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DaVita Inc. 2nd Quarter 2022 Results

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DENVER, Aug. 1, 2022 /PRNewswire/ -- DaVita Inc. (NYSE: DVA) announced financial and operating results for the quarter ended June 30, 2022.

"We are living in a dynamic time with a sustained global pandemic, labor shortage, supply chain disruption, and more. Despite all this, my confidence in our business and our dedicated caregivers and team has never wavered," said Javier Rodriguez. "Their hard work and commitment has enabled us to continue delivering high quality and equitable care to all of our constituents."

Financial and operating highlights for the quarter ended June 30, 2022:

  • Consolidated revenues were $2.927 billion.

  • Operating income was $433 million.

  • Diluted earnings per share was $2.30.

  • Operating cash flow and free cash flow were $188 million and $95 million, respectively.

  • Repurchased 3.9 million shares of our common stock at an average cost of $95.56 per share.


Three months ended


Six months ended June 30,


June 30, 2022


March 31, 2022


2022


2021

Net income attributable to DaVita Inc.:

(dollars in millions, except per share data)

Net income

$ 225


$ 162


$ 387


$ 531

Diluted per share

$ 2.30


$ 1.61


$ 3.90


$ 4.72


Three months ended

Six months ended June 30,


June 30, 2022


March 31, 2022


2022


2021


Amount


Margin


Amount


Margin


Amount


Margin


Amount


Margin


(dollars in millions)

Operating income

$ 433


14.8 %


$ 338


12.0 %


$ 771


13.4 %


$ 933


16.3 %

U.S. dialysis metrics:

Volume: Total U.S. dialysis treatments for the second quarter of 2022 were 7,269,160, or an average of 93,194 treatments per day, representing a per day increase of 0.9% compared to the first quarter of 2022. Normalized non-acquired treatment growth in the second quarter of 2022 compared to the second quarter of 2021 was (1.9)%.


Three months ended


Quarter

change


Six months ended


Year to date

change


June 30, 2022


March 31, 2022



June 30, 2022


June 30, 2021



(dollars in millions, except per treatment data)

Revenue per treatment

$ 365.54


$ 361.35


$ 4.19


$ 363.47


$ 357.35


$ 6.12

Patient care costs per treatment

$ 247.14


$ 252.61


$ (5.47)


$ 249.85


$ 237.79


$ 12.06

General and administrative

$ 241


$ 217


$ 24


$ 458


$ 456


$ 2

Primary drivers of the changes in the table above were as follows:

Revenue: The quarter change was primarily due to normal seasonal improvements driven by patients meeting their co-insurance and deductibles, as well as the continued shift to Medicare Advantage plans. The quarter change was negatively impacted by a seasonal decrease in hospital inpatient dialysis treatments and decreased government rate related to the reinstatement of 1% Medicare sequestration beginning April 1, 2022. The year to date change was primarily due to an increase in commercial mix and rate, an increase in the Medicare base rate in 2022 and the continued shift to Medicare Advantage plans, partially offset by the reinstatement of 1% Medicare sequestration described above.

Patient care costs: The quarter change was primarily due to decreased other direct operating expenses associated with our dialysis centers, including decreased utilities expense due to seasonality and our virtual power purchase arrangements. In addition, our fixed other direct operating expenses positively impacted patient care costs per treatment due to increased treatments in the second quarter of 2022. Other drivers of this change include declines in compensation expenses primarily related to seasonal decreases in payroll taxes, as well as decreases in health benefit expenses, professional fees, pharmaceutical unit costs and medical supplies expense. These decreases were partially offset by increased insurance expense. The year to date change was primarily due to increased compensation expenses driven by increased wage rates and increases in other direct operating expenses associated with our dialysis centers, which include increases in utilities expense resulting from lower expense in the first half of 2021 related to our virtual power purchase arrangements. In addition, our fixed other direct operating expenses negatively impacted patient care costs per treatment due to decreased treatments in the first half of 2022. Other drivers of this change include increases in insurance expense and costs related to travel and management meetings, partially offset by decreased pharmaceutical unit costs and professional fees.

