RENAL CARE GROUP INC
8-K, EX-99.2, 2000-09-28
MISC HEALTH & ALLIED SERVICES, NEC
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                                                                    EXHIBIT 99.2


                                RENAL CARE GROUP

                             MODERATOR: DIRK ALLISON
                               SEPTEMBER 21, 2000
                                   8:00 AM CT

Operator:             Ladies and gentlemen, thank you for standing by. Welcome
                      to the Renal Care Group conference call. At this time all
                      participants are in a listen only mode. Later we will
                      conduct a question and answer session. At that time if you
                      have a question, you will need to press the 1 followed by
                      the 4 on your telephone. As a reminder, this conference is
                      being recorded. Today is Thursday, September 21, 2000.

                      I would now like to turn the conference over to Mr. Dirk
                      Allison, Chief Financial Officer for Renal Care Group.
                      Please go ahead sir.

Dirk Allison:         Thank you. Good morning. Welcome to the Renal Care Group
                      special conference call. The purpose of our call today is
                      to discuss our expected three to five year earnings per
                      share growth rate, update you on our exit from the wound
                      care business and give you an update on the remainder of
                      2000.

                      Let me first introduce the members of management present
                      today. Sam Brooks, our Chairman and Chief Executive
                      Officer, is here along with Gary Burkhardt, our Chief
                      Operating Officer and Ray Hakim, our Chief Medical
                      Officer. Ray is joining us today from Jackson,
                      Mississippi. Also, Doug Chappell, our Corporate Counsel is
                      with us.

                      Sam will be making our formal presentation, after which
                      all members of management will be available for the
                      question and answer session. Before I



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                      turn things over to Sam, Doug Chappell needs to talk about
                      forward-looking statements.

Doug Chappell:        Thank you Dirk. I just wanted to remind all of you that
                      much of the information we discuss this morning is
                      forward-looking information and is given in reliance on
                      the Safe Harbor provided by the Private Securities
                      Litigation Reform Act. These forward-looking statements
                      involve risks and uncertainties. Our actual results could
                      differ materially from these forward-looking statements
                      due to certain factors including business and economic
                      conditions and the availability of financing. These and
                      other risks and uncertainties are discussed in our reports
                      filed with the SEC, copies of which are available from the
                      company.

Dirk Allison:         Thanks Doug. Now let me turn the call over to Sam Brooks,
                      our Chief Executive Officer.

Sam Brooks:           Okay, thank you Dirk. Well, thank you for being here
                      ladies and gentlemen. We might as well get to the number
                      one issue and that has to do with missing analysts'
                      earnings estimate for this year. It's the first time it's
                      happened. As you know, we've finished our first four years
                      ended 1999 meeting all our analysts' estimates, but this
                      year, the year 2000, we've had a bit of trouble.

                      As you know, we gave you some guidance up to about $1.40 a
                      share back in November, and then we had an unexpected
                      event with the EPO price being increased by Amgen that
                      brought us down another 5 cents back in, oh I think we did
                      that around March, April, May when we reported the second
                      quarter.

                      And now, you know, we're having a bit of difficulty
                      meeting our acquisition targets, and some of the ones that
                      we've acquired we have had trouble getting


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                      them closed in the time we thought we would. So therefore,
                      we're going to have to lower our earnings estimate for
                      this year again. That's cost us severely in the stock
                      price, and that hurts us all.

                      And I'm here to apologize for that. It's an event we can't
                      avoid. I mean those are the facts. That's what happened so
                      we need to report it to you as soon as we can.

                      Most analysts have expected us to be growing 20% a year.
                      That was the estimate for this year, the estimate ongoing,
                      but we don't think we can do that. We think it's going to
                      be closer to a 15% EPS growth company going forward, and
                      that's what we indicated in the press release.

                      The full explanation of that has to do with our
                      acquisition program because our ability to achieve both
                      the 20% and the 15%, but to a much lesser degree, is
                      partially dependent on our M&A activity. As you know,
                      we're a pretty disciplined buyer of dialysis facilities.
                      We look for a 20% internal rate of return. We act as if
                      this is our personal money. We are businessmen, and we're
                      buying businesses. We are not stock promoters who are out
                      trying to make earnings per share increases regardless of
                      whether it's a good business decision or not.

                      So we've had some problems closing those deals at the
                      prices we thought were acceptable. When we started the
                      year, we thought we'd be doing pretty well because TRL,
                      now DaVita, is out of the market, Fresenius was out of the
                      market, but it raised the money around July, and Gambro
                      has always been a disciplined buyer.


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                      But lately, Fresenius is back in the market, and we ran
                      into a few privately financed companies. The nonpublic
                      ones took a couple of deals away from us with some prices
                      paid that wouldn't give us the rates of return that we
                      want, and I suppose their return levels are less than ours
                      or else they're desperate enough to get into the business.
                      So the result is that we closed on fewer deals than we had
                      planned and it's principally because of price.

                      Let me just speak briefly to the acquisition process, not
                      to overdo this but just to set the stage. You know, we
                      have an M&A team of about four people, and their principal
                      job is to identify deals, create a pipeline, prioritize
                      the candidates and negotiate the price. We've got a due
                      diligence team that includes the participation by our
                      operating people, and they look at the deals carefully,
                      evaluate the medical care, the quality of the equipment,
                      the market and calculate the projected financials, and
                      that gives us our return on invested capital.

                      So our operating people accept the projections by the M&A
                      staff as their budgets, and I must say that this has
                      worked extremely well. So I cannot think of a single
                      acquisition that I regret having made or that didn't make
                      the budget that we set forward.

                      So our history has been exceptional. Our standards are
                      pretty high, but we're trying to create a first class
                      company here and that's our first priority.

                      Our company has suffered; well our stock has suffered
                      severely here in the past few days. It was 24 about June
                      30, and now it's 15 or 16 or so. That's down about 30%,
                      and it's attributable I'm told, and I pretty well believe,
                      to failing to meet earnings estimates.


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                      The business, just to remind you, as you all know is doing
                      well. Our EPS will be up about 18% we believe this year,
                      but it won't be up the 20% we anticipated it to be. I
                      might add that the company is fortunate to be in the
                      financial position it's in. We've got a great deal of
                      financial flexibility. We have a low debt level as you
                      know. Our cash flow is extremely strong. It's always been
                      a focus at this company.

                      We have a relatively modern plant and equipment. That's
                      one of Ray Hakim's jobs to make sure there is no deferred
                      maintenance here. We have first class equipment. And we've
                      done that since inception. So we've never let our existing
                      business suffer in order to shift money over to M&A and
                      the growth side, so we don't have any deferred maintenance
                      or any demands on our cash either from that or excessive
                      levels of debt. The bottom line is that leaves a pretty
                      significant sum available to the company to use to
                      increase shareholder value in the future, but we won't use
                      it unless it does increase shareholder value and it is a
                      good business decision.

                      Let me talk about Youngstown just a minute and Ray and
                      Gary and Dirk will all be available in the Q&A session if
                      you have to inquire further about this event.

                      This event too is, of course, unexpected. It's cut into
                      our profits in the third quarter, possibly the fourth
                      quarter, but as you know in any crisis situation like
                      this, your profits and your earnings go and take a second
                      seat if they even have a seat at all because you must
                      respond and put the patient first and handle that
                      immediately.

