Integer Holdings Corporation (NYSE:ITGR), a leading medical device outsource manufacturer, today announced results for the three months ended September 29, 2023.

Third Quarter 2023 Highlights (compared to Third Quarter 2022, except as noted)

  • Sales increased 18% to $405 million, with organic growth of 18%.
  • GAAP net income increased $11 million to $27 million, an increase of 70%. Non-GAAP adjusted net income increased $11 million to $43 million, an increase of 35%.
  • GAAP operating income increased $19 million to $48 million, an increase of 64%. Non-GAAP adjusted operating income increased $18 million to $64 million, an increase of 39%.
  • GAAP diluted EPS increased $0.33 per share to $0.81 per share. Non-GAAP adjusted EPS increased $0.32 per share to $1.27 per share.
  • Adjusted EBITDA increased $18 million to $81 million, an increase of 28%.
  • From the end of 2022, total debt increased $16 million to $941 million and net total debt increased $17 million to $924 million, mostly attributable to fees associated with the $500 million convertible notes and the $35 million related capped call, resulting in a leverage ratio of 3.1 times adjusted EBITDA as of September 29, 2023.

Acquired certain assets of InNeuroCo, Inc. to further strengthen neurovascular catheter capabilities

  • Closed acquisition October 1, 2023 and expect it to be immediately accretive to EPS.
  • InNeuroCo brings deep design expertise and manufacturing capabilities in high growth neurovascular catheters used primarily in the treatment of ischemic stroke and intracranial aneurysms.
  • $42 million purchase price plus additional consideration contingent on achieving specific revenue targets through 2027.
  • The acquisition structure provides tax deductions that are expected to offset cash taxes by approximately $5 million, net present value, over the next 15 years.
  • InNeuroCo 2023 sales estimated to be approximately $25 million with accretive margin profile. Integer’s fourth quarter 2023 outlook includes $5 million sales and $1 million adjusted operating income from InNeuroCo.

“Integer delivered another strong quarter with organic sales up 18% and adjusted operating income growth of 39%, more than twice the sales growth rate,” said Joseph Dziedzic, Integer’s president and CEO. “As we continue to see strong customer demand across our targeted growth markets, we are increasing our full year sales outlook to 15% growth at the midpoint. Additionally, we are raising our adjusted operating income outlook to 25% growth at midpoint. As part of our growth strategy, we completed the tuck-in acquisition of InNeuroCo on October 1st to further strengthen our neurovascular catheter capabilities.”

Discussion of Product Line Third Quarter 2023 Sales

  • Cardio & Vascular sales increased 23% in the third quarter 2023 compared to the third quarter 2022, driven by continued strong demand across all markets, growth in key products such as guidewires, new product ramps in electrophysiology and structural heart, and supply chain improvements.
  • Cardiac Rhythm Management & Neuromodulation sales increased 22% in the third quarter 2023 compared to the third quarter 2022, with double-digit growth in both CRM and Neuromodulation, driven by strong demand, including double-digit growth from emerging customers with PMA (pre-market approval) products, and supply chain improvements.
  • Advanced Surgical, Orthopedics & Portable Medical sales declined 13% in the third quarter 2023 compared to the third quarter 2022, driven by execution of the planned multi-year Portable Medical exit announced in 2022, and low double-digit decline of Advanced Surgical and Orthopedics.
  • Electrochem sales decreased 25% in the third quarter 2023 compared to the third quarter 2022, returning to a normalized run-rate after previously higher sales from the supply chain recovery.
2023 Outlook(a)(dollars in millions, except per share amounts)
 
    GAAP   Non-GAAP(b)
    As Reported   Change from Prior Year   Adjusted   Change from Prior Year
Sales   $1,575 to $1,595   14% to 16%   N/A   N/A
Operating income   $166 to $174   36% to 43%   $235 to $243   22% to 27%
EBITDA   N/A   N/A   $302 to $310   18% to 21%
Net income   $90 to $96   37% to 48%   $151 to $157   16% to 22%
Diluted earnings per share   $2.66 to $2.86   36% to 46%   $4.47 to $4.67   15% to 20%
Cash flow from operating activities   $185 to $205   59% to 76%   N/A   N/A
(a) Except as described below, further reconciliations by line item to the closest corresponding GAAP financial measure for Adjusted operating income, Adjusted EBITDA, Adjusted net income and Adjusted Earnings per Share (“EPS”) included in our “2023 Outlook” above, and Adjusted total interest expense, Adjusted effective tax rate and Leverage ratio in “Supplemental Financial Information” below, are not available without unreasonable efforts on a forward-looking basis due to the high variability, complexity and visibility of the charges excluded from these non-GAAP financial measures.
   
