INTEGRAMED AMERICA INC
8-K/A, 1998-05-26
OFFICES & CLINICS OF DOCTORS OF MEDICINE
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                                  UNITED STATES
                       SECURITIES AND EXCHANGE COMMISSION
                             Washington, D.C. 20549



                                   FORM 8-K/A
                                 Amendment No. 1

                                 CURRENT REPORT


                       Pursuant to Section 13 or 15(d) of
                      the Securities and Exchange Act 1934



Date of Report: May 26, 1998

                                  

   0-20260 and 1-11440                                    06-1150326
- --------------------------------------------------------------------------------
(Commission File Numbers)                      (IRS Employer Identification No.)


One Manhattanville Road, Purchase, NY                       10577
- --------------------------------------------------------------------------------
(Address of principal executive offices)                 (Zip Code)


Registrant's telephone no. including area code: (914) 253-8000


Registrant's former name: IVF America, Inc.


                                        2

<PAGE>



                            INTEGRAMED AMERICA, INC.
                                   FORM 8-K/A

                                TABLE OF CONTENTS

                               Items 7 (a) and (b)


                                                                            PAGE

  FINANCIAL INFORMATION

    Shady Grove Fertility Centers, P.C. Financial Statements

       Report of Independent Accountants.......................................3

       Balance Sheet as of March 12, 1998 (unaudited)
         and December 31, 1997 and 1996........................................4

       Statement of Operations for the interim-period ended March 12, 1998
         (unaudited) and the years ended December 31, 1997 and 1996............5

       Statement of Stockholders' Deficit for the interim-period ended
          March 12, 1998 (unaudited) and the years ended December 31, 1997
          and 1996.............................................................6

       Statement of Cash Flows for the interim-period ended March 12, 1998
          (unaudited) and the years ended December 31, 1997 and 1996...........7

       Notes to Financial Statements....................................... 8-11

    IntegraMed America, Inc. 
    Pro Forma Consolidated Financial Information (unaudited)

       Basis of Presentation..................................................12

       Pro Forma Consolidated Statement of Operations for the three-month 
         period ended March 31, 1998..........................................13

       Pro Forma Consolidated Statement of Operations for the year ended
         December 31, 1997....................................................14

  SIGNATURES..................................................................15

  INDEX TO EXHIBITS...........................................................16


                                        2

<PAGE>



                        Report of Independent Accountants


To the Stockholders of
Shady Grove Fertility Centers, P.C.


      In our opinion,  the accompanying  balance sheet and related statements of
operations,  of  stockholders'  equity and of cash flows present fairly,  in all
material respects, the financial position of Shady Grove Fertility Centers, P.C.
(the "Company") at December 31, 1997 and 1996, and the results of its operations
and its cash  flows  for the  years  then  ended in  conformity  with  generally
accepted   accounting   principles.   These   financial   statements   are   the
responsibility of the Company's management;  our responsibility is to express an
opinion on these  financial  statements  based on our audits.  We conducted  our
audits of these  statements  in  accordance  with  generally  accepted  auditing
standards which require that we plan and perform the audit to obtain  reasonable
assurance   about  whether  the  financial   statements  are  free  of  material
misstatement.  An audit includes examining, on a test basis, evidence supporting
the  amounts  and  disclosures  in  the  financial  statements,   assessing  the
accounting  principles  used and significant  estimates made by management,  and
evaluating the overall  financial  statement  presentation.  We believe that our
audits provide a reasonable basis for the opinion expressed above.

      As discussed in Note 10 to the  financial  statements,  on March 12, 1998,
the Company entered into agreements to sell its outstanding  stock to IntegraMed
America,  Inc. and give IntegraMed America, Inc. the right to manage the Company
for a twenty-five year period.




Price Waterhouse LLP
Stamford, Connecticut
May 1, 1998

                                        3

<PAGE>



                       SHADY GROVE FERTILITY CENTERS, P.C.     
                                  BALANCE SHEET
<TABLE>
<CAPTION>

                                     ASSETS
                                                                               March 12,           December 31,
                                                                               ---------     ----------------------
                                                                                 1998          1997           1996
                                                                               ---------     -------         ------
                                                                              (unaudited)
Current assets:
<S>                                                                          <C>           <C>             <C>  
    Cash and cash equivalents.............................................   $    9,884    $       50       $      50
    Patient accounts receivable, less allowances of $758,360,
      $753,857 and $324,098 in 1998, 1997 and 1996, respectively..........    1,411,670     1,416,243         684,798
    Other current assets..................................................       29,129         5,029           3,150
                                                                             ----------    ----------       ---------
         Total current assets.............................................    1,450,683     1,421,322         687,998

