0001193125-13-311985.txt : 20130731 0001193125-13-311985.hdr.sgml : 20130731 20130731121137 ACCESSION NUMBER: 0001193125-13-311985 CONFORMED SUBMISSION TYPE: 10-Q PUBLIC DOCUMENT COUNT: 12 CONFORMED PERIOD OF REPORT: 20130630 FILED AS OF DATE: 20130731 DATE AS OF CHANGE: 20130731 FILER: COMPANY DATA: COMPANY CONFORMED NAME: AMEDISYS INC CENTRAL INDEX KEY: 0000896262 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HOME HEALTH CARE SERVICES [8082] IRS NUMBER: 113131700 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 10-Q SEC ACT: 1934 Act SEC FILE NUMBER: 000-24260 FILM NUMBER: 13998206 BUSINESS ADDRESS: STREET 1: 5959 S SHERWOOD FOREST BLVD CITY: BATON ROUGE STATE: LA ZIP: 70816 BUSINESS PHONE: 2252922031 MAIL ADDRESS: STREET 1: 5959 S SHERWOOD FOREST BLVD CITY: BATON ROUGE STATE: LA ZIP: 70816 FORMER COMPANY: FORMER CONFORMED NAME: ANALYTICAL NURSING MANAGEMENT CORP DATE OF NAME CHANGE: 19940819 FORMER COMPANY: FORMER CONFORMED NAME: M&N CAPITAL CORP DATE OF NAME CHANGE: 19930125 10-Q 1 d555683d10q.htm FORM 10-Q Form 10-Q
Table of Contents

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington D.C. 20549

 

 

FORM 10-Q

 

 

(Mark One)

x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended June 30, 2013

or

 

¨ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                     to                     

Commission File Number: 0-24260

 

 

 

LOGO

AMEDISYS, INC.

(Exact Name of Registrant as Specified in its Charter)

 

 

 

Delaware   11-3131700

(State or other jurisdiction of

incorporation or organization)

 

(I.R.S. Employer

Identification No.)

5959 S. Sherwood Forest Blvd., Baton Rouge, LA 70816

(Address of principal executive offices, including zip code)

(225) 292-2031 or (800) 467-2662

(Registrant’s telephone number, including area code)

 

 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  x    No  ¨

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes  x    No  ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer,” and “smaller reporting company” in Rule 12b-2 of the Exchange Act. (Check one):

 

Large accelerated filer

 

¨

  

Accelerated filer

 

x

Non-accelerated filer

 

¨  (Do not check if a smaller reporting company)

  

Smaller reporting company

 

¨

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ¨    No  x

The number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date, is as follows: Common stock, $0.001 par value, 32,181,300 shares outstanding as of July 26, 2013.

 

 

 


Table of Contents

TABLE OF CONTENTS

 

SPECIAL CAUTION CONCERNING FORWARD-LOOKING STATEMENTS

     1   

PART I. FINANCIAL INFORMATION

  

ITEM 1.

 

FINANCIAL STATEMENTS (UNAUDITED):

  
 

CONDENSED CONSOLIDATED BALANCE SHEETS AS OF JUNE 30, 2013 AND DECEMBER 31, 2012

     2   
 

CONDENSED CONSOLIDATED INCOME STATEMENTS FOR THE THREE AND SIX-MONTH PERIODS ENDED JUNE 30, 2013 AND 2012

     3   
 

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME FOR THE THREE AND SIX-MONTH PERIODS ENDED JUNE 30, 2013 AND 2012

     4   
 

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS FOR THE SIX-MONTH PERIODS ENDED JUNE 30, 2013 AND 2012

     5   
 

NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

     6   

ITEM 2.

 

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

     17   

ITEM 3.

 

QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

     27   

ITEM 4.

 

CONTROLS AND PROCEDURES

     27   

PART II. OTHER INFORMATION

  

ITEM 1.

 

LEGAL PROCEEDINGS

     28   

ITEM 1A.

 

RISK FACTORS

     28   

ITEM 2.

 

UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS

     28   

ITEM 3.

 

DEFAULTS UPON SENIOR SECURITIES

     28   

ITEM 4.

 

MINE SAFETY DISCLOSURES

     28   

ITEM 5.

 

OTHER INFORMATION

     28   

ITEM 6.

 

EXHIBITS

     29   

SIGNATURES

     31   

INDEX TO EXHIBITS

     32   


Table of Contents

SPECIAL CAUTION CONCERNING FORWARD-LOOKING STATEMENTS

When included in this Quarterly Report on Form 10-Q, or in other documents that we file with the Securities and Exchange Commission (“SEC”) or in statements made by or on behalf of the Company, words like “believes,” “belief,” “expects,” “plans,” “anticipates,” “intends,” “projects,” “estimates,” “may,” “might,” “would,” “should” and similar expressions are intended to identify forward-looking statements as defined by the Private Securities Litigation Reform Act of 1995. These forward-looking statements involve a variety of risks and uncertainties that could cause actual results to differ materially from those described therein. These risks and uncertainties include, but are not limited to the following: changes in Medicare and other medical payment levels, our ability to open care centers, acquire additional care centers and integrate and operate these care centers effectively, our ability to divest care centers currently held for sale, changes in or our failure to comply with existing Federal and state laws or regulations or the inability to comply with new government regulations on a timely basis, competition in the home health industry, changes in the case mix of patients and payment methodologies, changes in estimates and judgments associated with critical accounting policies, our ability to maintain or establish new patient referral sources, our ability to attract and retain qualified personnel, changes in payments and covered services due to the economic downturn and deficit spending by Federal and state governments, future cost containment initiatives undertaken by third-party payors, our access to financing due to the volatility and disruption of the capital and credit markets, our ability to meet debt service requirements and comply with covenants in debt agreements, business disruptions due to natural disasters or acts of terrorism, our ability to integrate and manage our information systems, and changes in or developments with respect to any litigation or investigations relating to the Company, including the SEC investigation and the U.S. Department of Justice Civil Investigative Demands and various other matters, many of which are beyond our control.

Because forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified, you should not rely on any forward-looking statement as a prediction of future events. We expressly disclaim any obligation or undertaking and we do not intend to release publicly any updates or changes in our expectations concerning the forward-looking statements or any changes in events, conditions or circumstances upon which any forward-looking statement may be based, except as required by law. For a discussion of some of the factors discussed above as well as additional factors, see our Annual Report on Form 10-K for the year ended December 31, 2012, filed with the SEC on March 12, 2013, particularly Part I, Item 1A. – “Risk Factors” therein, which are incorporated herein by reference and Part II, Item 1A. – “Risk Factors” of this Quarterly Report on Form 10-Q. Additional risk factors may also be described in reports that we file from time to time with the SEC.

Available Information

Our company website address is www.amedisys.com. We use our website as a channel of distribution for important company information. Important information, including press releases, analyst presentations and financial information regarding our company, is routinely posted on and accessible on the Investor Relations subpage of our website, which is accessible by clicking on the tab labeled “Investors” on our website home page. We also use our website to expedite public access to time-critical information regarding our company in advance of or in lieu of distributing a press release or a filing with the SEC disclosing the same information. Therefore, investors should look to the Investor Relations subpage of our website for important and time-critical information. Visitors to our website can also register to receive automatic e-mail and other notifications alerting them when new information is made available on the Investor Relations subpage of our website. In addition, we make available on the Investor Relations subpage of our website (under the link “SEC filings”) free of charge our annual reports on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K, ownership reports on Forms 3, 4 and 5 and any amendments to those reports as soon as practicable after we electronically file such reports with the SEC. Further, copies of our Certificate of Incorporation and Bylaws, our Code of Ethical Business Conduct, our Corporate Governance Guidelines and the charters for the Audit, Compensation, Quality of Care and Nominating and Corporate Governance Committees of our Board are also available on the Investor Relations subpage of our website (under the link “Corporate Governance”).

Additionally, the public may read and copy any of the materials we file with the SEC at the SEC’s Public Reference Room at 100 F Street, NE, Room 1580, Washington, D.C. 20549. Information on the operation of the Public Reference Room may be obtained by calling the SEC at (800) SEC-0330. Our electronically filed reports can also be obtained on the SEC’s internet site at http://www.sec.gov.

 

1


Table of Contents

PART I. FINANCIAL INFORMATION

ITEM 1. FINANCIAL STATEMENTS

AMEDISYS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS

(Amounts in thousands, except share data)

(Unaudited)

 

     June 30, 2013     December 31, 2012  
ASSETS     

Current assets:

    

Cash and cash equivalents

   $ 30,118     $ 14,545  

Patient accounts receivable, net of allowance for doubtful accounts of $17,610 and $20,994

     124,766       169,172  

Prepaid expenses

     13,369       10,631  

Other current assets

     12,006       11,440  

Assets held for sale

     1,550       —    
  

 

 

   

 

 

 

Total current assets

     181,809       205,788  

Property and equipment, net of accumulated depreciation of $120,012 and $113,154

     156,887       156,709  

Goodwill

     209,260       209,594  

Intangible assets, net of accumulated amortization of $24,560 and $23,457

     43,109       47,050  

Deferred tax asset

     85,256       92,804  

Other assets, net

     23,932       18,650  
  

 

 

   

 

 

 

Total assets

   $ 700,253     $ 730,595  
  

 

 

   

 

 

 
LIABILITIES AND EQUITY     

Current liabilities:

    

Accounts payable

   $ 21,658     $ 29,175  

Payroll and employee benefits

     76,205       79,341  

Accrued expenses

     54,175       54,855  

Current portion of long-term obligations

     35,807       35,807  

Current portion of deferred income taxes

     3,169       5,609  
  

 

 

   

 

 

 

Total current liabilities

     191,014       204,787  

Long-term obligations, less current portion

     39,000       66,904  

Other long-term obligations

     5,209       4,671  
  

 

 

   

 

 

 

Total liabilities

     235,223       276,362  
  

 

 

   

 

 

 

Commitments and Contingencies—Note 6

    

Equity:

    

Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding

     —         —    

Common Stock, $0.001 par value, 60,000,000 shares authorized; 32,973,576, and 31,876,508 shares issued; and 32,106,174 and 31,086,619 shares outstanding

     33       32  

Additional paid-in capital

     458,475       450,792  

Treasury Stock at cost 867,402, and 789,889 shares of common stock

     (18,056     (17,116

Accumulated other comprehensive income

     15       15  

Retained earnings

     23,136       18,617  
  

 

 

   

 

 

 

Total Amedisys, Inc. stockholders’ equity

     463,603       452,340  

Noncontrolling interests

     1,427       1,893  
  

 

 

   

 

 

 

Total equity

     465,030       454,233  
  

 

 

   

 

 

 

Total liabilities and equity

   $ 700,253     $ 730,595  
  

 

 

   

 

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

 

2


Table of Contents

AMEDISYS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED INCOME STATEMENTS

(Amounts in thousands, except per share data)

(Unaudited)

 

     For the Three-Month Periods
Ended June 30,
    For the Six-Month Periods
Ended June 30,
 
             2013                     2012                     2013                     2012          

Net service revenue

   $ 313,148     $ 363,068     $ 639,201     $ 719,056  

Cost of service, excluding depreciation and amortization

     176,077       202,586       360,233       401,637  

General and administrative expenses:

        

Salaries and benefits

     74,601       82,983       154,043       166,270  

Non-cash compensation

     1,224       2,298       3,280       4,780  

Other

     41,121       45,632       82,739       88,240  

Provision for doubtful accounts

     4,658       4,534       8,502       10,217  

Depreciation and amortization

     11,674       9,678       21,621       19,515  
  

 

 

   

 

 

   

 

 

   

 

 

 

Operating expenses

     309,355       347,711       630,418       690,659  
  

 

 

   

 

 

   

 

 

   

 

 

 

Operating income

     3,793       15,357       8,783       28,397  

Other (expense) income:

        

Interest income

     11       28       22       42  

Interest expense

     (730     (2,002     (1,836     (4,076

Equity in earnings from equity investments

     337       396       700       701  

Gain on sale of care centers

     357       —         357       —    

Miscellaneous, net

     136       (126     196       309  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total other expense, net

     111       (1,704     (561     (3,024
  

 

 

   

 

 

   

 

 

   

 

 

 

Income before income taxes

     3,904       13,653       8,222       25,373  

Income tax expense

     (1,566     (5,666     (3,260     (10,530
  

 

 

   

 

 

   

 

 

   

 

 

 

Income from continuing operations

     2,338       7,987       4,962       14,843  

Discontinued operations, net of tax

     (490     (21     (982     (1,414
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

     1,848       7,966       3,980       13,429  

Net (income) loss attributable to noncontrolling interests

     (7     (84     539       (127
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to Amedisys, Inc.

   $ 1,841     $ 7,882     $ 4,519     $ 13,302  
  

 

 

   

 

 

   

 

 

   

 

 

 

Basic earnings per common share:

        

Income from continuing operations attributable to Amedisys, Inc. common stockholders

   $ 0.07     $ 0.26     $ 0.18     $ 0.50  

Discontinued operations, net of tax

     (0.01     —         (0.03     (0.05
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to Amedisys, Inc. common stockholders

   $ 0.06     $ 0.26     $ 0.15     $ 0.45  
  

 

 

   

 

 

   

 

 

   

 

 

 

Weighted average shares outstanding

     31,160       29,780       30,900       29,584  
  

 

 

   

 

 

   

 

 

   

 

 

 

Diluted earnings per common share:

        

Income from continuing operations attributable to Amedisys, Inc. common stockholders

   $ 0.07     $ 0.26     $ 0.17     $ 0.49  

Discontinued operations, net of tax

     (0.01     —         (0.03     (0.05
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income attributable to Amedisys, Inc. common stockholders

   $ 0.06     $ 0.26     $ 0.14     $ 0.44  
  

 

 

   

 

 

   

 

 

   

 

 

 

Weighted average shares outstanding

     31,489       30,026       31,298       29,903  
  

 

 

   

 

 

   

 

 

   

 

 

 

Amounts attributable to Amedisys, Inc. common stockholders:

        

Income from continuing operations

   $ 2,331     $ 7,903     $ 5,501     $ 14,716  

Discontinued operations, net of tax

     (490     (21     (982     (1,414
  

 

 

   

 

 

   

 

 

   

 

 

 

Net income

   $ 1,841     $ 7,882     $ 4,519     $ 13,302  
  

 

 

   

 

 

   

 

 

   

 

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

 

3


Table of Contents

AMEDISYS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME

(Amounts in thousands)

(Unaudited)

 

     For the Three-Month Periods
Ended June 30,
    For the Six-Month Periods
Ended June 30,
 
     2013     2012     2013      2012  

Net income

   $ 1,848     $ 7,966     $ 3,980      $ 13,429  

Other comprehensive income

         

Unrealized gain on deferred compensation plan assets

     —         —         —          2  
  

 

 

   

 

 

   

 

 

    

 

 

 

Comprehensive income

     1,848       7,966       3,980        13,431  

Comprehensive (income) loss attributable to non-controlling interests

     (7     (84     539        (127
  

 

 

   

 

 

   

 

 

    

 

 

 

Comprehensive income attributable to Amedisys, Inc.

   $ 1,841     $ 7,882     $ 4,519      $ 13,304  
  

 

 

   

 

 

   

 

 

    

 

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

 

4


Table of Contents

AMEDISYS, INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(Amounts in thousands)

(Unaudited)

 

     For the Six-Month Periods
Ended June 30,
 
             2013                     2012          

Cash Flows from Operating Activities:

    

Net income

   $ 3,980     $ 13,429  

Adjustments to reconcile net income to net cash provided by operating activities:

    

Depreciation and amortization

     19,679       20,071  

Provision for doubtful accounts

     8,722       10,621  

Non-cash compensation

     3,280       4,780  

401(k) employer match

     4,363       5,040  

Loss on disposal of property and equipment

     708       848  

Gain on sale of care centers

     (357     —    

Deferred income taxes

     2,959       5,557  

Write off of intangible assets

     2,286       —    

Equity in earnings of equity investments

     (700     (701

Amortization of deferred debt issuance costs

     370       788  

Return on equity investment

     400       625  

Changes in operating assets and liabilities, net of impact of acquisitions:

    

Patient accounts receivable

     35,684       (25,722

Other current assets

     (2,878     411  

Other assets

     (800     (545

Accounts payable

     (7,963     1,457  

Accrued expenses

     (4,293     (3,976

Other long-term obligations

     537       (578
  

 

 

   

 

 

 

Net cash provided by operating activities

     65,977       32,105  
  

 

 

   

 

 

 

Cash Flows from Investing Activities:

    

Proceeds from sale of deferred compensation plan assets

     100       239  

Proceeds from the sale of property and equipment

     126       590  

Purchases of deferred compensation plan assets

     (74     (127

Purchases of property and equipment

     (19,595     (20,241

Purchase of investment

     (6,227     —    

Acquisitions of businesses, net of cash acquired

     (627     (8,392

Proceeds from dispositions of care centers

     2,082       —    
  

 

 

   

 

 

 

Net cash used in investing activities

     (24,215     (27,931
  

 

 

   

 

 

 

Cash Flows from Financing Activities:

    

Proceeds from issuance of stock upon exercise of stock options and warrants

     113       145  

Proceeds from issuance of stock to employee stock purchase plan

     1,695       1,978  

Non-controlling interest distribution

     (93     (105

Proceeds from revolving line of credit

     25,500       —    

Repayments of revolving line of credit

     (25,500     —    

Principal payments of long-term obligations

     (27,904     (17,038
  

 

 

   

 

 

 

Net cash used in financing activities

     (26,189     (15,020
  

 

 

   

 

 

 

Net increase (decrease) in cash and cash equivalents

     15,573       (10,846

Cash and cash equivalents at beginning of period

     14,545       48,004  
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ 30,118     $ 37,158  
  

 

 

   

 

 

 

Supplemental Disclosures of Cash Flow Information:

    

Cash paid for interest

   $ 2,006     $ 3,494  
  

 

 

   

 

 

 

Cash paid for income taxes, net of refunds received

   $ 3,135     $ 1,470  
  

 

 

   

 

 

 

Supplemental Disclosures of Non-Cash Financing and Investing Activities:

    

Acquired non-controlling interests

   $ 167     $ —    
  

 

 

   

 

 

 

The accompanying notes are an integral part of these condensed consolidated financial statements.

 

5


Table of Contents

AMEDISYS, INC. AND SUBSIDIARIES

NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

(Unaudited)

1. NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS

Amedisys, Inc., a Delaware corporation, and its consolidated subsidiaries (“Amedisys,” “we,” “us,” or “our”) are a multi-state provider of home health and hospice services with approximately 84% and 82% of our revenue derived from Medicare for the three-month periods ended June 30, 2013 and 2012, respectively, and approximately 84% and 83% of our revenue derived from Medicare for the six-month periods ended June 30, 2013 and 2012, respectively. As of June 30, 2013, we owned and operated 409 Medicare-certified home health care centers, including 33 care centers held for sale, 94 Medicare-certified hospice care centers, including one care center held for sale, and one hospice inpatient unit in 37 states within the United States, the District of Columbia and Puerto Rico.

Basis of Presentation

In our opinion, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations and our cash flows in accordance with U.S. Generally Accepted Accounting Principles (“U.S. GAAP”). Our results of operations for the interim periods presented are not necessarily indicative of results of our operations for the entire year and have not been audited by our independent auditors.

Certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented. This report should be read in conjunction with our consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2012 as filed with the Securities and Exchange Commission (“SEC”) on March 12, 2013 (the “Form 10-K”), which includes information and disclosures not included herein.

Use of Estimates

Our accounting and reporting policies conform with U.S. GAAP. In preparing the unaudited condensed consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the condensed consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates.

Reclassifications and Comparability

Certain reclassifications have been made to prior period’s financial statements in order to conform to the current period’s presentation. We exited three home health care centers during 2012, and have committed to a plan to divest approximately 34 care centers. In accordance with applicable accounting guidance, the results of operations for these care centers are presented in discontinued operations in our condensed consolidated financial statements. See Note 3 for additional information regarding our discontinued operations. In addition during 2013, we have consolidated 28 care centers with care centers servicing the same markets which may affect the comparability of our operating results.

Principles of Consolidation

These unaudited condensed consolidated financial statements include the accounts of Amedisys, Inc., and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying unaudited condensed consolidated financial statements, and business combinations accounted for as purchases have been included in our unaudited condensed consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain investments that are accounted for as set forth below.

Investments

We consolidate investments when the entity is a variable interest entity and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50%. Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our condensed consolidated financial statements.

We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a variable interest entity in which we are the primary beneficiary. The book value of investments that we accounted for under the equity method of accounting was $5.7 million as of June 30, 2013 and $4.8 million as of December 31, 2012. We account for investments in entities in which we have less than a 20% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. The aggregate carrying amount of our cost method investment, which was acquired during the three-month period ended March 31, 2013, was $5.0 million as of June 30, 2013.

 

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2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

Revenue Recognition

We earn net service revenue through our home health and hospice care centers by providing a variety of services almost exclusively in the homes of our patients. This net service revenue is earned and billed either on an episode of care basis, on a per visit basis or on a daily basis depending upon the payment terms and conditions established with each payor for services provided. We refer to home health revenue earned and billed on a 60-day episode of care as episodic-based revenue.

When we record our service revenue, we record it net of estimated revenue adjustments and contractual adjustments to reflect amounts we estimate to be realizable for services provided, as discussed below. We believe, based on information currently available to us and based on our judgment, that changes to one or more factors that impact the accounting estimates (such as our estimates related to revenue adjustments, contractual adjustments and episodes in progress) we make in determining net service revenue, which changes are likely to occur from period to period, will not materially impact our reported consolidated financial condition, results of operations, cash flows or our future financial results.

Home Health Revenue Recognition

Medicare Revenue

Net service revenue is recorded under the Medicare prospective payment system (“PPS”) based on a 60-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a) an outlier payment if our patient’s care was unusually costly (capped at 10% of total reimbursement per provider number); (b) a low utilization payment adjustment (“LUPA”) if the number of visits was fewer than five; (c) a partial payment if our patient transferred to another provider or we received a patient from another provider before completing the episode; (d) a payment adjustment based upon the level of therapy services required (with various incremental adjustments made for additional visits, with larger payment increases associated with the sixth, fourteenth and twentieth visit thresholds); (e) adjustments to payments if we are unable to produce documentation for the face-to-face encounter requirement; (f) adjustments to payments if we are unable to perform periodic therapy assessments; (g) the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (h) changes in the base episode payments established by the Medicare Program; (i) adjustments to the base episode payments for case mix and geographic wages; and (j) recoveries of overpayments.

We make adjustments to Medicare revenue on completed episodes to reflect differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation or authorizations acceptable to the payor and other reasons unrelated to credit risk. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record this estimate during the period in which services are rendered as an estimated revenue adjustment and a corresponding reduction to patient accounts receivable. In addition, management evaluates the potential for revenue adjustments and, when appropriate, provides allowances based upon the best available information. Therefore, we believe that our reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered.

In addition to revenue recognized on completed episodes, we also recognize a portion of revenue associated with episodes in progress. Episodes in progress are 60-day episodes of care that begin during the reporting period, but were not completed as of the end of the period. We estimate this revenue on a monthly basis based upon historical trends. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per episode and our estimate of the average percentage complete based on visits performed. As of June 30, 2013 and 2012, the difference between the cash received from Medicare for a request for anticipated payment (“RAP”) on episodes in progress and the associated estimated revenue was immaterial and, therefore, the resulting credits were recorded as a reduction to our outstanding patient accounts receivable in our condensed consolidated balance sheets for such periods.

Non-Medicare Revenue

Episodic-based Revenue. We recognize revenue in a similar manner as we recognize Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms.

 

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Non-episodic based Revenue. Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates, as applicable. Contractual adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue and are also recorded as a reduction to our outstanding patient accounts receivable. In addition, we receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment.

Hospice Revenue Recognition

Hospice Medicare Revenue

Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are daily or hourly rates for each of the four levels of care we deliver. The four levels of care are routine care, general inpatient care, continuous home care and respite care. Routine care accounts for 99% of our total net Medicare hospice service revenue for the three and six-month periods ended June 30, 2013, as compared to 97% and 98% for the three and six-month periods ended June 30, 2012, respectively. We make adjustments to Medicare revenue for an inability to obtain appropriate billing documentation, acceptable authorizations or face to face documentation and other reasons unrelated to credit risk. We estimate the impact of these adjustments based on our historical experience, which primarily includes our historical collection rate on Medicare claims, and record it during the period services are rendered as an estimated revenue adjustment and as a reduction to our outstanding patient accounts receivable.

Additionally, as Medicare hospice revenue is subject to an inpatient cap limit and an overall payment cap for each provider number, we monitor these caps and estimate amounts due back to Medicare if a cap has been exceeded. We record these adjustments as a reduction to revenue and an increase in other accrued liabilities. We have settled our Medicare hospice reimbursements for all fiscal years through October 31, 2011. For the Federal cap years ended October 31, 2012 and October 31, 2013, we have $4.0 million and $4.8 million recorded for estimated amounts due back to Medicare in other accrued liabilities as of June 30, 2013 and December 31, 2012, respectively. As a result of our adjustments, we believe our revenue and patients accounts receivable are recorded at amounts that will be ultimately realized.

Hospice Non-Medicare Revenue

We record gross revenue on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per day rates, as applicable. Contractual adjustments are recorded for the difference between our established rates and the amounts estimated to be realizable from patients, third parties and others for services provided and are deducted from gross revenue to determine our net service revenue and patient accounts receivable.

Patient Accounts Receivable

Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party payors and patients. There is no single payor, other than Medicare, that accounts for more than 10% of our total outstanding patient receivables, and thus we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We fully reserve for accounts which are aged at 365 days or greater. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible.

We believe the credit risk associated with our Medicare accounts, which represent 71% and 68% of our net patient accounts receivable at June 30, 2013 and December 31, 2012, respectively, is limited due to our historical collection rate of over 99% from Medicare and the fact that Medicare is a U.S. government payor. Accordingly, we do not record an allowance for doubtful accounts for our Medicare patient accounts receivable, which are recorded at their net realizable value after recording estimated revenue adjustments as discussed above. During the three and six-month periods ended June 30, 2013, we recorded $2.8 million and $6.6 million, respectively, in estimated revenue adjustments to Medicare as compared to $2.1 million and $4.7 million during the three and six-month periods ended June 30, 2012, respectively.

We believe there is a certain level of credit risk associated with non-Medicare payors. To provide for our non-Medicare patient accounts receivable that could become uncollectible in the future, we establish an allowance for doubtful accounts to reduce the carrying amount to its estimated net realizable value.

Medicare Home Health

For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for 60% of our estimated payment for the initial episode at

 

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the start of care or 50% of the estimated payment for any subsequent episodes of care contiguous with the first episode for a particular patient. The full amount of the episode is billed after the episode has been completed (“final billed”). The RAP received for that particular episode is then deducted from our final payment. If a final bill is not submitted within the greater of 120 days from the start of the episode, or 60 days from the date the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other claims in process for that particular provider number. The RAP and final claim must then be re-submitted.

Medicare Hospice

For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. Once each patient has been confirmed for eligibility, we will bill Medicare on a monthly basis for the services provided to the patient.

Non-Medicare Home Health and Hospice

For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient’s eligibility for services with the applicable payor. Once the patient has been confirmed for eligibility, we will provide services to the patient and bill the applicable payor. Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular payors or groups of payors with similar characteristics that would subject us to any significant credit risk. We estimate an allowance for doubtful accounts based upon our assessment of historical and expected net collections, business and economic conditions, trends in payment and an evaluation of collectibility based upon the date that the service was provided. Based upon our best judgment, we believe the allowance for doubtful accounts adequately provides for accounts that will not be collected due to credit risk.

Fair Value of Financial Instruments

The following details our financial instruments where the carrying value and the fair value differ (amounts in millions):

 

     Fair Value at Reporting Date Using  

Financial Instrument

   As of
June  30,
2013
     Quoted Prices in
Active Markets for
Identical Items

(Level 1)
     Significant Other
Observable
Inputs (Level 2)
     Significant
Unobservable Inputs
(Level 3)
 

Long-term obligations

   $ 74.8      $ —        $ 75.1      $ —    

The estimates of the fair value of our long-term debt are based upon a discounted present value analysis of future cash flows. Due to the existing uncertainty in the capital and credit markets the actual rates that would be obtained to borrow under similar conditions could materially differ from the estimates we have used.

The fair value hierarchy is based on three levels of inputs, of which the first two are considered observable and the last unobservable, that may be used to measure fair value. The three levels of inputs are as follows:

 

   

Level 1 – Quoted prices in active markets for identical assets and liabilities.

 

   

Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.

 

   

Level 3 – Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities.

For our other financial instruments, including our cash and cash equivalents, patient accounts receivable, accounts payable and accrued expenses, we estimate the carrying amounts’ approximate fair value. Our deferred compensation plan assets are recorded at fair value.

 

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Weighted-Average Shares Outstanding

Net income per share attributable to Amedisys, Inc. common stockholders, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The following table sets forth, for the periods indicated, shares used in our computation of the weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands):

 

     For the Three-Month Periods
Ended June 30,
     For the Six-Month Periods
Ended June 30,
 
     2013      2012      2013      2012  

Weighted average number of shares outstanding—basic

     31,160        29,780        30,900        29,584  

Effect of dilutive securities:

           

Stock options

     12        23        17        16  

Non-vested stock and stock units

     317        223        381        303  
  

 

 

    

 

 

    

 

 

    

 

 

 

Weighted average number of shares outstanding—diluted

     31,489        30,026        31,298        29,903  
  

 

 

    

 

 

    

 

 

    

 

 

 

Anti-dilutive securities

     217        531        217        595  
  

 

 

    

 

 

    

 

 

    

 

 

 

3. DISCONTINUED OPERATIONS AND ASSETS HELD FOR SALE

As part of our management of our portfolio of care centers, we review each care center’s current financial performance, market penetration, forecasted market growth and the impact of proposed CMS payment revisions. As a result of our review, during the three-month period ended June 30, 2013, we committed to a plan to divest approximately 50 care centers; therefore, as of June 30, 2013, we classified 34 care centers as held for sale (33 home health care centers and one hospice care center) and consolidated 19 care centers (17 home health care centers and two hospice care centers) with care centers servicing the same markets. In addition, we sold assets associated with two home health care centers and one hospice care center.

As we are exiting certain selected geographical areas and in accordance with applicable accounting guidance, the 34 care centers which are held for sale and the three care centers sold are presented as discontinued operations in our condensed consolidated financial statements. The 19 care centers consolidated with care centers servicing the same markets are presented in continuing operations as we expect continuing cash flows from these markets. For additional information on the care centers consolidated with care centers servicing the same markets and the care centers sold see Note 4 – Exit Activities.

As of June 30, 2013, assets held for sale included $0.5 million in fixed assets, net, $0.3 million in intangible assets and $0.7 million in goodwill.

Net revenues and operating results for the periods presented for the care centers classified as discontinued operations are as follows (dollars in millions):

 

     For the Three-Month Periods
Ended June 30,
     For the Six-Month Periods
Ended June 30,
 
     2013     2012      2013     2012  

Net revenues

   $ 11.7     $ 15.3      $ 24.8     $ 30.4  

(Loss) before income taxes

     (0.8     —          (1.6     (2.4

Income tax benefit

     0.3       —          0.6       1.0  
  

 

 

   

 

 

    

 

 

   

 

 

 

Discontinued operations, net of tax

   $ (0.5   $ —        $ (1.0   $ (1.4
  

 

 

   

 

 

    

 

 

   

 

 

 

4. EXIT ACTIVITIES

Effective April 1, 2013, the Company sold assets associated with certain home health care centers in Alaska and Washington, as well as a hospice care center in Washington for cash consideration of approximately $1.6 million and recognized a gain of approximately $1.0 million.

Effective June 7, 2013, the Company sold its membership interest in one of our unconsolidated joint ventures for cash consideration of approximately $0.5 million and recognized a loss of approximately $0.7 million.

 

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In connection with the 19 care centers we consolidated, we recorded charges of $2.3 million in depreciation and amortization expense related to the write-off of intangible assets, $0.8 million in other general and administrative expenses related to lease termination costs and $0.7 million in salaries and benefits related to severance costs during the three-month period ended June 30, 2013.

5. LONG-TERM OBLIGATIONS

Long-term debt consisted of the following for the periods indicated (amounts in millions):

 

     June 30,
2013
    December 31,
2012
 

Senior Notes:

    

$35.0 million Series A Notes: semi-annual interest only payments; interest rate at
6.07% per annum; due March 25, 2013

   $ —       $ 20.0  

$30.0 million Series B Notes: semi-annual interest only payments; interest rate at
6.28% per annum; due March 25, 2014

     20.0       20.0  

$60.0 million Term Loan; $3.0 million principal payments plus accrued interest payable
quarterly; interest rate at ABR Rate plus applicable percentage or Eurodollar Rate plus the applicable percentage (2.45% at June 30, 2013); due October 26, 2017

     51.0       57.0  

Promissory notes

     3.8       5.7  
  

 

 

   

 

 

 
     74.8       102.7  

Current portion of long-term obligations

     (35.8     (35.8
  

 

 

   

 

 

 

Total

   $ 39.0     $ 66.9  
  

 

 

   

 

 

 

Our weighted average interest rate for our five year $60.0 million Term Loan was 2.6% and 2.7% for the three and six-month periods ended June 30, 2013, respectively.

Our Credit Agreement requires that our total leverage ratio cannot exceed 2.0 and our fixed charge coverage ratio to be greater than 1.25. As of June 30, 2013, our total leverage ratio was 1.01 and our fixed charge coverage ratio was 1.27. We currently anticipate we will be in compliance with the covenants associated with our long-term obligations over the next 12 months. In the event we are not in compliance with our debt covenants in the future, we would pursue various alternatives in an attempt to successfully resolve the non-compliance, which might include, among other things, seeking debt covenant waivers or amendments.

As of June 30, 2013, our availability under our $165.0 million Revolving Credit Facility is limited due to outstanding letters of credit of $21.7 million. The availability of the remaining $143.3 million undrawn portion of our Revolving Credit Facility is limited to $94.4 million due to the debt limitation associated with the leverage covenant which restricts overall debt to less than 2.0 times earnings before interest, taxes, depreciation and amortization as defined in our Credit Agreement.

6. COMMITMENTS AND CONTINGENCIES

Legal Proceedings

We are involved in the following legal actions:

United States Senate Committee on Finance Inquiry

On May 12, 2010, we received a letter of inquiry from the Senate Finance Committee requesting documents and information relating to our policies and practices regarding home therapy visits and therapy utilization trends. A similar letter was sent to the other major publicly traded home health care companies. We cooperated with the Committee with respect to this inquiry.

On October 3, 2011, the Committee publicly issued a report titled “Staff Report on Home Health and the Medicare Therapy Threshold.” The Committee recommended that the CMS “must move toward taking therapy out of the payment model.” We believe that the issuance of the report concludes the Committee’s inquiry, but are not in a position to speculate on the potential for future legislative or oversight action by the Committee.

Securities Class Action Lawsuits

On June 10, 2010, a putative securities class action complaint was filed in the United States District Court for the Middle District of Louisiana against the Company and certain of our current and former senior executives. Additional putative securities class actions were filed in the United States District Court for the Middle District of Louisiana on July 14, July 16, and July 28, 2010.

 

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On October 22, 2010, the Court issued an order consolidating the putative securities class action lawsuits and the Federal Derivative Actions (described immediately below) for pre-trial purposes. In the same order, the Court appointed the Public Employees Retirement System of Mississippi and the Puerto Rico Teachers’ Retirement System as co-lead plaintiffs (together, the “Co-Lead Plaintiffs”) for the putative class. On December 10, 2010, the Court also consolidated the ERISA class action lawsuit (described below) with the putative securities class actions and Federal Derivative Actions for pre-trial purposes.

On January 18, 2011, the Co-Lead Plaintiffs filed an amended, consolidated class action complaint (the “Securities Complaint”) which supersedes the earlier-filed securities class action complaints. The Securities Complaint alleges that the defendants made false and/or misleading statements and failed to disclose material facts about our business, financial condition, operations and prospects, particularly relating to our policies and practices regarding home therapy visits under the Medicare home health prospective payment system and the related alleged impact on our business, financial condition, operations and prospects. The Securities Complaint seeks a determination that the action may be maintained as a class action on behalf of all persons who purchased the Company’s securities between August 2, 2005 and September 28, 2010 and an unspecified amount of damages.

All defendants moved to dismiss the Securities Complaint. On June 28, 2012, the United States District Court for the Middle District of Louisiana granted the defendants’ motion to dismiss the Securities Complaint. On July 26, 2012, the Co-Lead Plaintiffs filed a motion for reconsideration, which the Court denied on April 9, 2013.

On May 3, 2013, the Co-Lead Plaintiffs appealed the dismissal of their Securities Class Action Complaint to the United States Court of Appeals for the Fifth Circuit. The United States Court of Appeals for the Fifth Circuit docketed the Co-Lead Plaintiffs’ appeal on July 16, 2013, and the Co-Lead Plaintiffs must file their opening brief on or before August 26, 2013. The appeal remains pending. While the Company will seek to have the District Court order granting the defendants’ motion to dismiss affirmed on appeal, no assurances can be given as to the timing or outcome of the appeals process.

Derivative Actions

On July 2, 2010, an alleged shareholder of the Company filed a derivative lawsuit in the United States District Court for the Middle District of Louisiana, purporting to assert claims on behalf of the Company against certain of our current and former officers and directors. Three similar derivative suits were filed in the United States District Court for the Middle District of Louisiana on July 15, July 21, and August 2, 2010 (together, the “Federal Derivative Actions”). We are named as a nominal defendant in all of those actions. As noted above, on October 22, 2010, the United States District Court for the Middle District of Louisiana issued an order consolidating the Federal Derivative Actions with the putative securities class action lawsuits and for pre-trial purposes.

On January 18, 2011, the plaintiffs in the Federal Derivative Actions filed a consolidated, amended complaint (the “Derivative Complaint”) which supersedes the earlier-filed derivative complaints. The Derivative Complaint alleges that certain of our current and former officers and directors breached their fiduciary duties to the Company by making allegedly false statements, by allegedly failing to establish sufficient internal controls over certain of our home health and Medicare billing practices, by engaging in alleged insider trading, and by committing unspecified acts of waste of corporate assets and unjust enrichment. All defendants in the Federal Derivative Actions, including the Company as a nominal defendant, moved to dismiss the Derivative Complaint. That motion is fully briefed and remains pending before the court.

On June 24, 2013, all parties to the Federal Derivative Actions entered into a Stipulation of Settlement (the “Stipulation”) with respect to the Federal Derivative Actions. On June 27, 2013, the United States District Court for the Middle District of Louisiana issued an order preliminarily approving the proposed settlement in accordance with the Stipulation. Pursuant to the Court’s June 27, 2013 Order, a copy of the Court-approved “Notice of Settlement of Amedisys, Inc. Derivative Action,” (the “Notice of Settlement”) was attached as Exhibit 99.1 to the Company’s Current Report on Form 8-K filed with the United States Securities and Exchange Commission on July 2, 2013. As described in the Notice of Settlement, the Court has scheduled a hearing on September 4, 2013, to determine whether the Court should issue an order of final approval of the proposed settlement. As further described in the Notice of Settlement, as part of the proposed settlement, the Company has agreed to adopt and/or maintain certain corporate governance reforms as set forth in the Stipulation. The Stipulation also provides that plaintiffs’ co-lead counsel will seek an award of attorneys’ fees and expenses in an amount not to exceed $445,000, which shall include all attorneys’ fees and costs that may be due any counsel (or anyone else) who has asserted, or participated in the assertion of, derivative claims on behalf of the Company in any court. Any award of fees and expenses will be paid by the Company (or its insurer on its behalf). If the proposed settlement is approved, the Federal Derivative Actions will be dismissed with prejudice, and all named defendants will be released by all plaintiffs, the Company, and its shareholders from all claims that were or could have been alleged in the Federal Derivative Actions. As of June 30, 2013, we have accrued $0.4 million related to the proposed settlement and a corresponding receivable for insurance proceeds related to the proposed settlement.

