EX-99.3 5 radnet_8ka-9903.htm UNAUDITED INTERIM FINANCIAL STATEMENTS

Exhibit 99.3

 

DIAGNOSTIC IMAGING GROUP HOLDINGS, LLC AND AFFILIATES

 

UNAUDITED CONDENSED COMBINED INTERIM FINANCIAL STATEMENTS

 

 

 

 

September 30, 2015

 

 

 

 

 

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DIAGNOSTIC IMAGING GROUP HOLDINGS, LLC AND AFFILIATES
CONDENSED COMBINED BALANCE SHEET 

   September 30, 2015   December 31, 2014 
   (unaudited)     
ASSETS          
Current Assets:          
Cash and cash equivalents  $2,181,334   $454,899 
Patient services receivable, net of allowances   20,374,703    20,857,870 
Deferred income tax assets   23,147    25,258 
Estimated insurance recoveries receivable   4,166,838    4,250,905 
Prepaid expenses and other current assets   640,683    2,500,949 
Total Current Assets   27,386,705    28,089,881 
Property and Equipment, net of accumulated depreciation   8,765,076    12,021,715 
Goodwill   49,839,016    54,370,516 
Deferred Income Tax Assets, net   206,359    204,248 
Estimated Insurance Recoveries Receivable, net of current portion   11,231,722    11,459,016 
Other Assets   560,863    1,002,882 
Total Assets  $97,989,741   $107,148,258 
LIABILITIES AND EQUITY          
Current Liabilities:          
Accounts payable and accrued expenses  $11,408,505   $12,661,921 
Current portion of regulatory settlement   2,000,000    2,000,000 
Current portion of capital lease obligations   1,309,261    1,476,494 
Current portion of long-term debt   82,821    166,706 
Current portion of medical malpractice reserves   4,345,242    4,656,693 
Total Current Liabilities   19,145,829    20,961,814 
Capital Lease Obligations, less current portion   578,999    1,412,259 
Long-term Debt, less current portion   45,399    108,227 
Deferred Rent   134,538    143,098 
Medical Malpractice Reserves, less current portion   13,797,121    14,108,482 
Loan Payable to Member   33,378,824    30,962,917 
Regulatory Settlement, less current portion   4,500,000    6,000,000 
Total Liabilities   71,580,710    73,696,797 
Equity:          
Doshi Diagnostic Imaging Services, P.C.:          
Additional paid-in capital   125,000    125,000 
Accumulated deficit   (17,491,492)   (19,428,198)
Total Stockholder’s Deficit   (17,366,492)   (19,303,198)
Diagnostic Imaging Group Holdings, LLC and Subsidiaries:          
Members’ capital   43,775,523    52,754,659 
Total Equity   26,409,031    33,451,461 
Total Liabilities and Equity  $97,989,741   $107,148,258 

 

The accompanying notes are an integral part of these interim financial statements

 

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DIAGNOSTIC IMAGING GROUP HOLDINGS, LLC AND AFFILIATES
CONDENSED COMBINED STATEMENT OF OPERATIONS (unaudited)

  Nine Months Ended September 30, 
   2015   2014 
Revenue          
Net Patient Service Revenue  $52,626,444   $55,456,796 
Capitation revenue   4,099,021    4,165,196 
Total revenue   56,725,465    59,621,992 
Expenses          
Salaries and related   29,764,409    29,977,717 
Other G&A Expenses   21,609,347    20,682,682 
Med Supplies   1,553,297    1,826,396 
Depreciation & Amortization   8,380,791    5,457,917 
Provision for Bad Debt   1,373,371    1,330,214 
Total Expenses   62,681,215    59,274,926 
           
Operating (loss) income   (5,955,750)   347,066 
           
Other Income / (Expense):          
Interest   (1,491,692)   (1,650,441)
Gain on extinguishment of debt   3,257,500    –  
Gain of Disposal of Equipment   422,503    70,615 
Total other (expense) income   (1,069,189)   1,677,674 
(Loss) income from continuing operations before taxes   (7,024,939)   2,024,740 
Current tax   17,491    17,630 
Net (loss) income  $(7,042,430)  $2,007,110 

