COMMUNITY HEALTH SYSTEMS, INC. - FORM 10-Q
SECURITIES AND EXCHANGE COMMISSION
Form 10-Q
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 2007
Commission file number 001-15925
COMMUNITY HEALTH SYSTEMS, INC.
(Exact name of registrant as specified in its charter)
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Delaware
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13-3893191 |
(State or other jurisdiction of
incorporation or organization)
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(I.R.S. Employer
Identification Number) |
4000 Meridian Boulevard
Franklin, Tennessee
(Address of principal executive offices)
37067
(Zip Code)
615-465-7000
(Registrants telephone number)
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.
Yes þ No o
Indicate by check mark whether the Registrant is a large accelerated filer, an accelerated
filer, or non-accelerated filer, see definition of accelerated filer and large accelerated
filer in Rule 126-2 of the Exchange Act (check one).
Larger accelerated filer þ Accelerated filer o Non-accelerated filer o
Indicated by check mark whether the registrant is a shell company (as defined in Rule 126-2 of
the Exchange Act).
Yes o No þ
As of July 23, 2007, there were outstanding 95,884,286 shares of the Registrants Common Stock,
$0.01 par value.
Community Health Systems, Inc.
Form 10-Q
For the Three and Six Months Ended June 30, 2007
1
PART I FINANCIAL INFORMATION
Item 1. Financial Statements
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
(In thousands, except share data)
(Unaudited)
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June 30, |
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December 31, |
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2007 |
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2006 |
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ASSETS |
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Current assets |
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Cash and cash equivalents |
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$ |
21,357 |
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$ |
40,566 |
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Patient accounts receivable, net of allowance for doubtful accounts of $498,473 and
$478,565 at June 30, 2007, and December 31, 2006, respectively |
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876,523 |
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773,984 |
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Supplies |
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121,964 |
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113,320 |
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Deferred income taxes |
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|
13,249 |
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|
13,249 |
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Prepaid expenses and taxes |
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36,287 |
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32,385 |
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Other current assets |
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62,933 |
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47,880 |
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Total current assets |
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1,132,313 |
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1,021,384 |
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Property and equipment |
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2,809,988 |
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2,630,366 |
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Less accumulated depreciation and amortization |
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(720,846 |
) |
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(643,789 |
) |
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Property and equipment, net |
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2,089,142 |
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1,986,577 |
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Goodwill |
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1,344,956 |
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1,336,525 |
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Other assets, net |
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226,700 |
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162,093 |
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Total assets |
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$ |
4,793,111 |
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$ |
4,506,579 |
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LIABILITIES AND STOCKHOLDERS EQUITY |
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Current liabilities |
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Current maturities of long-term debt |
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$ |
25,757 |
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$ |
35,396 |
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Accounts payable |
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257,730 |
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247,747 |
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Current income taxes payable |
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49,010 |
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7,626 |
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Accrued interest |
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8,375 |
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7,122 |
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Accrued liabilities |
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270,152 |
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277,392 |
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Total current liabilities |
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611,024 |
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575,283 |
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Long-term debt |
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1,974,240 |
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1,905,781 |
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Deferred income taxes |
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141,472 |
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141,472 |
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Other long-term liabilities |
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205,408 |
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160,370 |
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Stockholders equity |
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Preferred stock, $.01 par value per share, 100,000,000 shares authorized, none issued |
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Common stock, $.01 par value per share, 300,000,000 shares authorized;
95,881,020 shares issued and 94,905,471 shares outstanding
at June 30, 2007, and 95,026,494 shares issued and 94,050,945 shares
outstanding at December 31, 2006 |
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959 |
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950 |
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Additional paid-in capital |
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1,215,321 |
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1,195,947 |
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Treasury stock, at cost, 975,549 shares at June 30, 2007 and December 31, 2006 |
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(6,678 |
) |
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(6,678 |
) |
Accumulated other comprehensive income |
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15,622 |
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5,798 |
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Retained earnings |
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635,743 |
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527,656 |
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Total stockholders equity |
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1,860,967 |
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1,723,673 |
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Total liabilities and stockholders equity |
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$ |
4,793,111 |
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$ |
4,506,579 |
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See accompanying notes to the condensed consolidated financial statements.
2
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(In thousands, except share and per share data)
(Unaudited)
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Three Months Ended |
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Six Months Ended |
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June 30, |
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June 30, |
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2007 |
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2006 |
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2007 |
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2006 |
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Net operating revenues |
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$ |
1,249,128 |
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$ |
1,061,054 |
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$ |
2,453,125 |
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$ |
2,087,616 |
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Operating costs and expenses: |
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Salaries and benefits |
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495,085 |
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420,147 |
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981,421 |
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827,815 |
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Provision for bad debts |
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148,661 |
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115,704 |
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284,360 |
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223,295 |
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Supplies |
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146,033 |
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125,700 |
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286,541 |
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248,520 |
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Other operating expenses |
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258,556 |
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219,113 |
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503,815 |
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426,156 |
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Rent |
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28,244 |
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23,646 |
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54,240 |
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46,628 |
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Depreciation and amortization |
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53,349 |
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47,183 |
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|
104,619 |
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|
89,689 |
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Minority interest in earnings |
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625 |
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|
455 |
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818 |
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1,068 |
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Total operating costs and expenses |
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1,130,553 |
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951,948 |
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2,215,814 |
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1,863,171 |
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Income from operations |
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118,575 |
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109,106 |
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237,311 |
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224,445 |
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Interest expense, net |
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31,155 |
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|
23,870 |
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61,559 |
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45,657 |
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Income from continuing operations
before income taxes |
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87,420 |
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85,236 |
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175,752 |
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178,788 |
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Provision for income taxes |
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33,657 |
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32,867 |
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67,665 |
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69,165 |
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Income from continuing operations |
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53,763 |
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52,369 |
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108,087 |
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109,623 |
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Discontinued operations, net of taxes: |
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Loss from operations of hospital sold and held for sale |
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(657 |
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Loss on sale of hospital |
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(2,559 |
) |
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Loss on discontinued operations |
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(3,216 |
) |
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Net income |
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$ |
53,763 |
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$ |
52,369 |
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$ |
108,087 |
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$ |
106,407 |
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Income from continuing operations per common share: |
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Basic |
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$ |
0.57 |
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$ |
0.55 |
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$ |
1.16 |
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$ |
1.14 |
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Diluted |
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$ |
0.57 |
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$ |
0.54 |
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$ |
1.14 |
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$ |
1.13 |
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Net income per common share: |
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Basic |
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$ |
0.57 |
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$ |
0.55 |
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$ |
1.16 |
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$ |
1.11 |
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Diluted |
|
$ |
0.57 |
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$ |
0.54 |
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$ |
1.14 |
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$ |
1.09 |
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Weighted-average number of shares outstanding: |
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Basic |
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93,518,991 |
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|
95,769,030 |
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93,373,357 |
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96,158,575 |
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Diluted |
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94,647,870 |
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96,870,315 |
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94,422,000 |
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|
97,536,815 |
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See accompanying notes to the condensed consolidated financial statements.
3
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)
(Unaudited)
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Six Months Ended |
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June 30, |
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2007 |
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2006 |
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Cash flows from operating activities |
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Net income |
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$ |
108,087 |
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|
$ |
106,407 |
|
Adjustments to reconcile net income to net cash provided by operating activities: |
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|
|
|
|
|
|
Depreciation and amortization |
|
|
104,619 |
|
|
|
89,689 |
|
Minority interest in earnings |
|
|
818 |
|
|
|
1,068 |
|
Stock-based compensation expense |
|
|
14,295 |
|
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|
8,946 |
|
Excess tax benefits relating to stock-based compensation |
|
|
(2,295 |
) |
|
|
(4,588 |
) |
Other non-cash expenses, net |
|
|
(1,542 |
) |
|
|
3,306 |
|
Changes in operating assets and liabilities, net of effects of acquisitions and divestitures: |
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Patient accounts receivable |
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(47,415 |
) |
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|
(57,961 |
) |
Supplies, prepaid expenses and other current assets |
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|
(13,458 |
) |
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|
(93 |
) |
Accounts payable, accrued liabilities and income taxes |
|
|
46,353 |
|
|
|
69,988 |
|
Other |
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|
6,526 |
|
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|
(9,716 |
) |
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Net cash provided by operating activities |
|
|
215,988 |
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|
207,046 |
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Cash flows from investing activities |
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Acquisitions of facilities and other related equipment |
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(187,955 |
) |
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|
(178,015 |
) |
Purchases of property and equipment |
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|
(108,849 |
) |
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|
(94,194 |
) |
Disposition of hospital and other ancillary operations |
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|
12,662 |
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|
750 |
|
Proceeds from sale of equipment |
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|
234 |
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|
74 |
|
Increase in other assets |
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(25,362 |
) |
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|
(24,382 |
) |
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Net cash used in investing activities |
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|
(309,270 |
) |
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|
(295,767 |
) |
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Cash flows from financing activities |
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|
|
|
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|
Proceeds from exercise of stock options |
|
|
6,693 |
|
|
|
8,699 |
|
Excess tax benefits relating to stock-based compensation |
|
|
2,295 |
|
|
|
4,588 |
|
Stock buy-back |
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|
|
|
|
|
(137,666 |
) |
Deferred financing costs |
|
|
(367 |
) |
|
|
(16 |
) |
Redemption of convertible notes |
|
|
|
|
|
|
(128 |
) |
Proceeds from minority investors in joint ventures |
|
|
1,105 |
|
|
|
3,060 |
|
Redemption of minority investments in joint ventures |
|
|
(1,369 |
) |
|
|
(530 |
) |
Distributions to minority investors in joint ventures |
|
|
(1,705 |
) |
|
|
(1,977 |
) |
Borrowings under credit agreement |
|
|
132,000 |
|
|
|
176,000 |
|
Repayments of long-term indebtedness |
|
|
(64,579 |
) |
|
|
(43,260 |
) |
|
|
|
|
|
|
|
Net cash provided by financing activities |
|
|
74,073 |
|
|
|
8,770 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net change in cash and cash equivalents |
|
|
(19,209 |
) |
|
|
(79,951 |
) |
|
|
|
|
|
|
|
|
|
Cash and cash equivalents at beginning of period |
|
|
40,566 |
|
|
|
104,108 |
|
|
|
|
|
|
|
|
Cash and cash equivalents at end of period |
|
$ |
21,357 |
|
|
$ |
24,157 |
|
|
|
|
|
|
|
|
See accompanying notes to the condensed consolidated financial statements.
4
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
1. BASIS OF PRESENTATION
The unaudited condensed consolidated financial statements of Community Health Systems, Inc. and its
Subsidiaries (the Company) as of June 30, 2007 and for the three and six month periods ended June
30, 2007 and June 30, 2006, have been prepared in accordance with accounting principles generally
accepted in the United States of America. In the opinion of management, such information contains
all adjustments, consisting only of normal recurring adjustments, necessary for a fair presentation
of the results for such periods. All intercompany transactions and balances have been eliminated.
The results of operations for the three and six months ended June 30, 2007, are not necessarily
indicative of the results to be expected for the full fiscal year ending December 31, 2007.
Certain information and disclosures normally included in the notes to the consolidated financial
statements have been condensed or omitted as permitted by the rules and regulations of the
Securities and Exchange Commission (SEC), although the Company believes the included disclosures
are adequate to make the information presented not misleading. The accompanying unaudited condensed
consolidated financial statements should be read in conjunction with the consolidated financial
statements and notes thereto for the year ended December 31, 2006, contained in the Companys
Annual Report on Form 10-K.
Effective September 30, 2006, the Company began estimating the allowance for doubtful accounts by
reserving a percentage of all self-pay accounts receivable without regard to aging category, based
on collection history, adjusted for expected recoveries and, if present, anticipated changes in
trends. Since the Company has historically collected substantially all third-party insured
accounts receivable, which includes receivables from governmental agencies, within one year of date
of discharge, the Company began reserving 100% of only those third-party insured accounts aging
over 365 days from the date of discharge. The percentage used to reserve for all self-pay accounts
is based now on the Companys specific collection history for self-pay accounts. Previously, the
Company estimated the allowance for doubtful accounts by reserving all accounts aging over 150 days
from the date of discharge, without regard to payor class.
2. ACCOUNTING FOR STOCK-BASED COMPENSATION
Stock-based compensation awards are granted under the Community Health Systems, Inc. Amended
and Restated 2000 Stock Option and Award Plan (the 2000 Plan). The 2000 Plan allows for the
grant of incentive stock options intended to qualify under Section 422 of the Internal Revenue Code
as well as stock options which do not so qualify, stock appreciation rights, restricted stock,
performance units and performance shares, phantom stock awards and share awards. Persons eligible
to receive grants under the 2000 Plan include the Companys directors, officers, employees and
consultants. To date, the options granted under the 2000 Plan are nonqualified stock options for
tax purposes. Vesting of these granted options occurs in one third increments on each of the first
three anniversaries of the award date. Options granted prior to 2005 have a 10 year contractual
term and options granted in 2005 and 2006 have an 8 year contractual term. The exercise price of
options granted to employees under the 2000 Plan were equal to the fair value of the Companys
common stock on the option grant date. As of June 30, 2007, 9,863,232 shares of unissued common
stock remain reserved for future grants under the 2000 Plan. The Company also has options outstanding under its Employee Stock Option Plan (the 1996 Plan). These options are
fully vested and exercisable and no additional grants of options will be made under the 1996 Plan.
The following table reflects the impact of total compensation expense related to stock-based equity
plans under the Statement of Financial Accounting Standards (SFAS) No. 123(R), on the reported
operating results for the respective periods (in thousands, except per share data):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Six months ended |
|
|
|
June 30, |
|
|
June 30, |
|
|
|
2007 |
|
|
2006 |
|
|
2007 |
|
|
2006 |
|
Effect on income from continuing
operations before income taxes |
|
$ |
(7,965 |
) |
|
$ |
(5,279 |
) |
|
$ |
(14,295 |
) |
|
$ |
(8,946 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Effect on net income |
|
$ |
(4,839 |
) |
|
$ |
(3,367 |
) |
|
$ |
(8,684 |
) |
|
$ |
(5,750 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Effect on net income per share-diluted |
|
$ |
(0.05 |
) |
|
$ |
(0.04 |
) |
|
$ |
(0.09 |
) |
|
$ |
(0.06 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
SFAS No. 123(R) also requires the benefits of tax deductions in excess of the recognized tax
benefit on compensation expense to be reported as a financing cash flow, rather than as an
operating cash flow, as required under APB 25 and related interpretations. This requirement
reduced our net operating cash flows and increased our financing cash flows by $1.5 million and
$0.2 million for the three months ended June 30, 2007 and 2006, respectively, and $2.3 million and
$4.6 million for the six months ended June 30, 2007 and 2006, respectively.
5
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
2. ACCOUNTING FOR STOCK-BASED COMPENSATION (Continued)
At June 30, 2007, $55.2 million of unrecognized stock-based compensation expense from all
outstanding unvested stock options and restricted stock is expected to be recognized over a
weighted-average period of 20.4 months.
The fair value of stock-based awards was estimated using the Black Scholes option pricing model
with the assumptions and weighted-average fair values during the three and six months ended June
30, 2007 and June 30, 2006, as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Six months ended |
|
|
|
June 30, |
|
|
June 30, |
|
|
|
2007 |
|
|
2006 |
|
|
2007 |
|
|
2006 |
|
Expected volatility |
|
|
24.6 |
% |
|
|
23.2 |
% |
|
|
25.5 |
% |
|
|
24.1 |
% |
Expected dividends |
|
|
0 |
|
|
|
0 |
|
|
|
0 |
|
|
|
0 |
|
Expected term |
|
4 years |
|
4 years |
|
4 years |
|
4 years |
Risk-free interest rate |
|
|
4.77 |
% |
|
|
4.98 |
% |
|
|
4.50 |
% |
|
|
4.67 |
% |
In determining expected return, the Company examined concentrations of option holdings, historical
patterns of option exercises and forfeitures, as well as forward looking factors, to determine if
there were discernable employee populations. From this analysis, the Company identified two
employee populations, one consisting primarily of certain senior executives and the other
consisting of all other recipients.