(b) Adjusted operating income for 2023 consists of GAAP operating income, excluding items such as amortization of intangible assets, restructuring and restructuring-related charges, and acquisition and integration costs, totaling approximately $70 million, pre-tax. Adjusted net income and Adjusted EPS for 2023 consist of GAAP net income and diluted EPS, excluding items such as amortization of intangible assets, restructuring and restructuring-related charges, acquisition and integration costs, and gain or loss on equity investments totaling approximately $78 million, pre-tax. The after-tax impact of these items is estimated to be approximately $61 million, or approximately $1.81 per diluted share.
   
  Adjusted EBITDA is expected to consist of Adjusted net income, excluding items such as depreciation, interest, stock-based compensation and taxes totaling approximately $151 million to $153 million.
   

Supplemental Financial Information

(dollars in millions) 2023Outlook   2022Actual
Depreciation and amortization $98 to $102   $92
Adjusted total interest expense(a) $47 to $50   $39
Stock-based compensation $22 to $23   $21
Restructuring, acquisition and other charges(b) $15 to $18   $22
Adjusted effective tax rate(c) 17.5% to 18.5%   16.1%
Leverage ratio(d) 2.5x to 3.5x   3.5x
Capital expenditures(d) $100 to $120   $74
Cash income tax payments $29 to $33   $11
(a) Adjusted total interest expense refers to our expected full-year GAAP total interest expense, expected to range from $52 million to $55 million for 2023, adjusted to remove the full-year impact of charges associated with the accelerated write-off of deferred issuance costs and unamortized discounts (loss on extinguishment of debt) included in GAAP total interest expense, if any.
   
(b) Restructuring, acquisition and other charges consists of restructuring and restructuring-related charges, acquisition and integration costs, other general expenses, and incremental costs of complying with the new European Union medical device regulations.
   
(c) Adjusted effective tax rate refers to our full-year GAAP effective tax rate, expected to range from 15.0% to 16.0% for 2023, adjusted to reflect the full-year impact of the items that are excluded in providing adjusted net income and certain other identified items.
   
(d) Please see “Notes Regarding Non-GAAP Financial Information” for additional information regarding leverage ratio and capital expenditures.
   
Summary Financial Results(dollars in thousands, except per share data)
 
  Three Months Ended   Nine Months Ended
  September 29,2023   September 30,2022   QTD Change   September 29,2023   September 30,2022   YTD Change
Operating income $ 48,075   $ 29,258   64.3 %   $ 123,817   $ 84,462   46.6 %
Net income $ 27,257   $ 16,057   69.8 %   $ 64,293   $ 48,260   33.2 %
Diluted EPS $ 0.81   $ 0.48   68.8 %   $ 1.91   $ 1.45   31.7 %
                       
EBITDA(a) $ 68,591   $ 50,563   35.7 %   $ 191,762   $ 148,428   29.2 %
Adjusted EBITDA(a) $ 80,556   $ 62,917   28.0 %   $ 223,201   $ 183,019   22.0 %
Adjusted operating income(a) $ 64,212   $ 46,183   39.0 %   $ 173,898   $ 134,667   29.1 %
Adjusted net income(a) $ 42,971   $ 31,788   35.2 %   $ 110,403   $ 92,518   19.3 %
Adjusted EPS(a) $ 1.27   $ 0.95   33.7 %   $ 3.28   $ 2.78   18.0 %
                                   
(a) EBITDA, Adjusted EBITDA, Adjusted operating income, Adjusted net income, and Adjusted EPS are non-GAAP financial measures. Please see “Notes Regarding Non-GAAP Financial Information” for additional information regarding our use of non-GAAP financial measures. Refer to Tables A and B at the end of this release for reconciliations of adjusted amounts to the closest corresponding GAAP financial measures.
   
