10-Q 1 d10q.htm FOR THE QUARTERLY PERIOD ENDED SEPTEMBER 30, 2007 For the quarterly period ended September 30, 2007
Table of Contents

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

FORM 10-Q

 

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

For the quarterly period ended September 30, 2007

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 No. 1-15669

Gentiva Health Services, Inc.

(Exact name of registrant as specified in its charter)

 

Delaware   36-4335801

(State or other jurisdiction of

incorporation or organization)

 

(I.R.S. Employer

Identification No.)

 

3 Huntington Quadrangle, Suite 200S, Melville, NY   11747-4627
(Address of principal executive offices)   (Zip Code)

Registrant’s telephone number, including area code: (631) 501-7000

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 is a large accelerated filer, an accelerated filer, or a non-accelerated filer (as defined in Rule 12b-2 of the Exchange Act).

Large accelerated filer  ¨                    Accelerated filer  x                    Non-accelerated filer  ¨

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 the registrant’s Common Stock, as of November 5, 2007, was 27,974,558.

 



Table of Contents

INDEX

 

          Page No.

PART I - FINANCIAL INFORMATION

  

Item 1.

   Financial Statements   
   Consolidated Balance Sheets (Unaudited) – September 30, 2007 and December 31, 2006    3
   Consolidated Statements of Income (Unaudited) – Three Months and Nine Months Ended September 30, 2007 and October 1, 2006    4
   Consolidated Statements of Cash Flows (Unaudited) – Nine Months Ended September 30, 2007 and October 1, 2006    5
   Notes to Consolidated Financial Statements (Unaudited)    6-22

Item 2.

   Management’s Discussion and Analysis of Financial Condition and Results of Operations    22-35

Item 3.

   Quantitative and Qualitative Disclosures About Market Risk    35

Item 4.

   Controls and Procedures    36

PART II - OTHER INFORMATION

  

Item 1.

   Legal Proceedings    36

Item 1A.

   Risk Factors    36

Item 2.

   Unregistered Sales of Equity Securities and Use of Proceeds    36

Item 3.

   Defaults Upon Senior Securities    36

Item 4.

   Submission of Matters to a Vote of Security Holders    36

Item 5.

   Other Information    36

Item 6.

   Exhibits    37

SIGNATURES

   38

EXHIBIT INDEX

  


Table of Contents

PART I – FINANCIAL INFORMATION

 

Item 1. Financial Statements

Gentiva Health Services, Inc. and Subsidiaries

Consolidated Balance Sheets

(In thousands, except share and per share amounts)

(Unaudited)

 

     September 30, 2007     December 31, 2006  

ASSETS

    

Current assets:

    

Cash, cash equivalents and restricted cash

   $ 33,720     $ 32,910  

Short-term investments

     23,400       24,325  

Receivables, less allowance for doubtful accounts of $10,127 and $9,805 at September 30, 2007 and December 31, 2006, respectively

     214,510       181,549  

Deferred tax assets

     21,562       30,443  

Prepaid expenses and other current assets

     15,031       11,933  
                

Total current assets

     308,223       281,160  

Fixed assets, net

     57,481       49,684  

Intangible assets, net

     212,604       213,280  

Goodwill

     276,100       274,959  

Other assets

     26,518       24,799  
                

Total assets

   $ 880,926     $ 843,882  
                

LIABILITIES AND SHAREHOLDERS’ EQUITY

    

Current liabilities:

    

Current portion of long-term debt

   $ 1,577     $ —    

Accounts payable

     20,360       19,580  

Payroll and related taxes

     24,090       16,085  

Deferred revenue

     28,118       20,122  

Medicare liabilities

     9,619       9,232  

Cost of claims incurred but not reported

     21,175       19,462  

Obligations under insurance programs

     37,607       35,910  

Other accrued expenses

     42,472       45,020  
                

Total current liabilities

     185,018       165,411  

Long-term debt

     314,423       342,000  

Deferred tax liabilities, net

     46,101       41,065  

Other liabilities

     23,530       21,081  

Shareholders’ equity:

    

Common stock, $.10 par value; authorized 100,000,000 shares; issued 28,033,621 shares at September 30, 2007 and 27,483,789 shares at December 31, 2006

     2,803       2,748  

Additional paid-in capital

     312,008       298,450  

Accumulated deficit

     (1,238 )     (25,220 )

Accumulated other comprehensive loss

     (720 )     (886 )

Treasury stock, 59,063 shares at September 30, 2007 and 47,489 shares at December 31, 2006

     (999 )     (767 )
                

Total shareholders’ equity

     311,854       274,325  
                

Total liabilities and shareholders’ equity

   $ 880,926     $ 843,882  
                

See notes to consolidated financial statements.

 

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Gentiva Health Services, Inc. and Subsidiaries

Consolidated Statements of Income

(In thousands, except per share amounts)

(Unaudited)

 

     For the Three Months Ended     For the Nine Months Ended  
     September 30, 2007     October 1, 2006     September 30, 2007     October 1, 2006  

Net revenues

   $ 309,082     $ 286,169     $ 915,901     $ 813,470  

Cost of services and goods sold

     179,041       168,250       525,438       474,764  
                                

Gross profit

     130,041       117,919       390,463       338,706  

Selling, general and administrative expenses

     110,299       104,520       330,795       299,800  
                                

Operating income

     19,742       13,399       59,668       38,906  

Interest expense

     (6,564 )     (7,408 )     (20,649 )     (17,382 )

Interest income

     810       862       2,436       2,519  
                                

Income before income taxes

     13,988       6,853       41,455       24,043  

Income tax expense

     5,797       1,539       17,473       8,779  
                                

Net income

   $ 8,191     $ 5,314     $ 23,982     $ 15,264  
                          

Net income per common share:

        

Basic

   $ 0.29     $ 0.20     $ 0.86     $ 0.58  
                                

Diluted

   $ 0.28     $ 0.19     $ 0.84     $ 0.56  
                                

Weighted average shares outstanding:

        

Basic

     27,955       27,178       27,729       26,207  
                                

Diluted

     28,802       27,983       28,564       27,040  
                                

See notes to consolidated financial statements.

 

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Gentiva Health Services, Inc. and Subsidiaries

Consolidated Statements of Cash Flows

(In thousands)

(Unaudited)

 

     For the Nine Months Ended  
     September 30, 2007     October 1, 2006  

OPERATING ACTIVITIES:

    

Net income

   $ 23,982     $ 15,264  

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

    

Depreciation and amortization

     14,705       11,391  

Amortization of debt issuance costs

     763       759  

Provision for doubtful accounts

     6,644       5,416  

Reversal of tax audit reserves

     —         (800 )

Equity-based compensation expense

     5,085       2,951  

Windfall tax benefits associated with equity-based compensation

     (788 )     (1,729 )

Deferred income tax expense

     15,725       8,909  

Changes in assets and liabilities, net of acquired businesses:

    

Accounts receivable

     (39,837 )     855  

Prepaid expenses and other current assets

     (3,847 )     (2,233 )

Accounts payable

     766       (8,190 )

Payroll and related taxes

     8,005       5,496  

Deferred revenue

     7,996       (2,745 )

Medicare liabilities

     386       1,518  

Cost of claims incurred but not reported

     1,713       (2,038 )

Obligations under insurance programs

     1,697       1,571  

Other accrued expenses

     (2,295 )     8,750  

Other, net

     1,677       201  
                

Net cash provided by operating activities

     42,377       45,346  
                

INVESTING ACTIVITIES:

    

Purchase of fixed assets

     (19,534 )     (16,286 )

Acquisition of businesses, net of cash acquired

     (3,820 )     (212,422 )

Purchase of short-term investments available-for-sale

     (58,850 )     (143,095 )

Maturities of short-term investments available-for-sale

     59,775       159,270  
                

Net cash used in investing activities

     (22,429 )     (212,533 )
                

FINANCING ACTIVITIES:

    

Proceeds from issuance of common stock

     7,010       9,742  

Windfall tax benefits associated with equity-based compensation

     788       1,729  

Proceeds from issuance of debt

     —         370,000  

Healthfield debt repayments

     —         (195,305 )

Other debt repayments

     (26,000 )     (17,000 )

Changes in book overdrafts

     —         (1,395 )

Debt issuance costs

     —         (6,930 )

Repayment of capital lease obligations

     (936 )     (336 )
                

Net cash (used in) provided by financing activities

     (19,138 )     160,505  
                

Net change in cash, cash equivalents and restricted cash

     810       (6,682 )

Cash, cash equivalents and restricted cash at beginning of period

     32,910       38,617  
                

Cash, cash equivalents and restricted cash at end of period

   $ 33,720     $ 31,935  
                

SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION:

    

Interest paid

   $ 22,258     $ 7,680  

Income taxes paid, net of refunds

   $ 1,648     $ 2,400  

During the nine months ended October 1, 2006, the Company issued 3,194,137 shares of common stock in connection with the acquisition of The Healthfield Group, Inc. on February 28, 2006. On June 29, 2007, 11,574 shares of common stock were transferred as treasury shares from the Healthfield escrow account to satisfy certain pre-acquisition liabilities paid by the Company.

See notes to consolidated financial statements.

 

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Gentiva Health Services, Inc. and Subsidiaries

Notes to Consolidated Financial Statements

(Unaudited)

1. Background and Basis of Presentation

Gentiva® Health Services, Inc. (“Gentiva” or the “Company”) provides comprehensive home health services throughout most of the United States through its Home Health, CareCentrix® and Other Related Services operating segments. See Note 14 for a description of the Company’s reportable business segments.

On February 28, 2006, the Company completed the acquisition of The Healthfield Group, Inc. (“Healthfield”), a regional provider of home healthcare, hospice and related services, as further described in Note 5. In connection with the acquisition, the Company entered into a $445 million Credit Agreement and a Guarantee and Collateral Agreement, as further described in Note 9.

The accompanying interim consolidated financial statements are unaudited, and have been prepared by Gentiva using accounting principles consistent with those described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2006 and pursuant to the rules and regulations of the Securities and Exchange Commission and, in the opinion of management, include all adjustments necessary for a fair presentation of results of operations, financial position and cash flows for each period presented. Results for interim periods are not necessarily indicative of results for a full year. The year-end balance sheet data was derived from audited financial statements. The interim financial statements do not include all disclosures required by accounting principles generally accepted in the United States of America.

2. Accounting Policies

Cash, Cash Equivalents and Restricted Cash

The Company considers all investments with an original maturity of three months or less on their acquisition date to be cash equivalents. Restricted cash of $22.0 million at September 30, 2007 and December 31, 2006 primarily represented segregated cash funds in a trust account designated as collateral under the Company’s insurance programs. The Company, at its option, may access the cash funds in the trust account by providing equivalent amounts of alternative collateral. Interest on all restricted funds accrues to the Company. The Company had operating funds of approximately $4.0 million and $5.3 million at September 30, 2007 and December 31, 2006, respectively, which exclusively relate to a non-profit hospice operation in Florida. Cash and cash equivalents also included amounts on deposit with individual financial institutions in excess of $100,000, which is the maximum amount insured by the Federal Deposit Insurance Corporation. Management believes that these financial institutions are viable entities and believes any risk of loss is remote.

Short-Term Investments

The Company’s short-term investments consist primarily of AAA-rated auction rate securities and other debt securities with an original maturity of more than three months and less than one year on the acquisition date in accordance with Statement of Financial Accounting Standards (“SFAS”) No. 115, “Accounting for Certain Investments in Debt and Equity Securities.” Investments in debt securities are classified by individual security into one of three separate categories: available-for-sale, held-to-maturity or trading.

Available-for-sale investments are carried on the balance sheet at fair value, which for the Company approximates carrying value. Auction rate securities of $23.4 million and $24.3 million at September 30, 2007 and December 31, 2006, respectively, are classified as available-for-sale and are expected to be available to meet the Company’s current operational needs and accordingly are classified as short-term investments. The interest rates on auction rate securities are reset to current interest rates periodically, typically 7, 14 and 28 days. Contractual maturities of the auction rate securities exceed ten years.

Debt securities which the Company has the intent and ability to hold to maturity are classified as held-to-maturity investments and are reported at amortized cost, which approximates fair value. The Company has no investments classified as held-to-maturity investments.

The Company has no investments classified as trading securities.

Inventory

Inventories, which are included in prepaid expenses and other current assets, are stated at the lower of cost or market. Cost is determined using the specific identification method. Inventories amounted to $2.1 million at September 30, 2007 and $2.0 at December 31, 2006, respectively.

 

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Home Medical Equipment

Home medical equipment (“HME”), which is included in fixed assets, is stated at cost and consists of medical equipment, such as hospital beds and wheelchairs, provided to in-home patients in the Company’s respiratory therapy and HME operations. Depreciation is provided using the straight-line method over the estimated useful lives of the equipment. In 2007, in accordance with recent legislation, ownership of certain HME will transfer directly to the patient at the end of a 13-month continuous rental period. As a result, in the first quarter of fiscal 2007, the Company changed its estimated useful lives of certain HME whose ownership is ultimately expected to transfer to the patient and recorded a charge of approximately $400,000 in depreciation expense relating to the change in estimate. At September 30, 2007 and December 31, 2006, the net book value of HME included in fixed assets, net in the accompanying balance sheets was $5.6 million and $6.1 million, respectively.

3. New Accounting Standards

In July 2006, the Financial Accounting Standards Board (“FASB”) issued Interpretation No. 48, “Accounting for Uncertainty in Income Taxes” (“FIN 48”), which requires that realization of an uncertain income tax position must be more likely than not (i.e., greater than 50 percent likelihood of receiving a benefit) before it can be recognized in the financial statements. FIN 48 further prescribes the benefit to be recorded in the financial statements as the amount most likely to be realized assuming a review by tax authorities having all relevant information and applying current conventions. The Interpretation also clarifies the financial statement classification of tax-related penalties and interest and sets forth new disclosures regarding unrecognized tax benefits. This Interpretation is effective as of the beginning of an entity’s fiscal year that begins after December 15, 2006. The Company adopted this Interpretation in the first quarter of fiscal 2007 as further described in Note 13, and the adoption had no material impact on its consolidated financial statements.

In September 2006, the FASB issued SFAS No. 157, “Fair Value Measurements” (“SFAS 157”), which defines fair value, establishes a framework for measuring fair value under Generally Accepted Accounting Principles (“GAAP”) and expands disclosures about fair value measurements. This Statement will be effective for financial statements issued for fiscal years beginning after November 15, 2007, and interim periods within those fiscal years. The Company expects that the adoption of the Statement will have no material impact on the Company’s consolidated financial statements.

In February 2007, the FASB issued SFAS No. 159, “The Fair Value Option for Financial Assets and Financial Liabilities – Including an Amendment to FASB Statement No. 115” (“SFAS 159”), which permits entities to choose to measure many financial instruments and certain other items at fair value. SFAS 159 is effective as of the beginning of an entity’s first fiscal year that begins after November 15, 2007. The Company expects that the adoption of SFAS 159 will have no material impact on the Company’s consolidated financial position or results of operations.

