ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
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(STATE OR OTHER JURISDICTION OF INCORPORATION
OR ORGANIZATION) |
(I.R.S. EMPLOYER IDENTIFICATION NO.)
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(ADDRESS OF PRINCIPAL EXECUTIVE OFFICES)
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(ZIP CODE)
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Title of Each Class
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Trading Symbol
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Name of Each Exchange on Which Registered
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☑
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Accelerated filer
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☐
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Non-accelerated filer
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☐ (Do not check if a smaller reporting company)
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Smaller reporting company
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Emerging growth company
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DOCUMENT
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PART OF FORM 10-K
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Portions of Definitive Proxy Statement for the 2024 Annual Meeting of Shareholders
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Part III
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Page
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PART I
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Item 1.
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4
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Item 1A.
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15
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Item 1B.
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24
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Item 1C.
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24
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Item 2.
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26
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Item 3.
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26
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Item 4.
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27
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PART II
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Item 5.
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28
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Item 6.
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29
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Item 7.
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30
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Item 7A.
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46
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Item 8.
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47
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Item 9.
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86
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Item 9A.
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86
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Item 9B.
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87
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Item 9C.
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87
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PART III
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Item 10.
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87
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Item 11.
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87
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Item 12.
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87
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Item 13.
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87
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Item 14.
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87
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PART IV
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Item 15.
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87
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Item 16.
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95
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96
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• |
changes in Medicare rules and guidelines and reimbursement or failure of our clinics to maintain their Medicare certification and/or enrollment status;
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• |
revenue we receive from Medicare and Medicaid being subject to potential retroactive reduction;
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• |
changes in reimbursement rates or payment methods from third party payors including government agencies, and changes in the deductibles and co-pays owed by patients;
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• |
compliance with federal and state laws and regulations relating to the privacy of individually identifiable patient information, and associated fines and penalties for failure to comply;
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• |
competitive, economic or reimbursement conditions in our markets which may require us to reorganize or close certain clinics and thereby incur losses and/or closure costs including the possible write-down or
write-off of goodwill and other intangible assets;
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• |
the impact of future public health crises and epidemics/pandemics, such as was the case with the novel strain of COVID-19 and its variants;
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• |
one of our acquisition agreements contains a put-right related to a future purchase of a majority interest in a separate company;
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• |
the impact of future vaccinations and/or testing mandates at the federal, state and/or local level, which could have an adverse impact on staffing, revenue, costs and the results of operations;
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• |
our debt and financial obligations could adversely affect our financial condition, our ability to obtain future financing and our ability to operate our business;
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• |
changes as the result of government enacted national healthcare reform;
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• |
business and regulatory conditions including federal and state regulations;
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• |
governmental and other third party payor inspections, reviews, investigations and audits, which may result in sanctions or reputational harm and increased costs;
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• |
revenue and earnings expectations;
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• |
contingent consideration provisions in certain our acquisition agreements, the value of which may impact future financial results;
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• |
legal actions, which could subject us to increased operating costs and uninsured liabilities;
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• |
general economic conditions, including but not limited to inflationary and recessionary periods;
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• |
actual or perceived events involving banking volatility or limited liability, defaults or other adverse developments that affect the U.S or the international financial systems, may result in market wide
liquidity problems which could have a material and adverse impact on our available cash and results of operations;
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• |
our business depends on hiring, training, and retaining qualified employees;
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• |
availability and cost of qualified physical therapists;
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• |
competitive environment in the industrial injury prevention services business, which could result in the termination or non-renewal of contractual service arrangements and other adverse financial consequences
for that service line;
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• |
our ability to identify and complete acquisitions, and the successful integration of the operations of the acquired businesses;
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• |
impact on the business and cash reserves resulting from retirement or resignation of key partners and resulting purchase of their non-controlling interest (minority interests);
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• |
maintaining our information technology systems with adequate safeguards to protect against cyber-attacks;
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• |
a security breach of our or our third party vendors’ information technology systems may subject us to potential legal action and reputational harm and may result in a violation of the Health Insurance
Portability and Accountability Act of 1996 of the Health Information Technology for Economic and Clinical Health Act;
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• |
maintaining clients for which we perform management, industrial injury prevention related services, and other services, as a breach or termination of those contractual arrangements by such clients could cause
operating results to be less than expected;
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• |
maintaining adequate internal controls;
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• |
maintaining necessary insurance coverage;
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• |
availability, terms, and use of capital; and
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• |
weather and other seasonal factors.
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ITEM 1. |
BUSINESS
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% Interest
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Number of
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|||||
Acquisition
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Date
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Acquired
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Clinics
|
|||
October 2023 Acquisition
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October 31, 2023
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**
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*
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|||
September 2023 Acquisition 1
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September 29, 2023
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70%
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4
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|||
September 2023 Acquisition 2
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September 29, 2023
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70%
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1
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|||
July 2023 Acquisition
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July 31, 2023
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70%
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7
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|||
May 2023 Acquisition
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May 31, 2023
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45%
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4
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|||
February 2023 Acquisition
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February 28, 2023
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80%
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1
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|||
November 2022 Acquisition
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November 30, 2022
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80%
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13
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|||
October 2022 Acquisition
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October 31, 2022
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60%
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14
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|||
September 2022 Acquisition
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September 30, 2022
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80%
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2
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|||
August 2022 Acquisition
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August 31, 2022
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70%
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6
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|||
March 2022 Acquisition
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March 31, 2022
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70%
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6
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|||
December 2021 Acquisition
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December 31, 2021
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75%
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3
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|||
November 2021 Acquisition
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November 30, 2021
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70%
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*
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|||
September 2021 Acquisition
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September 30, 2021
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100%
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*
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|||
June 2021 Acquisition
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June 30, 2021
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65%
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8
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|||
March 2021 Acquisition
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March 31, 2021
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70%
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6
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* |
IIP business
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** |
On October 31, 2023, we concurrently acquired 100% of an IIP business and a 55% equity interest in an ergonomics software business (“October 2023 Acquisition”).
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For the Year Ended
|
||||||||||||
December 31, 2023
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December 31, 2022
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December 31, 2021
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||||||||||
Number of clinics, beginning of period
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640
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591
|
554
|
|||||||||
Additions
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46
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65
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42
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|||||||||
Closed or sold
|
(15
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)
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(16
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)
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(5
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)
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||||||
Number of clinics, end of period
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671
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640
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591
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For the Year Ended
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||||||||||||||||||||||||
December 31, 2023
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December 31, 2022
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December 31, 2021
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||||||||||||||||||||||
Net Patient
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Net Patient
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Net Patient
|
||||||||||||||||||||||
Payor
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Revenue
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Percentage
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Revenue
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Percentage
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Revenue
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Percentage
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||||||||||||||||||
Managed Care Programs/
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(In thousands, except percentages)
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|||||||||||||||||||||||
Commercial Health Insurance
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$
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244,470
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47.5
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%
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$
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215,822
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46.5
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%
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$
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209,129
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47.7
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%
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||||||||||||
Medicare/Medicaid
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188,329
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36.6
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%
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174,401
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37.5
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%
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155,122
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35.4
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%
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|||||||||||||||
Workers' Compensation Insurance
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48,834
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9.5
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%
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45,010
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9.7
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%
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44,549
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10.2
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%
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|||||||||||||||
Other
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32,923
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6.4
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%
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29,357
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6.3
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%
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29,530
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6.7
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%
|
|||||||||||||||
Total
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$
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514,556
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100.0
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%
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$
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464,590
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100.0
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%
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$
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438,330
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100.0
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%
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• |
Economic Benefits of Therapy Services – Purchasers and providers of healthcare services, such as insurance companies, health maintenance organizations, businesses, and
industries, continuously seek cost savings for traditional healthcare services. We believe that our therapy services provide a cost-effective way to prevent short-term disabilities from becoming chronic conditions, to help avoid invasive
procedures, to speed recovery from surgery and musculoskeletal injuries and eliminate or minimize the need for opioids.
|
• |
Earlier Hospital Discharge – Changes in health insurance reimbursement, both public and private, have encouraged the earlier discharge of patients to reduce costs. We
believe that early hospital discharge practices foster greater demand for outpatient physical therapy services.
|
• |
Aging Population – In general, the elderly population has a greater incidence of disability compared to the population as a whole. As this segment of the population
continues to grow, we believe that demand for rehabilitation services will expand.
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ITEM 1A. |
RISK FACTORS
|
• |
require us to maintain a quarterly fixed charge coverage ratio and minimum working capital ratio;
|
• |
limit our ability to obtain additional financing in the future for working capital, capital expenditures and acquisitions, to fund growth or for general corporate purposes;
|
• |
limit our future ability to refinance our indebtedness on terms acceptable to us or at all;
|
• |
limit our flexibility in planning for or reacting to changes in our business and market conditions or in funding our strategic growth plan; and
|
• |
impose on us financial and operational restrictions.
|
• |
facility and professional licensure/permits, including certificates of need;
|
• |
conduct of operations, including financial relationships among healthcare providers, Medicare fraud and abuse, and physician self-referral;
|
• |
addition of facilities and services; and
|
• |
coding, billing and payment for services.
|
• |
refunding amounts we have been paid pursuant to the Medicare or Medicaid programs or from managed care payors;
|
• |
state or federal agencies imposing fines, penalties and other sanctions on us;
|
• |
temporary suspension of payment for new patients to the facility or agency;
|
• |
decertification or exclusion from participation in the Medicare or Medicaid programs or one or more managed care payor networks;
|
• |
the imposition of a new Corporate Integrity Agreement;
|
• |
damage to our reputation;
|
• |
the revocation of a facility’s or agency’s license; and
|
• |
loss of certain rights under, or termination of, our contracts with managed care payors.
|
• |
the difficulty and expense of integrating acquired personnel into our business;
|
• |
the diversion of management’s time from existing operations;
|
• |
the potential loss of key employees of acquired companies;
|
• |
the difficulty of assignment and/or procurement of managed care contractual arrangements; and
|
• |
the assumption of the liabilities and exposure to unforeseen liabilities of acquired companies, including liabilities for failure to comply with healthcare regulations.
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ITEM 1B. |
UNRESOLVED STAFF COMMENTS
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ITEM 1C. |
CYBERSECURITY
|
● |
Current cybersecurity landscape and emerging threats;
|
● |
Status of ongoing cybersecurity initiatives and strategies;
|
● |
Incident reports and learnings from any cybersecurity events; and
|
● |
Compliance with regulatory requirements and industry standards.
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ITEM 2. |
PROPERTIES
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ITEM 3. |
LEGAL PROCEEDINGS
|
ITEM 4. |
MINE SAFETY DISCLOSURES
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ITEM 5.
|
MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES
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Declaration Date
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Record Date
|
Payment Date
|
Dividend Per Share
|
Aggregate Amount
(in thousands) |
||||||||
02/21/2023
|
03/10/2023
|
04/07/2023
|
$
|
0.43
|
$
|
5,617
|
||||||
05/02/2023
|
05/18/2023
|
06/09/2023
|
$
|
0.43
|
$
|
5,621
|
||||||
08/07/2023
|
08/18/2023
|
09/08/2023
|
$
|
0.43
|
$
|
6,445
|
||||||
11/06/2023
|
11/16/2023
|
12/08/2023
|
$
|
0.43
|
$
|
6,445
|
12/18
|
12/19
|
12/20
|
12/21
|
12/22
|
12/23
|
|
U. S. Physical Therapy, Inc.
|
100
|
112
|
117
|
93
|
79
|
91
|
NYSE Healthcare Index
|
100
|
119
|
132
|
161
|
155
|
159
|
ITEM 6. |
RESERVED
|
ITEM 7. |
MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
|
|
% Interest
|
Number of
|
||||
Acquisition
|
Date
|
Acquired
|
Clinics
|
|||
October 2023 Acquisition
|
October 31, 2023
|
**
|
*
|
|||
September 2023 Acquisition 1
|
September 29, 2023
|
70%
|
4
|
|||
September 2023 Acquisition 2
|
September 29, 2023
|
70%
|
1
|
|||
July 2023 Acquisition
|
July 31, 2023
|
70%
|
7
|
|||
May 2023 Acquisition
|
May 31, 2023
|
45%
|
4
|
|||
February 2023 Acquisition
|
February 28, 2023
|
80%
|
1
|
|||
November 2022 Acquisition
|
November 30, 2022
|
80%
|
13
|
|||
October 2022 Acquisition
|
October 31, 2022
|
60%
|
14
|
|||
September 2022 Acquisition
|
September 30, 2022
|
80%
|
2
|
|||
August 2022 Acquisition
|
August 31, 2022
|
70%
|
6
|
|||
March 2022 Acquisition
|
March 31, 2022
|
70%
|
6
|
|||
December 2021 Acquisition
|
December 31, 2021
|
75%
|
3
|
|||
November 2021 Acquisition
|
|
November 30, 2021
|
|
70%
|
|
*
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September 2021 Acquisition
|
|
September 30, 2021
|
|
100%
|
|
*
|
June 2021 Acquisition
|
|
June 30, 2021
|
|
65%
|
|
8
|
March 2021 Acquisition
|
|
March 31, 2021
|
|
70%
|
|
6
|
* |
IIP business
|
**
|
On October 31, 2023, we concurrently acquired 100% of an IIP business and a 55% equity interest in
an ergonomics software business (“October 2023 Acquisition”).
|
For the Year Ended
|
||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
||||||||||
Number of clinics, beginning of period
|
640
|
591
|
554
|
|||||||||
Additions
|
46
|
65
|
42
|
|||||||||
Closed or sold
|
(15
|
)
|
(16
|
)
|
(5
|
)
|
||||||
Number of clinics, end of period
|
671
|
640
|
591
|
Mature Clinics are clinics opened or acquired prior to January 1, 2022, and are still operating as of December 31, 2023.
|
Net rate per patient visit is net patient revenue related to our physical therapy operations divided by total number of
patient visits (defined below) during the periods presented.
|
Patient visits is the number of unique patient visits during the periods presented.
|
Average daily visits per clinic is patient visits divided by the number of days in which normal business operations were
conducted during the periods presented and further divided by the average number clinics in operation during the periods presented.
|
Full Year 2023 refers to the year ended December 31, 2023.
|
Full Year 2022 refers to the year ended December 31, 2022.
|
For the Year Ended
|
||||||||
December 31, 2023
|
December 31, 2022
|
|||||||
(In thousands, except per share data)
|
||||||||
Earnings per share
|
||||||||
Computation of earnings per share - USPH shareholders:
|
||||||||
Net income attributable to USPH shareholders
|
$
|
28,239
|
$
|
32,158
|
||||
Charges to retained earnings:
|
||||||||
Revaluation of redeemable non-controlling interest
|
(13,565
|
)
|
(3,890
|
)
|
||||
Tax effect at statutory rate (federal and state)
|
3,466
|
994
|
||||||
$
|
18,140
|
$
|
29,262
|
|||||
Earnings per share (basic and diluted)
|
$
|
1.28
|
$
|
2.25
|
||||
Shares used in computation - basic and diluted
|
14,188
|
12,985
|
For the Year Ended
|
||||||||
December 31, 2023
|
December 31, 2022
|
|||||||
(In thousands, except per share data)
|
||||||||
Adjusted EBITDA (a non-GAAP measure)
|
||||||||
Net income attributable to USPH shareholders
|
$
|
28,239
|
$
|
32,158
|
||||
Adjustments:
|
||||||||
Provision for income taxes
|
12,156
|
12,164
|
||||||
Depreciation and amortization
|
15,695
|
14,743
|
||||||
Interest expense, debt and other, net
|
9,303
|
5,779
|
||||||
Interest income from investments
|
(3,774
|
)
|
-
|
|||||
Impairment of goodwill and other intangible assets
|
17,495
|
9,112
|
||||||
Equity-based awards compensation expense
|
7,236
|
7,264
|
||||||
Change in revaluation of put-right liability
|
(2,582
|
)
|
5
|
|||||
Change in fair value of contingent earn-out consideration
|
1,550
|
(2,520
|
)
|
|||||
Relief Funds*
|
(467
|
)
|
-
|
|||||
Other income
|
(390
|
)
|
(859
|
)
|
||||
Allocation to non-controlling interests
|
(6,744
|
)
|
(4,185
|
)
|
||||
77,717
|
73,661
|
|||||||
Operating Results (a non-GAAP measure)
|
||||||||
Net income attributable to USPH shareholders
|
$
|
28,239
|
$
|
32,158
|
||||
Adjustments:
|
||||||||
Impairment of goodwill and other intangible assets
|
17,495
|
9,112
|
||||||
Change in fair value of contingent earn-out consideration
|
1,550
|
(2,520
|
)
|
|||||
Change in revaluation of put-right liability
|
(2,582
|
)
|
5
|
|||||
Relief Funds*
|
(467
|
)
|
-
|
|||||
Allocation to non-controlling interest
|
(5,215
|
)
|
(2,734
|
)
|
||||
Tax effect at statutory rate (federal and state)
|
(2,755
|
)
|
(987
|
)
|
||||
$
|
36,265
|
$
|
35,034
|
|||||
Operating Results per share (a non-GAAP measure)
|
$
|
2.56
|
$
|
2.70
|
For the Year Ended December 31,
|
Variance
|
|||||||||||||||||
2023
|
2022
|
$ |
|
%
|
||||||||||||||
(In thousands, except percentages)
|
||||||||||||||||||
Revenue related to:
|
||||||||||||||||||
Mature Clinics (1)
|
$
|
452,459
|
$
|
421,806
|
$
|
30,653
|
7.3
|
%
|
||||||||||
Clinic additions (2)
|
60,495
|
39,990
|
20,505
|
*
|
(6)
|
|||||||||||||
Clinics sold or closed (3)
|
1,602
|
2,794
|
(1,192
|
)
|
*
|
(6)
|
||||||||||||
Net Patient Revenue
|
514,556
|
464,590
|
49,966
|
10.8
|
%
|
|||||||||||||
Other (4)
|
11,992
|
11,502
|
490
|
4.3
|
%
|
|||||||||||||
Total
|
526,548
|
476,092
|
50,456
|
10.6
|
%
|
|||||||||||||
Operating costs (4)
|
421,484
|
380,035
|
41,449
|
10.9
|
%
|
|||||||||||||
Gross profit
|
$
|
105,064
|
$
|
96,057
|
$
|
9,007
|
9.4
|
%
|
||||||||||
Financial and operating metrics (not in thousands):
|
||||||||||||||||||
Net rate per patient visit (1)
|
$
|
102.80
|
$
|
103.63
|
$
|
(0.83
|
)
|
(0.8
|
)%
|
|||||||||
Patient visits (1)
|
5,005,426
|
4,483,282
|
522,144.0
|
11.6
|
%
|
|||||||||||||
Average daily visits per clinic (1)
|
30.0
|
28.7
|
1.3
|
4.5
|
%
|
|||||||||||||
Gross margin
|
20.0
|
%
|
20.2
|
%
|
|
|
|
|
||||||||||
Salaries and related costs per visit, clinics (5)
|
$
|
59.19
|
$
|
59.52
|
$
|
(0.33
|
)
|
(0.6
|
)%
|
|||||||||
Operating costs per visit, clinics (5)
|
$
|
82.79
|
$
|
83.34
|
$
|
(0.55
|
)
|
(0.7
|
)%
|
|||||||||
Working days
|
254
|
255
|
(1
|
)
|
(0.4
|
)%
|
||||||||||||
Number of clinics at the end of the period
|
671
|
640
|
31
|
4.8
|
%
|
(1) |
See defined terms above for definitions.
|
(2)
|
Clinic additions during the years ended 2023 and 2022.
|
(3)
|
Revenue from closed clinics includes revenues from the 15 and 16 clinics closed during the full year December 31, 2023 and 2022, respectively.
|
(4)
|
Includes revenues and costs from management contracts.
|
(5)
|
Excludes management contract costs.
|
(6)
|
Not meaningful.
|
For the Year Ended December 31,
|
||||||||
202
|
2022
|
|||||||
(In thousands, except percentages)
|
||||||||
Net revene
|
$
|
78,254
|
$
|
77,052
|
||||
Operating costs
|
61,809
|
61,085
|
||||||
Gross profit
|
$
|
16,445
|
$
|
15,967
|
||||
Gross margin
|
21.0
|
%
|
20.7
|
%
|
For the Year Ended
|
||||||||
December 31, 2023
|
December 31, 2022
|
|||||||
(In thousands, except percentages)
|
||||||||
Income before taxes
|
$
|
49,376
|
$
|
55,571
|
||||
Less: Net income attributable to non-controlling interest:
|
||||||||
Redeemable non-controlling interest - temporary equity
|
(4,426
|
)
|
(6,902
|
)
|
||||
Non-controlling interest - permanent equity
|
(4,555
|
)
|
(4,347
|
)
|
||||
$
|
(8,981
|
)
|
$
|
(11,249
|
)
|
|||
Income before taxes less net income attributable to non-controlling interest
|
$
|
40,395
|
$
|
44,322
|
||||
Provision for income taxes
|
$
|
12,156
|
$
|
12,164
|
||||
Effective income tax rate
|
30.1
|
%
|
27.4
|
%
|
Year Ended
|
||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
||||||||||
Net cash provided by operating activities
|
$
|
81,978
|
$
|
58,537
|
$
|
76,406
|
||||||
Net cash used in investing activities
|
45,015
|
81,269
|
124,136
|
|||||||||
Net cash provided by financing activities
|
84,268
|
25,759
|
43,379
|
1) |
Revolving Facility: $175 million, five-year, revolving credit facility (“Revolving Facility”), which includes a $12 million sublimit for the issuance of standby letters of credit and a $15 million sublimit for
swingline loans (each, a “Swingline Loan”).
|
2) |
Term Facility: $150 million term loan facility (the “Term Facility”). The Term Facility amortizes in quarterly installments of: (a) 0.625% in each of the first two years, (b) 1.250% in the third and fourth year,
and (c) 1.875% in the fifth year of the Credit Agreement. The remaining outstanding principal balance of all term loans is due on the maturity date.
|
Total
|
2024
|
2025
|
2026
|
2027
|
2028
|
Thereafter
|
||||||||||||||||||||||
(In thousands)
|
||||||||||||||||||||||||||||
Term facility (1)
|
$
|
144,375
|
5,625
|
7,500
|
9,375
|
$
|
121,875
|
$
|
-
|
$
|
-
|
|||||||||||||||||
Notes payable (2)
|
3,775
|
2,486
|
1,289
|
-
|
-
|
-
|
-
|
|||||||||||||||||||||
Interest expense on Term Facility and notes payable (3)
|
20,958
|
6,725
|
6,508
|
6,210
|
1,515
|
-
|
-
|
|||||||||||||||||||||
Operating leases (4)
|
144,666
|
46,845
|
36,447
|
27,406
|
18,495
|
10,025
|
5,448
|
|||||||||||||||||||||
$
|
313,774
|
$
|
61,681
|
$
|
51,744
|
$
|
42,991
|
$
|
141,885
|
$
|
10,025
|
$
|
5,448
|
ITEM 7A. |
QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
|
Reports of Independent Registered Public Accounting Firm—Grant Thornton LLP (PCAOB ID Number )
|
48 |
Audited Financial Statements:
|
|
51 | |
52 | |
53 | |
54 | |
55 | |
56 |
• |
We tested the design and operating effectiveness of controls relating to billing and cash collections, net rate trend analysis and cash collections versus net revenue trend
analysis.
|
• |
For a sample of patient visits, we inspected and compared underlying documents for each transaction, which included gross billing rates and cash collected (net revenue).
|
• |
For a sample of patient visits, we traced gross billings and net revenue to net revenue recorded in the general ledger and to each report used in determining and assessing the
contractual adjustment calculation.
|
• |
We compared cash collections to recorded net revenue over the twelve month period ended December 31, 2023 and again for the twelve month period ended in the first month
subsequent to period end, to identify whether there were unusual trends that would indicate that the usage of historical collection patterns would no longer be reasonable to predict future collection patterns.
|
• |
We tested the design and operating effectiveness of controls over management’s review of the assumptions used to project future cash flows, the selection of appropriate discount
rate, royalty rates, and valuation methodologies applied.
|
• |
We utilized valuation specialists to evaluate:
|
o |
The appropriateness of the methodologies applied,
|
o |
The reasonableness of the discount rate, royalty rates, and
|
o |
The qualifications of the third-party valuation specialist engaged by the Company based on their credentials and experience.
|
• |
We assessed the reasonableness of assumptions applied by management in their future cash flows, including revenue growth rates, EBITDA, and EBITDA margins.
|
December 31, 2023
|
December 31, 2022
|
|||||||
ASSETS
|
||||||||
Current assets:
|
||||||||
Cash and cash equivalents
|
$
|
|
$
|
|
||||
Patient accounts receivable, less provision for credit losses of $
|
|
|
||||||
Accounts receivable - other
|
|
|
||||||
Other current assets
|
|
|
||||||
Total current assets
|
|
|
||||||
Fixed assets:
|
||||||||
Furniture and equipment
|
|
|
||||||
Leasehold improvements
|
|
|
||||||
Fixed assets, gross
|
|
|
||||||
Less accumulated depreciation and amortization
|
(
|
)
|
(
|
)
|
||||
Fixed assets, net
|
|
|
||||||
Operating lease right-of-use assets
|
|
|
||||||
Investment in unconsolidated affiliate |
||||||||
Goodwill
|
|
|
||||||
Other identifiable intangible assets, net
|
|
|
||||||
Other assets
|
|
|
||||||
Total assets
|
$
|
|
$
|
|
||||
LIABILITIES, REDEEMABLE NON-CONTROLLING INTEREST, USPH
SHAREHOLDERS’ EQUITY AND NON-CONTROLLING INTEREST
|
||||||||
Current liabilities:
|
||||||||
Accounts payable - trade
|
$
|
|
$
|
|
||||
Accounts payable - due to seller of acquired business
|
||||||||
Accrued expenses
|
|
|
||||||
Current portion of operating lease liabilities
|
|
|
||||||
Current portion of term loan and notes payable
|
|
|
||||||
Total current liabilities
|
|
|
||||||
Notes payable, net of current portion
|
|
|
||||||
Revolving facility
|
|
|
||||||
Term loan, net of current portion and deferred financing costs | ||||||||
Deferred taxes
|
|
|
||||||
Operating lease liabilities, net of current portion
|
|
|
||||||
Other long-term liabilities
|
|
|
||||||
Total liabilities
|
|
|
||||||
Redeemable non-controlling interest - temporary equity
|
|
|
||||||
Commitments and Contingencies
|
||||||||
U.S. Physical Therapy, Inc. (“USPH”) shareholders’ equity: | ||||||||
Preferred stock, $
|
|
|
||||||
Common stock, $
|
|
|
||||||
Additional paid-in capital
|
|
|
||||||
Accumulated other comprehensive gain
|
||||||||
Retained earnings
|
|
|
||||||
Treasury stock at cost,
|
(
|
)
|
(
|
)
|
||||
Total USPH shareholders’ equity
|
|
|
||||||
Non-controlling interest - permanent equity
|
|
|
||||||
Total USPH shareholders’ equity and non-controlling interest - permanent equity
|
|
|
||||||
Total liabilities, redeemable non-controlling interest, USPH shareholders’ equity and
non-controlling interest - permanent equity
|
$
|
|
$
|
|
For the Year Ended
|
||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
||||||||||
Net patient revenue
|
$
|
|
$
|
|
$
|
|
||||||
Other revenue
|
|
|
|
|||||||||
Net revenue
|
|
|
|
|||||||||
Operating cost: | ||||||||||||
Salaries and related costs
|
|
|
|
|||||||||
Rent, supplies, contract labor and other
|
|
|
|
|||||||||
Provision for credit losses
|
|
|
|
|||||||||
Total operating cost
|
|
|
|
|||||||||
Gross profit
|
|
|
|
|||||||||
Corporate office costs |
||||||||||||
Impairment of goodwill and other intangible assets
|
||||||||||||
Operating income
|
|
|
|
|||||||||
Other (expense) income
|
||||||||||||
Interest expense, debt and other
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Interest income from investments
|
|
|
|
|||||||||
Change in fair value of contingent earn-out consideration
|
( |
) | ||||||||||
Change in revaluation of put-right liability
|
( |
) | ||||||||||
Equity in earnings of unconsolidated affiliate
|
|
|
|
|||||||||
Relief Funds
|
|
|
|
|||||||||
Settlement of a legal matter
|
( |
) | ||||||||||
Resolution of a payor matter
|
|
|
|
|||||||||
Other
|
||||||||||||
Total other (expense) income
|
(
|
)
|
(
|
)
|
|
|||||||
Income before taxes
|
|
|
|
|||||||||
Provision for income taxes
|
|
|
|
|||||||||
Net income
|
|
|
|
|||||||||
Less: Net income attributable to non-controlling interest:
|
||||||||||||
Redeemable non-controlling interest - temporary equity
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Non-controlling interest - permanent equity
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
(
|
)
|
(
|
)
|
(
|
)
|
|||||||
Net income attributable to USPH shareholders
|
$
|
|
$
|
|
$
|
|
||||||
Basic and diluted earnings per share attributable to USPH shareholders
|
$
|
|
$
|
|
$
|
|
||||||
Shares used in computation - basic and diluted
|
|
|
|
|||||||||
Dividends declared per common share
|
$
|
|
$
|
|
$
|
|
Year Ended | ||||||||||||
|
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
|||||||||
Net income
|
$
|
|
$
|
|
$
|
|
||||||
Other comprehensive loss
|
||||||||||||
Unrealized (loss) gain on cash flow hedge
|
(
|
)
|
|
|
||||||||
Tax effect at statutory rate (federal and state)
|
|
(
|
)
|
|
||||||||
Comprehensive income
|
$
|
|
$
|
|
$
|
|
||||||
Comprehensive income attributable to non-controlling interest
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Comprehensive income attributable to USPH shareholders
|
$
|
|
$
|
|
$
|
|
U.S. Physical Therapy, Inc. |
||||||||||||||||||||||||||||||||||||||||
Common Stock | Additional | Accumulated Other |
Retained | Treasury Stock | Total Shareholders’ | Non-Controlling | ||||||||||||||||||||||||||||||||||
Shares | Amount | Paid-In Capital | Comprehensive Gain |
Earnings | Shares | Amount | Equity | Interests | Total | |||||||||||||||||||||||||||||||
Balance January 1, 2021
|
|
$
|
|
$
|
|
$
|
|
$
|
|
(
|
)
|
$
|
(
|
)
|
$
|
|
$ | $ | ||||||||||||||||||||||
Net income attributable to USPH shareholders
|
-
|
|
|
|
-
|
|
|
|||||||||||||||||||||||||||||||||
Net income attributable to non-controlling interest - permanent equity
|
- | - | ||||||||||||||||||||||||||||||||||||||
Issuance of restricted stock, net of cancellations
|
||||||||||||||||||||||||||||||||||||||||
Revaluation of redeemable non-controlling interest
|
|
|
|
(
|
)
|
|
|
(
|
)
|
( |
) | |||||||||||||||||||||||||||||
Purchase of non-controlling interest
|
- | ( |
) | - | ( |
) | ( |
) | ( |
) | ||||||||||||||||||||||||||||||
Sale of non-controlling interest
|
- | - | ||||||||||||||||||||||||||||||||||||||
Compensation expense - equity-based awards
|
-
|
|
|
|
-
|
|
|
|||||||||||||||||||||||||||||||||
Dividends paid to USPH shareholders
|
-
|
|
|
(
|
)
|
-
|
|
(
|
)
|
( |
) | |||||||||||||||||||||||||||||
Distributions to non-controlling interest partners - permanent equity
|
-
|
|
|
|
-
|
|
|
( |
) | ( |
) | |||||||||||||||||||||||||||||
Short swing profit settlement
|
- | |||||||||||||||||||||||||||||||||||||||
Other
|
-
|
|
|
|
-
|
|
|
|||||||||||||||||||||||||||||||||
Balance December 31, 2021
|
|
$
|
|
$
|
|
$ |
$
|
|
(
|
)
|
$
|
(
|
)
|
$
|
|
$ | $ |
U.S. Physical Therapy, Inc. | ||||||||||||||||||||||||||||||||||||||||
Common Stock
|
Additional
|
Accumulated Other |
Retained
|
Treasury Stock
|
Total Shareholders’
|
Non-Controlling
|
||||||||||||||||||||||||||||||||||
Shares
|
Amount
|
Paid-In Capital | Comprehensive Gain | Earnings |
Shares
|
Amount
|
Equity | Interests | Total | |||||||||||||||||||||||||||||||
Balance January 1, 2022 | $ | $ | $ | $ | ( |
) | $ | ( |
) | $ | $ | $ | ||||||||||||||||||||||||||||
Net income attributable to USPH shareholders
|
- | - | ||||||||||||||||||||||||||||||||||||||
Net income attributable to non-controlling interest - permanent equity
|
- | - | ||||||||||||||||||||||||||||||||||||||
Issuance of restricted stock, net of cancellations
|
|
|
|
|
|
|
|
|||||||||||||||||||||||||||||||||
Revaluation of redeemable non-controlling interest
|
|
|
|
(
|
)
|
|
|
(
|
)
|
(
|
)
|
|||||||||||||||||||||||||||||
Purchase of non-controlling interest
|
- | ( |
) | - | ( |
) | ( |
) | ( |
) | ||||||||||||||||||||||||||||||
Compensation expense - equity-based awards
|
-
|
|
|
|
-
|
|
|
|||||||||||||||||||||||||||||||||
Transfer of compensation liability for certain stock
|
-
|
|
|
|
-
|
|
|
|||||||||||||||||||||||||||||||||
Dividends paid to USPH shareholders
|
-
|
|
|
(
|
)
|
-
|
|
(
|
)
|
(
|
)
|
|||||||||||||||||||||||||||||
Distributions to non-controlling interest partners - permanent equity
|
-
|
|
|
|
-
|
|
|
( |
) | ( |
) | |||||||||||||||||||||||||||||
Deferred taxes related to redeemable non-controlling interest - temporary equity
|
- | |||||||||||||||||||||||||||||||||||||||
Other comprehensive gain
|
- | |||||||||||||||||||||||||||||||||||||||
Other
|
-
|
|
|
(
|
)
|
-
|
|
|
|
|||||||||||||||||||||||||||||||
Balance December 31, 2022
|
|
$
|
|
$
|
|
$ |
$
|
|
(
|
)
|
$
|
(
|
)
|
$
|
|
$ | $ |
U.S. Physical Therapy, Inc. | ||||||||||||||||||||||||||||||||||||||||
Common Stock
|
Additional
|
Accumulated Other
|
Retained |
Treasury Stock
|
Total Shareholders’
|
Non-Controlling
|
||||||||||||||||||||||||||||||||||
Shares
|
Amount
|
Paid-In Capital | Comprehensive Loss |
Earnings
|
Shares
|
Amount
|
Equity | Interests | Total |
|||||||||||||||||||||||||||||||
Balance January 1, 2023 | $ | $ | $ | $ | ( |
) | $ | ( |
) | $ | $ | $ | ||||||||||||||||||||||||||||
Net income attributable to USPH shareholders
|
- | - | ||||||||||||||||||||||||||||||||||||||
Net income attributable to non-controlling interest - permanent equity
|
- | - | ||||||||||||||||||||||||||||||||||||||
Issuance of restricted stock, net of cancellations
|
|
|
|
|
|
|
|
|||||||||||||||||||||||||||||||||
Issuance of common stock, pursuant to the secondary public offering, net of issuance costs
|
||||||||||||||||||||||||||||||||||||||||
Revaluation of redeemable non-controlling interest
|
|
|
|
(
|
)
|
|
|
(
|
)
|
( |
) | |||||||||||||||||||||||||||||
Compensation expense - equity-based awards
|
-
|
|
|
|
-
|
|
|
|||||||||||||||||||||||||||||||||
Sale of non-controlling interest | - | - | ||||||||||||||||||||||||||||||||||||||
Purchase of partnership interests - non-controlling interest
|
- | ( |
) | - | ( |
) | ( |
) | ( |
) | ||||||||||||||||||||||||||||||
Dividends payable to USPH shareholders
|
-
|
|
|
(
|
)
|
-
|
|
(
|
)
|
( |
) | |||||||||||||||||||||||||||||
Distributions to non-controlling interest partners - permanent equity
|
-
|
|
|
|
-
|
|
|
( |
) | ( |
) | |||||||||||||||||||||||||||||
Deferred taxes related to redeeemable non-controlling interest - temporary equity
|
- | |||||||||||||||||||||||||||||||||||||||
Other comprehensive loss |
- | ( |
) | ( |
) | ( |
) | ( |
) | |||||||||||||||||||||||||||||||
Other |
- | ( |
) | - | ( |
) | ( |
) | ||||||||||||||||||||||||||||||||
Balance December 31, 2023
|
|
$
|
|
$
|
|
$ |
$
|
|
(
|
)
|
$
|
(
|
)
|
$
|
|
$ | $ |
Year Ended
|
||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
||||||||||
OPERATING ACTIVITIES
|
||||||||||||
Net income including non-controlling interest
|
$
|
|
$
|
|
$
|
|
||||||
Adjustments to reconcile net income including non-controlling interest to net cash provided by
operating activities:
|
||||||||||||
Depreciation and amortization
|
|
|
|
|||||||||
Provision for credit losses
|
|
|
|
|||||||||
Equity-based awards compensation expense
|
|
|
|
|||||||||
Amortization of debt issue costs
|
|
|
|
|||||||||
Change in deferred income taxes
|
|
|
|
|||||||||
Change in revaluation of put-right liability
|
( |
) | ||||||||||
Change in fair value of contingent earn-out consideration
|
( |
) | ||||||||||
Equity of earnings in unconsolidated affiliate
|
( |
) | ( |
) | ( |
) | ||||||
Loss (gain) on sale of clinics and fixed assets
|
( |
) | ||||||||||
Impairment of goodwill and other intangible assets
|
||||||||||||
Other
|
|
(
|
)
|
(
|
)
|
|||||||
Changes in operating assets and liabilities:
|
||||||||||||
Increase in patient accounts receivable
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Increase in accounts receivable - other
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Increase (decrease) in other current and long term assets
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Decrease (increase) in accounts payable and accrued expenses
|
|
(
|
)
|
|
||||||||
Decrease (increase) in other long-term liabilities
|
|
|
(
|
)
|
||||||||
Net cash provided by operating activities
|
|
|
|
|||||||||
INVESTING ACTIVITIES
|
||||||||||||
Purchase of fixed assets
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Purchase of majority interest in businesses, net of cash acquired
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Purchase of redeemable non-controlling interest, temporary equity
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Purchase of non controlling interest, permanent equity
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Proceeds on sale of non-controlling interest, permanent equity
|
||||||||||||
Proceeds on sale of partnership interest - redeemable non-controlling interest, temporary equity
|
|
|
|
|||||||||
Distributions from unconsolidated affiliate
|
||||||||||||
Proceeds on sale of partnership interest, clinics and fixed assets
|
||||||||||||
Other
|
||||||||||||
Net cash used in investing activities
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
FINANCING ACTIVITIES
|
||||||||||||
Proceeds from issuance of common stock pursuant to the secondary public offering, net of issuance costs
|
||||||||||||
Proceeds from revolving facility
|
||||||||||||
Distributions to non-controlling interest, permanent and temporary equity
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Cash dividends paid to shareholders
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Payments on revolving facility
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Principal payments on notes payable
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Payments on term loan
|
( |
) | ( |
) | ||||||||
Proceeds from term loan
|
||||||||||||
Payment of deferred financing costs
|
( |
) | ||||||||||
Payment of Medicare Accelerated and Advance Funds
|
|
|
(
|
)
|
||||||||
Other
|
|
|
|
|||||||||
Net cash provided by financing activities
|
|
|
|
|||||||||
Net increase in cash and cash equivalents
|
|
|
(
|
)
|
||||||||
Cash and cash equivalents - beginning of period
|
|
|
|
|||||||||
Cash and cash equivalents - end of period
|
$
|
|
$
|
|
$
|
|
||||||
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION
|
||||||||||||
Cash paid during the period for:
|
||||||||||||
Income taxes
|
$
|
|
$
|
|
$
|
|
||||||
Interest paid
|
$
|
|
$
|
|
$
|
|
||||||
Non-cash investing and financing transactions during the period:
|
||||||||||||
Purchase of businesses - seller financing portion
|
$
|
|
$
|
|
$
|
|
||||||
Liabilities assumed associated with a purchase of a business
|
$ | $ | $ | |||||||||
Notes payable related to purchase of redeemable non-controlling interest, temporary equity
|
$
|
|
$
|
|
$
|
|
||||||
Notes payable related to the purchase of non-controlling interest, permanent equity
|
$
|
|
$
|
|
$
|
|
||||||
Notes receivable related to sale of redeemable non-controlling interest, temporary equity
|
$
|
|
$
|
|
$
|
|
||||||
Notes receivable related to the sale of non-controlling interest, permanent equity
|
$
|
|
$
|
|
$
|
|
% Interest | Number of | |||||
Acquisition | Date | Acquired | Clinics | |||
October 2023 Acquisition | |
|||||
September 2023 Acquisition 1 | ||||||
September 2023 Acquisition 2 | ||||||
July 2023 Acquisition | ||||||
May 2023 Acquisition | ||||||
February 2023 Acquisition | ||||||
November 2022 Acquisition
|
||||||
October 2022 Acquisition
|
||||||
September 2022 Acquisition
|
||||||
August 2022 Acquisition
|
||||||
March 2022 Acquisition
|
||||||
December 2021 Acquisition
|
|
|
|
|
|
|
November 2021 Acquisition
|
|
|
|
|
|
|
September 2021 Acquisition
|
|
|
|
|
|
|
June 2021 Acquisition
|
|
|
|
|
|
|
March 2021 Acquisition
|
|
|
|
|
|
|
* |
|
** | |
•
|
Level 1 – Quoted prices in active markets for identical assets or liabilities.