On July 23, 2010, a derivative suit was filed in the Nineteenth Judicial District Court, Parish of East Baton Rouge, State of Louisiana. That action also purports to assert claims on behalf of the Company against certain of our current and former officers and directors. On December 8, 2010, the Court entered an order staying the action in deference to the earlier-filed derivative actions pending in Federal court. If the United States District Court for the Middle District of Louisiana issues an order of final approval of the settlement of the Federal Derivative Actions, the named defendants in the state court derivative suit and the Company, as a nominal defendant, will move for dismissal of the state court derivative suit.

 

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ERISA Class Action Lawsuit

On September 27, 2010 and October 22, 2010, separate putative class action complaints were filed in the United States District Court for the Middle District of Louisiana against the Company, certain of our current and former senior executives and members of our 401(k) Plan Administrative Committee. The suits allege violations of the Employee Retirement Income Security Act (“ERISA”) since January 1, 2006 and July 1, 2007, respectively. The plaintiffs brought the complaints on behalf of themselves and a class of similarly situated participants in our 401(k) plan. The plaintiffs assert that the defendants breached their fiduciary duties to the 401(k) Plan’s participants by causing the 401(k) plan to offer and hold Amedisys common stock during the respective class periods when it was an allegedly unduly risky and imprudent retirement investment because of our alleged improper business practices. The complaints seek a determination that the actions may be maintained as a class action, an award of unspecified monetary damages and other unspecified relief. As noted above, on December 10, 2010, the Court consolidated the putative ERISA class actions with the putative securities class actions and derivative actions for pre-trial purposes. In addition, on December 10, 2010, the Court appointed interim lead counsel and interim liaison counsel in the ERISA class action.

On March 10, 2011, Wanda Corbin, Pia Galimba and Linda Trammell (the “Co-ERISA Plaintiffs”), filed an amended, consolidated class action complaint (the “ERISA Complaint”), which supersedes the earlier-filed ERISA class action complaints. The ERISA Complaint seeks a determination that the action may be maintained as a class action on behalf of themselves and a class of similarly situated participants in our 401(k) plan from January 1, 2008 through present. All of the defendants have moved to dismiss the ERISA Complaint. That motion is fully briefed and remains pending before the court.

SEC Investigation

On June 30, 2010, we received notice of a formal investigation from the SEC and received a subpoena for documents relating to the matters under review by the United States Senate Committee on Finance and other matters involving our operations. We have cooperated with the SEC with respect to this investigation.

U.S. Department of Justice Civil Investigative Demand (“CID”)

On September 27, 2010, we received a CID issued by the U.S. Department of Justice pursuant to the federal False Claims Act. The CID requires the delivery of a wide range of documents and information relating to the Company’s clinical and business operations, including reimbursement and billing claims submitted to Medicare for home health services, and related compliance activities. The CID generally covers the period from January 1, 2003. On April 26, 2011, we received a second CID related to the CID issued in September 2010, which generally covers the same time period as the previous CID and requires the production of additional documents. Such CIDs are often associated with previously filed qui tam actions, or lawsuits filed under seal under the False Claims Act (“FCA”), 31 U.S.C. § 3729 et seq. Qui tam actions are brought by private plaintiffs suing on behalf of the federal government for alleged FCA violations. Subsequently, the Company and certain current and former employees have received additional CIDs for additional documents and/or testimony. We are cooperating with the Department of Justice with respect to this investigation and the requests for information and testimony.

Stark Law

In May 2012, we made a disclosure to CMS under the agency’s Stark Law Self-Referral Disclosure Protocol relating to certain services agreements between a subsidiary of ours and a large physician group. During some period of time since December 2007, the arrangements appear not to have complied in certain respects with an applicable exemption to the Stark Law referral prohibition. Medicare revenue earned as a result of referrals from the physician group from May 2008 to May 2012, the relevant four year “lookback” period under the Stark Law Self-Referral Disclosure Protocol, was approximately $4 million. On January 11, 2013, one of our subsidiaries received a CID from the United States Attorney’s Office for the Northern District of Georgia seeking certain information relating to that subsidiary’s relationship with this physician group. We are cooperating with the government in its review of this matter.

OIG Self-Disclosure

In October 2012, we made a disclosure to the Office of Counsel to the Inspector General of the United States Department of Health and Human Services (the “OIG”) pursuant to the OIG Provider Self-Disclosure Protocol regarding certain clinical documentation issues and eligibility regulatory requirements at two of our hospice care centers. These hospice care centers did not comply in some respects with certain state and Medicare hospice regulations, including those requiring physicians to certify patient eligibility and requiring patient face-to-face encounters. We are also in discussions with state healthcare authorities regarding this matter. Our review of this matter is ongoing, and we are cooperating with the OIG and the state regulatory authorities in their review of this matter.

 

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(Unaudited)

 

Wage and Hour Litigation

On July 25, 2012, a putative collective and class action complaint was filed in the United States District Court for the District of Connecticut against us in which three former employees allege wage and hour law violations. The former employees claim that they were not paid overtime for all hours worked over forty hours in violation of the Federal Fair Labor Standards Act (“FLSA”), as well as the Pennsylvania Minimum Wage Act. More specifically, they allege they were paid on both a per-visit and an hourly basis, and that such a pay scheme resulted in their misclassification as exempt employees, thereby denying them overtime pay. Moreover, in response to a Company motion arguing that plaintiffs’ complaint was deficient in that it was ambiguous and failed to provide fair notice of the claims asserted and plaintiffs’ opposition thereto, the court, on April 8, 2013, held that the complaint adequately raises general allegations that the plaintiffs were not paid overtime for all hours worked in a week over forty, which may include claims for unpaid overtime under other theories of liability, such as alleged off-the-clock work, in addition to plaintiffs’ more clearly stated allegations based on misclassification. Plaintiffs seek class certification of similar employees and seek attorneys’ fees, back wages and liquidated damages going back three years under the FLSA and three years under the Pennsylvania statute.

On September 13, 2012, a putative collective and class action complaint was filed in the United States District Court for the Northern District of Illinois against us in which a former employee alleges wage and hour law violations. The former employee claims she was paid on both a per-visit and an hourly basis, thereby misclassifying her as an exempt employee and entitling her to overtime pay. The plaintiff alleges violations of Federal and state law and seeks damages under the FLSA and the Illinois Minimum Wage Law. Plaintiff seeks class certification of similar employees who were or are employed in Illinois and seeks attorneys’ fees, back wages and liquidated damages going back three years under the FLSA and three years under the Illinois statute.

We are unable to assess the probable outcome or reasonably estimate the potential liability, if any, arising from the SEC investigation, the U.S. Department of Justice CIDs, the Stark Law matter we have disclosed to CMS, the OIG Self-Disclosure issue and the securities, shareholder derivative, ERISA and wage and hour litigation described above given the preliminary stage of these matters. The Company intends to continue to vigorously defend itself in the securities, shareholder derivative, ERISA and wage and hour litigation matters. No assurances can be given as to the timing or outcome of the SEC investigation, the U.S. Department of Justice CIDs, the Stark Law matter we have disclosed to CMS, the OIG Self-Disclosure issue or the securities, shareholder derivative, ERISA and wage and hour litigation matters described above or the impact of any of the inquiry, investigation or litigation matters on the Company, its consolidated financial condition, results of operations or cash flows, which could be material, individually or in the aggregate.

We recognize that additional putative securities class action complaints and other litigation could be filed, and that other investigations and actions could be commenced, relating to matters involving our home therapy visits and therapy utilization trends or other matters.

In addition to the matters referenced in this note, we are involved in legal actions in the normal course of business, some of which seek monetary damages, including claims for punitive damages. We do not believe that these normal course actions, when finally concluded and determined, will have a material impact on our consolidated financial condition, results of operations or cash flows.

Third Party Audits

From time to time, in the ordinary course of business, we are subject to audits under various governmental programs in which third party firms engaged by CMS conduct extensive review of claims data to identify potential improper payments under the Medicare program.

In January 2010, our subsidiary that provides home health services in Dayton, Ohio received from a Medicare Program Safeguard Contractor (“PSC”) a request for records regarding 137 claims submitted by the subsidiary paid from January 2, 2008 through November 10, 2009 (the “Claim Period”) to determine whether the underlying services met pertinent Medicare payment requirements. Based on the PSC’s findings for 114 of the claims, which were extrapolated to all claims for home health services provided by the Dayton subsidiary paid during the Claim Period, on March 9, 2011, the Medicare Administrative Contractor (“MAC”) for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment of approximately $5.6 million. We dispute these findings, and our Dayton subsidiary has filed appeals through the Original Medicare Standard Appeals Process, in which we are seeking to have those findings overturned. Most recently, a consolidated administrative law judge (“ALJ”) hearing was held in late March 2013. As of the date of this filing, the ALJ has not released a ruling. No assurances can be given as to the outcome of the ALJ appeal. As of June 30, 2013, we have recorded no liability with respect to the pending appeals as we do not believe that an estimate of a reasonably possible loss or range of loss can be made at this time.

In July 2010, our subsidiary that provides hospice services in Florence, South Carolina received from a Zone Program Integrity Contractor (“ZPIC”) a request for records regarding a sample of 30 beneficiaries who received services from the subsidiary during the period of January 1, 2008 through March 31, 2010 (the “Review Period”) to determine whether the underlying services met pertinent Medicare payment requirements. We acquired the hospice operations subject to this review on August 1, 2009; the Review Period covers time periods both before and after our ownership of these hospice operations. Based on the ZPIC’s findings for 16 beneficiaries, which were extrapolated to all claims for hospice services provided by the Florence subsidiary billed during the Review

 

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AMEDISYS, INC. AND SUBSIDIARIES

NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

(Unaudited)

 

Period, on June 6, 2011, the MAC for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment. We dispute these findings, and our Florence subsidiary has filed appeals through the Original Medicare Standard Appeals Process, in which we are seeking to have those findings overturned. Most recently, we have requested appeal hearings before an ALJ, but the ALJ hearings have not been scheduled, and no assurances can be given as to the timing or outcome of the ALJ appeal. The current alleged extrapolated overpayment is $6.1 million. In the event we pay any amount of this alleged overpayment, we are indemnified by the prior owners of the hospice operations for amounts relating to the period prior to August 1, 2009. As of June 30, 2013, we have recorded no liability for this claim as we do not believe that an estimate of a reasonably possible loss or range of loss can be made at this time.

In July 2009, Beacon Hospice, Inc., a subsidiary we acquired on June 7, 2011 (“Beacon”), received from Massachusetts Peer Review Organization, Inc. (“MassPro”), an entity contracted with the Massachusetts Office of Medicaid, a request for records regarding 25 beneficiaries in Boston, Framingham and Plymouth, Massachusetts, who received hospice services from Beacon during the period of August 1, 2007 through July 31, 2008 (the “Review Period”) to determine whether the underlying services met pertinent MassHealth Program regulations. Based on MassPro’s findings for 89 of the 112 claims submitted in connection with these beneficiaries, which were extrapolated to all MassHealth claims for hospice services provided by Beacon billed during the Review Period, on February 15, 2012, MassPro issued a notice of overpayment seeking recovery from Beacon of an alleged overpayment of approximately $6.6 million. The Review Period covers a time before our ownership of Beacon. On December 17, 2012, as a result of an appeal by Beacon, MassPro issued a final notice of determination of overpayment and fines (the “Final Notice”), determining an overpayment in only 35 of the original 112 claims and seeking recovery from Beacon in the amount of $0.1 million (the “Final Amount”). In the Final Notice, MassPro did not extrapolate the findings, and Beacon determined not to contest the Final Notice. In January 2013, Amedisys paid the Final Amount to MassPro, and the prior owners of Beacon paid the Final Amount to Amedisys, in accordance with their indemnification obligations set forth in the acquisition document.

Insurance

We are obligated for certain costs associated with our insurance programs, including employee health, workers’ compensation and professional liability. While we maintain various insurance programs to cover these risks, we are self-insured for a substantial portion of our potential claims. We recognize our obligations associated with these costs, up to specified deductible limits in the period in which a claim is incurred, including with respect to both reported claims and claims incurred but not reported. These costs have generally been estimated based on historical data of our claims experience. Such estimates, and the resulting reserves, are reviewed and updated by us on a quarterly basis.

Our health insurance has a retention limit of $0.9 million, our workers’ compensation insurance has a retention limit of $0.5 million and our professional liability insurance has a retention limit of $0.3 million.

7. SEGMENT INFORMATION

Our operations involve servicing patients through our two reportable business segments: home health and hospice. Our home health segment delivers a wide range of services in the homes of individuals who may be recovering from surgery, have a chronic disability or terminal illness or need assistance with the essential activities of daily living. Our hospice segment provides palliative care and comfort to terminally ill patients and their families. The “other” column in the following tables consists of costs relating to corporate support functions that are not directly attributable to a specific segment.

As of June 30, 2013, we classified 34 care centers as held for sale and sold three care centers which are reflected as discontinued operations in accordance with applicable accounting guidance. See Note 3 – Discontinued Operations and Assets Held for Sale for additional information. Prior periods have been reclassified to conform to the current presentation.

Management evaluates performance and allocates resources based on the operating income of the reportable segments, which includes an allocation of corporate expenses directly attributable to the specific segment and includes revenues and all other costs directly attributable to the specific segment. Segment assets are not reviewed by the company’s chief operating decision maker and therefore are not disclosed below (amounts in millions).

 

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AMEDISYS, INC. AND SUBSIDIARIES

NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS

(Unaudited)

 

     For the Three-Month Periods Ended June  30, 2013  
     Home Health      Hospice      Other     Total  

Net service revenue

   $ 248.6      $ 64.5      $ —       $ 313.1  

Cost of service, excluding depreciation and amortization

     142.0        34.1        —         176.1  

General and administrative expenses

     75.6        15.6        25.7       116.9  

Provision for doubtful accounts

     3.0        1.6        —         4.6  

Depreciation and amortization

     2.6        0.5        8.6       11.7  
  

 

 

    

 

 

    

 

 

   

 

 

 

Operating expenses

     223.2        51.8        34.3       309.3  
  

 

 

    

 

 

    

 

 

   

 

 

 

Operating income (loss)

   $ 25.4      $ 12.7      $ (34.3   $ 3.8  
  

 

 

    

 

 

    

 

 

   

 

 

 
     For the Three-Month Periods Ended June  30, 2012  
     Home Health      Hospice      Other     Total  

Net service revenue

   $ 290.6      $ 72.5      $ —       $ 363.1  

Cost of service, excluding depreciation and amortization

     165.3        37.3        —         202.6  

General and administrative expenses

     81.5        17.8        31.6       130.9  

Provision for doubtful accounts

     3.9        0.6        —         4.5  

Depreciation and amortization

     3.4        0.3        6.0       9.7  
  

 

 

    

 

 

    

 

 

   

 

 

 

Operating expenses

     254.1        56.0        37.6       347.7  
  

 

 

    

 

 

    

 

 

   

 

 

 

Operating income (loss)

   $ 36.5      $ 16.5      $ (37.6   $ 15.4  
  

 

 

    

 

 

    

 

 

   

 

 

 
     For the Six-Month Periods Ended June 30, 2013  
     Home Health      Hospice      Other     Total  

Net service revenue

   $ 508.8      $ 130.4      $ —       $ 639.2  

Cost of service, excluding depreciation and amortization

     291.3        68.9        —         360.2  

General and administrative expenses

     155.1        32.8        52.2       240.1  

Provision for doubtful accounts

     5.0        3.5        —         8.5  

Depreciation and amortization

     5.3        1.1        15.2       21.6  
  

 

 

    

 

 

    

 

 

   

 

 

 

Operating expenses

     456.7        106.3        67.4       630.4  
  

 

 

    

 

 

    

 

 

   

 

 

 

Operating income (loss)

   $ 52.1      $ 24.1      $ (67.4   $ 8.8  
  

 

 

    

 

 

    

 

 

   

 

 

 
     For the Six-Month Periods Ended June 30, 2012  
     Home Health      Hospice      Other     Total  

Net service revenue

   $ 578.4      $ 140.6      $ —       $ 719.0  

Cost of service, excluding depreciation and amortization

     328.5        73.1        —         401.6  

General and administrative expenses

     165.6        34.0        59.7       259.3  

Provision for doubtful accounts

     8.8        1.4        —         10.2  

Depreciation and amortization

     6.6        0.6        12.3       19.5  
  

 

 

    

 

 

    

 

 

   

 

 

 

Operating expenses

     509.5        109.1        72.0       690.6  
  

 

 

    

 

 

    

 

 

   

 

 

 

Operating income (loss)

   $ 68.9      $ 31.5      $ (72.0   $ 28.4  
  

 

 

    

 

 

    

 

 

   

 

 

 

 

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ITEM 2.

MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

The following discussion and analysis provides information we believe is relevant to an assessment and understanding of our results of operations and financial condition for the three and six-month periods ended June 30, 2013. This discussion should be read in conjunction with the condensed consolidated financial statements and notes thereto included herein, and the consolidated financial statements and notes and the related Management’s Discussion and Analysis of Financial Condition and Results of Operations in our Annual Report on Form 10-K for the year ended December 31, 2012 filed with the Securities and Exchange Commission (“SEC”) on March 12, 2013 (the “Form 10-K”), which are incorporated herein by this reference.

Unless otherwise provided, “Amedisys,” “we,” “our,” and the “Company” refer to Amedisys, Inc. and our consolidated subsidiaries.

Overview

We are a leading provider of high-quality, low-cost home health services to the chronic, co-morbid, aging American population with approximately 84% and 82% of our revenue derived from Medicare for the three-month periods ended June 30, 2013 and 2012, respectively and approximately 84% and 83% of our revenue derived from Medicare for the six-month periods ended June 30, 2013 and 2012, respectively. During the three-month period ended June 30, 2013, we had $313.1 million in net service revenue, earnings per diluted share of $0.06 and cash flow from operating activities of $33.6 million. For the six-month period ended June 30, 2013, we had $639.2 million in net service revenue, earnings per diluted share of $0.14 and cash flow from operating activities of $66.0 million.

Our operations involve servicing patients through our two reportable business segments: home health and hospice. Our home health segment delivers a wide range of services in the homes of individuals who may be recovering from an illness, injury or surgical procedure. Our hospice segment provides care that is designed to provide comfort and support for those who are facing a terminal illness. As of June 30, 2013, we owned and operated 409 Medicare-certified home health care centers, including 33 care centers held for sale, 94 Medicare-certified hospice care centers, including one care center held for sale, and one hospice inpatient unit in 37 states within the United States, the District of Columbia and Puerto Rico as detailed below:

 

     Owned and Operated Care Centers  
     Home Health     Hospice     Held for Sale Care
Centers
 

At December 31, 2012

     435       97       —    

Acquisitions

     2       —         —    

Held for Sale

     (33     (1     34  

Sold

     (2     (1     —    

Consolidated

     (26     (2     —    
  

 

 

   

 

 

   

 

 

 

At June 30, 2013

     376       93       34  
  

 

 

   

 

 

   

 

 

 

As part of our management of our portfolio of care centers, we review each care center’s current financial performance, market penetration, forecasted market growth and the impact of proposed CMS payment revisions. As a result of our review, during the three-month period ended June 30, 2013, we committed to a plan to divest approximately 50 care centers; therefore, as of June 30, 2013, we classified 34 care centers as held for sale (33 home health care centers and one hospice care center) and consolidated 19 care centers (17 home health care centers and two hospice care centers) with care centers servicing the same markets. In addition, we sold assets associated with two home health care centers and one hospice care center. In connection with the care centers we consolidated, we recorded charges of $2.3 million in depreciation and amortization expense related to the write-off of intangible assets, $0.8 million in other general and administrative expenses related to lease termination costs and $0.7 million in salaries and benefits related to severance costs during the three-month period ended June 30, 2013.

When we refer to “same store business,” we mean home health and hospice care centers that we have operated for at least the last twelve months; when we refer to “acquisitions,” we mean home health and hospice care centers that we acquired within the last twelve months; and when we refer to “start-ups,” we mean home health or hospice care centers opened by us in the last twelve months. Once a care center has been in operation for a twelve month period, the results for that particular care center are included as part of our same store business from that date forward. Non-Medicare revenue, admissions, recertifications or completed episodes, includes home health revenue, admissions, recertifications or completed episodes of care for those payors that pay on an episodic or per visit basis, which includes Medicare Advantage programs and private payors.

 

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Recent Developments

Governmental Inquiries and Investigations and Stockholder Litigation

See Note 6 to our condensed consolidated financial statements for a discussion of and updates regarding the governmental inquiries and investigations, self-disclosure matters and class action litigation we are involved in. No assurances can be given as to the timing or outcome of these items.

Payment

The failure of the 2011 Joint Select Committee to meet its Deficit Reduction goal has resulted in sequestration, an automatic reduction in Medicare home health and hospice payments of 2% in 2013. The 2% reduction was effective April 1, 2013 on home health episodes ending after March 31, 2013 and hospice days beginning on April 1, 2013. The 2% reduction resulted in approximately a $6 million and $7 million decrease in net service revenue during the three and six-month periods ended June 30, 2013, respectively.

In April 2013, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule to update and revise the Medicare hospice wage index for fiscal year 2014. The proposed rule includes a 2.5% market basket update which is reduced by the following: a 0.3% adjustment from the Patient Protection and Affordable Care Act (“PPACA”) and a 0.4% productivity adjustment. The net effect of the proposed rule increases the base rate for 2014 by 1.8%. We expect CMS to issue a final rule in the third quarter of 2013.

In June 2013, CMS issued a proposed rule to update and revise Medicare home health reimbursement rates for the calendar year 2014. The proposed rule includes the maximum rebasing cut of 3.5% as allowed by the PPACA and the Health Care and Education Reconciliation Act of 2010, a negative ICD-9 coding change impact of 0.5% offset by a 2.4% market-basket increase. The net effect of these changes is approximately a 1.5% decrease in reimbursement to home health providers. Our impact could differ depending on differences in the wage index and the impact of coding changes. In addition to the calendar year 2014 rebasing cut of 3.5%, CMS proposed to reduce reimbursement rates by 3.5% for rebasing in each year from calendar year 2015 to calendar year 2017. We expect CMS to issue a final rule in the fourth quarter of 2013.

Results of Operations

Three-Month Period Ended June 30, 2013 Compared to the Three-Month Period Ended June 30, 2012

Consolidated

The following table summarizes our consolidated results from continuing operations (amounts in millions):

 

     For the Three-Month Periods
Ended June 30,
 
     2013     2012  

Net service revenue

   $ 313.1     $ 363.1  

Gross margin, excluding depreciation and amortization

     137.0       160.5  

% of revenue

     43.8     44.2

Other operating expenses

     133.2       145.1  

% of revenue

     42.5     40.0
  

 

 

   

 

 

 

Operating income

     3.8       15.4  
  

 

 

   

 

 

 

Income tax expense

     (1.6     (5.7

Effective income tax rate

     40.1     41.5
  

 

 

   

 

 

 

Income from continuing operations

     2.3       8.0  
  

 

 

   

 

 

 

Net loss from discontinued operations

     (0.5     —    

Net (income) attributable to noncontrolling interests

     —         (0.1
  

 

 

   

 

 

 

Net income attributable to Amedisys, Inc.

   $ 1.8     $ 7.9  
  

 

 

   

 

 

 

Our operating income from continuing operations declined $12 million which is inclusive of a $6 million impact due to sequestration. Excluding the impact of sequestration, our home health operating income decreased $6 million, hospice operating income decreased $3 million and corporate expenses decreased $3 million. Our home health operating income declined primarily as a result of lower volumes. Our hospice operations experienced a decrease in average daily census and a decrease in other operating expenses. The decrease in corporate expense resulted from decreases in professional and legal fees, travel and training expenses and salary expense.

 

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Home Health Division

The following table summarizes our home health segment results from continuing operations:

 

     For the Three-Month Periods Ended June  30,  
     2013     2012  

Financial Information (in millions):

    

Medicare

   $ 202.9     $ 229.4  

Non-Medicare

     45.7       61.2  
  

 

 

   

 

 

 

Net service revenue

     248.6       290.6  

Cost of service

     142.0       165.3  
  

 

 

   

 

 

 

Gross margin

     106.6       125.3  

Other operating expenses

     81.2       88.8  
  

 

 

   

 

 

 

Operating income

   $ 25.4     $ 36.5  
  

 

 

   

 

 

 

Key Statistical Data:

    

Medicare:

    

Same Store Volume(1):

    

Revenue

     (10 %)      (8 %) 

Admissions

     0     2

Recertifications

     (18 %)      (7 %) 

Total:

    

Admissions

     47,381       48,023  

Recertifications

     27,331       33,965  

Completed episodes

     74,963       79,781  

Visits

     1,312,222       1,546,329  

Average revenue per completed episode(2)

   $ 2,828     $ 2,879  

Visits per completed episode(3)

     17.6       19.1  

Non-Medicare:

    

Admissions

     18,161       23,047  

Recertifications

     7,516       10,465  

Visits

     378,928       523,111  

Total:

    

Cost per Visit

   $ 83.98     $ 79.86  

Visits

     1,691,150       2,069,440  

 

(1)

Medicare revenue, admissions or recertifications same store volume is the percent increase (decrease) in our Medicare revenue, admissions or recertifications for the period as a percent of the Medicare revenue, admissions or recertifications of the prior period.

(2)

Average Medicare revenue per completed episode is the average Medicare revenue earned for each Medicare completed episode of care which excludes the impact of sequestration.

(3)

Medicare visits per completed episode are the home health Medicare visits on completed episodes divided by the home health Medicare episodes completed during the period.

Our operating income declined $11 million on a $42 million decrease in net service revenue. Sequestration only accounted for $5 million of our revenue decline; however, it accounted for 45% of the decline in our operating income. Both Medicare and non-Medicare revenues declined on lower volumes and a 1.8% decrease in revenue per episode which was offset by a decline in visits per episode and an $8 million decrease in other operating expenses.

Net Service Revenue

Our Medicare revenue decline of approximately $26 million consisted of $17 million due to lower volumes, $4 million due to a decline in revenue per episode and $5 million as a result of sequestration. The volume decline can be attributed to lower recertifications. The 1.8% decline in revenue per episode was offset by a 7.8% decline in our visits per episode.

 

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Our non-Medicare revenue decrease of $16 million consisted of an $11 million decrease as the result of changes to the reimbursement terms under our Humana contract (episodic to per-visit reimbursement) which became effective October 2012. In addition, we have experienced a decline in both the number of non-Medicare admissions and visits performed.

Cost of Service, Excluding Depreciation and Amortization

Our cost of service decreased $23 million primarily as a result of our decrease in visits offset by an increase in cost per visit. The increase in cost per visit is the result of pay raises that became effective in April 2012. Additionally, our cost per visit metric is impacted by lower visits due to the fixed nature of some of our care delivery costs.

Other Operating Expenses

Other operating expenses decreased approximately $8 million resulting from decreases in salaries and wages and in our provision for doubtful accounts, which is reflective of our decrease in non-Medicare revenue.

Hospice Division

The following table summarizes our hospice segment results from continuing operations:

 

     For the Three-Month Periods Ended June  30,  
     2013     2012  

Financial Information (in millions):

    

Medicare revenue

   $ 60.8     $ 68.7  

Non-Medicare revenue

     3.7       3.8  
  

 

 

   

 

 

 

Net service revenue

     64.5       72.5  

Cost of service

     34.1       37.3  
  

 

 

   

 

 

 

Gross margin

     30.4       35.2  

Other operating expenses

     17.7       18.7  
  

 

 

   

 

 

 

Operating income

   $ 12.7     $ 16.5  
  

 

 

   

 

 

 

Key Statistical Data:

    

Same store Medicare revenue growth (1)

     (12 %)      22

Hospice admits

     4,600       4,797  

Average daily census

     4,939       5,402  

Revenue per day

   $ 143.63     $ 147.39  

Cost of service per day

   $ 75.40     $ 75.79  

Average length of stay

     99       95  

 

(1)

Same store Medicare revenue growth is the percent increase in our Medicare revenue for the period as a percent of the Medicare revenue of the prior period.

Our operating income decreased $4 million on an $8 million decline in net service revenue. Sequestration accounted for $1 million of the decline in both revenue and operating income.

Net Service Revenue

Our hospice revenue decreased $8 million, related to the decrease in our average daily census and $1 million due to sequestration. We benefitted from a 0.9% hospice rate increase effective October 1, 2012.

Cost of Service, Excluding Depreciation and Amortization

Our hospice cost of service decreased $3 million, or 9%, which corresponds to our 9% decrease in average daily census as our cost per day remained flat. Our hospice clinicians are generally paid on a salaried basis, and our care centers are staffed based on their average census.

 

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Six-Month Period Ended June 30, 2013 Compared to the Six-Month Period Ended June 30, 2012

Consolidated

The following table summarizes our consolidated results from continuing operations (amounts in millions):

 

     For the Six-Month Periods
Ended June 30,
 
     2013     2012  

Net service revenue

   $ 639.2     $ 719.0  

Gross margin, excluding depreciation and amortization

     279.0       317.4  

% of revenue

     43.6     44.1

Other operating expenses

     270.2       289.0  

% of revenue

     42.3     40.2
  

 

 

   

 

 

 

Operating income

     8.8       28.4  
  

 

 

   

 

 

 

Income tax expense

     (3.3     (10.5

Effective income tax rate

     39.5     41.5
  

 

 

   

 

 

 

Income from continuing operations

     5.0       14.8  
  

 

 

   

 

 

 

Net loss from discontinued operations

     (1.0     (1.4

Net loss (income) attributable to noncontrolling interests

     0.5       (0.1
  

 

 

   

 

 

 

Net income attributable to Amedisys, Inc.

   $ 4.5     $ 13.3  
  

 

 

   

 

 

 

Our operating income from continuing operations declined $20 million as our home health and hospice operating income decreased $24 million and corporate operating expenses decreased $4 million. Our 2013 results were impacted by a $7 million decline in both revenue and operating income as a result of sequestration. Our home health operating income declined primarily as a result of lower volumes and lower revenue per episode. Our hospice operations experienced a decrease in average daily census which was partially offset by a decrease in cost of service. The decrease in corporate expense resulted from decreases in professional and legal fees and travel and training expenses.

 

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Table of Contents

Home Health Division

The following table summarizes our home health segment results from continuing operations:

 

     For the Six-Month Periods Ended June  30,  
     2013     2012  

Financial Information (in millions):

    

Medicare

   $ 413.9     $ 460.7  

Non-Medicare

     94.9       117.7  
  

 

 

   

 

 

 

Net service revenue

     508.8       578.4  

Cost of service

     291.3       328.5  
  

 

 

   

 

 

 

Gross margin

     217.5       249.9  

Other operating expenses

     165.4       181.0  
  

 

 

   

 

 

 

Operating income

   $ 52.1     $ 68.9  
  

 

 

   

 

 

 

Key Statistical Data:

    

Medicare:

    

Same Store Volume(1):

    

Revenue

     (9 %)      (8 %) 

Admissions

     1     0

Recertifications

     (17 %)      (6 %) 

Total:

    

Admissions

     97,047       96,767  

Recertifications

     55,836       68,328  

Completed episodes

     150,362       158,352  

Visits

     2,671,801       3,099,753  

Average revenue per completed episode(2)

   $ 2,801     $ 2,876  

Visits per completed episode(3)

     17.5       18.9  

Non-Medicare:

    

Admissions

     39,699       45,333  

Recertifications

     15,707       19,942  

Visits

     800,086       1,008,690  

Total:

    

Cost per Visit

   $ 83.90     $ 79.95  

Visits

     3,471,887       4,108,443  

 

(1)

Medicare revenue, admissions or recertifications volume is the percent increase (decrease) in our Medicare revenue, admissions or recertifications for the period as a percent of the Medicare revenue, admissions or recertifications of the prior period.

(2)

Average Medicare revenue per completed episode is the average Medicare revenue earned for each Medicare completed episode of care which excludes the impact of sequestration.

(3)

Medicare visits per completed episode are the home health Medicare visits on completed episodes divided by the home health Medicare episodes completed during the period.

Overall, our operating income declined $17 million on a $70 million decline in revenue from 2012. Sequestration impacted revenue and operating income by $6 million. Both Medicare and non-Medicare revenue were impacted by lower utilization offset by a $16 million decrease in other operating expenses.

Net Service Revenue

Our Medicare revenue decline of approximately $47 million consisted of $30 million due to lower volumes, $11 million due to lower revenue per episode and $6 million due to sequestration. The volume decline is primarily due to lower recertifications, as same store admissions were up slightly at 1%. Our revenue per episode declined 2.6%; however, this was offset by a 7.4% decrease in our visits per episode.

Our non-Medicare revenue decrease of $23 million consisted of a $20 million decrease as the result of changes to the reimbursement terms under our Humana contract (episodic to per-visit reimbursement) which became effective October 2012. In addition, we have experienced a decline in both the number of non-Medicare admissions, recertifications and visits performed.

 

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Table of Contents

Cost of Service, Excluding Depreciation and Amortization

Our cost of service decreased $37 million primarily as a result of our decrease in visits offset by an increase in cost per visit. The increase in cost per visit is the result of pay raises that became effective in April 2012. Additionally, our cost per visit metric is impacted by lower visits due to the fixed nature of some of our care delivery costs.

Other Operating Expenses

Other operating expenses decreased approximately $16 million resulting from decreases in salaries and wages and in our provision for doubtful accounts, which is reflective of our decrease in non-Medicare revenue and an increase in the number of contracted versus non-contracted payors.

Hospice Division

The following table summarizes our hospice segment results from continuing operations:

 

     For the Six-Month Periods Ended June  30,  
     2013     2012  

Financial Information (in millions):

    

Medicare revenue

   $ 122.9     $ 132.9  

Non-Medicare revenue

     7.5       7.7  
  

 

 

   

 

 

 

Net service revenue

     130.4       140.6  

Cost of service

     68.9       73.1  
  

 

 

   

 

 

 

Gross margin

     61.5       67.5  

Other operating expenses

     37.4       36.0  
  

 

 

   

 

 

 

Operating income

   $ 24.1     $ 31.5  
  

 

 

   

 

 

 

Key Statistical Data:

    

Same store Medicare revenue growth (1)

     (8 %)      20

Hospice admits

     9,528       9,589  

Average daily census

     4,973       5,248  

Revenue per day

   $ 144.84     $ 147.29  

Cost of service per day

   $ 76.30     $ 76.45  

Average length of stay

     101       93  

 

(1)

Same store Medicare revenue growth is the percent increase in our Medicare revenue for the period as a percent of the Medicare revenue of the prior period.

Our operating income decreased $7 million primarily as the result of a decrease in our average daily census and an increase in other operating expenses.

Net Service Revenue

Our hospice revenue decreased $10 million, primarily as the result of a decrease in our average daily census and $1 million due to sequestration. We benefitted from a 0.9% hospice rate increase effective October 1, 2012.

Cost of Service, Excluding Depreciation and Amortization

Our hospice cost of service decreased $4 million, or 6%, which corresponds to our 5% decrease in average daily census. Our hospice clinicians are generally paid on a salaried basis, and our care centers are staffed based on their average census.

 

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Table of Contents

Liquidity and Capital Resources

Cash Flows

The following table summarizes our cash flows for the periods indicated (amounts in millions):

 

     For the Six-Month Periods Ended
June 30,
 
     2013     2012  

Cash provided by operating activities

   $ 66.0     $ 32.1  

Cash used in investing activities

     (24.2     (27.9

Cash used in financing activities

     (26.2     (15.0
  

 

 

   

 

 

 

Net decrease in cash and cash equivalents

     15.6       (10.8

Cash and cash equivalents at beginning of period

     14.5       48.0  
  

 

 

   

 

 

 

Cash and cash equivalents at end of period

   $ 30.1     $ 37.2  
  

 

 

   

 

 

 

Cash provided by operating activities increased $33.9 million primarily due to a 7.6 day decrease in our days revenue outstanding from December 31, 2012.

Cash used in investing activities decreased $3.7 million due to a decrease in acquisition activities, which was offset by the purchase of investments.

Cash used in financing activities increased $11.2 million. We decreased our outstanding long-term obligations net of borrowings by $27.9 million from December 31, 2012, primarily due to the maturity of $20 million in senior notes.

Liquidity

Typically, our principal source of liquidity is the collection of our patient accounts receivable, primarily through the Medicare program; however, from time to time, we can and do obtain additional sources of liquidity through sales of our equity or by the incurrence of additional indebtedness. As of June 30, 2013, our availability under our $165.0 million Revolving Credit Facility is limited due to outstanding letters of credit of $21.7 million. Effective availability of the remaining $143.3 million undrawn portion of our Revolving Credit Facility is limited to $94.4 million due to the overall debt limitation associated with the leverage covenant which restricts overall debt to less than 2.0 times earnings before interest, taxes, depreciation and amortization as defined in our Credit Agreement.

During 2013, we spent $4.0 million in routine capital expenditures, which primarily included equipment and computer software and hardware. In addition, we spent $15.6 million in non-routine capital expenditures related to enhancements to our point of care software.

Based on our operating forecasts and our debt service requirements, we believe we will have sufficient liquidity to fund our operations, capital requirements and debt service requirements; however, our ongoing ability to comply with the debt covenants under our credit agreement depends largely on the achievement of adequate levels of operating performance and cash flow. We currently anticipate we will be in compliance with the covenants associated with our long-term obligations over the next 12 months. If our future operating performance and/or cash flows are less than expected, it could cause us to default on our financial covenants in the future. In the event we are not in compliance with our debt covenants in the future, we would pursue various alternatives in an attempt to successfully resolve the non-compliance, which might include, among other things, seeking debt covenant waivers or amendments. There can be no assurance that debt covenant waivers or amendments would be obtained, if needed. As of June 30, 2013, our total leverage ratio was 1.01, our fixed charge coverage ratio was 1.27, and we were in compliance with the covenants associated with our long-term obligations; however our margin of compliance with our fixed charge coverage ratio has narrowed as of June 30, 2013.

Outstanding Patient Accounts Receivable

Our patient accounts receivable, net decreased $44.4 million from December 31, 2012 to June 30, 2013. Our cash collection as a percentage of revenue was 109.5% for the six-month period ended June 30, 2013, and 100.9% for the six-month period ended December 31, 2012. Our days revenue outstanding, net has decreased 7.6 days since December 2012.

Our patient accounts receivable includes unbilled receivables and are aged based upon our initial service date. At June 30, 2013, our unbilled patient accounts receivable, as a percentage of gross patient accounts receivable, was 27.0%, or $40.3 million, compared to 32.2%, or $63.4 million, at December 31, 2012. We monitor unbilled receivables on a care center by care center basis to ensure that all efforts are made to bill claims within timely filing deadlines. The timely filing deadline for Medicare is one year from the date the episode was completed and varies by state for Medicaid-reimbursable services and among insurance companies and other private payors.

 

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Table of Contents

Our provision for estimated revenue adjustments (which is deducted from our service revenue to determine net service revenue) and provision for doubtful accounts were as follows for the periods indicated (amounts in millions). We fully reserve for both our Medicare and other patient accounts receivable that are aged over 365 days.

 

     For the Three-
Month Periods Ended
June 30,
    For the Six-
Month Periods Ended
June 30,
 
     2013     2012     2013     2012  

Provision for estimated revenue adjustments (1)

   $ 2.9     $ 2.4     $ 6.8     $ 5.2  

Provision for doubtful accounts (2)

     4.8       4.7       8.7       10.6  
  

 

 

   

 

 

   

 

 

   

 

 

 

Total

   $ 7.7     $ 7.1     $ 15.5     $ 15.8  
  

 

 

   

 

 

   

 

 

   

 

 

 

As a percent of revenue

     2.4     1.9     2.3     2.1
  

 

 

   

 

 

   

 

 

   

 

 

 

 

(1)

Includes $0.1 million and $0.3 million from discontinued operations for the three-months ended June 30, 2013 and 2012, respectively. Includes $0.3 million and $0.6 million from discontinued operations for the six-months ended June 30, 2013 and 2012, respectively.

