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Delaware
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(State or other jurisdiction of
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98-0676666
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incorporation or organization)
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(I.R.S. Employer Identification No.)
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Title of each class
Common Stock, $0.10 par value per share
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Name of each exchange on which registered
The NASDAQ Stock Market LLC
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Large accelerated filer
o
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Accelerated filer
o
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Non-accelerated filer
þ
(Do not check if a smaller reporting company)
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Smaller reporting company
o
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Page
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•
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each of the factors discussed in this Item 1A, Risk Factors as well as risks discussed elsewhere in this report;
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•
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each of the matters discussed in Item 3, Legal Proceedings;
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•
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our ability to recruit and retain qualified medical transcriptionists (“MTs”), medical editors (“MEs”), and other employees;
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•
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changes in law, including, without limitation, the impact HIPAA has on our business; and
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•
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the impact of our new services and products on the demand for our existing services and products.
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•
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M*Modal Fluency for Transcription
™
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•
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M*Modal Fluency
™
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•
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M*Modal Fluency Mobile
™
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•
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M*Modal Fluency Direct
™
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•
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M*Modal Fluency for Practices
™
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•
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M*Modal Fluency for Imaging
™
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•
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M*Modal Fluency for Coding
™
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•
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in-house service departments of healthcare providers, which we believe produce the majority of clinical documentation today based on the physician narrative;
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•
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national medical transcription service providers, such as Nuance;
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•
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local or regional medical transcription service organizations;
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•
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ASR software vendors, such as Nuance, which market ASR as a means to reduce clinical documentation labor; and
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•
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EHR software vendors which promote their systems as a replacement to narrative-based input by using on-screen templates and drop-down boxes for data entry.
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•
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Leader in a large, fragmented market:
We are one of the largest providers by revenue of clinical documentation solutions based on the physician narrative in the United States. Our size allows us to handle the clinical documentation requirements of many of the largest and most complex healthcare delivery networks in the United States, provides us with economies of scale, and we believe enables us to devote significantly more resources to enhancing our solutions through research than most of our competitors. Our clients include approximately 3,000 hospitals and clinics - including some of the nation's leading healthcare institutions - approximately 850 physician practices and approximately 200,000 physicians - as well as leading EHR application providers and medical transcription organizations. The average tenure of our top 50 customers is more than five years, and the majority of our revenue is generated from recurring services
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•
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Highly-efficient operating model:
Over the past two years, we have driven down our cost structure through leveraging our scalable infrastructure, standardizing processes, increased utilization of ASR and utilizing our global delivery capabilities. Our use of ASR, which has grown from 39% of our volume in the fourth quarter of 2008 to 74% in the fourth quarter of 2011, has increased our productivity. Additionally, our expanding footprint in India has enabled us to increase our offshore production from 28% of our volume to 47% over this same period. The financial impact of these measures has been an improvement in gross margins during this timeframe from 34% to 46%.
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•
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Integrated solutions delivered as a complete managed service:
We offer fully-integrated end-to-end managed services that capture and convert the physician narrative into a high quality customized electronic record. We integrate technologies and services for front-end speech, voice capture and transmission, ASR, medical transcription and editing, and clinical documentation workflow automation. The end result is value-added clinical documentation with high accuracy and quick turn-around times.
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•
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Cloud enabled solutions:
Because our Company's solutions are available via the cloud, they can be accessed from any internet-ready input device (computers, smartphones, tablets, etc.) and have their unique voice recognized from within any software application and can be used with any clinical software application. Additionally, they can be deployed without the traditional on-premise hardware requirements, which is particularly valuable in mobility solutions.
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•
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Leader in Speech and Language Understanding™:
We believe we are the only provider that can deliver Speech and Language Understanding™ capabilities beyond that of simple speech recognition to capture the context and meaning of speech, and convert it to clinically-relevant documents within a single process. This drives such benefits as ICD-10 coding transition, improved quality reporting, greater business intelligence for accurate reimbursement and enhanced quality of care. We provide true language-understanding services. This is much more than simple speech recognition that only captures the words from dictation. Within healthcare we are a market leader in front end speech recognition with a large client base of providers.
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•
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Ecosystem of partners:
We believe our ability to enable other forms of clinical documentation improve physician productivity and satisfaction, enhance revenue cycle performance, facilitate the adoption of EHR and achievement of Meaningful Use, and position healthcare for the future of ICD-10 coding initiatives. We work with an ecosystem of more than 40 partners that include EHR developers such as Allscripts, Greenway Health Systems and Merge Healthcare, imaging technology solution providers and leading healthcare institutions providing their own health record solutions.
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•
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Proven management team
: We have assembled an outstanding senior leadership team with significant industry experience and domain expertise in both domestic and offshore operations. Our management team has delivered substantial results and brings an entrepreneurial spirit with proven experience in managing growth, driving operational improvements and successfully integrating acquisitions.
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•
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physician, hospital and other healthcare provider demand for speech-enabled applications; and
|
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•
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continuous improvement in speech recognition and natural language understanding technology.
|
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•
|
increasing the difficulty of our ability to make payments on our outstanding debt;
|
|
•
|
increasing our vulnerability to general economic and industry conditions because our debt payment obligations may limit our ability to use our cash to respond to or defend against changes in the industry or the economy;
|
|
•
|
requiring a substantial portion of our cash flow from operations to be dedicated to the payment of principal and interest on our indebtedness, therefore reducing our ability to use our cash flow to fund our operations, capital expenditures and future business opportunities;
|
|
•
|
limiting our ability to obtain additional financing for working capital, capital expenditures, debt service requirements, acquisitions and general corporate or other purposes;
|
|
•
|
limiting our ability to pursue our growth strategy, including restricting us from making strategic acquisitions or causing us to make non-strategic divestitures; and
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•
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placing us at a disadvantage compared to our competitors who are less leveraged and may be better able to use their cash flow to fund competitive responses to changing industry, market or economic conditions.
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•
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enforce assignment and/or license agreements against our third-party developers;
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•
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enforce our issued patents;
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•
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protect our trade secrets or know-how;
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•
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enforce non-compete agreements; or
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•
|
determine the enforceability, scope and validity of the proprietary rights of others.
