10-Q
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Table of Contents
 
 
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
 
 
FORM
10-Q
 
 
 
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 2020
OR
 
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from
                    
to
                    
Commission File Number:
001-12111
 
 
MEDNAX, INC.
(Exact name of registrant as specified in its charter)
 
 
 
Florida
  
26-3667538
(State or other jurisdiction of
Incorporation or organization)
  
(I.R.S. Employer
Identification No.)
1301 Concord Terrace
  
Sunrise, Florida
  
33323
(Address of principal executive offices)
  
(Zip Code)
(954)
384-0175
(Registrant’s telephone number, including area code)
Not Applicable
(Former name, former address and former fiscal year, if changed since last report)
Securities registered pursuant to Section 12(b) of the Act:
 
Title of each class
  
Trading
Symbol
  
Name of each exchange
on which registered
Common Stock, par value $.01 per share
  
MD
  
New York Stock Exchange
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  ☒    No  ☐
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation
S-T
(§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).     Yes  ☒    No  ☐
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a
non-accelerated
filer, smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule
12b-2
of the Exchange Act.
 
Large accelerated filer      Accelerated filer  
Non-accelerated filer      Smaller reporting company  
     Emerging growth company  
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  ☐
Indicate by check mark whether the registrant is a shell company (as defined in Rule
12b-2
of the Exchange Act).    Yes  ☐    No  
On July 24, 2020, the registrant had outstanding
 
85,461,731 shares of Common Stock, par value $.01 per share.
 
 
 

Table of Contents
MEDNAX, INC.
INDEX
 
 
 
 
  
Page
 
PART I - FINANCIAL INFORMATION
  
     
     
Item 1.
 
Financial Statements
  
 
3
 
     
 
 
  
 
3
 
     
 
 
  
 
4
 
     
 
 
  
 
5
 
     
 
 
  
 
6
 
     
 
 
  
 
7
 
     
Item 2.
 
  
 
14
 
     
Item 3.
 
  
 
24
 
     
Item 4.
 
  
 
24
 
   
  
     
     
Item 1.
 
  
 
25
 
     
Item 1A.
 
  
 
25
 
     
Item 2.
 
  
 
26
 
     
Item 6.
 
  
 
27
 
   
  
 
28
 
 
2

Table of Contents
MEDNAX, INC.
CONSOLIDATED BALANCE SHEETS
(in thousands)
(Unaudited)
 
    
June 30, 2020
   
December 31, 2019
 
ASSETS
    
Current assets:
    
Cash and cash equivalents
   $ 132,151     $ 107,870  
Short-term investments
     90,642       74,510  
Accounts receivable, net
     345,682       498,869  
Prepaid expenses
     14,343       21,826  
Income taxes receivable
     64,428           
Other current assets
     41,083       16,864  
Assets held for sale
              11,569  
  
 
 
   
 
 
 
Total current assets
     688,329       731,508  
Property and equipment, net
     98,469       91,881  
Goodwill
     2,165,020       2,165,020  
Intangible assets, net
     200,408       209,564  
Operating lease
right-of-use
assets
     75,817       71,421  
Deferred income tax assets
     61,227       104,827  
Other assets
     97,942       89,368  
Assets held for sale
              682,312  
  
 
 
   
 
 
 
Total assets
   $ 3,387,212     $ 4,145,901  
  
 
 
   
 
 
 
LIABILITIES AND SHAREHOLDERS’ EQUITY
    
Current liabilities:
    
Accounts payable and accrued expenses
   $ 360,909     $ 453,110  
Current portion of finance lease liabilities
     1,426       130  
Current portion of operating lease liabilities
     21,598       20,485  
Income taxes payable
              6,039  
Liabilities held for sale
              62,055  
  
 
 
   
 
 
 
Total current liabilities
     383,933       541,819  
Long-term debt and finance lease liabilities, net
     1,737,176       1,730,295  
Long-term operating lease liabilities
     56,936       56,582  
Long-term professional liabilities
     260,936       226,892  
Deferred income tax liabilities
     68,681       56,468  
Other liabilities
     52,980       22,899  
Liabilities held for sale
              11,950  
  
 
 
   
 
 
 
Total liabilities
     2,560,642       2,646,905  
  
 
 
   
 
 
 
Commitments and contingencies
    
Shareholders’ equity:
    
Preferred stock; $.01 par value; 1,000 shares authorized; none issued
                  
Common stock; $.01 par value; 200,000 shares authorized; 85,536 and 84,248 shares issued and outstanding, respectively
     855       842  
Additional
paid-in
capital
     1,004,786       987,942  
Retained (deficit) earnings
     (179,071     510,212  
  
 
 
   
 
 
 
Total shareholders’ equity
     826,570       1,498,996  
  
 
 
   
 
 
 
Total liabilities and shareholders’ equity
   $ 3,387,212     $ 4,145,901  
  
 
 
   
 
 
 
The accompanying notes are an integral part of these Consolidated Financial Statements.
 
3

Table of Contents
MEDNAX, INC.
CONSOLIDATED STATEMENTS OF INCOME
(in thousands, except per share data)
(Unaudited)
 
    
Three Months Ended

June 30,
   
Six Months Ended

June 30,
 
    
2020
   
2019
   
2020
   
2019
 
Net revenue
   $ 509,203     $ 561,237     $ 1,071,054     $ 1,104,249  
  
 
 
   
 
 
   
 
 
   
 
 
 
Operating expenses:
        
Practice salaries and benefits
     349,258       361,203       748,715       731,571  
Practice supplies and other operating expenses
     21,433       24,783       46,839       47,107  
General and administrative expenses
     77,674       84,219       165,232       165,790  
Depreciation and amortization
     14,393       13,779       28,792       27,584  
Transformational and restructuring related expenses
     11,537       17,866       30,581       20,305  
  
 
 
   
 
 
   
 
 
   
 
 
 
Total operating expenses
     474,295       501,850       1,020,159       992,357  
  
 
 
   
 
 
   
 
 
   
 
 
 
Income from operations
     34,908       59,387       50,895       111,892  
Investment and other income
     3,851       1,219       3,172       2,866  
Interest expense
     (28,265     (31,063     (55,931     (61,764
Equity in earnings of unconsolidated affiliates
     479       1,990       1,824       3,187  
  
 
 
   
 
 
   
 
 
   
 
 
 
Total
non-operating
expenses
     (23,935     (27,854     (50,935     (55,711
  
 
 
   
 
 
   
 
 
   
 
 
 
Income (loss) from continuing operations before income taxes
     10,973       31,533       (40     56,181  
Income tax provision
     (3,373     (11,486     (6,109     (13,588
  
 
 
   
 
 
   
 
 
   
 
 
 
Income (loss) from continuing operations
     7,600       20,047       (6,149     42,593  
Loss from discontinued operations, net of tax
     (680,036     (28,292     (684,999     (293,710
  
 
 
   
 
 
   
 
 
   
 
 
 
Net loss
   $ (672,436   $
(8,245
  $ (691,148   $ (251,117
  
 
 
   
 
 
   
 
 
   
 
 
 
Per common and common equivalent share data:
        
Income (loss) from continuing operations:
        
Basic
   $ 0.09     $ 0.24     $ (0.07   $ 0.50  
  
 
 
   
 
 
   
 
 
   
 
 
 
Diluted
   $ 0.09     $ 0.24     $ (0.07   $ 0.50  
  
 
 
   
 
 
   
 
 
   
 
 
 
Loss from discontinued operations:
        
Basic
   $ (8.14   $ (0.34   $ (8.25   $ (3.47
  
 
 
   
 
 
   
 
 
   
 
 
 
Diluted
   $ (8.12   $ (0.34   $ (8.25   $ (3.45
  
 
 
   
 
 
   
 
 
   
 
 
 
Net loss:
        
Basic
   $ (8.05   $ (0.10   $ (8.32   $ (2.97
  
 
 
   
 
 
   
 
 
   
 
 
 
Diluted
   $ (8.03   $ (0.10   $ (8.32   $ (2.95
  
 
 
   
 
 
   
 
 
   
 
 
 
Weighted average common shares:
        
Basic
     83,490       83,234       83,061       84,623  
Diluted
     83,745       83,689       83,061       85,087  
The accompanying notes are an integral part of these Consolidated Financial Statements.
 
4

Table of Contents
MEDNAX, INC.
CONSOLIDATED STATEMENTS OF EQUITY
(in thousands)
 
    
Common Stock
                   
    
Number of
         
Additional
Paid-in
   
Retained
   
Total
 
    
Shares
   
Amount
   
Capital
   
Earnings
   
Equity
 
2020
          
Balance at January 1, 2020
     84,248     $ 842     $ 987,942     $ 510,212     $ 1,498,996  
Net loss
     —         —         —         (18,712     (18,712
Unrealized holding loss on investments, net of tax
(1)
     —         —         —         (213     (213
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan
     78       1       1,831       —         1,832  
Issuance of restricted stock
 
and conversion of restricted stock units to common stock
     968       10       (10     —         —    
Forfeitures of restricted stock
     (19     —         —         —         —    
Stock-based compensation expense
     —         —         8,035       —         8,035  
Repurchased common stock
     (125     (1     (2,541              (2,542
  
 
 
   
 
 
   
 
 
   
 
 
   
 
 
 
Balance at March 31, 2020
     85,150     $ 852     $ 995,257     $ 491,287     $ 1,487,396  
Net loss
     —         —         —         (672,436     (672,436
Unrealized holding gain on
investments, net of tax
     —         —         —        
2,078
      2,078  
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan
     277       3       2,541       —         2,544  
Issuance of restricted stock
     200       2       (2     —         —    
Forfeitures of restricted stock
     (57     (1     1       —         —    
Stock-based compensation expense
     —         —         7,489       —         7,489  
Repurchased common stock
     (34     (1     (500           (501
  
 
 
   
 
 
   
 
 
   
 
 
   
 
 
 
Balance at June 30, 2020
     85,536     $ 855     $ 1,004,786     $ (179,071   $ 826,570  
  
 
 
   
 
 
   
 
 
   
 
 
   
 
 
 
2019
          
Balance at January 1, 2019
     87,820     $ 878     $ 992,647     $ 2,094,359     $ 3,087,884  
Net loss
     —         —         —         (242,872     (242,872
Unrealized holding loss on investments, net of tax
(1)
     —         —         —         (194     (194
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan
     140       1       3,541       —         3,542  
Issuance of restricted stock
     978       10       (10     —         —    
Forfeitures of restricted stock
     (6     —         —         —         —    
Stock swaps
     (20     —         (666     —         (666
Stock-based compensation expense
     —         —         11,100       —         11,100  
Repurchased common stock
     (2,525     (25     (28,740     (50,217     (78,982
Balance at March 31, 2019
     86,387     $ 864     $ 977,872     $ 1,801,076     $ 2,779,812  
Net loss
     —         —         —         (8,245     (8,245
Unrealized holding gain on investments, net of tax
     —         —         —         232       232  
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan
     155       2       3,673       —         3,675  
Issuance of restricted stock
     123       1       (1     —         —    
Forfeitures of restricted stock
     (61     (1     1       —         —    
Stock-based compensation expense
     —         —         15,080       —         15,080  
Repurchased common stock
     (2,508     (25     (29,196     (36,306     (65,527
  
 
 
   
 
 
   
 
 
   
 
 
   
 
 
 
Balance at June 30, 2019
     84,096     $ 841     $ 967,429     $ 1,756,757     $ 2,725,027  
  
 
 
   
 
 
   
 
 
   
 
 
   
 
 
 
 
(1)
 
Presented within retained earnings on the consolidated balance sheet as the balance is immaterial.
The accompanying notes are an integral part of these Consolidated Financial Statements.
 
5

Table of Contents
MEDNAX, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(in thousands)
(Unaudited)
 
    
Six Months Ended June 30,
 
    
2020
   
2019
 
Cash flows from operating activities:
    
Net loss
   $ (691,148   $ (251,117
Loss from discontinued operations
     684,999       293,710  
Adjustments to reconcile net income to net cash from operating activities:
    
Depreciation and amortization
     28,792       27,584  
Amortization of premiums, discounts and issuance costs
     2,785       2,934  
Stock-based compensation expense
     13,819       20,853  
Deferred income taxes
     55,812       (12,378
Other
     (2,092     8,284  
Changes in assets and liabilities:
    
Accounts receivable
     44,296       1,703  
Prepaid expenses and other current assets
     (16,281     3,715  
Other long-term assets
     5,560       14,233  
Accounts payable and accrued expenses
     (86,609     (52,307
Income taxes payable
 
/
 
receivable
     (49,757     (40,181
Payments of contingent consideration liabilities
     (102     (418
Long-term professional liabilities
     2,931       4,628  
Other liabilities
     26,888       (14,212
  
 
 
   
 
 
 
Net cash provided by operating activities – continuing operations
     19,893       7,031  
Net cash provided by operating activities - discontinued operations
     26,658       56,184  
  
 
 
   
 
 
 
Net cash provided by operating activities
     46,551       63,215  
  
 
 
   
 
 
 
Cash flows from investing activities:
    
Acquisition payments, net of cash acquired
     (75     (11,450
Purchases of investments
     (32,335         
Proceeds from maturities or sales of investments
     18,135       8,180  
Purchases of property and equipment
     (23,326     (15,926
Proceeds from sale of business
, net of cash sold
     476           
  
 
 
   
 
 
 
Net cash used in investing activities – continuing operations
     (37,125     (19,196
Net cash
provided by (
used in
)
investing activities
discontinued operations
     15,466       (8,438
  
 
 
   
 
 
 
Net cash used in investing activities
     (21,659     (27,634
  
 
 
   
 
 
 
Cash flows from financing activities:
    
Borrowings on credit agreement
     527,500       898,500  
Payments on credit agreement
     (527,500     (1,286,500
Proceeds from issuance of senior notes
           500,000  
Payments for credit facility amendment and financing costs
     (510     (9,194
Payments of contingent consideration liabilities
     (1,248     (5,171
Payments on finance lease obligations
     (186     (98
Proceeds from issuance of common stock
     4,376       6,551  
Repurchases of common stock
     (3,043     (144,509
  
 
 
   
 
 
 
Net cash used in financing activities – continuing operations
     (611     (40,421
Net cash used in financing activities
discontinued operations
                  
  
 
 
   
 
 
 
Net cash used in financing activities
     (611     (40,421
  
 
 
   
 
 
 
Net
 
increase
(
decrease
)
in cash and cash equivalents
     24,281       (4,840
Cash and cash equivalents at beginning of period
     107,870       40,774  
  
 
 
   
 
 
 
Cash and cash equivalents at end of period
   $ 132,151     $ 35,934  
  
 
 
   
 
 
 
The accompanying notes are an integral part of these Consolidated Financial Statements.
 
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MEDNAX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
June 30, 2020
(Unaudited)
 
1.
Basis of Presentation and New Accounting Pronouncements:
The accompanying unaudited Consolidated Financial Statements of the Company and the notes thereto presented in this Form
10-Q
have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission applicable to interim financial statements, and do not include all disclosures required by accounting principles generally accepted in the United States of America (“GAAP”) for complete financial statements. In the opinion of management, these financial statements include all adjustments, consisting only of normal recurring adjustments, necessary for a fair statement of the results of the interim periods presented. The financial statements include all the accounts of MEDNAX, Inc. and its consolidated subsidiaries (collectively, “MDX”) together with the accounts of MDX’s affiliated business corporations or professional associations, professional corporations, limited liability companies and partnerships (the “affiliated professional contractors”). Certain subsidiaries of MDX have contractual management arrangements with its affiliated professional contractors, which are separate legal entities that provide physician services in certain states and Puerto Rico. The terms “MEDNAX” and the “Company” refer collectively to MEDNAX, Inc., its subsidiaries and the affiliated professional contractors.
The Company is a party to a joint venture in which it owns a 37.5% economic interest and a second joint venture in which it owns a 49.0% economic interest. The Company accounts for these joint ventures under the equity method of accounting because the Company exercises significant influence over, but does not control, these entities.
The consolidated results of operations for the interim periods presented are not necessarily indicative of the results to be experienced for the entire fiscal year. In addition, the accompanying unaudited Consolidated Financial Statements and the notes thereto should be read in conjunction with the Consolidated Financial Statements and the notes thereto included in the Company’s most recent Annual Report on Form
10-K
(the “Form
10-K”).
In October 2019, the Company divested its management services organization, which operated as MedData, to allow the Company to focus on its core physician services business. The operating results of MedData are reported as discontinued operations in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2019. See Note 6 – Assets Held for Sale and Discontinued Operations for additional information.
In May 2020, the Company divested its anesthesiology medical group. The operating results of the Company’s anesthesiology medical group are reported as discontinued operations in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2020 and 2019. Reclassifications have been made to certain prior period financial statements and footnote disclosures to reflect the impact of discontinued operations. See Note 6 – Assets Held for Sale and Discontinued Operations for additional information.
In June 2020, the Company announced the initiation of a process to divest its radiology services medical group when market conditions are appropriate in order to refocus the business as a dedicated pediatrics and obstetrics organization. However, there can be no assurance that this process will result in a transaction. The Company’s radiology services medical group is reported within continuing operations for all periods presented as the accounting criterion for assets held for sale was not met as of June 30, 2020.
New Accounting Pronouncements
In December 2019, accounting guidance related to income taxes was issued with the goal of enhancing and simplifying various aspects of the income tax accounting guidance, including requirements related to hybrid tax regimes, deferred taxes on
step-up
in tax basis of goodwill obtained in a transaction that is not a business combination, separate financial statements of entities not subject to tax, the intraperiod tax allocation exception to the incremental approach, deferred tax liabilities on outside basis differences, and interim-period accounting for enacted changes in tax law and certain
year-to-date
loss limitations. The guidance becomes effective for the Company on January 1, 2021, including interim periods therein, with early adoption permitted, including adoption in interim or annual periods for which financial statements have not yet been issued. The Company does not believe the adoption of this new guidance will have a material impact on its Consolidated Financial Statements and related disclosures.
 
2.
Coronavirus Pandemic
(“COVID-19”):
COVID-19
and related “stay at home” and social distancing measures implemented across the country have significantly impacted demand for medical services provided by the Company’s affiliated clinicians. Beginning in
mid-March
2020, the Company experienced a significant decline in the number of elective surgeries at the facilities where the Company’s affiliated clinicians provided anesthesiology services. See Note 6 – Assets Held for Sale and Discontinued Operations for information regarding the divestment of the Company’s anesthesiology medical group on May 6, 2020. Much of this decline was due to the closure of operating suites or facilities following federal advisories to cancel
non-urgent
procedures and the prohibition of such procedures by several states. Within the Company’s radiology services medical group, orders for radiological studies declined by a meaningful amount from historically normal levels, with much of this reduction focused in
non-urgent
studies. The Company’s affiliated office-based practices, which specialize in maternal-fetal medicine, pediatric cardiology, and numerous pediatric subspecialties, have seen a significant elevation of appointment cancellations compared to historical normal levels. At this time, the Company has not experienced, nor does it currently anticipate, any significant impact to neonatal intensive care unit (NICU) patient volumes as a result of
COVID-19.
Overall, the Company’s operating results since
mid-March
2020 have been significantly impacted by the
COVID-19
pandemic, but volumes did begin to normalize in May 2020 and substantially recovered during the month of June 2020.
 
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The Company implemented a number of actions to preserve financial flexibility and partially mitigate the significant anticipated impact of
COVID-19.
These steps included a suspension of most activities related to the Company’s transformational and restructuring programs, limiting these expenditures to those that provide essential support for the Company’s response to
COVID-19.
In addition, (i) the Company temporarily reduced executive and key management base salaries, including 50% reductions in salaries for its named executive officers through June 30, 2020; (ii) the Board of Directors agreed to forego their annual cash retainer and cash meeting payments, also through June 30, 2020; (iii) the Company enacted a combination of salary reductions and furloughs for
non-clinical
employees; and (iv) the Company enacted significant operational and practice-specific expense reduction plans across its clinical operations.
 
The Company also divested its anesthesiology medical group in May 2020, where operating results were significantly impacted by COVID-19.
In response to the anticipated impact of
COVID-19
on the Company’s results of operations, on March 25, 2020, the Company amended and restated its Credit Agreement to, among other things, (i) establish a deemed Consolidated EBITDA of $139.2 million for the second and third quarters of 2020, reflecting average Adjusted EBITDA from continuing operations for the prior eight quarters (calculated for purposes of the Credit Agreement), which will be used in the calculation of rolling four consecutive quarter Consolidated EBITDA under the Credit Agreement, (ii) temporarily increase the maximum consolidated net leverage ratio required to be maintained by the Company from 4.50:1:00 to 5.00:1:00 for the second and third quarters of 2020 and 4.75:1:00 for the fourth quarter of 2020, before returning to 4.50:1:00 for the first quarter of 2021 and beyond, (iii) require that the Company maintains minimum availability under the Credit Agreement of $300.0 million through the third quarter of 2021, (iv) provide for a weekly repayment of borrowings under the Credit Agreement through the second quarter of 2021 using unrestricted cash on hand in excess of $300.0 million, plus a reserve for certain payables, and (v) temporarily restrict the Company’s ability to make restricted payments under the Credit Agreement for the remainder of 2020, subject to certain exceptions. At June 30, 2020, the Company believes it was in compliance, in all material respects, with the financial covenants and other restrictions applicable to the Company under its Credit Agreement, its 5.25% senior unsecured notes due 2023
 
and its 6.25% senior unsecured notes due 2027. The Company believes it will be in compliance with these covenants for the next twelve months. 
At June 30, 2020, the Company had no outstanding principal balance on its Credit Agreement. The Company had outstanding letters of credit of $0.2 million which reduced the amount available on its Credit Agreement to $899.8 million at June 30, 2020, after giving effect to the temporary reduction of the capacity of its Credit Agreement described above through September 30, 2021.
CARES Act
On March 27, 2020, President Trump signed the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) into law. The CARES Act is a relief package intended to assist many aspects of the American economy, including providing up to $100 billion in aid to the healthcare industry to reimburse healthcare providers for lost revenue and expenses attributable to
COVID-19.
The remaining $70 billion in aid is intended to focus on providers in areas particularly impacted by
COVID-19,
rural providers, providers of services with lower shares of Medicare reimbursement or who predominantly serve the Medicaid population, and providers requesting reimbursement for the treatment of uninsured Americans. It is unknown what, if any, portion of the remaining healthcare industry funding on the CARES Act the Company and its affiliated physician practices will qualify for and receive. The Department of Health and Human Services (“HHS”) is administering this program and began disbursing funds in April 2020, of which the Company’s affiliated physician practices received an aggregate of approximately $12 million during the second quarter of 2020.
 
The Company has applications pending for certain affiliated physician practices for incremental relief beyond what has been received.
In addition, the CARES Act also provides for deferred payment of the employer portion of social security taxes through the end of 2020, with 50% of the deferred amount due December 31, 2021 and the remaining 50% due December 31, 2022. The Company intends to utilize this deferral option throughout 2020.
The Company currently expects that the
COVID-19
situation will materially impact its financial results, but due to the rapidly evolving environment and continued uncertainties surrounding the timeline of and impacts from
COVID-19,
the Company is unable to predict the ultimate impact on its business, financial condition, results of operations and cash flows. The Company, however, believes it will be able to generate sufficient liquidity to satisfy its obligations for the next twelve months.
 
3.
Cash Equivalents and Investments:
As of June 30, 2020 and December 31, 2019, the Company’s cash equivalents consisted entirely of money market funds totaling $1.7 million and $16.8 million, respectively. Investments consisted of corporate securities, municipal debt securities, federal home loan securities and certificates of deposit. All investments are classified as current.
Investments held at June 30, 2020 and December 31, 2019 are summarized as follows (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
Corporate securities
   $ 55,677      $ 32,962  
Municipal debt securities
     20,831        29,066  
Federal home loan securities
     8,537        8,013  
Certificates of deposit
     5,597        4,469  
  
 
 
    
 
 
 
   $ 90,642      $ 74,510  
  
 
 
    
 
 
 
 
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4.
Fair Value Measurements:
The accounting guidance establishes a fair value hierarchy that prioritizes valuation inputs into three levels based on the extent to which inputs used in measuring fair value are observable in the market. Each fair value measurement is reported in one of three levels:
Level 1 – inputs are based upon unadjusted quoted prices for identical instruments traded in active markets.
Level 2 – inputs are based upon quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model-based valuation techniques for which all significant assumptions are observable in the market or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
Level 3 – inputs are generally unobservable and typically reflect management’s estimates of assumptions that market participants would use in pricing the asset or liability. The fair values are therefore determined using model-based techniques that include option pricing models, discounted cash flow models, and similar techniques.
The following table presents information about the Company’s financial instruments that are accounted for at fair value on a recurring basis at June 30, 2020 and December 31, 2019 (in thousands):
 
           
Fair Value
 
    
Fair Value
Category
    
June 30,
 
2020
    
December 31,
 
2019
 
Assets:
        
Money market funds
     Level 1      $ 1,676      $ 16,775  
Short-term investments
     Level 2        90,642        74,510  
Mutual Funds
     Level 1        13,549        14,264  
Liabilities:
        
Contingent consideration
     Level 3                  2,696  
 
(1)
Investments were measured at carrying value as of December 31, 2019. See table below.
The following table presents information about the Company’s financial instruments that are not carried at fair value at June 30, 2020 and December 31, 2019 (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
    
Carrying
Amount
    
Fair

Value
    
Carrying
Amount
    
Fair

Value
 
Liabilities:
           
2023 Notes
     750,000        744,375        750,000        766,875  
2027 Notes
     1,000,000        1,000,000        1,000,000        1,025,600  
The carrying amounts of cash equivalents, accounts receivable and accounts payable and accrued expenses approximate fair value due to the short maturities of the respective instruments. The carrying value of the Company’s line of credit approximates fair value. If the Company’s line of credit was measured at fair value, it would be categorized as Level 2 in the fair value hierarchy.
 
5.
Accounts Receivable and Net Revenue:
Accounts receivable, net consists of the following (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
Gross accounts receivable
   $ 1,386,562      $ 1,943,664  
Allowance for contractual adjustments and uncollectibles
     (1,040,880      (1,444,795
  
 
 
    
 
 
 
   $ 345,682      $ 498,869  
  
 
 
    
 
 
 
Patient service revenue is recognized at the time services are provided by the Company’s affiliated physicians. The Company’s performance obligations related to the delivery of services to patients are satisfied at the time of service. Accordingly, there are no performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period with respect to patient service revenue. Almost all of the Company’s patient service revenue is reimbursed by government-sponsored healthcare programs (“GHC Programs”) and third-party insurance payors. Payments for services rendered to the Company’s patients are generally less than billed charges. The Company monitors its revenue and receivables from these sources and records an estimated contractual allowance to properly account for the anticipated differences between billed and reimbursed amounts.
 
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Accordingly, patient service revenue is presented net of an estimated provision for contractual adjustments and uncollectibles. The Company estimates allowances for contractual adjustments and uncollectibles on accounts receivable based upon historical experience and other factors, including days sales outstanding (“DSO”) for accounts receivable, evaluation of expected adjustments and delinquency rates, past adjustments and collection experience in relation to amounts billed, an aging of accounts receivable, current contract and reimbursement terms, changes in payor mix and other relevant information. Contractual adjustments result from the difference between the physician rates for services performed and the reimbursements by GHC Programs and third-party insurance payors for such services.
Collection of patient service revenue the Company expects to receive is normally a function of providing complete and correct billing information to the GHC Programs and third-party insurance payors within the various filing deadlines and typically occurs
within 30 to 60 days of billing.
Some of the Company’s hospital agreements require hospitals to pay the Company administrative fees. Some agreements provide for fees if the hospital does not generate sufficient patient volume in order to guarantee that the Company receives a specified minimum revenue level. The Company also receives fees from hospitals for administrative services performed by its affiliated physicians providing medical director or other services at the hospital.
The following table summarizes the Company’s net revenue by category (in thousands):
 
    
Three Months Ended

June 30,
    
Six Months Ended

June 30,
 
    
2020
    
2019
    
2020
    
2019
 
Net patient service revenue
   $ 428,473      $ 486,368      $ 919,431      $ 956,799  
Hospital contract administrative fees
     65,138        69,619        129,698        136,008  
Other revenue
     15,592        5,250        21,925        11,442  
  
 
 
    
 
 
    
 
 
    
 
 
 
   $ 509,203      $ 561,237      $ 1,071,054      $ 1,104,249  
  
 
 
    
 
 
    
 
 
    
 
 
 
The approximate percentage of net patient service revenue by type of payor was as follows:
 
    
Three Months Ended

June 30,
   
Six Months Ended

June 30,
 
    
2020
   
2019
   
2020
   
2019
 
Contracted managed care
     67     66     66     65
Government
     26       26       26       26  
Other third-parties
     6       7       6       7  
Private-pay
patients
     1       1       2       2  
  
 
 
   
 
 
   
 
 
   
 
 
 
     100     100     100     100
  
 
 
   
 
 
   
 
 
   
 
 
 
 
6.
Discontinued Operations:
Divestiture of Anesthesiology Medical Group
On May 6, 2020, the Company entered into a securities purchase agreement with an affiliate of North American Partners in Anesthesia (“NAPA”) to divest the Company’s anesthesiology medical group, and the transaction closed on May 6, 2020. Pursuant to the terms and conditions of the agreement, at the closing of the transaction, the Company received a cash payment of $50.0 million, subject to certain customary adjustments, as well as a contingent economic interest in NAPA with a value ranging from $0 to $250 million based upon the multiple of invested capital returned to NAPA’s owners upon exit of the investment. The Company will begin to receive a payment on its economic interest at an exit multiple of 2.0, with such payment reaching $250 million at an exit multiple of 5.0. In addition, the Company retained the accounts receivable of the anesthesiology medical group, which net of various other working capital items, approximated $110.0 million at March 31, 2020.
The operating results of the anesthesiology medical group service line were reported as a component of discontinued operations, net of income taxes, in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2020 and 2019.
The preliminary loss on sale recorded during the three months ended June 30, 2020 was
 
$644.2 million.
Upon completion of a valuation for the contingent economic interest and working capital true-up, final net proceeds will be determined, and the Company will adjust the loss on sale at that time. As a result of the sale, the Company currently estimates that it will generate an approximately $1.68 billion capital loss carryforward which expires in 2025. Based on management’s determination that it is more likely than not that the tax benefits related to this loss carryforward will not be realized, the Company has provided an approximately $419.0 million valuation allowance against this deferred tax asset in its financial results for the three months ended June 30, 2020.
The following table summarizes the results of discontinued operations related to the anesthesiology medical group for the three and six months ended June 30, 2020 and 2019 (in thousands):
 
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Table of Contents
 
    
Three Months Ended

June 30,
   
Six Months Ended

June 30,
 
    
2020
   
2019
   
2020
   
2019
 
Net revenue
   $ 90,894     $ 307,072     $ 374,961     $ 615,243  
  
 
 
   
 
 
   
 
 
   
 
 
 
Operating expenses:
        
Cost of service salaries and benefits
     95,398       247,759       348,662       498,930  
Cost of service supplies and other operating expenses
     1,350       3,233       5,216       6,700  
General and administrative expenses
     13,287       19,321       30,964       39,571  
Depreciation and amortization
     2,034       6,030       6,308       12,258  
Transformational and restructuring related expenses
     16,771       9,616       28,634       10,721  
Loss on sale, net
     644,162                640,154           
  
 
 
   
 
 
   
 
 
   
 
 
 
Total operating expenses
     773,002       285,959       1,059,938       568,180  
  
 
 
   
 
 
   
 
 
   
 
 
 
(Loss) income from operations
     (682,108     21,113       (684,977     47,063  
Non-operating
(expense) income, net
     (7     (14     51       3  
  
 
 
   
 
 
   
 
 
   
 
 
 
(Loss) income before income taxes
     (682,115     21,099       (684,926     47,066  
Income tax benefit (provision)
     5,111       (5,630     5,561       (12,490
  
 
 
   
 
 
   
 
 
   
 
 
 
Net (loss) income
   $ (677,004   $ 15,469     $ (679,365   $ 34,576  
  
 
 
   
 
 
   
 
 
   
 
 
 
Divestiture of MedData
During the three
 and six
months ended June 30, 2020, the Company recorded a net incremental loss on the sale of MedData of $3.0 million
 and
$5.6 
million, respectively, primarily for the finalization of certain transaction related expenses, a working capital true-up and incremental reserves related to indemnification matters, partially offset by the completion of its preliminary valuation for the contingent economic consideration. This incremental loss is reflected as a component of discontinued operations, net of income taxes, in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2020. The operating results of MedData were reported as a component of discontinued operations, net of income taxes, in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2019.
 
