ALMOST FAMILY INC LOUISVILLE, Ky., Aug. 6, 2014 /PRNewswire/ -- Almost Family, Inc. (Nasdaq: AFAM), a leading regional provider of home health nursing and personal care services, announced today its financial results for the three and six months ended June 30, 2014.
Second Quarter Highlights:
-- Record net service revenues of approximately $125 million
-- Net income attributable to Almost Family, Inc. of $4.0 million, or $0.42
per diluted share
-- Diluted EPS from continuing operations of $0.43, including $0.08 of
acquisition related expenses, excluding which diluted EPS would have
been $0.51
-- Results include Imperium-related operating results, which reduced
diluted EPS from continuing operations for the quarter by $0.03, without
which diluted EPS would have been $0.54
-- Record Visiting Nurse segment net revenues of $99.4 million and record
Personal Care segment revenues of $25.5 million
-- Acquired operations added $0.19 to diluted EPS from continuing
operations for the quarter with SunCrest contributing $0.17 and Indiana
Home Care contributing $0.02
-- Efficiency gains in the balance of the business improved diluted EPS by
$0.13, prior to the effects of Medicare rate cuts which reduced diluted
EPS by $0.05.
Comments on Second Quarter 2014 Results
William Yarmuth, Chief Executive Officer, commented on the news: "We are extremely pleased with the performance of our business in this quarter, highlighted by the progress we are making in the integration of the SunCrest operations. Our results for the quarter show the highly accretive effect acquisitions can have on our financial performance. I want to take this opportunity to thank all our employees for their hard work, their devotion to their patients and their commitment to our Company during these times of transition. As we proceed with our integration work through the balance of 2014, we will return our attention to acquisition and development opportunities to continue the growth and expansion of our business."
Steve Guenthner, President, added: "As we stated previously, the Medicare rebasing adjustments are forcing us to address every opportunity to control costs without compromising the quality of care we provide our patients. While more opportunities remain to achieve savings, we are particularly pleased that we have been able to move the needle in a very positive direction through much tighter adherence to our agency-level labor staffing standards. Additionally, we are making nice progress in Florida where we are well on our way to working through many of our previously discussed integration opportunities.
Regarding proposed Medicare regulations for 2015 recently published by CMS, Guenthner commented: "We are pleased to see the overall positive tone of the proposed language including in particular the recision of the physician face-to-face narrative requirement that has proven so troublesome for the industry. Although there are more improvements that could be made, these are some of the most positively written proposed regulations we have seen since the implementation of the home health prospective payment system in 2000. We hope this indicates an inflection point in our regulators' views on the value of our services and the contributions home health can make in addressing our national elder care issues."
Yarmuth added: "We are heartened by the greatly improved tone of the CMS proposed regulations. In addition, we are encouraged by recent comments issued by MedPac which highlight the increasingly important role home health services will play in the delivery of cost-effective care to our elderly, in particular when ACO's are involved. We welcome this progress and will continue our Company's efforts to work collaboratively with these policy-makers to lower costs, extend the life of the Medicare Trust Funds and improve the lives of America's seniors enabling them to stay in their own homes as long as possible."
Yarmuth concluded: "Internally, our next challenge is to hold the line on our efficiency gains while turning our attention back to driving organic volume growth in our VN segment like we have been able to deliver in our PC segment. We are confident that as time goes by, the quality of our services and the compassionate care of our nearly 12,000 employees will continue to differentiate us in the marketplace."
Second Quarter Financial Results
Almost Family reported second quarter results that included a full quarter of operating results for the following acquisitions, as compared to our results for the second quarter of 2013:
-- The December 6, 2013 acquisition of SunCrest added $35.1 million to
revenue ($30.8 million VN and $4.3 million PC) and $0.17 to diluted EPS
from continuing operations.
-- Improved cost controls, in particular tighter adherence to our
agency-level labor staffing standards improved the efficiency of our
care delivery allowing us to lower labor costs on very similar volumes
improving diluted EPS by $0.13 as compared to the same quarter of last
year.
-- The July 19, 2013 acquisition of Indiana Home Care Network added $2.6
million of revenue to the VN segment and $0.02 to diluted EPS from
continuing operations. Indiana Home Care results will be included with
same-store results starting with the third quarter of 2014.
