XML 41 R25.htm IDEA: XBRL DOCUMENT v3.8.0.1
SEGMENT AND RELATED INFORMATION
12 Months Ended
Dec. 31, 2016
SEGMENT AND RELATED INFORMATION  
SEGMENT AND RELATED INFORMATION

NOTE R — SEGMENT AND RELATED INFORMATION

 

We have identified two operating segments and both performance evaluation and resource allocation decisions are determined based on each operating segment’s income from operations.  The operating segments are described further below:

 

Patient Care - This segment consists of (i) our owned and operated patient care clinics, Dosteon, and CARES, and (ii) our contracting and network management business.  Dosteon is presented as a discontinued operation and has therefore been excluded from the summarized financial information below.  See Note S- “Discontinued Operations” within these consolidated financial statements.  CARES was closed in 2015.  The patient care clinics provide services to design and fit O&P devices to patients.  These clinics also instruct patients in the use, care and maintenance of the devices.  The principal reimbursement sources for our services are:

 

·

Commercial private payors and other, which consist of individuals, rehabilitation providers, commercial insurance companies, HMOs, PPOs, hospitals, vocational rehabilitation, workers’ compensation programs and similar sources;

 

·

Medicare, a federally funded health insurance program providing health insurance coverage for persons aged 65 or older and certain disabled persons, which provides reimbursement for O&P products and services based on prices set forth in published fee schedules with 10 regional pricing areas for prosthetics and orthotics and by state for durable medical equipment;

 

·

Medicaid, a health insurance program jointly funded by federal and state governments providing health insurance coverage for certain persons in financial need, regardless of age, which may supplement Medicare benefits for financially needy persons aged 65 or older; and

 

·

U.S. Department of Veterans Affairs.

 

Our contract and network management business, known as Linkia, is the only network management company dedicated solely to serving the O&P market and is focused on managing the O&P services of national and regional insurance companies.  We partner with healthcare insurance companies by securing a national or regional contract either as a preferred provider or to manage their O&P network of providers.

 

Products & Services - This segment consists of our distribution business, which distributes and fabricates O&P products and components to sell to both the O&P industry and our own patient care clinics, and our therapeutic solutions business.  The therapeutic solutions business leases and sells rehabilitation equipment and ancillary consumable supplies combined with equipment maintenance, education, and training.  This segment also develops emerging neuromuscular technologies for the O&P and rehabilitation markets.

 

Corporate & Other - This consists of corporate overhead and includes unallocated expense such as personnel costs, professional fees and corporate offices expenses.

 

The accounting policies of the segments are the same as those described in Note B - “Significant Accounting Policies”.

 

Summarized financial information concerning our reporting segments is shown in the following tables.  Segment performance is evaluated based on each segment’s earnings before interest expense, income taxes, and depreciation & amortization expenses (“EBITDA”).

 

Intersegment revenue primarily relates to sales of O&P components from the Products & Services segment to the Patient Care segment.  The sales are priced at the cost of the related materials plus overhead.

 

In 2014, intersegment revenue was made at prices which we believe approximate market values but has been reclassified to eliminate intercompany profit to be consistent with intersegment revenue in 2016 and 2015.  The reclassification adjustment to eliminate intersegment profit in 2014 is approximately $21.0 million.

 

We had no foreign and export sales and assets for the years ended December 31, 2016 and 2015.  Our foreign and export sales and assets located outside of the United States of America were not significant as of December 31, 2014.

 

For the Patient Care segment, government reimbursement, comprised of Medicare, Medicaid and the U.S. Department of Veterans Affairs, in the aggregate, accounted for approximately, 54.1%, 53.4% and 50.9% of their net revenue in 2016, 2015 and 2014, respectively.

 

Additionally, for the Products & Services segment, no single customer accounted for more than 10% of net revenues in 2016, 2015 or 2014, respectively.

