FORT MYERS, Fla., Nov. 14, 2016 (GLOBE NEWSWIRE) -- 21^st Century Oncology Holdings, Inc. (“21C” or the “Company”), the leading global provider of integrated cancer care (ICC) services, announced today its financial results for the third quarter of 2016.

Third Quarter 2016 Results

Total revenues decreased by $16.6 million, or 6.3%, from $262.3 million for the three months ended September 30, 2015 to $245.7 million for the three months ended September 30, 2016.

Net patient service revenue in our total domestic freestanding line of business declined $7.3 million, or 4.8%, as compared to the same period in the prior year. This decline was driven by a 1.3% decline in total radiation oncology treatments per day and a 3.6% decline in net patient service revenue per radiation oncology treatment for the third quarter of 2016 as compared to the same period in the prior year.

Net patient service revenue in our ICC line of business declined $7.2 million, or 9.0%, as compared to the same period in the prior year.  The conversion of our Jacksonville medical oncology group to a professional services agreement (PSA) with the University of Florida, whereby the Company will invoice for chemotherapy administration only, eliminating the drug portion, drove $4.6 million of the decline in ICC revenue. 

International net patient service revenue declined $3.4 million, or 10.7%, as compared to the same period in the prior year due to the devaluation in the Argentine Peso. Excluding the impact of currency fluctuations, international revenue growth was approximately 37.8%, or $8.9 million, quarter over quarter. 

Net loss for the third quarter of 2016 was $78.5 million as compared to a net loss of $55.2 million for the same period in the prior year. The increase in net loss was the result of a $16.6 million reduction in total revenue, an increase in other gains and losses of $6.2 million, an increase in interest expense of $3.4 million and a $3.0 million increase in provision for bad debt, partially offset by a $5.8 million decrease in salaries and benefits.

Pro-forma adjusted EBITDA in the third quarter of 2016 was $23.6 million, or 9.6% of total revenues, as compared to $31.4 million, or 12.0% of total pro-forma revenues, in the third quarter of 2015.

Total radiation oncology treatment plans decreased 0.2% in the third quarter of 2016 as compared to the same period in the prior year, and same market radiation oncology treatment plans increased 2.9% for the third quarter of 2016 as compared to the same period in the prior year.

Total radiation oncology treatments per day during the third quarter of 2016 declined 1.3% as compared to the same period in 2015 due to the closing of our Bronx-Lebanon, Riverhead, Upper Chesapeake and Holyoke centers as well as the transition of our Greenville, North Carolina radiation center to an unconsolidated health system joint venture. Same market radiation oncology treatments per day for the third quarter of 2016 increased 0.4% as compared to the same period in 2015.

Net patient service revenue per radiation oncology treatment decreased 3.6% in the third quarter of 2016 as compared to the same period in the prior year and same market net patient service revenue per radiation oncology treatment decreased 3.1% in the third quarter of 2016 as compared to the same period in the prior year. 

The number of open cases in our international line of business for the third quarter of 2016 increased 3.8% as compared to the same period in the prior year.  Due to devaluation in the Argentine Peso, revenue per radiation oncology case declined 14.0% for the third quarter of 2016 as compared to the same period in the prior year. Excluding the impact of currency fluctuations, international revenue per case increased by approximately 26.0%.

Year-to-Date September 2016 Results

Total revenues decreased by $41.7 million, or 5.1%, from $816.1 million for the nine months ended September 30, 2015 to $774.4 million for the nine months ended September 30, 2016.

Net patient service revenue in our domestic freestanding line of business declined $19.8 million, or 4.2%, as compared to the same period in the prior year. This decline was driven by a 3.0% decline in total radiation oncology treatments per day and a 1.8% decline in net patient service revenue per radiation oncology treatment for the first nine months of 2016 as compared to the same period in the prior year.

Net patient service revenue in our ICC line of business declined $15.1 million, or 5.9%, as compared to the same period in the prior year.  The conversion of our Jacksonville medical oncology group to a professional services agreement (PSA) with the University of Florida, whereby the Company will invoice for chemotherapy administration only, eliminating the drug portion, drove $12.1 million of the decline in ICC revenue. 

