First Quarter 2012 Financial Highlights:
- Total company revenues increased 13.4% to $177.4 million
- Domestic same practice treatments per day increased 2.1%
- International treatments increased 17.3%
- Pro Forma Adjusted EBITDA of $29.2 million
Recent Business Highlights:
- In May 2012, issued $350.0 million in aggregate principal amount of new 8.875% senior notes due 2017 and entered into new revolving credit facility, allowing for up to $140 million in borrowings
- In March 2012, secured an agreement to manage radiation therapy operations for North District of Broward Health, the 10th largest hospital system in the United States
- In March 2012, built on existing market presence and strengthened integrated cancer care model with highly accretive acquisition in Sarasota
FORT MYERS, Fla., May 14, 2012 (GLOBE NEWSWIRE) -- Radiation Therapy Services Holdings, Inc ("Radiation Therapy" or "the Company"), a leading operator of radiation therapy centers, today announced financial results for the first quarter ended March 31, 2012.
Dr. Daniel Dosoretz, President and Chief Executive Officer, said, "We accomplished a great deal in the first several months of 2012, including the refinancing of our existing senior credit facilities with new senior notes and a new revolving credit facility to support our growth strategy, an acquisition in Florida that serves to strengthen our integrated cancer care model and the agreement to manage radiation therapy operations for the Northern District of Broward Health, the 10th largest hospital system in the U.S. This is a testament to our technical and medical expertise and further validates the potential of our value added services offering."
"Over the past several years, we have made ongoing strategic investments in our infrastructure, building a strong platform from which to expand our leadership position and integrated cancer care model. With the access to capital provided by the refinancing, we are very strongly positioned to execute growth strategies, both domestically and internationally. Our acquisition pipeline remains strong with both small and mid-sized opportunities."
"Looking at our first quarter, we are very pleased with the results announced today. Domestic same practice treatments per day increased 2.1%. This growth reflects the continued return to utilization in markets that had been impacted by the economic downturn as more patients again have access to medical care, as well as the continued development of our integrated care model and increased referrals from our physician liaison program. Our Latin American operations continue to be a driver of robust growth, with centers in the region increasing treatments by 17.3%, including the two month period prior to the acquisition on March 1, 2011. We are extremely pleased with the growth that Medical Developers has provided and we continue to explore opportunities to build on our significant presence in the region. As we move into 2012, we will continue to focus on growing our presence and market leadership as a provider of integrated cancer care," concluded Dr. Dosoretz.
Recent Developments
On May 10, 2012, Radiation Therapy issued $350.0 million in aggregate principal amount of its new 8.875% senior secured second lien notes due 2017 (the "Notes"). Net proceeds from the sale of the Notes were used to repay Radiation Therapy's existing senior secured revolving credit facility and the Term Loan B portion of its senior secured credit facilities, to pay fees and expenses related to the notes offering and for general corporate purposes. In connection with the Notes offering, Radiation Therapy also entered into a new 4.5 year $140 million revolving credit facility. As of May 14, 2012, there are no borrowings under the new revolving credit facility.
In March 2012, the Company entered into an agreement with the North Broward Hospital District to license the space and equipment and assume responsibility for the operation of the radiation therapy departments at Broward General Medical Center and North Broward Medical Center. The North Broward Hospital District is the 10th largest hospital system in the United States. The Company will be operating the radiation therapy centers as part of its value added services offering.
On March 30, 2012, Radiation Therapy expanded its presence in Sarasota and Manatee Counties with the the acquisition of Lakewood Ranch Oncology Center ("LROC"), a radiation therapy facility located in Lakewood Ranch, Florida for approximately $26.0 million. LROC was previously owned by two groups of urology specialists whom Radiation Therapy hired as part of this transaction, thereby building on the Company's integrated cancer care model.
First Quarter 2012 Results
Total revenues for the first quarter of 2012 were $177.4 million, an increase of 13.4% compared to $156.5 million in revenues in the same quarter of 2011. The increase in revenue was principally due to the benefit of acquired integrated cancer care practices, the impact of strategic tuck-in acquisitions made in California, North Carolina, and Argentina, along with organic growth from Medical Developers.