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•
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require us to seek licenses from third-parties;
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•
|
prevent us from selling our products in certain markets or at all;
|
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•
|
subject us to significant liabilities to third-parties; or
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•
|
require us to modify or remove our products from the market.
|
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•
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cause our customers to lose confidence in our solutions;
|
|
•
|
harm our reputation;
|
|
•
|
expose us to liability; and
|
|
•
|
increase our expenses from potential remediation costs.
|
|
•
|
difficulty in transitioning and integrating the operations and personnel of the acquired businesses;
|
|
•
|
potential disruption of our ongoing business and distraction of management;
|
|
•
|
potential difficulty in successfully implementing, upgrading and deploying in a timely and effective manner new operational information systems and upgrades of our finance, accounting and product distribution systems;
|
|
•
|
difficulty in incorporating acquired technology and rights into our products and technology;
|
|
•
|
potential difficulties in completing projects associated with in-process research and development;
|
|
•
|
unanticipated expenses and delays in completing acquired development projects and technology integration;
|
|
•
|
management of geographically remote business units both in the United States and internationally;
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|
•
|
impairment of relationships with partners and customers;
|
|
•
|
assumption of unknown material liabilities of acquired companies;
|
|
•
|
accurate projection of revenue plans of the acquired entity in the due diligence process;
|
|
•
|
customers delaying purchases of our products pending resolution of product integration between our existing and our newly acquired products;
|
|
•
|
entering markets or types of businesses in which we have limited experience; and
|
|
•
|
potential loss of key employees of the acquired business.
|
|
•
|
costs incurred to combine the operations of businesses we acquire, such as transitional employee expenses and employee retention, redeployment or relocation expenses;
|
|
•
|
impairment of goodwill or intangible assets;
|
|
•
|
amortization of intangible assets acquired;
|
|
•
|
a reduction in the useful lives of intangible asset acquired;
|
|
•
|
identification of or changes to assumed contingent liabilities, both income tax and non-income tax related after our final determination of the amounts for these contingencies or the conclusion of the measurement period (generally up to one year from the acquisition date), whichever comes first;
|
|
•
|
charges to our operating results to eliminate certain duplicative pre-merger activities, to restructure our operations or to reduce our cost structure;
|
|
•
|
charges to our operating results resulting from expenses incurred to effect the acquisition; and
|
|
•
|
charges to our operating results due to the expensing of certain stock awards assumed in an acquisition.
|
|
•
|
changes in political, regulatory, legal or economic conditions;
|
|
•
|
governmental actions, such as restrictions on the transfer or repatriation of funds and foreign investments;
|
|
•
|
civil disturbances, including terrorism or war;
|
|
•
|
political instability;
|
|
•
|
public health emergencies;
|
|
•
|
changes in employment practices and labor standards;
|
|
•
|
local business and cultural factors that differ from our customary standards and practices; and
|
|
•
|
changes in tax laws.
|
|
•
|
significant underperformance relative to historical or projected future operating results;
|
|
•
|
significant changes in the manner of or use of the acquired assets or the strategy for our overall business;
|
|
•
|
significant negative industry or economic trends;
|
|
•
|
significant decline in our stock price for a sustained period;
|
|
•
|
changes in our organization or management reporting structure that could result in additional reporting units, which may require alternative methods of estimating fair values or greater disaggregation or aggregation in our analysis by reporting unit; and
|
|
•
|
a decline in our market capitalization below net book value.
|
|
•
|
market conditions affecting our customers' businesses, including the level of mergers and acquisitions activity;
|
|
•
|
the loss of any major customers or the acquisition of new customers for our services;
|
|
•
|
announcements of new services or functions by us or our competitors;
|
|
•
|
actual and anticipated fluctuations in our quarterly operating results;
|
|
•
|
rumors relating to us or our competitors;
|
|
•
|
actions of stockholders, including sales of shares by our directors and executive officers;
|
|
•
|
additions or departures of key personnel; and
|
|
•
|
developments concerning current or future strategic alliances or acquisitions.
|
|
•
|
a classified board of directors;
|
|
•
|
limitations on the removal of directors;
|
|
•
|
advance notice requirements for stockholder proposals and nominations;
|
|
•
|
the inability of stockholders to act by written consent or to call special meetings;
|
|
•
|
the ability of our board of directors to make, alter or repeal our by-laws; and
|
|
•
|
the authority of our board of directors to issue preferred stock with such terms as our board of directors may determine.
|
|
|
Share price
|
||||||
|
|
(Dollars)
|
||||||
|
|
High
|
|
Low
|
||||
|
Quarter
|
|
|
|
||||
|
Fourth Quarter 2011
|
$
|
10.23
|
|
|
$
|
6.21
|
|
|
Third Quarter 2011
|
$
|
14.20
|
|
|
$
|
6.80
|
|
|
Second Quarter 2011
|
$
|
13.48
|
|
|
$
|
9.00
|
|
|
First Quarter 2011 (February 4, 2011 through March 31, 2011)
|
$
|
10.71
|
|
|
$
|
7.84
|
|
|
First Quarter 2011 (January 1 to January 27, 2011 until ceased trading on AIM )
|
$
|
10.03
|
|
|
$
|
9.46
|
|
|
|
Share price
|
||||||
|
|
(Dollars)
|
||||||
|
|
High
|
|
Low
|
||||
|
Quarter
|
|
|
|
||||
|
Fourth Quarter 2010
|
$
|
11.39
|
|
|
$
|
8.19
|
|
|
Third Quarter 2010
|
$
|
9.48
|
|
|
$
|
7.84
|
|
|
Second Quarter 2010
|
$
|
10.41
|
|
|
$
|
5.80
|
|
|
First Quarter 2010
|
$
|
14.89
|
|
|
$
|
4.39
|
|
|
(In thousands except per share data)
|
For years ended December 31,
|
||||||||||||||||||
|
|
2011 (a)
|
|
2010 (b)
|
|
2009
|
|
2008 (c)
|
|
2007
|
||||||||||
|
Net revenues
|
$
|
443,800
|
|
|
$
|
417,326
|
|
|
$
|
353,932
|
|
|
$
|
171,413
|
|
|
$
|
42,191
|
|
|
Net income (loss) from continuing operations
|
$
|
65,077
|
|
|
$
|
17,191
|
|
|
$
|
9,171
|
|
|
$
|
(99,460
|
)
|
|
$
|
(3,003
|
)
|
|
(Loss) income from discontinued operations, net of tax
|
$
|
(142
|
)
|
|
$
|
556
|
|
|
$
|
(1,351
|
)
|
|
$
|
(9,059
|
)
|
|
$
|
407
|
|
|
Net income (loss) attributable to MModal Inc.
|
$
|
62,797
|
|
|
$
|
8,507
|
|
|
$
|
735
|
|
|
$
|
(113,673
|
)
|
|
$
|
(2,596
|
)
|
|
Adjusted EBITDA
(1)
|
$
|
118,094
|
|
|
$
|
85,805
|
|
|
$
|
59,674
|
|
|
$
|
16,905
|
|
|
$
|
641
|
|
|
Net income (loss) per common share from continuing operations
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Basic
|
$
|
1.15
|
|
|
$
|
0.14
|
|
|
$
|
(0.02
|
)
|
|
$
|
(4.68
|
)
|
|
$
|
(0.23
|
)
|
|
Diluted
|
$
|
1.12
|
|
|
$
|
0.14
|
|
|
$
|
(0.02
|
)
|
|
$
|
(4.68
|
)
|
|
$
|
(0.23
|
)
|
|
Net income (loss) per common share from discontinued operations
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Basic
|
$
|
—
|
|
|
$
|
0.02
|
|
|
$
|
(0.04
|
)
|
|
$
|
(0.40
|
)
|
|
$
|
0.03
|
|
|
Diluted
|
$
|
—
|
|
|
$
|
0.02
|
|
|
$
|
(0.04
|
)
|
|
$
|
(0.40
|
)
|
|
$
|
0.03
|
|
|
Net income (loss) per common share attributable MModal Inc.
