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Securities and Exchange Commission Washington, DC 20549
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FORM 10-K
ANNUAL REPORT
Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934
For the Fiscal Year ended December 31, 1997
Commission file number 1-12215
QUEST DIAGNOSTICS INCORPORATED
One Malcolm Avenue. Teterboro, New Jersey 07608
201.393.5000
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Delaware 16-1387862
(State of Incorporation) (I.R.S. Employer Identification Number)
Securities registered pursuant to Section 12(b) of the Act:
Title of Each Class Name of Each Exchange on Which Registered
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Common Stock
with attached Preferred Share Purchase Right New York Stock Exchange
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10.75% Senior Subordinated Notes due
2006 New York Stock Exchange
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Securities registered pursuant to
Section 12(g) of the Act: None
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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 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. _X_ Yes ___ No
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Indicate by check mark if disclosure of delinquent filers pursuant to Item 405
of Regulation S-K is not contained herein, and will not be contained, to the
best of registrant's knowledge, in definitive proxy or information statements
incorporated by reference in Part III of this Form 10-K. [X]
As of February 24, 1998, the aggregate market value of the voting and
non-voting common equity held by non-affiliates of the registrant was
approximately $464 million, based on the closing price on such date of the
Company's Common Stock on the New York Stock Exchange.
As of February 24, 1998, there were outstanding 30,130,081 shares of Common
Stock, $.01 par value.
Documents Incorporated by Reference
Part of Form 10-K
Document into which incorporated
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Portions of the Registrant's
Proxy Statement to be filed by
April 30, 1998 ............... Part III
Such Proxy Statement, except for portions thereof which have been specifically
incorporated by reference, shall not be deemed "filed" as part of this report
on Form 10-K.
[LOGO OF QUEST DIAGNOSTICS]
PART I
Item 1. Business
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Overview
Quest Diagnostics Incorporated, a Delaware corporation formerly known as
Corning Clinical Laboratories Inc., is one of the largest clinical laboratory
testing companies in the United States. Quest Diagnostics Incorporated and its
subsidiaries are collectively referred to as "Quest Diagnostics" or the
"Company." The Company offers a broad range of routine and esoteric testing
services used by the medical profession in the diagnosis, monitoring and
treatment of disease and other medical conditions. The Company currently
processes approximately 54 million requisitions for testing each year.
The Company is the successor by merger to MetPath Inc. ("MetPath"), a New York
corporation organized in 1967. Corning Incorporated ("Corning") acquired
MetPath in 1982 and in 1992 merged MetPath into the Company, which had been
organized in 1990 as a holding company. On December 31, 1996, Corning
distributed all of the outstanding shares of common stock of the Company to the
stockholders of Corning, with one share of the Company's common stock being
distributed for each eight shares of common stock of Corning outstanding on
December 31, 1996. This distribution was followed immediately by the
distribution to the stockholders of the Company of all of the outstanding
common stock of Covance Inc. ("Covance") (a contract research organization
previously known as Corning Pharmaceutical Services Inc. that was previously a
subsidiary of the Company), with one share of Covance's common stock being
distributed for each four shares of common stock of Corning outstanding on
December 31, 1996. These two distributions are collectively referred to as the
"Spin-Off Distribution."
Since its founding in 1967, the Company's clinical laboratory testing business
has grown into a network of 15 regional laboratories across the United States
and an esoteric testing laboratory and research and development facility
(Nichols Institute) located in San Juan Capistrano, California. In addition,
the Company has several smaller branch laboratories, including one located in
Mexico City, Mexico; approximately 150 stat laboratories; and approximately 800
patient service centers located throughout the United States. A substantial
portion of this growth has resulted from acquisitions. During the fourth
quarter of 1997, the Company decided to downsize several of its laboratories
and transfer testing currently performed at these laboratories to other
laboratories of the Company. These consolidation activities are expected to be
complete by the end of 1998. See "Acquisitions and Consolidations."
The principal executive offices of the Company are located at One Malcolm
Avenue, Teterboro, New Jersey 07608, telephone number: (201) 393-5000.
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Business Strategy
The Company's overall goal is to be recognized by its customers, employees and
competitors as the best provider of comprehensive and innovative diagnostic
testing, information and services. To achieve this, the Company has set several
strategic goals and put in place organizational structures to implement them.
Best Supplier. The Company seeks to be the best supplier of the highest quality
and the lowest-cost testing services. Health care providers and patients expect
accurate, timely and consistent laboratory test results at a fair price.
o Highest Quality Provider. The Company strives to achieve superior customer
satisfaction by being viewed as the highest quality provider of accurate and
timely test results and related services. Customer perceptions are measured
by means of extensive quarterly satisfaction surveys. A comprehensive Total
Quality Management System operates within each regional laboratory and is led
by the business unit leader. All Company employees attend quality awareness
training where they are taught quality principles. Programs aimed at ensuring
quality control and quality assurance are augmented by efforts to identify
and eliminate errors. Error rates are generally reported in parts per million
with aggressive goals set and progress monitored. Results are improved
primarily through the use of process improvement techniques, training and the
implementation of identified best practices. The Company believes that these
initiatives will allow the Company to improve the overall quality of its
clinical testing services while at the same time lowering costs.
Historically, the Company's experience verifies this relationship between
quality and costs. All of the Company's laboratories are accredited by the
College of American Pathologists.
o Lowest Cost Provider. Currently, approximately 39% of the Company's net
revenues are from laboratories that the Company believes are among the
lowest-cost providers in their respective markets. Management believes that
these laboratories are among the lowest-cost providers in their respective
markets based on
Quest Diagnostics Incorporated: 1997 Form 10-K
1
its knowledge of such markets and information obtained in acquiring other
laboratories. Currently, the Company's average cost per requisition varies
significantly among its regional laboratories. In many cases, these
variations do not relate to testing volumes or mixes, space costs, service
requirements or regional labor cost differences. To reduce costs, the
Company has begun to replicate the best practices from each region
throughout its national network. Standardization of processes, equipment
and supplies, as well as leveraging of the Company's purchasing power, are
part of this strategy. The Company estimates that it reduced clinical
operating costs by approximately $60 million during 1997 principally due to
these efforts (approximately 25% of such $60 million reduction was due to
reduced volume). The Company expects to achieve significant additional cost
savings during 1998 and 1999 as these programs are fully implemented.*
Despite these efforts, the average cost per requisition increased during
1997 due to the impact of fixed costs on a lower number of requisitions.
However, during 1998 the Company expects that these programs, together with
consolidations of several of the Company's facilities, will result in cost
reductions that exceed the revenue losses associated with any reduced
volume.*
Preferred Partner with Large Buyers. The Company seeks to be the preferred
provider of laboratory testing services to existing and new health care
networks on a selective basis determined by market position and fit between the
Company and the prospective partners. The Company believes that it will become
the preferred partner to these networks as (1) large networks typically prefer
to utilize large independent clinical laboratories that can service them on a
national or regional basis and (2) the Company continues to pursue its primary
strategy of becoming the highest quality, lowest cost provider. To achieve
this, the Company employs a national and regional process to identify
prospective customers and to efficiently allocate resources to support these
efforts. The Company also pursues innovative alliances and seeks to assist its
partners in achieving their business objectives.
o Account Profitability. The Company is refocusing its sales efforts on
pursuing and keeping only those accounts that generate an acceptable profit.
The Company is engaging in an active account management process with current
customers, including those who are providers for managed care organizations,
to evaluate their profitability and, where appropriate, to take action by
increasing pricing, changing the service levels or deselecting accounts that
cannot be serviced profitably. During 1997, the Company provided clear
pricing and service offering guidelines to its sales force and is working to
change the compensation structure of its sales staff so that compensation is
tied more closely to the profitability of (rather than revenues from) its
accounts. The first phase of the account management process, which was
targeted at the Company's smallest accounts, was completed during 1997. The
Company expects to implement the balance of the program, which is targeted at
the Company's entire base of larger accounts, by the end of 1998. Management
expects to achieve significant benefits from these programs within the next
two years, the majority of which are expected to be achieved by the end of
1998.**
o Regional Profitability. The Company presently believes that it has the
leading market share among independent clinical laboratories in most routine
testing markets of the northeast, mid-Atlantic and midwest regions.
Approximately two-thirds of the Company's revenues and almost all of its
earnings before net interest, taxes, depreciation and amortization ("EBITDA")
are generated from these markets. In most of these regions, the Company
believes that it also is among the lowest cost providers. During the last
several years, the Company has incurred operating losses in six regional
laboratories located principally in the south and southwest. During 1997 the
Company took several steps to eliminate excess capacity in four of these
regional laboratories. See "Acquisitions and Consolidations." The Company may
also make selected local acquisitions where appropriate.
Leading Innovator. The Company intends to remain a leading innovator in the
clinical laboratory industry by continuing to develop and introduce new tests,
technology and services. Through its relationship with the academic community
and pharmaceutical and biotech-
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* These are forward looking statements within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and are based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include the impact upon the Company's revenues and expenses
resulting from compliance with Medicare administrative policies; failure to
retain existing customers including by reason of consolidation of certain
laboratories; computer or other system failures; and development of technologies
that substantially alter the practice of medicine. See "Cautionary Statement for
Purposes of the 'Safe Harbor' Provisions of the Private Securities Litigation
Reform Act of 1995." In particular, see factors (c), (d), (f), (g), (j) and (l).
** This is a forward looking statement within the meaning of Section 27A of
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include heightened competition; changes in payor mix; failure to
retain existing customers including by reason of consolidation of certain
laboratories; and computer or other system failures. See "Cautionary Statement
for Purposes of the 'Safe Harbor' Provisions of the Private Securities
Litigation Reform Act of 1995." In particular, see factors (a), (b), (c), (d),
(f) and (g).
Quest Diagnostics Incorporated : 1997 Form 10-K
2
nology firms and its own internal research and development, the Company
believes it is one of the leaders in transferring innovation from academic
biotechnology laboratories to the market. For example, the Company has been
informed by its licensors that it is currently the only national independent
clinical laboratory that is using molecular signal amplification (branched
DNA), polymerase chain reaction (PCR) and nucleic acid sequence-based
amplification (NASBA[TM]) technologies for HIV testing. These technologies
permit the detection of lower levels of HIV than can be achieved using other
technologies, which in turn permits health care providers to better tailor drug
therapies for HIV-infected patients. The Company's esoteric laboratory located
at San Juan Capistrano is one of the leading esoteric testing laboratories in
the world. This esoteric laboratory serves hospitals throughout the country and
counts among its largest customers other independent clinical laboratory
companies. The Company hopes to leverage its existing relationships with
hospitals into increased routine testing for hospitals, which continue to
perform over half of the clinical laboratory testing in the United States.
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The Clinical Laboratory Testing Industry
Clinical testing is a critical component in the delivery of quality health care
service to patients. Currently, clinical laboratory testing is one of the first
steps in determining how a significant portion of all health care dollars are
spent. Laboratory tests and procedures are used generally by physicians and
other health care providers to assist in the diagnosis, evaluation, detection,
monitoring and treatment of diseases and other medical conditions through the
measurement and analysis of chemical and cellular components in blood, tissues
and other specimens. Clinical laboratory testing is generally categorized as
either clinical testing, which is performed on body fluids such as blood and
urine, or anatomical pathology testing, which is performed on tissue and other
samples, including human cells. Clinical and anatomical pathology procedures
are frequently ordered as part of regular physician office visits and hospital
admissions. Most clinical laboratory tests ordered by health care providers are
considered "routine" and can be performed by most independent clinical
laboratories, while "esoteric" tests (which generally require more
sophisticated equipment, materials and personnel) are generally referred to
laboratories, such as the Company's facility in San Juan Capistrano, that
specialize in such tests.
The Company believes that the entire United States clinical laboratory industry
has revenues of approximately $30 billion. The clinical laboratory industry
consists primarily of three types of providers: hospital-affiliated
laboratories, independent clinical laboratories, such as those owned by the
Company, and physician-office laboratories. The Company believes that over half
of the clinical testing in the United States is performed by
hospital-affiliated laboratories, approximately one-third is performed by
independent clinical laboratories and the balance is performed by physicians in
their offices and laboratories.
During 1997, the Company's base clinical testing volume, measured by the number
of test requisitions, declined 7% from 1996. The decline is due largely to
three factors: changes in government and private payor reimbursement policies
intended to reduce costs which have altered physician ordering patterns for
testing; intensified competition, including from hospital outreach laboratories
in several regions; and the Company's strategy of refusing to accept business
that does not meet minimum profitability objectives. The Company believes that
during 1998 clinical testing volume will continue to be negatively impacted by
these factors as well as by the Company's consolidation of several laboratories
during 1998. See "Regulation and Reimbursement-Regulation of Reimbursement for
Clinical Laboratory Services" and "Acquisitions and Consolidations."
On a long term basis, the Company believes that a number of factors are likely
to positively influence the volume of clinical laboratory testing performed in
the United States in the future, including (1) the general aging of the
population in the United States; (2) an expanded base of scientific knowledge
which has led to the development of more sophisticated and specialized tests;
(3) an increase in the awareness of physicians as well as patients of the value
of clinical laboratory testing as a cost-effective means of early detection of
disease and monitoring of treatment; (4) an increase in the number and types of
tests which are, due to advances in technology and increased cost efficiencies,
readily available on a more affordable basis to physicians; (5) expanded
substance-abuse testing by corporations and governmental agencies; and (6)
increased testing for sexually transmitted diseases such as AIDS.
The Company believes that the clinical laboratory industry will continue to be
subject to pricing pressures as a result of (1) continued growth of the managed
care sector; (2) a shift toward capitated payment contracts within the managed
care sector; and (3) decreases in Medicare reimbursement rates. In addition,
increased regulatory requirements in the billing of tests to Medicare are
expected to result in reimbursement reductions and decreased testing volume to
clinical laboratory testing companies in the United States, although in many
cases patients are willing to pay for screening tests that are not paid for by
Medicare. Notwithstanding these factors, as a result of increased focus on
profitability of accounts (See "Busi-
Quest Diagnostics Incorporated : 1997 Form 10-K
3
ness Strategy") the Company's prices for clinical laboratory tests rose 3%
during 1997 from 1996 levels, representing the first average price increases
since 1992.
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Services
The Company's laboratory business is comprised of routine testing, which the
Company's management estimates currently generates approximately 89% of the
Company's net laboratory revenues; and esoteric testing, which is performed at
the esoteric testing facility in San Juan Capistrano, which generates
approximately 9% of the Company's net laboratory revenues. The balance of the
Company's net revenues is derived from the manufacture and sale of clinical
laboratory test kits and from its clinical trials and informatics businesses.
Routine Testing Services and Operations. Routine tests, which are performed at
the Company's regional laboratories, include procedures in the areas of blood
chemistry, hematology, urine chemistry, virology, tissue pathology and
cytology. Commonly ordered individual tests include red and white blood cell
counts, Pap smears, blood cholesterol level tests, HIV-related tests,
urinalyses, pregnancy tests, and alcohol and other substance-abuse tests.
Routine test groups include tests to determine the function of the kidney,
heart, liver and thyroid, as well as other organs, and several health screens
that measure various important bodily health parameters.
The Company provides services through 15 regional laboratories located in major
metropolitan areas throughout the United States, as well as several branch
laboratories, approximately 150 stat laboratories and approximately 800 patient
service centers. The Company also operates a branch laboratory in Mexico.
Regional laboratories offer a full line of routine clinical testing procedures.
"Stat" laboratories are local laboratory facilities where the Company can
quickly perform and report results of certain routine tests for customers that
require such emergency testing services. "Branch laboratories" have a test menu
that is smaller than that of regional laboratories but larger than that of stat
laboratories. A "patient service center" is a facility maintained by the
Company, typically in or near a medical professional building, to which
patients can be referred by physicians for specimen collection. The Company is
in the process of consolidating certain of its branch and regional
laboratories. See "Acquisitions and Consolidations."
The Company operates 24 hours a day, 365 days a year, utilizing a fully
integrated collection and processing system. The Company generally performs and
reports most routine procedures within 24 hours, employing a variety of
sophisticated and computerized laboratory testing instruments. On an average
week day, the Company processes approximately 200,000 requisitions. The Company
provides daily pickup of specimens from most customers principally through an
in-house courier system. The specimens are sent to one of the Company's
laboratories (generally a regional or branch laboratory) where one or more
tests are performed.
Each patient specimen is generally accompanied by a test requisition form,
which is completed by a physician, that indicates the tests to be performed and
provides the necessary billing information. Each specimen and related
requisition form is checked for completeness and then given a unique bar-coded
identification number. The unique identification number assigned to each
specimen helps to assure that the results are attributed to the correct
patient. The requisition form is sent to specimen processing and billing
departments where a file is established for each patient and the necessary
testing and billing information is entered. Once this information is entered
into the computer system, the tests are performed and the results are entered,
primarily through computer interface or manually, depending upon the type of
testing equipment involved. Most of the Company's automated testing equipment
is directly linked with the Company's information systems. Most routine testing
is performed and completed during the evening and test results are readied for
distribution the following morning either electronically or by service
representatives. Many customers have local printer capabilities enabling
laboratory medical reports to be printed in their offices. Customers who
request that they be called with a result are so notified in the morning. It is
the Company's policy to notify the customer immediately if a life-threatening
result is found at any point during the course of the testing process.
Esoteric Testing Services and Operations. As a result of the acquisition of
Nichols Institute in 1994, the Company operates one of the leading esoteric
clinical testing laboratories in the world. Esoteric tests are performed in
cases where the information provided by routine tests is not specific enough or
is inconclusive as to the existence or absence of disease or when a physician
requires more information. Unlike routine testing, only one test is typically
ordered and performed per requisition. The logistics for esoteric testing are
similar to those for routine testing except that, due to the complexity of the
testing, approximately 60% of the tests are performed within 24 hours, with
almost all of the rest being performed within one week.
Esoteric tests generally require more sophisticated equipment and materials as
well as more highly skilled personnel to perform test procedures and analyze
results than what are required for routine testing.
Quest Diagnostics Incorporated : 1997 Form 10-K
4
Consequently, esoteric tests are generally priced substantially higher than
routine tests. New medical discoveries lead to the development of new esoteric
tests. However, over time esoteric tests may become routine tests as a result
of improved technology or increased volume. The volume of esoteric tests
required by most health care providers, including hospitals, is relatively low
compared to the volume of routine tests. Because it is generally not cost
effective for such health care providers to perform the low volume of esoteric
tests in-house, a significant portion of esoteric tests are referred to
clinical laboratories like the Company's esoteric laboratory at San Juan
Capistrano that specialize in such tests. Some examples of esoteric testing
procedures include capillary electrophoresis, cell culture technology, certain
chemiluminescent immunoassays, certain enzyme immunoassays, flow cytometry,
fluorescent in situ hybridization (FISH), inductively coupled plasma mass
spectroscopy (ICPMS), molecular tissue pathology, molecular signal
amplification (branched DNA), and polymerase chain reaction (PCR) technologies.
The Company's esoteric testing laboratory offers tests or "assays" in such
fields as endocrinology, genetics, immunology, microbiology, molecular biology,
oncology, serology, special chemistry and toxicology. The Company believes that
it is one of the leaders in transferring technological innovation from academic
biotechnology laboratories to the marketplace. The Company's Nichols Institute
was the first to introduce a number of tests, including immunoassay methods for
measurement of circulating hormone levels and sensitive tests to predict breast
cancer prognosis. Among more recent developments have been tests to detect a
variety of tumor types, a common form of mental retardation, leukemia, cystic
fibrosis, osteoporosis, hepatitis and neurological disorders and to monitor the
success of therapy for cancer and AIDS. The use of technologies such as
branched DNA, PCR and nucleic acid sequence-based amplification permit the
detection of lower levels of HIV than can be achieved under other technologies.
The ability to measure the amount of HIV permits health care providers to
better tailor drug therapies for HIV-infected patients. These techniques can be
applied to a variety of infectious agents. The Company has also expanded its
capabilities in molecular diagnostics by offering important gene sequencing
testing for an inherited cancer disorder in endocrinology (the Ret gene) and
resistance to drug therapy in HIV infection. As part of its research and
development efforts, the Company maintains a relationship with the academic
community through its Academic Associates program, under which approximately
sixty scientists from academia and biotechnology firms work directly with the
Company's staff scientists to monitor and consult on existing test procedures
and develop new esoteric test methods. In addition, the Company relies on
internal resources for the development of new tests as well as on license
arrangements and co-development agreements with biotechnology companies and
academic medical centers.
The Company also provides clinical laboratory testing in connection with
pre-marketing clinical trials of pharmaceutical drugs. Net revenues from such
testing accounted for less than 1% of the Company's net revenues in 1997.
Diagnostic Test Kits. Through its Nichols Institute Diagnostics subsidiaries,
which were acquired as a result of the acquisition of Nichols Institute in
August 1994, the Company manufactures and markets clinical laboratory kits
primarily for esoteric testing. Test kits are sold principally to hospital and
clinical laboratories. Nichols Institute Diagnostics is currently awaiting
approval from the Food and Drug Administration for its first cancer diagnostic
products, which will be featured on its recently launched Nichols Advantage[TM]
automated assay system.
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Customers and Payors
The Company provides testing services to a broad range of health care
providers. The primary types of customers served by the Company are as follows:
Independent Physicians and Physician Groups. Physicians requesting testing for
their patients who are unaffiliated with a managed care plan remain the
principal source of the Company's clinical laboratory business. Fees for
clinical laboratory testing services rendered for these physicians are billed
either to the physician, to the patient, or to the patient's third-party payor
such as an insurance company, Medicare or Medicaid. In several states,
including New York, New Jersey and Michigan, the Company is required to bill
patients directly. The clinical laboratory industry is supporting legislative
efforts to expand direct patient billing. Billings are typically on a
fee-for-service basis. If the billings are to the physician, they are based on
the laboratory's client fee schedule and are typically subject to negotiation.
Otherwise, the billings are based on the laboratory's patient fee schedule,
subject to limitations on fees imposed by third parties and to negotiation by
physicians on behalf of their patients. Reimbursement from Medicare and
Medicaid billings is based on fee schedules set by governmental authorities.
See "Regulation and Reimbursement."
HMOs and Other Managed Care Groups. HMOs and other managed care organizations
typically contract with a limited number of clinical laboratories and then
Quest Diagnostics Incorporated : 1997 Form 10-K
5
designate the laboratory or laboratories to be used for tests ordered by their
participating physicians. In an effort to control costs, the managed care
groups generally negotiate discounts to the fees usually charged by such
laboratories or negotiate capitated payment contracts, whereby the clinical
laboratory receives a monthly fee per enrolled individual. The fixed monthly
payment generally covers all laboratory tests performed during the month,
regardless of the number or cost of tests actually performed. Such contracts
shift the risks of additional routine testing beyond that covered by the
capitated payment to the clinical laboratory. In certain cases, however, the
monthly payment may be subject to prospective or retroactive adjustment if the
number of tests performed exceeds (or is less than) certain thresholds. The
types of tests covered by capitated contracts are negotiated for each contract,
with esoteric tests and anatomic pathology services frequently being billed on
a fee-for-service basis rather than being covered under the capitation rate.
Large regional and national HMOs and preferred provider organization networks
typically prefer to use large independent clinical laboratories such as the
Company that can service the managed care groups on a national or regional
basis. See "Effect of the Growth of the Managed Care Sector on the Clinical
Laboratory Business."
Hospitals. The Company provides to approximately half of the hospitals in the
country services that vary from providing esoteric testing to management
contracts, where the Company manages the hospital's laboratory for a fee.
Hospitals generally maintain an on-site laboratory to perform testing on
patients receiving care and refer less frequently needed procedures and highly
specialized procedures to outside laboratories. Hospitals are typically charged
for such tests on a negotiated fee-for-service basis which is based on the
laboratory's customer fee schedule. Many hospitals actively encourage community
physicians to send their testing to the hospital's laboratory. In addition,
many hospitals have been purchasing physician practices and requiring that
their employed physicians send their testing to the hospital's affiliated
laboratory. Hospitals have also been seeking to expand their commercial
outreach business. As a result, hospital-affiliated laboratories can be both a
customer and a competitor for independent clinical laboratories such as the
Company. Hospitals perform over half of the clinical laboratory testing
performed in the United States.
Other Institutions. The Company also serves other institutions, including
governmental agencies, such as the Department of Defense and prison systems,
large employers and independent clinical laboratories that do not have the full
range of the Company's testing capabilities. These institutions are typically
charged on a negotiated or bid fee-for-service basis. The Company's services to
employers principally involve the provision of substance abuse testing services
and occupational medicine. The Company is expanding its capabilities so that it
can serve a broader range of employer customers.
In 1997, no single customer or affiliated group of customers accounted for more
than 2% of the Company's net revenues. The Company believes that the loss of
any one of its customers would not have a material adverse effect on the
Company's results of operations or cash flows.