 

(in thousands)

 

Patient Care

 

Products &
Services

 

Corporate
& Other

 

Consolidating
Adjustments

 

Total

 

2016

 

 

 

 

 

 

 

 

 

 

 

Net revenue

 

 

 

 

 

 

 

 

 

 

 

Third party

 

$

840,130

 

$

201,924

 

$

 

$

 

$

1,042,054

 

Intersegments

 

 

175,539

 

 

(175,539

)

 

 

 

 

 

 

 

 

 

 

 

 

 

Total net revenue

 

840,130

 

377,463

 

 

(175,539

)

1,042,054

 

 

 

 

 

 

 

 

 

 

 

 

 

Material costs

 

 

 

 

 

 

 

 

 

 

 

Third party suppliers

 

230,957

 

101,114

 

 

 

332,071

 

Intersegments

 

25,055

 

150,484

 

 

(175,539

)

 

 

 

 

 

 

 

 

 

 

 

 

 

Total material costs

 

256,012

 

251,598

 

 

(175,539

)

332,071

 

 

 

 

 

 

 

 

 

 

 

 

 

Personnel costs

 

315,892

 

47,645

 

 

 

363,537

 

Other expenses

 

150,604

 

32,228

 

104,649

 

 

287,481

 

Depreciation & amortization

 

24,873

 

11,600

 

8,414

 

 

44,887

 

Impairment of intangible assets

 

 

86,164

 

 

 

86,164

 

 

 

 

 

 

 

 

 

 

 

 

 

Income (loss) from operations

 

92,749

 

(51,772

)

(113,063

)

 

(72,086

)

 

 

 

 

 

 

 

 

 

 

 

 

Interest expense (income), net

 

33,081

 

13,097

 

(979

)

 

45,199

 

Extinguishment of debt

 

 

 

6,031

 

 

6,031

 

 

 

 

 

 

 

 

 

 

 

 

 

Income (loss) from continuing operations before income taxes

 

59,668

 

(64,869

)

(118,115

)

 

(123,316

)

 

 

 

 

 

 

 

 

 

 

 

 

Benefit for income taxes

 

 

 

(15,910

)

 

(15,910

)

 

 

 

 

 

 

 

 

 

 

 

 

Income (loss) from continuing operations

 

$

59,668

 

$

(64,869

)

$

(102,205

)

$

 

$

(107,406

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EBITDA

 

$

117,622

 

$

(40,172

)

$

(104,649

)

$

 

$

(27,199

)

Total assets

 

419,895

 

159,354

 

175,855

 

 

755,104

 

Capital expenditures

 

14,581

 

820

 

5,747

 

 

21,148

 

 

(in thousands)

 

Patient Care

 

Products &
Services

 

Corporate
& Other

 

Consolidating
Adjustments

 

Total

 

2015

 

 

 

 

 

 

 

 

 

 

 

Net revenue

 

 

 

 

 

 

 

 

 

 

 

Third party

 

$

874,960

 

$

192,212

 

$

 

$

 

$

1,067,172

 

Intersegments

 

 

137,282

 

 

(137,282

)

 

 

 

 

 

 

 

 

 

 

 

 

 

Total net revenue

 

874,960

 

329,494

 

 

(137,282

)

1,067,172

 

 

 

 

 

 

 

 

 

 

 

 

 

Material costs

 

 

 

 

 

 

 

 

 

 

 

Third party suppliers

 

242,714

 

93,569

 

 

 

336,283

 

Intersegments

 

19,613

 

117,669

 

 

(137,282

)

 

 

 

 

 

 

 

 

 

 

 

 

 

Total material costs

 

262,327

 

211,238

 

 

(137,282

)

336,283

 

 

 

 

 

 

 

 

 

 

 

 

 

Personnel costs

 

317,927

 

49,167

 

 

 

367,094

 

Other expenses

 

163,240

 

25,487

 

92,520

 

 

281,247

 

Depreciation and amortization

 

25,674

 