 

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4. Net Revenues and Accounts Receivable

Net revenues by major payer classification were as follows:

 

(Dollars in millions)

   Third Quarter     First Nine Months  
     2007    2006    Percentage
Variance
    2007    2006    Percentage
Variance
 

Medicare

   $ 151.7    $ 136.1    11.5 %   $ 453.9    $ 367.9    23.4 %

Medicaid and Local Government

     37.9      45.5    (16.7 %)     116.5      132.4    (12.0 %)

Commercial Insurance and Other

     119.5      104.6    14.2 %     345.5      313.2    10.3 %
                                        
   $ 309.1    $ 286.2    8.0 %   $ 915.9    $ 813.5    12.6 %
                                        

The Company is party to a contract with CIGNA Health Corporation (“Cigna”), pursuant to which the Company provides or contracts with third-party providers to provide direct home nursing services and related services, home infusion therapies, and certain other specialty medical equipment to patients insured by Cigna. For the third quarter and first nine months of fiscal 2007, Cigna accounted for approximately 20 percent and 19 percent, respectively, of the Company’s total net revenues compared to approximately 18 percent and 20 percent for the third quarter and first nine months of fiscal 2006, respectively.

Net revenues generated under capitated agreements with managed care payers were approximately 5 percent of total net revenues for both the third quarter and first nine months of fiscal 2007, and 6 percent and 7 percent for the third quarter and first nine months of fiscal 2006, respectively.

Medicare revenues for the first nine months of fiscal 2006 included approximately $1.9 million received in settlement of the Company’s appeal filed with the U.S. Provider Relations Review Board (“PRRB”) related to the reopening of all of its 1999 cost reports. (See Note 12.)

Accounts receivable attributable to major payer sources of reimbursement were as follows (in thousands):

 

     September 30, 2007     December 31, 2006  

Medicare

   $ 92,130     $ 76,105  

Medicaid and Local Government

     23,578       24,175  

Commercial Insurance and Other

     108,929       91,074  
                

Gross Accounts Receivable

     224,637       191,354  

Less: Allowance for doubtful accounts

     (10,127 )     (9,805 )
                

Net Accounts Receivable

   $ 214,510     $ 181,549  
                

The Commercial Insurance and Other payer group included self-pay accounts receivable relating to patient co-payments of $7.2 million and $7.0 million as of September 30, 2007 and December 31, 2006, respectively.

5. Acquisitions

Baptist Home Care

Effective July 1, 2007, the Company acquired the home health operations as well as the respiratory and HME business of North Carolina Baptist Hospital pursuant to an asset purchase agreement. The transaction, which included the acquisition of certain assets and the assumption of certain liabilities related to contracts and leases, was completed primarily to expand the Company’s home health offerings in North Carolina.

Total consideration of $3.8 million was paid in cash in the third quarter of 2007. The purchase price was allocated to goodwill ($1.5 million), identifiable intangible assets (including a certificate of need) ($2.2 million) and other assets ($0.1 million). The Company determined the estimated fair values based on independent appraisals, discounted cash flows, quoted market prices, and management estimates derived from an independent valuation analysis of the intangible assets acquired.

 

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Carolina Vital Care and Lazarus House Hospice

During the second quarter of fiscal 2006, the Company completed two acquisitions to expand home infusion services in the Carolinas and hospice services into Tennessee.

The Company acquired the assets of Carolina Vital Care, a home infusion pharmacy business based in Charlotte, North Carolina, and commitments related to certain contracts and office leases with respect to the period after the closing date, pursuant to an asset purchase agreement.

The Company acquired certain assets and the operations of Lazarus House Hospice, a not-for-profit provider of licensed hospice services based in Tennessee, pursuant to an asset purchase agreement.

The combined purchase price for the two acquisitions was $4.5 million. The combined purchase price was allocated to goodwill ($2.2 million), identifiable intangible assets ($1.9 million), and other assets ($0.4 million). The Company determined the estimated fair values based on independent appraisals, discounted cash flows, quoted market prices, and management estimates derived from an independent valuation analysis of the intangible assets acquired.

Healthfield

On February 28, 2006, the Company completed the acquisition of 100 percent of the equity interest of Healthfield, a regional provider of home healthcare, hospice and related services with approximately 130 locations primarily in eight southeastern states. Total consideration for the acquisition was $466.0 million in cash and shares of Gentiva common stock, including transaction costs of $11.2 million. Total consideration included $2.0 million in adjustments recorded since the acquisition to reflect a change in estimate relating to the final true-up of working capital and net debt as of the Healthfield closing date, as well as incremental closing costs. In December 2006 and June 2007, the Company received, in interim settlements of escrow claims, fair value of approximately $0.8 million and $0.2 million, respectively, through the return of 47,489 shares and 11,574 shares of Gentiva common stock, respectively (see Note 12). Final consideration is subject to various post closing adjustments.

In connection with the acquisition, the Company repaid Healthfield’s existing long-term debt, including accrued interest and prepayment penalties, aggregating $195.3 million. The Company funded the purchase price using (i) $363.3 million of borrowings under a new senior term loan facility, exclusive of debt issuance costs (see Note 9); (ii) 3,194,137 shares of Gentiva common stock at a fair value of $53.3 million, determined based on the average stock price for the period beginning two days prior and ending two days after the measurement date, February 24, 2006; and (iii) existing cash balances of $49.4 million.

The Company acquired Healthfield to strengthen and expand the Company’s presence in the southeastern United States, which has favorable demographic trends and includes important Certificate of Need states; diversify the Company’s business mix; provide a meaningful platform for the Company to enter the hospice business, as well as expansion into respiratory therapy and HME services and infusion therapy as a direct provider of services; and expand its current specialty programs.

The transaction was accounted for in accordance with the provisions of SFAS No. 141, “Business Combinations” (“SFAS 141”). Accordingly, Healthfield’s results of operations are included in the Company’s consolidated financial statements from the acquisition date. The purchase price was allocated to the underlying assets acquired and liabilities assumed based on their estimated fair values at the date of the acquisition. The excess of the purchase price over the fair value of the net identifiable tangible and intangible assets acquired is recorded as goodwill. The Company, with the assistance of independent appraisers, has determined the estimated fair values based on such independent appraisals, discounted cash flows, quoted market prices, and management estimates derived from an independent valuation analysis of the intangible assets acquired. The following table summarizes the estimated fair values of the assets acquired and liabilities assumed as of the acquisition date inclusive of an adjustment made during fiscal 2007 as further described in Note 6 (in thousands):

 

Cash

   $ 13,705  

Accounts receivable

     48,716  

Deferred tax assets

     8,636  

Fixed assets

     12,912  

Identifiable intangible assets

     208,898  

Goodwill

     265,640  

Other assets

     3,074  
        

Total assets acquired

     561,581  

Accounts payable and accrued liabilities

     (50,359 )

Short-term and long-term debt

     (195,305 )

Deferred tax liability

     (45,700 )

Other liabilities

     (899 )
        

Total liabilities assumed

     (292,263 )
        

Net assets acquired

   $ 269,318  
        

 

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The valuation and useful lives of the intangible assets by component and assignment to reportable segments are as follows (in thousands):

 

     Home
Health
   Other
Related
Services
   Total    Useful Life

Intangible assets:

           

Tradenames

   $ 15,881    $ —      $ 15,881    10 Years

Customer relationships

     10,680      —        10,680    10 Years

Certificates of need

     178,311      4,026      182,337    Indefinite
                       

Total

   $ 204,872    $ 4,026    $ 208,898   
                       

Goodwill

   $ 196,857    $ 68,783    $ 265,640   
                       

The estimated fair values of the assets acquired and liabilities assumed as noted above reflect the completion of the independent valuation analysis and post closing adjustments through September 30, 2007. The Company expects that between 15 percent and 20 percent of the aggregate amount of goodwill and identifiable intangible assets will be amortizable for tax purposes.

Pro Forma Results

The following unaudited pro forma financial information presents the combined results of operations of the Company and Healthfield as if the acquisition had occurred at January 2, 2006, the beginning of fiscal 2006. The pro forma results presented below for the nine months ended October 1, 2006 combine the results of the Company for such period and the historical results of Healthfield from January 1, 2006 through February 28, 2006 (in thousands, except per share data):

 

     Nine Months Ended
October 1, 2006

Net revenues

   $ 863,991

Net income

   $ 15,447

Net income per common share:

  

Basic

   $ 0.57

Diluted

   $ 0.56

Weighted average shares outstanding:

  

Basic

     26,874

Diluted

     27,707

 

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The pro forma results above reflect adjustments for (i) interest on debt incurred, at the Company’s weighted average interest rate of 7.1 percent; (ii) amortization of identifiable intangibles related to the Healthfield acquisition; and (iii) income tax provision at a normalized tax rate of 39 percent. The information presented above is for illustrative purposes for the period ended October 1, 2006 only and is not necessarily indicative of results that would have been achieved if the acquisition had occurred as of the beginning of the Company’s 2006 fiscal year.

Pro forma financial information presenting the combined results of operations of the Company and Carolina Vital Care, Lazarus House Hospice and Baptist Home Care as if those acquisitions had occurred on January 2, 2006 would not vary significantly from the Company’s actual results of operations for the periods presented.

6. Goodwill and Other Intangible Assets

The gross carrying amount and accumulated amortization of each category of identifiable intangible assets and goodwill as of September 30, 2007 and December 31, 2006 were as follows (in thousands):

 

     September 30, 2007     December 31, 2006      
     Home
Health
    Other
Related
Services
    Total     Home
Health
    Other
Related
Services
    Total    

Useful

Life

Amortized intangible assets:

              

Covenants not to compete

   $ 1,198     $ 275     $ 1,473     $ 1,198     $ 275     $ 1,473     5 Years

Less: accumulated amortization

     (588 )     (75 )     (663 )     (409 )     (34 )     (443 )  
                                                  

Net covenants not to compete

     610       200       810       789       241       1,030    

Customer relationships

     16,170       1,600       17,770       14,650       1,600       16,250     7-10 Years

Less: accumulated amortization

     (2,944 )     (305 )     (3,249 )     (1,717 )     (133 )     (1,850 )  
                                                  

Net customer relationships

     13,226       1,295       14,521       12,933       1,467       14,400    

Tradenames

     17,028       —         17,028       17,028       —         17,028     10 Years

Less: accumulated amortization

     (2,792 )     —         (2,792 )     (1,515 )     —         (1,515 )  
                                                  

Net tradenames

     14,236       —         14,236       15,513       —         15,513    
                                                  

Subtotal

     28,072       1,495       29,567       29,235       1,708       30,943    

Indefinite-lived intangible assets:

              

Certificates of need

     179,011       4,026       183,037       178,311       4,026       182,337     Indefinite
                                                  

Total identifiable intangible assets

   $ 207,083     $ 5,521     $ 212,604     $ 207,546     $ 5,734     $ 213,280    
                                                  

Goodwill

   $ 205,150     $ 70,950     $ 276,100     $ 204,008     $ 70,951     $ 274,959    
                                                  

For the third quarter and first nine months of fiscal 2007, the Company recorded amortization expense of approximately $1.0 million and $2.9 million, respectively, as compared to $1.0 million and $2.4 million for the corresponding periods of fiscal 2006. The estimated amortization expense for the remainder of 2007 is $1.0 million and for each of the next five succeeding years approximates $4.0 million for fiscal years 2008 through 2009, $3.8 million for fiscal year 2010 and $3.7 million for fiscal years 2011 through 2012.

During the first nine months of 2007, the gross carrying amount of certain identifiable intangible assets and goodwill increased as a result of the Baptist Home Care acquisition (see Note 5) and goodwill decreased by $0.4 million as a result of adjustment of certain net operating loss carryforwards relating to Healthfield.

7. Restructuring and Integration Costs

During the third quarter and first nine months of fiscal 2007, the Company recorded restructuring and integration costs of approximately $0.6 million and $2.2 million, respectively, as compared to $1.7 million and $4.4 million for the corresponding periods of 2006, as further described below.

Integration Activities

The Company recorded charges of $0.6 million and $2.1 million during the third quarter and first nine months of fiscal 2007, respectively, as compared to $1.7 million and $3.7 million for the third quarter and first nine months of 2006, respectively, in connection with integration activities relating to the Healthfield acquisition. Charges include severance costs in connection with the termination of personnel, discretionary bonuses to certain employees in connection with the Healthfield acquisition, write-off of prepaid fees in connection with the Company’s former credit facility that was terminated on February 28, 2006, and the write-off of developed software for which there was determined to be minimal value. The Company expects to incur additional integration costs during fiscal 2007, primarily related to back office and systems integration, but the aggregate amount of such costs cannot be determined at this time.

 

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Other Related Services Restructuring Activities

During the first nine months of fiscal 2007, the Company recorded charges of $0.1 million and in the fourth quarter of fiscal 2006 recorded charges of $0.9 million, in connection with a restructuring plan associated with its hospice operations. Charges include severance costs in connection with the termination of personnel and lease costs associated with the closing of some facilities. The Company substantially completed this restructuring during the third quarter of 2007.

The costs incurred and cash expenditures associated with restructuring and integration activities for Home Health and Other Related Services were as follows (in thousands):

 

     Integration Activities     Other Related Services  
     Compensation
and
Severance
Costs
    Other
Costs
    Total     Compensation
and
Severance
Costs
    Facility
Lease
and Other
Costs
    Total  

Beginning balance at January 1, 2006

   $ —       $ —       $ —       $ —       $ —       $ —    

Charge in 2006

     3,205       2,925       6,130       748       125       873  

Cash expenditures

     (2,347 )     (2,221 )     (4,568 )     (325 )     (125 )     (450 )

Asset write-off

     —         (702 )     (702 )     —         —         —    
                                                

Ending balance at December 31, 2006

     858       2       860       423       —         423  

Charge in first quarter 2007

     559       417       976       1       (2 )     (1 )

Cash expenditures

     (838 )     (393 )     (1,231 )     (309 )     2       (307 )
                                                

Ending balance at April 1, 2007

     579       26       605       115       —         115  

Charge in second quarter 2007

     186       307       493       25       127       152  

Cash expenditures

     (273 )     (315 )     (588 )     (25 )     (119 )     (144 )
                                                

Ending balance at July 1, 2007

     492       18       510       115       8       123  

Charge in third quarter 2007

     412       159       571       (19 )     1       (18 )

Cash expenditures

     (262 )     (177 )     (439 )     (64 )     (9 )     (73 )
                                                

Ending balance at September 30, 2007

   $ 642     $ —       $ 642     $ 32     $ —       $ 32  
                                                

CareCentrix Restructuring Activities

During the first nine months of fiscal 2006, the Company recorded charges of $0.7 million in connection with a restructuring plan associated with its CareCentrix operations. This plan included the closing and consolidation of two regional care centers in response to changes primarily in the nature of services provided to Cigna members under an amended contract entered into in late 2005. The Company completed this restructuring during the second quarter of fiscal 2006.