Payors. Most clinical laboratory testing is billed to a party other than the
patient or the physician "customer" that ordered the test. Tests performed for
various patients of a single physician may be billed to different payors
besides the ordering physician, including third-party payors (generally
insurance companies and managed care organizations), Medicare, Medicaid or the
patient.
The following table sets forth current estimates of the breakdown by payor of
the Company's total volume of requisitions and average approximate revenues per
requisition:
Requisition Volume Revenue
as % of Total Per Requisition
-------------------------------------
Patient 5%-10% $60-$80
Medicare & Medicaid 20%-25% $20-$30
Monthly Bill (Physician,
Hospital, Employer, Other) 35%-40% $15-$35
Third Party Fee-For-Service 15%-20% $30-$40
Managed Care-Capitated 15%-20% $ 5-$15
For a discussion of the mix shift and the impact of the managed care sector on
volume and price trends, see "Effect of the Growth of the Managed Care Sector
on the Clinical Laboratory Business."
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Sales and Marketing
The Company markets and services its customers through its direct sales force,
as well as through its account representatives and couriers.
Most sales representatives market the mainstream or traditional routine
laboratory services primarily to physicians, while others concentrate on
individual market segments, such as hospitals or managed care organizations, or
on testing niches, such as substance abuse testing. The Company's sales
representatives are compensated through a combination of salaries, commissions
and bonuses, at levels commensurate with each individual's qualifications and
responsibilities. The Company is cur-
Quest Diagnostics Incorporated : 1997 Form 10-K
6
rently changing the compensation structure of its sales force so that
compensation is tied more closely to the profitability of (rather than revenues
from) its accounts. See "Business Strategy-Preferred Partner with Large
Buyers."
The Company's account representatives interact with customers on an ongoing
basis. Account representatives monitor the status of services being provided to
customers, act as problem-solvers, provide information on new testing
developments and serve as the customer's regular point of contact with the
Company. Account representatives are compensated with a combination of salaries
and bonuses commensurate with each individual's qualifications and
responsibilities.
The Company believes that the clinical laboratory service business is shifting
away from the traditional direct to physician sales structure and into one in
which the purchasing decisions for laboratory services are increasingly made by
physician groups and networks, managed care organizations, integrated health
delivery systems, insurance plans, hospitals or hospital groups, employers and
by patients themselves. In view of these changes, the Company has developed
regional market strategies and has reorganized its sales and marketing
organization structure to support these strategies and emerging customers.
The Company believes that, given the increasing regulation and complexity of
the clinical laboratory marketplace, training of its sales force is of
paramount importance. With this goal in mind, since 1995 the Company has
enhanced its comprehensive sales training program and compliance training. See
"Compliance Program."
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Effect of the Growth of the Managed Care Sector on the Clinical Laboratory
Business
The managed care industry is growing as well as undergoing rapid consolidation
which has created large managed care companies that control the delivery of
health care services for tens of millions of people, and have significant
bargaining power in negotiating fees with health care providers, including
clinical laboratories. The Company believes that there are opportunities for
large, high quality, low cost, clinical laboratories such as the Company to
capture additional testing volume from managed care organizations. The larger
regional and national managed care organizations typically prefer to use large
independent clinical laboratories, like the Company, that can service their
organizations on a national or a regional basis. In addition, smaller
laboratories are unlikely to be able to achieve the low cost structures
necessary to profitably service managed care organizations.
The growth of the managed care sector presents various challenges to
independent clinical laboratories, including the Company. Managed care
organizations frequently negotiate capitated payment contracts, whereby the
clinical laboratory receives a monthly fee per enrolled individual. The fixed
monthly payment generally covers all laboratory tests (excluding certain tests,
such as esoteric tests and anatomic pathology services) performed during the
month, regardless of the number or cost of the tests performed. Unlike
fee-for-service indemnity insurance, such contracts shift the risks of
additional routine testing beyond that covered by the capitated payment to the
clinical laboratory. In certain cases, however, the monthly payment may be
subject to prospective or retroactive adjustment if the number of tests
performed exceeds (or is less than) certain thresholds. The Company expects the
amount of clinical laboratory testing performed for managed care organizations
under capitated rate agreements to continue to grow.
Laboratory services agreements with managed care organizations have
historically been priced aggressively due to competitive pressures and the
expectation that a laboratory would capture not only the volume of testing
covered under the contract, but also additional fee-for-service business from
patients of participating physicians who are not covered under the managed care
plan. However, as the number of patients covered under managed care plans
continues to increase, there is less such fee-for-service business and,
accordingly, less profitable business to offset the low margin (and often
unprofitable) managed care business. Furthermore, increasingly, physicians are
affiliated with more than one managed care organization and as a result may be
required to refer clinical laboratory tests to different clinical laboratories,
depending on the coverage of their patients. As a result, a clinical laboratory
might receive little if any fee-for-service testing from such physicians. The
level of pricing charged to managed care organizations, including those under
capitated payment contracts, if continued, may adversely affect the clinical
laboratory industry.
The Company believes that the prices charged by the independent clinical
laboratory testing companies to managed care organizations must be increased.
The Company continues to review its pricing structures for agreements with
managed care organizations and intends to continue to negotiate price increases
for those agreements that are not profitably priced. Further, to obtain a wider
market presence, the Company has developed a centralized organization to ensure
consistent standards of practice and uniform approaches and to better respond
to and address the needs of national managed care plans. However, there can be
no assurance that the Company will be able to increase the prices charged to
managed care organizations or that the Company will not lose market share in
the managed care market to other clinical laboratories who continue to
aggressively price laboratory ser-
Quest Diagnostics Incorporated : 1997 Form 10-K
7
vices agreements with managed care organizations. The Company, as part of its
preferred partner strategy, will seek to secure large-volume, profitable
managed care contracts through providing low cost, high quality testing
services at rational prices.
- --------------------------------------------------------------------------------
Expansion Opportunities
The Company believes that there are several expansion opportunities which it
can take advantage of without incurring significant capital expenditures or
deploying significant resources.
Hospital Alliances. In response to the growth of the managed care sector and
the developments described under "Effect of the Growth of the Managed Care
Sector on the Clinical Laboratory Business," many health care providers have
established new alliances. Hospital-physician networks are emerging in many
markets to offer comprehensive, integrated service capabilities, either to
managed care plans or directly to employers.
Since the Company has traditionally derived a substantial portion of its
esoteric testing revenues from referrals from hospitals, which perform over
half of all clinical laboratory tests in the United States, the Company has
established a hospital alliance group whose primary goal is to develop
additional nontraditional hospital arrangements, including management and
consulting agreements, shared service and outsourcing arrangements and joint
ventures.
Under federal cost containment legislation enacted in 1985, treatment provided
to hospital inpatients covered by Medicare is classified into diagnosis-related
groups ("DRGs") which prescribe the maximum reimbursable payments for all
services, including laboratory testing services, provided on behalf of an
inpatient under each DRG. As a result of this payment structure, and similar
price constraints from managed care organizations and other third-party payors,
hospitals have an economic incentive to seek the most cost-effective laboratory
testing services for their patients. The Company believes that in many cases, by
entering into arrangements such as those described in the preceding paragraph,
the Company can improve a hospital laboratory's economic structure and preserve
hospital capital that would be required for needed laboratory improvements while
providing accurate and timely testing services due to greater economies of
scale, increased utilization of expensive testing and data processing equipment
through optimization of the mix between on-site and off-site testing and more
efficient use of laboratory employees. The Company has several such arrangements
with hospitals, including a joint venture established during July 1997 with
Samaritan Health System, a leading integrated health care delivery network in
Arizona; and a joint venture with approximately twenty hospitals in northwestern
Pennsylvania and southwestern New York. These laboratory arrangements, which
provide testing for the hospitals as well as unaffiliated physicians and other
health care providers in their geographical areas, serve as two of the Company's
laboratory facilities. The Company also has outsource agreements with a group of
approximately 25 hospitals in eastern Nebraska and manages the laboratories of
those hospitals. In addition, the Company also manages the laboratories at
several hospitals in the eastern United States. However, despite the potential
cost savings and additional revenues available to hospitals through such
arrangements, the Company believes that only a small percentage of the hospitals
in the United States have entered into such arrangements with independent
clinical laboratories. Nonetheless, the Company expects to enter into alliances
and outsource arrangements with a number of hospitals in the future.* The
Company has signed a letter of intent with UPMC (University of Pittsburgh
Medical Center) Health System to operate through a joint venture a clinical
laboratory utilizing the Company's existing laboratory facility in Pittsburgh.
Medical Information. The market need for medical information, particularly
disease-specific information about provider practices and patient care, is
growing rapidly. Large customers of clinical laboratories are increasingly
interested in using information from clinical laboratory data on their covered
populations to answer financial, marketing and quality related questions.
Integrated data from clinical laboratories and other health encounters provides
additional insights to these questions. To meet these emerging needs, the
Company created Quest Informatics, a division which focuses on the medical
information needs of managed care organizations, integrated health care
delivery networks, pharmaceutical companies, and other large customers. Through
internal development, the Company now has a portfolio of information products,
based primarily upon the Company's extensive database, that assist large
customers in delivering more effective health care to their patients. A
combination of advanced information technology and experienced analytical and
data integration skills provides the platform for delivery of these products.
- --------------------------------------------------------------------------------
* This is a forward looking statement within the meaning of Section 27A of
the Securities Act of 1933, as amended, and Section 27E of the Securities Act
of 1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and uncer-
tainties include increased competition from hospitals in the commercial out-
reach market. See "Cautionary Statement for Purposes of the 'Safe Harbor'
Provisions of the Private Securities Litigation Reform Act of 1995". In par-
ticular see factor (a).
Quest Diagnostics Incorporated : 1997 Form 10-K
8
As market interest has increased, Quest Informatics has devoted experienced
account executives to work with customers to meet their information needs.
Current information products include provider profiles and benchmarks,
high-risk patient registries based on customer disease management initiatives,
normative comparisons with other populations, and quantitative clinical
outcomes based on laboratory measures. Pharmaceutical customers have interest
in clinical data to expand sales and marketing efforts as well as to promote
disease management initiatives. The Company believes that health care customers
will increasingly see value in the information obtained from clinical
laboratory results.
- --------------------------------------------------------------------------------
Information Systems
The need for information systems to support laboratory, billing, customer
service, logistics, medical data, and other business requirements is
significant and will continue to place high demands on the Company's
information systems staff. The Company has historically not standardized the
billing, laboratory and other information systems at laboratories that it has
acquired. As a result, the Company has numerous different information systems
to handle billing, test result reporting and financial data and transactions.
The Company believes that the efficient handling of information involving
customers, patients, payors, and other parties will be critical to the
Company's future success. The Company is committed to building a standardized
company-wide infrastructure, including an information technology environment
that is Year 2000 compliant. To lead this effort, in November 1997 the Company
hired Gerald Marrone as its Senior Vice President and Chief Information
Officer. Mr. Marrone previously was with Citibank, N.A. for 12 years, most
recently serving as Vice President, Division Executive for Citibank's global
production support division. Mr. Marrone was also the Chief Information Officer
for Citibank's global cash management business. Prior to joining Citibank, Mr.
Marrone was the Chief Information Officer at Memorial Sloan-Kettering Cancer
Center for five years.
The Company has chosen its SYS billing system as its standard billing system and
its QuestLab system (which is licensed from a third party) as its standard
laboratory information system. The Company believes that both of these systems
are substantially Year 2000 compliant. The SYS billing system, which in March
1998 will become operational in the New York/New Jersey (Teterboro) regional
laboratory, has already been implemented in sites that, after giving effect to
the closing of certain facilities (see "Acquisitions and Consolidations") and
the conversion of the Teterboro laboratory, account for approximately 57% of
the Company's net revenues. The QuestLab laboratory information system is
already operational in sites that, after giving effect to the closing of certain
facilities, account for approximately 35% of the Company's net revenues. Five of
these sites also have the standard SYS billing system. The Company is continuing
to convert the remaining nonstandard billing and laboratory systems to the
standard systems, prioritized on a basis intended to minimize the cost of making
non-standardized systems Year 2000 compliant. The Company expects that by June
30, 1999, as a result of additional conversions, billing sites representing 71%
of its 1997 net revenues will be utilizing its SYS system; and laboratory sites
accounting for 61% of its 1997 net revenues will be utilizing its QuestLab
system; and the Company's remaining non-standard billing and laboratory systems
will have been made Year 2000 compliant.* The conversion costs are expected to
average approximately $3 million per billing system and $1 million to $3 million
per laboratory system.* As more billing sites are converted to the standard
billing system, consolidation of billing sites is expected to occur, which will
reduce overall conversion costs and improve billing efficiencies.* The Company
expects that its total capital expenditures during 1998 and 1999, including
spending on its information systems, will be between approximately $60 million
and $70 million per year.* In addition, the Company expects to incur during 1998
and 1999 an additional $25 million to $35 million in non-capitalized expenses in
making its systems Year 2000 compliant.*
The Company is developing systems that will permit managed care organizations
and other providers to have electronic access to place test orders and receive
results for participating physicians, which will permit managed care
organizations to better monitor and control the utilization of testing
services.
- --------------------------------------------------------------------------------
Billing
Billing for laboratory services is a complicated process. Laboratories must
bill different payors such as patients, insurance companies, Medicare,
Medicaid, doctors, and employer groups, all of whom have different billing
requirements. A significant portion of the Company's bad debt expense is the
result of many non-credit
- --------------------------------------------------------------------------------
* These are forward looking statements within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and are based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include computer or other system failures, including failure
resulting from the Year 2000 problem, the impact of compliance with Medicare
administrative policies, and development of technologies that substantially
alter the practice of medicine. See "Cautionary Statement for Purposes of the
'Safe Harbor' Provisions of the Private Securities Litigation Reform Act of
1995." In particular see factors (d), (j), (k), and (l).
Quest Diagnostics Incorporated : 1997 Form 10-K
9
related issues, primarily missing or incorrect billing information on
requisitions which slow the billing process, create backlogs of unbilled
requisitions and generally increase the aging of accounts receivable.
Approximately 10% of the requisitions that the Company receives either do not
provide all the necessary data or provide incorrect data. The Company believes
that this experience is similar to that of its primary competitors. The Company
performs the requested tests and reports back the test results regardless of
whether billing information has been provided at all or has been provided
incorrectly. The Company subsequently attempts to obtain any missing information
and rectify any incorrect billing information received from the health care
provider. Among the many other factors complicating the billing process are
pricing differences between the fee schedules of the Company and the payor,
disputes between payors as to the party responsible for payment of the bill and
auditing for specific compliance issues. Ultimately, if all issues are not
resolved in a timely manner, the related receivables are charged to the
allowance for doubtful accounts.
The Company's bad debt expense increased from 1993 to 1995 due principally to
increased complexity in the health care system, including changes in
reimbursement policies of Medicare carriers and third party payors, that further
complicated the billing process. This increased complexity has placed additional
requirements on the billing process, including the need for specific test
coding, additional research on processing rejected claims, increased audits for
compliance, and management of a large number of contracts which have very
different information requirements for pricing and reimbursement. The Company
has improved its management of these requirements and bad debt expense was
reduced substantially in 1996 and 1997 from 1995 levels. See "Management's
Discussion and Analysis of Financial Condition and Results of Operations." The
Company's billing has also been hampered by the existence of multiple billing
information systems. In 1995 the Company had severe billing problems at its
largest laboratory site in Teterboro, New Jersey. A new (but subsequently
abandoned) billing information system developed with outside consultants
experienced significant implementation problems, including excessive downtime,
which severely impacted the Company's ability to efficiently bill for its
services from the Teterboro location. The problem was compounded by a lack of
experienced staff as the result of work force reductions made to meet cost
reduction initiatives undertaken in anticipation of greater efficiencies from
the new billing information system. As a result of all of these factors, the
Company recorded a charge to bad debt expense of $62 million in the third
quarter of 1995. Of this amount, approximately $35 million was attributable to
the Teterboro location. During the third quarter of 1996 the Company decided to
abandon the new billing system and recorded a charge of $13.7 million to write
off capitalized software.
Integration of a standardized billing system is a priority of the Company and
the Company is in the process of implementing the SYS billing system, which has
generally proven reliable, throughout its network. The use of a standard system
will also provide for operational efficiencies as redundant programming efforts
are eliminated and the ability to consolidate billing sites will become more
feasible. See "Information Systems." Standardizing billing systems presents
conversion risk to the Company as key databases and masterfiles are transferred
to the SYS system and because the billing workflow is interrupted during the
conversion, which may cause backlogs. The Company has retained key people who
have been involved in prior conversions.
The Company has concentrated on improving its billing operations in the last two
years. Since the third quarter of 1995, the Company has achieved significant
reductions in unbilled requisitions; days sales outstanding; bad debt expense as
a percentage of net revenues; the percentage of requisitions received with
missing billing information; and backlogs in rejected claims, unapplied cash and
customer correspondence. These improvements were achieved in spite of a higher
level of information requirements necessary for correct billing, especially
those bills relating to Medicare. See "Regulation and Reimbursement-Regulation
of Reimbursement for Clinical Laboratory Services."
- --------------------------------------------------------------------------------
Acquisitions and Consolidations
MetPath, the Company's predecessor, originally commenced operations with a
laboratory only in the New York metropolitan area. Most of the Company's other
regional laboratories have been added through acquisitions. Principally as the
result of acquisitions that were completed in 1993 and 1994, the Company's
revenues have almost tripled since 1991. However, this increase in revenues is
not reflected in the historical financial data because several of the major
acquisitions are accounted for as poolings of interests and accordingly prior
financial statements have been restated on a combined basis. Acquisition
activity has diminished significantly since the end of 1994, in part so that the
Company could concentrate on the integration of the laboratory networks that had
been acquired in 1993 and 1994. Future acquisition efforts are expected to focus
on smaller laboratories that can be integrated into existing laboratories where
the Company can expect to achieve significant cost savings and other benefits
resulting from the elimination of redundant facilities and equipment and
reductions in personnel.
Quest Diagnostics Incorporated : 1997 Form 10-K
10
During 1997 the Company completed one such acquisition, Diagnostic Medical
Laboratory, a laboratory based in Connecticut that had duplicate operations
that have since been merged into the Company's operations.
The Company believes that it and the clinical laboratory industry at large
operate significantly below available capacity. During 1997 the Company took
several steps to eliminate excess capacity. In July the Company formed a joint
venture with Samaritan Health System ("Samaritan"), a leading integrated health
care delivery network in Arizona. The Company and Samaritan contributed their
existing laboratory assets in Arizona to the joint venture (known as Sonora
Quest Laboratories), which is now the leading clinical laboratory in the
Arizona market. Integration of the two systems is expected to be complete by
the end of 1998, thereby eliminating duplicative costs and improving financial
results. The joint venture is accounted for as an equity investment. During the
fourth quarter of 1997, the Company decided to convert two of its regional
laboratories (Atlanta and Tampa) into stat laboratories and local customer
centers, downsize one other regional laboratory (St. Louis) and several branch
laboratories (Indianapolis, Buffalo, Columbus and Cleveland), and transfer
testing currently performed at these laboratories to other of the Company's
laboratories. The total cash outlays associated with these consolidations is
expected to be approximately $40 million before taxes. By the beginning of
1999, when the consolidations are fully implemented, net annual benefits are
expected to be in excess of $20 million before taxes, although volume and
revenue are expected to be affected negatively by these consolidations.*
- --------------------------------------------------------------------------------
Competition
The clinical laboratory testing business is intensely competitive. As recently
as 1993, there were seven independent clinical laboratories that provided
clinical laboratory testing services on a national basis: the Company,
SmithKline Beecham Clinical Laboratories Inc. ("SmithKline"), National Health
Laboratories Inc. ("NHL"), Roche Biomedical Laboratories Inc. ("Roche"), Damon
Corporation ("Damon"), Allied Clinical Laboratories Inc. ("Allied") and Nichols
Institute. In April 1995 Roche merged into NHL (under the name Laboratory
Corporation of America Holdings ("LabCorp")), which had acquired Allied in June
1994. The Company acquired Damon in August 1993 and Nichols Institute in August
1994. In addition, in the last several years a number of large regional
laboratories have been acquired by national clinical laboratories. There are
presently three national independent clinical laboratories: the Company, which
had approximately $1.5 billion in revenues from clinical laboratory testing in
1997; LabCorp, which had approximately $1.5 billion in revenues from clinical
laboratory testing in 1997; and SmithKline, which had approximately $1.4 billion
in revenues from clinical laboratory testing in 1997. Both LabCorp and
SmithKline are affiliated with large corporations that have greater financial
resources than the Company. F. Hoffman La Roche Ltd. beneficially owns
approximately 49.9% of the outstanding capital stock of LabCorp; SmithKline is
wholly owned by SmithKline Beecham Ltd.
In addition to the three national clinical laboratories, the Company competes
on a regional basis with many smaller regional and local independent clinical
laboratories as well as laboratories owned by hospitals and physicians. The
Company has the leading market share in most of the northeast, mid-Atlantic and
midwest routine testing markets, while its market share is much lower in the
routine testing market in the rest of the country. The Company does not
generally compete in the California routine testing market other than in the
San Diego metropolitan area.
The independent clinical laboratory industry has experienced intense price
competition over the past several years, which has negatively impacted the
Company's profitability. However, pricing (measured by the average revenue per
requisition) remained relatively stable during 1996 and in 1997 increased by 3%
from 1996 levels. See "Customers and Payors."
The Company believes that the following factors, among others, are often used
by health care providers in selecting a laboratory: (i) pricing of the
laboratory's testing services; (ii) accuracy, timeliness and consistency in
reporting test results; (iii) number and type of tests performed; (iv) service
capability and convenience offered by the laboratory; and (v) its reputation in
the medical community. The Company believes that it competes favorably with its
principal competitors in each of these areas and is currently implementing
strategies to improve its competitive position. See "Business Strategy."
- --------------------------------------------------------------------------------
* This is a forward looking statement within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include the impact upon the Company's revenues and expenses
resulting from compliance with Medicare administrative policies; failure to
retain existing customers including by reason of consolidation of certain
laboratories; computer or other system failures; and development of
technologies that substantially alter the practice of medicine. See "Cautionary
Statement for Purposes of the 'Safe Harbor' Provisions of the Private
Securities Litigation Reform Act of 1995." In particular, see factors
(c),(d),(f),(j) and (k).
Quest Diagnostics Incorporated : 1997 Form 10-K
11
The Company believes that consolidation will continue in the clinical laboratory
testing business. In addition, the Company believes that it and the other large
independent clinical laboratory testing companies may be able to increase their
share of the overall clinical laboratory testing business due to a number of
external factors, including cost efficiencies afforded by large- scale automated
testing, Medicare reimbursement reductions and the growth of managed health care
entities which require low-cost testing services and large service networks.* In
addition, legal restrictions on physician referrals and the ownership of
laboratories as well as increased regulation of laboratories are expected to
contribute to the continuing consolidation of the industry.
- --------------------------------------------------------------------------------
Quality Assurance
The Company maintains a comprehensive quality assurance program for all of its
laboratories and patient service centers. The goal is to ensure optimal patient
care by continually improving the processes used for collection, storage and
transportation of patient specimens, as well as the precision and accuracy of
analysis and result reporting.
The Company's quality assurance efforts focus on proficiency testing, process
audits, statistical process control and personnel training.
Internal Quality Control and Audits. Quality control samples are processed in
parallel with the analysis of patient specimens. The results of tests on such
samples are then monitored to identify drift, shift or imprecision in the
analytical processes. In addition, the Company administers an extensive internal
program of "blind" proficiency testing. These samples are processed through the
Company's systems as routine patient samples, unknown to the laboratory as
quality control samples and reported. This provides a system to assure accuracy
of the entire pre- and post-analytical testing process. Another element of the
Company's comprehensive quality assurance program includes performance of
internal process audits.
External Proficiency Testing and Accreditation. All of the Company's
laboratories participate in numerous externally conducted, blind sample quality
surveillance programs. These include proficiency testing programs administered
by the College of American Pathologists ("CAP"), as well as many state agencies.
These programs supplement all other quality assurance procedures.
All of the Company's laboratories are accredited by CAP. Accreditation includes
on-site inspections and participation in the CAP Proficiency Test Program. CAP
is an independent nongovernmental organization of board certified pathologists
that offers an accreditation program to which laboratories may voluntarily
subscribe. CAP is approved by the Health Care Financing Administration ("HCFA")
to inspect clinical laboratories to determine compliance with the standards
required by the Clinical Laboratory Improvement Amendments of 1988 ("CLIA").
- --------------------------------------------------------------------------------
Regulation and Reimbursement
Overview. The clinical laboratory industry is subject to significant
governmental regulation at the federal and state levels. All of the Company's
laboratories and patient service centers are appropriately licensed and
accredited by various federal and state agencies.
