract] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Jun. 30, 2018 | |
Document Fiscal Year Focus | 2,018 | |
Document Fiscal Period Focus | Q2 | |
Trading Symbol | AMED | |
Entity Registrant Name | AMEDISYS INC | |
Entity Central Index Key | 896,262 | |
Current Fiscal Year End Date | --12-31 | |
Entity Filer Category | Large Accelerated Filer | |
Entity Common Stock, Shares Outstanding | 31,836,002 |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Current assets: | ||
Cash and cash equivalents | $ 25,904 | $ 86,363 |
Patient accounts receivable | 197,592 | 201,196 |
Prepaid expenses | 10,493 | 7,329 |
Other current assets | 24,784 | 16,268 |
Total current assets | 258,773 | 311,156 |
Property and equipment, net of accumulated depreciation of $101,128 and $146,814 | 27,998 | 31,122 |
Goodwill | 324,145 | 319,949 |
Intangible assets, net of accumulated amortization of $31,864 and $30,610 | 44,888 | 46,061 |
Deferred income taxes | 46,919 | 56,064 |
Other assets, net | 50,601 | 49,130 |
Total assets | 753,324 | 813,482 |
Current liabilities: | ||
Accounts payable | 29,810 | 25,384 |
Payroll and employee benefits | 87,239 | 89,936 |
Accrued expenses | 96,472 | 89,104 |
Current portion of long-term obligations | 668 | 10,638 |
Total current liabilities | 214,189 | 215,062 |
Long-term obligations, less current portion | 123,937 | 78,203 |
Other long-term obligations | 6,137 | 3,791 |
Total liabilities | 344,263 | 297,056 |
Commitments and Contingencies—Note 5 | ||
Equity: | ||
Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding | 0 | 0 |
Common stock, $0.001 par value, 60,000,000 shares authorized; 36,044,177 and 35,747,134 shares issued; and 31,801,357 and 33,964,767 shares outstanding | 36 | 35 |
Additional paid-in capital | 585,137 | 568,780 |
Treasury stock, at cost 4,242,820 and 1,782,367 shares of common stock | (237,947) | (53,713) |
Accumulated other comprehensive income | 15 | 15 |
Retained earnings | 60,712 | 204 |
Total Amedisys, Inc. stockholders’ equity | 407,953 | 515,321 |
Noncontrolling interests | 1,108 | 1,105 |
Total equity | 409,061 | 516,426 |
Total liabilities and equity | $ 753,324 | $ 813,482 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Statement of Financial Position [Abstract] | ||
Property and equipment, accumulated depreciation | $ 101,128 | $ 146,814 |
Intangible assets, accumulated amortization | $ 31,864 | $ 30,610 |
Preferred stock, par value (usd per share) | $ 0.001 | $ 0.001 |
Preferred stock, authorized (shares) | 5,000,000 | 5,000,000 |
Preferred stock, issued (shares) | 0 | 0 |
Preferred stock, outstanding (shares) | 0 | 0 |
Common stock, par value (usd per share) | $ 0.001 | $ 0.001 |
Common stock, authorized (shares) | 60,000,000 | 60,000,000 |
Common stock, issued (shares) | 36,044,177 | 35,747,134 |
Common stock, outstanding (shares) | 31,801,357 | 33,964,767 |
Treasury stock at cost (shares) | 4,242,820 | 1,782,367 |
CONSOLIDATED STATEMENTS OF OPER
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Income Statement [Abstract] | ||||
Net service revenue | $ 411,603 | $ 374,946 | $ 810,865 | $ 739,607 |
Cost of service, excluding depreciation and amortization | 242,564 | 220,541 | 480,873 | 436,870 |
General and administrative expenses: | ||||
Salaries and benefits | 77,215 | 74,943 | 152,846 | 149,402 |
Non-cash compensation | 3,767 | 4,356 | 7,811 | 8,230 |
Other | 42,104 | 41,617 | 83,784 | 82,034 |
Depreciation and amortization | 3,125 | 4,537 | 6,718 | 8,954 |
Securities Class Action Lawsuit settlement, net | 0 | 28,712 | 0 | 28,712 |
Operating expenses | 368,775 | 374,706 | 732,032 | 714,202 |
Operating income | 42,828 | 240 | 78,833 | 25,405 |
Other income (expense): | ||||
Interest income | 114 | 41 | 234 | 60 |
Interest expense | (2,140) | (1,197) | (3,843) | (2,265) |
Equity in earnings from equity method investments | 2,976 | 2,355 | 4,836 | 2,249 |
Miscellaneous, net | 359 | 1,127 | 960 | 2,239 |
Total other income, net | 1,309 | 2,326 | 2,187 | 2,283 |
Income before income taxes | 44,137 | 2,566 | 81,020 | 27,688 |
Income tax (expense) benefit | (10,596) | 1,963 | (20,159) | (7,960) |
Net income | 33,541 | 4,529 | 60,861 | 19,728 |
Net income attributable to noncontrolling interests | (192) | (68) | (353) | (137) |
Net income attributable to Amedisys, Inc. | $ 33,349 | $ 4,461 | $ 60,508 | $ 19,591 |
Basic earnings per common share: | ||||
Net income attributable to Amedisys, Inc. common stockholders, basic (usd per share) | $ 1 | $ 0.13 | $ 1.80 | $ 0.58 |
Weighted average shares outstanding, basic (shares) | 33,439 | 33,637 | 33,705 | 33,540 |
Diluted earnings per common share: | ||||
Net income attributable to Amedisys, Inc. common stockholders, diluted (usd per share) | $ 0.98 | $ 0.13 | $ 1.76 | $ 0.57 |
Weighted average shares outstanding, diluted (shares) | 34,179 | 34,329 | 34,391 | 34,203 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands | 6 Months Ended | |
Jun. 30, 2018 | Jun. 30, 2017 | |
Cash Flows from Operating Activities: | ||
Net income | $ 60,861 | $ 19,728 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Depreciation and amortization | 6,718 | 8,954 |
Non-cash compensation | 7,811 | 8,230 |
401(k) employer match | 4,894 | 4,367 |
Loss on disposal of property and equipment | 650 | 147 |
Deferred income taxes | 9,145 | 7,582 |
Equity in earnings from equity method investments | (4,836) | (2,249) |
Amortization of deferred debt issuance costs | 355 | 370 |
Write off of deferred debt issuance costs | 38 | 0 |
Return on equity investment | 2,204 | 3,416 |
Changes in operating assets and liabilities, net of impact of acquisitions: | ||
Patient accounts receivable | 3,604 | (6,833) |
Other current assets | (11,680) | (6,892) |
Other assets | 688 | (1,148) |
Accounts payable | 3,623 | 1,093 |
Securities Class Action Lawsuit settlement accrual, net | 0 | 28,712 |
Accrued expenses | 4,548 | (2,743) |
Other long-term obligations | 2,347 | 607 |
Net cash provided by operating activities | 90,970 | 63,341 |
Cash Flows from Investing Activities: | ||
Proceeds from sale of deferred compensation plan assets | 471 | 565 |
Proceeds from the sale of property and equipment | 11 | 0 |
Purchase of investment | 0 | (436) |
Purchases of property and equipment | (1,611) | (7,449) |
Acquisitions of businesses, net of cash acquired | (4,074) | (24,128) |
Net cash used in investing activities | (5,203) | (31,448) |
Cash Flows from Financing Activities: | ||
Proceeds from issuance of stock upon exercise of stock options and warrants | 2,609 | 4,203 |
Proceeds from issuance of stock to employee stock purchase plan | 1,157 | 1,187 |
Shares withheld upon stock vesting | (2,832) | (5,726) |
Non-controlling interest distribution | (350) | (90) |
Proceeds from borrowings under revolving line of credit | 127,500 | 0 |
Principal payments of long-term obligations | (90,475) | (2,500) |
Debt issuance costs | (2,433) | 0 |
Purchase of company stock | (181,402) | 0 |
Net cash used in financing activities | (146,226) | (2,926) |
Net (decrease) increase in cash and cash equivalents | (60,459) | 28,967 |
Cash and cash equivalents at beginning of period | 86,363 | 30,197 |
Cash and cash equivalents at end of period | 25,904 | 59,164 |
Supplemental Disclosures of Cash Flow Information: | ||
Cash paid for interest | 2,080 | 1,172 |
Cash paid for income taxes, net of refunds received | $ 6,149 | $ 284 |
NATURE OF OPERATIONS, CONSOLIDA
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS | 6 Months Ended |
Jun. 30, 2018 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS | NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS Amedisys, Inc., a Delaware corporation, (together with its consolidated subsidiaries, referred to herein as “Amedisys,” “we,” “us,” or “our”) is a multi-state provider of home health, hospice and personal care services with approximately 74% of our revenue derived from Medicare for the three and six -month periods ended June 30, 2018 and approximately 76% of our revenue derived from Medicare for the three and six -month periods ended June 30, 2017 . As of June 30, 2018 , we owned and operated 322 Medicare-certified home health care centers, 83 Medicare-certified hospice care centers and 15 personal-care care centers in 34 states within the United States and the District of Columbia. Basis of Presentation In our opinion, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations, and our cash flows in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial reporting. Our results of operations for the interim periods presented are not necessarily indicative of results of our operations for the entire year and have not been audited by our independent auditors. This report should be read in conjunction with our consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2017 , as filed with the Securities and Exchange Commission (“SEC”) on February 28, 2018 (the “Form 10-K”), which includes information and disclosures not included herein. Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented, as allowed by such SEC rules and regulations. Recently Adopted Accounting Pronouncements On January 1, 2018, the Company adopted Accounting Standards Update (“ASU”) 2014-09, Revenue from Contracts with Customers (Topic 606) and ASU 2015-14, Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date (collectively, “ASC 606”), the new accounting standards issued by the Financial Accounting Standards Board (“FASB”) on revenue recognition, using the full retrospective method. ASC 606 outlines a single comprehensive model to use in accounting for revenue arising from contracts with customers. The standards supersede existing revenue recognition requirements and eliminate most industry-specific guidance from U.S. GAAP. The core principle of the revenue recognition standard is to require an entity to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which it expects to be entitled in exchange for those goods or services. As a result of the Company's adoption of ASC 606, the revenue and related estimated uncollectible amounts owed to us by non-Medicare payors that were historically classified as a provision for doubtful accounts are now considered an implicit price concession in determining net service revenue. Accordingly, the Company reports uncollectible balances due from third-party payors and uncollectible balances associated with patient responsibility as a reduction of the transaction price and therefore, as a reduction in net service revenue (or as it relates to Hospice room and board, an increase in cost of service, excluding depreciation and amortization) when historically these amounts were classified as a provision for doubtful accounts within operating expenses within our condensed consolidated statements of operations. In addition, the adoption of ASC 606 resulted in increased disclosure, including qualitative and quantitative disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers. In August 2016, the FASB issued ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments , which provides specific guidance on eight cash flow classification issues not specifically addressed by U.S. GAAP. The ASU is effective for annual and interim periods beginning after December 15, 2017. The standard should be applied using a retrospective transition method unless it is impractical to do so for some of the issues. In such case, the amendments for those issues would be applied prospectively as of the earliest date practicable. Our adoption of this standard on January 1, 2018, using a retrospective transition method for each period presented, did not have an effect on our condensed consolidated financial statements. In January 2017, the FASB issued ASU 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business , which provides guidance to assist entities with evaluating whether transactions should be accounted for as an acquisition (or disposal) of assets or a business. The ASU is effective for annual and interim periods beginning after December 15, 2017. We adopted this ASU effective January 1, 2018, on a prospective basis. The impact on our consolidated financial statements and related disclosures will depend on the facts and circumstances of any specific future transactions as evaluated under the new framework. In January 2017, the FASB issued ASU 2017-04, Intangibles—Goodwill and Other (Topic 350)—Simplifying the Test for Goodwill Impairment , which eliminates the requirement to calculate the implied fair value of goodwill to measure a goodwill impairment charge (Step 2 of the goodwill impairment test). Instead, impairment will be measured using the difference between the carrying amount and the fair value of the reporting unit. The ASU is effective for annual and interim periods beginning after December 15, 2019. Early adoption is permitted. We adopted this ASU effective January 1, 2018, on a prospective basis and will apply this guidance to our future tests of goodwill impairment. Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) , which will require lessees to recognize a lease liability and right-of-use asset for all leases (with the exception of short-term leases) at the commencement date. The ASU is effective for annual and interim periods beginning on or after December 15, 2018. Early adoption is permitted. The standard requires a modified retrospective transition method which requires recognition and disclosure under the new guidance for all periods presented. While the Company expects adoption of this standard to lead to a material increase in the assets and liabilities recorded on our balance sheet, we are still evaluating the overall impact on our consolidated financial statements and related disclosures and the effect of the standard on our ongoing financial reporting. Use of Estimates Our accounting and reporting policies conform with U.S. GAAP. In preparing the unaudited condensed consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the condensed consolidated financial statements and accompanying notes. Actual results could differ from those estimates. Reclassifications and Comparability Certain reclassifications have been made to prior periods’ financial statements in order to conform to the current period’s presentation. Effective January 1, 2018, we adopted ASC 606 on a full retrospective basis which required the reclassification of certain previously reported results. See Note 2 - Summary of Significant Accounting Policies for further details on the impact of the adoption of ASC 606. Principles of Consolidation These unaudited condensed consolidated financial statements include the accounts of Amedisys, Inc., and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying unaudited condensed consolidated financial statements, and business combinations accounted for as purchases have been included in our unaudited condensed consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain equity investments that are accounted for as set forth below. Equity Investments We consolidate investments when the entity is a variable interest entity and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50% . Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our condensed consolidated financial statements. We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a variable interest entity in which we are the primary beneficiary. The book value of investments that we accounted for under the equity method of accounting was $29.0 million and $26.4 million as of June 30, 2018 and December 31, 2017 , respectively. We account for investments in entities in which we have less than a 20% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. |
SUMMARY OF SIGNIFICANT ACCOUNTI
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES | 6 Months Ended |
Jun. 30, 2018 | |
Accounting Policies [Abstract] | |