7.
Accounts Payable and Accrued Expenses: 
Accounts payable and accrued expenses consist of the following (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
Accounts payable
   $ 48,982      $ 38,598  
Accrued salaries and bonuses
     131,739        223,815  
Accrued payroll taxes and benefits
     43,087        61,130  
Accrued professional liabilities
     57,466        44,869  
Accrued interest
     32,679        32,910  
Other accrued expenses
     46,956        51,788  
  
 
 
    
 
 
 
   $ 360,909      $ 453,110  
  
 
 
    
 
 
 
The net decrease in accrued salaries and bonuses of $92.1 million, from December 31, 2019 to June 30, 2020, is primarily due to the payment of performance-based incentive compensation, principally to the Company’s affiliated physicians, partially offset by performance-based incentive compensation accrued during the six months ended June 30, 2020. A majority of the Company’s payments for performance-based incentive compensation is paid annually during the first quarter.
 
8.
Common and Common Equivalent Shares:
Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the period. Diluted net income per common share is calculated by dividing net income by the weighted average number of common and potential common shares outstanding during the period. Potential common shares consist of outstanding restricted stock, deferred stock and stock options and is calculated using the treasury stock method.
The calculation of shares used in the basic and diluted net income per common share calculation for the three and six months ended June 30, 2020 and 2019 is as follows (in thousands):
 
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Table of Contents
    
Three Months Ended

June 30,
    
Six Months
 
Ended

June 30,
 
    
2020
    
2019
    
2020
    
2019
 
Weighted average number of common shares outstanding
     83,490        83,234        83,061        84,623  
Weighted average number of dilutive common share equivalents
     255        455        —          464  
  
 
 
    
 
 
    
 
 
    
 
 
 
Weighted average number of common and common equivalent
 
shares outstanding (a)
     83,745        83,689        83,061        85,087  
  
 
 
    
 
 
    
 
 
    
 
 
 
Antidilutive securities not included in the diluted net income per
 
common share calculation
     1,335        923        1,092        713  
  
 
 
    
 
 
    
 
 
    
 
 
 
 
(a)
Due to a loss from continuing operations for the six months ended June 30, 2020, no incremental shares are included because the effect would be antidilutive.
 
9.
Stock Incentive Plans and Stock Purchase Plans:
The Company’s Amended and Restated 2008 Incentive Compensation Plan (the “A&R 2008 Incentive Plan”) provides for grants of stock options, stock appreciation rights, restricted stock, deferred stock, and other stock-related awards and performance awards that may be settled in cash, stock or other property.
Under the
 
A&R
2008 Incentive Plan, options to purchase shares of common stock may be granted at a price not less than the fair market value of the shares on the date of grant. The options must be exercised within 10 years from the date of grant and generally become exercisable on a pro rata basis over a three-year period from the date of grant. The Company issues new shares of its common stock upon exercise of its stock options. Restricted stock awards generally vest over periods of three years upon the fulfillment of specified service-based conditions and in certain instances performance-based conditions. Deferred stock awards generally vest upon the satisfaction of specified performance-based conditions and service-based conditions. The Company recognizes compensation expense related to its restricted stock and deferred stock awards ratably over the corresponding vesting periods. During the six months ended June 30, 2020, the Company granted 1.1 million shares of restricted stock to its employees and
non-employee
directors under the
A&R
2008 Incentive Plan. At June 30, 2020, the Company had 6.3 million shares available for future grants and awards under the
A&R
2008 Incentive Plan.
Under the Company’s 1996
Non-Qualified
Employee Stock Purchase Plan, as amended (the “ESPP”), employees are permitted to purchase the Company’s common stock at 85% of market value on January 1st, April 1st, July 1st and October 1st of each year. Under the Company’s 2015
Non-Qualified
Stock Purchase Plan (the “SPP”), certain eligible
non-employee
service providers are permitted to purchase the Company’s common stock at 90% of market value on January 1st, April 1st, July 1st and October 1st of each year.
Each of the ESPP and the SPP provide for the issuance of an aggregate of 2.6 million shares of the Company’s common stock less the number of shares of common stock purchased under the other plan. The Company recognizes stock-based compensation expense for the discount received by participating employees and
non-employee
service providers. During the six months ended June 30, 2020, approximately 0.4 million shares in
the
aggregate were issued under the ESPP and SPP. At June 30, 2020, the Company had approximately 0.7 million shares in
the
aggregate reserved for issuance under the ESPP and SPP.
During the three and six months ended June 30, 2020 and 2019, the Company recognized stock-based compensation expense of $6.6 million and $14.3 million, and $9.9 million and $20.9 million, respectively.
 
10.
Common Stock Repurchase Programs:
In July 2013, the Company’s Board of Directors authorized the repurchase of shares of the Company’s common stock up to an amount sufficient to offset the dilutive impact from the issuance of shares under the Company’s equity compensation programs. The share repurchase program allows the Company to make open market purchases from
time-to-time
based on general economic and market conditions and trading restrictions. The repurchase program also allows for the repurchase of shares of the Company’s common stock to offset the dilutive impact from the issuance of shares, if any, related to the Company’s acquisition program. No shares were purchased under this program during the six months ended June 30, 2020.
In August 2018, the Company announced that its Board of Directors had authorized the repurchase of up to $500.0 million of the Company’s common stock in addition to its existing share repurchase program, of which $107.2 million remained available for repurchase as of December 31, 2019. Under this share repurchase program, during the six months ended June 30, 2020, the Company withheld approximately 159,000 shares of its common stock to satisfy minimum statutory withholding obligations of $3.0 million in connection with the vesting of restricted stock.
The Company intends to utilize various methods to effect any future share repurchases, including, among others, open market purchases and accelerated share repurchase programs. The amount and timing of repurchases will depend upon several factors, including general economic and market conditions and trading restrictions.
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11.
Commitments and Contingencies:
The Company expects that audits, inquiries and investigations from government authorities and agencies will occur in the ordinary course of business. Such audits, inquiries and investigations and their ultimate resolutions, individually or in the aggregate, could have a material adverse effect on the Company’s business, financial condition, results of operations, cash flows and the trading price of its securities. The Company has not included an accrual for these matters as of June 30, 2020 in its Consolidated Financial Statements, as the variables affecting any potential eventual liability depend on the currently unknown facts and circumstances that arise out of, and are specific to, any particular future audit, inquiry and investigation and cannot be reasonably estimated at this time.
In the ordinary course of business, the Company becomes involved in pending and threatened legal actions and proceedings, most of which involve claims of medical malpractice related to medical services provided by the Company’s affiliated physicians. The Company’s contracts with hospitals generally require the Company to indemnify them and their affiliates for losses resulting from the negligence of the Company’s affiliated physicians. The Company may also become subject to other lawsuits which could involve large claims and significant costs. The Company believes, based upon a review of pending actions and proceedings, that the outcome of such legal actions and proceedings will not have a material adverse effect on its business, financial condition, results of operations, cash flows and the trading price of its securities. The outcome of such actions and proceedings, however, cannot be predicted with certainty and an unfavorable resolution of one or more of them could have a material adverse effect on the Company’s business, financial condition, results of operations, cash flows and the trading price of its securities.
Although the Company currently maintains liability insurance coverage intended to cover professional liability and certain other claims, the Company cannot assure that its insurance coverage will be adequate to cover liabilities arising out of claims asserted against it in the future where the outcomes of such claims are unfavorable. With respect to professional liability risk, the Company generally self-insures a portion of this risk through its wholly owned captive insurance subsidiary. Liabilities in excess of the Company’s insurance coverage, including coverage for professional liability and certain other claims, could have a material adverse effect on the Company’s business, financial condition, results of operations, cash flows and the trading price of its securities.
 
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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The following discussion highlights the principal factors that have affected our financial condition and results of operations, as well as our liquidity and capital resources, for the periods described. This discussion should be read in conjunction with the unaudited Consolidated Financial Statements and the notes thereto included in this Quarterly Report. In addition, reference is made to our audited consolidated financial statements and notes thereto and related Management’s Discussion and Analysis of Financial Condition and Results of Operations included in our Annual Report on Form
10-K
for the fiscal year ended December 31, 2019, filed with the Securities and Exchange Commission on February 20, 2020 (the “2019 Form
10-K”).
As used in this Quarterly Report, the terms “MEDNAX”, the “Company”, “we”, “us” and “our” refer to the parent company, MEDNAX, Inc., a Florida corporation, and the consolidated subsidiaries through which its businesses are actually conducted (collectively, “MDX”), together with MDX’s affiliated business corporations or professional associations, professional corporations, limited liability companies and partnerships (“affiliated professional contractors”). Certain subsidiaries of MDX have contracts with our affiliated professional contractors, which are separate legal entities that provide physician services in certain states and Puerto Rico. The following discussion contains forward-looking statements. Please see the Company’s 2019 Form
10-K,
including Item 1A, Risk Factors, and Item 1A. Risk Factors below, for a discussion of the uncertainties, risks and assumptions associated with these forward-looking statements. In addition, please see “Caution Concerning Forward-Looking Statements” below.
Overview
MEDNAX is a leading provider of physician services including newborn, maternal-fetal, radiology and teleradiology, pediatric cardiology and other pediatric subspecialty care. Our national network is comprised of affiliated physicians who provide clinical care in all 50 states, the District of Columbia and Puerto Rico. Our affiliated physicians provide neonatal clinical care, primarily within hospital-based neonatal intensive care units, to babies born prematurely or with medical complications; radiology services including diagnostic imaging and interventional radiology; and maternal-fetal and obstetrical medical care to expectant mothers experiencing complicated pregnancies primarily in areas where our affiliated neonatal physicians practice. Our network also includes other pediatric subspecialists, including those who provide pediatric intensive care, pediatric cardiology care, hospital-based pediatric care, pediatric surgical care, pediatric ear, nose and throat, pediatric ophthalmology and pediatric urology services. MEDNAX also provides radiology services including diagnostic imaging and interventional radiology, through a network of affiliated physicians, as well as teleradiology services through a network of affiliated radiologists. In addition to our national physician network, we provide services nationwide to healthcare facilities and physicians, including ours, through a consulting services company. MEDNAX divested its anesthesiology medical group on May 6, 2020.
Coronavirus Pandemic
(COVID-19)
COVID-19
and related “stay at home” and social distancing measures implemented across the country have significantly impacted demand for medical services provided by our affiliated clinicians. Beginning in
mid-March
2020, we experienced a significant decline in the number of elective surgeries at the facilities where our affiliated clinicians provided anesthesia services. Much of this decline was due to the closure of operating suites or facilities following federal advisories to cancel
non-urgent
procedures and the prohibition of such procedures by several states. Within our radiology service line, orders for radiological studies have declined by a meaningful amount from historically normal levels, with much of this reduction focused in
non-urgent
studies. Our affiliated office-based practices, which specialize in maternal-fetal medicine, pediatric cardiology, and numerous pediatric subspecialties, have seen a significant elevation of appointment cancellations compared to historical normal levels. At this time, we have not experienced, nor do we currently anticipate, any significant impact to neonatal intensive care unit (NICU) patient volumes as a result of
COVID-19.
Overall, our operating results since
mid-March
2020 have been significantly impacted by the
COVID-19
pandemic, but volumes did begin to normalize in May 2020 and substantially recovered during the month of June 2020. We also divested our anesthesiology medical group in May 2020, where operating results were significantly impacted by
COVID-19.
We implemented a number of actions to preserve financial flexibility and partially mitigate the significant impact of
COVID-19.
These steps included a suspension of most activities related to our transformational and restructuring programs, limiting these expenditures to those that provide essential support for our response to
COVID-19.
In addition, (i) we temporarily reduced executive and key management base salaries, including 50% reductions in salaries for our named executive officers through June 30, 2020; (ii) our Board of Directors agreed to forego their annual cash retainer and cash meeting payments, also through June 30, 2020; (iii) we enacted a combination of salary reductions and furloughs for
non-clinical
employees; and (iv) we enacted significant operational and practice-specific expense reduction plans across our clinical operations.
We also implemented a variety of solutions across specialties to support clinicians and patients during this pandemic, including
 
   
Clinician Shortage Support
Pediatric clinicians are lending their expertise to help fulfill the need for added adult care.
 
   
Strengthening of Supply Chain
MEDNAX is helping to address the shortage of personal protective equipment (PPE) by partnering with vendors across industries to source high filtration respirators, surgical masks and other forms of PPE for protective use.
 
   
Expanded Virtual Care Offerings
Utilizing VSee, an internationally recognized telehealth platform, MEDNAX has deployed a national multi-specialty virtual clinic to expand its telehealth offerings and make virtual care available to its clinical workforce, enabling continued patient consults and clinician collaboration while minimizing
COVID-19
exposure.
 
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Early Virus Detection Using Cutting-Edge Imaging Diagnostic Tools
MEDNAX Radiology Solutions is leading early detection efforts through chest imaging. vRad, a MEDNAX company, diagnosed one of the first
COVID-19
patients in the United States via chest computed tomography (“CT”), which showed findings consistent with a severe acute respiratory viral infection. In the absence of laboratory testing kits, chest CT can serve as a diagnostic tool. In addition, MEDNAX Radiology Solutions is refining natural language processing (“NLP”) to identify the incidence of viral pneumonia and typical findings of the
COVID-19
virus in the lungs via chest CT across the proprietary MEDNAX Imaging Platform and inference engine, which is connected to more than 2,000 partner facilities across the country. The NLP is run retrospectively to monitor the amount and rate of increase of suspected chest CT findings for
COVID-19
and viral pneumonia, supporting faster treatment. If successful, this cutting-edge diagnostic tool could serve as an effective tracker of the disease’s progression throughout the country and provide new insights for imaging findings for
COVID-19
patients.
 
   
Virtual Forum to Provide Clinician Support
To support frontline clinicians while abiding by social distancing recommendations, MEDNAX has created a virtual doctors’ lounge for clinicians across specialties to connect and socialize in the absence of typical
in-person
lounges, helping to boost morale and preserve a sense of normalcy.
We currently expect that
COVID-19
will materially impact our financial results, but due to the rapidly evolving environment and continued uncertainties surrounding the timeline of and impacts from
COVID-19,
we are unable to predict the ultimate impact on our business, financial condition, results of operations, cash flows and the trading price of our securities at this time.
CARES Act
On March 27, 2020, President Trump signed the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) into law. The CARES Act is a relief package intended to assist many aspects of the American economy, including providing up to $100 billion in aid to the healthcare industry to reimburse healthcare providers for lost revenue and expenses attributable to
COVID-19.
The remaining $70 billion in aid is intended to focus on providers in areas particularly impacted by
COVID-19,
rural providers, providers of services with lower shares of Medicare reimbursement or who predominantly serve the Medicaid population, and providers requesting reimbursement for the treatment of uninsured Americans. It is unknown what, if any, portion of the remaining healthcare industry funding on the CARES Act our affiliated physician practices will qualify for and receive.     The Department of Health and Human Services (“HHS”) is administering this program and began disbursing funds in April 2020, of which our affiliated physician practices received an aggregate of approximately $12 million during the second quarter of 2020. We have applications pending for certain affiliated physician practices for incremental relief beyond what has been received.
In addition, the CARES Act also provides for deferred payment of the employer portion of social security taxes through the end of 2020, with 50% of the deferred amount due December 31, 2021 and the remaining 50% due December 31, 2022. We intend to utilize this deferral option throughout 2020.
Divestiture of the Anesthesiology Medical Group
On May 6, 2020, we entered into a securities purchase agreement with an affiliate of North American Partners in Anesthesia (“NAPA”) to divest our anesthesiology medical group, and the transaction closed on May 6, 2020. Pursuant to the terms and conditions of the agreement, at the closing of the transaction, we received a cash payment of $50.0 million, subject to certain customary adjustments, as well as a contingent economic interest in NAPA with a value ranging from $0 to $250 million based upon the multiple of invested capital returned to NAPA’s owners upon exit of the investment. The operating results of the anesthesiology medical group were reported as discontinued operations in our consolidated statements of income for the three and six months ended June 30, 2020 and 2019, and the net assets sold were presented as assets and liabilities held for sale in our consolidated balance sheet for the year ended December 31, 2019.
Planned Divestiture of MEDNAX Radiology Solutions
In June 2020, we announced our initiation of a process to divest our radiology services medical group when market conditions are appropriate in order to refocus the business as a dedicated pediatrics and obstetrics organization. However, there can be no assurance that this process will result in a transaction.
Reclassifications
Reclassifications have been made to certain prior period financial statements and footnote disclosures to conform to the current period presentation, specifically to reflect the impact of the anesthesiology medical group being classified as assets held for sale and discontinued operations.
General Economic Conditions and Other Factors
Our operations and performance depend significantly on economic conditions. During the three months ended June 30, 2020, the percentage of our patient service revenue being reimbursed under government-sponsored healthcare programs (“GHC Programs”) decreased slightly as compared to the three months ended June 30, 2019. Economic conditions in the United States (“U.S.”) have deteriorated, primarily as a result of
COVID-19,
and patient volumes have declined. We could experience shifts toward GHC Programs if changes occur in population demographics within geographic locations in which we provide services, including an increase in unemployment and underemployment as well as losses of commercial health insurance. Payments received from GHC Programs are substantially less for equivalent services than payments received from commercial insurance payors. In addition, due to the rising costs of managed care premiums and patient responsibility amounts, we may experience lower net revenue resulting from increased bad debt due to patients’ inability to pay for certain services.
 
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Transformation and Restructuring Initiatives
We have developed a number of strategic initiatives across our organization, in both our shared services functions and our operational infrastructure, with a goal of generating improvements in our general and administrative expenses and our operational infrastructure. We have broadly classified these workstreams in four broad categories including practice operations, revenue cycle management, information technology and human resources. We have included the expenses, which in certain cases represent estimates, related to such activity on a separate line item in our consolidated statements. In our shared services departments, we were focused on improving processes, using our resources more efficiently and utilizing our scale more effectively to improve cost and service performance across our operations. Within our operational infrastructure, we developed specific operational plans within each of our service lines and affiliated physician practices, with specific milestones and regular reporting, with the goal of generating long-term operational improvements and fostering even greater collaboration across our national medical group. We intended to make a series of information-technology and other investments to improve processes and performance across our enterprise, using both internal and external resources. A significant amount of transformational and restructuring activities were related to our anesthesiology medical group, which was divested in May 2020. We believed these strategic initiatives, together with our continued plans to invest in focused, targeted and strategic organic and acquisitive growth, positioned us well to deliver a differentiated value proposition to our stakeholders while continuing to provide the highest quality care for our patients.
We originally expected these activities to continue through at least 2020. However, as discussed above, beginning in April 2020, we reduced the scope of our transformation and restructuring related initiatives unless they are initiatives that provide essential support for our response to
COVID-19.
Healthcare Reform
The Patient Protection and Affordable Care Act (the “ACA”) contains a number of provisions that have affected us and, absent amendment or repeal, may continue to affect us over the next several years. These provisions include the establishment of health insurance exchanges to facilitate the purchase of qualified health plans, expanded Medicaid eligibility, subsidized insurance premiums and additional requirements and incentives for businesses to provide healthcare benefits. Other provisions have expanded the scope and reach of the Federal Civil False Claims Act and other healthcare fraud and abuse laws. Moreover, we could be affected by potential changes to various aspects of the ACA, including changes to subsidies, healthcare insurance marketplaces and Medicaid expansion.
The ACA remains subject to continuing legislative and administrative flux and uncertainty. In 2017, Congress unsuccessfully sought to replace substantial parts of the ACA with different mechanisms for facilitating insurance coverage in the commercial and Medicaid markets. Congress may again attempt to enact substantial or target changes to the ACA in the future. Additionally, Centers for Medicare & Medicaid Services (“CMS”) has administratively revised a number of provisions and may seek to advance additional significant changes through regulation, guidance and enforcement in the future.
At the end of 2017, Congress repealed the part of the ACA that required most individuals to purchase and maintain health insurance or face a tax penalty, known as the individual mandate. In light of these changes, in December 2018, a federal district court in Texas declared that key portions of the ACA were inconsistent with the U.S. Constitution and that the entire ACA is invalid as a result. Several states appealed this decision, and in December 2019, a federal court of appeals upheld the district court’s conclusion that part of the ACA is unconstitutional but remanded for further evaluation whether in light of this defect the entire ACA must be invalidated. These legal proceedings are likely to continue for several years, and the fate of the ACA will be unresolved and uncertain during this period. Actions by the court of appeals or eventually the Supreme Court of the United States could invalidate portions or all of the ACA. Changes resulting from these proceedings could have a material impact on our business. In the meantime, it also is possible that as a result of these actions, enrollment in healthcare exchanges could decline.
In 2020, there will be federal and state elections that could affect which persons and parties occupy the Office of the President of the United States, control one or both chambers of Congress and many states’ governors and legislatures. Some candidates running for President of the United States are proposing sweeping changes to the U.S. healthcare system, including expanding government-funded healthcare insurance options. Any legislative or administrative change to the current healthcare financing system could have a material adverse effect on our financial condition, results of operations, cash flows and the trading price of our securities.
If the ACA is repealed or further substantially modified by judicial, legislative or administrative action, or if implementation of certain aspects of the ACA are diluted, delayed or replaced with a “Medicare for All” or single payor system, such repeal, modification or delay may impact our business, financial condition, results of operations, cash flows and the trading price of our securities. We are unable to predict the impact of any repeal, modification or delay in the implementation of the ACA, including the repeal of the individual mandate or implementation of a single payor system, on us at this time.
In addition to the potential impacts to the ACA, there could be changes to other GHC Programs, such as a change to the structure of Medicaid. Congress and the Administration have sought to convert Medicaid into a block grant or to institute “per capita spending caps”, among other things. These changes, if implemented, could eliminate the guarantee that everyone who is eligible and applies for benefits would receive them and could potentially give states new authority to restrict eligibility, cut benefits and make it more difficult for people to enroll. Additionally, several states are considering and pursuing changes to their Medicaid programs, such as requiring recipients to engage in employment or education activities as a condition of eligibility for most adults, disenrolling recipients for failure to pay a premium, or adjusting premium amounts based on income.
 
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As a result, we cannot predict with any assurance the ultimate effect of these laws and resulting changes to payments under GHC Programs, nor can we provide any assurance that they will not have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities. Further, any fiscal tightening impacting GHC Programs or changes to the structure of any GHC Programs could have a material adverse effect on our financial condition, results of operations, cash flows and the trading price of our securities.
The Medicare Access and CHIP Reauthorization Act
The Medicare Access and CHIP Reauthorization Act (“MACRA”) requires physicians to choose to participate in one of two payment formulas, Merit-Based Incentive Payment System (“MIPS”) or Alternative Payment Models (“APMs”). Beginning in 2020, MIPS allows eligible physicians to receive incentive payments based on the achievement of certain quality and cost metrics, among other measures, and be reduced for those who are underperforming against those same metrics and measures. As an alternative, physicians can choose to participate in an advanced APM, and physicians who are meaningful participants in APMs will receive bonus payments from Medicare pursuant to the law. MACRA also remains subject to review and potential modification by Congress, as well as shifting regulatory requirements established by CMS. We currently anticipate that our affiliated physicians will continue to be eligible to receive bonus payments in 2020 through participation in the MIPS, although the amounts of such bonus payments are not expected to be material. We will continue to operationalize the provisions of MACRA and assess any further changes to the law or additional regulations enacted pursuant to the law.
We cannot predict the ultimate effect that these changes will have on us, nor can we provide any assurance that its provisions will not have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities.
Medicaid Expansion
The ACA also allows states to expand their Medicaid programs through federal payments that fund most of the cost of increasing the Medicaid eligibility income limit from a state’s historic eligibility levels to 133% of the federal poverty level. To date, 37 states and the District of Columbia have expanded Medicaid eligibility to cover this additional
low-income
patient population, and other states are considering expansion. All of the states in which we operate, however, already cover children in the first year of life and pregnant women if their household income is at or below 133% of the federal poverty level.
“Surprise” Billing Legislation
“Surprise” medical bills arise when an insured patient receives care from an
out-of-network
provider resulting in costs that were not expected by the patient. The bill is a “surprise” either because the patient did not expect to receive care from an
out-of-network
provider, or because their cost-sharing responsibility is higher than the patient expected. For the past several years, state legislatures have been enacting laws that are intended to address the problems associated with surprise billing or balance billing.
More recently, Congress and President Trump have proposed bipartisan solutions to address this circumstance, either by working in tandem with, or in the absence of, applicable state laws. Several committees of jurisdiction in the U.S. House of Representatives and in the U.S. Senate have proposed solutions to address surprise medical bills, but it is unclear whether any of the proposed solutions will become law. In addition, state legislatures and regulatory bodies continue to address and modify existing laws on the same issue. Any state or federal legislation on the topic of surprise billing may have an unfavorable impact on
out-of-network
reimbursement that we receive. In addition, actual or prospective legislative changes in this area may impact, and may have impacted, our ability to contract with private payors at favorable reimbursement rates or remain in contract with such payors.
Although our
out-of-network
revenue is currently not material, we cannot predict the ultimate effect that these changes will have on us, nor can we provide any assurance that future legislation or regulations will not have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities.
Medicare Sequestration
The Budget Control Act of 2011, as amended by the American Taxpayer Relief Act of 2012, required
across-the-board
cuts (“sequestrations”) to Medicare reimbursement rates. These annual reductions of 2%, on average, apply to mandatory and discretionary spending through 2025. Unless Congress acts in the future to modify these sequestrations, Medicare reimbursements will be reduced by 2%, on average, annually. In connection with the CARES Act, the Medicare sequestrations were suspended beginning on May 1, 2020 and are expected to remain suspended through December 31, 2020. Aside from the suspension, the reduction in Medicare reimbursement rates is not expected to have a material adverse effect on our business, financial condition, results of operations, cash flows or the trading price of our securities.
Non-GAAP
Measures
In our analysis of our results of operations, we use certain
non-GAAP
financial measures. We have incurred and anticipate we will continue to incur certain expenses related to transformational and restructuring related expenses that are expected to be project-based and periodic in nature. Accordingly, beginning with the first quarter of 2019, we began reporting Adjusted earnings before interest, taxes and depreciation and amortization (“EBITDA”) from continuing operations, defined as income (loss) from continuing operations before interest, taxes, depreciation and amortization, and transformational and restructuring related expenses. Adjusted earnings per share (“Adjusted EPS”) from continuing operations has also been further adjusted for these items and beginning with the first quarter of 2019 consists of diluted income (loss) from continuing operations per common and common equivalent share adjusted for amortization expense, stock-based compensation expense and transformational and restructuring related expenses. Adjusted EPS from continuing operations is being further adjusted to reflect the impacts from discrete tax events.
 
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We believe these measures, in addition to income (loss) from continuing operations, net income (loss) and diluted net income (loss) from continuing operations per common and common equivalent share, provide investors with useful supplemental information to compare and understand our underlying business trends and performance across reporting periods on a consistent basis. These measures should be considered a supplement to, and not a substitute for, financial performance measures determined in accordance with GAAP. In addition, since these
non-GAAP
measures are not determined in accordance with GAAP, they are susceptible to varying calculations and may not be comparable to other similarly titled measures of other companies.
For a reconciliation of each of Adjusted EBITDA from continuing operations and Adjusted EPS from continuing operations to the most directly comparable GAAP measures for the three and six months ended June 30, 2020 and 2019, refer to the tables below (in thousands, except per share data).
 
    
Three Months Ended

June 30,
    
Six Months Ended

June 30,
 
    
2020
    
2019
    
2020
    
2019
 
Income (loss) from continuing operations
   $ 7,600      $ 20,047      $ (6,149    $ 42,593  
Interest expense
     28,265        31,063        55,931        61,764  
Income tax provision
     3,373        11,486        6,109        13,588  
Depreciation and amortization
     14,393        13,779        28,792        27,584  
Transformational and restructuring related expenses
     11,537        17,866        30,581        20,305  
  
 
 
    
 
 
    
 
 
    
 
 
 
Adjusted EBITDA from continuing operations
   $ 65,168      $ 94,241      $ 115,264      $ 165,834  
  
 
 
    
 
 
    
 
 
    
 
 
 
 
    
Three Months Ended

June 30,
 
    
2020
    
2019
 
Weighted average diluted shares outstanding
     83,745        83,689  
Income from continuing operations and diluted income from continuing operations per share
   $ 7,600      $ 0.09      $ 20,047      $ 0.24  
Adjustments
(1)
:
           
Amortization (net of tax of $1,731 and $1,655)
     5,193        0.06        4,964        0.06  
Stock-based compensation (net of tax of $1,658 and $2,477)
     4,973        0.06        7,430        0.09  
Transformational and restructuring related expenses (net of tax of $2,884 and $4,467)
     8,653        0.11        13,400        0.16  
Net impact from discrete tax events
     171        —          2,987        0.03  
  
 
 
    
 
 
    
 
 
    
 
 
 
Adjusted income and diluted EPS from continuing operations
   $ 26,590      $ 0.32      $ 48,828      $ 0.58  
  
 
 
    
 
 
    
 
 
    
 
 
 
 
(1)
Our blended statutory tax rate of 25% was used to calculate the tax effects of the adjustments for the three months ended June 30, 2020 and 2019.
 
    
Six Months Ended

June 30,
 
    
2020
    
2019
 
Weighted average diluted shares outstanding
     83,061        85,087  
(Loss) income from continuing operations and diluted income from continuing operations per share
   $ (6,149    $ (0.07    $ 42,593      $ 0.50  
Adjustments
(1)
:
           
Amortization (net of tax of $3,454 and $3,328)
     10,363        0.12        9,984        0.12  
Stock-based compensation (net of tax of $3,579 and $5,214)
     10,738        0.13        15,639        0.18  
Transformational and restructuring related expenses (net of tax of $7,645 and $5,076)
     22,936        0.28        15,229        0.18  
Net impact from discrete tax events
     5,028        0.06        (1,601      (0.02
  
 
 
    
 
 
    
 
 
    
 
 
 
Adjusted income and diluted EPS from continuing operations
   $ 42,916      $ 0.52      $ 81,844      $ 0.96  
  
 
 
    
 
 
    
 
 
    
 
 
 
 
(2)
Our blended statutory tax rate of 25% was used to calculate the tax effects of the adjustments for the six months ended June 30, 2020 and 2019.
 
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Results of Operations
Three Months Ended June 30, 2020 as Compared to Three Months Ended June 30, 2019
Our net revenue attributable to continuing operations was $509.2 million for the three months ended June 30, 2020, as compared to $561.2 million for the same period in 2019. The decrease in revenue of $52.0 million, or 9.3%, was primarily attributable to the unfavorable impacts from
COVID-19
on same-unit revenue, driven by declines in volume. Same units are those units at which we provided services for the entire current period and the entire comparable period. Same-unit net revenue declined by $65.3 million, or 11.7%. The decline in same-unit net revenue was comprised of a decrease of $66.2 million, or 11.9%, related to patient service volumes, partially offset by a net increase of $0.9 million, or 0.2%, from net reimbursement-related factors. The decrease in revenue from patient service volumes was related to a decline across all our services, primarily as a result of
COVID-19.
The net increase in revenue related to net reimbursement-related factors was primarily due to CARES Act relief, modest improvements in managed care contracting and an increase in revenue caused by a decrease in the percentage of our patients enrolled in GHC programs, partially offset by unfavorable net rate impacts from radiology services.
Practice salaries and benefits attributable to continuing operations decreased $11.9 million, or 3.3%, to $349.3 million for the three months ended June 30, 2020, as compared to $361.2 million for the same period in 2019. This decrease was primarily attributable to decreases in salary expense, including salary reductions and cessation of contract labor, related to the
COVID-19
mitigation initiatives. Of the $11.9 million decrease, $24.4 million was related to salaries, partially offset by an increase of $12.5 million for benefits and incentive compensation. Notwithstanding the salary expense decreases related to the
COVID-19
mitigation initiatives, we anticipate that we will experience a higher rate of growth in clinician compensation expense and malpractice expense at our existing units over historic averages, which could adversely affect our business, financial condition, results of operations, cash flows and the trading price of our securities.
Practice supplies and other operating expenses attributable to continuing operations decreased $3.4 million, or 13.5%, to $21.4 million for the three months ended June 30, 2020, as compared to $24.8 million for the same period in 2019. The decrease was primarily attributable to decreases in other practice operating expenses as compared to the prior year, primarily related to decreased activity across many expense categories such as travel, office expenses and professional services resulting from impacts of
COVID-19.
General and administrative expenses attributable to continuing operations primarily include all billing and collection functions and all other salaries, benefits, supplies and operating expenses not specifically identifiable to the
day-to-day
operations of our physician practices and services. General and administrative expenses were $77.7 million for the three months ended June 30, 2020, as compared to $84.2 million for the same period in 2019. The decrease of $6.5 million was primarily related to salary reductions and furloughs resulting from our
COVID-19
mitigation initiatives, partially offset by increases in other expense categories, primarily legal expenses. General and administrative expenses as a percentage of net revenue was 15.3% for the three months ended June 30, 2020, as compared to 15.0% for the same period in 2019. Certain general and administrative expenses related to corporate overhead represent various support services provided across the company, including costs that are continuing to support the recently divested anesthesiology medical group through a transition services agreement. Because a portion of such expenses were previously allocated to but not specifically identifiable to, the anesthesiology medical group, they are required to be presented as continuing operations. Therefore, general and administrative expenses do not reflect potential general and administrative cost savings that may be achieved in future periods.
Transformational and restructuring related expenses attributable to continuing operations were $11.5 million for the three months ended June 30, 2020, as compared to $17.9 million for the same period in 2019. The expenses were primarily for external consulting costs for various process improvement and restructuring initiatives. Beginning in April 2020, we reduced the scope of our transformation and restructuring related initiatives unless they were initiatives critical to our business operations or those that provide essential support for our response to
COVID-19.
Depreciation and amortization expense attributable to continuing operations was $14.4 million for the three months ended June 30, 2020, as compared to $13.8 million for the same period in 2019.
Income from operations attributable to continuing operations decreased $24.5 million, or 41.2%, to $34.9 million for the three months ended June 30, 2020, as compared to $59.4 million for the same period in 2019. Our operating margin was 6.9% for the three months ended June 30, 2020, as compared to 10.6% for the same period in 2019. The decrease in our operating margin was primarily due to the decrease in revenue related to
COVID-19,
partially offset by lower operating expense growth, including lower transformation and restructuring related expenses, primarily related to
COVID-19
mitigation initiatives. Excluding transformation and restructuring expenses, our income from operations attributable to continuing operations for the three months ended June 30, 2020 and 2019 was $46.4 million and $77.3 million, respectively, and our operating margin was 9.1% and 13.8%, respectively. We believe excluding the impacts from the transformational and restructuring related activity provides a more comparable view of our operating income and operating margin from continuing operations; however, this comparison is affected by the impacts from
COVID-19
during 2020.
Total
non-operating
expenses attributable to continuing operations were $23.9 million for the three months ended June 30, 2020, as compared to $27.9 million for the same period in 2019. The decrease in
non-operating
expenses was primarily related to a decrease in interest expense, primarily due to lower average borrowings under our credit agreement (the “Credit Agreement”) and other income related to the transition services being provided to the buyer of the anesthesiology medical group, partially offset by a decrease in equity earnings resulting from the impacts to the underlying joint venture from
COVID-19.
 
