LHC GROUP, INC.
Filed pursuant to Rule 424(b)(5)
Registration
No. 333-135024
PROSPECTUS SUPPLEMENT
(To Prospectus dated June 14, 2006)
4,000,000 Shares
Common Stock
We are offering 1,000,000 shares of our common stock. The
selling stockholders identified in this prospectus supplement
are selling an additional 3,000,000 shares of our common
stock in this offering. We will not receive any of the proceeds
from the sale of shares by the selling stockholders.
Our common stock is traded on the Nasdaq Global Market under the
symbol LHCG. On July 13, 2006, the last
reported sale price for our common stock on the Nasdaq Global
Market was $19.41 per share.
Investing in our common stock
involves risks.
See Risk Factors
beginning on
page S-9.
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Per
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Share
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Total
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Public offering price
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$
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19.25
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$
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77,000,000
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Underwriting discounts and
commissions
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$
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0.96
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$
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3,840,000
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Proceeds, before expenses, to LHC
Group
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$
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18.29
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$
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18,290,000
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Proceeds, before expenses, to the
selling stockholders
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$
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18.29
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$
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54,870,000
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Neither the Securities and Exchange Commission, any state
securities commission, nor any other regulatory body has
approved or disapproved of these securities or determined if
this prospectus supplement and the accompanying prospectus is
truthful or complete. Any representation to the contrary is a
criminal offense.
We and the selling stockholders have granted the underwriters an
option to purchase up to 150,000 and up to
450,000 additional shares of our common stock,
respectively, at the public offering price, less the
underwriting discounts and commissions, exercisable within
30 days of the date of this prospectus supplement to cover
over-allotments.
The underwriters expect to deliver the shares on or about
July 19, 2006.
Jefferies &
Company
CIBC World Markets
Stifel Nicolaus
The date of this prospectus supplement is July 13,
2006.
TABLE OF
CONTENTS
Prospectus
Supplement
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S-1
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S-8
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S-9
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S-21
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S-22
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S-23
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S-26
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S-28
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S-30
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S-30
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S-30
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S-30
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Prospectus
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ABOUT
THIS PROSPECTUS SUPPLEMENT
This prospectus supplement contains the terms of this offering.
This prospectus supplement is part of and should be read in
conjunction with the accompanying prospectus. This prospectus
supplement is not complete without, and may not be delivered or
utilized except in conjunction with the accompanying prospectus.
The information we present in this prospectus supplement may
add, update or change information included in the accompanying
prospectus. If information in this prospectus supplement, or the
information incorporated by reference herein, is inconsistent
with the accompanying prospectus, this prospectus supplement, or
the information incorporated by reference herein, will apply and
will supersede that information in the accompanying prospectus.
You should rely only on the information contained or
incorporated by reference in this prospectus supplement. We have
not authorized anyone to provide you with different information.
You should assume that the information in this prospectus
supplement and the accompanying prospectus, as well as the
information we have previously filed with the Securities and
Exchange Commission and incorporated by reference in this
prospectus supplement and the accompanying prospectus, is
accurate only as of the date of the documents containing the
information. This prospectus supplement may be used only where
it is legal to sell these securities.
PROSPECTUS
SUPPLEMENT SUMMARY
You should read this entire prospectus supplement, the
accompanying prospectus and the information incorporated by
reference herein, before making an investment decision. You
should also carefully consider the information set forth under
Risk Factors. Unless otherwise indicated, LHC
Group, we, us, and the
Company refer to LHC Group, Inc. and our consolidated
subsidiaries.
Overview
We provide post-acute healthcare services primarily to Medicare
beneficiaries in rural markets in the southern United States. We
provide these services through our home nursing agencies,
hospices, long-term acute care hospitals and outpatient
rehabilitation clinics. Since our founders began operations in
1994 with one home nursing agency in Palmetto, Louisiana, we
have grown to 100 locations in Louisiana, Mississippi, Arkansas,
Alabama, Texas and West Virginia as of March 31, 2006. We
have also grown our net service revenue from $28.2 million
in 2001 to $162.5 million in 2005, representing a compound
annual growth rate of 55.0%. During this same period, our annual
net income grew from $787,000 in 2001 to $10.1 million in
2005. During the three months ended March 31, 2006, we
reported $45.5 million of net service revenue and
$4.1 million of net income. Medicare accounted for 85.1% of
our net service revenue for the year ended December 31,
2005 and 84.9% of our net service revenue for the three months
ended March 31, 2006. We have been profitable every year
since 1999.
Our objective is to become the leading provider of post-acute
healthcare services to Medicare patients in selected rural
markets, which we define as counties having between 10,000 and
100,000 residents. We believe these markets, which have a higher
percentage of Medicare beneficiaries, are underserved relative
to urban or suburban markets. Upon entering a new market, we
implement our clinically-oriented business model that emphasizes
improved patient care, strong relationships with local
hospitals, physicians and other healthcare providers and an
expansion in the range of healthcare services available to
patients. Our model provides support and clinical guidelines to
our local caregivers while promoting treatment flexibility that
allows them to effectively address individual patient needs. Our
model also enhances our ability to expand efficiently into these
markets and deliver high quality care consistently on a
cost-effective basis across multiple locations.
We provide home-based post-acute healthcare services through our
home nursing agencies and hospices. As of March 31, 2006,
we owned and operated 80 home nursing locations, of which 77 are
certified to receive Medicare reimbursement. We also manage the
operations of three home nursing locations in which we currently
have no ownership interest. Our home nursing locations offer a
wide range of services, including skilled nursing, private duty
nursing, physical, occupational, and speech therapy and
medically-oriented social services. The nurses, home health
aides and therapists in our home nursing agencies work closely
with patients and their families to design and implement
individualized treatment responsive to a physician-prescribed
plan of care. As of March 31, 2006, we also owned and
operated four Medicare-certified hospices and managed the
operations of one Medicare-certified hospice in which we
currently have no ownership interest. Our hospices provide
palliative care to patients with terminal illnesses through
interdisciplinary teams of physicians, nurses, home health
aides, counselors and volunteers. For the years ended
December 31, 2004 and 2005 and the three months ended
March 31, 2006, our home-based services provided
$84.5 million, $107.4 million and $32.7 million,
respectively, of our net service revenue.
We provide facility-based post-acute healthcare services through
our long-term acute care hospitals and outpatient rehabilitation
clinics. As of March 31, 2006, we owned and operated four
long-term acute care hospitals with seven locations, with a
total of 175 licensed beds. Our long-term acute care hospitals,
all of which are located within host hospitals, provide services
primarily to patients who have transitioned out of a hospital
intensive care unit and suffer from complex medical conditions
that remain too severe for treatment in a non-acute setting. We
also owned and operated four outpatient rehabilitation clinics
and provided contract rehabilitation services to third parties.
We provide outpatient rehabilitation services through physical
therapists, occupational therapists and speech pathologists at
our five outpatient rehabilitation clinics in which we have an
ownership interest. We also provide outpatient rehabilitation
services on a contract basis. In addition, we
S-1
manage the operations of one inpatient rehabilitation facility
in which we have no ownership interest. For the years ended
December 31, 2004 and 2005 and the three months ended
March 31, 2006, our facility-based services provided
$38.5 million, $55.2 million and $12.8 million,
respectively, of our net service revenue.
Industry
and Market Opportunity
According to estimates of the Medicare Payment Advisory
Committee, or MedPAC, Medicare spending totaled
$14.3 billion in 2004 for the two primary post-acute
sectors in which we operate: home nursing and long-term acute
care. MedPAC estimates that Medicare spending on home nursing
services totaled $11.2 billion in 2004. The Centers for
Medicare and Medicaid Services, or CMS, estimates that there are
approximately 8,204 Medicare-certified home nursing agencies in
the United States, the majority of which are operated by small
local or regional providers. CMS has historically estimated that
approximately 32.0% of these home nursing agencies are
hospital-based or
not-for-profit,
freestanding agencies, and MedPAC estimates that approximately
36.0% are located in rural markets. CMS predicts that Medicare
spending on home nursing services will increase at an average
annual growth rate of 5.2% between 2005 and 2015. According to
MedPAC estimates, Medicare spending for services provided by
long-term acute care hospitals has grown from $0.4 billion
in 1993 to an estimated $3.1 billion in 2004.
We believe our post-acute healthcare services provide valuable
treatment alternatives to underserved, rural patient
populations. Rural areas typically do not offer the range of
post-acute healthcare services that are available in urban or
suburban markets; therefore, patients in rural markets often
face challenges in accessing healthcare in a convenient and
appropriate setting. Because most rural areas have the
population size to support only one or two general acute care
hospitals, the local hospital often plays a significant role in
rural market healthcare delivery systems. Rural patients who
require home nursing services frequently receive care from a
small home nursing agency or an agency that, while owned and
operated by the hospital, is not an area of focus for that
hospital. In addition, patients in these markets who require
services typically offered by long-term acute care hospitals
generally remain in the community hospital, as it is often the
only local facility equipped to deal with severe, complex
medical conditions.
Competitive
Strengths
We believe the following competitive strengths have enabled us
to grow our business and increase our net income while building
strong market share:
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We have a proven track record of success in serving rural
markets. Of our 100 locations as of March 31,
2006, 72.4% are located in counties with fewer than 100,000
residents. Our strategic plan for entering new markets is
specifically designed for rural markets and includes:
(1) building relationships with local hospitals, physicians
and other healthcare providers; (2) expanding the breadth
and quality of services provided; (3) recruiting qualified
nurses and other healthcare professionals; and
(4) transitioning acquired operations to our operating
model and technology platform.
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We are clinically-oriented and patient-focused. We
have developed a decentralized, care management operating model
that enhances our ability to deliver high-quality care on a
consistent and cost-effective basis across multiple locations.
Our operating model provides clinical guidelines at the agency
and caregiver levels while promoting treatment flexibility to
address patient-specific needs. We believe this approach also
allows us to allocate more resources to patient care, which
enhances clinical outcomes and increases physician and patient
satisfaction.
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We incur lower costs to enter new markets. We
often enter a new market by forming a joint venture with a local
hospital for, or by acquiring or assuming operations of, an
existing hospital-owned home nursing agency that may be
underperforming clinically or financially. Typically, we have
acquired the assets of these agencies with limited capital
investment. Upon acquiring these interests, we implement our
standardized operating model, which generally leads to increased
patient census, enhanced patient care and improved financial
performance.
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S-2
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We focus on maintaining strong employee
relations. Critical to our success is our ability to
attract and retain experienced and skilled employees and our
recognition of the importance of good relations with our
employees. The flexibility created by our care management
operating model, combined with our emphasis on communication,
education and competitive benefits, has allowed us to attract
and retain highly skilled and experienced employees. As a
result, we had an employee turnover rate for full-time employees
of approximately 18.7% for the twelve months ended
December 31, 2005, which we believe is below the comparable
national average.
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We have an experienced management team. Our ability
to grow profitability, deliver high-quality service, and expand
our operations has been due, in large part, to the experience of
our senior management team. Our four executive officers have
over 75 years of combined experience in the healthcare
services industry.
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Growth
Strategy
Our objective is to become the leading provider of post-acute
services to Medicare beneficiaries in rural markets in the
southern United States. To achieve this objective, we intend to:
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Drive internal growth in existing markets. We intend
to drive internal growth in our current markets by increasing
the number of healthcare providers in each market from whom we
receive referrals and by expanding the breadth of our services.
We intend to achieve this growth by: (1) continuing to
educate healthcare providers about the benefits of our services;
(2) reinforcing the position of our agencies and facilities
as community assets; (3) maintaining our emphasis on
high-quality medical care for our patients; and
(4) providing a superior work environment for our employees.
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Achieve margin improvement through the active management of
costs. The majority of our net service revenue is
generated under Medicare prospective payment systems through
which we are paid pre-determined rates based upon the clinical
condition and severity of the patients in our care. Because our
profitability in a fixed payment system depends upon our ability
to manage the costs of providing care, we continue to pursue
initiatives to improve our margins and net income.
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Expand into new rural markets. We will continue
expanding into new markets by developing new and acquiring
existing Medicare-certified home nursing agencies in attractive
markets. Once we have established a home nursing agency in a new
market, we will consider the development of a freestanding
long-term acute care hospital and the provision of other
complementary post-acute healthcare services in such market. We
currently plan to pursue expansion opportunities in 15
contiguous states, and we have identified approximately 500
underserved rural markets in those states where we believe we
can implement our operating model successfully.
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Pursue strategic acquisitions. We will continue to
identify and evaluate opportunities for strategic acquisitions
in new and existing markets that will enhance our market
position, increase our referral base and expand the breadth of
services we offer. We may use a portion of the proceeds of this
offering to pursue acquisitions that would allow us to acquire
market share in our target states through the purchase of larger
home nursing operations.
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Recent
Developments
On June 19, 2006, we entered into an agreement to purchase
the Kentucky-based assets of The Lifeline Health Group, Inc., or
Lifeline, a privately-held company based in Somerset, Kentucky,
a Certificate of Need state, for an aggregate cash purchase
price of $15.0 million. The acquisition involves an
approximate total patient census of 2,400 and 350 Lifeline
employees. As part of the purchased assets, we will acquire 17
locations in 29 counties throughout Kentucky. In 2005, Lifeline
reported Kentucky-based revenue of approximately
$23.0 million, which is subject to final verification in
connection with our pre-closing due diligence. The transaction
is expected to close by July 31, 2006, pending regulatory
clearance and satisfaction of customary closing conditions. We
cannot assure you that we will be able to consummate the
Lifeline transaction within the expected timeframe, if at all.
S-3
The
Offering
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Common stock offered by us |
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1,000,000 shares |
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Common sock offered by selling stockholders |
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3,000,000 shares |
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Common stock to be outstanding after this offering |
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17,567,995 shares |
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Use of Proceeds |
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We intend to use the proceeds that we receive from this offering
to fund contemplated and possible future acquisitions and for
other general corporate purposes, which may include repaying
indebtedness. We will not receive any of the proceeds from the
sale of shares of common stock by selling stockholders. See
Use of Proceeds. |
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Nasdaq symbol |
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LHCG |
The number of shares of our common stock that will be
outstanding after this offering is based on shares outstanding
of 16,567,995 as of June 30, 2006.
Except as otherwise noted, all information in this prospectus
supplement:
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assumes the underwriters do not exercise their over-allotment
option;
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excludes 89,050 shares of unvested restricted common stock
issued by us under our 2005 Long-Term Incentive Plan; and
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excludes 27,000 shares of our common stock issuable upon
exercise of outstanding stock options issued by us under our
Amended and Restated 2005 Non-Employee Directors Compensation
Plan.