Domestic same practice treatments per day increased 2.1% in the first quarter of 2012, reflecting stabilizing volumes and increased referrals from the Company's physician liaison program and integrated cancer care model, compared to the first quarter of 2011. However, domestic same practice therapy revenue per treatment decreased 2.8% from the first quarter of 2011, due to reductions in the reimbursement rate announced in the CMS 2012 Physician Fee Schedule which were partially offset by improved managed care pricing.
Total RVUs per day at same practice domestic freestanding centers, excluding the impact of the Las Vegas capitated contract, decreased 5.4% in the first quarter versus the same period of the prior year principally due to reductions in the reimbursement rate included in the CMS 2012 Physician Fee Schedule.
Adjusted earnings before interest, taxes, depreciation, amortization, stock-based compensation and other non-cash and pro forma items ("Pro Forma Adjusted EBITDA") in the first quarter of 2012 was $29.2 million, or 15.8% of total pro forma revenues, compared to $31.2 million, or 18.9% of total pro forma revenues, in the first quarter of 2011. Pro Forma Adjusted EBITDA margins declined in the quarter versus the prior year period primarily due to reductions in the Medicare reimbursement rate, along with growth in integrated care practices in which professional service revenues are largely paid out as physician compensation and investments made in key personnel. A reconciliation of net loss attributable to Radiation Therapy Services Holdings, Inc., determined in accordance with generally accepted accounting principles to Pro Forma Adjusted EBITDA and total revenues, determined in accordance with generally accepted accounting principles, to total pro forma revenues for the quarters ended March 31, 2012 and 2011 is included in the attached supplemental information.
Income tax expense in the first quarter of 2012 was $0.1 million, compared to income tax expense of $2.5 million in the first quarter of 2011. The net loss for the first quarter of 2012 was $8.4 million, compared to a net loss of $3.1 million in the first quarter of 2011.
Conference Call
Management will host a conference call Monday, May 14, 2012 at 4 p.m. ET to discuss financial results, other developments and business conditions. The dial-in numbers are (877) 407-0789 for domestic callers and (201) 689-8562 for international callers. In addition, a telephonic replay of the call will be available until May 28, 2012. The replay dial-in numbers are (877) 870-5176 for domestic callers and (858) 384-5517 for international callers. Please use the conference ID number 393644 to access the replay.
A live webcast and webcast replay of the call will also be available from the Investor Relations section on the corporate web site at www.rtsx.com.
About Radiation Therapy Services Holdings, Inc.
Radiation Therapy Services is a leading provider of advanced radiation therapy and other services to cancer patients in the United States and Latin America. The Company offers a comprehensive range of radiation treatment alternatives, focused on delivering academic quality, cost-effective patient care in a personal and convenient setting. In total, the Company operates 126 treatment centers, including 95 centers located in 15 U.S. states, strategically clustered in 28 local markets. The Company also operates 30 centers located in six countries in Latin America and 1 center located in India. The Company holds market leading positions in most of its domestic local markets and abroad. RTSX.
Forward-Looking Statements
This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Act of 1934, as amended. Statements preceded by, followed by or that otherwise include the words "believes", "expects", "anticipates", "intends", "projects", "estimates", "plans", "may increase", "forecast" and similar expressions or future or conditional verbs such as "will", "should", "would", "may" and "could" are generally forward-looking in nature and not historical facts. Forward-looking statements are based on management's current expectations or beliefs about the Company's future plans, expectations and objectives, including, but not limited to, the Company's expected financial results and estimates for 2012. These forward-looking statements are not historical facts and are subject to risks and uncertainties that could cause the actual results to differ materially from those projected in these forward-looking statements including, but not limited to reductions in Medicare reimbursement, healthcare reform, decreases in payments by managed care organizations and other commercial payers and other risk factors that may be described from time to time in the Company's filings with the Securities and Exchange Commission. Readers of this release are cautioned not to place undue reliance on forward-looking statements contained herein, which speak only as of the date stated, or if no date is stated, as of the date of this press release. The Company undertakes no obligation to publicly update or revise the forward-looking statements contained herein to reflect changed events or circumstances after the date of this release, unless required by law.