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Our effective income tax rate attributable to continuing operations was 30.7% and 36.4% for the three months ended June 30, 2020 and 2019, respectively. Income taxes for the second quarter of 2020 were calculated by applying the actual
year-to-date
effective rate to our
pre-tax
income. After excluding discrete tax impacts, during the three months ended June 30, 2020 and 2019, our effective income tax rate was 29.2% and 27.0%, respectively. We believe excluding discrete tax impacts on our effective income tax rate provides a more comparable view of our effective income tax rate.
Income from continuing operations was $7.6 million for the three months ended June 30, 2020, as compared to $20.0 million for the same period in 2019. Adjusted EBITDA from continuing operations was $65.2 million for the three months ended June 30, 2020, as compared to $94.2 million for the same period in 2019.
Diluted income from continuing operations per common and common equivalent share was $0.09 on weighted average shares outstanding of 83.7 million for the three months ended June 30, 2020, as compared to $0.24 on weighted average shares outstanding of 83.7 million for the same period in 2019. Adjusted EPS from continuing operations was $0.32 for the three months ended June 30, 2020, as compared to $0.58 for the same period in 2019.
Loss from discontinued operations, net of tax, was $680.0 million for the three months ended June 30, 2020, as compared to loss of $28.3 million for the same period in 2019. Diluted loss from discontinued operations per common and common equivalent share was $8.12 for the three months ended June 30, 2020, as compared to $0.34 for the same period in 2019.
Net loss was $672.4 million for the three months ended June 30, 2020, as compared to $8.2 million for the same period in 2019. Diluted net loss per common and common equivalent share was $8.03 for the three months ended June 30, 2020, as compared to $0.10 for the same period in 2019.
Six Months Ended June 30, 2020 as Compared to Six Months Ended June 30, 2019
Our net revenue attributable to continuing operations was $1.07 billion for the six months ended June 30, 2020, as compared to $1.10 billion for the same period in 2019. The decrease in revenue of $33.2 million, or 3.0%, was primarily attributable to the unfavorable impacts from
COVID-19
on same-unit revenue, driven by declines in volume. Same units are those units at which we provided services for the entire current period and the entire comparable period. Same-unit net revenue declined by $60.5 million, or 5.5%. The decline in same-unit net revenue was comprised of a decrease of $72.3 million, or 6.6%, related to patient service volumes, partially offset by a net increase of $11.8 million, or 1.1%, from net reimbursement-related factors. The decrease in revenue from patient service volumes was primarily related to a decline across all our services, primarily as a result of
COVID-19.
The net increase in revenue related to net reimbursement-related factors was primarily due to CARES Act relief, modest improvements in managed care contracting and an increase in revenue caused by a decrease in the percentage of our patients enrolled in GHC programs, partially offset by unfavorable net rate impacts from radiology services.                
Practice salaries and benefits attributable to continuing operations increased $17.1 million, or 2.3%, to $748.7 million for the six months ended June 30, 2020, as compared to $731.6 million for the same period in 2019. This increase was primarily attributable to growth in benefits related costs at our existing units, partially offset by the decrease in salary expense from salary reductions and cessation of contract labor resulting from
COVID-19
mitigation initiatives that took place during the second quarter of 2020. The increase of $17.1 million was comprised of $25.3 million from benefits and incentive compensation, primarily malpractice expense, partially offset by a decrease of $8.2 million from salaries. Notwithstanding the salary expense decreases related to the
COVID-19
mitigation initiatives, we anticipate that we will experience a higher rate of growth in clinician compensation expense and malpractice expense at our existing units over historic averages, which could adversely affect our business, financial condition, results of operations, cash flows and the trading price of our securities.
Practice supplies and other operating expenses attributable to continuing operations decreased $0.3 million, or 0.6%, to $46.8 million for the six months ended June 30, 2020, as compared to $47.1 million for the same period in 2019. The decrease was primarily attributable to decreases in other practice operating expenses as compared to the prior year, primarily related to decreased activity across many expense categories such as travel, office expenses and professional services resulting from impacts of
COVID-19,
primarily during the second quarter of 2020.
General and administrative expenses attributable to continuing operations primarily include all billing and collection functions and all other salaries, benefits, supplies and operating expenses not specifically identifiable to the
day-to-day
operations of our physician practices and services. General and administrative expenses were $165.2 million for the six months ended June 30, 2020, as compared to $165.8 million for the same period in 2019. The decrease of $0.6 million is primarily related to salary reductions and furloughs resulting from the
COVID-19
mitigation initiatives, almost entirely offset by increases in other expense categories, primarily legal expenses. General and administrative expenses as a percentage of net revenue was 15.4% for the three months ended June 30, 2020, as compared to 15.0% for the same period in 2019. Certain general and administrative expenses related to corporate overhead represent various support services provided across the company, including costs supporting the recently divested anesthesiology medical group through a transition services agreement. Because a portion of such expenses were previously allocated to but not specifically identifiable to the anesthesiology medical group, they are required to be presented as continuing operations. Therefore, general and administrative expenses do not reflect potential general and administrative cost savings that may be achieved in future periods.
Transformational and restructuring related expenses attributable to continuing operations were $30.6 million for the six months ended June 30, 2020, as compared to $20.3 million for the same period in 2019. The expenses were primarily for external consulting costs for various process improvement and restructuring initiatives. Beginning in April 2020, we reduced the scope of our transformation and restructuring related initiatives unless they were initiatives critical to our business operations or those that provide essential support for our response to
COVID-19.
 
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Depreciation and amortization expense attributable to continuing operations was $28.8 million for the six months ended June 30, 2020, as compared to $27.6 million for the same period in 2019.
Income from operations attributable to continuing operations decreased $61.0 million, or 54.5%, to $50.9 million for the six months ended June 30, 2020, as compared to $111.9 million for the same period in 2019. Our operating margin was 4.8% for the six months ended June 30, 2020, as compared to 10.1% for the same period in 2019. The decrease in our operating margin was primarily due to the decrease in revenue related to
COVID-19,
partially offset by lower operating expense growth, including transformation and restructuring related expenses, primarily related to
COVID-19
mitigation initiatives. Excluding transformation and restructuring expenses, our income from operations attributable to continuing operations for the six months ended June 30, 2020 and 2019 was $81.5 million and $132.2 million, respectively, and our operating margin was 7.6% and 12.0%, respectively. We believe excluding the impacts from the transformational and restructuring related activity provides a more comparable view of our operating income and operating margin from continuing operations; however, this comparison is affected by the impacts from
COVID-19
during 2020.
Total
non-operating
expenses attributable to continuing operations were $50.9 million for the six months ended June 30, 2020, as compared to $55.7 million for the same period in 2019. The decrease in
non-operating
expenses was primarily related to a decrease in interest expense, primarily due to lower average borrowings under our Credit Agreement, partially offset by a decrease in equity earnings resulting from the impacts to the underlying joint venture from
COVID-19
and the settlement of a litigation matter.
Our effective income tax rate attributable to continuing operations is not meaningful as calculated for the six months ended June 30, 2020 due to the insignificant level of
pre-tax
income generated due to the impacts from
COVID-19.
Income taxes for the six months ended June 30, 2020 were calculated by applying the actual
year-to-date
effective rate to our
pre-tax
loss. Our effective income tax attributable to continuing operations was 24.2% for the six months ended June 30, 2019. After excluding discrete tax impacts, during the six months ended June 30, 2019, our effective income tax rate was 27.0%. We believe excluding discrete tax impacts on our effective income tax rate provides a more comparable view of our effective income tax rate.
Loss from continuing operations was $6.1 million for the six months ended June 30, 2020, as compared to income from continuing operations of $42.6 million for the same period in 2019. Adjusted EBITDA from continuing operations was $115.3 million for the six months ended June 30, 2020, as compared to $165.8 million for the same period in 2019.
Diluted loss from continuing operations per common and common equivalent share was $0.07 on weighted average shares outstanding of 83.1 million for the six months ended June 30, 2020, as compared to diluted income of $0.50 on weighted average shares outstanding of 85.1 million for the same period in 2019. Adjusted EPS from continuing operations was $0.52 for the six months ended June 30, 2020, as compared to $0.96 for the same period in 2019. The decrease of 2.0 million in our weighted average shares outstanding is primarily due to the impact of shares repurchased in 2019 through open market repurchase activity and the exclusion of common stock equivalents from the weighted average shares calculation for the six months ended June 30, 2020 as the effect would have been antidilutive.
Loss from discontinued operations, net of tax, was $685.0 million for the six months ended June 30, 2020, as compared to loss of $293.7 million for the same period in 2019. Diluted loss from discontinued operations per common and common equivalent share was $8.25 for the six months ended June 30, 2020, as compared to $3.45 for the same period in 2019.
Net loss was $691.1 million for the six months ended June 30, 2020, as compared to $251.1 million for the same period in 2019. Diluted net loss per common and common equivalent share was $8.32 for the six months ended June 30, 2020, as compared $2.95 for the same period in 2019.
Liquidity and Capital Resources
As of June 30, 2020, we had $132.2 million of cash and cash equivalents attributable to our continuing operations as compared to $107.9 million at December 31, 2019. Additionally, we had working capital attributable to our continuing operations of $304.4 million at June 30, 2020, an increase of 64.2 million from working capital of $240.2 million at December 31, 2019.
Cash Flows from Continuing Operations
Cash (used in) provided by operating, investing and financing activities from continuing operations is summarized as follows (in thousands):
 
    
Six Months Ended

June 30,
 
    
2020
    
2019
 
Operating activities
   $ 19,893      $ 7,031  
Investing activities
     (37,125      (19,196
Financing activities
     (611      (40,421
Operating Activities from Continuing Operations
During the six months ended June 30, 2020, our net cash provided by operating activities for continuing operations was $19.9 million, compared to $7.0 million for the same period in 2019. The net increase in cash provided of $12.9 million was primarily due to an increase in cash flow from accounts receivable and increases in deferred taxes, partially offset by changes in accounts payable and accrued expenses and a decrease in cash flow from lower earnings.
 
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During the six months ended June 30, 2020, cash flow from accounts receivable for continuing operations was $44.3 million, as compared to $1.7 million for the same period in 2019. The increase in cash flow from accounts receivable for the six months ended June 30, 2020 was primarily due to decreases in ending accounts receivable balances at existing units due to timing of cash collections.
Days sales outstanding (“DSO”) is one of the key factors that we use to evaluate the condition of our accounts receivable and the related allowances for contractual adjustments and uncollectibles. DSO reflects the timeliness of cash collections on billed revenue and the level of reserves on outstanding accounts receivable. Our DSO for continuing operations was 52.4 days at June 30, 2020 as compared to 49.9 days at December 31, 2019.
Investing Activities from Continuing Operations
During the six months ended June 30, 2020, our net cash used in investing activities for continuing operations of $37.1 million consisted primarily of capital expenditures of $23.3 million and net purchases of investments of $14.2 million.
Financing Activities from Continuing Operations
During the six months ended June 30, 2020, our net cash used in financing activities for continuing operations of $0.6 million consisted of proceeds from the issuance of common stock of $4.4 million, partially offset by the repurchase of $3.0 million of our common stock and contingent consideration payments of $1.2 million.
Liquidity
On March 25, 2020, we amended and restated our Credit Agreement to, among other things, (i) establish a deemed Consolidated EBITDA of $139.2 million for the second and third quarters of 2020, reflecting average Adjusted EBITDA from continuing operations for the prior eight quarters (calculated for purposes of the Credit Agreement), which will be used in the calculation of rolling four consecutive quarter Consolidated EBITDA under the Credit Agreement, (ii) temporarily increase the maximum consolidated net leverage ratio required to be maintained by us from 4.50:1:00 to 5.00:1:00 for the second and third quarters of 2020 and 4.75:1:00 for the fourth quarter of 2020, before returning to 4.50:1:00 for the first quarter of 2021 and beyond, (iii) require that we maintain minimum availability under the Credit Agreement of $300.0 million through the third quarter of 2021, (iv) provide for a weekly repayment of borrowings under the Credit Agreement through the second quarter of 2021 using unrestricted cash on hand in excess of $300.0 million, plus a reserve for certain payables, and (v) temporarily restrict our ability to make restricted payments under the Credit Agreement for the remainder of 2020, subject to certain exceptions.
The Credit Agreement provides for a $1.2 billion unsecured revolving credit facility, subject to the limitations discussed above, and includes a $37.5 million
sub-facility
for the issuance of letters of credit. The Credit Agreement matures on March 28, 2024 and is guaranteed by substantially all of our subsidiaries and affiliated professional associations and corporations. At our option, borrowings under the Credit Agreement will bear interest at (i) the alternate base rate (defined as the higher of (a) the prime rate, (b) the Federal Funds Rate plus 1/2 of 1.00% and (c) LIBOR for an interest period of one month plus 1.00%) plus an applicable margin rate ranging from 0.125% to 0.750% based on our consolidated leverage ratio or (ii) the LIBOR rate plus an applicable margin rate ranging from 1.125% to 1.750% based on our consolidated leverage ratio. The Credit Agreement also calls for other customary fees and charges, including an unused commitment fee ranging from 0.150% to 0.200% of the unused lending commitments, based on our consolidated leverage ratio. The Credit Agreement contains customary covenants and restrictions, including covenants that require us to maintain a minimum interest charge ratio, not to exceed a specified consolidated leverage ratio and to comply with laws, and restrictions on the ability to pay dividends and make certain other distributions, as specified therein. Failure to comply with these covenants would constitute an event of default under the Credit Agreement, notwithstanding the ability of the company to meet its debt service obligations. The Credit Agreement also includes various customary remedies for the lenders following an event of default, including the acceleration of repayment of outstanding amounts under the Credit Agreement.
At June 30, 2020, we had no outstanding principal balance on our Credit Agreement. We had outstanding letters of credit of $0.2 million which reduced the amount available on our Credit Agreement to $899.8 million at June 30, 2020, after giving effect to the temporary reduction of the capacity of our Credit Agreement described above through September 30, 2021.
At June 30, 2020, we had an outstanding principal balance of $750.0 million on our 5.25% senior unsecured notes due 2023 (the “2023 Notes”) and an outstanding principal balance of $1.0 billion on our 6.25% senior unsecured notes due 2027 (the “2027 Notes”). Our obligations under the 2023 Notes and the 2027 Notes are guaranteed on an unsecured senior basis by the same subsidiaries and affiliated professional contractors that guarantee our Credit Agreement. Interest on the 2023 Notes accrues at the rate of 5.25% per annum, or $39.4 million, and is payable semi-annually in arrears on June 1 and December 1. Interest on the 2027 Notes accrues at the rate of 6.25% per annum, or $62.5 million, and is payable semi-annually in arrears on January 15 and July 15.
The indenture under which the 2023 Notes and the 2027 Notes are issued, among other things, limits our ability to (1) incur liens and (2) enter into sale and lease-back transactions, and also limits our ability to merge or dispose of all or substantially all of our assets, in all cases, subject to a number of customary exceptions. Although we are not required to make mandatory redemption or sinking fund payments with respect to the 2023 Notes or the 2027 Notes, upon the occurrence of a change in control of MEDNAX, we may be required to repurchase the 2023 Notes and the 2027 Notes at a purchase price equal to 101% of the aggregate principal amount of the 2023 Notes and the 2027 Notes repurchased plus accrued and unpaid interest.
At June 30, 2020, we believe we were in compliance, in all material respects, with the financial covenants and other restrictions applicable to us under the Credit Agreement and the 2023 Notes and the 2027 Notes. We believe we will be in compliance with these covenants throughout 2020.
 
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We maintain professional liability insurance policies with third-party insurers, subject to self-insured retention, exclusions and other restrictions. We self-insure our liabilities to pay self-insured retention amounts under our professional liability insurance coverage through a wholly owned captive insurance subsidiary. We record liabilities for self-insured amounts and claims incurred but not reported based on an actuarial valuation using historical loss information, claim emergence patterns and various actuarial assumptions. Our total liability related to professional liability risks at June 30, 2020 was $318.4 million, of which $57.5 million is classified as a current liability within accounts payable and accrued expenses in the Consolidated Balance Sheet. In addition, there is a corresponding insurance receivable of $35.4 million recorded as a component of other assets for certain professional liability claims that are covered by insurance policies.
We anticipate that funds generated from operations, together with our current cash on hand and funds available under our Credit Agreement, will be sufficient to finance our working capital requirements, fund anticipated acquisitions and capital expenditures, fund expenses related to our transformational and restructuring activities, fund our share repurchase programs and meet our contractual obligations for at least the next 12 months from the date of issuance of this Quarterly Report on Form
10-Q.
Caution Concerning Forward-Looking Statements
Certain information included or incorporated by reference in this Quarterly Report may be deemed to be “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). Forward-looking statements may include, but are not limited to, statements relating to our objectives, plans and strategies, and all statements, other than statements of historical facts, that address activities, events or developments that we intend, expect, project, believe or anticipate will or may occur in the future are forward-looking statements. These statements are often characterized by terminology such as “believe,” “hope,” “may,” “anticipate,” “should,” “intend,” “plan,” “will,” “expect,” “estimate,” “project,” “positioned,” “strategy” and similar expressions, and are based on assumptions and assessments made by our management in light of their experience and their perception of historical trends, current conditions, expected future developments and other factors they believe to be appropriate. Any forward-looking statements in this Quarterly Report are made as of the date hereof, and we undertake no duty to update or revise any such statements, whether as a result of new information, future events or otherwise. Forward-looking statements are not guarantees of future performance and are subject to risks and uncertainties. Important factors that could cause actual results, developments and business decisions to differ materially from forward-looking statements are described in the 2019 Form
10-K,
and this Quarterly Report, including the sections entitled “Risk Factors.”
 
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Item 3. Quantitative and Qualitative Disclosures about Market Risk
We are subject to market risk primarily from exposure to changes in interest rates based on our financing, investing and cash management activities. We intend to manage interest rate risk through the use of a combination of fixed rate and variable rate debt. We borrow under our Credit Agreement at various interest rate options based on the Alternate Base Rate or LIBOR rate depending on certain financial ratios. At June 30, 2020, we had no outstanding principal balance on our Credit Agreement.
Item 4. Controls and Procedures
Evaluation of Disclosure Controls and Procedures
We maintain disclosure controls and procedures (as defined in Rules
13a-15(e)
and
15d-15(e)
under the Exchange Act) that are designed to provide reasonable assurance that information required to be disclosed by the Company in reports it files or submits under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in SEC rules and forms and (ii) accumulated and communicated to our management, including our principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required disclosure.
We carried out an evaluation, under the supervision and with the participation of our management, including our Chief Executive Officer and Chief Financial Officer, of the effectiveness of our disclosure controls and procedures. Based upon that evaluation, the Chief Executive Officer and Chief Financial Officer have concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of June 30, 2020.
Changes in Internal Controls Over Financial Reporting
No changes in our internal control over financial reporting occurred during the three months ended June 30, 2020 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
 
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Table of Contents
PART II - OTHER INFORMATION
Item 1. Legal Proceedings
We expect that audits, inquiries and investigations from government authorities and agencies will occur in the ordinary course of business. Such audits, inquiries and investigations and their ultimate resolutions, individually or in the aggregate, could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities.
In the ordinary course of our business, we become involved in pending and threatened legal actions and proceedings, most of which involve claims of medical malpractice related to medical services provided by our affiliated physicians. Our contracts with hospitals generally require us to indemnify them and their affiliates for losses resulting from the negligence of our affiliated physicians and other clinicians. We may also become subject to other lawsuits that could involve large claims and significant defense costs. We believe, based upon a review of pending actions and proceedings, that the outcome of such legal actions and proceedings will not have a material adverse effect on our business, financial condition, results of operations, cash flows or the trading price of our securities. The outcome of such actions and proceedings, however, cannot be predicted with certainty and an unfavorable resolution of one or more of them could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities.
Although we currently maintain liability insurance coverage intended to cover professional liability and certain other claims, we cannot assure that our insurance coverage will be adequate to cover liabilities arising out of claims asserted against us in the future where the outcomes of such claims are unfavorable to us. With respect to professional liability risk, we self-insure a significant portion of this risk through our wholly owned captive insurance subsidiary. Liabilities in excess of our insurance coverage, including coverage for professional liability and certain other claims, could have a material adverse effect on our business, financial condition, results of operations, cash flows and the trading price of our securities.
On July 10, 2018, a securities class action lawsuit was filed against our company and certain of our officers and a director in the U.S. District Court for the Southern District of Florida (Case No.
0:18-cv-61572-WPD)
that purports to state a claim for alleged violations of Sections 10(b) and 20(a) of the Exchange Act, and Rule
10b-5
thereunder, based on statements made by the defendants primarily concerning our former anesthesiology business. The complaint was seeking unspecified damages, interest, attorneys’ fees and other costs. We filed a motion to dismiss in April 2019, which was granted in October 2019; however, the plaintiff filed a second amended complaint on October 25, 2019. On November 25, 2019, we filed a motion to dismiss the second amended complaint, and on February 7, 2020 a final order granting our motion to dismiss the second amended complaint with prejudice was issued.
On March 20, 2019, a separate derivative action was filed by plaintiff Beverly Jackson on behalf of MEDNAX, Inc. against MEDNAX, Inc. and certain of its officers and directors in the Seventeenth Judicial Circuit in and for Broward County, Florida (Case Number
CACE-19-006253).
The plaintiff purported to bring suit derivatively on behalf of our company against certain of our officers and directors for breach of fiduciary duties and unjust enrichment. The derivative complaint repeated many of the allegations in the securities class action described above. We filed a motion to dismiss in December 2019, and on March 16, 2020, an order granting our motion to dismiss without prejudice was issued. On April 6, 2020, the plaintiff filed an amended complaint, and on April 30, 2020, we filed a motion to dismiss the amended complaint.
Item 1A. Risk Factors
Item 1A. Risk Factors in our most recent Annual Report on Form
10-K
includes a discussion of our risk factors. The information presented below updates, and should be read in conjunction with, the risk factors disclosed in our most recent Annual Report on Form
10-K.
Except as presented below, there have been no material changes to the risk factors disclosed in our most recent Annual Report on Form
10-K.
Our financial condition and results of operations for fiscal year 2020 and beyond may be materially adversely affected by the ongoing coronavirus
(COVID-19)
outbreak.
The outbreak of
COVID-19
has evolved into a global pandemic. The coronavirus has spread to many regions of the world, including virtually all of the United States. The full extent to which the
COVID-19
outbreak will impact our business and operating results will depend on future developments that are highly uncertain and cannot be accurately predicted, including new information that may emerge concerning
COVID-19
and the actions to contain it or treat its impact, such as the potential for further shutdown or stay at home orders, and shifts toward GHC Programs if changes occur in population demographics within geographic locations in which we provide services, including an increase in unemployment and underemployment as well as losses of commercial health insurance.
Our anesthesiology medical group, which we divested on May 6, 2020, experienced a significant decline in the number of elective surgeries at a number of the facilities where its affiliated clinicians provide anesthesia services as a result of
COVID-19.
A significant portion of this decline was due to the closure of operating suites or facilities following federal advisories to cancel
non-urgent
procedures and the prohibition of such procedures by several states. Within our radiology medical group, orders for radiological studies declined by a meaningful amount from historically normal levels as a result of
COVID-19,
with much of this reduction focused in
non-urgent
studies. Additionally, our office-based practices, which specialize in maternal-fetal medicine, pediatric cardiology, and numerous pediatric subspecialties, saw a significant elevation of appointment cancellations compared to historical normal levels as a result of
COVID-19.
To date, we have not experienced, nor do we currently anticipate, any significant impact to our NICU patient volumes as a result of
COVID-19,
however, there is no assurance that
COVID-19
will not adversely affect our NICU patient volumes or otherwise adversely affect our NICU and related neonatology business. Overall, our operating results since
mid-March
2020 have been significantly impacted by the
COVID-19
pandemic, but volumes did begin to normalize in May 2020 and substantially recovered during the month of June 2020.
 
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Across our medical groups, we believe that these patient volume declines primarily reflect a deferral of healthcare services utilization to a later period, rather than a permanent reduction in demand for our services. Given the general necessity of the services our affiliated clinicians provide, we anticipate that this deferral of services may create a backlog of demand in the future, in addition to the resumption of historically normal activity, however, there is no assurance that either will occur. We may also require an increased level of working capital if we experience extended billing and collection cycles as a result of displaced employees, payors, revenue cycle management contractors, or otherwise. The foregoing and other continued disruptions to our business as a result of
COVID-19
could result in a material adverse effect on our business, results of operations, financial condition, prospects and the trading prices of our securities in the near-term and beyond 2020.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
During the three months ended June 30, 2020, we repurchased 34,157 shares of our common stock that were withheld to satisfy minimum statutory withholding obligations in connection with the vesting of restricted stock and deferred stock.
 
Period
  
Total Number of
Shares
Repurchased (a)
   
Average
Price Paid
per Share
    
Total Number of
Shares Purchased as
part of the
Repurchase Program
    
Approximate Dollar
Value of Shares that
May Yet Be Purchased
Under the Repurchase
Programs (a)
 
April 1 – April 30, 2020
     —       $ —          —          (a
May 1 – May 31, 2020
     12,310  
(b) 
    13.06        —          (a
June 1 – June 30, 2020
     21,847  
(b) 
    15.53        —          (a
  
 
 
   
 
 
    
 
 
    
 
 
 
Total
     34,157     $ 14.64        —          (a
 
(a)
We have two active repurchase programs. Our July 2013 program allows us to repurchase shares of our common stock up to an amount sufficient to offset the dilutive impact from the issuance of shares under our equity compensation programs. Our August 2018 repurchase program allows us to repurchase up to an additional $500.0 million of shares of our common stock, of which we repurchased $395.8 million as of June 30, 2020.
(b)
Represents shares withheld to satisfy minimum statutory withholding obligations of an aggregate of $0.5 million in connection with the vesting of restricted stock.
The amount and timing of any future repurchases will depend upon several factors, including general economic and market conditions and trading restrictions.
 
26

Table of Contents
Item 6. Exhibits
 
Exhibit No.
  
Description
2.1    Securities Purchase Agreement, dated as of May 6, 2020, by and between MEDNAX Services, Inc. and NMSC II, LLC (incorporated by reference to Exhibit 2.1 to MEDNAX’s Current Report on Form 8-K filed on May 12, 2020).
10.1+    Employment Agreement, dated July 12, 2020, by and between MEDNAX Services, Inc. and Mark S. Ordan.
10.2    First Amendment to Amended and Restated Employment Agreement, effective April 1, 2020, by and between MEDNAX Services, Inc. and Stephen D. Farber (incorporated by reference to Exhibit 10.24 to MEDNAX’s Annual Report on Form 10-K/A for the year ended December 31, 2019 filed on April 28, 2020).
10.3    First Amendment to Amended and Restated Employment Agreement, effective April 1, 2020, by and between MEDNAX Services, Inc. and Dominic J. Andreano (incorporated by reference to Exhibit 10.26 to MEDNAX’s Annual Report on Form 10-K/A for the year ended December 31, 2019 filed on April 28, 2020).
10.4    First Amendment to Employment Agreement, effective April 1, 2020, by and between MEDNAX Services, Inc. and John C. Pepia (incorporated by reference to Exhibit 10.28 to MEDNAX’s Annual Report on Form 10-K/A for the year ended December 31, 2019 filed on April 28, 2020).
31.1+    Certification of Chief Executive Officer pursuant to Securities Exchange Act Rule 13a-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
31.2+    Certification of Chief Financial Officer pursuant to Securities Exchange Act Rule 13a-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
32.1*    Certification pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
101.1+    Interactive Data File
101.INS+    XBRL Instance Document – the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.
101.SCH+    XBRL Schema Document.
101.CAL+    XBRL Calculation Linkbase Document.
101.DEF+    XBRL Definition Linkbase Document.
101.LAB+    XBRL Label Linkbase Document.
101.PRE+    XBRL Presentation Linkbase Document.
104+    Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101).
 
+
Filed herewith.
*
Furnished herewith.
 
27

Table of Contents
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
 
   
MEDNAX, INC.
Date: July 30, 2020     By:  
/s/ Mark S. Ordan
      Mark S. Ordan
      Chief Executive Officer
      (Principal Executive Officer)
Date: July 30, 2020     By:  
/s/ Stephen D. Farber
      Stephen D. Farber
      Chief Financial Officer
      (Principal Financial Officer)
Date: July 30, 2020     By:  
/s/ John C. Pepia
      John C. Pepia
      Chief Accounting Officer
      (Principal Accounting Officer)
 
28
EX-10.1

Exhibit 10.1

EMPLOYMENT AGREEMENT

THIS EMPLOYMENT AGREEMENT (this “Agreement”) is made and entered into by and between MEDNAX SERVICES, INC., a Florida corporation (“Employer”), MARK ORDAN (“Employee”), and solely for purposes of Sections 1.1, 2.2, 3.4, 5.13 and 8.7 hereof, MEDNAX, INC., a Florida corporation and the parent corporation of Employer (“MEDNAX”), effective as of July 12, 2020 (the “Effective Date”).

RECITALS

WHEREAS, Employer is presently engaged in “Employer’s Business” as defined on Exhibit A hereto;

WHEREAS,    Employer desires to employ Employee; and

WHEREAS, in order to induce Employer to enter into this Agreement on the terms and conditions set forth herein, and disclose its trade secrets and confidential information in connection with Employee’s employment by Employer and award from time to time equity based compensation, Employee hereby agrees to be bound by the terms of this Agreement, including the arbitration, non-competition and related restrictive covenants set forth herein.

NOW, THEREFORE, in consideration of the premises and mutual covenants set forth herein, the parties agree as follows:

1.    Employment.

1.1.    Employment and Term. Employer hereby agrees to employ Employee and Employee hereby agrees to serve Employer on the terms and conditions set forth herein for an “Initial Term” commencing on the Effective Date and continuing for a period of five (5) years, unless sooner terminated as hereinafter set forth; provided, however, that the Initial Term shall automatically renew for two successive one (1) year periods thereafter (each a “Renewal Period,” and any and all Renewal Periods (if any) together with the Initial Term, the “Employment Period”), unless at least ninety (90) days prior to the end of the Initial Term or the first Renewal Period, one party notifies the other in writing that he/it is exercising the option not to renew the Employment Period. Employee’s employment shall terminate on the last day of the Employment Period following any such notice of non-renewal or the end of the second Renewal Period, in the absence of a mutually agreed successor employment agreement. While serving in the position of Chief Executive Officer, MEDNAX shall appoint Employee to the Board (as defined below) as of the Effective Date and MEDNAX shall re-nominate Employee for election to the Board upon the end of each term of Employee’s service as a member of the Board during the Employment Period. Employee shall not receive additional compensation for his service as a Board member. As a Board member, Employee shall be held to, and must abide by, the highest fiduciary duties permitted under applicable state law. Upon the termination of this Agreement or his removal from the position of Chief Executive Officer for any reason, Employee shall be removed from the Board automatically and without any vote required by the shareholders of MEDNAX or other Board members.


