10-Q 1 g08744e10vq.htm AMSURG CORP. Amsurg Corp.
Table of Contents

 
 
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
Quarterly Report Pursuant to Section 13 or 15(d)
of the Securities Exchange Act of 1934
For the Quarterly Period Ended June 30, 2007
Commission File Number 000-22217
AMSURG CORP.
(Exact Name of Registrant as Specified in its Charter)
     
Tennessee
(State or other jurisdiction of
incorporation or organization)
  62-1493316
(I.R.S. Employer
Identification No.)
     
20 Burton Hills Boulevard
Nashville, TN

(Address of principal executive offices)
   
37215
(Zip code)
(615) 665-1283
(Registrant’s Telephone Number, Including Area Code)
     Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.
Yes þ       No o
     Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, or a non-accelerated filer. See definition of “accelerated filer and large accelerated filer” in Rule 12b-2 of the Exchange Act. (Check one):
Large accelerated filer þ       Accelerated filer o       Non-accelerated filer o
     Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).
Yes o       No þ
     As of August 3, 2007 there were outstanding 30,844,784 shares of the registrant’s Common Stock, no par value.
 
 

 


 

Table of Contents to Form 10-Q for the Six Months Ended June 30, 2007
 
                 
               
 
  Item 1.   Financial Statements     1  
 
  Item 2.   Management’s Discussion and Analysis of Financial Condition and Results of Operations     10  
 
  Item 3.   Quantitative and Qualitative Disclosures About Market Risk     16  
 
  Item 4.   Controls and Procedures     17  
 
  Item 4T.   Controls and Procedures     17  
 
               
               
 
  Item 1.   Legal Proceedings     17  
 
  Item 1A.   Risk Factors     17  
 
  Item 2.   Unregistered Sales of Equity Securities and Use of Proceeds     17  
 
  Item 3.   Defaults Upon Senior Securities     17  
 
  Item 4.   Submission of Matters to a Vote of Security Holders     17  
 
  Item 5.   Other Information     18  
 
  Item 6.   Exhibits     18  
 
               
    Signature     19  
 Exhibit 11
 Exhibit 31.1
 Exhibit 31.2
 Exhibit 32.1

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Table of Contents

Part I
Item 1. Financial Statements
AmSurg Corp.
Consolidated Balance Sheets
June 30, 2007 (unaudited) and December 31, 2006
(Dollars in thousands)
                 
    June 30,   December 31,
    2007   2006
     
Assets
               
 
               
Current assets:
               
Cash and cash equivalents
  $ 18,430     $ 20,083  
Accounts receivable, net of allowance of $6,997 and $6,628, respectively
    57,812       51,546  
Supplies inventory
    6,130       6,183  
Deferred income taxes
    1,560       915  
Prepaid and other current assets
    16,401       15,276  
     
 
               
Total current assets
    100,333       94,003  
 
               
Long-term receivables and other assets
    3,622       4,091  
Property and equipment, net
    91,517       89,175  
Intangible assets, net
    454,049       402,763  
     
 
               
Total assets
  $ 649,521     $ 590,032  
     
 
               
Liabilities and Shareholders’ Equity
               
 
               
Current liabilities:
               
Current portion of long-term debt
  $ 4,099     $ 3,367  
Accounts payable
    8,422       11,098  
Accrued salaries and benefits
    11,443       11,534  
Other accrued liabilities
    2,037       1,413  
     
 
               
Total current liabilities
    26,001       27,412  
 
               
Long-term debt
    135,233       123,948  
Deferred income taxes
    39,081       39,350  
Other long-term liabilities
    15,930       3,873  
Minority interest
    56,131       52,341  
Preferred stock, no par value, 5,000,000 shares authorized, no shares issued or outstanding
           
Shareholders’ equity:
               
Common stock, no par value, 70,000,000 shares authorized, 30,575,111 and 29,933,932 shares outstanding, respectively
    157,487       143,077  
Accumulated other comprehensive income, net of income taxes
    (72 )     (470 )
Retained earnings, net of ($634) cumulative adjustment to beginning retained earnings on January 1, 2007 for change in accounting for uncertainty in income taxes
    219,730       200,501  
     
 
               
Total shareholders’ equity
    377,145       343,108  
     
 
               
Total liabilities and shareholders’ equity
  $ 649,521     $ 590,032  
     
See accompanying notes to the unaudited consolidated financial statements.

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Table of Contents

Item 1. Financial Statements — (continued)
 
AmSurg Corp.
Consolidated Statements of Earnings (unaudited)
Three Months and Six Months Ended June 30, 2007 and 2006
(In thousands, except earnings per share
)
                                 
    Three Months Ended   Six Months Ended
    June 30,   June 30,
    2007   2006   2007   2006
     
 
                               
Revenues
  $ 131,726     $ 118,518     $ 258,921     $ 230,742  
 
                               
Operating expenses:
                               
Salaries and benefits
    38,098       34,311       76,431       68,741  
Supply cost
    15,105       14,148       29,633       26,831  
Other operating expenses
    27,968       22,734       52,816       44,138  
Depreciation and amortization
    4,743       4,287       9,437       8,419  
     
 
                               
Total operating expenses
    85,914       75,480       168,317       148,129  
     
 
                               
Operating income
    45,812       43,038       90,604       82,613  
 
                               
Minority interest
    25,998       24,505       51,331       48,134  
Interest expense, net of interest income
    2,197       2,046       4,684       3,745  
     
 
                               
Earnings from continuing operations before income taxes
    17,617       16,487       34,589       30,734  
 
                               
Income tax expense
    6,604       6,463       13,347       12,048  
     
 
                               
Net earnings from continuing operations
    11,013       10,024       21,242       18,686  
 
                               
Discontinued operations:
                               
Earnings from operations of discontinued interests in surgery centers, net of income tax expense
    32       80       80       143  
Gain on disposal of discontinued interest in surgery center, net of income tax expense
    147             147        
     
 
                               
Net earnings from discontinued operations
    179       80       227       143  
     
 
                               
Net earnings
  $ 11,192     $ 10,104     $ 21,469     $ 18,829  
     
 
                               
Basic earnings per common share:
                               
Net earnings from continuing operations
  $ 0.36     $ 0.34     $ 0.70     $ 0.63  
Net earnings
  $ 0.37     $ 0.34     $ 0.71     $ 0.63  
 
                               
Diluted earnings per common share:
                               
Net earnings from continuing operations
  $ 0.35     $ 0.33     $ 0.69     $ 0.62  
Net earnings
  $ 0.36     $ 0.33     $ 0.70     $ 0.62  
 
                               
Weighted average number of shares and share equivalents outstanding:
                               
Basic
    30,541       29,794       30,294       29,744  
Diluted
    31,085       30,472       30,795       30,345  
See accompanying notes to the unaudited consolidated financial statements.