Other Restructuring Activities

In connection with a restructuring plan adopted in fiscal year 2002, the Company had remaining lease obligations of $1.0 million at September 30, 2007 and $1.1 million at December 31, 2006. The balance of unpaid charges relating to all restructuring and integration activities aggregated $1.6 million at September 30, 2007 and $2.4 million at December 31, 2006, which was included in other accrued expenses in the consolidated balance sheets.

 

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8. Earnings Per Share

Basic and diluted earnings per share for each period presented has been computed by dividing net income by the weighted average number of shares outstanding for each respective period. The computations of the basic and diluted per share amounts were as follows (in thousands, except per share amounts):

 

     Three Months Ended    Nine Months Ended
     September 30, 2007    October 1, 2006    September 30, 2007    October 1, 2006

Net income

   $ 8,191    $ 5,314    $ 23,982    $ 15,264
                           

Basic weighted average common shares outstanding

     27,955      27,178      27,729      26,207

Shares issuable upon the assumed exercise of stock options and in connection with the employee stock purchase plan using the treasury stock method

     847      805      835      833
                           

Diluted weighted average common shares outstanding

     28,802      27,983      28,564      27,040
                           

Net income per common share:

           

Basic

   $ 0.29    $ 0.20    $ 0.86    $ 0.58

Diluted

   $ 0.28    $ 0.19    $ 0.84    $ 0.56

9. Long-Term Debt

Credit Arrangements

The Company’s credit agreement provides for an aggregate borrowing amount of $445.0 million of senior secured credit facilities consisting of (i) a seven year term loan of $370.0 million repayable in quarterly installments of 1 percent per annum (with the remaining balance due at maturity on March 31, 2013) and (ii) a six year revolving credit facility of $75.0 million, of which $55.0 million is available for the issuance of letters of credit and $10.0 million is available for swing line loans. A pre-approved $25.0 million increase to the revolving credit facility is available at the Company’s discretion. Upon the occurrence of certain events, including the issuance of capital stock, the incurrence of additional debt (other than that specifically allowed under the credit agreement), certain asset sales where the cash proceeds are not reinvested, or if the Company has excess cash flow (as defined in the agreement), mandatory prepayments of the term loan are required in the amounts specified in the credit agreement.

Interest under the credit agreement accrues at Base Rate or Eurodollar Rate (plus 1.25 percent for Base Rate Loans and 2.25 percent for Eurodollar Rate Loans) for both the revolving credit facility and the term loan. Overdue amounts bear interest at 2 percent per annum above the applicable rate. The interest rates under the credit agreement are reduced if the Company meets certain reduced leverage targets as follows:

 

Revolving Credit

Consolidated Leverage Ratio

  

Term Loan

Consolidated Leverage Ratio

   Margin for Base
Rate Loans
  Margin for
Eurodollar Loans

³ 3.5

   ³ 3.5    1.25%   2.25%

< 3.5 & ³ 3.0

   < 3.5 & ³ 3.0    1.00%   2.00%

< 3.0 & ³ 2.5

   < 3.0    0.75%   1.75%

< 2.5

      0.50%   1.50%

The Company is also subject to a revolving credit commitment fee equal to 0.5 percent per annum of the average daily difference between the total revolving credit commitment and the total outstanding borrowings and letters of credit, excluding amounts outstanding under swing loans. The commitment fee will be reduced to 0.375 percent per annum if the Company’s consolidated leverage ratio (as defined in the agreement) is less than 3.5. At July 1, 2007, the Company achieved a consolidated leverage ratio of less than 3.5 and, as a result, the margin on revolving credit and term loan borrowings was reduced by 25 basis points and the revolving credit commitment fee was reduced to 0.375 percent on a prospective basis, effective August 1, 2007. As of September 30, 2007, the consolidated leverage ratio was 3.02.

The credit agreement requires the Company to meet certain financial tests. These tests include a consolidated leverage ratio and a consolidated interest coverage ratio. The credit agreement also contains additional covenants which, among other things, require the Company to deliver to the lenders specified financial information, including annual and quarterly financial information, and limit the Company’s ability to do the following, subject to various exceptions and limitations: (i) merge with other companies; (ii) create liens on its property; (iii) incur additional debt obligations; (iv) enter into transactions with affiliates, except on an arms-length basis; (v) dispose of property; (vi) make capital expenditures; and (vii) pay dividends or acquire capital stock of the Company or its subsidiaries. As of September 30, 2007, the Company was in compliance with the covenants in the credit agreement.

 

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To assist in managing the potential interest rate risk associated with its floating rate term loan under the credit agreement, on July 3, 2006, the Company entered into a two year interest rate swap agreement with a notional value of $170 million. Under the swap agreement, the Company pays a fixed rate of 5.665 percent per annum plus an applicable margin (an aggregate of 7.915 percent per annum for the period July 3, 2006 through July 31, 2007 and 7.665 percent per annum thereafter) on the $170 million rather than a fluctuating rate plus an applicable margin.

During the third quarter and first nine months of fiscal 2007, the Company made prepayments of $8.0 million and $26 million, respectively, under its term loan. Beginning in the second quarter of 2008, the Company is required to make quarterly installment payments of $789,000 with the remaining balance due at maturity on March 31, 2013. The required quarterly installment payments are reduced by any additional prepayments the Company may make, applied against the quarterly installments pro rata based on the remaining outstanding principal amount of such installments, including the balance due at maturity. As of September 30, 2007, maturities under the term loan were as follows: no maturities through fiscal 2007, $2.4 million for fiscal 2008, $3.2 million per year for fiscal 2009 through fiscal 2011 and $304.0 million thereafter. As of September 30, 2007, the Company had outstanding borrowings under the term loan of $316.0 million. There were no borrowings outstanding under the revolving credit facility as of September 30, 2007.

Total outstanding letters of credit were approximately $20.1 million at September 30, 2007 and December 31, 2006. The letters of credit, which expire one year from the date of issuance, were issued to guarantee payments under the Company’s workers’ compensation program and for certain other commitments. The Company also had outstanding surety bonds of $1.9 million at September 30, 2007 and $2.7 million at December 31, 2006.

Guarantee and Collateral Agreement

The Company has entered into a Guarantee and Collateral Agreement, among the Company and certain of its subsidiaries, in favor of the administrative agent under the credit agreement (the “Guarantee and Collateral Agreement”). The Guarantee and Collateral Agreement grants a collateral interest in all real property and personal property of the Company and its subsidiaries, including stock of its subsidiaries. The Guarantee and Collateral Agreement also provides for a guarantee of the Company’s obligations under the credit agreement by substantially all subsidiaries of the Company.

Other

The Company has equipment capitalized under capital lease obligations. At September 30, 2007 and December 31, 2006, long-term capital lease obligations were $1.1 million and $1.2 million, respectively, and were recorded in other liabilities on the Company’s consolidated financial statements. The current portion of obligations under capital leases was $1.2 million and $1.1 million at September 30, 2007 and December 31, 2006, respectively, and was recorded in other accrued expenses on the Company’s consolidated balance sheets.

For the third quarter and first nine months of fiscal 2007, net interest expense was approximately $5.8 million and $18.2 million, respectively, which included interest income of $0.8 million and $2.4 million, respectively. For fiscal 2006, net interest expense for the third quarter and first nine months was $6.5 million and $14.9 million, respectively, which included interest income of $0.9 million and $2.5 million, respectively. Net interest expense for all periods consisted primarily of interest expense associated with the term loan borrowings, fees associated with the credit agreement and outstanding letters of credit and amortization of debt issuance costs, partially offset by interest income earned on short-term investments and existing cash balances.

 

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10. Shareholders’ Equity

Changes in shareholders’ equity for the nine months ended September 30, 2007 were as follows (in thousands, except share amounts):

 

     Common Stock   

Additional
Paid-in

Capital

  

Accumulated

Deficit

   

Accumulated
Other
Comprehensive

Loss

   

Treasury

Stock

   

Total

 
   Shares    Amount            

Balance at December 31, 2006

   27,483,789    $ 2,748    $ 298,450    $ (25,220 )   $ (886 )   $ (767 )   $ 274,325  

Comprehensive income:

                 

Net income

   —        —        —        23,982       —         —         23,982  

Unrealized gain on interest rate swap, net of tax

   —        —        —        —         166       —         166  
                                                   

Total comprehensive income

   —        —        —        23,982       166       —         24,148  

Income tax benefits associated with the exercise of non-qualified stock options

   —        —        1,520      —         —         —         1,520  

Equity-based compensation expense

   —        —        5,085      —         —         —         5,085  

Issuance of stock upon exercise of stock options and under stock plans for employees and directors

   549,832      55      6,953      —         —         —         7,008  

Treasury stock received from Healthfield escrow (11,574 shares)

   —        —        —        —         —         (232 )     (232 )
                                                   

Balance at September 30, 2007

   28,033,621    $ 2,803    $ 312,008    $ (1,238 )   $ (720 )   $ (999 )   $ 311,854  
                                                   

Comprehensive income amounted to $7.9 million and $4.2 million for the third quarter of fiscal 2007 and fiscal 2006, respectively, and $24.1 million and $14.1 million for the first nine months of fiscal 2007 and 2006, respectively.

The Company has an authorized stock repurchase program under which the Company can repurchase and retire up to 1,500,000 shares of its outstanding common stock. The repurchases can occur periodically in the open market or through privately negotiated transactions based on market conditions and other factors. The Company made no repurchases of its common stock during the nine months ended September 30, 2007. As of September 30, 2007, the Company had remaining authorization to repurchase an aggregate of 683,396 shares of its outstanding common stock.

11. Equity-Based Compensation Plans

Effective January 2, 2006, the Company adopted the fair value method of accounting for equity-based compensation arrangements in accordance with SFAS No. 123(Revised), “Share-Based Payment” (“SFAS 123(R)”). Under the provisions of SFAS 123(R), the estimated fair value of share-based awards granted under the Company’s equity-based compensation plans is recognized as compensation expense over the vesting period of the award. The Company used the modified prospective method of transition under which compensation expense is recognized for all share-based payments (i) granted after the effective date of adoption and (ii) granted prior to the effective date of adoption and that remain unvested on the date of adoption.

Stock option grants in fiscal 2007 and fiscal 2006 fully vest over a four year period based on a vesting schedule that provides for one-half vesting after year two and an additional one-fourth vesting after each of years three and four. Stock option grants in fiscal 2005 fully vest over a four year period based on a vesting schedule that provides for one-third vesting after each of years one, three and four.

For the third quarter and first nine months of fiscal 2007, the Company recorded equity-based compensation expense of $1.6 million and $5.1 million, respectively, as compared to $1.2 million and $3.0 million, respectively, for the corresponding periods of fiscal 2006. Equity-based compensation expense is reflected as selling, general and administrative expense in the consolidated statements of income, as calculated on a straight-line basis over the vesting periods of the related options in accordance with the provisions of SFAS 123(R). The weighted-average fair values of the Company’s stock options granted during the first nine months of fiscal 2007 and fiscal 2006, calculated using the Black-Scholes option-pricing model and other assumptions, are as follows:

 

     Nine Months Ended  
     September 30, 2007     October 1, 2006  

Weighted-average fair value of options granted

   $ 7.07     $ 7.28  

Risk-free interest rate

     4.70 %     4.79 %

Expected volatility

     30 %     35 %

Contractual life

     10 years       10 years  

Expected dividend yield

     0 %     0 %

 

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For stock options granted during the fiscal 2007 and 2006 periods, the expected life of an option is estimated to be 2.5 years following its vesting date, and forfeitures are reflected in the calculation using an estimate based on experience.

Compensation expense is calculated for the fair value of the employee’s purchase rights under the Company’s Employee Stock Purchase Plan (“ESPP”), using the Black-Scholes option pricing model. Assumptions for the first nine months of fiscal 2007 and fiscal 2006 are as follows:

 

     Nine Months Ended  
     September 30, 2007     October 1, 2006  
     1st offering
Period
    2nd offering
Period
    1st offering
Period
    2nd offering
Period
 

Risk-free interest rate

   5.09 %   5.01 %   4.42 %   5.30 %

Expected volatility

   30 %   23 %   32 %   34 %

Expected life

   0.5 years     0.5 years     0.5 years     0.5 years  

Expected dividend yield

   0 %   0 %   0 %   0 %

A summary of Gentiva stock option activity as of September 30, 2007 and changes during the nine months then ended is presented below:

 

     Number of
Options
    Weighted-
Average
Exercise
Price
   Weighted-
Average
Remaining
Contractual
Life (Years)
   Aggregate
Intrinsic
Value

Balance as of December 31, 2006

   3,321,961     $ 12.73      

Granted

   872,100       19.52      

Exercised

   (418,994 )     10.79      

Cancelled

   (311,705 )     18.01      
                  

Balance as of September 30, 2007

   3,463,362     $ 14.20    7.01    $ 17,354,929
                        

Exercisable Options

   1,562,498     $ 9.10    5.08    $ 15,799,172
                        

During the first nine months of fiscal 2007, the Company granted 872,100 stock options to officers and employees under its 2004 Equity Incentive Plan at an average exercise price of $19.52 and a weighted-average, grant-date fair value of $7.07. The total intrinsic value of options exercised during the nine months ended September 30, 2007 and October 1, 2006 was $3.9 million and $7.9 million, respectively.

As of September 30, 2007, the Company had $6.6 million of total unrecognized compensation cost related to nonvested stock options. This compensation expense is expected to be recognized over a weighted-average period of 1.1 years. The total fair value of options that vested during the first nine months of fiscal 2006 was $2.0 million. There were no options that vested during the first nine months of fiscal 2007.

12. Legal Matters

Litigation

In addition to the matters referenced in this Note 12, the Company is party to certain legal actions arising in the ordinary course of business, including legal actions arising out of services rendered by its various operations, personal injury and employment disputes. Management does not expect that these other legal actions will have a material adverse effect on the business or financial condition of the Company.

Indemnifications

Upon the closing of the acquisition of Healthfield on February 28, 2006, an escrow fund was created to cover potential indemnification claims by the Company after the closing. Covered claims include, for example, claims for breaches of representations under the acquisition agreement and claims relating to legal proceedings existing as of the closing date, taxes for the pre-closing periods and medical malpractice and workers’ compensation claims relating to any act or event occurring on or before the closing date. The escrow fund initially consisted of 1,893,656 shares of Gentiva’s common stock valued at $30 million and $5 million in cash. The first $5 million of any disbursements consist of shares of Gentiva’s common stock;

 

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the next $5 million of any disbursements consist of cash; and any additional disbursements consist of shares of Gentiva’s common stock. On December 29, 2006 and June 29, 2007, 47,489 shares and 11,574 shares of Gentiva’s common stock, respectively, valued at $767,415 and $232,066, respectively, were disbursed to the Company from the escrow fund covering interim claims the Company had made against the escrow fund. The escrow fund is subject to staged releases of shares of Gentiva’s common stock and cash in the escrow fund to certain principal stockholders of Healthfield, less the amount of claims the Company makes against the escrow fund. The final staged release will take place on February 28, 2008, the second anniversary of the closing.

