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Table of Contents

 

 

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 


 

FORM 10-Q

 


 

x  QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

 

For the quarterly period ended July 3, 2015

 

OR

 

o  TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

 

For the transition period from            to            

 

Commission file number  001-09848

 


 

GRAPHIC

 

ALMOST FAMILY, INC.

(Exact name of Registrant as specified in its charter)

 


 

Delaware

 

06-1153720

(State or other jurisdiction of
incorporation or organization)

 

(I.R.S. Employer Identification
Number)

 

9510 Ormsby Station Road, Suite 300, Louisville, Kentucky 40223

(Address of principal executive offices)

 

(502) 891-1000

(Registrant’s telephone number, including area code)

 

Not Applicable

(Former name, former address and former fiscal year, if changed since last report)

 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.  Yes x No o.

 

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).  Yes x No o.

 

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See definition of “accelerated filer, “large accelerated filer” and “smaller reporting company” in Rule 12b-2 of the Exchange Act (check one):

 

Large accelerated filer o

 

Accelerated filer x

 

 

 

Non-accelerated filer  o

 

Smaller Reporting Company o

 

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).

 

Yes o        No x

 

Indicate the number of shares outstanding of each of the issuer’s classes of common stock, as of the latest practicable date.

 

Class of Common Stock

 

$0.10 par value

 

Shares outstanding at July 27, 2015

 

9,820,132

 

 

 

 



Table of Contents

 

ALMOST FAMILY, INC. AND SUBSIDIARIES

 

FORM 10-Q

 

INDEX

 

PART I. FINANCIAL INFORMATION

3

 

 

 

Item 1.       Financial Statements. Consolidated Financial Statements and Supplementary Data (unaudited except December 31, 2014 Consolidated Balance Sheet)

3

 

 

 

 

Consolidated Balance Sheets as of July 3, 2015 and December 31, 2014

3

 

 

 

 

Consolidated Statements of Income for the Three and Six Month Periods Ended July 3, 2015 and June 30, 2014

4

 

 

 

 

Consolidated Statements of Cash Flows for the Six Month Periods Ended July 3, 2015 and June 30, 2014

5

 

 

 

 

Notes to Consolidated Financial Statements

6

 

 

 

Item 2.

Management’s Discussion and Analysis of Financial Condition and Results of Operations

13

 

 

 

Item 3.

Quantitative and Qualitative Disclosures about Market Risk

25

 

 

 

Item 4.

Controls and Procedures

25

 

 

 

PART II. OTHER INFORMATION

26

 

 

 

Item 1.

Legal Proceedings

26

Item 1A.

Risk Factors

26

Item 2.

Unregistered Sales of Equity Securities and Use of Proceeds

26

Item 3.

Defaults Upon Senior Securities

27

Item 4.

Mine Safety Disclosures

27

Item 5.

Other Information

27

Item 6.

Exhibits

27

 

2



Table of Contents

 

PART I — FINANCIAL INFORMATION

Item 1. Financial Statements

 

ALMOST FAMILY, INC. AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

(In thousands)

 

 

 

July 3, 2015

 

 

 

 

 

(UNAUDITED)

 

December 31, 2014

 

ASSETS

 

 

 

 

 

CURRENT ASSETS:

 

 

 

 

 

Cash and cash equivalents

 

$

6,498

 

$

6,886

 

Accounts receivable - net

 

83,060

 

74,894

 

Prepaid expenses and other current assets

 

6,986

 

10,420

 

Deferred tax assets

 

13,242

 

12,230

 

TOTAL CURRENT ASSETS

 

109,786

 

104,430

 

 

 

 

 

 

 

PROPERTY AND EQUIPMENT - NET

 

5,120

 

5,575

 

GOODWILL

 

195,067

 

192,523

 

OTHER INTANGIBLE ASSETS

 

54,639

 

54,402

 

OTHER ASSETS

 

2,457

 

558

 

TOTAL ASSETS

 

$

367,069

 

$

357,488

 

 

 

 

 

 

 

LIABILITIES AND STOCKHOLDERS’ EQUITY

 

 

 

 

 

CURRENT LIABILITIES:

 

 

 

 

 

Accounts payable

 

$

10,101

 

$

9,257

 

Accrued other liabilities

 

37,019

 

42,326

 

Current portion - notes payable and capital leases

 

34

 

51

 

TOTAL CURRENT LIABILITIES

 

47,154

 

51,634

 

 

 

 

 

 

 

LONG-TERM LIABILITIES:

 

 

 

 

 

Revolving credit facility

 

47,451

 

46,447

 

Deferred tax liabilities

 

26,257

 

23,510

 

Other

 

3,259

 

2,705

 

TOTAL LONG-TERM LIABILITIES

 

76,967

 

72,662

 

TOTAL LIABILITIES

 

124,121

 

124,296

 

 

 

 

 

 

 

NONCONTROLLING INTEREST - REDEEMABLE

 

3,639

 

3,639

 

 

 

 

 

 

 

STOCKHOLDERS’ EQUITY:

 

 

 

 

 

Preferred stock, par value $0.05; authorized 2,000 shares; none issued or outstanding

 

 

 

Common stock, par value $0.10; authorized 25,000; 9,633 and 9,574 issued and outstanding

 

963

 

957

 

Treasury stock, at cost, 103 and 94 shares of common stock

 

(2,731

)

(2,392

)

Additional paid-in capital

 

107,140

 

105,862

 

Noncontrolling interest - nonredeemable

 

(659

)

(420

)

Retained earnings

 

134,596

 

125,546

 

TOTAL STOCKHOLDERS’ EQUITY

 

239,309

 

229,553

 

TOTAL LIABILITIES AND STOCKHOLDERS’ EQUITY

 

$

367,069

 

$

357,488

 

 

See accompanying Notes to Consolidated Financial Statements.

 

3



Table of Contents

 

ALMOST FAMILY, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF INCOME

(UNAUDITED)

(In thousands, except per share data)

 

 

 

Three month period ended

 

Six month period ended

 

 

 

July 3, 2015

 

June 30, 2014

 

July 3, 2015

 

June 30, 2014

 

Net service revenues

 

$

127,366

 

$

125,192

 

$

255,765

 

$

245,532

 

Cost of service revenues (excluding depreciation & amortization)

 

66,343

 

65,556

 

134,670

 

131,083

 

Gross margin

 

61,023

 

59,636

 

121,095

 

114,449

 

General and administrative expenses:

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

35,832

 

35,875

 

72,225

 

69,541

 

Other

 

16,405

 

15,510

 

32,304

 

31,224

 

Deal and transition costs

 

206

 

1,243

 

614

 

4,357

 

Total general and administrative expenses

 

52,443

 

52,628

 

105,143

 

105,122

 

Operating income

 

8,580

 

7,008

 

15,952

 

9,327

 

Interest expense, net

 

(392

)

(329

)

(753

)

(677

)

Income before income taxes

 

8,188

 

6,679

 

15,199

 

8,650

 

Income tax expense

 

(3,393

)

(2,618

)

(6,380

)

(3,435

)

Net income from continuing operations

 

4,795

 

4,061

 

8,819

 

5,215

 

 

 

 

 

 

 

 

 

 

 

Discontinued operations:

 

 

 

 

 

 

 

 

 

Loss from operations, net of tax of ($9), ($41), ($5) and ($90)

 

(13

)

(64

)

(8

)

(134

)

Net income

 

4,782

 

3,997

 

8,811

 

5,081

 

Net loss (income) - noncontrolling interests

 

228

 

(36

)

592

 

153

 

Net income attributable to Almost Family, Inc.

 

$

5,010

 

$

3,961

 

$

9,403

 

$

5,234

 

 

 

 

 

 

 

 

 

 

 

Per share amounts-basic:

 

 

 

 

 

 

 

 

 

Average shares outstanding

 

9,393

 

9,338

 

9,377

 

9,316

 

Income from continuing operations attributable to Almost Family, Inc.

 

$

0.53

 

$

0.43

 

$

1.00

 

$

0.58

 

Discontinued operations

 

 

(0.01

)

 

(0.01

)

Net income attributable to Almost Family, Inc.

 

$

0.53

 

$

0.42

 

$

1.00

 

$

0.57

 

 

 

 

 

 

 

 

 

 

 

Per share amounts-diluted:

 

 

 

 

 

 

 

 

 

Average shares outstanding

 

9,569

 

9,431

 

9,554

 

9,423

 

Income from continuing operations attributable to Almost Family, Inc.

 

$

0.52

 

$

0.43

 

$

0.99

 

$

0.57

 

Discontinued operations

 

 

(0.01

)

 

(0.01

)

Net income attributable to Almost Family, Inc.

