10-Q 1 d398569d10q.htm FORM 10-Q Form 10-Q
Table of Contents

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

FORM 10-Q

 

 

 

x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended September 30, 2012.

or

 

¨ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from              to              .

Commission File Number 333-133319

 

 

LIFECARE HOLDINGS, INC.

(Exact name of registrant as specified in its charter)

 

 

 

Delaware   51-0372090

(State or other jurisdiction of

incorporation or organization)

 

(IRS Employer

Identification Number)

5560 Tennyson Parkway

Plano, Texas

  75024
(Address of Principal Executive Offices)   (Zip Code)

(469) 241-2100

(Registrant’s telephone number, including area code)

None

(Former name, former address and former fiscal year, if changes since last report)

 

 

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  x    No  ¨

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes  x    No  ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. Please see definition of “accelerated and large accelerated filer” in Rule 12b-2 of the Exchange Act.

 

Large Accelerated Filer:   ¨    Accelerated Filer:   ¨
Non-Accelerated Filer:   x    Smaller Reporting Company:   ¨

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).    Yes  ¨    No  x

As of November 9, 2012, the registrant had 100 shares of Common Stock, par value $0.01 per share, outstanding.

 

 

 


Table of Contents

LIFECARE HOLDINGS, INC.

TABLE OF CONTENTS

 

  PART I: FINANCIAL INFORMATION   

ITEM 1.

  CONSOLIDATED FINANCIAL STATEMENTS    3
  CONDENSED CONSOLIDATED BALANCE SHEETS    3
  CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS    4
  CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDER’S DEFICIT    5
  CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS    6
  NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS    7

ITEM 2.

  MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS    23

ITEM 3.

  QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK    34

ITEM 4.

  CONTROLS AND PROCEDURES    34
  PART II: OTHER INFORMATION    36

ITEM 1.

  LEGAL PROCEEDINGS    36

ITEM 1A.

  RISK FACTORS    36

ITEM 6.

  EXHIBITS    36

SIGNATURES

   37

 

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PART 1: FINANCIAL INFORMATION

ITEM 1: CONSOLIDATED FINANCIAL STATEMENTS

LIFECARE HOLDINGS, INC. AND SUBSIDIARIES

Condensed Consolidated Balance Sheets

September 30, 2012 and December 31, 2011

(In thousands, except share data)

(unaudited)

 

     September 30,
2012
    December 31,
2011
 
Assets     

Current assets:

    

Cash and cash equivalents

   $ 31,540      $ 11,569   

Accounts receivable, net of allowance for doubtful accounts of $6,073 and $8,477, respectively

     78,617        91,364   

Other current assets

     10,032        10,244   
  

 

 

   

 

 

 

Total current assets

     120,189        113,177   

Property and equipment, net

     69,327        73,767   

Other assets, net

     15,696        22,706   

Identifiable intangibles, net

     38,128        38,323   

Goodwill

     178,812        264,512   
  

 

 

   

 

 

 

Total assets

   $ 422,152      $ 512,485   
  

 

 

   

 

 

 
Liabilities and Stockholder’s Deficit     

Current liabilities:

    

Current portion of long-term debt

   $ 461,970      $ 5,912   

Current installments of obligations under capital leases

     190        414   

Current installments of lease financing obligation

     551        519   

Estimated third party payor settlements

     5,377        9,287   

Accounts payable

     23,329        30,991   

Accrued payroll

     5,599        9,806   

Accrued vacation

     7,121        6,589   

Accrued interest

     16,918        13,705   

Accrued other

     9,301        9,772   

Income taxes payable

     239        663   
  

 

 

   

 

 

 

Total current liabilities

     530,595        87,658   

Long-term debt, excluding current portion

     —          431,073   

Obligations under capital leases, excluding current installments

     56        89   

Lease financing obligation, excluding current installments

     18,621        19,038   

Accrued insurance

     5,823        4,102   

Other noncurrent liabilities

     20,783        16,841   
  

 

 

   

 

 

 

Total liabilities

     575,878        558,801   
  

 

 

   

 

 

 

Commitments and contingencies

    

Stockholder’s deficit:

    

Common stock, $0.01 par value, 100 shares authorized, issued and outstanding

     —          —     

Additional paid-in capital

     175,441        175,441   

Accumulated deficit

     (329,167     (221,757
  

 

 

   

 

 

 

Total stockholder’s deficit

     (153,726     (46,316
  

 

 

   

 

 

 
   $ 422,152      $ 512,485   
  

 

 

   

 

 

 

See accompanying notes to condensed consolidated financial statements.

 

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LIFECARE HOLDINGS, INC. AND SUBSIDIARIES

Condensed Consolidated Statements of Operations

For the three and nine months ended September 30, 2012 and 2011

(In thousands)

(Unaudited)

 

     Three Months     Nine Months  
     2012     2011     2012     2011  

Net patient service revenue

   $ 119,844      $ 102,599      $ 367,237      $ 293,510   
  

 

 

   

 

 

   

 

 

   

 

 

 

Salaries, wages and benefits

     57,968        50,526        174,167        139,941   

Supplies

     11,122        10,540        34,984        29,354   

Rent

     10,008        8,685        31,132        21,878   

Other operating expenses

     25,501        26,446        78,806        69,388   

Provision for doubtful accounts

     1,181        1,781        3,428        4,367   

Depreciation and amortization

     2,214        2,354        7,067        6,528   

Reorganization cost

     5,717        —         5,717        —    

Goodwill impairment charge

     85,700        —         85,700        —    

Loss on early extinguishment of debt

     —          —          —         2,772   

Interest expense, net

     18,289        15,571        53,265        40,845   
  

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     217,700        115,903        474,266        315,073   
  

 

 

   

 

 

   

 

 

   

 

 

 

Operating loss

     (97,856     (13,304     (107,029     (21,563

Equity in income of joint venture

     124        85        451        562   
  

 

 

   

 

 

   

 

 

   

 

 

 

Loss before income taxes

     (97,732     (13,219     (106,578     (21,001

Provision (benefit) for income taxes

     (229     100        832        550   
  

 

 

   

 

 

   

 

 

   

 

 

 

Net loss

   $ (97,503   $ (13,319   $ (107,410   $ (21,551
  

 

 

   

 

 

   

 

 

   

 

 

 

See accompanying notes to condensed consolidated financial statements.

 

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LIFECARE HOLDINGS, INC. AND SUBSIDIARIES

Condensed Consolidated Statements of Stockholder’s Deficit

For the nine months ended September 30, 2012

(In thousands)

(Unaudited)

 

     Common
Stock
     Additional
Paid-in
Capital
     Accumulated
Deficit
    Total
Stockholder’s
Deficit
 

Balance, December 31, 2011

   $ —         $ 175,441       $ (221,757   $ (46,316

Net loss

     —           —           (107,410     (107,410
  

 

 

    

 

 

    

 

 

   

 

 

 

Balance, September 30, 2012

   $ —         $ 175,441       $ (329,167   $ (153,726
  

 

 

    

 

 

    

 

 

   

 

 

 

See accompanying notes to condensed consolidated financial statements.

 

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LIFECARE HOLDINGS, INC. AND SUBSIDIARIES

Condensed Consolidated Statements of Cash Flows

For the nine months ended September 30, 2012 and 2011

(In thousands)

(Unaudited)

 

     2012     2011  

Cash flows from operating activities:

    

Net loss

   $ (107,410   $ (21,551

Adjustments to reconcile net loss to net cash provided by operating activities:

    

Depreciation and amortization (including amortization of debt issuance cost)

     15,103        11,879   

Provision for doubtful accounts

     3,428        4,367   

Paid in kind interest

     13,408        6,517   

Goodwill impairment charge

     85,700        —    

Loss on early extinguishment of debt

     —          2,772   

Equity in income of joint venture

     (451     (562

Deferred income taxes

     591        —     

Amortization of debt discount

     361        —     

Changes in operating assets and liabilities:

    

Accounts receivable

     9,319        (12,631

Income taxes

     (424     191   

Other current assets

     212        (1,283

Other assets

     (610     (2,835

Estimated third party payor settlements

     (3,909     5,046   

Accounts payable and accrued expenses

     (8,596     5,934   

Other noncurrent liabilities

     5,072        2,231   
  

 

 

   

 

 

 

Net cash provided by operating activities

     11,794        75   
  

 

 

   

 

 

 

Cash flows from investing activities:

    

Purchases of property and equipment

     (2,277     (3,165

Payments for acquisition

     —          (33,262
  

 

 

   

 

 

 

Net cash used in investing activities

     (2,277     (36,427
  

 

 

   

 

 

 

Cash flows from financing activities:

    

Deferred financing cost

     —          (22,291

Borrowings on revolving credit facility

     34,500        —     

Payments on revolving credit facility

     (18,500     (35,000

Proceeds from long-term debt

     —          304,700   

Payments of long-term debt

     (4,785     (243,018

Payments on obligations under capital leases

     (375     (693

Payments on lease financing obligation

     (386     (356
  

 

 

   

 

 

 

Net cash provided by financing activities

     10,454        3,342   
  

 

 

   

 

 

 

Net increase (decrease) in cash and cash equivalents

     19,971        (33,010

Cash and cash equivalents, beginning of period

     11,569        54,570   
  

 

 

   

 

 

 

Cash and cash equivalents, end of period

   $ 31,540      $ 21,560   
  

 

 

   

 

 

 

Supplemental disclosure of cash flow information:

    

Cash:

    

Interest paid

   $ 42,141      $ 31,932   

Net income taxes paid

     665        359   

Noncash:

    

Equipment purchased through capital lease financing

     118        86   

See accompanying notes to condensed consolidated financial statements.

 

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LifeCare Holdings, Inc. and Subsidiaries

Notes to Condensed Consolidated Financial Statements

(unaudited)

(1) Basis of Presentation

LifeCare Holdings, Inc. (the “Company”) is a wholly owned subsidiary of LCI Holdco, LLC (“Holdco”). Holdco is a wholly owned subsidiary of LCI Intermediate Holdco, Inc. (“Intermediate Holdco”). Intermediate Holdco is a wholly owned subsidiary of LCI Holding Company, Inc. (“Holdings”), which is owned by an investor group that includes affiliates of The Carlyle Group and members of our senior management and board of directors. The investor group acquired Holdings pursuant to a merger that occurred on August 11, 2005 (the “Merger”).

The accompanying unaudited condensed consolidated financial statements and financial information have been prepared in accordance with generally accepted accounting principles, and reflect all adjustments that are, in the opinion of management, necessary for a fair presentation of the results of the interim periods. The accompanying financial statements for the three and nine month periods ended September 30, 2012 and 2011, are not necessarily indicative of annualized financial results.

The accompanying unaudited condensed consolidated financial statements should be read in conjunction with the consolidated audited financial statements and notes thereto for the year ended December 31, 2011, included in the Form 10-K we filed on March 30, 2012, with the Securities and Exchange Commission. Certain information and disclosures normally included in the notes to consolidated financial statements have been condensed or omitted as permitted by the rules and regulations of the Securities and Exchange Commission, although we believe the disclosure is adequate to make the information presented not misleading.

(2) Liquidity and Uncertainties Related to Going Concern

As of September 30, 2012, we had $462.0 million of debt outstanding (including outstanding borrowings under our revolving credit facility) consisting of our senior secured term loan credit facility in an outstanding principal amount of $324.3 million, which matures on February 1, 2016, our senior subordinated notes in an outstanding principal amount of $119.3 million, which mature on August 11, 2013, our note payable to Vibra Specialty Hospital of Dallas LLC (“Vibra”) in an outstanding principal amount of $2.4 million, which matures on June 1, 2013, and our revolving credit facility, which matures on February 1, 2015, in an outstanding principal amount of $16.0 million. Additionally as of September 30, 2012, we have issued and outstanding letters of credit of $9.0 million. The scheduled maturity dates of the senior secured term loan and revolving credit facility will accelerate to May 15, 2013, if the senior subordinated notes are not refinanced, purchased or defeased in full by May 15, 2013.

Given our current capital structure and operating cash flows, it is unlikely that we will be able to refinance, purchase or defease the senior subordinated notes by May 15, 2013. As a result, our senior secured credit facility and revolving credit facility continue to be reflected as current liabilities. Additionally, an event of default will occur under the indenture governing the senior subordinated notes in the event the senior secured term loan credit facility maturity is accelerated. Accordingly, we have also classified the senior subordinated notes as a current liability. In light of these circumstances, on May 8, 2012, we engaged Rothschild, Inc. as a financial advisor to assist us in evaluating strategic alternatives for our capital structure as it relates to the pending maturity of our senior subordinated notes and the potential accelerated maturity of our senior secured term loan. We have recorded $5.7 million as reorganization costs, which represents professional fees paid to Rothschild, Inc., attorneys and other advisors to assist in our consideration and evaluation of various strategic alternatives in connection with our capital restructuring.

We did not pay the interest payment due on August 15, 2012 under our senior subordinated notes in the amount of $5.5 million. The failure to make this payment constituted an event of default under the indenture governing the senior subordinated notes upon expiration of the 30-day payment grace period. The failure to make the senior subordinated notes interest payment prior to the end of such grace period resulted in an event of default under our senior secured credit facility. The occurrence of an event of default under these agreements could permit the holders to accelerate such indebtedness.

On September 14, 2012, we entered into a Limited Waiver and First Amendment to Credit Agreement and Termination of Revolving Commitments with our senior secured facility holders, which was extended on November 1, 2012 (as extended, the “Agreement”). The Agreement (i) waived any default or event of default arising from the failure of us to make the required interest payment on our senior subordinated notes due on August 15, 2012 and to remedy such failure within the applicable 30-day payment grace period that ended on September 14, 2012 during the Waiver Period (as defined below), (ii) effected certain amendments to the senior secured term loan and revolving credit facility, including terminating access to our revolving credit facility and limits on making certain payments to The Carlyle Group and employees, (iii) permanently terminated all unused revolving commitments under the senior secured revolving credit facility and (iv) waived certain other defaults and events of default during the Waiver Period.

As extended the “Waiver Period” is the period from September 14, 2012 to the earlier of (i) December 15, 2012 and (ii) the occurrence of any waiver default, which will occur immediately upon the occurrence of certain events, including (a) the occurrence of a default or event of default under the senior secured credit facility not arising from the failure to make the interest payment on the senior subordinated notes (other than those otherwise waived by the Agreement), (b) the entry into certain refinancing transactions, (c) the making of payments under the senior subordinated notes or certain other of our outstanding indebtedness, (d) the occurrence of

 

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an event of default under the senior subordinated notes or the termination of the waiver agreement for the senior subordinated notes, as discussed below, or (e) any material amendment to our existing employee retention plans or adoption of new employee retention plans without approval. The occurrence of certain other events, including our failure to comply with the terms, conditions or covenants of the Agreement, will constitute a default of the waiver if such events remain uncured for five business days after written notice is provided to us.