Government Matters

PRRB Appeal

The Company’s annual cost reports, which were filed with the Centers for Medicare & Medicaid Services (“CMS”), were subject to audit by the fiscal intermediary engaged by CMS. In connection with the audit of the Company’s 1997 cost reports, the Medicare fiscal intermediary made certain audit adjustments related to the methodology used by the Company to allocate a portion of its residual overhead costs. The Company filed cost reports for years subsequent to 1997 using the fiscal intermediary’s methodology. The Company believed the methodology it used to allocate such overhead costs was accurate and consistent with past practice accepted by the fiscal intermediary; as such, the Company filed appeals with the PRRB concerning this issue with respect to cost reports for the years 1997, 1998 and 1999. The Company’s consolidated financial statements for the years 1997, 1998 and 1999 had reflected use of the methodology mandated by the fiscal intermediary.

In June 2003, the Company and its Medicare fiscal intermediary signed an Administrative Resolution relating to the issues covered by the appeals pending before the PRRB. Under the terms of the Administrative Resolution, the fiscal intermediary agreed to reopen and adjust the Company’s cost reports for the years 1997, 1998 and 1999 using a modified version of the methodology used by the Company prior to 1997. This modified methodology will also be applied to cost reports for the year 2000, which are currently under audit. The Administrative Resolution required that the process to (i) reopen all 1997 cost reports, (ii) determine the adjustments to allowable costs through the issuance of Notices of Program Reimbursement and (iii) make appropriate payments to the Company, be completed in early 2004. Cost reports relating to years subsequent to 1997 were to be reopened after the process for the 1997 cost reports was completed. During fiscal 2004, the Company received an aggregate of $10.4 million in connection with the reopening of the 1997 and 1998 cost reports.

The fiscal intermediary completed the reopening of the 1999 cost reports during the first quarter of fiscal 2006. The Company received an aggregate amount of $5.5 million, of which $1.9 million was recorded as net revenues during the first quarter of fiscal 2006 and $3.6 million was received and recorded as net revenues during fiscal 2005.

The time frame for resolving all items relating to the 2000 cost reports cannot be determined at this time.

Subpoena

On April 17, 2003, the Company received a subpoena from the Department of Health and Human Services, Office of the Inspector General, Office of Investigations (“OIG”). The subpoena seeks information regarding the Company’s implementation of settlements and corporate integrity agreements entered into with the government, as well as the Company’s treatment on cost reports of employees engaged in sales and marketing efforts. With respect to the cost report issues, the government has preliminarily agreed to narrow the scope of production to the period from January 1, 1998 through September 30, 2000. On February 17, 2004, the Company received a subpoena from the U.S. Department of Justice (“DOJ”) seeking additional information related to the matters covered by the OIG subpoena. The Company has provided documents and other information requested by the OIG and DOJ pursuant to their subpoenas and similarly intends to cooperate fully with any future OIG or DOJ information requests. To the Company’s knowledge, the government has not filed a complaint against the Company.

13. Income Taxes

The Company recorded a federal and state income tax provision of $5.8 million for the third quarter of fiscal 2007, of which $0.7 million represented a current tax benefit and $6.5 million represented a deferred tax provision. The difference between the federal statutory income tax rate of 35 percent and the Company’s effective rate of 41.4 percent for the quarter ended September 30, 2007 is primarily due to (i) the impact of the adoption of SFAS 123(R) (approximately 2.2 percent) and (ii) state taxes and other items, partially offset by tax exempt interest (approximately 4.2 percent).

For the nine months ended September 30, 2007, the Company recorded a federal and state income tax provision of $17.5 million representing a current tax provision of $1.8 million and a deferred tax provision of $15.7 million. The difference between the federal statutory income tax rate of 35 percent and the Company’s effective rate of 42.1 percent for the first nine months of 2007 is primarily due to (i) the impact of the adoption of SFAS 123(R) (approximately 2.4 percent) and (ii) state taxes and other items, partially offset by tax exempt interest and a change in the state valuation allowance (approximately 4.7 percent).

 

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The Company recorded a federal and state income tax provision of $1.5 million for the third quarter of fiscal 2006, of which $0.7 million represented a current tax benefit and $2.2 million represented a deferred tax provision. For the nine months ended October 1, 2006, the Company recorded a federal and state income tax provision of $8.8 million representing a current tax benefit of $0.1 million and a deferred tax provision of $8.9 million.

The difference between the federal statutory income tax rate of 35 percent and the Company’s effective rate of 22.5 percent for the quarter ended October 1, 2006 is primarily due to (i) the impact of the adoption of SFAS 123(R) (approximately 4.8 percent) and (ii) state taxes and other items partially offset by tax exempt interest (approximately 4.3 percent), offset by (iii) the release of $0.8 million of tax reserves associated with the expiration of the statute of limitations (approximately 11.6 percent) and (iv) additional state net operating loss carryforwards resulting from the finalization of prior year state tax audits (approximately 10.0 percent).

The difference between the federal statutory income tax rate of 35 percent and the Company’s effective rate of 36.5 percent for the first nine months of fiscal 2006 is primarily due to (i) the impact of the adoption of SFAS 123(R) (approximately 3.4 percent) and (ii) state taxes and other items partially offset by tax exempt interest (approximately 4.2 percent), offset by (iii) the release of $0.8 million of tax reserves associated with the expiration of the statute of limitations (approximately 3.3 percent) and (iv) additional state net operating loss carryforwards resulting from the finalization of prior year state tax audits (approximately 2.8 percent).

Deferred tax assets and deferred tax liabilities were as follows (in thousands):

 

     September 30, 2007     December 31, 2006  

Deferred tax assets

    

Current:

    

Reserves and allowances

   $ 11,531     $ 14,017  

Federal net operating loss and other carryforwards

     6,392       13,373  

Other

     3,639       3,053  
                

Total current deferred tax assets

     21,562       30,443  

Noncurrent:

    

Intangible assets

     44,610       49,453  

State net operating loss

     8,438       8,689  

Less: valuation allowance

     (4,295 )     (4,191 )
                

Total noncurrent deferred tax assets

     48,753       53,951  
                

Total deferred tax assets

     70,315       84,394  
                

Deferred tax liabilities:

    

Noncurrent:

    

Fixed assets

     (1,453 )     (2,828 )

Intangible assets

     (81,068 )     (82,227 )

Developed software

     (10,427 )     (7,316 )

Acquisition reserves

     (1,545 )     (1,513 )

Other

     (361 )     (1,132 )
                

Total non-current deferred tax liabilities

     (94,854 )     (95,016 )
                

Net deferred tax liabilities

   $ (24,539 )   $ (10,622 )
                

At September 30, 2007, the Company had a federal tax credit carryforward of $1.9 million and federal net operating loss carryforwards of $12.7 million, which begin to expire in 2025. The federal net operating loss carryforwards of $12.7 million are from the Healthfield acquisition and are subject to Internal Revenue Code §382 limitations. Deferred tax assets relating to federal net operating loss carryforwards approximate $4.4 million. In addition, the Company had state net operating loss carryforwards of approximately $169 million, which expire between 2007 and 2026. Deferred tax assets relating to state net operating loss carryforwards approximate $8.4 million. A valuation allowance of $4.3 million at September 30, 2007 and $4.2 million at December 31, 2006 has been recorded to reduce this deferred tax asset to its estimated realizable value since certain state net operating loss carryforwards may expire before realization. Approximately $1.1 million of the valuation allowance relates to Healthfield’s state net operating losses, the benefit of which, if realized, will be credited to goodwill.

On January 1, 2007, the Company adopted FIN 48, which requires that the realization of an uncertain income tax position must be more likely than not (i.e., greater than 50 percent likelihood of receiving a benefit) before it can be recognized in the financial statements. The implementation of FIN 48 had no significant impact on the Company’s consolidated financial statements. On January 1, 2007, the date of adoption, the Company had $5.5 million of unrecognized

 

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tax benefits, of which $2.8 million would affect the Company’s effective tax rate if recognized. As of January 1, 2007, it is not likely that there would be a change in the Company’s uncertain tax benefits that would significantly impact the Company’s tax rate within the next twelve months.

The Company recognizes interest and penalties on uncertain tax positions in income tax expense. As of September 30, 2007 and December 30, 2006, the Company had approximately $0.6 million and $0.7 million, respectively, of accrued interest related to uncertain tax positions.

As of January 1, 2007, the Company is subject to federal income tax examinations for the tax years 2003 through 2006. In the major state jurisdictions under which the Company is subject to income tax, tax years 2003 through 2006 remain subject to examination, with the exception of Arizona, Michigan and Texas, for which tax years 2002 through 2006 remain subject to examination.

14. Business Segment Information

The Company’s operations involve servicing patients and customers through its three reportable business segments: Home Health, CareCentrix and Other Related Services. The Other Related Services segment encompasses the Company’s hospice, respiratory therapy and HME, infusion therapy and consulting services businesses.

Home Health

The Home Health segment is comprised of direct home nursing and therapy services operations, including specialty programs. The Company conducts direct home nursing and therapy services operations through licensed and Medicare-certified agencies from which the Company provides various combinations of skilled nursing and therapy services, paraprofessional nursing services and homemaker services to pediatric, adult and elder patients. The Company’s direct home nursing and therapy services operations also deliver services to its customers through focused specialty programs that include:

 

   

Gentiva Orthopedics, which provides individualized home orthopedic rehabilitation services to patients recovering from joint replacement or other major orthopedic surgery;

 

 

 

Gentiva Safe Strides®, which provides therapies for patients with balance issues who are prone to injury or immobility as a result of falling;

 

   

Gentiva Cardiopulmonary, which helps patients and their physicians manage heart and lung health in a home-based environment; and

 

 

 

Gentiva Rehab Without Walls®, which provides home and community-based neurorehabilitation therapies for patients with traumatic brain injury, cerebrovascular accident injury and acquired brain injury, as well as a number of other complex rehabilitation cases.

CareCentrix

The CareCentrix segment encompasses Gentiva’s ancillary care benefit management and the coordination of integrated homecare services for managed care organizations and health benefit plans. CareCentrix operations provide an array of administrative services and coordinate the delivery of home nursing services, acute and chronic infusion therapies, HME, respiratory products, orthotics and prosthetics, and services for managed care organizations and health benefit plans. CareCentrix accepts case referrals from a wide variety of sources, verifies eligibility and benefits and transfers case requirements to the providers for services to the patient. CareCentrix provides services to its customers, including the fulfillment of case requirements, care management, provider credentialing, eligibility and benefits verification, data reporting and analysis, and coordinated centralized billing for all authorized services provided to the customer’s enrollees.

Other Related Services

Hospice

Hospice serves terminally ill patients in the southeast United States. The Company provides comprehensive management of the healthcare services and products needed by hospice patients and their families through the use of an interdisciplinary team. Depending on a patient’s needs, each hospice patient is assigned an interdisciplinary team comprised of a physician, nurse(s), home health aide(s), medical social worker(s), chaplain, dietary counselor and bereavement coordinator, as well as other care professionals.

 

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Respiratory Therapy and Home Medical Equipment

Respiratory therapy and HME services are provided to patients at home through branch locations primarily in the southeast United States. Patients are offered a broad portfolio of products and services that serve as an adjunct to traditional home health nursing and hospice care. Respiratory therapy services are provided to patients who suffer from a variety of conditions including asthma, chronic obstructive pulmonary diseases, cystic fibrosis and other respiratory conditions. HME includes hospital beds, wheelchairs, ambulatory aids, bathroom aids, patient lifts and rehabilitation equipment.

Infusion Therapy

Infusion therapy is provided to patients at home through pharmacy locations in the southeast United States. Infusion therapy serves as a complement to the Company’s traditional service offerings, providing clients with a comprehensive home health provider while diversifying the Company’s revenue base. Services provided include: (i) enteral nutrition, (ii) antibiotic therapy, (iii) total parenteral nutrition, (iv) pain management, (v) chemotherapy, (vi) patient education and training and (vii) nutrition management.

Consulting

The Company provides consulting services to home health agencies through its Gentiva Consulting unit. These services include billing and collection activities, on-site agency support and consulting, operational support and individualized strategies for reduction of days sales outstanding.

Corporate Expenses

Corporate expenses consist of costs relating to executive management and corporate and administrative support functions that are not directly attributable to a specific segment, as well as equity-based compensation expense. Corporate and administrative support functions represent primarily information services, accounting and reporting, tax compliance, risk management, procurement, marketing, legal, regulatory compliance and human resource benefits and administration.

Other Information

The Company’s senior management evaluates performance and allocates resources based on operating contributions of the reportable segments, which exclude corporate expenses, depreciation, amortization and net interest costs, but include revenues and all other costs (including special items and restructuring and integration costs) directly attributable to the specific segment. Intersegment revenues primarily represent Home Health segment revenues generated from services provided to the CareCentrix segment. Segment assets represent net accounts receivable, inventory, HME, identifiable intangible assets, goodwill and certain other assets associated with segment activities. Intersegment assets represent accounts receivable associated primarily with services provided by the Home Health segment to the CareCentrix segment. All other assets are assigned to corporate assets for the benefit of all segments for the purposes of segment disclosure.

For the third quarter and first nine months of fiscal 2007, net revenues relating to the Company’s participation in Medicare amounted to $151.7 million and $453.9 million, respectively, of which $137.1 million and $409.1 million, respectively, was included in the Home Health segment and $14.6 million and $44.8 million, respectively, was included in the Other Related Services segment.

For the third quarter and nine months ended October 1, 2006, net revenues relating to the Company’s participation in Medicare amounted to $136.1 million and $367.9 million, respectively, of which $119.1 million and $329.9 million, respectively, were included in the Home Health segment and $17.0 million and $38.0 million, respectively, were included in the Other Related Services segment. Revenues from Cigna amounting to $62.3 million and $52.1 million for the third quarter of fiscal 2007 and 2006, respectively, and $176.7 million and $160.2 million for the first nine months of fiscal 2007 and 2006, respectively, were included in the CareCentrix segment.