The health care industry is undergoing significant change as third-party
payors, such as Medicare (which principally serves patients aged 65 years and
older), Medicaid (which principally serves indigent patients), private insurers
and large employers increase their efforts to control the cost, utilization and
delivery of health care services. In an effort to address the problem of
increasing health care costs, legislation has been proposed or enacted at both
the federal and state levels to regulate health care delivery in general and
clinical laboratories in particular. Some of the proposals include managed
competition, global budgeting and price controls. Although the Clinton
Administration's health care reform proposal, initially advanced in 1994, was
not enacted, such proposal or other proposals may be considered in the future.
In particular, the Company believes that reductions in reimbursement for
Medicare services may continue to be implemented from time to time. Reductions
in the reimbursement rates of other third-party payors are likely to occur as
well. The Company cannot predict the effect health care reform, if enacted,
would have on its business, and there can be no assurance that such reforms, if
enacted, would not have a material adverse effect on the Company's business and
operations.
Regulation of Clinical Laboratory Operations. CLIA extends federal oversight to
virtually all clinical laborato-
- --------------------------------------------------------------------------------
* This is a forward looking statement within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include heightened competition; impact of changes in payor mix;
adverse actions by Medicare and other third party payors; computer or other
system failures; and development of technologies that substantially alter the
practice of medicine. See "Cautionary Statement for Purposes of the 'Safe
Harbor' Provisions of the Private Securities Litigation Reform Act of 1995." In
particular, see factors (a), (b), (c), (d), (j) and (l).
Quest Diagnostics Incorporated : 1997 Form 10-K
12
ries by requiring that laboratories be certified by the government. Many
clinical laboratories must also meet governmental quality and personnel
standards, undergo proficiency testing and be subject to biennial inspection.
Rather than focusing on location, size or type of laboratory, this extended
oversight is based on the complexity of the tests performed by the laboratory.
The CLIA standards were designed to ensure that all clinical laboratory testing
services are uniformly accurate and of high quality by using a single set of
requirements. The final rules implementing CLIA generally became effective in
1992. These regulations extended federal oversight, with few exceptions, to
virtually all clinical laboratories regardless of size, type, location or
ownership of the laboratory. The standards for laboratory personnel, quality
control, quality assurance and patient test management are based on complexity
and risk factors. Laboratories categorized as "high" complexity are required to
meet more stringent requirements than either "moderate" or "waived" (performing
only tests regarded as having a low potential for error and requiring little or
no oversight) laboratories.
All of the Company's regional and branch laboratories and most of the Company's
stat laboratories are categorized as high complexity and these laboratories are
in compliance with the more stringent standards for personnel, quality control,
quality assurance and patient test management. A few of the Company's
laboratories are categorized as moderate complexity (some stat laboratories) or
waived (only patient service centers). The sanction for failure to comply with
these regulations may be suspension, revocation or limitation of a laboratory's
CLIA certificate necessary to conduct business, significant fines or criminal
penalties. The loss of a license, imposition of a fine or future changes in such
federal, state and local laws and regulations (or in the interpretation of
current laws and regulations) could have a material adverse effect on the
Company.
The Company is also subject to state regulation. CLIA permits states to adopt
regulations that are more stringent than federal law. For example, state law
may require that laboratory personnel meet certain more stringent
qualifications, specify certain quality control standards, maintain certain
records and undergo additional proficiency testing. For example, certain of the
Company's laboratories are subject to the State of New York's clinical
laboratory regulations, which contain certain provisions that are significantly
more stringent than federal law on the same matters.
The Company believes it is in material compliance with the foregoing standards.
See "Compliance Program."
Drug Testing. Drug testing for public sector employees is regulated by the
Substance Abuse and Mental Health Services Administration ("SAMHSA") (formerly
the National Institute on Drug Abuse), which has established detailed
performance and quality standards that laboratories must meet in order to be
approved to perform drug testing on employees of federal government contractors
and certain other entities. To the extent that the Company's laboratories
perform such testing, each must be certified by the Department of Health and
Human Services ("HHS") as meeting SAMHSA standards. Eight of the Company's
laboratories are SAMHSA certified.
Controlled Substances. The use of controlled substances in testing for drug
abuse is regulated by the federal Drug Enforcement Administration ("DEA"). All
of the Company's laboratories using controlled substances for testing purposes
are licensed by the DEA.
Medical Waste and Radioactive Materials. The Company is subject to licensing
and regulation under federal, state and local laws relating to the handling and
disposal of medical specimens and hazardous waste and radioactive materials as
well as to the safety and health of laboratory employees. All of the Company's
laboratories are operated in material compliance with applicable federal and
state laws and regulations relating to disposal of all laboratory specimens.
The Company utilizes outside vendors for disposal of specimens. Although the
Company believes that it is currently in compliance in all material respects
with such federal, state and local laws, failure to comply could subject the
Company to denial of the right to conduct business, fines, criminal penalties
and other enforcement actions.
Occupational Safety. In addition to its comprehensive regulation of safety in
the workplace, the federal Occupational Safety and Health Administration
("OSHA") has established extensive requirements relating to workplace safety
for health care employers, including clinical laboratories, whose workers may
be exposed to blood-borne and air-borne pathogens such as HIV and the hepatitis
B virus. These regulations, among other things, require work practice controls,
protective clothing and equipment, training, medical follow-up, vaccinations
and other measures designed to minimize exposure to chemicals and transmission
of blood-borne and airborne pathogens.
Specimen Transportation. Regulations of the Department of Transportation, the
United States Public Health Service and the Postal Service apply to the surface
and air transportation of clinical laboratory specimens.
Regulation of Reimbursement for Clinical Laboratory Services. Containment of
health care costs, including
Quest Diagnostics Incorporated : 1997 Form 10-K
13
reimbursement for clinical laboratory services, has been a focus of ongoing
governmental activity. In 1984, Congress established a Medicare fee schedule
for clinical laboratory services performed for patients covered under Part B of
the Medicare program. Subsequently, Congress imposed a national ceiling on the
amount that would be paid under the Medicare fee schedule. Laboratories must
bill the program directly and must accept the scheduled amount as payment in
full for most tests performed on behalf of Medicare beneficiaries. In addition,
state Medicaid programs are prohibited from paying more (and in most instances,
pay significantly less) than the Medicare fee schedule for clinical laboratory
testing services furnished to Medicaid recipients. In 1997, the Company derived
approximately 17% and 3% of its net revenues from tests performed for
beneficiaries of Medicare and Medicaid programs, respectively. In addition, the
Company's other business depends significantly on continued participation in
these programs because many clients want a single laboratory to perform all of
their clinical laboratory testing services.
Since 1984, Congress has periodically reduced the ceilings on Medicare
reimbursement to clinical laboratories from previously authorized levels. In
1993, pursuant to the Omnibus Budget and Reconciliation Act of 1993 ("OBRA
'93"), Congress reduced the Medicare national fee schedule limitations from 88%
of the 1984 national median to 76% of the 1984 national median, which
reductions were phased in from 1994 through 1996 (to 84% on January 1, 1994, to
80% on January 1, 1995 and to 76% on January 1, 1996, in each case as a
percentage of the 1984 national median). OBRA '93 also eliminated the provision
for annual fee schedule increases based upon the consumer price index for 1994
and 1995 (but not for 1996 or 1997). Under the 1997 Balanced Budget Act,
effective January 1, 1998, the Medicare national fee schedule limitations were
further reduced to 74% of the 1984 national median, and consumer price index
adjustments are eliminated through 2002. Medicare reimbursement reductions have
a direct adverse effect on the Company's net earnings and cash flows. The
Company cannot predict if additional Medicare reductions will be implemented.
During the last several years HCFA has taken several measures to reduce
utilization of clinical laboratory testing and to ensure that except for
certain limited exceptions Medicare does not pay for tests that are ordered for
screening purposes. Since 1995 most Medicare carriers have begun to require
clinical laboratories to submit documentation supporting the medical necessity,
as judged by ordering physicians, for many commonly ordered tests. Effective as
of March 1, 1996, HCFA eliminated its prior policy of permitting payment for
all tests contained in an automated chemistry panel when at least one of the
tests in the panel is medically necessary. Under the new policy, Medicare will
only pay for those individual tests in a chemistry panel that are medically
necessary. During 1996, in conjunction with HCFA, the American Medical
Association ("AMA") designed four new panels of "clinically relevant" automated
chemistry panels (each consisting of between 4 and 12 tests) to replace the
previous automated chemistry test panels consisting of 19 to 22 tests.
Effective January 1, 1998, HCFA began implementation of these new panels but
granted clinical laboratories a grace period through April 1, 1998 during which
laboratories can choose to use either the old or new panel codes. The Company
believes that HCFA is encouraging its carriers to focus any future limited
coverage applications to the panel level (and not to the test component level).
In response to these developments, the Company is implementing a
Medicare/Medicaid only requisition form that incorporates the new AMA panels
and highlights "limited coverage" tests for which Medicare/
Medicaid will pay only if an approved diagnosis has been provided by the
ordering physician. The Company has field tested the requisition form in two
regional laboratories, where implementation of the new panels resulted in a net
reduction of approximately 10% of the Company's Medicare revenues (or
approximately 2% of the Company's aggregate net revenues) in these regional
laboratories. The Company is generally permitted to bill patients for certain
statutorily excluded clinical laboratory services. The Company is also
generally permitted to bill patients for clinical laboratory tests that
Medicare does not pay for due to "medical necessity" limitations (e.g., limited
coverage tests for which an approved diagnosis code is not provided by the
ordering physician) if the patient signs an advance beneficiary notice ("ABN"),
which is included on the Company's new Medicare/Medicaid-only requisition form.
However, since the majority of the Company's requisitions are filled out by
physician clients, the Company cannot mandate the proper use of the ABN. If the
ABN is not signed by the patient, the Company may perform tests which are not
covered by Medicare but cannot subsequently bill the patient for them.
The Company expects to incur additional reimbursement reductions and additional
costs associated with the implementation of these requirements of HCFA and
Medicare carriers. The amount of the reductions in reimbursements and
additional costs cannot be determined at this time. See "Billing." While these
changes could have a material adverse affect on the Company's results of
operations, management does
Quest Diagnostics Incorporated : 1997 Form 10-K
14
not believe that these changes will have a material adverse effect on the
Company's financial condition.*
Currently Medicare is administered by over 20 local carriers, which have had
inconsistent policies on such matters as test coverage, automated chemistry
panels, diagnostics coding and claims documentation. Inconsistent regulation
has increased the complexity of the billing process for national clinical
laboratories such as the Company. As part of the 1997 Balanced Budget Act, HHS
is required to adopt uniform policies regarding such matters by January 1, 1999
and replace the current local carriers with no more than five regional
carriers. In addition, the 1997 Balanced Budget Act requires carriers to
include a representative of the laboratory industry on any advisory committee
that may be established to consider laboratory coverage, payment and claims
policies.
Major clinical laboratories, including the Company, typically use dual fee
schedules: "client" fees charged to physicians, hospitals, and institutions with
which a laboratory deals on a wholesale basis, which fees are generally subject
to negotiation or discount, and "patient" fees charged to individual patients
and third-party payors, including Medicare and Medicaid, who generally require
separate bills or claims for each requisition. Medicare and other third party
payors also set maximum fees that they will pay which are substantially lower
than the patient fees otherwise charged by the Company, but are generally higher
than the Company's fees actually charged to clients. Federal and some state
regulatory programs prohibit clinical laboratories from charging government
programs more than certain charges to other customers. During 1992, in issuing
final regulations implementing the federal statutory prohibition against
charging Medicare substantially in excess of a provider's usual charge, the OIG
declined to provide any guidance concerning the interpretation of this
legislation, including whether or not discounting to non-governmental clients
and payors or the dual fee structure employed by clinical laboratories might be
inconsistent with the provision. A proposed rule released in September 1997
would authorize the OIG to exclude from Medicare providers, including clinical
laboratories, who charge Medicare and other programs fees that are
"substantially in excess of . . . .usual charges. . . . to any of the
[laboratories'] customers, clients or patients." If the rule is adopted as
proposed, the Company and other clinical laboratories would have to pass on to
Medicare discounts that they pass on to other clients charged on the "client"
fee schedule. The proposed rule, if adopted in such form, could have a material
adverse effect on the Company's net earnings and cash flows.
The 1997 Balanced Budget Act permits HCFA to adjust the statutorily prescribed
fees for certain medical services, including clinical laboratory services, if
such fees are "grossly excessive." In January 1998 HCFA issued an interim final
rule setting forth the criteria used by HCFA in determining whether or not to
exercise this adjustment power. Among the factors listed in the rule are
whether the statutorily prescribed fees are "grossly higher or lower than the
payment made for the. . . . services by other purchasers in the same locality."
Medicare reimbursement reductions effected pursuant to this rule would have a
direct adverse effect on the Company's net earnings and cash flows. The Company
cannot predict if and the extent to which such Medicare reductions will be
implemented.
HCFA is currently planning a demonstration project to determine whether
competitive bidding can be used to provide quality laboratory and other medical
services at prices below current Medicare reimbursement rates. The project is
expected to take place in Tennessee and begin by early 1999. If competitive
bidding were implemented on a regional or national basis for clinical
laboratory testing, such action could materially adversely affect the clinical
laboratory industry, including the Company. The 1997 Balanced Budget Act
requires HCFA to conduct five other Medicare bidding demonstrations involving
various types of medical services and complete them by 2002.
Future changes in federal, state and local regulations (or in the
interpretation of current regulations) affecting governmental reimbursement for
clinical laboratory testing could have a material adverse effect on the
Company. The Company is unable to predict, however, whether and what type of
legislation will be enacted into law.
Fraud and Abuse Regulations. The Medicare and Medicaid anti-kickback laws
prohibit clinical laboratories from, among other things, making payments or
furnishing other benefits to influence the referral of tests billed to
Medicare, Medicaid or other federal programs. Penalties for violations of these
federal laws include exclusion from participation in the Medicare/
Medicaid programs, asset forfeitures, and civil and criminal penalties and
fines. Under the Health Insur-
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* This is a forward looking statement within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include the impact upon the Company's revenues and expenses
resulting from compliance with Medicare administrative policies; computer or
other system failures; and development of technologies that substantially alter
the practice of medicine. See "Cautionary Statement for Purposes of the 'Safe
Harbor' Provisions of the Private Securities Litigation Reform Act of 1995." In
particular, see factors (c), (d), (j) and (l).
Quest Diagnostics Incorporated : 1997 Form 10-K
15
ance Portability and Accountability Act of 1996 ("HIPAA"), on January 1, 1997
civil administrative penalties for a wide range of offenses were increased to
up to $10,000 per item plus three times the amount claimed. In the case of
certain criminal offenses, exclusion from participation in Medicare and
Medicaid is a mandatory penalty.
The fraud and abuse provisions are interpreted liberally and enforced
aggressively by various enforcement agencies of the federal government,
including the Federal Bureau of Investigation ("FBI") and the Office of the
Inspector General of HHS ("OIG"). According to public statements by the
Department of Justice ("DOJ"), health care fraud has been elevated to the
second-highest priority of the DOJ, and FBI agents have been transferred from
investigating counterintelligence activities to health care provider fraud. The
OIG also is involved in such investigations and has, according to recent
workplans, targeted certain laboratory practices for study, investigation and
prosecution. The federal government's involvement in curtailing fraud and abuse
is likely to increase as a result of the enactment in August 1996 of the HIPAA
which requires the U.S. Attorney General and the OIG to jointly establish a
program to (a) coordinate federal, state and local enforcement programs to
control fraud and abuse with respect to health care, (b) conduct
investigations, audits, evaluations and inspections relating to the delivery
and payment for health care, (c) facilitate the enforcement of the health care
fraud and abuse laws, (d) provide for the modification and establishment of
safe harbors and to issue advisory opinions and Special Fraud Alerts and (e)
provide for a data collection system for the reporting and disclosure of
adverse actions taken against health care providers. HIPAA also authorizes the
establishment of an anti-fraud and abuse account funded through the collection
of penalties and fines for violations of the health care anti-fraud laws as
well as amounts authorized therefor by Congress. HIPAA also requires HHS to
establish a program to encourage Medicare beneficiaries and others to report
violations of the health care anti-fraud laws, including paying to the
reporting person a portion of any fines and penalties collected.
In October 1994, the OIG issued a Special Fraud Alert, which set forth a number
of practices allegedly engaged in by clinical laboratories and health care
providers that the OIG believes violate the anti-kickback laws. These practices
include providing employees to collect patient samples at physician offices if
the employees perform additional services for physicians that are typically the
responsibility of the physicians' staff; selling laboratory services to renal
dialysis centers at prices that are below fair market value in return for
referrals of Medicare tests which are billed to Medicare at higher rates;
providing free testing to a physician's HMO patients in situations where the
referring physicians benefit from lower utilization; providing free pickup and
disposal of bio-hazardous waste for physicians for items unrelated to a
laboratory's testing services; providing facsimile machines or computers to
physicians that are not exclusively used in connection with the laboratory
services performed; and providing free testing for health care providers, their
families and their employees (professional courtesy testing). The OIG stressed
in the Special Fraud Alert that when one purpose of an arrangement is to induce
referral of program-reimbursed laboratory testing, both the clinical laboratory
and the health care provider or physician may be liable under the anti-kickback
laws and may be subject to criminal prosecution and exclusion from participation
in the Medicare and Medicaid programs. The Special Fraud Alert was issued in
part at the request of the American Clinical Laboratory Association ("ACLA"),
which sought clarification of certain of these rules. The Company does not
believe that it has been negatively affected by the issuance of the Special
Fraud Alert.
Many of these statutes and regulations, including those relating to joint
ventures and alliances, are vague or indefinite and have not been interpreted by
the courts. In addition, regulators have generally offered little guidance to
the clinical laboratory industry. Despite several requests from ACLA for
clarification of the anti-fraud and abuse rules, since 1992, OIG has issued only
two fraud alerts specifically with regard to clinical laboratory practices and
has insisted that it lacked statutory authority to issue advisory opinions.
Legislation requiring OIG to issue fraud alerts and advisory opinions was
enacted in August 1996, and several advisory opinions on health care matters
have been issued. As a result, the Company is hopeful that additional regulatory
guidance will be given to the clinical laboratory industry in the future.
Many states have anti-kickback, anti-rebate, anti-fee splitting and other laws
which also impact the Company's relationships with clients who refer other than
government reimbursed laboratory testing to the Company.
A federal anti-"self-referral" law commonly known as the "Stark" law has, since
1992, generally prohibited (with certain exceptions) Medicare payments for
laboratory tests referred by physicians who have (personally or through a family
member) an investment interest in, or a compensation arrangement with, the
testing laboratory. Since January 1995, these restrictions apply to
Medicaid-covered services as well. Physicians may, however, be reimbursed by
Medicare and Medicaid for
Quest Diagnostics Incorporated : 1997 Form 10-K
16
testing performed by or under the supervision of the physician or the group
practice to which the physician belongs. In addition, a physician may refer
specimens to a laboratory owned by a company, such as the Company, whose stock
is traded on a public exchange and which has stockholders' equity exceeding $75
million even if the physician owns stock of that company. An amendment to the
Stark law in August 1993 makes it clear that ordinary day-to-day transactions
between laboratories and their customers, including, but not limited to,
discounts granted by laboratories to their customers, are not covered by the
compensation arrangement provisions of the Medicare statute. Sanctions for
laboratory violations of the prohibition include denial of Medicare payments,
refunds, civil money penalties of up to $15,000 for each service billed in
violation of the prohibition and exclusion from the Medicare and Medicaid
programs.
The 1995 House Medicare reform proposal contained, and the House-Senate report
adopted, provisions that would significantly narrow the scope of the Stark
anti-referral laws. That proposal would, among other changes, have ended the
ban on physician referrals to laboratories based on any "compensation
arrangement" between the laboratory and the physician. The President vetoed
this bill on December 6, 1995.
Many states have similar anti-"self-referral" and other laws which also impact
investment and compensation arrangements with physicians who refer other than
government reimbursed laboratory testing to the Company.
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Government Investigations and Related Claims
The Company has settled various government and private claims (such as those by
private insurers) relating primarily to industry-wide billing and marketing
practices that had been substantially discontinued by early 1993. Specifically,
the Company has entered into, (i) for an aggregate of approximately $180
million, five settlements with the OIG and the DOJ (including the MetPath and
Damon settlements discussed below) and two settlements with state governments
with respect to Medicare and Medicaid marketing and billing practices of the
Company and certain companies acquired by the Company prior to their
acquisition and (ii) fourteen settlements relating to private claims totaling
approximately $12 million. In addition, there are several pending
investigations by the OIG and DOJ, including one into billing and marketing
practices at three regional laboratories operated by Nichols Institute prior to
its acquisition by the Company and one into billing and marketing practices at
a former joint venture of Damon.
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Government Settlements
The MetPath Settlement. In September 1993, the Company (under the name MetPath
Inc.) entered into an agreement with the DOJ and the OIG pursuant to which the
Company paid a total of approximately $36 million in settlement of civil claims
by the United States that the Company had wrongfully induced physicians to
order certain laboratory tests without their realizing that such tests would be
billed to Medicare at rates higher than those the physicians believed were
applicable.
The Damon Settlement. By issuance of a civil subpoena in August 1993, the
government began a formal investigation of Damon, an independent clinical
laboratory company acquired by Corning earlier the same month. Subsequent to
September 1993, several additional subpoenas were issued. By a plea agreement
and civil settlement agreement and release dated October 9, 1996, between the
DOJ and Damon, all federal criminal matters within the scope of the various
federal investigations against Damon, and all claims included in the civil qui
tam cases underlying the civil investigations, were settled for an aggregate of
$119 million, which sum was reimbursed to the Company by Corning. The
settlement included base recoupments of approximately $40 million and total
criminal and civil payments in excess of base recoupments of approximately $79
million. The Damon settlement does not exclude the Company from future
participation in any federal health care programs on account of Damon's
practices. For further information regarding the Damon settlement, see Note 14
to the Consolidated Financial Statements.
Other Government Settlements. In addition to the MetPath settlement and the
Damon settlement, since 1992 the Company has settled five other federal and
state billing-related claims for a total of approximately $25 million.
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Ongoing Government Investigations
The Nichols Investigation. By issuance of a civil subpoena in August 1993, the
government began a formal investigation of Nichols Institute, a company
acquired by Corning in August 1994. The investigation of Nichols Institute
remains open. While the Company has established reserves in respect of the
Nichols investigations, at present there are no settlement discussions pending
between the DOJ and the Company regarding Nichols Institute, and it is too
early to predict the outcome of this investigation. Remedies available to the
government include exclusion from participation in the Medicare and Medicaid
programs, criminal fines, civil recoveries plus civil penalties and asset
forfeitures. However, in light of the Corporate Integrity Agreement
Quest Diagnostics Incorporated : 1997 Form 10-K
17
referred to below entered into between the Company and the OIG in connection
with the Damon settlement, the fact that the matters apparently being
investigated were corrected with or before the Company's acquisition of Nichols
Institute and the Company's cooperation in this investigation, the Company
believes the prospect of such exclusion on account of the investigation is
remote. Additionally, while application of such remedies and penalties could
materially and adversely affect the Company's business, financial condition,
and prospects, management believes that the possibility of such effects are
likewise remote. As discussed below, Corning has agreed to indemnify the
Company against any monetary penalties, fines or settlements for any
governmental claims that may arise as a result of the Nichols investigations.
Damon Joint Venture Investigation. In connection with the investigation that
resulted in the Damon settlement discussed above, the government began an
investigation into a joint venture between Damon and Vivra Inc. (which
dissolved in May 1996) and a predecessor joint venture between Damon and
Vivra's former parent. These joint ventures operated Damon's Atlanta regional
laboratory and furnished testing services to Vivra's dialysis centers, which
provided dialysis treatment to end stage renal dialysis ("ESRD") patients. As
discussed in the following paragraph, several former officers of Damon have
been indicted in part on account of their involvement with the organization and
operation of the joint venture. The terms of the Damon settlement releases the
Company of further criminal liability on account of the partnership; however,
civil recovery of overcharges remained a possibility after that settlement. The
government asserts that the joint ventures were formed and operated as a scheme
to generate referrals for medically unnecessary testing for ESRD patients by
providing unlawful kickbacks to Damon's joint venture partners in the form of
partnership profits. The Company has established reserves regarding this
investigation. As discussed below, Corning has agreed to indemnify the Company
against any monetary penalties, fines or settlements for any governmental
claims that may arise as a result of this investigation.
The Damon Officer Indictments. In January 1998, four former officers of Damon
Corporation were indicted by the United States of America for alleged health
care fraud committed during their employment by Damon. The indictment relates
to matters that were the subject of the Damon settlement and, in the case of
three of the officers, to the investigation of the former Damon joint venture
discussed in the preceding paragraph. Under the agreement and plan of merger
under which Damon was acquired by Corning, the Company is obligated to
indemnify these former officers of Damon to the fullest extent permitted by
Delaware law. The Company's obligations (primarily advancing fees and expenses
of counsel in connection with the defense by these former officers of Damon)
will not be indemnified by Corning. As part of the Damon settlement, Corning
agreed to cooperate with the DOJ in its continuing investigation of individuals
formerly associated with Damon and, in connection therewith, the Company
provided additional information pursuant to several subpoenas.
