e10vq
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 10-Q
(MARK ONE)
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þ |
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QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
FOR THE QUARTERLY PERIOD ENDED March 31, 2010
OR
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o |
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
FOR THE TRANSITION PERIOD FROM TO
COMMISSION FILE NUMBER 1-11151
U.S. PHYSICAL THERAPY, INC.
(EXACT NAME OF REGISTRANT AS SPECIFIED IN ITS CHARTER)
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NEVADA
(STATE OR OTHER JURISDICTION OF
INCORPORATION OR ORGANIZATION)
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76-0364866
(I.R.S. EMPLOYER
IDENTIFICATION NO.) |
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1300 WEST SAM HOUSTON PARKWAY SOUTH, SUITE 300,
HOUSTON, TEXAS
(ADDRESS OF PRINCIPAL EXECUTIVE OFFICES)
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77042
(ZIP CODE) |
REGISTRANTS TELEPHONE NUMBER, INCLUDING AREA CODE: (713) 297-7000
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by
Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for
such shorter period that the registrant was required to file such reports), and (2) has been
subject to such filing requirements for the past 90 days.
þ Yes o No
Indicate by check mark whether the registrant has submitted electronically and posted on its
corporate Web site, if any, every Interactive Data File required to be submitted and posted
pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period
that the registrant was required to submit and post such files).
o Yes o No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a
non-accelerated filer, or a smaller reporting company. See the definitions of large accelerated
filer, accelerated filer and smaller reporting company in Rule 12b-2 of the Exchange Act.
(Check One):
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Large accelerated filer o
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Accelerated filer þ
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Non-accelerated filer o
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Smaller reporting company o |
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(Do not check if a smaller reporting company) |
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Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the
Exchange Act).
o Yes þ No
As of May 10, 2010, the number of shares outstanding (issued less treasury stock) of the
registrants common stock, par value $.01 per share, was: 11,614,508.
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ITEM 1. |
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FINANCIAL STATEMENTS. |
U. S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(IN THOUSANDS, EXCEPT SHARE DATA)
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March 31, |
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December 31, |
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2010 |
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2009 |
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(unaudited) |
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ASSETS |
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Current assets: |
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Cash |
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$ |
11,471 |
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$ |
6,429 |
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Patient accounts receivable, less allowance for doubtful
accounts of $2,031 and $1,830, respectively |
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23,482 |
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22,300 |
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Accounts receivable other, less allowance for doubtful
accounts of $50 and $42, respectively |
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2,146 |
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1,331 |
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Other current assets |
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2,124 |
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2,959 |
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Total current assets |
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39,223 |
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33,019 |
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Fixed assets: |
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Furniture and equipment |
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32,154 |
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31,973 |
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Leasehold improvements |
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18,916 |
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19,012 |
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51,070 |
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50,985 |
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Less accumulated depreciation and amortization |
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37,185 |
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36,646 |
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13,885 |
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14,339 |
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Goodwill |
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68,801 |
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57,247 |
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Other intangible assets, net |
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5,830 |
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5,955 |
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Other assets |
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885 |
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869 |
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$ |
128,624 |
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$ |
111,429 |
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LIABILITIES AND SHAREHOLDERS EQUITY |
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Current liabilities: |
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Accounts payable trade |
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$ |
1,188 |
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$ |
1,292 |
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Accrued expenses |
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12,559 |
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12,459 |
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Current portion of notes payable |
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1,113 |
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1,013 |
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Total current liabilities |
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14,860 |
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14,764 |
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Notes payable |
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100 |
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Revolving line of credit |
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10,900 |
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400 |
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Deferred rent |
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1,011 |
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1,027 |
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Other long-term liabilities |
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2,564 |
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3,013 |
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Total liabilities |
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29,435 |
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19,204 |
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Commitments and contingencies |
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Shareholders equity: |
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U. S. Physical Therapy, Inc. shareholders equity: |
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Preferred stock, $.01 par value, 500,000 shares authorized,
no shares issued and outstanding |
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Common stock, $.01 par value, 20,000,000 shares authorized,
13,829,245 and 13,828,470 shares issued, respectively |
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138 |
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138 |
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Additional paid-in capital |
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43,514 |
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43,210 |
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Retained earnings |
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78,804 |
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75,632 |
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Treasury stock at cost, 2,214,737 shares |
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(31,628 |
) |
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(31,628 |
) |
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Total U. S. Physical Therapy, Inc. shareholders equity |
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90,828 |
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87,352 |
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Noncontrolling interests |
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8,361 |
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4,873 |
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Total equity |
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99,189 |
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92,225 |
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$ |
128,624 |
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$ |
111,429 |
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See notes to consolidated financial statements.
3
U. S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF NET INCOME
(IN THOUSANDS, EXCEPT PER SHARE DATA)
(unaudited)
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Three Months Ended March 31, |
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2010 |
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2009 |
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Net patient revenues |
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$ |
48,779 |
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$ |
46,664 |
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Management contract revenues and other revenues |
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1,626 |
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1,505 |
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Net revenues |
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50,405 |
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48,169 |
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Clinic operating costs: |
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Salaries and related costs |
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26,771 |
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25,403 |
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Rent, clinic supplies, contract labor and
other |
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10,100 |
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10,213 |
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Provision for doubtful accounts |
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1,034 |
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706 |
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Closure costs |
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29 |
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2 |
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Total clinic operating costs |
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37,934 |
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36,324 |
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Corporate office costs |
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5,805 |
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5,388 |
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Operating income |
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6,666 |
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6,457 |
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Interest and other income, net |
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580 |
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3 |
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Interest expense |
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(64 |
) |
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(88 |
) |
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Income before taxes |
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7,182 |
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6,372 |
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Provision for income taxes |
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2,051 |
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1,779 |
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Net income including noncontrolling interests |
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5,131 |
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4,593 |
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Less: net income attributable to noncontrolling interests |
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(1,959 |
) |
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(1,839 |
) |
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Net income attributable to common shareholders |
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$ |
3,172 |
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$ |
2,754 |
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Earnings per share attributable to common shareholders: |
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Basic |
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$ |
0.27 |
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$ |
0.23 |
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Diluted |
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$ |
0.27 |
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$ |
0.23 |
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Shares used in computation: |
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Basic |
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11,614 |
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12,020 |
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Diluted |
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11,840 |
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12,025 |
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See notes to consolidated financial statements.