During the Waiver Period, loans outstanding under the senior secured term loan credit facility will bear interest at a rate of 2% plus the rate otherwise applicable to such loan, which additional interest will be payable half as pay-in-kind interest and half in cash.

On September 14, 2012, we also entered into a Limited Waiver Agreement with certain of our senior subordinated note holders, which was extended on November 1, 2012 (as extended, the “Waiver Agreement”). Pursuant to the Waiver Agreement, the requisite amount of holders of the senior subordinated notes have agreed to waive the default or event of default associated with our failure to pay interest on the senior subordinated notes on August 15, 2012. As extended, the Waiver Agreement is effective during the period (i) commencing on and including September 15, 2012 and (ii) ending on, but not including, the date that is the earlier of (a) December 15, 2012 and (b) the occurrence of a termination event. A termination event includes (i)(x) the occurrence of an event of default under the senior subordinated notes other than an event of default resulting from the failure to pay interest on the senior subordinated notes on August 15, 2012, (y) our failure or failure of the guarantor (as discussed in note 13) to timely comply with the terms, conditions or covenants set forth in the Waiver Agreement or (z) the failure of any representation or warranty made by us or any guarantor in the Waiver Agreement to be true and correct in any material respect as of the date when made and (ii) the termination of the applicable waiver period under the Agreement as discussed above.

The Waiver Agreement contains certain representations, conditions and covenants for us and the guarantors, including restrictions on certain payments by us, the guarantors of the senior subordinated notes and their respective restricted subsidiaries.

On November 1, 2012 we entered into a Limited Waiver and Second Amendment to Credit Agreement with our senior secured lenders that extended the applicable waiver period regarding any default under the senior secured credit facility to the earlier of December 15, 2012 or any waiver default. On November 1, 2012 we also entered into a Second Limited Waiver Agreement with certain of the senior subordinated noteholders that extended the applicable waiver period regarding any default under the senior subordinated notes to the earlier of December 15, 2012 or any termination event.

We have a cash balance in excess of $28.0 million as of the date hereof. This amount, together with cash from operating activities, is sufficient to meet our obligations arising in the ordinary course of business, absent an acceleration of our indebtedness due to an event of default as discussed herein.

We are required to comply on a quarterly basis with certain financial and other covenants under our senior secured credit facility, including a minimum consolidated cash interest expense coverage ratio test and a maximum senior secured leverage ratio test. We were required to meet a leverage ratio of 5.75x (or less) at September 30, 2012, which reduces to 5.50x at March 31, 2013. Our leverage ratio at September 30, 2012 was 5.48x. We were required to meet an interest coverage ratio of not less than 1.25x at September 30, 2012 and throughout 2012, which increases to 1.30x on March 31, 2013. Our interest coverage ratio was 1.50x at September 30, 2012. As a result of changes in reimbursement rates, other healthcare regulations, and market factors impacting our business along with increasingly more restrictive covenant requirements, our projection of future earning indicates we expect we will be unable to meet our debt covenant requirements during the next twelve month period. The Agreement also amends the senior secured term loan and revolving credit facility to impose additional restrictions, as previously described, with which we are required to comply.

In the event we are unable to comply with the covenants under our senior secured credit facility, an event of default will occur. If we are unable to obtain waivers or amendments to cure such event of default, the lenders would be entitled to take various actions, including the acceleration of amounts due under our senior secured credit facility, terminating access to our revolving credit facility, and all actions permitted to be taken by a secured creditor. Acceleration under our senior secured credit facility would create a cross-default under our senior subordinated notes indenture. Any such acceleration could have a material adverse effect on our financial position, results of operations and cash flow.

We are required to comply with certain covenants under our hospital facility leases, including a minimum net worth test, a minimum cash balance test, and a current ratio test. We did not meet the minimum net worth test or the current ratio test required under our master lease for six of the facilities, and did not meet the minimum net worth, minimum cash balance, and current ratio tests required for our Boise facility. If we are unable to resolve the covenant defaults, the landlord would be entitled to take various actions, including terminating the underlying leases. In addition, on September 17, 2012, the landlord of our Dallas facility alleged that an event of default under the indenture governing the senior subordinated notes noted above resulted in a default under our lease, and in conjunction with the alleged default, purported to terminate the lease. We dispute the alleged lease default and termination, and intends to vigorously defend our rights under the Dallas lease. On October 8, 2012, the landlord filed suit in Dallas County, Texas, seeking a declaratory judgment that holds that we committed an event of default under the Dallas lease, and that the landlord’s subsequent termination of the lease was lawful and valid. We intend to vigorously defend this declaratory judgment action.

 

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We have prepared the accompanying financial statements on a going-concern basis. Our ability to continue to operate on this basis will be dependent on successfully addressing our capital structure. We are continuing to work with our financial advisor and lenders under our senior secured credit facility and senior subordinated notes to develop a comprehensive strategy that will allow us to refinance or restructure our existing capital structure prior to the acceleration of any indebtedness. We are also working with our landlords to resolve any events of default. There can be no assurance, however, that any of these efforts will prove successful or be on economically reasonable terms. In the event of a failure to obtain necessary waivers or forbearance agreements or otherwise achieve a restructuring of our financial obligations, we may be forced to seek reorganization under Chapter 11 of the United States Bankruptcy Code. These issues along with the issues identified in the preceding paragraphs create substantial doubt about our ability to continue as a going concern.

(3) Summary of Significant Accounting Policies

Use of Estimates

The preparation of the financial statements requires us to make a number of estimates and assumptions relating to the reported amount of assets and liabilities and the disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenue and expenses during the reporting period. Actual amounts could differ from those estimates.

Goodwill

We review our goodwill annually, or more frequently if circumstances warrant a more timely review, to determine if there has been an impairment. We review goodwill based upon one reporting unit, as our company is managed as one operating segment. In calculating the fair value of the reporting unit, we use various assumptions including estimated cash flows and discount rates. If estimated future cash flows decline from the current amounts projected by management, an impairment charge may be recorded. See discussion of our goodwill impairment in note 5.

Income Taxes

For the nine months ended September 30, 2012, income tax expense recorded represents the estimated income tax liability for certain state income taxes and deferred federal income tax expense associated with goodwill and other non-amortizable identifiable intangible assets that are amortizable and deductible for federal income tax purposes. We believe that it is more likely than not that no benefit or expense will be realized during 2012 for federal income taxes based on estimated federal taxable losses for 2012, other than the recurring deferred federal income tax expense associated with the goodwill and other non-amortizable identifiable intangible assets. We anticipate that federal net operating losses generated during 2012 will be offset by an increase in the valuation allowance against net deferred tax assets.

We follow the threshold of more-likely-than-not for recognition of tax benefits of uncertain tax positions taken or expected to be taken in a tax return. We record accrued interest and penalties associated with uncertain tax positions, if any, as income tax expense in the condensed consolidated statements of operations.

The federal statute of limitations remains open for original tax returns filed for 2008 through 2011. State jurisdictions generally have statutes of limitations ranging from three to five years. The state income tax impact of federal income tax changes remains subject to examination by various states for a period up to one year after formal notification to the states.

Stock Compensation

We estimate the fair value of our equity-based compensation awards on the date of grant, or the date of award modification if applicable, using the Black-Scholes option pricing model. The weighted average fair value of options granted during the nine months ended September 30, 2012 was nominal and was calculated based on the following assumptions: expected volatility of 40%, expected dividend yield of 0%, expected life of 6.25 years, and a risk-free interest rate of 1.38%. Expected volatility was derived using data drawn from other healthcare public companies for five to seven years prior to the date of grant. The expected life was computed utilizing the simplified method as permitted by the Securities and Exchange Commission’s Staff Accounting Bulletin No. 110, Share-Based Payment. The expected forfeiture rates are 50% and are based upon a review of our recent history and expectations. The risk-free interest rate is based on the approximate yield on seven-year United States Treasury Bonds as of the date of grant. There were 250,000 options granted during the nine months ended September 30, 2012 (see note 7).

Recent Accounting Pronouncements

In July 2012, the Financial Accounting Standards Board issued authoritative guidance that simplifies the indefinite-lived intangible asset impairment assessment by allowing a company to first review qualitative factors to determine the likelihood of whether the fair value of an indefinite-lived intangible asset is less than its carrying amount before applying the quantitative impairment test. If it is determined that it is more likely than not that the fair value of an indefinite-lived intangible asset is greater than its carrying amount, the company would not be required to perform the quantitative impairment test for that asset. This update became effective for interim

 

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and annual indefinite-lived intangible asset impairment tests performed for fiscal years beginning after September 15, 2012 with early adoption permitted. The adoption of this guidance is not expected to have a material impact on our business, financial position, results of operations or liquidity.

Reclassifications

Certain reclassifications have been made to the consolidated financial statements for prior periods to conform to the presentation of the 2011 condensed consolidated financial statements. Such reclassifications had no impact on net income or stockholder’s deficit.

(4) Net Patient Service Revenue

We recognize in our consolidated financial statements the impact of adjustments, if any, to Medicare reimbursement when the amounts can be reasonably determined. Net revenues for the three and nine months ended September 30, 2012 included adjustments of $0.8 million and $1.5 million, respectively, related to changes in estimates and settlements on prior year cost reports filed with the Medicare program, compared to adjustments of $(0.2) million and $(0.2) million for the three and nine months ended September 30, 2011, respectively. Approximately 64.7% and 59.9% of our total net patient service revenue for the nine months ended September 30, 2012 and 2011, respectively, came from Medicare reimbursement.

(5) Goodwill and Impairment Analysis

As a result of the impact of our actions with respect to our outstanding debt, acquisition offers received for our operations, and consideration of the current likelihood, format and timing of a potential capital restructuring or other alternative strategies, we concluded that impairment indicators existed which required us to perform an interim impairment test as of September 30 2012. We performed step one of the goodwill impairment test, which indicated that the fair value of our reporting unit was less than the book value of its net assets. Therefore the required second step of the assessment was performed, in which the implied fair value of goodwill was compared to its book value. The implied fair value of goodwill is determined in the same manner as the amount of goodwill recognized in a business combination, that is, the estimated fair value of the reporting unit is allocated to all assets and liabilities (including both recognized and unrecognized intangible assets) as if the reporting unit had been acquired in a business combination and the estimated fair value of the reporting unit was the purchase price paid. If the carrying amount of the goodwill is greater than the implied fair value of the goodwill, an impairment loss is recognized in the amount of the excess and is charged to operations. To determine fair value we must make assumptions about a wide variety of internal and external factors. Significant assumptions used in the impairment analysis include financial projections of free cash flow (including significant assumptions about operations in particular expected organic growth rates, future healthcare legislation and reimbursement rates, capital requirements and income taxes), long-term growth rates for determining terminal value, and discount rates. We determined the fair value of the reporting unit using the income approach, specifically, the discounted estimated future cash flows, as well as a market approach which considered the recent offers for our operations. Our estimates of discounted cash flows may differ from actual cash flows due to, among other things, economic conditions, changes to our business model or changes in operating performance. These factors increase the risk of differences between projected and actual performance that could impact future estimates of the fair value of the reporting unit.

As a result of our interim impairment assessment, we recognized a non-cash goodwill impairment charge of $85.7 million as of September 30, 2012. In our review of the carrying value of the other identifiable intangible assets, we noted no identifiable intangible impairment charges were required as of September 30, 2012. The impairment primarily results from our inability to negotiate a timely restructuring of our capital structure and the perceived value of our operations to market participants. The impairment did not have any impact on our compliance with our debt covenants or on our cash flows .

The assessment of the fair value of our assets and liabilities that was performed in the second step, fell within Level 3 of the fair value hierarchy due to the use of significant unobservable inputs to determine their nonrecurring fair value measurement. The present value of future cash flows and other market approaches were calculated using unobservable inputs. The amount and timing of future cash flows within our analysis was based on our most recent forecasts and other estimates. A restructuring of our debt could cause further impairment to our goodwill and our other identifiable intangible assets in future periods.

The changes in the carrying amount of goodwill are as follows (in thousands):

 

Goodwill at December 31, 2011, net of accumulated impairment losses of $169,034

   $ 264,512   

2012 impairment charge

     (85,700
  

 

 

 

Goodwill at September 30, 2012, net of accumulated impairment losses of $254,734

     178,812   
  

 

 

 

(6) Long-Term Debt

Long-term debt consists of the following (in thousands):

 

     September 30,
2012
    December 31,
2011
 

Senior secured credit facility—term loan

   $ 324,306      $ 313,182   

9 1/4% senior subordinated notes

     119,299        119,299   

Revolving credit facility

     16,000        —     

Note payable

     2,365        4,504   
  

 

 

   

 

 

 

Total long-term debt

     461,970        436,985   

Current portion of long-term debt

     (461,970     (5,912
  

 

 

   

 

 

 

Long-term debt, excluding current portion

   $ —        $ 431,073   
  

 

 

   

 

 

 

 

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Senior Secured Credit Facility

As a result of the impending maturities and increasingly more restrictive covenant requirements under our previous senior secured credit facility, we entered into a new senior secured credit facility on February 1, 2011, that consisted of (a) an initial $257.5 million senior secured term loan (subject to paid in kind interest options as discussed below) and (b) a senior secured revolving credit facility providing for borrowings of up to $30.0 million (the “Credit Agreement”). Availability of borrowings under the revolving credit facility are reduced by outstanding letters of credit, which were $9.0 million as of September 30, 2012. The proceeds of this new Credit Agreement along with available cash on hand were utilized to pay off our previous senior secured credit facility, revolving credit facility and the fees and expenses associated with the new Credit Agreement.

The terms of the Credit Agreement also provided that we had the right to request additional term loan commitments of up to $50.0 million. On August 1, 2011, in connection with the completion of the acquisition of five long-term acute care hospitals, which operate at seven locations, from HealthSouth Corporation, we borrowed $47.2 million of the available $50.0 million.