Net revenues associated with the Other Related Services segment are as follows (in thousands):

 

     Three Months Ended    Nine Months Ended
     September 30, 2007    October 1, 2006    September 30, 2007    October 1, 2006

Hospice

   $ 16,633    $ 19,834    $ 49,907    $ 44,604

Respiratory services and HME

     9,708      8,322      28,776      19,772

Infusion therapies

     2,839      3,006      9,050      7,032

Consulting services

     1,147      886      3,489      2,663
                           

Total net revenues

   $ 30,327    $ 32,048    $ 91,222    $ 74,071
                           

 

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Segment information about the Company’s operations is as follows (in thousands):

 

     Home Health     CareCentrix     Other
Related Services
    Total  

For the three months ended September 30, 2007 (unaudited)

        

Net revenue - segments

   $ 204,410     $ 75,295     $ 30,327     $ 310,032  
                          

Intersegment revenues

           (950 )
              

Total net revenue

         $ 309,082  
              

Operating contribution

   $ 30,895 (1)   $ 6,949     $ 2,762 (1)   $ 40,606  
                          

Corporate expenses

           (15,857 )(1)

Depreciation and amortization

           (5,007 )

Interest expense, net

           (5,754 )
              

Income before income taxes

         $ 13,988  
              

For the three months ended October 1, 2006 (unaudited)

        

Net revenue - segments

   $ 192,343     $ 64,829     $ 32,048     $ 289,220  
                          

Intersegment revenues

           (3,051 )
              

Total net revenue

         $ 286,169  
              

Operating contribution

   $ 23,567 (1)   $ 5,661     $ 6,333     $ 35,561  
                          

Corporate expenses

           (17,769 )(1)

Depreciation and amortization

           (4,393 )

Interest expense, net

           (6,546 )
              

Income before income taxes

         $ 6,853  
              

For the nine months ended September 30, 2007 (unaudited)

        

Net revenue - segments

   $ 614,335     $ 214,511     $ 91,222     $ 920,068  
                          

Intersegment revenues

           (4,167 )
              

Total net revenue

         $ 915,901  
              

Operating contribution

   $ 91,984 (1)   $ 21,890     $ 10,228 (1)   $ 124,102  
                          

Corporate expenses

           (49,729 )(1)

Depreciation and amortization

           (14,705 )

Interest expense, net

           (18,213 )
              

Income before income taxes

         $ 41,455  
              

Segment assets

   $ 546,119     $ 58,825     $ 100,399     $ 705,343  
                          

Intersegment assets

           (277 )

Corporate assets

           175,860  
              

Total assets

         $ 880,926  
              

For the nine months ended October 1, 2006 (unaudited)

        

Net revenue - segments

   $ 549,791 (2)   $ 199,411 (3)   $ 74,071     $ 823,273  
                          

Intersegment revenues

           (9,803 )
              

Total net revenue

         $ 813,470  
              

Operating contribution

   $ 68,996 (1),(2)   $ 18,346 (3)   $ 13,839     $ 101,181  
                          

Corporate expenses

           (50,884 )(1)

Depreciation and amortization

           (11,391 )

Interest income, net

           (14,863 )
              

Income before income taxes

         $ 24,043  
              

Segment assets

   $ 527,522     $ 49,870     $ 93,492     $ 670,884  
                          

Intersegment assets

           (1,048 )

Corporate assets

           170,425  
              

Total assets

         $ 840,261  
              

 

(1) For the third quarter and first nine months of 2007 and 2006, operating contribution and corporate expenses were impacted by the following costs incurred in connection with integration and restructuring activities relating to the Healthfield acquisition (dollars in millions):

 

     3rd Quarter    Nine Months
     2007    2006    2007    2006

Home Health

   $ 0.1    $ 0.6    $ 0.6    $ 1.7

Other Related Services

     —        —        0.1      —  

Corporate expenses

     0.5      1.1      1.5      2.0
                           

Total

   $ 0.6    $ 1.7    $ 2.2    $ 3.7
                           

 

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(2) The Home Health segment net revenues and operating contribution for the first nine months of fiscal 2006 included funds received of $1.9 million related to the $5.5 million settlement of the Company’s appeal filed with the PRRB related to the reopening of all of its 1999 Medicare cost reports. (See Note 12.)

 

(3) For the first nine months ended October 1, 2006, CareCentrix operating contribution included restructuring costs of $0.7 million associated with the restructuring relating to the closing and consolidation of two regional care centers. (See Note 7.)

In addition, net revenue and operating contribution for the first nine months of fiscal 2006 included an increase of $0.6 million which represented incremental revenue relating to a classification change of a CareCentrix contract.

 

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Forward-looking Statements

Certain statements contained in this Quarterly Report on Form 10-Q, including, without limitation, statements containing the words “believes,” “anticipates,” “intends,” “expects,” “assumes,” “trends” and similar expressions, constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements are based upon the Company’s current plans, expectations and projections about future events. However, such statements involve known and unknown risks, uncertainties and other factors that may cause the actual results, performance or achievements of the Company to be materially different from any future results, performance or achievements expressed or implied by such forward-looking statements. Such factors include, among others, the following:

 

   

general economic and business conditions;

 

   

demographic changes;

 

   

changes in, or failure to comply with, existing governmental regulations;

 

   

legislative proposals for healthcare reform;

 

   

changes in Medicare and Medicaid reimbursement levels, including changes to the Medicare home health Prospective Payment System adopted August 2007;

 

   

effects of competition in the markets in which the Company operates;

 

   

liability and other claims asserted against the Company;

 

   

ability to attract and retain qualified personnel;

 

   

availability and terms of capital;

 

   

loss of significant contracts or reduction in revenue associated with major payer sources;

 

   

ability of customers to pay for services;

 

   

business disruption due to natural disasters or terrorist acts;

 

   

ability to successfully integrate the operations of Healthfield and other acquisitions the Company may make to achieve synergies and operational efficiencies from the acquisitions within expected timeframes;

 

   

effect on liquidity of the Company’s debt service requirements;

 

   

a material shift in utilization within capitated agreements; and

 

   

changes in estimates and judgments associated with critical accounting policies and estimates.

 

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Forward-looking statements are found throughout “Management’s Discussion and Analysis of Financial Condition and Results of Operations” and elsewhere in this Quarterly Report on Form 10-Q. The reader should not place undue reliance on forward-looking statements, which speak only as of the date of this report. Except as required under the federal securities laws and the rules and regulations of the Securities and Exchange Commission (“SEC”), the Company does not have any intention or obligation to publicly release any revisions to forward-looking statements to reflect unforeseen or other events after the date of this report. The Company has provided a detailed discussion of risk factors in its 2006 Annual Report on Form 10-K and various filings with the SEC. The reader is encouraged to review these risk factors and filings.

General

The following discussion and analysis provides information which management believes is relevant to an assessment and understanding of Gentiva’s results of operations and financial position. This discussion and analysis should be read in conjunction with the Company’s consolidated financial statements and related notes included elsewhere in this report.

The Company’s results of operations are impacted by various regulations and other matters that are implemented from time to time in its industry, some of which are described in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006 and in other filings with the SEC.

Overview

Gentiva Health Services, Inc. is the nation’s largest provider of comprehensive home health and related services. Gentiva serves patients through more than 300 locations in 35 states, and through CareCentrix, which provides an array of administrative services and coordinates the delivery of home nursing services, acute and chronic infusion therapies, home medical equipment (“HME”), respiratory products, orthotics and prosthetics, and services for managed care organizations and health plans. These administrative services are delivered through an extensive nationwide network of approximately 4,000 third-party provider locations in all 50 states. The Company provides a single source for skilled nursing; physical, occupational, speech and neurorehabilitation services; hospice services; social work; nutrition; disease management education; help with daily living activities; respiratory therapy and HME; infusion therapy services; and other therapies and services. Gentiva’s revenues are generated from federal and state government programs, commercial insurance and individual consumers.

The Company has identified three business segments for reporting purposes: Home Health, CareCentrix and Other Related Services. The Other Related Services segment encompasses the Company’s hospice, respiratory therapy and HME, infusion therapy and consulting services businesses. This presentation aligns financial reporting with the manner in which the Company manages its business operations with a focus on the strategic allocation of resources and separate branding strategies among the business segments.

Home Health

The Home Health segment is comprised of direct home nursing and therapy services operations, including specialty programs. The Company conducts direct home nursing and therapy services operations through licensed and Medicare-certified agencies from which the Company provides various combinations of skilled nursing and therapy services, paraprofessional nursing services and homemaker services to pediatric, adult and elder patients. The Company’s direct home nursing and therapy services operations also deliver services to its customers through focused specialty programs that include:

 

   

Gentiva Orthopedics, which provides individualized home orthopedic rehabilitation services to patients recovering from joint replacement or other major orthopedic surgery;

 

   

Gentiva Safe Strides, which provides therapies for patients with balance issues who are prone to injury or immobility as a result of falling;

 

   

Gentiva Cardiopulmonary, which helps patients and their physicians manage heart and lung health in a home-based environment; and

 

   

Gentiva Rehab Without Walls, which provides home and community-based neurorehabilitation therapies for patients with traumatic brain injury, cerebrovascular accident injury and acquired brain injury, as well as a number of other complex rehabilitation cases.

CareCentrix

The CareCentrix segment encompasses Gentiva’s ancillary care benefit management and the coordination of integrated homecare services for managed care organizations and health benefit plans. CareCentrix operations provide an array of administrative services and coordinate the delivery of home nursing services, acute and chronic infusion therapies, home medical equipment, respiratory products, orthotics and prosthetics, and services for managed care organizations and health benefit plans. CareCentrix accepts case referrals from a wide variety of sources, verifies eligibility and benefits and transfers case requirements to the providers for services to the patient. CareCentrix provides services to its customers, including the fulfillment of case requirements, care management, provider credentialing, eligibility and benefits verification, data reporting and analysis, and coordinated centralized billing for all authorized services provided to the customer’s enrollees.

 

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Other Related Services

Hospice

Hospice serves terminally ill patients in the southeast United States. The Company provides comprehensive management of the healthcare services and products needed by hospice patients and their families through the use of an interdisciplinary team. Depending on a patient’s needs, each hospice patient is assigned an interdisciplinary team comprised of a physician, nurse(s), home health aide(s), medical social worker(s), chaplain, dietary counselor and bereavement coordinator, as well as other care professionals.

Respiratory Therapy and Home Medical Equipment

Respiratory therapy and HME services are provided to patients at home through branch locations primarily in the southeast United States. Patients are offered a broad portfolio of products and services that serve as an adjunct to traditional home health nursing and hospice care. Respiratory therapy services are provided to patients who suffer from a variety of conditions including asthma, chronic obstructive pulmonary diseases, cystic fibrosis and other respiratory conditions. HME includes hospital beds, wheelchairs, ambulatory aids, bathroom aids, patient lifts and rehabilitation equipment.

Infusion Therapy

Infusion therapy is provided to patients at home through pharmacy locations in the southeast United States. Infusion therapy serves as a complement to the Company’s traditional service offerings, providing clients with a comprehensive home health provider while diversifying the Company’s revenue base. Services provided include: (i) enteral nutrition, (ii) antibiotic therapy, (iii) total parenteral nutrition, (iv) pain management, (v) chemotherapy, (vi) patient education and training and (vii) nutrition management.

Consulting

The Company provides consulting services to home health agencies through its Gentiva Consulting unit. These services include billing and collection activities, on-site agency support and consulting, operational support and individualized strategies for reduction of days sales outstanding.

Significant Developments

Healthfield Acquisition

On February 28, 2006, the Company completed the acquisition of Healthfield, a regional provider of home healthcare, hospice and related services with approximately 130 locations primarily in eight southeastern states, for $466 million in cash and shares of Gentiva common stock. Total consideration included transaction costs and post-closing adjustments. The Company funded the purchase price from approximately $363 million of borrowings under a new senior term loan facility, approximately 3.2 million shares of Gentiva common stock and the remainder from existing cash balances. A portion of the purchase price was used to refinance Healthfield’s existing net indebtedness.

The Company acquired Healthfield to strengthen and expand the Company’s presence in the southeast United States, which has favorable demographic trends and includes important Certificate of Need states; diversify the Company’s business mix; provide a meaningful platform for the Company to enter the hospice business, as well as expansion into respiratory therapy and HME services and infusion therapy as a direct provider of services; and expand its current specialty programs.

The comparison of results of operations between the first nine months of fiscal 2007 and 2006 has been impacted significantly by the inclusion of the operating results of former Healthfield locations for approximately seven months of fiscal 2006 versus the full first nine months of fiscal 2007.

Results of Operations

Revenues

The Company’s net revenues increased by $22.9 million, or 8.0 percent, to $309.1 million for the quarter ended September 30, 2007 as compared to the quarter ended October 1, 2006. For the nine months ended September 30, 2007 as compared to the nine months ended October 1, 2006, net revenues increased by $102.4 million, or 12.6 percent, to $915.9 million from $813.5 million.

 

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A summary of the Company’s net revenues by segment follows:

 

(Dollars in millions)

   Third Quarter     First Nine Months  
     2007     2006     Percentage
Variance
    2007     2006     Percentage
Variance
 

Home Health

   $ 204.4     $ 192.3     6.3 %   $ 614.3     $ 549.8     11.7 %

CareCentrix

     75.3       64.8     16.2 %     214.5       199.4     7.6 %

Other Related Services

     30.3       32.1     (5.6 %)     91.2       74.1     23.1 %

Intersegment revenues

     (0.9 )     (3.0 )   (70.0 %)     (4.1 )     (9.8 )   (58.2 %)
                                            

Total net revenues

   $ 309.1     $ 286.2     8.0 %   $ 915.9     $ 813.5     12.6 %
                                            

A summary of the Company’s net revenues by payer follows:

 

(Dollars in millions)

   Third Quarter     First Nine Months  
     2007    2006    Percentage
Variance
    2007    2006    Percentage
Variance
 

Medicare

                

Home Health

   $ 137.1    $ 119.1    15.1 %   $ 409.1    $ 329.9    24.0 %

Other

     14.6      17.0    (14.1 %)     44.8      38.0    17.9 %
                                    

Total Medicare

     151.7      136.1    11.5 %     453.9      367.9    23.4 %

Medicaid and Local Government

     37.9      45.5    (16.7 %)     116.5      132.4    (12.0 %)

Commercial Insurance and Other

     119.5      104.6    14.2 %     345.5      313.2    10.3 %
                                        
   $ 309.1    $ 286.2    8.0 %   $ 915.9    $ 813.5    12.6 %
                                        

Home Health

Home Health segment revenues are derived from all three payer groups: Medicare, Medicaid and Local Government and Commercial Insurance and Other. Third quarter 2007 net revenues were $204.4 million, up $12.1 million or 6.3 percent from $192.3 million in the prior year period. For the first nine months of fiscal 2007, net revenues were $614.3 million, a $64.5 million or 11.7 percent increase compared to $549.8 million for the corresponding period of fiscal 2006.

The increase in net revenues for the first nine months of 2007 as compared to the first nine months of 2006 was positively impacted by the acquisition of Healthfield, whose home health revenues averaged $18 million per month. Healthfield revenues were included for seven months in the 2006 period as compared to a full nine months in fiscal 2007. As a result of a commingling of business and resources between legacy Gentiva branch locations and former Healthfield branch locations in selected markets in the southeast United States, it is not possible to provide specific net revenue information for former Healthfield locations for fiscal 2007.

Revenues generated from Medicare were $137.1 million in the third quarter of 2007, an increase of 15.1 percent as compared to $119.1 million in the third quarter of 2006. The majority of Medicare revenue growth resulted from increased volume in specialty programs in both new and existing locations as well as growth in traditional Medicare home health business and higher revenue per admission due to increases in the mix of patients with higher acuity level and reimbursement rate changes as noted below.