International net patient service revenue declined $8.1 million, or 9.2%, as compared to the same period in the prior year due to the devaluation in the Argentine Peso.  Excluding the impact of currency fluctuations, international revenue growth was approximately 36.1%, or $24.3 million, year over year.

Net loss for the nine month period ended September 30, 2016 was $92.9 million as compared to a net loss of $133.9 million for the same period in the prior year. The decrease in net loss resulted from a $22.4 million reduction in salaries and benefits, a decrease in general and administrative expense of $40.3 million and a $37.4 million reduction in the early extinguishment of debt, offset by a $41.7 million decline in revenue, a $3.6 million increase in provision for doubtful accounts, and a $13.8 million increase in fair value measurements.

Pro-forma adjusted EBITDA for the nine month period ended September 30, 2016 was $96.0 million, or 12.4% of total revenues, as compared to $120.3 million, or 14.7% of total pro-forma revenues, for the same period in the prior year.

Total radiation oncology treatment plans decreased 1.6% for the nine month period ended September 30, 2016 as compared to the same period in the prior year, and same market radiation oncology treatment plans increased 0.1% as compared to the same period in the prior year.

Total radiation oncology treatments per day during for the nine month period ended September 30, 2016 declined 3.0% as compared to the same period in 2015 due to the closing of our Bronx-Lebanon, Riverhead, Upper Chesapeake and Holyoke centers as well as the transition of our Greenville, North Carolina radiation center to an unconsolidated health system joint venture. Same market radiation oncology treatments per day for the nine month period ended September 30, 2016 declined 1.4% as compared to the same period in 2015.

Net patient service revenue per radiation oncology treatment decreased 1.8% for the nine month period ended September 30, 2016 as compared to the same period in the prior year and same market net patient service revenue per radiation oncology treatment decreased 2.2% for the nine month period ended September 30, 2016 as compared to the same period in the prior year. 

The number of open cases in our international line of business for the nine month period ended September 30, 2016 increased 7.3% as compared to the same period in the prior year.  Due to devaluation in the Argentine Peso, revenue per radiation oncology case declined 15.4% for the nine month period ended September 30, 2016 as compared to the same period in the prior year. Excluding the impact of currency fluctuations, international revenue per case increased by approximately 26.3%

Recent Developments

On November 1, 2016, the Company announced that it failed to make a semi-annual interest payment as required by the indenture governing its 11.00% Senior Notes due 2023. The failure to make such interest payment, if not cured within 30 days, will result in an event of default under the Indenture.  The Company is using the available cure period to work with its lenders, bondholders and stakeholders to address the default.

William R. Spalding, President and Chief Executive Officer, said, “The Company’s business strategy is fundamentally sound, with a unique, integrated cancer care model that positions us well in the healthcare reform marketplace. I also believe that our size and scale, low cost, outpatient model with convenient locations contribute to our uniqueness and value in the cancer care market. I remain confident that investors and lenders, whether a part of the organization today or those who want to be a part of its future, have the same perspective and that a path forward exists which should allow us to address near term liquidity issues and better position our overall capital structure for the future.”

Earnings Conference Call

The Company will host a conference call on Friday, November 18, 2016 at 10 am Eastern Time, during which management will discuss the financial results in further detail.  The conference call and replay of the conference call may be accessed as follows:

Dial-in numbers: 877-407-9039 (Domestic); 201-689-8470 (International)

Replay Dial-in Numbers (Available until December 2, 2016): 844-512-2921 (Domestic); 412-317-6671 (International); Replay Pin Number: 13650240

A live webcast and webcast replay of the call will also be available from the Events section of the corporate website at www.21co.com. 

About 21^st Century Oncology Holdings, Inc.