-- The October 4, 2013 acquisition of our 61% interest in Imperium lowered
diluted EPS from continuing operations by $0.03. Operating costs of
$0.4 million associated with Imperium are included in our corporate
expenses. Imperium did not generate material revenue in the period.
-- One-time transaction costs, severance, wind-down, lease abandonment and
transition costs related to the SunCrest transaction approximated $1.2
million ($0.08 per diluted share) in the quarter ended June 30, 2014.
Excluding acquired revenue, Medicare rate cuts, from 2014's rebasing, reduced revenue and operating income, by $0.8 million and diluted EPS from continuing operations by $0.05. VN segment Medicare admissions decreased organically by 0.9%, primarily in our Florida operations where we have overlap with SunCrest operations. Our PC segment hours of service and revenues grew organically by 1.5% and 4.1%, respectively and grew through acquisition by 13.8% and 20.9%, respectively.
Our effective tax rate for the second quarter of 2014 was 39.2% compared to 41.8% for the second quarter of 2013.
The Company reminds investors that the quarter ended June historically has higher patient volumes than the other quarters due to seasonality including in the State of Florida where the Company generates nearly 40% of its Visiting Nurse segment revenues.
Six Month Period Financial Results
Almost Family reported six month results that included a full six months of operating results for the following acquisitions, as compared to our results for the six month period of 2013:
-- The December 6, 2013 acquisition of SunCrest added $68.8 million to
revenue ($60.7 million VN and $8.1 million PC) and $0.32 to diluted EPS
from continuing operations.
-- Approximately $4.3 million ($0.28 per diluted share) of transition
costs, primarily SunCrest, were incurred in the six months ended June
30, 2014.
-- The July 19, 2013 acquisition of Indiana Home Care Network added $5.1
million of revenue to the VN segment and $0.04 to diluted EPS from
continuing operations
-- The October 4, 2013 acquisition of our 61% interest in Imperium lowered
diluted EPS from continuing operations by $0.04. Operating costs of
$0.7 million associated with Imperium are included in our corporate
expenses. Imperium did not generate material revenue in the period.
Medicare rate cuts in our VN segment, from 2014's rebasing cuts and sequestration for episodes ending after March 31, 2013, reduced revenue and operating income by $2.4 million and diluted EPS from continuing operations by $0.15. VN segment Medicare admissions decreased organically by 3.5%, primarily in our Florida operations where we have overlap with SunCrest operations. Our PC segment hours of service and revenues grew by 3.3% organically and 13.5% through acquisition.
Our effective tax rate for the six month period of 2014 was 39.7% compared to 39.2% for the six month period of 2013. The higher year to date 2014 income tax rate from continuing operations was primarily due to a benefit recognized in the first quarter of 2013 resulting from the January 2, 2013 retroactive extension of the Work Opportunity Tax Credit (WOTC). The WOTC has not yet been extended for 2014.
2015 Medicare Proposed Rule
On July 1, 2014, CMS issued the proposed rule for 2015. The proposed rule included the maximum rebasing cut in Medicare reimbursement rates (3.5% rate reduction in each of the years 2014-2017) allowable by the Patient Protection and Affordable Care Act (the ACA), which was signed into law in March 2010. The rebasing cuts are in addition to other legislated cuts for that same period by the ACA. The 2015 proposed rule is currently open for comment. The final rule is expected to be released in late October 2014.
Discontinued Operations
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, the Company acquired some operations which had been discontinued prior to acquisition. During the quarter ended June 30, 2013, the Company completed the sale of two Alabama locations, which operated in the VN segment. The operations and any related gain on sale for these operations were reclassified from continuing operations into discontinued operations for all periods presented.
Definitions
As used herein "CMS" means the Centers for Medicare and Medicaid Services, "MedPac" means the Medicare Payment Advisory Commission and "ACO" means Accountable Care Organizations as established by the ACA.
ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME
(UNAUDITED)
(In thousands, except per share data)
Three Months Ended Six Months Ended
June 30, June 30,
-------- --------
2014 2013 2014 2013
---- ---- ---- ----
Net service revenues $124,937 $86,400 $244,969 $171,854
Cost of service revenues (excluding 65,587 46,147 131,119 91,592
depreciation & amortization)
---
Gross margin 59,350 40,253 113,850 80,262
General and administrative expenses:
Salaries and benefits 35,840 24,835 69,498 49,186
Other 15,259 10,846 30,667 21,215
Deal and transition costs 1,243 128 4,358 139
----- --- ----- ---
Total general and administrative expenses 52,342 35,809 104,523 70,540
Operating income 7,008 4,444 9,327 9,722
Interest expense, net (329) (11) (677) (29)
---- --- ---- ---
Income before income taxes 6,679 4,433 8,650 9,693
Income tax expense (2,618) (1,852) (3,435) (3,802)
------ ------ ------ ------
Net income from continuing operations 4,061 2,581 5,215 5,891
Discontinued operations:
Loss from operations, net
of tax of ($41), $49, ($90) and ($2) (64) (227) (134) (290)
Gain on sale, net of tax of $973 - 169 - 169
--- --- --- ---
Loss on discontinued operations (64) (58) (134) (121)
--- --- ---- ----
Net income 3,997 2,523 5,081 5,770
Net (income) loss attributable to (36) - 153 -
noncontrolling interests
Net income attributable to Almost Family, Inc. $3,961 $2,523 $5,234 $5,770
====== ====== ====== ======
Per share amounts-basic:
Average shares outstanding 9,338 9,270 9,316 9,253
Income from continuing operations attributable $0.43 $0.28 $0.58 $0.64
to Almost Family, Inc.
Discontinued operations (0.01) (0.01) (0.01) (0.01)
----- ----- ----- -----
Net income attributable to Almost Family, Inc. $0.42 $0.27 $0.57 $0.63
===== ===== ===== =====
Per share amounts-diluted:
Average shares outstanding 9,431 9,348 9,423 9,332
Income from continuing operations attributable $0.43 $0.28 $0.57 $0.63
to Almost Family, Inc.
Discontinued operations (0.01) (0.01) (0.01) (0.01)
----- ----- ----- -----
Net income attributable to Almost Family, Inc. $0.42 $0.27 $0.56 $0.62
===== ===== ===== =====
ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
(In thousands)
June 30, 2014
ASSETS (UNAUDITED) December 31, 2013
---------- -----------------
CURRENT ASSETS:
Cash and cash equivalents $2,765 $12,246
Accounts receivable - net 64,324 61,651
Prepaid expenses and other current assets 10,915 10,278
Deferred tax assets 13,146 11,532
------ ------
TOTAL CURRENT ASSETS 91,150 95,707
PROPERTY AND EQUIPMENT - NET 6,929 8,142
GOODWILL 196,070 192,575
OTHER INTANGIBLE ASSETS 55,875 55,075
OTHER ASSETS 679 774
--- ---
TOTAL ASSETS $350,703 $352,273
======== ========
LIABILITIES AND STOCKHOLDERS' EQUITY
CURRENT LIABILITIES:
Accounts payable $9,150 $11,526
Accrued other liabilities 37,879 38,916
Current portion - notes payable and capital leases 130 702
--- ---
TOTAL CURRENT LIABILITIES 47,159 51,144
LONG-TERM LIABILITIES:
Revolving credit facility 50,655 56,000
Deferred tax liabilities 27,585 25,580
Other 1,710 1,856
----- -----
TOTAL LONG-TERM LIABILITIES 79,950 83,436
TOTAL LIABILITIES 127,109 134,580
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; 9,562 and 9,500
issued and outstanding 956 950
Treasury stock, at cost, 94 and 92 shares of common stock (2,393) (2,340)
Additional paid-in capital 104,725 103,858
Noncontrolling interest - nonredeemable (93) (203)
Retained earnings 116,760 111,789
------- -------
TOTAL STOCKHOLDERS' EQUITY 219,955 214,054
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY $350,703 $352,273
======== ========
ALMOST FAMILY, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
(UNAUDITED)
(In thousands)
Six Months Ended June 30,
-------------------------
2014 2013
---- ----