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Basic
|
$
|
1.15
|
|
|
$
|
0.16
|
|
|
$
|
(0.06
|
)
|
|
$
|
(5.08
|
)
|
|
$
|
(0.20
|
)
|
|
Diluted
|
$
|
1.12
|
|
|
$
|
0.16
|
|
|
$
|
(0.06
|
)
|
|
$
|
(5.08
|
)
|
|
$
|
(0.20
|
)
|
|
Weighted average shares
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Basic
|
48,959
|
|
|
35,012
|
|
|
34,692
|
|
|
22,593
|
|
|
12,873
|
|
|||||
|
Diluted
|
50,138
|
|
|
35,954
|
|
|
34,692
|
|
|
22,593
|
|
|
12,873
|
|
|||||
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
Cash and cash equivalents
|
$
|
29,557
|
|
|
$
|
66,779
|
|
|
$
|
29,633
|
|
|
$
|
42,868
|
|
|
$
|
2,667
|
|
|
Total assets
|
$
|
531,795
|
|
|
$
|
414,879
|
|
|
$
|
253,068
|
|
|
$
|
279,177
|
|
|
$
|
51,420
|
|
|
Long term debt, including current portion
|
$
|
296,534
|
|
|
$
|
294,494
|
|
|
$
|
107,340
|
|
|
$
|
126,008
|
|
|
$
|
14,075
|
|
|
Total equity
|
$
|
125,051
|
|
|
$
|
34,511
|
|
|
$
|
72,301
|
|
|
$
|
79,350
|
|
|
$
|
29,853
|
|
|
(1)
|
Adjusted EBITDA is a non-GAAP financial measure. Please see Management's Discussion and Analysis of Financial Condition and Results of Operation for a discussion of this non-GAAP financial measure as well as a reconciliation of Net income (loss) attributable to MModal Inc. to Adjusted EBITDA
|
|
(a)
|
Includes the reduction in our income tax valuation allowance of $54.4 million and a reduction of our accrual for the Customer Accommodation Program of $9.7 million. We also completed the Initial Public Offering, the Private and Public Exchange and the Short Form Merger as described under the Management Discussion and Analysis.
|
|
(b)
|
Includes the acquisition of Spheris in April 2010.
|
|
(c)
|
Includes a goodwill impairment charge of $99.0 million, and the acquisition of MModal MQ Inc. in August 2008.
|
|
▪
|
Consolidation within our industry;
|
|
▪
|
Reductions in overhead and other administrative costs;
|
|
▪
|
Improvements in the quality and delivery speed of transcribed medical reports;
|
|
▪
|
Access to leading technologies, such as speech recognition technology, without development and investment risk;
|
|
▪
|
Implementation and management of a medical transcription system tailored to the providers' specific requirements;
|
|
▪
|
Access to skilled MTs and MEs;
|
|
▪
|
Solutions for compliance with governmental and industry mandated privacy and security requirements; and
|
|
▪
|
Product offerings that interface with EHR initiatives.
|
|
▪
|
Production volumes;
|
|
▪
|
Adjusted EBITDA;
|
|
▪
|
Net cash provided by operating activities.
|
|
▪
|
our net book value compared to our fair value;
|
|
▪
|
significant adverse economic and industry trends;
|
|
▪
|
significant decrease in the market value of the asset;
|
|
▪
|
the extent that we use an asset or changes in the manner that we use it;
|
|
▪
|
significant changes to the asset since we acquired it; and
|
|
▪
|
other changes in circumstances that potentially indicate all or a portion of the company will be sold.
|
|
•
|
provide updated guidance on whether multiple deliverables exist, how the elements in an arrangement should be separated, and how the consideration should be allocated;
|
|
•
|
require an entity to allocate revenue in an arrangement using estimated selling prices (“ESP”) of each element if a vendor does not have vendor-specific objective evidence of selling price (“VSOE”) or third-party evidence of selling price (“TPE”); and eliminate the use of the residual method and require a vendor to allocate revenue using the relative selling price method.
|
|
|
Years ended December 31,
|
|
|
|
|
|||||||||||||||
|
|
2011
|
|
2010
|
|
|
|
|
|||||||||||||
|
(dollars in thousands)
|
Amount
|
|
% of Net
Revenues
|
|
Amount
|
|
% of Net
Revenues
|
|
$ Change
|
|
Change in % of Net Revenues
|
|||||||||
|
Net Revenues
|
$
|
443,800
|
|
|
100.0
|
%
|
|
$
|
417,326
|
|
|
100.0
|
%
|
|
$
|
26,474
|
|
|
—
|
%
|
|
Cost of revenues
|
255,566
|
|
|
57.6
|
%
|
|
259,194
|
|
|
62.1
|
%
|
|
(3,628
|
)
|
|
(4.5
|
)%
|
|||
|
Gross Profit
|
188,234
|
|
|
42.4
|
%
|
|
158,132
|
|
|
37.9
|
%
|
|
30,102
|
|
|
4.5
|
%
|
|||
|
Operating costs and expenses :
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
|
Selling, general and administrative expenses
|
64,188
|
|
|
14.5
|
%
|
|
61,062
|
|
|
14.6
|
%
|
|
3,126
|
|
|
(0.2
|
)%
|
|||
|
Research and development
|
9,570
|
|
|
2.2
|
%
|
|
12,030
|
|
|
2.9
|
%
|
|
(2,460
|
)
|
|
(0.7
|
)%
|
|||
|
Depreciation and amortization
|
37,826
|
|
|
8.5
|
%
|
|
32,617
|
|
|
7.8
|
%
|
|
5,209
|
|
|
0.7
|
%
|
|||
|
(Benefit) cost of legal proceedings and settlements
|
(6,678
|
)
|
|
(1.5
|
)%
|
|
3,605
|
|
|
0.9
|
%
|
|
(10,283
|
)
|
|
(2.4
|
)%
|
|||
|
Acquisition and restructuring
|
26,943
|
|
|
6.1
|
%
|
|
11,079
|
|
|
2.7
|
%
|
|
15,864
|
|
|
3.4
|
%
|
|||
|
Total operating costs and expenses
|
131,849
|
|
|
29.7
|
%
|
|
120,393
|
|
|
28.8
|
%
|
|
11,456
|
|
|
0.9
|
%
|
|||
|
Operating income
|
56,385
|
|
|
12.7
|
%
|
|
37,739
|
|
|
9.0
|
%
|
|
18,646
|
|
|
3.7
|
%
|
|||
|
Gain on the sale of investment
|
—
|
|
|
—
|
%
|
|
8,780
|
|
|
2.1
|
%
|
|
(8,780
|
)
|
|
(2.1
|
)%
|
|||
|
Equity in income of affiliated company
|
—
|
|
|
—
|
%
|
|
693
|
|
|
0.2
|
%
|
|
(693
|
)
|
|
(0.2
|
)%
|
|||
|
Other (expense) income
|
(5,405
|
)
|
|
(1.2
|
)%
|
|
460
|
|
|
0.1
|
%
|
|
(5,865
|
)
|
|
(1.3
|
)%
|
|||
|
Loss on extinguishment of debt
|
—
|
|
|
—
|
%
|
|
(13,525
|
)
|
|
(3.2
|
)%
|
|
13,525
|
|
|
3.2
|
%
|
|||
|
Interest expense, net
|
(29,301
|
)
|
|
(6.6
|
)%
|
|
(19,268
|
)
|
|
(4.6
|
)%
|
|
(10,033
|
)
|
|
(2.0
|
)%
|
|||
|
Income from continuing operations before income taxes and noncontrolling interest
|
21,679
|
|
|
4.9
|
%
|
|
14,879
|
|
|
3.6
|
%
|
|
6,800
|
|
|
1.3
|
%
|
|||
|
Income tax benefit
|
(43,398
|
)
|
|
(9.8
|
)%
|
|
(2,312
|
)
|
|
(0.6
|
)%
|
|
(41,086
|
)
|
|
(9.2
|
)%
|
|||
|
Net income from continuing operations
|
65,077
|
|
|
14.7
|
%
|
|
17,191
|
|
|
4.1
|
%
|
|
47,886
|
|
|
10.5
|
%
|
|||
|
(Loss) income from discontinued operations, net of tax
|
(142
|
)
|
|
—
|
%
|
|
556
|
|
|
0.1
|
%
|
|
(698
|
)
|
|
(0.2
|
)%
|
|||
|
(Loss) income from discontinued operations
|
(142
|
)
|
|
—
|
%
|
|
556
|
|
|
0.1
|
%
|
|
(698
|
)
|
|
(0.2
|
)%
|
|||
|
Net income
|
64,935
|
|
|
14.6
|
%
|
|
17,747
|
|
|
4.3
|
%
|
|
47,188
|
|
|
10.4
|
%
|
|||
|
Less: Net income attributable to noncontrolling interests
|
(2,138
|
)
|
|
(0.5
|
)%
|
|
(9,240
|
)
|
|
(2.2
|
)%
|
|
7,102
|
|
|
1.7
|
%
|
|||
|
Net income attributable to MModal Inc.
