-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, IezTk0G5sN7WKJSn+NzmvUI1IwzNE7WRH3OKjzHR7UzqXDEeJn6ifbKArvvpuSGF kP44zfmlNMXLeO8Ifh8NRQ== 0000950123-98-003275.txt : 19980402 0000950123-98-003275.hdr.sgml : 19980402 ACCESSION NUMBER: 0000950123-98-003275 CONFORMED SUBMISSION TYPE: 10-K PUBLIC DOCUMENT COUNT: 6 CONFORMED PERIOD OF REPORT: 19971231 FILED AS OF DATE: 19980401 SROS: NASD FILER: COMPANY DATA: COMPANY CONFORMED NAME: ADVANCED HEALTH CORP CENTRAL INDEX KEY: 0001002628 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 133893841 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 10-K SEC ACT: SEC FILE NUMBER: 000-21209 FILM NUMBER: 98584691 BUSINESS ADDRESS: STREET 1: 555 WHITE PLAINS RD CITY: TARRYTOWN STATE: NY ZIP: 10591 BUSINESS PHONE: 9145244200 MAIL ADDRESS: STREET 1: 560 WHITE PLAINS RD STREET 2: 2ND FLOOR CITY: TARRYTOWN STATE: NY ZIP: 10591 10-K 1 ADVANCED HEALTH CORPORATION 1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 10-K (Mark One) [X] Annual report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 for the fiscal year ended December 31, 1997 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 0-21209 ADVANCED HEALTH CORPORATION (Exact name of registrant as specified in its charter) Delaware 13-3893841 (State or other jurisdiction (IRS employer identification of incorporation) or organization number) 555 White Plains Road 10591 Tarrytown, New York (Zip code) (Address of principal executive offices) Registrants' telephone number, including area code: (914) 524-4200 Securities registered pursuant to Section 12(b) of the Act: None Securities registered pursuant to Section 12(g) of the Act: Common Stock, $.01 par value Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the 1 2 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 if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to the best of registrant's knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K: [ ] The aggregate market value of the shares of Common Stock held by non-affiliates of the registrant is $127,675,436, based on the closing price of the Common Stock on March 25, 1998. As of March 25, 1998, there were 9,997,371 shares of Common Stock outstanding. DOCUMENTS INCORPORATED BY REFERENCE Portions of the registrant's definitive Proxy Statement for the 1998 Annual Meeting of Stockholders to be filed with the Securities and Exchange Commission within 120 days after December 31, 1997, are incorporated by reference in Part III hereof. 2 3 STATEMENTS MADE OR INCORPORATED INTO THIS ANNUAL REPORT INCLUDE A NUMBER OF FORWARD-LOOKING STATEMENTS WITHIN THE MEANING OF SECTION 27A OF THE SECURITIES ACT OF 1933, AS AMENDED, AND SECTION 21E OF THE SECURITIES EXCHANGE ACT OF 1934. FORWARD-LOOKING STATEMENTS INCLUDE, WITHOUT LIMITATION, STATEMENTS CONTAINING THE WORDS "ANTICIPATES," "BELIEVES," "EXPECTS," "INTENDS," "FUTURE" AND WORDS OF SIMILAR IMPORT WHICH EXPRESS MANAGEMENT'S BELIEF, EXPECTATIONS OR INTENT REGARDING THE COMPANY'S FUTURE PERFORMANCE. THE COMPANY'S ACTUAL RESULTS COULD DIFFER MATERIALLY FROM THOSE SET FORTH IN THE FORWARD-LOOKING STATEMENTS. FACTORS THAT MAY CAUSE SUCH DIFFERENCES ARE DESCRIBED IN THE SECTION ENTITLED "CERTAIN FACTORS THAT MAY AFFECT FUTURE RESULTS" FOUND ON PAGE 33 OF THIS ANNUAL REPORT. PART I ITEM 1. BUSINESS Overview Advanced Health Corporation (the "Company") provides a full range of integrated management services and clinical information systems to physician group practices, single legal entities comprised of multiple physicians, and to physician networks, aggregations of individual physicians and physician groups formed for the purpose of entering into contracts with third-party payors. The Company's clinical information systems are also licensed to hospitals, integrated delivery systems, information system companies, and other health care organizations. The management services provided by the Company include physician practice and network development, marketing, payor contracting, financial and administrative management, clinical information management, human resource management, and practice and network governance management. Through the management of multi-specialty and single-specialty physician group practices and networks, the Company focuses its management efforts on high-cost, high-volume areas of medical care. The Company currently manages twelve multi-specialty physician group practices and five cardiology physician group practices comprised of 342 providers in the greater New York and Philadelphia metropolitan areas and 15 physician networks with approximately 1,700 physicians in the greater New York, Philadelphia and Atlanta metropolitan and surrounding areas, and provides physician group consulting services to more than 50 physicians. The Company developed its clinical information systems to provide physicians, at the point of care and on a real-time basis, with patient-specific clinical and payor information and the ability to generate patient medical orders and facilitate the implementation of disease management programs. In response to the impact of the development of managed care programs on the delivery of health care services, physician practice management companies have emerged in recent years to manage the financial and administrative requirements of physician organizations. More importantly, the Company believes there exists an even greater need among physicians for clinical management services and information systems. The Company believes that assisting physicians in managing the clinical aspects of 3 4 their practices represents the greatest opportunity to enhance the quality and reduce the cost of health care. The Company believes that it is well positioned to attract, organize and manage physician group practices and networks by offering a full range of integrated management services and clinical information systems. The Company believes that its clinical information systems will allow physicians, at the point of care and on a real-time basis, (i) to access patient-specific clinical and payor information, (ii) to generate patient instructions, prescriptions and orders for tests, specialty referrals and specialty procedures and (iii) to access databases containing managed care and disease management protocols, diagnostic treatment preferences and guidelines affecting medical orders. By combining its group practice and network management services with its clinical information systems, the Company believes it can provide physicians with integrated solutions for managing the increased financial opportunities and risks associated with managed care contracts while allowing physicians to improve the quality of care. The Company's strategy includes (i) establishing long-term contractual alliances with physician organizations, (ii) managing high-cost, high-volume areas of medical care in geographic markets that offer concentrations of physicians seeking the Company's services, (iii) providing physicians with clinical information at the point of care, and (iv) developing strategic health care information system ("HCIS") relationships with key industry participants. Through its recent acquisition of Bukstel and Halfpenny Corporation, a company involved in clinical data integration and communications, and its other developing technologies, the Company has entered into licenses with hospitals, integrated delivery systems, information system companies and other health care organizations. The Company's predecessor, Med-E-Systems Corporation ("MES"), was incorporated on August 27, 1993 as a clinical information systems development company. Effective August 23, 1995, MES became a subsidiary of the Company through a tax-free reorganization. The Company was subsequently merged with and into Majean, Inc., a Delaware corporation, and the surviving corporation changed its name to Advanced Health Corporation. On October 3, 1996, the Company consummated the initial public offering (the "IPO") of its Common Stock (including the exercise of the underwriters' over-allotment option). In the IPO, the Company sold 2,645,000 shares of Common Stock at an initial public offering price of $13.00 per share. On October 7, 1997, the Company completed its follow-on offering of 2,250,000 shares of Common Stock including the underwriters' over-allotments option. The follow-on offering generated proceeds to the Company of approximately $46.0 million, net of underwriting expenses. 4 5 Strategy The objective of the Company is to become a leading provider of integrated management services and clinical information systems to physician organizations. By enabling physicians to develop and efficiently manage group practices and networks, the Company seeks to assist physicians in facilitating risk-based managed care contracts, developing and implementing disease management programs and monitoring and controlling health care outcomes and costs. The Company's strategy includes (i) establishing long-term contractual alliances with physician organizations, (ii) managing high-cost, high-volume areas of medical care in selected geographic markets that offer concentrations of physicians seeking the Company's services (iii) providing physicians with clinical information at the point of care, and (iv) developing strategic HCIS relationships with key industry participants. Physician Practice and Network Services The Company provides physicians with a full range of integrated services to form and develop group practices and networks, to manage group practice and network operations, to develop disease management programs and to manage medical risk. These integrated services include clinical support and administrative and marketing services as well as point-of-care information systems and support. The Company often initially provides physician practice and network services pursuant to a consulting arrangement. The Company believes that its point-of-care information systems provide physicians with the information needed to improve the quality and reduce the cost of health care. In addition to providing administrative management services to physician organizations, the Company seeks to differentiate itself by assisting physicians in managing the clinical aspects of 5 6 their practices. The Company believes that its integrated management services and clinical information systems will enhance the ability of physician group practices and networks to implement disease management programs and to manage practices under risk-based contracts. The Company is working to assist physicians in developing disease-specific clinical practice guidelines and in practicing in accordance with applicable standards of care. The Company markets its physician practice management and network management services through (i) direct sales methods, (ii) consultative sales that include providing advice on the development, consolidation and financing of group practices and networks and (iii) cross-selling to customers of its clinical information systems. The Company offers a comprehensive set of physician practice management services, including practice formation, operations development and strategic planning, marketing, payor contracting and management, financial and administrative management, clinical information management, human resource management and practice governance. The Company's physician network management services include network development and strategic planning, disease management program development, payor marketing and contracting, financial and administrative management, clinical information management and network governance. Clinical Information Systems The Company has developed clinical information systems that link physician users at the point of care and on a real-time basis with patient data and clinical guidelines maintained by the Company and third parties. The Company's clinical information systems consist of proprietary software, third-party hardware, proprietary and third-party databases and related support services. The Company's clinical information systems are designed to allow physicians (i) to access patient-specific clinical and payor information, (ii) to generate patient instructions, prescriptions and orders for tests, specialty referrals and specialty procedures and (iii) to access databases containing managed care and disease management guidelines, diagnostic/treatment preferences and guidelines affecting medical orders. 6 7 In September 1997, the Company acquired Bukstel & Halfpenny Incorporated's ("B&H") proprietary laboratory and other health care information technologies business. These technologies expanded the Company's product and service offerings, which provide electronic linkages between physicians and other health care organizations. The primary acquired asset was B&H's DR. CHART system, which links physicians with hospital-based clinical systems such as laboratory, radiology, and pathology systems. This technology allows physicians to view clinical results rapidly and accurately regardless of which lab or facility produced the report. The Company's clinical information systems are designed to complement existing health care information systems and to function with third-party applications. The clinical information system connects to physician users either through the use of a hand-held computer equipped with a wireless modem or a desktop computer using a standard wireline modem. Access to the Company's clinical information systems is delivered to physician users and other health care professionals via both private and public networks, including the Internet. The Company's product suites operate within a client/server-based open architecture. The Company's products support HL-7 interfaces, incorporate TCP/IP protocols for real-time data transmission and run on the Microsoft Windows operating system and standard hardware platforms. The Company employs proprietary processes and standard commercial security measures to ensure the privacy of the data communication paths within its products. The Company licenses its clinical information systems to third party health care organizations as well as its affiliated physicians. The Company continues to pursue strategic relationships with health care providers as well as hospital information systems companies, physician practice management systems companies and on-line services companies for the purpose of further developing and marketing its information systems. The Company offers a broad range of clinical information systems for physician users, presently through applications summarized as follows: Product Name Product Description Med-E-Practice(TM) Med-E-Practice(TM)is a clinical software program designed for use by physicians and their clinical assistants in support of clinical decision making, clinical ordering, 7 8 record keeping and administrative management. This application can co-exist with current paper-based filing systems while supporting a migration path towards a complete electronic medical record (EMR). Additionally, Med-E-Practice(TM) allows an enterprise system to collect clinical data while working cohesively with its community providers. Med-E-Practice(TM) allows physicians to electronically develop the core elements of a medical record by capturing key patient data as a byproduct of their routine patient care. A physician's orders are entered directly into Med-E-Practice(TM), instantly creating a computerized medical record that includes a patient's allergies, medications, and problem list. Dr. Chart(TM) Dr. Chart(TM) is a clinical software application that allows physicians, nurses and other clinicians to effectively manage patient information from multiple sources, such as clinical laboratory, radiology, and pathology systems. Working in conjunction with our CDX(TM) integration product, Dr. Chart(TM) provides clinicians with a common user interface to view, annotate, 8 9 and print patient data from various electronic information sources. 9 10 E-Rx E-Rx(TM) is the first application available to physicians under the EOS-2000(TM) umbrella. This application creates legible and complete prescriptions that are screened for clinical and financial interactions. The resulting prescription can then be printed, faxed, or sent electronically to the patient's pharmacy. The patient's medication, allergy, and problem history is automatically stored in a central server, allowing for convenient data access by any physician involved in the patient's care. 10 11 The Company believes that the timely development of new clinical information applications and the enhancement of existing clinical information systems are important to its competitive position. The Company's product development strategy is directed toward creating new applications that (i) increase the functionality of current products by providing enhanced interfaces to third-party systems and data repositories, (ii) expand coverage along the continuum of clinical care, (iii) increase coverage to additional disease and procedure groups and (iv) provide customers with a range of decision support systems at various price points. The Company has approximately 40 professionals dedicated to systems development. Concentration of Revenues In the year ended December 31, 1997, Madison Medical - The Private Practice Group of New York, LLP ("Madison") and the Advanced Heart Physicians & Surgeons Network, P.C. ("AHP&S") accounted for approximately 17% and 16% of revenues, respectively. The Company's management services agreements generally have an initial term of five to 30 years. Any termination or significant deterioration of the Company's relationships with its principal 11 12 customers could have a material adverse effect on the Company's business, financial condition and results of operations. Contractual Relationships with Affiliated Physicians The Company typically establishes a majority-owned management service organization ("MSO") for each physician organization it manages. The MSO is a joint venture between the physician organization and the Company, with the Company owning at least 51% of the equity in the MSO. The MSO enters into a long-term management services agreement with the physician organization pursuant to which the MSO provides group practice management or network management services that provide both administrative and clinical support to members of the physician organization. The MSO concurrently enters into a services agreement with the Company pursuant to which it gains access to management services and clinical information systems from the Company. The MSO's assets consist primarily of its management service contracts with the physician group or network served and its liabilities consist primarily of its obligations under its agreement with the Company and its obligations to its employees. For certain MSOs, a stockholders agreement is entered into among the MSO, the physician organization and the Company. The stockholders agreement, among other things, (i) restricts the transfer of MSO equity, (ii) provides the terms upon which, after the occurrence of the Trigger Event (as hereinafter defined), the MSO can, at the Company's option, be merged with and into a wholly-owned subsidiary of the Company in a transaction in which interests of the physician groups and networks in such MSO would be exchanged for Common Stock (the "Roll Up Transaction") and (iii) grants to the physician organization the right to put its equity in the MSO to the Company at a price equal to 110% of the then-current fair market value of the shares of Common Stock that would have otherwise been issued in the Roll Up Transaction if the Company does not exercise its option to cause the Roll Up Transaction to occur within one year after the occurrence of the Trigger Event. In the case of each such MSO, a Trigger Event will occur at such time as (i) the Company is providing physician practice management services to at least 300 physicians, (ii) the Company is providing physician network management services to at least 2,000 physicians, (iii) the Company has at least $75,000,000 in stockholders' equity and (iv) the Company's Common Stock is publicly traded. The Company has reserved 548,224 shares of 12 13 Common Stock for issuance upon the merger of such MSOs into the Company. Physician Practices. The management services agreements between the MSO and a physician practice group generally have an initial term of five to 30 years and are automatically renewable for additional terms. Such agreements typically are subject to early termination for cause. The management services agreements generally obligate an MSO to provide certain non-medical practice management services to the physician practice group for a monthly fee. The fee paid to the MSO is generally a combination of fixed fees for certain services and percentage fees for certain services, dependent upon certain state regulations. For risk-based contracts that the physician practice group enters into, the management services agreement will generally provide for additional management fees based upon savings recognized by the physician practice group because of any cost efficiencies resulting from the MSO's performance. The fees are set to be competitive within the geographic area in which the physician practice group is located. A provision restricting the physician practice group from competing against the MSO or employing the MSO's employees is generally included in the agreement. Physician Networks. The management services agreements between the MSO and a physician network generally have an initial term of at least five years and are automatically renewable for additional terms. Such agreements typically are subject to early termination for cause. The management services agreements generally obligate an MSO to provide certain non-medical practice management services to the physician network for a fee. The fee paid to the MSO for risk-based contracts is generally a service fee equal to a specified percentage of capitated revenues, for providing the non-medical management services. The fees are set to be competitive within the geographic area in which the physician network is located. In the agreement, the physician network agrees that the MSO will be the exclusive provider of non-medical management services to the physician network. Capitated and Other Fixed-Fee Arrangements. In the future, the Company anticipates entering into managed care or capitated arrangements, either indirectly through the assignment of managed care contracts entered into between its affiliated physicians and third-party payors or directly through the formation of an independent physician association ("IPA"). The Company has not earned, recognized or recorded any such revenue through December 31, 1997. The Company does, however, provide management services 13 14 to physician groups and networks that have entered into such capitated contracts. Revenues under any managed care or capitated arrangements entered into directly by the Company will generally be a fixed amount per enrollee. Under such an arrangement, the Company would contract with affiliated physicians for the provision of health care services and the Company would be responsible for the provision of all or a portion of the health care requirements of such enrollees. Proprietary Rights The Company is relying upon the effectiveness of protection provided by a combination of patent, trade secret and copyright laws, nondisclosure and other contractual provisions and technological measures to protect its proprietary position in its methodologies, databases and software. The Company has two U.S. patent applications, which, in March 1998, were allowed by the United States Patent and Trademark Office, and a foreign patent application having subject matter common with both U.S. applications. The patent applications are directed to the Company's electronic prescription management system and related technologies. No assurance can be given that patent, trade secrets, copyright or other intellectual property rights can be successfully asserted in any court action. The Company also has copyrights in its software, user documentation and databases. The copyright protection accorded to databases, however, is fairly limited. While the arrangement and selection of data are protectable, the actual data are not, and others are free to create databases that perform the same function. The Company distributes its clinical information systems products under agreements that grant customers non-exclusive licenses and generally contain terms and conditions restricting the disclosure and use of the Company's systems. In addition, the Company attempts to protect the secrecy of its proprietary databases and other trade secrets and proprietary information through confidentiality agreements with employees, consultants and third parties. The Company believes that, aside from the various legal protections of its proprietary information and technologies, 14 15 factors such as the technological and creative skills of its personnel and product maintenance and support are integral to establishing and maintaining its position within the health care industry. Although the Company believes that its products do not infringe upon the proprietary rights of third parties, there can be no assurance that third parties will not assert infringement claims against the Company in the future. Competition The provision of physician practice and network management services is a highly competitive business in which the Company competes for contracts with several national and many regional and local companies. The Company also competes with traditional managers of health care services that directly recruit and manage physicians. Certain of the Company's competitors have access to substantially greater financial resources than the Company. The Company believes that competition in this industry is generally based on cost and quality of services. The market for health care information systems and services is highly competitive and rapidly changing. The Company believes that the principal competitive factors for clinical information systems are the proprietary nature of methodologies, databases and technical resources, the usefulness of the data and reports generated by the software, customer service and support, compatibility with the customer's existing information systems, potential for product enhancement, vendor reputation, price and the effectiveness of marketing and sales efforts. The Company's competitors include other providers of clinical information systems and practice management systems. Many of the Company's competitors and potential competitors have greater financial, product development, technical and marketing resources than the Company, and currently have, or may develop or acquire, substantial installed customer bases in the health care industry. In addition, as the market for clinical information systems and practice management systems develops, additional competitors may enter the market and competition may intensify. While the Company believes that it will successfully differentiate its clinical information systems from those of its competitors, there can be no assurance that future competition will not have a material adverse effect on the Company. Government Regulation 15 16 As a participant in the health care industry, the Company's operations and relationships are subject to extensive and increasing regulation by a number of governmental entities at the federal, state and local levels. The Company believes its operations are in material compliance with applicable laws. Nevertheless, because of the nature of the Company's relationship with physician organizations, many aspects of the Company's business operations have not been the subject of formal state or federal regulatory interpretations and there can be no assurance that a review by courts or regulatory authorities of the Company's business or that of its affiliated physician organizations will not result in a determination that could adversely affect the operations of the Company or that the health care regulatory environment will not change so as to restrict the Company's or the affiliated physicians' existing operations or their expansion. Reimbursement. Management estimates that approximately 40% of the revenues of the Company's affiliated physician group practices are derived from payments made by government-sponsored health care programs (principally Medicare, Medicaid and state reimbursement programs). Consequently, any change in reimbursement regulations, policies, practices, interpretations or statutes could adversely affect the operations of the Company. The federal Medicare program has implemented a system of reimbursement of physician services, RBRVS. The Company expects that future changes in the RBRVS fee schedule, as required by law, and in Medicare reimbursement generally, will result, in some cases, in a reduction and, in some cases, in an increase from historical levels in the per-patient Medicare revenue received by certain of the physician organizations with which the Company contracts. Reductions in the RBRVS fee schedule may have a material adverse effect on the Company, and if adopted by other payors, could have a further material adverse effect on the Company. Billing. There are state and federal civil and criminal statutes, which impose substantial penalties, including civil and criminal fines and imprisonment, on health care providers who fraudulently or wrongfully bill governmental or other third-party payors for health care services. The federal law prohibiting false billings allows a private person to bring a civil action in the name of the U.S. government for violations of its provisions. There is no assurance that the Company's activities will not be challenged or scrutinized by governmental authorities. Moreover, technical Medicare and other reimbursement rules affect the structure of physician billing arrangements. The Company believes 16 17 it is in material compliance with such regulations, but regulatory authorities may differ in their interpretations of such regulations and, in such event, the Company might have to modify its relationship with physician organizations. Noncompliance with such regulations by either the Company or its affiliated physician groups could have a material adverse effect on the business, financial condition and results of operations of the Company and subject it and affiliated physician groups to penalties and additional costs. Billing Agent, and Medicare Reassignment Rules. The Company may be subject to Medicare rules governing billing agents. These rules prohibit a billing agent from receiving a fee based on a percentage of Medicare collections if the billing agent collects Medicare payments for its own account, and may require Medicare payments for the services of physicians to be made directly to the physician providing the services or to an account opened solely in the name of the physician or the physician's group. If an enforcement agency determines that the physician or his group violated any of these rules, the physician and/or his group could be excluded from the Medicare program and subject to civil monetary penalties, and Medicare payments collected under the agency arrangement would be subject to recoupment, all of which could have a material adverse effect on the Company. In addition, the revenues of physician practices affiliated with the Company and the Company's revenues from all insurers, including governmental insurers, are subject to significant regulation. Some payors limit the extent to which physicians may assign their revenues from services rendered to beneficiaries. Under these "reassignment" rules, the Company may not be able to require physicians to assign third-party payor revenues received from government-sponsored payment programs unless the physicians are employees of the Company, the Company is a health care delivery system (or physician directed clinic), the Company is a qualified billing agent for the physicians, or other conditions are met. In addition, governmental payment programs and certain commercial insurers will not pay for the services of mid-level practitioners who are supervised by physicians, unless the mid-level practitioners' services are rendered "incident to" physician services. To meet this "incident to" requirement, the mid-level practitioners must be either direct or leased employees of the physician group at which they work. If an enforcement agency determines that the Company or an affiliated physician practice has violated any of the various "reassignment" and "incident to" rules, the affiliated physician practice could be excluded from such payment program, payments could be recouped, civil penalties could be imposed, and continued violations, after notice, could result in criminal penalties. Corporate Practice of Medicine and Fee Splitting. The laws of many states prohibit business corporations such as the Company from practicing medicine and employing physicians to practice medicine. These laws forbid both direct control over medical decisions and indirect interference, such as splitting medical fees with physicians or controlling budgetary allotments for patient care. Laws regarding the corporate practice of medicine vary from state to state and are enforced by the courts and by regulatory authorities. All of the management service agreements ("MSAs") between the Company's majority-owned MSOs and the physician groups and networks they serve address this issue by providing that the physician organization retains complete control over medical decisionmaking, and that the MSO may neither interfere with the professional judgment of medical personnel nor control, direct or supervise the provision of medical services. Furthermore, the MSAs provide that the MSO may not perform any services or activities which constitute the practice of medicine. For instance, the MSO has no responsibility to make decisions regarding level of patient care, credentialing or quality monitoring. Each MSO controlled by the Company is a management organization whose role is to perform administrative and business functions. Although the Company believes it is in material compliance with regulations regarding the corporate practice of medicine, no assurance can be given that its operations will not be challenged by regulatory authorities. A recent letter by the general counsel of the New York State Department of Health has called into question commonplace practices with regard to management services fees charged to physician practices by corporations such as the Company. Specifically, this letter took the position that per visit fees and billing fees based on a percentage of collections violated New York's prohibition on fee-splitting by licensed professionals. The Company has abandoned such percentage of collection fees in all of the new MSAs with physicians in New York and is currently working toward modifying all of its current MSAs in New York. Furthermore, expansion of the operations of the Company to certain 17 18 jurisdictions may require it to comply with such jurisdictions' regulations which could lead to structural and organizational modifications of the Company's form of relationships with physician organizations. Such changes, if any, could have a material adverse effect on the Company's business, financial condition and results of operations and on the price of the Common Stock. In addition, a determination in any state that the Company is engaged in the corporate practice of medicine or fee splitting could render any management services agreement or Independent Practice Association ("IPA") provider agreement between the Company and a practice in such state unenforceable or subject to modification in a manner materially adverse to the Company. Fraud and Abuse Statutes. Certain provisions of the Social Security Act, commonly referred to as the "Anti-kickback Statute," prohibit the offer, payment, solicitation or receipt of any form of remuneration which is intended to induce business for which payment may be made under a federal health care program. A federal health care program is any plan or program that provides health benefits, whether directly, through insurance or otherwise, which is funded directly, in whole or in part, by the United States government (e.g., Medicare, Medicaid and CHAMPUS). Excluded from the definition of federal health care program is the Federal Employee Health Benefits Program. The type of remuneration covered by the Anti-kickback Statute is very broad. It includes not only kickbacks, bribes and rebates, but also proscribes any such remuneration, whether made directly or indirectly, overtly or covertly, in cash or in kind. Moreover, prohibited conduct includes not only remuneration intended to induce referrals, but also remuneration