The expected volatility rate was estimated based on historical volatility. In determining expected
volatility, the Company also reviewed the market based implied volatility of actively traded
options of its common stock and determined that historical volatility did not differ significantly
from the implied volatility.
The expected life computation is based on historical exercise and cancellation patterns and forward
looking factors, where present, for each population identified. The risk-free interest rate is
based on the U.S. Treasury yield curve in effect at the time of the grant. The pre-vesting
forfeiture rate is based on historical rates and forward looking factors for each population
identified. As required under SFAS No. 123(R), the Company will adjust the estimated forfeiture
rate to its actual experience.
Options outstanding and exercisable under the 1996 Plan and the 2000 Plan as of June 30, 2007, and
changes during the three and six months then ended were as follows (in thousands, except share and
per share data):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
average |
|
|
|
|
|
|
|
|
|
|
Weighted |
|
|
remaining |
|
|
Aggregate |
|
|
|
|
|
|
|
average |
|
|
contractual |
|
|
intrinsic |
|
|
|
|
|
|
|
exercise |
|
|
term |
|
|
value as of |
|
|
|
Shares |
|
|
price |
|
|
(in years) |
|
|
June 30, 2007 |
|
|
Outstanding at December 31, 2006 |
|
|
5,482,528 |
|
|
$ |
26.48 |
|
|
|
|
|
|
|
|
|
Granted |
|
|
852,500 |
|
|
|
37.21 |
|
|
|
|
|
|
|
|
|
Exercised |
|
|
(121,861 |
) |
|
|
26.13 |
|
|
|
|
|
|
|
|
|
Forfeited and cancelled |
|
|
(24,002 |
) |
|
|
35.77 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Outstanding at March 31, 2007 |
|
|
6,189,165 |
|
|
|
27.93 |
|
|
|
|
|
|
|
|
|
Granted |
|
|
54,000 |
|
|
|
37.20 |
|
|
|
|
|
|
|
|
|
Exercised |
|
|
(123,321 |
) |
|
|
26.82 |
|
|
|
|
|
|
|
|
|
Forfeited and cancelled |
|
|
(70,841 |
) |
|
|
36.16 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Outstanding at June 30, 2007 |
|
|
6,049,003 |
|
|
$ |
27.94 |
|
|
6.45 years |
|
$ |
75,680 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Exercisable at June 30, 2007 |
|
|
4,017,912 |
|
|
$ |
23.53 |
|
|
5.98 years |
|
$ |
67,984 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The weighted-average grant date fair value of stock options granted during the six months ended
June 30, 2007 and June 30, 2006, was $10.36 and $10.39, respectively. The aggregate intrinsic
value in the table above represents the total pretax intrinsic value (the difference between the
Companys closing stock price on the last trading day of the reporting period ($40.45) and the
exercise price, multiplied by the number of
6
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
2. ACCOUNTING FOR STOCK-BASED COMPENSATION (Continued)
the in-the-money options) that would have been received by the option holders had all option
holders exercised their options on June 30, 2007. This amount changes based on the market value of
the Companys common stock. The aggregate intrinsic value of options exercised during the three
months ended June 30, 2007 and 2006 was $1.5 million and $0.6 million, respectively, and the
aggregate intrinsic value of options exercised during the six months ended June 30, 2007 and 2006
was $2.9 million and $11.7 million, respectively.
The Company has also awarded restricted stock under the 2000 Plan to various employees and its
directors. The restrictions on these shares generally lapse in one-third increments on each of the
first three anniversaries of the award date. Certain of the restricted stock awards granted to the
Companys senior executives also contain a performance objective that must be met in addition to
the vesting requirements. If the performance objective is not attained the awards will be
forfeited in their entirety. Once the performance objective has been attained, restrictions will
lapse in one-third increments on each of the first three anniversaries of the award date.
Notwithstanding the above mentioned performance objectives and vesting requirements, the
restrictions will lapse earlier in the event of death, disability, termination of employment by
employer for reason other than for cause of the holder of the restricted stock or in the event of
change in control of the Company. Restricted stock awards subject to performance standards are
not considered outstanding for purposes of determining earnings per share until the performance
objectives have been satisfied.
Restricted stock outstanding under the 2000 Plan as of June 30, 2007, and changes during the three
and six months then ended are as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted |
|
|
|
|
|
|
|
average |
|
|
|
|
|
|
|
fair |
|
|
|
Shares |
|
|
value |
|
|
Unvested at December 31, 2006 |
|
|
969,691 |
|
|
$ |
36.05 |
|
Granted |
|
|
681,000 |
|
|
|
37.19 |
|
Vested |
|
|
(376,679 |
) |
|
|
35.42 |
|
Forfeited |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Unvested at March 31, 2007 |
|
|
1,274,012 |
|
|
|
36.84 |
|
Granted |
|
|
8,500 |
|
|
|
37.20 |
|
Vested |
|
|
|
|
|
|
|
|
Forfeited |
|
|
(16,002 |
) |
|
|
36.66 |
|
|
|
|
|
|
|
|
|
Unvested at June 30, 2007 |
|
|
1,266,510 |
|
|
|
36.84 |
|
|
|
|
|
|
|
|
|
As of June 30, 2007, there was $38.9 million of unrecognized stock-based compensation expense
related to unvested restricted stock expected to be recognized over a weighted-average period of
21.4 months.
Under the Directors Fee Deferral Plan, the Companys outside directors may elect to receive share
equivalent units in lieu of cash for their directors fee. These units are held in the plan until
the director electing to receive the share equivalent units retires or otherwise terminates his/her
directorship with the Company. Share equivalent units are converted to shares of common stock of
the Company at the time of distribution. The following table represents the amount of directors
fees which were deferred and the equivalent units into which they converted for each of the
respective periods:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Six months ended |
|
|
|
June 30, |
|
|
June 30, |
|
|
|
2007 |
|
|
2006 |
|
|
2007 |
|
|
2006 |
|
Directors fees earned
and deferred into plan |
|
$ |
29,375 |
|
|
$ |
41,875 |
|
|
$ |
65,250 |
|
|
$ |
93,750 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Equivalent units |
|
|
726.205 |
|
|
|
1,139.456 |
|
|
|
1,743.936 |
|
|
|
2,574.449 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
At June 30, 2007, there are a total of 11,529.937 units deferred in the plan with an aggregate fair
value of $466,386 based on the closing market price of the Companys common stock on the last
trading day of the reporting period of $40.45.
7
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
3. COST OF REVENUE
The majority of the Companys operating costs and expenses are cost of revenue items. Operating
costs that could be classified as general and administrative by the Company would include the
Companys corporate office costs, which were $23.9 million and $23.3 million for the three months
ended June 30, 2007 and 2006, respectively, and $47.0 million and $44.3 million for the six months
ended June 30, 2007 and 2006, respectively. These corporate office costs include stock-based
compensation expense recognized under SFAS No. 123(R).
4. USE OF ESTIMATES
The preparation of financial statements in conformity with accounting principles generally accepted
in the United States of America requires management of the Company to make estimates and
assumptions that affect the amounts reported in the consolidated financial statements. Actual
results could differ from the estimates.
5. ACQUISITIONS AND DIVESTITURES
On July 25, 2007, the Company completed its acquisition of Triad Hospitals, Inc. (Triad) pursuant
to which the Company acquired Triad for $54 per share in cash, or approximately $6.968 billion in
the aggregate, including the assumption of approximately $1.702 billion of existing indebtedness of
Triad. The combined company owns or operates approximately 130 hospitals in 28 states, with a
total bed count of approximately 19,200. The merger was approved by Triads stockholders at a
meeting held on June 13, 2007. In connection with the consummation of the merger, the Company
obtained $7.215 billion of senior secured financing under a new credit facility (the New Credit
Facility) and its wholly-owned subsidiary, CHS/Community Health Systems, Inc. (the Issuer),
issued $3.021 billion aggregate principal amount ($3.000 billion, net of discount) of 8.875% senior
notes due 2015 (the Notes) at the closing of the merger. The Notes are senior obligations of the
Issuer and are guaranteed on a senior basis by the Company and by certain of the Companys domestic
subsidiaries (including certain of the acquired Triad subsidiaries). The Company used the net proceeds from the Notes offering and the net proceeds of the
$6.065 billion of term loans under the New Credit Facility to pay the consideration under the
merger agreement, to refinance certain of its indebtedness and indebtedness of Triad, to complete
certain related transactions, to pay certain costs and expenses of the transactions and for general
corporate uses. A $750 million revolving credit facility and a $400 million delayed draw term loan
facility is available to the Company for working capital and general corporate purposes under the
New Credit Facility. This revolving credit facility also will include a subfacility for letters of
credit and a swingline subfacility. Also, in connection with the consummation of the merger, the Company completed an early repayment of its outstanding $300
million aggregate principal amount of 6-1/2% Senior Subordinated Notes due 2012 through a cash
tender offer and consent solicitation.
Prior to entering the merger agreement, Triad terminated an Agreement and Plan of Merger that it
entered into on February 4, 2007 (the Prior Merger Agreement) with Panthera Partners, LLC,
Panthera Holdco Corp. and Panthera Acquisition Corporation (collectively, Panthera). Concurrent
with the termination of the Prior Merger Agreement and pursuant to the terms thereof, Triad paid a
termination fee of $20 million to Panthera and advanced $20 million to Panthera to cover its
out-of-pocket expenses. The Company has reimbursed Triad for the termination fee and the advance
for expense reimbursement paid to Panthera. These amounts have been included in other assets on
the accompanying June 30, 2007 balance sheet and will subsequently be included in the total
allocated purchase price relative to the Triad acquisition.
Effective April 1, 2007, the Company completed its acquisition of Lincoln General Hospital (157
licensed beds), located in Ruston, Louisiana. The total consideration for this hospital was
approximately $47.8 million, of which $43.6 million was paid in cash and $4.2 million was assumed
in liabilities. On May 1, 2007, the Company completed its acquisition of Porter Health, a 301 bed
acute care hospital located in Valparaiso, Indiana, with a satellite
campus in Portage, Indiana, and
outpatient medical campuses in Chesterton, Demotte, and Hebron, Indiana. As part of this
acquisition, the Company has agreed to construct a 225-bed replacement facility for the Valparaiso
hospital no later than April 2011. The total consideration for Porter Health was approximately
$110.1 million, of which $83.2 million was paid in cash and $26.9 million was assumed in
liabilities. During the quarter ended June 30, 2007, the Company made its initial purchase price
allocation relating to these acquisitions resulting in approximately
$6.6 million of goodwill
being recorded. This allocation is preliminary pending, among other things, finalization of
appraisals of tangible and intangible assets.
8
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
5. ACQUISITIONS AND DIVESTITURES (Continued)
During 2006, the Company acquired through seven separate purchase transactions and three capital
lease transactions, substantially all of the assets and working capital of eight hospitals and
three home health agencies. On March 1, 2006, the Company acquired, through a combination of
purchasing certain assets and entering into a capital lease for other related assets, Forrest City
Hospital, a 118 bed hospital located in Forrest City, Arkansas. On April 1, 2006, the Company
completed the acquisition of two hospitals from Baptist Health System, Birmingham, Alabama: Baptist
Medical Center DeKalb (134 beds) and Baptist Medical Center Cherokee (60 beds). On May 1,
2006, the Company acquired Via Christi Oklahoma Regional Medical Center, a 140 bed hospital located
in Ponca City, Oklahoma. On June 1, 2006, the Company acquired Mineral Area Regional Medical
Center, a 135 bed hospital located in Farmington, Missouri. On June 30, 2006, the Company acquired
Cottage Home Options, a home health agency and related business, located in Galesburg, Illinois.
On July 1, 2006, the Company acquired the healthcare assets of Vista Health, which included Victory
Memorial Hospital (336 beds) and St. Therese Medical Center (71 non-acute care beds), both located
in Waukegan, Illinois. On September 1, 2006, the Company acquired Humble Texas Home Care, a home
health agency located in Humble, Texas. On October 1, 2006, the Company acquired Helpsource Home
Health, a home health agency located in Wichita Falls, Texas. On November 1, 2006, the Company
acquired through two separate capital lease transactions, Campbell Memorial Hospital, a 99 bed
hospital located in Weatherford, Texas and Union County Hospital, a 25 bed hospital located in
Anna, Illinois. The aggregate consideration for these eight hospitals and three home health
agencies totaled approximately $385.7 million, of which $353.8 million was paid in cash and $31.9
million was assumed in liabilities. Goodwill recognized in these transactions totaled $65.6
million, which is expected to be fully deductible for tax purposes.
Effective March 18, 2006, the Company sold Highland Medical Center, a 123 bed facility located in
Lubbock, Texas, to Shiloh Health Services, Inc. of Louisville, Kentucky. The proceeds from this
sale were $0.5 million. This hospital had previously been classified as held for sale. In
connection with the above sale transaction and in accordance with SFAS No. 144, Accounting for the
Impairment or Disposal of Long-Lived Assets, the Company has classified the results of operations
of Highland Medical Center as discontinued operations in the accompanying condensed consolidated
statements of income.
Net operating revenues and loss from discontinued operations, related to the above mentioned sale,
for the six months ended June 30, 2006 (as applicable) are as follows (in thousands):
|
|
|
|
|
|
|
Six months ended |
|
|
|
June 30, |
|
|
|
2006 |
|
|
|
|
|
|
Net operating revenues |
|
$ |
4,294 |
|
|
|
|
|
|
|
|
|
|
Loss from operations before income taxes |
|
$ |
(1,008 |
) |
Loss on sale of hospital |
|
|
(3,938 |
) |
|
|
|
|
Loss from discontinued operations, before taxes |
|
|
(4,946 |
) |
Income tax benefit |
|
|
1,730 |
|
|
|
|
|
Loss from discontinued operations, net of tax |
|
$ |
(3,216 |
) |
|
|
|
|
Since the sale of Highland Medical Center occurred in the first quarter of 2006, there are no
net operating revenues and no loss from discontinued operations for the three months ended June 30,
2006. The computation of the loss from discontinued operations, before taxes, for the six months
ended June 30, 2006 includes the net write-off of $4.4 million of tangible assets at the one
hospital sold during the six months ended June 30, 2006.
There are no material assets or liabilities related to the hospitals classified as discontinued
operations in the accompanying condensed consolidated balance sheets as of June 30, 2007 and
December 31, 2006.
6. INCOME TAXES
The Company adopted the provisions of the Financial Accounting Standards Board (FASB)
Interpretation No. 48, Accounting for Uncertainty in Income Taxes, on January 1, 2007. The total
amount of unrecognized benefit that would affect the effective tax rate, if recognized, is $9.0
million. It is the Companys policy to recognize interest accrued related to unrecognized benefits
in its statement of operations as income tax expense. Approximately $1.2 million of interest is
included in the amount of unrecognized benefit at June 30, 2007. During the year ending December
31, 2007, it is possible the Company could release up
9
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
6. INCOME TAXES (Continued)
to $5.2 million plus accrued interest of $0.8 million of its FASB Interpretation No. 48 liability,
as a result of the potential expiration of the statute of limitations pertaining to tax positions
taken in prior years relative to legal settlements.
The Company or one of its subsidiaries files income tax returns in the U.S. federal jurisdiction
and various state jurisdictions. With few exceptions, the Company is no longer subject to U.S.
federal or state income tax examinations for years prior to 2003. During 2006, the Company agreed
to a settlement at the Internal Revenue Service Appeals Office with respect to the 2003
consolidated income tax year. The Company has since received a closing letter with respect to the
examination for the tax year 2003. The settlement was not material to the Companys consolidated
statement of income or financial position.
Cash paid for income taxes, net of refunds received, was $16.2 million and $15.5 million during the
three months ended June 30, 2007 and 2006, respectively, and $29.4 million and $36.6 million during
the six months ended June 30, 2007 and 2006, respectively.
