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NextGen Healthcare
Annual Report 2009

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FY2009 Annual Report · NextGen Healthcare
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CORPORATE HEADQUARTERS/QSI DENTAL DIVISION LOCATION

NEXTGEN HEALTHCARE INFORMATION SYSTEMS LOCATIONS

18111 Von Karman Avenue, Suite 600

Irvine, California  92612

949.255.2600

www.qsii.com

795 Horsham Road

Horsham, Pennsylvania  19044

215.657.7010

3340 Peachtree Road NE, Suite 2700

Atlanta, Georgia  30326

404.467.1500

286 Grand Avenue

Southlake, Texas  76092

215.657.7010

1836 Lackland Hill Parkway

St. Louis, Missouri  63146

314.989.0300

11350 McCormick Road

Executive Plaza IV, Suite 600

Hunt Valley, Maryland  21031

443.933.4300

www.nextgen.com

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
C O M P A N Y   P R O F I L E

C O R P O R A T E   I N F O R M A T I O N

Quality Systems, Inc. (NASDAQ:QSII) and its NextGen Healthcare Information Systems 

subsidiary develop and market computer-based practice management, electronic health records 

and revenue cycle management applications as well as connectivity products and services for 

medical and dental group practices.     

F I N A N C I A L   H I G H L I G H T S

Fiscal year ended March 31,

2009  

2008 

 2007 

2006  

 2005

Revenue 

Net income 

$245,515  $186,500  $157,165  $119,287 

$88,961

46,119 

40,078 

33,232 

23,322 

16,109

Diluted earnings per share 

$1.62 

$1.44 

$1.21 

 $0.85 

$0.61

Cash dividends declared per share  

$1.15 

$1.00 

$1.00 

$0.875 

$0.75

Total shareholders’ equity 

$155,567  $113,705 

$91,246 

$72,409 

$62,731

 (in thousands, except per share amounts)

A B O U T   T H E   C O V E R

The front cover is a representation of a geometric shape known as a fractal. A fractal is divisible into parts, each of which 

is a smaller copy of the whole. Similarly, Quality Systems’ computer-based solutions for the healthcare industry, such as 

practice management, patient records and revenue cycle management applications, can be customized into parts to meet 

the specifi c needs of a medical and/or dental practice.  Currently used by more than 55,000 physicians and dentists 

nationwide, Quality Systems’ solutions have been tested, trusted and proven and can be scaled to handle the impending 

nationwide demand for a unifi ed transition to Electronic Health Records (EHR).   

President and Chief Executive Officer, Quality Systems, Inc. 

I N D E P E N D E N T   A U D I T O R S

B O A R D   O F   D I R E C T O R S

Sheldon Razin

Chairman of the Board

Steven T. Plochocki

Murray Brennan, MD

Emeritus Chairman, Memorial Sloan-Kettering 

Cancer Center, Department of Surgery

George Bristol

Managing Director, Crowell Weedon & Co. 

Patrick B. Cline

President, NextGen Healthcare Information Systems

Ahmed Hussein

Director

Cairo, Egypt

Philip N. Kaplan

Chief Executive Officer, Deer Valley Ventures, LLC

Vincent J. Love

Managing Director, Finance Scholars Group

Russell Pfl ueger

Chairman and CEO, Quiescence Medical, Inc.

O F F I C E R S   O F   T H E   C O M P A N Y

Steven T. Plochocki

President and Chief Executive Officer

Patrick B. Cline

President, NextGen Healthcare Information Systems

Paul A. Holt

Chief Financial Officer and Secretary

Donn Neufeld

QSI Dental Division

Senior Vice President and General Manager, 

L E G A L   C O U N S E L

Rutan & Tucker, LLP

Costa Mesa, California

Grant Thornton, LLP

Irvine, California

S T O C K   T R A N S F E R   A G E N T   & 

R E G I S T R A R

Computershare

Glendale, California

A N N U A L   M E E T I N G

The annual meeting of stockholders will be held on 

Thursday, August 13, 2009 at 1:00 PM, Pacific Time at:

The Center Club 

650 Town Center Drive 

Costa Mesa, California  92626

F O R M   10 - K

A copy of the Company’s Annual Report on Form 10-K, 

as filed with the Securities and Exchange Commission, is 

available on the Company’s website at www.qsii.com or by 

contacting the Company at: 

18111 Von Karman Avenue, Suite 600

Irvine, California 92612

949.255.2600

F O R W A R D - L O O K I N G   S T A T E M E N T S

Statements made in this Annual Report to Shareholders and in our Annual Report on Form 10-K (“Form 10-K”) contained herein (collectively, this “Report”), 

other reports and proxy statements fi led with the Securities and Exchange Commission (“Commission”), communications to shareholders, press releases 

and oral statements made by our representatives that are not historical in nature, or that state our or management’s intentions, hopes, beliefs, expectations 

or predictions of the future, may constitute “forward-looking statements” within the meaning of Section 21E of the Securities and Exchange Act of 1934, 

as amended. Forward-looking statements can often be identifi ed by the use of forward-looking terminology, such as “could,” “should,” “will,” “will be,” 

“will lead,” “will assist,” “intended,” “continue,” “believe,” “may,” “expect,” “hope,” “anticipate,” “goal,” “forecast,” “plan,” “potentially” or “estimate” or 

variations thereof or similar expressions. Forward-looking statements are not guarantees of future performance. Forward-looking statements involve risks, 

uncertainties and assumptions. It is important to note that any such performance and actual results, fi nancial condition or business, could differ materially 

from those expressed in such forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to, the risk 

factors discussed in Item 1A of our Form 10-K as well as factors discussed elsewhere in this and other reports and documents we fi le with the Commission. 

Other unforeseen factors not identifi ed herein could also have such an effect. We undertake no obligation to update or revise forward-looking statements 

to refl ect changed assumptions, the occurrence of unanticipated events or changes in future operating results, fi nancial condition or business over time 

unless required by law. Interested persons are urged to review the risks described under Item 1A, “Risk Factors” and in Item 7, “Management’s Discussion 

and Analysis of Financial Condition and Results of Operations” in our Form 10-K, as well as in our other public disclosures and fi lings with the Commission. 

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D

 
 
 
 
 
 
 
 
 
 
 
L E T T E R   T O   S H A R E H O L D E R S

Steven T. Plochocki
President
and Chief Executive Offi cer

Sheldon Razin
Chairman of the Board 

and Founder

Revenues
(in millions)

Thirty-fi ve  years  ago, Quality 

$ 250

Systems, Inc. was incorporated as a computer

$ 200

consulting business. The company quickly iden-

tifi ed  an  opportunity  in  the  computerization  of

$ 150

dental practices and began developing systems 

$ 100

to automate them. Quality Systems introduced the 

fi rst turn-key, customizable practice management 

solution that could meet the needs of any size 

dental practice. At that time, no formal healthcare 

$ 50

$ 0

05

06

07

08

09

Over  the  years,  both  the  QSI  Dental 

Division  and  NextGen  have  built  strong  posi-

tions in large practice markets across the dental

and medical arenas.

Both  divisions  create  software  that  auto-

mates and streamlines administrative and clinical

functions  necessary  to  the  successful  operation

of a medical or dental practice. Examples of our

practice management solutions include a range of

information technology (HIT) sector existed. As a pioneer in what 

scheduling and billing software.

has now evolved into a fully developed specialty sector within

the healthcare services arena, Quality Systems has emerged a 

The Breadth and Depth of 
the Quality Systems Offering

leading participant, serving both medical and dental practices.

Quality Systems has continually remained on the cutting edge

Today, Quality Systems’ electronic-based medical solutions are 

of  electronic  health  records  (EHR).  NextGen  is  one  of  the

used by approximately 55,000 physicians and dentists, spanning 

indusstry’s  leaders  in  the  development  and  provision  of  EHR 

nearly 2,000 practices throughout the country. 

and  practice  management  systems  (PMS),  connectivity  solu-

Two Distinctly Complementary and 
Successful Divisions

tions and billing services for medical practices. 

NextGen’s EHR platform is designed to improve patient 

Quality Systems is comprised of its QSI Dental Division and

care, increase revenues, decrease expenses, reduce risk and 

a wholly owned subsidiary, NextGen Healthcare Information 

improove  overall  patient  satisfaction.  NextGen  EHR  allows 

Systems (NextGen). 

physician specialty providers to document and manage patient 

The QSI Dental Division, located in Irvine, Ca., focuses on 

care,  automatically  create  documents  and  letters,  manage

developing, marketing and supporting software suites for dental 

presccriptions  and  clinical  images,  provide  patient  education 

and certain niche medical practices. 

and eexchange data with other systems, within and external to,

NextGen, with headquarters in Horsham, Pa., and loca-

the  eenterprise.  NextGen  EHR  is  capable  of  linking  fi nancial 

tions  in  Atlanta,  Ga.,  Southlake,  Tx.,  St.  Louis,  Mo.  and  Hunt

and  clinical  information,  improving  healthcare  delivery  and 

Valley,  Md.,  primarily  develops  and  markets  products  and 

eliminnating paperwork for medical practices of any size.

services for medical practices.

Q u a l i t y   S y s t e m s ,   I n c .       |       1

Diluted Earnings 
Per Share

NextGen’s revolutionary suite of services

fully  automates  medical  practices.  Its  enter-

prise  practice  management  system  (NextGen 

EPM)  provides  a  common  registration  system,

$ 2.00

$ 1.60

$ 1.20

During  fiscal  2009,  Quality  Systems

continued  to  further  cement  its  market  lead-

ership  position  within  the  HIT  sector,  which 

included  the  completion  of  two  acquisitions.

enterprise-wide appointment scheduling, referral 

$ 0.80

These  marked  our  entry  into  a  new  market

tracking,  a  custom  report  writer  and  patient

segment – revenue cycle management – which

fi nancial management.

aids physicians in the automation and manage-

$ 0.40

Our  QSI  Dental  Division  offers  dental 

$ 0

05

06

07

08

09

ment of their practice’s billing-related functions 

practices powerful, feature-rich and fl exible soft-

and  expedites  the  billing  and  collections

Cash Flow from 
Operations
(in millions)

ware  solutions  that  allow  hundreds  of  dental 

practices to operate more effi ciently and cost

effectively.  The  dental  suite  of  software  solu-

tions  and  services  consists  of  a  wide  range 

of components including those that assist with

patient  scheduling  and  registration,  accounts 

receivable,  billing,  management  reporting,

$ 50

$ 40

$ 30

$ 20

process. In May 2008, we acquired St. Louis,

Mo.-based  Healthcare  Strategic  Initiatives 

(HSI), a full-service healthcare revenue manage-

ment  company  serving  healthcare  clients.  In 

October  2008,  Hunt  Valley,  Md.-based 

Practice  Management  Partners  (PMP),  also  a

full-service  healthcare  revenue  cycle  manage-

electronic  claims  and  statement  processing 

ment entity, joined the Quality Systems network.

and comprehensive electronic patient records, 

$ 10

Both of these companies have strengthened the

along with other Internet applications.

scope of our services within the revenue cycle 

The Year in Review 

$ 0

05

06

07

08

09

management  sector  and  afford  us  the  ability 

to  cross-sell  products  and  services  to  our  existing  customer

Fiscal  2009  was  another  successful  year.  Revenue  reached 

$245.5 million, rising 32 percent when compared with $186.5

million  in  fi scal  2008.  Net  income  for  the  year  was  $46.1 

million  versus  $40.1  million  for  2008,  an  increase  of  15 

percent.  Diluted  earnings  per  share  were  $1.62  compared 

with $1.44 reported in 2008, up 13 percent. The increases 

in  revenue  and  income  are  primarily  attributable  to  growth

in  systems  sales,  maintenance  and  the  addition  of  revenue

cycle management services to our portfolio of service offerings. 

base of users.

The  company  continued  to  generate  strong  operating

cash fl ows, enabling us to pay approximately $30.8 million in

dividends as well as invest in the two revenue cycle manage-

ment  acquisitions  noted  above,  while  leaving  our  cash  and

marketable securities position roughly unchanged from the start

of the year at $78.9 million from $81.7 million a year ago.

2       |       2 0 0 9   A n n u a l   R e p o r t

“We view the H ITECH portion of the economic stimulus plan as a 
potentially signifi cant opportunity for Quality Systems.”

New vs. 
Recurring Revenues

Positioning for the Future: 
Pursuing the Opportunity of 
a Lifetime

NNeeeww
4400%%%

future of EHR presents a vast opportunity and 

viable competitive advantage for the strongest

exchange health information to improve quality 

and  promote  care  coordination;  and  (iii)  the

ability  to  report  on  clinical  quality  measures. 

Reeccurrrinnng
6600%

These  incentives  are  expected  to  be  offered 

through 2015.

We believe our highly advanced NextGen 

and soundest players in the space to secure leadership roles. 

EHR products are well positioned to enable physicians to benefitfi

Recently,  as  part  of  the  Obama  Administration’s 

from the incentives offered in the stimulus package. 

economic  stimulus  plan,  it  was  announced  that  more  than 

$29 billion has been dedicated to the HIT sector, as stated in 

Economic and Clinical 
The Health Information Technology for Economic and Clinical 

ology for E

Health  Act  (HITECH),  which  is  part  of

t

The  2009  American 

Recovery  and  Reinvestment  AAct 

(ARRA)

,  passed  into  law  by

Congress in February 2009. 

We have already begun preparing to take advantage of 

this extraordinarily rare industry opportunity by expanding our

sales organization as well as our 

ll

l

implementation and training 

d

l

teams. Additionally, we are establ

ishing new relationships with 

third-party consultants to aid in the

 implementation and training 

process. We are also expanding o

our reseller base to ensure we 

The  ARRA  includes  mo

re  than  $1

19  billion  earmarked

can support future sales efforts.

to  aid  healthcare  organizatio

ons  in  thei

r  quest  to  modernize 

Providers are incrreaseasingingly ly us

iing ng tectechnohn logy to: maximize

operations through the acquis

sition and i

implementation of HIT. 

Of that amount, $17.2 billion 

has been 

allocated to HIT infra-

structure  relating  to  Medicar

e  and  Me

edicaid  incentives  for 

doctors and hospitals. 

We view the HITECH p

portion of t

the economic stimulus 

plan as a potentially signifi can

t opportun

ity for Quality Systems.

The portions of the stimu

ulus plan d

dedicated to Federally 

the effi ciencies of theieir br businesss aa

nd nd medmedicaical pl

ractices; better

compete amid the rapiapidlydly chchangang

inging h healthcac re arena; assist 

in enhancing patient carcare; e; and ma

aintain the privacy of patient

information.  Additionally,  as  thehe  

rereimbursement  environment

also  continues  to  evolvelv ,  more

e  healthcare  providers  are 

entering into contracts ts – oftentin me

es with multiple entities – that 

defi ne the terms unded r which carar

rere i is adminnisti ered and paid. 

Qualifi ed Healthcare Centers 

($1.5 billioon) and Indian Health 
on) and Indian Health

The  diversity  of  payoyor  organizatat
h d

f

iions,  aas  wellel   as  additional 
l

dd

ll

Services ($85 million) are jusst starting tto be distributed now. 

Quality Systems has worked wwith each oof these constituencies 

for  the  past  15  years.  The  mmajority  of  the  funds  allocated

under  the  stimulus  plan  that  are  tied  into  physician  incen-

tives  are  slated  to  begin  in  2011  for  those  physicians  that 

can  demonstrate  “meaningfuul  use”  of  EHR.  While  the  fi nal

defi nition of meaningful use haas not yet been determined, we 

believe  that  Quality  Systems  is  ready  tto  meet  the  expected 

government regulationon and chang

gess in reimbbursursement models, 

have greatly increaseedd the compl

exity of ppriricing, b, ,  illing, reim-

bursement and recoordsrds managem

ment forfo  medical and dental 

practices.  To  operate  effectively,

,  healthcare  providers  mmustus

effi cientntly  manage  patient  care 

and  other  information  and

workfl ow processes which increas

singly extend across multiplee

locations and business entities. A

All of these requirements are

expected  to  continue  to  strength

en  Quality  Systems’  current 

fi
nal deefi
nitions arre expected to include:
fi
fi nal requirements. The fi
fi

market leadership position.

(i)  e-prescribing  capability;  (ii)  the  abbility  to  electronically

Q u a l i t y   S y s t e m s ,   I n c .       |       3

A Time to Recognize

a CCHIT Certifi ed® 08 Ambulatory EHR. According to CCHIT,

2009  marks  35  years  since  our  incorporation  and  demon-

NextGen‘s product meets the Certifi cation Commission’s EHR 

strates  decades  of  continued  success  in  our  ability  to  take

criteria  for  offi ce-based  use.  The  Commission  –  a  private,

the HIT sector to new levels. For the 10-year period ended 

nonprofi t organization – is the recognized certifi cation body in 

January  1,  2009,  according  to  Motley  Fool,  Quality

the U.S. for HIT products.

Systems  ranked  the  third  best-performing  stock  on  Wall

As  we  refl ect  upon  all  the  accomplishments  since  the 

Street,  appreciating  4,130  percent.  In  2008,  Quality

company’s founding, we want to take this opportunity to thank 

Systems’  shares  were  up  43.1  percent  while  the  NASDAQ 

our  shareholders  for  their  continued  support;  our  Board  of

Composite was down 40.5 percent.

Directors for their insight and guidance; our customers for their 

The  company  also  ranked  fourth  in Forbes’  2008

business and commitment to our company; and our employees

America’s 200 Best Small Companies list, moving up a notch

for  their  loyalty  and  dedication.  Quality  Systems  is  proud  to 

from its fi fth-place position in 2007.

celebrate  35  years  of  extraordinary  growth  and  remarkable 

Additionally,  Quality  Systems’  integrated  HIT  platform

success thanks to all of their contributions.

was  evaluated  by  the  non-profi t  organization,  the  National

Network  for  Oral  Health  Access  (NNOHA).  The  NNOHA

Respectfully,
Respectfully

recognized the company’s platform for its outstanding features, 

functionality  and  performance.  The  organization’s  HIT 

Committee  determined  that,  when  used  in  conjunction  with

Sheldon Razin

Steven T. Plochocki

NextGen  products  on  the  same  platform,  Quality  Systems’

features, functionality and integration wwere considered to be 

Chairman of the Board 
and
and Founder

President 
and Chief Executive Offi cer

best practice and state-of-the-art.

Furthermore, the Certifi cation Commission for Healthcare

InfInfIn ormormatiation on Tecechnohn loggy (y CCHITT®TT ) approvved NextGen’s EHR as

4       |       2 0 0 9   A n n u a l   R e p o r t

UNITED STATES 
SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, DC 20549
FORM 10-K

(Mark One)
x  ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the fiscal year ended March 31, 2009

or

o  TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                             to                            

Commission File Number: 001-12537

QUALITY SYSTEMS, INC.

(Exact name of registrant as specified in its charter)

California 
 (State or other jurisdiction of incorporation or organization) 

95-2888568
(IRS employer identification no.)

18111 Von Karman Avenue, Suite 600, Irvine, California 92612 
(Address of principal executive offices)

(949) 255-2600
(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:

Common Stock, $0.01 Par Value 
Title of each class 

NASDAQ Global Select Market

Name of each exchange on which registered

Securities registered pursuant to Section 12(g) of the Act:
None
Title of each class

Indicate  by  check  mark  if  the  registrant  is  a  well-known  seasoned  issuer,  as  defined  in  Rule  405  of  the  Securities  
Act. Yes  o  No  x

Indicate  by  check  mark  if  the  registrant  is  not  required  to  file  reports  pursuant  to  Section  13  or  Section  15(d)  of  
the Act. Yes  o  No  x

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities 
Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such 
reports), and (2) has been subject to such filing requirements for the past 90 days. Yes  x   No  o

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every 
Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) 
during  the  preceding  12  months  (or  for  such  shorter  period  that  the  registrant  was  required  to  submit  and  post  such  files).  
Yes  o   No  o

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will 
not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference 
in Part III of this Form 10-K or any amendment to this Form 10-K. x

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a 
smaller reporting company. See the definitions of “large accelerated filer,” “accelerated filer” and “smaller reporting company” 

1

  
  
  
 
  
  
 
  
 
in Rule 12b-2 of the Exchange Act. (Check one):

Large accelerated filer   x 

Accelerated Filer   o 

Non-accelerated Filer   o
(Do not check if a smaller  

reporting company)

Smaller reporting company   o

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes  o   No  x

The aggregate market value of the voting stock held by non-affiliates of the Registrant as of September 30, 2008: $783,989,000 
(based on the closing sales price of the Registrant’s common stock as reported on the NASDAQ Global Select Market on that 
date of $42.26 per share).*

The Registrant has no non-voting common equity.

Indicate the number of shares outstanding of each of the Registrant’s classes of common stock, as of the latest practicable date.

Common Stock, $.01 par value 
(Class) 

28,504,868
(Outstanding at May 22, 2009)

  *For purposes of this Annual Report on Form 10-K, in addition to those shareholders which fall within the definition of 
“affiliates” under Rule 405 of the Securities Act of 1933, as amended, holders of ten percent or more of the Registrant’s common 
stock are deemed to be affiliates for purposes of this Report.

Documents Incorporated by Reference

The following documents (or parts thereof) are incorporated by 
reference into the following parts of this Form 10-K:

Proxy Statement for the 2009 Annual Meeting of Shareholders —  
Part III Items 10, 11, 12, 13 and 14.

2

  
 
  
 
QUALITY SYSTEMS, INC. 
FORM 10-K 
For the Fiscal Year Ended March 31, 2009

Part I

Item  

Item 1. 

Business 

Item 1A.  Risk Factors 

Item 1B.  Unresolved Staff Comments 

Item 2. 

Properties 

Item 3. 

Legal Proceedings 

Item 4. 

Submission of Matters to a Vote of Security Holders 

Part II

Page

4

10

19

19

20

20

Item 5.  Market for Registrant’s Common Stock, Related Shareholder Matters and Issuer Purchases of Equity Securities  20

Item 6. 

Selected Financial Data 

Item 7.  Management’s Discussion and Analysis of Financial Condition and Results of Operations 

Item 7A.  Quantitative and Qualitative Disclosures About Market Risk 

Item 8. 

Financial Statements and Supplementary Data 

Item 9. 

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 

Item 9A.  Controls and Procedures 

Item 9B.  Other Information 

Item 10.  Directors, Executive Officers and Corporate Governance 

Item 11. 

Executive Compensation 

Part III

Item 12.  Security Ownership of Certain Beneficial Owners and Management and Related Shareholder Matters 

Item 13.  Certain Relationships and Related Transactions, and Director Independence 

Item 14. 

Principal Accountant Fees and Services 

Part IV

Item 15. 

