Surgical Care Affiliates, Inc. Announces Second Quarter 2015 Results


Revenues Increase 22% Over Prior Year Period

Same Site Systemwide Net Patient Revenues Increase 7.1% Over Prior Year Period

DEERFIELD, Ill., Aug. 4, 2015 (GLOBE NEWSWIRE) -- Surgical Care Affiliates, Inc. (NASDAQ:SCAI) ("SCA" or the "Company"), a leading provider of surgical solutions, announced today results for the second quarter and six months ended June 30, 2015.

For the three months ended June 30, 2015, SCA delivered net operating revenue of $253.7 million which represents growth of 21.5% over the prior year second quarter. For the second quarter of 2015, operating income grew 29.8% to $60.9 million, adjusted EBITDA less NCI grew 12.4% to $43.0 million, and net income attributable to SCA was $4.6 million. Same site net patient revenue grew 7.1% for the three months ended June 30, 2015 compared to the prior year second quarter. 

Since the beginning of the year, the Company has acquired thirteen new facilities, seven of which are partnered with health systems. The Company reiterates its original guidance of 8% to 11% growth in adjusted EBITDA less NCI for 2015.

Andrew Hayek, President and CEO of SCA, said, "We are pleased with our clinical, strategic, and financial performance. Patient care is our first priority, and our teammates and physician partners continue to achieve strong clinical quality and patient satisfaction results. From a strategic standpoint, SCA continues to partner with health systems and physician groups, and our development pipeline remains strong. From a financial standpoint, we are on track with our original guidance, and we are on track to achieve a seventh consecutive year of approximately ten percent growth in adjusted EBITDA less NCI. We are grateful to our physicians and teammates across the country who deliver outstanding patient care every day and drive our success."

Strategic Transactions and Facility Count Update

During the second quarter of 2015, the Company acquired seven new facilities, five of which were consolidated and two of which were nonconsolidated. Also, during the same period, three of the Company's existing facilities converted from managed only to nonconsolidated. Since the end of the second quarter, the Company has added two more facilities. Additionally, as part of the Company's ongoing effort to optimize its portfolio, the Company merged one facility and closed or sold five non-strategic facilities. The Company's total facility count as of August 4, 2015 was 193.

The Company continues to expand many of its existing health system relationships and cultivate new relationships, including adding two new facilities in the second quarter in partnership with the Virtua Health System, the largest health system in southern New Jersey, converting two facilities from managed only to equity relationships in partnership with UnityPoint Health, one of the two leading statewide health systems in Iowa, and adding two surgery centers in partnership with an affiliate of Catholic Health Initiatives, a leading national health system.

The Company's number of facilities in partnership with health systems as of August 4, 2015 was 108, up from 98 as of December 31, 2014.

Second Quarter 2015 Results

Total net operating revenues, which exclude revenues from facilities in which SCA owns a non-controlling interest, increased 21.5% in the second quarter of 2015 to $253.7 million from $208.7 million in the prior year period. This increase was driven by revenues earned from acquisitions, higher acuity case mix and higher volumes in some of the Company's larger facilities.

Systemwide net operating revenues, which include revenues from all facilities in which SCA has an ownership interest (without adjustment based on SCA's percentage of ownership) and management fee revenues from managed-only facilities, increased 18.2% in the second quarter as compared to the prior year period. On a same site basis, systemwide net patient revenue for the second quarter of 2015 increased 7.1% and same site systemwide case volume increased 3.3% compared to the prior year period. The growth in systemwide revenue metrics was largely driven by acquisitions and higher case acuity and payer mix in certain large facilities.

Net income attributable to SCA, which includes certain non-cash and non-recurring expenses, was $4.6 million for the second quarter of 2015, compared to a net income attributable to SCA of $6.0 million for the second quarter of 2014. One-time expenses related to the HealthSouth option of $1.8 million and an impairment recorded relating to advances previously extended to a nonconsolidated affiliate that were deemed not recoverable of $2.7 million impacted the second quarter of 2015 . Adjusted net income, which adjusts for items that are non-cash or non-recurring in nature, was $19.9 million for the second quarter of 2015, as compared to $19.6 million for the same period of the prior year. Adjusted net income in the second quarter of 2015 increased slightly from the same quarter last year due to the increase in acquisition activity. Acquisitions drive higher interest and depreciation expense and often have lower earnings in their initial months due to planned integration activities. To accommodate future growth, the Company also made several capital investments in its IT infrastructure and facilities that increase depreciation. Lastly, the second quarter was the first complete quarter of increased interest expense following the Company's debt refinancing completed in March of this year.

