Restatement Of Consolidated Financial Statements (Tables)

12 Months Ended

Dec. 31, 2014

Restatement Of Consolidated Financial Statements [Abstract]

Summary Of Effects Of Restatement Adjustments On Consolidated Financial Statements

	As of December 31, 2014
			Adjustments by Category
	Previously Reported		MDL Revenue		Medical Malpractice		Meaningful Use (EHR)		Restatement Tax Impact		Other		Total Adjustments		As Restated
ASSETS
Current assets:
Cash and cash equivalents	$	99,167	$	—	$	—	$	—	$	—	$	(85)	$	(85)	$	99,082
Restricted cash		7,051		—		—		—		—		232		232		7,283
Accounts receivable, net		137,807		(19,694)		—		(1,375)		—		5,061		(16,008)		121,799
Prepaid expenses		8,728		—		—		—		—		—		—		8,728
Inventories		4,526		—		—		—		—		(1,364)		(1,364)		3,162
Income taxes receivable		—		—		—		—	—	4,432				4,432		4,432
Deferred income taxes		227		—		—		—		1,544		—		1,544		1,771
Other		7,457		—		68		—		—		766		834		8,291
Total current assets		264,963		(19,694)		68		(1,375)		5,976		4,610		(10,415)		254,548
Equity investments in joint ventures		1,646		—		—		—		—		—		—		1,646
Property and equipment, net		270,757		—		—		—		—		(1,187)		(1,187)		269,570
Real estate subject to finance obligation		22,552		—		—		—		—		—		—		22,552
Goodwill		469,596		2,667		3,519		528		—		249		6,963		476,559
Intangible assets, net		81,680		—		—		—		—		(295)		(295)		81,385
Other assets		35,530		—		10,483		—		371		800		11,654		47,184
Total assets	$	1,146,724	$	(17,027)	$	14,070	$	(847)	$	6,347	$	4,177	$	6,720	$	1,153,444
LIABILITIES AND EQUITY
Current liabilities:
Accounts payable	$	57,635	$	—	$	—	$	—	$	—	$	4,872	$	4,872	$	62,507
Accrued expenses		82,609		—		(2,386)		5,797		410		2,174		5,995		88,604
Income taxes payable		2,114		—		—		—		(788)		—		(788)		1,326
Current portion of long-term debt		26,350		—		—		—		—		—		—		26,350
Current portion of finance obligation		433		—		—		—		—		—		—		433
Other current liabilities		19,687		—		(175)		—		—		—		(175)		19,512
Total current liabilities		188,828		—		(2,561)		5,797		(378)		7,046		9,904		198,732
Long-term debt, less current portion		940,771		—		—		—		—		—		—		940,771
Finance obligation, less current portion		23,610		—		—		—		—		—		—		23,610
Embedded derivative features of Series A convertible redeemable preferred stock		15,843		—		—		—		—		—		—		15,843
Other long-term liabilities		51,079		—		20,058		—		785		63		20,906		71,985
Deferred income taxes		4,480		—		—		—		489		(135)		354		4,834
Total liabilities		1,224,611		—		17,497		5,797		896		6,974		31,164		1,255,775
Series A convertible redeemable preferred stock, $0.001 par value, $1,000 stated value, 3,500,000 authorized, 385,000 issued and outstanding at December 31, 2014		328,926		—		—		—		—		(8,929)		(8,929)		319,997
Noncontrolling interests - redeemable		49,797		—		—		—		—		(34,524)		(34,524)		15,273
Commitments and contingencies
Equity:
Common stock, $0.01 par value, 1,000,000 shares authorized,  1,028 issued and outstanding at December 31, 2014		—		—		—		—		—		—		—		—
Additional paid-in capital		626,001		—		—		—		—		8,929		8,929		634,930
Retained deficit		(1,067,487)		(22,251)		(3,427)		(6,644)		7,211		1,149		(23,962)		(1,091,449)
Accumulated other comprehensive loss, net of tax		(38,690)		6,212		—		—		(1,760)		(2,682)		1,770		(36,920)
Total 21st Century Oncology Holdings, Inc. shareholder’s deficit		(480,176)		(16,039)		(3,427)		(6,644)		5,451		7,396		(13,263)		(493,439)
Noncontrolling interests - nonredeemable		23,566		(988)		—		—		—		33,260		32,272		55,838
Total deficit		(456,610)		(17,027)		(3,427)		(6,644)		5,451		40,656		19,009		(437,601)
Total liabilities and equity	$	1,146,724	$	(17,027)	$	14,070	$	(847)	$	6,347	$	4,177	$	6,720	$	1,153,444