     Fixed assets, net....................................................      642,621       627,614         233,482
     Long-term accounts receivable........................................      100,000       100,000            --
     Other assets.........................................................       46,553        41,523          25,387
                                                                             ----------    ----------       ---------

         Total assets.....................................................   $2,239,857    $2,190,459       $ 946,867
                                                                             ==========    ==========       =========


                      LIABILITIES AND STOCKHOLDERS' DEFICIT

Current liabilities:
     Accounts payable and accrued liabilities.............................   $  740,230    $  787,709       $ 182,898
     Accrued physician compensation.......................................         --            --           229,930
     Loans payable to stockholders'.......................................      200,000          --              --
     Accrued profit sharing...............................................       91,231        99,400          90,072
     Line of credit.......................................................         --         270,000         120,000
     Current portion of long-term debt....................................       84,342        97,620          39,330
     Deferred revenue.....................................................    1,134,781     1,103,322         389,456
                                                                             ----------    ----------       ---------
         Total current liabilities........................................    2,250,584     2,358,051       1,051,686
     Long-term debt.......................................................      222,509       222,509          62,456
     Commitments and contingencies........................................         --            --              --
     Stockholders' deficit:
     Common stock (2,000 shares issued and outstanding at
      March 12, 1998 and December 31, 1997 and 1996)......................        2,000         2,000           2,000
     Accumulated deficit..................................................     (235,236)     (392,101)       (169,275)
                                                                             ----------    ----------       ---------
         Total stockholders' deficit......................................     (233,236)     (390,101)       (167,275)
                                                                             ----------    ----------       ---------

         Total liabilities and stockholders' deficit......................   $2,239,857    $2,190,459       $ 946,867
                                                                             ==========    ==========       =========

</TABLE>






               See accompanying notes to the financial statements.

                                        4

<PAGE>



                       SHADY GROVE FERTILITY CENTERS, P.C.
                             STATEMENT OF OPERATIONS
<TABLE>
<CAPTION>


                                                                    For the
                                                                    interim-                 For the
                                                                  period ended             years ended
                                                                    March 12,              December 31,
                                                                  -----------       -------------------------
                                                                     1998             1997             1996
                                                                  -----------       --------          -------
                                                                  (unaudited)

<S>                                                                <C>             <C>              <C>       
  Revenues, net...............................................     $1,915,580      $7,090,695       $3,962,081

  Costs of services rendered..................................      1,115,781       5,093,057        2,810,792
                                                                  -----------      -----------      ----------
  Contribution................................................        799,799       1,997,638        1,151,289

  General and administrative expenses.........................        638,769       2,211,967        1,103,480
  Interest expense............................................          4,561          28,766           14,113
  Interest income.............................................            396           6,529            5,564
                                                                  -----------      -----------      ----------
  Total other expenses........................................        642,934       2,234,204        1,112,029
                                                                  -----------      -----------      ----------
  Income (loss) before income taxes...........................        156,865        (236,566)          39,260
  (Benefit) provision for taxes...............................           --           (13,740)          13,740
                                                                  -----------      -----------      ----------
  Net income (loss)...........................................    $   156,865      $ (222,826)      $   25,520
                                                                  ===========      ===========      ==========



</TABLE>











               See accompanying notes to the financial statements.


                                        5

<PAGE>



                       SHADY GROVE FERTILITY CENTERS, P.C.
                       STATEMENT OF STOCKHOLDERS' DEFICIT

<TABLE>
<CAPTION>



                                                                                                    Total
                                                         Common Stock            Accumulated    Stockholders'
                                                     Shares         Amount          Deficit        Deficit
                                                     ------         ------         ---------      ---------

<S>                                                  <C>           <C>            <C>            <C>       
  BALANCE AS OF JANUARY 1, 1996..................     2,000         $2,000         $(194,795)     $(192,795)
  Net income.....................................       --             --             25,520         25,520
                                                      -----         ------         ---------      ---------

  BALANCE AS OF DECEMBER 31, 1996................     2,000          2,000          (169,275)      (167,275)
  Net loss.......................................       --             --           (222,826)      (222,826)
                                                      -----         ------         ---------      ---------

  BALANCE AS OF DECEMBER 31, 1997................     2,000          2,000          (392,101)      (390,101)
  Net income (unaudited).........................       --             --            156,865        156,865
                                                      -----         ------         ---------      ---------

  BALANCE AS OF MARCH 12, 1998 (unaudited).......     2,000         $2,000         $(235,236)     $(233,236)
                                                      =====         ======         =========      =========





</TABLE>























               See accompanying notes to the financial statements.