Summary Product Line Results(dollars in thousands)
 
  Three Months Ended
  September 29,2023   September 30,2022   QTD Change   Organic Change(a)
Medical Sales              
Cardio & Vascular $ 214,003   $ 174,131   22.9 %   22.2 %
Cardiac Rhythm Management & Neuromodulation   159,221     130,631   21.9 %   21.9 %
Advanced Surgical, Orthopedics & Portable Medical   22,678     26,150   (13.3 )%   (13.3 )%
Total Medical Sales   395,902     330,912   19.6 %   19.3 %
Non-Medical Sales   8,791     11,768   (25.3 )%   (25.3 )%
Total Sales $ 404,693   $ 342,680   18.1 %   17.8 %
               
  Nine Months Ended
  September 29,2023   September 30,2022   YTD Change   Organic Change(a)
Medical Sales              
Cardio & Vascular $ 613,700   $ 513,772   19.4 %   18.4 %
Cardiac Rhythm Management & Neuromodulation   457,771     389,900   17.4 %   17.4 %
Advanced Surgical, Orthopedics & Portable Medical   77,808     69,101   12.6 %   12.6 %
Total Medical Sales   1,149,279     972,773   18.1 %   17.6 %
Non-Medical Sales   34,243     30,900   10.8 %   10.8 %
Total Sales $ 1,183,522   $ 1,003,673   17.9 %   17.4 %
 
(a) Organic sales change is a non-GAAP financial measure. Please see “Notes Regarding Non-GAAP Financial Information” for additional information regarding our use of non-GAAP financial measures and refer to Table D at the end of this release for a reconciliation of these amounts.
   

Conference Call Information

The Company will host a conference call on Thursday, October 26, 2023, at 8 a.m. CT / 9 a.m. ET to discuss these results. The scheduled conference call will be webcast live and is accessible through our website at investor.integer.net or by dialing (888) 330-3567 (U.S.) or (646) 960-0842 (outside U.S.) and the conference ID is 9252310. The call will be archived on the Company’s website. An earnings call slide presentation containing supplemental information about the Company’s results will be posted to our website at investor.integer.net prior to the conference call and will be referenced during the conference call.

From time to time, the Company posts information that may be of interest to investors on its website at investor.integer.net. To automatically receive Integer financial news by email, please visit investor.integer.net and subscribe to email alerts.

About Integer®

Integer Holdings Corporation (NYSE: ITGR) is one of the largest medical device outsource (MDO) manufacturers in the world serving the cardiac, neuromodulation, vascular, portable medical and orthopedics markets. The Company provides innovative, high-quality medical technologies that enhance the lives of patients worldwide. In addition, the Company develops batteries for high-end niche applications in energy, military, and environmental markets. The Company's brands include Greatbatch Medical®, Lake Region Medical® and Electrochem®. Additional information is available at www.integer.net.

Investor Relations:

Andrew Senn763.951.8312andrew.senn@integer.net

Notes Regarding Non-GAAP Financial Information

In addition to our results reported in accordance with generally accepted accounting principles in the United States of America (“GAAP”), we provide adjusted net income, adjusted EPS, earnings before interest, taxes, depreciation and amortization (“EBITDA”), adjusted EBITDA, adjusted operating income, and organic sales change rates.

Adjusted net income and adjusted EPS consist of GAAP amounts adjusted for the following to the extent occurring during the period: (i) amortization of intangible assets, (ii) certain legal expenses, (iii) restructuring and restructuring-related charges; (iv) acquisition and integration related costs; (v) other general expenses; (vi) (gain) loss on equity investments; (vii) extinguishment of debt charges; (viii) European Union medical device regulation incremental charges, (ix) inventory step-up amortization; (x) unusual, or infrequently occurring items; (xi) the income tax provision (benefit) related to these adjustments and (xii) certain tax items that are outside the normal tax provision for the period. Adjusted EPS is calculated by dividing adjusted net income by diluted weighted average shares outstanding.