|
$
|
62,797
|
|
|
14.1
|
%
|
|
$
|
8,507
|
|
|
2.0
|
%
|
|
$
|
54,290
|
|
|
12.1
|
%
|
|
|
Years ended December 31,
|
|
|
|
|
|||||||||||||||
|
|
2010
|
|
2009
|
|
|
|
|
|||||||||||||
|
(dollars in thousands)
|
Amount
|
|
% of Net
Revenues
|
|
Amount
|
|
% of Net
Revenues
|
|
$ Change
|
|
Change in % of Net Revenues
|
|||||||||
|
Net Revenues
|
$
|
417,326
|
|
|
100.0
|
%
|
|
$
|
353,932
|
|
|
100.0
|
%
|
|
$
|
63,394
|
|
|
—
|
%
|
|
Cost of revenues
|
259,194
|
|
|
62.1
|
%
|
|
229,701
|
|
|
64.9
|
%
|
|
29,493
|
|
|
(2.8
|
)%
|
|||
|
Gross Profit
|
158,132
|
|
|
37.9
|
%
|
|
124,231
|
|
|
35.1
|
%
|
|
33,901
|
|
|
2.8
|
%
|
|||
|
Operating costs and expenses :
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
|
Selling, general and administrative expenses
|
61,062
|
|
|
14.6
|
%
|
|
53,089
|
|
|
15.0
|
%
|
|
7,973
|
|
|
(0.4
|
)%
|
|||
|
Research and development
|
12,030
|
|
|
2.9
|
%
|
|
9,604
|
|
|
2.7
|
%
|
|
2,426
|
|
|
0.2
|
%
|
|||
|
Depreciation and amortization
|
32,617
|
|
|
7.8
|
%
|
|
25,366
|
|
|
7.2
|
%
|
|
7,251
|
|
|
0.6
|
%
|
|||
|
Cost of legal proceedings and settlements
|
3,605
|
|
|
0.9
|
%
|
|
14,943
|
|
|
4.2
|
%
|
|
(11,338
|
)
|
|
(3.4
|
)%
|
|||
|
Acquisition and restructuring
|
11,079
|
|
|
2.7
|
%
|
|
3,973
|
|
|
1.1
|
%
|
|
7,106
|
|
|
1.5
|
%
|
|||
|
Total operating costs and expenses
|
120,393
|
|
|
28.8
|
%
|
|
106,975
|
|
|
30.2
|
%
|
|
13,418
|
|
|
(1.4
|
)%
|
|||
|
Operating income (loss)
|
37,739
|
|
|
9.0
|
%
|
|
17,256
|
|
|
4.9
|
%
|
|
20,483
|
|
|
4.2
|
%
|
|||
|
Gain on the sale of investment
|
8,780
|
|
|
2.1
|
%
|
|
—
|
|
|
—
|
%
|
|
8,780
|
|
|
2.1
|
%
|
|||
|
Equity in income of affiliated company
|
693
|
|
|
0.2
|
%
|
|
1,933
|
|
|
0.5
|
%
|
|
(1,240
|
)
|
|
(0.4
|
)%
|
|||
|
Other income
|
460
|
|
|
0.1
|
%
|
|
13
|
|
|
—
|
%
|
|
447
|
|
|
0.1
|
%
|
|||
|
Loss on extinguishment of debt
|
(13,525
|
)
|
|
(3.2
|
)%
|
|
—
|
|
|
—
|
%
|
|
(13,525
|
)
|
|
(3.2
|
)%
|
|||
|
Interest expense, net
|
(19,268
|
)
|
|
(4.6
|
)%
|
|
(9,019
|
)
|
|
(2.5
|
)%
|
|
(10,249
|
)
|
|
(2.1
|
)%
|
|||
|
Income from continuing operations before income taxes and noncontrolling interest
|
14,879
|
|
|
3.6
|
%
|
|
10,183
|
|
|
2.9
|
%
|
|
4,696
|
|
|
0.7
|
%
|
|||
|
Income tax (benefit) provision
|
(2,312
|
)
|
|
(0.6
|
)%
|
|
1,012
|
|
|
0.3
|
%
|
|
(3,324
|
)
|
|
(0.8
|
)%
|
|||
|
Net income from continuing operations
|
17,191
|
|
|
4.1
|
%
|
|
9,171
|
|
|
2.6
|
%
|
|
8,020
|
|
|
1.5
|
%
|
|||
|
Discontinued operations
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
|
Income (loss) from discontinued operations, net of tax
|
556
|
|
|
0.1
|
%
|
|
(1,351
|
)
|
|
(0.4
|
)%
|
|
1,907
|
|
|
0.5
|
%
|
|||
|
Income (loss) from discontinued operations
|
556
|
|
|
0.1
|
%
|
|
(1,351
|
)
|
|
(0.4
|
)%
|
|
1,907
|
|
|
0.5
|
%
|
|||
|
Net income
|
17,747
|
|
|
4.3
|
%
|
|
7,820
|
|
|
2.2
|
%
|
|
9,927
|
|
|
2.0
|
%
|
|||
|
Less: Net income attributable to noncontrolling interests
|
(9,240
|
)
|
|
(2.2
|
)%
|
|
(7,085
|
)
|
|
(2.0
|
)%
|
|
(2,155
|
)
|
|
(0.2
|
)%
|
|||
|
Net income attributable to MModal Inc.