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Table of Contents

Item 1. Financial Statements — (continued)
 
AmSurg Corp.
Consolidated Statements of Cash Flows (unaudited)
Six Months Ended June 30, 2007 and 2006
(In thousands
)
                 
    Six Months Ended
    June 30,
    2007   2006
     
Cash flows from operating activities:
               
Net earnings
  $ 21,469     $ 18,829  
Adjustments to reconcile net earnings to net cash flows provided by operating activities:
               
Minority interest
    51,331       48,134  
Distributions to minority partners
    (49,352 )     (45,673 )
Share-based compensation
    2,272       4,041  
Depreciation and amortization
    9,327       8,419  
Deferred income taxes
    3,410       2,301  
Excess tax benefit from share-based compensation
    (1,924 )     (934 )
Net loss on sale and impairment of long-lived assets
    1,066        
Increase (decrease) in cash and cash equivalents, net of effects of acquisitions and dispositions, due to changes in:
               
Accounts receivable, net
    (4,193 )     (3,244 )
Supplies inventory
    208       (231 )
Prepaid and other current assets
    627       422  
Accounts payable
    (2,381 )     (1,567 )
Accrued expenses and other liabilities
    1,596       3,430  
Other, net
    12       (15 )
     
 
               
Net cash flows provided by operating activities
    33,468       33,912  
 
               
Cash flows from investing activities:
               
Acquisition of interests in surgery centers
    (48,867 )     (25,670 )
Acquisition of property and equipment
    (10,202 )     (10,156 )
Proceeds from sale of surgery center
    1,659        
Decrease in long-term receivables
    1,071       1,094  
     
 
               
Net cash flows used in investing activities
    (56,339 )     (34,732 )
 
               
Cash flows from financing activities:
               
Proceeds from long-term borrowings
    55,269       58,011  
Repayment on long-term borrowings
    (44,609 )     (62,757 )
Proceeds from issuance of common stock upon exercise of stock options
    8,608       1,701  
Proceeds from capital contributions by minority partners
    32       114  
Excess tax benefit from share-based compensation
    1,924       934  
Financing cost incurred
    (6 )     (1 )
     
 
               
Net cash flows provided by (used in) financing activities
    21,218       (1,998 )
     
 
               
Net decrease in cash and cash equivalents
    (1,653 )     (2,818 )
Cash and cash equivalents, beginning of period
    20,083       20,496  
     
 
               
Cash and cash equivalents, end of period
  $ 18,430     $ 17,678  
     
See accompanying notes to the unaudited consolidated financial statements.

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Table of Contents

Item 1. Financial Statements — (continued)
 
AmSurg Corp.
Notes to the Unaudited Consolidated Financial Statements
(1) Basis of Presentation
AmSurg Corp. (the “Company”), through its wholly owned subsidiaries, owns majority interests, primarily 51%, in limited partnerships and limited liability companies (“LLCs”) which own and operate practice-based ambulatory surgery centers (“centers”). The Company also has majority ownership interests in other limited partnerships and LLCs formed to develop additional centers. The unaudited consolidated financial statements include the accounts of the Company and its subsidiaries and the majority owned limited partnerships and LLCs in which the Company’s wholly owned subsidiaries are the general partner or majority member. Consolidation of such limited partnerships and LLCs is necessary as the Company’s wholly owned subsidiaries have 51% or more of the financial interest, are the general partner or majority member with all the duties, rights and responsibilities thereof, are responsible for the day-to-day management of the limited partnerships and LLCs, and have control of the entities. The responsibilities of the Company’s minority partners (limited partners and minority members) are to supervise the delivery of medical services, with their rights being restricted to those that protect their financial interests, such as approval of the acquisition of significant assets or the incurrence of debt which they are required to guarantee on a pro rata basis based upon their respective ownership interests. Intercompany profits, transactions and balances have been eliminated. All limited partnerships and LLCs and minority partners are referred to herein as partnerships and partners, respectively.
Surgery center profits and losses are allocated to the Company’s partners in proportion to their ownership percentages and reflected in the aggregate as minority interest. The partners of the Company’s surgery center partnerships typically are organized as general partnerships, limited partnerships or limited liability companies that are not subject to federal income tax. Each partner shares in the pre-tax earnings of the surgery center in which it is a partner. Accordingly, the minority interest in each of the Company’s partnerships is determined on a pre-tax basis and presented before earnings before income taxes in order to present that amount of earnings on which the Company must determine its tax expense. In addition, distributions from the Company’s partnerships are made to both the Company’s wholly owned subsidiaries and the partners on a pre-tax basis.
As described above, the Company is a holding company and its ability to service corporate debt is dependent upon distributions from its partnerships. Positive operating cash flows of individual centers are the sole source of cash used to make distributions to the Company’s wholly owned subsidiaries, as well as to the partners, which the Company is obligated to make on a monthly basis in accordance with each partnership’s partnership or operating agreement. Accordingly, distributions to the Company’s partners are included in the consolidated financial statements as a component of the Company’s cash flows from operating activities.
The Company operates in one reportable business segment, the ownership and operation of ambulatory surgery centers.
These financial statements have been prepared in accordance with generally accepted accounting principles for interim financial reporting and in accordance with Rule 10-01 of Regulation S-X. In the opinion of management, the unaudited consolidated financial statements contained in this report reflect all adjustments, consisting of only normal recurring accruals, which are necessary for a fair presentation of the financial position and the results of operations for the interim periods presented. The results of operations for any interim period are not necessarily indicative of results for the full year.
The accompanying unaudited consolidated financial statements should be read in conjunction with the financial statements and notes thereto included in the Company’s 2006 Annual Report on Form 10-K.
(2) Use of Estimates
The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

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Table of Contents

Item 1. Financial Statements — (continued)
 
AmSurg Corp.
Notes to the Unaudited Consolidated Financial Statements — (continued)
The determination of contractual and bad debt allowances constitutes a significant estimate. Some of the factors considered by management in determining the amount of such allowances are the historical trends of the centers’ cash collections and contractual and bad debt write-offs, accounts receivable agings, established fee schedules, contracts with payors and procedure statistics. Accordingly, net accounts receivable at June 30, 2007 and December 31, 2006 reflect allowances for contractual adjustments of $66,922,000 and $63,721,000, respectively, and allowances for bad debt expense of $6,997,000 and $6,628,000, respectively.
(3) Revenue Recognition
Center revenues consist of billing for the use of the centers’ facilities (the “facility fee”) directly to the patient or third-party payor, and in limited instances, billing for anesthesia services. Such revenues are recognized when the related surgical procedures are performed. Revenues exclude any amounts billed for physicians’ surgical services, which are billed separately by the physicians to the patient or third-party payor.
Revenues from centers are recognized on the date of service, net of estimated contractual allowances from third-party medical service payors including Medicare and Medicaid. During the six months ended June 30, 2007 and 2006, the Company derived approximately 33% and 34%, respectively, of its revenues from Medicare and Medicaid. Concentration of credit risk with respect to other payors is limited due to the large number of such payors.
(4) Share-Based Compensation
In May 2006, the Company adopted the AmSurg Corp. 2006 Stock Incentive Plan. The Company also has options outstanding under the AmSurg Corp. 1997 Stock Incentive Plan, under which no additional options may be granted. Under these plans, the Company has granted non-qualified options to purchase shares of common stock to employees and outside directors from its authorized but unissued common stock. Options are granted at market value on the date of the grant. Prior to 2007, granted options vested ratably over four years. Options granted in 2007 vest four years from the grant date. Options have a term of ten years from the date of grant. At June 30, 2007, 1,970,807 shares were authorized for grant and 1,369,362 shares were available for future option grants. Options outstanding and exercisable under these stock option plans as of June 30, 2007 and stock option activity for the six months ended June 30, 2007 is summarized as follows:
                         