1.2.    Duties of Employee. As of the Effective Date and thereafter during the remaining Employment Period, Employee shall serve as Chief Executive Officer of Employer and MEDNAX, and perform such duties as are customary to the position Employee holds or as may be reasonably assigned to Employee by the Board of Directors of MEDNAX (“Employee’s Supervisor” or the “Board”), including, but not limited to, also serving as an officer and/or director, or equivalent, of subsidiaries and/or affiliates of MEDNAX; provided, that such duties as assigned shall be customary to Employee’s role as chief executive officer of Employer and MEDNAX. Employee shall report solely and directly to the Board. Employee’s employment shall be full-time and, as such, Employee agrees to devote substantially all of Employee’s attention and professional time to the business and affairs of Employer and MEDNAX. Employee will devote his reasonable best efforts to the promotion of the goodwill of Employer, MEDNAX and their affiliates, taken as a whole. During the Employment Period, Employer shall promote the proficiency of Employee by, among other things, providing Employee with Confidential Information, specialized professional development programs, and information regarding the organization, administration and operation of Employer. During the Employment Period, Employee agrees that Employee will not, without the prior written consent of Employer (which consent shall not be unreasonably withheld), serve as a director on a corporate board of directors or in any other similar capacity for any institution other than Employer and MEDNAX, and their respective subsidiaries and affiliates in accordance with this Section 1.2. Employer agrees that Employee’s serving on the board of directors of the entities disclosed to Employer on or prior to the Effective Date has been consented to by Employer and such service shall not constitute Employee’s breach of this Agreement. During the Employment Period, it shall not be a violation of this Agreement to (i) serve on civic or charitable boards or committees, (ii) manage personal investments, or (iii) deliver lectures, fulfill speaking engagements or teach at educational institutions, so long as such activities do not violate any code of conduct or personnel policies and procedures of Employer or MEDNAX and do not interfere with the performance of Employee’s responsibilities as an employee of Employer in accordance with this Agreement, including the restrictions of Section 8 hereof.

1.3.    Place of Performance. Employee shall be permitted to work remotely, except for required travel relating to Employer’s Business.

2.    Compensation and Performance Bonus.

2.1.    Base Salary. Employee shall be paid an annual base salary as determined by the Compensation Committee (“Compensation Committee”) of the Board from time to time (the “Base Salary”), payable in installments consistent with Employer’s customary payroll schedule and subject to applicable withholding for taxes and other Employee directed withholdings. Employee’s initial Base Salary will be set forth on Exhibit B hereto. The Compensation Committee shall review the amount of Employee’s Base Salary, for increase but not decrease, on an annual basis no later than ninety (90) days after the beginning of Employer’s fiscal year. Any change to Employee’s Base Salary that is approved by the Compensation Committee shall become Employee’s new Base Salary for purposes of this Agreement.

 

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2.2.    Initial Equity Award. On the Effective Date, MEDNAX shall grant to Employee, pursuant to the terms of the MEDNAX, Inc. Amended and Restated 2008 Incentive Compensation Plan, as amended (the “Plan”) and applicable award agreements, the following equity grants:

(i)    Stock Grant. A grant of 113,314 shares of Restricted Stock (as defined in the Plan), pursuant to the terms of the Plan and an award agreement in the form attached hereto as Exhibit C, which the Employee must continue to directly own until the fifth (5th) anniversary of the grant date, unless otherwise set forth in the award agreement.

(ii)    Performance-Based Stock Option Grant. A grant of stock options under the Plan exercisable for up to 550,331 shares of common stock of MEDNAX (the “2020 Option”), subject to the terms of the Plan and an award agreement in the form attached hereto as Exhibit D. The 2020 Option shall be a nonqualified stock option and will have an exercise price per share equal to the Fair Market Value (as defined in the Plan) of one share of common stock of MEDNAX on the date of grant.

2.3.    2020 Corporate Strategy. Employer shall pay Employee $250,000 upon delivery of a strategic plan for MEDNAX to the Strategy Committee of the Board no later than October 1, 2020. Such amount shall be subject to applicable taxes and withholdings and shall be paid to the Employee within 90 days of delivering a satisfactory plan as determined reasonably and in good faith by the Strategy Committee, but in no event later than December 31, 2020.

2.4    Performance Bonus. Employee shall be eligible for an annual bonus in accordance with the incentive programs approved from time to time by the Compensation Committee, which programs shall contemplate a target bonus payment of at least the amount set forth on Exhibit B (the “Performance Bonus”) based upon the fulfillment of reasonable performance objectives set by the Compensation Committee in consultation with Employee. Except in the situations described in Sections 5.4 and 5.6, the Performance Bonus shall only be payable to Employee if Employee is employed with Employer as of the date that the Performance Bonus is paid by Employer. Each Performance Bonus (except the Performance Bonus for the fiscal year commencing January 1, 2020 (the “2020 Performance Bonus”)) shall be paid in the calendar year immediately following the calendar year in which it is earned, as soon as practicable after the audited financial statements for Employer for the year for which the bonus is earned have been released, but in no event later than March 15th following the year for which the Performance Bonus is earned. The 2020 Performance Bonus shall be prorated (on a daily basis relative to 366) based on the Effective Date and payable at 150% of Employee’s Base Salary (as so prorated) and shall be paid in a lump amount on December 31, 2020.

3.    Benefits.

3.1.    Expense Reimbursement. Employer shall promptly reimburse Employee for all out-of-pocket expenses reasonably incurred by Employee during the Employment Period on behalf of or in connection with Employer’s Business pursuant to the reimbursement standards and guidelines of Employer in effect from time to time and no less favorable than provided for other senior executive officers of Employer, including reimbursement for appropriate professional organizations. Employee shall account for such expenses and submit reasonable supporting documentation to Employer in accordance with Employer’s policies in effect from time to time.

 

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Employee shall be permitted to travel first-class and to use Employer’s private aircraft for business travel during the lease period of such aircraft, provided that Employer shall not be obligated to maintain any such leased aircraft during the Employment Period.

3.2    Employee Benefits. During the Employment Period, Employee shall be entitled to participate in such health, welfare, disability, retirement savings, perquisites and other fringe benefit plans and programs (subject to the terms and conditions of such plans and programs) as may be provided from time to time to senior executive officers of Employer and to the extent that such plans and programs are applicable to other senior executive officers of Employer. Notwithstanding the foregoing, Employee may choose to waive participation in Employer’s health and welfare plans pursuant to the standard waiver provisions thereof and remain on Employee’s existing health and welfare plans, in which case Employee shall be reimbursed a monthly amount equal to the cost of such Employee health and welfare plans, up to the amount of Employer’s monthly COBRA (as defined below) rate, subject to applicable taxes and withholdings.

3.3.    Leave Time. During the Employment Period, Employee shall be entitled to paid vacation and leave days each calendar year in accordance with the leave policies established by Employer from time to time, but in no event less than 38 days per year. Any leave time not used during each fiscal year of Employer may be carried over into the next year to the extent permitted by Employer policy.

3.4    Equity Plans. During the Employment Period, it shall be recommended to the Compensation Committee that Employee shall receive equity compensation grants following the Effective Date, of stock options and restricted stock and other time-based or performance-based stock units, options, or other awards (each an “Equity Award”) pursuant to the Plan, or any other similar plan adopted by MEDNAX(each an “Equity Plan”), with a guideline grant value that will be at least the amount set forth on Exhibit B, with the actual grant value and forms of grant determined by the Compensation Committee in the same manner as for other executive officers of Employer. Every Equity Award made to Employee shall be subject to the terms and conditions of this Agreement and the terms of the applicable Equity Plan and shall be made subject to an award agreement that is consistent with the foregoing. Employee shall also be eligible to participate in MEDNAX’s non-qualified employee stock purchase plan and any successor plan. Employee acknowledges Employee’s participation in the Equity Plan pursuant to this Section 3 is sufficient consideration for Employee to enter into this Agreement, including the restrictive covenants set forth in Section 8 below.

4.    Termination.

4.1.    Termination for Cause. Employer may terminate Employee’s employment under this Agreement for Cause. As used in this Agreement, the term “Cause” shall mean the occurrence of any of:

(i) Employee’s engagement in (A) willful misconduct resulting in material harm to MEDNAX or Employer, or (B) gross negligence resulting in material harm to MEDNAX or Employer;

 

4


(ii) Employee’s conviction of, or pleading nolo contendere to, a felony or any other crime involving fraud, financial misconduct, or misappropriation of Employer’s assets;

(iii) Employee’s willful and continual refusal after written notice from the Board to (A) perform substantially his employment duties consistent with his position and authority, or (B) follow, consistent with Employee’s position, duties, and authorities, the reasonable written and lawful mandates of the Board;

(iv) Employee’s failure or refusal to comply in a material respect with a reasonable policy, standard or regulation of Employer in a manner that could reasonably be expected to cause harm to Employer, MEDNAX, or their affiliates taken as a whole, including but not limited to Employer’s sexual harassment, other unlawful harassment, workplace discrimination or substance abuse policies; or

(v) Employee’s breach of Section 8.4 of this Agreement resulting in material harm to MEDNAX or Employer.

No act or omission shall be deemed willful or grossly negligent for purposes of this definition if taken or omitted to be taken by Employee in a good faith belief that such act or omission to act was in the best interests of Employer or MEDNAX or if done at the express direction of the Board or upon the advice of counsel to Employer. Employee shall be provided written notice of any action or inaction alleged to constitute Cause and not less than thirty (30) days to cure, to the extent curable. The termination date for a termination of Employee’s employment under this Agreement pursuant to this Section 4.1 shall be the date specified by Employer in a written notice to Employee of finding of Cause, which may not be retroactive. Upon termination of Employee’s employment under this Agreement pursuant to Section 4.1, Employee shall be entitled to compensation in accordance with and subject to, the provisions of Section 5.1 hereof.

4.2.    Disability. Employer may terminate Employee’s employment under this Agreement upon the Disability (as defined below) of Employee. Subject to the requirements of applicable law, Employee shall be deemed to have a “Disability” for purposes of this Agreement in the event of both: (i) Employee’s inability to perform Employee’s duties hereunder, with or without a reasonable accommodation, as a result of physical or mental illness or injury, and (ii) a determination by an independent qualified physician selected by Employer and acceptable to Employee (which acceptance shall not be unreasonably withheld) that Employee is currently unable to perform such duties and in all reasonable likelihood such inability will continue for a period in excess of an additional one hundred and eighty (180)or more days. The termination date for a termination of this Agreement pursuant to this Section 4.2 shall be the date specified by Employer in a notice to Employee, which date shall not be retroactive. Upon any termination of this Agreement pursuant to this Section 4.2, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section 5.2 hereof.

4.3.    Death. Employee’s employment under this Agreement shall terminate automatically upon the death of Employee, without any requirement of notice by Employer to Employee’s estate. The date of Employee’s death shall be the termination date for a termination of Employee’s employment under this Agreement pursuant to this Section 4.3. Upon any termination of Employee’s employment under this Agreement pursuant to this Section 4.3, Employee shall be entitled to the compensation specified in Section 5.3 hereof.

 

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4.4.    Termination by Employer Without Cause. Employer may terminate Employee’s employment without Cause by giving Employee written notice of such termination. The termination date shall be the date specified by Employer in such notice, which shall be between thirty (30) and ninety (90) days from the date of such notice. The non-renewal of this Agreement pursuant to Section 1.1 as of the end of the Initial Term or the end of the first Renewal Period shall be considered a termination of Employee’s employment by Employer without Cause. Upon any termination of Employee’s employment under this Agreement pursuant to this Section 4.4, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section 5.4 hereof.

4.5.    Termination by Employee. Employee may terminate Employee’s employment under this Agreement for any reason whatsoever upon not less than sixty (60) days prior written notice to Employer. Upon receipt of such notice from Employee, Employer may, at its option, require Employee to terminate employment at any time in advance of the expiration of such sixty (60) day period. The termination date under this Section 4.5 shall be the date specified by Employer, but in no event more than ninety (90) days after Employer’s receipt of notice from Employee as contemplated by this Section. Upon any termination of Employee’s employment under this Agreement pursuant to this Section 4.5, Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section 5.5 hereof.

4.6.    Termination by Employee with Good Reason. Employee may terminate Employee’s employment hereunder with Good Reason. For purposes of this Section, “Good Reason” shall mean, without the Employee’s express written consent:

(a)     a decrease in Employee’s Base Salary;

(b)     a decrease in Employee’s Performance Bonus opportunity as set forth on Exhibit B or a failure of the Compensation Committee to approve an equity grant within the guidelines set forth on Exhibit B;

(c)    Employee is assigned any position, duties, responsibilities or compensation that is inconsistent with the position, duties, or responsibilities of Employee contemplated herein as of the Effective Date or compensation of Employee as of the Effective Date, excluding for this purpose any isolated, insubstantial and inadvertent action not taken in bad faith and which is remedied by Employer promptly after receipt of written notice;

(d)    Employee experiences a material diminution in his authorities, duties or responsibilities, excluding for this purpose any isolated and inadvertent action not taken in bad faith and which is remedied by Employer promptly after receipt of written notice, provided that, if following a Change in Control, neither the common stock of MEDNAX nor the common equity of its successor, parent or subsidiary is listed for trading on a national securities exchange or if Employee is not chief executive officer of a publicly-traded entity, Employee shall have Good Reason to terminate employment;

 

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(e)    Employee is required to report to any person other than the Board, is not nominated to the Board, or is removed from the Board;

(f)    the requirement by Employer that Employee be based in any office or location outside of the metropolitan area where Employee resides as of the Effective Date, except for travel reasonably required in the performance of Employee’s duties; or

(g)    any other action or inaction that constitutes a material breach of this Agreement or any material compensation agreement by Employer or MEDNAX (including a violation of Section 6.1);

If Employee desires to terminate Employee’s employment under this Agreement pursuant to this Section, Employee must, within one hundred eighty (180) days after Employee’s knowledge of the occurrence of events giving rise to the Good Reason, provide Employer with a written notice describing the Good Reason in reasonable detail. If Employer fails to cure the matter cited within thirty (30) days after the date of Employee’s notice, then Employee shall have sixty (60) days following the end of such cure period to terminate employment with Good Reason. If Employee terminates Employee’s employment under this Agreement pursuant to this Section 4.6, then Employee shall be entitled to compensation and/or benefits in accordance with, and subject to, the provisions of Section 5.6 hereof.

4.7.    Termination of Employee in Connection With Change in Control of Employer. In the event that Employer terminates Employee’s employment without Cause in accordance with Section 4.4, or Employee terminates Employee’s employment with Good Reason in accordance with Section 4.6, and in either case the termination occurs within six (6) months prior to or within 12 months following the effective date of a Change in Control, then in lieu of the compensation and/or benefits that Employee would otherwise be entitled to under Section 5.4 or Section 5.6, Employee shall be entitled to the compensation and/or benefits in accordance with, and subject to, the provisions of Section 5.14. For purposes of this Agreement, “Change in Control” shall mean (i) the acquisition by a person or an entity or a group of persons and entities, directly or indirectly, of more than fifty (50%) percent of MEDNAX’s common stock in a single transaction or a series of transactions (hereinafter referred to as a “50% Change in Control”), (ii) a merger or other form of corporate reorganization of MEDNAX resulting in an actual or de facto 50% Change in Control, or (iii) the failure of Applicable Directors (defined below) to constitute a majority of the Board during any two (2) consecutive year period after the date of this Agreement (the “Two-Year Period”). “Applicable Directors” shall mean those individuals who are members of the Board at the inception of a Two-Year Period and any new director whose election to the Board or nomination for election to the Board was approved (prior to any vote thereon by the shareholders) by a vote of at least two-thirds (2/3) of the directors then still in office who either were directors at the beginning of the Two-Year Period at issue or whose election or nomination for election during such Two-Year Period was previously approved as provided in this sentence.

 

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5.    Compensation and Benefits Upon Termination.

5.1.    Cause. If Employee’s employment is terminated for Cause, Employer shall pay Employee’s Base Salary through the termination date specified in Section 4.1 at the rate in effect at the termination date.

5.2.    Disability. In the event of Employee’s Disability, Employee shall continue to receive Employee’s Base Salary for the first ninety (90) days of Disability plus any amounts as may be due under Sections 5.7, 5.10 and 5.13. Employee shall also receive any earned and unpaid Performance Bonus with respect to the year prior to the year of termination, which shall be paid in accordance with Section 2.4 without regard to its continued employment requirement. Amounts payable under this Section 5.2 are not intended to be in lieu of benefits under any long-term disability plan Employer may maintain from time to time, but any benefits and payments under any such plan shall offset the payments to be made in the first sentence of this Section, and Employee’s entitlement to benefits under such plan, if any, shall be determined solely by the plan’s terms.

5.3.    Death. Upon Employee’s death during the Employment Period, Employer shall pay to the person or entity designated by Employee in a notice filed with Employer or, if no person is designated, to Employee’s estate any unpaid amounts of Base Salary to the date of Employee’s death, plus any amounts as may be due under Sections 5.7, 5.10, and 5.13 below. Employee’s estate (or the person or entity designated by Employee in a notice filed with Employer) shall also receive any earned and unpaid Performance Bonus with respect to the year prior to the year of termination, which shall be paid in accordance with Section 2.4 without regard to its continued employment requirement. Any payments that Employee’s spouse, beneficiaries or estate may be entitled to receive pursuant to any pension plan, employee welfare benefit plan, life insurance policy, or similar plan or policy then maintained by Employer shall be determined and paid in accordance with the written instruments governing the respective plans and policies. In the event of Employee’s death during the Employment Period, Employer shall notify Employee’s designee or estate of the Equity Awards held by Employee and the procedures pursuant to which all vested stock options may be exercised and other Equity Awards may be realized under the terms applicable to such awards.

5.4.    Termination by Employer Without Cause. If Employer terminates Employee’s employment in accordance with Section 4.4, then (i) Employer shall pay Employee’s Base Salary through the termination date specified in Section 4.4 at the rate in effect at such termination date, plus any amount due under Section 5.7 hereof; (ii) Employer shall pay Employee a bonus calculated and paid in accordance with Section 5.10 hereof; (iii) Employee shall also receive any earned and unpaid Performance Bonus with respect to the year prior to the year of termination, which shall be paid in accordance with Section 2.4 without regard to its continued employment requirement; (iv) within sixty (60) days of the termination date and on the first (1st) anniversary of the termination date, Employer shall pay Employee on each such date a lump sum payment equal to Employee’s annual Base Salary; (v) within sixty (60) days of the termination date and on the first (1st) anniversary of the termination date, Employer shall pay Employee on each such date an amount equal to the greater of (A) Employee’s Average Annual Performance Bonus (as defined below) or (B) Employee’s target Performance Bonus amount set forth on Exhibit B; and (v) if applicable, Employee shall vest into the Equity Awards granted to Employee that are outstanding (the “Accelerated Awards”) as set forth in Section 5.13 hereof. For purposes

 

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of this Agreement, “Average Annual Performance Bonus” shall be equal to the average of the percentage of the Performance Bonus target achieved by (or provided to) Employee for the three (3) calendar years (including the partial 2020 year) prior to the termination date (or such lesser period as Employee may have been employed by Employer), and calculated based on Employee’s Base Salary and target Performance Bonus in Employee’s current position. For illustration purposes, if Employee earned 40%, 100% and 70% of Employee’s target Performance Bonus in each of the three full calendar years prior to termination, and Employee’s current target Performance Bonus was 100% of Base Salary, and Base Salary was $1,000,000.00, then Employee’s Average Annual Performance Bonus would equal $700,000.00. ((40%+ 100% + 70%) / 3 x 100% x $1,000,000.00 = $700,000.00).

5.5.    Termination by Employee. If Employee’s employment under this Agreement terminates pursuant to Section 4.5 hereof, Employer shall pay to Employee any unpaid amounts of Base Salary to the termination date specified in Section 4.5, plus any amounts as may be due under Section 5.7 below. In the event that the termination date specified by Employer is less than ninety (90) days after the date of Employer’s receipt of notice as contemplated by Section 4.5, then Employer shall continue Employee’s Base Salary for a period of days equal to ninety (90) minus the number of days from Employee’s notice to the termination date.

5.6.    Termination with Good Reason. If Employee’s employment under this Agreement is terminated pursuant to Section 4.6, then Employer shall pay or provide the same benefits as described in Section 5.4 (and any reductions in Base Salary or target Performance Bonus opportunity resulting in Good Reason shall be disregarded).

5.7.    Expense Reimbursement; Vacation, Benefits Plans. Upon any termination of employment, Employee shall be entitled to reimbursement for reasonable business expenses incurred prior to the termination date, subject, however to the provisions of Section 3.1. Such reimbursement shall be made at the times and in accordance with Employer’s normal procedures for reimbursements. In addition, Employee shall be paid for accrued vacation pursuant to Employer’s then-current policy and shall be provided his vested and accrued employee benefits pursuant to the terms of the applicable benefits plans of Employer.

5.8.    Continuation of Benefit Plans. Employee shall be entitled to continuation of health, medical, hospitalization and other similar health insurance programs on the same basis as regular, full-time employees of Employer and their eligible dependents (or the reimbursement amounts provided in Section 3.2) during the period with respect to which Employee is receiving Base Salary payments under Section 5 of this Agreement (e.g., twenty-four (24) months of Base Salary severance corresponds to twenty-four (24) months of continued benefits) and, in all cases, as provided by any applicable law. Following such period of continued benefit plan coverage, Employee and each of his eligible dependents shall be entitled to elect for continuation of coverage provided pursuant to Section 601 et. seq. of the Employee Retirement Income Security Act of 1974, 29 USC §1101 (“COBRA”). If the Employee’s employment under this Agreement terminates pursuant to Sections 4.2, 4.3, 4.4, 4.6, or 4.7, Employee may continue on Employer’s group medical plan until he is eligible for Medicare benefits provided that he timely elects COBRA coverage, such continuation is permitted under the terms of the applicable group health and, except as provided in this Section 5.8, Employee pays the full cost (at applicable COBRA rates) of such benefits continuation.

 

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5.9    Period for Exercising Stock Options After Termination. With respect to stock options granted to the Employee during the Employment Period:

(i)    after termination of Employee’s employment under this Agreement for any reason other than pursuant to Section 4.1, with respect to any stock option that includes a share price condition (a “Share Price Option”) vested as of Employee ’s termination date, Employee shall be allowed a period of twelve (12) months after termination under this Agreement to exercise any such option (subject to earlier termination as set forth below); and

(ii)    after termination of Employee’ s employment under this Agreement pursuant to Section 4.2, 4.3, 4.4, or 4.6, with respect to any Share Price Option that is unvested as of Employee’ s termination date, such option shall remain outstanding for twelve (12) months to determine if the applicable performance vesting condition(s) have been met (subject to earlier termination as set forth below) and shall become exercisable only if the applicable price condition(s) during such continuation period are met.

Notwithstanding the foregoing paragraphs (i) and (ii), in no event shall the period during which Employee may exercise any stock option be extended pursuant to this Section 5.9 to a date that is later than the earlier of (i) the latest date upon which the stock right could have expired by its original terms under any circumstances or (ii) the tenth (10th) anniversary of the original date of grant of the stock right. In all other respects, the terms of the applicable Equity Plan and award agreement shall control with respect to the period for exercising stock options after termination of employment.

5.10.    Performance Bonus. In the situations described in Sections 5.2, 5.3, 5.4 and 5.6, the Employer shall pay Employee, solely in consideration of services rendered by Employee prior to termination, a bonus with respect to Employer’s fiscal year in which the termination date occurs, equal to Employee’s Performance Bonus amount set forth on Exhibit B determined based on actual performance, multiplied by the number of days in the fiscal year prior to and including the date of termination and divided by three hundred sixty five (365), which shall be paid in the calendar year immediately following the calendar year in which it is earned, as soon as practicable after the audited financial statements for Employer for the year for which the bonus is earned have been released, but in no event later than March 15th following the year for which the Performance Bonus is earned.

5.11.    Section 409A Compliance.

(a)    General. It is the intention of both Employer and Employee that the benefits and rights to which Employee could be entitled in connection with termination of employment comply with Section 409A of the Code and the Treasury Regulations and other guidance promulgated or issued thereunder (“Section 409A”), and the provisions of this Agreement shall be construed in a manner consistent with that intention. If Employee or Employer believes, at any time, that any such benefit or right does not so comply, it shall promptly advise the other and shall negotiate reasonably and in good faith to amend the terms of such benefits and rights such that they comply with Section 409A of the Code (with the most limited possible economic effect on Employee and on Employer).

 

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(b)    Distributions on Account of Separation from Service. If and to the extent required to comply with Section 409A, no payment or benefit required to be paid under this Agreement on account of termination of Employee’s employment shall be made unless and until Employee incurs a “separation from service”, within the meaning of Section 409A.

(c)    6 Month Delay for Specified Employees.

(i)    If Employee is a “specified employee”, then no payment or benefit that is payable on account of Employee’s “separation from service”, as that term is defined for purposes of Section 409A, shall be made before the date that is six months after Employee’s “separation from service” (or, if earlier, the date of Employee’s death) if and to the extent that such payment or benefit constitutes deferred compensation (or may be nonqualified deferred compensation) under Section 409A and such deferral is required to comply with the requirements of Section 409A. Any payment or benefit delayed by reason of the prior sentence shall be paid out or provided in a single lump sum at the end of such required delay period in order to catch up to the original payment schedule.

(ii)    For purposes of this provision, Employee shall be considered to be a “specified employee” if, at the time of his separation from service, Employee is a “key employee”, within the meaning of Section 416(i) of the Code, of Employer (or any person or entity with whom Employer would be considered a single employer under Section 414(b) or Section 414(c) of the Code) any stock in which is publicly traded on an established securities market or otherwise.

(d)    No Acceleration of Payments. Neither Employer nor Employee, individually or in combination, may accelerate any payment or benefit that is subject to Section 409A, except in compliance with Section 409A and the provisions of this Agreement, and no amount shall be paid prior to the earliest date on which it may be paid without violating Section 409A.

(e)    Treatment of Each Installment as a Separate Payment. For purposes of applying the provisions of Section 409A to this Agreement, each separately identified amount to which Employee is entitled under this Agreement shall be treated as a separate payment. In addition, to the extent permissible under Section 409A, any series of installment payments under this Agreement shall be treated as a right to a series of separate payments.

(f)    Reimbursements and In-Kind Benefits.

(i)    Any reimbursements by Employer to Employee of any eligible expenses pursuant to Section 3.1 or 5.7 of this Agreement, that are not excludible from Employee’s income for Federal income tax purposes (“Taxable Reimbursements”) shall be made on or before the last day of the taxable year of Employee following the year in which the expense was incurred.

 

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(ii)    The amount of any Taxable Reimbursements, and the value of any in-kind benefits to be provided to Employee under this Agreement, during any taxable year of Employee shall not affect the expenses eligible for reimbursement, or in-kind benefits to be provided, in any other taxable year of Employee.

(iii)    The right to Taxable Reimbursements, or in-kind benefits, shall not be subject to liquidation or exchange for another benefit.

5.12.    Release. Employer shall provide Employee with a general release in the form attached as Exhibit E (subject to such modifications as Employer may reasonably request to comply with applicable law) within seven (7) days after Employee’s termination date. Payments or benefits to which Employee may be entitled pursuant to this Section 5 (other than any accrued but unpaid Base Salary, reimbursement of business expenses, accrued vacation pursuant to Employer’s then-current policy and employee benefits as of the end of the Employment Period) (the “Severance Amounts”) shall be conditioned upon Employee executing the general release within twenty one (21) days after receiving it from Employer and the general release becoming irrevocable upon the expiration of seven (7) days following Employee’s execution of it. Payment of the Severance Amounts shall be suspended during the period (the “Suspension Period”) that begins on Employee’s termination date and ends on the date (“Suspension Termination Date”) that is thirty-five (35) days after Employee’s termination date; provided, however, that this suspension shall not apply to, and Employer shall be required to provide, any continued health insurance coverage that would be required under Section 5.8 hereof during the Suspension Period. If Employee executes the general release and the general release becomes irrevocable by no later than the Suspension Termination Date, then payment of any Severance Amounts that were suspended pursuant to this provision shall be made in the first payroll period that follows the Suspension Termination Date, and any Severance Amounts that are payable after the Suspension Termination Date shall be paid at the times provided in Section 5.

5.13.    Vesting of Incentive Awards (Accelerated Awards). Notwithstanding any contrary provision in this Agreement or any Equity Plan then maintained by MEDNAX, and in addition to any other payments or benefits provided in this Agreement, in the event Employee’s employment terminates pursuant to Section 4.2, 4.3, 4.4, or 4.6, all time-based Equity Awards (which for the avoidance of doubt does not include the 2020 Option) granted to Employee by MEDNAX prior to termination of Employee’s employment shall immediately become fully vested, non-forfeitable, and, if applicable, exercisable, and all performance-based shares awards (which for the avoidance of doubt does not include the 2020 Option) shall remain outstanding and shall vest based upon actual performance determined at the end of the applicable performance period. In the event Employee’s employment is terminated pursuant to Section 4.7, all time-based Equity Awards (which for the avoidance of doubt does not include the 2020 Option) granted to Employee by MEDNAX prior to termination of Employee’s employment shall immediately become fully vested, non-forfeitable, and, if applicable, exercisable and, with respect to performance-based share awards (which for the avoidance of doubt does not include the 2020 Option), if the applicable performance condition has been met at the time of the Change in Control, any such Equity Award that is assumed or converted shall immediately become fully vested, non-forfeitable and, if applicable, exercisable upon termination of employment except if Employee is terminated for Cause.

 

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5.14.    Termination of Employee in Connection With Change in Control of Employer. If Employee’s employment under this Agreement is terminated in accordance with Section 4.7, then Employer shall pay Employee’s monthly Base Salary through the termination date specified pursuant to Section 4.7 at the rate in effect at such termination date, plus any amounts as may be due under Section 5.7 hereof. In addition, Employee will receive the following severance payments from the Employer if he is terminated within six (6) months prior to a Change in Control or within twelve (12) months after a Change in Control that is not a “change in control” for purposes of Section 409A of the Code: (i) within sixty (60) days of the termination date and on the first (1st) anniversary of the termination date, on each such date a lump sum payment equal to eighteen (18) months of Employee’s Base Salary; (ii) a bonus calculated and paid in accordance with Section 5.10 hereof; (iii) any earned and unpaid Performance Bonus with respect to the year prior to the year of termination, which shall be paid in accordance with Section 2.4; (iv) within sixty (60) days of the termination date and on the first (1st) anniversary of the termination date, Employer shall pay Employee on each such date an amount equal to the greater of (A) one and one half (1.5) times Employee’s Average Annual Performance Bonus (as defined below) or (B) one and one half (1.5) times Employee’s target Performance Bonus amount set forth on Exhibit B; and (v) if applicable, Employee shall vest into the Accelerated Awards as set forth in Section 5.13 hereof. If Employee is terminated on or after a Change in Control that is a “change in control” for purposes of Section 409A of the Code, Employee will receive the following severance payments: (A) (i) a lump sum payment within sixty (60) days of termination equal to thirty-six (36) months of Employee’s Base Salary; (ii) a bonus calculated and paid in accordance with Section 5.10 hereof; (iii) any earned and unpaid Performance Bonus with respect to the year prior to the year of termination, which shall be paid in accordance with Section 2.4; (iv) a lump sum payment within sixty (60) days of termination of an amount equal to the greater of (1) three (3) times Employee’s Average Annual Performance Bonus or (2) three (3) times Employee’s target Performance Bonus amount set forth on Exhibit B, and (v) if applicable, Employee shall vest into the Accelerated Awards as set forth in Section 5.13 hereof. For the avoidance of doubt, and any reductions in Base Salary or target Performance Bonus opportunity resulting in Good Reason shall be disregarded in calculating severance under this Section 5.14.

5.15    Termination of Employment Period. For the avoidance of doubt, termination of Employee’s employment at the end of the second Renewal Period shall not entitle Employee to payment of severance under this Section 5.

