American Renal Associates Holdings, Inc. (NYSE: ARA) (“ARA” or
the “Company”), a leading provider of outpatient dialysis services,
today announced financial and operating results for the first
quarter ended March 31, 2016.
Certain metrics, including those expressed on an adjusted basis,
are non-GAAP financial measures (See “Use of Non-GAAP Financial
Measures” and the reconciliation tables further below).
First Quarter 2016 Highlights (all percentage changes
compare Q1 2016 to Q1 2015 unless noted):
- Net patient service operating revenues
increased 15% to $172.1 million;
- Adjusted EBITDA less noncontrolling
interests (“Adjusted EBITDA-NCI”) increased 9% to $27.2 million;
net income attributable to American Renal Associates Holdings, Inc.
increased 31% to $3.8 million;
- Total dialysis treatments increased
15%, of which 14% was non-acquired growth (“NAG”);
- Adjusted cash provided by operating
activities less distributions to NCI increased 61% to $15.1
million; Cash provided by operating activities increased 33% to
$36.6 million and distributions to noncontrolling interests
increased 18% to $21.4 million;
- As of March 31, 2016, the Company
operated 194 outpatient dialysis centers serving approximately
13,400 patients.
Joseph (Joe) Carlucci, Chairman and Chief Executive Officer,
said, “We are very pleased to report our first quarter after
becoming a public company. Our first quarter 2016 results
demonstrate ARA’s continued growth and commitment to high quality
patient care. Our differentiated physician partnership model is
gaining momentum in the nephrology community, as evidenced by our
industry-leading non-acquired growth rate. Our organization
continues to build scale in a disciplined manner so that we can
maintain a responsible pace of expansion. ARA remains positioned
well to execute on continued growth due to its experienced team and
highly-engaged physician partners.”
“Additionally, we are gratified to have completed our initial
public offering subsequent to the first quarter of 2016,” continued
Carlucci. “We founded ARA 16 years ago with the belief that the
physician partnership model and our operating philosophy – centered
on our Core Values – would differentiate ARA from the rest of the
industry. I am proud to see ARA reach this milestone as a
publicly-traded company.”
Financial and operating highlights include:
Revenue: Net patient service operating revenues for the
first quarter of 2016 were $172.1 million, an increase of 15.3% as
compared to $149.3 million for the prior-year period.
Treatment Volume: Total dialysis treatments for the first
quarter of 2016 were 482,666 representing an increase of 14.9% over
the first quarter of 2015. Non-acquired treatment growth was 14.4%
and acquired treatment growth was 0.5% for the first quarter of
2016.
Center Activity: As of March 31, 2016, the Company
provided services at 194 outpatient dialysis centers serving 13,420
patients. During the first quarter of 2016, we opened two de novo
centers. Subsequent to March 31, 2016, we acquired a dialysis
clinic in New York. As of March 31, 2016, we had 35 signed de novo
clinics scheduled to open in the future, of which two clinics
opened in April and another clinic opened in May.
Adjusted EBITDA and Adjusted EBITDA less
noncontrolling interests (NCI): Adjusted EBITDA less NCI for
the first quarter of 2016 was $27.2 million, an increase of 8.8% as
compared to $25.0 million for the prior-year period. Adjusted
EBITDA for the first quarter of 2016 was $46.0 million as compared
to $40.7 million for the first quarter of 2015. Net income and net
income attributable to noncontrolling interests for the three
months ended March 31, 2016 were $22.6 million and $18.8 million,
respectively, as compared to $18.6 million and $15.7 million,
respectively, in the three months ended March 31, 2015.
Operating Expenses: Patient care costs for the first
quarter of 2016 were $105.5 million or 61.3% of net patient service
operating revenues as compared to $92.1 million or 61.7% of net
patient service operating revenues in the prior-year period.
General and administrative expenses, which include costs associated
with becoming a public company during the first quarter of 2016,
were $21.5 million or 12.5% of net patient service operating
revenues as compared to $17.2 million or 11.5% of net patient
service operating revenues in the prior-year period.
Cash Flow: Cash provided by operating activities for the
first quarter of 2016 were $36.6 million as compared to $27.6
million in the prior-year period. Adjusted cash provided by
operating activities less distributions to noncontrolling interests
for the first quarter of 2016 were $15.1 million as compared to
$9.4 million in the prior-year period. Total capital expenditures
for the first quarter of 2016 were $16.4 million as compared to
$11.0 million in the prior-year period. Capital expenditures for
the first quarter of 2016 included $2.9 million for maintenance and
$13.5 million for new clinic development.