                                        6

<PAGE>



                       SHADY GROVE FERTILITY CENTERS, P.C.
                             STATEMENT OF CASH FLOWS

<TABLE>
<CAPTION>

                                                                             For the
                                                                             interim-            For the
                                                                           period ended        years ended
                                                                             March 12,         December 31,
                                                                            ----------   -----------------------
                                                                               1998         1997          1996
                                                                            ----------   ----------    ---------
                                                                           (unaudited)

  Cash flows from operating activities:
<S>                                                                         <C>          <C>           <C>      
    Net income (loss)..................................................     $156,865     $ (222,826)   $  25,520
    Adjustments to reconcile net income (loss) to net cash provided by
       operating activities:
       Depreciation and amortization...................................       22,000         87,000       52,785
       Contractual allowance and bad debt reserve......................        4,503        428,949      230,278
    Changes in assets and liabilities:
       (Increase) decrease in assets:
         Patient accounts receivable...................................           70     (1,160,394)    (540,747)
         Long-term accounts receivable.................................          --        (100,000)         --
         Other assets..................................................      (29,130)       (18,015)      (1,539)
       Increase (decrease) in liabilities:
         Accounts payable and accrued liabilities......................      (47,479)       604,811      (83,436)
         Accrued physician compensation................................          --        (229,930)     (43,027)
         Accrued profit sharing........................................       (8,169)         9,328       14,826
         Deferred revenue..............................................       31,459        713,866      389,456
                                                                            --------     ----------    ---------
  Net cash provided by operating activities............................      130,119        112,789       44,116
                                                                            --------     ----------    ---------
  Cash flows used in investing activities:
    Purchase of fixed assets and leasehold improvements................      (37,007)      (481,132)     (17,628)
                                                                            --------     ----------    ---------
  Cash flows (used in) provided by financing activities:
    Net (decrease) increase in line of credit..........................     (270,000)       150,000      120,000
    Note receivable....................................................         --             --         44,000
    Repayment of debt..................................................     ( 13,278)       (82,121)    (190,488)
    Proceeds from stockholders' loans..................................      200,000           --           --
    Proceeds from issuance of debt.....................................         --          300,464         --
                                                                            --------     ----------    ---------
  Net cash (used in) provided by financing activities..................      (83,278)       368,343      (26,488)
                                                                            --------     ----------    ---------
  Net  increase in cash................................................        9,834           --           --
  Cash at beginning of period..........................................           50             50           50
                                                                            --------     ----------    ---------
  Cash at end of period................................................     $  9,884     $       50    $      50
                                                                            ========     ==========    =========
    Interest paid......................................................     $  4,561     $   28,766    $  14,113
                                                                            ========     ==========    =========
</TABLE>



               See accompanying notes to the financial statements.

                                        7

<PAGE>



                       SHADY GROVE FERTILITY CENTERS, P.C.
                          NOTES TO FINANCIAL STATEMENTS


  NOTE 1 - THE COMPANY:

      Shady Grove  Fertility  Centers,  P.C. (the  "Company") is a six physician
group  practice with four locations in the  Washington  D.C. area.  Three of the
physicians (the "Stockholders") own 100% of the common stock of the Company. The
Company  specializes in providing assisted  reproductive  technology and related
infertility services in the Washington D.C. area (see Note 10).


  NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES:

   Basis of presentation --

      The accompanying financial statements of the Company comprise the accounts
of Shady Grove Fertility Centers, P.C.

   Revenues and cost recognition --

      Revenues consist of services rendered for patients and are recognized upon
performance  of such services.  Revenues are recorded on a net realizable  basis
after  deducting  contractual   allowances  and  consist  of  patient  fees  for
infertility and related services performed by the Company.  Related direct costs
are recognized in the period in which the clinical  and/or  laboratory  services
are  rendered.  Net  realization  is  dependent  upon  benefits  provided by the
patient's  insurance  policy or agreements  between the Company and  third-party
payors. Payments collected from patients in advance for services are included in
deferred revenue and revenue is recognized as the services are performed.

   Cash and cash equivalents --

      The  Company  considers  all  highly  liquid   instruments  with  original
maturities of three months or less to be cash equivalents.

   Patient accounts receivable --

      Patient  accounts  receivable  represent  receivables  from  patients  and
insurance  companies for medical services provided by the Company.  Such amounts
are recorded net of contractual allowances and estimated bad debts.