21^st Century Oncology Holdings, Inc. is the largest global provider of integrated cancer care services. The Company offers a comprehensive range of cancer treatment services, focused on delivering academic quality, cost-effective coordinated patient care in personal and convenient community settings. As of September 30, 2016, the Company operated 180 radiation treatment centers, including 144 centers located in 17 U.S. states and 36 centers located in seven countries in Latin America.

Forward-Looking Statements
This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Act of 1934, as amended. Statements preceded by, followed by or that otherwise include the words “believes”, “expects”, “anticipates”, “intends”, “projects”, “estimates”, “plans”, “may increase”, “forecast” and similar expressions or future or conditional verbs such as “will”, “should”, “would”, “may” and “could” are generally forward-looking in nature and not historical facts. Forward-looking statements are based on management’s current expectations or beliefs about the Company’s future plans, expectations and objectives. These forward-looking statements are not historical facts and are subject to risks and uncertainties that could cause the actual results to differ materially from those projected in these forward-looking statements including, but not limited to reductions in Medicare reimbursement, healthcare reform, state and federal investigations, claims and litigation matters, decreases in payments by managed care organizations and other commercial payers, liquidity, leverage ratios and compliance with other debt covenants  and other risk factors that may be described from time to time in the Company’s filings with the Securities and Exchange Commission. Readers of this release are cautioned not to place undue reliance on forward-looking statements contained herein, which speak only as of the date stated, or if no date is stated, as of the date of this press release. The Company undertakes no obligation to publicly update or revise the forward-looking statements contained herein to reflect changed events or circumstances after the date of this release, unless required by law.

21ST CENTURY ONCOLOGY HOLDINGS, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(in thousands, except share and per-share amounts)
		September 30,				December 31,
			2016				2015
		(unaudited)				(a)
ASSETS
Current assets:
Cash and cash equivalents		$	49,696			$	65,211
Restricted cash			300				195
Marketable securities			1,756				1,078
Accounts receivable, net			126,629				122,355
Prepaid expenses			10,494				7,822
Inventories			3,731				3,918
Income tax receivable			5,153				4,966
Other current assets			17,875				15,732
Total current assets			215,634				221,277
Equity investments in joint ventures			15,209				1,214
Property and equipment, net			214,695				238,585
Real estate subject to finance obligation			14,970				12,631
Goodwill			491,742				498,680
Intangible assets, net			59,481				70,115
Embedded derivative & other financial instrument features of
Series A convertible redeemable preferred stock			499				17,883
Other long-term assets			40,487				41,588
Deferred income taxes			2,243				1,888
Total assets		$	1,054,960			$	1,103,861
LIABILITIES AND DEFICIT
Current liabilities:
Accounts payable		$	57,666			$	59,888
Accrued expenses			82,879				111,653
Income taxes payable			3,697				2,501
Current portion of long-term debt			1,106,662				1,023,877
Current portion of finance obligation			230				283
Other current liabilities			11,620				14,265
Total current liabilities			1,262,754				1,212,467
Long-term debt, less current portion			17,731				49,233
Finance obligation, less current portion			15,641				13,318
Embedded derivative & other financial instrument features of
Series A convertible redeemable preferred stock			24,843				19,911
Other long-term liabilities			71,298				70,928
Deferred income taxes			4,989				3,887
Total liabilities			1,397,256				1,369,744
Series A convertible redeemable preferred stock, $0.001 par value, $1,000 stated
value, 3,500,000 authorized, 410,000 and 385,000 issued and outstanding
at September 30, 2016 and December 31, 2015, respectively			472,349				389,514
Noncontrolling interests - redeemable			19,247				19,233
Commitments and Contingencies
Equity:
Common stock, $0.01 par value, 1,000,000 shares authorized
1,059 shares issued and outstanding at September 30, 2016
and December 31, 2015			-				-
Additional paid-in capital			521,350				579,920
Retained deficit			(1,323,777	)			(1,226,298	)
Accumulated other comprehensive loss, net of tax			(58,966	)			(54,574	)
Total 21st Century Oncology Holdings, Inc. shareholder's deficit			(861,393	)			(700,952	)
Noncontrolling interests - nonredeemable			27,501				26,322
Total deficit			(833,892	)			(674,630	)
Total liabilities and deficit		$	1,054,960			$	1,103,861
(a)  Derived from audited financial statements