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S-4
Summary
Consolidated Financial Data
The summary consolidated financial data presented below is
derived from our consolidated financial statements, which are
incorporated by reference herein. The summary financial
information set forth below as of and for the years ended
December 31, 2003, 2004 and 2005 has been derived from our
audited consolidated financial statements. The summary financial
information as of and for the three months ended March 31,
2005 and 2006 has been derived from our unaudited consolidated
financial statements, which include all adjustments consisting
of normal recurring accruals that we consider necessary for a
fair presentation of the financial position and the results of
operations for these periods. Historical results are not
necessarily indicative of future performance. See Note on
Discontinued Operations at the end of this Summary.
The as adjusted consolidated balance sheet data as of
March 31, 2006 presented below gives effect to the
completion of this offering and application of the net proceeds
by us, as described in Use of Proceeds, as if each
had occurred as of March 31, 2006. The as adjusted summary
financial data is not necessarily indicative of what our
consolidated financial position would have been had this
offering been completed as of the dates indicated, nor is such
data necessarily indicative of our consolidated financial
position as of any future date.
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Three Months Ended
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Year Ended
December 31,
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March 31,
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2003
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2004
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2005
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2005
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2006
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(in thousands)
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Consolidated Statements of
Income Data:
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Net service revenue
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$
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72,365
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$
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122,980
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$
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162,549
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$
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35,557
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$
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45,482
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Cost of service revenue
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37,146
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63,249
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88,343
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17,779
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24,047
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Gross margin
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35,219
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59,731
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74,206
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17,778
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21,435
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General and administrative expenses
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24,761
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37,926
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49,884
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10,017
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14,994
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Impairment loss
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31
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Equity-based compensation expense
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864
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1,788
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3,856
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504
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Operating income
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9,563
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20,017
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20,466
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7,257
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6,441
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Interest expense
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1,226
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1,189
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1,068
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308
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86
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Non-operating (income) loss,
including gain on sale of assets
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(106
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150
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(595
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(518
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(167
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Income from continuing operations
before income taxes and minority interest and cooperative
endeavor allocations
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8,443
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18,678
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19,993
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7,467
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6,522
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Income tax expense
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2,320
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5,605
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5,364
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2,304
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1,715
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Minority interest and cooperative
endeavor allocations
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2,837
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4,046
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4,527
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1,441
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1,028
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Income from continuing operations
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3,286
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9,027
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10,102
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3,722
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3,779
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Loss from discontinued operations,
net
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(443
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(26
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(435
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(240
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Gain on sale of discontinued
operations, net
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312
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597
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Net income
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2,843
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9,313
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10,102
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3,287
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4,136
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Change in the redemption value of
redeemable minority interests
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(1,476
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)
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843
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Net income available to common
stockholders
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$
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2,843
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$
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9,313
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$
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8,626
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$
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3,287
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$
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4,979
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S-5
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Three Months Ended
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Year Ended December 31,
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March 31,
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2003
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2004
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2005
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2005
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2006
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Earnings per share-basic:
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Income from continuing operations
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$
|
0.27
|
|
|
$
|
0.75
|
|
|
$
|
0.69
|
|
|
$
|
0.31
|
|
|
$
|
0.23
|
|
Loss from discontinued operations
|
|
(0.03
|
)
|
|
|
|
|
|
|
|
(0.04
|
)
|
|
(0.01
|
)
|
Gain on sale of discontinued
operations, net
|
|
|
|
|
0.02
|
|
|
|
|
|
|
|
|
0.04
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income
|
|
0.24
|
|
|
0.77
|
|
|
0.69
|
|
|
0.27
|
|
|
0.26
|
|
Change in the redemption value of
redeemable minority interests
|
|
|
|
|
|
|
|
(0.10
|
)
|
|
|
|
|
0.05
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income available to common
stockholders
|
|
$
|
0.24
|
|
|
$
|
0.77
|
|
|
$
|
0.59
|
|
|
$
|
0.27
|
|
|
$
|
0.31
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Earnings per share-diluted:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Income from continuing operations
|
|
$
|
0.26
|
|
|
$
|
0.74
|
|
|
$
|
0.69
|
|
|
$
|
0.30
|
|
|
$
|
0.23
|
|
Loss from discontinued operations
|
|
(0.03
|
)
|
|
|
|
|
|
|
|
(0.04
|
)
|
|
(0.01
|
)
|
Gain on sale of discontinued
operations, net
|
|
|
|
|
0.02
|
|
|
|
|
|
|
|
|
0.04
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income
|
|
0.23
|
|
|
0.76
|
|
|
0.69
|
|
|
0.26
|
|
|
0.26
|
|
Change in the redemption value of
redeemable minority interests
|
|
|
|
|
|
|
|
(0.10
|
)
|
|
|
|
|
0.05
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net income available to common
stockholders
|
|
$
|
0.23
|
|
|
$
|
0.76
|
|
|
$
|
0.59
|
|
|
$
|
0.26
|
|
|
$
|
0.31
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average shares
outstanding:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic
|
|
12,085,154
|
|
|
12,085,154
|
|
|
14,628,737
|
|
|
12,085,154
|
|
|
16,557,828
|
|
Diluted
|
|
12,114,675
|
|
|
12,145,150
|
|
|
14,684,639
|
|
|
12,207,532
|
|
|
16,563,368
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
As of March 31,
|
|
|
|
As of December 31,
|
|
|
|
|
|
2006
|
|
|
|
2003
|
|
|
2004
|
|
|
2005
|
|
|
Actual
|
|
|
As Adjusted
|
|
|
|
(in thousands)
|
|
|
Consolidated Balance Sheet
Data:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash
|
|
$
|
1,725
|
|
|
$
|
2,911
|
|
|
$
|
17,398
|
|
|
$
|
18,133
|
|
|
$
|
35,923
|
|
Total assets
|
|
27,915
|
|
|
47,519
|
|
|
104,418
|
|
|
110,137
|
|
|
127,927
|
|
Total debt
|
|
12,277
|
|
|
18,275
|
|
|
5,427
|
|
|
4,715
|
|
|
4,715
|
|
Total stockholders equity
|
|
6,909
|
|
|
16,351
|
|
|
78,444
|
|
|
83,579
|
|
|
101,369
|
|
S-6
Note on
Discontinued Operations
During the three months ended March 31, 2006, we sold one
of our long-term acute care hospitals and closed substantially
all of our private duty operations. The results of these closed
private duty operations are reported as discontinued operations
in the consolidated financial information above for the three
months ended March 31, 2005 and 2006. In addition, we
identified an outpatient rehabilitation clinic, a home health
agency and a long-term acute care hospital as held for sale as
of March 31, 2006. The operations of these businesses were
also reported as discontinued operations in the consolidated
financial information above for the three months ended
March 31, 2006 and 2005. The outpatient rehabilitation
clinic and home health agency have been subsequently sold. The
results of these discontinued operations identified in 2006 are
not classified as discontinued operations in the years ended
December 31, 2003, 2004, and 2005. In the years ended
December 31, 2003 and 2004, the loss from discontinued
operations represents operations that were discontinued in 2004.
Net service revenue from the discontinued operations identified
in 2006 for the years ended December 31, 2003, 2004 and
2005 was $3.5 million, $6.4 million, and
$9.5 million, respectively. Costs, expenses and minority
interest and cooperative endeavor allocations were
$3.6 million, $7.5 million, and $12.1 million,
for the years ended December 31, 2003, 2004, and 2005.
Losses from discontinued operations were $0, $1.1 million,
and $2.6 million for the years ended December 31,
2003, 2004 and 2005, respectively.
S-7
SPECIAL
NOTE REGARDING FORWARD-LOOKING STATEMENTS
This prospectus supplement contains forward-looking
statements. Forward-looking statements relate to
expectations, beliefs, future plans and strategies, anticipated
events or trends and similar expressions concerning matters that
are not historical facts or that necessarily depend upon future
events. In some cases, you can identify forward-looking
statements by terms such as may, will,
should, could, would,
expect, plan, anticipate,
believe, estimate, project,
predict, potential, and similar
expressions. Specifically, this prospectus supplement contains,
among others, forward-looking statements about:
|
|
|
|
|
our expectations regarding financial condition or consolidated
results of operations for periods after March 31, 2006;
|
|
|
|
our future sources of and need for liquidity and capital
resources;
|
|
|
|
our expectations regarding the size and growth of the market for
our services;
|
|
|
|
our business strategies and our ability to grow our business;
|
|
|
|
the implementation or interpretation of current or future
regulations and legislation; and
|
|
|
|
the reimbursement levels of third-party payors.
|
These forward-looking statements reflect our current views about
future events, are based on assumptions and are subject to known
and unknown risks and uncertainties. Many important factors,
some of which are discussed elsewhere in this prospectus
supplement, could cause actual results or achievements to differ
materially from any future results or achievements expressed or
implied by forward-looking statements. Many of the factors that
will determine future events or achievements are beyond our
ability to control or predict. Important factors that could
cause actual results or achievements to differ materially from
current expectations reflected in these forward-looking
statements include, among others, the factors discussed under
Risk Factors.
You should read this prospectus supplement, the accompanying
prospectus, and the documents incorporated by reference herein,
completely and with the understanding that our actual future
results may be materially different from what we expect.
The forward-looking statements contained in this prospectus
supplement reflect our views and assumptions only as of the date
of this prospectus. Except as required by law, we assume no
responsibility for updating any forward-looking statements.
We qualify all of our forward-looking statements by these
cautionary statements.
S-8
RISK
FACTORS
You should carefully consider the risks described below
before investing in LHC Group. The risks and uncertainties
described below are not the only ones we face. Other
risks and uncertainties that we have not predicted or assessed
may also adversely affect us. If any of the following risks
occurs, our earnings, financial condition or business could be
materially harmed, and the trading price of our common stock
could decline, resulting in the loss of all or part of your
investment.
More than
80% of our net service revenue is derived from Medicare. If
there are changes in Medicare rates or methods governing
Medicare payments for our services, or if we are unable to
control our costs, our net service revenue and net income could
decline materially.
For the years ended December 31, 2003, 2004, and 2005 and
for the three months ended March 31, 2006, we received
83.1%, 84.6%, 85.1% and 84.9%, respectively, of our net service
revenue from Medicare. Reductions in Medicare rates or changes
in the way Medicare pays for services could cause our net
service revenue and net income to decline, perhaps materially.
Reductions in Medicare reimbursement could be caused by many
factors, including:
|
|
|
|
|
administrative or legislative changes to the base rates under
the applicable prospective payment systems;
|
|
|
|
the reduction or elimination of annual rate increases;
|
|
|
|
the imposition or increase by Medicare of mechanisms, such as
co-payments, shifting more responsibility for a portion of
payment to beneficiaries;
|
|
|
|
adjustments to the relative components of the wage index used in
determining reimbursement rates;
|
|
|
|
changes to case mix or therapy thresholds;
|
|
|
|
the reclassification of home health resource groups or long-term
care diagnosis-related groups; or
|
|
|
|
further limitations on referrals to long-term acute care
hospitals from host hospitals.
|
We generally receive fixed payments from Medicare for our
services based on the level of care provided to our patients.
Consequently, our profitability largely depends upon our ability
to manage the cost of providing these services. Medicare
currently provides for an annual adjustment of the various
payment rates, such as the base episode rate for our home
nursing services, based upon the increase or decrease of the
medical care expenditure category of the Consumer Price Index,
which may be less than actual inflation. This adjustment could
be eliminated or reduced in any given year. Our base episode
rate for home nursing services is also subject to an annual
market basket adjustment. Further, Medicare routinely
reclassifies home health resource groups and long-term care
diagnosis-related groups. As a result of those
reclassifications, we could receive lower reimbursement rates
depending on the case mix of the patients we service. If our
cost of providing services increases by more than the annual
Medicare price adjustment, or if these reclassifications result
in lower reimbursement rates, our net income could be adversely
impacted.
We are
subject to extensive government regulation. Any changes in the
laws governing our business, or the interpretation and
enforcement of those laws or regulations, could cause us to
modify our operations and could negatively impact our operating
results.
As a provider of healthcare services, we are subject to
extensive regulation on the federal, state and local levels,
including with regard to:
|
|
|
|
|
agency, facility and professional licensure, certificates of
need and permits of approval;
|
|
|
|
conduct of operations, including financial relationships among
healthcare providers, Medicare fraud and abuse, and physician
self-referral;
|
|
|
|
maintenance and protection of records, including the Health
Insurance Portability and Accountability Act of 1996, or HIPAA;
|
S-9
|
|
|
|
|
environmental protection, health and safety;
|
|
|
|
certification of additional agencies or facilities by the
Medicare program; and
|
|
|
|
payment for services.
|
The laws and regulations governing our operations, along with
the terms of participation in various government programs,
regulate how we do business, the services we offer, and our
interactions with patients and other providers. These laws and
regulations, and their interpretations, are subject to frequent
change. Changes in existing laws or regulations, or their
interpretations, or the enactment of new laws or regulations
could increase our costs of doing business and cause our net
income to decline. If we fail to comply with these applicable
laws and regulations, we could suffer civil or criminal
penalties, including the loss of our licenses to operate and our
ability to participate in federal and state reimbursement
programs.
We are subject to various routine and non-routine governmental
reviews, audits, and investigations. In recent years federal and
state civil and criminal enforcement agencies have heightened
and coordinated their oversight efforts related to the
healthcare industry, including with respect to referral
practices, cost reporting, billing practices, joint ventures and
other financial relationships among healthcare providers. A
violation or change in the interpretation of the laws governing
our operations, or changes in the interpretation of those laws,
could result in the imposition of fines, civil or criminal
penalties, the termination of our rights to participate in
federal and state-sponsored programs, or the suspension or
revocation of our licenses to operate. If we become subject to
material fines or if other sanctions or other corrective actions
are imposed upon us, we may suffer a substantial reduction in
net income.
If any of
our agencies or facilities fail to comply with the conditions of
participation in the Medicare program, that agency or facility
could be terminated from Medicare, which would adversely affect
our net service revenue and net income.
Our agencies and facilities must comply with the extensive
conditions of participation in the Medicare program. These
conditions of participation vary depending on the type of agency
or facility, but in general require our agencies and facilities
to meet specified standards relating to personnel, patient
rights, patient care, patient records, administrative reporting
and legal compliance. If an agency or facility fails to meet any
of the Medicare conditions of participation, that agency or
facility may receive a notice of deficiency from the applicable
state surveyor. If that agency or facility then fails to
institute and comply with a plan of correction to correct the
deficiency within the time period provided by the state
surveyor, that agency or facility could be terminated from the
Medicare program. We respond in the ordinary course to
deficiency notices issued by state surveyors, and none of our
facilities or agencies have ever been terminated from the
Medicare program for failure to comply with the conditions of
participation. Any termination of one or more of our agencies or
facilities from the Medicare program for failure to satisfy the
Medicare conditions of participation would affect adversely our
net service revenue and net income.