|
•
|
Level 2 – Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly.
|
•
|
Level 3 – Unobservable inputs based on the Company’s own assumptions.
|
For the Year Ended
|
||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
||||||||||
|
(In thousands, except per share data) | |||||||||||
Computation of earnings per share - USPH shareholders: | ||||||||||||
Net income attributable to USPH shareholders
|
$
|
|
$
|
|
$
|
|
||||||
Charges to retained earnings:
|
||||||||||||
Revaluation of redeemable non-controlling interest
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Tax effect at statutory rate (federal and state)
|
|
|
|
|||||||||
$
|
|
$
|
|
$
|
|
|||||||
Earnings per share (basic and diluted)
|
$
|
|
$
|
|
$
|
|
||||||
Shares used in computation:
|
||||||||||||
Basic and diluted earnings per share - weighted-average shares
|
|
|
|
|
|
% Interest
|
Number of
|
|||||||
Acquisition
|
Date
|
Acquired
|
Clinics
|
|||||||
October 2023 Acquisition
|
|
|
|
|||||||
September 2023 Acquisition1
|
|
|
|
|
||||||
September 2023 Acquisition2
|
|
|
|
|
||||||
July 2023 Acquisition
|
|
|
|
|
||||||
May 2023 Acquisition
|
|
|
|
|
||||||
February 2023 Acquisition
|
|
|
|
|
* |
IIP business
|
** |
On October 31,
2023, the Company concurrently acquired
|
For the Year Ended December 31, 2023
|
||||||||||||
Physical Therapy
|
||||||||||||
IIP
|
Operations
|
Total
|
||||||||||
(In thousands)
|
||||||||||||
Cash paid, net of cash acquired
|
$
|
|
$
|
|
$
|
|
||||||
Seller note
|
|
|
|
|||||||||
Deferred payments
|
|
|
|
|||||||||
Contingent payments
|
|
|
|
|||||||||
Total consideration
|
$
|
|
$
|
|
$
|
|
||||||
|
||||||||||||
Estimated fair value of net tangible assets acquired:
|
||||||||||||
Total current assets
|
$
|
|
$
|
|
$
|
|
||||||
Total non-current assets
|
|
|
|
|||||||||
Total liabilities
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Net tangible assets acquired
|
|
|
|
|||||||||
Customer and referral relationships
|
|
|
|
|||||||||
Non-compete agreement
|
|
|
|
|||||||||
Tradenames
|
|
|
|
|||||||||
Goodwill
|
|
|
|
|||||||||
Fair value of non-controlling interest (classified as redeemable non-controlling interest)
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
$
|
|
$
|
|
$
|
|
|
|
% Interest
|
Number of
|
|||||||
Acquisition
|
Date
|
Acquired
|
Clinics
|
|||||||
November 2022 Acquisition
|
|
|
|
|
||||||
October 2022 Acquisition
|
|
|
|
|
||||||
September 2022 Acquisition
|
|
|
|
|
||||||
August 2022 Acquisition
|
|
|
|
|
||||||
March 2022 Acquisition
|
|
|
|
|
Physical Therapy | ||||
Operations
|
||||
(In thousands) |
||||
Cash paid, net of cash acquired
|
$
|
|
||
Seller notes
|
|
|||
Contingent payments
|
|
|||
Total consideration
|
$
|
|
||
Estimated fair value of net tangible assets acquired:
|
||||
Total current assets
|
$
|
|
||
Total non-current assets
|
|
|||
Total liabilities
|
(
|
)
|
||
Net tangible assets acquired
|
(
|
)
|
||
Customer and referral relationships
|
|
|||
Non-compete agreements
|
|
|||
Tradenames
|
|
|||
Goodwill
|
|
|||
Fair value of non-controlling interest (classified as redeemable non-controlling interest)
|
(
|
)
|
||
$
|
|
% Interest |
Number of | |||||||||
Acquisition | Date | Acquired | Clinics |
|||||||
December 2021 Acquisition | ||||||||||
November 2021 Acquisition
|
|
|
|
|
||||||
September 2021 Acquisition
|
|
|
|
|
||||||
June 2021 Acquisition
|
|
|
|
|
||||||
March 2021 Acquisition |
* |
IIP business
|
Physical Therapy
|
|
|||||||||||
IIP | Operations | Total | ||||||||||
(In thousands) | (In thousands) | (In thousands) |
||||||||||
Cash paid, net of cash acquired
|
$
|
|
$
|
|
$
|
|
||||||
Seller notes
|
|
|
|
|||||||||
Contingent payments
|
||||||||||||
Other payable
|
||||||||||||
Seller put right
|
|
|
||||||||||
Total consideration
|
$
|
|
$
|
|
$
|
|
||||||
|
||||||||||||
Estimated fair value of net tangible assets acquired:
|
||||||||||||
Total current assets
|
$
|
|
$
|
|
$
|
|
||||||
Total non-current assets
|
|
|
|
|||||||||
Total liabilities
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Net tangible assets acquired
|
|
|
|
|
|
|
||||||
Customer and referral relationships
|
|
|
|
|||||||||
Non-compete agreements
|
|
|
|
|||||||||
Tradenames
|
|
|
|
|||||||||
Goodwill
|
|
|
|
|||||||||
Fair value of non-controlling interest (classified as redeemable non-controlling interest)
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
$
|
|
$
|
|
$
|
|
1. |
Prior to the Acquisition, the Therapy Practice exists as a separate legal entity (the “Seller Entity”). The Seller Entity is owned by one
or more individuals (the “Selling Shareholders”) most of whom are physical therapists that work in the Acquired Therapy Practice and provide physical therapy services to patients.
|
2. |
In conjunction with the Acquisition, the Seller Entity contributes the acquired Therapy Practice into a newly-formed limited partnership
(“NewCo”), in exchange for one hundred percent (
|
3. | The Company enters into an agreement (the “Purchase Agreement”) to acquire from the Seller Entity a majority (ranges from |
4. |
The Company and the Seller Entity also execute a partnership agreement (the “Partnership Agreement”) for NewCo that sets forth the rights
and obligations of the limited and general partners of NewCo. After the Acquisition, the Company is the general partner of NewCo.
|
5. |
As noted above, the Company does not purchase 100% of the limited partnership interests in NewCo and the Seller Entity retains a portion
of the limited partnership interest in NewCo (“Seller Entity Interest”).
|
6. |
In most cases, some or all of the Selling Shareholders enter into an employment agreement (the “Employment Agreement”) with NewCo with an
initial term that ranges from
to |
7. |
The compensation of each Employed Selling Shareholder is specified in the Employment Agreement and is customary and commensurate with his
or her responsibilities based on other employees in similar capacities within NewCo, the Company and the industry.
|
8. |
The Company and the Selling Shareholder (including both Employed Selling Shareholders and Selling Shareholders not employed by NewCo)
execute a non-compete agreement (the “Non-Compete Agreement”) which restricts the Selling Shareholder from engaging in competing Therapy Practice activities for a specified period of time (the “Non-Compete Term”). A Non-Compete Agreement is
executed with the Selling Shareholders in all cases. That is, even if the Selling Shareholder does not become an Employed Selling Shareholder, the Selling Shareholder is restricted from engaging in a competing Therapy Practice during the
Non-Compete Term.
|
9. |
The Non-Compete Term commences as of the date of the Acquisition and expires on the later of:
|
a. |
|
b. |
|
10. |
The Non-Compete Agreement applies to a restricted region which is defined as a mileage radius from the Acquired Therapy Practice. That is,
an Employed Selling Shareholder is permitted to engage in competing Therapy Practices or activities outside the designated geography (after such Employed Selling Shareholder no longer is employed by NewCo) and a Selling Shareholder who is
not employed by NewCo immediately is permitted to engage in the competing Therapy Practice or activities outside the designated geography.
The Partnership Agreement contains provisions for the redemption of the Seller Entity Interest, either at the option of the Company (the
“Call Right”) or at the option of the Seller Entity (the “Put Right”) as follows:
|
1. |
Put Right
|
a. |
In the event that any Selling Shareholder’s employment is terminated under certain circumstances prior to the fifth anniversary of the
Closing Date, the Seller Entity thereafter may have an irrevocable right to cause the Company to purchase from Seller Entity the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest at the purchase price
described in “3” below.
|
b. |
In the event that any Selling Shareholder is not employed by NewCo as of the fifth anniversary of the Closing Date and the Company has not
exercised its Call Right with respect to the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest, Seller Entity thereafter has the Put Right to cause the Company to purchase from Seller Entity the Terminated
Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest at the purchase price described in “3” below.
|
c.
|
In the event that any Selling Shareholder’s employment with NewCo is terminated for any reason on or after the fifth anniversary of
the Closing Date, the Seller Entity has the Put Right, and upon the exercise of the Put Right, the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest shall be redeemed by the Company at the purchase price
described in “3” below.
|
2. |
Call Right
|
a. |
If any Selling Shareholder’s employment by NewCo is terminated prior to the fifth anniversary of the Closing Date, the Company thereafter
has an irrevocable right to purchase from Seller Entity the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest, in each case at the purchase price described in “3” below.
|
b. |
In the event that any Selling Shareholder’s employment with NewCo is terminated for any reason on or after the fifth anniversary of the
Closing Date, the Company has the Call Right, and upon the exercise of the Call Right, the Terminated Selling Shareholder’s Allocable Percentage of Seller Entity’s Interest shall be redeemed by the Company at the purchase price described in
“3” below.
|
3. |
For the Put Right and the Call Right, the purchase price is derived from a formula based on a specified multiple of NewCo’s trailing
twelve months of earnings before interest, taxes, depreciation, amortization, and the Company’s internal management fee, plus an Allocable Percentage of any undistributed earnings of NewCo (the “Redemption Amount”). NewCo’s earnings are
distributed monthly based on available cash within NewCo; therefore, the undistributed earnings amount is small, if any.
|
4. |
The Purchase Price for the initial equity interest purchased by the Company is also based on the same specified multiple of the trailing
twelve-month earnings that is used in the Put Right and the Call Right noted above.
|
5. |
The Put Right and the Call Right do not have an expiration date.
|
6. |
The Put Right and the Call Right never apply to Selling Shareholders who do not become employed by NewCo, since the Company requires that
such Selling Shareholders sell their entire ownership interest in the Seller Entity at the closing of the Acquisition.
An Employed Selling Shareholder’s ownership of his or her equity interest in the Seller Entity predates the Acquisition and the Company’s
purchase of its partnership interest in NewCo. The Employment Agreement and the Non-Compete Agreement do not contain any provision to escrow or “claw back” the equity interest in the Seller Entity held by such Employed Selling Shareholder,
nor the Seller Entity Interest in NewCo, in the event of a breach of the employment or non-compete terms. More specifically, even if the Employed Selling Shareholder is terminated for “cause” by NewCo, such Employed Selling Shareholder does
not forfeit his or her right to his or her full equity interest in the Seller Entity and the Seller Entity does not forfeit its right to any portion of the Seller Entity Interest. The Company’s only recourse against the Employed Selling
Shareholder for breach of either the Employment Agreement or the Non-Compete Agreement is to seek damages and other legal remedies under such agreements. There are no conditions in any of the arrangements with an Employed Selling
Shareholder that would result in a forfeiture of the equity interest held in the Seller Entity or of the Seller Entity Interest.
|
1. |
Prior to the acquisition, the Progressive Subsidiaries were owned by a legal entity (“Progressive Parent”) controlled by its
individual owners (the “Progressive Selling Shareholders”), who work in and manage the Progressive business.
|
2. |
In conjunction with the acquisition, the Progressive Selling Shareholders caused the Progressive Parent to transfer its ownership of
the Progressive Subsidiaries into a newly-formed limited liability company (“Progressive NewCo”), in exchange for one hundred percent (
|
3. |
The Company entered into an agreement (the “Progressive Purchase Agreement”) to acquire from the Progressive Selling Shareholders a
majority of the membership interest in Progressive NewCo. The consideration for the acquisition is primarily payable in the form of cash at closing, a relatively small portion paid in cash after the closing contingent on certain
performance criteria, and a small note in lieu of an escrow (the “Progressive Purchase Price”).
|
4. |
The Company and the Progressive Selling Shareholders also executed an operating agreement (the “Progressive Operating Agreement”) for
Progressive NewCo that sets forth the rights and obligations of the members of Progressive NewCo.
|
5. |
As noted above, the Company did not purchase
|
6. |
The Company and the Progressive Selling Shareholders executed a non-compete agreement (the “Progressive Non-Compete Agreement”) which
restricts the Progressive Selling Shareholders from competing for a specified period of time (the “Progressive Non-Compete Term”).
|
7. |
The Progressive Non-Compete Term commences as of the date of the closing of the Progressive acquisition (the “Progressive Closing
Date”) and expires on the later of:
|
a. |
|
b. |
|
8. |
The Progressive Non-Compete Agreement applies to the entire United States.
|
9. |
The Progressive Put Right (as defined below) and the Progressive Call Right (as defined below) do not have an expiration date. The
Progressive Operating Agreement contains provisions for the redemption of the Progressive Selling Shareholder’s Interest, either at the option of the Company (the “Progressive Call Right”) or at the option of the Progressive Selling
Shareholder (the “Progressive Put Right”) as follows:
|
1. |
Progressive Put Right
|
a.
|
Each of the Progressive Selling Shareholders has the right to sell
|
b. |
In the event that any Progressive Selling Shareholder terminates his management relationship with Progressive NewCo for any reason on
or after the seventh anniversary of the Closing Date, the Progressive Selling Shareholder has the Progressive Put Right, and upon the exercise of the Progressive Put Right, the Progressive Selling Shareholder’s Interest shall be
redeemed by the Company at the purchase price described in “3” below.
|
2. |
Progressive Call Right
|
a. |
If any Progressive Selling Shareholder’s ceases to perform management services on behalf of Progressive NewCo, the Company thereafter
shall have an irrevocable right to purchase from such Progressive Selling Shareholder his Interest, in each case at the purchase price described in “3” below.
|
3. |
For the Progressive Put Right and the Progressive Call Right, the purchase price is derived from a formula based on a specified
multiple of Progressive NewCo’s trailing twelve months of earnings before interest, taxes, depreciation, amortization, and the Company’s internal management fee, plus an Allocable Percentage of any undistributed earnings of Progressive
NewCo (the “Progressive Redemption Amount”). Progressive NewCo’s earnings are distributed monthly based on available cash within Progressive NewCo; therefore, the undistributed earnings amount is small, if any.
|
4. |
The Progressive Purchase Price for the initial equity interest purchased by the Company is also based on the same specified multiple
of the trailing twelve-month earnings that is used in the Progressive Put Right and the Progressive Call Right noted above.
|
5. |
The Progressive Put Right and the Progressive Call Right do not have an expiration date.
|
For the Year Ended
|
||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
||||||||||
(In thousands) | ||||||||||||
Beginning balance
|
$
|
|
$
|
|
$
|
|
||||||
Net income allocated to redeemable non-controlling interest
|
|
|
|
|||||||||
Distributions to redeemable non-controlling interest partners
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Changes in the fair value of redeemable non-controlling interest
|
|
|
|
|||||||||
Purchases of redeemable non-controlling interest
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Acquired interest
|
|
|
|
|||||||||
Contributed capital
|
|
|
||||||||||
Sales of redeemable non-controlling interest
|
|
|
|
|||||||||
Changes in notes receivable related to redeemable non-controlling interest
|
(
|
)
|
(
|
)
|
(
|
)
|
||||||
Adjustments in notes receivables related to the sales of redeemable non-controlling interest
|
|
|
|
|||||||||
Ending balance
|
$
|
|
$
|
|
$
|
|
As of the Year Ended | ||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
||||||||||
(In thousands) | ||||||||||||
Contractual time period has lapsed but holder’s employment has not terminated
|
$
|
|
$
|
|
$
|
|
||||||
Contractual time period has not lapsed and holder’s employment has not terminated
|
|
|
|
|||||||||
Holder’s employment has terminated and contractual time period has expired
|
|
|
|
|||||||||
Holder’s employment has terminated and contractual time period has not expired
|
|
|
|
|||||||||
$
|
|
$
|
|
$
|
|
For the Year Ended
|
||||||||
December 31, 2023 | December 31, 2022 | |||||||
(In thousands) | ||||||||
Beginning balance
|
$
|
|
$
|
|
||||
Acquisitions
|
|
|
||||||
Adjustments for purchase price allocation of businesses acquired in prior year
|
|
(
|
)
|
|||||
Impairment of goodwill
|
( |
) | ( |
) | ||||
Ending balance
|
$
|
|
$
|
|
As of the Year Ended
|
||||||||||||||||||||||||
December 31, 2023 | December 31, 2022 | |||||||||||||||||||||||
Gross
Amount
|
Accumulated
Amortization
|
Net Carrying
Amount
|
Gross
Amount
|
Accumulated
Amortization
|
Net Carrying
Amount
|
|||||||||||||||||||
(In thousands)
|
||||||||||||||||||||||||
Customer and referral relationships
|
$
|
|
$
|
(
|
)
|
$
|
|
$
|
|
$
|
(
|
)
|
$
|
|
||||||||||
Tradenames
|
|
|
|
|
|
|
||||||||||||||||||
Non-compete agreements
|
|
(
|
)
|
|
|
(
|
)
|
|
||||||||||||||||
$
|
|
$
|
(
|
)
|
$
|
|
$
|
|
$
|
(
|
)
|
$
|
|
For the Year Ended | ||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
||||||||||
(In thousands)
|
||||||||||||
Customer and referral relationships
|
$
|
|
$
|
|
$
|
|
||||||
Non-compete agreements
|
|
|
|
|||||||||
|
$
|
|
$
|
|
$
|
|
For the Year Ended December 31,
|
Customer and
Referral Relationships
|
Non-Compete
Agreements
|
||||||
(In thousands)
|
||||||||
2024
|
$
|
|
$
|
|
||||
2025
|
|
|
||||||
2026
|
|
|
||||||
2027
|
|
|
||||||
2028
|
|
|
||||||
Thereafter
|
$
|
|
$
|
|
As of the Year Ended |
||||||||
December 31, 2023
|
December 31, 2022
|
|||||||
(In thousands) |
||||||||
Salaries and related costs
|
$
|
|
$
|
|
||||
Credit balances due to patients and payors
|
|
|
||||||
Group health insurance claims
|
|
|
||||||
Federal income taxes payable
|
|
|
||||||
Contingency payable
|
|
|
||||||
Other property taxes payable |
||||||||
Interest payable |
||||||||
Closure costs
|
||||||||
Other
|
|
|
||||||
|
$
|
|
$
|
|
As of the Year Ended |
||||||||||||||||||||||||
December 31, 2023 |
December 31, 2022 |
|||||||||||||||||||||||
Principal
Amount
|
Unamortized Debt
Issuance Cost
|
Net Debt
|
Principal
Amount
|
|
|
Unamortized Debt
Issuance Cost
|
|
|
Net Debt
|
|||||||||||||||
(In thousands) | ||||||||||||||||||||||||
Term Facility
|
$
|
|
$
|
(
|
)
|
$
|
|
$
|
|
$
|
(
|
)
|
$
|
|
||||||||||
Revolving Facilitiy
|
|
|
|
|
|
|
||||||||||||||||||
Other (1)
|
|
|
|
|
|
|
||||||||||||||||||
Total debt
|
|
|
|
(
|
)
|
|
|
|
|
|
(
|
)
|
|
|
||||||||||
Less: Current portion of long-term
debt
|
|
(
|
)
|
|
|
(
|
)
|
|
||||||||||||||||
Long-term debt, net of current portion
|
$
|
|
$
|
(
|
)
|
$
|
|
$
|
|
$
|
(
|
)
|
$
|
|
1)
|
Revolving Facility: $ |
2)
|
Term Facility: $
|
For the Year Ended |
||||||||
December 31, 2023 | December 31, 2022 | |||||||
(In thousands) |
||||||||
Net income
|
$
|
|
$
|
|
||||
Other comprehensive (loss) gain
|
||||||||
Unrealized (loss) gain on cash flow hedge
|
(
|
)
|
|
|||||
Tax effect at statutory rate (federal and state)
|
|
(
|
)
|
|||||
Comprehensive income
|
$
|
|
$
|
|
||||
Comprehensive income attributable to non-controlling interest
|
(
|
)
|
(
|
)
|
||||
Comprehensive income attributable to USPH shareholders
|
|
|
As of the Year Ended |
||||||||
December 31, 2023
|
December 31, 2022
|
|||||||
(In thousands) |
||||||||
Other current assets
|
$
|
|
$
|
|
||||
Other assets
|
$
|
|
$ | |||||
For the Year Ended
|
||||||||||||
December 31, 2023 |
December 31, 2022
|
December 31, 2021
|
||||||||||
(In thousands) | ||||||||||||
Operating lease cost
|
$ |
$
|
|
$
|
|
|||||||
Short-term lease cost
|
|
|
||||||||||
Variable lease cost
|
|
|
||||||||||
Total lease cost*
|
$ |
$
|
|
$
|
|
*
|
|
For the Year Ended
|
||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021 | ||||||||||
(In thousands) | ||||||||||||
Cash paid for amounts included in the measurement of operating lease liabilities
|
$ |
$
|
|
$
|
|
|||||||
Right-of-use assets obtained in exchange for new operating lease liabilities
|
$ |
$
|
|
$
|
|
Fiscal Year
|
Amount
(In thousands)
|
|||
2024 |
$
|
|||
2025 |
||||
2026 |
||||
2027 |
||||
2028 and thereafter
|
||||
Total lease payments
|
$
|
|||
Less: imputed interest
|
||||
Total operating lease liabilities
|
$
|
As of the Year Ended
|
||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021 |
||||||||||
Weighted-average remaining lease term
|
||||||||||||
Weighted-average discount rate
|
% | % | % |
As of the Year Ended |
||||||||
December 31, 2023
|
December 31, 2022
|
|||||||
(In thousands) |
||||||||
Deferred tax assets:
|
||||||||
Compensation
|
$
|
|
$
|
|
||||
Allowance for credit losses
|
|
|
||||||
Lease obligations - including closed clinics
|
|
|
||||||
Deferred tax assets
|
$
|
|
$
|
|
||||
Deferred tax liabilities:
|
||||||||
Depreciation and amortization
|
$
|
(
|
)
|
$
|
(
|
)
|
||
Operating lease right-of-use assets
|
(
|
)
|
(
|
)
|
||||
Gain on cash flow hedge
|
( |
) | ( |
) | ||||
Change in revaluation of put-right liability
|
( |
) | ||||||
Other
|
(
|
)
|
(
|
)
|
||||
Deferred tax liabilities
|
(
|
)
|
(
|
)
|
||||
Net deferred tax liabilities
|
$
|
(
|
)
|
$
|
(
|
)
|
For the Year Ended |
||||||||||||||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021 | ||||||||||||||||||||||
(In Thousands) |
||||||||||||||||||||||||
U. S. tax at statutory rate
|
$
|
|
|
%
|
$
|
|
|
%
|
$
|
|
|
%
|
||||||||||||
State income taxes, net of federal benefit
|
|
|
%
|
|
|
%
|
|
|
%
|
|||||||||||||||
Shortfall (excess) equity compensation deduction
|
|
|
%
|
|
|
%
|
(
|
)
|
-
|
%
|
||||||||||||||
Non-deductible expenses
|
|
|
%
|
|
|
%
|
|
|
%
|
|||||||||||||||
Return to provision adjustments
|
% | % | % | |||||||||||||||||||||
$
|
|
|
%
|
$
|
|
|
%
|
$
|
|
|
%
|
For the Year Ended |
||||||||||||
December 31, 2023
|
December 31, 2022
|
December 31, 2021
|
||||||||||
(In Thousands) |
||||||||||||
Current:
|
||||||||||||
Federal
|
$
|
|
$
|
(
|
)
|
$
|
|
|||||
State
|
|
|
|
|||||||||
Total current
|
|
(
|
)
|
|
||||||||
Deferred:
|
||||||||||||
Federal
|
|
|
|
|||||||||
State
|
|
|
|
|||||||||
Total deferred
|
|
|
|
|||||||||
Total income tax provision
|
$
|
|
$
|
|
$
|
|
For the Year Ended December 31, | ||||||||||||
2023
|
2022
|
2021
|
||||||||||
(In thousands)
|
||||||||||||
Net revenue:
|
||||||||||||
Physical therapy operations
|
$
|
|
$
|
|
$
|
|
||||||
Industrial injury prevention services
|
|
|
|
|||||||||
Total Company
|
$
|
|
$
|
|
$
|
|
||||||
Operating Costs: | ||||||||||||
Salaries and related costs:
|
||||||||||||
Physical therapy operations
|
$ | $ | $ | |||||||||
Industrial injury prevention services
|
||||||||||||
Total salaries and related costs
|
$ | $ | $ | |||||||||
Rent supplies, contract labor
and other:
|
||||||||||||
Physical therapy operations
|
$ | $ | $ | |||||||||
Industrial injury prevention services
|
||||||||||||
Total rent, supplies, contract labor and other
|
$ | $ | $ | |||||||||
Provision for credit losses:
|
||||||||||||
Physical therapy operations
|
$ | $ | $ | |||||||||
Industrial injury prevention services
|
||||||||||||
Total provision for credit losses
|
$ | $ | $ | |||||||||
Total Company | $ | $ | $ | |||||||||
Gross profit:
|
||||||||||||
Physical therapy operations
|
$
|
|
$
|
|
$
|
|
||||||
Industrial injury prevention services
|
|
|
|
|||||||||
Total Company
|
$
|
|
$
|
|
$
|
|
||||||
|
||||||||||||
Total Assets:
|
||||||||||||
Physical therapy operations
|
$
|
|
$
|
|
$
|
|
||||||
Industrial injury prevention services
|
|
|
|
|||||||||
Total Company
|
$
|
|
$
|
|
$
|
|
|
|
Weighted Average Fair
|
||||||
Year Granted | Number of Shares | Value Per Share | ||||||
2023
|
|
$
|
|
|||||
2022
|
|
$
|
|
|||||
2021
|
|
$
|
|
|
|
Weighted Average Fair
|
||||||
Year Cancelled | Number of Shares | Value Per Share | ||||||
2023
|
|
$
|
|
|||||
2022
|
|
$
|
|
|||||
2021
|
|
$
|
|
ITEM 9. |
CHANGES IN DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE
|
• |
Pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the Company;
|
• |
Provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that our receipts and
expenditures are being made only in accordance with authorizations of the Company’s management and directors; and
|
• |
Provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of the Company’s assets that could have a material effect on the financial statements.
|
ITEM 9C. |
DISCLOSURE REGARDING FOREIGN JURISDICATIONS THAT PREVENT INSPECTION
|
ITEM 10. |
DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE
|
ITEM 11. |
EXECUTIVE COMPENSATION
|
ITEM 12. |
SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMEMNT AND RELATED STOCKHOLDER MATTERS
|
ITEM 13. |
CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE
|
ITEM 14. |
PRINCIPAL ACCOUNTANT FEES AND SERVICES
|
ITEM 15. |
EXHIBITS AND FINANCIAL STATEMENT SCHEDULES
|
1. |
Financial Statements
|
2. |
Financial Statement Schedules
|
3. |
Exhibits
|
Number
|
|
Description
|
Underwriting Agreement, dated May 24, 2023, by and between U.S. Physical Therapy, and BofA Securities, Inc. and J.P. Morgan Securities LLC., as
representatives of the several underwriters named therein. [incorporated by reference to Exhibit 1.1 to the Company’s Current Report on Form 8-K filed with the SEC on May 25, 2023.]
|
||
|
Articles of Incorporation of the Company [filed as an exhibit to the Company’s Form 10-Q for the quarterly period ended June 30, 2001 and incorporated herein by reference].
|
|
|
||
|
Amendment to the Articles of Incorporation of the Company [filed as an exhibit to the Company’s Form 10-Q for the quarterly period ended June 30, 2001 and incorporated herein by reference].
|
|
|
||
3.3
|
|
Bylaws of the Company, as amended [filed as an exhibit to the Company’s Form 10-KSB for the year ended December 31, 1993 and incorporated herein by reference—Commission File Number—1-11151].
|
|
||
|
Description of Company Securities [filed herewith the Company’s Form 10-K for the year ended December 31, 2019 filed with the SEC on February 28, 2020.]
|
|
|
||
|
1999 Employee Stock Option Plan (as amended and restated May 20, 2008) [incorporated by reference to Appendix A to the Company’s Definitive Proxy Statement on Schedule 14A, filed with the SEC on April 17, 2008].
|
|
|
||
|
U.S. Physical Therapy, Inc. 2003 Stock Incentive Plan, (as amended and restated effective March 26, 2016) [incorporated herein by reference to Appendix A to the Company's Definitive Proxy Statement on Schedule
14A filed with the SEC on April 7, 2016.]
|
|
|
First Amendment to U.S. Physical Therapy, Inc. 2003 Stock Incentive Plan, (as amended and restated effective March 26, 2016) effective on March 1, 2022 [incorporated herein by reference to Appendix A to the
Company's Definitive Proxy Statement on Schedule 14A filed with the SEC on April 4, 2022.]
|
|
|
Form of Restricted Stock Agreement [incorporated by reference to Exhibit 10.5 to the Company’s Current Report on Form 8-K filed with the SEC on March 16, 2016].
|
Number
|
|
Description
|
|
||
|
Objective Long-Term Incentive Plan for Senior Management [incorporated by reference to Exhibit 99.1 to the Company’s Current Report on Form 8-K filed with the SEC on March 8, 2019.]
|
|
|
||
|
Discretionary Long-Term Incentive Plan for Senior Management [incorporated by reference to Exhibit 99.2 to the Company’s Current Report on Form 8-K filed with the SEC on March 8, 2019.]
|
|
|
||
|
Third Amended and Restated Employment Agreement by and between the Company and Christopher J. Reading dated effective May 21, 2019 [incorporated by reference to Exhibit 10.1 to the Company’s Current Report on
Form 8-K filed with the SEC on May 22, 2019]
|
Number
|
|
Description
|
|
||
|
Amended & Restated Employment Agreement commencing by and between the Company and Graham Reeve dated effective May 21, 2019 [incorporated by reference to Exhibit 10.4 to the Company’s Current Report on Form
8-K filed with the SEC on March 22, 2019]
|
|
|
||
|
Form of Restricted Stock Agreement [incorporated by reference to Exhibit 10.5 to the Company’s Current Report on Form 8-K filed with the SEC on March 22, 2019]
|
|
|
||
|
U. S. Physical Therapy, Inc. Objective Long-Term Incentive Plan for Senior Management for 2020, effective March 3, 2020 [incorporated by reference to Exhibit 99.1 to the Company Current Report on Form 8-K filed
with the SEC on March 6, 2020].
|
|
|
Amendment to Employment Agreement entered into as of March 26, 2020 by and between the Company and Christopher Reading [incorporated by reference to Exhibit 10.3 to the Company Current Report on Form 8-K filed
with the SEC on March 26, 2020].
|
|
|
||
|
Amendment to Employment Agreement entered into as of March 26, 2020 by and between the Company and Graham Reeve [incorporated by reference to Exhibit 10.4 to the Company Current Report on Form 8-K filed with the
SEC on March 26, 2020].
|
|
|
||
|
Employment Agreement by and between the Company and Eric Williams entered into on December 3, 2020 and commencing as of July 1, 2021 [filed by reference to Exhibit 10.1 to the Company Current Report on Form 8-K
filed with the SEC on December 7, 2020.]
|
|
|
||
U. S. Physical Therapy, Inc. Objective Long-Term Incentive Plan for Senior Management for 2021, effective March 17, 2021 [incorporated by reference to Exhibit 99.1 of the Current Report on Form 8-K filed by U.S.