 

21ST CENTURY ONCOLOGY HOLDINGS, INC.
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS
(in thousands)
(unaudited)
		Three Months Ended							Nine Months Ended
		September 30,							September 30,
			2016			2015				2016			2015
Revenues:
Net patient service revenue		$	226,505		$	243,768			$	715,974		$	755,877
Management fees			14,240			14,180				43,514			45,261
Other revenue			4,934			4,309				14,872			14,965
Total revenues			245,679			262,257				774,360			816,103
Expenses:
Salaries and benefits			136,859			142,640				414,610			436,996
Medical supplies			22,211			22,498				74,215			73,563
Facility rent expenses			17,440			16,983				52,304			50,821
Other operating expenses			16,007			15,951				47,678			46,994
General and administrative expenses			35,344			68,306				101,070			141,341
Depreciation and amortization			21,319			22,439				63,412			66,775
Provision for doubtful accounts			8,610			5,617				17,270			13,683
Interest expense, net			27,151			23,771				77,353			73,836
Other gains and losses			481			(5,696	)			(12,699	)		(7,363	)
Impairment loss			770			-				2,595			-
Early extinguishment of debt			-			-				-			37,390
Fair value measurements			34,976			1,799				22,187			8,404
Gain (loss) on foreign currency transactions			(5	)		333				300			537
Total expenses			321,163			314,641				860,295			942,977
Loss before income taxes and equity interest in net
income of joint ventures			(75,484	)		(52,384	)			(85,935	)		(126,874	)
Income tax expense			3,166			2,851				7,967			7,198
Net loss before equity interest in net income (loss)
of joint ventures			(78,650	)		(55,235	)			(93,902	)		(134,072	)
Equity interest in net income (loss) of joint ventures, net of tax			150			(10	)			957			202
Net loss			(78,500	)		(55,245	)			(92,945	)		(133,870	)
Net  income attributable to noncontrolling
interests- redeemable and non-redeemable			(1,422	)		(2,530	)			(4,534	)		(6,610	)
Net loss attributable to 21st Century
Oncology Holdings, Inc. shareholder			(79,922	)		(57,775	)			(97,479	)		(140,480	)
Other comprehensive loss, net of tax:
Unrealized loss on foreign currency translation			(1,150	)		(2,415	)			(5,146	)		(6,414	)
Other comprehensive loss			(1,150	)		(2,415	)			(5,146	)		(6,414	)
Comprehensive loss			(79,650	)		(57,660	)			(98,091	)		(140,284	)
Comprehensive income attributable to noncontrolling
interests- redeemable and non-redeemable			(1,429	)		(2,067	)			(3,780	)		(5,599	)
Comprehensive loss attributable to 21st Century
Oncology Holdings, Inc. shareholder		$	(81,079	)	$	(59,727	)		$	(101,871	)	$	(145,883	)

 