|
$
|
8,507
|
|
|
2.0
|
%
|
|
$
|
735
|
|
|
0.2
|
%
|
|
$
|
7,772
|
|
|
1.8
|
%
|
|
(dollars in thousands)
|
2011
|
|
2010
|
|
2009
|
|
2008
|
|
2007
|
||||||||||
|
Net income (loss) attributable to MModal Inc.
|
$
|
62,797
|
|
|
$
|
8,507
|
|
|
$
|
735
|
|
|
$
|
(113,673
|
)
|
|
$
|
(2,596
|
)
|
|
Net income (loss) attributable to noncontrolling interest
|
2,138
|
|
|
9,240
|
|
|
7,085
|
|
|
5,154
|
|
|
(57
|
)
|
|||||
|
Income tax (benefit) provision
|
(43,398
|
)
|
|
(2,312
|
)
|
|
1,012
|
|
|
(5,531
|
)
|
|
(113
|
)
|
|||||
|
Interest expense, net
|
29,301
|
|
|
19,268
|
|
|
9,019
|
|
|
3,813
|
|
|
2,108
|
|
|||||
|
Depreciation and amortization
|
37,826
|
|
|
32,617
|
|
|
25,366
|
|
|
13,488
|
|
|
2,915
|
|
|||||
|
(Benefit) cost of legal proceedings and settlements
|
(6,678
|
)
|
|
3,605
|
|
|
14,943
|
|
|
5,311
|
|
|
—
|
|
|||||
|
Acquisition and restructuring
|
26,943
|
|
|
11,079
|
|
|
3,973
|
|
|
7,726
|
|
|
—
|
|
|||||
|
Other expense (income)
|
5,405
|
|
|
(460
|
)
|
|
(13
|
)
|
|
(9
|
)
|
|
—
|
|
|||||
|
Realized loss on settlement of foreign currency hedges
|
(364
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|||||
|
Goodwill impairment charge
|
—
|
|
|
—
|
|
|
—
|
|
|
89,633
|
|
|
—
|
|
|||||
|
Equity in income of affiliated company
|
—
|
|
|
(693
|
)
|
|
(1,933
|
)
|
|
(66
|
)
|
|
105
|
|
|||||
|
Gain on the sale of investment
|
—
|
|
|
(8,780
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|||||
|
Loss on extinguishment of debt
|
—
|
|
|
13,525
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|||||
|
Asset impairment charges, severance charges and accrual reversals
|
—
|
|
|
—
|
|
|
(1,864
|
)
|
|
2,000
|
|
|
—
|
|
|||||
|
Share based compensation and other non-cash awards
|
3,982
|
|
|
765
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|||||
|
Loss (income) from discontinued operations
|
142
|
|
|
(556
|
)
|
|
1,351
|
|
|
9,059
|
|
|
(1,721
|
)
|
|||||
|
Adjusted EBITDA
|
$
|
118,094
|
|
|
$
|
85,805
|
|
|
$
|
59,674
|
|
|
$
|
16,905
|
|
|
$
|
641
|
|
|
Adjusted EBITDA as a percentage of net revenues
|
26.6
|
%
|
|
20.6
|
%
|
|
16.9
|
%
|
|
9.9
|
%
|
|
1.5
|
%
|
|||||
|
•
|
potential differences caused by variations in capital structures (affecting interest expense, net), tax positions (such as the impact on periods or companies for changes in effective tax rates), the age and book depreciation of fixed assets (affecting depreciation expense);
|
|
•
|
the impact of non-cash charges; and
|
|
•
|
the impact of acquisition and integration related charges, restructuring charges, and certain unusual or nonrecurring items.
|
|
•
|
Adjusted EBITDA does not reflect our cash expenditures or future requirements for capital expenditures or contractual commitments;
|
|
•
|
Adjusted EBITDA does not reflect changes in, or cash requirements for, our working capital needs;
|
|
•
|
Although depreciation is a non-cash charge, the assets being depreciated will often have to be replaced in the future, and Adjusted EBITDA does not reflect any cash requirements for such replacements; and
|
|
•
|
Other companies in our industry may calculate Adjusted EBITDA differently than we do, limiting its usefulness as a comparative measure.
|
|
•
|
Improvement in net income, which increased to $64.9 million for the year ended December 31, 2011, compared to $17.7 million for the same period in the prior year;
|
|
•
|
Improved collections of accounts receivable balances provided $14.2 million of cash for the year ended December 31, 2011, compared to higher accounts receivable balances resulting in a use of cash of $10.0 million for the year ended December 31, 2010;
|
|
•
|
The prepayment of certain software licenses;
|
|
•
|
The timing of payments for accounts payable and other accrued liabilities;
|
|
•
|
Deferred income tax benefit of $46.9 million for the year ended December 31, 2011, compared to $3.9 million for the same period in the prior year;
|
|
•
|
The loss on extinguishment of debt in 2010 of $13.5 million; and
|
|
•
|
The Customer Accommodation Program reversal of $9.7 million in 2011.
|
|
•
|
addition of cash flows provided by Spheris operations;
|
|
•
|
acquisition and integration related charges associated with the Spheris acquisition;
|
|
•
|
cash received from the sale of A-Life and Patient Financial Services business;
|
|
•
|
restructuring payments; and
|
|
•
|
other working capital changes.
|
|
(dollars in thousands)
|
December 31,
|
|||||
|
|
2011
|
2010
|
||||
|
Senior Secured Credit Facility consisting of:
|
|
|
||||
|
Term loan
|
$
|
175,000
|
|
200,000
|
|
|
|
Revolving credit facility
|
25,000
|
|
—
|
|
||
|
Senior subordinated notes
|
85,000
|
|
85,000
|
|
||
|
Short-term credit facilities
|
5,982
|
|
3,597
|
|
||
|
Capital lease obligations
|
3,860
|
|
3,779
|
|
||
|
Equipment loans from banks
|
1,692
|
|
2,118
|
|
||
|
Total debt
|
296,534
|
|
294,494
|
|
||
|
Less: current portion
|
22,712
|
|
27,817
|
|
||
|
Long-term debt, net of current portion
|
$
|
273,822
|
|
$
|
266,677
|
|
|
(dollars in thousands)
|
Payment Due By Period
|
||||||||||||||||||
|
|
Total
|
|
Less than
1 Year
|
|
1-3 Years
|
|
3-5 Years
|
|
After
5 Years
|
||||||||||
|
Operating Lease Obligations
|
$
|
24,762
|
|
|
$
|
7,283
|
|
|
$
|
10,929
|
|
|
$
|
6,550
|
|
|
$
|
—
|
|
|
Purchase Obligations (1)
|
3,694
|
|
|
1,587
|
|
|
2,086
|
|
|
21
|
|
|
—
|
|
|||||
|
Deferred Acquisition Payments
|
41,840
|
|
|
23,052
|
|
|
15,822
|
|
|
2,966
|
|
|
—
|
|
|||||
|
Long-Term Debt (including current maturities)
|
296,534
|
|
|
22,712
|
|
|
163,737
|
|
|
110,085
|
|
|
—
|
|
|||||
|
Total Contractual Obligations
|
$
|
366,830
|
|
|
$
|
54,634
|
|
|
$
|
192,574
|
|
|
$
|
119,622
|
|
|
$
|
—
|
|
|
(1)
|
Purchase obligations are primarily for telecommunication contracts.