Medicare reimbursement rate changes included a 3.3 percent market basket increase that became effective for patients on service on or after January 1, 2007, partially offset by the elimination of the 5 percent rate increase related to home health services performed in specially defined rural areas of the country (referred to as the rural add-on provision). These changes resulted in an overall rate change of about 2.5 percent in 2007 as compared to 2006.

Medicare revenues represented approximately 67 percent of total Home Health revenues in the 2007 third quarter as compared to 62 percent of total Home Health revenues in the 2006 third quarter. Medicare revenues increased by 15 percent, for the third quarter of 2007 as compared to the corresponding 2006 period and, for branch locations that were part of either Gentiva or Healthfield for more than one year, increased by 14 percent for the first nine months of 2007 as compared to the corresponding period of fiscal 2006.

 

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For the nine months ended September 30, 2007, revenues generated from Medicare increased $79.2 million to $409.1 million from $329.9 million for the nine months ended October 1, 2006, due to the reasons noted above. This period to period comparison was also impacted by a Medicare special item of $1.9 million recorded and received during the first quarter of fiscal 2006 in settlement of the Company’s appeal filed with the PRRB related to the reopening of its 1999 cost reports.

Revenues from all other payer sources were $67.3 million in the third quarter of 2007 and $73.2 million in the third quarter of 2006. For the first nine months of fiscal 2007 and fiscal 2006, revenues from all other payer sources were $205.2 million and $219.9 million, respectively. The decreases for the third quarter and first nine months of 2007 compared to the corresponding periods of 2006 resulted primarily from a reduction in hourly Medicaid and Local Government revenues (approximately $5 million and $16 million, respectively) offset somewhat by incremental revenues from former Healthfield locations for the first nine months of 2007. The decrease in legacy Gentiva locations is primarily due to the Company’s decision to exit certain low margin business as the Company continues to pursue more favorable commercial pricing and a higher mix of Medicare business.

CareCentrix

CareCentrix segment revenues are derived from the Commercial Insurance and Other payer group only. Third quarter 2007 net revenues were $75.3 million, a 16.2 percent increase from $64.8 million reported in the prior year period. For the first nine months of fiscal 2007, net revenues were $214.5 million, a 7.6 percent increase compared to $199.4 million for the corresponding period of fiscal 2006. The increase in net revenues for the third quarter and first nine months is due primarily to membership increases in Cigna’s PPO and Open Access plans offset somewhat, for the nine month period, by the absence of transitional revenues of approximately $9 million due to contractual changes with Cigna implemented during the first quarter of 2006. Revenues derived from Cigna increased by approximately $10.2 million and $16.5 million, respectively, in the third quarter and first nine months of 2007 as compared to the corresponding periods of the prior year.

Other Related Services

Other Related Services segment revenues are derived from all three payer groups and include hospice, respiratory therapy and HME services, and infusion therapy net revenues, as well as revenues derived from consulting. Third quarter and first nine months of fiscal 2007 net revenues were $30.3 million and $91.2 million, respectively, as compared to the third quarter and first nine months of fiscal 2006 net revenues of $32.1 million and $74.1 million, respectively. In comparing revenues for the third quarters of fiscal 2007 and fiscal 2006, revenue increases in respiratory services and HME and consulting services were offset primarily by a decline in hospice services. The decline in hospice revenue reflected the impact of certain restructuring activities which commenced during the second half of 2006. The increase in revenues in the first nine months of fiscal 2007 was due primarily to revenues generated from Healthfield operations subsequent to its acquisition on February 28, 2006.

Medicaid and Local Government revenues amounted to $6.3 million and $18.4 million for the third quarter and first nine months of 2007 as compared to $6.7 million and $15.8 million for the corresponding periods of 2006, respectively. Revenues derived from Commercial Insurance and Other payers for the third quarter and first nine months of 2007 were $9.4 million and $28.0 million, respectively, as compared to $8.3 million and $20.2 million for the third quarter and first nine months of 2006, respectively.

 

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Gross Profit

 

(Dollars in millions)

   Third Quarter     First Nine Months  
     2007     2006     Variance     2007     2006     Variance  

Gross profit

   $ 130.0     $ 117.9     $ 12.1     $ 390.5     $ 338.7     $ 51.8  

As a percent of revenues

     42.1 %     41.2 %     0.9 %     42.6 %     41.6 %     1.0 %

Gross profit in the fiscal 2007 periods increased primarily from increased revenues and improvements in gross margin percentage, as compared to the corresponding periods of 2006.

As a percentage of revenues, gross profit of 42.1 percent in the third quarter of 2007 represented a 0.9 percentage point increase as compared to the third quarter of 2006. From a total Company perspective, increases in Home Health segment gross margin percentage attributable to significant changes in business mix were somewhat offset by growth in the lower gross margin CareCentrix business and incremental depreciation in the respiratory therapy and HME business due to a change in early 2007 in the estimated useful lives of certain equipment. The changes in revenue mix in the Home Health segment resulted from (i) organic revenue growth in Medicare, particularly in the Company’s specialty programs, and (ii) the elimination or reduction of certain low margin Medicaid and local government business and commercial business. These changes in revenue mix contributed to an increase in gross margin within the Home Health segment from 47.6 percent in the third quarter of 2006 to 50.4 percent in the third quarter of 2007.

In addition to reasons noted above, the increase in gross margin percentage for the nine months period of 2007 reflected the full impact of the Healthfield acquisition and the corresponding increase in Medicare revenue at a traditionally higher gross margin than certain other business lines as well as productivity gains in the clinician workforce. This increase was partially offset by the Medicare special item recorded in the first quarter of 2006, as discussed above, which had a positive impact on gross profit of $1.9 million or 0.2 percent of revenues in the first nine months of 2006 and the positive impact of a $0.6 million change in estimate related to prior period contract revenue in CareCentrix.

Gross profit was impacted by depreciation expense of $1.3 million and $3.8 million in the third quarter and first nine months of 2007, respectively, as compared to $0.9 million and $2.0 million for the third quarter and first nine months of 2006, respectively.

Selling, General and Administrative Expenses

Selling, general and administrative expenses increased $5.8 million to $110.3 million for the quarter ended September 30, 2007, as compared to $104.5 million for the quarter ended October 1, 2006, and $31.0 million to $330.8 million for the nine months ended September 30, 2007, as compared to $299.8 million for the nine months ended October 1, 2006.

The increase of $5.8 million for the third quarter of 2007 as compared to the corresponding period of 2006 was primarily attributable to (i) the Other Related Services segment (approximately $2 million) due to continuing investments in infrastructure and capacity necessary to accelerate future growth, (ii) incremental provision for doubtful accounts of approximately $1 million related to certain receivable balances in the Other Related Services segment, (iii) Home Health segment field operating costs (approximately $4 million) to support higher revenue volume in the 2007 period as compared to the 2006 period, (iv) incremental equity-based compensation costs (approximately $0.4 million) and (v) increased depreciation and amortization expense (approximately $0.5 million).

The increase of $31.0 million for the first nine months of 2007 as compared to the first nine months of 2006 was primarily attributable to the impact of the Healthfield acquisition. Selling, general and administrative expenses associated with Healthfield’s corporate and field locations, which averaged about $10 million per month in fiscal 2006, were included for about seven months (from February 28, 2006, the Healthfield acquisition date), in the first nine months of 2006 but were included in the entire first nine months of 2007. As a result of commingling of business and resources between legacy Gentiva locations and former Healthfield locations, it is not possible to provide specific selling, general and administrative expense information for former Healthfield locations for the fiscal 2007 period.

 

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In addition to the impact of the Healthfield acquisition, selling, general and administrative expenses also increased during the first nine months of 2007 due to (i) investments in the Other Related Services segment as noted above, (ii) incremental provision for doubtful accounts of approximately $1 million related to certain receivable balances in the Other Related Services segment, (iii) increased costs in the Home Health segment to support higher revenue volume, (iv) incremental costs of $2.1 million relating to equity-based compensation, which was $5.1 million for the first nine months of 2007 and $3.0 million for the first nine months of 2006, (v) incremental depreciation and amortization expense of $1.5 million as noted below and (vi) incremental costs of approximately $3 million for employees and consultants to support information services and the Company’s strategic technology projects, including the Company’s new LifeSmart clinical management system.

These increases during the first nine months of 2007 were offset somewhat by synergies realized in connection with the consolidation of certain Gentiva and Healthfield back office functions as well as lower restructuring and integration costs relating to the Healthfield acquisition and CareCentrix restructuring activities in the 2006 nine month period. The aggregate amount of restructuring and integration costs were $2.2 million for the first nine months of 2007 and $4.4 million for the first nine months of 2006.

Depreciation and amortization expense included in selling, general and administrative expenses were $3.7 million and $10.9 million for the third quarter and first nine months of 2007, respectively, as compared to $3.5 million and $9.4 million for the corresponding periods of 2006.

Interest Expense and Interest Income

For the third quarter and first nine months of fiscal 2007, net interest expense was approximately $5.8 million and $18.2 million, respectively, which included interest income of $0.8 million and $2.4 million, respectively. For fiscal 2006, net interest expense for the third quarter and first nine months was $6.5 million and $14.9 million, respectively, including interest income of $0.9 million and $2.5 million, respectively. Net interest expense for all periods consisted primarily of interest expense associated with the term loan borrowings, fees associated with the credit agreement and outstanding letters of credit and amortization of debt issuance costs, partially offset by interest income earned on short-term investments and existing cash balances.

Income before Income Taxes

Components of income before income taxes were as follows:

 

(Dollars in millions)

   Third Quarter     First Nine Months  
      2007     2006     Variance     2007     2006     Variance  

Operating Contribution:

            

Home Health

   $ 30.9     $ 23.6     $ 7.3     $ 92.0     $ 69.0     $ 23.0  

CareCentrix

     6.9       5.7       1.2       21.9       18.4       3.5  

Other Related Services

     2.8       6.3       (3.5 )     10.2       13.8       (3.6 )
                                                

Total Operating Contribution

     40.6       35.6       5.0       124.1       101.2       22.9  

Corporate expenses

     (15.9 )     (17.8 )     1.9       (49.7 )     (50.9 )     1.2  

Depreciation and amortization

     (5.0 )     (4.4 )     (0.6 )     (14.7 )     (11.4 )     (3.3 )

Interest (expense) income, net

     (5.7 )     (6.5 )     0.8       (18.2 )     (14.9 )     (3.3 )
                                                

Income before income taxes

   $ 14.0     $ 6.9     $ 7.1     $ 41.5     $ 24.0     $ 17.5  

As a percent of revenues

     4.5 %     2.4 %     2.1 %     4.5 %     3.0 %     1.5 %

Income Taxes

The Company recorded a federal and state income tax provision of $5.8 million for the third quarter of fiscal 2007, of which $0.7 million represented a current tax benefit and $6.5 million represented a deferred tax provision. The difference between the federal statutory income tax rate of 35 percent and the Company’s effective rate of 41.4 percent for the quarter ended September 30, 2007 is primarily due to (i) the impact of the adoption of SFAS 123(R) (approximately 2.2 percent) and (ii) state taxes and other items, partially offset by tax exempt interest (approximately 4.2 percent).

 

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For the nine months ended September 30, 2007, the Company recorded a federal and state income tax provision of $17.5 million representing a current tax provision of $1.8 million and a deferred tax provision of $15.7 million. The difference between the federal statutory income tax rate of 35 percent and the Company’s effective rate of 42.1 percent for the first nine months of 2007 is primarily due to (i) the impact of the adoption of SFAS 123(R) (approximately 2.4 percent) and (ii) state taxes and other items, partially offset by tax exempt interest and a change in the state valuation allowance (approximately 4.7 percent).

The Company recorded a federal and state income tax provision of $1.5 million for the third quarter of fiscal 2006, of which $0.7 million represented a current tax benefit and $2.2 million represented a deferred tax provision. For the nine months ended October 1, 2006, the Company recorded a federal and state income tax provision of $8.8 million representing a current tax benefit of $0.1 million and a deferred tax provision of $8.9 million.

The difference between the federal statutory income tax rate of 35 percent and the Company’s effective rate of 22.5 percent for the quarter ended October 1, 2006 is primarily due to (i) the impact of the adoption of SFAS 123(R) (approximately 4.8 percent) and (ii) state taxes and other items partially offset by tax exempt interest (approximately 4.3 percent), offset by (iii) the release of $0.8 million of tax reserves associated with the expiration of the statute of limitations (approximately 11.6 percent) and (iv) additional state net operating loss carryforwards resulting from the finalization of prior year state tax audits (approximately 10.0 percent).

The difference between the federal statutory income tax rate of 35 percent and the Company’s effective rate of 36.5 percent for the first nine months of 2006 is primarily due to (i) the impact of the adoption of SFAS 123(R) (approximately 3.4 percent) and (ii) state taxes and other items partially offset by tax exempt interest (approximately 4.2 percent), offset by (iii) the release of $0.8 million of tax reserves associated with the expiration of the statute of limitations (approximately 3.3 percent) and (iv) additional state net operating loss carryforwards resulting from the finalization of prior year state tax audits (approximately 2.8 percent).

Net Income

For the third quarter of fiscal 2007, net income was $8.2 million, or $0.28 per diluted share, compared with net income of $5.3 million, or $0.19 per diluted share, for the corresponding period of 2006.

For the first nine months of fiscal 2007, net income was $24.0 million, or $0.84 per diluted share, compared with net income of $15.3 million, or $0.56 per diluted share, for the first nine months of fiscal 2006.

Net income for the 2007 third quarter and first nine months reflected a pre-tax charge of $0.6 million, or $0.02 per diluted share, and $2.2 million, or $0.05 per diluted share, respectively, relating to restructuring and integration costs. In addition, net income per diluted share for the 2007 third quarter and first nine months included a net cost of $0.03 and $0.13 per diluted share, respectively, representing a pre-tax charge of $1.6 million and $5.1 million, respectively, associated with equity-based compensation charges and the respective impact on the Company’s effective tax rate.

Net income for the 2006 third quarter and first nine months reflected (i) a pre-tax charge of $1.7 million, or $0.04 per diluted share, and $4.4 million, or $0.10 per diluted share, respectively, relating to restructuring and integration costs and (ii) a net cost of $0.04 and $0.10 per diluted share, respectively, representing a pre-tax charge of $1.2 million and $3.0 million, respectively, associated with equity-based compensation charges and the respective impact on the Company’s effective tax rate. In addition, net income per diluted share for the 2006 first nine months included a special item related to Medicare which had a positive pre-tax impact of $1.9 million, or $0.04 per diluted share.

Liquidity and Capital Resources

Liquidity

The Company’s principal source of liquidity is the collection of its accounts receivable. For healthcare services, the Company grants credit without collateral to its patients, most of whom are insured under third party commercial or governmental payer arrangements.