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES | SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Revenue Recognition Our adoption of ASC 606 on January 1, 2018, on a full retrospective basis, impacted the Company's previously reported results as follows (amounts in thousands, unaudited): As Previously Reported Adjustment for the Adoption of ASC 606 As Adjusted As of December 31, 2017 Condensed Consolidated Balance Sheets Patient accounts receivable $ 201,196 $ — $ 201,196 Allowance for doubtful accounts $ 20,866 $ 20,866 $ — For the three-month period ended June 30, 2017 Condensed Consolidated Statements of Operations Net service revenue $ 378,821 $ (3,875 ) $ 374,946 Cost of service, excluding depreciation and amortization $ 219,765 $ 776 $ 220,541 Provision for doubtful accounts $ 4,651 $ (4,651 ) $ — Net income attributable to Amedisys, Inc. $ 4,461 $ — $ 4,461 For the six-month period ended June 30, 2017 Condensed Consolidated Statements of Operations Net service revenue $ 749,279 $ (9,672 ) $ 739,607 Cost of service, excluding depreciation and amortization $ 435,550 $ 1,320 $ 436,870 Provision for doubtful accounts $ 10,992 $ (10,992 ) $ — Net income attributable to Amedisys, Inc. $ 19,591 $ — $ 19,591 Condensed Consolidated Statements of Cash Flows Provision for doubtful accounts $ 10,992 $ (10,992 ) $ — Changes in operating assets and liabilities, net of impact of acquisitions: Patient accounts receivable $ (17,825 ) $ 10,992 $ (6,833 ) We earn net service revenue through our home health, hospice and personal care segments through the delivery of a variety of services that best suit our patients' needs, whether that is home-based recovery and rehabilitation after an operation or injury, care that empowers patients to manage a chronic disease, hospice care at the end of life, or providing assistance with daily activities through our personal care segment. We account for revenue from contracts with customers in accordance with ASC 606, and as such, we recognize revenue in the period in which we satisfy our performance obligations under our contracts by transferring our promised services to our customers, in amounts that reflect the consideration to which we expect to be entitled in exchange for providing patient care, which are the transaction prices allocated to the distinct services. The Company's cost of obtaining contracts is not material. Revenues are recognized as performance obligations are satisfied, which varies based on the nature of the services provided. Our performance obligation is the delivery of patient care services in accordance with the nature and frequency of services outlined in physicians' orders, which are determined by a physician based on a patient's specific goals. The Company's performance obligations relate to contracts with a duration of less than one year; therefore, the Company has elected to apply the optional exemption provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied as of the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period. We determine the transaction price based on gross charges for services provided, reduced by contractual adjustments provided to third-party payors and estimates of implicit price concessions provided to self-pay or uninsured patients or other payors. The Company assesses the patient's ability to pay for their healthcare services at the time of patient admission based on the Company's verification of the patient's insurance coverage under Medicare, Medicaid, and other commercial or managed care insurance programs. Medicare contributes to approximately 74% of the Company's consolidated net service revenue. We determine our estimates of contractual adjustments and implicit price concessions by major payor class based on contractual agreements with individual third-party payors, our historical collection experience, aged accounts receivable by payor and current economic conditions. The implicit price concession included in estimating the transaction price represents the difference between amounts billed and amounts we expect to collect based on our collection history with similar payors. Subsequent changes to the estimate of the transaction price are recorded as adjustments to net service revenue in the period of change. Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay (i.e. change in credit risk) are recorded as a provision for doubtful accounts. We record our service revenue net of estimated revenue adjustments related to third-party payor payment reviews to reflect amounts we estimate to be realizable for services provided. Amounts due from third-party payors, primarily commercial health insurers and government programs (Medicare and Medicaid), include variable consideration for retroactive revenue adjustments due to settlements of audits and reviews. We make estimates for these revenue adjustments based on our historical experience and success rates in the claim appeals and adjudication process. Home Health Revenue Recognition Medicare Revenue Net service revenue is recorded under the Medicare prospective payment system (“PPS”) based on an established Federal Medicare home health episode payment rate, that is subject to adjustment based on certain variables, including, but not limited to (a) an outlier payment if our patient’s care was unusually costly (capped at 10% of total reimbursement per provider number); (b) a low utilization payment adjustment (“LUPA”) if the number of visits was fewer than five ; (c) a partial payment if our patient transferred to another provider or we received a patient from another provider before completing the episode; (d) a payment adjustment based upon the level of therapy services required (with various incremental adjustments made for additional visits, with larger payment increases associated with the sixth , fourteenth and twentieth visit thresholds); (e) adjustments to payments if we are unable to perform periodic therapy assessments; (f) the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (g) changes in the base episode payments established by the Medicare Program; (h) adjustments to the base episode payments for case mix and geographic wages; and (i) recoveries of overpayments. Medicare rates are based on the severity of the patient's condition, service needs and goals, and other factors relating to the cost of providing services and supplies, bundled into an episode of care, not to exceed 60 days. An episode starts the first day a billable visit is performed and ends 60 days later or upon discharge, if earlier, with multiple continuous episodes allowed. The Medicare home health benefit requires that beneficiaries be homebound (meaning that the beneficiary is unable to leave their home without a considerable and taxing effort), require intermittent skilled nursing, physical therapy or speech therapy services, and receive treatment under a plan of care established and periodically reviewed by a physician. All Medicare contracts are required to have a signed plan of care which represents a single performance obligation, comprising of the delivery of a series of distinct services that are substantially similar and have a similar pattern of transfer to the customer. Accordingly, the Company accounts for the series of services ("episode") as a single performance obligation satisfied over time, as the customer simultaneously receives and consumes the benefits of the goods and services provided. Expected Medicare revenue per episode is recognized based on a pro-rated service output method, utilizing our historical average length of episode prior to discharge. The base episode payment can be adjusted based on each patient's health including clinical condition, functional abilities, and service needs, as well as for the applicable geographic wage index, low utilization, patient transfers and other factors. The services covered by the episode payment include all disciplines of care in addition to medical supplies. Medicare can also make various adjustments to payments received if we are unable to produce appropriate billing documentation or acceptable authorizations. In addition, we make adjustments to Medicare revenue if we find we are unable to obtain appropriate billing documentation, authorizations or face-to-face documentation. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record this estimate during the period in which services are rendered as an estimated price concession and a corresponding reduction to patient accounts receivable. A portion of reimbursement from each Medicare episode is billed near the start of each episode, and cash is typically received before all services are rendered. The amount of revenue recognized for episodes of care which are incomplete at period end is based on the company's average percentage of days complete on episodes as of the end of the year. As of June 30, 2018 and 2017 , the difference between the cash received from Medicare for a request for anticipated payment (“RAP”) on episodes in progress and the associated estimated revenue was immaterial and, therefore, the resulting credits were recorded as a reduction to our outstanding patient accounts receivable in our condensed consolidated balance sheets for such periods. Non-Medicare Revenue Episodic-based Revenue. We recognize revenue in a similar manner as we recognize Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms which generally range from 90% to 100% of Medicare rates. Non-episodic based Revenue. Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates. Contractual adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue. We also make adjustments to non-episodic revenue for any implicit price concessions, based on historical experience, to reflect the estimated transaction price. We receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment. Hospice Revenue Recognition Hospice Medicare Revenue Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are predetermined daily or hourly rates for each of the four levels of care we deliver. The four levels of care are routine care, general inpatient care, continuous home care and respite care. Routine care accounts for 99% of our total net Medicare hospice service revenue for each of the three and six-month periods ended June 30, 2018 , and 99% and 98% of our total net Medicare hospice service revenue for each of the three and six -month periods ended June 30, 2017 , respectively. There are two separate payment rates for routine care: payments for the first 60 days of care and care beyond 60 days. In addition to the two routine rates, we may also receive a service intensity add-on (“SIA”). The SIA is based on visits made in the last seven days of life by a registered nurse (“RN”) or medical social worker (“MSW”) for patients in a routine level of care. The performance obligation is the delivery of hospice services to the patient, as determined by a physician, each day the patient is on hospice care. We make adjustments to Medicare revenue for an inability to obtain appropriate billing documentation or acceptable authorizations and other reasons unrelated to credit risk. We estimate the impact of these adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record it during the period services are rendered as an estimated price concession and as a reduction to our outstanding patient accounts receivable. Additionally, our hospice service revenue is subject to certain limitations on payments from Medicare which are considered variable consideration. We are subject to an inpatient cap limit and an overall Medicare payment cap for each provider number. We monitor these caps on a provider-by-provider basis and estimate amounts due back to Medicare if we estimate a cap has been exceeded. We record these adjustments as a reduction to revenue and an increase in other accrued liabilities. Beginning for the cap year ending October 31, 2017, providers are required to self-report and pay their estimated cap liability by February 28 th of the following year. As of June 30, 2018 , we have settled our Medicare hospice reimbursements for all fiscal years through October 31, 2012. As of June 30, 2018 , we have recorded $1.1 million for estimated amounts due back to Medicare in other accrued liabilities for the Federal cap years ended October 31, 2013 through September 30, 2018. As of December 31, 2017 , we had recorded $0.9 million for estimated amounts due back to Medicare in other accrued liabilities for the Federal cap years ended October 31, 2013 through September 30, 2018. Hospice Non-Medicare Revenue Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per day rates, as applicable. Contractual adjustments are recorded for the difference between our established rates and the amounts estimated to be realizable from patients, third parties and others for services provided and are deducted from gross revenue to determine our net service revenue. We also make adjustments to non-Medicare revenue for any implicit price concessions, based on historical experience, to reflect the estimated transaction price. Personal Care Revenue Recognition Personal Care Revenue We generate net service revenues by providing our services directly to patients based on authorized hours, visits or units determined by the relevant agency, at a rate that is either contractual or fixed by legislation, which are recognized as net service revenue at the time services are rendered. We receive payment for providing such services from payors, including state and local governmental agencies, managed care organizations, commercial insurers and private consumers. Payors include the following elder service agencies: Aging Services Access Points (ASAPs), Senior Care Options (SCOs), Program of All-Inclusive Care for the Elderly (PACE) and the Veterans Administration (VA). Patient Accounts Receivable We report accounts receivable from services rendered at their estimated transaction price, which includes price concessions based on the amounts expected to be due from payors. Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party payors and patients. As of June 30, 2018 , there is only one single payor, other than Medicare, that accounts for more than 10% of our total outstanding patient receivables (approximately 11.8% ). Thus, we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. We believe the collectibility risk associated with our Medicare accounts, which represent 56% and 59% of our patient accounts receivable at June 30, 2018 and December 31, 2017 , respectively, is limited due to our historical collection rate of over 99% from Medicare and the fact that Medicare is a U.S. government payor. Accordingly, we do not record an allowance for doubtful accounts for our Medicare patient accounts receivable, which are recorded at their net realizable value after recording estimated price concessions as discussed above. During the three and six -month periods ended June 30, 2018 , we recorded $2.5 million and $4.2 million , respectively, in estimated revenue adjustments to Medicare revenue as compared to $5.0 million and $8.4 million during the three and six -month periods ended June 30, 2017 , respectively. We do not believe there are any significant concentrations of revenues from any payor that would subject us to any significant credit risk in the collection of our accounts receivable. Medicare Home Health For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for 60% of our estimated payment for the initial episode at the start of care or 50% of the estimated payment for any subsequent episodes of care contiguous with the first episode for a particular patient. The full amount of the episode is billed after the episode has been completed (“final billed”). The RAP received for that particular episode is then deducted from our final payment. If a final bill is not submitted within the greater of 120 days from the start of the episode, or 60 days from the date the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other claims in process for that particular provider number. The RAP and final claim must then be resubmitted. Medicare Hospice For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We bill Medicare on a monthly basis for the services provided to the patient. Non-Medicare Home Health, Hospice and Personal Care For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient’s eligibility for services with the applicable payor. Once the patient has been confirmed for eligibility, we will provide services to the patient and bill the applicable payor. Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular payors or groups of payors with similar characteristics that would subject us to any significant credit risk. Property and Equipment Property and equipment is stated at cost and we depreciate it on a straight-line basis over the estimated useful lives of the assets. Additionally, we have internally developed computer software for our own use. Additions and improvements (including interest costs for construction of qualifying long-lived assets) are capitalized. Maintenance and repair expenses are charged to expense as incurred. The cost of property and equipment sold or disposed of and the related accumulated depreciation are eliminated from the property and related accumulated depreciation accounts, and any gain or loss is credited or charged to other general and administrative expenses. During the six-month period ended June 30, 2018 , we reviewed the balances of our property and equipment and as a result, eliminated those asset balances for which the asset was no longer in service. The following table summarizes the balances related to our property and equipment for the periods indicated (amounts in millions): As of June 30, 2018 As of December 31, 2017 Building and leasehold improvements $ 8.8 $ 7.8 Equipment and furniture 56.9 72.9 Computer software 63.4 97.2 129.1 177.9 Less: accumulated depreciation (101.1 ) (146.8 ) $ 28.0 $ 31.1 Fair Value of Financial Instruments The fair value hierarchy is based on three levels of inputs, of which the first two are considered observable and the last unobservable, that may be used to measure fair value. The three levels of inputs are as follows: • Level 1 – Quoted prices in active markets for identical assets and liabilities. • Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. • Level 3 – Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities. Our deferred compensation plan assets are recorded at fair value and are considered a level 2 measurement. For our other financial instruments, including our cash and cash equivalents, patient accounts receivable, accounts payable, payroll and employee benefits and accrued expenses, we estimate the carrying amounts approximate fair value. As of June 30, 2018 , the carrying amount of our long-term debt is subject to a variable rate of interest based on current market rates, and as such, the carrying values approximate fair value. Weighted-Average Shares Outstanding Net income per share attributable to Amedisys, Inc. common stockholders, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The following table sets forth, for the periods indicated, shares used in our computation of the weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands): For the Three- Month Periods Ended June 30, For the Six- Month Periods Ended June 30, 2018 2017 2018 2017 Weighted average number of shares outstanding - basic 33,439 33,637 33,705 33,540 Effect of dilutive securities: Stock options 425 329 381 285 Non-vested stock and stock units 315 363 305 378 Weighted average number of shares outstanding - diluted 34,179 34,329 34,391 34,203 Anti-dilutive securities 57 169 88 248 |
ACQUISITIONS
ACQUISITIONS | 6 Months Ended |
Jun. 30, 2018 | |
Business Combinations [Abstract] | |
ACQUISITIONS | ACQUISITIONS We complete acquisitions from time to time in order to pursue our strategy of increasing our market presence by expanding our service base and enhancing our position in certain geographic areas as a leading provider of home health, hospice and personal care services. The purchase price paid for acquisitions is negotiated through arm’s length transactions, with consideration based on our analysis of, among other things, comparable acquisitions and expected cash flows. Acquisitions are accounted for as purchases and are included in our consolidated financial statements from their respective acquisition dates. Goodwill generated from acquisitions is recognized for the excess of the purchase price over tangible and identifiable intangible assets because of the expected contributions of the acquisitions to our overall corporate strategy. We typically engage outside appraisal firms to assist in the fair value determination of identifiable intangible assets. The preliminary purchase price allocation is adjusted, as necessary, up to one year after the acquisition closing date if management obtains more information regarding asset valuations and liabilities assumed. On March 1, 2018, we acquired the assets of Christian Care at Home which provides home health services to the state of Kentucky for a total purchase price of $2.3 million . The purchase price was paid with cash on hand on the date of the transaction. Based on our preliminary purchase price allocation, we recorded goodwill of $2.3 million in connection with the acquisition during the three-month period ended March 31, 2018. On May 1, 2018, we acquired the assets of East Tennessee Personal Care Services which owns and operates one personal-care care center servicing the state of Tennessee for a total purchase price of $2.0 million (subject to certain adjustments, of which $0.2 million was placed in a promissory note to be paid over 24 months, subject to any offsets or withholds for indemnification purposes). The purchase price was paid with cash on hand on the date of the transaction. During the three-month period ended June 30, 2018 , we recorded goodwill of $1.9 million and other intangibles - non-compete agreements of $0.1 million in connection with the acquisition. The non-compete agreement will be amortized over a weighted-average period of 2.8 years. |
LONG-TERM OBLIGATIONS
LONG-TERM OBLIGATIONS | 6 Months Ended |
Jun. 30, 2018 | |
Debt Disclosure [Abstract] | |
LONG-TERM OBLIGATIONS | 3.00 to 1.0 0.35% 2.00% 2.25% 1.25% II ≤ 3.00 to 1.0 but > 2.00 to 1.0 0.30% 1.75% 2.00% 1.00% III ≤ 2.00 to 1.0 but > 1.00 to 1.0 0.25% 1.50% 1.75% 0.75% IV ≤ 1.00 to 1.0 0.20% 1.25% 1.50% 0.50% The Credit Agreement requires maintenance of two financial covenants: (i) a consolidated leverage ratio of funded indebtedness to EBITDA, as defined in the Credit Agreement, and (ii) a consolidated interest coverage ratio of EBITDA to cash interest charges, all as defined in the Credit Agreement. Each of these covenants is calculated over rolling four-quarter periods and also is subject to certain exceptions and baskets. The Credit Agreement also contains customary covenants, including, but not limited to, restrictions on: incurrence of liens; incurrence of additional debt; sales of assets and other fundamental corporate changes; investments; and declarations of dividends. These covenants contain customary exclusions and baskets as detailed in the Credit Agreement. The Credit Facility is guaranteed by substantially all of our wholly-owned direct and indirect subsidiaries. The Credit Agreement requires at all times that we (i) provide guarantees from wholly-owned subsidiaries that in the aggregate represent not less than 95% of our consolidated net revenues and adjusted EBITDA from all wholly-owned subsidiaries and (ii) provide guarantees from subsidiaries that in the aggregate represent not less than 70% of consolidated adjusted EBITDA, subject to certain exceptions. In connection with entering into the Credit Agreement, we entered into (i) a Security Agreement with the Administrative Agent dated June 29, 2018 and (ii) a Pledge Agreement with the Administrative Agent dated as of June 29, 2018 for the purpose of securing the payment of our obligations under the Credit Agreement. Pursuant to the Security Agreement and the Pledge Agreement, as of the effective date of the Credit Agreement, our obligations under the Credit Agreement are secured by (i) the grant of a first lien security interest in the non-real estate assets of substantially all of our direct and indirect, wholly-owned subsidiaries (subject to exceptions) and (ii) the pledge of the equity interests in (a) substantially all of our direct and indirect, wholly-owned corporate, limited liability company and limited partnership subsidiaries and (b) those joint ventures which constitute subsidiaries under the Credit Agreement (subject, in the case of the Pledge Agreement, to exceptions). In connection with our entry into the Credit Agreement, we recorded $2.4 million in deferred debt issuance costs as long-term obligations, less current portion within our condensed consolidated balance sheet. Our weighted average interest rate for our $100.0 million Term Loan, under our Prior Credit Agreement, was 3.9% and 3.8% for the three and six -month periods ended June 30, 2018 , respectively, and 3.0% and 2.9% for the three and six -month periods ended June 30, 2017 , respectively. Our weighted average interest rate for our $550.0 million Revolving Credit Facility was 3.7% at June 30, 2018 . As of June 30, 2018 , our consolidated leverage ratio was 0.8 , our consolidated interest coverage ratio was 51.0 and we are in compliance with our covenants under the Credit Agreement. In the event we are not in compliance with our debt covenants in the future, we would pursue various alternatives in an attempt to successfully resolve the non-compliance, which might include, among other things, seeking debt covenant waivers or amendments. As of June 30, 2018 , our availability under our $550.0 million Revolving Credit Facility was $388.1 million as we have $127.5 million outstanding in borrowings and $34.4 million outstanding in letters of credit." id="sjs-B4">LONG-TERM OBLIGATIONS Long-term debt consisted of the following for the periods indicated (amounts in millions): June 30, 2018 December 31, 2017 $100.0 million Term Loan; principal payments plus accrued interest payable quarterly; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate; due August 28, 2020 $ — $ 90.0 $200.0 million Revolving Credit Facility; interest only payments; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate; due August 28, 2020 — — $550.0 million Revolving Credit Facility; interest only payments; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (3.7% at June 30, 2018); due June 29, 2023 127.5 — Promissory notes 0.9 0.7 Capital leases 0.1 — Principal amount of long-term obligations 128.5 90.7 Deferred debt issuance costs (3.9 ) (1.9 ) 124.6 88.8 Current portion of long-term obligations (0.7 ) (10.6 ) Total $ 123.9 $ 78.2 Credit Agreement On June 29, 2018, we entered into our Amended and Restated Credit Agreement ("Credit Agreement") that provides for a senior secured revolving credit facility in an initial aggregate principal amount of up to $550.0 million (the “Revolving Credit Facility”). The Revolving Credit Facility provides for and includes within its $550.0 million limit a $25.0 million swingline facility and commitments for up to $60.0 million in letters of credit. Upon lender approval, we may increase the aggregate loan amount under the Revolving Credit Facility by either i) $125.0 million or ii) an unlimited amount subject to a leverage limit of 0.5 x under the maximum allowable consolidated leverage ratio per the Credit Agreement. The net proceeds of the Revolving Credit Facility were used to pay off our existing indebtedness under our prior credit agreement, dated as of August 28, 2015 (the "Prior Credit Agreement"), with a principal balance of $127.5 million . The final maturity of the Revolving Credit Facility is June 29, 2023 and there is no mandatory amortization on the outstanding principal balances which are payable in full upon maturity. The Revolving Credit Facility may be used to provide ongoing working capital and for general corporate purposes of the Company and our subsidiaries, including permitted acquisitions, as defined in the Credit Agreement. The interest rate on borrowings under the Revolving Credit Facility shall be selected by us from the following: (i) the Base Rate plus the Applicable Rate or (ii) the Eurodollar Rate plus the Applicable Rate. The “Base Rate” means a fluctuating rate per annum equal to the highest of (a) the federal funds rate plus 0.50% per annum, (b) the prime rate of interest established by the Administrative Agent, and (c) the Eurodollar Rate plus 1% per annum. The “Eurodollar Rate” means the quoted rate per annum equal to the London Interbank Offered Rate (“LIBOR”) or a comparable successor rate approved by the Administrative Agent for an interest period of one, two, three or six months (as selected by us). The “Applicable Rate” is based on the consolidated leverage ratio and is presented in the table below. As of June 30, 2018, the Applicable Rate is 0.50% per annum for Base Rate Loans and 1.50% per annum for Eurodollar Rate Loans. We are also subject to a commitment fee and letter of credit fee under the terms of the Credit Agreement, as presented in the table below. Pricing Tier Consolidated Leverage Ratio Commitment Fee Letter of Credit Fee Eurodollar Rate Loans Base Rate Loans I > 3.00 to 1.0 0.35% 2.00% 2.25% 1.25% II ≤ 3.00 to 1.0 but > 2.00 to 1.0 0.30% 1.75% 2.00% 1.00% III ≤ 2.00 to 1.0 but > 1.00 to 1.0 0.25% 1.50% 1.75% 0.75% IV ≤ 1.00 to 1.0 0.20% 1.25% 1.50% 0.50% The Credit Agreement requires maintenance of two financial covenants: (i) a consolidated leverage ratio of funded indebtedness to EBITDA, as defined in the Credit Agreement, and (ii) a consolidated interest coverage ratio of EBITDA to cash interest charges, all as defined in the Credit Agreement. Each of these covenants is calculated over rolling four-quarter periods and also is subject to certain exceptions and baskets. The Credit Agreement also contains customary covenants, including, but not limited to, restrictions on: incurrence of liens; incurrence of additional debt; sales of assets and other fundamental corporate changes; investments; and declarations of dividends. These covenants contain customary exclusions and baskets as detailed in the Credit Agreement. The Credit Facility is guaranteed by substantially all of our wholly-owned direct and indirect subsidiaries. The Credit Agreement requires at all times that we (i) provide guarantees from wholly-owned subsidiaries that in the aggregate represent not less than 95% of our consolidated net revenues and adjusted EBITDA from all wholly-owned subsidiaries and (ii) provide guarantees from subsidiaries that in the aggregate represent not less than 70% of consolidated adjusted EBITDA, subject to certain exceptions. In connection with entering into the Credit Agreement, we entered into (i) a Security Agreement with the Administrative Agent dated June 29, 2018 and (ii) a Pledge Agreement with the Administrative Agent dated as of June 29, 2018 for the purpose of securing the payment of our obligations under the Credit Agreement. Pursuant to the Security Agreement and the Pledge Agreement, as of the effective date of the Credit Agreement, our obligations under the Credit Agreement are secured by (i) the grant of a first lien security interest in the non-real estate assets of substantially all of our direct and indirect, wholly-owned subsidiaries (subject to exceptions) and (ii) the pledge of the equity interests in (a) substantially all of our direct and indirect, wholly-owned corporate, limited liability company and limited partnership subsidiaries and (b) those joint ventures which constitute subsidiaries under the Credit Agreement (subject, in the case of the Pledge Agreement, to exceptions). In connection with our entry into the Credit Agreement, we recorded $2.4 million in deferred debt issuance costs as long-term obligations, less current portion within our condensed consolidated balance sheet. Our weighted average interest rate for our $100.0 million Term Loan, under our Prior Credit Agreement, was 3.9% and 3.8% for the three and six -month periods ended June 30, 2018 , respectively, and 3.0% and 2.9% for the three and six -month periods ended June 30, 2017 , respectively. Our weighted average interest rate for our $550.0 million Revolving Credit Facility was 3.7% at June 30, 2018 . As of June 30, 2018 , our consolidated leverage ratio was 0.8 , our consolidated interest coverage ratio was 51.0 and we are in compliance with our covenants under the Credit Agreement. In the event we are not in compliance with our debt covenants in the future, we would pursue various alternatives in an attempt to successfully resolve the non-compliance, which might include, among other things, seeking debt covenant waivers or amendments. As of June 30, 2018 , our availability under our $550.0 million Revolving Credit Facility was $388.1 million as we have $127.5 million outstanding in borrowings and $34.4 million outstanding in letters of credit. |