Initial public offering: Subsequent to March 31, 2016,
ARA completed an initial public offering of 8,625,000 newly-issued
shares of common stock. The Company’s shares began trading on the
New York Stock Exchange on April 21, 2016. Net proceeds of $176.9
million from the initial public offering, together with borrowings
under our first lien credit facility and cash on hand, were used to
repay in full, all outstanding amounts under our second lien credit
facility. The Company is providing certain information to help
investors and analysts evaluate the pro forma effect of the initial
public offering. As of March 31, 2016 and pro forma for the initial
public offering, ARA had 30.8 million of common stock outstanding.
The Company estimates its pro forma diluted shares outstanding to
be 34.2 million on a pro forma basis for the initial public
offering and other transactions occurring at the time of the
initial public offering as of March 31, 2016. As of March 31, 2016
and pro forma for the initial public offering, debt refinancing and
other transactions occurring at the time of the initial public
offering, ARA had $436.4 million of corporate debt, $104.5 million
of clinic-level debt (of which $52.2 million was guaranteed by
ARA), $3.8 million of corporate cash and $56.5 million of
clinic-level cash (of which $28.6 million was ARA’s pro rata
interest), resulting in Adjusted owned net debt of $456.2
million.
Balance Sheet: Pro forma for the initial public offering,
our Adjusted owned net debt, which excludes clinic-level debt not
guaranteed by ARA and clinic-level cash not owned by ARA, to last
twelve months Adjusted EBITDA less NCI leverage ratio was 3.9x at
March 31, 2016. On a historical basis, our Adjusted owned net debt
to last twelve months Adjusted EBITDA less NCI leverage ratio was
5.0x at March 31, 2016 as compared to 5.1x at December 31, 2015. As
of March 31, 2016, patient accounts receivable were $75.8 million
and DSO in the period was 40 days as compared to 40 days at
December 31, 2015.
Conference Call
American Renal Associates Holdings, Inc. will hold a conference
call to discuss this release on Friday, May 13, at 9:00 a.m.
Eastern time. Investors will have the opportunity to listen to the
conference call by dialing (877) 407-8029, or for international
callers (201) 689-8029 or may listen over the Internet by going to
the Investor Relations section at www.americanrenal.com. For those
who cannot listen to the live broadcast, a replay will be available
and can be accessed by dialing (877) 660-6853, or for international
callers (201) 612-7415. The conference ID for the live call and the
replay is 13636937.
About American Renal Associates
American Renal Associates Holdings, Inc. (NYSE: ARA) is a
leading provider of outpatient dialysis services in the United
States. As of March 31, 2016, ARA operated 194 dialysis clinic
locations in 25 states and the District of Columbia serving
approximately 13,400 patients with end stage renal disease. ARA
operates exclusively through a physician joint venture model, in
which it partners with 356 local nephrologists to develop, own and
operate dialysis clinics. ARA’s Core Values emphasize taking good
care of patients, providing physicians with clinical autonomy and
operational support, hiring and retaining the best possible staff
and providing best practices management services. For more
information about American Renal Associates, visit
www.americanrenal.com.
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. You can identify
forward-looking statements because they do not relate strictly to
historical or current facts. These statements may include words
such as “aim,” “anticipate,” “believe,” “estimate,” “expect,”
“forecast,” “outlook,” “potential,” “project,” “projection,”
“plan,” “intend,” “seek,” “may,” “could,” “would,” “will,”
“should,” “can,” “can have,” “likely,” the negatives thereof and
other words and terms of similar meaning in connection with any
discussion of the timing or nature of future operating or financial
performance or other events.
The forward-looking statements appear in a number of places
throughout this press release and include statements regarding our
intentions, beliefs or current expectations concerning, among other
things, our results of operations, financial condition, liquidity,
prospects, growth, strategies and the industry in which we operate.
All forward-looking statements are subject to risks and
uncertainties, including but not limited to those risks and
uncertainties described in “Risk Factors” and “Special Note
Regarding Forward-Looking Statements” in our Prospectus dated April
20, 2016 filed with the SEC that may cause actual results to differ
materially from those that we expected.
