UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 8-K

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): July 31, 2014 (July 31, 2014)

AMSURG CORP.
(Exact Name of Registrant as Specified in its Charter)

Tennessee
001-36531
62-1493316
(State or Other Jurisdiction of Incorporation)
(Commission
 File Number)
(I.R.S. Employer
 Identification No.)
 
 
 
20 Burton Hills Boulevard
 
 
Nashville, Tennessee
 
37215
(Address of Principal
Executive Offices)
 
(Zip Code)

(615) 665-1283
(Registrant’s Telephone Number, Including Area Code)
Not Applicable
(Former Name or Former Address, if Changed Since Last Report)

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):

[ ]
Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
[ ]
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
[ ]
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
[ ]
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))





Item 2.02. Results of Operations and Financial Condition

On July 31, 2014, AmSurg Corp. issued a press release, the text of which is set forth as Exhibit 99.

Item 7.01. Regulation FD Disclosure

On July 31, 2014, AmSurg Corp. issued a press release, the text of which is set forth as Exhibit 99.

Item 9.01. Financial Statements and Exhibits

(d) 99 Press release dated July 31, 2014





SIGNATURES


Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 
 
AMSURG CORP.
 
 
 
 
 
 
 
 
 
 
By:
/s/ Claire M. Gulmi
 
 
Claire M. Gulmi
 
 
 
 
 
Executive Vice President and Chief Financial Officer
 
 
(Principal Financial and Duly Authorized Officer)

Date:    July 31, 2014





INDEX TO EXHIBITS

Exhibit
 
 
Number
 
Description
99
 
Press release dated July 31, 2014






 
Exhibit 99
Press Release
 
 
Contact:
Claire M. Gulmi
 
 
Executive Vice President and
 
 
Chief Financial Officer
 
 
(615) 665-1283

AMSURG REPORTS SECOND-QUARTER 2014 RESULTS

UPDATES 2014 FINANCIAL GUIDANCE FOR THE ACQUISITION
OF SHERIDAN HEALTHCARE

NASHVILLE, Tenn. ─ (July 31, 2014) ─ Christopher A. Holden, President and Chief Executive Officer of AmSurg Corp. (NASDAQ: AMSG), today announced financial results for the second quarter ended June 30, 2014. Revenues increased 5% for the quarter to $281.1 million from $267.1 million for the second quarter of 2013. Net earnings from continuing operations attributable to AmSurg common shareholders were $19.0 million, or $0.59 per diluted share, for the second quarter of 2014 compared with $18.4 million, or $0.58 per diluted share, for the second quarter of 2013. Results for the second quarter of 2014 included an after-tax net gain of $0.8 million, or $0.03 per diluted share, related to the deconsolidation of three surgery centers that AmSurg contributed to two joint ventures created during the quarter with new hospital system partners, as well as after-tax transaction expense of $2.1 million, or $0.07 per diluted share, related to the previously announced acquisition of Sheridan Healthcare (the “Sheridan Transaction”). Excluding these items, adjusted net earnings from continuing operations per diluted share attributable to AmSurg common shareholders for the second quarter of 2014 were $0.63, up 9% from $0.58 for the second quarter last year. Please see page 6 for a reconciliation of all GAAP and non-GAAP financial results in this news release.

For the first six months of 2014, revenues were $544.2 million, an increase of 4% from $525.3 million for the same period in 2013. Net earnings from continuing operations attributable to AmSurg common shareholders were $36.5 million, or $1.13 per diluted share, for the first half of 2014 compared with $36.2 million, or $1.13 per diluted share, for the first half last year. These results included after-tax net deconsolidation gains of $1.4 million, or $0.04 per diluted share, for 2014 and $1.3 million, or $0.04 per diluted share, for 2013. In addition, the results for the first half of 2014 include after-tax transaction expense of $2.1 million, or $0.07 per diluted share, related to the Sheridan Transaction. Excluding these items, adjusted net earnings from continuing operations per diluted share attributable to AmSurg common shareholders for the first six months of 2014 were $1.16 compared with $1.10 for the first half of 2013.