Borrowings under the term loan facility of the Credit Agreement bear interest at a rate per annum equal to an applicable margin plus, at our option, either (a) an alternate base rate determined by reference to the highest of (1) the prime rate of JPMorgan Chase Bank, N.A., (2) the federal funds rate in effect on such date plus 0.50% and (3) the LIBOR rate for a one month interest period plus 1% or (b) a LIBOR rate determined by reference to the cost of funds for U.S. dollar deposits for the relevant interest period adjusted for certain additional costs. The applicable margin percentage is 12.25% for term loans that are alternate base rate loans and 13.25% for term loans based on the LIBOR rate. For the term loans, we may, in our discretion, elect for the relevant interest period (a) to pay the entire amount of interest in cash or (b) to pay 5.50% of such interest “in-kind” by adding such interest to the outstanding principal of the term loans as of the applicable interest payment date. The average interest rate for the term loan facility for the nine months ended September 30, 2012 and 2011, was 13.75% and 12.85%, respectively. At September 30, 2012 and December 31, 2011, the weighted average interest rate applicable to the outstanding amounts under our term loan facility was 13.71% and 13.65%, respectively. Additionally, we are paying another 2% interest during the Waiver Period on amounts outstanding under the senior secured credit facility in relation to the Agreement as discussed in note 2.

The applicable margin percentage is 6.75% for revolving loans that are alternate base loans and 7.75% for revolving loans that are based on the LIBOR rate, subject to quarterly adjustments based on our leverage ratio (as defined in the new senior secured credit agreement). In addition to paying interest on outstanding principal under the senior secured credit agreement, we are required to pay a commitment fee of 0.50% per annum in respect of the unutilized commitments under the revolving credit facility, subject to quarterly adjustment based on our leverage ratio (as defined in the Credit Agreement). We are also required to pay annual customary agency fees.

We are required to make scheduled quarterly payments under the senior secured term loan facility equal to 0.25% of the original principal amount of the term loan and the additional principal amount borrowed on August 1, 2011, with the balance payable on February 1, 2016. Additionally, we are required to prepay outstanding term loans under this agreement with (a) 100% of the net cash proceeds of any debt or equity issued by us or our restricted subsidiaries (with exceptions for certain debt permitted to be incurred or equity permitted to be issued under the agreement), (b) 75% (which percentage will be reduced to 50% if our senior secured leverage ratio (as defined in the Credit Agreement) is less than 4:00 to 1:00) of our annual excess cash flow (as defined in the Credit Agreement), and (c) 100% of the net cash proceeds of certain asset sales or other dispositions of property by us or our restricted subsidiaries, subject to reinvestment rights and certain other exceptions specified in the Credit Agreement. Mandatory prepayments of the term loans, subject to certain exceptions, are subject to a prepayment fee of 2% if such repayment occurs after February 1, 2012 and on or prior to February 1, 2013, and 1% if such prepayment occurs after February 1, 2013 and on or prior to February 1, 2014.

We may voluntarily prepay outstanding loans under the term loan facility and reduce the unutilized portion of the commitment amount in respect of the senior secured revolving credit facility at any time. Any such voluntary prepayments are subject to a prepayment fee of 2% if such prepayment occurs after February 1, 2012 and on or prior to February 1, 2013, and 1% if such prepayment occurs after February 1, 2013 and on or prior to February 1, 2014. Other than as described above, prepayments are not subject to any premium or penalty other than customary “breakage” costs with respect to loans based on the LIBOR rate.

The term loan and revolving credit facility under the Credit Agreement have scheduled maturity dates of February 1, 2016, and February 1, 2015, respectively. However, if our outstanding senior subordinated notes are not refinanced, purchased or defeased in full by May 15, 2013, then the term loan and the then outstanding balance under the revolving credit facility will be due in full on May 15, 2013.

 

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The Credit Agreement also imposes certain financial covenants on us including: a maximum ratio of 5.75x consolidated EBITDA to total senior secured indebtedness tested quarterly; and a minimum ratio of 1.25x consolidated EBITDA to consolidated cash interest expense, tested quarterly. Our leverage ratio was 5.48x, and our interest coverage ratio was 1.50x at September 30, 2012. The maximum leverage ratio is scheduled to adjust to 5.50x beginning with the trailing four quarter period ending March 31, 2013. The minimum interest coverage ratio is scheduled to adjust to 1.30x beginning with the trailing four quarter period ending March 31, 2013. We are currently in compliance with these financial covenants of our senior secured credit facility, however, see discussion in note 2 regarding other violations.

The Credit Agreement is secured by substantially all of our tangible and intangible assets, except for assets held by subsidiaries that have been designated as nonguarantor subsidiaries. The Credit Agreement also contains certain customary representations and warranties, affirmative covenants and events of default, including payment defaults, breach of representations and warranties, covenant defaults, cross defaults to certain material indebtedness, certain events of bankruptcy, certain events under ERISA, change of control, material judgments, failure of certain guaranty documents to be in full force and effect and failure of a lien to have the priority or otherwise be valid and perfected with respect to material collateral.

If we are unable to maintain compliance with the covenants and requirements contained in the Credit Agreement, an event of default would occur, unless we are able to obtain a waiver or enter into an amendment with the senior lenders to revise the covenants and requirements. If any such event of default occurs, the lenders under the Credit Agreement would be entitled to take various actions, including the acceleration of amounts due under the Credit Agreement, terminating access to our revolving credit facility, and all actions permitted to be taken by a secured creditor. If we are required to obtain a waiver or execute an amendment to the Credit Agreement, it is likely we will incur additional fees and expenses, and will be required to pay a higher interest margin on our outstanding indebtedness in subsequent periods. An event of default would have a material adverse effect on our financial position, results of operations and cash flow.

See note 2 – “Liquidity and Uncertainties Related to Going Concern” for additional disclosures regarding of our capital structure.

(7) Stock Options

At September 30, 2012, there were 2.9 million shares of common stock of Holdings available under the 2005 Equity Incentive Plan (“Plan”) for stock option grants and other incentive awards, including restricted stock units. Options granted generally have an exercise price equal to the fair market value of the shares on the date of grant and expire 10 years from the date of grant. A restricted stock unit is a contractual right to receive one share of Holdings common stock in the future. Options typically vest one-quarter on each of the first four anniversary dates of the grant and restricted stock units typically vest in three equal annual installments.

For the three months and nine months ended September 30, 2012 and 2011, there was no pre-tax compensation costs related to our stock-based compensation arrangements.

The following table summarizes stock option activity during the nine months ended September 30, 2012:

 

     Number of
Shares
    Weighted
average
exercise
price
 

Balance at December 31, 2011

     1,691,250      $ 2.50   

Granted

     250,000        2.50   

Exercised

     —          —     

Forfeited

     (20,000     2.50   

Expired

     (77,250     2.50   
  

 

 

   

Balance at September 30, 2012

     1,844,000      $ 2.50   
  

 

 

   

At September 30, 2012, the weighted average remaining contractual life of outstanding options was 6.4 years. There were 1.3 million stock options exercisable at September 30, 2012. At September 30, 2012, the weighted average exercise price of the vested stock options was $2.50, the remaining weighted average contractual life was 5.4 years and they had no intrinsic value. As of September 30, 2012, there was no unrecognized compensation costs related to stock options.

Restricted Stock Awards

There have been no restricted stock awards issued during the nine months ended September 30, 2012. As of September 30, 2012, there was no unrecognized compensation costs related to restricted stock awards.

 

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Warrants

In connection with the acquisition of the long-term acute care hospitals from HealthSouth Corporation in 2011, we granted warrants to purchase 1.3 million shares, or 6.25%, of Holdings’ common stock, with an exercise price of $0.01 per share to HealthCare REIT, Inc. The warrants expire on the later of December 31, 2026 or the termination of the lease agreement. These warrants were determined to have no value on the grant date.

(8) Regulatory Matters

All healthcare providers are required to comply with a significant number of laws and regulations at the federal and state government levels. These laws are extremely complex, and in many instances, providers do not have the benefit of significant regulatory or judicial interpretation as to how to interpret and/or apply these laws and regulations. The U.S. Department of Justice and other federal and state agencies are increasing resources dedicated to regulatory investigations and compliance audits of healthcare providers. As a healthcare provider, we are subject to these regulatory efforts. Healthcare providers that do not comply with these laws and regulations may be subject to civil or criminal penalties, the loss of their licenses, or restriction in their ability to participate in various federal and state healthcare programs. We endeavor to conduct our business in compliance with applicable laws and regulations, including healthcare fraud and abuse laws.

As a result of our hospital’s state licensures and certifications under the Medicare and various Medicaid programs, we are subject to regular reviews, surveys, audits and investigations conducted by, or on the behalf of, the federal and state agencies, including the Centers for Medicare & Medicaid Services (“CMS”), that are responsible for the oversight of these programs. These agencies’ reviews may include reviews or surveys of our compliance with required conditions of participation regulations. The purpose of these surveys is to ensure that healthcare providers are in compliance with governmental requirements, including requirements such as adequacy of medical care, equipment, personnel, operating policies and procedures, maintenance of adequate records, compliance with building codes and environmental protection and healthcare fraud and abuse. These surveys may identify deficiencies with conditions of participation which require corrective actions to be made by the hospital within a given timeline. If a hospital is not successful in addressing the deficiencies and conditions in a timely manner, then CMS reserves the right to deem the hospital to be out of compliance with Medicare conditions of participation and may terminate the hospital from participation in the Medicare program.

We have recorded accrued liabilities for such regulatory matters that are both probable and can be reasonably estimated.

(9) Commitments and Contingencies

We have certain pending and threatened litigation and claims incurred in the ordinary course of business. We believe (based, in part, on the advice of legal counsel) that the probable resolution of such contingencies will not exceed our insurance coverage and will not materially affect our consolidated financial position, results of operations or liquidity.

(10) Fair Value of Financial Instruments

The carrying amount of cash and cash equivalents, accounts receivable, third-party payor settlements, and accounts payable and accrued expenses approximates fair value because of the short-term maturity of these instruments. The carrying amount of these obligations is a reasonable estimate of fair value.

We follow the guidance for the fair value hierarchy that requires an entity to maximize the use of observable inputs and minimize the use of subjective inputs when measuring fair value. The guidance describes three levels of inputs that may be used to measure fair value:

Level 1—Inputs are unadjusted, quoted prices in active markets for identical assets or liabilities at the measurement date.

Level 2—Inputs (other than prices included in Level 1) are either directly or indirectly observable, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active, and other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.

Level 3—Inputs are unobservable and reflect management’s best estimate of what market participants would use in pricing the asset or liability at the measurement date. Consideration is given to the risk inherent in the valuation technique and the risk inherent in the inputs to the model.

The Senior Secured Credit Facility and the Senior Subordinated Notes are traded in private institutional markets. The carrying amounts of the Senior Secured Credit Facility and the Senior Subordinated Notes were $324.3 million and $119.3 million, respectively, at September 30, 2012. Using available quoted market prices, the fair values of the Senior Secured Credit Facility and the Senior Subordinated Notes were approximately $306.9 million and $44.1 million, respectively, at September 30 2012. The carrying amount of the Senior Secured Credit Facility and the Senior Subordinated Notes was $313.2 million and $119.3 million, respectively, at December 31, 2011. Using available quoted market prices, the fair values of the Senior Secured Credit Facility and the Senior Subordinated Notes were approximately $261.5 million and $92.5 million, respectively, at December 31, 2011. The fair values are

 

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based on quoted market prices at each balance sheet date; however, these quoted market prices represent Level 2 inputs as the markets in which the Senior Secured Credit Facility and the Senior Subordinated Notes trade are not active. The carrying value of the note payable to Vibra was $2.4 million at September 30, 2012. Using available quoted market prices for our other debt as a basis, we estimated the fair market value of the note payable at $2.3 million at September 30, 2012. The carrying value of the note payable related to the Vibra acquisition was $4.5 million at December 31, 2011. Using available quoted market prices for our other debt as a basis, we estimated the fair market value of the note payable at $4.5 million at December 31, 2011. This valuation is categorized as a Level 2 in the valuation hierarchy. The revolving credit facility has a carrying value of $16.0 million at September 30, 2012. Using available quoted market prices for the Senior Secured Credit Facility as a basis, we estimated the fair market value of the revolving credit facility at $14.2 million at September 30, 2012. This valuation is categorized as a Level 2 in the valuation hierarchy.

(11) Exit Cost

On December 1, 2011, we purchased selected assets of a long-term acute care hospital from Vibra, pursuant to an Asset Purchase Agreement. In connection with the acquisition, we relocated and merged our existing operations into the operating location formerly utilized by Vibra. In addition, we entered into an early termination agreement with the landlord for the lease of our former operating location whereby we will pay an early termination fee of $1.8 million, payable over an 18 month period, ending June 30, 2013. This fee, along with other costs associated with the abandonment of the facility, was accrued as exit cost as of December 31, 2011.

The following table summarizes the activity of the accrued exit cost for the nine months ended September 30, 2012 (in thousands):

 

Accrued exit cost at December 31, 2011

   $ 2,296   

Payments made

     (1,426
  

 

 

 

Accrued exit cost at September 30, 2012

   $ 870   
  

 

 

 

12) Acquisition

On August 1, 2011, we purchased five long-term acute care hospitals, which operate at seven locations, from HealthSouth Corporation and certain affiliates of HealthSouth Corporation, pursuant to an Asset Purchase Agreement.

On December 1, 2011, we purchased selected assets of a long-term acute care hospital from Vibra, pursuant to an Asset Purchase Agreement. According to the agreement, we acquired substantially all of the inventory and equipment, along with some indentified liabilities.

The following pro forma information assumes the acquisitions had occurred at the beginning of the earliest period presented. Such results have been prepared by adjusting our historical results to include the results of operations, exit cost, depreciation, amortization of acquired definite-lived intangibles and incremental interest related to acquisition debt related to the entities acquired during the year. The pro forma results do not include any cost savings that may result from the combination of the Company and facilities acquired. The pro forma results may not necessarily reflect the consolidated operations that would have existed had the acquisition been completed at the beginning of such period nor are they necessarily indicative of future results. Amounts are in thousands of dollars.

 

     Nine months  ended
September 30, 2011
 
     Pro Forma  

Net patient service revenues

   $ 337,407   

Net loss

   $ (12,501

(13) Financial Information for Subsidiary Guarantors and Nonguarantor Subsidiaries under the Senior Subordinated Notes

The senior subordinated notes are fully and unconditionally guaranteed by substantially all of our wholly-owned subsidiaries (the “Subsidiary Guarantors”), however, certain of our subsidiaries did not guarantee the senior subordinated notes (the Nonguarantor Subsidiaries”).

Presented below is condensed consolidating financial information for LifeCare Holdings, Inc., the Subsidiary Guarantors, and the Nonguarantor Subsidiaries for the three and nine months ended at September 30, 2012 and 2011. The equity method has been used with respect to investments in subsidiaries. Separate financial statements of the Subsidiary Guarantors are not presented.

 

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Table of Contents

LifeCare Holdings, Inc.