Physical Therapy, Inc. on March 16, 2021]
|
||
U. S. Physical Therapy, Inc. Discretionary Long-Term Incentive Plan for Senior Management for 2021, effective March 17, 2021 [incorporated by reference to Exhibit 99.2 of the Current Report on Form 8-K filed by
U.S. Physical Therapy, Inc. on March 16, 2021]
|
||
Third Amended and Restated Credit Agreement dated as of June 17, 2022 among the Company, as the borrower, and Bank of America, N.A., as Administrative Agent, Regions Capital Markets as Syndication Agent, BofA
Securities Inc. and Regions Capital Markets as Joint Load Arrangers, BofA Securities Inc., as Sole Bookrunner and the lenders named therein. [incorporated by reference to Exhibit 10.1 to the Company's Current Report on Form 10-Q filed
with the SEC on June 21, 2022]
|
||
Employment Agreement by and between the Company and Rick Binstein entered into on March 23, 2022 [incorporated by reference to Exhibit 10.1 to the Company Current Report
on Form 8-K filed with the SEC on March 23, 2022]
|
||
U. S. Physical Therapy, Inc. Objective Long-Term Incentive Plan for Senior Management for 2022, effective March 14, 2022 [incorporated by reference to Exhibit 99.1 of the Current Report on Form 8-K filed by U.S.
Physical Therapy, Inc. on March 14, 2022]
|
||
U. S. Physical Therapy, Inc. Discretionary Long-Term Incentive Plan for Senior Management for 2022, effective March 14, 2022 [incorporated by reference to Exhibit 99.2 of the Current Report on Form 8-K filed by
U.S. Physical Therapy, Inc. on March 14, 2022]
|
||
U. S. Physical Therapy, Inc. Objective Cash/RSA Bonus Plan for Senior Management for 2022, effective March 14, 2022 [incorporated by reference to Exhibit 99.3 of the Current Report on Form 8-K filed by U.S.
Physical Therapy, Inc. on March 14, 2022]
|
U. S. Physical Therapy, Inc. Discretionary Cash/RSA Bonus Plan for Senior Management for 2022, effective March 14, 2022 [incorporated by reference to Exhibit 99.4 of the Current Report on Form 8-K filed by U.S.
Physical Therapy, Inc. on March 14, 2022]
|
U. S. Physical Therapy, Inc. Objective Long-Term Incentive Plan for Senior Management for 2023, effective March 2, 2023 [incorporated by reference to Exhibit 99.1 of the Current Report on Form 8-K filed by U.S.
Physical Therapy, Inc. on March 8, 2023]
|
||
U. S. Physical Therapy, Inc. Discretionary Long-Term Incentive Plan for Senior Management for 2023, effective March 2, 2023 [incorporated by reference to Exhibit 99.2 of the Current Report on Form 8-K filed by
U.S. Physical Therapy, Inc. on March 8, 2023]
|
||
U. S. Physical Therapy, Inc. Objective Cash/RSA Bonus Plan for Senior Management for 2023, effective March 2, 2023 [incorporated by reference to Exhibit 99.3 of the Current Report on Form 8-K filed by U.S.
Physical Therapy, Inc. on March 8, 2023]
|
||
U. S. Physical Therapy, Inc. Discretionary Cash/RSA Bonus Plan for Senior Management for 2023, effective March 2, 2023 [incorporated by reference to Exhibit 99.4 of the Current Report on Form 8-K filed by U.S.
Physical Therapy, Inc. on March 8, 2023]
|
||
|
Employment Agreement entered into as of November 9, 2020 by and between U.S. Physical Therapy and Carey Hendrickson [incorporated by reference to Exhibit 10.1 to the Company Current Report on Form 8-K filed with
the SEC on September 23, 2020.]
|
Number
|
|
Description
|
|
Subsidiaries of the Registrant
|
|
|
||
|
Consent of Independent Registered Public Accounting Firm—Grant Thornton LLP
|
|
|
||
|
Certification of Chief Executive Officer pursuant to Rule 13a-14(a) of the Securities Exchange Act of 1934, as amended
|
|
|
||
|
Certification of Chief Financial Officer pursuant to Rule 13a-14(a) of the Securities Exchange Act of 1934, as amended
|
|
|
||
|
Certification of Periodic Report of the Chief Executive Officer and Chief Financial Officer pursuant to Rule 13a-14(b) of the Securities Exchange Act of 1934, as amended, and 18 U.S.C. Section 1350, as adopted
pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
|
|
|
||
|
U.S. Physical Therapy Compensation Clawback Policy
|
|
101.INS*
|
|
XBRL Instance Document
|
|
||
101.SCH*
|
|
XBRL Taxonomy Extension Schema Document
|
|
||
101.CAL*
|
|
XBRL Taxonomy Extension Calculation Linkbase Document
|
|
||
101.DEF*
|
|
XBRL Taxonomy Extension Definition Linkbase Document
|
|
||
101.LAB*
|
|
XBRL Taxonomy Extension Label Linkbase Document
|
|
||
101.PRE*
|
|
XBRL Taxonomy Extension Presentation Linkbase Document
|
* |
Filed herewith
|
+ |
Management contract or compensatory plan or arrangement.
|
Balance at
Beginning of Period
|
Additions Charged
to Costs and Expenses
|
Additions Charged
to Other Accounts
|
Deductions
|
Balance at
End of Period
|
||||||||||||||||
YEAR ENDED DECEMBER 31, 2023:
|
||||||||||||||||||||
Reserves and allowances deducted from asset accounts:
|
||||||||||||||||||||
Allowance for credit losses(1)
|
$
|
|
$
|
|
|
$
|
|
(2)
|
$
|
|
||||||||||
YEAR ENDED DECEMBER 31, 2022:
|
||||||||||||||||||||
Reserves and allowances deducted from asset accounts:
|
||||||||||||||||||||
Allowance for credit losses
|
$
|
|
$
|
|
|
$
|
|
(2)
|
$
|
|
||||||||||
YEAR ENDED DECEMBER 31, 2021:
|
||||||||||||||||||||
Reserves and allowances deducted from asset accounts:
|
||||||||||||||||||||
Allowance for credit losses
|
$
|
|
$
|
|
|
$
|
|
(2)
|
$
|
|
(1) |
|
(2) |
|
* |
All other schedules are omitted because of the absence of conditions under which they are required or because the required information is
shown in the financial statements or notes thereto.
|
ITEM 16. |
FORM 10-K SUMMARY
|
U.S. PHYSICAL THERAPY, INC.
|
||
(Registrant)
|
||
By:
|
/s/ Carey Hendrickson
|
|
Carey Hendrickson
Chief Financial Officer
|
||
(Principal Financial Officer and Principal Accounting Officer)
|
/s/ Carey Hendrickson
|
Chief Financial Officer
(Principal Financial Officer and Principal Accounting Officer)
|
February 29, 2024
|
Carey Hendrickson |
/s/ Chris J. Reading
|
Chief Executive Officer, President and Director
(Principal Executive Officer)
|
February 29, 2024
|
Chris J. Reading
|
||
/s/ Edward L. Kuntz
|
Chairman of the Board
|
February 29, 2024
|
Edward L. Kuntz
|
||
/s/ Bernard A. Harris
|
Director
|
February 29, 2024
|
Dr. Bernard A. Harris, Jr.
|
||
/s/ Kathleen A. Gilmartin
|
Director
|
February 29, 2024
|
Kathleen A. Gilmartin
|
||
/s/ Anne Motsenbocker
|
Director
|
February 29, 2024
|
Anne Motsenbocker
|
||
/s/ Reginald E. Swanson
|
Director
|
February 29, 2024
|
Reginald E. Swanson
|
||
/s/ Clayton K. Trier
|
Director
|
February 29, 2024
|
Clayton K. Trier
|
/s/ Nancy J. Ham
|
Director
|
February 29, 2024
|
Nancy J. Ham
|
Notes
|
Name
|
DBA
|
Entity Type
|
State of Formation
|
Date of Formation
|
Foreign Qualification
|
General Partner (LP)/BOD (corp)/Manging Member or Board of Managers (LLC)
|
Tax ID
|
|
1 On 1 Physical Therapy, LLC
|
|
LLC
|
DE
|
1/13/2022
|
|
|
|
|
2037953 Ontario, Inc.
|
|
Corp
|
Canada
|
|
|
Briotix Health, LP
|
|
|
Ability Health PT Management GP, LLC
|
|
LLC
|
TX
|
|
FL
|
Rehab Partners #4, Inc.
|
81-4216526
|
|
Ability Health Services and Rehabilitation, L.P.
|
Ability Rehabilitation SST Rehab
|
LP
|
TX
|
|
FL
|
Ability Health PT Management GP, LLC
|
38-4017532
|
|
Achieve Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc
|
47-3291851
|
|
Achieve Physical Therapy and Performance, Limited Partnership
|
|
LP
|
TX
|
|
|
Achieve Management GP, LLC
|
47-3283941
|
|
Action Therapy Centers, Limited Partnership
|
Action Physical Therapy
Houston Hand Therapy PT Professionals |
LP
|
TX
|
|
|
Rehab Partners #1, Inc.
|
76-0389610
|
|
Adams County Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
PA
|
Rehab Partners #5, Inc.
|
76-0483100
|
|
Advance Rehabilitation & Consulting, Limited Partnership
|
|
LP
|
TX
|
|
AL, FL & GA
|
Advance Rehabilitation Management GP, LLC
|
27-4414647
|
|
Advance Rehabilitation Management GP, LLC
|
|
LLC
|
TX
|
|
FL
|
Rehab Partners #4, Inc
|
27-4414443
|
|
Agape Physical Therapy & Sports Rehabilitation, Limited Partnership
|
|
LP
|
TX
|
|
MD
|
Agape Physical Therapy Management GP, LLC
|
32-0378859
|
|
Agape Physical Therapy Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc
|
45-5378415
|
|
Agility Spine & Sports PT Management GP LLC
|
|
LLC
|
TX
|
|
|
|
82-1024870
|
|
Agility Spine & Sports Physical Therapy and Rehabilitation, Limited Partnership
|
|
LP
|
TX
|
|
AZ
|
Agility Spine & Sports PT Management GP, LLC
|
82-0901134
|
|
ARC Iowa PT Plus, LLC
|
|
LLC
|
TX
|
|
IA
|
ARC PT Management GP, LLC (note: owned 100% by ARC Physical Therapy Plus, LP)
|
82-5241308
|
|
ARC Physical Therapy Plus, Limited Partnership
|
|
LP
|
TX
|
|
IA, KS, MO
|
ARC PT Management GP, LLC
|
80-0955852
|
|
ARC PT Management GP, LLC
|
|
LLC
|
TX
|
|
MO
|
Rehab Partners #4, Inc.
|
46-3942987
|
|
ARCH Physical Therapy and Sports Medicine, Limited Partnership
|
|
LP
|
TX
|
|
MI
|
Rehab Partners #1, Inc.
|
27-5086288
|
|
Arrow Physical Therapy, Limited Partnership
|
Broken Arrow Physical Therapy
|
LP
|
TX
|
|
OK
|
Rehab Partners #2, Inc.
|
76-0631992
|
|
Arrowhead Physical Therapy, Limited Partnership
|
Elite Sports Medicine & Physical Therapy
|
LP
|
TX
|
|
MS
|
Rehab Partners #2, Inc.
|
26-0176798
|
|
Ashland Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
OR
|
Rehab Partners #6, Inc.
|
75-3054977
|
|
Atlas PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
93-2148037
|
|
Atlas Physical Therapy , Limited Partnership
|
|
LP
|
CO
|
|
|
Atlas PT Management GP, LLC
|
93-2689010
|
|
Audubon Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
LA
|
Rehab Partners #6, Inc.
|
76-0622471
|
|
Barren Ridge Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
VA
|
Rehab Partners #6, Inc.
|
26-3594831
|
|
Bayside Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc
|
27-4348787
|
|
Bayside Physical Therapy & Sports Rehabilitation, Limited Partnership
|
|
LP
|
TX
|
|
MD
|
Bayside Management GP, LLC
|
27-4348871
|
|
Beaufort Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
NC
|
Rehab Partners #3, Inc.
|
76-0639928
|
|
Bow Physical Therapy & Spine Center, Limited Partnership
|
|
LP
|
TX
|
|
NH
|
Rehab Partners #6, Inc.
|
76-0623486
|
|
Brazos Valley Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
|
Rehab Partners #3, Inc.
|
76-0407118
|
|
Brick Hand & Rehabilitative Services, Limited Partnership
|
|
LP
|
TX
|
|
NJ
|
Rehab Partners #3, Inc.
|
76-0420711
|
|
Briotix Health, Limited Partnership
|
InSite Health (6/25/2020 - Per Cyndi M. and Leon P. this dba is no longer used).
|
LP
|
DE
|
|
AL, AZ, CA, CO, CT, FL, GA, HI, IL, IA, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NV, NJ, NY, NC, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI
|
Briotix Management GP, LLC
|
81-1190407
|
|
Briotix Management GP, LLC
|
|
LLC
|
TX
|
|
FL, MA, OH, UT
|
|
81-1200727
|
|
BTE Workforce Solutions, LLC (formerly BTE Technoligies, Inc.)
|
|
LLC
|
DE
|
|
AK, AL,CO, DC, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MO,MS, MT, NC, ND, NE, NH, NJ, NM, NV, OK, PA, RI, SC, SD, TN, TX, UT, VT,
WI, WV, WY
|
Briotix Health, LP
|
52-1165956
|
|
C. Foster Physical Therapists, Limited Partnership
|
|
LP
|
TX
|
|
|
C. Foster PT Management GP, LLC
|
36-4965660
|
|
C. Foster PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
35-2689219
|
|
Cape Cod Hand Therapy, Limited Partnership
|
Cape Cod Hand & Upper Extremity Therapy
|
LP
|
TX
|
|
MA
|
Rehab Partners #1, Inc.
|
27-0058293
|
|
Carbon County Therapy, LLC
|
|
LLC
|
WY
|
|
|
Fremont Therapy Group, Limited Partnership
|
85-2336515
|
|
Carolina Physical Therapy and Sports Medicine, Limited Partnership
|
|
LP
|
TX
|
|
SC
|
Carolina PT Management GP, LLC
|
82-1408170
|
|
Carolina PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
|
82-1453799
|
|
Center for Physical Rehabilitation and Therapy, Limited Partnership
|
|
LP
|
DE
|
|
MI
|
CPR Management GP, LLC
|
47-4006118
|
|
Cleveland Physical Therapy, Ltd.
|
|
LP
|
TX
|
|
|
Rehab Partners #2, Inc.
|
76-0410649
|
|
Clinical Partnership Solutions, LLC
|
ProgressiveHealth Clinical Partnership Solutions
|
LLC
|
IN
|
|
|
|
27-3006735
|
|
Clinical Management Solutions, LLC
|
ProgressiveHealth Clinical Management Solutions
|
LLC
|
IN
|
|
KY
|
|
38-3975536
|
|
Comprehensive Hand & Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
FL
|
Rehab Partners #2, Inc.
|
76-0452158
|
|
Coppell Spine & Sports Rehab, Limited Partnership
|
North Davis/Keller Physical Therapy Physical Therapy of Colleyville
Physical Therapy of North Texas Physical Therapy of Corinth Trinity Sports & Physical Therapy Physical Therapy of Flower Mound Southlake Physical Therapy Physical Therapy of Trophy Club Heritage Trace Physical Therapy Therapy Partners of Frisco/Little Elm Therapy Partners of North Texas |
LP
|
TX
|
|
|
Rehab Partners #5, Inc.
|
76-0513962
|
|
CPR Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
47-3434985
|
|
Cross Creek Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
MS
|
Rehab Partners #4, Inc.
|
35-2185612
|
|
Crossroads Physical Therapy, Limited Partnership
|
Green Oaks Physical Therapy - Fort Worth Green Oaks Physical Therapy
|
LP
|
TX
|
|
|
Rehab Partners #1, Inc.
|
76-0551398
|
|
Crossroads Rehabilitation, Limited Partnership
|
Crossroads Physical Therapy
|
LP
|
TX
|
|
MI
|
Rehab Partners #1, Inc.
|
84-1658419
|
|
Custom Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
NV
|
Rehab Partners #4, Inc.
|
04-3708931
|
|
Cutting Edge Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
IN
|
Rehab Partners #4, Inc.
|
20-4069256
|
|
Dearborn Physical Therapy, Ltd.
|
Advanced Physical Therapy
|
LP
|
TX
|
|
MI
|
Rehab Partners #1, Inc.
|
76-0376595
|
|
Decatur Hand and Physical Therapy Specialists, Limited Partnership
|
|
LP
|
TX
|
|
GA
|
Rehab Partners #4, Inc.
|
20-3319149
|
|
Dekalb Comprehensive Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
GA
|
Rehab Partners #4, Inc.
|
20-3631634
|
|
Denali Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
AK
|
Rehab Partners #5, Inc.
|
20-8666329
|
|
DHT Hand Therapy, Limited Partnership
|
Arizona Desert Hand Therapy Services Desert Hand and Physical Therapy
|
LP
|
TX
|
|
AZ
|
DHT Management GP, LLC
|
20-5881475
|
|
DHT Management GP, LLC
|
|
LLC
|
TX
|
|
AZ
|
Rehab Partners #4, Inc
|
20-5881418
|
|
Dynamic Hand Therapy & Rehabilitation, Limited Partnership
|
|
LP
|
TX
|
|
IL
|
Rehab Partners #4, Inc.
|
20-8847486
|
|
Eastgate Physical Therapy, Limited Partnership
|
Summit Physical Therapy
|
LP
|
TX
|
|
OH
|
Rehab Partners #4, Inc.
|
76-0637484
|
|
Edge Physical Therapy, Limited Partnership
|
River's Edge Physical Therapy
|
LP
|
TX
|
|
MT
|
Rehab Partners #3, Inc.
|
76-0473771
|
|
Elite PT Management GP, LLC
|
|
LLC
|
TX
|
11/28/2022
|
|
Rehab Partners #4, Inc
|
92-1227794
|
|
Elite Spine and Sports Physical Therapy, LP
|
|
LP
|
TX
|
|
PA
|
|
92-1300829
|
|
Enhanced Physiotherapy and Performance, LLC
|
Enhanced Physical Therapy
|
LLC
|
TX
|
1/25/2022
|
TN
|
STAR Physical Therapy, LP
|
87-4738491
|
|
Enid Therapy Center, Limited Partnership
|
Enid Physical Therapy
|
LP
|
TX
|
|
OK
|
Rehab Partners #2, Inc.
|
76-0384228
|
|
Everett Management, LLC
|
|
LLC
|
WA
|
|
|
U.S. Physical Therapy, Ltd.
|
37-1776322
|
|
Evergreen Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
MI
|
Rehab Partners #1, Inc.
|
20-8613843
|
|
Excel Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
AK
|
Excel PT Texas GP, LLC
|
20-3951569
|
|
Excel PT Texas GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #6, Inc.
|
20-3951532
|
|
Excel Orthopedic PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
88-2873165
|
|
Excel Orthopedic Physical Therapy, Limited Partnership
|
Excel Physical Therapy
|
LP
|
TX
|
|
MT
|
Excel Orthopedic PT Management GP, LLC
|
88-2946955
|
|
Fit2WRK, Inc.
|
|
Corp
|
TX
|
|
|
U.S. Physical Therapy, Inc.
|
27-1647054
|
|
Five Rivers Therapy Services, Limited Partnership
|
Peak Physical Therapy
|
LP
|
TX
|
|
AR
|
Rehab Partners #3, Inc.
|
20-3785604
|
|
Flannery Physical Therapy, Limited Partnership
|
Physical Therapy Plus
|
LP
|
TX
|
|
NJ
|
Rehab Partners #3, Inc.
|
76-0580514
|
|
Fredericksburg Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
|
Rehab Partners #1, Inc.
|
20-3589445
|
|
Fremont PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
|
85-4237359
|
|
Fremont Therapy Group, Limited Partnership
|
|
LP
|
TX
|
|
UT, WY
|
Fremont PT Management GP, LLC
|
86-1249211
|
|
Frisco Physical Therapy, Limited Partnership
|
PT of Prosper
|
LP
|
TX
|
|
|
Rehab Partners #1, Inc.
|
76-0625171
|
|
Gahanna Physical Therapy, Limited Partnership
|
Cornerstone Physical Therapy
|
LP
|
TX
|
|
OH
|
Rehab Partners #4, Inc.
|
27-0643842
|
|
Genesee Valley Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
MI
|
Rehab Partners #1, Inc.
|
26-2299603
|
|
Green Oaks Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
|
Rehab Partners #1, Inc.
|
72-1531238
|
|
Hamilton Physical Therapy Services, LP
|
|
LP
|
TX
|
|
NJ
|
HPTS Management GP, LLC
|
74-3145890
|
|
Hands-On Sports Medicine, Limited Partnership
|
Metro Spine and Sports Rehabilitation
|
LP
|
TX
|
|
IL
|
Rehab Partners #4, Inc.
|
20-3300800
|
|
Hanoun Medical, Inc.
|
BTE Workforce Solutions Briotix Health
|
Corp
|
Ontario, Canada
|
|
British Columbia
|
2037053 Ontario, Inc. (owned by Briotix Health, LP)
|
|
|
Harbor Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
MD
|
Rehab Partners #6, Inc.
|
20-3303737
|
|
HH Rehab Associates, Inc.
|
Genesee Valley Physical Therapy
Theramax Physical Therapy |
Corp
|
MI
|
|
DE
|
U.S. PT - Michigan, Inc.
|
38-2427228
|
|
High Plains Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
WY
|
Rehab Partners #4, Inc.
|
41-2060941
|
|
Highlands Physical Therapy & Sports Medicine, Limited Partnership
|
|
LP
|
TX
|
|
NJ
|
Rehab Partners #3, Inc.
|
27-3126287
|
|
Horizon Rehabilitation PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
USPT, Ltd.
|
87-3158670
|
|
Horizon Rehabilitation and Sports Medicine, Limited Partnership
|
|
LP
|
TX
|
|
SC
|
Horizon Rehabilitation PT Management GP, LLC
|
87-3221050
|
|
Houston On Demand Physical Therapy, LLC
|
|
LLC
|
TX
|
|
|
Kingwood Physical Therapy, Ltd.
|
85-3267403
|
|
HPTS Management GP, LLC
|
|
LLC
|
TX
|
|
NJ
|
Rehab Partners #3, Inc.
|
74-3145888
|
|
Indy ProCare Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
IN
|
Rehab Partners #4, Inc.
|
45-4419567
|
|
Integrated Rehab PT Management GP, LLC
|
|
LLC
|
TX
|
8/1/2022
|
|
Rehab Partners #4, Inc.
|
88-3566334
|
|
Integrated Rehabilitation Services, Limited Partnership
|
|
LP
|
TX
|
8/10/2022
|
|
Integrated Rehab PT Management GP, LLC
|
88-3692263
|
|
Integrius, LLC
|
|
LLC
|
GA
|
|
|
|
46-4689092
|
To be dissolved
|
InSite Health Limited Partnership
|
|
LP
|
DE
|
|
|
IH GP, LLC
|
82-4365153
|
|
Intermountain Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
ID
|
Rehab Partners #6, Inc.
|
76-0532873
|
|
Jackson Clinics PT Management GP , LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
46-4470249
|
|
Jackson Clinics, Limited Partnership
|
|
LP
|
TX
|
|
MD, VA
|
Jackson Clinics PT Management GP, LLC
|
61-1729833
|
|
Jaco Rehab Honolulu Management GP, LLC
|
|
LLC
|
TX
|
|
|
|
84-3191941
|
|
Jaco Kapolei Management GP, LLC
|
|
LLC
|
TX
|
|
|
|
84-3152468
|
|
Jaco Mililani Management GP LLC
|
|
LLC
|
TX
|
|
|
|
84-3167120
|
|
Jaco Waikele Management GP LLC
|
|
LLC
|
TX
|
|
|
|
84-3176419
|
|
Jaco Rehab Honolulu, Limited Partnership
|
|
LP
|
TX
|
|
HI
|
Jaco Rehab Honolulu Management GP, LLC
|
84-3255422
|
|
Jaco Rehab Kapolei, Limited Partnership
|
|
LP
|
TX
|
|
HI
|
Jaco Kapolei Management GP, LLC
|
84-3236943
|
|
Jaco Rehab Mililani, Limited Partnership
|
|
LP
|
TX
|
|
|
Jaco Mililani Management GP, LLC
|
84-3206751
|
|
Jaco Rehab Waikele, Limited Partnership
|
|
LP
|
TX
|
|
HI
|
Jaco Waikele Management GP, LLC
|
84-3226914
|
|
Joan Ostermeier Physical Therapy, Limited Partnership
|
Sport & Spine Clinic of Wittenberg
|
LP
|
TX
|
|
WI
|
Rehab Partners #1, Inc.
|
76-0556793
|
|
Julie Emond Physical Therapy, Limited Partnership
|
Maple Valley Physical Therapy
|
LP
|
TX
|
|
VT
|
Rehab Partners #5, Inc.
|
76-0544267
|
|
Kelly Lynch Physical Therapy, Limited Partnership
|
Sport & Spine Clinic of Watertown
|
LP
|
TX
|
|
WI
|
Rehab Partners #1, Inc.
|
76-0559026
|
|
Kennebec Physical Therapy, LLC
|
|
LLC
|
TX
|
|
ME
|
U.S. Physical Therapy, Ltd.
|
46-4456545
|
|
Kingwood Physical Therapy, Ltd.
|
Spring-Klein Physical Therapy West Woodlands Physical Therapy Lake Conroe Sports Medicine and Rehabilitation Cypress Oaks Physical Therapy Star
Therapy Services of Fairfield; Grand Oaks Sports Medicine and Rehabilitation Star Therapy Services of Lakewood
|
LP
|
TX
|
|
|
Rehab Partners #2, Inc.
|
76-0384227
|
|
Lake Houston Physical Therapy, Limited Partnership
|
Northern Oaks Orthopedic & Sports PT
|
LP
|
TX
|
|
|
Rehab Partners #1, Inc.
|
75-3050296
|
|
Leader Physical Therapy, Limited Partnership
|
Memphis Physical Therapy
|
LP
|
TX
|
|
TN
|
Rehab Partners #4, Inc.
|
76-0539465
|
Withdraw PA
|
Life Fitness Physical Therapy, LLC
|
In Balance Physical Therapy Herbst Physical Therapy
|
LLC
|
MD
|
|
PA
|
U.S. Physical Therapy, Ltd.
|
20-1193079
|
|
Life Strides Physical Therapy and Rehabilitation, Limited Partnership
|
|
LP
|
TX
|
|
SC
|
Rehab Partners #2, Inc.
|
20-5120914
|
|
LiveWell Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
|
Rehab Partners #5, Inc.
|
26-3700763
|
|
Madden and Gilbert PT GP, LLC
|
|
LLC
|
TX
|
1/7/2022
|
|
OPTN, LLC
|
87-4640726
|
|
Madden and Gilbert Physical Therapy, LP
|
|
LP
|
TX
|
1/20/2022
|
MD
|
Madden and Gilbert PT GP, LLC
|
87-4672389
|
|
Madison Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
NJ
|
MSPT Management GP, LLC
|
27-2047964
|
|
Madison Spine, Limited Partnership
|
|
LP
|
TX
|
|
NJ
|
MSPT Management GP, LLC
|
90-0813058
|
|
Max Motion Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
AZ
|
Rehab Partners #3, Inc.
|
26-3988733
|
|
Merrill Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
WI
|
Rehab Partners #1, Inc.
|
76-0512097
|
|
Mishock Physical Therapy, Limited Partnership
|
Xcelerate Physical Therapy
|
LP
|
TX
|
|
PA
|
Mishock PT Management GP, LLC
|
30-0783139
|
|
Mishock PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
46-2793533
|
|
Mission Rehabilitation and Sports Medicine, Limited Partnership
|
RYKE Rehabilitation
|
LP
|
TX
|
|
|
RYKE Management GP, LLC
|
26-3747839
|
|
Mobile Spine and Rehabilitation, Limited Partnership
|
|
LP
|
TX
|
|
AL
|
Rehab Partners #6, Inc.
|
76-0600186
|
|
Momentum Physical & Sports Rehabilitation, L.P.
|
Momentum Physical Therapy & Sports Rehab; Momentum On-Demand; Momentum Mobile PT; Momentum Physical Therapy
|
LP
|
TX
|
|
FL, CO, AZ
|
Rehab Partners #10, LLC
|
47-2388509
|
|
Mountain View Physical Therapy, Limited Partnership
|
Mountain View Physical and Hand Therapy
|
LP
|
TX
|
|
OR
|
Rehab Partners #6, Inc.
|
76-0528482
|
|
MSPT Management GP, LLC
|
|
LLC
|
TX
|
|
NJ
|
Rehab Partners #4, Inc
|
27-2047906
|
|
National Rehab Delaware, Inc.
|
|
Corp
|
DE
|
|
MO
|
National Rehab GP, Inc.
|
74-2899827
|
shows tax clearance
|
National Rehab GP, Inc.
|
|
Corp
|
TX
|
|
FL,MO
|
U.S. PT - Delaware, Inc.
|
76-0345539
|
|
National Rehab Management GP, Inc.
|
|
Corp
|
TX
|
|
IL, OH
|
U.S. PT - Delaware, Inc.
|
76-0345543
|
|
New Horizons Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
IN
|
Rehab Partners #4, Inc.
|
20-2729857
|
|
Norman Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
OK
|
Rehab Partners #4, Inc.
|
76-0420713
|
|
North Jersey Game On Physical Therapy, Limited Partnership
|
Madison Spine & Physical Therapy
|
LP
|
TX
|
|
NJ
|
Rehab Partners #3, Inc.
|
27-3885529
|
|
North Lake Physical Therapy and Rehab, Limited Partnership
|
|
LP
|
TX
|
|
OR
|
North Lake PT Management GP, LLC
|
90-0964749
|
|
North Lake PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
46-2599705
|
|
Northern Edge PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
93-2850049
|
|
Northern Edge Physical Therapy, Limited Partnership
|
|
LP
|
DE
|
|
|
Northern Edge PT Management GP, LLC
|
93-2812858
|
|
Northern Lights Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
ND
|
Rehab Partners #3, Inc.
|
27-0342077
|
|
Northwest PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
82-2410286
|
|
Northwoods Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
MI
|
Rehab Partners #1, Inc.
|
26-1258418
|
|
OPR Management Services, Inc.
|
|
Corp
|
TX
|
|
AK, AL, AZ, CO, CT, DE, FL, GA, HI, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, SC, SD, TN,
VA, VT, WI, WY
|
U.S. Physical Therapy, Ltd.
|
81-3815218
|
|
OSR Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
MN
|
OSR Physical Therapy Management GP, LLC
|
83-0657305
|
|
OSR Physical Therapy Management GP LLC
|
|
LLC
|
TX
|
|
|
|
83-0649952
|
|
One to One PT Management GP LLC
|
|
LLC
|
TX
|
|
FL
|
Rehab Partners #4, Inc.
|
84-4060850
|
|
One to One Physical Therapy, Limited Partnership
|
|
LP
|
DE
|
|
FL
|
One to One PT Management GP, LLC
|
84-4074270
|
|
Oregon Spine & Physical Therapy, Limited Partnership
|
Peak State Physical Therapy
|
LP
|
TX
|
|
OR
|
Rehab Partners #6, Inc.
|
76-0613909
|
|
P4 Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
GA, TN
|
TX - P4 PT Management GP, LLC
|
88-3148972
|
|
Peak Performance PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Peak Performance Physical Therapy and Fitness, LLC
|
85-3948317
|
|
Peak Performance Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
LA
|
Peak Performance PT Management GP, LLC
|
85-4174416
|
|
Pelican State Physical Therapy, Limited Partnership
|
Audubon Physical Therapy
|
LP
|
TX
|
|
LA
|
Rehab Partners #6, Inc.
|
76-0433513
|
|
Penns Wood Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
PA, OH, WI
|
Rehab Partners #5, Inc.
|
76-0430771
|
|
PerformancePro Sports Medicine and Rehabilitation, Limited Partnership
|
|
LP
|
TX
|
|
|
Rehab Partners #5, Inc.
|
26-1539873
|
|
Phoenix Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
OH
|
Rehab Partners #4, Inc.
|
27-0932165
|
Check with Peter if to be dissolved
|
Physical Restoration and Sports Medicine, Limited Partnership
|
|
LP
|
TX
|
|
VA
|
Rehab Partners #6, Inc.
|
27-0878621
|
|
Physical Therapy Northwest, Limited Partnership
|
|
LP
|
TX
|
|
OR
|
Northwest PT Management GP, LLC
|
82-2397360
|
|
Physical Therapy and Spine Institute, Limited Partnership
|
|
LP
|
TX
|
|
IL
|
Rehab Partners #4, Inc.