In addition, if our long-term acute care hospitals fail to meet
or maintain the standards for Medicare certification as
long-term acute care hospitals, such as for average minimum
length of patient stay, they will receive reimbursement under
the prospective payment system applicable to general acute care
hospitals rather than the system applicable to long-term acute
care hospitals. Payments at rates applicable to general acute
care hospitals would likely result in our long-term acute care
hospitals receiving less Medicare reimbursement than they
currently receive for their patient services. Moreover, all of
our long-term acute care hospitals are subject to additional
Medicare criteria because they operate as separate hospitals
located in space leased from, and located in, a general acute
care hospital, known as a host hospital. This is known as a
hospital within a hospital model. These additional
criteria include requirements concerning financial and
operational separateness from the host hospital. If several of
our long-term acute care hospitals were subject to payment as
general acute care hospitals or fail to comply with the
separateness requirements, our net service revenue and net
income would decline.
S-10
CMS has
adopted regulations that could materially and adversely impact
the revenue and net income of our long-term acute care
hospitals.
In August 2004, CMS adopted regulations that implement
significant changes affecting our long-term acute care
hospitals. Among other things, these new regulations, effective
for hospital cost reporting periods beginning on or after
October 2004, mandate that long-term acute care hospitals
operating in the hospital within a hospital model receive lower
rates of reimbursement for Medicare admissions from their host
hospitals that are in excess of specified percentages. For new
long-term acute care hospitals opened after October 1, 2004
located within hospitals, the Medicare admissions limitation
will be 25.0% for hospitals located in a metropolitan
statistical area, or MSA, and 50.0% for hospitals located in a
non-MSA. This means a new long-term acute care hospital located
within a hospital will receive lower rates of reimbursement for
patients admitted from their host hospitals in excess of 25.0%,
or 50.0% if located in a non-MSA.
For existing long-term acute care hospitals within hospitals and
those under development that meet specified criteria, the
Medicare admissions limitations are being phased in over a
four-year period starting with hospital cost reporting periods
beginning on or after October 1, 2004 and also provide for
different percentages of allowable admissions based on whether
the facilities are located in MSAs or non-MSAs. Further, for
cost reporting periods beginning prior to October 1, 2007,
the Medicare admissions limitation for each existing long-term
acute care hospital is the lesser of the percentage of Medicare
discharges admitted from its host hospital during its 2004 cost
reporting period or the amount set forth in the table below.
|
|
|
|
|
|
|
|
|
|
|
Allowable Admissions
|
|
|
|
From Host Hospital
|
|
|
|
Before Payment
|
|
|
|
Reduction
|
|
Cost Report Period
Beginning
|
|
MSAs
|
|
|
Non-MSAs
|
|
|
Until September 30, 2005
|
|
|
100.0
|
%
|
|
|
100.0
|
%
|
October 1,
2005 September 30, 2006
|
|
|
75.0
|
%
|
|
|
75.0
|
%
|
October 1,
2006 September 30, 2007
|
|
|
50.0
|
%
|
|
|
50.0
|
%
|
October 1,
2007 and thereafter
|
|
|
25.0
|
%
|
|
|
50.0
|
%
|
As of March 31, 2006, of our seven long-term acute care
hospital locations, five are physically located in a non-MSA. Of
these five locations, two are satellite locations of a parent
hospital that is located in a MSA. Based on our discussions with
CMS, we believe this satellite location will be viewed as being
located in a non-MSA regardless of the location of its parent
hospital and will be treated independently from its parent for
purposes of calculating its compliance with the admissions
limitations. For the three months ended March 31, 2006, on
an individual basis, one of our long-term acute care hospital
locations admitted less than 50.0% of its patients from its host
hospital, four of our long-term acute care hospital locations
admitted between 50.0% and 75.0% of their patients from their
host hospitals and one of our long-term acute care hospital
locations admitted more than 75.0% of its patients from its host
hospital. The seventh long-term acute care hospital is not a
hospital within a hospital. For the three months ended
March 31, 2006, three of our long-term acute care hospital
locations admitted a higher percentage of their patients from
their host hospitals than the percentage of Medicare discharges
admitted from their host hospitals in the 2005 cost reporting
year.
Our ability to quantify the potential reduction in our
reimbursement rates resulting from the implementation of these
new regulations is contingent upon a variety of factors, such as
our ability to reduce the percentage of admissions that are
derived from our host hospitals and, if necessary, our ability
to relocate our existing long-term acute care hospitals to
freestanding locations. We may not be able to successfully
restructure or relocate these operations without incurring
significant expense or in a manner that avoids reimbursement
reductions. If these new regulations result in lower
reimbursement rates, our net service revenue and net income
could decline. As a result of these new rules, we do not intend
to expand the number of hospital within a hospital long-term
acute care hospitals that we operate.
We are reimbursed by Medicare for services we provide in our
long-term acute care hospitals based on the long-term care
diagnosis-related group assigned to each patient. CMS
establishes these long-term care
S-11
diagnosis-related groups by grouping diseases by diagnosis,
which group reflects the amount of resources needed to treat a
given disease. These new rules reclassify certain long-term care
diagnosis-related groups, which could result in a decrease in
reimbursement rates. Further, the new rules kept in place the
financial penalties associated with the failure to limit the
total number of Medicare patients discharged to a host hospital
and subsequently readmitted to a long-term acute care hospital
located within the host hospital to no greater than 5.0%. If we
fail to comply with these readmission rates or if our
reimbursement rates decline due to the reclassification of
certain long-term care diagnosis-related groups, our net service
revenue and net income could decline.
Legislative
initiatives could negatively impact our operations and financial
results.
In recent years, an increasing number of legislative initiatives
have been introduced or proposed in Congress and in state
legislatures that would result in major changes in the
healthcare system, either at the national or state level. Many
of these proposals have been introduced in an effort to reduce
costs. For example, the Medicare Modernization Act of 2003, or
MMA, allocated significant additional funds to Medicare managed
care providers in order to promote greater participation in
those plans by Medicare beneficiaries. If these increased
funding levels achieve their intended result, the rate of growth
in the Medicare
fee-for-service
market could decline. For the years ended December 31,
2003, 2004, and 2005 and for the three months ended
March 31, 2006, we received 83.1%, 84.6%, 85.1% and 84.9%,
respectively, of our net service revenue from the Medicare
fee-for-service
market. Among other proposals that have been introduced are
insurance market reforms to increase the availability of group
health insurance to small businesses, requirements that all
businesses offer health insurance coverage to their employees
and the creation of government health insurance or plans that
would cover all citizens and increase payments by beneficiaries.
We cannot predict whether any of the above proposals, or any
other future proposals, will be adopted. If adopted, we could be
forced to expend considerable resources to comply with and
implement such reforms.
More than
70% of our net service revenue is currently generated in
Louisiana, making us particularly sensitive to economic and
other conditions in that state.
Our Louisiana agencies and facilities accounted for
approximately 89.0%. 82.8%. 79.5% and 70.3% of our net service
revenue during the years ended December 31, 2003, 2004 and
2005 and the three months ended March 31, 2006. Any
material change in the current economic or competitive
conditions in Louisiana, which could result from events such as
the implementation of certificate of need regulations or changes
in state tax laws, could have a disproportionate effect on our
overall business results.
Hurricanes
or other adverse weather events could negatively affect our
local economies or disrupt our operations, which could have an
adverse effect on our business or results of
operations.
Our market areas in the southern United States are particularly
susceptible to hurricanes. Such weather events can disrupt our
operations, result in damage to our properties and negatively
affect the local economies in which we operate. In late summer
2005, Hurricane Katrina and Hurricane Rita struck the Gulf Coast
region of the United States and caused extensive and
catastrophic physical damage to those areas. While we believe we
have recovered from the effects of Hurricane Katrina and
Hurricane Rita, future hurricanes could affect our operations or
the economies in those market areas and result in damage to
certain of our facilities and the equipment located at such
facilities, or equipment on rent with customers in those areas.
Our business or results of operations may be adversely affected
by these and other negative effects of future hurricanes.
Future
acquisitions may be unsuccessful and could expose us to
unforeseen liabilities.
Our growth strategy involves the acquisition of home nursing
agencies in rural markets. These acquisitions involve
significant risks and uncertainties, including difficulties
integrating acquired personnel and other corporate cultures into
our business, the potential loss of key employees or patients of
acquired agencies, and the assumption of liabilities and
exposure to unforeseen liabilities of acquired agencies. We may
not be able to fully integrate the operations of the acquired
businesses with our current business structure in an
S-12
efficient and cost-effective manner. The failure to effectively
integrate any of these businesses could have a material adverse
effect on our operations.
We generally structure our acquisitions as asset purchase
transactions in which we expressly state that we are not
assuming any pre-existing liabilities of the seller and obtain
indemnification rights from the previous owners for acts or
omissions arising prior to the date of such acquisitions.
However, the allocation of liability arising from such acts or
omissions between the parties could involve the expenditure of a
significant amount of time, manpower and capital. Further, the
former owners of the agencies and facilities we acquire may not
have the financial resources necessary to satisfy our
indemnification claims relating to pre-existing liabilities. If
we were unsuccessful in a claim for indemnification from a
seller, the liability imposed could materially, adversely affect
our operations.
If we are
unable to maintain relationships with existing referral sources
or establish new referral sources, our growth and net income
could be adversely affected.
Our success depends significantly on referrals from physicians,
hospitals, and other healthcare providers in the communities in
which we deliver our services. Our referral sources are not
obligated to refer business to us and may refer business to
other healthcare providers. We believe many of our referral
sources refer business to us as a result of the quality of
patient service provided by our local employees in the
communities in which our agencies and facilities are located. If
we are unable to retain these employees, our referral sources
may refer business to other healthcare providers. Our loss of,
or failure to maintain, existing relationships or our failure to
develop new relationships could affect adversely our ability to
expand our operations and operate profitably.
Delays in
reimbursement may cause liquidity problems.
Our business is characterized by delays in reimbursement from
the time we request payment for our services to the time we
receive reimbursement or payment. A portion of our estimated
reimbursement (60.0% for an initial episode of care and 50.0%
for subsequent episodes of care) for each Medicare home nursing
episode is billed at the commencement of the episode and we
typically receive payment within approximately 12 days. The
remaining reimbursement is billed upon completion of the episode
and is typically paid within 14-17 days from billing date.
If we have information system problems or issues arise with
Medicare or other payors, we may encounter further delays in our
payment cycle. For example, in the past we have experienced
delays resulting from problems arising out of the implementation
by Medicare of new or modified reimbursement methodologies or as
a result of natural disasters, such as hurricanes. We have also
experienced delays in reimbursement resulting from our
implementation of new information systems related to our
accounts receivable and billing functions. Any future timing
delay may cause working capital shortages. As a result, working
capital management, including prompt and diligent billing and
collection, is an important factor in our consolidated results
of operations and liquidity. Our working capital management
procedures may not successfully negate this risk. Significant
delays in payment or reimbursement could have an adverse impact
on our liquidity and financial condition.
Future
cost containment initiatives undertaken by private third party
payors may limit our future net service revenue and net
income.
Initiatives undertaken by major insurers and managed care
companies to contain healthcare costs may affect our net income.
These payors attempt to control healthcare costs by contracting
with hospitals and other healthcare providers to obtain services
on a discounted basis. We believe that this trend may continue
and may limit reimbursements for healthcare services. If
insurers or managed care companies from whom we receive
substantial payments were to reduce the amounts they pay for
services, our profit margins may decline, or we may lose
patients if we choose not to renew our contracts with these
insurers at lower rates.
S-13
If the
structures or operations of our joint ventures are found to
violate the law, our financial condition and consolidated
results of operations could be materially adversely
impacted.
As of March 31, 2006, we have entered into 35 joint
ventures for the ownership and operation of 42 home nursing
agency locations, two hospices, one outpatient rehabilitation
clinic and six long-term acute care hospital locations. Of these
35 joint ventures, 23 are with hospitals, five are with
physicians and seven are with other parties. Our joint venture
relationships are structured as equity joint ventures,
cooperative endeavors or license leasing arrangements. Our joint
ventures with hospitals and physicians are governed by the
federal anti-kickback statute and similar state laws. These
anti-kickback statutes prohibit the payment or receipt of
anything of value in return for referrals of patients or
services covered by governmental healthcare programs, such as
Medicare. The Office of Inspector General of the Department of
Health and Human Services has published numerous safe harbors
that exempt qualifying arrangements from enforcement under the
federal anti-kickback statute. We have sought to satisfy as many
safe harbor requirements as possible in structuring these joint
ventures. For example, each of our equity joint ventures with
hospitals and physicians is structured in accordance with the
following principles:
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The investment interest offered is not based upon actual or
expected referrals by the hospital or physician.
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Our joint venture partners are not required to make or influence
referrals to the joint venture.
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At the time the joint venture is formed, each hospital or
physician joint venture partner is required to make an actual
capital contribution to the joint venture equal to the fair
market value of its investment interest and is at risk to lose
its investment.
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Neither we nor the joint venture entity lends funds to or
guarantees a loan to acquire interests in the joint venture for
a hospital or physician.
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Distributions to our joint venture partners are based solely on
their equity interests and not affected by referrals from the
hospital or physician.
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Although we have sought to satisfy as many safe harbor
requirements as possible, our joint ventures may not satisfy all
elements of the safe harbor requirements.
Our five joint ventures with physicians are also governed by the
federal Stark Law and similar state laws, which restrict
physicians from making referrals for particular healthcare
services to entities with which the physicians or their families
have a financial relationship. We also believe we have
structured our physician joint ventures in a way that meets
applicable exceptions under the federal Stark Law and similar
state physician referral laws. For example, we believe our two
physician joint ventures for home nursing agencies comply with
the rural provider exception to the Stark Law and that our three
physician joint ventures for long-term acute care hospitals
comply with the whole hospital exception to the Stark Law.
If any of our joint ventures were found to be in violation of
federal or state anti-kickback or physician referral laws, we
could be required to restructure them or refuse to accept
referrals from the physicians or hospitals with which we have
entered into a joint venture. We also could be required to repay
to Medicare amounts we have received pursuant to any prohibited
referrals, and we could suffer civil or criminal penalties,
including the loss of our licenses to operate and our ability to
participate in federal and state healthcare programs. If any of
our joint ventures were subject to any of these penalties, our
business could be damaged. In addition, our growth strategy is,
in part, based on the continued development of new joint
ventures with rural hospitals for the ownership and operation of
home nursing agencies. If the structure of any of these joint
ventures were found to violate federal or state anti-kickback
statutes or physician referral laws, we may be unable to
implement our growth strategy, which could have an adverse
impact on our future net income and consolidated results of
operations.
S-14
If we are
required to either repurchase or sell a substantial portion of
the equity interests in our joint ventures, our capital
resources and financial condition could be materially, adversely
impacted.