6.    Successors; Binding Agreement.

6.1.    Successors. Employer shall require any successor (whether direct or indirect, by purchase, merger, consolidation or otherwise) acquiring a majority of Employer’s voting common stock or any other successor to all or substantially all of the business and/or assets of Employer to expressly assume and agree to perform this Agreement in the same manner and to the same extent that Employer would be required to perform it if no such succession had taken place and Employee hereby consents to any such assignment. In such event, “Employer” shall mean Employer as previously defined and any successor to its business and/or assets which

 

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executes and delivers the agreement provided for in this Section 6 or which otherwise becomes bound by all the terms and provisions of this Agreement by operation of law. This Section shall not limit Employee’s ability to terminate this Agreement in the circumstances described in Section 4.6.

6.2.    Benefit. This Agreement and all rights of Employee under this Agreement shall inure to the benefit of and be enforceable by Employee’s personal or legal representatives, executors, administrators, successors, heirs, distributees, devisees and legatees. If Employee should die after the termination date and amounts would have been payable to Employee under this Agreement if Employee had continued to live, including under Section 5 hereof, then such amounts shall be paid to Employee’s devisee, legatee, or other designee or, if there is no such designee, Employee’s estate.

7.    Conflicts. Except as otherwise provided in this Agreement, this Agreement constitutes the entire agreement among the parties pertaining to the subject matter hereof, and supersedes and revokes any and all prior offer letters or existing agreements, written or oral, relating to the subject matter hereof, and this Agreement shall be solely determinative of the subject matter hereof. Any conflict between this Agreement and any plan document or award agreement or policy shall be resolved in favor of this Agreement.

8.    Restrictive Covenants; Confidential Information; Work Product; Injunctive Relief.

8.1.    No Material Competition. Employer and Employee acknowledge and agree that a strong relationship and connection exists between Employer and its current and prospective patients, referral sources, and customers as well as the hospitals and healthcare facilities at which it provides professional services. Employer and Employee further acknowledge and agree that the restrictive covenants described in this Section are designed to enforce, and are ancillary to or part of, the promises contained in this Agreement and are reasonably necessary to protect the legitimate interests of Employer in the following: (1) the use and disclosure of the Confidential Information as described in Section 8.4; (2) the professional development activities described in Section 1.2; and (3) the goodwill of Employer, as promoted by Employee as provided in Section 1.2. The foregoing listing is by way of example only and shall not be construed to be an exclusive or exhaustive list of such interests. Employee acknowledges that the restrictive covenants set forth below are of significant value to Employer and were a material inducement to Employer in agreeing to the terms of this Agreement. Employee further acknowledges that the goodwill and other proprietary interest of Employer will suffer irreparable and continuing damage in the event Employee enters into competition with Employer in violation of this Section.

Therefore, Employee agrees that, except with respect to services performed under this Agreement on behalf of Employer, Employee shall not, at any time during the Restricted Period (as defined below), for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, intentionally, knowingly, or willingly participate or engage in or own an interest in, directly or indirectly, any individual proprietorship, partnership, corporation, joint venture, trust or other form of business entity, whether as an individual proprietor, partner, joint venturer, officer, director, member, employee, consultant, independent contractor, stockholder, or

 

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lender, , if such entity is engaged in, directly or indirectly, “Employer’s Business”, as defined on Exhibit A hereto. Employee acknowledges that, as of the date hereof, Employee’s responsibilities will include matters affecting the businesses of Employer listed on Exhibit A. Notwithstanding the foregoing and except as otherwise set forth on Exhibit A, Employee shall not violate this Section 8.1 by providing services to an entity which has a unit, division, subsidiary, or affiliate engaged in the Employer’s Business so long as Employee does not directly or indirectly provide services to such unit, division, subsidiary, or affiliate. For purposes of this Section 8, the “Restricted Period” shall mean the Employment Period plus (i) eighteen (18) months in the event this Agreement is terminated pursuant to Section 4.1, and (ii) twenty-four (24) months in the event the Agreement is terminated for any other reason.

8.2.    No Hire. Employee further agrees that Employee shall not, at any time during the Employment Period (other than on behalf of Employer or its affiliates) and for a period of eighteen (18) months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, intentionally, knowingly, or willingly employ, or intentionally, knowingly, or willingly permit any company or business directly or indirectly controlled by Employee to (a) employ or otherwise hire (i) any person who is a then current employee or exclusive independent contractor of Employer or one of its affiliates , or (ii) any person who was an employee or exclusive independent contractor of Employer or one of its affiliates in the prior six (6) month period, or (b) take any action that would reasonably be expected to induce an employee or independent contractor of Employer or one of its affiliates to leave his employment or engagement with Employer or one of its affiliates (including without limitation for or on behalf of a subsequent employer of Employee). Employee shall not violate this Section 8.2 by (x) soliciting employees or consultants through a general advertisement not directed specifically at employees or exclusive independent contractors of Employer or one of its affiliates or (y) providing a personal reference.

8.3     Non-Solicitation. Employee further agrees that Employee shall not, at any time during the Employment Period (other than on behalf of Employer or its affiliates) and for a period of eighteen (18) months immediately following termination of this Agreement for any reason, for Employee or on behalf of any other person, persons, firm, partnership, corporation or employer, intentionally, knowingly, or willingly solicit or accept business from (but solely in connection with Employer’s Business) or take any action that would reasonably be expected to materially interfere with, diminish or impair the valuable relationships that Employer or its affiliates have with (i) hospitals or other health care facilities with which Employer or its affiliates have contracts to render professional services or otherwise have established relationships, (ii) patients, (iii) referral sources, (iv) vendors, (v) any other clients of Employer or its affiliates , or (vi) prospective hospitals, patients, referral sources, vendors or clients whose business Employee was aware that Employer or any affiliate of Employer was in the process of soliciting at the time of Employee’s termination (including potential acquisition targets).

8.4.    Confidential Information. At all times during the term of this Agreement, Employer shall provide Employee with access to “Confidential Information.” As used in this Agreement, the term “Confidential Information” means any and all confidential, proprietary or trade secret information, whether disclosed, directly or indirectly, verbally, in writing or by any other means in tangible or intangible form, including that which is conceived or developed by

 

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Employee, applicable to or in any way related to: (i) patients with whom Employer has a physician/patient relationship; (ii) the present or future business of Employer; or (iii) the research and development of Employer. Without limiting the generality of the foregoing, Confidential Information includes: (a) the development and operation of Employer’s medical practices, including information relating to budgeting, staffing needs, marketing, research, hospital relationships, equipment capabilities, and other information concerning such facilities and operations and specifically including the procedures and business plans developed by Employer for use at the hospitals where Employer conducts its business; (b) contractual arrangements between Employer and insurers or managed care associations or other payors; (c) the databases of Employer; (d) the clinical and research protocols of Employer, including coding guidelines; (e) the referral sources of Employer; (f) other confidential information of Employer that is not generally known to the public that gives Employer the opportunity to obtain an advantage over competitors who do not know or use it, including the names, addresses, telephone numbers or special needs of any of its patients, its patient lists, its marketing methods and related data, lists or other written records used in Employer’s business, compensation paid to employees and other terms of employment, accounting ledgers and financial statements, contracts and licenses, business systems, business plan and projections, and computer programs. The parties agree that, as between them, this Confidential Information constitutes important, material, and confidential trade secrets that affect the successful conduct of Employer’s business and its goodwill. Employer acknowledges that the Confidential Information specifically enumerated above is special and unique information and is not information that would be considered a part of the general knowledge and skill Employee has or might otherwise obtain.

Notwithstanding the foregoing, Confidential Information shall not include any information that (i) was known by Employee from a third party source before disclosure by or on behalf of Employer, (ii) becomes available to Employee from a source other than Employer that is not, to Employee’s knowledge, bound by a duty of confidentiality to Employer, (iii) becomes generally available or known in the industry other than as a result of its disclosure by Employee, or (iv) has been independently developed by Employee and may be disclosed by Employee without breach of this Agreement, provided, in each case, that Employee shall bear the burden of demonstrating that the information falls under one of the above-described exceptions.

Additionally, notwithstanding anything herein to the contrary, nothing in this Agreement or any other agreement between Employer and Employee shall prevent Employee from filing a charge, sharing information and communicating in good faith, without prior notice to Employer, with any federal government agency having jurisdiction over Employer or its operations, and cooperating in any investigation by any such federal government agency; provided, however, that to the maximum extent permitted by law, Employee agrees that if such an administrative claim is made, Employee shall not be entitled to recover any individual monetary relief or other individual remedies thereunder.

Except as provided herein, Employee agrees that Employee will not at any time, whether during or subsequent to the term of Employee’s employment with Employer, in any fashion, form or manner, unless specifically consented to in writing by Employer (or as reasonably appropriate in connection with Employee’s performance of his duties), either directly or indirectly, use or divulge, disclose, or communicate to any person, firm or corporation, in any manner

 

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whatsoever, any Confidential Information of any kind, nature, or description, subject to applicable law. The parties agree that any breach by Employee of any term of this Section 8.4 resulting in material harm to MEDNAX or Employer is a material breach of this Agreement and shall constitute “Cause” for the termination of Employee’s employment hereunder pursuant to Section 4.1 hereof. In the event that Employee is ordered to disclose any Confidential Information, whether in a legal or a regulatory proceeding or otherwise, to the extent legally permitted, Employee shall provide Employer with prompt written notice of such request or order so that Employer may seek to prevent disclosure or, if that cannot be achieved, the entry of a protective order or other appropriate protective device or procedure in order to assure, to the extent practicable, compliance with the provisions of this Agreement. In the case of any disclosure required by law, Employee shall disclose only that portion of the Confidential Information that Employee is ordered to disclose in a legally binding subpoena, demand or similar order issued pursuant to a legal or regulatory proceeding. Employee may also disclose Confidential Information as reasonably appropriate pursuant to any litigation or arbitration between Employee and Employer or any of its affiliates.

All Confidential Information, and all equipment, notebooks, documents, memoranda, reports, files, samples, books, correspondence, lists, other written and graphic records, in any media (including electronic or video) containing Confidential Information or relating to the business of Employer, which Employee shall prepare, use, construct, observe, possess, or control shall be and remain Employer’s sole property (collectively “Employer Property”). Upon termination or expiration of this Agreement, or earlier upon Employer’s request, Employee shall promptly deliver to Employer all Employer Property, retaining none other than Employee’s contacts, calendar and personal correspondence and any of Employee’s compensation-related information.

8.5.    Ownership of Work Product. Employee agrees and acknowledges that (i) all copyrights, patents, trade secrets, trademarks, service marks, or other intellectual property or proprietary rights associated with any ideas, concepts, techniques, inventions, processes, or works of authorship developed or created by Employee during the course of performing work for Employer and any other work product conceived, created, designed, developed or contributed by Employee during the term of this Agreement that relates in any way to Employer’s Business (collectively, the “Work Product”), shall belong exclusively to Employer and shall, to the extent possible, be considered a work made for hire within the meaning of Title 17 of the United States Code. To the extent the Work Product may not be considered a work made for hire owned exclusively by Employer, Employee hereby assigns to Employer all right, title, and interest worldwide in and to such Work Product at the time of its creation, without any requirement of further consideration. Upon request of Employer (and at Employer’s cost), Employee shall take such further actions and execute such further documents as Employer may deem necessary or desirable to further the purposes of this Agreement, including without limitation separate assignments of all right, title, and interest in and to all rights of copyright and all right, title, and interest in and to any inventions or patents and any reissues or extensions which may be granted therefore, and in and to any improvements, additions to, or modifications thereto, which Employee may acquire by invention or otherwise, the same to be held and enjoyed by Employer for its own use and benefit, and for the use and benefit of Employer’s successors and assigns, as fully and as entirely as the same might be held by Employee had this assignment not been made.

 

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8.6.    Clearance Procedure for Proprietary Rights Not Claimed by Employer. In the event that Employee wishes to create or develop, other than on Employer’s time or using Employer’s resources, anything that may be considered Work Product but to which Employee believes Employee should be entitled to the personal benefit of, Employee agrees to follow the clearance procedure set forth in this Section. Before beginning any such work, Employee agrees to give Employer advance written notice and provide Employer with a sufficiently detailed written description of the work under consideration for Employer to make a determination regarding the work. Unless otherwise agreed in a writing signed by Employer prior to receipt, Employer shall have no obligation of confidentiality with respect to such request or description. Employer will determine in its sole discretion, within thirty (30) days after Employee has fully disclosed such plans to Employer, whether rights in such work will be claimed by Employer. If Employer determines that it does not claim rights in such work, Employer agrees to so notify Employee in writing and Employee may retain ownership of the work to the extent that such work has been expressly disclosed to Employer. If Employer fails to so notify Employee within such thirty (30) day period, then Employer shall be deemed to have agreed that such work is not considered Work Product for purposes of this Agreement. Employee agrees to submit for further review any significant improvement, modification, or adaptation that could reasonably be related to Employer’s Business so that it can be determined whether the improvement, modification, or adaptation relates to the business or interests of Employer. Clearance under this procedure does not relieve Employee of the restrictive covenants set forth in this Section 8.

8.7.    Non-Disparagement. For a period of ten (10) years after termination of Employee’s employment , Employee will not, directly or indirectly, as an individual or on behalf of a firm, corporation, partnership or other legal entity, intentionally, knowingly, or willingly make any comment that would reasonably be expected to be materially disparaging or negative to any other person or entity regarding Employer or MEDNAX or any of its affiliates, employees, officers and directors, Employee’s work conditions or circumstances surrounding Employee’s separation from Employer or otherwise impugn or criticize the name or reputation of Employer or MEDNAX, its affiliates, employees, officers or directors, orally or in writing. For a period of ten (10) years after termination of Employee’s employment, Employer and MEDNAX will not, directly or indirectly, intentionally, knowingly, or willingly make any comment that would reasonably be expected to be materially disparaging or negative to Employee, Employee’s work performance or circumstances surrounding Employee’s separation from Employer or otherwise impugn or criticize the name or reputation of Employee. This Section 8.7 shall not be violated by truthful testimony or statements made in the normal course of Employee’s employment or permitted competitive activities or by Employer or Employee in enforcing the terms of this Agreement.

8.8.    Review by Employee. Employee has carefully read and considered the terms and provisions of this Section 8, and having done so, agrees that the restrictions set forth in this Section 8 are fair and reasonably required for the protection of the interests of Employer. In the event that any term or provision set forth in this Section 8 shall be held to be invalid or unenforceable by a court of competent jurisdiction, the parties hereto agree that such invalid or unenforceable term(s) or provision(s) may be severed from this Agreement without, in any manner, affecting the remaining portions hereof. Without limiting other possible remedies available to Employer, Employee agrees that injunctive or other equitable relief will be available

 

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to enforce the covenants set forth in this Section, such relief to be without the necessity of posting a bond. In the event that, notwithstanding the foregoing, any part of the covenants set forth in this Section shall be held to be invalid, overbroad, or unenforceable by an arbitration panel or a court of competent jurisdiction, the parties hereto agree that such invalid, overbroad, or unenforceable provision(s) may be modified or severed from this Agreement without, in any manner, affecting the remaining portions of this Section 8 (all of which shall remain in full force and effect). In the event that any provision of this Section 8 related to time period or areas of restriction shall be declared by an arbitration panel or a court of competent jurisdiction to exceed the maximum time period, area or activities such arbitration panel or court deems reasonable and enforceable, said time period or areas of restriction shall be deemed modified to the minimum extent necessary to make the geographic or temporal restrictions or activities reasonable and enforceable.

8.9.    Survival; Notice of Breach and Right to Cure.

If Employer reasonably believes that Employee has breached a provision of this Section 8, Employer shall provide prompt written notice thereof to Employee that explains such reasonably believed breach (the “Alleged Breach”). Employer agrees to work in good faith with Employee to provide Employee a reasonable opportunity to promptly cure such Alleged Breach. In the event that Employee, acting in good faith, promptly takes actions that would reasonably be expected to cure the Alleged Breach, including, with respect to a comment made by Employee that Employer reasonably believes is in breach of Section 8.7, by Employee retracting such comment, then Employee shall be deemed not to be in breach of this Section 8 with respect to the Alleged Breach. Employer and Employee further agree that Employee shall not be deemed to be in breach of any term of Section 8.4 or Section 8.7 unless such breach results in material harm to MEDNAX or Employer.

The provisions of this Section 8 shall survive the termination of this Agreement and Employee’s employment with Employer. In the event of a breach of this Section 8 by Employee, as finally determined pursuant to Section 11 hereof, Employer retains the right to terminate any continuing payments to Employee provided for in Section 5 of this Agreement. In the event of a breach of any provisions of this Section 8 by Employee, as finally determined pursuant to Section 11 hereof, the period for which those provisions would remain in effect shall be extended for a period of time equal to that period beginning when such breach commenced and ending when the activities constituting such breach shall have been finally terminated (unless Employer was aware of such breach and did not commence actions to cause Employee to cease his actions), in each case as finally determined pursuant to Section 11 hereof.

The provisions of this Section 8 are expressly intended to benefit and be enforceable by other affiliated entities of Employer, who are express third party beneficiaries hereof. Employee shall not assist others in engaging in any of the activities described in the foregoing restrictive covenants.

9.    Section 280G. Notwithstanding any other provision of this Agreement or any other plan, arrangement or agreement to the contrary, if any of the payments or benefits provided or to be provided by Employer or its affiliates to Employee or for Employee’s benefit pursuant to the terms of this Agreement or otherwise (the “Covered Payments”) constitute parachute payments

 

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(the “Parachute Payments”) within the meaning of Section 280G of the Code and, but for this Section 9, would be subject to the excise tax imposed under Section 4999 of the Code (or any successor provision thereto) or any similar tax imposed by state or local law or any interest or penalties with respect to such taxes (collectively, the “Excise Tax”), then prior to making the Covered Payments, a calculation shall be made comparing (i) the Net Benefit (as defined below) to Employee of the Covered Payments after payment of the Excise Tax to (ii) the Net Benefit to Employee if the Covered Payments are limited to the extent necessary to avoid being subject to the Excise Tax. Only if the amount calculated under (i) above is less than the amount under (ii) above will the Covered Payments be reduced to the minimum extent necessary to ensure that no portion of the Covered Payments is subject to the Excise Tax (that amount, the “Reduced Amount”). “Net Benefit” shall mean the present value of the Covered Payments net of all federal, state, local, foreign income, employment and excise taxes.

(a)    Any such reduction shall be made in accordance with Section 409A and the following:

(i)    the Covered Payments consisting of cash severance benefits that do not constitute nonqualified deferred compensation subject to Section 409A shall be reduced first, in reverse chronological order; and

(ii)    all other Covered Payments consisting of cash payments, and Covered Payments consisting of accelerated vesting of equity based awards to which Treas. Reg. § 1.280G-1 Q/A-24(c) does not apply, and that in either case do not constitute nonqualified deferred compensation subject to Section 409A, shall be reduced second, in reverse chronological order;

(iii)    all Covered Payments consisting of cash payments that constitute nonqualified deferred compensation subject to Section 409A shall be reduced third, in reverse chronological order; and

(iv)    all Covered Payments consisting of accelerated vesting of equity-based awards to which Treas. Reg. § 1.280G-1 Q/A-24(c) applies shall be the last Covered Payments to be reduced.

(b)    Any determination required under this Section 9 shall be made in writing in good faith by an independent accounting firm selected by Employee, subject to the approval of Employer which shall not be unreasonably withheld (the “Accountants”). Employer and Employee shall provide the Accountants with such information and documents as the Accountants may reasonably request in order to make a determination under this Section 9. For purposes of making the calculations and determinations required by this Section 9, the Accountants may rely on reasonable, good-faith assumptions and approximations concerning the application of Section 280G and Section 4999 of the Code. The Accountants’ determinations shall be final and binding on Employer and Employee, absent manifest error. Employer shall be responsible for all fees and expenses incurred by the Accountants in connection with the calculations required by this Section 9. The Accountants shall Employee with its analysis as soon as practicable following Employee’s request and prior to the occurrence of any transaction which would result in the possibility of Covered Payments being made. Employer shall cooperate with the Employee in good faith in

 

20


valuing, and the Accountants shall take into account the value of, services to be provided by the Employee (including the Employee agreeing to refrain from performing services pursuant to a covenant not to compete) before, on or after the date of the transaction which causes the application of Section 280G of the Code such that payments in respect of such services may be considered to be “reasonable compensation” within the meaning of Q&A-9 and Q&A-40 to Q&A-44 of the final regulations under Section 280G of the Code and/or exempt from the definition of the term “parachute payment” within the meaning of Q&A-2(a) of such final regulations in accordance with Q&A-5(a) of such final regulations

(c)    It is possible that after the determinations and selections made pursuant to this Section 9, Employee will receive Covered Payments that are in the aggregate more than the amount intended or required to be provided after application of this Section 9 (“Overpayment”) or less than the amount intended or required to be provided after application of this Section 9 (“Underpayment”).

(i)    In the event that: (A) the Accountants determine, based upon the assertion of a deficiency by the Internal Revenue Service against either Employer or Employee that the Accountants believe has a high probability of success, that an Overpayment has been made or (B) it is established pursuant to a final determination of a court or an Internal Revenue Service proceeding that has been finally and conclusively resolved that an Overpayment has been made, then Employee shall pay any such Overpayment to Employer together with interest at the applicable federal rate (as defined in Section 7872(f)(2)(A) of the Code) from the date of Employee’s receipt of the Overpayment until the date of repayment.

(ii)    In the event that: (A) the Accountants, based upon controlling precedent or substantial authority, determine that an Underpayment has occurred or (B) a court of competent jurisdiction determines that an Underpayment has occurred, any such Underpayment will be paid promptly by Employer to or for the benefit of Employee together with interest at the applicable federal rate (as defined in Section 7872(f)(2)(A) of the Code) from the date the amount should have otherwise been paid to Employee until the payment date.

11.    Arbitration. Any controversy or claim arising out of or relating to this Agreement, or any alleged breach hereof shall be finally determined by a single arbitrator, jointly selected by Employee and Employer, provided that if Employee and Employer are unable to agree upon a single arbitrator after reasonable efforts, the arbitrator shall be an impartial arbitrator selected by the American Arbitration Association. Each party hereto shall share equally the costs of the arbitrator, and the parties agree that the costs of arbitration shall not be subject to reapportionment by the arbitrator; provided, however, that if following a termination of Employee’s employment that follows or is within six (6) months prior to a Change in Control, Employee seeks arbitration to enforce the terms of this Agreement, Employer shall bear all costs associated with such arbitration, including but not limited to all costs of the arbitrator, and shall reimburse Employee on a monthly basis for his reasonable legal and other expenses, including all fees, incurred in connection with any such arbitration. The arbitration proceedings shall be held in Broward County, Florida, unless otherwise mutually agreed by the parties, and shall be conducted in

 

21


accordance with the American Arbitration Association National Rules for the Resolution of Employment Disputes then in effect. Judgment on the award rendered by the arbitration panel may be entered and enforced by any court having jurisdiction thereof. Any such arbitration shall be treated as confidential by all parties thereto, except as otherwise provided by law or as otherwise necessary to enforce any judgment or order issued by the arbitrators.

Notwithstanding anything herein to the contrary, if Employer or Employee shall require immediate injunctive relief, then the party shall be entitled to seek such relief in any court having jurisdiction, and if the party elects to do so, the other party hereby consents to the jurisdiction of the state and federal courts sitting in the State of Florida and to the applicable service of process. Employee and Employer hereby waive and agree not to assert, to the fullest extent permitted by applicable law, any claim that (i) they are not subject to the jurisdiction of such courts, (ii) they are immune from any legal process issued by such courts and (iii) any litigation or other proceeding commenced in such courts is brought in an inconvenient forum. In the event that either party hereto brings suit seeking injunctive relief, the party found to be at fault shall pay all reasonable court costs and attorneys’ fees of the other, whether such costs and fees are incurred in a court of original jurisdiction or one or more courts of appellate jurisdiction. Notwithstanding the foregoing, in the event that Employer brings suit against Employee seeking injunctive relief, Employer agrees to advance all of Employee’s reasonable legal and other expenses, including all fees, incurred by Employee in connection with such action, provided, however, that if Employer ultimately prevails in seeking injunctive relief, Employee shall reimburse Employer all such advanced legal fees and other expenses.

12.    Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Florida without regard to its conflict of laws principles to the extent that such principles would require the application of laws other than the laws of the State of Florida.

13.    Notices. Any notice required or permitted to be given under this Agreement shall be in writing and shall be deemed to have been given when delivered by hand or when deposited in the United States mail by registered or certified mail, return receipt requested, postage prepaid, addressed as follows:

 

If to Employer:   If to Employee:
Mednax Services, Inc.   Mark Ordan
1301 Concord Terrace   Last known address on
Sunrise, FL 33323   Employer’s records.
Attention: General Counsel  

or to such other addresses as either party hereto may from time to time give notice of to the other in the aforesaid manner.

14.    Benefits: Binding Effect. This Agreement shall be for the benefit of and binding upon the parties hereto and their respective heirs, personal representatives, legal representatives, successors and, where applicable in connection with corporate acquisition transactions, assigns.

 

22


Notwithstanding the foregoing, Employee may not assign the rights or benefits hereunder without the prior written consent of Employer, other than in connection with Employee’s death.

15.    Severability. The invalidity of any one or more of the words, phrases, sentences, clauses or sections contained in this Agreement shall not affect the enforceability of the remaining portions of this Agreement or any part thereof, all of which are inserted conditionally on their being valid in law, and, in the event that any one or more of the words, phrases, sentences, clauses or sections contained in this Agreement shall be declared invalid, this Agreement shall be construed as if such invalid word or words, phrase or phrases, sentence or sentences, clause or clauses, or section or sections had not been inserted. If such invalidity is caused by length of time or size of area, or both, the otherwise invalid provision will be considered to be reduced to a period or area, which would cure such invalidity.

16.    Waivers. The waiver by either party hereto of a breach or violation of any term or provision of this Agreement shall not operate nor be construed as a waiver of any subsequent breach or violation.

17.    Damages. Nothing contained herein shall be construed to prevent Employer or Employee from seeking and recovering from the other damages sustained by either or both of them as a result of a breach of any term or provision of this Agreement.

18.    No Third Party Beneficiary. Except as provided in Section 8.9, nothing expressed or implied in this Agreement is intended, or shall be construed, to confer upon or give any person (other than the parties hereto and, in the case of Employee, Employee’s heirs, personal representative(s) and/or legal representative) any rights or remedies under or by reason of this Agreement. No agreements or representations, oral or otherwise, express or implied, have been made by either party with respect to the subject matter of this Agreement which agreements or representations are not set forth expressly in this Agreement, and this Agreement supersedes any other employment agreement between Employer and Employee.

19.    Assignment. Upon notice to Employee, this Agreement may be assigned by Employer to an affiliate of Employer (with a sufficient net worth to perform the obligations hereunder) in connection with a corporate reorganization, restructuring, or similar corporate transaction, or to a successor to Employer in connection with a Change in Control.

20. Legal Fees. Employer shall reimburse Employee for his reasonable legal fees incurred in connection with the negotiation of this Agreement and the ancillary agreements.

The remainder of this page has been left blank intentionally.

 

23


IN WITNESS WHEREOF, the undersigned have executed this Agreement this 12th day of July, 2020, effective as of the Effective Date.

 

EMPLOYER:       EMPLOYEE:
MEDNAX SERVICES, INC.                                 
By:  

/s/ Dominic J. Andreano

      By:  

/s/ Mark S. Ordan

  Name:    Dominic J. Andreano         Mark S. Ordan
  Title:   EVP, General Counsel and Secretary        
MEDNAX, INC.        
By:  

/s/ Dominic J. Andreano

       
  Name:    Dominic J. Andreano        
  Title:   EVP, General Counsel and Secretary        

[Signature Page to Employment Agreement]


EXHIBIT A

BUSINESS OF EMPLOYER

As of the date hereof, Employer, directly or through its affiliates, provides professional medical services and all aspects of practice management services in medical practice areas that include, but are not limited to, the following (collectively referred to herein as “Employer’s Business”):

(1) Neonatology, including hospital well baby care;

(2) Maternal-Fetal Medicine, including general obstetrics services;

(3) Pediatric Cardiology;

(4) Pediatric Intensive Care, including Pediatric Hospitalist Care;

(5) Newborn hearing screening services;

(6) Pediatric Surgery;

(7) Pediatric Emergency Medicine; and

(8) Radiology and Teleradiology.

References to Employer’s Business in this Agreement shall include such other medical service lines, practice management services and other businesses in which Employer is engaged during the Employment Period; provided, that to be considered a part of Employer’s Business, Employer must have engaged in such other service line, practice management service or other business at least six (6) months prior to the termination of Employee’s employment. For purposes of this Exhibit A, businesses of Employer shall include the businesses conducted by Employer’s subsidiaries, entities under common control and affiliates as defined under Rule 144 of the Securities Act of 1933, as amended. Such affiliates shall include the professional corporations and associations whose operating results are consolidated with Employer for financial reporting purposes, provided that for purposes of Section 8.2 and 8.3 of the Agreement, the term “affiliates” shall only mean the foregoing affiliates and subsidiaries. As used in the Agreement, the term “affiliate” shall exclude unrelated entities owned by an acquirer of Employer or MEDNAX.

Notwithstanding the foregoing, Employer acknowledges and agrees to the following exceptions and clarifications regarding the scope of Employer’s Business.

A.    Hospital Services. Employer and Employee acknowledge that, as of the date hereof, Employer does not currently operate hospitals, hospital systems or universities. Nevertheless, the businesses of hospitals, hospital systems and universities would be the same as Employer’s Business where such hospitals, hospital systems or universities provide or contract with others to provide some or all of the medical services included in Employer’s Business. Therefore, the parties desire to clarify their intent with respect to the limitations on Employee’s ability to work for or contract with others to provide services for a hospital, hospital system or university during the Employment Period and during the Restricted Period. Section 8.1 shall not be deemed to restrict Employee’s ability to work for a hospital, hospital system or university if the hospital, hospital system or university does not provide any of the medical services included in Employer’s Business. Furthermore, even if a hospital, hospital system or university provides medical services that are included in Employer’s Business, Employee may work for such hospital,

 

A-1


hospital system or university if Employee has no direct supervisory responsibility for or involvement in the hospital’s, hospital system’s or university’s provision of medical services that are Employer’s Business. For the avoidance of doubt, Employer and Employee agree that if Employee becomes the Chief Executive Officer of, or a member of the board of directors of, a university, a hospital system or health system, or other executive officer of similar level to the foregoing, that Employee shall not be in breach of the provisions of this Agreement. Finally, Employer agrees that Employee may hold direct supervisory responsibility for or be involved in the medical services of a hospital, hospital system or university that are included in Employer’s Business so long as such hospital, hospital system or university is located at least ten (10) miles from a medical practice owned or operated by Employer or its affiliate. Subject to paragraph B below, the provisions of this paragraph shall not apply to the extent that, after the date hereof, Employer enters into the business of operating a hospital or hospital system.

B.    De Minimus Exception. Employer agrees that a medical service line (other than those listed in items (1) through (8) above), practice management service or other business in which Employer is engaged shall not be considered to be a part of Employer’s Business if such medical service line, practice management service or other business constitutes less than three percent (3%) of Employer’s annual revenues.

C.    Divested Lines of Service. Employer agrees that any medical service line (including those listed in items (1) through (8) above), practice management or other business in which Employer is engaged that is divested pursuant to a disposition, sale of assets or equity, or otherwise after the Effective Date shall not be considered to be a part of Employer’s Business effective as of the effective date of such divestiture.

D.    Certain Ownership Interests. It shall not be deemed to be a violation of Section 8.1 for Employee to: (i) own, directly or indirectly, one percent (1%) or less of a publicly-traded entity that has a market capitalization of $1 billion or more; (ii) own, directly or indirectly, five percent (5%) or less of a publicly-traded entity that has a market capitalization of less than $1 billion; or (iii) own, directly or indirectly, less than ten percent (10%) of a privately-held business or company, if Employee is at all times a passive investor with no board representation, management authority or other special rights to control operations of such business or company.

 

A-2


EXHIBIT B

COMPENSATION

Base Salary: One Million US Dollars ($1,000,000).

Performance Bonus: Target of One Hundred and Fifty Percent (150%) of Employee’s Base Salary with a Maximum Bonus potential of Two Hundred Percent (200%) of Employee’s Base Salary, and opportunity for threshold bonus. Employee’s 2020 performance bonus shall be prorated (on a daily basis relative to 366) based on the Effective Date and payable at 150% of Employee’s Base Salary (as so prorated).

Equity Compensation: Employee’s initial 2020 equity compensation grant fair value amount shall be at least $5 million, consisting of $2 million in Restricted Stock and $3 million in performance stock options, and Employee’s equity compensation grant fair value amount for 2021 shall be at least $3.5 million and thereafter shall be an annual fair value amount of at least $3.5 million, subject to the approval of the Compensation Committee. The terms of the equity grants and the breakdown of performance and time-based awards shall be no less favorable than that provided for other senior executive officers of Employer, and shall be agreed upon by Employee and the Compensation Committee.