General and administrative: The quarter change was primarily due to increased advocacy costs to counter union policy efforts, including a California ballot initiative, increased compensation expense including increased wage rates, as well as increased travel costs. These increases were offset by gains recognized on the sale of our self-developed properties. The year to date change was primarily due to increases in advocacy costs, as described above, travel costs and compensation expenses partially offset the gains on sale, as described above, and decreases in professional fees and contributions to our charitable foundation.

Share repurchases: During the three months ended June 30, 2022, we repurchased 3.9 million shares of our common stock for $370 million, at an average cost of $95.56 per share.

Subsequent to June 30, 2022 through July 29, 2022, we repurchased 0.9 million shares of our common stock for $75 million, at an average cost of $82.94 per share.

Financial and operating metrics:


Three months ended

June 30,


Twelve months ended

June 30,


2022


2021


2022


2021

Cash flow:

(dollars in millions)

Operating cash flow

$ 188


$ 680


$ 1,607


$ 1,802

Free cash flow(1)

$ 95


$ 503


$ 890


$ 982



(1)

For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 16.


Three months ended

June 30, 2022


Six months ended

June 30, 2022

Effective income tax rate on:




Income

18.4 %


19.8 %

Income attributable to DaVita Inc.(1)

22.1 %


23.8 %



(1)

For definitions of non-GAAP financial measures, see the note titled "Note on Non-GAAP Financial Measures" and related reconciliations beginning on page 16.

Center activity: As of June 30, 2022, we provided dialysis services to a total of approximately 243,700 patients at 3,159 outpatient dialysis centers, of which 2,810 centers were located in the United States and 349 centers were located in 11 countries outside of the United States. During the second quarter of 2022, we opened a total of 18 new dialysis centers and closed 17 dialysis centers in the United States. We also acquired two dialysis centers and opened one dialysis center outside of the United States during the second quarter of 2022.

Integrated kidney care (IKC): As of June 30, 2022, we had approximately 44,000 patients in risk-based integrated care arrangements representing approximately $3.7 billion in annualized medical spend. We also had an additional 12,000 patients in other integrated care arrangements; we do not include the medical spend for these patients in this annualized medical spend estimate. See additional description of these metrics at Note 2.

Certain items impacting the quarter:

Advocacy costs: During the three and six months ended June 30, 2022, we incurred advocacy costs of approximately $23 million to counter union policy efforts, including a California ballot initiative. These costs are included in the U.S. dialysis segment's general and administrative expense.

Outlook:

The following forward-looking measures and the underlying assumptions involve significant known and unknown risks and uncertainties, including those described below, and actual results may vary materially from these forward-looking measures. For example, the widespread impact of the COVID-19 pandemic continues to generate significant risk and uncertainty, and as a result, our future results could vary materially from the guidance provided below. We do not provide guidance for operating income or diluted net income per share attributable to DaVita Inc. on a basis consistent with United States generally accepted accounting principles (GAAP) nor a reconciliation of forward-looking non-GAAP financial measures to the most directly comparable GAAP financial measures on a forward-looking basis because we are unable to predict certain items contained in the GAAP measures without unreasonable efforts. These non-GAAP financial measures do not include certain items, including foreign currency fluctuations, which may be significant. The guidance for our effective income tax rate on adjusted income attributable to DaVita Inc. also excludes the amount of third-party owners' income and related taxes attributable to non-tax paying entities.


2022 guidance


Low


High


(dollars in millions, except per share data)

Adjusted operating income

$1,525


$1,675

Adjusted diluted net income per share attributable to DaVita Inc.

$7.50


$8.50

Free cash flow

$850


$1,100

Key drivers of 2023 adjusted operating income growth1:

(dollars in millions)

Absence of ballot initiative expenses

$60

Integrated Kidney Care

$0 — $25

Treatment volume growth

($25) — $125

Revenue per treatment growth

$200 — $250

Labor pressure and inflation

($275) — ($225)

Cost savings initiatives

$125 — $175



2023 Adjusted Operating Income Growth

$200 — $300



(1)

Adjusted operating income growth outlook relative to 2022 adjusted operating income outlook, excluding certain items in both periods.