Exhibits and Financial Statement Schedules 

Signatures 

22

23

44

44

44

44

45

46

46

46

46

46

46

50

3

 
  
 
Cautionary Statement

Statements made in this Annual Report on Form 10-K (this “Report”), the Annual Report to Shareholders in which this Report is 
made a part, other reports and proxy statements filed with the Securities and Exchange Commission (“Commission”), communi-
cations to shareholders, press releases and oral statements made by our representatives that are not historical in nature, or that 
state our or management’s intentions, hopes, beliefs, expectations or predictions of the future, may constitute “forward-looking 
statements” within the meaning of Section 21E of the Securities and Exchange Act of 1934, as amended (the “Exchange Act”). 
Forward-looking statements can often be identified by the use of forward-looking terminology, such as “could,” “should,” “will,” 
“will be,” “will lead,” “will assist,” “intended,” “continue,” “believe,” “may,” “expect,” “hope,” “anticipate,” “goal,” “forecast,” “plan,” 
or “estimate” or variations thereof or similar expressions. Forward-looking statements are not guarantees of future performance. 

Forward-looking statements involve risks, uncertainties and assumptions. It is important to note that any such performance 
and actual results, financial condition or business, could differ materially from those expressed in such forward-looking state-
ments. Factors that could cause or contribute to such differences include, but are not limited to, the risk factors discussed in Item 
1A of this Report as well as factors discussed elsewhere in this and other reports and documents we file with the Commission. 
Other unforeseen factors not identified herein could also have such an effect. We undertake no obligation to update or revise 
forward-looking statements to reflect changed assumptions, the occurrence of unanticipated events or changes in future operat-
ing results, financial condition or business over time unless required by law. Interested persons are urged to review the risks de-
scribed under Item 1A. “Risk Factors” and in Item 7. “Management’s Discussion and Analysis of Financial Condition and Results 
of Operations” as well as in our other public disclosures and filings with the Commission.

Part I

ITEM 1. Business

Company Overview
Quality  Systems  Inc.,  comprised  of  the  QSI  Division  (“QSI 
Division”),  a  wholly-owned  subsidiary,  NextGen  Healthcare 
Information  Systems,  Inc.  (“NextGen  Division”),  Lackland 
Acquisition II, LLC dba Healthcare Strategic Initiatives (“HSI”) 
and Practice Management Partners, Inc. (“PMP”) (collectively, 
the  “Company”,  “we”,  “our”,  or  “us”)  develops  and  markets 
healthcare information systems that automate certain aspects 
of medical and dental practices, networks of practices such as 
physician  hospital  organizations  (“PHOs”)  and  management 
service organizations (“MSOs”), ambulatory care centers, com-
munity health centers, and medical and dental schools. The 
Company also provides revenue cycle management (“RCM”) 
services  through  its  Practice  Solutions  division  of  NextGen. 
Operationally, HSI and PMP are considered and administered 
as part of the NextGen Division.

The Company, a California corporation formed in 1974, 
was  founded  with  an  early  focus  on  providing  information 
systems to dental group practices. In the mid-1980’s, we capi-
talized on the increasing focus on medical cost containment 
and further expanded our information processing systems to 
serve the medical market. In the mid-1990’s we made two ac-
quisitions that accelerated our penetration of the medical mar-
ket. These two acquisitions formed the basis for the NextGen 
Division.  Today,  we  serve  the  medical  and  dental  markets 
through our two divisions. 

The two divisions operate largely as stand-alone opera-
tions, with each division maintaining its own distinct product 
lines,  product  platforms,  development,  implementation  and 
support teams, sales staffing and branding. The two divisions 
share the resources of our “corporate office” which includes 
a  variety  of  accounting  and  other  administrative  functions. 
Additionally, there are a small number of clients who are si-
multaneously utilizing software from each of our two divisions. 

The  QSI  Division,  co-located  with  our  Corporate 
Headquarters in Irvine, California, currently focuses on devel-
oping, marketing and supporting software suites sold to dental 
and certain niche medical practices. In addition, the division 
supports a number of medical clients that utilize the division’s 
UNIX based medical practice management software product. 

The  NextGen  Division,  with  headquarters  in  Horsham, 
Pennsylvania, and significant locations in Atlanta, Georgia, St. 
Louis, Missouri and Hunt Valley, Maryland, focuses principally 
on developing and marketing products and services for medi-
cal practices.

Both  divisions  develop  and  market  practice  manage-
ment software that is designed to automate and streamline a 
number of the administrative functions required for operating a 
medical or dental practice. Examples of practice management 
software functions include scheduling and billing capabilities. 
It  is  important  to  note  that  in  both  the  medical  and  dental 
environments,  practice  management  software  systems  have 

4

already been implemented by the vast majority of practices. 
Therefore, we actively compete for the replacement market. 

In addition, both divisions develop and market software 
that automates the patient record. Adoption rates for this soft-
ware, commonly referred to as clinical software, are relatively 
low. Therefore, we are typically competing to replace paper-
based  patient  record  alternatives  as  opposed  to  replacing 
previously purchased systems. 

Electronic  Data  Interchange  (“EDI”)/connectivity  products 
are  intended  to  automate  a  number  of  manual,  often  paper-
based or telephony intensive communications between patients 
and/or providers and/or payors. Two of the more common EDI 
services are forwarding insurance claims electronically from pro-
viders to payors and assisting practices with issuing statements 
to patients. Most client practices utilize at least some of these 
services from us or one of our competitors. Other EDI connectiv-
ity services are used more sporadically by client practices. We 
typically compete to displace incumbent vendors for claims and 
statements  accounts,  and  attempt  to  increase  usage  of  other 
elements  in  our  EDI/connectivity  product  line.  In  general,  EDI 
services are only sold to those accounts utilizing software from 
one of our divisions.

The  NextGen  Division  also  offers  RCM  services  under 
the  Practice  Solutions  name.  Services  provided  through  the 
Practice Solutions/RCM unit consist primarily of billing and col-
lections services for medical practices. The Practice Solutions 
unit  utilizes  NextGen  Enterprise  Practice  Management  soft-
ware to a significant extent. 

The QSI Division’s practice management software suite 
utilizes  a  UNIX  operating  system.  Its  Clinical  Product  Suite 
(“CPS”) utilizes a Windows NT operating system and can be 
fully integrated with the practice management software from 
each division. CPS incorporates a wide range of clinical tools 
including,  but  not  limited  to,  periodontal  charting  and  digi-
tal imaging of X-ray and inter-oral camera images as part of 
the electronic patient record. The division develops, markets, 
and manages our EDI/connectivity applications. The QSInet 
Application  Service  Provider  (“ASP/Internet”)  offering  is  also 
developed and marketed by the Division. 

Our  NextGen  Division  develops  and  sells  proprietary 
electronic medical records software and practice management 
systems under the NextGen product name. Major product cat-
egories of the NextGen suite include Electronic Health Records 
(“NextGen EHR”), Enterprise Practice Management (“NextGen 
EPM”),  Enterprise  Appointment  Scheduling  (“NextGen  EAS”), 
Enterprise  Master  Patient  Index  (“NextGen  EPI”),  NextGen 
Image  Control  System  (“NextGen  ICS”),  Managed  Care 
Server (“NextGen MCS”), Electronic Data Interchange, System 
Interfaces,  Internet  Operability  (“NextGen  WEB”),  a  Patient-
centric  and  Provider-centric  Web  Portal  solution  (“NextMD.

com”), NextGen Express, a version of NextGen EHR designed 
for small practices and NextGen Community Health Solution 
(“NextGen CHS”). Beginning in the fiscal year ended March 
31,  2008,  the  NextGen  Division  began  offering  optional 
NextGen  Hosting  Solutions  to  new  and  existing  customers. 
NextGen products utilize Microsoft Windows technology and 
can operate in a client-server environment as well as via private 
intranet, the Internet, or in an ASP environment. 

We  continue  to  pursue  product  enhancement  initiatives 
within  each  division.  The  majority  of  such  expenditures  are 
currently targeted to the NextGen Division product line and 
client base. 

Inclusive  of  divisional  maintenance,  EDI  and  RCM  rev-
enue,  the  NextGen  Division  accounted  for  approximately 
93.5%  of  our  revenue  for  fiscal  year  2009  compared  to 
91.4% in fiscal year 2008. Inclusive of divisional maintenance 
and EDI revenue, the QSI Division accounted for approximate-
ly 6.5% and 8.6% of revenue in fiscal year 2009 and 2008, 
respectively.  The  NextGen  Division’s  revenue  grew  34.7% 
and 21.3% in fiscal year 2009 and 2008, respectively, while 
the QSI Division’s revenue decreased by 1.2% and decreased 
by  3.3%  in  fiscal  year  2009  and  2008,  respectively,  over 
the prior year. 

In  addition  to  the  aforementioned  software  solutions 
which  we  offer  through  our  two  divisions,  each  division  of-
fers  comprehensive  hardware  and  software  installation  ser-
vices, maintenance and support services, and system training 
services.

On December 11, 2007, the Company announced the 
formal public launch of NextGen Practice Solutions, a business 
division devoted to providing physician practices with cost ef-
fective RCM services. This division combines a web-delivered 
Software as a Service, or SaaS model and the NextGen EPM 
software platform to execute its service offerings. Clients may 
also deploy NextGen EHR as part of their Practice Solutions 
implementation.

On May 20, 2008, we acquired St. Louis-based HSI, a 
full-service healthcare RCM company. HSI operates under the 
umbrella  of  NextGen  Practice  Solutions.  Founded  in  1996, 
HSI  currently  provides  RCM  services  to  providers  including 
health  systems,  hospitals,  and  physicians  in  private  practice 
with an in-house team of more than 200 employees including 
specialists in medical billing, coding and compliance, payor 
credentialing, and information technology. We intend to cross 
sell both software and RCM services to the acquired customer 
base of HSI and NextGen.

On October 28, 2008, we acquired Maryland-based 
PMP,  a  full-service  healthcare  RCM  company.  This  acquisi-
tion is also part of our growth strategy for NextGen Practice 
Solutions.  Similar  to  HSI,  PMP  operates  under  the  umbrella 

5

of NextGen Practice Solutions. Founded in 2001, PMP pro-
vides physician billing and technology management services 
to  healthcare  providers,  primarily  in  the  Mid-Atlantic  region. 
We intend to cross sell both software and RCM services to the 
acquired customer base of PMP and NextGen.

information  incorporating  administrative,  financial  and  clinical 
information  from  multiple  entities.  In  addition,  large  healthcare 
organizations increasingly require information systems that can 
deliver high performance in environments with multiple concur-
rent computer users.

Industry Background
The  turbulence  in  the  worldwide  economy  has  impacted  
almost  all  industries.  While  healthcare  is  not  immune  to  
economic cycles, we believe it is more resilient than most seg-
ments  of  the  economy.  The  impact  of  the  current  economic 
conditions  on  our  existing  and  prospective  clients  has  been 
mixed. We continue to see organizations that are doing fairly 
well operationally, however, some organizations with a large 
dependency on Medicaid populations are being impacted by 
the challenging financial condition of the many state govern-
ments in whose jurisdictions they conduct business. A positive 
factor for U.S. healthcare is the fact that the Obama adminis-
tration is pursuing broad healthcare reform aimed at improving 
issues  surrounding  healthcare.  The  American  Recovery  and 
Reinvestment Act (ARRA), which became law on February 17, 
2009, includes more than $20 billion to help healthcare or-
ganizations  modernize  operations  through  the  acquisition  of 
health care information technology. While we are unsure of 
the immediate impact from the ARRA, the long-term potential 
could be significant. 

Moreover, to compete in the continually changing health-
care environment, providers are increasingly using technology 
to help maximize the efficiency of their business practices, to 
assist in enhancing patient care, and to maintain the privacy 
of patient information. 

As  the  reimbursement  environment  continues  to  evolve, 
more healthcare providers enter into contracts, often with mul-
tiple entities, which define the terms under which care is ad-
ministered and paid. The diversity of payor organizations, as 
well as additional government regulation and changes in re-
imbursement models, have greatly increased the complexity of 
pricing, billing, reimbursement, and records management for 
medical and dental practices. To operate effectively, health-
care  provider  organizations  must  efficiently  manage  patient 
care  and  other  information  and  workflow  processes  which 
increasingly  extend  across  multiple  locations  and  business 
entities.

In  response,  healthcare  provider  organizations  have 
placed increasing demands on their information systems. Initially, 
these information systems automated financial and administrative 
functions. As it became necessary to manage patient flow pro-
cesses, the need arose to integrate “back-office” data with such 
clinical information as patient test results and office visits. We be-
lieve information systems must facilitate management of patient 

Many  existing  healthcare  information  systems  were 
designed  for  limited  administrative  tasks  such  as  billing  and 
scheduling and can neither accommodate multiple computing 
environments nor operate effectively across multiple locations 
and entities. We believe that practices that leverage technol-
ogy to more efficiently handle patient clinical data as well as 
administrative, financial and other practice management data 
will be best able to enhance patient flow, pursue cost efficien-
cies, and improve quality of care. As healthcare organizations 
transition to new computer platforms and newer technologies, 
we believe such organizations will be migrating toward the 
implementation  of  enterprise-wide,  patient-centric  computing 
systems embedded with automated clinical patient records. 

Our Strategy  
Our  strategy  is,  at  present,  to  focus  on  providing  software 
and services to medical and dental practices. Among the key  
elements of this strategy are:

•	 Continued	development	and	enhancement	of	select	soft-

ware solutions in target markets; 

•	 Continued	 investments	 in	 our	 infrastructure	 including,	 but	
not  limited  to,  product  development,  sales,  marketing,  
implementation, and support;  

•	 Continued	efforts	to	make	infrastructure	investments	within	
an  overall  context  of  maintaining  reasonable  expense 
discipline; 

•	 Addition  of  new  customers  through  maintaining  and 
expanding  sales,  marketing  and  product  development  
activities; and 

•	 Expanding	our	relationship	with	existing	customers	through	

delivery of new products and services.

While these are the key elements of our current strategy, 
there can be no guarantee that our strategy will not change, 
or that we will succeed in achieving these goals individually 
or collectively. 

Products
In  response  to  the  growing  need  for  more  comprehensive, 
cost-effective  healthcare  information  solutions  for  physician 
and dental practices, our systems provide our clients with the 
ability to redesign patient care and other workflow processes 
while improving productivity through facilitation of managed 
access  to  patient  information.  Utilizing  our  proprietary  soft-
ware in combination with third party hardware and software 

6

solutions, our products enable the integration of a variety of 
administrative and clinical information operations. Leveraging 
more than thirty years of experience in the healthcare informa-
tion services industry, we believe we continue to add value by 
providing our clients with sophisticated, full-featured software 
systems  along  with  comprehensive  systems  implementation, 
maintenance and support services. Any single transaction may 
or may not include software, hardware or services. 

Practice Management Systems. Our products consist primarily 
of proprietary healthcare software applications together with 
third party hardware and other non-industry specific software. 
The systems range in capacity from one to thousands of us-
ers, allowing us to address the needs of both small and large 
organizations.  The  systems  are  modular  in  design  and  may 
be expanded to accommodate changing client requirements.

The  QSI  Division’s  character-based  practice  manage-
ment system is available in both dental and medical versions 
and  primarily  uses  the  IBM  RS6000  central  processing  unit 
and IBM’S AIX version of the UNIX operating system as a plat-
form for our application software, enabling a wide range of 
flexible and functional systems. The hardware components, as 
well as the requisite operating system licenses, are purchased 
from  manufacturers  or  distributors  of  those  components. We 
configure and test the hardware components and incorporate 
our software and other third party packages into completed 
systems. We continually evaluate third party hardware compo-
nents with a view toward utilizing hardware that is functional, 
reliable and cost-effective. 

NextGen EPM is the NextGen Division’s practice man-
agement offering. NextGen EPM has been developed with 
a  functionally  graphical  user  interface  certified  for  use  with 
Windows  2000  and  Windows  XP  operating  systems.  The 
product  leverages  a  relational  database  (Microsoft  SQL 
Server) with support on both 32 and 64 bit enterprise serv-
ers.  NextGen  EPM  is  a  scalable,  multi-module  solution  that 
includes a master patient index, enterprise-wide appointment 
scheduling with referral tracking, clinical support, and central-
ized or decentralized patient financial management based on 
either a managed care or fee-for-service model. The NextGen 
EPM  product  is  a  highly  configurable,  cost-effective  proven 
solution that enables the effective management of both single 
and multi-practice settings.

We also offer a practice management solution for den-
tal  practices  and  an  electronic  health  records  and  practice 
management system for medical practices through the Internet 
(software as a service). These products are marketed under the 
QSINet and NextGen WEB trade names, respectively. 

Clinical  Systems.  Our  dental  charting  software  system,  the 
Clinical Product Suite (CPS), is a comprehensive solution de-
signed specifically for the dental group practice environment. 

CPS integrates the dental practice management product with 
a computer-based clinical information system that incorporates 
a wide range of clinical tools, including:

•	 Electronic	 charting	 of	 dental	 procedures,	 treatment	 plans	

and existing conditions;

•	 Periodontal  charting  via  light-pen,  voice-activation,  or  key-
board entry for full periodontal examinations and PSR scoring;

•	 Digital	imaging	of	X-ray	and	intra-oral	camera	images;

•	 Computer-based	 patient	 education	 modules,	 viewable	

chair-side to enhance case presentation;

•	 Full	 access	 to	 patient	 information,	 treatment	 plans,	 and	
insurance  plans  via  a  fully  integrated  interface  with  our 
dental practice management product; and 

•	 Document	and	image	scanning	for	digital	storage	and	link-

age to the electronic patient record.

The result is a comprehensive clinical information manage-
ment  system  that  helps  practices  save  time,  reduce  costs,  im-
prove  case  presentation,  and  enhance  the  delivery  of  dental 
services  and  quality  of  care.  Clinical  information  is  managed 
and maintained electronically thus forming an electronic patient 
record that allows for the implementation of the “chartless” office. 

CPS  incorporates Windows-based  client-server  technol-
ogy consisting of one or more file servers together with any 
combination of one or more desktop, laptop, or pen-based 
PC workstations. The file server(s) used in connection with CPS 
utilize(s) Windows 2000 or Windows 2003 operating sys-
tem  and  the  hardware  is  typically  an  Intel-based  single  or 
multi-processor  platform.  Based  on  the  server  configuration 
chosen, CPS is scalable from one to hundreds of workstations. 
A typical configuration may also include redundant disk stor-
age, magnetic tape units, intra- and extra-oral cameras, digi-
tal X-ray components, digital scanners, conventional and flat 
screen displays, and printers. The hardware components, in-
cluding the requisite operating system licenses, are purchased 
from third party manufacturers or distributors either directly by 
the customer or by us for resale to the customer.

NextGen  provides  clinical  software  applications  that 
are complementary to, and are integrated with, our medical 
practice  management  offerings  and  interface  with  many  of 
the other leading practice management software systems on 
the  market.  The  applications  incorporated  into  our  practice 
management solutions and others such as scheduling, eligibil-
ity, billing and claims processing are augmented by clinical 
information captured by NextGen EHR, including services ren-
dered and diagnoses used for billing purposes. We believe 
that we currently provide a comprehensive information man-
agement solution for the medical marketplace. 

NextGen EHR was developed with client-server architecture 

7

and a GUI and utilizes Microsoft Windows 2000, Windows 
NT or Windows XP on each workstation and either Windows 
2000, Windows NT, Windows XP or UNIX on the database 
server. NextGen EHR maintains data using industry standard 
relational  database  engines  such  as  Microsoft  SQL  Server 
or  Oracle.  The  system  is  scalable  from  one  to  thousands  of 
workstations.

NextGen EHR stores and maintains clinical data including:

•	 Data	captured	using	user-customizable	input	“templates”;

•	 Scanned	 or	 electronically	 acquired	 images,	 including	

X-rays and photographs;

•	 Data	electronically	acquired	through	interfaces	with	clinical	

instruments or external systems;

•	 Other	records,	documents	or	notes,	including	electronically	

captured handwriting and annotations; and

•	 Digital	voice	recordings.

NextGen EHR also offers a workflow module, prescrip-
tion management, automatic document and letter generation, 
patient  education,  referral  tracking,  interfaces  to  billing  and 
lab systems, physician alerts and reminders, and powerful re-
porting and data analysis tools. NextGen Express is a version 
of NextGen EHR designed for small practices.

The  NextGen  Division  also  markets  NextGen  CHS. 
NextGen  CHS  facilitates  cross-enterprise  data  sharing,  en-
abling individual medical practices in a given community to 
selectively share critical data such as demographics, referrals, 
medications lists, allergies, diagnoses, lab results, histories and 
more. This is accomplished through a secure, community-wide 
data repository that links health care providers, whether they 
have the NextGen EHS system, another compatible EMR sys-
tem,  or  no  EMR,  together  with  hospitals,  payors,  labs  and 
other entities. The product is designed to facilitate a Regional 
Health  Information  Organization,  or  RHIO.  The  result  is  that 
for every health care encounter in the community, a patient-
centric and complete record is accessible for the provider. The 
availability, currency and completeness of information plus the 
elimination of duplicate data entry can lead to significantly im-
proved patient safety, enhanced decision making capabilities, 
time efficiencies and cost savings. 

NextGen also markets RCM services through our Practice 
Solutions unit. This service provides billing services to solo and 
group practices.

Connectivity  Services.  We  make  available  EDI  capabilities 
and connectivity services to our customers. The EDI/connectivity 
capabilities  encompass  direct  interfaces  between  our  prod-
ucts and external third party systems, as well as transaction-
based services. Services include:

8

•	 Electronic	claims	submission	through	our	relationships	with	
a number of payors and national claims clearinghouses;

•	 Electronic	 patient	 statement	 processing,	 appointment	 re-
minder  cards  and  calls,  recall  cards,  patient  letters,  and 
other correspondence; 

•	 Electronic	insurance	eligibility	verification;	and

•	 Electronic	 posting	 of	 remittances	 from	 insurance	 carriers	

into the accounts receivable application.

Revenue Cycle Management Services. Our NextGen Practice 
Solutions unit offers RCM services to physicians. On May 20, 
2008, we acquired HSI, a full-service healthcare RCM com-
pany servicing the RCM needs of physician groups and a vari-
ety of other healthcare clients. HSI has historically and primarily 
focused on assisting its clients in increasing the accuracy and 
speed of client billing and collections activities. On October 
28, 2008, we acquired PMP, a full-service healthcare RCM 
company. Founded in 2001, PMP provides physician billing 
and technology management services to healthcare providers, 
primarily in the Mid-Atlantic region. 

Internet  Applications.  Our  NextGen  Division  maintains  an 
Internet-based patient health portal, NextMD.com. NextMD.com 
is a vertical portal for the healthcare industry, linking patients 
with  their  physicians,  while  providing  a  centralized  source 
of health-oriented information for both consumers and medi-
cal professionals. Patients whose physicians are linked to the 
portal  are  able  to  request  appointments,  send  appointment 
changes or cancellations, receive test results on-line, request 
prescription refills, view and/or pay their statements, and com-
municate with their physicians, all in a secure, on-line environ-
ment. Our NextGen suite of information systems are or can be 
linked to NextMD.com, integrating a number of these features 
with physicians’ existing systems.