 

B-1


EXHIBIT C

MEDNAX, INC.

RESTRICTED STOCK AGREEMENT

FOR

Mark Ordan

(the “Recipient”)

 

1.

Grant of Restricted Stock. The Compensation Committee (the “Committee”) of the Board of Directors of MEDNAX, Inc. (the “Company”) has granted on July 12, 2020, the “Date of Grant”), to the Recipient, 113,314 shares of restricted common stock, par value $.01 per share, of the Company (collectively the “Restricted Stock”). The Restricted Stock shall be subject to the terms, conditions and restrictions set forth in this Agreement. The Restricted Stock was issued pursuant to the Company’s Amended and Restated 2008 Incentive Compensation Plan (the “Plan”), which is incorporated herein for all purposes. The Recipient hereby acknowledges receipt of a copy of the Plan and agrees to be bound by all of the terms and conditions hereof and thereof and all applicable laws and regulations. Unless otherwise provided herein, terms used herein that are defined in the Plan and not defined herein shall have the meanings attributed thereto in the Plan.

 

2.

Vesting of Restricted Stock.

The shares of Restricted Stock shall be fully vested on the Date of Grant.

 

3.

Delivery of Restricted Stock.

 

  (a)

The Restricted Stock shall be issued in the name of the Recipient and held in electronic book entry format by the Company’s transfer agent until the date (the “Applicable Date”) on which the shares (or a portion thereof) subject to this Restricted Stock award become transferable or otherwise subject to disposition. All such Restricted Stock held by the Company’s transfer agent shall be deemed restricted and may not be sold, transferred, or disposed of until the earlier of (A) the fifth (5th) anniversary of the grant date (the “Anniversary Date”), (B) a Change in Control (as defined in Recipient’s employment agreement dated July 12, 2020 (the “Employment Agreement”), (C) Recipient’s termination of employment pursuant to Sections 4.2, 4.3, 4.4, or 4.6 of the Employment Agreement, or (D) Recipient’s termination of employment pursuant to Sections 4.1 or 4.5 of the Employment Agreement, in which case of this subsection (D) Recipient must own 100% of such shares until the earlier of (i) the twelve (12) month anniversary of Recipient’s termination, (ii) the Anniversary Date, or (iii) a Change in Control.

 

  (b)

Until such shares become transferable or otherwise subject to disposition, the Recipient hereby irrevocably appoints the Secretary of the Company as his/her attorney-in-fact, with full power of appointment and substitution, to effectuate the transfer of the Restricted Stock (or assignment of distributions thereon) on the books and records of the Company in accordance with and as required to adhere to the restrictions set forth in this Agreement.

 

  (c)

On or after each Applicable Date and subject to compliance with Section 7 below, upon written request to the Company by the Recipient, the Company shall promptly cause a certificate or certificates to be issued for and with respect to all shares, which certificate(s) shall be delivered to the Recipient as soon as administratively practicable after the date of receipt by the Company of the Recipient’s written request. The certificate(s) shall bear those legends and endorsements that the Company shall deem necessary or appropriate (including those relating to restrictions on transferability and/or obligations and restrictions under the Securities Laws).

 

C-1


4.

Rights with Respect to Restricted Stock.

 

  (a)

Except as otherwise provided in this Agreement, the Recipient shall have, with respect to all of the shares of Restricted Stock, all of the rights of a holder of shares of common stock of the Company, including without limitation (i) the right to vote such Restricted Stock, (ii) the right to receive dividends, if any, as may be declared on the Restricted Stock from time to time, and (iii) the rights available to all holders of shares of common stock of the Company upon any merger, consolidation, reorganization, liquidation or dissolution, stock split-up, stock dividend or recapitalization undertaken by the Company; provided, however, that all of such rights shall be subject to the terms, provisions, conditions and restrictions set forth in this Agreement. Any shares of Stock issued to the Recipient as a dividend with respect to shares of Restricted Stock shall have the same status and bear the same legend as the shares of Restricted Stock and shall be held by the Company, if the shares of Restricted Stock that such dividend is attributed to is being so held, unless otherwise determined by the Committee. In addition, notwithstanding any provision to the contrary herein, any cash dividends declared with respect to shares of Restricted Stock subject to this Agreement shall be paid to the Recipient.

 

  (b)

If at any time while this Agreement is in effect, there shall be any increase or decrease in the number of issued and outstanding shares of Stock of the Company through the declaration of a stock dividend or through any recapitalization, combination or exchange of such shares, then and in that event, the Board or the Committee shall make any adjustments it deems in good faith fair and appropriate, in view of such change, in the number of shares of Restricted Stock then subject to this Agreement, to preserve the intended economics of the Restricted Stock. If any such adjustment shall result in a fractional share, such fraction shall be disregarded.

 

  (c)

Notwithstanding any term or provision of this Agreement to the contrary, the existence of this Agreement, or of any outstanding Restricted Stock awarded hereunder, shall not affect in any manner the right, power or authority of the Company to make, authorize or consummate: (i) any or all adjustments, recapitalizations, reorganizations or other changes in the Company’s capital structure or its business; (ii) any merger, consolidation or similar transaction by or of the Company; (iii) any offer, issue or sale by the Company of any capital stock of the Company, including any equity or debt securities, or preferred or preference stock that would rank prior to or on parity with the Restricted Stock and/or that would include, have or possess other rights, benefits and/or preferences superior to those that the Restricted Stock includes, has or possesses, or any warrants, options or rights with respect to any of the foregoing; (iv) the dissolution or liquidation of the Company; (v) any sale, transfer or assignment of all or any part of the stock, assets or business of the Company; or (vi) any other corporate transaction, act or proceeding (whether of a similar character or otherwise).

 

6.

Non-Transferability of Shares. A Beneficiary or other person claiming any rights under the Plan or this Agreement from or through the Recipient shall be subject to all of the terms and conditions of the Plan and this Agreement, except as otherwise determined by the Committee, and to any additional terms and conditions deemed necessary or appropriate by the Committee.

 

7.

Tax Matters.

 

  (a)

The Company shall withhold such number of shares of Restricted Stock on the Grant Date having a fair market value (as determined by the Company) equal to the amount necessary to satisfy the Recipient’s federal, state or local taxes of any kind required by law (the “Tax Obligations”).

 

  (d)

Tax consequences on the Recipient (including without limitation federal, state, local and foreign income tax consequences) with respect to the Restricted Stock (including without limitation the grant and the Tax Obligations) are the sole responsibility of the Recipient. The Recipient shall consult with his or her own personal accountant(s) and/or tax advisor(s) regarding these matters including the payment (or tax liability) obligations.

 

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8.

Amendment, Modification & Assignment; Non-Transferability. This Agreement may only be modified or amended in a written document signed by the parties hereto. No promises, assurances, commitments, agreements, undertakings or representations, whether oral, written, electronic or otherwise, and whether express or implied, with respect to the subject matter hereof, have been made by either party which are not set forth expressly in this Agreement. The rights and obligations created hereunder shall be binding on the Recipient and his heirs and legal representatives and on the successors and assigns of the Company.

 

9.

Complete Agreement. This Agreement (together with those agreements and documents expressly referred to herein, for the purposes referred to herein) embody the complete and entire agreement and understanding between the parties with respect to the subject matter hereof, and supersede any and all prior promises, assurances, commitments, agreements, undertakings or representations, whether oral, written, electronic or otherwise, and whether express or implied, which may relate to the subject matter hereof in any way.

 

10.

Miscellaneous.

 

  (a)

No Right to (Continued) Employment or Service. This Agreement and the grant of Restricted Stock hereunder shall not confer, or be construed to confer, upon the Recipient any right to employment or service, or continued employment or service, with the Company or any Related Entity.

 

  (b)

No Limit on Other Compensation Arrangements. Nothing contained in this Agreement shall preclude the Company or any Related Entity from adopting or continuing in effect other or additional compensation plans, agreements or arrangements, and any such plans, agreements and arrangements may be either generally applicable or applicable only in specific cases or to specific persons.

 

  (c)

Severability. If any term or provision of this Agreement is or becomes or is deemed to be invalid, illegal or unenforceable in any jurisdiction or under any applicable law, rule or regulation, then such provision shall be construed or deemed amended to conform to applicable law (or if such provision cannot be so construed or deemed amended without materially altering the purpose or intent of this Agreement and the grant of Restricted Stock hereunder, such provision shall be stricken as to such jurisdiction and the remainder of this Agreement and the award hereunder shall remain in full force and effect).

 

  (d)

No Trust or Fund Created. Neither this Agreement nor the grant of Restricted Stock hereunder shall create or be construed to create a trust or separate fund of any kind or a fiduciary relationship between the Company or any Related Entity and the Recipient or any other person. To the extent that the Recipient or any other person acquires a right to receive payments from the Company or any Related Entity pursuant to this Agreement, such right shall be no greater than the right of any unsecured general creditor of the Company.

 

  (e)

Law Governing. This Agreement shall be governed by and construed and enforced in accordance with the internal laws of the State of Florida (without reference to the conflict of laws rules or principles thereof).

 

  (f)

Interpretation. This Agreement is subject to all of the terms, conditions and provisions of the Plan, including, without limitation, the amendment provisions thereof, and to such rules, regulations and interpretations relating to the Plan adopted by the Committee as may be in effect from time to time. If and to the extent that the Agreement conflicts or is inconsistent with the terms, conditions and provisions of the Plan, this Agreement shall control. The Recipient accepts the Restricted Stock subject to all of the terms, provisions and restrictions of this Agreement and the Plan.

 

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  (g)

Headings. Section, paragraph and other headings and captions are provided solely as a convenience to facilitate reference. Such headings and captions shall not be deemed in any way material or relevant to the construction, meaning or interpretation of this Agreement or any term or provision hereof.

 

  (h)

Notices. Any notice under this Agreement shall be in writing and shall be deemed to have been duly given when delivered personally or when deposited in the United States mail, registered, postage prepaid, and addressed, in the case of the Company, to the Company’s General Counsel at 1301 Concord Terrace, Sunrise, FL 33323 or if the Company should move its principal office, to such principal office, and, in the case of the Recipient, to the Recipient’s last permanent address as shown on the Company’s records, subject to the right of the Company to designate some other address at any time hereafter in a notice satisfying the requirements of this Section.

 

  (i)

Non-Waiver of Breach. The waiver by any party hereto of the other party’s prompt and complete performance, or breach or violation, of any term or provision of this Agreement shall be effected solely in writing signed by such party, and shall not operate nor be construed as a waiver of any subsequent breach or violation, and the waiver by any party hereto to exercise any right or remedy which he or it may possess shall not operate nor be construed as the waiver of such right or remedy by such party, or as a bar to the exercise of such right or remedy by such party, upon the occurrence of any subsequent breach or violation.

 

  (j)

Counterparts. This Agreement may be executed in two or more separate counterparts, each of which shall be an original, and all of which together shall constitute one and the same agreement.

 

11.

Return of Value of Shares.

 

  (a)

If the Recipient is a party to an Employment Agreement with the Company or any Related Entity and the Recipient violates in any material respect any non-competition, non-solicitation, or confidentiality agreement contained therein (and such violation is not cured within 30 days following written notice from the Company), then, in addition to any other remedy the Company may have, the Company may, in the sole discretion of the Committee, require the Recipient to pay to the Company, upon written demand, (i) if the Recipient is employed by the Company at the time of such violation, an amount equal to the aggregate Fair Market Value of the Shares of Restricted Stock that have vested during the period beginning on the date twelve months before such violation and ending on the date on which senior management of the Company acquires actual knowledge of such violation or (ii) if the Recipient is not employed by the Company at the time of such violation, an amount equal to the aggregate Fair Market Value of the Shares of Restricted Stock that have vested during the twelve months preceding the date on which the Recipient’s employment with the Company was terminated. The aggregate Fair Market Value of such Shares of Restricted Stock shall be determined with respect to each Share on the applicable vesting date for that Share pursuant to Section 2 hereof, without regard to any changes in the Fair Market Value that occurred after the vesting date.

 

  (b)

Regardless of whether the Recipient is a party to an Employment Agreement with the Company or any Related Entity, in addition to any other remedy the Company may have, the Shares of Restricted Stock subject of this Agreement shall be subject to recoupment by the Company if the Recipient is subject to any recoupment or clawback policy of the Company in effect on or after the date hereof (a “Clawback Policy”) or any law, rule or regulation which imposes mandatory recoupment. Recipient acknowledges that, as of the

 

C-4


  date hereof, the Company has adopted the Clawback Policy set forth on Appendix A attached hereto and agrees to comply therewith and with any proper demand of the Company, the Board or Committee made pursuant thereto to enforce or otherwise comply with such Clawback Policy.

To enforce the provisions of Section 11 the Company may (i) cause the cancellation of Restricted Stock, (ii) require Recipient to return to the Company the Shares of Restricted Stock, (iii) require reimbursement of any benefit under the Restricted Stock granted to the Recipient, (iv) require the Recipient to pay to the Company the value realized by the Recipient from the sale or other disposition of the Shares of Restricted Stock and (v) effect any other right of recoupment or legal remedy with respect to equity or other compensation provided under the Plan or otherwise, in all cases, in accordance with and to the extent required by any Clawback Policy applicable to the Recipient. Additionally, the Company may require that, and the Recipient shall, repay to the Company certain previously paid compensation, either provided under the Plan or an award agreement or otherwise, in accordance with any Clawback Policy.

By accepting the Restricted Stock granted hereunder, the Recipient agrees to be bound by any existing or future Clawback Policy adopted by the Board or the Committee, or any amendments to any Clawback Policy that may from time to time be made by the Board or the Committee in their discretion or as any law, rule or regulation which imposes recoupment.

[Remainder of page intentionally left blank]

 

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IN WITNESS WHEREOF, the parties hereto, intending to be legally bound, have executed this Agreement as of the date first written above.

 

MEDNAX, Inc.
By:  

 

Name:   Dominic J. Andreano
Title:   EVP, General Counsel and Secretary

Agreed and Accepted:

 

Recipient:  

 

  Mark S. Ordan


APPENDIX A

Clawback Policy

The following policy is excerpted from the MEDNAX, Inc. Corporate Governance Principles:

Recoupment of Incentive Compensation. In the event of a restatement of the Company’s financial statements due to the material noncompliance of the Company with any financial reporting requirement under applicable securities laws as a result of misconduct, the result of which is that any incentive compensation (as defined below) that was based on such noncompliant financial statements and received during the three year period preceding the date on which the Board of Directors or a duly authorized committee thereof determines that the Company is required to prepare such restatement would have been a lower amount had it been based on such restated financial statements, a committee consisting of non-management members of the Board of Directors established by the Board of Directors in its discretion in light of the circumstances, which may be the Audit Committee of the Board of Directors (any such committee, the “Independent Director Committee”), shall review such incentive compensation.

If the Independent Director Committee determines that the amount of any such incentive compensation actually paid or awarded to an executive officer (the “Awarded Compensation”) would have been a lower amount had it been calculated based on such restated financial statements (the “Actual Compensation”) and such executive officer engaged in Improper Conduct (as defined below) that materially contributed to the need for such restatement, then the Independent Director Committee shall, except as provided below, seek to recover for the benefit of the Company the after-tax portion of the difference between the Awarded Compensation and the Actual Compensation (such difference, the “Excess Compensation”).

In determining the after-tax portion of the Excess Compensation, the Independent Director Committee shall take into account its good faith estimate of the value of any tax deduction available to the executive officer in respect of such repayment.

The Independent Director Committee may determine not to seek recovery to the extent it finds (i) that to do so would be inappropriate or unreasonable or (ii) that it would be better for the Company not to do so. In making such determination, the Independent Director Committee shall take into account such considerations as it deems appropriate, including, without limitation, (A) the position held by the executive officer at the time of the material non-compliance, (B) the conduct of the executive officer with respect to any such material non-compliance, (C) the likelihood of success under governing law versus the cost and effort involved, (D) whether the assertion of a claim may prejudice the interests of the Company, including in any related proceeding or investigation, (E) the passage of time since the occurrence of the act in respect of the material non-compliance, (F) any pending legal proceeding relating to the applicable non-compliance and (G) whether the executive officer’s employment with the Company has terminated.

Before the Independent Director Committee determines to seek recovery pursuant to this policy, it shall provide to the applicable executive officer written notice and the opportunity to be heard, at a meeting of the Independent Director Committee (which may be in-person or telephonic, as determined by the Independent Director Committee).

If the Independent Director Committee determines to seek a recovery pursuant to this policy, it shall make a written demand for repayment from the executive officer and, if the executive officer does not within a reasonable period tender repayment in response to such demand, and the Independent Director Committee determines that he or she is unlikely to do so, the Independent Director Committee may seek a court order against the executive officer for such repayment.

For the purposes of this policy, (i) the term “executive officer” has the meaning given to that term in the Securities Exchange Act of 1934, as amended; (ii) the term “incentive compensation” means all bonuses, other incentive compensation and equity compensation awarded to each of the Company’s executive officers, the amount, payment and/or vesting of which was calculated based wholly or in part on the application of objective financial performance criteria measured during any part of the period covered by


the restatement and set forth in or reflected in the Company’s financial statements subject to the restatement; and (iii) “Improper Conduct” shall mean willful commission of an act of fraud, dishonesty or recklessness in the performance of a person’s duties.

This policy shall apply to incentive compensation awards granted on or after January 1, 2014.

 

2


EXHIBIT D

MEDNAX, INC.

NONQUALIFIED STOCK OPTION AGREEMENT

FOR

Mark Ordan

(the “Optionee”)

1.    Grant of Option. The Compensation Committee (the “Committee”) of the Board of Directors (the “Board”) of MEDNAX, Inc. (the “Company”) has granted on July 12, 2020 (“Date of Grant”), to the Optionee an option (the “Option”) to purchase up to 550,331 shares of the Company’s Common Stock, $.01 par value per share (the “Shares”), at an exercise price per share equal to $17.65 (the “Exercise Price”). The Option shall be subject to the terms and conditions set forth in this Agreement. The Option was issued pursuant to the Company’s Amended and Restated 2008 Incentive Compensation Plan, as may be amended from time to time (the “Plan”), which is incorporated herein for all purposes. The Option is a Nonqualified Stock Option, and not an Incentive Stock Option. The Optionee hereby acknowledges receipt of a copy of the Plan and agrees to be bound by all of the terms and conditions hereof and thereof and all applicable laws and regulations. Unless otherwise provided herein, terms used herein that are defined in the Plan and not defined herein shall have the meanings attributed thereto in the Plan.

2.    Vesting and Exercisability; Expiration.

Except as otherwise provided herein with respect to an earlier expiration date, the Option will expire and be of no further effect on the ninetieth (90th) day (the “Expiration Date”) after the third anniversary of the Date of Grant (the “Performance End Date”).

The Option shall become vested on the first anniversary of the Date of Grant so long as the Optionee remains in Continuous Service from the Date of Grant through such first anniversary (such service vesting requirement referred to herein as the “Service Vesting Requirement”), except as otherwise provided herein. The Option may only be exercised, however, after the Optionee has satisfied the Service Vesting Requirement and only if and to the extent the Option has become exercisable due to satisfaction of the stock price hurdle requirements (“Price Hurdle Requirement”) during the Optionee’s Continuous Service as follows, except as otherwise provided herein:

The Option shall be exercisable with respect to 175,747 Shares if and when the Company stock price on the NYSE closes at $22 per Share (or above) for any 40 consecutive trading days before the Performance End Date.

The Option shall be exercisable with respect to 181,160 Shares if and when the Company stock price on the NYSE closes at $25 per Share (or above) for any 40 consecutive trading days before the Performance End Date.

The Option shall be exercisable with respect to 193,424 Shares if and when the Company stock price on the NYSE closes at $29 per Share (or above) for any 40 consecutive trading days before the Performance End Date.

The Share price targets shall be subject to adjustment by the Committee due to changes in capitalization or other transactions as described in Section 10(c) of the Plan.

If a Change in Control occurs, then the 40 consecutive trading days requirement of the foregoing Price Hurdle Requirements is waived but the stock price still must be achieved for the applicable portion of the Option to become exercisable as of immediately before and contingent upon the Change in Control.

If the Price Hurdle Requirement for any one-third tranche is not achieved by the Performance End Date, then such applicable portion of the Option is cancelled for no consideration. Notwithstanding the foregoing, the Committee shall have discretion to determine a performance tranche achieved if the specific requirements above have not been met.

If the Optionee’s Continuous Service terminates due to death, Disability, termination by the Company without Cause or by the Optionee with Good Reason (as those terms are defined in the Optionee’s employment agreement with the Company), then the vested and exercisable portion of the Option as of the Optionee’s termination date will remain exercisable until the earlier of the one year anniversary of such termination or the Expiration Date. Additional portions of the Option may become vested and exercisable as provided below.

If the Optionee’s Continuous Service terminates due to voluntary termination by the Optionee without Good Reason, then the vested and exercisable portion of the Option as of the Optionee’s termination date will remain exercisable until the earlier of the thirtieth (30th) day after such termination or the Expiration Date.

If the Optionee’s Continuous Service terminates due to death, Disability, termination by the Company without Cause or by the Optionee with Good Reason before a Change in Control and before either the Service Vesting Requirement or all of the Price Hurdle Requirements are achieved, then the Option will remain outstanding with respect to the portions thereof for which the Price Hurdle Requirement has not been achieved until the earlier of the one year anniversary of such termination date or the Expiration Date but will become exercisable if and to the extent any of such Price Hurdle Requirements are achieved before such expiration.

 

D-1


Unless otherwise provided herein, upon the termination of the Optionee’s Continuous Service, any portion of the Option which is not yet vested and/or exercisable shall automatically and without notice terminate and be null and void. Upon termination of the Optionee’s Continuous Service by the Company for Cause, the Option shall immediately terminate for no consideration, whether vested or exercisable.

If, upon a Change in Control, the Service Vesting Requirement has not been achieved but the Price Hurdle Requirement has been achieved with respect to all or a portion of the Option, and the Optionee continues in employment with a successor company that is publicly-listed and the Option is converted into a successor option, then the Service Vesting Requirement will be deemed achieved upon termination of the Optionee’s Continuous Service by the Company or successor without Cause or by the Optionee for Good Reason. If a successor is privately held, and the Price Hurdle Requirement has been achieved with respect to all or a portion of the Option, then the Service Vesting Requirement will be deemed achieved immediately before and contingent upon the Change in Control.

The Expiration Date shall be tolled while the Optionee cannot exercise the Option because such an exercise would violate an applicable Federal, state, local, or foreign law, provided that the period during which the Option may be exercised is not extended more than 30 days after the exercise of the Option first would no longer violate an applicable Federal, state, local, or foreign law.

3.    Method of Exercise. The vested and exercisable portion of this Option shall be exercisable in whole or in part in accordance with Section 2 hereof by written notice, in a form approved by the Company, which notice shall state the election to exercise the Option, the number of Shares in respect of which the Option is being exercised, and such other representations and agreements as to the holder’s investment intent with respect to such Shares as may be required by the Company pursuant to the provisions of the Plan. Such written notice shall be signed by the Optionee and shall be delivered in person or by certified mail or facsimile to the Secretary of the Company. The written notice shall be accompanied by payment of the Exercise Price or arrangements in place, which are satisfactory to the Company, for such payment, which are set forth in paragraph 4 below. This Option shall be deemed to be exercised after both (a) receipt by the Company of such written notice accompanied by the Exercise Price or satisfactory arrangements in place for payment of the Exercise Price and (b) arrangements that are satisfactory to the Company in its sole discretion have been made for Optionee’s payment to the Company of the amount, if any, that is necessary to be withheld in accordance with applicable Federal or state withholding requirements. No Shares will be issued pursuant to the Option unless and until such issuance and such exercise shall comply with all relevant provisions of applicable law, including the requirements of any stock exchange upon which the Shares then may be traded.

4.    Method of Payment. Payment of the Exercise Price shall be by any of the following, or a combination thereof, at the election of the Optionee: (a) cash; (b) check; (c) pursuant to a “cashless exercise” procedure, by delivery of a properly executed exercise notice together with such other documentation, and subject to such guidelines, as the Committee shall require to effect an exercise of the Option and delivery to the Company by a licensed broker acceptable to the Company of proceeds from the sale of Shares sufficient to pay the Exercise Price and any applicable income or employment taxes; or (d) such other consideration or in such other manner as may be determined by the Committee in its absolute discretion.

5.    Non-Transferability. The Option shall not be pledged, hypothecated or otherwise encumbered or subject to any lien, obligation or liability of the Optionee to any party (other than the Company or any Related Entity), or assigned or transferred by the Optionee otherwise than by will or the laws of descent and distribution or to a Beneficiary upon the death of the Optionee, and during the lifetime of the Optionee, the Option only may be exercisable by the Optionee or his or her guardian or legal representative; except that the Option may be transferred to one or more Beneficiaries or other transferees during the lifetime of the Optionee, and may be exercised by such transferees in accordance with the terms of this Agreement, but only if and to the extent such transfers are permitted by the Committee (and subject to any terms and conditions which the Committee may impose thereon). A Beneficiary or other person claiming any rights under the Plan or this Agreement from or through the Optionee shall be subject to all of the terms and conditions of the Plan and this Agreement, except as otherwise determined by the Committee, and to any additional terms and conditions deemed necessary or appropriate by the Committee.

6.    No Rights of Stockholders. Neither the Optionee nor any personal representative (or beneficiary) shall be, or shall have any of the rights and privileges of, a stockholder of the Company with respect to any Shares purchasable or issuable upon the exercise of the Option, in whole or in part, prior to the date of exercise of the Option.

7.    Amendment, Modification & Binding Effect. This Agreement may only be modified or amended in a written document signed by the parties hereto. No promises, assurances, commitments, agreements, undertakings or representations, whether oral, written, electronic or otherwise, and whether express or implied, with respect to the subject matter hereof, have been made by either party which are not set forth expressly in this Agreement. The rights and obligations created hereunder shall be binding on the Optionee and his heirs and legal representatives and on the successors and assigns of the Company.

 

D-2


8.    Complete Agreement. This Agreement (together with those agreements and documents expressly referred to herein, for the purposes referred to herein) embody the complete and entire agreement and understanding between the parties with respect to the subject matter hereof, and supersede any and all prior promises, assurances, commitments, agreements, undertakings or representations, whether oral, written, electronic or otherwise, and whether express or implied, which may relate to the subject matter hereof in any way.

9.    Miscellaneous.

(a)    No Right to (Continued) Employment or Service. This Agreement and the grant of the Option hereunder shall not confer, or be construed to confer, upon the Optionee any right to employment or service, or continued employment or service with the Company or any Related Entity.

(b)    No Limit on Other Compensation Arrangements. Nothing contained in this Agreement shall preclude the Company or any Related Entity from adopting or continuing in effect other or additional compensation plans, agreements or arrangements, and any such plans, agreements and arrangements may be either generally applicable or applicable only in specific cases or to specific persons.

(c)    Severability. If any term or provision of this Agreement is or becomes or is deemed to be invalid, illegal or unenforceable in any jurisdiction or under any applicable law, rule or regulation, then such provision shall be construed or deemed amended to conform to applicable law (or if such provision cannot be so construed or deemed amended without materially altering the purpose or intent of this Agreement and the grant of the Option hereunder, such provision shall be stricken as to such jurisdiction and the remainder of this Agreement and the award hereunder shall remain in full force and effect).

(d)    No Trust or Fund Created. Neither this Agreement nor the grant of the Option hereunder shall create or be construed to create a trust or separate fund of any kind or a fiduciary relationship between the Company or any Related Entity and the Optionee or any other person. To the extent that the Optionee or any other person acquires a right to receive payments from the Company or any Related Entity pursuant to this Agreement, such right shall be no greater than the right of any unsecured general creditor of the Company.

(e)    Law Governing. This Agreement shall be governed by and construed and enforced in accordance with the internal laws of the State of Florida (without reference to the conflict of laws, rules or principles thereto).

(f)    Interpretation. This Agreement is subject to all of the terms, conditions and provisions of the Plan, including, without limitation, the amendment provisions thereof, and to such rules, regulations and interpretations relating to the Plan adopted by the Committee as may be in effect from time to time. If and to the extent that this Agreement conflicts or is inconsistent with the terms, conditions and provisions of the Plan, this Agreement shall control. The Optionee accepts the Option subject to all of the terms and provisions of the Plan and this Agreement.

(g)    Headings. Section, paragraph and other headings and captions are provided solely as a convenience to facilitate reference. Such headings and captions shall not be deemed in any way material or relevant to the construction, meaning or interpretation of this Agreement or any term or provision hereof.

(h)    Notices. Any notice under this Agreement shall be in writing and shall be deemed to have been duly given when delivered personally or when deposited in the United States mail, registered, postage prepaid, and addressed, in the case of the Company, to the Company’s General Counsel at the Company’s principal office, and, in the case of the Optionee, to the Optionee’s last permanent address as shown on the Company’s records, subject to the right of the Company to designate some other address at any time hereafter in a notice satisfying the requirements of this Section.

(i)    Non-Waiver of Breach. The waiver by any party hereto of the other party’s prompt and complete performance, or breach or violation, of any term or provision of this Agreement shall be effected solely in a writing signed by such party, and shall not operate nor be construed as a waiver of any subsequent breach or violation, and the waiver by any party hereto to exercise any right or remedy which he or it may possess shall not operate nor be construed as the waiver of such right or remedy by such party, or as a bar to the exercise of such right or remedy by such party, upon the occurrence of any subsequent breach or violation.

(j)    Counterparts. This Agreement may be executed in two or more separate counterparts, each of which shall be an original, and all of which together shall constitute one and the same agreement.

 

D-3


10.    Return of Option Gains. In consideration for the Company’s grant of this Option to the Optionee, and for the valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Optionee agrees to the following:

(a)    If the Optionee is a party to an Employment Agreement with the Company or any Related Entity and the Optionee violates in any material respect any non-competition, non-solicitation, or confidentiality agreement contained therein (and such violation is not cured within 30 days following written notice from the Company), then, in addition to any other remedy the Company or the Related Entity may have, the Company may, in the sole discretion of the Committee, require the Optionee to pay to the Company, upon written demand, (i) if the Optionee is employed by the Company at the time of such violation, an amount equal to Optionee’s aggregate Option Gains during the period beginning on the date twelve months before such violation and ending on the date on which senior management of the Company acquires actual knowledge of such violation or (ii) if the Optionee is not employed by the Company at the time of such violation, an amount equal to the Optionee’s aggregate Option Gains during the twelve months preceding the date on which the Optionee’s employment with the Company was terminated. For the purposes of this Agreement, “Option Gains” shall mean (i) the Fair Market Value of a Share on the date of exercise during the relevant period less the Exercise Price, multiplied by (ii) the number of Shares that the Optionee purchased as a result of the exercise of the Option. No regard shall be given to any changes in the Fair Market Value of a Share that occurred after the date of exercise.

[Remainder of page intentionally left blank]

 

D-4


IN WITNESS WHEREOF, the parties hereto, intending to be legally bound, have executed this Agreement effective as of the date first written above.

 

MEDNAX, Inc.
By:  

 

  Dominic J. Andreano
  EVP, General Counsel and Secretary

Agreed and Accepted:

 

Optionee:  

 

  Mark S. Ordan

 

D-5


EXHIBIT E

FORM OF RELEASE

GENERAL RELEASE OF CLAIMS

1.    Mark Ordan (“Employee”), for himself and his family, heirs, executors, administrators, legal representatives and their respective successors and assigns, in exchange for the consideration received pursuant to Section 5.[ ] of that certain Employment Agreement, dated as of July 12, 2020, by and between Employee and Employer, to which this release is attached as Exhibit E (the “Employment Agreement”), does hereby release and forever discharge                      (“Employer”), its subsidiaries, affiliated companies, successors and assigns, and its current or former directors, officers, employees, shareholders or agents in such capacities (collectively with Employer, the “Released Parties”) from any and all actions, causes of action, suits, controversies, claims and demands whatsoever, for or by reason of any matter, cause or thing whatsoever, whether known or unknown arising as a result of events occurring through the date hereof, including, but not limited to, all claims under any laws applicable to Employee’s employment, whether for discrimination, harassment, retaliation, claims relating to or in connection with Employee’s employment or termination thereof, claims for tort, breach of express or implied employment contract, wrongful discharge, intentional infliction of emotional distress, or defamation or injuries incurred on the job or incurred as a result of loss of employment. Employee acknowledges that Employer encouraged him to consult with an attorney of his choosing, and through this General Release of Claims encourages Employee to consult with his attorney with respect to possible claims under the Age Discrimination in Employment Act (“ADEA”) and that he understands that the ADEA is a Federal statute that, among other things, prohibits discrimination on the basis of age in employment and employee benefits and benefit plans. Without limiting the generality of the release provided above, Employee expressly waives any and all claims under ADEA that he may have as of the date hereof. Employee further understands that by signing this General Release of Claims he is in fact waiving, releasing and forever giving up any claim under the ADEA as well as all other laws within the scope of this paragraph 1 that may have existed on or prior to the date hereof. Notwithstanding anything in this paragraph 1 to the contrary, this General Release of Claims shall not apply to (i) any actions to enforce rights to receive any payments or benefits which may be due Employee pursuant to Section 5.[    ] of the Employment Agreement, or under any of Employer’s employee benefit or incentive compensation plans, (ii) any rights or claims that may arise as a result of events occurring after the date this General Release of Claims is executed, (iii) any indemnification rights Employee may have as a former officer or director of Employer or its subsidiaries or affiliated companies, (iv) any claims for benefits under any directors’ and officers’ liability policy maintained by Employer or its subsidiaries or affiliated companies in accordance with the terms of such policy, and (v) any rights as a holder of equity securities or equity awards of Employer or MEDNAX.

