UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
FORM 10-Q
[X] | Quarterly report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 | |
For the period ended November 30, 2003. | ||
[ ] | Transition report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 | |
For the transition period from ___________________ to ___________________ | ||
Commission File Number 1-9927 |
COMPREHENSIVE CARE CORPORATION
Delaware | 95-2594724 | |
|
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(State or other jurisdiction of incorporation or organization) |
(IRS Employer Identification No.) |
200 South Hoover Blvd, Suite 200, Tampa, FL 33609
(813) 288-4808
Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.
Yes [X] No [ ]
Indicate by check mark whether the registrant is an accelerated filer (as defined in Rule 12b-2 of the Exchange Act).
Yes [ ] No [X]
Indicate the number of shares outstanding of each of the issuers classes of Common Stock, as of the latest practicable date:
Classes | Outstanding at January 5, 2004 | |
|
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Common Stock, par value $.01 per share | 4,643,049 |
COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
Index
Page | ||||||
PART I FINANCIAL INFORMATION |
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Item 1Consolidated Financial Statements |
||||||
Consolidated Balance Sheets,
November 30, 2003 and May 31, 2003 |
3 | |||||
Consolidated Statements of Operations for
the Three and Six months ended November 30, 2003 and 2002 |
4 | |||||
Consolidated Statements of Cash Flows for
the Six months ended November 30, 2003 and 2002 |
5 | |||||
Notes to Consolidated Financial Statements |
6-11 | |||||
Item 2Managements Discussion and Analysis of Financial Condition and
Results of Operations |
11-18 | |||||
Item 3 Quantitative and Qualitative Disclosures About Market Risk |
18 | |||||
Item 4Controls and Procedures |
18-19 | |||||
PART II OTHER INFORMATION |
||||||
Item 1 Legal Proceedings |
20 | |||||
Item 2Changes in Securities and Use of Proceeds |
20 | |||||
Item 6 Exhibits and Reports on Form 8-K |
20 | |||||
Signatures |
21 | |||||
Certifications |
22-25 |
2
COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
PART
I. FINANCIAL INFORMATION
Consolidated Balance Sheets
November 30, | May 31, | ||||||||
2003 | 2003 | ||||||||
(unaudited) | |||||||||
(Amounts in thousands) | |||||||||
ASSETS |
|||||||||
Current assets: |
|||||||||
Cash and cash equivalents |
$ | 2,796 | $ | 3,590 | |||||
Accounts receivable, less allowance for doubtful accounts of $27 |
255 | 75 | |||||||
Accounts receivable managed care reinsurance contract |
482 | 354 | |||||||
Other current assets |
368 | 605 | |||||||
Total current assets |
3,901 | 4,624 | |||||||
Property and equipment, net |
374 | 230 | |||||||
Note receivable |
153 | 155 | |||||||
Goodwill, net |
991 | 991 | |||||||
Restricted cash |
327 | 328 | |||||||
Other assets |
52 | 51 | |||||||
Total assets |
$ | 5,798 | $ | 6,379 | |||||
LIABILITIES AND STOCKHOLDERS DEFICIT |
|||||||||
Current liabilities: |
|||||||||
Accounts payable and accrued liabilities |
$ | 1,782 | $ | 1,836 | |||||
Accrued claims payable |
3,873 | 4,103 | |||||||
Accrued reinsurance claims payable |
3,315 | 3,117 | |||||||
Income taxes payable |
19 | 15 | |||||||
Total current liabilities |
8,989 | 9,071 | |||||||
Long-term liabilities: |
|||||||||
Long-term debt |
2,244 | 2,244 | |||||||
Other liabilities |
87 | 54 | |||||||
Total long-term liabilities |
2,331 | 2,298 | |||||||
Total liabilities |
11,320 | 11,369 | |||||||
Commitments and Contingencies (Note 5) |
|||||||||
Stockholders deficit: |
|||||||||
Preferred stock, $50.00 par value; authorized 18,740 shares; none issued |
| | |||||||
Common stock, $0.01 par value; authorized 12,500,000 shares; issued
and outstanding 3,943,049 and 3,936,549 |
39 | 39 | |||||||
Additional paid-in-capital |
51,941 | 51,928 | |||||||
Deferred compensation |
(4 | ) | (16 | ) | |||||
Accumulated deficit |
(57,498 | ) | (56,941 | ) | |||||
Total stockholders deficit |
(5,522 | ) | (4,990 | ) | |||||
Total liabilities and stockholders deficit |
$ | 5,798 | $ | 6,379 | |||||
See accompanying notes.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
Consolidated Statements of Operations
(Unaudited)
(Amounts in thousands, except per share amounts)
Three months Ended | Six Months Ended | ||||||||||||||||
November 30, | November 30, | ||||||||||||||||
2003 | 2002 | 2003 | 2002 | ||||||||||||||
Operating revenues |
$ | 7,011 | $ | 8,631 | $ | 14,904 | $ | 16,938 | |||||||||
Costs and expenses: |
|||||||||||||||||
Healthcare operating expenses |
6,199 | 7,760 | 13,051 | 15,113 | |||||||||||||
General and administrative expenses |
970 | 952 | 1,878 | 1,840 | |||||||||||||
Recovery of doubtful accounts |
(4 | ) | (6 | ) | (12 | ) | (14 | ) | |||||||||
Depreciation and amortization |
28 | 63 | 55 | 131 | |||||||||||||
7,193 | 8,769 | 14,972 | 17,070 | ||||||||||||||
Operating loss from continuing operations before items
shown below |
(182 | ) | (138 | ) | (68 | ) | (132 | ) | |||||||||
Other income (expense): |
|||||||||||||||||
Gain on sale of assets |
| 1 | | 4 | |||||||||||||
Loss on disposal of assets |
| | | (5 | ) | ||||||||||||
Interest income |
6 | 13 | 18 | 29 | |||||||||||||
Interest expense |
(54 | ) | (44 | ) | (102 | ) | (90 | ) | |||||||||
Other non-operating income |
| 478 | 1 | 478 | |||||||||||||
(Loss) income from continuing operations before income taxes |
(230 | ) | 310 | (151 | ) | 284 | |||||||||||
Income tax expense |
3 | 3 | 20 | 10 | |||||||||||||
(Loss) income from continuing operations |
$ | (233 | ) | $ | 307 | $ | (171 | ) | $ | 274 | |||||||
Loss from discontinued operations |
| | (387 | ) | | ||||||||||||
Net (loss) income attributable to common stockholders |
$ | (233 | ) | $ | 307 | $ | (558 | ) | $ | 274 | |||||||
(Loss) income per common share basic: |
|||||||||||||||||
(Loss) income from continuing operations |
$ | (0.06 | ) | $ | 0.08 | $ | (0.04 | ) | $ | 0.07 | |||||||
Loss from discontinued operations |
| | (0.10 | ) | | ||||||||||||
Net (loss) income |
$ | (0.06 | ) | $ | 0.08 | $ | (0.14 | ) | $ | 0.07 | |||||||
(Loss) income per common share diluted: |
|||||||||||||||||
(Loss) income from continuing operations |
$ | (0.06 | ) | $ | 0.07 | $ | (0.04 | ) | $ | 0.07 | |||||||
Loss from discontinued operations |
| | (0.10 | ) | | ||||||||||||
Net (loss) income |
$ | (0.06 | ) | $ | 0.07 | $ | (0.14 | ) | $ | 0.07 | |||||||
Weighted average common shares outstanding: |
|||||||||||||||||
Basic |
3,942 | 3,898 | 3,939 | 3,892 | |||||||||||||
Diluted |
3,942 | 4,254 | 3,939 | 3,984 | |||||||||||||
See accompanying notes.