11,883

 

8,786

 

 

46,343

 

Impairment of intangible assets

 

382,860

 

2,947

 

 

 

 

 

385,807

 

 

 

 

 

 

 

 

 

 

 

 

 

(Loss) income from operations

 

(277,068

)

28,772

 

(101,306

)

 

(349,602

)

 

 

 

 

 

 

 

 

 

 

 

 

Interest expense (income), net

 

33,677

 

13,114

 

(16,899

)

 

29,892

 

Extinguishment of debt

 

 

 

7,237

 

 

7,237

 

 

 

 

 

 

 

 

 

 

 

 

 

(Loss) income from continuing operations before income taxes

 

(310,745

)

15,658

 

(91,644

)

 

(386,731

)

 

 

 

 

 

 

 

 

 

 

 

 

Benefit for income taxes

 

 

 

(67,614

)

 

(67,614

)

 

 

 

 

 

 

 

 

 

 

 

 

(Loss) income from continuing operations

 

$

(310,745

)

$

15,658

 

$

(24,030

)

$

 

$

(319,117

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EBITDA

 

$

(251,394

)

$

40,655

 

$

(92,520

)

$

 

$

(303,259

)

Total assets

 

468,575

 

257,640

 

246,869

 

 

973,084

 

Capital expenditures

 

16,505

 

2,937

 

8,178

 

 

27,620

 

 

(in thousands)

 

Patient
Care

 

Products &
Services

 

Corporate
& Other

 

Consolidating
Adjustments

 

Total

 

2014

 

 

 

 

 

 

 

 

 

 

 

Net revenue

 

 

 

 

 

 

 

 

 

 

 

Third party

 

$

837,080

 

$

175,020

 

$

 

$

 

$

1,012,100

 

Intersegments

 

 

162,636

 

 

(162,636

)

 

 

 

 

 

 

 

 

 

 

 

 

 

Total net revenue

 

837,080

 

337,656

 

 

(162,636

)

1,012,100

 

 

 

 

 

 

 

 

 

 

 

 

 

Material costs

 

 

 

 

 

 

 

 

 

 

 

Third party suppliers

 

240,685

 

83,599

 

 

 

324,284

 

Intersegments

 

19,587

 

143,049

 

 

(162,636

)

 

 

 

 

 

 

 

 

 

 

 

 

 

Total material costs

 

260,272

 

226,648

 

 

(162,636

)

324,284

 

 

 

 

 

 

 

 

 

 

 

 

 

Personnel costs

 

305,651

 

47,935

 

 

 

353,586

 

Other expenses

 

152,176

 

27,498

 

88,124

 

 

267,798

 

Depreciation and amortization

 

18,769

 

12,022

 

8,138

 

 

38,929

 

Impairment of intangible assets

 

 

223

 

 

 

223

 

 

 

 

 

 

 

 

 

 

 

 

 

Income (loss) from operations

 

100,212

 

23,330

 

(96,262

)

 

27,280

 

 

 

 

 

 

 

 

 

 

 

 

 

Interest expense (income), net

 

33,465

 

13,079

 

(18,267

)

 

28,277

 

 

 

 

 

 

 

 

 

 

 

 

 

Income (loss) from continuing operations before income taxes

 

66,747

 

10,251

 

(77,995

)

 

(997

)

 

 

 

 

 

 

 

 

 

 

 

 

Provision for income taxes

 

 

 

2,023

 

 

2,023

 

 

 

 

 

 

 

 

 

 

 

 

 

Income (loss) from continuing operations

 

$

66,747

 

$

10,251

 

$

(80,018

)

$

 

$

(3,020

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EBITDA

 

$

118,981

 

$

35,352

 

$

(88,124

)

$

 

$

66,209

 

Total assets

 

848,092

 

262,721

 

124,920

 

 

1,235,733

 

Capital expenditures

 

14,067

 

1,305

 

11,724

 

 

27,096