                      And I must say I'm very proud of the way our people
                      responded starting with the people in Youngstown, the
                      physicians responsible for those patients, the


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                      unit nurses, the nurses' aides, the social workers. Yes, I
                      was very proud to be with a company that they are
                      associated with.

                      Our Chief Medical Officer, Ray Hakim, and some of the
                      water system techs went down to Youngstown immediately
                      upon hearing about it. We heard about it in the afternoon.
                      Within an hour and a half, Ray had his bag packed and was
                      on a plane we had chartered and was down there
                      immediately. Our Chief Operating Officer was in Milwaukee
                      when he heard it, and he left immediately along with the
                      Regional Chief Operating Officer who was there.

                      And we brought in people from Phoenix and other places
                      that assisted the operating group there in that region in
                      solving that problem. But all the focus was on solving the
                      problem, getting the patients taken care of, putting the
                      patients and the families first.

                      Again, I was quite proud of the way they responded. As you
                      know, when you're under pressure is when the cracks in
                      your character start to show, and I didn't see any cracks
                      in our people or in our company's character. I think they
                      did the right thing, and, as importantly, they did it
                      immediately.

                      So that cost us some money. I'm not fully aware of all the
                      costs. Dirk may have the numbers, but I really haven't
                      asked for a final accounting because there probably isn't
                      one yet. We're probably not fully aware of all the costs
                      that will come from this, but Dirk might be able to give
                      you a reasonable estimate.

                      Again, if you have any further questions on that, Ray and
                      Gary were on the spot, and they can answer those.


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                      As to the Wound Care business and the write-off of this,
                      first a little background. Some of you who've been with us
                      for some time might know we purchased that company in
                      December of '97, and we picked it up as part of a large
                      dialysis operation we acquired. We weren't quite sure what
                      to do with it, but we decided to keep it for several
                      reasons.

                      One of which, we really liked the people running it. They
                      were first class people, and the service they provided was
                      of benefit to many of our patients and other patients with
                      end stage renal disease that weren't being treated in our
                      centers.

                      We've operated it for 2-1/2 years. It's profitable.
                      Quality initiatives and quality measurements have been
                      implemented. They already have (unintelligible) and we
                      implemented a system in documenting that. We have a first
                      rate medical director, the Ray Hakim of Wound Care I call
                      him. He's a first class guy, a guy you'd really like to
                      build a business around.

                      The contract renewals have been positive. The problem with
                      it is size. We worked hard at making it larger. We looked
                      at acquisitions, four or five of them. We looked at
                      building it from scratch. We put in a major effort with an
                      M&A team to get more contracts with a focus on this as a
                      good service that we'd be proud of this medical service
                      being a part of Renal Care Group. Let's see if we can't
                      build it up to $50 to $100 million revenues. Well, we
                      can't do that. So we've decided to reposition the company.
                      It's taken some top management time, and we haven't been
                      able to achieve our objectives of building it into a large
                      company and a major profit producer. So we think the best
                      way to handle that is to put it in the hands of other
                      management, perhaps sell it to the existing management,
                      and perhaps sell it to others. But our


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                      primary focus would be to use it in our company as more of
                      an outside vendor than it would as a wholly owned
                      subsidiary.

                      Renal Care Group may retain an ownership piece in this,
                      not only perhaps to help management to buy it but also to
                      keep our access to their services and get the benefit of
                      those services.

                      Okay, so let me finally say this before we get into the
                      Q&A session. As I mentioned, the past four years we've
                      done a good job of meeting our targeted EPS but we all
                      know the story. It's every quarter you have to do the job,
                      and we haven't done it this quarter.

                      And we felt now is the time to let you know. We would have
                      loved to have waited a little later, maybe a month or two,
                      because there's still some events occurring, especially in
                      Washington that Ray can bring you up to date on that will
                      affect our profitability next year, but we think we've got
                      - you know, we based some adjustments and some allowances
                      that we hope will account for that in the year 2000.

                      But the bottom line is we think this is closer to a 15%
                      growth company in terms of earnings per share in the
                      future than it is 20%. The internal business is a good
                      business. It has a good internal growth rate, and our
                      company has the cash flow to be able to enhance that a
                      bit, but we essentially missed closing on some deals
                      during 2000, and we don't intend to lower our internal
                      invested capital objectives. So I think we need to be a
                      little more modest in our earnings growth projections.

                      I want to finally point out that we too feel your pain.
                      You know, our management incentives, our cash incentives
                      are tied to financial objectives


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                      and earnings per share. So all our management team will
                      suffer this year as a result of not meeting these
                      earnings.

                      And in addition, there's a significant part of it tied to
                      stock options. And a great deal of those are underwater as
                      a result of missing these projections. So it's not
                      something we're particularly proud of, and we don't
                      particularly like it. Our commitment is to do better in
                      the coming years in meeting our objectives, and everyone
                      is committed to that.

                      I'd be somewhat remiss if I didn't point out that the
                      business is very good. The cash flow is the focus of our
                      operating people, and they've once again hit their
                      targets. It is a primary focus of this company to make
                      sure of to have a good business. We do a good job in
                      caring for these patients and we run the business in a
                      professional way.

                      And finally, our company is in excellent shape, and that's
                      reflected principally by the balance sheet and the profit
                      and loss statement. Our projections aren't very good, but
                      we haven't screwed up the company by making deals that are
                      improper or overleveraged in any way. So I'm quite proud
                      of the way our medical outcomes are, the way our financial
                      statements look and the fact that the business is in good
                      shape.

                      I'm not very happy as CEO with the way we do our
                      projections, but I think we've got some estimates going
                      forward that I think are more reasonable and that I think
                      we'll be able to attain.

                      Okay Dirk, I think I'm ready for Q&A then.

Dirk Allison:         Thank you. Operator, if you'll now open it up for question
                      and answers.


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Operator:             Thank you sir. Ladies and gentlemen, we will now begin the
                      question and answer session. If you have a question, you
                      will need to press the 1 followed by the 4 on your
                      push-button phone. You will hear a three tone prompt
                      acknowledging your request. If your questions have been
                      answered and you would like to withdraw your polling
                      request, you may do so my pressing the 1 followed by the 3
                      on your push button phone. And if you are using a speaker
                      phone, please pick up your handset before entering your
                      request.

                      One moment please for the first question...

                      Andrea Bici with CS First Boston, please go ahead with
                      your question.

Andrea Bici:          Good morning. A couple of questions. In the guidance that
                      you've provided, what have you assumed in Medicare update
                      factor, and what do you think the likelihood of being able
                      to receive an annual update factor is?

                      And secondly, at these levels and I think the DCA
                      acquisition was long ago enough would you be able to look
                      into share repurchases, you know to bolster the share
                      price and given your pause from the acquisition market.

                      And finally, what's a reasonable price per patient? I
                      think the price per patient last fall was around $40,000.
                      I think it sort of crept up to $50,000 was what I was
                      seeing, so if you could provide more color on that as well
                      that would be great.

Dirk Allison:         Andrea, great, thanks. What I'll do, I'll answer two or
                      three of those myself. I'll pass the annual update to Ray
                      when I get through, and then Sam will probably want to
                      comment on the share repurchase.