COMMITMENTS AND CONTINGENCIES
COMMITMENTS AND CONTINGENCIES | 6 Months Ended |
Jun. 30, 2018 | |
Commitments and Contingencies Disclosure [Abstract] | |
COMMITMENTS AND CONTINGENCIES | COMMITMENTS AND CONTINGENCIES Legal Proceedings - Ongoing We are involved in the following legal actions: Subpoena Duces Tecum Issued by the U.S. Department of Justice On May 21, 2015, we received a Subpoena Duces Tecum (“Subpoena”) issued by the U.S. Department of Justice. The Subpoena requests the delivery of information regarding 53 identified hospice patients to the United States Attorney’s Office for the District of Massachusetts. It also requests the delivery of documents relating to our hospice clinical and business operations and related compliance activities. The Subpoena generally covers the period from January 1, 2011 through May 21, 2015. We are fully cooperating with the U.S. Department of Justice with respect to this investigation. Based on the information currently available to us, we cannot predict the timing or outcome of this investigation or reasonably estimate the amount or range of potential losses, if any, which may arise from this matter. Civil Investigative Demands Issued by the U.S. Department of Justice On November 3, 2015, we received a civil investigative demand (“CID”) issued by the U.S. Department of Justice pursuant to the federal False Claims Act relating to claims submitted to Medicare and/or Medicaid for hospice services provided through designated facilities in the Morgantown, West Virginia area. The CID requests the delivery of information to the United States Attorney’s Office for the Northern District of West Virginia regarding 66 identified hospice patients, as well as documents relating to our hospice clinical and business operations in the Morgantown area. The CID generally covers the period from January 1, 2009 through August 31, 2015. We are fully cooperating with the U.S. Department of Justice with respect to this investigation. Based on the information currently available to us, we cannot predict the timing or outcome of this investigation or reasonably estimate the amount or range of potential losses, if any, which may arise from this matter. On June 27, 2016, we received a CID issued by the U.S. Department of Justice pursuant to the federal False Claims Act relating to claims submitted to Medicare and/or Medicaid for hospice services provided through designated facilities in the Parkersburg, West Virginia area. The CID requests the delivery of information to the United States Attorney’s Office for the Southern District of West Virginia regarding 68 identified hospice patients, as well as documents relating to our hospice clinical and business operations in the Parkersburg area. The CID generally covers the period from January 1, 2011 through June 20, 2016. We are fully cooperating with the U.S. Department of Justice with respect to this investigation. Based on the information currently available to us, we cannot predict the timing or outcome of this investigation or reasonably estimate the amount or range of potential losses, if any, which may arise from this matter. In addition to the matters referenced in this note, we are involved in legal actions in the normal course of business, some of which seek monetary damages, including claims for punitive damages. We do not believe that these normal course actions, when finally concluded and determined, will have a material impact on our consolidated financial condition, results of operations or cash flows. Legal Proceedings - Settled Securities Class Action Lawsuits As previously disclosed, between June 10 and July 28, 2010, several putative securities class action complaints were filed in the United States District Court for the Middle District of Louisiana (the “District Court”) against the Company and certain of our former senior executives. The cases were consolidated into the first-filed action Bach, et al. v. Amedisys, Inc., et al. Case No. 3:10-cv-00395, and the District Court appointed as co-lead plaintiffs the Public Employees’ Retirement System of Mississippi and the Puerto Rico Teachers’ Retirement System (the “Co-Lead Plaintiffs”). The Plaintiffs were granted leave to file a First Amended Consolidated Complaint (the “First Amended Securities Complaint”) on behalf of all purchasers or acquirers of Amedisys’ securities between August 2, 2005 and September 30, 2011. The First Amended Securities Complaint alleges that the Company and seven individual defendants violated Section 10(b), Section 20(a), and Rule 10b-5 of the Securities Exchange Act of 1934 by materially misrepresenting the Company’s financial results and concealing a scheme to obtain higher Medicare reimbursements and additional patient referrals by (1) providing medically unnecessary care to patients, including certifying and re-certifying patients for medically unnecessary 60-day treatment episodes; (2) implementing clinical tracks such as “Balanced for Life” and wound care programs that provided a pre-set number of therapy visits irrespective of medical need; (3) “upcoding” patients’ Medicare forms to attribute a “primary diagnosis” to a medical condition associated with higher billing rates; and (4) providing improper and illegal remuneration to physicians to obtain patient certifications or re-certifications. The First Amended Securities Complaint seeks certification of the case as a class action and an unspecified amount of damages, as well as interest and an award of attorneys’ fees. On June 12, 2017, the Company reached an agreement-in-principle to settle this matter. All parties to the action executed a binding term sheet that, subject to final documentation and court approval, provided in part for a settlement payment of approximately $43.7 million , which we accrued as of June 30, 2017, and the dismissal with prejudice of the litigation. Approximately $15.0 million of the settlement amount paid by the Company’s insurance carriers during the three-month period ended September 30, 2017, was previously recorded within other current assets in our condensed consolidated balance sheet as of June 30, 2017. The net of these two amounts, $28.7 million , was recorded as a charge in our condensed consolidated statements of operations during the three-month period ended June 30, 2017 and paid with cash on hand during the three-month period ended September 30, 2017. On December 19, 2017, the Court entered the final order and judgment on the case. Other Investigative Matters - Ongoing Corporate Integrity Agreement On April 23, 2014, with no admissions of liability on our part, we entered into a settlement agreement with the U.S. Department of Justice relating to certain of our clinical and business operations. Concurrently with our entry into this agreement, we entered into a corporate integrity agreement (“CIA”) with the Office of Inspector General-HHS (“OIG”). The CIA formalizes various aspects of our already existing ethics and compliance programs and contains other requirements designed to help ensure our ongoing compliance with federal health care program requirements. Among other things, the CIA requires us to maintain our existing compliance program, executive compliance committee and compliance committee of the Board of Directors; provide certain compliance training; continue screening new and current employees to ensure they are eligible to participate in federal health care programs; engage an independent review organization to perform certain auditing and reviews and prepare certain reports regarding our compliance with federal health care programs, our billing submissions to federal health care programs and our compliance and risk mitigation programs; and provide certain reports and management certifications to the OIG. Additionally, the CIA specifically requires that we report substantial overpayments that we discover we have received from federal health care programs, as well as probable violations of federal health care laws. Upon breach of the CIA, we could become liable for payment of certain stipulated penalties, or could be excluded from participation in federal health care programs. The corporate integrity agreement has a term of five years . Third Party Audits - Ongoing From time to time, in the ordinary course of business, we are subject to audits under various governmental programs in which third party firms engaged by the Centers for Medicare and Medicaid Services (“CMS”) conduct extensive review of claims data to identify potential improper payments under the Medicare program. In July 2010, our subsidiary that provides hospice services in Florence, South Carolina received from a Zone Program Integrity Contractor (“ZPIC”) a request for records regarding a sample of 30 beneficiaries who received services from the subsidiary during the period of January 1, 2008 through March 31, 2010 (the “Review Period”) to determine whether the underlying services met pertinent Medicare payment requirements. We acquired the hospice operations subject to this review on August 1, 2009; the Review Period covers time periods both before and after our ownership of these hospice operations. Based on the ZPIC’s findings for 16 beneficiaries, which were extrapolated to all claims for hospice services provided by the Florence subsidiary billed during the Review Period, on June 6, 2011, the Medicare Administrative Contractor (“MAC”) for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment. We dispute these findings, and our Florence subsidiary has filed appeals through the Original Medicare Standard Appeals Process, in which we are seeking to have those findings overturned. An administrative law judge ("ALJ") hearing was held in early January 2015. On January 18, 2016, we received a letter dated January 6, 2016 referencing the ALJ hearing decision for the overpayment issued on June 6, 2011. The decision was partially favorable with a new overpayment amount of $3.7 million with a balance owed of $5.6 million , including interest, based on 9 disputed claims (originally 16 ). We filed an appeal to the Medicare Appeals Council on the remaining 9 disputed claims and also argued that the statistical method used to select the sample was not valid. No assurances can be given as to the timing or outcome of the Medicare Appeals Council decision. As of June 30, 2018 , Medicare has withheld payments of $5.7 million (including additional interest) as part of their standard procedures once this level of the appeal process has been reached. In the event we are not able to recoup this alleged overpayment, we are entitled to be indemnified by the prior owners of the hospice operations for amounts relating to the period prior to August 1, 2009. As of June 30, 2018 , we have an indemnity receivable of approximately $4.9 million for the amount withheld related to the period prior to August 1, 2009. In July 2016, the Company received a request for medical records from SafeGuard Services, L.L.C (“SafeGuard”), a ZPIC related to services provided by some of the care centers that the Company acquired from Infinity Home Care, L.L.C. The review period covers time periods both before and after our ownership of the care centers, which were acquired on December 31, 2015. In August 2017, the Company received Requests for Repayment from Palmetto GBA, LLC ("Palmetto") regarding Infinity Home Care of Lakeland, LLC ("Lakeland Care Centers") and Infinity Home Care of Pinellas, LLC ("Clearwater Care Center"). The Palmetto letters are based on statistical extrapolation performed by SafeGuard which alleged an overpayment of $34.0 million for the Lakeland Care Centers on a universe of 72 Medicare claims totaling $0.2 million in actual claims payments using a 100% error rate and an overpayment of $4.8 million for the Clearwater Care Center on a universe of 70 Medicare claims totaling $0.2 million in actual claims payments using a 100% error rate. The Lakeland Request for Repayment covers claims between January 2, 2014 and September 13, 2016. The Clearwater Request for Repayment covers claims between January 2, 2015 and December 9, 2016. As a result of Level I Administrative Appeals, also known as Redetermination, the alleged overpayment for the Lakeland Care Centers has been reduced to $27.0 million and the alleged overpayment for the Clearwater Care Center has been reduced to $3.3 million . The Company filed Level II Administrative Appeals, also known as Reconsideration, and has received the decision of the Qualified Independent Contractor ("QIC"), which was partially favorable and partially unfavorable. With regard to the extrapolation, the QIC found that although SafeGuard made certain mistakes in performing the extrapolation, it did not invalidate the extrapolation. The QIC directed Palmetto to ensure that the Company received credit for all payments made as a result of an extensive self-audit. We have requested that Palmetto recalculate the amount allegedly due consistent with the findings of the QIC. The Company will continue to vigorously pursue its appeal rights, which include contesting the methodology used by the ZPIC contractor to perform statistical extrapolation. The Company is contractually entitled to indemnification by the prior owners for all claims prior to December 31, 2015, for up to $12.6 million . At this stage of the review, based on the information currently available to the Company, the Company cannot predict the timing or outcome of this review. The Company estimates a low-end potential range of loss related to this review of $6.5 million (assuming the Company is successful in seeking indemnity from the prior owners and unsuccessful in demonstrating that the extrapolation method used by SafeGuard was erroneous). The Company has reduced its high-end potential range of loss from $38.8 million (the maximum amount Palmetto claims has been overpaid for both the Lakeland Care Centers and the Clearwater Care Center of which amount $12.6 million is subject to indemnification by the prior owners) to $30.3 million based on the partial success achieved by the Company in prosecuting its Level I Administrative Appeals. As of June 30, 2018 , we have an accrued liability of approximately $17.4 million related to this matter. We expect to be indemnified by the prior owners for approximately $10.9 million of the total $12.6 million available indemnification related to this matter and have recorded this amount within other assets, net in our condensed consolidated balance sheet as of June 30, 2018 . The net of these two amounts, $6.5 million , was recorded as a reduction in revenue in our condensed consolidated statements of operations during the three-month period ended September 30, 2017. As of June 30, 2018 , $2.7 million of receivables have been impacted by this payment suspension. Insurance We are obligated for certain costs associated with our insurance programs, including employee health, workers’ compensation and professional liability. While we maintain various insurance programs to cover these risks, we are self-insured for a substantial portion of our potential claims. We recognize our obligations associated with these costs, up to specified deductible limits in the period in which a claim is incurred, including with respect to both reported claims and claims incurred but not reported. These costs have generally been estimated based on historical data of our claims experience. Such estimates, and the resulting reserves, are reviewed and updated by us on a quarterly basis. Our health insurance has an exposure limit of $1.0 million for any individual covered life. Our workers’ compensation insurance has a retention limit of $0.5 million per incident and our professional liability insurance has a retention limit of $0.3 million per incident. |