Some of the factors that could cause actual results to differ
materially from those expressed or implied by the forward-looking
statements include, among others, the following:
- decline in the number of patients with
commercial insurance or decline in commercial payor reimbursement
rates;
- reduction of government-based payor
reimbursement rates or insufficient rate increases or adjustments
that do not cover all of our operating costs;
- our ability to successfully develop de
novo clinics, acquire existing clinics and attract new physician
partners;
- our ability to compete effectively in
the dialysis services industry;
- the performance of our joint venture
subsidiaries and their ability to make distributions to us;
- changes to the Medicare ESRD program
that could affect reimbursement rates and evaluation criteria, as
well as changes in Medicaid or other non-Medicare government
programs or payment rates;
- federal or state healthcare laws that
could adversely affect us;
- our ability to comply with all of the
complex federal, state and local government regulations that apply
to our business, including those in connection with federal and
state anti-kickback laws and state laws prohibiting the corporate
practice of medicine or fee-splitting;
- heightened federal and state
investigations and enforcement efforts;
- changes in the availability and cost of
ESAs and other pharmaceuticals used in our business;
- development of new technologies that
could decrease the need for dialysis services or decrease our
in-center patient population;
- our ability to correctly estimate the
amount of revenues that we recognize in a reporting period;
- our ability to timely and accurately
bill for our services and meet payor billing requirements;
- claims and losses relating to
malpractice, professional liability and other matters; the
sufficiency of our insurance coverage for those claims and rising
insurances costs; and any negative publicity or reputational damage
arising from such matters;
- loss of any members of our senior
management;
- damage to our reputation or our brand
and our ability to maintain brand recognition;
- our ability to maintain relationships
with our medical directors and renew our medical director
agreements;
- shortages of qualified skilled clinical
personnel, or higher than normal turnover rates;
- competition and consolidation in the
dialysis services industry;
- deteriorations in economic conditions,
particularly in states where we operate a large number of clinics,
or disruptions in the financial markets;
- the participation of our physician
partners in material strategic and operating decisions and our
ability to favorably resolve any disputes;
- our ability to honor obligations under
the joint venture operating agreements with our physician partners
were they to exercise certain put rights and other rights;
- unauthorized disclosure of personally
identifiable, protected health or other sensitive or confidential
information;
- our ability to meet our obligations and
comply with restrictions under our substantial level of
indebtedness; and
- the ability of our principal
stockholder, whose interests may conflict with yours, to strongly
influence or effectively control our corporate decisions after the
completion of the IPO.
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 SEC.
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, the Company has presented
the following non-GAAP financial measures: EBITDA, Adjusted EBITDA,
Adjusted EBITDA less noncontrolling interests (NCI), and Adjusted
cash provided by operating activities, 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. Please see
"Reconciliation of Non-GAAP Financial Measures" for additional
reasons for why these measures are provided.
American Renal
Associates Holdings, Inc. Consolidated Statements of
Income (Unaudited) (dollars in thousands except per
share amounts) Three Months Ended March 31,
2016 2015 Patient service operating revenues $
173,554 $ 150,344 Provision for uncollectible accounts
(1,423) (1,021) Net patient service operating revenues
172,131 149,323 Operating expenses: Patient care costs 105,455
92,130 General and administrative 21,499 17,203 Transaction-related
costs 24 — Depreciation and amortization 7,677 7,741
Total operating expenses 134,655 117,074 Operating
income 37,476 32,249 Interest expense, net (12,258)
(11,462) Income before income taxes 25,218 20,787 Income tax
expense 2,661 2,207 Net income 22,557 18,580 Less:
Net income attributable to noncontrolling interests (18,801)
(15,704) Net income attributable to American Renal
Associates Holdings, Inc. $ 3,756 $ 2,876 Earnings per share: Basic
$ 0.17 $ 0.13 Diluted $ 0.16 $ 0.13 Weighted-average number of
common shares outstanding Basic 22,213,967 22,107,409 Diluted
22,785,670 22,609,455
American Renal Associates Holdings, Inc.