We will be holding a conference call to discuss our results for the second quarter ended June 30, 2022, on August 1, 2022, at 5:00 p.m. Eastern Time. To join the conference call, please dial (877) 918-6630 from the U.S. or (517) 308-9042 from outside the U.S., and provide the operator the password 'Earnings'. This call is being webcast and can be accessed at the DaVita Investor Relations website investors.davita.com. A replay of the conference call will also be available at investors.davita.com for the following 30 days.

Forward looking statements

DaVita Inc. and its representatives may from time to time make written and oral forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 (PSLRA), including statements in this release, filings with the Securities and Exchange Commission (SEC), reports to stockholders and in meetings with investors and analysts. All statements in this release, during the related presentation or other meetings, other than statements of historical fact, are forward-looking statements and as such are intended to be covered by the safe harbor for "forward-looking statements" provided by the PSLRA. These forward-looking statements could include, among other things, DaVita's response to and the expected future impacts of the coronavirus (COVID-19), including statements about our balance sheet and liquidity, our expenses and expense offsets, revenues, billings and collections, availability or cost of supplies, treatment volumes, mix expectation, such as the percentage or number of patients under commercial insurance, the availability, acceptance, impact, administration and efficacy of COVID-19 vaccines, treatments and therapies, the continuing impact on the U.S. and global economies, unemployment and labor market conditions, and overall impact on our patients and teammates, as well as other statements regarding our future operations, financial condition and prospects, expenses, strategic initiatives, government and commercial payment rates, expectations related to value-based care, integrated kidney care, and Medicare Advantage plan enrollment and our ongoing stock repurchase program, and statements related to our guidance and expectations for future periods and the assumptions underlying any such projections. All statements in this release, other than statements of historical fact, are forward-looking statements. Without limiting the foregoing, statements including the words "expect," "intend," "will," "could," "plan," "anticipate," "believe," "forecast," "guidance," "outlook," "goals," and similar expressions are intended to identify forward-looking statements. These forward-looking statements are based on DaVita's current expectations and are based solely on information available as of the date of this release. DaVita undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of changed circumstances, new information, future events or otherwise, except as may be required by law. Actual future events and results could differ materially from any forward-looking statements due to numerous factors that involve substantial known and unknown risks and uncertainties. These risks and uncertainties include, among other things:

  • the continuing impact of the dynamic and evolving COVID-19 pandemic, including, without limitation, on our patients, teammates, physician partners, suppliers, business, operations, reputation, financial condition and results of operations; the government's response to the COVID-19 pandemic, including, among other things, federal, state and local vaccine mandates or surveillance testing requirements and the extent to which they may ultimately be applicable to us; the pandemic's continuing impact on the U.S. and global economies, unemployment and other labor market conditions, interest rates, inflation and evolving monetary policies; the availability, acceptance, impact and efficacy of COVID-19 vaccines, treatments and therapies; further spread or resurgence of the virus, including as a result of the emergence of new strains of the virus, such as the Omicron variant and its subvariants; the continuing impact of the pandemic on our revenue and non-acquired growth due to lower treatment volumes; COVID-19's impact on the chronic kidney disease (CKD) population and our patient population including on the mortality of these patients; any potential negative impact on our commercial mix or the number of our patients covered by commercial insurance plans; continued increased COVID-19-related costs;our ability to successfully implement planned cost savings initiatives in response to COVID-19-related impacts on us; supply chain challenges and disruptions, including with respect to our clinical supplies; and higher salary and wage expense driven in part by labor market conditions and a high demand for our clinical personnel, any of which may also have the effect of heightening many of the other risks and uncertainties discussed below, and in many cases, the impact of the pandemic and the aforementioned global economic conditions on our business may persist after the pandemic subsides;

  • the extent to which the ongoing implementation of healthcare reform, or changes in or new legislation, regulations or guidance, enforcement thereof or related litigation result in a reduction in coverage or reimbursement rates for our services, a reduction in the number of patients enrolled in or that select higher-paying commercial plans, including for example Medicare Advantage plans or other material impacts to our business or operations; or our making incorrect assumptions about how our patients will respond to any such developments;