SEGMENT INFORMATION
SEGMENT INFORMATION | 6 Months Ended |
Jun. 30, 2018 | |
Segment Reporting [Abstract] | |
SEGMENT INFORMATION | SEGMENT INFORMATION Our operations involve servicing patients through our three reportable business segments: home health, hospice and personal care. Our home health segment delivers a wide range of services in the homes of individuals who may be recovering from surgery, have a chronic disability or terminal illness or need assistance with completing important personal tasks. Our hospice segment provides palliative care and comfort to terminally ill patients and their families. Our personal care segment provides patients with assistance with the essential activities of daily living. The “other” column in the following tables consists of costs relating to executive management and administrative support functions, primarily information services, accounting, finance, billing and collections, legal, compliance, risk management, procurement, marketing, clinical administration, training, human resources and administration. Management evaluates performance and allocates resources based on the operating income of the reportable segments, which includes an allocation of corporate expenses directly attributable to the specific segment and includes revenues and all other costs directly attributable to the specific segment. Segment assets are not reviewed by the company’s chief operating decision maker and therefore are not disclosed below (amounts in millions). For the Three-Month Period Ended June 30, 2018 Home Health Hospice Personal Care Other Total Net service revenue $ 291.5 $ 101.4 $ 18.7 $ — $ 411.6 Cost of service, excluding depreciation and amortization 176.5 51.7 14.4 — 242.6 General and administrative expenses 68.4 20.3 3.3 31.1 123.1 Depreciation and amortization 0.8 0.3 — 2.0 3.1 Operating expenses 245.7 72.3 17.7 33.1 368.8 Operating income (loss) $ 45.8 $ 29.1 $ 1.0 $ (33.1 ) $ 42.8 For the Three-Month Period Ended June 30, 2017 Home Health Hospice Personal Care Other Total Net service revenue $ 270.3 $ 90.3 $ 14.3 $ — $ 374.9 Cost of service, excluding depreciation and amortization 164.8 45.4 10.3 — 220.5 General and administrative expenses 68.9 19.1 3.0 30.0 121.0 Depreciation and amortization 1.0 0.2 — 3.3 4.5 Securities Class Action Lawsuit settlement, net — — — 28.7 28.7 Operating expenses 234.7 64.7 13.3 62.0 374.7 Operating income (loss) $ 35.6 $ 25.6 $ 1.0 $ (62.0 ) $ 0.2 For the Six-Month Period Ended June 30, 2018 Home Health Hospice Personal Care Other Total Net service revenue $ 575.6 $ 198.7 $ 36.6 $ — $ 810.9 Cost of service, excluding depreciation and amortization 350.9 101.8 28.2 — 480.9 General and administrative expenses 136.4 40.3 6.5 61.3 244.5 Depreciation and amortization 1.6 0.5 0.1 4.5 6.7 Operating expenses 488.9 142.6 34.8 65.8 732.1 Operating income (loss) $ 86.7 $ 56.1 $ 1.8 $ (65.8 ) $ 78.8 For the Six-Month Period Ended June 30, 2017 Home Health Hospice Personal Care Other Total Net service revenue $ 537.9 $ 173.9 $ 27.8 $ — $ 739.6 Cost of service, excluding depreciation and amortization 327.8 88.4 20.7 — 436.9 General and administrative expenses 136.9 37.0 6.2 59.5 239.6 Depreciation and amortization 1.9 0.5 0.1 6.5 9.0 Securities Class Action Lawsuit settlement, net — — — 28.7 28.7 Operating expenses 466.6 125.9 27.0 94.7 714.2 Operating income (loss) $ 71.3 $ 48.0 $ 0.8 $ (94.7 ) $ 25.4 |
SHARE REPURCHASE SHARE REPURCHA
SHARE REPURCHASE SHARE REPURCHASE | 6 Months Ended |
Jun. 30, 2018 | |
Equity [Abstract] | |
SHARE REPURCHASE | SHARE REPURCHASE On June 4, 2018, we purchased 2,418,304 of our common shares from affiliates of KKR Credit Advisors (US) LLC ("KKR"), representing one-half of KKR's holdings in the Company and 7.1% of the aggregate outstanding shares of the Company's common stock for a total purchase price of $ 181.4 million including related direct costs. The Company repurchased the shares at $ 73.96 which represents 96% of the closing stock price of the Company's common stock on June 4, 2018. |
SUMMARY OF SIGNIFICANT ACCOUN13
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies) | 6 Months Ended |
Jun. 30, 2018 | |
Accounting Policies [Abstract] | |
Basis of Presentation | Basis of Presentation In our opinion, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations, and our cash flows in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”) for interim financial reporting. Our results of operations for the interim periods presented are not necessarily indicative of results of our operations for the entire year and have not been audited by our independent auditors. This report should be read in conjunction with our consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2017 , as filed with the Securities and Exchange Commission (“SEC”) on February 28, 2018 (the “Form 10-K”), which includes information and disclosures not included herein. |
Recent Accounting Pronouncements | Recently Adopted Accounting Pronouncements On January 1, 2018, the Company adopted Accounting Standards Update (“ASU”) 2014-09, Revenue from Contracts with Customers (Topic 606) and ASU 2015-14, Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date (collectively, “ASC 606”), the new accounting standards issued by the Financial Accounting Standards Board (“FASB”) on revenue recognition, using the full retrospective method. ASC 606 outlines a single comprehensive model to use in accounting for revenue arising from contracts with customers. The standards supersede existing revenue recognition requirements and eliminate most industry-specific guidance from U.S. GAAP. The core principle of the revenue recognition standard is to require an entity to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which it expects to be entitled in exchange for those goods or services. As a result of the Company's adoption of ASC 606, the revenue and related estimated uncollectible amounts owed to us by non-Medicare payors that were historically classified as a provision for doubtful accounts are now considered an implicit price concession in determining net service revenue. Accordingly, the Company reports uncollectible balances due from third-party payors and uncollectible balances associated with patient responsibility as a reduction of the transaction price and therefore, as a reduction in net service revenue (or as it relates to Hospice room and board, an increase in cost of service, excluding depreciation and amortization) when historically these amounts were classified as a provision for doubtful accounts within operating expenses within our condensed consolidated statements of operations. In addition, the adoption of ASC 606 resulted in increased disclosure, including qualitative and quantitative disclosures about the nature, amount, timing and uncertainty of revenue and cash flows arising from contracts with customers. In August 2016, the FASB issued ASU 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments , which provides specific guidance on eight cash flow classification issues not specifically addressed by U.S. GAAP. The ASU is effective for annual and interim periods beginning after December 15, 2017. The standard should be applied using a retrospective transition method unless it is impractical to do so for some of the issues. In such case, the amendments for those issues would be applied prospectively as of the earliest date practicable. Our adoption of this standard on January 1, 2018, using a retrospective transition method for each period presented, did not have an effect on our condensed consolidated financial statements. In January 2017, the FASB issued ASU 2017-01, Business Combinations (Topic 805): Clarifying the Definition of a Business , which provides guidance to assist entities with evaluating whether transactions should be accounted for as an acquisition (or disposal) of assets or a business. The ASU is effective for annual and interim periods beginning after December 15, 2017. We adopted this ASU effective January 1, 2018, on a prospective basis. The impact on our consolidated financial statements and related disclosures will depend on the facts and circumstances of any specific future transactions as evaluated under the new framework. In January 2017, the FASB issued ASU 2017-04, Intangibles—Goodwill and Other (Topic 350)—Simplifying the Test for Goodwill Impairment , which eliminates the requirement to calculate the implied fair value of goodwill to measure a goodwill impairment charge (Step 2 of the goodwill impairment test). Instead, impairment will be measured using the difference between the carrying amount and the fair value of the reporting unit. The ASU is effective for annual and interim periods beginning after December 15, 2019. Early adoption is permitted. We adopted this ASU effective January 1, 2018, on a prospective basis and will apply this guidance to our future tests of goodwill impairment. Recently Issued Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) , which will require lessees to recognize a lease liability and right-of-use asset for all leases (with the exception of short-term leases) at the commencement date. The ASU is effective for annual and interim periods beginning on or after December 15, 2018. Early adoption is permitted. The standard requires a modified retrospective transition method which requires recognition and disclosure under the new guidance for all periods presented. While the Company expects adoption of this standard to lead to a material increase in the assets and liabilities recorded on our balance sheet, we are still evaluating the overall impact on our consolidated financial statements and related disclosures and the effect of the standard on our ongoing financial reporting. |
Use of Estimates | Use of Estimates Our accounting and reporting policies conform with U.S. GAAP. In preparing the unaudited condensed consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the condensed consolidated financial statements and accompanying notes. Actual results could differ from those estimates. |
Reclassifications and Comparability | Reclassifications and Comparability Certain reclassifications have been made to prior periods’ financial statements in order to conform to the current period’s presentation. |
Principles of Consolidation | Principles of Consolidation These unaudited condensed consolidated financial statements include the accounts of Amedisys, Inc., and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying unaudited condensed consolidated financial statements, and business combinations accounted for as purchases have been included in our unaudited condensed consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain equity investments that are accounted for as set forth below. |
Equity Investments | Equity Investments We consolidate investments when the entity is a variable interest entity and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50% . Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our condensed consolidated financial statements. We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a variable interest entity in which we are the primary beneficiary. The book value of investments that we accounted for under the equity method of accounting was $29.0 million and $26.4 million as of June 30, 2018 and December 31, 2017 , respectively. We account for investments in entities in which we have less than a 20% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. |
Revenue Recognition | Revenue Recognition Our adoption of ASC 606 on January 1, 2018, on a full retrospective basis, impacted the Company's previously reported results as follows (amounts in thousands, unaudited): As Previously Reported Adjustment for the Adoption of ASC 606 As Adjusted As of December 31, 2017 Condensed Consolidated Balance Sheets Patient accounts receivable $ 201,196 $ — $ 201,196 Allowance for doubtful accounts $ 20,866 $ 20,866 $ — For the three-month period ended June 30, 2017 Condensed Consolidated Statements of Operations Net service revenue $ 378,821 $ (3,875 ) $ 374,946 Cost of service, excluding depreciation and amortization $ 219,765 $ 776 $ 220,541 Provision for doubtful accounts $ 4,651 $ (4,651 ) $ — Net income attributable to Amedisys, Inc. $ 4,461 $ — $ 4,461 For the six-month period ended June 30, 2017 Condensed Consolidated Statements of Operations Net service revenue $ 749,279 $ (9,672 ) $ 739,607 Cost of service, excluding depreciation and amortization $ 435,550 $ 1,320 $ 436,870 Provision for doubtful accounts $ 10,992 $ (10,992 ) $ — Net income attributable to Amedisys, Inc. $ 19,591 $ — $ 19,591 Condensed Consolidated Statements of Cash Flows Provision for doubtful accounts $ 10,992 $ (10,992 ) $ — Changes in operating assets and liabilities, net of impact of acquisitions: Patient accounts receivable $ (17,825 ) $ 10,992 $ (6,833 ) We earn net service revenue through our home health, hospice and personal care segments through the delivery of a variety of services that best suit our patients' needs, whether that is home-based recovery and rehabilitation after an operation or injury, care that empowers patients to manage a chronic disease, hospice care at the end of life, or providing assistance with daily activities through our personal care segment. We account for revenue from contracts with customers in accordance with ASC 606, and as such, we recognize revenue in the period in which we satisfy our performance obligations under our contracts by transferring our promised services to our customers, in amounts that reflect the consideration to which we expect to be entitled in exchange for providing patient care, which are the transaction prices allocated to the distinct services. The Company's cost of obtaining contracts is not material. Revenues are recognized as performance obligations are satisfied, which varies based on the nature of the services provided. Our performance obligation is the delivery of patient care services in accordance with the nature and frequency of services outlined in physicians' orders, which are determined by a physician based on a patient's specific goals. The Company's performance obligations relate to contracts with a duration of less than one year; therefore, the Company has elected to apply the optional exemption provided by ASC 606 and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially unsatisfied as of the end of the reporting period. The unsatisfied or partially unsatisfied performance obligations are generally completed when the patients are discharged, which generally occurs within days or weeks of the end of the reporting period. We determine the transaction price based on gross charges for services provided, reduced by contractual adjustments provided to third-party payors and estimates of implicit price concessions provided to self-pay or uninsured patients or other payors. The Company assesses the patient's ability to pay for their healthcare services at the time of patient admission based on the Company's verification of the patient's insurance coverage under Medicare, Medicaid, and other commercial or managed care insurance programs. Medicare contributes to approximately 74% of the Company's consolidated net service revenue. We determine our estimates of contractual adjustments and implicit price concessions by major payor class based on contractual agreements with individual third-party payors, our historical collection experience, aged accounts receivable by payor and current economic conditions. The implicit price concession included in estimating the transaction price represents the difference between amounts billed and amounts we expect to collect based on our collection history with similar payors. Subsequent changes to the estimate of the transaction price are recorded as adjustments to net service revenue in the period of change. Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay (i.e. change in credit risk) are recorded as a provision for doubtful accounts. We record our service revenue net of estimated revenue adjustments related to third-party payor payment reviews to reflect amounts we estimate to be realizable for services provided. Amounts due from third-party payors, primarily commercial health insurers and government programs (Medicare and Medicaid), include variable consideration for retroactive revenue adjustments due to settlements of audits and reviews. We make estimates for these revenue adjustments based on our historical experience and success rates in the claim appeals and adjudication process. Home Health Revenue Recognition Medicare Revenue Net service revenue is recorded under the Medicare prospective payment system (“PPS”) based on an established Federal Medicare home health episode payment rate, that is subject to adjustment based on certain variables, including, but not limited to (a) an outlier payment if our patient’s care was unusually costly (capped at 10% of total reimbursement per provider number); (b) a low utilization payment adjustment (“LUPA”) if the number of visits was fewer than five ; (c) a partial payment if our patient transferred to another provider or we received a patient from another provider before completing the episode; (d) a payment adjustment based upon the level of therapy services required (with various incremental adjustments made for additional visits, with larger payment increases associated with the sixth , fourteenth and twentieth visit thresholds); (e) adjustments to payments if we are unable to perform periodic therapy assessments; (f) the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (g) changes in the base episode payments established by the Medicare Program; (h) adjustments to the base episode payments for case mix and geographic wages; and (i) recoveries of overpayments. Medicare rates are based on the severity of the patient's condition, service needs and goals, and other factors relating to the cost of providing services and supplies, bundled into an episode of care, not to exceed 60 days. An episode starts the first day a billable visit is performed and ends 60 days later or upon discharge, if earlier, with multiple continuous episodes allowed. The Medicare home health benefit requires that beneficiaries be homebound (meaning that the beneficiary is unable to leave their home without a considerable and taxing effort), require intermittent skilled nursing, physical therapy or speech therapy services, and receive treatment under a plan of care established and periodically reviewed by a physician. All Medicare contracts are required to have a signed plan of care which represents a single performance obligation, comprising of the delivery of a series of distinct services that are substantially similar and have a similar pattern of transfer to the customer. Accordingly, the Company accounts for the series of services ("episode") as a single performance obligation satisfied over time, as the customer simultaneously receives and consumes the benefits of the goods and services provided. Expected Medicare revenue per episode is recognized based on a pro-rated service output method, utilizing our historical average length of episode prior to discharge. The base episode payment can be adjusted based on each patient's health including clinical condition, functional abilities, and service needs, as well as for the applicable geographic wage index, low utilization, patient transfers and other factors. The services covered by the episode payment include all disciplines of care in addition to medical supplies. Medicare can also make various adjustments to payments received if we are unable to produce appropriate billing documentation or acceptable authorizations. In addition, we make adjustments to Medicare revenue if we find we are unable to obtain appropriate billing documentation, authorizations or face-to-face documentation. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record this estimate during the period in which services are rendered as an estimated price concession and a corresponding reduction to patient accounts receivable. A portion of reimbursement from each Medicare episode is billed near the start of each episode, and cash is typically received before all services are rendered. The amount of revenue recognized for episodes of care which are incomplete at period end is based on the company's average percentage of days complete on episodes as of the end of the year. As of June 30, 2018 and 2017 , the difference between the cash received from Medicare for a request for anticipated payment (“RAP”) on episodes in progress and the associated estimated revenue was immaterial and, therefore, the resulting credits were recorded as a reduction to our outstanding patient accounts receivable in our condensed consolidated balance sheets for such periods. Non-Medicare Revenue Episodic-based Revenue. We recognize revenue in a similar manner as we recognize Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms which generally range from 90% to 100% of Medicare rates. Non-episodic based Revenue. Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates. Contractual adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue. We also make adjustments to non-episodic revenue for any implicit price concessions, based on historical experience, to reflect the estimated transaction price. We receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment. Hospice Revenue Recognition Hospice Medicare Revenue Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are predetermined daily or hourly rates for each of the four levels of care we deliver. The four levels of care are routine care, general inpatient care, continuous home care and respite care. Routine care accounts for 99% of our total net Medicare hospice service revenue for each of the three and six-month periods ended June 30, 2018 , and 99% and 98% of our total net Medicare hospice service revenue for each of the three and six -month periods ended June 30, 2017 , respectively. There are two separate payment rates for routine care: payments for the first 60 days of care and care beyond 60 days. In addition to the two routine rates, we may also receive a service intensity add-on (“SIA”). The SIA is based on visits made in the last seven days of life by a registered nurse (“RN”) or medical social worker (“MSW”) for patients in a routine level of care. The performance obligation is the delivery of hospice services to the patient, as determined by a physician, each day the patient is on hospice care. We make adjustments to Medicare revenue for an inability to obtain appropriate billing documentation or acceptable authorizations and other reasons unrelated to credit risk. We estimate the impact of these adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record it during the period services are rendered as an estimated price concession and as a reduction to our outstanding patient accounts receivable. Additionally, our hospice service revenue is subject to certain limitations on payments from Medicare which are considered variable consideration. We are subject to an inpatient cap limit and an overall Medicare payment cap for each provider number. We monitor these caps on a provider-by-provider basis and estimate amounts due back to Medicare if we estimate a cap has been exceeded. We record these adjustments as a reduction to revenue and an increase in other accrued liabilities. Beginning for the cap year ending October 31, 2017, providers are required to self-report and pay their estimated cap liability by February 28 th of the following year. As of June 30, 2018 , we have settled our Medicare hospice reimbursements for all fiscal years through October 31, 2012. As of June 30, 2018 , we have recorded $1.1 million for estimated amounts due back to Medicare in other accrued liabilities for the Federal cap years ended October 31, 2013 through September 30, 2018. As of December 31, 2017 , we had recorded $0.9 million for estimated amounts due back to Medicare in other accrued liabilities for the Federal cap years ended October 31, 2013 through September 30, 2018. Hospice Non-Medicare Revenue Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per day rates, as applicable. Contractual adjustments are recorded for the difference between our established rates and the amounts estimated to be realizable from patients, third parties and others for services provided and are deducted from gross revenue to determine our net service revenue. We also make adjustments to non-Medicare revenue for any implicit price concessions, based on historical experience, to reflect the estimated transaction price. Personal Care Revenue Recognition Personal Care Revenue We generate net service revenues by providing our services directly to patients based on authorized hours, visits or units determined by the relevant agency, at a rate that is either contractual or fixed by legislation, which are recognized as net service revenue at the time services are rendered. We receive payment for providing such services from payors, including state and local governmental agencies, managed care organizations, commercial insurers and private consumers. Payors include the following elder service agencies: Aging Services Access Points (ASAPs), Senior Care Options (SCOs), Program of All-Inclusive Care for the Elderly (PACE) and the Veterans Administration (VA). |
Patient Accounts Receivable | Patient Accounts Receivable We report accounts receivable from services rendered at their estimated transaction price, which includes price concessions based on the amounts expected to be due from payors. Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party payors and patients. As of June 30, 2018 , there is only one single payor, other than Medicare, that accounts for more than 10% of our total outstanding patient receivables (approximately 11.8% ). Thus, we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. We believe the collectibility risk associated with our Medicare accounts, which represent 56% and 59% of our patient accounts receivable at June 30, 2018 and December 31, 2017 , respectively, is limited due to our historical collection rate of over 99% from Medicare and the fact that Medicare is a U.S. government payor. Accordingly, we do not record an allowance for doubtful accounts for our Medicare patient accounts receivable, which are recorded at their net realizable value after recording estimated price concessions as discussed above. During the three and six -month periods ended June 30, 2018 , we recorded $2.5 million and $4.2 million , respectively, in estimated revenue adjustments to Medicare revenue as compared to $5.0 million and $8.4 million during the three and six -month periods ended June 30, 2017 , respectively. We do not believe there are any significant concentrations of revenues from any payor that would subject us to any significant credit risk in the collection of our accounts receivable. Medicare Home Health For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for 60% of our estimated payment for the initial episode at the start of care or 50% of the estimated payment for any subsequent episodes of care contiguous with the first episode for a particular patient. The full amount of the episode is billed after the episode has been completed (“final billed”). The RAP received for that particular episode is then deducted from our final payment. If a final bill is not submitted within the greater of 120 days from the start of the episode, or 60 days from the date the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other claims in process for that particular provider number. The RAP and final claim must then be resubmitted. Medicare Hospice For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We bill Medicare on a monthly basis for the services provided to the patient. Non-Medicare Home Health, Hospice and Personal Care For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient’s eligibility for services with the applicable payor. Once the patient has been confirmed for eligibility, we will provide services to the patient and bill the applicable payor. Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular payors or groups of payors with similar characteristics that would subject us to any significant credit risk. |
Property and Equipment | Property and Equipment Property and equipment is stated at cost and we depreciate it on a straight-line basis over the estimated useful lives of the assets. Additionally, we have internally developed computer software for our own use. Additions and improvements (including interest costs for construction of qualifying long-lived assets) are capitalized. Maintenance and repair expenses are charged to expense as incurred. The cost of property and equipment sold or disposed of and the related accumulated depreciation are eliminated from the property and related accumulated depreciation accounts, and any gain or loss is credited or charged to other general and administrative expenses. |
Fair Value of Financial Instruments | Fair Value of Financial Instruments The fair value hierarchy is based on three levels of inputs, of which the first two are considered observable and the last unobservable, that may be used to measure fair value. The three levels of inputs are as follows: • Level 1 – Quoted prices in active markets for identical assets and liabilities. • Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. • Level 3 – Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities. Our deferred compensation plan assets are recorded at fair value and are considered a level 2 measurement. For our other financial instruments, including our cash and cash equivalents, patient accounts receivable, accounts payable, payroll and employee benefits and accrued expenses, we estimate the carrying amounts approximate fair value. |
Weighted-Average Shares Outstanding | Weighted-Average Shares Outstanding Net income per share attributable to Amedisys, Inc. common stockholders, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. |
SUMMARY OF SIGNIFICANT ACCOUN14
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Accounting Policies [Abstract] | |
Schedule of Effect of Adoption of ASC 606 | Our adoption of ASC 606 on January 1, 2018, on a full retrospective basis, impacted the Company's previously reported results as follows (amounts in thousands, unaudited): As Previously Reported Adjustment for the Adoption of ASC 606 As Adjusted As of December 31, 2017 Condensed Consolidated Balance Sheets Patient accounts receivable $ 201,196 $ — $ 201,196 Allowance for doubtful accounts $ 20,866 $ 20,866 $ — For the three-month period ended June 30, 2017 Condensed Consolidated Statements of Operations Net service revenue $ 378,821 $ (3,875 ) $ 374,946 Cost of service, excluding depreciation and amortization $ 219,765 $ 776 $ 220,541 Provision for doubtful accounts $ 4,651 $ (4,651 ) $ — Net income attributable to Amedisys, Inc. $ 4,461 $ — $ 4,461 For the six-month period ended June 30, 2017 Condensed Consolidated Statements of Operations Net service revenue $ 749,279 $ (9,672 ) $ 739,607 Cost of service, excluding depreciation and amortization $ 435,550 $ 1,320 $ 436,870 Provision for doubtful accounts $ 10,992 $ (10,992 ) $ — Net income attributable to Amedisys, Inc. $ 19,591 $ — $ 19,591 Condensed Consolidated Statements of Cash Flows Provision for doubtful accounts $ 10,992 $ (10,992 ) $ — Changes in operating assets and liabilities, net of impact of acquisitions: Patient accounts receivable $ (17,825 ) $ 10,992 $ (6,833 ) |