4
COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
Consolidated Statements of Cash Flows
(Unaudited)
Six Months Ended | |||||||||
November 30, | |||||||||
2003 | 2002 | ||||||||
(Amounts in thousands) | |||||||||
Cash flows from operating activities: |
|||||||||
Net (loss) income from continuing operations |
$ | (171 | ) | $ | 274 | ||||
Adjustments to reconcile net (loss) income from continuing operations
to net cash used in operating activities: |
|||||||||
Depreciation and amortization |
55 | 131 | |||||||
Gain on sale of assets |
| (4 | ) | ||||||
Compensation expense stock issued |
23 | 20 | |||||||
Compensation expense stock options issued |
| 1 | |||||||
Other non-operating gain |
| (470 | ) | ||||||
Loss on disposal of assets |
| 5 | |||||||
Changes in assets and liabilities: |
|||||||||
Accounts receivable |
(180 | ) | (807 | ) | |||||
Accounts receivable managed care reinsurance contract |
(128 | ) | (62 | ) | |||||
Other current assets, restricted funds, and other non-current assets |
145 | 21 | |||||||
Accounts payable and accrued liabilities |
(345 | ) | (621 | ) | |||||
Accrued claims payable |
(230 | ) | (91 | ) | |||||
Accrued reinsurance claims payable |
198 | 542 | |||||||
Income taxes payable |
4 | (2 | ) | ||||||
Other liabilities |
(1 | ) | | ||||||
Net cash used in continuing operations |
(630 | ) | (1,063 | ) | |||||
Net cash used in discontinued operations |
(22 | ) | | ||||||
Net cash used in continuing and discontinued operations |
(652 | ) | (1,063 | ) | |||||
Cash flows from investing activities: |
|||||||||
Net proceeds from sale of property and equipment |
| 3 | |||||||
Payments received on note receivable |
2 | 2 | |||||||
Additions to property and equipment |
(132 | ) | (22 | ) | |||||
Net cash used in investing activities |
(130 | ) | (17 | ) | |||||
Cash flows from financing activities: |
|||||||||
Proceeds from the issuance of Common Stock |
2 | | |||||||
Repayment of debt |
(14 | ) | (6 | ) | |||||
Net cash used in financing activities |
(12 | ) | (6 | ) | |||||
Net decrease in cash and cash equivalents |
(794 | ) | (1,086 | ) | |||||
Cash and cash equivalents at beginning of year |
3,590 | 5,340 | |||||||
Cash and cash equivalents at end of period |
$ | 2,796 | $ | 4,254 | |||||
See accompanying notes
5
COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
Note 1 Summary of Significant Accounting Policies
The consolidated balance sheet as of November 30, 2003, and the related consolidated statements of operations for the three and six months ended November 30, 2003 and 2002, and cash flows for the six months ended November 30, 2003 and 2002 are unaudited and have been prepared in accordance with accounting principles generally accepted in the United States of America for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. In the opinion of management, all adjustments necessary for a fair presentation of such financial statements have been included. Such adjustments consisted only of normal recurring items. The results of operations for the six months ended November 30, 2003 are not necessarily indicative of the results to be expected during the balance of the fiscal year.
The consolidated financial statements do not include all information and footnotes necessary for a complete presentation of financial position, results of operations and cash flows in conformity with accounting principles generally accepted in the United States of America. The balance sheet at May 31, 2003 has been derived from the audited financial statements at that date, but does not include all of the information and footnotes required by accounting principles generally accepted in the United States of America for complete financial statement presentation. Notes to consolidated financial statements included in Form 10-K for the year ended May 31, 2003 are on file with the Securities and Exchange Commission and provide additional disclosures and a further description of accounting policies.
The Companys financial statements are presented on the basis that it is a going concern, which contemplates the realization of assets and satisfaction of liabilities in the normal course of business. The consolidated financial statements do not include any adjustments to reflect the possible future effects on the recovery and classification of assets or the amount and classification of liabilities that may result from the outcome of the uncertainties described in Note 2 Basis of Presentation.
The Companys managed care activities are performed under the terms of agreements with health maintenance organizations (HMOs), preferred provider organizations (PPOs), and other health plans or payers to provide contracted behavioral healthcare services to subscribing participants. Revenue under a substantial portion of these agreements is earned monthly based on the number of qualified participants regardless of services actually provided (generally referred to as capitation arrangements). Such agreements accounted for 87.2%, or $13.0 million, of revenue for the six months ended November 30, 2003 and 88.0%, or $14.9 million, of revenue for the six months ended November 30, 2002. The balance of the Companys revenues is earned on a fee-for-service basis and is recognized as services are rendered.
Restricted Cash
As of November 30, 2003 and May 31, 2003, non-current restricted accounts include $0.3 million of cash held in trust in connection with the Companys Directors and Officers liability insurance policy.
Accrued Claims Payable
The accrued claims payable liability represents the estimated ultimate net amounts owed for all behavioral healthcare services provided through the respective balance sheet dates, including estimated amounts for claims incurred but not yet reported (IBNR) to the Company. The unpaid claims liability is estimated using an actuarial paid completion factor methodology and other statistical analyses and is continually reviewed and adjusted, if necessary, to reflect any change in the estimated liability. These estimates are subject to the effects of trends in utilization and other factors. However, actual claims incurred could differ from the estimated claims payable amount reported as of November 30, 2003. Although considerable variability is inherent in such estimates, management believes that the unpaid claims liability is adequate.
Income Taxes
The Company calculates deferred taxes and related income tax expense using the liability method. This method determines deferred taxes by applying the current tax rate to net operating loss carryforwards and to the cumulative temporary differences between the recorded carrying amounts and the corresponding tax basis of assets and liabilities. A valuation allowance is established for deferred tax assets unless their realization is considered more
6
COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
likely than not. The Companys provision for income taxes is the sum of the change in the balance of deferred taxes between the beginning and the end of the period and income taxes currently payable or receivable.
Stock Options
In December 2002, the Financial Accounting Standards Board issued Statements of Financial Accounting Standards No. 148, Accounting for Stock-Based Compensation Transition and Disclosure, which amends the disclosure requirements of SFAS 123, Accounting for Stock-Based Compensation and provides alternative methods of transition for a voluntary change to the fair value method of accounting for stock-based employee compensation. As permitted by SFAS 148, the Company has elected to follow Accounting Principles Board Opinion No. 25, Accounting for Stock Issued to Employees (APB 25) and related interpretations in accounting for its employee stock options. Under APB 25, in the event that the exercise price of the Companys employee stock options is less than the market price of the underlying stock on the date of grant, compensation expense is recognized. No stock-based employee compensation cost is reflected in net (loss) income, as all options granted under the Companys employee stock options plans had an exercise price equal to the market value of the underlying common stock on the date of grant. The following table illustrates the effect on net (loss) income and (loss) income per share if the Company had applied the fair value recognition provisions of SFAS No. 123 to stock-based employee compensation.