 

$

0.52

 

$

0.42

 

$

0.99

 

$

0.56

 

 

See accompanying Notes to Consolidated Financial Statements.

 

4



Table of Contents

 

ALMOST FAMILY, INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

(UNAUDITED)

(In thousands)

 

 

 

Six month period ended

 

 

 

July 3, 2015

 

June 30, 2014

 

Cash flows of operating activities:

 

 

 

 

 

Net income

 

$

8,811

 

$

5,081

 

Loss on discontinued operations, net of tax

 

(8

)

(134

)

Net income from continuing operations

 

8,819

 

5,215

 

Adjustments to reconcile net income to net cash provided by (used in) operating activities:

 

 

 

 

 

Depreciation and amortization

 

1,780

 

2,152

 

Provision for uncollectible accounts

 

4,803

 

4,308

 

Stock-based compensation

 

1,005

 

872

 

Deferred income taxes

 

1,639

 

2,402

 

 

 

18,046

 

14,949

 

Change in certain net assets and liabilities, net of the effects of acquisitions:

 

 

 

 

 

Accounts receivable

 

(12,485

)

(11,863

)

Prepaid expenses and other current assets

 

3,536

 

(728

)

Other assets

 

26

 

1

 

Accounts payable and accrued expenses

 

(4,097

)

(4,457

)

Net cash provided by (used in) operating activities

 

5,026

 

(2,098

)

 

 

 

 

 

 

Cash flows of investing activities:

 

 

 

 

 

Capital expenditures

 

(1,147

)

(735

)

Cost basis investment

 

(1,000

)

 

Acquisitions, net of cash acquired

 

(3,000

)

(969

)

Net cash used in investing activities

 

(5,147

)

(1,704

)

 

 

 

 

 

 

Cash flows of financing activities:

 

 

 

 

 

Credit facility borrowings

 

87,747

 

655

 

Credit facility repayments

 

(86,743

)

(6,000

)

Debt issuance fees

 

(1,161

)

 

Proceeds from stock option exercises

 

68

 

39

 

Purchase of common stock in connection with share awards

 

(338

)

(52

)

Tax impact of share awards

 

210

 

(38

)

Payment of special dividend in connection with share awards

 

(50

)

(35

)

Principal payments on notes payable and capital leases

 

(30

)

(606

)

Net cash used in financing activities

 

(297

)

(6,037

)

 

 

 

 

 

 

Cash flows from discontinued operations

 

 

 

 

 

Operating activities

 

30

 

358

 

Investing activities

 

 

 

Net cash provided by discontinued operations

 

30

 

358

 

 

 

 

 

 

 

Net change in cash and cash equivalents

 

(388

)

(9,481

)

Cash and cash equivalents at beginning of period

 

6,886

 

12,246

 

Cash and cash equivalents at end of period

 

$

6,498

 

$

2,765

 

 

See accompanying Notes to Consolidated Financial Statements.

 

5



Table of Contents

 

ALMOST FAMILY, INC. AND SUBSIDIARIES

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS (UNAUDITED)

(Unless otherwise indicated, all dollars and share amounts are in thousands, except per share data)

 

1.                                      Accounting Policies

 

Basis of Presentation

 

The accompanying unaudited consolidated financial statements for the periods ended July 3, 2015 and June 30, 2014, have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (SEC).  Certain information and footnote disclosures normally included in financial statements prepared in accordance with accounting principles generally accepted in the United States have been omitted pursuant to such rules and regulations.  Accordingly, the reader of this Form 10-Q is referred to Almost Family, Inc.’s (the “Company”) Annual Report on Form 10-K for the year ended December 31, 2014 for further information.  In the opinion of management of the Company, the accompanying unaudited consolidated financial statements reflect all adjustments (consisting of normal recurring adjustments) necessary to present fairly the financial position at July 3, 2015, and the results of operations and cash flows for the periods ended July 3, 2015 and June 30, 2014.  The results of operations for the period ended July 3, 2015 are not necessarily indicative of the operating results for the year.

 

Effective with the first quarter of 2015, the Company adopted a 52-53 fiscal reporting calendar under which it will report its annual results going forward in four equal 13-week quarters.  Every fifth year, one quarter will include 14 weeks and that year will include 53 weeks of operating results.  Once fully adopted, this approach will help minimize the impact of calendar differences when comparing different historical periods. 

 

As a result of the change in the fiscal reporting calendar, the quarter ended April 3, 2015 and the year to date period January 1, 2015 through July 3, 2015 included 3 more days of results than they would have had if the change not been made.  The three month period for the second quarter of 2015, which includes operating results from April 4, 2015 through July 3, 2015 had the same number of days it would have had if the reporting calendar change had not been made.  However the Independence Day holiday observed on July 3, 2015 would have otherwise been reported in the next period.  Including the Independence Day holiday reduced diluted EPS by $0.03 in the current period.

 

Use of Estimates

 

The preparation of financial statements in conformity with accounting principles generally accepted in the United States 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 reported amounts of revenues and expenses during the reporting period.  Actual results could differ from those estimates.

 

Recently Issued Accounting Pronouncements

 

The Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2014-09, Revenue from Contracts with Customers (Topic 606), during the second quarter of 2014.  Topic 606 affects virtually all aspects of an entity’s revenue recognition, including determining the measurement of revenue and the timing of when it is recognized for the transfer of goods or services to customers.  Topic 606 is effective for annual reporting periods beginning after December 15, 2017.  The Company is currently evaluating the effect of the adoption of Topic 606 on its financial position and results of operations.

 

In April, the FASB issued ASU No. 2015-03, Interest — Imputation of Interest (Subtopic 835-30):  Simplifying the Presentation of Debt Issuance Costs.  Subtopic 835-30 requires that debt issuance costs related to a

 

6



Table of Contents

 

recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability.  Subtopic 835-30 is effective for annual and interim periods beginning after December 15, 2015.  The Company is currently evaluating the effect of the adoption of ASU No 2015-03 on its financial position and results of operations.

 

Discontinued Operations

 

In April 2014, the FASB issued accounting guidance amending the requirements for reporting discontinued operations Accounting Standards Codification (ASC 205 Presentation of Financial Statements and ASC 360 Property, Plant and Equipment). This guidance limits the requirement for discontinued operations treatment to the disposal of a component of an entity, or a group of components of an entity, that represents a strategic shift that has (or will have) a major effect on an entity’s operations and financial results.  Additionally, this new guidance no longer precludes discontinued operations presentation based on continuing involvement or cash flows following the disposal. This guidance became effective prospectively for the Company on January 1, 2015, and will impact the Company’s determination and disclosure of discontinued operations treatment for subsequent qualifying divestitures, if any.

 

In the first quarter of 2014, the Company’s VN segment exited a market in the Northeast through the closure of a branch location.  In conjunction with the SunCrest acquisition in 2013, the Company acquired operations which had been discontinued prior to acquisition.  The operations and any related gain on sale for these operations were reclassified from continuing operations into discontinued operations for all periods presented.  Unless otherwise noted, amounts in these Notes to Consolidated Financial Statements exclude amounts attributable to discontinued operations.

 

Cost-basis Investment

 

On January 29, 2015, the Company invested $1,000 in a development stage analytics software company, NavHealth, Inc.  The cost basis investment is included in other assets in the Company’s balance sheet.  The Company, through its ownership interest, is not in a position to significantly influence the activities of NavHealth, Inc.

 

2.                                Segment Data

 

The Company has two divisions, Home Health Care and Healthcare Innovations.  The Home Health Care division is comprised of two reportable segments, Visiting Nurse Services (VN or Visiting Nurse) and Personal Care Services (PC or Personal Care).  Healthcare Innovations is also a reportable segment.  Reportable segments have been identified based upon how management has organized the business by services provided to customers and how the chief operating decision maker manages the business and allocates resources, consistent with the criteria in ASC 280, Segment Reporting.

 

Consistent with information given to the chief operating decision maker, the Company does not allocate certain expenses to the reportable segments.  The Company evaluates the performance of its business segments based on operating income.  Intercompany and intersegment transactions have been eliminated.

 

The VN segment provides skilled medical services in patients’ homes largely to enable recipients to reduce or avoid periods of hospitalization and/or nursing home care.  Approximately 96% of the VN segment revenues are generated from the Medicare program while the balance is generated from Medicaid and private insurance programs.  VN Medicare revenues include revenues from all Medicare sources including traditional Medicare and Medicare Advantage, whether paid on a per episode basis or a per visit basis.

 

The PC segment services are also provided in patients’ homes.  These services (generally provided by paraprofessional staff such as home health aides) are generally of a custodial rather than skilled nature.  PC revenues are generated on an hourly basis.  Approximately 85% of the PC segment revenues are generated from Medicaid and other government programs while the balance is generated from insurance programs and private pay patients.

