Segment And Geographic Information

6 Months Ended

Jun. 30, 2015

Segment And Geographic Information [Abstract]

Segment And Geographic Information

16. Segment and geographic information

The Company operates in one line of business, which is operating physician group practices. The Company’s operations are organized into two geographically organized groups: the U.S. Domestic operating segment and the International operating segment, which are also the reporting segments.  The accounting policies of the segments are the same as those described in the summary of significant accounting policies. Transactions between reporting segments are properly eliminated. The Company assesses performance of and makes decisions on how to allocate resources to its operating segments based on multiple factors including current and projected facility gross profit and market opportunities. Facility gross profit is defined as total revenues less cost of revenues.

Financial information by geographic segment is as follows (in thousands):

	Three Months ended June 30,				Six Months ended June 30,
	2015		2014		2015		2014
Total revenues:
U.S. Domestic	$	254,122	$	241,598	$	503,285	$	453,823
International		31,087		24,300		60,407		45,472
Total	$	285,209	$	265,898	$	563,692	$	499,295
Facility gross profit:
U.S. Domestic	$	71,635	$	69,089	$	137,240	$	124,937
International		18,094		13,435		34,934		24,857
Total	$	89,729	$	82,524	$	172,174	$	149,794
Depreciation and amortization:
U.S. Domestic	$	20,754	$	20,924	$	41,834	$	40,412
International		1,488		1,238		2,977		2,472
Total	$	22,242	$	22,162	$	44,811	$	42,884
Capital expenditures: *
U.S. Domestic					$	24,905	$	36,504
International						2,695		8,887
Total					$	27,600	$	45,391
*  includes capital lease obligations related to capital expenditures

	June 30, 2015		December 31, 2014
Total assets:
U.S. Domestic	$	993,825	$	997,136
International		153,206		149,588
Total	$	1,147,031	$	1,146,724
Property and equipment:
U.S. Domestic	$	229,166	$	239,203
International		30,899		31,554
Total	$	260,065	$	270,757
Acquisition-related goodwill and intangible assets:
U.S. Domestic	$	505,131	$	483,214
International		65,423		68,062
Total	$	570,554	$	551,276

The reconciliation of the Company’s reportable segment profit and loss is as follows (in thousands):

	Three Months ended June 30,				Six Months ended June 30,
	2015		2014		2015		2014
Facility gross profit	$	89,729	$	82,524	$	172,174	$	149,794
Less:
General and administrative expenses		43,776		34,060		72,686		64,174
General and administrative salaries		27,977		27,958		55,564		55,262
General and administrative depreciation and amortization		3,951		4,398		7,944		9,208
Provision for doubtful accounts		3,753		3,428		8,221		7,724
Interest expense, net		24,326		29,899		50,013		57,426
Impairment loss		—		182,000		—		182,000
Early extinguishment of debt		37,390		—		37,390		—
Equity IPO expenses		—		4,163		—		4,163
Fair value adjustment of noncontrolling interest and earn-out liability		2,745		204		3,205		403
Fair value adjustment of embedded derivative		5,217		—		6,559		—
Loss on sale leaseback transaction		—		—		—		135
Gain on the sale of an interest in a joint venture		—		—		—		-
Foreign currency transaction loss		(31)		79		211		107
Gain on foreign currency derivative contracts		—		—		—		(4)
Loss before income taxes	$	(59,375)	$	(203,665)	$	(69,619)	$	(230,804)