Quarter | Quarter | Six Months | Six Months | |||||||||||||||
Ended | Ended | Ended | Ended | |||||||||||||||
11/30/03 | 11/30/02 | 11/30/03 | 11/30/02 | |||||||||||||||
Net (loss) income, as reported |
$ | (233 | ) | $ | 307 | $ | (558 | ) | $ | 274 | ||||||||
Deduct: |
||||||||||||||||||
Total stock-based employee compensation expense determined
under fair value based method for all awards, net of related tax
Effects |
(110 | ) | (43 | ) | (110 | ) | (62 | ) | ||||||||||
Pro forma net (loss) income |
$ | (343 | ) | $ | 264 | $ | (668 | ) | $ | 212 | ||||||||
(Loss) income per common share: |
||||||||||||||||||
Basic as reported |
$ | (0.06 | ) | $ | 0.08 | $ | (0.14 | ) | $ | 0.07 | ||||||||
Diluted as reported |
$ | (0.06 | ) | $ | 0.07 | $ | (0.14 | ) | $ | 0.07 | ||||||||
Basic pro forma |
$ | (0.09 | ) | $ | 0.07 | $ | (0.17 | ) | $ | 0.05 | ||||||||
Diluted pro forma |
$ | (0.09 | ) | $ | 0.06 | $ | (0.17 | ) | $ | 0.05 | ||||||||
Per Share data
In calculating basic (loss) income per share, net (loss) income is divided by the weighted average number of common shares outstanding for the period. Diluted (loss) income per share reflects the assumed exercise or conversion of all dilutive securities, such as options, warrants, and convertible debentures. No such exercise or conversion is assumed where the effect is antidilutive, such as when there is a net loss. The following table sets forth the computation of basic and diluted (loss) income per share in accordance with Statement No. 128, Earnings Per Share (amounts in thousands, except per share data):
7
COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
Three Months Ended | Six Months Ended | |||||||||||||||||
November 30, | November 30, | |||||||||||||||||
2003 | 2002 | 2003 | 2002 | |||||||||||||||
Numerator: |
||||||||||||||||||
Numerator for diluted (loss) income per share from continuing
operations |
$ | (233 | ) | $ | 307 | $ | (171 | ) | $ | 274 | ||||||||
Loss from discontinued operations |
| | (387 | ) | | |||||||||||||
Net (loss) income attributable to common stockholders |
$ | (233 | ) | $ | 307 | $ | (558 | ) | $ | 274 | ||||||||
Denominator: |
||||||||||||||||||
Weighted average shares |
3,942 | 3,898 | 3,939 | 3,892 | ||||||||||||||
Effect of dilutive securities: |
||||||||||||||||||
Employee stock options |
| 356 | | 92 | ||||||||||||||
Denominator for diluted (loss) income per share-adjusted weighted
average shares after assumed conversions |
3,942 | 4,254 | 3,939 | 3,984 | ||||||||||||||
Basic (loss) income per share: |
||||||||||||||||||
(Loss) income from continuing operations |
$ | (0.06 | ) | $ | 0.08 | $ | (0.04 | ) | $ | 0.07 | ||||||||
Loss from discontinued operations |
| | (0.10 | ) | | |||||||||||||
Net (loss) income |
$ | (0.06 | ) | $ | 0.08 | $ | (0.14 | ) | $ | 0.07 | ||||||||
Diluted (loss) income per share: |
||||||||||||||||||
(Loss) income from continuing operations |
$ | (0.06 | ) | $ | 0.07 | $ | (0.04 | ) | $ | 0.07 | ||||||||
Loss from discontinued operations |
| | (0.10 | ) | | |||||||||||||
Net (loss) income |
$ | (0.06 | ) | $ | 0.07 | $ | (0.14 | ) | $ | 0.07 | ||||||||
Authorized shares of common stock reserved for possible issuance for convertible debentures and stock options are as follows at November 30, 2003:
Convertible debentures |
9,044 | |||
Outstanding stock options |
1,174,724 | |||
Possible future issuance under stock option plans |
372,235 | |||
Total |
1,556,003 | |||
Note 2 Basis of Presentation
The accompanying consolidated financial statements are prepared on a going concern basis. During the six months ended November 30, 2003, net cash used in continuing operations amounted to $630,000 and $22,000 was used in discontinued operations. Additionally, the Company used $117,000 in connection with the Companys ongoing implementation of its new, customized management information system. The Companys capital needs during Fiscal 2004 will include additional installments toward the $253,000 that remains to be paid in connection with this system, which has expected total costs of approximately $370,000. Once implemented, this system will enable the Company to meet HIPAA requirements, streamline the Companys entire clinical and claims functions, and offer service improvements to the Companys participating providers. Further, in addition to amounts already paid during Fiscal 2004, the Company may be required to repay a total of approximately $300,000 in principal and interest to Medicare within the current fiscal year in connection with one Medicare cost report settlement (see Note 4 Discontinued Operations). As of November 30, 2003, the Company had a working capital deficiency of $5.1 million and a stockholders deficit of $5.5 million. In December 2003, the Company raised approximately $1.0 million through the sale of an aggregate of 700,000 shares of common stock in a private transaction thereby reducing its working capital deficiency and stockholders deficit each by approximately $1.0 million as a result of this transaction (see Note 6 Subsequent Event). The shares issued in connection with this private placement have not been registered and may be resold pursuant to Rule 144 under the general rules and regulations of the Securities Act of 1933 as amended assuming that all of the conditions and provisions of the rule are complied with. The earliest date that these shares would become eligible for resale without a registration statement would be December 8, 2004. The Company is continuing to pursue sources of financing on terms that would support the Companys capital needs and provide available funds for working capital during Fiscal 2004. Management cannot state with any degree of certainty whether any required additional equity or debt financing will be available to the Company during Fiscal 2004 and, if available, that the source of financing would be available on terms and conditions acceptable to the Company. These conditions raise substantial doubt about the Companys ability to continue as a going concern, which is dependent
8
COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
upon its ability to continue to generate sufficient cash flow to meet its obligations on a timely basis, obtaining additional financing as may be required and, ultimately, sustaining an operating profit. The accompanying consolidated financial statements do not include any adjustments that may result from the outcome of this uncertainty.
Note 3 Major Customers/Contracts
(1) Beginning January 1, 2003, the Company contracted with a new HMO client to provide behavioral healthcare services to contracted Medicaid members in Florida. This business accounted for 25.3%, or $3.8 million, of the Companys operating revenues during the six months ended November 30, 2003. During the prior fiscal year, such Medicaid members were serviced by the Company through its contract with another HMO whose agreements with the Company covered Medicaid, Medicare, and commercial members and represented a combined 23.5%, or $4.0 million, of the Companys operating revenue for the six months ended November 30, 2002. On December 31, 2002, the Company received a formal termination notice, effective February 28, 2003, from the prior HMO client with respect to the Medicare and commercial business. In addition, the acquiring HMO, whose contract with the Company was scheduled to renew in January 2004, formally advised the Company on October 30, 2003 that it had determined to insource behavioral health and, therefore, would not renew its contract with the Company. Accordingly, the Companys contract with this HMO customer terminated effective December 31, 2003. In preparation for the loss of revenue specific to this contract, the Company has undertaken efforts to restructure its regional and corporate operations, including the centralization of certain clinical and administrative functions, generalized staff downsizing, and the elimination of certain expenses that cannot be supported with existing and remaining revenues.
(2) The Company has one contract to provide behavioral healthcare services to Connecticut members under contract with one HMO. This agreement represented approximately 11.3%, or $1.7 million and 8.5%, or $1.4 million, of the Companys operating revenue for the six months ended November 30, 2003 and 2002, respectively. Additionally, this contract provides that the Company, through its contract with this HMO, receives additional funds directly from a state reinsurance program for the purpose of paying providers. During the six months ended November 30, 2003 and 2002, the Company filed reinsurance claims totaling approximately $1.1 million and $1.6 million, respectively. Such claims represent cost reimbursements and, as such, are not included in the reported operating revenues and are accounted for as reductions of healthcare operating expenses. As of November 30, 2003 and May 31, 2003, respectively, the Company has reported $0.5 million and $0.4 million as accounts receivablemanaged care reinsurance contracts, with $3.3 million and $3.1 million reported as accrued reinsurance claims payable, in the accompanying balance sheet. In the event that the Company does not collect the amounts receivable related to reinsurance amounts, the Company could remain liable for the costs of the specific services provided to members that qualify for such reimbursements. The difference between the reinsurance receivable amount and the reinsurance payable amount is related to timing differences between the authorization date, the date the money is received by the Company, and the date the money is paid to the provider. In certain cases, providers have submitted claims for authorized services having incorrect service codes or otherwise incorrect information that has caused payment to be denied by the Company. In such cases, there are contractual and statutory provisions that allow the provider to appeal a denied claim. If no appeal is received by the Company within the prescribed amount of time, the Company may be required to remit the reinsurance funds back to the appropriate party. For non-reinsurance claims incurred but not reported under this contract, the Company estimates its claims payable using a similar method as that used for other existing contracts. This HMO has been a customer since March 2001. The original contract term ended December 31, 2002 and, in accordance with its terms, has automatically renewed for two consecutive one-year periods, with the current term ending December 31, 2004.