                    Weighted
                    Average
            Weighted   Remaining
    Number   Average   Contractual
    of   Exercise   Term
    Shares   Price   (in years)
     
 
                       
Outstanding at December 31, 2006
    4,589,532     $ 20.46       7.1  
Options granted
    360,293       22.81          
Options exercised with aggregate intrinsic value of $2,744,000
    (562,841 )     15.29          
Options terminated
    (46,775 )     23.79          
 
                       
 
                       
Outstanding at June 30, 2007 with aggregate intrinsic value of $14,011,000
    4,340,209     $ 21.29       7.0  
 
                       
 
                       
Exercisable at June 30, 2007 with aggregate intrinsic value of $11,629,000
    2,654,136     $ 20.09       6.1  
 
                       
The aggregate intrinsic value represents the total pre-tax intrinsic value received by the option holders on the exercise date or that would have been received by the option holders had all holders of outstanding options at June 30, 2007 exercised their options at the Company’s closing stock price on June 30, 2007.

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Table of Contents

Item 1. Financial Statements — (continued)
 
AmSurg Corp.
Notes to the Unaudited Consolidated Financial Statements — (continued)
In the six months ended June 30, 2007, the Company issued 75,322 shares of restricted stock to certain employees under the 2006 Stock Incentive Plan at a fair value of $22.84 per share and 4,473 shares of restricted stock to outside directors at a fair value of $23.49 per share. The fair value of restricted stock was determined based on the closing bid price of the Company’s common stock on the grant date. In addition, 1,457 shares of restricted stock issued to employees at a fair value of $22.84 per share were cancelled during the six months ended June 30, 2007. At June 30, 2007, 77,974 shares of unvested restricted stock were outstanding, including 4,109 shares issued to outside directors. The granted shares of restricted stock vest four years from the date of grant for all employees then in service. Granted shares of restricted stock to outside directors vest two years from the date of grant and are restricted from trading for five years from the date of grant.
The Company accounts for share-based payment transactions in which the Company receives employee and non-employee services in exchange for the Company’s equity instruments or liabilities that are based on the fair value of the Company’s equity securities or may be settled by the issuance of these securities in accordance with Statement of Financial Accounting Standards (“SFAS”) No. 123R, “Share-Based Payment (Revised 2004).” The Company recorded share-based expense of $1,156,000 and $1,467,000 in the three months ended June 30, 2007 and 2006, respectively, and $2,272,000 and $4,041,000 in the six months ended June 30, 2007 and 2006, respectively.
The Company, using the Black-Scholes option pricing model for all stock options awards on the date of grant, applied the following assumptions (no awards were made during the three months ended June 30, 2007):
                                 
    Three Months Ended   Six Months Ended
    June 30,   June 30,
     
    2007   2006   2007   2006
     
Applied assumptions:
                               
Weighted average fair value of options at the date of grant
        $ 8.11     $ 8.61     $ 7.65  
Dividends
                       
Expected term/life of options in years
          4.1       4.8       4.1  
Forfeiture rate
          13.5 %     0.1 %     11.1 %
Average risk-free interest rate
          5.0 %     4.8 %     4.6 %
Volatility rate
          37.3 %     34.4 %     37.8 %
The expected volatility rate applied was estimated based on historical volatility. The expected term assumption applied is based on contractual terms, historical exercise and cancellation patterns and forward looking factors where present for each population of employee identified. The risk-free interest rate used is based on the U.S. Treasury yield curve in effect at the time of the grant. The pre-vesting forfeiture rate is based on historical rates and forward looking factors for each population of employee identified. As required under SFAS No. 123R, the Company will adjust the estimated forfeiture rate to its actual experience. The Company is precluded from paying dividends under its credit facility, and therefore, there is no expected dividend yield.
(5) Acquisitions and Dispositions
During the six months ended June 30, 2007, the Company, through three wholly owned subsidiaries and in eight separate transactions, acquired majority interests in nine physician practice-based surgery centers. The aggregate amount paid for the acquisition and other acquisition costs was approximately $48,867,000, which was funded by borrowings under the Company’s credit facility and purchase price payable of $4,600,000, a component of other long-term liabilities, paid in July 2007.
At June 30, 2007, the Company had contingent purchase price obligations relating to six acquisitions completed in 2006 and 2007. These obligations were dependent upon final rulemaking by The Centers for Medicare and Medicaid Services (“CMS”) related to a change in the rate setting methodology, payment rates, payment policies and the list of covered surgical procedures for ambulatory surgery centers. On July 16, 2007, CMS announced a final rule to be effective January 1, 2008 based on payment rates to be finalized in November 2007. As of June 30, 2007, the Company recognized additional purchase price payable of approximately $1,200,000 in other long-term liabilities related to the

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Table of Contents

Item 1. Financial Statements — (continued)
 
AmSurg Corp.
Notes to the Unaudited Consolidated Financial Statements — (continued)

additional contingent purchase price payable that the Company estimates it will be required to pay once the rule is effective.
During 2007, the Company sold its interest in a surgery center following management’s assessment of the limited growth opportunities at the center. The results of operations of the center have been classified as discontinued operations and the 2006 periods have been restated. Results of operations of the combined discontinued surgery centers for the three and six months ended June 30, 2007 and 2006 are as follows (in thousands):
                                 
    Three Months Ended   Six Months Ended
    June 30,   June 30,
     
    2007   2006   2007   2006
     
 
                       
Revenues
  $ 315     $ 1,436     $ 734     $ 2,846  
Earnings before income taxes
    53       132       132       235  
Net earnings
    32       80       80       143  
(6) Intangible Assets
Amortizable intangible assets at June 30, 2007 and December 31, 2006 consisted of the following (in thousands):
                                                 
    June 30, 2007   December 31, 2006
    Gross                   Gross        
    Carrying   Accumulated           Carrying   Accumulated    
    Amount   Amortization   Net   Amount   Amortization   Net
         
 
                       
Deferred financing cost
  $ 2,509     $ 1,613     $ 896     $ 2,503     $ 1,503     $ 1,000  
Agreements not to compete
    1,000       1,000             1,000       1,000        
         
 
                       
Total amortizable intangible assets
  $ 3,509     $ 2,613     $ 896     $ 3,503     $ 2,503     $ 1,000  
         
Estimated amortization of intangible assets for the remainder of 2007 and the following five years is $112,000, $224,000, $224,000, $223,000, $112,000 and $1,000, respectively.
The changes in the carrying amount of goodwill for the three and six months ended June 30, 2007 and 2006 are as follows (in thousands):
                                 
    Three Months Ended   Six Months Ended
    June 30,   June 30,
     
    2007   2006   2007   2006
     
 
                       
Balance, beginning of period
  $ 438,756     $ 371,381     $ 397,147     $ 347,424  
Goodwill acquired (adjusted) during period
    10,315       (19 )     51,924       23,938  
Goodwill disposed during period
    (1,051 )           (1,051 )      
     
 
                               
Balance, end of period
  $ 448,020     $ 371,362     $ 448,020     $ 371,362  
     
At June 30, 2007 and December 31, 2006, other non-amortizable intangible assets related to non-compete arrangements were $5,133,000 and $4,616,000, respectively.