| RADIATION THERAPY SERVICES HOLDINGS, INC. | ||
| CONDENSED CONSOLIDATED BALANCE SHEETS | ||
| (in thousands, except share and per share amounts) | ||
| March 31, | December 31, | |
| 2012 | 2011 | |
| (unaudited) | ||
| ASSETS | ||
| Current assets: | ||
| Cash and cash equivalents | $ 12,407 | $ 10,177 |
| Accounts receivable, net | 101,169 | 87,094 |
| Prepaid expenses | 5,889 | 5,731 |
| Inventories | 4,927 | 4,308 |
| Deferred income taxes | 2,969 | 2,969 |
| Other | 4,457 | 6,025 |
| Total current assets | 131,818 | 116,304 |
| Equity investments in joint ventures | 522 | 692 |
| Property and equipment, net | 244,292 | 236,411 |
| Real estate subject to finance obligation | 13,735 | 13,719 |
| Goodwill | 569,901 | 556,547 |
| Intangible assets, net | 45,809 | 42,393 |
| Other assets | 30,457 | 32,526 |
| Total assets | $ 1,036,534 | $ 998,592 |
| LIABILITIES AND EQUITY | ||
| Current liabilities: | ||
| Accounts payable | $ 39,402 | $ 27,748 |
| Accrued expenses | 53,923 | 42,596 |
| Income taxes payable | 5,484 | 5,310 |
| Current portion of long-term debt | 22,777 | 13,945 |
| Current portion of finance obligation | 184 | 161 |
| Other current liabilities | 5,374 | 6,615 |
| Total current liabilities | 127,144 | 96,375 |
| Long-term debt, less current portion | 681,985 | 665,088 |
| Finance obligation, less current portion | 14,133 | 14,105 |
| Other long-term liabilities | 23,142 | 22,659 |
| Deferred income taxes | 10,259 | 10,343 |
| Total liabilities | 856,663 | 808,570 |
| Noncontrolling interests - redeemable | 12,925 | 12,728 |
| Commitments and Contingencies | ||
| Equity: | ||
| Common stock, $0.01 par value, 1,025 shares authorized, issued and outstanding | -- | -- |
| Additional paid-in capital | 648,798 | 648,703 |
| Retained deficit | (493,364) | (483,815) |
| Notes receivable from shareholder | (125) | (125) |
| Accumulated other comprehensive loss, net of tax | (5,859) | (4,890) |
| Total Radiation Therapy Services Holdings, Inc. shareholder's equity | 149,450 | 159,873 |
| Noncontrolling interests - nonredeemable | 17,496 | 17,421 |
| Total equity | 166,946 | 177,294 |
| Total liabilities and equity | $ 1,036,534 | $ 998,592 |
| RADIATION THERAPY SERVICES HOLDINGS, INC. | ||
| CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS | ||
| (in thousands) | ||
| (unaudited) | ||
| Three Months Ended | ||
| March 31, | ||
| 2012 | 2011 | |
| Revenues: | ||
| Net patient service revenue | $ 175,548 | $ 155,083 |
| Other revenue | 1,897 | 1,454 |
| Total revenues | 177,445 | 156,537 |
| Expenses: | ||
| Salaries and benefits | 93,843 | 80,899 |
| Medical supplies | 15,460 | 12,491 |
| Facility rent expense | 9,590 | 7,823 |
| Other operating expenses | 8,701 | 7,458 |
| General and administrative expenses | 19,682 | 17,836 |
| Depreciation and amortization | 15,196 | 12,455 |
| Provision for doubtful accounts | 5,061 | 3,801 |
| Interest expense, net | 17,555 | 14,493 |
| Gain on fair value adjustment of previously held equity investment | -- | (234) |
| Foreign currency transaction loss | 49 | 10 |
| Loss on foreign currency derivative contracts | 594 | 116 |
| Total expenses | 185,731 | 157,148 |
| Loss before income taxes | (8,286) | (611) |
| Income tax expense | 110 | 2,466 |
| Net loss | (8,396) | (3,077) |
| Net income attributable to noncontrolling interests- redeemable and non-redeemable | (1,153) | (1,439) |
| Net loss attributable to Radiation Therapy Services Holdings, Inc. shareholder | (9,549) | (4,516) |
| Other comprehensive (loss) income: | ||
| Unrealized (loss) gain on derivative interest rate swap agreements | (333) | 1,296 |
| Unrealized loss on foreign currency translation | (528) | (155) |
| Other comprehensive (loss) income: | (861) | 1,141 |
| Comprehensive loss: | (9,257) | (1,936) |
| Comprehensive income attributable to noncontrolling interests- redeemable and non-redeemable | (1,177) | (1,411) |