|
|
(a)
|
Documents filed as part of this report:
|
|
(b)
|
Exhibits:
|
|
Number
|
Description of Document
|
|
3.1
|
Certificate of Incorporation
|
|
|
|
|
3.2
|
Certificate of Ownership and Merger (Incorporated by reference to Exhibit 3.1 of the Current Report on our Form 8-K filed with the SEC on January 24, 2012 (File No. 001-35069))
|
|
|
|
|
3.3
|
By-Laws (Incorporated by reference to Exhibit 3.2 of the Current Report on our Form 8-K filed with the SEC on January 24, 2012 (File No. 001-35069))
|
|
|
|
|
4.1
|
Warrant Agreement, dated March 19, 2001, between MedQuist Holdings Inc. and Oosterveld International BV (Incorporated by reference to Exhibit 4.5 of Amendment No. 1 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
4.2
|
Senior Subordinated Note Purchase Agreement, dated as of September 30, 2010, among CBay Inc., MedQuist Inc. and MedQuist Transcriptions Ltd., CBaySystems Holdings Limited, BlackRock Kelso Capital Corporation, PennantPark Investment Corporation, Citibank, N.A. and THL Credit Inc. (Incorporated by reference to Exhibit 4.2 of Amendment No. 1 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. filed with the SEC on November 26, 2010 (File No. 333-169997))
|
|
|
|
|
4.3
|
Form of 13% Senior Subordinated Note due 2016 (included as part of Exhibit 4.3 and incorporated herein by reference)
|
|
|
|
|
4.4
|
Guaranty Agreement, dated as of September 30, 2010, among CBaySystems Holdings Limited, MedQuist IP LLC, MedQuist CM LLC, MedQuist Delaware, Inc. and Each Other Guarantor From Time to Time Party Hereto, BlackRock Kelso Capital Corporation, PennantPark Investment Corporation, Citibank, N.A. and THL Credit Inc. (Incorporated by reference to Exhibit 10.4 of Amendment No. 1 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. filed with the SEC on November 26, 2010 (File No. 333-169997))
|
|
|
|
|
4.5
|
Exchange Agreement, dated as of September 30, 2010, by and between CBaySystems Holdings Limited and the Investors signatories thereto (Incorporated by reference to Exhibit 4.4 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
4.6
|
Amendment No. 1 to the Exchange Agreement, dated as of December 30, 2010, by and between CBaySystems Holdings Limited and the Investors signatories thereto (Incorporated by reference to Exhibit 4.4.1 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
4.7
|
Form of common stock certificate (Incorporated by reference to Exhibit 4.1 to our Registration Statement on Form S-4/A filed with the SEC on October 3, 2011 (File No. 333-176582))
|
|
|
|
|
9.1
|
Voting Agreement, dated September 30, 2010, by and between CBaySystems Holdings Limited, S.A.C. PEI CB Investment, L.P., S.A.C. PEI CB Investment II, LLC and International Equities (S.A.C. Asia) Limited (Incorporated by reference to Exhibit 9.1 of Amendment No. 1 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. filed with the SEC on November 26, 2010 (File No. 333-169997))
|
|
|
|
|
10.1
|
Stock and Asset Purchase Agreement, dated April 15, 2010, between Spheris Holding II, Inc., Spheris Inc., Spheris Operations LLC, Vianeta Communications, Spheris Leasing LLC, Spheris Canada Inc., CBay Inc. and MedQuist Inc. (Incorporated by reference to Exhibit 10.1 of Amendment No. 1 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. filed with the SEC on November 26, 2010 (File No. 333-169997))
|
|
|
|
|
10.2
|
Credit Agreement, dated as of October 1, 2010, among CBay Inc., MedQuist Inc. and MedQuist Transcriptions, Limited, as Borrowers, CBaySystems Holdings Limited, as Holdings, the Lenders and L/C Issuers party thereto, General Electric Capital Corporation, as Administrative Agent and Collateral Agent, SunTrust Bank, as Syndication Agent, and ING Capital LLC and Regions Bank, as Co-Documentation Agents (Incorporated by reference to Exhibit 10.2 of Amendment No. 1 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. filed with the SEC on November 26, 2010 (File No. 333-169997))
|
|
|
|
|
10.3
|
Guaranty and Security Agreement, dated as of October 14, 2010, among CBay Inc., MedQuist Inc., MedQuist Transcriptions, Limited, General Electric Capital Corporation, as Administrative Agent and Collateral Agent, and Each Other Guarantor party thereto (Incorporated by reference to Exhibit 10.3 of Amendment No. 1 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.4
|
Subordination and Intercreditor Agreement, dated October 1, 2010, among BlackRock Kelso Capital Corporation, PennantPark Investment Corporation, Citibank, N.A. and THL Credit, Inc., CBay Inc., MedQuist Inc., MedQuist Transcriptions Ltd. and General Electric Corporation (Incorporated by reference to Exhibit 10.5 of Amendment No. 1 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.5
|
Agreement, dated August 19, 2008, between CBaySystems Holdings Limited, S.A.C. PEI CB Investment II, LLC and Lehman Brothers Commercial Corporation Asia Limited (Incorporated by reference to Exhibit 10.6 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.6
|
Registration Rights Agreement, dated as of February 9, 2011, among MedQuist Holdings, Inc., S.A.C. PEI CB Investment, L.P., S.A.C. PEI CB Investment II, LLC and International Equities (S.A.C. Asia) Limited (Incorporated by reference to Exhibit 10.6 of the Annual Report on Form 10-K filed with the SEC on March 16, 2011 (File No. 001-35069))
|
|
|
|
|
10.7
|
Stockholders Agreement, dated as of February 11, 2011, among MedQuist Holdings Inc., S.A.C. PEI CB Investment, L.P., S.A.C. PEI CB Investment II, LLC, International Equities (S.A.C. Asia) Limited and the other signatories party thereto (Incorporated by reference to Exhibit 10.7 of the Annual Report on Form 10-K filed with the SEC on March 16, 2011 (File No. 001-35069)).