(2)

Includes $0.1 million and $0.2 million from discontinued operations for the three-months ended June 30, 2013 and 2012, respectively. Includes $0.2 million and $0.4 million from discontinued operations for the six-months ended June 30, 2013 and 2012, respectively.

The following schedules detail our patient accounts receivable, net of estimated revenue adjustments, by payor class, aged based upon initial date of service (amounts in millions, except days revenue outstanding, net):

 

     0-90      91-180      181-365      Over 365      Total  

At June 30, 2013:

              

Medicare patient accounts receivable, net (1)

   $ 77.8      $ 8.7      $ 1.9      $ —        $ 88.4  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

Other patient accounts receivable:

              

Medicaid

     10.5        2.6        1.9        0.2        15.2  

Private

     20.5        7.5        6.7        4.1        38.8  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

Total

   $ 31.0      $ 10.1      $ 8.6      $ 4.3      $ 54.0  
  

 

 

    

 

 

    

 

 

    

 

 

    

Allowance for doubtful accounts (2)

                 (17.6
              

 

 

 

Non-Medicare patient accounts receivable, net

               $ 36.4  
              

 

 

 

Total patient accounts receivable, net

               $ 124.8  
              

 

 

 

Days revenue outstanding, net (3)

                 33.9  
              

 

 

 
     0-90      91-180      181-365      Over 365      Total  

At December 31, 2012:

              

Medicare patient accounts receivable, net (1)

   $ 96.2      $ 17.1      $ 2.1      $ —        $ 115.4  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

Other patient accounts receivable:

              

Medicaid

     14.9        4.4        2.0        0.3        21.6  

Private

     30.4        12.9        7.8        2.1        53.2  
  

 

 

    

 

 

    

 

 

    

 

 

    

 

 

 

Total

   $ 45.3      $ 17.3      $ 9.8      $ 2.4      $ 74.8  
  

 

 

    

 

 

    

 

 

    

 

 

    

Allowance for doubtful accounts (2)

                 (21.0
              

 

 

 

Non-Medicare patient accounts receivable, net

               $ 53.8  
              

 

 

 

Total patient accounts receivable, net

               $ 169.2  
              

 

 

 

Days revenue outstanding, net (3)

                 41.5  
              

 

 

 

 

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Table of Contents
(1)

The following table summarizes the activity and ending balances in our estimated revenue adjustments (amounts in millions), which is recorded to reduce our Medicare outstanding patient accounts receivable to their estimated net realizable value, as we do not estimate an allowance for doubtful accounts for our Medicare claims.

 

     For the Three-Month
Period Ended

June 30, 2013
    For the Three-Month
Period Ended
December 31, 2012
    For the Six-Month
Period Ended

June 30, 2013
    For the Six-Month
Period Ended
December 31, 2012
 

Balance at beginning of period

   $ 7.1     $ 6.5     $ 6.4     $ 6.6  

Provision for estimated revenue
adjustments (a)

     2.9       2.7       6.8       5.4  

Write offs

     (3.2     (2.8     (6.4     (5.6
  

 

 

   

 

 

   

 

 

   

 

 

 

Balance at end of period

   $ 6.8     $ 6.4     $ 6.8     $ 6.4  
  

 

 

   

 

 

   

 

 

   

 

 

 

 

(a)

Includes $0.1 million from discontinued operations for the three-month periods ended June 30, 2013 and December 31, 2012, respectively. Includes $0.3 million from discontinued operations for the six-month periods ended June 30, 2013 and December 31, 2012, respectively.

Our estimated revenue adjustments were 7.1% and 5.3% of our outstanding Medicare patient accounts receivable at June 30, 2013 and December 31, 2012, respectively.

 

(2)

The following table summarizes the activity and ending balances in our allowance for doubtful accounts (amounts in millions), which is recorded to reduce only our Medicaid and private payer outstanding patient accounts receivable to their estimated net realizable value.

 

     For the Three-Month
Period Ended
June 30, 2013
    For the Three-Month
Period Ended
December 31, 2012
    For the Six-Month
Period Ended
June 30, 2013
    For the Six-Month
Period Ended
December 31, 2012
 

Balance at beginning of period

   $ 19.0     $ 20.4     $ 21.0     $ 19.6  

Provision for doubtful accounts (a)

     4.8       5.4       8.7       11.1  

Write offs

     (6.2     (4.8     (12.1     (9.7
  

 

 

   

 

 

   

 

 

   

 

 

 

Balance at end of period

   $ 17.6     $ 21.0     $ 17.6     $ 21.0  
  

 

 

   

 

 

   

 

 

   

 

 

 

 

(a)

Includes $0.1 million and $0.2 million from discontinued operations for the three-month periods ended June 30, 2013 and December 31, 2012, respectively. Includes $0.2 million and $0.4 million from discontinued operations for the six-month periods ended June 30, 2013 and December 31, 2012, respectively.

Our allowance for doubtful accounts was 32.6% and 28.1% of our outstanding Medicaid and private patient accounts receivable at June 30, 2013 and December 31, 2012, respectively.

 

(3)

Our calculation of days revenue outstanding, net is derived by dividing our ending net patient accounts receivable (i.e., net of estimated revenue adjustments and allowance for doubtful accounts ) at June 30, 2013 and December 31, 2012 by our average daily net patient revenue for the three-month periods ended June 30, 2013 and December 31, 2012, respectively.

Indebtedness

Our weighted average interest rate for our five year $60.0 million Term Loan was 2.6% and 2.7% for the three and six-month periods ended June 30, 2013, respectively.

Our Credit Agreement requires that our total leverage ratio cannot exceed 2.0 and our fixed charge coverage ratio to be greater than 1.25. As of June 30, 2013, our total leverage ratio was 1.01, our fixed charge coverage ratio was 1.27. We currently anticipate we will be in compliance with the covenants associated with our long-term obligations over the next 12 months. In the event we are not in compliance with our debt covenants in the future, we would pursue various alternatives in an attempt to successfully resolve the non-compliance, which might include, among other things, seeking debt covenant waivers or amendments.

As of June 30, 2013, our availability under our $165.0 million Revolving Credit Facility is limited due to outstanding letters of credit of $21.7 million. The availability of the remaining $143.3 million undrawn portion of our Revolving Credit Facility is limited to $94.4 million due to the debt limitation associated with the leverage covenant which restricts overall debt to less than 2.0 times earnings before interest, taxes, depreciation and amortization as defined in our Credit Agreement.

See Note 7 of the financial statements included in our Form 10-K for additional details on our outstanding long-term obligations which were outstanding as June 30, 2013.

 

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Table of Contents

Inflation

We do not believe inflation has significantly impacted our results of operations.

Critical Accounting Policies

See Part II, Item 7 – Critical Accounting Policies and our consolidated financial statements and related notes in Part IV, Item 15 of our 2012 Annual Report on Form 10-K, for accounting policies and related estimates we believe are the most critical to understanding our condensed consolidated financial statements, financial condition and results of operations and which require complex management judgment and assumptions, or involve uncertainties. These critical accounting policies include revenue recognition; patient accounts receivable; insurance; goodwill and intangible assets; and income taxes. There have not been any changes to our significant accounting policies or their application since we filed our 2012 Annual Report on Form 10-K.

 

ITEM 3.

QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

We are exposed to market risk from fluctuations in interest rates. Our Revolving Credit Facility and Term Loan carry a floating interest rate which is tied to the Eurodollar rate (i.e. LIBOR) and the Prime Rate and therefore, our condensed consolidated statements of operations and our condensed consolidated statements of cash flows will be exposed to changes in interest rates. As of June 30, 2013, the total amount of outstanding debt subject to interest rate fluctuations was $51.0 million. A 1.0% interest rate change would cause interest expense to change by approximately $0.5 million annually.

 

ITEM 4.

CONTROLS AND PROCEDURES

Evaluation of Disclosure Controls and Procedures

We have established disclosure controls and procedures which are designed to provide reasonable assurance of achieving their objectives and to ensure that information required to be disclosed in our reports filed under the Exchange Act is recorded, processed, summarized, disclosed and reported within the time periods specified in the SEC’s rules and forms. This information is also accumulated and communicated to our management and Board of Directors to allow timely decisions regarding required disclosure.

In connection with the preparation of this Quarterly Report on Form 10-Q, as of June 30, 2013, under the supervision and with the participation of our management, including our principal executive officer and principal financial officer, we conducted an evaluation of the effectiveness of our disclosure controls and procedures, as such term is defined under Rules 13a-15(e) and 15d-15(e) promulgated under the Exchange Act.

Based on this evaluation, our principal executive officer and principal financial officer concluded that our disclosure controls and procedures were effective at a reasonable assurance level as of June 30, 2013, the end of the period covered by this Quarterly Report.

Changes in Internal Controls

There have been no changes in our internal control over financial reporting (as defined in Exchange Act Rule 13a-15(f)) that have occurred during the quarter ended June 30, 2013, that have materially impacted, or are reasonably likely to materially impact, our internal control over financial reporting.

Inherent Limitations on Effectiveness of Controls

Our management, including our principal executive officer and principal financial officer, does not expect that our disclosure controls or our internal controls over financial reporting will prevent or detect all errors and all fraud. A control system, no matter how well designed and operated, can provide only reasonable, not absolute, assurance that the control system’s objectives will be met. The design of a control system must reflect the fact that there are resource constraints, and the benefits of controls must be considered relative to their costs. Further, because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that misstatements due to error or fraud will not occur or that all control issues and instances of fraud, if any, have been detected. These inherent limitations include the realities that judgments in decision-making can be faulty and that breakdowns can occur because of simple error or mistake. Controls can also be circumvented by the individual acts of some persons, by collusion of two or more people, or by management override of the controls. The design of any system of controls is based in part on certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions. Projections of any evaluation of controls’ effectiveness to future periods are subject to risks. Over time, controls may become inadequate because of changes in conditions or deterioration in the degree of compliance with policies and procedures. Our disclosure controls and procedures are designed to provide reasonable assurance of achieving their objectives and, based on an evaluation of our controls and procedures, our principal executive officer and our principal financial officer concluded our disclosure controls and procedures were effective at a reasonable assurance level as of June 30, 2013, the end of the period covered by this Quarterly Report.

 

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Table of Contents

PART II. OTHER INFORMATION

 

ITEM 1.

LEGAL PROCEEDINGS

See Note 6 to the condensed consolidated financial statements for information concerning our legal proceedings.

 

ITEM 1A.

RISK FACTORS

In addition to the other information set forth in this Quarterly Report on Form 10-Q, you should carefully consider the risk factors included in Part I, “Item 1A. – “Risk Factors”” of our Annual Report on Form 10-K. These risk factors could materially impact our business, financial condition and/or operating results. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially adversely impact our business, financial condition and/or operating results.

 

ITEM 2.

UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS

The following table provides the information with respect to purchases made by us of shares of our common stock during each of the months during the three-month period ended June 30, 2013:

 

Period

   (a) Total Number
of Share (or Units)
Purchased
    (b) Average Price
Paid per Share (or
Unit)
     (c) Total Number
of Shares (or Units)
Purchased as Part of

Publicly Announced
Plans or Programs
     (d) Maximum Number (or
Approximate Dollar
Value) of Shares (or
Units) That May Yet Be
Purchased Under the
Plans or Programs
 

April 1, 2013 to April 30, 2013

     75,601     $ 10.96        —        $ —    

May 1, 2013 to May 31, 2013

     529       11.12        —          —    

June 1, 2013 to June 30, 2013

     7,918       12.96        —          —    
  

 

 

   

 

 

    

 

 

    

 

 

 
     84,048 (1)    $ 11.15        —          —    
  

 

 

   

 

 

    

 

 

    

 

 

 

 

(1)

Includes shares of common stock surrendered to us by certain employees to:

i. satisfy tax withholding obligations in connection with the vesting of non-vested stock previously awarded to such employees

under our 2008 Omnibus Incentive Compensation Plan.

ii. satisfy tax withholding obligations in connection with the exercise of stock options previously awarded to such employees

under our 1998 Stock Option Plan.

 

ITEM 3.

DEFAULTS UPON SENIOR SECURITIES

None.

 

ITEM 4.

MINE SAFETY DISCLOSURES

Not applicable.

 

ITEM 5.

OTHER INFORMATION

None.

 

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Table of Contents
ITEM 6.

EXHIBITS

The exhibits marked with the cross symbol (†) are filed and the exhibits marked with a double cross (††) are furnished with this Form 10-Q. Any exhibits marked with the asterisk symbol (*) are management contracts or compensatory plans or arrangements filed pursuant to Item 601(b)(10)(iii) of Regulation S-K.

 

Exhibit

Number

  

Document Description

  

Report or Registration Statement

  

SEC File or
Registration
Number

   Exhibit
or Other
Reference
3.1    Composite of Certificate of Incorporation of the Company inclusive of all amendments through June 14, 2007    The Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2007    0-24260    3.1
3.2    Composite of By-Laws of the Company inclusive of all amendments through October 22, 2009    The Company’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2009    0-24260    3.2
4.1    Common Stock Specimen    The Company’s Registration Statement on Form S-3 filed August 20, 2007    333-145582    4.8
4.2.1    Note Purchase Agreement dated March 25, 2008 among Amedisys, Inc., Amedisys Holding, L.L.C. and the Purchasers identified on Schedule A thereto, relating to the issuance and sale of (a) $35,000,000 aggregate principal amount of their 6.07% Series A Senior Notes due March 25, 2013 (b) $30,000,000 aggregate principal amount of their 6.28% Series B Senior Notes due March 25, 2014 and (c) $35,000,000 aggregate principal amount of their 6.49% Series C Senior Notes due March 25, 2015    The Company’s Current Report on Form 8-K filed on April 1, 2008    0-24260    4.1
4.2.2    Amendment No. 1 dated October 26, 2012 to the Note Purchase Agreement dated March 25, 2008 among Amedisys, Inc., Amedisys Holding, L.L.C. relating to the issuance and sale of (a) $35,000,000 aggregate principal amount of their 6.07% Series A Senior Notes due March 25, 2013, (b) $30,000,000 aggregate principal amount of their 6.28% Series B Senior Notes due March 25, 2014 and (c) $35,000,000 aggregate principal amount of their 6.49% Series C Senior Notes due March 25, 2015    The Company’s Current Report on Form 8-K filed on October 30, 2012    0-24260    4.1
4.2.3    Waiver No. 1 dated October 26, 2012 to the Note Purchase Agreement dated March 25, 2008 among Amedisys, Inc., Amedisys Holding, L.L.C. relating to the issuance and sale of (a) $35,000,000 aggregate principal amount of their 6.07% Series A Senior Notes due March 25, 2013, (b) $30,000,000 aggregate principal amount of their 6.28% Series B Senior Notes due March 25, 2014 and (c) $35,000,000 aggregate principal amount of their 6.49% Series C Senior Notes due March 25, 2015    The Company’s Current Report on Form 8-K filed on October 30, 2012    0-24260    4.2

 

29


Table of Contents

Exhibit

Number

  

Document Description

  

Report or Registration Statement

  

SEC File or
Registration
Number

   Exhibit
or Other
Reference
4.3    Form of Series B Note due March 25, 2014 (attached as Exhibit C to the Amendment No. 1 to the Note Purchase Agreement Incorporated by reference as Exhibit 4.2.2 hereto)    The Company’s Current Report on Form 8-K filed on October 30, 2012    0-24260    4.4
†31.1    Certification of William F. Borne, Chief Executive Officer, pursuant to Section 302 of the Sarbanes-Oxley Act of 2002         
†31.2    Certification of Ronald A. LaBorde, Chief Financial Officer, pursuant to Section 302 of the Sarbanes-Oxley Act of 2002         
††32.1    Certification of William F. Borne, Chief Executive Officer, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002         
††32.2    Certification of Ronald A. LaBorde, Chief Financial Officer, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002         
††101.INS    XBRL Instance         
††101.SCH    XBRL Taxonomy Extension Schema Document         
††101.CAL    XBRL Taxonomy Extension Calculation Linkbase Document         
††101.DEF    XBRL Taxonomy Extension Definition Linkbase         
††101.LAB    XBRL Taxonomy Extension Labels Linkbase Document         
††101.PRE    XBRL Taxonomy Extension Presentation Linkbase Document         

 

30


Table of Contents

SIGNATURES

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, as amended, the Registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.

 

AMEDISYS, INC.

(Registrant)

By:

 

/s/ SCOTT G. GINN

  Scott G. Ginn,
 

Principal Accounting Officer and

Duly Authorized Officer

Date: July 31, 2013

 

31


Table of Contents

EXHIBIT INDEX

The exhibits marked with the cross symbol (†) are filed and the exhibits marked with a double cross (††) are furnished with this Form 10-Q. Any exhibits marked with the asterisk symbol (*) are management contracts or compensatory plans or arrangements filed pursuant to Item 601(b)(10)(iii) of Regulation S-K.

 

Exhibit

Number

  

Document Description

  

Report or Registration Statement

   SEC File or
Registration
Number
     Exhibit
or Other
Reference
 
3.1    Composite of Certificate of Incorporation of the Company inclusive of all amendments through June 14, 2007    The Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2007      0-24260         3.1   
3.2    Composite of By-Laws of the Company inclusive of all amendments through October 22, 2009    The Company’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2009      0-24260         3.2   
4.1    Common Stock Specimen    The Company’s Registration Statement on Form S-3 filed August 20, 2007      333-145582         4.8   
4.2.1    Note Purchase Agreement dated March 25, 2008 among Amedisys, Inc., Amedisys Holding, L.L.C. and the Purchasers identified on Schedule A thereto, relating to the issuance and sale of (a) $35,000,000 aggregate principal amount of their 6.07% Series A Senior Notes due March 25, 2013 (b) $30,000,000 aggregate principal amount of their 6.28% Series B Senior Notes due March 25, 2014 and (c) $35,000,000 aggregate principal amount of their 6.49% Series C Senior Notes due March 25, 2015    The Company’s Current Report on Form 8-K filed on April 1, 2008      0-24260         4.1   
4.2.2    Amendment No. 1 dated October 26, 2012 to the Note Purchase Agreement dated March 25, 2008 among Amedisys, Inc., Amedisys Holding, L.L.C. relating to the issuance and sale of (a) $35,000,000 aggregate principal amount of their 6.07% Series A Senior Notes due March 25, 2013, (b) $30,000,000 aggregate principal amount of their 6.28% Series B Senior Notes due March 25, 2014 and (c) $35,000,000 aggregate principal amount of their 6.49% Series C Senior Notes due March 25, 2015    The Company’s Current Report on Form 8-K filed on October 30, 2012      0-24260         4.1   
4.2.3    Waiver No. 1 dated October 26, 2012 to the Note Purchase Agreement dated March 25, 2008 among Amedisys, Inc., Amedisys Holding, L.L.C. relating to the issuance and sale of (a) $35,000,000 aggregate principal amount of their 6.07% Series A Senior Notes due March 25, 2013, (b) $30,000,000 aggregate principal amount of their 6.28% Series B Senior Notes due March 25, 2014 and (c) $35,000,000 aggregate principal amount of their 6.49% Series C Senior Notes due March 25, 2015    The Company’s Current Report on Form 8-K filed on October 30, 2012      0-24260         4.2   

 

32


Table of Contents

Exhibit

Number

  

Document Description

  

Report or Registration Statement

   SEC File or
Registration
Number
     Exhibit
or Other
Reference
 
4.3    Form of Series B Note due March 25, 2014 (attached as Exhibit C to the Amendment No. 1 to the Note Purchase Agreement Incorporated by reference as Exhibit 4.2.2 hereto)    The Company’s Current Report on Form 8-K filed on October 30, 2012      0-24260         4.4   
†31.1    Certification of William F. Borne, Chief Executive Officer, pursuant to Section 302 of the Sarbanes-Oxley Act of 2002         
†31.2    Certification of Ronald A. LaBorde, Chief Financial Officer, pursuant to Section 302 of the Sarbanes-Oxley Act of 2002         
††32.1    Certification of William F. Borne, Chief Executive Officer, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002         
††32.2    Certification of Ronald A. LaBorde, Chief Financial Officer, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002         
††101.INS    XBRL Instance         
††101.SCH    XBRL Taxonomy Extension Schema Document         
††101.CAL    XBRL Taxonomy Extension Calculation Linkbase Document         
††101.DEF    XBRL Taxonomy Extension Definition Linkbase         
††101.LAB    XBRL Taxonomy Extension Labels Linkbase Document         
††101.PRE    XBRL Taxonomy Extension Presentation Linkbase Document         

 

33

EX-31.1 2 d555683dex311.htm EX-31.1 EX-31.1

Exhibit 31.1

CERTIFICATION

I, William F. Borne, certify that:

1. I have reviewed this Quarterly Report on Form 10-Q for the quarter ended June 30, 2013, of Amedisys, 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 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 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 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.

Date: July 31, 2013

 

/s/ WILLIAM F. BORNE

William F. Borne
Chief Executive Officer
EX-31.2 3 d555683dex312.htm EX-31.2 EX-31.2

Exhibit 31.2

CERTIFICATION

I, Ronald A. LaBorde, certify that:

1. I have reviewed this Quarterly Report on Form 10-Q for the quarter ended June 30, 2013, of Amedisys, 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 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 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 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.

Date: July 31, 2013

 

/s/ Ronald A. LaBorde

Ronald A. LaBorde
Chief Financial Officer
EX-32.1 4 d555683dex321.htm EX-32.1 EX-32.1

Exhibit 32.1

CERTIFICATION OF CHIEF EXECUTIVE OFFICER PURSUANT TO 18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of Amedisys, Inc. (the “Company”) on Form 10-Q for the quarter ended June 30, 2013 (the “Report”), I, William F. Borne, Chief Executive Officer of the Company, hereby certify to my knowledge, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

(1) The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2) The information contained in the Report fairly presents, in all material respects, the financial condition and result of operations of the Company.

Date: July 31, 2013

 

/s/ WILLIAM F. BORNE

William F. Borne
Chief Executive Officer
EX-32.2 5 d555683dex322.htm EX-32.2 EX-32.2

Exhibit 32.2

CERTIFICATION OF CHIEF FINANCIAL OFFICER PURSUANT TO 18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Quarterly Report of Amedisys, Inc. (the “Company”) on Form 10-Q for the quarter ended June 30, 2013 (the “Report”), I, Ronald A. LaBorde, Chief Financial Officer of the Company, hereby certify to my knowledge, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

(1) The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2) The information contained in the Report fairly presents, in all material respects, the financial condition and result of operations of the Company.

Date: July 31, 2013

 