Cash flows of operating activities:
Net income $5,081 $5,770
Loss on discontinued operations, net of tax (134) (121)
---- ----
Net income from continuing operations 5,215 5,891
Adjustments to reconcile income to net cash of operating activities:
Depreciation and amortization 2,152 1,298
Provision for uncollectible accounts 4,308 2,466
Stock-based compensation 872 654
Deferred income taxes 2,402 790
14,949 11,099
Change in certain net assets and liabilities, net of the effects of acquisitions:
Accounts receivable (11,861) (8,342)
Prepaid expenses and other current assets (728) 1,079
Other assets 96 107
Accounts payable and accrued expenses (4,330) 1,455
------ -----
Net cash (used in) provided by operating activities (1,874) 5,398
------ -----
Cash flows of investing activities:
Capital expenditures (735) (1,250)
Acquisitions, net of cash acquired (969) (43)
---- ---
Net cash used in investing activities (1,704) (1,293)
------ ------
Cash flows of financing activities:
Credit facility repayments, net (5,345) -
Proceeds from stock options exercises 39 -
Purchase of common stock in connection with share awards (52) -
Tax impact of share awards (38) (67)
Payment of special dividend in connection with share awards (35) -
Principal payments on notes payable and capital leases (606) (500)
Net cash used in financing activities (6,037) (567)
------ ----
Cash flows from discontinued operations
Operating activities 134 (1,353)
Investing activities - 3,075
--- -----
Net cash provided by discontinued operations 134 1,722
--- -----
Net change in cash and cash equivalents (9,481) 5,260
Cash and cash equivalents at beginning of period 12,246 26,120
Cash and cash equivalents at end of period $2,765 $31,380
====== =======
ALMOST FAMILY, INC. AND SUBSIDIARIES
RESULTS OF OPERATIONS
(UNAUDITED)
(In thousands)
Three Months Ended June 30,
---------------------------
2014 2013 Change
---- ---- ------
Amount % Rev Amount % Rev Amount %
------ ----- ------ ----- ------ ---
Net service revenues:
Visiting Nurse $99,438 79.6% $66,000 76.4% $33,438 50.7%
Personal Care 25,499 20.4% 20,400 23.6% 5,099 25.0%
------ ------ -----
124,937 100.0% 86,400 100.0% 38,537 44.6%
------- ------ ------
Operating income before corporate expenses:
Visiting Nurse 13,597 13.7% 6,824 10.3% 6,773 99.3%
Personal Care 3,335 13.1% 3,176 15.6% 159 5.0%
----- ----- ---
16,932 13.6% 10,000 11.6% 6,932 69.3%
Corporate expenses 8,681 6.9% 5,428 6.3% 3,253 59.9%
Deal and transition costs 1,243 1.0% 128 0.1% 1,115 NM
----- --- -----
Operating income 7,008 5.6% 4,444 5.1% 2,564 57.7%
Interest expense, net (329) -0.3% (11) 0.0% (318) NM
Income tax expense (2,618) -2.1% (1,852) -2.1% (766) 41.4%
------ ------ ----
Net income from continuing operations $4,061 3.3% $2,581 3.0% $1,480 57.3%
====== ====== ======
Adjusted EBITDA from continuing
operations $9,759 7.8% $5,609 6.5% $4,150 74.0%
ALMOST FAMILY, INC. AND SUBSIDIARIES
RESULTS OF OPERATIONS
(UNAUDITED)
(In thousands)
Six Months Ended June 30,
-------------------------
2014 2013 Change
---- ---- ------
Amount % Rev Amount % Rev Amount %
------ ----- ------ ----- ------ ---
Net service revenues:
Visiting Nurse $195,194 79.7% $132,552 77.1% $62,642 47.3%
Personal Care 49,775 20.3% 39,302 22.9% 10,473 26.6%
------ ------ ------
244,969 100.0% 171,854 100.0% 73,115 42.5%
------- ------- ------
Operating income before corporate expenses:
Visiting Nurse 22,970 11.8% 15,161 11.4% 7,809 51.5%
Personal Care 5,859 11.8% 5,174 13.2% 685 13.2%
----- ----- ---
28,829 11.8% 20,335 11.8% 8,494 41.8%
Corporate expenses 15,144 6.2% 10,474 6.1% 4,670 44.6%
Deal and transition costs 4,358 1.8% 139 0.1% 4,219 NM
----- --- -----
Operating income 9,327 3.8% 9,722 5.7% (395) -4.1%
Interest expense, net (677) -0.3% (29) 0.0% (648) NM