 

7



Table of Contents

 

The Company’s Healthcare Innovations business segment was created to house and separately report on our developmental activities outside the traditional home health business platform.  These activities are intended ultimately, whether directly or indirectly, to benefit the Company’s patients and payors through the enhanced provision of home health services.  The activities all share a common goal of improving patient experiences and quality outcomes, while lowering costs.  They include, but are not limited to, items such as: technology, information, population health management, risk-sharing, care-coordination and transitions, clinical advancements, enhanced patient engagement and informed clinical decision and technology enabled in-home clinical assessments.

 

 

 

Three month period ended

 

Six month period ended

 

Consolidated

 

July 3, 2015

 

June 30, 2014

 

July 3, 2015

 

June 30, 2014

 

Home Health Operations

 

 

 

 

 

 

 

 

 

Net service revenues:

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

$

97,748

 

$

96,776

 

$

197,283

 

$

189,949

 

Personal Care

 

29,488

 

28,160

 

58,249

 

55,020

 

 

 

127,236

 

124,936

 

255,532

 

244,969

 

Operating income before corporate expenses:

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

12,362

 

12,445

 

24,786

 

21,193

 

Personal Care

 

3,724

 

3,501

 

6,599

 

6,140

 

 

 

16,086

 

15,946

 

31,385

 

27,333

 

Healthcare Innovations

 

 

 

 

 

 

 

 

 

Revenue

 

130

 

256

 

233

 

563

 

Operating loss before noncontrolling interest

 

(402

)

(427

)

(919

)

(683

)

 

 

 

 

 

 

 

 

 

 

Corporate expenses

 

6,898

 

7,268

 

13,900

 

12,966

 

Deal, transition and other

 

206

 

1,243

 

614

 

4,357

 

Operating income

 

8,580

 

7,008

 

15,952

 

9,327

 

Interest expense, net

 

(392

)

(329

)

(753

)

(677

)

Income tax expense

 

(3,393

)

(2,618

)

(6,380

)

(3,435

)

Net income from continuing operations

 

$

4,795

 

$

4,061

 

$

8,819

 

$

5,215

 

 

3.                                      Capitalized Software Development Costs

 

The Company capitalizes the cost of internally generated computer software developed for the Company’s own use.  Software development costs of approximately $215 and $108 were capitalized in the three month periods ended July 3, 2015 and June 30, 2014, respectively.  Software development costs of approximately $287 and $192 were capitalized in the six month periods ended July 3, 2015 and June 30, 2014, respectively.  Capitalized software development costs are amortized over the estimated useful life, generally three years, once the software is ready for its intended use.

 

4.                                      Goodwill and Other Intangible Assets

 

The Company conducts annual reviews for impairment, or more frequently if circumstances indicate impairment may have occurred.  Other intangible assets consist of certificates of need and licenses, trade names and non-compete agreements.  Finite-lived intangible assets are amortized on a straight-line basis over their estimated useful lives.  Licenses, provider numbers, certificates of need and trade names have indefinite lives and are reviewed at least annually for possible impairment, or whenever events or changes in circumstances indicate that carrying amounts may not be recoverable.  The Company completed its most recent annual impairment test of goodwill and other indefinite-lived intangible assets as of December 31, 2014 and determined that no impairment existed.

 

The following table summarizes the activity related to goodwill and other intangible assets for 2015:

 

8



Table of Contents

 

 

 

 

 

Other Intangible Assets

 

 

 

Goodwill

 

Certificates
of Need and
Licenses

 

Trade
Names

 

Non-compete
Agreements

 

Total

 

Balances at 12-31-14

 

$

192,523

 

$

39,611

 

$

14,771

 

$

20

 

$

54,402

 

Acquisitions

 

2,544

 

250

 

 

 

250

 

Amortization

 

 

 

(5

)

(8

)

(13

)

Balances at 7-3-15

 

$

195,067

 

$

39,861

 

$

14,766

 

$

12

 

$

54,639

 

 

Acquisitions in the table relate to the WillCare Ohio acquisition discussed further in Note 10, “Acquisitions”.

 

The following table summarizes the Company’s goodwill and other intangible assets by segment:

 

 

 

 

 

Other Intangible Assets

 

 

 

Goodwill

 

Certificates
of Need and
Licenses

 

Trade
Names

 

Non-compete
Agreements

 

Total

 

Visiting Nurse

 

$

148,071

 

$

39,041

 

$

11,386

 

$

6

 

$

50,433

 

Personal Care

 

39,412

 

820

 

3,380

 

6

 

4,206

 

Healthcare Innovations

 

7,584

 

 

 

 

 

Balances at 7-3-15

 

$

195,067

 

$

39,861

 

$

14,766

 

$

12

 

$

54,639

 

 

5.                                      Revolving Credit Facility

 

At July 3, 2015, the Company had a senior secured revolving credit facility with JP Morgan Chase Bank, NA, as Administrative Agent, Bank of America, as Syndication Agent, and certain other lenders (the “Facility”).  The Facility consists of a $175,000 credit line with a maturity date of November 15, 2020 and an “accordion” feature providing for potential future expansion of the Facility to $250,000.  Borrowings (other than letters of credit) under the credit facility generally will bear interest at a rate varying from the London Interbank Offered Rate (LIBOR) plus 1.75% to LIBOR rate plus 3.00%, depending on leverage.  The Facility is secured by substantially all of the Company’s assets and the stock of its subsidiaries.

 

Borrowings under the Facility are subject to various covenants including a multiple of 3.5 times earnings before interest, taxes, depreciation and amortization (“EBITDA”). “EBITDA” may include “Acquired EBITDA” from pro-forma acquisitions as defined. Borrowings under the New Facility may be used for general corporate purposes, including acquisitions.  Application of the Facility’s borrowing formula as of July 3, 2015, permitted an additional $80,700 to be used.  The Company had irrevocable letters of credit totaling $9,800 outstanding in connection with the Company’s self-insurance programs, which resulted in a total of $70,900 being available for use at July 3, 2015.  As of July 3, 2015, the Company was in compliance with the various financial covenants.  Under the most restrictive of its covenants, the Company was required to maintain minimum net worth of at least $172,200 at July 3, 2015.  At such date, the Company’s net worth was approximately $239,300.

 

The effective interest rates on the Company’s borrowings were 2.58% and 2.39% for the three month periods ended July 3, 2015 and June 30, 2014, respectively.

 

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6.                                      Fair Value Measurements

 

The Company’s financial instruments consist of cash, accounts receivable, payables and debt instruments.  The carrying values of cash, accounts receivable and payables are considered representative of their respective fair values due to the short-term nature of these instruments.  The fair value of the Company’s debt instruments approximates their carrying values as substantially all of such debt instruments have rates which fluctuate with changes in market rates.  The Company does not have any assets or liabilities carried at fair value that are measured on a recurring basis.

 

7.                                      Stock-Based Compensation

 

The Company issues both restricted share and option awards to employees and non-employee directors.  Restricted share awards to employees cliff vest on the third anniversary of the grant date, while option share awards vest annually in 25% increments over four years from the grant date.  Stock option grant date fair values are determined at the date of grant using a Monte Carlo option valuation model with suboptimal exercise behavior.  Changes in unvested awards are summarized as follows:

 

 

 

Restricted shares

 

Options

 

 

 

Shares

 

Wtd Avg.
Grant Price

 

Shares

 

Wtd Avg.
Exercise Price

 

Aggregate
Intrinsic
Value

 

December 31, 2014

 

122

 

$

22.68

 

427

 

$

24.89

 

$

1,734

 

Granted

 

53

 

36.23

 

56

 

37.30

 

107

 

Vested or exercised

 

(45

)

22.87

 

(8

)

20.91

 

(139

)

Forfeited

 

 

 

(2

)

(20.18

)

(89

)

July 3, 2015

 

130

 

$

28.17

 

473

 

$

26.44

 

$

6,047

 

 

8.                                      Earnings per Common Share

 

A reconciliation of the weighted average shares outstanding used in the calculation of basic and diluted earnings per common share is as follows:

 

 

 

Three month period ended

 

Six month period ended

 

 

 

July 3, 2015

 

June 30, 2014

 

July 3, 2015

 

June 30, 2014

 

Basic weighted average outstanding shares

 

9,393

 

9,338

 

9,377

 

9,316

 

Add common equivalent shares representing shares issuable upon exercise of dilutive awards

 

176

 

93

 

177

 

107

 

Diluted weighted average number of shares

 

9,569

 

9,431

 

9,554

 

9,423

 

 

 

 

 

 

 

 

 

 

 

Anti-dilutive shares excluded from calculation

 

3

 

261

 

22

 

96

 

 

See footnote 12, “Subsequent Event” related to the issuance of shares subsequent to quarter end which are expected to be dilutive to earnings per share.