/s/ Ronald A. LaBorde

Ronald A. LaBorde
Chief Financial Officer
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3494000 5557000 127000 -848000 145000 239000 -411000 37158000 -15020000 8392000 1978000 17038000 -10846000 625000 25722000 48004000 10621000 8722300 126000 590000 20071000 19679100 0 6227000 25500000 0 537000 -578000 4363000 5040000 167000 0 0 2082000 2286400 0 93000 105000 25500000 0 <p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Basis of Presentation</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In our opinion, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations and our cash flows in accordance with U.S. Generally Accepted Accounting Principles (&#8220;U.S. GAAP&#8221;). Our results of operations for the interim periods presented are not necessarily indicative of results of our operations for the entire year and have not been audited by our independent auditors.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented. This report should be read in conjunction with our consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 201</font><font style="font-family:Times New Roman;font-size:10pt;">2</font><font style="font-family:Times New Roman;font-size:10pt;"> as filed with the Securities and Exchange Commission (&#8220;SEC&#8221;) on </font><font style="font-family:Times New Roman;font-size:10pt;">March 12</font><font style="font-family:Times New Roman;font-size:10pt;">, 201</font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;"> (the &#8220;Form 10-K&#8221;), which includes information and disclosures not included herein</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p> <p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Principles of Consolidation </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">These </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements include the accounts of </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, Inc.</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements, and business combinations accounted for as purchases have been included in our</font><font style="font-family:Times New Roman;font-size:10pt;"> unaudited condensed</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">investments that are </font><font style="font-family:Times New Roman;font-size:10pt;">accounted for as set forth below</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p> 0.84 0.82 0.84 0.83 0.5 5700000 0.2 5000000 0.5 4800000 <p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Use of Estimates </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our accounting and reporting policies conform with U.S.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">G</font><font style="font-family:Times New Roman;font-size:10pt;">AAP. In preparing the </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the</font><font style="font-family:Times New Roman;font-size:10pt;"> condensed</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates. </font></p> <p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Investments </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We consolidate </font><font style="font-family:Times New Roman;font-size:10pt;">investments when the entity is a variable interest entity and </font><font style="font-family:Times New Roman;font-size:10pt;">we </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">%. Third party equity interests in our consolidated joint ventures are reflected as </font><font style="font-family:Times New Roman;font-size:10pt;">noncontrolling</font><font style="font-family:Times New Roman;font-size:10pt;"> interests in our </font><font style="font-family:Times New Roman;font-size:10pt;">condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">% or less of the voting stock and the entity is not a variable interest entity in which we are the primary </font><font style="font-family:Times New Roman;font-size:10pt;">beneficiary. The book value of </font><font style="font-family:Times New Roman;font-size:10pt;">investments </font><font style="font-family:Times New Roman;font-size:10pt;">that we accounted for under the equity method of accounting </font><font style="font-family:Times New Roman;font-size:10pt;">was $</font><font style="font-family:Times New Roman;font-size:10pt;">5.</font><font style="font-family:Times New Roman;font-size:10pt;">7</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">million</font><font style="font-family:Times New Roman;font-size:10pt;"> as of June 30, 2013 and $</font><font style="font-family:Times New Roman;font-size:10pt;">4.8 </font><font style="font-family:Times New Roman;font-size:10pt;">million as of De</font><font style="font-family:Times New Roman;font-size:10pt;">cember 31, 2012. We account for investments in entities in which we have less than a </font><font style="font-family:Times New Roman;font-size:10pt;">20</font><font style="font-family:Times New Roman;font-size:10pt;">% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. The aggregate carrying amount of our cost method investment</font><font style="font-family:Times New Roman;font-size:10pt;">, which was acquired during the three-month period ended March 31, 2013, </font><font style="font-family:Times New Roman;font-size:10pt;">was $</font><font style="font-family:Times New Roman;font-size:10pt;">5.0 </font><font style="font-family:Times New Roman;font-size:10pt;">million as of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30</font><font style="font-family:Times New Roman;font-size:10pt;">, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">. </font></p> <p style='margin-top:0pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;margin-left:0px;">1</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">. NATURE OF OPERATIONS</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">,</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;"> </font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">CONSOLIDATION </font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">AND PRESENTATION </font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">OF FINANCIAL STATEMENTS </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, Inc., a Delaware corporation, and its consolidated subsidiaries (&#8220;</font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">,&#8221; &#8220;we,&#8221; &#8220;us,&#8221; or &#8220;our&#8221;) </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> a multi-state provider of home health and hospice services with </font><font style="font-family:Times New Roman;font-size:10pt;">approximately</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">84%</font><font style="font-family:Times New Roman;font-size:10pt;"> and</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">82%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">of our revenue derived from Medicare for</font><font style="font-family:Times New Roman;font-size:10pt;"> the</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">three</font><font style="font-family:Times New Roman;font-size:10pt;">-</font><font style="font-family:Times New Roman;font-size:10pt;">month</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> and approximately </font><font style="font-family:Times New Roman;font-size:10pt;">84%</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">83%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">of our revenue derived from Medicare for the six-month periods ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we owned and operated </font><font style="font-family:Times New Roman;font-size:10pt;">409</font><font style="font-family:Times New Roman;font-size:10pt;"> Medicare-certified home health </font><font style="font-family:Times New Roman;font-size:10pt;">care centers, including 33 care centers </font><font style="font-family:Times New Roman;font-size:10pt;">held</font><font style="font-family:Times New Roman;font-size:10pt;"> for sale, </font><font style="font-family:Times New Roman;font-size:10pt;">94</font><font style="font-family:Times New Roman;font-size:10pt;"> Medicare-certified hospice </font><font style="font-family:Times New Roman;font-size:10pt;">care centers</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> including one care center </font><font style="font-family:Times New Roman;font-size:10pt;">held</font><font style="font-family:Times New Roman;font-size:10pt;"> for sale,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and </font><font style="font-family:Times New Roman;font-size:10pt;">one</font><font style="font-family:Times New Roman;font-size:10pt;"> hospice inpatient unit </font><font style="font-family:Times New Roman;font-size:10pt;">in </font><font style="font-family:Times New Roman;font-size:10pt;">37</font><font style="font-family:Times New Roman;font-size:10pt;"> states within the United States, the District of Columbia and Puerto Rico</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Basis of Presentation</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In our opinion, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations and our cash flows in accordance with U.S. Generally Accepted Accounting Principles (&#8220;U.S. GAAP&#8221;). Our results of operations for the interim periods presented are not necessarily indicative of results of our operations for the entire year and have not been audited by our independent auditors.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented. This report should be read in conjunction with our consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 201</font><font style="font-family:Times New Roman;font-size:10pt;">2</font><font style="font-family:Times New Roman;font-size:10pt;"> as filed with the Securities and Exchange Commission (&#8220;SEC&#8221;) on </font><font style="font-family:Times New Roman;font-size:10pt;">March 12</font><font style="font-family:Times New Roman;font-size:10pt;">, 201</font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;"> (the &#8220;Form 10-K&#8221;), which includes information and disclosures not included herein</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Use of Estimates </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our accounting and reporting policies conform with U.S.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">G</font><font style="font-family:Times New Roman;font-size:10pt;">AAP. In preparing the </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the</font><font style="font-family:Times New Roman;font-size:10pt;"> condensed</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Reclassifications and Comparability</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Certain reclassifications have been made to prior period's financial statements in order to conform to the current period's presentation</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">W</font><font style="font-family:Times New Roman;font-size:10pt;">e exited three home health care centers</font><font style="font-family:Times New Roman;font-size:10pt;"> during 2012, and have </font><font style="font-family:Times New Roman;font-size:10pt;">committed to a plan to divest approximately 3</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers. In accordance with applicable accounting guidance</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> the results of operations for these care centers are presented in discontinued operations in our condensed consolidated financial statements. See Note </font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;"> for additional information regarding our discontinued operations.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">In addition</font><font style="font-family:Times New Roman;font-size:10pt;"> during 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, w</font><font style="font-family:Times New Roman;font-size:10pt;">e have consolidated </font><font style="font-family:Times New Roman;font-size:10pt;">2</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers with care centers servicing the same market</font><font style="font-family:Times New Roman;font-size:10pt;">s,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">which may affect the comparability of our operating results.</font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Principles of Consolidation </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">These </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements include the accounts of </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, Inc.</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements, and business combinations accounted for as purchases have been included in our</font><font style="font-family:Times New Roman;font-size:10pt;"> unaudited condensed</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">investments that are </font><font style="font-family:Times New Roman;font-size:10pt;">accounted for as set forth below</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Investments </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We consolidate </font><font style="font-family:Times New Roman;font-size:10pt;">investments when the entity is a variable interest entity and </font><font style="font-family:Times New Roman;font-size:10pt;">we </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">%. Third party equity interests in our consolidated joint ventures are reflected as </font><font style="font-family:Times New Roman;font-size:10pt;">noncontrolling</font><font style="font-family:Times New Roman;font-size:10pt;"> interests in our </font><font style="font-family:Times New Roman;font-size:10pt;">condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">% or less of the voting stock and the entity is not a variable interest entity in which we are the primary </font><font style="font-family:Times New Roman;font-size:10pt;">beneficiary. The book value of </font><font style="font-family:Times New Roman;font-size:10pt;">investments </font><font style="font-family:Times New Roman;font-size:10pt;">that we accounted for under the equity method of accounting </font><font style="font-family:Times New Roman;font-size:10pt;">was $</font><font style="font-family:Times New Roman;font-size:10pt;">5.</font><font style="font-family:Times New Roman;font-size:10pt;">7</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">million</font><font style="font-family:Times New Roman;font-size:10pt;"> as of June 30, 2013 and $</font><font style="font-family:Times New Roman;font-size:10pt;">4.8 </font><font style="font-family:Times New Roman;font-size:10pt;">million as of De</font><font style="font-family:Times New Roman;font-size:10pt;">cember 31, 2012. We account for investments in entities in which we have less than a </font><font style="font-family:Times New Roman;font-size:10pt;">20</font><font style="font-family:Times New Roman;font-size:10pt;">% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. The aggregate carrying amount of our cost method investment</font><font style="font-family:Times New Roman;font-size:10pt;">, which was acquired during the three-month period ended March 31, 2013, </font><font style="font-family:Times New Roman;font-size:10pt;">was $</font><font style="font-family:Times New Roman;font-size:10pt;">5.0 </font><font style="font-family:Times New Roman;font-size:10pt;">million as of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30</font><font style="font-family:Times New Roman;font-size:10pt;">, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p> <p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Reclassifications and Comparability</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Certain reclassifications have been made to prior period's financial statements in order to conform to the current period's presentation</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">W</font><font style="font-family:Times New Roman;font-size:10pt;">e exited three home health care centers</font><font style="font-family:Times New Roman;font-size:10pt;"> during 2012, and have </font><font style="font-family:Times New Roman;font-size:10pt;">committed to a plan to divest approximately 3</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers. In accordance with applicable accounting guidance</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> the results of operations for these care centers are presented in discontinued operations in our condensed consolidated financial statements. See Note </font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;"> for additional information regarding our discontinued operations.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">In addition</font><font style="font-family:Times New Roman;font-size:10pt;"> during 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, w</font><font style="font-family:Times New Roman;font-size:10pt;">e have consolidated </font><font style="font-family:Times New Roman;font-size:10pt;">2</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers with care centers servicing the same market</font><font style="font-family:Times New Roman;font-size:10pt;">s,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">which may affect the comparability of our operating results.</font></p><p style='margin-top:13.5pt; margin-bottom:0pt'>&#160;</p> 37 409 94 1 33 1 34 28 3 0.1 60 <p style='margin-top:10pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;margin-left:0px;">2</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">. </font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">Summary of Significant Accounting Policies</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Revenue Recognition</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;"> </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We earn net service revenue through our home health and hospice </font><font style="font-family:Times New Roman;font-size:10pt;">care center</font><font style="font-family:Times New Roman;font-size:10pt;">s by providing a variety of services almost exclusively in the homes of our patients. This net service revenue is earned and billed either on an episode of care basis, on a per visit basis or on a daily basis depending upon the payment terms and conditions established with each </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;"> for services provided. We refer to home health revenue earned and billed on a </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episode of care as episodic-based revenue. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">When we record our service revenue, we record it net of estimated revenue adjustments and contractual adjustments to reflect amounts we estimate to be realizable for services provided, as discussed below. We believe, based on information currently available to us and based on our judgment, that changes to one or more factors that impact the accounting estimates (such as our estimates related to revenue adjustments, contractual adjustments and episodes in progress) we make in determining net service revenue, which changes are likely to occur from period to period, will not materially impact our reported consolidated financial condition, results of operations, cash flows or our future financial results. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Home Health Revenue Recognition</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Net service revenue is recorded under the Medicare prospective payment system (&#8220;PPS&#8221;) based on a </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a)&#160;an outlier payment if our patient's care was unusually costly (capped at </font><font style="font-family:Times New Roman;font-size:10pt;">10</font><font style="font-family:Times New Roman;font-size:10pt;">% of total reimbursement per provider number); (b)&#160;a low utilization payment adjustment (&#8220;LUPA&#8221;) if the number of visits was fewer than five; (c)&#160;a partial payment if our patient transferred to another provider or we received a patient from another provider before completing the episode; (d)&#160;a payment adjustment based upon the level of therapy services required (</font><font style="font-family:Times New Roman;font-size:10pt;">with various incremental adjustments made for additional visits, with larger payment increases associated with the sixth, fourteenth and twentieth visit thresholds</font><font style="font-family:Times New Roman;font-size:10pt;">); </font><font style="font-family:Times New Roman;font-size:10pt;">(e) adjustments to payments if we are unable to produce documentation for the face-to-face encounter requirement; (f) adjustments to payments if we are unable to perform periodic therapy assessments; </font><font style="font-family:Times New Roman;font-size:10pt;">(</font><font style="font-family:Times New Roman;font-size:10pt;">g</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (</font><font style="font-family:Times New Roman;font-size:10pt;">h</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;changes in the base episode payments established by the Medicare Program; (</font><font style="font-family:Times New Roman;font-size:10pt;">i</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;adjustments to the base episode payments for case mix and geographic wages; and (</font><font style="font-family:Times New Roman;font-size:10pt;">j</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;recoveries of overpayments. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We make adjustments to Medicare revenue on completed episodes to reflect</font><font style="font-family:Times New Roman;font-size:10pt;"> differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation or authorizations acceptable to the </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;"> and other reasons unrelated to credit risk. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of </font><font style="font-family:Times New Roman;font-size:10pt;">over </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> on</font><font style="font-family:Times New Roman;font-size:10pt;"> Medicare claims, and record this estimate during the period in which services are rendered as an estimated revenue adjustment and a corresponding reduction to patient accounts receivable. In addition, management evaluates the potential for revenue adjustments and, when appropriate, provides allowances based upon the best available information. Therefore, we believe that our reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In addition to revenue recognized on completed episodes, we also recognize a portion of revenue associated with episodes in progress. Episodes in progress are </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episodes of care that begin during the reporting period, but were not completed as of the end of the period. We estimate this revenue on a monthly basis based upon historical trends. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per episode and our estimate of the average percentage complete based on visits performed. As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, the difference between the cash received from Medicare for a request for anticipated payment (&#8220;RAP&#8221;) on episodes in progress and the associated estimated revenue was immaterial and, therefore, the resulting credits were recorded as a reduction to our outstanding pa</font><font style="font-family:Times New Roman;font-size:10pt;">tient accounts receivable in our condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated balance sheets for such periods. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Non-Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Episodic-based Revenue. </font><font style="font-family:Times New Roman;font-size:10pt;">We recognize revenue in a similar manner as we recognize Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Non-episodic </font><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;">b</font><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;">ased Revenue. </font><font style="font-family:Times New Roman;font-size:10pt;">Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates, as applicable. Contractual adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue and are also recorded as a reduction to our outstanding patient accounts receivable. In addition, we receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Hospice Revenue Recognition </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Hospice Medicare Revenue </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are daily or hourly rates for each of the four levels of care we deliver. The four levels of care</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">are routine care, general inpatient care, continuous home care and respite care. Routine care accounts </font><font style="font-family:Times New Roman;font-size:10pt;">for </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">of our</font><font style="font-family:Times New Roman;font-size:10pt;"> total net Medicare hospice service revenue for the</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">three </font><font style="font-family:Times New Roman;font-size:10pt;">and six-</font><font style="font-family:Times New Roman;font-size:10pt;">mon</font><font style="font-family:Times New Roman;font-size:10pt;">th</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, as compared to </font><font style="font-family:Times New Roman;font-size:10pt;">97</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and 98% </font><font style="font-family:Times New Roman;font-size:10pt;">for the three and six-month periods ended June 30, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">We make adjustmen</font><font style="font-family:Times New Roman;font-size:10pt;">ts to Medicare revenue for an inability to obtain appropriate billing documentation</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">acceptable </font><font style="font-family:Times New Roman;font-size:10pt;">authorizations</font><font style="font-family:Times New Roman;font-size:10pt;"> or face to face documentation and</font><font style="font-family:Times New Roman;font-size:10pt;"> other reasons unrelated to credit risk. We estimate the impact of these adjustments based on our historical experience, which primarily includes our historical collection rate on Medicare claims, and record it during the period services are rendered as an estimated revenue adjustment and as a reduction to our outstanding patient accounts receivable. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Additionally, as Medicare hospice revenue is subject to an inpatient cap limit and an overall payment cap for each provider number, we monitor these caps and estimate amounts due back to Medicare if a cap has been exceeded.&#160;We record these adjustments as a reduction to revenue and an increase in other accrued liabilities.&#160; We have settled our Medicare hospice reimbursements for all fiscal y</font><font style="font-family:Times New Roman;font-size:10pt;">ears through October 31, 20</font><font style="font-family:Times New Roman;font-size:10pt;">11</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">For the </font><font style="font-family:Times New Roman;font-size:10pt;">Federal </font><font style="font-family:Times New Roman;font-size:10pt;">cap years ended October 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and</font><font style="font-family:Times New Roman;font-size:10pt;"> October 31, </font><font style="font-family:Times New Roman;font-size:10pt;">201</font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;">, we </font><font style="font-family:Times New Roman;font-size:10pt;">have $</font><font style="font-family:Times New Roman;font-size:10pt;">4.0</font><font style="font-family:Times New Roman;font-size:10pt;"> million</font><font style="font-family:Times New Roman;font-size:10pt;"> and $</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> million </font><font style="font-family:Times New Roman;font-size:10pt;">recorded for estimated amounts due back to Medicare in other accrued liabilities as of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and </font><font style="font-family:Times New Roman;font-size:10pt;">December 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">As a result of our adjustments, we believe our revenue and patients accounts receivable are recorded at amounts that will be ultimately realized. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Hospice Non-Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We record gross revenue on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per </font><font style="font-family:Times New Roman;font-size:10pt;">day </font><font style="font-family:Times New Roman;font-size:10pt;">rates, as applicable. Contractual adjustments are recorded for the difference between our established rates and the amounts estimated to be realizable from patients, third parties and others for services provided and are deducted from gross revenue to determine our net service revenue and patient accounts receivable</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p><p style='margin-top: 0pt; margin-bottom: 0pt;'></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Patient Accounts Receivable </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;"> and patients. </font><font style="font-family:Times New Roman;font-size:10pt;">There is no single </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">, other than Medicare, that accounts for more than </font><font style="font-family:Times New Roman;font-size:10pt;">10</font><font style="font-family:Times New Roman;font-size:10pt;">% of our total</font><font style="font-family:Times New Roman;font-size:10pt;"> outstanding patient receivables, and thus we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We fully reserve for accounts which are aged at </font><font style="font-family:Times New Roman;font-size:10pt;">36</font><font style="font-family:Times New Roman;font-size:10pt;">5</font><font style="font-family:Times New Roman;font-size:10pt;"> days or greater. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We believe the credit risk associated with our Medicare accounts</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">which represent </font><font style="font-family:Times New Roman;font-size:10pt;">71% and </font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> of our</font><font style="font-family:Times New Roman;font-size:10pt;"> net patient accounts receivable at </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">December 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">respectively, </font><font style="font-family:Times New Roman;font-size:10pt;">is limited due to our historical collection rate of over </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">% </font><font style="font-family:Times New Roman;font-size:10pt;">from Medicare and the fact that Medicare is a U.S. government </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">. Accordingly, we do not record an allowance for doubtful accounts for our Medicare patient accounts receivable, which are recorded at their net realizable value after recording estimated revenue </font><font style="font-family:Times New Roman;font-size:10pt;">adjustments as discussed above. </font><font style="font-family:Times New Roman;font-size:10pt;">During the three </font><font style="font-family:Times New Roman;font-size:10pt;">and six-</font><font style="font-family:Times New Roman;font-size:10pt;">month</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we recorded $2.</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> million and $</font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;"> million, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> in estimated revenue adjustments to Medicare as compared to $2.</font><font style="font-family:Times New Roman;font-size:10pt;">1</font><font style="font-family:Times New Roman;font-size:10pt;"> million and $</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">7</font><font style="font-family:Times New Roman;font-size:10pt;"> million during the three and six-month periods ended June 30, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">respectively.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We believe there is a certain level of credit risk associated with non-Medicare </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;">. To provide for our non-Medicare patient accounts receivable that could become uncollectible in the future, we establish an allowance for doubtful accounts to reduce the carrying amount to its estimated net realizable value.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Medicare Home Health </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">% of our estimated payment for the initial episode at the start of care or </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">% of the estimated payment for any subsequent episodes of care contiguous with the first episode for a particular patient. The full amount of the episode is billed after the episode has been completed (&#8220;final billed&#8221;). The RAP received for that particular episode is then deducted from our final payment. If a final bill is not submitted within the greater of </font><font style="font-family:Times New Roman;font-size:10pt;">120</font><font style="font-family:Times New Roman;font-size:10pt;"> days from the start of the episode, or </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;"> days from the date the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other claims in process for that particular provider number. The RAP and final claim must then be re-submitted. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Medicare Hospice </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services t</font><font style="font-family:Times New Roman;font-size:10pt;">hat we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. </font><font style="font-family:Times New Roman;font-size:10pt;">Once each patient has been confirmed for eligibility, we will bill Medicare on a monthly basis for the services provided to the patient. </font></p><p style='margin-top:0pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:7.5pt;margin-left:0px;">&#160; </font></p><p style='margin-top:0pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Non-Medicare Home Health and Hospice </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient's eligibility for services with the applicable </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">. 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This net service revenue is earned and billed either on an episode of care basis, on a per visit basis or on a daily basis depending upon the payment terms and conditions established with each </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;"> for services provided. We refer to home health revenue earned and billed on a </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episode of care as episodic-based revenue. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">When we record our service revenue, we record it net of estimated revenue adjustments and contractual adjustments to reflect amounts we estimate to be realizable for services provided, as discussed below. We believe, based on information currently available to us and based on our judgment, that changes to one or more factors that impact the accounting estimates (such as our estimates related to revenue adjustments, contractual adjustments and episodes in progress) we make in determining net service revenue, which changes are likely to occur from period to period, will not materially impact our reported consolidated financial condition, results of operations, cash flows or our future financial results. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Home Health Revenue Recognition</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Net service revenue is recorded under the Medicare prospective payment system (&#8220;PPS&#8221;) based on a </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a)&#160;an outlier payment if our patient's care was unusually costly (capped at </font><font style="font-family:Times New Roman;font-size:10pt;">10</font><font style="font-family:Times New Roman;font-size:10pt;">% of total reimbursement per provider number); (b)&#160;a low utilization payment adjustment (&#8220;LUPA&#8221;) if the number of visits was fewer than five; (c)&#160;a partial payment if our patient transferred to another provider or we received a patient from another provider before completing the episode; (d)&#160;a payment adjustment based upon the level of therapy services required (</font><font style="font-family:Times New Roman;font-size:10pt;">with various incremental adjustments made for additional visits, with larger payment increases associated with the sixth, fourteenth and twentieth visit thresholds</font><font style="font-family:Times New Roman;font-size:10pt;">); </font><font style="font-family:Times New Roman;font-size:10pt;">(e) adjustments to payments if we are unable to produce documentation for the face-to-face encounter requirement; (f) adjustments to payments if we are unable to perform periodic therapy assessments; </font><font style="font-family:Times New Roman;font-size:10pt;">(</font><font style="font-family:Times New Roman;font-size:10pt;">g</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (</font><font style="font-family:Times New Roman;font-size:10pt;">h</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;changes in the base episode payments established by the Medicare Program; (</font><font style="font-family:Times New Roman;font-size:10pt;">i</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;adjustments to the base episode payments for case mix and geographic wages; and (</font><font style="font-family:Times New Roman;font-size:10pt;">j</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;recoveries of overpayments. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We make adjustments to Medicare revenue on completed episodes to reflect</font><font style="font-family:Times New Roman;font-size:10pt;"> differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation or authorizations acceptable to the </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;"> and other reasons unrelated to credit risk. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of </font><font style="font-family:Times New Roman;font-size:10pt;">over </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> on</font><font style="font-family:Times New Roman;font-size:10pt;"> Medicare claims, and record this estimate during the period in which services are rendered as an estimated revenue adjustment and a corresponding reduction to patient accounts receivable. In addition, management evaluates the potential for revenue adjustments and, when appropriate, provides allowances based upon the best available information. Therefore, we believe that our reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In addition to revenue recognized on completed episodes, we also recognize a portion of revenue associated with episodes in progress. Episodes in progress are </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episodes of care that begin during the reporting period, but were not completed as of the end of the period. We estimate this revenue on a monthly basis based upon historical trends. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per episode and our estimate of the average percentage complete based on visits performed. As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, the difference between the cash received from Medicare for a request for anticipated payment (&#8220;RAP&#8221;) on episodes in progress and the associated estimated revenue was immaterial and, therefore, the resulting credits were recorded as a reduction to our outstanding pa</font><font style="font-family:Times New Roman;font-size:10pt;">tient accounts receivable in our condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated balance sheets for such periods. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Non-Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Episodic-based Revenue. </font><font style="font-family:Times New Roman;font-size:10pt;">We recognize revenue in a similar manner as we recognize Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Non-episodic </font><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;">b</font><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;">ased Revenue. </font><font style="font-family:Times New Roman;font-size:10pt;">Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates, as applicable. Contractual adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue and are also recorded as a reduction to our outstanding patient accounts receivable. In addition, we receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Hospice Revenue Recognition </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Hospice Medicare Revenue </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are daily or hourly rates for each of the four levels of care we deliver. The four levels of care</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">are routine care, general inpatient care, continuous home care and respite care. Routine care accounts </font><font style="font-family:Times New Roman;font-size:10pt;">for </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">of our</font><font style="font-family:Times New Roman;font-size:10pt;"> total net Medicare hospice service revenue for the</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">three </font><font style="font-family:Times New Roman;font-size:10pt;">and six-</font><font style="font-family:Times New Roman;font-size:10pt;">mon</font><font style="font-family:Times New Roman;font-size:10pt;">th</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, as compared to </font><font style="font-family:Times New Roman;font-size:10pt;">97</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and 98% </font><font style="font-family:Times New Roman;font-size:10pt;">for the three and six-month periods ended June 30, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">We make adjustmen</font><font style="font-family:Times New Roman;font-size:10pt;">ts to Medicare revenue for an inability to obtain appropriate billing documentation</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">acceptable </font><font style="font-family:Times New Roman;font-size:10pt;">authorizations</font><font style="font-family:Times New Roman;font-size:10pt;"> or face to face documentation and</font><font style="font-family:Times New Roman;font-size:10pt;"> other reasons unrelated to credit risk. We estimate the impact of these adjustments based on our historical experience, which primarily includes our historical collection rate on Medicare claims, and record it during the period services are rendered as an estimated revenue adjustment and as a reduction to our outstanding patient accounts receivable. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Additionally, as Medicare hospice revenue is subject to an inpatient cap limit and an overall payment cap for each provider number, we monitor these caps and estimate amounts due back to Medicare if a cap has been exceeded.&#160;We record these adjustments as a reduction to revenue and an increase in other accrued liabilities.&#160; We have settled our Medicare hospice reimbursements for all fiscal y</font><font style="font-family:Times New Roman;font-size:10pt;">ears through October 31, 20</font><font style="font-family:Times New Roman;font-size:10pt;">11</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">For the </font><font style="font-family:Times New Roman;font-size:10pt;">Federal </font><font style="font-family:Times New Roman;font-size:10pt;">cap years ended October 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and</font><font style="font-family:Times New Roman;font-size:10pt;"> October 31, </font><font style="font-family:Times New Roman;font-size:10pt;">201</font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;">, we </font><font style="font-family:Times New Roman;font-size:10pt;">have $</font><font style="font-family:Times New Roman;font-size:10pt;">4.0</font><font style="font-family:Times New Roman;font-size:10pt;"> million</font><font style="font-family:Times New Roman;font-size:10pt;"> and $</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> million </font><font style="font-family:Times New Roman;font-size:10pt;">recorded for estimated amounts due back to Medicare in other accrued liabilities as of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and </font><font style="font-family:Times New Roman;font-size:10pt;">December 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">As a result of our adjustments, we believe our revenue and patients accounts receivable are recorded at amounts that will be ultimately realized. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Hospice Non-Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We record gross revenue on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per </font><font style="font-family:Times New Roman;font-size:10pt;">day </font><font style="font-family:Times New Roman;font-size:10pt;">rates, as applicable. Contractual adjustments are recorded for the difference between our established rates and the amounts estimated to be realizable from patients, third parties and others for services provided and are deducted from gross revenue to determine our net service revenue and patient accounts receivable</font></p> 4000000 4800000 60 0.99 6 5 0.99 0.98 6600000 4700000 14 20 0.71 0.68 0.99 0.97 2100000 2800000 365 0.6 0.5 120 0.1 <p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Patient Accounts Receivable </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;"> and patients. </font><font style="font-family:Times New Roman;font-size:10pt;">There is no single </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">, other than Medicare, that accounts for more than </font><font style="font-family:Times New Roman;font-size:10pt;">10</font><font style="font-family:Times New Roman;font-size:10pt;">% of our total</font><font style="font-family:Times New Roman;font-size:10pt;"> outstanding patient receivables, and thus we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We fully reserve for accounts which are aged at </font><font style="font-family:Times New Roman;font-size:10pt;">36</font><font style="font-family:Times New Roman;font-size:10pt;">5</font><font style="font-family:Times New Roman;font-size:10pt;"> days or greater. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We believe the credit risk associated with our Medicare accounts</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">which represent </font><font style="font-family:Times New Roman;font-size:10pt;">71% and </font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> of our</font><font style="font-family:Times New Roman;font-size:10pt;"> net patient accounts receivable at </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">December 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">respectively, </font><font style="font-family:Times New Roman;font-size:10pt;">is limited due to our historical collection rate of over </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">% </font><font style="font-family:Times New Roman;font-size:10pt;">from Medicare and the fact that Medicare is a U.S. government </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">. Accordingly, we do not record an allowance for doubtful accounts for our Medicare patient accounts receivable, which are recorded at their net realizable value after recording estimated revenue </font><font style="font-family:Times New Roman;font-size:10pt;">adjustments as discussed above. </font><font style="font-family:Times New Roman;font-size:10pt;">During the three </font><font style="font-family:Times New Roman;font-size:10pt;">and six-</font><font style="font-family:Times New Roman;font-size:10pt;">month</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we recorded $2.</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> million and $</font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;"> million, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> in estimated revenue adjustments to Medicare as compared to $2.</font><font style="font-family:Times New Roman;font-size:10pt;">1</font><font style="font-family:Times New Roman;font-size:10pt;"> million and $</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">7</font><font style="font-family:Times New Roman;font-size:10pt;"> million during the three and six-month periods ended June 30, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">respectively.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We believe there is a certain level of credit risk associated with non-Medicare </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;">. To provide for our non-Medicare patient accounts receivable that could become uncollectible in the future, we establish an allowance for doubtful accounts to reduce the carrying amount to its estimated net realizable value.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Medicare Home Health </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">% of our estimated payment for the initial episode at the start of care or </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">% of the estimated payment for any subsequent episodes of care contiguous with the first episode for a particular patient. The full amount of the episode is billed after the episode has been completed (&#8220;final billed&#8221;). The RAP received for that particular episode is then deducted from our final payment. If a final bill is not submitted within the greater of </font><font style="font-family:Times New Roman;font-size:10pt;">120</font><font style="font-family:Times New Roman;font-size:10pt;"> days from the start of the episode, or </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;"> days from the date the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other claims in process for that particular provider number. The RAP and final claim must then be re-submitted. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Medicare Hospice </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services t</font><font style="font-family:Times New Roman;font-size:10pt;">hat we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. </font><font style="font-family:Times New Roman;font-size:10pt;">Once each patient has been confirmed for eligibility, we will bill Medicare on a monthly basis for the services provided to the patient. </font></p><p style='margin-top:0pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:7.5pt;margin-left:0px;">&#160; </font></p><p style='margin-top:0pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Non-Medicare Home Health and Hospice </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient's eligibility for services with the applicable </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">. Once the patient has been confirmed for eligibility, we will provide services to the patient </font><font style="font-family:Times New Roman;font-size:10pt;">and bill the applicable </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;"> or groups of </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;"> with similar characteristics that would subject us to any significant credit risk. </font><font style="font-family:Times New Roman;font-size:10pt;">We estimate an allowance for doubtful accounts</font><font style="font-family:Times New Roman;font-size:10pt;"> based upon our assessment of historical and expected net collections, business and economic conditions, trends in payment and an evaluation of </font><font style="font-family:Times New Roman;font-size:10pt;">collectibility</font><font style="font-family:Times New Roman;font-size:10pt;"> based upon the date that the service was provided. 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border-top-style:double;border-top-width:3px;text-align:left;border-color:#000000;min-width:90px;">&#160;</td></tr></table></div> 74800000 102700000 0.0607 0.0628 2013-03-25 2014-03-25 0.0245 2017-10-26 35000000 30000000 60000000 1.27 39000000 66900000 3000000 21700000 143300000 P5Y 94400000 2.0 20000000 20000000 51000000 57000000 5700000 3800000 20000000 0 2.0 1.25 1.01 165000000 0.026 0.027 <p style='margin-top:0pt; margin-bottom:10pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;margin-left:0px;">6</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">. </font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">COMMITMENTS AND CONTINGENCIES</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;"> </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Legal Proceedings </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We are involved in the </font><font style="font-family:Times New Roman;font-size:10pt;">following </font><font style="font-family:Times New Roman;font-size:10pt;">legal actions</font><font style="font-family:Times New Roman;font-size:10pt;">:</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">United States Senate Committee on Finance Inquiry </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On May 12, 2010, we received a letter of inquiry from the Senate Finance Committee requesting documents and information relating to our policies and practices regarding home therapy visits and therapy utilization trends. </font><font style="font-family:Times New Roman;font-size:10pt;">A similar letter was sent to the other major publicly traded home health care companies.</font><font style="font-family:Times New Roman;font-size:10pt;"> We cooperated with the Committee with respect to this inquiry.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On October 3, 2011, the Committee publicly issued a report titled &#8220;Staff Report on Home Health and the Medicare Therapy Threshold.&#8221; The Committee recommended that the CMS &#8220;must move toward taking therapy out of the payment model.&#8221; We believe that the issuance of the report concludes the Committee's inquiry, but are not in a position to speculate on the potential for future legislative or oversight action by the Committee.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Securities Class Action Lawsuits </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On June&#160;</font><font style="font-family:Times New Roman;font-size:10pt;">10</font><font style="font-family:Times New Roman;font-size:10pt;">, 2010, a putative securities class action complaint was filed in the United States District Court for the Middle District of Louisiana against the Company and certain of our current and former senior executives. Additional putative securities class actions were filed in the United States District Court for the Middle District of Louisiana on July&#160;14,&#160;July&#160;16, and July&#160;28, 2010.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On October&#160;22, 2010, the&#160;Court&#160;issued an order consolidating the putative&#160;securities&#160;class action lawsuits&#160;and the Federal Derivative Actions (described immediately below) for pre-trial purposes.&#160;In the same order, the Court&#160;appointed the Public Employees Retirement System of Mississippi and the Puerto Rico Teachers' Retirement System as co-lead plaintiffs (together, the &#8220;Co-Lead Plaintiffs&#8221;) for the putative class.&#160;On December&#160;10, 2010, the Court also consolidated the ERISA class action lawsuit (described below) with the putative securities class actions and Federal Derivative Actions for pre-trial purposes.</font><font style="font-family:Times New Roman;font-size:10pt;"> &#160;</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On January&#160;18, 2011, the Co-Lead Plaintiffs filed an amended, consolidated&#160;class action complaint (the &#8220;Securities Complaint&#8221;) which supersedes the earlier-filed securities class action complaints.&#160;The Securities Complaint alleges that the defendants made false and/or misleading statements and failed to disclose material facts about our business, financial condition, operations and prospects, particularly relating to our policies and practices regarding home therapy visits under the Medicare home health prospective payment system and the related alleged impact on our business, financial condition, operations and prospects. The Securities Complaint seeks a determination that the action may be maintained as a class action on behalf of all persons who purchased the Company's securities between August&#160;2, 2005 and September&#160;28, 2010 and an unspecified amount of damages. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">All defendants moved to dismiss the Securities Complaint. </font><font style="font-family:Times New Roman;font-size:10pt;"> On June 28, 2012, the United States District Court for the Middle District of Louisiana granted the </font><font style="font-family:Times New Roman;font-size:10pt;">defendants' motion to dismiss the Securities Complaint. On July 26, 2012, the Co-Lead Plaintiffs filed a motion for reconsideration</font><font style="font-family:Times New Roman;font-size:10pt;">, which the Court denied on April 9, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On May 3,</font><font style="font-family:Times New Roman;font-size:10pt;"> 2013,</font><font style="font-family:Times New Roman;font-size:10pt;"> the Co-Lead Plaintiffs appealed the dismissal of their Securities Class Action Complaint to the United States Court of Appeals for the Fifth Circuit. The United States Court of Appeals for the Fifth Circuit docketed the Co-Lead Plaintiffs' appeal on July 16, 2013, and the Co-Lead Plaintiffs must file their opening brief on or before August 26, 2013. The appeal remains pending. While the Company will seek to have the District Court order granting the defendants' motion to dismiss affirmed on appeal, no assurances can be given as to the timing or outcome of the appeals process.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Derivative Actions </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On July&#160;2, 2010, an alleged shareholder of the Company filed a derivative lawsuit in the United States District Court for the Middle District of Louisiana, purporting to assert claims on behalf of the Company against certain of our current and former officers and directors.&#160;Three similar derivative suits were filed in the United States District Court for the Middle District of Louisiana on July&#160;15,&#160;July&#160;21, and August&#160;2, 2010 (together, the &#8220;Federal Derivative Actions&#8221;).&#160;We are named as a nominal defendant in&#160;all of those&#160;actions.&#160;As noted above, on October&#160;22, 2010, the United States District Court for the Middle District of Louisiana issued an order consolidating the Federal Derivative Actions with the&#160;putative securities class action lawsuits&#160;and&#160;for pre-trial purposes.</font><font style="font-family:Times New Roman;font-size:10pt;">&#160;&#160;</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On January&#160;18, 2011, the&#160;plaintiffs in the Federal Derivative Actions&#160;filed a consolidated, amended complaint&#160;(the &#8220;Derivative Complaint&#8221;) which supersedes the earlier-filed derivative complaints. The Derivative Complaint alleges that certain of our current and former officers and directors breached their fiduciary duties to the Company by making allegedly false statements, by allegedly failing to establish sufficient internal controls over certain of our home health and Medicare billing practices, by engaging in alleged insider trading, and by committing unspecified acts of waste of corporate assets and unjust enrichment. All defendants in the Federal Derivative Actions, including the Company as a nominal defendant, moved to dismiss the Derivative Complaint.</font><font style="font-family:Times New Roman;font-size:10pt;"> That motion is fully briefed and remains pending before the court.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On June 24, 2013, all parties to the Federal Derivative Actions entered into a Stipulation of Settlement (the &#8220;Stipulation&#8221;) with respect to the Federal Derivative Actions. On June 27, 2013, the United States District Court for the Middle District of Louisiana issued an order preliminarily approving the proposed settlement in accordance with the Stipulation. Pursuant to the Court's June 27, 2013 Order, a copy of the Court-approved &#8220;Notice of Settlement of </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, Inc. Derivative Action,&#8221; (the &#8220;Notice of Settlement&#8221;) was attached as Exhibit 99.1 to the Company's Current Report on Form 8-K filed with the United States Securities and Exchange Commission on July 2, 2013. As described in the Notice of Settlement, the Court has scheduled a hearing on September 4, 2013, to determine whether the Court should issue an order of final approval of the proposed settlement. As further described in the Notice of Settlement, as part of the proposed </font><font style="font-family:Times New Roman;font-size:10pt;">s</font><font style="font-family:Times New Roman;font-size:10pt;">ettlement, the Company has agreed to adopt and/or maintain certain corporate governance reforms as set forth in the Stipulation. The Stipulation also provides that plaintiffs' co-lead counsel will seek an award of attorneys' fees and expenses in an amount not to exceed $445,000, which shall include all attorneys' fees and costs that may be due any counsel (or anyone else) who has asserted, or participated in the assertion of, derivative claims on behalf of t</font><font style="font-family:Times New Roman;font-size:10pt;">he Company in any court. Any award of fees and expenses will be paid by the Company (or its insurer on its behalf). If the proposed settlement is approved, the Federal Derivative Actions will be dismissed with prejudice, and all named defendants will be released by all plaintiffs, the Company, and its shareholders from all claims that were or could have been alleged in the Federal Derivative Actions.</font><font style="font-family:Times New Roman;font-size:10pt;"> As of June 30, 2013, we have accrued $0.4 million related to the proposed settlement and a corresponding receivable for insurance proceeds related to the </font><font style="font-family:Times New Roman;font-size:10pt;">proposed </font><font style="font-family:Times New Roman;font-size:10pt;">settlement.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On July&#160;23, 2010, a derivative suit was filed in the Nineteenth Judicial District Court, Parish of East Baton Rouge, </font><font style="font-family:Times New Roman;font-size:10pt;">State</font><font style="font-family:Times New Roman;font-size:10pt;"> of </font><font style="font-family:Times New Roman;font-size:10pt;">Louisiana</font><font style="font-family:Times New Roman;font-size:10pt;">.&#160;That action also purports to assert claims on behalf of the Company against certain of our current and former officers and directors.&#160;On December&#160;8, 2010, the Court entered an order staying the action in deference to the earlier-filed derivative actions&#160;pending in </font><font style="font-family:Times New Roman;font-size:10pt;">Federal court. If the United States District Court for the Middle District of Louisiana issues an order of final approval of the settlement of the Federal Derivative Actions, the named defendants in the state court derivative suit and the Company, as a nominal defendant, will move for dismissal of the state court derivative suit.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">ERISA Class Action Lawsuit </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On September&#160;27, 2010 and October&#160;22, 2010, separate putative class action complaints were filed in the United States District Court for the Middle District of Louisiana against the Company, certain of our current and former senior executives and members of our 401(k) Plan Administrative Committee.&#160;The suits allege violations of the Employee Retirement Income Security Act (&#8220;ERISA&#8221;) since January&#160;1, 2006 and July 1, 2007, respectively. The plaintiffs brought the complaints on behalf of themselves and a class of similarly situated participants in our 401(k) plan.&#160;The plaintiffs assert that the defendants breached their fiduciary duties to the 401(k) Plan's participants by causing the 401(k) plan to offer and hold </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;"> common stock during the respective class periods when it was an allegedly unduly risky and imprudent retirement investment because of our alleged improper business practices.&#160;The complaints seek a determination that the actions may be maintained as a class action, an award of unspecified monetary damages and other unspecified relief. As noted above, on December&#160;10, 2010, the Court consolidated the putative ERISA class actions with the putative securities class actions and derivative actions for pre-trial purposes. In addition, on December 10, 2010, the Court appointed interim lead counsel and interim liaison counsel in the ERISA class action. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On March 10, 2011, </font><font style="font-family:Times New Roman;font-size:10pt;">Wanda</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">Corbin</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">Pia</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">Galimba</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">Linda</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">Trammell</font><font style="font-family:Times New Roman;font-size:10pt;"> (the &#8220;Co-ERISA Plaintiffs&#8221;), filed an amended, consolidated&#160;class action complaint (the &#8220;ERISA Complaint&#8221;), which supersedes the earlier-filed ERISA class action complaints.&#160; The ERISA Complaint seeks a determination that the action may be maintained as a class action on behalf of themselves and a class of similarly situated participants in our 401(k) plan from January 1, 2008 through present. All of the defendants have moved to dismiss the ERISA Complaint.</font><font style="font-family:Calibri;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">That motion is fully briefed and remains pending before the court.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">SEC Investigation </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On June&#160;30, 2010, we received notice of a formal investigation from the SEC and received a subpoena for documents relating to the matters under review by the United States Senate Committee on Finance and other matters involving our operations. We have cooperated with the SEC with respect to this investigation.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">U.S. Department of Justice Civil Investigative Demand (&#8220;CID&#8221;) </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On September&#160;27, 2010, we received a CID issued by the U.S. Department of Justice pursuant to the federal False Claims Act. The CID require</font><font style="font-family:Times New Roman;font-size:10pt;">s</font><font style="font-family:Times New Roman;font-size:10pt;"> the delivery of a wide range of documents and information relating to the Company's clinical and business operations, including reimbursement and billing claims submitted to Medicare for home health services, and related compliance activities. The CID generally covers the period from January&#160;1, 2003.&#160; On April 26, 2011, we received a second CID related to the CID issued in September 2010, which generally covers the same time period as the previous CID and requires the production of additional documents. Such CIDs are often associated with previously filed qui tam actions, or lawsuits filed under seal under the False Claims Act (&#8220;FCA&#8221;), 31 U.S.C. </font><font style="font-family:Calibri;font-size:10pt;">&#167;</font><font style="font-family:Times New Roman;font-size:10pt;"> 3729 et seq. Qui tam actions are brought by private plaintiffs suing on behalf of the federal government for alleged FCA violations. Subsequently, the Company and certain current and former employees have received additional CIDs for additional documents and/or testimony. We are cooperating with the Department of Justice with respect to this investigation and the requests for information and testimony.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Stark Law</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In May 2012, we made a disclosure to CMS under the agency's Stark Law Self-Referral Disclosure Protocol relating to certain services agreements between a subsidiary of ours and a large physician group. During some period of time since December 2007, the arrangements appear not to have complied in certain respects with an applicable exemption to the Stark Law referral prohibition. </font><font style="font-family:Times New Roman;font-size:10pt;">Medicare r</font><font style="font-family:Times New Roman;font-size:10pt;">evenue earned as a result of referrals from the physician group </font><font style="font-family:Times New Roman;font-size:10pt;">from May 2008 to May 2012, the relevant four year &#8220;</font><font style="font-family:Times New Roman;font-size:10pt;">lookback</font><font style="font-family:Times New Roman;font-size:10pt;">&#8221; period under the Stark Law Self-Referral Disclosure Protocol, w</font><font style="font-family:Times New Roman;font-size:10pt;">as approximately $4 million. On January 11, 2013, one of our subsidiaries received a CID from the United States Attorney's Office for the Northern District of Georgia seeking certain information relating to that subsidiary's relationship with this physician group. </font><font style="font-family:Times New Roman;font-size:10pt;">We </font><font style="font-family:Times New Roman;font-size:10pt;">are </font><font style="font-family:Times New Roman;font-size:10pt;">cooperating</font><font style="font-family:Times New Roman;font-size:10pt;"> with the government in its review of this matter.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">OIG Self-Disclosure</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In October 2012, we made a disclosure to the Office of Counsel to the Inspector General of the United States Department of Health and Human Services (the "OIG") pursuant to the OIG Provider Self-Disclosure Protocol regarding certain clinical documentation issues and eligibility</font><font style="font-family:Times New Roman;font-size:10pt;"> regulatory </font><font style="font-family:Times New Roman;font-size:10pt;">requirements at two of our hospice care centers.&#160; These hospice care centers </font><font style="font-family:Times New Roman;font-size:10pt;">did</font><font style="font-family:Times New Roman;font-size:10pt;"> not compl</font><font style="font-family:Times New Roman;font-size:10pt;">y</font><font style="font-family:Times New Roman;font-size:10pt;"> in some respects with certain state and </font><font style="font-family:Times New Roman;font-size:10pt;">Medicare hospice regulations</font><font style="font-family:Times New Roman;font-size:10pt;">, including those requiring physicians to certify patient eligibility and requiring patient face-to-face encounters.&#160; We are also in discussions with state healthcare authorities regarding this matter.&#160; Our review of this matter is ongoing, and we </font><font style="font-family:Times New Roman;font-size:10pt;">are cooperating</font><font style="font-family:Times New Roman;font-size:10pt;"> with the OIG and </font><font style="font-family:Times New Roman;font-size:10pt;">the state</font><font style="font-family:Times New Roman;font-size:10pt;"> regulatory authorities in their review of this matter.</font><font style="font-family:Arial;font-size:10pt;">&#160;</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Wage and Hour Litigation</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On July 25, 2012, a putative collective and class action complaint was filed in the United States District Court for the District of Connecticut against us in which three former employees allege wage and hour law violations.&#160; The former employees </font><font style="font-family:Times New Roman;font-size:10pt;">claim that they were not paid overtime for all hours worked over fort</font><font style="font-family:Times New Roman;font-size:10pt;">y</font><font style="font-family:Times New Roman;font-size:10pt;"> hours in violation of the Federal Fair Labor </font><font style="font-family:Times New Roman;font-size:10pt;">Standards Act (&#8220;FLSA&#8221;), as well as the</font><font style="font-family:Times New Roman;font-size:10pt;"> Pennsylvania Minimum Wage Act. More specifically, they allege they were paid on both a per-visit and an hourly basis, and that such a pay scheme resulted in their misclassification as exempt employees, thereby denying them overtime pay. 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The plaintiff alleges violations of Federal and state law and seeks damages under the FLSA and the Illinois Minimum Wage Law. &#160;Plaintiff seeks class certification of similar employees who were or are employed in Illinois and seeks attorneys' fees, back wages and liquidated damages going back three years under the FLSA and three years under the Illinois statute.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We are unable to assess the probable outcome or reasonably estimate the potential liability, if any, arising from the SEC investigation, the U.S. Department of Justice CIDs, the Stark Law matter we have disclosed to CMS, the OIG Self-Disclosure issue and the securities, </font><font style="font-family:Times New Roman;font-size:10pt;">shareholder derivative, </font><font style="font-family:Times New Roman;font-size:10pt;">ERISA and wage and hour litigation described above given the preliminary stage of these matters.&#160; The Company intends to continue to vigorously defend itself in the securities,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">shareholder derivative,</font><font style="font-family:Times New Roman;font-size:10pt;"> ERISA and wage and hour litigation matters.&#160; No assurances can be given as to the timing or outcome of the SEC investigation, the U.S. Department of Justice CIDs, the Stark Law matter we have disclosed to CMS, the OIG Self-Disclosure issue or the securities, </font><font style="font-family:Times New Roman;font-size:10pt;">shareholder derivative, </font><font style="font-family:Times New Roman;font-size:10pt;">ERISA and wage and hour litigation matters described above or the impact of any of the inquiry, investigation or litigation matters on the Company, its consolidated financial condition, results of operations or cash flows, which could be material, individually or in the aggregate.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We recognize that additional putative securities class action complaints and other litigation could be filed, and that other investigations and actions could be commenced, relating to matters involving our home therapy visits and therapy utilization trends or other matters.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In addition to the matters referenced in this note, we are involved in legal actions in the normal course of business, some of which seek monetary damages, including claims for punitive damages. We do not believe that these normal course actions, when finally concluded and determined, will have a material impact on our consolidated financial condition, results of operations or cash flows.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Third Party Audits</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">From time to time, in the ordinary course of business, we are subject to audits under various governmental programs in which third party firms engaged by CMS conduct extensive review of claims data to identify potential improper payments under the Medicare program. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In January 2010, our subsidiary that provides home health services in Dayton, Ohio received from a Medicare Program Safeguard Contractor (&#8220;PSC&#8221;) a request for records regarding 137 claims submitted by the subsidiary paid from January 2, 2008 through November 10, 2009 (the &#8220;Claim Period&#8221;) to determine whether the underlying services met pertinent Medicare payment requirements. Based on the PSC's findings for 114 of the claims, which were extrapolated to all claims for home health services provided by the </font><font style="font-family:Times New Roman;font-size:10pt;">Dayton</font><font style="font-family:Times New Roman;font-size:10pt;"> subsidiary paid during the Claim Period, on March 9, 2011, the Medicare Administrative Contractor (&#8220;MAC&#8221;) for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment of approximately $5.6 million. We dispute the</font><font style="font-family:Times New Roman;font-size:10pt;">se</font><font style="font-family:Times New Roman;font-size:10pt;"> findings</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">our Dayton subsidiary has </font><font style="font-family:Times New Roman;font-size:10pt;">filed appeals</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">through the Original Medicare Standard Appeals Process, </font><font style="font-family:Times New Roman;font-size:10pt;">in which we </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> seek</font><font style="font-family:Times New Roman;font-size:10pt;">ing</font><font style="font-family:Times New Roman;font-size:10pt;"> to have those findings overturned. </font><font style="font-family:Times New Roman;font-size:10pt;">Most recently, a</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated </font><font style="font-family:Times New Roman;font-size:10pt;">administrative law judge (&#8220;</font><font style="font-family:Times New Roman;font-size:10pt;">ALJ</font><font style="font-family:Times New Roman;font-size:10pt;">&#8221;)</font><font style="font-family:Times New Roman;font-size:10pt;"> hearing </font><font style="font-family:Times New Roman;font-size:10pt;">was held in late March </font><font style="font-family:Times New Roman;font-size:10pt;">2013. </font><font style="font-family:Times New Roman;font-size:10pt;">As of </font><font style="font-family:Times New Roman;font-size:10pt;">the date of this filing</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> the ALJ has not released a ruling.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">No assurances can be given as to the outcome of the ALJ appeal. </font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we have recorded no liability with respect to the pending appeals as we do not believe that an estimate of a reasonably possible loss or range of loss can be made at this time.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In July 2010, our subsidiary that provides hospice services in Florence, South Carolina received from a Zone Program Integrity Contractor (&#8220;ZPIC&#8221;) a request for records regarding a sample of 30 beneficiaries who received services from the subsidiary during the period of January 1, 2008 through March 31, 2010 (the &#8220;Review Period&#8221;) to determine whether the underlying services met pertinent Medicare payment requirements.&#160; We acquired the hospice operations subject to this review on August 1, 2009; the Review Period covers time periods both before and after our ownership of these hospice operations.&#160; Based on the ZPIC's findings for 16 beneficiaries, which were extrapolated to all claims for hospice services provided by the Florence subsidiary billed during the Review Period, on June 6, 2011, the MAC for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;"> We dispute the</font><font style="font-family:Times New Roman;font-size:10pt;">se</font><font style="font-family:Times New Roman;font-size:10pt;"> findings</font><font style="font-family:Times New Roman;font-size:10pt;">, and our Florence subsidiary has </font><font style="font-family:Times New Roman;font-size:10pt;">filed appeals</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">through the Original Medicare Standard Appeals Process, </font><font style="font-family:Times New Roman;font-size:10pt;">in which we </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> seek</font><font style="font-family:Times New Roman;font-size:10pt;">ing</font><font style="font-family:Times New Roman;font-size:10pt;"> to have those findings overturned. </font><font style="font-family:Times New Roman;font-size:10pt;">Most recently, we have requested appeal hearings before an ALJ, but the</font><font style="font-family:Times New Roman;font-size:10pt;"> ALJ hearings have not been scheduled, and no assurances can be given as to the timing or outcome of the ALJ appeal. </font><font style="font-family:Times New Roman;font-size:10pt;">The current alleged extrapolated overpayment is $6.1 million. In</font><font style="font-family:Times New Roman;font-size:10pt;"> the event we pay any amount of this alleged overpayment, we are indemnified by the prior owners of the hospice operations for amounts relating to the period prior to August 1, 2009. </font><font style="font-family:Times New Roman;font-size:10pt;">As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we </font><font style="font-family:Times New Roman;font-size:10pt;">have recorded no liability for this claim</font><font style="font-family:Times New Roman;font-size:10pt;"> as we do not believe that an estimate of a reasonably possible loss or range of loss can be made at this time</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In July 2009, Beacon Hospice, Inc., a subsidiary we acquired on June 7, 2011 (&#8220;Beacon&#8221;), received from Massachusetts Peer Review Organization, Inc. (&#8220;</font><font style="font-family:Times New Roman;font-size:10pt;">MassPro</font><font style="font-family:Times New Roman;font-size:10pt;">&#8221;), an entity contracted with the Massachusetts Office of Medicaid, a request for records regarding 25 beneficiaries in Boston, Framingham and Plymouth, Massachusetts, who received hospice services from Beacon during the period of August 1, 2007 through July 31, 2008 (the &#8220;Review Period&#8221;) to determine whether the underlying services met pertinent </font><font style="font-family:Times New Roman;font-size:10pt;">MassHealth</font><font style="font-family:Times New Roman;font-size:10pt;"> Program regulations. 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In January 2013, </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;"> paid the Final Amount to </font><font style="font-family:Times New Roman;font-size:10pt;">MassPro</font><font style="font-family:Times New Roman;font-size:10pt;">, and the prior owners of Beacon paid the Final Amount to </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, in accordance with their indemnification obligations set forth in the acquisition document.</font></p><p style='margin-top: 0pt; margin-bottom: 0pt;'></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Insurance </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We are obligated for certain costs associated with our insurance programs, including employee health, workers' compensation and professional liability. While we maintain various insurance programs to cover these risks, we are self-insured for a substantial portion of our potential claims. We recognize our obligations associated with these costs</font><font style="font-family:Times New Roman;font-size:10pt;">, up to specified deductible </font><font style="font-family:Times New Roman;font-size:10pt;">limits</font><font style="font-family:Times New Roman;font-size:10pt;"> in the period in which a claim is incurred, including with respect to both reported claims and claims incurred but not reported</font><font style="font-family:Times New Roman;font-size:10pt;">. These costs have generally been estimated based on historical data of our claims experience. 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Segment Information</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our operations involve servicing patients through our two reportable business segments: home health and hospice. Our home health segment delivers a wide range of services in the homes of individuals who may be recovering from surgery, have a chronic disability or terminal illness or need assistance with the essential activities of daily living. Our hospice segment provides palliative care and comfort to terminally ill patients and their families. The &#8220;other&#8221; column in the following tables consist</font><font style="font-family:Times New Roman;font-size:10pt;">s</font><font style="font-family:Times New Roman;font-size:10pt;"> of costs relating to corporate support functions that are not directly attributable to a specific segment. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">As of June 30, 2013, we classified </font><font style="font-family:Times New Roman;font-size:10pt;">34</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers as held for sale and sold three care centers which are reflected as discontinued operations in accordance with applicable accounting guidance. See Note 3 &#8211; Discontinued Operations and Assets Held for Sale for additional information. 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This net service revenue is earned and billed either on an episode of care basis, on a per visit basis or on a daily basis depending upon the payment terms and conditions established with each </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;"> for services provided. We refer to home health revenue earned and billed on a </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episode of care as episodic-based revenue. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">When we record our service revenue, we record it net of estimated revenue adjustments and contractual adjustments to reflect amounts we estimate to be realizable for services provided, as discussed below. We believe, based on information currently available to us and based on our judgment, that changes to one or more factors that impact the accounting estimates (such as our estimates related to revenue adjustments, contractual adjustments and episodes in progress) we make in determining net service revenue, which changes are likely to occur from period to period, will not materially impact our reported consolidated financial condition, results of operations, cash flows or our future financial results. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Home Health Revenue Recognition</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Net service revenue is recorded under the Medicare prospective payment system (&#8220;PPS&#8221;) based on a </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a)&#160;an outlier payment if our patient's care was unusually costly (capped at </font><font style="font-family:Times New Roman;font-size:10pt;">10</font><font style="font-family:Times New Roman;font-size:10pt;">% of total reimbursement per provider number); (b)&#160;a low utilization payment adjustment (&#8220;LUPA&#8221;) if the number of visits was fewer than five; (c)&#160;a partial payment if our patient transferred to another provider or we received a patient from another provider before completing the episode; (d)&#160;a payment adjustment based upon the level of therapy services required (</font><font style="font-family:Times New Roman;font-size:10pt;">with various incremental adjustments made for additional visits, with larger payment increases associated with the sixth, fourteenth and twentieth visit thresholds</font><font style="font-family:Times New Roman;font-size:10pt;">); </font><font style="font-family:Times New Roman;font-size:10pt;">(e) adjustments to payments if we are unable to produce documentation for the face-to-face encounter requirement; (f) adjustments to payments if we are unable to perform periodic therapy assessments; </font><font style="font-family:Times New Roman;font-size:10pt;">(</font><font style="font-family:Times New Roman;font-size:10pt;">g</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (</font><font style="font-family:Times New Roman;font-size:10pt;">h</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;changes in the base episode payments established by the Medicare Program; (</font><font style="font-family:Times New Roman;font-size:10pt;">i</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;adjustments to the base episode payments for case mix and geographic wages; and (</font><font style="font-family:Times New Roman;font-size:10pt;">j</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;recoveries of overpayments. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We make adjustments to Medicare revenue on completed episodes to reflect</font><font style="font-family:Times New Roman;font-size:10pt;"> differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation or authorizations acceptable to the </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;"> and other reasons unrelated to credit risk. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of </font><font style="font-family:Times New Roman;font-size:10pt;">over </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> on</font><font style="font-family:Times New Roman;font-size:10pt;"> Medicare claims, and record this estimate during the period in which services are rendered as an estimated revenue adjustment and a corresponding reduction to patient accounts receivable. In addition, management evaluates the potential for revenue adjustments and, when appropriate, provides allowances based upon the best available information. Therefore, we believe that our reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In addition to revenue recognized on completed episodes, we also recognize a portion of revenue associated with episodes in progress. Episodes in progress are </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episodes of care that begin during the reporting period, but were not completed as of the end of the period. We estimate this revenue on a monthly basis based upon historical trends. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per episode and our estimate of the average percentage complete based on visits performed. As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, the difference between the cash received from Medicare for a request for anticipated payment (&#8220;RAP&#8221;) on episodes in progress and the associated estimated revenue was immaterial and, therefore, the resulting credits were recorded as a reduction to our outstanding pa</font><font style="font-family:Times New Roman;font-size:10pt;">tient accounts receivable in our condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated balance sheets for such periods. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Non-Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Episodic-based Revenue. </font><font style="font-family:Times New Roman;font-size:10pt;">We recognize revenue in a similar manner as we recognize Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Non-episodic </font><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;">b</font><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;">ased Revenue. </font><font style="font-family:Times New Roman;font-size:10pt;">Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates, as applicable. Contractual adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue and are also recorded as a reduction to our outstanding patient accounts receivable. In addition, we receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Hospice Revenue Recognition </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Hospice Medicare Revenue </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are daily or hourly rates for each of the four levels of care we deliver. The four levels of care</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">are routine care, general inpatient care, continuous home care and respite care. Routine care accounts </font><font style="font-family:Times New Roman;font-size:10pt;">for </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">of our</font><font style="font-family:Times New Roman;font-size:10pt;"> total net Medicare hospice service revenue for the</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">three </font><font style="font-family:Times New Roman;font-size:10pt;">and six-</font><font style="font-family:Times New Roman;font-size:10pt;">mon</font><font style="font-family:Times New Roman;font-size:10pt;">th</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, as compared to </font><font style="font-family:Times New Roman;font-size:10pt;">97</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and 98% </font><font style="font-family:Times New Roman;font-size:10pt;">for the three and six-month periods ended June 30, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">We make adjustmen</font><font style="font-family:Times New Roman;font-size:10pt;">ts to Medicare revenue for an inability to obtain appropriate billing documentation</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">acceptable </font><font style="font-family:Times New Roman;font-size:10pt;">authorizations</font><font style="font-family:Times New Roman;font-size:10pt;"> or face to face documentation and</font><font style="font-family:Times New Roman;font-size:10pt;"> other reasons unrelated to credit risk. We estimate the impact of these adjustments based on our historical experience, which primarily includes our historical collection rate on Medicare claims, and record it during the period services are rendered as an estimated revenue adjustment and as a reduction to our outstanding patient accounts receivable. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Additionally, as Medicare hospice revenue is subject to an inpatient cap limit and an overall payment cap for each provider number, we monitor these caps and estimate amounts due back to Medicare if a cap has been exceeded.&#160;We record these adjustments as a reduction to revenue and an increase in other accrued liabilities.&#160; We have settled our Medicare hospice reimbursements for all fiscal y</font><font style="font-family:Times New Roman;font-size:10pt;">ears through October 31, 20</font><font style="font-family:Times New Roman;font-size:10pt;">11</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">For the </font><font style="font-family:Times New Roman;font-size:10pt;">Federal </font><font style="font-family:Times New Roman;font-size:10pt;">cap years ended October 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and</font><font style="font-family:Times New Roman;font-size:10pt;"> October 31, </font><font style="font-family:Times New Roman;font-size:10pt;">201</font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;">, we </font><font style="font-family:Times New Roman;font-size:10pt;">have $</font><font style="font-family:Times New Roman;font-size:10pt;">4.0</font><font style="font-family:Times New Roman;font-size:10pt;"> million</font><font style="font-family:Times New Roman;font-size:10pt;"> and $</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> million </font><font style="font-family:Times New Roman;font-size:10pt;">recorded for estimated amounts due back to Medicare in other accrued liabilities as of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and </font><font style="font-family:Times New Roman;font-size:10pt;">December 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">As a result of our adjustments, we believe our revenue and patients accounts receivable are recorded at amounts that will be ultimately realized. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Hospice Non-Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We record gross revenue on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per </font><font style="font-family:Times New Roman;font-size:10pt;">day </font><font style="font-family:Times New Roman;font-size:10pt;">rates, as applicable. Contractual adjustments are recorded for the difference between our established rates and the amounts estimated to be realizable from patients, third parties and others for services provided and are deducted from gross revenue to determine our net service revenue and patient accounts receivable</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p><p style='margin-top: 0pt; margin-bottom: 0pt;'></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Patient Accounts Receivable </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;"> and patients. </font><font style="font-family:Times New Roman;font-size:10pt;">There is no single </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">, other than Medicare, that accounts for more than </font><font style="font-family:Times New Roman;font-size:10pt;">10</font><font style="font-family:Times New Roman;font-size:10pt;">% of our total</font><font style="font-family:Times New Roman;font-size:10pt;"> outstanding patient receivables, and thus we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We fully reserve for accounts which are aged at </font><font style="font-family:Times New Roman;font-size:10pt;">36</font><font style="font-family:Times New Roman;font-size:10pt;">5</font><font style="font-family:Times New Roman;font-size:10pt;"> days or greater. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We believe the credit risk associated with our Medicare accounts</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">which represent </font><font style="font-family:Times New Roman;font-size:10pt;">71% and </font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> of our</font><font style="font-family:Times New Roman;font-size:10pt;"> net patient accounts receivable at </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">December 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">respectively, </font><font style="font-family:Times New Roman;font-size:10pt;">is limited due to our historical collection rate of over </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">% </font><font style="font-family:Times New Roman;font-size:10pt;">from Medicare and the fact that Medicare is a U.S. government </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">. Accordingly, we do not record an allowance for doubtful accounts for our Medicare patient accounts receivable, which are recorded at their net realizable value after recording estimated revenue </font><font style="font-family:Times New Roman;font-size:10pt;">adjustments as discussed above. </font><font style="font-family:Times New Roman;font-size:10pt;">During the three </font><font style="font-family:Times New Roman;font-size:10pt;">and six-</font><font style="font-family:Times New Roman;font-size:10pt;">month</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we recorded $2.</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> million and $</font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;"> million, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> in estimated revenue adjustments to Medicare as compared to $2.</font><font style="font-family:Times New Roman;font-size:10pt;">1</font><font style="font-family:Times New Roman;font-size:10pt;"> million and $</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">7</font><font style="font-family:Times New Roman;font-size:10pt;"> million during the three and six-month periods ended June 30, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">respectively.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We believe there is a certain level of credit risk associated with non-Medicare </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;">. To provide for our non-Medicare patient accounts receivable that could become uncollectible in the future, we establish an allowance for doubtful accounts to reduce the carrying amount to its estimated net realizable value.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Medicare Home Health </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">% of our estimated payment for the initial episode at the start of care or </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">% of the estimated payment for any subsequent episodes of care contiguous with the first episode for a particular patient. The full amount of the episode is billed after the episode has been completed (&#8220;final billed&#8221;). The RAP received for that particular episode is then deducted from our final payment. If a final bill is not submitted within the greater of </font><font style="font-family:Times New Roman;font-size:10pt;">120</font><font style="font-family:Times New Roman;font-size:10pt;"> days from the start of the episode, or </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;"> days from the date the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other claims in process for that particular provider number. The RAP and final claim must then be re-submitted. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Medicare Hospice </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services t</font><font style="font-family:Times New Roman;font-size:10pt;">hat we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. </font><font style="font-family:Times New Roman;font-size:10pt;">Once each patient has been confirmed for eligibility, we will bill Medicare on a monthly basis for the services provided to the patient. </font></p><p style='margin-top:0pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:7.5pt;margin-left:0px;">&#160; </font></p><p style='margin-top:0pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Non-Medicare Home Health and Hospice </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient's eligibility for services with the applicable </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">. Once the patient has been confirmed for eligibility, we will provide services to the patient </font><font style="font-family:Times New Roman;font-size:10pt;">and bill the applicable </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;"> or groups of </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;"> with similar characteristics that would subject us to any significant credit risk. </font><font style="font-family:Times New Roman;font-size:10pt;">We estimate an allowance for doubtful accounts</font><font style="font-family:Times New Roman;font-size:10pt;"> based upon our assessment of historical and expected net collections, business and economic conditions, trends in payment and an evaluation of </font><font style="font-family:Times New Roman;font-size:10pt;">collectibility</font><font style="font-family:Times New Roman;font-size:10pt;"> based upon the date that the service was provided. Based upon our best judgment, we believe the allowance for doubtful accounts adequately provides for accounts that will not be collected due to credit risk</font></p><p style='margin-top: 0pt; margin-bottom: 0pt;'></p><div><table style="border-collapse:collapse;margin-top:20px;"><tr style="height: 18px"><td colspan="12" style="width: 710px; text-align:left;border-color:#000000;min-width:710px;"><font style="FONT-WEIGHT: bold;FONT-STYLE: italic;FONT-FAMILY: Times New Roman;FONT-SIZE: 10pt;COLOR: #000000;TEXT-ALIGN: left;">Fair Value of Financial Instruments</font></td></tr><tr style="height: 17px"><td style="width: 255px; text-align:left;border-color:#000000;min-width:255px;">&#160;</td><td style="width: 10px; text-align:left;border-color:#000000;min-width:10px;">&#160;</td><td style="width: 75px; text-align:left;border-color:#000000;min-width:75px;">&#160;</td><td style="width: 10px; text-align:left;border-color:#000000;min-width:10px;">&#160;</td><td style="width: 12px; text-align:left;border-color:#000000;min-width:12px;">&#160;</td><td style="width: 102px; 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Operating activities generally involve producing and delivering goods and providing services. Operating activity cash flows include transactions, adjustments, and changes in value that are not defined as investing or financing activities. While for technical reasons this element has no balance attribute, the default assumption is a debit balance consistent with its label.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3602-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 28 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. 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Reference 5: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 25 -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3536-108585 true223true 2us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstractus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1falsefalsefalse00falsefalsefalse2falsefalsefalse00falsefalsefalsexbrli:stringItemTypestringfalse024false 3us-gaap_ProceedsFromSaleOfRestrictedInvestmentsus-gaap_truedebitdurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1truefalsefalse100000100falsefalsefalse2truefalsefalse239000239falsefalsefalsexbrli:monetaryItemTypemonetaryThe cash inflow associated with the sale of investments that are pledged or subject to withdrawal restrictions during the period.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3179-108585 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 15, 16 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false225false 3us-gaap_ProceedsFromSaleOfPropertyPlantAndEquipmentus-gaap_truedebitdurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1truefalsefalse126000126falsefalsefalse2truefalsefalse590000590falsefalsefalsexbrli:monetaryItemTypemonetaryThe cash inflow from the sale of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 15 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3179-108585 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 16 -Subparagraph c -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false226false 3us-gaap_PaymentsToAcquireRestrictedInvestmentsus-gaap_truecreditdurationfalsefalsefalsefalsefalsefalsefalsetruenegatedLabel1truefalsefalse-74000-74falsefalsefalse2truefalsefalse-127000-127falsefalsefalsexbrli:monetaryItemTypemonetaryThe cash outflow to acquire investments (not to include restricted cash) that are pledged or subject to withdrawal restrictions.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3213-108585 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 15, 17 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false227false 3us-gaap_PaymentsToAcquirePropertyPlantAndEquipmentus-gaap_truecreditdurationfalsefalsefalsefalsefalsefalsefalsetruenegatedLabel1truefalsefalse-19595000-19595falsefalsefalse2truefalsefalse-20241000-20241falsefalsefalsexbrli:monetaryItemTypemonetaryThe cash outflow associated with the acquisition of long-lived, physical assets that are used in the normal conduct of business to produce goods and services and not intended for resale; includes cash outflows to pay for construction of self-constructed assets.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (c) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3213-108585 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 17 -Subparagraph c -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 15 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false228false 3us-gaap_PaymentsForProceedsFromInvestmentsus-gaap_truecreditdurationfalsefalsefalsefalsefalsefalsefalsetruenegatedLabel1truefalsefalse-6227000-6227falsefalsefalse2truefalsefalse00falsefalsefalsexbrli:monetaryItemTypemonetaryThe net cash paid (received) associated with the acquisition or disposal of all investments, including securities and other assets.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3095-108585 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 15 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 9 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3098-108585 false229false 3us-gaap_PaymentsToAcquireBusinessesNetOfCashAcquiredus-gaap_truecreditdurationfalsefalsefalsefalsefalsefalsefalsetruenegatedLabel1truefalsefalse-627000-627falsefalsefalse2truefalsefalse-8392000-8392falsefalsefalsexbrli:monetaryItemTypemonetaryThe cash outflow associated with the acquisition of a business, net of the cash acquired from the purchase.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 13 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3213-108585 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 15, 17 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false230false 3us-gaap_ProceedsFromDivestitureOfBusinessesus-gaap_truedebitdurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1truefalsefalse20820002082falsefalsefalse2truefalsefalse00falsefalsefalsexbrli:monetaryItemTypemonetaryThe cash inflow associated with the amount received from the sale of a portion of the company's business, for example a segment, division, branch or other business, during the period.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Investing Activities -URI http://asc.fasb.org/extlink&oid=6516133 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 12 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3179-108585 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 15, 16 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. 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This item inherently excludes any excess tax benefit, which the entity may have realized and reported separately.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 18 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. 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This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false234false 3us-gaap_ProceedsFromStockPlansus-gaap_truedebitdurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1truefalsefalse16950001695falsefalsefalse2truefalsefalse19780001978falsefalsefalsexbrli:monetaryItemTypemonetaryThe cash inflow associated with the amount received from the stock plan during the period.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 18 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. 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This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false237false 3us-gaap_RepaymentsOfShortTermDebtus-gaap_truecreditdurationfalsefalsefalsefalsefalsefalsefalsetruenegatedLabel1truefalsefalse-25500000-25500falsefalsefalse2truefalsefalse00falsefalsefalsexbrli:monetaryItemTypemonetaryThe cash outflow for a borrowing having initial term of repayment within one year or the normal operating cycle, if longer.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Glossary Financing Activities -URI http://asc.fasb.org/extlink&oid=6513228 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 15 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=6943989&loc=d3e3291-108585 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 95 -Paragraph 20 -Subparagraph b -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. 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LONG-TERM OBLIGATIONS (Tables)
6 Months Ended
Jun. 30, 2013
Debt Disclosure [Abstract]  
Long-Term Debt
5. LONG-TERM OBLIGATIONS
        