Sales and Marketing  
We sell and market our products nationwide primarily through 
a direct sales force. The efforts of the direct sales force are aug-
mented by a small number of reseller relationships established by 
us. Software license sales to resellers represented less than 10% 
of total revenue for the years ended March 31, 2009, 2008 
and 2007.

Our  direct  sales  force  typically  makes  presentations  to  
potential clients by demonstrating the system and our capabili-
ties on the prospective client’s premises. Sales efforts aimed at 
smaller practices can be performed on the prospective clients’ 
premises, or remotely via telephone or Internet-based presen-
tations. Our sales and marketing employees identify prospec-
tive clients through a variety of means, including referrals from 
existing  clients,  industry  consultants,  contacts  at  professional 
society meetings, trade shows and seminars, trade journal ad-
vertising, direct mail advertising, and telemarketing. 

Our  sales  cycle  can  vary  significantly  and  typically 
ranges  from  six  to  twenty-four  months  from  initial  contact  to 
contract execution. Software licenses are normally delivered 
to a customer almost immediately upon receipt of an order. 
Implementation  and  training  services  are  normally  rendered 
based on a mutually agreed upon timetable. As part of the 
fees paid by our clients, we normally receive up-front licensing 
fees.  Clients  have  the  option  to  purchase  maintenance  ser-
vices which, if purchased, are invoiced on a monthly, quarterly 
or annual basis. 

Several clients have purchased our practice management 
software  and,  in  turn,  are  providing  either  time-share  or  bill-
ing services to single and group practice practitioners. Under 
the time-share or billing service agreements, the client provides 
the use of our software for a fee to one or more practitioners. 
Although we typically do not receive a fee directly from the dis-
tributor’s customers, implementation of such arrangements has, 
from time to time, resulted in the purchase of additional software 
capacity by the distributor, as well as new software purchases 
made by the distributor’s customers should such customers de-
cide to perform the practice management functions in-house.

We continue to concentrate our direct sales and market-
ing efforts on medical and dental practices, networks of such 
practices  including  MSOs  and  PHOs,  professional  schools, 
community health centers and other ambulatory care settings.

MSOs,  PHOs  and  similar  networks  to  which  we  have 
sold systems provide use of our software to those group and 
single physician practices associated with the organization or 
hospital on either a service basis or by directing us to contract 
with those practices for the sale of stand-alone systems.

We have also entered into marketing assistance agree-
ments with certain of our clients pursuant to which the clients 
allow us to demonstrate to potential clients the use of systems 
on the existing clients’ premises.

From time to time we assist prospective clients in identify-
ing third party sources for financing the purchase of our sys-
tems. The financing is typically obtained by the client directly 
from institutional lenders and typically takes the form of a loan 
from the institution secured by the system to be purchased or a 
leasing arrangement. We do not guarantee the financing nor 
retain any continuing interest in the transaction. 

We have numerous clients and do not believe that the 
loss of any single client would adversely affect us. No client 
accounted for 10% or more of our net revenue during the fiscal 
years ended March 31, 2009, 2008 or 2007.

Customer Service and Support
We believe our success is attributable in part to our customer 
service  and  support  departments.  We  offer  support  to  our 
clients seven days a week,twenty-four hours a day.

Our client support staff is comprised of specialists who 
are knowledgeable in the areas of software and hardware 
as well as in the day-to-day operations of a practice. System 
support activities range from correcting minor procedural prob-
lems  in  the  client’s  system  to  performing  complex  database 
reconstructions or software updates.

We utilize automated online support systems which assist 
clients  in  resolving  minor  problems  and  facilitate  automated 
electronic retrieval of problems and symptoms following a cli-
ent’s call to the automated support system. Additionally, our 
online support systems maintain call records, available at both 
the client’s facility and our offices.

We  offer  our  clients  support  services  for  most  system 
components,  including  hardware  and  software,  for  a  fixed 
monthly, quarterly or annual fee. Customers also receive ac-
cess to future unspecified versions of the software, on a when-
and-if available basis, as part of support services. We also 
subcontract,  in  certain  instances,  with  third  party  vendors  to 
perform specific hardware maintenance tasks. 

Implementation and Training  
We  offer  full  service  implementation  and  training  services. 
When a client signs a contract for the purchase of a system 
that  includes  implementation  and  training  services,  a  client 
manager/implementation  specialist  trained  in  medical  and/
or dental group practice procedures is assigned to assist the 
client in the installation of the system and the training of appro-
priate practice staff. Implementation services include loading 
the  software,  training  customer  personnel,  data  conversion, 
running test data, and assisting in the development and docu-
mentation of procedures. Implementation and training services 
are provided by our employees as well as certified third par-
ties and certain resellers. 

Training may include a combination of computer assisted 
instruction, or CAI, for certain of our products, remote training 
techniques and training classes conducted at the client’s or our 
office(s). CAI consists of workbooks, computer interaction and 
self-paced instruction. CAI is also offered to clients, for an ad-
ditional charge, after the initial training program is completed 
for  the  purpose  of  training  new  and  additional  employees. 
Remote training allows a trainer at our offices to train one or 
more people at a client site via telephone and computer con-
nection, thus allowing an interactive and client-specific mode 
of training without the expense and time required for travel. In 
addition, our on-line “help” and other documentation features 
facilitate client training as well as ongoing support.

In  addition,  NextGen  “E-learning”  is  an  on-line  learning 
subscription service which allows end users to train on the soft-
ware on the internet. E-learning allows end users to self manage 
their own learning with their personal learning path and pace. 
The service allows users to track the status of courses taken. 

9

At present, our training facilities are located in (i) Horsham, 
Pennsylvania, (ii) Atlanta, Georgia, (iii) Dallas, Texas, and (iv) 
Irvine, California. 

Competition
The  markets  for  healthcare  information  systems  and  services 
are  intensely  competitive.  The  industry  is  highly  fragmented 
and includes numerous competitors, none of which we believe 
dominates  these  markets.  Our  principal  existing  competitors 
in the healthcare information systems and services market in-
clude: General Electric, Allscripts, EPIC and other competitors.

The electronic patient records and connectivity markets, 
in particular, are subject to rapid changes in technology, and 
we expect that competition in these market segments will in-
crease as new competitors enter the market. We believe our 
principal competitive advantages are the features and capa-
bilities of our products and services, our high level of customer 
support, and our extensive experience in the industry. 

Available Information 
Our  Internet  Web  site  address  is  www.qsii.com.  We  make 
our  periodic  and  current  reports,  together  with  amendments 
to these reports, available on our Internet Web site, free of 
charge, as soon as reasonably practicable after such material 
is electronically filed with, or furnished to, the Commission. You 
may access such filings under the “Investor Relations” button 
on our Web site. Members of the public may also read and 
copy any materials we file with, or furnish to, the Commission 
at the Commission’s Public Reference Room at 100 F Street, 
NE, Washington, DC 20549. To obtain information on the 
operation of the Public Reference Room, please call the SEC 
at  1-800-SEC-0330.  The  Commission  maintains  an  Internet 
site  at  www.sec.gov  that  contains  the  reports,  proxy  state-
ments and other information that we file electronically with the 
Commission. The information on our Internet Web site is not 
incorporated by reference into this Report or any other report 
or information we file with the Commission. 

Product Enhancement and Development
The  healthcare  information  management  and  computer  soft-
ware  and  hardware  industries  are  characterized  by  rapid 
technological  change  requiring  us  to  engage  in  continuing 
investments  to  update,  enhance,  and  improve  our  systems. 
During  fiscal  years  2009,  2008  and  2007,  we  expended 
approximately $19.7 million, $17.4 million and $15.2 million, 
respectively,  on  research  and  development  activities,  includ-
ing capitalized software amounts of $5.9 million, $6.0 million 
and  $5.0  million,  respectively.  In  addition,  a  portion  of  our 
product enhancements have resulted from software develop-
ment work performed under contracts with our clients. 

Other Information 

Employees
As of March 31, 2009, we employed approximately 1,263 
persons,  of  which  1,251  were  full-time  employees.  We  be-
lieve that our future success depends in part upon recruiting 
and retaining qualified sales, marketing and technical person-
nel as well as other employees. 

Intellectual Property 
To protect our intellectual property, we enter into confidenti-
ality  agreements  and  invention  assignment  agreements  with 
our employees with whom such controls are relevant. Certain 
qualified employees enter into additional agreements that per-
mit them access under certain circumstances, to software mat-
ters that are both confidential and more strictly controlled. In 
addition, we include intellectual property protective provisions 
in many of our customer contracts. 

ITEM 1A. Risk Factors
The  more  prominent  risks  and  uncertainties  inherent  in  our 
business are described below. However, additional risks and 
uncertainties may also impair our business operations. If any 
of  the  following  risks  actually  occur,  our  business,  financial 
condition or results of operations will likely suffer. Any of these 
or other factors could harm our business and future results of 
operations  and  may  cause  you  to  lose  all  or  part  of  your 
investment.

We  face  increasing  involvement  of  the  federal  government 
in our industry. In February, 2009, President Obama signed 
the  American  Recovery  and  Reinvestment  Act  allocates  de-
voted over $20 billion dollars to healthcare IT over the next 
several  years.  The  ARRA  includes  significant  financial  incen-
tives to healthcare providers who can demonstrate meaningful 
use of certified EHR technology beginning in 2011. While the 
Company expects the ARRA to create significant opportunities 
for  sales  of  NextGen EHR  over  the  next  several  years,  the 
lack of a final definition of “meaningful use” as well as other 
details  we  believe  has  negatively  impacted  sales  cycles  in 
the March, 2009 quarter. While the Federal government has 
set a deadline of December 31, 2009 to publish final rules, 
there can be no assurance that the slowdown in sales cycles 
resulting from such uncertainty will not continue into the fiscal 
year, 2010. 

The effects of the recent global economic crisis may impact 
our  business,  operating  results  or  financial  condition.  The 
recent global economic crisis has caused a general tighten-
ing  in  the  credit  markets,  lower  levels  of  liquidity,  increases 
in  the  rates  of  default  and  bankruptcy,  and  extreme  volatil-
ity in credit, equity and fixed income markets. These macro-
economic developments could negatively affect our business, 

10

operating results or financial condition in a number of ways. 
For example, current or potential customers may be unable to 
fund software purchases, which could cause them to delay, 
decrease or cancel purchases of our products and services or 
to not pay us or to delay paying us for previously purchased 
products and services. Our clients may cease business opera-
tions or conduct business on a greatly reduced basis. Finally, 
our investment portfolio, which includes auction rate securities, 
is  generally  subject  to  general  credit,  liquidity,  counterparty, 
market and interest rate risks that may be exacerbated by the 
recent global financial crisis. If the banking system or the fixed 
income, credit or equity markets continue to deteriorate or re-
main volatile, our investment portfolio may be impacted and 
the values and liquidity of our investments could be adversely 
affected as well. 

We face significant, evolving competition which, if we fail to 
properly address, could adversely affect our business, results 
of operations, financial condition and price of our stock. The 
markets for healthcare information systems are intensely com-
petitive, and we face significant competition from a number of 
different sources. Several of our competitors have significantly 
greater name recognition as well as substantially greater finan-
cial, technical, product development and marketing resources 
than we do. There has been significant merger and acquisition 
activity among a number of our competitors in recent years. 
Transaction  induced  pressures,  or  other  related  factors  may 
result in price erosion or other negative market dynamics that 
could  adversely  affect  our  business,  results  of  operations,  fi-
nancial condition and price of our stock.

We  compete  in  all  of  our  markets  with  other  major 
healthcare related companies, information management com-
panies,  systems  integrators,  and  other  software  developers. 
Competitive pressures and other factors, such as new product 
introductions by us or our competitors, may result in price or 
market share erosion that could adversely affect our business, 
results of operations and financial condition. Also, there can 
be no assurance that our applications will achieve broad mar-
ket acceptance or will successfully compete with other avail-
able software products.

Our inability to make initial sales of our systems to newly 
formed groups and/or healthcare providers that are replacing 
or substantially modifying their healthcare information systems 
could adversely affect our business, results of operations and 
financial condition. If new systems sales do not materialize, our 
near term and longer term revenue will be adversely affected.

The  unpredictability  of  our  quarterly  operating  results  may 
cause the price of our common stock to fluctuate or decline. 
Our revenue may fluctuate in the future from quarter to quarter 
and period to period, as a result of a number of factors includ-
ing, without limitation: 

•	 The	size	and	timing	of	orders	from	clients;		

•	 The	 specific	 mix	 of	 software,	 hardware,	 and	 services	 in	

client orders;

•	 The	length	of	sales	cycles	and	installation	processes;	

•	 The	 ability	 of	 our	 clients	 to	 obtain	 financing	 for	 the	 pur-

chase of our products; 

•	 Changes	in	pricing	policies	or	price	reductions	by	us	or	

our competitors; 

•	 The	 timing	 of	 new	 product	 announcements	 and	 product	

introductions by us or our competitors; 

•	 Changes	in	revenue	recognition	or	other	accounting	guide-
lines employed by us and/or established by the Financial 
Accounting Standards Board or other rule-making bodies; 

•	 Accounting	policies	concerning	the	timing	of	the	recogni-

tion of revenue;

•	 The	availability	and	cost	of	system	components;	

•	 The	financial	stability	of	clients;	

•	 Market	 acceptance	 of	 new	 products,	 applications	 and	

product enhancements; 

•	 Our	 ability	 to	 develop,	 introduce	 and	 market	 new	 prod-

ucts, applications and product enhancements; 

•	 Our	 success	 in	 expanding	 our	 sales	 and	 marketing	

programs; 

•	 Deferrals	of	client	orders	in	anticipation	of	new	products,	
applications,  product  enhancements,  or  public/private 
sector initiatives; 

•	 Execution	of	or	changes	to	our	strategy;

•	 Personnel	changes;	and	

•	 General	market/economic	factors.

Our software products are generally shipped as orders 
are received and accordingly, we have historically operated 
with a minimal backlog of license fees. As a result, revenue 
in any quarter is dependent on orders booked and shipped 
in that quarter and is not predictable with any degree of cer-
tainty.  Furthermore,  our  systems  can  be  relatively  large  and 
expensive, and individual systems sales can represent a signifi-
cant portion of our revenue and profits for a quarter such that 
the loss or deferral of even one such sale can adversely affect 
our quarterly revenue and profitability. 

Clients  often  defer  systems  purchases  until  our  quarter 
end,  so  quarterly  results  generally  cannot  be  predicted  and 
frequently are not known until after the quarter has concluded. 

Our  sales  are  dependent  upon  clients’  initial  decisions 
to  replace  or  substantially  modify  their  existing  information 
systems,  and  subsequently,  their  decision  concerning  which 

11

products and services to purchase. These are major decisions 
for healthcare providers and, accordingly, the sales cycle for 
our systems can vary significantly and typically ranges from six 
to twenty-four months from initial contact to contract execution/
shipment. 

Our common stock price has been volatile, which could result 
in  substantial  losses  for  investors  purchasing  shares  of  our 
common stock and in litigation against us. Volatility may be 
caused by a number of factors including but not limited to:

•	 Actual	 or	 anticipated	 quarterly	 variations	 in	 operating	

Because  a  significant  percentage  of  our  expenses  are 
relatively fixed, a variation in the timing of systems sales, imple-
mentations,  and  installations  can  cause  significant  variations 
in  operating  results  from  quarter  to  quarter.  As  a  result,  we 
believe that interim period-to-period comparisons of our results 
of operations are not necessarily meaningful and should not 
be relied upon as indications of future performance. Further, 
our historical operating results are not necessarily indicative of 
future performance for any particular period. 

We  currently  recognize  revenue  pursuant  to  Statement 
of  Position  (“SOP”)  97-2,  as  modified  by  SOP  98-9  and 
Staff  Accounting  Bulletin  (SAB)  104.  SAB  104  summarizes 
the  Commission  staff’s  views  in  applying  generally  accept-
ed  accounting  principles  to  revenue  recognition  in  financial 
statements. 

There can be no assurance that application and subse-
quent interpretations of these pronouncements will not further 
modify our revenue recognition policies, or that such modifica-
tions would not adversely affect our operating results reported 
in any particular quarter or year. 

Due to all of the foregoing factors, it is possible that our 
operating  results  may  be  below  the  expectations  of  public 
market analysts and investors. In such event, the price of our 
common stock would likely be adversely affected.

The failure of auction rate securities to sell at their reset dates 
could impact the liquidity of the investment and could nega-
tively impact the carrying value of the investment. Our invest-
ments include auction rate securities (“ARS”). ARS are securities 
that  are  structured  with  short-term  interest  rate  reset  dates  of 
generally  less  than  ninety  days  but  with  longer  contractual 
maturities that range, for our holdings, from nine to 28 years. 
At  the  end  of  each  reset  period,  investors  can  typically  sell 
at auction or continue to hold the securities at par. These se-
curities  are  subject  to  fluctuations  in  interest  rate  depending 
on the supply and demand at each auction. Through March 
31, 2009, auctions held for the Company’s ARS with a total 
aggregate value of approximately $8.1 million failed. As of 
March 31, 2009, we were holding a total of approximately 
$7.4 million, net of unrealized loss, in ARS. While these debt 
securities are all highly-rated investments, generally with AAA/
Aaa ratings, continued failure to sell at their reset dates could 
impact the liquidity of the investment which in turn could nega-
tively impact our liquidity position. 

results; 

•	 Rumors	 about	 our	 performance,	 software	 solutions,	 or	

merger and acquisition activity; 

•	 Changes	in	expectations	of	future	financial	performance	or	

changes in estimates of securities analysts;

•	 Governmental	regulatory	action;

•	 Health	care	reform	measures;

•	 Client	relationship	developments;

•	 Purchases	or	sales	of	company	stock;

•	 Activities	by	one	or	more	of	our	major	shareholders	con-

cerning our policies and operations;

•	 Changes	occurring	in	the	markets	in	general;	

•	 Macroeconomic	 conditions,	 both	 nationally	 and	 interna-

tionally; and 

•	 Other	factors,	many	of	which	are	beyond	our	control.	

Furthermore, the stock market in general, and the market 
for  software,  healthcare  and  high  technology  companies  in 
particular,  has  experienced  extreme  volatility  that  often  has 
been  unrelated  to  the  operating  performance  of  particular 
companies. These broad market and industry fluctuations may 
adversely  affect  the  trading  price  of  our  common  stock,  re-
gardless of actual operating performance. 

Moreover, in the past, securities class action litigation has 
often been brought against a company following periods of 
volatility in the market price of its securities. We may in the fu-
ture be the target of similar litigation. Securities litigation could 
result  in  substantial  costs  and  divert  management’s  attention 
and resources. 

Two  of  our  directors  are  significant  shareholders,  which 
makes it possible for them to have significant influence over 
the outcome of all matters submitted to our shareholders for 
approval and which influence may be alleged to conflict with 
our interests and the interests of our other shareholders. Two 
of our directors and principal shareholders beneficially owned 
an  aggregate  of  approximately  34.2%  of  the  outstanding 
shares of our common stock at March 31, 2009. California 
law and our Bylaws permit our shareholders to cumulate their 
votes, the effect of which is to provide shareholders with suffi-
ciently large concentrations of our shares the opportunity to as-
sure themselves one or more seats on our Board. The amounts 
required to assure a Board position can vary based upon the 

12

number  of  shares  outstanding,  the  number  of  shares  voting, 
the number of directors to be elected, the number of “broker 
non-votes,” and the number of shares held by the shareholder 
exercising cumulative voting rights. In the event that cumulative 
voting is invoked, it is likely that the two of our directors hold-
ing an aggregate of approximately 34.2% of the outstanding 
shares  of  our  common  stock  at  March  31,  2009  will  each 
have sufficient votes to assure themselves of one or more seats 
on our Board. With or without cumulative voting, these share-
holders will have significant influence over the outcome of all 
matters submitted to our shareholders for approval, including 
the  election  of  our  directors  and  other  corporate  actions.  In 
fiscal year 2009, one of the principal shareholders, Ahmed 
Hussein, proposed a different slate of directors than what the 
Company proposed to shareholders. The Company spent ap-
proximately  $1.5  million  to  defend  the  Company’s  slate.  In 
addition, such influence by one or both of these shareholders 
could have the effect of discouraging others from attempting 
to purchase us, implement a change over our Board and man-
agement,  and/or  reducing  the  market  price  offered  for  our 
common stock in such an event. 

If our principal products and our new product development 
fail to meet the needs of our clients, we may fail to realize 
future growth. We currently derive substantially all of our net 
revenue from sales of our healthcare information systems and 
related services. We believe that a primary factor in the mar-
ket acceptance of our systems has been our ability to meet the 
needs of users of healthcare information systems. Our future 
financial performance will depend in large part on our ability 
to continue to meet the increasingly sophisticated needs of our 
clients through the timely development and successful introduc-
tion and implementation of new and enhanced versions of our 
systems and other complementary products. We have histori-
cally expended a significant percentage of our net revenue on 
product  development  and  believe  that  significant  continuing 
product  development  efforts  will  be  required  to  sustain  our 
growth. Continued investment in our sales staff and our client 
implementation and support staffs will also be required to sup-
port future growth. 

There can be no assurance that we will be successful in 
our product development efforts, that the market will continue 
to accept our existing products, or that new products or prod-
uct enhancements will be developed and implemented in a 
timely manner, meet the requirements of healthcare providers, 
or  achieve  market  acceptance.  If  new  products  or  product 
enhancements do not achieve market acceptance, our busi-
ness,  results  of  operations  and  financial  condition  could  be 
adversely affected. At certain times in the past, we have also 
experienced  delays  in  purchases  of  our  products  by  clients 
anticipating our launch, or the launch of our competitors, of 
new products. There can be no assurance that material order 

deferrals in anticipation of new product introductions from our-
selves or other entities will not occur. 

If the emerging technologies and platforms of Microsoft and 
others  upon  which  we  build  our  products  do  not  gain  or 
continue to maintain broad market acceptance, or if we fail 
to develop and introduce in a timely manner new products 
and  services  compatible  with  such  emerging  technologies, 
we may not be able to compete effectively and our ability 
to  generate  revenue  will  suffer.  Our  software  products  are 
built and depend upon several underlying and evolving rela-
tional database management system platforms such as those 
developed by Microsoft. To date, the standards and technolo-
gies  upon  which  we  have  chosen  to  develop  our  products 
have proven to have gained industry acceptance. However, 
the  market  for  our  software  products  is  subject  to  ongoing 
rapid  technological  developments,  quickly  evolving  industry 
standards and rapid changes in customer requirements, and 
there may be existing or future technologies and platforms that 
achieve  industry  standard  status,  which  are  not  compatible 
with our products.