Upon the occurrence of fundamental changes to the laws and
regulations applicable to our joint ventures, or if a
substantial number of our joint venture partners were to
exercise the buy/sell provisions contained in many of our joint
venture agreements, we may be obligated to purchase or sell the
equity interests held by us or our joint venture partners. The
purchase price under these buy/sell provisions is typically
based on a multiple of the historical or projected earnings
before income taxes, depreciation and amortization of the joint
venture at the time the buy/sell option is exercised. In the
event the buy/sell provisions are exercised and we lack
sufficient capital to purchase the interest of our joint venture
partners, we may be obligated to sell our equity interest in
these joint ventures. If we are forced to sell our equity
interest, we will lose the benefit of those particular joint
venture operations. If these buy/sell provisions are exercised
and we choose to purchase the interest of our joint venture
partners, we may be obligated to expend significant capital in
order to complete such acquisitions. If either of these events
occur, our net service revenue and net income could decline or
we may not have sufficient capital necessary to implement our
growth strategy.
Shortages
in qualified nurses and other healthcare professionals could
increase our operating costs
significantly or constrain our ability to grow.
We rely on our ability to attract and retain qualified nurses
and other healthcare professionals. The availability of
qualified nurses nationwide has declined in recent years, and
competition for these and other healthcare professionals has
increased. Salary and benefit costs have risen accordingly. Our
ability to attract and retain these nurses and other healthcare
professionals depends on several factors, including our ability
to provide desirable assignments and competitive benefits and
salaries. We may not be able to attract and retain qualified
nurses or other healthcare professionals in the future. In
addition, the cost of attracting and retaining these
professionals and providing them with attractive benefit
packages may be higher than anticipated which could cause our
net income to decline. Moreover, if we are unable to attract and
retain qualified professionals, the quality of services offered
to our patients may decline or our ability to grow may be
constrained.
The loss
of certain senior management could have a material adverse
effect on our operations and
financial performance.
Our success depends upon the continued employment of certain
members of our senior management, including our co-founder,
President, Chief Executive Officer and Chairman, Keith G. Myers;
our Senior Vice President, Chief Financial Officer and
Treasurer, Barry E. Stewart; our Executive Vice President, Chief
Operating Officer, Secretary and Director, John L. Indest; and
our Senior Vice President, Acquisitions and Market Development,
Daryl J. Doise. We have entered into an employment agreement
with each of these officers in an effort to further secure their
employment.
If we are
subject to substantial malpractice or other similar claims, our
net income could be materially, adversely impacted.
The services we offer have an inherent risk of professional
liability and related, substantial damage awards. We and the
nurses and other healthcare professionals who provide services
on our behalf may be the subject of medical malpractice claims.
These nurses and other healthcare professionals could be
considered our agents and, as a result, we could be held liable
for their medical negligence. We cannot predict the effect that
any claims of this nature, regardless of their ultimate outcome,
could have on our business or reputation or on our ability to
attract and retain patients and employees. We maintain
malpractice liability insurance that provides primary coverage
on a claims-made basis of $1.0 million per incident and
$3.0 million in annual aggregate amounts. In addition, we
maintain multiple layers of umbrella coverage in the aggregate
amount of $10.0 million that provide excess coverage for
professional malpractice and other liabilities. We are
responsible for deductibles and amounts in excess of the limits
of our coverage. Claims that could be made in the future in
excess of the limits of such insurance, if successful, could
materially, adversely affect our ability to conduct business or
manage our assets. In addition, our insurance coverage may not
continue to be available to us at commercially reasonable rates,
in adequate amounts or on satisfactory terms.
S-15
The
application of state certificate of need and permit of approval
regulations and compliance with
federal and state licensing requirements could substantially
limit our ability to operate and grow our business.
Our ability to expand operations in a state will depend on our
ability to obtain a state license to operate. States may have a
limit on the number of licenses they issue. For example, as of
March 31, 2006 we operated 45 home nursing agencies in
Louisiana. Louisiana currently has a moratorium on the issuance
of new home nursing agency licenses through July 1, 2008.
We cannot predict whether this moratorium will be extended
beyond this date or whether any other states in which we
currently operate, or may wish to operate in the future, may
adopt a similar moratorium.
In addition to the moratorium imposed by the state of Louisiana,
ten of the states in which we currently operate, or plan to
operate in the future, require healthcare providers to obtain
prior approval, known as a certificate of need or a permit of
approval, for the purchase, construction or expansion of
healthcare facilities, to make certain capital expenditures or
to make changes in services or bed capacity. Of the states in
which we currently operate, or intend to operate in the future,
Alabama, Arkansas, Georgia, Kentucky, Mississippi, North
Carolina, South Carolina, Tennessee, Virginia and West Virginia
have certificate of need or permit of approval laws. In granting
approval, these states consider the need in the service area for
additional or expanded healthcare facilities or services. The
failure to obtain any requested certificate of need, permit of
approval or other license could impair our ability to operate or
expand our business.
We face
competition, including from competitors with greater resources,
which may make it difficult for us to compete effectively as a
provider of post-acute healthcare services.
We compete with local and regional home nursing and hospice
companies, hospitals, and other businesses that provide
post-acute healthcare services, some of which are large
established companies that have significantly greater resources
than we do. Our primary competition comes from local operators
in each of our markets. We expect our competitors to develop
joint ventures with providers, referral sources, and payors,
which could result in increased competition. The introduction by
our competitors of new and enhanced service offerings, in
combination with industry consolidation and the development of
competitive joint ventures, could cause a decline in net service
revenue, loss of market acceptance of our services, or make our
services less attractive. Future increases in competition from
existing competitors or new entrants may limit our ability to
maintain or increase our market share. We may not be able to
compete successfully against current or future competitors, and
competitive pressures may have a material, adverse impact on our
business, financial condition, or consolidated results of
operations.
If we are
unable to protect the proprietary nature of our software systems
and methodologies,
our business and financial condition could be harmed.
We have developed a proprietary software system, which we refer
to as our Service Value Point system that allows us to collect
assessment data, establish treatment plans, monitor patient
treatment, and evaluate our clinical and financial performance.
In addition, we rely on other proprietary methodologies or
information to which others may obtain access or independently
develop. To protect our proprietary information, we require
certain employees, consultants, financial advisors and strategic
partners to enter into confidentiality and non-disclosure
agreements. These agreements may not ultimately provide
meaningful protection for our proprietary information in the
event of any unauthorized use, misappropriation or disclosure.
If our competitors were able to replicate our Service Value
Point system, it could allow them to improve their operations
and thereby compete more effectively in the markets in which we
provide our services. If we are unable to protect the
proprietary nature of our Service Value Point system or our
other proprietary information or methodologies, our business and
financial performance could be harmed.
S-16
Failure
of, or problems with, our critical software or information
systems could harm our business and operating results.
In addition to our Service Value Point system, we also depend on
other non-proprietary third-party accounting and billing
software systems. Problems with, or the failure of, these
systems could negatively impact our clinical performance and our
management and reporting capabilities. Any such problems or
failure could materially and adversely affect our operations and
reputation, result in significant costs to us, cause delays in
our ability to bill Medicare or other payors for our services,
or impair our ability to provide our services in the future. The
costs incurred in correcting any errors or problems with regard
to our proprietary and non-proprietary software may be
substantial and could adversely affect our net income.
Our information systems are networked via public network
infrastructure and standards based encryption tools that meet
regulatory requirements for transmission of protected healthcare
information over such networks. However, threats from computer
viruses, instability of the public network on which our data
transit relies, or other instances that might render those
networks unstable or disabled would create operational
difficulties for us, including the ability to effectively
transmit claims and maintain efficient clinical oversight of our
patients as well as the disruption of revenue reporting and
billing and collections management, which could adversely affect
our business or operations.
Our
acquisition and internal development activity may impose strains
on our existing resources.
We have grown significantly over the past four years. As we
continue to expand our markets, our growth could strain our
resources, including management, information and accounting
systems, regulatory compliance, logistics, and other internal
controls. Our resources may not keep pace with our anticipated
growth. If we do not manage our expected growth effectively, our
future prospects could be affected adversely.
We may
face increased competition for attractive acquisition and joint
venture candidates.
We intend to continue growing through the acquisition of
additional home nursing agencies and the formation of joint
ventures with rural hospitals for the operation of home nursing
agencies. We face competition for acquisition and joint venture
candidates, which may limit the number of acquisition and joint
venture opportunities available to us or lead to the payment of
higher prices for our acquisitions and joint ventures. Recently,
we have observed an increase in the acquisition prices for
select home nursing agencies. We cannot assure you that we will
be able to identify suitable acquisition or joint venture
opportunities in the future or that any such opportunities, if
identified, will be consummated on favorable terms, if at all.
Without successful acquisitions or joint ventures, our future
growth rate could decline. In addition, we cannot assure you
that any future acquisitions or joint ventures, if consummated,
will result in further growth.
We may be
unable to secure the additional capital necessary to implement
our growth strategy.
As of March 31, 2006, we had cash of $18.1 million.
Based on our current plan of operations, including acquisitions,
we believe this amount, when combined with the proceeds from
this offering and a revolving line of credit of approximately
$22.5 million available under our senior secured credit
facility, which, subject to certain conditions, may be increased
to $25.0 million, will be sufficient to fund our growth
strategy and to meet our currently anticipated operating
expenses, capital expenditures and debt service obligations for
at least the next 12 months. If our future net service
revenue or cash flow from operations is less than we currently
anticipate, we may not have sufficient funds to implement our
growth strategy. Further, we cannot readily predict the timing,
size, and success of our acquisition and internal development
efforts and the associated capital commitments. If we do not
have sufficient cash resources, our growth could be limited
unless we are able to obtain additional equity or debt financing.
We are a
holding company with no operations of our own.
We are a holding company with no operations of our own.
Accordingly, our ability to service our debt and pay dividends,
if any, is dependent upon the earnings from the business
conducted by our subsidiaries. The distributions of those
earnings or advances or other distributions of funds by these
subsidiaries to us are
S-17
contingent upon the subsidiaries earnings and are subject
to various business considerations. In addition, distributions
by subsidiaries could be subject to statutory restrictions,
including state laws requiring that the subsidiary be solvent,
or contractual restrictions. If our subsidiaries are unable to
make sufficient distributions or advances to us, we may not have
the cash resources necessary to service our debt or pay
dividends.
Our
executive officers and directors and their affiliates hold a
substantial portion of our stock and could exercise significant
influence over matters requiring stockholder approval,
regardless of the wishes of other stockholders.
Our executive officers and directors, and individuals or
entities affiliated with them, currently beneficially own an
aggregate of approximately 31.4% of our outstanding common stock
and will beneficially own an aggregate of approximately 23.0% of
our outstanding common stock immediately following this offering
(or 22.1% if the underwriters exercise their over-allotment
option in full). The interests of these stockholders may differ
from your interests. If they were to act together, these
stockholders would be able to significantly influence all
matters that our stockholders vote upon, including the election
of directors, business combinations, the amendment of our
certificate of incorporation and other significant corporate
actions.
Certain
provisions of our charter, bylaws and Delaware law may delay or
prevent a change in control of our company.
Delaware law and our corporate documents contain provisions that
may enable our board of directors to resist a change in control
of our company. These provisions include:
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a staggered board of directors;
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limitations on persons authorized to call a special meeting of
stockholders;
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the authorization of undesignated preferred stock, the terms of
which may be established and shares of which may be issued
without stockholder approval; and
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advance notice procedures required for stockholders to nominate
candidates for election as directors or to bring matters before
an annual meeting of stockholders.
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These anti-takeover defenses could discourage, delay or prevent
a transaction involving a change in control of our company.
These provisions could also discourage proxy contests and make
it more difficult for you and other stockholders to elect
directors of your choosing or cause us to take other corporate
actions you desire.
Our stock
price may be volatile and your investment in our common stock
could suffer a decline in value.
The price at which our common stock trades may be volatile. The
stock market has from time to time experienced significant price
and volume fluctuations that have affected the market prices of
securities, particularly securities of healthcare companies. The
market price of our common stock may be influenced by many
factors, including:
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our operating and financial performance;
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variances in our quarterly financial results compared to
research analyst expectations;
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the depth and liquidity of the market for our common stock;
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future sales of our common stock or the perception that sales
could occur;
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investor perception of our business, acquisitions and our
prospects;
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developments relating to litigation or governmental
investigations;
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S-18
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changes or proposed changes in healthcare laws or regulations or
enforcement of these laws and regulations, or announcements
relating to these matters; or
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general economic and stock market conditions.
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In addition, the stock market, and the Nasdaq Global Market, or
Nasdaq, in particular, has experienced price and volume
fluctuations that have often been unrelated or disproportionate
to the operating performance of healthcare provider companies.
These broad market and industry factors may materially reduce
the market price of our common stock, regardless of our
operating performance. In the past, securities
class-action
litigation has often been brought against companies following
periods of volatility in the market price of their respective
securities. We may become involved in this type of litigation in
the future. Litigation of this type is often expensive to defend
and may divert the attention of our senior management as well as
resources from the operation of our business.
Our
senior management has broad discretion to spend a large portion
of the net proceeds from this offering and may do so in ways
with which you do not agree.
The net proceeds to us from this offering will be approximately
$17.8 million, after deducting underwriting discounts and
commissions and estimated offering expenses. We have not
determined specific uses for a large portion of these net
proceeds. Our board of directors and senior management will have
broad discretion over the use and investment of the net proceeds
of this offering and they may apply these proceeds to uses that
you may not consider desirable. The failure of management to
apply these funds effectively could harm our business.
We
currently do not intend to pay dividends on our common stock
and, consequently, your only opportunity to achieve a return on
your investment is if the price of our common stock
appreciates.
We do not plan to declare dividends on shares of our common
stock in the foreseeable future. Further, our senior secured
credit facility imposes limits on our ability to pay dividends.
Consequently, your only opportunity to achieve a return on your
investment in our common stock will be if the market price of
our common stock appreciates and you sell your shares at a
profit. There is no guarantee that the price of our common stock
will ever exceed the price that you pay.
We incur
costs as a result of being a public company.
As a public company, we incur significant legal, accounting and
other expenses associated with our public company reporting
requirements and corporate governance requirements, including
requirements under the Sarbanes-Oxley Act of 2002, or
Sarbanes-Oxley, and the rules of the Securities and Exchange
Commission, or the Commission, and Nasdaq. These requirements
result in increased legal and financial compliance costs and
make some activities more time-consuming and costly. For
example, we expect to incur significant costs in connection with
the assessment of our internal controls. These rules and
regulations also make it more expensive for us to obtain
director and officer liability insurance. We consistently
evaluate and monitor developments with respect to these rules
and regulations, and we cannot predict or estimate the amount of
additional costs we may incur or the timing of such costs.
If we
identify deficiencies in our internal control over financial
reporting, our business and our stock price could be adversely
affected.
In connection with the 2005 audit of our financial statements
and managements required assessment of our disclosure
controls and procedures, Ernst & Young, LLP, our
independent registered public accounting firm, issued a
management letter which noted a material weakness in our
internal control over financial reporting relating to preventing
posting errors within the patient billing system for certain
rebilled accounts. Specifically, that our personnel lacked
sufficient knowledge and experience in our billing and revenue
management software and we did not establish appropriate
controls to detect or correct errors relating to these rebilled
transactions. The correction of these posting errors resulted in
a $900,000 increase to revenue for the year ended
December 31, 2005. The potential effects of these posting
errors on our financial statements issued
S-19
during the interim periods of 2005 were not material. Subsequent
to identifying this material weakness, we initiated the process
of improving our internal controls over rebilled transactions
through the requirement of additional training on our software
for those individuals recording these transactions, the
implementation of strict procedural controls and documentation
requirements over rebilled transactions, and newly established
monitoring, review and approval controls over these
transactions. No other material weaknesses in our internal
control over financial reporting were identified in the
management letter.