| Comprehensive loss attributable to Radiation Therapy Services Holdings, Inc. shareholder | $ (10,434) | $ (3,347) |
| RADIATION THERAPY SERVICES HOLDINGS, INC. | ||
| CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS | ||
| (in thousands) | ||
| (unaudited) | ||
| Three Months Ended | ||
| March 31, | ||
| 2012 | 2011 | |
| Cash flows from operating activities | ||
| Net loss | $ (8,396) | $ (3,077) |
| Adjustments to reconcile net loss to net cash provided by operating activities: | ||
| Depreciation | 12,450 | 10,829 |
| Amortization | 2,746 | 1,626 |
| Deferred rent expense | 316 | 289 |
| Deferred income taxes | (106) | 1,968 |
| Stock-based compensation | 95 | 680 |
| Provision for doubtful accounts | 5,061 | 3,801 |
| Loss (gain) on the sale/disposal of property and equipment | 90 | (8) |
| Amortization of termination of interest rate swap | (84) | -- |
| Gain on fair value adjustment of previously held equity investment | -- | (234) |
| Loss on foreign currency transactions | 9 | 49 |
| Loss on foreign currency derivative contracts | 594 | 116 |
| Amortization of debt discount | 218 | 192 |
| Amortization of loan costs | 1,334 | 1,014 |
| Equity interest in net loss of joint ventures | 381 | 250 |
| Distribution received from unconsolidated joint ventures | 9 | -- |
| Changes in operating assets and liabilities: | ||
| Accounts receivable and other receivables | (18,772) | (15,597) |
| Income taxes payable | 200 | (337) |
| Inventories and other current assets | (392) | (677) |
| Prepaid expenses | 195 | 765 |
| Accounts payable | 11,316 | 2,844 |
| Accrued deferred compensation | 199 | -- |
| Accrued expenses / other long-term liabilities | 11,374 | 13,887 |
| Net cash provided by operating activities | 18,837 | 18,380 |
| Cash flows from investing activities | ||
| Purchase of property and equipment | (6,902) | (11,413) |
| Acquisition of medical practices | (23,103) | (42,104) |
| Proceeds from the sale of property and equipment | 26 | 5 |
| (Loans to) repayments from employees | (136) | 135 |
| Contribution of capital to joint venture entities | (225) | -- |
| Distribution received from joint venture entities | -- | 300 |
| Proceeds from the sale of equity interest in a joint venture | -- | 312 |
| Payment of foreign currency derivative contracts | (292) | (552) |
| Premiums on life insurance policies | (155) | -- |
| Change in other assets and other liabilities | 155 | (60) |
| Net cash used in investing activities | (30,632) | (53,377) |
| Cash flows from financing activities | ||
| Proceeds from issuance of debt (net of original issue discount of $------- and $625, respectively) | 560 | 49,401 |
| Net proceeds from revolving credit facility | 20,000 | -- |
| Principal repayments of debt | (5,599) | (2,456) |
| Repayments of finance obligation | (26) | (13) |
| Proceeds from equity contribution | -- | 3 |
| Cash distributions to noncontrolling interest holders - redeemable and non-redeemable | (905) | (923) |
| Payments of loan costs | -- | (1,534) |
| Net cash provided by financing activities | 14,030 | 44,478 |
| Effect of exchange rate changes on cash and cash equivalents | (5) | (3) |
| Net increase in cash and cash equivalents | 2,230 | 9,478 |
| Cash and cash equivalents, beginning of period | 10,177 | 13,977 |
| Cash and cash equivalents, end of period | $ 12,407 | $ 23,455 |
| Supplemental disclosure of noncash transactions | ||
| Recorded finance obligation related to real estate projects | $ 77 | $ 1,575 |
| Recorded capital lease obligations related to the purchase of equipment | $ 696 | $ -- |
| Recorded issuance of Parent equity units related to the acquisition of medical practices | $ -- | $ 16,282 |
| Recorded issuance of senior subordinated notes related to the acquisition of medical | ||
| $ -- | $ 16,250 | |