“AmSurg’s financial results met our expectations for the second quarter,” commented Mr. Holden. “We benefitted from a 1% increase in same-center revenue, despite having one less business day in the quarter compared with the secondquarter last year. Average revenue per procedure increased 4% on a comparable-quarter basis, primarily due to changing procedure mix.

“During the second quarter, we continued to act on opportunities to partner with health systems in attractive markets, by agreeing with two new health systems to create ambulatory surgery center (ASC) joint ventures. We contributed our controlling interests in three centers to these joint ventures. We also acquired one center to end the quarter with 243 centers. We had six centers under letter of intent at the end of the second quarter and one de novo center under development, which we expect to open in 2015.

“In July, CMS announced proposed 2015 ASC reimbursement rates. We estimate these rates will positively impact our 2015 revenue by approximately $7 million. These proposed rates are subject to final approval in November 2014.

-MORE-

AMSG Reports Second-Quarter Results
 
 
Page 2
 
 
July 31, 2014
 
 



“Further, we launched a new era at AmSurg during the second quarter with our agreement to acquire Sheridan Healthcare, a leading national provider of outsourced physician services to hospitals, ASCs and other healthcare facilities. On July 16, 2014, we completed this transaction for approximately $2.35 billion in cash and stock. AmSurg financed the cash portion of the transaction through a combination of common and preferred stock offerings, a new senior secured credit facility and the issuance of senior unsecured notes. Through this transaction, we have effectively doubled the Company’s size, strengthened our geographic, payor and revenue diversity and accelerated expected revenue growth, greatly enlarged our addressable market, created a strongly differentiated competitive market position and substantially enhanced our organic and acquisition growth opportunities. In addition to the ample growth opportunities represented just in our respective customer bases, we believe the combination of our operations gives us a unique and scaled platform with which to strategically engage physician groups, health systems and payers as the healthcare industry shifts to greater performance and payment risk.”

AmSurg remains positioned to fund its organic and acquisition growth strategies for the post-merger company. The Company has significant net cash flows from operations, which, excluding distributions to noncontrolling interests, totaled $62 million for the first six months of 2014. In addition, AmSurg’s new senior secured credit facility includes a $300 million revolving credit facility under which the Company currently has no borrowings.

AmSurg today is revising its financial and operating guidance for 2014, primarily for the impact of the Sheridan Transaction, and establishing guidance for the third quarter of 2014. During the third quarter, the Company will record the transaction fees related to the Sheridan Transaction, which will be in excess of $50 million and which will result in a net loss for the third quarter. Due to this transaction, AmSurg will now provide guidance on adjusted net earnings per diluted share from continuing operations attributable to common shareholders (“Adjusted EPS”). Adjusted EPS for all periods will exclude transaction and severance costs related to the acquisition, acquisition-related amortization expense, gains or losses on deconsolidations and share-based compensation expense. The Company’s guidance is as follows:

Revenues in a range of $1.61 billion to $1.63 billion.
Same-center revenue increase of 1% to 2% for ASCs, 6% to 8% organic revenue growth in physician services.
Net cash flow provided by operating activities, less distributions to noncontrolling interests, in a range of $170 million to $180 million, excluding transaction costs.
Adjusted EPS in a range of $2.61 to $2.66.
For the third quarter of 2014, Adjusted EPS in a range of $0.63 to $0.65.

The information contained in the preceding paragraphs, including information regarding the Company’s acquisition plans and financial results for future periods, is forward-looking information. Forward-looking information involves known and unknown risks and uncertainties as described below. There can be no assurance that AmSurg will be successful in completing the acquisitions described above, and the attainment of the financial targets set forth in this press release is dependent on the assumptions described above. The Company’s actual results and performance could differ materially from those expressed or implied by the forward-looking information contained in this press release.