Adjusted EBITDA less NCI, which adds back certain non-recurring expenses, increased 12.4% for the second quarter of 2015 to $43.0 million from $38.2 million in the same period of the prior year.

SCA's operating cash flow was $78.1 million for the second quarter, up $35.9 million from the second quarter of 2014. Adjusted operating cash flow less distributions to non-controlling interests was $39.4 million for the second quarter, up $21.8 million from the second quarter of 2014 due to improved cash flows from operating activities, including favorable changes in working capital, partially offset by an increase in distributions to non-controlling interests.

Full Year 2015 Guidance

For 2015, the Company is reiterating its original 2015 guidance, which it initially disclosed in January. The Company expects 2015 adjusted EBITDA less NCI growth to be in the range of 8% to 11%. 

Conference Call Information

SCA will hold a webcast conference call to discuss this release today at 9:00 a.m. ET. The live webcast of the conference call will be available by accessing http://investor.scasurgery.com. Following the call, an archived replay of the webcast will be available on the corporate website for 30 days.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. These statements, which have been included in reliance of the "safe harbor" provisions of the Private Securities Litigation Reform Act of 1995, involve risks and uncertainties and assumptions relating to our operations, financial condition, business, prospects, growth strategy and liquidity, which may cause our actual results to differ materially from those projected by such forward-looking statements, and the Company cannot give assurances that such statements will prove to be correct. Investors are hereby cautioned that these statements may be affected by important factors, including, but not limited to, the following risks: our dependence on payments from third-party payers, including governmental healthcare programs, commercial payers and workers' compensation programs; our inability or the inability of our healthcare system partners to negotiate favorable contracts or renew existing contracts with non-governmental third-party payers on favorable terms; significant changes in our payer mix or case mix resulting from fluctuations in the types of cases performed at our facilities; the fact that the Medicare and Medicaid programs provide a significant portion of our revenues and are each particularly susceptible to legislative and regulatory change; the implementation by states of reduced fee schedules and reimbursement rates for workers' compensation programs; our inability to maintain good relationships with our current health system partners or our inability to enter into relationships with new health system partners; material changes in Internal Revenue Service revenue rulings, case law or the interpretation of such rulings; our dependence on physician utilization of our facilities, which could decrease if we fail to maintain good relationships with these physicians; the potential reduction in the number of surgical procedures because of physician treatment methodologies and governmental or commercial health insurance controls; our inability to attract new physician investors and to acquire and develop additional surgical facilities on favorable terms; shortages of, or quality control issues with, surgery-related products, equipment and medical supplies that could result in a disruption of our operations; the competition for staffing, shortages of qualified personnel or other factors that drive up labor costs; the intense competition we face for patients, physician use of our facilities, strategic relationships and commercial payer contracts; the fact that we are subject to significant malpractice and related legal claims, and we could be required to pay significant damages in connection with those claims; the adverse effect of current and future economic conditions on volume and case mix; the regulatory, economic and other conditions in certain states in which many of our facilities are concentrated; the fact that we have a history of net losses and may not achieve profitability in the future; the fact that we may have a special legal responsibility to the holders of ownership interests in the entities through which we own our facilities, which may conflict with, and prevent us from acting solely in, our own best interest; the difficulty in operating and integrating newly acquired or developed facilities; the growth of patient receivables or the deterioration in the ability to collect on those accounts; the loss of the service of our senior management; our reliance on our private equity sponsor; our substantial indebtedness, and our ability to incur additional indebtedness in the future; our inability to generate sufficient cash in order to meet our debt service obligations; restrictions on our current and future operations because of the terms of our senior secured credit facilities; market risks related to interest rate changes; significant loans that we have made to the partnerships and limited liability companies that own and operate certain of our facilities; our liability for certain debt and other obligations of the partnerships and limited liability companies that own and operate certain of our facilities; recognition of impairment on our long-lived assets or equity method investments; our inability to manage and secure our information systems effectively, which could disrupt our operations; our inability to fully realize the value of our net operating loss carry-forwards; adverse impact of weather and other factors beyond our control on our facilities; our inability to predict the impact on us of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Affordability Reconciliation Act of 2010, which represents a significant change to the healthcare industry; our failure to comply with numerous federal and state laws and regulations relating to our facilities, which could lead to the incurrence of significant penalties by us or require us to make significant changes to our operations; our obligations to purchase some or all of the ownership interests of our physician partners or renegotiate some of our partnership and operating agreements because of changes to laws or regulations governing physician ownership of our facilities; our failure to comply with a federal criminal law referred to as the Anti-Kickback Statute or the physician self-referral laws; restrictions by federal law on our ability to expand surgical capacity of our surgical hospitals; our being subject to federal and state audits and investigations, including actions for false and improper claims; our failure to comply with Medicare's conditions for coverage and conditions of participation, which could result in loss of program payment or other government sanctions; ensuring our continued compliance with the Health Insurance Portability and Accountability Act of 1996 or HIPAA, which could require us to expend significant resources and capital; our failure to effectively and timely implement electronic health records systems and transition to the ICD-10 coding system; efforts to regulate the construction, relocation, acquisition, change of ownership, change of control or expansion of healthcare facilities, which could prevent us from acquiring additional facilities, renovating our existing facilities or expanding the breadth of services we offer; our being subject to enforcement action from antitrust authorities; our being subject to constantly evolving healthcare laws and regulations; and the fact that our private equity sponsor has significant influence over us and key decisions about our business that could limit other stockholders' ability to influence the outcome of matters submitted to stockholders for a vote.