Beginning with our annual report for the year ending
December 31, 2006, we will be required to report on the
effectiveness of our internal control over financial reporting
as required by Section 404 of Sarbanes-Oxley. Under
Section 404, we will be required to assess the
effectiveness of our internal control over financial reporting
and report our conclusion in our annual report. Our auditor is
also required to report its conclusion regarding the
effectiveness of our internal control over financial reporting.
The existence of one or more material weaknesses would require
us and our auditor to conclude that our internal control over
financial reporting is not effective. If there are identified
deficiencies in our internal control over financial reporting,
we could be subject to regulatory scrutiny and a loss of public
confidence in our financial reporting, which could have an
adverse effect on our business and our stock price.
S-20
USE OF
PROCEEDS
The net proceeds to us from the sale of 1,000,000 shares of
common stock that we are offering will be approximately
$17.8 million, or approximately $20.5 million if the
underwriters over-allotment option is exercised in full,
after deducting the underwriting discounts and commissions and
our estimated offering expenses. We will not receive any of the
proceeds from the sale of shares of common stock by the selling
stockholders.
We intend to use the net proceeds from this offering to fund
currently contemplated and possible future acquisitions and for
other general corporate purposes, which may include the
repayment of indebtedness.
We have from time to time engaged in, and expect to continue to
pursue, discussions with respect to possible business
acquisitions. In that regard, we expect to use an aggregate of
approximately $15.0 million of the net proceeds of this
offering to fund various costs in connection with the Lifeline
transaction, as described in Prospectus Supplement
Summary Recent Developments. While we
have no present commitments or agreements with respect to any
other business acquisitions, we frequently investigate
acquisitions of companies engaged in businesses that we believe
will complement our existing business.
Our management will have considerable discretion in the
application of the net proceeds of this offering and may spend
the net proceeds in a manner and at times other than as set
forth above. As a result, you will not have the opportunity, as
part of your investment decision, to assess how and when the net
proceeds will be used.
Until we use the net proceeds of this offering for the above
purposes, we intend to invest the funds in short-term,
investment grade, interest-bearing securities. We cannot predict
whether the proceeds invested will yield a favorable return.
S-21
CAPITALIZATION
The following table sets forth our capitalization as of
March 31, 2006, on an actual basis and on an as adjusted
basis to reflect:
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our sale of 1,000,000 shares of common stock in this
offering at the public offering price of $19.25 per
share; and
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our application of the estimated net proceeds of this offering
in the manner described under Use of Proceeds as if
it had occurred on March 31, 2006.
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You should read this table together with the information under
Use of Proceeds and with our consolidated financial
statements and related notes which are incorporated by reference
herein.
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As of
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March 31,
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2006
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Actual
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As Adjusted
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(unaudited)
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(dollars in thousands)
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Cash and cash equivalents
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$
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18,133
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$
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35,923
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Total debt, including current
portion:
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Capital lease obligations
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$
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638
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$
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638
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Long-term debt
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4,077
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4,077
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Total debt
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$
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4,715
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$
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4,715
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Stockholders equity:
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Common stock: $0.01 par
value; 40,000,000 shares authorized, 19,507,887 shares
issued; 16,557,828 shares outstanding;
20,507,887 shares issued as adjusted;
17,557,828 shares outstanding as adjusted
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166
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176
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Treasury stock:
2,950,059 units at cost
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(2,856
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(2,856
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Additional paid-in capital
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58,752
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76,532
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Retained earnings
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27,517
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27,517
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Total stockholders equity
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83,579
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101,369
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Total capitalization
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$
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88,294
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$
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106,084
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S-22
MANAGEMENT
Executive
Officers and Directors
The following table sets forth, as of July 13, 2006,
information about our executive officers and directors.
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Name
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Age
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Position(s)
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Keith G. Myers
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46
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President and Chief Executive
Officer, Chairman of the Board
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John L. Indest
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54
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Executive Vice President, Chief
Operating Officer, Secretary, Director
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Barry E. Stewart
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51
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Senior Vice President, Chief
Financial Officer, Treasurer
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Daryl J. Doise
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48
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Senior Vice President,
Acquisitions and Market Development
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W.J. Billy Tauzin
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63
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Lead Independent Director
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Nancy G. Brinker
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59
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Director
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Ted W. Hoyt
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52
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Director
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George A. Lewis
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69
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Director
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W. Patrick Mulloy, II
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53
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Director
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Ronald T. Nixon
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50
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Director
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Dan S. Wilford
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66
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Director
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Keith G. Myers is our co-founder, and has served as
Chairman of the Board, President and Chief Executive Officer (or
similar positions in our predecessors) since 1994. Prior to
joining us, Mr. Myers founded, co-owned and operated
Louisiana Premium Seafoods, Inc., an international food
processing, procurement and distribution company. Mr. Myers
received credentials in 1999 from the National Association for
Home Care with regard to the home/hospice care sector.
Mr. Myers was named Business Executive of the Year in 1999
by Louisiana Rural Health Association and Entrepreneur of the
Year in the healthcare category by Ernst & Young LLP
with respect to the Texas, Louisiana and Mississippi Region.
John L. Indest currently serves as our Executive Vice
President and Chief Operating Officer. He previously served as
our Senior Vice President and Chief Operating Officer of
Home-Based Services, beginning in May 2001. Mr. Indest has
also served as a director since June 2000 and as Secretary since
August 2004. From November 1998 to May 2001, Mr. Indest
served as our Vice President. Prior to joining us in November
1998, Mr. Indest served as President, Chief Executive
Officer and co-owner of Homebound Care, Inc., a regional home
health provider. Mr. Indest has testified before the United
States House of Representatives Ways and Means
Subcommittee on healthcare issues and currently serves as
co-chairman of the Louisiana Task Force on Ethics, overseeing
compliance issues applicable to home health and hospice in the
state of Louisiana. Mr. Indest is a registered nurse with a
Masters of Science in Health Services Administration from the
University of St. Francis.
Barry E. Stewart currently serves as our Senior Vice
President, Chief Financial Officer and Treasurer. Prior to
joining the Company on June 1, 2006, he previously served
as Chief Financial Officer and Treasurer of Rotech Healthcare,
Inc. From 2001 to 2004, Mr. Stewart served as Chief
Financial Officer of Evolved Digital Systems, Inc., a healthcare
technology solutions company, and from 1996 to 2001 he served as
Vice President of Finance of Community Health Systems, Inc., a
provider of general hospital healthcare services. Prior to 1996,
Mr. Stewart served in various managing director positions
with national commercial banks. Mr. Stewart currently
serves as a director and the chairman of the audit committee of
the Board of Directors for FloTek Industries, Inc., a publicly
traded company engaged in oilfield solutions headquartered in
Houston, Texas. Mr. Stewart is a licensed Certified Public
Accountant.
Daryl J. Doise serves as our Senior Vice President of
Acquisitions and Market Development. He previously served as our
Chief Operating Officer of Facility-Based Services, beginning
May 2002. Prior to joining LHC Group, Mr. Doise was
employed for the previous four years by Quorum Health Services
where
S-23
he served as President and Chief Executive Officer of Opelousas
General Hospital, a 200-bed hospital with over 800 employees.
Mr. Doise has also served as an officer and member of the
board of directors of the Louisiana Hospital Association.
Mr. Doise received a Bachelor of Science degree from
Louisiana State University, with a major in accounting, and
earned a Masters of Business Administration from Tulane
University.
Congressman W.J. Billy Tauzin was appointed
as our lead independent director in January 2005. In December
2004, Congressman Tauzin was named President and Chief Executive
Officer of the Pharmaceutical Research and Manufacturers of
America, a trade group that serves as one of the pharmaceutical
industrys top lobbying groups. He served 12 terms in the
U.S. House of Representatives, representing
Louisianas 3rd Congressional District since being
first sworn in 1980. From January 2001 through December 2004,
Congressman Tauzin served as Chairman of the House Committee on
Energy and Commerce. He also served as a senior member of the
House Resources Committee and Deputy Majority Whip. Prior to
being a member of Congress, Congressman Tauzin was a member of
the Louisiana State Legislature, where he served as Chairman of
the House Natural Resources Committee and Chief Administration
Floor Leader. Congressman Tauzin received a Bachelor of Arts
Degree from Nicholls State University in 1964 and a Juris
Doctorate from Louisiana State University.
Nancy Goodman Brinker was appointed as a director in June
2006. In 2001, she was appointed by President Bush to serve as
U.S. Ambassador to the Republic of Hungary, a title she held
until 2003. Ambassador Brinker is also the founder of the Susan
G. Komen Breast Cancer Foundation, established in 1982 and named
after her sister, Susan, who died from the disease. Prior to her
appointment as Ambassador, Ms. Brinker served on the boards
of Manpower, Inc., US Oncology, Inc., United Rentals, Inc., and
the Meditrust Corporation. Ambassador Brinker has served on
government panels under three U.S. presidents, including as a
member of President Reagans National Cancer Advisory
Board, President George H.W. Bushs Cancer Panel and as
chairperson of a federal subcommittee monitoring research,
progress and development in the fight against breast cancer.
Currently, Ambassador Brinker is a member of the board of
directors of the Susan G. Komen Breast Cancer Foundation, the
Bush-Clinton Katrina Fund, and FasterCures, an action
think tank dedicated to removing barriers to the discovery
and development of medical solutions. Ambassador Brinker is also
the recipient of numerous national awards, including the
Champions of Excellence Award presented by the Centers for
Disease Control, the Healthcare Humanitarian Award presented by
the Global Conference Institute, and the James Ewing Layman
Award from the Society of Surgical Oncology, among many others.
Ambassador Brinker received a Bachelor of Arts degree in Liberal
Arts from the University of Illinois in 1968.
Ted W. Hoyt has served as a director since August 2004.
Mr. Hoyt has practiced corporate and tax law since 1977,
counseling both private and public corporations. Since January
1999, Mr. Hoyt has served as the Managing General Manager
of the law firm of Hoyt & Stanford, LLC. Mr. Hoyt
was the co-founder of Omni Geophysical Corporation, which later
became Omni Energy Services, a publicly traded company, for
which he served as a director and officer from 1986 to 1996.
Mr. Hoyt has also served as a tax attorney with the
National Office of the Internal Revenue Service. Mr. Hoyt
holds a Bachelor of Science degree in Business Administration
degree from the University of Louisiana at Lafayette, a Juris
Doctorate from Louisiana State University and a Masters in Tax
Law degree from Georgetown University. Mr. Hoyt is admitted
to the Bar in Louisiana, New York and the District of Columbia.
George A. Lewis has served as a director since August
2004. Mr. Lewis commenced his auditing career with Arthur
Andersen & Co. in 1958. In 1963, Mr. Lewis joined
the firm of Broussard, Poche, Lewis & Breaux, L.L.P.,
Certified Public Accountants, where he served as an audit
partner until his retirement in 1996. Since 1996, Mr. Lewis
has primarily served as an expert audit and accounting defense
witness with respect to litigation involving various nationally
recognized accounting firms. Mr. Lewis has served on
various committees of the American Institute of Certified Public
Accountants, including as a member of the Auditing Standards
Board from 1990 to 1994, and as a member of the Society of
Louisiana Certified Public Accountants. Mr. Lewis has
authored an education course to train CPAs to deal with issues
of the elderly. Mr. Lewis received a Bachelor of Science
degree from Louisiana State University. Mr. Lewis serves as
the financial expert on our Audit Committee.
S-24
W. Patrick Mulloy, II was appointed as a
director in January 2005. Since November 2005, Mr. Mulloy
has served as President/CEO of SCRE Investments, Inc. a
multi-state provider of skilled nursing, rehabilitation
hospitals, and senior housing services. From September 2001 to
November 2004, Mr. Mulloy served as President and Chief
Executive Officer of LifeTrust America, a privately held senior
housing company which owned and operated assisted living
communities in seven states across the Southeast. In 2004,
LifeTrust merged with Five Star Quality Care, Inc., a publicly
traded senior housing company. From 1996 until 2000,
Mr. Mulloy served as Chief Executive Officer, President and
as a director of Atria, Inc., an operator of assisted and
retirement living facilities. Prior to joining Atria,
Mr. Mulloy was a partner at Greenebaum, Doll and McDonald,
PLLC, a law firm headquartered in Louisville, Kentucky, and,
from 1992 to 1994, he served as the Secretary of Finance to the
Governor of Kentucky. Mr. Mulloy received a Bachelor of
Arts Degree and a Juris Doctorate, each from Vanderbilt
University, where he was a member of the Phi Beta Kappa Society.
Ronald T. Nixon has served as a director since July 2001.
Mr. Nixon is a founding principal of The Catalyst Group,
formed in 1990, which manages two small business investment
companies, or SBICs, one participating preferred SBIC and three
private equity investment funds. Prior to joining The Catalyst
Group, Mr. Nixon operated companies in the manufacturing,
distribution and service sectors. Mr. Nixon serves on the
board of directors of numerous private companies. Mr. Nixon
holds a Bachelor of Science degree in Mechanical Engineering
that he received from the University of Texas at Austin and is a
registered Professional Engineer in the State of Texas.
Dan S. Wilford was appointed a director in November 2005.
He served from 1984 through 2002 as the President and Chief
Executive Officer of Memorial Hermann Healthcare System
headquartered in Houston, Texas. Mr. Wilford also served as
Chief Executive Officer of a community-based,
not-for-profit,
multi-hospital system in the greater Houston area. Prior to
that, he was associated for ten years with Hillcrest Medical
Center in Tulsa, Oklahoma and was President of North Mississippi
Health Services in Tupelo, Mississippi. He currently serves on
the board of directors for two other publicly traded companies,
Healthcare Realty Trust and Sanders Morris Harris Group, and
twelve
not-for-profit
organizations, most of which are related to the healthcare
industry. Mr. Wilford also continues to serve as an advisor
to Memorial Hermann Healthcare System.
S-25
SELLING
STOCKHOLDERS
The following table sets forth information regarding the
beneficial ownership of our common stock, as of July 13,
2006, by each of our stockholders selling shares in this
offering. Except as indicated by footnote, and except for
community property laws where applicable, we believe, based on
information provided to us, that the persons named in the table
below have sole voting and investment power with respect to all
shares of common stock shown as beneficially owned by them.
Beneficial ownership is determined in accordance with the rules
of the Commission. The percentage of beneficial ownership before
the offering is based on 16,657,045 shares of common stock
deemed outstanding as of June 30, 2006, which includes
89,050 shares of unvested restricted common stock.