EBITDA is calculated by adding back interest expense, provision (benefit) for income taxes, depreciation expense, and amortization expense from intangible assets and financing leases, to net income, which is the most directly comparable GAAP financial measure. Adjusted EBITDA consists of EBITDA plus adding back stock-based compensation and the same adjustments as listed above except for items (i), (vii), (xi) and (xii). Adjusted operating income consists of operating income adjusted for the same items listed above except for items (vi), (vii), (xi) and (xii).

Organic sales change is reported sales growth adjusted for the impact of foreign currency and the contribution of acquisitions. To calculate the impact of foreign currency on sales growth rates, we convert any sale made in a foreign currency by converting current period sales into prior period sales using the exchange rate in effect at that time and then compare the two, negating any effect foreign currency had on our transactional revenue, and exclude the amount of sales acquired or divested during the period from the current/previous period amounts, respectively.

We believe that the presentation of adjusted net income, adjusted EPS, EBITDA, adjusted EBITDA, adjusted operating income, and organic sales change rates, provides important supplemental information to management and investors seeking to understand the financial and business trends relating to our financial condition and results of operations. In addition to the performance measures identified above, we believe that net total debt and leverage ratio provide meaningful measures of liquidity and a useful basis for assessing our ability to fund our activities, including the financing of acquisitions and debt repayments. Net total debt is calculated as total principal amount of debt outstanding less cash and cash equivalents. We calculate leverage ratio as net total debt divided by adjusted EBITDA for the trailing 4 quarters. Free cash flow is defined as Net cash provided by operating activities (as stated in our Condensed Consolidated Statements of Cash Flows) reduced by capital expenditures (acquisition of property, plant, and equipment (PP&E), net of proceeds from the sale of PP&E).

Forward-Looking Statements

Some of the statements contained in this press release are “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, including 2023 financial results and guidance; statements relating to future sales, expenses, and profitability; customer demand; supplier performance (including delivery delays); costs (including wages, staffing levels and freight); future development and expected growth of our business and industry, including expansion of our manufacturing capacity; our ability to execute our business model and our business strategy, including completion and integration of current or future acquisition targets; having available sufficient cash and borrowing capacity to meet working capital, debt service and capital expenditure requirements for the next twelve months; projected capital spending; and other events, conditions or developments that will or may occur in the future. You can identify forward-looking statements by terminology such as “outlook,” “projected,” “may,” “will,” “should,” “could,” “expect,” “intends,” “plans,” “anticipates,” “believes,” “estimates,” “predicts,” “potential,” “project,” or “continue” or variations or the negative of these terms or other comparable terminology. These statements are only predictions. Actual events or results may differ materially from those stated or implied by these forward-looking statements. In evaluating these statements and our prospects, you should carefully consider the factors set forth below.

Although it is not possible to create a comprehensive list of all factors that may cause actual results to differ from the results expressed or implied by our forward-looking statements or that may affect our future results, some of these factors and other risks and uncertainties that arise from time to time are described in Item 1A “Risk Factors” of our Annual Report on Form 10-K and in our other periodic filings with the SEC and include the following:

  • operational risks, such as the duration, scope and impact of global supply chain issues and the military conflicts between Russia and Ukraine and between Israel and Hamas, including the evolving economic, social and governmental environments and their effects on our associates, suppliers and customers as well as the global economy; our dependence upon a limited number of customers; pricing pressures that we face from customers; our reliance on third party suppliers for raw materials, key products and subcomponents; the competitive labor market and our ability to attract, train and retain a sufficient number of qualified associates; the potential for harm to our reputation caused by quality problems related to our products; the dependence of our energy market-related revenues on the conditions in the oil and natural gas industry; interruptions in our manufacturing operations; our dependence upon our information technology systems and our ability to prevent cyber-attacks and other failures; and our dependence upon our senior management team and technical personnel;
  • strategic risks, such as the intense competition we face and our ability to successfully market our products; our ability to respond to changes in technology; our ability to develop new products and expand into new geographic and product markets; and our ability to successfully identify, make and integrate acquisitions to expand and develop our business in accordance with expectations;
  • financial risks, such as our significant amount of outstanding indebtedness and our ability to remain in compliance with financial and other covenants under our senior secured credit facilities; economic and credit market uncertainties that could interrupt our access to capital markets, borrowings or financial transactions; financial and market risks related to our international operations and sales; our complex international tax profile; and our ability to realize the full value of our intangible assets; and
  • legal and compliance risks, such as regulatory issues resulting from product complaints, recalls or regulatory audits; the potential of becoming subject to product liability or intellectual property claims; our ability to protect our intellectual property and proprietary rights; our ability and the cost to comply with environmental regulations; our ability to comply with customer-driven policies and third party standards or certification requirements; our ability to obtain necessary licenses for new technologies; legal and regulatory risks from our international operations, including trade regulation; and the fact that the healthcare industry is highly regulated and subject to various regulatory changes.