	As of Decmember 31, 2013
			Adjustments by Category
	Previously Reported		MDL Revenue		Medical Malpractice		Meaningful Use (EHR)		Restatement Tax Impact		Other		Total Adjustments		As Restated
ASSETS
Current assets:
Cash and cash equivalents	$	17,462	$	—	$	—	$	—	$	—	$	(334)	$	(334)	$	17,128
Restricted cash		3,768		—		—		—		—		334		334		4,102
Accounts receivable, net		117,044		(15,032)		—		(1,708)		—		4,863		(11,877)		105,167
Prepaid expenses		7,577		—		—		—		—		—		—		7,577
Inventories		4,393		—		—		—		—		(1,719)		(1,719)		2,674
Income taxes receivable		—		—		—		—		2,425		—		2,425		2,425
Deferred income taxes		375		—		—		—		3,557		—		3,557		3,932
Other		12,534		—		(2,054)		—		—		1,251		(803)		11,731
Total current assets		163,153		(15,032)		(2,054)		(1,708)		5,982		4,395		(8,417)		154,736
Equity investments in joint ventures		2,555		—		—		—		—		—		—		2,555
Property and equipment, net		240,371		—		—		—		—		(1,134)		(1,134)		239,237
Real estate subject to finance obligation		19,239		—		—		—		—		—		—		19,239
Goodwill		578,013		3,485		—		—		—		(1,623)		1,862		579,875
Intangible assets, net		85,025		—		—		—		—		(283)		(283)		84,742
Other assets		39,835		—		9,054		—		245		835		10,134		49,969
Total assets	$	1,128,191	$	(11,547)	$	7,000	$	(1,708)	$	6,227	$	2,190	$	2,162	$	1,130,353
LIABILITIES AND EQUITY
Current liabilities:
Accounts payable	$	57,613	$	—	$	—	$	—	$	—	$	3,600		3,600	$	61,213
Accrued expenses		64,021		—		(2,371)		2,246		252		—		127		64,148
Income taxes payable		2,372		—		—		—		(651)		—		(651)		1,721
Current portion of long-term debt		17,536		—		—		—		—		—		—		17,536
Current portion of finance obligation		317		—		—		—		—		—		—		317
Other current liabilities		12,237		—		(2,247)		—		—		—		(2,247)		9,990
Total current liabilities		154,096		—		(4,618)		2,246		(399)		3,600		829		154,925
Long-term debt, less current portion		974,130		—		—		—		—		—		—		974,130
Finance obligation, less current portion		20,333		—		—		—		—		—		—		20,333
Other long-term liabilities		38,453		—		14,895		—		—		—		14,895		53,348
Deferred income taxes		4,498		—		—		—		2,885		(64)		2,821		7,319
Total liabilities		1,191,510		—		10,277		2,246		2,486		3,536		18,545		1,210,055
Noncontrolling interests - redeemable		15,899		—		—		—		—		—		—		15,899
Commitments and contingencies
Equity:
Common stock, $0.01 par value, 1,028 shares authorized, issued, and outstanding at December 31, 2013		—		—		—		—		—		—		—		—
Additional paid-in capital		650,879		—		—		—		—		—		—		650,879
Retained deficit		(718,237)		(14,234)		(3,277)		(3,954)		4,659		885		(15,921)		(734,158)
Accumulated other comprehensive loss, net of tax		(26,393)		3,440		—		—		(918)		(2,231)		291		(26,102)
Total 21st Century Oncology Holdings, Inc. shareholder’s deficit		(93,751)		(10,794)		(3,277)		(3,954)		3,741		(1,346)		(15,630)		(109,381)
Noncontrolling interests - nonredeemable		14,533		(753)		—		—		—		—		(753)		13,780
Total deficit		(79,218)		(11,547)		(3,277)		(3,954)		3,741		(1,346)		(16,383)		(95,601)
Total liabilities and equity	$	1,128,191	$	(11,547)	$	7,000	$	(1,708)	$	6,227	$	2,190	$	2,162	$	1,130,353

The table below summarizes the effects of the Restatement adjustments on the Consolidated Statement of Operations and Comprehensive Loss for the years ended December 31, 2014, 2013, 2012 (in thousands):

