Date of Report (Date of earliest event reported): March 5, 2020 |
Surgery Partners, Inc. |
(Exact Name of Registrant as Specified in Charter) |
Delaware | 001-37576 | 47-3620923 |
(State or Other Jurisdiction of Incorporation) | (Commission File Number) | (IRS Employer Identification No.) |
310 Seven Springs Way, Suite 500 Brentwood, Tennessee 37027 |
(Address of Principal Executive Offices) (Zip Code) |
(615) 234-5900 |
(Registrant's Telephone Number, Including Area Code) |
Not Applicable |
(Former Name or Former Address, If Changed Since Last Report) |
Title of each class | Trading Symbol(s) | Name of each exchange on which registered | ||
Common Stock, par value $0.01 per share | SGRY | The Nasdaq Global Select Market | ||
SURGERY PARTNERS, INC. | |
By: | /s/ Thomas F. Cowhey Thomas F. Cowhey Executive Vice President and Chief Financial Officer |

• | Revenues increased 5.3% to $517.2 million and Adjusted Revenues increased 4.2% to $520.7 million; when excluding closed or divested facilities, Adjusted Revenues increased 7.6% |
• | Days adjusted Same-facility Revenues increased 7.9% over prior year |
• | Net loss attributable to common stockholders of $27.5 million |
• | Adjusted EBITDA increased 15.1% over prior year to $84.4 million |
• | Revenues increased 3.4% to $1.8 billion and Adjusted Revenues increased 2.8% to $1.9 billion; when excluding closed or divested facilities, Adjusted Revenues increased 7.6% |
• | Days adjusted Same-facility Revenues increased 7.6% over prior year |
• | Net loss attributable to common stockholders of $109.5 million |
• | Adjusted EBITDA increased 10.1% over prior year to $258.6 million |
• | Revenues projected to grow high single-digit percentage |
• | Adjusted EBITDA projected to grow double-digit percentage |
Three Months Ended December 31, | Year Ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Revenues | $ | 517.2 | $ | 491.2 | $ | 1,831.4 | $ | 1,771.5 | ||||||||
Operating expenses: | ||||||||||||||||
Salaries and benefits | 148.8 | 139.5 | 550.0 | 534.7 | ||||||||||||
Supplies | 143.3 | 134.6 | 507.9 | 490.3 | ||||||||||||
Professional and medical fees | 44.8 | 38.2 | 154.8 | 145.5 | ||||||||||||
Lease expense | 22.6 | 21.8 | 85.6 | 86.7 | ||||||||||||
Other operating expenses | 28.5 | 25.6 | 109.3 | 104.2 | ||||||||||||
Cost of revenues | 388.0 | 359.7 | 1,407.6 | 1,361.4 | ||||||||||||
General and administrative expenses | 23.7 | 23.9 | 88.6 | 93.6 | ||||||||||||
Depreciation and amortization | 20.2 | 18.0 | 76.5 | 67.4 | ||||||||||||
Income from equity investments | (3.6 | ) | (2.6 | ) | (10.2 | ) | (8.9 | ) | ||||||||
Loss (gain) on disposal and deconsolidations, net | 2.6 | 15.9 | (4.4 | ) | 31.8 | |||||||||||
Transaction and integration costs | 7.4 | 7.9 | 19.0 | 31.7 | ||||||||||||
Impairment charges | 7.9 | 74.4 | 7.9 | 74.4 | ||||||||||||
Loss on debt extinguishment | — | — | 11.7 | — | ||||||||||||
Loss on litigation settlements | 0.2 | 46.0 | 0.2 | 46.0 | ||||||||||||
Other income | (1.0 | ) | (0.1 | ) | (1.4 | ) | (3.7 | ) | ||||||||
Total operating expenses | 445.4 | 543.1 | 1,595.5 | 1,693.7 | ||||||||||||
Operating income (loss) | 71.8 | (51.9 | ) | 235.9 | 77.8 | |||||||||||
Tax receivable agreement expense | — | — | (2.4 | ) | — | |||||||||||
Interest expense, net | (44.8 | ) | (39.6 | ) | (178.9 | ) | (147.0 | ) | ||||||||
Income (loss) before income taxes | 27.0 | (91.5 | ) | 54.6 | (69.2 | ) | ||||||||||
Income tax expense | 3.4 | 15.5 | 8.5 | 26.4 | ||||||||||||
Net income (loss) | 23.6 | (107.0 | ) | 46.1 | (95.6 | ) | ||||||||||
Less: Net income attributable to non-controlling interests | (41.8 | ) | (40.7 | ) | (119.9 | ) | (110.1 | ) | ||||||||
Net loss attributable to Surgery Partners, Inc. | (18.2 | ) | (147.7 | ) | (73.8 | ) | (205.7 | ) | ||||||||
Less: Amounts attributable to participating securities | (9.3 | ) | (8.5 | ) | (35.7 | ) | (32.4 | ) | ||||||||