7. GOODWILL AND OTHER INTANGIBLE ASSETS
The changes in the carrying amount of goodwill for the six months ended June 30, 2007, are as
follows (in thousands):
|
|
|
|
|
Balance as of December 31, 2006 |
|
$ |
1,336,525 |
|
Goodwill acquired as part of acquisitions during 2007 |
|
|
6,577 |
|
Consideration adjustments and finalization of purchase price
allocations for acquisitions completed prior to 2007 |
|
|
3,476 |
|
Goodwill written-off as part of disposal transaction |
|
|
(1,622 |
) |
Balance as of June 30, 2007 |
|
$ |
1,344,956 |
|
In May 2007, the Company sold certain operations ancillary to one of its hospitals. This
transaction and related operations were not material.
The Company completed its most recent annual goodwill impairment test as required by SFAS No. 142,
Goodwill and Other Intangible Assets, during 2006, using a measurement date of September 30,
2006. Based on the results of the impairment test, the Company was not required to recognize an
impairment of goodwill in 2006.
As previously disclosed and further discussed in the footnote on Subsequent Events, on July 25,
2007, the Company completed its acquisition of Triad. In connection with this transaction, the
Company has engaged a third-party valuation firm to assist it in determining the fair market value
of the tangible and intangible assets acquired from Triad. The Company will make a preliminary
allocation of purchase price in the third quarter of 2007 and anticipates that this transaction
will create a significant amount of goodwill.
The gross carrying amount of the Companys other intangible assets was $15.6 million at June 30,
2007 and $13.7 million at December 31, 2006, and the net carrying amount was $9.7 million at June
30, 2007 and $7.4 million at December 31, 2006. Other intangible assets are included in other
assets, net on the Companys condensed consolidated balance sheets.
The weighted-average amortization period for the intangible assets subject to amortization is
approximately seven years. There are no expected residual values related to these intangible
assets. Amortization expense on these intangible assets during the three months ended June 30, 2007
and 2006 was $0.5 million and $0.4 million, respectively. Amortization expense on these intangible
assets during the six months ended June 30, 2007 and 2006 was $1.0 million and $0.9 million,
respectively. Amortization expense on intangible assets is estimated to be $1.9 million for the
remainder of 2007, $2.1 million in 2008, $1.8 million in 2009, $1.2 million in 2010, $0.6 million
in 2011, and $0.5 million in 2012.
10
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
8. EARNINGS PER SHARE
The following table sets forth the components of the numerator and denominator for the
computation of basic and diluted income from continuing operations per share (in thousands, except
share data):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended June 30, |
|
|
Six months ended June 30, |
|
|
|
2007 |
|
|
2006 |
|
|
2007 |
|
|
2006 |
|
Numerator: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Numerator for basic earnings per share - |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income from continuing operations available to
common stockholders basic |
|
$ |
53,763 |
|
|
$ |
52,369 |
|
|
$ |
108,087 |
|
|
$ |
109,623 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Numerator for diluted earnings per share - |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income from continuing operations |
|
$ |
53,763 |
|
|
$ |
52,369 |
|
|
$ |
108,087 |
|
|
$ |
109,623 |
|
Interest, net of tax, on 4.25% convertible notes |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
135 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income from continuing operations available
to common stockholders diluted |
|
$ |
53,763 |
|
|
$ |
52,369 |
|
|
$ |
108,087 |
|
|
$ |
109,758 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Denominator: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted-average number of shares outstanding basic |
|
|
93,518,991 |
|
|
|
95,769,030 |
|
|
|
93,373,357 |
|
|
|
96,158,575 |
|
Effect of dilutive securities: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Non-employee director options |
|
|
|
|
|
|
11,850 |
|
|
|
5,913 |
|
|
|
11,882 |
|
Restricted stock awards |
|
|
181,183 |
|
|
|
108,432 |
|
|
|
111,539 |
|
|
|
76,849 |
|
Employee options |
|
|
947,696 |
|
|
|
981,003 |
|
|
|
931,191 |
|
|
|
996,865 |
|
4.25% convertible notes |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
292,644 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted-average number of shares outstanding diluted |
|
|
94,647,870 |
|
|
|
96,870,315 |
|
|
|
94,422,000 |
|
|
|
97,536,815 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Dilutive securities outstanding not included in the
computation of earnings per share because their
effect is antidilutive: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Employee options |
|
|
1,032,071 |
|
|
|
1,028,400 |
|
|
|
1,479,319 |
|
|
|
1,045,400 |
|
9. STOCKHOLDERS EQUITY
On January 17, 2006, the Company completed the redemption of all its remaining outstanding 4.25%
Convertible Subordinated Notes due 2008 (the 4.25% Notes). Prior to the call for redemption made
on December 16, 2005, there was $136.6 million in aggregate principal amount of the 4.25% Notes
outstanding. At the conclusion of the call for redemption, $0.1 million in principal amount of the
4.25% Notes were redeemed for cash and $136.5 million of the 4.25% Notes were converted by the
holders into 4,074,510 shares of the Companys common stock, $0.01 par value per share.
On January 14, 2006, the Company commenced an open market repurchase program for up to 5,000,000
shares of the Companys common stock, not to exceed $200 million in repurchases. Under this
program, the Company repurchased the entire 5,000,000 shares at a weighted average price of $35.23.
This program concluded on November 8, 2006 when the maximum number of shares had been repurchased.
On December 13, 2006, the Company commenced another open market repurchase program for up to
5,000,000 shares of the Companys common stock not to exceed $200 million in repurchases. This
program will conclude at the earlier of three years or when the maximum number of shares have been
repurchased. As of June 30, 2007, the Company has not repurchased any shares under this program.
11
10. COMPREHENSIVE INCOME
The following table presents the components of comprehensive income, net of related taxes. The net
change in fair value of interest rate swap agreements is a function of the spread between the fixed
interest rate of each swap and the underlying variable interest rate under the Companys credit
facility and the change in fair value of available for sale securities is the unrealized gains
(losses) on the related investments (in thousands):
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three months ended |
|
|
Six months ended |
|
|
|
June 30, |
|
|
June 30, |
|
|
|
2007 |
|
|
2006 |
|
|
2007 |
|
|
2006 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income |
|
$ |
53,763 |
|
|
$ |
52,369 |
|
|
$ |
108,087 |
|
|
$ |
106,407 |
|
Net change in fair value of interest rate swaps |
|
|
13,670 |
|
|
|
2,370 |
|
|
|
9,800 |
|
|
|
7,504 |
|
Net change in fair value of available for sale securities |
|
|
237 |
|
|
|
(138 |
) |
|
|
24 |
|
|
|
28 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Comprehensive income |
|
$ |
67,670 |
|
|
$ |
54,601 |
|
|
$ |
117,911 |
|
|
$ |
113,939 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The net change in fair value of the interest rate swap agreements and the net change in fair
value of available for sale securities are included in stockholders equity on the accompanying
condensed consolidated balance sheets.
11. LONG-TERM DEBT
On August 19, 2004, the Company entered into a $1.625 billion senior secured credit facility with a
consortium of lenders which was subsequently amended on December 16, 2004, July 8, 2005 and
December 13, 2006. The purpose of the facility was to refinance the Companys previous credit
agreement, repay specified other indebtedness, and fund general corporate purposes including
amending the credit facility to permit declaration and payment of cash dividends, to repurchase
shares or make other distributions, subject to certain restrictions. This facility replaced the
Companys previous credit facility and consists of a $1.2 billion term loan that matures in 2011
and a $425 million revolving credit facility that matures in 2009. The First Incremental Facility
Amendment, dated as of December 13, 2006, increased our term loans by $400 million (the
Incremental Term Loan Facility) and also gave the Company the ability to add up to $400 million
of additional term loans. The full amount of the Incremental Term Loan Facility was funded on
December 13, 2006, and the proceeds were used to repay the full outstanding amount (approximately
$326 million) of the revolving credit facility under the credit agreement and the balance was
available to be used for general corporate purposes. The Company may elect from time to time an
interest rate per annum for the borrowings under the term loan, including the incremental term
loan, and revolving credit facility equal to (a) an alternate base rate, which will be equal to the
greatest of (i) the Prime Rate (as defined) in effect and (ii) the Federal Funds Effective Rate (as
defined), plus 50 basis points, plus (1) 75 basis points for the term loan and (2) the Applicable Margin (as defined) for
revolving credit loans or (b) the Eurodollar Rate (as defined) plus (1) 175 basis points for the
term loan and (2) the Applicable Margin for Eurodollar revolving credit loans. The Company also
pays a commitment fee for the daily average unused commitments under the revolving credit facility.
The commitment fee is based on a pricing grid depending on the Applicable Margin for Eurodollar
revolving credit loans and ranges from 0.250% to 0.500%. The commitment fee is payable quarterly
in arrears and on the revolving credit termination date with respect to the available revolving
credit commitments. In addition, the Company will pay fees for each letter of credit issued under
the credit facility. In connection with this refinancing, the Company recorded a pre-tax write-off
of approximately $0.8 million in deferred loan costs relative to the early extinguishment of a
portion of the previous credit facility.
As of June 30, 2007, the Companys availability for additional borrowings under its revolving
credit facility was $425 million, of which $22.4 million was set aside for outstanding letters of
credit. The Company also had the ability to add up to $200 million of borrowing capacity from
receivable transactions (including securitizations) under its senior secured credit facility which
had not yet been accessed. As stated above, the Company also had the ability to amend the senior
secured credit facility to provide for one or more tranches of term loans in an aggregate principal
amount of $400 million, which the Company had not yet accessed. As of June 30, 2007, the Companys
weighted-average interest rate under its credit facility was 7.5%.
Cash paid for interest, net of interest income, was $34.6 million and $28.1 million during the
three months ended June 30, 2007 and 2006, respectively, and $60.3 million and $47.4 million during
the six months ended June 30, 2007 and 2006, respectively.
As previously disclosed and further discussed in the footnote on Subsequent Events, in connection
with the consummation of the acquisition of Triad on July 25, 2007, the Company used a portion of
the net proceeds from its New Credit Facility and Notes offering to repay its outstanding debt
under the above mentioned credit facility. Upon repayment, the above mentioned credit facility was
terminated.
The Company has entered into this New Credit Facility with a syndicate of financial institutions
led by Credit Suisse, as administrative agent and collateral agent. The New Credit Facility
consists of a $6.065 billion funded term loan facility with a maturity of seven years, a $400
million delayed draw term loan facility with a maturity of seven years and a $750 million revolving
credit facility with a maturity of six years. The revolving credit facility also will include a
subfacility for letters of credit and a swingline subfacility. The
New Credit Facility requires the
Company to make quarterly amortization payments of each term
12
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
loan facility in quarterly amounts equal to 0.25% of the outstanding amount of the term loans, if any, with the outstanding principal
balance payable on the anniversary of the New Credit Facility in 2014.
The term loan facility must be prepaid in an amount equal to (1) 100% of the net cash proceeds of
certain asset sales and dispositions by the Company and its subsidiaries,
subject to certain exceptions and reinvestment rights, (2) 100% of the net cash proceeds of
issuances of certain debt obligations by the Company and its subsidiaries, subject to certain
exceptions, and (3) 50%, subject to reduction to a lower percentage based on the Companys leverage
ratio, of excess cash flow for any year, commencing in 2008, subject to certain exceptions.
Voluntary prepayments and commitment reductions are permitted in whole or in part, without any
premium or penalty, subject to minimum prepayment or reduction requirements.
All of the Companys obligations under the New Credit Facility are unconditionally guaranteed by
the Company and certain existing and subsequently acquired or organized domestic subsidiaries. All
obligations under the New Credit Facility and the related guarantees will be secured by a perfected
first priority lien or security interest in substantially all of the Companys assets and each
subsidiary guarantors assets, including equity interests held by the Company or any subsidiary
guarantor, excluding, among others, the equity interests of non-significant subsidiaries,
syndication subsidiaries, securitization subsidiaries and joint venture subsidiaries. The loans
under the New Credit Facility will bear interest on the outstanding unpaid principal amount at a
rate equal to an applicable percentage plus, at the Companys option, either (a) an alternative
base rate determined by reference to the greater of (1) the prime rate announced by Credit Suisse
and (2) the federal funds rate plus one-half of 1.0%, or (b) a reserve adjusted Eurodollar rate.
The applicable percentage for term loans is 1.25% for alternative base rate loans and 2.25% for
Eurodollar rate loans, and the applicable percentage for revolving loans will be up to 1.25% for
alternative base rate revolving loans and up to 2.25% for Eurodollar revolving loans, in each case
based on the Companys leverage ratio. Loans under the swingline subfacility bear interest at the
rate applicable to alternative base rate loans under the revolving credit facility.
The Company has agreed to pay letter of credit fees equal to the applicable percentage then in
effect with respect to Eurodollar rate loans under the revolving credit facility times the maximum
aggregate amount available to be drawn under all letters of credit issued under the subfacility for
letters of credit. The issuer of any letter of credit issued under the subfacility for letters of
credit will also receive a customary fronting fee and other customary processing charges. The
Company is also obligated to pay commitment fees, depending on our total leverage ratio, of up to
0.50% per annum, on the unused portion of the revolving credit facility. For purposes of this
calculation, swingline loans are not treated as usage of the revolving credit facility. The
Company will also pay arrangement fees on the closing of the New Credit Facility and an annual
administrative agent fee.
The New Credit Facility contains customary representations and warranties, subject to limitations
and exceptions, and customary covenants restricting the Company and its subsidiaries ability to,
among other things and subject to various exceptions, (1) declare dividends, make distributions or
redeem or repurchase capital stock, (2) prepay, redeem or repurchase other debt, (3) incur liens or
grant negative pledges, (4) make loans and investments and enter into acquisitions and joint ventures, (5)
incur additional indebtedness, (6) make capital expenditures, (7) engage in mergers, acquisitions and asset sales, (8) conduct
transactions with affiliates, (9) alter the nature of the
Companys businesses, or (10) change the
Companys fiscal
year. The Company and its subsidiaries are also required to comply with specified financial
covenants (consisting of a leverage ratio and an interest coverage ratio) and various affirmative
covenants.
Events of default under the New Credit Facility include, but are not limited to, (1) the Companys
failure to pay principal, interest, fees or other amounts under the credit agreement when due
(taking into account any applicable grace period), (2) any representation or warranty proving to
have been materially incorrect when made, (3) covenant defaults subject, with respect to certain
covenants, to a grace period, (4) bankruptcy events, (5) a cross default to certain other debt, (6)
certain undischarged judgments (not paid within an applicable grace period), (7) a change of
control, (8) certain ERISA-related defaults, and (9) the invalidity or impairment of specified
security interests.
The Notes issued in connection with the Triad acquisition were issued in the principal amount of
$3.021 billion. These Notes will mature on July 15, 2015. Interest on the Notes will accrue at
the rate of 8.875% per annum and will be payable semiannually in
arrears on January 15 and July 15,
commencing January 15, 2008. Interest on the Notes will accrue from the date of original issuance.
Interest will be calculated on the basis of 360-day year comprised of
twelve 30-day months.
Except as set forth below, the Issuer is not entitled to redeem the Notes at its option prior to
July 15, 2011.
On and after July 15, 2011, the Issuer is entitled at its option to redeem all or a portion of the
2015 Notes upon not less than 30 nor more than 60 days notice, at the redemption prices (expressed
as a percentage of principal amount on the redemption date),
13
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
plus accrued interest to the redemption
date (subject to the right of Holders of record on the relevant record date to receive interest due
on the relevant interest payment date), if redeemed during the 12 month period commencing on July
15 of the years set forth below:
|
|
|
|
|
Period |
|
Redemption Price |
|
|
|
|
|
2011 |
|
|
104.438 |
% |
2012 |
|
|
102.219 |
% |
2013 and thereafter |
|
|
100.000 |
% |
In addition, any time prior to July 15, 2010, the Issuer is entitled at its option on one or
more occasions to redeem the Notes (which include additional Notes, if any) in an aggregate
principal amount not to exceed 35% of the aggregate principal amount of the Notes (which includes
additional Notes, if any) originally issued at a redemption price (expressed as a percentage of
principal amount) of 108.875%, plus accrued and unpaid interest to
the redemption date, with the Net Cash Proceeds (as defined) from one or more Public Equity
Offerings (provided that if the Public Equity Offering (as defined) is an offering by Parent, a portion of the
Net Cash Proceeds (as defined) thereof equal to the amount required to redeem any such Notes is contributed to
the equity capital of the Issuer); provided, however, that
|
(1) |
|
at least 65% of such aggregate principal amount of Notes
originally issued remains outstanding immediately after the
occurrence of each such redemption (other than the Notes held,
directly or indirectly, by the Company or its Subsidiaries); and |
|
|
(2) |
|
each such redemption occurs within 90 days after the
date of the related Public Equity Offering. |
The Issuer is entitled at its option to redeem the Notes, in whole or in part, at any time prior to
July 15, 2011, upon not less than 30 or more than 60 days notice, at a redemption price equal to
100% of the principal amount of Notes redeemed plus the Application Premium (as defined) and accrued and
unpaid interest, if any, as of the applicable redemption date.