|
76-0438263
|
|
Physical Therapy Solutions, Limited Partnership
|
|
LP
|
DE
|
|
VA
|
PTS GP Management, LLC
|
47-3075583
|
|
Pinnacle Therapy Services, LLC
|
|
LLC
|
DE
|
|
MO
|
U.S. Physical Therapy, Ltd.
|
46-3247784
|
|
Pioneer Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
NE
|
Rehab Partners #1, Inc.
|
20-3530492
|
|
Plymouth Physical Therapy Specialists, Limited Partnership
|
|
LP
|
TX
|
|
MI
|
Rehab Partners #3, Inc.
|
76-0424739
|
|
Port City Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
ME
|
Rehab Partners #3, Inc.
|
76-0585914
|
|
Precision Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
PA
|
Rehab Partners #5, Inc.
|
76-0438265
|
|
Premier Physical Therapy and Sports Performance, Limited Partnership
|
|
LP
|
DE
|
|
|
Premier Management GP, LLC
|
47-5385666
|
|
Premier Management GP, LLC
|
|
LLC
|
DE
|
|
|
Rehab Partners #4, Inc.
|
47-5403407
|
|
ProActive Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
SD
|
Rehab Partners #3, Inc.
|
76-0600187
|
ProCare Physical Therapy Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
46-2044643
|
|
|
ProCare PT, Limited Partnership
|
|
LP
|
TX
|
|
PA
|
ProCare Physical Therapy Management GP, LLC
|
90-0941849
|
|
ProgressiveHealth Companies, LLC
|
|
LLC
|
DE
|
|
|
U.S. Physical Therapy, Ltd.
|
87-4264322
|
|
ProgressiveHealth Occ Health, LLC
|
|
LLC
|
IN
|
|
AZ, MI, MO, NJ, NY, TN, UT
|
U.S. Physical Therapy, Ltd.
|
20-8266936
|
|
ProgressiveHealth HealthSpot, LLC
|
|
LLC
|
IN
|
|
AL, WV
|
U.S. Physical Therapy, Ltd.
|
85-3187128
|
|
ProgressiveHealth, LLC
|
|
LLC
|
IN
|
|
KY, MO, TX
|
|
68-0666444
|
|
ProgressiveHealth Rehabilitation Solutions,Inc.
|
|
Corp
|
GA
|
|
|
|
58-1888359
|
|
Progressive Physical Therapy Clinic, Ltd.
|
Progressive Hand and Physical Therapy
|
LP
|
TX
|
|
|
Rehab Partners #1, Inc.
|
76-0387638
|
|
PTS GP Management, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
47-3239903
|
|
Quad City Physical Therapy & Spine, Limited Partnership
|
|
LP
|
TX
|
|
IA
|
Rehab Partners #5, Inc.
|
14-1921829
|
|
RACVA GP, LLC
|
|
LLC
|
TX
|
|
VA
|
Rehab Partners #4, Inc.
|
37-1838302
|
|
R. Clair Physical Therapy, Limited Partnership
|
Clair Physical Therapy
|
LP
|
TX
|
|
|
Rehab Partners #1, Inc.
|
76-0478967
|
|
Radtke Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
MN
|
Rehab Partners #5, Inc.
|
76-0574455
|
|
Reaction Physical Therapy, LLC
|
|
LLC
|
DE
|
|
OK
|
U.S. Physical Therapy, Ltd.
|
47-1586428
|
|
Rebound Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
OR
|
Rebound PT Management GP, LLC
|
81-1026078
|
|
Rebound PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
81-1045143
|
|
Red River Valley Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
|
Rehab Partners #5, Inc.
|
20-4489003
|
|
Redmond Ridge Management, LLC
|
|
LLC
|
WA
|
|
|
U.S. Physical Therapy, Ltd.
|
61-1754288
|
|
Regional Physical Therapy Center, Limited Partnership
|
|
LP
|
TX
|
|
|
Rehab Partners #5, Inc.
|
76-0429008
|
|
Rehab Partners #1, Inc.
|
|
Corp
|
TX
|
|
FL, MA, & WI
|
U.S. PT Delaware, Inc.
|
76-0345544
|
|
Rehab Partners #2, Inc.
|
|
Corp
|
TX
|
|
FL
|
U.S. PT Delaware, Inc.
|
76-0379584
|
Withdraw, NJ
|
Rehab Partners #3, Inc.
|
|
Corp
|
TX
|
|
MO, MT, NJ, ND, & SD
|
U.S. PT Delaware, Inc.
|
76-0394604
|
Withdraw UT
|
Rehab Partners #4, Inc.
|
|
Corp
|
TX
|
|
OH, & UT
|
U.S. PT Delaware, Inc.
|
76-0418425
|
|
Rehab Partners #5, Inc.
|
|
Corp
|
TX
|
|
OH
|
U.S. PT Delaware, Inc.
|
76-0427607
|
|
Rehab Partners #6, Inc.
|
|
Corp
|
TX
|
|
OR
|
U.S. PT Delaware, Inc.
|
76-0433511
|
|
Rehab Partners Acquisition #1, Inc.
|
|
Corp
|
TX
|
|
|
U.S. Physical Therapy, Inc.
|
76-0377650
|
|
Rehabilitation Associates of Central Virginia, Limited Partnership
|
Rehab Associates of Central Virginia (Campbell County)
|
LP
|
TX
|
|
VA
|
RACVA GP, LLC
|
81-3831622
|
|
Rice Rehabilitation Associates, Limited Partnership
|
|
LP
|
TX
|
|
GA
|
Rehab Partners #4, Inc.
|
76-0430769
|
|
Riverview Physical Therapy, Limited Partnership (formerly Yarmouth Physical Therapy)
|
|
LP
|
TX
|
|
ME
|
Rehab Partners #3, Inc.
|
27-0001262
|
|
Roepke Physical Therapy, Limited Partnership
|
Elite Hand & Upper Extremity Clinic
|
LP
|
TX
|
|
WI
|
Rehab Partners #1, Inc.
|
76-0483099
|
|
RYKE Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #5, Inc.
|
26-3747599
|
|
Saginaw Valley Sport and Spine, Limited Partnership
|
Sport & Spine Physical Therapy and Rehab; Evergreen PT
|
LP
|
TX
|
|
MI
|
Rehab Partners #3, Inc.
|
76-0403520
|
|
Saline Physical Therapy of Michigan, Ltd.
|
Physical Therapy in Motion
|
LP
|
TX
|
|
MI
|
Rehab Partners #1, Inc.
|
76-0376594
|
|
San Antonio On Demand Physical Therapy, LLC
|
|
LLC
|
TX
|
|
|
U.S. Physical Therapy, Ltd.
|
86-1384984
|
|
Seacoast Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
ME
|
Rehab Partners #3, Inc.
|
45-2498148
|
|
Signature Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
OK
|
Rehab Partners #2, Inc.
|
20-5992649
|
|
Snohomish Management, LLC
|
|
LLC
|
WA
|
|
|
U.S. Physical Therapy, Ltd.
|
38-3953679
|
|
South Tulsa Physical Therapy, Limited Partnership
|
Physical Therapy of Jenks South Tulsa Physical Therapy Jenks Physical Therapy
|
LP
|
TX
|
|
OK
|
Rehab Partners #2, Inc.
|
76-0566430
|
|
Spectrum Physical Therapy, Limited Partnership
|
Southshore Physical Therapy
|
LP
|
TX
|
|
CT
|
Rehab Partners #2, Inc.
|
76-0393448
|
|
Sport & Spine Clinic of Fort Atkinson, Limited Partnership
|
Sport & Spine Clinic of Sauk City
Sport & Spine Clinic of Madison Sport & Spine Clinic of Jefferson Sport & Spine Edgerton |
LP
|
TX
|
|
WI
|
Rehab Partners #1, Inc.
|
76-0694802
|
|
Sport & Spine Clinic, L.P.
|
Sport & Spine Sport & Spine Clinic of Edgar Sport & Spine Minocqua Sport & Spine - Rib Mountain
|
LP
|
DE
|
|
WI
|
Rehab Partners Acquisition #1, Inc.
|
76-0376131
|
|
Spracklen Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
NE
|
Rehab Partners #1, Inc.
|
76-0580510
|
|
STAR PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc
|
26-1107563
|
|
STAR Physical Therapy, LP
|
|
LP
|
TX
|
|
AL, AR, MO, TN, IN
|
STAR PT Management GP, LLC
|
62-1707893
|
|
Star Therapy Centers, Limited Partnership
|
Star Therapy Services of Copperfield Star Therapy Services of Cy-Fair Star Therapy Services of Fulshear
Star Therapy Services of Katy Star Therapy Services of Magnolia Star Therapy Services of Spring Cypress Star Therapy Services of Cinco Ranch |
LP
|
TX
|
|
|
Rehab Partners #1, Inc.
|
76-0389608
|
|
Summit Hand Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
93-1966427
|
Summit Hand Therapy, Limited Partnership
|
|
LP
|
DE
|
|
UT
|
Summit Hand Management GP, LLC
|
93-1996735
|
|
|
Summit PT Management GP, LLC
|
|
LLC
|
TX
|
5/18/2022
|
|
Rehab Partners #4, Inc.
|
88-2457192
|
|
Summit Physical Therapy, Limited Partnership
|
Brookeville Physical Therapy
|
LP
|
TX
|
5/23/2022
|
OH, WV
|
Summit PT Management GP, LLC
|
88-2606821
|
|
Texstar Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
|
Rehab Partners #5, Inc.
|
76-0669263
|
|
The Hale Hand Center, Limited Partnership
|
|
LP
|
TX
|
|
FL
|
Rehab Partners #2, Inc.
|
76-0601187
|
|
The U.S. Physical Therapy Foundation
|
|
NP
|
TX
|
|
Qualified to fund raise in CA, FL, KS, MD, MI, TN, TX, VA
|
81-1071364
|
|
|
Therapyworks Physical Therapy, LLC
|
Therapyworks
|
LLC
|
DE
|
|
IN
|
U.S. Physical Therapy, Ltd.
|
46-4446075
|
|
Thibodeau Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
MI
|
Rehab Partners #1, Inc.
|
26-1147899
|
|
Thomas Hand and Rehabilitation Specialists, Limited Partnership
|
CoreFit Rehabilitation
|
LP
|
TX
|
AL, AZ, CA, PA, OH, VA, WI
|
Rehab Partners #3, Inc.
|
76-0528480
|
|
|
Thunder Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
WA
|
Rehab Partners #4, Inc.
|
26-3806761
|
|
TX - P4 PT Management GP, LLC
|
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
88-3055868
|
|
U.S. Physical Therapy, Inc.
|
|
Corp
|
NV
|
|
AZ; HI; MI; NJ
|
N/A
|
76-0364866
|
|
U.S. Physical Therapy, Inc. PAC
|
|
NP
|
TX
|
5/5/2021
|
|
|
86-3943048
|
|
U.S. Physical Therapy, Ltd.
|
|
LP
|
TX
|
|
NC |
National Rehab GP, Inc.
|
76-0388092
|
|
U.S. PT - Delaware, Inc.
|
|
Corp
|
DE
|
|
FL, IL, MN, MO
NM, |
U.S. Physical Therapy, Inc.
|
51-0343523
|
|
U.S. PT Alliance Rehabilitation Services, Inc.
|
Alliance Rehabilitation Services
|
Corp
|
TX
|
|
PA
|
U.S. Physical Therapy, Inc.
|
26-2377769
|
|
U.S. PT Management, Ltd.
|
|
LP
|
TX
|
|
CA, ID, OH, WA, WI
|
National Rehab Management GP, Inc.
|
76-0388500
|
|
U.S. PT Michigan #1, Limited Partnership
|
Genesee Valley Physical Therapy
|
LP
|
TX
|
|
MI
|
Rehab Partners #1, Inc.
|
76-0570431
|
|
U.S. PT Michigan #2, Limited Partnership
|
Physical Therapy Solutions
|
LP
|
TX
|
|
MI
|
Rehab Partners #2, Inc.
|
76-0579492
|
|
U.S. PT Solutions, Inc.
|
Physical Therapy Solutions
|
Corp
|
TX
|
|
VA
|
U.S. Physical Therapy, Inc.
|
26-0609553
|
|
U.S. PT Texas, Inc.
|
Kinetix Physical Therapy
|
Corp
|
TX
|
|
MS
|
U.S. Physical Therapy, Inc.
|
20-5125415
|
To be dissolved
|
U.S. PT Therapy Services, Inc. (formerly U.S. Surgical Partners, Inc.)
|
Capstone Physical Therapy
Carolina Hand and Wellness Center Hand Therapy of North Texas - Frisco Hand Therapy of North Texas - Coppell Innovative Physical Therapy Lake City Hand Therapy Life Sport Physical Therapy Life Sport Physical Therapy - Glen Ellyn Metro Hand Rehabilitation Missouri City Physical Therapy Mountain View Physical Therapy of Medford Mountain View Physical Therapy of Talent Northern Illinois Therapy Services Propel Physical Therapy ReAction Physical Therapy Therapeutic Concepts Tulsa Hand Therapy Waco Sports Medicine and Rehabilitation |
Corp
|
DE
|
|
CA, FL, IA, IL, IN, KS, ME, MS, MO, NC, OH, OK, OR, PA, TX VA, & WI
|
U.S. Physical Therapy, Inc.
|
76-0613914
|
|
U.S. PT Turnkey Services, Inc.
(formerly Surgical Management GP, Inc. |
The Hand & Orthopedic Rehab Clinic
|
Corp
|
TX
|
|
IN
|
U.S. Physical Therapy, Inc.
|
20-2803028
|
|
U.S. Therapy, Inc.
|
First Choice Physical Therapy
|
Corp
|
TX
|
|
IN
|
U.S. PT - Delaware, Inc.
|
76-0637511
|
|
|
The Facilities Group, Inc.
|
|
|
|
|
|
|
|
University Physical Therapy, Limited Partnership
|
|
LP
|
TX
|
|
VA
|
Rehab Partners #6, Inc.
|
76-0613913
|
|
USPT Physical Therapy, Limited Partnership
|
Body Basics Physical Therapy
|
LP
|
TX
|
|
IA
|
Rehab Partners #5, Inc.
|
20-5441273
|
|
Victory Physical Therapy, Limited Partnership
|
LP
|
TX
|
|
|
Rehab Partners #5, Inc.
|
20-4406904
|
|
|
West Texas Physical Therapy, Limited Partnership
|
LP
|
TX
|
|
|
Rehab Partners #5, Inc.
|
20-5834588
|
|
Wright PT Management GP, LLC
|
LLC
|
TX
|
|
|
Rehab Partners #4, Inc.
|
82-3239740
|
||
|
Wright Physical Therapy, Limited Partnership
|
LP
|
TX
|
|
ID
|
Wright PT Management GP, LLC
|
82-3255983
|
/s/ GRANT THORNTON LLP
|
Houston, Texas
|
February 29, 2024
|
1. |
I have reviewed this annual report on Form 10-K of U.S. Physical Therapy, Inc.;
|
2. |
Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made,
in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
|
3. |
Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial
condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
|
4. |
The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act
Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
|
(a) |
Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material
information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
|
(b) |
Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
|
(c) |
Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the
disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
|
(d) |
Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter
(the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and
|
5. |
The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the
registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
|
(a) |
All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to
adversely affect the registrant’s ability to record, process, summarize and report financial information; and
|
(b) |
Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial
reporting.
|
/s/ Christopher J. Reading
|
|
Christopher J. Reading
President and Chief Executive Officer
(Principal Executive Officer)
|
1. |
I have reviewed this annual report on Form 10-K of U.S. Physical Therapy, Inc.;
|
2. |
Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made,
in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;
|
3. |
Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial
condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;
|
4. |
The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act
Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:
|
(a) |
Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material
information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;
|
(b) |
Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;
|
(c) |
Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the
disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and
|
(d) |
Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter
(the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and
|
5. |
The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the
registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):
|
(a) |
All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to
adversely affect the registrant’s ability to record, process, summarize and report financial information; and
|
(b) |
Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial
reporting.
|
/s/ Carey Hendrickson
|
|
Carey Hendrickson
Chief Financial Officer
(Principal Financial and Accounting Officer)
|
(1) |
The report fully complies with the requirements of section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended; and
|
(2) |
The information contained in the report fairly presents, in all material respects, the financial condition and results of operations of the registrant.
|
/s/ Christopher J. Reading
|
|
Christopher J. Reading
Principal Executive Officer
|
|
/s/ Carey Hendrickson
|
|
Carey Hendrickson
Principal Financial and Accounting Officer
|
1. |
Purpose and Scope. U.S. Physical Therapy, Inc. (the “Company”) has adopted this compensation Clawback Policy (the “Policy”) to comply with
Section 954 of the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010 (“Dodd-Frank”), as codified by Section 10D of the Securities
Exchange Act of 1934, as amended (the “Exchange Act”), Exchange Act Rule 10D-1, and the rules of the New York Stock Exchange (the “NYSE”), which require the recovery of certain forms of executive compensation in the case of accounting restatements resulting from a material error in an
issuer’s financial statements. This Policy is adopted by the Board of Directors of the Company (the “Board”) and shall be administered by the
Compensation Committee of the Board (the “Committee”).
|
2. |
Effective Date. This Policy shall be effective as of November 14, 2023 (the “Effective Date”), and shall apply to Incentive-Based Compensation, as defined below, that is approved, awarded, or granted to Covered Executives on or
after the Effective Date.
|
3. |
Covered Executives. This Policy applies to all of the Company’s current and former
executive officers, as defined below, and such other employees who may from time to time be deemed subject to this Policy by the Committee (each, a “Covered
Executive”). For purposes of this Policy, an executive officer means an officer as defined in Rule 10D-1(d) under the Exchange Act, as amended from time to time. As of the Effective Date, "Executive officers" subject to recovery policies adopted under Rule 10D-1 include (1) a president, (2) any vice-president in charge of a principal business unit, division, or function (such as
sales, administration or finance), (3) any other officer who performs a policy-making function, or (4) any other person who performs similar policy-making functions for the Company, including executive officers of the Company or its
subsidiaries if they perform such functions.
|
(a) |
For Covered Executives hired after the Effective Date, the Policy will be attached as an exhibit to their employment agreement and/or any award compensation agreement and will
require an acknowledgment of the Policy in the agreement.
|
(b) |
All Covered Executives hired before the Effective Date will be bound by the Policy from the Effective Date. For such purposes, they shall be provided with a copy of the Policy,
which they shall sign in acknowledgment in a manner substantially consistent with Exhibit A hereof.
|
4. |
Incentive-Based Compensation. For purposes of this Policy, the term “Incentive-Based Compensation” means any compensation that is granted, earned, or vested based wholly or in part upon the attainment of a financial
reporting measure and includes, but is not limited to, compensation received pursuant to the Company’s incentive plan, as well as any compensation that Covered
Executives would not have been entitled to receive had the financial statements been accurate. “Financial reporting measures” are measures
determined and presented in accordance with the accounting principles used in preparing the Company's financial statements, and any measures derived wholly or in part from such measures, including General Accepted Accounting Principles (“GAAP”), non-GAAP financial measures, as well as the Company's stock price and total shareholder return. For the avoidance of doubt, Incentive-Based
Compensation does not include annual salary, compensation awarded based on completion of a specified period of service, time-vesting awards or compensation that
is awarded solely at the discretion of the Board or the Committee (in each case as long as their grant was not based on the achievement of a financial performance measure), or compensation awarded based on subjective standards,
strategic measures, or operational measures (in each case as long as their grant was not based on the achievement of a financial performance measure).
|
5. |
Recovery; Accounting Restatement. In the event the Company is required to prepare an
accounting restatement of its financial statements due to material noncompliance with any financial reporting requirement under the federal securities laws, including any required accounting restatement to correct an error in previously
issued financial statements that is material to the previously issued financial statements, or that would result in a material misstatement if the error were corrected in the current period or left uncorrected in the current period (a “Restatement”), the Company shall, as promptly as it reasonably can, recover any Incentive-Based Compensation received by a Covered Executive during the
three completed fiscal years immediately preceding the date on which the Company is required to prepare such Restatement (the “Restatement Date”), so
long as the Incentive-Based Compensation received by such Covered Executive is in excess of what would have been awarded or vested after giving effect to the Restatement. In addition to these last three completed fiscal years, the Policy
shall apply to any transition period (that results from a change in the Company’s fiscal year) within or immediately following those three completed fiscal years. However, a transition period between the last day of the Company’s previous
fiscal year end and the first day of its new fiscal year that comprises a period of nine to 12 months would be deemed a completed fiscal year. The Company’s obligation to recover erroneously awarded Incentive-Based Compensation is not
dependent on if or when the restated financial statements are filed.
|
5.1. |
The Restatement Date shall be the earlier of (i) the date the Board, the Committee, or officer(s) are authorized to take such action if Board action is not required, concludes, or
reasonably should have concluded, that the Company is required to prepare a Restatement due to the material noncompliance of the Company with any financial reporting requirement under the securities laws as described in Rule 10D-1(b)(1)
under the Exchange Act or (ii) the date a court, regulator, or other legally authorized body directs the Company to prepare a Restatement.
|
5.2. |
The amount to be recovered will be the excess of the Incentive-Based Compensation paid to the Covered Executive based on the erroneous data in the original financial statements
over the Incentive-Based Compensation that would have been paid to the Covered Executive had it been based on the restated results, without respect to any taxes paid. For Incentive-Based Compensation based on stock price or total
shareholder return, where the amount of erroneously awarded compensation is not subject to mathematical recalculation directly from the information in an accounting restatement:
|
A. |
The amount must be based on a reasonable estimate of the effect of a Restatement on the stock price or total shareholder return upon which the Incentive-Based Compensation was
received; and
|
B. |
The Company must maintain documentation of the determination of that reasonable estimate and provide such documentation to the NYSE.
|
5.3. |
This Policy shall apply even if the Covered Executive did not engage in any misconduct and even if the Covered Executive had no responsibility for the financial statement errors,
miscalculations, omissions or other reasons requiring Restatement.
|
5.4. |
Subsequent changes in a Covered Executive’s employment status, including retirement or termination of employment, do not affect the Company’s rights to recover Incentive-Based
Compensation pursuant to this Policy. For purposes of this Policy, Incentive-Based Compensation shall be deemed to have been received during the fiscal period in which the financial reporting measure specified in the award is attained, even
if such Incentive-Based Compensation is paid or granted after the end of such fiscal period.
|
5.5. |
The Company must recover erroneously awarded Incentive-Based Compensation in compliance with this Policy, except to the extent that the Committee has made a determination that
recovery would be impracticable for the reasons stated below:
|
A. |
The direct expense paid to a third party to assist in enforcing the Policy would exceed the amount to be recovered. Before concluding that it would be impracticable to recover any
amount of erroneously awarded Incentive-Based Compensation based on the expense of enforcement, the Company must make a reasonable attempt to recover such erroneously awarded Incentive-Based Compensation, document such reasonable attempt(s)
to recover, and provide that documentation to the NYSE.
|
B. |
Recovery would likely cause an otherwise tax-qualified retirement plan, under which benefits are broadly available to employees of the Company, to fail to meet the requirements of
26 U.S.C. 401(a)(13) or 26 U.S.C. 411(a) and regulations thereunder.
|
5.6. |
The Committee shall determine, in its sole discretion, the method of recovering any Incentive-Based Compensation pursuant to this Policy.
|
6. |
No Indemnification. The Company shall not indemnify any current or former Covered
Executive against the loss of erroneously awarded Incentive-Based Compensation, and shall not pay, or reimburse any Covered Executives for premiums, for any insurance policy to fund such executive’s potential recovery payments.
|
7. |
Disclosures. The Company must file all disclosures with respect to the Policy in accordance
with the requirements of the Exchange Act and other laws and regulations, including the disclosure required by applicable Securities and Exchange Commission (the “SEC”) filings.
|
8. |
Notice. Before the Committee determines to seek recovery pursuant to this Policy, it shall
provide the Covered Executive with written notice and the opportunity to be heard at a meeting of the Committee (either in person or via telephone).
|
9. |
Amendment and Interpretation. The Committee may amend this Policy from time to time in its
discretion and shall amend this Policy as it deems necessary to reflect the regulations adopted by the SEC and to comply with any rules or standards adopted by NYSE, on which the Company’s securities are listed. It is intended that this
Policy be interpreted in a manner that is consistent with the requirements of Section 10D of the Exchange Act and any applicable rules or standards adopted by the SEC and NYSE, or any other exchange on which the Company’s securities are
listed.
|
U.S. Physical Therapy, Inc.
|
||
By:
|
||
Print:
|
||
Title:
|
COVERED EXECUTIVE:
|
|
Print Name:
|
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CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
---|---|---|
Current assets: | ||
Provision for credit losses, patient accounts receivable | $ 2,736 | $ 2,829 |
U. S. Physical Therapy, Inc. shareholders' equity: | ||
Preferred stock, par value (in dollars per share) | $ 0.01 | $ 0.01 |
Preferred stock, shares authorized (in shares) | 500,000 | 500,000 |
Preferred stock, shares issued (in shares) | 0 | 0 |
Preferred stock, shares outstanding (in shares) | 0 | 0 |
Common stock, par value (in dollars per share) | $ 0.01 | $ 0.01 |
Common stock, shares authorized (in shares) | 20,000,000 | 20,000,000 |
Common stock, shares issued (in shares) | 17,202,291 | 15,216,326 |
Treasury stock, shares (in shares) | 2,214,737 | 2,214,737 |
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME [Abstract] | |||
Net income | $ 37,220 | $ 43,407 | $ 57,924 |
Other comprehensive loss | |||
Unrealized (loss) gain on cash flow hedge | (1,642) | 5,378 | 0 |
Tax effect at statutory rate (federal and state) | 420 | (1,374) | 0 |
Comprehensive income | 35,998 | 47,411 | 57,924 |
Comprehensive income attributable to non-controlling interest | (8,981) | (11,249) | (17,093) |
Comprehensive income attributable to USPH shareholders | $ 27,017 | $ 36,162 | $ 40,831 |
Organization, Nature of Operations and Basis of Presentation |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Organization, Nature of Operations and Basis of Presentation [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Organization, Nature of Operations and Basis of Presentation |
1. Organization, Nature of Operations and
Basis of Presentation
The
consolidated financial statements include the accounts of U.S. Physical Therapy, Inc. and its subsidiaries (the “Company”). All significant intercompany transactions and balances have been eliminated.
The Company
operates its business through two reportable business segments. The Company’s reportable segments include the physical therapy
operations segment and the industrial injury prevention services (“IIP”) segment. The Company’s physical therapy operations consist of physical therapy and occupational therapy clinics that provide pre-and post-operative care and treatment for
orthopedic-related disorders, sports-related injuries, preventive care, rehabilitation of injured workers and neurological injuries. Services provided by the IIP segment include onsite injury prevention and rehabilitation, performance optimization
and ergonomic assessments.
During
the last three years, the Company completed the acquisitions of the following clinic practices and IIP businesses detailed below:
In
May 2023, the Company completed a secondary offering of 1,916,667 shares of its common stock at an offering price of $90.00 per share. Upon completion of the offering, the Company received net proceeds of approximately $163.6 million, after deducting an underwriting discount of $8.6
million and recognizing related fees and expenses of $0.2 million. A portion of the net proceeds was used to repay the $35.0 million then outstanding under the Company’s credit facility while the remainder is expected to be used primarily for additional acquisitions.
Impact of COVID-19
Relief Funds
In March 2020 in
response to the COVID-19 pandemic, the federal government approved the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”). The CARES Act provided additional waivers, reimbursement, grants and other funds to assist health care
providers during the COVID-19 pandemic, including $100.0 billion in appropriations for the Public Health and Social Services
Emergency Fund, also referred to as the Provider Relief Fund, to be used for preventing, preparing, and responding to the coronavirus, and for reimbursing eligible health care providers for lost revenues and health care related expenses that
are attributable to COVID-19. For the year ended December 31, 2021, the Company recorded income of approximately $4.6 million under
the CARES Act (“Relief Funds”). Under the Company’s accounting policy, these payments were recorded as Other income – Relief Funds.
|
Significant Accounting Policies |
12 Months Ended | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023 | |||||||||||
Significant Accounting Policies [Abstract] | |||||||||||
Significant Accounting Policies |
2. Significant Accounting Policies
Cash Equivalents
The Company maintains its cash and cash equivalents at financial institutions. The Company considers all highly liquid investments with a maturity
of three months or less when purchased to be cash equivalents. The combined account balances at several institutions typically exceed Federal Deposit Insurance Corporation (“FDIC”) insurance coverage and, as a result, there is a concentration of
credit risk related to amounts on deposit in excess of FDIC insurance coverage. Management believes that this risk is not significant.
Long-Lived Assets
Fixed assets are stated at cost. Depreciation is computed on the straight-line method over the estimated useful lives of the related assets.
Estimated useful lives for furniture and equipment range from
to eight years and for software purchased from to seven years. Leasehold improvements are amortized over the shorter of the related lease term or estimated useful lives of the assets, which is generally
to five years.Impairment of Long-Lived Assets
The Company reviews property and equipment and intangible assets with finite lives for
impairment upon the occurrence of certain events or circumstances that indicate the related amounts may be impaired.
Goodwill and Other Indefinite-Lived Intangible Assets
Goodwill represents the excess of the amount paid and fair value of the
non-controlling interests over the fair value of the acquired business assets, which include certain identifiable intangible assets. Historically, goodwill has been derived from acquisitions and, prior to 2009, from the purchase of some or all of a particular local management’s equity interest in an existing clinic. Effective January 1, 2009, if the purchase price of a non-controlling interest by the Company exceeds or is less than the book value at the time of purchase, any excess or shortfall is recognized as an adjustment to additional paid-in
capital.
Goodwill and other indefinite-lived
intangible assets are not amortized but are instead subject to periodic impairment evaluations. The fair value of goodwill and other identifiable intangible assets with indefinite lives are evaluated for impairment at least annually and upon the
occurrence of certain events or conditions and are written down to fair value if considered impaired. These events or conditions include but are not limited to a significant adverse change in the business environment, regulatory environment, or
legal factors; a current period operating, or cash flow loss combined with a history of such losses or a projection of continuing losses; or a sale or disposition of a significant portion of a reporting unit. The occurrence of one of these events
or conditions could significantly impact an impairment assessment, necessitating an impairment charge. The Company evaluates indefinite-lived tradenames in conjunction with our annual goodwill impairment test.
The Company operates its business through two segments consisting of physical therapy clinics and an IIP
business. For the purposes of goodwill impairment analysis, the segments are further broken down into reporting units. Reporting units within our physical therapy business are comprised of six regions primarily based on each clinic’s location. In addition to the six
regions, in 2023 and 2022, the IIP business consisted of two reporting units.
As part of the impairment analysis, the Company is first required to assess qualitatively if it can conclude whether goodwill is more likely than not impaired. If goodwill is
more likely than not impaired, it is then required to complete a quantitative analysis of whether a reporting unit’s fair value is less than its carrying amount. In evaluating whether it is more likely than not that the fair value of a reporting
unit is less than its carrying amount, the Company considers relevant events or circumstances that affect the fair value or carrying amount of a reporting unit. The Company considers both the income and market approach in determining the fair value
of its reporting units when performing a quantitative analysis.
An impairment loss generally would be recognized when the
carrying amount of the net assets of a reporting unit, inclusive of goodwill and other identifiable intangible assets, exceeds the estimated fair value of the reporting unit. The evaluation of goodwill in 2021 did not result in any goodwill amounts
that were deemed impaired.
The Company recorded a charge for goodwill impairment of $15.8 million and $9.1 million in the
years ended December 31, 2023, and December 31, 2022, respectively. The Company also recorded a charge of $1.7 million for
of a tradename during the year ended December 31, 2023. The charges for impairment related to one reporting unit in the IIP business.During the year ended December 31, 2023, the Company did not recognize any additional impairment as a result of the Company’s annual assessment of goodwill and tradenames for the other seven reporting units. The Company also noted no
impairment to long-lived assets for all reporting units.
The Company will continue to monitor for any triggering
events or other indicators of impairment.
Investment in unconsolidated affiliates
Investments in unconsolidated affiliates, in which the Company has less than a controlling interest, are accounted for under the equity method of accounting and, accordingly,
are adjusted for capital contributions, distributions and the Company’s equity in net earnings or loss of the respective joint venture.
Redeemable Non-Controlling Interest
The non-controlling interest that is reflected as redeemable
non-controlling interest in the consolidated financial statements consists of those in which the owners and the Company have certain redemption rights, whether currently exercisable or not, and which currently, or in the future, require that the
Company purchase or the owner sell the non-controlling interest held by the owner, if certain conditions are met. The purchase price is derived at a predetermined formula based on a multiple of trailing twelve months earnings performance as defined
in the respective limited partnership agreements. The redemption rights can be triggered by the owner or the Company at such time as both of the following events have occurred: 1) termination of the owner’s employment, regardless of the reason for
such termination, and 2) the passage of specified number of years after the closing of the transaction, typically
to five years, as defined in the limited partnership agreement. The redemption rights are not automatic or mandatory (even upon death) and require either
the owner or the Company to exercise its rights when the conditions triggering the redemption rights have been satisfied.On the date the Company acquires a controlling interest in a
partnership, and the limited partnership agreement for such partnership contains redemption rights not under the control of the Company, the fair value of the non-controlling interest is recorded in the consolidated balance sheet under the caption—Redeemable
non-controlling interest – temporary equity. Then, in each reporting period thereafter until it is purchased by the Company, the redeemable non-controlling interest is adjusted to the greater of its then current redemption value or initial carrying
value, based on the predetermined formula defined in the respective limited partnership agreement. As a result, the value of the non-controlling interest is not adjusted below its initial carrying value. The Company records any adjustment in the
redemption value, net of tax, directly to retained earnings and are not reflected in the consolidated statements of net income. Although the adjustments are not reflected in the consolidated statements of net income, current accounting rules
require that the Company reflects the adjustments, net of tax, in the earnings per share calculation. The amount of net income attributable to redeemable non-controlling interest owners is included in consolidated net income on the face of the
consolidated statements of net income. Management believes the redemption value (i.e. the carrying amount) and fair value are the same.
Non-Controlling Interest
The Company recognizes non-controlling interest, in which the Company has no obligation but the right to purchase the non-controlling interest, as
permanent equity in the consolidated financial statements separate from the parent entity’s equity. The amount of net income attributable to non-controlling interests is included in consolidated net income on the face of the statements of net
income. Changes in a parent entity’s ownership interest in a subsidiary that do not result in deconsolidation are treated as equity transactions if the parent entity retains its controlling financial interest. The Company recognizes a gain or loss
in net income when a subsidiary is deconsolidated. Such gain or loss is measured using the fair value of the non-controlling equity investment on the deconsolidation date.
When the purchase price of a non-controlling interest by the Company exceeds the book value at the time of purchase, any excess or shortfall is
recognized as an adjustment to additional paid-in capital. Additionally, operating losses are allocated to non-controlling interests even when such allocation creates a deficit balance for the non-controlling interest partner.
Revenue Recognition
The
Company recognizes revenue in accordance with Accounting Standards Codification (“ASC”) 606. For ASC 606, there is an implied contract between us and the patient upon each patient visit. Separate contractual arrangements exist between us and
third-party payors (e.g. insurers, managed care programs, government programs, workers’ compensation) which establish the amounts the third parties pay on behalf of the patients for covered services rendered. While these agreements are not
considered contracts with the customer, they are used for determining the transaction price for services provided to the patients covered by the third-party payors. The payor contracts do not indicate performance obligations for us but indicate
reimbursement rates for patients who are covered by those payors when the services are provided. At that time, the Company is obligated to provide services for the reimbursement rates stipulated in the payor contracts. The execution of the
contract alone does not indicate a performance obligation. For self-paying customers, the performance obligation exists when we provide the services at established rates. The difference between the Company’s established rate and the anticipated reimbursement rate is accounted for as an offset to revenue—contractual allowance. Payments for services rendered are typically due to 120 days after receipt of the invoice.