 

9.                                      Commitments and Contingencies

 

Insurance Programs

 

The Company bears significant insurance risk under its large-deductible workers’ compensation insurance program and its self-insured employee health program.  Under the workers’ compensation insurance program, the Company bears risk up to $400 per incident, after which stop-loss coverage is maintained.  The Company purchases stop-loss insurance for the employee health plan that places a specific limit, generally $300, on its exposure for any individual covered life.

 

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Malpractice and general patient liability claims for incidents which may give rise to litigation have been asserted against the Company by various claimants.  The claims are in various stages of processing and some may ultimately be brought to trial.  The Company is aware of incidents that have occurred through July 3, 2015 that may result in the assertion of additional claims.  The Company currently carries professional and general liability insurance coverage (on a claims made basis) for this exposure with no deductible.  The Company also carries D&O coverage (also on a claims made basis) for potential claims against the Company’s directors and officers, including securities actions, with deductibles ranging from $100 to $200 per claim.

 

The Company records estimated liabilities for its insurance programs based on information provided by the third-party plan administrators, historical claims experience, the life cycle of claims, expected costs of claims incurred but not paid, and expected costs to settle unpaid claims.  The Company monitors its estimated insurance-related liabilities and recoveries, if any, on a monthly basis and records amounts due under insurance policies in other current assets, while recording the estimated carrier liability in other current liabilities.  As facts change, it may become necessary to make adjustments that could be material to the Company’s results of operations and financial condition.

 

Legal Proceedings

 

The Company is currently, and from time to time, subject to claims and suits arising in the ordinary course of its business, including claims for damages for personal injuries.  In the opinion of management, after discussions with legal counsel, the ultimate resolution of any of these ordinary course pending claims and legal proceedings will not have a material effect on the Company’s financial position or results of operations.

 

10.                               Acquisition

 

On February 24, 2015 the Company signed a definitive agreement to acquire the stock of WillCare.  WillCare, based in Buffalo NY, reported $72,000 in revenue in 2014 with VN and PC branch locations in New York, Connecticut and Ohio.  The purchase price is expected to total between $46,000 and $53,000 based on changes in earnings and working capital between execution of the definitive agreement and the current expected close in the third quarter of 2015 pending final New York regulatory approval, which is to be heard on August 6, 2015.  The transaction will be funded by borrowings under the Company’s bank credit facility.  On March 1, 2015, the Company acquired the stock of WillCare’s Ohio operations for $3,000.

 

11.                               Income Taxes

 

The Company’s effective income tax rates from continuing operations for the three month periods ended July 3, 2015 and June 30, 2014 were approximately 40.3% and 39.2%, respectively.

 

Accounting principles generally accepted in the United States prescribe a recognition threshold and measurement attribute for the accounting and financial statement disclosure of tax positions taken or expected to be taken in a tax return.  The evaluation of a tax position is a two-step process.  The first step requires the Company to determine whether it is more likely than not that a tax position will be sustained upon examination based on the technical merits of the position.  The second step requires the Company to recognize in the financial statements each tax position that meets the more likely than not criteria, measured at the amount of benefit that has a greater than 50% likelihood of being realized.  The Company had $1,800 of unrecognized tax benefits at July 3, 2015, the total amount of which, if recognized, would affect the tax rate.  The Company includes the full amount of unrecognized tax benefits in other liabilities in the Consolidated Balance Sheets.  Additionally, the Company may from time to time be assessed interest and penalties by tax jurisdictions.  Any such assessments historically have been immaterial to the Company’s financial results and are classified as other general and administrative expenses in the consolidated statements of income.

 

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12.                               Subsequent Events

 

On July 23, 2015, the Company acquired 100% of the equity of Ingenios Health Co. for approximately 260 shares of the Company’s common stock plus $2,000 in cash.  Ingenios is a leading provider of technology enabled in-home clinical assessments for Medicare Advantage, Managed Medicaid and Commercial Exchange lives in 7 states and Washington, D.C.  The operating results of Ingenios will be reported in the Company’s Healthcare Innovations business segment, while the issuance of shares is expected to be dilutive to earnings per share.

 

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ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

 

The Company

 

Almost Family, Inc. and subsidiaries (collectively “Almost Family”) is a leading regional provider of home health nursing services. In this report, the terms “Company,” “we,” “us” or “our” mean Almost Family, Inc. and all subsidiaries included in our consolidated financial statements.

 

Cautionary Statements - Forward Outlook and Risks

 

Certain statements contained in this quarterly report on Form 10-Q, including, without limitation, statements containing the words “believes,” “anticipates,” “intends,” “expects,” “assumes,” “trends” and similar expressions, constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995.  Forward-looking statements are based upon the Company’s current plans, expectations and projections about future events.  However, such statements involve known and unknown risks, uncertainties and other factors that may cause the actual results, performance or achievements of the Company to be materially different from any future results, performance or achievements expressed or implied by such forward-looking statements.  These factors include, among others, the following:

 

·                  general economic and business conditions;

·                  demographic changes;

·                  changes in, or failure to comply with, existing governmental regulations;

·                  legislative proposals for healthcare reform;

·                  changes in Medicare and Medicaid reimbursement levels;

·                  changes in laws and regulations with respect to Accountable Care Organizations;

·                  changes in the marketplace and regulatory environment for Health Risk Assessments;

·                  effects of competition in the markets in which the Company operates;

·                  liability and other claims asserted against the Company;

·                  potential audits and investigations by government and regulatory agencies, including the impact of any negative publicity or litigation;

·                  ability to attract and retain qualified personnel;

·                  availability and terms of capital;

·                  loss of significant contracts or reduction in revenues associated with major payor sources;

·                  ability of customers to pay for services;

·                  business disruption due to natural disasters or terrorist acts;

·                  ability to effectively integrate, manage and keep secure our information systems;

·                  ability to successfully integrate the operations of acquired businesses and achieve expected synergies and operating efficiencies from the acquisition, in each case within expected time-frames or at all;

·                  significant deterioration in economic conditions and significant market volatility;

·                  effect on liquidity of the Company’s financing arrangements; and

·                  changes in estimates and judgments associated with critical accounting policies and estimates.

 

For a detailed discussion of these and other factors that could cause the Company’s actual results to differ materially from the results contemplated by the forward-looking statements, please refer to Item 1A. “Risk Factors” and Item 7. “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in the Company’s annual report on Form 10-K for year ended December 31, 2014 and this Form 10-Q.  The reader should not place undue reliance on forward-looking statements, which speak only as of the date of this report.  Except as required by law, the Company assumes no responsibility for updating forward-looking statements to reflect unforeseen or other events after the date of this report. The Company has provided a detailed discussion of risk factors in its Form 10-K and various filings with the Securities and Exchange Commission (SEC).  The reader is encouraged to review these risk factors and filings.

 

Critical Accounting Policies

 

Refer to the “Critical Accounting Policies” section of Item 7. “Management’s Discussion and Analysis of Financial Condition and Results of Operations” included in our Form 10-K for the year ended December 31,

 

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2014 for a detailed discussion of our critical accounting policies.  There have been no material changes to our critical accounting policies and estimates as described therein.

 

Fiscal Year End

 

Effective with the first quarter of 2015 the Company adopted a 52-53 fiscal reporting calendar under which it will report its annual results going forward in four equal 13-week quarters.  Every fifth year, one quarter will include 14 weeks and that year will include 53 weeks of operating results.  Once fully adopted, this approach will help minimize the impact of calendar differences when comparing different historical periods.

 

As a result of the change in the fiscal reporting calendar, the quarter ended April 3, 2015 and the year to date period January 1, 2015 through July 3, 2015 included 3 more days of results than they would have had if the change not been made.  The three month period for the second quarter of 2015, which includes operating results from April 4, 2015 through July 3, 2015 had the same number of days it would have had if the reporting calendar change had not been made.  However the Independence Day holiday observed on July 3, 2015 would have otherwise been reported in the next period.  Including the Independence Day holiday reduced diluted EPS by $0.03 in the current period.

 

Operating Segments

 

The Company has two divisions, Home Health Care and Healthcare Innovations.  The Home Health Care division is comprised of two reportable segments, Visiting Nurse Services (VN or Visiting Nurse) and Personal Care Services (PC or Personal Care).  Our Healthcare Innovations division is also a reporting segment.  Reportable segments have been identified based upon how management has organized the business by services provided to customers and how the chief operating decision maker manages the business and allocates resources, consistent with the criteria in ASC 280, Segment Reporting.