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Table of Contents

Item 1. Financial Statements — (continued)
 
AmSurg Corp.
Notes to the Unaudited Consolidated Financial Statements — (continued)
(7) Long-term Debt
The Company’s revolving credit facility permits the Company to borrow up to $200,000,000 to, among other things, finance its acquisition and development projects and any future stock repurchase programs at an interest rate equal to, at the Company’s option, the prime rate, or LIBOR plus 0.50% to 1.50%, or a combination thereof; provides for a fee of 0.15% to 0.30% of unused commitments; prohibits the payment of dividends; and contains certain covenants relating to the ratio of debt to net worth, operating performance and minimum net worth. Borrowings under the revolving credit facility mature in July 2011. At June 30, 2007, the Company had $125,500,000 outstanding under its revolving credit facility and was in compliance with all covenants.
The Company entered into an interest rate swap agreement in April 2006, the objective of which is to hedge exposure to the variability of the future expected cash flows attributable to the variable interest rate of a portion of the Company’s outstanding balance under its revolving credit facility. The interest rate swap has a notional amount of $50,000,000. The Company pays to the counterparty a fixed rate of 5.365% of the notional amount of the interest rate swap and receives a floating rate from the counterparty based on LIBOR. The interest rate swap matures in April 2011. In the opinion of management and as permitted by SFAS No. 133, “Accounting for Derivative Investments and Hedging Activities,” the interest rate swap (as a cash flow hedge) is a fully effective hedge. Payments or receipts of cash under the interest rate swap are shown as a part of operating cash flow, consistent with the interest expense incurred pursuant to the credit facility. The swap had a negative fair value of $119,000, is included as part of other long-term liabilities and represents the estimated amount the Company would have paid as of June 30, 2007 upon termination of the agreement based on a valuation obtained from the financial institution that is the counterparty to the interest rate swap agreement. An increase of $522,000 and $398,000, net of income taxes, in the fair value of the interest rate swap agreement during the three and six months ended June 30, 2007, respectively, was recognized in accumulated other comprehensive loss. An increase of $176,000, net of income taxes, in the fair value of the interest rate swap agreement during the three and six months ended June 30, 2006, respectively, was recognized in accumulated other comprehensive loss.
(8) Impairment of Long-lived Assets
During the three and six months ended June 30, 2007, the Company recorded in other operating expenses a charge of approximately $1,000,000 for an impairment of long-lived assets associated with real estate held and used by one of its surgery centers. The surgery center anticipates selling and relocating its facility by 2008, and the impairment charge was necessary in order to record the property while held and used at its fair value based on recent comparable property sales within the center’s market.
(9) Income Taxes
In June 2006, the Financial Accounting Standards Board (“FASB”) issued FASB Interpretation (“FIN”) No. 48, “Accounting for Uncertainty in Income Taxes — an interpretation of SFAS No. 109,” which clarifies the accounting for uncertainty in income taxes recognized in financial statements in accordance with SFAS No. 109, “Accounting for Income Taxes.” FIN No. 48 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The provisions of FIN No. 48 are effective for fiscal years beginning after December 15, 2006, with the cumulative effect of the change in accounting principle recorded as an adjustment to opening retained earnings. The Company adopted the provisions of FIN No. 48 on January 1, 2007. As of the adoption date, the Company had no unrecognized benefits that, if recognized, would affect its effective tax rate. Except for a cumulative adjustment in accordance with FIN No. 48, it is the Company’s policy to recognize interest accrued and penalties, if any, related to unrecognized benefits as income tax expense in its statement of earnings. Approximately $1,100,000 of accrued interest was established as a FIN No. 48 liability on January 1, 2007 through a tax affected adjustment to beginning retained earnings of $634,000. Additionally, as of January 1, 2007, the Company reclassified approximately $4,900,000 from long-term deferred tax liability to other long-term liabilities to reflect the amount of its tax-effected unrecognized benefits.

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Item 1. Financial Statements — (continued)
 
AmSurg Corp.
Notes to the Unaudited Consolidated Financial Statements — (continued)
The Company and its subsidiaries file income tax returns in the U.S. federal jurisdiction and various state jurisdictions. With few exceptions, the Company is no longer subject to U.S. federal or state income tax examinations for years prior to 2003. The Company does not expect significant changes to its tax positions or FIN No. 48 liability during the next twelve months.
(10) Commitments and Contingencies
The Company and its partnerships are insured with respect to medical malpractice risk on a claims-made basis. The Company also maintains insurance for general liability, director and officer liability and property. Certain policies are subject to deductibles. In addition to the insurance coverage provided, the Company indemnifies its officers and directors for actions taken on behalf of the Company and its partnerships. Management is not aware of any claims against the Company or its partnerships which would have a material financial impact.
The Company’s wholly owned subsidiaries, as general partners in the Company’s limited partnerships, are responsible for all debts incurred but unpaid by the limited partnerships. As manager of the operations of the limited partnership, the Company has the ability to limit potential liabilities by curtailing operations or taking other operating actions.
In the event of a change in current law, which would prohibit the physicians’ current form of ownership in the partnerships, the Company would be obligated to purchase the physicians’ interests in substantially all of the Company’s partnerships. The purchase price to be paid in such event would be determined by a predefined formula, as specified in the partnership agreements. The Company believes the likelihood of a change in current law, which would trigger such purchases, was remote as of June 30, 2007.
(11) Recent Accounting Pronouncements
In September 2006, the FASB issued SFAS No. 157, “Fair Value Measurements.” SFAS No. 157 defines fair value, establishes a framework for measuring fair value, and expands disclosures about fair value measurements. SFAS No. 157 is effective for financial statements issued for fiscal years beginning after November 15, 2007 and will become effective for the Company beginning with the first quarter of 2008. The Company has not yet determined the impact of the adoption of SFAS No. 157 on its financial statements and note disclosures.
In February 2007, the FASB issued SFAS No. 159, “The Fair Value Option for Financial Assets and Financial Liabilities.” SFAS No. 159 allows entities the option to measure eligible financial instruments at fair value as of specified dates. Such election, which may be applied on an instrument by instrument basis, is typically irrevocable once elected. SFAS No. 159 is effective for financial statements issued for fiscal years beginning after November 15, 2007 and will become effective for the Company beginning with the first quarter of 2008. The Company has not yet determined the impact of the adoption of SFAS No. 159 on its financial statements and note disclosures.
(12) Subsequent Events
In July and August 2007, the Company, through a wholly owned subsidiary and in separate transactions, acquired majority interests in two ambulatory surgery centers for approximately $12,100,000.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Forward-Looking Statements
This report contains certain forward-looking statements (all statements other than with respect to historical fact) within the meaning of the federal securities laws, which are intended to be covered by the safe harbors created thereby. Investors are cautioned that all forward-looking statements involve known and unknown risks and uncertainties including, without limitation, those described below, some of which are beyond our control. Although we believe that the assumptions underlying the forward-looking statements contained herein are reasonable, any of the assumptions could be inaccurate. Therefore there can be no assurance that the forward-looking statements included in this report will prove to be accurate. Actual results could differ materially and adversely from those contemplated by any forward-looking statement. In light of the significant risks and uncertainties inherent in the forward-looking statements included herein, the inclusion of such information should not be regarded as a representation by us or any other person that our objectives and plans will be achieved. We undertake no obligation to publicly release any revisions to any forward-looking statements in this discussion to reflect events and circumstances occurring after the date hereof or to reflect unanticipated events.
Forward-looking statements, and our liquidity, financial condition and results of operations, may be affected by the following risks and uncertainties and the other risks and uncertainties discussed in our Annual Report on Form 10-K for the fiscal year ended December 31, 2006 under “Item 1A. — Risk Factors,” as well as other unknown risks and uncertainties:
    changes in the reimbursement system for outpatient surgical procedures under the Medicare program;
 