The forward-looking statements made in this press release are made only as of the date of the hereof. Except as required by law, we undertake no obligation to update any forward-looking statement, whether as a result of new information or otherwise. More information about potential factors that could affect our business and financial results is included in our filings with the Securities and Exchange Commission, including in our most recent annual report on Form 10-K and subsequently filed quarterly reports on Form 10-Q.

In addition, SCA cannot provide any assurances about the timing, terms or interest rate associated with the planned refinancing, or that the refinancing transactions can be completed at all. 

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, SCA has presented the following non-GAAP financial measures, which management uses to gauge operating performance: adjusted EBITDA less NCI, adjusted net income (including diluted adjusted net income per share), and adjusted operating cash flow less distributions to NCI. These non-GAAP financial measures 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 finds useful in assessing the Company's operating performance between periods and that we believe are useful for investors to analyze our operating performance on the same basis as used by our management. You should be aware that there is no certainty that we will not incur expenses in the future that are similar to those excluded in the calculation of adjusted EBITDA less NCI, adjusted net income (including diluted adjusted net income per share) and adjusted operating cash flow less distributions to NCI. Other companies in our industry may calculate adjusted EBITDA less NCI, adjusted net income (including diluted adjusted net income per share) and adjusted operating cash flow less distributions to NCI differently than we do, limiting their usefulness as comparative measures. Because of these limitations, none of adjusted EBITDA less NCI, adjusted net income (including diluted adjusted net income per share) or adjusted operating cash flow less distributions to NCI should be considered the primary measure of the operating performance of our business. We strongly encourage you to review the Company's GAAP financial statements and not to rely on any single financial measure to evaluate our business.

As of June 30, 2015, 67 of SCA's 193 facilities were nonconsolidated. SCA accounts for these facilities using the equity method. For consolidated subsidiaries, the Company's financial statements reflect 100% of the revenues and expenses for these subsidiaries, after elimination of intercompany transactions and accounts. For nonconsolidated affiliates, our consolidated statements of operations reflect our earnings from such facilities in two line items:

  • Equity in net income of nonconsolidated affiliates, which represents SCA's combined share of the net income of each equity method facility that is based on such equity method facility's net income and the percentage of such equity method facility's outstanding equity interests owned by us; and
  • Management fee revenues, which represents the Company's combined income from management fees that are earned from managing the day-to-day operations of the facilities that are not consolidated for financial reporting purposes.