Except as may be required by law, we assume no obligation to update forward-looking statements in this press release whether to reflect changed assumptions, the occurrence of unanticipated events or changes in future operating results, financial conditions or prospects, or otherwise.

Condensed Consolidated Balance Sheets - Unaudited
(in thousands)
   
  September 29, 2023   December 31, 2022
ASSETS      
Current assets:      
Cash and cash equivalents $ 32,142     $ 24,272
Accounts receivable, net   226,327       224,325
Inventories   232,158       208,766
Refundable income taxes   4,832       2,003
Contract assets   86,637       71,927
Prepaid expenses and other current assets   27,248       27,005
Total current assets   609,344       558,298
Property, plant and equipment, net   364,283       317,243
Goodwill   979,886       982,192
Other intangible assets, net   779,115       819,889
Deferred income taxes   6,398       6,247
Operating lease assets   67,418       74,809
Financing lease assets   8,352       8,852
Other long-term assets   24,553       26,856
Total assets $ 2,839,349     $ 2,794,386
LIABILITIES AND STOCKHOLDERS’ EQUITY      
Current liabilities:      
Current portion of long-term debt $     $ 18,188
Accounts payable   108,351       110,780
Income taxes payable   2,282       10,923
Operating lease liabilities   9,977       10,362
Accrued expenses and other current liabilities   82,491       73,499
Total current liabilities   203,101       223,752
Long-term debt   941,383       907,073
Deferred income taxes   151,386       160,671
Operating lease liabilities   57,325       64,049
Financing lease liabilities   7,488       8,006
Other long-term liabilities   15,317       13,379
Total liabilities   1,376,000       1,376,930
Stockholders’ equity:      
Common stock   33       33
Additional paid-in capital   721,283       731,393
Retained earnings   744,994       680,701
Accumulated other comprehensive income   (2,961 )     5,329
Total stockholders’ equity   1,463,349       1,417,456
Total liabilities and stockholders’ equity $ 2,839,349     $ 2,794,386
 
Condensed Consolidated Statements of Operations - Unaudited        
(in thousands, except per share data)              
               
  Three Months Ended   Nine Months Ended
  September 29,2023   September 30,2022   September 29,2023   September 30,2022
Sales $ 404,693   $ 342,680     $ 1,183,522   $ 1,003,673  
Cost of sales (COS)   299,137     255,962       875,489     742,583  
Gross profit   105,556     86,718       308,033     261,090  
Operating expenses:              
Selling, general and administrative (SG&A)   42,102     38,195       129,815     119,541  
Research, development and engineering (RD&E)   14,539     16,123       50,514     47,077  
Restructuring and other charges (R&O)   840     3,142       3,887     10,010  
Total operating expenses   57,481     57,460       184,216     176,628  
Operating income   48,075     29,258       123,817     84,462  
Interest expense   11,967     10,676       40,680     24,417  
Loss on equity investments   3,451     2,887       3,472     5,611  
Other (gain) loss, net   580     (1,300 )     1,699     (932 )
Income before taxes   32,077     16,995       77,966     55,366  
Provision for income taxes   4,820     938       13,673     7,106  
Net income $ 27,257   $ 16,057     $ 64,293   $ 48,260  
               
Earnings per share:              
Basic $ 0.82   $ 0.48     $ 1.93   $ 1.46  
Diluted $ 0.81   $ 0.48     $ 1.91   $ 1.45  
               
Weighted average shares outstanding:              
Basic   33,346     33,145       33,305     33,116  
Diluted   33,774     33,336       33,679     33,329  
                           