Patient revenue
Net patient revenue consists of revenues for physical therapy
and occupational therapy clinics that provide pre-and post-operative care and treatment for orthopedic related disorders, sports-related injuries, preventative care, rehabilitation of injured workers and neurological-related injuries. Net patient
revenues (patient revenues less estimated contractual adjustments, see – Contractual Adjustments, for additional information) are recognized
at the estimated net realizable amounts from third-party payors, patients and others in exchange for services rendered when obligations under the terms of the contract are satisfied. There is an implied contract between us and the patient upon each
patient visit. Generally, this occurs as the Company provides physical and occupational therapy services, as each service provided is distinct and future services rendered are not dependent on previously rendered services. The Company has
agreements with third-party payors that provide payments to the Company at amounts different from its established rates.
Other Revenue
Revenue from the IIP business, which is included in other revenue in the consolidated statements of net income, is derived from onsite services
the Company provides to clients’ employees including injury prevention, rehabilitation, ergonomic assessments, post-offer employment testing and performance optimization. Revenue
from the Company’s IIP business is recognized when obligations under the terms of the contract are satisfied. Revenues are recognized at an amount equal to the consideration the company expects to receive in exchange for providing injury prevention
services to its clients. The revenue is determined and recognized based on the number of hours and respective rate for services provided in a given period.
Management contract
revenue, which is also included in other revenue, is derived from contractual arrangements whereby the Company manages a clinic for third party owners. The Company does not have any ownership interest in these clinics. Typically, revenue is
determined based on the number of visits conducted at the clinic and recognized at a point in time when services are performed. Costs, typically salaries for the Company’s employees, are recorded when incurred. Management contract revenue was $8.6 million, $8.1 million and $9.9 million for the years ended December 31, 2023, December 31, 2022, and December 31, 2021, respectively.
Additionally, other revenue from physical therapy operations includes services the Company provides
on-site at locations such as schools and industrial worksites for physical or occupational therapy services, athletic trainers and gym membership fees. Contract terms and rates are agreed to in advance between the Company and the third parties.
Services are typically performed over the contract period and revenue is recorded at the point of service. If the services are paid in advance, revenue is recorded as a contract liability over the period of the agreement and recognized at the point
in time, when the services are performed.
Contractual Allowances
The allowance for estimated contractual adjustments is based on terms of payor contracts and historical collection and write-off experience.
Contractual allowances result from the differences between the rates charged for services performed and expected reimbursements by both insurance companies and government sponsored healthcare programs for such services. Medicare regulations and the
various third-party payors and managed care contracts are often complex and may include multiple reimbursement mechanisms payable for the services provided in Company clinics. The Company estimates contractual allowances based on its interpretation
of the applicable regulations, payor contracts and historical calculations. Each month the Company estimates its contractual allowance for each clinic based on payor contracts and the historical collection experience of the clinic and applies an
appropriate contractual allowance reserve percentage to the gross accounts receivable balances for each payor of the clinic. Based on the Company’s historical experience, calculating the contractual allowance reserve percentage at the payor level
is sufficient to allow the Company to provide the necessary detail and accuracy with its collectability estimates. However, the services authorized and provided and related reimbursement are subject to interpretation that could result in payments
that differ from the Company’s estimates. Payor terms are periodically revised necessitating continual review and assessment of the estimates made by management. The Company’s billing system does not capture the exact change in its contractual
allowance reserve estimate from period to period in order to assess the accuracy of its revenues and hence its contractual allowance reserves. Management regularly compares its cash collections to corresponding net revenues measured both in the
aggregate and on a clinic-by-clinic basis. In the aggregate, historically the difference between net revenues and corresponding cash collections for any fiscal year has generally reflected a difference within approximately 1% to 1.5% of net revenues.
Additionally, analysis of subsequent periods’ contractual write-offs on a payor basis reflects a difference within approximately 1.0% to
1.5% between the actual aggregate contractual reserve percentage as compared to the estimated contractual allowance reserve percentage
associated with the same period end balance. As a result, the Company believes that a change in the contractual allowance reserve estimate would not likely be more than 1.0% to 1.5% of gross billings included in accounts receivable each at
December 31, 2023 and December 31, 2022.
Allowance for Credit Losses
The Company determines allowances for credit losses based on the specific agings and payor classifications at each clinic. The provision for
credit losses is included in operating costs in the consolidated statements of net income. Patient accounts receivable, which are stated at the historical carrying amount net of contractual allowances, write-offs and allowance for credit losses,
includes only those amounts the Company estimates to be collectible.
Income Taxes
Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax
consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are
measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized
in income in the period that includes the enactment date.
The Company recognizes the financial statement benefit of a tax position only after determining that the relevant tax authority would more likely
than not sustain the position following an audit. For tax positions meeting the more-likely-than-not threshold, the amount to be recognized in the financial statements is the largest benefit that has a greater than 50 percent likelihood of being
realized upon ultimate settlement with the relevant tax authority.
The CARES Act includes changes to certain tax law related to net operating losses and the deductibility of interest expense and depreciation. ASC 740, Income Taxes
requires the effects of changes in tax rates and laws on deferred tax balances to be recognized in the period in which the legislation is enacted. The legislation had no effect on the Company’s deferred income taxes and current income taxes
payable during the year ended December 31, 2023.
The
Company records interest or penalties in interest and other expense, in the consolidated statements of net income. The Company did not
have any interest or penalties in each of the years ended December 31, 2023, 2022 and 2021.
Fair Value of Financial Instruments
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. Assets and liabilities measured at fair value are
classified using the following hierarchy, which is based upon the transparency of inputs to the valuation at the measurement date.
The carrying amounts reported in the balance sheets for cash and cash equivalents, contingent earn-out payments, accounts receivable, accounts payable and notes
payable approximate their fair values due to the short-term maturity of these financial instruments. The carrying amount under the Credit Agreement approximates the fair value due to the proximity of the debt issue date and the balance sheet date
and the variable component of interest on debt. The interest rate on the Credit Agreement is tied to the Secured Overnight Financing Rate (“SOFR”).
The put right associated with the potential future purchase of the separate company in the November 2021 acquisition are both is also marked to fair value on a recurring basis using Level 3 inputs. The put right associated with the
potential future purchase of the separate company in the IIP business is determined using a Monte Carlo simulation model utilizing unobservable inputs such as asset volatility and discount rates. The unobservable inputs in the valuation include
asset volatility of 25.0% and a discount rate of 11.22%. The value of the put right associated with the potential future purchase of a company in the IIP business decreased $2.6 million from $3.6 million on December 31, 2022 to approximately $1.0 million on December 31, 2023. Accordingly, the Company recognized a gain of $2.6 million on this change in revaluation for the twelve months ended December 31, 2023.
The valuations of the Company’s interest rate derivative is
measured as the present value of all expected future cash flows based on SOFR-based yield curves. The present value calculation uses discount rates that have been adjusted to reflect the credit quality of the Company and its counterparty which is a
Level 2 fair value measurement. The fair value of the interest rate swap on December 31, 2023, was $3.7 million, of which $2.6 million has been included within Other current assets and $1.1 million has been included in Other assets in the accompanying Consolidated Balance Sheet. The impact of the interest rate swap on the accompanying Consolidated Statements of
Comprehensive Income was an unrealized loss of $1.2 million, net of tax, for the year ended December 31, 2023.
The redemption value of redeemable non-controlling interests
approximates the fair value. See Note 6 for the changes in the fair value of Redeemable non-controlling interest.
The consideration for some of the Company’s acquisitions
include future payments that are contingent upon the occurrence of future operational objectives being met. The Company estimates the fair value of contingent consideration obligations through valuation models designed to estimate the probability
of such contingent payments based on various assumptions and incorporating estimated success rates. These fair value measurements are based on significant inputs not observable in the market. Substantial judgment is employed in determining the
appropriateness of these assumptions as of the acquisition date and for each subsequent period. Accordingly, changes in assumptions could have a material impact on the amount of contingent consideration expense the Company records in any given
period.The Company determined the fair value of its contingent consideration obligation to be $9.8 million and $8.3 million on December 31, 2023 and 2022.
Segment Reporting
Operating segments are components of an enterprise for which separate financial
information is available that is evaluated regularly by chief operating decision makers in determining the allocation of resources and in assessing performance. The Company currently operates through two segments: physical therapy operations and industrial injury prevention services.
Use of Estimates
In preparing the Company’s consolidated financial statements, management makes certain estimates and assumptions, especially in relation to, but
not limited to, goodwill impairment, tradenames, allocations of purchase price, allowance for receivables, tax provision and contractual allowances, that affect the amounts reported in the consolidated financial statements and related disclosures.
Actual results may differ from these estimates.
Self-Insurance Program
The Company utilizes a self-insurance plan for its employee group health and dental insurance coverage administered by a third party.
Predetermined loss limits have been arranged with the insurance company to minimize the Company’s maximum liability and cash outlay. Accrued expenses include the estimated incurred but unreported costs to settle unpaid claims and estimated future
claims. Management believes that the current accrued amounts are sufficient to pay claims arising from self-insurance claims incurred through December 31, 2023.
Restricted Stock
Restricted stock issued to employees and directors is subject to continued employment or continued service on the board, respectively. Generally,
restrictions on the stock granted to employees lapse in equal annual installments on the following
anniversaries of the date of
grant. For those shares granted to directors, the restrictions will lapse in equal quarterly installments during the year after
the date of grant. For those granted to officers, the restriction will lapse in equal quarterly installments during the four years
following the date of grant. Compensation expense for grants of restricted stock is recognized based on the fair value per share on the date of grant amortized over the vesting period. The Company recognizes any forfeitures as they occur. The
restricted stock issued is included in basic and diluted shares for the earnings per share computation. Reclassification of Prior Period Presentation
Certain prior year amounts have been
reclassified for consistency with the current year presentation. These reclassifications had no effect on the reported results of operations.
Recently Adopted Accounting Pronouncements
In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740)–Simplifying the Accounting for Income Taxes (“ASU 2019-12”). The objective of ASU 2019-12 is to simplify the accounting for income taxes by removing
certain exceptions to the general principles in Topic 740 and to provide more consistent application to improve the comparability of financial statements. The amendments in this ASU are effective for fiscal years beginning after December 15, 2020, and early adoption was permitted. The Company completed the adoption of ASU 2020-06
effective January 1, 2021 and there was no material impact on the Company’s financial statements.
In August 2020, the FASB issued ASU 2020-06 Debt—Debt with
Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity, which simplifies the accounting
for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. As part of this update, convertible instruments are to be included in diluted earnings per
share using the if-converted method, rather than the treasury stock method. Further, contracts which can be settled in cash or shares, excluding liability-classified share-based payment awards, are to be included in diluted earnings per share on an
if-converted basis if the effect is dilutive, regardless of whether the entity or the counterparty can choose between cash and share settlement. The share-settlement presumption may not be rebutted based on past experience or a stated policy.
This pronouncement was effective for fiscal years, and for interim periods within those fiscal years, beginning after December 15, 2021.The Board specified that an
entity should adopt the guidance at the beginning of its annual fiscal year. The Company adopted this pronouncement as of January 1, 2022. The use of either the modified retrospective or fully retrospective method of transition is permitted. The
adoption of ASU 2020-06 did not have a material impact on the Company’s financial statements.
In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848):
Facilitation of the Effects of Reference Rate Reform on Financial Reporting. This ASU provides temporary optional expedients and exceptions to the
guidance on contract modifications and hedge accounting to ease the financial reporting burdens of the expected market transition from LIBOR and other
interbank offered rates to alternative reference rates. The new guidance was effective upon issuance, and the Company has elected to apply the amendments prospectively through December 31, 2022. Borrowings under the Company’s Credit Agreement
bear interest based on SOFR.
Recently Issued Accounting Guidance
In March 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-01, Leases (Topic 842): Common Control Arrangements,
which requires companies to amortize leasehold improvements associated with related party leases under common control over the useful life of the leasehold improvement to the common control group. The ASU is effective for annual reporting periods
beginning on or after December 15, 2023; however, early adoption is permitted. The ASU can either be applied prospectively or retrospectively. The adoption of ASU 2023-01 did not have a material effect on the Company’s financial statements.
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Earnings Per Share |
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Earnings Per Share [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Earnings Per Share |
3. Earnings Per Share
The computations of basic and diluted earnings are as follows.
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Acquisitions of Businesses |
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Acquisitions of Businesses |
4. Acquisitions of Businesses
The Company’s strategy is to continue acquiring
multi-clinic outpatient physical therapy practices, to develop outpatient physical therapy clinics as satellites in existing partnerships and to continue acquiring companies that provide and serve the IIP sector. The consideration paid for each
acquisition is derived through arm’s length negotiations and funded through working capital, borrowings under the Company’s revolving credit facilities or proceeds from the recently completed secondary offering discussed in Note 1.
The finalized purchase prices plus the fair value of the
non-controlling interests for the acquisitions in 2022 and 2021 were allocated to the fair value of the assets acquired, inclusive of identifiable intangible assets, i.e. trade names, referral relationships and non-compete agreements, and
liabilities assumed based on the fair values at the acquisition date, with the amount exceeding the fair values being recorded as goodwill. For some of the acquisitions in 2023, the Company is in the process of completing its formal valuation
analysis to identify and determine the fair value of tangible and identifiable intangible assets acquired and the liabilities assumed. Thus, the final allocation of the purchase price may differ from the preliminary estimates used at December 31,
2023 based on additional information obtained and completion of the valuation of the identifiable intangible assets. Changes in the estimated valuation of the tangible assets acquired, the completion of the valuation of identifiable intangible
assets and the completion by the Company of the identification of any unrecorded pre-acquisition contingencies, where the liability is probable and the amount can be reasonably estimated, will likely result in adjustments to goodwill. The Company
does not expect the adjustments to be material.
The results of operations of the acquisitions below have been
included in the Company’s consolidated financial statements since their respective date of acquisition. Unaudited proforma consolidated financial information for the acquisitions have not been included, as the results, individually and in the
aggregate, were not material to current operations.
For the 2023, 2022 and 2021 acquisitions, total current
assets primarily represent patient accounts receivable. Total non-current assets are fixed assets, primarily equipment, used in the practices.
During 2023, 2022 and 2021, the Company acquired a majority
interest in the following businesses:
2023 Acquisitions
On October 31, 2023, the Company concurrently acquired 100% of an IIP business and a 55%
equity interest in the ergonomics software business. The previous owner of the ergonomics software business retained a 45% equity
interest. The total purchase price of the combined businesses was approximately $4.0 million and was paid in cash.
On September 29, 2023, the Company acquired a 70% equity interest in a four-clinic
physical therapy practice. The owner of the practice retained 30% of the equity interests. The purchase price for the 70% equity interest was approximately $6.0
million, of which $5.4 million was paid in cash, and $0.6 million was in the form of a note payable. The note accrues interest at 5.0%
per annum and the principal and interest are payable in two installments. The first payment of principal and interest of $0.3 million was paid in January 2024, and the second installment of $0.3 million is due on September 30, 2025.
In a separate transaction, on September 29, 2023, the Company
acquired a 70% equity interest in a
clinic physical therapy practice. The owner of the practice retained 30% of the equity interests. The purchase price for the 70% equity interest was approximately $7.8
million, of which $7.4 million was paid in cash and $0.4 million is a deferred payment due on June 30, 2025.On July 31, 2023, the Company acquired a 70% equity interest in a five-clinic
practice. The practice’s owners retained a 30% equity interest. The purchase price for the 70% equity interest was approximately $2.1 million, of which $1.8 million was paid in cash and $0.3
million is a deferred payment due on June 30, 2025.
On May 31, 2023, the Company and a local partner together
acquired a 75% interest in a four-clinic
physical therapy practice. After the transaction, the Company’s ownership interest is 45%, the Company’s local partner’s ownership
interest is 30%, and the practice’s pre-acquisition owners have a 25% ownership interest. The purchase price for the 75% equity interest was
approximately $3.1 million, of which $1.7
million was paid in cash by the Company, $1.1 million was paid in cash by the local partner, and $0.3 million was in the form of a note payable, (of which $0.2
million will be paid by the Company and $0.1 million will be paid by the local partner). The note will be paid on July 1, 2024. The
Company guaranteed the full payment of $0.3 million on its due date.
On February 28, 2023, the Company acquired an 80% interest in a one-clinic physical
therapy practice. The practice’s owners retained 20% of the equity interests. The purchase price for the 80% equity interest was approximately $6.2
million, of which $5.8 million was paid in cash and $0.4 million in the form of a note payable. The note accrues interest at 4.5%
per annum and the principal and interest are payable on February 28, 2025.
The purchase prices for the 2023 acquisitions have been preliminarily allocated as
follows.
Total current assets
primarily represent accounts receivable while total non-current assets consist of fixed assets and equipment used in the practice.
For the acquisitions in
2023, the values assigned to the customer and referral relationships and non-compete agreement are being amortized on a straight-line basis over their respective estimated lives. For customer and referral relationships, the weighted-average
amortization period is 12.0 years. For the non-compete agreements, the weighted-average amortization period is 5.1 years. The values assigned to tradenames are tested annually for impairment.
2022 Acquisitions
On November 30, 2022, the Company acquired an 80%
interest in a thirteen-clinic physical therapy practice. The practice’s owners retained 20% of the equity interests. The purchase price for the 80%
equity interest was approximately $25.0 million, of which $24.2 million was paid in cash and $0.8 million in the form of a note payable. The note accrues interest
at 7.0% per annum and the principal and interest are payable on November 30, 2024. As part of the acquisition, the Company agreed to
additional contingent consideration of up to $1.6 million if future operational objectives were met. The additional contingent
consideration was valued at $1.6 million on December 31, 2023, and was paid in full in January 2024.
On October 31, 2022, the Company acquired a 60%
interest in a fourteen-clinic physical therapy practice. The practice’s owners retained 40% of the equity interests. The purchase price for the 60%
equity interest was approximately $19.5 million, with additional contingent consideration valued at $9.8 million on December 31, 2023, to be paid at a later date based on the performance of the business. There is no maximum payout. The estimate of this
contingent consideration will continue to be marked at fair value based on the practice’s operational results and updated market inputs.
On September 30, 2022, the Company acquired an 80%
interest in a two-clinic physical therapy practice. The practice’s owners retained 20% of the equity interests. The purchase price for the 80%
equity interest was approximately $4.2 million, of which $3.9 million was paid in cash and $0.3 million in the form of a note payable. The note accrues interest
at 5.5% per annum and the principal and interest are payable on September 30, 2024.
On August 31, 2022, the Company acquired a 70% interest
in a six-clinic physical therapy practice. The practice’s owners retained 30% of the equity interests. The purchase price for the 70%
equity interest was approximately $3.5 million, of which $3.3 million was paid in cash and $0.2 million in the form of a note payable. The note accrues interest
at 5.5% per annum and the principal and interest are payable on August 31, 2024.
On March 31, 2022, the Company acquired a 70% interest
in a six-clinic physical therapy practice. The practice’s owners retained 30% of the equity interests. The purchase price for the 70%
equity interest was approximately $11.5 million, of which $11.2 million was paid in cash and $0.3 million in the form of a note payable. The note accrues interest
at 3.5% per annum and the principal and interest are payable on March 31, 2024.
The purchase price for the 2022 acquisitions has been allocated as follows.
Total current assets
primarily represent accounts receivable while total non-current assets consist of fixed assets and equipment used in the practice.
The purchase price
plus the fair value of the non-controlling interests for the acquisitions in 2022 were allocated to the fair value of the assets acquired, inclusive of identifiable intangible assets, (i.e. trade names, referral relationships and non-compete
agreements) and liabilities assumed based on the fair values at the acquisition date, with the amount exceeding the fair values being recorded as goodwill.
For the acquisitions
in 2022, the values assigned to the customer and referral relationships and non-compete agreements are being amortized to expense equally over the respective estimated lives. For customer and referral relationships, the weighted-average
amortization period is 12.2 years. For non-compete agreements, the weighted-average amortization period is 5.0 years. The values assigned to tradenames are tested annually for impairment.
2021 Acquisitions
On December 31, 2021, the Company acquired a 75%
interest in three-clinic physical therapy practice with the practice founder retaining 25%. The purchase price for the 75% interest was approximately $3.7 million, of which $3.5 million was paid
in cash and $0.2 million in the form of a note payable. The note accrued interest at 3.25% per annum and the principal and interest was paid on December 31, 2023.
On November 30, 2021, the Company acquired an approximate 70% interest in a leading provider of industrial injury prevention services (“IIP Acquisition”). In each case, the previous owners retained the
remaining interest. The purchase price for the approximate 70% equity interest, not inclusive of a contingent payment up to $2.0 million, was approximately $63.2 million of which $60.7 million was
paid in cash and $1.0 million in the form of a note payable. The note accrues interest at 3.25% per annum and the principal and interest is payable on November 30, 2023. As part of the transaction, the Company also agreed to the potential future purchase
of a separate company under the same ownership that provides physical therapy and rehabilitation services to hospitals and other ancillary providers in a distinct market area. The current owners have the right to put this transaction to the Company
in approximately five years, with such right having a $1.2 million value on December 31, 2023, as reflected on the Company’s consolidated balance sheet in Other long-term liabilities. The value of this right will be adjusted in future periods,
as appropriate, with any change in value reflected in the Company’s consolidated statement of income. The Company does not currently possess more than 50% of the controlling interests in this separate company, does not control this company through
contract or governance rights and currently does not exercise significant influence over this separate company. Due to the aforementioned reasons, and based on current accounting guidance, the Company did not consolidate the separate company
through the variable interest or voting interest model. The Company revalued the contingent earn-out consideration related to the acquisition during the year ended December 31, 2022, resulting in a gain of $2.0 million and the reduction of the liability to $0.
On September 30, 2021, the Company acquired a company that specializes in return-to-work and ergonomic services, among other offerings. The
Company acquired the company’s assets at a purchase price of approximately $3.3 million (which includes the obligation to pay an
amount up to $0.6 million in contingent payment consideration in conjunction with the acquisition if specified future operational
objectives are met), and contributed those assets to Briotix Health. The initial purchase price, not inclusive of the $0.6 million
contingent payment, was approximately $2.7 million, of which $2.4 million was paid in cash, and $0.3 million is in the form of a note
payable. The note accrued interest at 3.25% per annum and the principal and interest was paid in September 2023. The Company
revalued the contingent earn-out consideration related to the acquisition during the year ended December 31, 2022, resulting in the elimination of the $0.6
million liability previously booked to $0.
On June 30, 2021, the Company acquired a 65%
interest in an eight-clinic physical therapy with the previous owners retaining 35%. The purchase price was approximately $10.3 million, of
which $9.0 million was paid in cash, $1.0
million is payable based on the achievement of certain business criteria and $0.3 million is in the form of a note payable. The note
accrued interest at 3.25% per annum and the principal and interest and was paid in June 2023. Additionally, the Company has an
obligation to pay an additional amount up to $0.8 million in contingent payment consideration in conjunction with the acquisition if
specified future operational objectives are met. The Company recorded acquisition-date fair value of this contingent liability based on the likelihood of the contingent earn-out payment. The earn-out payment valued at $0.8 million on December 31, 2023, will subsequently be remeasured to fair value each reporting date.
On March 31, 2021, the Company acquired a 70%
interest in a five-clinic physical therapy practice with the previous owners retaining 30%. When acquired, the practice was developing a sixth clinic which has been completed. The purchase price for the 70% interest was approximately $12.0 million, of which $11.7 million was paid in cash and $0.3
million in the form of a note payable. The note accrued interest at 3.25% per annum and the principal and interest was paid in
March 2023.
The purchase price for the 2021 acquisitions has been allocated as follows.
|
Acquisitions and Sale of Non-Controlling Interests |
12 Months Ended |
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Dec. 31, 2023 | |
Acquisitions and Sale of Non-Controlling Interests [Abstract] | |
Acquisitions and Sale of Non-Controlling Interests |
5. Acquisitions and Sale of Non-Controlling Interests
During 2023, the Company acquired additional interests in three
partnerships which are included in non-controlling interests - permanent equity. The additional interests purchased in each of the partnerships ranged from 0.15% to 35.0%. The aggregated purchase price for these acquired interests was
$0.5 million. The Company also sold interests in four partnerships for an aggregate price of $0.6 million. The non-controlling
interests - permanent equity sold in each of the partnerships ranged from 0.5% to 8.0%.
During
2022, the Company acquired additional interests in three partnerships which are included in non-controlling interest. The additional
interests purchased in each of the partnerships ranged from 10% to 35%. The aggregated purchase price for these acquired interests was $0.3
million.
During 2021, the
Company acquired additional interests in five partnerships which are included in non-controlling interest. The additional interests
purchased in each of the partnerships ranged from 5% to 35%. The aggregated purchase price for these acquired interests was $1.3
million. The Company also sold an interest in a partnership for $0.1 million.
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Redeemable Non-Controlling Interest |
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REDEEMABLE NON-CONTROLLING INTEREST [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Redeemable Non-Controlling Interest |
6. Redeemable Non-Controlling Interest
Physical
Therapy Practice Acquisitions
When the Company acquires a majority interest (the “Acquisition”) in a physical therapy clinic (referred to as “Therapy Practice”), these Therapy
Practice transactions occur in a series of steps which are described below.
ProgressiveHealth Acquisition
On November 30, 2021, the Company acquired a majority interest in ProgressiveHealth Companies, LLC (“Progressive”), which owns a majority
interest in certain subsidiaries (“Progressive Subsidiaries”) that operate in the industrial injury prevention and therapy services businesses. The Progressive transaction was completed in a series of steps which are described below.
Neither the Progressive Operating Agreement nor the Progressive Non-Compete Agreement contain any provision to escrow or “claw back” the equity
interest in Progressive NewCo held by the Progressive Selling Shareholders, in the event of a breach of the operating agreement or non-compete terms, or the management services agreement pursuant to which the Progressive Selling Shareholders
perform services on behalf of Progressive NewCo. The Company’s only recourse against the Progressive Selling Shareholder for breach of any of these agreements is to seek damages and other legal remedies under such agreements. There are no
conditions in any of the arrangements with a Progressive Selling Shareholder that would result in a forfeiture of the equity interest in Progressive NewCo held by a Progressive Selling Shareholder.
For both scenarios described above, an employed Progressive Selling Shareholder’s ownership of his or her equity interest in the Seller Entity
predates the Progressive Acquisition and the Company’s purchase of its partnership interest in NewCo. The Employment Agreement and the Non-Compete Agreement do not contain any provision to escrow or “claw back” the equity interest in the Seller
Entity held by such Employed Selling Shareholder, nor the Seller Entity Interest in NewCo, in the event of a breach of the employment or non-compete terms. More specifically, even if the Employed Selling Shareholder is terminated for “cause” by
NewCo, such Employed Selling Shareholder does not forfeit his or her right to his or her full equity interest in the Seller Entity and the Seller Entity does not forfeit its right to any portion of the Seller Entity Interest. The Company’s only
recourse against the Employed Selling Shareholder for breach of either the Employment Agreement or the Non-Compete Agreement is to seek damages and other legal remedies under such agreements. There are no conditions in any of the arrangements
with an Employed Selling Shareholder that would result in a forfeiture of the equity interest held in the Seller Entity or of the Seller Entity Interest.
Carrying Amounts of Redeemable Non-Controlling Interests
For the years ended December 31, 2023, 2022 and 2021, the following table details the changes in the carrying amount (fair value) of the
redeemable non-controlling interests.
The following table categorizes the carrying amount (fair value) of the redeemable non-controlling interests.
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Goodwill |
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Goodwill [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Goodwill |
7. Goodwill
The changes in the carrying amount of goodwill consisted of the following.
During the
years ended December 31, 2023, and December 31, 2022, the Company recorded a charge for goodwill impairment of $15.8 million and $9.1 million respectively, related to an IIP Acquisition. The impairment is related to a change in an IIP subsidiary’s current and projected operating
income as well as various market inputs based on current market conditions.
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Intangible Assets, net |
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Intangible Assets, net |
8. Intangible Assets, net
The Company’s intangible assets, net, consisted of the following.
Tradenames, customer and referral relationships and non-compete agreements are related to the businesses acquired. The value assigned to tradenames has an indefinite life and is tested at least annually
for impairment using the relief from royalty method in conjunction with the Company’s annual goodwill impairment test. The value assigned to customer and referral relationships is being amortized over their respective estimated useful lives which
range from 6 to 14 years.
Non-compete agreements are amortized over the respective term of the agreements which range from 5 to 6 years. The weighted average amortization period for customer and referral relationships was 12.7 years for the year ended December 31, 2023 and 12.9 years for the year
ended December 31, 2022. The weighted average amortization period for non-compete agreements was 5.6 years for the years ended
December 31, 2023, and December 31, 2022. During the year ended December 31, 2023, the Company recognized a charge of $1.7 million
related to the of a tradename related to an IIP acquisition.
The following table details the amount of amortization expense recorded for intangible assets for the periods presented.
The remaining balances of the customer and referral relationships and non-compete agreements are expected to be amortized as follows.
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Accrued Expenses |
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Accrued Expenses |
9.
Accrued Expenses
Accrued expenses consisted of the following.
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Borrowings |
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Borrowings |
10.
Borrowings
Amounts outstanding under the Credit Agreement (as defined above) and notes payable consisted of the following.
(1) The long-term portion is included as part of Other Long-Term Liabilities in the Consolidated Balance Sheet.
Effective December 5,
2013, the Company entered into an Amended and Restated Credit Agreement with a commitment for a $125.0 million revolving credit facility.
This agreement was amended and/or restated in August 2015, January 2016, March 2017, November 2017, and January 2021. On June 17, 2022, the Company entered into the Third Amended and Restated Credit Agreement (the “Credit Agreement”) among Bank of
America, N.A., as administrative agent (“Administrative Agent”) and the lenders from time-to-time party thereto.
The Credit Agreement, which matures on June 17, 2027, provides for loans in an aggregate principal amount of $325 million. Such loans were made available through the following facilities (collectively, the “Senior Credit Facilities”):
The proceeds of the Revolving Facility shall be used by the Company for working capital and other general corporate purposes of the Company and its subsidiaries, including to fund future acquisitions and invest in growth
opportunities. The proceeds of the Term Facility were used by the Company to refinance the indebtedness outstanding under the Amended Credit Agreement, to pay fees and expenses incurred in connection with the transactions involving the loan
facilities, for working capital and other general corporate purposes of the Company and its subsidiaries.
The Company is permitted to increase the Revolving Facility and/or add one or more tranches of term loans in an aggregate
amount not to exceed the sum of (i) $100 million plus (ii) an unlimited additional amount,
provided that (in the case of clause (ii)), after giving effect to such increases, the pro forma Consolidated Leverage Ratio (as defined in the Credit Agreement) would not exceed 2.0:1.0, and the aggregate amount of all incremental increases under the Revolving Facility does not exceed $50,000,000.
The interest rates per annum applicable to the Senior Credit Facilities (other than in respect of Swingline Loans) will be
Term SOFR (as defined in the Credit Agreement) plus an applicable margin or, at the option of the Company, an alternate base rate plus an applicable margin. Each Swingline Loan shall bear interest at the base rate plus the applicable margin.
The applicable margin for Term SOFR borrowings ranges from 1.50% to 2.25%, and the applicable margin for alternate base rate borrowings ranges from 0.50% to 1.25%, in each case, based on the Consolidated Leverage Ratio of the Company and its
subsidiaries. Interest is payable at the end of the selected interest period but no less frequently than quarterly and on the date of maturity.
The Company is also required to pay to the Administrative Agent, for the account of each lender under the Revolving Facility, a commitment fee equal to the actual daily excess of each lender’s commitment over its
outstanding credit exposure under the Revolving Facility (“unused fee”). Such unused fee will range between 0.25% and 0.35% per annum and is also based on the Consolidated Leverage Ratio of the Company and its subsidiaries. The Company may prepay and/or repay the
revolving loans and the term loans, and/or terminate the revolving loan commitments, in whole or in part, at any time without premium or penalty, subject to certain conditions.
The Credit Agreement contains customary covenants limiting, among other things, the incurrence of additional indebtedness,
the creation of liens, mergers, consolidations, liquidations and dissolutions, sales of assets, dividends and other payments in respect of equity interests, acquisitions, investments, loans and guarantees, subject, in each case, to customary
exceptions, thresholds and baskets. The Credit Agreement includes certain financial covenants which include the Consolidated Fixed Charge Coverage Ratio, and the Consolidated Leverage Ratio, as defined in the Credit Agreement. The Credit
Agreement also contains customary events of default.
The Company’s obligations under the Credit Agreement are guaranteed by its wholly-owned material domestic subsidiaries (each,
a “Guarantor”), and the obligations of the Company and any Guarantors are secured by a perfected first priority security interest in substantially all of the existing and future personal property of the Company and each Guarantor, subject to
certain exceptions.
As of December 31, 2023, $144.4
million was outstanding on the Term Facility while none was outstanding under the Revolving Facility resulting in $175.0 million of credit availability. As of December 31, 2023, the Company was in compliance with all of the covenants contained in the Credit
Agreement.
The Company generally enters into various notes payable as a means of financing a portion of its acquisitions and purchasing of non- controlling interests. In conjunction with these
transactions in 2023 and 2022, the Company entered into notes payable in the aggregate amount of $4.7 million of which an aggregate
principal payment of $0.9 million was paid in 2023, $2.5 million is due in 2024, and $1.3 million is due in 2025. Interest accrues
in the range of 3.25% to 7.0%
per annum and is payable with each principal installment.
|
Derivative Instruments |
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Derivative Instruments [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Derivative Instruments |
11.
Derivative Instruments
The Company is exposed to certain market risks during the ordinary course of business due to adverse changes in interest rates. The exposure to interest rate risk
primarily results from the Company’s variable-rate borrowing. The Company may elect to use derivative financial instruments to manage risks from fluctuations in interest rates. The Company does not purchase or hold derivatives for trading or
speculative purposes. Fluctuations in interest rates can be volatile and the Company’s risk management activities do not eliminate these risks.
Interest Rate Swap
In May 2022, the Company entered into an interest rate swap agreement, effective on June 30, 2022, with Bank of America, N.A. The swap has a $150 million notional value adjusted concurrently with scheduled principal payments made on the term loan. The swap has a maturity date of June 30, 2027. Beginning in July 2022, the Company receives a 1-month SOFR, and pays a fixed rate of interest of 2.815% on 1-month SOFR on a quarterly basis. The total interest rate in any period will also include an applicable margin based on the Company’s consolidated
leverage ratio.
In connection with the swap, no cash was exchanged between the Company and the counterparty.
The Company designated its interest rate swap as a cash flow hedge and structured it to be highly effective. Consequently, unrealized gains and losses related to the
fair value of the interest rate swap are recorded to accumulated other comprehensive income (loss), net of tax.
Savings from the interest rate swap arrangement totaled $3.3
million for the year ended December 31, 2023, and less than $0.1 million for the year ended December 31, 2022. These savings reduce the
amount of interest expense, debt and other in the accompanying consolidated statements of income.
The impacts of the Company’s derivative instruments on the accompanying Consolidated Statements of Comprehensive Income are presented in the table below.