(3) The Company has contracts with one HMO to provide behavioral healthcare services to contracted commercial, Medicaid, and Childrens Health Insurance Program (CHIP) members in Texas. This business accounted for approximately 12.6%, or $1.9 million, and 11.4%, or $1.9 million, of the Companys operating revenues during the six months ended November 30, 2003 and 2002, respectively. Under recently passed legislation, the benefits available to Texas CHIP recipients had been significantly reduced and, as a result, the Company and this HMO customer agreed to amend their current contract covering CHIP members to reflect a reduced fee and benefit arrangement. For each of the six months ended November 30, 2003 and 2002, CHIP business under this contract accounted for approximately $0.7 million, or 4.7%, and $1.2 million, or 6.8%, respectively, of the Companys operating revenues. The recent CHIP legislation was subject to pending bills that have since been passed, thereby restoring the majority of the benefits available to CHIP recipients. As a result, the Company and this HMO client are currently evaluating their existing contractual arrangement given these very recent developments in Texas. The company has responded to the expected revenue reductions by adjusting staffing and other operating costs as part of its current cost reduction program begun during the quarter ended November 30, 2003. Management will continue to closely monitor developments in Texas.
9
COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
This HMO has been a customer of the Company since November 1998. The original contract term was for one year and the contract provides for automatic one-year renewal terms.
(4) During the prior fiscal year, the Company had three contracts with one HMO to provide behavioral healthcare services to Florida members. The combined revenue from these contracts accounted for 18.9%, or $3.2 million, of the Companys operating revenues during the six months ended November 30, 2002. These contracts covering Florida members terminated effective January 1, 2003. Additionally, the Company has one major contract with an affiliate of this HMO (see Item 2 above).
Although there can be no assurance that the Company will be able to reduce its costs in an amount sufficient to offset the gross margins associated with the customer listed under (1) above and the CHIP business described under (3) above, the Company has undertaken efforts to restructure its regional and corporate operations, including the centralization of certain clinical and administrative functions, generalized staff downsizing, and the elimination of certain expenses that cannot be supported with existing and remaining revenues, to minimize any effect on future results of operations.
In general, the Companys contracts with its customers are typically for initial one-year terms, with automatic annual extensions. Such contracts generally provide for cancellation by either party with 60 to 90 days written notice.
Note 4 Discontinued Operations
Results for the six months ended November 30, 2003 include a change in estimate that resulted in a net charge of approximately $387,000 during the quarter ended August 31, 2003, which has been included under Discontinued Operations in the accompanying financial statements. Such charge is primarily due to the Companys Fiscal 1999 Medicare cost report for its Aurora, Colorado psychiatric hospital that was owned by the Company until its disposal on March 11, 1999, which completed the Companys plan to dispose of its hospital business segment. The Fiscal 1999 cost report had recently been under audit by the Medicare fiscal intermediary in the normal course of completing the final settlement for Fiscal 1999. Prior to the intermediarys completion of the audit, management reviewed proposed adjustments with the Medicare fiscal intermediary and separately with the Companys cost report consultant. After filing the Companys response to the proposed adjustments, which included documentation that was accepted by the Medicare intermediary, thereby allowing the intermediary to reverse specific adjustments that would have been unfavorable, and based on continuing discussions with the Medicare intermediary, management believed that no liability existed in relation to this Fiscal 1999 cost report. However, in late September 2003, the Company received notice from the Medicare fiscal intermediary that the intermediary had completed its audit and that various audit adjustments made by the intermediary would result in approximately $400,000 being due back to the Medicare program specific to Fiscal 1999.
The Company does not expect to appeal this settlement and, as such, expects to repay the full amount of approximately $400,000 specific to Fiscal 1999 less approximately $22,000 paid during the quarter ended November 30, 2003 and less approximately $106,000 in Medicare refunds that are currently due the Company in connection with the Fiscal 1995 and 1996 Medicare cost report settlements for this same Aurora, Colorado hospital. The Company has requested an installment payment plan from Medicare and, during the quarter ended November 30, 2003, while awaiting approval of the plan, the Company paid an aggregate of $22,000 representing two installments under the proposed settlement. If the Medicare fiscal intermediary determines that no installment plan is available to the Company, it would require that the remaining principal balance of approximately $272,000 plus any accrued interest would be due in an immediate lump sum payment. Such amount is included in accounts payable and accrued expenses in the accompanying balance sheet at November 30, 2003.
Note 5 Commitments and Contingencies
(1) Contracts with two existing clients require the Company to maintain performance bonds throughout the contract terms. At November 30, 2003, the Company maintained performance bonds of $1,200,000 and $600,000 in compliance with these requirements.
(2) The Company would remain liable to perform the services covered under subcapitation agreements if the parties with which the Company subcapitates were unable to fulfill their responsibilities under such agreements.
(3) Related to the Companys discontinued hospital operations, Medicare guidelines allow the Medicare fiscal intermediary to re-open previously filed cost reports. Management believes that the Companys Fiscal 1998 and
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
1999 cost reports remain eligible for re-opening at some future date, in which case the intermediary may determine that additional amounts are due to or from Medicare.
(4) The Company is subject to the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The purpose of the HIPAA provisions is to improve the efficiency and effectiveness of the healthcare system through standardization of the electronic data interchange of certain administrative and financial transactions and, also, to protect the security and privacy of protected health information. Entities subject to HIPAA include some healthcare providers and all healthcare plans. To meet the specific requirements of HIPAA, the Company recently determined it needed to make a significant investment in its current information system or in a new information system that would better meet the Companys future needs. As a result, the Company entered into a Letter of Intent with Qualifacts Systems, Inc. (Qualifacts), a vendor that has provided the Company with an immediate, temporary solution to meet HIPAA compliance rules specific to the Electronic Health Care Transactions and Code Sets Standards Model Compliance Plan with the Centers for Medicare and Medicaid Services and, additionally, to design a new, customized management information system that will enable the Company to continue to meet HIPAA requirements in the future. The Company expects to incur a total of approximately $0.4 million of costs to customize the Qualifacts system and activate the licenses needed for Qualifacts and other, related third-party software.
From time to time, the Company and its subsidiaries are also parties and their property is subject to ordinary, routine litigation incidental to their business, in which case claims may exceed insurance policy limits and the Company or any one of its subsidiaries may have exposure to a liability that is not covered by insurance. Management is not aware of any such lawsuits that could have a material adverse impact on the Companys financial statements.
NOTE 6 Subsequent Events
(1) Effective December 8, 2003, the Company completed a private transaction for the sale of an aggregate of 700,000 shares of its common stock, $.01 par value, to two individuals for an aggregate of $1,015,000 in gross proceeds to the Company. The Company realized net proceeds of approximately $1.0 million thereby reducing its working capital deficiency and stockholders deficit each by approximately $1.0 million as a result of this transaction. The shares issued in connection with this private placement have not been registered and may be resold pursuant to Rule 144 under the general rules and regulations of the Securities Act of 1933 as amended assuming that all of the conditions and provisions of the rule are complied with. The earliest date that these shares would become eligible for resale without a registration statement would be December 8, 2004. Further, the number of issued and outstanding shares of the Companys common stock increased from 3,943,049 to 4,643,049.
(2) Effective December 30, 2003, the Company received cash totaling $137,500 from Jefferson Hills Corporation (JHC) in full settlement of the secured 8.0% promissory note receivable, which originated out of the sale in Fiscal 1999 of the Companys Aurora, Colorado facility to JHC. Such note, which amounted to approximately $156,000 as of November 30, 2003, had been due in April 2006. The Company allowed JHC a discount of approximately 12% for the early payment and, as a result, the Company expects to record an $18,000, non-operating loss during the fiscal quarter ending February 28, 2004.
Item 2 Managements discussion and analysis of financial condition and Results of operations
This quarterly report on Form 10-Q includes forward-looking statements, the realization of which may be impacted by certain important factors discussed below under Cautionary Statement and Risk Factors Important Factors Related to Forward-Looking Statements and Associated Risks (page 15).
General
Introduction
The Company has provided managed behavioral healthcare services and products since 1992. Services are marketed primarily through business development staff who are responsible for developing new sales leads and for preparing responses to formal commercial and public sector Requests for Proposals (RFPs). The Company typically has several RFPs in process, with submissions being made to a diverse selection of existing and prospective clients. Current services include a broad spectrum of inpatient and outpatient mental health and substance abuse therapy, counseling, and supportive interventions.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
Results of Operations
For the six months ended November 30, 2003, the Company reported a loss from continuing operations of $171,000, or $0.04 loss per share (basic and diluted), and a net loss of $558,000, or $0.14 loss per share (basic and diluted), compared to net income of $274,000, or $0.07 earnings per share (basic and diluted) for the six months ended November 30, 2002, which included a $470,000, non-operating gain related to one settlement.
