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55 things to know about ASC company 2Q financial reports

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The ambulatory surgery center industry endured a slow start to the year. First quarter results reflected the affects of harsh weather and patient reluctance to undergo elective surgery early in the year, but the second quarter holds promise for the rest of the year.

Here are 55 things to know about financial reports from eight publicly traded ASC companies.

AmSurg

1. Revenues rose to $281.1 million, up 5 percent from $267.1 million in the second quarter of 2013.

2. Net earnings attributable to common shareholders were $19 million, or $0.59 per diluted share, up from $18.4 million, or $0.58 per diluted share, in the same period last year.

3. For the first six months of the year, revenues were $544.2 million, up 4 percent from $525.3 million in same period last year.

4. Net earnings from continuing operations attributable to common shareholders were $36.5 million, or $1.13 per diluted share, compared to $36.2 million, or $1.13 per diluted share, in the first half of 2013.

5. "AmSurg's financial results met our expectations for the second quarter. We benefited from a 1 percent increase in same-center revenue, despite having one less business day in the quarter compared with the second quarter last year. Average revenue per procedure increased 4 percent on a comparable quarter basis, primarily due to changing procedure mix," said AmSurg CEO and President Christopher Holden.

6. During the second quarter, AmSurg deconsolidated three surgery centers and contributed their controlling interests in the centers to create two joint ventures with two health systems.

7. The company also acquired a surgery center to end the quarter with a total of 243 centers.

8. AmSurg has an additional six surgery centers under letter of intent and a de novo ASC under development, expected to open next year.

9. The company completed the $2.35 billion Sheridan Healthcare acquisition on July 16. "Through this transaction, we have effectively doubled the company's size, strengthened our geographic, payer 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," said Mr. Holden.

10. In light of the Sheridan acquisition the company revised its financial and operating guidance for 2014. AmSurg will record the transaction fees related to the acquisition in the third quarter, which will result in a net loss for that quarter. Revenues are now expected to fall between $1.61 billion and $1.63 billion.

11. AmSurg expects a favorable outlook on 2015. "In July, CMS announced proposed 2015 ASC reimbursement rates. We estimate these rates will positively impact our 2015 revenue by approximately $7 million," said Mr. Holden.

Foundation Healthcare

12. The company reported $22.1 million in revenue for the quarter, a 2 percent increase from $21.6 million in the second quarter of 2013.

13. Foundation Healthcare had an adjusted EBITDA of $1.5 million for the second quarter, compared to $3 million in the same period last year.

14. Patient services revenue increased 7 percent from the second quarter of 2013 to $19.9 million. The increase can be traced back to an increase in average reimbursement at Foundation Healthcare's East El Paso Physician Medical Center and an increase in case volume at Foundation Surgical Hospital of San Antonio.

15. Operating expenses rose 6.8 percent from $21.7 million in the prior year period to $23.1 million. The increase was due to stock compensation, salary and benefits expenses.

16. "We are pleased with our results as we recorded an 8 percent increase in revenue at our majority owned hospitals for the second quarter of 2014 as compared to the second quarter 2013. In addition, we successful refinanced our debt at the end of the quarter reducing our average cost of funds from 6.5 percent to 4.25 percent and extending debt amortization to reduce costs by $2 million annually," said CEO Stanton Nelson.

17. Foundation Healthcare operations resulted in a net loss, attributable to the company's stock, of $1.5 million in the second quarter, compared to $0.6 million in the second quarter of 2013.

18. As of June 30, the company had cash and cash equivalents totaling $1.9 million, compared to $4 million in the year prior.  

Hospital Corporation of America

19. Hospital Corporation of America's net income increased 14 percent from $423 million in the second quarter of 2013 to $483 million this year.

20. Second quarter revenue rose 9.2 percent from $8.45 billion in the prior year period to $9.23 billion.

21. Adjusted EBITDA was $2 billion in the second quarter, up 18.5 percent from $1.69 billion in the second quarter.

22. HCA's same-facility revenue per equivalent admission rose 5.4 percent year-over-year.

Medical Facilities Corporation

23. Revenue for the second quarter was $74.4 million, a slight increase of 0.9 percent from $73.7 million in the second quarter of 2013.

24. Income from operations was down 2.5 percent from $20.8 million last year to $20.3 million.

25. "The company's second quarter 2014 revenue continued to be consistent with that from one year ago. While our margins were impacted by higher operating costs, which were mostly due to changes in case volumes and case mix at your centers, and selected reimbursement reductions emanating from new contracts at two of our centers, we continue to generate sustainable cash flows and distributions to our shareholders as evidenced by our cash available for distribution and payout ratio for the quarter," said CEO Donald Schellpfeffer, MD.