 

The accompanying notes are an integral part of these interim financial statements

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DIAGNOSTIC IMAGING GROUP HOLDINGS, LLC AND AFFILIATES
CONDENSED COMBINED STATEMENT OF EQUITY

(unaudited)

   Common Stock   Additional
Paid in
Capital
   Retained
Earnings
(Accumulated
Deficit)
   Loans from Stockholder   Members'
Capital
   Receivable from Member   Total Equity 
Balance 1/1/2015  $   $125,000   $(19,428,198)  $   $52,754,659   $   $33,451,461 
Contributions                             
Net Income / (Loss)           1,936,706        (8,979,136)       (7,042,430)
Balance 09/30/2015  $   $125,000   $(17,491,492)  $   $43,775,523   $   $26,409,031 
                                    
Balance 1/1/2014  $   $125,000   $(21,017,216)  $(7,141,385)  $57,323,478   $(181,364)  $29,108,513 
Contributions                             
Collection of Loans Receivable               7,141,385        181,364    7,322,749- 
Net Income / (Loss)           (66,960)       2,074,070        2,007,110 
Balance 09/30/2014  $   $125,000   $(21,084,176)  $   $59,397,548   $   $38,438,372 

 

The accompanying notes are an integral part of these interim financial statements

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DIAGNOSTIC IMAGING GROUP HOLDINGS, LLC AND AFFILIATES
CONDENSED COMBINED STATEMENT OF CASH FLOWS

(unaudited)

  Nine Months Ended September 30, 
   2015   2014 
Cash flows from operating activities          
Net loss  $(7,042,430)  $2,007,110 
           
Adjustments to reconcile net loss to cash provided by operating activities          
Depreciation and amortization   8,380,791    5,457,917 
Provision for bad debts   1,217,923    1,330,214 
Gain on extinguishment of debt       (3,257,500)
Gain on Disposition of Assets,net   (422,503)   (70,615)
Deferred rent   (8,560)    
Changes in operating assets and liabilities:          
Patient care receivables   (734,756)   (2,909,255)
Prepaid expenses and other current assets   1,860,266    1,627,032 
Other assets   442,019    126,637 
Other Liabilities   (1,500,000)   (1,184,000)
Medical malpractice reserves   (311,451)   (868,094)
Accounts payable and accrued expenses   (1,253,416)   (8,639,227)
Net cash provided by operating activities   627,883    (6,379,781)
           
Cash flows from investing activities          
Purchase of property plant and equipment   (424,828)   (631,085)
Proceeds from disposition of assets,net   422,503    81,200 
Net cash used in investing activities   (2,325)   (549,885)
           
Cash flows from financing activities          
Principal payments on capital lease payments   (1,168,317)   (1,181,251)
Advances from Owners   2,415,907    37,512,166 
Principal payments on long term debt   (146,713)   (29,494,773)
Net cash provided by financing activities   1,100,877    6,836,142 
           
Net increase in cash and cash equivalents   1,726,435    (93,524)
Cash and cash equivalents at beginning of period   454,899    1,592,566 
Cash and cash equivalents at end of period  $2,181,334   $1,499,042 
           
Supplemental Disclosure of Cash Flow Information:          
Cash paid during the period for interest  $269,775   $595,831 
Cash paid during the period for income taxes  $17,491   $17,491 
           
Supplemental Disclosure of Noncash Investing & Financing Activity:          
Equipment financed under capital leases and long term debt  $167,824   $676,031 

The accompanying notes are an integral part of these interim financial statements

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DIAGNOSTIC IMAGING GROUP HOLDINGS, LLC AND AFFILIATES

 

NOTES TO UNAUDITED CONDENSED COMBINED INTERIM FINANCIAL STATEMENTS

 

1. Organization

 

The principal business of Diagnostic Imaging Group Holdings, LLC (“DIGH”), a Delaware limited liability company, and its subsidiaries and affiliates (collectively, the “Company”) is as follows:

 

Doshi Diagnostic Imaging Services, P.C. (“DDIS”), is principally engaged in the business of establishing and operating fixed-site diagnostic imaging and radiology facilities providing all types of outpatient radiological services, including x-rays, C-T scans, mammography and MRIs.