Condensed Consolidating Balance Sheet

September 30, 2012

(in thousands)

 

     Parent     Guarantor
Subsidiaries
     Nonguarantor
Subsidiaries
    Eliminations     Consolidated
Totals
 
Assets            

Current assets:

           

Cash and cash equivalents

   $ —       $ 13,280       $ 18,260      $ —        $ 31,540   

Accounts receivable, net of allowance for doubtful accounts

     —         77,140         1,477        —          78,617   

Due to/from related parties

     (57,300     79,046         (21,746     —          —     

Other current assets

     —         9,358         674        —          10,032   
  

 

 

   

 

 

    

 

 

   

 

 

   

 

 

 

Total current assets

     (57,300     178,824         (1,335     —          120,189   

Investment in subsidiaries

     378,103        —          —         (378,103     —     

Property and equipment, net

     —         49,839         19,488        —          69,327   

Other assets, net

     8,429        5,333         1,934        —          15,696   

Identifiable intangibles, net

     —         38,128         —         —          38,128   

Goodwill

     —         178,812         0        —          178,812   
  

 

 

   

 

 

    

 

 

   

 

 

   

 

 

 

Total assets

   $ 329,232      $ 450,936       $ 20,087      $ (378,103   $ 422,152   
  

 

 

   

 

 

    

 

 

   

 

 

   

 

 

 
Liabilities and Stockholder’s Equity (Deficit)            

Current liabilities:

           

Current portion of long-term debt

   $ 459,605      $ 2,365       $ —       $ —        $ 461,970   

Current installments of obligations under capital leases

     —         183         7        —          190   

Current installments of lease financing obligation

     —         —          551        —          551   

Estimated third party payor settlements

     —         2,319         3,058        —          5,377   

Accounts payable

     344        22,565         420        —          23,329   

Accrued payroll

     —         5,456         143        —          5,599   

Accrued vacation

     —         6,950         171        —          7,121   

Accrued interest

     16,918        —          —         —          16,918   

Accrued other

     —         9,104         197        —          9,301   

Income taxes payable

     —         239         —         —          239   
  

 

 

   

 

 

    

 

 

   

 

 

   

 

 

 

Total current liabilities

     476,867        49,181         4,547        —          530,595   

Obligations under capital leases, excluding current installments

     —         56         —         —          56   

Lease financing obligation, excluding current installments

     —         —          18,621        —          18,621   

Accrued insurance

     —         5,823         —         —          5,823   

Other noncurrent liabilities

     6,091        14,692         —         —          20,783   
  

 

 

   

 

 

    

 

 

   

 

 

   

 

 

 

Total liabilities

     482,958        69,752         23,168        —          575,878   

Stockholder’s equity (deficit):

           

Common stock

     —          —           —          —          —     

Additional paid-in capital

     175,441        63         12,580        (12,643     175,441   

Retained earnings (accumulated deficit)

     (329,167     381,121         (15,661     (365,460     (329,167
  

 

 

   

 

 

    

 

 

   

 

 

   

 

 

 

Total stockholder’s equity (deficit)

     (153,726     381,184         (3,081     (378,103     (153,726
  

 

 

   

 

 

    

 

 

   

 

 

   

 

 

 
   $ 329,232      $ 450,936       $ 20,087      $ (378,103   $ 422,152   
  

 

 

   

 

 

    

 

 

   

 

 

   

 

 

 

 

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LifeCare Holdings, Inc.

Condensed Consolidating Balance Sheet

December 31, 2011

(in thousands)

     Parent     Guarantor
Subsidiaries
    Nonguarantor
Subsidiaries
    Eliminations     Consolidated
Totals
 
Assets           

Current assets:

          

Cash and cash equivalents

   $ —        $ 11,568      $ 1      $ —        $ 11,569   

Accounts receivable, net of allowance for doubtful accounts

     —          87,644        3,720        —          91,364   

Due to/from related parties

     42,281        (38,735     (3,546     —          —     

Other current assets

     —          9,472        772        —          10,244   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total current assets

     42,281        69,949        947        —          113,177   

Investment in subsidiaries

     346,849        —          —          (346,849     —     

Property and equipment, net

     —          53,431        20,336        —          73,767   

Other assets, net

     16,502        4,545        1,659        —          22,706   

Identifiable intangibles, net

     —          38,323        —          —          38,323   

Goodwill

     —          264,512        —          —          264,512   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total assets

   $ 405,632      $ 430,760      $ 22,942      $ (346,849   $ 512,485   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 
Liabilities and Stockholder’s Equity (Deficit)           

Current liabilities:

          

Current portion of long-term debt

   $ 3,047      $ 2,865      $ —        $ —        $ 5,912   

Current installments of obligations under capital leases

     —          389        25        —          414   

Current installments of lease financing obligation

     —          —          519        —          519   

Estimated third party payor settlements

     —          6,245        3,042        —          9,287   

Accounts payable

     262        29,026        1,703        —          30,991   

Accrued payroll

     —          9,801        5        —          9,806   

Accrued vacation

     —          6,393        196        —          6,589   

Accrued interest

     13,705        —          —          —          13,705   

Accrued other

     —          9,621        151        —          9,772   

Income taxes payable

     —          663        —          —          663   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total current liabilities

     17,014        65,003        5,641        —          87,658   

Long-term debt, excluding current portion

     429,434        1,639        —          —          431,073   

Obligations under capital leases, excluding current installments

     —          86        3        —          89   

Lease financing obligation, excluding current installments

     —          —          19,038        —          19,038   

Accrued insurance

     —          4,102        —          —          4,102   

Other noncurrent liabilities

     5,500        11,341        —          —          16,841   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total liabilities

     451,948        82,171        24,682        —          558,801   

Stockholder’s equity (deficit):

          

Common stock

     —          —          —          —          —     

Additional paid-in capital

     175,441        63        12,580        (12,643     175,441   

Retained earnings (accumulated deficit)

     (221,757     348,526        (14,320     (334,206     (221,757
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total stockholder’s equity (deficit)

     (46,316     348,589        (1,740     (346,849     (46,316
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 
   $ 405,632      $ 430,760      $ 22,942      $ (346,849   $ 512,485   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

16


Table of Contents

LifeCare Holdings, Inc. and Subsidiaries

Condensed Consolidating Statement of Operations

For the Three Months Ended September 30, 2012

(in thousands)

     Parent     Guarantor
Subsidiaries
    Nonguarantor
Subsidiaries
    Eliminations     Consolidated
Totals
 

Net patient service revenue

   $ —       $ 116,037      $ 3,807      $ —        $ 119,844   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Salaries, wages and benefits

     —         56,143        1,825        —          57,968   

Supplies

     —         10,815        307        —          11,122   

Rent

     —         9,737        271        —          10,008   

Other operating expenses

     304        24,310        887        —          25,501   

Provision for doubtful accounts

     —         1,124        57        —          1,181   

Depreciation and amortization

     —         1,924        290        —          2,214   

Reorganization cost

     —         5,717        —         —          5,717   

Goodwill impairment charge

     —         85,700        —         —          85,700   

Intercompany (income) expenses

     85,142        (85,339     197              —          —    

Interest expense, net

     17,712        177        400        —          18,289   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     103,158        110,308        4,234        —          217,700   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating income (loss)

     (103,158     5,729        (427     —          (97,856

Earnings in investments in subsidiaries

     (5,493     —         —         5,493        —    

Equity in income of joint venture

     —         —         124        —          124   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     (97,665     5,729        (303     (5,493     (97,732

Benefit from income taxes

     (162     (67     —         —          (229
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

   $ (97,503   $ 5,796      $ (303   $ (5,493   $ (97,503
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

17


Table of Contents

LifeCare Holdings, Inc. and Subsidiaries

Condensed Consolidating Statement of Operations

For the Nine Months Ended September 30, 2012

(in thousands)

     Parent     Guarantor
Subsidiaries
    Nonguarantor
Subsidiaries
    Eliminations     Consolidated
Totals
 

Net patient service revenue

   $ —       $ 355,709      $ 11,528      $ —        $ 367,237   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Salaries, wages and benefits

     6        168,354        5,807        —          174,167   

Supplies

     —         34,044        940        —          34,984   

Rent

     —         30,304        828        —          31,132   

Other operating expenses

     885        75,044        2,877        —          78,806   

Provision for doubtful accounts

     —         3,263        165        —          3,428   

Depreciation and amortization

     —         6,187        880        —          7,067   

Reorganization cost

     —         5,717        —         —          5,717   

Goodwill impairment charge

     —         85,700        —         —          85,700   

Intercompany (income) expenses

     85,791        (86,383     592              —          —     

Interest expense, net

     51,390        643        1,232        —          53,265   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     138,072        322,873        13,321        —          474,266   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating income (loss)

     (138,072     32,836        (1,793     —          (107,029

Earnings in investments in subsidiaries

     (31,253     —         —         31,253        —     

Equity in income of joint venture

     —         —         451        —          451   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     (106,819     32,836        (1,342     (31,253     (106,578

Provision for (benefit from) income taxes

     591        241        —         —          832   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

   $ (107,410   $ 32,595      $ (1,342   $ (31,253   $ (107,410
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

18


Table of Contents

LifeCare Holdings, Inc.

Condensed Consolidating Statement of Operations

For the Three Months Ended September 30, 2011

(in thousands)

 

     Parent     Guarantor
Subsidiaries
    Nonguarantor
Subsidiaries
    Eliminations     Consolidated
Totals
 

Net patient service revenue

   $ —        $ 98,363      $ 4,236      $ —        $ 102,599   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Salaries, wages and benefits

     3        48,461        2,062        —          50,526   

Supplies

     —          10,159        381        —          10,540   

Rent

     —          8,444        241        —          8,685   

Other operating expenses

     240        25,055        1,151        —          26,446   

Provision for doubtful accounts

     —          1,706        75        —          1,781   

Depreciation and amortization

     —          2,047        307        —          2,354   

Intercompany (income) expenses

     308        (549     241        —          —     

Interest expense, net

     15,145        20        406        —          15,571   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     15,696        95,343        4,864        —          115,903   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating income (loss)

     (15,696     3,020        (628     —          (13,304

Earnings in investments in subsidiaries

     (2,377     —          —          2,377        —     

Equity in income of joint venture

     —          —          85        —          85   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     (13,319     3,020        (543     (2,377     (13,219

Provision for income taxes

     —          100        —          —          100   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

   $ (13,319   $ 2,920      $ (543   $ (2,377   $ (13,319
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

19


Table of Contents

LifeCare Holdings, Inc.

Condensed Consolidating Statement of Operations

For the Nine Months Ended September 30, 2011

(in thousands)

 

     Parent     Guarantor
Subsidiaries
    Nonguarantor
Subsidiaries
    Eliminations     Consolidated
Totals
 

Net patient service revenue

   $ —        $ 279,084      $ 14,426      $ —        $ 293,510   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Salaries, wages and benefits

     9        133,766        6,166        —          139,941   

Supplies

     —          28,216        1,138        —          29,354   

Rent

     —          21,196        682        —          21,878   

Other operating expenses

     613        65,138        3,637        —          69,388   

Provision for doubtful accounts

     —          4,129        238        —          4,367   

Loss on early extinguishment of debt

     2,772        —          —          —          2,772   

Depreciation and amortization

     —          5,596        932        —          6,528   

Intercompany (income) expenses

     1,976        (2,908     932        —          —     

Interest expense, net

     39,636        (1     1,210        —          40,845   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     45,006        255,132        14,935        —          315,073   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Operating income (loss)

     (45,006     23,952        (509     —          (21,563

Earnings in investments in subsidiaries

     (23,455     —          —          23,455        —     

Equity in income of joint venture

     —          —          562        —          562   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Income (loss) before income taxes

     (21,551     23,952        53        (23,455     (21,001

Provision for income taxes

     —          550        —          —          550   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net income (loss)

   $ (21,551   $ 23,402      $ 53      $ (23,455   $ (21,551
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

20


Table of Contents

LifeCare Holdings, Inc. and Subsidiaries

Condensed Consolidating Statement of Cash Flows

For the Nine Months Ended September 30, 2012

(in thousands)

 

     Parent     Guarantor
Subsidiaries
    Nonguarantor
Subsidiaries
    Eliminations     Consolidated  

Cash flows from operating activities:

          

Net income (loss)

   $ (107,410   $ 32,595      $ (1,342   $ (31,253   $ (107,410

Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:

          

Depreciation and amortization (including amortization of debt issuance cost)

     8,072        6,151        880        —          15,103   

Provision for doubtful accounts

     —         3,263        165        —          3,428   

Paid in kind interest

     13,408        —         —         —          13,408   

Goodwill impairment charge

     —         85,700        —         —          85,700   

Equity in income of joint venture

     —         —         (451           —          (451

Deferred income taxes

     591        —         —           591   

Amortization of debt discount

     —         361        —         —          361   

Changes in operating assets and liabilities:

          

Accounts receivable

     —         7,241        2,078        —          9,319   

Income taxes

     —         (424     —         —          (424

Other current assets

     —         114        98        —          212   

Change in investments in subsidiaries

     (31,253     —         —         31,253        —     

Other assets

     —         (787     177        —          (610

Due to/from related parties

     99,575        (117,776     18,201        —          —     

Estimated third party payor settlements

     —         (3,924     15        —          (3,909

Accounts payable and accrued expenses

     3,302        (10,774     (1,124     —          (8,596

Other noncurrent liabilities

     —         5,072        —          —          5,072   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash provided by (used in) operating activities

     (13,715     6,812        18,697        —          11,794   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash flows from investing activities:

          

Purchases of property and equipment

     —         (2,245     (32     —          (2,277
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash used in investing activities

     —         (2,245     (32     —          (2,277
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash flows from financing activities:

          

Borrowings on revolving credit facility

     34,500        —          —          —          34,500   

Payments on revolving credit facility

     (18,500     —          —          —          (18,500

Payments of long-term debt

     (2,285     (2,500     —          —          (4,785

Payments on obligations under capital leases

     —         (355     (20     —          (375

Payments on lease financing obligation

     —         —          (386     —          (386
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash provided by (used in) financing activities

     13,715        (2,855     (406     —          10,454   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net increase in cash and cash equivalents

     —         1,712        18,259        —          19,971   

Cash and cash equivalents, beginning of period

     —         11,568        1        —          11,569   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash and cash equivalents, end of period

   $ —       $ 13,280      $ 18,260      $ —        $ 31,540   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

21


Table of Contents

LifeCare Holdings, Inc.