Other Government Investigations. In December 1995 and December 1996, the
Company received subpoenas from the OIG seeking information as to the Company's
policies in instances in which specimens were received and tested by a
laboratory without first receiving or verifying specific test requisitions. The
Company has concluded the occurrence of this practice was relatively rare and
was engaged in primarily to preserve the integrity of test results from
specimens subject to rapid deterioration. The Company has reached a tentative
settlement with the DOJ to settle this investigation for $6.8 million. The
Company has voluntarily self-reported to the government several isolated events
that may have resulted in overpayments by Medicare and Medicaid to the Company.
It is the Company's policy to internally investigate all such incidents and to
self-report and reimburse payors as appropriate. Although the Company has
commenced internal investigations to quantify the amounts that may be recouped
by the government and corrective action has been taken as to each such event,
it is too early to predict the outcome of these disclosures to the government.
As discussed below under "Corning Indemnity," Corning has agreed to indemnify
the Company against any monetary penalties, fines or settlements for certain
governmental claims that may arise as a result of the investigations commenced
prior to January 1, 1997.
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Outlook for Future Government Investigations
The Damon settlement involved, and a settlement regarding Nichols Institute is
expected to involve, only matters predating Corning's acquisition of both such
companies, and turned on, or will turn on, facts unique to those companies and
other factors individual government enforcement personnel may take into
account. However, recent experience in the Company's settlement of the Damon
case and public announcements by various government officials indicate that the
government's position on health care fraud is still hardening and collections
of amounts greatly in excess of mere recoupment of overcharges from
laboratories and other providers will be more prevalent. In addition, HIPAA
includes provisions relating to health care fraud and abuse that gives federal
Quest Diagnostics Incorporated : 1997 Form 10-K
18
enforcement personnel substantially increased funding, powers and remedies to
pursue suspected fraud and abuse. In connection with the Damon settlement, the
Company signed a Corporate Integrity Agreement pursuant to which the Company
will maintain its corporate compliance program, modify certain of its marketing
materials, make periodic reports to the OIG and take certain other steps to
demonstrate the Company's integrity as a provider of services to federally
sponsored health care programs. This agreement also includes an obligation to
self-report instances of noncompliance that are uncovered by the Company, but
also gives the Company the opportunity to obtain clearer guidance on matters of
compliance and to resolve compliance issues directly with OIG. Importantly, the
agreement gives the Company the opportunity to cure any asserted breaches and to
otherwise initiate corrective actions, which the Company believes should help to
avoid enforcement actions outside of the process provided in the agreement. See
"Compliance Program."
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Private Settlements and Claims
Since 1992 the Company has settled fourteen private actions relating to the
governmental settlements described above for an aggregate of approximately $12
million. The Company has received notices of claims from a number of private
payors relating to billing issues similar to those that were the subject of the
government settlements with MetPath and Damon. The outcome of these claims
cannot presently be predicted.
In March 1997, a former subsidiary of Damon, together with SmithKline and
LabCorp, was served with a complaint in a purported class action. The complaint
asserts claims under the federal civil RICO statute relating to private
reimbursement of billings by Damon that are similar to those that were part of
the government settlement. The ultimate outcome of the claim cannot be presently
predicted.
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Corning Indemnity
In connection with the Spin-Off Distribution, Corning has agreed to indemnify
the Company against all monetary penalties, fines or settlements for any
governmental claims arising out of alleged violations of applicable federal
fraud and health care statutes and relating to billing practices of the Company
and its predecessors that have been settled or are pending on December 31, 1996,
when the Spin-Off Distribution was completed. This includes the settlements
described above under "Government Settlements" and the claims pending at
December 31, 1996 that are described above under "Ongoing Government
Investigations-The Nichols Investigation", "-Damon Joint Venture Investigation"
and "-Other Government Investigations." Corning has also agreed to indemnify the
Company for 50% of the aggregate of all judgment or settlement payments made by
the Company that are in excess of $42 million in respect of claims by private
parties (i.e., nongovernmental parties such as private insurers) that relate to
indemnified or previously settled governmental claims (such as the Damon
settlement) and that alleged overbillings by the Company or any existing
subsidiaries of the Company, for services provided prior to January 1, 1997;
provided, however, such indemnification will not exceed $25 million in the
aggregate and that all amounts indemnified against by Corning for the benefit of
the Company will be calculated on a net after-tax basis by taking into account
any deductions and other tax benefits realized by the Company (or a consolidated
group of which the Company is a member after Spin-Off Distribution ("the Company
Group")) in respect of the underlying settlement, judgment payment, or other
loss (or portion thereof) indemnified against by Corning, generally to the
extent such deductions or tax benefits are deemed to reduce the tax liability of
the Company or the Company Group.
Corning will not indemnify the Company against (i) any governmental claims that
arise after December 31, 1996 pursuant to service of subpoena or other notice of
such investigation after December 31, 1996, (ii) any nongovernmental claims
unrelated to the indemnified governmental claims or investigations, (iii) any
nongovernmental claims not settled prior to December 31, 2001, (iv) any
consequential or incidental damages relating to the billing claims, including
losses of revenues and profits as a consequence of exclusion for participation
in federal or state health care programs or (v) the fees and expenses of
litigation. The Company will control the defense of any governmental claim or
investigation unless Corning elects to assume such defense. However, in the case
of all nongovernmental claims related to indemnified governmental claims related
to alleged overbillings, the Company will control the defense. All disputes
relating to the Corning indemnification agreement are subject to binding
arbitration.
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The Company's Reserves
The Company's aggregate reserve with respect to all governmental and private
claims was approximately $76 million at December 31, 1997. The reserve
represents amounts for future government and private settlements of matters
which are either presently pending or anticipated as a consequence of the
government and private settlements and self-reported matters described above.
The Company believes that its reserves are adequate. The reserves are based on
the
Quest Diagnostics Incorporated : 1997 Form 10-K
19
Company's experience with prior settlements and other information available to
the Company on potentially disputed billings. However, it is possible that
additional information may become available (such as the indication by the
government of criminal activity, additional tests being questioned or other
changes in the government's or private claimant's theories of wrongdoing) which
may cause the final resolution of these matters to be in excess of established
reserves by an amount which could be material to the Company's results of
operations and cash flows in the period in which such claims are settled. The
Damon settlement was significantly in excess of the reserves existing in 1996
prior to the settlement. While it is likely that none of the current
governmental or nongovernmental investigations or claims is covered by
insurance, the Company does not believe that these matters will have a material
adverse effect on the Company's overall financial condition.
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Compliance Program
Because of evolving interpretations of regulations and the national debate over
health care, compliance with all Medicare, Medicaid and other legal government-
established rules and regulations has become a significant concern throughout
the clinical laboratory industry. The Company began the implementation of a
compliance program early in 1993. The objective of the program is to develop
aggressive and reliable compliance standards and safeguards. Emphasis is placed
on developing training programs for personnel intended to assure the strict
implementation and observance of all applicable rules and regulations. Further,
in-depth reviews of procedures, personnel and facilities are conducted to
assure regulatory compliance throughout the Company. The Company's current
compliance plan establishes a Compliance Committee of the Board of Directors
and requires periodic reporting of compliance operations by management to the
Compliance Committee. Such sharpened focus on regulatory standards and
procedures will continue to be a priority for the Company in the future.
The Company's current comprehensive program is designed to ensure that it is in
compliance in all material respects with all statutes, regulations and other
requirements applicable to its clinical laboratory operations. This program has
been publicly cited by government officials as a "model" for the industry. In
addition, the government advised the Company's representatives that the
Company's compliance program, coupled with corrective action taken by the
Company after its acquisition of Damon, greatly reduced the amounts of fines
and penalties, and was influential in causing the OIG not to seek exclusion of
the Company from future participation in governmental health care programs.
Pursuant to the Damon settlement, in October 1996 the Company signed a five
year Corporate Integrity Agreement with the OIG pursuant to which the Company
will, among other things, maintain its corporate compliance program, make
certain changes to its test order forms, provide certain additional notices to
ordering physicians, provide to the OIG data on certain test ordering patterns,
adopt certain pricing guidelines, audit laboratory operations, deliver annual
reports on compliance activities, and investigate and report instances of
noncompliance, including any corrective actions and disciplinary steps.
Importantly, the agreement gives the Company the opportunity to cure any
asserted breaches and to otherwise initiate corrective actions, which the
Company believes should help to reduce the occurrence of enforcement actions
outside of the process provided in the agreement. The agreement gives the
Company the opportunity to obtain clearer guidance on matters of compliance and
to resolve compliance issues directly with the OIG. LabCorp and SmithKline have
executed similar agreements with the OIG. In 1997 the OIG published a guideline
on the essential elements of a satisfactory compliance program for the entire
clinical laboratory industry, including hospital laboratories. This guideline
is similar to the Company's compliance program, and it is believed that this
development may help create a fairer competitive environment for the Company.
None of the undertakings included in the Company's Corporate Integrity
Agreement or in the recently published guideline is expected to have any
material adverse affect on the Company's business, financial condition, results
of operations and prospects. The clinical laboratory testing industry is,
however, subject to extensive regulation. The Company believes that, in all
material respects, it is in compliance with all applicable statutes and
regulations. However, there can be no assurance that any statutes or
regulations might not be interpreted or applied by a prosecutorial, regulatory
or judicial authority in a manner that would adversely affect the Company.
Potential sanctions for violation of these statutes and regulations include
significant fines and the loss of various licenses, certificates and
authorizations.
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Insurance
The Company maintains liability insurance (subject to maximum limits and
self-insured retentions) for claims, which may be substantial, that could
result from providing or failing to provide clinical laboratory testing and
anatomic pathology services, including inaccurate testing results. While there
can be no assurance that coverage will be adequate to cover all future
exposure, management believes that the present levels of insurance coverage and
reserves are adequate to cover currently estimated exposures. Although the
Quest Diagnostics Incorporated : 1997 Form 10-K
20
Company believes that it will be able to obtain adequate insurance coverage in
the future at acceptable costs, there can be no assurance that the Company will
be able to obtain such coverage or will be able to do so at an acceptable cost
or that the Company will not incur significant liabilities in excess of policy
limits.
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Employees
At December 31, 1997, the Company employed approximately 16,300 people, as
compared to 18,300 employees at December 31, 1996. Approximately 14,400 of the
Company's employees at December 31, 1997 are full-time employees and
approximately 1,900 are part-time employees. These totals exclude employees of
the Company's two joint ventures. The Company has no collective bargaining
agreements with any unions and believes that its overall relations with its
employees are good.
- --------------------------------------------------------------------------------
Seasonality
During the summer months, year-end holiday periods and other major holidays,
volume of testing declines, reducing net revenues and resulting cash flows
below annual averages during such periods. Winter months are also subject to
declines in testing volume due to inclement weather. As a result, comparisons
of the results of successive quarters may not accurately reflect trends or
results for the full year. See "Management's Discussion and Analysis of
Financial Condition and Results of Operations-Overview."
- --------------------------------------------------------------------------------
Cautionary Statement for Purposes of the "Safe Harbor" Provisions of the
Private Securities Litigation Reform
Act of 1995
The Private Securities Litigation Reform Act of 1995 ("Litigation Reform Act")
provides a new "safe harbor" for forward-looking statements to encourage
companies to provide prospective information about their companies without fear
of litigation so long as those statements are identified as forward-looking and
are accompanied by meaningful cautionary statements identifying important
factors that could cause actual results to differ materially from those
projected in the statement. The Company desires to take advantage of the new
"safe harbor" provisions of the Litigation Reform Act in connection with the
information included herein and is including this section in order to do so.
Accordingly, the Company hereby identifies the following important factors that
could cause the Company's actual financial results to differ materially from
those projected, forecast or estimated by the Company in forward-looking
statements.
The Company wishes to caution investors that the following factors are hereby
identified as important factors that could cause the Company's actual financial
results to differ materially from those projected, forecast or estimated by the
Company in forward-looking statements.
(a) Heightened competition, including the intensification of price competition
and increased competition from hospitals in the commercial outreach
business. See "Competition."
(b) Impact of changes in payor mix, including the shift from traditional,
fee-for-service medicine to managed-cost health care. See "Effect of the
Growth of the Managed Care Sector on the Clinical Laboratory Business."
(c) Adverse actions by governmental or other third-party payors, including
unilateral reduction of fee schedules payable to the Company. See
"Regulation and Reimbursement-Regulation of Reimbursement for Clinical
Laboratory Services."
(d) The impact upon the Company's volume and collected revenues or general or
administrative expenses resulting from compliance with Medicare
administrative policies and requirements of third party payors, including
specifically the recent requirements of Medicare carriers to provide
diagnosis codes for commonly ordered tests; the policy of HCFA to limit
Medicare reimbursement for tests contained in automated chemistry panels
to the amount that would have been paid if only the covered tests,
determined on the basis of demonstrable "medical necessity," had been
ordered; the recent introduction of four new panels of "clinically
relevant" automated chemistry panels (each consisting of between 4 and 12
tests) to replace the previous automated chemistry test panels consisting
of 19 to 22 tests; and the likelihood that third party payors will adopt
similar requirements. See "Regulation and Reimbursement-Regulation of
Reimbursement for Clinical Laboratory Services."
(e) Adverse results from pending governmental investigations, including in
particular significant monetary damages and/or exclusion from the Medicare
and Medicaid programs and/or other significant litigation matters. Also,
the absence of indemnification from Corning for private claims unrelated
to the indemnified governmental claims or investigations and for private
claims that are not settled within five years of the Distribution Date.
See "Government Investigations and Related Claims."
Quest Diagnostics Incorporated : 1997 Form 10-K
21
(f) Failure to obtain new customers at profitable pricing or failure to retain
existing customers, including by reason of the consolidation of certain of
the Company's laboratories. See "Acquisitions and Consolidations."
Reduction in tests ordered or specimens submitted by existing customers.
(g) Inability to obtain professional liability insurance coverage or a
material increase in premiums for such coverage. See "Insurance."
(h) Denial of CLIA certification or other licensure of any of the Company's
clinical laboratories under CLIA, by HCFA for Medicare and Medicaid
programs or other federal, state and local agencies. See "Regulation and
Reimbursement".
(i) Adverse publicity and news coverage about the Company or the clinical
laboratory industry.
(j) Computer or other system failures that affect the ability of the Company
to perform tests, report test results or properly bill customers,
including potential failures resulting from systems conversions or from
the Year 2000 problem. See "Information Systems" and "Billing."
(k) Failure of third party payors, including Medicare carriers, and suppliers,
to adequately address the Year 2000 problem, which could lead to delays in
reimbursement for clinical laboratory testing performed by the Company.
(l) Development of technologies that substantially alter the practice of
laboratory medicine.
(m) Changes in interest rates causing a substantial increase in the Company's
effective borrowing rate.
Item 2. Properties
The Company's principal laboratories (listed alphabetically by state) are
located in the following metropolitan areas:
Location Type of Laboratory Leased or Owned
- -------------------------- -------------------- ----------------
Phoenix, Arizona Joint Leased by
Venture Joint Venture
San Diego, California Regional Leased
San Juan Capistrano, Esoteric Owned
California
Denver, Colorado Regional Leased
New Haven, Connecticut Regional Owned
Fort Lauderdale, Florida Regional Leased
Chicago, Illinois Regional Leased
Baltimore, Maryland Regional Owned
Boston, Massachusetts Regional Leased
Detroit, Michigan Regional Leased
Grand Rapids, Michigan Branch Leased
St. Louis, Missouri Regional Leased
Lincoln, Nebraska Regional Leased
New York, New York Regional Owned
(Teterboro, New
Jersey)
Long Island, New York Branch Leased
Portland, Oregon Regional Leased
Erie, Pennsylvania Joint Leased by
Venture Joint Venture
Philadelphia, Regional Leased
Pennsylvania
Pittsburgh, Pennsylvania Regional Leased
Nashville, Tennessee Branch Owned
Dallas, Texas Regional Leased
The Company's executive offices are located in Teterboro, New Jersey in the
facility that also serves as the Company's regional laboratory in the New York
City metropolitan area. The Company owns its branch laboratory facility in
Mexico City. The Company believes that, in general, its laboratory facilities
are suitable and adequate for its current and anticipated future levels of
operation. The Company believes that if it were unable to renew the lease on
any of its testing facilities, it could find alternative space at competitive
market rates and relocate its operations to such new locations.
Item 3. Legal Proceedings
In addition to the investigations described in "Government Investigations and
Related Claims," the Company is involved in various legal proceedings arising
in the ordinary course of business. Some of the proceedings against the Company
involve claims that are substantial in amount. Although it is not feasible to
predict the outcome of such proceedings or any claims made against the Company,
it does not anticipate that the ultimate liability of such proceedings or
claims will have a material adverse effect on the Company's financial position
or results of operations as they primarily relate to professional liability for
which the Company believes it has adequate insurance coverage. See
"Business-Insurance."
Item 4. Submission of Matters to a Vote of Security Holders
None
Quest Diagnostics Incorporated : 1997 Form 10-K
22
PART II
Item 5. Market for the Registrant's Common Stock and Related Security Holder
Matters
The common stock of the Company is listed and traded on the New York Stock
Exchange under the symbol "DGX". The common stock began trading on December 17,
1996, on a when issued basis. During the period from December 17, 1996, through
December 31, 1996, the high sales price was $15.75 per share and the low sales
price was $13.25 per share. On January 14, 1997, the common stock began trading
on a regular way basis. The following table sets forth, for the periods
indicated, the high and low sales price per share as reported on the New York
Stock Exchange Consolidated Tape:
1997 High Low
- ------------------------- ------------ ------------
First Calendar Quarter $ 17.875 $ 14.675
Second Calendar Quarter $ 20.875 $ 14.25
Third Calendar Quarter $ 20.3125 $ 16.25
Fourth Calendar Quarter $ 17.375 $ 16.125
As of February 24, 1998, the Company had approximately 8,800 record holders of
its common stock.
The Company does not expect to pay dividends on its common stock in the
foreseeable future. The bank credit facility prohibits the Company from paying
cash dividends on its common stock. The Indenture relating to the Company's
10.75% senior subordinated notes due 2006 restricts the ability of the Company
to pay cash dividends based primarily on a percentage of the Company's
earnings, as defined.
Item 6. Selected Financial Data
See page 28.
Item 7. Management's Discussion and Analysis of Financial Condition and Results
of Operations
See pages 29-34.
Item 7A. Quantitative and Qualitative Disclosures About Market Risk
Not applicable
Item 8. Financial Statements and Supplementary Data
See Item 14 (a)1. and 2.
Item 9. Changes in and Disagreements with Accountants on Accounting and
Financial Disclosure
None
PART III
Item 10. Directors and Executive Officers of the Registrant
Information concerning the directors of the Company is incorporated by
reference to the information in the Company's proxy statement to be filed on or
before April 30, 1998 (the "Proxy Statement") appearing under the caption
"Election of Directors."
- --------------------------------------------------------------------------------
Executive Officers of the Registrant
Officers of the Company are elected by the Board of Directors and hold office
until their respective successors are elected and qualified. The following
persons serve as executive officers of the Company:
Robert A. Carothers (61) is Vice President and Chief Financial Officer. Mr.
Carothers joined Corning in 1959 and has served in a number of key financial
positions in the United States and Japan. He was elected Assistant Controller
in 1991. In January 1996 he was appointed Assistant to the President of the
Company and in January 1997 assumed his current responsibilities.
James D. Chambers (41) is Senior Vice President-Marketing and Business
Development, with overall responsibility for development and execution of
growth strategies. Mr. Chambers joined Corning in 1986 and has served in a
variety of managerial and financial positions for Corning and its subsidiaries,
becoming Assistant Treasurer in 1991. Mr. Chambers joined the Company in 1992
as Treasurer and served as Chief Financial Officer from 1994 through 1995. In
1995 Mr. Chambers assumed responsibility for overseeing the Company's billing
process. In January 1997 Mr. Chambers assumed responsibility for investor
relations and in April 1997, the information systems and communications
functions. Mr. Chambers assumed his current position in February 1998.
Gregory C. Critchfield, M.D. (46) is Senior Vice President, and Chief Medical
and Science Officer. Dr. Critchfield joined the Company in 1995 as Chief
Laboratory Officer and assumed his current responsibilities in May 1996. Dr.
Critchfield has served as a consultant to the National Institutes of Health in
the capacity of a reviewer for more than ten years and was selected as Study
Section Chair of several Multidisciplinary Review Teams during the last two
years. Prior to joining the Company, Dr. Critchfield was a clinical pathologist
with Intermountain Health Care ("IHC") for eight years and served in various
director positions with IHC
Quest Diagnostics Incorporated : 1997 Form 10-K
23
Laboratory Services, including Director of Clinical Pathology. Dr. Critchfield
also served as Chairman of the Department of Pathology at Utah Valley Regional
Medical Center from 1994 through 1995.
Kurt R. Fischer (43) is Vice President-Human Resources. Mr. Fischer joined
Corning in 1976 and has served in a variety of Human Resources positions. He
was appointed Human Resource Manager for the Research, Development and
Engineering Group in 1986 and Director-Quality and Performance Management for
the Specialty Materials Group in 1991. Mr. Fischer assumed his present Human
Resources responsibilities with the Company in December 1995. In February 1998,
Mr. Fischer assumed responsibility for the Corporate Communications function.
Kenneth W. Freeman (47) is Chairman of the Board, Chief Executive Officer and
President of the Company. Mr. Freeman joined the Company in May 1995 as
President and Chief Executive Officer, was elected a director in July 1995 and
was elected Chairman of the Board in December 1996. Prior to 1995, he served in
a variety of key financial and managerial positions at Corning, which he joined
in 1972. He was elected controller and a vice president of Corning in 1985,
senior vice president in 1987, and general manager of the Science Products
Division in 1989. He was appointed president and chief executive officer of
Corning Asahi Video Products Company in 1990. In 1993, he was elected executive
vice president of Corning.
Raymond C. Marier (53) is Vice President and General Counsel. Mr. Marier joined
Corning's Legal Department in 1973 as an Assistant Counsel, where he worked
with a number of Corning's operating units, including its Medical and Science
Products Divisions. He has held his present position since 1992.
Gerald C. Marrone (55) is Senior Vice President and Chief Information Officer.
Prior to joining the Company in November 1997, Mr. Marrone was with Citibank,
N.A. for 12 years. During his tenure he was most recently Vice President,
Division Executive for Citibank's Global Production Support Division. While at
Citibank, he was also the Chief Information Officer of Citibank's Global Cash
Management business. Prior to joining Citibank, he was the Chief Information
Officer for Memorial Sloan-Kettering Cancer Center in New York for 5 years.
C. Kim McCarthy (42) is Vice President-Compliance and Government Affairs. Ms.
McCarthy joined Corning in 1987 as Director of Federal Government Affairs and
Legislative Counsel. She became Vice President of Public Affairs of the Company
in 1992 and Senior Vice President of Corporate Affairs in 1994. Ms. McCarthy
assumed her present responsibilities in June 1996.
Alister W. Reynolds (40) is Vice President-Strategic Planning. Mr. Reynolds
joined the Company in 1982 and has served in a variety of staff, executive and
general management positions. Mr. Reynolds assumed his current responsibilities
in 1995.
Douglas M. VanOort (42) is Senior Vice President-Operations. Mr. VanOort joined
Corning in 1982 and has served in various finance, analysis and control
positions. He became Vice President and Chief Financial Officer of Corning's
Life Sciences division in 1990, Senior Vice President-Finance and New Business
Development of Corning's Life Sciences division in 1993 and Executive Vice
President and Chief Financial Officer of the Company in 1995. Mr. VanOort
assumed his current responsibilities in January 1997.
David M. Zewe (46) is Vice President-Sales with overall responsibility for
traditional commercial segments. Mr. Zewe joined the Company in 1994 as General
Manager of the Philadelphia regional laboratory and became Regional Vice
President-Sales and Marketing for the mid-Atlantic region in August 1996. Mr.
Zewe assumed his current position in October 1997. Prior to joining the
Company, Mr. Zewe was with the Squibb Diagnostics Division of Bristol Myers
Squibb, most recently serving as Vice President of Sales.
Item 11. Executive Compensation
The information called for by this Item is incorporated by reference to the
information under the caption "Executive Compensation" appearing in the Proxy
Statement. The information contained in the Proxy Statement under the captions
"Compensation Committee Report" and "Performance Graph" is not incorporated
herein by reference.
Item 12. Security Ownership by Certain Beneficial Owners and Management
The information called for by this Item is incorporated by reference to the
information under the caption "Security Ownership of Certain Beneficial Owners
and Management" appearing in the Proxy Statement.