intended to induce the purchasing, leasing, arranging or ordering of any goods, facilities, services or items paid for by a federal health care program. In some instances, for example, the government may construe some of the marketing and managed care contracting activities conducted by the Company as arranging for the referral of patients to physician groups managed by the Company. In addition, in the event the Company provides management services to two or more physician groups and charges a percentage-based fee for those services, any cross-referral from a physician in one group to a physician in another group could be deemed to benefit the referring physician since the value of that physician's ownership in the Company will increase if the other physician group pays a management fee which is related to the service provided pursuant to the referring physician's referral. The Anti-kickback Statute has been broadly interpreted by courts in many jurisdictions. Read literally, the statute places at risk many business arrangements potentially subjecting such arrangements to lengthy expensive investigations and prosecutions initiated by federal and state government officials. Many states, including some of those in which the Company does business, have adopted similar prohibitions against payments intended to induce referrals of Medicaid and other third-party payor patients. The Company believes that, although it is receiving remuneration under the MSAs for management services, it is not in a position to make or influence the referral of patients or services reimbursed under government programs to the physician groups and, therefore, believes it has not violated the Anti-kickback Statute. Although the Company will assist physician groups and networks in negotiating its contracts to provide professional services and will provide marketing and advertising services on behalf of such groups and networks, the Company will not refer patients to such groups and networks. Payments to the Company by such groups and networks in connection with marketing and advertising services should not be viewed as payments to the Company to induce referrals because the marketing services provided by the Company are of a general nature, and are not intended to direct patients to any particular provider for any particular Medicare/Medicaid covered item or service. Payments or issuances of Company stock or stock options to physicians should also not be viewed as payments to induce the purchase of an item or service reimbursable by Medicare or state health care programs, and management fees paid by affiliated physician groups and/or networks to the Company should not be viewed as payments to induce the Company to refer patients to such groups and networks because such payments will be consistent with the fair market value of the items or services received in exchange. Nevertheless, because of the breadth of federal and state anti-kickback statutes and the absence of court decisions interpreting their application to arrangements such as those entered into by the Company, there can be no assurance that the Company's activities will not be challenged by regulatory authorities or that the Company's position will prevail if challenged. Although the Company believes that it is in compliance with the federal fraud and abuse statute, any exclusion or penalty applied to one or more affiliated physician groups or networks due to a violation of the federal fraud and abuse laws could have a material adverse effect upon the Company. Moreover, the Company is not a separate provider of Medicare or state health program reimbursed services. To the extent the Company is deemed 18 19 to be either a referral source or a separate provider under its MSAs and to receive referrals from physicians, the financial arrangements under such agreements could be subject to scrutiny and prosecution under the Anti-kickback Statute. Violation of the Anti-kickback Statute is a felony, punishable by criminal fines up to $25,000 per violation and imprisonment for up to five years; a civil monetary penalty of $50,000; and/or civil damages of not more than three times the amount of remuneration offered, paid, solicited or received without regard to whether any portion of such remuneration was for a lawful purpose. In addition, the U.S. Department of Health and Human Services ("HHS") may impose civil penalties excluding violators from participation in Medicare or state health programs. In July 1991, in part to address concerns regarding the Anti-kickback Statute, the federal government published regulations that provided exceptions, or "safe harbors," for transactions that will be deemed not to violate the Anti-kickback Statute. Among the safe harbors included in the regulations were provisions relating to the sale of practitioner practices, management and personal services agreements and employee relationships. Additional safe harbors were proposed in September 1993 offering new protections under the Anti-kickback Statute to eight activities, including referrals within group practices consisting of active investors. Proposed amendments to clarify these safe harbors were published in July 1994 which, if adopted, would cause substantive retroactive changes to the 1991 regulations. The failure of an activity to qualify under a safe harbor provision, while potentially leading to greater regulatory scrutiny, does not render the activity illegal. Although the Company believes that it is not in violation of the Anti-kickback Statute, its operations may not fit within any of the existing or proposed safe harbors. As a component of the recently enacted Health Insurance Portability and Accountability Act of 1996, Congress directed the Secretary of HHS to issue advisory opinions regarding compliance with the Anti-kickback Statute. Advisory opinions are available concerning what constitutes prohibited remuneration within the meaning of the Anti-kickback Statute, whether an arrangement satisfies the statutory exceptions to the Anti-kickback Statute, whether an arrangement meets a safe harbor, what constitutes an illegal inducement to reduce or limit services to individuals entitled to benefits covered by the Anti-kickback Statute and whether an activity constitutes grounds for the imposition of civil or criminal penalties under the applicable exclusion. Advisory opinions, however, will not assess fair market value for any goods, services or property or determine whether an individual is a bona fide employee within the meaning of the Internal Revenue Code. The statutory language makes clear that advisory opinions 19 20 are available for both proposed and existing arrangements. The failure of a party to seek an advisory opinion, however, may not be introduced into evidence to prove that the party intended to violate the Anti-kickback Statute. The Company has not sought, and has no present intention of seeking, an advisory opinion regarding any aspect of its current operations or arrangements with physicians. Significant prohibitions against physician referrals were enacted by Congress in the Omnibus Budget Reconciliation Act of 1993. These prohibitions, commonly known as "Stark II," amended prior physician self-referral legislation known as "Stark I" by dramatically enlarging the field of physician-owned or physician-interested entities to which the referral prohibitions apply. Effective January 1, 1995, Stark II prohibits, subject to certain exceptions, a physician or a member of his or her immediate family from referring Medicare patients to an entity providing designated health services in which the physician has an ownership or investment interest, or with which the physician has entered into a compensation arrangement, including the physician's group practice. The designated health services include radiology and other diagnostic services, radiation therapy services, physical and occupational therapy services and providing durable medical equipment, parenteral and enteral nutrients, equipment and supplies, prosthetics, orthotics, outpatient prescription drugs, home health services and inpatient and outpatient hospital services. The penalties for violating Stark II include a prohibition on payment by these government programs and civil penalties of as much as $15,000 for each violative referral and $100,000 for participation in a "circumvention scheme." The Company believes that its activities are not in violation of Stark I or Stark II. Stark II also applies to indirect financial arrangements. To the extent physicians managed by the Company are determined to have an indirect financial relationship with physicians in separate practices which are managed by the Company, absent a Stark II exception, referrals for designated health services between physicians in different practices could be prohibited. Stark II also governs a physician's ability to refer patients for designated health services within the practices and networks that the Company manages in light of the physician's ongoing compensation arrangements with such practices and networks. An exception for in-office ancillary services requires that the practices and networks meet certain structural and operational requirements on an ongoing basis in order to bill for in-office ancillary designated health services rendered by employed or contracted physicians. A key feature of the in-office ancillary services exception is the Stark law's definition of "group 20 21 practice." In this regard, on January 9, 1998, the Health Care Financing Administration ("HCFA") published proposed regulations interpreting the scope and refining the application of the Stark II law. These regulations provide, in the case of designated health services provided by a group practice, that the overhead expenses and income from the practice must be distributed according to methods that indicate that the practice is a unified business and not based on each satellite office operating as if it were a separate enterprise. There can be no assurance that the distribution methodologics used by practice groups managed by the Company will meet the unified business requirement. A determination that any practice group's sharing of overhead expenses and income does not comply with Stark II would preclude physician owners of such practice groups from referring Medicare/Medicaid patients to their practice group(s) for certain designated health services, and could have a material adverse effect on such group(s), and therefore the Company. In addition, the proposed regulations contemplate that the issuance to physicians of stock in a company prior to such company being publicly traded may not satisfy the Stark exception for ownership interests in publicly traded companies. Thus, to the extent the Company becomes a provider of designated health services, physicians who have received stock or stock options in the Company before it became public may be precluded from making Medicare/Medicaid referrals to the Company and, under certain circumstances, to other affiliated medical groups, for designated health services, which could have a material adverse impact on the Company. In addition, the proposed Stark II regulations present a variety of additional modifications, clarifications and additions to the current Stark I regulations, including changes to the definition of designated health services. Many of these proposed changes, if finally adopted in their current or even modified form, could have a material adverse effect on the physician groups and networks managed by the Company, and therefore could have a material adverse effect on the Company. It is not clear when the final Stark II regulations will be issued in their final form. In the recently enacted Balanced Budget Act of 1997, Congress directed the Secretary of HHS to issue advisory opinions as to whether a referral relating to designated health services (other than clinical laboratory services) is prohibited under the Stark law. The advisory opinion mechanism is authorized to begin on or about November 3, 1997. An advisory opinion issued by the Secretary will be binding as to the Secretary and the party or parties requesting the opinion. The Company has no present intention to seek an advisory opinion regarding its current operations, arrangements with physicians or the referral activities of physicians in the practices and networks it manages. A number of states have enacted self-referral laws that are similar in purpose to Stark II but which impose different restrictions on referrals from Stark II. These various state self-referral laws have different requirements. Some states, for example, only prohibit referrals when the physician's financial relationship with a health care provider is based upon an investment interest. Other state laws apply only to a limited number of designated health services or, alternatively, to all health care services furnished by a provider. Some states do not prohibit referrals at all, but require only that a patient be informed of the financial relationship before the referral is made. Most of the states in which the Company conducts business have adopted some form of self-referral law. Many states, including Pennsylvania, have self-referral laws that are particularly applicable to workers' compensation patients. The Company believes that its current operations and the structure of the practices and networks it manages are in material compliance with the self-referral laws of the states in which such practices and networks are located. Under numerous federal laws, including the Federal False Claims Act (the "False Claims Act"), the federal government is authorized to impose criminal, civil and administrative penalties on any health care provider that files a false claim for reimbursement from a federally funded health program (such as 21 22 Medicare or Medicaid). Recently enacted federal legislation also imposes federal criminal penalties on persons who file false or fraudulent claims with private insurers. While the criminal statutes are generally reserved for instances of fraud, the civil and administrative penalty statutes are being applied by the government in an increasingly broad range of circumstances. Civil sanctions may be imposed if the claimant knew or should have known that billing was improper. The government also has taken the position that claiming reimbursement for services that are substandard is a violation of these false claims statutes if the claimant knew or should have known that the care was substandard or rendered under improper circumstances. Private persons may bring civil actions to enforce the False Claims Act. Under certain lower court decisions, claims derived from the Anti-kickback Statute or the Stark law have been deemed to be, or may under certain circumstances be construed to be, false claims. PIP Regulations. HCFA has issued final regulations (the "PIP regulations") covering the use of physician incentive plans ("PIPs") by HMOs and other managed care contractors and subcontractors that contract to arrange for services to Medicare and Medicaid beneficiaries ("Organizations"). Any Organization that contracts with a physician group that places the individual physician members of the group at substantial financial risk for the provision of services that the group does not directly provide (e.g., if a primary care group takes risk but subcontracts with a specialty group to provide certain services) must satisfy certain disclosure, survey and stop-loss requirements. Under the PIP regulations, payments of any kind, direct or indirect, to induce providers to reduce or limit covered or medically necessary services are prohibited ("Prohibited Payments"). Further, where there are no Prohibited Payments but there is risk sharing among participating providers related to utilization of services by their patients, the regulations contain three groups of requirements: (i) requirements for physician incentive plans that place physicians at "substantial financial risk," (ii) disclosure requirements for all Organizations with PIPs: and (iii) requirements related to subcontracting arrangements. In case of 22 23 substantial financial risk (defined in the regulations according to several methods, but essentially risk in excess of 25% of the maximum payments anticipated under a plan with less than 25,000 covered lives), Organizations must conduct enrollee surveys and ensure that all providers have specified stop-loss protection. The violation of the requirements of the PIP regulations may result in a variety of sanctions, including suspension of enrollment of new Medicaid or Medicare members, or a civil monetary penalty of $25,000 for each determination of noncompliance. In addition, because of the increasing public concerns regarding PIPs, the PIP regulations may become a model for the industry as a whole. Although the Company currently has no contracts that require compliance with the PIP regulations, the new regulations, by limiting the amount of risk that may be imposed upon physicians in certain arrangements, could have an effect on the ability of the Company to effectively reduce the costs of providing services, by limiting the amount of risk that may be imposed upon physicians. Antitrust. Because the physician organizations managed by the Company remain separate legal entities, they may be deemed competitors subject to a range of antitrust laws which prohibit anti-competitive conduct, including price fixing, concerted refusals to deal and divisions of markets. In particular, the antitrust laws have been interpreted by the Federal Trade Commission and the United States Department of Justice to prohibit joint negotiations by competitors of price terms in the absence of financial risk that is shared among the competitors, other financial integration or substantial clinical integration among the competitors. The Company intends to comply with such state and federal laws as may affect its development of, and contracting for, integrated health care delivery networks, but there can be no assurance that review of the Company's business by courts or regulatory authorities will not result in a determination that could adversely affect the operation of the Company and its affiliated physician groups. Insurance Regulations. Laws in all states regulate the business of insurance and the operation of Health Maintenance Organizations ("HMOs") HMOs. On August 10, 1995, the National Association of Insurance Commissioners ("NAIC") issued a report opining that certain risk-transferring arrangements may entail the business of insurance, to which state licensure laws apply, but that licensure laws would not apply where an unlicensed entity contracts to assume "downstream risk" from a duly licensed health insurer or HMO for health care provided to that carrier's enrollees. In addition, in December 1996, the NAIC issued a report entitled "Regulation of Health Risk Bearing Entities," which sets forth issues to be 23 24 considered by state insurance regulators when considering new regulations, and encourages that a uniform body of regulation be adopted by the states. Certain states have enacted statutes or adopted regulations affecting risk assumption in the health care industry. In some states, including some of those in which the Company does business, these statutes and regulations subject any physician or physician network engaged in risk-based contracting, even if through HMOs and insurance companies, to applicable insurance laws and regulations, or other laws and regulations, which may include, among other things, providing for minimum capital requirements and other safety and soundness requirements. Although the NAIC's conclusions are not binding on the states, the Company believes that additional regulation at the state level will be forthcoming in response to the NAIC initiatives. The Company will enter into capitated contracts only with licensed insurance companies and HMOs, and only if allowed by state law. The Company believes that it is in compliance with these laws in the states in which it does business, but there can be no assurance that future interpretations of insurance laws and health care network laws by the regulatory authorities in these states or in the states into which the Company may expand will not require licensure or a restructuring of some or all of the Company's operations. Health Care Reform. As a result of the continued escalation of health care costs and the inability of many individuals to obtain health insurance, numerous proposals have been and may continue to be introduced in the U.S. Congress and state legislatures relating to health care reform. There can be no assurance as to the ultimate content, timing or effect of any health care reform legislation, nor is it possible at this time to estimate the impact of potential legislation, which may be material to the Company. Confidentiality of Patient Records. The confidentiality of patient records and the circumstances under which such records may be released is subject to substantial regulation under state and federal laws and regulations. Although the Company does not currently collect aggregate clinical data for utilization review and quality assurance purposes, it plans to develop such databases. Data entries to these databases would delete any patient identifiers, including name, address, hospital and physician. With respect to its electronic clinical information systems, the Company uses a state-of-the-art security system, including user passwords, 128-bit key encryption technology and a triple-DES encryption algorithm, to safeguard the privacy of clinical data accessed or transmitted on both private and public 24 25 networks, including the Internet, and will continue to employ such security measures in the future. The Company believes that its procedures comply with the laws and regulations regarding the collection of patient data in substantially all jurisdictions, but regulations governing patient confidentiality rights are evolving rapidly and are often difficult to apply. Additional legislation governing the dissemination of medical record information has been proposed at both the state and federal level. Furthermore, the Health Insurance Portability and Accountability Act of 1996 requires the Secretary of HHS to recommend legislation or promulgate regulations governing privacy standards for individually identifiable health information and creates a federal criminal offense for knowing disclosure or misuse of such information. These statutes and regulations may require holders of such information to implement security measures that may be of substantial cost to the Company. There can be no assurance that changes to state or federal laws would not materially restrict the ability of the Company to obtain patient information originating from records. Licensure, Certificate of Need and Prescription Laws. Certain of the ancillary services that the Company anticipates providing on behalf of the practices and networks it manages are now, or may in the future be, subject to licensure or certificate of need laws in various states. There can be no assurance that the Company, or the practices or networks it manages, will be able to obtain such licenses or certificate of need approval to the extent required for the particular ancillary service. Each state establishes rules related to the practice of medicine, including the method of prescribing drugs. In addition, the federal drug enforcement administration (the "DEA") regulates the issuance and content of prescriptions for controlled substances. The application of these federal and state rules to the use of the electronic prescription writing and management systems (the "Prescription Systems") varies. Certain states in which the Company does business, such as New York, Delaware and Tennessee, prohibit the use of the Prescription Systems while the other states in which the Company does business, Connecticut, Georgia, New Jersey and Pennsylvania, limit the use of the Prescription Systems and the DEA neither specifically permits nor specifically prohibits electronic transmission of prescription orders. The DEA is investigating the possibility of adopting a policy regarding electronic transmission of prescription orders, such as that used by the Prescription Systems, for controlled substances. The Company will advise users of the Prescription Systems of the existence of these restrictions and limitations and believes its use of the Prescription Systems will be in compliance with 25 26 applicable state and federal laws. Modification or further clarification of federal and state rules regarding use of the Prescription Systems in a manner that reduces their utility may have a material adverse effect on the Company. FDA Regulation. Certain products, including software applications, intended for use in the diagnosis of disease or other conditions, or in the cure, treatment, mitigation or prevention of disease, are subject to regulation by the Food and Drug Administration ("FDA") under the Federal Food, Drug and Cosmetic Act of 1938, as amended (the "FDCA"). The FDCA imposes substantial regulatory controls over the manufacturing, testing, labeling, sale, distribution, marketing and promotion of medical devices and other related activities. These regulatory controls can include, for example, compliance with the following: manufacturer establishment registration and device listing; current good manufacturing practices; FDA clearance of a premarket notification submission or FDA approval of a premarket approval application; medical device adverse event reporting; and prohibitions on misbranding and adulteration. Violations of the FDCA can result in severe criminal and civil penalties, and other sanctions, including, but not limited to, product seizure, recall, repair or refund orders, withdrawal or denial of premarket notifications or premarket approval applications, denial or suspension of government contracts, and injunctions against unlawful product manufacture, labeling, promotion, and distribution or other activities. In its 1989 Draft Policy Statement, the FDA stated that it intended to exempt certain clinical decision support software products from a number of regulatory controls. Under the 1989 Draft Policy Statement, the FDA stated that it intended to exempt decision support software products that involve "competent human intervention before any impact on human health occurs (e.g., where clinical judgment and experience can be used to check and interpret a system output)" from the following controls: manufacturer establishment registration and device listing, premarket notification and compliance with the medical device reporting and current good manufacturing practice regulations. In the 1989 Draft Policy Statement, the FDA stated that until it formally exempted decision support software products from these requirements, manufacturers of eligible decision support software products would be required to comply with those controls. Since issuing the 1989 Draft Policy Statement, the FDA has not issued a final policy on this issue and has not formally exempted any products as discussed in the 1989 Draft Policy 26 27 Statement. The FDA has referred to the 1989 Draft Policy Statement in official presentations regarding software regulation and in decisions and opinions regarding the regulatory status of various products. Over the last several years, however, the FDA has stated that it intends to issue a new policy concerning computer products and has been increasing its efforts to develop this policy in recent months. Under this new policy, exemptions from regulatory controls, if any, may be based upon a product specific "risk factor" analysis. For purposes of this analysis, the FDA may consider, among other things, the following: (i) seriousness of the disease to be diagnosed or treated, (ii) the time frame for use of the information, (iii) whether the data output is provided or manipulated in a novel or non-traditional manner, (iv) whether the software provides individualized patient care recommendations, (v) whether the mechanism by which the software arrives at a decision is hidden or transparent and (vi) whether the product provides new capabilities for the user. Given the FDA's intent to issue a new policy concerning the regulation of computer software, there can be no assurance as to the effect of such a policy, if any, upon the regulatory status of the Company's products. The Company's clinical information systems are intended to assist health care providers in analyzing economic and quality data related to patient care and expected outcomes in order to maximize the cost-effectiveness of general treatment plans and practice protocols. These products are not intended to provide specific diagnostic data, results or affect the use of specific therapeutic interventions for individual patients. As such, the Company believes that its clinical information systems are not medical devices under the FDCA and, thus, are not subject to the controls imposed on manufacturers of medical devices and do not fall within the scope of the 1989 Draft Policy Statement. The Company further believes that to the extent that its products might be determined to be medical devices, they fall within the exemptions for decision support systems provided by the 1989 Draft Policy Statement. The Company has not taken action to comply with the requirements that would otherwise apply if the Company's products were determined to be non-exempt medical devices. There can be no assurance that the FDA will not make a request or take other action to require the Company to comply with any or all current or future controls applicable to medical devices under the FDCA. There can be no assurance that, if such a request were made or other action were taken, the Company could comply in a timely manner, if at all, or that any failure to comply would not have a material adverse effect on the Company's business, financial condition or results of operations, or that 27 28 the Company would not be subjected to significant penalties or other sanctions. There can be no assurance that the FDA will continue to permit any or all of the exemptions provided in the 1989 Draft Policy Statement, or in a new policy statement, if any, or that the FDA will promulgate regulations formally implementing such exemptions. There can be no assurance that the Company's current or future clinical information systems will qualify for future exemptions, if any, nor can there be any assurance that any future requirements will not have a material adverse effect on the Company's business, financial condition or results of operations. While the Company believes that it and the MSOs are in compliance with the foregoing federal and state laws, future regulations could require the Company to modify the form of its relationships with physician organizations. Moreover, the violation of any such state or federal law by the Company, the MSOs or the physician organizations managed by the Company could have a material adverse effect on the Company. The health care industry is subject to changing political, economic and regulatory influences that may affect the procurement practices and operations of health care industry participants. During the past several years, government regulation of reimbursement rates in the United States health care industry has increased. Lawmakers continue to propose programs to reform the United States health care system, which may contain proposals to increase government involvement in health care, lower reimbursement rates and otherwise change the operating environment for the Company's customers. Health care industry participants may react to these proposals by curtailing or deferring investments, including investments in the Company's products. The Company cannot predict what impact, if any, such factors may have on its business, financial condition and results of operations or on the price of the common Stock. Year 2000 The Year 2000 date change issue is believed to affect virtually all companies and organizations. If not corrected, many long term applications could fail or create erroneous reults by or at year 2000. The Company is undertaking an investigation to dertermine if the Company's computer systems, the Company's proprietary software products, and the computer systems of the physician practices and networks and other third parties with which the Company does business (as they relate to the Company) are Year 2000 compliant. The failure of any of the foregoing matters to be Year 2000 compliant might materially adversely affect the Company. Employees As of December 31, 1997, the Company had a total of approximately 700 employees, approximately 500 of whom were employed by the MSOs, approximately 55 of whom were employed in the Company's information systems subsidiary. None of the Company's employees is subject to a collective bargaining agreement. The Company has never experienced a work stoppage and believes that its employee relations are satisfactory. ITEM 2. PROPERTIES The Company currently occupies 26,302 square feet of leased office space in Tarrytown, New York, 16,252 of square feet of leased space in Hawthorne, New York, 4,065 square feet of leased office space in Marietta, Georgia, 8,028 square feet of leased office space in Fort Washington, Pennsylvania and 10,742 square feet of leased office and data center space in Chicago, Illinois. The 28 29 current lease for the Tarrytown office has an annual rental of approximately $500,000 and expires in March 2002. The lease for the Marietta office expires in January 2001 and has an annual rental of approximately $50,000. The lease for the Fort Washington office expires in December 2002 and has an annual rental of approximately $128,000. The lease for the Chicago office expires in March 2001 and has an annual rental of $184,000 for the current year. The Company believes that these facilities are adequate for the foreseeable future. ITEM 3. LEGAL PROCEEDINGS On May 22, 1997, an action captioned Benenson & Associates, Inc and Michael J. Benenson v. Advanced Health Corporation, Advanced Health Management Corp. f/k/a Advanced Clinical Networks Corp., Jonathan Edelson, M.D., Steven I. Hochberg and Alan B. Masarek was filed in the United States District Court for the Southern District of New York. The action relates to: (i) an Employment Agreement dated April 1, 1996 between the Company and Michael J. Benenson and (ii) an Asset Purchase Agreement dated April 1, 1996, among the Company, Benenson & Associates, Inc. and Mr. Benenson, Plaintiffs have asserted claims against all defendants for alleged violations of the Exchange Act, common law fraud and fraudulent inducement, and against the Company for breach of contract. Plaintiffs' complaint seeks both damages and equitable relief. The Company believes that each of the plaintiffs' claims is without merit, and it intends to defend against the action vigorously. On September 23, 1997, the Company commenced an action against Synetic, Inc. ("Synetic") entitled Advanced Health Med-E-Systems Corporation v. Synetic, Inc. in the Supreme Court of the State of New York to collect $1 million owing by Synetic to the Company pursuant to a software license agreement dated as of March 31, 1997, as amended (the "License Agreement"), between Synetic and the Company, with respect to E-Rx(TM). On October 1, 1997, Synetic filed an answer to this lawsuit and asserted various counterclaims against the Company, in which Synetic alleges that the subject software and documentation was not timely delivered and installed in accordance with the License Agreement. As relief, Synetic seeks a declaratory judgment that Synetic is not obligated to make the $1 million payment, as well as unspecified damages. The Company believes that Synetic's defenses and counterclaims are without merit. 29 30 From time to time, the Company is involved in litigation. Although the actual amount of any liability that could arise with respect to any such litigation cannot be accurately predicted, in the opinion of management, the resolution of these matters is not expected to have material adverse effect on the Company's business, results of operations or financial condition. Item 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY-HOLDERS NONE. 30 31 PART II Item 5. MARKET FOR REGISTRANTS' COMMON EQUITY AND RELATED STOCKHOLDER MATTERS The Common Stock began trading on the Nasdaq National Market under the symbol "ADVH" on October 3, 1996. (a) Market Information The following sets forth the high and low bid price for the period commencing January 1, 1997 through December 31, 1997 as reported by NASDAQ. Quotations reflect interdealer prices without retail mark-up, mark-down or commission, and may not represent actual transactions.