As a result of this accounting treatment in SCA's reported results, management supplementally focuses on non-GAAP systemwide metrics to analyze the results of operations. These systemwide metrics include systemwide net operating revenues growth, same site systemwide net patient revenues growth, systemwide net patient revenues per case growth, same site systemwide net patient revenues per case growth and same site systemwide case volume (day adjusted). Systemwide metrics treat SCA's nonconsolidated facilities as if they were consolidated. The Company includes management fee revenue from managed-only facilities in systemwide net operating revenues growth and same site systemwide net operating revenues growth, but not patient or other revenues from managed-only facilities (in which SCA holds no ownership interest). The Company does not include revenues from managed-only facilities in systemwide net patient revenues per case growth or same site systemwide net patient revenues per case growth. While net patient revenues earned at the nonconsolidated facilities are not recorded in our consolidated financial statements, management believes systemwide growth metrics are important to understand the Company's financial performance because the metrics are used to interpret the sources of our growth and provide a growth metric incorporating the net patient revenues earned by all affiliated facilities, regardless of the accounting treatment. As SCA executes on its strategy of partnering with health systems, management expects the number of our facilities accounted for as equity method facilities will increase relative to the total number of affiliated facilities.

About Surgical Care Affiliates

An industry leader, SCA partners with physicians, health systems and health plans to develop and implement surgery strategies across the country. As of June 30, 2015, SCA operated 193 surgical facilities, 106 of which are in affiliation with health system partnerships – including ambulatory surgery centers and surgical hospitals – in partnership with approximately 2,600 physicians. SCA's clinical systems, service line growth strategies, benchmarking processes and efficiency programs create measurable advantage for surgical facilities – clinically, operationally and financially. For more information on SCA, visit www.scasurgery.com.

Surgical Care Affiliates, Inc.
Unaudited Selected Financial and Operating Data
(In millions, except per share data)
         
  THREE-MONTHS ENDED
JUNE 30,
SIX-MONTHS ENDED
JUNE 30,
  2015 2014 2015 2014
Statement of Operations Data:        
Net operating revenues:        
Net patient revenues  $ 233.9  $ 191.3  $ 450.5  $ 366.1
Management fee revenues  14.4  15.3  28.5  28.4
Other revenues  5.4  2.1  8.8  6.8
Total net operating revenues  253.7  208.7  487.8  401.4
Equity in net income of nonconsolidated affiliates  11.6  7.9  23.7  13.6
Operating expenses:        
Salaries and benefits  84.9  72.7  168.3  141.9
Supplies  51.8  43.4  101.3  84.5
Other operating expenses  38.1  30.2  74.8  59.4
Depreciation and amortization  15.9  12.8  31.1  24.4
Occupancy costs  9.2  7.3  17.4  14.1
Provision for doubtful accounts  4.5  3.4  8.7  6.3
Impairment of intangible and long-lived assets  —   —   —   0.5
(Gain) loss on disposal of assets  (0.0)  (0.0)  0.2  (0.1)
Total operating expenses  204.4  169.7  401.8  331.1
Operating income  60.9  46.9  109.7  83.9
Interest expense  10.7  8.4  19.5  16.4
HealthSouth option expense  1.9 —   11.7  — 
Debt modification expense  0.2 —   5.0  — 
Loss on extinguishment of debt  —  —   0.5  — 
Interest income  (0.0)  (0.0)  (0.1)  (0.1)
Loss (gain) on sale of investments  0.3  (0.0)  (1.6)  4.3
Income from continuing operations before income tax expense  47.9  38.6  74.5  63.3
Provision for income tax expense  4.3  1.4  8.1  3.1
Income from continuing operations  43.7  37.2  66.4  60.2
Loss from discontinued operations, net of income tax expense  (0.2)  (2.7)  (1.6)  (2.6)
Net income  43.5  34.5  64.8  57.7
Less: Net income attributable to noncontrolling interests  (39.0)  (28.5)  (69.4)  (51.4)
Net income (loss) attributable to Surgical Care Affiliates  $ 4.6  $ 6.0 $ (4.6)  $ 6.3
Net income (loss) per diluted share attributable to SCA  $ 0.11  $ 0.15 $ (0.12)  $ 0.16
 