| Recorded earn-out accrual related to the acquisition of medical practices | $ -- | $ 2,280 |
| Recorded property and equipment related to the North Broward Hospital District license agreement | $ 4,260 | $ -- |
| Recorded capital lease obligations related to the acquisition of medical practices | $ 5,726 | $ -- |
| RADIATION THERAPY SERVICES HOLDINGS, INC. | ||
| Supplemental Financial Information (Unaudited) | ||
| Reconciliation of Total Pro-forma Revenue and Pro-forma Adjusted EBITDA to Net Loss Attributable | ||
| to Radiation Therapy Services Holdings, Inc. Shareholder | ||
| Three Months Ended | ||
| March 31, | ||
| 2012 | 2011 | |
| (in thousands): | ||
| Total revenues | $ 177,445 | $ 156,537 |
| Pro-forma full period effect of acquisitions (a) | 7,269 | 8,345 |
| Total pro-forma revenues | $ 184,714 | $ 164,882 |
| Net loss attributable to Radiation Therapy Services Holdings, Inc. shareholder | $ (9,549) | $ (4,516) |
| Income tax expense | 110 | 2,466 |
| Interest expense, net | 17,555 | 14,493 |
| Depreciation and amortization | 15,196 | 12,455 |
| Gain on fair value adjustment of previously held equity investment | -- | (234) |
| Loss on foreign currency derivative contracts | 594 | 116 |
| Management fees (b) | 213 | 277 |
| Non-cash expenses (c) | 602 | 1,342 |
| Sale-lease back adjustments (d) | (243) | (196) |
| Acquisition-related costs (e) | 644 | 1,648 |
| Other expenses (f) | 456 | 321 |
| Litigation settlement (g) | 510 | -- |
| Expenses associated with idle / closed treatment facilities (h) | 949 | -- |
| Pro-forma full period effect of acquisition EBITDA (a) | 2,136 | 3,000 |
| Pro-forma Adjusted EBITDA (1) | $ 29,173 | $ 31,172 |
| Pro-forma Adjusted EBITDA as a percentage of total pro-forma revenues | 15.8% | 18.9% |
| (1) Pro-forma Adjusted EBITDA is defined as income (loss) before interest expense (net of interest income), income taxes, | ||
| depreciation and amortization, foreign currency derivative contract loss, gain on fair value adjustment of previously held equity investment, | ||
| management fees from our sponsor, non-cash expenses including costs relating to stock compensation, amortization of straight-- | ||
| line rent and amortization of capital expenditures relating to repairs and maintenance, sale-lease back adjustments, acquisition-related | ||
| costs, other expenses including loss on sale of assets, severance payments related to termination of employee staff reductions and tail | ||
| premiums on termed physicians, litigation settlements with physicians and pro-forma full period effect of acquisition EBITDA. | ||
| (a) Pro-forma amounts related to adjustments to total revenues and Pro-forma Adjusted EBITDA to reflect the full period effect of | ||
| our acquisitions completed during 2011 and 2012. The adjustments reflect the impact to our total revenues and Pro-forma | ||
| Adjusted EBITDA as if the acquisitions had occurred at the beginning of the year. | ||
| (b) Management fees are fees paid to our sponsor, Vestar Capital Partners. | ||
| (c) Non-cash expenses including costs relating to stock compensation, amortization of straight-line rent and amortization of capital | ||
| expenditures relating to warranty arrangements amortized to repairs and maintenance. | ||
| (d) Sale-lease back adjustments relates to the adjustment of benefit derived from the classification of operating leases as finance | ||
| obligations reflecting a reclassification of interest expense and depreciation and amortization expense as rent expense. | ||
| (e) Acquisition related costs associated with the adoption of ASC 805, Business Combinations, requiring prior capitalized costs be | ||
| expensed, including professional fees and due diligence costs relating to the acquisition of physician practices. | ||
| (f) Other expenses include loss on sale of assets, severance payments related to termination of employee staff reductions and tail | ||