|
|
|
|
|
10.8
|
Stockholders Agreement, dated as of February 4, 2011, among MedQuist Holdings Inc., S.A.C. PEI CB Investment, L.P., S.A.C. PEI CB Investment II, LLC and International Equities (S.A.C. Asia) Limited (Incorporated by reference to Exhibit 10.8 of the Annual Report on Form 10-K filed with the SEC on March 16, 2011 (File No. 001-35069))
|
|
|
|
|
10.9
|
Amended and Restated Management Stockholder's Agreement (Incorporated by reference to Exhibit 10.9 of the Annual Report on Form 10-K filed with the SEC on March 16, 2011 (File No. 001-35069))
|
|
|
|
|
10.10†
|
MedQuist Inc. 2002 Stock Option Plan (Incorporated by reference to Exhibit 10.15 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.11†
|
Form of Stock Option Agreement under the MedQuist Inc. 2002 Stock Option Plan (Incorporated by reference to Exhibit 10.16 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.12†
|
MedQuist Inc. Long-Term Incentive Plan adopted on August 27, 2009 (Incorporated by reference to Exhibit 10.17 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.13†
|
MedQuist Inc. Executive Deferred Compensation Plan, Amended and restated, Effective November 15, 2001 (Incorporated by reference to Exhibit 10.18 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.14†
|
MedQuist Transcriptions, Ltd. 2010 Management Incentive Plan (Incorporated by reference to Exhibit 10.19 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.15†
|
CBaySystems Holdings Limited 2007 Equity Incentive Plan (Incorporated by reference to Exhibit 10.11 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.16†
|
Form of Share Option Agreement in connection with the 2007 Equity Incentive Plan (Incorporated by reference to Exhibit 10.12 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.17†
|
MedQuist Holdings Inc. 2010 Senior Executive Bonus Plan (Incorporated by reference to Exhibit 10.19.1 of Amendment No. 5 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.18†
|
MedQuist Holdings Inc. 2010 Equity Incentive Plan (Incorporated by reference to Exhibit 10.13 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.19†
|
MedQuist Holdings Inc. 2010 Employee Stock Purchase Plan (Incorporated by reference to Exhibit 10.14 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.20†
|
Amended and Restated employment agreement by and between CBaySystems Holdings Limited, CBay Inc., CBay Systems (India) Pvt. Ltd. and V. Raman Kumar, dated as of December 6, 2010 (Incorporated by reference to Exhibit 10.21 of Amendment No. 5 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.21†
|
Employment agreement by and between CBaySystems Holdings Limited, CBay Inc. and Michael Seedman, dated as of August 8, 2008 (Incorporated by reference to Exhibit 10.23 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.22†
|
Employment agreement by and between CBaySystems Holdings Limited, CBay Inc. and Clyde Swoger, dated as of August 2008 (Incorporated by reference to Exhibit 10.24 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.23†
|
Employment Agreement between Anthony D. James and MedQuist Inc. for the position of Co-Chief Operating Officer dated June 24, 2010 (Incorporated by reference to Exhibit 10.29 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.24†
|
Offer of Employment between MedQuist Inc. and Michael Clark dated April 21, 2005 (Incorporated by reference to Exhibit 10.29.1 of Amendment No. 6 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.25†
|
Form of 2010 Amendment to Employment Agreement dated as of August 2008 (Incorporated by reference to Exhibit 10.25 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.26†
|
Form of Letter of Appointment from CBaySystems Holdings Limited to each non-executive director (Incorporated by reference to Exhibit 10.26 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.27†
|
Form of Deed of Variation to Letter of Appointment between each compensated non-executive director and CBaySystems Holdings Limited (Incorporated by reference to Exhibit 10.27 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.28
|
Form of Indemnification Agreement between MedQuist Holdings Inc. and certain Directors and Officers (Incorporated by reference to Exhibit 10.30 of Amendment No. 5 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.29
|
Form of Management Indemnification Agreement by and between MedQuist Inc. and Certain Officers (Incorporated by reference to Exhibit 10.30.1 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.30
|
First Amendment to the Form of Management Indemnification Agreement by and between MedQuist Inc. and Certain Officers (Incorporated by reference to Exhibit 10.30.2 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.31
|
Indemnification Agreement dated November 21, 2008 between MedQuist Inc. and Peter Masanotti (Incorporated by reference to Exhibit 10.31 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.32
|
Office Lease, dated June 2006, between Ford Motor Land Development Corporation and Spheris Operations Inc. (Incorporated by reference to Exhibit 10.32.1 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.33
|
Amendment to Office Lease Agreement, dated March 27, 2009, between Carothers Office Acquisition LLC and Spheris Operations, Inc. (Incorporated by reference to Exhibit 10.32.2 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.34
|
Assignment, Assumption and Agreement to Relinquish Office Space and Amendment to Office Lease Agreement, dated April 22, 2010 between Carothers Office Acquisition LLC and MedQuist Transcriptions, Ltd. (Incorporated by reference to Exhibit 10.32.3 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.35
|
First Amendment to Lease Agreement, dated March 1, 2009, by and between Atlanta Lakeside Real Estate, L.P. and MedQuist Transcriptions, Ltd. (Incorporated by reference to Exhibit 10.33.1 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.36
|
Second Amendment to Lease Agreement, effective August 1, 2009, by and between Atlanta Lakeside Real Estate, L.P. and MedQuist Transcriptions, Ltd. (Incorporated by reference to Exhibit 10.33.2 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.37#
|
Licensing Agreement, as amended, dated as of November 10, 2009, between MedQuist Inc. and Nuance Communications, Inc. (Incorporated by reference to Exhibit 10.34 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.38#
|
Third Amended and Restated OEM Supply Agreement dated November 10, 2009, between MedQuist Inc. and Nuance Communications, Inc. (Incorporated by reference to Exhibit 10.35 of Amendment No. 2 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.39#
|
Licensing Agreement by and between Nuance Communications, Inc. and MedQuist Inc., dated November 10, 2009 (Incorporated by reference to Exhibit 10.36 of Amendment No. 5 to the Registration Statement on Form S-1 of MedQuist Holdings Inc. (File No. 333-169997))
|
|
|
|
|
10.40
|
Redemption Agreement among Lehman Brothers Commercial Corporation Asia Limited, S.A.C. Private Equity Investors, L.P., S.A.C. PEI CB Investment, L.P. and S.A.C. PEI CB Investment GP, Limited and the Liquidators named therein (Incorporated by reference to Exhibit 10.44 of the Annual Report on Form 10-K filed with the SEC on March 16, 2011 (File No. 001-35069))
|
|
|
|
|
10.41
|
First Amendment to Credit Agreement, Waiver and Consent, dated as of July 11, 2011, by and among CBay Inc., MedQuist Inc., MedQuist Transcriptions, Ltd., MedQuist Holdings Inc., the other loan parties signatory thereto, the lenders signatory thereto, and General Electric Capital Corporation as agent for the lenders (Incorporated by reference to Exhibit 10.1 to the Current Report on Form 8-K filed with the SEC on July 12, 2011 (File No. 001-35069)).
|
|
|
|
|
10.42
|
Waiver and First Amendment to Senior Subordinated Note Purchase Agreement, dated as of July 11, 2011, by and among CBay Inc., MedQuist Inc., MedQuist Transcriptions, Ltd., MedQuist Holdings Inc., BlackRock Kelso Capital Corporation, PennantPark Investment Corporation, Citibank, N.A. and THL Credit, Inc. (Incorporated by reference to Exhibit 10.2 to the Current Report on Form 8-K filed with the SEC on July 12, 2011 (File No. 001-35069)).
|
|
|
|
|
10.43
|
Second Amendment to Senior Subordinated Note Purchase Agreement, dated as of July 11, 2011, by and among CBay, Inc., MedQuist Inc., MedQuist Transcriptions, Ltd., MedQuist Holdings Inc., BlackRock Kelso Capital Corporation, PennantPark Investment Corporation, Citibank, N.A. and THL Credit, Inc. (Incorporated by reference to Exhibit 10.3 to the Current Report on Form 8-K filed with the SEC on July 12, 2011 (File No. 001-35069)).