Long-term debt consisted of the following for the periods indicated (amounts in millions):
        
    June 30, 2013  December 31, 2012
Senior Notes:      
 $35.0 million Series A Notes: semi-annual interest only payments; interest rate at 6.07% per annum; due March 25, 2013 $0.0 $20.0
 $30.0 million Series B Notes: semi-annual interest only payments; interest rate at 6.28% per annum; due March 25, 2014  20.0  20.0
$60.0 million Term Loan; $3.0 million principal payments plus accrued interest payable quarterly; interest rate at ABR Rate plus applicable percentage or Eurodollar Rate plus the applicable percentage (2.45% at June 30, 2013); due October 26, 2017  51.0  57.0
Promissory notes  3.8  5.7
    74.8  102.7
Current portion of long-term obligations  (35.8)  (35.8)
 Total $39.0 $66.9
        
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CONDENSED CONSOLIDATED INCOME STATEMENTS (USD $)
In Thousands, except Per Share data, unless otherwise specified
3 Months Ended 6 Months Ended
Jun. 30, 2013
Jun. 30, 2012
Jun. 30, 2013
Jun. 30, 2012
Net service revenue $ 313,148 $ 363,068 $ 639,201 $ 719,056
Cost of service, excluding depreciation and amortization 176,077 202,586 360,233 401,637
General and administrative expenses:        
Salaries and benefits 74,601 82,983 154,043 166,270
Non-cash compensation 1,224 2,298 3,280 4,780
Other 41,121 45,632 82,739 88,240
Provision for doubtful accounts 4,658 4,534 8,502 10,217
Depreciation and amortization 11,674 9,678 21,621 19,515
Operating expenses 309,355 347,711 630,418 690,659
Operating income 3,793 15,357 8,783 28,397
Other (expense) income:        
Interest income 11 28 22 42
Interest expense (730) (2,002) (1,836) (4,076)
Equity in earnings from equity investments 337 396 700 701
Gain on sale of care centers 357 0 357 0
Miscellaneous, net 136 (126) 196 309
Total other expense, net 111 (1,704) (561) (3,024)
Income before income taxes 3,904 13,653 8,222 25,373
Income tax expense (1,566) (5,666) (3,260) (10,530)
Income from continuing operations 2,338 7,987 4,962 14,843
Discontinued operations, net of tax (490) (21) (982) (1,414)
Net income 1,848 7,966 3,980 13,429
Net loss (income) attributable to noncontrolling interests (7) (84) 539 (127)
Net income attributable to Amedisys, Inc. 1,841 7,882 4,519 13,302
Basic earnings per common share:        
Income from continuing operations attributable to Amedisys, Inc. common stockholders $ 0.07 $ 0.26 $ 0.18 $ 0.50
Discontinued operations, net of tax $ (0.01) $ 0.00 $ (0.03) $ (0.05)
Net income attributable to Amedisys, Inc. common stockholders $ 0.06 $ 0.26 $ 0.15 $ 0.45
Weighted average shares outstanding 31,160 29,780 30,900 29,584
Diluted earnings per common share:        
Income from continuing operations attributable to Amedisys, Inc. common stockholders $ 0.07 $ 0.26 $ 0.17 $ 0.49
Discontinued operations, net of tax $ (0.01) $ 0.00 $ (0.03) $ (0.05)
Net income attributable to Amedisys, Inc. common stockholders $ 0.06 $ 0.26 $ 0.14 $ 0.44
Weighted average shares outstanding 31,489 30,026 31,298 29,903
Amounts attributable to Amedisys, Inc. common stockholders:        
Income from continuing operations 2,331 7,903 5,501 14,716
Discontinued operations, net of tax (490) (21) (982) (1,414)
Net income attributable to Amedisys, Inc. $ 1,841 $ 7,882 $ 4,519 $ 13,302
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EXIT ACTIVITIES
6 Months Ended
Jun. 30, 2013
Restructuring and Related Activities  
EXIT ACTIVITIES

4. EXIT ACTIVITIES

Effective April 1, 2013, the Company sold assets associated with certain home health care centers in Alaska and Washington, as well as a hospice care center in Washington for cash consideration of approximately $1.6 million and recognized a gain of approximately $1.0 million.

Effective June 7, 2013, the Company sold its membership interest in one of our unconsolidated joint ventures for cash consideration of approximately $0.5 million and recognized a loss of approximately $0.7 million.

In connection with the 19 care centers we consolidated, we recorded charges of $2.3 million in depreciation and amortization expense related to the write-off of intangible assets, $0.8 million in other general and administrative expenses related to lease termination costs and $0.7 million in salaries and benefits related to severance costs during the three-month period ended June 30, 2013.

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Schedule of Net Revenues and Operating Results (Detail) (USD $)
3 Months Ended 6 Months Ended
Jun. 30, 2013
Jun. 30, 2012
Jun. 30, 2013
Jun. 30, 2012
Discontinued Operation, Additional Disclosures [Abstract]        
Net revenues $ 11,700,000 $ 15,300,000 $ 24,800,000 $ 30,400,000
(Loss) before income taxes (800,000) 0 (1,600,000) (2,400,000)
Income tax benefit 300,000 0 600,000 1,000,000
Discontinued operations, net of tax $ (490,000) $ (21,000) $ (982,000) $ (1,414,000)
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SEGMENT INFORMATION (Tables)
6 Months Ended
Jun. 30, 2013
Segment Reporting [Abstract]  
Operating Income of Reportable Segments
  For the Three-Month Periods Ended June 30, 2013 
   Home Health  Hospice  Other  Total 
 Net service revenue$248.6 $64.5 $0.0 $313.1 
 Cost of service, excluding depreciation and amortization 142.0  34.1  0.0  176.1 
 General and administrative expenses 75.6  15.6  25.7  116.9 
 Provision for doubtful accounts 3.0  1.6  0.0  4.6 
 Depreciation and amortization 2.6  0.5  8.6  11.7 
 Operating expenses 223.2  51.8  34.3  309.3 
 Operating income (loss)$25.4 $12.7 $(34.3) $3.8 
              
  For the Three-Month Periods Ended June 30, 2012 
   Home Health  Hospice  Other  Total 
 Net service revenue$290.6 $72.5 $0.0 $363.1 
 Cost of service, excluding depreciation and amortization 165.3  37.3  0.0  202.6 
 General and administrative expenses 81.5  17.8  31.6  130.9 
 Provision for doubtful accounts 3.9  0.6  0.0  4.5 
 Depreciation and amortization 3.4  0.3  6.0  9.7 
 Operating expenses 254.1  56.0  37.6  347.7 
 Operating income (loss)$36.5 $16.5 $(37.6) $15.4 
              
  For the Six-Month Periods Ended June 30, 2013 
   Home Health  Hospice  Other  Total 
 Net service revenue$508.8 $130.4 $0.0 $639.2 
 Cost of service, excluding depreciation and amortization 291.3  68.9  0.0  360.2 
 General and administrative expenses 155.1  32.8  52.2  240.1 
 Provision for doubtful accounts 5.0  3.5  0.0  8.5 
 Depreciation and amortization 5.3  1.1  15.2  21.6 
 Operating expenses 456.7  106.3  67.4  630.4 
 Operating income (loss)$52.1 $24.1 $(67.4) $8.8 
              
  For the Six-Month Periods Ended June 30, 2012 
   Home Health  Hospice  Other  Total 
 Net service revenue$578.4 $140.6 $0.0 $719.0 
 Cost of service, excluding depreciation and amortization 328.5  73.1  0.0  401.6 
 General and administrative expenses 165.6  34.0  59.7  259.3 
 Provision for doubtful accounts 8.8  1.4  0.0  10.2 
 Depreciation and amortization 6.6  0.6  12.3  19.5 
 Operating expenses 509.5  109.1  72.0  690.6 
 Operating income (loss)$68.9 $31.5 $(72.0) $28.4 
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Long Term Obligations - Additional Information (Detail) (USD $)
In Millions, unless otherwise specified
3 Months Ended 6 Months Ended
Jun. 30, 2013
Jun. 30, 2013
Debt Instrument [Line Items]    
Total leverage ratio 1.01 1.01
Fixed charge coverage ratio 1.27 1.27
Line of Credit Facility Debt Restrictions 2.0 2.0
Maximum leverage ratio 2.0 2.0
Minimum fixed charge coverage ratio 1.25 1.25
Revolving Credit Facilities [Member]
   
Debt Instrument [Line Items]    
Principal amount $ 165.0 $ 165.0
Availability under the revolving credit facility 143.3 143.3
Outstanding letters of credit 21.7 21.7
Effective availability under the revolving credit facility 94.4 94.4
Term Loan [Member]
   
Debt Instrument [Line Items]    
Term loan, period   5 years
Weighted-average interest rate for five year Term Loan 2.60% 2.70%
Principal amount $ 60.0 $ 60.0
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Long Term Debt (Detail) (USD $)
Jun. 30, 2013
Dec. 31, 2012
Debt Instrument [Line Items]    
Long-term debt including current portion $ 74,800,000 $ 102,700,000
Current portion of long-term obligations (35,807,000) (35,807,000)
Total 39,000,000 66,900,000
Series A Notes [Member]
   
Debt Instrument [Line Items]    
Long-term debt including current portion 0 20,000,000
Series B Notes [Member]
   
Debt Instrument [Line Items]    
Long-term debt including current portion 20,000,000 20,000,000
Term Loan [Member]
   
Debt Instrument [Line Items]    
Long-term debt including current portion 51,000,000 57,000,000
Promissory Notes
   
Debt Instrument [Line Items]    
Long-term debt including current portion $ 3,800,000 $ 5,700,000
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Operating Income of Reportable Segments (Detail) (USD $)
3 Months Ended 6 Months Ended
Jun. 30, 2013
Jun. 30, 2012
Jun. 30, 2013
Jun. 30, 2012
Segment Reporting Information [Line Items]        
Net service revenue $ 313,148,000 $ 363,068,000 $ 639,201,000 $ 719,056,000
Cost of service, excluding depreciation and amortization 176,077,000 202,586,000 360,233,000 401,637,000
General and administrative expenses 116,900,000 130,900,000 240,100,000 259,300,000
Provision for doubtful accounts 4,658,000 4,534,000 8,502,000 10,217,000
Depreciation and amortization 11,674,000 9,678,000 21,621,000 19,515,000
Operating expenses 309,355,000 347,711,000 630,418,000 690,659,000
Operating (loss) income 3,793,000 15,357,000 8,783,000 28,397,000
Home Health [Member]
       
Segment Reporting Information [Line Items]        
Net service revenue 248,600,000 290,600,000 508,800,000 578,400,000
Cost of service, excluding depreciation and amortization 142,000,000 165,300,000 291,300,000 328,500,000
General and administrative expenses 75,600,000 81,500,000 155,100,000 165,600,000
Provision for doubtful accounts 3,000,000 3,900,000 5,000,000 8,800,000
Depreciation and amortization 2,600,000 3,400,000 5,300,000 6,600,000
Operating expenses 223,200,000 254,100,000 456,700,000 509,500,000
Operating (loss) income 25,400,000 36,500,000 52,100,000 68,900,000
Hospice [Member]
       
Segment Reporting Information [Line Items]        
Net service revenue 64,500,000 72,500,000 130,400,000 140,600,000
Cost of service, excluding depreciation and amortization 34,100,000 37,300,000 68,900,000 73,100,000
General and administrative expenses 15,600,000 17,800,000 32,800,000 34,000,000
Provision for doubtful accounts 1,600,000 600,000 3,500,000 1,400,000
Depreciation and amortization 500,000 300,000 1,100,000 600,000
Operating expenses 51,800,000 56,000,000 106,300,000 109,100,000
Operating (loss) income 12,700,000 16,500,000 24,100,000 31,500,000
All Other Segments [Member]
       