Common Stock High Low ---- --- October 3, 1996 through December 31, 1997 $17.75 $12.50 First Quarter ended March 31, 1997 18.25 6.625 Second Quarter ended June 30, 1997 20.75 14.125 Third Quarter ended September 30, 1997 24.875 17.00 Fourth Quarter ended December 31, 1997 28.125 11.00
(b) Approximate Number of Equity Stockholders Based upon information supplied from the Company's transfer agent, the Company believes that the number of record holders of the Company's equity securities as of March 25, 1998 is approximately 250 The Company believes that the number of beneficial holders of the Company's Class A Common Stock as of March 25, 1998 is in excess of 300. (c) Dividends The Company has not declared or paid any cash dividends on its capital stock since inception and does not expect to pay cash dividends in the foreseeable future. The Company presently intends to retain future earnings, if any, to finance the expansion of its business. The payment of any cash dividends in the future will depend on the Company's earnings, financial condition, results of 31 32 operations, capital needs and other factors deemed pertinent by the Company's Board of Directors, subject to laws and regulations then in effect. Item 6. SELECTED FINANCIAL DATA The selected consolidated statement of operations data for the years ended December 31, 1995, 1996 and 1997, and the consolidated balance sheet data as of December 31, 1996 and 1997, are derived from the consolidated Financial Statements of the Company included elsewhere in this Annual Report on Form 10-K, which have been audited by Arthur Andersen LLP, independent public accountants. The selected consolidated statement of operations data for the period from inception (August 27, 1993) to December 31, 1993 and the selected consolidated balance sheet data as of December 31, 1993 and 1994 are derived from the consolidated financial statements of the Company which have been audited by Arthur Andersen LLP, independent public accountants, but which are not included in this Annual Report on Form 10-K. The selected consolidated financial data set forth below is qualified by reference to, and should be read in conjunction with, the Company's Consolidated Financial Statements and the Notes thereto and "Management's Discussion and Analysis of Financial Condition and Results of Operations" contained elsewhere in this Annual Report on Form 10-K.
Period from inception (August 27, 1993) to December 31, 1993 1994 1995 1996 1997 (In thousands, except per share data) Statement of Operations Data: Revenues $ -- $ 379 $ 1,054 $ 19,136 $ 61,006 Cost of revenues -- 12 340 14,265 45,636 ------- ------- -------- -------- -------- Gross profit -- 367 714 4,871 15,370 Operating expenses 521 2,901 6,412 7,328 8,954 ------- ------- -------- -------- -------- Operating (loss) income (521) (2,534) (5,698) (2,457) 6,416 Other income (expense) -- (15) (9) 15 1,144 ------- ------- -------- -------- -------- Net loss before income taxes (521) (2,549) (5,707) (2,442) 7,560 Income tax provision (benefit) -- -- -- (977) 402 ------- ------- -------- -------- -------- Net (loss) income $ (521) $(2,549) $ (5,707) $ (1,465) $ 7,158 ======= ======= ======== ======== ======== Net (loss) income per share; Basic $ (0.30) $ (1.29) $ (1.67) $ (0.28) $ 0.91 ======= ======= ======== ======== ======== Diluted $ (0.30) $ (1.29) $ (1.67) $ (0.28) $ 0.81 ======= ======= ======== ======== ======== Common shares used in computing per share amounts; Basic 1,725 1,978 3,420 5,149 7,872 ======= ======= ======== ======== ======== Diluted 1,725 1,978 3,420 5,149 8,891 ======= ======= ======== ======== ========
32 33
1995 1996 1997 (In thousands) Balance Sheet Data: Cash and cash equivalents $ 1,464 $12,086 $ 7,534 Investments in marketable securities -- 7,390 34,082 Certificates of deposit -0- -0- 5,399 Working capital (deficit) (741) 26,603 61,644 Total assets 6,462 35,400 94,358 Total debt 235 26 Total stockholders' equity 2,675 31,884 93,100
ITEM 7. MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS The following discussion of the results of operations and financial condition of the Company should be read in conjunction with the Consolidated Financial Statements and the notes thereto included elsewhere in this Annual Report on Form 10-K. CERTAIN FACTORS THAT MAY AFFECT FUTURE RESULTS The Company's actual results could differ materially from its historical results or from any forward-looking statements made or incorporated into this Annual Report. Factors that may cause such differences include: the Company's ability to successfully enter in to new contractual alliances with Physician organizations and to preserve its existing contractual relationships; the Company's ability to successfully expand its business to new markets; the Company's ability to attract and retain qualified personnel and management; changes in state insurance laws and related government regulations; increased competition and growth in the medical practice management market; and other unanticipated changes in economic conditions. Overview Advanced Health Corporation (the "Company") provides a full range of integrated management services and clinical information systems to physician group practices, single legal entities comprised of multiple physicians, and to physician networks, aggregations of individual physicians and physician groups formed for the purpose of entering into contracts with third-party payors. The Company's clinical information systems are also licensed to hospitals, integrated delivery systems, information system companies, and other health care organizations. 33 34 The Company generates revenues from (i) fees for managing and providing consulting services to physician group, practices, (ii) fees for managing physician networks and (iii) fees for use and support of its clinical information systems, including licensed, software installation, software integration, training and data conversion fees. The Company contracts with its physician practice and network management clients pursuant to long-term agreements with its MSOs, the financial results of such MSOs are included in the Consolidated Financial Statements. The Company believes that its historical results of operations from period to period are not comparable and that such results are not necessarily indicative of results for any future periods because the Company was a development stage company investing in technology development and did not provide physician practice and network management services prior to December 11, 1995. Results of Operations Year Ended December 31, 1997 and 1996 Total revenues for the year ended December 31, 1997 increased to $61.0 million from $19.1 million in the year ended December 31, 1996, primarily as a result of the addition of new physician group practices under management, provision of incremental network management services and fees for the use and support of clinical information systems. The provision of physician group practice management and related services and network management services accounted for approximately $48.7 million of the Company's net revenues for the year ended December 31, 1997 as compared to $15.1 million in the year ended December 34 35 31, 1996. The Company earned fees for the use and support of its clinical information systems, including the recognition of license revenues and software, systems and training revenues, of approximately $12.3 million for the year ended December 31, 1997, as compared to $4.0 million in the year ended December 31, 1996. Of the $12.3 million of information technology revenues, approximately $4.6 million were earned in connection with software licenses or information management service fees with affiliated entities or with entities in which the Company has a minority equity interest. Cost of revenues for the year ended December 31, 1997 increased to $45.6 million from approximately $14.3 million for the year ended December 31, 1996. The increase in cost of revenues related primarily to the expenses outsourced to the Company from physician group practices under management. Operating expenses for the year ended December 31, 1997 increased to $9.0 million from $7.3 million for the year ended December 31, 1996 and included approximately $.7 million and $2.8 of research and development costs respectively. The increase in operating expenses related to the increased provision of physician group practice management and related services. For the year ended December 31, 1997, the Company also earned interest income in the amount of $1.2 million from investments in marketable securities as a result of the investment proceeds from the IPO and follow-on offerings. The Company earned interest income in the amount of $.2 million from investments in marketable securities as a result of the investment of proceeds from the IPO for the comparable period ended December 31, 1996. The Company incurred interest expense of approximately $.2 million for the period ending December 31, 1996, which related primarily to interest on $5.0 million of then outstanding indebtedness bearing interest at 8% per annum ($3.0 million), 9% per annum ($2.0 million) and interest on capital lease obligations. An income tax benefit of approximately $1.0 million was recorded in 1996 as a result of the Company's determination, based on profitable fourth quarter operations, that the related deferred income tax asset would be realized through the generation of taxable income in the future. The net income for the year ended December 31, 1997 was $7.2 million compared to a loss of $1.5 million for the year ended December 31, 1996 due to the factors describe above. Year Ended December 31, 1996 and 1995 Total revenues for the year ended December 31, 1996 increased to $19.1 million from $1.1 million in the year ended December 31, 1995, 35 36 primarily as a result of the addition of new physician group practices under management, provision of incremental network management services and fees for the use and support of its clinical information systems. The Company began to provide physician network management services in September 1995 and physician group practice management and related services in December 1995. The provision of physician group practice management and related services and network management services accounted for approximately $15.1 million of the Company's net revenue in the year ended December 31, 1996 as compared to $.7 million for the comparable period ended December 31, 1995. The Company earned fees for the use and support of its clinical information systems, including the recognition of license revenues and software systems, and from revenues of approximately $4.0 million for the year ended December 31, 1996, as compared to $.4 million for the comparable period ended December 31, 1995. Operating expenses for the year ended December 31, 1996 increased to $7.3 million from $6.4 million for the year ended December 31, 1995. The increase in operating expenses was due to the increases in staffing and general corporate expenses required to fund the Company's transition from a development stage company involved in the development of clinical information systems to a full service physician practice and network management company. The net loss for the year ended December 31, 1996 was $1.5 million compared to a loss of $5.7 million for the year ended December 31, 1995. Liquidity and Capital Resources At December 31, 1997, the Company had aggregate cash, cash equivalents, certificates of deposit and marketable securities of $47.0 million, compared to $19.5 million at December 31, 1996. The cash flow from operations in 1997 was $3.6 million versus a net use of cash of $9.8 million in 1996. This increase in net cash from operations resulted primarily from an $8.6 million increase in net income. Net cash used in investing activities grew from $9.7 million in 1996 to $55.4 million in 1997. This increase was due to several factors, including the investment in marketable securities of the proceeds of the Company's follow-on equity offering, the acquisition of Bukstel & Halfpenny, a company that develops and provides software that links physicians with hospital-based clinical systems such as laboratory, radiology and pathology systems, a minority investment in Patient Care Dynamics, a compnay that provides an integrated family of technology-based patient care support systems and services to physicians, a minority investment and loan to ACRM, an organization that will provide advanced cardiovascular research management, a minority investment in Caresoft, a developer of disease management tools, and capitalized software development costs. Cash flow from financing activities grew to $47.2 million in 1997 from $30.2 million in 1996. The net cash provided by financing activities in 1997 was primarily attributable to the Company's public offering of Common Stock in October 1997, which raised net proceeds of $46.0 million. 36 37 The Company's operating plan for 1998 includes continued development of the Company's integrated management services and clinical information systems. The principal categories of expenditures include further development of the Company's clinical information systems, as well as ongoing business development and marketing. The Company believes that the net proceeds of the follow-on equity offering together with other, cash and investments on hand, interest income and revenues from operations will be sufficient to fund planned operations of the Company through at least mid 1999. During January and February 1997, the Company loaned $2 million to Madison, a physician practice it currently manages, secured by the physicians' 49% ownership interest in its MSO. The loan bears interest at prime plus 2 percent and is to be repaid in 12 equal monthly installments beginning January 1998. Furthermore, the Company provided a letter of credit on behalf of Madison that expires January 8, 1998, in the amount of $1.8 million by depositing restricted cash with the lending institution that issued the letter of credit. The Company has no other planned material capital expenditures or other capital commitments. From time to time in the ordinary course of its business, the Company evaluates possible acquisitions of businesses, products and technologies that are complementary to those of the Company. Under certain specified circumstances, the Company has the option to cause certain MSOs to be merged with and into a wholly-owned subsidiary of the Company in a transaction in which the interests of the physician groups and networks in such MSOs would be exchanged for Common Stock of the Company. The Company has reserved 548,224 shares of Common Stock for issuance upon consummation of the Roll Up Transaction, all of which will be issued if the Company effects the Roll Up Transaction. In addition, certain of the physician groups and networks managed by the Company have rights to require the Company to purchase all or part of such physicians' interest in their respective MSO in the event that the Company does not consummate the Roll Up Transaction within one year after the satisfaction of specified conditions. There can be no assurance that the Company will have the financial resources to purchase such interests in accordance with its obligations at the time any such rights are exercised, or that the 37 38 Company would be able to obtain financing on satisfactory terms or conditions, if at all, to purchase such interests. In addition, pursuant to its agreement with one of its physician group practice clients, the Company has agreed, under certain circumstances, to advance funds to such group practice to finance working capital. To date, the Company has not made any advances to such group practice under the agreement and it does not expect to do so in the future. YEAR 2000 The Year 2000 date change issue is believed to affect virtually all companies and organizations. If not corrected, many computer applications could fail or create erroneous results by or at the year 2000. The Company has not completed its assessment of compliance issues for the Companys' proprietary software products, for its computer systems (both hardware and software), for equipment ancillary to the Company's business that contains computers or computer chips, for the computer systems of other entities with which the Company does business. The Company has also not determined the cost of these compliance issues or the time it will take to complete compliance. The Company expects to complete its full assessment of the Year 2000 issue no later than December 31, 1998, which is prior to any anticipated impact on its operting systems. As part of the Year 2000 assessment, the Company expects to communicate with all of its physician practices and networks, as well as suppliers and third parties with which the Company does business, to determine the extent to which the Company's interface systems are vulnerable to those parties' failure to remedy their Year 2000 issues. There is no guarantee that the systems of other companies on which the Compnay relies will be corrected in a timely manner or that the failure to correct will not have a material adverse effect on the Company's systems. Year 2000 modifications and assessments are based on managements' best estimates, which were derived utilizing numerous assumptions of future events, including availability of certain resources and other factors. However, there can be no guarantee the estimates and assessments will be achieved or come to pass, and actual results could differ materially from those anticipated. 38 39 ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA Financial Statements Report of Independent Public Accountants F-1 Consolidated Balance Sheets as of December 31, 1996 and 1997 F-2 Consolidated Statements of Operations for the three years ended December 31, 1997 F-3 Consolidated Statements of Stockholders' Equity for the three years ended December 31, 1997 F-4 Consolidated Statements of Cash Flows for the three years ended December 31, 1997 F-5 Notes to Consolidated Financial Statements F-6 Financial Statement Schedules All schedules, other than those disclosed, have been omitted because they are not applicable or not required or because the required information is included in the Consolidated Financial Statements or notes thereto. Item 9. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE None. PART III ITEM 10. DIRECTORS AND EXECUTIVE OFFICERS OF THE REGISTRANT The information called for by this item is incorporated herein by reference to the sections of the definitive Proxy Statement to be filed with the Securities and Exchange Commission not later than 120 days after December 31, 1997, and delivered to stockholders in connection with the 1998 Annual Meeting of Stockholders, captioned "Election of Directors," "Executive Officers" and "Disclosure Pursuant to Section 16 of the Exchange Act." ITEM 11. EXECUTIVE COMPENSATION 39 40 The information called for by this item is incorporated herein by reference to the sections of the definitive Proxy Statement to be filed with the Securities and Exchange Commission not later than 120 days after December 31, 1997, and delivered to stockholders in connection with the 1998 Annual Meeting of Stockholders, captioned "Meetings of the Board of Directors and Committees of the Board of Directors; Compensation of Directors" and "Executive Compensation and Related Information." ITEM 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT The information called for by this item is incorporated herein by reference to the section of the definitive Proxy Statement to be filed with the Securities and Exchange Commission not later than 120 days after December 31, 1997, and delivered to stockholders in connection with the 1998 Annual Meeting of Stockholders, captioned "Security Ownership of Certain Beneficial Owners, Directors and Management." ITEM 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS The information called for by this item is incorporated herein by reference to the section of the definitive Proxy Statement to be filed with the Securities and Exchange Commission not later than 120 days after December 31, 1997, and delivered to stockholders in connection with the 1998 Annual Meeting of Stockholders, captioned "Certain Transactions." PART IV Item 14. EXHIBITS, FINANCIAL STATEMENT SCHEDULES AND REPORTS ON FORM 8-K (a) Documents Filed as Part of the Report 1. Financial Statements The financial statements listed under Item 8 are filed as part of this report. 2. Financial Statement Schedules 40 41 Certain schedules have been omitted because they are either not applicable or the required information has been disclosed in the financial statements or notes thereto. 3. Exhibits The exhibits listed on the accompanying Exhibit Index are filed as part of this report or incorporated by reference herein. (b) Reports on Form 8-K No Current Reports on Form 8-K were filed by the registrant during the fourth quarter of the year ended December 31, 1997. SIGNATURES Pursuant to the requirements of Section 13 or 15(d) 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, on the 30th day of March, 1998. ADVANCED HEALTH CORPORATION By /s/ Jonathan Edelson ------------------------ Jonathan Edelson, M.D. Chairman of the Board and Chief Executive Officer Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed by the following persons on behalf of the registrant and in the capacities and on the dates indicated: Signature Title Date /s/ Jonathan Edelson Chairman of the Board, Chief March 30, 1998 - -------------------- Executive Officer and Director Jonathan Edelson, M.D (Principal Executive Officer) 41 42 /s/ Steven Hochberg Vice-Chairman and Director March 30, 1998 - -------------------- Steven Hochberg /s/ Alan B. Masarek President and Chief Operating March 30, 1998 - -------------------- Officer Alan B.Masarek /s/ Michael W. Rogers Executive Vice-President, Corporate March 30, 1998 - -------------------- Development and Chief Financial Officer Michael W. Rogers (Principal Financial and Accounting Officer) /s/ James T. Carney Director March 30, 1998 - -------------------- James T. Carney /s/ Barry Kurokawa Director March 30, 1998 - -------------------- Barry Kurokawa /s/ Jonathan Lieber Director March 30, 1998 - -------------------- Jonathan Lieber 42 43 EXHIBIT INDEX Exhibit No. Description of Exhibit Page **3.1 Restated Certificate of Incorporation of the Registrant **3.2 By-laws of the Registrant +**10.1 Management Services Agreement dated as of December 11, 1995, between Madison Medical -- The Private Practice Group of New York, L.L.P. and Uptown Physician Management, Inc. **10.2 Stockholders' Agreement dated as of December 11, 1995, among Uptown Physician Management, Inc. and certain stockholders +**10.3 Management Services Agreement dated as of August 7, 1995, among Advanced Heart Institute of New York, P.C., Valavanur A. Subramanian, M.D., Jeffrey Moses M.D. and Majean Sub 2, Inc. +**10.4 Management Services Agreement dated as of July 1, 1996, between Specialist Physicians Management, Inc. and Cardiology First of New Jersey, P.A. **10.5 Stockholders' Agreement dated as of July 1, 1996 among Specialist Physicians Management, Inc., Specialist Physicians MSO, L.L.C. and Advanced Health Management Corporation. +**10.6 Management Services Agreement dated as of July 1, 1996 between Diamond Physician Management, Inc. and Long Island Interventional Cardiology. **10.7 Tarrytown, New York Office Lease Agreement dated November 30, 1995, between Tarrytown Corporate Center IV, L.P. and the Registrant. **10.8 First Amendment to Lease Agreement between Reckson Operating Partnership, LP, as Owner, and the Registrant, as Tenant **10.9 Chicago Office Lease Agreement dated December 8, 1995, between Adams Family, L.L.C. and the Registrant 43 44 *10.10 Fort Washington Lease Agreement dated November 13, 1997, between Comdrive Associates, L.P. and Registrant as Tenant *10.11 Hawthorne Lease Agreement dated January 8, 1998, between United Parcel Service, Inc. and Registrant as Tenant **10.12 Form of Director Indemnification Agreement **10.13 Employment Agreement between the Registrant and Jonathan Edelson, M.D. **10.14 Employment Agreement between the Registrant and Steven Hochberg **10.15 Employment Agreement between the Registrant and Alan B. Masarek **10.16 Employment Agreement between the Registrant and Robert Alger *10.17 Employment Agreement between the Registrant and Michael P. Rogers **10.18 Amended and Restated Advanced Health Corporation 1995 Stock Option Plan **10.19 Employee Stock Purchase Plan *11.1 Earnings Per Common Share Computation **21 List of Subsidiaries *23.2 Consent of Arthur Andersen LLP *27 Financial Data Schedule * Filed herewith. ** Filed as an exhibit to the Registrant's Registration Statement on Form S-1, as amended (Registration No. 333-06283), Registrant's Registration Statement on Form S-1, as amended (Registration No. 333-35115), and Registrant's Form 10-K, dated March 30, 1997 incorporated herein by reference. 44 45 + Portions of such exhibit have been deleted therefrom pursuant to Rule 406 promulgated under the Securities Act of 1933, as amended, and confidential treatment has been granted therefor. 45 46 REPORT OF INDEPENDENT PUBLIC ACCOUNTANTS To Advanced Health Corporation: We have audited the accompanying consolidated balance sheets of Advanced Health Corporation (a Delaware corporation) and subsidiaries as of December 31, 1996 and 1997, and the related consolidated statements of operations, shareholders' equity and cash flows for the three years ended December 31, 1997. These financial statements are the responsibility of the Company's management. Our responsibility is to express an opinion on these financial statements based on our audits. We conducted our audits in accordance with generally accepted auditing standards. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Advanced Health Corporation and subsidiaries as of December 31, 1996 and 1997, and the results of their operations and their cash flows for the three years ended December 31, 1997 in conformity with generally accepted accounting principles. ARTHUR ANDERSEN LLP New York, New York March 19, 1998 F-1 47 ADVANCED HEALTH CORPORATION AND SUBSIDIARIES CONSOLIDATED BALANCE SHEETS (in thousands, except share data)
December 31, -------------------- ASSETS 1996 1997 ------ ---- ---- CURRENT ASSETS: Cash and cash equivalents $ 12,086 $ 7,534 Certificates of deposit -- 5,399 Investments in marketable securities 7,390 34,082 Accounts receivable, net 8,637 11,059 Deferred income taxes 977 4,092 Other current assets 829 736 -------- -------- Total current assets 29,919 62,902 PROPERTY AND EQUIPMENT, net 2,053 3,664 INTANGIBLE ASSETS, net 1,858 9,415 INVESTMENTS IN AFFILIATES -- 7,000 OTHER ASSETS 1,570 11,377 -------- -------- Total assets $ 35,400 $ 94,358 ======== ======== LIABILITIES AND SHAREHOLDERS' EQUITY ------------------------------------ CURRENT LIABILITIES: Accounts payable and accrued expenses $ 2,864 $ 933 Other current liabilities 452 325 -------- -------- Total current liabilities 3,316 1,258 DEFERRED REVENUE 200 -- -------- -------- Total liabilities 3,516 1,258 ======== ======== COMMITMENTS SHAREHOLDERS' EQUITY: Preferred stock, $.01 par value; 5,000,000 shares authorized; 0 shares issued and outstanding, respectively -- -- Common stock, $.01 par value; 15,000,000 shares authorized; 7,166,941 and 9,869,719 shares issued and outstanding, respectively 72 99 Additional paid-in capital 42,069 95,976 Accumulated deficit (10,242) (3,084) Net unrealized gain on marketable securities, net of deferred income taxes 60 184 Less: Treasury stock, at cost; 8,937 shares, respectively (75) (75) -------- -------- Total shareholders' equity 31,884 93,100 -------- -------- Total liabilities and shareholders' equity $ 35,400 $ 94,358 ======== ========
The accompanying notes are an integral part of these consolidated balance sheets. F-2 48 ADVANCED HEALTH CORPORATION AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF OPERATIONS (in thousands, except share and per share data)