21ST CENTURY ONCOLOGY HOLDINGS, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(in thousands)
(unaudited)
						Nine Months Ended
						September 30,
							2016				2015
Cash flows from operating activities
Net loss						$	(92,945	)		$	(133,870	)
Adjustments to reconcile net loss to net cash (used in) provided by
	operating activities:
	Depreciation and amortization						63,412				66,775
	Deferred rent expense						200				356
	Deferred income taxes						739				(912	)
	Stock-based compensation						-				6
	Provision for doubtful accounts						17,270				13,683
	Gain on the sale/disposal of property and equipment						(480	)			(203	)
	Gain on the contribution of a radiation facility to a joint venture						(12,629	)			-
	Gain on the sale of marketable securities						-				(2	)
	Impairment loss						2,595				-
	Early extinguishment of debt						-				37,390
	Debt modification costs						5,910				-
	Loss on foreign currency transactions						158				298
	Fair value adjustment of earn-out liabilities						1				(518	)
	Fair value adjustment of embedded derivatives and other financial instruments						22,186				8,922
	Amortization of debt discount						1,415				1,228
	Amortization of loan costs						3,229				3,675
	Paid in kind interest on notes payable						1,888				370
	Equity interest in net income of joint ventures, net of tax						(957	)			(202	)
	Distribution received from unconsolidated joint ventures						269				106
	Pension plan contributions						(927	)			(1,756	)
	Changes in operating assets and liabilities:
				Accounts receivable and other current assets			(26,974	)			(34,277	)
				Prepaid expenses and other assets			597				2,192
				Inventories			231				(624	)
				Accounts payable			(2,214	)			4,500
				Accrued deferred compensation			1,198				1,057
				Income taxes payable			843				435
				Accrued expenses / other liabilities			(27,849	)			64,692
Net cash (used in) provided by operating activities							(42,834	)			33,321
Cash flows from investing activities
Purchase of property and equipment							(24,204	)			(33,595	)
Acquisition of medical practices							(129	)			(33,064	)
Change in restricted cash associated with medical practice acquisitions							(105	)			7,009
Proceeds from the sale of equity interest in a joint venture							6,170				-
Purchase of joint venture interests							(502	)			-
Proceeds from the sale of property and equipment							124				1,143
Purchase of marketable securities							(711	)			(4,633	)
Sale of marketable securities							-				4,013
(Loans to) repayments from employees							(221	)			353
Distribution received from joint venture entities							-				496
Purchase of company owned life insurance policies							(1,105	)			(1,015	)
Change in other assets and other liabilities							545				45
Net cash used in investing activities							(20,138	)			(59,248	)

 

21ST CENTURY ONCOLOGY HOLDINGS, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(in thousands)
(unaudited)
						Nine Months Ended
						September 30,
							2016				2015
Cash flows from financing activities
Proceeds from issuance of debt							62,748				972,851
Principal repayments of debt							(27,582	)			(921,871	)
Repayments of finance obligation							(200	)			(168	)
Proceeds from issuance of Series A convertible redeemable preferred stock							25,000				-
Payments of issue costs related to the issuance of preferred stock							(30	)			-
Proceeds from issuance of noncontrolling interest							-				743
Proceeds from noncontrolling interest holders - redeemable and non-redeemable							-				3,230
Purchase of noncontrolling interest - non-redeemable							-				(16,233	)
Cash distributions to noncontrolling interest holders - redeemable
	and non-redeemable						(3,208	)			(4,072	)
Payments for contingent considerations							(149	)			(8,537	)
Payment of call premium on long-term debt							-				(24,877	)
Payment of debt modification costs							(5,910	)			-
Payment of other financing costs							(552	)			-
Payments of loan costs							(2,638	)			(26,481	)
Net cash provided by (used in) financing activities							47,479				(25,415	)
Effect of exchange rate changes on cash and cash equivalents							(22	)			(15	)
Net decrease in cash and cash equivalents							(15,515	)			(51,357	)
Cash and cash equivalents, beginning of period							65,211				99,082
Cash and cash equivalents, end of period						$	49,696			$	47,725