    the risk that payments from third-party payors, including government healthcare programs, may decrease or not increase as our costs increase;
 
    our ability to maintain favorable relations with our physician partners;
 
    our ability to acquire and develop additional surgery centers on favorable terms;
 
    our ability to grow revenues at our existing centers;
 
    our ability to manage the growth in our business;
 
    our ability to obtain sufficient capital resources to complete acquisitions and develop new surgery centers;
 
    our ability to compete for physician partners, managed care contracts, patients and strategic relationships;
 
    risks associated with weather and other factors that may affect our surgery centers located in Florida;
 
    our failure to comply with applicable laws and regulations;
 
    the risk of changes in legislation, regulations or regulatory interpretations that may negatively affect us;
 
    the risk of becoming subject to federal and state investigation;
 
    the risk of regulatory changes that may obligate us to buy out interests of physicians who are minority owners of our surgery centers;
 
    risks associated with our status as a general partner of limited partnerships;
 
    our legal responsibility to minority owners of our surgery centers, which may conflict with our interests and prevent us from acting solely in our best interests;
 
    risks associated with the write-off of the impaired portion of intangible assets; and
 
    risks associated with the tax deductibility of goodwill.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations — (continued)
Overview
We develop, acquire and operate practice-based ambulatory surgery centers, or ASCs, in partnership with physician practice groups. As of June 30, 2007, we owned a majority interest (51% or greater) in 165 surgery centers. The following table presents the changes in the number of surgery centers in operation, under development and under letter of intent for the three and six months ended June 30, 2007 and 2006. A center is deemed to be under development when a limited partnership or limited liability company has been formed with the physician group partner to develop the center.
                                 
    Three Months Ended     Six Months Ended  
    June 30,     June 30,  
    2007     2006     2007     2006  
     
 
                               
Centers in operation, beginning of the period
    163       153       156       149  
New center acquisitions placed in operation.
    2             9       3  
New development centers placed in operation.
    1             1       1  
Centers sold
    (1 )           (1 )      
     
 
                               
Centers in operation, end of the period
    165       153       165       153  
     
 
                               
Centers under development, end of period
    4       4       4       4  
Development centers awaiting regulatory approval, end of period
          3             3  
Average number of continuing centers in operation, during period
    163       153       163       153  
Centers under letter of intent, end of period
    8       2       8       2  
Of the continuing surgery centers in operation at June 30, 2007, 114 centers performed gastrointestinal endoscopy procedures, 38 centers performed ophthalmology surgery procedures, five centers performed orthopedic procedures and eight centers performed procedures in more than one specialty. The other partner or member in each limited partnership or limited liability company is generally an entity owned by physicians who perform procedures at the center. We intend to expand primarily through the acquisition and development of additional practice-based ASCs in targeted surgical specialties and through future same-center growth. Our growth targets for 2007 include the acquisition or development of 18 to 20 surgery centers and the achievement of annual same-center revenue growth of 3% to 4%.
While we generally own 51% of the entities that own the surgery centers, our consolidated statements of earnings include 100% of the results of operations of the entities, reduced by the minority partners’ share of the net earnings or loss of the surgery center entities.
Sources of Revenues
Substantially all of our revenues are derived from facility fees charged for surgical procedures performed in our surgery centers. These fees vary depending on the procedure, but usually include all charges for operating room usage, special equipment usage, supplies, recovery room usage, nursing staff and medications and, in limited instances, billing for anesthesia services. Facility fees do not include the charges of the patient’s surgeon, anesthesiologist or other attending physicians, which are billed directly by the physicians. Our revenues are recorded net of estimated contractual adjustments from third-party medical service payors.
Practice-based ASCs, such as those in which we own a majority interest, depend upon third-party reimbursement programs, including governmental and private insurance programs, to pay for services rendered to patients. The amount of payment a surgery center receives for its services may be adversely affected by market and cost factors, as well as other factors over which we have no control, including Medicare and Medicaid regulations and the cost containment and utilization decisions of third-party payors. We derived approximately 33% and 34% of our revenues in the six months ended June 30, 2007 and 2006, respectively, from governmental healthcare programs, primarily Medicare, and the remainder from a wide mix of commercial payors and patient co-pays and deductibles. The Medicare program currently pays ASCs in accordance with predetermined fee schedules.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations — (continued)
On February 8, 2006, the President signed into law the Deficit Reduction Act of 2005, which includes a provision that limits Medicare reimbursement for certain procedures performed at ASCs to the amounts paid to hospital outpatient departments under the Medicare hospital outpatient department fee schedule for those procedures beginning in 2007. This act negatively impacts the reimbursement of after-cataract laser surgery procedures performed at our ophthalmology ASCs, the result of which will be an approximately $0.03 reduction in our net earnings per diluted share for 2007. We believe the after-cataract laser surgery procedure is the only procedure performed in significant numbers in our centers for which the current reimbursement rate exceeds the Medicare hospital outpatient development fee schedule amount.
On July 16, 2007, the Centers for Medicare and Medicaid Services, or CMS, announced a final rule to revise the payment system for services provided in ASCs. The key points of the final rule as it relates to us are:
    CMS’s estimate that the revised ASC rates would be 65% of the corresponding rates of the hospital outpatient prospective payment system;
 
    a scheduled phase in of the revised rates over four years, beginning January 1, 2008;
 