For the Years Ended December 31, ----------------------------------- 1995 1996 1997 ---- ---- ---- REVENUES $ 1,054 $ 19,136 $ 61,006 COST OF REVENUES 340 14,265 45,636 --------- --------- --------- Gross profit 714 4,871 15,370 OPERATING EXPENSES 6,412 7,328 8,954 --------- --------- --------- Operating (loss) income (5,698) (2,457) 6,416 INTEREST EXPENSE (9) (164) (11) INTEREST INCOME -- 179 1,155 --------- --------- --------- Net (loss) income before income taxes (5,707) (2,442) 7,560 INCOME TAX (BENEFIT) PROVISION -- (977) 402 --------- --------- --------- Net (loss) income $ (5,707) $ (1,465) $ 7,158 ========= ========= ========= PER SHARE INFORMATION: Net (loss) income per share: Basic $ (1.67) $ (0.28) $ 0.91 ========== ========= ========= Diluted $ (1.67) $ (0.28) $ 0.81 ========== ========= ========= Common shares used in computing per share amounts: Basic 3,419,638 5,149,207 7,872,204 ========== ========== ========== Diluted 3,419,638 5,149,207 8,890,856 ========== ========== ==========
The accompanying notes are an integral part of these consolidated statements. F-3 49 ADVANCED HEALTH CORPORATION AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (in thousands, except share data)
Unrealized Additional Common Stock Gain On Common Stock Paid-in Subscriptions Receivable Accumulated Marketable --------------------- ------------------------ Shares Par Value Capital Shares Amount Deficit Securities --------- --------- --------- --------- --------- --------- --------- BALANCE, December 31, 1994 2,051,539 $ 20 $ 2,728 185,893 $ (3) $ (3,070) $ -- Issuance of Common Stock 50,641 1 (1) -- -- -- -- Issuance of Series C convertible Preferred Stock 178,743 2 1,498 -- -- -- -- Issuance of common stock in private placement 79,780 1 624 -- -- -- -- Redemption of common stock subscriptions -- -- -- (185,893) 3 -- -- Exercise of stock options 885,279 9 11 -- -- -- -- Common stock issued for acquisitions 649,753 7 1,629 -- -- -- -- Issuance of Series D Convertible Preferred Stock 595,535 6 4,992 -- -- -- -- Repurchase of treasury stock -- -- -- -- -- -- -- Net loss -- -- -- -- -- (5,707) -- --------- --------- --------- --------- --------- --------- --------- BALANCE, December 31, 1995 4,491,270 46 11,481 -- -- (8,777) -- Common stock issued for acquisition 8,937 -- 45 -- -- -- -- Exercise of stock options 21,734 -- 86 -- -- -- -- Issuance of common stock in public offering, net of expenses of $3,922 2,645,000 26 30,457 -- -- -- -- Unrealized gain on marketable securities, net of deferred income taxes of $40 -- -- -- -- -- -- 60 Net loss -- -- -- -- -- (1,465) -- --------- --------- --------- --------- --------- --------- --------- BALANCE, December 31, 1996 7,166,941 72 42,069 -- -- (10,242) 60 Issuance of common stock, net of expenses of $4,102 2,250,000 22 45,939 -- -- -- -- Exercise of stock options 352,614 4 1,249 -- -- -- -- Common stock issued for acquisitions 100,164 1 3,759 -- -- -- -- Unrealized gain on marketable securities, net of deferred income taxes of $79 -- -- -- -- -- -- 124 Income tax benefit from exercise of stock options -- -- 2,960 -- -- -- -- Net income -- -- -- -- -- 7,158 -- --------- --------- --------- --------- --------- --------- --------- BALANCE, December 31, 1997 9,869,719 $ 99 $ 95,976 $ -- $ -- $ (3,084) $ 184 ========= ========= ========= ========= ========= ========= ========= Treasury Stock --------------------- Shares Amount Total --------- --------- --------- BALANCE, December 31, 1994 -- $ -- $ (325) Issuance of Common Stock -- -- -- Issuance of Series C convertible Preferred Stock -- -- 1,500 Issuance of common stock in private placement -- -- 625 Redemption of common stock subscriptions -- -- 3 Exercise of stock options -- -- 20 Common stock issued for acquisitions -- -- 1,636 Issuance of Series D Convertible Preferred Stock -- -- 4,998 Repurchase of treasury stock 8,937 (75) (75) Net loss -- -- (5,707) --------- --------- --------- BALANCE, December 31, 1995 8,937 (75) 2,675 Common stock issued for acquisition -- -- 45 Exercise of stock options -- -- 86 Issuance of common stock in public offering, net of expenses of $3,922 -- -- 30,483 Unrealized gain on marketable securities, net of deferred income taxes of $40 -- -- 60 Net loss -- -- (1,465) --------- --------- --------- BALANCE, December 31, 1996 8,937 (75) 31,884 Issuance of common stock, net of expenses of $4,102 45,961 Exercise of stock options 1,253 Common stock issued for acquisitions 3,760 Unrealized gain on marketable securities, net of deferred income taxes of $79 -- -- 124 Income tax benefit from exercise of exercise of stock options -- -- 2,960 Net income -- -- 7,158 --------- --------- --------- BALANCE, December 31, 1997 8,937 $ (75) $ 93,100 ========= ========= =========
The accompanying notes are an integral part of these consolidated statements. F-4 50 ADVANCED HEALTH CORPORATION AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF CASH FLOWS (in thousands)
For the Years Ended December 31, -------------------------------- 1995 1996 1997 -------- -------- -------- CASH FLOWS FROM OPERATING ACTIVITIES: Net (loss) income $ (5,707) $ (1,465) $ 7,158 Adjustments to reconcile net (loss) income to net cash used in operating activities- Depreciation and amortization 457 890 1,471 Deferred income taxes -- (977) -- Allowance for doubtful accounts -- 210 450 Changes in operating assets and liabilities- Accounts receivable (1,021) (7,826) (2,872) Other current assets (396) (426) 93 Other assets (33) (310) (400) Accounts payable, accrued expenses and other current liabilities 1,274 1,162 (2,058) Due to affiliate (376) -- -- Deferred revenue 1,500 (1,100) (200) -------- -------- -------- Net cash (used in) provided by operating activities (4,302) (9,842) 3,642 -------- -------- -------- CASH FLOWS FROM INVESTING ACTIVITIES: Minority investment in affiliated entities -- -- (7,000) Issuance of note receivable from affiliate (500) -- (2,500) Proceeds from repayment of note receivable from affiliate 500 -- -- Other assets -- (1,130) (6,907) Investments in certificates of deposit -- -- (5,399) Investments in marketable securities -- (7,290) (26,692) Intangible assets -- -- (4,021) Cash paid for acquisitions (150) -- (306) Purchases of property and equipment, net (882) (1,296) (2,552) -------- -------- -------- Net cash used in investing activities (1,032) (9,716) (55,377) -------- -------- -------- CASH FLOWS FROM FINANCING ACTIVITIES: (Repayment of) loan payable related to acquisition (50) (94) -- Net proceeds from sale and issuance of common stock 628 30,483 45,961 Net proceeds from exercise of stock options 20 86 1,254 Net proceeds from promissory notes -- 5,000 -- Repayment of promissory notes -- (5,000) -- Purchase of treasury stock (75) -- -- Net proceeds from issuance of Series C Convertible Preferred Stock 1,500 -- -- Net proceeds from issuance of Series D Convertible Preferred Stock 4,998 -- -- Repayment of capital lease obligations (230) (295) (32) -------- -------- -------- Net cash provided by financing activities 6,791 30,180 47,183 -------- -------- -------- Net change in cash and cash equivalents 1,457 10,622 (4,552) CASH AND CASH EQUIVALENTS, beginning of year 7 1,464 12,086 -------- -------- -------- CASH AND CASH EQUIVALENTS, end of year $ 1,464 $ 12,086 $ 7,534 ======== ======== ======== SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION: Cash paid during the year for: Interest $ 21 $ 160 $ 11 ======== ======== ======== Income taxes $ 15 $ 36 $ 248 ======== ======== ======== SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES: Capital lease obligations incurred $ 281 $ 58 $ -- ======== ======== ======== Fair market value of common stock issued for acquisitions $ 1,636 $ 45 $ 3,760 ======== ======== ======== Unrealized gain on marketable securities $ - $ 100 $ 297 ======== ======== ======== Loan payable issued for acquisition $ 150 $ 23 $ -- ======== ======== ========
The accompanying notes are an integral part of these consolidated statements. F-5 51 ADVANCED HEALTH CORPORATION AND SUBSIDIARIES NOTES TO CONSOLIDATED FINANCIAL STATEMENTS DECEMBER 31, 1996 AND 1997 (in thousands, except share and per share data) 1. ORGANIZATION AND BUSINESS: The Company Advanced Health Corporation ("AHC") and subsidiaries (collectively, the "Company") provide physician groups and networks with professional practice and network management services and clinical information systems and services. The Company's wholly-owned subsidiary was incorporated on August 27, 1993 as Med-E-Systems Corporation, and was engaged at inception to design and develop clinical information systems for physician users. Effective August 1995, Med-E-Systems Corporation became a wholly-owned subsidiary of AHC, an entity incorporated in March 1995, through a stock-for-stock transfer in which preferred and common shareholders of Med-E-Systems Corporation exchanged their interests for the same amounts and classes of preferred and common stock in AHC as those then outstanding in Med-E-Systems Corporation. The Company was subsequently merged with and into Majean, Inc. (Note 3), a Delaware corporation, and the surviving corporation changed its name to Advanced Health Corporation. The Company operates in a highly-regulated environment in which its sources of revenues are dependent on the Company's ability to successfully negotiate with third parties for its various services. Currently, the Company depends on revenue generated by a limited number of customers, including physician groups and networks which are under long-term contracts. Formation of Management Service Organizations The Company has established Management Service Organizations ("MSOs") by forming majority owned subsidiaries to facilitate the provision of management services to physician practice and network clients. In the three years ended December 31, 1997, the Company obtained a 51% interest in each of one, five and eight newly formed MSOs, respectively, whereby the Company acquired these interests as part of the formation of the MSOs and concurrent with the signing of long-term management services agreements between the MSOs and physician practices. In forming these MSOs, the Company conveyed 49% interests (Note 3) to the physician practice or network in exchange for the execution of the long-term management services agreements described above. The Company records the fair value of these arrangements, which is, in the opinion of management, more readily determinable than the 49% MSO interest conveyed. These intangible assets, which are not material, will be amortized over the life of the related contracts. 2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES: Basis of Consolidation The accompanying consolidated financial statements include the accounts of AHC and its wholly-owned subsidiaries, Advanced Health Management Corporation ("AHM"), Advanced Health Med-E-Systems F-6 52 Corporation ("MES"), Bukstel & Halfpenny, Inc. ("B&H") and the MSOs discussed in Note 1. The consolidated financial statements for 1995 include the results of operations of the Company, including other entities formed or acquired from their formation or acquisition during those years, through December 31, 1995. The structure of the Company's wholly or majority-owned MSOs presently provides for the Company to receive activity-based fee income from the MSOs for management services provided, and reimbursement from the MSOs for certain expenses incurred, with the result being that there are no profits in the MSO entity for which a minority interest is required to be calculated. Accordingly, the consolidated financial statements do not reflect any minority interest in the operations of the MSOs. In the event that profits remain in MSO entities in the future, minority interests will be reflected in the Company's consolidated financial statements. All intercompany accounts and transactions have been eliminated in consolidation. Use of Estimates The preparation of financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions specifically for the useful lives of capitalized software costs and intangible assets, that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Revenue Recognition Operating revenues are generated from three principal sources: (a) Physician Practice Revenues: A physician group practice is a single legal entity comprised of multiple physicians. Through its majority or wholly-owned consolidated MSOs, the Company enters into management services agreements with physician group practices, whereby such physician practices outsource their non-medical and administrative functions to the MSO. Activity-based fees are generated by the MSO through the provision of these outsourced services as well as certain additional management, marketing and information services. Fees for such services are either fixed or based on the level of services provided, as negotiated in the Company's various agreements for the provision of services, and are recognized monthly or as these services are rendered, respectively, based on the terms of the related agreements. The Company's contracts with its physician group practices also include pre-determined incentives which are earned and recognized as revenue in the event that the Company is successful in reducing a physician group practice's administrative overhead as a percentage of collections. (b) Physician Network Revenues: A physician network is an aggregation of individual physicians and physician groups formed for the purpose of entering into contracts with third-party payors. A physician network enters into a contract with a third-party payor pursuant to which the physicians comprising the network agree to provide medical services to network enrollees in return for a fixed per enrollee fee, known as "capitated" payments, or for a fixed fee paid only on an as incurred basis, known as "case rate" payments. The physician network then enters into a management services agreement with the Company's majority-owned, consolidated MSO, pursuant to which the aggregate capitated or case rate payments are assigned to the MSO. From these payments, the MSO pays a fixed percentage of the capitated or case rate premium to fund all administrative and management services required under the contract. After payment of such administrative and management expenses, the MSO pays the network physicians in return for the physicians' provision of medical services to medical enrollees. Such payments are limited, in the aggregate, to the monies remaining in the MSO after payment of F-7 53 administrative and management expenses. The Company has not earned, recognized or recorded any capitated revenues, and only nominal case rate revenues, in the three years ended December 31, 1997. (c) Information Systems and Services Revenue: The Company's current business strategy for providing integrated physician practice and network management services includes licensing its information systems and services as a means of ultimately providing a full range of services. In order to generate operating funds and demonstrate the uses of its systems and development capabilities, the Company has licensed, and may continue to license, certain components of its software to third parties. The Company recognizes revenue from the licensing of its information systems and services (upon installation and acceptance), and from the licensing of its software to third parties (upon delivery). Certain of these third parties provide payment in advance for the development and installation of software, databases and systems. The Company accounts for these advance payments as deferred revenue when received, and recognizes revenue ratably over the period of time during which the software is delivered and services are performed. In December 1991, the American Institute of Certified Public Accountants ("AICPA") issued Statement of Position ("SOP") 91-1, "Software Revenue Recognition". The Company's revenue recognition policy is in compliance with the provisions of the SOP. Concentration of Credit Risk Financial instruments that potentially subject the Company to concentrations of credit risk consist principally of trade receivables from the provision of management services to physician practices and networks and information systems and services rendered. The Company has recorded these items in its consolidated financial statements based on their respective fair values. Cash and Cash Equivalents Cash and cash equivalents include cash and highly liquid investments with original maturities of three months or less when purchased. Included in the balance at December 31, 1997 is a certificate of deposit that was pledged as collateral on an outstanding letter of credit related to one of the Company's management service agreements (Note 4). Certificates of Deposit Certificates of deposit consist of a series of time deposits with maturities greater than three months to one year from December 31, 1997. Investments in Marketable Securities The Company accounts for investments in accordance with Statement of Financial Accounting Standards ("SFAS") No. 115, "Accounting for Certain Investments in Debt and Equity Securities". In accordance with this pronouncement, the investment and debt securities held by the Company and included in the accompanying consolidated balance sheets that may be sold in response to changes in interest rates, prepayments, and other factors have been classified as available-for-sale. Such securities are reported at fair value, with unrealized gains and losses excluded from earnings and reported in a separate component of shareholders' equity (on an after-tax basis). Gains and losses on the disposition of securities are recognized on the specific identification method in the period in which they occur. F-8 54 Property and Equipment Property and equipment, consisting primarily of electronic data processing equipment, are stated at cost and depreciated on a straight-line basis over the useful lives of the assets (3 to 5 years). Equipment held under capital leases is amortized utilizing the straight-line method over the lesser of the term of the lease or the estimated useful life of the asset. Capitalized Software Costs The Company develops computer software, which is marketed to third parties. Development costs incurred in the research and development of new software products and enhancements to existing software products are expensed as incurred until technological feasibility is established. Any additional development costs are capitalized in accordance with SFAS No. 86, "Accounting for the Costs of Computer Software to be Sold, Leased or Otherwise Marketed." Amortization of such costs is provided using the straight-line basis over the estimated economic life of the products (5 years). The Company performs an annual review of the recoverability of such capitalized software costs. At the time a determination is made that capitalized amounts are not recoverable based on estimated cash flows to be generated from the applicable software, any remaining capitalized amounts are expensed. Capitalized software costs were $1,130 and $6,037, respectively for the two years ended December 31, 1997, and are included in other assets in the accompanying consolidated balance sheets. Computer software amortization charged to expense aggregated $25, $28 and $300, respectively, for each of the three years ended December 31, 1997. Intangible Assets Goodwill, which represents the excess of the purchase price over the fair value of the net assets acquired, covenants not-to-compete and management contracts are included in intangible assets and are presently being amortized over periods of 4 to 30 years on a straight-line basis. These amortization periods are evaluated by management on a continuing basis, and will be adjusted if the lives of the related intangible assets are impaired. Accounting for Long-Lived Assets The Company accounts for long-lived assets under the provisions of SFAS No. 121, "Accounting for the Impairment of Long-Lived Assets and for Long-Lived Assets to be Disposed Of". This statement establishes financial accounting and reporting standards for the impairment of long-lived assets, certain identifiable intangibles, and goodwill related to those assets to be held and used, and for long-lived assets and certain identifiable intangibles to be disposed of. This statement was adopted by the Company in 1996 and the effect of the adoption was not material to the Company's consolidated financial statements. Investments in Affiliates Investments in affiliates represent purchased interest of less than 20% and is accounted for on the cost method. The Company reviews these investments for impairment whenever events or changes in circumstances indicate that the carrying amounts of the assets may not be recoverable. Research and Development Research and development costs are expensed as incurred by the Company. Research and development expense aggregated $3,157, $2,843 and $770, respectively, for the three years ended December 31, 1997. F-9 55 Income Taxes The Company accounts for income taxes under SFAS No. 109, "Accounting for Income Taxes", which requires recognition of deferred tax liabilities and assets for the estimated future tax effects of events that have been recognized in the financial statements or income tax returns. Under this method, deferred tax liabilities and assets are determined based on (1) differences between the financial accounting and income tax bases of assets and liabilities, and (2) net operating loss carry-forwards, using enacted tax rates in effect for the years in which the differences and carry-forwards are expected to reverse and be utilized, respectively (Note 13). Net Income (Loss) Per Common Share Effective December 31, 1997, the Company adopted SFAS No. 128, "Earnings Per Share". Basic net income (loss) per common share ("Basic EPS") is computed by dividing net income (loss) by the weighted average number of common shares outstanding. Diluted net income (loss) per common share ("Diluted EPS") is computed by dividing net income (loss) by the weighted average number of common shares and dilutive potential common shares then outstanding. SFAS No. 128 requires the presentation of both Basic EPS and Diluted EPS on the face of the consolidated statements of operations. The impact of the adoption of this statement was not material to all previously reported EPS amounts. A reconciliation between the numerator and denominator of Basic EPS and Diluted EPS is as follows:
Net Income (Loss) Per Net Income Common Common (Loss) Shares Share ------ ------ ----- For the Year Ended December 31, 1995 Basic EPS Net loss attributable to common stock $ (5,707) 3,419,638 $(1.67) Effect of dilutive securities: stock options -- -- -- --------- --------- ----- Diluted EPS Net loss attributable to common stock $ (5,707) 3,419,638 $(1.67) ========= ========= ===== For the Year Ended December 31, 1996 Basic EPS Net loss attributable to common stock $ (1,465) 5,149,207 $(0.28) Effect of dilutive securities: stock options and warrants -- -- -- --------- --------- ----- Diluted EPS Net loss attributable to common stock $ (1,465) 5,149,207 $(0.28) ========= ========= ===== For the Year Ended December 31, 1997 Basic EPS Net income attributable to common stock $ 7,158 7,872,204 $0.91 Effect of dilutive securities: stock options and warrants -- 1,018,652 (0.10) --------- --------- ----- Diluted EPS Net income attributable to common stock and assumed options exercises $ 7,158 8,890,856 $0.81 ========= ========= =====
Diluted EPS for 1995 and 1996 does not include the impact of stock options and warrants then outstanding as the effect of their inclusion would be anti-dilutive. F-10 56 Stock-Based Compensation In 1996, the Company adopted the provisions of SFAS No. 123 "Accounting for Stock-Based Compensation" ("SFAS No. 123"), and elected to continue the accounting set forth in Accounting Principles Board No. 25, "Accounting for Stock Issued to Employees" ("APB No. 25") and to provide the necessary pro-forma disclosures as if the fair value method had been applied (Note 12). New Accounting Pronouncements On October 27, 1997, the AICPA issued SOP 97-2 "Software Revenue Recognition". This new SOP supersedes SOP 91-1. SOP 97-2 applies to all entities that earn revenue by licensing, selling, leasing or otherwise marketing computer software. It does not apply to revenue earned on products or services when the software contained in those products or services is incidental to the products or services as a whole. SOP 97-2 requires that revenue be allocated to each product or service upon a high threshold of "vendor-specific objective evidence" and deferred until all of the following four criteria are met for that particular product or service: (1) persuasive evidence of an agreement must exist, (2) delivery must have occurred, (3) the vendor's fee must be fixed or determinable, and (4) collectibility must be probable. The SOP is effective for all transactions entered into in fiscal years beginning after December 15, 1997. Earlier application is acceptable, but must commence at the beginning of either (a) a fiscal year, or (b) an interim period. The provisions of SOP 97-2 are to be adopted on a prospective basis. Retroactive application is prohibited. The Company does not expect the adoption of SOP 97-2 to have a material effect on its consolidated financial statements. Reclassifications Certain prior year amounts have been reclassified to conform to the current year's presentation. 