21ST CENTURY ONCOLOGY HOLDINGS, INC.
Supplemental Financial Information (Unaudited)
Reconciliation of Total Pro-forma Revenue and Pro-forma Adjusted EBITDA to Net Loss Attributable
to 21st Century Oncology Holdings, Inc. Shareholder
	Three Months Ended							Nine Months Ended
	September 30,							September 30,
		2016			2015				2016			2015
(in thousands):
Total revenues	$	245,679		$	262,257			$	774,360		$	816,103
Pro-forma full period effect of acquisitions (a)		-			169				-			1,183
Total pro-forma revenues	$	245,679		$	262,426			$	774,360		$	817,286
Net income (loss) attributable to 21st Century
Oncology Holdings, Inc. shareholder	$	(79,922	)	$	(57,775	)		$	(97,479	)	$	(140,480	)
Income tax expense		3,166			2,851				7,967			7,198
Interest expense, net		27,151			23,771				77,353			73,836
Depreciation and amortization		21,319			22,439				63,412			66,775
Gain on the contribution of a radiation facility to a joint venture		-			-				(12,629	)		-
Gain on BP settlement		-			(5,796	)			(517	)		(5,796	)
Impairment loss		770			-				2,595			-
Early extinguishment of debt		-			-				-			37,390
Fair value adjustment of earn-out liabilities		-			12				1			(518	)
Fair value adjustment of embedded derivatives
and other financial instruments		34,976			1,787				22,186			8,922
Net income attributable to noncontrolling interests,
net of cash distributions		(379	)		480				1,326			2,538
Other expenses (a)		6,226			2,200				9,961			6,145
Non-cash expenses (b)		800			944				2,433			3,293
Sale-lease back adjustments (c)		(359	)		4				(940	)		(760	)
Acquisition-related costs (d)		190			1,128				1,180			3,507
Litigation matters (e)		636			39,256				1,888			57,775
Expenses associated with debt/waiver amendments and
restatement of previously issued financial statements (f)		9,049			-				17,230			-
Pro-Forma full period effect of acquisition EBITDA (a)		-			117				-			467
Pro-Forma Adjusted EBITDA (1)	$	23,623		$	31,418			$	95,967		$	120,292
Pro-Forma Adjusted EBITDA as a percentage of
total revenues		9.6	%		12.0	%			12.4	%		14.7	%
(1) Pro-forma Adjusted EBITDA, as defined in our Credit Agreement, dated as of April 30, 2015, is calculated as
income (loss) before interest expense (net of interest income), income taxes, depreciation and amortization, net income attributable
to noncontrolling interests, net of cash distributions, gain on the sale of an interest in a joint venture, loss on sale leaseback
transaction, early extinguishment of debt, fair value adjustment of earn-out liability, fair value adjustment of embedded derivative,
impairment loss, foreign currency derivative contract loss (gain), management fees accrued to our sponsor, non-cash expenses
including costs relating to stock compensation, amortization of straight-line rent and amortization of capital expenditures relating
to repairs and maintenance, non-cash equipment rent, sale-lease back adjustments, acquisition-related costs, other expenses
including loss on sale of assets, severance payments related to termination of employee staff reductions, tail premiums on termed
physicians, franchise taxes, costs relating to consulting services on Medicare reimbursement, litigation settlements with physicians,
costs associated with tradename and rebranding initiatives, expenses associated with idle/closed radiation therapy treatment
facilities.
(a) Other expenses include management fees accrued to our sponsor, Vestar Capital Partners, loss on sale of assets, exit/disposal costs
severance payments related to termination of employee staff reductions, tail premiums paid on terminated physicians,
franchise taxes and costs relating to consulting services on Medicare reimbursement. Expenses related to the costs associated
with the Company's tradename and rebranding initiatives and expenses associated with idle/closed radiation therapy facilities and
costs associated with the CMS Medicare freeze.
(b) Non-cash expenses including costs relating to stock compensation, amortization of straight-line rent, amortization of capital
expenditures relating to warranty arrangements amortized to repairs and maintenance and non-cash equipment rent.
(c) Sale-lease back adjustments relates to the adjustment of benefit derived from the classification of operating leases as finance
obligations reflecting a reclassification of interest expense and depreciation and amortization expense as rent expense.
(d) Acquisition related costs associated with ASC 805, "Business Combinations," including professional fees, corporate
development, integration and due diligence costs relating to the acquisition of medical practices.
(e) Litigation matters relate to loss contingency reserves related to the Medicare investigative matters and costs associated with the
termination of physicians.
(f) Expenses associated with debt/waiver amendments and accounting, legal and consulting fees associated with the restatement of
previously issued financial statements.
We believe the Pro-Forma Adjusted EBITDA provides useful information about our financial performance to investors, lenders, financial
analysts and rating agencies as these groups have historically used EBITDA-related measures in the healthcare industry, along
with other measures, to estimate the value of a company, to make informed investment decisions, to evaluate a company's leverage
capacity and its ability to meet its debt service requirements.  Pro-Forma Adjusted EBITDA eliminates the uneven effect of non-cash
depreciation of tangibles assets and amortization of intangible assets, much of which results from acquisitions accounted for under
the purchase method of accounting.  Pro-Forma Adjusted EBITDA is also used by us to measure individual performance for incentive
compensation purposes and as an analytical indicator for purposes of allocating resources to our operating business and assessing
their performance, both internally and relative to our peers, as well as to evaluate the performance of our operating management teams,
and for purposes in the calculation of debt covenants and related disclosures.
Pro-Forma Adjusted EBITDA is not intended as a substitute for net income (loss) attributable to 21st Century Oncology Holdings, Inc.
shareholder, operating cash flows or other cash flow data determined in accordance with accounting principles generally accepted in the
United States. Due to varying methods of calculation, Pro-Forma Adjusted EBITDA as presented may not be comparable to similarly
titled measures of other companies.