    an annual increase in the ASC rates beginning in 2010 based on the consumer price index; and
 
    an expansion of the list of procedures that can be performed in an ASC.
The final rule will result in a significant reduction in the reimbursement rates for gastroenterology procedures, which make up approximately 75% of the procedures performed by our surgery centers, and certain ophthalmology and pain procedures. Based on our 2007 procedure mix, payor mix and volume, we estimate the proposed rule would reduce our net earnings per diluted share in 2008 by approximately $0.04 to $0.05 and our net earnings per diluted share in 2009 by approximately $0.04 to $0.05. After 2009, we believe the impact will be nominal.
Critical Accounting Policies
A summary of significant accounting policies is disclosed in our 2006 Annual Report on Form 10-K. Our critical accounting policies are further described under the caption “Critical Accounting Policies” in Management’s Discussion and Analysis of Financial Condition and Results of Operations in our 2006 Annual Report on Form 10-K. There have been no changes in the nature of our critical accounting policies or the application of those policies since December 31, 2006.
Results of Operations
Our revenues are directly related to the number of procedures performed at our surgery centers. Our overall growth in procedure volume is impacted directly by the increase in the number of surgery centers in operation and the growth in procedure volume at existing centers. We increase our number of surgery centers through both acquisitions and developments. Procedure growth at any existing center may result from additional contracts entered into with third-party payors, increased market share of the associated medical practice of our physician partners, additional physicians utilizing the center and/or scheduling and operating efficiencies gained at the surgery center. A significant measurement of how much our revenues grow from year to year for existing centers is our same-center revenue percentage. We define our same-center group each year as those centers that contain full year-to-date operations in both comparable reporting periods, including the expansion of the number of operating centers within a limited partnership or limited liability company. We expect our annual same-center revenue growth to be 3% to 4% in 2007. Our 2007 same-center group, comprised of 146 centers, had revenue growth of 3% in the three and six months ended June 30, 2007.
Expenses directly and indirectly related to procedures performed at our surgery centers include clinical and administrative salaries and benefits, supply cost and other operating expenses such as linen cost, repair and maintenance of equipment, billing fees and bad debt expense. The majority of our corporate salary and benefits cost is associated directly with the number of centers we own and manage and tends to grow in proportion to the growth of our centers in operation. Our centers and corporate offices also incur costs that are more fixed in nature, such as lease expense, legal fees, property taxes, utilities and depreciation and amortization.
Surgery center profits are allocated to our minority partners in proportion to their individual ownership percentages and reflected in the aggregate as minority interest. The minority partners of our surgery center limited partnerships and limited liability companies typically are organized as general partnerships, limited partnerships or limited liability companies that are not subject to federal income tax. Each minority partner shares in the pre-tax earnings of the surgery center of which it is a minority partner. Accordingly, the minority interest in each of our surgery center limited

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations — (continued)
partnerships and limited liability companies is determined on a pre-tax basis and presented before earnings before income taxes in order to present that amount of earnings on which we must determine our tax expense.
Our interest expense results primarily from our borrowings used to fund acquisition and development activity, as well as interest incurred on capital leases.
We file a consolidated federal income tax return and numerous state income tax returns with varying tax rates. Our income tax expense reflects the blending of these rates.
The following table shows certain statement of earnings items expressed as a percentage of revenues for the three and six months ended June 30, 2007 and 2006:
                                 
    Three Months Ended     Six Months Ended  
    June 30,     June 30,  
    2007     2006     2007     2006  
     
 
                               
Revenues
    100.0 %     100.0 %     100.0 %     100.0 %
 
                               
Operating expenses:
                               
Salaries and benefits
    28.9       29.0       29.5       29.8  
Supply cost
    11.5       11.9       11.5       11.6  
Other operating expenses
    21.2       19.2       20.4       19.1  
Depreciation and amortization
    3.6       3.6       3.6       3.7  
     
 
                               
Total operating expenses
    65.2       63.7       65.0       64.2  
     
 
                               
Operating income
    34.8       36.3       35.0       35.8  
 
                               
Minority interest
    19.7       20.7       19.8       20.9  
Interest expense, net of interest income
    1.7       1.7       1.8       1.6  
     
 
                               
Earnings from continuing operations before income taxes
    13.4       13.9       13.4       13.3  
 
                               
Income tax expense
    5.0       5.4       5.2       5.2  
     
 
                               
Net earnings from continuing operations
    8.4       8.5       8.2       8.1  
 
                               
Net earnings from discontinued operations
    0.1             0.1       0.1  
     
 
                               
Net earnings
    8.5 %     8.5 %     8.3 %     8.2 %
     
Revenues increased $13.2 million and $28.2 million, or 11% and 12%, to $131.7 million and $258.9 million in the three and six months ended June 30, 2007, respectively, from $118.5 million and $230.7 million in the comparable 2006 periods. The additional revenues resulted primarily from:
    nine centers acquired in the six months ended June 30, 2007, which generated $6.2 million and $11.6 million in revenues during the three and six months ended June 30, 2007, respectively;
 
    nine centers acquired or opened in the last two quarters of 2006, which contributed $4.5 million and $12.1 million of additional revenues due to having a full period of operations in the three and six months ended June 30, 2007; and
 
    $2.3 million and $4.2 million of revenue growth for the three and six months ended June 30, 2007, respectively, recognized by our 2007 same-center group, reflecting a 3% increase in both periods presented, primarily as a result of procedure growth.
Our procedures increased by 26,010 and 49,298, or 12% in the three and six months ended June 30, 2007, respectively, to 242,290 and 476,248 from 216,280 and 426,950 in the comparable 2006 periods. The difference between our revenue

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations — (continued)
growth and our procedure growth was primarily the result of the change in the mix of procedures in our same-center group.
Staff at newly acquired and developed centers, as well as the additional staffing required at existing centers due to increased volume, resulted in a 14% and 17% increase in salaries and benefits at our surgery centers in the three and six months ended June 30, 2007 compared to the comparable 2006 periods. We experienced a 1% and 7% decrease in salaries and benefits at our corporate offices during the three and six months ended June 30, 2007, respectively, over the comparable 2006 periods. In 2007, we began issuing fewer annual stock option awards, and issued restricted stock awards to employees for the first time. Those awards vest 100% on the fourth anniversary date of grant. These changes resulted in a reduction in our share-based compensation expense in the three and six months ended June 30, 2007 over the comparable 2006 periods. Salaries and benefits increased in total by 11% during the three and six months ended June 30, 2007, respectively, to $38.1 million and $76.4 million from $34.3 million and $68.7 million over the comparable 2006 periods. Salaries and benefits as a percentage of revenues decreased during the three and six months ended June 30, 2007 over the comparable 2006 periods due to the changes instituted in our share-based compensation.
Supply cost was $15.1 million and $29.6 million in the three and six months ended June 30, 2007, respectively, an increase of $1.0 million and $2.8 million, or 7% and 10%, respectively, over supply cost in the comparable 2006 periods. This increase was primarily the result of additional procedure volume. In addition, our average supply cost per procedure decreased to $62 during the three and six months ended June 30, 2007, respectively, compared to $65 and $63 in the comparable 2006 periods. The increase in the number of gastroenterology surgery centers placed in operation in 2007 resulted in a decrease in supply cost per procedure due to the lower supply cost incurred at these types of centers.
Other operating expenses increased $5.2 million, or 23%, to $28.0 million in the three months ended June 30, 2007 over the comparable 2006 period and $8.7 million, or 20%, to $52.8 million in the six months ended June 30, 2007 over the comparable 2006 period. The additional expense in the three and six months ended June 30, 2007 resulted primarily from:
    an increase of $3.1 million and $4.0 million in other operating expenses from our 2007 same-center group in the three and six months ended June 30, 2007, respectively, resulting primarily from additional procedure volume and general inflationary cost increases, as well as a $1.3 million impairment charge and property loss incurred at a center that will be relocating its facility during 2008;
 