We  face  the  possibility  of  subscription  pricing,  which  may 
force us to adjust our sales, marketing and pricing strategies. 
In  April,  2009  we  announced  a  new  subscription  based, 
Software as a service delivery model which includes monthly 
subscription pricing. This model is designed for smaller prac-
tices to quickly access the NextGen EHR or NextGen EPM 
products at a modest monthly per provider price. We currently 
derive substantially all of our systems revenue from traditional 
software license, implementation and training fees, as well as 
the resale of computer hardware. Today, the majority of our 
customers pay an initial license fee for the use of our products, 
in addition to a periodic maintenance fee. While the intent of 
the new subscription based delivery model is to further pen-
etrate the smaller practice market, there can be no assurance 
that this delivery model will not become increasingly popular 
with  both  small  and  large  customers.  If  the  marketplace  in-
creasingly demands subscription pricing, we may be forced 
to  further  adjust  our  sales,  marketing  and  pricing  strategies 
accordingly, by offering a higher percentage of our products 
and services through these means. Shifting to a significantly 
greater degree of subscription pricing could adversely affect 
our financial condition, cash flows and quarterly and annual 
revenue and results of operations, as our revenue would ini-
tially decrease substantially. There can be no assurance that 
the  marketplace  will  not  increasingly  embrace  subscription 
pricing.

13

Many of our competitors have greater resources than we do. 
In  order  to  compete  successfully,  we  must  keep  pace  with 
our competitors in anticipating and responding to the rapid 
changes involving the industry in which we operate, or our 
business,  results  of  operations  and  financial  condition  may 
be adversely affected. The software market generally is char-
acterized by rapid technological change, changing customer 
needs, frequent new product introductions, and evolving indus-
try standards. The introduction of products incorporating new 
technologies  and  the  emergence  of  new  industry  standards 
could render our existing products obsolete and unmarketable. 
There can be no assurance that we will be successful in de-
veloping and marketing new products that respond to techno-
logical changes or evolving industry standards. New product 
development  depends  upon  significant  research  and  devel-
opment  expenditures  which  depend  ultimately  upon  sales 
growth. Any material shortfall in revenue or research funding 
could impair our ability to respond to technological advances 
or opportunities in the marketplace and to remain competitive. 
If we are unable, for technological or other reasons, to devel-
op and introduce new products in a timely manner in response 
to changing market conditions or customer requirements, our 
business, results of operations and financial condition may be 
adversely affected.

In  response  to  increasing  market  demand,  we  are  cur-
rently developing new generations of certain of our software 
products. There can be no assurance that we will successfully 
develop these new software products or that these products 
will operate successfully, or that any such development, even 
if successful, will be completed concurrently with or prior to 
introduction of competing products. Any such failure or delay 
could adversely affect our competitive position or could make 
our current products obsolete.

We face risk and/or the possibility of claims from activities 
related to strategic partners, which could be expensive and 
time-consuming,  divert  personnel  and  other  resources  from 
our business and result in adverse publicity that could harm 
our business. We rely on third parties to provide services that 
affect  our  business.  For  example,  we  use  national  clearing-
houses  in  the  processing  of  some  insurance  claims  and  we 
outsource  some  of  our  hardware  maintenance  services  and 
the printing and delivery of patient statements for our custom-
ers. These third parties could raise their prices and/or be ac-
quired by competitors of ours, which could potentially create 
short and long-term disruptions to our business negatively im-
pacting our revenue, profit and/or stock price. We also have 
relationships with certain third parties where these third parties 
serve  as  sales  channels  through  which  we  generate  a  por-
tion of our revenue. Due to these third-party relationships, we 
could be subject to claims as a result of the activities, products, 
or services of these third-party service providers even though 

14

we were not directly involved in the circumstances leading to 
those claims. Even if these claims do not result in liability to 
us, defending and investigating these claims could be expen-
sive and time-consuming, divert personnel and other resources 
from  our  business  and  result  in  adverse  publicity  that  could 
harm our business. 

We face the possibility of claims based upon our Web site 
content, which may cause us expense and management dis-
traction. We could be subject to third party claims based on 
the nature and content of information supplied on our Web 
site  by  us  or  third  parties,  including  content  providers  or  us-
ers. We could also be subject to liability for content that may 
be accessible through our Web site or third party Web sites 
linked from our Web site or through content and information 
that may be posted by users in chat rooms, bulletin boards or 
on Web sites created by professionals using our applications. 
Even if these claims do not result in liability to us, investigat-
ing and defending against these claims could be expensive 
and time consuming and could divert management’s attention 
away from our operations.

We  may  engage  in  future  acquisitions,  which  may  be  ex-
pensive  and  time  consuming  and  from  which  we  may  not 
realize anticipated benefits. We may acquire additional busi-
nesses, technologies and products if we determine that these 
additional businesses, technologies and products are likely to 
serve our strategic goals. On May 20, 2008, we acquired 
HSI,  and  on  October  28,  2008,  we  acquired  PMP,  both 
are full-service healthcare RCM companies servicing physician 
groups and other healthcare clients. The specific risks we may 
encounter  in  these  types  of  transactions  include  but  are  not 
limited to the following:

•	 Potentially	dilutive	issuances	of	our	securities,	the	incurrence	
of debt and contingent liabilities and amortization expens-
es related to intangible assets, which could adversely af-
fect our results of operations and financial condition; 

•	 Use	of	cash	as	acquisition	currency	may	adversely	affect	
interest or investment income, thereby potentially adversely 
affecting our earnings and /or earnings per share;

•	 Difficulty  in  effectively  integrating  any  acquired  tech-
nologies or software products into our current products 
and technologies;

•	 Difficulty	in	predicting	and	responding	to	issues	related	to	
product  transition  such  as  development,  distribution  and 
customer support;

•	 The	possible	adverse	effect	of	such	acquisitions	on	exist-
ing relationships with third party partners and suppliers of 
technologies and services; 

•	 The	 possibility	 that	 staff	 or	 customers	 of	 the	 acquired	
company  might  not  accept  new  ownership  and  may 

transition to different technologies or attempt to renego-
tiate  contract  terms  or  relationships,  including  mainte-
nance or support agreements; 

•	 The	possibility	that	the	due	diligence	process	in	any	such	
acquisition may not completely identify material issues as-
sociated with product quality, product architecture, product 
development, intellectual property issues, key personnel is-
sues  or  legal  and  financial  contingencies,  including  any 
deficiencies  in  internal  controls  and  procedures  and  the 
costs associated with remedying such deficiencies;  

•  Difficulty in integrating acquired operations due to geograph-
ical distance, and language and cultural differences; and

•	 The  possibility  that  acquired  assets  become  impaired, 
requiring us to take a charge to earnings which could 
be significant.

A failure to successfully integrate acquired businesses or 
technology for any of these reasons could have an adverse 
effect on our financial condition and results of operations. 

We face the risks and uncertainties that are associated with 
litigation  against  us,  which  may  adversely  impact  our  mar-
keting,  distract  management  and  have  a  negative  impact 
upon our business, results of operations and financial condi-
tion. We  face  the  risks  associated  with  litigation  concerning 
the operation of our business. The uncertainty associated with 
substantial  unresolved  litigation  may  have  an  adverse  effect 
on our business. In particular, such litigation could impair our 
relationships with existing customers and our ability to obtain 
new  customers.  Defending  such  litigation  may  result  in  a  di-
version of management’s time and attention away from busi-
ness operations, which could have an adverse effect on our 
business,  results  of  operations  and  financial  condition.  Such 
litigation  may  also  have  the  effect  of  discouraging  potential 
acquirers  from  bidding  for  us  or  reducing  the  consideration 
such acquirers would otherwise be willing to pay in connection 
with an acquisition.  

There  can  be  no  assurance  that  such  litigation  will  not 
result in liability in excess of our insurance coverage, that our 
insurance will cover such claims or that appropriate insurance 
will continue to be available to us in the future at commercially 
reasonable rates.

Because we believe that proprietary rights are material to our 
success, misappropriation of these rights could adversely af-
fect our financial condition. We are heavily dependent on the 
maintenance and protection of our intellectual property and 
we rely largely on license agreements, confidentiality proce-
dures, and employee nondisclosure agreements to protect our 
intellectual property. Our software is not patented and existing 
copyright laws offer only limited practical protection. 

There  can  be  no  assurance  that  the  legal  protections 
and  precautions  we  take  will  be  adequate  to  prevent  mis-
appropriation  of  our  technology  or  that  competitors  will  not 
independently develop technologies equivalent or superior to 
ours. Further, the laws of some foreign countries do not protect 
our proprietary rights to as great an extent as do the laws of 
the United States and are often not enforced as vigorously as 
those in the United States.

We  do  not  believe  that  our  operations  or  products  in-
fringe on the intellectual property rights of others. However, 
there can be no assurance that others will not assert infringe-
ment or trade secret claims against us with respect to our cur-
rent or future products or that any such assertion will not require 
us to enter into a license agreement or royalty arrangement or 
other financial arrangement with the party asserting the claim. 
Responding  to  and  defending  any  such  claims  may  distract 
the attention of our management and adversely affect our busi-
ness, results of operations and financial condition. In addition, 
claims may be brought against third parties from which we 
purchase software, and such claims could adversely affect our 
ability to access third party software for our systems.

If we are deemed to infringe on the proprietary rights of third 
parties, we could incur unanticipated expense and be pre-
vented  from  providing  our  products  and  services.  We  are 
and may continue to be subject to intellectual property infringe-
ment claims as the number of our competitors grows and our 
applications’ functionality is viewed as similar or overlapping 
with competitive products. We do not believe that we have 
infringed  or  are  infringing  on  any  proprietary  rights  of  third 
parties.  However,  claims  are  occasionally  asserted  against 
us,  and  we  cannot  assure  you  that  infringement  claims  will 
not be asserted against us in the future. Also, we cannot as-
sure you that any such claims will be unsuccessful. We could 
incur substantial costs and diversion of management resources 
defending any infringement claims – even if we are ultimately 
successful in the defense of such matters. Furthermore, a party 
making a claim against us could secure a judgment awarding 
substantial damages, as well as injunctive or other equitable 
relief that could effectively block our ability to provide products 
or services. In addition, we cannot assure you that licenses for 
any intellectual property of third parties that might be required 
for our products or services will be available on commercially 
reasonable terms, or at all. 

We are dependent on our license rights and other services 
from third parties, which may cause us to discontinue, delay 
or reduce product shipments. We depend upon licenses for 
some of the technology used in our products as well as other 
services from third-party vendors. Most of these arrangements 
can be continued/renewed only by mutual consent and may 
be  terminated  for  any  number  of  reasons.  We  may  not  be 

15

able to continue using the products or services made available 
to us under these arrangements on commercially reasonable 
terms or at all. As a result, we may have to discontinue, delay 
or reduce product shipments or services provided until we can 
obtain  equivalent  technology  or  services.  Most  of  our  third-
party licenses are non-exclusive. Our competitors may obtain 
the right to use any of the business elements covered by these 
arrangements and use these elements to compete directly with 
us. In addition, if our vendors choose to discontinue providing 
their technology or services in the future or are unsuccessful in 
their continued research and development efforts, we may not 
be able to modify or adapt our own products. 

We face the possibility of damages resulting from internal and 
external  security  breaches,  and  viruses.  In  the  course  of  our 
business operations, we compile and transmit confidential infor-
mation, including patient health information, in our processing 
centers and other facilities. A breach of security in any of these 
facilities could damage our reputation and result in damages 
being assessed against us. In addition, the other systems with 
which we may interface, such as the Internet and related sys-
tems may be vulnerable to security breaches, viruses, program-
ming errors, or similar disruptive problems. The effect of these 
security  breaches  and  related  issues  could  disrupt  our  ability 
to perform certain key business functions and could potentially 
reduce demand for our services. Accordingly, we have expend-
ed significant resources toward establishing and enhancing the 
security of our related infrastructures, although no assurance can 
be given that they will be entirely free from potential breach. 
Maintaining  and  enhancing  our  infrastructure  security  may  
require us to expend significant capital in the future. 

The success of our strategy to offer our EDI services and 
Internet solutions depends on the confidence of our customers 
in our ability to securely transmit confidential information. Our 
EDI services and Internet solutions rely on encryption, authen-
tication and other security technology licensed from third par-
ties to achieve secure transmission of confidential information. 
We may not be able to stop unauthorized attempts to gain 
access  to  or  disrupt  the  transmission  of  communications  by 
our customers. Anyone who is able to circumvent our security 
measures  could  misappropriate  confidential  user  information 
or interrupt our, or our customers’, operations. In addition, our 
EDI and Internet solutions may be vulnerable to viruses, physi-
cal or electronic break-ins, and similar disruptions. 

Any failure to provide secure infrastructure and/or elec-
tronic communication services could result in a lack of trust by 
our customers causing them to seek out other vendors, and/or 
damage  our  reputation  in  the  market,  making  it  difficult  to  
obtain new customers.

We are subject to the development and maintenance of the 
Internet  infrastructure,  which  is  not  within  our  control,  and 

which may diminish Internet usage and availability as well 
as access to our Web site. We deliver Internet-based services 
and, accordingly, we are dependent on the maintenance of 
the Internet by third parties. The Internet infrastructure may be 
unable to support the demands placed on it and our perfor-
mance may decrease if the Internet continues to experience 
its historic trend of expanding usage. As a result of damage 
to  portions  of  its  infrastructure,  the  Internet  has  experienced 
a variety of performance problems which may continue into 
the foreseeable future. Such Internet related problems may di-
minish Internet usage and availability of the Internet to us for 
transmittal of our Internet-based services. In addition, difficul-
ties, outages, and delays by Internet service providers, online 
service providers and other Web site operators may obstruct 
or diminish access to our Web site by our customers resulting 
in a loss of potential or existing users of our services.

Our failure to manage growth could harm our business, re-
sults of operations and financial condition. We have in the 
past experienced periods of growth which have placed, and 
may  continue  to  place,  a  significant  strain  on  our  non-cash 
resources. We also anticipate expanding our overall software 
development, marketing, sales, client management and training 
capacity. In the event we are unable to identify, hire, train and 
retain qualified individuals in such capacities within a reason-
able timeframe, such failure could have an adverse effect on 
us. In addition, our ability to manage future increases, if any, 
in the scope of our operations or personnel will depend on 
significant expansion of our research and development, market-
ing and sales, management, and administrative and financial 
capabilities. The failure of our management to effectively man-
age expansion in our business could have an adverse effect 
on our business, results of operations and financial condition.

Our operations are dependent upon our key personnel. If such 
personnel were to leave unexpectedly, we may not be able to 
execute our business plan. Our future performance depends in 
significant part upon the continued service of our key technical 
and senior management personnel, many of whom have been 
with us for a significant period of time. These personnel have 
acquired specialized knowledge and skills with respect to our 
business. We maintain key man life insurance on only one of 
our employees. Because we have a relatively small number of 
employees when compared to other leading companies in our 
industry, our dependence on maintaining our relationships with 
key employees is particularly significant. We are also depen-
dent on our ability to attract high quality personnel, particularly 
in the areas of sales and applications development. 

The industry in which we operate is characterized by a 
high level of employee mobility and aggressive recruiting of 
skilled personnel. There can be no assurance that our current 
employees  will  continue  to  work  for  us.  Loss  of  services  of 

16

key employees could have an adverse effect on our business, 
results of operations and financial condition. Furthermore, we 
may need to grant additional equity incentives to key employ-
ees and provide other forms of incentive compensation to at-
tract and retain such key personnel. Equity incentives may be 
dilutive to our per share financial performance. Failure to pro-
vide such types of incentive compensation could jeopardize 
our recruitment and retention capabilities. 

Our products may be subject to product liability legal claims, 
which could have an adverse effect on our business, results 
of operations and financial condition. Certain of our products 
provide applications that relate to patient clinical information. 
Any  failure  by  our  products  to  provide  accurate  and  timely 
information  concerning  patients,  their  medication,  treatment, 
and health status, generally, could result in claims against us 
which could materially and adversely impact our financial per-
formance, industry reputation and ability to market new system 
sales. In addition, a court or government agency may take the 
position that our delivery of health information directly, includ-
ing through licensed practitioners, or delivery of information by 
a third party site that a consumer accesses through our Web 
sites, exposes us to assertions of malpractice, other personal 
injury liability, or other liability for wrongful delivery/handling 
of  healthcare  services  or  erroneous  health  information.  We 
maintain insurance to protect against claims associated with 
the use of our products as well as liability limitation language 
in our end-user license agreements, but there can be no as-
surance that our insurance coverage or contractual language 
would adequately cover any claim asserted against us. A suc-
cessful  claim  brought  against  us  in  excess  of  or  outside  of 
our insurance coverage could have an adverse effect on our 
business,  results  of  operations  and  financial  condition.  Even 
unsuccessful claims could result in our expenditure of funds for 
litigation and management time and resources. 

Certain  healthcare  professionals  who  use  our  Internet-
based  products  will  directly  enter  health  information  about 
their  patients  including  information  that  constitutes  a  record 
under applicable law that we may store on our computer sys-
tems. Numerous federal and state laws and regulations, the 
common law, and contractual obligations, govern collection, 
dissemination,  use  and  confidentiality  of  patient-identifiable 
health information, including:

•	 State	and	federal	privacy	and	confidentiality	laws;

•	 Our	contracts	with	customers	and	partners;

•	 State	laws	regulating	healthcare	professionals;

•	 Medicaid	laws;	

•	 The	Health	Insurance	Portability	and	Accountability	Act	of	
1996 (“HIPAA”) and related rules proposed by the Health 
Care Financing Administration; and 

•	 Health	Care	Financing	Administration	standards	for	Internet	

transmission of health data.

HIPAA establishes elements including, but not limited to, 
federal privacy and security standards for the use and protec-
tion of Protected Health Information. Any failure by us or by our 
personnel or partners to comply with applicable requirements 
may result in a material liability to us.

Although we have systems and policies in place for safe-
guarding Protected Health Information from unauthorized dis-
closure, these systems and policies may not preclude claims 
against us for alleged violations of applicable requirements. 
Also,  third  party  sites  and/or  links  that  consumers  may  ac-
cess through our web sites may not maintain adequate sys-
tems to safeguard this information, or may circumvent systems 
and policies we have put in place. In addition, future laws or 
changes in current laws may necessitate costly adaptations to 
our policies, procedures, or systems.

There can be no assurance that we will not be subject to 
product liability claims, that such claims will not result in liability 
in  excess  of  our  insurance  coverage,  that  our  insurance  will 
cover such claims or that appropriate insurance will continue 
to be available to us in the future at commercially reasonable 
rates. Such product liability claims could adversely affect our 
business, results of operations and financial condition.

We are subject to the effect of payor and provider conduct 
which we cannot control and accordingly, there is no assur-
ance that revenues for our services will continue at historic 
levels. We offer certain electronic claims submission products 
and services as part of our product line. While we have imple-
mented certain product features designed to maximize the ac-
curacy and completeness of claims submissions, these features 
may not be sufficient to prevent inaccurate claims data from 
being submitted to payors. Should inaccurate claims data be 
submitted to payors, we may be subject to liability claims. 

Electronic data transmission services are offered by cer-
tain payors to healthcare providers that establish a direct link 
between  the  provider  and  payor.  This  process  reduces  rev-
enue to third party EDI service providers such as us. As a result 
of this, or other market factors, we are unable to ensure that 
we will continue to generate revenue at or in excess of prior 
levels for such services. 

A significant increase in the utilization of direct links be-
tween healthcare providers and payors could adversely affect 
our transaction volume and financial results. In addition, we 
cannot provide assurance that we will be able to maintain our 
existing links to payors or develop new connections on terms 
that are economically satisfactory to us, if at all. 

17

There  is  significant  uncertainty  in  the  healthcare  industry 
in  which  we  operate,  and  we  are  subject  to  the  possibility 
of  changing  government  regulation,  which  may  adversely 
impact  our  business,  financial  condition  and  results  of  op-
erations. The healthcare industry is subject to changing politi-
cal, economic and regulatory influences that may affect the 
procurement processes and operation of healthcare facilities. 
During  the  past  several  years,  the  healthcare  industry  has 
been  subject  to  an  increase  in  governmental  regulation  of, 
among other things, reimbursement rates and certain capital 
expenditures. 

In the past, various legislators have announced that they 
intend to examine proposals to reform certain aspects of the 
U.S. healthcare system including proposals which may change 
governmental  involvement  in  healthcare  and  reimbursement 
rates, and otherwise alter the operating environment for us and 
our clients. Healthcare providers may react to these proposals, 
and the uncertainty surrounding such proposals, by curtailing 
or deferring investments, including those for our systems and re-
lated services. Cost-containment measures instituted by health-
care  providers  as  a  result  of  regulatory  reform  or  otherwise 
could result in a reduction in the allocation of capital funds. 
Such a reduction could have an adverse effect on our ability 
to sell our systems and related services. On the other hand, 
changes  in  the  regulatory  environment  have  increased  and 
may continue to increase the needs of healthcare organiza-
tions for cost-effective data management and thereby enhance 
the overall market for healthcare management information sys-
tems. We cannot predict what effect, if any, such proposals 
or  healthcare  reforms  might  have  on  our  business,  financial 
condition and results of operations.

As  existing  regulations  mature  and  become  better  
defined, we anticipate that these regulations will continue to 
directly  affect  certain  of  our  products  and  services,  but  we 
cannot  fully  predict  the  effect  at  this  time.  We  have  taken 
steps to modify our products, services and internal practices 
as necessary to facilitate our compliance with the regulations, 
but there can be no assurance that we will be able to do so 
in a timely or complete manner. Achieving compliance with 
these regulations could be costly and distract management’s 
attention and divert other company resources, and any non-
compliance by us could result in civil and criminal penalties. 

In addition, developments of additional federal and state 
regulations and policies have the potential to positively or neg-
atively affect our business. 
In addition, our software may po-
tentially be subject to regulation by the U.S. Food and Drug 
Administration  (“FDA”)  as  a  medical  device.  Such  regulation 
could require the registration of the applicable manufacturing 
facility and software and hardware products, application of 
detailed  record-keeping  and  manufacturing  standards,  and 
FDA approval or clearance prior to marketing. An approval or 

18

clearance requirement could create delays in marketing, and 
the FDA could require supplemental filings or object to certain 
of these applications, the result of which could adversely affect 
our business, financial condition and results of operations. 