 
Surgical Care Affiliates, Inc.
Unaudited Selected Financial and Operating Data, continued
(In millions, except number of shares in thousands and facility count)
         
  June 30,
2015
December 31,
2014
   
Balance Sheet Data (at period end):        
Cash and cash equivalents  $ 77.8  $ 8.7    
Total current assets  274.1  237.5    
Total assets  1,798.6  1,647.4    
         
Current portion of long-term debt  26.8  24.7    
Total current liabilities  218.6  249.4    
Long-term debt, net of current portion  774.9  665.1    
Total liabilities  1,156.1  1,065.0    
         
Total Surgical Care Affiliates' equity  260.1  243.3    
Noncontrolling interests — non-redeemable  365.4  323.6    
Total equity  625.5  567.0    
         
Facilities (at period end):        
Consolidated facilities 102 95    
Equity method facilities 67 65    
Managed-only facilities 24 26    
Total facilities 193 186    
         
Perioperative contracts 9 13    
         
         
  THREE-MONTHS ENDED
JUNE 30,
SIX-MONTHS ENDED
JUNE 30,
  2015 2014 2015 2014
Net income (loss) per share        
Diluted net income (loss) per share attributable to SCA  $ 0.11  $ 0.15 $ (0.12)  $ 0.16
Adjusted number of shares outstanding used to compute diluted net income (loss) per share 40,797 39,865 39,073 39,921
         
Cash flow data:        
Net cash provided by (used in):        
Operating activities  $ 78.1  $ 42.3  $ 116.7  $ 86.7
Investing activities  (56.0)  (32.2)  (76.7)  (49.7)
Capital expenditures  (11.0)  (9.7)  (19.0)  (18.2)
Investments in new businesses  (69.6)  (33.1)  (85.0)  (39.0)
Financing activities  (38.2)  (11.3)  29.1  (33.7)
Distributions to noncontrolling interests  (39.1)  (24.9)  (73.7)  (49.5)
 
 
Surgical Care Affiliates, Inc.
Supplemental Information
(Unaudited; in millions, except cases, growth rates and per share data)
         
  THREE-MONTHS ENDED
JUNE 30,
SIX-MONTHS ENDED
JUNE 30,
  2015 2014 2015 2014
Consolidated and Equity Method Facility Data:        
Net Operating Revenues:        
Consolidated facilities  $ 253.7  $ 208.7  $ 487.8  $ 401.4
Equity method facilities  182.2  160.1  343.3  307.9
         
Net Patient Revenues:        
Consolidated facilities  233.9  191.3  450.5  366.1
Equity method facilities  180.6  158.4  340.1  305.0
         
Case Volume:        
Consolidated facilities 126,826 110,252 239,608 209,357
Equity method facilities 75,959 66,493 141,297 129,279
Systemwide case volume(1) 202,785 176,745 380,905 338,636
         
Number of work days in the period 64 64 127 127
         
Systemwide net operating revenues growth(2)  18.2%  10.2%  17.2%  9.7%
Systemwide net patient revenues per case growth(3)  3.3%  4.7%  4.7%  5.1%
Same site systemwide net patient revenues growth(3)(4)  7.1%  1.6%  7.7%  0.2%
Same site systemwide net patient revenues per case growth(3)(4)  3.7%  1.8%  5.1%  0.9%
Same site systemwide case volume growth (day adjusted)(1)(4)  3.3%  -0.2%  2.5%  -0.7%
         
Other Financial Data:        
Adjusted EBITDA-NCI(5)(6) $ 43.0 $ 38.2 $ 78.9 $ 70.6
Adjusted net income(5)(6) $ 19.9 $ 19.6 $ 35.0 $ 34.6
Diluted Adjusted net income per share(5)  $ 0.49  $ 0.49  $ 0.89  $ 0.87
 
 
Surgical Care Affiliates, Inc.
Reconciliation of Non-GAAP Financial Measures
(Unaudited; in millions, except per share count in thousands)
         