26. MFC generated Cdn$9.7 million in cash available for distribution, or Cdn$0.31 per common share. The company declared dividends of Cdn$8.8 million, or Cdn$0.281 per common share. This represents a payout ratio of 90.6 percent, compared to a ratio of 93.8 percent in the second quarter of last year.

27. The company's operating expenses were $54.1 million, or 72.7 percent of revenue. Operating expenses were up slightly from the same period last year – $52.9 million or 71.7 percent of revenue in 2013.

28. Total net income and comprehensive income was $23.1 million, compared to $14.8 million in 2013.

29. The $8.4 million increase in income was largely due to the positive impact of the changes in values of exchangeable interest liability and convertible debentures, decrease in interest gained and gain on foreign currency.

Northstar Healthcare

30. In July, Northstar Healthcare reported $15.1 million in estimated revenue for the second quarter of 2014. The company ended the quarter on track with the estimate, a 157.8 percent increase from $5.9 million in net patient service revenue in 2013.

31. The company performed 1,297 cases in the second quarter, up 26.9 percent from the same period last year.

32. EBITA for the second quarter was $0.6 million, up from $.04 million in 2013.

33. Cash flows used for operating activities were $0.1 million, down from $.14 million during the second quarter of 2013.

Surgical Care Affiliates

34. Total net operating revenues, excluding revenues from centers in which SCA does not hold a controlling interest, rose 8 percent from $196.7 million in the second quarter of 2013 to $212.4 million.

35. System-wide revenue, including all centers in which the company has an interest or manages, rose 10.2 percent.

36. The company's cash flow from operating activities was $42.3 million, up 7.3 percent from the second quarter of last year.

37. Operating cash flow less distributions to non-controlling interests increased 34.5 percent from $12.9 million in the prior year to $17.3 million.

38. SCA's net income, including certain non-cash and non-recurring expenses, was $6 million, compared to $9.8 million in net loss attributable to the company in the second quarter of 2013.

39. "Our acquisition pipeline remains robust and the acquisition activity is accelerating as we enter the back half of the year. We remain pleased with our development program and our outlook remains positive as we continue to optimize our existing portfolio while we deploy capital in attractive opportunities in current markets and with new health system partners," said president and CEO Andrew Hayek.

40. System-wide net patient revenue per case increased 4.9 percent from the second quarter of 2013. The growth in system-wide revenue was driven by acquisitions, changes in case volume and changes in certain payer contract rates.

41. SCA reiterates its previous guidance, which sets adjusted EBITDA less NCI in the rage of $154 million to $158 million.  

Symbion

42. The company’s revenue was up 7.5 percent from $132.3 million in the second quarter of 2013 to $142.2 million in the second quarter of 2014.

43. Symbion ended the quarter with $6.6 million in net income, up from $1.5 million in the second quarter of 2013.

44. Operating income rose from $13.2 million in the second quarter of 2013 to $22.3 million in the second quarter of this year.

45. Operating expenses were $119.9 million, a slight increase from $119.1 million in the same period last year.

46. Symbion's case volume dipped slightly from 55,384 cases performed in the second quarter of 2013 to 55,242 cases. But, patient services revenues grew from $131 million in the year prior to $140.8 million.  

47. On June 13, Symbion entered into an agreement and plan of merger with Surgery Center Holdings. In the second quarter, Symbion incurred $2.3 million in related merger transaction costs.

48. As of June 30, Symbion owned 50 surgical facilities, 44 ambulatory surgery centers and six surgical hospitals. The company owns a majority stake in 30 of the 50 facilities.

United Surgical Partners International

49. Operating income, $60.6 million in the second quarter of 2013, rose 18 percent to $71.7 million.

50. Net revenues increased to $161.1 million, up 4 percent from $155.2 million in the prior year.

51. EBITDA less non-controlling interest grew to $58.1 million, up 5 percent from $55.2 million in the second quarter of 2013.

52. USPI's cash flows for the second quarter were $44.9 million compared to $38.9 million in the same period last year.

53. System-wide revenues for the company's facilities increased 5 percent year-over-year and rose 3 percent on a same-store basis.

54. The second quarter represented a welcome improvement in our operations and financial performance compared with the first quarter. While some volume weakness remains, the sequential trend is encouraging. In additional, we have had a very successful year so far from a development perspective, and we remain optimistic that this success will continue in the second half of the year," said CEO William H. Wilcox.

55. USPI acquired three facilities during the second quarter and two additional centers after the quarter's close. The company intends to add five to 10 more facilities before year's end. The company had ownership interest in and operates 219 facilities, 152 of which are joint ventured with non-profit health systems.

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