4
U. S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(IN THOUSANDS)
(unaudited)
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Three Months Ended March 31, |
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2010 |
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2009 |
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OPERATING ACTIVITIES |
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Net income including noncontrolling interests |
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$ |
5,131 |
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$ |
4,593 |
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Adjustments to reconcile net income including noncontrolling interests
to net cash provided by operating activities: |
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Depreciation and amortization |
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1,431 |
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1,472 |
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Provision for doubtful accounts |
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1,034 |
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|
706 |
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Equity-based awards compensation expense |
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306 |
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414 |
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(Gain) Loss on sale of business and sale or abandonment of assets, net |
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(558 |
) |
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27 |
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Deferred income tax |
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(284 |
) |
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54 |
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Other |
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(24 |
) |
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(117 |
) |
Changes in operating assets and liabilities: |
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Increase in patient accounts receivable |
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(1,583 |
) |
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(503 |
) |
(Increase) decrease in accounts receivable other |
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(62 |
) |
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197 |
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Decrease (increase) in other assets |
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741 |
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(144 |
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Decrease in accounts payable and accrued expenses |
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(58 |
) |
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(324 |
) |
(Decrease) increase in other liabilities |
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(45 |
) |
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58 |
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Net cash provided by operating activities |
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6,029 |
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6,433 |
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INVESTING ACTIVITIES |
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Purchase of fixed assets |
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(588 |
) |
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(1,562 |
) |
Purchase of businesses, net of cash acquired |
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(8,785 |
) |
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Acquisitions of noncontrolling interests |
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(17 |
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Net proceeds on sale of fixed assets and business |
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125 |
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10 |
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Net cash used in investing activities |
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(9,265 |
) |
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(1,552 |
) |
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FINANCING ACTIVITIES |
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Distributions to noncontrolling interests |
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(2,237 |
) |
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(2,393 |
) |
Purchase and retirement of common stock |
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(2,647 |
) |
Proceeds from revolving line of credit |
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19,500 |
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|
5,700 |
|
Payments on revolving line of credit |
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(9,000 |
) |
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(4,500 |
) |
Payment of notes payable |
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(73 |
) |
Excess tax benefit from stock options exercised |
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8 |
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Proceeds from exercise of stock options |
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7 |
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Net cash provided by (used in) financing activities |
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8,278 |
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(3,913 |
) |
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Net increase in cash |
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5,042 |
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|
968 |
|
Cash beginning of period |
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6,429 |
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|
10,113 |
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Cash end of period |
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$ |
11,471 |
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$ |
11,081 |
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SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION |
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Cash paid during the period for: |
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Income taxes |
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$ |
419 |
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$ |
1,744 |
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Interest |
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$ |
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$ |
5 |
|
Non-cash investing and financing transactions during the period: |
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Purchase of business seller financing portion |
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$ |
225 |
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$ |
|
|
See notes to consolidated financial statements.
5
U. S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF SHAREHOLDERS EQUITY
(IN THOUSANDS)
(unaudited)
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U. S. Physical Therapy, Inc |
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Additional |
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Total |
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Common Stock |
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Paid-In |
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Retained |
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Treasury Stock |
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Shareholders |
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Noncontrolling |
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Shares |
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Amount |
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Capital |
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Earnings |
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Shares |
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Amount |
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Equity |
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Interests |
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Total |
|
Balance December 31, 2009 |
|
|
13,829 |
|
|
$ |
138 |
|
|
$ |
43,210 |
|
|
$ |
75,632 |
|
|
|
(2,215 |
) |
|
$ |
(31,628 |
) |
|
$ |
87,352 |
|
|
$ |
4,873 |
|
|
$ |
92,225 |
|
Proceeds from exercise of stock options |
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|
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7 |
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7 |
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|
7 |
|
Tax benefit from exercise of
stock options |
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|
|
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|
|
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8 |
|
|
|
|
|
|
|
|
|
|
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|
|
8 |
|
|
|
|
|
|
|
8 |
|
Compensation expense restricted stock |
|
|
|
|
|
|
|
|
|
|
275 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
275 |
|
|
|
|
|
|
|
275 |
|
Compensation expense stock options |
|
|
|
|
|
|
|
|
|
|
31 |
|
|
|
|
|
|
|
|
|
|
|
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|
31 |
|
|
|
|
|
|
|
31 |
|
Purchase of business |
|
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
3,858 |
|
|
|
3,858 |
|
Sale of business |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(92 |
) |
|
|
(92 |
) |
Purchase of noncontrolling interests |
|
|
|
|
|
|
|
|
|
|
(17 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(17 |
) |
|
|
|
|
|
|
(17 |
) |
Distributions to noncontrolling interest partners |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(2,237 |
) |
|
|
(2,237 |
) |
Net income |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
3,172 |
|
|
|
|
|
|
|
|
|
|
|
3,172 |
|
|
|
1,959 |
|
|
|
5,131 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balance March 31, 2010 |
|
|
13,829 |
|
|
$ |
138 |
|
|
$ |
43,514 |
|
|
$ |
78,804 |
|
|
|
(2,215 |
) |
|
$ |
(31,628 |
) |
|
$ |
90,828 |
|
|
$ |
8,361 |
|
|
$ |
99,189 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
See notes to consolidated financial statements.
6
U.S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
March 31, 2010
(unaudited)
1. BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES
The consolidated financial statements include the accounts of U.S. Physical Therapy, Inc. and its
subsidiaries. All significant intercompany transactions and balances have been eliminated. The
Company primarily operates through subsidiary clinic partnerships, in which the Company generally
owns a 1% general partnership interest and a 64% limited partnership interest. The managing
therapist of each clinic owns, directly or indirectly, the remaining limited partnership interest
in the majority of the clinics (hereinafter referred to as Clinic Partnership). To a lesser
extent, the Company operates some clinics, through wholly-owned subsidiaries, under profit sharing
arrangements with therapists (hereinafter referred to as Wholly-Owned Facilities).
The Company continues to seek to attract physical and occupational therapists who have established
relationships with physicians by offering therapists a competitive salary and a share of the
profits of the clinic operated by that therapist. The Company has developed satellite clinic
facilities of existing clinics, with the result that many clinic groups operate more than one
clinic location. In addition, the Company has acquired a majority interest in a number of clinics
through acquisitions.
During the three months ended March 31, 2010, the Company opened one new clinic, acquired five,
sold five and closed two. The clinic opened was a new Clinic Partnership. On February 26, 2010,
the Company acquired a 70% interest in five clinics and, on March 31, 2010, the Company sold its
51% interest in five Texas clinics. The Company ended March 2010 with 367 clinics.
The Company intends to continue to focus on developing new clinics and on opening satellite clinics
where deemed appropriate. The Company will also continue to evaluate acquisition opportunities.
The accompanying unaudited consolidated financial statements were prepared in accordance with
accounting principles generally accepted in the United States of America for interim financial
information and in accordance with the instructions for Form 10-Q. However, the statements do not
include all of the information and footnotes required by accounting principles generally accepted
in the United States of America for complete financial statements. Management believes this report
contains all necessary adjustments (consisting only of normal recurring adjustments) to present
fairly, in all material respects, the Companys financial position, results of operations and cash
flows for the interim periods presented. For further information regarding the Companys
accounting policies, please read the audited financial statements included in the Companys Form
10-K for the year ended December 31, 2009.
The Company believes, and the Chief Executive Officer, Chief Financial Officer and Corporate
Controller have certified, that the financial statements included in this report present fairly, in
all material respects, the Companys financial position, results of operations and cash flows for
the interim periods presented.
Operating results for the three months ended March 31, 2010 are not necessarily indicative of the
results the Company expects for the entire year. Please also review the Risk Factors section
included in our Form 10-K for the year ended December 31, 2009.
Clinic Partnerships
For Clinic Partnerships, the earnings and liabilities attributable to the noncontrolling interests,
typically owned by the managing therapist, directly or indirectly, are recorded within the balance
sheets and income statements as noncontrolling interests.
Wholly-Owned Facilities
For Wholly-Owned Facilities with profit sharing arrangements, an appropriate accrual is recorded
for the amount of profit sharing due the profit sharing therapists. The amount is expensed as
compensation and included in clinic operating costs salaries and related costs. The respective
liability is included in current liabilities accrued expenses on the balance sheet.
7
Significant Accounting Policies
Cash
The Company maintains its cash at financial institutions. The combined account balances at several
institutions may exceed the Federal Deposit Insurance Corporation (FDIC) insurance coverage and,
as a result, there is a concentration of credit risk related to amounts on deposit in excess of
FDIC insurance coverage. Management believes that this risk is not significant.
Long-Lived Assets
Fixed assets are stated at cost. Depreciation is computed on the straight-line method over the
estimated useful lives of the related assets. Estimated useful lives for furniture and equipment
range from three to eight years and for software purchased from three to seven years. Leasehold
improvements are amortized over the shorter of the related lease term or estimated useful lives of
the assets, which is generally three to five years.