	Year Ended December 31, 2014
(in thousands):	Previously Reported		MDL Revenue		Medical Malpractice		EHR/ Meaningful Use		Restatement Tax Impact		Other		Total Adjustments		As Restated
Revenues:
Net patient service revenue	$	946,897	$	(8,190)	$	—	$	—	$	—	$	(219)	$	(8,409)	$	938,488
Management fees		67,012		—		—		—		—		—		—		67,012
Other revenue		12,513		—		—		—		—		169		169		12,682
Total revenues		1,026,422		(8,190)		—		—		—		(50)		(8,240)		1,018,182
Expenses:
Salaries and benefits		545,025		—		—		—		—		—		—		545,025
Medical supplies		97,367		—		—		—		—		—		—		97,367
Facility rent expenses		63,048		—		—		—		—		63		63		63,111
Other operating expenses		61,735		—		—		—		—		49		49		61,784
General and administrative expenses		135,257		—		148		—		226		188		562		135,819
Depreciation and amortization		86,701		—		—		—		—		(118)		(118)		86,583
Provision for doubtful accounts		18,713		—		—		—		—		540		540		19,253
Interest expense, net		113,279		—		—		—		—		—		—		113,279
Electronic health records incentive income		(2,783)		—		—		2,690		—		—		2,690		(93)
Impairment loss		229,526		—		—		—		—		—		—		229,526
Early extinguishment of debt		8,558		—		—		—		—		—		—		8,558
Equity initial public offering expenses		4,905		—		—		—		—		—		—		4,905
Loss on sale leaseback transaction		135		—		—		—		—		—		—		135
Fair value adjustment of earn-out liability		1,627		—		—		—		—		—		—		1,627
Fair value adjustment of embedded derivative		837		—		—		—		—		—		—		837
Loss on the sale/disposal of property and equipment		—		—		—		—		—		119		119		119
Loss on foreign currency transactions		557		—		—		—		—		121		121		678
(Gain) loss on foreign currency derivative contracts		(4)		—		—		—		—		—		—		(4)
Total expenses		1,364,483		—		148		2,690		226		962		4,026		1,368,509
Loss before income taxes and equity in net loss of joint ventures		(338,061)		(8,190)		(148)		(2,690)		(226)		(1,012)		(12,266)		(350,327)
Income tax expense (benefit)		5,159		—		—		—		(2,778)		(62)		(2,840)		2,319
Loss before equity in net loss of joint ventures		(343,220)		(8,190)		(148)		(2,690)		2,552		(950)		(9,426)		(352,646)
Equity in net loss of joint ventures, net of tax		—		—		—		—		—		(50)		(50)		(50)
Net loss		(343,220)		(8,190)		(148)		(2,690)		2,552		(1,000)		(9,476)		(352,696)
Net income attributable to noncontrolling interests – redeemable and non-redeemable		(6,030)		171		—		—		—		1,264		1,435		(4,595)
Net loss attributable to 21st Century Oncology Holdings, Inc. shareholder		(349,250)		(8,019)		(148)		(2,690)		2,552		264		(8,041)		(357,291)
Other comprehensive loss, net of tax:
Net periodic benefit cost of pension plan		(91)		—		—		—		—		—		—		(91)
Unrealized loss on foreign currency translation		(13,514)		2,708		—		—		(737)		(555)		1,416		(12,098)
Other comprehensive loss		(13,605)		2,708		—		—		(737)		(555)		1,416		(12,189)
Comprehensive loss:		(356,825)		(5,482)		(148)		(2,690)		1,815		(1,555)		(8,060)		(364,885)
Comprehensive income attributable to noncontrolling interests-redeemable and non-redeemable		(4,722)		234		—		—		—		1,264		1,498		(3,224)
Comprehensive loss attributable to 21st Century Oncology Holdings, Inc. shareholder	$	(361,547)	$	(5,248)	$	(148)	$	(2,690)	$	1,815	$	(291)	$	(6,562)	$	(368,109)