The Notes are unsecured obligations of the Company. Secured debt and other secured obligation of
the Company (including obligations with respect to the New Credit
Facility) will be effectively senior
to the Notes to the extent of the value of the assets securing such
debt or other obligations.
The Issuer has agreed, pursuant to the Registration Rights Agreement, that it will be subject to
certain exceptions, file a registration statement (the Exchange Offer Registration Statement)
with the SEC within 90 days of the date the Notes were issued
(the Issue Date) to make an offer to exchange the Notes for new notes (the Exchange Notes) having terms
substantially identical in all material respects to the Notes. If the
Exchange Offer Registration Statement is not filed with the SEC within that 90 day period ,the Exchange Offer Registration
Statement is not declared effective by the SEC on or prior to the
210th day after the Issue Date, the exchange offer is not consummated
on or before the 40th day after the Exchange Offer Registration Statement is declared effective or certain other
circumstances (each, a Registration Default), additional interest will be paid on the Notes at a rate of 0.25% per annum
for the first 90 day period following the Registration Default, and such rate will increase by an additional 0.25% per annum with
respect to each subsequent 90 day period until all Registration Defaults have been cured, up to a maximum additional interest rate of 1.0% per annum.
12. RECENT ACCOUNTING PRONOUNCEMENTS
In September 2006, the FASB issued SFAS No. 157, Fair Value Measurements", which defines fair
value, provides framework for measuring fair value, and expands the disclosures required for fair
value measurements. SFAS No. 157 applies to other accounting pronouncements that require fair
value measurements; it does not require any new fair value measurements. SFAS No. 157 is effective
for fiscal years beginning after November 15, 2007 and is required to be adopted by the Company
beginning in the first quarter of 2008. Although the Company will continue to evaluate the
application of SFAS No. 157, management does not currently believe adoption will have a material
impact on the Companys results of operations or financial position.
13. CONTINGENCIES
The
Company is a party to various legal proceedings incidental to its
business. In the opinion of management, any ultimate liability with
respect to these actions will not have a material adverse effect on
the Companys consolidated financial position, cash flows or
results of operations. In addition, in connection with the closing of
the Triad acquisition on July 25, 2007, the Company has assumed both
recorded and unrecorded contingencies of Triad. The Companys
management is not aware of any unrecorded contingencies, assumed in
connection with the Triad acquisition, whose ultimate outcome will
have an adverse effect on the Companys consolidated financial
position, cash flows or results of operations.
14. SUBSEQUENT EVENTS
On July 25, 2007, the Company completed its acquisition of Triad (former
NYSE: TRI). Pursuant to the merger agreement under which the acquisition was completed,
shareholders of Triad received $54 in cash per share of common stock, or approximately $6.968
billion in the aggregate, including the assumption of approximately $1.702 billion of existing
indebtedness of Triad. Triad stock ceased to trade on the New York Stock Exchange effective at the
close of business on July 25, 2007.
14
COMMUNITY HEALTH SYSTEMS, INC. AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)
In connection with the consummation of the Triad merger, the Company obtained $7.215 billion of
senior secured financing under the New Credit Facility and the Issuer, issued $3.021 billion
aggregate principal amount ($3.000 billion, net of discount) of its 8.875% senior notes due 2015 at
the closing of the merger. The Notes are senior obligations of the Issuer and are guaranteed on a
senior basis by the Company and by certain of the Companys domestic subsidiaries. The Company used
the net proceeds from the Notes offering and the net proceeds of the $6.065 billion of term loans
under the New Credit Facility to pay the consideration under the merger agreement, to repay certain
of its indebtedness, including the repayment of term loans under its existing credit agreement and
indebtedness of Triad, to complete certain related transactions, to pay certain costs and expenses
of the transactions and for general corporate uses. A $750 million revolving credit facility and a
$400 million delayed draw term loan facility is available to the Company for working capital and
general corporate purposes under the new credit facility. The revolving credit facility also will
include a subfacility for letters of credit and a swingline subfacility. Also, in connection with
the consummation of the merger, the Company completed an early repayment of its outstanding $300
million aggregate principal amount of 6-1/2% Senior Subordinated
Notes due 2012 through a cash tender
offer and consent solicitation.
15
Item 2. Managements Discussion and Analysis of Financial Condition and Results of Operations
You should read this discussion together with our unaudited condensed consolidated financial
statements and accompanying notes included herein.
Unless the context otherwise requires, Community Health Systems, the Company we, us and
our refer to Community Health Systems, Inc. and its consolidated subsidiaries.
Executive Overview
We are the largest non-urban provider of general hospital healthcare services in the United States
in terms of number of facilities and net operating revenues. We generate revenue by providing a
broad range of general hospital healthcare services to patients in the communities in which we are
located. We are paid for our services by governmental agencies, private insurers and directly by
the patients we serve. For the three months ended June 30, 2007, we generated $1.249 billion in
net operating revenues, a growth of 17.7% over the three months ended June 30, 2006, $53.8 million
in income from continuing operations, a growth of 2.7% over the three months ended June 30, 2006,
and $53.8 million in net income, a growth of 2.7% over the three months ended June 30, 2006. For
the six months ended June 30, 2007, we generated $2.453 billion in net operating revenues, a growth
of 17.5% over the six months ended June 30, 2006, $108.1 million in income from continuing
operations, a decrease of 1.4% over the six months ended June 30, 2006 and $108.1 million in net
income, a growth of 1.6% over the six months ended June 30, 2006.
On a consolidated basis, total admissions increased 10.9% during the three months ended June 30,
2007 and 11.8% for the six months ended June 30, 2007, as compared to the same periods in the prior
year. Admissions at hospitals owned throughout both periods decreased 0.2% during the three months
ended June 30, 2007 and increased 0.4% for the six months ended June 30, 2007, as compared to the
same periods in the prior year. Adjusted admissions for those same hospitals decreased 0.4% during
the three month period ended June 30, 2007 and increased 0.4% for the six months ended June 30,
2007, as compared to the same periods in the prior year. The increase in our consolidated
admissions reflects our strategy of growing through selective acquisitions. The flat trend in
same-store admissions reflects our targeted closure of certain unprofitable service offerings in
specific markets and a general trend in the industry during the current period. Furthermore,
although we have experienced an increase in bad debts related to self-pay business and an increase
in salaries and benefits related to additional employed physicians and incremental stock based
compensation, we believe that our consolidated financial results reflect our strategy and ability
to increase revenue and effectively manage costs while facing difficult industry related issues
such as increasing numbers of uninsured and underinsured patients.
Sources of Consolidated Net Operating Revenue
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended |
|
Six Months Ended |
|
|
June 30, |
|
June 30, |
|
|
2007 |
|
2006 |
|
2007 |
|
2006 |
Medicare |
|
|
29.5 |
% |
|
|
31.0 |
% |
|
|
30.3 |
% |
|
|
31.4 |
% |
Medicaid |
|
|
11.6 |
% |
|
|
10.4 |
% |
|
|
10.9 |
% |
|
|
9.8 |
% |
Managed Care and other third
party payors |
|
|
46.5 |
% |
|
|
45.8 |
% |
|
|
46.3 |
% |
|
|
46.6 |
% |
Self-pay |
|
|
12.4 |
% |
|
|
12.8 |
% |
|
|
12.5 |
% |
|
|
12.2 |
% |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
|
100.0 |
% |
|
|
100.0 |
% |
|
|
100.0 |
% |
|
|
100.0 |
% |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues include amounts estimated by management to be reimbursable by Medicare
and Medicaid under prospective payment systems and provisions of cost-based reimbursement and other
payment methods. In addition, we are reimbursed by non-governmental payors using a variety of
payment methodologies. Amounts we receive for treatment of patients covered by these programs are
generally less than the standard billing rates. We account for the differences between the
estimated program reimbursement rates and the standard billing rates as contractual allowance
adjustments, which we deduct from gross revenues to arrive at net operating revenues. Final
settlements under some of these programs are subject to adjustment based on administrative review
and audit by third parties. We account for adjustments to previous program reimbursement estimates
as contractual allowance adjustments and report them in the periods that these adjustments become
known. Adjustments related to final
16
settlements or appeals that increased revenue were insignificant in each of the three month periods ended June 30, 2007 and 2006.
The payment rates under the Medicare program for inpatient acute services are based on a
prospective payment system, depending upon the diagnosis of a patients condition. While these
rates are indexed for inflation annually, the increases have historically been less than actual
inflation. Reductions in the rate of increase in Medicare reimbursement may cause our net operating
revenue growth to decline. While the Medicare Prescription Drug, Improvement and Modernization Act
of 2003 provides a broad range of provider payment benefits, federal government spending in excess
of federal budgetary provisions contained in passage of the Medicare Prescription Drug, Improvement
and Modernization Act of 2003 could result in future deficit spending for the Medicare system,
which could cause future payments under the Medicare system to decline. In addition, specified
managed care programs, insurance companies, and employers are actively negotiating the amounts paid
to hospitals.
Results of Operations
Our hospitals offer a variety of services involving a broad range of inpatient and outpatient
medical and surgical services. These include orthopedics, cardiology, occupational medicine,
diagnostic services, emergency services, rehabilitation treatment, home health and skilled nursing.
The strongest demand for hospital services generally occurs during January through April and the
weakest demand for these services occurs during the summer months. Accordingly, eliminating the
effect of new acquisitions, our net operating revenues and earnings are historically highest during the first quarter and lowest
during the third quarter. Same-store results are for any hospitals owned throughout both periods,
and in the case of leased hospitals, whose lease is not expiring within twelve months.
The following tables summarize, for the periods indicated, selected operating data.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended |
|
Six Months Ended |
|
|
June 30, |
|
June 30, |
|
|
2007 |
|
2006 |
|
2007 |
|
2006 |
Consolidated (a) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net operating revenues |
|
|
100.0 |
% |
|
|
100.0 |
% |
|
|
100.0 |
% |
|
|
100.0 |
% |
Operating expenses (b) |
|
|
(86.2 |
) |
|
|
(85.2 |
) |
|
|
(86.0 |
) |
|
|
(84.9 |
) |
Depreciation and amortization |
|
|
(4.3 |
) |
|
|
(4.5 |
) |
|
|
(4.3 |
) |
|
|
(4.3 |
) |
Minority interest in earnings |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income from operations |
|
|
9.5 |
|
|
|
10.3 |
|
|
|
9.7 |
|
|
|
10.8 |
|
Interest expense, net |
|
|
(2.5 |
) |
|
|
(2.3 |
) |
|
|
(2.5 |
) |
|
|
(2.2 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income from continuing operations
before income taxes |
|
|
7.0 |
|
|
|
8.0 |
|
|
|
7.2 |
|
|
|
8.6 |
|
Provision for income taxes |
|
|
(2.7 |
) |
|
|
(3.1 |
) |
|
|
(2.8 |
) |
|
|
(3.3 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income from continuing operations |
|
|
4.3 |
|
|
|
4.9 |
|
|
|
4.4 |
|
|
|
5.3 |
|
Loss on discontinued operations |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(0.2 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net Income |
|
|
4.3 |
% |
|
|
4.9 |
% |
|
|
4.4 |
% |
|
|
5.1 |
% |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
17
|
|
|
|
|
|
|
|
|
|
|
Three Months Ended |
|
Six Months Ended |
|
|
June 30, 2007 |
|
June 30, 2007 |
Percentage increase (decrease) from same period
prior year (a): |
|
|
|
|
|
|
|
|
Net operating revenues |
|
|
17.7 |
% |
|
|
17.5 |
% |
Admissions |
|
|
10.9 |
|
|
|
11.8 |
|
Adjusted admissions (c) |
|
|
11.3 |
|
|
|
12.6 |
|
Average length of stay |
|
|
|
|
|
|
(2.4 |
) |
Net Income (d) |
|
|
2.7 |
|
|
|
1.6 |
|
|
Same-store percentage increase (decrease)
from same period prior year (a)(e): |
|
|
|
|
|
|
|
|
Net operating revenues |
|
|
4.5 |
% |
|
|
5.3 |
% |
Admissions |
|
|
(0.2 |
) |
|
|
0.4 |
|
Adjusted admissions (c) |
|
|
(0.4 |
) |
|
|
0.4 |
|
|
|
|
(a) |
|
Pursuant to Statement of Financial Accounting Standards (SFAS) No. 144, Accounting
for the Impairment or Disposal of Long-Lived Assets, we have restated our prior period
financial statements and statistical results to reflect the reclassification as discontinued
operations of one hospital which was sold. |
|
(b) |
|
Operating expenses include salaries and benefits, provision for bad debts, supplies,
rent and other operating expenses. |
|
(c) |
|
Adjusted admissions is a general measure of combined inpatient and outpatient volume.
We computed adjusted admissions by multiplying admissions by gross patient revenues and then
dividing that number by gross inpatient revenues. |
|
(d) |
|
Includes loss from operations of discontinued hospital and loss on sale of discontinued
hospital. |
|
(e) |
|
Includes acquired hospitals to the extent we operated them during comparable periods in
both years. |
Three months Ended June 30, 2007 Compared to Three months Ended June 30, 2006
Net operating revenues increased 17.7% to $1.249 billion for the three months ended June 30, 2007,
from $1.061 billion for the three months ended June 30, 2006. Of the $188.1 million increase in
net operating revenues, those facilities which are not included in same-store revenues, contributed
approximately $140.7 million and those facilities included same-store results contributed
approximately $47.4 million, an increase of 4.5% over the same period in the prior year. The
increase from same-store facilities was attributable to rate increases, payor mix and the acuity
level of services provided, offset by a decrease in volume.
Inpatient admissions increased by 10.9%. Adjusted admissions increased by 11.3%. On a same-store
basis, inpatient admissions decreased by 0.2% and same-store adjusted admissions decreased by 0.4%.
With respect to consolidated admissions, approximately 10.9% of admissions were from newly
acquired hospitals. On a same-store basis, net inpatient revenues increased by 1.1% and net
outpatient revenues increased by 7.9%. Consolidated average length of stay and same-store average
length of stay were unchanged from the prior period at 4.1 days.
Operating expenses, as a percentage of net operating revenues, increased to 86.2% for the three
months ended June 30, 2007 compared to 85.2% for the three months ended June 30, 2006. Salaries
and benefits, as a percentage of net operating revenues, was unchanged from the prior period at
39.6% for the three months ended June 30, 2007, as the impact of the five hospitals acquired in
2006, the increase in the number of employed physicians and the recognition of additional
stock-based compensation offset efficiencies gained since the prior year period. The additional
stock-based compensation represents an incremental year of expense as no restricted stock or
options were granted in 2004. The three month period ended June 30, 2007 contains expense for
three annual equity grants, as compared to the three month period ended June 30, 2006 which
contains expense for two annual equity grants. Provision for bad debts, as a percentage of net
operating revenues, increased 1.0% to 11.9% for the three months ended June 30, 2007, compared to
10.9% for the three months ended June 30, 2006, primarily as a result of the increase in self-pay
revenues. Supplies, as a percentage of net operating revenues, decreased 0.1% to 11.7% for the
three months ended June 30, 2007, as compared to 11.8% for the three months ended June 30, 2006.
Rent and other operating expenses, as a percentage of net operating revenues, increased from 22.9%
for the three months ended June 30, 2006, to 23.0% for the three months ended June 30, 2007.