The valuations of the Company’s interest rate derivatives are measured as the present value of all expected future cash flows based on SOFR-based
yield curves. The present value calculation uses discount rates that have been adjusted to reflect the credit quality of the Company and its counterparty, which is a Level 2 fair value measurement.
The carrying and fair value of the Company’s interest rate derivatives (included in other current assets and other assets) were as follows:
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Leases |
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Leases [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Leases |
12.
Leases
The Company has operating leases for its corporate offices and operating facilities. The Company determines if an arrangement is a lease at the
inception of a contract. Right-of-use assets represent the Company’s right to use an underlying asset during the lease term and operating lease liabilities represent net present value of the Company’s obligation to make lease payments arising from
the lease. Right-of-use assets and operating lease liabilities are recognized at commencement date based on the net present value of the fixed lease payments over the lease term. The Company’s operating lease terms are generally five years or less. The Company’s lease terms include options to extend or terminate the lease when it is reasonably certain that the option will be
exercised. As most of the Company’s operating leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments.
Operating fixed lease expense is recognized on a straight-line basis over the lease term.Variable lease payment amounts that cannot be determined at the commencement of the lease such as increases in lease payments based on changes in index rates or
usage are not included in the right-of-use assets or operating lease liabilities. These are expensed as incurred and recorded as variable lease expense.
The components of lease expense were as follows.
Lease costs are reflected in the consolidated statements of net income in the
line item — rent, supplies, contract labor and other.
The supplemental cash flow information related to leases was as follows.
The aggregate future lease payments for
operating leases as of December 31, 2023, were as follows.
Average lease terms and discount rates were as follows:
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Income Taxes |
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Income Taxes [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Income Taxes |
13. Income Taxes
Significant components of deferred tax assets and liabilities included in the consolidated balance sheets as of the periods below were as follows.
The deferred tax assets and liabilities related to purchased interests not yet finalized may result in an immaterial adjustment.
As of December 31, 2023, the Company has a federal tax payable of $1.0 million and state tax receivables of $2.1 million. The federal and state
income tax receivable is included in other current assets on the accompanying consolidated balance sheets.
The differences between the federal tax rate and the Company’s effective tax rate for the years ended December 31, were as follows for the periods
presented:
Significant components of the provision for income taxes were as follows for the periods presented.
Each year, the Company
performs a detailed reconciliation of its federal and state taxes payable and receivable accounts along with its federal and state deferred tax asset and liability accounts. This process resulted in a $1.0 million increase in income tax expense in 2023. The Company considers this reconciliation process to be an annual control.
The Company is required to establish a valuation allowance for deferred tax assets if, based on the weight of available evidence, it is more likely
than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences
become deductible. Management considers the projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable income and projections for future taxable income in the periods which the
deferred tax assets are deductible, management believes that a valuation allowance is not required, as it is more likely than not that the results of future operations will generate sufficient taxable income to realize the deferred tax assets.
The Company’s U.S. federal returns remain open to examination for
and U.S. state jurisdictions are open for periods ranging from .The Company does not believe that it has any significant uncertain tax positions at December 31, 2023 and December 31, 2022, nor is this expected to
change within the next twelve months due to the settlement and expiration of statutes of limitation.
The Company did not have any
accrued interest or penalties associated with any unrecognized tax benefits nor was any interest expense recognized during the years ended December 31, 2023, 2022 and 2021.
|
Segment Information |
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Segment Information [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Segment Information |
14. Segment Information
The Company’s reportable segments include the physical therapy operations segment and
the IIP segment. Also included in the physical therapy operations segment are revenues from management contract services and other services which include services the Company provides on-site, such as athletic
trainers for schools.
Physical Therapy Operations
The physical therapy operations segment primarily operates through subsidiary clinic partnerships (“Clinic Partnerships”), in which the Company generally owns a 1% general partnership interest in all the Clinic Partnerships. The Company’s limited partnership interests generally range from 65% to 75% (the range is 10% - 99%) in the Clinic Partnerships.
The managing therapist of each clinic owns, directly or indirectly, the remaining limited partnership interest in most of the clinics (hereinafter referred to as “Clinic Partnerships”). To a lesser extent, the Company operates some clinics,
through wholly-owned subsidiaries, under profit sharing arrangements with therapists (hereinafter referred to as “Wholly-Owned Facilities”).
The Company continues to seek to attract for employment physical therapists who have established relationships with physicians and other referral sources, by offering these therapists a competitive salary and incentives
based on the profitability of the clinic that they manage. For multi-site clinic practices in which a controlling interest is acquired by the Company, the prior owners typically continue on as employees to manage the clinic operations, retain a
non-controlling ownership interest in the clinics and receive a competitive salary for managing the clinic operations. In addition, the Company has developed satellite clinic facilities as part of existing Clinic Partnerships and Wholly-Owned
Facilities, with the result that a substantial number of Clinic Partnerships and Wholly-Owned Facilities operate more than one clinic
location.
Besides the multi-clinic acquisitions referenced in the table above, during 2023 and 2022, we purchased the assets and businesses of nine and three physical therapy clinics, respectively, in separate transactions.
Clinic Partnerships
For non-acquired Clinic Partnerships, the earnings and liabilities attributable to the non-controlling interests, typically owned by the managing therapist, directly or indirectly, are recorded within the balance sheets and
income statements as non-controlling interest—permanent equity. For acquired Clinic Partnerships with redeemable non-controlling interests, the earnings attributable to the redeemable non-controlling
interests are recorded within the consolidated balance sheets and income statements as redeemable non-controlling interest—temporary equity.
Wholly-Owned Facilities
For Wholly-Owned Facilities with profit sharing arrangements, an appropriate accrual is recorded for the amount of profit sharing due the clinic partners/directors. The amount is expensed as compensation and included in
clinic operating costs—salaries and related costs. The respective liability is included in current liabilities—accrued expenses on the consolidated balance sheets.
Industrial Injury Prevention Services
Services provided in the IIP segment include onsite injury prevention and rehabilitation, performance optimization, post offer employment testing, functional capacity evaluations, and ergonomic assessments. The majority of
these services are contracted with and paid for directly by employers, including a number of Fortune 500 companies. Other clients include large insurers and their contractors. The Company performs these services through Industrial Sports Medicine
Professionals, consisting primarily of specialized certified athletic trainers (“ATCs”).
On
October 31, 2023, the Company purchased a 100% interest in an IIP business and a 55% equity interest in an ergonomics software business for a total purchase price of approximately $4.0 million.
Segment Financials
The Company
evaluates the performance of the segments based on gross profit. The Company has provided additional information regarding its reportable segments which contributes to the understanding of the Company and provides useful information.
The following table summarizes selected financial data for the Company’s reportable segments. Prior
year results presented herein have been changed to conform to the current presentation.
|
Investment in Unconsolidated Affiliate |
12 Months Ended |
---|---|
Dec. 31, 2023 | |
Investment in Unconsolidated Affiliate [Abstract] | |
Investment in Unconsolidated Affiliate |
15. Investment in Unconsolidated Affiliate
Through one of its subsidiaries, the Company has a 49%
joint venture interest in a company which provides physical therapy services for patients at hospitals. The Company is deemed to not have a controlling interest in the company, and therefore the Company’s investment is accounted for using the equity method of accounting.
The investment balance of this joint venture as of December 31, 2023, is $12.3 million and the earnings amounted to approximately $1.0 million. The investment balance of this joint venture as of December 31, 2022, was $12.1
million and the earnings amounted to approximately $1.2 million.
|
Equity Based Plans |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Equity Based Plans [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Equity Based Plans |
16. Equity Based Plans
Stock-based compensation expense was approximately $7.2
million, $7.3 million, and $7.8
million for the years ended December 31, 2023, 2022 and 2021 respectively. As of December 31, 2023, the remaining $9.8 million of
compensation expense will be recognized over a weighted average period of 1.75 years.
Stock Incentive Plans
Amended and Restated 1999 Employee Stock Option Plan The Amended and Restated 1999 Employee Stock Option Plan (the “Amended 1999 Plan”) permits the Company to grant to non-employee directors and employees of the Company up to 600,000 non-qualified options to purchase shares of common stock and restricted stock (subject to proportionate adjustments in the event of stock dividends, splits, and similar corporate transactions). The exercise prices of options granted under the Amended 1999 Plan are determined by the Compensation Committee. The period within which each option will be exercisable is determined by the Compensation Committee. As of December 31, 2023, there were less than 0.1 million shares remaining that can be subject to new awards under the Amended 1999 Plan. Amended and Restated 2003 Stock Option Plan The Amended and Restated 2003 Stock Option Plan (the “Amended 2003 Plan”) permits the Company to grant to key employees and outside directors of the Company incentive and non-qualified options and shares of restricted stock covering up to 2,600,000 shares of common stock (subject to proportionate adjustments in the event of stock dividends, splits, and similar corporate transactions). As of December 31, 2023, there were 0.5 million shares remaining that can be subject to new awards under the Amended 2003 Plan. Restricted Stock Awards
During 2023, 2022 and 2021, the Company granted the following shares
of restricted stock to directors, officers, and employees pursuant to its equity plans as follows:
During 2023, 2022 and 2021, the following shares were cancelled due to employee terminations prior to restrictions lapsing:
Generally, restrictions on the stock granted to employees lapse in equal annual installments on the following
anniversaries of the date of grant. For those shares granted to directors, the restrictions will lapse in equal quarterly installments during the
first year after the date of grant. For those granted to officers, the restriction will lapse in equal quarterly installments during the four years
following the date of grant.There were 124,638 and 124,939 shares outstanding as of December 31, 2023, and December 31, 2022, respectively, for which restrictions had not lapsed. The restrictions will
lapse from 2024 through 2027.
|
Preferred and Common Stock |
12 Months Ended |
---|---|
Dec. 31, 2023 | |
Preferred and Common Stock [Abstract] | |
Preferred and Common Stock |
17. Preferred and Common Stock
Preferred Stock
The Board is empowered, without approval of the shareholders, to cause shares of preferred stock to be issued in one or more series and to establish the number of shares to be included in each such series and the rights, powers, preferences, and limitations of each series. There are no provisions in the Company’s Articles of Incorporation specifying the vote required by the holders of preferred stock to take action. All such provisions would be set out in the designation of any series of preferred stock established by the Board. The bylaws of the Company specify that, when a quorum is present at any meeting, the vote of the holders of at least a majority of the outstanding shares entitled to vote who are present, in person or by proxy, shall decide any question brought before the meeting, unless a different vote is required by law or the Company’s Articles of Incorporation. Because the Board has the power to establish the preferences and rights of each series, it may afford the holders of any series of preferred stock, preferences, powers, and rights, voting or otherwise, senior to the right of holders of common stock. The issuance of the preferred stock could have the effect of delaying or preventing a change in control of the Company. Common Stock
From September 2001 through December 31, 2008, the Board authorized the Company to purchase, in the open market or in privately negotiated
transactions, up to 2,250,000 shares of the Company’s common stock. In March 2009, the Board authorized the repurchase of up to 10% or approximately 1,200,000 shares of
its common stock (“March 2009 Authorization”). Under the March 2009 Authorization, the Company has purchased a total of 859,499 shares.
The Company is required to retire shares purchased under the March 2009 Authorization.
In November 2023, the Board terminated the March 2009 Authorization such that any such proposed repurchase of our common stock would be considered
and determined by the Board at such time. The Company did not purchase any shares of its common stock during 2023, 2022 or 2021.
In May 2023, the Company completed a secondary offering of 1,916,667 shares of its common stock at an offering price of $90.00 per share. Upon completion of the
offering, the Company received net proceeds of approximately $163.6 million, after deducting an underwriting discount of $8.6 million and recognizing related fees and expenses of $0.2
million. A portion of the net proceeds was used to repay the $35.0 million then outstanding under the Company’s credit facility while the
remainder is expected to be used primarily for additional acquisitions.
|
Defined Contribution Plan |
12 Months Ended |
---|---|
Dec. 31, 2023 | |
Defined Contribution Plan [Abstract] | |
Defined Contribution Plan |
18. Defined Contribution Plan
The Company has several 401(k) profit sharing plans covering all employees with three months of service. For certain plans, the Company makes matching contributions. The Company may also make discretionary contributions of up to 50% of employee contributions. The Company did not
make any discretionary contributions for the years ended December 31, 2023, 2022 and 2021.The Company matching contributions totaled $2.2 million, $2.0 million and $1.9 million, respectively, for the years ended
December 31, 2023, 2022 and 2021.
|
Contingencies |
12 Months Ended |
---|---|
Dec. 31, 2023 | |
Contingencies [Abstract] | |
Contingencies |
19. Contingencies
The Company is a party to various legal actions, proceedings, and claims (some of which are
not insured), and regulatory and other governmental audits and investigations in the ordinary course of our business.
Prior Florida Legal Matter In 2019, a qui tam lawsuit (“the Complaint”) was filed by a relator on behalf of the United States against the Company and one of our Florida majority-owned subsidiaries (the “Hale Partnership”). This whistleblower lawsuit was filed in the U.S. District Court for the Southern District of Texas, seeking damages and civil penalties under the federal False Claim Act. The U.S Government declined to intervene in the case and unsealed the Complaint in July 2019. The Complaint alleged that the Hale Partnership engaged in conduct to purposely “upcode” its billings for services provided to Medicare patients. The plaintiff-relator also claimed that similar false claims occurred on other days and at other Company-owned partnerships. In January 2022, the Company entered into a settlement agreement with the plaintiff-relator.
In the settlement agreement, the plaintiff-relator released all defendants from liability for all conduct alleged in the Complaint, and the Company admitted no liability or wrongdoing. In connection with the settlement, the Office of the United
States Attorney for the Southern District of Texas agreed to a dismissal of the claims against the Hale Partnership and the Company. Under the terms of the settlement, the Company agreed to make aggregate payments to the government, the
plaintiff-relator and her counsel of $2.8 million.
|
Related Party Transactions |
12 Months Ended |
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Dec. 31, 2023 | |
Related Party Transactions [Abstract] | |
Related Party Transactions |
20. Related
Party Transactions
For the year ended December 31, 2021, the Company recorded approximately $20,000 related to the short swing profit settlement remitted by a shareholder of the Company under Section 16(b) of the Securities Exchange Act of 1934, as amended. The Company recognized the proceeds as an increase to additional paid-in-capital in the consolidated balance sheets as of December 31, 2021, and consolidated statements of stockholder’s equity, as well as in cash provided by financing activities included in Other, in the consolidated statements of cash flows, for the year ended December 31, 2021. |
Subsequent Event |
12 Months Ended |
---|---|
Dec. 31, 2023 | |
Subsequent Event [Abstract] | |
Subsequent Event |
21. Subsequent Event
On February 27, 2024, the Company’s Board of Directors declared a dividend of $0.44 per share which will be paid on April 5, 2024 to shareholders of record as of March 12, 2024. |
Insider Trading Arrangements |
3 Months Ended |
---|---|
Dec. 31, 2023 | |
Insider Trading Arrangements [Line Items] | |
Rule 10b5-1 Arrangement Adopted [Flag] | false |
Non-Rule 10b5-1 Arrangement Adopted [Flag] | false |
Rule 10b5-1 Arrangement Terminated [Flag] | false |
Non-Rule 10b5-1 Arrangement Terminated [Flag] | false |
SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS |
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SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS |
FINANCIAL STATEMENT SCHEDULE*
SCHEDULE II — VALUATION AND QUALIFYING ACCOUNTS U.S. PHYSICAL THERAPY, INC. AND SUBSIDIARIES (In Thousands)
|
Significant Accounting Policies (Policies) |
12 Months Ended | ||||||||||
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Dec. 31, 2023 | |||||||||||
Significant Accounting Policies [Abstract] | |||||||||||
Cash Equivalents |
Cash Equivalents
The Company maintains its cash and cash equivalents at financial institutions. The Company considers all highly liquid investments with a maturity
of three months or less when purchased to be cash equivalents. The combined account balances at several institutions typically exceed Federal Deposit Insurance Corporation (“FDIC”) insurance coverage and, as a result, there is a concentration of
credit risk related to amounts on deposit in excess of FDIC insurance coverage. Management believes that this risk is not significant.
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Long-Lived Assets |
Long-Lived Assets
Fixed assets are stated at cost. Depreciation is computed on the straight-line method over the estimated useful lives of the related assets.
Estimated useful lives for furniture and equipment range from
to eight years and for software purchased from to seven years. Leasehold improvements are amortized over the shorter of the related lease term or estimated useful lives of the assets, which is generally
to five years. |
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Impairment of Long-Lived Assets |
Impairment of Long-Lived Assets
The Company reviews property and equipment and intangible assets with finite lives for
impairment upon the occurrence of certain events or circumstances that indicate the related amounts may be impaired.
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Goodwill and Other Indefinite-Lived Intangible Assets |
Goodwill and Other Indefinite-Lived Intangible Assets
Goodwill represents the excess of the amount paid and fair value of the
non-controlling interests over the fair value of the acquired business assets, which include certain identifiable intangible assets. Historically, goodwill has been derived from acquisitions and, prior to 2009, from the purchase of some or all of a particular local management’s equity interest in an existing clinic. Effective January 1, 2009, if the purchase price of a non-controlling interest by the Company exceeds or is less than the book value at the time of purchase, any excess or shortfall is recognized as an adjustment to additional paid-in
capital.
Goodwill and other indefinite-lived
intangible assets are not amortized but are instead subject to periodic impairment evaluations. The fair value of goodwill and other identifiable intangible assets with indefinite lives are evaluated for impairment at least annually and upon the
occurrence of certain events or conditions and are written down to fair value if considered impaired. These events or conditions include but are not limited to a significant adverse change in the business environment, regulatory environment, or
legal factors; a current period operating, or cash flow loss combined with a history of such losses or a projection of continuing losses; or a sale or disposition of a significant portion of a reporting unit. The occurrence of one of these events
or conditions could significantly impact an impairment assessment, necessitating an impairment charge. The Company evaluates indefinite-lived tradenames in conjunction with our annual goodwill impairment test.
The Company operates its business through two segments consisting of physical therapy clinics and an IIP
business. For the purposes of goodwill impairment analysis, the segments are further broken down into reporting units. Reporting units within our physical therapy business are comprised of six regions primarily based on each clinic’s location. In addition to the six
regions, in 2023 and 2022, the IIP business consisted of two reporting units.
As part of the impairment analysis, the Company is first required to assess qualitatively if it can conclude whether goodwill is more likely than not impaired. If goodwill is
more likely than not impaired, it is then required to complete a quantitative analysis of whether a reporting unit’s fair value is less than its carrying amount. In evaluating whether it is more likely than not that the fair value of a reporting
unit is less than its carrying amount, the Company considers relevant events or circumstances that affect the fair value or carrying amount of a reporting unit. The Company considers both the income and market approach in determining the fair value
of its reporting units when performing a quantitative analysis.
An impairment loss generally would be recognized when the
carrying amount of the net assets of a reporting unit, inclusive of goodwill and other identifiable intangible assets, exceeds the estimated fair value of the reporting unit. The evaluation of goodwill in 2021 did not result in any goodwill amounts
that were deemed impaired.
The Company recorded a charge for goodwill impairment of $15.8 million and $9.1 million in the
years ended December 31, 2023, and December 31, 2022, respectively. The Company also recorded a charge of $1.7 million for
of a tradename during the year ended December 31, 2023. The charges for impairment related to one reporting unit in the IIP business.During the year ended December 31, 2023, the Company did not recognize any additional impairment as a result of the Company’s annual assessment of goodwill and tradenames for the other seven reporting units. The Company also noted no
impairment to long-lived assets for all reporting units.
The Company will continue to monitor for any triggering
events or other indicators of impairment.
|
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Investment in Unconsolidated Affiliates |
Investment in unconsolidated affiliates
Investments in unconsolidated affiliates, in which the Company has less than a controlling interest, are accounted for under the equity method of accounting and, accordingly,
are adjusted for capital contributions, distributions and the Company’s equity in net earnings or loss of the respective joint venture.
|
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Redeemable Non-Controlling Interest |
Redeemable Non-Controlling Interest
The non-controlling interest that is reflected as redeemable
non-controlling interest in the consolidated financial statements consists of those in which the owners and the Company have certain redemption rights, whether currently exercisable or not, and which currently, or in the future, require that the
Company purchase or the owner sell the non-controlling interest held by the owner, if certain conditions are met. The purchase price is derived at a predetermined formula based on a multiple of trailing twelve months earnings performance as defined
in the respective limited partnership agreements. The redemption rights can be triggered by the owner or the Company at such time as both of the following events have occurred: 1) termination of the owner’s employment, regardless of the reason for
such termination, and 2) the passage of specified number of years after the closing of the transaction, typically
to five years, as defined in the limited partnership agreement. The redemption rights are not automatic or mandatory (even upon death) and require either
the owner or the Company to exercise its rights when the conditions triggering the redemption rights have been satisfied.On the date the Company acquires a controlling interest in a
partnership, and the limited partnership agreement for such partnership contains redemption rights not under the control of the Company, the fair value of the non-controlling interest is recorded in the consolidated balance sheet under the caption—Redeemable
non-controlling interest – temporary equity. Then, in each reporting period thereafter until it is purchased by the Company, the redeemable non-controlling interest is adjusted to the greater of its then current redemption value or initial carrying
value, based on the predetermined formula defined in the respective limited partnership agreement. As a result, the value of the non-controlling interest is not adjusted below its initial carrying value. The Company records any adjustment in the
redemption value, net of tax, directly to retained earnings and are not reflected in the consolidated statements of net income. Although the adjustments are not reflected in the consolidated statements of net income, current accounting rules
require that the Company reflects the adjustments, net of tax, in the earnings per share calculation. The amount of net income attributable to redeemable non-controlling interest owners is included in consolidated net income on the face of the
consolidated statements of net income. Management believes the redemption value (i.e. the carrying amount) and fair value are the same.
|
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Non-Controlling Interest |
Non-Controlling Interest
The Company recognizes non-controlling interest, in which the Company has no obligation but the right to purchase the non-controlling interest, as
permanent equity in the consolidated financial statements separate from the parent entity’s equity. The amount of net income attributable to non-controlling interests is included in consolidated net income on the face of the statements of net
income. Changes in a parent entity’s ownership interest in a subsidiary that do not result in deconsolidation are treated as equity transactions if the parent entity retains its controlling financial interest. The Company recognizes a gain or loss
in net income when a subsidiary is deconsolidated. Such gain or loss is measured using the fair value of the non-controlling equity investment on the deconsolidation date.
When the purchase price of a non-controlling interest by the Company exceeds the book value at the time of purchase, any excess or shortfall is
recognized as an adjustment to additional paid-in capital. Additionally, operating losses are allocated to non-controlling interests even when such allocation creates a deficit balance for the non-controlling interest partner.
|
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Revenue Recognition |
Revenue Recognition
The
Company recognizes revenue in accordance with Accounting Standards Codification (“ASC”) 606. For ASC 606, there is an implied contract between us and the patient upon each patient visit. Separate contractual arrangements exist between us and
third-party payors (e.g. insurers, managed care programs, government programs, workers’ compensation) which establish the amounts the third parties pay on behalf of the patients for covered services rendered. While these agreements are not
considered contracts with the customer, they are used for determining the transaction price for services provided to the patients covered by the third-party payors. The payor contracts do not indicate performance obligations for us but indicate
reimbursement rates for patients who are covered by those payors when the services are provided. At that time, the Company is obligated to provide services for the reimbursement rates stipulated in the payor contracts. The execution of the
contract alone does not indicate a performance obligation. For self-paying customers, the performance obligation exists when we provide the services at established rates. The difference between the Company’s established rate and the anticipated reimbursement rate is accounted for as an offset to revenue—contractual allowance. Payments for services rendered are typically due to 120 days after receipt of the invoice.
Patient revenue
Net patient revenue consists of revenues for physical therapy
and occupational therapy clinics that provide pre-and post-operative care and treatment for orthopedic related disorders, sports-related injuries, preventative care, rehabilitation of injured workers and neurological-related injuries. Net patient
revenues (patient revenues less estimated contractual adjustments, see – Contractual Adjustments, for additional information) are recognized
at the estimated net realizable amounts from third-party payors, patients and others in exchange for services rendered when obligations under the terms of the contract are satisfied. There is an implied contract between us and the patient upon each
patient visit. Generally, this occurs as the Company provides physical and occupational therapy services, as each service provided is distinct and future services rendered are not dependent on previously rendered services. The Company has
agreements with third-party payors that provide payments to the Company at amounts different from its established rates.
Other Revenue
Revenue from the IIP business, which is included in other revenue in the consolidated statements of net income, is derived from onsite services
the Company provides to clients’ employees including injury prevention, rehabilitation, ergonomic assessments, post-offer employment testing and performance optimization. Revenue
from the Company’s IIP business is recognized when obligations under the terms of the contract are satisfied. Revenues are recognized at an amount equal to the consideration the company expects to receive in exchange for providing injury prevention
services to its clients. The revenue is determined and recognized based on the number of hours and respective rate for services provided in a given period.
Management contract
revenue, which is also included in other revenue, is derived from contractual arrangements whereby the Company manages a clinic for third party owners. The Company does not have any ownership interest in these clinics. Typically, revenue is
determined based on the number of visits conducted at the clinic and recognized at a point in time when services are performed. Costs, typically salaries for the Company’s employees, are recorded when incurred. Management contract revenue was $8.6 million, $8.1 million and $9.9 million for the years ended December 31, 2023, December 31, 2022, and December 31, 2021, respectively.
Additionally, other revenue from physical therapy operations includes services the Company provides
on-site at locations such as schools and industrial worksites for physical or occupational therapy services, athletic trainers and gym membership fees. Contract terms and rates are agreed to in advance between the Company and the third parties.
Services are typically performed over the contract period and revenue is recorded at the point of service. If the services are paid in advance, revenue is recorded as a contract liability over the period of the agreement and recognized at the point
in time, when the services are performed.
|
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Contractual Allowances |
Contractual Allowances
The allowance for estimated contractual adjustments is based on terms of payor contracts and historical collection and write-off experience.
Contractual allowances result from the differences between the rates charged for services performed and expected reimbursements by both insurance companies and government sponsored healthcare programs for such services. Medicare regulations and the
various third-party payors and managed care contracts are often complex and may include multiple reimbursement mechanisms payable for the services provided in Company clinics. The Company estimates contractual allowances based on its interpretation
of the applicable regulations, payor contracts and historical calculations. Each month the Company estimates its contractual allowance for each clinic based on payor contracts and the historical collection experience of the clinic and applies an
appropriate contractual allowance reserve percentage to the gross accounts receivable balances for each payor of the clinic. Based on the Company’s historical experience, calculating the contractual allowance reserve percentage at the payor level
is sufficient to allow the Company to provide the necessary detail and accuracy with its collectability estimates. However, the services authorized and provided and related reimbursement are subject to interpretation that could result in payments
that differ from the Company’s estimates. Payor terms are periodically revised necessitating continual review and assessment of the estimates made by management. The Company’s billing system does not capture the exact change in its contractual
allowance reserve estimate from period to period in order to assess the accuracy of its revenues and hence its contractual allowance reserves. Management regularly compares its cash collections to corresponding net revenues measured both in the
aggregate and on a clinic-by-clinic basis. In the aggregate, historically the difference between net revenues and corresponding cash collections for any fiscal year has generally reflected a difference within approximately 1% to 1.5% of net revenues.
Additionally, analysis of subsequent periods’ contractual write-offs on a payor basis reflects a difference within approximately 1.0% to
1.5% between the actual aggregate contractual reserve percentage as compared to the estimated contractual allowance reserve percentage
associated with the same period end balance. As a result, the Company believes that a change in the contractual allowance reserve estimate would not likely be more than 1.0% to 1.5% of gross billings included in accounts receivable each at
December 31, 2023 and December 31, 2022.
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Allowance for Credit Losses |
Allowance for Credit Losses
The Company determines allowances for credit losses based on the specific agings and payor classifications at each clinic. The provision for
credit losses is included in operating costs in the consolidated statements of net income. Patient accounts receivable, which are stated at the historical carrying amount net of contractual allowances, write-offs and allowance for credit losses,
includes only those amounts the Company estimates to be collectible.
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Income Taxes |
Income Taxes
Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax
consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are
measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized
in income in the period that includes the enactment date.
The Company recognizes the financial statement benefit of a tax position only after determining that the relevant tax authority would more likely
than not sustain the position following an audit. For tax positions meeting the more-likely-than-not threshold, the amount to be recognized in the financial statements is the largest benefit that has a greater than 50 percent likelihood of being
realized upon ultimate settlement with the relevant tax authority.
The CARES Act includes changes to certain tax law related to net operating losses and the deductibility of interest expense and depreciation. ASC 740, Income Taxes
requires the effects of changes in tax rates and laws on deferred tax balances to be recognized in the period in which the legislation is enacted. The legislation had no effect on the Company’s deferred income taxes and current income taxes
payable during the year ended December 31, 2023.
The
Company records interest or penalties in interest and other expense, in the consolidated statements of net income. The Company did not
have any interest or penalties in each of the years ended December 31, 2023, 2022 and 2021.
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Fair Value of Financial Instruments |
Fair Value of Financial Instruments
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. Assets and liabilities measured at fair value are
classified using the following hierarchy, which is based upon the transparency of inputs to the valuation at the measurement date.
The carrying amounts reported in the balance sheets for cash and cash equivalents, contingent earn-out payments, accounts receivable, accounts payable and notes
payable approximate their fair values due to the short-term maturity of these financial instruments. The carrying amount under the Credit Agreement approximates the fair value due to the proximity of the debt issue date and the balance sheet date
and the variable component of interest on debt. The interest rate on the Credit Agreement is tied to the Secured Overnight Financing Rate (“SOFR”).
The put right associated with the potential future purchase of the separate company in the November 2021 acquisition are both is also marked to fair value on a recurring basis using Level 3 inputs. The put right associated with the
potential future purchase of the separate company in the IIP business is determined using a Monte Carlo simulation model utilizing unobservable inputs such as asset volatility and discount rates. The unobservable inputs in the valuation include
asset volatility of 25.0% and a discount rate of 11.22%. The value of the put right associated with the potential future purchase of a company in the IIP business decreased $2.6 million from $3.6 million on December 31, 2022 to approximately $1.0 million on December 31, 2023. Accordingly, the Company recognized a gain of $2.6 million on this change in revaluation for the twelve months ended December 31, 2023.
The valuations of the Company’s interest rate derivative is
measured as the present value of all expected future cash flows based on SOFR-based yield curves. The present value calculation uses discount rates that have been adjusted to reflect the credit quality of the Company and its counterparty which is a
Level 2 fair value measurement. The fair value of the interest rate swap on December 31, 2023, was $3.7 million, of which $2.6 million has been included within Other current assets and $1.1 million has been included in Other assets in the accompanying Consolidated Balance Sheet. The impact of the interest rate swap on the accompanying Consolidated Statements of
Comprehensive Income was an unrealized loss of $1.2 million, net of tax, for the year ended December 31, 2023.
The redemption value of redeemable non-controlling interests
approximates the fair value. See Note 6 for the changes in the fair value of Redeemable non-controlling interest.
The consideration for some of the Company’s acquisitions
include future payments that are contingent upon the occurrence of future operational objectives being met. The Company estimates the fair value of contingent consideration obligations through valuation models designed to estimate the probability
of such contingent payments based on various assumptions and incorporating estimated success rates. These fair value measurements are based on significant inputs not observable in the market. Substantial judgment is employed in determining the
appropriateness of these assumptions as of the acquisition date and for each subsequent period. Accordingly, changes in assumptions could have a material impact on the amount of contingent consideration expense the Company records in any given
period.The Company determined the fair value of its contingent consideration obligation to be $9.8 million and $8.3 million on December 31, 2023 and 2022.
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Segment Reporting |
Segment Reporting
Operating segments are components of an enterprise for which separate financial
information is available that is evaluated regularly by chief operating decision makers in determining the allocation of resources and in assessing performance. The Company currently operates through two segments: physical therapy operations and industrial injury prevention services.
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Use of Estimates |
Use of Estimates
In preparing the Company’s consolidated financial statements, management makes certain estimates and assumptions, especially in relation to, but
not limited to, goodwill impairment, tradenames, allocations of purchase price, allowance for receivables, tax provision and contractual allowances, that affect the amounts reported in the consolidated financial statements and related disclosures.
Actual results may differ from these estimates.
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Self-Insurance Program |
Self-Insurance Program
The Company utilizes a self-insurance plan for its employee group health and dental insurance coverage administered by a third party.
Predetermined loss limits have been arranged with the insurance company to minimize the Company’s maximum liability and cash outlay. Accrued expenses include the estimated incurred but unreported costs to settle unpaid claims and estimated future
claims. Management believes that the current accrued amounts are sufficient to pay claims arising from self-insurance claims incurred through December 31, 2023.
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Restricted Stock |
Restricted Stock
Restricted stock issued to employees and directors is subject to continued employment or continued service on the board, respectively. Generally,
restrictions on the stock granted to employees lapse in equal annual installments on the following
anniversaries of the date of
grant. For those shares granted to directors, the restrictions will lapse in equal quarterly installments during the year after
the date of grant. For those granted to officers, the restriction will lapse in equal quarterly installments during the four years
following the date of grant. Compensation expense for grants of restricted stock is recognized based on the fair value per share on the date of grant amortized over the vesting period. The Company recognizes any forfeitures as they occur. The
restricted stock issued is included in basic and diluted shares for the earnings per share computation. |
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Reclassification of Prior Period Presentation |
Reclassification of Prior Period Presentation
Certain prior year amounts have been
reclassified for consistency with the current year presentation. These reclassifications had no effect on the reported results of operations.
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Recently Issued Accounting Pronouncement |
Recently Adopted Accounting Pronouncements
In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740)–Simplifying the Accounting for Income Taxes (“ASU 2019-12”). The objective of ASU 2019-12 is to simplify the accounting for income taxes by removing
certain exceptions to the general principles in Topic 740 and to provide more consistent application to improve the comparability of financial statements. The amendments in this ASU are effective for fiscal years beginning after December 15, 2020, and early adoption was permitted. The Company completed the adoption of ASU 2020-06
effective January 1, 2021 and there was no material impact on the Company’s financial statements.
In August 2020, the FASB issued ASU 2020-06 Debt—Debt with
Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity, which simplifies the accounting
for certain financial instruments with characteristics of liabilities and equity, including convertible instruments and contracts on an entity’s own equity. As part of this update, convertible instruments are to be included in diluted earnings per
share using the if-converted method, rather than the treasury stock method. Further, contracts which can be settled in cash or shares, excluding liability-classified share-based payment awards, are to be included in diluted earnings per share on an
if-converted basis if the effect is dilutive, regardless of whether the entity or the counterparty can choose between cash and share settlement. The share-settlement presumption may not be rebutted based on past experience or a stated policy.
This pronouncement was effective for fiscal years, and for interim periods within those fiscal years, beginning after December 15, 2021.The Board specified that an
entity should adopt the guidance at the beginning of its annual fiscal year. The Company adopted this pronouncement as of January 1, 2022. The use of either the modified retrospective or fully retrospective method of transition is permitted. The
adoption of ASU 2020-06 did not have a material impact on the Company’s financial statements.