   Deferred revenue --

      Deferred revenue  represents  payments  collected from patients in advance
for  services  to be  rendered.  Revenue  is  recognized  as  the  services  are
performed.

   Fixed assets --

      Fixed  assets  are  valued  at  cost  less  accumulated  depreciation  and
amortization.  Depreciation  is  computed  on a  straight-line  basis  over  the
estimated  useful  lives of the related  assets,  generally  three to ten years.
Leasehold  improvements  are amortized over the shorter of the asset life or the
remaining term of the lease.

      When assets are retired or  otherwise  disposed  of, the costs and related
accumulated  depreciation are removed from the accounts.  The difference between
the net book value of the assets and proceeds from  disposition is recognized as
a gain or loss.  Routine  maintenance  and  repairs  are  charged  to expense as
incurred, while costs of betterments and renewals are capitalized.


                                        8

<PAGE>


                       SHADY GROVE FERTILITY CENTERS, P.C.
                    NOTES TO FINANCIAL STATEMENTS (continued)

   Income taxes --

      The Company  accounts for income taxes  utilizing  the asset and liability
approach.   Deferred  tax  assets  and  liabilities  are  determined   based  on
differences  between financial reporting and tax bases of assets and liabilities
and are measured using the enacted tax rates and laws.

   Financial instruments --

      The carrying value of the Company's financial instruments,  including cash
and cash equivalents, accounts receivable, accounts payable, and long-term debt,
as reported in the accompanying balance sheet, approximates fair value.

   Common Stock --

      The Company had 2,000 shares of common stock outstanding at March 12, 1998
and December 31, 1997 and 1996 with a par value of $1 per share.

   Use of estimates in the preparation of the financial statements --

      The preparation of these financial statements in conformity with generally
accepted  accounting  principles  requires  management  of the  Company  to make
estimates  and  assumptions  that  affect  the  reported  amounts  of assets and
liabilities and disclosures of contingent assets and liabilities, at the date of
the  financial  statements,  and the  reported  amounts of revenues and expenses
during the reporting period. Actual results could differ from those estimates.


  NOTE 3 - FIXED ASSETS, NET:

      Fixed  assets,  net  at  December  31,  1997  and  1996  consisted  of the
following:

                                                      1997          1996
                                                   ----------     --------   

       Furniture, office and other equipment...... $  861,454     $482,569
       Leasehold improvements.....................    243,572      141,325
                                                   ----------     --------
       Total  ....................................  1,105,026      623,894
       
       Less - accumulated depreciation and
        amortization..............................   (477,412)    (390,412)
                                                   ----------     --------

                                                   $  627,614     $233,482
                                                   ==========     ========

      Depreciation  and  amortization   expense  totaled  $87,000  and  $52,785,
respectively, for the years ended December 31, 1997 and 1996.




                                        9

<PAGE>


                       SHADY GROVE FERTILITY CENTERS, P.C.
                    NOTES TO FINANCIAL STATEMENTS (continued)

  NOTE 4 - DEBT:

      Long-term debt at December 31, 1997 and 1996 consisted of the following:

                                                         1997          1996
                                                       --------      -------

           Business term loans..............           $216,892      $75,000
           Equipment loans..................            103,237       26,786
                                                       --------      -------

           Total debt.......................            320,129      101,786
           Less - current portion...........             97,620       39,330
                                                       --------      -------

           Long-term debt...................           $222,509      $62,456
                                                       ========      =======

      Two business  term loans  existed as of December 31, 1997.  The first loan
was issued in March 1996 for $100,000 and requires  monthly  principal  payments
through March 1999. This loan bears interest at a rate of 9.25%. The second loan
was issued in April 1997 for  $210,000  and requires  monthly  payments  through
April  2002.  This  loan  bears  interest  at a rate of  9.5%.  Both  loans  are
collateralized by accounts receivable and equipment of the Company.

      The equipment loans represent loans for two automobiles  which are payable
over a 5 year period and are  collateralized by the automobiles.  The first loan
was issued in December  1995 for $32,718 and bears  interest at a rate of 8.75%.
The second loan was issued in May 1997 for $90,464 and bears  interest at a rate
of 9.25%.

      The Company also  maintains a $325,000 line of credit  arrangement  with a
local bank. This line of credit bears a variable rate of interest which is equal
to the prime rate plus 1%. The total amount outstanding under the line of credit
was $270,000 and $120,000 at December 31, 1997 and 1996, respectively.  The line
of credit was paid in full on January 22, 1998.

