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Surgery Partners, Inc. Announces Fourth Quarter and Full Year 2018 Results

March 13, 2019 7:00 AM

Same Store Volume and Revenue Growth, Along with Expanding Margins, Highlight Progress of Strategic Growth Initiatives

BRENTWOOD, Tenn., March 13, 2019 (GLOBE NEWSWIRE) -- Surgery Partners, Inc. (NASDAQ: SGRY) ("Surgery Partners" or the "Company"), a leading provider of surgical services, today announced results for the fourth quarter and full year ended December 31, 2018.

Highlights for the Fourth Quarter 2018:

Highlights for 2018:

2019 Outlook:

Adjusted revenues and Adjusted EBITDA are non-GAAP financial measures. A definition and reconciliation of these measures appears beginning on page 7.

Wayne DeVeydt, Chief Executive Officer of Surgery Partners, stated, “Our fourth quarter results were highlighted by strong Adjusted EBITDA growth, as well as our second consecutive quarter of same store volume growth. We continue to advance our agenda both operationally and strategically, as we remain focused on repositioning our portfolio for growth, investing in our platforms and processes, and deploying capital to continue to execute on organic and inorganic growth opportunities.”

Mr. DeVeydt continued, “Looking ahead to 2019, we are excited to provide investors an outlook for double-digit Adjusted EBITDA growth. As our growth strategy continues to gain traction, our goal is to make 2019 the first of many years of double-digit Adjusted EBITDA growth.”

Tom Cowhey, Chief Financial Officer of Surgery Partners, commented, “Fourth quarter results demonstrated good progress as we reposition the company for growth in 2019. We are quite pleased to close 2018 at the high end or above our revised guidance ranges for Adjusted EBITDA and Adjusted Revenues, respectively, and in a sound liquidity position. Further, with the charge we took today on our outstanding investigation by the federal government, we are excited to continue to reduce distractions and focus additional management time on our core short-stay surgical facilities business.”

Fourth Quarter 2018 Results

Revenues increased 6.7% to $491.2 million and adjusted revenues (refer to footnote 3 on page 7) for the fourth quarter of 2018 increased 8.5% to $499.7 million from $460.3 million for the fourth quarter of 2017. Same-facility revenues for the fourth quarter of 2018 increased 7.4% from the same period last year as a result of a 1.1% increase in same facility cases and a 6.3% increase in revenue per case. For the fourth quarter of 2018, the Company’s net loss attributable to common shareholders was $156.2 million compared to a net loss attributable to common shareholders of $40.0 million for the same period last year. For the fourth quarter of 2018, the Company’s Adjusted EBITDA increased 14.7% to $73.3 million compared to $63.9 million for the same period last year, primarily as a result of executing against our strategic growth initiatives.

Results for the fourth quarter of 2018 include a non-cash goodwill impairment charge of $74.4 million related to the Company's Ancillary and Optical reporting units and a litigation charge of $46.0 million related to the civil investigative demand letter received from the federal government in October 2017, as disclosed in our previous SEC filings.

Full Year 2018 Results

Total revenues for 2018 increased 32.1% to $1.8 billion and adjusted revenues for 2018 increased 34.6% to $1.8 billion from $1.3 billion for 2017. Same-facility revenues for 2018 increased 5.0% from 2017. The increase was driven by a 5.8% increase in revenue per case offset by a decline in case growth of 0.8%. For the full year 2018, the Company’s net loss attributable to common shareholders was $238.1 million compared to a net loss attributable to common shareholders of $79.0 million for the same period last year. For 2018, the Company’s Adjusted EBITDA increased 42.9% to $234.8 million compared to $164.3 million for 2017.

Net loss attributable to common shareholders for 2018 includes the non-cash goodwill impairment and litigation related charges as described above.

Liquidity

Surgery Partners had cash and cash equivalents of $184.3 million and availability of approximately $71.2 million under its revolving credit facility at December 31, 2018. Net operating cash flow, including operating cash flow less distributions to non-controlling interests, was $16.6 million for the fourth quarter of 2018. For the full year, net operating cash flow was $35.6 million. The Company’s ratio of total net debt to EBITDA, as calculated under the Company’s credit agreement, at the end of the fourth quarter of 2018, was 7.7x. During 2018, the Company acquired a controlling interest in five surgical facilities in new markets, two surgical facilities in existing markets (one of which was merged into an existing facility) and multiple physician practices for a combined cash purchase price of $106.8 million, net of cash acquired.