In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848):
Facilitation of the Effects of Reference Rate Reform on Financial Reporting. This ASU provides temporary optional expedients and exceptions to the
guidance on contract modifications and hedge accounting to ease the financial reporting burdens of the expected market transition from LIBOR and other
interbank offered rates to alternative reference rates. The new guidance was effective upon issuance, and the Company has elected to apply the amendments prospectively through December 31, 2022. Borrowings under the Company’s Credit Agreement
bear interest based on SOFR.
Recently Issued Accounting Guidance
In March 2023, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2023-01, Leases (Topic 842): Common Control Arrangements,
which requires companies to amortize leasehold improvements associated with related party leases under common control over the useful life of the leasehold improvement to the common control group. The ASU is effective for annual reporting periods
beginning on or after December 15, 2023; however, early adoption is permitted. The ASU can either be applied prospectively or retrospectively. The adoption of ASU 2023-01 did not have a material effect on the Company’s financial statements.
|
Organization, Nature of Operations and Basis of Presentation (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Organization, Nature of Operations and Basis of Presentation [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Acquisitions Within Physical Therapy Operations Segment |
During
the last three years, the Company completed the acquisitions of the following clinic practices and IIP businesses detailed below:
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Earnings Per Share (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Earnings Per Share [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Computations of Basic and Diluted Earnings |
The computations of basic and diluted earnings are as follows.
|
Acquisitions of Businesses (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Acquisitions of Businesses [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Clinic Acquisition |
During 2023, 2022 and 2021, the Company acquired a majority
interest in the following businesses:
2023 Acquisitions
2022 Acquisitions
2021 Acquisitions
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Purchase Price Allocation |
The purchase prices for the 2023 acquisitions have been preliminarily allocated as
follows.
The purchase price for the 2022 acquisitions has been allocated as follows.
The purchase price for the 2021 acquisitions has been allocated as follows.
|
Redeemable Non-Controlling Interest (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
REDEEMABLE NON-CONTROLLING INTEREST [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Changes in Carrying Amount (Fair Value) of Redeemable Non-Controlling Interest |
For the years ended December 31, 2023, 2022 and 2021, the following table details the changes in the carrying amount (fair value) of the
redeemable non-controlling interests.
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Carrying Amount of (Fair Value) Redeemable Non-Controlling Interest |
The following table categorizes the carrying amount (fair value) of the redeemable non-controlling interests.
|
Goodwill (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Goodwill [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Changes in Carrying Amount of Goodwill |
The changes in the carrying amount of goodwill consisted of the following.
|
Intangible Assets, net (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Intangible Assets, net [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Intangible Assets, Net |
The Company’s intangible assets, net, consisted of the following.
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Amortization Expenses |
The following table details the amount of amortization expense recorded for intangible assets for the periods presented.
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Amortization of Customer and Referral Relationships and Non-compete Agreements |
The remaining balances of the customer and referral relationships and non-compete agreements are expected to be amortized as follows.
|
Accrued Expenses (Tables) |
12 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Accrued Expenses [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Accrued Expenses |
Accrued expenses consisted of the following.
|
Borrowings (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
BORROWINGS [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Credit Agreement and Notes Payable |
Amounts outstanding under the Credit Agreement (as defined above) and notes payable consisted of the following.
(1) The long-term portion is included as part of Other Long-Term Liabilities in the Consolidated Balance Sheet.
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Derivative Instruments (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Derivative Instruments [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Impacts of Derivative Instruments on Consolidated Statements of Comprehensive Income |
The impacts of the Company’s derivative instruments on the accompanying Consolidated Statements of Comprehensive Income are presented in the table below.
|
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Carrying and Fair Value of Interest Rate Derivatives |
The carrying and fair value of the Company’s interest rate derivatives (included in other current assets and other assets) were as follows:
|
Leases (Tables) |
12 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Leases [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Components of Lease Expense |
The components of lease expense were as follows.
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Supplemental Information Related to Leases |
The supplemental cash flow information related to leases was as follows.
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Future Lease Payments for Operating Leases |
The aggregate future lease payments for
operating leases as of December 31, 2023, were as follows.
|
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Average Lease Terms and Discount Rates |
Average lease terms and discount rates were as follows:
|
Income Taxes (Tables) |
12 Months Ended | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Income Taxes [Abstract] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Components of Deferred Tax Assets and Liabilities Included in Consolidated Balance Sheets |
Significant components of deferred tax assets and liabilities included in the consolidated balance sheets as of the periods below were as follows.
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Differences Between Federal Tax Rate and Company's Effective Tax Rate for Results of Continuing Operations |
The differences between the federal tax rate and the Company’s effective tax rate for the years ended December 31, were as follows for the periods
presented:
|
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Significant Components of Provision for Income Taxes for Continuing Operations |
Significant components of the provision for income taxes were as follows for the periods presented.
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Segment Information (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Segment Information [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Selected Financial Data for Reportable Segments |
The following table summarizes selected financial data for the Company’s reportable segments. Prior
year results presented herein have been changed to conform to the current presentation.
|
Equity Based Plans (Tables) |
12 Months Ended | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Equity Based Plans [Abstract] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Restricted Stock Granted and Cancelled |
During 2023, 2022 and 2021, the Company granted the following shares
of restricted stock to directors, officers, and employees pursuant to its equity plans as follows:
During 2023, 2022 and 2021, the following shares were cancelled due to employee terminations prior to restrictions lapsing:
|
Organization, Nature of Operations and Basis of Presentation - Summary (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Change Due to Net Income Attributable to Parent and Effects of Changes, Net [Abstract] | |||
Relief funds | $ 467 | $ 0 | $ 4,597 |
Public Health and Social Services Emergency Fund [Member] | |||
Consolidation, Less than Wholly Owned Subsidiary, Parent Ownership Interest, Change Due to Net Income Attributable to Parent and Effects of Changes, Net [Abstract] | |||
Grants and other funds | $ 100,000,000 | ||
Relief funds | $ 4,600 |
Significant Accounting Policies, Long-Lived Assets (Details) |
Dec. 31, 2023 |
---|---|
Furniture and Equipment [Member] | Minimum [Member] | |
Long-Lived Assets [Abstract] | |
Estimated useful lives | 3 years |
Furniture and Equipment [Member] | Maximum [Member] | |
Long-Lived Assets [Abstract] | |
Estimated useful lives | 8 years |
Software [Member] | Minimum [Member] | |
Long-Lived Assets [Abstract] | |
Estimated useful lives | 3 years |
Software [Member] | Maximum [Member] | |
Long-Lived Assets [Abstract] | |
Estimated useful lives | 7 years |
Leasehold Improvements [Member] | Minimum [Member] | |
Long-Lived Assets [Abstract] | |
Estimated useful lives | 3 years |
Leasehold Improvements [Member] | Maximum [Member] | |
Long-Lived Assets [Abstract] | |
Estimated useful lives | 5 years |
Significant Accounting Policies, Goodwill and Other Indefinite-Lived Intangible Assets (Details) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023
USD ($)
ReportingUnit
Region
Segment
|
Dec. 31, 2022
USD ($)
Region
ReportingUnit
|
Dec. 31, 2021
USD ($)
|
|
Goodwill and Other Indefinite-Lived Intangible Assets [Abstract] | |||
Number of business segments | Segment | 2 | ||
Number of regions | Region | 6 | 6 | |
Goodwill impairment | $ 15,800 | $ 9,112 | |
Impairment of goodwill and tradenames | 17,495 | $ 9,112 | $ 0 |
Impairment of long-lived assets | $ 0 | ||
Industrial Injury Prevention Services [Member] | |||
Goodwill and Other Indefinite-Lived Intangible Assets [Abstract] | |||
Number of reporting units | ReportingUnit | 2 | 2 | |
Goodwill impairment | $ 15,800 | $ 9,100 | |
Impairment of tradename | $ 1,700 | ||
Impairment, Intangible Asset, Indefinite-Lived (Excluding Goodwill), Statement of Income or Comprehensive Income [Extensible Enumeration] | Impairment of goodwill and tradenames | ||
Other [Member] | |||
Goodwill and Other Indefinite-Lived Intangible Assets [Abstract] | |||
Number of reporting units | ReportingUnit | 7 | ||
Impairment of goodwill and tradenames | $ 0 |
Significant Accounting Policies, Redeemable Non-Controlling Interest (Details) |
12 Months Ended |
---|---|
Dec. 31, 2023 | |
Minimum [Member] | |
Redeemable Non-Controlling Interest [Abstract] | |
Redeemable non-controlling interest, redemption rights, commencement period | 3 years |
Maximum [Member] | |
Redeemable Non-Controlling Interest [Abstract] | |
Redeemable non-controlling interest, redemption rights, commencement period | 5 years |
Significant Accounting Policies, Revenue Recognition (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Revenue Recognition [Abstract] | |||
Revenue | $ 604,802 | $ 553,144 | $ 495,022 |
Minimum [Member] | |||
Revenue Recognition [Abstract] | |||
Terms for payments due for services rendered | 30 days | ||
Maximum [Member] | |||
Revenue Recognition [Abstract] | |||
Terms for payments due for services rendered | 120 days | ||
Management Contract Revenue [Member] | |||
Revenue Recognition [Abstract] | |||
Revenue | $ 8,600 | $ 8,100 | $ 9,900 |
Significant Accounting Policies, Contractual Allowances (Details) |
12 Months Ended |
---|---|
Dec. 31, 2023 | |
Minimum [Member] | |
Contractual Allowances [Abstract] | |
Difference between net revenues and corresponding cash collections, approximately of net revenues | 1.00% |
Difference between actual aggregate contractual reserve and estimated contractual allowance reserve percentage | 1.00% |
Maximum contractual allowance reserve estimate | 1.00% |
Maximum [Member] | |
Contractual Allowances [Abstract] | |
Difference between net revenues and corresponding cash collections, approximately of net revenues | 1.50% |
Difference between actual aggregate contractual reserve and estimated contractual allowance reserve percentage | 1.50% |
Maximum contractual allowance reserve estimate | 1.50% |
Significant Accounting Policies, Income Taxes (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Income Taxes [Abstract] | |||
Interest or penalties | $ 0 | $ 0 | $ 0 |
Significant Accounting Policies, Fair Value of Financial Instruments (Details) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023
USD ($)
|
Dec. 31, 2022
USD ($)
|
Dec. 31, 2021
USD ($)
|
|
Fair Values of Financial Instruments [Abstract] | |||
Decrease in put right | $ (2,600) | ||
Put right value | $ 1,000 | 3,600 | |
Gain on change in revaluation of put-right liability | 2,582 | (5) | $ 0 |
Interest rate derivative | 3,700 | ||
Unrealized loss from interest rate swap | (1,200) | ||
Fair value of contingent consideration | 9,800 | $ 8,300 | |
Other Current Assets [Member] | |||
Fair Values of Financial Instruments [Abstract] | |||
Interest rate derivative | 2,600 | ||
Other Assets [Member] | |||
Fair Values of Financial Instruments [Abstract] | |||
Interest rate derivative | $ 1,100 | ||
Volatility [Member] | |||
Fair Values of Financial Instruments [Abstract] | |||
Debt instrument, measurement input | 0.25 | ||
Discount Rate [Member] | |||
Fair Values of Financial Instruments [Abstract] | |||
Debt instrument, measurement input | 0.1122 |
Significant Accounting Policies, Segment Reporting (Details) |
12 Months Ended |
---|---|
Dec. 31, 2023
Segment
| |
Segment Reporting [Abstract] | |
Number of business segments | 2 |
Significant Accounting Policies, Restricted Stock (Details) |
12 Months Ended |
---|---|
Dec. 31, 2023 | |
Employees [Member] | |
Restricted Stock [Abstract] | |
Period in which restrictions lapse on stock granted | 4 years |
Directors [Member] | |
Restricted Stock [Abstract] | |
Period in which restrictions lapse on stock granted | 1 year |
Officers [Member] | |
Restricted Stock [Abstract] | |
Period in which restrictions lapse on stock granted | 4 years |
Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Computation of earnings per share - USPH shareholders [Abstract] | |||
Net income attributable to USPH shareholders | $ 28,239 | $ 32,158 | $ 40,831 |
Charges to retained earnings [Abstract] | |||
Revaluation of redeemable non-controlling interest | (13,565) | (3,890) | (13,011) |
Tax effect at statutory rate (federal and state) | 3,466 | 994 | 3,324 |
Net income attributable to common shareholders | $ 18,140 | $ 29,262 | $ 31,144 |
Earnings per share basic (in dollars per share) | $ 1.28 | $ 2.25 | $ 2.41 |
Earnings per share diluted (in dollars per share) | $ 1.28 | $ 2.25 | $ 2.41 |
Shares used in computation [Abstract] | |||
Basic earnings per share - weighted-average shares (in shares) | 14,188 | 12,985 | 12,898 |
Diluted earnings per share - weighted-average shares (in shares) | 14,188 | 12,985 | 12,898 |
Acquisitions of Businesses, 2023 Acquired Majority Interest (Details) |
12 Months Ended | |||||
---|---|---|---|---|---|---|
Dec. 31, 2023
Clinic
| ||||||
October 2023 Acquisition [Member] | ||||||
Business Combination, Description [Abstract] | ||||||
Acquisition date | Oct. 31, 2023 | [1],[2] | ||||
Percentage of interest acquired | [2] | |||||
Number of clinics | [1] | |||||
September 2023 Acquisition 1 [Member] | ||||||
Business Combination, Description [Abstract] | ||||||
Acquisition date | Sep. 29, 2023 | |||||
Percentage of interest acquired | 70.00% | |||||
Number of clinics | 4 | |||||
September 2023 Acquisition 2 [Member] | ||||||
Business Combination, Description [Abstract] | ||||||
Acquisition date | Sep. 29, 2023 | |||||
Percentage of interest acquired | 70.00% | |||||
Number of clinics | 1 | |||||
July 2023 Acquisition [Member] | ||||||
Business Combination, Description [Abstract] | ||||||
Acquisition date | Jul. 31, 2023 | |||||
Percentage of interest acquired | 70.00% | |||||
Number of clinics | 7 | |||||
May 2023 Acquisition [Member] | ||||||
Business Combination, Description [Abstract] | ||||||
Acquisition date | May 31, 2023 | |||||
Percentage of interest acquired | 45.00% | |||||
Number of clinics | 4 | |||||
February 2023 Acquisition [Member] | ||||||
Business Combination, Description [Abstract] | ||||||
Acquisition date | Feb. 28, 2023 | |||||
Percentage of interest acquired | 80.00% | |||||
Number of clinics | 1 | |||||
|
Acquisitions of Businesses, 2023 Acquisitions (Details) $ in Thousands |
12 Months Ended | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Oct. 31, 2023
USD ($)
|
Sep. 29, 2023
USD ($)
Clinic
Installment
|
Jul. 31, 2023
USD ($)
Clinic
|
May 31, 2023
USD ($)
Clinic
|
Feb. 28, 2023
USD ($)
Clinic
|
Nov. 30, 2022
USD ($)
Clinic
|
Oct. 31, 2022
USD ($)
Clinic
|
Sep. 30, 2022
USD ($)
Clinic
|
Aug. 31, 2022
USD ($)
Clinic
|
Mar. 31, 2022
USD ($)
Clinic
|
Dec. 31, 2021
USD ($)
Clinic
|
Jun. 30, 2021
USD ($)
Clinic
|
Mar. 31, 2021
USD ($)
Clinic
|
Dec. 31, 2023
USD ($)
|
Dec. 31, 2022
USD ($)
|
|
Business Combination, Description [Abstract] | |||||||||||||||
Contingent payments | $ 9,800 | $ 8,300 | |||||||||||||
Customer and Referral Relationships [Member] | |||||||||||||||
Estimated fair value of net tangible assets acquired [Abstract] | |||||||||||||||
Estimated useful lives of acquired intangibles | 12 years | 12 years 2 months 12 days | |||||||||||||
Non-compete Agreements [Member] | |||||||||||||||
Estimated fair value of net tangible assets acquired [Abstract] | |||||||||||||||
Estimated useful lives of acquired intangibles | 5 years 1 month 6 days | 5 years | |||||||||||||
Physical Therapy Operations [Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Deferred payments | $ 830 | ||||||||||||||
Contingent payments | $ 837 | 200 | |||||||||||||
Cash paid, net of cash acquired | 22,627 | ||||||||||||||
Seller notes | 800 | 985 | |||||||||||||
Total consideration | 26,267 | 24,642 | |||||||||||||
Estimated fair value of net tangible assets acquired [Abstract] | |||||||||||||||
Total current assets | 1,885 | 1,141 | |||||||||||||
Total non-current assets | 7,014 | 3,149 | |||||||||||||
Total liabilities | (8,313) | (3,163) | |||||||||||||
Net tangible assets acquired | 586 | 1,127 | |||||||||||||
Customer and referral relationships | 7,969 | 6,819 | |||||||||||||
Non-compete agreements | 415 | 329 | |||||||||||||
Tradenames | 2,144 | 1,680 | |||||||||||||
Goodwill | 27,109 | 25,521 | |||||||||||||
Fair value of non-controlling interest (classified as redeemable non-controlling interest) | (11,956) | (10,834) | |||||||||||||
Total consideration | 26,267 | 24,642 | |||||||||||||
IIP Business [Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Percentage of interest acquired | 100.00% | ||||||||||||||
Deferred payments | 0 | ||||||||||||||
Contingent payments | 0 | ||||||||||||||
Cash paid, net of cash acquired | 3,955 | ||||||||||||||
Seller notes | 0 | ||||||||||||||
Total consideration | 3,955 | ||||||||||||||
Estimated fair value of net tangible assets acquired [Abstract] | |||||||||||||||
Total current assets | 392 | ||||||||||||||
Total non-current assets | 335 | ||||||||||||||
Total liabilities | (41) | ||||||||||||||
Net tangible assets acquired | 686 | ||||||||||||||
Customer and referral relationships | 757 | ||||||||||||||
Non-compete agreements | 37 | ||||||||||||||
Tradenames | 187 | ||||||||||||||
Goodwill | 2,562 | ||||||||||||||
Fair value of non-controlling interest (classified as redeemable non-controlling interest) | (274) | ||||||||||||||
Total consideration | 3,955 | ||||||||||||||
Ergonomics Software Business [Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Percentage of interest acquired | 55.00% | ||||||||||||||
Percentage of interest retained by practice founder | 45.00% | ||||||||||||||
IIP and Ergonomics Software Business [Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Aggregate purchase price for the acquisition | $ 4,000 | ||||||||||||||
Acquisitions [Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Deferred payments | 830 | ||||||||||||||
Contingent payments | 3,357 | 200 | $ 10,000 | ||||||||||||
Cash paid, net of cash acquired | 26,582 | ||||||||||||||
Seller notes | 2,050 | 985 | 1,574 | ||||||||||||
Total consideration | 96,752 | 28,597 | 71,362 | ||||||||||||
Estimated fair value of net tangible assets acquired [Abstract] | |||||||||||||||
Total current assets | 7,473 | 1,533 | 1,329 | ||||||||||||
Total non-current assets | 19,634 | 3,484 | 7,798 | ||||||||||||
Total liabilities | (13,155) | (3,204) | (10,930) | ||||||||||||
Net tangible assets acquired | 13,952 | 1,813 | (1,803) | ||||||||||||
Customer and referral relationships | 29,096 | 7,576 | 18,062 | ||||||||||||
Non-compete agreements | 915 | 366 | 934 | ||||||||||||
Tradenames | 7,285 | 1,867 | 5,445 | ||||||||||||
Goodwill | 85,366 | 28,083 | 75,525 | ||||||||||||
Fair value of non-controlling interest (classified as redeemable non-controlling interest) | (39,862) | (11,108) | (26,801) | ||||||||||||
Total consideration | $ 96,752 | 28,597 | $ 71,362 | ||||||||||||
Clinic Practice [Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Percentage of interest acquired | 70.00% | 75.00% | 80.00% | 80.00% | 60.00% | 80.00% | 70.00% | 70.00% | 75.00% | 65.00% | 70.00% | ||||
Number of clinics | Clinic | 5 | 4 | 1 | 13 | 14 | 2 | 6 | 6 | 3 | 8 | 5 | ||||
Deferred payments | $ 300 | ||||||||||||||
Contingent payments | $ 9,800 | $ 800 | $ 1,600 | ||||||||||||
Percentage of ownership interest after the acquisition | 45.00% | ||||||||||||||
Percentage of ownership interest by local partner after the acquisition | 30.00% | ||||||||||||||
Percentage of interest retained by practice founder | 30.00% | 20.00% | 20.00% | 40.00% | 20.00% | 30.00% | 30.00% | 25.00% | |||||||
Percentage of pre-acquisition interest retained by practice founder | 25.00% | ||||||||||||||
Aggregate purchase price for the acquisition | $ 2,100 | $ 3,100 | $ 6,200 | $ 25,000 | $ 19,500 | $ 4,200 | $ 3,500 | $ 11,500 | $ 3,700 | 10,300 | $ 12,000 | ||||
Cash paid by local partner | 1,100 | ||||||||||||||
Seller note to be paid by entity | 200 | ||||||||||||||
Seller note to be paid by local partner | 100 | ||||||||||||||
Cash paid, net of cash acquired | $ 1,800 | 1,700 | 5,800 | 24,200 | 3,900 | 3,300 | 11,200 | 3,500 | 9,000 | 11,700 | |||||
Seller notes | $ 300 | $ 400 | $ 800 | $ 300 | $ 200 | $ 300 | $ 200 | $ 300 | $ 300 | ||||||
Percentage of interest accrued | 4.50% | 7.00% | 5.50% | 5.50% | 3.50% | 3.25% | 3.25% | 3.25% | |||||||
September 2023 Multi Clinic Practice Acquisition [Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Percentage of interest acquired | 70.00% | ||||||||||||||
Number of clinics | Clinic | 4 | ||||||||||||||
Percentage of interest retained by practice founder | 30.00% | ||||||||||||||
Aggregate purchase price for the acquisition | $ 6,000 | ||||||||||||||
Cash paid, net of cash acquired | 5,400 | ||||||||||||||
Seller notes | $ 600 | ||||||||||||||
Percentage of interest accrued | 5.00% | ||||||||||||||
Number of installments of payment of consideration due | Installment | 2 | ||||||||||||||
September 2023 Multi Clinic Practice Acquisition [Member] | First Installment Due on January 31, 2024 [Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Payment of principal and interest | $ 300 | ||||||||||||||
September 2023 Multi Clinic Practice Acquisition [Member] | Second Installment Due on September 30, 2025[Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Payment of principal and interest | $ 300 | ||||||||||||||
September 2023 Single Clinic Practice Acquisition [Member] | |||||||||||||||
Business Combination, Description [Abstract] | |||||||||||||||
Percentage of interest acquired | 70.00% | ||||||||||||||
Number of clinics | Clinic | 1 | ||||||||||||||
Deferred payments | $ 400 | ||||||||||||||
Percentage of interest retained by practice founder | 30.00% | ||||||||||||||
Aggregate purchase price for the acquisition | $ 7,800 | ||||||||||||||
Cash paid, net of cash acquired | $ 7,400 |
Acquisitions of Businesses, 2022 Acquired Majority Interest (Details) |
12 Months Ended |
---|---|
Dec. 31, 2023
Clinic
| |
November 2022 Acquisition [Member] | |
Business Combination, Description [Abstract] | |
Acquisition date | Nov. 30, 2022 |
Percentage of interest acquired | 80.00% |
Number of clinics | 13 |
October 2022 Acquisition [Member] | |
Business Combination, Description [Abstract] | |
Acquisition date | Oct. 31, 2022 |
Percentage of interest acquired | 60.00% |
Number of clinics | 14 |
September 2022 Acquisition [Member] | |
Business Combination, Description [Abstract] | |
Acquisition date | Sep. 30, 2022 |
Percentage of interest acquired | 80.00% |
Number of clinics | 2 |
August 2022 Acquisition [Member] | |
Business Combination, Description [Abstract] | |
Acquisition date | Aug. 31, 2022 |
Percentage of interest acquired | 70.00% |
Number of clinics | 6 |
March 2022 Acquisition [Member] | |
Business Combination, Description [Abstract] | |
Acquisition date | Mar. 31, 2022 |
Percentage of interest acquired | 70.00% |
Number of clinics | 6 |
Acquisitions of Businesses, 2022 Acquisition (Details) $ in Thousands |
12 Months Ended | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Jul. 31, 2023
USD ($)
Clinic
|
May 31, 2023
USD ($)
Clinic
|
Feb. 28, 2023
USD ($)
Clinic
|
Nov. 30, 2022
USD ($)
Clinic
|
Oct. 31, 2022
USD ($)
Clinic
|
Sep. 30, 2022
USD ($)
Clinic
|
Aug. 31, 2022
USD ($)
Clinic
|
Mar. 31, 2022
USD ($)
Clinic
|
Dec. 31, 2021
USD ($)
Clinic
|
Jun. 30, 2021
USD ($)
Clinic
|
Mar. 31, 2021
USD ($)
Clinic
|
Dec. 31, 2023
USD ($)
|
Dec. 31, 2022
USD ($)
|
Dec. 31, 2021
USD ($)
|
|
Business Combination, Description [Abstract] | ||||||||||||||
Cash paid, net of cash acquired | $ 26,582 | $ 59,788 | $ 86,823 | |||||||||||
Contingent payments | $ 9,800 | $ 8,300 | ||||||||||||
Customer and Referral Relationships [Member] | ||||||||||||||
Estimated fair value of net tangible assets acquired [Abstract] | ||||||||||||||
Estimated useful lives of acquired intangibles | 12 years | 12 years 2 months 12 days | ||||||||||||
Non-compete Agreements [Member] | ||||||||||||||
Estimated fair value of net tangible assets acquired [Abstract] | ||||||||||||||
Estimated useful lives of acquired intangibles | 5 years 1 month 6 days | 5 years | ||||||||||||
Clinic Practice [Member] | ||||||||||||||
Business Combination, Description [Abstract] | ||||||||||||||
Percentage of interest acquired | 70.00% | 75.00% | 80.00% | 80.00% | 60.00% | 80.00% | 70.00% | 70.00% | 75.00% | 65.00% | 70.00% | 75.00% | ||
Number of clinics | Clinic | 5 | 4 | 1 | 13 | 14 | 2 | 6 | 6 | 3 | 8 | 5 | |||
Percentage of interest retained by practice founder | 30.00% | 20.00% | 20.00% | 40.00% | 20.00% | 30.00% | 30.00% | 25.00% | 25.00% | |||||
Aggregate purchase price for the acquisition | $ 2,100 | $ 3,100 | $ 6,200 | $ 25,000 | $ 19,500 | $ 4,200 | $ 3,500 | $ 11,500 | $ 3,700 | $ 10,300 | $ 12,000 | |||
Cash paid for acquisition | $ 1,800 | 1,700 | $ 5,800 | $ 24,200 | $ 3,900 | $ 3,300 | $ 11,200 | $ 3,500 | $ 9,000 | $ 11,700 | ||||
Percentage of interest accrued | 4.50% | 7.00% | 5.50% | 5.50% | 3.50% | 3.25% | 3.25% | 3.25% | 3.25% | |||||
Seller notes | $ 300 | $ 400 | $ 800 | $ 300 | $ 200 | $ 300 | $ 200 | $ 300 | $ 300 | $ 200 | ||||
Contingent payments | $ 9,800 | $ 800 | $ 1,600 | |||||||||||
Clinic Practice [Member] | Maximum [Member] | ||||||||||||||
Business Combination, Description [Abstract] | ||||||||||||||
Percentage of interest acquired | 35.00% | 35.00% | 35.00% | 35.00% | ||||||||||
Contingent payments | $ 1,600 | |||||||||||||
Acquisitions [Member] | ||||||||||||||
Business Combination, Description [Abstract] | ||||||||||||||
Cash paid for acquisition | $ 26,582 | |||||||||||||
Cash paid, net of cash acquired | $ 59,788 | $ 86,823 | ||||||||||||
Seller notes | $ 2,050 | 985 | 1,574 | 2,050 | ||||||||||
Contingent payments | 3,357 | 200 | 10,000 | 3,357 | ||||||||||
Total consideration | 96,752 | 28,597 | 71,362 | 96,752 | ||||||||||
Estimated fair value of net tangible assets acquired [Abstract] | ||||||||||||||
Total current assets | 7,473 | 1,533 | 1,329 | 7,473 | ||||||||||
Total non-current assets | 19,634 | 3,484 | 7,798 | 19,634 | ||||||||||
Total liabilities | (13,155) | (3,204) | (10,930) | (13,155) | ||||||||||
Net tangible assets acquired | 13,952 | 1,813 | (1,803) | 13,952 | ||||||||||
Customer and referral relationships | 29,096 | 7,576 | 18,062 | 29,096 | ||||||||||
Non-compete agreements | 915 | 366 | 934 | 915 | ||||||||||
Tradenames | 7,285 | 1,867 | 5,445 | 7,285 | ||||||||||
Goodwill | 85,366 | 28,083 | 75,525 | 85,366 | ||||||||||
Fair value of non-controlling interest (classified as redeemable non-controlling interest) | (39,862) | (11,108) | (26,801) | (39,862) | ||||||||||
Total consideration | $ 96,752 | $ 28,597 | $ 71,362 | $ 96,752 |
Acquisitions of Businesses, 2021 Acquired Majority Interest (Details) |
12 Months Ended | |||
---|---|---|---|---|
Dec. 31, 2023
Clinic
| ||||
December 2021 Acquisition [Member] | ||||
Business Combination, Description [Abstract] | ||||
Acquisition date | Dec. 31, 2021 | |||
Percentage of interest acquired | 75.00% | |||
Number of clinics | 3 | |||
November 2021 Acquisition [Member] | ||||
Business Combination, Description [Abstract] | ||||
Acquisition date | Nov. 30, 2021 | |||
Percentage of interest acquired | 70.00% | |||
Number of clinics | [1] | |||
September 2021 Acquisition [Member] | ||||
Business Combination, Description [Abstract] | ||||
Acquisition date | Sep. 30, 2021 | |||
Percentage of interest acquired | 100.00% | |||
Number of clinics | [1] | |||
June 2021 Acquisition [Member] | ||||
Business Combination, Description [Abstract] | ||||
Acquisition date | Jun. 30, 2021 | |||
Percentage of interest acquired | 65.00% | |||
Number of clinics | 8 | |||
March 2021 Acquisition [Member] | ||||
Business Combination, Description [Abstract] | ||||
Acquisition date | Mar. 31, 2021 | |||
Percentage of interest acquired | 70.00% | |||
Number of clinics | 6 | |||
|
Acquisitions of Businesses, 2021 Acquisition (Details) $ in Thousands |
12 Months Ended | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Jul. 31, 2023
USD ($)
Clinic
|
May 31, 2023
USD ($)
Clinic
|
Feb. 28, 2023
USD ($)
Clinic
|
Nov. 30, 2022
USD ($)
Clinic
|
Oct. 31, 2022
USD ($)
Clinic
|
Sep. 30, 2022
USD ($)
Clinic
|
Aug. 31, 2022
USD ($)
Clinic
|
Mar. 31, 2022
USD ($)
Clinic
|
Dec. 31, 2021
USD ($)
Clinic
|
Nov. 30, 2021
USD ($)
|
Sep. 30, 2021
USD ($)
|
Jun. 30, 2021
USD ($)
Clinic
|
Mar. 31, 2021
USD ($)
Clinic
|
Dec. 31, 2023
USD ($)
|
Dec. 31, 2022
USD ($)
|
Dec. 31, 2021
USD ($)
|
|
Business Combination, Description [Abstract] | ||||||||||||||||
Contingent payment consideration | $ 9,800 | $ 8,300 | ||||||||||||||
Elimination of contingent consideration liability after revaluation | $ (1,550) | 2,520 | $ 0 | |||||||||||||
IIPS [Member] | ||||||||||||||||
Business Combination, Description [Abstract] | ||||||||||||||||
Percentage of interest acquired | 70.00% | |||||||||||||||
Aggregate purchase price for the acquisition | $ 63,200 | |||||||||||||||
Contingent payment consideration | $ 2,520 | 2,520 | ||||||||||||||
Cash paid for acquisition | 60,700 | |||||||||||||||
Seller notes | $ 1,250 | $ 1,000 | 1,250 | |||||||||||||
Percentage of interest accrued | 3.25% | |||||||||||||||
Remaining contract term | 5 years | |||||||||||||||
Ownership rights | $ 1,200 | $ 3,522 | ||||||||||||||
Elimination of contingent consideration liability after revaluation | 2,000 | |||||||||||||||
Reduction of liability | 0 | |||||||||||||||
IIPS [Member] | Maximum [Member] | ||||||||||||||||
Business Combination, Description [Abstract] | ||||||||||||||||
Contingent payment consideration | $ 2,000 | |||||||||||||||
Return-to-work and Ergonomic Services [Member] | ||||||||||||||||
Business Combination, Description [Abstract] | ||||||||||||||||
Aggregate purchase price for the acquisition | $ 2,700 | |||||||||||||||
Contingent payment consideration | 600 | |||||||||||||||
Aggregate purchase price for the acquisition including contingent consideration | 3,300 | |||||||||||||||
Cash paid for acquisition | 2,400 | |||||||||||||||
Seller notes | $ 300 | |||||||||||||||
Percentage of interest accrued | 3.25% | |||||||||||||||
Elimination of contingent consideration liability after revaluation | 600 | |||||||||||||||
Reduction of liability | $ 0 | |||||||||||||||
Clinic Practice [Member] | ||||||||||||||||
Business Combination, Description [Abstract] | ||||||||||||||||
Percentage of interest acquired | 70.00% | 75.00% | 80.00% | 80.00% | 60.00% | 80.00% | 70.00% | 70.00% | 75.00% | 65.00% | 70.00% | 75.00% | ||||
Number of clinics | Clinic | 5 | 4 | 1 | 13 | 14 | 2 | 6 | 6 | 3 | 8 | 5 | |||||
Percentage of interest retained by practice founder | 30.00% | 20.00% | 20.00% | 40.00% | 20.00% | 30.00% | 30.00% | 25.00% | 25.00% | |||||||