Condensed Consolidating Statement of Cash Flows

For the Nine Months Ended September 30, 2011

(in thousands)

 

     Parent     Guarantor
Subsidiaries
    Nonguarantor
Subsidiaries
    Eliminations     Consolidated  

Cash flows from operating activities:

          

Net income (loss)

   $ (21,551   $ 23,402      $ 53      $ (23,455   $ (21,551

Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:

          

Depreciation and amortization (including amortization of debt issuance cost)

     5,351        5,596        932        —          11,879   

Provision for doubtful accounts

     —          4,129        238        —          4,367   

Paid in kind interest

     6,517        —          —          —          6,517   

Loss on early extinguishment of debt

     2,772        —          —          —          2,772   

Equity in income of joint venture

     —          —          (562     —          (562

Changes in operating assets and liabilities:

          

Accounts receivable

     —          (15,267     2,636        —          (12,631

Income taxes

     —          191        —          —          191   

Other current assets

     —          (936     (347     —          (1,283

Change in investments in subsidiaries

     (23,455     —          —          23,455        —     

Other assets

     —          (2,835     —          —          (2,835

Due to/from related parties

     22,454        (19,176     (3,278     —          —     

Estimated third party payor settlements

     —          4,564        482        —          5,046   

Accounts payable and accrued liabilities

     3,521        2,033        380        —          5,934   

Other noncurrent liabilities

     —          2,231        —          —          2,231   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash provided by (used in) operating activities

     (4,391     3,932        534        —          75   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash flows from investing activities:

          

Purchases of property and equipment

     —          (3,113     (52     —          (3,165

Payments for acquisition

     —          (33,262     —          —          (33,262
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash used in investing activities

     —          (36,375     (52     —          (36,427
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash flows from financing activities:

          

Deferred financing costs

     (22,291     —          —          —          (22,291

Payments under the line of credit

     (35,000     —          —          —          (35,000

Proceeds from long–term debt

     304,700        —          —          —          304,700   

Payments of long–term debt

     (243,018     —          —          —          (243,018

Payments on obligations under capital leases

     —          (567     (126     —          (693

Payments on lease financing obligation

     —          —          (356     —          (356
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net cash provided by (used in) financing activities

     4,391        (567     (482     —          3,342   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Net decrease in cash and cash equivalents

     —          (33,010     —          —          (33,010

Cash and cash equivalents, beginning of period

     —          54,569        1        —          54,570   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

Cash and cash equivalents, end of period

   $ —        $ 21,559      $ 1      $ —        $ 21,560   
  

 

 

   

 

 

   

 

 

   

 

 

   

 

 

 

 

22


Table of Contents
ITEM 2: MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

This discussion and analysis should be read in conjunction with our condensed consolidated financial statements and the accompanying notes.

Company Overview

We began operations in 1993 and have grown our business through developing and acquiring hospitals to become a leading operator of long-term acute care (“LTAC”) hospitals in the United States. As of September 30, 2012, we operated 27 hospitals located in ten states, consisting of eight “hospital within a hospital” facilities (20% of beds) and 19 freestanding facilities (80% of beds). Through these 27 long-term acute care hospitals, we operate a total of 1,390 licensed beds. We employ approximately 4,600 people, the majority of whom are registered or licensed nurses and respiratory therapists. Additionally, we hold a 50% investment in a joint venture for a 51-bed LTAC hospital located in Muskegon, Michigan.

We believe we have developed a reputation for excellence in providing treatment for patients with complex medical needs requiring extended treatment. Our patients have serious medical conditions such as respiratory failure, chronic pulmonary disease, nervous system disorders, infectious diseases and severe wounds. They generally require a high level of monitoring and specialized care, yet may not require the continued services of an intensive care unit. Due to their serious medical conditions, our patients are generally not clinically appropriate for admission to a skilled nursing facility or inpatient rehabilitation facility. By combining general acute care services with a focus on long-term treatment, we believe that our hospitals provide medically complex patients with better and more cost-effective outcomes.

LifeCare Holdings, Inc. (the “Company”) is a wholly owned subsidiary of LCI Holdco, LLC (“Holdco”). Holdco is a wholly owned subsidiary of LCI Intermediate Holdco, Inc. (“Intermediate Holdco”). Intermediate Holdco is a wholly owned subsidiary of LCI Holding Company, Inc. (“Holdings”), which is owned by an investor group that includes affiliates of The Carlyle Group and members of our senior management and board of directors. The investor group acquired Holdings pursuant to a merger that occurred on August 11, 2005 (the “Merger”).

Liquidity and Uncertainties Related to Going Concern

As of September 30, 2012, we had $462.0 million of debt outstanding (including outstanding borrowings under our revolving credit facility) consisting of our senior secured term loan credit facility in an outstanding principal amount of $324.3 million, which matures on February 1, 2016, our senior subordinated notes in an outstanding principal amount of $119.3 million, which mature on August 11, 2013, our note payable to Vibra Specialty Hospital of Dallas LLC (“Vibra”) in an outstanding principal amount of $2.4 million, which matures on June 1, 2013, and our revolving credit facility, which matures on February 1, 2015, in an outstanding principal amount of $16.0 million. Additionally as of September 30, 2012, we have issued and outstanding letters of credit of $9.0 million. The scheduled maturity dates of the senior secured term loan and revolving credit facility will accelerate to May 15, 2013, if the senior subordinated notes are not refinanced, purchased or defeased in full by May 15, 2013.

Given our current capital structure and operating cash flows, it is unlikely that we will be able to refinance, purchase or defease the senior subordinated notes by May 15, 2013. As a result, our senior secured credit facility and revolving credit facility continue to be reflected as current liabilities. Additionally, an event of default will occur under the indenture governing the senior subordinated notes in the event the senior secured term loan credit facility maturity is accelerated. Accordingly, we have also classified the senior subordinated notes as a current liability. In light of these circumstances, on May 8, 2012, we engaged Rothschild, Inc. as a financial advisor to assist us in evaluating strategic alternatives for our capital structure as it relates to the pending maturity of our senior subordinated notes and the potential accelerated maturity of our senior secured term loan. We have recorded $5.7 million as reorganization costs, which represents professional fees paid to Rothschild, Inc., attorneys and other advisors to assist in our consideration and evaluation of various strategic alternatives in connection with our capital restructuring.

We did not pay the interest payment due on August 15, 2012 under our senior subordinated notes in the amount of $5.5 million. The failure to make this payment constituted an event of default under the indenture governing the senior subordinated notes upon expiration of the 30-day payment grace period. The failure to make the senior subordinated notes interest payment prior to the end of such grace period resulted in an event of default under our senior secured credit facility. The occurrence of an event of default under these agreements could permit the holders to accelerate such indebtedness.

On September 14, 2012, we entered into a Limited Waiver and First Amendment to Credit Agreement and Termination of Revolving Commitments with our senior secured facility holders, which was extended on November 1, 2012 (as extended, the “Agreement”). The Agreement (i) waived any default or event of default arising from the failure of us to make the required interest payment on our senior subordinated notes due on August 15, 2012 and to remedy such failure within the applicable 30-day payment grace period that ended on September 14, 2012 during the Waiver Period (as defined below), (ii) effected certain amendments to the senior secured term loan and revolving credit facility, including terminating access to our revolving credit facility and limits on making certain payments to The Carlyle Group and employees, (iii) permanently terminated all unused revolving commitments under the senior secured revolving credit facility and (iv) waived certain other defaults and events of default during the Waiver Period.

As extended the “Waiver Period” is the period from September 14, 2012 to the earlier of (i) December 15, 2012 and (ii) the occurrence of any waiver default, which will occur immediately upon the occurrence of certain events, including (a) the occurrence of a default or event of default under the senior secured credit facility not arising from the failure to make the interest payment on the senior subordinated notes (other than those otherwise waived by the Agreement), (b) the entry into certain refinancing transactions, (c) the making of payments under the senior subordinated notes or certain other of our outstanding indebtedness, (d) the occurrence of an event of default under the senior subordinated notes or the termination of the waiver agreement for the senior subordinated notes, as discussed below, or (e) any material amendment to our existing employee retention plans or adoption of new employee retention plans without approval. The occurrence of certain other events, including our failure to comply with the terms, conditions or covenants of the Agreement, will constitute a default of the waiver if such events remain uncured for five business days after written notice is provided to us.

During the Waiver Period, loans outstanding under the senior secured term loan credit facility will bear interest at a rate of 2% plus the rate otherwise applicable to such loan, which additional interest will be payable half as pay-in-kind interest and half in cash.

On September 14, 2012, we also entered into a Limited Waiver Agreement with certain of our senior subordinated note holders, which was extended on November 1, 2012 (as extended, the “Waiver Agreement”). Pursuant to the Waiver Agreement, the requisite amount of holders of the senior subordinated notes have agreed to waive the default or event of default associated with our failure to pay interest on the senior subordinated notes on August 15, 2012. As extended, the Waiver Agreement is effective during the period (i) commencing on and including September 15, 2012 and (ii) ending on, but not including, the date that is the earlier of (a) December 15, 2012 and (b) the occurrence of a termination event. A termination event includes (i)(x) the occurrence of an event of default under the senior subordinated notes other than an event of default resulting from the failure to pay interest on the senior subordinated notes on August 15, 2012, (y) our failure or failure of the guarantor (as discussed in note 13) to timely comply with the terms, conditions or covenants set forth in the Waiver Agreement or (z) the failure of any representation or warranty made by us or any guarantor in the Waiver Agreement to be true and correct in any material respect as of the date when made and (ii) the termination of the applicable waiver period under the Agreement as discussed above.

The Waiver Agreement contains certain representations, conditions and covenants for us and the guarantors, including restrictions on certain payments by us, the guarantors of the senior subordinated notes and their respective restricted subsidiaries.

On November 1, 2012 we entered into a Limited Waiver and Second Amendment to Credit Agreement with our senior secured lenders that extended the applicable waiver period regarding any default under the senior secured credit facility to the earlier of December 15, 2012 or any waiver default. On November 1, 2012 we also entered into a Second Limited Waiver Agreement with certain of the senior subordinated noteholders that extended the applicable waiver period regarding any default under the senior subordinated notes to the earlier of December 15, 2012 or any termination event.

We have a cash balance in excess of $28.0 million as of the date hereof. This amount, together with cash from operating activities, is sufficient to meet our obligations arising in the ordinary course of business, absent an acceleration of our indebtedness due to an event of default as discussed herein.

We are required to comply on a quarterly basis with certain financial and other covenants under our senior secured credit facility, including a minimum consolidated cash interest expense coverage ratio test and a maximum senior secured leverage ratio test. We were required to meet a leverage ratio of 5.75x (or less) at September 30, 2012, which reduces to 5.50x at March 31, 2013. Our leverage ratio at September 30, 2012 was 5.48x. We were required to meet an interest coverage ratio of not less than 1.25x at September 30, 2012 and throughout 2012, which increases to 1.30x on March 31, 2013. Our interest coverage ratio was 1.50x at September 30, 2012. As a result of changes in reimbursement rates, other healthcare regulations, and market factors impacting our business along with increasingly more restrictive covenant requirements, our projection of future earning indicates we expect we will be unable to meet our debt covenant requirements during the next twelve month period. The Agreement also amends the senior secured term loan and revolving credit facility to impose additional restrictions, as previously described, with which we are required to comply.

 

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In the event we are unable to comply with the covenants under our senior secured credit facility, an event of default will occur. If we are unable to obtain waivers or amendments to cure such event of default, the lenders would be entitled to take various actions, including the acceleration of amounts due under our senior secured credit facility, terminating access to our revolving credit facility, and all actions permitted to be taken by a secured creditor. Acceleration under our senior secured credit facility would create a cross-default under our senior subordinated notes indenture. Any such acceleration could have a material adverse effect on our financial position, results of operations and cash flow.

We are required to comply with certain covenants under our hospital facility leases, including a minimum net worth test, a minimum cash balance test, and a current ratio test. We did not meet the minimum net worth test or the current ratio test required under our master lease for six of the facilities, and did not meet the minimum net worth, minimum cash balance, and current ratio tests required for our Boise facility. If we are unable to resolve the covenant defaults, the landlord would be entitled to take various actions, including terminating the underlying leases. In addition, on September 17, 2012, the landlord of our Dallas facility alleged that an event of default under the indenture governing the senior subordinated notes noted above resulted in a default under our lease, and in conjunction with the alleged default, purported to terminate the lease. We dispute the alleged lease default and termination, and intends to vigorously defend our rights under the Dallas lease. On October 8, 2012, the landlord filed suit in Dallas County, Texas, seeking a declaratory judgment that holds that we committed an event of default under the Dallas lease, and that the landlord’s subsequent termination of the lease was lawful and valid. We intend to vigorously defend this declaratory judgment action.

We have prepared the accompanying financial statements on a going-concern basis. Our ability to continue to operate on this basis will be dependent on successfully addressing our capital structure. We are continuing to work with our financial advisor and lenders under our senior secured credit facility and senior subordinated notes to develop a comprehensive strategy that will allow us to refinance or restructure our existing capital structure prior to the acceleration of any indebtedness. We are also working with our landlords to resolve any events of default. There can be no assurance, however, that any of these efforts will prove successful or be on economically reasonable terms. In the event of a failure to obtain necessary waivers or forbearance agreements or otherwise achieve a restructuring of our financial obligations, we may be forced to seek reorganization under Chapter 11 of the United States Bankruptcy Code. These issues along with the issues identified in the preceding paragraphs create substantial doubt about our ability to continue as a going concern.

As a result of the impact of our actions with respect to our outstanding debt, acquisition offers received for our operations, and consideration of the current likelihood, format and timing of a potential capital restructuring or other alternative strategies, we concluded that impairment indicators existed which required us to perform an interim impairment test as of September 30, 2012. As a result of our interim impairment assessment, we recognized a non-cash goodwill impairment charge of $85.7 million as of September 30, 2012.

Recent Trends and Events

Hospital Openings and Closings

On December 1, 2011, we purchased selected assets of a long-term acute care hospital operated by Vibra Specialty Hospital (“Vibra”) located in Dallas, Texas for approximately $10.9 million, less adjustments for certain equipment items and liabilities assumed. We relocated 60 beds from our existing Dallas location into Vibra’s facility and discontinued operations in our existing facility.

On August 1, 2011, we purchased five long-term acute care hospitals (the “Facilities”), which operate at seven locations, from HealthSouth Corporation and certain affiliates of HealthSouth Corporation (collectively, the “Sellers”), pursuant to an Asset Purchase Agreement (the “Purchase Agreement”). According to the Purchase Agreement, we acquired substantially all of the non-real estate assets (excluding accounts receivable and certain other components of working capital) in exchange for a cash purchase price of approximately $42.5 million less the value of working capital associated with the Facilities. We financed the acquisition with a combination of an incremental term loan from our existing senior secured credit facility and cash on hand. In addition, Health Care REIT, Inc. purchased the real estate assets associated with four of these Facilities from the Sellers for $75.0 million. We simultaneously entered into a lease with Health Care REIT, Inc. for these properties as discussed below.