      In January 1998, the  Stockholders  of the Company loaned  $200,000 to the
Company which was used towards  repaying the line of credit.  The Company repaid
in full the non-interest bearing loan in early April 1998.

      As of December 31,  1997,  the annual  maturities  of the  long-term  debt
during each of the next five years were as follows:

             1998...........................................  $ 97,620
             1999...........................................    71,462
             2000...........................................    68,559
             2001...........................................    62,759
             2002 and thereafter............................    19,729
                                                                ------

             Total debt payments............................  $320,129
                                                              ========

  NOTE 5 - OPERATING LEASES:

      The Company  leases  certain  office space and equipment  under  operating
lease agreements  which extend for one to five years.  Effective March 12, 1998,
in conjunction with the sub-management  agreement with IntegraMed America, Inc.,
these leases became the obligations of IntegraMed America, Inc. (see Note 10).

      Rent  expense  under  operating  leases was  $348,881 and $200,579 for the
years ended December 31, 1997 and 1996, respectively.



                                       10

<PAGE>


                       SHADY GROVE FERTILITY CENTERS, P.C.
                    NOTES TO FINANCIAL STATEMENTS (continued)

  NOTE 6 - INCOME TAXES:

      The Company did not record a tax  provision  for the interim  period ended
March 12, 1998 due to its  utilization  of  operating  loss  carryforwards.  The
Company's 1997 tax benefit primarily  represents an operating loss carryback for
federal  and  state  income  taxes  which is  partially  offset  by a  valuation
allowance.  The 1996 tax provision  represents  current federal and state income
taxes.  The Company had no deferred  tax assets or  liabilities  at December 31,
1997 and an insignificant deferred tax liability at December 31, 1996.

  NOTE 7 - COMMITMENTS AND CONTINGENCIES:

      The Company is subject to certain federal and state laws and  regulations,
many  of  which  have  not  been  the   subject  of   judicial   or   regulatory
interpretation.  Management believes the Company's operations are in substantial
compliance with applicable laws and  regulations.  Although an adverse review or
determination  by any  such  authority  could  be  significant  to the  Company,
management believes the effects of any such review or determination would not be
material to the Company's financial condition or results of operations.


  NOTE 8 - RELATED PARTY TRANSACTIONS:

      Physician   compensation  and  benefits  were  $513,542,   $2,408,162  and
$1,265,486  for the  interim  period  ended  March 12,  1998 and the years ended
December 31, 1997 and 1996, respectively.


  NOTE 9 - EMPLOYEE BENEFIT PLANS:

      The Company  maintains a profit  sharing plan for certain  physicians  and
employees of the Company.  The Company  provided $93,000 and $90,366 to the plan
for the years ended December 31, 1997 and 1996, respectively.


  NOTE 10 - SUBSEQUENT EVENT:

      On March 11,  1998,  the Company  entered  into a  twenty-year  management
agreement  with Levy,  Sagoskin and  Stillman,  M.D.,  P.C.  (the "Shady  Grove,
P.C.").  Effective  March 12, 1998, the Company  changed to a Maryland  business
corporation from a Maryland professional corporation and transferred its medical
practice  operations  to the Shady  Grove,  P.C.  Contemporaneously,  IntegraMed
America,   Inc.,  a  publicly  held  physician   practice   management   company
("IntegraMed"),  acquired the  majority of the capital  stock of the Company and
entered into a twenty-year  sub-management  agreement with the Shady Grove, P.C.
In April 1998,  IntegraMed  issued  warrants to the  Stockholders  to acquire an
aggregate  of 45,000  shares of  IntegraMed  Common  Stock in  consideration  of
extending IntegraMed's  sub-management agreement with the Shady Grove, P.C. from
twenty to twenty-five years.  IntegraMed will acquire the balance of the capital
stock of the Company on or about November 1, 1998.


                                       11

<PAGE>

                            INTEGRAMED AMERICA, INC.

             Unaudited Pro Forma Consolidated Financial Information
                              Basis of Presentation

      The transaction detailed below was accounted for by the purchase method of
accounting  and the  purchase  price  has been  allocated  to the  tangible  and
intangible assets acquired and liabilities assumed based upon the estimated fair
values  at  the  date  of  acquisition.  The  unaudited  consolidated  financial
statements  include the results of this  transaction from the respective date of
acquisition.