Impairment of Long-Lived Assets and Long-Lived Assets to Be Disposed Of
The Company reviews property and equipment and intangible assets with finite lives for impairment
upon the occurrence of certain events or circumstances which indicate that the related amounts may
be impaired. Assets to be disposed of are reported at the lower of the carrying amount or fair
value less costs to sell.
Goodwill
For 2010 acquisitions, goodwill represents the excess of the amount paid and fair value of the
noncontrolling interests over the fair value of the acquired business assets. Historically,
goodwill has been derived from acquisitions and, prior to 2009, from the purchase of some or all of
a particular local managements equity interest in an existing clinic. Effective January 1, 2009,
if the purchase price of a noncontrolling interest by the Company exceeds or is less than the book
value at the time of purchase, any excess or shortfall is recognized as an adjustment to
additional-paid-in-capital.
The fair value of goodwill and other intangible assets with indefinite lives are tested for
impairment at least annually and upon the occurrence of certain events, and are written down to
fair value if considered impaired. The Company evaluates goodwill for impairment on at least an
annual basis (in its third quarter) by comparing the fair value of each reporting unit to the
carrying value of the reporting unit including related goodwill. The Company operates a one
segment business which is made up of various clinics within partnerships. A reporting unit refers
to the acquired interest of a single clinic or group of clinics. Local management typically
continues to manage the acquired clinic or group of clinics. For each clinic or group of clinics,
the Company maintains discrete financial information and both corporate and local management
regularly review the operating results. Historically, the Company has not combined any of the
reporting units for impairment testing because they did not meet the criteria for aggregation. For
each purchase of the equity interest, goodwill is assigned to the respective clinic or group of
clinics, if deemed appropriate.
An impairment loss generally would be recognized when the carrying amount of the net assets of the
reporting unit, inclusive of goodwill and other intangible assets, exceed the estimated fair value
of the reporting unit. The estimated fair value of a reporting unit is determined using two
factors: (i) earnings prior to taxes, depreciation and amortization for the reporting unit
multiplied by a price/earnings ratio used in the industry and (ii) a discounted cash flow analysis.
A weight is assigned to each factor and the sum of each weight times the factor is considered the
estimated fair value. During the three months ended March 31, 2010, the Company did not identify
any triggering events that would require the performance of impairment testing during the period.
Noncontrolling interests
The Company recognizes noncontrolling interests as equity in the consolidated financial statements
separate from the parent entitys equity. The amount of net income attributable to noncontrolling
interests is included in consolidated net income on the face of the income statement. Changes in a
parent entitys ownership interest in a subsidiary that do not result in deconsolidation are
treated as equity transactions if the parent entity retains its controlling financial interest. The
Company recognizes a gain or loss in net income when a subsidiary is deconsolidated. Such gain or
loss is measured using the fair value of the noncontrolling equity investment on the
deconsolidation date.
When the purchase price of a noncontrolling interest by the Company exceeds or is less than the
book value at the time of purchase, any excess or shortfall is recognized as an adjustment to
additional-paid-in-capital. Additionally, operating losses are allocated to noncontrolling
interests even when such allocation creates a deficit balance for the noncontrolling interest
partner.
8
Revenue Recognition
Revenues are recognized in the period in which services are rendered. Net patient revenues (patient
revenues less estimated contractual adjustments) are reported at the estimated net realizable
amounts from third-party payors, patients and others for services rendered. The Company has
agreements with third-party payors that provide for payments to the Company at amounts different
from its established rates. The allowance for estimated contractual adjustments is based on terms
of payor contracts and historical collection and write-off experience.
The Company determines allowances for doubtful accounts based on the specific agings and payor
classifications at each clinic. The provision for doubtful accounts is included in clinic
operating costs in the statement of net income. Net accounts receivable, which are stated at the
historical carrying amount net of contractual allowances, write-offs and allowance for doubtful
accounts, includes only those amounts the Company estimates to be collectible. Since 1999,
reimbursement for outpatient therapy services provided to Medicare beneficiaries has been made
according to a Medicare Physician Fee Schedule (MPFS) published by the Department of Health and
Human Services (HHS). Under the Balanced Budget Act of 1997, the total amount paid by Medicare in
any one year for outpatient physical therapy or occupational therapy (including speech-language
pathology) to any one patient is subjected to a stated dollar amount (the Medicare Cap or Limit),
except for services provided in hospitals. Outpatient therapy services rendered to Medicare
beneficiaries by the Companys therapists are subject to the Medicare Cap, except to the extent
these services are rendered pursuant to certain management and professional services agreements
with inpatient facilities. In 2006, Congress passed the Deficit Reduction Act (DRA), which
allowed the Centers for Medicare & Medicaid Services (CMS) to grant exceptions to the Medicare
Cap for services provided during the year, as long as those services met certain qualifications.
The exception process initially allowed for automatic and manual exceptions to the Medicare Cap for
medically necessary services. CMS subsequently revised the exceptions procedures and eliminated
the manual exceptions process. Beginning January 1, 2008, all services that required exceptions to
the Medicare Cap were processed as automatic exceptions. While the basic procedure for obtaining
an automatic exception remained the same, CMS expanded requirements for documentation related to
the medical necessity of services provided above the cap. Under the Medicare Improvements for
Patients and Providers Act as passed July 16, 2008, the extension process remained through
December 31, 2009. The Temporary Extension Act of 2010, enacted on March 2, 2010, extended the
therapy cap exceptions process through March 31, 2010, retroactive to January 1, 2010. With respect
to the MPFS, in April the Continuing Extension Act of 2010 was signed into law extending the zero
percent update through May 31, 2010.
On March 23, 2010, the President signed into law the Patient Protection and Affordable Care Act,
which extended the exceptions process for the outpatient therapy Medicare Cap. Outpatient therapy
service providers may continue to submit claims when an exception is appropriate, for services
furnished on or after January 1, 2010 through December 31, 2010. For physical therapy and speech
language pathology service combined, and for occupational therapy services, the Medicare Cap for
2010 is $1,860.
Since the Medicare Cap was implemented, patients who have been impacted by the cap and those who do
not qualify for an exception may choose to pay for services in excess of the cap themselves;
however, it is assumed that the Medicare Cap will result in some lost revenues to the Company.
Laws and regulations governing the Medicare program are complex and subject to interpretation. The
Company believes that it is in compliance in all material respects with all applicable laws and
regulations and is not aware of any pending or threatened investigations involving allegations of
potential wrongdoing that would have a material effect on the Companys financial statements as of
March 31, 2010. Compliance with such laws and regulations can be subject to future government
review and interpretation, as well as significant regulatory action including fines, penalties, and
exclusion from the Medicare program.
Management contract revenues are derived from contractual arrangements whereby the Company manages
a clinic for third party owners. The Company does not have any ownership interest in these
clinics. Typically, revenues are determined based on the number of visits conducted at the clinic
and recognized when services are performed.