3. ACQUISITION OF BUSINESSES: Acquisitions The transaction with Majean, Inc. described in Note 1 was accounted for as a purchase through the issuance of 543,564 shares of the Company's stock to the shareholders of Majean, Inc., who were not previously affiliated with the Company, for an aggregate purchase price of $1,368. Additionally, options to purchase 283,010 shares of common stock at $.0112 per share were issued as part of this transaction. These options are only exercisable, as contingent consideration, upon the achievement of certain capitalization levels related to regulatory requirements. The entire purchase price of this acquisition has been allocated to intangible assets in the accompanying consolidated balance sheets, as will any contingent consideration which arises due to the option described above, based on a twenty-year contract with a MSO, which was contributed to Majean, Inc. by its shareholders upon its formation immediately prior to the transaction. Accordingly, this intangible asset is being amortized over a period of twenty-years. In 1997, as a result of the achievement of certain targeted operating goals, as defined in previous purchase agreements, certain related parties exercised warrants for 72,196 shares of the Company's common stock valued at $1,354, which represents the difference between the market value of the stock at the date of exercise ($23.13 per share) and the value at the date of grant ($4.38 per share) and the Company issued 33,966 shares of common stock at a value of $21 per share for a total value of $713. These amounts have been recorded as adjustments to the original purchase prices and accordingly included in intangible assets as goodwill in the accompanying consolidated balance sheet. F-11 57 During 1997, the Company acquired certain assets of a B&H clinical information technology company for $306 in cash, 66,201 shares of common stock ($21.81 per share) and options for the purchase of 12,012 shares ($21 per share) of the Company's common stock, for an aggregate purchase price of $2,000. Furthermore, the B&H purchase agreement calls for the issuance of an additional 114,613 shares of common stock, as contingent consideration. The Company records the effect of the contingent consideration, if any, related to these acquisitions based upon the provisions of Emerging Issues Task Force Issue 95-8, "Accounting for Contingent Consideration Paid to the Shareholders of an Acquired Company in a Purchase Business Combination", which sets forth the criteria for determining the allocation of contingent consideration as either additional purchase price or compensation expense. These criteria provide for the recognition of contingent consideration, as opposed to compensation expense, upon the exercisability, if any, of such options and warrants where relevant facts and circumstances, such as continued employment of the sellers, components of the selling shareholder group, reasons for contingent payments and other agreements and issues, indicate that such accounting is warranted. Management of the Company believes that the terms of the acquisitions described above meet the criteria for recognition of contingent consideration. These acquisitions described above were valued based on, as applicable, either public trading values or on management's estimate of the fair value of common stock at the date of acquisition, which was determined by the Company's management by comparisons to (i) arms-length transactions with unrelated third-parties for the same or similar securities and (ii) an independent third-party appraisal. Costs and the pro forma effects of these transactions have not been presented, as the results are immaterial to the Company's consolidated financial statements taken as a whole. The stockholders agreements for these MSOs and those MSOs which were formed as described in Note 1, among other issues, (i) restrict the transfer of MSO equity, (ii) provide the terms upon which the MSO can, at the Company's option, be merged with and into a wholly-owned subsidiary of the Company in a transaction in which the physician practice or network will receive stock of the Company in exchange for shares in the MSO, and (iii) grant to the physician practice or network the right to put its equity share in the MSO to the Company within one year of the Company's satisfaction of certain specified targets if the Company has not called its right to acquire those interests within that period. The agreements provide that these call transactions will be paid in the Company's common stock, and put transactions will be paid in cash, and that either transaction, if effected, would be based on an agreed-upon amount at the time of the transaction. The Company will, in the event that these transactions take place, account for such transactions as purchases at the agreed-upon fair market value of the MSO interest being purchased. F-12 58 4. RELATED PARTY TRANSACTIONS: Transactions with Officers In accordance with the Company's Senior Executive Loan Policy, which is administered by the Compensation Committee of the Board of Directors, the Company has made loans to certain senior executives of the Company aggregating $430 and $780, which are included in other assets in the accompanying consolidated balance sheets as of December 31, 1996 and 1997, respectively. These loans are due three years from the loan date with interest payable monthly at a rate of 6% per annum. Transactions with MSOs In December 1996, one of the MSOs purchased accounts receivable from a physician practice, under the terms of its management services agreement, for an aggregate amount of $4,501, which is included in accounts receivable in the accompanying consolidated balance sheet as of December 31, 1996. In accordance with the agreement, all purchased accounts receivable outstanding after ninety days from the purchase date are to be sold back to the physician practice at face value. In the event that the physician practice is unable to repurchase the receivables, the aggregate outstanding amount is converted to a loan which is collateralized by outstanding shares of the Company held by the shareholders of the physician practice. During 1996, a separate MSO made advances aggregating $600, in the ordinary course of business, to a physician practice with which the MSO has a long-term management services agreement. These advances were satisfied subsequent to December 31, 1996, as the physician practice simultaneously assigned certain accounts receivable to the MSO to satisfy the advances and sold additional accounts receivable to the MSO. This amount is included in other current assets in the accompanying consolidated balance sheet as of December 31, 1996. This amount was paid in full during 1997. In June 1997, in connection with an amendment to the management services agreement with Madison, the Company exchanged approximately $3.8 million of accounts receivable from Madison for an increase in the fees payable by Madison, an increase in the term of the management services agreement from 20 to 30 years and the elimination of Madison's right to terminate the agreement, without cause, prior to the end of the tenth year of the term. This consideration has been allocated to management contracts and will be amortized over the remaining life of the related contract, as amended. Loans to Affiliates During 1997, the Company loaned $2,000 to Madison Medical - The Private Practice Group of New York, L.L.P. ("Madison") at the prime rate plus 2%, not to exceed 10%, with interest payable monthly and the outstanding principal payable in twelve monthly installments beginning in January 1998. In connection with this loan, the Company has guaranteed a letter of credit to Madison, in the amount $1,727, by depositing and restricting cash in the same amount in a certificate of deposit with the same financial institution providing that letter of credit. These obligations are secured by the 49% ownership interest in Uptown Physician Management, Inc., an MSO in which the Company has a 51% interest. This amount is included in other assets from affiliates in the accompanying consolidated balance sheet. In connection with an investment in ACRM, Inc. ("ACRM") (Note 8), the Company loaned ACRM $2,500 at 7% interest, with interest payable monthly and the outstanding principal payable in full in December 1999. F-13 59 Management of the Company believes that these related party transactions were effected on terms which approximate fair market value 5. INVESTMENTS IN MARKETABLE SECURITIES: The carrying amounts, gross unrealized gains and losses and estimated market values of investment securities are summarized as follows:
December 31, 1997 ---------------------------------------------------- Gross Gross Estimated Carrying Unrealized Unrealized Market Amount Gains (Losses) Value ------ ----- -------- ----- Treasury bills $ 19,500 $ 215 $ - $19,715 Commercial paper 2,000 - - 2,000 U.S. Government and agencies 9,793 85 - 9,878 Corporate bonds 2,492 - (3) 2,489 ---------- -------- ---------- --------- $ 33,785 $ 300 $ (3) $34,082 ======== ===== ======= =======
December 31, 1996 ---------------------------------------------------- Gross Gross Estimated Carrying Unrealized Unrealized Market Amount Gains (Losses) Value ------ ----- -------- ----- Commercial paper $ 7,290 $ 100 $ - $ 7,390 ======== ===== ====== =======
The carrying amount and estimated market value of investment securities at December 31, 1997, by contractual maturity, are :
Estimated Carrying Market Amount Value -------- -------- Due in one year or less $ 31,293 $ 31,593 Due after one year through two years 2,492 2,489 -------- -------- $ 33,785 $ 34,082 ======== ========
Expected maturities will differ from contractual maturities because borrowers may have the right to call or prepay obligations with or without call or prepayment penalties. 6. PROPERTY AND EQUIPMENT: Property and equipment consist of the following:
December 31, ------------------- 1996 1997 ------ ------ Computer equipment and software $2,276 $4,484 Equipment under capital leases 471 471 Furniture and fixtures 272 615 Leasehold improvements 43 43 ------ ------ 3,062 5,613 Less: Accumulated depreciation and amortization 1,009 1,949 ------ ------ Property and equipment, net $2,053 $3,664 ====== ======
F-14 60 Depreciation and amortization aggregated $397, $782 and $940, respectively, for the three years ended December 31, 1997. 7. INTANGIBLE ASSETS: Intangible assets consist of the following:
December 31, ----------------------- 1996 1997 ---- ---- Management contracts $ 1,368 $ 5,131 Goodwill 619 4,644 Covenants not-to-compete 20 20 ------- ------- 2,007 9,795 Less: Accumulated amortization 149 380 ------- ------- $ 1,858 $ 9,415 ======= =======
Amortization aggregated $42, $108 and $231, respectively, for the three years ended December 31, 1997. 8. INVESTMENTS IN AFFILIATES: Investments in affiliates consist of the following:
December 31, 1997 ----------------- PatientCare Dynamics, LLC (a) $ 5,000 ACRM(b) 1,000 Caresoft (c) 500 Peachstate Eye Care, LLC (d) 500 ======== $ 7,000 ========
(a) On December 30, 1997, the Company purchased Class B Shares and a Warrant equal to $5,000 of PatientCare Dynamics, LLC, a corporation that, among other things, provides technology based support systems and services to health care professionals. (b) On September 30, 1997, the Company paid $1,000 for 9.9% preferred stock ownership of ACRM, a corporation that provides advanced cardiovascular research management. (c) In June 1997, the Company purchased $500 of Series A Preferred Stock issued by Caresoft, Inc., a corporation that, among other things, develops chronic disease and patient compliance software. (d) On November 14, 1997, the Company paid $500 for a 15% interest in Peachstate Eye Care, LLC ("Peachstate"), a corporation engaged in the business of delivery eye and vision care. The Company has the right to purchase the remaining membership interest, or be required by Peachstate to purchase the remaining membership interest, in future years, as stipulated in the Membership Interest Purchase Agreement. Each of these investments is accounted for under the cost method of accounting for investments. F-15 61 9. ACCOUNTS PAYABLE AND ACCRUED EXPENSES: Accounts payable and accrued expenses consist of the following:
December 31, 1996 ----------------- Accounts payable $ 1,968 Public stock offering expenses 245 Other 651 ------- Total accounts payable and accrued expenses $ 2,864 =======
The Company had no individual accrued expenses in excess of 5% of current liabilities as of December 31, 1997. 10. OTHER CURRENT LIABILITIES: Other current liabilities consist of the following:
December 31, --------------------- 1996 1997 ---- ---- Deferred revenue $ 200 $ 200 Capital lease obligations 212 46 Other 40 119 ------- ------- $ 452 $ 365 ======= =======
11. BRIDGE FINANCING: Bridge Financing On February 28, 1996, the Company entered into an agreement to issue three 8% promissory notes to an investor for an aggregate amount of $3,000. The Company issued one promissory note and received $1,500 upon the closing, issued a second promissory note and received $750 at the second closing date, April 26, 1996, and issued a third promissory note and received the remaining $750 on the third closing date, June 28, 1996. Each note was due on the earlier of the initial public offering of the Company's securities or one year from the respective closing dates. Interest was due quarterly on each of the notes. In addition, the investor received warrants to purchase 16,757 shares of common stock of the Company at $16.78 per share which expire on June 28, 2001. The exercise price of $16.78 per share was, in the opinion of management, greater than the fair market value of such shares at the date the warrants were issued. The investor also received 8,937 contingent warrants to purchase the Company's stock at $8.39 per share. These contingent warrants were to be exercisable during the period from January 1, 1997 through June 28, 2001 if payment had not been made on the notes by the agreed-upon payment dates described above or if an initial public offering was not consummated prior to January 1, 1997; however, when payments on the notes were made by the specified dates, these contingent warrants were canceled. F-16 62 The Company also entered into an agreement with the owners of the Company's Series D Convertible Preferred Stock and related warrants (Note 12) for additional bridge financing in the amount of approximately $2,000. This financing was unsecured, bore interest at 9% and expired on the earlier of the consummation of an initial public offering or July 31,1997. On June 19, 1996, the Company issued three promissory notes in the aggregate principal amount of $1 million and on August 13, 1996, the Company issued three additional promissory notes in the aggregate principal amount of $1,000 under this agreement. 12. SHAREHOLDERS' EQUITY: Common Stock (a) In 1995, the Company sold 79,780 common shares pursuant to a private placement agreement dated April 21, 1995 for an aggregate of $625. In accordance with this agreement, the holders of these shares have the right, on two occasions, to participate on a "piggy-back" basis in a registration by the Company under the Securities Act of 1933, as amended, subject to certain restrictions, for a period ending on September 30, 2000, and commencing twelve months from the closing of an initial public offering of the securities of the Company. (b) In October 1996, the Company completed an initial public offering of its common stock. The offering included the sale of 2,300,000 shares of common stock (on a basis which reflected the reverse split described below) at $13 per share plus an underwriters' overallotment of 345,000 shares. Total net proceeds from this offering were $30,483. (c) In October 1997, the Company completed a second public offering of its common stock. The offering included the sale of 2,000,000 shares of common stock by the Company and 500,000 shares of common stock by existing shareholders, at $22.25 per share plus an underwriters' overallotment of 750,000. Total net proceeds to the Company from this offering were $45,961. Preferred Stock Prior to the initial public offering, the Company had 2,000,000 shares of authorized Preferred Stock with a par value of $.01 per share, of which 971,800 shares had been designated and issued as Series A Convertible Preferred Stock and 282,900 shares had been designated and issued as Series B Convertible Preferred. In January 1995, the Company authorized and sold 200,000 shares of Series C Convertible Preferred Stock for $1,500 pursuant to a Private Placement Agreement. In August 1995, the Company authorized and sold 666,360 shares of Series D Convertible Preferred Stock for $4,998 pursuant to a Private Placement Agreement. All of the above shares are not redeemable. Each individual share of Series A, B, C and D Convertible Preferred Stock was convertible into 1.5 common shares at the holder's option, subject to adjustment for antidilution. Subject to certain provisions, registration rights, as defined in the agreement, may be exercised after the earlier of (1) August 23, 1999, or (2) the effective date of the first registration statement for a public offering of securities of the Company. Holders of Series B, C and D Convertible Preferred Stock have voting rights. Furthermore, holders of Series D Convertible Preferred Stock have the right to purchase 446,858 shares of Class D Convertible Preferred Stock at $8.39 per share. Pursuant to the terms of the Series A, B, C and D Convertible Preferred Stock, these securities were converted, on a 1.5 to 1 share basis, to common stock immediately prior to the effective date of the initial public offering. F-17 63 Stock Splits In January 1995, the Company authorized a 100 for 1 stock split on its Series A and B Preferred Stock and a 100 for 1 stock split on the common stock sold in 1993. In April 1996, the Company authorized a 1.5 for 1 stock split on its common stock in the form of a stock dividend. In connection with the initial public offering, the Company effected a recapitalization whereby the presently outstanding common stock (including converted Series A, B, C and D Convertible Preferred Stock) was converted to shares of common stock on a .59581 to 1 share basis. All information in the accompanying consolidated financial statements and footnotes has been retroactively restated to give effect to these transactions. Stock Options During 1995, the Company adopted the 1995 Stock Option Plan (the "1995 Plan") for the purpose of granting incentive stock options to employees, officers or directors of, or consultants or advisors to, the Company, provided that incentive stock options may only granted to individuals who are employees of the Company. Options granted under the 1995 Plan typically vest annually over a three-year period and expire ten years from the date of grant. The Company reserved 1,500,000 shares of common stock for issuance under the 1995 Plan. The Company also adopted the Advanced Health Corporation Employee Stock Purchase Plan (the "Employee Plan") during 1996 in order to allow the employees of the Company to acquire a proprietary interest in the Company through the purchase of the Company's common stock. Under the Employee Plan, eligible employees will be granted options to purchase shares of common stock through regular payroll deductions. The total number of shares of common stock that are authorized for issuance under the Employee Plan is 1,200,000. No shares have been issued under the Employee Plan. The Company accounts for these plans under APB Opinion No. 25, under which no compensation cost has been recognized. Had compensation cost for these plans been determined consistent with SFAS No. 123, the Company's net income (loss) and basic net income (loss) per share would have been changed to the following pro forma amounts:
1995 1996 1997 -------- -------- ------ Net income (loss): As Reported $ (5,707) $ (1,465) $7,158 Pro Forma (5,898) (1,850) 4,370 Basic net income (loss) per share: As Reported $ (1.68) $ (0.26) $ .91 Pro Forma (1.71) (0.33) .56
Because the SFAS No. 123 method of accounting has not been applied to options granted prior to January 1, 1995, the resulting pro forma compensation cost may not be representative of that to be expected in future years. F-18 64 A summary of the status of the 1995 Plan at December 31, 1996 and 1997, and changes during the years then ended, is presented in the table and narrative below:
1996 1997 ---------------------- ------------------ Wtd. Avg. Wtd. Avg. Shares Ex Price Shares Ex Price ---------------------- ------------------ Outstanding at beg. of year 888,916 $ 0.17 804,444 $ 1.31 Grant 154,733 6.77 1,775,895 16.85 Exercised (21,734) 3.71 (352,005) 3.95 Forfeited (217,471) 4.17 (140,007) 8.07 --------- --------- Outstanding at end of year 804,444 1.31 2,088,327 13.72 ========= ========= Exercisable at end of year 306,511 N/A 282,583 3.03 ========= ========= Weighted average fair value of options granted $ 3.54 N/A $ 8.52
The fair value of each option grant is estimated on the date of grant using the Black-Scholes option pricing model with the following weighted-average assumptions used for grants in 1996 and 1997, respectively: risk-free interest rates of 6.2%; expected dividend yields of 0%; expected lives of 3 years; expected stock price volatility of 74%. 13. INCOME TAXES: Income tax provision (benefit) consists of the following:
Years Ended December 31, ------------------------------------ 1995 1996 1997 ---- ---- ---- Federal: Current $ - $ - $ - Deferred - (757) 2,556 State and Local: Current - - - Deferred - (220) 451 Adjustment to valuation allowance related to opening net deferred tax assets - - (2,605) ------- ------- ------ Total income tax provision (benefit) $ - $ (977) $ 402 ======= ======= ======
A reconciliation of the difference between the statutory Federal income tax rate and the Company's effective tax rate for the years ended December 31, 1995, 1996, and 1997 are as follows:
1995 1996 1997 ---- ---- ---- Tax provision (benefit) at statutory rate 34% 34% 34% State and local taxes 6% 6% 6% Loss without benefit (40%) -- -- Change in valuation allowance for opening net deferred tax assets -- (40%) (35%) ---- ---- ---- -- -- 5% ==== ==== ====
F-19 65 The tax effects of temporary differences that give rise to a significant portion of the deferred income tax asset, net, at December 31, 1997 and 1996 are as follows:
December 31, ----------------------- 1996 1997 ---- ---- Net operating loss carryforward $ 3,511 $ 2,132 Exercise of stock options -- 1,360 Allowance for doubtful accounts 84 264 Amortization 380 238 Deferred revenue 160 80 Other (11) 18 ------- ------- 4,124 4,092 Less: Valuation allowance (3,147) - ------- ------- Total current deferred income taxes, net $ 977 $ 4,092 ======= =======
At December 31, 1997, the Company had net operating loss carryforwards ("NOLs") available to offset taxable income of approximately $4,900 expiring in varying amounts through 2011. In 1997, management of the Company determined that, more likely than not, its previously-reserved deferred tax assets would be realized and, accordingly, reduced the related valuation allowance. The reduction in the valuation allowance is included in the income tax provision in the accompanying consolidated statement of operations for 1997. The determination that the net deferred tax asset of $4,092 at December 31, 1997 is realizable is based on the Company's profitability during 1997. Deferred tax assets of approximately $1,360, all of which are related to tax benefits associated with the exercise of stock options, did not result in a tax benefit in the accompanying consolidated statements of operations but, rather, increase additional paid in capital. 14. COMMITMENTS: The Company leases certain office space for its operations. Leases for this space expire through 2002 and call for annual rent, with immaterial escalations through the end of the leases. The Company has also entered into several operating leases for office equipment. Future minimum payments for operating leases at December 31, 1997 are as follows:
Year ending December 31, ------------------------ 1998 $ 969 1999 1,158 2000 787 2001 820 2002 and thereafter 239
Rent expense was $126, $630 and $443, respectively, for the three years ended December 31, 1997. F-20 66 Employment Agreements During 1997, the Company entered into employment agreements with the following four employees: (1) the Chairman of the Board and Chief Executive Officer, (2) Vice Chairman and Director, (3) President and Chief Operating Officer and (4) Executive Vice President and Chief Information Officer. The employment agreements provide for initial base salaries of $220, $220, $200, and $174 respectively. The employees are also entitled to receive discretionary bonuses. The employment agreements provide for a three-year term that is automatically renewable for successive one-year terms unless either party gives prior written notice of its intent not to renew. 15. LITIGATION: On May 22, 1997, a shareholder commenced an action against the Company and certain of its executives in the United States District Court for the Southern District of New York. The action relates to: (i) employment Agreement dated April 1, 1996 between the Company and the shareholder and (ii) an Asset Purchase Agreement dated April 1, 1996, among the Company, the shareholder, and a company previously owned by the shareholder. Plaintiffs have asserted claims against all defendants for alleged violations of the Exchange Act, common law fraud and fraudulent inducement, and against the Company for breach of contract. Plaintiffs' complaint seeks both damages and equitable relief. The Company believes that each of the plaintiffs' claims is without merit, and it intends to defend against the action vigorously. On September 23, 1997, the Company commenced an action against a customer to collect $1,000 owed by the customer to the Company pursuant to a software license agreement dated as of March 31, 1997, as amended (the "License Agreement"), between the customer and the Company. On October 1, 1997, the customer filed an answer to this lawsuit and asserted various counterclaims against the Company, in which the customer alleges that the subject software and documentation was not timely delivered and installed in accordance with the License Agreement. As relief, the customer seeks a declaratory judgment that the customer is not obligated to make the $1,000 payment, as well as unspecified damages. The Company believes that the customer defenses and counterclaims are without merit. From time to time, the Company is involved in litigation. Although the actual amount of any liability that could arise with respect to any such litigation cannot be accurately predicted, in the opinion of management, the resolution of these matters is not expected to have material adverse effect on the Company's business, results of operations or financial condition. F-21 67 SUPPLEMENTAL SCHEDULE II
(in thousands) Additions ---------- Balance at Charged to Charged to Balance at beginning cost and other end Description of period expenses accounts Deductions of period - --------------------------------------------------------------------------------------------------------------------------------- December 31, 1995 Allowance for Doubtful Accounts $ - $ - $ - $ - $ - 1996 Allowance for Doubtful Accounts $ - $ 210 $ - $ - $ 210 1997 Allowance for Doubtful Accounts $ 210 $ 450 $ - $ - $ 660 =============================================================================
S-2 68 REPORT OF INDEPENDENT PUBLIC ACCOUNTANTS ON SCHEDULE To Advanced Health Corporation: We have audited, in accordance with generally accepted auditing standards, the consolidated financial statements of Advanced Health Corporation included in this annual report on Form 10-K and have issued our report thereon dated March 19, 1998. Our audits were made for the purpose of forming an opinion on the basic consolidated financial statements taken as a whole. This schedule is presented for purposes of complying with the Securities and Exchange Commission's rules and is not part of the basic consolidated financial statements. This schedule has been subjected to the auditing procedures applied in our audits of the basic consolidated financial statements and, in our opinion, fairly states in all material respects the financial data required to be set forth therein in relation to the basic consolidated financial statements taken as a whole. ARTHUR ANDERSEN LLP New York, New York March 19, 1998 S-1 69 EXHIBIT INDEX Exhibit No. Description of Exhibit Page **3.1 Restated Certificate of Incorporation of the Registrant **3.2 By-laws of the Registrant +**10.1 Management Services Agreement dated as of December 11, 1995, between Madison Medical -- The Private Practice Group of New York, L.L.P. and Uptown Physician Management, Inc. **10.2 Stockholders' Agreement dated as of December 11, 1995, among Uptown Physician Management, Inc. and certain stockholders +**10.3 Management Services Agreement dated as of August 7, 1995, among Advanced Heart Institute of New York, P.C., Valavanur A. Subramanian, M.D., Jeffrey Moses M.D. and Majean Sub 2, Inc. +**10.4 Management Services Agreement dated as of July 1, 1996, between Specialist Physicians Management, Inc. and Cardiology First of New Jersey, P.A. **10.5 Stockholders' Agreement dated as of July 1, 1996 among Specialist Physicians Management, Inc., Specialist Physicians MSO, L.L.C. and Advanced Health Management Corporation. +**10.6 Management Services Agreement dated as of July 1, 1996 between Diamond Physician Management, Inc. and Long Island Interventional Cardiology. **10.7 Tarrytown, New York Office Lease Agreement dated November 30, 1995, between Tarrytown Corporate Center IV, L.P. and the Registrant. **10.8 First Amendment to Lease Agreement between Reckson Operating Partnership, LP, as Owner, and the Registrant, as Tenant **10.9 Chicago Office Lease Agreement dated December 8, 1995, between Adams Family, L.L.C. and the Registrant 70 *10.10 Fort Washington Lease Agreement dated November 13, 1997, between Comdrive Associates, L.P. and Registrant as Tenant *10.11 Hawthorne Lease Agreement dated January 8, 1998, between United Parcel Service, Inc. and Registrant as Tenant **10.12 Form of Director Indemnification Agreement **10.13 Employment Agreement between the Registrant and Jonathan Edelson, M.D. **10.14 Employment Agreement between the Registrant and Steven Hochberg **10.15 Employment Agreement between the Registrant and Alan B. Masarek ****10.16 Employment Agreement between the Registrant and Robert Alger *10.17 Employment Agreement between the Registrant and Michael P. Rogers **10.18 Amended and Restated Advanced Health Corporation 1995 Stock Option Plan **10.19 Employee Stock Purchase Plan **11.1 Earnings Net Loss Per Common Share Computation **21 List of Subsidiaries *23.2 Consent of Arthur Andersen LLP *27 Financial Data Schedule * Filed herewith. ** Filed as an exhibit to the Registrant's Registration Statement on Form S-1, as amended (Registration No. 333-06283), Registrant's Registration Statement on Form S-1, as amended (Registration No. 333-35115), and Registrant's Form 10-K, dated March 30, 1997 incorporated herein by reference. + Portions of such exhibit have been deleted therefrom pursuant to Rule 406 promulgated under the Securities Act of 1933, as amended, and confidential treatment has been granted therefor.