  • risks arising from potential changes in laws, regulations or requirements applicable to us, such as potential and proposed federal and/or state legislation, regulation, ballot, executive action or other initiatives, including, without limitation, those related to healthcare and/or labor matters, such as AB 290 and the Dialysis Clinic Requirements Initiative in California;

  • the concentration of profits generated by higher-paying commercial payor plans for which there is continued downward pressure on average realized payment rates; a reduction in the number or percentage of our patients under such plans, including, without limitation, as a result of restrictions or prohibitions on the use and/or availability of charitable premium assistance, which may result in the loss of revenues or patients, as a result of our making incorrect assumptions about how our patients will respond to any change in financial assistance from charitable organizations; as a result of payors' implementing restrictive plan designs, including, without limitation, actions taken in response to the U.S. Supreme Court's decision in Marietta Memorial Hospital Employee Health Benefit Plan, et al. v. DaVita Inc. et al. ("Marietta"); how and whether regulators and legislators will respond to the Marietta decision including, without limitation, whether they will issue regulatory guidance or adopt new legislation; how courts will interpret other anti-discriminatory provisions that may apply to restrictive plan designs; whether there could be other potential negative impacts of the Marietta decision; and the timing of each of these items;

  • our ability to successfully implement our strategies with respect to integrated kidney care and value-based care initiatives and home based dialysis in the desired time frame and in a complex, dynamic and highly regulated environment, including, among other things, maintaining our existing business; meeting growth expectations; recovering our investments; entering into agreements with payors, third party vendors and others on terms that are competitive and, as appropriate, prove actuarially sound; structuring operations, agreements and arrangements to comply with evolving rules and regulations; finding, training and retaining appropriate staff; and further developing our integrated care and other capabilities to provide competitive programs at scale;

  • a reduction in government payment rates under the Medicare End Stage Renal Disease program, state Medicaid or other government-based programs and the impact of the Medicare Advantage benchmark structure;

  • our ability to attract, retain and motivate teammates and our ability to manage operating cost increases or productivity decreases whether due to union organizing activities, legislative or other changes, demand for labor, volatility and uncertainty in the labor market, the current challenging and highly competitive labor market conditions, or other reasons;

  • U.S. and global economic and marketplace conditions, interest rates, inflation, unemployment, labor market conditions, and evolving monetary policies, and our ability to respond to these changing conditions, including our ability to successfully implement cost savings initiatives in response;

  • noncompliance by us or our business associates with any privacy or security laws or any security breach by us or a third party involving the misappropriation, loss or other unauthorized use or disclosure of confidential information;

  • legal and compliance risks, such as our continued compliance with complex, and at times, evolving government regulations and requirements;

  • the impact of the political environment and related developments on the current healthcare marketplace and on our business, including with respect to the Affordable Care Act, the exchanges and many other core aspects of the current healthcare marketplace, as well as the composition of the U.S. Supreme Court and the current presidential administration and congressional majority;

  • changes in pharmaceutical practice patterns, reimbursement and payment policies and processes, or pharmaceutical pricing, including with respect to hypoxia inducible factors, among other things;

  • our ability to develop and maintain relationships with physicians and hospitals, changing affiliation models for physicians, and the emergence of new models of care or other initiatives introduced by the government or private sector that, among other things, may erode our patient base and impact reimbursement rates;

  • our ability to complete acquisitions, mergers, dispositions, joint ventures or other strategic transactions that we might announce or be considering, on terms favorable to us or at all, or to successfully integrate any acquired businesses, or to successfully operate any acquired businesses, joint ventures or other strategic transactions, or to successfully expand our operations and services in markets outside the United States, or to businesses or products outside of dialysis services;

  • continued increased competition from dialysis providers and others, and other potential marketplace changes, including without limitation increased investment in and availability of funding to new entrants in the dialysis and pre-dialysis marketplace;

  • the variability of our cash flows, including without limitation any extended billing or collections cycles; the risk that we may not be able to generate or access sufficient cash in the future to service our indebtedness or to fund our other liquidity needs; and the risk that we may not be able to refinance our indebtedness as it becomes due, on terms favorable to us or at all;