2.    Employee represents that he has not filed against the Released Parties any complaints, charges, or lawsuits arising out of his employment, or any other matter arising on or prior to the date of this General Release of Claims , and covenants and agrees that he will never individually or with any person file, or commence the filing of, any charges, lawsuits, complaints or proceedings with any governmental agency, or against the Released Parties with respect to any of the matters released by Employee pursuant to paragraph 1 hereof (a “Proceeding”).

 

E-1


3.    Notwithstanding anything in this Agreement to the contrary, nothing in this Agreement or any other agreement between Employer and Employee shall prevent Employee from filing a charge, sharing information and communicating in good faith, without prior notice to Employer, with any federal government agency having jurisdiction over Employer or its operations, and cooperating in any investigation by any such federal government agency; However, to the maximum extent permitted by law, Employee agrees that if such an administrative claim is made relating to claims that would otherwise be released pursuant to paragraph 1 above, Employee shall not be entitled to recover any individual monetary relief or other individual remedies.

4.    Employee hereby acknowledges that Employer has informed him that he has up to twenty-one (21) days to sign this General Release of Claims and he may knowingly and voluntarily waive that twenty-one (21) day period by signing this General Release of Claims earlier. Employee also understands that he shall have seven (7) days following the date on which he signs this General Release of Claims within which to revoke it by providing a written notice of his revocation to Employer.

5.    Employee acknowledges that this General Release of Claims will be governed by and construed and enforced in accordance with the internal laws of the State of Florida applicable to contracts made and to be performed entirely within such State.

6.    Employee acknowledges that he has read this General Release of Claims, that he has been advised that he should consult with an attorney before he executes this general release of claims, and that he understands all of its terms and executes it voluntarily and with full knowledge of its significance and the consequences thereof.

7.    This General Release of Claims shall take effect on the eighth day following Employee’s execution of this General Release of Claims unless Employee’s written revocation is delivered to Employer within seven (7) days after such execution.

 

 

 

            , 20    

 

E-2

EX-31.1

Exhibit 31.1

CERTIFICATION PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Mark S. Ordan, certify that:

 

  1.

I have reviewed this quarterly report on Form 10-Q of MEDNAX, Inc.;

 

  2.

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

 

  3.

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

 

  4.

The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

 

  (a)

Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

 

  (b)

Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

 

  (c)

Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

 

  (d)

Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

 

  5.

The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

 

  (a)

All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

 

  (b)

Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: July 30, 2020

 

By:  

/s/ Mark S. Ordan

  Mark S. Ordan
  Chief Executive Officer
  (Principal Executive Officer)

 

EX-31.2

Exhibit 31.2

CERTIFICATION PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

I, Stephen D. Farber, certify that:

 

  1.

I have reviewed this quarterly report on Form 10-Q of MEDNAX, Inc.;

 

  2.

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

 

  3.

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

 

  4.

The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

 

  (a)

Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

 

  (b)

Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

 

  (c)

Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

 

  (d)

Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

 

  5.

The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

 

  (a)

All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

 

  (b)

Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: July 30, 2020

 

By:  

/s/ Stephen D. Farber

  Stephen D. Farber
  Chief Financial Officer
  (Principal Financial Officer)
EX-32.1

Exhibit 32.1

Certification Pursuant to 18 U.S.C Section 1350

(Adopted by Section 906 of the Sarbanes-Oxley Act of 2002)

In connection with the Quarterly Report of MEDNAX, Inc. on Form 10-Q for the quarter ended June 30, 2020 (the “Report”), each of the undersigned hereby certifies, pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that (i) the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934 and (ii) the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of MEDNAX, Inc.

A signed original of this written statement required by Section 906 has been provided to MEDNAX, Inc. and will be retained by MEDNAX, Inc. and furnished to the Securities and Exchange Commission or its staff upon request.

July 30, 2020

 

By:  

/s/ Mark S. Ordan

  Mark S. Ordan
  Chief Executive Officer
  (Principal Executive Officer)
By:  

/s/ Stephen D. Farber

  Stephen D. Farber
  Chief Financial Officer
  (Principal Financial Officer)
v3.20.2
Cover Page - shares
6 Months Ended
Jun. 30, 2020
Jul. 24, 2020
Cover [Abstract]    
Document Type 10-Q  
Document Quarterly Report true  
Document Transition Report false  
Amendment Flag false  
Document Period End Date Jun. 30, 2020  
Document Fiscal Year Focus 2020  
Document Fiscal Period Focus Q2  
Entity Registrant Name MEDNAX, INC.  
Entity Central Index Key 0000893949  
Current Fiscal Year End Date --12-31  
Entity Current Reporting Status Yes  
Entity Interactive Data Current Yes  
Entity Common Stock, Shares Outstanding   85,461,731
Title of 12(b) Security Common Stock  
Trading Symbol MD  
Security Exchange Name NYSE  
Entity File Number 001-12111  
Entity Incorporation, State or Country Code FL  
Entity Tax Identification Number 26-3667538  
Entity Address, Address Line One 1301 Concord Terrace  
Entity Address, City or Town Sunrise  
Entity Address, State or Province FL  
Entity Address, Postal Zip Code 33323  
City Area Code 954  
Local Phone Number 384-0175  
Entity Filer Category Large Accelerated Filer  
Entity Small Business false  
Entity Emerging Growth Company false  
Entity Shell Company false  
v3.20.2
Consolidated Balance Sheets (Unaudited) - USD ($)
$ in Thousands
Jun. 30, 2020
Dec. 31, 2019
Current assets:    
Cash and cash equivalents $ 132,151 $ 107,870
Short-term investments 90,642 74,510
Accounts receivable, net 345,682 498,869
Prepaid expenses 14,343 21,826
Income taxes receivable 64,428 0
Other current assets 41,083 16,864
Assets held for sale 0 11,569
Total current assets 688,329 731,508
Property and equipment, net 98,469 91,881
Goodwill 2,165,020 2,165,020
Intangible assets, net 200,408 209,564
Operating lease right-of-use assets 75,817 71,421
Deferred income tax assets 61,227 104,827
Other assets 97,942 89,368
Assets held for sale 0 682,312
Total assets 3,387,212 4,145,901
Current liabilities:    
Accounts payable and accrued expenses 360,909 453,110
Current portion of finance lease liabilities 1,426 130
Current portion of operating lease liabilities 21,598 20,485
Income taxes payable 0 6,039
Liabilities held for sale 0 62,055
Total current liabilities 383,933 541,819
Long-term debt and finance lease liabilities, net 1,737,176 1,730,295
Long-term operating lease liabilities 56,936 56,582
Long-term professional liabilities 260,936 226,892
Deferred income tax liabilities 68,681 56,468
Other liabilities 52,980 22,899
Liabilities held for sale 0 11,950
Total liabilities 2,560,642 2,646,905
Shareholders' equity:    
Preferred stock; $.01 par value; 1,000 shares authorized; none issued 0 0
Common stock; $.01 par value; 200,000 shares authorized; 85,536 and 84,248 shares issued and outstanding, respectively 855 842
Additional paid-in capital 1,004,786 987,942
Retained (deficit) earnings (179,071) 510,212
Total shareholders' equity 826,570 1,498,996
Total liabilities and shareholders' equity $ 3,387,212 $ 4,145,901
v3.20.2
Consolidated Balance Sheets (Unaudited) (Parenthetical) - $ / shares
Jun. 30, 2020
Dec. 31, 2019
Statement of Financial Position [Abstract]    
Preferred stock, par value $ 0.01 $ 0.01
Preferred stock, shares authorized 1,000,000 1,000,000
Preferred stock, issued 0 0
Common stock, par value $ 0.01 $ 0.01
Common stock, shares authorized 200,000,000 200,000,000
Common stock, shares issued 85,536,000 84,248,000
Common stock, shares outstanding 85,536,000 84,248,000
v3.20.2
Consolidated Statements of Income - USD ($)
shares in Thousands, $ in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Jun. 30, 2020
Jun. 30, 2019
Income Statement [Abstract]        
Net revenue $ 509,203 $ 561,237 $ 1,071,054 $ 1,104,249
Operating expenses:        
Practice salaries and benefits 349,258 361,203 748,715 731,571
Practice supplies and other operating expenses 21,433 24,783 46,839 47,107
General and administrative expenses 77,674 84,219 165,232 165,790
Depreciation and amortization 14,393 13,779 28,792 27,584
Transformational and restructuring related expenses 11,537 17,866 30,581 20,305
Total operating expenses 474,295 501,850 1,020,159 992,357
Income from operations 34,908 59,387 50,895 111,892
Investment and other income 3,851 1,219 3,172 2,866
Interest expense (28,265) (31,063) (55,931) (61,764)
Equity in earnings of unconsolidated affiliates 479 1,990 1,824 3,187
Total non-operating expenses (23,935) (27,854) (50,935) (55,711)
Income (loss) from continuing operations before income taxes 10,973 31,533 (40) 56,181
Income tax provision (3,373) (11,486) (6,109) (13,588)
Income (loss) from continuing operations 7,600 20,047 (6,149) 42,593
Loss from discontinued operations, net of tax (680,036) (28,292) (684,999) (293,710)
Net loss $ (672,436) $ (8,245) $ (691,148) $ (251,117)
Income (loss) from continuing operations:        
Basic $ 0.09 $ 0.24 $ (0.07) $ 0.50
Diluted 0.09 0.24 (0.07) 0.50
Loss from discontinued operations:        
Basic (8.14) (0.34) (8.25) (3.47)
Diluted (8.12) (0.34) (8.25) (3.45)
Net loss:        
Basic (8.05) (0.10) (8.32) (2.97)
Diluted $ (8.03) $ (0.10) $ (8.32) $ (2.95)
Weighted average common shares:        
Basic 83,490 83,234 83,061 84,623
Diluted [1] 83,745 83,689 83,061 85,087
[1] Due to a loss from continuing operations for the six months ended June 30, 2020, no incremental shares are included because the effect would be antidilutive.
v3.20.2
Consolidated Statements of Equity - USD ($)
shares in Thousands, $ in Thousands
Total
Common Stock [Member]
Additional Paid-in Capital [Member]
Retained Earnings [Member]
Balance at Dec. 31, 2018 $ 3,087,884 $ 878 $ 992,647 $ 2,094,359
Balance, Shares at Dec. 31, 2018   87,820    
Net loss (242,872)     (242,872)
Unrealized holding gain (loss) on investments, net of tax [1] (194)     (194)
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan 3,542 $ 1 3,541  
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares   140    
Issuance of restricted stock and conversion of restricted stock units to common stock   $ 10 (10)  
Issuance of restricted stock and conversion of restricted stock units to common stock, shares   978    
Stock-based compensation expense 11,100   11,100  
Stock swaps (666)   (666)  
Stock swaps, shares   (20)    
Forfeitures of restricted stock, shares   (6)    
Repurchased common stock (78,982) $ (25) (28,740) (50,217)
Repurchased common stock, shares   (2,525)    
Balance at Mar. 31, 2019 2,779,812 $ 864 977,872 1,801,076
Balance, Shares at Mar. 31, 2019   86,387    
Balance at Dec. 31, 2018 3,087,884 $ 878 992,647 2,094,359
Balance, Shares at Dec. 31, 2018   87,820    
Net loss (251,117)      
Balance at Jun. 30, 2019 2,725,027 $ 841 967,429 1,756,757
Balance, Shares at Jun. 30, 2019   84,096    
Balance at Mar. 31, 2019 2,779,812 $ 864 977,872 1,801,076
Balance, Shares at Mar. 31, 2019   86,387    
Net loss (8,245)     (8,245)
Unrealized holding gain (loss) on investments, net of tax 232     232
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan 3,675 $ 2 3,673  
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares   155    
Issuance of restricted stock and conversion of restricted stock units to common stock   $ 1 (1)  
Issuance of restricted stock and conversion of restricted stock units to common stock, shares   123    
Stock-based compensation expense 15,080   15,080  
Forfeitures of restricted stock   $ (1) 1  
Forfeitures of restricted stock, shares   (61)    
Repurchased common stock (65,527) $ (25) (29,196) (36,306)
Repurchased common stock, shares   (2,508)    
Balance at Jun. 30, 2019 2,725,027 $ 841 967,429 1,756,757
Balance, Shares at Jun. 30, 2019   84,096    
Balance at Dec. 31, 2019 1,498,996 $ 842 987,942 510,212
Balance, Shares at Dec. 31, 2019   84,248    
Net loss (18,712)     (18,712)
Unrealized holding gain (loss) on investments, net of tax [1] (213)     (213)
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan 1,832 $ 1 1,831  
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares   78    
Issuance of restricted stock and conversion of restricted stock units to common stock   $ 10 (10)  
Issuance of restricted stock and conversion of restricted stock units to common stock, shares   968    
Stock-based compensation expense 8,035   8,035  
Forfeitures of restricted stock, shares   (19)    
Repurchased common stock (2,542) $ (1) (2,541) 0
Repurchased common stock, shares   (125)    
Balance at Mar. 31, 2020 1,487,396 $ 852 995,257 491,287
Balance, Shares at Mar. 31, 2020   85,150    
Balance at Dec. 31, 2019 1,498,996 $ 842 987,942 510,212
Balance, Shares at Dec. 31, 2019   84,248    
Net loss (691,148)      
Balance at Jun. 30, 2020 826,570 $ 855 1,004,786 (179,071)
Balance, Shares at Jun. 30, 2020   85,536    
Balance at Mar. 31, 2020 1,487,396 $ 852 995,257 491,287
Balance, Shares at Mar. 31, 2020   85,150    
Net loss (672,436)     (672,436)
Unrealized holding gain (loss) on investments, net of tax 2,078     2,078
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan 2,544 $ 3 2,541  
Common stock issued under employee stock option, employee stock purchase plan and stock purchase plan, shares   277    
Issuance of restricted stock and conversion of restricted stock units to common stock   $ 2 (2)  
Issuance of restricted stock and conversion of restricted stock units to common stock, shares   200    
Stock-based compensation expense 7,489   7,489  
Forfeitures of restricted stock   $ (1) 1  
Forfeitures of restricted stock, shares   (57)    
Repurchased common stock (501) $ (1) (500) 0
Repurchased common stock, shares   (34)    
Balance at Jun. 30, 2020 $ 826,570 $ 855 $ 1,004,786 $ (179,071)
Balance, Shares at Jun. 30, 2020   85,536    
[1] Presented within retained earnings on the consolidated balance sheet as the balance is immaterial.
v3.20.2
Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Cash flows from operating activities:    
Net loss $ (691,148) $ (251,117)
Loss from discontinued operations 684,999 293,710
Adjustments to reconcile net income to net cash from operating activities:    
Depreciation and amortization 28,792 27,584
Amortization of premiums, discounts and issuance costs 2,785 2,934
Stock-based compensation expense 13,819 20,853
Deferred income taxes 55,812 (12,378)
Other (2,092) 8,284
Changes in assets and liabilities:    
Accounts receivable 44,296 1,703
Prepaid expenses and other current assets (16,281) 3,715
Other long-term assets 5,560 14,233
Accounts payable and accrued expenses (86,609) (52,307)
Income taxes payable / receivable (49,757) (40,181)
Payments of contingent consideration liabilities (102) (418)
Long-term professional liabilities 2,931 4,628
Other liabilities 26,888 (14,212)
Net cash provided by operating activities – continuing operations 19,893 7,031
Net cash provided by operating activities - discontinued operations 26,658 56,184
Net cash provided by operating activities 46,551 63,215
Cash flows from investing activities:    
Acquisition payments, net of cash acquired (75) (11,450)
Purchases of investments (32,335) 0
Proceeds from maturities or sales of investments 18,135 8,180
Purchases of property and equipment (23,326) (15,926)
Proceeds from sale of business, net of cash sold 476 0
Net cash used in investing activities – continuing operations (37,125) (19,196)
Net cash provided by (used in) investing activities—discontinued operations 15,466 (8,438)
Net cash used in investing activities (21,659) (27,634)
Cash flows from financing activities:    
Borrowings on credit agreement 527,500 898,500
Payments on credit agreement (527,500) (1,286,500)
Proceeds from issuance of senior notes 0 500,000
Payments for credit facility amendment and financing costs (510) (9,194)
Payments of contingent consideration liabilities (1,248) (5,171)
Payments on finance lease obligations (186) (98)
Proceeds from issuance of common stock 4,376 6,551
Repurchases of common stock (3,043) (144,509)
Net cash used in financing activities – continuing operations (611) (40,421)
Net cash used in financing activities - discontinued operations 0 0
Net cash used in financing activities (611) (40,421)
Net increase (decrease) in cash and cash equivalents 24,281 (4,840)
Cash and cash equivalents at beginning of period 107,870 40,774
Cash and cash equivalents at end of period $ 132,151 $ 35,934
v3.20.2
Basis of Presentation and New Accounting Pronouncements
6 Months Ended
Jun. 30, 2020
Accounting Policies [Abstract]  
Basis of Presentation and New Accounting Pronouncements
1.
Basis of Presentation and New Accounting Pronouncements:
The accompanying unaudited Consolidated Financial Statements of the Company and the notes thereto presented in this Form
10-Q
have been prepared in accordance with the rules and regulations of the Securities and Exchange Commission applicable to interim financial statements, and do not include all disclosures required by accounting principles generally accepted in the United States of America (“GAAP”) for complete financial statements. In the opinion of management, these financial statements include all adjustments, consisting only of normal recurring adjustments, necessary for a fair statement of the results of the interim periods presented. The financial statements include all the accounts of MEDNAX, Inc. and its consolidated subsidiaries (collectively, “MDX”) together with the accounts of MDX’s affiliated business corporations or professional associations, professional corporations, limited liability companies and partnerships (the “affiliated professional contractors”). Certain subsidiaries of MDX have contractual management arrangements with its affiliated professional contractors, which are separate legal entities that provide physician services in certain states and Puerto Rico. The terms “MEDNAX” and the “Company” refer collectively to MEDNAX, Inc., its subsidiaries and the affiliated professional contractors.
The Company is a party to a joint venture in which it owns a 37.5% economic interest and a second joint venture in which it owns a 49.0% economic interest. The Company accounts for these joint ventures under the equity method of accounting because the Company exercises significant influence over, but does not control, these entities.
The consolidated results of operations for the interim periods presented are not necessarily indicative of the results to be experienced for the entire fiscal year. In addition, the accompanying unaudited Consolidated Financial Statements and the notes thereto should be read in conjunction with the Consolidated Financial Statements and the notes thereto included in the Company’s most recent Annual Report on Form
10-K
(the “Form
10-K”).
In October 2019, the Company divested its management services organization, which operated as MedData, to allow the Company to focus on its core physician services business. The operating results of MedData are reported as discontinued operations in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2019. See Note 6 – Assets Held for Sale and Discontinued Operations for additional information.
In May 2020, the Company divested its anesthesiology medical group. The operating results of the Company’s anesthesiology medical group are reported as discontinued operations in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2020 and 2019. Reclassifications have been made to certain prior period financial statements and footnote disclosures to reflect the impact of discontinued operations. See Note 6 – Assets Held for Sale and Discontinued Operations for additional information.
In June 2020, the Company announced the initiation of a process to divest its radiology services medical group when market conditions are appropriate in order to refocus the business as a dedicated pediatrics and obstetrics organization. However, there can be no assurance that this process will result in a transaction. The Company’s radiology services medical group is reported within continuing operations for all periods presented as the accounting criterion for assets held for sale was not met as of June 30, 2020.
New Accounting Pronouncements
In December 2019, accounting guidance related to income taxes was issued with the goal of enhancing and simplifying various aspects of the income tax accounting guidance, including requirements related to hybrid tax regimes, deferred taxes on
step-up
in tax basis of goodwill obtained in a transaction that is not a business combination, separate financial statements of entities not subject to tax, the intraperiod tax allocation exception to the incremental approach, deferred tax liabilities on outside basis differences, and interim-period accounting for enacted changes in tax law and certain
year-to-date
loss limitations. The guidance becomes effective for the Company on January 1, 2021, including interim periods therein, with early adoption permitted, including adoption in interim or annual periods for which financial statements have not yet been issued. The Company does not believe the adoption of this new guidance will have a material impact on its Consolidated Financial Statements and related disclosures.
v3.20.2
Coronavirus Pandemic ("COVID-19")
6 Months Ended
Jun. 30, 2020
Extraordinary Items [Abstract]  
Coronavirus Pandemic ("COVID-19")
2.
Coronavirus Pandemic
(“COVID-19”):
COVID-19
and related “stay at home” and social distancing measures implemented across the country have significantly impacted demand for medical services provided by the Company’s affiliated clinicians. Beginning in
mid-March
2020, the Company experienced a significant decline in the number of elective surgeries at the facilities where the Company’s affiliated clinicians provided anesthesiology services. See Note 6 – Assets Held for Sale and Discontinued Operations for information regarding the divestment of the Company’s anesthesiology medical group on May 6, 2020. Much of this decline was due to the closure of operating suites or facilities following federal advisories to cancel
non-urgent
procedures and the prohibition of such procedures by several states. Within the Company’s radiology services medical group, orders for radiological studies declined by a meaningful amount from historically normal levels, with much of this reduction focused in
non-urgent
studies. The Company’s affiliated office-based practices, which specialize in maternal-fetal medicine, pediatric cardiology, and numerous pediatric subspecialties, have seen a significant elevation of appointment cancellations compared to historical normal levels. At this time, the Company has not experienced, nor does it currently anticipate, any significant impact to neonatal intensive care unit (NICU) patient volumes as a result of
COVID-19.
Overall, the Company’s operating results since
mid-March
2020 have been significantly impacted by the
COVID-19
pandemic, but volumes did begin to normalize in May 2020 and substantially recovered during the month of June 2020.
The Company implemented a number of actions to preserve financial flexibility and partially mitigate the significant anticipated impact of
COVID-19.
These steps included a suspension of most activities related to the Company’s transformational and restructuring programs, limiting these expenditures to those that provide essential support for the Company’s response to
COVID-19.
In addition, (i) the Company temporarily reduced executive and key management base salaries, including 50% reductions in salaries for its named executive officers through June 30, 2020; (ii) the Board of Directors agreed to forego their annual cash retainer and cash meeting payments, also through June 30, 2020; (iii) the Company enacted a combination of salary reductions and furloughs for
non-clinical
employees; and (iv) the Company enacted significant operational and practice-specific expense reduction plans across its clinical operations.
 
The Company also divested its anesthesiology medical group in May 2020, where operating results were significantly impacted by COVID-19.
In response to the anticipated impact of
COVID-19
on the Company’s results of operations, on March 25, 2020, the Company amended and restated its Credit Agreement to, among other things, (i) establish a deemed Consolidated EBITDA of $139.2 million for the second and third quarters of 2020, reflecting average Adjusted EBITDA from continuing operations for the prior eight quarters (calculated for purposes of the Credit Agreement), which will be used in the calculation of rolling four consecutive quarter Consolidated EBITDA under the Credit Agreement, (ii) temporarily increase the maximum consolidated net leverage ratio required to be maintained by the Company from 4.50:1:00 to 5.00:1:00 for the second and third quarters of 2020 and 4.75:1:00 for the fourth quarter of 2020, before returning to 4.50:1:00 for the first quarter of 2021 and beyond, (iii) require that the Company maintains minimum availability under the Credit Agreement of $300.0 million through the third quarter of 2021, (iv) provide for a weekly repayment of borrowings under the Credit Agreement through the second quarter of 2021 using unrestricted cash on hand in excess of $300.0 million, plus a reserve for certain payables, and (v) temporarily restrict the Company’s ability to make restricted payments under the Credit Agreement for the remainder of 2020, subject to certain exceptions. At June 30, 2020, the Company believes it was in compliance, in all material respects, with the financial covenants and other restrictions applicable to the Company under its Credit Agreement, its 5.25% senior unsecured notes due 2023
 
and its 6.25% senior unsecured notes due 2027. The Company believes it will be in compliance with these covenants for the next twelve months. 
At June 30, 2020, the Company had no outstanding principal balance on its Credit Agreement. The Company had outstanding letters of credit of $0.2 million which reduced the amount available on its Credit Agreement to $899.8 million at June 30, 2020, after giving effect to the temporary reduction of the capacity of its Credit Agreement described above through September 30, 2021.
CARES Act
On March 27, 2020, President Trump signed the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) into law. The CARES Act is a relief package intended to assist many aspects of the American economy, including providing up to $100 billion in aid to the healthcare industry to reimburse healthcare providers for lost revenue and expenses attributable to
COVID-19.
The remaining $70 billion in aid is intended to focus on providers in areas particularly impacted by
COVID-19,
rural providers, providers of services with lower shares of Medicare reimbursement or who predominantly serve the Medicaid population, and providers requesting reimbursement for the treatment of uninsured Americans. It is unknown what, if any, portion of the remaining healthcare industry funding on the CARES Act the Company and its affiliated physician practices will qualify for and receive. The Department of Health and Human Services (“HHS”) is administering this program and began disbursing funds in April 2020, of which the Company’s affiliated physician practices received an aggregate of approximately $12 million during the second quarter of 2020.
 
The Company has applications pending for certain affiliated physician practices for incremental relief beyond what has been received.
In addition, the CARES Act also provides for deferred payment of the employer portion of social security taxes through the end of 2020, with 50% of the deferred amount due December 31, 2021 and the remaining 50% due December 31, 2022. The Company intends to utilize this deferral option throughout 2020.
The Company currently expects that the
COVID-19
situation will materially impact its financial results, but due to the rapidly evolving environment and continued uncertainties surrounding the timeline of and impacts from
COVID-19,
the Company is unable to predict the ultimate impact on its business, financial condition, results of operations and cash flows. The Company, however, believes it will be able to generate sufficient liquidity to satisfy its obligations for the next twelve months.
v3.20.2
Cash Equivalents and Investments
6 Months Ended
Jun. 30, 2020
Investments, Debt and Equity Securities [Abstract]  
Cash Equivalents and Investments
3.
Cash Equivalents and Investments:
As of June 30, 2020 and December 31, 2019, the Company’s cash equivalents consisted entirely of money market funds totaling $1.7 million and $16.8 million, respectively. Investments consisted of corporate securities, municipal debt securities, federal home loan securities and certificates of deposit. All investments are classified as current.
Investments held at June 30, 2020 and December 31, 2019 are summarized as follows (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
Corporate securities
   $ 55,677      $ 32,962  
Municipal debt securities
     20,831        29,066  
Federal home loan securities
     8,537        8,013  
Certificates of deposit
     5,597        4,469  
  
 
 
    
 
 
 
   $ 90,642      $ 74,510  
  
 
 
    
 
 
 
v3.20.2
Fair Value Measurements
6 Months Ended
Jun. 30, 2020
Fair Value Disclosures [Abstract]  
Fair Value Disclosures
4.
Fair Value Measurements:
The accounting guidance establishes a fair value hierarchy that prioritizes valuation inputs into three levels based on the extent to which inputs used in measuring fair value are observable in the market. Each fair value measurement is reported in one of three levels:
Level 1 – inputs are based upon unadjusted quoted prices for identical instruments traded in active markets.
Level 2 – inputs are based upon quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active, and model-based valuation techniques for which all significant assumptions are observable in the market or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
Level 3 – inputs are generally unobservable and typically reflect management’s estimates of assumptions that market participants would use in pricing the asset or liability. The fair values are therefore determined using model-based techniques that include option pricing models, discounted cash flow models, and similar techniques.
The following table presents information about the Company’s financial instruments that are accounted for at fair value on a recurring basis at June 30, 2020 and December 31, 2019 (in thousands):
 
           
Fair Value
 
    
Fair Value
Category
    
June 30,
 
2020
    
December 31,
 
2019
 
Assets:
        
Money market funds
     Level 1      $ 1,676      $ 16,775  
Short-term investments
     Level 2        90,642        74,510  
Mutual Funds
     Level 1        13,549        14,264  
Liabilities:
        
Contingent consideration
     Level 3        —          2,696  
 
(1)
Investments were measured at carrying value as of December 31, 2019. See table below.
The following table presents information about the Company’s financial instruments that are not carried at fair value at June 30, 2020 and December 31, 2019 (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
    
Carrying
Amount
    
Fair

Value
    
Carrying
Amount
    
Fair

Value
 
Liabilities:
           
2023 Notes
     750,000        744,375        750,000        766,875  
2027 Notes
     1,000,000        1,000,000        1,000,000        1,025,600  
The carrying amounts of cash equivalents, accounts receivable and accounts payable and accrued expenses approximate fair value due to the short maturities of the respective instruments. The carrying value of the Company’s line of credit approximates fair value. If the Company’s line of credit was measured at fair value, it would be categorized as Level 2 in the fair value hierarchy.
v3.20.2
Accounts Receivable and Net Revenue
6 Months Ended
Jun. 30, 2020
Text Block [Abstract]  
Accounts Receivable and Net Revenue
5.
Accounts Receivable and Net Revenue:
Accounts receivable, net consists of the following (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
Gross accounts receivable
   $ 1,386,562      $ 1,943,664  
Allowance for contractual adjustments and uncollectibles
     (1,040,880      (1,444,795
  
 
 
    
 
 
 
   $ 345,682      $ 498,869  
  
 
 
    
 
 
 
Patient service revenue is recognized at the time services are provided by the Company’s affiliated physicians. The Company’s performance obligations related to the delivery of services to patients are satisfied at the time of service. Accordingly, there are no performance obligations that are unsatisfied or partially unsatisfied at the end of the reporting period with respect to patient service revenue. Almost all of the Company’s patient service revenue is reimbursed by government-sponsored healthcare programs (“GHC Programs”) and third-party insurance payors. Payments for services rendered to the Company’s patients are generally less than billed charges. The Company monitors its revenue and receivables from these sources and records an estimated contractual allowance to properly account for the anticipated differences between billed and reimbursed amounts.
Accordingly, patient service revenue is presented net of an estimated provision for contractual adjustments and uncollectibles. The Company estimates allowances for contractual adjustments and uncollectibles on accounts receivable based upon historical experience and other factors, including days sales outstanding (“DSO”) for accounts receivable, evaluation of expected adjustments and delinquency rates, past adjustments and collection experience in relation to amounts billed, an aging of accounts receivable, current contract and reimbursement terms, changes in payor mix and other relevant information. Contractual adjustments result from the difference between the physician rates for services performed and the reimbursements by GHC Programs and third-party insurance payors for such services.
Collection of patient service revenue the Company expects to receive is normally a function of providing complete and correct billing information to the GHC Programs and third-party insurance payors within the various filing deadlines and typically occurs
within 30 to 60 days of billing.
Some of the Company’s hospital agreements require hospitals to pay the Company administrative fees. Some agreements provide for fees if the hospital does not generate sufficient patient volume in order to guarantee that the Company receives a specified minimum revenue level. The Company also receives fees from hospitals for administrative services performed by its affiliated physicians providing medical director or other services at the hospital.
The following table summarizes the Company’s net revenue by category (in thousands):
 
    
Three Months Ended

June 30,
    
Six Months Ended

June 30,
 
    
2020
    
2019
    
2020
    
2019
 
Net patient service revenue
   $ 428,473      $ 486,368      $ 919,431      $ 956,799  
Hospital contract administrative fees
     65,138        69,619        129,698        136,008  
Other revenue
     15,592        5,250        21,925        11,442  
  
 
 
    
 
 
    
 
 
    
 
 
 
   $ 509,203      $ 561,237      $ 1,071,054      $ 1,104,249  
  
 
 
    
 
 
    
 
 
    
 
 
 
The approximate percentage of net patient service revenue by type of payor was as follows:
 
    
Three Months Ended

June 30,
   
Six Months Ended

June 30,
 
    
2020
   
2019
   
2020
   
2019
 
Contracted managed care
     67     66     66     65
Government
     26       26       26       26  
Other third-parties
     6       7       6       7  
Private-pay
patients
     1       1       2       2  
  
 
 
   
 
 
   