Income from continuing operations margin decreased from 4.9% for the three months ended June 30,
2006, to 4.3% for the three months ended June 30, 2007. Net income margin decreased from 4.9% for
the three months ended June 30, 2006 to 4.3% for the three months ended June 30, 2007. The
decrease in income from continuing operations margin and net income margin
18
are reflective of the net increases in operating expenses as discussed above and an increase in interest expense as
discussed below.
On a same-store basis, we experienced a decrease in salary and benefits expense of 0.2% of net
operating revenues resulting primarily from efficiency gains at acquired hospitals recently rolling
into same-store results offset by increases in the number of employed physicians and stock
compensation expense. The same-store provision for bad debts increased 0.7% of net operating
revenues as a result of the increase in self pay revenues. Also, on a same-store basis we
experienced a decrease in supplies expense of 0.3% of net operating revenues primarily as a result
of improved pricing and compliance under our group purchasing agreement.
Depreciation and amortization increased by $6.1 million from $47.2 million for the three months
ended June 30, 2006 to $53.3 million for the three months ended June 30, 2007. Depreciation and
amortization relating to hospitals acquired in 2007 and 2006, which have not yet been included in
same-store results, accounted for $4.6 million of the increase, while depreciation and amortization
related to all other capital expenditures accounted for the remaining $1.5 million.
Interest expense, net, increased by $7.3 million from $23.9 million for the three months ended June
30, 2006, to $31.2 million for the three months ended June 30, 2007. An increase in interest rates
during the three months ended June 30, 2007, as compared to the three months ended June 30, 2006,
accounted for $1.7 million of this increase, while an increase in our average outstanding debt
during the three months ended June 30, 2007, as compared to the
three months ended June 30, 2006, due primarily to our
repurchase of company stock and hospital acquisitions,
accounted for the remaining $5.6 million.
The net results of the above mentioned changes resulted in income from continuing operations before
income taxes increasing $2.2 million from $85.2 million for the three months ended June 30, 2006 to
$87.4 million for the three months ended June 30, 2007.
Provision for income taxes increased from $32.9 million for the three months ended June 30, 2006,
to $33.7 million for the three months ended June 30, 2007, due primarily to the increase in income
from continuing operations which increased taxable income.
Net income was $53.8 million for the three months ended June 30, 2007, compared to $52.4 million
for the three months ended June 30, 2006, an increase of 2.7%.
Six months Ended June 30, 2007 Compared to Six months Ended June 30, 2006
Net operating revenues increased 17.5% to $2.453 billion for the six months ended June 30, 2007,
from $2.088 billion for the six months ended June 30, 2006. Of the $365.5 million increase in net
operating revenues, those facilities which are not yet included in same-store revenues, contributed
approximately $255.9 million, and those facilities included in same-store results contributed
approximately $109.6 million, an increase of 5.3% over the same period in the prior year. The
increase from same-store facilities was attributable to a mix of rate increases, payor mix, acuity
level of services provided, and volume improvement.
Inpatient admissions increased by 11.8%. Adjusted admissions increased by 12.6%. On a samestore
basis, inpatient admissions increased by 0.4% and same-store adjusted admissions increased by 0.4%.
With respect to consolidated admissions, approximately 11.1% of admissions were from newly
acquired hospitals. On a same-store basis, net inpatient revenues increased by 3.2% and net
outpatient revenues increased by 7.6%. Consolidated average length of stay and same-store average
length of stay decreased to 4.1 days from the prior year period which was 4.2 days.
Operating expenses, as a percentage of net operating revenues, increased to 86.0% for the six
months ended June 30, 2007, compared to 84.9% for the six months ended June 30, 2006. Salaries and
benefits, as a percentage of net operating revenues, increased 0.3% to 40.0% for the three months
ended June 30, 2007, compared to 39.7% for the six months ended June 30, 2006, as the impact of
recent acquisitions and the recognition of additional stock-based compensation offset efficiencies
gained since the prior year period. Provision for bad debts, as a percentage of net operating
revenues, increased 0.9% to 11.6% for the six months ended June 30, 2007, compared to 10.7% for the
six months ended June 30, 2006, primarily as a result of the increase in self-pay revenues.
Supplies, as a percentage of net operating revenues, decreased 0.2% to 11.7% for the six months
ended June 30, 2007, as compared to 11.9% for the six months ended June 30, 2006, primarily as a
result of improved pricing and
19
compliance under our group purchasing agreement. Rent and other operating expenses, as a percentage of net
operating revenues, increased from 22.6% for the six months ended June 30, 2006, to 22.7% for the
six months ended June 30, 2007, primarily as a result of recent acquisitions having higher other
operating expenses as a percentage of net operating revenues. Income from continuing operations
margin decreased 0.9% to 4.4% for the six months ended June 30, 2007, as compared to 5.3% for the
six months ended June 30, 2006. Net income margins decreased from 5.1% for the six months ended
June 30, 2006 to 4.4% for the six months ended June 30, 2007. The decrease in income from
continuing operations margin and net income margin are reflective of the net increases in operating
expenses as discussed above and an increase in interest expense as discussed below.
On a same-store basis, we experienced an increase in salary and benefits expense of 0.1% of net
operating revenues primarily resulting from increases in the number of employed physicians and
stock compensation expense offset by efficiency gains at acquired hospitals rolling into same-store
results. The same-store provision for bad debts increased 0.6% of net operating revenues as a
result of the increase in self-pay revenues. Also, we experienced a decrease in supplies expense
of 0.4% of net operating revenues as a result of improved pricing and compliance under our group
purchasing agreement, offset by increases in bad debt expense.
Depreciation and amortization increased by $14.9 million from $89.7 million for the six months
ended June 30, 2006 to $104.6 million for the six months ended June 30, 2007. Depreciation and
amortization relating to hospitals acquired in 2006 and 2007, which have not been included in
same-store results, accounted for $8.9 million of the increase, and capital expenditures accounted
for the remaining $6.0 million.
Interest expense, net, increased by $15.9 million from $45.7 million for the six months ended June
30, 2006, to $61.6 million for the six months ended June 30, 2007. An increase in our average
outstanding debt during the six months ended June 30, 2007, as compared to the six months ended
June 30, 2006, primarily attributable to borrowing for the
repurchase of company stock and hospital acquisitions,
accounted for $11.3 million of this increase, while an increase in interest rates during the six
months ended June 30, 2007, as compared to the six months ended June 30, 2006, accounted for the
remaining $4.6 million.
The net results of the above mentioned changes resulted in income from continuing operations before
income taxes decreasing $3.0 million from $178.8 million for the six months ended June 30, 2006, to
$175.8 million for the six months ended June 30, 2007.
Provision for income taxes decreased from $69.2 million for the six months ended June 30, 2006, to
$67.7 million for the six months ended June 30, 2007, due primarily to a reduction in taxable
income in the comparable periods which was the result of higher operating expenses.
Net income was $108.1 million for the six months ended June 30, 2007, compared to $106.4 million
for the six months ended June 30, 2006, an increase of 1.6%.
Liquidity and Capital Resources
Net cash provided by operating activities increased $9.0 million from $207.0 million in the six
months ended June 30, 2006 to $216.0 million for the six months ended June 30, 2007. The increase
in cash flows from operations as compared to the same period in the prior year is the result of an
increase in net income of $1.7 million, increases in non-cash expenses of $17.5 million, related
primarily to depreciation and stock-based compensation and an increase in cash generated from
accounts receivable of $10.5 million. These increases in cash inflows were offset by outflows of
cash for the comparable periods related to supplies, prepaid expenses and other current assets of
$13.3 million and accounts payables, accrued liabilities and income taxes of $23.6 million. For
the comparable periods, other assets and liabilities resulted in increased cash flows of $16.2
million.
Capital Expenditures
Cash expenditures related to purchases of facilities were $188.0 million for the six months ended
June 30, 2007 and $178.0 million for the six months ended June 30, 2006. These expenditures during
the six months ended June 30, 2007, included $45.5 million related to the acquisition of Triad, and
$137.1 million for the current year acquisition of two hospitals, and the contingent settlements of
working capital items from prior years acquisition and the acquisition of five physician practices
and $5.4 million for the purchase of information systems and other equipment to integrate recently
acquired hospitals. The expenditures during the six months ended June 30, 2006, included $169.1
million for the acquisition of five hospitals, contingent settlements of working capital items from
20
three prior year acquisitions and the acquisition of the remaining 60% interest we did not
previously own of a home health agency in one of our current markets as well as $8.9 million for
information systems and other equipment to integrate recently acquired hospitals.
Excluding the cost to construct replacement hospitals, our capital expenditures for the six months
ended June 30, 2007, totaled $71.0 million, compared to $91.9 million for the six months ended June
30, 2006. Costs to construct replacement hospitals totaled $37.8 million during the six months
ended June 30, 2007 and $2.3 million during the six months ended June 30, 2006.
Pursuant to hospital purchase agreements in effect as of June 30, 2007, we are required to build
replacement facilities in Petersburg, Virginia, by August 2008, and in Shelbyville, Tennessee by
June 2009. Also, as required by an amendment to a lease agreement entered into in 2005, we agreed
to build a replacement hospital at our Barstow, California location. As part of our acquisition of
Porter Health, we agreed to construct a 225 bed replacement facility for the Valparaiso hospital no
later than April 2011. Estimated construction costs, including equipment, are approximately $450.2
million for these four replacement facilities.
Capital Resources
Net working capital was $521.3 million at June 30, 2007, compared to $446.1 million at December 31,
2006. The $75.2 million increase was attributable primarily to an increase in accounts receivable
and other assets, offset by increases in income taxes payable.
In connection with the consummation of the Triad merger, we obtained $7.215 billion of senior
secured financing under a new credit facility with a syndicate of financial institutions led by
Credit Suisse, as administrative agent and collateral agent. The new
credit facility will provide for financing which will consist of a $6.065 billion funded term loan
facility with a maturity of seven years, a $400 million delayed draw term loan facility with a
maturity of seven years and a $750 million revolving credit facility with a maturity of six years.
The revolving credit facility also will include a subfacility for letters of credit and a swingline
subfacility. The new credit facility requires us to make quarterly amortization payments of each
term loan facility in quarterly amounts equal to 0.25% of the outstanding amount of the term loans,
if any, with the outstanding principal balance payable on the anniversary of the credit facility in
2014.
The term loan facility must be prepaid in an amount equal to (1) 100% of the net cash proceeds of
certain asset sales and dispositions by us and our subsidiaries, subject to certain exceptions and
reinvestment rights, (2) 100% of the net cash proceeds of issuances of certain debt obligations by
us and our subsidiaries, subject to certain exceptions, and (3) 50%, subject to reduction to a
lower percentage based on our leverage ratio, of excess cash flow for any year, commencing in 2008,
subject to certain exceptions.
Voluntary prepayments and commitment reductions are permitted in whole or in part, without premium
or penalty, subject to minimum prepayment or reduction requirements.
All of our obligations under the new credit facility are unconditionally guaranteed by us and
certain existing and subsequently acquired or organized domestic subsidiaries. All obligations
under the new credit facility and the related guarantees will be secured by a perfected first
priority lien or security interest in substantially all of our assets and each subsidiary
guarantors assets, including equity interests held by us or any subsidiary guarantor, excluding,
among others, the equity interests of non-significant subsidiaries, syndication subsidiaries,
securitization subsidiaries and joint venture subsidiaries. The loans under the new credit
facility will bear interest on the outstanding unpaid principal amount at a rate equal to an
applicable percentage plus, at our option, either (a) an alternative base rate determined by
reference to the greater of (1) the prime rate announced by Credit Suisse and (2) the federal funds
rate plus one-half of 1.0%, or (b) a reserve adjusted Eurodollar rate. The applicable percentage
for term loans is 1.25% for alternative base rate loans and 2.25% for Eurodollar rate loans, and
the applicable percentage for revolving loans will be up to 1.25% for alternative base rate
revolving loans and up to 2.25% for Eurodollar revolving loans, in each case based on our leverage
ratio. Loans under the swingline subfacility bear interest at the rate applicable to alternative
base rate loans under the revolving credit facility.
We have agreed to pay letter of credit fees equal to the applicable percentage then in effect with
respect to Eurodollar rate loans under the revolving credit facility times the maximum aggregate
amount available to be drawn under all letters of credit issued under the subfacility for letters
of credit. The issuer of any letter of credit issued under the subfacility for letters of credit
will also receive a customary fronting fee and other customary
21
processing charges. We are also obligated to pay commitment fees, depending on our total leverage ratio, of up to 0.50% per annum,
on the unused portion of the revolving credit facility. For purposes of this calculation,
swingline loans are not treated as usage of the revolving credit facility. We will also pay
arrangement fees on the closing of the new credit facility and an annual administrative agent fee.
The new credit facility contains customary representations and warranties, subject to limitations
and exceptions, and customary covenants restricting our and our subsidiaries ability to, among
other things and subject to various exceptions, (1) declare dividends, make distributions or redeem
or repurchase capital stock, (2) prepay, redeem or repurchase other debt, (3) incur liens or grant
negative pledges, (4) make loans and investments and enter into acquisitions and joint ventures,
(5) incur additional indebtedness, (6) make capital expenditures, (7) engage in mergers,
acquisitions and asset sales, (8) conduct transactions with affiliates, (9) alter the nature of our
businesses, or (10) change our fiscal year. We and our subsidiaries are also required to comply
with specified financial covenants (consisting of a leverage ratio and an interest coverage ratio)
and various affirmative covenants.
Events of default under the credit agreement include, but are not limited to, (1) our failure to
pay principal, interest, fees or other amounts under the credit agreement when due (taking into
account any applicable grace period), (2) any representation or warranty proving to have been
materially incorrect when made, (3) covenant defaults subject, with respect to certain covenants,
to a grace period, (4) bankruptcy events, (5) a cross default to certain other debt, (6) certain
undischarged judgments (not paid within an applicable grace period), (7) a change of control, (8)
certain ERISA-related defaults, and (9) the invalidity or impairment of specified security
interests.
Upon
closing of the Triad merger, there was approximately $1.150 billion of available borrowing
capacity under our new credit facility. These funds, along with internally generated cash, and
continued access to the bank credit and capital markets, we believe will be sufficient to finance
future acquisitions, capital expenditures and working capital requirements through the next 12
months and into the foreseeable future.
As of
June 30, 2007, we were a party to the following interest rate swap agreements to
limit the effect of changes in interest rates on a portion of our long-term borrowings. On each of
these swaps, we received a variable rate of interest based on the three-month London Inter-Bank
Offer Rate (LIBOR), in exchange for the payment by us of a fixed rate of interest. As of June
30, 2007, we were required to pay, on a quarterly basis, a margin above LIBOR of 175 basis points
for revolver loans and term loans under the senior secured credit facility.
22
|
|
|
|
|
|
|
|
|
|
|
Notional |
|
Fixed |
|
|
|
|
|
Amount |
|
Interest |
|
Termination |
|
Swap # |
|
(in
000s) |
|
Rate |
|
Date |
|
1 |
|
150,000 |
|
3.3000% |
|
November 4, 2007 |
|
2 |
|
100,000 |
|
2.4000% |
|
June 13, 2008 |
|
3 |
|
100,000 |
|
3.5860% |
|
August 29, 2008 |
|
4 |
|
100,000 |
|
4.0600% |
|
May 30, 2008 |
|
5 |
|
100,000 |
|
3.9350% |
|
June 6, 2009 |
|
6 |
|
100,000 |
|
4.3375% |
|
November 30, 2009 |
|
7 |
|
100,000 |
|
4.9360% |
|
October 4, 2010 |
|
8 |
|
100,000 |
|
4.7090% |
|
January 24, 2011 |
|
9 |
|
100,000 |
|
4.7185% |
|
August 19, 2011 |
|
10 |
|
100,000 |
|
4.7040% |
|
August 19, 2011 |
|
11 |
|
100,000 |
|
4.6250% |
|
August 19, 2011 |
|
12 |
|
250,000 |
|
5.0185% |
|
May 30, 2012 |
|
13 |
|
150,000 |
|
5.0250% |
|
May 30, 2012 |
|
14 |
|
100,000 |
|
5.0230% |
|
May 30, 2013 |
(1) |
15 |
|
100,000 |
|
5.0380% |
|
August 30, 2013 |
(2) |
16 |
|
100,000 |
|
5.0500% |
|
November 30, 2013 |
(3) |
|
|
|
(1) |
|
This swap agreement becomes effective May 30, 2008, concurrent with the
termination of agreement #4 listed above. |
|
(2) |
|
This swap agreement becomes effective June 13, 2008, concurrent with the
termination of agreement #2 listed above. |
|
(3) |
|
This swap agreement becomes effective September 2, 2008,
after the
termination of agreement #3 listed above. |
All of these swaps remained in effect after the refinancing for the Triad merger and will continue
to be used to limit the effects of changes in interest rates on portions of our new credit
facility.