	Year Ended December 31, 2013
(in thousands):	Previously Reported		MDL Revenue		Medical Malpractice		EHR/ Meaningful Use		Restatement Tax Impact		Other		Total Adjustments		As Restated
Revenues:
Net patient service revenue	$	715,999	$	(8,597)	$	—	$	—	$	—	$	214	$	(8,383)	$	707,616
Management fees		11,139		—		—		—		—		—		—		11,139
Other revenue		9,378		—		—		—		—		790		790		10,168
Total revenues		736,516		(8,597)		—		—		—		1,004		(7,593)		728,923
Expenses:
Salaries and benefits		409,352		—		—		—		—		—		—		409,352
Medical supplies		64,640		—		—		—		—		—		—		64,640
Facility rent expenses		45,565		—		—		—		—		—		—		45,565
Other operating expenses		45,629		—		—		—		—		—		—		45,629
General and administrative expenses		106,887		—		255		—		189		64		508		107,395
Depreciation and amortization		65,195		—		—		—		—		(99)		(99)		65,096
Provision for doubtful accounts		12,146		—		—		—		—		—		—		12,146
Interest expense, net		86,747		—		—		—		—		—		—		86,747
Electronic health records incentive income		(1,698)		—		—		1,698		—		—		1,698		—
Loss on sale leaseback transaction		313		—		—		—		—		—		—		313
Fair value adjustment of earn-out liability		130		—		—		—		—		—		—		130
Loss on the sale/disposal of property and equipment		—		—		—		—		—		336		336		336
Gain on the sale of an interest in a joint venture		(1,460)		—		—		—		—		—		—		(1,460)
Loss on foreign currency transactions		1,283		—		—		—		—		(145)		(145)		1,138
(Gain) loss on foreign currency derivative contracts		467		—		—		—		—		—		—		467
Total expenses		835,196		—		255		1,698		189		156		2,298		837,494
Loss before income taxes and equity in net loss of joint ventures		(98,680)		(8,597)		(255)		(1,698)		(189)		848		(9,891)		(108,571)
Income tax expense (benefit)		(20,432)		—		—		—		(2,642)		6		(2,636)		(23,068)
Loss before equity in net loss of joint ventures		(78,248)		(8,597)		(255)		(1,698)		2,453		842		(7,255)		(85,503)
Equity in net loss of joint ventures, net of tax		—		—		—		—		—		(454)		(454)		(454)
Net loss		(78,248)		(8,597)		(255)		(1,698)		2,453		388		(7,709)		(85,957)
Net income attributable to noncontrolling interests – redeemable and non-redeemable		(1,966)		128		—		—		—		—		128		(1,838)
Net loss attributable to 21st Century Oncology Holdings, Inc. shareholder		(80,214)		(8,469)		(255)		(1,698)		2,453		388		(7,581)		(87,795)
Other comprehensive loss, net of tax:
Unrealized loss on foreign currency translation		(16,242)		2,141		—		—		(507)		(1,205)		429		(15,813)
Other comprehensive loss		(16,242)		2,141		—		—		(507)		(1,205)		429		(15,813)
Comprehensive loss:		(94,490)		(6,456)		(255)		(1,698)		1,946		(817)		(7,280)		(101,770)
Comprehensive income attributable to noncontrolling interests-redeemable and non-redeemable		(653)		350		—		—		—		—		350		(303)
Comprehensive loss attributable to 21st Century Oncology Holdings, Inc. shareholder	$	(95,143)	$	(6,106)	$	(255)	$	(1,698)	$	1,946	$	(817)	$	(6,930)	$	(102,073)