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                      As far as the medical update in our projections, what we
                      have done as everyone should be aware, there is 1.2% that
                      is already in the law for next year. There is another 1.2%
                      that's been proposed, bringing it to a total of 2.4%. We
                      have put a little of that in our number, but we reserve
                      back against it, so there is not a lot of effect of the
                      2.4 in there, but there is some. It should not change our
                      projections the way we did it, though, either way.

                      We are certainly anticipating that that will be a positive
                      result. As relating to price per patient in our
                      acquisition, you know we told you all year long on each of
                      the previous conference calls that our company was looking
                      to purchase new businesses in the $40,000 to $45,000 range
                      for our acquisitions. And we have been very consistent
                      with that.

                      At the early part of the year, there was some at the low
                      end of that. The later ones have been a little on the top
                      end of that, but we've been pretty consistent. And just
                      within the last few weeks has it come to our attention
                      that, as Sam mentioned, a couple of the deals that we
                      thought we were very close to bringing on board, we were
                      told that we were outbid significantly. And when I say
                      significantly, the indications that we have on pricing are
                      now more closely aligned to the $50,000 to $60,000 range,
                      somewhere in that range. And as Sam mentioned, being a
                      disciplined buyer, that's not something that we feel we
                      can give our shareholders the return that's necessary with
                      a dollar spent.

                      Relating to date the timing of the share repurchase,
                      you're correct, we did the RDM transaction at the
                      beginning of April. We will actually pass a six month
                      window on October 2 of this year and so in a minute Sam
                      will comment


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                      possibly a little more on that. But let me turn it over to
                      Ray to talk about the possibility of an annual update
                      going forward.

Ray Hakim:            Thanks Dirk. As you know, a bipartisan bill has been
                      introduced both in the Senate and in the House that has
                      two elements in it. One is to increase the projected
                      updates from 1.2 starting January to 2.4, which is an
                      increase of another 1.2. And that also has the support of
                      the Administration, which had proposed it in their July
                      Medicare budget.

                      So that element to us looks reasonable. The bills both in
                      the House and in the Senate include an annual update. That
                      has to be scored by the Budget Office before everybody
                      signs on to it. But there is a lot of sympathy and
                      recognition of the unfairness of having dialysis being
                      completely excluded from an annual update and that this
                      might be a way to correct this inequity.

                      So the bill has been introduced as I said in a bipartisan
                      way and also by some of the more conservative members of
                      both the Congress and the Senate, those who have been
                      generally labeled fiscally very conservative.

                      And I must say that it's been supported by every element
                      of this industry from the National Kidney Foundation to,
                      you know, the people, the patients. And so we are hopeful
                      that this will pass. I don't know that I can tell you that
                      for certainty. As you know, a lot of these things get
                      finalized at the last minute, but we have been able to
                      mobilize a lot of the Senate members and the House members
                      to focus on this issue. And I think we are hopeful that
                      both elements of the bill, the increase of an additional
                      1.2% and, you know, the annual updates after that will
                      occur.


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                      You all know better than I do, that none of this is with
                      any certainty, but we are still going to work hard at it.
                      We've had a lot of employees and associates writing
                      letters in support of this and also the patients.
                      Surprisingly, the patients also have been very mobilized.
                      So that's really what I would want to say about that
                      possibility.

Sam Brooks:           On stock repurchase, we're committed to building
                      shareholder value and at this price a repurchase of shares
                      would do that. We did have an acquisition accounted for as
                      a pooling of interest, and we'd like to retain it. We
                      looked very hard at that, and there are some tax reasons,
                      some P&L reasons and some other things that cause us to
                      come down and decided we'd like to try and retain that
                      pooling.

                      And Dirk tells me that on Monday, October 2, we're past
                      the six month date that we have to honor. So I think
                      that's all I can say on that. Dirk. . . .

Dirk Allison:         Thank you, Sam.

Operator:             Next question comes from Kip Hewitt with Legg Mason.
                      Please go ahead with your question.

Kip Hewitt:           Two questions. First, could you give us a little color on
                      the amount and the components of what you expect to be
                      spending relating to the Youngstown problem so we can get
                      a sense of how much that does affect your earnings in the
                      third quarter if not in the fourth.

                      And then secondly, could you talk a little about same
                      facility treatment growth and whether you're seeing a
                      change on that and if so, what the factors are behind
                      that.


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Dirk Allison:         Okay. Kip, as it relates to Youngstown, as Sam said, it's
                      still a little bit of a moving target. And we're probably
                      at the end of the day, that range is going to be $0.5
                      million to $1.0 million or so that we will have spent on
                      that. It really affects more the third quarter than the
                      fourth. And let me tell you the type costs that we're
                      taking care of there.

                      Obviously, we stated that we are adequately covered in our
                      opinion from an insured standpoint, but there are
                      deductibles associated with that. We have the cost of
                      mobilizing our management team on the site as Sam
                      mentioned, Gary and Ray's response and the team of
                      Operations folks and experts that went up there, the
                      consultants that we hired to work with our water treatment
                      system.

                      And then also, you know, we think it's our responsibility.
                      These patients are under our care, so we're going to take
                      care of the medical costs associated with that.

                      So those are the type expenses, like the ones related to
                      the water treatment system, that's in process right now.
                      Again, that will be largely in the third quarter.

                      Ray, why don't I turn it over to you and let you talk a
                      little bit about the treatment growth we're seeing.

Ray Hakim:            Let me just add also that as the events unfolded in
                      Youngstown, as you know there were five other facilities
                      that were able to accommodate all the patients that were
                      traditionally dialyzed in the facility that had the
                      problem. So in terms of servicing the other patients
                      because we had to close down the unit to


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                      do the investigations, we have been able to do that
                      without major disruptions to the patients. We were able to
                      accommodate them in the other facilities.

                      So the closing of the facility with the problem really has
                      not affected our ongoing ability to provide treatment. Now
                      we have also been very diligent in working with all the
                      interested parties from the Health Department and CDC and
                      we have now started the process of changing the water
                      systems in that facility. And our projections are that
                      sometime next week, provided we get all the okays from all
                      the relevant health authorities primarily local, that we
                      should be able to open the facility and service the
                      patients back at their usual place.

                      And frankly, that's been a request that everybody has
                      heard from the patients over and over again, when can we
                      get back to my facility? So we're very pleased with that
                      and as I said we hope that sometime by next week we should
                      be able to open that facility.

Kip Hewitt:           And then on the treatment growth issue?

Ray Hakim:            I think, you know, we're all waiting for the report from
                      the new USRDS that's coming from Minneapolis this time. We
                      have always prided ourselves that we'll do better than the
                      national inherent growth in the number of patients because
                      of our really focusing on reducing mortality and reducing
                      hospitalization.

                      Just as a background for you, we have snippets of the new
                      USRDS that have been published, and in 1998, which is the
                      latest one, there were 85,000 new patients coming into
                      dialysis. Unfortunately, there was also immortality of


<PAGE>   16

                      about 63,000. So our focus has been to really focus on
                      reducing immortality, and we feel we have done that.

                      And so the latest number that I'm aware is that we're
                      still tracking well into the 6-7% range. We obviously want
                      to do better than that, but that's what this year seems to
                      look like.