We may be subject to false or fraudulent claim laws. There 
are numerous federal and state laws that forbid submission of 
false information or the failure to disclose information in con-
nection with submission and payment of physician claims for 
reimbursement. In some cases, these laws also forbid abuse of 
existing systems for such submission and payment. Any failure 
of our RCM services to comply with these laws and regula-
tions could result in substantial liability including, but not limited 
to,  criminal  liability,  could  adversely  affect  demand  for  our 
services and could force us to expend significant capital, re-
search and development and other resources to address the 
failure. Errors by us or our systems with respect to entry, format-
ting, preparation or transmission of claim information may be 
determined  or  alleged  to  be  in  violation  of  these  laws  and 
regulations.  Determination  by  a  court  or  regulatory  agency 
that our services violate these laws could subject us to civil or 
criminal penalties, invalidate all or portions of some of our cli-
ent contracts, require us to change or terminate some portions 
of our business, require us to refund portions of our services 
fees,  cause  us  to  be  disqualified  from  serving  clients  doing 
business with government payors and have an adverse effect 
on our business.

In most cases where we are permitted to do so, we cal-
culate charges for our RCM services based on a percentage 
of the collections that our clients receive as a result of our ser-
vices. To the extent that violations or liability for violations of 
these laws and regulations require intent, it may be alleged that 
this percentage calculation provides us or our employees with 
incentive to commit or overlook fraud or abuse in connection 
with  submission  and  payment  of  reimbursement  claims.  The 
U.S. Centers for Medicare and Medicaid Services has stated 
that it is concerned that percentage-based billing services may 
encourage billing companies to commit or to overlook fraudu-
lent or abusive practices. 

A  portion  of  our  business  involves  billing  of  Medicare 
claims on behalf of its clients. In an effort to combat fraudulent 
Medicare  claims,  the  federal  government  offers  rewards  for 
reporting of Medicare fraud which could encourage others to 
subject us to a charge of fraudulent claims, including charges 
that are ultimately proven to be without merit. 

If our products fail to comply with evolving government and 
industry  standards  and regulations,  we  may have difficulty 
selling our products. We may be subject to additional federal 
and state statutes and regulations in connection with offering 
services and products via the Internet. On an increasingly fre-
quent basis, federal and state legislators are proposing laws 

and regulations that apply to Internet commerce and communi-
cations. Areas being affected by these regulations include user 
privacy, pricing, content, taxation, copyright protection, distribu-
tion, and quality of products and services. To the extent that our 
products and services are subject to these laws and regulations, 
the sale of our products and services could be harmed.

We are subject to changes in and interpretations of financial 
accounting matters that govern the measurement of our per-
formance, one or more of which could adversely affect our 
business, financial condition, cash flows, revenue and results 
of  operations.  Based  on  our  reading  and  interpretations  of 
relevant guidance, principles or concepts issued by, among 
other  authorities,  the  American  Institute  of  Certified  Public 
Accountants, the Financial Accounting Standards Board, and 
the  Commission,  we  believe  our  current  sales  and  licensing 
contract  terms  and  business  arrangements  have  been  prop-
erly reported. However, there continue to be issued interpreta-
tions and guidance for applying the relevant standards to a 
wide range of sales and licensing contract terms and business  
arrangements  that  are  prevalent  in  the  software  industry. 
Future interpretations or changes by the regulators of existing  
accounting  standards  or  changes  in  our  business  practices 
could  result  in  changes  in  our  revenue  recognition  and/or 
other accounting policies and practices that could adversely 
affect  our  business,  financial  condition,  cash  flows,  revenue 
and results of operations.

If  material  weaknesses  in  our  internal  controls  are  identi-
fied by us or our independent registered public accountants, 
our per share price may be adversely affected. Any material 
weaknesses  identified  in  our  internal  controls  as  part  of  the 
ongoing evaluation being undertaken by us and our indepen-
dent  registered  public  accountants  pursuant  to  Section  404 
of the Sarbanes-Oxley Act of 2002 could have an adverse 
effect on the price at which our stock trades. 

No evaluation process can provide complete assurance 
that  our  internal  controls  will  detect  and  correct  all  failures 
within our company to disclose material information otherwise 
required to be reported. The effectiveness of our controls and 
procedures  could  also  be  limited  by  simple  errors  or  faulty 
judgments.  In  addition,  if  we  continue  to  expand,  through 
either  organic  growth  or  through  acquisitions  (or  both),  the 
challenges involved in implementing appropriate controls will 
increase and may require that we evolve some or all of our 
internal control processes. 

It is also possible that the overall scope of Section 404 of 
the Sarbanes-Oxley Act of 2002 may be revised in the future, 
thereby causing our auditors and ourselves to review, revise or 
reevaluate our internal control processes which may result in 
the expenditure of additional human and financial resources. 

Continuing  worldwide  political  and  economic  uncertainties 
may adversely affect our revenue and profitability. The last 
several  years  have  been  periodically  marked  by  concerns 
including but not limited to inflation, decreased consumer con-
fidence, the lingering effects of international conflicts, energy 
costs and terrorist and military activities. These conditions can 
make it extremely difficult for our customers, our vendors and 
us  to  accurately  forecast  and  plan  future  business  activities, 
and they could cause constrained spending on our products 
and services, and/or delay and lengthen sales cycles. 

Our future policy concerning stock splits is uncertain. While 
we effected a 2:1 split of our stock in March 2005 and a 
second 2:1 stock split in March 2006, there can be no assur-
ance that another stock split will occur in the future. Unfulfilled 
expectations to the contrary could adversely affect the price 
of our stock.

Our future policy concerning the payment of dividends is un-
certain, which could adversely affect the price of our stock. 
We have announced our intention to pay a quarterly dividend 
commencing with the conclusion of our first fiscal quarter of 
2008 (June 30, 2007) and pursuant to this policy our Board 
has declared a quarterly cash dividend ranging from $0.25 
to its most recent level of $0.30 per share on our outstanding 
shares of common stock, each quarter thereafter. We antici-
pate that future quarterly dividends, if and when declared by 
our Board pursuant to this policy, would likely be distributable 
on or about the fifth day of each of the months of October, 
January, April and July. There can be no guarantees that we 
will  have  the  financial  wherewithal  to  fund  this  dividend  in 
perpetuity or to pay it at historic rates. Further, our Board may 
decide not to pay the dividend at some future time for financial 
or  non-financial  reasons.  Unfulfilled  expectations  regarding  
future dividends could adversely affect the price of our stock.

ITEM 1B. Unresolved Staff Comments
None.

ITEM 2. Properties
Our principal administrative, accounting, QSI Division opera-
tions and NextGen training operations are located in Irvine, 
California,  under  a  lease  for  24,000  square  feet  that  com-
menced in October 2007. This lease expires in May 2013.

We lease approximately 78,000 square feet of space 
for the principal office of our NextGen Division in Horsham, 
Pennsylvania.  This  lease  expires  in  March  2011.  In  January 
2007, we executed a new lease for approximately 35,000 
square  feet  of  space  for  the  NextGen  Division  in  Atlanta, 
Georgia. This lease expires in October 2011. In May 2006, 
we executed a lease for approximately 3,000 square feet of 
space in Dallas, Texas for NextGen staff and a new NextGen 

19

training  facility.  In  addition,  we  lease  approximately  6,000 
square feet of space in Santa Ana, California, to house our 
assembly and warehouse operations of the QSI Division. We 
also have an aggregate of approximately 3,000 square feet 
of  space  in  Minnesota,  Utah,  Wisconsin,  and  Washington 
to house additional sales, training, development and service 
operations. These leases, excluding options, have expiration 
dates ranging from month-to-month to October 2011. Should 
we continue to grow, we may be required to lease additional 
space. We believe that suitable additional or substitute space 
is available, if needed, at market rates. 

As a result of our acquisition of HSI on May 20, 2008, 
we  lease  approximately  46,400  square  feet  for  our  HSI 
operations  in  St.  Louis,  Missouri  under  leases  that  expire  in 
November 2010. 

As a result of our acquisition of PMP on October 28, 2008, 
we lease approximately 40,500 square feet for our PMP op-
erations in Hunt Valley, Maryland under various leases which 
will expire in July 2010.

ITEM 3. Legal Proceedings
In the normal course of business, we are involved in various 
claims  and  legal  proceedings.  While  the  ultimate  resolution 
of these currently pending matters has yet to be determined, 
we do not presently believe that their outcome will adversely 
affect our financial position, results of operations or liquidity.

ITEM 4. Submission of Matters  
to a Vote of Security Holders
No matter was submitted to a vote of security holders during 
the fourth quarter of fiscal year 2009.

Part II

ITEM 5. Market For Registrant’s  
Common Stock, Related Shareholder 
Matters and Issuer Purchases of  
Equity Securities

Market Price and Holders
Our common stock is traded on the NASDAQ Global Select 
Market under the symbol “QSII.” The following table sets forth 
for  the  quarters  indicated  the  high  and  low  sales  prices  for 
each period indicated as reported on the NASDAQ Global 
Select Market and reflects all stock splits effected.

Quarter Ended

June 30, 2007 

High 

Low  

  $42.44 

  $36.96 

September 30, 2007

  $45.35 

  $32.37 

December 31, 2007

  $38.99  

  $26.08 

March 31, 2008

  $36.30  

  $26.90 

June 30, 2008

  $35.97 

  $29.00 

September 30, 2008

$47.94 

  $27.34 

December 31, 2008

  $44.98 

  $25.70 

March 31, 2009

  $48.46 

  $34.26

At May 22, 2009, there were approximately 103 holders of 
record of our common stock. 

Dividends
On  May  27,  2009,  our  Board  approved  a  quarterly  cash 
dividend  of  $0.30  per  share  on  our  outstanding  shares  of 
common stock, payable to shareholders of record as of June 
12,  2009  with  an  expected  distribution  date  on  or  about 
 July 6, 2009.

On  January  28,  2009,  our  Board  approved  a  quar-
terly  cash  dividend  of  $0.30  per  share  on  our  outstanding 
shares of common stock, payable to shareholders of record 
as of March 11, 2009 with a distribution date on or about  
April 3, 2009.

On  October  30,  2008,  our  Board  approved  a  quar-
terly  cash  dividend  of  $0.30  per  share  on  our  outstanding 
shares of common stock, payable to shareholders of record as 
of December 15, 2008 with a distribution date on or about 
January 5, 2009. 

On  August  4,  2008,  our  Board  approved  a  quarterly 
cash dividend of $0.30 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
September  15,  2008  with  a  distribution  date  on  or  about 
October 1, 2008.

On  May  29,  2008,  our  Board  approved  a  quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of common stock, payable to shareholders of record as of June 
15, 2008 with a distribution date on or about July 2, 2008. 

On January 30, 2008, our Board approved a quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
March 14, 2008 and was distributed to shareholders on or 
about April 7, 2008. 

On October 25, 2007, our Board approved a quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
December 14, 2007 and was distributed to shareholders on 
or about January 7, 2008. 

20

 
 
 
 
On  July  31,  2007,  our  Board  approved  a  quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
September 14, 2007 and was distributed to shareholders on 
or about October 5, 2007.

On  May  31,  2007,  our  Board  declared  a  quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
June  15,  2007  and  was  distributed  to  shareholders  on  July 
5, 2007.

In February 2007, we paid a $1.00 per share cash divi-
dend on shares of our common stock. The record date for the 
dividend was February 13, 2007. 

In January 2007, our Board adopted a policy whereby 
we intend to pay a regular quarterly dividend of $0.25 per 
share  on  our  outstanding  common  stock  commencing  with 
conclusion of our first fiscal quarter of 2008 (June 30, 2007) 

and continuing each fiscal quarter thereafter, subject to further 
Board review and approval and establishment of record and 
distribution dates by our Board prior to the declaration of each 
such quarterly dividend. In August 2008, our Board increased 
the quarterly dividend to $0.30 per share. We anticipate that 
future quarterly dividends, if and when declared by our Board 
pursuant  to  this  policy,  would  likely  be  distributable  on  or 
about the fifth day of each of the months of October, January, 
April and July.

Payment of future dividends, if any, will be at the discre-
tion  of  our  Board  after  taking  into  account  various  factors, 
including  without  limitation,  our  financial  condition,  operat-
ing  results,  current  and  anticipated  cash  needs  and  plans  
for expansion. 

Performance Graph
The following graph compares the cumulative total returns of our common stock, the NASDAQ Composite Index, and the 
NASDAQ Computer & Data Processing Services Stock Index over the five-year period ended March 31, 2009 assuming $100 
was invested on March 31, 2004 with all dividends, if any, reinvested. This performance graph shall not be deemed to be 
“soliciting material” or “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange 
Act”) or otherwise subject to the liabilities under that Section and shall not be deemed to be incorporated by reference into any 
filing of the Company under the Securities Act of 1933, as amended or the Exchange Act. 

COMPARISON OF 5 YEAR CUMULATIVE TOTAL RETURN* 
Among Quality Systems, Inc., The NASDAQ Composite Index 
And The NASDAQ Computer & Data Processing Index 

$500 

$450 

$400 

$350 

$300 

$250 

$200 

$150 

$100 

$50 

$0 

3/04 

3/05 

3/06 

3/07 

3/08 

3/09 

Quality Systems, Inc. 

NASDAQ Composite 

NASDAQ Computer & Data Processing 

*$100 invested on 3/31/04 in stock or index, including reinvestment of dividends. 
Fiscal year ending March 31. 

21

Graph produced by Research Data Group, Inc.

5/20/2009

The  last  trade  price  of  our  common  stock  on  each  of 
March 31, 2005, 2006, 2007, 2008 and 2009 was pub-
lished by NASDAQ and, accordingly for the periods ended 
March 31, 2005, 2006, 2007, 2008 and 2009 the report-
ed last trade price was utilized to compute the total cumulative 
return  for  our  common  stock  for  the  respective  periods  then 
ended. Shareholder returns over the indicated periods should 
not  be  considered  indicative  of  future  stock  prices  or  share-
holder returns. 

ITEM 6. Selected Financial Data
The  following  selected  financial  data  with  respect  to  our 
Consolidated  Statements  of  Income  data  for  each  of  the 
five  years  in  the  period  ended  March  31,  2009  and  the 
Consolidated Balance Sheet data as of the end of each such 
fiscal year are derived from our audited consolidated financial 
statements. The following information should be read in con-
junction with our Consolidated Financial Statements and the 
related notes thereto and “Item 7. Management’s Discussion 
and Analysis of Financial Condition and Results of Operations” 
included  elsewhere  herein.  All  share  prices  in  the  table  be-
low have been retroactively adjusted to reflect the fiscal year 
2006 and 2005 stock splits. 

Consolidated Financial Data (In Thousands, Except for Share Data)

Statements of Income Data:

Revenue

Cost of revenue

Gross profit

Selling, general and administrative 
expenses

Research and development costs

Income from operations

Interest income

Other income (expense)

Income before provision for income 
taxes

Provision for income taxes

Year ended March 31,

2009

2008

2007

2006

2005

$   245,515 

 $  186,500 

 $  157,165 

 $  119,287 

 $  88,961 

 88,890 

 62,501 

 50,784 

 156,625 

 123,999 

 106,381 

 39,828 

 79,459 

 32,669 

 56,292 

 70,445 

 13,777 

 72,403 

 1,203 

 (279)

 53,260 

 11,350 

 59,389 

 2,661 

 953 

 45,337 

 10,166 

 50,878 

 3,306 

 - 

 35,554 

 24,776 

 8,087 

 6,903 

 35,818 

 24,613 

 2,108 

 - 

 876 

 - 

 73,327 

 27,208 

 63,003 

 22,925 

 54,184 

 20,952 

 37,926 

 14,604 

 25,489 

 9,380 

Net income

 $     46,119 

 $   40,078 

  $     33,232 

  $     23,322 

 $   16,109 

Basic net income per share

 $         1.65 

 $       1.47 

 $        1.24 

 $       0.88 

 $      0.63 

Diluted net income per share

 $         1.62 

 $       1.44 

 $        1.21 

 $       0.85 

 $      0.61 

Basic weighted average shares 
outstanding

Diluted weighted average shares 
outstanding

Balance Sheet Data (at end of year):

 28,031 

 27,298 

 26,882 

 26,413 

 25,744 

 28,396 

 27,770 

 27,550 

 27,356 

 26,406 

Cash and cash equivalents

 $     70,180 

  $     59,046 

 $   60,028 

 $    57,255 

 $   51,157 

Working capital

Total assets

Total liabilities

 $    98,980 

  $     79,932 

 $    76,616 

 $    61,724 

 $   55,111 

 $  242,101 

$  187,908 

 $  150,681 

 $  122,247 

 $  99,442 

 $   86,534 

 $    74,203 

 $    59,435 

 $    49,838 

 $  36,711 

Total shareholders’ equity

 $  155,567 

$  113,705 

 $    91,246 

 $    72,409 

 $  62,731

22

ITEM 7. Management’s Discussion  
and Analysis of Financial Condition and  
Results of Operations
Except  for  the  historical  information  contained  herein,  the  mat-
ters  discussed  in  this  management’s  discussion  and  analysis  of 
financial condition and results of operations, or MD&A, including 
discussions of our product development plans, business strategies 
and market factors influencing our results, may include forward-
looking  statements  that  involve  certain  risks  and  uncertainties. 
Actual results may differ from those anticipated by us as a result 
of  various  factors,  both  foreseen  and  unforeseen,  including,  but 
not limited to, our ability to continue to develop new products and 
increase systems sales in markets characterized by rapid techno-
logical evolution, consolidation, and competition from larger, bet-
ter  capitalized  competitors.  Many  other  economic,  competitive, 
governmental and technological factors could affect our ability to 
achieve our goals, and interested persons are urged to review the 
risks described in “Item 1A. Risk Factors” as set forth above, as well 
as in our other public disclosures and filings with the Commission.

Overview 
This  MD&A  is  provided  as  a  supplement  to  the  Consolidated 
Financial  Statements  and  notes  thereto  included  in  this  Report, 
in order to enhance your understanding of our results of opera-
tions and financial condition and the following discussion should 
be read in conjunction with, and is qualified in its entirety by, 
the Consolidated Financial Statements and related notes thereto 
included elsewhere in this Report. Historical results of operations, 
percentage margin fluctuations and any trends that may be in-
ferred from the discussion below are not necessarily indicative of 
the operating results for any future period.

Our MD&A is organized as follows: 

		•	 Management Overview. This section provides a general de-
scription of our Company and operating segments, a discus-
sion as to how we derive our revenue, background information 
on certain trends and developments affecting our Company, 
a summary of our acquisition transactions and a discussion on 
management’s strategy for driving revenue growth.

		•	 Critical  Accounting  Policies  and  Estimates.  This  section  dis-
cusses those accounting policies that are considered impor-
tant to the evaluation and reporting of our financial condition 
and results of operations, and whose application requires us 
to exercise subjective or complex judgments in making esti-
mates and assumptions. In addition, all of our significant ac-
counting policies, including our critical accounting policies, 
are  summarized  in  Note  2  to  the  Consolidated  Financial 
Statements included in this Report. 

		•	 Overview of Results of Operations and Results of Operations 
by Operating Divisions. These sections provide our analysis 
and outlook for the significant line items on our consolidated 
statements of operations, as well as other information that we 

deem meaningful to understand our results of operations on 
both a consolidated basis and an operating division basis. 

		•	 Liquidity  and  Capital  Resources.  This  section  provides  an 
analysis of our liquidity and cash flows and discussions of 
our  contractual  obligations  and  commitments  as  of  March 
31, 2009. 

		•	 Recent  Accounting  Pronouncements.  This  section  provides 
a summary of the most recent authoritative accounting stan-
dards and guidance that have either been recently adopted 
by our Company or may be adopted in the future. 

Management Overview 
Our Company is comprised of the QSI Division, the NextGen 
Division, HSI and PMP. We primarily derive revenue by develop-
ing and marketing healthcare information systems that automate 
certain  aspects  of  medical  and  dental  practices,  networks  of 
practices such as PHOs and MSOs, ambulatory care centers, 
community health centers, and medical and dental schools. We 
also provide RCM services through our Practice Solutions divi-
sion of NextGen which consists primarily of billing and collection 
services for medical practices.

The turbulence in the worldwide economy has impacted al-
most all industries. While healthcare is not immune to economic 
cycles, we believe it is more resilient than most segments of the 
economy. The impact of the current economic conditions on our 
existing and prospective clients has been mixed. We continue to 
see organizations that are doing fairly well operationally, how-
ever, some organizations with a large dependency on Medicaid 
populations  are  being  impacted  by  the  challenging  financial 
condition of the many state governments in whose jurisdictions 
they  conduct  business.  A  positive  factor  for  U.S.  healthcare  is 
the fact that the Obama administration is pursuing broad health-
care reform aimed at improving issues surrounding healthcare. 
The ARRA, which became law on February 17, 2009, includes 
more than $20 billion to help healthcare organizations modern-
ize operations through the acquisition of health care information 
technology. While we are unsure of the immediate impact from 
the ARRA, the long-term potential could be significant. 

On  May  20,  2008,  we  acquired  HSI,  a  full-service 
healthcare RCM company. HSI operates under the umbrella of 
NextGen  Practice  Solutions.  Founded  in  1996,  HSI  currently 
provides  RCM  services  to  providers  including  health  systems, 
hospitals,  and  physicians  in  private  practice  with  an  in-house 
team of more than 200 employees including specialists in medi-
cal  billing,  coding  and  compliance,  payor  credentialing,  and 
information technology. 

On  October  28,  2008,  we  acquired  PMP,  a  full-service 
healthcare  RCM  company.  This  acquisition  is  also  part  of  our 
growth strategy for NextGen Practice Solutions. Similar to HSI, 
PMP operates under the umbrella of NextGen Practice Solutions. 

23

Founded in 2001, PMP provides physician billing and technol-
ogy management services to healthcare providers, primarily in 
the Mid-Atlantic region. 

Our  strategy  is,  at  present,  to  focus  on  providing  soft-
ware and services to medical and dental practices. The key 
elements  of  this  strategy  are  to  continue  development  and 
enhancement  of  select  software  solutions  in  target  markets, 
to continue investments in our infrastructure including but not 
limited to product development, sales, marketing, implementa-
tion, and support, to continue efforts to make infrastructure in-
vestments within an overall context of maintaining reasonable 
expense discipline, to add new customers through maintaining 
and expanding sales, marketing and product development ac-
tivities, and to expand our relationship with existing customers 
through delivery of new products and services.

Critical Accounting Policies and Estimates
The  discussion  and  analysis  of  our  consolidated  financial 
statements and results of operations is based upon our con-
solidated financial statements which have been prepared in 
accordance with accounting principles generally accepted in 
the United States of America. The preparation of these con-
solidated  financial  statements  requires  us  to  make  estimates 
and  judgments  that  affect  the  reported  amounts  of  assets, 
liabilities,  revenue  and  expenses,  and  related  disclosures  of 
contingent  assets  and  liabilities.  On  an  on-going  basis,  we 
evaluate estimates, including but not limited to those related 
to revenue recognition, valuation of marketable securities, ARS 
put option rights, uncollectible accounts receivable, intangible 
assets, software development cost, and income taxes for rea-
sonableness. We base our estimates on historical experience 
and on various other assumptions that management believes 
to be reasonable under the circumstances, the results of which 
form the basis for making judgments about the carrying values 
of assets and liabilities that may not be readily apparent from 
other  sources.  Actual  results  may  differ  from  these  estimates 
under different assumptions or conditions.