2019 Outlook

The Company projects that it will be able to grow revenues at a low single-digit percentage rate in 2019; when the 2018 baseline is adjusted for divested revenues, 2019 revenue growth is projected to be high single digits. The Company also projects that it will be able to grow Adjusted EBITDA at a double-digit percentage rate in 2019, which is expected to be weighted more towards the back half of the year. The Company’s outlook does not incorporate the impact of unidentified merger and acquisition activity.

Conference Call Information

Surgery Partners will hold a conference call today, March 13, 2019 at 8:30 a.m. (Eastern Time). The conference call can be accessed live over the phone by dialing 1-877-451-6152, or for international callers, 1-201-389-0879. A replay will be available two hours after the call and can be accessed by dialing 1-844-512-2921, or for international callers, 1-412-317-6671. The passcode for the live call and the replay is 13688435. The replay will be available until March 27, 2019.

Interested investors and other parties may also listen to a simultaneous webcast of the conference call by logging onto the Investor Relations section of the Company's website at www.surgerypartners.com. The on-line replay will remain available for a limited time beginning immediately following the call.

To learn more about Surgery Partners, please visit the company's website at www.surgerypartners.com. Surgery Partners uses its website as a channel of distribution for material Company information. Financial and other material information regarding Surgery Partners is routinely posted on the Company's website and is readily accessible.

About Surgery Partners

Headquartered in Brentwood, Tennessee, Surgery Partners is a leading healthcare services company with a differentiated outpatient delivery model focused on providing high quality, cost effective solutions for surgical and related ancillary care in support of both patients and physicians. Founded in 2004, Surgery Partners is one of the largest and fastest growing surgical services businesses in the country, with more than 180 locations in 31 states, including ambulatory surgery centers, surgical hospitals, a diagnostic laboratory, multi-specialty physician practices and urgent care facilities. For additional information, visit www.surgerypartners.com.

Forward-Looking Statements

This press release contains forward-looking statements, including those regarding growth, our anticipated operating results for 2019, our expectations regarding resolving the previously disclosed government investigation into our practices and other similar statements. These statements can be identified by the use of words such as “believes,” “anticipates,” “expects,” “intends,” “plans,” “continues,” “estimates,” “predicts,” “projects,” “forecasts,” and similar expressions. All forward looking statements are based on current expectations and beliefs as of the date of this release and are subject to risks, uncertainties and assumptions that could cause actual results to differ materially from those discussed in, or implied by, the forward-looking statements, including but not limited to, our ability to execute on our operational and strategic initiatives, the timing and impact of our portfolio optimization efforts, our ability to continue to improve same store volume and revenue growth on the timeline anticipated, if at all, our ability to successfully integrate acquisitions, the anticipated impact and timing of our ongoing efficiency efforts, including insurance consolidations and completed headcount actions, as well as our ongoing procurement and revenue cycle efforts, the impact of adverse weather conditions and other events outside of our control, whether or not a settlement is reached with the government relating to the previously disclosed investigation, the terms of any such settlement and the ongoing cost of complying with the terms of any such settlement, as well as the risks identified and discussed from time to time in the Company’s reports filed with the SEC, including in Item 1A under the heading “Risk Factors” in the Company’s most recent Annual Report on Form 10-K. Except as required by law, the Company undertakes no obligation to revise or update publicly any forward-looking statements to reflect events or circumstances after the date of this report, or to reflect the occurrence of unanticipated events or circumstances.

Use of Non-GAAP Financial Measures

In addition to the results prepared in accordance with generally accepted accounting principles in the United States ("GAAP") provided throughout this press release, Surgery Partners has presented the following non-GAAP financial measures: Adjusted Revenues and Adjusted EBITDA, which exclude various items detailed in the attached "Reconciliation of Non-GAAP Financial Measures".