                      We'll also focus on de novos because in many areas we have
                      growth enough to justify new facilities. We'll be doing
                      that also so...

Kip Hewitt:           Okay, so if I could just ask one more question on the
                      acquisitions, you mentioned that there are new buyers
                      coming into the market. In terms of the people that you're
                      seeing bidding the $50,000 to $60,000 per patient, are
                      these any large existing players? Are they pretty much new
                      financial entrants into the market? Or is it a change in
                      the seller expectations that you're seeing?

Dirk Allison:         Well, I think there is a change in the seller expectations
                      driven by the fact that there's two or three companies out
                      there apparently willing to pay a little more, and they
                      appear to be private companies. We have not yet seen any
                      of the large public companies to our knowledge go that
                      high.

Sam Brooks:           Yes, this is Sam. I might add that wasn't expected this
                      year. I didn't expect those private companies. You know, I
                      looked at the big public companies, and I thought I had a
                      pretty good handle on what their M&A activity would be for
                      this year. But then there were three deals that I thought
                      we would get this year. We had worked on them for some
                      time. We liked them and we lost them on the price.


<PAGE>   17

                      And they were to privately financed companies, and we were
                      rather surprised at that. We would have thought that a
                      privately financed organization would have a pretty high
                      return on investment criteria. They're paying all cash and
                      they're probably borrowing some. But we lost those.

Kip Hewitt:           Thank you.

Operator:             Our next question comes from Bill Bonello with US Bancorp
                      Piper Jaffrey. Please go ahead with your question.

Bill Bonello:         Good morning guys. I just wanted to follow up a little bit
                      on some of the assumptions again underlying the numbers.
                      Just first of all, I not sure I understood your answer
                      about your assumption on the increase in the composite
                      rate. It sounds like what you're saying is if we do get a
                      2.4% increase we wouldn't necessarily assume that the
                      numbers would then be higher than what we're currently
                      projecting.

Dirk Allison:         That's correct.

Bill Bonello:         And if we don't get that increase?

Dirk Allison:         There can be some slight effect if we don't get the
                      increase. We tried to cushion that a bit, Bill, to protect
                      against it. But we did use some of that into our numbers.

Bill Bonello:         Okay. And then in terms of what you're assuming on the AWP
                      or potential AWP changes for a couple of the drugs that
                      you administer, is that baked into the numbers?


<PAGE>   18

Dirk Allison:         We did back a little bit of that in there. We didn't back
                      a lot. The reason being, we do believe that there's a
                      potential that that will in fact come about January 1 of
                      next year, and so we wanted to put some of the number in
                      there, but we believe there are various ways and things
                      that we can do to mitigate a lot of that increase. And so
                      we tried to factor in both the increase as well as what we
                      can do to mitigate that going to our bottom line.

Ray Hakim:            And Bill, I know you mentioned in the report that maybe we
                      are looking at transitions related to AWP changes. I think
                      clearly these are medical decisions. I did not expect that
                      this will be anytime over by October or January. I think
                      this will be a gradual process. So I just wanted to make
                      sure that we're not the type of the company that will say
                      all right, tomorrow you stop doing this.

                      So we will work through that process, but I think Dirk is
                      right that, you know, it's not completely mitigated but
                      it's not completely factored in either.

Bill Bonello:         Okay, thanks. That's helpful. And then in terms of cost
                      pressure, I know last quarter you saw a bit of a bump in
                      the cost per treatment and some of that was labor cost
                      driven and due to sort of one-time salary increases and
                      you thought there may be some more of those coming down
                      the pike. Can you give us any sense of what's happened
                      there and what's kind of assumed in the projections?

Dirk Allison:         Yes Bill, we have seen a labor market that's tightening.
                      We've seen some market adjustments necessary to keep pace,
                      try to lower our turnover rate that we're experiencing,
                      and so what we have done going forward in the EPS growth
                      rate that Sam has shared with you today, we've raised our
                      wage factor up into the 5 to 6% range. We believe that
                      maybe in the future that will


<PAGE>   19

                      moderate a bit. We don't know but we wanted to protect
                      ourselves, the company and the estimates by putting that
                      in there.

Bill Bonello:         Okay, great.  Thank you very much.

Dirk Allison:         Thanks Bill.

Operator:             Our next question comes from Adrian Dawes with J. M.
                      Hartwell. Please go ahead with your question...

                      Adrian Dawes with J. M. Hartwell, please go ahead with
                      your question.

Adrian Dawes:         Thank you. A couple of questions. Relating to the balance
                      sheet, how much net cash do you have and how much cash
                      flow do you expect to generate on a quarterly basis going
                      forward?

Dirk Allison:         We have approximately $20 million or so net cash on the
                      balance sheet. From a free cash flow basis, let me talk
                      about that. Operating cash flow we should generate
                      anywhere from $18 million to $22 million, $23 million a
                      quarter from that standpoint.

                      But from a free cash flow, after-cap-ex, taxes and what
                      not, you're going to be in the $65 million to $75 million
                      range for the year 2001.

Adrian Dawes:         Is there an existing share buyback on the books at the
                      moment that just needs to be activated post October 2 or
                      does the Board need to meet and then authorize one?

Dirk Allison:         We have not done anything on a share buyback at this
                      point.


<PAGE>   20

Doug Chappel:         Yes, the Board would have to meet.

Adrian Dawes:         Okay. What have been some of the prices that Fresenius and
                      Gambro have made acquisitions at? Are they around the
                      $40,000 to $45,000 level?

Dirk Allison:         I'm sorry, that's who?  Is that Gambro you mentioned?

Adrian Dawes:         Correct.

Dirk Allison:         And Fresenius.

Sam Brooks:           Fresenius. Well, Fresenius has been out of the market for
                      some time, Dirk. I can't remember when but I bet it's been
                      a year and a half probably -- maybe more. So they're back
                      in now. We're competing with them on two deals right now
                      whereas I know we hadn't seen them in a year and a half.
                      It could have been longer than that.

                      Gambro, we competed with them on one deal. And we got that
                      deal, right Dirk?

Dirk Allison:         Yes.

Sam Brooks:           But generally speaking, Gambro is trying hard to get Vivra
                      integrated, and they've had some management changes. So
                      their focus has been more internal than external recently,
                      which I took into account when we were looking at our
                      targets for the coming year. So our competition has been,
                      I call it reasonable, very disciplined buyers as we are.
                      So I don't mind competing with Gambro on deals. Of course,
                      I'd rather not compete with anyone...


<PAGE>   21

Adrian Dawes:         Sure.

Dirk Allison:         But I think that might give you a picture, doesn't it?

Adrian Dawes:         Final question. Given the slower growth rate, would you
                      consider selling the company to one of those two entities?

Dirk Allison:         Well, we run this company as professionally as we can, and
                      that is a Board decision and they're fully aware of that.
                      We do have a shareholders' rights plan in effect. So that
                      helps put the decision more in the Board's hands. So, yes,
                      it'd be a consideration.

                      I haven't had any offers, of course. I'm not supposed to
                      say that, am I? But yes, it's not something, we're
                      thinking of actively. Management is committed to running
                      the company professionally and part of that is getting the
                      best deal for the shareholders. So we would be open to
                      those. We're not here working 80 house a week because we
                      love our salaries.