	Year Ended December 31, 2012
(in thousands):	Previously Reported		MDL Revenue		Medical Malpractice		EHR/ Meaningful Use		Restatement Tax Impact		Other		Total Adjustments		As Restated
Revenues:
Net patient service revenue	$	686,216	$	(2,221)	$	—	$	—	$	—	$	(214)	$	(2,435)	$	683,781
Other revenue		7,735		—		—		—		—		1,564		1,564		9,299
Total revenues		693,951		(2,221)		—		—		—		1,350		(871)		693,080
Expenses:
Salaries and benefits		372,656		—		—		—		—		—		—		372,656
Medical supplies		61,589		—		—		—		—		—		—		61,589
Facility rent expenses		39,802		—		—		—		—		—		—		39,802
Other operating expenses		38,988		—		—		—		—		—		—		38,988
General and administrative expenses		82,236		—		913		—		135		30		1,078		83,314
Depreciation and amortization		64,893		—		—		—		—		(79)		(79)		64,814
Provision for doubtful accounts		16,916		—		—		—		—		—		—		16,916
Interest expense, net		77,494		—		—		—		—		—		—		77,494
Electronic health records incentive income		(2,256)		—		—		2,256		—		—		2,256		—
Impairment loss		81,021		—		—		—		—		—		—		81,021
Early extinguishment of debt		4,473		—		—		—		—		—		—		4,473
Fair value adjustment of earn-out liability		1,219		—		—		—		—		—		—		1,219
Loss on the sale/disposal of property and equipment		—		—		—		—		—		748		748		748
Loss on foreign currency transactions		339		—		—		—		—		(98)		(98)		241
(Gain) loss on foreign currency derivative contracts		1,165		—		—		—		—		—		—		1,165
Total expenses		840,535		—		913		2,256		135		601		3,905		844,440
Loss before income taxes and equity in net loss of joint ventures		(146,584)		(2,221)		(913)		(2,256)		(135)		749		(4,776)		(151,360)
Income tax expense (benefit)		4,545		—		—		—		(1,071)		3		(1,068)		3,477
Loss before equity in net loss of joint ventures		(151,129)		(2,221)		(913)		(2,256)		936		746		(3,708)		(154,837)
Equity in net loss of joint ventures		—		—		—		—		—		(817)		(817)		(817)
Net loss		(151,129)		(2,221)		(913)		(2,256)		936		(71)		(4,525)		(155,654)
Net income attributable to noncontrolling interests – redeemable and non-redeemable		(3,079)		26		—		—		—		—		26		(3,053)
Net loss attributable to 21st Century Oncology Holdings, Inc. shareholder		(154,208)		(2,195)		(913)		(2,256)		936		(71)		(4,499)		(158,707)
Other comprehensive loss:
Unrealized loss on derivative interest rate swap agreements, net of tax		(333)		—		—		—		—		—		—		(333)
Unrealized loss on foreign currency translation		(7,882)		789		—		—		(263)		(655)		(129)		(8,011)
Other comprehensive loss		(8,215)		789		—		—		(263)		(655)		(129)		(8,344)
Comprehensive loss:		(159,344)		(1,432)		(913)		(2,256)		673		(726)		(4,654)		(163,998)
Comprehensive income attributable to noncontrolling interests-redeemable and non-redeemable		(2,396)		180		—		—		—		—		180		(2,216)
Comprehensive loss attributable to 21st Century Oncology Holdings, Inc. shareholder	$	(161,740)	$	(1,252)	$	(913)	$	(2,256)	$	673	$	(726)	$	(4,474)	$	(166,214)

The Restatement adjustments had an impact on the cash and cash equivalents balance as of December 31, 2014, 2013, and 2012 primarily related to the correction of certain cash classified as cash and cash equivalents to restricted cash. The Restatement adjustments affecting the consolidated statement of cash flows for the year ending December 31, 2014, are predominantly included in the Company’s net loss from operations, offset by non-cash adjustments to net loss and changes in operating assets and liabilities. The significant non-cash adjustments include decreases to depreciation and amortization offset by adjustments to deferred tax assets. Changes in operating assets and liabilities are largely attributable to decreases in accounts receivable and increases to liabilities associated with revenue recognition adjustments. There were no significant adjustments related to cash provided by financing activities.

The table below summarizes the effects of the Restatement adjustments on the Consolidated Statement of Cash Flows for the year ended December 31, 2014, 2013, 2012 (in thousands):

(in thousands):	2014 As Reported (1)		Adjustments		2014 As Restated
Cash flows from operating activities
Net loss	$	(343,220)	$	(9,476)	$	(352,696)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Depreciation		72,914		(130)		72,784
Amortization		13,787		12		13,799
Deferred rent expense		711		63		774
Deferred income taxes		(329)		(454)		(783)
Stock-based compensation		106		—		106
Provision for doubtful accounts		18,713		540		19,253
Loss on the sale/disposal of property and equipment		119		—		119
Loss on sale leaseback transaction		135		—		135
Impairment loss		229,526		—		229,526
Early extinguishment of debt		8,558		—		8,558
Equity initial public offering expenses		4,905		—		4,905
Loss on foreign currency transactions		348		—		348
(Gain) loss on foreign currency derivative contracts		(4)		—		(4)
Fair value adjustment of earn-out liability		1,627		—		1,627
Fair value adjustment of embedded derivative		837		—		837
Amortization of debt discount		2,483		—		2,483
Amortization of loan costs		6,277		—		6,277
Equity interest in net loss of joint ventures		50		—		50
Distribution received from unconsolidated joint ventures		221		—		221
Pension plan contributions		(1,587)		—		(1,587)
Changes in operating assets and liabilities:
Accounts receivable and other current assets		(42,218)		7,110		(35,108)
Income taxes payable		(500)		(2,953)		(3,453)
Inventories		(88)		96		8
Prepaid expenses and other assets		3,339		338		3,677
Accounts payable and other current liabilities		346		168		514
Accrued deferred compensation		1,522		—		1,522
Accrued expenses / other current liabilities		6,054		5,267		11,321
Net cash (used in) provided by operating activities		(15,368)		581		(14,787)
Cash flows from investing activities
Purchase of property and equipment		(56,563)		(96)		(56,659)
Acquisition of medical practices		(50,245)		—		(50,245)
Restricted cash associated with medical practice acquisitions		(3,283)		102		(3,181)
Proceeds from the sale of property and equipment		96		—		96
Loans to employees		(888)		(338)		(1,226)
Contribution of capital to joint venture entities		(620)		—		(620)
Proceeds (payment) of foreign currency derivative contracts		26		—		26
Premiums on life insurance policies		(1,265)		—		(1,265)
Change in other assets and other liabilities		(765)		—		(765)
Net cash used in investing activities		(113,507)		(332)		(113,839)