Off-balance sheet arrangements
Our consolidated operating results for the six months ended June 30, 2007 and 2006, included $149.3
million and $142.0 million, respectively, of net operating revenue and $9.9 million in each of the
two periods of income from operations, generated from seven hospitals operated by us under
operating lease arrangements. In accordance with generally accepted accounting principles, the
respective assets and the future lease obligations under these arrangements are not recorded on our
consolidated balance sheet. Lease payments under these arrangements are included in rent expense
when paid and totaled approximately $8.3 million for the six months ended June 30, 2007 and $7.8
million for the six months ended June 30, 2006. The current terms of these operating leases expire
between October 2007 and December 2019, not including lease extensions that we have options to
exercise. One of these leases is scheduled to expire in October 2007. We have notified the lessor
of our intent not to renew. This hospital for which we are not renewing our lease generated $12.9 million in net operating revenue and $0.03 million loss from continuing
operations for the six months ended June 30, 2007. When this lease expires, we will no longer
generate revenue nor incur expenses from the ongoing operations of this hospital.
23
In the past, we have utilized operating leases as a financing tool for obtaining the operations of
specified hospitals without acquiring, through ownership, the related assets of the hospital and
without a significant outlay of cash at the front end of the lease. We utilize the same management
and operating strategies to improve operations at those hospitals held under operating leases as we
do at those hospitals that we own. We have not entered into any operating leases for hospital
operations since December 2000 other than renewing existing leases.
Joint Ventures
We have from time to time sold minority interests in certain of our subsidiaries or acquired
subsidiaries with existing minority interest ownership positions. This was the case with our
acquisition of Chestnut Hill Hospital in March 2005, pursuant to which we acquired an 85% interest
with the remaining 15% interest owned by the University of Pennsylvania. In our other joint
ventures, physicians are the minority interest holders. The amount of minority interest in equity
is included in other long-term liabilities and the minority interest in income or loss is recorded
separately in the condensed consolidated statements of income. We do not believe these minority
ownerships are material to our financial position or results of operations. The balance of
minority interests included in long-term liabilities was
$23.6 million as of June 30, 2007 and December
31, 2006, and the amount of minority interest in earnings was $0.6 million and $0.5 million for the
three months ended June 30, 2007 and 2006, respectively, and $0.8 million and $1.1 million for the
six months ended June 30, 2007 and 2006, respectively.
Reimbursement, Legislative and Regulatory Changes
Legislative and regulatory action has resulted in continuing change in the Medicare and Medicaid
reimbursement programs which will continue to limit payment increases under these programs and in
some cases implement payment decreases. Within the statutory framework of the Medicare and
Medicaid programs, there are substantial areas subject to administrative rulings, interpretations,
and discretion which may further affect payments made under those programs, and the federal and
state governments might, in the future, reduce the funds available under those programs or require
more stringent utilization and quality reviews of hospital facilities. Additionally, there may be a
continued rise in managed care programs and future restructuring of the financing and delivery of
healthcare in the United States. These events could cause our future results to decline.
Inflation
The healthcare industry is labor intensive. Wages and other expenses increase during periods of
inflation and when labor shortages occur in the marketplace. In addition, our suppliers pass along
rising costs to us in the form of higher prices. We have implemented cost control measures,
including our case and resource management program, to curb increases in operating costs and
expenses. We have, generally, offset increases in operating costs by increasing reimbursement for
services and expanding services and reducing costs in other areas. However, we cannot predict our ability to cover or offset future cost increases.
24
Critical Accounting Policies
The discussion and analysis of our financial condition and results of operations are based
upon our consolidated financial statements, which have been prepared in accordance with accounting
principles generally accepted in the United States of America. The preparation of these financial
statements requires us to make estimates and judgments that affect the reported amount of assets
and liabilities, revenues and expenses, and related disclosure of contingent assets and liabilities
at the date of our consolidated financial statements. Actual results may differ from these
estimates under different assumptions or conditions.
Critical accounting policies are defined as those that are reflective of significant judgments and
uncertainties, and potentially result in materially different results under different assumptions
and conditions. We believe that our critical accounting policies are limited to those described
below.
Third Party Reimbursement
Net operating revenues include amounts estimated by management to be reimbursable by Medicare
and Medicaid under prospective payment systems and provisions of cost-reimbursement and other
payment methods. In addition, we are reimbursed by non-governmental payors using a variety of
payment methodologies. Amounts we receive for treatment of patients covered by these programs are
generally less than the standard billing rates. Contractual allowances are automatically
calculated and recorded through our internally developed automated contractual allowance system.
Within the automated system, actual Medicare DRG data, coupled with all payors historical paid
claims data, is utilized to calculate the contractual allowances. This data is automatically
updated on a monthly basis and subjected to review by management to ensure reasonableness and
accuracy. We account for the differences between the estimated program reimbursement rates and the
standard billing rates as contractual allowance adjustments, which we deduct from gross revenues to
arrive at net operating revenues. Final settlements under some of these programs are subject to
adjustment based on administrative review and audit by third parties. We record adjustments to the
estimated billings in the periods that such adjustments become known. We account for adjustments to
previous program reimbursement estimates as contractual allowance adjustments and report them in
future periods as final settlements are determined. However, due to the complexities involved in
these estimates, actual payments we receive could be different from the amounts we estimate and
record. Contractual allowance adjustments related to final settlements or appeals increased net
operating revenue by an insignificant amount in each of the three and six month periods ended June
30, 2007 and June 30, 2006.
Allowance for Doubtful Accounts
During the third quarter of 2006, our same-store self-pay admissions were 8.1% of total
same-store admissions. This represented the highest same-store self-pay admissions as a percentage
of total same-store admissions experienced by us since at least December 31, 2002. Also during
this same period we experienced lower cash collections as a percentage of trailing twelve month net
revenues less provision for bad debts. We believe these occurrences were the result of current economic trends, including an increase in the
number of individuals without medical insurance, reduced enrollment under Medicaid programs such as
TennCare (which resulted in an increase in uninsured patients) and the trend by private insurers
and employers of increasing insured patients portion of their healthcare expenditures, primarily
in the form of higher deductibles and co-payments. The third quarter 2006 increase in self-pay
volume and decrease in collection percentages caused us to reconsider the manner in which we
estimate our allowance for doubtful accounts since a greater percentage of our total accounts
receivable balance was now exposed to increased collection risk. No similar change in trends or
risk was identified in connection with third-party insured accounts such as Medicare, Medicaid,
managed care and other third party payors. We believed these trends reflected an increased
collection risk from self-pay accounts, and as a result, we performed a review and analysis of the
adequacy of our allowance for doubtful accounts. Based on this analysis, we recorded a change in
estimate to increase our allowance for doubtful accounts by $65.0 million on our September 30, 2006
balance sheet and a corresponding $65.0 million pre-tax increase to our provision for bad debts,
resulting in a $40.0 million after-tax reduction in income from continuing operations.
Self-pay revenues represented approximately 12.4% and 12.8% of our net operating revenue for the
three months ended June 30, 2007 and 2006, respectively, and 12.5% and 12.2% for the six months
ended June 30, 2007 and 2006, respectively. Although uninsured and underinsured patients continue
to be an industry-wide issue in certain markets, we do not anticipate a significant amount of
continuing deterioration in our self-pay business, primarily because the participants disenrolled
in the TennCare program have now been disenrolled for more than one year.
25
Substantially, all of our accounts receivable are related to providing healthcare services to our
hospitals patients. Collection of these accounts receivable is our primary source of cash and is
critical to our operating performance. Our primary collection risks relate to uninsured patients
and outstanding patient balances for which the primary insurance payor has paid some but not all of
the outstanding balance, with the remaining outstanding balance (generally deductibles and
co-payments) owed by the patient. For patients required to make a co-payment, we generally collect
approximately 10% of the related revenue at the point of service. For all procedures scheduled in
advance, our policy is to verify insurance coverage prior to the date of the procedure. Insurance
coverage is not verified in advance of procedures for walk-in and emergency room patients.
Effective September 30, 2006, we began estimating the allowance for doubtful accounts by reserving
a percentage of all self-pay accounts receivable without regard to aging category, based on
collection history, adjusted for expected recoveries and, if present, anticipated changes in
trends. Since we have historically collected substantially all third-party insured accounts
receivable, which includes receivables from governmental agencies, within one year of date of
discharge, we began reserving 100% of only those third-party insured accounts aging over 365 days
from the date of discharge. The percentage used to reserve for all self-pay accounts is based now
on our specific collection history for self-pay accounts. Previously, we estimated the allowance
for doubtful accounts by reserving all accounts aging over 150 days from the date of discharge, without regard to payor class. We believe
the revised methodology provides a better approach to reflect changes in payor mix and historical
collection patterns and to respond to changes in trends and will be more responsive to changes in
those factors that impact the collectibility of our accounts receivable. Collections are impacted
by the economic ability of patients to pay and the effectiveness of our collection efforts.
Significant changes in payor mix, business office operations, economic conditions or trends in
federal and state governmental healthcare coverage could affect our collection of accounts
receivable. We also review our overall reserve adequacy by monitoring historical cash collections
as a percentage of trailing net revenue less provision for bad debts, as well as by analyzing
current period net revenue and admissions by payor classification, aged accounts receivable, days
revenue outstanding, and the impact of recent acquisitions and dispositions.
Our policy is to write-off gross accounts receivable if the balance is under $10.00 or when such
amounts are placed with outside collection agencies. We believe this policy accurately reflects
the ongoing collection efforts within the Company and is consistent with industry practices. We
had approximately $920 million and $834 million at June 30, 2007 and December 31, 2006,
respectively, being pursued by various outside collection agencies. We expect to collect less than
4%, net of estimated collection fees, of the amounts being pursued by outside collection agencies.
As these amounts have been written-off, they are not included in our gross accounts receivable or
our allowance for doubtful accounts. However, we take into consideration estimated collections of
these amounts written-off in evaluating the reasonableness of our allowance for doubtful accounts.
Days revenue outstanding was 64 days at June 30, 2007 and 62 days at December 31, 2006. On a
same-store basis, days revenue outstanding was 60 days at June 30, 2007 and at December 31, 2006.
Our target range for days revenue outstanding is 57 62 days.
Total gross accounts receivable (prior to allowance for contractual adjustments and doubtful
accounts) was approximately $2.534 billion as of June 30, 2007 and $2.274 billion as of December
31, 2006. The approximate percentage of total gross accounts receivable (prior to allowance for
contractual adjustments and doubtful accounts) summarized by aging categories is as follows:
|
|
|
|
|
|
|
|
|
|
|
As of |
|
|
June 30, |
|
December 31, |
|
|
2007 |
|
2006 |
0 to 60 days |
|
|
65.8 |
% |
|
|
63.3 |
% |
61 to 150 days |
|
|
16.4 |
% |
|
|
17.7 |
% |
151 to 360 days |
|
|
12.0 |
% |
|
|
13.2 |
% |
Over 360 days |
|
|
5.8 |
% |
|
|
5.8 |
% |
|
|
|
|
|
|
|
|
|
Total |
|
|
100.0 |
% |
|
|
100.0 |
% |
|
|
|
|
|
|
|
|
|
26
The approximate percentage of total gross accounts receivable (prior to allowances for
contractual adjustments and doubtful accounts) summarized by payor category is as follows:
|
|
|
|
|
|
|
|
|
|
|
As of |
|
|
June 30, |
|
December 31, |
|
|
2007 |
|
2006 |
Insured receivables |
|
|
69 |
% |
|
|
66 |
% |
Self-pay receivables |
|
|
31 |
% |
|
|
34 |
% |
|
|
|
|
|
|
|
|
|
Total |
|
|
100 |
% |
|
|
100 |
% |
|
|
|
|
|
|
|
|
|
The total allowance for doubtful accounts, as reported in the condensed consolidated financial
statements, as a percentage of self-pay receivables, net of other contractual allowance discounts,
was approximately 64% at June 30, 2007 and 64% at December 31, 2006.
Goodwill and Other Intangibles
Goodwill represents the excess of cost over the fair value of net assets acquired. Goodwill
arising from business combinations is accounted for under the provisions of SFAS No. 141 Business
Combinations and SFAS No. 142 Goodwill and Other Intangible Assets and is not amortized. SFAS
No. 142 requires goodwill to be evaluated for impairment at the same time every year and when an
event occurs or circumstances change such that it is reasonably possible that an impairment may
exist. We selected September 30th as our annual testing date.
The SFAS No. 142 goodwill impairment model requires a comparison of the book value of net assets to
the fair value of the related operations that have goodwill assigned to them. If the fair value is
determined to be less than book value, a second step is performed to compute the amount of the
impairment. We estimated the fair values of the related operations using both a debt-free
discounted cash flow model as well as an adjusted EBITDA multiple model. These models are both
based on our best estimate of future revenues and operating costs and are reconciled to our
consolidated market capitalization. The cash flow forecasts are adjusted by an appropriate
discount rate based on our weighted-average cost of capital. We performed our initial evaluation,
as required by SFAS No. 142, during the first quarter of 2002 and the annual evaluation as of each
succeeding September 30. No impairment has been indicated by these evaluations. Estimates used to
conduct the impairment review, including revenue and profitability projections or fair values,
could cause our analysis to indicate that our goodwill is impaired in subsequent periods and result
in a write-off of a portion or all of our goodwill.
Professional Liability Insurance Claims
We accrue for estimated losses resulting from professional liability claims. The accrual,
which includes an estimate for incurred but not reported claims, is based on historical loss
patterns and actuarially determined projections and is discounted to its net present value using a
weighted-average risk-free discount rate of 4.6% and 4.1% in 2006 and 2005, respectively. To the extent that subsequent claims information varies from managements
estimates, the liability is adjusted currently. Our insurance is underwritten on a claims-made
basis. Prior to June 1, 2002, substantially all of our professional and general liability risks
were subject to a $0.5 million per occurrence deductible; for claims reported from June 1, 2002
through June 1, 2003, these deductibles were $2.0 million per occurrence. Additional coverage
above these deductibles was purchased through captive insurance companies in which we had a 7.5%
minority ownership interest in each and to which the premiums paid by us represented less than 8%
of the total premium revenues of each captive insurance company. With the formation of our own
wholly-owned captive insurance company in June 2003, we terminated our minority interest
relationships in those entities. Substantially all claims reported on or after June 1, 2003 and
before June 1, 2005 are self-insured up to $4 million per claim. Substantially, all claims
reported on or after June 1, 2005 are self-insured up to $5 million per claim. Management on
occasion has selectively increased the insured risk at certain hospitals based upon insurance
pricing and other factors and may continue that practice in the future. Excess insurance for all
hospitals is purchased through commercial insurance companies and generally covers us for
liabilities in excess of the self-insured amount and up to $100 million per occurrence for all
claims reported on or after June 1, 2003.
Income Taxes
We must make estimates in recording provision for income taxes, including determination of deferred
tax assets and deferred tax liabilities and any valuation allowances that might be required against
the deferred tax assets. We
27
believe that future income will enable us to realize these deferred
tax assets, subject to the valuation allowances we have established.
We adopted the provisions of FASB Interpretation No. 48, Accounting for Uncertainty in Income
Taxes, on January 1, 2007. The total amount of unrecognized benefit that would affect the
effective tax rate, if recognized, is $9.0 million. It is our policy to recognize interest accrued
related to unrecognized benefits in its statement of operations as income tax expense.