      On March 12, 1998,  IntegraMed America, Inc.  ("IntegraMed")  acquired the
majority of the capital stock of Shady Grove  Fertility  Centers,  Inc.  ("Shady
Grove"),  currently a Maryland business  corporation  which provides  management
services, and formerly a Maryland professional  corporation engaged in providing
infertility services.  Prior to the closing of the transaction,  Shady Grove had
entered  into  a  twenty-year  management  agreement  with  Levy,  Sagoskin  and
Stillman,  M.D., P.C. (the "Shady Grove, P.C."), an infertility  physician group
practice  comprised of six  physicians  (the  "Physicians")  and four  locations
surrounding the greater Washington,  D.C. area. In April 1998, IntegraMed issued
warrants to the shareholders of the Shady Grove, P.C. to acquire an aggregate of
45,000  shares  of  IntegraMed   Common  Stock  in  consideration  of  extending
IntegraMed's  management  agreement  with the Shady Grove,  P.C.  from twenty to
twenty-five  years.  IntegraMed  will  acquire  the  balance of the Shady  Grove
capital stock on or about November 1, 1998.

      The aggregate  purchase price for all of the Shady Grove capital stock was
approximately  $5.7 million,  consisting of approximately  $2.8 million in cash,
$1.4 million in Common Stock, and $1.5 million in promissory notes. On March 12,
1998, the first closing date, the following consideration was paid to two of the
three  shareholder  physicians:  (i)  approximately  $1.8 million in cash,  (ii)
approximately  $1.2 million in stock or 639,551  shares of  IntegraMed's  Common
Stock, and (iii)  approximately $1.1 million in promissory notes. The promissory
notes are  payable  in two equal  annual  installments  due on April 1, 1999 and
2000, respectively, and bear interest at an annual rate of 8.5%. IntegraMed will
pay the balance of the  aggregate  purchase  price on or about  November 1, 1998
(the "Second Closing  Date"),  when the balance of the Shady Grove capital stock
is transferred to IntegraMed. The number of shares of Common Stock of IntegraMed
to be issued on the Second Closing Date,  which will have a fair market value of
approximately  $200,000, will be determined based upon the average closing price
of  IntegraMed's  Common Stock for the ten-day trading period prior to the third
business day before the Second Closing Date; provided, however, that in no event
will the price per share exceed $2.00 or be less than $1.70 for purposes of this
calculation.

      Under long term  employment  agreements  with the Shady Grove,  P.C.,  the
Physicians will provide medical services, as defined.

      The following  unaudited pro forma  consolidated  statements of operations
have been prepared by  management  based on the  unaudited  information  for the
interim-period  ended March 12, 1998 and audited  information for the year ended
December  31, 1997 of Shady Grove  adjusted  where  necessary,  with  respect to
pre-acquisition  periods,  to the  basis of  accounting  used in the  historical
financial  statements of  IntegraMed.  Such  adjustments  include  modifying the
results to reflect operations as if the related acquisition had been consummated
on  January  1, 1998 and  January  1,  1997,  respectively.  Additional  general
corporate  expenses  which would have been required to support the operations of
the Shady Grove  Network  Site are not  included in the pro forma  results.  The
unaudited pro forma results may not be indicative of the results that would have
occurred if the acquisition  and management  agreement had been in effect on the
dates indicated or which may be obtained in the future.


                                       12

<PAGE>



<TABLE>

                            INTEGRAMED AMERICA, INC.

                 Pro Forma Consolidated Statement of Operations
                 for the Three-Month Period Ended March 31, 1998
              (all amounts in thousands, except per share amounts)
                                   (unaudited)
<CAPTION>

                                                                                Transaction      Pro Forma
                                                              Historical        Adjustments    Consolidated
                                                              ----------        -----------    ------------

<S>                                                               <C>            <C>              <C>    
Revenues, net................................................     $8,746         $1,468(a)        $10,214

Operating expenses incurred on behalf of Network Sites.......      7,009          1,241(b)          8,250
                                                                  ------         ------           -------

Network Sites' contribution .................................      1,737            227             1,964
                                                                  ------         ------           -------

General and administrative expenses..........................      1,185             --             1,185
Intangible asset amortization................................        233             45(c)            278
Interest expense, net........................................         60             --                60
                                                                  ------         ------           -------
Total other expenses.........................................      1,478             45             1,523
                                                                  ------         ------           -------

Income before income taxes ..................................        259            182               441

Provision for income taxes ..................................         49             34                83
                                                                  ------         ------           -------

Net income...................................................        210            148               358

Less: Dividends accrued on Preferred Stock...................         33             --                33
                                                                  ------         ------           -------

Net income applicable to Common Stock........................     $  177         $  148           $   325
                                                                  ======         ======           =======

Basic earnings per share of Common Stock.....................     $ 0.01                          $  0.02
                                                                  ======                          =======