(in thousands):	2014 As Reported (1)		Adjustments		2014 As Restated
Cash flows from financing activities
Proceeds from issuance of debt (net of original issue discount of $3.4 million)		169,845		—		169,845
Principal repayments of debt		(268,377)		—		(268,377)
Repayments of finance obligation		(278)		—		(278)
Proceeds from issuance of Series A convertible redeemable preferred stock		325,000		—		325,000
Payments of issue costs related to the issuance of preferred stock		(6,137)		—		(6,137)
Proceeds from issuance of noncontrolling interest		1,250		—		1,250
Proceeds from noncontrolling interest holders - redeemable and non-redeemable		259		—		259
Cash distributions to noncontrolling interest holders – redeemable and non-redeemable		(3,599)		—		(3,599)
Payments of costs for equity securities offering		(4,905)		—		(4,905)
Payments of loan costs		(2,436)		—		(2,436)
Net cash provided by financing activities		210,622		—		210,622
Effect of exchange rate changes on cash and cash equivalents		(42)				(42)
Net increase in cash and cash equivalents		81,705		249		81,954
Cash and cash equivalents, beginning of period		17,462		(334)		17,128
Cash and cash equivalents, end of period	$	99,167	$	(85)	$	99,082
Supplemental disclosure of cash flow information
Interest paid	$	101,149	$	—	$	101,149
Income taxes paid	$	7,585	$	—	$	7,585
Supplemental disclosure of non-cash transactions
Finance obligation related to real estate projects	$	7,790	$	—	$	7,790
Derecognition of finance obligation related to real estate projects	$	4,119	$	—	$	4,119
Capital lease obligations related to the purchase of equipment	$	17,625	$	—	$	17,625
Medical equipment and service contract component related to the acquisition of medical equipment through accounts payable	$	3,049	$	—	$	3,049
Issuance of notes payable relating to the acquisition of medical practices	$	2,000	$	—	$	2,000
Liability relating to the escrow debt and purchase price of medical practices	$	2,970	$	—	$	2,970
Capital lease obligations related to the acquisition of medical practices	$	47,796	$	—	$	47,796
Earn-out accrual related to the acquisition of medical practices	$	11,052	$	—	$	11,052
Amounts payable to sellers in the purchase of a medical practice	$	249	$	—	$	249
Noncash dividend declared to noncontrolling interest	$	194	$	—	$	194
Accrued dividends on Series A convertible preferred stock	$	23,078	$	(10,395)	$	12,683
Accretion of redemption value on Series A convertible preferred stock	$	1,991	$	1,466	$	3,457
Noncash contribution of capital by noncontrolling interest holders	$	37	$	—	$	37