The results of operations of the Facilities are included in our consolidated results of operations beginning August 1, 2011. The assets acquired and liabilities assumed of the Facilities were recognized at their acquisition date fair values. The allocation of the purchase price to the assets acquired and liabilities assumed of the Facilities (and the related estimated lives of depreciable tangible and identifiable intangible assets) required a significant amount of judgment. The allocation of the purchase price has been determined based upon the analysis performed. Any premium paid by us in this transaction is attributable to strategic benefits, including enhanced financial and operational scale, and market diversification. The goodwill associated with this transaction is fully deductible for income tax purposes.

On August 1, 2011, we entered into a Second Amended and Restated Master Lease Agreement (the “Second Amended and Restated Lease”) with Health Care REIT, Inc., which included the real estate properties for two of our existing operations and the four new Facilities discussed previously. The Second Amended and Restated Lease became effective with respect to the hospitals on August 1, 2011 and its initial 15-year term ends on July 31, 2026. The Second Amended and Restated Lease contains an option to renew for one 14-year, 11-month renewal term. The rent for the hospitals under the Second Amended and Restated Lease is computed based upon the Health Care REIT, Inc.’s investment amount multiplied by the greater of (i) a spread over the trading yield on 10-year U.S.

 

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Treasury Notes, or (ii) 9.71%, and is subject to an annual inflation adjustment. In addition, on August 1, 2011, we paid a transaction fee of $750,000 to Health Care REIT, Inc., and an indirect parent of the Company granted a warrant to HealthCare REIT, Inc. to purchase 6.25% of the shares of such parent’s common stock on August 1, 2011, with an exercise price of $0.01 per share.

On May 17, 2011, we entered into an amendment, (the “Incremental Amendment”), to our current credit agreement (the “Credit Agreement”), with JPMorgan Chase Bank, N.A., the lenders party thereto, and the other agents named therein. The Incremental Amendment provided for an additional $47.2 million in new senior secured term loans. Proceeds were restricted to (i) payment of consideration for the acquisition of the Facilities, (ii) payment of fees and expenses in connection with the acquisition of the Facilities and (iii) working capital purposes of the Company and its subsidiaries. The new senior secured term loans have the same terms as the outstanding senior secured term loans, including with respect to interest rate, amortization, maturity date and optional and mandatory prepayments. On August 1, 2011, in connection with the completion of the acquisition and the funding of the additional term loan proceeds, we paid a consent fee of $1.4 million to the lenders under the Credit Agreement for consenting to the Incremental Amendment.

On September 6, 2011 we opened a new 40 bed transitional care unit located at one of our Pittsburgh, PA hospital locations. This unit operates as a sub-provider of an existing Pittsburgh, PA operation.

Regulatory Changes

Approximately 64.7% and 59.9% of our total net patient service revenue for the nine months ended September 30, 2012 and 2011, respectively, came from Medicare reimbursement. Our industry is subject to extensive government regulation, including regulation of the Medicare reimbursement process. Changes in these regulations can have a material impact on the way we operate our business and on our results of operations. The discussion included herein provides a summary analysis of recent regulatory changes that have had an impact on our results of operations for the nine months ended September 30, 2012, and recently proposed regulations that may have an impact on our future results of operations. A more detailed discussion of the regulatory environment in which we operate may be found in Part I – Business – Government Regulations, in our Annual Report filed on Form 10-K on March 30, 2012 with the Securities and Exchange Commission, for the year ended December 31, 2011. The information below should be read in connection with that more detailed discussion.

2012 Final Rule

On August 1, 2012, the Centers for Medicare & Medicaid Services (“CMS”) published their annual payment update for LTAC hospitals for the 2013 rate year, which will be effective for all discharges on or after October 1, 2012 (the “2012 Final Rule”). The 2012 Final Rule includes a net increase in the standard federal rate of $694 to $40,916, or 1.7%, for the period October 1, 2012 through December 28, 2012. For discharges on or after December 29, 2012 through September 30, 2013, the standard federal rate would then decrease by $518 to $40,398, which represents a 0.4% increase from the current rate of $40,222. Both of these standard federal rates include a market basket update of 2.6%, less a 0.074% area wage level budget neutrality factor, and two adjustments required by the Patient Protection and Affordable Care Act (“PPACA”): the multifactor productivity (“MFP”) adjustment of 0.7% and a statutory payment rate reduction of 0.1%. The standard federal base rate beginning December 29, 2012, is further reduced by 1.266%, which represents the first year impact of a three-year phase in of a “one-time” 3.75% budget neutrality adjustment. The 2012 Final Rule also includes a decrease in the high-cost outlier fixed-loss amount to $15,408 from $17,931, updates to the weighting of Medicare-Severity Diagnosis Related Groups (“MS-LTC-DRG”), and the implementation of reduced Medicare payments for patients with very short stays in LTAC hospitals for discharges occurring on or after December 29, 2012. CMS has estimated that the changes for the 2013 rate year, taken as a whole, will result in an increase of 1.7% in Medicare reimbursement to LTAC hospitals. Individual hospitals, however, may see varying effects of the 2012 Final Rule depending upon their Medicare patient population and their specific base rate changes due to geographical location.

As a result of certain federal laws enacted in recent years, including the “Medicare, Medicaid and SCHIP Extension Act of 2007,” the “PPACA of 2010,” and the “Health Care and Education Affordability Reconciliation Act of 2010,” CMS had previously been restricted from further implementation of the “25 Percent Rule,” the application of a budget neutrality adjustment and the implementation of very short-stay outlier payment reductions, among other items, until the December 29, 2012, expiration of certain provisions of these laws. These laws also contained a moratorium, subject to certain exceptions, on the development of new LTAC hospital beds until December 29, 2012. The regulations discussed above include the anticipated implementation of the budget neutrality adjustment and the very short-stay outlier policy for discharges on or after December 29, 2012. Additionally, the proposed regulations allow for the expiration of the moratorium on the development of new LTAC hospital beds after December 29, 2012.

However, CMS is proposing a one-year extension on the existing moratorium on the “25 Percent Rule” policy for cost report periods beginning on or after October 1, 2012, pending results of an on-going research initiative to re-define the role of LTAC hospitals in the Medicare program. As a result of various laws and regulations, this extension, however, creates a “gap” period for LTAC hospitals that lose statutory relief between July 1, 2012 and October 1, 2012. CMS recognizes this gap period in the final rule and created a regulatory moratorium to provide relief from the 25 Percent Rule for discharges occurring within this gap period.

 

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2011 Final Rule

On August 1, 2011, CMS published their annual payment update for LTAC hospitals for the 2012 rate year, which became effective for all discharges on or after October 1, 2011 (the “2011 Final Rule”). The 2011 Final Rule included a net increase in the standard federal rate of $623 to $40,222, or 1.6%, which was based on a market basket update of 2.9% less a 0.22% area wage level budget neutrality factor and the two adjustments required by the PPACA: the multifactor productivity adjustment of 1.0% and statutory payment rate reduction of 0.1%. The 2011 Final Rule also included a decrease in the high-cost outlier fixed-loss amount to $17,931 from $18,785. Additionally, the 2011 Final Rule included updates to the weighting of MS-LTC-DRG. CMS estimated that the changes outlined above for the 2012 rate year, taken as a whole, would result in an increase of 2.5% in Medicare reimbursement to LTAC hospitals. Individual hospitals, however, may see varying effects of the 2011 Final Rule depending upon their Medicare patient population and their specific base rate changes due to geographical location. The 2011 Final Rule also established a new quality reporting program for LTAC hospitals in accordance with provisions of the Affordable Care Act and clarified CMS’ position that Medicare Advantage days, along with traditional Medicare fee-for-service program days, were to be included in the determination of whether a LTAC hospital meets the greater than 25 day average length of stay requirement. Furthermore, the 2011 Final Rule extended the application of the LTAC bed moratorium to LTAC hospitals developed under exceptions to the LTAC facility moratorium and proposed a rebasing of the market basket used by LTCH hospitals.

The 2010 Final Rule

On July 30, 2010, CMS published their annual payment update for LTAC hospitals for the 2011 rate year, which became effective for all discharges on or after October 1, 2010 (the “2010 Final Rule”). The 2010 Final Rule included a net decrease in the standard federal rate of $195, or 0.5%, to $39,600, which was based on a market basket update of 2.5% less an adjustment of 0.5% as required by the PPACA of 2010, discussed below, and less an adjustment of 2.5% to account for changes in documentation and coding practices. The 2010 Final Rule also included an increase in the high-cost outlier fixed-loss amount to $18,785 from $18,615. Additionally, the 2010 Final Rule included updates to the weighting of MS-LTC-DRGs, which CMS indicated will be budget neutral for aggregate LTAC hospital payments. CMS also estimated that the changes for the 2011 rate year, taken as a whole, including changes to the area wage adjustments for the 2011 rate year, an increase in high-cost outlier payments and an increase in short-stay outlier payments, would result in an increase of 0.5% in Medicare reimbursement to LTAC hospitals.

2010 Healthcare Reform Law

On March 23, 2010, the President signed into law the PPACA. This act made dramatic changes to the Medicare and Medicaid programs by adopting numerous initiatives intended to improve the quality of healthcare, promote patient safety, reduce the cost of healthcare, increase transparency and reduce fraud and abuse of federal healthcare programs. Additionally, on March 30, 2010, the President signed the Health Care and Education Affordability Reconciliation Act of 2010, which made certain amendments to the law signed by the President on March 23, 2010.

The PPACA, together with the Health Care and Education Affordability Reconciliation Act of 2010, also made changes to the Medicare program relevant to the LTAC industry, including the following key provisions, among other things:

 

   

a two-year extension of the LTAC provisions originally included in the Medicare, Medicaid and SCHIP Extension Act of 2007 (the “SCHIP Extension Act”),

 

   

the implementation of quality reporting requirements for LTAC hospitals beginning in rate year 2014,

 

   

reductions in the annual market basket rate increases of 0.25% for rate year 2010, and ranging from 0.1% to 0.75% for rate years beginning 2011 through 2019,

 

   

additional reductions in the annual market basket rate increases as the result of productivity adjustments beginning in 2012, which are expected to approximate 1% annually, and

 

   

the development of a new hospital wage index system to replace the current system of calculating the hospital wage index based on cost report data.

In addition, the PPACA created an “Independent Payment Advisory Board” to develop and submit proposals to the President and Congress designed to reduce Medicare spending, and provided for pilot programs to explore a bundled payment system for an episode of care that includes an inpatient stay in a hospital and post-acute care provided within 30 days after discharge.

Regulatory Matters

Periodically CMS will conduct surveys of hospitals and other health care providers as a condition of participation in the Medicare program. The purpose of these surveys is to ensure that healthcare providers are in compliance with various governmental requirements related to adequacy of medical care, equipment, personnel, operating policies and procedures, maintenance of adequate records, compliance with building codes and environmental protection and healthcare fraud and abuse.

 

 

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Sources of Revenue

We are reimbursed for our services provided to patients by a number of sources, including the federal Medicare program and commercial payors. Payment arrangements include prospectively determined rates per discharge, reimbursed costs, discounted charges and per diem rates. Our net patient service revenue consists of the amounts that we estimate to be reimbursable from each of the applicable non-governmental payors and the Medicare and Medicaid programs. We account for the differences between the estimated reimbursement rates and our standard billing rates as contractual adjustments, which are deducted from gross revenues to arrive at net revenues. We record accounts receivable resulting from such payment arrangements net of contractual allowances. Net patient service revenues generated directly from the Medicare program approximated 64.7% and 59.9% of total net patient service revenue for the nine months ended September 30, 2012 and 2011, respectively. Net patient service revenues generated from non-Medicare payors were substantially from commercial payors.

Laws and regulations governing provider reimbursement pursuant to the Medicare program are complex and subject to interpretation. The Medicare reimbursement amounts reported in our financial statements are based upon estimates and, as such, are subject to adjustment until such time as our billings and cost reports are filed and settled with the appropriate regulatory authorities. Federal regulations require that providers participating in the Medicare program submit annual cost reports associated with services provided to program beneficiaries. In addition, payments under LTAC hospital PPS are subject to review by the regulatory authorities, including enhanced medical necessity reviews pursuant to the SCHIP Extension Act and the Recovery Audit Contractor (“RAC”) program pursuant to the Tax Relief and Health Care Act of 2006. These reviews primarily focus on the accuracy of the MS-LTC-DRG assigned to each discharged patient and normally occur after the completion of the billing process.

The annual cost reports are subject to review and adjustment by CMS through its fiscal intermediaries. These reviews may not occur until several years after a provider files its cost reports and often results in adjustments to amounts reported by providers in their cost reports as a result of the complexity of the regulations and the inherent judgment that is required in the application of certain provisions of provider reimbursement regulations. Since these reviews of filed cost reports occur periodically, there is a possibility that recorded estimated Medicare reimbursement reflected in our consolidated financial statements and previously filed cost reports may change by a material amount in future periods. We recognize in our consolidated financial statements the impact of adjustments, if any, to estimated Medicare reimbursement when the amounts can be reasonably determined.

Total Expenses

Total expenses consist of salaries, wages and benefits, supplies, which includes expenses related to drug and medical supplies, rent, other operating expenses, provision for doubtful accounts, depreciation and amortization and interest expense. Other operating expenses include expenses such as contract labor, legal and accounting fees, insurance and contracted services purchased from host hospitals. Reorganization cost includes professional fees paid to our attorneys and advisors to assist in our consideration and evaluation of various strategic alternatives in connection with our capital structuring.

Other Operating Metrics

We use certain operating metrics in the management of our facility operations. These include:

Licensed beds. Licensed beds represent beds for which a facility has been granted approval to operate from the applicable state licensing agency. These licensed beds are used in the determination of average licensed beds and occupancy rates.

Average licensed beds. We compute average licensed beds by computing a weighted average based upon the number of licensed beds in place for each month within the reporting period.

Admissions. Admissions are the total number of patients admitted to our facilities during the reporting period.

Patient days. Patient days are the cumulative number of days that licensed beds are occupied in our facilities for the entire reporting period. We also refer to patient days as our census.

Average length of stay (days). We compute average length of stay in days by dividing patient days for discharged patients by discharges.

Occupancy rates. We compute our occupancy rate by determining the percentage of average licensed beds that are occupied for a 24-hour period during a reporting period. The occupancy rate provides a measure of the utilization of inpatient rooms.

 

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Net patient service revenue per patient day. This measure is determined by dividing our total net patient service revenue by the number of patient days in a reporting period. We use this metric to provide a measure of the net patient service revenue generated for each patient day.