EX-10.10 2 FORT WASHINGTON LEASE AGREEMENT 1 AGREEMENT OF LEASE BETWEEN COMDRIVE ASSOCIATES, L.P. AS LANDLORD AND ADVANCED HEALTH CORPORATION AS TENANT 2 OFFICE LEASE LEASE made this 13th day of November, 1997 by and between Comdrive Associates, L.P. (hereinafter called "Landlord"), and Advanced Health Corporation a Delaware Corporation (hereinafter called "Tenant"). WITNESSETH, THAT: 1. DEMISED PREMISES. Landlord, for the term and subject to the provisions and conditions hereof, leases to Tenant and Tenant accepts from Landlord, the space consisting of approximately 8.028 rentable square feet on the ____ floor known as Suite _______ (hereinafter referred to as the "Demised Premises") of the building known as 401 Commerce Drive located in Fort Washington, Upper Dublin Township, Pennsylvania (hereinafter referred to as the "Building"), and more particularly described by the cross-hatched area on the floor plans annexed herein as Exhibit "A", to be used by Tenant for the purpose of Office and for no other purpose. 2. TERM. Tenant shall use and occupy the Demised Premises for a term of Five (6) years and Zero (0) months, commencing on the First day of January, 1998 and ending on the Thirty First day of December, 2002 unless sooner terminated as herein provided. 3. MINIMUM RENT. (a) See Rent Rider attached. The first installment to be payable on the execution of this Lease and subsequent installments to be payable on the first day of each successive month of term hereof following the first month of such terms. (b) If the term of this Lease begins on a day other than the first day of a month, rent from such day until the first day of the following month shall be prorated at the rate of one-thirtieth of the fixed monthly rental for each day of the first full calendar month of the term hereof (and, in such event, the installment of rent paid at execution hereof shall be applied to the rent due for the first full calendar month of the term hereof). (c) All rent and other sums due to Landlord hereunder shall be payable to Comdrive Associates, LP. and mailed to the office of Landlord at Equivest Management Company P.O. Box 13700, Philadelphia, Pennsylvania, 19191-1062, or to such other party or at such other address as Landlord may designate, from time to time, by written notice to Tenant, without demand and without deduction, set-off or counterclaim (except to the extent demand or notice shall be expressly provided for herein). (d) If Landlord, at any time or times, shall accept said rent or any other sum due to it hereunder after the same, shall become due and payable such acceptance shall not excuse delay upon subsequent occasions, or constitute or be construed as, a waiver of any of Landlord's rights hereunder. Page - 2 3 4. ESCALATION IN TAXES, OPERATING COSTS, COSTS OF LIVING: COST OF ELECTRICITY. (A) Definitions. As used in this Section 4, the following terms shall be defined as hereinafter set forth. (i) "Taxes" shall mean all real estate taxes and assessments, general and special, ordinary or extraordinary, foreseen or unforeseen, imposed upon the Building or with respect to the ownership thereof and the parcel of land appurtenant thereto. If, due to a future change in the method of taxation, any franchise, income, profit or other tax, however designated, shall be levied or imposed in substitution in whole or in part, for (or in lieu of) any tax which would otherwise be included within the defined herein. (ii) "Base Year Operating Expenses" shall be $4.00 per square foot. (iii) "Tenant's Fraction" shall be a fraction, the numerator of which is the Demised Rentable Square Feet and the denominator of which is the Rentable Square Feet in the Building. 8,028/45,000 (iv) (a) Operating Expenses" shall mean except as hereinafter limited, Landlord's actual out-of-pocket expenses in respect of the operation, maintenance and management of the Building (after deducting any reimbursement, discount, credit, reduction or other allowance received by Landlord) and shall include, without limitation: (1) wages and salaries (and taxes imposed upon employers with respect to such employed by Landlord for rendering service in the normal operation, cleaning, maintenance, and repair of the Building; (2) contract costs of contractors hired for the operation, maintenance and repair of the Building; (3) the cost of steam, electricity, water and sewer and other utilities (except for electricity, which is separately charged by Landlord as herein provided) chargeable to the operation and maintenance of the Building; (4) cost of insurance for the Building including fire and extended coverage, elevator, boiler, sprinkler leakage, water damage, public liability and property damage, plate glass, and rent protection, but excluding any charge for increased premiums due to acts or omissions of other occupants of the Building or because of extra risk which are reimbursed to Landlord by such other occupants; (5) supplies; and (6) reasonable legal and accounting expenses; (7) Taxes (8) management expense. The term "Operating Expenses" shall not include: (1) the cost of redecorating or repairing not provided on a regular basis to tenants of the Building; (2) the cost of any repair or replacement item which, by standard accounting practice, should be capitalized; (3) any charge for depreciation, interest or rents paid or incurred by Landlord; (4) any charge for Landlord's income tax, excess profit taxes, franchise taxes or similar taxes on Landlord's business; (5) commissions. Page - 3 4 (b) In determining Operating Expenses for any year, if less than ninety-five percent (95%) of the Building rentable area shall have been occupied by tenants at any time during such year, Operating Expenses shall be deemed for such year to be an amount equal to the like expenses which Landlord reasonably determines would normally be incurred had such occupancy been ninety-five percent (95%) throughout such year, provided base year is increased to ninety five percent (95%). (c) If, after the Base Year for Operating Expenses, Landlord shall eliminate any component of Operating Expenses, as a result of the introduction of a labor saving device or other capital improvement, the corresponding item of Operating Expenses shall be deducted from the Operating Expenses expended by Landlord in said Base Year for purposes of calculating Tenant's Proportionate Share of any increased Operating Expenses. (v) "Demised Rentable Square Feet" shall mean 8.028 square feet. (vi) "Rentable Square feet in the Building" shall mean 45.000 square feet. (B) Escalation of Operating Expenses. (i) For and with respect to each calendar year of the term of this Lease (and any renewals or extensions thereof) subsequent to the Base Year for Operating Expenses there shall accrue, as additional rent, an amount equal to the product obtained by multiplying the Tenant's Fraction by the amount of the increase, if any, of Operating Expenses for such year over the Base Year Operating Expenses (appropriately prorated for any partial calendar year included within the beginning and of the term). (ii) Landlord shall furnish to Tenant as soon as reasonably possible after the beginning of each calendar year of the term hereof subsequent to the Base Year for Operating Expenses, in the event Tenant over pays operating pass-through, Landlord will promptly reimburse Tenant: (a) A statement (the "Expense Statement":) setting forth (1) Operating Expenses for the previous calendar year, and (2) Tenant's Fraction of the Operating Expenses for the previous calendar year and (b) A statement of Landlord's good faith estimate of Operating Expenses, and the amount of Tenant's Fraction thereof (the "Estimated Share"), for the current calendar year. (iii) Beginning with the next installment of minimum rent due after delivery of the foregoing statements to Tenant, Tenant shall pay to Landlord, on account of its share of Operating Expenses (or Landlord shall pay to Tenant, if the following quantity is negative): (a) One-twelfth of the Estimated Share multiplied by the number of full or partial calendar months elapsed during the current calendar year up to and including the month payment is made, plus any amounts due from Tenant to Landlord on account of Operating Expenses for prior periods of time, less: Page - 4 5 (b) The amount, if any, by which the aggregate of payments made by Tenant on account of Operating Expenses for the previous calendar year exceed those actually due as specified in the Expense Statement. (iv) On the first day of each succeeding month up to the time Tenant shall receive a new Expense Statement and statement of Tenants Estimated Share, Tenant shall pay to Landlord, on account of its share of Operating Expenses, one-twelfth of the then current Estimated Share. Any payment due from Tenant to Landlord, or any refund due from Landlord to Tenant, on account of Operating Expenses not yet determined as of the expiration of the term hereof shall be made within twenty (20) days after submission to Tenant of the next Expense Statement. 5. UTILITIES SEPARATELY CHARGED TO DEMISED PREMISES. Tenant shall be responsible for all utilities (including gas and electric) which are consumed within the Demised Premises. If a separate meter is installed, Tenant shall pay for the consumption of such utilities based on its metered usage. if no meter is installed, Tenant shall pay a pro-rata share of any utility charges covering the Demised Premises and other areas of the Building which pro-rata share shall be based on the percentage which the Demised Rentable Square Feet bears to the square footage of the areas of the Building serviced by such utility. Tenant shall pay utility bills within ten (10) days after the receipt and non-payment or late payment of such bills shall be considered a default under this Lease. Landlord warrants that this building is submetered and submeters are in good working order. 6. SECURITY DEPOSIT. As additional security for the full and prompt performance by Tenant of the terms and covenants of this Lease, Tenant has deposited with the Landlord the sum of Eleven Thousand One Hundred Five Dollars and Forty Cents ($11,105.40) which shall not constitute rent for any month (unless so applied by Landlord on account of Tenant's default). Tenant shall, upon demand, restore any portion of said security deposit, which may be applied by Landlord to the cure of any default by Tenant hereunder. To the extent that Landlord has not applied said sum on account of a default, the security deposit shall be returned (without interest) to Tenant promptly at termination of this Lease. 7. SERVICES. Landlord agrees that it shall: (a) Provide passenger elevator service to the Demised Premises during all days with one (1) elevator subject to call at all other times. Tenant and its employees and agents shall have access to the Demised Premises at all times, subject to compliance with such security measures as shall be in effect for the Building. (b) Provide water for drinking, lavatory and toilet purposes drawn through fixtures installed by Landlord; and Page - 5 6 (c) Furnish the Demised Premises with electric for heating, hot and chilled water and air-conditioning. Tenant shall not install or operate in the Demised Premises any electrically operated equipment or other machinery, other than typewriters, computers, telecommunication equipment, adding machine and other machinery and equipment normally used in modern offices, or any plumbing fixtures, without first obtaining the prior written consent of the Landlord which will not be unreasonably withheld. Landlord may condition such consent upon the payment by Tenant of additional rent as compensation for the additional consumption of water and/or electricity occasioned by the operation of said equipment, fixtures, or machinery. Tenant, at Tenant's sole expense, shall be responsible for the installation, maintenance, and use of any equipment of any kind or nature whatsoever which would or might necessitate any changes, replacements, or additions to the water system, plumbing system, heating system, air-conditioning system, or the electrical system servicing the Demised Premises or any other portion of the Building without the prior written consent of the Landlord which shall not be unreasonably withheld, and in the event such consent is granted, such replacement, changes or additions shall be paid for by Tenant. It is understood that Landlord does not warrant that any of the services referred to in this Section 7 will be free from interruption from causes beyond the reasonable control of Landlord. No interruption of service shall ever be deemed an eviction or disturbance of Tenant's use and possession of the Demised Premises or any part thereof or render Landlord liable to Tenant for damages by abatement or rent or otherwise relieve Tenant from performance of Tenant's obligations under this Lease, unless Landlord, after reasonable notice, shall willfully and without cause fail or refuse to take action within its control. Landlord represents and warrants that everything within the Building is within the control of the Landlord. In the event after Tenant notifies Landlord that services have been interrupted for a period of two (2) days, rent shall abate one (1) day for every day that services remain interrupted. 8. CARE OF DEMISED PREMISES. Tenant agrees, on behalf of itself, its employees and agents that it shall: (a) Comply at all times with any and all federal, state and local statutes, regulations, ordinances, and other requirements of any of the constituted public authorities relating to its use and occupancy of the Demised Premises except for major and structural alterations. (b) Give Landlord access to the Demised Premises at all reasonable times, without charge or diminution of rent, to enable Landlord (i) to examine the same and to make such repairs, additions and alterations as Landlord may be permitted to make hereunder or as Landlord may deem reasonably advisable for the preservation of the integrity, safety and good order of the Building or any part thereof; and (ii) upon reasonable notice during business hours, to show the Demised Premises to prospective mortgagees and purchasers and, during the three (3) months prior to expiration of the term, to prospective tenants; (c) Keep the Demised Premises in good order and condition and replace all glass broken by Tenant, its agents, employees or invitees with glass of the same quality as that broken, except for glass broken by fire and extended coverage type risks, or by Landlord, and commit no waste in the Demised Premises; Page - 6 7 (d) Upon the termination of this Lease in any manner whatsoever, remove Tenant's goods effects and those of any other person claiming under Tenant, and quit and deliver up the Demised Premises to Landlord peaceably and quietly in as good order and condition at the inception of the term of this Lease or as the same hereafter may be improved by Landlord or Tenant, reasonable use and wear thereof damage from fire and extended coverage type risks, and repairs which are Landlord's obligation excepted. Goods and effects not removed by Tenant at the termination of this Lease, however terminated, shall be considered abandoned and Landlord may dispose of and/or store the same as it deems expedient, the cost thereof to be charged to Tenant; (e) Not place signs on the Demised Premises except on doors and then only of a type and with lettering and text approved by Landlord. Identification of Tenant and Tenant's location shall be provided in a directory in the Building Lobby; (f) Not overload, damage or deface the Demised Premises or do any act which might make void or voidable any insurance on the Demised Premises or the Building or which may reasonably render an increased or extra premium payable for insurance (and without prejudice to any right or remedy of Landlord regarding this subparagraph, Landlord shall have the right to collect from Tenant, upon demand, any such increase or extra premium). Tenant shall maintain at its own sole cost adequate insurance coverage for all of its equipment, furniture, supplies and fixtures and provide Landlord with certificates evidencing such coverage; (g) Not make any alteration of or addition to the Demised Premises without the prior written approval of Landlord (except for work of a decorative nature); (h) Not install or authorize the installation of any coin operated vending machine, except for the dispensing of cigarettes, coffee, and similar items to the employees of Tenant for consumption upon the Demised Premises: and (i) Observe the rules and regulations annexed hereto as Exhibit "C", as Landlord may from time to time amend the same for the general safety, comfort and convenience of Landlord, occupants and tenants of the Building. 9. SUBLETTING AND ASSIGNING. Tenant shall not assign this Lease or sublet all or any portion of the Demised Premises without first obtaining Landlord's prior written consent which can not be unreasonable withheld thereto. If such consent is given, it will not release Tenant from its obligations hereunder and which will not be deemed a consent to any further subletting or assignment. If Landlord consents to any such subletting or assignment it shall nevertheless be a condition to the effectiveness thereof that a fully executed copy of the sublease or assignment be furnished to Landlord and that any assignee assume in writing all obligations of Tenant hereunder, Tenant shall not mortgage or encumber this Lease. Page - 7 8 10. DELAY IN POSSESSION. If Landlord shall be unable to deliver possession of the Demised Premises to Tenant on the date specified for commencement of the term hereof because of the holding over or retention of possession of any tenant or occupant, or if repairs improvements or decoration of the Demised Premises are not completed, or for any other reason, Landlord shall not be subject to any liability to Tenant. Under such circumstances, the rent reserved and covenanted to be paid herein shall not commence until possession of Demised Premises is given and no such failure to give possession shall in any other respect affect the validity of this Lease or any obligation to extend the term of this Lease. In such event that substantial completion of Tenant Improvements have not been completed by December 31, 1997 subject that Leases and Exhibit A are executed by November 13, 1997, Tenant will receive one days rent abatement for each day that Tenant is delayed occupancy beyond December 31, 1997. Substantial completion shall be defined herein as follows: Landlord shall have received a Certificate of Occupancy and Tenant and Landlord shall be reviewing punchlist items relating to the completion of Tenant improvements within Demised Premises. In the event that Landlord has not met substantial completion by January 31, 1998, Tenant will have the Option to Terminate this Lease with written notice to Landlord. 11. FIRE OR CASUALTY. In case of damage to the Demised Premises or the Building by fire or other casualty, Tenant shall give immediate notice thereof to Landlord. Landlord shall thereupon cause the damage to be repaired with reasonable speed, subject to delays, which may arise by reason of adjustment of loss under insurance policies and for delays beyond the reasonable control of Landlord. To the extent and for the time that the Demised Premises are thereby rendered untenantable, the rent shall proportionately abate. In the event the damage shall be so extensive that Landlord shall decide not to repair or rebuild, or if any mortgagee, having the right to do so shall direct that the insurance proceeds are to be applied to reduce the mortgage debt rather than to the repair of such damage, this Lease shall, at the option of Landlord, exercisable by written notice to Tenant given within thirty (30) days after Landlord is notified of the casualty, be terminated as of a date specified in such notice (which shall not be more than ninety (90) days thereafter), and the rent (taking into account any abatement as aforesaid) shall be adjusted to the termination date. Thereafter, Tenant shall promptly vacate the Demised Premises. 12. LIABILITY. Tenant agrees that Landlord and its building manager and their officers, employees and agents shall not be liable to Tenant, and Tenant hereby releases said parties, for any personal injury or damage to or loss of personal property in the Demised Premise from any cause whatsoever unless such damage, loss or injury is the result of the gross negligence or willful acts of Landlord, its building manager, or their officers, employees or agents, and Landlord and its building manager and their officers or employees shall not be liable to Tenant for any such damage or loss whether or not the result of their willful and gross negligence to the extent Tenant is compensated therefor by Tenant's insurance. Tenant shall and does hereby indemnify and hold Landlord harmless of and from all loss or liability incurred by Landlord in connection with any failure of Tenant to fully perform its obligations under this Lease and in connection with any personal injury or damage of any type or nature occurring in or resulting out of Tenant's use of the Demised Premises, unless due to Landlord's fault. Page - 8 9 13. EMINENT DOMAIN. If the whole or a substantial part of the Building shall be taken or condemned for a public or quasi-public use under an statute or by right of eminent domain or private purchase in lieu thereof by any competent authority, Tenant shall have no claim against Landlord and shall not have any claim or right to any portion of the amount that may be awarded as damages or paid as a result of any such condemnation or purchase; and all right of the Tenant to damages therefore are hereby assigned by Tenant to Landlord. The foregoing shall not, however, deprive Tenant of any separate award for moving expenses or for any other award which would not reduce the award payable to Landlord. Upon the date the right to possession shall vest in the condemning authority, this Lease shall cease and terminate with rent adjusted to such date, and Tenant shall have no claim against Landlord for the value of any unexplored term of this Lease. 14. INSOLVENCY. (a) The appointment of a receiver or trustee to take possession of all or a portion of the assets of Tenant, or (b) an assignment by Tenant for the benefit of creditors, or (c) the Institution by or against Tenant of any proceedings for bankruptcy or reorganization under any state or federal law (unless in the case of involuntary proceedings, the same shall be dismissed within thirty (30) days after institution), or (d) any execution issued against Tenant which is not stayed or discharged within fifteen (15) days after issuance of any execution sale of the assets of Tenant, shall constitute a breach of this Lease by Tenant. Landlord in the event of such a breach, shall have, without need of further notice, the rights enumerated in Section 15 herein. 15. DEFAULT. (a) If Tenant shall fail to pay rent or any other sum payable to Landlord five (5) business days with written notice from date due, or if Tenant shall fall to perform or observe any of the other covenants, terms or conditions contained in this Lease within fifteen (15) days (or such longer period as is reasonably required to correct any such default, provided Tenant promptly commences and diligently continues to effectuate a cure), but in any event within thirty (30) days after written notice thereof by Landlord, or if any of the events specified in Section 14 occur, or if Tenant vacates or abandons the Demised Premises during the term hereof or removes or manifests an intention to remove any of Tenant's goods or property therefrom other than in the ordinary and usual course of Tenant's business, then and in any of said cases (notwithstanding any former breach of covenant or waiver thereof in a former instance), Landlord, in addition to all other rights and remedies available to it by law or equity or by any other provisions hereof, may at any time thereafter, Tenant however with written notice to Landlord which can not be unreasonably withheld may vacate Demised Premises and this will not constitute Default of this Lease: (i) upon three (3) days notice to Tenant, declare to be immediately due and payable, the rent and other charges herein reserved for the balance of the term of this Lease (taken without regard to any early termination of said term on account of default), a sum equal to the Accelerated Rent Component (as hereinafter defined), and Tenant shall remain liable to Landlord as hereinafter provided: and/or Page - 9 10 (ii) whether or not Landlord has elected to recover the Accelerated Rent Component, terminate this Lease on at least five (5) days notice to Tenant and, on the date specified in said notice, this Lease and the term hereby demised and all rights of Tenant hereunder shall expire and terminate and Tenant shall thereupon quit and surrender possession of the Demised Premises to Landlord in the condition elsewhere herein required and Tenant shall remain liable to Landlord as hereinafter provided. (b) For purposes herein, the Accelerated Rent Component shall mean the present value aggregate of: (i) all rent and other charges, payments, costs and expenses due from Tenant to Landlord and in areas at the time of the election of Landlord to recover the Accelerated Rent Component; (ii) the minimum rent reserved for the then entire unexpired balance of the term of this Lease (taken without regard to any early termination of the term by virtue of any default), plus all other charges, payments, costs and expenses herein agreed to be paid by Tenant up to the end of said term which shall be capable of precise determination at the time of Landlord's election to recover the Accelerated Rent Component; and (iii) Landlord's good faith estimate of all charges, payments, costs and expenses herein agreed to be paid by Tenant up to the end of said term which shall not be capable to precise determination as aforesaid (and for such purposes no estimate of any component of the additional rent to accrue pursuant to the provisions of Section 4 hereof shall be less than the amount which would be due if each such component continued at the highest monthly rate or amount in effect during the twelve (12) months immediately preceding the default). (c) In any case in which this Lease shall have been terminated, or in any case in which Landlord shall have elected to recover the Accelerated Rent Component and any portion of such sum shall remain unpaid, Landlord may without further notice, enter upon and repossess the Demised Premises, by force, summary proceedings, ejectment or otherwise, and may dispossess Tenant and remove Tenant and all other persons and property from the Demised Premises and may have, hold and enjoy the Demised Premises and the rents and profits therefrom. Landlord may, in its own name, as agent for Tenant, if this Lease has not been terminated, or in its own behalf, if this Lease has been terminated, relet the Demised Premises or any part thereof for such term or terms (which may be greater or less than the period which would otherwise have constituted the balance of the term of this Lease) and on such terms (which may include concessions of free rent) as Landlord in its sole discretion may determine. Landlord may, in connection with any such reletting, cause the Demised Premises to be decorated, altered, divided, consolidated with other space or otherwise changed or prepared for reletting. No reletting shall be deemed a surrender and acceptance of the Demised Premises. Page - 10 11 (d) Tenant shall, with respect to all periods of time up to and including the expiration of the term of this Lease (or what would have been the expiration date in the absence of default or breach) remain liable to Landlord as follows: (i) In the event of termination of this Lease on account of Tenant's default or breach, Tenant shall remain liable to Landlord for damages equal to the rent and other charges payable under this Lease by Tenant as if this Lease were still in effect, less the net proceeds of any reletting after deducting all costs incident thereto (including without limitation all repossession costs, brokerage and management commission, operating and legal expenses and fees, alteration costs and expenses of preparation for reletting (and to the extent such damages shall not have been recovered by Landlord by virtue of payment by Tenant of the Accelerated Rent Component (but without prejudice to the right of Landlord to demand and receive the Accelerated Rent Component), such damages shall be payable to Landlord monthly upon presentation to Tenant of a bill for the amount due. (ii) In the event and so long as this Lease shall not have been terminated after default or breach by Tenant, the rent and all other charges payable under this Lease shall be reduced by the net proceeds of any reletting by Landlord (after deducting all costs incident thereto as above set forth) and by any portion of the Accelerated Rent Component paid by Tenant to Landlord, and any amount due to Landlord shall be payable monthly upon presentation to Tenant of a bill for the amount due. (e) In the event Landlord shall, after default or breach by Tenant, recover the Accelerated Rent Component from Tenant and it shall be determined at the expiration of the term of this Lease (taken without regard to early termination for default) that a credit is due Tenant because the net proceeds of reletting, as aforesaid, plus amounts paid to Landlord by Tenant exceed the aggregate of rent and other charges accrued in favor of Landlord to the end of said term, Landlord shall refund such excess to Tenant, without interest, promptly after such determination. (f) Landlord shall in no event be responsible or liable for any failure to relet the Demised Premises or any part thereof, or for any failure to collect any rent due upon a reletting. Landlord will use reasonable efforts to relet Demised Premises. (g) As an additional and cumulative remedy of Landlord in the event of termination of this Lease by Landlord following any breach or default by Tenant, Landlord, at its option, shall be entitled to recover damages for such breach in an amount equal to the Accelerated Rent Component (determined from and after the date of Landlord's election under this subsection (g) less the fair rental value of the Demised Premises for the remainder of the term of this Lease (taken without regard to the early termination) and such damages shall be payable by Tenant upon demand. Nothing contained in this Lease shall limit or prejudice the right of Landlord to prove and obtain as damages incident to a termination of this Lease, in any bankruptcy reorganization or other court proceedings, the maximum amount allowed by any statute or rule of law in effect with such damages are to be proved. (h) In the event of any default occurrence by which Landlord shall have the rights and remedies specified in this Section 15: Page - 11 12 (i) Tenant hereby authorizes and empowers any prothonotary or attorney of any court of record to appear for Tenant and to Confess Judgment against Tenant (whether by Complaint to Confess Judgment or otherwise) in favor of Landlord for any amount due to Landlord hereunder (including without limitation the Accelerated Rent Component), together with interest and costs and an attorney's commission of five percent (5%) of the amount due; (ii) For the purpose of obtaining possession of the Demised Premises, Tenant hereby authorizes and empowers any prothonotary or attorney of any court of record to appear for Tenant and to file in any court an agreement for entering an amicable action and judgment in ejectment for recovery of possession, and/or to confess judgment for possession against Tenant and those claiming by, through or under Tenant in favor of Landlord by Complaint to Confess Judgment or otherwise, and Tenant agrees that upon such entry or judgment a writ of possession for the Demised Premises may forthwith issue; and (i) Tenant hereby waives all errors and defect of a procedural nature in any proceedings brought against it by Landlord under this Lease. Tenant further waives the right to any notices to quit as may be specified in the Landlord and Tenant Act of Pennsylvania, as amended, and agrees that five (5) days notice shall be sufficient in any case where a longer period may be statutorily specified. (j) If rent or any other sum due from Tenant to Landlord shall be over due for more than five (5) days alter notice from Landlord, it shall thereafter bear interest at the rate of twenty percent (20%) per annum (or, if lower, the highest legal rate) until paid. 16. SUBORDINATION. This lease is and shall be subject and subordinate to all the terms and conditions of all underlying mortgages and to all ground or underlying leases of the entire Building which may now or hereafter be secured upon the Building, and to all renewals, modifications, consolidations, replacements and extensions thereof. This clause shall be self-operative and no further instrument of subordination, Tenant shall execute, within fifteen (15) days after request, any certificate that Landlord may reasonably require acknowledging such subordination. Notwithstanding the foregoing, the party holding the instrument to which this Lease is subordinate shall have the right to recognize and preserve this Lease in the event of any foreclosure sale or possessory action, and in such case this Lease shall continue in full force and effect at the option of the party holding the superior lien, and Tenant shall attorn to such party and shall execute, acknowledge and deliver any instrument that has for its purpose and effect the confirmation of such attornment. 