(in thousands):	2013 As Reported (1)		Adjustments		2013 As Restated
Cash flows from operating activities
Net loss	$	(78,248)	$	(7,709)	$	(85,957)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Depreciation		55,430		(219)		55,211
Amortization		9,765		120		9,885
Deferred rent expense		973		—		973
Deferred income taxes		(27,908)		(209)		(28,117)
Stock-based compensation		597		—		597
Provision for doubtful accounts		12,146		—		12,146
Loss on the sale/disposal of property and equipment		336		—		336
Loss on sale leaseback transaction		313		—		313
Gain on the sale of an interest in a joint venture		(1,460)		—		(1,460)
Loss on foreign currency transactions		143		—		143
(Gain) loss on foreign currency derivative contracts		467		—		467
Fair value adjustment of earn-out liability		—		130		130
Amortization of debt discount		1,191		—		1,191
Amortization of loan costs		5,595		—		5,595
Equity interest in net loss of joint ventures		454		—		454
Distribution received from unconsolidated joint ventures		21		—		21
Changes in operating assets and liabilities:
Accounts receivable and other current assets		(42,570)		10,031		(32,539)
Income taxes payable		20		(2,267)		(2,247)
Inventories		(102)		(93)		(195)
Prepaid expenses and other assets		3,544		647		4,191
Accounts payable and other current liabilities		29,373		—		29,373
Accrued deferred compensation		1,344		—		1,344
Accrued expenses / other current liabilities		16,999		125		17,124
Net cash (used in) provided by operating activities		(11,577)		556		(11,021)
Cash flows from investing activities
Purchase of property and equipment		(40,744)		93		(40,651)
Acquisition of medical practices		(68,659)		(2)		(68,661)
Restricted cash associated with medical practice acquisitions		(3,768)		—		(3,768)
Proceeds from the sale of equity interest in a joint venture		1,460		—		1,460
Proceeds from the sale of property and equipment		78		—		78
Loans to employees		(212)		(647)		(859)
Contribution of capital to joint venture entities		(992)		—		(992)
Purchase of noncontrolling interest - non-redeemable		(1,509)		—		(1,509)
Proceeds (payment) of foreign currency derivative contracts		(171)		—		(171)
Premiums on life insurance policies		(1,234)		—		(1,234)
Change in other assets and other liabilities		(2,212)		—		(2,212)
Net cash used in investing activities		(117,963)		(556)		(118,519)

(in thousands):	2013 As Reported (1)		Adjustments		2013 As Restated
Cash flows from financing activities				—
Proceeds from issuance of debt (net of original issue discount of $2.3 million)		306,063		—		306,063
Principal repayments of debt		(171,432)		—		(171,432)
Repayments of finance obligation		(182)		—		(182)
Proceeds from noncontrolling interest holders - redeemable and non-redeemable		765		—		765
Cash distributions to noncontrolling interest holders – redeemable and non-redeemable		(2,211)		—		(2,211)
Payments of loan costs		(1,359)		—		(1,359)
Net cash provided by financing activities		131,644		—		131,644
Effect of exchange rate changes on cash and cash equivalents		(52)				(52)
Net increase in cash and cash equivalents		2,052		—		2,052
Cash and cash equivalents, beginning of period		15,410		(334)		15,076
Cash and cash equivalents, end of period	$	17,462	$	(334)	$	17,128
Supplemental disclosure of cash flow information
Interest paid	$	78,750	$	—	$	78,750
Income taxes paid	$	9,364	$	—	$	9,364
Supplemental disclosure of non-cash transactions
Finance obligation related to real estate projects	$	7,580	$	—	$	7,580
Derecognition of finance obligation related to real estate projects	$	3,940	$	—	$	3,940
Capital lease obligations related to the purchase of equipment	$	3,054	$	—	$	3,054
Issuance of notes payable relating to the acquisition of medical practices	$	2,097	$	—	$	2,097
Capital lease obligations related to the acquisition of medical practices	$	10,903	$	—	$	10,903
Earn-out accrual related to the acquisition of medical practices	$	7,950	$	—	$	7,950
Costs incurred for professional fees relating to issuance of equity securities	$	1,323	$	—	$	1,323
Noncash dividend declared to noncontrolling interest	$	77	$	—	$	77
Noncash deconsolidation of noncontrolling interest	$	9	$	—	$	9
Noncash contribution of capital by noncontrolling interest holders	$	4,235	$	—	$	4,235
Termination of prepaid services by noncontrolling interest holder	$	2,551	$	—	$	2,551
Issuance of notes payable relating to the earn-out liability in the acquisition of Medical Developers	$	2,679	$	—	$	2,679
Issuance of equity LLC units relating to the earn-out liability in the acquisition of Medical Developers	$	705	$	—	$	705
Issuance of senior secured notes related to the acquisition of medical practices	$	75,000	$	—	$	75,000
Reserve claim liability related to the acquisition of medical practices	$	3,682	$	—	$	3,682
Noncash dividend declared from unconsolidated joint venture	$	150	$	—	$	150
Step up basis in joint venture interest	$	83	$	—	$	83