For the quarter ended November 30, 2003, the Company reported a net loss of $233,000, or $0.06 basic and diluted earnings per share, compared to net income of $307,000, or $0.08 basic earnings per share ($0.07 diluted earnings per share) for the quarter ended November 30, 2002, which included a $470,000, non-operating gain related to one settlement.
Due to the recent loss of business in certain markets, we reduced our staff by approximately 10% in December 2003. Additionally, as part of our ongoing expense reduction program to align costs with expected revenues, we will maintain in effect a temporary salary freeze applicable to all employees, salary reductions applicable to senior and executive management personnel, and certain other reductions in operating costs associated with the specific contracts that have terminated or otherwise cannot be supported by expected revenues.
The following tables summarize the Companys operating results from continuing operations for the three and six months ended November 30, 2003 and 2002 (in thousands):
The three months Ended November 30, 2003 Compared To The three months Ended November 30, 2002:
Consolidated | Consolidated | |||||||
Continuing | Continuing | |||||||
Operations | Operations | |||||||
Fiscal 2004 | Fiscal 2003 | |||||||
Operating revenues |
$ | 7,011 | $ | 8,631 | ||||
Healthcare operating expenses |
6,199 | 7,760 | ||||||
General/administrative expenses |
970 | 952 | ||||||
Other operating expenses |
24 | 57 | ||||||
7,193 | 8,769 | |||||||
Operating loss |
$ | (182 | ) | $ | (138 | ) | ||
The Company reported a net loss of $233,000 and an operating loss of $182,000 for the quarter ended November 30, 2003 compared to net income of $307,000 and an operating loss of $138,000 for the quarter ended November 30, 2002. Operating revenues decreased by 18.8%, or $1.6 million, to $7.0 million for the quarter ended November 30, 2003 compared to $8.6 million for the quarter ended November 30, 2002. This decrease is primarily attributable to the loss of one major customer in Florida that accounted for $1.7 million of revenue during the fiscal quarter ended November 30, 2002 and a decrease in Texas CHIP revenue of approximately $0.8 million during the fiscal quarter ended November 30, 2003 compared to the same period in Fiscal 2003. These decreases were partially offset by new business in Indiana and Michigan.
Healthcare operating expenses decreased by approximately $1.6 million, or 20.1%, for the quarter ended November 30, 2003 as compared to the quarter ended November 30, 2002. This decrease is directly attributable to the loss of revenue as described above. Healthcare operating expense as a percentage of operating revenue decreased by 1.5%, from 89.9% for the quarter ended November 30, 2002 to 88.4% for the quarter ended November 30, 2003. This decrease is primarily due to the termination in January 2003 of one major contract that consistently returned a high medical loss ratio.
General and administrative expenses increased by $18,000, or 1.9%, for the quarter ended November 30, 2003 as compared to the quarter ended November 30, 2002. This increase is primarily attributable to increased usage of outside professional services during the quarter ended November 30, 2003, including approximately $100,000 of legal and consulting services in connection with one unsuccessful bid in Tennessee. General and administrative expense as a percentage of operating revenue increased from 11.0% for the quarter ended November 30, 2002 to 13.8% for the quarter ended November 30, 2003.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
Other operating expenses decreased by $33,000 for the quarter ended November 30, 2003 compared to the quarter ended November 30, 2002. This decrease is directly attributable to a reduction in depreciation expense as a result of specific assets being fully depreciated.
The Six months Ended November 30, 2003 Compared To The Six months Ended November 30, 2002:
Consolidated | Consolidated | |||||||
Continuing | Continuing | |||||||
Operations | Operations | |||||||
Fiscal 2004 | Fiscal 2003 | |||||||
Operating revenues |
$ | 14,904 | $ | 16,938 | ||||
Healthcare operating expenses |
13,051 | 15,113 | ||||||
General/administrative expenses |
1,878 | 1,840 | ||||||
Other operating expenses |
43 | 117 | ||||||
14,972 | 17,070 | |||||||
Operating loss |
$ | (68 | ) | $ | (132 | ) | ||
The Company reported an operating loss of $68,000, a loss from continuing operations of $171,000 and a net loss of $558,000 for the six months ended November 30, 2003 compared to an operating loss of $132,000 and net income of $274,000 for the six months ended November 30, 2002, which included a $470,000, non-operating gain related to one settlement. Operating revenues decreased by 12.0%, or $2.0 million, to $14.9 million for the six months ended November 30, 2003 compared to $16.9 million for the six months ended November 30, 2002. This decrease is primarily attributable to the loss of one major customer in Florida that accounted for $3.2 million of revenue during the six months ended November 30, 2002 and a decrease in Texas CHIP revenue of approximately $795,000 during the six months ended November 30, 2003 compared to the same period in Fiscal 2003. These decreases were partially offset by new business in Indiana and Michigan.
Healthcare operating expenses decreased by approximately $2.1 million, or 13.6%, for the six months ended November 30, 2003 as compared to the six months ended November 30, 2002. This decrease is directly attributable to the loss of revenue as described above. Healthcare operating expense as a percentage of operating revenue decreased by 1.6%, from 89.2% for the six months ended November 30, 2002 to 87.6% for the six months ended November 30, 2003. This decrease is primarily due to the termination in January 2003 of one major contract that consistently returned a high medical loss ratio.
General and administrative expenses increased by $38,000, or 2.1%, for the six months ended November 30, 2003 as compared to the six months ended November 30, 2002. This increase is primarily attributable to increased usage of outside professional services during Fiscal 2004, including approximately $110,000 of legal and consulting services in connection with one unsuccessful bid in Tennessee. General and administrative expense as a percentage of operating revenue increased from 10.9% for the six months ended November 30, 2002 to 12.6% for the six months ended November 30, 2003.
Other operating expenses decreased by $74,000 for the six months ended November 30, 2003 compared to the six months ended November 30, 2002. This decrease is directly attributable to a reduction in depreciation expense as a result of specific assets being fully depreciated.
Seasonality of Business
Historically, we have experienced consistently low utilization during our first fiscal quarter, which comprises the months of June, July, and August, and increased utilization during our fourth fiscal quarter, which comprises the months of March, April and May. Such variations in utilization impact our costs of care during these months, generally having a positive impact on our gross margins and operating profits during the first fiscal quarter and a negative impact on our gross margins and operating profits during the fourth quarter.
Liquidity and Capital Resources
During the six months ended November 30, 2003, net cash used in continuing operations amounted to $630,000 and $22,000 was used in discontinued operations. Additionally, we used $117,000 in connection with our ongoing implementation of our new, customized management information system. At November 30, 2003, we have
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
cash and cash equivalents of $2.8 million. Giving effect to the private placement that was completed on December 8, 2003 in which the Company received net cash proceeds of approximately $1.0 million, our cash and cash equivalents on a pro forma basis are $3.8 million as of November 30, 2003. Our capital needs during Fiscal 2004 will include additional installments toward the $253,000 that remains to be paid in connection with this system, which has expected total costs of approximately $370,000. Once implemented, this system will enable us to meet HIPAA requirements, streamline our entire clinical and claims functions, and offer service improvements to our participating providers. Further, in addition to amounts already paid during Fiscal 2004, we may be required to repay the remaining principal balance of approximately $272,000 plus any accrued interest to Medicare within the current fiscal year in connection with one Medicare cost report settlement (see Note 4 to the unaudited, consolidated financial statements Discontinued Operations). As of November 30, 2003, the Company has a working capital deficiency of $5.1 million and a stockholders deficit of $5.5 million. In December 2003, we raised approximately $1.0 million through the sale of an aggregate of 700,000 shares of our common stock in a private transaction thereby reducing our working capital deficiency and stockholders deficit each by approximately $1.0 million as a result of this transaction. The shares issued in connection with this private placement have not been registered and may be resold pursuant to Rule 144 under the general rules and regulations of the Securities Act of 1933 as amended assuming that all of the conditions and provisions of the rule are complied with. The earliest date that these shares would become eligible for resale without a registration statement would be December 8, 2004. We are continuing to pursue additional sources of financing on terms that would support our future capital needs and provide available funds for working capital in Fiscal 2004. We cannot state with any degree of certainty whether any required additional equity or debt financing will be available to us during Fiscal 2004 and, if available, that the source of financing would be available on terms and conditions acceptable to us. These conditions raise substantial doubt about the Companys ability to continue as a going concern, which is dependent upon our ability to continue to generate sufficient cash flow to meet our obligations on a timely basis, obtaining additional financing as may be required and, ultimately, sustaining an operating profit.