Adrian Dawes:         Thanks guys.

Operator:             Peter Emch with CS First Boston, please go ahead with your
                      question.

Peter Emch:           Sam, could you talk a little bit more broadly about how
                      you see using the free cash that you're going to generate?
                      It would seem like if you're only going to acquire 500
                      patients a year or so, that's maybe top end $25 million.
                      And given the stability of the nature of your business,
                      what kind of debt-to-cap do you think is appropriate for
                      the company at this point and how would you apply your
                      free cash?


<PAGE>   22

Sam Brooks:           Well, I think the highest debt-to-cap is a 1:1 ratio, so
                      as you can see, we are considerably underleveraged. But
                      Peter, I'm not going to invest the money unless I make
                      some money on it. And we have some opportunities. There
                      are opportunities to buy units, but I'm only going to buy
                      them if I make money off of it. I not only need to
                      increase earnings per share, but I need to get a return on
                      the money I'm laying out because it's an all cash
                      transaction and I want a return on it.

                      Anything else I should comment on that, Dirk? I think it's
                      been brought out now at these prices our company's selling
                      at a pretty cheap price per patient. I'm not sure what it
                      is, but that's an attractive use of our money. And I will
                      say this, I think that opportunity is there because the
                      company is in great shape. You know, like I said, the
                      business is a good business. We haven't screwed it up, and
                      the margins are there. We have the highest operating
                      margins in the business, so we ought to be able to pay
                      more than anybody else because we get better margins, and
                      our debt-to-equity ratio is low, our cash flow is strong
                      because we haven't deferred any maintenance, so it gets us
                      some choices. And we're doing our best to put that to work
                      as quickly and as a well as we can, but we haven't done a
                      good job this year of estimating our earnings per share,
                      and our stock has suffered because of that.

                      The good news is the stock hasn't suffered because the
                      company has done poorly. The business is doing okay. So
                      that presents you with an opportunity to buy the stock
                      back and we have the fire power to do that.

Peter Emch:           I would think, as a follow-up, that given how high your
                      margins are that on a per patient basis maybe acquisitions
                      if you price them per patient are not going to be much
                      higher than you are on stock but on an EBITDA basis, if


<PAGE>   23

                      that's what you're looking at buying at a multiple of
                      EBITDA. I would think your stock would be more attractive
                      than acquisitions you would be making with the stock at
                      this price. Would that be true?

Ray Brooks:           Yes. Dirk would - I don't know the numbers but I'm sure it
                      is.

Dirk Allison:         Yes, and Peter one thing you need to understand, and I
                      know you do. We've talked enough and I think most people
                      understand. When we talk dollars per patient, how much we
                      pay per patient, that's not how we price acquisitions. We
                      are EBITDA driven. So we actually price all of our
                      acquisition opportunities off a multiple of EBITDA, and
                      based on that criteria, I certainly agree with what you
                      said.

Sam Brooks:           I might add our Chief Operating Officer is here, and he
                      runs his business based on EBITDA, and when I pass him in
                      the hall and ask him how are things, his reply has to do
                      with EBITDA. And the same thing occurs when he's at his
                      meetings of our Regional chief operating officers.

                      So it's a principal business focus around here, and I
                      think you as an analyst investor would appreciate that,
                      right Gary?

Gary Brukhardt:       Yes, I think our people - solid performance is what we try
                      to stress. And our Regional chief operating officers, our
                      chief financial officers, our area administrators,
                      facility managers, we take a very measured, consistent,
                      focused approach on operations. It's hard work. People
                      have to stay focused. They can't let up. Looking at labor
                      costs, we've got a whole listing of things that we do.
                      There's no one thing that you can do or magic way to deal
                      with those issues.


<PAGE>   24

                      And this management team steps up and continually stays
                      focused on that.. Margin improvement and EBITDA
                      improvement is what we try to constantly strive for, and
                      I'm pretty proud of what they've accomplished in that
                      area.

Peter Emch:           Do you think you can hold EBITDA margins constant going
                      forward?

Gary Brukhardt:       Well, I think one of the big issues that has been talked
                      about is the labor cost issue. And I just want to add a
                      couple of things and I know everyone wants to say what's
                      the one thing that you do.

                      But let me go through a couple of things on the labor cost
                      side and what our operators are doing because I think
                      that's reflective of the solid core of the business that
                      we have here, and you don't get that done easily. So I
                      want to go over a couple of things on that because I know
                      that's on the minds of a lot of folks.

                      We've got some things working in our favor. We've got some
                      geographic dispersion. First you have to find good staff,
                      then the most important thing is to keep them. Because of
                      our geographic dispersion of the company, we've got some
                      areas and markets that help us out in terms of that.

                      We've had to make some market adjustments because
                      obviously people are the most important resource in our
                      company. And then a couple of other things that we've been
                      doing to address that, and, by the way, each market also
                      does some specific things that they have to do to stay
                      competitive. We installed a new computerized human
                      resources system last year and a software product called
                      (FastGap). It probably doesn't mean a lot to people, but
                      it means a lot to us because it allows us to focus on our
                      labor cost per treatment,


<PAGE>   25

                      looking at overtime, outside labor, etc., giving our
                      managers tools to constantly stay focused on that.

                      There's no doubt that in several of our markets, we're
                      going to continue to face challenges on the labor side.
                      We've also gone to a new program also just within the last
                      month that we call targeted selection because not only do
                      you want to find people, but you want to make sure that
                      you hire people that are going to stay with you. So we are
                      rolling out to all of our facility managers a targeted
                      selection process to hire staff.

                      So we've got a lot of things that we're working on and all
                      of that focuses on margin improvement. So I'm pretty proud
                      of what these people have accomplished and will continue
                      to accomplish going forward, but it's just a lot of basic
                      activity that you have to perform. So I thought I'd share
                      some of that with you.

                      And by the way, because of our best demonstrated practices
                      in our regional operations, we got a lot of people with a
                      lot of creative ideas. Every quarter I meet with facility
                      managers and our management staff here does and our chief
                      operating officers. I've never seen a more dedicated and
                      committed group of people to make sure that they take good
                      care of these patients. We have good patient satisfaction
                      and they manage the resources of the company effectively.

                      So that's kind of a long answer, but I thought I wanted to
                      share and address that labor issue because that's
                      something every one of us gets up every day worrying about
                      after we worry about taking care of patients.

Peter Emch:           Okay, thank you.


<PAGE>   26

Operator:             Our next question comes from Jim Baker with SunTrust
                      Equitable. Please go ahead with your question.

Jim Baker:            Sam, I wonder if you could comment on managed care pricing
                      and specifically I'm interested if you look at, for
                      example, health care services, i.e. hospitals. They've
                      been able to do a very good job of taking the sort of
                      givebacks for price increases they've gotten from the
                      government and been able to go to managed care and get,
                      you know, other pretty nice managed care price increases.

                      Would the prospects of getting, you know, potential
                      inflationary annual adjustment increase in place and just
                      some increases from the government - can you just talk
                      about number one, sort of the managed care pricing you've
                      seen this year and perhaps more importantly, what we
                      should maybe look for in 2001?