Item 13. Certain Relationships and Related
Transactions
The information called for by this Item is incorporated by reference to the
information under the caption "Certain Relationships and Related Transactions"
appearing in the Proxy Statement.
Quest Diagnostics Incorporated : 1997 Form 10-K
24
PART IV
- --------------------------------------------------------------------------------
Item 14. Exhibits, Financial Statement Schedules and Reports on Form 8-K
(a) Documents filed as part of this report:
1. Index to financial statements and supplementary data filed as part
of this report:
Item Page
------------------------------------------------- ----
Report of Independent Accountants F-1
Consolidated Balance Sheets F-2
Consolidated Statements of Operations F-3
Consolidated Statements of Cash Flows F-4
Consolidated Statements of Stockholders' Equity F-5
Notes to Consolidated Financial Statements F-6
Supplementary Data: Quarterly Operating Results F-22
(unaudited)
2. Financial Statement Schedule:
Schedule II--Valuation Accounts and Reserves F-23
3. Exhibits filed as part of this report:
See (c) below.
(b) Reports on Form 8-K filed during the last quarter of 1997:
On December 3, 1997, the Company filed a current report on Form 8-K (Date
of Report: December 2, 1997) disclosing under Item 5 certain steps being taken
to reduce excess capacity. See "Business-Acquisitions and Consolidations."
(c) Exhibits filed as part of this report:
Exhibit
Number Description
- -------- --------------------------------------------------------------------
2.1 Form of Transaction Agreement among Corning Incorporated, Corning
Life Sciences Inc., Corning Clinical Laboratories Inc. (Delaware),
Covance Inc. and Corning Clinical Laboratories Inc. (Michigan),
dated as of November 22, 1996 (filed as an exhibit to Corning
Clinical Laboratories Inc.'s ("CCL") Registration Statement on Form
10 (File No. 1-12215) and incorporated herein by this reference)
3.1 Certificate of Incorporation of the Registrant (filed as an exhibit
to CCL's Registration Statement on Form 10 (File No. 1-12215) and
incorporated herein by this reference)
3.2 By-Laws of the Registrant (filed as an exhibit to CCL's Registration
Statement on Form 10 (File No. 1-12215) and incorporated herein by
this reference)
4.1 Form of Rights Agreement dated December 31, 1996 between Corning
Clinical Laboratories Inc. and Harris Trust and Savings Bank as
Rights Agent (filed as an Exhibit to CCL's Registration Statement on
Form 10 (File No. 1-12215) and incorporated herein by reference).
10.1 Form of Tax Sharing Agreement among Corning Incorporated, Corning
Clinical Laboratories Inc. and Covance Inc. (filed as an Exhibit to
CCL's Registration Statement on Form 10 (File No. 1-12215) and
incorporated herein by this reference)
10.2 Form of Spin-Off Distribution Tax Indemnification Agreement between
Corning Incorporated and Corning Clinical Laboratories Inc. (filed
as an Exhibit to CCL's Registration Statement on Form 10 (File No.
1-12215) and incorporated herein by this reference)
10.3 Form of Spin-Off Distribution Tax Indemnification Agreement between
Corning Clinical Laboratories Inc. and Covance Inc. (filed as an
Exhibit to CCL's Registration Statement on Form 10 (File No.
1-12215) and incorporated herein by reference)
10.4 Form of Spin-Off Distribution Tax Indemnification Agreement between
Covance Inc. and Corning Clinical Laboratories Inc. (filed as an
Exhibit to CCL's Registration Statement on Form 10 (File No.
1-12215) and incorporated herein by reference)
Quest Diagnostics Incorporated : 1997 Form 10-K
25
10.5 Form of Executive Retirement Supplemental Plan (filed as an Exhibit
to CCL's Registration Statement on Form 10 (File No. 1-12215) and
incorporated herein by reference)
10.6 Form of Variable Compensation Plan (filed as an Exhibit to CCL's
Registration Statement on Form 10 (File No. 1-12215) and
incorporated herein by reference)
10.7 Form of Employees Stock Purchase Plan (filed as an Exhibit to CCL's
Registration Statement on Form 10 (File No. 1-12215) and
incorporated herein by reference)
10.8 Form of Employees Equity Participation Program (filed as an Exhibit
to CCL's Registration Statement on Form 10 (File No. 1-12215) and
incorporated herein by reference)
10.9 Form of Profit Sharing Plan (filed as an Exhibit to CCL's
Registration Statement on Form 10 (File No. 1-12215) and
incorporated herein by reference)
10.10 Form of Directors' Restricted Stock Plan (filed as an Exhibit to
CCL's Registration Statement on Form 10 (File No. 1-12215) and
incorporated herein by reference)
10.11 Form of Termination of Directors' Restricted Stock Plan
10.12 Form of Stock Option Plan for Non-Employee Directors (filed as an
Exhibit to the Company's 1998 Proxy Statement and incorporated
herein by reference)
10.13 Form of Credit Agreement among Corning Clinical Laboratories Inc.,
the Banks named therein, NationsBank N.A., as Issuing Bank, Wachovia
Bank of Georgia, N.A., as Swingline Bank, Morgan Guaranty Trust
Company of New York, as Administrative Agent, and Morgan Guaranty
Trust Company of New York, NationsBank, N.A. and Wachovia Bank of
Georgia, N.A., as Arranging Agents, dated December 5, 1996 (filed as
an Exhibit to CCL's Registration Statement on Form S-1 (File No.
333-15867) and incorporated herein by reference)
10.14 Form of Amendment No. 1 to the Credit Agreement referred to in
Exhibit 10.13
10.15 Form of 10.75% Senior Subordinated Notes due 2006 (included in
Exhibit 4.2) (filed as an Exhibit to CCL's Registration Statement on
Form S-1 (File No. 333-15867) and incorporated herein by reference)
10.16 Form of Indenture between Corning Clinical Laboratories Inc. and The
Bank of New York, as Trustee, dated December 16, 1996 (filed as an
Exhibit to CCL's Registration Statement on Form S-1 (File
No.333-15867) and incorporated herein by reference)
10.17 Employment Agreement between Corning Clinical Laboratories Inc. and
Kenneth W. Freeman (filed as an Exhibit to the Company's Annual
Report on Form 10-K for the year ended December 31, 1996 and
incorporated herein by reference)
21. Subsidiaries of Quest Diagnostics Incorporated
23. Consent of Price Waterhouse LLP
27. Financial Data Schedule
Quest Diagnostics Incorporated : 1997 Form 10-K
26
Signatures
Pursuant to the requirements of Sections 13 or 15(d) of the Securities Exchange
Act of 1934, the Registrant has duly caused this report to be signed on its
behalf by the undersigned, thereunto duly authorized.
Quest Diagnostics Incorporated
By /s/ Kenneth W. Freeman President and February 24, 1998
-------------------------- Chief Executive Officer
Kenneth W. Freeman
By /s/ Robert A. Carothers Vice President and February 24, 1998
-------------------------- Chief Financial Officer
Robert A. Carothers
By /s/ Robert A. Hagemann Vice President and Controller February 24, 1998
--------------------------
Robert A. Hagemann
Pursuant to the requirements of the Securities Exchange Act of 1934, this
report has been signed below by the following persons on behalf of the
Registrant and on the dates indicated.
Capacity Date
------------------------ ------------------
/s/ Kenneth W. Freeman Chairman of the Board, February 24, 1998
- ------------------------- President and
Kenneth W. Freeman Chief Executive Officer
/s/ Kenneth D. Brody Director February 24, 1998
- -------------------------
Kenneth D. Brody
/s/ Van C. Campbell Director February 24, 1998
- -------------------------
Van C. Campbell
/s/ Mary A. Cirillo Director February 24, 1998
- -------------------------
Mary A. Cirillo
/s/ David A. Duke Director February 24, 1998
- -------------------------
David A. Duke
/s/ Dan C. Stanzione Director February 24, 1998
- -------------------------
Dan C. Stanzione
/s/ Gail R. Wilensky Director February 24, 1998
- -------------------------
Gail R. Wilensky
Quest Diagnostics Incorporated : 1997 Form 10-K
27
Quest Diagnostics Incorporated and Subsidiaries Selected Historical Financial
Data
Year Ended December 31,
------------------------------------------------------------------------------------
1997 1996 1995 1994(a) 1993(a)
----------------- ------------------- ------------------ ------------- -------------
(in thousands)
Operations Data:
Net revenues $1,528,695 $1,616,296 $1,629,388 $1,633,699 $1,416,338
Provisions for restructuring
and other special charges 48,688(b) 668,544(c) 50,560 79,814 99,600
Net income (loss) (22,260) (625,960) (52,052)(d) 28,345 34,197
Basic and diluted net loss per
common share(e) $ (0.77)
Balance Sheet Data (at end of period):
Accounts receivable, net $ 238,369 $ 297,743 $ 318,252 $ 360,410 $ 315,902
Total assets 1,400,928 1,395,066 1,853,385 1,882,663 1,861,162
Long-term debt 482,161 515,008 1,195,566 1,153,054 1,025,787
Stockholders' equity 541,661 538,719 295,801 386,812 395,509
Other Data:
Net cash provided by (used in)
operating activities $ 176,267 $ (88,486)(f) $ 85,828 $ 37,963 $ 99,614
Net cash used in investing activities (35,101) (63,674) (93,087) (46,186) (473,687)
Net cash (used in) provided by
financing activities (21,465) 157,674 4,986 7,532 392,956
Adjusted EBITDA(g) 153,800 166,358 176,521(d) 295,381 278,665
Bad debt expense 118,223(h) 111,238 152,590(d) 59,480 47,240
Rent expense 47,940 49,713 46,900 49,400 46,900
Capital expenditures 30,836 70,396 74,045 93,354 65,317
(a) In August 1993, Quest Diagnostics acquired Damon, a national
clinical-testing laboratory with approximately $280 million in annualized
revenues, excluding Damon's California-based laboratories, which were sold
in April 1994. In November 1993, Quest Diagnostics acquired certain
clinical-testing laboratories of Unilab Corporation ("Unilab"), with
approximately $90 million in annualized revenues. The Damon and Unilab
acquisitions were accounted for as purchases. Quest Diagnostics acquired
Maryland Medical Laboratory, Inc. ("MML"), Nichols and Bioran Medical
Laboratory ("Bioran") in June, August and October 1994, respectively, and
accounted for these acquisitions as poolings of interest. Results
presented include the results of Quest Diagnostics, MML, Nichols and
Bioran on a pooled basis. The increase in 1994 net revenues compared to
1993 net revenues was primarily due to the Damon and Unilab acquisitions.
(b) Includes a charge of $16 million to write-down intangible assets as
discussed in Note 5 to the Consolidated Financial Statements.
(c) Includes a charge of $445 million to reflect the write-down of intangible
assets as discussed in Note 2 to the Consolidated Financial Statements.
(d) Includes a third quarter charge of $62 million to increase the provision
for doubtful accounts resulting from billing systems implementation and
integration problems at certain laboratories and increased regulatory
requirements.
(e) Historical earnings per share data are not meaningful as the Company's
historical capital structure is not comparable with the capital structure
subsequent to the Spin-Off Distribution.
(f) Includes the payment of Damon and other billing related settlements
totaling approximately $144 million and the settlement of amounts owed to
Corning of $45 million.
(g) Adjusted EBITDA represents income (loss) before income taxes plus net
interest expense, depreciation and amortization and special charges,
including, in 1997, $6.8 million included in selling, general and
administrative expense, primarily for additional provisions for doubtful
accounts, to recognize the reduced recoverability of certain receivables
from accounts which will no longer be served as a result of the Company's
consolidation of its laboratory network. Adjusted EBITDA is presented and
discussed because management believes that Adjusted EBITDA is a useful
adjunct to net income and other measurements under generally accepted
accounting principles since it is a meaningful measure of a leveraged
company's performance and ability to meet its future debt service
requirements, fund capital expenditures and meet working capital
requirements. Adjusted EBITDA is not a measure of financial performance
under generally accepted accounting principles and should not be
considered as an alternative to (i) net income (or any other measure of
performance under generally accepted accounting principles) as a measure
of performance or (ii) cash flows from operating, investing or financing
activities as an indicator of cash flows or as a measure of liquidity.
(h) Includes a fourth quarter charge of $5.3 million to increase the provision
for doubtful accounts to recognize the reduced recoverability of certain
receivables from accounts which will no longer be served as a result of
the Company's consolidation plan.
Quest Diagnostics Incorporated : 1997 Form 10-K
28
Quest Diagnostics Incorporated Management's Discussion and Analysis of
Financial Condition and Results of Operations
- --------------------------------------------------------------------------------
Overview
In the last several years, Quest Diagnostics' business has been affected by
significant government regulation, price competition and rapid change resulting
from payors' efforts to control cost, utilization and delivery of health care
services. As a result of these factors, Quest Diagnostics' profitability has
been impacted by changes in the volume of testing and mix of payors, the prices
and costs of its services and the level of bad debt expense. Increased
government regulation focusing on health care cost containment has reduced
testing and reimbursements and added costs for the clinical laboratory industry
by increasing complexity and adding new regulatory requirements.
Payments for clinical laboratory services are made by the government, managed
care organizations, insurance companies, physicians and patients. In recent
years, there has been a significant shift away from traditional fee-for-service
health care to managed health care, as employers and other payors of health
care costs aggressively move the populations they control into lower cost
plans. Managed care organizations frequently negotiate capitated payment
contracts whereby health care providers receive a fixed monthly fee per covered
individual for all services included under contract. Capitated contract
arrangements shift the risks of increased testing to the clinical laboratory.
The managed care industry is growing, as well as undergoing rapid
consolidation, which has created large managed care companies that control the
delivery of health care services for millions of people, and have significant
bargaining power in negotiating fees with providers, including clinical
laboratories. The growth of managed care and use of capitated agreements is
expected to continue for the foreseeable future. The Company has begun to
aggressively review the profitability of its existing and new business,
including capitated agreements. Business that does not meet profitability
guidelines is subject to pricing and service level adjustments to ensure an
adequate profit level is achieved. These actions have favorably impacted prices
but unfavorably impacted volume in 1997.
The clinical laboratory industry is subject to seasonal fluctuations in
operating results and cash flows. During the summer months, year-end holiday
periods and other major holidays, volume of testing declines, reducing net
revenues and resulting cash flows below annual averages. Winter months are also
subject to declines in testing volume due to inclement weather, which varies in
severity from year to year.
The clinical laboratory industry is labor intensive. Approximately half of the
Company's total costs and expenses are associated with employee compensation
and benefits. Cost of services, which has approximated sixty percent of net
revenues over the past several years, consists principally of costs for
obtaining, transporting and testing specimens. Selling, general and
administrative expenses consist principally of the cost of the sales force,
billing operations (including bad debt expense), and general management and
administrative support.
Spin-Off from Corning. On December 31, 1996, Corning distributed to its
shareholders on a pro rata basis all of the shares of Quest Diagnostics. In
conjunction with the Spin-Off Distribution, the Company was recapitalized by
borrowing $500 million in long-term debt to repay Corning for certain
intercompany borrowings, with the remaining intercompany borrowings contributed
by Corning to Quest Diagnostics' capital. This recapitalization had the effect
of reducing the Company's total debt by approximately $700 million.
Additionally, coincident with the Spin-Off Distribution, the Company adopted a
new accounting policy for evaluating the recoverability of intangible assets
and measuring possible impairment which resulted in a $445.0 million reduction
in the carrying value of intangible assets.
- --------------------------------------------------------------------------------
Results of Operations
Year Ended December 31, 1997 Compared with Year Ended December 31, 1996.
Reported earnings improved from the prior year principally due to a reduced
level of special charges and lower interest and amortization expense in 1997.
Improved pricing and ongoing cost reduction efforts principally offset the
impact on operating earnings of lower volume.
Net Revenues
Net revenues decreased by $87.6 million from the prior year, principally due to
declines in base clinical testing volume of 7.3%, the sale in November 1996 of
a majority share of the Company's imaging business and the July 1997
contribution of the Company's Arizona operations to a joint venture. These
decreases were partially offset by a 2.9% improvement in average prices of
clinical testing and a small strategic acquisition in Connecticut in May 1997.
The clinical testing volume decline is primarily attributable to intense
competition for existing business, changes in physician ordering patterns
resulting from government regulations requiring documentation of the medical
necessity
Quest Diagnostics Incorporated : 1997 Form 10-K
29
of testing and the Company's increased selectiveness in retaining and pursuing
new business. The price increase is the result of the Company's increased
selectiveness in retaining and pursuing new business.
Costs and Expenses
Total operating costs declined $76.2 million from the prior year. Approximately
$34 million of the decline was attributable to the sale of the majority share
of the Company's imaging business and the July 1997 contribution of the
Company's Arizona operations to a joint venture. The Company's efforts to
reduce its operating cost structure have had a favorable impact on costs as a
percentage of net revenue. However, this benefit was principally offset by
lower volume and a $6.8 million charge included in selling, general and
administrative expense related to the Company's consolidation of its laboratory
network. Plans, including the consolidation of its laboratory network, are
being implemented to further reduce the Company's cost structure.
Cost of services, as a percentage of revenues, decreased to 60.7% from 62.5% in
the prior year, reflecting the Company's progress in reducing its cost structure
and the sale of the majority share of its imaging business. Selling, general and
administrative expenses, as a percentage of revenues, increased to 32.8% from
30.6% in the prior year. The increase is primarily the effect of reduced
revenues without a proportionate cost decrease, a special charge of $6.8 million
related to the Company's consolidation of its laboratory network and an increase
in bad debt expense. The $6.8 million charge consists primarily of additional
provisions for doubtful accounts and recognizes the Company's estimate, based on
prior experience, of the reduced recoverability of certain receivables from
accounts which will no longer be served as a result of the consolidation plan.
Excluding the charge, bad debt expense was 7.4% of net revenues compared to 6.9%
in the prior year. While bad debt expense was above the prior year level for the
first half of the year, excluding the charge, it was below the prior year level
during the second half of the year, reflecting progress made in dealing with the
Medicare medical necessity documentation requirements enforced during 1997.
These requirements, when initially imposed or subsequently expanded, increase
the backlog of unbilled requisitions and further complicate the billing process.
The Company has successfully dealt with these requirements in most of its
billing sites where they were imposed earlier, and is leveraging the processes
and experiences from those locations in addressing the additional requirements
at its billing operations which have not been fully impacted. Additional efforts
to improve billing operations are being made and are expected to lower bad debt
expense below the 1997 rate in 1998.*
Net interest expense decreased from the prior year by $33.9 million primarily
due to reduced debt levels as a result of Corning forgiving in excess of $700
million of intercompany debt in connection with the Spin-Off Distribution.
Amortization of intangible assets decreased from the prior year by $17.7
million principally due to the write-down of intangible assets coincident with
the Spin-Off Distribution, as well as certain other intangible assets having
become fully amortized.
In the fourth quarter of 1997, the Company recorded special charges totaling
$55.5 million in connection with a series of actions aimed at reducing excess
capacity in its network of clinical laboratories through facility reductions
and consolidations. As noted earlier, $6.8 million of the charges was included
in selling, general and administrative expense. The remaining $48.7 million has
been presented separately and consisted primarily of workforce reduction
programs, costs associated with exiting a number of lease facilities, the
write-off of certain assets and a $16.0 million write-down of intangible assets
to reflect the estimated impairment as a result of the Company's consolidation
activities.
During 1996, the Company recorded special charges totaling $668.5 million.
These charges consisted primarily of a $445.0 million write-down of intangible
assets associated with the Company's adoption of a new accounting policy;
$188.0 million to establish additional reserves associated with government and
other claims primarily related to billing activities at certain laboratories of
Damon and Nichols prior to their acquisition by the Company; and $21.9 million
associated with the Company's spin-off from Corning.
The change in other, net compared with the prior year is primarily the result
of the current year including charges related to the integration of a small,
strategic acquisition completed in Connecticut and the Company's contribution
of its Arizona business to a joint venture, and the prior year including gains
on the sale of several small investments and the favorable settlement of a
contractual obligation.
- --------------------------------------------------------------------------------
* This is a forward looking statement within the meaning of Section 27A of
the Securities Act of 1933, as amended, and Section 27E of the Securities Act
of 1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and uncer-
tainties include the impact upon the Company's volume and expenses result-
ing from compliance with Medicare administrative policies and computer or
other system failures. See "Business--Cautionary Statement for Purposes of
the 'Safe Harbor' Provisions of the Private Securities Litigation Reform Act of
1995." In particular, see factors (c), (d) and (j).
Quest Diagnostics Incorporated : 1997 Form 10-K
30
The Company's effective tax rate is significantly impacted by goodwill
amortization, a majority of which is not deductible for tax purposes, and has
the effect of increasing the overall tax rate or reducing the tax benefit rate.
The Company's 1997 tax rate was also impacted by the write-down of intangible
assets which was not deductible for tax purposes. The effect of this
non-deductibility is particularly pronounced when amortization and other
non-deductible charges increase in proportion to pre-tax earnings, as was the
case in both 1997 and 1996.
Year Ended December 31, 1996 Compared with Year Ended December 31, 1995.
Earnings were substantially below those for the prior year due principally to
special charges, price declines, increases in salaries and wages, and unusually
severe winter weather experienced during the first quarter of 1996.
Net Revenues
Net revenues decreased by $13.1 million from the prior year, principally due to
average price declines of approximately 3%, partially offset by a 0.6% increase
in clinical testing volume and increased revenues from the Company's
nonclinical businesses. Adversely affecting the volume growth was unusually
severe winter weather in the northeastern and central parts of the United
States during the first quarter of 1996. While the prices for laboratory tests
were stable over the course of the year, they were lower than 1995 when prices
declined steadily. The majority of the price declines for 1996 compared to 1995
resulted from changes in reimbursement policies of various third-party payors,
shifts in volume to lower-priced managed care business, and intense price
competition in the industry. Also contributing to the price declines was a
reduction in Medicare fee schedules effective January 1, 1996, which accounted
for approximately a 1% decrease in net revenues.
Costs and Expenses
Cost of services increased by 2.4% as a percentage of net revenues from the
prior year. The increase was due principally to the effects of declining prices
and increases in salaries and wages associated with improving customer service
levels and wage adjustments.
Selling, general and administrative expenses decreased by $27.9 million, or
1.5% as a percentage of net revenues from the prior year. The decrease was due
principally to a reduction in bad debt expense, which decreased by $41.4
million to 6.9% of net revenues from 9.4% of net revenues in 1995, and was
partially offset by costs associated with developing and implementing strategic
action plans and operating improvement plans. The reduction in bad debt expense
results primarily from the unusually high level of bad debt expense in the
prior year, which included a charge of $62 million to increase receivable
reserves. The Company has established, and maintains, rigorous programs to
improve the effectiveness of its billing and collection operations. The
established programs include standard policies and procedures, employee
training programs and regular reporting and tracking of key measures by senior
management. The implementation of these programs during the fourth quarter of
1995 has aided in reducing bad debt expense. However, additional requirements
to provide documentation of the medical necessity of testing added to the
backlog of unbilled receivables and caused bad debt expense during the second
half of 1996 to increase above the rate the Company had experienced during the
first half of 1996.
Net interest expense decreased by $7.1 million from the prior year as a result
of Corning contributing greater than $700 million of intercompany debt to the
Company's equity during the fourth quarter. Amortization of intangible assets
decreased below the prior year level by $3.0 million due to certain intangible
assets having been fully amortized.
In the second quarter of 1996, as a consequence of an investigation begun in
1993, the DOJ notified Quest Diagnostics that it had taken issue with payments
related to certain tests received by Damon from federally funded health care
programs prior to the acquisition of Damon by the Company. During 1996,
management met with the DOJ several times to evaluate the substance of the
government's allegations. During the second and third quarters, the Company
recorded charges totaling $188.0 million to establish additional reserves
associated with government and other claims primarily related to billing
practices at certain laboratories of Damon and Nichols Institute prior to their
acquisition. During the fourth quarter, the Company entered into an agreement
with the DOJ to pay $119 million to settle all federal and Medicaid claims
related to the billing by Damon of certain blood test series for federally
sponsored health care programs. Corning contributed $119 million to the
Company's capital to fund the payment of the Damon settlement. See Note 14 to
the Consolidated Financial Statements.
In the third quarter of 1996 the Company recorded a charge of $13.7 million to
write off capitalized software as a result of its decision to abandon what had
been intended as its company-wide billing system. Management now plans to
standardize billing systems using a system already implemented in several of
its sites.
Quest Diagnostics Incorporated : 1997 Form 10-K
31
In the fourth quarter of 1996, Quest Diagnostics recorded a non-recurring
charge of $21.9 million. The charge consisted of the cost to fund an employee
stock ownership plan ($11.7 million) and fees for advisors and other costs
associated with establishing Quest Diagnostics as an independent entity.