These non-GAAP financial measures are not intended to replace financial performance measures determined in accordance with GAAP. Rather, they are presented as supplemental measures of the Company's performance that management believes may enhance the evaluation of the Company's ongoing operating results. These non-GAAP financial measures are not presented in accordance with GAAP, and the Company’s computation of these non-GAAP financial measures may vary from those used by other companies. These measures have limitations as an analytical tool, and should not be considered in isolation or as a substitute or alternative to revenue, net income or loss, operating income or loss, cash flows from operating activities, total indebtedness or any other measures of operating performance, liquidity or indebtedness derived in accordance with GAAP.

SURGERY PARTNERS, INC.SELECTED CONSOLIDATED FINANCIAL DATA(Amounts in thousands, except shares and per share amounts)

Three Months Ended December 31, Year Ended December 31,
2018 2017 2018 2017
Revenues $491,168 $460,346 $1,771,456 $1,341,219
Operating expenses:
Salaries and benefits 139,544 133,619 534,740 416,552
Supplies 134,550 125,987 490,251 354,337
Professional and medical fees 38,167 33,807 145,461 102,992
Lease expense 21,763 21,010 86,673 64,371
Other operating expenses 25,716 24,281 104,306 75,548
Cost of revenues 359,740 338,704 1,361,431 1,013,800
General and administrative expenses 23,829 21,376 93,558 75,950
Depreciation and amortization 18,061 18,474 67,440 51,928
Provision for doubtful accounts 8,765 28,752
Income from equity investments (2,615) (2,607) (8,898) (6,467)
Loss (gain) on disposal and deconsolidations, net 15,947 (328) 31,822 1,720
Transaction and integration costs 7,894 4,487 31,665 13,054
Impairment charges 74,359 74,359
Loss on debt refinancing 18,211
Loss (gain) on litigation settlements 46,009 (8,740) 46,009 (12,534)
Gain on acquisition escrow release (167) (1,167)
Other (income) expense (167) 38 (3,768) (262)
Total operating expenses 543,057 380,002 1,693,618 1,182,985
Operating (loss) income (51,889) 80,344 77,838 158,234
Gain on amendment to tax receivable agreement 16,392
Tax receivable agreement benefit 25,329 25,329
Interest expense, net (39,635) (32,857) (147,003) (117,669)
(Loss) income before income taxes (91,524) 72,816 (69,165) 82,286
Income tax expense (benefit) 15,556 71,850 26,461 53,550
Net (loss) income (107,080) 966 (95,626) 28,736
Less: Net income attributable to non-controlling interests (40,662) (33,142) (110,080) (81,721)
Net loss attributable to Surgery Partners, Inc. (147,742) (32,176) (205,706) (52,985)
Less: Amounts attributable to participating securities (8,453) (7,848) (32,426) (26,047)
Net loss attributable to common stockholders $(156,195) $(40,024) $(238,132) $(79,032)
Net loss per share attributable to common stockholders
Basic $(3.25) $(0.83) $(4.96) $(1.64)
Diluted (1) $(3.25) $(0.83) $(4.96) $(1.64)
Weighted average common shares outstanding
Basic 48,047,192 48,319,851 48,027,875 48,187,844
Diluted (1) 48,047,192 48,319,851 48,027,875 48,187,844

(1) The impact of potentially dilutive securities for all periods was not considered because the effect would be anti-dilutive in each periods.

SURGERY PARTNERS, INC.Selected Financial and Operating Data(Amounts in thousands, except shares and per share amounts)

December 31, 2018 December 31, 2017
Balance Sheet Data (at period end):
Cash and cash equivalents $184,308 $174,914
Total current assets 588,322 563,225
Total assets 4,676,267 4,622,773
Current maturities of long-term debt 55,552 58,726
Total current liabilities 349,299 303,005
Long-term debt, less current maturities 2,270,898 2,130,556
Total liabilities 2,891,384 2,656,041
Total Surgery Partners, Inc. stockholders' equity 404,640 654,731
Non-controlling interests—non-redeemable 694,305 681,879
Total stockholders' equity 1,098,945 1,336,610