Aggregate purchase price for the acquisition | $ 2,100 | $ 3,100 | $ 6,200 | $ 25,000 | $ 19,500 | $ 4,200 | $ 3,500 | $ 11,500 | $ 3,700 | $ 10,300 | $ 12,000 | |||||
Contingent payment consideration | $ 9,800 | 800 | 1,600 | |||||||||||||
Cash paid for acquisition | $ 1,800 | 1,700 | 5,800 | 24,200 | 3,900 | 3,300 | 11,200 | 3,500 | 9,000 | 11,700 | ||||||
Amount payable upon achievement of certain business criteria | 1,000 | |||||||||||||||
Seller notes | $ 300 | $ 400 | $ 800 | $ 300 | $ 200 | $ 300 | $ 200 | $ 300 | $ 300 | $ 200 | ||||||
Percentage of interest accrued | 4.50% | 7.00% | 5.50% | 5.50% | 3.50% | 3.25% | 3.25% | 3.25% | 3.25% | |||||||
Earn-out payment | $ 800 | |||||||||||||||
Clinic Practice [Member] | Maximum [Member] | ||||||||||||||||
Business Combination, Description [Abstract] | ||||||||||||||||
Percentage of interest acquired | 35.00% | 35.00% | 35.00% | 35.00% | ||||||||||||
Contingent payment consideration | $ 1,600 | |||||||||||||||
Clinic Practice [Member] | Pre-Closing Practice Owners [Member] | ||||||||||||||||
Business Combination, Description [Abstract] | ||||||||||||||||
Percentage of retained interest by previous owners | 35.00% | 30.00% |
Acquisition of Business, 2021 Preliminary Purchase Prices Allocation (Details) - USD ($) $ in Thousands |
12 Months Ended | |||
---|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Nov. 30, 2021 |
|
Business Combination, Description [Abstract] | ||||
Cash paid, net of cash acquired | $ 26,582 | $ 59,788 | $ 86,823 | |
Contingent payments | 9,800 | 8,300 | ||
Physical Therapy Operations [Member] | ||||
Business Combination, Description [Abstract] | ||||
Cash paid, net of cash acquired | 23,630 | |||
Seller notes | 985 | 800 | ||
Contingent payments | 200 | 837 | ||
Other payable | 1,000 | |||
Seller put right | 0 | |||
Total consideration | 24,642 | 26,267 | ||
Estimated fair value of net tangible assets acquired [Abstract] | ||||
Total current assets | 1,141 | 1,885 | ||
Total non-current assets | 3,149 | 7,014 | ||
Total liabilities | (3,163) | (8,313) | ||
Net tangible assets acquired | 1,127 | 586 | ||
Customer and referral relationships | 6,819 | 7,969 | ||
Non-compete agreements | 329 | 415 | ||
Tradenames | 1,680 | 2,144 | ||
Goodwill | 25,521 | 27,109 | ||
Fair value of non-controlling interest (classified as redeemable non-controlling interest) | (10,834) | (11,956) | ||
Total consideration | 24,642 | 26,267 | ||
IIPS [Member] | ||||
Business Combination, Description [Abstract] | ||||
Cash paid, net of cash acquired | 63,193 | |||
Seller notes | 1,250 | $ 1,000 | ||
Contingent payments | 2,520 | |||
Other payable | 0 | |||
Seller put right | 1,200 | 3,522 | ||
Total consideration | 70,485 | |||
Estimated fair value of net tangible assets acquired [Abstract] | ||||
Total current assets | 5,588 | |||
Total non-current assets | 12,620 | |||
Total liabilities | (4,842) | |||
Net tangible assets acquired | 13,366 | |||
Customer and referral relationships | 21,127 | |||
Non-compete agreements | 500 | |||
Tradenames | 5,141 | |||
Goodwill | 58,257 | |||
Fair value of non-controlling interest (classified as redeemable non-controlling interest) | (27,906) | |||
Total consideration | 70,485 | |||
Acquisitions [Member] | ||||
Business Combination, Description [Abstract] | ||||
Cash paid, net of cash acquired | 59,788 | 86,823 | ||
Seller notes | 985 | 1,574 | 2,050 | |
Contingent payments | 200 | 10,000 | 3,357 | |
Other payable | 1,000 | |||
Seller put right | 3,522 | |||
Total consideration | 28,597 | 71,362 | 96,752 | |
Estimated fair value of net tangible assets acquired [Abstract] | ||||
Total current assets | 1,533 | 1,329 | 7,473 | |
Total non-current assets | 3,484 | 7,798 | 19,634 | |
Total liabilities | (3,204) | (10,930) | (13,155) | |
Net tangible assets acquired | 1,813 | (1,803) | 13,952 | |
Customer and referral relationships | 7,576 | 18,062 | 29,096 | |
Non-compete agreements | 366 | 934 | 915 | |
Tradenames | 1,867 | 5,445 | 7,285 | |
Goodwill | 28,083 | 75,525 | 85,366 | |
Fair value of non-controlling interest (classified as redeemable non-controlling interest) | (11,108) | (26,801) | (39,862) | |
Total consideration | $ 28,597 | $ 71,362 | $ 96,752 |
Acquisitions and Sale of Non-Controlling Interests (Details) $ in Millions |
12 Months Ended | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023
USD ($)
Partnership
|
Dec. 31, 2022
USD ($)
Partnership
|
Dec. 31, 2021
USD ($)
Partnership
|
Jul. 31, 2023 |
May 31, 2023 |
Feb. 28, 2023 |
Nov. 30, 2022 |
Oct. 31, 2022 |
Sep. 30, 2022 |
Aug. 31, 2022 |
Mar. 31, 2022 |
Jun. 30, 2021 |
Mar. 31, 2021 |
|
Business Combination, Description [Abstract] | |||||||||||||
Number of partnerships in which interest acquired | Partnership | 3 | 3 | 5 | ||||||||||
Purchase price for additional non controlling interest | $ | $ 0.5 | $ 0.3 | $ 1.3 | ||||||||||
Number of partnerships in which the company sold interest | Partnership | 4 | ||||||||||||
Cash proceeds from sale of non-controlling interest | $ | $ 0.6 | $ 0.1 | |||||||||||
Clinic Practice [Member] | |||||||||||||
Business Combination, Description [Abstract] | |||||||||||||
Percentage of interest acquired | 75.00% | 70.00% | 75.00% | 80.00% | 80.00% | 60.00% | 80.00% | 70.00% | 70.00% | 65.00% | 70.00% | ||
Clinic Practice [Member] | Minimum [Member] | |||||||||||||
Business Combination, Description [Abstract] | |||||||||||||
Percentage of interest acquired | 0.15% | 10.00% | 5.00% | ||||||||||
Percentage of non-controlling interests - permanent equity sold in each partnership | 0.50% | ||||||||||||
Clinic Practice [Member] | Maximum [Member] | |||||||||||||
Business Combination, Description [Abstract] | |||||||||||||
Percentage of interest acquired | 35.00% | 35.00% | 35.00% | ||||||||||
Percentage of non-controlling interests - permanent equity sold in each partnership | 8.00% |
Redeemable Non-Controlling Interest (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Changes in Carrying Amount (Fair Value) of Redeemable Non-Controlling Interests [Roll Forward] | |||
Beginning balance | $ 167,515 | ||
Net income allocated to redeemable non-controlling interest | 4,426 | $ 6,902 | $ 11,358 |
Ending balance | 174,828 | 167,515 | |
Carrying Amount (Fair Value) of Redeemable Non-Controlling Interest [Abstract] | |||
Fair value | 174,828 | 167,515 | |
Redeemable Non-Controlling Interest [Member] | |||
Changes in Carrying Amount (Fair Value) of Redeemable Non-Controlling Interests [Roll Forward] | |||
Beginning balance | 167,515 | 155,262 | 132,340 |
Net income allocated to redeemable non-controlling interest | 4,426 | 6,902 | 11,358 |
Distributions to redeemable non-controlling interest partners | (11,533) | (10,102) | (11,359) |
Changes in the fair value of redeemable non-controlling interest | 13,565 | 3,862 | 13,011 |
Purchases of redeemable non-controlling interest | (12,073) | (16,061) | (30,204) |
Acquired interest | 11,007 | 26,746 | 39,862 |
Contributed capital | 0 | 231 | 0 |
Sales of redeemable non-controlling interest | 5,012 | 1,982 | 982 |
Changes in notes receivable related to redeemable non-controlling interest | (3,091) | (1,901) | (914) |
Adjustments in notes receivables related to the sales of redeemable non-controlling interest | 0 | 594 | 186 |
Ending balance | 174,828 | 167,515 | 155,262 |
Carrying Amount (Fair Value) of Redeemable Non-Controlling Interest [Abstract] | |||
Contractual time period has lapsed but holder's employment has not been terminated | 96,876 | 75,688 | 80,781 |
Contractual time period has not lapsed and holder's employment has not been terminated | 77,952 | 91,827 | 74,481 |
Holder's employment has terminated and contractual time period has expired | 0 | 0 | 0 |
Holder's employment has terminated and contractual time period has not expired | 0 | 0 | 0 |
Fair value | $ 174,828 | $ 167,515 | $ 155,262 |
Therapy Practice [Member] | Minimum [Member] | |||
Business Combination, Description [Abstract] | |||
Business acquisition, percentage of limited partnership acquired | 50.00% | ||
Therapy Practice [Member] | Maximum [Member] | |||
Business Combination, Description [Abstract] | |||
Business acquisition, percentage of limited partnership acquired | 90.00% | ||
Therapy Practice [Member] | NewCo. [Member] | |||
Business Combination, Description [Abstract] | |||
Percentage of equity interest of subsidiary contributed for acquisition | 100.00% | ||
Business acquisition, percentage of general partnership interest acquired | 100.00% | ||
Business acquisition, consideration payable, term of note | 2 years | ||
Employment agreement renewal term | 1 year | ||
Non-Compete agreement term under condition of termination of employment of employed selling shareholder | 2 years | ||
Therapy Practice [Member] | NewCo. [Member] | Minimum [Member] | |||
Business Combination, Description [Abstract] | |||
Employment agreement term | 3 years | ||
Non-Compete agreement term regardless of whether the selling shareholder is employed | 5 years | ||
Therapy Practice [Member] | NewCo. [Member] | Maximum [Member] | |||
Business Combination, Description [Abstract] | |||
Employment agreement term | 5 years | ||
Non-Compete agreement term regardless of whether the selling shareholder is employed | 6 years | ||
ProgressiveHealth [Member] | NewCo. [Member] | |||
Business Combination, Description [Abstract] | |||
Percentage of equity interest of subsidiary contributed for acquisition | 100.00% | ||
Non-Compete agreement term under condition of termination of employment of employed selling shareholder | 2 years | ||
Non-Compete agreement term regardless of whether the selling shareholder is employed | 7 years | ||
Percentage of right to sell equity interest on each of the 4th and 5th anniversaries | 30.00% | ||
Percentage of right to sell equity interest on each of the 6th and 7th anniversaries | 10.00% |
Goodwill (Details) - USD ($) $ in Thousands |
12 Months Ended | |
---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
|
Goodwill [Roll Forward] | ||
Beginning balance | $ 494,101 | $ 434,679 |
Acquisitions | 28,083 | 72,674 |
Adjustments for purchase price allocation of businesses acquired in prior year | 3,187 | (4,140) |
Impairment of goodwill | (15,800) | (9,112) |
Ending balance | $ 509,571 | $ 494,101 |
Intangible Assets, net, Intangible Assets, Net (Details) - USD ($) $ in Thousands |
12 Months Ended | |
---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
|
Finite-Lived Intangible Assets, Net [Abstract] | ||
Gross amount | $ 147,690 | $ 139,490 |
Accumulated amortization | (38,008) | (30,735) |
Net carrying amount | 109,682 | 108,755 |
Customer and Referral Relationships [Member] | ||
Finite-Lived Intangible Assets, Net [Abstract] | ||
Gross amount | 93,658 | 86,974 |
Accumulated amortization | (30,414) | (23,736) |
Net carrying amount | $ 63,244 | $ 63,238 |
Customer and Referral Relationships [Member] | Minimum [Member] | ||
Finite-Lived Intangible Assets, Net [Abstract] | ||
Estimated useful life | 6 years | |
Weighted average amortization period | 12 years 8 months 12 days | |
Customer and Referral Relationships [Member] | Maximum [Member] | ||
Finite-Lived Intangible Assets, Net [Abstract] | ||
Estimated useful life | 14 years | |
Weighted average amortization period | 12 years 10 months 24 days | |
Tradenames [Member] | ||
Finite-Lived Intangible Assets, Net [Abstract] | ||
Gross amount | $ 44,573 | $ 43,373 |
Accumulated amortization | 0 | 0 |
Net carrying amount | 44,573 | 43,373 |
Intangible Assets, Net (Excluding Goodwill) [Abstract] | ||
Impairment of tradename | $ 1,700 | |
Impairment, Intangible Asset, Indefinite-Lived (Excluding Goodwill), Statement of Income or Comprehensive Income [Extensible Enumeration] | Impairment of goodwill and tradenames | |
Non-compete Agreements [Member] | ||
Finite-Lived Intangible Assets, Net [Abstract] | ||
Gross amount | $ 9,459 | 9,143 |
Accumulated amortization | (7,594) | (6,999) |
Net carrying amount | $ 1,865 | $ 2,144 |
Non-compete Agreements [Member] | Minimum [Member] | ||
Finite-Lived Intangible Assets, Net [Abstract] | ||
Estimated useful life | 5 years | |
Weighted average amortization period | 5 years 7 months 6 days | |
Non-compete Agreements [Member] | Maximum [Member] | ||
Finite-Lived Intangible Assets, Net [Abstract] | ||
Estimated useful life | 6 years | |
Weighted average amortization period | 5 years 7 months 6 days |
Intangible Assets, net, Amortization Expenses (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Amortization of Deferred Charges [Abstract] | |||
Amortization expenses | $ 7,273 | $ 6,523 | $ 3,698 |
Customer and Referral Relationships [Member] | |||
Amortization of Deferred Charges [Abstract] | |||
Amortization expenses | 6,678 | 5,974 | 3,240 |
Non-compete Agreements [Member] | |||
Amortization of Deferred Charges [Abstract] | |||
Amortization expenses | $ 595 | $ 549 | $ 458 |
Intangible Assets, net, Amortization of Referral Relationships and Non-Competition Agreements (Details) $ in Thousands |
Dec. 31, 2023
USD ($)
|
---|---|
Customer and Referral Relationships [Member] | |
Finite-Lived Intangible Assets, Amortization Expense, Maturity [Abstract] | |
2024 | $ 6,967 |
2025 | 6,823 |
2026 | 6,356 |
2027 | 6,192 |
2028 | 5,923 |
Thereafter | 30,983 |
Non-compete Agreements [Member] | |
Finite-Lived Intangible Assets, Amortization Expense, Maturity [Abstract] | |
2024 | 599 |
2025 | 533 |
2026 | 393 |
2027 | 232 |
2028 | 102 |
Thereafter | $ 6 |
Accrued Expenses (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
---|---|---|
Payables and Accruals [Abstract] | ||
Salaries and related costs | $ 25,641 | $ 22,912 |
Credit balances due to patients and payors | 8,847 | 8,094 |
Group health insurance claims | 2,301 | 1,666 |
Federal income taxes payable | 1,006 | 0 |
Contingency payable | 12,285 | 620 |
Other property taxes payable | 355 | 277 |
Interest payable | 235 | 273 |
Closure costs | 231 | 243 |
Other | 4,443 | 3,328 |
Total | $ 55,344 | $ 37,413 |
Borrowings, Amended Credit Agreement and Credit Agreement (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
||
---|---|---|---|---|
Debt Instruments [Abstract] | ||||
Principal amount | $ 148,150 | $ 185,555 | ||
Principal amount, current portion | 8,111 | 8,271 | ||
Principal amount, net of current portion | 140,039 | 177,284 | ||
Unamortized debt issuance cost [Abstract] | ||||
Unamortized debt issuance cost | (1,468) | (1,861) | ||
Unamortized debt issuance cost, current portion | (420) | (408) | ||
Unamortized debt issuance cost, net of current portion | (1,048) | (1,453) | ||
Net debt [Abstract] | ||||
Net debt | 146,682 | 183,694 | ||
Net debt, less current portion | 7,691 | 7,863 | ||
Net debt, net of current portion | 138,991 | 175,831 | ||
Revolving Facility [Member] | ||||
Debt Instruments [Abstract] | ||||
Principal amount | 0 | 31,000 | ||
Unamortized debt issuance cost [Abstract] | ||||
Unamortized debt issuance cost | 0 | 0 | ||
Net debt [Abstract] | ||||
Net debt | 0 | 31,000 | ||
Term Facility [Member] | ||||
Debt Instruments [Abstract] | ||||
Principal amount | 144,375 | 148,125 | ||
Unamortized debt issuance cost [Abstract] | ||||
Unamortized debt issuance cost | (1,468) | (1,861) | ||
Net debt [Abstract] | ||||
Net debt | 142,907 | 146,264 | ||
Other [Member] | ||||
Debt Instruments [Abstract] | ||||
Principal amount | [1] | 3,775 | 6,430 | |
Unamortized debt issuance cost [Abstract] | ||||
Unamortized debt issuance cost | [1] | 0 | 0 | |
Net debt [Abstract] | ||||
Net debt | [1] | $ 3,775 | $ 6,430 | |
|
Borrowings, Credit Facilities (Details) - USD ($) |
12 Months Ended | |||
---|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Dec. 05, 2013 |
|
Debt Instruments [Abstract] | ||||
Aggregate amount of notes payable | $ 148,150,000 | $ 185,555,000 | ||
Payment of debt | 3,750,000 | 1,875,000 | $ 0 | |
Notes Payable [Member] | ||||
Debt Instruments [Abstract] | ||||
Aggregate amount of notes payable | 4,700,000 | |||
Payment of debt | 900,000 | |||
Aggregate principal payment due in 2024 | 2,500,000 | |||
Aggregate principal payment due in 2025 | $ 1,300,000 | |||
Notes Payable [Member] | Minimum [Member] | ||||
Debt Instruments [Abstract] | ||||
Average effective interest rate | 3.25% | |||
Notes Payable [Member] | Maximum [Member] | ||||
Debt Instruments [Abstract] | ||||
Average effective interest rate | 7.00% | |||
Term Facility [Member] | ||||
Debt Instruments [Abstract] | ||||
Revolving credit facility commitment | $ 150,000,000 | |||
Frequency of term facility | quarterly | |||
Interest rate on credit facility in first two years | 0.625% | |||
Interest rate on credit facility in third and fourth year | 1.25% | |||
Interest rate on credit facility in fifth year | 1.875% | |||
Outstanding amount | $ 144,400,000 | |||
Aggregate amount of notes payable | 144,375,000 | 148,125,000 | ||
Revolving Facility [Member] | ||||
Debt Instruments [Abstract] | ||||
Revolving credit facility commitment | $ 175,000,000 | $ 125,000,000 | ||
Term of credit facility | 5 years | |||
Outstanding amount | $ 0 | |||
Aggregate amount of notes payable | $ 0 | $ 31,000,000 | ||
Revolving Facility [Member] | Minimum [Member] | ||||
Debt Instruments [Abstract] | ||||
Percentage of unused commitment fee | 0.25% | |||
Revolving Facility [Member] | Maximum [Member] | ||||
Debt Instruments [Abstract] | ||||
Increase on limit of credit facility | $ 50,000,000 | |||
Percentage of unused commitment fee | 0.35% | |||
Standby Letters of Credit [Member] | ||||
Debt Instruments [Abstract] | ||||
Revolving credit facility commitment | $ 12,000,000 | |||
Swingline Loans [Member] | ||||
Debt Instruments [Abstract] | ||||
Revolving credit facility commitment | $ 15,000,000 | |||
Swingline Loans [Member] | SOFR [Member] | Minimum [Member] | ||||
Debt Instruments [Abstract] | ||||
Applicable margin for SOFR borrowings rate | 1.50% | |||
Swingline Loans [Member] | SOFR [Member] | Maximum [Member] | ||||
Debt Instruments [Abstract] | ||||
Applicable margin for SOFR borrowings rate | 2.25% | |||
Swingline Loans [Member] | Alternate Base Rate [Member] | Minimum [Member] | ||||
Debt Instruments [Abstract] | ||||
Spread on variable rate | 0.50% | |||
Swingline Loans [Member] | Alternate Base Rate [Member] | Maximum [Member] | ||||
Debt Instruments [Abstract] | ||||
Spread on variable rate | 1.25% | |||
Senior Credit Facility [Member] | ||||
Debt Instruments [Abstract] | ||||
Debt instrument, maturity date | Jun. 17, 2027 | |||
Aggregate principal amount | $ 325,000,000 | |||
Increase on limit of credit facility | $ 100,000,000 | |||
Leverage ratio | 2 | |||
Remaining revolving credit outstanding | $ 175,000,000 |
Derivative Instruments (Details) - USD ($) $ in Thousands |
12 Months Ended | ||||
---|---|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Jul. 31, 2022 |
Jun. 30, 2022 |
|
Derivative Instrument, Consolidated Statements of Comprehensive Income [Abstract] | |||||
Net income | $ 37,220 | $ 43,407 | $ 57,924 | ||
Other comprehensive (loss) gain [Abstract] | |||||
Unrealized (loss) gain on cash flow hedge | (1,642) | 5,378 | 0 | ||
Tax effect at statutory rate (federal and state) | 420 | (1,374) | 0 | ||
Comprehensive income | 35,998 | 47,411 | 57,924 | ||
Comprehensive income attributable to non-controlling interest | (8,981) | (11,249) | (17,093) | ||
Comprehensive income attributable to USPH shareholders | 27,017 | 36,162 | $ 40,831 | ||
Carrying and Fair Value of Interest Rate Derivatives [Abstract] | |||||
Interest rate derivative | 3,736 | 5,378 | |||
Other Current Assets [Member] | |||||
Carrying and Fair Value of Interest Rate Derivatives [Abstract] | |||||
Interest rate derivative | 2,663 | 2,858 | |||
Other Assets [Member] | |||||
Carrying and Fair Value of Interest Rate Derivatives [Abstract] | |||||
Interest rate derivative | $ 1,073 | 2,520 | |||
Interest Rate Swap [Member] | |||||
Derivative Instruments [Abstract] | |||||
Notional value | $ 150,000 | ||||
Debt instrument, maturity date | Jun. 30, 2027 | ||||
Savings from interest rate swap arrangements | $ 3,300 | ||||
Interest Rate Swap [Member] | Maximum [Member] | |||||
Derivative Instruments [Abstract] | |||||
Savings from interest rate swap arrangements | $ 100 | ||||
Interest Rate Swap [Member] | SOFR [Member] | |||||
Derivative Instruments [Abstract] | |||||
Term of variable rate | 1 month | ||||
Debt instrument, fixed rate of interest | 2.815% |
Leases (Details) - USD ($) $ in Thousands |
12 Months Ended | ||||
---|---|---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|||
Components of Lease Expense [Abstract] | |||||
Operating lease cost | $ 38,559 | $ 35,154 | $ 32,021 | ||
Short-term lease cost | 1,353 | 1,049 | 1,160 | ||
Variable lease cost | 8,912 | 6,287 | 7,057 | ||
Total lease cost | [1] | 48,824 | 42,490 | 40,238 | |
Supplemental Information Related to Leases [Abstract] | |||||
Cash paid for amounts included in the measurement of operating lease liabilities | 39,813 | 36,136 | 33,192 | ||
Right-of-use assets obtained in exchange for new operating lease liabilities | 36,264 | $ 40,502 | $ 46,088 | ||
Future Lease Payments for Operating Leases [Abstract] | |||||
2024 | 38,809 | ||||
2025 | 30,628 | ||||
2026 | 22,845 | ||||
2027 | 15,275 | ||||
2028 and thereafter | 13,174 | ||||
Total lease payments | 120,731 | ||||
Less: imputed interest | 8,826 | ||||
Total operating lease liabilities | $ 111,905 | ||||
Weighted Average Discount Rates [Abstract] | |||||
Weighted-average remaining lease term | 3 years 10 months 24 days | 4 years 1 month 6 days | 4 years 2 months 12 days | ||
Weighted-average discount rate | 4.00% | 2.90% | 2.80% | ||
Maximum [Member] | |||||
Operating Lease [Abstract] | |||||
Lease term | 5 years | ||||
|
Income Taxes, Components of Deferred Tax Assets and Liabilities Included in Consolidated Balance Sheets (Details) - USD ($) $ in Thousands |
Dec. 31, 2023 |
Dec. 31, 2022 |
---|---|---|
Deferred tax assets [Abstract] | ||
Compensation | $ 1,680 | $ 1,464 |
Allowance for credit losses | 574 | 605 |
Lease obligations - including closed clinics | 28,592 | 28,525 |
Deferred tax assets | 30,846 | 30,594 |
Deferred tax liabilities [Abstract] | ||
Depreciation and amortization | (27,290) | (23,836) |
Operating lease right-of-use assets | (26,427) | (26,318) |
Gain on cash flow hedge | (955) | (1,373) |
Change in revaluation of put-right liability | (586) | 0 |
Other | (403) | (370) |
Deferred tax liabilities | (55,661) | (51,897) |
Net deferred tax liabilities | $ (24,815) | $ (21,303) |
Income Taxes, Summary (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Income Tax Examination [Abstract] | |||
Increase in income tax expense from adjustment through reconciliation process | $ 1,000 | ||
Accrued interest and penalties associated with any unrecognized tax benefits | 0 | $ 0 | $ 0 |
Interest expense recognized | 0 | $ 0 | $ 0 |
Federal [Member] | |||
Income Tax Examination [Abstract] | |||
Tax payable | $ 1,000 | ||
Periods open for examination | 2020 2021 2022 | ||
State [Member] | |||
Income Tax Examination [Abstract] | |||
Tax receivable included in other current assets | $ 2,100 | ||
Periods open for examination | 2019 2020 2021 2022 |
Income Taxes, Differences Between Federal Tax Rate and Company's Effective Tax Rate for Results of Continuing Operations (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Income Taxes [Abstract] | |||
U.S. tax at statutory rate | $ 8,483 | $ 9,307 | $ 11,782 |
State income taxes, net of federal benefit | 2,135 | 2,079 | 2,478 |
Shortfall (excess) equity compensation deduction | 123 | 149 | (246) |
Non-deductible expenses | 710 | 629 | 1,258 |
Return to provision adjustments | 705 | 0 | 0 |
Total income tax provision | $ 12,156 | $ 12,164 | $ 15,272 |
U.S. tax at statutory rate | 21.00% | 21.00% | 21.00% |
State income taxes, net of federal benefit and tax reform | 5.30% | 4.70% | 4.40% |
Shortfall (excess) equity compensation deduction | 0.30% | 0.30% | (0.40%) |
Nondeductible expenses | 1.80% | 1.40% | 2.20% |
Return to provision adjustments | 1.70% | 0.00% | 0.00% |
Total | 30.10% | 27.40% | 27.20% |
Income Taxes, Significant Components of Provision for Income Taxes for Continuing Operations (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Current [Abstract] | |||
Federal | $ 6,996 | $ (770) | $ 7,477 |
State | 512 | 518 | 2,107 |
Total current | 7,508 | (252) | 9,584 |
Deferred [Abstract] | |||
Federal | 3,819 | 9,933 | 4,866 |
State | 829 | 2,483 | 822 |
Total deferred | 4,648 | 12,416 | 5,688 |
Total income tax provision | $ 12,156 | $ 12,164 | $ 15,272 |
Segment Information, Summary (Details) $ in Millions |
12 Months Ended | |
---|---|---|
Oct. 31, 2023
USD ($)
|
Dec. 31, 2023
Location
|
|
Segment Information [Abstract] | ||
Percentage of general partnership interest owned | 1.00% | |
IIP Business [Member] | ||
Segment Information [Abstract] | ||
Percentage of interest acquired | 100.00% | |
Ergonomics Software Business [Member] | ||
Segment Information [Abstract] | ||
Percentage of interest acquired | 55.00% | |
IIP and Ergonomics Software Business [Member] | ||
Segment Information [Abstract] | ||
Purchase price | $ | $ 4.0 | |
Minimum [Member] | ||
Segment Information [Abstract] | ||
Percentage of limited partnership interest owned | 65.00% | |
Percentage range of limited partnership interest owned | 10.00% | |
Number of operating clinic locations | Location | 1 | |
Maximum [Member] | ||
Segment Information [Abstract] | ||
Percentage of limited partnership interest owned | 75.00% | |
Percentage range of limited partnership interest owned | 99.00% |
Segment Information, Segment Financials (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Segment Information [Abstract] | |||
Net revenue | $ 604,802 | $ 553,144 | $ 495,022 |
Operating Costs [Abstract] | |||
Salaries and related costs | 353,390 | 319,191 | 278,469 |
Rent, supplies, contract labor and other | 123,731 | 116,381 | 94,066 |
Provision for credit losses | 6,172 | 5,548 | 5,305 |
Total operating cost | 483,293 | 441,120 | 377,840 |
Gross profit | 121,509 | 112,024 | 117,182 |
Total assets | 997,238 | 858,154 | 749,426 |
Reportable Segments [Member] | Physical Therapy Operations [Member] | |||
Segment Information [Abstract] | |||
Net revenue | 526,548 | 476,092 | 451,122 |
Operating Costs [Abstract] | |||
Salaries and related costs | 302,765 | 272,360 | 251,256 |
Rent, supplies, contract labor and other | 112,547 | 102,114 | 88,073 |
Provision for credit losses | 6,129 | 5,517 | 5,249 |
Gross profit | 105,064 | 96,057 | 106,488 |
Total assets | 857,274 | 708,662 | 587,801 |
Reportable Segments [Member] | Industrial Injury Prevention Services [Member] | |||
Segment Information [Abstract] | |||
Net revenue | 78,254 | 77,052 | 43,900 |
Operating Costs [Abstract] | |||
Salaries and related costs | 50,625 | 46,831 | 27,213 |
Rent, supplies, contract labor and other | 11,184 | 14,267 | 5,993 |
Provision for credit losses | 43 | 31 | 56 |
Gross profit | 16,445 | 15,967 | 10,694 |
Total assets | $ 139,964 | $ 149,492 | $ 161,625 |
Investment in Unconsolidated Affiliate (Details) - USD ($) $ in Thousands |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Investments in Unconsolidated Affiliate [Abstract] | |||
Investment in unconsolidated affiliate | $ 12,256 | $ 12,131 | |
Earnings from investment in unconsolidated affiliate | $ 955 | 1,175 | $ 112 |
Joint Venture Interest [Member] | |||
Investments in Unconsolidated Affiliate [Abstract] | |||
Percentage of ownership in joint venture interest | 49.00% | ||
Investment in unconsolidated affiliate | $ 12,300 | 12,100 | |
Earnings from investment in unconsolidated affiliate | $ 1,000 | $ 1,200 |
Equity Based Plans, Stock-based Compensation Expense (Details) - USD ($) $ in Millions |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Equity Based Plans [Abstract] | |||
Stock-based compensation expense | $ 7.2 | $ 7.3 | $ 7.8 |
Compensation not yet recognized | $ 9.8 | ||
Weighted average period | 1 year 9 months |
Equity Based Plans, Amended and Restated Employee Stock Option Plans (Details) |
Dec. 31, 2023
shares
|
---|---|
Amended 2003 Plan [Member] | |
Share-based Compensation [Abstract] | |
Number of common shares available for grant (in shares) | 500,000 |
Maximum [Member] | Amended 2003 Plan [Member] | Non Qualified Stock Options [Member] | |
Share-based Compensation [Abstract] | |
Number of shares authorized (in shares) | 2,600,000 |
Maximum [Member] | Amended 1999 Plan [Member] | |
Share-based Compensation [Abstract] | |
Number of common shares available for grant (in shares) | 100,000 |
Maximum [Member] | Amended 1999 Plan [Member] | Non Qualified Stock Options [Member] | |
Share-based Compensation [Abstract] | |
Number of shares authorized (in shares) | 600,000 |
Equity Based Plans, Restricted Stock Granted to Directors, Officers and Employees Pursuant to its Equity Plans (Details) - Restricted Stock [Member] - $ / shares |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Share-based Compensation [Abstract] | |||
Number of shares (in shares) | 73,384 | 95,316 | 60,317 |
Weighted average fair value (in dollars per share) | $ 102.79 | $ 100.08 | $ 131.29 |
Equity Based Plans, Restricted Stock Cancelled Due to Employee Terminations Prior to Restrictions Lapsing (Details) - Restricted Stock [Member] - $ / shares |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Share-based Compensation [Abstract] | |||
Number of shares (in shares) | 4,086 | 5,180 | 439 |
Weighted average fair value (in dollars per share) | $ 103.99 | $ 109.42 | $ 113.8 |
Equity Based Plans, Summary (Details) - shares |
12 Months Ended | |
---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
|
Share-based Compensation [Abstract] | ||
Shares outstanding for which restrictions had not lapsed (in shares) | 124,638 | 124,939 |
Employees [Member] | ||
Share-based Compensation [Abstract] | ||
Restricted period on the stock granted | 4 years | |
Executive Officer [Member] | ||
Share-based Compensation [Abstract] | ||
Restricted period on the stock granted | 4 years | |
Minimum [Member] | ||
Share-based Compensation [Abstract] | ||
Restrictions will lapse in | 2024 | |
Maximum [Member] | ||
Share-based Compensation [Abstract] | ||
Restrictions will lapse in | 2027 |
Preferred and Common Stock (Details) - USD ($) $ / shares in Units, $ in Thousands |
1 Months Ended | 12 Months Ended | |||||
---|---|---|---|---|---|---|---|
May 31, 2023 |
May 31, 2023 |
Mar. 31, 2009 |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
Dec. 31, 2008 |
|
Class of Stock Disclosures [Abstract] | |||||||
Total purchased shares (in shares) | 859,499 | 0 | 0 | 0 | |||
Shares issued (in shares) | 1,916,667 | 1,916,667 | |||||
Offering price (in dollars per share) | $ 90 | $ 90 | |||||
Net proceeds from issuance of common stock | $ 163,600 | $ 163,600 | $ 163,646 | $ 0 | $ 0 | ||
Underwriting discount | 8,600 | 8,600 | |||||
Offering fees and expenses | 200 | 200 | |||||
Repayment of revolving credit facility | $ 35,000 | $ 35,000 | $ 55,000 | $ 184,000 | $ 218,000 | ||
Maximum [Member] | |||||||
Class of Stock Disclosures [Abstract] | |||||||
Common stock authorized by the Board of Directors (in shares) | 1,200,000 | 2,250,000 | |||||
Percentage of repurchase of common stock | 10.00% |
Defined Contribution Plan (Details) - USD ($) $ in Millions |
12 Months Ended | ||
---|---|---|---|
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Defined Contribution Plan [Abstract] | |||
Required time period for employees for profit sharing plan | 3 months | ||
Maximum employer contribution as a percentage of employee contribution | 50.00% | ||
Contribution expense recognized | $ 0.0 | $ 0.0 | $ 0.0 |
Employer matching contribution amount | $ 2.2 | $ 2.0 | $ 1.9 |
Contingencies (Details) $ in Millions |
1 Months Ended |
---|---|
Jan. 31, 2022
USD ($)
| |
Contingency Settlement [Abstract] | |
Payments to plaintiff-relator and her counsel | $ 2.8 |
Related Party Transactions (Details) $ in Thousands |
12 Months Ended |
---|---|
Dec. 31, 2021
USD ($)
| |
Settlement of Short Swing Profit Claim [Abstract] | |
Short swing profit settlement | $ 20 |
Subsequent Event (Details) - $ / shares |
12 Months Ended | |||
---|---|---|---|---|
Feb. 27, 2024 |
Dec. 31, 2023 |
Dec. 31, 2022 |
Dec. 31, 2021 |
|
Dividends [Abstract] | ||||
Dividends declared per common share (in dollars per share) | $ 1.72 | $ 1.64 | $ 1.46 | |
Subsequent Event [Member] | ||||
Dividends [Abstract] | ||||
Dividends declared per common share (in dollars per share) | $ 0.44 | |||
Dividend payable | Apr. 05, 2024 | |||
Dividend recorded | Mar. 12, 2024 |
SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS (Details) - Allowance for Credit Losses [Member] - USD ($) $ in Thousands |
12 Months Ended | ||||||||
---|---|---|---|---|---|---|---|---|---|
Dec. 31, 2023 |
[1] | Dec. 31, 2022 |
Dec. 31, 2021 |
||||||
Movement in Valuation Allowances and Reserves [Roll Forward] | |||||||||
Beginning Balance | $ 2,829 | $ 2,768 | $ 2,008 | ||||||
Additions Charged to Cost and Expenses | 6,172 | 5,548 | 5,305 | ||||||
Additions Charged to Other Accounts | 0 | 0 | 0 | ||||||
Deductions | [2] | 6,265 | 5,487 | 4,545 | |||||
Ending Balance | $ 2,736 | $ 2,829 | [1] | $ 2,768 | |||||
|
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