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Shares Beneficially
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Shares Beneficially
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Shares Beneficially
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Shares to
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Owned After Offering
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Owned
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Shares to
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Owned After
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be Sold in
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with Over-
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Name and Address of
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Prior to Offering
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be Sold in
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Offering
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Over-
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Allotment
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Beneficial
Owner(1):
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Number
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Percent
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Offering
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Number
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Percent
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Allotment
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Number
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Percent
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Keith G.
Myers(2)
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3,890,183
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23.4
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%
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463,251
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3,426,932
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19.4
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%
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81,749
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3,345,183
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18.9
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%
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John L.
Indest(3)
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564,812
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3.4
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%
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233,750
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331,062
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1.9
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%
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41,250
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289,812
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1.6
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%
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Daryl J.
Doise(4)
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59,943
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*
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29,748
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30,195
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*
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5,252
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24,943
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*
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Earline Bihm(5)
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866,889
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5.2
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%
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255,000
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611,889
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3.5
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%
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45,000
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566,889
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3.2
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%
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James
Gravois(6)
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1,119,508
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6.7
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%
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255,000
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864,508
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4.9
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%
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45,000
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819,508
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4.6
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%
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Harold
Taylor(7)
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1,120,245
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6.7
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%
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463,251
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656,994
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3.7
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%
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81,749
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575,245
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3.3
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%
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R. Barr
Brown(8)
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219,723
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1.3
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%
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127,500
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92,223
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*
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22,500
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69,723
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*
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David
Hebert(9)
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380,747
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2.3
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%
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297,500
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83,247
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*
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52,500
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30,747
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*
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Denise
Romano(10)
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335,616
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2.0
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%
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85,000
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250,616
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1.4
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%
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15,000
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235,616
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1.3
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%
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Chris
Thibodeaux(11)
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589,624
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3.5
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%
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340,000
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249,624
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1.4
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%
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60,000
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189,624
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1.1
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%
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The Catalyst Fund,
Ltd.(12)
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320,660
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1.9
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%
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225,000
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95,660
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*
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95,660
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*
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Southwest/Catalyst Capital,
Ltd.(12)
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320,660
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1.9
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%
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225,000
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95,660
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*
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95,660
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*
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* |
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Less than 1% |
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(1) |
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Unless otherwise noted below, the address of each beneficial
owner listed in the table above is c/o LHC Group, Inc.,
420 West Pinhook Rd., Suite A, Lafayette, LA 70503 |
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(2) |
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Includes 360,490 shares held by his wife, Ginger Myers,
3,370,002 shares held by K&G Family, LLC, of which
Mr. Myers is a Manager, and 9,604 shares of unvested
restricted common stock. All shares shown on the table above as
being sold by Mr. Myers in the offering, including those
shares to be sold upon the exercise of the over-allotment
option, are being sold by K&G Family, LLC. |
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(3) |
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Includes 462,102 shares held by Duperier Avenue Investors,
LLC, of which Mr. Indest is a Manager and 8,731 shares
of unvested restricted common stock. Of the 275,000 aggregate
shares shown on the table above as being sold by Mr. Indest
in the offering, including those shares to be sold upon the
exercise of the over-allotment option, 93,979 shares are
being sold by Mr. Indest and 181,021 shares are being
sold by Duperier Avenue Investors, LLC. |
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(4) |
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Includes 6,548 shares of unvested restricted common stock. |
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(5) |
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Includes 866,889 shares held by SKE Management, LLC, of
which Ms. Bihm is a Manager. All shares shown on the table
above as being sold by Ms. Bihm in the offering, including
those shares to be sold upon the exercise of the over-allotment
option, are being sold by SKE Management, LLC. |
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(6) |
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Includes 975,960 shares held by Gravois Investments, LLC,
of which Mr. Gravois is a Manager. All shares shown on the
table above as being sold by Mr. Gravois in the offering,
including those shares to be sold upon the exercise of the
over-allotment option, are being sold by Gravois Investments,
LLC. |
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(7) |
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Includes 490,511 shares held by Silver State Partners, LLC,
and 490,511 shares held by Bayou State Partners, LLC, each
of which Mr. Taylor is a Manager. Of the 545,000 aggregate
shares shown on the table |
S-26
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above as being sold by Mr. Taylor in the offering,
including those shares to be sold upon the exercise of the
over-allotment option, 100,000 shares are being sold by
Mr. Taylor, 222,500 shares are being sold by Silver
State Partners, LLC, and 222,500 shares are being sold by
Bayou State Partners, LLC. |
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(8) |
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The address for Mr. Brown is 530 West Pinhook Rd.,
Lafayette, LA 70503. |
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(9) |
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Includes 240,438 shares held by Stamp Properties, LLC, of
which Mr. Hebert is a Manager. Of the 350,000 aggregate
shares shown on the table above as being sold by Mr. Hebert
in the offering, including those shares to be sold upon the
exercise of the over-allotment option, 140,309 shares are
being sold by Mr. Hebert and 209,691 shares are being
sold by Stamp Properties, LLC. |
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(10) |
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Includes 321,329 shares held by Bayou State Associates,
LLC, of which Ms. Romano is a Manager. All shares shown on
the table above as being sold by Ms. Romano in the
offering, including those shares to be sold upon the exercise of
the over-allotment option, are being sold by Bayou State
Associates, LLC. |
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(11) |
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Includes 524,741 shares held by Thibodeaux Family
Investors, LLC, of which Mr. Thibodeaux is a Manager. All
shares shown on the table above as being sold by
Mr. Thibodeaux in the offering, including those shares to
be sold upon the exercise of the over-allotment option, are
being sold by Thibodeaux Family Investors, LLC. |
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(12) |
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The address for The Catalyst Fund, Ltd. and Southwest/Catalyst
Capital, Ltd. is Two Riverway, Suite 1710, Houston, TX
77056. |
S-27
UNDERWRITING
Subject to the terms and conditions stated in the underwriting
agreement among us, the selling stockholders and the
underwriters, each of the underwriters named below has severally
agreed to purchase, and we and the selling stockholders have
agreed to sell to each named underwriter, the number of shares
of common stock set forth opposite its name in the following
table:
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Number
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Underwriter
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of Shares
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Jefferies & Company,
Inc.
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2,400,000
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CIBC World Markets Corp.
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800,000
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Stifel, Nicolaus &
Company, Incorporated
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800,000
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Total
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4,000,000
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The underwriting agreement provides that the obligation of the
several underwriters to purchase the shares offered by us and
the selling stockholders is subject to some conditions. The
underwriters are obligated to purchase all of the shares offered
by us, other than those covered by the over-allotment option
described below, if any of the shares are purchased. The
underwriting agreement also provides that, in the event of a
default by an underwriter, in some circumstances the purchase
commitments of non-defaulting underwriters may be increased or
the underwriting agreement may be terminated.
The underwriters propose to offer the shares directly to the
public initially at the public offering price set forth on the
cover page of this prospectus supplement and to some dealers at
that price less a concession not in excess of $0.57 per
share. The underwriters may allow, and those dealers may
reallow, a discount not in excess of $0.10 per share to
other dealers. After this offering, the public offering price,
the concession to selected dealers and re-allowance to other
dealers may be changed by the underwriters.
We and certain selling stockholders have granted to the
underwriters an option, exercisable not later than 30 days
after the date of this prospectus supplement, to purchase, in
whole or in part, up to 150,000 and up to 450,000 additional
shares, respectively, at the public offering price less the
underwriting discounts and commissions set forth on the cover of
this prospectus supplement. The underwriters may exercise the
option only to cover over-allotments, if any, made in connection
with the sale of the shares of common stock offered by us and
the selling stockholders. To the extent the options are
exercised, each underwriter will be obligated, subject to some
conditions, to purchase a number of additional shares
approximately proportionate to that underwriters initial
purchase commitment as indicated in the table above.
The following table shows the per share and total underwriting
discounts and commissions to be paid to the underwriters by us
and the selling stockholders. Such amounts are shown assuming
both no exercise and full exercise of the underwriters
option to purchase 600,000 additional shares.
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Paid by the Selling
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Paid by Us
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Stockholders
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Without
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With Full
|
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Without
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With Full
|
|
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Exercise of
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Exercise of
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Exercise of
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Exercise of
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Over-
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Over-
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Over-
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Over-
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|
allotment
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|
allotment
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|
allotment
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|
allotment
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Per share
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$
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0.96
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$
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0.96
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$
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0.96
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$
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0.96
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Total Underwriting Fee
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$
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960,000
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$
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1,104,000
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$
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2,880,000
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$
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3,312,000
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We estimate that the total expenses of this offering that will
be paid by us, excluding the underwriting discounts and
commissions, will be approximately $500,000.
This offering of shares of our common stock is made for delivery
when, as and if accepted by the underwriters and subject to
prior sale and to withdrawal, cancellation or modification of
this offering without notice. The underwriters reserve the right
to reject an order for the purchase of shares in whole or in
part.
S-28
The underwriters and their affiliates have in the past and may
from time to time in the future engage in transactions with us
and perform services for us in the ordinary course of their
business. We have paid and will pay them customary compensation
for these services.
This offering of the shares is made for delivery when, as and if
accepted by the underwriters and subject to prior sale and to
withdrawal, cancellation or modification of this offering
without notice. The underwriters reserve the right to reject an
order for the purchase of shares in whole or in part.
We and the selling stockholders have agreed to indemnify the
underwriters against certain liabilities, including liabilities
under the Securities Act, and to contribute to payments the
underwriters may be required to make in respect of these
liabilities.
We, our executive officers and directors and the selling
stockholders have agreed, for a period of 90 days after the
date of this prospectus supplement, not to offer, sell, contract
to sell, pledge or otherwise dispose of any shares of our common
stock or securities or other rights convertible into or
exchangeable or exercisable for any shares of our common stock
either owned as of the date of this prospectus supplement or
thereafter acquired, subject to limited exceptions, without the
prior written consent of Jefferies & Company, Inc. The
lock-up
period may be extended if (1) during the last 17 days
of the
lock-up
period we issue an earnings release or material news or a
material event relating to us occurs or (2) prior to the
expiration of the
lock-up
period, we announce that we will release earnings results during
the 16-day
period beginning on the last day of the
lock-up
period. The period of such extension will be 18 days,
beginning on the issuance of the earnings release or the
occurrence of the material news or material event.
We have been advised by the underwriters that, in accordance
with Regulation M under the Securities Act, some persons
participating in this offering may engage in transactions,
including syndicate covering transactions, stabilizing bids or
the imposition of penalty bids, that may have the effect of
stabilizing or maintaining the market price of the shares at a
level above that which might otherwise prevail in the open
market.
A syndicate covering transaction is a bid for or the
purchase of shares on behalf of the underwriters to reduce a
syndicate short position incurred by the underwriters in
connection with this offering. The underwriters may create a
syndicate short position by making short sales of our shares and
may purchase our shares in the open market to cover syndicate
short positions created by short sales. Short sales involve the
sale by the underwriter of a greater number of shares than it is
required to purchase in this offering. Short sales can be either
covered or naked. Covered
short sales are sales made in an amount not greater than the
underwriters over-allotment option to purchase additional
shares from us in this offering. Naked short sales
are sales in excess of the over-allotment option. A naked short
position is more likely to be created if the underwriters are
concerned that there may be downward pressure on the price of
the shares in the open market after pricing that could adversely
affect investors who purchase in this offering. If the
underwriters create a syndicate short position, they may choose
to reduce or cover this position by either
exercising all or part of the over-allotment option to purchase
additional shares from us or by engaging in syndicate
covering transactions. The underwriters may close out any
covered short position by either exercising their over-allotment
option or purchasing shares in the open market. The underwriters
must close out any naked short position by purchasing shares in
the open market. In determining the source of shares to close
out the covered short position, the underwriters will consider,
among other things, the price of shares available for purchase
in the open market as compared to the price at which it may
purchase shares through the over-allotment option.
A stabilizing bid is a bid for or the purchase of
shares by the underwriters for the purpose of fixing or
maintaining the price of our common stock. A penalty
bid is an arrangement that permits the underwriters to
reclaim the selling concession from a selling group member when
shares sold by such member are purchased by the representative
in a syndicate covering transaction and, therefore, have not
been effectively placed by such member.
We have been advised by the underwriters that these transactions
may be effected on Nasdaq or otherwise and, if commenced, may be
discontinued at any time. Similar to other purchase activities,
these activities may have the effect of raising or maintaining
the market price of our common stock or preventing or
S-29
retarding a decline in the market price of our common stock. As
a result, the price of our common stock may be higher than the
price that might otherwise exist in the open market.
A prospectus supplement in electronic format may be available on
sites maintained on the Internet or through other online
services maintained by the underwriters or selling group members
participating in this offering, or by their affiliates. In those
cases, prospective investors may view offering terms online and,
depending on the particular underwriter or selling group member,
prospective investors may be allowed to place orders online. In
addition, the underwriters participating in this offering may
distribute prospectus supplements electronically. Other than the
prospectus supplement in electronic format, the information on
these websites is not a part of this prospectus supplement, the
prospectus or the registration statement of which this
prospectus supplement forms a part, has not been approved or
endorsed by us or any underwriter in its capacity as
underwriter, and should not be relied upon by investors.
Our shares of common stock are traded on Nasdaq under the symbol
LHCG. Any common stock sold pursuant to this
prospectus supplement will be listed on Nasdaq, subject to
official notice of issuance.
LEGAL
MATTERS
The validity of the shares of common stock offered hereby will
be passed upon by Alston & Bird LLP, Atlanta, Georgia.
Morrison & Foerster LLP, New York, New York, will pass
upon certain matters in connection with this offering on behalf
of the underwriters.
EXPERTS
The consolidated financial statements of LHC Group, Inc.
appearing in LHC Group, Inc.s Annual Report on
Form 10-K
for the year ended December 31, 2005 have been audited by
Ernst & Young LLP, independent registered public
accounting firm, as set forth in their report thereon, included
therein, and incorporated herein by reference. Such consolidated
financial statements are incorporated herein by reference in
reliance upon such report given on the authority of such firm as
experts in accounting and auditing.
WHERE YOU
CAN FIND MORE INFORMATION
We file annual, quarterly and special reports, proxy statements
and other information with the Commission. You may read and copy
any document we file at the Commissions public reference
room located at 100 F Street, N.E., Washington, D.C. 20549.
Please call the Commission at
1-800-SEC-0330
for further information on the public reference room. Our
filings are also available to the public at the
Commissions website at http://www.sec.gov. You may also
inspect copies of these materials and other information about us
at the offices of the Nasdaq Stock Market, Inc., 1735 K Street,
N.W., Washington, D.C.
20006-1500.