Critical Accounting Matters

This discussion and analysis of our financial condition and results of operation is based on our consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States. The preparation of those financial statements requires the use of estimates and judgments that affect the reported amounts and related disclosures. We rely on historical experience and other assumptions that we believe are reasonable at the time in forming the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual amounts may differ from these estimates.

We believe that the following critical accounting policies as more fully described in our annual financial statements as of December 31, 2011, as filed in the Form 10-K, affect the more significant judgments and estimates used in the preparation of our consolidated financial statements.

 

   

Revenue recognition

 

   

Accounts receivable and allowance for doubtful accounts

 

   

Estimated third party payor settlements

 

   

Insurance risks

 

   

Impairment of long-lived assets

 

   

Accounting for income taxes

 

   

Goodwill

 

   

Business Combinations

Results of Operations

The following table sets forth operating results for each of the periods presented (in thousands):

 

     Three Months Ended
September 30
    Nine Months Ended
September 30
 
     2012     2011     2012     2011  

Net patient service revenue

   $ 119,844      $ 102,599      $ 367,237      $ 293,510   

Salaries, wages and benefits

     57,968        50,526        174,167        139,941   

Supplies

     11,122        10,540        34,984        29,354   

Rent

     10,008        8,685        31,132        21,878   

Other operating expenses

     25,501        26,446        78,806        69,388   

Provision for doubtful accounts

     1,181        1,781        3,428        4,367   

Depreciation and amortization

     2,214        2,354        7,067        6,528   

Reorganization cost

     5,717        —          5,717        —     

Goodwill impairment charge

     85,700        —          85,700        —     

Loss on early extinguishment of debt

     —          —          —          2,772   

Interest expense, net

     18,289        15,571        53,265        40,845   
  

 

 

   

 

 

   

 

 

   

 

 

 

Total expenses

     217,700        115,903        474,266        315,073   
  

 

 

   

 

 

   

 

 

   

 

 

 

Operating loss

     (97,856     (13,304     (107,029     (21,563

Equity in income of joint venture

     124        85        451        562   
  

 

 

   

 

 

   

 

 

   

 

 

 

Loss before income taxes

     (97,732     (13,219     (106,578     (21,001

Provision for income taxes

     (229     100        832        550   
  

 

 

   

 

 

   

 

 

   

 

 

 

Net loss

   $ (97,503   $ (13,319   $ (107,410   $ (21,551
  

 

 

   

 

 

   

 

 

   

 

 

 

 

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Operating Statistics

The following table sets forth operating statistics for each of the periods presented.

 

     Three Months Ended
September 30
    Nine Months Ended
September 30
 
     2012     2011     2012     2011  

Number of hospitals within hospitals (end of period)

     8        8        8        8   

Number of freestanding hospitals (end of period)

     19        19        19        19   

Number of total hospitals (end of period)

     27        27        27        27   

Licensed beds LTAC (end of period)

     1,390        1,392        1,390        1,392   

Licensed beds transitional care unit beds (end of period)

     40        40        40        40   

Total licensed beds (end of period)

     1,430        1,432        1,430        1,432   

Average licensed beds (1)

     1,430        1,294        1,430        1,136   

LTAC admissions

     2,781        2,364        8,561        6,500   

Transitional care unit admissions

     126        7        355        7   

LTAC patient days

     76,151        66,884        235,149        186,778   

Transitional care unit patient days

     2,527        55        7,231        55   

LTAC occupancy rate

     59.5     56.8     61.7     60.5

Transitional care unit occupancy rate

     68.7     5.5     66.0     5.5

Percent net patient service revenue from Medicare

     64.7     60.1     64.7     59.9

Percent net patient service revenue from commercial payors and Medicaid (2)

     35.3     39.9     35.3     40.1

Net patient service revenue per patient day (3)

   $ 1,523      $ 1,533      $ 1,515      $ 1,571   

 

(1) The average licensed beds are only calculated on the beds at locations that were open for operations during the applicable periods.
(2) The percentage of net patient service revenue from Medicaid is less than two percent for each of the periods presented.
(3) This includes LTAC and transitional care unit revenue and patient days.

Three Months Ended September 30, 2012 Compared to Three Months Ended September 30, 2011

Net Revenues

Our net patient service revenue of $119.8 million for the three months ended September 30, 2012, increased by $17.2 million, or 16.8%, from the comparable period in 2011. Patient days increased by 11,739, or 17.5%, while admissions increased by 536, or 22.6%, for the three months ended September 30, 2012, as compared to the same period in 2011. On a same store basis, which excludes the hospitals acquired from HealthSouth prior to August 1, 2012 and the new transitional care unit prior to September 6, 2012, patient days increased by 4,165, or 6.2%, and admissions increased by 211, or 8.9%, for the three months ended September 30, 2012, as compared to the same period in 2011.

The increase of $17.2 million in net patient service revenue was attributable to an increase of $9.1 million from the recently acquired hospitals and the new transitional care unit and an increase of $8.1 million on a same store basis. The net increase on a same store basis was comprised of a favorable variance of $6.4 million attributable to an increase in patient days, a favorable variance of $0.9 million as the result of the increase in net patient service revenue on a per patient day basis and a net increase of $0.8 million attributable to adjustments related to changes in estimates and settlements on cost reports filed with the Medicare program.

Our net patient service revenue per patient day during the three months ended September 30, 2012 and 2011, was $1,523 and $1,533, respectively. However, exclusive of the cost report reimbursement adjustments and results of the new hospitals and the new transitional care unit, net patient service revenue per patient day for the three months ended September 30, 2012 and 2011, was $1,548 and $1,535, respectively. The increase in our net patient service revenue per patient day was primarily attributable to a higher acuity level of patients treated during the 2012 period when excluding the results of the new hospitals and the new transitional care unit.

Total Expenses

Total expenses increased by $101.8 million to $217.7 million for the three months ended September 30, 2012, as compared to the same period in 2011. A portion of this increase was attributable to the addition of the recently acquired hospitals and new transitional care unit. On a same store basis, total expenses increased $93.2 million for the three months ended September 30, 2012, as compared to the same period in 2011.

 

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The same store increase of $93.2 million in expenses was primarily attributable to a $85.7 million impairment to goodwill, $5.7 million of reorganization cost related to the professional fees paid to our attorneys and advisors to assist in our consideration and evaluation of various strategic alternatives in connection with our capital structuring, an increase of $2.7 million in net interest expense, and an increase of $2.9 million in salaries, wages and benefits, offset by a $2.8 million decrease in other operating and a $0.8 million decrease in provision for doubtful accounts. The impairment to goodwill and potential capital restructuring are discussed under Liquidity and Uncertainties Related to Going Concern above. The $2.7 million increase in net interest expense was the result of the interest on the additional borrowing related to the purchase of the new hospitals and capitalized paid in kind interest payments along with the additional 2% interest on the senior secured credit facility for the waiver. The principal amount outstanding under our term loan facility at September 30, 2012 and 2011, was $324.3 million and $309.8 million, respectively. The $2.9 million increase in salaries, wages and benefits is due to the increase in patient days for the current period. The $2.8 million decrease in other operating expense is primarily due to professional fees incurred in 2011 related to the acquisition of the hospitals from HealthSouth. The $0.8 million decrease in the provision for doubtful accounts was due principally to the decrease in our days of net patient service revenue outstanding as a result of improved collections on current and previously reserved accounts.

Income Tax Expense

For the three months ended September 30, 2012, income tax expense recorded represents the estimated income tax liability for certain state income taxes and deferred federal income tax expense associated with goodwill and other non-amortizing identifiable intangible assets that are amortizable and deductible for federal income tax purposes along with the impact of the goodwill impairment. We believe that it is more likely than not that no benefit or expense will be realized during 2012 for federal income taxes based on estimated federal taxable losses for 2012, other than the recurring deferred federal income tax expense associated with the goodwill and other non-amortizable identifiable intangible assets. We anticipate that federal net operating losses generated during 2012 will be offset by an increase in the valuation allowance against net deferred tax assets.

Nine Months Ended September 30, 2012 Compared to Nine Months Ended September 30, 2011

Net Revenues

Our net patient service revenue of $367.2 million for the nine months ended September 30, 2012, increased by $73.7 million, or 25.1%, from the comparable period in 2011. Patient days increased by 55,547, or 29.7%, while admissions increased by 2,409, or 37.0%, for the nine months ended September 30, 2012, as compared to the same period in 2011. On a same store basis, which excludes the hospitals acquired from HealthSouth prior to August 1, 2012 and the new transitional care unit prior to September 6, 2012, patient days increased by 7,545, or 4.0%, and admissions increased by 491, or 7.5%, for the nine months ended September 30, 2012, as compared to the same period in 2011.

The increase of $73.7 million in net patient service revenue was attributable to an increase of $63.7 million from the recently acquired hospitals and the new transitional care unit and an increase of $10.0 million on a same store basis. The net increase on a same store basis was comprised of a favorable variance of $11.9 million attributable to an increase in patient days and a net increase of $1.8 million attributable to adjustments related to changes in estimates and settlements on cost reports filed with the Medicare program, offset by an unfavorable variance of $3.7 million as the result of the decrease in net patient service revenue on a per patient day basis. During the nine months ended September 30, 2012 and 2011, we recorded an increase in net patient service revenue of $0.5 million and a reduction of $1.3 million, respectively, related to changes in estimates and settlements on cost reports filed with the Medicare program.

Our net patient service revenue per patient day during the nine months ended September 30, 2012 and 2011, was $1,515 and $1,571, respectively. However, exclusive of the cost report reimbursement adjustments and results of the new hospitals and the new transitional care unit, net patient service revenue per patient day for the nine months ended September 30, 2012 and 2011, was $1,559 and $1,578, respectively. The decrease in our net patient service revenue per patient day was primarily attributable to an increase in the volume of Medicare patients as a percentage of our total patient volume. On a per patient day basis, average reimbursement for Medicare patients is generally lower than reimbursement for non-Medicare patients.

Total Expenses

Total expenses increased by $159.2 million to $474.3 million for the nine months ended September 30, 2012, as compared to the same period in 2011. A portion of this increase was attributable to the addition of the recently acquired hospitals and new transitional care unit. On a same store basis, total expenses increased by $100.7 million for the nine months ended September 30, 2012, as compared to the same period in 2011.

The same store increase of $100.7 million in expenses was primarily attributable to a $85.7 goodwill impairment, $5.7 million of reorganization cost related to the potential capital restructuring, an increase of $12.4 million in net interest expense and an increase of $4.1 million in salaries, wages and benefits, offset by a $2.8 million loss related to the write-off of deferred financing cost as a result of the refinancing of the senior secured credit facility during 2011. The impairment to goodwill and potential capital restructuring are discussed under Liquidity and Uncertainties Related to Going Concern above. The $12.4 million increase in net interest expense was

 

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the result of the higher margin rate associated with the new senior secured credit agreement and interest on the additional borrowing related to the purchase of the new hospitals and capitalized paid in kind interest payments along with the additional 2% interest on the senior secured credit facility for the waiver. The principal amount outstanding under our term loan facility at September 30, 2012 and 2011, was $324.3 million and $309.8 million, respectively, and had an average interest rate of 13.75% and 12.85% for the nine months ended September 30, 2012 and 2011, respectively. The increase in salaries, wages and benefits was due mainly to the increase in patient days during the period.

Income Tax Expense

For the nine months ended September 30, 2012, income tax expense recorded represents the estimated income tax liability for certain state income taxes and deferred federal income tax expense associated with goodwill and other non-amortizing identifiable intangible assets that are amortizable and deductible for federal income tax purposes along with the impact of the goodwill impairment. We believe that it is more likely than not that no benefit or expense will be realized during 2012 for federal income taxes based on estimated federal taxable losses for 2012, other than the recurring deferred federal income tax expense associated with the goodwill and other non-amortizable identifiable intangible assets. We anticipate that federal net operating losses generated during 2012 will be offset by an increase in the valuation allowance against net deferred tax assets.

Liquidity and Capital Resources

Our primary sources of liquidity are cash on hand, expected cash flows generated by operations, and availability of borrowings under a revolving credit facility. Availability of borrowings under our revolving credit facility are generally dependent upon our ability to meet the maximum leverage ratio test included in the senior secured credit facility. However, as further discussed in note 2, “Liquidity and Uncertainties Related to Going Concern” and under Liquidity and Uncertainties Related to Going Concern above, we currently do not meet the conditions to drawing under our revolving credit facility should we have any availability thereunder. Nonetheless, we have a cash balance in excess of $28.0 million as of the date hereof. Our primary liquidity requirements are for debt service on our senior secured credit facilities and the notes, capital expenditures and working capital. As a result of these and other issues discussed further in note 2, “Liquidity and Uncertainties Related to Going Concern” and under Liquidity and Uncertainties Related to Going Concern above, there is substantial doubt about our ability to continue as a going concern. You are encouraged to read discussion in the above referenced sections together with our discussion of liquidity and capital resources below.

As a result of impending maturities and increasingly more restrictive covenant requirements under our previous senior secured credit facility, we completed a refinancing of our previous senior secured credit facility with a new senior secured credit facility that consisted of an initial $257.5 million senior secured term loan and a new $30.0 million senior secured revolving credit facility on February 1, 2011 (the “Credit Agreement”). The proceeds of this new Credit Agreement along with available cash on hand were utilized to pay off our existing senior secured credit facility and revolving credit facility and the fees and expenses associated with the new Credit Agreement.

The terms of the Credit Agreement also provided that we had the right to request additional term loan commitments of up to $50.0 million. This right was exercised in connection with the HealthSouth acquisition, which occurred on August 1, 2011, as previously discussed.

Borrowings under the term loan facility of the Credit Agreement bear interest at a rate per annum equal to an applicable margin plus, at our option, either (a) an alternate base rate determined by reference to the highest of (1) the prime rate of JPMorgan Chase Bank, N.A., (2) the federal funds rate in effect on such date plus 0.5% and (3) the LIBOR rate for a one month interest period plus 1% or (b) a LIBOR rate determined by reference to the cost of funds for U.S. dollar deposits for the relevant interest period adjusted for certain additional costs. For a more detailed discussion of the interest rates applicable to the term loan facility of the Credit Agreement, see note 6, “Long Term Debt.” At September 30, 2012, the weighted average interest rate applicable to the $324.3 million outstanding under our term loan facility was 13.71%.