Income tax expense (3,435) -1.4% (3,802) -2.2% 367 -9.7%
------ ------ ---
Net income from continuing operations $5,215 2.1% $5,891 3.4% $(676) -11.5%
====== ====== =====
Adjusted EBITDA from continuing
operations $16,709 6.8% $11,813 6.9% $4,896 41.4%
ALMOST FAMILY, INC. AND SUBSIDIARIES
VISITING NURSE SEGMENT OPERATING METRICS
Three Months Ended June 30,
---------------------------
2014 2013 Change
Amount Amount Amount %
------ ------ ------ ---
Average number of locations 173 104 69 66.3%
All payors:
Patient months 82,709 53,977 28,732 53.2%
Admissions 24,665 15,522 9,143 58.9%
Billable visits 685,271 478,510 206,761 43.2%
Medicare:
Admissions 22,040 89% 14,177 91% 7,863 55.5%
Revenue (in thousands) $92,388 93% $61,200 93% $31,188 51.0%
Revenue per admission $4,192 $4,317 $(125) -2.9%
Billable visits 596,418 87% 408,308 85% 188,110 46.1%
Recertifications 12,108 7,999 4,109 51.4%
Payor mix % of Admissions
Traditional Medicare Episodic 83.9% 91.9% -8.0%
Replacement Plans Paid Episodically 3.2% 2.8% 0.4%
Replacement Plans Paid Per Visit 12.9% 5.3% 7.6%
Non-Medicare:
Admissions 2,625 11% 1,345 9% 1,280 95.2%
Revenue (in thousands) $7,050 7% $4,800 7% $2,250 46.9%
Revenue per admission $2,686 $3,569 $(883) -24.7%
Billable visits 88,853 13% 70,202 15% 18,651 26.6%
Recertifications 1,532 1,382 150 10.9%
Payor mix % of Admissions
Medicaid & other governmental 26.9% 31.7% -4.8%
Private payors 73.1% 68.3% 4.8%
PERSONAL CARE OPERATING METRICS
Three Months Ended June 30,
---------------------------
2014 2013 Change
---- ---- ------
Amount Amount Amount %
------ ------ ------ ---
Average number of locations 61 60 1 1.7%
Admissions 1,523 1,154 369 32.0%
Patient months of care 20,111 17,565 2,546 14.5%
Billable hours 1,322,771 1,147,174 175,597 15.3%
Revenue per billable hour $19.28 $17.78 $1.49 8.4%
ALMOST FAMILY, INC. AND SUBSIDIARIES
VISITING NURSE SEGMENT OPERATING METRICS
Six Months Ended June 30,
-------------------------
2014 2013 Change
Amount Amount Amount %
------ ------ ------ ---
Average number of locations 174 104 70 67.3%
All payors:
Patient months 164,160 108,559 55,601 51.2%
Admissions 49,854 31,775 18,079 56.9%
Billable visits 1,342,247 947,801 394,446 41.6%
Medicare:
Admissions 44,585 89% 29,134 92% 15,451 53.0%
Revenue (in thousands) $181,336 93% $122,938 93% $58,398 47.5%
Revenue per admission $4,067 $4,220 $(153) -3.6%
Billable visits 1,168,197 87% 809,091 85% 359,106 44.4%
Recertifications 23,988 15,959 8,029 50.3%
Payor mix % of Admissions
Traditional Medicare Episodic 83.4% 91.4% -8.0%
Replacement Plans Paid Episodically 3.2% 2.7% 0.5%
Replacement Plans Paid Per Visit 13.4% 5.9% 7.5%
Non-Medicare:
Admissions 5,269 11% 2,641 8% 2,628 99.5%
Revenue (in thousands) $13,858 7% $9,614 7% $4,244 44.1%
Revenue per admission $2,630 $3,640 $(1,010) -27.8%
Billable visits 174,050 13% 138,710 15% 35,340 25.5%
Recertifications 3,046 2,719 327 12.0%
Payor mix % of Admissions
Medicaid & other governmental 25.7% 30.1% -4.4%
Private payors 74.3% 69.9% 4.4%
PERSONAL CARE OPERATING METRICS
Six Months Ended June 30,
-------------------------
2014 2013 Change
---- ---- ------
Amount Amount Amount %
------ ------ ------ ---
Average number of locations 61 60 1 1.7%
Admissions 2,959 2,243 716 31.9%
Patient months of care 39,705 34,904 4,801 13.8%
Billable hours 2,589,816 2,216,611 373,205 16.8%
Revenue per billable hour $19.22 $17.73 $1.49 8.4%
Non-GAAP Financial Measure
The information provided in some of the tables in this release includes certain non-GAAP financial measures as defined under SEC rules. In accordance with SEC rules, the Company has provided, in the supplemental information, a reconciliation of those measures to the most directly comparable GAAP measures.