Consolidated Balance Sheets (dollars in thousands except
for share data) March 31,2016 December
31,2015 (Unaudited)
Assets Cash $ 95,965 $ 90,988
Accounts receivable, less allowance for doubtful accounts of $7,949
and $7,435, respectively 75,831 76,919 Inventories 5,515 4,291
Prepaid expenses and other current assets 19,507 18,863 Income tax
receivable 2,661 2,686 Total current assets 199,479 193,747
Property and equipment, net of accumulated depreciation of $144,733
and $138,163, respectively 151,204 142,701 Intangible assets, net
of accumulated depreciation of $22,466 and $22,378, respectively
25,877 25,662 Other long-term assets 6,574 6,850 Goodwill
569,315 569,318 Total assets $ 952,449 $ 938,278
Liabilities and Equity Accounts payable $ 23,857 $ 22,571
Accrued compensation and benefits 21,496 22,504 Accrued expenses
and other current liabilities 31,110 26,788 Current portion of
long-term debt 27,171 25,610 Total current
liabilities 103,634 97,473 Long-term debt, less current portion
661,369 657,372 Other long-term liabilities 9,927 9,483 Deferred
tax liabilities 15,096 15,029 Total Liabilities
790,026 779,357 Commitments and contingencies (Note 11)
Noncontrolling interests subject to put provisions 107,414 108,211
Equity: Preferred stock, $0.01 par value, 1,000,000 shares
authorized; none issued Common stock, $0.01 par value, 29,770,000
shares authorized, 22,213,967 issued and outstanding 98 98
Additional paid-in capital 457 — Receivable from noncontrolling
interests (605) (529) Accumulated deficit (124,505) (128,261)
Accumulated other comprehensive loss, net of tax (401)
(501) Total American Renal Associates Holdings, Inc. deficit
(124,956) (129,193) Noncontrolling interests not subject to put
provisions 179,965 179,903 Total equity 55,009
50,710 Total liabilities and equity $ 952,449 $ 938,278
American Renal
Associates Holdings, Inc. Consolidated Statements of Cash
Flows (Unaudited) (dollars in thousands)
Three Months Ended March 31, Operating
activities 2016 2015 Net income $ 22,557 $ 18,580
Adjustments to reconcile net income to cash provided by operating
activities: Depreciation and amortization 7,677 7,741 Amortization
of discounts, fees and deferred financing costs 797 715 Stock-based
compensation 386 283 Excess tax benefit for stock options
exercised, net (15) — Deferred taxes 67 1,815 Non-cash charge
related to interest rate swap 623 400 Non-cash rent charges 512 67
Change in operating assets and liabilities, net of acquisitions:
Accounts receivable 1,088 (5,243) Inventories (1,224) 138 Prepaid
expenses and other current assets (152) 2,088 Other assets (18)
(909) Accounts payable 1,286 (1,002) Accrued compensation and
benefits (1,008) 2,662 Accrued expenses and other liabilities
3,985 258 Cash provided by operating activities
36,561 27,593
Investing activities Purchases of
property, equipment and intangible assets (16,396) (10,997) Cash
paid for acquisitions — (600) Cash used in investing
activities (16,396) (11,597)
Financing activities
Proceeds from term loans 12,282 5,895 Payments on long-term debt
(7,462) (4,175) Payments on capital lease obligations — (5) Excess
tax benefit from stock option exercises 15 — Payments of deferred
offering costs (467) Common stock repurchases for tax withholdings
of net settlement equity awards — (52) Distributions to
noncontrolling interests (21,440) (18,157) Contributions from
noncontrolling interests 1,884 1,350 Purchases of noncontrolling
interests — (2,474) Proceeds from sales of additional
noncontrolling interests — 250 Cash used in financing
activities (15,188) (17,368) Increase (Decrease) in cash
4,977 (1,372) Cash at beginning of period 90,988
61,475 Cash at end of period $ 95,965 $ 60,103
Supplemental Disclosure of Cash Flow Information Cash paid
for income taxes $ 193 $ 393 Cash paid for interest 10,581 10,275
Supplemental Disclosure of Non-Cash Flow Information Accrued
offering costs 680 —
American Renal Associates Holdings,
Inc. Unaudited Supplemental Business Metrics (dollars
in thousands) Three Months Ended March 31,
December 31, March 31, Dialysis Clinic
Activity: 2016 2015 2015 Number of clinics
(as of end of period)
194 192 177 Number of de
novo clinics opened (during period)
2 4 1
Number of acquired clinics (during period) —
1 1
Signed clinics (as of end of period)
35 32 22
Patients and Treatment Volume: Patients (as of end of
period)
13,420 13,151 11,982 Treatments
482,666 476,068 419,966 Number of treatment days 78 79 77
Treatments per day 6,188 6,026 5,454
Sources of treatment