INFORMATION
INCORPORATED BY REFERENCE
The Commission allows us to incorporate by reference
in this prospectus supplement the information in other documents
that we file with it, which means that we can disclose important
information to you by referring you to those documents. The
information incorporated by reference is considered to be part
of this prospectus supplement, and later information that we
file will automatically update and supersede information
contained in documents filed earlier with the Commission or
contained in this prospectus supplement or the accompanying
prospectus. We incorporate by reference the documents listed
below and any future filings made with the Commission under
Sections 13(a), 13(c), 14, or 15(d) of the Securities
Exchange Act of 1934, between the date of this prospectus
supplement and the termination of the offering and also between
the date of the initial registration statement and prior to its
effectiveness:
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our Annual Report on
Form 10-K
for the year ended December 31, 2005, filed on
March 31, 2006.
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our Quarterly Report on
Form 10-Q
for the quarter ended March 31, 2006, filed on May 15,
2006.
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our Proxy Statement for the annual meeting of stockholders held
on June 13, 2006, filed on April 28, 2006.
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our Current Reports on
Form 8-K
filed on January 4, 2006, January 23, 2006,
February 23, 2006, March 16, 2006, March 31,
2006, May 5, 2006, May 9, 2006, May 23, 2006,
June 7, 2006, June 16, 2006, and June 23, 2006.
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the description of the shares of common stock contained in the
Registration Statement on
Form 8-A
filed on June 6, 2005 (File no.
000-51343).
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This prospectus supplement is part of a registration statement
on
Form S-3
we have filed with the Commission under the Securities Act. This
prospectus supplement does not contain all of the information in
the registration statement. We have omitted certain parts of the
registration statement or the exhibits and schedules thereto, as
permitted by the rules and regulations of the Commission. You
may inspect and copy the registration statement, including
exhibits, at the Commissions public reference room or
website. Our statements in this prospectus supplement about the
contents of any contract or other document are summaries of
their terms and are not necessarily complete. You should refer
to the copy of each contract or other document we have filed as
an exhibit to the registration statement for complete
information.
We will furnish without charge to you, upon written or oral
request, a copy of any or all of the documents incorporated by
reference, including the exhibits or schedules to these
documents. You should direct any such requests to LHC
Groups secretary at LHC Group, Inc., 420 West Pinhook
Road, Suite A, Lafayette, Louisiana 70503 or by telephone
at
(337) 233-1307.
S-31
PROSPECTUS
$50,000,000
Common Stock
Preferred Stock
4,000,000 Shares
Common Stock
LHC Group, Inc. may from time to time offer up to an aggregate
of $50,000,000 in shares of common stock or preferred stock.
Our common stock is traded on the Nasdaq National Market under
the symbol LHCG. On June 8, 2006, the last
reported sale price for our common stock on the Nasdaq National
Market was $19.92 per share. We will apply to list any
shares of common stock sold under this prospectus and any
prospectus supplement on the Nasdaq National Market. We have not
determined whether we will list any series of preferred stock we
may offer on any exchange or
over-the-counter
market. If we decide to seek listing of any series of preferred
stock, a prospectus supplement will disclose the exchange or
market.
Some of our stockholders may sell up to 4,000,000 shares of
our common stock under this prospectus and any prospectus
supplement. In the prospectus supplement relating to sales by
selling stockholders, we will identify each selling stockholder
and the number of shares of our common stock that each selling
stockholder will be selling.
When we offer securities, we will provide specific terms of such
securities in supplements to this prospectus. The securities
offered by this prospectus and any prospectus supplement may be
offered directly by us to investors, through agents designated
from time to time or through underwriters or dealers. For
additional information on the methods of sale, you should refer
to the section entitled Plan of Distribution. If any
underwriters are involved in the sale of any securities offered
by this prospectus and any prospectus supplement, their names,
and any applicable purchase price, fee, commission or discount
arrangement between or among them, will be set forth, or will be
calculable from the information set forth, in the applicable
prospectus supplement. The net proceeds we expect to receive
from such sale will also be set forth in a prospectus supplement.
You should read this prospectus and any prospectus supplement
carefully before you invest in any of our securities.
Investing in our securities involves risks. Risks associated
with an investment in our securities will be described in the
applicable prospectus supplement and certain of our filings with
the Securities and Exchange Commission, as described under the
section entitled Risk Factors on page 1.
Neither the Securities and Exchange Commission, any state
securities commission, nor any other regulatory body has
approved or disapproved of these securities or determined if
this prospectus is truthful or complete. Any representation to
the contrary is a criminal offense.
The date of this prospectus is June 14, 2006.
TABLE OF
CONTENTS
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ABOUT
THIS PROSPECTUS
This prospectus is a part of a registration statement that we
filed with the Securities and Exchange Commission, or the
Commission, utilizing a shelf registration process.
Under this shelf registration process, we may sell any
combination of the securities described in this prospectus in
one or more offerings up to a total dollar amount of
$50,000,000. In addition, some of our stockholders may sell up
to 4,000,000 shares of our common stock under our shelf
registration statement. This prospectus provides you with a
general description of the securities we or any selling
stockholder may offer. Each time we or any selling stockholders
sell securities under this shelf registration, we will provide a
prospectus supplement that will contain specific information
about the terms of that offering. The prospectus supplement may
also add, update or change information contained in this
prospectus. You should read both this prospectus and any
prospectus supplement together with additional information
described under the heading Where You Can Find More
Information.
We have not authorized any dealer, salesman or other person to
give any information or to make any representation other than
those contained or incorporated by reference in this prospectus
and the accompanying supplement to this prospectus. You must not
rely upon any information or representation not contained or
incorporated by reference in this prospectus or the accompanying
prospectus supplement. This prospectus and the accompanying
supplement to this prospectus do not constitute an offer to sell
or the solicitation of an offer to buy any securities other than
the registered securities to which they relate, nor do this
prospectus and the accompanying supplement to this prospectus
constitute an offer to sell or the solicitation of an offer to
buy securities in any jurisdiction to any person to whom it is
unlawful to make such offer or solicitation in such
jurisdiction. You should not assume that the information
contained in this prospectus and the accompanying prospectus
supplement is accurate on any date subsequent to the date set
forth on the front of the document or that any information we
have incorporated by reference is correct on any date subsequent
to the date of the document incorporated by reference, even
though this prospectus and any accompanying prospectus
supplement is delivered or securities are sold on a later date.
Unless the context otherwise requires or as otherwise expressly
stated, references in this prospectus to LHC Group,
we, us, our, and similar
terms refer to LHC Group, Inc. and our consolidated subsidiaries.
ABOUT LHC
GROUP
We provide post-acute healthcare services primarily to Medicare
beneficiaries in rural markets in the southern United States. We
provide home-based services, primarily through home nursing
agencies and hospices, and facility-based services, primarily
through long-term acute care hospitals and outpatient
rehabilitation clinics. Through our wholly and majority-owned
subsidiaries, equity joint ventures, and controlled affiliates,
we currently operate in Louisiana, Mississippi, Arkansas,
Alabama, Texas, and West Virginia. As of March 31, 2006, we
owned and operated 80 home nursing locations, of which 77 were
Medicare-certified, and four Medicare-certified hospices. Of
these 84 home-based services locations, 40 are wholly-owned by
us and 44 are majority-owned or controlled by us through joint
ventures. We also manage the operations of three home nursing
agencies and one hospice in which we have no ownership interest.
With respect to our facility-based services operations, as of
March 31, 2006, we owned and operated four long-term acute
hospitals with a total of seven locations, all located within
host hospitals. We also owned and operated four outpatient
rehabilitation clinics and provided contract rehabilitation
services to third parties. Of these 11 facility-based services
locations, four are wholly-owned by us and seven are
majority-owned or controlled by us through joint ventures. We
also manage the operations of one inpatient rehabilitation
facility in which we have no ownership interest.
Our founders began operations in September 1994 as
St. Landry Home Health, Inc. in Palmetto, Louisiana. After
several years of expansion, in June 2000, our founders
reorganized their business and began operating as Louisiana
Healthcare Group, Inc. In March 2001, Louisiana Healthcare
Group, Inc. reorganized and became a wholly owned subsidiary of
The Healthcare Group, Inc., also a Louisiana business
corporation. Effective December 2002, The Healthcare Group, Inc.
merged into LHC Group, LLC, a Louisiana limited liability
company, with LHC Group, LLC being the surviving entity. In
January 2005, LHC Group, LLC established a wholly owned Delaware
subsidiary, LHC Group, Inc. Effective February 9, 2005, LHC
Group, LLC merged into LHC Group, Inc.
LHC Group is a Delaware corporation. Our principal executive
offices are located at 420 West Pinhook Road, Suite A,
Lafayette, Louisiana, 70503. Our telephone number is
(337) 233-1307
and our website address is www.lhcgroup.com. Information
contained on our website is not a part of this prospectus.
RISK
FACTORS
You should carefully consider the specific risks set forth under
the caption Risk Factors in the applicable
prospectus supplement and under the caption Risk
Factors in any of our filings with the Commission pursuant
to Sections 13(a), 13(c), 14, or 15(d) of the
Securities Exchange Act of 1934, or the Exchange Act,
incorporated by reference herein, including, without limitation,
our
Form 10-Q
for the quarter ended March 31, 2006, before making an
investment decision. For more information see Where You
Can Find More Information.
FORWARD-LOOKING
STATEMENTS
This prospectus and the documents incorporated by reference into
this prospectus contain forward-looking statements that are
based on current expectations, estimates and projections about
our industry, managements beliefs, and assumptions made by
management. Words such as anticipates,
expects, intends, plans,
believes, seeks, estimates,
and variations of such words and similar expressions are
intended to identify such forward-looking statements. These
statements are not guarantees of future performance and are
subject to certain risks, uncertainties and assumptions that are
difficult to predict; therefore, actual results may differ
materially from those expressed or forecasted in any
forward-looking statements. The risks and uncertainties include
those noted in Risk Factors above and in the
documents incorporated by reference. Except as required by law,
we undertake no obligation to update publicly any
forward-looking statements, whether as a result of new
information, future events or otherwise.
1
RATIO OF
EARNINGS TO COMBINED FIXED CHARGES
AND PREFERRED STOCK DIVIDENDS
Our ratio of earnings to combined fixed charges and preferred
stock dividends for each of the five fiscal years ended
December 31, 2001, 2002, 2003, 2004 and 2005 and for the
three months ended March 31, 2006 are set forth below. The
information set forth below should be read in conjunction with
the financial information incorporated by reference herein.
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Year Ended
December 31,
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Three Months Ended
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2001
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2002
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2003
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2004
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2005
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March 31, 2006
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Ratio of earnings to combined
fixed charges and preferred stock dividends
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9.6
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8.0
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7.9
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16.7
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19.7
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76.8
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USE OF
PROCEEDS
We will use the net proceeds from our sale of the securities for
our general corporate purposes, which may include repaying
indebtedness, increasing our working capital, funding future
acquisitions or for any other purpose we describe in the
applicable prospectus supplement. We will not receive any of the
proceeds from the sale of common stock that may be sold by
selling stockholders.
SELLING
STOCKHOLDERS
The selling stockholders may be our directors, executive
officers, former directors, employees, former employees or other
holders of our common stock. The shares of common stock to be
sold by the selling stockholders were originally acquired in one
of the following transactions:
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as founders shares in connection with our formation;
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through private offerings prior to our initial public
offering; or
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through the conversion of joint venture equity interests or key
employee equity participation units in connection with our
initial public offering.
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The prospectus supplement for any offering of the common stock
by selling stockholders will include the following information:
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the names of the selling stockholders;
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the nature of any position, office or other material
relationship which each selling stockholder has had within the
last three years with us or any of our predecessors or
affiliates;
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the number of shares held by each of the selling stockholders
before and after the offering;
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the percentage of the common stock held by each of the selling
stockholders before and after the offering; and
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the number of shares of our common stock offered by each of the
selling stockholders.
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2
DESCRIPTION
OF OUR CAPITAL STOCK
The following description of our capital stock is only a
summary. Because it is only a summary, it does not contain all
the information that may be important to you. For a complete
description, we encourage you to read our certificate of
incorporation and bylaws, copies of which are on file with the
Commission as exhibits to registration statements previously
filed by us, as well as the relevant portions of the Delaware
General Corporation Law. See Where You Can Find More
Information. As of the date of this prospectus, we are
authorized to issue up to 40,000,000 shares of common
stock, $0.01 par value, and 5,000,000 shares of
preferred stock, $0.01 par value.
Common
Stock
General. As of June 13, 2006, we had
outstanding 16,559,828 shares of our common stock.
Voting Rights. The holders of our common stock
are entitled to one vote for each share held of record on all
matters submitted to a vote of the stockholders, including the
election of directors, and do not have cumulative voting rights.
Accordingly, the holders of a majority of the shares of common
stock entitled to vote in any election of directors can elect
all of the directors standing for election, if they so choose.
Dividends. Subject to preferences that may be
applicable to any then outstanding preferred stock, holders of
our common stock are entitled to receive ratably those
dividends, if any, as may be declared by the board of directors
out of legally available funds.
Liquidation, Dissolution and Winding Up. Upon
our liquidation, dissolution or winding up, the holders of our
common stock will be entitled to share ratably in the net assets
legally available for distribution to stockholders after the
payment of all of our debts and other liabilities, subject to
the prior rights of any preferred stock then outstanding.
Preemptive Rights. Holders of our common stock
have no preemptive or conversion rights or other subscription
rights and there are no redemption or sinking funds provisions
applicable to our common stock.
Assessment. All outstanding shares of our
common stock are, and the shares of our common stock to be
outstanding upon completion of any offering of common stock
pursuant to this prospectus will be, fully paid and
nonassessable.
Miscellaneous. The transfer agent and
registrar for our common stock is SunTrust Bank. Our common
stock is listed and traded on the Nasdaq National Market under
the symbol LHCG.
Preferred
Stock
A total of 5,000,000 shares of undesignated preferred stock
is authorized, none of which is outstanding. The board of
directors has the authority, without further action by the
stockholders, to issue from time to time the undesignated
preferred stock in one or more series and to fix the number of
shares, designations, preferences, powers, and relative,
participating, optional or other special rights and the
qualifications or restrictions thereof. The preferences, powers,
rights and restrictions of different series of preferred stock
may differ with respect to dividend rates, amounts payable on
liquidation, voting rights, conversion rights, redemption
provisions, sinking fund provisions, purchase funds and other
matters. The issuance of preferred stock could decrease the
amount of earnings and assets available for distribution to
holders of our common stock or adversely affect the rights and
powers, including voting rights, of the holders of our common
stock, and may have the effect of delaying, deferring or
preventing a change in control of our company.
You should read the particular terms of any series of preferred
stock offered by us, which will be described in more detail in
any prospectus supplement relating to such series, together with
the more detailed provisions of our certificate of incorporation
and the certificate of designation relating to each particular
series of preferred stock for provisions that may be important
to you. The certificate of designation relating to the
particular series of preferred stock offered by an accompanying
prospectus supplement and this prospectus will be filed as an
exhibit to a document incorporated by reference in the
registration statement and will describe
3
the terms of the series of preferred stock we are offering
before the issuance of the related series of preferred stock.