Segment Reporting Information [Line Items]        
Net service revenue 0 0 0 0
Cost of service, excluding depreciation and amortization 0 0 0 0
General and administrative expenses 25,700,000 31,600,000 52,200,000 59,700,000
Provision for doubtful accounts 0 0 0 0
Depreciation and amortization 8,600,000 6,000,000 15,200,000 12,300,000
Operating expenses 34,300,000 37,600,000 67,400,000 72,000,000
Operating (loss) income $ (34,300,000) $ (37,600,000) $ (67,400,000) $ (72,000,000)
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On July 26, 2012, the Co-Lead Plaintiffs filed a motion for reconsideration</font><font style="font-family:Times New Roman;font-size:10pt;">, which the Court denied on April 9, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On May 3,</font><font style="font-family:Times New Roman;font-size:10pt;"> 2013,</font><font style="font-family:Times New Roman;font-size:10pt;"> the Co-Lead Plaintiffs appealed the dismissal of their Securities Class Action Complaint to the United States Court of Appeals for the Fifth Circuit. The United States Court of Appeals for the Fifth Circuit docketed the Co-Lead Plaintiffs' appeal on July 16, 2013, and the Co-Lead Plaintiffs must file their opening brief on or before August 26, 2013. The appeal remains pending. While the Company will seek to have the District Court order granting the defendants' motion to dismiss affirmed on appeal, no assurances can be given as to the timing or outcome of the appeals process.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Derivative Actions </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On July&#160;2, 2010, an alleged shareholder of the Company filed a derivative lawsuit in the United States District Court for the Middle District of Louisiana, purporting to assert claims on behalf of the Company against certain of our current and former officers and directors.&#160;Three similar derivative suits were filed in the United States District Court for the Middle District of Louisiana on July&#160;15,&#160;July&#160;21, and August&#160;2, 2010 (together, the &#8220;Federal Derivative Actions&#8221;).&#160;We are named as a nominal defendant in&#160;all of those&#160;actions.&#160;As noted above, on October&#160;22, 2010, the United States District Court for the Middle District of Louisiana issued an order consolidating the Federal Derivative Actions with the&#160;putative securities class action lawsuits&#160;and&#160;for pre-trial purposes.</font><font style="font-family:Times New Roman;font-size:10pt;">&#160;&#160;</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On January&#160;18, 2011, the&#160;plaintiffs in the Federal Derivative Actions&#160;filed a consolidated, amended complaint&#160;(the &#8220;Derivative Complaint&#8221;) which supersedes the earlier-filed derivative complaints. The Derivative Complaint alleges that certain of our current and former officers and directors breached their fiduciary duties to the Company by making allegedly false statements, by allegedly failing to establish sufficient internal controls over certain of our home health and Medicare billing practices, by engaging in alleged insider trading, and by committing unspecified acts of waste of corporate assets and unjust enrichment. All defendants in the Federal Derivative Actions, including the Company as a nominal defendant, moved to dismiss the Derivative Complaint.</font><font style="font-family:Times New Roman;font-size:10pt;"> That motion is fully briefed and remains pending before the court.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On June 24, 2013, all parties to the Federal Derivative Actions entered into a Stipulation of Settlement (the &#8220;Stipulation&#8221;) with respect to the Federal Derivative Actions. On June 27, 2013, the United States District Court for the Middle District of Louisiana issued an order preliminarily approving the proposed settlement in accordance with the Stipulation. Pursuant to the Court's June 27, 2013 Order, a copy of the Court-approved &#8220;Notice of Settlement of </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, Inc. Derivative Action,&#8221; (the &#8220;Notice of Settlement&#8221;) was attached as Exhibit 99.1 to the Company's Current Report on Form 8-K filed with the United States Securities and Exchange Commission on July 2, 2013. As described in the Notice of Settlement, the Court has scheduled a hearing on September 4, 2013, to determine whether the Court should issue an order of final approval of the proposed settlement. As further described in the Notice of Settlement, as part of the proposed </font><font style="font-family:Times New Roman;font-size:10pt;">s</font><font style="font-family:Times New Roman;font-size:10pt;">ettlement, the Company has agreed to adopt and/or maintain certain corporate governance reforms as set forth in the Stipulation. The Stipulation also provides that plaintiffs' co-lead counsel will seek an award of attorneys' fees and expenses in an amount not to exceed $445,000, which shall include all attorneys' fees and costs that may be due any counsel (or anyone else) who has asserted, or participated in the assertion of, derivative claims on behalf of t</font><font style="font-family:Times New Roman;font-size:10pt;">he Company in any court. Any award of fees and expenses will be paid by the Company (or its insurer on its behalf). If the proposed settlement is approved, the Federal Derivative Actions will be dismissed with prejudice, and all named defendants will be released by all plaintiffs, the Company, and its shareholders from all claims that were or could have been alleged in the Federal Derivative Actions.</font><font style="font-family:Times New Roman;font-size:10pt;"> As of June 30, 2013, we have accrued $0.4 million related to the proposed settlement and a corresponding receivable for insurance proceeds related to the </font><font style="font-family:Times New Roman;font-size:10pt;">proposed </font><font style="font-family:Times New Roman;font-size:10pt;">settlement.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On July&#160;23, 2010, a derivative suit was filed in the Nineteenth Judicial District Court, Parish of East Baton Rouge, </font><font style="font-family:Times New Roman;font-size:10pt;">State</font><font style="font-family:Times New Roman;font-size:10pt;"> of </font><font style="font-family:Times New Roman;font-size:10pt;">Louisiana</font><font style="font-family:Times New Roman;font-size:10pt;">.&#160;That action also purports to assert claims on behalf of the Company against certain of our current and former officers and directors.&#160;On December&#160;8, 2010, the Court entered an order staying the action in deference to the earlier-filed derivative actions&#160;pending in </font><font style="font-family:Times New Roman;font-size:10pt;">Federal court. If the United States District Court for the Middle District of Louisiana issues an order of final approval of the settlement of the Federal Derivative Actions, the named defendants in the state court derivative suit and the Company, as a nominal defendant, will move for dismissal of the state court derivative suit.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">ERISA Class Action Lawsuit </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On September&#160;27, 2010 and October&#160;22, 2010, separate putative class action complaints were filed in the United States District Court for the Middle District of Louisiana against the Company, certain of our current and former senior executives and members of our 401(k) Plan Administrative Committee.&#160;The suits allege violations of the Employee Retirement Income Security Act (&#8220;ERISA&#8221;) since January&#160;1, 2006 and July 1, 2007, respectively. The plaintiffs brought the complaints on behalf of themselves and a class of similarly situated participants in our 401(k) plan.&#160;The plaintiffs assert that the defendants breached their fiduciary duties to the 401(k) Plan's participants by causing the 401(k) plan to offer and hold </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;"> common stock during the respective class periods when it was an allegedly unduly risky and imprudent retirement investment because of our alleged improper business practices.&#160;The complaints seek a determination that the actions may be maintained as a class action, an award of unspecified monetary damages and other unspecified relief. As noted above, on December&#160;10, 2010, the Court consolidated the putative ERISA class actions with the putative securities class actions and derivative actions for pre-trial purposes. In addition, on December 10, 2010, the Court appointed interim lead counsel and interim liaison counsel in the ERISA class action. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On March 10, 2011, </font><font style="font-family:Times New Roman;font-size:10pt;">Wanda</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">Corbin</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">Pia</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">Galimba</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">Linda</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">Trammell</font><font style="font-family:Times New Roman;font-size:10pt;"> (the &#8220;Co-ERISA Plaintiffs&#8221;), filed an amended, consolidated&#160;class action complaint (the &#8220;ERISA Complaint&#8221;), which supersedes the earlier-filed ERISA class action complaints.&#160; The ERISA Complaint seeks a determination that the action may be maintained as a class action on behalf of themselves and a class of similarly situated participants in our 401(k) plan from January 1, 2008 through present. All of the defendants have moved to dismiss the ERISA Complaint.</font><font style="font-family:Calibri;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">That motion is fully briefed and remains pending before the court.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">SEC Investigation </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On June&#160;30, 2010, we received notice of a formal investigation from the SEC and received a subpoena for documents relating to the matters under review by the United States Senate Committee on Finance and other matters involving our operations. We have cooperated with the SEC with respect to this investigation.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">U.S. Department of Justice Civil Investigative Demand (&#8220;CID&#8221;) </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On September&#160;27, 2010, we received a CID issued by the U.S. Department of Justice pursuant to the federal False Claims Act. The CID require</font><font style="font-family:Times New Roman;font-size:10pt;">s</font><font style="font-family:Times New Roman;font-size:10pt;"> the delivery of a wide range of documents and information relating to the Company's clinical and business operations, including reimbursement and billing claims submitted to Medicare for home health services, and related compliance activities. The CID generally covers the period from January&#160;1, 2003.&#160; On April 26, 2011, we received a second CID related to the CID issued in September 2010, which generally covers the same time period as the previous CID and requires the production of additional documents. Such CIDs are often associated with previously filed qui tam actions, or lawsuits filed under seal under the False Claims Act (&#8220;FCA&#8221;), 31 U.S.C. </font><font style="font-family:Calibri;font-size:10pt;">&#167;</font><font style="font-family:Times New Roman;font-size:10pt;"> 3729 et seq. Qui tam actions are brought by private plaintiffs suing on behalf of the federal government for alleged FCA violations. Subsequently, the Company and certain current and former employees have received additional CIDs for additional documents and/or testimony. We are cooperating with the Department of Justice with respect to this investigation and the requests for information and testimony.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Stark Law</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In May 2012, we made a disclosure to CMS under the agency's Stark Law Self-Referral Disclosure Protocol relating to certain services agreements between a subsidiary of ours and a large physician group. During some period of time since December 2007, the arrangements appear not to have complied in certain respects with an applicable exemption to the Stark Law referral prohibition. </font><font style="font-family:Times New Roman;font-size:10pt;">Medicare r</font><font style="font-family:Times New Roman;font-size:10pt;">evenue earned as a result of referrals from the physician group </font><font style="font-family:Times New Roman;font-size:10pt;">from May 2008 to May 2012, the relevant four year &#8220;</font><font style="font-family:Times New Roman;font-size:10pt;">lookback</font><font style="font-family:Times New Roman;font-size:10pt;">&#8221; period under the Stark Law Self-Referral Disclosure Protocol, w</font><font style="font-family:Times New Roman;font-size:10pt;">as approximately $4 million. On January 11, 2013, one of our subsidiaries received a CID from the United States Attorney's Office for the Northern District of Georgia seeking certain information relating to that subsidiary's relationship with this physician group. </font><font style="font-family:Times New Roman;font-size:10pt;">We </font><font style="font-family:Times New Roman;font-size:10pt;">are </font><font style="font-family:Times New Roman;font-size:10pt;">cooperating</font><font style="font-family:Times New Roman;font-size:10pt;"> with the government in its review of this matter.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">OIG Self-Disclosure</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In October 2012, we made a disclosure to the Office of Counsel to the Inspector General of the United States Department of Health and Human Services (the "OIG") pursuant to the OIG Provider Self-Disclosure Protocol regarding certain clinical documentation issues and eligibility</font><font style="font-family:Times New Roman;font-size:10pt;"> regulatory </font><font style="font-family:Times New Roman;font-size:10pt;">requirements at two of our hospice care centers.&#160; These hospice care centers </font><font style="font-family:Times New Roman;font-size:10pt;">did</font><font style="font-family:Times New Roman;font-size:10pt;"> not compl</font><font style="font-family:Times New Roman;font-size:10pt;">y</font><font style="font-family:Times New Roman;font-size:10pt;"> in some respects with certain state and </font><font style="font-family:Times New Roman;font-size:10pt;">Medicare hospice regulations</font><font style="font-family:Times New Roman;font-size:10pt;">, including those requiring physicians to certify patient eligibility and requiring patient face-to-face encounters.&#160; We are also in discussions with state healthcare authorities regarding this matter.&#160; Our review of this matter is ongoing, and we </font><font style="font-family:Times New Roman;font-size:10pt;">are cooperating</font><font style="font-family:Times New Roman;font-size:10pt;"> with the OIG and </font><font style="font-family:Times New Roman;font-size:10pt;">the state</font><font style="font-family:Times New Roman;font-size:10pt;"> regulatory authorities in their review of this matter.</font><font style="font-family:Arial;font-size:10pt;">&#160;</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Wage and Hour Litigation</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On July 25, 2012, a putative collective and class action complaint was filed in the United States District Court for the District of Connecticut against us in which three former employees allege wage and hour law violations.&#160; The former employees </font><font style="font-family:Times New Roman;font-size:10pt;">claim that they were not paid overtime for all hours worked over fort</font><font style="font-family:Times New Roman;font-size:10pt;">y</font><font style="font-family:Times New Roman;font-size:10pt;"> hours in violation of the Federal Fair Labor </font><font style="font-family:Times New Roman;font-size:10pt;">Standards Act (&#8220;FLSA&#8221;), as well as the</font><font style="font-family:Times New Roman;font-size:10pt;"> Pennsylvania Minimum Wage Act. More specifically, they allege they were paid on both a per-visit and an hourly basis, and that such a pay scheme resulted in their misclassification as exempt employees, thereby denying them overtime pay. Moreover, in response to a Company motion arguing that plaintiffs' complaint was deficient in that it was ambiguous and failed to provide fair notice of the claims asserted and plaintiffs' opposition thereto, the court</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> on April 8, 2013, held that the complaint adequately raises general allegations that the plaintiffs were not paid overtime for all hours worked in a week over </font><font style="font-family:Times New Roman;font-size:10pt;">forty</font><font style="font-family:Times New Roman;font-size:10pt;">, which may include claims for unpaid overtime under other theories of liability, such as alleged off-the-clock work, in addition to plaintiffs' more clearly stated allegations based on misclassification. </font><font style="font-family:Times New Roman;font-size:10pt;">Plaintiffs seek class certification of similar employees and seek attorneys' fees, back wages and liquidated damages going back three years under the FLSA and three years under the Pennsylvania statute.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">On September 13, 2012, a putative collective and class action complaint was filed in the United States District Court for the Northern District of Illinois against us in which a former employee alleges wage and hour law </font><font style="font-family:Times New Roman;font-size:10pt;">violations.&#160; The former employee claims she was paid on both a per-visit and an hourly basis, thereby misclassifying her as an exempt employee and entitling her to overtime pay. The plaintiff alleges violations of Federal and state law and seeks damages under the FLSA and the Illinois Minimum Wage Law. &#160;Plaintiff seeks class certification of similar employees who were or are employed in Illinois and seeks attorneys' fees, back wages and liquidated damages going back three years under the FLSA and three years under the Illinois statute.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We are unable to assess the probable outcome or reasonably estimate the potential liability, if any, arising from the SEC investigation, the U.S. Department of Justice CIDs, the Stark Law matter we have disclosed to CMS, the OIG Self-Disclosure issue and the securities, </font><font style="font-family:Times New Roman;font-size:10pt;">shareholder derivative, </font><font style="font-family:Times New Roman;font-size:10pt;">ERISA and wage and hour litigation described above given the preliminary stage of these matters.&#160; The Company intends to continue to vigorously defend itself in the securities,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">shareholder derivative,</font><font style="font-family:Times New Roman;font-size:10pt;"> ERISA and wage and hour litigation matters.&#160; No assurances can be given as to the timing or outcome of the SEC investigation, the U.S. Department of Justice CIDs, the Stark Law matter we have disclosed to CMS, the OIG Self-Disclosure issue or the securities, </font><font style="font-family:Times New Roman;font-size:10pt;">shareholder derivative, </font><font style="font-family:Times New Roman;font-size:10pt;">ERISA and wage and hour litigation matters described above or the impact of any of the inquiry, investigation or litigation matters on the Company, its consolidated financial condition, results of operations or cash flows, which could be material, individually or in the aggregate.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We recognize that additional putative securities class action complaints and other litigation could be filed, and that other investigations and actions could be commenced, relating to matters involving our home therapy visits and therapy utilization trends or other matters.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In addition to the matters referenced in this note, we are involved in legal actions in the normal course of business, some of which seek monetary damages, including claims for punitive damages. We do not believe that these normal course actions, when finally concluded and determined, will have a material impact on our consolidated financial condition, results of operations or cash flows.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Third Party Audits</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">From time to time, in the ordinary course of business, we are subject to audits under various governmental programs in which third party firms engaged by CMS conduct extensive review of claims data to identify potential improper payments under the Medicare program. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In January 2010, our subsidiary that provides home health services in Dayton, Ohio received from a Medicare Program Safeguard Contractor (&#8220;PSC&#8221;) a request for records regarding 137 claims submitted by the subsidiary paid from January 2, 2008 through November 10, 2009 (the &#8220;Claim Period&#8221;) to determine whether the underlying services met pertinent Medicare payment requirements. Based on the PSC's findings for 114 of the claims, which were extrapolated to all claims for home health services provided by the </font><font style="font-family:Times New Roman;font-size:10pt;">Dayton</font><font style="font-family:Times New Roman;font-size:10pt;"> subsidiary paid during the Claim Period, on March 9, 2011, the Medicare Administrative Contractor (&#8220;MAC&#8221;) for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment of approximately $5.6 million. We dispute the</font><font style="font-family:Times New Roman;font-size:10pt;">se</font><font style="font-family:Times New Roman;font-size:10pt;"> findings</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">our Dayton subsidiary has </font><font style="font-family:Times New Roman;font-size:10pt;">filed appeals</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">through the Original Medicare Standard Appeals Process, </font><font style="font-family:Times New Roman;font-size:10pt;">in which we </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> seek</font><font style="font-family:Times New Roman;font-size:10pt;">ing</font><font style="font-family:Times New Roman;font-size:10pt;"> to have those findings overturned. </font><font style="font-family:Times New Roman;font-size:10pt;">Most recently, a</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated </font><font style="font-family:Times New Roman;font-size:10pt;">administrative law judge (&#8220;</font><font style="font-family:Times New Roman;font-size:10pt;">ALJ</font><font style="font-family:Times New Roman;font-size:10pt;">&#8221;)</font><font style="font-family:Times New Roman;font-size:10pt;"> hearing </font><font style="font-family:Times New Roman;font-size:10pt;">was held in late March </font><font style="font-family:Times New Roman;font-size:10pt;">2013. </font><font style="font-family:Times New Roman;font-size:10pt;">As of </font><font style="font-family:Times New Roman;font-size:10pt;">the date of this filing</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> the ALJ has not released a ruling.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">No assurances can be given as to the outcome of the ALJ appeal. </font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we have recorded no liability with respect to the pending appeals as we do not believe that an estimate of a reasonably possible loss or range of loss can be made at this time.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In July 2010, our subsidiary that provides hospice services in Florence, South Carolina received from a Zone Program Integrity Contractor (&#8220;ZPIC&#8221;) a request for records regarding a sample of 30 beneficiaries who received services from the subsidiary during the period of January 1, 2008 through March 31, 2010 (the &#8220;Review Period&#8221;) to determine whether the underlying services met pertinent Medicare payment requirements.&#160; We acquired the hospice operations subject to this review on August 1, 2009; the Review Period covers time periods both before and after our ownership of these hospice operations.&#160; Based on the ZPIC's findings for 16 beneficiaries, which were extrapolated to all claims for hospice services provided by the Florence subsidiary billed during the Review Period, on June 6, 2011, the MAC for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;"> We dispute the</font><font style="font-family:Times New Roman;font-size:10pt;">se</font><font style="font-family:Times New Roman;font-size:10pt;"> findings</font><font style="font-family:Times New Roman;font-size:10pt;">, and our Florence subsidiary has </font><font style="font-family:Times New Roman;font-size:10pt;">filed appeals</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">through the Original Medicare Standard Appeals Process, </font><font style="font-family:Times New Roman;font-size:10pt;">in which we </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> seek</font><font style="font-family:Times New Roman;font-size:10pt;">ing</font><font style="font-family:Times New Roman;font-size:10pt;"> to have those findings overturned. </font><font style="font-family:Times New Roman;font-size:10pt;">Most recently, we have requested appeal hearings before an ALJ, but the</font><font style="font-family:Times New Roman;font-size:10pt;"> ALJ hearings have not been scheduled, and no assurances can be given as to the timing or outcome of the ALJ appeal. </font><font style="font-family:Times New Roman;font-size:10pt;">The current alleged extrapolated overpayment is $6.1 million. In</font><font style="font-family:Times New Roman;font-size:10pt;"> the event we pay any amount of this alleged overpayment, we are indemnified by the prior owners of the hospice operations for amounts relating to the period prior to August 1, 2009. </font><font style="font-family:Times New Roman;font-size:10pt;">As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we </font><font style="font-family:Times New Roman;font-size:10pt;">have recorded no liability for this claim</font><font style="font-family:Times New Roman;font-size:10pt;"> as we do not believe that an estimate of a reasonably possible loss or range of loss can be made at this time</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In July 2009, Beacon Hospice, Inc., a subsidiary we acquired on June 7, 2011 (&#8220;Beacon&#8221;), received from Massachusetts Peer Review Organization, Inc. (&#8220;</font><font style="font-family:Times New Roman;font-size:10pt;">MassPro</font><font style="font-family:Times New Roman;font-size:10pt;">&#8221;), an entity contracted with the Massachusetts Office of Medicaid, a request for records regarding 25 beneficiaries in Boston, Framingham and Plymouth, Massachusetts, who received hospice services from Beacon during the period of August 1, 2007 through July 31, 2008 (the &#8220;Review Period&#8221;) to determine whether the underlying services met pertinent </font><font style="font-family:Times New Roman;font-size:10pt;">MassHealth</font><font style="font-family:Times New Roman;font-size:10pt;"> Program regulations. Based on </font><font style="font-family:Times New Roman;font-size:10pt;">MassPro's</font><font style="font-family:Times New Roman;font-size:10pt;"> findings for 89 of the 112 claims submitted in connection with these beneficiaries, </font><font style="font-family:Times New Roman;font-size:10pt;">which</font><font style="font-family:Times New Roman;font-size:10pt;"> were extrapolated to all </font><font style="font-family:Times New Roman;font-size:10pt;">MassHealth</font><font style="font-family:Times New Roman;font-size:10pt;"> claims for hospice services provided by Beacon billed during the Review Period, on February 15, 2012, </font><font style="font-family:Times New Roman;font-size:10pt;">MassPro</font><font style="font-family:Times New Roman;font-size:10pt;"> issued a notice of overpayment seeking recovery from Beacon of an alleged overpayment of approximately $6.6 million. The Review Period covers a time before our ownership of Beacon. On December 17, 2012, as a result of </font><font style="font-family:Times New Roman;font-size:10pt;">an</font><font style="font-family:Times New Roman;font-size:10pt;"> appeal</font><font style="font-family:Times New Roman;font-size:10pt;"> by Beacon</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">MassPro</font><font style="font-family:Times New Roman;font-size:10pt;"> issued a final notice of determination of overpayment and fines (the &#8220;Final Notice&#8221;), determining an overpayment in only 35 of the original 112 claims and seeking recovery from Beacon in the amount of $</font><font style="font-family:Times New Roman;font-size:10pt;">0.1 million</font><font style="font-family:Times New Roman;font-size:10pt;"> (the &#8220;Final Amount&#8221;). In the Final Notice, </font><font style="font-family:Times New Roman;font-size:10pt;">MassPro</font><font style="font-family:Times New Roman;font-size:10pt;"> did not extrapolate the findings, and Beacon determined not to contest the Final Notice. In January 2013, </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;"> paid the Final Amount to </font><font style="font-family:Times New Roman;font-size:10pt;">MassPro</font><font style="font-family:Times New Roman;font-size:10pt;">, and the prior owners of Beacon paid the Final Amount to </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, in accordance with their indemnification obligations set forth in the acquisition document.</font></p><p style='margin-top: 0pt; margin-bottom: 0pt;'></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Insurance </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We are obligated for certain costs associated with our insurance programs, including employee health, workers' compensation and professional liability. While we maintain various insurance programs to cover these risks, we are self-insured for a substantial portion of our potential claims. We recognize our obligations associated with these costs</font><font style="font-family:Times New Roman;font-size:10pt;">, up to specified deductible </font><font style="font-family:Times New Roman;font-size:10pt;">limits</font><font style="font-family:Times New Roman;font-size:10pt;"> in the period in which a claim is incurred, including with respect to both reported claims and claims incurred but not reported</font><font style="font-family:Times New Roman;font-size:10pt;">. These costs have generally been estimated based on historical data of our claims experience. Such estimates, and the resulting reserves, are reviewed and updated by us on a quarterly basis. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our </font><font style="font-family:Times New Roman;font-size:10pt;">health insurance has a retention limit of $</font><font style="font-family:Times New Roman;font-size:10pt;">0.</font><font style="font-family:Times New Roman;font-size:10pt;">9</font><font style="font-family:Times New Roman;font-size:10pt;"> million, our workers' compensation insurance has a retention limit of $</font><font style="font-family:Times New Roman;font-size:10pt;">0.</font><font style="font-family:Times New Roman;font-size:10pt;">5</font><font style="font-family:Times New Roman;font-size:10pt;"> million and our professional liability insurance has a retention limit of $</font><font style="font-family:Times New Roman;font-size:10pt;">0.3</font><font style="font-family:Times New Roman;font-size:10pt;"> million</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p>falsefalsefalsenonnum:textBlockItemTypenaThe entire disclosure for commitments and contingencies.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name FASB Interpretation (FIN) -Number 14 -Paragraph 3 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02.25) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 825 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=6449706&loc=d3e16207-108621 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 460 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6398077&loc=d3e12565-110249 Reference 5: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=6952336&loc=d3e14435-108349 Reference 6: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 440 -SubTopic 10 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=6394976&loc=d3e25287-109308 Reference 7: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 5 -Paragraph 9, 10, 11, 12 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false0falseCOMMITMENTS AND CONTINGENCIESUnKnownUnKnownUnKnownUnKnowntruefalsefalseSheethttp://www.amedisys.com/role/COMMITMENTSANDCONTINGENCIES12 XML 29 R25.htm IDEA: XBRL DOCUMENT v2.4.0.8
Exit Activities (Detail) (USD $)
3 Months Ended 6 Months Ended 4 Months Ended 6 Months Ended 3 Months Ended
Jun. 30, 2013
Agencies
Jun. 30, 2012
Jun. 30, 2013
Agencies
Jun. 30, 2012
Apr. 30, 2013
Alaska and Washington Care Centers [Member]
Jun. 30, 2013
Unconsolidated Joint Venture [Member]
Jun. 30, 2013
Severance [Member]
Jun. 30, 2013
Intangible Assets Write-Off [Member]
Jun. 30, 2013
Lease Termination [Member]
Restructuring Cost and Reserve [Line Items]                  
Other Restructuring Costs             $ 700,000 $ 2,300,000 $ 800,000
Number Of Care Centers Consolidated 19   28            
Gains (Losses) on Sales of Assets 357,000 0 357,000 0 1,000,000 (700,000)      
Proceeds from Divestiture of Business     $ 2,082,000 $ 0 $ 1,600,000 $ 500,000      
XML 30 R6.htm IDEA: XBRL DOCUMENT v2.4.0.8
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $)
In Thousands, unless otherwise specified
6 Months Ended
Jun. 30, 2013
Jun. 30, 2012
Cash Flows from Operating Activities:    
Net income $ 3,980 $ 13,429
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 19,679 20,071
Provision for doubtful accounts 8,722 10,621
Non-cash compensation 3,280 4,780
401(k) employer match 4,363 5,040
Loss on disposal of property and equipment 708 848
Gain on sale of care centers (357) 0
Deferred income taxes 2,959 5,557
Write off intangible assets 2,286 0
Equity in earnings of equity investments (700) (701)
Amortization of deferred debt issuance costs 370 788
Return on equity investment 400 625
Changes in operating assets and liabilities, net of impact of acquisitions:    
Patient accounts receivable 35,684 (25,722)
Other current assets (2,878) 411
Other assets (800) (545)
Accounts payable (7,963) 1,457
Accrued expenses (4,293) (3,976)
Other long-term obligations 537 (578)
Net cash provided by operating activities 65,977 32,105
Cash Flows from Investing Activities:    
Proceeds from sale of deferred compensation plan assets 100 239
Proceeds from the sale of property and equipment 126 590
Purchases of deferred compensation plan assets (74) (127)
Purchases of property and equipment (19,595) (20,241)
Purchase of Investment (6,227) 0
Acquisitions of businesses, net of cash acquired (627) (8,392)
Proceeds from dispositions of care centers 2,082 0
Net cash used in investing activities (24,215) (27,931)
Cash Flows from Financing Activities:    
Proceeds from issuance of stock upon exercise of stock options and warrants 113 145
Proceeds from issuance of stock to employee stock purchase plan 1,695 1,978
Non-controlling interest distribution (93) (105)
Proceeds from revolving line of credit 25,500 0
Repayments of revolving line of credit (25,500) 0
Principal payments of long-term obligations (27,904) (17,038)
Net cash used in financing activities (26,189) (15,020)
Net increase (decrease) in cash and cash equivalents 15,573 (10,846)
Cash and cash equivalents at beginning of period 14,545 48,004
Cash and cash equivalents at end of period 30,118 37,158
Supplemental Disclosures of Cash Flow Information:    
Cash paid for interest 2,006 3,494
Cash paid for income taxes, net of refunds received 3,135 1,470
Supplemental Disclosures of Non-Cash Financing and Investing Activities    
Acquired Noncontrolling Interest $ 167 $ 0
XML 31 R8.htm IDEA: XBRL DOCUMENT v2.4.0.8
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
6 Months Ended
Jun. 30, 2013
Accounting Policies [Abstract]  
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

2. Summary of Significant Accounting Policies

Revenue Recognition

We earn net service revenue through our home health and hospice care centers by providing a variety of services almost exclusively in the homes of our patients. This net service revenue is earned and billed either on an episode of care basis, on a per visit basis or on a daily basis depending upon the payment terms and conditions established with each payor for services provided. We refer to home health revenue earned and billed on a 60-day episode of care as episodic-based revenue.

When we record our service revenue, we record it net of estimated revenue adjustments and contractual adjustments to reflect amounts we estimate to be realizable for services provided, as discussed below. We believe, based on information currently available to us and based on our judgment, that changes to one or more factors that impact the accounting estimates (such as our estimates related to revenue adjustments, contractual adjustments and episodes in progress) we make in determining net service revenue, which changes are likely to occur from period to period, will not materially impact our reported consolidated financial condition, results of operations, cash flows or our future financial results.

Home Health Revenue Recognition

Medicare Revenue

Net service revenue is recorded under the Medicare prospective payment system (“PPS”) based on a 60-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a) an outlier payment if our patient's care was unusually costly (capped at 10% of total reimbursement per provider number); (b) a low utilization payment adjustment (“LUPA”) if the number of visits was fewer than five; (c) a partial payment if our patient transferred to another provider or we received a patient from another provider before completing the episode; (d) a payment adjustment based upon the level of therapy services required (with various incremental adjustments made for additional visits, with larger payment increases associated with the sixth, fourteenth and twentieth visit thresholds); (e) adjustments to payments if we are unable to produce documentation for the face-to-face encounter requirement; (f) adjustments to payments if we are unable to perform periodic therapy assessments; (g) the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (h) changes in the base episode payments established by the Medicare Program; (i) adjustments to the base episode payments for case mix and geographic wages; and (j) recoveries of overpayments.

We make adjustments to Medicare revenue on completed episodes to reflect differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation or authorizations acceptable to the payor and other reasons unrelated to credit risk. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record this estimate during the period in which services are rendered as an estimated revenue adjustment and a corresponding reduction to patient accounts receivable. In addition, management evaluates the potential for revenue adjustments and, when appropriate, provides allowances based upon the best available information. Therefore, we believe that our reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered.

In addition to revenue recognized on completed episodes, we also recognize a portion of revenue associated with episodes in progress. Episodes in progress are 60-day episodes of care that begin during the reporting period, but were not completed as of the end of the period. We estimate this revenue on a monthly basis based upon historical trends. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per episode and our estimate of the average percentage complete based on visits performed. As of June 30, 2013 and 2012, the difference between the cash received from Medicare for a request for anticipated payment (“RAP”) on episodes in progress and the associated estimated revenue was immaterial and, therefore, the resulting credits were recorded as a reduction to our outstanding patient accounts receivable in our condensed consolidated balance sheets for such periods.

Non-Medicare Revenue

Episodic-based Revenue. We recognize revenue in a similar manner as we recognize Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms.

Non-episodic based Revenue. Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates, as applicable. Contractual adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue and are also recorded as a reduction to our outstanding patient accounts receivable. In addition, we receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment.

Hospice Revenue Recognition

Hospice Medicare Revenue

Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are daily or hourly rates for each of the four levels of care we deliver. The four levels of care are routine care, general inpatient care, continuous home care and respite care. Routine care accounts for 99% of our total net Medicare hospice service revenue for the three and six-month periods ended June 30, 2013, as compared to 97% and 98% for the three and six-month periods ended June 30, 2012, respectively. We make adjustments to Medicare revenue for an inability to obtain appropriate billing documentation, acceptable authorizations or face to face documentation and other reasons unrelated to credit risk. We estimate the impact of these adjustments based on our historical experience, which primarily includes our historical collection rate on Medicare claims, and record it during the period services are rendered as an estimated revenue adjustment and as a reduction to our outstanding patient accounts receivable.

Additionally, as Medicare hospice revenue is subject to an inpatient cap limit and an overall payment cap for each provider number, we monitor these caps and estimate amounts due back to Medicare if a cap has been exceeded. We record these adjustments as a reduction to revenue and an increase in other accrued liabilities.  We have settled our Medicare hospice reimbursements for all fiscal years through October 31, 2011. For the Federal cap years ended October 31, 2012 and October 31, 2013, we have $4.0 million and $4.8 million recorded for estimated amounts due back to Medicare in other accrued liabilities as of June 30, 2013 and December 31, 2012, respectively. As a result of our adjustments, we believe our revenue and patients accounts receivable are recorded at amounts that will be ultimately realized.

Hospice Non-Medicare Revenue

We record gross revenue on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per day rates, as applicable. Contractual adjustments are recorded for the difference between our established rates and the amounts estimated to be realizable from patients, third parties and others for services provided and are deducted from gross revenue to determine our net service revenue and patient accounts receivable.

Patient Accounts Receivable

Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party payors and patients. There is no single payor, other than Medicare, that accounts for more than 10% of our total outstanding patient receivables, and thus we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We fully reserve for accounts which are aged at 365 days or greater. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible.

We believe the credit risk associated with our Medicare accounts, which represent 71% and 68% of our net patient accounts receivable at June 30, 2013 and December 31, 2012, respectively, is limited due to our historical collection rate of over 99% from Medicare and the fact that Medicare is a U.S. government payor. Accordingly, we do not record an allowance for doubtful accounts for our Medicare patient accounts receivable, which are recorded at their net realizable value after recording estimated revenue adjustments as discussed above. During the three and six-month periods ended June 30, 2013, we recorded $2.8 million and $6.6 million, respectively, in estimated revenue adjustments to Medicare as compared to $2.1 million and $4.7 million during the three and six-month periods ended June 30, 2012, respectively.

We believe there is a certain level of credit risk associated with non-Medicare payors. To provide for our non-Medicare patient accounts receivable that could become uncollectible in the future, we establish an allowance for doubtful accounts to reduce the carrying amount to its estimated net realizable value.

Medicare Home Health

For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for 60% of our estimated payment for the initial episode at the start of care or 50% of the estimated payment for any subsequent episodes of care contiguous with the first episode for a particular patient. The full amount of the episode is billed after the episode has been completed (“final billed”). The RAP received for that particular episode is then deducted from our final payment. If a final bill is not submitted within the greater of 120 days from the start of the episode, or 60 days from the date the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other claims in process for that particular provider number. The RAP and final claim must then be re-submitted.

Medicare Hospice

For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. Once each patient has been confirmed for eligibility, we will bill Medicare on a monthly basis for the services provided to the patient.

 

Non-Medicare Home Health and Hospice

For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient's eligibility for services with the applicable payor. Once the patient has been confirmed for eligibility, we will provide services to the patient and bill the applicable payor. Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular payors or groups of payors with similar characteristics that would subject us to any significant credit risk. We estimate an allowance for doubtful accounts based upon our assessment of historical and expected net collections, business and economic conditions, trends in payment and an evaluation of collectibility based upon the date that the service was provided. Based upon our best judgment, we believe the allowance for doubtful accounts adequately provides for accounts that will not be collected due to credit risk

Fair Value of Financial Instruments
            
The following details our financial instruments where the carrying value and the fair value differ (amounts in millions):
            
  Fair Value at Reporting Date Using
Financial Instrument As of June 30, 2013  Quoted Prices in Active Markets for Identical Items (Level 1)  Significant Other Observable Inputs (Level 2)  Significant Unobservable Inputs (Level 3)
Long-term obligations$74.8 $0 $75.1 $0

The estimates of the fair value of our long-term debt are based upon a discounted present value analysis of future cash flows. Due to the existing uncertainty in the capital and credit markets the actual rates that would be obtained to borrow under similar conditions could materially differ from the estimates we have used.

 

The fair value hierarchy is based on three levels of inputs, of which the first two are considered observable and the last unobservable, that may be used to measure fair value. The three levels of inputs are as follows:

 

  • Level 1 – Quoted prices in active markets for identical assets and liabilities.
  • Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
  • Level 3 – Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities.

 

For our other financial instruments, including our cash and cash equivalents, patient accounts receivable, accounts payable and accrued expenses, we estimate the carrying amounts' approximate fair value. Our deferred compensation plan assets are recorded at fair value.

Weighted-Average Shares Outstanding

 

Net income per share attributable to Amedisys, Inc. common stockholders, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The following table sets forth, for the periods indicated, shares used in our computation of the weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands):

   For the Three-Month Periods Ended June 30, For the Six-Month Periods Ended June 30,
   2013 2012 2013 2012
 Weighted average number of shares outstanding - basic31,160 29,780 30,900 29,584
 Effect of dilutive securities:       
  Stock options12 23 17 16
  Non-vested stock and stock units317 223 381 303
 Weighted average number of shares outstanding - diluted31,489 30,026 31,298 29,903
 Anti-dilutive securities217 531 217 595
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LONG-TERM OBLIGATIONS
6 Months Ended
Jun. 30, 2013
Debt Disclosure [Abstract]  
LONG-TERM OBLIGATIONS
5. LONG-TERM OBLIGATIONS
        
Long-term debt consisted of the following for the periods indicated (amounts in millions):
        
    June 30, 2013  December 31, 2012
Senior Notes:      
 $35.0 million Series A Notes: semi-annual interest only payments; interest rate at 6.07% per annum; due March 25, 2013 $0.0 $20.0
 $30.0 million Series B Notes: semi-annual interest only payments; interest rate at 6.28% per annum; due March 25, 2014  20.0  20.0
$60.0 million Term Loan; $3.0 million principal payments plus accrued interest payable quarterly; interest rate at ABR Rate plus applicable percentage or Eurodollar Rate plus the applicable percentage (2.45% at June 30, 2013); due October 26, 2017  51.0  57.0
Promissory notes  3.8  5.7
    74.8  102.7
Current portion of long-term obligations  (35.8)  (35.8)
 Total $39.0 $66.9
        

Our weighted average interest rate for our five year $60.0 million Term Loan was 2.6% and 2.7% for the three and six-month periods ended June 30, 2013, respectively.

 

Our Credit Agreement requires that our total leverage ratio cannot exceed 2.0 and our fixed charge coverage ratio to be greater than 1.25. As of June 30, 2013, our total leverage ratio was 1.01 and our fixed charge coverage ratio was 1.27. We currently anticipate we will be in compliance with the covenants associated with our long-term obligations over the next 12 months. In the event we are not in compliance with our debt covenants in the future, we would pursue various alternatives in an attempt to successfully resolve the non-compliance, which might include, among other things, seeking debt covenant waivers or amendments.

As of June 30, 2013, our availability under our $165.0 million Revolving Credit Facility is limited due to outstanding letters of credit of $21.7 million. The availability of the remaining $143.3 million undrawn portion of our Revolving Credit Facility is limited to $94.4 million due to the debt limitation associated with the leverage covenant which restricts overall debt to less than 2.0 times earnings before interest, taxes, depreciation and amortization as defined in our Credit Agreement.