Net loss attributable to common stockholders | $ | (27.5 | ) | $ | (156.2 | ) | $ | (109.5 | ) | $ | (238.1 | ) | ||||
Net loss per share attributable to common stockholders | ||||||||||||||||
Basic | $ | (0.57 | ) | $ | (3.25 | ) | $ | (2.27 | ) | $ | (4.96 | ) | ||||
Diluted (1) | $ | (0.57 | ) | $ | (3.25 | ) | $ | (2.27 | ) | $ | (4.96 | ) | ||||
Weighted average common shares outstanding | ||||||||||||||||
Basic | 48,326 | 48,047 | 48,280 | 48,028 | ||||||||||||
Diluted (1) | 48,326 | 48,047 | 48,280 | 48,028 | ||||||||||||
(1) | The impact of potentially dilutive securities for all periods presented was not considered because the effect would be anti-dilutive in those periods. |
December 31, 2019 | December 31, 2018 | |||||||
Balance Sheet Data (at period end): | ||||||||
Cash and cash equivalents | $ | 92.7 | $ | 184.3 | ||||
Total current assets | 525.5 | 588.3 | ||||||
Total assets | 5,019.4 | 4,676.3 | ||||||
Current maturities of long-term debt | 56.0 | 55.6 | ||||||
Total current liabilities | 397.6 | 349.3 | ||||||
Long-term debt, less current maturities | 2,524.7 | 2,270.9 | ||||||
Total liabilities | 3,319.0 | 2,891.5 | ||||||
Non-controlling interests—redeemable | 321.0 | 326.6 | ||||||
Redeemable preferred stock | 395.0 | 359.3 | ||||||
Total Surgery Partners, Inc. stockholders' equity | 297.8 | 404.6 | ||||||
Non-controlling interests—non-redeemable | 686.6 | 694.3 | ||||||
Total stockholders' equity | 984.4 | 1,098.9 | ||||||
Three Months Ended December 31, | Year Ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Cash Flow Data: | ||||||||||||||||
Net cash provided by (used in): | ||||||||||||||||
Operating activities | $ | 25.4 | $ | 45.5 | $ | 129.5 | $ | 144.6 | ||||||||
Investing activities | (23.4 | ) | (62.3 | ) | (85.2 | ) | (128.9 | ) | ||||||||
Capital expenditures | (23.4 | ) | (13.2 | ) | (73.6 | ) | (39.8 | ) | ||||||||
Payments for acquisitions, net of cash acquired | — | (51.6 | ) | (13.8 | ) | (106.8 | ) | |||||||||
Financing activities | (20.6 | ) | 122.0 | (135.9 | ) | (6.3 | ) | |||||||||
Distributions to non-controlling interest holders | (31.7 | ) | (28.9 | ) | (121.2 | ) | (109.0 | ) | ||||||||
Three Months Ended December 31, | Year Ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Other Data: | ||||||||||||||||
Number of surgical facilities as of the end of period | 128 | 123 | 128 | 123 | ||||||||||||
Number of consolidated surgical facilities as of the end of period | 107 | 106 | 107 | 106 | ||||||||||||
Cases | 137,699 | 137,028 | 525,136 | 520,741 | ||||||||||||
Adjusted Revenue per case | $ | 3,781 | $ | 3,646 | $ | 3,536 | $ | 3,468 | ||||||||
Adjusted EBITDA | $ | 84.4 | $ | 73.3 | $ | 258.6 | $ | 234.8 | ||||||||
Adjusted EBITDA margin (1) | 16.2 | % | 14.7 | % | 13.9 | % | 13.0 | % | ||||||||
Adjusted net gain (loss) per share attributable to common stockholders - Basic | $ | 0.14 | $ | (0.17 | ) | $ | (0.85 | ) | $ | (0.80 | ) | |||||
Adjusted net gain (loss) per share attributable to common stockholders - Diluted | $ | 0.10 | $ | (0.17 | ) | $ | (0.85 | ) | $ | (0.80 | ) | |||||
(1) | Defined as Adjusted EBITDA as a % of Adjusted Revenues. A reconciliation of these non-GAAP financial measures appears below. |
Three Months Ended December 31, | Year Ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Same-facility Information (1): | ||||||||||||||||
Cases | 150,254 | 147,371 | 556,424 | 545,717 | ||||||||||||
Case growth | 2.0 | % | N/A | 2.0 | % | N/A | ||||||||||
Revenue per case | $ | 3,494 | $ | 3,301 | $ | 3,293 | $ | 3,120 | ||||||||
Revenue per case growth | 5.9 | % | N/A | 5.5 | % | N/A | ||||||||||
Number of work days in the period | 62 | 62 | 253 | 253 | ||||||||||||
Case growth (days adjusted) | 2.0 | % | N/A | 2.0 | % | N/A | ||||||||||
Revenue growth (days adjusted) | 7.9 | % | N/A | 7.6 | % | N/A | ||||||||||