Schedule of Property and Equipment | The following table summarizes the balances related to our property and equipment for the periods indicated (amounts in millions): As of June 30, 2018 As of December 31, 2017 Building and leasehold improvements $ 8.8 $ 7.8 Equipment and furniture 56.9 72.9 Computer software 63.4 97.2 129.1 177.9 Less: accumulated depreciation (101.1 ) (146.8 ) $ 28.0 $ 31.1 |
Schedule of Weighted-Average Shares Outstanding | The following table sets forth, for the periods indicated, shares used in our computation of the weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands): For the Three- Month Periods Ended June 30, For the Six- Month Periods Ended June 30, 2018 2017 2018 2017 Weighted average number of shares outstanding - basic 33,439 33,637 33,705 33,540 Effect of dilutive securities: Stock options 425 329 381 285 Non-vested stock and stock units 315 363 305 378 Weighted average number of shares outstanding - diluted 34,179 34,329 34,391 34,203 Anti-dilutive securities 57 169 88 248 |
LONG-TERM OBLIGATIONS LONG-TERM
LONG-TERM OBLIGATIONS LONG-TERM OBLIGATIONS (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Debt Disclosure [Abstract] | |
Schedule of Long-Term Debt | Long-term debt consisted of the following for the periods indicated (amounts in millions): June 30, 2018 December 31, 2017 $100.0 million Term Loan; principal payments plus accrued interest payable quarterly; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate; due August 28, 2020 $ — $ 90.0 $200.0 million Revolving Credit Facility; interest only payments; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate; due August 28, 2020 — — $550.0 million Revolving Credit Facility; interest only payments; interest rate at Base Rate plus Applicable Rate or Eurodollar Rate plus the Applicable Rate (3.7% at June 30, 2018); due June 29, 2023 127.5 — Promissory notes 0.9 0.7 Capital leases 0.1 — Principal amount of long-term obligations 128.5 90.7 Deferred debt issuance costs (3.9 ) (1.9 ) 124.6 88.8 Current portion of long-term obligations (0.7 ) (10.6 ) Total $ 123.9 $ 78.2 |
Schedule of Commitment Fee Under Credit Facilities | We are also subject to a commitment fee and letter of credit fee under the terms of the Credit Agreement, as presented in the table below. Pricing Tier Consolidated Leverage Ratio Commitment Fee Letter of Credit Fee Eurodollar Rate Loans Base Rate Loans I > 3.00 to 1.0 0.35% 2.00% 2.25% 1.25% II ≤ 3.00 to 1.0 but > 2.00 to 1.0 0.30% 1.75% 2.00% 1.00% III ≤ 2.00 to 1.0 but > 1.00 to 1.0 0.25% 1.50% 1.75% 0.75% IV ≤ 1.00 to 1.0 0.20% 1.25% 1.50% 0.50% |
SEGMENT INFORMATION (Tables)
SEGMENT INFORMATION (Tables) | 6 Months Ended |
Jun. 30, 2018 | |
Segment Reporting [Abstract] | |
Schedule of Operating Income of Reportable Segments | For the Three-Month Period Ended June 30, 2018 Home Health Hospice Personal Care Other Total Net service revenue $ 291.5 $ 101.4 $ 18.7 $ — $ 411.6 Cost of service, excluding depreciation and amortization 176.5 51.7 14.4 — 242.6 General and administrative expenses 68.4 20.3 3.3 31.1 123.1 Depreciation and amortization 0.8 0.3 — 2.0 3.1 Operating expenses 245.7 72.3 17.7 33.1 368.8 Operating income (loss) $ 45.8 $ 29.1 $ 1.0 $ (33.1 ) $ 42.8 For the Three-Month Period Ended June 30, 2017 Home Health Hospice Personal Care Other Total Net service revenue $ 270.3 $ 90.3 $ 14.3 $ — $ 374.9 Cost of service, excluding depreciation and amortization 164.8 45.4 10.3 — 220.5 General and administrative expenses 68.9 19.1 3.0 30.0 121.0 Depreciation and amortization 1.0 0.2 — 3.3 4.5 Securities Class Action Lawsuit settlement, net — — — 28.7 28.7 Operating expenses 234.7 64.7 13.3 62.0 374.7 Operating income (loss) $ 35.6 $ 25.6 $ 1.0 $ (62.0 ) $ 0.2 For the Six-Month Period Ended June 30, 2018 Home Health Hospice Personal Care Other Total Net service revenue $ 575.6 $ 198.7 $ 36.6 $ — $ 810.9 Cost of service, excluding depreciation and amortization 350.9 101.8 28.2 — 480.9 General and administrative expenses 136.4 40.3 6.5 61.3 244.5 Depreciation and amortization 1.6 0.5 0.1 4.5 6.7 Operating expenses 488.9 142.6 34.8 65.8 732.1 Operating income (loss) $ 86.7 $ 56.1 $ 1.8 $ (65.8 ) $ 78.8 For the Six-Month Period Ended June 30, 2017 Home Health Hospice Personal Care Other Total Net service revenue $ 537.9 $ 173.9 $ 27.8 $ — $ 739.6 Cost of service, excluding depreciation and amortization 327.8 88.4 20.7 — 436.9 General and administrative expenses 136.9 37.0 6.2 59.5 239.6 Depreciation and amortization 1.9 0.5 0.1 6.5 9.0 Securities Class Action Lawsuit settlement, net — — — 28.7 28.7 Operating expenses 466.6 125.9 27.0 94.7 714.2 Operating income (loss) $ 71.3 $ 48.0 $ 0.8 $ (94.7 ) $ 25.4 |
NATURE OF OPERATIONS, CONSOLI17
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS - Narrative (Details) $ in Millions | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2018USD ($)statecare_center | Jun. 30, 2017 | Jun. 30, 2018USD ($)statecare_center | Jun. 30, 2017 | Dec. 31, 2017USD ($) | |
Organization, Consolidation and Presentation of Financial Statements [Line Items] | |||||
Number of states with facilities | state | 34 | 34 | |||
Minimum ownership percentage for controlling interest (percent) | 50.00% | 50.00% | |||
Maximum ownership percentage for equity method investment (percent) | 50.00% | 50.00% | |||
Equity method investment, aggregate cost | $ | $ 29 | $ 29 | $ 26.4 | ||
Maximum ownership percentage for cost method investment (percent) | 20.00% | 20.00% | |||
Home Health | |||||
Organization, Consolidation and Presentation of Financial Statements [Line Items] | |||||
Number of owned and operated care centers | 322 | 322 | |||
Hospice | |||||
Organization, Consolidation and Presentation of Financial Statements [Line Items] | |||||
Number of owned and operated care centers | 83 | 83 | |||
Personal Care | |||||
Organization, Consolidation and Presentation of Financial Statements [Line Items] | |||||
Number of owned and operated care centers | 15 | 15 | |||
Net Service Revenue | Medicare Revenue | |||||
Organization, Consolidation and Presentation of Financial Statements [Line Items] | |||||
Percent of net services revenue | 74.00% | 76.00% | 74.00% | 76.00% |
SUMMARY OF SIGNIFICANT ACCOUN18
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Revenue Recognition Impact From Adoption (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | Dec. 31, 2017 | |
Condensed Consolidated Balance Sheets | |||||
Patient accounts receivable | $ 197,592 | $ 197,592 | $ 201,196 | ||
Allowance for doubtful accounts | 0 | ||||
Condensed Consolidated Statements of Operations | |||||
Net service revenue | 411,603 | $ 374,946 | 810,865 | $ 739,607 | |
Cost of service, excluding depreciation and amortization | 242,564 | 220,541 | 480,873 | 436,870 | |
Provision for doubtful accounts | 0 | 0 | |||
Net income attributable to Amedisys, Inc. | $ 33,349 | 4,461 | 60,508 | 19,591 | |
Condensed Consolidated Statements of Cash Flows | |||||
Provision for doubtful accounts | 0 | 0 | |||
Changes in operating assets and liabilities, net of impact of acquisitions: | |||||
Patient accounts receivable | $ 3,604 | (6,833) | |||
ASU 2014-09 | As Previously Reported | |||||
Condensed Consolidated Balance Sheets | |||||
Patient accounts receivable | 201,196 | ||||
Allowance for doubtful accounts | (20,866) | ||||
Condensed Consolidated Statements of Operations | |||||
Net service revenue | 378,821 | 749,279 | |||
Cost of service, excluding depreciation and amortization | 219,765 | 435,550 | |||
Provision for doubtful accounts | 4,651 | 10,992 | |||
Net income attributable to Amedisys, Inc. | 4,461 | 19,591 | |||
Condensed Consolidated Statements of Cash Flows | |||||
Provision for doubtful accounts | 4,651 | 10,992 | |||
Changes in operating assets and liabilities, net of impact of acquisitions: | |||||
Patient accounts receivable | (17,825) | ||||
ASU 2014-09 | Adjustment for the Adoption of ASC 606 | |||||
Condensed Consolidated Balance Sheets | |||||
Patient accounts receivable | 0 | ||||
Allowance for doubtful accounts | $ 20,866 | ||||
Condensed Consolidated Statements of Operations | |||||
Net service revenue | (3,875) | (9,672) | |||
Cost of service, excluding depreciation and amortization | 776 | 1,320 | |||
Provision for doubtful accounts | (4,651) | (10,992) | |||
Net income attributable to Amedisys, Inc. | 0 | 0 | |||
Condensed Consolidated Statements of Cash Flows | |||||
Provision for doubtful accounts | $ (4,651) | (10,992) | |||
Changes in operating assets and liabilities, net of impact of acquisitions: | |||||
Patient accounts receivable | $ 10,992 |
SUMMARY OF SIGNIFICANT ACCOUN19
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Revenue Recognition Narrative (Details) $ in Millions | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2018USD ($) | Jun. 30, 2017 | Jun. 30, 2018USD ($)visit | Jun. 30, 2017 | Dec. 31, 2017USD ($) | |
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||||
Episode of care as episodic-based revenue (days) | 60 days | ||||
Net service revenue episode payment rate (days) | 60 days | ||||
Percentage of total reimbursement of outlier payment | 10.00% | ||||
Low utilization payment adjustment, maximum number of visits | 5 | ||||
First threshold of therapy services required (visits) | 6 | ||||
Second threshold of therapy services required (visits) | 14 | ||||
Third threshold of therapy services required (visits) | 20 | ||||
Historical collection rate from Medicare | 99.00% | ||||
Hospice Medicare revenue rate accounted for routine care | 99.00% | 99.00% | 99.00% | 98.00% | |
Minimum [Member] | |||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||||
Non-Medicare revenue term rates | 90.00% | ||||
Maximum [Member] | |||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||||
Non-Medicare revenue term rates | 100.00% | ||||
Home Health | |||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||||
Historical collection rate from Medicare | 99.00% | ||||
Hospice | |||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||||
Historical collection rate from Medicare | 99.00% | ||||
Cap Year 2013 Through 2018 | |||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||||
Estimated amounts due back to Medicare | $ | $ 1.1 | $ 1.1 | $ 0.9 | ||
Medicare Revenue | Net Service Revenue | |||||
Revenue Recognition, Multiple-deliverable Arrangements [Line Items] | |||||
Percent of net services revenue | 74.00% | 76.00% | 74.00% | 76.00% |
SUMMARY OF SIGNIFICANT ACCOUN20
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Patient Accounts Receivable Narrative (Details) $ in Millions | 3 Months Ended | 6 Months Ended | |||
Jun. 30, 2018USD ($) | Jun. 30, 2017USD ($) | Jun. 30, 2018USD ($)day | Jun. 30, 2017USD ($) | Dec. 31, 2017 | |
Concentration Risk [Line Items] | |||||
Percentage of patient receivables outstanding | 10.00% | ||||
Accounts receivable derived from Medicare | 56.00% | 56.00% | 59.00% | ||
Historical collection rate from Medicare | 99.00% | ||||
Revenue adjustment to Medicare revenue | $ | $ 2.5 | $ 5 | $ 4.2 | $ 8.4 | |
Rate of request for anticipated payment submitted for the initial episode of care | 60.00% | ||||
Rate of request for anticipated payment submitted for subsequent episodes of care | 50.00% | ||||
Maximum days to submit final bill from the start of episode | 120 | ||||
Maximum days to submit final bill from the date the request for anticipated payment was paid | 60 | ||||
Customer Concentration Risk | Accounts Receivable | Single Payor | |||||
Concentration Risk [Line Items] | |||||
Concentration risk (percent) | 11.80% |
SUMMARY OF SIGNIFICANT ACCOUN21
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Property and Equipment (Details) - USD ($) $ in Thousands | Jun. 30, 2018 | Dec. 31, 2017 |
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | $ 129,100 | $ 177,900 |
Less: accumulated depreciation | (101,128) | (146,814) |
Property and equipment | 27,998 | 31,122 |
Building and leasehold improvements | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | 8,800 | 7,800 |
Equipment and furniture | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | 56,900 | 72,900 |
Computer software | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | $ 63,400 | $ 97,200 |
SUMMARY OF SIGNIFICANT ACCOUN22
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Weighted-Average Shares Outstanding (Details) - shares shares in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Accounting Policies [Abstract] | ||||
Weighted average number of shares outstanding - basic (shares) | 33,439 | 33,637 | 33,705 | 33,540 |
Effect of dilutive securities: | ||||
Stock options (shares) | 425 | 329 | 381 | 285 |
Non-vested stock and stock units (shares) | 315 | 363 | 305 | 378 |
Weighted average number of shares outstanding - diluted (shares) | 34,179 | 34,329 | 34,391 | 34,203 |
Anti-dilutive securities (shares) | 57 | 169 | 88 | 248 |
ACQUISITIONS - Narrative (Detai
ACQUISITIONS - Narrative (Details) $ in Millions | May 01, 2018USD ($)care_center | Mar. 01, 2018USD ($) | Jun. 30, 2018USD ($) | Mar. 31, 2018USD ($) | Jun. 30, 2018USD ($) | Dec. 31, 2017USD ($) |
Business Acquisition [Line Items] | ||||||
Principal amount | $ 128.5 | $ 128.5 | $ 90.7 | |||
Home Health | Christian Care at Home | ||||||
Business Acquisition [Line Items] | ||||||
Payments to acquire business | $ 2.3 | |||||
Goodwill recorded during period | $ 2.3 | |||||
Personal Care | East Tennessee Personal Care Services | ||||||
Business Acquisition [Line Items] | ||||||
Payments to acquire business | $ 2 | |||||
Goodwill recorded during period | 1.9 | |||||
Tennessee [Member] | Personal Care | East Tennessee Personal Care Services | ||||||
Business Acquisition [Line Items] | ||||||
Acquisition, number of care centers acquired | care_center | 1 | |||||
Noncompete Agreements [Member] | Personal Care | East Tennessee Personal Care Services | ||||||
Business Acquisition [Line Items] | ||||||
Acquisition, other intangibles recorded | 0.1 | $ 0.1 | ||||
Weighted-average amortization period | 2 years 9 months 18 days | |||||
Promissory Notes [Member] | ||||||
Business Acquisition [Line Items] | ||||||
Principal amount | $ 0.9 | $ 0.9 | $ 0.7 | |||
Promissory Notes [Member] | Personal Care | East Tennessee Personal Care Services | ||||||
Business Acquisition [Line Items] | ||||||
Principal amount | $ 0.2 |
LONG-TERM OBLIGATIONS - Schedul
LONG-TERM OBLIGATIONS - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions | Jun. 30, 2018 | Dec. 31, 2017 |
Debt Instrument [Line Items] | ||
Principal amount | $ 128.5 | $ 90.7 |
Deferred debt issuance costs | (3.9) | (1.9) |
Long-term obligations, including current portion | 124.6 | 88.8 |
Current portion of long-term obligations | (0.7) | (10.6) |
Long-term obligations, less current portion | 123.9 | 78.2 |
Term Loan | 100 Million Term Loan | ||
Debt Instrument [Line Items] | ||
Principal amount | 0 | 90 |
Promissory Notes [Member] | ||
Debt Instrument [Line Items] | ||
Principal amount | 0.9 | 0.7 |
Capital Lease Obligations [Member] | ||
Debt Instrument [Line Items] | ||
Principal amount | 0.1 | 0 |
Revolving Credit Facility [Member] | 200 Million Revolving Credit Facility | ||
Debt Instrument [Line Items] | ||
Principal amount | 0 | 0 |
Revolving Credit Facility [Member] | 550 Million Revolving Credit Facility [Member] | ||
Debt Instrument [Line Items] | ||
Principal amount | $ 127.5 | $ 0 |
LONG-TERM OBLIGATIONS - Sched25
LONG-TERM OBLIGATIONS - Schedule of Long-Term Debt Additional Information (Details) - USD ($) | 6 Months Ended | |
Jun. 30, 2018 | Jun. 29, 2018 | |
Term Loan | 100 Million Term Loan | ||
Debt Instrument [Line Items] | ||
Debt instrument, face amount | $ 100,000,000 | |
Term Loan [Member] | 100 Million Term Loan | ||
Debt Instrument [Line Items] | ||
Maturity Date | Aug. 28, 2020 | |
Revolving Credit Facility [Member] | 200 Million Revolving Credit Facility | ||
Debt Instrument [Line Items] | ||
Debt instrument, face amount | $ 200,000,000 | |
Maturity Date | Aug. 28, 2020 | |
Revolving Credit Facility [Member] | 550 Million Revolving Credit Facility [Member] | ||