 

	21ST CENTURY ONCOLOGY HOLDINGS, INC.
	KEY OPERATING STATISTICS
	(unaudited)
		Three Months Ended												Nine Months Ended
		September 30,								%				September 30,								%
Operating Metrics			2016				2015			Change					2016				2015			Change
	Number of operating days		64				64				0.0	%			192				191				0.5	%
	Domestic
	Radiation oncology treatment plans (total) (1)		8,816				8,832				-0.2	%			27,039				27,481				-1.6	%
	Radiation oncology treatments per day (total)		3,083				3,124				-1.3	%			3,167				3,265				-3.0	%
	Net patient service revenue per radiation oncology	$	727			$	754				-3.6	%		$	737			$	750				-1.8	%
	treatment (total)
	Radiation oncology treatment plans (same market) (1,2)		8,814				8,569				2.9	%			26,879				26,860				0.1	%
	Radiation oncology treatments per day (same market) (2)		3,079				3,066				0.4	%			3,159				3,205				-1.4	%
	Net patient service revenue per radiation oncology
	treatment (same market) (2)	$	728			$	751				-3.1	%		$	735			$	752				-2.2	%
	International
	Total number of open cases		5,094				4,907				3.8	%			15,055				14,034				7.3	%
	Revenue per radiation oncology case	$	5,525			$	6,421				-14.0	%		$	5,273			$	6,230				-15.4	%
		Three Months Ended												Nine Months Ended
		September 30,								%				September 30,								%
Revenue Details			2016				2015			Change					2016				2015			Change
	Net patient service revenue per Consolidated Statements
	of Operations and Comprehensive Loss	$	226,505			$	243,768							$	715,974			$	755,877
	Less net patient service revenue ICC		(72,125	)			(79,292	)							(240,586	)			(255,654	)
	Less net patient service revenue professional services		(1,898	)			(1,820	)							(5,730	)			(6,180	)
	Plus net patient service revenue unconsolidated MSAs (3)		19,169				19,653								57,975				61,450
	Less international net patient service revenue		(28,142	)			(31,508	)							(79,384	)			(87,434	)
	Domestic freestanding net patient service revenue	$	143,509			$	150,801				-4.8	%		$	448,249			$	468,059				-4.2	%
		September 30,
Center Details			2016				2015
	Radiation therapy centers - freestanding (domestic)		132				134
	Radiation therapy centers - freestanding (international)		36				36
	Radiation therapy centers - professional / other		12				12
	Total radiation therapy centers		180				182
	(1) Total radiation oncology treatment plans represent the number
	of prescriptions issued by the physicians to start the treatment process.
	(2) Same market is defined as markets that have been open in excess of 12 months.
	This includes in-market acquisitions and conversion of existing professional only relationships to freestanding.
	(3) Medical services agreement

 

21st Century Oncology Contact:
LeAnne M. Stewart
Chief Financial Officer
239-931-7281
leanne.stewart@21co.com

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