Approximately $1.2 million of interest is included in the amount of unrecognized benefit at June
30, 2007. During the year ending December 31, 2007, it is possible we could release up to $5.2
million, plus accrued interest of approximately $0.8 million, of our FASB Interpretation No. 48
liability, as a result of the potential expiration of the statute of limitations pertaining to tax
positions taken in prior years relative to legal settlements.
We or one of our subsidiaries files income tax returns in the U.S. federal jurisdiction and various
state jurisdictions. With few exceptions, we are no longer subject to U.S. federal or state income
tax examinations for years prior to 2003. During 2006, we agreed to a settlement at the Internal
Revenue Service Appeals Office with respect to the 2003 consolidated income tax year. We have
since received a closing letter with respect to the examination for the tax year 2003. The
settlement was not material to our consolidated statement of income or financial position.
Recent Accounting Pronouncements
In September 2006, the FASB issued SFAS No. 157, Fair Value Measurements, which defines fair
value, provides framework for measuring fair value, and expands the disclosures required for fair
value measurements. SFAS No. 157 applies to other accounting pronouncements that require fair
value measurements; it does not require any new fair value measurements. SFAS No. 157 is effective
for fiscal years beginning after November 15, 2007 and is required to be adopted by us beginning in
the first quarter of 2008. Although we will continue to evaluate the application of SFAS No. 157,
management does not currently believe adoption will have a material impact on our results of
operations or financial position.
28
FORWARD-LOOKING STATEMENTS
Some of the matters discussed in this report include forward-looking statements. Statements that
are predictive in nature, that depend upon or refer to future events or conditions or that include
words such as expects, anticipates, intends, plans, believes, estimates,
thinks, and similar expressions are forward-looking statements. These statements involve known
and unknown risks, uncertainties, and other factors that may cause our actual results and
performance to be materially different from any future results or performance expressed or implied
by these forward-looking statements. These factors include, but are not limited to, the following:
|
|
|
general economic and business conditions, both nationally and in the regions in which
we operate; |
|
|
|
|
our ability to successfully integrate any acquisitions or to recognize expected
synergies from such acquisitions; |
|
|
|
|
risks associated with our substantial indebtedness, leverage and debt service
obligations; |
|
|
|
|
demographic changes; |
|
|
|
|
existing governmental regulations and changes in, or the failure to comply with,
governmental regulations; |
|
|
|
|
legislative proposals for healthcare reform; |
|
|
|
|
the impact of the Medicare Prescription Drug, Improvement and Modernization Act of
2003, which includes specific reimbursement changes for small urban and non-urban
hospitals; |
|
|
|
|
our ability, where appropriate, to enter into managed care provider arrangements and
the terms of these arrangements; |
|
|
|
|
changes in inpatient or outpatient Medicare and Medicaid payment levels; |
|
|
|
|
increases in the amount and risk of collectibility of patient
accounts receivable; |
|
|
|
|
increases in wages as a result of inflation or competition for highly technical
positions and rising supply cost due to market pressure from pharmaceutical companies and
new product releases; |
|
|
|
|
liability and other claims asserted against us, including self-insured malpractice
claims; |
|
|
|
|
competition; |
|
|
|
|
our ability to attract and retain qualified personnel, key management, physicians,
nurses, and other healthcare workers; |
|
|
|
|
trends toward treatment of patients in less acute or specialty healthcare settings
including ambulatory surgery centers or specialty hospitals; |
|
|
|
|
changes in medical or other technology; |
|
|
|
|
changes in generally accepted accounting principles; |
|
|
|
|
the availability and terms of capital to fund additional acquisitions or replacement
facilities; |
|
|
|
|
our ability to successfully acquire and integrate additional hospitals (including the
Triad hospitals acquired); |
|
|
|
|
our ability to obtain adequate levels of general and professional liability insurance; |
|
|
|
|
potential adverse impact of known and unknown government investigations; and |
|
|
|
|
timeliness of reimbursement payments received under government programs. |
Although we believe that these statements are based upon reasonable assumptions, we can give no
assurance that our goals will be achieved. Given these uncertainties, prospective investors are
cautioned not to place undue reliance on these forward-looking statements. These forward-looking
statements are made as of the date of this filing. We assume no obligation to update or revise them
or provide reasons why actual results may differ.
29
Item 3. Quantitative and Qualitative Disclosures about Market Risk
We are exposed to interest rate changes, primarily as a result of our senior secured credit
facility which bears interest based on floating rates. In order to manage the volatility relating
to the market risk, we entered into interest rate swap agreements described under the heading
Liquidity and Capital Resources in Item 2. We do not anticipate any material changes in our
primary market risk exposures in 2007. We utilize risk management procedures and controls in
executing derivative financial instrument transactions. We do not execute transactions or hold
derivative financial instruments for trading purposes. Derivative financial instruments related to
interest rate sensitivity of debt obligations are used with the goal of mitigating a portion of the
exposure when it is cost effective to do so.
A 1% change in interest rates on variable rate debt would have resulted in interest expense
fluctuating approximately $0.1 million for the three months ended June 30, 2007 and $1.2 million
for the six months ended June 30, 2007.
Item 4. Controls and Procedures
Our Chief Executive Officer and Chief Financial Officer, with the participation of other
members of management, have evaluated the effectiveness of our disclosure controls and procedures
(as defined in Rules 13a 15(e) and 15d 15(e) under the Securities and Exchange Act of 1934,
as amended, as of December 31, 2006. Based on such evaluations, our Chief Executive Officer and
Chief Financial Officer concluded that, as of such date, our disclosure controls and procedures
were effective (at the reasonable assurance level) to ensure that the information required to be
included in this report has been recorded, processed, summarized and reported within the time
periods specified in the Commissions rules and forms and to ensure that the information required
to be included in this report was accumulated and communicated to management, including our Chief
Executive Officer and Chief Financial Officer, to allow timely decisions regarding required
disclosure. There have been no changes in our internal control over financial reporting during the
quarter ended June 30, 2007, that have materially affected, or are reasonably likely to materially
affect, our internal control over financial reporting.
30
PART II OTHER INFORMATION
Item 1. Legal Proceedings
From time to time, we receive various inquiries or subpoenas from state regulators, fiscal
intermediaries, the Centers for Medicare and Medicaid Services and the Department of Justice
regarding various Medicare and Medicaid issues. In addition, we are subject to other claims and
lawsuits arising in the ordinary course of our business. We are not aware of any pending or
threatened litigation that is not covered by insurance policies or reserved for in our financial
statements or which we believe would have a material adverse impact on us.
In May 1999, we were served with a complaint in U.S. ex rel. Bledsoe v. Community Health Systems,
Inc., subsequently moved to the Middle District of Tennessee, Case No. 2-00-0083. This qui tam
action sought treble damages and penalties under the False Claims Act against us. The Department of
Justice did not intervene in this action. The allegations in the amended complaint were extremely
general, but involved Medicare billing at our White County Community Hospital in Sparta, Tennessee.
By order entered on September 19, 2001, the U.S. District Court granted our motion for judgment on
the pleadings and dismissed the case, with prejudice.
The qui tam whistleblower (also referred to as a relator) appealed the district courts ruling to
the U.S. Court of Appeals for the Sixth Circuit. On September 10, 2003, the Sixth Circuit Court of
Appeals rendered its decision in this case, affirming in part and reversing in part the district
courts decision to dismiss the case with prejudice. The court affirmed the lower courts dismissal
of certain of plaintiffs claims on the grounds that his allegations had been previously publicly
disclosed. In addition, the appeals court agreed that, as to all other allegations, the relator had
failed to include enough information to meet the special pleading requirements for fraud under the
False Claims Act and the Federal Rules of Civil Procedure. However, the case was returned to the
district court to allow the relator another opportunity to amend his complaint in an attempt to
plead his fraud allegations with particularity.
In May 2004, the relator in U.S. ex rel. Bledsoe filed an amended complaint alleging fraud
involving Medicare billing at White County Community Hospital. We then filed a renewed motion to
dismiss the amended complaint. On January 6, 2005, the District Court dismissed with prejudice the
bulk of the relators allegations. The only remaining allegations involve a handful of 1997-98
charges at White County. After further motion practice between the relator and the United States
Government regarding the relators right to participate in a previous settlement with the Company,
the District Court again dismissed all claims in the case on December 13, 2005. On January 9,
2006, the relator filed a notice of appeal to the U.S. Court of Appeals for the Sixth Circuit.
This appeal has been fully briefed and argued and we await the courts ruling.
In August 2004, we were served a complaint in Arleana Lawrence and Robert Hollins v. Lakeview
Community Hospital and Community Health Systems, Inc. (now styled Arleana Lawrence and Lisa Nichols
vs. Eufaula Community Hospital, Community Health Systems, Inc., South Baldwin Regional Medical Center and
Community Health Systems Professional Services Corporation) in the Circuit Court of Barbour County, Alabama (Eufaula Division). This
alleged class action was brought by the plaintiffs on behalf of themselves and as the
representatives of similarly situated uninsured individuals who were treated at our Lakeview
Hospital or any of our other Alabama hospitals. The plaintiffs allege that uninsured patients who
do not qualify for Medicaid, Medicare or charity care are charged unreasonably high rates for
services and materials and that we use unconscionable methods to collect bills. The plaintiffs seek
restitution of overpayment, compensatory and other allowable damages and injunctive relief. In
October 2005, the complaint was amended to eliminate one of the named plaintiffs and to add our
management company subsidiary as a defendant. In November 2005, the complaint was again amended to
add another plaintiff, Lisa Nichols and another defendant, our hospital in Foley, Alabama, South
Baldwin Regional Medical Center. Discovery has been concluded on the class determination issues
and a hearing was held on June 13, 2007. We are vigorously defending this case.
In September 2004, we were served with a complaint in James Monroe v. Pottstown Memorial Hospital
and Community Health Systems, Inc. in the Court of Common Pleas, Montgomery County, Pennsylvania.
This alleged class action was brought by the plaintiff on behalf of himself and as the
representative of similarly situated uninsured individuals who were treated at our Pottstown
Memorial Hospital or any of our other Pennsylvania hospitals. This case has been settled.
On March 3, 2005, we were served with a complaint in Sheri Rix v. Heartland Regional Medical Center
and Health Care Systems, Inc. in the Circuit Court of Williamson County, Illinois. This alleged
class action was
31
brought by the plaintiff on behalf of herself and as the representative of
similarly situated uninsured individuals who were treated at our Heartland Regional Medical Center.
The plaintiff alleges that uninsured patients who do not qualify for Medicaid, Medicare or charity
care are charged unreasonably high rates for services and materials and that we use unconscionable
methods to collect bills. The plaintiff seeks recovery for breach of contract and the covenant of
good faith and fair dealing, violation of the Illinois Consumer Fraud and Deceptive Practices Act,
restitution of overpayment, and for unjust enrichment. The plaintiff class seeks compensatory and
other damages and equitable relief. The Circuit Court Judge recently granted our motion to dismiss
the case, but allowed the plaintiff to re-plead her case. The plaintiff elected to appeal the
Circuit Courts decision in lieu of amending her case. The parties are briefing their positions.
We are vigorously defending this case.
On April 8, 2005, we were served with a first amended complaint, styled Chronister, et al. v.
Granite City Illinois Hospital Company, LLC d/b/a Gateway Regional Medical Center, in the Circuit
Court of Madison County, Illinois. The complaint seeks class action status on behalf of the
uninsured patients treated at Gateway Regional Medical Center and alleges statutory, common law,
and consumer fraud in the manner in which the hospital bills and collects for the services rendered
to uninsured patients. The plaintiff seeks compensatory and punitive damages and declaratory and
injunctive relief. Our motion to dismiss has been granted in part and denied in part and discovery has commenced.
Gateway Regional Medical Center v. Holman is a companion case to the Chronister action, seeking
counterclaim recovery on a collections case. Holman has been stayed pending the outcome of the
Chronister action. We are vigorously defending these cases.
On February 10, 2006, we received a letter from the Civil Division of the Department of Justice
requesting documents in an investigation they are conducting involving the Company. The inquiry
relates to the way in which different state Medicaid programs apply to the federal government for
matching or supplemental funds that are ultimately used to pay for a small portion of the services
provided to Medicaid and indigent patients. These programs are referred to by different names,
including intergovernmental payments, upper payment limit programs, and Medicaid
disproportionate share hospital payments. The February 10th letter focused on our hospitals in 3
states: Arkansas, New Mexico, and South Carolina. On August 31, 2006, we received a follow up
letter from the Department of Justice requesting additional documents relating to the programs in
New Mexico and the payments to the Companys three hospitals in that state. For hospitals in New
Mexico, the payments for this program approximate 0.3% of annual net operating revenue for 2006.
We have provided the Department of Justice with the requested documents and continue to cooperate
with the governments inquiry. We are unable at this time to evaluate the existence or extent of
any potential financial exposure.
In August 2006, our facility in Petersburg, Virginia (Southside Regional Medical Center) was
notified of the pendency of a federal False Claims Act case styled U.S. ex rel. Vuyyuru v. Jadhav
et al. filed in the Eastern District of Virginia. In addition to naming the hospital, Community
Health Systems Professional Services Corporation, our management subsidiary, has also been named.
The suit alleges that Dr. Jadhav, Southside Regional Medical Center, and other healthcare providers
performed medically unnecessary procedures and billed federal healthcare programs and also alleges
that the defendants defamed Dr. Vuyyuru in the process of terminating his medical staff privileges.
Almost all of the allegations pre-date our acquisition of this facility and the sellers
successor-in-interest has agreed to indemnify the Company and its affiliates. The district court
has granted our motion to dismiss the case. The relator has appealed the ruling to the U.S. Court
of Appeals for the Fourth Circuit.
Item 1A.Risk Factors
The Companys Annual Report on Form 10-K for 2006 includes a listing of risk factors to be
considered by investors in the Companys securities. Appearing below are updates of two of the risk
factors in the Form 10-K and additional risks related to the Companys merger with Triad.
Our level of indebtedness could adversely affect our ability to raise additional
capital to fund our operations, limit our ability to react to changes in the
economy or our industry and prevent us from meeting our obligations under the
agreements relating to our indebtedness.
We are significantly leveraged. The chart below shows our level of indebtedness and other
information as of June 30, 2007. In connection with the consummation of our acquisition of Triad,
we obtained $7.215 billion of senior secured financing under a new credit facility and our
wholly-owned subsidiary, CHS/Community Health Systems, Inc. (the Issuer), issued $3.021 billion
aggregate principal amount of its 8.875% senior notes due 2015 (the Notes) at the closing of the
merger. The Notes are senior obligations of this subsidiary and are guaranteed on a senior basis
by us and by certain of our domestic subsidiaries. We used the net proceeds from the Notes offering
32
and the net proceeds of the $6.065 billion of term loans under the new credit facility to pay the
consideration under the merger agreement with Triad, to refinance certain of our indebtedness and
the indebtedness of Triad, to complete certain related transactions, to pay certain costs and
expenses of the transactions and for general corporate uses. A $750 million revolving credit
facility and a $400 million delayed draw term loan facility are available to us for working capital
and general corporate purposes under the new credit facility. As of July 25, 2007, after giving
effect to the Triad acquisition, our total debt is approximately $9.102 billion.
Also, in connection with the consummation of the acquisition of Triad, we completed an early
repayment of the $300 million aggregate principal amount of 6-1/2% Senior Subordinated Notes due
2012 through a cash tender offer and consent solicitation.