Diluted earnings per share of Common Stock...................     $ 0.01                          $  0.02
                                                                  ======                          =======

Weighted average shares-- Basic..............................     20,024            505(d)         20,529
                                                                  ======         ======           =======

Weighted average shares-- Diluted............................     20,401            505(d)         20,906
                                                                  ======         ======           =======

Note:  Under  the Shady  Grove  management  agreement,  IntegraMed  receives  as
compensation for its management  services a three-part  management fee comprised
of: (i) a fixed percentage of net revenues,  (ii) reimbursed  operating expenses
(expenses  incurred in managing  Shady Grove and any expenses  paid on behalf of
Shady Grove), and (iii) a variable percentage of earnings. Pursuant to Amendment
No. 2 dated May 6,  1998 to the  Shady  Grove  Management  Agreement,  the third
component of the management fee was changed to a variable percentage of earnings
from a percentage of revenues effective March 11, 1998.

(a)  To record net revenues earned for the  interim-period  ended March 12, 1998
     under the Shady Grove management agreement.

(b)  To record operating expenses incurred during the interim-period ended March
     12, 1998 under the Shady Grove management agreement.

(c)  To record amortization of exclusive  management rights, which are amortized
     over the twenty-five year term of the Shady Grove management agreement, for
     the interim-period ended March 12, 1998.

(d)  Represents the balance of 639,551 shares which were assumed to be issued on
     January 1, 1998 as opposed to March 12, 1998.
</TABLE>

                                       13
<PAGE>



                            INTEGRAMED AMERICA, INC.
<TABLE>

                 Pro Forma Consolidated Statement of Operations
                      for the Year Ended December 31, 1997
              (all amounts in thousands, except per share amounts)
                                   (unaudited)
<CAPTION>

                                                                                Transaction      Pro Forma
                                                              Historical        Adjustments    Consolidated
                                                              ----------        -----------    ------------

<S>                                                              <C>             <C>              <C>    
Revenues, net................................................    $22,638         $5,683(a)        $28,321

Operating expenses incurred on behalf of Network Sites.......     17,251          4,905(b)         22,156
                                                                 -------         ------           -------

Network Sites' contribution .................................      5,387            778             6,165
                                                                 -------         ------           -------

General and administrative expenses..........................      4,192             --             4,192
Intangible asset amortization................................        766            228(c)            994
Interest income, net.........................................        (49)            --               (49)
                                                                 -------         ------           -------
Total other expenses.........................................      4,909            228             5,137
                                                                 -------         ------           -------

Income before income taxes ..................................        478            550             1,028

Provision for income taxes ..................................        104            117               221
                                                                 -------         ------           -------

Net income...................................................        374            433               807

Less: Dividends accrued on Preferred Stock...................        133             --               133
                                                                 -------         ------           -------

Net income applicable to Common Stock........................    $   241         $  433           $   674
                                                                 =======         ======           =======

Basic earnings per share of Common Stock.....................    $  0.02                          $  0.05
                                                                 =======                          =======

Diluted earnings per share of Common Stock...................    $  0.02                          $  0.05
                                                                 =======                          =======

Weighted average shares-- Basic..............................     12,405            640(d)         13,045
                                                                 =======         ======           =======

Weighted average shares-- Diluted............................     12,616            640(d)         13,256
                                                                 =======         ======           =======

Note:  Under  the Shady  Grove  management  agreement,  IntegraMed  receives  as
compensation for its management  services a three-part  management fee comprised
of: (i) a fixed percentage of net revenues,  (ii) reimbursed  operating expenses
(expenses  incurred in managing  Shady Grove and any expenses  paid on behalf of
Shady Grove), and (iii) a variable percentage of earnings. Pursuant to Amendment
No. 2 dated May 6,  1998 to the  Shady  Grove  Management  Agreement,  the third
component of the management fee was changed to a variable percentage of earnings
from a percentage of revenues effective March 11, 1998.

(a)  To record net  revenues  earned for the year ended  December 31, 1997 under
     the Shady Grove management agreement.

(b)  To record  operating  expenses  incurred during the year ended December 31,
     1997 under the Shady Grove management agreement.

(c)  To record amortization of exclusive  management rights, which are amortized
     over the twenty-five year term of the Shady Grove management agreement, for
     the year ended December 31, 1997.

(d) Assumes 639,551 shares were issued on January 1, 1997.
</TABLE>

                                       14

<PAGE>







                                   SIGNATURES


       Pursuant to the requirements of the Securities  Exchange Act of 1934, the
Registrant  has duly  caused  this  report  to be  signed  on its  behalf by the
undersigned thereunto duly authorized.