Condensed Consolidated Statements of Cash Flows - Unaudited
(in thousands)
   
  Nine Months Ended
  September 29,2023   September 30,2022
Cash flows from operating activities:      
Net income $ 64,293     $ 48,260  
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization   73,116       68,645  
Debt related charges included in interest expense   7,126       1,445  
Inventory step-up amortization         798  
Stock-based compensation   17,099       15,973  
Non-cash lease expense   8,124       8,179  
Non-cash loss on equity investments   3,472       5,611  
Contingent consideration fair value adjustment   (526 )      
Other non-cash (gains) losses   (734 )     3,373  
Deferred income taxes   (5 )     (969 )
Changes in operating assets and liabilities, net of acquisition:      
Accounts receivable   (58 )     (33,496 )
Inventories   (25,785 )     (59,036 )
Prepaid expenses and other assets   (1,473 )     (1,255 )
Contract assets   (14,863 )     (7,698 )
Accounts payable   (869 )     25,524  
Accrued expenses and other liabilities   7,401       (6,012 )
Income taxes payable   (11,692 )     (4,563 )
Net cash provided by operating activities   124,626       64,779  
Cash flows from investing activities:      
Acquisition of property, plant and equipment   (82,885 )     (43,098 )
Proceeds from sale of property, plant and equipment   100       636  
Acquisitions, net         (126,636 )
Net cash used in investing activities   (82,785 )     (169,098 )
Cash flows from financing activities:      
Principal payments of term loans   (415,938 )     (11,437 )
Proceeds from issuance of convertible notes, net of discount   486,250        
Proceeds from revolving credit facility   294,603       160,000  
Payments of revolving credit facility   (353,993 )     (39,000 )
Purchase of capped calls   (35,000 )      
Payment of debt issuance costs   (2,181 )      
Proceeds from the exercise of stock options   2,303        
Tax withholdings related to net share settlements of restricted stock unit awards   (3,067 )     (2,073 )
Contingent consideration payments   (7,660 )     (493 )
Principal payments on finance leases   (854 )     (585 )
Net cash (used in) provided by financing activities   (35,537 )     106,412  
Effect of foreign currency exchange rates on cash and cash equivalents   1,566       209  
Net increase in cash and cash equivalents   7,870       2,302  
Cash and cash equivalents, beginning of period   24,272       17,885  
Cash and cash equivalents, end of period $ 32,142     $ 20,187  
 
Table A: Net Income and Diluted EPS Reconciliations(in thousands, except per share amounts)
 
  Three Months Ended
  September 29, 2023   September 30, 2022
  Pre-Tax   Net of Tax   PerDilutedShare   Pre-Tax   Net of Tax   PerDilutedShare
Net income (GAAP) $ 32,077   $ 27,257   $ 0.81   $ 16,995     $ 16,057     $ 0.48
Adjustments(a):                      
Amortization of intangible assets   13,105     10,358     0.31     12,126       9,583       0.29
Restructuring and restructuring-related charges(b)   703     628     0.02     3,258       2,529       0.08
Acquisition and integration costs(c)   777     580     0.02     597       505       0.02
Other general expenses(d)   28     28         626       465       0.01
Loss on equity investments(e)   3,451     2,726     0.08     2,887       2,281       0.07
Loss on extinguishment of debt(f)   87     68                    
Medical device regulations(g)   205     164         320       254       0.01
Other adjustments(h)   1,319     1,042     0.03     (2 )     (1 )    
Tax adjustments(i)       120               115      
Adjusted net income (non-GAAP) $ 51,752   $ 42,971     1.27   $ 36,807     $ 31,788       0.95
                       