(1) | Same-facility information includes cases and revenues from our consolidated and non-consolidated surgical facilities (excluding facilities acquired in new markets or divested during the current and prior periods). |
Three Months Ended December 31, | Year Ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Segment Revenues: | ||||||||||||||||
Surgical facility services | $ | 497.3 | $ | 470.8 | $ | 1,748.2 | $ | 1,682.4 | ||||||||
Ancillary services | 19.1 | 19.3 | 79.4 | 79.6 | ||||||||||||
Optical services | 0.8 | 1.1 | 3.8 | 9.5 | ||||||||||||
Total revenues | $ | 517.2 | $ | 491.2 | $ | 1,831.4 | $ | 1,771.5 | ||||||||
Three Months Ended December 31, | Year Ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Adjusted EBITDA: | ||||||||||||||||
Surgical facility services | $ | 105.0 | $ | 93.0 | $ | 328.9 | $ | 309.5 | ||||||||
Ancillary services | (0.9 | ) | 0.1 | 2.6 | 3.0 | |||||||||||
Optical services | 0.1 | 0.4 | 1.4 | 2.5 | ||||||||||||
All other | (19.8 | ) | (20.2 | ) | (74.3 | ) | (80.2 | ) | ||||||||
Total Adjusted EBITDA | $ | 84.4 | $ | 73.3 | $ | 258.6 | $ | 234.8 | ||||||||
Three Months Ended December 31, | Year Ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Adjusted Revenues (1): | ||||||||||||||||
Revenues | $ | 517.2 | $ | 491.2 | $ | 1,831.4 | $ | 1,771.5 | ||||||||
Add: provision for doubtful accounts | 3.5 | 8.4 | 25.3 | 34.2 | ||||||||||||
Total Adjusted Revenues | $ | 520.7 | $ | 499.6 | $ | 1,856.7 | $ | 1,805.7 | ||||||||
(1) | In accordance with a new accounting standard that was effective prospectively beginning January 1, 2018, we reflected our estimated provision for doubtful accounts net of revenues rather than as an operating expense, as it had historically been presented. Adjusted Revenues add back the estimated provision for doubtful accounts. We believe such an adjustment is appropriate, as the new standard did not affect historical results prior to 2018, which impacts historical comparability. Our calculation of adjusted revenues may not be comparable to similarly titled measures reported by other companies. |
Three Months Ended December 31, | Year Ended December 31, | |||||||||||||||
2019 | 2018 | 2019 | 2018 | |||||||||||||
Income (loss) before income taxes | $ | 27.0 | $ | (91.5 | ) | $ | 54.6 | $ | (69.2 | ) | ||||||
Net income attributable to non-controlling interests | (41.8 | ) | (40.7 | ) | (119.9 | ) | (110.1 | ) | ||||||||
Interest expense, net | 44.8 | 39.6 | 178.9 | 147.0 | ||||||||||||
Depreciation and amortization | 20.2 | 18.0 | 76.5 | 67.4 | ||||||||||||
Equity-based compensation expense | 2.6 | 3.0 | 10.2 | 9.3 | ||||||||||||
Transaction, integration and acquisition costs (2) | 19.3 | 8.6 | 36.1 | 34.0 | ||||||||||||
Loss (gain) on disposals and deconsolidations, net | 2.6 | 15.9 | (4.4 | ) | 31.8 | |||||||||||
Loss on litigation settlements and other litigation costs (3) | 1.8 | 46.0 | 4.6 | 46.0 | ||||||||||||
Loss on debt extinguishment | — | — | 11.7 | — | ||||||||||||
Tax receivable agreement expense | — | — | 2.4 | — | ||||||||||||
Impairment charges | 7.9 | 74.4 | 7.9 | 74.4 | ||||||||||||
Reserve adjustments (4) | — | — | — | 2.7 | ||||||||||||
Contingent acquisition compensation expense | — | — | — | 1.5 | ||||||||||||
Adjusted EBITDA (1) | $ | 84.4 | $ | 73.3 | $ | 258.6 | $ | 234.8 | ||||||||
(1) | We use Adjusted EBITDA as a measure of financial performance. Adjusted EBITDA is a key measure used by management to assess operating performance, make business decisions and allocate resources. Non-controlling interests represent the interests of third parties, such as physicians, and in some cases, healthcare systems that own an interest in surgical facilities that we consolidate for financial reporting purposes. We believe that it is helpful to investors to present Adjusted EBITDA as defined above because it excludes the portion of net income attributable to these third-party interests and clarifies for investors our portion of Adjusted EBITDA generated by our surgical facilities and other operations. |