 

Our VN segment provides skilled medical services in patients’ homes largely to enable recipients to reduce or avoid periods of hospitalization and/or nursing home care.  VN Medicare revenues include revenues from all Medicare sources including traditional Medicare and Medicare Advantage, whether paid on a per episode basis or a per visit basis.  Approximately 96% of the VN segment revenues are generated from the Medicare program while the balance is generated from Medicaid and private insurance programs.

 

Our PC segment services are also provided in patients’ homes.  These services (generally provided by paraprofessional staff such as home health aides) are generally of a custodial rather than skilled nature.  PC revenues are typically generated on an hourly basis.  Approximately 85% of the PC segment revenues are generated from Medicaid and other government programs while the balance is generated from insurance programs and private pay patients.

 

Our Healthcare Innovations business segment was created to separately report on our developmental activities outside our traditional home health business platform.   These activities are intended ultimately, whether directly or indirectly, to benefit our patients and our payers through the enhanced provision of home health services.   Our activities all share a common goal of improving patient experiences and quality outcomes while lowering costs.   They include, but are not limited to, items such as: technology, information, population health management, risk-sharing, care coordination and transitions, clinical advancements, enhanced patient engagement and informed clinical decision and technology enabled in-home clinical assessments.

 

Certain general and administrative expenses incurred at the corporate level have not been allocated to the segments.

 

Acquisitions and Investment

 

On July 23, 2015, we acquired 100% of the equity of Ingenios Health Co. for approximately 260,000 shares of the Company’s common stock plus $2 million in cash.  Ingenios is a leading provider of technology enabled in-home clinical assessments for Medicare Advantage, Managed Medicaid and Commercial Exchange lives in 7 states and Washington, D.C.  The operating results of Ingenios will be reported in our

 

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Table of Contents

 

Healthcare Innovations business segment, while the issuance of shares is expected to be dilutive to earnings per share.

 

On February 24, 2015, we signed a definitive agreement to acquire the stock of WillCare.  WillCare, based in Buffalo NY, reported $72 million in revenue in 2014 with VN and PC branch locations in New York, Connecticut and Ohio.  The purchase price is expected to total between $46 and $53 million based on changes in earnings and working capital between execution of the definitive agreement and the expected close, currently expected in the third quarter of 2015 pending final New York regulatory approval, which is to be heard on August 6, 2015.  The transaction will be funded by borrowings under our bank credit facility.  On March 1, 2015, we acquired the stock of WillCare’s Ohio operations for $3 million.

 

On January 29, 2015, we invested $1.0 million in a development stage analytics software company, NavHealth, Inc.  The cost basis investment is included in other assets in our balance sheet.  We are not in a position to significantly influence the activities of NavHealth, Inc.

 

Health Care Reform Legislation and Medicare Regulations

 

The reader is encouraged to review our detailed discussion of Health Care Reform Legislation and Medicare Regulations in the similarly titled section in Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations,” along with the discussion under “Government Regulation” in Part I, Item 1, “Business” including but not limited to Item 1A. “Risk Factors” in the Company’s annual report on Form 10-K for year ended December 31, 2014.

 

On July 10, 2015, the Centers for Medicare and Medicaid Services (CMS) issued its proposed rule for 2016.  CMS is proposing a 1.8% rate cut consisting of a 2.9% market basket update minus a 0.6% productivity adjustment, a 2.5% rebasing cut and a 1.72% case mix adjustment.  CMS is proposing to implement a “Value Based Purchasing” (VBP) demonstration in 9 states under which certain 2016 agency specific performance measures would be used to establish individual agency reimbursement rates for 2018.  The proposed rule is currently open for comment.  The final rule is expected to be released in late October 2015.

 

Seasonality

 

Our VN segment operations in Florida, where nearly 34% of that segment’s revenues are generated, normally experience higher admissions during the first quarter and lower admissions during the third quarter than in the other quarters due to seasonal population fluctuations.

 

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RESULTS OF OPERATIONS

SECOND QUARTER

Consolidated

(In thousands)

 

 

 

Three months ended

 

 

 

 

 

 

 

July 3, 2015

 

June 30, 2014

 

Change

 

 

 

Amount

 

% Rev

 

Amount

 

% Rev

 

Amount

 

%

 

Home Health Operations

 

 

 

 

 

 

 

 

 

 

 

 

 

Net service revenues:

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

$

97,748

 

76.8

%

$

96,776

 

77.5

%

$

972

 

1.0

%

Personal Care

 

29,488

 

23.2

%

28,160

 

22.5

%

1,328

 

4.7

%

 

 

127,236

 

100.0

%

124,936

 

100.0

%

2,300

 

1.8

%

Operating income before corporate expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

12,362

 

12.6

%

12,445

 

12.9

%

(83

)

-0.7

%

Personal Care

 

3,724

 

12.6

%

3,501

 

12.4

%

223

 

6.4

%

 

 

16,086

 

12.6

%

15,946

 

12.8

%

140

 

0.9

%

Healthcare Innovations

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenue

 

130

 

 

 

256

 

 

 

(126

)

-49.2

%

Operating loss before noncontrolling interest

 

(402

)

NM

 

(427

)

NM

 

25

 

-5.9

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corporate expenses

 

6,898

 

5.4

%

7,268

 

5.8

%

(370

)

-5.1

%

Deal, transition and other

 

206

 

0.2

%

1,243

 

1.0

%

(1,037

)

-83.4

%

Operating income

 

8,580

 

6.7

%

7,008

 

5.6

%

1,572

 

22.4

%

Interest expense, net

 

(392

)

-0.3

%

(329

)

-0.3

%

(63

)

19.1

%

Income tax expense

 

(3,393

)

-2.7

%

(2,618

)

-2.1

%

(775

)

29.6

%

Net income from continuing operations

 

$

4,795

 

3.8

%

$

4,061

 

3.2

%

$

734

 

18.1

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA-HHO (1)

 

$

10,606

 

8.3

%

$

10,264

 

8.2

%

$

342

 

3.3

%

Adjusted Earnings-HHO (1)

 

$

5,293

 

4.2

%

$

4,921

 

3.9

%

$

372

 

7.6

%

 


(1)          See Page 24 for GAAP reconciliation of Adjusted EBITDA from home health operations and Adjusted earnings from home health operations.

 

Home health operating net revenues increased $2.3 million, or 1.8%, to $127.2 million primarily on favorable Medicare reimbursement rates. Operating income from home health operations grew $0.1 million, primarily in the PC Segment, due to acquired operations and mix changes. Refer to VN and PC segment discussions below for further home health division operating performance details. Refer to “Fiscal Year End” related to our 52-53 reporting calendar conversion.

 

Corporate expenses declined as a percent of revenues to 5.4% in the 2015 period from 5.8% resulting primarily from higher management incentives in the 2014 period due to relative performance against plan on a year to date basis. Deal and transition costs declined by $1.0 million to $0.2 million from $1.2 million in 2014 as the transition of our 2013 acquisitions were completed during 2014. Deal and transition costs in 2015 were related to the WillCare and Ingenios acquisitions.

 

Our effective tax rate for the second quarter of 2015 was 40.3% compared to 39.2% for the second quarter of 2014. The higher income tax rate in 2015 occurred primarily due to the expiration of the Work Opportunity Tax Credit.

 

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Visiting Nurse Segment

 

 

 

Three months ended

 

 

 

 

 

 

 

July 3, 2015

 

June 30, 2014

 

Change

 

(In thousands, except for statistics)

 

Amount

 

% Rev

 

Amount

 

% Rev

 

Amount

 

%

 

Net service revenues

 

$

97,748

 

100.0

%

$

96,776

 

100.0

%

$

972

 

1.0

%

Cost of service revenues

 

46,499

 

47.6

%

46,344

 

47.9

%

155

 

0.3

%

Gross margin

 

51,249

 

52.4

%

50,432

 

52.1

%

817

 

1.6

%

General and administrative expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

28,313

 

29.0

%

27,987

 

28.9

%

326

 

1.2

%

Other

 

10,574

 

10.8

%

10,000

 

10.3

%

574

 

5.7

%

Total general and administrative expenses

 

38,887

 

39.8

%

37,987

 

39.3

%

900

 

2.4

%

Operating income before corporate expenses

 

$

12,362

 

12.6

%

$

12,445

 

12.9

%

$

(83

)

-0.7

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Average number of locations

 

162

 

 

 

173

 

 

 

(11

)

-6.4

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

All payors:

 

 

 

 

 

 

 

 

 

 

 

 

 

Patient months

 

81,067

 

 

 

80,412

 

 

 

655

 

0.8

%

Admissions

 

24,920

 

 

 

24,545

 

 

 

375

 

1.5

%

Billable visits

 

638,479

 

 

 

637,361

 

 

 

1,118

 

0.2

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions (1)

 

22,367

 