  • factors that may impact our ability to repurchase stock under our stock repurchase program and the timing of any such stock repurchases, as well as our use of a considerable amount of available funds to repurchase stock;

  • risks arising from the use of accounting estimates, judgments and interpretations in our financial statements;

  • impairment of our goodwill, investments or other assets;

  • our aspirations, goals and disclosures related to environmental, social and governance (ESG) matters, including evolving regulatory requirements affecting ESG standards, measurements and reporting requirements; the availability of suppliers that can meet our sustainability standards; and our ability to recruit, develop and retain diverse talent in our labor markets; and

  • the other risk factors, trends and uncertainties set forth in our Annual Report on Form 10-K for the year ended December 31, 2021 and Quarterly Report on Form 10-Q for the quarter ended March 31, 2022, and the risks and uncertainties discussed in any subsequent reports that we file or furnish with the SEC from time to time.

The financial information presented in this release is unaudited and is subject to change as a result of subsequent events or adjustments, if any, arising prior to the filing of the Company's Quarterly Report on Form 10-Q for the quarter ended June 30, 2022.

DAVITA INC.

CONSOLIDATED STATEMENTS OF INCOME

(unaudited)

(dollars and shares in thousands, except per share data)



Three months ended June 30,


Six months ended June 30,


2022


2021


2022


2021

Dialysis patient service revenues

$ 2,810,099


$ 2,817,957


$ 5,526,380


$ 5,532,544

Other revenues

116,658


98,553


217,932


203,967

Total revenues

2,926,757


2,916,510


5,744,312


5,736,511

Operating expenses:








Patient care costs

2,016,788


1,965,277


4,035,317


3,903,607

General and administrative

315,219


298,091


610,039


579,517

Depreciation and amortization

171,176


169,689


344,120


335,390

Equity investment income, net

(9,141)


(7,023)


(16,187)


(15,081)

Total operating expenses

2,494,042


2,426,034


4,973,289


4,803,433

Operating income

432,715


490,476


771,023


933,078

Debt expense

(82,586)


(73,324)


(156,377)


(140,338)

Other (loss) income, net

(1,284)


15,188


(3,070)


16,356

Income before income taxes

348,845


432,340


611,576


809,096

Income tax expense

64,229


81,309


121,242


166,520

Net income

284,616


351,031


490,334


642,576

Less: Net income attributable to noncontrolling interests

(59,807)


(57,211)


(103,403)


(111,353)

Net income attributable to DaVita Inc.

$ 224,809


$ 293,820


$ 386,931


$ 531,223









Earnings per share attributable to DaVita Inc.:








Basic net income

$ 2.38


$ 2.76


$ 4.06


$ 4.94

Diluted net income

$ 2.30


$ 2.64


$ 3.90


$ 4.72









Weighted average shares for earnings per share:








Basic shares

94,457


106,364


95,382


107,606

Diluted shares

97,772


111,423


99,121


112,555

DAVITA INC.

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME

(unaudited)

(dollars in thousands)



Three months ended June 30,


Six months ended June 30,


2022


2021


2022


2021

Net income

$ 284,616


$ 351,031


$ 490,334


$ 642,576

Other comprehensive (loss) income, net of tax:








Unrealized gains (losses) on interest rate cap agreements:








Unrealized gains (losses)

13,217


(2,059)


54,349


2,823

Reclassifications of net realized losses into net income

1,033


1,033


2,066


2,066

Unrealized (losses) gains on foreign currency translation:

(91,176)


57,910


(28,964)


(4,634)

Other comprehensive (loss) income

(76,926)


56,884


27,451


255

Total comprehensive income

207,690


407,915


517,785


642,831

Less: Comprehensive income attributable to

noncontrolling interests

(59,807)


(57,211)


(103,403)


(111,353)

Comprehensive income attributable to DaVita Inc.

$ 147,883


$ 350,704


$ 414,382


$ 531,478

DAVITA INC.