Our unpaid claims liability is estimated using an actuarial paid completion factor methodology and other statistical analyses. These estimates are subject to the effects of trends in utilization and other factors. Any significant increase in member utilization that falls outside of our estimations would increase healthcare operating expenses and may impact our ability to achieve profitability and positive cash flow. Although considerable variability is inherent in such estimates, we believe that the unpaid claims liability is adequate. However, actual results could differ from the $3.9 million claims payable amount reported as of November 30, 2003.
Summary of Significant Accounting Policies
Our discussion and analysis of our financial condition and results of operations is based upon the Companys consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States of America. The preparation of these financial statements requires us to make significant estimates and judgments to develop the amounts reflected and disclosed in the financial statements. On an on-going basis, we evaluate the appropriateness of our estimates and we maintain a thorough process to review the application of our accounting policies. We base our estimates on historical experience and on various other assumptions that we believe to be reasonable under the circumstances. Actual results may differ from these estimates under different assumptions or conditions.
We believe the following significant accounting policies involve our most significant judgments and estimates that are material to our consolidated financial statements:
Accrued Claims Payable The accrued claims payable liability represents the estimated ultimate net amounts owed for all behavioral healthcare services provided through the respective balance sheet dates, including estimated amounts for claims incurred but not yet reported (IBNR) to the Company. The unpaid claims liability is estimated using an actuarial paid completion factor methodology and other statistical analyses and is continually reviewed and adjusted, if necessary, to reflect any change in the estimated liability. These estimates are subject to the effects of trends in utilization and other factors. However, actual claims incurred could differ from the estimated claims payable amount reported as of November 30, 2003. Although considerable variability is inherent in such estimates, we believe that the unpaid claims liability is adequate.
Revenue Recognition Our managed care activities are performed under the terms of agreements with health maintenance organizations, preferred provider organizations, and other health plans or payers to provide contracted behavioral healthcare services to subscribing participants. Revenue under a substantial portion of these agreements is earned monthly based on the number of qualified participants regardless of services actually provided (generally
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
referred to as capitation arrangements). The information regarding qualified participants is supplied by our clients and we rely extensively on the accuracy of the client remittance and other reported information to determine the amount of revenue to be recognized. Such agreements accounted for 87.2%, or $13.0 million, of revenue from continuing operations for the six months ended November 30, 2003. The balance of our revenues is earned on a fee-for-service basis and is recognized as services are rendered.
CAUTIONARY STATEMENT FOR THE PURPOSES OF THE SAFE HARBOR PROVISIONS OF THE PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995: Certain information included in this quarterly report on Form 10-Q and in other Company reports, SEC filings, statements, and presentations is forward looking within the meaning of the Private Securities Litigation Reform Act of 1995, including, but not limited to, statements concerning the Companys anticipated operating results, financial resources, increases in revenues, increased profitability, interest expense, growth and expansion, and the ability to obtain new behavioral healthcare contracts. Such forward-looking information involves important risks and uncertainties that could significantly affect actual results and cause them to differ materially from expectations expressed herein and in other Company reports, SEC filings, statements, and presentations. These risks and uncertainties include local, regional, and national economic and political conditions, the effect of governmental regulation, the competitive environment in which the Company operates, and other risks detailed from time to time in the Companys SEC reports.
Risk Factors
Important Factors Related to Forward-Looking Statements and Associated Risks
This quarterly report on Form 10-Q contains certain forward-looking statements that are based on current expectations and involve a number of risks and uncertainties. Factors that may materially affect revenues, expenses and operating results include, without limitation, our success in (i) expanding the managed behavioral healthcare operations, (ii) effective management in the delivery of services, and (iii) risk and utilization in context of capitated payouts.
Concentration of Risk
We currently have contracts with three health plans to provide behavioral healthcare services under commercial, Medicaid, and CHIP plans to contracted members in Connecticut, Florida, and Texas. These combined contracts represent approximately 49.2%, or $7.3 million, of our operating revenue for the six months ended November 30, 2003 and include one major contract that terminated effective December 31, 2003, which accounted for 25.3%, or $3.8 million, of our operating revenue for the six months ended November 30, 2003 (see Note 3(1) to the unaudited, consolidated financial statements Major Customers/Contracts). Although the loss of this customer could have a material, adverse effect on the Companys financial condition and future results of operations, we believe the Company will be able to reduce its internal cost of servicing this account to minimize any effect on future results of operations. In general, the terms of each contract are generally for one-year periods and are automatically renewable for additional one-year periods unless terminated by either party. The loss of any one of these customers or changes in any of these States Medicaid reimbursement rules could have a material, adverse effect on our working capital and future results of operations (see Medicaid and Other State Funded Programs below).
History of Operating Losses Uncertainty of Future Profitability
For each of the fiscal years ending May 31, 2003, 2002 and 2001, we had operating losses of approximately $608,000, $774,000 and $1,163,000, respectively. The report of the Companys independent auditors with respect to their examination of the Companys financial statements for the years ended May 31, 2003, 2002 and 2001 contains an explanatory paragraph relating to the preparation of the Companys financial statements on a going concern basis and states that the Companys working capital deficiency and stockholders deficit raise substantial doubt about its ability to continue as a going concern. For the six months ended November 30, 2003, the Company reported a loss from continuing operations of $171,000 and a net loss of $558,000. At November 30, 2003, the Companys total current liabilities exceeded its total current assets by approximately $5.1 million and it had an accumulated deficit of approximately $57.5 million, with a total stockholders deficit of approximately $5.5 million. Due to the recent loss of business in certain markets, we reduced our staff by approximately 10% in December 2003. Additionally, as part of our ongoing expense reduction program to align costs with expected revenues, we will maintain in effect a temporary salary freeze applicable to all employees, salary reductions applicable to senior and executive management personnel, and certain other reductions in operating costs associated with the specific contracts that have terminated or otherwise cannot be supported by expected revenues. While our management has addressed the conditions giving rise to the
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
going concern uncertainty, there is no certainty that we will be successful in implementing any of the plans of management to restore us to profitability, to achieve and maintain positive cash flow on an ongoing basis, or otherwise to ensure that we will be able to continue as a going concern.
Costs of Care Estimated Claims Incurred But Not Reported
Our costs of care include estimated amounts for claims incurred but not yet reported (IBNR) to us. The IBNR is estimated using an actuarial paid completion factor methodology and other statistical analyses that we continually review and adjust, if necessary, to reflect any change in the estimated liability. These estimates are subject to the effects of trends in utilization and other factors. Although considerable variability is inherent in such estimates, we believe that our unpaid claims liability is adequate. However, actual results may differ materially from the estimated amounts reported.
Need for Additional Funds; Uncertainty of Future Funding
We believe that our ability to increase business is dependent on our ability to have available working capital and, therefore, we will require additional funding. Effective December 8, 2003, we raised approximately $1.0 million through a private transaction of an aggregate of 700,000 shares of our common stock thereby reducing our working capital deficiency and stockholders deficit each by approximately $1.0 million as a result of this transaction. The shares issued in connection with this private placement have not been registered and may be resold pursuant to Rule 144 under the general rules and regulations of the Securities Act of 1933 as amended assuming that all of the conditions and provisions of the rule are complied with. The earliest date that these shares would become eligible for resale without a registration statement would be December 8, 2004. We are continuing to pursue additional sources of financing on terms that would support our future capital needs and provide available funds for working capital in Fiscal 2004. We cannot state with any degree of certainty whether any required additional equity or debt financing will be available to us during Fiscal 2004 and, if available, that the source of financing would be available on terms and conditions acceptable to us.