XML 34 R14.xml IDEA: NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS (Policies) 2.4.0.8020010 - Disclosure - NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS (Policies)truefalsefalse1false falsefalseFROM_Jan01_2013_TO_Jun30_2013http://www.sec.gov/CIK0000896262duration2013-01-01T00:00:002013-06-30T00:00:001true 1us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstractus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalse1falsefalsefalse00falsefalsefalsexbrli:stringItemTypestringfalse02false 2us-gaap_BasisOfAccountingPolicyPolicyTextBlockus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1falsefalsefalse00<p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Basis of Presentation</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In our opinion, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations and our cash flows in accordance with U.S. Generally Accepted Accounting Principles (&#8220;U.S. GAAP&#8221;). Our results of operations for the interim periods presented are not necessarily indicative of results of our operations for the entire year and have not been audited by our independent auditors.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented. This report should be read in conjunction with our consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 201</font><font style="font-family:Times New Roman;font-size:10pt;">2</font><font style="font-family:Times New Roman;font-size:10pt;"> as filed with the Securities and Exchange Commission (&#8220;SEC&#8221;) on </font><font style="font-family:Times New Roman;font-size:10pt;">March 12</font><font style="font-family:Times New Roman;font-size:10pt;">, 201</font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;"> (the &#8220;Form 10-K&#8221;), which includes information and disclosures not included herein</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p>falsefalsefalsenonnum:textBlockItemTypenaDisclosure of accounting policy for basis of accounting, or basis of presentation, used to prepare the financial statements (for example, US Generally Accepted Accounting Principles, Other Comprehensive Basis of Accounting, IFRS).No definition available.false03false 2us-gaap_UseOfEstimatesus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1falsefalsefalse00<p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Use of Estimates </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our accounting and reporting policies conform with U.S.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">G</font><font style="font-family:Times New Roman;font-size:10pt;">AAP. In preparing the </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the</font><font style="font-family:Times New Roman;font-size:10pt;"> condensed</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates. </font></p>falsefalsefalsenonnum:textBlockItemTypenaDisclosure of accounting policy for the use of estimates in the preparation of financial statements in conformity with generally accepted accounting principles.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 9 -URI http://asc.fasb.org/extlink&oid=6927468&loc=d3e6143-108592 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 8 -URI http://asc.fasb.org/extlink&oid=6927468&loc=d3e6132-108592 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 275 -SubTopic 10 -Section 50 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=6927468&loc=d3e6061-108592 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher AICPA -Name Statement of Position (SOP) -Number 94-6 -Paragraph 11, 14 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false04false 2us-gaap_ComparabilityOfPriorYearFinancialDataus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1falsefalsefalse00<p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Reclassifications and Comparability</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Certain reclassifications have been made to prior period's financial statements in order to conform to the current period's presentation</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">W</font><font style="font-family:Times New Roman;font-size:10pt;">e exited three home health care centers</font><font style="font-family:Times New Roman;font-size:10pt;"> during 2012, and have </font><font style="font-family:Times New Roman;font-size:10pt;">committed to a plan to divest approximately 3</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers. In accordance with applicable accounting guidance</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> the results of operations for these care centers are presented in discontinued operations in our condensed consolidated financial statements. See Note </font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;"> for additional information regarding our discontinued operations.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">In addition</font><font style="font-family:Times New Roman;font-size:10pt;"> during 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, w</font><font style="font-family:Times New Roman;font-size:10pt;">e have consolidated </font><font style="font-family:Times New Roman;font-size:10pt;">2</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers with care centers servicing the same market</font><font style="font-family:Times New Roman;font-size:10pt;">s,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">which may affect the comparability of our operating results.</font></p><p style='margin-top:13.5pt; margin-bottom:0pt'>&#160;</p>falsefalsefalsenonnum:textBlockItemTypenaDisclosure of accounting policy for reporting any exceptions to the comparability of prior year financial data with data shown for the most recent accounting period.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 205 -SubTopic 10 -Section 45 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=7668296&loc=d3e288-107754 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher AICPA -Name Accounting Research Bulletin (ARB) -Number 43 -Section A -Paragraph 3 -Chapter 2 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false05false 2us-gaap_ConsolidationPolicyTextBlockus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1falsefalsefalse00<p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Principles of Consolidation </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">These </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements include the accounts of </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, Inc.</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements, and business combinations accounted for as purchases have been included in our</font><font style="font-family:Times New Roman;font-size:10pt;"> unaudited condensed</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">investments that are </font><font style="font-family:Times New Roman;font-size:10pt;">accounted for as set forth below</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p>falsefalsefalsenonnum:textBlockItemTypenaDisclosure of accounting policy regarding (1) the principles it follows in consolidating or combining the separate financial statements, including the principles followed in determining the inclusion or exclusion of subsidiaries or other entities in the consolidated or combined financial statements and (2) its treatment of interests (for example, common stock, a partnership interest or other means of exerting influence) in other entities, for example consolidation or use of the equity or cost methods of accounting. 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Reference 5: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 140 -Paragraph 46 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 6: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name FASB Interpretation (FIN) -Number 46R -Paragraph 4 -Subparagraph d -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 7: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 02, 03 -Article 3A Reference 8: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Emerging Issues Task Force (EITF) -Number 96-16 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 9: http://www.xbrl.org/2003/role/presentationRef -Publisher AICPA -Name Accounting Principles Board Opinion (APB) -Number 18 -Paragraph 20 -Subparagraph a(2) -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 10: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name FASB Interpretation (FIN) -Number 46R -Paragraph 14, 15 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 11: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section 50 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=6367646&loc=d3e18780-107790 Reference 12: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -URI http://asc.fasb.org/subtopic&trid=2197480 Reference 13: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=18733093&loc=d3e5614-111684 Reference 14: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 810 -SubTopic 10 -Section S99 -Paragraph 2 -Subparagraph (SX 210.3A-02) -URI http://asc.fasb.org/extlink&oid=6959686&loc=d3e355033-122828 Reference 15: http://www.xbrl.org/2003/role/presentationRef -Publisher AICPA -Name Accounting Research Bulletin (ARB) -Number 51 -Paragraph 2-6 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. 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Reference 16: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 860 -SubTopic 40 -Section 45 -URI http://asc.fasb.org/section&trid=2197723 Reference 17: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 323 -SubTopic 10 -URI http://asc.fasb.org/subtopic&trid=2196966 Reference 18: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 325 -SubTopic 20 -URI http://asc.fasb.org/subtopic&trid=2197087 Reference 19: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 323 -SubTopic 10 -Section 45 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=16385135&loc=d3e33801-111570 false06false 2us-gaap_EquityMethodInvestmentsPolicyus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1falsefalsefalse00<p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Investments </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We consolidate </font><font style="font-family:Times New Roman;font-size:10pt;">investments when the entity is a variable interest entity and </font><font style="font-family:Times New Roman;font-size:10pt;">we </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">%. Third party equity interests in our consolidated joint ventures are reflected as </font><font style="font-family:Times New Roman;font-size:10pt;">noncontrolling</font><font style="font-family:Times New Roman;font-size:10pt;"> interests in our </font><font style="font-family:Times New Roman;font-size:10pt;">condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">% or less of the voting stock and the entity is not a variable interest entity in which we are the primary </font><font style="font-family:Times New Roman;font-size:10pt;">beneficiary. The book value of </font><font style="font-family:Times New Roman;font-size:10pt;">investments </font><font style="font-family:Times New Roman;font-size:10pt;">that we accounted for under the equity method of accounting </font><font style="font-family:Times New Roman;font-size:10pt;">was $</font><font style="font-family:Times New Roman;font-size:10pt;">5.</font><font style="font-family:Times New Roman;font-size:10pt;">7</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">million</font><font style="font-family:Times New Roman;font-size:10pt;"> as of June 30, 2013 and $</font><font style="font-family:Times New Roman;font-size:10pt;">4.8 </font><font style="font-family:Times New Roman;font-size:10pt;">million as of De</font><font style="font-family:Times New Roman;font-size:10pt;">cember 31, 2012. We account for investments in entities in which we have less than a </font><font style="font-family:Times New Roman;font-size:10pt;">20</font><font style="font-family:Times New Roman;font-size:10pt;">% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. 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This disclosure may also include a detailed description of the policy for determining the amount of equity method losses recognized after an investment has been reduced to zero as a result of previous losses, reasons for not using the equity method when the investor company owns 20 percent or more of the voting stock of the investee's company (including identification of the significant investee), reasons for using the equity method when the ownership percentage is less than 20 percent, and discussion of recognition of equity method losses when an investor's total investment in an investee includes, in addition to an investment in common stock, other investments such as preferred stock and loans to the investee. An entity also may describe how such investments are assessed for impairment.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Emerging Issues Task Force (EITF) -Number 02-14 -Paragraph 6 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Emerging Issues Task Force (EITF) -Number D-46 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. 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Reference 5: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section 50 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=6367646&loc=d3e18780-107790 Reference 6: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 210 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.5-02.12) -URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682 Reference 7: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 323 -SubTopic 10 -URI http://asc.fasb.org/subtopic&trid=2196966 Reference 8: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Regulation S-X (SX) -Number 210 -Section 02 -Paragraph 12 -Article 5 Reference 9: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 825 -SubTopic 10 -Section 50 -Paragraph 28 -Subparagraph (f) -URI http://asc.fasb.org/extlink&oid=6957238&loc=d3e14064-108612 Reference 10: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 159 -Paragraph 18 -Subparagraph f -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 11: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 323 -SubTopic 10 -Section 50 -Paragraph 3 -Subparagraph (a)(2) -URI http://asc.fasb.org/extlink&oid=6382943&loc=d3e33918-111571 Reference 12: http://www.xbrl.org/2003/role/presentationRef -Publisher AICPA -Name Accounting Principles Board Opinion (APB) -Number 18 -Paragraph 5, 6, 16-20 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 13: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Emerging Issues Task Force (EITF) -Number 98-13 -Paragraph 5, 15 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. false07false 2us-gaap_RevenueRecognitionPolicyTextBlockus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1falsefalsefalse00<p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Revenue Recognition</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;"> </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We earn net service revenue through our home health and hospice </font><font style="font-family:Times New Roman;font-size:10pt;">care center</font><font style="font-family:Times New Roman;font-size:10pt;">s by providing a variety of services almost exclusively in the homes of our patients. This net service revenue is earned and billed either on an episode of care basis, on a per visit basis or on a daily basis depending upon the payment terms and conditions established with each </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;"> for services provided. We refer to home health revenue earned and billed on a </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episode of care as episodic-based revenue. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">When we record our service revenue, we record it net of estimated revenue adjustments and contractual adjustments to reflect amounts we estimate to be realizable for services provided, as discussed below. We believe, based on information currently available to us and based on our judgment, that changes to one or more factors that impact the accounting estimates (such as our estimates related to revenue adjustments, contractual adjustments and episodes in progress) we make in determining net service revenue, which changes are likely to occur from period to period, will not materially impact our reported consolidated financial condition, results of operations, cash flows or our future financial results. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Home Health Revenue Recognition</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Net service revenue is recorded under the Medicare prospective payment system (&#8220;PPS&#8221;) based on a </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a)&#160;an outlier payment if our patient's care was unusually costly (capped at </font><font style="font-family:Times New Roman;font-size:10pt;">10</font><font style="font-family:Times New Roman;font-size:10pt;">% of total reimbursement per provider number); (b)&#160;a low utilization payment adjustment (&#8220;LUPA&#8221;) if the number of visits was fewer than five; (c)&#160;a partial payment if our patient transferred to another provider or we received a patient from another provider before completing the episode; (d)&#160;a payment adjustment based upon the level of therapy services required (</font><font style="font-family:Times New Roman;font-size:10pt;">with various incremental adjustments made for additional visits, with larger payment increases associated with the sixth, fourteenth and twentieth visit thresholds</font><font style="font-family:Times New Roman;font-size:10pt;">); </font><font style="font-family:Times New Roman;font-size:10pt;">(e) adjustments to payments if we are unable to produce documentation for the face-to-face encounter requirement; (f) adjustments to payments if we are unable to perform periodic therapy assessments; </font><font style="font-family:Times New Roman;font-size:10pt;">(</font><font style="font-family:Times New Roman;font-size:10pt;">g</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (</font><font style="font-family:Times New Roman;font-size:10pt;">h</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;changes in the base episode payments established by the Medicare Program; (</font><font style="font-family:Times New Roman;font-size:10pt;">i</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;adjustments to the base episode payments for case mix and geographic wages; and (</font><font style="font-family:Times New Roman;font-size:10pt;">j</font><font style="font-family:Times New Roman;font-size:10pt;">)&#160;recoveries of overpayments. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We make adjustments to Medicare revenue on completed episodes to reflect</font><font style="font-family:Times New Roman;font-size:10pt;"> differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation or authorizations acceptable to the </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;"> and other reasons unrelated to credit risk. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of </font><font style="font-family:Times New Roman;font-size:10pt;">over </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> on</font><font style="font-family:Times New Roman;font-size:10pt;"> Medicare claims, and record this estimate during the period in which services are rendered as an estimated revenue adjustment and a corresponding reduction to patient accounts receivable. In addition, management evaluates the potential for revenue adjustments and, when appropriate, provides allowances based upon the best available information. Therefore, we believe that our reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In addition to revenue recognized on completed episodes, we also recognize a portion of revenue associated with episodes in progress. Episodes in progress are </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">-day episodes of care that begin during the reporting period, but were not completed as of the end of the period. We estimate this revenue on a monthly basis based upon historical trends. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per episode and our estimate of the average percentage complete based on visits performed. As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, the difference between the cash received from Medicare for a request for anticipated payment (&#8220;RAP&#8221;) on episodes in progress and the associated estimated revenue was immaterial and, therefore, the resulting credits were recorded as a reduction to our outstanding pa</font><font style="font-family:Times New Roman;font-size:10pt;">tient accounts receivable in our condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated balance sheets for such periods. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Non-Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Episodic-based Revenue. </font><font style="font-family:Times New Roman;font-size:10pt;">We recognize revenue in a similar manner as we recognize Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Non-episodic </font><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;">b</font><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;">ased Revenue. </font><font style="font-family:Times New Roman;font-size:10pt;">Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates, as applicable. Contractual adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue and are also recorded as a reduction to our outstanding patient accounts receivable. In addition, we receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Hospice Revenue Recognition </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Hospice Medicare Revenue </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are daily or hourly rates for each of the four levels of care we deliver. The four levels of care</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">are routine care, general inpatient care, continuous home care and respite care. Routine care accounts </font><font style="font-family:Times New Roman;font-size:10pt;">for </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">of our</font><font style="font-family:Times New Roman;font-size:10pt;"> total net Medicare hospice service revenue for the</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">three </font><font style="font-family:Times New Roman;font-size:10pt;">and six-</font><font style="font-family:Times New Roman;font-size:10pt;">mon</font><font style="font-family:Times New Roman;font-size:10pt;">th</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, as compared to </font><font style="font-family:Times New Roman;font-size:10pt;">97</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and 98% </font><font style="font-family:Times New Roman;font-size:10pt;">for the three and six-month periods ended June 30, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">We make adjustmen</font><font style="font-family:Times New Roman;font-size:10pt;">ts to Medicare revenue for an inability to obtain appropriate billing documentation</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">acceptable </font><font style="font-family:Times New Roman;font-size:10pt;">authorizations</font><font style="font-family:Times New Roman;font-size:10pt;"> or face to face documentation and</font><font style="font-family:Times New Roman;font-size:10pt;"> other reasons unrelated to credit risk. We estimate the impact of these adjustments based on our historical experience, which primarily includes our historical collection rate on Medicare claims, and record it during the period services are rendered as an estimated revenue adjustment and as a reduction to our outstanding patient accounts receivable. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Additionally, as Medicare hospice revenue is subject to an inpatient cap limit and an overall payment cap for each provider number, we monitor these caps and estimate amounts due back to Medicare if a cap has been exceeded.&#160;We record these adjustments as a reduction to revenue and an increase in other accrued liabilities.&#160; We have settled our Medicare hospice reimbursements for all fiscal y</font><font style="font-family:Times New Roman;font-size:10pt;">ears through October 31, 20</font><font style="font-family:Times New Roman;font-size:10pt;">11</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">For the </font><font style="font-family:Times New Roman;font-size:10pt;">Federal </font><font style="font-family:Times New Roman;font-size:10pt;">cap years ended October 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and</font><font style="font-family:Times New Roman;font-size:10pt;"> October 31, </font><font style="font-family:Times New Roman;font-size:10pt;">201</font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;">, we </font><font style="font-family:Times New Roman;font-size:10pt;">have $</font><font style="font-family:Times New Roman;font-size:10pt;">4.0</font><font style="font-family:Times New Roman;font-size:10pt;"> million</font><font style="font-family:Times New Roman;font-size:10pt;"> and $</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> million </font><font style="font-family:Times New Roman;font-size:10pt;">recorded for estimated amounts due back to Medicare in other accrued liabilities as of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and </font><font style="font-family:Times New Roman;font-size:10pt;">December 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">As a result of our adjustments, we believe our revenue and patients accounts receivable are recorded at amounts that will be ultimately realized. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;text-decoration:underline;margin-left:0px;">Hospice Non-Medicare Revenue </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We record gross revenue on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per </font><font style="font-family:Times New Roman;font-size:10pt;">day </font><font style="font-family:Times New Roman;font-size:10pt;">rates, as applicable. Contractual adjustments are recorded for the difference between our established rates and the amounts estimated to be realizable from patients, third parties and others for services provided and are deducted from gross revenue to determine our net service revenue and patient accounts receivable</font></p>falsefalsefalsenonnum:textBlockItemTypenaDisclosure of accounting policy for revenue recognition. If the entity has different policies for different types of revenue transactions, the policy for each material type of transaction is generally disclosed. If a sales transaction has multiple element arrangements (for example, delivery of multiple products, services or the rights to use assets) the disclosure may indicate the accounting policy for each unit of accounting as well as how units of accounting are determined and valued. The disclosure may encompass important judgment as to appropriateness of principles related to recognition of revenue. The disclosure also may indicate the entity's treatment of any unearned or deferred revenue that arises from the transaction.Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section 50 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=6367646&loc=d3e18780-107790 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=6367646&loc=d3e18726-107790 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Staff Accounting Bulletin (SAB) -Number Topic 13 -Section B -Paragraph Question 1 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 605 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SAB TOPIC 13.B.Q1) -URI http://asc.fasb.org/extlink&oid=6600647&loc=d3e214044-122780 Reference 5: http://www.xbrl.org/2003/role/presentationRef -Publisher AICPA -Name Accounting Principles Board Opinion (APB) -Number 22 -Paragraph 8, 12, 13 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 6: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section 50 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=6367646&loc=d3e18823-107790 false08false 2us-gaap_TradeAndOtherAccountsReceivablePolicyus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1falsefalsefalse00<p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Patient Accounts Receivable </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;"> and patients. </font><font style="font-family:Times New Roman;font-size:10pt;">There is no single </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">, other than Medicare, that accounts for more than </font><font style="font-family:Times New Roman;font-size:10pt;">10</font><font style="font-family:Times New Roman;font-size:10pt;">% of our total</font><font style="font-family:Times New Roman;font-size:10pt;"> outstanding patient receivables, and thus we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We fully reserve for accounts which are aged at </font><font style="font-family:Times New Roman;font-size:10pt;">36</font><font style="font-family:Times New Roman;font-size:10pt;">5</font><font style="font-family:Times New Roman;font-size:10pt;"> days or greater. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible. </font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We believe the credit risk associated with our Medicare accounts</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">which represent </font><font style="font-family:Times New Roman;font-size:10pt;">71% and </font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;">%</font><font style="font-family:Times New Roman;font-size:10pt;"> of our</font><font style="font-family:Times New Roman;font-size:10pt;"> net patient accounts receivable at </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">December 31, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">respectively, </font><font style="font-family:Times New Roman;font-size:10pt;">is limited due to our historical collection rate of over </font><font style="font-family:Times New Roman;font-size:10pt;">99</font><font style="font-family:Times New Roman;font-size:10pt;">% </font><font style="font-family:Times New Roman;font-size:10pt;">from Medicare and the fact that Medicare is a U.S. government </font><font style="font-family:Times New Roman;font-size:10pt;">payor</font><font style="font-family:Times New Roman;font-size:10pt;">. Accordingly, we do not record an allowance for doubtful accounts for our Medicare patient accounts receivable, which are recorded at their net realizable value after recording estimated revenue </font><font style="font-family:Times New Roman;font-size:10pt;">adjustments as discussed above. </font><font style="font-family:Times New Roman;font-size:10pt;">During the three </font><font style="font-family:Times New Roman;font-size:10pt;">and six-</font><font style="font-family:Times New Roman;font-size:10pt;">month</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we recorded $2.</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> million and $</font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">6</font><font style="font-family:Times New Roman;font-size:10pt;"> million, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> in estimated revenue adjustments to Medicare as compared to $2.</font><font style="font-family:Times New Roman;font-size:10pt;">1</font><font style="font-family:Times New Roman;font-size:10pt;"> million and $</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;">7</font><font style="font-family:Times New Roman;font-size:10pt;"> million during the three and six-month periods ended June 30, </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">respectively.</font></p><p style='margin-top:9pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We believe there is a certain level of credit risk associated with non-Medicare </font><font style="font-family:Times New Roman;font-size:10pt;">payors</font><font style="font-family:Times New Roman;font-size:10pt;">. To provide for our non-Medicare patient accounts receivable that could become uncollectible in the future, we establish an allowance for doubtful accounts to reduce the carrying amount to its estimated net realizable value.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Medicare Home Health </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;">% of our estimated payment for the initial episode at the start of care or </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">% of the estimated payment for any subsequent episodes of care contiguous with the first episode for a particular patient. The full amount of the episode is billed after the episode has been completed (&#8220;final billed&#8221;). The RAP received for that particular episode is then deducted from our final payment. If a final bill is not submitted within the greater of </font><font style="font-family:Times New Roman;font-size:10pt;">120</font><font style="font-family:Times New Roman;font-size:10pt;"> days from the start of the episode, or </font><font style="font-family:Times New Roman;font-size:10pt;">60</font><font style="font-family:Times New Roman;font-size:10pt;"> days from the date the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other claims in process for that particular provider number. The RAP and final claim must then be re-submitted. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-style:italic;margin-left:0px;">Medicare Hospice </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services t</font><font style="font-family:Times New Roman;font-size:10pt;">hat we provide to our patients. 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DISCONTINUED OPERATIONS
6 Months Ended
Jun. 30, 2013
Discontinued Operation, Additional Disclosures [Abstract]  
DISCONTINUED OPERATIONS

3. DISCONTINUED OPERATIONS AND ASSETS HELD FOR SALE

As part of our management of our portfolio of care centers, we review each care center's current financial performance, market penetration, forecasted market growth and the impact of proposed CMS payment revisions. As a result of our review, during the three-month period ended June 30, 2013, we committed to a plan to divest approximately 50 care centers; therefore, as of June 30, 2013, we classified 34 care centers as held for sale (33 home health care centers and one hospice care center) and consolidated 19 care centers (17 home health care centers and two hospice care centers) with care centers servicing the same markets. In addition, we sold assets associated with two home health care centers and one hospice care center.

As we are exiting certain selected geographical areas and in accordance with applicable accounting guidance, the 34 care centers which are held for sale and the three care centers sold are presented as discontinued operations in our condensed consolidated financial statements. The 19 care centers consolidated with care centers servicing the same markets are presented in continuing operations as we expect continuing cash flows from these markets. For additional information on the care centers consolidated with care centers servicing the same markets and the care centers sold see Note 4 Exit Activities.

As of June 30, 2013, assets held for sale included $0.5 million in fixed assets, net, $0.3 million in intangible assets and $0.7 million in goodwill.

 

Net revenues and operating results for the periods presented for the care centers classified as discontinued operations are as follows (dollars in millions):  
                
    For the Three-Month Periods Ended June 30,  For the Six-Month Periods Ended June 30,  
    2013  2012  2013  2012  
                
 Net revenues $11.7 $15.3 $24.8 $30.4  
 (Loss) before income taxes  (0.8)  0.0  (1.6)  (2.4)  
 Income tax benefit  0.3  0.0  0.6  1.0  
 Discontinued operations, net of tax $(0.5) $0.0 $(1.0) $(1.4)  
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Long Term Debt (Parenthetical) (Detail) (USD $)
In Millions, unless otherwise specified
6 Months Ended
Jun. 30, 2013
Series A Notes [Member]
 
Debt Instrument [Line Items]  
Principal amount $ 35.0
Senior long-term notes, interest rate 6.07%
Maturity date Mar. 25, 2013
Series B Notes [Member]
 
Debt Instrument [Line Items]  
Principal amount 30.0
Senior long-term notes, interest rate 6.28%
Maturity date Mar. 25, 2014
Term Loan [Member]
 
Debt Instrument [Line Items]  
Principal amount 60.0
Eurodollar Rate plus the applicable percentage 2.45%
Maturity date Oct. 26, 2017
Debt Instrument Periodic Payment Principal $ 3.0
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margin-bottom:10pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;margin-left:0px;">4</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">. </font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">EXIT ACTIVITIES</font></p><p style='margin-top:0pt; margin-bottom:10pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Effective April 1, 2013, the Company sold assets associated with certain home health care centers in Alaska and Washington, as well as a hospice care center in Washington for cash consideration of approximately $</font><font style="font-family:Times New Roman;font-size:10pt;">1.6</font><font style="font-family:Times New Roman;font-size:10pt;"> million and recognized a gain of approximately $</font><font style="font-family:Times New Roman;font-size:10pt;">1.0</font><font style="font-family:Times New Roman;font-size:10pt;"> million. </font></p><p style='margin-top:0pt; margin-bottom:10pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Effective June 7, 2013, the Company sold its membership interest in one of our unconsolidated joint ventures for cash consideration of approximately $</font><font style="font-family:Times New Roman;font-size:10pt;">0.5 </font><font style="font-family:Times New Roman;font-size:10pt;">million and recognized a loss of approximately $</font><font style="font-family:Times New Roman;font-size:10pt;">0.7</font><font style="font-family:Times New Roman;font-size:10pt;"> million.</font></p><p style='margin-top:0pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In connection with the</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">1</font><font style="font-family:Times New Roman;font-size:10pt;">9</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers we consolidated</font><font style="font-family:Times New Roman;font-size:10pt;">, </font><font style="font-family:Times New Roman;font-size:10pt;">we recorded charges of $</font><font style="font-family:Times New Roman;font-size:10pt;">2.3</font><font style="font-family:Times New Roman;font-size:10pt;"> million in depreciation and amortization expense related to the write-off of intangible assets</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> $</font><font style="font-family:Times New Roman;font-size:10pt;">0.8</font><font style="font-family:Times New Roman;font-size:10pt;"> million in </font><font style="font-family:Times New Roman;font-size:10pt;">other general and administrative expenses related to </font><font style="font-family:Times New Roman;font-size:10pt;">lease termination costs</font><font style="font-family:Times New Roman;font-size:10pt;"> and $</font><font style="font-family:Times New Roman;font-size:10pt;">0.7</font><font style="font-family:Times New Roman;font-size:10pt;"> million in salaries and benefits related to severance costs</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">during the three-month period ended June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p>falsefalsefalsenonnum:textBlockItemTypenaThe entire disclosure for restructuring and related activities. 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In Thousands, except Share data, unless otherwise specified
Jun. 30, 2013
Dec. 31, 2012
Patient accounts receivable, allowance for doubtful accounts $ 17,610 $ 20,994
Property and equipment, accumulated depreciation 120,012 113,154
Intangible assets, accumulated amortization $ 24,560 $ 23,457
Preferred stock, par value $ 0.001 $ 0.001
Preferred stock, shares authorized 5,000,000 5,000,000
Preferred stock, issued 0 0
Preferred stock, outstanding 0 0
Common Stock, par value $ 0.001 $ 0.001
Common Stock, shares authorized 60,000,000 60,000,000
Common Stock, shares issued 32,973,576 31,876,508
Common Stock, shares outstanding 32,106,174 31,086,619
Treasury Stock at cost, shares 867,402 789,889

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NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS (Policies)
6 Months Ended
Jun. 30, 2013
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Basis of Presentation

Basis of Presentation

In our opinion, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations and our cash flows in accordance with U.S. Generally Accepted Accounting Principles (“U.S. GAAP”). Our results of operations for the interim periods presented are not necessarily indicative of results of our operations for the entire year and have not been audited by our independent auditors.

Certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented. This report should be read in conjunction with our consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2012 as filed with the Securities and Exchange Commission (“SEC”) on March 12, 2013 (the “Form 10-K”), which includes information and disclosures not included herein.

Use of Estimates

Use of Estimates

Our accounting and reporting policies conform with U.S. GAAP. In preparing the unaudited condensed consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the condensed consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates.

Reclassifications and Comparability

Reclassifications and Comparability

Certain reclassifications have been made to prior period's financial statements in order to conform to the current period's presentation. We exited three home health care centers during 2012, and have committed to a plan to divest approximately 34 care centers. In accordance with applicable accounting guidance, the results of operations for these care centers are presented in discontinued operations in our condensed consolidated financial statements. See Note 3 for additional information regarding our discontinued operations. In addition during 2013, we have consolidated 28 care centers with care centers servicing the same markets, which may affect the comparability of our operating results.

 

Principles of Consolidation

Principles of Consolidation

These unaudited condensed consolidated financial statements include the accounts of Amedisys, Inc., and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying unaudited condensed consolidated financial statements, and business combinations accounted for as purchases have been included in our unaudited condensed consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain investments that are accounted for as set forth below.

Equity Investments

Investments

We consolidate investments when the entity is a variable interest entity and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50%. Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our condensed consolidated financial statements.

We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a variable interest entity in which we are the primary beneficiary. The book value of investments that we accounted for under the equity method of accounting was $5.7 million as of June 30, 2013 and $4.8 million as of December 31, 2012. We account for investments in entities in which we have less than a 20% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. The aggregate carrying amount of our cost method investment, which was acquired during the three-month period ended March 31, 2013, was $5.0 million as of June 30, 2013.

Revenue Recognition

Revenue Recognition

We earn net service revenue through our home health and hospice care centers by providing a variety of services almost exclusively in the homes of our patients. This net service revenue is earned and billed either on an episode of care basis, on a per visit basis or on a daily basis depending upon the payment terms and conditions established with each payor for services provided. We refer to home health revenue earned and billed on a 60-day episode of care as episodic-based revenue.

When we record our service revenue, we record it net of estimated revenue adjustments and contractual adjustments to reflect amounts we estimate to be realizable for services provided, as discussed below. We believe, based on information currently available to us and based on our judgment, that changes to one or more factors that impact the accounting estimates (such as our estimates related to revenue adjustments, contractual adjustments and episodes in progress) we make in determining net service revenue, which changes are likely to occur from period to period, will not materially impact our reported consolidated financial condition, results of operations, cash flows or our future financial results.

Home Health Revenue Recognition

Medicare Revenue

Net service revenue is recorded under the Medicare prospective payment system (“PPS”) based on a 60-day episode payment rate that is subject to adjustment based on certain variables including, but not limited to: (a) an outlier payment if our patient's care was unusually costly (capped at 10% of total reimbursement per provider number); (b) a low utilization payment adjustment (“LUPA”) if the number of visits was fewer than five; (c) a partial payment if our patient transferred to another provider or we received a patient from another provider before completing the episode; (d) a payment adjustment based upon the level of therapy services required (with various incremental adjustments made for additional visits, with larger payment increases associated with the sixth, fourteenth and twentieth visit thresholds); (e) adjustments to payments if we are unable to produce documentation for the face-to-face encounter requirement; (f) adjustments to payments if we are unable to perform periodic therapy assessments; (g) the number of episodes of care provided to a patient, regardless of whether the same home health provider provided care for the entire series of episodes; (h) changes in the base episode payments established by the Medicare Program; (i) adjustments to the base episode payments for case mix and geographic wages; and (j) recoveries of overpayments.

We make adjustments to Medicare revenue on completed episodes to reflect differences between estimated and actual payment amounts, an inability to obtain appropriate billing documentation or authorizations acceptable to the payor and other reasons unrelated to credit risk. We estimate the impact of such adjustments based on our historical experience, which primarily includes a historical collection rate of over 99% on Medicare claims, and record this estimate during the period in which services are rendered as an estimated revenue adjustment and a corresponding reduction to patient accounts receivable. In addition, management evaluates the potential for revenue adjustments and, when appropriate, provides allowances based upon the best available information. Therefore, we believe that our reported net service revenue and patient accounts receivable will be the net amounts to be realized from Medicare for services rendered.

In addition to revenue recognized on completed episodes, we also recognize a portion of revenue associated with episodes in progress. Episodes in progress are 60-day episodes of care that begin during the reporting period, but were not completed as of the end of the period. We estimate this revenue on a monthly basis based upon historical trends. The primary factors underlying this estimate are the number of episodes in progress at the end of the reporting period, expected Medicare revenue per episode and our estimate of the average percentage complete based on visits performed. As of June 30, 2013 and 2012, the difference between the cash received from Medicare for a request for anticipated payment (“RAP”) on episodes in progress and the associated estimated revenue was immaterial and, therefore, the resulting credits were recorded as a reduction to our outstanding patient accounts receivable in our condensed consolidated balance sheets for such periods.

Non-Medicare Revenue

Episodic-based Revenue. We recognize revenue in a similar manner as we recognize Medicare revenue for episodic-based rates that are paid by other insurance carriers, including Medicare Advantage programs; however, these rates can vary based upon the negotiated terms.

Non-episodic based Revenue. Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to our established or estimated per-visit rates, as applicable. Contractual adjustments are recorded for the difference between our standard rates and the contracted rates to be realized from patients, third parties and others for services provided and are deducted from gross revenue to determine net service revenue and are also recorded as a reduction to our outstanding patient accounts receivable. In addition, we receive a minimal amount of our net service revenue from patients who are either self-insured or are obligated for an insurance co-payment.

Hospice Revenue Recognition

Hospice Medicare Revenue

Gross revenue is recorded on an accrual basis based upon the date of service at amounts equal to the estimated payment rates. The estimated payment rates are daily or hourly rates for each of the four levels of care we deliver. The four levels of care are routine care, general inpatient care, continuous home care and respite care. Routine care accounts for 99% of our total net Medicare hospice service revenue for the three and six-month periods ended June 30, 2013, as compared to 97% and 98% for the three and six-month periods ended June 30, 2012, respectively. We make adjustments to Medicare revenue for an inability to obtain appropriate billing documentation, acceptable authorizations or face to face documentation and other reasons unrelated to credit risk. We estimate the impact of these adjustments based on our historical experience, which primarily includes our historical collection rate on Medicare claims, and record it during the period services are rendered as an estimated revenue adjustment and as a reduction to our outstanding patient accounts receivable.

Additionally, as Medicare hospice revenue is subject to an inpatient cap limit and an overall payment cap for each provider number, we monitor these caps and estimate amounts due back to Medicare if a cap has been exceeded. We record these adjustments as a reduction to revenue and an increase in other accrued liabilities.  We have settled our Medicare hospice reimbursements for all fiscal years through October 31, 2011. For the Federal cap years ended October 31, 2012 and October 31, 2013, we have $4.0 million and $4.8 million recorded for estimated amounts due back to Medicare in other accrued liabilities as of June 30, 2013 and December 31, 2012, respectively. As a result of our adjustments, we believe our revenue and patients accounts receivable are recorded at amounts that will be ultimately realized.

Hospice Non-Medicare Revenue

We record gross revenue on an accrual basis based upon the date of service at amounts equal to our established rates or estimated per day rates, as applicable. Contractual adjustments are recorded for the difference between our established rates and the amounts estimated to be realizable from patients, third parties and others for services provided and are deducted from gross revenue to determine our net service revenue and patient accounts receivable

Patient Accounts Receivable

Patient Accounts Receivable

Our patient accounts receivable are uncollateralized and consist of amounts due from Medicare, Medicaid, other third-party payors and patients. There is no single payor, other than Medicare, that accounts for more than 10% of our total outstanding patient receivables, and thus we believe there are no other significant concentrations of receivables that would subject us to any significant credit risk in the collection of our patient accounts receivable. We fully reserve for accounts which are aged at 365 days or greater. We write off accounts on a monthly basis once we have exhausted our collection efforts and deem an account to be uncollectible.

We believe the credit risk associated with our Medicare accounts, which represent 71% and 68% of our net patient accounts receivable at June 30, 2013 and December 31, 2012, respectively, is limited due to our historical collection rate of over 99% from Medicare and the fact that Medicare is a U.S. government payor. Accordingly, we do not record an allowance for doubtful accounts for our Medicare patient accounts receivable, which are recorded at their net realizable value after recording estimated revenue adjustments as discussed above. During the three and six-month periods ended June 30, 2013, we recorded $2.8 million and $6.6 million, respectively, in estimated revenue adjustments to Medicare as compared to $2.1 million and $4.7 million during the three and six-month periods ended June 30, 2012, respectively.

We believe there is a certain level of credit risk associated with non-Medicare payors. To provide for our non-Medicare patient accounts receivable that could become uncollectible in the future, we establish an allowance for doubtful accounts to reduce the carrying amount to its estimated net realizable value.

Medicare Home Health

For our home health patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. We submit a RAP for 60% of our estimated payment for the initial episode at the start of care or 50% of the estimated payment for any subsequent episodes of care contiguous with the first episode for a particular patient. The full amount of the episode is billed after the episode has been completed (“final billed”). The RAP received for that particular episode is then deducted from our final payment. If a final bill is not submitted within the greater of 120 days from the start of the episode, or 60 days from the date the RAP was paid, any RAPs received for that episode will be recouped by Medicare from any other claims in process for that particular provider number. The RAP and final claim must then be re-submitted.

Medicare Hospice

For our hospice patients, our pre-billing process includes verifying that we are eligible for payment from Medicare for the services that we provide to our patients. Our Medicare billing begins with a process to ensure that our billings are accurate through the utilization of an electronic Medicare claim review. Once each patient has been confirmed for eligibility, we will bill Medicare on a monthly basis for the services provided to the patient.

 

Non-Medicare Home Health and Hospice

For our non-Medicare patients, our pre-billing process primarily begins with verifying a patient's eligibility for services with the applicable payor. Once the patient has been confirmed for eligibility, we will provide services to the patient and bill the applicable payor. Our review and evaluation of non-Medicare accounts receivable includes a detailed review of outstanding balances and special consideration to concentrations of receivables from particular payors or groups of payors with similar characteristics that would subject us to any significant credit risk. We estimate an allowance for doubtful accounts based upon our assessment of historical and expected net collections, business and economic conditions, trends in payment and an evaluation of collectibility based upon the date that the service was provided. Based upon our best judgment, we believe the allowance for doubtful accounts adequately provides for accounts that will not be collected due to credit risk.

Fair Value of Financial Instruments
Fair Value of Financial Instruments
            
The following details our financial instruments where the carrying value and the fair value differ (amounts in millions):
            
  Fair Value at Reporting Date Using
Financial Instrument As of June 30, 2013  Quoted Prices in Active Markets for Identical Items (Level 1)  Significant Other Observable Inputs (Level 2)  Significant Unobservable Inputs (Level 3)
Long-term obligations$74.8 $0 $75.1 $0

The estimates of the fair value of our long-term debt are based upon a discounted present value analysis of future cash flows. Due to the existing uncertainty in the capital and credit markets the actual rates that would be obtained to borrow under similar conditions could materially differ from the estimates we have used.

 

The fair value hierarchy is based on three levels of inputs, of which the first two are considered observable and the last unobservable, that may be used to measure fair value. The three levels of inputs are as follows:

 

  • Level 1 – Quoted prices in active markets for identical assets and liabilities.
  • Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
  • Level 3 – Unobservable inputs that are supported by little or no market activity and are significant to the fair value of the assets or liabilities.

 

For our other financial instruments, including our cash and cash equivalents, patient accounts receivable, accounts payable and accrued expenses, we estimate the carrying amounts' approximate fair value. Our deferred compensation plan assets are recorded at fair value.

Weighted-Average Shares Outstanding

Weighted-Average Shares Outstanding

 

Net income per share attributable to Amedisys, Inc. common stockholders, calculated on the treasury stock method, is based on the weighted average number of shares outstanding during the period. The following table sets forth, for the periods indicated, shares used in our computation of the weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands):

   For the Three-Month Periods Ended June 30, For the Six-Month Periods Ended June 30,
   2013 2012 2013 2012
 Weighted average number of shares outstanding - basic31,160 29,780 30,900 29,584
 Effect of dilutive securities:       
  Stock options12 23 17 16
  Non-vested stock and stock units317 223 381 303
 Weighted average number of shares outstanding - diluted31,489 30,026 31,298 29,903
 Anti-dilutive securities217 531 217 595
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CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (USD $)
In Thousands, unless otherwise specified
3 Months Ended 6 Months Ended
Jun. 30, 2013
Jun. 30, 2012
Jun. 30, 2013
Jun. 30, 2012
Statement of Other Comprehensive Income [Abstract]        
Net income $ 1,848 $ 7,966 $ 3,980 $ 13,429
Unrealized gain on deferred compensation plan assets 0 0 0 2
Comprehensive income 1,848 7,966 3,980 13,431
Net loss (income) attributable to noncontrolling interests (7) (84) 539 (127)
Comprehensive income attributable to Amedisys, Inc. $ 1,841 $ 7,882 $ 4,519 $ 13,304
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CONDENSED CONSOLIDATED BALANCE SHEETS (USD $)
In Thousands, unless otherwise specified
Jun. 30, 2013
Dec. 31, 2012
Current assets:    
Cash and cash equivalents $ 30,118 $ 14,545
Patient accounts receivable, net of allowance for doubtful accounts of $17,610, and $20,994 124,766 169,172
Prepaid expenses 13,369 10,631
Other current assets 12,006 11,440
Assets Held-for-sale 1,550 0
Total current assets 181,809 205,788
Property and equipment, net of accumulated depreciation of $120,012 and $113,154 156,887 156,709
Goodwill 209,260 209,594
Intangible assets, net of accumulated amortization of $24,560 and $23,457 43,109 47,050
Deferred tax asset 85,256 92,804
Other assets, net 23,932 18,650
Total assets 700,253 730,595
Current liabilities:    
Accounts payable 21,658 29,175
Payroll and employee benefits 76,205 79,341
Accrued expenses 54,175 54,855
Current portion of long-term obligations 35,807 35,807
Current portion of deferred income taxes 3,169 5,609
Total current liabilities 191,014 204,787
Long-term obligations, less current portion 39,000 66,904
Other long-term obligations 5,209 4,671
Total liabilities 235,223 276,362
Commitments and Contingencies - 0 0
Equity:    
Preferred stock, $0.001 par value, 5,000,000 shares authorized; none issued or outstanding 0 0
Common Stock, $0.001 par value, 60,000,000 shares authorized; 32,973,576, and 31,876,508 shares issued; and 32,106,174 and 31,086,619 shares outstanding 33 32
Additional paid-in capital 458,475 450,792
Treasury Stock at cost 867,402, and 789,889 shares of common stock (18,056) (17,116)
Accumulated other comprehensive income 15 15
Retained earnings 23,136 18,617
Total Amedisys, Inc. stockholders' equity 463,603 452,340
Noncontrolling interests 1,427 1,893
Total equity 465,030 454,233
Total liabilities and equity $ 700,253 $ 730,595
XML 50 R7.xml IDEA: NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS 2.4.0.8010107 - Disclosure - NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTStruefalsefalse1false falsefalseFROM_Jan01_2013_TO_Jun30_2013http://www.sec.gov/CIK0000896262duration2013-01-01T00:00:002013-06-30T00:00:001true 1us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstractus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalse1falsefalsefalse00falsefalsefalsexbrli:stringItemTypestringfalse02false 2us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsDisclosureTextBlockus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1falsefalsefalse00<p style='margin-top:0pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;margin-left:0px;">1</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">. NATURE OF OPERATIONS</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">,</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;"> </font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">CONSOLIDATION </font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">AND PRESENTATION </font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;">OF FINANCIAL STATEMENTS </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, Inc., a Delaware corporation, and its consolidated subsidiaries (&#8220;</font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">,&#8221; &#8220;we,&#8221; &#8220;us,&#8221; or &#8220;our&#8221;) </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> a multi-state provider of home health and hospice services with </font><font style="font-family:Times New Roman;font-size:10pt;">approximately</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">84%</font><font style="font-family:Times New Roman;font-size:10pt;"> and</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">82%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">of our revenue derived from Medicare for</font><font style="font-family:Times New Roman;font-size:10pt;"> the</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">three</font><font style="font-family:Times New Roman;font-size:10pt;">-</font><font style="font-family:Times New Roman;font-size:10pt;">month</font><font style="font-family:Times New Roman;font-size:10pt;"> periods</font><font style="font-family:Times New Roman;font-size:10pt;"> ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> and approximately </font><font style="font-family:Times New Roman;font-size:10pt;">84%</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">83%</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">of our revenue derived from Medicare for the six-month periods ended </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;"> and </font><font style="font-family:Times New Roman;font-size:10pt;">2012</font><font style="font-family:Times New Roman;font-size:10pt;">, respectively</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> As of </font><font style="font-family:Times New Roman;font-size:10pt;">June 30, 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, we owned and operated </font><font style="font-family:Times New Roman;font-size:10pt;">409</font><font style="font-family:Times New Roman;font-size:10pt;"> Medicare-certified home health </font><font style="font-family:Times New Roman;font-size:10pt;">care centers, including 33 care centers </font><font style="font-family:Times New Roman;font-size:10pt;">held</font><font style="font-family:Times New Roman;font-size:10pt;"> for sale, </font><font style="font-family:Times New Roman;font-size:10pt;">94</font><font style="font-family:Times New Roman;font-size:10pt;"> Medicare-certified hospice </font><font style="font-family:Times New Roman;font-size:10pt;">care centers</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> including one care center </font><font style="font-family:Times New Roman;font-size:10pt;">held</font><font style="font-family:Times New Roman;font-size:10pt;"> for sale,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">and </font><font style="font-family:Times New Roman;font-size:10pt;">one</font><font style="font-family:Times New Roman;font-size:10pt;"> hospice inpatient unit </font><font style="font-family:Times New Roman;font-size:10pt;">in </font><font style="font-family:Times New Roman;font-size:10pt;">37</font><font style="font-family:Times New Roman;font-size:10pt;"> states within the United States, the District of Columbia and Puerto Rico</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Basis of Presentation</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">In our opinion, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations and our cash flows in accordance with U.S. Generally Accepted Accounting Principles (&#8220;U.S. GAAP&#8221;). Our results of operations for the interim periods presented are not necessarily indicative of results of our operations for the entire year and have not been audited by our independent auditors.</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented. This report should be read in conjunction with our consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 201</font><font style="font-family:Times New Roman;font-size:10pt;">2</font><font style="font-family:Times New Roman;font-size:10pt;"> as filed with the Securities and Exchange Commission (&#8220;SEC&#8221;) on </font><font style="font-family:Times New Roman;font-size:10pt;">March 12</font><font style="font-family:Times New Roman;font-size:10pt;">, 201</font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;"> (the &#8220;Form 10-K&#8221;), which includes information and disclosures not included herein</font><font style="font-family:Times New Roman;font-size:10pt;">.</font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Use of Estimates </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our accounting and reporting policies conform with U.S.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">G</font><font style="font-family:Times New Roman;font-size:10pt;">AAP. In preparing the </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the</font><font style="font-family:Times New Roman;font-size:10pt;"> condensed</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates. </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Reclassifications and Comparability</font><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Certain reclassifications have been made to prior period's financial statements in order to conform to the current period's presentation</font><font style="font-family:Times New Roman;font-size:10pt;">. </font><font style="font-family:Times New Roman;font-size:10pt;">W</font><font style="font-family:Times New Roman;font-size:10pt;">e exited three home health care centers</font><font style="font-family:Times New Roman;font-size:10pt;"> during 2012, and have </font><font style="font-family:Times New Roman;font-size:10pt;">committed to a plan to divest approximately 3</font><font style="font-family:Times New Roman;font-size:10pt;">4</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers. In accordance with applicable accounting guidance</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> the results of operations for these care centers are presented in discontinued operations in our condensed consolidated financial statements. See Note </font><font style="font-family:Times New Roman;font-size:10pt;">3</font><font style="font-family:Times New Roman;font-size:10pt;"> for additional information regarding our discontinued operations.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">In addition</font><font style="font-family:Times New Roman;font-size:10pt;"> during 2013</font><font style="font-family:Times New Roman;font-size:10pt;">, w</font><font style="font-family:Times New Roman;font-size:10pt;">e have consolidated </font><font style="font-family:Times New Roman;font-size:10pt;">2</font><font style="font-family:Times New Roman;font-size:10pt;">8</font><font style="font-family:Times New Roman;font-size:10pt;"> care centers with care centers servicing the same market</font><font style="font-family:Times New Roman;font-size:10pt;">s,</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">which may affect the comparability of our operating results.</font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Principles of Consolidation </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">These </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements include the accounts of </font><font style="font-family:Times New Roman;font-size:10pt;">Amedisys</font><font style="font-family:Times New Roman;font-size:10pt;">, Inc.</font><font style="font-family:Times New Roman;font-size:10pt;">,</font><font style="font-family:Times New Roman;font-size:10pt;"> and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying </font><font style="font-family:Times New Roman;font-size:10pt;">unaudited condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements, and business combinations accounted for as purchases have been included in our</font><font style="font-family:Times New Roman;font-size:10pt;"> unaudited condensed</font><font style="font-family:Times New Roman;font-size:10pt;"> consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">investments that are </font><font style="font-family:Times New Roman;font-size:10pt;">accounted for as set forth below</font><font style="font-family:Times New Roman;font-size:10pt;">.</font><font style="font-family:Times New Roman;font-size:10pt;"> </font></p><p style='margin-top:13.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;font-weight:bold;font-style:italic;margin-left:0px;">Investments </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We consolidate </font><font style="font-family:Times New Roman;font-size:10pt;">investments when the entity is a variable interest entity and </font><font style="font-family:Times New Roman;font-size:10pt;">we </font><font style="font-family:Times New Roman;font-size:10pt;">are</font><font style="font-family:Times New Roman;font-size:10pt;"> the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">%. Third party equity interests in our consolidated joint ventures are reflected as </font><font style="font-family:Times New Roman;font-size:10pt;">noncontrolling</font><font style="font-family:Times New Roman;font-size:10pt;"> interests in our </font><font style="font-family:Times New Roman;font-size:10pt;">condensed </font><font style="font-family:Times New Roman;font-size:10pt;">consolidated financial statements. </font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold </font><font style="font-family:Times New Roman;font-size:10pt;">50</font><font style="font-family:Times New Roman;font-size:10pt;">% or less of the voting stock and the entity is not a variable interest entity in which we are the primary </font><font style="font-family:Times New Roman;font-size:10pt;">beneficiary. The book value of </font><font style="font-family:Times New Roman;font-size:10pt;">investments </font><font style="font-family:Times New Roman;font-size:10pt;">that we accounted for under the equity method of accounting </font><font style="font-family:Times New Roman;font-size:10pt;">was $</font><font style="font-family:Times New Roman;font-size:10pt;">5.</font><font style="font-family:Times New Roman;font-size:10pt;">7</font><font style="font-family:Times New Roman;font-size:10pt;"> </font><font style="font-family:Times New Roman;font-size:10pt;">million</font><font style="font-family:Times New Roman;font-size:10pt;"> as of June 30, 2013 and $</font><font style="font-family:Times New Roman;font-size:10pt;">4.8 </font><font style="font-family:Times New Roman;font-size:10pt;">million as of De</font><font style="font-family:Times New Roman;font-size:10pt;">cember 31, 2012. We account for investments in entities in which we have less than a </font><font style="font-family:Times New Roman;font-size:10pt;">20</font><font style="font-family:Times New Roman;font-size:10pt;">% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. 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Commitments and Contigencies (Details) (USD $)
6 Months Ended 49 Months Ended 9 Months Ended 7 Months Ended 22 Months Ended 2 Months Ended 27 Months Ended 12 Months Ended 5 Months Ended 1 Months Ended 12 Months Ended
Jun. 30, 2013
May 31, 2012
Sep. 13, 2012
Wage and Hour Litigation [Member]
Illinois [Member]
Employee
Jul. 25, 2012
Wage and Hour Litigation [Member]
Connecticut [Member]
Employee
Jun. 30, 2013
Federal Derivative Actions [Member]
Jun. 24, 2013
Federal Derivative Actions [Member]
Nov. 10, 2009
Home Health [Member]
Ohio [Member]
Claims
Mar. 09, 2011
Home Health [Member]
Extrapolated [Member]
Ohio [Member]
Claims
Mar. 31, 2010
Hospice [Member]
South Carolina [Member]
Beneficiary
Jul. 31, 2008
Hospice [Member]
Massachusetts [Member]
Claims
Beneficiary
Jun. 06, 2011
Hospice [Member]
Extrapolated [Member]
South Carolina [Member]
Beneficiary
Feb. 15, 2012
Hospice [Member]
Extrapolated [Member]
Massachusetts [Member]
Claims
Dec. 17, 2012
Hospice [Member]
Final Litigation Settlment [Member]
Massachusetts [Member]
Claims
Commitments and Contingencies Disclosure [Line Items]                          
Medicare Revenue   $ 4,000,000                      
Number of former employees who filled a putative collective and class action complaint     1 3                  
Number of claims submitted by subsidiary             137 114   112   89 35
Recovery amount of the overpayment made to the subsidiary               5,600,000     6,100,000 6,600,000 100,000
Health insurance retention limit 900,000                        
Workers' compensation insurance retention limit 500,000                        
Professional liability insurance retention limit 300,000                        
Number of beneficiaries                 30 25 16    
Loss Contingency, Settlement Agreement, Consideration           445,000              
Loss Contingency Accrual, at Carrying Value         $ 400,000                
XML 57 R23.htm IDEA: XBRL DOCUMENT v2.4.0.8
Discontinued Operations - Additional Information (Detail) (USD $)
In Thousands, unless otherwise specified
3 Months Ended 6 Months Ended 12 Months Ended
Jun. 30, 2013
Agencies
Jun. 30, 2013
Agencies
Dec. 31, 2012
Agencies
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]      
Number of care centers consolidated 19 28  
Number of care centers closed     3
Number of care centers available for sale 34    
Number of care centers sold 3 3  
Number of care centers included in divestiture plan 50    
Property Plant And Equipment Net $ 156,887 $ 156,887 $ 156,709
Goodwill 209,260 209,260 209,594
Intangible Assets Net Excluding Goodwill 43,109 43,109 47,050
Assets Held-for-sale [Member]
     