(2) | For the three months ended December 31, 2019 and 2018, this amount includes transaction and integration costs of $7.4 million and $7.9 million, respectively, and acquisition costs of $0.8 million and $0.7 million, respectively. This amount further includes start-up costs related to a de novo surgical hospital of $11.1 million for the three months ended December 31, 2019, with no comparable costs in the 2018 period. For the years ended December 31, 2019 and 2018, this amount includes transaction and integration costs of $19.0 million and $31.7 million, respectively, and acquisition costs of $2.8 million and $2.2 million, respectively. This amount further includes start-up costs related to a de novo surgical hospital of $14.3 million for the year ended December 31, 2019, with no comparable costs in 2018. |
(3) | For the three months ended December 31, 2019 and 2018, this amount includes a loss on litigation settlements of $0.2 million and $46.0 million, respectively, and further includes other litigation costs of $1.6 million in 2019 with no comparable costs in the 2018 period. For the years ended December 31, 2019 and 2018, this amount includes a loss on litigation settlements of $0.2 million and $46.0 million, respectively, and further includes other litigation costs of $4.4 million in 2019, with no comparable costs in 2018. |
(4) | This amount represents adjustments to revenue in order to apply consistent policies to businesses acquired by Surgery Partners in prior periods. |
Three Months Ended December 31 | Year Ended December 31 | ||||||
Adjusted Revenues for 2018 | $ | 499.6 | $ | 1,805.7 | |||
Less: Adjusted Revenues from divested facilities | (15.5 | ) | (79.7 | ) | |||
484.1 | 1,726.0 | ||||||
Adjusted Revenues for 2019 | 520.7 | 1,856.7 | |||||
Adjusted Revenue growth | 36.6 | 130.7 | |||||
Percentage Adjusted Revenue growth adjusted for the impact of closed or divested facilities | 7.6 | % | 7.6 | % | |||
Three Months Ended December 31, | Year Ended December 31, | ||||||||||||||
2019 | 2018 | 2019 | 2018 | ||||||||||||
Consolidated Statements of Operations Data: | |||||||||||||||
Net Income (Loss) | $ | 23.6 | $ | (107.0 | ) | $ | 46.1 | $ | (95.6 | ) | |||||
Plus (minus): | |||||||||||||||
Net income attributable to non-controlling interests | (41.8 | ) | (40.7 | ) | (119.9 | ) | (110.1 | ) | |||||||
Amounts attributable to participating securities | (9.3 | ) | (8.5 | ) | (35.7 | ) | (32.4 | ) | |||||||
Equity-based compensation expense | 2.6 | 3.0 | 10.2 | 9.3 | |||||||||||
Transaction, integration and acquisition costs | 19.3 | 8.6 | 36.1 | 34.0 | |||||||||||
Loss (gain) on disposals and deconsolidations, net | 2.6 | 15.9 | (4.4 | ) | 31.8 | ||||||||||
Loss on litigation settlements and other litigation costs | 1.8 | 46.0 | 4.6 | 46.0 | |||||||||||
Loss on debt extinguishment | — | — | 11.7 | — | |||||||||||
Tax receivable agreement expense | — | — | 2.4 | — | |||||||||||
Impairment charges | 7.9 | 74.4 | 7.9 | 74.4 | |||||||||||
Reserve adjustments | — | — | — | 2.7 | |||||||||||
Contingent acquisition compensation expense | — | — | — | 1.5 | |||||||||||
Adjusted net gain (loss) attributable to common stockholders | $ | 6.7 | $ | (8.3 | ) | $ | (41.0 | ) | $ | (38.4 | ) | ||||
Adjusted net gain (loss) per share attributable to common stockholders | |||||||||||||||
Basic | $ | 0.14 | $ | (0.17 | ) | $ | (0.85 | ) | $ | (0.80 | ) | ||||
Diluted (1) | $ | 0.10 | $ | (0.17 | ) | $ | (0.85 | ) | $ | (0.80 | ) | ||||
Weighted average common shares outstanding | |||||||||||||||
Basic | 48,326 | 48,047 | 48,280 | 48,028 | |||||||||||
Diluted (1) | 69,079 | 48,047 | 48,280 | 48,028 | |||||||||||
(1) | For the three months ended December 31, 2018 and the years ended December 31, 2019 and December 31, 2018, the impact of potentially dilutive securities was not considered because the effect would be anti-dilutive in those periods. |