Three Months Ended December 31, Year Ended December 31,
2018 2017 2018 2017
Cash Flow Data:
Net cash provided by (used in):
Operating activities $45,546 $54,447 $144,600 $120,943
Investing activities (62,251) (35,890) (128,862) (783,449)
Purchases of property and equipment, net (13,187) (8,987) (39,805) (29,600)
Payments for acquisitions, net of cash acquired (51,559) (28,086) (106,772) (755,102)
Financing activities 121,890 (43,344) (6,344) 767,721
Distributions to non-controlling interest holders (28,933) (27,046) (109,024) (83,833)

Three Months Ended December 31, Year Ended December 31,
2018 2017 2018 2017
Other Data:
Number of surgical facilities at the end of period 123 124 123 124
Number of consolidated surgical facilities as of the end of period 106 108 106 108
Cases 137,028 136,108 520,741 468,443
Revenue per case $3,584 $3,382 $3,402 $2,863
Adjusted EBITDA $73,303 $63,895 $234,768 $164,301
Adjusted EBITDA as a % of revenues 14.9% 13.9% 13.3% 12.3%

SURGERY PARTNERS, INC.Supplemental Information(Unaudited, in thousands, except cases and growth rates)

Three Months Ended December 31, Year Ended December 31,
2018 2017 2018 2017
Same-facility Information:
Cases 143,007 141,444 542,335 546,719
Case growth 1.1% N/A (0.8)% N/A
Revenue per case (2) $3,589 $3,378 $3,408 $3,220
Revenue per case growth 6.3% N/A 5.8% N/A

(2) Same-facility revenue per case reflects revenues from our consolidated and non-consolidated surgical facilities (excluding facilities acquired in new markets or divested during the current and prior periods) along with the revenues from our ancillary services comprised of a diagnostic laboratory, multi-specialty physician practices, urgent care facilities, anesthesia services, optical services and specialty pharmacy services that complement our surgical facilities in our existing markets.

Three Months Ended December 31, Year Ended December 31,
2018 2017 2018 2017
Segment Revenues:
Surgical facility services $470,816 $438,863 $1,682,278 $1,253,183
Ancillary services 19,321 18,885 79,633 76,921
Optical services 1,031 2,598 9,545 11,115
Total revenues $491,168 $460,346 $1,771,456 $1,341,219

Three Months Ended December 31, Year Ended December 31,
2018 2017 2018 2017
Adjusted EBITDA:
Surgical facility services $92,974 $82,813 $309,513 $229,672
Ancillary services 83 (990) 3,008 (8,781)
Optical services 413 543 2,500 2,950
All other (20,167) (18,471) (80,253) (59,540)
Total $73,303 $63,895 $234,768 $164,301

SURGERY PARTNERS, INC.Reconciliation of Non-GAAP Financial Measures(Unaudited, Amounts in thousands)

The following table reconciles adjusted revenues to revenues in the selected consolidated financial information, the most directly comparable U.S. GAAP measure:

2018
Q1 Q2 Q3 Q4 Full-Year
Adjusted Revenues (3):
Revenues prior to provision for doubtful accounts reclassification $411,332 $436,579 $432,377 $491,168 $1,771,456
Add: provision for doubtful accounts 6,037 8,196 11,555 8,482 34,270
Total adjusted revenues $417,369 $444,775 $443,932 $499,650 $1,805,726

(3) In accordance with a new accounting standard that was effective prospectively beginning January 1, 2018, we reflected our estimated provision for doubtful accounts net of revenues rather than as an operating expense, as it had historically been presented. Adjusted revenues add back the estimated provision for doubtful accounts. We believe such an adjustment is appropriate, as the new standard did not affect prior year results, which impacts comparability. Our calculation of adjusted revenues may not be comparable to similarly titled measures reported by other companies. Further, we are presenting a comparative reconciliation of each quarter in 2018, as prior quarterly presentation did not classify our provision for doubtful accounts as a component of revenues.