|
|
|
|
|
10.44†
|
Employment Agreement by and between MedQuist Holdings Inc. and Roger L. Davenport dated July 11, 2011 (Incorporated by reference to Exhibit 10.4 to the Current Report on Form 8-K filed with the SEC on July 12, 2011 (File No. 001-35069)).
|
|
|
|
|
10.45
|
Restricted Stock Agreement, dated as of July 11, 2011, by and between MedQuist Holdings Inc. and Roger L. Davenport (Incorporated by reference to Exhibit 10.5 to the Current Report on Form 8-K filed with the SEC on July 12, 2011 (File No. 001-35069)).
|
|
|
|
|
10.46†
|
Separation Agreement by and between MedQuist Holdings Inc., MedQuist Inc. and Peter Masanotti dated July 11, 2011 (Incorporated by reference to Exhibit 10.6 to the Current Report on Form 8-K filed with the SEC on July 12, 2011 (File No. 001-35069)).
|
|
|
|
|
10.47†
|
Agreement and Release, dated August 2, 2011, by and between Robert Aquilina and the Company Group (Incorporated by reference to Exhibit 10.1 to the Current Report on Form 8-K filed with the SEC on August 16, 2011 (File No. 001-35069)).
|
|
|
|
|
10.48†
|
Separation Agreement and General Release, dated August 2, 2011, by and between Michael Seedman and the Company (Incorporated by reference to Exhibit 10.2 to the Current Report on Form 8-K filed with the SEC on August 16, 2011 (File No. 001-35069)).
|
|
|
|
|
10.49†
|
Amendment to Share Option Agreement, dated August 2, 2011, by and between Robert Aquilina and the Company. (Incorporated by reference to Exhibit 10.3 to the Current Report on Form 8-K filed with the SEC on August 16, 2011 (File No. 001-35069)).
|
|
|
|
|
10.50†
|
Amendment to Share Option Agreement, effective August 2, 2011, by and between Michael Seedman and the Company (Incorporated by reference to Exhibit 10.4 to the Current Report on Form 8-K filed with the SEC on August 16, 2011(File No. 001-35069)).
|
|
|
|
|
10.51
|
Subordinated Intercompany Note dated as of August 18, 2011 issued by CBay Inc. in favor of MedQuist Inc. (Incorporated by reference to Exhibit 10.1 to the Current Report on Form 8-K filed with the SEC on August 23, 2011 (File No. 001-35069)).
|
|
|
|
|
10.52
|
Amendment No. 1 to Registration Rights Agreement dated as of August 18, 2011 by and among the Company and S.A.C. PEI CB Investment L.P., S.A.C. PEI CB Investment II, LLC and International Equities (S.A.C. Asia) Limited (Incorporated by reference to Exhibit 10.2 to the Current Report on Form 8-K filed with the SEC on August 23, 2011 (File No. 001-35069)).
|
|
|
|
|
10.53
|
Stockholders' Agreement dated as of August 18, 2011 by and among the Company and the other parties listed on the signature pages thereto (Incorporated by reference as an Exhibit to the Registration Statement on Form S-4 filed with the SEC on August 31, 2011 (File No. 001-35069)).
|
|
|
|
|
10.54†
|
Employment Agreement, dated August 15, 2011, by and between the Company and Ronald L. Scarboro (Incorporated by reference to Exhibit 10.1 to the Current Report on Form 8-K filed with the SEC on September 8, 2011 (File No. 001-35069)).
|
|
10.55†
|
Restricted Stock Award Agreement, dated August 15, 2011, by and between the Company and Ronald L. Scarboro (Incorporated by reference to Exhibit 10.2 to the Current Report on Form 8-K filed with the SEC on September 8, 2011 (File No. 001-35069)).
|
|
|
|
|
10.56
|
Second Amendment to Credit Agreement, dated as of September 14, 2011, by and among CBay Inc., MedQuist Inc., MedQuist Transcriptions, Ltd., MedQuist Holdings Inc., the other loan parties signatory thereto, the lenders signatory thereto, and General Electric Capital Corporation, as agent for the lenders (Incorporated by reference as an Exhibit to the Current Report on Form 8-K filed with the SEC on September 20, 2011 (File No. 001-35069)).
|
|
|
|
|
10.57#
|
Fee Agreement dated June 30, 2011, by and between Nuance Communications, Inc. and MedQuist Inc. (Incorporated by reference to Exhibit 10.1 to the Quarterly Report on Form 10-Q for the quarterly period ended June 30, 2011 (File No. 001-35069)).
|
|
|
|
|
10.58†
|
Employment Agreement, dated August 18, 2011, by and between the Company and Michael Finke (Incorporated by reference to Exhibit 10.55 of Amendment No. 1 to our Registration Statement on Form S-4 filed with the SEC on October 4, 2011 (File No. 333-176582)).
|
|
|
|
|
10.59†
|
Restricted Stock Award Agreement, dated August 18, 2011, by and between the Company and Michael Finke (Incorporated by reference to Exhibit 10.56 of Amendment No. 1 to our Registration Statement on Form S-4 filed with the SEC on October 4, 2011 (File No. 333-176582)).
|
|
|
|
|
10.60†
|
Restrictive Covenant Agreement, dated August 18, 2011, by and between the Company and Michael Finke (Incorporated by reference to Exhibit 10.57 of Amendment No. 1 to our Registration Statement on Form S-4 filed with the SEC on October 4, 2011 (File No. 333-176582)).
|
|
|
|
|
10.61†
|
Employment Agreement, dated August 18, 2011, by and between the Company and Juergen Fritsch (Incorporated by reference to Exhibit 10.58 of Amendment No. 1 to our Registration Statement on Form S-4 filed with the SEC on October 4, 2011 (File No. 333-176582)).
|
|
|
|
|
10.62†
|
Restricted Stock Award Agreement, dated August 18, 2011, by and between the Company and Juergen Fritsch (Incorporated reference to Exhibit 10.59 of Amendment No. 1 to our Registration Statement on Form S-4 filed with the SEC on October 4, 2011 (File No. 333-176582)).
|
|
|
|
|
10.63†
|
Restrictive Covenant Agreement, dated August 18, 2011, by and between the Company and Juergen Fritsch (Incorporated by reference to Exhibit 10.60 of Amendment No. 1 to our Registration Statement on Form S-4 filed with the SEC on October 4, 2011 (File No. 333-176582)).
|
|
|
|
|
10.64†
|
Employment Agreement, dated August 18, 2011, by and between the Company and Detlef Koll (Incorporated by reference to Exhibit 10.61 of Amendment No. 1 to our Registration Statement on Form S-4 filed with the SEC on October 4, 2011 (File No. 333-176582)).
|
|
|
|
|
10.65†
|
Restricted Stock Award Agreement, dated August 18, 2011, by and between the Company and Detlef Koll (Incorporated by reference to Exhibit 10.62 of Amendment No. 1 to our Registration Statement on Form S-4 filed with the SEC on October 4, 2011 (File No. 333-176582)).
|
|
|
|