During the third quarter of 2007, cash provided by operating activities was $20.9 million and cash generated from the issuance of common stock upon exercise of stock options and under the Company’s Employee Stock Purchase Plan (“ESPP”) was $0.5 million. In the 2007 third quarter, the Company used $7.0 million of cash for capital expenditures, $3.8 million in the acquisition of Baptist Home Care and $8.0 million on voluntary debt prepayments relating to the Company’s term loan.

 

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The Company generated net cash from operating activities of $42.4 million in the nine months ended September 30, 2007 as compared to net cash from operating activities of $45.3 million in the nine months ended October 1, 2006. The decrease of $2.9 million in net cash provided by operating activities between the 2006 and 2007 periods was primarily driven by changes in accounts receivable and other assets ($42.3 million) offset by changes impacting the statement of income ($24.0 million) and changes in current liabilities and other items ($15.4 million) between the 2006 and 2007 reporting periods. Adjustments to add back non-cash items affecting net income are summarized as follows (in thousands):

 

     For the Nine Months Ended
     September 30,
2007
    October 1,
2006
    Variance

OPERATING ACTIVITIES:

      

Net income

   $ 23,982     $ 15,264     $ 8,718

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

      

Depreciation and amortization

     14,705       11,391       3,314

Amortization of debt issuance costs

     763       759       4

Provision for doubtful accounts

     6,644       5,416       1,228

Reversal of tax audit reserves

     —         (800 )     800

Equity-based compensation expense

     5,085       2,951       2,134

Windfall tax benefits associated with equity-based compensation

     (788 )     (1,729 )     941

Deferred income tax expense

     15,725       8,909       6,816
                      

Total cash provided by operations prior to changes in assets and liabilities

   $ 66,116     $ 42,161     $ 23,955
                      

The $24.0 million difference in “Total cash provided by operations prior to changes in assets and liabilities” between the 2006 and 2007 periods is primarily related to improvements in net income after adjusting for components of income that do not have an impact on cash, such as depreciation and amortization, deferred income taxes and equity-based compensation expense.

The comparison of cash flow from operating activities between the first nine months of 2006 and 2007 was negatively impacted by $40.7 million resulting from changes in net accounts receivable represented by a $0.9 million reduction during the 2006 reporting period and a $39.8 million increase during the 2007 reporting period. These changes were exclusive of accounts receivable of acquired businesses as of the respective acquisition dates and the impact of the provision for doubtful accounts during each reporting period.

The increase in accounts receivable for the 2007 period was due primarily to revenue growth in the Company’s CareCentrix and Home Health businesses ($7 million and $7 million, respectively), as well as (i) delays in cash received due to a change in the intermediary assigned to process Medicare claims for the respiratory therapy and HME business, (ii) short-term delays in certain billing and collection activities associated with ongoing billing center consolidation activity, and (iii) the reclassification of approximately $2 million in customer credits from accounts receivable to other accrued expenses. Cash flow from operating activities was positively impacted by $13.9 million as a result of changes in current liabilities of $18.3 million in the 2007 period and $4.4 million in the 2006 period. A summary of the changes in current liabilities impacting cash flow from operating activities for the nine month fiscal period ended September 30, 2007 follows (in thousands):

 

     For the Nine Months Ended  
     September 30,
2007
    October 1,
2006
    Variance  

OPERATING ACTIVITIES:

      

Changes in current liabilities:

      

Accounts payable

   $ 766     $ (8,190 )   $ 8,956  

Payroll and related taxes

     8,005       5,496       2,509  

Deferred revenue

     7,996       (2,745 )     10,741  

Medicare liabilities

     386       1,518       (1,132 )

Cost of claims incurred but not reported

     1,713       (2,038 )     3,751  

Obligations under insurance programs

     1,697       1,571       126  

Other accrued expenses

     (2,295 )     8,750       (11,045 )
                        

Total changes in current liabilities

   $ 18,268     $ 4,362     $ 13,906  
                        

The primary drivers for the $13.9 million difference resulting from changes in current liabilities that impacted cash flow from operating activities include:

 

   

Accounts payable, which had a positive impact on cash of $9.0 million, and payroll and related taxes, which had a positive impact of $2.5 million, between the 2006 and 2007 reporting periods primarily related to the timing of payments.

 

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Deferred revenue, which had a positive impact of $10.7 million between the 2006 and 2007 reporting periods, exclusive of businesses acquired, primarily due to growth in Medicare revenues.

 

   

Medicare liabilities, which had a negative impact of $1.1 million between the 2006 and 2007 reporting periods, primarily related to the repayment associated with corrections CMS made to the Medicare hospice cap amounts for the periods from November 1, 2002 to October 31, 2003 and from November 1, 2003 to October 31, 2004 as further described below.

 

   

Cost of claims incurred but not reported, which had a positive impact of $3.7 million on the changes in operating cash flows between the 2006 and 2007 reporting periods, associated with growth in the Company’s CareCentrix business and timing of claims adjudication.

 

   

Obligations under insurance programs, which had a positive impact on the change in operating cash flow of $0.1 million between the 2006 and 2007 reporting periods, primarily as a result of an increase in workers’ compensation and health and welfare benefit liabilities due to an increase in the number of covered associates, offset by continuing favorable trends in workers’ compensation and malpractice claims.

 

   

Other accrued expenses, which had a negative impact on the change in operating cash flow of $11.0 million between the 2006 and 2007 reporting periods, due primarily to accrued interest payable associated with the credit agreement and incentive and commission payments during the first nine months of fiscal 2007, as well as changes in various other accrued expenses.

Working capital at September 30, 2007 was approximately $123 million, an increase of $7 million as compared to approximately $116 million at December 31, 2006, primarily due to:

 

   

a $33 million increase in accounts receivable, due to the reasons noted above; and

 

   

a $3 million increase in prepaid expenses and other assets due to prepayments made in connection with the Company’s insurance programs, offset somewhat by:

 

   

a $9 million decrease in deferred tax assets; and

 

   

a $20 million increase in current liabilities, consisting of increases in payroll and related taxes ($8 million), deferred revenue ($8 million), cost of claims incurred but not reported ($2 million), obligations under insurance programs ($2 million), accounts payable ($1 million), and current portion of long term debt ($2 million), partially offset by a decrease in other accrued expenses ($3 million). The changes in current liabilities are described above in the discussion on changes in current liabilities that impacted cash flow from operating activities.

Days Sales Outstanding (“DSO”) as of September 30, 2007 were 63 days, an increase of seven days from December 31, 2006. The increase was due primarily to normal seasonal patterns and revenue growth primarily in the CareCentrix and Medicare business, as well as, (i) delays in cash received due to a change in the intermediary assigned to process Medicare claims for our HME and respiratory services business, (ii) short-term delays in certain billing and collection activities associated with ongoing billing center consolidation activity, and (iii) the reclassification of approximately $2 million in customer credits from accounts receivable to other accrued expenses.

 

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Accounts receivable attributable to major payer sources of reimbursement at September 30, 2007 and December 31, 2006 were as follows (in thousands):

 

     September 30, 2007
     Total    Current    31 - 90 days    91 - 180 days    Over 180 days

Medicare

   $ 92,130    $ 46,030    $ 32,796    $ 8,617    $ 4,687

Medicaid and Local Government

     23,578      11,576      7,110      2,925      1,967

Commercial Insurance and Other

     101,703      63,733      18,825      10,131      9,014

Self - Pay

     7,226      761      1,679      2,176      2,610
                                  

Gross Accounts Receivable

   $ 224,637    $ 122,100    $ 60,410    $ 23,849    $ 18,278
                                  
     December 31, 2006
     Total    Current    31- 90 days    91 - 180 days    Over 180 days

Medicare

   $ 76,105    $ 35,794    $ 28,882    $ 8,445    $ 2,984

Medicaid and Local Government

     24,175      12,064      7,581      2,410      2,120

Commercial Insurance and Other

     84,089      49,129      20,101      8,375      6,484

Self - Pay

     6,985      569      1,401      1,638      3,377
                                  

Gross Accounts Receivable

   $ 191,354    $ 97,556    $ 57,965    $ 20,868    $ 14,965
                                  

The Company participates in Medicare, Medicaid and other federal and state healthcare programs. Revenue mix by major payer classifications is as follows:

 

     Three Months Ended     Nine Months Ended  
     September 30, 2007     October 1, 2006     September 30, 2007     October 1, 2006  

Medicare

   49 %   48 %   50 %   45 %

Medicaid and Local Government

   12 %   16 %   13 %   16 %

Commercial Insurance and Other

   39 %   36 %   37 %   39 %
                        
   100 %   100 %   100 %   100 %
                        

In November 2006, CMS announced an increase of 3.3 percent in Medicare home health rates (the “market basket increase”) for episodes ending on or after January 1, 2007 and the elimination of a temporary 5 percent premium reflected in the reimbursement rate for specifically defined rural-areas of the country (the “rural add-on provision”) for episodes that begin on or after January 1, 2007. In August 2007, CMS issued its final rule that contains refinements to the Medicare home health prospective payment system including, among other things, a multi-year reduction in the home health system payment rates to offset coding changes since the original implementation of PPS in 2000, and a rate update for calendar year 2008. The rule becomes effective on January 1, 2008.

Medicare reimbursement rates for hospice services increased by 3.4 percent effective October 1, 2006. On June 29, 2007, CMS released a transmittal that confirmed an increase of 3.3 percent to the fiscal 2008 Medicare hospice annual update payment. On April 20, 2007, CMS released a transmittal which described corrections to the Medicare hospice cap amount for the periods from November 1, 2002 to October 31, 2003 and from November 1, 2003 to October 31, 2004. Based on the notifications received from CMS through September 30, 2007, the Company believes that the aggregate amount to be repaid as a result of Medicare hospice cap corrections for the aforementioned periods approximates $1.3 million, of which the Company has repaid approximately $1.1 million. The Company has filed a claim for substantially all of this amount under the indemnification provisions of a previous acquisition agreement under Healthfield.

There are certain standards and regulations that the Company must adhere to in order to continue to participate in these programs. As part of these standards and regulations, the Company is subject to periodic audits, examinations and investigations conducted by, or at the direction of, governmental investigatory and oversight agencies. Periodic and random audits conducted or directed by these agencies could result in a delay or adjustment to the amount of reimbursements received under these programs. Violation of the applicable federal and state health care regulations can result in the Company’s exclusion from participating in these programs and can subject the Company to substantial civil and/or criminal penalties. The Company believes it is currently in compliance with these standards and regulations.

The Company is party to a contract with Cigna, pursuant to which the Company provides or contracts with third-party providers to provide direct home nursing services and related services, home infusion therapies, and certain other specialty medical equipment to patients insured by Cigna. For the third quarter and first nine months of fiscal 2007, Cigna accounted for approximately 20 percent and 19 percent of the Company’s total net revenues, respectively, compared to approximately 18 percent and 20 percent for the third quarter and first nine months of fiscal 2006, respectively. The increase for the third quarter of 2007 as compared to the 2006 period is primarily attributable to contractual rate changes and membership

 

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increases in Cigna’s PPO and Open Access plans. For the nine month period, the decline in Cigna revenues as a percent of the Company’s total net revenues is primarily attributable to revenue growth resulting from the Healthfield acquisition and lower revenues from Cigna as a result of changes in the Cigna contract in the 2006 period, partially offset by the Cigna membership growth and contractual rate changes noted above. Effective February 1, 2006, the Company no longer provides respiratory therapy services and certain home medical equipment services under its Cigna contract. However, the Company extended its relationship with Cigna by entering into an amendment to its contract in October 2005 relating to the coordination of the provision of direct home nursing and related services, home infusion services and certain other specialty medical equipment. The term of the contract, as now amended, extends to January 31, 2009, and automatically renews thereafter for additional one year terms unless terminated. Each party has the right to terminate at the end of each subsequent one year term by providing at least 90 days advance written notice to the other party prior to the start of the new term. If Cigna chose to terminate or not renew the contract, or to significantly modify its use of the Company’s services, there could be a material adverse effect on the Company’s cash flow.

Net revenues generated under capitated agreements with managed care payers were approximately 5 percent of total net revenues for both the third quarter and first nine months of fiscal 2007, and 6 percent and 7 percent of total net revenues for the third quarter and first nine months of fiscal 2006, respectively.

Credit Arrangements

The Company’s credit agreement provides for an aggregate borrowing amount of $445.0 million of senior secured credit facilities consisting of (i) a seven year term loan of $370.0 million repayable in quarterly installments of 1 percent per annum (with the remaining balance due at maturity on March 31, 2013) and (ii) a six year revolving credit facility of $75.0 million, of which $55.0 million is available for the issuance of letters of credit and $10.0 million is available for swing line loans. A pre-approved $25.0 million increase to the revolving credit facility is available at the Company’s discretion. Upon the occurrence of certain events, including the issuance of capital stock, the incurrence of additional debt (other than that specifically allowed under the credit agreement), certain asset sales where the cash proceeds are not reinvested, or if the Company has excess cash flow (as defined in the agreement), mandatory prepayments of the term loan are required in the amounts specified in the credit agreement.

Interest under the credit agreement accrues at Base Rate or Eurodollar Rate (plus 1.25 percent for Base Rate Loans and 2.25 percent for Eurodollar Rate Loans) for both the revolving credit facility and the term loan. Overdue amounts bear interest at 2 percent per annum above the applicable rate. The interest rates under the credit agreement are reduced if the Company meets certain reduced leverage targets as follows:

 

Revolving Credit Consolidated Leverage Ratio

  

Term Loan Consolidated Leverage Ratio

   Margin for Base
Rate Loans
  Margin for
Eurodollar Loans

³ 3.5

   ³ 3.5    1.25%   2.25%

< 3.5 & ³ 3.0

   < 3.5 & ³ 3.0    1.00%   2.00%

< 3.0 & ³ 2.5

   < 3.0    0.75%   1.75%

< 2.5

      0.50%   1.50%

The Company is also subject to a revolving credit commitment fee equal to 0.5 percent per annum of the average daily difference between the total revolving credit commitment and the total outstanding borrowings and letters of credit, excluding amounts outstanding under swing loans. The commitment fee will be reduced to 0.375 percent per annum if the Company’s consolidated leverage ratio (as defined in the agreement) is less than 3.5. At July 1, 2007, the Company achieved a consolidated leverage ratio of less than 3.5 and, as a result, the margin on revolving credit and term loan borrowings was reduced by 25 basis points and the revolving credit commitment fee was reduced to 0.375 percent on a prospective basis, effective August 1, 2007. As of September 30, 2007, the consolidated leverage ratio was 3.02.

The credit agreement requires the Company to meet certain financial tests. These tests include a consolidated leverage ratio and a consolidated interest coverage ratio. The credit agreement also contains additional covenants which, among other things, require the Company to deliver to the lenders specified financial information, including annual and quarterly financial information, and limit the Company’s ability to do the following, subject to various exceptions and limitations: (i) merge with other companies; (ii) create liens on its property; (iii) incur additional debt obligations; (iv) enter into transactions with affiliates, except on an arms-length basis; (v) dispose of property; (vi) make capital expenditures; and (vii) pay dividends or acquire capital stock of the Company or its subsidiaries. As of September 30, 2007, the Company was in compliance with the covenants in the credit agreement.