Debt Instrument [Line Items] | ||
Debt instrument, face amount | $ 550,000,000 | $ 550,000,000 |
Maturity Date | Jun. 29, 2023 | |
Revolving Credit Facility [Member] | 550 Million Revolving Credit Facility [Member] | Eurodollar [Member] | ||
Debt Instrument [Line Items] | ||
Basis spread on variable rate | 3.70% |
LONG-TERM OBLIGATIONS - Fees an
LONG-TERM OBLIGATIONS - Fees and Rates Under Credit Facilities (Details) | 6 Months Ended |
Jun. 30, 2018 | |
Consolidated Leverage Ratio: Greater Than 3.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Commitment fee percentage | 0.35% |
Letter Of Credit Fee | 2.00% |
Consolidated Leverage Ratio: Greater Than 3.00 to 1.0 | Eurodollar [Member] | |
Line of Credit Facility [Line Items] | |
Basis spread on variable rate | 2.25% |
Consolidated Leverage Ratio: Greater Than 3.00 to 1.0 | Base Rate [Member] | |
Line of Credit Facility [Line Items] | |
Basis spread on variable rate | 1.25% |
Consolidated Leverage Ratio: Less Than Equal To 3.00 to 1.0 but Greater Than 2.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Commitment fee percentage | 0.30% |
Letter Of Credit Fee | 1.75% |
Consolidated Leverage Ratio: Less Than Equal To 3.00 to 1.0 but Greater Than 2.00 to 1.0 | Eurodollar [Member] | |
Line of Credit Facility [Line Items] | |
Basis spread on variable rate | 2.00% |
Consolidated Leverage Ratio: Less Than Equal To 3.00 to 1.0 but Greater Than 2.00 to 1.0 | Base Rate [Member] | |
Line of Credit Facility [Line Items] | |
Basis spread on variable rate | 1.00% |
Consolidated Leverage Ratio: Less Than Equal to 2.00 to 1.0 but Greater Than 1.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Commitment fee percentage | 0.25% |
Letter Of Credit Fee | 1.50% |
Consolidated Leverage Ratio: Less Than Equal to 2.00 to 1.0 but Greater Than 1.00 to 1.0 | Eurodollar [Member] | |
Line of Credit Facility [Line Items] | |
Basis spread on variable rate | 1.75% |
Consolidated Leverage Ratio: Less Than Equal to 2.00 to 1.0 but Greater Than 1.00 to 1.0 | Base Rate [Member] | |
Line of Credit Facility [Line Items] | |
Basis spread on variable rate | 0.75% |
Consolidated Leverage Ratio: Less Than Equal to 1.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Commitment fee percentage | 0.20% |
Letter Of Credit Fee | 1.25% |
Consolidated Leverage Ratio: Less Than Equal to 1.00 to 1.0 | Eurodollar [Member] | |
Line of Credit Facility [Line Items] | |
Basis spread on variable rate | 1.50% |
Consolidated Leverage Ratio: Less Than Equal to 1.00 to 1.0 | Base Rate [Member] | |
Line of Credit Facility [Line Items] | |
Basis spread on variable rate | 0.50% |
Minimum [Member] | Consolidated Leverage Ratio: Greater Than 3.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 3 |
Minimum [Member] | Consolidated Leverage Ratio: Less Than Equal To 3.00 to 1.0 but Greater Than 2.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 2 |
Minimum [Member] | Consolidated Leverage Ratio: Less Than Equal to 2.00 to 1.0 but Greater Than 1.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 1 |
Maximum [Member] | Consolidated Leverage Ratio: Less Than Equal To 3.00 to 1.0 but Greater Than 2.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 3 |
Maximum [Member] | Consolidated Leverage Ratio: Less Than Equal to 2.00 to 1.0 but Greater Than 1.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 2 |
Maximum [Member] | Consolidated Leverage Ratio: Less Than Equal to 1.00 to 1.0 | |
Line of Credit Facility [Line Items] | |
Consolidated Leverage Ratio | 1 |
LONG-TERM OBLIGATIONS - Narrati
LONG-TERM OBLIGATIONS - Narrative (Details) | Jun. 29, 2018USD ($) | Jun. 30, 2018USD ($) | Jun. 30, 2017 | Jun. 30, 2018USD ($) | Jun. 30, 2017USD ($) | Dec. 31, 2017USD ($) |
Debt Instrument [Line Items] | ||||||
Consolidated leverage ratio | 0.8 | 0.8 | ||||
Consolidated interest coverage ratio | 51 | 51 | ||||
Credit facility, maximum borrowing capacity | $ 550,000,000 | |||||
Principal payments of long-term obligations | $ 90,475,000 | $ 2,500,000 | ||||
Deferred debt issuance cost | $ 2,400,000 | 2,400,000 | ||||
Principal amount | 128,500,000 | 128,500,000 | $ 90,700,000 | |||
Term Loan | 100 Million Term Loan | ||||||
Debt Instrument [Line Items] | ||||||
Debt instrument, face amount | $ 100,000,000 | $ 100,000,000 | ||||
Weighted average interest rate (percent) | 3.90% | 3.00% | 3.80% | 2.90% | ||
Principal amount | $ 0 | $ 0 | 90,000,000 | |||
Swing Line Loan [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Revolving Credit Facility Total | 25,000,000 | |||||
Letter of Credit [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Revolving Credit Facility Total | 60,000,000 | |||||
Revolving Credit Facility [Member] | 200 Million Revolving Credit Facility | ||||||
Debt Instrument [Line Items] | ||||||
Debt instrument, face amount | 200,000,000 | $ 200,000,000 | ||||
Maturity Date | Aug. 28, 2020 | |||||
Principal amount | 0 | $ 0 | 0 | |||
Revolving Credit Facility [Member] | 550 Million Revolving Credit Facility [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Debt instrument, face amount | 550,000,000 | $ 550,000,000 | $ 550,000,000 | |||
Weighted average interest rate (percent) | 3.70% | 3.70% | ||||
Credit facility, maximum additional borrowing capacity | $ 125,000,000 | |||||
Credit facility, maximum allowable consolidated leverage ratio multiple | 0.5 | |||||
Maturity Date | Jun. 29, 2023 | |||||
Remaining availability under revolving credit facility | $ 388,100,000 | $ 388,100,000 | ||||
Principal amount | 127,500,000 | $ 127,500,000 | $ 0 | |||
Prior Credit Agreement [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Principal payments of long-term obligations | $ 127,500,000 | |||||
Credit Agreement [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Additional interest rate above Federal Fund rate | 0.50% | |||||
Additional interest rate above Eurodollar rate | 1.00% | |||||
Percentage of consolidated revenue and adjusted EBITDA that guarantor wholly-owned subsidiaries represent | 95.00% | |||||
Percentage of adjusted EBITDA that guarantor subsidiaries represent | 70.00% | |||||
Line of Credit [Member] | 550 Million Revolving Credit Facility [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Outstanding letters of credit | $ 34,400,000 | $ 34,400,000 | ||||
Base Rate [Member] | Credit Agreement [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Description of variable rate basis | Fluctuating rate per annum equal to the highest of (a) the federal funds rate plus 0.50% per annum, (b) the prime rate of interest established by the Administrative Agent, and (c) the Eurodollar Rate for an interest period of one month plus 1% per annum. | |||||
Base Rate [Member] | Credit Agreement [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Basis spread on variable rate | 0.50% | |||||
Eurodollar [Member] | Credit Agreement [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Description of variable rate basis | Rate at which Eurodollar deposits in the London interbank market for an interest period of one, two, three or six months | |||||
Eurodollar [Member] | Revolving Credit Facility [Member] | 550 Million Revolving Credit Facility [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Basis spread on variable rate | 3.70% | |||||
Eurodollar [Member] | Credit Agreement [Member] | ||||||
Debt Instrument [Line Items] | ||||||
Basis spread on variable rate | 1.50% |
COMMITMENTS AND CONTINGENCIES -
COMMITMENTS AND CONTINGENCIES - Narrative (Details) $ in Thousands | Jun. 27, 2016patient | Jan. 18, 2016USD ($)claim | Nov. 03, 2015patient | May 21, 2015patient | Apr. 23, 2014 | Jun. 06, 2011beneficiary | Aug. 31, 2017USD ($)claim | Jun. 30, 2018USD ($) | Sep. 30, 2017USD ($) | Jun. 30, 2017USD ($) | Jun. 30, 2018USD ($) | Jun. 30, 2017USD ($) | Mar. 31, 2010beneficiary | Dec. 31, 2017USD ($) |
Loss Contingencies [Line Items] | ||||||||||||||
Corporate integrity agreement term (years) | 5 years | |||||||||||||
Securities Class Action Lawsuit settlement, net | $ 0 | $ 28,712 | $ 0 | $ 28,712 | ||||||||||
Patient accounts receivable | 197,592 | 197,592 | $ 201,196 | |||||||||||
Health insurance retention limit | 1,000 | |||||||||||||
Workers compensation insurance retention limit | 500 | |||||||||||||
Professional liability insurance retention limit | 300 | |||||||||||||
Hospice | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Securities Class Action Lawsuit settlement, net | 0 | 0 | ||||||||||||
Home Health | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Securities Class Action Lawsuit settlement, net | 0 | 0 | ||||||||||||
South Carolina | Hospice | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of beneficiaries | beneficiary | 30 | |||||||||||||
Indemnity receivable related to amounts withheld prior to August 2009 | 4,900 | 4,900 | ||||||||||||
South Carolina | Hospice | Extrapolated | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of beneficiaries | beneficiary | 16 | |||||||||||||
South Carolina | Hospice | Unfavorable | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of overpayment made to subsidiary | $ 3,700 | |||||||||||||
Recovery amount of overpayment made to subsidiary including interest | $ 5,600 | |||||||||||||
Number of claims submitted by subsidiary | claim | 9 | |||||||||||||
Recovery amount of over payment made to subsidiary including interest withheld | 5,700 | 5,700 | ||||||||||||
US Department of Justice | Massachusetts | Hospice | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of patients | patient | 53 | |||||||||||||
US Department of Justice | Morgantown, West Virginia | Hospice | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of patients | patient | 66 | |||||||||||||
US Department of Justice | Parkersburg, West Virginia | Hospice | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Number of patients | patient | 68 | |||||||||||||
Securities Class Action Lawsuit [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Payments for legal settlements | $ 28,700 | |||||||||||||
Loss contingency accrual | 43,700 | 43,700 | ||||||||||||
Settlement amount to be paid by company's insurance carriers | 15,000 | $ 15,000 | ||||||||||||
Securities Class Action Lawsuit settlement, net | $ 28,700 | |||||||||||||
Safeguard Zone Program Integrity Contractor | Florida | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Loss contingency accrual | 17,400 | 17,400 | ||||||||||||
Indemnity receivable | 10,900 | 10,900 | ||||||||||||
Indemnification amount | 12,600 | 12,600 | ||||||||||||
Safeguard Zone Program Integrity Contractor | Florida | Infinity HomeCare | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Indemnification amount | 12,600 | 12,600 | ||||||||||||
Safeguard Zone Program Integrity Contractor | Florida | Home Health | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Florida ZPIC revenue reduction | 6,500 | |||||||||||||
Safeguard Zone Program Integrity Contractor | Florida | Home Health | Minimum [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of overpayment made to subsidiary | 6,500 | 6,500 | ||||||||||||
Safeguard Zone Program Integrity Contractor | Florida | Home Health | Maximum [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of overpayment made to subsidiary | $ 38,800 | 30,300 | 30,300 | |||||||||||
Safeguard Zone Program Integrity Contractor | Florida | Home Health | Infinity HomeCare | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Patient accounts receivable | 2,700 | 2,700 | ||||||||||||
Safeguard Zone Program Integrity Contractor | Lakeland, Florida | Home Health | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of overpayment made to subsidiary | $ 34,000 | 27,000 | 27,000 | |||||||||||
Number of claims submitted by subsidiary | claim | 72 | |||||||||||||
Actual claims payment | $ 200 | |||||||||||||
Error rate (percent) | 100.00% | |||||||||||||
Safeguard Zone Program Integrity Contractor | Clearwater, Florida | Home Health | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Recovery amount of overpayment made to subsidiary | $ 4,800 | $ 3,300 | $ 3,300 | |||||||||||
Number of claims submitted by subsidiary | claim | 70 | |||||||||||||
Actual claims payment | $ 200 | |||||||||||||
Error rate (percent) | 100.00% | |||||||||||||
Company's insurance carriers [Member] | Securities Class Action Lawsuit [Member] | ||||||||||||||
Loss Contingencies [Line Items] | ||||||||||||||
Payments for legal settlements | $ 15,000 |
SEGMENT INFORMATION - Narrative
SEGMENT INFORMATION - Narrative (Details) | 6 Months Ended |
Jun. 30, 2018Segments | |
Segment Reporting [Abstract] | |
Number of reportable business segments | 3 |
SEGMENT INFORMATION - Operating
SEGMENT INFORMATION - Operating Income of Reportable Segments (Details) - USD ($) $ in Thousands | 3 Months Ended | 6 Months Ended | ||
Jun. 30, 2018 | Jun. 30, 2017 | Jun. 30, 2018 | Jun. 30, 2017 | |
Segment Reporting Information [Line Items] | ||||
Net service revenue | $ 411,603 | $ 374,946 | $ 810,865 | $ 739,607 |
Cost of service, excluding depreciation and amortization | 242,564 | 220,541 | 480,873 | 436,870 |
General and administrative expenses | 123,100 | 121,000 | 244,500 | 239,600 |
Depreciation and amortization | 3,125 | 4,537 | 6,718 | 8,954 |
Securities Class Action Lawsuit settlement, net | 0 | 28,712 | 0 | 28,712 |
Operating expenses | 368,775 | 374,706 | 732,032 | 714,202 |
Operating income | 42,828 | 240 | 78,833 | 25,405 |
Home Health | ||||
Segment Reporting Information [Line Items] | ||||
Net service revenue | 291,500 | 270,300 | 575,600 | 537,900 |
Cost of service, excluding depreciation and amortization | 176,500 | 164,800 | 350,900 | 327,800 |
General and administrative expenses | 68,400 | 68,900 | 136,400 | 136,900 |
Depreciation and amortization | 800 | 1,000 | 1,600 | 1,900 |
Securities Class Action Lawsuit settlement, net | 0 | 0 | ||
Operating expenses | 245,700 | 234,700 | 488,900 | 466,600 |
Operating income | 45,800 | 35,600 | 86,700 | 71,300 |
Hospice | ||||
Segment Reporting Information [Line Items] | ||||
Net service revenue | 101,400 | 90,300 | 198,700 | 173,900 |
Cost of service, excluding depreciation and amortization | 51,700 | 45,400 | 101,800 | 88,400 |
General and administrative expenses | 20,300 | 19,100 | 40,300 | 37,000 |
Depreciation and amortization | 300 | 200 | 500 | 500 |
Securities Class Action Lawsuit settlement, net | 0 | 0 | ||
Operating expenses | 72,300 | 64,700 | 142,600 | 125,900 |
Operating income | 29,100 | 25,600 | 56,100 | 48,000 |
Personal Care | ||||
Segment Reporting Information [Line Items] | ||||
Net service revenue | 18,700 | 14,300 | 36,600 | 27,800 |
Cost of service, excluding depreciation and amortization | 14,400 | 10,300 | 28,200 | 20,700 |
General and administrative expenses | 3,300 | 3,000 | 6,500 | 6,200 |
Depreciation and amortization | 0 | 0 | 100 | 100 |
Securities Class Action Lawsuit settlement, net | 0 | 0 | ||
Operating expenses | 17,700 | 13,300 | 34,800 | 27,000 |
Operating income | 1,000 | 1,000 | 1,800 | 800 |
Other | ||||
Segment Reporting Information [Line Items] | ||||
Net service revenue | 0 | 0 | 0 | 0 |
Cost of service, excluding depreciation and amortization | 0 | 0 | 0 | 0 |
General and administrative expenses | 31,100 | 30,000 | 61,300 | 59,500 |
Depreciation and amortization | 2,000 | 3,300 | 4,500 | 6,500 |
Securities Class Action Lawsuit settlement, net | 28,700 | 28,700 | ||
Operating expenses | 33,100 | 62,000 | 65,800 | 94,700 |
Operating income | $ (33,100) | $ (62,000) | $ (65,800) | $ (94,700) |
SHARE REPURCHASE Narrative (Det
SHARE REPURCHASE Narrative (Details) - USD ($) $ / shares in Units, $ in Thousands | Jun. 04, 2018 | Jun. 30, 2018 | Jun. 30, 2017 |
Share Repurchase [Line Items] | |||
Purchase of company stock | $ 181,402 | $ 0 | |
KKR Share Repurchase [Member] | |||
Share Repurchase [Line Items] | |||
Treasury Stock, shares, acquired | 2,418,304 | ||
Percentage of shares outstanding | 7.10% | ||
Purchase of company stock | $ 181,400 | ||
Discounted closing stock price | $ 73.96 | ||
Percentage of closing stock price | 96.00% |