CONSOLIDATED STATEMENTS OF CASH FLOW

(unaudited)

(dollars in thousands)



Six months ended June 30,


2022


2021

Cash flows from operating activities:




Net income

$ 490,334


$ 642,576

Adjustments to reconcile net income to net cash provided by operating activities:




Depreciation and amortization

344,120


335,390

Stock-based compensation expense

50,109


51,717

Deferred income taxes

9,069


40,685

Equity investment loss (income), net

90


(2,764)

Other non-cash charges, net

(32,858)


1,274

Changes in operating assets and liabilities, net of effect of acquisitions and divestitures:




Accounts receivable

(132,043)


(117,171)

Inventories

(1,927)


(3,270)

Other receivables and prepaid and other current assets

(61,811)


14,465

Other long-term assets

(49,093)


(13,706)

Accounts payable

24,517


(47,390)

Accrued compensation and benefits

(102,513)


(90,381)

Other current liabilities

42,517


25,090

Income taxes

(63,638)


10,753

Other long-term liabilities

(6,557)


(13,232)

Net cash provided by operating activities

510,316


834,036

Cash flows from investing activities:




Additions of property and equipment

(265,461)


(294,438)

Acquisitions

(9,491)


(23,890)

Proceeds from asset and business sales

114,829


29,774

Purchase of debt investments held-to-maturity

(89,530)


(7,923)

Purchase of other debt and equity investments

(3,010)


(2,164)

Proceeds from debt investments held-to-maturity

8,415


7,923

Proceeds from sale of other debt and equity investments

3,775


11,908

Purchase of equity method investments

(23,806)


(6,029)

Distributions from equity method investments

1,047


1,140

Net cash used in investing activities

(263,232)


(283,699)

Cash flows from financing activities:




Borrowings

1,182,911


1,611,086

Payments on long-term debt

(841,687)


(754,407)

Deferred financing and debt redemption costs


(9,089)

Purchase of treasury stock

(617,432)


(560,507)

Distributions to noncontrolling interests

(118,315)


(99,362)

Net payments related to stock purchases and awards

(47,866)


(43,605)

Contributions from noncontrolling interests

9,116


15,925

Proceeds from sales of additional noncontrolling interests

3,673


Purchases of noncontrolling interests

(15,365)


(4,493)

Net cash (used in) provided by financing activities

(444,965)


155,548

Effect of exchange rate changes on cash, cash equivalents and restricted cash

(1,342)


(1,197)

Net (decrease) increase in cash, cash equivalents and restricted cash

(199,223)


704,688

Cash, cash equivalents and restricted cash at beginning of the year

554,960


501,790

Cash, cash equivalents and restricted cash at end of the period

$ 355,737


$ 1,206,478

DAVITA INC.

CONSOLIDATED BALANCE SHEETS

(unaudited)

(dollars and shares in thousands, except per share data)



June 30, 2022


December 31, 2021

ASSETS




Cash and cash equivalents

$ 262,605


$ 461,900

Restricted cash and equivalents

93,132


93,060

Short-term investments

100,489


22,310

Accounts receivable

2,093,830


1,957,583

Inventories

109,522


107,428

Other receivables

502,921


427,321

Prepaid and other current assets

63,539


72,517

Income tax receivable

38,070


25,604

Total current assets

3,264,108


3,167,723

Property and equipment, net of accumulated depreciation of $4,989,142 and $4,763,135, respectively

3,304,596


3,479,972

Operating lease right-of-use assets

2,771,757


2,824,787

Intangible assets, net of accumulated amortization of $44,985 and $60,730, respectively

184,740


177,693

Equity method and other investments

253,457


238,881

Long-term investments

44,562


49,514

Other long-term assets

257,577


136,677

Goodwill

7,019,778


7,046,241


$ 17,100,575


$ 17,121,488

LIABILITIES AND EQUITY




Accounts payable

$ 402,308


$ 402,049

Other liabilities

752,717


709,345

Accrued compensation and benefits

559,791


659,960

Current portion of operating lease liabilities

398,421


394,357

Current portion of long-term debt

197,510


179,030

Income tax payable


...