Weighted average shares for adjusted diluted EPS       33,774             33,336      
                       
  Nine Months Ended
  September 29, 2023   September 30, 2022
  Pre-Tax   Net of Tax   PerDilutedShare   Pre-Tax   Net of Tax   PerDilutedShare
Net income (GAAP) $ 77,966   $ 64,293   $ 1.91   $ 55,366     $ 48,260     $ 1.45
Adjustments(a):                      
Amortization of intangible assets   39,136     30,934     0.92     36,015       28,465       0.85
Restructuring and restructuring-related charges(b)   5,624     4,485     0.13     5,895       4,604       0.14
Acquisition and integration costs(c)   1,715     1,282     0.04     5,866       4,654       0.14
Other general expenses(d)   137     107         1,127       861       0.03
Loss on equity investments(e)   3,472     2,743     0.08     5,611       4,433       0.13
Loss on extinguishment of debt(f)   4,518     3,569     0.11                
Medical device regulations(g)   1,241     981     0.03     612       484       0.01
Other adjustments(h)   2,228     1,760     0.05     (108 )     (84 )    
Inventory step-up amortization (COS)(j)               798       630       0.02
Tax adjustments(i)       249     0.01           211       0.01
Adjusted net income (Non-GAAP) $ 136,037   $ 110,403   $ 3.28   $ 111,182     $ 92,518     $ 2.78
                       
Weighted average shares for adjusted diluted EPS       33,679             33,329      
(a) The difference between pre-tax and net of tax amounts is the estimated tax impact related to the respective adjustment. Net of tax amounts are computed using a 21% U.S. tax rate, and the statutory tax rates applicable in foreign tax jurisdictions, as adjusted for the existence of net operating losses (“NOLs”). Expenses that are not deductible for tax purposes (i.e. permanent tax differences) are added back at 100%.
   
(b)  We initiate discrete restructuring programs primarily to realign resources to better serve our customers and markets, improve operational efficiency and capabilities, and lower operating costs or improve profitability. Depending on the program, restructuring charges may include termination benefits, contract termination, facility closure and other exit and disposal costs. Restructuring-related expenses are directly related to the program and may include retention bonuses, accelerated depreciation, consulting expense and costs to transfer manufacturing operations among our facilities.
   
(c)  Acquisition and integration costs are incremental costs that are directly related to a business or asset acquisition. These costs may include, among other things, professional, consulting and other fees, system integration costs, and fair value adjustments relating to contingent consideration.
   
(d)  Other general expenses are discrete transactions occurring sporadically and affect period-over-period comparisons. The expenses for the 2023 and 2022 periods primarily include severance, information technology systems conversion expenses, and expenses related to the restructuring of certain legal entities of the company.
   
(e) During the third quarter of 2023, we determined that an investment in one of our non-marketable equity securities was impaired and recorded an impairment charge of $3.3 million. The residual amounts for 2023 and 2022 relate to our share of equity method investee losses including unrealized appreciation/depreciation of the underlying interests of the investee.
   
(f) Loss on extinguishment of debt consists of accelerated write-offs of unamortized deferred debt issuance costs and discounts which are included in interest expense. The 2023 amounts represent a write-off of unamortized deferred debt issuance costs and discounts in connection with the amendments to the credit agreement governing our credit facilities, prepayments of portions of the Term Loan A facility, and repayment in full of our Term B Loan Facility.
   
(g)  The charges represent incremental costs of complying with the new European Union medical device regulations for previously registered products and primarily include charges for contractors supporting the project and other direct third-party expenses.
   
(h)  For the 2023 periods, amounts relate to costs associated with leadership transitions and certain formal strategic projects. Leadership transition costs primarily include severance costs associated with the departure of executives and incremental costs associated with the related leadership transitions. Strategic projects primarily involve system reconfiguration to support our manufacturing excellence operational strategic imperative and investments in certain technology and platform development to align our capabilities to meet customer needs. Other adjustments for the three and nine months ended September 29, 2023 included pre-tax leadership transition costs of $0.3 million and $1.2 million, respectively, and pre-tax costs related to strategic projects of $1.0 million and $1.1 million, respectively. The 2022 amounts relate to a former customer that filed bankruptcy in November 2019 and are predominantly due to favorable settlements on supplier purchase order termination clauses and benefits recognized from the utilization or sale of previously reserved inventory.
   
(i)  For the 2023 and 2022 periods, tax adjustments predominately relate to acquired foreign tax credits, including utilization, changes to uncertain tax benefits and associated interest. For the 2022 periods, tax adjustments also include acquisition costs that are not deductible for tax purposes.
   