We believe revenue recognition, valuation of marketable 
securities and ARS put option rights, the allowance for doubtful 
accounts, capitalized software costs, share-based compensa-
tion, income taxes and business combinations are among the 
most critical accounting policies that affect our consolidated fi-
nancial statements. We believe that significant accounting pol-
icies, as described in Note 2 of our Consolidated Financial 
Statements,  “Summary  of  Significant  Accounting  Policies”, 
should be read in conjunction with Management’s Discussion 
and Analysis of Financial Condition and Results of Operations. 

Revenue Recognition. We currently recognize system sales rev-
enue pursuant to SOP 97-2, as amended by SOP 98-9. We 
generate revenue from the sale of licensing rights to use our 
software products sold directly to end-users and value-added 

24

resellers,  or  VARs.  We  also  generate  revenue  from  sales  of 
hardware and third party software, implementation, training, 
software  customization,  EDI,  post-contract  support  (mainte-
nance) and other services, including RCM services, performed 
for customers who license our products. 

A  typical  system  contract  contains  multiple  elements  of 
the  above  items.  SOP  97-2,  as  amended,  requires  revenue 
earned on software arrangements involving multiple elements 
to  be  allocated  to  each  element  based  on  the  relative  fair 
values  of  those  elements.  The  fair  value  of  an  element  must 
be  based  on  vendor  specific  objective  evidence  (“VSOE”). 
We limit our assessment of VSOE for each element to either 
the price charged when the same element is sold separately 
or the price established by management having the relevant 
authority  to  do  so,  for  an  element  not  yet  sold  separately. 
VSOE calculations are updated and reviewed at the end of 
each quarter or annually depending on the nature of the prod-
uct  or  service.  We  have  established  VSOE  for  the  related 
undelivered elements based on the bell-shaped curve method. 
Maintenance VSOE for our largest customers is based on stat-
ed renewal rates only if the rate is determined to be substan-
tive and falls within our customary pricing practices. 

When  evidence  of  fair  value  exists  for  the  undelivered 
elements only, the residual method, provided for under SOP 
98-9, is used. Under the residual method, we defer revenue 
related to the undelivered elements in a system sale based on 
VSOE of fair value of each of the undelivered elements, and al-
locate the remainder of the contract price net of all discounts to 
revenue recognized from the delivered elements. Undelivered 
elements  of  a  system  sale  may  include  implementation  and 
training services, hardware and third party software, mainte-
nance, future purchase discounts, or other services. If VSOE 
of  fair  value  of  any  undelivered  element  does  not  exist,  all 
revenue is deferred until VSOE of fair value of the undelivered 
element is established or the element has been delivered.

We bill for the entire system sales contract amount upon 
contract execution, except for maintenance which is billed sep-
arately. Amounts billed in excess of the amounts contractually 
due are recorded in accounts receivable as advance billings. 
Amounts are contractually due when services are performed 
or in accordance with contractually specified payment dates. 
Provided the fees are fixed and determinable and collection is 
considered probable, revenue from licensing rights and sales 
of hardware and third party software is generally recognized 
upon  shipment  and  transfer  of  title.  In  certain  transactions 
whose collections risk is high, the cash basis method is used 
to recognize revenue. If the fee is not fixed or determinable, 
then the revenue recognized in each period (subject to appli-
cation of other revenue recognition criteria) will be the lesser of 
the aggregate of amounts due and payable or the amount of 
the arrangement fee that would have been recognized if the 

fees were being recognized using the residual method. Fees 
which are considered fixed or determinable at the inception 
of our arrangements must include the following characteristics:

•	 The	fee	must	be	negotiated	at	the	outset	of	an	arrange-
ment, and generally be based on the specific volume of 
products to be delivered without being subject to change 
based on variable pricing mechanisms such as the number 
of units copied or distributed or the expected number of 
users; and

•	 Payment	terms	must	not	be	considered	extended.	If	a	sig-
nificant portion of the fee is due more than 12 months after 
delivery  or  after  the  expiration  of  the  license,  the  fee  is 
presumed not fixed and determinable.

Revenue  from  implementation  and  training  services  is 
recognized  as  the  corresponding  services  are  performed. 
Maintenance revenue is recognized ratably over the contrac-
tual maintenance period.

Contract  accounting  is  applied  where  services  in-
clude  significant  software  modification,  development  or 
customization. In such instances, the arrangement fee is ac-
counted for in accordance with SOP 81-1 “Accounting for 
Performance of Construction-Type and Certain Production-
Type Contracts.”

Pursuant to SOP 81-1, we use the percentage of comple-

tion method provided all of the following conditions exist:

•	 The	 contract	 includes	 provisions	 that	 clearly	 specify	 the	
enforceable rights regarding goods or services to be pro-
vided and received by the parties, the consideration to be 
exchanged, and the manner and terms of settlement;

•	 The	 customer	 can	 be	 expected	 to	 satisfy	 its	 obligations	

under the contract;

•	 We	can	be	expected	to	perform	our	contractual	obliga-

tions; and

•	 Reliable	estimates	of	progress	towards	completion	can	 

be made.

We measure completion using labor input hours. Costs 
of providing services, including services accounted for in ac-
cordance with SOP 81-1, are expensed as incurred.

If a situation occurs in which a contract is so short term that 
the consolidated financial statements would not vary materially 
from using the percentage-of-completion method or in which we 
are unable to make reliable estimates of progress of completion 
of the contract, the completed contract method is utilized. 

Product  returns  are  estimated  in  accordance  with 
Statement  of  Financial  Accounting  Standards  (“SFAS”)  No. 
48, “Revenue Recognition When Right of Return Exists”. The 
Company also ensures that the other criteria in SFAS 48 have 
been met prior to recognition of revenue: 

•	 The	price	is	fixed	or	determinable;	

•	 The	customer	is	obligated	to	pay	and	there	are	no	contin-
gencies surrounding the obligation or the payment; 

•	 The	customer’s	obligation	would	not	change	in	the	event	of	

theft or damage to the product; 

•	 The	customer	has	economic	substance;	

•	 The	amount	of	returns	can	be	reasonably	estimated;	and	

•	 We	 do	 not	 have	 significant	 obligations	 for	 future	 perfor-
mance in order to bring about resale of the product by the 
customer.

We  have  historically  offered  short-term  rights  of  return 
of  less  than  thirty  days  in  certain  sales  arrangements.  If  we 
are able to estimate returns for these types of arrangements, 
revenue is recognized and these arrangements are recorded 
in the consolidated financial statements. If we are unable to 
estimate returns for these types of arrangements, revenue is not 
recognized in our consolidated financial statements until the 
rights of return expire. 

Revenue  related  to  sales  arrangements  which  include 
the right to use software stored on the Company’s hardware 
are accounted for under the Emerging Issues Task Force Issue 
(“EITF”) No. 00-3 “Application of AICPA Statement of Position 
97-2  to  arrangements  that  include  the  right  to  use  software 
stored on another entity’s hardware”. EITF No. 00-3 requires 
that for software licenses and related implementation services 
to  continue  to  fall  under  SOP  No.  97-2,  the  customer  must 
have the contractual right to take possession of the software 
without  incurring  a  significant  penalty  and  it  must  be  feasi-
ble for the customer to either host the software themselves or 
through another third party. If an arrangement is not deemed 
to be accounted for under SOP 97-2, the entire arrangement 
is  accounted  for  as  a  service  contract  in  accordance  with 
EITF  Issue  No.  00-21  “Revenue  Arrangements  with  Multiple 
Deliverables”. In that instance, the entire arrangement would 
be recognized as the hosting services are being performed.

RCM  revenue  is  derived  from  services  fees,  which  in-
clude amounts charged for ongoing billing and other related 
services and are generally billed to the customer as a percent-
age  of  total  collections.  We  do  not  recognize  revenue  for 
services fees until these collections are made as the services 
fees are not fixed and determinable until such time. 

From time to time, we offer future purchase discounts on 
our products and services as part of our sales arrangements. 
Pursuant  to  AICPA  TPA  5100.51,  discounts  which  are  incre-
mental to the range of discounts reflected in the pricing of the 
other elements of the arrangement, which are incremental to 
the range of discounts typically given in comparable transac-
tions, and which are significant, are treated as an additional el-
ement of the contract to be deferred. Amounts deferred related 

25

to future purchase options are not recognized until either the 
customer exercises the discount offer or the offer expires.

Revenue  is  divided  into  two  categories,  “system  sales” 
and  “maintenance,  EDI,  RCM  and  other  services”.  Revenue 
in  the  system  sales  category  includes  software  license  fees, 
third party hardware and software, and implementation and 
training  services  related  to  purchase  of  the  Company’s  soft-
ware systems. The majority of the revenue in the system sales 
category  is  related  to  the  sale  of  software.  Revenue  in  the 
maintenance, EDI, RCM and other services category includes, 
maintenance, EDI, RCM, follow on training and implementa-
tion services, annual third party license fees, hosting services 
and other revenue.

Valuation of marketable securities and ARS put option rights. 
Marketable  securities  are  recorded  at  fair  value,  based  on 
quoted  market  rates  or  on  valuation  analysis  when  appro-
priate. The cost of marketable securities sold is based upon 
the specific identification method. In addition, the Company 
classifies marketable securities as current or non-current based 
upon whether such assets are reasonably expected to be real-
ized in cash or sold or consumed during the normal operating 
cycle of the business. Realized gains or losses and other-than-
temporary  declines  in  the  fair  value  of  marketable  securities 
are determined on a specific identification basis and reported 
in interest and other income, net, as incurred.

The  fair  value  of  our  marketable  securities  has  been 
estimated  by  management  based  on  certain  assumptions 
of  what  market  participants  would  use  in  pricing  the  as-
set  in  a  current  transaction,  or  level  3  –  unobservable  in-
puts  in  accordance  with  SFAS  157  (see  Note  4  of  our 
Notes to the Consolidated Financial Statements: “Fair Value 
Measurements”). Management used a model to estimate the 
fair value of these securities that included certain level 2 inputs 
as well as assumptions, including a liquidity discount, based 
on management’s judgment, which are highly subjective and 
therefore considered level 3 inputs in the fair value hierarchy. 
The estimate of the fair value of the marketable securities could 
change based on market conditions. 

Our ARS are managed by UBS Financial Services Inc. 
(“UBS”). On November 13, 2008, we entered into an Auction 
Rate  Security  Rights  Agreement  (the  Rights  Agreement)  with 
UBS, whereby we accepted UBS’ offer to purchase our ARS 
investments at any time during the period of June 30, 2010 
through July 2, 2012. As a result we had obtained an asset, 
ARS put option rights, whereby we have a right to “put” the 
ARS back to UBS. We expect to exercise our ARS put option 
rights and put our ARS back to UBS on June 30, 2010, the 
earliest date allowable under the Rights Agreement. 

As we will be permitted to put the ARS back to UBS at 
par value, we have accounted for the ARS put option rights 

26

as a separate asset that was initially measured and will con-
tinue  to  be  measured  at  its  fair  value.  We  are  required  to 
assess  the  fair  value  of  these  two  individual  assets  and  to 
record corresponding changes in fair value in each reporting 
period  through  the  Consolidated  Statements  of  Operations 
until the ARS put option rights are exercised and the ARS are 
redeemed or sold. Since the ARS put option rights represent 
the right to sell the securities back to UBS at par, we will be 
required to periodically assess the economic ability of UBS to 
meet that obligation in assessing the fair value of the ARS put 
options rights. 

Allowance for Doubtful Accounts. We maintain allowances 
for  doubtful  accounts  for  estimated  losses  resulting  from  the 
inability  of  our  customers  to  make  required  payments.  We 
perform credit evaluations of our customers and maintain re-
serves for estimated credit losses. Reserves for potential credit 
losses are determined by establishing both specific and gen-
eral reserves. Specific reserves are based on management’s 
estimate  of  the  probability  of  collection  for  certain  troubled 
accounts. General reserves are established based on our his-
torical experience of bad debt expense and the aging of our 
accounts  receivable  balances  net  of  deferred  revenue  and 
specifically reserved accounts. If the financial condition of our 
customers  were  to  deteriorate  resulting  in  an  impairment  of 
their ability to make payments, additional allowances would 
be required.

Software Development Costs. Development costs incurred in 
the research and development of new software products and 
enhancements to existing software products are expensed as 
incurred  until  technological  feasibility  has  been  established. 
After technological feasibility is established with the comple-
tion of a working model of the enhancement or product, any 
additional development costs are capitalized in accordance 
with SFAS 86, “Accounting for the Costs of Computer Software 
to be Sold, Leased or Otherwise Marketed.”  Such capitalized 
costs are amortized on a straight line basis over the estimated 
economic life of the related product, which is generally three 
years. We perform an annual review of the recoverability of 
such capitalized software costs. At the time a determination is 
made that capitalized amounts are not recoverable based on 
the estimated cash flows to be generated from the applicable 
software, any remaining capitalized amounts are written off.

Share-Based  Compensation.  We  apply  the  provisions  of 
SFAS 123R, “Share-Based Payment,” which requires the mea-
surement  and  recognition  of  compensation  expense  for  all 
share-based payment awards made to employees and direc-
tors  based  on  estimated  fair  values.  SFAS  123R  requires  us 
to estimate the fair value of share-based payment awards on 
the date of grant using an option-pricing model. During fiscal 
year 2009, we estimate the expected term of the option us-
ing  historical  exercise  experience.  Prior  to  fiscal  year  2009 

we used the simplified method to estimate the expected term 
of  an  option.  We  estimate  volatility  by  using  the  weighted 
average historical volatility of our common stock, which we 
believe approximates expected volatility. The risk free rate is 
the implied yield available on the U.S Treasury zero-coupon 
issues with remaining terms equal to the expected term. The 
expected dividend yield is the average dividend rate during a 
period equal to the expected term of the option. Those inputs 
are then entered into the Black Scholes model to determine the 
estimated fair value. The value of the portion of the award that 
is expected to vest is recognized as expense over the requisite 
service period in our consolidated statement of income. 

Research and Development Tax Credits. Management’s treat-
ment of research and development tax credits represented a 
significant  estimate  which  affected  the  effective  income  tax 
rate for us for the years ended March 31, 2009, 2008 and 
2007. Research and development credits taken by us involve 
certain  assumptions  and  judgments  regarding  qualified  ex-
penses under Internal Revenue Code (“IRC”) Section 41. These 
credits  are  subject  to  examination  by  the  federal  and  state 
taxing authorities.

During each of the years ended March 31, 2009, 2008 
and 2007, we recognized approximately $1.0 million, $0.8 
million and $0.8 million in credits, respectively, related to re-
search and development. We expect to capture this benefit 
on our federal tax returns.

Qualified  Production  Activities  Deduction.  Management’s 
treatment  of  this  deduction  represented  an  estimate  that  af-
fected the effective income tax rate for us for the years ended 
March  31,  2009,  2008  and  2007.  The  deduction  taken 
by us involved certain assumptions and judgments regarding 
the  allocation  of  indirect  expenses  as  prescribed  under  IRC 
Section 199.

During  the  years  ended  March  31,  2009,  2008  and 
2007, we recognized approximately $2.7 million, $3.1 million 
and $1.5 million, respectively, in deductions related to the qual-
ified production activities deduction (“QPAD”) under IRC. The 
QPAD calculation was determined using interim guidance pro-
vided by proposed Internal Revenue Service regulations and 
notices. We expect to capture this benefit on our tax returns.

Business  Combinations. 
In  accordance  with  business 
combination  accounting  under  SFAS  No.  141,  “Business 
Combinations,”  we  allocate  the  purchase  price  of  acquired 
businesses to the tangible and intangible assets acquired and 
liabilities  assumed  based  on  estimated  fair  values.  Such  al-
locations  require  management  to  make  significant  estimates 
and assumptions, especially with respect to intangible assets 
acquired.  Management’s  estimates  of  fair  value  are  based 
upon assumptions believed to be reasonable. These estimates 
are based on information obtained from management of the 

acquired companies and are inherently uncertain. Critical es-
timates in valuing certain of the intangible assets include, but 
are not limited to:

•	 Future	expected	cash	flows	from	acquired	businesses;	and	

•	 The	acquired	company’s	brand	and	market	position.	

Unanticipated  events  and  circumstances  may  occur 
which may affect the accuracy or validity of such assumptions, 
estimates  or  actual  results  and  we  will  continue  to  evaluate 
events and circumstances on an ongoing basis.

Overview of Our Results 
•	 Our	total	revenue	increased	31.6%	and	income	from	op-
erations grew 21.9% on a consolidated basis for the year 
ended March 31, 2009. This performance was driven by 
growth  in  our  NextGen  Division,  offset  by  decreases  in 
revenue  and  operating  income  in  our  QSI  Division  and 
higher corporate expenses. 

•	 Our	year	over	year	growth	in	revenue	and	operating	in-
come during the year ended March 31, 2009 was par-
tially attributable to the HSI and PMP acquisitions. HSI and 
PMP  generated  $15.6  million  of  revenue  for  the  period 
May 21, 2008 to March 31, 2009 and $8.6 million of 
revenue for the period October 29, 2008 to March 31, 
2009, respectively. 

•	 Operating	income	was	positively	impacted	by	an	increase	
in revenue offset by a shift in revenue mix with an increased 
share of hardware, EDI, and RCM revenue resulting in a 
decline in our gross profit margin. We also experienced 
higher selling, general and administrative expenses. Higher 
selling, general and administrative expenses were impact-
ed negatively by approximately $1.5 million of expenses 
incurred in conjunction with the proxy contest involving our 
election  of  directors  at  our  2008  Annual  Shareholder’s 
Meeting and higher than usual legal expenses, primarily 
as  a  result  of  our  contested  proxy  election  and  certain 
legal  matters  related  to  intellectual  property  infringement 
claims in the NextGen Division. 

•	 We	do	not	believe	the	revenue	mix	changes	noted	above	
represent a change in the overall purchasing environment. 
On top of the potential benefits from the recently enacted 
ARRA, we have benefited and hope to continue to benefit 
from the increased demands on healthcare providers for 
greater efficiency and lower costs, as well as increased 
adoption  rates  for  electronic  medical  records  and  other 
technology in the healthcare arena.

27

•	 While	the	Company	expects	to	benefit	from	the	increasing	
demands for greater efficiency as well as government sup-
port for increased adoption of electronic medical records, 
the  current  economic  environment  combined  with  unpre-
dictability of the federal government’s plans to promote in-
creased adoption of electronic medical records negatively 
impacted the Company’s fourth quarter results and makes 
the near term achievement of such benefits and, ultimately, 
their impact on system sales, uncertain.

NextGen Division
•	 NextGen Division revenue increased 34.7% in the year 
ended  March  31,  2009  and  income  from  operations 
increased 25.9% from the year ended March 31, 2008. 
Organic  revenue  and  operating  income  growth  in  the 
NextGen Division not including acquisitions was 20.5% 
and 21.3% for the years ended March 31, 2009 and 
2008, respectively.

•	 The	Divisions’	year	over	year	growth	in	revenue	and	op-
erating income for the Company during the year ended 
March 31, 2009 was partially attributable to the HSI and 
PMP acquisitions. 

•	 HSI	contributed	$15.6	million	to	NextGen’s	revenue	from	
the  date  of  its  acquisition  on  May  20,  2008  to  March 
31,  2009.  HSI’s  operating  income  added  $0.7  million 
to  NextGen’s  operating  income  during  the  year  ended 
March 31, 2009.

•	 PMP	contributed	$8.6	million	to	NextGen’s	revenue	from	
the date of its acquisition on October 28, 2008 to March 
31,  2009.  PMP’s  operating  income  added  $2.5  million 
to  NextGen’s  operating  income  during  the  year  ended 
March 31, 2009.

•	 During	the	year	ended	March	31,	2009,	we	added	staff-
ing resources to most of our client-interfacing departments, 
and  intend  to  continue  doing  so  in  future  periods.  Such  
divisional  headcount  additions  caused  selling,  general 
and administrative expenses to increase. 

•	 Our	 goals	 include	 taking	 maximum	 advantage	 of	 future	
benefits related to the ARRA and continuing to further en-
hance  and  expand  the  marketing  and  sales  of  our  ex-
isting  products,  developing  new  products  for  targeted  
markets, continuing to add new customers, selling additional 
software  and  services  to  existing  customers,  expanding 
penetration of connectivity and other services to new and 
existing customers, and capitalizing on growth and cross 
selling opportunities within the Practice Solutions arena. 

QSI Division
•	 QSI	Division	revenue	decreased	1.2%	in	the	year	ended	
March 31, 2009 and Divisional operating loss decreased 
7.6% (excluding unallocated corporate expenses) from the 
year ended March 31, 2008. Divisional revenue and op-
erating income performance for the Division, while below 
fiscal year 2008 levels, were within the Division’s historical 
performance range. 

•	 A	drop	in	annual	revenue,	slight	changes	in	the	Division’s	
sales mix in favor of lower margin hardware and EDI prod-
ucts, and an increase in selling, general and administra-
tive expenses were the chief contributors to the operating 
income decline.

•	 Our	goals	for	the	QSI	Division	include	maximizing	profit	
performance given the constraints represented by a rela-
tively  weak  purchasing  environment  in  the  dental  group 
practice market. The QSI division also intends to leverage 
the NextGen sales force to sell its dental EMR software to 
practices  that  provide  both  medical  and  dental  services 
such as Federal Qualified Health Centers. 

28

The following table sets forth for the periods indicated the percentage of net revenue represented by each item in our 

consolidated statements of income. 