Adjusted EBITDA
Earnings before interest, income taxes, depreciation, amortization and amortization of stock-based compensation (Adjusted EBITDA) is not a measure of financial performance under accounting principles generally accepted in the United States of America. 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 are significant components in understanding and evaluating financial performance and liquidity. Management routinely calculates and communicates Adjusted EBITDA 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 also used in certain covenants contained in our credit agreement.
The following tables set forth a reconciliation of net income to Adjusted EBITDA:
ALMOST FAMILY, INC. AND SUBSIDIARIES
RECONCILIATION OF ADJUSTED EBITDA
(In thousands)
Three Months Ended Six Months Ended
June 30, June 30,
-------- --------
(in thousands) 2014 2013 2014 2013
---- ---- ---- ----
Net income from continuing operations $4,061 $2,581 $5,215 $5,891
Add back:
Interest expense 329 11 677 29
Income tax expense 2,618 1,852 3,435 3,802
Depreciation and amortization 1,050 670 2,152 1,298
Amortization of stock-based compensation 458 367 872 654
Deal and transition costs 1,243 128 4,358 139
Earnings before interest, income taxes, depreciation and amortization,
amortization of stock-based compensation and deal and transition costs
(Adjusted EBITDA) from continuing operations 9,759 5,609 16,709 11,813
===== ===== ====== ======
About Almost Family, Inc.
Almost Family, Inc., founded in 1976, is a leading regional provider of home health nursing services, with branch locations in Florida, Ohio, Tennessee, Kentucky, Connecticut, New Jersey, Massachusetts, Indiana, Pennsylvania, Georgia, Missouri, Illinois, Mississippi and Alabama (in order of revenue significance). Almost Family, Inc. and its subsidiaries operate a Medicare-certified segment and a personal care segment. Almost Family operates over 230 branch locations in fourteen U.S. states.
Forward Looking Statements
All statements, other than statements of historical facts, included in this news release are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may be identified by the use of forward-looking terminology such as "may," "will," "expect," "believe," "estimate," "project," "anticipate," "continue," or similar terms, variations of those terms or the negative of those terms. These forward-looking statements are based on the Company's current plans, expectations and projections about future events.
Because forward-looking statements involve risks and uncertainties, the Company's actual results could differ materially from any future results, performance or achievements expressed or implied by such forward-looking statements. The potential risks and uncertainties which could cause actual results to differ materially include: regulatory approvals or third-party consents may not be obtained; the impact of further changes in healthcare reimbursement systems, including the ultimate outcome of potential changes to Medicare reimbursement for home health services and to Medicaid reimbursement due to state budget shortfalls; the ability of the Company to maintain its level of operating performance and achieve its cost control objectives; changes in our relationships with referral sources; the ability of the Company to integrate acquired operations including obtaining synergies, integration objectives and anticipated timelines; government regulation; health care reform; pricing pressures from Medicare, Medicaid and other third-party payers; changes in laws and interpretations of laws relating to the healthcare industry; the ability of the Company to integrate, manage and keep secure our information systems; and the Company's self-insurance risks. For a more complete discussion regarding these and other factors which could affect the Company's financial performance, refer to the Company's various filings with the Securities and Exchange Commission, including its filing on Form 10-K for the year ended December 31, 2013, in particular information under the headings "Special Caution Regarding Forward-Looking Statements" and "Risk Factors." With regard to the Company's recent investment in Imperium, in particular given that it is a development stage enterprise, there can be no assurance that its operational and developmental objectives will be realized or that any savings in healthcare spending or any participation in Medicare Shared Savings Program payments will be realized. The Company undertakes no obligation to update or revise its forward-looking statements.
Almost Family, Inc. The Ruth Group
Steve Guenthner Investor Relations
(502) 891-1000 Nick Laudico
(646) 536-7030
nlaudico@theruthgroup.com
SOURCE Almost Family, Inc.
