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Acquisitions (Tables)
12 Months Ended
Dec. 31, 2017
Business Combinations [Abstract]  
Schedule of business acquisitions
The following is the estimated fair value of the purchase price for Mediscan on October 30, 2015:
 
(amounts in thousands)
Cash purchase price paid at closing
$
28,000

Fair value of shares
4,723

Fair value of contingent consideration
3,686

Net working capital adjustment, including receivable
503

Total consideration
$
36,912

The following is the estimated fair value of the purchase price for Advantage on July 1, 2017:
 
(amounts in thousands)
Purchase price
$
88,000

Net working capital adjustments
(1,438
)
Cash consideration
86,562

Cash acquired
2,833

Total consideration
$
89,395

Schedule of assets acquired and liabilities assumed
The following table is an estimate of the fair value of the assets acquired and liabilities assumed on July 1, 2017.
 
(amounts in thousands)
Cash and cash equivalents
$
2,833

Accounts receivable
14,396

Other current assets
392

Property and equipment
333

Goodwill
43,596

Other intangible assets
29,900

Total assets acquired
91,450

Accounts payable and accrued expenses
368

Accrued employee compensation and benefits
1,685

Other current liabilities
2

Total liabilities assumed
2,055

Net assets acquired
$
89,395

The following table summarizes the fair value of the assets acquired and liabilities assumed. The Company used a third-party appraiser to assist with the determination of the fair value and estimated useful lives of acquired assets and liabilities assumed as of October 30, 2015:
 
(amounts in thousands)
Cash and cash equivalents
$
79

Accounts receivable
6,851

Other current assets
140

Property and equipment
20

Goodwill
14,338

Other intangible assets
17,200

Total assets acquired
38,628

Accounts payable and accrued expenses
306

Accrued employee compensation and benefits
1,410

Total liabilities assumed
1,716

Net assets acquired
$
36,912

Pro forma information
The following unaudited pro forma financial information approximates the consolidated results of operations of the Company as if the Advantage acquisition had occurred as of January 1, 2016, after giving effect to certain adjustments, including additional interest expense on the amount the Company borrowed on the date of the transaction, the amortization of acquired intangible assets, and the elimination of certain expenses that will not be recurring in post-acquisition periods, net of an estimated income tax impact. These adjustments include removing transaction-related expenses of approximately $2.0 million for the year ended December 31, 2017. These results are not necessarily indicative of future results as they do not include incremental investments in support functions, elimination of costs for integration or operating synergies, or an estimate of any impact on interest expense resulting from the operating cash flow of the acquired businesses, among other adjustments that could be made in the future but are not factually supportable on the date of the transaction.
 
Year Ended December 31,
 
2017
 
2016
 
(unaudited, amounts in thousands except per share data)
Revenue from services
$
916,149

 
$
934,904

 
 
 
 
Net income attributable to common shareholders
$
40,255

 
$
11,391

 
 
 
 
Net income per common share attributable to common shareholders - basic
$
1.16

 
$
0.35

 
 
 
 
Net income per common share attributable to common shareholders - diluted
$
1.09

 
$
0.25