(Unaudited)

Revenues:

  Software, hardware and supplies

Implementation and training services

System sales

  Maintenance

  Electronic data interchange services

  Revenue cycle management

  Other services

Maintenance, EDI, RCM and other services

  Total revenue

Cost of revenue:

  Software, hardware and supplies

Implementation and training services

Total cost of system sales

  Maintenance

  Electronic data interchange services

  Revenue cycle management

  Other services

Total cost of maintenance, EDI, RCM and other services

  Total cost of revenue

  Gross profit

Operating expenses:

  Selling, general and administrative

  Research and development

Income from operations

Interest income

Other income (expense)

Income before provision for income taxes

Provision for income taxes

  Net income

* does not foot due to rounding

            Year Ended March 31,

2009

2008

2007

34.8%

40.9%

43.8%

5.4

40.2

29.7

12.0

8.7

9.3

59.8*

100.0

5.4

4.2

9.6

4.8

8.7

6.0

7.1

26.6

36.2

63.8*

28.7

5.6

29.5*

0.5

(0.1)

29.9*

11.1

7.2

48.1

30.3

12.0

0.5

9.1

51.9

100.0

5.8

5.5

11.3

6.7

8.5

0.3

6.7

22.2

33.5

66.5

28.6

6.1

31.8

1.4

0.5

33.7

12.3

7.8

51.6

26.7

10.8

0.3

10.6

48.4

100.0

5.4

5.5

10.9

7.5

7.7

0.2

6.0

21.4

32.3

67.7

28.8

6.5

32.4

2.1

0.0

34.5

13.3

18.8%*  

21.4%

21.1%*

29

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Comparison of Fiscal Years Ended  
March 31, 2009 and March 31, 2008
For  the  year  ended  March  31,  2009,  our  net  income  was 
$46.1 million or $1.65 per share on a basic and $1.62 per 
share  on  a  fully  diluted  basis.  In  comparison,  we  earned 
$40.1 million or $1.47 per share on a basic and $1.44 per 
share on a fully diluted basis in the year ended March 31, 
2008. The increase in net income for the year ended March 
31, 2009 was achieved primarily through the following:

•  A 31.6% increase in consolidated revenue, including $21.4 
million in RCM revenue from our recently acquired entities;

•	 A	34.7%	increase	in	NextGen	Division	revenue	which	ac-

counted for 93.5% of consolidated revenue; 

•	 A	 shift	 in	 revenue	 mix	 with	 increased	 maintenance,	 EDI	
and RCM revenue resulting in a decline in our gross profit 
margin; 

•	 An	increase	in	selling,	general	and	administrative	expens-
es as a percentage of revenue related to higher than usual 
legal expenses, primarily as a result of certain legal matters 
related  to  intellectual  property  infringement  claims  in  the 
NextGen Division and a proxy contest; and

•	 A	decrease	in	interest	income	primarily	due	a	greater	pro-
portion of funds invested in short-term U.S Treasuries and 
tax free money market accounts which returned significant-
ly lower interest rates as compared to the prior year. 

Revenue.  Revenue  for  the  year  ended  March  31,  2009  in-
creased 31.6% to $245.5 million from $186.5 million for the 
year ended March 31, 2008. NextGen Division revenue in-
creased 34.7% to $229.7 million from $170.5 million in the 
year  ended  March  31,  2008,  while  QSI  Division  revenue 
decreased by 1.2% during that same period, to $15.9 million 

from $16.0 million. NextGen revenue is inclusive of approxi-
mately $15.6 million in revenue from HSI and $8.6 million in 
revenue from PMP, our two recent RCM acquisitions.

We  divide  revenue  into  two  categories,  “system  sales” 
and “maintenance, EDI, RCM and other services.”  Revenue in 
the system sales category includes software license fees, third 
party hardware and software, and implementation and train-
ing services related to purchase of our software systems. The 
majority of the revenue in the system sales category is related 
to the sale of software. Revenue in the maintenance, EDI, RCM 
and other services category includes maintenance, EDI, RCM, 
follow-on  training  and  implementation  services,  annual  third 
party  license  fees,  hosting  and  other  revenue.  Maintenance 
revenue includes amounts initially deferred in conjunction with 
new customer arrangements and subsequently amortized and 
billings to existing customers. 

System Sales. Revenue earned from Company-wide sales of 
systems for the year ended March 31, 2009 increased 10.0% 
to $98.8 million from $89.8 million in the prior year. 

Our increase in revenue from sales of systems was prin-
cipally the result of a 9.9% increase in category revenue at 
our  NextGen  Division  whose  sales  in  this  category  grew 
from $87.1 million during the year ended March 31, 2008 to 
$95.7 million during the year ended March 31, 2009. This 
increase  was  driven  by  higher  sales  of  NextGen EHR  and 
NextGen EPM software to both new and existing clients, as 
well as increases in sales of hardware, third party software 
and supplies and implementation and training services. 

Systems sales revenue in the QSI Division increased to 
approximately  $3.0  million  in  the  year  ended  March  31, 
2009 from $2.6 million in the year ended March 31, 2008. 

The following table breaks down our reported system sales into software, hardware, third party software, supplies, and 

implementation and training services components by division:

Software

Hardware, Third Party 
Software and Supplies

Implementation 
and Training Services

Total System Sales

$ 

915 

  76,525 

$ 77,440 

$ 

360 

  69,276 

$ 69,636 

$ 1,171 

  6,775 

$ 7,946 

$ 1,134 

  5,593 

$ 6,727 

$ 

938 

  12,437 

$ 13,375 

$  1,154 

  12,252 

$ 13,406 

$  3,024 

  95,737 

$ 98,761 

$  2,648 

  87,121 

$ 89,769

Year ended March 31, 2009

QSI Division

NextGen Division

Consolidated

Year ended March 31, 2008

QSI Division

NextGen Division

Consolidated

30

 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NextGen  Division  software  license  revenue  increased 
10.5%  between  the  year  ended  March  31,  2008  and  the 
year ended March 31, 2009. The Division’s software revenue 
accounted for 79.9% of divisional system sales revenue during 
the year ended March 31, 2009, compared to 79.5% during 
the year ended March 31, 2008. Software license revenue 
growth continues to be an area of primary emphasis for the 
NextGen Division. 

During  the  year  ended  March  31,  2009,  7.1%  of 
NextGen’s  system  sales  revenue  was  represented  by  hard-
ware and third party software compared to 6.4% during the 
year ended March 31, 2008. The number of customers who 
purchase hardware and third party software and the dollar 
amount of hardware and third party software revenue fluctu-
ates each quarter depending on the needs of customers. The 
inclusion of hardware and third party software in the Division’s 
sales arrangements is typically at the request of the customer 
and is not a priority focus for us.

Implementation  and  training  revenue  related  to  system 
sales  at  the  NextGen  Division  increased  1.5%  in  the  year 
ended March 31, 2009 compared to the year ended March 
31, 2008. The amount of implementation and training services 
revenue  is  dependent  on  several  factors,  including  timing  of 
customer implementations, the availability of qualified staff, and 
the mix of services being rendered. The number of implementa-
tion and training staff increased during the year ended March 
31, 2009 versus 2008 in order to accommodate the increased 
amount of implementation services sold in conjunction with in-
creased software sales. In order to achieve growth in this area, 
additional staffing increases and additional training facilities are 
anticipated, though actual future increases in revenue and staff 
will depend upon the availability of qualified staff, business mix 
and conditions, and our ability to retain current staff members.

The NextGen Division’s growth has come in part from in-
vestments in sales and marketing activities including a revamped 
NextGen.com Web site, new NextGen logo, new marketing 
campaigns, trade show attendance, and other expanded adver-
tising and marketing expenditures. We have also benefited from 
winning  numerous  industry  awards  for  the  NextGen  Division’s 
flagship NextGen EHR and NextGen EPM software products 
and the apparent increasing acceptance of electronic medical 
records technology in the healthcare industry. 

For the QSI Division, total system sales increased 14.2% in 
the year ended March 31, 2009 compared to the year ended 
March 31, 2008. We do not presently foresee any material 
changes  in  the  business  environment  for  the  Division  with  re-
spect to the weak purchasing environment in the dental group 
practice market that has existed for the past several years.

Maintenance, EDI, Revenue Cycle Management and Other 
Services.  For  the  year  ended  March  31,  2009,  Company-
wide revenue from maintenance, EDI, RCM and other services 
grew 51.7% to $146.8 million from $96.7 million for the year 
ended  March  31,  2008.  The  increase  in  this  category  re-
sulted from an increase in maintenance, EDI, RCM and other 
services revenue from the NextGen Division. Total NextGen 
Division maintenance revenue for the year ended March 31, 
2009  grew  33.3%  to  $65.7  million  from  $49.3  million  in 
the prior year, while EDI revenue grew 38.4% to $24.8 mil-
lion compared to $17.9 million in the prior year. RCM grew 
to  $21.4  million  primarily  as  a  result  of  the  HSI  and  PMP  
acquisitions. Other services revenue for the NextGen Division, 
which consists primarily of third party annual software license 
renewals, consulting services and hosting services increased 
43.9% to $22.0 million from $15.3 million a year ago. QSI 
Division maintenance, EDI and other revenue decreased 4.2% 
to $12.8 million for the year ended March 31, 2009 com-
pared to $13.4 million in the prior year. 

The following table details maintenance, EDI, RCM, and other revenue by category for the years ended March 31, 2009 

and 2008:

Year ended March 31, 2009

QSI Division

NextGen Division

Consolidated

Year ended March 31, 2008

QSI Division

NextGen Division

Consolidated

Maintenance

Revenue Cycle 
Management

EDI

Other

Total

$  7,167 

$  4,766 

$ 

- 

$ 

894 

  $  12,827 

  65,695 

  24,756 

  21,431 

  22,045 

  133,927 

   $ 72,862 

$ 29,522 

$ 21,431 

$ 22,939 

  $ 146,754 

$  7,186 

$  4,564 

$ 

- 

$  1,639 

  $  13,389 

  49,269 

  17,886 

871 

  15,316 

  83,342 

$ 56,455 

$ 22,450 

$ 

871 

$ 16,955 

  $  96,731

31

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The  growth  in  maintenance  revenue  for  the  NextGen 
Division has come from new customers that have been added 
each quarter, existing customers who have purchased addi-
tional  licenses,  and  our  relative  success  in  retaining  existing 
maintenance customers. NextGen’s EDI revenue growth has 
come from new customers and from further penetration of the 

Division’s  existing  customer  base.  The  growth  in  RCM  is  a 
result of the HSI and PMP acquisitions and future growth is ex-
pected from cross selling opportunities between the customer 
bases. We intend to continue to promote maintenance, EDI 
and RCM services to both new and existing customers.

The following table provides the number of billing sites which were receiving maintenance services as of the last business 
day of the year ended March 31, 2009 and 2008 respectively, as well as the number of billing sites receiving EDI services 
during the last month of each respective period at each division of the Company. The table presents summary information only 
and includes billing entities added and removed for any reason. Note also that a single client may include one or multiple bill-
ing sites, and changes in billing protocols for certain clients can cause period to period changes in the number of billing sites. 
During the year ended March 31, 2009, a higher than usual fluctuation in the billing sites removed resulted primarily from a 
change in classification for billing sites.

March 31, 2008

Billing sites added

Billing sites removed

March 31, 2009

NextGen

QSI

Consolidated

Maintenance

EDI

Maintenance

EDI

Maintenance

EDI

   1,129

246

(15)

  993

  533

(258)

251

  165

  1,380

14

(14)

39

(44)

260

(29)

 1,158

  572

(302)

  1,360

 1,268

251

  160

  1,611

 1,428

Cost of Revenue. Cost of revenue for the year ended March 
31, 2009 increased 42.2% to $88.9 million from $62.5 mil-
lion  for  the  year  ended  March  31,  2008  and  the  cost  of 
revenue as a percentage of revenue increased to 36.2% from 

33.5% due to the fact that the rate of growth in cost of revenue 
grew  faster  than  the  aggregate  revenue  growth  rate  for  the 
Company.

The following table details revenue and cost of revenue on a consolidated and divisional basis for the years ended March 

31, 2009 and 2008:

Year Ended March 31,

2009

 %

2008

%

  $  15,852 

7,582 

  $  8,270 

  $ 229,663 

  81,308 

  $ 148,355 

  $ 245,515 

  88,890 

  $ 156,625 

100.0%

47.8%

52.2%

100.0%

35.4%

64.6%

100.0%

36.2%

63.8%

  $  16,037 

7,545 

  $  8,492 

  $ 170,463 

  54,956 

  $ 115,507 

  $ 186,500 

  62,501 

  $ 123,999

100.0%

47.0%

53.0%

100.0%

32.2%

67.8%

100.0%

33.5%

66.5%

QSI Division

Revenue

Cost of revenue

Gross profit

NextGen Division

Revenue

Cost of revenue

Gross profit

Consolidated

Revenue

Cost of revenue

Gross profit

32

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Gross profit margins at the NextGen Division for the 
year  ended  March  31,  2009  decreased  to  64.6%  from 
67.8% from the year ended March 31, 2008. Gross profit 

margins at the QSI Division for the year ended March 31, 
2009 decreased to 52.2% from 53.0% for the year ended 
March 31, 2008. 

The following table details the individual components of cost of revenue and gross profit as a percentage of total revenue 

on a consolidated and divisional basis for the years ended March 31, 2009 and 2008. 

Hardware, Third 
Party Software

Payroll and 
Related Benefits

EDI

Other

Total Cost 
of Revenue Gross Profit

Year ended March 31, 2009

QSI Division

NextGen Division

Consolidated

Year ended March 31, 2008

QSI Division

NextGen Division

Consolidated

7.6%

3.5%

3.7%

8.0%

3.8%

4.2%

19.8%

14.8%

15.1%

19.1%

11.2%

11.8%

17.1%

7.8%

8.4%

15.7%

7.5%

8.2%

3.3%

9.3%

9.0%

4.2%

9.7%

9.3%

47.8%

35.4%

36.2%

47.0%

32.2%

33.5%

52.2%

64.6%

63.8%

53.0%

67.8%

66.5%

of the PMP acquisition. In addition, related headcount, payroll 
and benefits expense associated with delivering products and 
services in the NextGen Division increased by $6.1 million in 
the year ended March 31, 2009 to $25.1 million from $19.0 
million in the year ended March 31, 2008. Payroll and ben-
efits expense associated with delivering products and services 
in the QSI Division remained consistent at $3.1 million in the 
year  ended  March  31,  2009  and  2008,  respectively.  The 
application of SFAS 123R added approximately $0.2 million 
and $0.5 million in compensation expense to cost of revenue 
in the years ended March 31, 2009 and 2008, respectively. 

As  a  result  of  the  foregoing  events  and  activities,  the 
gross profit percentage for the Company and both our divi-
sions decreased for the year ended March 31, 2009 versus 
the prior year.

We anticipate continued additions to headcount in the 
NextGen Division in areas related to delivering products and 
services  in  future  periods  but  due  to  the  uncertainties  in  the 
timing of our sales arrangements, our sales mix, the acquisi-
tion and training of qualified personnel, and other issues, we 
cannot accurately predict if related headcount expense as a 
percentage of revenue will increase or decrease in the future. 

We do not currently intend to make any significant addi-

tions to related headcount at the QSI Division.

The  increase  in  our  consolidated  cost  of  revenue  as  a 
percentage of revenue between the year ended March 31, 
2009 and the year ended March 31, 2008 is primarily at-
tributable to an increase in RCM revenue, which carries higher 
payroll and related benefits as a percentage of revenue and 
higher  EDI  costs  in  both  divisions,  offset  by  a  decrease  in 
hardware and third party software, and other expense as a 
percentage of revenue. Other expense, which consists of out-
side service costs, amortization of software development costs 
and  other  costs,  decreased  to  9.0%  of  total  revenue  during 
the year ended March 31, 2009 from 9.3% of total revenue 
during the year ended March 31, 2008. 

During the year ended March 31, 2009, hardware and 
third  party  software  constituted  a  smaller  portion  of  consoli-
dated cost of revenue compared to the prior year period in the 
NextGen  Division.  The  number  of  customers  who  purchase 
hardware and third party software and the dollar amount of 
hardware and third party software purchased fluctuates each 
quarter depending on the needs of the customers and is not a 
priority focus for us.

Our payroll and benefits expense associated with deliver-
ing our products and services increased to 15.1% of consolidat-
ed revenue in the year ended March 31, 2009 compared to 
11.8% during the year ended March 31, 2008 primarily due 
to the acquisition of HSI and PMP which as service businesses 
have an inherently higher percentage of payroll costs as a per-
centage of revenue. The absolute level of consolidated payroll 
and benefit expenses grew from $22.1 million in the year end-
ed March 31, 2008 to $37.1 million in the year ended March 
31, 2009, an increase of 67.9% or approximately $15.0 mil-
lion. Of the $15.0 million increase, approximately $4.8 million 
was a result of the HSI acquisition and $3.9 million was a result 

33

Selling, General and Administrative Expenses. Selling,  gen-
eral and administrative expenses for the year ended March 
31,  2009  increased  32.3%  to  $70.4  million  as  compared 
to  $53.3  million  for  the  year  ended  March  31,  2008.  The 
increase in these expenses resulted from a:

•	 $2.7	 million	 increase	 in	 legal	 expenses	 in	 the	 NextGen	

Division; 

•	 $1.7	 million	 increase	 in	 compensation	 expense	 in	 the	

NextGen Division; 

•	 $1.2	million	increase	in	outside	services	and	consulting	ser-

vices in the NextGen Division; 

•	 $0.9 million increase in advertising in the NextGen Division;

•	 $6.7	million	increase	in	other	selling,	general	and	adminis-

compensation  expense  to  research  and  development  costs 
net of amounts capitalized as software development in those 
fiscal years. Additions to capitalized software costs offset re-
search  and  development  costs.  For  the  year  ended  March 
31,  2009,  $5.9  million  was  added  to  capitalized  software 
costs while $6.0 million was capitalized during the year end-
ed March 31, 2008. Research and development costs as a 
percentage of revenue decreased to 5.6% in the year ended 
March  31,  2009  from  6.1%  in  the  year  ended  March  31, 
2008. Research and development expenses are expected to 
continue at or above current dollar levels.

Interest Income. Interest income for the year ended March 31, 
2009 decreased to $1.2 million compared to $2.7 million in 
the year ended March 31, 2008 primarily due to:

trative expenses in the NextGen Division; and 

•	 A	 lower	 amount	 of	 investments	 held	 in	 ARS	 when	 com-

•	 $3.9	million	increase	in	corporate	related	expenses.	

Approximately $1.5 million of the year over year increase 
in corporate related expense was related to expenses asso-
ciated with the proxy contest which occurred in conjunction 
with the 2008 Annual Shareholders’ Meeting. Amortization of 
identifiable intangibles related to the HSI and PMP acquisitions 
of  approximately  $1.0  million  and  an  increase  in  corporate 
salaries and related benefits of $0.7 million also contributed 
to the year over year corporate increase. 

The  application  of  SFAS  123R  added  approximately 
$1.5 million and $2.5 million in compensation expense to sell-
ing, general and administrative expenses for the year ended 
March 31, 2009 and 2008, respectively, and is included in 
the aforementioned amounts. Selling, general and administra-
tive expenses as a percentage of revenue increased slightly 
from 28.6% in the year ended March 31, 2008 to 28.7% in 
the year ended March 31, 2009.

We  anticipate  increased  expenditures  for  trade  shows, 
advertising and the employment of additional sales and ad-
ministrative staff at the NextGen Division. We also anticipate 
future  increases  in  corporate  expenditures  being  made  in  a 
wide  range  of  areas  including  professional  services.  While 
we expect selling, general and administrative expenses to in-
crease on an absolute basis, we cannot accurately predict the 
impact these additional expenditures will have on selling, gen-
eral, and administrative expenses as a percentage of revenue. 

Research and Development Costs. Research and development 
costs for the years ended March 31, 2009 and 2008 were 
$13.8 million and $11.4 million, respectively. The increases in 
research and development expenses were due in part to in-
creased investment in the NextGen product line. Additionally, 
the application of SFAS 123R in fiscal year 2009 and 2008 
added  approximately  $0.2  million  and  $0.8  million  in  the 
years  ended  March  31,  2009  and  2008,  respectively,  in 

pared to the prior year;

•	 Larger	amounts	invested	in	money	market	accounts	which	
earned significantly lower interest rates as compared to the 
prior year; and

•	 Overall	 comparatively	 lower	 amounts	 of	 funds	 available	
for  investment  during  the  year  due  to  payments  of  $8.2 
million and $17.0 million, respectively, for the Company’s 
acquisitions of HSI and PMP and increased quarterly divi-
dend payments. 

Our investment policy is determined by our Board. We 
currently  maintain  our  cash  in  very  liquid  short  term  assets 
including  tax  exempt  and  taxable  money  market  funds  and 
short-term U.S. Treasuries. We owned approximately $7.4 mil-
lion in ARS as of March 31, 2009, which are illiquid due to 
the auction failure in the ARS market. Our Board continues to 
review alternate uses for our cash including, but not limited to, 
payment of a special dividend, initiation of a stock buy back 
program,  an  expansion  of  our  investment  policy  to  include 
investments with longer maturities of greater than 90 days, or 
other items. Additionally, it is possible that we will utilize some 
or all of our cash to fund acquisitions or other similar business 
activities. Any or all of these programs could significantly im-
pact our investment income in future periods. 

Other Income (Expense). Other income (expense) for the year 
ended March 31, 2009 consists of gains and losses in fair 
value recorded on our ARS investments as well as on our ARS 
Put Option Rights. We recognized a pre-tax unrealized loss 
on our ARS of approximately $0.7 million. At the same time, 
we estimated the fair value of our ARS Put Option Rights at 
approximately $0.4 million. 

Included in other income for the year ended March 31, 
2008 was approximately $1.0 million, resulting from a gain 
on  life  insurance  proceeds  due  to  the  passing  of  Gregory 
Flynn, Executive Vice President and General Manager of the 

34

The  above  increases  to  net  income  were  offset  by  a 
decline  in  gross  profit  margin  resulting  from  a  greater  pro-
portion  of  revenue  being  derived  from  hardware  and  EDI  
revenue  which  have  relatively  lower  gross  margin  percent-
ages. The gross profit margin declined to 66.5% in the year 
ended March 31, 2008 versus 67.7% in the prior year period.

Revenue.  Revenue  for  the  year  ended  March  31,  2008  in-
creased 18.7% to $186.5 million from $157.2 million for the 
year ended March 31, 2007. NextGen Division revenue in-
creased 21.3% from $140.6 million to approximately $170.5 
million  in  the  period  ended  March  31,  2008,  while  QSI 
Division revenue decreased by 3.3% during that same period, 
from $16.6 million to $16.0 million.

We  divide  revenue  into  two  categories,  “system  sales” 
and “maintenance, EDI, RCM and other services”. Revenue in 
the system sales category includes software license fees, third 
party hardware and software, and implementation and train-
ing services related to purchase of our software systems. The 
majority of the revenue in the system sales category is related 
to the sale of software. Revenue in the maintenance, EDI, RCM 
and other services category includes maintenance, EDI, RCM, 
follow-on  training  and  implementation  services,  annual  third 
party  license  fees,  hosting  and  other  revenue.  Maintenance 
revenue includes amounts initially deferred in conjunction with 
new customer arrangements and subsequently amortized and 
billings to existing customers. 

System Sales. Revenue earned from Company-wide sales of 
systems for the year ended March 31, 2008 increased 10.8% 
to $89.8 million from $81.0 million in the prior year. 

Our increase in revenue from sales of systems was prin-
cipally  the  result  of  a  12.2%  increase  in  category  revenue 
at our NextGen Division whose sales in this category grew 
from $77.7 million during the year ended March 31, 2007 
to $87.1 million during the year ended March 31, 2008. This 
increase  was  driven  primarily  by  higher  sales  of  NextGen 
EHR and  NextGen  EPM  software  to  both  new  and  existing 
clients, as well as an increase in the delivery of related imple-
mentation services offset by a decline in the sale of related 
hardware, third party software and supplies. 