 

New PrimeCare, LLC (“New PrimeCare”), a Delaware limited liability company, provides payor contracting, billing and collection, and other administrative services to DDIS.

 

New PrimeCare is wholly owned by Diagnostic Imaging Group, LLC (“DIG”).

 

DDIS operates 23 facilities in the New York City boroughs of Manhattan, Brooklyn, Bronx and Queens, and in Nassau County. The Company also has one administrative office.

 

The Operating Agreement (the “Agreement”) of DIGH provides for distributions to the members to be made at least quarterly, in proportion to their sharing percentages, as defined in the Agreement, so the members may make their estimated, or actual, income tax payments as necessary associated with the taxable income of DIGH allocated to such members (“Tax Distributions”). The Agreement provides that distributions other than Tax Distributions may be made to the members first, in proportion to their respective total capital contributions, as defined in the Agreement, and second, in proportion to their sharing percentages, as defined in the Agreement, subject to certain other provisions of the Agreement. The allocation of income or loss to the members is subject to certain provisions of the Internal Revenue Code.

 

2. Summary of Significant Accounting Policies

 

During the period covered in these unaudited interim financial statements, there have been no material changes to the significant accounting policies we use, and have been explained, in our audited financial statements as of and for the year ended December 31, 2014.

 

3. Property and Equipment

 

A summary of property and equipment as of September 30, 2015 is as follows:

 

Medical equipment  $53,500,751 
Office equipment and fixtures   13,206,173 
Automobiles   60,287 
Leasehold improvements   25,079,491 
    91,846,703 
Less accumulated depreciation and amortization   83,081,627 
   $8,765,076 

 

Property and equipment include assets recorded under capitalized leases totaling approximately $3,429,000 at September 30, 2015. Accumulated amortization attributable to assets recorded under capitalized leases was approximately $1,765,000 at September 30, 2015. Depreciation and amortization expense was approximately $3,849,000 for the period ended September 30, 2015.

 

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4. Related Party Transactions

 

Operating leases - The Company has operating lease agreements with entities controlled by a member of DIGH for the rental of nine diagnostic imaging and radiology facilities, the corporate office and a storage unit during the year ended September 30, 2015. The leases have varying terms expiring through 2021. Rent expense related to these operating lease agreements for the period ended September 30, 2015 was approximately $1,295,000. This excludes approximately $1,038,000 of contingent costs which relate to real estate taxes and common area maintenance charges for the period ended September 30, 2015.

 

At September 30, 2015, the Company had no outstanding amounts due to related parties under operating lease arrangements for facilities.

 

Loan payable to member - At September 30, 2015, DIGH had an unsecured demand loan payable to its member in the amount of $33,379,000. The note bears interest at an annual rate of 5.5% during the period ended September 30, 2015 and an annual rate of ___% after September 30, 2015. Interest expense for the period ended September 30, 2015 was approximately $1,256,000, which is included in accounts payable and accrued expenses. The member of DIGH has informed DIGH that such member does not intend to demand payment prior to September 30, 2016. Accordingly, this loan has been classified as noncurrent.

 

Other related party transactions - The Company purchases marketing supply materials from an entity owned by a family member of one of the Company’s members. Amounts paid to the entity during the period ended September 30, 2015 were approximately $111,500, of which approximately $6,700 is included in accounts payable.

 

5. Long-term Debt and Capital Leases

 

New PrimeCare has various unsecured notes payable in the original aggregate amount of $1,110,911 to finance equipment and equipment-related construction costs. The loans bear interest at various rates ranging from 4.19% to 10.15% per annum and are payable in 60 consecutive monthly installments of principal and interest in the aggregate amount of $7,500. The notes mature at various dates through 2018.

 

The outstanding balances under the aforesaid notes payable totaled approximately $128,000 at September 30, 2015.

 

At September 30, 2015, New PrimeCare had approximately $1,888,000 of capital lease obligations, at varying rates of imputed interest from 2.5% to 16.5%, collateralized by leased equipment.