17. NOTICES. All bills, statements, notices or communications which Landlord may desire or be required to give to Tenant shall be deemed sufficiently given or rendered if in writing and or sent by registered, or certified mail or overnight delivery service addressed to Tenant at the Building with a copy sent to Advanced Health General Counsel at 555 White Plains Road, 5th Floor, in Tarrytown, NY 10591, and the time of the giving of such notice or communication shall be deemed to be the time when the same is delivered to Tenant or deposited in the mail, as the case may be. Any notice by Tenant to Landlord must be served by registered, certified mall or national overnight delivery addressed to Landlord at the address where the last previous rental hereunder was payable, or in the case of subsequent change upon notice given, to the latest address furnished. Page - 12 13 18. HOLDING-OVER. Should Tenant continue to occupy the Demised Premises after expiration of the term of this Lease or any renewal or renewals thereof, or after a forfeiture incurred, such tenancy shall (without limitation of any of Landlord's rights or remedies therefor) be one at sufferance from month to month at a minimum monthly rental equal to 125% the rent payable for the last month of the term of this Lease. 19. MISCELLANEOUS. (a) Landlord and Tenant hereby represent and warrant that they have not employed any broker or agent as its representative in the negotiation for or the obtaining of this Lease, and agrees to indemnify and hold Landlord harmless from any and all cost or liability for compensation claimed by any broker or agent with whom it has dealt. (b) The word "Tenant" as used in this Lease shall be construed to mean tenants in all cases where there is more than one tenant, and the necessary grammatical changes required to make the provisions hereof apply to corporations, partnerships or individuals, men or women, shall in all cases be assumed as though in each case fully expressed. This Lease shall not inure to the benefit of any assignee, heir, legal representative, transferee or successor of Tenant except upon the express written consent or election of Landlord. Subject to the foregoing limitation, each provision hereof shall extend to and shall, as the case may require, bind and inure to the benefit of Tenant and its heirs, legal representatives, successors and assigns. (c) The term "Landlord" as used in this Lease means the fee owner of the Building or, if different, the party holding and exercising the right, as against all others (except space Tenants of the Building) to possession of the entire Building. Landlord above-named represents that it is the holder of such rights as of the dale of execution hereof. In the event of the voluntary transfer of such ownership or right to a successor-in-interest of Landlord, Landlord shall be freed and relieved of all liability and obligation hereunder which shall thereafter accrue (and, as to any unapplied portion of Tenant's security deposit, Landlord shall be relieved of all liability therefor upon transfer of such portion to its successor in interest provided such successor assumes the Lease in writing) and Tenant shall look solely to such successor in interest for the performance of the covenants and obligations of the Landlord hereunder (either in terms of ownership or possessory rights). The successor in interest shall not (i) be liable for any previous act or omission of a prior landlord; (ii) be subject to any rental offsets or defenses against a prior landlord; (iii) be bound by any amendment of this Lease made without its written consent, or by payment by Tenant of rent in advance in excess of one (1) month's rent; or (iv) be liable for any security not actually received by it. Subject to the foregoing, the provisions hereof shall be binding upon and inure to the benefit of the successors and assigns of Landlord. Notwithstanding anything to the contrary contained in this Lease, any liability of Landlord, its agents, partners or employees, arising out of or in respect of this Lease, the Demised Premises or the Building, and if Landlord shall default in the performance of Landlord's obligation under this Lease or otherwise Tenant shall look solely to the equity of Landlord in its interest in the Building. (d) Tenant agrees to execute a memorandum of this Lease in the form submitted by Landlord, which may be recorded by Landlord. Tenant also agrees to execute any assignment of this Lease by Landlord, evidencing its consent to such assignment. Page - 13 14 20. LANDLORD IMPROVEMENT. Landlord shall, in a good and workmanlike manner, cause the Demised Premises to be completed in accordance with the plans approved by Landlord and Tenant pursuant to Exhibit "A" hereof, reserving the right to: (a) make substitutions of material of equivalent grade and quality when and if any specified material shall not be readily and reasonably available; (b) make changes necessitated or by conditions met during the course of construction, provided that Tenant's approval of any substantial change (and any reduction of cost incident thereto) shall first be obtained (which approval shall not be reasonably withheld so long as there shall be general conformity with said working drawings). 21. WAIVER OF SUBROGATION. Each party hereto hereby waives any and every claim which arises or which may arise in its favor and against the other party hereto during the term of this Lease, or any extension or renewal thereof, for any and all loss of, or damage to, any of its property located within or upon or constituting a part of the Building. Each party agrees to request its insurers to issue policies containing such provisions and if any extra premium is payable therefor, the party which would benefit from the provision shall have the option to pay such additional premium in order to obtain such benefit. 22. RENT TAX. If, during the term of this Lease or any renewal or extension thereof, any tax is imposed upon the privilege of renting or occupying the Demised Premises or upon the amount of rentals collected therefor, Tenant will pay each month, as additional rent, a sum equal to such tax or charge that is imposed for such month, but nothing in this Lease shall be taken to require Tenant to pay any income, estate, inheritance or franchise tax imposed upon Landlord. 23. PRIOR AGREEMENT, AMENDMENTS. Neither party hereto has made any representations nor promises except as contained herein or in some further writing signed by the party making such representation or promise. No other agreement hereinafter made shall be effective to change, modify, discharge or effect an abandonment of this Lease, in whole or in part, unless such agreement is in writing and signed by the party against whom enforcement of the change, modification, discharge or abandonment is sought. Tenant agrees to execute any amendment to this Lease required by a mortgagee of the Building, which amendment does not materially adversely affect Tenant's rights or obligation hereunder. 24. CAPTIONS. The captions of the paragraphs in this Lease are inserted and included solely for convenience and shall not be considered or given any effect in construing the provisions hereof. 26. MECHANIC'S LIEN. Tenant shall, within thirty (30) days after notice from Landlord, discharge any mechanic's lien for materials or labor claimed to have been furnished to the Demised Premises on Tenant's behalf (except for work contracted for by Landlord) and shall indemnify and hold harmless Landlord from any loss incurred in connection therewith. 26. LANDLORD'S RIGHT TO CURE. Landlord may (but shall not be obligated), on five (5) days notice to Tenant (except that no notice need be given in case of emergency) cure on behalf of Tenant any default hereunder by Tenant, and the cost of such cure (including any attorney's fees incurred) shall be deemed additional rent payable upon demand. Page - 14 15 27. PUBLIC LIABILITY INSURANCE. Tenant shall at all times during the term hereof maintain in full force and effect with respect to the Demised Premises and Tenant's use thereof, comprehensive public liability insurance, naming Landlord as an additional insured, covering injury to person in amounts at least equal to One Million ($1,000,000) Dollars combined single limit bodily injury and property. Tenant shall lodge with Landlord duplicate originals or certificates of such insurance at or prior to the commencement date of the term hereof, together with evidence of paid-up premiums, and shall lodge with Landlord renewals thereof at least fifteen (15) days prior to expiration. 28. ESTOPPEL STATEMENT. Tenant shall from time to time, within twenty (20) days after request by Landlord, execute, acknowledge and deliver to Landlord a statement certifying that this Lease is unmodified and in full force and effect (or that the same is in full force and effect as modified, listing any instruments or modifications), the dates to which rent and other charges have been paid, and whether or not, to the best of Tenant's knowledge, Landlord is in default or whether Tenant has any claims or demands against Landlord (and, if so, the default, claim and/or demand shall be specified). 29. ADA COMPLIANCE. Landlord shall pay all the costs, expenses, fines, penalties and damages which may be imposed upon Landlord or Tenant by reason of or arising out of Landlord's failure to fully comply with all legal requirements which shall impose any violation, order or duty upon Landlord or Tenant with respect to Leased Premises or the use or occupation thereof. The legal requirements shall mean laws, statutes and ordinances, and the orders, rules and regulations, directives and requirements of governmental and official agencies, including without limitation, The Americans With Disabilities Act of 1990, whether now or hereafter in force, which may be applicable to the Leased Premises, any part thereof, and areas adjacent thereto. 30. ENVIRONMENTAL COMPLIANCE. A. Tenant hereby covenants and agrees to use and occupy the Demised Premises and to conduct its business and operations thereupon in substantial compliance with all applicable material statutes, codes, rules, regulations, and ordinances as they may change from time to time pertaining to the protection of the environment and to hazardous substances and hazardous wastes as those terms may be defined from time to time in such statutes, codes, rules, regulations, and ordinances ("Environmental Laws") provided Tenant is not responsible to make any structural alterations. B. Tenant shall promptly provide Landlord with copies of all correspondence from or to the U.S. Environmental Protection Agency, the Pennsylvania Department of Environmental Resources or any other federal, state or local governmental agency which pertains to the Demised Premises regarding but not limited to the following: (1) Tenant's compliance with the Environmental Laws; (2) any permits which Tenant may be required to obtain pursuant to the Environmental Laws; (3) any release or threat of release of a hazardous substance or hazardous waste which has occurred in the Demised Premises. C. Tenant shall immediately notify Landlord of its receipt of any notices of alleged violations of the Environmental Law from any other party including but not limited to governmental agencies including requests for information. Page - 15 16 D. In the event of any "Release" of a "Hazardous Substance" or "Hazardous Waste" as those terms are defined in any of the Environmental Laws, ~ release requires notification of any governmental agency, Tenant shall immediately Landlord of the release. E. At any time during the term hereof, Landlord shall have a right to enter upon the Demised Premises, upon reasonable notice and during business hours unless Tenant is in Default, to inspect the Demised Premises and to evaluate Tenant's compliance with the Environmental Laws. Such right of access shall include a right to review Tenant's records pertaining to compliance with the Environmental Laws. Tenant hereby agrees to cooperate with Landlord in any such inspection and evaluation. F. Tenant during the term of the Lease and Landlord prior to Lease commencement hereby agree to indemnify, defend and hold each other harmless from and against any and all claims, demands, judgments, suits, liens, actions, and other proceedings, arising out of or relating to the removal, remediation, corrective action or clean up of any hazardous waste or hazardous substance as defined in the Environmental Laws or any other proceedings or actions threatened, or brought for the enforcement of any Environmental Laws now or hereafter applicable to the Demised Premises and resulting from or arising out of Tenant's use, operation, and occupation thereof during the term of this Lease. Such indemnification shall include but not be limited to costs of investigation, engineering fees, attorney's fees, costs of remediation and clean up and future site maintenance. G. All of the terms and conditions of this Section shall survive the termination of this Lease Agreement for so long as any liability may arise under the Environmental Laws with respect to the Demised Premises. 31. RIGHT OF FIRST OFFER ON CONTIGUOUS SPACE. As contiguous space becomes available, Landlord will notify Tenant of all availabilities and present Tenant with a Lease Proposal outlining the terms and conditions to which Landlord would enter into a Lease Expansion with Tenant. Upon Tenant's acceptance, Landlord and Tenant will execute a Lease Expansion Amendment outlining the agreed upon terms and conditions. 32. The Lease between Lee Park Investors, L.P. and Bukstel and Halfpenny, Inc. will be terminated as of December 31, 1997 unless Bukstel and Halfpenny, Inc. is in Default of their Lease Agreement. In the event that Tenant Improvements are not completed in the Demised Premises in 401 Commerce Drive Bukstel and Halfpenny, Inc. will be able to stay in Demised Premises in Lee Park without incurring any hold-over penalties. Page - 16 17 IN WITNESS WHEREOF, the parties hereto have executed this Lease or caused this Lease to be executed by their duly authorized representatives the day and year first above written. LANDLORD: COMDRIVE ASSOCIATES, L.P. BY: /s/ [illegible] ---------------- DATE: 11/20/97 TENANT: ADVANCED HEALTH CORPORATION BY: /s/ [illegible] ---------------- Vice President Finance DATE: 11/13/97 Page - 17 18 SCHEDULE "A" RENT RIDER
PERIOD MONTHLY ANNUALLY ------ ------- -------- January 1, 1998 -- March 2, 1998 -0- -0- March 3, 1998 -- March 31, 1998 $ 10,388.92 N/A April 1, 1998 -- December 31, 1998 $ 11,105.40 N/A January 1, 1999 -- December 31, 1999 $ 11,105.40 $133,264.80 January 1, 2000 -- December 31, 2000 $ 11,105.40 $133,264.80 January 1, 2001 -- December 31, 2001 $ 11,105.40 $133,264.80 January 1, 2002 -- December 31, 2002 $ 11,105.40 $133,264.80
Page - 18 19 EXHIBIT "C" BUILDING RULES AND REGULATIONS 1. The sidewalks, entryways, passages, corridors, stairways and elevators shall not be obstructed by any of the tenants, their employees or agents, or used by them for purposes other than ingress or egress to and from their respective suites. All safes or other heavy articles shall be carried up or into the leased premises only at such times and in such manner as shall be prescribed by the Landlord and the Landlord shall in all cases have the right to specify a maximum weight and proper position or location of any such safe or other heavy article. The Tenant shall pay any damage done to the Building by taking in or removing any safe or from overloading any floor in any way. The Tenant shall pay for the cost of repairing or restoring any part of the Building, which shall be defaced or injured by a tenant, its agents or employees. 2. Each Tenant will refer all contractors, contractor's representatives and installation technicians rendering any service on or to the leased premises for the tenant to Landlord for Landlord's approval and supervision before permanence of any contractual service. This provision shall apply to all work performed in the Building, including installation of telephones, telegraph equipment, electrical devices and attachments and installations of any nature affecting floors, walls, woodwork, trim, windows, ceilings, equipment or any other physical portion of the Building. 3. No, sign, advertisement or notice shall be inscribed, painted or affixed on any part of the inside or outside of the Building unless of such color, size and style and in such place upon or in the Building as shall first be designated by Landlord; there shall be no obligation or duty on Landlord to allow any sign, advertisement or notice to be inscribed, painted or affixed on any part of the inside or outside of the Building except as specified in a tenant's lease. Signs on or adjacent to doors shall be in color, size and style approved by Landlord, the cost to be paid by the tenants. Landlord will provide a directory in a conspicuous place, with the names of tenants, Landlord will make any necessary revision in this within a reasonable time after notice from the tenant of an error or of a change making revision necessary. No furniture shall be placed in front of the Building or in any lobby or corridor without written consent of Landlord. 4. No tenant shall do or permit anything to be done in its leased premises, or bring to keep anything therein, which will in any way increase the rate of fire insurance on the Building, or on property kept therein, or obstruct or interfere with the rights of other tenants, or in any way injure or annoy them, or conflict with the laws relating to fire prevention and safety, or with any regulations of the fire department, or with any rules or ordinances of any Board of Health or other governing bodies having jurisdiction over the Building. 5. The janitor of the Building may at all times keep a pass-key, and he and other agents of the Landlord shall at all times, be allowed admittance to the leased premises for purposes permitted in Tenant's lease. Page - 19 20 6. No additional locks shall be placed upon any doors without the written consent of the Landlord with consent shall be unreasonably withheld. All necessary keys shall be furnished by the Landlord, and the same shall be surrendered upon the termination of this Lease, and the Tenant shall then give the Landlord or his agents explanation of the combination of all locks upon the doors of vaults. 7. The water closets and other water fixtures shall not be used for any purpose other than those for which they were constructed, and any damage resulting to them from misuse or abuse by a tenant or its agents, employees or invitees, shall be borne by the Tenant. 8. No person shall disturb the occupants of the Building by the use of any musical instruments; the making or transmittal of noises which are audible outside the leased premises, or any unreasonable use. No dogs or other animals or pets of any kind will be allowed in the Building. 9. No bicycles or similar vehicles will be allowed in the building. 10. Nothing shall be thrown out the windows of the building or down the stairways or other passages. 11. Tenants shall not be permitted to use or to keep in the Building any kerosene, camphene, burning fluid or other illuminating materials. 12. If any tenant desires telegraphic, telephonic or other electric connections, Landlord or its agents will direct the electricians as to what and how the wires may be introduced, and without such directions no boring or cutting for wires will be permitted. 13. If a tenant desires shades, they must be of such shape, color, materials and make as shall be prescribed by Landlord. No outside awning shall be permitted. 14. No portion of the Building shall be used for the purposes of lodging rooms or for any immoral or unlawful purposes. 15. No tenant shall store anything outside the building or in any common areas in the building. Page - 20 21 [GRAPHIC OMITTED] EXHIBIT "A" BUKSTELL & HALFPENNY/ADVANCED HEALTH TENANT FITOUT AT 401 COMMERCE DRIVE
EX-10.11 3 HAWTHORNE LEASE AGREEMENT 1 STANDARD FORM OF SUBLEASE AGREEMENT SUBLEASE made between United Parcel Service, Inc., a New York corporation with offices at 55 Glenlake Parkway, NE, Atlanta, GA 30328 ("SUBLESSOR"), and Advanced Health Corporation, a Delaware corporation with offices at 555 White Plains Road, Tarrytown, NY 10591 hereinafter ("SUBLESSEE") PRELIMINARY STATEMENT SUBLESSOR has leased, as Tenant, from Robert Martin-Eastview North Co., as Landlord, ("Overlandlord") premises in the building located at 15 Skyline Drive, Hawthorne, County of Westchester, New York (the "Demised Premises") pursuant to a certain lease dated September 4, 1990 (the "Lease") as amended by First Amendment dated August 23, 1995 and by Second Amendment dated March 10, 1997 (hereinafter the Lease, First Amendment and Second Amendment are referred to as the "Major Lease"); and SUBLESSOR desires to sublet to SUBLESSEE and SUBLESSEE desires to hire from SUBLESSOR approximately 16,252 square feet of the Demised Premises; and It is agreed as follows: 1. SUBLEASE. SUBLESSOR sublets to SUBLESSEE a portion of the Demised Premises consisting of approximately 16,252 square feet as shown on the floor plan annexed hereto as Exhibit A (the "Sublet Premises"), for general office use and for no other purpose. 2. TERM. The term of this sublease ("Sublease Term") shall commence on January 15, 1998 and expire on October 30, 2000, or such earlier date upon which the Sublease Term expires or terminates pursuant to the provisions of this sublease or pursuant to law. 2 3. RENT. The rent for the Sublease Term shall be $240,204.56 per annum and shall be payable monthly, in advance, on the first (1st) day of each calendar month commencing on June 1, 1998, in equal monthly installments of Twenty Thousand Seventeen Dollars and 05/00 ($20,017.05), except that the installment for the first month of the Sublease Term shall be payable upon the execution hereof. SUBLESSEE shall pay as additional rent to SUBLESSOR on demand 85.08% of any payments or expenses required to be made by Tenant under the Major Lease which relate to the Sublet Premises. All payments called for under this sublease shall be made by SUBLESSEE to SUBLESSOR without notice, demand, setoff or deduction, at SUBLESSOR'S office or at such other address as SUBLESSOR may designate. All Base Rent and additional rent and all other sirs payable by SUBLESSEE under this Sublease are referred to collectively herein as "Rent" or "rent" and shall be collectible by SUBLESSOR as rent. SUBLESSEE shall reimburse SUBLESSOR on demand for increases in real estate taxes (Section 45 of the Major Lease) and for increases in common area maintenance charge (Section 46 of the Major Lease) over the base year of January 1, 1997 through December 30, 1997. 4. SUBORDINATION TO MAJOR LEASE. This sublease is subordinate to, and SUBLESSEE accepts this sublease subordinate to, the Major Lease and the matters to which the Major Lease is subordinate. This sublease is also subordinate to, and SUBLESSEE accepts this sublease subordinate to, any amendments to the Major Lease hereafter made between Overlandlord and SUBLESSOR. The Major Lease is represented by SUBLESSOR to be the full agreement by the Overlandlord and SUBLESSOR. Copies of the documents comprising the Major Lease have been delivered to and reviewed by SUBLESSEE. SUBLESSEE acknowledges that SUBLESSOR cannot convey to SUBLESSEE any greater estate than SUBLESSOR has been granted pursuant to the Major Lease. The provisions of the Major Lease are incorporated herein by -2- 3 reference with the same force and effect as if they were tally set forth herein, except as otherwise specifically provided herein. SUBLESSEE covenants that SUBLESSEE will not do anything in or with respect to the Sublet Premises or omit to do anything which SUBLESSEE is obligated to do under the terms of the sublease which would constitute a default under the Major Lease or might cause the Major Lease or the rights of SUBLESSOR as tenant thereunder to be cancelled, terminated or forfeited or might make SUBLESSOR liable for any damages, claims or penalties. SUBLESSEE covenants to assume and perform all of the liabilities and obligations of Tenant under the Major Lease. SUBLESSEE shall hold SUBLESSOR harmless of and indemnify SUBLESSOR from all liability, judgments, costs, damages, claims, or demands, including reasonable attorney's fees, arising out of SUBLESSEE's failure to comply with or perform SUBLESSOR's obligations under both the Major Lease and this Sublease. If Subtenant fails to pay any Rent as required in this Sublease or fails to perform any of Tenant's obligations under the terms of the Major Lease, SUBLESSOR shall have the same rights and remedies as the Landlord has under the Major Lease for default in the event that SUBLESSEE breaches any of the terms and conditions of this Sublease including but not limited to any action or omission which causes a default under the Major Lease. Notwithstanding anything to the contrary herein, SUBLESSOR shall have any other rights and remedies available to SUBLESSOR in law or equity in the event of SUBLESSEE's default. 5. DAMAGE OR INJURY. Overlandlord and SUBLESSOR shall not be liable for any damage to property or injury to persons, sustained by SUBLESSEE or others, caused by conditions or activities on the Sublet Premises. SUBLESSEE shall indemnify the Overlandlord and SUBLESSOR against all claims arising therefrom and shall carry insurance as required to be carried by Tenant by the Major Lease naming the Overlandlord and SUBLESSOR as additional insureds. -3- 4 6. REPAIRS BY OVERLANDLORD. SUBLESSEE shall look only to SUBLESSOR for any services to be furnished to SUBLESSEE in accordance with this sublease. SUBLESSOR shall use its reasonable efforts to obtain for SUBLESSEE any services which are the obligation of Overlandlord. SUBLESSOR shall have no obligations whatsoever to repair and maintain the Sublease Premises or any part thereof or equipment therein, whether structural or nonstructural. SUBLESSOR shall not be liable to SUBLESSEE for injury or damage that may result from any defect in the construction or condition 7. ALTERATIONS. Except as set forth in insert 2 of page 1A of the Major Lease, SUBLESSEE shall not make any alterations, additions or improvements upon or to the Sublet Premises without the prior written consent of SUBLESSOR and Overlandlord. Any permitted alterations, additions and improvements shall be made at the sole cost of SUBLESSEE and shall become the property of SUBLESSOR and shall remain on and be surrendered with the Sublet Premises at the termination of this sublease. SUBLESSEE shall deliver up the same, at the expiration or sooner termination of the term of this sublease, in as good condition as they are now in, ordinary wear, fire and other unavoidable casualties excepted. 8. ACCESS. At all reasonable hours and upon reasonable notice to SUBLESSEE, the Sublet Premises shall be open to Overlandlord and SUBLESSOR, their agents and representatives for inspecting or for repairs, additions or alterations by either party. 9. BROKER. SUBLESSEE warrants and represents that it has dealt with no broker or any other person who would legally claim to be entitled to receive a brokerage commission or finder's or consultant's fee with respect to this transaction except KOLL/CB COMMERCIAL and MACK-CALI REALTY L.P.. SUBLESSEE shall indemnify -4- 5 SUBLESSOR and Overlandlord against the claim of any person, firm or corporation arising out of any inaccuracy or alleged inaccuracy of the above representation. 10. SUBLESSEE'S COVENANTS. SUBLESSEE covenants with SUBLESSOR to hire said premises and to pay the rent therefore as aforesaid, that it will commit no waste, nor suffer the same to be committed thereon, nor injure nor misuse the same; and also that it shall not make alterations therein, nor use the same for any purpose but that hereinbefore authorized. SUBLESSEE has inspected the Sublet Premises and accepts same in their present condition, without any warranties or representations (express or implied) being relied upon and is relying upon its own inspection. SUBLESSEE further covenants that this sublease shall not be assigned, encumbered or otherwise transferred, the Sublet Premises shall not be further sublet by SUBLESSEE, in whole or in part, and SUBLESSEE shall neither suffer nor permit any of the Sublet Premises to be used or occupied by others without the prior consent of Overlandlord in each instance. 11. DEFAULT BY SUBLESSOR/Overlandlord UNDER MAJOR LEASE. In the event of a default by SUBLESSOR under the Major Lease which results in termination of such lease, this sublease shall, at the option of the Overlandlord, remain in full force and effect and the SUBLESSEE shall attorn to and recognize Overlandlord as Landlord hereunder and shall promptly upon such Overlandlord's request, execute and deliver all instruments necessary or appropriate to confirm such attornment and recognition. The SUBLESSEE hereunder hereby waives all rights under any present or future law or otherwise to elect, by reason of the termination of the Major Lease, to terminate this sublease or surrender possession of the premises demised hereby. SUBLESSEE agrees to release SUBLESSOR, its successors, and -5- 6 assigns of liability, with respect to any and all damages, claims, losses, liabilities and expenses of any kind, including but not limited to legal and consulting expenses, incurred by SUBLESSEE, its successors or assigns, or which are asserted against or imposed upon SUBLESSEE, its successors or assigns, by any other party arising out of or in connection with Overlandlord's breach of, or misrepresentation in, any provision of the Major Lease. 