The following table reconciles Adjusted EBITDA to (loss) income before income taxes in the reported consolidated financial information, the most directly comparable U.S. GAAP financial measure:

Three Months Ended December 31, Year Ended December 31,
2018 2017 2018 2017
Adjusted EBITDA (4) 73,303 63,895 234,768 164,301
Net income attributable to non-controlling interests 40,662 33,142 110,080 81,721
Depreciation and amortization (18,061) (18,474) (67,440) (51,928)
Interest expense, net (39,635) (32,857) (147,003) (117,669)
Non-cash stock compensation expense (3,041) (204) (9,344) (5,584)
Contingent acquisition compensation expense (1,377) (1,510) (7,039)
Transaction, integration and practice acquisition costs (5) (8,437) (5,873) (33,856) (17,007)
(Loss) gain on litigation settlement (46,009) 8,740 (46,009) 12,534
Gain on acquisition escrow 167 1,167
(Loss) gain on disposal or impairment of long-lived assets, net (15,947) 328 (31,822) (1,720)
Reserve adjustments (2,670)
Impairment charges (74,359) (74,359)
Gain on amendment to tax receivable agreement 16,392
Tax receivable agreement benefit 25,329 25,329
Loss on debt refinancing (18,211)
(Loss) income before income taxes $(91,524) $72,816 $(69,165) $82,286

(4) We use Adjusted EBITDA as a measure of financial performance. Adjusted EBITDA is a key measure used by management to assess operating performance, make business decisions and allocate resources. Non-controlling interests represent the interests of third parties, such as physicians, and in some cases, healthcare systems that own an interest in surgical facilities that we consolidate for financial reporting purposes. We believe that it is helpful to investors to present Adjusted EBITDA as defined above because it excludes the portion of net income attributable to these third-party interests and clarifies for investors our portion of Adjusted EBITDA generated by our surgical facilities and other operations.

Adjusted EBITDA is not a measurement of financial performance under GAAP, and should not be considered in isolation or as a substitute for net income, operating income or any other measure calculated in accordance with generally accepted accounting principles. The items excluded from Adjusted EBITDA are significant components in understanding and evaluating our financial performance. We believe such adjustments are appropriate, as the magnitude and frequency of such items can vary significantly and are not related to the assessment of normal operating performance. Our calculation of Adjusted EBITDA may not be comparable to similarly titled measures reported by other companies. Surgery Partners is not able to project the items excluded from Adjusted EBITDA and therefore cannot reconcile projected Adjusted EBITDA to projected net income for 2019.

(5) This amount includes merger transaction and integration costs of $7.9 million and $4.5 million for the three months ended December 31, 2018 and 2017, respectively, and practice acquisition costs of $0.5 million and $1.4 million for the three months ended December 31, 2018 and 2017, respectively.

This amount includes merger transaction and integration costs of $31.7 million and $13.1 million for the years ended December 31, 2018 and 2017, respectively, and practice acquisition costs of $2.2 million and $3.9 million for the years ended December 31, 2018 and 2017, respectively.

In connection with the Preferred Private Placement and the Private Sale, as previously disclosed on Form 8-K filed with the Securities and Exchange Commission on September 1, 2017, the Company elected to apply “pushdown” accounting with the change of control effective August 31, 2017, by applying the guidance in Accounting Standards Codification Topic ("ASC") 805, Business Combinations. Accordingly, the consolidated financial statements of the Company for periods before and after August 31, 2017 will reflect different bases of accounting, and the financial positions and results of operations of those periods are not comparable. Throughout the Company's consolidated financial statements and the accompanying notes therein to be filed no later than March 18, 2019, periods prior to the change of control are identified as "Predecessor" and periods after the change of control are identified as "Successor."

The following table reconciles the consolidated statement of operations for the year ended December 31, 2017 presented above, to the Successor and Predecessor periods:

Successor Predecessor
September 1 to December 31, January 1 to August 31,
2017 2017
Revenues $592,604 $748,615
Operating expenses:
Salaries and benefits 175,403 241,149
Supplies 161,015 193,322
Professional and medical fees 45,061 57,931
Lease expense 27,868 36,503
Other operating expenses 32,281 43,267
Cost of revenues 441,628 572,172
General and administrative expenses (6) 29,153 46,797
Depreciation and amortization 21,804 30,124
Provision for doubtful accounts 12,455 16,297
Income from equity investments (3,319) (3,148)
Loss on disposals and deconsolidations, net 5 1,715
Transaction and integration costs 7,470 5,584
Loss on debt refinancing 18,211
Gain on litigation settlements (8,740) (3,794)
Gain on acquisition escrow release (167) (1,000)
Other expense (income) 45 (307)
Total operating expenses 500,334 682,651
Operating income 92,270 65,964
Gain on amendment to tax receivable agreement 1,098 15,294
Tax receivable agreement benefit 25,329
Interest expense, net (48,740) (68,929)
Income before income taxes 69,957 12,329
Income tax expense (benefit) 71,639 (18,089)
Net (loss) income (1,682) 30,418
Less: Net income attributable to non-controlling interests (39,634) (42,087)
Net loss attributable to Surgery Partners, Inc. (41,316) (11,669)
Less: Amounts attributable to participating securities (7) (26,047)
Net loss attributable to common stockholders $(67,363) $(11,669)
Net loss per share attributable to common stockholders
Basic $(1.39) $(0.24)
Diluted (8) $(1.39) $(0.24)
Weighted average common shares outstanding
Basic 48,319,193 48,121,404
Diluted (8) 48,319,193 48,121,404

(6) Includes contingent acquisition compensation expense of $1.9 million for the four months ended December 31, 2017 (Successor), and contingent acquisition compensation expense of $5.1 million for the eight months ended August 31, 2017 (Predecessor).(7) Includes accrued dividends of $10.4 million and the mark to redemption adjustment of $15.6 million for the Series A Preferred Stock for the four months ended December 31, 2017 (Successor). There were no participating securities during the Predecessor period.(8) The impact of potentially dilutive securities for both periods presented was not considered because the effect would be anti-dilutive.

The following table reconciles the selected cash flow data for the year ended December 31, 2017 as presented above to the Successor and Predecessor periods:

Successor Predecessor
September 1 to December 31, January 1 to August 31,
2017 2017
Cash Flow Data:
Net cash provided by (used in):
Operating activities $53,225 $67,718
Investing activities (38,893) (744,556)
Capital expenditures (10,827) (18,773)
Investments in new businesses (29,249) (725,853)
Financing activities (53,624) 821,345
Distributions to non-controlling interests (33,490) (50,343)

The following table reconciles the revenues by segment for the year ended December 31, 2017 as presented above to the Successor and Predecessor periods:

Successor Predecessor
September 1 to December 31, January 1 to August 31,
2017 2017
Revenues:
Surgical facility services $564,458 $688,725
Ancillary services 24,660 52,261
Optical services 3,486 7,629
Total revenues $592,604 $748,615

The following table reconciles the Adjusted EBITDA tables for the year ended December 31, 2017 as presented above to the Successor and Predecessor periods:

Successor Predecessor
September 1 to December 31, January 1 to August 31,
2017 2017
Adjusted EBITDA:
Surgical facility services $103,760 $125,912
Ancillary services (2,255) (6,526)
Optical services 736 2,214
All other (23,504) (36,036)
Total Adjusted EBITDA 78,737 85,564
Net income attributable to non-controlling interests 39,634 42,087
Depreciation and amortization (21,804) (30,124)
Interest expense, net (48,740) (68,929)
Non-cash stock compensation expense (1,887) (3,697)
Contingent acquisition compensation expense (1,982) (5,057)
Transaction, integration and practice acquisition costs (9) (9,330) (7,677)
Gain on litigation settlement 8,740 3,794
Gain on acquisition escrow release 167 1,000
Loss on disposal or impairment of long-lived assets, net (5) (1,715)
Gain on amendment to tax receivable agreement 1,098 15,294
Tax receivable agreement benefit 25,329
Loss on debt refinancing (18,211)
Income before income taxes $69,957 $12,329

(9) This amount includes merger transaction and integration costs of $7.5 million for the four months ended December 31, 2017 (Successor) and $5.6 million for the eight months ended August 31, 2017 (Predecessor).

This amount includes practice acquisition costs of $1.8 million for the four months ended December 31, 2017 (Successor) and $2.1 million for the eight months ended August 31, 2017 (Predecessor).

Contact

Thomas F. Cowhey, Chief Financial OfficerSurgery Partners, Inc.(615) 234-8940[email protected]

SurgeryPartnersLinear (1).jpg

Source: Surgery Partners, Inc.

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