Uncertainties Related to Pricing, Healthcare Reform, and Related Matters
Managed care operations are at risk for costs incurred to supply agreed upon levels of service. Failure to anticipate or control costs could have material, adverse effects on the Company. Additionally, the business of providing services on a full-risk capitation basis exposes us to the additional risk that contracts negotiated and entered into may ultimately be determined to be unprofitable if utilization levels require us to deliver and provide services at capitation rates which do not account for or factor in such utilization levels.
We typically contract with small to medium sized HMOs who may be adversely affected by the continuing efforts of governmental and third party payers to contain or reduce the costs of healthcare through various means. Our clients may fall under state supervision or otherwise be subject to state discipline placing them at risk of losing membership to their competitors in which case we may be unable to contract with any succeeding HMOs. They may also determine to manage the behavioral healthcare benefits in house and, as a result, discontinue contracting with the Company. Additionally, our clients may be acquired by larger HMOs, in which case there can be no assurance that the acquiring company would renew our contract.
Medicaid and Other State funded Programs
As of November 30, 2003, we managed approximately 787,000 lives in connection with behavioral and substance abuse services covered through Medicaid in Connecticut, Florida, Michigan and Texas. Any changes in Medicaid reimbursement could ultimately affect the Company through contract bidding and cost structures with the health plans first impacted by such changes. The State of Texas recently passed legislation that reduced the amount of funds allocated to our clients to cover behavioral healthcare services to Childrens Health Insurance Program (CHIP) recipients in the State of Texas. As a result, two of the companys existing clients determined not to continue the CHIP portion of their contracts with us and one existing client renegotiated its contract with us to reflect the reduced CHIP benefits. The recent CHIP legislation was subject to pending bills that have since been passed, thereby restoring the majority of the benefits available to CHIP recipients. As a result, the Company, our continuing CHIP client, and certain prospective clients are currently evaluating their existing contractual arrangements given these very recent developments in Texas. There can be no assurance that we will be successful in regaining CHIP business from our two existing clients that recently terminated their CHIP contracts or from the prospective new CHIP clients with which we are negotiating. We will continue to closely monitor developments in Texas and to take any
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
steps necessary in addition to the current cost restructuring that began during the quarter ended November 30, 2003 to align costs with expected revenues. For the six months ended November 30, 2003, we had operating revenue of $1.0 million specific to contracts covering Texas CHIP recipients. These changes to Texas CHIP programs could have a material, adverse impact on our operations.
Seasonality of Business
Historically and during Fiscal 2003, we have experienced consistently low utilization during our first fiscal quarter, which comprises the months of June, July, and August, and increased utilization during our fourth fiscal quarter, which comprises the months of March, April, and May. Such variations in utilization impact our costs of care during these months, generally having a positive impact on our gross margins and operating profits during the first fiscal quarter and a negative impact on our gross margins and operating profits during the fourth quarter.
Regulatory compliance
We are subject to extensive and evolving state and federal regulations relating to the nations mental health system as well as changes in Medicaid and Medicare reimbursement that could have an effect on the profitability of our contracts. These regulations range from licensure and compliance with regulations related to insurance companies and other risk-assuming entities, to licensure and compliance with regulations related to healthcare providers. These laws and regulations may vary considerably among states. As a result, CompCare may be subject to the specific regulatory approach adopted by each state for regulation of managed care companies and for providers of behavioral healthcare treatment services.
We hold licenses or certificates to perform utilization review and third party administrator (TPA) services in certain states. Certain of the services provided by our managed behavioral healthcare subsidiaries may be subject to such licensing requirements in other states. There can be no assurance that additional utilization review or TPA licenses will not be required or, if required, that CompCare will qualify to obtain such licenses. In many states, entities that assume risk under contract with licensed insurance companies or health plans have not been considered by state regulators to be conducting an insurance or HMO business. As a result, we have not sought licensure as either an insurer or HMO in any state. If the regulatory positions of these states were to change, our business could be materially affected until such time as we are able to meet the regulatory requirements. Currently, we cannot quantify the potential effects of additional regulation of the managed care industry, but such costs will have an adverse effect on future operations to the extent that they are not able to be recouped in future managed care contracts.
We are subject to the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The purpose of the HIPAA provisions is to improve the efficiency and effectiveness of the healthcare system through standardization of the electronic data interchange of certain administrative and financial transactions and, also, to protect the security and privacy of protected health information. Entities subject to HIPAA include some healthcare providers and all healthcare plans. To meet the specific requirements of HIPAA, we recently determined we needed to make a significant investment in our current information system or in a new information system that would better meet our future needs. As a result, we entered into a Letter of Intent with Qualifacts Systems, Inc. (Qualifacts), a vendor that has provided us with an immediate, temporary solution to meet HIPAA compliance rules specific to the Electronic Health Care Transactions and Code Sets Standards Model Compliance Plan with the Centers for Medicare and Medicaid Services and, additionally, to design a new, customized management information system that will enable us to continue to meet HIPAA requirements in the future. While these efforts will be ongoing, we believe we have met substantially all compliance rules and timetables with respect to the HIPAA regulations. Failure to do so may result in penalties and have a material adverse effect on the Companys ability to retain its customers or to gain new business.
Dependence on Key Personnel
We currently rely heavily on several key executives and other management, clinical and technical personnel for our business performance and development. Recent new hires have included senior management personnel and other essential employees that are assisting executive management with marketing efforts and enhancements to our clinical system designs. Our future success will depend in large part upon our continued ability to attract and retain highly skilled employees.
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
Shares Eligible for Future Sale
As of January 5, 2004, the Company has issued 1,174,724 options, with exercise prices ranging from $0.25 to $4.00. A total of 885,666 options are exercisable and in the money as of January 5, 2004 and, accordingly, could be exercised and resold by optionees. Additionally, in connection with the private transaction that was completed on December 8, 2003, an aggregate of 700,000 shares of our common stock were issued to two private investors. The shares issued in connection with this private placement have not been registered and may be resold pursuant to Rule 144 under the general rules and regulations of the Securities Act of 1933 as amended assuming that all of the conditions and provisions of the rule are complied with. The earliest date that these shares would become eligible for resale without a registration statement would be December 8, 2004.
Anti-takeover Provisions
The Companys Restated Certificate of Incorporation provides for 60,000 authorized shares of Preferred Stock, the rights, preferences, qualifications, limitations and restrictions of which may be fixed by our Board of Directors without any vote or action by the stockholders that could have the effect of diluting the Common Stock or reducing working capital that would otherwise be available to the Company. As of November 30, 2003, there are 18,740 remaining shares authorized and available to issue, and no outstanding shares of Preferred Stock. The Companys Restated Certificate of Incorporation also provides for a classified board of directors with directors divided into three classes serving staggered terms. The Companys stock option plans generally provide for the acceleration of vesting of options granted under such plans in the event of certain transactions that result in a change of control of the Company. Section 203 of the General Corporation Law of Delaware prohibits us from engaging in certain business combinations with interested stockholders. These provisions may have the effect of delaying or preventing a change in control of the Company without action by the stockholders and therefore could adversely affect the price of our Common Stock or the possibility of sale of shares to an acquiring person.
Assumptions relating to the foregoing involve judgments that are difficult to predict accurately and are subject to many factors that can materially affect results. Budgeting and other management decisions are subjective in many respects and thus susceptible to interpretations and periodic revisions based on actual experience and business developments, the impact of which may cause us to alter our budgets which may in turn affect the Companys results. In light of the factors that can materially affect the forward-looking information included herein, the inclusion of such information should not be regarded as a representation by the Company or any other person that our objectives or plans will be achieved.
Item 3. Quantitative and Qualitative Disclosures About Market Risk
While we currently have market risk sensitive instruments, we have no significant exposure to changing interest rates as the interest rate on our long-term debt is fixed. Additionally, we do not use derivative financial instruments for investment or trading purposes and our investments are generally limited to cash deposits.