Contractual Allowances
Contractual allowances result from the differences between the rates charged for services performed
and expected reimbursements for such services by both insurance companies and government sponsored
healthcare programs. Medicare regulations and the various third party payors and managed care
contracts are often complex and may include multiple reimbursement mechanisms payable for the
services provided in Company clinics. The Company estimates contractual allowances based on its
interpretation of the applicable regulations, payor contracts and historical calculations. Each
month the Company estimates its contractual allowance for each clinic based on payor contracts and
the historical
9
collection experience of the clinic and applies an appropriate contractual allowance reserve
percentage to the gross accounts receivable balances for each payor of the clinic. Based on the
Companys historical experience, calculating the contractual allowance reserve percentage at the
payor level is sufficient to allow us to provide the necessary detail and accuracy with its
collectibility estimates. However, the services authorized and provided and related reimbursement
are subject to interpretation that could result in payments that differ from the Companys
estimates. Payor terms are periodically revised necessitating continual review and assessment of
the estimates made by management. The Companys billing systems may not capture the exact change
in our contractual allowance reserve estimate from period to period in order to assess the accuracy
of our revenues, and hence, our contractual allowance reserves. Management regularly compares its
cash collections to corresponding net revenues measured both in the aggregate and on a
clinic-by-clinic basis. In the aggregate, historically the difference between net revenues and
corresponding cash collections has generally reflected a difference within approximately 1% of net
revenues. Additionally, analysis of subsequent periods contractual write-offs on a payor basis
shows a less than 1% difference between the actual aggregate contractual reserve percentage as
compared to the estimated contractual allowance reserve percentage associated with the same period
end balance. As a result, the Company believes that a change in the contractual allowance reserve
estimate would not likely be more than 1% at March 31, 2010.
Income Taxes
Income taxes are accounted for under the asset and liability method. Deferred tax assets and
liabilities are recognized for the future tax consequences attributable to differences between the
financial statement carrying amounts of existing assets and liabilities and their respective tax
bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are
measured using enacted tax rates expected to apply to taxable income in the years in which those
temporary differences are expected to be recovered or settled. The effect on deferred tax assets
and liabilities of a change in tax rates is recognized in income in the period that includes the
enactment date.
The Company recognizes the financial statement benefit of a tax position only after determining
that the relevant tax authority would more likely than not sustain the position following an audit.
For tax positions meeting the more-likely-than-not threshold, the amount to be recognized in the
financial statements is the largest benefit that has a greater than 50 percent likelihood of being
realized upon ultimate settlement with the relevant tax authority.
The Company recognizes accrued interest expense and penalties associated with unrecognized tax
benefits as income tax expense. The Company did not have any accrued interest or penalties
associated with any unrecognized tax benefits nor was any interest expense recognized during the
three months ended March 31, 2010 and 2009.
Fair Value of Financial Instruments
The carrying amounts reported in the balance sheet for cash and cash equivalents, accounts
receivable, accounts payable and notes payable approximate their fair values due to the short-term
maturity of these financial instruments. The carrying amount of the revolving line of credit
approximates its fair value. The interest rate on the revolving line of credit, which is tied to
the Eurodollar Rate, is set at various short-term intervals as detailed in the credit agreement.
Segment Reporting
Operating segments are components of an enterprise for which separate financial information is
available that is evaluated regularly by chief operating decision makers in deciding how to
allocate resources and in assessing performance. The Company identifies operating segments based
on management responsibility and believes it meets the criteria for aggregating its operating
segments into a single reporting segment.
Use of Estimates
In preparing the Companys consolidated financial statements, management makes certain estimates
and assumptions, especially in relation to, but not limited to, goodwill impairment, allowance for
receivables, tax provision and contractual allowances, that affect the amounts reported in the
consolidated financial statements and related disclosures. Actual results may differ from these
estimates.
Self-Insurance Program
The Company utilizes a self-insurance plan for its employee group health insurance coverage
administered by a third party. Predetermined loss limits have been arranged with the insurance
company to limit the Companys maximum liability and cash outlay. Accrued expenses include the
estimated incurred but unreported costs to settle unpaid claims and estimated future claims.
Management believes that the current accrued amounts are sufficient to pay claims arising from self
insurance incurred through March 31, 2010.
10
Stock Options
The Company measures and recognizes compensation expense for all stock-based payments at fair
value. Compensation cost recognized includes (i) compensation for all stock-based payments granted
prior to, but not yet vested, on January 1, 2006, based on the grant-date fair value estimated at
the time of grant and (ii) compensation cost for the stock-based payments granted subsequent to
January 1, 2006, based on the grant-date fair value. No stock options were granted during the three
months ended March 31, 2010.
Restricted Stock
Restricted stock issued to employees and directors is subject to continued employment or continued
service on the board, respectively. Typically the transfer restrictions for shares granted to
employees lapse in equal installments on the following five annual anniversaries of the date of
grant. Compensation expense for grants of restricted stock is recognized based on the fair value
per share on the date of grant amortized over the vesting period. The restricted stock issued is
included in basic and diluted shares for the earnings per share computation. There were no shares
of restricted stock granted during the three months ended March 31, 2010.
2. EARNINGS PER SHARE
The computations of basic and diluted earnings per share for the Company are as follows (in
thousands, except per share data):
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended |
|
|
|
March 31, |
|
|
|
2010 |
|
|
2009 |
|
Numerator: |
|
|
|
|
|
|
|
|
Net income attributable to common shareholders |
|
$ |
3,172 |
|
|
$ |
2,754 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Denominator: |
|
|
|
|
|
|
|
|
Denominator for basic earnings per share -
weighted-average shares |
|
|
11,614 |
|
|
|
12,020 |
|
Effect of dilutive securities -
Stock options |
|
|
226 |
|
|
|
5 |
|
|
|
|
|
|
|
|
Denominator for diluted earnings per share -
adjusted weighted-average shares |
|
|
11,840 |
|
|
|
12,025 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Earnings per share attributable to common shareholders: |
|
|
|
|
|
|
|
|
Basic |
|
$ |
0.27 |
|
|
$ |
0.23 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Diluted |
|
$ |
0.27 |
|
|
$ |
0.23 |
|
|
|
|
|
|
|
|
Options to purchase 110,000 and 881,000 shares for the three months ended March 31, 2010 and
2009, respectively, were excluded from the diluted earnings per share calculations for the
respective periods because the options exercise prices were greater than the average market price
of the common shares during the periods.
The restricted stock issued is included in basic and diluted shares for the earnings per share
computation.
3. ACQUISITIONS AND DIVESTITURE
Acquisition of Businesses
On February 26, 2010, the Company acquired a 70% interest in a five clinic outpatient therapy group
(February Acquisition). The purchase price for the 70% interest in the February Acquisition was
$9.0 million, which consisted of $8.8 million in cash and $200,000 in seller notes, which are
payable in two principal installments totaling $100,000 each in February 2011 and 2012. The seller
notes accrue interest at 4% per annum. For the February Acquisition, the
11
Company incurred acquisition costs totaling $0.1 million which was expensed. The consideration
paid for the February Acquisition was derived through arms length negotiations. Funding for the
cash portion of the purchase price was provided by the Companys credit facility.
Because of the proximity of the February Acquisition to quarter ended March 31, 2010, the purchase
price plus the fair value of the noncontrolling interest was allocated to the fair value of the
assets acquired and liabilities assumed based on the preliminary estimates of the fair values at
the acquisition date, with the amount exceeding the estimated fair values being recorded as
goodwill. The Company is in the process of completing its formal valuation analysis to identify
and determine the fair value of tangible and intangible assets acquired and the liabilities
assumed. Thus, the final allocation of the purchase price may differ from the preliminary estimates
used at March 31, 2010 based on additional information obtained. Changes in the estimated
valuation of the tangible and intangible assets acquired and the completion by the Company of the
identification of any unrecorded pre-acquisition contingencies, where the liability is probable and
the amount can be reasonably estimated, will result in adjustments to goodwill.