90

%

21,876

 

89

%

491

 

2.2

%

Revenue (in thousands)

 

$

93,673

 

96

%

$

92,412

 

95

%

$

1,261

 

1.4

%

Revenue per admission

 

$

4,188

 

 

 

$

4,224

 

 

 

$

(36

)

-0.9

%

Billable visits (1)

 

577,358

 

90

%

576,001

 

90

%

1,357

 

0.2

%

Recertifications

 

11,384

 

 

 

12,140

 

 

 

(756

)

-6.2

%

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

Traditional Medicare Episodic

 

84.4

%

 

 

84.5

%

 

 

-0.1

%

 

 

Replacement Plans Paid Episodically

 

4.0

%

 

 

3.2

%

 

 

0.8

%

 

 

Replacement Plans Paid Per Visit

 

11.6

%

 

 

12.3

%

 

 

-0.7

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions (1)

 

2,553

 

10

%

2,669

 

11

%

(116

)

-4.3

%

Revenue (in thousands)

 

$

4,075

 

4

%

$

4,364

 

5

%

$

(289

)

-6.6

%

Revenue per admission

 

$

1,596

 

 

 

$

1,635

 

 

 

$

(39

)

-2.4

%

Billable visits (1)

 

61,121

 

10

%

61,360

 

10

%

(239

)

-0.4

%

Recertifications

 

480

 

 

 

470

 

 

 

10

 

2.1

%

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicaid & other governmental

 

30.8

%

 

 

22.0

%

 

 

8.8

%

 

 

Private payors

 

69.2

%

 

 

78.0

%

 

 

-8.8

%

 

 

 


(1)  Percentages pertain to percentage of total admissions or total billable visits, as applicable.

 

VN segment net revenue increased by $1.0 million to $97.7 million from $96.8 million in the prior year period primarily due to an approximately 1% effective rate increase from Medicare.  The average number of locations declined due to the 2014 combination of certain branches with overlapping service territory in Florida following the SunCrest acquisition.

 

Cost of service revenues were essentially unchanged on a per visit basis which combined with the effective Medicare rate increase which led to a slightly higher gross margin.  General and administrative expenses — Salaries and benefits increased 1.2% primarily due to higher wage rates.  General and administrative expenses — Other increased primarily due to higher provision for uncollectible accounts.

 

As a result, VN segment operating income before corporate expenses was $12.4 million for both periods, while VN segment operating income as percentage of revenue decreased to 12.6% from 12.9% in the prior year period.

 

17



Table of Contents

 

Personal Care Segment

 

 

 

Three months ended

 

 

 

 

 

 

 

July 3, 2015

 

June 30, 2014

 

Change

 

(In thousands, except for statistics)

 

Amount

 

% Rev

 

Amount

 

% Rev

 

Amount

 

%

 

Net service revenues

 

$

29,488

 

100.0

%

$

28,160

 

100.0

%

$

1,328

 

4.7

%

Cost of service revenues

 

19,825

 

67.2

%

19,144

 

68.0

%

681

 

3.6

%

Gross margin

 

9,663

 

32.8

%

9,016

 

32.0

%

647

 

7.2

%

General and administrative expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

3,878

 

13.2

%

3,573

 

12.7

%

305

 

8.5

%

Other

 

2,061

 

7.0

%

1,942

 

6.9

%

119

 

6.1

%

Total general and administrative expenses

 

5,939

 

20.1

%

5,515

 

19.6

%

424

 

7.7

%

Operating income before corporate expenses

 

$

3,724

 

12.6

%

$

3,501

 

12.4

%

$

223

 

6.4

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Average number of locations

 

62

 

 

 

61

 

 

 

1

 

1.6

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions

 

1,651

 

 

 

1,653

 

 

 

(2

)

-0.1

%

Patient months of care

 

23,722

 

 

 

22,502

 

 

 

1,220

 

5.4

%

Billable hours

 

1,317,978

 

 

 

1,348,504

 

 

 

(30,526

)

-2.3

%

Revenue per billable hour

 

$

22.37

 

 

 

$

20.88

 

 

 

$

1.49

 

7.1

%

 

Net service revenues increased $1.3 million, or 4.7%, to $29.5 million in 2015 from $28.2 million in 2014.  Approximately $0.9 million of the revenue increase came from the WillCare Ohio acquisition and the balance came from changes in business mix.  Cost of service revenues as a percentage of Net service revenues decreased slightly to 67.2% in 2015 from 68.0% in 2014, primarily due to changes in business mix.

 

Total general and administrative expenses as a percent of net service revenues increased to 20.2% in 2015 from 19.6% in 2014, primarily due to a $0.3 million increase in bad debt provision in certain states that transitioned to Medicaid Management Care providers.

 

PC segment operating income before corporate expenses increased to $3.7 million from $3.5 million in 2014, while operating income before corporate expenses as percentage of revenue increased 0.2%.

 

18



Table of Contents

 

YEAR TO DATE

Consolidated

(In thousands)

 

 

 

Six months ended

 

 

 

 

 

 

 

July 3, 2015

 

June 30, 2014

 

Change

 

 

 

Amount

 

% Rev

 

Amount

 

% Rev

 

Amount

 

%

 

Home Health Operations

 

 

 

 

 

 

 

 

 

 

 

 

 

Net service revenues:

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

$

197,283

 

77.2

%

$

189,949

 

77.5

%

$

7,334

 

3.9

%

Personal Care

 

58,249

 

22.8

%

55,020

 

22.5

%

3,229

 

5.9

%

 

 

255,532

 

100.0

%

244,969

 

100.0

%

10,563

 

4.3

%

Operating income before corporate expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

Visiting Nurse

 

24,786

 

12.6

%

21,193

 

11.2

%

3,593

 

17.0

%

Personal Care

 

6,599

 

11.3

%

6,140

 

11.2

%

459

 

7.5

%

 

 

31,385

 

12.3

%

27,333

 

11.2

%

4,052

 

14.8

%

Healthcare Innovations

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenue

 

233

 

 

 

563

 

 

 

(330

)

-58.6

%

Operating loss before noncontrolling interest

 

(919

)

NM

 

(683

)

NM

 

(236

)

34.6

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Corporate expenses

 

13,900

 

5.4

%

12,966

 

5.3

%

934

 

7.2

%

Deal, transition and other

 

614

 

0.2

%

4,357

 

1.8

%

(3,743

)

-85.9

%

Operating income

 

15,952

 

6.2

%

9,327

 

3.8

%

6,625

 

71.0

%

Interest expense, net

 

(753

)

-0.3

%

(677

)

-0.3

%

(76

)

11.2

%

Income tax expense

 

(6,380

)

-2.5

%

(3,435

)

-1.4

%

(2,945

)

85.7

%

Net income from continuing operations

 

$

8,819

 

3.4

%

$

5,215

 

2.1

%

$

3,604

 

69.1

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Adjusted EBITDA-HHO (1)

 

$

20,442

 

8.0

%

$

17,505

 

7.1

%

$

2,937

 

16.8

%

Adjusted Earnings-HHO (1)

 

$

10,112

 

4.0

%

$

8,210

 

3.4

%

$

1,902

 

23.2

%

 


(1)          See Page 24 for GAAP reconciliation of Adjusted EBITDA from home health operations and Adjusted earnings from home health operations.

 

Home health operating net revenues increased $10.6 million, or 4.3%, to $255.5 million on higher volumes and rates.  Operating income from home health operations grew $4.0 million, primarily in the VN Segment, where additional volumes and favorable Medicare reimbursement combined to increase our operating margin by 1.4%.  Refer to VN and PC segment discussions below for further home health division operating performance details.  Refer to “Fiscal Year End” related to our 52-53 reporting calendar conversion.

 

Our Healthcare Innovations operating loss deteriorated slightly as lower monthly fee revenues were only partially offset by lower labor and administrative expenses.

 

Corporate expenses for 2015 increased slightly as a percentage of revenue to 5.4% from 5.3% in the prior year period, primarily related to support for acquisitions and organic growth.  Deal and transition costs declined by $3.7 million to $0.6 million from $4.4 million in 2014 as the transition of our 2013 acquisitions were completed during 2014.  Deal and transition costs in 2015 were related to the WillCare and Ingenios acquisitions.

 

Our year to date effective tax rate for 2015 was 40.4% compared to 39.7% for the prior year.  The higher income tax rate in 2015 occurred primarily due to the expiration of the Work Opportunity Tax Credit.