Item 4. Controls and Procedures
Evaluation of the Companys Disclosure Controls and Internal Controls. Within the 90 days prior to filing this report on Form 10-Q, the Company evaluated the effectiveness of the design and operation of its disclosure controls and procedures (Disclosure Controls), and its internal controls and procedures for financial reporting (Internal Controls). This evaluation (the Controls Evaluation) was done under the supervision and with the participation of our Chief Executive Officer (CEO) and Chief Financial Officer (CFO). Rules adopted by the Securities and Exchange Commission (SEC) require that in this section of the quarterly report on Form 10-Q we present the conclusions of the CEO and the CFO about the effectiveness of our Disclosure Controls and Internal Controls based on and as of the date of the Controls Evaluation.
Disclosure Controls and Internal Controls. As provided in Rule 13a-14 of the General Rules and Regulations under the Securities Exchange Act of 1934, as amended, Disclosure Controls are defined as meaning controls and procedures that are designed with the objective of insuring that information required to be disclosed in our reports filed under the Securities Exchange Act of 1934, as amended (the Exchange Act), is recorded, processed, designed and reported within the time periods specified by the SECs rules and forms. Disclosure Controls include, within the definition under the Exchange Act, and without limitation, controls and procedures designed to insure that information required to be disclosed by us in our reports is accumulated and communicated to our management including our CEO and CFO, as appropriate, to allow timely decisions regarding disclosure. Internal Controls are procedures which are
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COMPREHENSIVE CARE CORPORATION AND SUBSIDIARIES
designed with the objective of providing reasonable assurance that (1) our transactions are properly authorized; (2) our assets are safeguarded against unauthorized or improper use; and (3) our transactions are properly recorded and reported, all to permit the preparation of our financial statements in conformity with accounting principles generally accepted in the United States of America.
Scope of the Controls Evaluation. The evaluation made by our CEO and CFO of our Disclosure Controls and our Internal Controls included a review of the controls objectives and design, the controls implementation by the Company and the effect of the controls on the information generated for use in this Form 10-Q. In the course of the Controls Evaluation, we sought to identify data errors, control problems or acts of fraud and to confirm that appropriate corrective action, including process improvements, were being undertaken. This type of evaluation will be done on a quarterly basis so that the conclusions concerning controls effectiveness can be reported in our quarterly reports on Form 10-Q and Annual Report on Form 10-K. The overall goals of these various evaluation activities are to monitor our Disclosure Controls and our Internal Controls and to make modifications as necessary; our intent in this regard is that the Disclosure Controls and the Internal Controls will be maintained as dynamic systems that change (including with improvements and corrections) as conditions warrant.
Among other matters, we sought in our evaluation to determine whether there were any significant deficiencies or material weaknesses in the Companys Internal Controls, or whether the Company had identified any acts of fraud involving personnel who have a significant role in the Companys Internal Controls. In the professional auditing literature, significant deficiencies are referred to as reportable conditions; these are control issues that could have a significant adverse effect on the ability to record, process, summarize and report financial data in the financial statements. A material weakness is defined in the auditing literature as a particularly serious reportable condition where the internal control does not reduce to a relatively low level the risk that misstatements caused by error or fraud may occur in amounts that would be material in relation to the financial statements and not be detected within a timely period by employees in the normal course of performing their assigned functions. We also sought to deal with other controls matters in the Controls Evaluation, and in each case if a problem was identified, we considered what revision, improvement and/or correction to make in accordance with our on-going procedures. Following the completion of the audit of the Companys financial statements, the Companys external auditors issued their management letter to the Board of Directors, which did not identify any significant deficiency or material weakness in the Companys internal controls but did recommend certain improvements in the Companys existing internal controls.
The Companys management, including the CEO and CFO, does not expect that our Disclosure Controls or our Internal Controls will prevent all errors and all fraud. A control system, no matter how well designed and operated, can provide only reasonable, not absolute, assurance that the control systems objectives will be met. Further, the design of a control system must reflect the fact that there are resource constraints, and the benefits of controls must be considered relative to their costs. Because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that all control issues and instances of fraud, if any, within the Company have been detected. These inherent limitations include the realities that judgments in decision-making can be faulty, and that breakdowns can occur because of simple error or mistake. Controls can also be circumvented by the individual acts of some persons, by collusion of two or more people, or by management override of the controls. The design of any system of controls is based in part upon certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions. Over time, controls may become inadequate because of changes in conditions or deterioration in the degree of compliance with its policies or procedures. Because of the inherent limitations in a cost-effective control system, misstatements due to error or fraud may occur and not be detected.
In accordance with SEC requirements, our CEO and CFO each have confirmed that, since the date of the Controls Evaluation to the date of this quarterly report on Form 10-Q, there have been no significant changes in Internal Controls or in other factors that could significantly affect Internal Controls, including any corrective actions with regard to significant deficiencies and material weaknesses.
Conclusion. Based upon the Controls Evaluation, our CEO and CFO have each concluded that our Disclosure Controls are effective to ensure that material information relating to the Company and its consolidated subsidiaries is made known to management, including the CEO and CFO, particularly during the period when our periodic reports are being prepared, and that our Internal Controls are effective to provide reasonable assurance that our financial statements are fairly presented in conformity with accounting principles generally accepted in the United States of America.
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PART II OTHER INFORMATION
Item 1 LEGAL PROCEEDINGS
From time to time, the Company and its subsidiaries may be parties to and their property is subject to ordinary, routine litigation incidental to their business, in which case claims may exceed insurance policy limits and the Company or any one of its subsidiaries may have exposure to a liability that is not covered by insurance. Management is not aware of any such lawsuits that could have a material adverse impact on the Companys financial statements.
Item 2 CHANGES IN SECURITIES AND USE OF PROCEEDS
As previously reported in the Companys Current Report on Form 8-K dated December 9, 2003, the Company, on December 8, 2003, completed the sale of 700,000 shares of its common stock, $.01 par value (the Shares), for an aggregate of $1,015,000, of which the Company realized net proceeds of approximately $971,500. The Company intends to utilize the net proceeds for working capital purposes. The Shares were sold to two individuals in a private transaction not involving a public offering. The shares issued in connection with this private placement have not been registered and may be resold pursuant to Rule 144 under the general rules and regulations of the Securities Act of 1933 as amended assuming that all of the conditions and provisions of the rule are complied with. The earliest date that these shares would become eligible for resale without a registration statement would be December 8, 2004. As a result of this transaction, the number of issued and outstanding shares of the Companys common stock increased from 3,943,049 shares to 4,643,049 shares.
Item 6 Exhibits and Reports on Form 8-K
EXHIBIT | ||||||
NUMBER | DESCRIPTION | PAGE NUMBER | ||||
31.1 | Comprehensive Care Corporation CEO Certification pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 | 22 |
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31.2 | Comprehensive Care Corporation CFO Certification pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 | 23 |
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32.1 | Comprehensive Care Corporation CEO Certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 | 24 |
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32.2 | Comprehensive Care Corporation CFO Certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 | 25 |
(b) | Reports on Form 8-K During the quarter ended November 30, 2003, the following reports on Form 8-K were filed by the Registrant: |
Date of Report | Item Reported | Description | ||
October 14, 2003 | Item 5 Other Events | Appointment of Steven J. Scheidt as Vice President, Private Sector Sales for the Company. | ||
November 7, 2003 | Item 5 Other Events | The Company announced the termination of one major contract and, also, changes in Texas legislation whereby the State of Texas will restore the majority of the behavioral health benefits available under the Texas Childrens Health Insurance Program. |
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the Company has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
COMPREHENSIVE CARE CORPORATION | ||||
January 9, 2004 | By | /s/ MARY JANE JOHNSON | ||
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Mary Jane Johnson President and Chief Executive Officer (Principal Executive Officer) |
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By | /s/ ROBERT J. LANDIS | |||
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Robert J. Landis Chairman, Chief Financial Officer and Treasurer (Principal Financial and Accounting Officer) |
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