Mr. Holden concluded, “In considering the many compelling reasons for bringing together the complementary businesses of AmSurg and Sheridan Healthcare, we were struck by the foundational commitment that Sheridan has always demonstrated to adding value for its physician staff. This same commitment drives AmSurg and is the focus of our value proposition for our physician partners. We are confident that integrating our similar physician-centric cultures will strengthen both businesses and position our Company for long-term growth in earnings and shareholder value.”

-MORE-

AMSG Reports Second-Quarter Results
 
 
Page 3
 
 
July 31, 2014
 
 



AmSurg Corp. will hold a conference call to discuss this release today, July 31, 2014, at 5:00 p.m. Eastern time. Investors will have the opportunity to listen to the conference call over the Internet by going to www.amsurg.com and clicking “Investors” at least 15 minutes early to register, download, and install any necessary audio software. For those who cannot listen to the live broadcast, a replay will be available at these sites shortly after the call and continue for 30 days.

This press release contains forward-looking statements. These statements, which have been included in reliance on the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995, involve risks and uncertainties. Investors are hereby cautioned that these statements may be affected by important factors, including, but not limited to, the following risks: the risk that payments from third-party payors, including government healthcare programs, may decrease or not increase as costs increase; the potential loss of collections and revenue if the Company is unable to timely enroll providers in the Medicare and Medicaid programs; the Company’s ability to acquire and develop additional surgery centers and its ability to acquire or develop additional relationships with providers for outsourced physician services on favorable terms; the Company’s ability to compete for physician partners, managed care contracts, patients and strategic relationships; adverse developments affecting the medical practices of the Company’s physician partners and affiliated practices; the Company’s ability to maintain favorable relations with its physician partners, affiliated practices and clients; the Company’s ability to grow revenues by increasing procedure volume while maintaining operating margins and profitability within its existing centers and outsourced physician services operations; the Company’s ability to manage the growth in its business, successfully integrate and operate acquired businesses and achieve expected benefits from acquisitions; the Company’s ability to obtain sufficient capital resources to complete acquisitions and develop new surgery centers or operations related to its outsourced physician services; the Company’s ability to generate sufficient cash to service all of its indebtedness; adverse weather and other factors beyond the Company’s control that may affect its surgery centers or operations of its outsourced physician services; the Company’s failure to comply with applicable laws and regulations; the Company’s failure to effectively and timely transition to the ICD-10 coding system; the risk of changes in legislation, regulations or regulatory interpretations that may negatively affect the Company; the risk of becoming subject to federal and state investigation; the risk from an unpredictable impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010; the risk of regulatory changes that may obligate the Company to buy out interests of physicians who are minority owners of its surgery centers; the risk that non-competition agreements in place with the Company’s physicians or other clinical employees may not be enforceable; the risk of payment delays, forfeiture of payment or civil and criminal penalties related to failing to satisfy any notification and reapplication requirements for any acquired companies to maintain licensure, certification and other authorities to operate after an acquisition; potential liabilities associated with the Company’s status as a general partner of limited partnerships; liabilities for claims brought against the Company; the risk that the Company’s reserves established with respect to its losses covered under its insurance programs are not adequate; the Company’s legal responsibility to minority owners of its surgery centers, which may conflict with its interests and prevent the Company from acting solely in its best interests; potential write-offs of the impaired portion of intangible assets; and potential liabilities relating to the tax deductibility of goodwill; and other risk factors described in AmSurg’s Annual Report on Form 10-K for the fiscal year ended December 31, 2013 and other filings with the Securities and Exchange Commission. Consequently, actual results, performance or developments may differ materially from the forward-looking statements included above. AmSurg disclaims any intent or obligation to update these forward-looking statements.

AmSurg Corp. acquires, develops and operates ambulatory surgery centers in partnership with physician practice groups throughout the U.S. and provides outsourced physician services in multiple specialties to hospitals, ASCs and other healthcare facilities, primarily in the areas of anesthesiology, children’s services, emergency medicine and radiology. AmSurg owns and operates 243 ASCs in 34 states and provides physician services in 25 states, employing more than 2,600 physicians and other healthcare professionals.