Sam Brooks:           Well, in talking to my friends in the hospital business in
                      Nashville and in talking to people that are in the
                      hospital business in not for profits, I've seen that
                      they've achieved some pretty good price increases with
                      managed care. They have probably been more aggressive than
                      we have.

                      We've done a pretty good job in the past, and I don't have
                      any criticism of it in the past. I think we can do a
                      better job in the future.

                      But I will say this, in looking at the average revenue per
                      treatment - that's the number, isn't it - average revenue
                      per treatment in the four public companies, I think we are
                      the second from bottom. We are in third place. There are
                      two others that have total charges greater than ours, so
                      it appears that there's some ability for us to increase
                      our prices just based on that alone. And I know it's a


<PAGE>   27

                      principal focus of Gary. He has people responsible for
                      this. So Dirk, do you want to comment?

Dirk Allison:         Yes, I want to comment on what we've done in this budget
                      looking forward, and then I'm going to pass it over to
                      Gary and let him talk a little bit about that. Jim, right
                      at this point in time not really knowing, we put anywhere
                      from 4 to 7% increases in our projection to get to the 15%
                      as it relates to managed care pricing.

                      And Gary, why don't you comment a little bit on what
                      you're seeing there?

Gary Brukhardt:       Jim, a couple of things that we're doing. First of all, as
                      you know, we've got several people on our senior staff and
                      in our field operations actually that have managed care
                      backgrounds. We've got some good dialysis resources
                      clearly in the company, and we were fortunate to attract
                      some folks that come out of the managed care industry. And
                      I think that always helps when you're sitting across the
                      table from a managed care company and negotiating a
                      contract.

                      They're getting premium increases 10, 15, 30% in some
                      cases. That's a very cyclical industry, and I think it's
                      an opportunity for us as providers to go back to these
                      managed care companies on a market by market basis.

                      A couple of comments on things we're trying to do mitigate
                      and to make sure we can stay consistent with the pressure
                      in that area. Again we've got some pretty significant
                      market share in a lot of markets, which I think when we
                      put the company together, we knew that was a positive. And
                      I think it gives us an opportunity to effectively deal
                      with these managed care organizations.


<PAGE>   28

                      I've always felt very positive about the fact that our
                      accounts receivable management and our billing offices are
                      in multiple markets. One of the things that's real
                      critical in dealing with these managed care companies is
                      knowing these payers. And because we don't bill out of one
                      shop, we're able to deal effectively and know our payers
                      and know what they're doing and try to be proactively
                      working with them rather than reactively because that's
                      where you don't want to be with them, is on a reactive
                      basis.

                      So I think our multiple billing offices - we've got some
                      good folks with some good background of knowledge in terms
                      of managed care dealing with them. I think there's some
                      opportunity here in certain select markets to look at
                      these increases in payments to us. And everything that we
                      do is, we'll catalog and analyze all of our contracts
                      locally and nationally so that we know what's happening.

                      As you know, there's some consolidation in that industry,
                      too, and we have make sure we stay on top of that. So it's
                      not a simple answer, but there's a lot going on. I think
                      there's some opportunity there to take advantage of our
                      market position and to deal with this.

                      And I think over the long period of time, people still buy
                      price and geography, but I think that quality in the end
                      will win out, and I think we should stay focused on that
                      in our business. We're going to be the provider of choice
                      for both the patient, the physician and the payer. So
                      that's kind of how I think it through on what we're
                      working on. Not an easy answer, not a simple answer, but
                      you've just got to do a lot of things to address it.


<PAGE>   29

Jim Baker:            But Dirk, if I can just follow-up. If you're sort of
                      expecting maybe looking for 4 to 7% next year, I'd assume
                      that's an increase from what you've experienced this year?

Dirk Allison:         That's correct.

Jim Baker:            Okay, thank you.

Operator:             Our next question comes from Joel Ray with First Union
                      Securities. Please go ahead with your question.

Joel Ray:             Good morning. I've got two unrelated questions. First is
                      internal growth and development of new centers. I know
                      that again 12, 15 new properties have developed this year.
                      Is there any chance of focusing your cash flow on
                      heightened internal development project team given the
                      fact that it's cheaper certainly in the long run to
                      internally develop?

                      And secondly, as we're focusing the company's initiatives
                      just onto dialysis versus other potential related
                      businesses or diversification, is there any chance that
                      you're going to reevaluate your corporate structure to
                      look to trim G&A?

Dirk Allison:         Okay, those are both good questions. Let me let Gary
                      discuss those just a bit.

Gary Brukhardt:       Joel, one of the things that we're right now focused on
                      obviously in our 2001 budget and our business planning
                      process - in fact all of our Regional chief operating
                      officers and chief financial officers are in town today,
                      and one of the things we're focusing on for next year is
                      what we call a fulfillment strategy. We have very good
                      operations in place, and what we've done is and what we're
                      in the process of doing is - your comment's excellent.


<PAGE>   30

                      Where are all the opportunities within the existing
                      operations that we have? And where are opportunities to
                      partner with physicians, where are opportunities where we
                      can recruit physicians to markets that are underserved and
                      need to meet the needs of the patients?

                      And we're going to put a very big emphasis next year on de
                      novo development because in that fulfillment strategy, we
                      don't have to add G&A. We already have the structure in
                      place. It doesn't take additional resources to do that.
                      And when you can incrementally add a clinic, that's the
                      best thing that we can do. So that's an excellent
                      observation. That's something we're really focused on in
                      the 2001 budget.

Ray Hakim:            Dirk, can I add in something here?

Dirk Allison:         Sure, Ray.

Ray Hakim:            I think the other focus that we are doing actively
                      starting sort of mid this year and really ongoing next
                      year are two other areas that I think will again focus on
                      internal growth.

                      One is to increase the number of patients who are aware or
                      have the option of peritoneal dialysis because that is a
                      very viable therapy that has not been really focused on as
                      much perhaps within the company or the industry. But it is
                      a very viable therapy that allows patients to be at home,
                      allows them much more mobility and incidentally can be
                      done with much less capital expenditure. That's one area
                      that we are focusing on in the context of providing
                      patients with options for their treatment so that it's not
                      always only hemodialysis.


<PAGE>   31

                      The other area, of course, is to do really a process of
                      education both to the patients and to the physicians about
                      when is the time to initiate patients on dialysis and how
                      to get them ready for dialysis without having to
                      necessarily admit them to the hospital and have them with
                      temporary catheters and so on.

                      So these are the two areas also from a medical point of
                      view that we are focusing on that we believe will help
                      internal growth also.

Dirk Allison:         Thank you Ray. Joel, as it relates to your second part
                      about the fact that we're really focusing on dialysis in
                      our corporate structure. Realize that we created this
                      corporate structure we have today to a decentralized
                      approach for a reason. We think it is absolutely essential
                      to some of the things we are doing, our low days' sales
                      outstanding, the control that Gary has over his operation.
                      So I think we are solidly behind the decentralized
                      approach.

                      What we are always doing, and we are doing that right now,
                      is that we're constantly working to lower our G&A. And we
                      will continue that process and we should see results on
                      that in the coming years.

Joel Ray:             Thank you very much.

Dirk Allison:         Sam, would you like to comment any more on that?

Sam Brooks:           No thank you.

Operator:             Our next question comes from Andrew Bhak with Morgan
                      Stanley, Dean Witter. Please go ahead with your question.