Coincident with the Spin-Off Distribution, the Company adopted a new accounting
policy for evaluating the recoverability of its intangible assets and measuring
possible impairment based on the estimated amount for which each of its
regional laboratories could be sold in an arm's-length transaction. Management
believes fair value is a better indicator of the extent to which the intangible
assets may be recoverable and therefore, may be impaired. The change in policy
resulted in the Company recording a non-cash charge of $445.0 million. See Note
2 to the Consolidated Financial Statements.
In the second quarter of 1995, the Company recorded a provision for
restructuring totaling $33.0 million primarily for work force reduction
programs and the costs of exiting a number of leased facilities. Additionally,
in the first quarter of 1995 the Company recorded a special charge of $12.8
million for the settlement of claims related to the inadvertent billing of
certain laboratory tests that were not completely and/or successfully performed
or reported due to insufficient samples and/or invalid results.
Gains on the sale of several small investments and the favorable settlement of
a contractual obligation, both of which occurred in 1996, accounted for the
majority of the change in other, net compared to the prior year.
Quest Diagnostics' effective tax rate is significantly impacted by goodwill
amortization which is not deductible for tax purposes. This had the effect of
reducing the tax benefit rate of the Company in both 1996 and 1995. The
Company's 1996 tax rate was also impacted by the write-down of intangible
assets which was not deductible for tax purposes. The effect of this non-
deductibility is particularly pronounced when amortization and other
non-deductible charges increase in proportion to pre-tax earnings, as was the
case in both 1996 and 1995.
- --------------------------------------------------------------------------------
Liquidity and Capital Resources
Cash and cash equivalents at December 31, 1997 increased from 1996 to $161.7
million, an increase of $119.7 million from the prior year end balance. The
increase resulted from operating activities which provided cash of $176.3
million, partially offset by investing and financing activities which required
cash of $56.6 million. Cash and cash equivalents for the year ended December
31, 1996 increased from 1995 by $5.5 million due to financing activities which
provided cash of $157.7 million, partially offset by operating and investing
activities which used cash of $152.2 million.
Net cash from operating activities in 1997 increased compared to 1996 primarily
due to a reduction in payments associated with restructuring and other special
charges, improvements in billing operations, and changes in accounts payable
and accrued expense levels. Net cash from operating activities for the year
ended December 31, 1996 decreased from the prior year as a result of reduced
earnings, payment of billing related settlements totaling approximately $144
million, and the settlement of amounts owed to Corning. Improvements in the
billing operations during 1997 and 1996 have led to an improvement in the
number of days sales outstanding. The number of days sales outstanding, a
measure of billing and collection efficiency, was 63 days at December 31, 1997
compared to 73 days at December 31, 1996 and 76 days at December 31, 1995.
Net cash used for investing activities for the year ended December 31, 1997 was
below the prior year level primarily due to reduced capital spending partially
offset by payment for a small, strategic acquisition in 1997. Cash used for
investing activities for the year ended December 31, 1996 was below the prior
year level due to reduced acquisition activity and the sale of several small
investments during 1996.
Net cash used in financing activities in 1997 consisted primarily of the
Company's repayment of $19.3 million on its revolving Working Capital Facility,
as defined in Note 9 to the Consolidated Financial Statements. Other than for
the reduction for outstanding letters of credit, which currently approximate
$6.4 million, all of the revolving Working Capital Facility is currently
available for borrowing. Net cash provided by financing activities for the year
ended December 31, 1996 increased above the prior year level primarily due to
Corning's contribution of $119.1 million to capital to fund the Damon
settlement and a reduction in dividends paid to Corning. Financing activities
in 1995 consisted principally of dividend payments to, and net borrowing
activities with, Corning.
The Company estimates that it will invest approximately $60 million to $70
million during 1998 for capital expenditures, principally related to
investments in information technology infrastructure and equipment
Quest Diagnostics Incorporated : 1997 Form 10-K
32
and facility upgrades.* The Company expects to expand its operations
principally through internal growth and accelerated growth in strategic markets
and related lines of business. The Company expects such activities will be
funded from existing cash and cash equivalents, cash flow from operations, and,
if necessary, borrowings under the Working Capital Facility. Quest Diagnostics
believes that the Working Capital Facility will be sufficient to meet both its
short-term and its foreseeable financing needs. As a result, the Company
believes it has sufficient financial flexibility and sufficient access to funds
to meet seasonal working capital requirements, to fund capital expenditures and
to fund growth opportunities.
During February 1998 Quest Diagnostics' Board of Directors authorized a limited
share repurchase program which permits the Company to repurchase up to $27
million of its outstanding common stock through 1999. The program is intended
to mitigate the dilutive impact on earnings per share from issuing new shares
for certain of the Company's employee benefit plans. These limited repurchases
are permitted under both the Company's Credit Agreement and the Notes, defined
in Note 9 to the Consolidated Financial Statements.
The Company does not anticipate paying dividends on its common stock in the
foreseeable future. The Credit Agreement prohibits the payment of cash
dividends and the Notes restrict the Company's ability to pay cash dividends on
its common stock. These restrictions are primarily based on a percentage of the
Company's earnings, as defined. Additionally, the Credit Agreement contains
various customary affirmative and negative covenants, including the maintenance
of certain financial ratios and tests, and limitations on common stock
repurchases.
Periodically, there may be acquisitions or other growth opportunities which
will require additional external financing, and the Company may from time to
time seek to obtain funds from public or private issuances of equity or debt
securities. There can be no assurance that such financing will be available on
terms acceptable to the Company.
Management believes that Quest Diagnostics' successful implementation of its
business strategy, together with the indemnification by Corning against
monetary fines, penalties or losses from outstanding government claims, will
enable it to generate strong cash flows.** Additionally, management believes
that these actions, together with the Company's leading market position or low
cost provider status in a number of geographic regions accounting for the
majority of its net revenues, will aid the Company in meeting the ongoing
challenges in the clinical laboratory industry brought on by growth in managed
care and increased regulatory complexity.**
Adjusted EBITDA
Adjusted EBITDA represents income (loss) before income taxes plus net interest
expense, depreciation and amortization and special charges, including a $6.8
million charge included in selling, general and administrative expenses related
to the Company's consolidation of its laboratory network in 1997. Adjusted
EBITDA is presented and discussed because management believes it is a useful
adjunct to net income and other measurements under generally accepted
accounting principles. Additionally, management believes it is a meaningful
measure of a leveraged company's performance and ability to meet its future
debt service requirements, fund capital expenditures and meet working capital
requirements. Adjusted EBITDA is not a measure of financial performance under
generally accepted accounting principles and should not be considered as an
alternative to (i) net income (or any other measure of performance under
generally accepted accounting principles) as a measure of performance or (ii)
cash flows from operating, investing or financing activities as an indicator of
cash flows or as a measure of liquidity.
Adjusted EBITDA for 1997 was $153.8 million, or 10.1% of net revenues. Adjusted
EBITDA for the prior period was $166.4 million, or 10.3% of net revenues. The
decline was principally due to changes in physician ordering patterns, intense
competition for exist-
- --------------------------------------------------------------------------------
* These are forward looking statements within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and are based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include computer or other system failures, including failure
resulting from the Year 2000 problem, and the development of technologies that
substantially alter the practice of medicine. See "Business--Cautionary
Statement for Purposes of the 'Safe Harbor' Provisions of the Private Securities
Litigations Reform Act of 1995." In particular, see factors (j), (k) and (l).
- --------------------------------------------------------------------------------
** This is a forward looking statement within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include heightened competition; changes in payor mix; failure to
retain existing customers, including by reason of consolidation of certain
laboratories; computer or other system failures; development of technologies
that substantially alter the practice of medicine; and changes in interest
rates. See "Business--Cautionary Statement for Purposes of the 'Safe Harbor'
Provisions of the Private Securities Litigation Reform Act of 1995." In
particular, see factors (a), (b), (c), (d), (e), (f), (j) and (m).
Quest Diagnostics Incorporated : 1997 Form 10-K
33
ing business and the Company's increased selectiveness in retaining and
pursuing new business, which have reduced volume at a rate greater than that at
which costs have been reduced. However, Adjusted EBITDA increased as a
percentage of net revenues from the prior year for the six months ended
December 31, 1997, reflecting the Company's continued progress in reducing its
cost structure.
Adjusted EBITDA for 1996 was $166.4 million, or 10.3% of net revenues. Adjusted
EBITDA for the prior period was $176.5 million, or 10.8% of net revenues. The
decline in Adjusted EBITDA was principally due to price declines and increases
in salaries and wages associated with improving customer service levels
partially offset by a reduction in bad debt expense.
- --------------------------------------------------------------------------------
Outlook
Those factors which impacted volume during 1997 will continue to negatively
impact volume in 1998. In addition, the Company's actions to reduce excess
capacity through facility consolidations will further reduce volume, but are
expected to improve overall profitability. By the beginning of 1999, when the
actions are fully implemented, annual benefits are expected to be in excess of
$20 million before taxes.*
During 1998, the Company will begin deploying a new test requisition designed to
comply with the new disease-oriented test panels recommended by the American
Medical Association for Medicare and Medicaid patients. When these new panels
become mandatory on April 1, 1998, the Company believes that they will have a
negative impact on revenues. However, the Company believes that this decrease
may be partially offset by revenues that result from patients
electing to pay for tests not covered by Medicare.** While the introduction of
these new panels could have a material adverse effect on the Company's results
of operations, management does not believe that these changes will have a
material adverse effect on its overall financial condition.
- --------------------------------------------------------------------------------
Year 2000 Readiness
The Company has taken actions to understand the nature and the extent of the
work required to make its computer systems and information infrastructure Year
2000 compliant and has begun work to prepare its computer-based systems for the
Year 2000. Actions include replacing existing systems to standardized platforms
that are Year 2000 compliant as well as updating existing legacy systems. The
Company continues to evaluate the estimated costs associated with these efforts
based on actual experience. Current estimates to prepare the Company's computer
systems for the Year 2000 are $60 million to $70 million, of which
approximately 40% to 50% will be capitalized. While these efforts will involve
additional costs, the Company believes, based on available information, that it
will be able to manage its total Year 2000 transition without any material
adverse effect on its operations or financial position.***
- --------------------------------------------------------------------------------
Inflation
The Company believes that inflation generally does not have a material adverse
effect on its operations or financial condition because the majority of its
contracts are short-term.
- --------------------------------------------------------------------------------
* This is a forward looking statement within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include the impact upon the Company's revenues and expenses
resulting from compliance with Medicare administrative policies; failure to
retain existing customers including by reason of consolidation of certain
laboratories; computer or other system failures; and development of technologies
that substantially alter the practice of medicine. See "Cautionary Statement for
Purposes of the 'Safe Harbor' Provisions of the Private Securities Litigation
Reform Act of 1995." In particular, see factors (c), (d), (f), (j) and (k).
** This is a forward looking statement within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include the impact upon the Company's revenues and expenses
resulting from compliance with Medicare administrative policies. See
"Business--Cautionary Statement for Purposes of the 'Safe Harbor' Provisions of
the Private Securities Litigation Reform Act of 1995." In particular, see
factor (d).
*** This is a forward looking statement within the meaning of Section 27A of the
Securities Act of 1933, as amended, and Section 27E of the Securities Act of
1934, as amended, and is based on current expectations. Forward looking
statements involve risks and uncertainties that could cause actual results to
differ materially from the forward looking statement. These risks and
uncertainties include computer or other system failures, including failure
resulting from the Year 2000 problem. See "Business--Cautionary Statement for
Purposes of the 'Safe Harbor' Provisions of the Private Securities Litigation
Reform Act of 1995." In particular, see factors (j) and (k).
Quest Diagnostics Incorporated : 1997 Form 10-K
34
Report of Independent Accountants
[PRICE WATERHOUSE LOGO]
To the Board of Directors and Stockholders of
Quest Diagnostics Incorporated
In our opinion, the consolidated financial statements listed in the index
appearing under Item 14(a) 1. and 2. on page 25 present fairly, in all material
respects, the financial position of Quest Diagnostics Incorporated and its
subsidiaries at December 31, 1997 and 1996, and the results of their operations
and their cash flows for each of the three years in the period ended December
31, 1997, in conformity with generally accepted accounting principles. These
financial statements are the responsibility of the Company's management; our
responsibility is to express an opinion on these financial statements based on
our audits. We conducted our audits of these statements in accordance with
generally accepted auditing standards which require that we plan and perform
the audit to obtain reasonable assurance about whether the financial statements
are free of material misstatement. An audit includes examining, on a test
basis, evidence supporting the amounts and disclosures in the financial
statements, assessing the accounting principles used and significant estimates
made by management, and evaluating the overall financial statement
presentation. We believe that our audits provide a reasonable basis for the
opinion expressed above.
As discussed in Note 2, the Company adopted a new accounting policy for
evaluating the recoverability of intangible assets during 1996.
Price Waterhouse LLP
New York, New York
January 23, 1998.
Quest Diagnostics Incorporated : 1997 Form 10-K
F-1
Quest Diagnostics Incorporated and Subsidiaries
Consolidated Balance Sheets
December 31, 1997 and 1996
(in thousands, except per share data)
Assets 1997 1996
Current assets:
- --------------------------------------------------------------------------------
Cash and cash equivalents $ 161,661 $ 41,960
Accounts receivable, net of allowance
of $89,870 and $115,018 at December 31, 1997
and 1996, respectively 238,369 297,743
Inventories 30,360 28,524
Deferred taxes on income 97,471 98,162
Due from Corning Incorporated 31,600 30,894
Prepaid expenses and other current assets 12,423 13,682
- --------------------------------------------------------------------------------
Total current assets 571,884 510,965
Property, plant and equipment, net 250,223 287,749
Intangible assets, net 513,779 546,457
Deferred taxes on income 23,182 20,420
Other assets 41,860 29,475
- --------------------------------------------------------------------------------
Total assets $1,400,928 $1,395,066
========================
Liabilities and Stockholders' Equity
- --------------------------------------------------------------------------------
Current liabilities:
Accounts payable and accrued expenses $ 244,885 $ 206,701
Short-term borrowings 32,648 20,785
Income taxes payable 17,613 21,946
- --------------------------------------------------------------------------------
Total current liabilities 295,146 249,432
Long-term debt 482,161 515,008
Other liabilities 81,961 91,907
- --------------------------------------------------------------------------------
Total liabilities 859,268 856,347
- --------------------------------------------------------------------------------
Commitments and contingencies
Stockholders' equity:
- --------------------------------------------------------------------------------
Preferred stock 1,000 1,000
Common stock, par value $0.01 per share;
100,000 shares authorized; 29,986 and
28,822 shares issued at December 31, 1997
and 1996, respectively 300 288
Additional paid-in capital 1,198,194 1,170,152
Accumulated deficit (650,281) (627,892)
Cumulative translation adjustment (1,170) (619)
Market valuation adjustment (1,345) (4,210)
Unearned compensation (5,038) --
- --------------------------------------------------------------------------------
Total stockholders' equity 541,660 538,719
- --------------------------------------------------------------------------------
Total liabilities and stockholders' equity $1,400,928 $1,395,066
========================
The accompanying notes are an integral part of these statements.
Quest Diagnostics Incorporated : 1997 Form 10-K
F-2
Quest Diagnostics Incorporated and Subsidiaries
Consolidated Statements of Operations
For the Years Ended December 31, 1997, 1996 and 1995
(in thousands, except per share data)
1997 1996 1995
Net revenues $1,528,695 $1,616,296 $1,629,388
Costs and expenses:
- --------------------------------------------------------------------------------
Cost of services 927,864 1,010,875 980,232
Selling, general and administrative 502,123 495,323 523,271
Interest expense, net 40,996 74,918 82,016
Amortization of intangible assets 23,951 41,625 44,656
Provisions for restructuring and
other special charges 48,688 668,544 50,560
Other, net 4,131 1,213 6,221
- --------------------------------------------------------------------------------
Total 1,547,753 2,292,498 1,686,956
- --------------------------------------------------------------------------------
Loss before taxes (19,058) (676,202) (57,568)
Income tax expense (benefit) 3,202 (50,242) (5,516)
- --------------------------------------------------------------------------------
Net loss $ (22,260) $ (625,960) $ (52,052)
====================================
Basic and diluted net loss
per common share $ (0.77)
==========
The accompanying notes are an integral part of these statements.
Quest Diagnostics Incorporated : 1997 Form 10-K
F-3
Quest Diagnostics Incorporated and Subsidiaries
Consolidated Statements of Cash Flows
For the Years Ended December 31, 1997, 1996 and 1995
(in thousands)
1997 1996 1995
Cash flows from operating activities:
- --------------------------------------------------------------------------------
Net loss $ (22,260) $ (625,960) $ (52,052)
Adjustments to reconcile net loss
to net cash provided by (used in)
operating activities:
Depreciation and amortization 76,397 99,098 101,513
Provision for doubtful accounts 118,223 111,238 152,590
Provisions for restructuring and
other special charges 48,688 668,544 50,560
Deferred income tax provision (1,090) (4,472) (32,384)
Other, net 6,117 558 8,303
Changes in operating assets and
liabilities:
Accounts receivable (63,865) (94,657) (109,500)
Accounts payable and accrued expenses 27,835 (16,671) 14,604
Restructuring, settlement and
integration provisions (16,703) (160,627) (57,768)
Due from/to Corning Incorporated
and affiliates 8,755 (44,729) 2,934
Other assets and liabilities, net (5,830) (20,808) 7,028
- --------------------------------------------------------------------------------
Net cash provided by (used in)
operating activities 176,267 (88,486) 85,828
- --------------------------------------------------------------------------------
Cash flows from investing activities:
- --------------------------------------------------------------------------------
Capital expenditures (30,836) (70,396) (74,045)
Proceeds from disposition of assets 10,397 11,989 2,880
Acquisition of businesses,
net of cash acquired (16,000) -- (22,907)
Decrease (increase) in investments 1,338 (5,267) 985
- --------------------------------------------------------------------------------
Net cash used in investing activities (35,101) (63,674) (93,087)
- --------------------------------------------------------------------------------
Cash flows from financing activities:
- --------------------------------------------------------------------------------
Net (repayments) borrowings under
Working Capital Facility (19,300) 19,300 --
Proceeds from borrowings -- 559,342 55,729
Repayment of long-term debt (2,067) (528,178) (13,784)
Payment of debt issuance costs -- (10,681) --
Contribution of capital from
Corning Incorporated -- 119,063 --
Dividends paid (98) (1,172) (36,959)
- --------------------------------------------------------------------------------
Net cash (used in) provided by
financing activities (21,465) 157,674 4,986
- --------------------------------------------------------------------------------
Net change in cash and cash equivalents 119,701 5,514 (2,273)
Cash and cash equivalents,
beginning of year 41,960 36,446 38,719
- --------------------------------------------------------------------------------
Cash and cash equivalents, end of year $ 161,661 $ 41,960 $ 36,446
====================================
The accompanying notes are an integral part of these statements.
Quest Diagnostics Incorporated : 1997 Form 10-K
F-4
Quest Diagnostics Incorporated and Subsidiaries
Consolidated Statements of Stockholders' Equity
For the years ended December 31, 1997, 1996 and 1995
(in thousands)
Retained
Additional Earnings Cumulative Market Total
Preferred Common Paid-in (Accumulated Translation Valuation Unearned Stockholders
Stock Stock Capital Deficit) Adjustment Adjustment Compensation Equity
- ------------------------------------------------------------------------------------------------------------------------------------
Balance,
December 31, 1994 $ -- $ -- $ 297,823 $ 85,893 $ 3,096 $ -- $ -- $ 386,812
Net loss (52,052) (52,052)
Dividends paid to
Corning Incorporated (36,959) (36,959)
Translation adjustment (771) (771)
Market valuation
adjustment (1,229) -- (1,229)
- ------------------------------------------------------------------------------------------------------------------------------------
Balance,
December 31, 1995 -- -- 297,823 (3,118) 2,325 (1,229) -- 295,801
Net loss (625,960) (625,960)
Dividends paid to
Corning Incorporated (1,172) (1,172)
Issuance of preferred
stock 1,000 (1,000) --
Capital contribution
and Spin-Off
Distribution
(28,043 shares) 280 861,683 861,963
Establishment of
employee stock
ownership plan
(779 shares) 8 11,646 11,654
Translation adjustment 2,358 (2,944) (586)
Market valuation
adjustment (2,981) (2,981)
- ------------------------------------------------------------------------------------------------------------------------------------
Balance,
December 31, 1996 1,000 288 1,170,152 (627,892) (619) (4,210) -- 538,719
Net loss (22,260) (22,260)
Preferred dividends
declared (129) (129)
Issuance of common
stock under benefit
compensation plans
(1,164 shares) 12 18,501 (6,975) 11,538
Capital contribution 9,541 9,541
Translation adjustment (551) (551)
Market valuation
adjustment 2,865 2,865
Amortization of
unearned
compensation 1,937 1,937
- ------------------------------------------------------------------------------------------------------------------------------------
Balance,
December 31, 1997 $1,000 $300 $1,198,194 $ (650,281) $ (1,170) $ (1,345) $ (5,038) $ 541,660
========================================================================================================
The accompanying notes are an integral part of these statements.
Quest Diagnostics Incorporated : 1997 Form 10-K
F-5
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
- --------------------------------------------------------------------------------
1. Basis of Presentation
Quest Diagnostics Incorporated and its subsidiaries ("Quest Diagnostics" or the
"Company") is one of the largest clinical laboratory testing businesses in the
United States. Prior to January 1, 1997, Quest Diagnostics was a wholly-owned
subsidiary of Corning Incorporated ("Corning"). On December 31, 1996, Corning
distributed all of the outstanding shares of common stock of the Company to the
stockholders of Corning, with one share of common stock of the Company being
distributed for each eight shares of outstanding common stock of Corning. This
distribution was followed immediately by the distribution to the stockholders
of the Company of all the outstanding common stock of Covance Inc. ("Covance")
(formerly Corning Pharmaceutical Services Inc.), with one share of common stock
of Covance being distributed for each four shares of outstanding common stock
of Corning. These two distributions are collectively referred to as the
"Spin-Off Distribution." The result was the creation of two new independent,
publicly-owned companies. Prior to the Spin-Off Distribution, Corning received
a ruling from the Internal Revenue Service that the Spin-Off Distribution would
be tax-free. In conjunction with the Spin-Off Distribution, Corning, Quest
Diagnostics and Covance entered into a transaction agreement and tax
indemnification and tax sharing agreements. The transaction agreement provides
for, among other things, Corning to indemnify the Company against all
settlements for government claims pending at December 31, 1996 (see Note 14).
Additionally, in conjunction with the Spin-Off Distribution, the Company
borrowed $500 million in long-term debt to repay Corning for certain
intercompany borrowings. The remaining intercompany debt was contributed by
Corning to the Company's equity.
- --------------------------------------------------------------------------------
2. Summary of Significant Accounting Policies
Principles of Consolidation
The consolidated financial statements include the accounts of all entities
controlled by the Company. The equity method of accounting is used for
investments in affiliates which are not Company controlled and in which the
Company's interest is generally between 20 and 50 percent. The Company's share
of the net income or loss of its equity investments is included in other, net.
All significant intercompany accounts and transactions are eliminated.
The preparation of financial statements in conformity with generally accepted
accounting principles requires management to make estimates and assumptions
that affect the reported amounts of assets and liabilities and disclosure of
contingent assets and liabilities at the date of the financial statements and
the reported amounts of revenues and expenses during the reporting period.
Actual results could differ from those estimates.
Revenue Recognition
The Company generally recognizes revenue for services rendered upon completion
of the testing process. Billings for services under third-party payor programs,
including Medicare and Medicaid, are recorded as revenues net of allowances for
differences between amounts billed and the estimated receipts under such
programs. Adjustments to the estimated receipts, based on final settlement with
the third-party payors, are recorded upon settlement. In 1997, 1996 and 1995,
approximately 20%, 21% and 23%, respectively, of net revenues were generated by
Medicare and Medicaid programs.
Concentrations of Credit Risk
Concentrations of credit risk with respect to accounts receivable are limited
due to the diversity of the Company's clients as well as their dispersion
across many different geographic regions.
Taxes on Income
The Company uses the asset and liability approach to account for income taxes.
Under this method, deferred tax assets and liabilities are recognized for the
expected future tax consequences of differences between the carrying amounts of
assets and liabilities and their respective tax bases using tax rates in effect
for the year in which the differences are expected to reverse. The effect on
deferred tax assets and liabilities of a change in tax rates is recognized in
income in the period when the change is enacted.
Cash and Cash Equivalents
Cash and cash equivalents include all highly-liquid investments with
maturities, at the time acquired by the Company, of three months or less.
Inventories
Inventories, which consist principally of supplies, are valued at the lower of
cost (first in, first out method) or market.
Quest Diagnostics Incorporated : 1997 Form 10-K
F-6
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
Property, Plant and Equipment
Property, plant and equipment are recorded at cost. Depreciation and
amortization are provided on the straight-line method over expected useful
asset lives, which range from three to forty years.