-MORE-

AMSG Reports Second-Quarter Results
 
 
Page 4
 
 
July 31, 2014
 
 



AMSURG CORP.
Unaudited Selected Consolidated Financial and Operating Data
(In thousands, except earnings per share)
 
 
Three Months Ended June 30,
 
Six Months Ended June 30,
Statement of Earnings Data:
 
2014
 
2013
 
2014
 
2013
Revenues
 
$
281,105

 
$
267,102

 
$
544,212

 
$
525,291

Operating expenses:
 
 
 
 
 
 
 
 
Salaries and benefits
 
84,866

 
81,085

 
168,060

 
162,043

Supply cost
 
41,283

 
38,989

 
80,003

 
76,202

Other operating expenses
 
60,331

 
53,925

 
115,600

 
106,652

Depreciation and amortization
 
8,550

 
8,125

 
16,924

 
16,133

Total operating expenses
 
195,030

 
182,124

 
380,587

 
361,030

Gain on deconsolidation
 
1,366

 

 
3,411

 
2,237

Equity in earnings of unconsolidated affiliates
 
539

 
696

 
1,303

 
1,098

Operating income
 
87,980

 
85,674

 
168,339

 
167,596

Interest expense
 
6,894

 
7,512

 
13,857

 
15,054

Earnings from continuing operations before income taxes
 
81,086

 
78,162

 
154,482

 
152,542

Income tax expense
 
12,921

 
12,710

 
25,978

 
24,979

Net earnings from continuing operations
 
68,165

 
65,452

 
128,504

 
127,563

Discontinued operations:
 
 
 
 
 
 
 
 
Earnings from operations of discontinued interests in surgery centers, net of income tax
 

 
384

 
137

 
546

Gain (loss) on disposal of discontinued interests in surgery centers, net of income tax
 
7

 

 
(355
)
 

Net earnings (loss) from discontinued operations
 
7

 
384

 
(218
)
 
546

Net earnings and comprehensive income
 
68,172

 
65,836

 
128,286

 
128,109

Less net earnings and comprehensive income attributable to noncontrolling interests:
 
 
 
 
 
 
 
 
Net earnings from continuing operations
 
49,211

 
47,035

 
92,046

 
91,396

Net earnings from discontinued operations
 

 
238

 
84

 
339

Total net earnings and comprehensive income attributable to noncontrolling interests
 
49,211

 
47,273

 
92,130

 
91,735

Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders
 
$
18,961

 
$
18,563

 
$
36,156

 
$
36,374

Amounts attributable to AmSurg Corp. common shareholders:
 
 
 
 
 
 
 
 
Earnings from continuing operations, net of income tax
 
$
18,954

 
$
18,417

 
$
36,458

 
$
36,167

Discontinued operations, net of income tax
 
7

 
146

 
(302
)
 
207

Net earnings and comprehensive income attributable to AmSurg Corp. common shareholders
 
$
18,961

 
$
18,563

 
$
36,156

 
$
36,374

Earnings per share-basic:
 
 
 
 
 
 
 
 
Net earnings from continuing operations attributable to AmSurg Corp. common shareholders
 
$
0.60

 
$
0.59

 
$
1.15

 
$
1.16

Net earnings (loss) from discontinued operations attributable to AmSurg Corp. common shareholders
 

 

 
(0.01
)
 
0.01

Net earnings attributable to AmSurg Corp. common shareholders
 
$
0.60

 
$
0.59

 
$
1.14

 
$
1.17

Earnings per share-diluted:
 
 
 
 
 
 
 
 
Net earnings from continuing operations attributable to AmSurg Corp. common shareholders
 
$
0.59

 
$
0.58

 
$
1.13

 
$
1.13

Net earnings (loss) from discontinued operations attributable to AmSurg Corp. common shareholders
 

 

 
(0.01
)
 