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]      
Property Plant And Equipment Net 500 500  
Goodwill 700 700  
Intangible Assets Net Excluding Goodwill $ 300 $ 300  
Home Health [Member]
     
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]      
Number of care centers consolidated 17    
Number of care centers available for sale 33    
Number of care centers sold 2 2  
Hospice [Member]
     
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]      
Number of care centers consolidated 2    
Number of care centers available for sale 1    
Number of care centers sold 1 1  
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Additional Information (Detail) 2.4.0.8040050 - Disclosure - Segment Information - Additional Information (Detail)truefalsefalse1false falsefalseFROM_Apr01_2013_TO_Jun30_2013http://www.sec.gov/CIK0000896262duration2013-04-01T00:00:002013-06-30T00:00:00AgenciesStandardhttp://www.amedisys.com/20130630Agenciesamed01true 1us-gaap_SegmentReportingAbstractus-gaap_truenadurationfalsefalsefalsefalsefalsefalsefalsefalse1falsefalsefalse00falsefalsefalsexbrli:stringItemTypestringfalse02false 2amed_NumberOfCareCentersAvailableForSaleamed_falsenadurationfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1truefalsefalse3434falsefalsefalsexbrli:integerItemTypeintegerNumber of care centers that were classified as available for sale during the period.No definition available.false2563false 2amed_NumberOfCareCentersSoldamed_falsenainstantfalsefalsefalsefalsefalsefalsefalsefalseterseLabel1truefalsefalse33falsefalsefalsexbrli:integerItemTypeintegerNumber of care centers sold during the period.No definition available.false256falseSegment Information - 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SEGMENT INFORMATION
6 Months Ended
Jun. 30, 2013
Segment Reporting [Abstract]  
SEGMENT INFORMATION

7. Segment Information

Our operations involve servicing patients through our two reportable business segments: home health and hospice. Our home health segment delivers a wide range of services in the homes of individuals who may be recovering from surgery, have a chronic disability or terminal illness or need assistance with the essential activities of daily living. Our hospice segment provides palliative care and comfort to terminally ill patients and their families. The “other” column in the following tables consists of costs relating to corporate support functions that are not directly attributable to a specific segment.

As of June 30, 2013, we classified 34 care centers as held for sale and sold three care centers which are reflected as discontinued operations in accordance with applicable accounting guidance. See Note 3 – Discontinued Operations and Assets Held for Sale for additional information. Prior periods have been reclassified to conform to the current presentation.

Management evaluates performance and allocates resources based on the operating income of the reportable segments, which includes an allocation of corporate expenses directly attributable to the specific segment and includes revenues and all other costs directly attributable to the specific segment. Segment assets are not reviewed by the company's chief operating decision maker and therefore are not disclosed below (amounts in millions).

 

  For the Three-Month Periods Ended June 30, 2013 
   Home Health  Hospice  Other  Total 
 Net service revenue$248.6 $64.5 $0.0 $313.1 
 Cost of service, excluding depreciation and amortization 142.0  34.1  0.0  176.1 
 General and administrative expenses 75.6  15.6  25.7  116.9 
 Provision for doubtful accounts 3.0  1.6  0.0  4.6 
 Depreciation and amortization 2.6  0.5  8.6  11.7 
 Operating expenses 223.2  51.8  34.3  309.3 
 Operating income (loss)$25.4 $12.7 $(34.3) $3.8 
              
  For the Three-Month Periods Ended June 30, 2012 
   Home Health  Hospice  Other  Total 
 Net service revenue$290.6 $72.5 $0.0 $363.1 
 Cost of service, excluding depreciation and amortization 165.3  37.3  0.0  202.6 
 General and administrative expenses 81.5  17.8  31.6  130.9 
 Provision for doubtful accounts 3.9  0.6  0.0  4.5 
 Depreciation and amortization 3.4  0.3  6.0  9.7 
 Operating expenses 254.1  56.0  37.6  347.7 
 Operating income (loss)$36.5 $16.5 $(37.6) $15.4 
              
  For the Six-Month Periods Ended June 30, 2013 
   Home Health  Hospice  Other  Total 
 Net service revenue$508.8 $130.4 $0.0 $639.2 
 Cost of service, excluding depreciation and amortization 291.3  68.9  0.0  360.2 
 General and administrative expenses 155.1  32.8  52.2  240.1 
 Provision for doubtful accounts 5.0  3.5  0.0  8.5 
 Depreciation and amortization 5.3  1.1  15.2  21.6 
 Operating expenses 456.7  106.3  67.4  630.4 
 Operating income (loss)$52.1 $24.1 $(67.4) $8.8 
              
  For the Six-Month Periods Ended June 30, 2012 
   Home Health  Hospice  Other  Total 
 Net service revenue$578.4 $140.6 $0.0 $719.0 
 Cost of service, excluding depreciation and amortization 328.5  73.1  0.0  401.6 
 General and administrative expenses 165.6  34.0  59.7  259.3 
 Provision for doubtful accounts 8.8  1.4  0.0  10.2 
 Depreciation and amortization 6.6  0.6  12.3  19.5 
 Operating expenses 509.5  109.1  72.0  690.6 
 Operating income (loss)$68.9 $31.5 $(72.0) $28.4 
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Segment Information - Additional Information (Detail)
3 Months Ended
Jun. 30, 2013
Agencies
Segment Reporting [Abstract]  
Number of care centers available for sale 34
Number of care centers sold 3
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DISCONTINUED OPERATIONS (Tables)
6 Months Ended
Jun. 30, 2013
Discontinued Operation, Additional Disclosures [Abstract]  
Net Revenues and Operating Results
Net revenues and operating results for the periods presented for the care centers classified as discontinued operations are as follows (dollars in millions):  
                
    For the Three-Month Periods Ended June 30,  For the Six-Month Periods Ended June 30,  
    2013  2012  2013  2012  
                
 Net revenues $11.7 $15.3 $24.8 $30.4  
 (Loss) before income taxes  (0.8)  0.0  (1.6)  (2.4)  
 Income tax benefit  0.3  0.0  0.6  1.0  
 Discontinued operations, net of tax $(0.5) $0.0 $(1.0) $(1.4)  
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COMMITMENTS AND CONTINGENCIES
6 Months Ended
Jun. 30, 2013
Commitments and Contingencies Disclosure [Abstract]  
COMMITMENTS AND CONTINGENCIES

6. COMMITMENTS AND CONTINGENCIES

Legal Proceedings

We are involved in the following legal actions:

United States Senate Committee on Finance Inquiry

On May 12, 2010, we received a letter of inquiry from the Senate Finance Committee requesting documents and information relating to our policies and practices regarding home therapy visits and therapy utilization trends. A similar letter was sent to the other major publicly traded home health care companies. We cooperated with the Committee with respect to this inquiry.

On October 3, 2011, the Committee publicly issued a report titled “Staff Report on Home Health and the Medicare Therapy Threshold.” The Committee recommended that the CMS “must move toward taking therapy out of the payment model.” We believe that the issuance of the report concludes the Committee's inquiry, but are not in a position to speculate on the potential for future legislative or oversight action by the Committee.

Securities Class Action Lawsuits

On June 10, 2010, a putative securities class action complaint was filed in the United States District Court for the Middle District of Louisiana against the Company and certain of our current and former senior executives. Additional putative securities class actions were filed in the United States District Court for the Middle District of Louisiana on July 14, July 16, and July 28, 2010.

On October 22, 2010, the Court issued an order consolidating the putative securities class action lawsuits and the Federal Derivative Actions (described immediately below) for pre-trial purposes. In the same order, the Court appointed the Public Employees Retirement System of Mississippi and the Puerto Rico Teachers' Retirement System as co-lead plaintiffs (together, the “Co-Lead Plaintiffs”) for the putative class. On December 10, 2010, the Court also consolidated the ERISA class action lawsuit (described below) with the putative securities class actions and Federal Derivative Actions for pre-trial purposes.  

On January 18, 2011, the Co-Lead Plaintiffs filed an amended, consolidated class action complaint (the “Securities Complaint”) which supersedes the earlier-filed securities class action complaints. The Securities Complaint alleges that the defendants made false and/or misleading statements and failed to disclose material facts about our business, financial condition, operations and prospects, particularly relating to our policies and practices regarding home therapy visits under the Medicare home health prospective payment system and the related alleged impact on our business, financial condition, operations and prospects. The Securities Complaint seeks a determination that the action may be maintained as a class action on behalf of all persons who purchased the Company's securities between August 2, 2005 and September 28, 2010 and an unspecified amount of damages.

All defendants moved to dismiss the Securities Complaint. On June 28, 2012, the United States District Court for the Middle District of Louisiana granted the defendants' motion to dismiss the Securities Complaint. On July 26, 2012, the Co-Lead Plaintiffs filed a motion for reconsideration, which the Court denied on April 9, 2013.

On May 3, 2013, the Co-Lead Plaintiffs appealed the dismissal of their Securities Class Action Complaint to the United States Court of Appeals for the Fifth Circuit. The United States Court of Appeals for the Fifth Circuit docketed the Co-Lead Plaintiffs' appeal on July 16, 2013, and the Co-Lead Plaintiffs must file their opening brief on or before August 26, 2013. The appeal remains pending. While the Company will seek to have the District Court order granting the defendants' motion to dismiss affirmed on appeal, no assurances can be given as to the timing or outcome of the appeals process.

Derivative Actions

On July 2, 2010, an alleged shareholder of the Company filed a derivative lawsuit in the United States District Court for the Middle District of Louisiana, purporting to assert claims on behalf of the Company against certain of our current and former officers and directors. Three similar derivative suits were filed in the United States District Court for the Middle District of Louisiana on July 15, July 21, and August 2, 2010 (together, the “Federal Derivative Actions”). We are named as a nominal defendant in all of those actions. As noted above, on October 22, 2010, the United States District Court for the Middle District of Louisiana issued an order consolidating the Federal Derivative Actions with the putative securities class action lawsuits and for pre-trial purposes.  

On January 18, 2011, the plaintiffs in the Federal Derivative Actions filed a consolidated, amended complaint (the “Derivative Complaint”) which supersedes the earlier-filed derivative complaints. The Derivative Complaint alleges that certain of our current and former officers and directors breached their fiduciary duties to the Company by making allegedly false statements, by allegedly failing to establish sufficient internal controls over certain of our home health and Medicare billing practices, by engaging in alleged insider trading, and by committing unspecified acts of waste of corporate assets and unjust enrichment. All defendants in the Federal Derivative Actions, including the Company as a nominal defendant, moved to dismiss the Derivative Complaint. That motion is fully briefed and remains pending before the court.

On June 24, 2013, all parties to the Federal Derivative Actions entered into a Stipulation of Settlement (the “Stipulation”) with respect to the Federal Derivative Actions. On June 27, 2013, the United States District Court for the Middle District of Louisiana issued an order preliminarily approving the proposed settlement in accordance with the Stipulation. Pursuant to the Court's June 27, 2013 Order, a copy of the Court-approved “Notice of Settlement of Amedisys, Inc. Derivative Action,” (the “Notice of Settlement”) was attached as Exhibit 99.1 to the Company's Current Report on Form 8-K filed with the United States Securities and Exchange Commission on July 2, 2013. As described in the Notice of Settlement, the Court has scheduled a hearing on September 4, 2013, to determine whether the Court should issue an order of final approval of the proposed settlement. As further described in the Notice of Settlement, as part of the proposed settlement, the Company has agreed to adopt and/or maintain certain corporate governance reforms as set forth in the Stipulation. The Stipulation also provides that plaintiffs' co-lead counsel will seek an award of attorneys' fees and expenses in an amount not to exceed $445,000, which shall include all attorneys' fees and costs that may be due any counsel (or anyone else) who has asserted, or participated in the assertion of, derivative claims on behalf of the Company in any court. Any award of fees and expenses will be paid by the Company (or its insurer on its behalf). If the proposed settlement is approved, the Federal Derivative Actions will be dismissed with prejudice, and all named defendants will be released by all plaintiffs, the Company, and its shareholders from all claims that were or could have been alleged in the Federal Derivative Actions. As of June 30, 2013, we have accrued $0.4 million related to the proposed settlement and a corresponding receivable for insurance proceeds related to the proposed settlement.

On July 23, 2010, a derivative suit was filed in the Nineteenth Judicial District Court, Parish of East Baton Rouge, State of Louisiana. That action also purports to assert claims on behalf of the Company against certain of our current and former officers and directors. On December 8, 2010, the Court entered an order staying the action in deference to the earlier-filed derivative actions pending in Federal court. If the United States District Court for the Middle District of Louisiana issues an order of final approval of the settlement of the Federal Derivative Actions, the named defendants in the state court derivative suit and the Company, as a nominal defendant, will move for dismissal of the state court derivative suit.

ERISA Class Action Lawsuit

On September 27, 2010 and October 22, 2010, separate putative class action complaints were filed in the United States District Court for the Middle District of Louisiana against the Company, certain of our current and former senior executives and members of our 401(k) Plan Administrative Committee. The suits allege violations of the Employee Retirement Income Security Act (“ERISA”) since January 1, 2006 and July 1, 2007, respectively. The plaintiffs brought the complaints on behalf of themselves and a class of similarly situated participants in our 401(k) plan. The plaintiffs assert that the defendants breached their fiduciary duties to the 401(k) Plan's participants by causing the 401(k) plan to offer and hold Amedisys common stock during the respective class periods when it was an allegedly unduly risky and imprudent retirement investment because of our alleged improper business practices. The complaints seek a determination that the actions may be maintained as a class action, an award of unspecified monetary damages and other unspecified relief. As noted above, on December 10, 2010, the Court consolidated the putative ERISA class actions with the putative securities class actions and derivative actions for pre-trial purposes. In addition, on December 10, 2010, the Court appointed interim lead counsel and interim liaison counsel in the ERISA class action.

On March 10, 2011, Wanda Corbin, Pia Galimba and Linda Trammell (the “Co-ERISA Plaintiffs”), filed an amended, consolidated class action complaint (the “ERISA Complaint”), which supersedes the earlier-filed ERISA class action complaints.  The ERISA Complaint seeks a determination that the action may be maintained as a class action on behalf of themselves and a class of similarly situated participants in our 401(k) plan from January 1, 2008 through present. All of the defendants have moved to dismiss the ERISA Complaint. That motion is fully briefed and remains pending before the court.

SEC Investigation

On June 30, 2010, we received notice of a formal investigation from the SEC and received a subpoena for documents relating to the matters under review by the United States Senate Committee on Finance and other matters involving our operations. We have cooperated with the SEC with respect to this investigation.

U.S. Department of Justice Civil Investigative Demand (“CID”)

On September 27, 2010, we received a CID issued by the U.S. Department of Justice pursuant to the federal False Claims Act. The CID requires the delivery of a wide range of documents and information relating to the Company's clinical and business operations, including reimbursement and billing claims submitted to Medicare for home health services, and related compliance activities. The CID generally covers the period from January 1, 2003.  On April 26, 2011, we received a second CID related to the CID issued in September 2010, which generally covers the same time period as the previous CID and requires the production of additional documents. Such CIDs are often associated with previously filed qui tam actions, or lawsuits filed under seal under the False Claims Act (“FCA”), 31 U.S.C. § 3729 et seq. Qui tam actions are brought by private plaintiffs suing on behalf of the federal government for alleged FCA violations. Subsequently, the Company and certain current and former employees have received additional CIDs for additional documents and/or testimony. We are cooperating with the Department of Justice with respect to this investigation and the requests for information and testimony.

Stark Law

In May 2012, we made a disclosure to CMS under the agency's Stark Law Self-Referral Disclosure Protocol relating to certain services agreements between a subsidiary of ours and a large physician group. During some period of time since December 2007, the arrangements appear not to have complied in certain respects with an applicable exemption to the Stark Law referral prohibition. Medicare revenue earned as a result of referrals from the physician group from May 2008 to May 2012, the relevant four year “lookback” period under the Stark Law Self-Referral Disclosure Protocol, was approximately $4 million. On January 11, 2013, one of our subsidiaries received a CID from the United States Attorney's Office for the Northern District of Georgia seeking certain information relating to that subsidiary's relationship with this physician group. We are cooperating with the government in its review of this matter.

OIG Self-Disclosure

In October 2012, we made a disclosure to the Office of Counsel to the Inspector General of the United States Department of Health and Human Services (the "OIG") pursuant to the OIG Provider Self-Disclosure Protocol regarding certain clinical documentation issues and eligibility regulatory requirements at two of our hospice care centers.  These hospice care centers did not comply in some respects with certain state and Medicare hospice regulations, including those requiring physicians to certify patient eligibility and requiring patient face-to-face encounters.  We are also in discussions with state healthcare authorities regarding this matter.  Our review of this matter is ongoing, and we are cooperating with the OIG and the state regulatory authorities in their review of this matter. 

Wage and Hour Litigation

On July 25, 2012, a putative collective and class action complaint was filed in the United States District Court for the District of Connecticut against us in which three former employees allege wage and hour law violations.  The former employees claim that they were not paid overtime for all hours worked over forty hours in violation of the Federal Fair Labor Standards Act (“FLSA”), as well as the Pennsylvania Minimum Wage Act. More specifically, they allege they were paid on both a per-visit and an hourly basis, and that such a pay scheme resulted in their misclassification as exempt employees, thereby denying them overtime pay. Moreover, in response to a Company motion arguing that plaintiffs' complaint was deficient in that it was ambiguous and failed to provide fair notice of the claims asserted and plaintiffs' opposition thereto, the court, on April 8, 2013, held that the complaint adequately raises general allegations that the plaintiffs were not paid overtime for all hours worked in a week over forty, which may include claims for unpaid overtime under other theories of liability, such as alleged off-the-clock work, in addition to plaintiffs' more clearly stated allegations based on misclassification. Plaintiffs seek class certification of similar employees and seek attorneys' fees, back wages and liquidated damages going back three years under the FLSA and three years under the Pennsylvania statute.

On September 13, 2012, a putative collective and class action complaint was filed in the United States District Court for the Northern District of Illinois against us in which a former employee alleges wage and hour law violations.  The former employee claims she was paid on both a per-visit and an hourly basis, thereby misclassifying her as an exempt employee and entitling her to overtime pay. The plaintiff alleges violations of Federal and state law and seeks damages under the FLSA and the Illinois Minimum Wage Law.  Plaintiff seeks class certification of similar employees who were or are employed in Illinois and seeks attorneys' fees, back wages and liquidated damages going back three years under the FLSA and three years under the Illinois statute.

We are unable to assess the probable outcome or reasonably estimate the potential liability, if any, arising from the SEC investigation, the U.S. Department of Justice CIDs, the Stark Law matter we have disclosed to CMS, the OIG Self-Disclosure issue and the securities, shareholder derivative, ERISA and wage and hour litigation described above given the preliminary stage of these matters.  The Company intends to continue to vigorously defend itself in the securities, shareholder derivative, ERISA and wage and hour litigation matters.  No assurances can be given as to the timing or outcome of the SEC investigation, the U.S. Department of Justice CIDs, the Stark Law matter we have disclosed to CMS, the OIG Self-Disclosure issue or the securities, shareholder derivative, ERISA and wage and hour litigation matters described above or the impact of any of the inquiry, investigation or litigation matters on the Company, its consolidated financial condition, results of operations or cash flows, which could be material, individually or in the aggregate.

We recognize that additional putative securities class action complaints and other litigation could be filed, and that other investigations and actions could be commenced, relating to matters involving our home therapy visits and therapy utilization trends or other matters.

In addition to the matters referenced in this note, we are involved in legal actions in the normal course of business, some of which seek monetary damages, including claims for punitive damages. We do not believe that these normal course actions, when finally concluded and determined, will have a material impact on our consolidated financial condition, results of operations or cash flows.

Third Party Audits

From time to time, in the ordinary course of business, we are subject to audits under various governmental programs in which third party firms engaged by CMS conduct extensive review of claims data to identify potential improper payments under the Medicare program.

In January 2010, our subsidiary that provides home health services in Dayton, Ohio received from a Medicare Program Safeguard Contractor (“PSC”) a request for records regarding 137 claims submitted by the subsidiary paid from January 2, 2008 through November 10, 2009 (the “Claim Period”) to determine whether the underlying services met pertinent Medicare payment requirements. Based on the PSC's findings for 114 of the claims, which were extrapolated to all claims for home health services provided by the Dayton subsidiary paid during the Claim Period, on March 9, 2011, the Medicare Administrative Contractor (“MAC”) for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment of approximately $5.6 million. We dispute these findings, and our Dayton subsidiary has filed appeals through the Original Medicare Standard Appeals Process, in which we are seeking to have those findings overturned. Most recently, a consolidated administrative law judge (“ALJ”) hearing was held in late March 2013. As of the date of this filing, the ALJ has not released a ruling. No assurances can be given as to the outcome of the ALJ appeal. As of June 30, 2013, we have recorded no liability with respect to the pending appeals as we do not believe that an estimate of a reasonably possible loss or range of loss can be made at this time.

In July 2010, our subsidiary that provides hospice services in Florence, South Carolina received from a Zone Program Integrity Contractor (“ZPIC”) a request for records regarding a sample of 30 beneficiaries who received services from the subsidiary during the period of January 1, 2008 through March 31, 2010 (the “Review Period”) to determine whether the underlying services met pertinent Medicare payment requirements.  We acquired the hospice operations subject to this review on August 1, 2009; the Review Period covers time periods both before and after our ownership of these hospice operations.  Based on the ZPIC's findings for 16 beneficiaries, which were extrapolated to all claims for hospice services provided by the Florence subsidiary billed during the Review Period, on June 6, 2011, the MAC for the subsidiary issued a notice of overpayment seeking recovery from our subsidiary of an alleged overpayment. We dispute these findings, and our Florence subsidiary has filed appeals through the Original Medicare Standard Appeals Process, in which we are seeking to have those findings overturned. Most recently, we have requested appeal hearings before an ALJ, but the ALJ hearings have not been scheduled, and no assurances can be given as to the timing or outcome of the ALJ appeal. The current alleged extrapolated overpayment is $6.1 million. In the event we pay any amount of this alleged overpayment, we are indemnified by the prior owners of the hospice operations for amounts relating to the period prior to August 1, 2009. As of June 30, 2013, we have recorded no liability for this claim as we do not believe that an estimate of a reasonably possible loss or range of loss can be made at this time.

In July 2009, Beacon Hospice, Inc., a subsidiary we acquired on June 7, 2011 (“Beacon”), received from Massachusetts Peer Review Organization, Inc. (“MassPro”), an entity contracted with the Massachusetts Office of Medicaid, a request for records regarding 25 beneficiaries in Boston, Framingham and Plymouth, Massachusetts, who received hospice services from Beacon during the period of August 1, 2007 through July 31, 2008 (the “Review Period”) to determine whether the underlying services met pertinent MassHealth Program regulations. Based on MassPro's findings for 89 of the 112 claims submitted in connection with these beneficiaries, which were extrapolated to all MassHealth claims for hospice services provided by Beacon billed during the Review Period, on February 15, 2012, MassPro issued a notice of overpayment seeking recovery from Beacon of an alleged overpayment of approximately $6.6 million. The Review Period covers a time before our ownership of Beacon. On December 17, 2012, as a result of an appeal by Beacon, MassPro issued a final notice of determination of overpayment and fines (the “Final Notice”), determining an overpayment in only 35 of the original 112 claims and seeking recovery from Beacon in the amount of $0.1 million (the “Final Amount”). In the Final Notice, MassPro did not extrapolate the findings, and Beacon determined not to contest the Final Notice. In January 2013, Amedisys paid the Final Amount to MassPro, and the prior owners of Beacon paid the Final Amount to Amedisys, in accordance with their indemnification obligations set forth in the acquisition document.

Insurance

We are obligated for certain costs associated with our insurance programs, including employee health, workers' compensation and professional liability. While we maintain various insurance programs to cover these risks, we are self-insured for a substantial portion of our potential claims. We recognize our obligations associated with these costs, up to specified deductible limits in the period in which a claim is incurred, including with respect to both reported claims and claims incurred but not reported. These costs have generally been estimated based on historical data of our claims experience. Such estimates, and the resulting reserves, are reviewed and updated by us on a quarterly basis.

Our health insurance has a retention limit of $0.9 million, our workers' compensation insurance has a retention limit of $0.5 million and our professional liability insurance has a retention limit of $0.3 million.

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NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS
6 Months Ended
Jun. 30, 2013
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS

1. NATURE OF OPERATIONS, CONSOLIDATION AND PRESENTATION OF FINANCIAL STATEMENTS

Amedisys, Inc., a Delaware corporation, and its consolidated subsidiaries (“Amedisys,” “we,” “us,” or “our”) are a multi-state provider of home health and hospice services with approximately 84% and 82% of our revenue derived from Medicare for the three-month periods ended June 30, 2013 and 2012, respectively, and approximately 84% and 83% of our revenue derived from Medicare for the six-month periods ended June 30, 2013 and 2012, respectively. As of June 30, 2013, we owned and operated 409 Medicare-certified home health care centers, including 33 care centers held for sale, 94 Medicare-certified hospice care centers, including one care center held for sale, and one hospice inpatient unit in 37 states within the United States, the District of Columbia and Puerto Rico.

Basis of Presentation

In our opinion, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting solely of normal recurring adjustments) necessary to present fairly our financial position, our results of operations and our cash flows in accordance with U.S. Generally Accepted Accounting Principles (“U.S. GAAP”). Our results of operations for the interim periods presented are not necessarily indicative of results of our operations for the entire year and have not been audited by our independent auditors.

Certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted from the interim financial information presented. This report should be read in conjunction with our consolidated financial statements and related notes included in our Annual Report on Form 10-K for the year ended December 31, 2012 as filed with the Securities and Exchange Commission (“SEC”) on March 12, 2013 (the “Form 10-K”), which includes information and disclosures not included herein.

Use of Estimates

Our accounting and reporting policies conform with U.S. GAAP. In preparing the unaudited condensed consolidated financial statements, we are required to make estimates and assumptions that impact the amounts reported in the condensed consolidated financial statements and accompanying notes. Actual results could materially differ from those estimates.

Reclassifications and Comparability

Certain reclassifications have been made to prior period's financial statements in order to conform to the current period's presentation. We exited three home health care centers during 2012, and have committed to a plan to divest approximately 34 care centers. In accordance with applicable accounting guidance, the results of operations for these care centers are presented in discontinued operations in our condensed consolidated financial statements. See Note 3 for additional information regarding our discontinued operations. In addition during 2013, we have consolidated 28 care centers with care centers servicing the same markets, which may affect the comparability of our operating results.

Principles of Consolidation

These unaudited condensed consolidated financial statements include the accounts of Amedisys, Inc., and our wholly owned subsidiaries. All significant intercompany accounts and transactions have been eliminated in our accompanying unaudited condensed consolidated financial statements, and business combinations accounted for as purchases have been included in our unaudited condensed consolidated financial statements from their respective dates of acquisition. In addition to our wholly owned subsidiaries, we also have certain investments that are accounted for as set forth below.

Investments

We consolidate investments when the entity is a variable interest entity and we are the primary beneficiary or if we have controlling interests in the entity, which is generally ownership in excess of 50%. Third party equity interests in our consolidated joint ventures are reflected as noncontrolling interests in our condensed consolidated financial statements.

We account for investments in entities in which we have the ability to exercise significant influence under the equity method if we hold 50% or less of the voting stock and the entity is not a variable interest entity in which we are the primary beneficiary. The book value of investments that we accounted for under the equity method of accounting was $5.7 million as of June 30, 2013 and $4.8 million as of December 31, 2012. We account for investments in entities in which we have less than a 20% ownership interest under the cost method of accounting if we do not have the ability to exercise significant influence over the investee. The aggregate carrying amount of our cost method investment, which was acquired during the three-month period ended March 31, 2013, was $5.0 million as of June 30, 2013.

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Segment Information</font></p><p style='margin-top:4.5pt; margin-bottom:0pt'><font style="font-family:Times New Roman;font-size:10pt;margin-left:0px;">Our operations involve servicing patients through our two reportable business segments: home health and hospice. Our home health segment delivers a wide range of services in the homes of individuals who may be recovering from surgery, have a chronic disability or terminal illness or need assistance with the essential activities of daily living. Our hospice segment provides palliative care and comfort to terminally ill patients and their families. 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Nature of Operations Consolidation and Presentation of Financial Statements - Additional Information (Detail) (USD $)
In Millions, unless otherwise specified
3 Months Ended 6 Months Ended 12 Months Ended
Jun. 30, 2013
Agencies
States
Jun. 30, 2012
Jun. 30, 2013
Agencies
States
Jun. 30, 2012
Dec. 31, 2012
Agencies
Organization And Nature Of Operations [Line Items]          
Percent Of Net Services Revenue Provided By Medicare 84.00% 82.00% 84.00% 83.00%  
Number Of States With Facilities 37   37    
Number of care centers closed         3
Minimum percent ownership for controlling interest percent 50.00%   50.00%    
Equity Method Investment Aggregate Cost $ 5.7   $ 5.7   $ 4.8
Cost Method Investments $ 5.0   $ 5.0    
Maximum Percent Ownership For Equity Method Percent 50.00%   50.00%    
Maximum Percent Ownership For Cost Method Percent 20.00%   20.00%    
Number of care centers consolidated 19   28    
Number of care centers included in divestiture plan 50        
Number of care centers available for sale 34        
Home Health [Member]
         
Organization And Nature Of Operations [Line Items]          
Operating Care Centers 409   409    
Number of care centers consolidated 17        
Number of care centers available for sale 33        
Hospice [Member]
         
Organization And Nature Of Operations [Line Items]          
Operating Care Centers 94   94    
Number of care centers consolidated 2        
Number of care centers available for sale 1        
Hospice Inpatient [Member]
         
Organization And Nature Of Operations [Line Items]          
Operating Care Centers 1   1    
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SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)
6 Months Ended
Jun. 30, 2013
Accounting Policies [Abstract]  
Financial Instruments Where Carrying Value and Fair Value Differ
Fair Value of Financial Instruments
            
The following details our financial instruments where the carrying value and the fair value differ (amounts in millions):
            
  Fair Value at Reporting Date Using
Financial Instrument As of June 30, 2013  Quoted Prices in Active Markets for Identical Items (Level 1)  Significant Other Observable Inputs (Level 2)  Significant Unobservable Inputs (Level 3)
Long-term obligations$74.8 $0 $75.1 $0
Weighted-Average Shares Outstanding

The following table sets forth, for the periods indicated, shares used in our computation of the weighted-average shares outstanding, which are used to calculate our basic and diluted net income attributable to Amedisys, Inc. common stockholders (amounts in thousands):

   For the Three-Month Periods Ended June 30, For the Six-Month Periods Ended June 30,
   2013 2012 2013 2012
 Weighted average number of shares outstanding - basic31,160 29,780 30,900 29,584
 Effect of dilutive securities:       
  Stock options12 23 17 16
  Non-vested stock and stock units317 223 381 303
 Weighted average number of shares outstanding - diluted31,489 30,026 31,298 29,903
 Anti-dilutive securities217 531 217 595
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Schedule of Weighted Average Shares Outstanding (Detail)
In Thousands, unless otherwise specified
3 Months Ended 6 Months Ended
Jun. 30, 2013
Jun. 30, 2012
Jun. 30, 2013
Jun. 30, 2012
Accounting Policies [Abstract]        
Weighted average number of shares outstanding - basic 31,160 29,780 30,900 29,584
Stock options 12 23 17 16
Non-vested stock and stock units 317 223 381 303
Weighted average number of shares outstanding - diluted 31,489 30,026 31,298 29,903
Anti-dilutive securities 217 531 217 595
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Summary of Significant Accounting Policies - Additional Information (Detail) (USD $)
In Millions, unless otherwise specified
3 Months Ended 6 Months Ended 12 Months Ended
Jun. 30, 2013
Jun. 30, 2012
Jun. 30, 2013
D
Number_of_Visits
Jun. 30, 2012
Dec. 31, 2012
Revenue Recognition, Multiple-deliverable Arrangements [Line Items]          
Episode of care as episodic-based revenue, days     60    
Percentage of total reimbursement of outlier payment     10.00%    
Low utilization payment adjustment, maximum number of visits     5    
First threshold of therapy services required, visits     6    
Second threshold of services required, visits     14    
Third threshold of therapy services required, visits     20    
Historical collection rate from Medicare     99.00%    
Episodes of progress that begin during reporting period, days     60    
Hospice Medicare revenue rate accounted for routine care 99.00% 97.00% 99.00% 98.00%  
Estimated amounts due back to Medicare $ 4.0   $ 4.0   $ 4.8
Percentage of patient receivables outstanding     10.00%    
Minimum days for accounts receivable outstanding to be fully reserved     365    
Portion of accounts receivable derived from Medicare     71.00%   68.00%
Revenue adjustment to Medicare revenue $ 2.8 $ 2.1 $ 6.6 $ 4.7  
Rate of request for anticipated payment submitted for the initial episode of care     60.00%    
Rate of request for anticipated payment submitted for subsequent episodes of care     50.00%    
Maximum days to submit final bill from the start of episode     120    
Maximum days to submit final bill from the date the request for anticipated payment was paid     60    
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Document and Entity Information
6 Months Ended
Jun. 30, 2013
Jul. 26, 2013
Document Information [Line Items]    
Document Type 10-Q  
Amendment Flag false  
Document Period End Date Jun. 30, 2013  
Document Fiscal Year Focus 2013  
Document Fiscal Period Focus Q2  
Trading Symbol AMED  
Entity Registrant Name AMEDISYS INC  
Entity Central Index Key 0000896262  
Current Fiscal Year End Date --12-31  
Entity Filer Category Accelerated Filer  
Entity Common Stock, Shares Outstanding   32,181,300
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Schedule of Financial Instruments Where Carrying Value and Fair Value Differ (Detail) (USD $)
In Millions, unless otherwise specified
Jun. 30, 2013
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]  
Long-term obligations, excluding capital leases $ 74.8
Fair Value, Inputs, Level 1 [Member]
 
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]  
Long-term obligations, excluding capital leases 0
Fair Value Inputs Level 2 [Member]
 
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]  
Long-term obligations, excluding capital leases 75.1
Fair Value, Inputs, Level 3 [Member]
 
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]  
Long-term obligations, excluding capital leases $ 0
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