growth (year over year % change): Non-acquired growth 14.4%
11.2% 9.4% Acquired growth 0.5% 3.0% 4.7% Total treatment growth
14.9% 14.2% 14.1%
Revenue: Patient service operating
revenues (in thousands) $ 173,554 $ 175,386 $ 150,344 Patient
service operating revenues per treatment $ 359.57 $ 368.41 $ 357.99
Net patient service operating revenues (in thousands) $ 172,131 $
174,211 $ 149,323
Expenses: Patient care costs Amount
(in thousands) $ 105,455 $ 102,606 $ 92,130 As a % of net patient
service operating revenues 61.3% 58.9% 61.7% Per treatment $ 218.48
$ 215.53 $ 219.37 General and administrative expenses Amount
(in thousands) $ 21,499 $ 20,587 $ 17,203 As a % of net patient
service operating revenues 12.5% 11.8% 11.5% Per treatment $ 44.54
$ 43.24 $ 40.96 Provision for uncollectible accounts Amount
(in thousands) $ 1,423 $ 1,175 $ 1,021 As a % of net patient
service operating revenues 0.8% 0.7% 0.7% Per treatment $ 2.95 $
2.47 $ 2.43
Accounts receivable DSO (days) 40 40 46
Adjusted EBITDA* Adjusted EBITDA including
noncontrolling interests (in thousands) $ 46,020 $ 52,012 $ 40,731
Adjusted EBITDA - NCI (in thousands) $ 27,219 $ 31,134 $ 25,027
Clinical (quarterly averages): Dialysis adequacy - %
of patients with Kt/V > 1.2 98% 98% 98% Vascular access - %
catheter in use > 90 days 11% 11% 11%
* See reconciliation of Non-GAAP Financial Measures.
American Renal Associates Holdings,
Inc.Reconciliation of Non-GAAP Financial
Measures:(Unaudited)(dollars in thousands)
We use Adjusted EBITDA and Adjusted EBITDA-NCI to track our
performance. “Adjusted EBITDA” is defined as net income before
income taxes, interest expense, depreciation and amortization, as
adjusted for stock-based compensation, loss on early extinguishment
of debt, transaction-related costs, income tax receivable agreement
expense, and management fees. “Adjusted EBITDA-NCI” is defined as
Adjusted EBITDA less net income attributable to noncontrolling
interests. We believe Adjusted EBITDA and Adjusted EBITDA-NCI
provide information useful for evaluating our business and
understanding our operating performance in a manner similar to
management. We believe Adjusted EBITDA is helpful in highlighting
trends because Adjusted EBITDA excludes the results of decisions
that are outside the operational control of management and can
differ significantly from company to company depending on long-term
strategic decisions regarding capital structure, the tax
jurisdictions in which companies operate and capital investments.
We believe Adjusted EBITDA-NCI is helpful in highlighting the
amount of Adjusted EBITDA that is available to us after reflecting
the interests of our joint venture partners. Adjusted EBITDA and
Adjusted EBITDA-NCI are not measures of operating performance
computed in accordance with GAAP and should not be considered as a
substitute for operating income, net income, cash flows from
operations, or other statement of operations or cash flow data
prepared in conformity with GAAP, or as measures of profitability
or liquidity. In addition, Adjusted EBITDA and Adjusted EBITDA-NCI
may not be comparable to similarly titled measures of other
companies. Adjusted EBITDA and Adjusted EBITDA-NCI may not be
indicative of historical operating results, and we do not mean for
it to be predictive of future results of operations or cash flows.
Adjusted EBITDA and Adjusted EBITDA-NCI have limitations as
analytical tools, and you should not consider these items in
isolation, or as substitutes for an analysis of our results as
reported under GAAP. Some of these limitations are that Adjusted
EBITDA and Adjusted EBITDA-NCI
- do not include stock-based compensation
expense;
- do not include transaction-related
costs;
- do not include depreciation and
amortization—because construction and operation of our dialysis
clinics requires significant capital expenditures, depreciation and
amortization are a necessary element of our costs and ability to
generate profits;
- do not include interest expense—as we
have borrowed money for general corporate purposes, interest
expense is a necessary element of our costs and ability to generate
profits and cash flows;
- do not include income tax receivable
agreement income and expense;
- do not include certain income tax
payments that represent a reduction in cash available to us;
and
- do not reflect changes in, or cash
requirements for, our working capital needs.
In addition, Adjusted EBITDA is not adjusted for the portion of
earnings that we distribute to our joint venture partners.