0.01

Net earnings attributable to AmSurg Corp. common shareholders
 
$
0.59

 
$
0.58

 
$
1.12

 
$
1.14

Weighted average number of shares and share equivalents outstanding:
 
 
 
 
 
 
 
 
Basic
 
31,825

 
31,208

 
31,770

 
31,213

Diluted
 
32,233

 
31,862

 
32,177

 
31,872



-MORE-

AMSG Reports Second-Quarter Results
 
 
Page 5
 
 
July 31, 2014
 
 



AMSURG CORP.
Unaudited Selected Consolidated Financial and Operating Data, continued
(Dollars in thousands)
 
Three Months Ended June 30,
 
Six Months Ended June 30,
Operating Data:
2014
 
2013
 
2014
 
2013
Continuing centers in operation at end of period (consolidated)
236

 
239

 
236

 
239

Continuing centers in operation at end of period (unconsolidated)
7

 
4

 
7

 
4

Average number of continuing centers in operation (consolidated)
238

 
234

 
238

 
234

New centers added during the period
1

 
2

 
2

 
2

Centers discontinued during the period

 

 
1

 

Centers under development/not opened at end of period
1

 

 
1

 

Centers under letter of intent at end of period
6

 
5

 
6

 
5

Average revenue per consolidated center
$
1,182

 
$
1,141

 
$
2,284

 
$
2,245

Same center revenues increase (decrease)
1
%
 
0
%
 
(1
)%
 
(1
)%
Procedures performed during the period at consolidated centers
420,575

 
415,786

 
810,562

 
807,489

Income tax expense attributable to noncontrolling interests
$
176

 
$
182

 
$
344

 
$
368


-MORE-

AMSG Reports Second-Quarter Results
 
 
Page 6
 
 
July 31, 2014
 
 



AMSURG CORP.
Reconciliations of Non-GAAP Measures to GAAP Measures
(In thousands)

 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2014
 
2013
 
2014
 
2013
Reconciliation of net earnings to Adjusted EBITDA (1):
 
 
 
 
 
 
 
Net earnings from continuing operations attributable to AmSurg Corp. common shareholders
$
18,954

 
$
18,417

 
$
36,458

 
$
36,167

Income tax expense
12,921

 
12,710

 
25,978

 
24,979

Interest expense, net
6,894

 
7,512

 
13,857

 
15,054

Depreciation and amortization
8,550

 
8,125

 
16,924

 
16,133

Share-based compensation
2,506

 
1,916

 
4,964

 
3,966

Acquisition costs
3,572

 
140

 
3,579

 
175

Gain on deconsolidation
(1,366
)
 

 
(3,411
)
 
(2,237
)
Adjusted EBITDA
$
52,031

 
$
48,820

 
$
98,349

 
$
94,237


 
Three Months Ended June 30,
 
Six Months Ended June 30,
 
2014
 
2013
 
2014
 
2013
Reconciliation of net earnings per share-diluted to adjusted net earnings per share-diluted (2):
 
 
 
 
 
 
 
Net earnings from continuing operations attributable to AmSurg Corp. common shareholders
$
0.59

 
$
0.58

 
$
1.13

 
$
1.13

Gain on deconsolidation, net of tax
(0.03
)
 

 
(0.04
)
 
(0.04
)
Acquisition costs, net of tax
0.07

 

 
0.07

 

Adjusted net earnings from continuing operations attributable to AmSurg Corp. common stockholders
$
0.63