                                   INTEGRAMED AMERICA, INC.
                                   (Registrant)




Date:  May 26, 1998           By:  /s/ Eugene R. Curcio
                                   --------------------

                                   Eugene R. Curcio
                                   Vice President and
                                   Chief Financial Officer
                                   (Principal Financial and Accounting Officer)

                                       15
<PAGE>



                                INDEX TO EXHIBITS


Exhibit
Number                              Exhibit
- -------                             -------
10.105(b) -- Amendment  No. 2  to  Management  Agreement  between  Shady  Grove
             Fertility Centers, Inc. and Levy, Sagoskin and Stillman, M.D.,P.C.





















                                       16


                    AMENDMENT NO. 2 TO MANAGEMENT AGREEMENT
                                    BETWEEN
                      SHADY GROVE FERTILITY CENTERS, INC.
                                      AND
                    LEVY, SAGOSKIN AND STILLMAN, M.D., P.C.


      This Amendment No. 2 to Management Agreement  ("Amendment No. 2") is dated
as of May 6, 1998 by and among IntegraMed America, Inc., a Delaware corporation,
with its principal place of business at One Manhattanville Road,  Purchase,  New
York 10577  ("IntegraMed"),  Shady Grove  Fertility  Centers,  Inc.,  a Maryland
corporation,  having a place of business at One Manhattanville  Road,  Purchase,
New York 10577 ("Shady Grove") and Levy,  Sagoskin and Stillman,  M.D.,  P.C., a
Maryland  professional  corporation,  with a place of business  at 9707  Medical
Center Drive, Suite 230, Rockville, Maryland 20850 ("PC").

                                    RECITALS

      WHEREAS,   Shady  Grove  and  PC  entered  into  a  Management   Agreement
("Management Agreement") dated March 11, 1998; and

      WHEREAS,  IntegraMed  acquired the majority of the issued and  outstanding
capital stock of Shady Grove on March 12, 1998; and

      WHEREAS, Shady Grove and IntegraMed entered into a Submanagement Agreement
("Submanagement  Agreement"),  with PC's consent, dated March 12, 1998, pursuant
to which  IntegraMed  agreed to perform certain duties and  responsibilities  of
Shady Grove under the Management Agreement; and

      WHEREAS, the Management Agreement was amended by agreement dated April 16,
1998; and

      WHEREAS, the parties desire to amend further the Management Agreement,  in
pertinent part, to provide for a revised  Additional  Management Fee, as defined
in the Management Agreement.


<PAGE>

      NOW  THEREFORE,  in  consideration  of the mutual  promises and  covenants
herein  contained,   and  as  contained  in  the  Management  and  Submanagement
Agreements, IntegraMed, Shady Grove and PC agree as follows:

      1. Section  7.1.4 of the  Management  Agreement  is hereby  deleted in its
entirety and the following is hereby substituted therefore, retroactive to March
11, 1998:

      "7.1.4  an  Additional   Management   Fee,  paid  monthly  but  reconciled
quarterly, in accordance with the following table:

                      Years 1 through 5 of this Agreement
                      -----------------------------------

      Cost of Services plus the Base
      Management Fee as a % of Revenues             Additional Management Fee
      ---------------------------------             -------------------------

      Below 76%                                     20% of PDE
      76% to 81%                                    17.5% of PDE
      81% or more                                   15% of PDE

                      Years 6 through 25 of this Agreement
                      ------------------------------------

      Below 76%                                     25% of PDE
      76% to 81%                                    22.5% of PDE
      81% or more                                   20% of PDE

      2. Section  7.4.2 of the  Management  Agreement  is hereby  deleted in its
entirety.

      3. All other provisions of the Management  Agreement,  as amended,  not in
conflict with this Amendment No. 2 remain in full force and effect.

      4.  This  Amendment  No.  2 may be  executed  in any  number  of  separate
counterparts,  each of which shall be deemed to be an original, but all of which
together shall constitute one and the same instrument.

      IN WITNESS WHEREOF,  the parties have signed this Amendment No. 2 the date
first above written.

INTEGRAMED AMERICA, INC.                 LEVY, SAGOSKIN AND STILLMAN, MD., P.C.


By: /s/Gerardo Canet                      By: /s/Michael J. Levy
    ------------------------                  ---------------------------
    Gerardo Canet, President                  Michael J. Levy, President


SHADY GROVE FERTILITY CENTERS, INC.


By: /s/Gerardo Canet
   ------------------------
   Gerardo Canet, President


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