<PAGE>   32

Andrew Bhak:          Yes, good morning. I'd just like to get a little gut check
                      here in trying to summarize some of the comments you've
                      made. If we look at the company today and I'm thinking
                      obviously to my own forecast where we've revised earnings
                      for next year to $1.52. I had incorporated a 6% increase
                      in labor cost. I had not incorporated the AWP versus the
                      1.2 because it seems to me it is a little bit of a jump
                      ball but we should know by the end of next month. I've
                      made adjustments to the revenue model that would affect
                      the exit of the wound care business.

                      When you sort of sum total all of these elements and we
                      look forward, is it reasonable to assume that the 15%
                      earnings growth that you factored in really, largely to me
                      reflects organic growth in the market. In that sense, when
                      I look at the operating costs in thinking about what could
                      be a wild card in terms of pressuring it, it would really
                      only be an acceleration in labor costs and potentially
                      another EPO hike by Amgen, although I guess next week
                      we'll, or towards the end of this month we'll find out
                      what's happening with the TKT ruling.

                      So when I look at that and look forward over the next 12
                      months, am I missing anything or does that seem sort of a
                      reasonable characterization of where the company is today?

Sam Brooks:           I might comment, Andrew. I think that's a good analysis.
                      Those are the three big unknowns at this time. In the
                      first four years, our company did pretty well in meeting
                      its estimates and anticipating negative surprises, and of
                      course our budgets always have a reserve in there for
                      those things, but this year we somewhat missed it because
                      we were surprised by EPO. That just hadn't been increased
                      in ten years. It came right out of the blue.


<PAGE>   33

                      So there could be something that none of us in this room
                      have thought of, so we're being a little more cautious
                      than we have in the past, but I wouldn't say that 15% is
                      just internal growth. I think it requires some use of
                      money and some investment and might have some M&A activity
                      in it also.

                      But I think you've identified the major risks to our
                      projections. Dirk, did I speak to soon there?

Dirk Allison:         No, I might add I think it will take about 500 patients to
                      get to the 15% but we feel like that is more than
                      achievable, in fact there may be a potential for upside in
                      the future should prices moderate. I think the only other
                      issue out there that could be both a positive and a
                      potential negative is our managed care. Just realize that
                      we have a percentage of our reimbursement structure that
                      is dependent on the private aspect, and we're going to
                      focus and do a much better job. I think we do a good job
                      in managed care. We're going to work to do a better job,
                      so there's potential there that we might be a little
                      higher than we are currently anticipating.

                      On the other hand, as you know managed care is a tough
                      market, and if they focus on dialysis then we run the risk
                      that there could be a little pressure there.

Ray Hakim:            And Andrew, I think I'm sure you know that the full force
                      of the AWP if it passes more than equals the gain that we
                      could expect even from the additional 1.2% increase. So
                      how that will play out we'll see in hopefully the next
                      month or so positively. But we need to make adjustments
                      for AWP and hopefully that will be mitigated as we go
                      along.

Sam Brooks:           As you know, that's a significant risk. I would love to
                      have had this phone call a month from now after Congress
                      adjourned. We'd have some visibility


<PAGE>   34

                      on AWP and the price increases because they're significant
                      in determining our 2001 budget, but the price was
                      declining on the stock and Dirk thought we ought to do it
                      right now.

                      So yes, you've correctly analyzed that, Andrew, as a big
                      risk but we ought to have some visibility on it in 30
                      days.

Andrew Bhak:          Okay, sounds good. Thanks very much.

Dirk Allison:         Thank you Andrew.

Operator:             Our next question comes from Tim Curro with Value
                      Holdings. Please go ahead with your question.

Tim Curro:            Sam, you mentioned the pooling issue. I just don't see how
                      preserving pooling would affect cash flow enough to use it
                      as a reason to not buy back stock around the current
                      levels, do you?

Sam Brooks:           It has to do with some issues, some tax issues surrounding
                      the seller. They're not significant. You're correct,
                      that's not a significant reason. But the more significant
                      reason is it's only a few days, and it's a lot of work to
                      recast all those documents.

Tim Curro:            Thank you.

Operator:             Greg Macosko with Lord Abbott, please go ahead with your
                      question.


<PAGE>   35

Greg Macosko:         Yes, I'd like to follow-up on a couple of the previous
                      questions if I could. Just so I understand, you mentioned
                      6 to 7% growth. I'm assuming that's internal unit growth?

Dirk Allison:         That is same store treatment growth.  Correct, Greg.

Greg Macosko:         And is that lower than what it has been in the past for
                      the past few years?

Dirk Allison:         Yes, it has. We've been anywhere from 7 to 9% in the past
                      few years.

Greg Macosko:         And can you tell me why that number has come down?

Dirk Allison:         Ray, are you there?

Ray Hakim:            Yes, there are complex reasons that we don't control and
                      that basically relates to the number of patients who begin
                      therapy. That because of as you know 50% of our patients
                      who come to dialysis are diabetics - to the extent that
                      there have been advances that can slow down the rate at
                      which these patients' renal failure progresses then that
                      starts picking up, that is reducing the rate of new
                      patients coming in.

                      Second, as a treatment for hypertension, which is the
                      other major cause of patients developing end stage renal
                      disease, become more tolerable in terms of side effects.
                      The ability to control blood pressure has improved, and
                      that will also slow down the rate at which patients
                      develop end stage renal disease.

                      Unfortunately, and I say that as a physician, there is
                      also the trend that we're beginning to see where there is
                      a much higher incidence of obesity and


<PAGE>   36

                      development of secondary diabetes, the adult onset
                      diabetes, that we are beginning to see across this
                      country.

                      And then also, the aging of the population is clearly
                      increasing. I think the number of patients over 70 where
                      there is a very high incidence of end stage renal disease
                      is increasing.

                      So all of these factors put together - at the moment I
                      think we are seeing some slow down, but you know from a
                      growth point of view, we still feel that - and as I said
                      in 1998, there were 85,000 new patients coming into
                      dialysis in 1998 which is the latest number. And that is a
                      considerable number. So our focus has been the numbers
                      coming into dialysis. What we want to do is reduce
                      mortality rate as we go forward, and that's why we think
                      our growth rate can be sustained at about 6 to 7%.

                      But you're right, it has gone down from the 8% or so that
                      we had last year. We think as we concentrate on internal
                      growth, on new development and peritoneal dialysis, we may
                      be able to, not next year, but hopefully the year after
                      that, retain a internal growth rate back to the 7 - 8%.

Greg Macosko:         Okay, and could you talk about the pricing? You mentioned
                      the 4 to, I believe 4 to 6%, or 4 to 7% pricing. That is
                      in addition to the unit growth, right?

Dirk Allison:         That is correct.

Greg Macosko:         Okay. And could you tell me when the next Board meeting
                      is?

Sam Brooks:           What good would it do to tell you when the next regularly
                      scheduled Board meeting is, but I'd be glad to tell you.
                      When is it, Doug?


<PAGE>   37

Doug Chappell:        Our next regularly scheduled Board meeting is the first
                      week in November, but we can call a special meeting, and
                      have historically called special meetings, on 24 hours'
                      notice under our bylaws.