 
$
0.58

 
$
1.16

 
$
1.10

                           
(1)
We define Adjusted EBITDA of AmSurg as earnings before interest, income taxes, depreciation, amortization, share-based compensation, acquisition costs and gains or losses on deconsolidations. Adjusted EBITDA should not be considered a measure of financial performance under generally accepted accounting principles. Items excluded from Adjusted EBITDA are significant components in understanding and assessing financial performance. Adjusted EBITDA is an analytical indicator used by management and the health care industry to evaluate company performance, allocate resources and measure leverage and debt service capacity. Adjusted EBITDA should not be considered in isolation or as an alternative to net income, cash flows generated by operations, investing or financing activities, or other financial statement data presented in the consolidated financial statements as indicators of financial performance or liquidity. Because Adjusted EBITDA is not a measurement determined in accordance with generally accepted accounting principles and is thus susceptible to varying calculations, Adjusted EBITDA as presented may not be comparable to other similarly titled measures of other companies. Net earnings from continuing operations attributable to AmSurg Corp. common shareholders is the financial measure calculated and presented in accordance with generally accepted accounting principles that is most comparable to Adjusted EBITDA as defined.
(2)
We believe the calculation of adjusted net earnings from continuing operations per diluted share attributable to AmSurg Corp. common shareholders provides a better measure of our ongoing performance and provides better comparability to prior periods because it excludes the gains or loss from deconsolidations, which are non-cash in nature, and acquisition costs (the majority of which relate to the Sheridan Transaction), which are of a nature and significance not generally associated with our historical individual center acquisition activity. Adjusted net earnings from continuing operations per diluted share attributable to AmSurg Corp. common shareholders should not be considered as a measure of financial performance under accounting principles generally accepted in the United States, and the item excluded from it is a significant component in understanding and assessing financial performance. Because adjusted net earnings from continuing operations per diluted share attributable to AmSurg Corp. common shareholders is not a measurement determined in accordance with accounting principles generally accepted in the United States and is thus susceptible to varying calculations, it may not be comparable as presented to other similarly titled measures of other companies.




-MORE-

AMSG Reports Second-Quarter Results
 
 
Page 7
 
 
July 31, 2014
 
 



AMSURG CORP.
Unaudited Selected Consolidated Financial and Operating Data, continued
(In thousands)
 
 
June 30,
 
December 31,
Balance Sheet Data:
 
2014
 
2013
Assets
 
 
 
 
Current assets:
 
 
 
 
Cash and cash equivalents
 
$
44,911

 
$
50,840

Accounts receivable, net of allowance of $30,414 and $27,862, respectively
 
110,538

 
105,072

Supplies inventory
 
18,808

 
18,414

Deferred income taxes
 
3,386

 
3,097

Prepaid and other current assets
 
34,658

 
33,602

Total current assets
 
212,301

 
211,025

Property and equipment, net
 
168,839

 
169,895

Investments in unconsolidated affiliates and other
 
26,546

 
16,392

Goodwill
 
1,794,493

 
1,758,970

Intangible assets, net
 
20,829

 
21,662

Total assets
 
$
2,223,008

 
$
2,177,944

Liabilities and Equity
 
 
 
 
Current liabilities:
 
 
 
 
Current portion of long-term debt
 
$
20,208

 
$
20,844

Accounts payable
 
26,353

 
27,501

Accrued salaries and benefits
 
29,849

 
32,294

Other accrued liabilities
 
9,771

 
9,231

Total current liabilities
 
86,181

 
89,870

Long-term debt
 
556,793

 
583,298

Deferred income taxes
 
194,181

 
176,020

Other long-term liabilities
 
25,695

 
25,503

Commitments and contingencies
 
 
 
 
Noncontrolling interests – redeemable
 
177,063

 
177,697

Equity:
 
 
 
 
Preferred stock, no par value, 5,000 shares authorized, no shares issued or outstanding
 

 

Common stock, no par value, 70,000 shares authorized, 32,572 and 32,353 shares outstanding, respectively
 
189,822

 
185,873

Retained earnings
 
614,480

 
578,324

Total AmSurg Corp. equity
 
804,302

 
764,197

Noncontrolling interests – non-redeemable
 
378,793

 
361,359

Total equity
 
1,183,095

 
1,125,556

Total liabilities and equity
 
$
2,223,008

 
$
2,177,944




-MORE-

AMSG Reports Second-Quarter Results
 
 
Page 8
 
 
July 31, 2014
 
 



AMSURG CORP.
Unaudited Selected Consolidated Financial and Operating Data, continued
(In thousands)