(j)  The accounting associated with our acquisitions require us to record inventory at its fair value, which is sometimes greater than the previous book value of inventory. The increase in inventory value is amortized to cost of sales over the period that the related inventory is sold. We exclude inventory step-up amortization from our non-GAAP financial measures because it is a non-cash expense that we do not believe is indicative of our ongoing operating results.
   

Please see “Notes Regarding Non-GAAP Financial Information” for additional information regarding our use of non-GAAP financial measures.

Table B: Adjusted Operating Income Reconciliations(in thousands)
 
  Three Months Ended   Nine Months Ended
  September 29,2023   September 30,2022   September 29,2023   September 30,2022
Operating income (GAAP) $ 48,075   $ 29,258     $ 123,817   $ 84,462  
Adjustments:              
Amortization of intangible assets   13,105     12,126       39,136     36,015  
Restructuring and restructuring-related charges   703     3,258       5,624     5,895  
Acquisition and integration costs   777     597       1,715     5,866  
Other general expenses   28     626       137     1,127  
Medical device regulations   205     320       1,241     612  
Other adjustments   1,319     (2 )     2,228     (108 )
Inventory step-up amortization                 798  
Adjusted operating income (non-GAAP) $ 64,212   $ 46,183     $ 173,898   $ 134,667  
 
Table C: EBITDA Reconciliations(in thousands)
 
  Three Months Ended   Nine Months Ended
  September 29,2023   September 30,2022   September 29,2023   September 30,2022
Net income (GAAP) $ 27,257   $ 16,057     $ 64,293   $ 48,260  
               
Interest expense   11,967     10,676       40,680     24,417  
Provision for income taxes   4,820     938       13,673     7,106  
Depreciation   11,100     10,479       32,982     31,881  
Amortization of intangible assets and financing leases   13,447     12,413       40,134     36,764  
EBITDA (non-GAAP)   68,591     50,563       191,762     148,428  
Stock-based compensation(a)   5,482     4,668       17,022     14,790  
Restructuring and restructuring-related charges   703     3,258       5,624     5,895  
Acquisition and integration costs   777     597       1,715     5,866  
Other general expenses   28     626       137     1,127  
Loss on equity investments   3,451     2,887       3,472     5,611  
Medical device regulations   205     320       1,241     612  
Other adjustments   1,319     (2 )     2,228     (108 )
Inventory step-up amortization                 798  
Adjusted EBITDA (non-GAAP) $ 80,556   $ 62,917     $ 223,201   $ 183,019  
 
(a) Total stock-based compensation expense less amounts included in Restructuring and restructuring-related charges and Acquisition and integration costs.
   
Table D: Organic Sales Change Reconciliation (% Change)
 
  GAAP Reported Growth   Impact of Acquisitions and Foreign Currency(a)   Non-GAAP Organic Change
QTD Change (3Q 2023 vs. 3Q 2022)          
Medical Sales          
Cardio & Vascular 22.9%   0.7%   22.2%
Cardiac Rhythm Management & Neuromodulation 21.9%   —%   21.9%
Advanced Surgical, Orthopedics & Portable Medical (13.3)%   —%   (13.3)%
Total Medical Sales 19.6%   0.3%   19.3%
Non-Medical Sales (25.3)%   —%   (25.3)%
Total Sales 18.1%   0.3%   17.8%
           
YTD Change (9M 2023 vs. 9M 2022)          
Medical Sales          
Cardio & Vascular 19.4%   1.0%   18.4%
Cardiac Rhythm Management & Neuromodulation 17.4%   —%   17.4%
Advanced Surgical, Orthopedics & Portable Medical 12.6%   —%   12.6%
Total Medical Sales 18.1%   0.5%   17.6%
Non-Medical Sales 10.8%   —%   10.8%
Total Sales 17.9%   0.5%   17.4%
(a) Sales have been adjusted to exclude the impact of foreign currency exchange rate fluctuations and acquisitions.
   
Table E: Net Total Debt Reconciliation(in thousands)
 
  September 29,2023   December 31,2022
Total debt $ 941,383   $ 925,261
Add: Unamortized discount and deferred debt issuance costs included above   14,864     5,977
Total principal amount of debt outstanding   956,247     931,238
Less: Cash and cash equivalents   32,142     24,272
Net Total Debt (non-GAAP) $ 924,105   $ 906,966

 

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