 

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During the third quarter and first nine months of fiscal 2007, the Company made prepayments of $8.0 million and $26.0 million, respectively, under its term loan. Beginning in the second quarter of 2008, the Company is required to make quarterly installment payments of $789,000 with the remaining balance due at maturity on March 31, 2013. The required quarterly installment payments are reduced by any additional prepayments the Company may make, applied against the quarterly installments pro rata based on the remaining outstanding principal amount of such installments, including the balance due at maturity. As of September 30, 2007, maturities under the term loan were as follows: no maturities through fiscal 2007, $2.4 million for fiscal 2008, $3.2 million per year for fiscal 2009 through fiscal 2011 and $304.0 million thereafter. As of September 30, 2007, the Company had outstanding borrowings under the term loan of $316.0 million. There were no borrowings outstanding under the revolving credit facility as of September 30, 2007.

Guarantee and Collateral Agreement

The Company has entered into a Guarantee and Collateral Agreement which grants a collateral interest in all real property and personal property of the Company and its subsidiaries, including stock of its subsidiaries, in favor of the administrative agent under the credit agreement. The Guarantee and Collateral Agreement also provides for a guarantee of the Company’s obligations under the credit agreement by substantially all subsidiaries of the Company.

Insurance Programs

The Company may be subject to workers’ compensation claims and lawsuits alleging negligence or other similar legal claims. The Company maintains various insurance programs to cover these risks with insurance policies subject to substantial deductibles and retention amounts. The Company recognizes its obligations associated with these programs in the period the claim is incurred. The Company estimates the cost of both reported claims and claims incurred but not reported, up to specified deductible limits and retention amounts, based on its own specific historical claims experience and current enrollment statistics, industry statistics and other information. These estimates and the resulting reserves are reviewed and updated periodically.

The Company is responsible for the cost of individual workers’ compensation claims and individual professional liability claims up to $500,000 per incident which occurred prior to March 15, 2002 and $1,000,000 per incident thereafter. The Company also maintains excess liability coverage relating to professional liability and casualty claims which provides insurance coverage for individual claims of up to $25,000,000 in excess of the underlying coverage limits. Payments under the Company’s workers’ compensation program are guaranteed by letters of credit and segregated restricted cash balances.

Capital Expenditures

The Company’s capital expenditures for the nine months ended September 30, 2007 were $19.5 million as compared to $16.3 million for the same period in fiscal 2006. The Company intends to make investments and other expenditures to upgrade its computer technology and system infrastructure and comply with regulatory changes in the industry, among other things. In this regard, management expects that capital expenditures for fiscal 2007 will approximate $24 million. Management expects that the Company’s capital expenditure needs will be met through operating cash flow and available cash reserves.

Cash Resources and Obligations

The Company had cash, cash equivalents, restricted cash and short-term investments of approximately $57.1 million as of September 30, 2007. The restricted cash of $22.0 million at September 30, 2007 related primarily to cash funds of $21.8 million that have been segregated in a trust account to provide collateral under the Company’s insurance programs. The Company, at its option, may access the cash funds in the trust account by providing equivalent amounts of alternative collateral, including letters of credit and surety bonds. In addition, restricted cash included $0.2 million on deposit to comply with New York state regulations requiring that one month of revenues generated under capitated agreements in the state be held in escrow. As of September 30, 2007, the Company had operating funds of approximately $4.0 million exclusively relating to a non-profit hospice operation in Florida. Interest on all restricted funds accrues to the Company.

The Company anticipates that repayments to Medicare for partial episode payments and prior year cost report settlements will be made periodically through 2007. These amounts are included in Medicare liabilities in the accompanying consolidated balance sheets.

The Company made no purchases of its common stock during the first nine months of 2007. As of September 30, 2007, the Company had remaining authorization to repurchase an aggregate of 683,396 shares of its outstanding common stock.

Management anticipates that in the near term the Company may make voluntary prepayments on the term loan rather than stock repurchases with certain excess cash resources.

 

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As of October 24, 2007, the Company has an effective shelf registration statement under which the Company may from time to time offer debt securities, guarantees, preferred stock, common stock, warrants or any combination of such securities for a maximum aggregate offering amount of $300 million. Unless otherwise described in future prospectus supplements, the Company intends to use the net proceeds from the sale of securities registered under this universal shelf registration statement for general corporate purposes, including strategic acquisitions, the repayment of debt, capital expenditures and working capital requirements.

Contractual Obligations and Commercial Commitments

As of September 30, 2007, the Company had outstanding borrowings of $316.0 million under the term loan of the credit agreement. There were no borrowings under the revolving credit facility. Debt repayments, future minimum rental commitments for all non-cancelable leases and purchase obligations at September 30, 2007 are as follows (in thousands):

 

     Payment due by period
          Less than              More than

Contractual Obligations

   Total    1 year    1-3 years    4-5 years    5 years

Long-term debt obligations

   $ 316,000    $ 1,577    $ 6,309    $ 6,309    $ 301,805

Capital lease obligations

     2,300      1,213      874      213      —  

Operating lease obligations

     71,980      21,171      33,649      15,644      1,516

Purchase obligations

     10,998      2,588      5,175      3,235      —  
                                  

Total

   $ 401,278    $ 26,549    $ 46,007    $ 25,401    $ 303,321
                                  

During the first nine months of fiscal 2007, the Company made voluntary debt prepayments of $26.0 million relating to its term loan. Prepayments have extinguished all required principal payments on the term loan through the first quarter of 2008. Beginning in the second quarter of 2008, the Company is required to make quarterly installment payments which currently approximate $0.8 million. During the second week of October 2007, the Company made additional prepayments of $1.0 million on the term loan. (See Note 9 to the consolidated financial statements.)

The Company had total letters of credit outstanding of approximately $20.1 million at September 30, 2007 and at December 31, 2006. The letters of credit, which expire one year from date of issuance, were issued to guarantee payments under the Company’s workers’ compensation program and for certain other commitments. The Company has the option to renew these letters of credit or set aside cash funds in a segregated account to satisfy the Company’s obligations as further discussed above under the caption “Cash Resources and Obligations.” The Company also had outstanding surety bonds of $1.9 million and $2.7 million at September 30, 2007 and December 31, 2006, respectively.

The Company has no other off-balance sheet arrangements and has not entered into any transactions involving unconsolidated, limited purpose entities or commodity contracts.

Management expects that the Company’s working capital needs for fiscal 2007 will be met through operating cash flow and existing cash balances. The Company may also consider other alternative uses of cash including, among other things, acquisitions, voluntary prepayments on the term loan, additional share repurchases and cash dividends. These uses of cash may require the approval of its Board of Directors and may require the approval of its lenders. If cash flows from operations, cash resources or availability under the credit agreement fall below expectations, the Company may be forced to delay planned capital expenditures, reduce operating expenses, seek additional financing or consider alternatives designed to enhance liquidity.

 

Item 3. Quantitative and Qualitative Disclosures about Market Risk

Generally, the fair market value of fixed rate debt will increase as interest rates fall and decrease as interest rates rise. The Company is exposed to market risk from fluctuations in interest rates. The interest rate on the Company’s borrowings under the credit agreement can fluctuate based on both the interest rate option (i.e., base rate or LIBOR plus applicable margins) and the interest period. As of September 30, 2007, the total amount of outstanding debt subject to interest rate fluctuations was $146.0 million. A hypothetical 100 basis point change in short-term interest rates as of that date would result in an increase or decrease in interest expense of $1.5 million per year, assuming a similar capital structure.

To assist in managing the potential interest rate risk associated with its floating rate term loan under the credit agreement, on July 3, 2006, the Company entered into a two year interest rate swap agreement with a notional value of $170 million. Under the swap agreement, the Company will pay a fixed rate of 5.665 percent per annum plus an applicable margin (an aggregate of 7.915 percent per annum for the period July 3, 2006 through July 31, 2007 and 7.665 percent per annum thereafter) on the $170 million rather than a fluctuating rate plus an applicable margin. (See Note 9 to the consolidated financial statements.)

 

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Item 4. Controls and Procedures

Evaluation of disclosure controls and procedures

The Company’s Chief Executive Officer and Chief Financial Officer have evaluated the effectiveness of the design and operation of the Company’s disclosure controls and procedures (as defined in the Securities Exchange Act of 1934 (“Exchange Act”) Rule 13a-15(e)) as of the end of the period covered by this report. Based on that evaluation, the Company’s Chief Executive Officer and Chief Financial Officer have concluded that the Company’s disclosure controls and procedures are effective as of the end of such period to ensure that information required to be disclosed by the Company in the reports that it files or submits under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms.

Changes in internal control over financial reporting

As required by the Exchange Act Rule 13a-15(d), the Company’s Chief Executive Officer and Chief Financial Officer evaluated the Company’s internal control over financial reporting to determine whether any change occurred during the quarter ended September 30, 2007 that has materially affected, or is reasonably likely to materially affect, the Company’s internal control over financial reporting. Based on that evaluation, there has been no such change during such quarter.

PART II – OTHER INFORMATION

 

Item 1. Legal Proceedings

See Note 12 to the consolidated financial statements included in this report for a description of legal matters and pending legal proceedings, which description is incorporated herein by reference.

 

Item 1A. Risk Factors

There have been no material changes from the risk factors as previously disclosed in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2006.

 

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

None.

 

Item 3. Defaults Upon Senior Securities

None.

 

Item 4. Submission of Matters to a Vote of Security Holders

None.

 

Item 5. Other Information

Corporate Integrity Agreement

In connection with a July 19, 1999 settlement with various government agencies, Olsten Corporation, the Company’s former parent corporation, executed a corporate integrity agreement with the OIG, effective until August 18, 2004, subject to the Company’s filing of a final annual report with the OIG in form and substance acceptable to the government. The Company has filed a final annual report and is awaiting closure by the government.

The Company believes that it has been in compliance with the corporate integrity agreement and has timely filed all required reports. If the Company has failed to comply with the terms of its corporate integrity agreement, the Company will be subject to penalties. The corporate integrity agreement applies to the Company’s businesses that bill the federal government health programs directly for services, such as its nursing brand, and focuses on issues and training related to cost report preparation, contracting, medical necessity and billing of claims. Under the corporate integrity agreement, the Company is required, for example, to maintain a corporate compliance officer to develop and implement compliance programs, and to maintain a compliance program and reporting systems, as well as to provide certain training to employees.

 

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Item 6. Exhibits

 

Exhibit

Number

 

Description

3.1   Amended and Restated Certificate of Incorporation of Company. (1)
3.2   Amended and Restated By-Laws of Company. (1)
4.1   Specimen of Common Stock. (4)
4.2   Form of Certificate of Designation of Series A Junior Participating Preferred Stock. (2)
4.3   Form of Certificate of Designation of Series A Cumulative Non-Voting Redeemable Preferred Stock. (3)
4.4   Indenture, dated as of September 25, 2007, between Company and The Bank of New York, a New York banking corporation, as Trustee. (5)
10.1   2005 Nonqualified Retirement Plan.*
10.2   Nonqualified Retirement and Savings Plan, as amended and restated effective November 1, 2007.*
10.3   Stock & Deferred Compensation Plan for Non-Employee Directors, as amended and restated as of December 31, 2007.*
10.4   Amendment No. 1 to 2004 Equity Incentive Plan.*
31.1   Certification of Chief Executive Officer pursuant to Rule 13a-14(a).*
31.2   Certification of Chief Financial Officer pursuant to Rule 13a-14(a).*
32.1   Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350.*
32.2   Certification of Chief Financial Officer pursuant to 18 U.S.C. Section 1350.*

(1) Incorporated herein by reference to Form 8-K of Company dated May 12, 2006 and filed May 15, 2006.

 

(2) Incorporated herein by reference to Amendment No. 2 to the Registration Statement of Company on Form S-4 dated January 19, 2000 (File No. 333-88663).

 

(3) Incorporated herein by reference to Amendment No. 3 to the Registration Statement of Company on Form S-4 dated February 4, 2000 (File No. 333-88663).

 

(4) Incorporated herein by reference to Amendment No. 4 to the Registration Statement of Company on Form S-4 dated February 9, 2000 (File No. 333-88663).

 

(5) Incorporated herein by reference to the Registration Statement of Company on Form S-3 dated September 25, 2007 (File No. 333-146297).

 

* Filed herewith

 

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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 thereunto duly authorized.

 

   

GENTIVA HEALTH SERVICES, INC.

(Registrant)

Date: November 9, 2007       /s/ Ronald A. Malone
       

Ronald A. Malone

Chairman and Chief Executive Officer

Date: November 9, 2007       /s/ John R. Potapchuk
       

John R. Potapchuk

Executive Vice President,

Chief Financial Officer and Treasurer

 

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EXHIBIT INDEX

 

Exhibit

Number

  

Description

3.1    Amended and Restated Certificate of Incorporation of Company. (1)
3.2    Amended and Restated By-Laws of Company. (1)
4.1    Specimen of Common Stock. (4)
4.2    Form of Certificate of Designation of Series A Junior Participating Preferred Stock. (2)
4.3    Form of Certificate of Designation of Series A Cumulative Non-Voting Redeemable Preferred Stock. (3)
4.4    Indenture, dated as of September 25, 2007, between Company and The Bank of New York, a New York banking corporation, as Trustee. (5)
10.1    2005 Nonqualified Retirement Plan.*
10.2    Nonqualified Retirement and Savings Plan, as amended and restated effective November 1, 2007.*
10.3    Stock & Deferred Compensation Plan for Non-Employee Directors, as amended and restated as of December 31, 2007.*
10.4    Amendment No. 1 to 2004 Equity Incentive Plan.*
31.1    Certification of Chief Executive Officer pursuant to Rule 13a-14(a).*
31.2    Certification of Chief Financial Officer pursuant to Rule 13a-14(a).*
32.1    Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350.*
32.2    Certification of Chief Financial Officer pursuant to 18 U.S.C. Section 1350.*

(1) Incorporated herein by reference to Form 8-K of Company dated May 12, 2006 and filed May 15, 2006.

 

(2) Incorporated herein by reference to Amendment No. 2 to the Registration Statement of Company on Form S-4 dated January 19, 2000 (File No. 333-88663).

 

(3) Incorporated herein by reference to Amendment No. 3 to the Registration Statement of Company on Form S-4 dated February 4, 2000 (File No. 333-88663).

 

(4) Incorporated herein by reference to Amendment No. 4 to the Registration Statement of Company on Form S-4 dated February 9, 2000 (File No. 333-88663).

 

(5) Incorporated herein by reference to the Registration Statement of Company on Form S-3 dated September 25, 2007 (File No. 333-146297).

 

* Filed herewith