Long-Lived Assets
The Company reviews the recoverability of its long-lived assets when events or
changes in circumstances occur that indicate that the carrying value of the
asset may not be recoverable. Evaluation of possible impairment is based on the
Company's ability to recover the asset from the expected future pre-tax cash
flows (undiscounted and without interest charges) of the related operations. If
the expected undiscounted pre-tax cash flows are less than the carrying value
of such asset, an impairment loss would be recognized for the difference
between estimated fair value and carrying value.
Accounting for Intangible Assets
Acquisition costs in excess of the fair value of net tangible assets acquired
are capitalized and amortized over periods not exceeding forty years. Other
intangible assets are recorded at cost and amortized over periods not exceeding
fifteen years.
Coincident with the Spin-Off Distribution, management adopted a new accounting
policy for evaluating the recoverability of intangible assets and measuring
possible impairment under Accounting Principles Board Opinion No. 17,
"Intangible Assets". Most of the Company's intangible assets resulted from
purchase business combinations in 1993. Significant changes in the clinical
laboratory and health care industries subsequent to 1993, including increased
government regulation and movement from traditional fee-for-service care to
managed cost health care, had caused the fair value of the intangible assets to
be significantly less than historical carrying value. Management believes that
a valuation of intangible assets based on the amount for which each regional
laboratory could be sold in an arm's-length transaction is preferable to using
projected undiscounted pre-tax cash flows. The Company believes fair value is a
better indicator of the extent to which the intangible assets may be
recoverable and therefore, may be impaired. This change in method of evaluating
the recoverability of intangible assets resulted in a charge of $445.0 million
to operations in 1996 to reflect the impairment of intangible assets, which is
included in provisions for restructuring and other special charges.
The fair value method is applied to each of the regional laboratories.
Management's estimate of fair value is primarily based on multiples of
forecasted revenue or multiples of forecasted earnings before interest, taxes,
depreciation and amortization ("EBITDA"). The multiples are primarily
determined based upon publicly available information regarding comparable
publicly-traded companies in the industry, but also considered (i) the
financial projections of each regional laboratory, (ii) the future prospects of
each regional laboratory, including its growth opportunities, managed care
concentration and likely operational improvements, and (iii) comparable sales
prices, if available. Multiples of revenues are used to estimate fair value in
cases where the Company believes that the likely acquirer of a regional
laboratory would be a strategic buyer within the industry which would realize
synergies from such an acquisition. In regions where management does not
believe there is a potential strategic buyer within the industry, and,
accordingly, believes the likely buyer would not have synergy opportunities,
multiples of EBITDA are used for estimating fair value. Regional laboratories
with lower levels of profitability valued using revenue multiples would
generally be ascribed a higher value than if multiples of EBITDA were used, due
to assumed synergy opportunities. Management's estimate of fair value is
currently based on multiples of revenue primarily ranging from 0.5 to 0.7 times
revenue and on multiples of EBITDA primarily ranging from 5 to 6 times EBITDA.
While management believes the estimation methods are reasonable and reflective
of common valuation practices, there can be no assurance that a sale to a buyer
for the estimated value ascribed to a regional laboratory could be completed.
Changes to the method of valuing regional laboratories will be made only when
there is a significant and fundamental change in facts and circumstances, such
as significant changes in market position or the entrance or exit of a
significant competitor from a regional market. No changes were made to the
method of valuing regional laboratories in 1997.
On a quarterly basis, management performs a review of each regional laboratory
to determine if events or changes in circumstances have occurred which could
have a material adverse effect on the fair value of the business and its
intangible assets. If such events or changes in circumstances were deemed to
have occurred, management would consult with one or more of its advisors in
estimating the impact on fair value of the regional laboratory. Should the
estimated fair value of a regional laboratory be less than the net book value
for such laboratory at the end of a quarter, the Company will record a charge
to operations to recognize an impairment of its intangible assets for
Quest Diagnostics Incorporated : 1997 Form 10-K
F-7
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
such difference. During 1997, the Company recorded a charge of $16.0 million
related to the impairment of intangible assets (see Note 5).
Investments
The Company accounts for investments in equity securities, which are included
in other assets, in conformity with Statement of Financial Accounting Standards
No. 115, "Accounting for Certain Investments in Debt and Equity Securities"
("SFAS 115"), which requires the use of fair value accounting for trading or
available-for-sale securities. Unrealized losses for available-for-sale
securities are recorded as a separate component within stockholders' equity.
Investments in equity securities are not material to the Company.
Earnings Per Share
Earnings per share are computed by dividing net income (loss), less dividends
on the Company's Preferred Stock, by the weighted average number of common
shares outstanding. Basic and diluted earnings per share are based upon the
weighted average number of shares outstanding during 1997 of 29.2 million
shares. Potentially dilutive common shares result primarily from stock options.
Earnings per share data for 1996 and 1995 are not meaningful as the Company's
historical capital structure is not comparable with the capital structure
subsequent to the Spin-Off Distribution.
New Accounting Pronouncement
In June 1997, the Financial Accounting Standards Board issued SFAS No. 130,
"Reporting Comprehensive Income" ("SFAS 130"). SFAS 130 establishes standards
for reporting and display of comprehensive income and its components in the
financial statements. SFAS 130 is effective for fiscal years beginning after
December 15, 1997. Reclassification of financial statements for earlier periods
provided for comparative purposes is required. The Company is in the process of
determining its preferred format. The adoption of SFAS 130 will have no impact
on the Company's consolidated results of operations, financial position or cash
flows.
- --------------------------------------------------------------------------------
3. Taxes on Income
For periods prior to the Spin-Off Distribution, the Company was included in the
consolidated federal income tax return filed by Corning and had a tax sharing
agreement with Corning, pursuant to which the Company was required to compute
its provision for income taxes on a separate return basis and pay to Corning
the separate federal income tax return liability so computed. In conjunction
with the Spin-Off Distribution, the Company, Corning, and Covance entered into
a tax sharing agreement which allocates among them responsibility for federal,
state and local taxes relating to taxable periods before and after the Spin-Off
Distribution and provides for computing and apportioning tax liabilities and
tax benefits for such periods among the parties.
The Company, Corning, and Covance also entered into tax indemnification
agreements that generally restrict the Company and Covance for a period of two
years after the Spin-Off Distribution from taking certain actions that might
jeopardize the favorable tax treatment of the Spin-Off Distribution and that
provide Corning with certain rights of indemnification against the Company and
Covance. Additionally, the tax indemnification agreements provide the Company
and Covance with certain rights of indemnification against each other. The tax
indemnification agreements also require the Company and Covance to take such
actions as Corning may reasonably request to preserve the favorable tax
treatment provided for in any rulings obtained from the Internal Revenue
Service in respect of the Spin-Off Distribution.
The Company's pre-tax net loss for 1997 consisted of approximately $16.7
million from U.S. operations and approximately $2.4 million from foreign
operations. The Company's pre-tax loss from foreign operations was immaterial
for 1996 and 1995.
The components of the provision (benefit) for income taxes for 1997, 1996 and
1995 are as follows:
1997 1996 1995
-----------------------------------
Current:
Federal $3,904 $(47,429) $22,786
State and local 223 765 3,556
Foreign 165 894 526
Deferred:
Federal (885) 2,524 (28,109)
State and local (205) (6,996) (4,275)
-----------------------------------
Total $3,202 $(50,242) $(5,516)
===================================
Quest Diagnostics Incorporated : 1997 Form 10-K
F-8
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
A reconciliation of the federal statutory rate to the Company's effective tax
rate for 1997, 1996 and 1995 is as follows:
1997 1996 1995
---------------------------
Tax provision (benefit)
at statutory rate (35.0%) (35.0%) (35.0%)
State and local income taxes,
net of federal tax benefit 0.1% (0.6%) (0.8%)
Non-deductible goodwill amortization 25.8% 1.4% 17.6%
Non-deductible write-down
of intangible assets 29.4% 23.0% --
Adjustment of prior years
tax liabilities (10.9%) -- --
Impact of foreign operations 5.3% 0.2% 0.9%
Other non-deductible items 2.1% 3.7% 6.0%
Other, net -- (0.1%) 1.7%
---------------------------
Effective tax rate 16.8% (7.4%) (9.6%)
===========================
The tax effects of temporary differences that give rise to significant portions
of the deferred tax assets and liabilities at December 31, 1997 and 1996 are as
follows:
1997 1996
------------------------
Current deferred tax asset (liability):
Accounts receivable reserve $ 24,193 $ 34,667
Liabilities not currently deductible 64,532 50,552
Establishment of employee stock ownership
plan -- 4,597
Net operating losses 8,549 9,897
Other 197 (1,551)
------------------------
Total $ 97,471 $ 98,162
========================
Non-current deferred tax asset (liability):
Liabilities not currently deductible $ 34,763 $ 34,129
Depreciation and amortization (11,581) (13,709)
------------------------
Total $ 23,182 $ 20,420
========================
At December 31, 1997 the Company had net operating losses for state income tax
purposes of approximately $190 million with expiration dates through 2011.
Income taxes payable at December 31, 1997 and 1996 were $17.6 million and $21.9
million, respectively, and consist primarily of federal income taxes payable of
$17.0 million and $16.8 million, respecively.
- --------------------------------------------------------------------------------
4. Supplemental Data
1997 1996 1995
------------------------------------------
Depreciation expense $ 52,446 $ 57,473 $ 56,857
Interest expense $ 46,040 $ 77,691 $ 84,753
Interest income (5,044) (2,773) (2,737)
------------------------------------------
Interest expense, net $ 40,996 $ 74,918 $ 82,016
Interest paid $ 41,622 $ 91,026 $ 74,201
Income taxes paid $ 10,788 $ 13,102 $ 21,689
- --------------------------------------------------------------------------------
Quest Diagnostics Incorporated : 1997 Form 10-K
F-9
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
- --------------------------------------------------------------------------------
5. Provisions for Restructuring and Other Special Charges
In the fourth quarter of 1997, the Company recorded provisions for
restructuring and other special charges totaling $48.7 million in connection
with a series of actions aimed at reducing excess capacity in its network of
clinical laboratories through facility reductions and consolidations. The
charges consisted primarily of workforce reduction programs, costs associated
with exiting a number of leased facilities, the write-off of certain assets,
the write-down of a non-strategic investment and a charge of $16.0 million to
write-down intangible assets reflecting the estimated impairment as a result of
the Company's actions. In addition to the restructuring and other special
charges, the Company recorded $6.8 million in selling, general and
administrative expenses. This consisted primarily of additional provisions for
doubtful accounts to recognize the reduced recoverability of certain
receivables from accounts which will no longer be served as a result of the
consolidation plan.
Coincident with the Spin-Off Distribution, the Company recorded special charges
totaling $466.8 million. The charges consisted primarily of $445.0 million
related to the change in accounting policy discussed in Note 2 and the cost
associated with the funding of an employee stock ownership plan ($11.7
million), as well as the costs for advisors and other expenses associated with
establishing the Company as a separate publicly-traded entity.
As discussed in Note 14, in 1996, the Company recorded charges totaling $188.0
million to increase its reserves related to claims by the Civil Division of the
U.S. Department of Justice ("DOJ") for certain payments received by Damon
Corporation ("Damon") prior to its acquisition by the Company, and other
related and similar claims. Additionally, in the third quarter of 1996, the
Company recorded a special charge of $13.7 million to write-off capitalized
software as a result of its decision to abandon what had been intended as its
standard company-wide billing system. Management now plans to standardize
billing systems using a system already implemented in several of its sites.
In the second quarter of 1995, the Company recorded a provision for
restructuring totaling $33.0 million primarily for workforce reduction programs
and the costs of exiting a number of leased facilities. Additionally, in the
first quarter of 1995, the Company recorded a special charge of $12.8 million
for the settlement of claims related to inadvertent billing errors of certain
laboratory tests that were not completely and/or successfully performed or
reported due to insufficient samples and/or invalid results. Also, in the
fourth quarter of 1995, the Company recorded a charge of $4.8 million related
to claims by the DOJ of alleged billing errors related to a laboratory test
performed by Bioran Medical Laboratory prior to its acquisition by the Company.
The 1997 provision includes estimated severance benefits related to the
termination of approximately 1,300 employees which will result in a net
reduction of 1,000 employee positions after considering the resulting staffing
increases required at remaining facilities. Certain severance and facility exit
costs included in the 1997 plan have payment terms extending beyond 1998.
Excluding facility exit costs, all prior restructuring plans are substantially
completed.
The following summarizes the Company's accruals for restructuring (in
millions):
Balance at Amounts Balance at Amounts Balance at
Dec. 31, Utilized Dec. 31, 1997 Utilized Dec. 31,
1995 in 1996 1996 Provision in 1997 1997
----------------------------------------------------------------------
Employee termination costs $ 14.1 $ 6.6 $ 7.5 $ 17.8 $ 6.8 $ 18.5
Write-off of fixed assets 11.0 10.0 1.0 7.5 5.3 3.2
Costs of exiting leased facilities 8.7 3.2 5.5 3.4 2.3 6.6
Other 3.9 1.8 2.1 4.0 1.0 5.1
----------------------------------------------------------------------
Total $ 37.7 $ 21.6 $ 16.1 $ 32.7 $ 15.4 $ 33.4
======================================================================
- --------------------------------------------------------------------------------
Quest Diagnostics Incorporated : 1997 Form 10-K
F-10
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
- --------------------------------------------------------------------------------
6. Property, Plant and Equipment
Property, plant and equipment at December 31, 1997 and 1996 consists of the
following:
1997 1996
----------------------------
Land $ 14,995 $ 16,303
Buildings and improvements 178,100 191,428
Laboratory equipment, furniture
and fixtures 329,729 310,972
Leasehold improvements 49,474 46,927
Construction-in-progress 4,120 9,537
----------------------------
576,418 575,167
Less: accumulated depreciation
and amortization (326,195) (287,418)
----------------------------
Total $ 250,223 $ 287,749
============================
- --------------------------------------------------------------------------------
7. Intangible Assets
Intangible assets at December 31, 1997 and 1996 consist of the following:
1997 1996
----------------------------
Goodwill $ 567,381 $ 621,873
Customer lists 65,472 76,967
Other (principally non-compete
covenants) 44,602 48,949
----------------------------
677,455 747,789
Less: accumulated amortization (163,676) (201,332)
----------------------------
Total $ 513,779 $ 546,457
============================
- --------------------------------------------------------------------------------
8. Accounts Payable and Accrued Expenses
Accounts payable and accrued expenses at December 31, 1997 and 1996 consist of
the following:
1997 1996
--------------------------
Accrued wages and benefits $ 81,375 $ 71,031
Restructuring, settlement and
integration provisions 78,311 50,145
Accrued expenses 60,922 57,331
Trade accounts payable 24,277 28,194
--------------------------
Total $244,885 $206,701
==========================
- --------------------------------------------------------------------------------
9. Short-Term Borrowings and Long-Term Debt
Short-term borrowings at December 31, 1997 and 1996 consist of the following:
1997 1996
-------------------------
Current maturities of long-
term debt $32,648 $ 1,485
Working Capital Facility -- 19,300
-------------------------
Total $32,648 $20,785
=========================
Long-term debt, exclusive of current maturities, at December 31, 1997 and 1996
consists of the following:
1997 1996
-------------------------
Variable rate bank term loans $319,000 $350,000
10.75% senior subordinated
notes due 2006 150,000 150,000
Note payable denominated in
pounds Sterling, interest at
the London Interbank
Sterling Rate minus 1%, due 2002 6,589 7,632
Mortgage note payable through
2011, interest at 9.25% 5,672 5,916
Other 900 1,460
-------------------------
Total $482,161 $515,008
=========================
On December 6, 1996, in connection with the Spin-Off Distribution, Quest
Diagnostics entered into a credit agreement (the "Credit Agreement") with
several banks providing for a $450.0 million credit facility (the "Credit
Facility"). The $450.0 million commitment under the Credit Facility is
comprised of three sub-facilities: (i) a $300.0 million six-year amortizing
term loan, (ii) a seven-year $50.0 million term loan with minimal amortization
until the seventh year and (iii) a $100.0 million six-year revolving working
capital credit facility (the "Working Capital Facility"). Under the Working
Capital Facility, up to $20 million may be used for letters of credit. At
December 31, 1997, approximately $6.4 million in letters of credit were
outstanding, which reduced the amount available under the Working Capital
Facility. The Credit Facility is secured by substantially all of the Company's
accounts receivable and by a guaranty from, and a pledge of all capital stock,
accounts receivable and intercompany loans of, substantially all of the
Company's domestic subsidiaries. The borrowings under the Credit Facility rank
senior in priority of repayment to any Permitted Subordinated Debt (as defined
in the Credit Agreement), including the senior subordinated notes discussed
below. Interest is based on certain published rates plus an applicable margin
which
Quest Diagnostics Incorporated : 1997 Form 10-K
F-11
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
will vary depending on the financial performance of the Company. The weighted
average interest rate at December 31, 1997 was 7.7% for the term loans. The
weighted average interest rate at December 31, 1996 was 7.4% and 8.2% for the
term loans and Working Capital Facility, respectively.
On December 16, 1996, the Company issued $150.0 million of 10.75% senior
subordinated notes due 2006 (the "Notes"). The Notes are general unsecured
obligations of the Company and are subordinated in right of payment to all
existing and future senior debt (as defined in the indenture relating to the
Notes (the "Indenture")), including all indebtedness of the Company under the
Credit Facility. Interest is payable on June 15 and December 15. The Notes will
be redeemable, in whole or in part, at the option of the Company at any time on
or after December 15, 2001, at specified redemption prices. The Notes are
guaranteed, fully, jointly and severally, and unconditionally, on a senior
subordinated basis by substantially all of the Company's wholly-owned, domestic
subsidiaries.
The Credit Agreement and the Indenture contain various customary affirmative and
negative covenants, including, in the case of the Credit Agreement, the
maintenance of certain financial ratios and tests. The Credit Agreement
prohibits the Company from paying cash dividends on its common stock. The
Indenture restricts the Company's ability to pay cash dividends based,
primarily, on a percentage of the Company's earnings, as defined. Additionally,
the Company will be required to offer to purchase the Notes and repay amounts
borrowed under the Credit Facility upon a change of control, as defined, and in
the event of certain asset sales. The Credit Agreement covenant ratios were
amended in 1997 in conjunction with the fourth quarter restructuring and other
special charges discussed in Note 5.
The proceeds from the Notes, together with approximately $350.0 million of
borrowings under the term loans of the Credit Facility, were used to repay
approximately $495.0 million of intercompany debt with Corning. Corning
contributed to the Company's equity the remaining intercompany debt owed to
Corning.
Long-term debt, including capital leases, maturing in each of the years
subsequent to December 31, 1998 is as follows:
Year ending December 31,
1999 $ 58,004
2000 71,438
2001 76,470
2002 76,504
2003 and thereafter 199,745
--------
Total long-term debt $482,161
========
Based on borrowing rates currently available to the Company, the carrying amount
of the Company's long-term debt at December 31, 1997 and 1996 approximates fair
value.
- --------------------------------------------------------------------------------
10. Stockholders' Equity
Voting Cumulative Preferred Stock
In conjunction with the Spin-Off Distribution, Quest Diagnostics issued to
Corning 1,000 shares of Voting Cumulative Preferred Stock, which have a $1.0
million aggregate liquidation preference. Dividends are at an annual rate of
11.75% and are payable quarterly. The Voting Cumulative Preferred Stock is
generally entitled to one vote per share, voting together as one class with the
Company's common stock. Whenever dividends on the Voting Cumulative Preferred
Stock are in arrears, no dividends or redemptions or purchases of shares may be
made with respect to any stock ranking junior as to dividends or liquidation to
the Voting Cumulative Preferred Stock until all such amounts have been paid. The
Voting Cumulative Preferred Stock is not convertible into shares of any other
class or series of stock of the Company and will be redeemable in whole or in
part, at the option of the Company at any time on or after December 31, 2002, at
specified redemption prices. On January 1, 2022, the Company must redeem all of
the then outstanding shares of the Voting Cumulative Preferred Stock at a
redemption price equal to the liquidation preference plus any unpaid dividends.
The Voting Cumulative Preferred Stock ranks senior to the Quest Diagnostics
common stock and the Series A Preferred Stock, discussed below.
Series Preferred Stock
Quest Diagnostics is authorized to issue up to 10 million shares of Series
Preferred Stock, par value $1.00 per share. The Company's Board of Directors has
the authority to issue such shares without shareholder approval and to determine
the designations, prefer-
Quest Diagnostics Incorporated : 1997 Form 10-K
F-12
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
ences, rights, and restrictions of such shares. Of the authorized shares,
600,000 shares have been designated Series A Preferred Stock and 1,000 shares
have been designated Voting Cumulative Preferred Stock. No shares have been
issued, other than the Voting Cumulative Preferred Stock.
Preferred Share Purchase Rights
Each share of Quest Diagnostics common stock trades with a preferred share
purchase right which entitles shareholders to purchase one-hundredth of a share
of Series A Preferred Stock upon the occurrence of certain events. In addition,
the rights entitle shareholders to purchase shares of common stock at a
predefined price in the event a person or group acquires 20% or more of the
Company's outstanding common stock. The preferred share purchase rights expire
December 31, 2006.
- --------------------------------------------------------------------------------
11. Stock Ownership and Compensation Plans
Employees Equity Participation Program
The Employees Equity Participation Program (the "EEPP") consists of two plans:
(a) a stock option plan and (b) an incentive stock plan. The EEPP provides for
the grant to eligible employees of either non-qualified or incentive stock
options, or both, to purchase shares of Quest Diagnostics' common stock at no
less than fair market value on the date of grant. The EEPP also allows for
awards to eligible employees of shares, or the right to receive shares, of
Quest Diagnostics' common stock, the equivalent value in cash or a combination
thereof. Key executive, managerial and technical employees are eligible to
participate in the plan.
Under the EEPP, the maximum number of shares of Quest Diagnostics' common stock
that may be optioned or granted is 3 million, excluding the Substitute Options
discussed below. In addition to the options granted under the stock option
plan, approximately 400 thousand shares of restricted stock were granted in
1997 under the incentive stock plan, primarily to executive employees. The
weighted average fair value of the shares granted during the period was $16.14
per share. These shares are contingent on achievement of financial performance
goals and are subject to forfeiture if employment terminates prior to the end
of the prescribed period. The market value of the shares awarded under the plan
is recorded as unearned compensation. The unearned amounts are amortized to
compensation expense as earned and are subject to adjustment based upon changes
in earnings estimates.
Transactions under the stock option plan were as follows:
Weighted
Shares average exercise
(in thousands) price
---------------------------------
Options outstanding at
December 31, 1996 -- --
Substitute Options granted
(discussed below) 725 $10.56
Options granted 1,209 $16.48
Options exercised -- --
Options terminated 38 $16.40
---------------------------------
Options outstanding at
December 31, 1997 1,896 $14.22
=================================
Weighted average fair value
of options granted during
the year $ 7.58
======
No options were exercisable at December 31, 1997. The following relates to
options outstanding at December 31, 1997:
Weighted Weighted
Average Average
Range of Shares Remaining Exercise
exercise price (in thousands) Contractual Life Price
- --------------------------------------------------------------------------------
$10.51 to $11.33 725 8.1 $10.56
$15.94 to $17.94 1,171 9.2 $16.48
Prior to the Spin-Off Distribution, certain employees of Quest Diagnostics were
granted stock awards, including stock options to acquire Corning common stock
and restricted shares of Corning common stock, under various Corning
compensation programs. Company employees were also eligible to participate in
the Corning Employee Stock Purchase Plan. Expenses related to these programs
have been included in the Company's financial statements.
Coincident with the Spin-Off Distribution, with the exception of certain
options granted in 1995 and 1996, the number and exercise price of the Corning
options outstanding were adjusted and will remain options to purchase Corning
common stock. Additionally, certain Corning options outstanding and held by
Company employees which were granted in 1995 and 1996 were canceled. On January
1, 1997, the Company issued, in substitution for two-thirds of the canceled
options, approximately 725 thousand options to purchase its common stock under
the EEPP (the "Substitute Options"). The Substitute Options become exercisable
in installments from four to five years from their original grant dates in 1995
and 1996. The adjusted Corning stock options and the Substitute Options have
the same vesting provisions, option periods, and other terms and conditions
Quest Diagnostics Incorporated : 1997 Form 10-K
F-13
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
as the awards they replaced. Additionally, the adjusted Corning stock options
and the Substitute Options have the same ratio of the exercise price per share
to the market value per share, and the same aggregate difference between market
value and exercise price as the stock options they replaced.
Quest Diagnostics has adopted the disclosure-only provisions of Statement of
Financial Accounting Standards No. 123, "Accounting for Stock-Based
Compensation" ("SFAS 123"), but follows Accounting Principles Board Opinion No.