The preliminary purchase price allocation is as follows (in thousands):
|
|
|
|
|
Cash paid, net of cash acquired |
|
$ |
8,710 |
|
Seller notes |
|
|
200 |
|
|
|
|
|
Total consideration |
|
$ |
8,910 |
|
|
|
|
|
|
|
|
|
|
Estimated fair value of net tangible assets acquired: |
|
|
|
|
Total current assets |
|
$ |
991 |
|
Total non-current assets |
|
|
360 |
|
Total liabilities |
|
|
(106 |
) |
|
|
|
|
Net tangible assets acquired |
|
$ |
1,245 |
|
Goodwill |
|
|
11,523 |
|
Fair value of noncontrolling interest |
|
|
(3,858 |
) |
|
|
|
|
|
|
$ |
8,910 |
|
|
|
|
|
On March 1, 2010, a subsidiary of the Company purchased an outpatient therapy practice for
$100,000 (March Acquisition), which consisted of $75,000 of cash and a payable of $25,000. The
purchase price was allocated $30,000 to non-current assets and $70,000 to goodwill. The practice
was consolidated into an existing clinic.
The results of operations of the February Acquisition and March Acquisition have been included in
the Companys consolidated financial statements since the respective dates acquired. Unaudited
proforma consolidated financial information for these two acquisitions has not been included as the
results were not material to current operations.
Divestiture of business
On March 31, 2010, the Company sold its 51% interest in a joint venture of five Texas clinics. The
Company recorded a pre-tax gain of $578,000, which is included in other income in the consolidated
statements of net income. Of the $974,000 sales price, $213,000 was received on March 31, 2010 and
the remaining $761,000 (included in accounts receivable other on the March 31, 2010 balance
sheet) was received in April 2010.
The operating results of these locations were not material to the operations of the Company, and
therefore, the operating results of these clinics were not reclassified and reported as
discontinued operations. The cash flow impact of these clinics was determined to be immaterial for
the consolidated statements of cash flows.
12
4. Goodwill
The changes in the carrying amount of goodwill consisted of the following (in thousands):
|
|
|
|
|
|
|
Three Months |
|
|
|
Ended |
|
|
|
March 31, |
|
|
|
2010 |
|
Beginning balance |
|
$ |
57,247 |
|
Goodwill acquired during the year |
|
|
11,593 |
|
Goodwill written off |
|
|
(39 |
) |
|
|
|
|
Ending balance |
|
$ |
68,801 |
|
|
|
|
|
The goodwill written off relates to the five Texas clinics sold in March 2010.
ITEM 2. MANAGEMENTS DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.
EXECUTIVE SUMMARY
Our Business
We operate outpatient physical and/or occupational therapy clinics that provide preventive and
post-operative care for a variety of orthopedic-related disorders and sports-related injuries,
treatment for neurologically-related injuries and rehabilitation of injured workers. During the
three months ended March 31, 2010, the Company opened one new clinic, acquired five, sold five and
closed two. The clinic opened was a new Clinic Partnership. On February 26, 2010, the Company
acquired a 70% interest in five clinics and, on March 31, 2010, the Company sold its 51% interest
in five Texas clinics. At March 31, 2010, we operated 367 clinics in 43 states. The average age
of our clinics at March 31, 2010 was 7.1 years.
In addition to our owned clinics, we also manage physical therapy facilities for third parties,
primarily physicians, with 14 third-party facilities under management as of March 31, 2010.
Selected Operating and Financial Data
The following table presents selected operating and financial data that we believe are key
indicators of our operating performance.
|
|
|
|
|
|
|
|
|
|
|
For the Three Months |
|
|
|
Ended March 31, |
|
|
|
2010 |
|
|
2009 |
|
Number of clinics, at the end of period |
|
|
367 |
|
|
|
365 |
|
Working Days |
|
|
63 |
|
|
|
63 |
|
Average visits per day per clinic |
|
|
20.2 |
|
|
|
20.3 |
|
Total patient visits |
|
|
468,651 |
|
|
|
462,958 |
|
|
|
|
|
|
|
|
|
|
Net patient revenue per visit |
|
$ |
104.08 |
|
|
$ |
100.80 |
|
Statement of operations per visit: |
|
|
|
|
|
|
|
|
Net revenues |
|
$ |
107.55 |
|
|
$ |
104.05 |
|
Salaries and related costs |
|
|
57.12 |
|
|
|
54.87 |
|
Rent, clinic supplies, contract labor and other |
|
|
21.55 |
|
|
|
22.06 |
|
Provision for doubtful accounts |
|
|
2.21 |
|
|
|
1.53 |
|
Closure costs |
|
|
0.06 |
|
|
|
|
|
|
|
|
|
|
|
|
Contribution from clinics |
|
|
26.61 |
|
|
|
25.59 |
|
Corporate office costs |
|
|
12.39 |
|
|
|
11.64 |
|
|
|
|
|
|
|
|
Operating income from continuing operations |
|
$ |
14.22 |
|
|
$ |
13.95 |
|
|
|
|
|
|
|
|
13
RESULTS OF OPERATIONS
Three Months Ended March 31, 2010 Compared to the Three Months Ended March 31, 2009
|
|
|
Net revenues increased to $50.4 million for the three months ended March 31, 2010 (2010
First Quarter) from $48.2 million for the three months ended March 31, 2009 (2009 First
Quarter) due to an increase of $3.28 from $100.80 to $104.08 in net patient revenue per
visit and a 1.2% increase in patient visits from 463,000 to 469,000. Our net patient
revenue per visit has increased due to our continuing efforts to provide additional
services and to negotiate more favorable reimbursement rates with certain payors. |
|
|
|
|
Net income attributable to our common shareholders for the 2010 First Quarter was $3.2
million versus $2.8 million for the 2009 First Quarter. Net income was $0.27 per diluted
share for the 2010 First Quarter as compared to $0.23 per diluted share for the 2009 First
Quarter. Total diluted shares were 11.8 million for the 2010 First Quarter and 12.0 million
for the 2009 First Quarter. |
Net Patient Revenues
|
|
|
Net patient revenues increased to $48.8 million for the 2010 First Quarter from $46.7
million for the 2009 First Quarter, an increase of $2.1 million, or 4.5%, due to an
increase of $3.28 in net patient revenues per visit from $100.80 to $104.08 and a 1.2%
increase in patient visits from 463,000 to 469,000. |
|
|
|
|
The growth in patient visits was attributable to an increase of 14,000 visits in clinics
opened or acquired between April 1, 2009 and March 31, 2010 (New Clinics) offset by a
decrease of 8,000 for clinics opened or acquired prior to April 1, 2009 (Mature Clinics). |
|
|
|
|
The $2.1 million net patient revenues increase for the 2010 First Quarter included $1.5
million from New Clinics and $0.6 million from Mature Clinics, especially from those opened
in 2009 First Quarter due to increased business. |
Net patient revenues are based on established billing rates less allowances and discounts for
patients covered by contractual programs and workers compensation. Net patient revenues are after
contractual and other adjustments relating to patient discounts from certain payors. Payments
received under these programs are based on predetermined rates and are generally less than the
established billing rates of the clinics.
Management Contract and Other Revenues
Management contract and other revenues increased by $121,000 from $1,505,000 to $1,626,000 due to
additional management contracts in place. During the 2010 First Quarter, we had 14 management
contracts versus 11 for the 2009 First Quarter.
Clinic Operating Costs
Clinic operating costs as a percentage of net revenues were 75.3% for the 2010 First Quarter and
75.4% for the 2009 First Quarter.
Clinic Operating Costs Salaries and Related Costs
Salaries and related costs increased to $26.8 million for the 2010 First Quarter from $25.4
million for the 2009 First Quarter, an increase of $1.4 million, or 5.4%. The $1.4 million
increase included costs of $1.0 million attributable to the New Clinics. The remaining
increase was due to slightly higher costs of $0.4 million at the Mature Clinics. Salaries and
related costs as a percentage of net revenues were 53.1% for the 2010 First Quarter and 52.7%
for the 2009 First Quarter.