The debt financing may contain covenants or other terms more restrictive than our existing
financing arrangements, which may limit our ability to raise additional capital, react to changes
or meet our obligations under our financing agreements.
|
|
|
|
|
|
|
As of |
|
|
|
June 30, 2007 |
|
|
|
($ in millions) |
|
|
|
|
|
|
Senior secured credit facility |
|
|
|
|
Term loans |
|
$ |
1,642,000 |
|
Notes |
|
|
300,000 |
|
Other |
|
|
57,997 |
|
|
|
|
|
Total debt |
|
|
1,999,997 |
|
|
|
|
|
Stockholders equity |
|
|
1,860,967 |
|
|
|
|
|
|
|
|
|
|
|
|
Twelve Months |
|
|
Ended |
|
|
June 30, 2007 |
Ratio of earnings to fixed charges (a) |
|
|
3.25 |
x |
|
|
|
|
|
|
|
|
(a) |
|
In calculating the ratio of earnings to fixed charges, earnings consist of income from
continuing operations before income taxes plus fixed charges. Fixed charges consist of
interest expense (which includes amortization of deferred financing costs and debt issuance
costs) and one-quarter of rent expense deemed representative of that portion of rent expense
to be attributable to interest. |
As of the
date of our new credit facility, our $1.550 billion notional amount of interest rate swap
agreements represented approximately 26% of our variable rate debt. Accordingly, a 1% change in
interest rates on the remaining unhedged variable rate debt would result in interest expense fluctuating
approximately $11.3 million per quarter.
Our leverage could have important consequences for you, including the following:
|
|
|
it may limit our ability to obtain additional debt or equity financing for working
capital, capital expenditures, debt service requirements, acquisitions and general
corporate or other purposes; |
|
|
|
|
a substantial portion of our cash flows from operations will be dedicated to the
payment of principal and interest on our indebtedness and will not be available for other
purposes, including our operations, capital expenditures and future business
opportunities; |
|
|
|
|
the debt service requirements of our indebtedness could make it more difficult for us
to satisfy our financial obligations; |
|
|
|
|
some of our borrowings, including borrowings under our senior secured credit facility,
are at variable rates of interest, exposing us to the risk of increased interest rates; |
|
|
|
|
it may limit our ability to adjust to changing market conditions and place us at a
competitive disadvantage compared to our competitors that have less debt; and |
|
|
|
|
we may be vulnerable in a downturn in general economic conditions or in our business,
or we may be unable to carry out capital spending that is important to our growth. |
If we fail to improve the operations of future acquired hospitals, we may be unable to
achieve our growth strategy.
33
Most of the hospitals we have acquired or will acquire had or may have significantly lower
operating margins than we do and/or operating losses prior to the time we acquired them. In the
past, we have occasionally experienced temporary delays in improving the operating margins or
effectively integrating the operations of these acquired hospitals. In the future, if we are
unable to improve the operating margins of acquired hospitals, operate them profitably, or
effectively integrate their operations, we may be unable to achieve our growth strategy. We
acquired 53 hospitals in the Triad acquisition. In the past, we have not acquired this many
hospitals at one time. We may experience delays or difficulties in improving the operating margins
or effectively integrating the operations of these acquired hospitals.
At the time of the Triad acquisition, we assumed all of Triads potential liabilities, including
liabilities relating to pending or threatened litigation matters, which, if adversely decided,
could have a material adverse effect on our future results and operations.
Given the number of hospitals acquired, senior management may need to devote a significant amount
of time to integration of the acquired hospitals, which may detract
from the ability of senior management to execute our past acquisition strategy of attempting to
acquire two to four hospitals each year. Except for one hospital, for
which we currently have submitted a letter of intent to acquire, we
do not anticipate acquiring more hospitals during the remainder of
2007 and 2008.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
On January 14, 2006, the Company commenced an open market repurchase program for up to 5,000,000
shares of the Companys common stock, not to exceed $200 million in repurchases. Under this
program, the Company repurchased the entire 5,000,000 shares at a weighted average price of $35.23.
This program concluded on November 8, 2006 when the maximum number of shares had been repurchased.
This repurchase plan followed a prior repurchase plan for up to 5,000,000 shares which concluded
on January 13, 2006. The Company repurchased 3,029,700 shares at a weighted average price of
$31.17 per share under this program. On December 13, 2006, the Company commenced another open
market repurchase program for up to 5,000,000 shares of the Companys common stock not to exceed
$200 million in repurchases. This program will conclude at the earlier of three years or when the
maximum number of shares have been repurchased. As of June 30, 2007, the Company has not
repurchased any shares under this program.
We have not paid any dividends since our inception, and do not anticipate the payment of cash
dividends in the foreseeable future. Our new credit facility limits our ability to pay dividends
and/or repurchase stock to an amount not to exceed $300 million in the aggregate.
Item 3. Defaults Upon Senior Securities
None
Item 4. Submission of Matters to a Vote of Security Holders
|
(a) |
|
The annual meeting of the stockholders of Community Health Systems, Inc., was held in
New York, New York on May 22, 2007, for the purpose of voting on the proposals described
below. |
|
|
(b) |
|
Proxies for the meeting were solicited pursuant to Section 14(a) of the Securities
and Exchange Act of 1934 and there was no solicitation in opposition to the Governance and
Nominating Committees nominees for directors. All of the Governance and Nominating
Committees nominees for directors were elected as set forth in clause (c) below. In
addition, the terms of office as a director of Wayne T. Smith, Dale F. Frey, John A.
Clerico, John A. Fry and Julia B. North continued after the meeting. |
|
|
(c) |
|
Three proposals were submitted to a vote of security holders as follows: |
|
(1) |
|
The stockholders approved the election of the following persons as
directors of the Company: |
|
|
|
|
|
|
|
|
|
Name |
|
For |
|
Withheld |
|
|
|
|
|
|
|
|
|
W. Larry Cash |
|
|
72,446,984 |
|
|
|
11,474,409 |
|
|
|
|
|
|
|
|
|
|
Harvey Klein, M.D. |
|
|
75,900,019 |
|
|
|
8,021,374 |
|
|
|
|
|
|
|
|
|
|
H. Mitchell Watson, Jr. |
|
|
68,320,487 |
|
|
|
15,600,906 |
|
34
|
(2) |
|
Approval of the Community Health Systems, Inc. Amended and Restated 2000 Stock
Option and Award Plan: |
|
|
|
|
|
|
|
|
|
For |
|
Against |
|
Abstain |
65,079,451 |
|
|
11,792,730 |
|
|
|
1,096,413 |
|
|
(3) |
|
The Board of Directors appointment of Deloitte & Touche, LLP, as the Companys
independent accountants for 2007 was ratified by the affirmative votes of
stockholders: |
|
|
|
|
|
|
|
|
|
For |
|
Against |
|
Abstain |
82,953,238 |
|
|
806,150 |
|
|
|
17,968 |
|
|
(d) |
|
Prior to the meeting of the stockholders on May 22, 2007, Heavy and General
Laborers Fund of New Jersey withdrew its stockholder proposal set forth in the
Definitive Proxy Statement, as filed with the Securities and Exchange Commission
on April 12, 2007. |
Item 5. Other Information
None
Item 6. Exhibits
|
|
|
|
|
|
31.1 |
|
|
Certification of Chief Executive Officer pursuant to Section 302 of
the Sarbanes-Oxley Act of 2002. |
|
|
|
|
|
|
31.2 |
|
|
Certification of Chief Financial Officer pursuant to Section 302 of
the Sarbanes-Oxley Act of 2002. |
|
|
|
|
|
|
32.1 |
|
|
Certification of Chief Executive Officer pursuant to 18 U.S.C.
Section 1350, adopted pursuant to Section 906 of the Sarbanes-Oxley
Act of 2002. |
|
|
|
|
|
|
32.2 |
|
|
Certification of Chief Financial Officer pursuant to 18 U.S.C.
Section 1350, adopted pursuant to Section 906 of the Sarbanes-Oxley
Act of 2002. |
35
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused
this Report to be signed on its behalf by the undersigned thereunto duly authorized.
|
|
|
|
|
Date: July 31, 2007 |
COMMUNITY HEALTH SYSTEMS, INC.
(Registrant)
|
|
|
By: |
/s/ Wayne T. Smith
|
|
|
|
Wayne T. Smith |
|
|
|
Chairman of the Board,
President and Chief Executive Officer
(principal executive officer) |
|
|
|
|
|
|
By: |
/s/ W. Larry Cash
|
|
|
|
W. Larry Cash |
|
|
|
Executive Vice President, Chief Financial
Officer and Director
(principal financial officer) |
|
|
|
|
|
|
By: |
/s/ T. Mark Buford
|
|
|
|
T. Mark Buford |
|
|
|
Vice President and Corporate Controller
(principal accounting officer) |
|
36
Index to Exhibits
|
|
|
|
|
No. |
|
Description |
|
|
|
|
|
|
31.1 |
|
|
Certification of Chief Executive Officer
pursuant to Section 302 of the Sarbanes-Oxley
Act of 2002. |
|
|
|
|
|
|
31.2 |
|
|
Certification of Chief Financial Officer
pursuant to Section 302 of the Sarbanes-Oxley
Act of 2002. |
|
|
|
|
|
|
32.1 |
|
|
Certification of Chief Executive Officer
pursuant to 18 U.S.C. Section 1350, adopted
pursuant to Section 906 of the Sarbanes-Oxley
Act of 2002. |
|
|
|
|
|
|
32.2 |
|
|
Certification of Chief Financial Officer
pursuant to 18 U.S.C. Section 1350, adopted
pursuant to Section 906 of the Sarbanes-Oxley
Act of 2002. |
37
EX-31.1 SECTION 302 CERTIFICATION OF THE CEO
Exhibit 31.1
I, Wayne T. Smith, certify that:
1. |
|
I have reviewed this quarterly report on Form 10-Q of Community Health Systems, Inc.; |
|
2. |
|
Based on my knowledge, this quarterly report does not contain any untrue statement of a
material fact or omit to state a material fact necessary to make the statements made, in light
of the circumstances under which such statements were made, not misleading with respect to the
period covered by this quarterly report; |
|
3. |
|
Based on my knowledge, the financial statements, and other financial information included in
this quarterly report, fairly present in all material respects the financial condition,
results of operations and cash flows of the registrant as of, and for, the periods presented
in this quarterly report; |
|
4. |
|
The registrants other certifying officer and I are responsible for establishing and
maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and
15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules
13a-15(f) and 15d-15(f)) for the registrant and we have: |
a) designed such disclosure controls and procedures, or caused such disclosure controls and
procedures to be designed under our supervision, to ensure that material information
relating to the registrant, including its consolidated subsidiaries, is made known to us by
others within those entities, particularly during the period in which this quarterly report
is being prepared;
b) designed such internal controls over financial reporting, or caused such internal
control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation
of financial statements for external purposes in accordance with generally accepted
accounting principles;
c) evaluated the effectiveness of the registrants disclosure controls and procedures and
presented in this report our conclusions about the effectiveness of the disclosure controls
and procedures, as of the end of the period covered by this report based on such
evaluation; and
d) disclosed in this report any change in the registrants internal control over financial
reporting that occurred during the registrants most recent fiscal quarter (the
registrants fourth fiscal quarter in the case of an annual report) that has materially
affected, or is reasonably likely to materially affect, the registrants internal control
over financial reporting; and
5. |
|
The registrants other certifying officer and I have disclosed, based on our most recent
evaluation of internal control over financial reporting, to the registrants auditors and the
audit committee of
the registrants board of directors: |
a) all significant deficiencies and material weaknesses in the design or operation of
internal control over financial reporting which are reasonably likely to adversely affect
the registrants ability to record, process, summarize and report financial information;
and
b) any fraud, whether or not material, that involves management or other employees who have
a significant role in the registrants internal control over financial reporting.
|
|
|
|
|
|
|
|
Date: July 31, 2007 |
/s/ Wayne T. Smith
|
|
|
Wayne T. Smith |
|
|
Chairman of the Board, President
and Chief Executive Officer |
|
EX-31.2 SECTION 302 CERTIFICATION OF THE CFO
Exhibit 31.2
I, W. Larry Cash, certify that:
1. |
|
I have reviewed this quarterly report on Form 10-Q of Community Health Systems, Inc.; |
|
2. |
|
Based on my knowledge, this quarterly report does not contain any untrue statement of a
material fact or omit to state a material fact necessary to make the statements made, in light
of the circumstances under which such statements were made, not misleading with respect to the
period covered by this quarterly report; |
|
3. |
|
Based on my knowledge, the financial statements, and other financial information included in
this quarterly report, fairly present in all material respects the financial condition,
results of operations and cash flows of the registrant as of, and for, the periods presented
in this quarterly report; |
|
4. |
|
The registrants other certifying officer and I are responsible for establishing and
maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and
15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules
13a-15(f) and 15d-15(f)) for the registrant and we have: |
a) designed such disclosure controls and procedures, or caused such disclosure controls and
procedures to be designed under our supervision, to ensure that material information
relating to the registrant, including its consolidated subsidiaries, is made known to us by
others within those entities, particularly during the period in which this quarterly report
is being prepared;
b) designed such internal controls over financial reporting, or caused such internal
control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation
of financial statements for external purposes in accordance with generally accepted
accounting principles;
c) evaluated the effectiveness of the registrants disclosure controls and procedures and
presented in this report our conclusions about the effectiveness of the disclosure controls
and procedures, as of the end of the period covered by this report based on such
evaluation; and
d) disclosed in this report any change in the registrants internal control over financial
reporting that occurred during the registrants most recent fiscal quarter (the
registrants fourth fiscal quarter in the case of an annual report) that has materially
affected, or is reasonably likely to materially affect, the registrants internal control
over financial reporting; and
5. |
|
The registrants other certifying officer and I have disclosed, based on our most recent
evaluation of internal control over financial reporting, to the registrants auditors and the audit
committee of the registrants board of directors: |
a) all significant deficiencies and material weaknesses in the design or operation of
internal control over financial reporting which are reasonably likely to adversely affect
the registrants ability to record, process, summarize and report financial information;
and
b) any fraud, whether or not material, that involves management or other employees who
have a significant role in the registrants internal control over financial reporting.
|
|
|
|
|
|
|
|
Date: July 31, 2007 |
/s/ W. Larry Cash
|
|
|
W. Larry Cash |
|
|
Executive Vice President,
Chief Financial Officer and Director |
|
EX-32.1 SECTION 302 CERTIFICATION OF THE CEO
Exhibit 32.1
CERTIFICATION PURSUANT TO
18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002
In connection with the Quarterly Report of Community Health Systems, Inc. (the Company) on
Form 10-Q for the period ending June 30, 2007, as filed with the Securities and Exchange Commission
on the date hereof (the Report), I, Wayne T. Smith, Chairman of the Board, President and Chief
Executive Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to §
906 of the Sarbanes-Oxley Act of 2002, that:
|
(1) |
|
The Report fully complies with the requirements of Section 13(a) or 15(d) of
the Securities Exchange Act of 1934; and |
|
|
(2) |
|
The information contained in the Report fairly presents, in all material
respects, the financial condition and result of operations of the Company. |
|
|
|
|
|
|
|
|
/s/ Wayne T. Smith
|
|
|
Wayne T. Smith |
|
|
Chairman of the Board, President and Chief Executive Officer |
|
|
|
July 31, 2007
A signed original of this written statement required by Section 906 has been provided to Community
Health Systems, Inc. and will be retained by Community Health Systems, Inc. and furnished to the
Securities and Exchange Commission or its staff upon request.
EX-32.2 SECTION 906 CERTIFICATION OF THE CFO
Exhibit 32.2
CERTIFICATION PURSUANT TO
18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002
In connection with the Quarterly Report of Community Health Systems, Inc. (the Company) on
Form 10-Q for the period ending June 30, 2007, as filed with the Securities and Exchange Commission
on the date hereof (the Report), I, W. Larry Cash, Executive Vice President, Chief Financial
Officer and Director of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to
§ 906 of the Sarbanes-Oxley Act of 2002, that:
|
(1) |
|
The Report fully complies with the requirements of Section 13(a) or 15(d) of
the Securities Exchange Act of 1934; and |
|
|
(2) |
|
The information contained in the Report fairly presents, in all material
respects, the financial condition and result of operations of the Company. |
|
|
|
|
|
|
|
|
/s/ W. Larry Cash
|
|
|
W. Larry Cash |
|
|
Executive Vice President, Chief Financial Officer and Director |
|
|
|
July 31, 2007
A signed original of this written statement required by Section 906 has been provided to Community
Health Systems, Inc. and will be retained by Community Health Systems, Inc. and furnished to the
Securities and Exchange Commission or its staff upon request.