  THREE-MONTHS ENDED
JUNE 30,
SIX-MONTHS ENDED
JUNE 30,
  2015 2014 2015 2014
Adjusted EBITDA-NCI:        
Net income  $ 43.5  $ 34.5  $ 64.8  $ 57.7
(Minus):        
Net income attributable to noncontrolling interests  (39.0)  (28.5)  (69.4)  (51.4)
Net income (loss) attributable to SCA  4.6  6.0  (4.6)  6.3
Plus (minus):        
Interest expense, net  10.7  8.4  19.5  16.3
Provision for income tax expense  4.3  1.4  8.1  3.1
Depreciation and amortization  15.9  12.8  31.1  24.4
Loss from discontinued operations, net  0.2  2.7  1.6  2.6
Equity method amortization expense (7)  0.2  5.8  0.4  11.6
Loss (gain) on sale of investments  0.3  (0.0)  (1.6)  4.3
HealthSouth option expense  1.9  —   11.7  — 
Debt modification expense  0.2  —   5.0  — 
Loss on extinguishment of debt  —   —   0.5  — 
Asset impairments  2.7  —   2.7  0.3
(Gain) loss on disposal of assets  (0.0)  (0.0)  0.2  (0.1)
Stock compensation expense  2.0  0.9  3.7  1.6
Other  0.2  0.2  0.5  0.3
Adjusted EBITDA-NCI  $ 43.0  $ 38.2  $ 78.9  $ 70.6
         
Adjusted Net Income:        
Net income (loss) attributable to SCA  $ 4.6  $ 6.0 $ (4.6)  $ 6.3
Plus (minus)        
Provision for income tax expense  4.3  1.4  8.1  3.1
HealthSouth option expense  1.9  —   11.7  — 
Debt modification expense  0.2  —   5.0  — 
Loss on extinguishment of debt  —   —   0.5  — 
Asset impairments  2.7  0  2.7  0.3
Amortization expense  3.5  2.5  6.7  4.6
Loss from discontinued operations, net  0.2  2.7  1.6  2.6
Loss (gain) on sale of investments  0.3  (0.0)  (1.6)  4.3
(Gain) loss on disposal of assets  (0.0)  (0.0)  0.2  (0.1)
Equity method amortization expense (7)  0.2  5.8  0.4  11.6
Stock compensation expense  2.0  0.9  3.7  1.6
Other  0.2  0.2  0.5  0.3
Adjusted Net Income  $ 19.9  $ 19.6  $ 35.0  $ 34.6
         
Number of shares outstanding used to compute diluted Adjusted net income per share 40,797 39,865 39,073 39,921
         
Adjusted Operating cash flow less distributions to NCI:        
Net cash provided by operating activities  $ 78.1  $ 42.3  $ 116.7  $ 86.7
Plus        
Debt modification costs  0.2  —   5.6  — 
Secondary offering costs  0.2  0.2  0.5  0.3
Adjusted Operating cash flow  78.4  42.5  122.9  87.0
Distributions to noncontrolling interests of consolidated affiliates  (39.1)  (24.9)  (73.7)  (49.5)
Adjusted Operating cash flow less distributions to NCI  $ 39.4  $ 17.6  $ 49.2  $ 37.5