 
 
   
 
 
 
     100     100     100     100
  
 
 
   
 
 
   
 
 
   
 
 
 
v3.20.2
Discontinued Operations
6 Months Ended
Jun. 30, 2020
Discontinued Operations and Disposal Groups [Abstract]  
Discontinued Operations
6.
Discontinued Operations:
Divestiture of Anesthesiology Medical Group
On May 6, 2020, the Company entered into a securities purchase agreement with an affiliate of North American Partners in Anesthesia (“NAPA”) to divest the Company’s anesthesiology medical group, and the transaction closed on May 6, 2020. Pursuant to the terms and conditions of the agreement, at the closing of the transaction, the Company received a cash payment of $50.0 million, subject to certain customary adjustments, as well as a contingent economic interest in NAPA with a value ranging from $0 to $250 million based upon the multiple of invested capital returned to NAPA’s owners upon exit of the investment. The Company will begin to receive a payment on its economic interest at an exit multiple of 2.0, with such payment reaching $250 million at an exit multiple of 5.0. In addition, the Company retained the accounts receivable of the anesthesiology medical group, which net of various other working capital items, approximated $110.0 million at March 31, 2020.
The operating results of the anesthesiology medical group service line were reported as a component of discontinued operations, net of income taxes, in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2020 and 2019.
The preliminary loss on sale recorded during the three months ended June 30, 2020 was
 
$644.2 million.
Upon completion of a valuation for the contingent economic interest and working capital true-up, final net proceeds will be determined, and the Company will adjust the loss on sale at that time. As a result of the sale, the Company currently estimates that it will generate an approximately $1.68 billion capital loss carryforward which expires in 2025. Based on management’s determination that it is more likely than not that the tax benefits related to this loss carryforward will not be realized, the Company has provided an approximately $419.0 million valuation allowance against this deferred tax asset in its financial results for the three months ended June 30, 2020.
The following table summarizes the results of discontinued operations related to the anesthesiology medical group for the three and six months ended June 30, 2020 and 2019 (in thousands):
    
Three Months Ended

June 30,
   
Six Months Ended

June 30,
 
    
2020
   
2019
   
2020
   
2019
 
Net revenue
   $ 90,894     $ 307,072     $ 374,961     $ 615,243  
  
 
 
   
 
 
   
 
 
   
 
 
 
Operating expenses:
        
Cost of service salaries and benefits
     95,398       247,759       348,662       498,930  
Cost of service supplies and other operating expenses
     1,350       3,233       5,216       6,700  
General and administrative expenses
     13,287       19,321       30,964       39,571  
Depreciation and amortization
     2,034       6,030       6,308       12,258  
Transformational and restructuring related expenses
     16,771       9,616       28,634       10,721  
Loss on sale, net
     644,162       —         640,154       —    
  
 
 
   
 
 
   
 
 
   
 
 
 
Total operating expenses
     773,002       285,959       1,059,938       568,180  
  
 
 
   
 
 
   
 
 
   
 
 
 
(Loss) income from operations
     (682,108     21,113       (684,977     47,063  
Non-operating
(expense) income, net
     (7     (14     51       3  
  
 
 
   
 
 
   
 
 
   
 
 
 
(Loss) income before income taxes
     (682,115     21,099       (684,926     47,066  
Income tax benefit (provision)
     5,111       (5,630     5,561       (12,490
  
 
 
   
 
 
   
 
 
   
 
 
 
Net (loss) income
   $ (677,004   $ 15,469     $ (679,365   $ 34,576  
  
 
 
   
 
 
   
 
 
   
 
 
 
Divestiture of MedData
During the three
 and six
months ended June 30, 2020, the Company recorded a net incremental loss on the sale of MedData of $3.0 million
 and
$5.6 
million, respectively, primarily for the finalization of certain transaction related expenses, a working capital true-up and incremental reserves related to indemnification matters, partially offset by the completion of its preliminary valuation for the contingent economic consideration. This incremental loss is reflected as a component of discontinued operations, net of income taxes, in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2020. The operating results of MedData were reported as a component of discontinued operations, net of income taxes, in the Company’s Consolidated Statements of Income for the three and six months ended June 30, 2019.
v3.20.2
Accounts Payable and Accrued Expenses
6 Months Ended
Jun. 30, 2020
Payables and Accruals [Abstract]  
Accounts Payable and Accrued Expenses
7.
Accounts Payable and Accrued Expenses: 
Accounts payable and accrued expenses consist of the following (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
Accounts payable
   $ 48,982      $ 38,598  
Accrued salaries and bonuses
     131,739        223,815  
Accrued payroll taxes and benefits
     43,087        61,130  
Accrued professional liabilities
     57,466        44,869  
Accrued interest
     32,679        32,910  
Other accrued expenses
     46,956        51,788  
  
 
 
    
 
 
 
   $ 360,909      $ 453,110  
  
 
 
    
 
 
 
The net decrease in accrued salaries and bonuses of $92.1 million, from December 31, 2019 to June 30, 2020, is primarily due to the payment of performance-based incentive compensation, principally to the Company’s affiliated physicians, partially offset by performance-based incentive compensation accrued during the six months ended June 30, 2020. A majority of the Company’s payments for performance-based incentive compensation is paid annually during the first quarter.
v3.20.2
Common and Common Equivalent Shares
6 Months Ended
Jun. 30, 2020
Earnings Per Share [Abstract]  
Common and Common Equivalent Shares
8.
Common and Common Equivalent Shares:
Basic net income per common share is calculated by dividing net income by the weighted average number of common shares outstanding during the period. Diluted net income per common share is calculated by dividing net income by the weighted average number of common and potential common shares outstanding during the period. Potential common shares consist of outstanding restricted stock, deferred stock and stock options and is calculated using the treasury stock method.
The calculation of shares used in the basic and diluted net income per common share calculation for the three and six months ended June 30, 2020 and 2019 is as follows (in thousands):
 
    
Three Months Ended

June 30,
    
Six Months
 
Ended

June 30,
 
    
2020
    
2019
    
2020
    
2019
 
Weighted average number of common shares outstanding
     83,490        83,234        83,061        84,623  
Weighted average number of dilutive common share equivalents
     255        455        —          464  
  
 
 
    
 
 
    
 
 
    
 
 
 
Weighted average number of common and common equivalent
 
shares outstanding (a)
     83,745        83,689        83,061        85,087  
  
 
 
    
 
 
    
 
 
    
 
 
 
Antidilutive securities not included in the diluted net income per
 
common share calculation
     1,335        923        1,092        713  
  
 
 
    
 
 
    
 
 
    
 
 
 
 
(a)
Due to a loss from continuing operations for the six months ended June 30, 2020, no incremental shares are included because the effect would be antidilutive.
v3.20.2
Stock Incentive Plans and Stock Purchase Plans
6 Months Ended
Jun. 30, 2020
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]  
Stock Incentive Plans and Stock Purchase Plans
9.
Stock Incentive Plans and Stock Purchase Plans:
The Company’s Amended and Restated 2008 Incentive Compensation Plan (the “A&R 2008 Incentive Plan”) provides for grants of stock options, stock appreciation rights, restricted stock, deferred stock, and other stock-related awards and performance awards that may be settled in cash, stock or other property.
Under the
 
A&R
2008 Incentive Plan, options to purchase shares of common stock may be granted at a price not less than the fair market value of the shares on the date of grant. The options must be exercised within 10 years from the date of grant and generally become exercisable on a pro rata basis over a three-year period from the date of grant. The Company issues new shares of its common stock upon exercise of its stock options. Restricted stock awards generally vest over periods of three years upon the fulfillment of specified service-based conditions and in certain instances performance-based conditions. Deferred stock awards generally vest upon the satisfaction of specified performance-based conditions and service-based conditions. The Company recognizes compensation expense related to its restricted stock and deferred stock awards ratably over the corresponding vesting periods. During the six months ended June 30, 2020, the Company granted 1.1 million shares of restricted stock to its employees and
non-employee
directors under the
A&R
2008 Incentive Plan. At June 30, 2020, the Company had 6.3 million shares available for future grants and awards under the
A&R
2008 Incentive Plan.
Under the Company’s 1996
Non-Qualified
Employee Stock Purchase Plan, as amended (the “ESPP”), employees are permitted to purchase the Company’s common stock at 85% of market value on January 1st, April 1st, July 1st and October 1st of each year. Under the Company’s 2015
Non-Qualified
Stock Purchase Plan (the “SPP”), certain eligible
non-employee
service providers are permitted to purchase the Company’s common stock at 90% of market value on January 1st, April 1st, July 1st and October 1st of each year.
Each of the ESPP and the SPP provide for the issuance of an aggregate of 2.6 million shares of the Company’s common stock less the number of shares of common stock purchased under the other plan. The Company recognizes stock-based compensation expense for the discount received by participating employees and
non-employee
service providers. During the six months ended June 30, 2020, approximately 0.4 million shares in
the
aggregate were issued under the ESPP and SPP. At June 30, 2020, the Company had approximately 0.7 million shares in
the
aggregate reserved for issuance under the ESPP and SPP.
During the three and six months ended June 30, 2020 and 2019, the Company recognized stock-based compensation expense of $6.6 million and $14.3 million, and $9.9 million and $20.9 million, respectively.
v3.20.2
Common Stock Repurchase Programs
6 Months Ended
Jun. 30, 2020
Text Block [Abstract]  
Common Stock Repurchase Programs
10.
Common Stock Repurchase Programs:
In July 2013, the Company’s Board of Directors authorized the repurchase of shares of the Company’s common stock up to an amount sufficient to offset the dilutive impact from the issuance of shares under the Company’s equity compensation programs. The share repurchase program allows the Company to make open market purchases from
time-to-time
based on general economic and market conditions and trading restrictions. The repurchase program also allows for the repurchase of shares of the Company’s common stock to offset the dilutive impact from the issuance of shares, if any, related to the Company’s acquisition program. No shares were purchased under this program during the six months ended June 30, 2020.
In August 2018, the Company announced that its Board of Directors had authorized the repurchase of up to $500.0 million of the Company’s common stock in addition to its existing share repurchase program, of which $107.2 million remained available for repurchase as of December 31, 2019. Under this share repurchase program, during the six months ended June 30, 2020, the Company withheld approximately 159,000 shares of its common stock to satisfy minimum statutory withholding obligations of $3.0 million in connection with the vesting of restricted stock.
The Company intends to utilize various methods to effect any future share repurchases, including, among others, open market purchases and accelerated share repurchase programs. The amount and timing of repurchases will depend upon several factors, including general economic and market conditions and trading restrictions.
v3.20.2
Commitments and Contingencies
6 Months Ended
Jun. 30, 2020
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies
11.
Commitments and Contingencies:
The Company expects that audits, inquiries and investigations from government authorities and agencies will occur in the ordinary course of business. Such audits, inquiries and investigations and their ultimate resolutions, individually or in the aggregate, could have a material adverse effect on the Company’s business, financial condition, results of operations, cash flows and the trading price of its securities. The Company has not included an accrual for these matters as of June 30, 2020 in its Consolidated Financial Statements, as the variables affecting any potential eventual liability depend on the currently unknown facts and circumstances that arise out of, and are specific to, any particular future audit, inquiry and investigation and cannot be reasonably estimated at this time.
In the ordinary course of business, the Company becomes involved in pending and threatened legal actions and proceedings, most of which involve claims of medical malpractice related to medical services provided by the Company’s affiliated physicians. The Company’s contracts with hospitals generally require the Company to indemnify them and their affiliates for losses resulting from the negligence of the Company’s affiliated physicians. The Company may also become subject to other lawsuits which could involve large claims and significant costs. The Company believes, based upon a review of pending actions and proceedings, that the outcome of such legal actions and proceedings will not have a material adverse effect on its business, financial condition, results of operations, cash flows and the trading price of its securities. The outcome of such actions and proceedings, however, cannot be predicted with certainty and an unfavorable resolution of one or more of them could have a material adverse effect on the Company’s business, financial condition, results of operations, cash flows and the trading price of its securities.
Although the Company currently maintains liability insurance coverage intended to cover professional liability and certain other claims, the Company cannot assure that its insurance coverage will be adequate to cover liabilities arising out of claims asserted against it in the future where the outcomes of such claims are unfavorable. With respect to professional liability risk, the Company generally self-insures a portion of this risk through its wholly owned captive insurance subsidiary. Liabilities in excess of the Company’s insurance coverage, including coverage for professional liability and certain other claims, could have a material adverse effect on the Company’s business, financial condition, results of operations, cash flows and the trading price of its securities.
v3.20.2
Basis of Presentation and New Accounting Pronouncements (Policies)
6 Months Ended
Jun. 30, 2020
Accounting Policies [Abstract]  
New Accounting Pronouncements
New Accounting Pronouncements
In December 2019, accounting guidance related to income taxes was issued with the goal of enhancing and simplifying various aspects of the income tax accounting guidance, including requirements related to hybrid tax regimes, deferred taxes on
step-up
in tax basis of goodwill obtained in a transaction that is not a business combination, separate financial statements of entities not subject to tax, the intraperiod tax allocation exception to the incremental approach, deferred tax liabilities on outside basis differences, and interim-period accounting for enacted changes in tax law and certain
year-to-date
loss limitations. The guidance becomes effective for the Company on January 1, 2021, including interim periods therein, with early adoption permitted, including adoption in interim or annual periods for which financial statements have not yet been issued. The Company does not believe the adoption of this new guidance will have a material impact on its Consolidated Financial Statements and related disclosures.
v3.20.2
Cash Equivalents and Investments (Tables)
6 Months Ended
Jun. 30, 2020
Investments, Debt and Equity Securities [Abstract]  
Schedule of Investments
Investments held at June 30, 2020 and December 31, 2019 are summarized as follows (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
Corporate securities
   $ 55,677      $ 32,962  
Municipal debt securities
     20,831        29,066  
Federal home loan securities
     8,537        8,013  
Certificates of deposit
     5,597        4,469  
  
 
 
    
 
 
 
   $ 90,642      $ 74,510  
  
 
 
    
 
 
 
v3.20.2
Fair Value Measurements (Tables)
6 Months Ended
Jun. 30, 2020
Fair Value Disclosures [Abstract]  
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis
The following table presents information about the Company’s financial instruments that are accounted for at fair value on a recurring basis at June 30, 2020 and December 31, 2019 (in thousands):
 
           
Fair Value
 
    
Fair Value
Category
    
June 30,
 
2020
    
December 31,
 
2019
 
Assets:
        
Money market funds
     Level 1      $ 1,676      $ 16,775  
Short-term investments
     Level 2        90,642        74,510  
Mutual Funds
     Level 1        13,549        14,264  
Liabilities:
        
Contingent consideration
     Level 3        —          2,696  
Financial Instruments Measured At Carrying Amount
The following table presents information about the Company’s financial instruments that are not carried at fair value at June 30, 2020 and December 31, 2019 (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
    
Carrying
Amount
    
Fair

Value
    
Carrying
Amount
    
Fair

Value
 
Liabilities:
           
2023 Notes
     750,000        744,375        750,000        766,875  
2027 Notes
     1,000,000        1,000,000        1,000,000        1,025,600  
v3.20.2
Accounts Receivable and Net Revenue (Tables)
6 Months Ended
Jun. 30, 2020
Text Block [Abstract]  
Schedule of Accounts Receivable, Net
Accounts receivable, net consists of the following (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
Gross accounts receivable
   $ 1,386,562      $ 1,943,664  
Allowance for contractual adjustments and uncollectibles
     (1,040,880      (1,444,795
  
 
 
    
 
 
 
   $ 345,682      $ 498,869  
  
 
 
    
 
 
 
Schedule of Net Revenue
The following table summarizes the Company’s net revenue by category (in thousands):
 
    
Three Months Ended

June 30,
    
Six Months Ended

June 30,
 
    
2020
    
2019
    
2020
    
2019
 
Net patient service revenue
   $ 428,473      $ 486,368      $ 919,431      $ 956,799  
Hospital contract administrative fees
     65,138        69,619        129,698        136,008  
Other revenue
     15,592        5,250        21,925        11,442  
  
 
 
    
 
 
    
 
 
    
 
 
 
   $ 509,203      $ 561,237      $ 1,071,054      $ 1,104,249  
  
 
 
    
 
 
    
 
 
    
 
 
 
Schedule of Percentage of Net Revenue
The approximate percentage of net patient service revenue by type of payor was as follows:
 
    
Three Months Ended

June 30,
   
Six Months Ended

June 30,
 
    
2020
   
2019
   
2020
   
2019
 
Contracted managed care
     67     66     66     65
Government
     26       26       26       26  
Other third-parties
     6       7       6       7  
Private-pay
patients
     1       1       2       2  
  
 
 
   
 
 
   
 
 
   
 
 
 
     100     100     100     100
  
 
 
   
 
 
   
 
 
   
 
 
 
v3.20.2
Discontinued Operations (Tables)
6 Months Ended
Jun. 30, 2020
Discontinued Operations and Disposal Groups [Abstract]  
Disposal Groups, Including Discontinued Operations
The following table summarizes the results of discontinued operations related to the anesthesiology medical group for the three and six months ended June 30, 2020 and 2019 (in thousands):
    
Three Months Ended

June 30,
   
Six Months Ended

June 30,
 
    
2020
   
2019
   
2020
   
2019
 
Net revenue
   $ 90,894     $ 307,072     $ 374,961     $ 615,243  
  
 
 
   
 
 
   
 
 
   
 
 
 
Operating expenses:
        
Cost of service salaries and benefits
     95,398       247,759       348,662       498,930  
Cost of service supplies and other operating expenses
     1,350       3,233       5,216       6,700  
General and administrative expenses
     13,287       19,321       30,964       39,571  
Depreciation and amortization
     2,034       6,030       6,308       12,258  
Transformational and restructuring related expenses
     16,771       9,616       28,634       10,721  
Loss on sale, net
     644,162       —         640,154       —    
  
 
 
   
 
 
   
 
 
   
 
 
 
Total operating expenses
     773,002       285,959       1,059,938       568,180  
  
 
 
   
 
 
   
 
 
   
 
 
 
(Loss) income from operations
     (682,108     21,113       (684,977     47,063  
Non-operating
(expense) income, net
     (7     (14     51       3  
  
 
 
   
 
 
   
 
 
   
 
 
 
(Loss) income before income taxes
     (682,115     21,099       (684,926     47,066  
Income tax benefit (provision)
     5,111       (5,630     5,561       (12,490
  
 
 
   
 
 
   
 
 
   
 
 
 
Net (loss) income
   $ (677,004   $ 15,469     $ (679,365   $ 34,576  
  
 
 
   
 
 
   
 
 
   
 
 
 
v3.20.2
Accounts Payable and Accrued Expenses (Tables)
6 Months Ended
Jun. 30, 2020
Payables and Accruals [Abstract]  
Schedule of Accounts Payable and Accrued Expenses
Accounts payable and accrued expenses consist of the following (in thousands):
 
    
June 30, 2020
    
December 31, 2019
 
Accounts payable
   $ 48,982      $ 38,598  
Accrued salaries and bonuses
     131,739        223,815  
Accrued payroll taxes and benefits
     43,087        61,130  
Accrued professional liabilities
     57,466        44,869  
Accrued interest
     32,679        32,910  
Other accrued expenses
     46,956        51,788  
  
 
 
    
 
 
 
   $ 360,909      $ 453,110  
  
 
 
    
 
 
 
v3.20.2
Common and Common Equivalent Shares (Tables)
6 Months Ended
Jun. 30, 2020
Earnings Per Share [Abstract]  
Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share The calculation of shares used in the basic and diluted net income per common share calculation for the three and six months ended June 30, 2020 and 2019 is as follows (in thousands):
    
Three Months Ended

June 30,
    
Six Months
 
Ended

June 30,
 
    
2020
    
2019
    
2020
    
2019
 
Weighted average number of common shares outstanding
     83,490        83,234        83,061        84,623  
Weighted average number of dilutive common share equivalents
     255        455        —          464  
  
 
 
    
 
 
    
 
 
    
 
 
 
Weighted average number of common and common equivalent
 
shares outstanding (a)
     83,745        83,689        83,061        85,087  
  
 
 
    
 
 
    
 
 
    
 
 
 
Antidilutive securities not included in the diluted net income per
 
common share calculation
     1,335        923        1,092        713  
  
 
 
    
 
 
    
 
 
    
 
 
 
 
(a)
Due to a loss from continuing operations for the six months ended June 30, 2020, no incremental shares are included because the effect would be antidilutive.
v3.20.2
Basis of Presentation and New Accounting Pronouncements - Additional Information (Detail)
Jun. 30, 2020
Unnamed Corporate Joint Venture One [Member]  
Basis Of Presentation [Line Items]  
Equity method ownership percentage in joint venture 37.50%
Unnamed Corporate Joint Venture Two [Member]  
Basis Of Presentation [Line Items]  
Equity method ownership percentage in joint venture 49.00%
v3.20.2
Coronavirus Pandemic ("COVID-19") - Additional Information (Detail) - USD ($)
$ in Millions
6 Months Ended
Mar. 27, 2020
Mar. 25, 2020
Jun. 30, 2020
Line of credit remaining borrowing capacity     $ 899.8
Senior Unsecurd Notes 2023 [Member]      
Debt Instrument Interest Rate     5.25%
Senior Unsecurd Notes 2027 [Member]      
Debt Instrument Interest Rate     6.25%
Letters of Credit [Member]      
Line of credit outstanding     $ 0.2
Forecast For Second And Third Quarters Of 2020 [Member] | Credit Agreement [Member]      
Estimated EBITDA   $ 139.2  
Forecast For Second And Third Quarters Of 2020 [Member] | Credit Agreement [Member] | Maximum [Member]      
Leverage ratio   5.00:1:00  
Forecast For Second And Third Quarters Of 2020 [Member] | Credit Agreement [Member] | Minimum [Member]      
Leverage ratio   4.50:1:00  
Forecast For Fourth Quarter Of 2020 [Member] | Credit Agreement [Member]      
Leverage ratio   4.75:1:00  
Forecast For First Quarter Of 2021 [Member] | Credit Agreement [Member]      
Leverage ratio   2020  
Forecast For Second Quarter Of 2021 [Member] | Credit Agreement [Member]      
Credit Facility Borrowing Capacity   $ 300.0  
COVID-19 [Member]      
Reimbursement of Lost Revenue $ 100.0    
Proceeds From Contribution In Aid Of Reimbursement of Lost Revenue     $ 12.0
Deferred Payment Of Social Security Taxes | % 50.00%    
COVID-19 [Member] | Rural Area [Member]      
Reimbursement of Lost Revenue $ 70.0    
COVID-19 [Member] | Executive Officer [Member]      
Decrease In Salary | %     50.00%
v3.20.2
Cash Equivalents and Investments - Additional Information (Detail) - USD ($)
$ in Millions
Jun. 30, 2020
Dec. 31, 2019
Cash Equivalents [Member]    
Cash Equivalents And Investments [Line Items]    
Cash equivalents $ 1.7 $ 16.8
v3.20.2
Cash Equivalents and Investments - Schedule of Investments (Detail) - USD ($)
$ in Thousands
Jun. 30, 2020
Dec. 31, 2019
Available-for-sale [Line Items]    
Available-for-sale Securities $ 90,642 $ 74,510
Corporate Securities [Member]    
Available-for-sale [Line Items]    
Available-for-sale Securities 55,677 32,962
Municipal Debt Securities [Member]    
Available-for-sale [Line Items]    
Available-for-sale Securities 20,831 29,066
Federal Home Loan Securities [Member]    
Available-for-sale [Line Items]    
Available-for-sale Securities 8,537 8,013
Certificates of Deposit [Member]    
Available-for-sale [Line Items]    
Available-for-sale Securities $ 5,597 $ 4,469
v3.20.2
Fair Value Measurements - Schedule of fair value on a recurring basis (Details) - Fair Value, Measurements, Recurring [Member] - USD ($)
$ in Thousands
Jun. 30, 2020
Dec. 31, 2019
Fair Value, Inputs, Level 1 [Member]    
Assets:    
Money market funds $ 1,676 $ 16,775
Mutual Funds 13,549 14,264
Fair Value, Inputs, Level 2 [Member]    
Assets:    
Short-term investments 90,642 74,510
Fair Value, Inputs, Level 3 [Member]    
Liabilities:    
Contingent consideration $ 0 $ 2,696
v3.20.2
Fair Value Measurements - Schedule of financial instruments that are not carried at fair value (Details) - USD ($)
$ in Thousands
Jun. 30, 2020
Dec. 31, 2019
2023 Notes [Member]    
Liabilities:    
Notes Payable $ 750,000 $ 750,000
Liabilities:    
Notes Payable Fair Value Disclosure 744,375 766,875
2027 Notes [Member]    
Liabilities:    
Notes Payable 1,000,000 1,000,000
Liabilities:    
Notes Payable Fair Value Disclosure $ 1,000,000 $ 1,025,600
v3.20.2
Accounts Receivable and Net Revenue - Schedule of Accounts Receivable, Net (Detail) - USD ($)
$ in Thousands
Jun. 30, 2020
Dec. 31, 2019
Receivables [Abstract]    
Gross accounts receivable $ 1,386,562 $ 1,943,664
Allowance for contractual adjustments and uncollectibles (1,040,880) (1,444,795)
Accounts receivable, net $ 345,682 $ 498,869
v3.20.2
Accounts Receivable and Net Revenue - Schedule of Net Revenue (Detail) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Jun. 30, 2020
Jun. 30, 2019
Disaggregation of Revenue [Abstract]        
Net revenue $ 509,203 $ 561,237 $ 1,071,054 $ 1,104,249
Net patient service revenue [Member]        
Disaggregation of Revenue [Abstract]        
Net revenue 428,473 486,368 919,431 956,799
Hospital contract administrative fees [Member]        
Disaggregation of Revenue [Abstract]        
Net revenue 65,138 69,619 129,698 136,008
Other revenue [Member]        
Disaggregation of Revenue [Abstract]        
Net revenue $ 15,592 $ 5,250 $ 21,925 $ 11,442
v3.20.2
Accounts Receivable and Net Revenue - Schedule of Net Patient Service Revenue by Type of Payor (Detail)
3 Months Ended 6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Jun. 30, 2020
Jun. 30, 2019
Health Care Organization, Receivable and Revenue Disclosures [Line Items]        
Percentage of net patient service revenue 100.00% 100.00% 100.00% 100.00%
Contracted Managed Care [Member]        
Health Care Organization, Receivable and Revenue Disclosures [Line Items]        
Percentage of net patient service revenue 67.00% 66.00% 66.00% 65.00%
Government [Member]        
Health Care Organization, Receivable and Revenue Disclosures [Line Items]        
Percentage of net patient service revenue 26.00% 26.00% 26.00% 26.00%
Other Third-Parties [Member]        
Health Care Organization, Receivable and Revenue Disclosures [Line Items]        
Percentage of net patient service revenue 6.00% 7.00% 6.00% 7.00%
Private-Pay Patients [Member]        
Health Care Organization, Receivable and Revenue Disclosures [Line Items]        
Percentage of net patient service revenue 1.00% 1.00% 2.00% 2.00%
v3.20.2
Discontinued Operations - Additional information (Detail) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended
May 06, 2020
Jun. 30, 2020
Jun. 30, 2019
Jun. 30, 2020
Jun. 30, 2019
Net incremental loss on the sale of MedData   $ (680,036) $ (28,292) $ (684,999) $ (293,710)
North American Partners In Anesthesia [Member]          
Preliminary and incremental gain loss on sale   644,200      
Increase decrease in valuation allowance deferred tax assets   419,000      
Proceeds from Divestiture of Businesses $ 50,000        
Maximum consideration receivable 250,000        
Accounts receivable retained 110,000        
North American Partners In Anesthesia [Member] | Tax Year Two Thousand and Twenty Five [Member]          
Capital loss carry forward   1,680,000   1,680,000  
North American Partners In Anesthesia [Member] | Maximum [Member]          
Maximum consideration receivable 250,000        
North American Partners In Anesthesia [Member] | Minimum [Member]          
Maximum consideration receivable $ 0        
Divestiture of MedData [Member]          
Net incremental loss on the sale of MedData   $ 3,000   $ 5,600  
v3.20.2
Discontinued Operations - Schedule of Discontinued Operations (Details) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Jun. 30, 2020
Jun. 30, 2019
Operating expenses:        
Net (loss) income $ (680,036) $ (28,292) $ (684,999) $ (293,710)
Discontinued Operations, Held-for-sale [Member]        
Net revenue 90,894 307,072 374,961 615,243
Operating expenses:        
Cost of service salaries and benefits 95,398 247,759 348,662 498,930
Cost of service supplies and other operating expenses 1,350 3,233 5,216 6,700
General and administrative expenses 13,287 19,321 30,964 39,571
Depreciation and amortization 2,034 6,030 6,308 12,258
Transformational and restructuring related expenses 16,771 9,616 28,634 10,721
Loss on sale, net 644,162 0 640,154 0
Total operating expenses 773,002 285,959 1,059,938 568,180
(Loss) income from operations (682,108) 21,113 (684,977) 47,063
Non-operating (expense) income, net (7) (14) 51 3
(Loss) income before income taxes (682,115) 21,099 (684,926) 47,066
Income tax benefit (provision) 5,111 (5,630) 5,561 (12,490)
Net (loss) income $ (677,004) $ 15,469 $ (679,365) $ 34,576
v3.20.2
Accounts Payable and Accrued Expenses - Schedule of Accounts Payable and Accrued Expenses (Detail) - USD ($)
$ in Thousands
Jun. 30, 2020
Dec. 31, 2019
Payables and Accruals [Abstract]    
Accounts payable $ 48,982 $ 38,598
Accrued salaries and bonuses 131,739 223,815
Accrued payroll taxes and benefits 43,087 61,130
Accrued professional liabilities 57,466 44,869
Accrued interest 32,679 32,910
Other accrued expenses 46,956 51,788
Accounts payable and accrued expenses, total $ 360,909 $ 453,110
v3.20.2
Accounts Payable and Accrued Expenses - Additional Information (Detail)
$ in Millions
6 Months Ended
Jun. 30, 2020
USD ($)
Net decrease in accrued salaries and bonuses $ 92.1
v3.20.2
Common and Common Equivalent Shares - Schedule of Calculation of Shares Used in Basic and Diluted Net Income Per Share (Detail) - shares
shares in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Jun. 30, 2020
Jun. 30, 2019
Earnings Per Share [Abstract]        
Weighted average number of common shares outstanding 83,490 83,234 83,061 84,623
Weighted average number of dilutive common share equivalents 255 455   464
Weighted average number of common and common equivalent shares outstanding [1] 83,745 83,689 83,061 85,087
Antidilutive securities not included in the diluted net income per common share calculation 1,335 923 1,092 713
[1] Due to a loss from continuing operations for the six months ended June 30, 2020, no incremental shares are included because the effect would be antidilutive.
v3.20.2
Stock Incentive Plans and Stock Purchase Plans - Additional Information (Detail) - USD ($)
$ in Millions
3 Months Ended 6 Months Ended
Jun. 30, 2020
Jun. 30, 2019
Jun. 30, 2020
Jun. 30, 2019
Dec. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Common stock, aggregate shares authorized 200,000,000   200,000,000   200,000,000
Stock-based compensation expense $ 6.6 $ 9.9 $ 14.3 $ 20.9  
Stock Option [Member] | Maximum [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Vesting period of options, maximum years     10 years    
Restricted Stock [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Award vesting period     3 years    
1996 Non-Qualified Employee Stock Purchase Plan [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Percentage of market value of common stock at which employees are permitted to purchase     85.00%    
2015 Non-Qualified Stock Purchase Plan [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Percentage of market value of common stock at which employees are permitted to purchase     90.00%    
Amended and Restated 2008 Plan [Member] | Stock Option [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Shares available for future grants and awards under Stock Incentive Plans 6,300,000   6,300,000    
Amended and Restated 2008 Plan [Member] | Restricted Stock [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period     1,100,000    
1996 Non-Qualified Employee Stock Purchase Plan and 2015 Non-Qualified Stock Purchase Plan [Member]          
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]          
Common stock, aggregate shares authorized 2,600,000   2,600,000    
Aggregate number Shares issued under Stock Purchase Plans     400,000    
Common stock, reserved for issuance 700,000   700,000    
v3.20.2
Common Stock Repurchase Programs - Additional Information (Detail) - USD ($)
$ in Millions
6 Months Ended
Jun. 30, 2020
Dec. 31, 2019
Aug. 31, 2018
Common Stock [Line Items]      
Common stock authorized for repurchase     $ 500.0
Company's Common stock repurchased   $ 107.2  
Restricted Stock [Member]      
Common Stock [Line Items]      
Number of shares withheld to satisfy minimum statutory tax withholding obligations 159,000    
Amount withheld to satisfy minimum statutory tax withholding obligations $ 3.0