You should not consider Adjusted EBITDA and Adjusted EBITDA-NCI
as alternatives to income from operations or net income, determined
in accordance with GAAP, as an indicator of our operating
performance, or as alternatives to cash provided by operating
activities, determined in accordance with GAAP, as an indicator of
cash flows or as a measure of liquidity. This presentation of
Adjusted EBITDA and Adjusted EBITDA-NCI may not be directly
comparable to similarly titled measures of other companies, since
not all companies use identical calculations.
We use Adjusted cash provided by operating activities less
distributions to NCI because it is a useful measure to evaluate the
cash flow that is available to the Company for investment in
property, plant and equipment, debt service, growth and other
general corporate purposes. “Adjusted cash provided by operating
activities less distributions to noncontrolling interests” is
defined as cash provided by operating activities plus
transaction-related expenses less distributions to noncontrolling
interests.
We use Adjusted owned net debt because it is a useful metric to
evaluate the Company’s pro rata share of our interests in the cash
on our balance sheet and the pro rata share of the debt guaranteed
by the Company. “Adjusted owned net debt” is defined as Debt (other
than clinic-level debt) plus Clinic-level debt guaranteed by
American Renal Associates Holdings, Inc. less Cash (other than
clinic-level cash) less the Company’s pro rata interest in
Clinic-level cash. “Owned Net Leverage” is defined as the ratio of
Owned Net Debt to our trailing twelve months Adjusted EBITDA less
NCI. The following table presents the reconciliation from net
income to Adjusted EBITDA and Adjusted EBITDA-NCI for the periods
indicated:
Reconciliation of Net income to
Three Months Ended LTM (1) as of Adjusted
EBITDA: March 31, December 31, March 31,
March 31, 2016 2015 2015 2016
Net income $ 22,557 $ 27,720 $ 18,580 $ 97,054 Interest expense,
net 12,258 10,761 11,462 46,196 Income tax expense 2,661 3,552
2,207 12,827 Depreciation and amortization 7,677 9,004 7,741 31,782
Transaction-related costs 24 (19) - 2,110 Stock-based compensation
386 399 306 1,531 Management fee 457 595 435 1,844 Adjusted EBITDA
(including noncontrolling interests) $ 46,020 $ 52,012 $ 40,731 $
193,344 Less: Net income attributable to noncontrolling interests
(18,801) (20,878) (15,704) (77,329) Adjusted EBTIDA-NCI $ 27,219 $
31,134 $ 25,027 $ 116,015
American Renal Associates
Holdings, Inc. Unaudited Supplemental Cash Flow
(dollars in thousands)
Three Months Ended Ended March 31, 2016
2015 Cash provided by operating activities $36,561
$27,593 Plus: Transaction-related costs (2) 24 —
Adjusted cash
provided by operating activities 36,585 27,593 Distributions to
noncontrolling interests (21,440) (18,157)
Adjusted cash
provided by operating activities less distributions to NCI
15,145 9,436
Capital expenditure breakdown: Routine
and maintenance capital expenditures $2,858 $1,932 Development
capital expenditures 13,538 9,065
Total capital expenditures
$16,396 $10,997
Note:(1) Last twelve months ("LTM") is the period beginning
April 1, 2015 through March 31, 2016(2) Transaction-related costs
include IPO related costs.
American Renal Associates Holdings,
Inc. Unaudited Supplemental Balance Sheet (dollars in
thousands) Proforma As of March 31, 2016
As of March 31, 2016 Total ARA ARA "Owned" Total ARA ARA
"Owned" Cash (other than clinic-level cash) $39,449 $39,449 $3,798
$3,798 Clinic-level cash 56,516 28,587 56,516 28,587 Total cash
$95,965 $68,036 $60,314 $32,385 Debt (other than
clinic-level debt) $619,202 $619,202 $440,643 $440,643 Clinic-level
debt 78,353 38,318 104,488 52,158 Unamortized debt discounts and
fees (9,015) (9,015) (4,220) (4,220) Total debt $688,540 $648,505
$540,911 $488,581
Net debt (total debt - total cash)
$580,469 $456,196 Adjusted EBITDA less NCI,
LTM $116,015 $116,015 Leverage ratio (1)
5.0x 3.9x
Note:(1) Leverage ratio calculated as follows: Net debt divided
by Adjusted EBITDA less NCI, last twelve months.
View source
version on businesswire.com: http://www.businesswire.com/news/home/20160512006507/en/
American Renal Associates HoldingsDarren Lehrich,
978-922-3080 x134SVP Strategy & Investor
Relationsdlehrich@americanrenal.com
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