This description will include:
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the title and stated value;
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the number of shares we are offering;
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the liquidation preference per share;
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the purchase price per share;
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the dividend rate per share, if any, dividend period and payment
dates and method of calculation for dividends;
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whether dividends will be cumulative or non-cumulative and, if
cumulative, the date from which dividends will accumulate;
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whether dividends may be payable in additional shares of
preferred stock and the method of calculation therefor;
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our right, if any, to defer payment of dividends and the maximum
length of any such deferral period;
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the procedures for any auction and remarketing, if any;
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the provisions for a sinking fund, if any;
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the provisions for redemption or repurchase, if any, and any
restrictions on our ability to exercise those redemption and
repurchase rights;
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any listing of the preferred stock on any securities exchange or
market;
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whether the preferred stock will be convertible into our common
stock, and, if applicable, the conversion period, the conversion
price, or how it will be calculated, and under what
circumstances it may be adjusted;
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voting rights, if any, of the preferred stock;
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preemption rights, if any;
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restrictions on transfer, sale or other assignment, if any;
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whether interests in the preferred stock will be represented by
depositary shares;
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a discussion of any material or special United States federal
income tax considerations applicable to the preferred stock;
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the relative ranking and preferences of the preferred stock as
to dividend rights and rights if we liquidate, dissolve or wind
up our affairs;
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any limitations on issuances of any class or series of preferred
stock ranking senior to or on a parity with the series of
preferred stock being issued as to dividend rights and rights if
we liquidate, dissolve or wind up our affairs; and
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any other specific terms, rights, preferences, privileges,
limitations or restrictions of the preferred stock.
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When we issue shares of preferred stock under this prospectus,
the shares will be fully paid and nonassessable and will not
have, or be subject to, any preemptive or similar rights.
Delaware law provides that the holders of preferred stock have
the right to vote separately as a class on any proposal
involving fundamental changes in the rights of holders of that
preferred stock. This right is in addition to any voting rights
that may be provided for in a certificate of designation.
The transfer agent, registrar, dividend disbursing agent and
redemption agent for shares of each series of preferred stock
will be named in the prospectus supplement relating to such
series.
4
Anti-Takeover
Effects of Provisions of our Certificate of Incorporation and
Bylaws and Delaware Law
Some provisions of Delaware law and our certificate of
incorporation and bylaws contain provisions that could make the
following transactions more difficult: (1) acquisition of
us by means of a tender offer; (2) acquisition of us by
means of a proxy contest or otherwise; or (3) removal of
our incumbent officers and directors. These provisions,
summarized below, are intended to encourage persons seeking to
acquire control of us to first negotiate with our board of
directors. These provisions also serve to discourage hostile
takeover practices and inadequate takeover bids.
Undesignated Preferred Stock. Our board of
directors has the ability to authorize undesignated preferred
stock, which allows the board of directors to issue preferred
stock with voting or other rights or preferences that could
impede the success of any unsolicited attempt to change control
of our company. This ability may have the effect of deferring
hostile takeovers or delaying changes in control or management
of our company.
Stockholder Meetings. Our bylaws provide that
a special meeting of stockholders may be called only by our
President, our Chief Executive Officer or by a resolution
adopted by a majority of our board of directors.
Requirements for Advance Notification of Stockholder
Nominations and Proposals. Our bylaws establish
advance notice procedures with respect to stockholder proposals
and the nomination of candidates for election as directors,
other than nominations made by or at the direction of our board
of directors or a committee thereof.
Elimination of Stockholder Action by Written
Consent. Our certificate of incorporation
eliminates the right of stockholders to act by written consent
without a meeting.
Election and Removal of Directors. Our board
of directors is divided into three classes. The directors in
each class will serve for a three-year term, one class being
elected each year by our stockholders. Once elected, directors
may be removed only for cause and only by the affirmative vote
of a majority of our outstanding common stock. This system of
electing and removing directors may tend to discourage a third
party from making a tender offer or otherwise attempting to
obtain control of us because it generally makes it more
difficult for stockholders to replace a majority of the
directors.
Delaware Anti-Takeover Statute. We are subject
to Section 203 of the Delaware General Corporation Law
which prohibits persons deemed interested
stockholders from engaging in a business
combination with a Delaware corporation for three years
following the date these persons become interested stockholders.
Generally, an interested stockholder is a person
who, together with affiliates and associates, owns, or within
three years prior to the determination of interested stockholder
status did own, 15.0% or more of a corporations voting
stock. Generally, a business combination includes a
merger, asset or stock sale, or other transaction resulting in a
financial benefit to the interested stockholder. The existence
of this provision may have an anti-takeover effect with respect
to transactions not approved in advance by the board of
directors.
The provisions of Delaware law and our certificate of
incorporation and bylaws could have the effect of discouraging
others from attempting hostile takeovers and, as a consequence,
they may also inhibit temporary fluctuations in the market price
of our common stock that often result from actual or rumored
hostile takeover attempts. Such provisions may also have the
effect of preventing changes in our management. It is possible
that these provisions could make it more difficult to accomplish
transactions which stockholders may otherwise deem to be in
their best interests.
Limitations
of Liability and Indemnification Matters
We have adopted provisions in our certificate of incorporation
that limit the liability of our directors for monetary damages
for breach of their fiduciary duties, except for liability that
cannot be eliminated under the Delaware General Corporation Law.
Delaware law provides that directors of a corporation will not
be personally liable for monetary damages for breach of their
fiduciary duties as directors, except liability for any of the
following: (1) any breach of their duty of loyalty to the
corporation or the stockholders; (2) acts or omissions not
in good faith or that involve intentional misconduct or a
knowing violation of law; (3) unlawful payments of
dividends or unlawful stock repurchases or redemptions as
provided in Section 174 of the Delaware General Corporation
Law; or (4) any transaction from which the director derived
an improper
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personal benefit. This limitation of liability does not apply to
liabilities arising under the federal securities laws and does
not affect the availability of equitable remedies such as
injunctive relief or rescission.
Our bylaws also provide that we will indemnify our directors and
executive officers and we may indemnify our other officers and
employees and other agents to the fullest extent permitted by
law. We believe that indemnification under our bylaws covers at
least negligence and gross negligence on the part of indemnified
parties. Our bylaws also permit us to secure insurance on behalf
of any officer, director, employee or other agent for any
liability arising out of his or her actions in such capacity,
regardless of whether our bylaws would permit indemnification.
We have entered into separate indemnification agreements with
our directors and executive officers, in addition to the
indemnification provided for in our charter documents. These
agreements, among other things, provide for indemnification of
our directors and executive officers for expenses, judgments,
fines, and settlement amounts incurred by any such person in any
action or proceeding arising out of such persons services
as a director or executive officer or at our request.
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PLAN OF
DISTRIBUTION
We or the selling stockholders may sell securities through
underwriters or dealers, through agents, or directly to one or
more purchasers or through a combination of any of these methods
of sale. A prospectus supplement or supplements will describe
the terms of the offering of the securities, including:
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the name or names of any underwriters, if any;
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the purchase price of the securities and the proceeds we will
receive from the sale;
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any over-allotment options under which underwriters may purchase
additional securities from us;
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any agency fees or underwriting discounts and other items
constituting agents or underwriters compensation;
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any public offering price;
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any discounts or concessions allowed or reallowed or paid to
dealers; and
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any securities exchange or market on which the securities may be
listed.
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We or any selling stockholder may sell securities from time to
time in one or more transactions:
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at a fixed price or prices, which may be changed,
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at market prices prevailing at the time of sale,
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at prices relating to the prevailing market prices or at
negotiated prices.
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The distribution of the securities may be effected from time to
time in one or more transactions, by means of one or more of the
following transactions, which may include:
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block trades;
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at-the-market
offerings;
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negotiated transactions;
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put or call option transactions relating to the securities;
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under delayed delivery contracts or other contractual
commitments; or
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a combination of such methods of sale.
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The selling stockholders may also sell shares under
Rule 144 under the Securities Act of 1933, as amended, or
the Securities Act, if available, rather than under this
prospectus.
Only underwriters named in the prospectus supplement are
underwriters of the securities offered by the prospectus
supplement.
If underwriters are used in the sale, they will acquire the
securities for their own account and may resell the stock from
time to time in one or more transactions at a fixed public
offering price. The obligations of the underwriters to purchase
the securities will be subject to the conditions set forth in
the applicable underwriting agreement. We or the selling
stockholders may offer the securities to the public through
underwriting syndicates represented by managing underwriters or
by underwriters without a syndicate. Subject to certain
conditions, the underwriters will be obligated to purchase all
the securities offered by the prospectus supplement. Any public
offering price and any discounts or concessions allowed or
reallowed or paid to dealers may change from time to time. We
may use underwriters with whom we have a material relationship,
which we will describe in the applicable prospectus supplement,
naming the underwriter.
If a dealer is used in the sale of the securities, we, the
selling stockholders or an underwriter will sell the securities
to the dealer, as principal. The dealer may resell the
securities to the public at varying prices to be determined by
the dealer at the time of resale. The prospectus supplement will
set forth the name of the dealer and the terms of the
transaction.
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We or the selling stockholders may sell securities directly or
through agents we designate from time to time. We will name any
agent involved in the offering and sale of securities and we
will describe any commissions we will pay the agent in the
prospectus supplement. Unless the prospectus supplement states
otherwise, any such agent will act on a best-efforts basis for
the period of its appointment.
We or the selling stockholders may authorize agents or
underwriters to solicit offers by certain types of institutional
investors to purchase securities from us or the selling
stockholders at the public offering price set forth in the
prospectus supplement pursuant to delayed delivery contracts
providing for payment and delivery on a specified date in the
future. We will describe the conditions to these contracts and
the commissions we or the selling stockholders must pay for
solicitation of these contracts in the prospectus supplement.
We and the selling stockholders may provide agents and
underwriters with indemnification against civil liabilities
related to this offering, including liabilities under the
Securities Act, or contribution with respect to payments that
the agents or underwriters may make with respect to these
liabilities. The prospectus supplement will describe the terms
and conditions of indemnification or contribution. Agents and
underwriters may engage in transactions with, or perform
services for, us in the ordinary course of business.
Any underwriter may engage in overallotment, stabilizing
transactions, short covering transactions and penalty bids in
accordance with Regulation M under the Exchange Act.
Overallotment involves sales in excess of the offering size,
which create a short position. Stabilizing transactions permit
bids to purchase the underlying security so long as the
stabilizing bids do not exceed a specified maximum. Short
covering transactions involve purchases of the securities in the
open market after the distribution is completed to cover short
positions.
Penalty bids permit the underwriters to reclaim a selling
concession from a dealer when the securities originally sold by
the dealer is purchased in a covering transaction to cover short
positions. Those activities may cause the price of the
securities to be higher than it would otherwise be. If
commenced, the underwriters may discontinue any of the
activities at any time.
Any underwriters who are qualified market makers on the Nasdaq
National Market may engage in passive market making transactions
in the securities on the Nasdaq National Market in accordance
with Rule 103 of Regulation M, during the business day
prior to the pricing of the offering, before the commencement of
offers or sales of the securities. Passive market makers must
comply with applicable volume and price limitations and must be
identified as passive market makers. In general, a passive
market maker must display its bid at a price not in excess of
the highest independent bid for such security; if all
independent bids are lowered below the passive market
makers bid, however, the passive market makers bid
must then be lowered when certain purchase limits are exceeded.
LEGAL
MATTERS
Unless otherwise specified in the prospectus supplement
accompanying this prospectus, Alston & Bird LLP,
Atlanta, Georgia, will provide opinions about certain legal
matters with respect to the securities. Any underwriters will
also be advised about legal matters by their own counsel, who
will be named in the prospectus supplement.
EXPERTS
The consolidated financial statements of LHC Group, Inc.
appearing in LHC Group, Inc.s Annual Report on
Form 10-K
for the year ended December 31, 2005 have been audited by
Ernst & Young LLP, independent registered public
accounting firm, as set forth in their report thereon, included
therein, and incorporated herein by reference. Such consolidated
financial statements are incorporated herein by reference in
reliance upon such report given on the authority of such firm as
experts in accounting and auditing.
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WHERE YOU
CAN FIND MORE INFORMATION
We file annual, quarterly and special reports, proxy statements
and other information with the Commission. You may read and copy
any document we file at the Commissions public reference
room located at 100 F Street, N.E., Washington, D.C. 20549.
Please call the Commission at
1-800-SEC-0330
for further information on the public reference room. Our
filings with the Commission are also available to the public at
the Commissions website at http://www.sec.gov. You may
also inspect copies of these materials and other information
about us at the offices of the Nasdaq Stock Market, Inc.,
National Market System, 1735 K Street, N.W.,
Washington, D.C.
20006-1500.
INFORMATION
INCORPORATED BY REFERENCE
The Commission allows us to incorporate by reference
in this prospectus the information in other documents that we
file with it, which means that we can disclose important
information to you by referring you to those documents. The
information incorporated by reference is considered to be part
of this prospectus, and later information that we file with the
Commission will automatically update and supersede information
contained in documents filed earlier with the Commission or
contained in this prospectus or a prospectus supplement. We
incorporate by reference the documents listed below and any
future filings made with the Commission under
Sections 13(a), 13(c), 14, or 15(d) of the Exchange
Act, between the date of this prospectus and the termination of
the offering and also between the date of the initial
registration statement and prior to effectiveness of the
registration statement:
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our Annual Report on
Form 10-K
for the fiscal year ended December 31, 2005, filed on
March 31, 2006.
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our Quarterly Report on
Form 10-Q
for the quarterly period ended March 31, 2006, filed on
May 15, 2006.
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our Proxy Statement relating to the annual meeting of
stockholders to be held on June 13, 2006, filed on
April 28, 2006.
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our Current Reports on
Form 8-K
filed on January 4, 2006, January 23, 2006,
March 16, 2006, May 5, 2006, May 23, 2006, and
June 7, 2006.
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the description of the shares of common stock contained in the
Registration Statement on
Form 8-A
filed on June 6, 2005 (File no.
000-51343).
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This prospectus is part of a registration statement on
Form S-3
we have filed with the Commission under the Securities Act. This
prospectus does not contain all of the information in the
registration statement. We have omitted certain parts of the
registration statement or the exhibits and schedules thereto, as
permitted by the rules and regulations of the Commission. You
may inspect and copy the registration statement, including
exhibits, at the Commissions public reference room or
website. Our statements in this prospectus about the contents of
any contract or other document are summaries of the terms of
such contracts or documents and are not necessarily complete.
You should refer to the copy of each contract or other document
we have filed as an exhibit to the registration statement for
complete information.
We will furnish without charge to you, upon written or oral
request, a copy of any or all of the documents incorporated by
reference, including the exhibits or schedules to these
documents. You should direct any such requests to the
Companys secretary at LHC Group, Inc., 420 West
Pinhook Road, Suite A, Lafayette, Louisiana 70503 or by
telephone at
(337) 233-1307.
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