Clinic Operating Costs Rent, Clinic Supplies, Contract Labor and Other
Rent, clinic supplies, contract labor and other decreased to $10.1 million for the 2010 First
Quarter from $10.2 million for the 2009 First Quarter. For New Clinics, rent, clinic
supplies, contract labor and other amounted to $0.4 million for the 2010 First Quarter. For
Mature Clinics, rent, clinic supplies, contract labor and other decreased by $0.5 million in
the 2010 First Quarter. Rent, clinic supplies, contract labor and other as a percentage of
net revenues was 20.0% for the 2010 First Quarter and 21.2% for the 2009 First Quarter.
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Clinic Operating Costs Provision for Doubtful Accounts
The provision for doubtful accounts was $1.0 million for the 2010 First Quarter and $0.7
million for the 2009 First Quarter. The provision for doubtful accounts for patients accounts
receivable as a percentage of net patient revenues was 2.1% for the 2010 First Quarter and
1.5% for the 2009 First Quarter. Our allowance for bad debts for patients accounts receivable
as a percentage of total patient accounts receivable was 7.9% at March 31, 2010, as compared
to 7.6% at December 31, 2009. Our days sales outstanding was 46 days at March 31, 2010
compared to 45 days at December 31, 2009.
Corporate Office Costs
Corporate office costs, consisting primarily of salaries and benefits of corporate office
personnel, rent, insurance costs, depreciation and amortization, travel, legal, professional, and
recruiting fees, were $5.8 million, or 11.5% of net revenues, for the 2010 First Quarter and $5.4
million, or 11.2% of net revenues for the 2009 First Quarter. This increase of $0.4 million is due
to increased salaries and benefits, increased accrual for incentive compensation and legal fees
associated with the February Acquisition. In accordance with current accounting guidance, costs
related to acquisition activity are expensed as incurred.
Interest and Other Income
Other income in the 2010 First Quarter included a pre-tax gain of $578,000 from the sale of our 51%
interest in a five clinic Texas joint venture.
Interest Expense
Interest expense was $64,000 for the 2010 First Quarter and $88,000 for the 2009 First Quarter,
which represents a decrease of $24,000, or 27.3%, due to a decrease in average borrowings
outstanding during the period in 2010 compared to 2009. At March 31, 2010, $10.9 million was
outstanding under our revolving credit facility. See Liquidity and Capital Resources below for a
discussion of the terms of our revolving credit facility contained in the Credit Agreement.
Provision for Income Taxes
The provision for income taxes increased to $2.1 million for the 2010 First Quarter from $1.8
million for the 2009 First Quarter. During the 2010 First Quarter, the Company accrued state and
federal income taxes at an effective tax rate (provision for taxes divided by the difference
between income from operations and net income attributable to noncontrolling interest) of 39.3%
versus 39.2% for the 2009 First Quarter.
Noncontrolling Interests
Net income attributable to noncontrolling interests was $2.0 million for the 2010 First Quarter and
$1.8 million for the 2009 First Quarter. Net income attributable to noncontrolling interests as a
percentage of operating income before corporate office costs was 15.7% for the 2010 First Quarter
and 15.5% for the 2009 First Quarter.
LIQUIDITY AND CAPITAL RESOURCES
We believe that our business is generating sufficient cash flow from operating activities to allow
us to meet our short-term and long-term cash requirements, other than those with respect to future
acquisitions. At March 31, 2010, we had $11.4 million in cash compared to cash of $6.4 million at
December 31, 2009, an increase of 78.4%. At March 31, 2010, cash included those funds required for
payroll which occurred on April 2, 2010. Although the start-up costs associated with opening new
clinics and our planned capital expenditures are significant, we believe that our cash and
availability under our revolving credit facility are sufficient to fund the working capital needs
of our operating subsidiaries, corporate costs, purchases of our common stock, clinic closure costs
accrued, future clinic development and investments through at least March 2011. Significant
acquisitions would likely require financing under our existing revolving credit facility.
The increase in cash of $5.0 million from December 31, 2009 to March 31, 2010 was due to $6.0
million provided by operations, $10.5 million of net proceeds from our Credit Agreement and $0.1
million proceeds from the sale of fixed asset and business, offset by major uses of cash which
included: purchase of businesses ($8.8 million), purchase of fixed assets ($0.6 million) and
distributions to noncontrolling interest partners ($2.2 million).
Effective August 27, 2007, we entered into the Credit Agreement with a commitment for a $30.0
million revolving credit facility which was increased to $50.0 million effective June 4, 2008.
Effective March 18, 2009, we amended the Credit Agreement to permit the Company to purchase up to
$15,000,000 of its common stock subject to compliance with certain covenants, including the
requirement that after giving effect to any stock purchase, our consolidated leverage ratio (as
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defined in the Credit Agreement) be less than 1.0 to 1.0 and that any stock repurchased be retired
within seven days of purchase. In addition, the Credit Agreement was amended to adjust the pricing
grid which is based on our consolidated leverage ratio with the applicable spread over LIBOR
ranging from 1.5% to 2.5%. The Credit Agreement has a four year term maturing August 31, 2011, is
unsecured and includes standard financial covenants. Proceeds from the Credit Agreement may be used
for acquisitions, working capital, purchases of our common stock, capital expenditures and other
corporate purposes. Fees under the Credit Agreement include a closing fee of .25% and an unused
commitment fee ranging from .1% to .35% depending on our consolidated leverage ratio and the amount
of funds outstanding under the Credit Agreement. On March 31, 2010, the outstanding balance on the
revolving credit facility was $10.9 million leaving $39.1 million in availability, and we were in
compliance with all of the covenants thereunder.
Historically, we have generated sufficient cash from operations to fund our development activities
and to cover operational needs. We plan to continue developing new clinics and making additional
acquisitions in selected markets. We have from time to time purchased the noncontrolling interests
in our Clinic Partnerships. We may purchase additional noncontrolling interests in the future.
Generally, any acquisition or purchase of noncontrolling interests is expected to be accomplished
using a combination of cash and financing. Any large acquisition would likely require financing.
We make reasonable and appropriate efforts to collect accounts receivable, including applicable
deductible and co-payment amounts, in a consistent manner for all payor types. Claims are
submitted to payors daily, weekly or monthly in accordance with our policy or payors requirements.
When possible, we submit our claims electronically. The collection process is time consuming and
typically involves the submission of claims to multiple payors whose payment of claims may be
dependent upon the payment of another payor. Claims under litigation and vehicular incidents can
take a year or longer to collect. Medicare and other payor claims relating to new clinics awaiting
Medicare Rehab Agency status approval initially may not be submitted for six months or more. When
all reasonable internal collection efforts have been exhausted, accounts are written off prior to
sending them to outside collection firms. With managed care, commercial health plans and self-pay
payor type receivables, the write-off generally occurs after the account receivable has been
outstanding for at least 120 days.
In connection with the February Acquisition, we incurred notes payable in the aggregate totaling
$200,000 payable in two equal annual installments totaling $100,000 on February 26, 2011 and 2012,
plus any accrued and unpaid interest. Interest accrues at a fixed rate of 4.00% per annum. In
addition, we assumed leases with remaining terms ranging from three to nine and one-half years for
the operating facilities.
In connection with the acquisition of a 65% interest in an outpatient rehabilitation practice with
four clinics in November 2008, we incurred a note payable in the amount of $400,400 payable in
equal annual installments totaling $200,200 beginning November 18, 2009, plus any accrued and
unpaid interest. Interest accrues at a fixed rate of 4.00% per annum. The final principal payment
and any accrued and unpaid interest then outstanding is due and payable on November 18, 2010. In
addition, we assumed leases with remaining terms ranging from nine months to three years for the
operating facilities. At March 31, 2010, the principal amount outstanding related to this note was
$200,200.