Sam Brooks:           Great, yes. I think that answered your question, didn't
                      it?

Greg Macosko:         Yes, yes, very good.

Sam Brooks:           That's what you were looking for, yes.

Greg Macosko:         Right. And also, you are going to - can we expect more
                      than 12 to 15 properties to be added in '01?

Dirk Allison:         You know, we're in the capital budget process right now,
                      and that's all coming together. As Gary mentioned earlier,
                      that stems from our operators driving where growth can be
                      achieved, and so if in fact opportunities exist to
                      increase our growth by adding more than 12 to 15 de novos,
                      you rest assured we will consider that strongly.

Ray Hakim:            And again, keep in mind our focus is going to be on the
                      peritoneal dialysis, which does not necessarily need
                      additional centers. So the fact that we may not have more
                      growth than 12 to 15 facilities does not mean that we are
                      not looking for a substantial increase in the treatments.

Greg Macosko:         So the peritoneal dialysis would be an incremental 6 to 7%
                      sort of patient growth...


<PAGE>   38

Ray Hakim:            No, no, no. We're considering that but whether the 6 to 7%
                      growth needs 12 or 15 or 20 or less than that depending on
                      how many patients choose one therapy versus another,
                      that's something that, you know, I wanted to at least put
                      out so that you don't think if we decide to have only 12
                      that our internal growth rate will necessarily be less
                      than what we expect.

Greg Macosko:         Okay and finally, would you talk about nursing homes? I've
                      heard rumors that the nursing homes are looking at setting
                      up small dialysis centers in their facilities or something
                      along that line. Could you comment about that?

Ray Hakim:            Well, all I know are mostly rumors. I think as you well
                      know for a nursing home to be involved in dialysis, there
                      are fairly substantial regulatory hurdles that they have
                      to cross in terms of getting permission. And second, those
                      facilities are by nature small facilities with high
                      overhead cost. So I'm not sure what their projections or
                      their financial model is. I don't think it would represent
                      a threat. In fact, my thinking is that a few of them may
                      try, but then they'll come back to a major provider and
                      see whether those services can be provided on site by the
                      provider, not by the nursing home.


<PAGE>   39

                      It's simply not an easy business to get into, and not very
                      economical when you only treat four and five patients a
                      day. That's not going to make it.

Greg Macosko:         I agree with you, but have you heard of any specific
                      examples of it happening at this point?

Ray Hakim:            Maybe Dirk...

Dirk Allison:         Ray, let me comment. Yes, there's a national pharmacy
                      provider to nursing home chains that has been presenting
                      that they're going to be opening dialysis centers in some
                      of their facilities.

                      In fact, I've gone through the numbers on that. And the
                      problem you have that you have to be aware of is as Ray
                      mentioned, the concentration of patients in a home - a
                      typical nursing home averages about a hundred patients.
                      You're not going to have three or four of those on
                      dialysis. It's very difficult to run a program of that
                      size on any cost effective basis, although I understand
                      they already have the fixed cost of the building.

                      But realize, too, that the patient population is going to
                      be largely skewed to Medicare patients at that point in
                      time, whereas as you are aware, our revenue mix on most of
                      the companies, about 55% of our revenue runs Medicare, 5%
                      Medicaid with the majority of the rest in the private and
                      managed care markets.

                      So the financial model for us is a little difficult to
                      understand.

Greg Macosko:         I agree with you, but have they opened one at this point?
                      Is one specifically open?

Dirk Allison:         I do know they're trying at least one.

Greg Macosko:         Okay, thank you.

Operator:             Our next question comes from Howard Capek with UBS
                      Warburg. Please go ahead with your question.


<PAGE>   40

Howard Capek:         Hi, Howard Capek. Good morning. Just two brief, quick
                      questions. On the charge for the wound care, is any piece
                      of that cash?

Dirk Allison:         Yes, of the $9 million, you've got about 30% that will be
                      cash, and the other 70% will be noncash.

Howard Capek:         To circle back to Youngstown and the fallout there, when
                      does the contract for the water treatment on Youngstown
                      and the rest of those clinics that you acquired wind down?
                      Are you going to try to accelerate that and bring it in
                      house faster?

Ray Hakim:            It's winding down in November, Howard. And we are at the
                      moment in the phase where we are training our inside staff
                      to do their own training in preparation for taking over
                      the management of the water system. This is the model
                      we've had in all other facilities. I think I may have
                      mentioned to you earlier. The one sort of time where we
                      said well, the contract is running out in November as we
                      train new staff to take over. So that's where we are.

Howard Capek:         Okay, thanks. Last, just to circle back on the
                      acquisitions, the stuff that sort of traded away from you.
                      Were they hospital-based, physician-owned? And what size
                      were they? And that's it, thank you.

Sam Brooks:           On the acquisitions that we missed?

Howard Capek:         Yes.

Sam Brooks:           Okay.

Dirk Allison:         Howard, I apologize. Could you repeat that question one
                      more time?


<PAGE>   41

Howard Capek:         Yes, on the acquisitions that traded away from you.

Dirk Allison:         Yes.

Howard Capek:         Were they physician-owned, hospital-based and what size
                      range?

Sam Brooks:           Actually, they were both hospital and physician and
                      they're going to be in the size of between 150 and 300
                      patients.

Howard Capek:         Thanks very much.

Operator:             Ladies and gentlemen, if there are any additional
                      questions, please press the 1 followed by the 4 at this
                      time.

                      Chuck Ruff with Insight Investments, please go ahead with
                      your question.

Chuck Ruff:           Hi, just two quick ones. You talked about acquisition
                      pricing and really you priced it on a EBITDA multiple
                      basis. What sort of multiples do you like to see them in
                      and what kind of multiples did those recent acquisitions
                      go at that ran away from you?

Sam Brooks:           Well, Chuck I like to see them in the 4-1/2 range but
                      that's probably not feasible. Actually, we probably look
                      in the 5, 5-1/2. You can pay up to 6, but it would have to
                      really be a good acquisition. I don't know the final price
                      of that those went in, but I would tell you they are above
                      the 6 EBITDA multiple range.


<PAGE>   42

Chuck Ruff:           Okay and this 15% earnings growth. As someone mentioned,
                      if you apply that to next year, you come up with about
                      $1.52 or so. And we talked a lot about the assumptions to
                      get there. Does that assume share buyback or is that
                      before any share buyback?

Dirk Allison:         No, it does not assume any share buyback.

Chuck Ruff:           Great, thanks a lot guys.

Dirk Allison:         Thanks.

Sam Brooks:           Okay, well ladies and gentlemen, thank you very much for
                      being with us today. We apologize for this call. We wish
                      it hadn't of happened, but we thought it best to have it
                      and get it out and get it out to you as soon as we can. So
                      I think you got a good understanding of where we are and
                      of our estimates for the coming year and the risks as best
                      as we know them for those estimates having to do with
                      three or four things that have been brought up during this
                      call.

                      So okay, thanks for being with us and I believe we'll be
                      talking to you again at our earnings release in November,
                      isn't it Dirk?

Dirk Allison:         Right.

Sam Brooks:           Okay, thank you Operator. Thank you Ray.

Operator:             Ladies and gentlemen, that does conclude your conference
                      for today. You may all disconnect and thank you for
                      participating.

                                       END


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