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Consolidated Balance Sheets (USD $)
In Thousands, unless otherwise specified
Dec. 31, 2014
Dec. 31, 2013
Current Assets:    
Cash and cash equivalents $ 69,767us-gaap_CashAndCashEquivalentsAtCarryingValue $ 81,705us-gaap_CashAndCashEquivalentsAtCarryingValue
Restricted cash and cash equivalents 7,020us-gaap_RestrictedCashAndCashEquivalentsAtCarryingValue 10,298us-gaap_RestrictedCashAndCashEquivalentsAtCarryingValue
Marketable securities 132,535us-gaap_MarketableSecuritiesCurrent 105,009us-gaap_MarketableSecuritiesCurrent
Restricted marketable securities 19,805us-gaap_MarketableSecuritiesRestrictedCurrent 14,027us-gaap_MarketableSecuritiesRestrictedCurrent
Accounts receivable, less allowance for doubtful accounts of $5,738 and $4,972, respectively 78,843us-gaap_AccountsReceivableNetCurrent 79,856us-gaap_AccountsReceivableNetCurrent
Inventories 7,127us-gaap_InventoryNet 7,146us-gaap_InventoryNet
Prepaid expenses and other assets 2,260us-gaap_PrepaidExpenseAndOtherAssetsCurrent 1,208us-gaap_PrepaidExpenseAndOtherAssetsCurrent
Notes receivable, current portion 441us-gaap_NotesAndLoansReceivableNetCurrent 417us-gaap_NotesAndLoansReceivableNetCurrent
Federal income tax receivable 4,727us-gaap_IncomeTaxesReceivable  
Total current assets 322,525us-gaap_AssetsCurrent 299,666us-gaap_AssetsCurrent
Property and Equipment:    
Property and equipment, at cost 821,792us-gaap_PropertyPlantAndEquipmentGross 734,682us-gaap_PropertyPlantAndEquipmentGross
Accumulated depreciation and amortization (307,048)us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment (277,884)us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment
Net property and equipment 514,744us-gaap_PropertyPlantAndEquipmentNet 456,798us-gaap_PropertyPlantAndEquipmentNet
Other Assets:    
Restricted cash and cash equivalents 3,631us-gaap_RestrictedCashAndCashEquivalentsNoncurrent 3,631us-gaap_RestrictedCashAndCashEquivalentsNoncurrent
Restricted marketable securities 138,468us-gaap_MarketableSecuritiesRestrictedNoncurrent 127,976us-gaap_MarketableSecuritiesRestrictedNoncurrent
Deposits and other assets 8,791us-gaap_DepositsAssetsNoncurrent 6,808us-gaap_DepositsAssetsNoncurrent
Goodwill 17,600us-gaap_Goodwill 17,600us-gaap_Goodwill
Notes receivable, less current portion 12,548us-gaap_NotesAndLoansReceivableNetNoncurrent 14,961us-gaap_NotesAndLoansReceivableNetNoncurrent
Deferred income taxes 18,700us-gaap_DeferredTaxAssetsNetNoncurrent 18,164us-gaap_DeferredTaxAssetsNetNoncurrent
Investments in limited liability companies 37,116us-gaap_InvestmentsInAffiliatesSubsidiariesAssociatesAndJointVentures 38,754us-gaap_InvestmentsInAffiliatesSubsidiariesAssociatesAndJointVentures
Total other assets 236,854us-gaap_OtherAssetsNoncurrent 227,894us-gaap_OtherAssetsNoncurrent
Total assets 1,074,123us-gaap_Assets 984,358us-gaap_Assets
Current Liabilities:    
Trade accounts payable 15,877us-gaap_AccountsPayableTradeCurrent 13,050us-gaap_AccountsPayableTradeCurrent
Capital lease obligations, current portion 3,088us-gaap_CapitalLeaseObligationsCurrent  
Accrued payroll 59,859us-gaap_AccruedSalariesCurrent 63,462us-gaap_AccruedSalariesCurrent
Amounts due to third party payors 22,931us-gaap_AccountsPayableOtherCurrent 21,619us-gaap_AccountsPayableOtherCurrent
Accrued risk reserves, current portion 26,825us-gaap_SelfInsuranceReserveCurrent 24,325us-gaap_SelfInsuranceReserveCurrent
Deferred income taxes 35,506us-gaap_DeferredTaxLiabilitiesCurrent 24,790us-gaap_DeferredTaxLiabilitiesCurrent
Other current liabilities 12,472us-gaap_OtherLiabilitiesCurrent 13,784us-gaap_OtherLiabilitiesCurrent
Dividends payable 7,000us-gaap_DividendsPayableCurrent 6,730us-gaap_DividendsPayableCurrent
Total current liabilities 183,558us-gaap_LiabilitiesCurrent 167,760us-gaap_LiabilitiesCurrent
Long-term debt 10,000us-gaap_LongTermDebtNoncurrent 10,000us-gaap_LongTermDebtNoncurrent
Capital lease obligations, less current portion 33,508us-gaap_CapitalLeaseObligationsNoncurrent  
Accrued risk reserves, less current portion 79,393us-gaap_SelfInsuranceReserveNoncurrent 86,232us-gaap_SelfInsuranceReserveNoncurrent
Refundable entrance fees 10,219us-gaap_OtherAccruedLiabilitiesNoncurrent 10,720us-gaap_OtherAccruedLiabilitiesNoncurrent
Obligation to provide future services 3,927us-gaap_AccountsPayableOtherCurrentAndNoncurrent 3,689us-gaap_AccountsPayableOtherCurrentAndNoncurrent
Other noncurrent liabilities 16,011us-gaap_OtherLiabilitiesNoncurrent 14,525us-gaap_OtherLiabilitiesNoncurrent
Deferred revenue 3,359us-gaap_DeferredRevenueNoncurrent 3,320us-gaap_DeferredRevenueNoncurrent
Stockholders' Equity:    
Series A convertible preferred stock; $.01 par value; 25,000,000 shares authorized; 10,836,659 and 10,837,665 shares, respectively, issued and outstanding; stated at liquidation value of $15.75 per share 170,494us-gaap_PreferredStockValue 170,510us-gaap_PreferredStockValue
Common stock, $.01 par value; 30,000,000 shares authorized; 14,110,859 and 14,078,028 shares, respectively, issued and outstanding 140us-gaap_CommonStockValue 140us-gaap_CommonStockValue
Capital in excess of par value 154,965us-gaap_AdditionalPaidInCapital 153,061us-gaap_AdditionalPaidInCapital
Retained earnings 343,941us-gaap_RetainedEarningsAccumulatedDeficit 318,216us-gaap_RetainedEarningsAccumulatedDeficit
Accumulated other comprehensive income 64,608us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax 46,185us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax
Total stockholders’ equity 734,148us-gaap_StockholdersEquity 688,112us-gaap_StockholdersEquity
Total liabilities and stockholders’ equity $ 1,074,123us-gaap_LiabilitiesAndStockholdersEquity $ 984,358us-gaap_LiabilitiesAndStockholdersEquity