In connection with the acquisition of a 65% interest in Rehab Management Group in October 2008, we
incurred a note payable in the amount of $157,100 payable in equal annual installments totaling
$78,550 beginning October 8, 2009, plus any accrued and unpaid interest. Interest accrues at a
fixed rate of 5.00% per annum. The final principal payment and any accrued and unpaid interest
then outstanding is due and payable on October 8, 2010. The purchase agreement also provides for
possible contingent consideration of up to $3,781,000 based on the achievement of a designated
level of operating results within a three-year period following the acquisition. In 2009, we paid
$1.2 million of additional consideration related to this acquisition related to operating results
for the first year. Such amount was recorded as goodwill. At March 31, 2010, the principal amount
outstanding related to this note was $78,550.
In connection with the acquisition of a 65% interest in a multi-partner outpatient rehabilitation
practice with nine clinics in June 2008, we incurred notes payable in the aggregate totaling
$950,625 payable in equal annual installments totaling $475,312, plus any accrued and unpaid
interest, which began June 11, 2009. Interest accrues at a fixed rate of 5.00% per annum. The
final principal payment and any accrued and unpaid interest then outstanding is due and payable on
June 11, 2010. The purchase agreement also provides for possible contingent consideration of up to
$1,500,000 based on the achievement of a designated level of operating results within a three-year
period following the acquisition. There was no contingent consideration earned based on the
operating results of the first year. At March 31, 2010, the principal amount outstanding related
to these notes was $475,312.
In connection with the acquisition of a 70% interest in STAR Physical Therapy, LP in September
2007, we incurred notes payable in the aggregate totaling $1,000,000 payable in equal annual
installments totaling $333,333, plus any accrued and unpaid interest, with the first payment due
September 6, 2008. Interest accrues at a fixed rate of 8.25% per annum. The remaining principal
and any accrued and unpaid interest then outstanding is due and payable on September 6, 2010. In
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addition, we assumed leases with remaining terms ranging from two months to six years for the
operating facilities. At March 31, 2010, the principal amount outstanding related to these notes
was $258,333.
Except for RMG, in conjunction with the above mentioned acquisitions, in the event that a
noncontrolling interest partners employment ceases at any time after three years from the
acquisition date, we have agreed to repurchase that individuals interest at a predetermined
multiple of earnings before interest and taxes.
In September 2001 through December 31, 2008, the Board authorized us to purchase, in the open
market or in privately negotiated transactions, up to 2,250,000 shares of our common stock;
however, the terms of the Companys bank credit agreement had prohibited such purchases since
August 2007. As of December 31, 2008, there were approximately 50,000 shares remaining that could
be purchased under these programs. In March 2009, the Board authorized the repurchase of up to 10%
or approximately 1,200,000 shares of our common stock (March 2009 Authorization). In connection
with the March 2009 Authorization, we amended our bank credit agreement to permit the share
repurchases. We are required to retire shares purchased under the March 2009 Authorization. Since
there is no expiration date for these share repurchase programs, additional shares may be purchased
from time to time in the open market or private transactions depending on price, availability and
our cash position. During the three months ended March 31, 2010, we did not purchase any shares. As
of March 31, 2010, there were approximately 730,000 shares remaining that could be purchased under
these programs.
FACTORS AFFECTING FUTURE RESULTS
The risks related to our business and operations include:
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The uncertain economic conditions and the historically high unemployment rate may have
material adverse impacts on our business and financial condition that we currently cannot
predict. |
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We depend upon reimbursement by third-party payors. |
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We depend upon the cultivation and maintenance of relationships with the physicians in
our markets. |
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We also depend upon our ability to recruit and retain experienced physical and
occupational therapists. |
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Our revenues may fluctuate due to weather. |
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Our operations are subject to extensive regulation. |
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Healthcare reform legislation may affect our business. |
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We operate in a highly competitive industry. |
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We may incur closure costs and losses. |
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Future acquisitions may use significant resources, may be unsuccessful and could expose
us to unforeseen liabilities. |
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Certain of our internal controls, particularly as they relate to billings and cash
collections, are largely decentralized at our clinic locations. |
See Risk Factors in Item 1A of our Annual Report on Form 10-K for the year ended December 31, 2009
and in Part II Other Information Item 1A. Risk Factorsof this report.
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FORWARD LOOKING STATEMENTS
Forward-Looking Statements
We make statements in this report that are considered to be forward-looking within the meaning
under Section 21E of the Securities Exchange Act of 1934. These statements contain forward-looking
information relating to the financial condition, results of operations, plans, objectives, future
performance and business of our Company. These statements (often using words such as believes,
expects, intends, plans, appear, should and similar words) involve risks and
uncertainties that could cause actual results to differ materially from those we project. Included
among such statements are those relating to opening new clinics, availability of personnel and the
reimbursement environment. The forward-looking statements are based on our current views and
assumptions and actual results could differ materially from those anticipated in such
forward-looking statements as a result of certain risks, uncertainties, and factors, which include,
but are not limited to:
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revenue and earnings expectations; |
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general economic conditions; |
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business and regulatory conditions including federal and state regulations; |
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changes as the result of government enacted national healthcare reform; |
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availability and cost of qualified physical and occupational therapists; |
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personnel productivity; |
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changes in Medicare guidelines and reimbursement or failure of our clinics to maintain
their Medicare certification status; |
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competitive, economic or reimbursement conditions in our markets which may require us to
reorganize or close certain clinics and thereby incur losses and/or closure costs including
the possible write-down or write-off of goodwill and other intangible assets; |
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changes in reimbursement rates or payment methods from third party payors including
government agencies and deductibles and co-pays owed by patients; |
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maintaining adequate internal controls; |
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availability, terms, and use of capital; |
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acquisitions and the successful integration of the operations of the acquired
businesses; and |
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weather and other seasonal factors. |
Many factors are beyond our control. Given these uncertainties, you should not place undue reliance
on our forward-looking statements. Please see our periodic reports filed with the Securities and
Exchange Commission (the SEC) for more information on these factors. Our forward-looking
statements represent our estimates and assumptions only as of the date of this press release.
Except as required by law, we are under no obligation to update any forward-looking statement,
regardless of the reason the statement is no longer accurate.
ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK.
We do not maintain any derivative instruments, interest rate swap arrangements, hedging contracts,
futures contracts or the like. The Companys primary market risk exposure is the changes in
interest rates obtainable on our revolving credit agreement. The interest on our revolving credit
agreement is based on a variable rate. Based on the balance of the revolving credit facility at
March 31, 2010, any change in the interest rate of 1% would yield a decrease or increase in annual
interest expense of $109,000.
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ITEM 4. CONTROLS AND PROCEDURES.
(a) Evaluation of Disclosure Controls and Procedures
As of the end of the period covered by this report, the Companys management completed an
evaluation, under the supervision and with the participation of our principal executive officer and
principal financial officer, of the effectiveness of our disclosure controls and procedures. Based
on this evaluation, our principal executive officer and principal financial officer concluded (i)
that our disclosure controls and procedures are designed to ensure that information required to be
disclosed in the reports that we file or submit under the Securities Exchange Act of 1934 is
recorded, processed, summarized and reported within the time periods specified in the SECs rules
and forms and that such information is accumulated and communicated to our management, including
our principal executive officer and principal financial officer, or persons performing similar
functions, as appropriate to allow timely decisions regarding required disclosure (ii) that our
disclosure controls and procedures are effective.
(b) Changes in Internal Control
There have been no changes in our internal control over financial reporting during the period
covered by this report that have materially affected, or are reasonably likely to materially
affect, our internal control over financial reporting.