    nine centers acquired during the three and six months ended June 30, 2007, respectively, which resulted in an increase of $1.0 million and $1.9 million, respectively, in other operating expenses; and
 
    nine centers acquired or opened during the last two quarters of 2006, which resulted in an increase of $600,000 and $1.7 million in other operating expenses due to having a full period of operations in the three and six months ended June 30, 2007, respectively.
Depreciation and amortization expense increased $500,000 and $1.0 million, or 11% and 12%, in the three and six months ended June 30, 2007, respectively, from the comparable 2006 periods, primarily as a result of centers acquired since June 30, 2006 and the newly developed surgery centers in operation, which have an initially higher level of depreciation expense due to their construction costs.
We anticipate further increases in operating expenses in 2007, primarily due to additional acquired centers and additional start-up centers expected to be placed in operation. Typically, a start-up center will incur start-up losses while under development and during its initial months of operation and will experience lower revenues and operating margins than an established center. This typically continues until the case load at the center grows to a more normal operating level, which generally is expected to occur within 12 months after the center opens. At June 30, 2007, we had four centers under development and three centers that had been open for less than one year.
Minority interest in earnings from continuing operations before income taxes for the three and six months ended June 30, 2007 increased $1.5 million and $3.2 million, or 6% and 7%, respectively, from the comparable 2006 periods, primarily as a result of minority partners’ interest in earnings at surgery centers recently added to operations. As a percentage of revenues, minority interest decreased to 19.7% and 19.8% in the three and six months ended June 30, 2007, respectively, from 20.7% and 20.9% in the comparable 2006 periods as a result of lower same-center revenue growth.
Interest expense increased approximately $150,000 and $900,000 during the three and six months ended June 30, 2007, or 7% and 25%, respectively, over the comparable 2006 periods, primarily due to additional long-term debt outstanding

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations — (continued)
during the three and six months ended June 30, 2007 resulting from acquisition activity. See “— Liquidity and Capital Resources.”
We recognized income tax expense from continuing operations of $6.6 million and $13.3 million in the three and six months ended June 30, 2007, respectively, compared to $6.5 million and $12.0 million in the comparable 2006 periods. Our effective tax rate in the three and six months ended June 30, 2007 was 37.5% and 38.6%, respectively, of earnings from continuing operations before income taxes, and differed from the federal statutory income tax rate of 35%, primarily due to the impact of state income taxes. Effective January 1, 2007, we adopted Financial Accounting Standards Board Interpretation No. 48, “Accounting for Uncertainty in Income Taxes — an interpretation of SFAS No. 109,” or FIN No. 48, and recorded a cumulative reduction to beginning retained earnings of $634,000. In addition, during the three and six months ended June 30, 2007, we incurred additional income tax expense of $99,000 and $189,000, respectively, related to FIN No. 48. We estimate that the adoption of FIN No. 48 will result in additional income tax expense of approximately $224,000 for the full year ended December 31, 2007. In addition, we recognized an additional tax benefit of approximately $400,000 in the three and six months ended
June 30, 2007 associated with the recognition of a capital loss carryforward. We anticipate that our overall effective tax rate for the remainder of 2007 will be approximately 39.2%. Because we deduct goodwill amortization for tax purposes only, our deferred tax liability continues to increase, which would only be due in part or in whole upon the disposition of a portion or all of our surgery centers.
During 2007, we sold our ownership interest in a surgery center. The results of operation of the center have been classified as discontinued operations in the 2007 period. The net earnings derived from the operations of the discontinued surgery center in the six months ended June 30, 2006 were $80,000.
Liquidity and Capital Resources
At June 30, 2007, we had working capital of $74.3 million compared to $66.6 million at December 31, 2006. Operating activities for the six months ended June 30, 2007 generated $32.5 million in cash flow from operations compared to $33.9 million in 2006. The decrease in operating cash flow activity resulted primarily from the payment of a higher amount of accrued bonuses from the prior fiscal year during the six months ended June 30, 2007 compared to the comparable 2006 period. Cash and cash equivalents at June 30, 2007 and December 31, 2006 were $18.4 million and $20.1 million, respectively.
The principal source of our operating cash flow is the collection of accounts receivable from governmental payors, commercial payors and individuals. Each of our surgery centers bills for services as delivered, either electronically or in paper form, usually within several days following the delivery of the procedure. Generally, unpaid amounts that are 30 days past due are rebilled based on a standard set of procedures. If amounts remain uncollected after 60 days, our surgery centers proceed with a series of late-notice notifications until amounts are either collected, contractually written-off in accordance with contracted rates or determined to be uncollectible, typically after 90 to 120 days. Receivables determined to be uncollectible are written off and such amounts are applied to our estimate of allowance for bad debts as previously established in accordance with our policy for allowance for bad debt. The amount of actual write-offs of account balances for each of our surgery centers is continuously compared to established allowances for bad debt to ensure that such allowances are adequate. At June 30, 2007 and December 31, 2006, our accounts receivable represented 39 and 40 days of revenue outstanding, respectively.
During the six months ended June 30, 2007, we had total capital expenditures of $58.1 million, which included:
    $48.9 million for acquisitions of interests in practice-based ASCs;
 
    $7.8 million for new or replacement property at existing surgery centers, including $460,000 in new capital leases; and
 
    $1.9 million for surgery centers under development.
Our cash flow from operations was approximately 57% of our cash payments for acquisition and development activity, and we received approximately $32,000 from capital contributions of our minority partners to fund their proportionate share of development activity. Borrowings under long-term debt were used to fund the remaining portion of our obligations. At June 30, 2007, we had unfunded construction and equipment purchase commitments for centers under development or under renovation of approximately $3.5 million, which we intend to fund through additional borrowings of long-term debt, operating cash flow and capital contributions by minority partners.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations — (continued)
 