(in thousands):	2012 As Reported (1)		Adjustments		2012 As Restated
Cash flows from operating activities
Net loss	$	(151,129)	$	(4,525)	$	(155,654)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Depreciation		53,052		(174)		52,878
Amortization		11,841		95		11,936
Deferred rent expense		1,234		—		1,234
Deferred income taxes		(2,023)		(1,006)		(3,029)
Stock-based compensation		3,257		—		3,257
Provision for doubtful accounts		16,916		—		16,916
Loss on the sale/disposal of property and equipment		748		—		748
Impairment loss		81,021		—		81,021
Early extinguishment of debt		4,473		—		4,473
Amortization of termination of interest rate swap		958		—		958
Write-off of loan costs		525		—		525
Termination of derivative interest rate swap agreements		(972)		—		(972)
Loss on fair value adjustment of noncontrolling interests-redeemable		175		—		175
Loss on foreign currency transactions		33		—		33
(Gain) loss on foreign currency derivative contracts		1,165		—		1,165
Fair value adjustment of earn-out liability		—		1,219		1,219
Amortization of debt discount		798		—		798
Amortization of loan costs		5,434		—		5,434
Equity interest in net loss of joint ventures		817		—		817
Distribution received from unconsolidated joint ventures		9		—		9
Changes in operating assets and liabilities:
Accounts receivable and other current assets		(21,578)		4,648		(16,930)
Income taxes payable		(2,121)		49		(2,072)
Inventories		639		(37)		602
Prepaid expenses		3,262		553		3,815
Accounts payable and other current liabilities		(1)		(1)		(2)
Accrued deferred compensation		1,339		—		1,339
Accrued expenses / other current liabilities		6,258		(306)		5,952
Net cash (used in) provided by operating activities		16,130		515		16,645
Cash flows from investing activities
Purchase of property and equipment		(30,676)		37		(30,639)
Acquisition of medical practices		(25,862)		1		(25,861)
Restricted cash associated with medical practice acquisitions		—		(7)		(7)
Proceeds from the sale of property and equipment		2,987		—		2,987
Loans to employees		(68)		(553)		(621)
Contribution of capital to joint venture entities		(714)		—		(714)
Purchase of noncontrolling interest - non-redeemable		(1,364)		—		(1,364)
Proceeds (payment) of foreign currency derivative contracts		(670)		—		(670)
Premiums on life insurance policies		(1,313)		—		(1,313)
Change in other assets and other liabilities		370		—		370
Net cash used in investing activities		(57,310)		(522)		(57,832)

(in thousands):	2012 As Reported (1)		Adjustments		2012 As Restated
Cash flows from financing activities
Proceeds from issuance of debt (net of original issue discount of $3.4 million and $2.3 million, respectively)		448,163		—		448,163
Principal repayments of debt		(383,344)		—		(383,344)
Repayments of finance obligation		(109)		—		(109)
Cash distributions to noncontrolling interest holders – redeemable and non-redeemable		(3,920)		—		(3,920)
Payments of notes receivable from shareholder		72		—		72
Payments of loan costs		(14,437)		—		(14,437)
Net cash provided by financing activities		46,425		—		46,425
Effect of exchange rate changes on cash and cash equivalents		(12)				(12)
Net increase in cash and cash equivalents		5,233		(7)		5,226
Cash and cash equivalents, beginning of period		10,177		(327)		9,850
Cash and cash equivalents, end of period	$	15,410	$	(334)	$	15,076
Supplemental disclosure of cash flow information
Interest paid	$	63,632	$	—	$	63,632
Income taxes paid	$	9,120	$	—	$	9,120
Supplemental disclosure of non-cash transactions
Finance obligation related to real estate projects	$	3,035	$	—	$	3,035
Capital lease obligations related to the purchase of equipment	$	7,281	$	—	$	7,281
Capital lease obligations related to the acquisition of medical practices	$	5,746	$	—	$	5,746
Earn-out accrual related to the acquisition of medical practices	$	400	$	—	$	400
Noncash dividend declared to noncontrolling interest	$	167	$	—	$	167
Property and equipment related to the North Broward Hospital District license agreement	$	4,260	$	—	$	4,260
Noncash redemption of Parent equity units	$	53	$	—	$	53

The table below summarizes the effects of the cumulative Restatement adjustments recorded to all periods prior to December 31, 2012 on previously reported retained deficit balance (in thousands):

	December 31, 2011
Accumulated deficit, as reported	$	(483,815)
Revenue recognition:
MDL revenue		(3,563)
Other revenue		564
Total revenue recognition		(2,999)
Medical malpractice		(2,112)
Restatement tax impact		1,270
Cumulative adjustments to accumulated deficit		(3,841)
Accumulated deficit, as restated	$	(487,656)