PART II OTHER INFORMATION
ITEM 1A. Risk Factors.
The risk factor presented below updates and replaces a risk factor disclosed in the Companys
Annual Report on Form 10-K for the fiscal year ended December 31, 2009, and should be considered in
addition to the risk factors disclosed in that Annual Report. There have been no other material
changes to the Companys risk factors as set forth in Item 1A. Risk Factors, in the Companys
Annual Report on Form 10-K for the fiscal year ended December 31, 2009.
We depend upon reimbursement by third-party payors.
Substantially all of our revenues are derived from private and governmental third-party payors. In
2009, approximately 80% of our revenues were derived collectively from managed care plans,
commercial health insurers, workers compensation payors, and other private pay revenue sources and
approximately 20% of our revenues were derived from Medicare and Medicaid. Initiatives undertaken
by industry and government to contain healthcare costs affect the profitability of our clinics.
These payors attempt to control healthcare costs by contracting with healthcare providers to obtain
services on a discounted basis. We believe that this trend will continue and may limit
reimbursements for healthcare services. If insurers or managed care companies from whom we receive
substantial payments were to reduce the amounts they pay for services, our profit margins may
decline, or we may lose patients if we choose not to renew our contracts with these insurers at
lower rates. In addition, in certain geographical areas, our clinics must be approved as providers
by key health maintenance organizations and preferred provider plans. Failure to obtain or maintain
these approvals would adversely affect our financial results.
Since 1999, reimbursement for outpatient therapy services provided to Medicare
beneficiaries has been made according to a Medicare Physician Fee Schedule (MPFS) published by
the HHS. Under the Balanced Budget Act of 1997, the total amount paid by Medicare in any one year
for outpatient physical therapy or occupational therapy (including speech-language pathology) to
any one patient is subjected to a stated dollar amount, except for services provided in hospitals.
Outpatient therapy services rendered to Medicare beneficiaries by the Companys therapists are
subject to the Medicare Cap, except to the extent these services are rendered pursuant to certain
management and professional services agreements with inpatient facilities. In 2006, Congress passed
the DRA, which allowed the CMS to grant exceptions to the Medicare Cap for services provided during
the year, as long as those services met certain qualifications. The exception process initially
allowed for automatic and manual exceptions to the Medicare Cap for medically necessary services.
CMS subsequently revised the exceptions procedures and eliminated the manual exceptions process.
Beginning January 1, 2008, all services that required exceptions to the Medicare Cap were processed
as automatic exceptions. While the basic procedure for obtaining an automatic exception remained
the same, CMS expanded requirements for documentation related to the medical necessity of services
provided above the cap. Under the MIPPA, the extension process remained through December 31, 2009.
The Temporary Extension Act of 2010, enacted on March 2, 2010, extends the therapy cap exceptions
process through March 31, 2010, retroactive to January 1, 2010. With respect to the MPFS, in April,
the Continuing Extension Act of 2010 was signed into law extending the zero percent update through
May 31, 2010.
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On March 23, 2010, the President signed into law the Patient Protection and Affordable Care
Act, which extended the exceptions process for the outpatient therapy Medicare Cap. Outpatient
therapy service providers may continue to submit claims when an exception is appropriate, for
services furnished on or after January 1, 2010 through December 31, 2010. For physical therapy and
speech language pathology service combined, and for occupational therapy services, the limit for
2010 is $1,860.
Since the Medicare Cap was implemented, patients who have been impacted by the cap and those who do
not qualify for an exception may choose to pay for services in excess of the cap themselves;
however, it is assumed that the Medicare Cap will continue to result in some lost revenues to the
Company.
For a further description of this and other laws and regulations involving governmental
reimbursements, see Business Sources of Revenue and Regulation and Healthcare Reform in
Item 1 in our Annual Report on Form 10-K for the year ended December 31, 2009.
ITEM 6. EXHIBITS.
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Exhibit Number |
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Description |
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10.1+
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U. S. Physical Therapy, Inc. Objective Long-Term Incentive Plan
for Senior Management, effective March 30, 2010 (incorporated by
reference to Exhibit 99.1 to the Companys current report on Form 8-K filed with the SEC on March 29, 2010). |
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10.2+
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U. S. Physical Therapy, Inc. Discretionary Long-Term Incentive
Plan for Senior Management for 2010, effective March 30, 2010
(incorporated by reference to Exhibit 99.2 to the Companys
current report on Form 8-K filed with the SEC on March 29, 2010). |
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10.3+
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U. S. Physical Therapy, Inc. Objective Cash Bonus Plan for 2010,
effective March 30, 2010 (incorporated by reference to Exhibit
99.3 to the Companys current report on Form 8-K filed with the
SEC on March 29, 2010). |
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10.4+
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U. S. Physical Therapy, Inc. Discretionary Cash Bonus Plan for
2010, effective March 30, 2010 (incorporated by reference to
Exhibit 99.4 to the Companys current report on Form 8-K filed
with the SEC on March 29, 2010). |
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31.1*
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Rule 13a-14(a)/15d-14(a) Certification of Chief Executive Officer. |
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31.2*
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Rule 13a-14(a)/15d-14(a) Certification of Chief Financial Officer. |
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31.3*
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Rule 13a-14(a)/15d-14(a) Certification of Corporate Controller. |
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32*
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Certification Pursuant to 18 U.S.C 1350, as Adopted Pursuant to
Section 906 of the Sarbanes-Oxley Act of 2002. |
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* |
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Filed herewith |
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Management compensatory plan |
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Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused
this report to be signed on our behalf by the undersigned thereunto duly authorized.
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U.S. PHYSICAL THERAPY, INC.
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Date: May 10, 2010 |
By: |
/s/ LAWRANCE W. MCAFEE
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Lawrance W. McAfee |
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Chief Financial Officer |
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(duly authorized officer and principal financial
and accounting officer)
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By: |
/s/ JON C. BATES
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Jon C. Bates |
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Vice President/Corporate Controller |
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INDEX OF EXHIBITS
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Exhibit Number |
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Description |
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10.1+
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U. S. Physical Therapy, Inc. Objective Long-Term Incentive Plan
for Senior Management, effective March 30, 2010 (incorporated by
reference to Exhibit 99.1 to the Companys current report on Form 8-K filed with the SEC on March 29, 2010). |
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10.2+
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U. S. Physical Therapy, Inc. Discretionary Long-Term Incentive
Plan for Senior Management for 2010, effective March 30, 2010
(incorporated by reference to Exhibit 99.2 to the Companys
current report on Form 8-K filed with the SEC on March 29, 2010). |
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10.3+
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U. S. Physical Therapy, Inc. Objective Cash Bonus Plan for 2010,
effective March 30, 2010 (incorporated by reference to Exhibit
99.3 to the Companys current report on Form 8-K filed with the
SEC on March 29, 2010). |
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10.4+
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U. S. Physical Therapy, Inc. Discretionary Cash Bonus Plan for
2010, effective March 30, 2010 (incorporated by reference to
Exhibit 99.4 to the Companys current report on Form 8-K filed
with the SEC on March 29, 2010). |
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31.1*
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Rule 13a-14(a)/15d-14(a) Certification of Chief Executive Officer. |
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31.2*
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Rule 13a-14(a)/15d-14(a) Certification of Chief Financial Officer. |
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31.3*
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Rule 13a-14(a)/15d-14(a) Certification of Corporate Controller. |
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32*
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Certification Pursuant to 18 U.S.C 1350, as Adopted Pursuant to
Section 906 of the Sarbanes-Oxley Act of 2002. |
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* |
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Filed herewith |
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Management compensatory plan |
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