 

6. Stockholder’s Equity

 

At September 30, 2015, 200 shares of no par value DDIS common stock are authorized, consisting of one share of Class A voting common stock issued and outstanding and 199 shares of Class B nonvoting common stock issued and outstanding.

 

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7. Commitments and Contingencies

 

Litigation - The Company is a party to routine legal actions and complaints arising in the ordinary course of business. In the opinion of management, all such matters are adequately covered by insurance or, if not so covered, are without merit or are of such kind, or involve such amounts, that unfavorable disposition would not have a material effect on the financial position of the Company.

 

The Company is exposed to various risks of loss related to litigation resulting from claims of malpractice and maintains professional liability insurance with coverage amounts considered adequate by Company management. The Company’s claims-made policies provide coverage up to the policy limits for claims made during the policy term, subject to certain deductible requirements. The Company does not anticipate claims in excess of the policy limits. The Company amortizes the cost of the claims-made policies as insurance expense over the policy terms.

 

The policy covering the Company’s New York locations expires on November 4, 2015 and is retroactive for claims made on or after June 30, 2008. The policy covering the Company’s Florida locations expired on December 14, 2014 and is retroactive for claims made on or after September 17, 2001. The Company does not believe that any retroactive adjustment would be material. The Company purchased occurrence basis policies covering claims relating to services provided prior to these retroactive dates.

 

There are known claims and incidents that have been asserted, as well as claims from unknown incidents that may be asserted in the future, arising from services provided to patients as of September 30, 2015. The Company has recorded a liability of approximately $18,142,000 as of September 30, 2015, for the estimated ultimate costs of defending and settling such claims, including incurred but not reported claims.

 

The above amount is reported gross of estimated insurance recoveries receivable of approximately $15,399,000 as of September 30, 2015, as required by ASU 2010-24, “Health Care Entities (Topic 954): Presentation of Insurance Claims and Related Insurance Recoveries.”

 

Regulatory inquiry - In April and August 2010, the Company received subpoenas from the U.S. Department of Health and Human Services Office of Inspector General (“OIG”) and, in April 2011, from the U.S. Attorney’s Office for the Eastern District of New York in connection with a joint investigation by the OIG and the U.S. Department of Justice (the “DOJ”) relating to certain of the Company’s billing practices. The Company responded to the subpoenas and cooperated in the investigation.

 

Effective February 20, 2014, the Company entered into a settlement agreement with the OIG, the State of New Jersey, and the State of New York (collectively referred to as Government Entities) whereby the Company agreed to pay an aggregate amount of $15,500,000 plus interest. The settlement agreement is neither an admission of liability by the Company nor a concession by the Government Entities that their claims are not well founded. An initial payment of $6,000,000 plus interest (accrued beginning November 1, 2013) was paid on January 29, 2014. The remaining balance is to be paid in 19 quarterly payments with interest at 2.2 percent per annum commencing April 30, 2014. It was further agreed that in the event of certain changes in ownership of the Company, as defined in the settlement agreement, the unpaid balance of the settlement amount plus any accrued interest shall be immediately due.

 

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Principal payment requirements of the settlement agreement obligation are as follows:

 

Period ending September 30:     
2016  $2,000,000 
2017   2,000,000 
2018   2,000,000 
2019   500,000 
      
   $6,500,000 

 

As part of the settlement, effective February 19, 2014, the Company entered into a Corporate Integrity Agreement (“CIA”) with the OIG. The period of compliance obligations assumed by the Company under the CIA is five years from the effective date of the agreement. The five required one-year reporting periods commence on the effective date of the agreement. Key requirements of the agreement include, but are not limited to, appointing a compliance officer and compliance committee, implementing and distributing a written Code of Conduct, providing training on the CIA requirements and compliance program, engaging an Independent Review Organization to perform specified reviews during each reporting period, and providing annual reports for each reporting period with respect to the status of, and findings regarding the Company’s compliance activities. The agreement also specifies monetary and other penalties if the Company fails to comply with certain obligations under the CIA, including exclusion from Medicare and other federal health care programs in the event of the Company’s material breach (as defined) of the agreement. The Company believes it is in compliance with the requirements of the CIA.

 

 

 

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