| premiums paid on terminated physicians. | ||
| (g) Litigation settlement relates to costs associated with the termination of physicians during 2011 and 2012. | ||
| (h) Expenses associated with idle / closed radiation therapy treatment facilities. | ||
| We believe the Pro-forma Adjusted EBITDA provides useful information about our financial performance to investors, lenders, financial | ||
| analysts and rating agencies since these groups have historically used EBITDA-related measures in the healthcare industry, along | ||
| with other measures, to estimate the value of a company, to make informed investment decisions, to evaluate a company's leverage | ||
| capacity and its ability to meet its debt service requirements. Pro-forma Adjusted EBITDA eliminates the uneven effect of non-cash | ||
| depreciation of tangibles assets and amortization of intangible assets, much of which results from acquisitions accounted for under | ||
| the purchase method of accounting. Pro-forma Adjusted EBITDA is also used by us to measure individual performance for incentive | ||
| compensation purposes and as an analytical indicator for purposes of allocating resources to our operating business and assessing | ||
| their performance, both internally and relative to our peers, as well as to evaluate the performance of our operating management teams, | ||
| and for purposes in the calculation of debt covenants and related disclosures. | ||
| Pro-forma Adjusted EBITDA is not intended as a substitute for net income (loss) attributable to Radiation Therapy Services Holdings, Inc. | ||
| shareholder, operating cash flows or other cash flow data determined in accordance with accounting principles generally accepted in the | ||
| United States. Due to varying methods of calculation, Pro-forma Adjusted EBITDA as presented may not be comparable to similarly | ||
| titled measures of other companies. | ||
| RADIATION THERAPY SERVICES HOLDINGS, INC. | |||||
| KEY OPERATING STATISTICS | |||||
| (unaudited) | |||||
| Three Months Ended | |||||
| March 31, | % | ||||
| Domestic U.S. | 2012 | 2011 * | Change | ||
| Number of treatment days | 64 | 64 | |||
| Total RVU's - freestanding centers | 2,932,832 | 3,093,311 | -5.2% | ||
| RVU's per day - freestanding centers | 45,826 | 48,333 | -5.2% | ||
| Percentage change in RVU's per day -- | |||||
| freestanding centers - same practice basis | -5.4% | 7.4% | |||
| Total treatments - freestanding centers | 125,316 | 122,556 | 2.3% | ||
| Treatments per day - freestanding centers | 1,958 | 1,915 | 2.3% | ||
| Percentage change in revenue per treatment -- | |||||
| freestanding centers - same practice basis | -2.8% | 3.0% | |||
| Percentage change in treatments per day -- | |||||
| freestanding centers - same practice basis | 2.1% | -1.5% | |||
| Number of regions at period end (global) | 9 | 9 | |||
| Number of local markets at period end | 28 | 28 | |||
| Treatment centers - freestanding (global) | 121 | 112 | 8.0% | ||
| Treatment centers - hospital / other groups (global) | 5 | 6 | -16.7% | ||
| 126 | 118 | 6.8% | |||
| Days sales outstanding at quarter end | 39 | 40 | |||
| Percentage change in freestanding revenues | |||||
| - same practice basis | -0.8% | 3.1% | |||
| Net patient service revenue - professional | |||||
| services only (in thousands) | $ 48,735 | $ 42,097 | |||
| * Excludes the impact of the termination of a capitated contract in Las Vegas, Nevada | |||||
| Three Months Ended | |||||
| March 31, | % | ||||
| International | 2012 | 2011 ** | Change | ||
| Number of treatments | |||||
| 2-D treatments | 1,359 | 1,354 | |||
| 3-D treatments | 2,023 | 1,588 | |||
| IMRT / IGRT treatments | 436 | 312 | |||
| Total | 3,818 | 3,254 | 17.3% | ||
| ** includes full period operating statistics, including period prior to our acquisition on March 1, 2011 | |||||