 

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Table of Contents

 

Visiting Nurse Segment

 

 

 

Six months ended

 

 

 

 

 

 

 

July 3, 2015

 

June 30, 2014

 

Change

 

(In thousands, except for statistics)

 

Amount

 

% Rev

 

Amount

 

% Rev

 

Amount

 

%

 

Net service revenues

 

$

197,283

 

100.0

%

$

189,949

 

100.0

%

$

7,334

 

3.9

%

Cost of service revenues

 

94,583

 

47.9

%

93,031

 

49.0

%

1,552

 

1.7

%

Gross margin

 

102,700

 

52.1

%

96,918

 

51.0

%

5,782

 

6.0

%

General and administrative expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

56,991

 

28.9

%

55,146

 

29.0

%

1,845

 

3.3

%

Other

 

20,923

 

10.6

%

20,579

 

10.8

%

344

 

1.7

%

Total general and administrative expenses

 

77,914

 

39.5

%

75,725

 

39.9

%

2,189

 

2.9

%

Operating income before corporate expenses

 

$

24,786

 

12.6

%

$

21,193

 

11.2

%

$

3,593

 

17.0

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Average number of locations

 

162

 

 

 

174

 

 

 

(12

)

-6.9

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

All payors:

 

 

 

 

 

 

 

 

 

 

 

 

 

Patient months

 

162,049

 

 

 

159,600

 

 

 

2,449

 

1.5

%

Admissions

 

51,199

 

 

 

49,651

 

 

 

1,548

 

3.1

%

Billable visits

 

1,281,071

 

 

 

1,248,405

 

 

 

32,666

 

2.6

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions (1)

 

46,089

 

90

%

44,337

 

89

%

1,752

 

4.0

%

Revenue (in thousands)

 

$

188,794

 

96

%

$

181,388

 

95

%

$

7,406

 

4.1

%

Revenue per admission

 

$

4,096

 

 

 

$

4,091

 

 

 

$

5

 

0.1

%

Billable visits (1)

 

1,161,796

 

91

%

1,128,402

 

90

%

33,394

 

3.0

%

Recertifications

 

23,311

 

 

 

24,055

 

 

 

(744

)

-3.1

%

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

Traditional Medicare Episodic

 

84.3

%

 

 

83.9

%

 

 

0.4

%

 

 

Replacement Plans Paid Episodically

 

4.0

%

 

 

3.2

%

 

 

0.8

%

 

 

Replacement Plans Paid Per Visit

 

11.7

%

 

 

12.9

%

 

 

-1.2

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Non-Medicare:

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions (1)

 

5,110

 

10

%

5,314

 

11

%

(204

)

-3.8

%

Revenue (in thousands)

 

$

8,489

 

4

%

$

8,561

 

5

%

$

(72

)

-0.8

%

Revenue per admission

 

$

1,661

 

 

 

$

1,611

 

 

 

$

50

 

3.1

%

Billable visits (1)

 

119,275

 

9

%

120,003

 

10

%

(728

)

-0.6

%

Recertifications

 

907

 

 

 

934

 

 

 

(27

)

-2.9

%

Payor mix % of Admissions

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicaid & other governmental

 

30.8

%

 

 

21.6

%

 

 

9.2

%

 

 

Private payors

 

69.2

%

 

 

78.4

%

 

 

-9.2

%

 

 

 


(1)  Percentages pertain to percentage of total admissions or total billable visits, as applicable.

 

VN segment net revenue increased by $7.3 million to $197.3 million from $189.9 million in the prior year period primarily due to higher volumes and an effective Medicare rate increase of about 1%.  The average number of locations declined due to the 2014 combination of certain branches with overlapping service territory in Florida following the SunCrest acquisition.

 

Gross margin as a percent of revenue increased 1.1% primarily due to the Medicare rate increase.  General and administrative expenses — Salaries and benefits increased due to a combination of higher patient months and higher wage rates.  General and administrative expenses — Other increased primarily due to higher provision for uncollectible accounts.

 

As a result, VN segment operating income before corporate expenses improved to $24.8 million from $21.2 million in the prior year period, while VN segment operating income as percentage of revenue increased to 12.6% from 11.2% in the prior year period.

 

20



Table of Contents

 

Personal Care Segment

 

 

 

Six months ended

 

 

 

 

 

 

 

July 3, 2015

 

June 30, 2014

 

Change

 

(In thousands, except for statistics)

 

Amount

 

% Rev

 

Amount

 

% Rev

 

Amount

 

%

 

Net service revenues

 

$

58,249

 

100.0

%

$

55,020

 

100.0

%

$

3,229

 

5.9

%

Cost of service revenues

 

40,022

 

68.7

%

37,893

 

68.9

%

2,129

 

5.6

%

Gross margin

 

18,227

 

31.3

%

17,127

 

31.1

%

1,100

 

6.4

%

General and administrative expenses:

 

 

 

 

 

 

 

 

 

 

 

 

 

Salaries and benefits

 

7,775

 

13.3

%

7,056

 

12.8

%

719

 

10.2

%

Other

 

3,853

 

6.6

%

3,931

 

7.1

%

(78

)

-2.0

%

Total general and administrative expenses

 

11,628

 

20.0

%

10,987

 

20.0

%

641

 

5.8

%

Operating income before corporate expenses

 

$

6,599

 

11.3

%

$

6,140

 

11.2

%

$

459

 

7.5

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Average number of locations

 

62

 

 

 

61

 

 

 

1

 

1.6

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Admissions

 

3,078

 

 

 

3,172

 

 

 

(94

)

-3.0

%

Patient months of care

 

46,488

 

 

 

44,359

 

 

 

2,129

 

4.8

%

Billable hours

 

2,604,862

 

 

 

2,635,794

 

 

 

(30,932

)

-1.2

%

Revenue per billable hour

 

$

22.36

 

 

 

$

20.87

 

 

 

$

1.49

 

7.1

%

 

Net service revenues increased $3.2 million, or 5.9%, to $58.2 million in 2015 from $55.0 million in 2014 primarily due to mix changes and the WillCare Ohio acquisition.  Cost of service revenues as a percentage of Net service revenues decreased slightly to 68.7% in 2015 from 68.9% in 2014, primarily due to changes in business mix.

 

Total general and administrative expenses as a percent of net service revenues was 20.0% in 2015 and 2014.

 

As a result, PC segment operating income before corporate expenses increased to $6.6 million from $6.1 million in 2014, while operating income before corporate expenses as percentage of revenue increased 0.1%.

 

21



Table of Contents

 

Liquidity and Capital Resources

 

Revolving Credit Facility

 

At July 3, 2015, we had a senior secured revolving credit facility with JP Morgan Chase Bank, NA, as Administrative Agent, Bank of America, as Syndication Agent, and certain other lenders (the “Facility”).  The Facility consists of a $175 million credit line with a maturity date of November 15, 2020 and an “accordion” feature providing for potential future expansion of the Facility to $250 million.  Borrowings (other than letters of credit) under the credit facility generally will bear interest at a rate varying from the London Interbank Offered Rate (LIBOR) plus 1.75% to LIBOR rate plus 3.00%, depending on leverage.  The Facility is secured by substantially all of our assets and the stock of our subsidiaries.

 

Borrowings under the Facility are subject to various covenants including a multiple of 3.5 times earnings before interest, taxes, depreciation and amortization (“EBITDA”). “EBITDA” may include “Acquired EBITDA” from pro-forma acquisitions as defined. Borrowings under the New Facility may be used for general corporate purposes, including acquisitions.  Application of the Facility’s borrowing formula as of July 3, 2015, permitted $80.7 million to be used.  We had irrevocable letters of credit totaling $9.8 million outstanding in connection with our self-insurance programs, which resulted in a total of $70.9 million being available for use at July 3, 2015.  As of July 3, 2015, we were in compliance with the various financial covenants.  Under the most restrictive of its covenants, we were required to maintain minimum net worth of at least $172.2 million at July 3, 2015.  At such date, our net worth was approximately $239.3 million.

 

We believe that this facility plus cash on hand will be sufficient to fund our operating needs and expansion plans for at least the next year.  We will continue to evaluate additional capital, including possible debt and equity investments in the Company, to support a more rapid development of the business than would be possible with internal funds.

 

Cash Flows

 

Key elements to the Consolidated Statements of Cash Flows for the six month periods ended July 3, 2015 and June 30, 2014 were:

 

Net Change in Cash and Cash Equivalents (in thousands)

 

2015

 

2014

 

(Used in) provided by:

 

 

 

 

 

Operating activities

 

$

5,026

 

$

(2,098

)

Investing activities

 

(5,147

)

(1,704

)

Financing activities

 

(297

)

(6,037

)

Discontinued operations activities

 

30

 

358

 

Net change in cash and cash equivalents

 

$

(388

)

$

(9,481

)

 

2015

 

Net cash provided by operating activities resulted primarily from current period net income of $8.8 million plus certain non-cash items, net of changes in accounts receivable, accounts payable and accrued expenses.  Accounts receivable days sales outstanding, which were 59 at July 3, 2015 and 55 at December 31, 2014 increased due to collection delays, primarily in the PC segment, due to changes in patient enrollment and billing requirements enacted by the Medicaid managed care providers in the states of Tennessee and to a lesser degree Ohio.  Accounts receivable days sales outstanding declined by 3 days during the three months ended July 3, 2015.