We are required to make scheduled quarterly payments under the senior secured term loan facility equal to 0.25% of the original principal amount of the term loan and the additional principal amount borrowed on August 1, 2011, with the balance payable on February 1, 2016. Additionally, we are required to prepay outstanding term loans under this agreement with (a) 100% of the net cash proceeds of any debt or equity issued by us or our restricted subsidiaries (with exceptions for certain debt permitted to be incurred or equity permitted to be issued under the agreement), (b) 75% (which percentage will be reduced to 50% if our senior secured leverage ratio (as defined in the Credit Agreement) is less than 4:00 to 1:00) of our annual excess cash flow (as defined in the Credit Agreement), and (c) 100% of the net cash proceeds of certain asset sales or other dispositions of property by us or our restricted subsidiaries, subject to reinvestment rights and certain other exceptions specified in the Credit Agreement. Mandatory prepayments of the term loans, subject to certain exceptions, are subject to a prepayment fee of 2% if such repayment occurs after February 1, 2012 and on or prior to February 1, 2013, and 1% if such prepayment occurs after February 1, 2013 and on or prior to February 1, 2014. We also have the ability to voluntarily prepay outstanding loans under the term loan facility, subject to certain conditions. For a discussion of our ability of voluntarily prepay outstanding loans, see note 6, “Long Term Debt.”

 

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The term loan and revolving credit facility under the Credit Agreement have scheduled maturity dates of February 1, 2016, and February 1, 2015, respectively. However, if our outstanding senior subordinated notes are not refinanced, purchased or defeased in full by May 15, 2013, then the term loan and the then outstanding balance under the revolving credit facility will be due in full on May 15, 2013.

The Credit Agreement also imposes certain financial covenants on us including: a maximum ratio of 5.75x consolidated EBITDA to total senior secured indebtedness tested quarterly on a trailing 12 month basis, and a minimum ratio of 1.25x consolidated EBITDA to consolidated cash interest expense, tested quarterly on a trailing 12 month basis. The maximum leverage ratio is scheduled to adjust to 5.50x beginning with the trailing four quarter period ending March 31, 2013. As a result of changes in reimbursement rates, other healthcare regulations, and market factors impacting our business along with increasingly more restrictive covenant requirements, our projection of future earnings indicates we expect we will be unable to meet our debt covenant requirements during the next twelve month period.

The Credit Agreement is secured by substantially all of our tangible and intangible assets, except for assets held by subsidiaries that have been designated as nonguarantor subsidiaries. The Credit Agreement also contains certain customary representations and warranties, affirmative covenants and events of default, including payment defaults, breach of representations and warranties, covenant defaults, cross defaults to certain material indebtedness, certain events of bankruptcy, certain events under ERISA, change of control, material judgments, failure of certain guaranty documents to be in full force and effect and failure of a lien to have the priority or otherwise be valid and perfected with respect to material collateral.

We believe that our cash on hand and expected cash flows from operations will be sufficient to meet our obligations arising in the ordinary course of business, absent maturity of the senior subordinated notes or an acceleration of our indebtedness under our senior secured credit facility due to an event of default as discussed herein. However, as further discussed in note 2, “Liquidity and Uncertainties Related to Going Concern” and under Liquidity and Uncertainties Related to Going Concern above, there is substantial doubt about our ability to continue as a going concern.

We and our subsidiaries, affiliates or significant stockholders may from time to time seek to retire or purchase our outstanding debt through cash purchases and/or exchanges for equity securities, in open market purchases, privately negotiated transactions or otherwise. Such repurchases or exchanges, if any, will depend on prevailing market conditions, our liquidity requirements, contractual restrictions and other factors.

Capital Expenditures

We anticipate that we may incur capital expenditures of approximately $1.5 million during the remainder of 2012 based on our current plans of ongoing capital maintenance expenditure requirements at our facilities, including those related to the LTAC hospitals acquired during 2011, as previously discussed. We may enter into lease arrangements to finance a portion of these equipment expenditures.

Historical Cash Flow

For the nine months ended September 30, 2012, operating activities provided $11.8 million of cash as compared to $0.1 million of cash for the comparable period in 2011. For the nine months ended September 30, 2012, we had a net loss of $107.4 million as compared to a net loss of $21.6 million for the same period in 2011.

For the nine months ended September 30, 2012, there was an $85.7 goodwill impairment, as discussed under Liquidity and Uncertainties Related to Going Concern above. Accounts receivable decreased by $9.3 million for the nine months ended September 30, 2012 as compared to an increase of $12.6 million for the same period during 2011. Days of net patient service revenue in accounts receivable at September 30, 2012 had decreased to 60.0 as compared to 69.2 at December 31, 2011. The $9.3 million decrease in accounts receivable and the decrease in days of net patient service revenue in accounts receivable as of September 30, 2012, was primarily the result of improved collections on the accounts receivable of the hospitals acquired during 2011. As of December 31, 2011, we were pending CMS’s approval of the transfer of certain acquired Medicare provider numbers. All of these approvals were received by March 31, 2012.

Estimated third party payor settlements used cash of $3.9 million as compared to providing cash of $5.0 million for the nine months ended September 30, 2011. The use of cash during the 2012 period was principally due to the under payment by Medicare of amounts received as interim payments during 2012 as compared to revenues ultimately recognized and the net settlement of certain matters on previously filed cost reports.

Accounts payable and accrued expenses used cash of $8.6 million for the nine months ended September 30, 2012 as compared to providing cash of $5.9 million for the same period in 2011. This increase in the use of cash was primarily attributable to the timing of our bi-weekly payroll payments.

 

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Cash used in investing activities was $2.3 million for the nine months ended September 30, 2012, as compared to $36.4 million in 2011. Cash used in investing activities during the 2012 period was principally for recurring maintenance capital expenditures. Cash used in investing activates during 2011 was principally for the hospitals acquired from HealthSouth, which occurred on August 1, 2011, as previously discussed.

Cash provided by financing activities for the nine months ended September 30, 2012 was $10.5 million as compared to $3.3 million for the same period in 2011. The $10.5 million net cash provided by financing activities in the 2012 period was principally due to net borrowings of $16.0 million under our revolving credit facility to provide additional liquidity as we evaluate our capital structure alternatives as discussed previously. The nine months ended September 30, 2011 included proceeds of $257.5 million from the refinancing of the senior secured credit facility and an additional $47.2 million in new senior secured term loans in relation to the HealthSouth acquisition previously discussed, offset by outflows to pay down the previous senior secured credit facility and scheduled payments on the current secured credit facility. We also paid down the $35.0 million for the outstanding balance under the previous revolving line of credit. During 2011 we made payments of $22.3 million for deferred financing cost associated with the debt refinance and new senior secured term loans utilized for the hospitals acquired from HealthSouth.

Seasonality

Our business experiences seasonality resulting in variation in census levels, with the highest census historically occurring in the first quarter of the year and the lowest census occurring in the third quarter of the year.

Inflation

We derive a substantial portion of our revenue from the Medicare program. LTAC hospital PPS payments are subject to fixed payments that generally are adjusted annually for inflation. However, there can be no assurance that these adjustments, if received, will reflect the actual increase in our costs for providing healthcare services.

Labor and supply expenses make up a substantial portion of our operating expense structure. The expenses can be subject to increase in periods of rising inflation.

Forward Looking Statements

This quarterly report contains forward-looking statements regarding, among other things, our financial condition, results of operations, plans, objectives, future performance and business. All statements contained in this document other than historical information are forward-looking statements. Forward-looking statements include, but are not limited to, statements that represent our beliefs concerning future operations, strategies, financial results or other developments, and contain words and phrases such as “may,” “expects,” “believes,” “anticipates,” “estimates,” “should,” or similar expressions. Because these forward-looking statements are based on estimates and assumptions that are subject to significant business, economic and competitive uncertainties, many of which are beyond our control or are subject to change, actual results could be materially different. Although we believe that our plans, intentions and expectations reflected in or suggested by these forward-looking statements are reasonable, we cannot assure you that we will achieve or realize these plans, intentions or expectations. Forward-looking statements are inherently subject to risks, uncertainties and assumptions. Important factors that could cause actual results to differ materially from the forward-looking statements include, but are not limited to:

 

   

our ability to successfully negotiate waivers and/or forbearance of remedies with respect to potential defaults of our outstanding indebtedness and our capital structure issues described herein, and our ability to successfully continue as a going concern;

 

   

the failure to maintain compliance with our financial covenants could be costly or have a material adverse effect on us;

 

   

the amount of outstanding indebtedness, the high interest rates applicable to our indebtedness and the restrictive covenants in the agreements governing our indebtedness increase the difficulty of operating on a profitable basis and may limit our operating and financial flexibility;

 

   

the condition of the financial markets, including volatility and deterioration in the capital and credit markets, could have a material adverse effect on the availability and terms of financing sources;

 

   

development or acquisition of new facilities may prove difficult or unsuccessful, use significant resources or expose us to unforeseen liabilities;

 

   

the failure to comply with the provisions of any of our Master Lease Agreements could materially adversely affect our financial position, results of operations and liquidity;

 

   

changes in government reimbursement for our services may have an adverse effect on our future revenues and profitability including, for example, the changes described under “Regulatory Changes”;

 

   

healthcare reform may have an adverse effect on our future revenues and profitability;

 

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a government investigation or assertion that we have violated applicable regulations may result in increased costs or sanctions that reduce our revenues and profitability;

 

   

periodic reviews, surveys, audits and investigations by federal and state government agencies and private payors could result in adverse findings and may negatively impact our revenues and profitability;

 

   

actions that may be brought by individuals on the government’s behalf under the False Claims Act’s qui tam or whistleblower provisions may expose us to unforeseen liabilities;

 

   

the failure of our long-term acute care hospitals to maintain their qualification would cause our revenues and profitability to decline;

 

   

the failure of our “satellite” facilities to qualify for provider-based status with the applicable “main” facilities may adversely affect our results of operations;

 

   

private third party payors for our services may merge or undertake future cost containment initiatives that limit our future revenues and profitability;

 

   

an increase in uninsured and underinsured patients in our hospitals or the deterioration in the collectability of the accounts of such patients could harm our results of operations;

 

   

the failure to maintain established relationships with the physicians in our markets could reduce our revenues and profitability;

 

   

shortages in qualified nurses, therapists and other healthcare professionals or union activity may significantly increase our operating costs;

 

   

competition may limit our ability to grow and result in a decrease in our revenues and profitability;

 

   

the loss of key members of our management team could significantly disrupt our operations;

 

   

the geographic concentration of our facilities in Texas, Pennsylvania and Louisiana makes us sensitive to economic, regulatory, environmental and other developments in these states;

 

   

adverse changes in individual markets could significantly affect operating results;

 

   

the effect of legal actions asserted against us or lack of adequate available insurance could subject us to substantial uninsured liabilities;

 

   

an inability to ensure and maintain an effective system of internal controls over financial reporting could expose us to liability; and,

 

   

the failure to prevent damage or interruption to our systems and operations or to conform to regulatory standards for electronic health records could result in improper functioning, security breaches of our information systems, additional expenses or penalties.

Consequently, such forward-looking statements should be regarded solely as our current plans, estimates and beliefs. We do not intend, and do not undertake, any obligation to update any forward-looking statements to reflect future events or circumstances after the date of this report.

 

ITEM 3: QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

At September 30, 2012, we had $324.3 million in senior term loans outstanding and a borrowing of $16.0 million under our revolving credit facility, each bearing interest at variable rates. Each 0.125% point change in interest rates would result in a $0.4 million annual change in interest expense on our term loans and revolving credit facility loans, assuming that our revolving credit facility is fully drawn.

 

ITEM 4: CONTROLS AND PROCEDURES

We carried out an evaluation, under the supervision and with the participation of our principal executive officer and principal financial officer, of the effectiveness of the design and operation of our disclosure controls and procedures (as defined in Rule 13a-15(e) of the Securities Exchange Act of 1934) as of the end of the period covered in this report. The disclosure controls and procedures are designed to ensure that information required to be disclosed in reports filed under the Securities Exchange Act of 1934 is recorded, processed, summarized and reported within required time periods, and include controls and disclosures designed to ensure that this information is accumulated and communicated to the company’s management, including its principal executive officer and principal financial officer, as appropriate, to allow timely decisions regarding required disclosures. Based on this evaluation, our principal executive officer and principal financial officer have concluded that as of September 30, 2012 our disclosure controls and procedures were effective to provide reasonable assurance that information required to be included in our periodic Securities and Exchange Commission reports is recorded accurately, processed, summarized and reported within the time periods specified in the relevant Securities and Exchange Commission rules and forms.

 

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In addition, we reviewed our internal controls, and there have been no changes in our internal controls over financial reporting identified in connection with an evaluation that occurred during the quarter ended September 30, 2012 that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

 

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PART II: OTHER INFORMATION

 

ITEM 1: LEGAL PROCEEDINGS

We are a party to several legal actions that arose in the ordinary course of business. The majority of these actions are related to malpractice claims that are covered under various insurance policies; however, there may be some actions which are not insured. We are unable to predict the ultimate outcome of pending litigation and government investigations, nor can there be any guarantee that the resolution of any litigation or investigation, either individually or in the aggregate, would not have a material adverse effect on our financial position, results of operations or liquidity. However, in our opinion, the outcome of these actions will not have a material adverse effect on the financial position, results of operations or liquidity of our company.

 

ITEM 1A: RISK FACTORS

No changes.

 

ITEM 6: EXHIBITS

The exhibits to this report are listed in the Exhibit Index.

 

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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.

 

LifeCare Holdings, Inc.
By:  

/s/ Phillip B. Douglas

  Phillip B. Douglas
  Chief Executive Officer
By:  

/s/ Stuart A. WALKER

  Stuart A. Walker
  Chief Financial Officer

Dated: November 14, 2012

 

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EXHIBIT INDEX

 

Exhibit

  

Description

  10.1    The form agreement for the Key Employee Retention Program for Phil B. Douglas, Grant B. Asay, Catherine A. Conner, and Erik C. Pahl.
  31.1    Certification of Chief Executive Officer pursuant to Rule 13a-14 of the Securities Exchange Act of 1934, as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
  31.2    Certification of Chief Financial Officer pursuant to Rule 13a-14 of the Securities Exchange Act of 1934, as adopted 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, as 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, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
101.INS    XBRL Instance Document*
101.SCH    XBRL Taxonomy Extension Schema Document*
101.CAL    XBRL Taxonomy Extension Calculation Linkbase Document*
101.LAB    XBRL Taxonomy Extension Label Linkbase Document*
101.PRE    XBRL Taxonomy Extension Presentation Linkbase Document*
101.DEF    XBRL Taxonomy Extension Definition Linkbase Document*

 

* These interactive data files are being submitted electronically with this report and, in accordance with Rule 406T of Regulation S-T, are not deemed filed or part of a registration statement or prospectus for purposes of Section 11 or 12 of the Securities Act of 1933, as amended, are not deemed filed for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and otherwise are not subject to liability under those sections.

 

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