 
 
Three Months Ended June 30,
 
Six Months Ended June 30,
Statement of Cash Flow Data:
 
2014
 
2013
 
2014
 
2013
Cash flows from operating activities:
 
 
 
 
 
 

 
 
Net earnings
 
$
68,172

 
$
65,836

 
$
128,286

 
$
128,109

Adjustments to reconcile net earnings to net cash flows provided by operating activities:
 
 
 
 
 
 
 
 
Depreciation and amortization
 
8,550

 
8,125

 
16,924

 
16,133

Net loss on sale of long-lived assets
 
7

 

 
611

 

Gain on deconsolidation
 
(1,366
)
 

 
(3,411
)
 
(2,237
)
Share-based compensation
 
2,506

 
1,916

 
4,964

 
3,966

Excess tax benefit from share-based compensation
 
(363
)
 
(922
)
 
(2,090
)
 
(1,210
)
Deferred income taxes
 
5,939

 
6,400

 
17,872

 
19,329

Equity in earnings of unconsolidated affiliates
 
(539
)
 
(696
)
 
(1,303
)
 
(1,098
)
Increases (decreases) in cash and cash equivalents, net of effects of acquisitions and dispositions, due to changes in:
 
 
 
 
 
 
 
 
Accounts receivable, net
 
(4,328
)
 
(3,516
)
 
(5,979
)
 
(5,221
)
Supplies inventory
 
238

 
(119
)
 
(7
)
 
(320
)
Prepaid and other current assets
 
1,328

 
(2,074
)
 
(2,310
)
 
(2,057
)
Accounts payable
 
1,181

 
689

 
(2,397
)
 
(2,351
)
Accrued expenses and other liabilities
 
1,375

 
1,946

 
769

 
(2,155
)
Other, net
 
1,062

 
1,100

 
1,652

 
1,662

Net cash flows provided by operating activities
 
83,762

 
78,685

 
153,581

 
152,550

Cash flows from investing activities:
 
 
 
 
 
 
 
 
Acquisition of interests in surgery centers and related transactions
 
(19,399
)
 
(18,094
)
 
(24,437
)
 
(18,346
)
Acquisition of property and equipment
 
(9,037
)
 
(6,362
)
 
(16,075
)
 
(12,472
)
Proceeds from sale of interests in surgery centers
 
981

 
55

 
2,092

 

Other
 
(963
)
 

 
(1,381
)
 
55

Net cash flows used in investing activities
 
(28,418
)
 
(24,401
)
 
(39,801
)
 
(30,763
)
Cash flows from financing activities:
 
 
 
 
 
 
 
 
Proceeds from long-term borrowings
 
42,301

 
40,052

 
74,246

 
70,922

Repayment on long-term borrowings
 
(51,473
)
 
(48,011
)
 
(102,326
)
 
(96,222
)
Distributions to noncontrolling interests
 
(48,816
)
 
(47,612
)
 
(92,010
)
 
(91,526
)
Proceeds from issuance of common stock upon exercise of stock options
 
1,158

 
8,037

 
1,646

 
13,728

Repurchase of common stock
 

 
(9,406
)
 
(2,857
)
 
(26,164
)
Capital contributions and ownership transactions by noncontrolling interests
 
(1,082
)
 
377

 
(498
)
 
936

Excess tax benefit from share-based compensation
 
363

 
922

 
2,090

 
1,210

Financing cost incurred
 

 
(1,133
)
 

 
(1,146
)
Net cash flows used in financing activities
 
(57,549
)
 
(56,774
)
 
(119,709
)
 
(128,262
)
Net decrease in cash and cash equivalents
 
(2,205
)
 
(2,490
)
 
(5,929
)
 
(6,475
)
Cash and cash equivalents, beginning of period
 
47,116

 
42,413

 
50,840

 
46,398

Cash and cash equivalents, end of period
 
$
44,911

 
$
39,923

 
$
44,911

 
$
39,923



-END-
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