During the six months ended June 30, 2007, notes receivables decreased by approximately $1.1 million, primarily due to payments on a note receivable related to the sale of a surgery center in 2004. The note is secured by a pledge of a 51% ownership interest in the center, is guaranteed by the physician partners at the center and is due in installments through 2009. The balance of this note at June 30, 2007 was $5.4 million.
During the six months ended June 30, 2007, we had net borrowings on long-term debt of $10.7 million. At June 30, 2007, we had $125.5 million outstanding under our revolving credit facility which permits us to borrow up to $200.0 million to, among other things, finance our acquisition and development projects and any future stock repurchase programs at a rate equal to, at our option, the prime rate, LIBOR plus 0.50% to 1.50% or a combination thereof. The loan agreement provides for a fee of 0.15% to 0.30% of unused commitments, prohibits the payment of dividends and contains covenants relating to the ratio of debt to net worth, operating performance and minimum net worth. We were in compliance with all covenants at June 30, 2007. Borrowings under the revolving credit facility are due in July 2011 and are secured primarily by a pledge of the stock of our subsidiaries that serve as the general partners of our limited partnerships and our partnership and membership interests in the limited partnerships and limited liability companies.
During the six months ended June 30, 2007, we received approximately $8.6 million from the exercise of options and issuance of common stock under our employee stock option plans. The tax benefit received from the exercise of those options was approximately $1.9 million.
Recent Accounting Pronouncements
In June 2006, the Financial Accounting Standards Board, or FASB, issued FIN No. 48 which clarifies the accounting for uncertainty in income taxes recognized in financial statements in accordance with Statement of Financial Accounting Standards, or SFAS, No. 109, “Accounting for Income Taxes.” FIN No. 48 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. The provisions of FIN No. 48 are effective for fiscal years beginning after December 15, 2006, with the cumulative effect of the change in accounting principle recorded as an adjustment to opening retained earnings. Upon adoption of FIN No. 48, we established a tax reserve of approximately $634,000 through a cumulative reduction to beginning retained earnings and expect to add to the tax reserve through income tax expense approximately $224,000 by the end of fiscal 2007.
In September 2006, the FASB issued SFAS No. 157, “Fair Value Measurements.” SFAS No. 157 defines fair value, establishes a framework for measuring fair value, and expands disclosures about fair value measurements. SFAS No. 157 is effective for financial statements issued for fiscal years beginning after November 15, 2007 and will become effective for us beginning with the first quarter of 2008. We have not yet determined the impact of the adoption of SFAS No. 157 on our financial statements and note disclosures.
In February 2007, the FASB issued SFAS No. 159, “The Fair Value Option for Financial Assets and Financial Liabilities.” SFAS No. 159 allows entities the option to measure eligible financial instruments at fair value as of specified dates. Such election, which may be applied on an instrument by instrument basis, is typically irrevocable once elected. The Statement is effective for financial statements issued for fiscal years beginning after November 15, 2007 and will become effective for us beginning with the first quarter of 2008. We have not yet determined the impact of the adoption of SFAS No. 159 on our financial statements and note disclosures.
Item 3. Quantitative and Qualitative Disclosures About Market Risk
We are subject to market risk from exposure to changes in interest rates based on our financing, investing and cash management activities. We utilize a balanced mix of maturities along with both fixed-rate and variable-rate debt to manage our exposures to changes in interest rates. Our debt instruments are primarily indexed to the prime rate or LIBOR. We entered into an interest rate swap agreement in April 2006 in which $50.0 million of the principal amount outstanding under the revolving credit facility will bear interest at a fixed rate of 5.365% for the period from April 28, 2006 to April 28, 2011. Interest rate changes would result in gains or losses in the market value of our debt portfolio due to differences in market interest rates and the rates at the inception of the debt agreements. Based upon our indebtedness at June 30, 2007, a 100 basis point interest rate change would impact the pre-tax net income and cash flow by approximately $800,000 annually. Although there can be no assurances that interest rates will not change significantly, we do not expect changes in interest rates to have a material effect on our income or cash flows in 2007.

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Item 4. Controls and Procedures
Evaluation of Disclosure Controls and Procedures
Under the supervision and with the participation of our management team, including our chief executive officer and chief financial officer, we conducted an evaluation of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) of the Securities Exchange Act of 1934, as amended, or the Exchange Act) as of June 30, 2007. Based on that evaluation, our chief executive officer (principal executive officer) and chief financial officer (principal accounting officer) have concluded that our disclosure controls and procedures are effective to allow timely decisions regarding disclosure of material information required to be included in our periodic reports.
Changes in Internal Control Over Financial Reporting
During the period covered by this report, there has been no change in our internal control over financial reporting that has materially affected or is reasonably likely to materially affect our internal control over financial reporting.
Item 4T. Controls and Procedures.
          Not applicable.
Part II
Item 1. Legal Proceedings.
               Not applicable.
Item 1A. Risk Factors.
               Not applicable.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds.
               Not applicable.
Item 3. Defaults Upon Senior Securities.
               Not applicable.
Item 4. Submission of Matters to a Vote of Security Holders.
     At our Annual Meeting of Shareholders held on May 17, 2007, the following members were elected to the Board of Directors for the terms set forth below:
                         
    Term   Votes   Votes
    Expires   For   Withheld
     
 
                       
James A. Deal, Class I Director
    2010       26,847,137       1,563,302  
Steven I. Geringer, Class I Director
    2010       27,039,666       1,370,773  
Claire M. Gulmi, Class I Director
    2010       24,144,034       4,266,405  
     In addition to the foregoing directors, the following table sets forth the other members of the Board of Directors whose term of office continued after the Annual Meeting and the year in which his or her term expires:
         
    Term
    Expires
 
       
Henry D. Herr, Class II Director
    2008  
Kevin P. Lavender, Class II Director
    2008  
Ken P. McDonald, Class II Director
    2008  
Thomas G. Cigarran, Class III Director
    2009  
Debora A. Guthrie, Class III Director
    2009  
Bergein F. Overholt, M.D., Class III Director
    2009  

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Item 4. Submission of Matters to a Vote of Security Holders — (continued)
 
Also, the following proposals were considered and approved at the Annual Meeting of Shareholders by the votes set forth below:
                                 
    Votes   Votes   Votes   Votes
    For   Against   Withheld   Abstained
     
 
                               
Approval of certain amendments to the AmSurg Corp. 2006 Stock Incentive Plan
    23,436,258       3,554,762       1,407,124       12,295  
 
                               
Ratification of the appointment of Deloitte & Touche LLP as our independent registered public accounting firm for fiscal 2007
    28,047,043       358,480             4,916  
Item 5. Other Information.
             Not applicable.
Item 6. Exhibits.
             Exhibits
  11   Earnings Per Share
 
  31.1   Certification of President and Chief Executive Officer pursuant to Rule 13a-14(a)
 
  31.2   Certification of Executive Vice President and Chief Financial Officer pursuant to Rule 13a-14(a)
 
  32.1   Section 1350 Certification

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Signature
 
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.
         
  AMSURG CORP.
 
 
Date: August 6, 2007  By:   /s/ Claire M. Gulmi    
    Claire M. Gulmi   
    Executive Vice President and Chief Financial Officer (Principal Financial, Accounting and Duly Authorized Officer)   
 

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