12. CONSENT. No rights are conferred upon SUBLESSEE until (i) this sublease has been signed by SUBLESSOR and an executed copy has been delivered to SUBLESSEE and (ii) the consent of Overlandlord has been obtained. SUBLESSOR shall promptly after the execution of this sublease by both SUBLESSOR and SUBLESSEE submit this sublease to Overlandlord for its consent. If the Overlandlord refuses to grant consent or if the Major Lease is cancelled for any reason whatsoever prior to the first day of the Sublease Term, all sins received hereunder by SUBLESSOR shall be returned to SUBLESSEE without interest and without any further liability on the part of the SUBLESSOR and this sublease shall be deemed void and of no effect. 13. PARKING. Subtenant shall be entitled to the non-exclusive use of a total of sixty (60) parking spaces at no cost to Subtenant. 14. SECURITY DEPOSIT. SUBLESSEE agrees to deposit with Landlord upon execution of this Sublease, a Security Deposit equal to $40,034.10, which sum shall be held by SUBLESSOR, without obligation for interest, as security for the performance of SUBLESSEE's covenants and obligations under this Sublease. The Security Deposit is not an advance rental deposit or a measure of damages incurred by SUBLESSOR in case of SUBLESSEE's default. Upon the occurrence of any event of default by SUBLESSEE, SUBLESSOR may, from time to time, without prejudice to any other remedy provided herein or provided by law, use such fund to the -6- 7 extent necessary to make good any arrears of Rent or other payments due to SUBLESSOR hereunder, and any other damage, injury, expense or liability caused by such event of default, and SUBLESSEE shall pay to SUBLESSOR, on demand, the amount so applied in order to restore the Security Deposit to its original amount. Although the Security Deposit shall be deemed the property of SUBLESSOR, any remaining balance of such deposit shall be returned by SUBLESSOR to SUBLESSEE at such time after termination of this Sublease that all of SUBLESSEE's obligations under this Sublease have been fulfilled. SUBLESSOR may use and commingle the Security Deposit with other funds of SUBLESSOR. 15. NOTICE. All notices or other communications required or permitted hereunder shall be in writing and shall be effective upon receipt whether delivered by personal delivery or UPS Next Day Air, or sent by United States registered or certified mail, return receipt requested, postage prepaid, addressed to the respective parties as follows: Notices to SUBLESSOR: United Parcel Service 55 Glenlake Parkway, NE Atlanta, GA 30328 ATTN: Real Estate Department With a copy to: United Parcel Service 643 43rd Street New York, New York 10036 ATTN: Region Real Estate Manager If to SUBLESSEE: Advanced Health Corporation 555 White Plains Road Tarrytown, NY 10591 ATTN: Jeffrey Sauerhoff -7- 8 Notices shall be deemed received upon the earlier of (a) if personally delivered or via UPS NEXT DAY AIR, the date of delivery to the address of the person to receive such notice, or (b) if mailed, upon the date of receipt as disclosed on the return receipt. Notice of change of address shall be given written notice in the manner detailed in this paragraph. Rejection or other refusal to accept or the inability to deliver because of changed address of which no notice was given shall be deemed to constitute receipt of the notice, demand, request or communication sent. 16. UTILITIES. SUBLESSEE shall pay directly for all water, gas, heat, air conditioning, light, power, telephone, sewer, sprinkler charges and other utilities and services used on or from the Sublet Premises, together with any taxes, penalties, surcharges or the like pertaining thereto, and maintenance charges for utilities and shall furnish all electric light bulbs, ballasts and tubes. 17. Entire Agreement. This Sublease contains the whole agreement between the parties, There are no understandings between the parties regarding the Sublease except those contained in this Sublease. This Sublease cannot be amended except by a writing executed by both parties and consented to in writing by Overlandlord. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals this 8th day of January, 1998. UNITED PARCEL SERVICE, INC. As SUBLESSOR By: /s/ [illegible] --------------------- Vice President -8- 9 ADVANCED HEALTH CORPORATION As SUBLESSEE By: /s/ Jeffrey M. Sauerhoff ------------------------ Title: Vice President --------------------- CONSENT BY MID-WESTCHESTER REALTY ASSOCIATES, L. P. MID-WESTCHESTER REALTY ASSOCIATES L.P. HEREBY consents to the above sublease. MID-WESTCHESTER REALTY ASSOCIATES. L.P. As OVERLANDLORD By: Cali Sub VI Inc., general partner By: /s/ [illegible] ------------------------ Title: Vice President --------------------- -9- EX-10.17 4 EMPLOYMENT AGREEMENT RE ROGERS 1 EXECUTION COPY EMPLOYMENT AGREEMENT dated as of January 21, 1998, between ADVANCED HEALTH CORPORATION, a Delaware corporation (the "Company"), and MICHAEL W. ROGERS (the Employee"). The Company desires to formalize the employment arrangements between the Company and the Employee and to continue to employ the Employee as the Executive Vice President - Chief Financial and Corporate Development Officer of the Company and the Employee desires to accept such continued employment by the Company, on the terms and subject to the conditions hereinafter set forth. NOW, THEREFORE, in consideration of the mutual covenants and obligations hereinafter set forth, the parties hereto hereby agree as follows: 1. Employment. The Company hereby employs the Employee, and the Employee hereby accepts employment by the Company, upon the terms and subject to the conditions hereinafter set forth. 2. Term. The employment of the Employee hereunder shall be for the four-year period commencing on February 16, 1998, and ending on February 16, 2002 (the "Base Term"). The Base Term shall automatically renew for consecutive one-year terms (each, a "Renewal Term" and together with the Base Term collectively, the "Employment Period") unless either the Company or the Employee gives the other party hereto at least 90 days' prior written notice before the end of the Employment Period of its intent not to renew this Agreement. 3. Duties. The Employee shall be employed as the Executive Vice President - -- Chief Financial and Corporate Development Officer of the Company or in such other position as the Company and the Employee shall agree in writing. The Employee shall perform such duties and services as are appropriate and commensurate with the Employee's position as Executive Vice President -- Chief Financial and Corporate Development Officer of the Company and would otherwise be consistent in stature and prestige with the position of Executive Vice President -- Chief Financial and Corporate Development Officer of a corporation with similar operations as the Company, as the same may be assigned to him from time to time by the Board of Directors of the Company (the "Board"). 4. Time to be Devoted to Employment; Place of Employment. (a) Except for twenty-two days of paid time off per year (in addition to public holidays) and absences due to temporary illness, during the Employment Period the Employee shall devote substantially all of his business time, attention and energies to the business and affairs of the Company. (b) During the Employment Period, the Employee shall not be engaged in any other business activity which conflicts with the duties of the Employee hereunder, whether or not such activity is pursued for gain, profit or other pecuniary advantage. (c) During the Employment Period, the Company shall maintain its primary business location in the greater New York City metropolitan area and the Employee shall not be required to relocate outside such area without his written consent. 1 2 5. Compensation; Reimbursement. (a) Commencing on February 16, 1998, and continuing during the Employment Period, the Company (or at the Company's option, any subsidiary or affiliate thereof) shall pay to the Employee an annual salary (the "Base Salary") of not less than $190,000, payable in such installments as is the policy of the Company with respect to its senior executive officers. Such Base Salary will be reviewed at least annually and may be increased by the Board (or, if such authority shall be delegated by the Board to the Compensation Committee thereof, then by such Committee) in its sole discretion. The Employee will be reimbursed $600 per month for car allowance. (b) The Employee will be eligible to participate in the Employer's annual bonus program in accordance with the provisions of that plan. The bonus opportunity for the Employee is up to 30% of base salary, prorated in the first year of employment for the Employee's date of hire. Payment of bonus is dependent upon company performance and the Employee's individual performance of pre-established goals, and is payable in cash. (c) Following the expiration or termination of this Agreement for any reason, the Employee shall have the right to maintain any (i) health and life insurance benefits provided by the Company to the extent provided under applicable law and (ii) any life insurance benefits provided by the Company so long as the Employee makes the premium payments relating to such life insurance. (d) During the Employment Period and to the extent available to employees of the Company, the Employee shall be entitled to participate in all of the Company's benefit plans, pension and retirement plans, life insurance, hospitalization and surgical and major medical coverages, sick leave, vacation and holiday policies, long-term disability coverage and such other fringe benefits enjoyed by other employees at substantially the same employment level as the Employee. (e) The Company shall reimburse the Employee, in accordance with the practice from time to time for other employees of the Company, for all reasonable and necessary travelling expenses, disbursements and other reasonable and necessary incidental expenses incurred by him for or on behalf of the Company in the performance of his duties hereunder upon presentation by the Employee to the Company of appropriate vouchers. (f) The Company shall reimburse the Employee for reasonable relocation expenses incurred by the Employee in order to relocate to the greater New York City metropolitan area (the "Relocation Expenses"), including expenses relating to housing search visits to the greater New York City metropolitan area for the Employee and the Employee's spouse, temporary living expenses in the greater New York metropolitan area through May 16, 1998, packing and moving of the Employee's and the Employee's family's goods, closing costs in connection with the purchase of a house upon relocation to the greater New York City metropolitan area and real estate commissions incurred in connection with the sale of the Employee's house in Winchester, Massachusetts; provided that the Company shall not be obligated to reimburse the Employee more than $55,000 in the aggregate for all Relocation Expenses, excluding housing search visits to the greater New York City metropolitan area. All Relocation Expenses shall be approved in advance by another officer of the Company. The Employee shall be fully relocated to the greater New York City metropolitan area as of May 16, 1998. Prior to May 16, 1998, the Company shall reimburse the Employee for the expenses incurred by the Employee in connection with the Employee's trips to and from Winchester, Massachusetts. The Employer will grant an additional "gross-up-payment" of all expenses paid which are not tax deductible under the Internal Revenue Code. The "gross-up-payment" will be calculated as a percentage of applicable expenses based on the Employee's annualized base salary at the time the Employee's move is completed. 2 3 6. Involuntary Termination. (a) If the Employee is incapacitated or disabled by accident, sickness or other cause so as to render him mentally or physically incapable of performing the services required to be performed by him under this Agreement for a period of 90 days or longer during any six-month period (such condition being herein referred to as a "Disability"), prior to the Employee resuming the performance of his duties as contemplated herein, the Company may terminate the employment of the Employee under this Agreement (an "Involuntary Termination"). Until the Company or the Employee shall have terminated the Employee's employment hereunder, the Employee shall be entitled to receive his compensation and other benefits as set forth in this Agreement notwithstanding any such physical or mental disability. (b) If the Employee dies during the Employment Period, his employment hereunder shall be deemed to cease as of the date of his death, and the termination of his employment occasioned thereby shall be deemed an Involuntary Termination. (c) In the event of Involuntary Termination as provided in Section 6(a) and (b), all stock options granted to the Employee by the Company shall become immediately vested as of the date of such event. 7. Termination for Cause. The Company may terminate the Employee's employment hereunder for "Cause" (a "Termination for Cause"). For purposes of this Agreement, "Cause" shall be limited to: (i) the willful and continued failure by the Employee substantially to perform the duties described in Section 3 (other than any failure resulting from an illness or other similar incapacity or disability), for 30 days after a written demand for performance is delivered to the Employee on behalf of the Board that specifically identifies the manner in which it is alleged that the Employee has not substantially performed his duties; (ii) the commission by the Employee of misappropriation of funds, properties or assets of the Company, sexual harassment of employees of the Company, chronic alcoholism or drug addiction, slander or libel concerning the Company or a material tort relating to his office or employment with the Company that has a material adverse effect on the Company; or (iii) the Employee's conviction of a crime constituting a felony. 8. Termination Without Cause. (a) The Company may terminate the employment of the Employee hereunder at any time during the Employment Period without "Cause" and (b) the Employee may terminate his employment hereunder at any time during the Employment Period in the event of the willful and continued failure by the Company to perform its obligations hereunder for 30 days after a written demand for performance is delivered to the Board on behalf of the Company by the Employee that specifically identifies the manner in which it is alleged that the Company has not performed its obligations (each, a "Termination Without Cause"). It is expressly acknowledged and agreed that nonrenewal of this Agreement as contemplated by Section 2 shall not constitute a Termination Without Cause. 9. Voluntary Termination. Any termination of the employment of the Employee hereunder otherwise than as a result of an Involuntary Termination, a Termination For Cause or a Termination Without Cause shall be deemed to be a "Voluntary Termination." A Voluntary Termination shall be deemed to be effective immediately upon written notice of such termination to the Company. 3 4 10. Change in Control. For purposes of this Agreement, a "Change in Control" of the Company shall be deemed to have occurred if (a) there shall be consummated (x) any consolidation or merger of the Company in which the Company is not the continuing or surviving corporation or pursuant to which shares of the common stock of the Company (the "Common Stock") would be converted into cash, securities or other property, other than a merger of the Company in which the holders of the Common Stock immediately prior to the merger have the same proportionate ownership of common stock of the surviving corporation immediately after the merger, or (y) any sale, lease, exchange or other transfer (in one transaction or a series of related transactions) of all, or substantially all, of the assets of the Company; or (b) the stockholders of the Company approve any plan or proposal for the liquidation or dissolution of the Company; or (c) any person (as such term is used in Sections 13(d) and 14(d)(2) of the Securities Exchange Act of 1934, as amended (the "Exchange Act")), shall become the beneficial owner (within the meaning of Rule 13d-3 under the Exchange Act) of 30% or more of the Company's outstanding Common Stock; or (d) during any period of two consecutive years, individuals who at the beginning of such period constitute the entire Board of Directors shall cease for any reason to constitute a majority thereof unless the election, or the nomination for election by the Company's stockholders, of each new director was approved by a vote of at least two-thirds of the directors then still in office who were directors at the beginning of the period. If the Employee is Terminated Without Cause or Terminates With Good Reason within six months of a Change in Control, all stock options granted to the Employee by the Company shall become immediately vested as of the date of such event. For the purpose of this Section 10, "Good Reason" shall mean (i) a reduction in the level of the Employee's compensation without the Employee's written consent, or (ii) a material diminishment in the Employee's authority or responsibilities. 11. Effect of Termination of Employment. (a) Upon the termination of the Employee's employment hereunder pursuant to a Voluntary Termination or a Termination For Cause, neither the Employee nor his beneficiary or estate shall have any further rights or claims against the Company under this Agreement except to receive: (i) any unpaid portion of the Base Salary provided for in Section 5(a), computed on a pro rata basis to the date of termination; (ii) cash compensation equal to the product of (A) the number of days of accrued paid time off, if any, accumulated by the Employee to the effective date of termination divided by the total number of work days per annum for which the Employee receives a Base Salary multiplied by (B) the Base Salary; and (iii) reimbursement for any expenses for which the Employee shall not have theretofore been reimbursed as provided in Section 5(e) and (f). (b) Upon the termination of the Employee's employment hereunder pursuant to an Involuntary Termination, neither the Employee nor his beneficiary or estate shall have any further rights or claims against the Company under this Agreement except the right (i) to receive a termination payment equal to that provided for in Section 11(a) hereof and (ii) to receive a cash severance payment in an aggregate amount equal to the cash compensation received by the Employee during the 3-month period immediately prior to the effective date of the Involuntary Termination, payable in equal monthly installments. (c) Upon the termination of the Employee's employment hereunder pursuant to a Termination Without Cause, neither the Employee nor his beneficiary or estate shall have any further rights or claims against the Company under this Agreement except the right (i) to receive a termination payment equal to the 4 5 amount provided for in Section 11(a) hereof and (ii) to receive a cash severance payment in an aggregate amount equal to the cash compensation received by the Employee during the 6-month period immediately prior to the effective date of the Termination Without Cause, payable in equal monthly installments; provided, however, that in the event that the Employee obtains full-time employment of comparable scope and duties to the Employee's current position with the Company during the 6-month period following the Termination Without Cause or Termination For Good Reason, then the severance payments contemplated by clause (ii) above shall terminate on the later of (A) the date when the Employee commences such employment and (B) the six-month anniversary of the effective date of the Termination Without Cause. Notwithstanding the foregoing, upon Termination Without Cause or Termination for Good Reason within six months of a Change In Control, as defined in Section 10 herein, such cash severance payment referred to in Section 11(c)(ii) shall be 12 months subject to modification for comparable employment described in this paragraph. 12. Non-Competition; Non-Disclosure of Information. (a) Except as provided in Section 12(d) below, the Employee shall not, for a period of one year following the termination of the Employment Period, (i) directly or indirectly engage in any Competitive Business (as defined below), whether such engagement shall be as an employee, employer, owner, consultant, partner or other participant in any Competitive Business, (ii) assist others in engaging in any Competitive Business in the manner described in the foregoing clause (i), (iii) induce employees of the Company to terminate their employment with the Company or engage in any Competitive Business or (iv) induce customers or vendors of the Company to alter or terminate their business relationship with the Company; provided, however, that the Employee may own directly or indirectly, solely as a passive investment, securities of any Competitive Business traded on any national securities exchange if the Employee is not a controlling person of, nor a member of a group which controls such person and does not, directly or indirectly, own 5% or more of any class of securities of such person. As used herein, the term "Competitive Business" shall mean any business which, directly or indirectly, competes with the Company in the business of primarily providing physician practice management, physician network management and/or clinical information technology to or for physicians to physician groups and physician networks consisting, at any time during the one year period following the termination of the Employment Period, of greater than three physicians; provided, however, that a business conducted directly by the Employee which provides physician practice management, physician network management and/or clinical information technology to or for physician groups consisting of three or fewer physicians shall not be deemed to be a "Competitive Business". (b) The Employee understands that the foregoing restrictions may limit his ability to earn a livelihood in a Competitive Business, but he nevertheless believes that he has received and will receive sufficient consideration and other benefits in connection with his employment to clearly justify such restrictions which, in any event, the Employee does not believe would prevent him from earning a living. Nothing herein contained shall prohibit the Employee from engaging in a business that is not a Competitive Business. (c) The Employee agrees that he will not, at any time during or after the Employment Period, disclose to any person, firm, corporation or other entity, except as required by law, any secret or confidential information concerning the business, clients or affairs of the Company or any subsidiary or affiliate thereof for any reason or purpose whatsoever other than in furtherance of the Employee's work for the Company nor shall the Employee make use of any of such secret or confidential information for his own purpose or for the benefit of any person, firm, corporation or other business entity except the Company or any subsidiary or affiliate thereof. 13. Company Right to Inventions. The Employee shall promptly disclose, grant and assign to the Company for its sole use and benefit any and all inventions, improvements, technical information, methods and suggestions relating in any way to the business of providing physician practice management, 5 6 physician network management and/or clinical information technology to or for physicians, which he may develop or acquire during the period of the Employee's employment with the Company prior to any termination of employment (whether or not during usual working hours), together with all patent applications, patents, copyrights and reissues thereof that may at any time be granted for or upon any such invention, improvement, technical information or method. In connection therewith: (a) the Employee shall without charge, but at the expense of the Company, promptly at all times hereafter execute and deliver such applications, assignments, descriptions and other instruments as may be reasonably necessary or proper in the reasonable opinion of the Company to vest title to any such inventions, improvements, technical information, methods, patent applications, patents, copyright applications, copyrights or reissues of any thereof in the Company and to enable it to obtain and maintain the entire right and title thereto throughout the world; and (b) the Employee shall render to the Company at its expense (including a reasonable payment for the time involved in case he is not then in its employ) all such assistance as it may reasonably require in the prosecution of applications for said patents, copyrights or reissues thereof, in the prosecution or defense or interferences which may be declared involving any said applications, patents or copyrights and in any litigation in which the Company may be involved relating to any such patents, copyrights, inventions, improvements, technical information or methods. 14. Enforcement. It is the desire and intent of the parties hereto that the provisions of this Agreement shall be enforced to the fullest extent permissible under the laws and public policies applied in each jurisdiction in which enforcement is sought. Accordingly, if any particular provision of this Agreement shall be adjudicated to be invalid or unenforceable, such provision shall be deemed amended to delete therefrom the portion thus adjudicated to be invalid or unenforceable, such amendment to apply only with respect to the operation of such provision in the particular jurisdiction in which such adjudication is made; provided, however, that if any one or more of the provisions contained in this Agreement shall be adjudicated to be invalid or unenforceable because such provision is held to be excessively broad as to duration, geographical scope, activity or subject, such provision shall be deemed amended by limiting and reducing it so as to be valid and enforceable to the maximum extent compatible with the applicable laws of such jurisdiction, such amendment to apply only with respect to the operation of such provision in the particular jurisdiction in which such adjudication is made. 15. Remedies; Survival. (a) The Employee acknowledges and understands that the provisions of this Agreement are of a special and unique nature, the loss of which cannot be accurately compensated for in damages by an action at law, and that the breach of the provisions of this Agreement would cause the Company irreparable harm. In the event of a breach by the Employee of the provisions of Section 12 or 13 hereof, the Company shall be entitled to an injunction restraining him from such breach. Nothing herein contained shall be construed as prohibiting the Company from pursuing any other remedies available for any breach of this Agreement. (b) Notwithstanding anything contained in this Agreement to the contrary, the provisions of Sections 12, 13, 14 and this Section 15 shall survive the expiration or other termination of this Agreement until, by their terms, such provisions are no longer operative. (c) It is understood and agreed that the provisions of Sections 12 and 13 of this Agreement are separate and distinct from any other agreement between the parties hereto. Accordingly, in the event of a breach of such provisions, the breaching party shall only be held responsible for damages arising under such 6 7 provisions and not for any damages which may be claimed to arise under or with respect to any other agreement that is not separately breached. 16. Notices. Notices and other communications hereunder shall be in writing and shall be delivered personally or sent by air courier or first class certified or registered mail, return receipt requested and postage prepaid, addressed as follows: If to the Employee: Michael W. Rogers 6 Birch Lane Winchester, MA 01890 If to the Company: Advanced Health Corporation 555 White Plains Road, Fifth Floor Tarrytown, New York 10591 Attention: President and COO or to such other address as the party to whom notice is to be given may have furnished to the other party in writing in accordance herewith. All notices and other communications hereunder shall be deemed to have been given on the date of delivery if personally delivered; on the business day after the date when sent if sent by air courier; and on the third business day after the date when sent if sent by mail, in each case addressed to such party as provided in this Section 16. 17. Binding Agreement. This Agreement shall inure to the benefit of and be enforceable by the Employee's personal or legal representatives, executors, administrators, successors, heirs, distributees and devisees. If the Employee should die while any amount would still be payable to him hereunder if he had continued to live, all such amounts, unless otherwise provided herein, shall be paid in accordance with the terms of this Agreement to the beneficiary designated by the Employee in a writing delivered to the Company, or if there be no such designated beneficiary, to his estate. 18. Governing Law. This Agreement shall be governed by, and construed and enforced in accordance with, the laws of the State of New York applicable to contracts made and to be performed wholly therein. 19. Waiver of Breach. The waiver by either party of a breach of any provision of this Agreement by the other party must be in writing and shall not operate or be construed as a waiver of any subsequent breach by such other party. 20. Entire Agreement; Amendments; Execution. This Agreement and the other agreements referred to herein contain the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements or understandings among the parties with respect thereto. This Agreement may be amended only by an agreement in writing signed by the parties hereto. This Agreement may be executed in any number of counterparts, each of which shall be deemed an original document but all of which shall constitute but one agreement. 21. Headings. The section headings contained in this Agreement are for reference purposes only and shall not affect in any way the meaning or interpretation of this Agreement. 7 8 22. Severability. Any provision of this Agreement that is prohibited or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof, and any such prohibition or unenforceability in any jurisdiction shall not invalidate or render unenforceable such provision in any other jurisdiction. 23. Assignment. With respect to the Employee, this Agreement is personal in its nature and the Employee shall not assign or transfer this Agreement or any rights or obligations hereunder. The Company may in its sole discretion assign or otherwise transfer this Agreement and the provisions hereof (including, without limitation, Sections 12, 13 and 14) shall inure to the benefit of, and be binding upon, each successor of the Company, whether by merger, consolidation, transfer of all or substantially all assets, or otherwise. IN WITNESS WHEREOF, the parties have duly executed this Agreement as of the date first above written. ADVANCED HEALTH CORPORATION By: /s/ Alan B. Masarek ------------------------ Name: Alan B. Masarek Title: President By: /s/ Michael W. Rogers ----------------------- Michael W. Rogers 8 EX-23.2 5 CONSENT OF ARTHUR ANDERSEN LLP 1 EXHIBIT 23.02 CONSENT OF INDEPENDENT PUBLIC ACCOUNTANTS As independent public accountants, we hereby consent to the incorporation of our reports included in this Form 10-K, into the Company's previously filed Registration Statement Files No. 333-16919 and 333-16921. ARTHUR ANDERSEN LLP New York, New York March 30, 1998 EX-27 6 FINANCIAL DATA SCHEDULE
5 YEAR DEC-31-1997 JAN-01-1997 DEC-31-1997 7,534 34,082 11,059 0 0 62,902 3,664 1,949 94,358 1,258 0 0 0 99 93,001 94,358 0 61,006 0 45,636 8,954 450 11 7,560 402 7,158 0 0 0 7,158 .91 .81
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