Note: Totals above may not sum due to rounding.
(1)  The number of cases performed at SCA's consolidated and equity method facilities (does not include managed-only facilities) is a key metric utilized to regularly evaluate performance.
(2)  The revenues and expenses of equity method facilities are not directly included in SCA's consolidated GAAP results; only the net income earned from such facilities is reported on a net basis in the line item "Equity in net income of nonconsolidated affiliates." Because of this, management supplementally focuses on non-GAAP systemwide results, which measure results from all our facilities, including revenues from our consolidated facilities and the Company's equity method facilities (without adjustment based on our percentage of ownership). SCA includes management fee revenue from managed-only facilities in systemwide net operating revenues growth, but not patient or other revenues from managed-only facilities (in which SCA holds no ownership interest).
(3)  The revenues and expenses of equity method facilities are not directly included in SCA's consolidated GAAP results; only the net income earned from such facilities is reported on a net basis in the line item "Equity in net income of nonconsolidated affiliates." Because of this, management supplementally focuses on non-GAAP systemwide results, which measure results from all our facilities, including revenues from our consolidated facilities and the Company's equity method facilities (without adjustment based on our percentage of ownership). SCA does not include facilities in which no ownership interest is held and provides only management services in systemwide net patient revenues per case growth, same site systemwide net patient revenues growth or same site systemwide net patient revenues per case growth.
(4)  Same site refers to facilities that were operational in both the current and prior period, as applicable.
(5)  Represents adjusted EBITDA-NCI and adjusted net income (including diluted adjusted net income per share) as computed and used by management. Adjusted EBITDA-NCI means net income before provisions for income tax expense, net interest expense, depreciation and amortization, net income (loss) from discontinued operations, equity method amortization expense, gain (loss) on sale of investments, loss on extinguishment of debt, debt modification expense, HealthSouth option expense, asset impairments, gain (loss) on disposal of assets and stock compensation expense less net income attributable to noncontrolling interests. Adjusted net income means net income (loss) attributable to SCA before provisions for income tax, loss on extinguishment of debt, debt modification expense, HealthSouth option expense, asset impairments, amortization expense, net income (loss) from discontinued operations, gain (loss) on sale of investments, gain (loss) on disposal of assets, equity method amortization expense and stock compensation expense. We present adjusted EBITDA-NCI and adjusted net income (including diluted adjusted net income per share) because management believes they are useful for investors to analyze SCA's operating performance on the same basis as that used by management. Management believes adjusted EBITDA-NCI can be useful to facilitate comparisons of operating performance between periods because it excludes the effect of depreciation and amortization, which represents a non-cash charge to earnings, income tax, interest expense and other expenses or income not related to the normal, recurring operations of our business. Management believes adjusted net income (including diluted adjusted net income per share) can be useful to facilitate comparisons of SCA's operating performance between periods because it excludes the effect of certain non-cash and other charges to earnings whose fluctuations from period-to-period do not necessarily correspond to the normal, recurring operations of our business. Adjusted EBITDA-NCI and adjusted net income (including diluted adjusted net income per share) are each considered a "non-GAAP financial measure" under SEC rules and should not be considered a substitute for net income (loss) or net operating income (or net loss per share) as determined in accordance with GAAP. In addition adjusted EBITDA-NCI and adjusted net income (including diluted Adjusted net income per share) have limitations as analytical tools, including the following:

  • Adjusted EBITDA-NCI and adjusted net income (including diluted adjusted net income per share) do not reflect our historical capital expenditures, or future requirements for capital expenditures, or contractual commitments;
  • Adjusted EBITDA-NCI and adjusted net income (including diluted adjusted net income per share) do not reflect changes in, or cash requirements for, the Company's working capital needs;
  • Adjusted EBITDA-NCI does not reflect the significant interest expense or the cash requirements necessary to service interest or principal payments under the Company's credit agreement;
  • Adjusted EBITDA-NCI and adjusted net income (including diluted adjusted net income per share) do not reflect our historical impairments recognized;
  • Adjusted EBITDA-NCI and adjusted net income (including diluted adjusted net income per share) do not reflect SCA's historical amortization expenses; and
  • Adjusted EBITDA-NCI does not reflect income tax expense or the cash requirements to pay taxes.

In addition, you should be aware that there is no certainty that SCA will not incur expenses in the future that are similar to those excluded in the calculation of adjusted EBITDA-NCI or adjusted net income (including diluted adjusted net income per share). Other companies in SCA's industry may calculate adjusted EBITDA-NCI or adjusted net income (including diluted adjusted net income per share) differently than SCA does, limiting their usefulness as comparative measures.
Because of these limitations, neither adjusted EBITDA-NCI nor adjusted net income (including diluted adjusted net income per share) should be considered the primary measure of the operating performance of SCA's business. The Company strongly encourages you to review the GAAP financial statements and not to rely on any single financial measure to evaluate our business.
(6)  Adjusted EBITDA-NCI for the second quarter of 2015 was $42,971 compared to $38,233 in the second quarter of 2014, for a 12.4% increase period over period. Adjusted net income for the second quarter of 2015 was $19,942 compared to $19,575 in the second quarter of 2014, for a 1.9% increase period over period. 
(7)  For the three-months ended June 30, 2015 and June 30, 2014, we recorded $0.2 million and $5.8 million, respectively, of amortization expense for definite-lived intangible assets attributable to equity method investments. These expenses are included in Equity in net income of nonconsolidated affiliates in our consolidated financial statements.



            

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