 

Cash used in investing activities was primarily due to our March 1, 2015 acquisition of the stock of WillCare’s Ohio operations for $3.0 million, capital expenditures of $1.1 million and a $1.0 million cost basis investment.

 

22



Table of Contents

 

2014

 

Net cash used in operating activities resulted primarily from current period net income of $5.2 million plus certain non-cash items, net of an increase in accounts receivable, and decreases in accounts payable and accrued expenses.  The cash used in investing activities was primarily due to an April 2014 acquisition and capital expenditures. Cash used in financing activities resulted from $6.0 million of payments on the revolving credit facility.

 

Impact of Inflation

 

Management does not believe that inflation has had a material effect on income during the past several years.

 

23



Table of Contents

 

Non-GAAP Financial Measures

 

The information provided in some of the tables use certain non-GAAP financial measures as defined under SEC rules. In accordance with SEC rules, the Company has provided, in the supplemental information below, a reconciliation of those measures to the most directly comparable GAAP measures.

 

Adjusted Earnings from Home Health Operations

 

Adjusted earnings from home health operations (Adjusted Earnings-HHO) is not a measure of financial performance under accounting principles generally accepted in the United States of America (US GAAP).  It should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.  We believe the use of non-GAAP measures on a consolidated and business segment basis assists investors in understanding the ongoing operating performance by presenting comparable financial results between periods.  The non-GAAP information provided is used by us and may not be determined in a manner consistent with the methodologies used by other companies.

 

 

 

Three month period ended

 

Six month period ended

 

(in thousands)

 

July 3, 2015

 

June 30, 2014

 

July 3, 2015

 

June 30, 2014

 

Net income attributable to Almost Family, Inc.

 

$

5,010

 

$

3,961

 

$

9,403

 

$

5,234

 

 

 

 

 

 

 

 

 

 

 

Addbacks:

 

 

 

 

 

 

 

 

 

Deal, transition and other, net of tax

 

123

 

740

 

365

 

2,592

 

Loss on discontinued operations, net of tax

 

13

 

64

 

8

 

134

 

Adjusted earnings

 

5,146

 

4,765

 

9,776

 

7,960

 

Healthcare Innovations operating loss after Noncontrolling interest, net of tax

 

147

 

156

 

336

 

250

 

Adjusted Earnings-HHO

 

$

5,293

 

$

4,921

 

$

10,112

 

$

8,210

 

 

Adjusted EBITDA from Home Health Operations

 

Adjusted earnings before interest, income tax, depreciation, amortization, amortization of stock-based compensation, Healthcare Innovations operating loss and deal, transition and other from Home Health Operations (Adjusted EBITDA-HHO) is not a measure of financial performance under U.S. GAAP.  It should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles.  The items excluded from Adjusted EBITDA-HHO are significant components in understanding and evaluating financial performance and liquidity.  Management routinely calculates and communicates Adjusted EBITDA-HHO and believes that it is useful to investors because it is commonly used as an analytical indicator within our industry to evaluate performance, measure leverage capacity and debt service ability, and to estimate current or prospective enterprise value. Adjusted EBITDA is used in certain covenants contained in our Credit Facility.

 

The following table sets forth a reconciliation of net income to Adjusted EBITDA-HHO as of July 3 (in thousands):

 

 

 

Three month period ended

 

Six month period ended

 

(in thousands)

 

July 3, 2015

 

June 30, 2014

 

July 3, 2015

 

June 30, 2014

 

Net income from continuing operations

 

$

4,795

 

$

4,061

 

$

8,819

 

$

5,215

 

Add back:

 

 

 

 

 

 

 

 

 

Interest expense

 

392

 

329

 

753

 

677

 

Income tax expense

 

3,393

 

2,618

 

6,380

 

3,435

 

Depreciation and amortization

 

862

 

1,050

 

1,780

 

2,152

 

Stock-based compensation from HHO

 

485

 

458

 

1,005

 

872

 

Deal and transition costs

 

206

 

1,243

 

614

 

4,357

 

Adjusted EBITDA

 

10,133

 

9,759

 

19,351

 

16,708

 

Healthcare Innovation operating loss

 

473

 

505

 

1,091

 

797

 

Adjusted EBITDA from HHO

 

$

10,606

 

$

10,264

 

$

20,442

 

$

17,505

 

 

24



Table of Contents

 

ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

 

Derivative Instruments

 

The Company does not use derivative instruments.

 

Market Risk of Financial Instruments

 

Our primary market risk exposure with regard to financial instruments is to changes in interest rates on long-term obligations.

 

At July 3, 2015, a hypothetical 100 basis point increase in short-term interest rates would result in a reduction of approximately $0.5 million in our quarter pre-tax earnings.

 

ITEM 4. CONTROLS AND PROCEDURES.

 

Disclosure Controls and Procedures — As of July 3, 2015, the Company’s management, with participation of the Company’s Chief Executive Officer and Principal Financial Officer, evaluated the effectiveness of the Company’s disclosure controls and procedures as defined in Exchange Act Rules 13a-15(e).  Based on that evaluation, the Chief Executive Officer and Principal Financial Officer concluded that the Company’s disclosure controls and procedures were effective as of July 3, 2015.

 

Changes in Internal Control Over Financial Reporting - There were no changes in the Company’s internal control over financial reporting during the second quarter of 2015, that have materially affected, or are reasonably likely to materially affect, Almost Family, Inc.’s internal control over financial reporting.

 

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PART II - OTHER INFORMATION

 

ITEM 1. LEGAL PROCEEDINGS

 

From time to time, we are subject to various legal actions arising in the ordinary course of our business, including claims for damages for personal injuries.  In our opinion, after discussion with legal counsel, the ultimate resolution of any of these pending ordinary course claims and legal proceedings will not have a material effect on our financial position or results of operations.

 

ITEM 1A. RISK FACTORS

 

Information regarding risk factors appears in our Form 10-K for the year ending December 31, 2014, under the heading “Special Caution Regarding Forward — Looking Statements” and in the Form 10-K Part I, Item 1A. Risk Factors.  There have been no material changes from the risk factors disclosed in our Form 10-K and subsequent Form 10-Q.

 

ITEM 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS

 

Issuer Purchases of Equity Securities (1)

 

 

 

 

 

(d) Maximum Number

 

Period

 

(a) Total
Number of
Shares (or
Units)
Purchased (1)

 

(b) Average
Price Paid
per Share
(or Unit)

 

c) Total Number of
Shares (or Units)
Purchased as Part of
Publicly Announced
Plans or Programs

 

(or Approximate Dollar
Value) of Shares (or
Units) that May Yet Be
Purchased Under the
Plans or Programs

 

April 4, 2015 - May 1, 2015

 

 

$

 

 

 

May 2, 2015 - May 29, 2015

 

462

 

$

39.05

 

 

 

May 30, 2015 - July 3, 2015

 

1,057

 

$

41.96

 

 

 

Total

 

1,519

 

$

41.07

 

 

 

 


(1)  Shares were submitted by optionees in lieu of cash purchase price that would have otherwise been due on exercise in transactions approved by the Company’s  Board of Directors.

 

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ITEM 3. DEFAULTS UPON SENIOR SECURITIES

 

None

 

ITEM 4. MINE SAFETY DISCLOSURES

 

Not applicable

 

ITEM 5. OTHER INFORMATION

 

None

 

ITEM 6. EXHIBITS

 

31.1

Certifications of Chief Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

 

31.2

Certifications of Principal Financial Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.

 

32.1

Certifications of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

 

32.2

Certifications of Principal Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.

 

101

Financial statements from the quarterly report on Form 10-Q of Almost Family, Inc. for the quarter ended July 3, 2015, filed on July 30, 2015, formatted in XBRL:  (i) Consolidated Balance Sheets, (ii) Consolidated Statements of Income, (iii) Consolidated Statements of Cash Flows, and (iv) the Notes to Consolidated Financial Statements.

 

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SIGNATURES

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

 

 

ALMOST FAMILY, INC.

 

 

Date July 30, 2015

By:

/s/ William B. Yarmuth

 

 

William B. Yarmuth

 

 

Chairman of the Board and

 

 

Chief Executive Officer

 

 

 

 

 

 

 

By:

/s/ C. Steven Guenthner

 

 

C. Steven Guenthner

 

 

President and

 

 

Principal Financial Officer

 

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