25, "Accounting for Stock Issued to Employees," and related interpretations in
accounting for its stock-based compensation plans. Stock-based compensation
expense was $1.9 million in 1997 and was immaterial for 1996 and 1995. If the
Company had elected to recognize compensation cost based on the fair value at
the grant dates for awards under those plans (including the adjusted awards),
consistent with the method prescribed by SFAS 123, the pro forma impact on the
Company's net loss in 1996 and 1995 would have been immaterial. For 1997, the
Company's pro forma net loss would have been $26.1 million, or $0.90 per share.
The pro forma impact on the net loss was estimated using the fair value of the
Quest Diagnostics options granted in 1997, the Corning stock options and the
Substitute Options. The fair value of the Corning stock options is the
estimated present value at grant date using the Black-Scholes option-pricing
model with the following weighted average assumptions for 1996 and 1995:
dividend yield of 2.3%; expected volatility of 24.5%; risk free interest rate
of 6.5%; and an expected holding period of seven years. The fair value of the
Substitute Options was determined using the Black-Scholes option-pricing model
with the following weighted average assumptions: dividend yield of 0.0%;
expected volatility of 38.0%; risk free interest rate of 5.5%; and an expected
holding period of seven years. The fair value of the options granted in 1997
was determined using the Black-Scholes option pricing model with the following
weighted average assumptions: dividend yield of 0.0%; expected volatility of
55.0%; risk free interest rate of 6.3%; and an expected holding period of five
years.
Employee Stock Purchase Plan
Under the Company's Employee Stock Purchase Plan ("ESPP"), substantially all
employees can elect to have up to 10% of their annual wages withheld to
purchase Quest Diagnostics' common stock. The purchase price of the stock is
85% of the lower of its beginning-of-quarter or end-of-quarter market price.
Under the ESPP, the maximum number of shares of Quest Diagnostics' common stock
which may be purchased by eligible employees is 2 million. In 1997,
approximately 200 thousand shares of common stock were purchased by eligible
employees. No purchases were made in 1996.
Employee Stock Ownership Plan
Under the Company's employee stock ownership plan ("ESOP"), approximately 800
thousand shares of Quest Diagnostics' common stock were issued for the account
of all active regular employees as of December 31, 1996. No contributions were
made to the ESOP in 1997.
- --------------------------------------------------------------------------------
12. Employee Retirement Plans
Defined Contribution Plan
The Company maintains a defined contribution plan covering substantially all of
its employees. The Company's expense for its contributions to this plan
aggregated $16.9 million, $14.1 million and $12.0 million for 1997, 1996 and
1995, respectively.
Defined Benefit Plans
An acquired entity had a defined benefit pension plan which in 1990 was frozen
as to the further accrual of benefits. During 1997 the Company filed an
application for determination with the Internal Revenue Service ("IRS") to
terminate the plan. Upon receipt of the determination letter from the IRS,
which is expected in early 1998, the participants will receive lump-sum cash
payments or annuity contracts in settlement of their rights to receive pension
benefits. At December 31, 1997, the estimated settlement obligation was $26.6
million and the fair value of the plan assets (primarily money market funds)
was $24.5 million. The unfunded settlement obligation has been accrued at
December 31, 1997. Coincident with the Spin-Off Distribution, the Company
established a nonqualified, unfunded defined benefit plan for the benefit of
key employees and executive officers who are former Corning employees. The
present value of the projected benefit obligation of this plan was immaterial
at December 31, 1997.
- --------------------------------------------------------------------------------
13. Related Party Transactions
The Company, in the ordinary course of business, conducted a number of
transactions with Corning and its affiliates. The significant transactions
occurring during the years ended December 31, 1996 and
Quest Diagnostics Incorporated : 1997 Form 10-K
F-14
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
1995 are as follows:
1996 1995
------------------------
Interest expense on borrowings $72,861 $78,930
Purchase of laboratory supplies 8,893 11,261
Corporate fees 2,695 2,800
In 1996, Corning contributed capital to the Company of $862.0 million. Of this
amount, $712.0 million was contributed primarily through the forgiveness of
certain intercompany indebtedness (see Note 9), $119.1 million through the
funding of the Damon settlement (see Note 14) and $30.9 million primarily
related to Corning's indemnification of government claims. During 1997, the
receivable from Corning was increased by $9.5 million and recorded as an
increase in additional paid-in capital, based on management's best estimate of
amounts which are probable of being received from Corning to satisfy the
remaining indemnified government claims (see Note 14).
- --------------------------------------------------------------------------------
14. Commitments and Contingencies
Minimum rental commitments under noncancelable operating leases, primarily real
estate, in effect at December 31, 1997 are as follows:
Year ending December 31,
1998 $ 52,985
1999 39,848
2000 29,864
2001 22,277
2002 19,608
2003 and thereafter 81,557
--------
Minimum lease payments 246,139
Noncancelable sub-lease payments (49,805)
--------
Net minimum lease payments $196,334
========
Operating lease rental expense for 1997, 1996 and 1995 aggregated $47.9
million, $49.7 million and $46.9 million, respectively.
The Company is substantially self-insured for all casualty losses and maintains
excess coverage primarily on a claims made basis. The basis for the insurance
reserve at December 31, 1997 and 1996 is the actuarially determined projected
losses for each program (limited by its self-insured retention) based upon the
Company's loss experience.
At present, government investigations of certain practices by Nichols
Institute, a clinical laboratory company acquired in 1994, and a former joint
venture of Damon, a clinical laboratory acquired in 1993, are ongoing. During
1996, the Company entered into several settlement agreements with various
governmental and private payors. The largest of these involved Damon. In the
second quarter of 1996, the DOJ notified the Company that it had taken issue
with certain payments received by Damon from federally funded healthcare
programs prior to its acquisition by the Company. Specifically, in late April
1996, the DOJ for the first time disclosed to the Company the total amount of
the claims that it proposed to assert against Damon. The government presented
its claim for the base recoupment (by lab, by test, by year) and discussed
various theories on which criminal and civil payments of up to three times the
various base recoupment amounts could be assessed. Settlement discussions began
in July 1996 and ended with the settlement agreement dated October 9, 1996. The
settlement included base recoupments of approximately $40 million and total
criminal and civil payments in excess of base recoupments of approximately $79
million. This settlement concludes all federal and Medicaid civil claims
relating to the billing by Damon of certain blood tests to Medicare and
Medicaid patients and all criminal matters relating to Damon being investigated
by the DOJ. Additionally, in 1996 the Company entered into a separate
settlement agreement with the DOJ totaling $6.9 million related to billings of
hematology indices provided with hematology test results.
As a result of the ongoing claims and the above mentioned settlement
agreements, management reassessed the level of reserves recorded for other
asserted and unasserted claims related to the Damon and other similar
government investigations, including the investigation of billing practices by
Nichols Institute. The Company recorded charges totaling $188.0 million in 1996
to establish additional reserves to provide for the settlement agreements and
management's best estimate of potential amounts which could be required to
satisfy the remaining claims. During the fourth quarter 1996, Corning
contributed $119.1 million to the Company's capital to fund the Damon
settlement.
In 1997, a number of private healthcare insurance providers, and a group
purporting to represent a national class of persons and providers allegedly
overcharged by MetPath Inc. (a predecessor of the Company) or Damon, or various
of their subsidiaries, brought claims against the Company or its predecessors
or subsidiaries. While the ultimate outcome of these claims can not be
predicted, based on information currently available to the Company, management
does not believe that exposure related to these claims
Quest Diagnostics Incorporated : 1997 Form 10-K
F-15
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
or the remaining government investigations in excess of recorded reserves is
material.
Corning has agreed to indemnify the Company against all monetary settlements
for any governmental claims relating to billing practices of the Company and
its predecessors based on investigations that were pending on December 31,
1996. Corning also agreed to indemnify the Company for 50% of the aggregate of
all settlement payments made by the Company that are in excess of $42.0 million
to private parties that relate to indemnified or previously settled
governmental claims (such as the Damon settlement) for services provided prior
to December 31, 1996; provided however, the indemnification of private party
claims will not exceed $25.0 million and will be paid to the Company net of
anticipated tax benefits to be realized by the Company. Such indemnification
does not cover any non-governmental claims settled after December 31, 2001.
Coincident with the Spin-Off Distribution, the Company recorded a receivable
for indemnified claims and a contribution of capital from Corning of $22.4
million. During 1997, the receivable from Corning was increased to $31.6
million, through an adjustment to additional paid-in capital, based on
management's best estimate of amounts which are probable of being received from
Corning to satisfy the remaining indemnified governmental claims on an
after-tax basis.
At December 31, 1997, recorded reserves approximated $76.1 million, including
$27.5 million in other long-term liabilities. Although management believes that
established reserves for both indemnified and non-indemnified claims are
sufficient, it is possible that additional information (such as the indication
by the government of criminal activity, additional tests being questioned or
other changes in the government's or private claimants' theories of wrongdoing)
may become available which may cause the final resolution of these matters to
exceed established reserves by an amount which could be material to the
Company's results of operations and cash flows in the period in which such
claims are settled. The Company does not believe that these issues will have a
material adverse effect on its overall financial condition.
- --------------------------------------------------------------------------------
15. Summarized Financial Information
The Notes described in Note 9 are guaranteed, fully, jointly and severally, and
unconditionally, on a senior subordinated basis by substantially all of the
Company's wholly-owned, domestic subsidiaries ("Subsidiary Guarantors"). The
non-guarantor subsidiaries are foreign and less than wholly-owned subsidiaries.
The following condensed consolidating financial data illustrates the
composition of the combined guarantors. The Company believes that separate
complete financial statements of the respective guarantors would not provide
additional material information which would be useful in assessing the
financial composition of the Subsidiary Guarantors.
Investments in subsidiaries are accounted for by the parent on the equity
method for purposes of the supplemental consolidating presentation. Earnings
(losses) of subsidiaries are therefore reflected in the parent's investment
accounts and earnings. The principal elimination entries eliminate investments
in subsidiaries and intercompany balances and transactions. During 1997, one
subsidiary ceased to be wholly-owned and, as of the date ownership interest was
reduced, is included as a non-guarantor subsidiary.
Quest Diagnostics Incorporated : 1997 Form 10-K
F-16
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
Condensed Consolidating Balance Sheet
December 31, 1997
Subsidiary Non-Guarantor
Parent Guarantors Subsidiaries Eliminations Consolidated
Assets -----------------------------------------------------------------------
Current assets:
Cash and cash equivalents $ 123,052 $ 35,527 $ 3,082 $ -- $ 161,661
Accounts receivable, net 87,231 148,618 2,520 -- 238,369
Other current assets 119,751 48,865 3,238 -- 171,854
-----------------------------------------------------------------------
Total current assets 330,034 233,010 8,840 -- 571,884
Property, plant and equipment, net 101,700 144,849 3,674 -- 250,223
Intangible assets, net 165,068 348,391 320 -- 513,779
Intercompany (payable) receivable (14,134) 24,103 (9,969) -- --
Investment in subsidiaries 412,413 -- -- (412,413) --
Other assets 40,474 9,290 15,278 -- 65,042
-----------------------------------------------------------------------
Total assets $1,035,555 $759,643 $ 18,143 $ (412,413) $1,400,928
=======================================================================
Liabilities and Stockholders' Equity
Current liabilities:
Accounts payable and accrued expenses $ 188,966 $ 70,542 $ 2,990 $ -- $ 262,498
Short-term borrowings 15,688 16,640 320 -- 32,648
-----------------------------------------------------------------------
Total current liabilities 204,654 87,182 3,310 -- 295,146
Long-term debt 225,145 252,480 4,536 -- 482,161
Other liabilities 64,096 15,568 2,297 -- 81,961
-----------------------------------------------------------------------
Total liabilities 493,895 355,230 10,143 -- 859,268
-----------------------------------------------------------------------
Stockholders' equity 541,660 404,413 8,000 (412,413) 541,660
-----------------------------------------------------------------------
Total liabilities and stockholders' equity $1,035,555 $759,643 $ 18,143 $ (412,413) $1,400,928
=======================================================================
Quest Diagnostics Incorporated : 1997 Form 10-K
F-17
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
Condensed Consolidating Balance Sheet
December 31, 1996
Subsidiary Non-Guarantor
Parent Guarantors Subsidiaries Eliminations Consolidated
Assets -----------------------------------------------------------------------
Current assets:
Cash and cash equivalents $ 26,975 $ 12,882 $ 2,103 $ -- $ 41,960
Accounts receivable, net 127,872 167,428 2,443 -- 297,743
Other current assets 119,788 49,714 1,760 -- 171,262
-----------------------------------------------------------------------
Total current assets 274,635 230,024 6,306 -- 510,965
Property, plant and equipment, net 118,581 166,061 3,107 -- 287,749
Intangible assets, net 189,289 355,821 1,347 -- 546,457
Intercompany (payable) receivable (15,041) 20,877 (5,836) -- --
Investment in subsidiaries 419,501 -- -- (419,501) --
Other assets 45,632 4,460 (197) -- 49,895
-----------------------------------------------------------------------
Total assets $1,032,597 $777,243 $ 4,727 $ (419,501) $1,395,066
=======================================================================
Liabilities and Stockholders' Equity (Deficit)
Current liabilities:
Accounts payable and accrued expenses $ 163,421 $ 61,023 $ 4,203 $ -- $ 228,647
Short-term borrowings 20,390 360 35 -- 20,785
-----------------------------------------------------------------------
Total current liabilities 183,811 61,383 4,238 -- 249,432
Long-term debt 232,605 277,512 4,891 -- 515,008
Other liabilities 77,462 13,468 977 -- 91,907
-----------------------------------------------------------------------
Total liabilities 493,878 352,363 10,106 -- 856,347
-----------------------------------------------------------------------
Stockholders' equity (deficit) 538,719 424,880 (5,379) (419,501) 538,719
-----------------------------------------------------------------------
Total liabilities and stockholders' equity $1,032,597 $777,243 $ 4,727 $ (419,501) $1,395,066
=======================================================================
Quest Diagnostics Incorporated : 1997 Form 10-K
F-18
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
Condensed Consolidating Statement of Operations
For the Year Ended December 31, 1997
Subsidiary Non-Guarantor
Parent Guarantors Subsidiaries Eliminations Consolidated
--------------------------------------------------------------------
Net revenues $ 658,383 $847,348 $ 22,964 $ -- $1,528,695
Costs and expenses:
Cost of services 386,605 529,534 11,725 -- 927,864
Selling, general and administrative 283,607 208,157 10,359 -- 502,123
Interest expense, net 15,514 24,891 591 -- 40,996
Amortization of intangible assets 8,402 15,375 174 -- 23,951
Provisions for restructuring and other
special charges 42,986 5,702 -- -- 48,688
Royalty (income) expense (71,073) 71,073 -- -- --
Other, net 1,214 221 2,696 -- 4,131
--------------------------------------------------------------------
Total 667,255 854,953 25,545 -- 1,547,753
--------------------------------------------------------------------
Loss before taxes (8,872) (7,605) (2,581) -- (19,058)
Income tax expense (benefit) 7,006 (3,857) 53 -- 3,202
Equity loss from affiliates (6,382) -- -- 6,382 --
--------------------------------------------------------------------
Net loss $ (22,260) $ (3,748) $ (2,634) $ 6,382 $ (22,260)
====================================================================
Condensed Consolidating Statement of Operations
For the Year Ended December 31, 1996
Subsidiary Non-Guarantor
Parent Guarantors Subsidiaries Eliminations Consolidated
--------------------------------------------------------------------
Net revenues $ 685,671 $ 892,805 $ 37,820 $ -- $1,616,296
Costs and expenses:
Cost of services 418,435 566,126 26,314 -- 1,010,875
Selling, general and administrative 260,307 220,951 14,065 -- 495,323
Interest expense, net 27,766 46,295 857 -- 74,918
Amortization of intangible assets 15,573 25,373 679 -- 41,625
Provisions for restructuring and other
special charges 363,152 294,146 11,246 -- 668,544
Royalty (income) expense (70,043) 70,043 -- -- --
Other, net 309 (46) 950 -- 1,213
--------------------------------------------------------------------
Total 1,015,499 1,222,888 54,111 -- 2,292,498
--------------------------------------------------------------------
Loss before taxes (329,828) (330,083) (16,291) -- (676,202)
Income tax expense (benefit) (42,993) (7,302) 53 -- (50,242)
Equity loss from affiliates (339,125) -- -- 339,125 --
--------------------------------------------------------------------
Net loss $ (625,960) $ (322,781) $ (16,344) $339,125 $ (625,960)
====================================================================
Quest Diagnostics Incorporated : 1997 Form 10-K
F-19
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
Condensed Consolidating Statement of Operations
For the Year Ended December 31, 1995
Subsidiary Non-Guarantor
Parent Guarantors Subsidiaries Eliminations Consolidated
---------------------------------------------------------------------
Net revenues $ 677,195 $ 930,472 $21,721 $ -- $ 1,629,388
Costs and expenses:
Cost of services 383,661 587,100 9,471 -- 980,232
Selling, general and administrative 293,821 220,338 9,112 -- 523,271
Interest expense, net 37,273 44,000 743 -- 82,016
Amortization of intangible assets 15,259 28,680 717 -- 44,656
Provisions for restructuring and other
special charges 38,635 11,873 52 -- 50,560
Royalty (income) expense (76,154) 76,154 -- -- --
Other, net 5,038 153 1,030 -- 6,221
----------------------------------------------------------------------
Total 697,533 968,298 21,125 -- 1,686,956
----------------------------------------------------------------------
Income (loss) before taxes (20,338) (37,826) 596 -- (57,568)
Income tax expense (benefit) (2,759) (3,865) 1,108 -- (5,516)
Equity loss from affiliates (34,473) -- -- 34,473 --
----------------------------------------------------------------------
Net loss $ (52,052) $ (33,961) $ (512) $34,473 $ (52,052)
=====================================================================
Condensed Consolidating Statement of Cash Flows
For the Year Ended December 31, 1997
Subsidiary Non-Guarantor
Parent Guarantors Subsidiaries Eliminations Consolidated
----------------------------------------------------------------------
Net loss $ (22,260) $ (3,748) $ (2,634) $ 6,382 $ (22,260)
Adjustments to reconcile net loss to net cash
provided by operating activities:
Depreciation and amortization 33,313 41,953 1,131 -- 76,397
Provision for doubtful accounts 69,368 48,211 644 -- 118,223
Provisions for restructuring and other
special charges 42,986 5,702 -- -- 48,688
Other, net 3,264 (2,927) 4,690 -- 5,027
Changes in operating assets and liabilities (14,848) (33,372) (2,292) 704 (49,808)
----------------------------------------------------------------------
Net cash provided by operating activities 111,823 55,819 1,539 7,086 176,267
Net cash used in investing activities (3,486) (24,422) (107) (7,086) (35,101)
Net cash used in financing activities (12,260) (8,752) (453) -- (21,465)
----------------------------------------------------------------------
Net change in cash and cash equivalents 96,077 22,645 979 -- 119,701
Cash and cash equivalents, beginning of year 26,975 12,882 2,103 -- 41,960
----------------------------------------------------------------------
Cash and cash equivalents, end of year $ 123,052 $ 35,527 $ 3,082 $ -- $ 161,661
======================================================================
Quest Diagnostics Incorporated : 1997 Form 10-K
F-20
Quest Diagnostics Incorporated and Subsidiaries (dollars in thousands,
Notes to Consolidated Financial Statements unless otherwise indicated)
(Continued)
Condensed Consolidating Statement of Cash Flows
For the Year Ended December 31, 1996
Subsidiary Non-Guarantor
Parent Guarantors Subsidiaries Eliminations Consolidated
-----------------------------------------------------------------------
Net loss $ (625,960) $ (322,781) $ (16,344) $ 339,125 $ (625,960)
Adjustments to reconcile net loss to net cash
provided by (used in) operating activities:
Depreciation and amortization 42,312 55,128 1,658 -- 99,098
Provision for doubtful accounts 61,032 49,615 591 -- 111,238
Provisions for restructuring and other
special charges 363,152 294,146 11,246 -- 668,544
Other, net (14,864) 11,836 (886) -- (3,914)
Changes in operating assets and liabilities 113,155 (49,053) 1,883 (403,477) (337,492)
-----------------------------------------------------------------------
Net cash provided by (used in) operating
activities (61,173) 38,891 (1,852) (64,352) (88,486)
Net cash used in investing activities (83,939) (43,468) (619) 64,352 (63,674)
Net cash provided by financing activities 149,012 5,750 2,912 -- 157,674
-----------------------------------------------------------------------
Net change in cash and cash equivalents 3,900 1,173 441 -- 5,514
Cash and cash equivalents, beginning of year 23,075 11,709 1,662 -- 36,446
-----------------------------------------------------------------------
Cash and cash equivalents, end of year $ 26,975 $ 12,882 $ 2,103 $ -- $ 41,960
=======================================================================
Condensed Consolidating Statement of Cash Flows
For the Year Ended December 31, 1995
Subsidiary Non-Guarantor
Parent Guarantors Subsidiaries Eliminations Consolidated
----------------------------------------------------------------------
Net loss $ (52,052) $ (33,961) $ (512) $ 34,473 $ (52,052)
Adjustments to reconcile net loss to net cash
provided by (used in) operating activities:
Depreciation and amortization 41,062 58,765 1,686 -- 101,513
Provision for doubtful accounts 93,606 58,463 521 -- 152,590
Provisions for restructuring and other
special charges 38,635 11,873 52 -- 50,560
Other, net (19,507) (4,697) 123 -- (24,081)
Changes in operating assets and liabilities (90,574) (50,229) (3,497) 1,598 (142,702)
----------------------------------------------------------------------
Net cash provided by (used in) operating
activities 11,170 40,214 (1,627) 36,071 85,828
Net cash used in investing activities (22,666) (33,936) (414) (36,071) (93,087)
Net cash (used in) provided by financing
activities 15,102 (9,695) (421) -- 4,986
----------------------------------------------------------------------
Net change in cash and cash equivalents 3,606 (3,417) (2,462) -- (2,273)
Cash and cash equivalents, beginning of year 19,469 15,126 4,124 -- 38,719
----------------------------------------------------------------------
Cash and cash equivalents, end of year $ 23,075 $ 11,709 $ 1,662 $ -- $ 36,446
======================================================================
Quest Diagnostics Incorporated : 1997 Form 10-K
F-21
Quest Diagnostics Incorporated and Subsidiaries (in thousands,
Quarterly Operating Results (unaudited) except per share data)
First Second Third Fourth Total
Quarter Quarter Quarter Quarter Year
1997 -----------------------------------------------------------------------------
Net revenues $388,103 $401,523 $ 373,633 $ 365,436 $1,528,695
Gross profit 148,789 161,930 144,469 145,643 600,831
Income (loss) before taxes 8,417 16,444 6,266 (50,185)(a) (19,058)
Net income (loss) 4,047 8,088 2,993 (37,388) (22,260)
Basic and diluted net income (loss)
per common share $ 0.14 $ 0.28 $ 0.10 $ (1.29) $ (0.77)
1996 -----------------------------------------------------------------------------
Net revenues $401,395 $424,543 $ 405,352 $ 385,006 $1,616,296
Gross profit 154,277 158,242 149,962 142,940 605,421
Loss before taxes (1,642) (37,518)(b) (162,989) (b) (474,053)(b) (676,202)
Net loss (1,511) (37,922) (119,436) (467,091) (625,960)
(a) Includes impact of charges totaling $48.7 million discussed in Note 5. In
addition to these charges, the Company recorded $6.8 million in selling,
general and administrative expenses, primarily for additional provisions
for doubtful accounts, to recognize the reduced recoverability of certain
receivables from accounts which will no longer be served as a result of the
Company's consolidation of its laboratory network.
(b) Includes impact of restructuring and other special charges of $46.0
million, $155.7 million, and $466.8 million, in the second quarter, third
quarter and fourth quarter, respectively, which are discussed in Notes 5
and 14.
(c) Earnings per share data for 1996 are not meaningful as the Company's
historical capital structure is not comparable with the capital structure
subsequent to the Spin-Off Distribution.
Quest Diagnostics Incorporated : 1997 Form 10-K
F-22
Quest Diagnostics Incorporated and Subsidiaries (in thousands)
Schedule II - Valuation Accounts and Reserves
Balance at Net Deductions Balance at
1-1-97 Additions and Other 12-31-97
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Year ended December 31, 1997
Doubtful accounts and allowances $115,018 $118,223 $143,371 $89,870
Balance at Net Deductions Balance at
1-1-96 Additions and Other 12-31-96
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Year ended December 31, 1996
Doubtful accounts and allowances 147,947 111,238 144,167 115,018
Balance at Net Deductions Balance at
1-1-95 Additions and Other 12-31-95
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Year ended December 31, 1995
Doubtful accounts and allowances 74,829 152,590 79,472 147,947
Quest Diagnostics Incorporated : 1997 Form 10-K
F-23