Systems  sales  revenue  in  the  QSI  Division  decreased 
to approximately $2.6 million in the year ended March 31, 
2008 from $3.4 million in the year ended March 31, 2007. 

QSI Division. Mr. Flynn participated in our deferred compen-
sation plan which is funded through the purchase of life insur-
ance policies with the Company named as beneficiary. There 
was no gain or loss recorded on investment securities during 
the year ended March 31, 2008. 

Provision for Income Taxes. The provision for income taxes for 
the year ended March 31, 2009 was approximately $27.2 
million  as  compared  to  approximately  $22.9  million  for  the 
prior year. The effective tax rates for fiscal 2009 and 2008 
were 37.1% and 36.4%, respectively. The provision for income 
taxes for the years ended March 31, 2009 and 2008 differs 
from the combined statutory rates primarily due to the impact 
of varying state income tax rates, research and development 
tax credits, the qualified production activities deduction, and 
exclusions  for  company-owned  life  insurance  proceeds  and 
tax-exempt  interest  income.  The  change  in  the  effective  rate 
for the year ended March 31, 2009 includes an increase in 
the benefit from research and development credits, which was 
mostly offset by a decrease in qualified production activities 
deduction and an increase in state income tax expense. 

During the year ended March 31, 2009 and 2008, we 
claimed research and development tax credits of approximate-
ly $1.0 million and $0.8 million, respectively. The Company 
also claimed the qualified production activities deduction un-
der Section 199 of the IRC of approximately $2.7 million and 
$3.1  million  during  the  years  ended  March  31,  2009  and 
2008,  respectively.  Research  and  development  credits  and 
the qualified production activities income deduction taken by 
us involve certain assumptions and judgments regarding quali-
fication of expenses under the relevant tax code provision.

Comparison of Fiscal Years Ended March 31, 
2008 and March 31, 2007
For  the  year  ended  March  31,  2008,  our  net  income  was 
$40.1  million  or  $1.47  per  share  on  a  basic  and  $1.44 
per share on a fully diluted basis. In comparison, we earned 
$33.2 million or $1.24 per share on a basic and $1.21 per 
share on a fully diluted basis in the year ended March 31, 
2007. The increase in net income for the year ended March 
31, 2008 was achieved primarily through the following:

•	 A	18.7%	increase	in	consolidated	revenue;	

•	 A	21.3%	increase	in	NextGen	Division	revenue	which	ac-

counted for 91.4% of consolidated revenue; and

•	 Approximately	$1.0	million	gain	on	life	insurance	proceeds	
the  Company  recorded,  which  was  offset  by  additional 
compensation  expense  of  approximately  $0.2  million. 
The  additional  compensation  expense  was  recorded  in 
Selling, General and Administrative Expenses and the in-
surance proceeds were recorded as Other Income in the 
Consolidated Statement of Income. 

35

The following table breaks down our reported system sales into software, hardware, third party software, supplies, and 

implementation and training services components by division: 

     Software  

Hardware, Third Party 
Software and Supplies

Implementation and 
Training Services

  Total System Sales

Year ended March 31, 2008

QSI Division

NextGen Division

Consolidated

Year ended March 31, 2007

QSI Division

NextGen Division

Consolidated

$ 

360 

  69,276 

$ 69,636 

$ 

355 

  62,957 

$ 63,312 

$  1,134 

5,593 

$  6,727 

$  2,356 

3,203 

$  5,559 

$  1,154 

  12,252 

$ 13,406 

$ 

655 

  11,522 

$ 12,177 

$  2,648 

  87,121 

$ 89,769 

$  3,366 

  77,682 

$ 81,048

NextGen Division software revenue increased 10.0% be-
tween the year ended March 31, 2007 and the year ended 
March 31, 2008. The Division’s software revenue accounted 
for 79.5% of Divisional system sales revenue during the year 
ended March 31, 2008, a decrease from 81.0% in the prior 
year period. 

During  the  year  ended  March  31,  2008,  6.4%  of  the 
NextGen Division’s system sales revenue was represented by 
hardware and third party software compared to 4.1% in the 
prior year. The number of customers who purchase hardware 
and third party software and the dollar amount of hardware 
and third party software revenue fluctuates each quarter and 
year depending on the needs of customers. The inclusion of 
hardware and third party software in the Division’s sales ar-
rangements is typically at the request of the customer and is 
not a priority focus for us.

Implementation  and  training  revenue  at  the  NextGen 
Division increased 6.3% in the year ended March 31, 2008 
compared to the year ended March 31, 2007. The growth in 
implementation and training revenue is the result of increases in 
the amount of implementation and training services rendered 
to our new customers. Implementation and training revenue at 
the NextGen Division decreased its share of divisional system 
sales revenue to 14.0% in the year ended March 31, 2008 
from 14.8% in the year ended March 31, 2007. The amount 
of implementation and training services revenue in any given 
quarter  is  dependent  on  several  factors,  including  timing  of 
customer  implementations,  the  availability  of  qualified  staff, 
and the mix of services being rendered. The number of imple-
mentation and training staff increased during the year ended 
March 31, 2008 versus 2007 in order to accommodate the 
increased amount of implementation services sold in conjunc-
tion with increased software sales. In order to achieve growth 
in this area, additional staffing increases and additional train-
ing facilities are anticipated, though actual future increases in 
revenue and staff will depend upon the availability of qualified 

staff, business mix and conditions, and our ability to retain cur-
rent staff members.

The  NextGen  Division’s  growth  has  come  in  part  from  
investments  in  sales  and  marketing  activities  including  hiring 
additional sales representatives, trade show attendance, and 
advertising expenditures. We have also benefited from win-
ning  numerous  industry  awards  for  the  NextGen  Division’s 
flagship NextGen EHR and NextGen EPM software products 
and the apparent increasing acceptance of electronic medical  
records technology in the healthcare industry. 

For  the  QSI  Division,  total  system  sales  decreased  by 
approximately  $0.7  million  in  the  year  ended  March  31, 
2008  compared  to  the  year  ended  March  31,  2007.  We 
do not presently foresee any material changes in the business  
environment for the QSI Division with respect to the constrained 
environment that has been in place for the past several years. 

Maintenance, EDI, Revenue Cycle Management and Other 
Services.  Company-wide  revenue  from  maintenance,  EDI, 
RCM and other services grew 27.1% to $96.7 million for the 
year ended March 31, 2008 from $76.1 million for the year 
ended March 31, 2007. The increase in this category resulted 
principally from an increase in maintenance and EDI and to 
a  lesser  extent  due  to  an  increase  in  RCM  and  other  ser-
vices  revenue  generated  from  the  NextGen  Division’s  client 
base.  Total  NextGen  Division  maintenance  revenue  for  the 
year ended March 31, 2008 grew 41.3% to $49.3 million 
from $34.9 million in the prior year, while EDI revenue grew 
42.9% to $17.9 million for the year ended March 31, 2008 
compared to $12.5 million in the prior year. Other services 
revenue,  excluding  RCM,  for  the  NextGen  Division,  which 
consists primarily of third party license renewals, time and ma-
terials billings, travel reimbursements, and other services grew 
3.5% to $16.1 million for the year ended March 31, 2008 
compared  to  $15.5  million  a  year  ago.  QSI  Division  main-
tenance revenue increased 1.5% to $7.2 million for the year 
ended March 31, 2007 compared to $7.1 million in the prior 

36

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
year while divisional EDI revenue increased by approximately 
1.0%  to  $4.6  million  for  the  year  ended  March  31,  2008 
compared to $4.5 million in the prior year. Other revenue for 

the QSI Division was essentially flat for the year ended March 
31, 2008 compared to a year ago.

The following table details maintenance, EDI, RCM and other revenue by category for the years ended March 31, 2008 

and 2007:

Year ended March 31, 2008

QSI Division

NextGen Division

Consolidated

Year ended March 31, 2007

QSI Division

NextGen Division

Consolidated

Maintenance

       EDI

Revenue Cycle   
Management

    Other

   Total

$  7,186 

  49,269 

$ 56,455 

$  4,564 

  17,886 

$ 22,450 

$  7,081 

  34,867 

$ 41,948 

$  4,529 

  12,520 

$ 17,049 

$ 

-    

  871 

$ 871 

$ 

- 

  534 

$ 534 

$  1,639 

  15,316 

$ 16,955 

$ 13,389 

  83,342 

$ 96,731 

$  1,615 

  14,971 

$ 16,586 

$ 13,225 

  62,892 

$ 76,117

The following table provides the number of billing sites which were receiving maintenance services as of the last business 
day of the year ended March 31, 2008 and 2007 respectively, as well as the number of billing sites receiving EDI services 
during the last month of each respective period at each division of our company. The table presents summary information only 
and includes billing entities added and removed for any reason. Note also that a single client may include one or multiple 
billing sites.

NextGen

QSI 

Consolidated

Maintenance

EDI

Maintenance

EDI

Maintenance

March 31, 2007

Billing sites added

Billing sites removed

March 31, 2008

982 

194 

(47)

1,129 

769 

289 

(65)

993 

257 

9 

(15)

251 

173 

29 

(37)

165 

1,239 

203 

(62)

EDI

942 

318 

(102)

1,380 

1,158

Cost of revenue. Cost of revenue for the year ended March 
31, 2008 increased 23.1% to $62.5 million from $50.8 mil-
lion for the year ended March 31, 2007, while the cost of rev-
enue as a percentage of net revenue increased to 33.5% from 
32.3%. Our consolidated gross profit is affected by the level 
of hardware content included in system sales, the percentage 
of EDI revenue in our overall sales mix, and certain headcount 

expenses directly related to the cost of delivering our products 
and services. Consolidated gross profit for fiscal year 2008 
was impacted by the decline in gross profit percentage at the 
NextGen  Division,  offset  by  a  slight  increase  in  gross  profit 
percentage at the QSI Division. 

37

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following table details revenue and cost of revenue on a consolidated and divisional basis for the years ended March 

31, 2008 and 2007:

QSI Division

Revenue

Cost of revenue

Gross profit

NextGen Division

Revenue

Cost of revenue

Gross profit

Consolidated

Revenue

Cost of revenue

Gross profit

2008

%

2007

%

Year Ended March 31,

  $  16,037 

7,545 

  $ 

8,492 

  $  170,463 

54,956 

  $  115,507 

  $  186,500 

62,501 

  $  123,999 

100.0%

47.0%

53.0%

100.0%

32.2%

67.8%

100.0%

33.5%

66.5%

  $  16,589 

7,847 

  $ 

8,742 

  $  140,576 

42,937 

  $  97,639 

  $  157,165 

50,784 

  $  106,381 

100.0%

47.3%

52.7%

100.0%

30.5%

69.5%

100.0%

32.3%

67.7%

    Gross profit margins at the NextGen Division for the year 
ended  March  31,  2008  decreased  to  67.8%  from  69.5% 
primarily due to an increase in the proportionate level of hard-
ware  and  third  party  software  content  included  in  revenue. 

The QSI Division’s gross profit margin increased to 53.0% from 
52.7% between the years ended March 31, 2008 and 2007 
primarily due to a decrease in the level of hardware and third 
party software content included in revenue. 

The following table details the individual components of cost of revenue and gross profit as a percentage of total revenue 

for our entire Company and our two divisions:

Hardware, Third 
Party Software 

Payroll and  
Related Benefits

EDI

Other

Total Cost  
of Revenue Gross Profit

Year ended March 31, 2008

QSI Division

NextGen Division

Consolidated

Year ended March 31, 2007

QSI Division

NextGen Division

Consolidated

8.0%

3.8%

4.2%

10.0%

3.1%

3.8%

19.1%

11.2%

11.8%

17.3%

11.9%

12.4%

15.7%

7.5%

8.2%

15.1%

6.4%

7.4%

4.2%

9.7%

9.3%

4.9%

9.1%

8.7%

47.0%

32.2%

33.5%

47.3%

30.5%

32.3%

53.0%

67.8%

66.5%

52.7%

69.5%

67.7%

During the year ended March 31, 2008, hardware and 
third party software constituted a larger portion of consolidat-
ed cost of revenue compared to the prior year period. The 
number of customers who purchase hardware and third party 
software and the dollar amount of hardware and third party 
software purchased fluctuates each quarter depending on the 
needs of the customers and is not a priority focus for us.

Our payroll and benefits expense associated with deliver-
ing our products and services decreased to 11.8% of consoli-
dated revenue for the year ended March 31, 2008 compared 
to 12.4% during the prior year ended March 31, 2007. The 

absolute  level  of  consolidated  payroll  and  benefit  expenses 
grew from $19.6 million in the year ended March 31, 2007 to 
$22.1 million in the year ended March 31, 2008, an increase 
of 13% or $2.5 million, primarily due to additions to related 
headcount, payroll and benefits expense associated with de-
livering products and services in the NextGen Division. Payroll 
and benefits expense associated with delivering products and 
services in the QSI Division increased on a percentage of rev-
enue basis. The application of SFAS 123R in fiscal year 2008 
and 2007 added approximately $0.5 million in compensation 
to consolidated cost of revenue in both fiscal years.

38

 
 
 
 
 
 
 
 
 
 
 
 
We anticipate continued additions to headcount in the 
NextGen Division in areas related to delivering products and 
services in future periods, but due to the uncertainties in the 
timing of our sales arrangements, our sales mix, the acquisi-
tion and training of qualified personnel, and other issues, we 
cannot accurately predict if related headcount expense as a 
percentage of revenue will increase or decrease in the future. 

We  do  not  currently  intend  to  make  any  significant 

changes to related headcount at the QSI Division.

“Other,” which consists of outside service costs, amortiza-
tion of software development costs, hosting service costs and 
other service costs, increased to 17.5% of revenue during the 
year  ended  March  31,  2008  from  16.1%  during  the  year 
ended March 31, 2007. 

Should the NextGen Division continue to represent a ma-
jor and or increasing share of our revenue, our consolidated 
gross margin percentages should move in concert with those 
of the NextGen Division. 

Selling, General and Administrative Expenses. Selling, gen-
eral and administrative expenses for the year ended March 
31,  2008  increased  17.5%  to  $53.3  million  as  compared 
to  $45.3  million  for  the  year  ended  March  31,  2007.  The 
increase  in  the  amount  of  such  expenses  resulted  primarily 
from increases of $3.6 million in salaries, commissions, and 
related benefits in the NextGen Division, $1.7 million in sell-
ing related expenses in the NextGen Division, $1.0 million in 
travel related costs in the NextGen Division, $0.8 million in 
other general expenses in the NextGen Division and $0.9 mil-
lion in increased corporate related expenses. The increase in 
corporate expenses was primarily composed of salaries and 
related benefits. Selling, general and administrative expenses 
as a percentage of revenue decreased from 28.9% in the year 
ended March 31, 2007 to 28.6% in the year ended March 
31,  2008  due  in  to  the  fact  that  revenue  grew  faster  than 
selling, general and administrative expense for the Company.

The application of SFAS 123R in fiscal year 2008 and 
2007  added  approximately  $2.5  million  in  compensation 
expense  to  consolidated  selling,  general  and  administrative 
expenses and is included in the aforementioned amounts. 

We  anticipate  increased  expenditures  for  trade  shows, 
advertising and the employment of additional sales and admin-
istrative staff at the NextGen Division. We also anticipate future 
increases in corporate expenditures being made in areas includ-
ing but not limited to staffing and professional services. While 
we expect selling, general and administrative expenses to in-
crease on an absolute basis, we cannot accurately predict the 
impact these additional expenditures will have on selling, gen-
eral, and administrative expenses as a percentage of revenue. 

Research and Development Costs. Research and development 
costs for the years ended March 31, 2008 and 2007 were 
$11.4  million  and  $10.2  million,  respectively.  The  increase 
in research and development costs was primarily due to in-
creased investment in the NextGen product line. Additionally, 
the application of SFAS 123R in fiscal year 2008 and 2007 
added  approximately  $0.8  million  in  both  periods,  in  com-
pensation expense to research and development costs net of 
amounts capitalized as software development in those fiscal 
years. Additions to capitalized software costs offset research 
and development costs. For the year ended March 31, 2008, 
$6.0 million was added to capitalized software costs while 
$5.0  million  was  capitalized  during  the  year  ended  March 
31, 2007. Research and development costs as a percentage 
of net revenue decreased to 6.1% in the year ended March 
31,  2008  from  6.5%  in  the  year  ended  March  31,  2007 
primarily  due  to  revenue  growing  at  a  faster  rate  than  the 
increase  in  research  and  development  costs.  Research  and 
development  costs  are  expected  to  continue  at  or  above  
current levels.

Interest  Income.  Interest  income  for  the  year  ended  March 
31, 2008 decreased to $2.7 million compared to $3.3 mil-
lion  in  the  year  ended  March  31,  2007.  Interest  income  in 
the year ended March 31, 2008 decreased primarily due to 
(i) a greater proportion of funds invested in tax favored ARS 
which offer lower interest rates but higher after-tax yields com-
pared to money market or short term U.S. Treasuries, and (ii) 
comparatively lower short term interest rates in the year ended 
March 31, 2008 versus 2007. 

Our investment policy is determined by our Board. We 
currently maintain our cash in very liquid short term assets in-
cluding money market funds, 30-60 day treasury bills as well 
as ARS. 

Other Income. Other income for the year ended March 31, 
2008  was  approximately  $1.0  million.  There  was  no  other 
income recorded for the year ended March 31, 2007. We 
recorded  a  gain  on  life  insurance  proceeds  as  a  result  of 
the  passing  of  Gregory  Flynn,  Executive  Vice  President  and 
General Manager of the QSI Division. Mr. Flynn participated 
in our deferred compensation plan which is funded through 
the  purchase  of  life  insurance  policies  with  the  Company 
named as beneficiary. 

Provision  for  Income  Taxes.  The  provision  for  income  taxes 
for  the  year  ended  March  31,  2008  was  approximately 
$22.9  million  as  compared  to  approximately  $21.0  million 
for the prior year. The effective tax rates for fiscal 2008 and 
2007  were  36.4%  and  38.7%,  respectively.  The  provision 
for income taxes for the years ended March 31, 2008 and 
2007 differs from the combined statutory rates primarily due 
to the impact of varying state income tax rates, research and 

39

development  tax  credits,  the  qualified  production  activities 
deduction, and exclusions for company-owned life insurance 
proceeds and tax-exempt interest income. The effective rate for 
the year ended March 31, 2008 also includes an increase 
in  benefit  from  the  qualified  production  activities  deduction, 
which  was  mostly  offset  by  non-deductible  option  expense 
related to incentive stock options. 

During the year ended March 31, 2008 and 2007, we 
claimed research and development tax credits of approximately 

$0.8 million in both years. We also claimed the qualified pro-
duction activities deduction under Section 199 of the IRC, of 
approximately $3.1 million and $1.5 million during the years 
ended  March  31,  2008  and  2007,  respectively.  Research 
and development credits and the qualified production activi-
ties income deduction taken by us involve certain assumptions 
and judgments regarding qualification of expenses under the 
relevant tax code provision.

Liquidity and Capital Resources
The following table presents selected financial statistics and information for each of the years ended March 31, 2009, 2008 
and 2007:

Cash and cash equivalents

Net increase (decrease) in cash and cash equivalents

Net income

Net cash provided by operations during the year

Number of days of sales outstanding

   Year Ended March 31,

2009

$  70,180 

$  11,134 

$  46,119 

$  48,712 

125 

2008

$  59,046 

$ 

(982)

$  40,078 

$  43,599 

136 

2007

$  60,028 

$  2,803 

$  33,232 

$  29,570 

129

Cash Flow from Operating Activities
Cash provided by operations has historically been our primary source of cash and has primarily been driven by our net income 
and secondarily by non-cash expenses including depreciation, amortization of capitalized software and other intangible assets, 
provisions for bad debts and inventory obsolescence, and stock option expenses.

The following table summarizes our statement of cash flows for the years ended March 31, 2009, 2008 and 2007:

Net income

Non-cash expenses

Gain on life insurance proceeds, net

Tax benefit from exercise of stock options, net

Change in deferred revenue

Change in accounts receivable

Change in other assets and liabilities

   Year Ended March 31,

2009

$  46,119 

  17,719 

-    

1 

3,130 

(11,369)

(6,888)

2008

$  40,078 

  11,299 

(755)

65 

5,447 

(13,811)

1,276 

2007

$  33,232 

8,977 

- 

167 

3,532 

(20,760)

4,422 

Net cash provided by operating activities

$  48,712 

$  43,599 

$  29,570

Net  Income.  As  referenced  in  the  above  table,  net  income 
makes up the majority of our cash generated from operations 
for the years ended March 31, 2009, 2008 and 2007. Our 
NextGen Division’s contribution to net income has increased 
each year due to that division’s operating income increasing 
more quickly than our Company as a whole.

Non-Cash  Expenses.  Non-cash  expenses  include  depre-
ciation, amortization of intangibles and capitalized software 
costs, provisions for bad debts, inventory obsolescence, stock  

option expenses, and deferred taxes. Total non-cash expenses 
were $17.7 million, $11.3 million and $9.0 million for the years 
ended March 31, 2009, 2008 and 2007, respectively. The 
change for the year ended March 31, 2009 as compared 
to the prior year is primarily related to approximately $1.0 mil-
lion of amortization of capitalized software costs, $1.0 million 
of amortization of other intangibles due to the HSI and PMP 
acquisitions, $1.0 million in the allowance for bad debt and 
$4.7 million in deferred taxes, offset by a decrease of $1.8 
million in share-based compensation. 

40

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Tax Benefits From Stock Options. Although the value of stock 
options  exercised  by  employees  grew  in  the  years  ended 
March 31, 2009, March 31, 2008 and 2007, our applica-
tion of SFAS 123R required excess tax benefits of $3.4 million, 
$1.3  million  and  $2.5  million,  respectively,  to  be  reclassed 
to financing activities, resulting in a net decrease in the years 
ended March 31, 2009, 2008 and 2007.

Deferred  Revenue.  Cash  from  operations  benefited  signifi-
cantly from increases in deferred revenue primarily due to an 
increase  in  the  volume  of  implementation  and  maintenance 
services invoiced by the NextGen Division which had not yet 
been rendered or recognized as revenue. This benefit is offset 
by the increase in unpaid deferred revenue. Deferred revenue 
grew by approximately $3.1 million for the year ended March 
31, 2009 versus growth of $5.4 million and $3.5 million for 
the years ended March 31, 2008 and 2007, resulting in in-
creases to cash provided by operating activities for the respec-
tive periods. 

Accounts Receivable. Accounts receivable grew by approxi-
mately $11.4 million, $13.8 million and $20.8 million for the 
years ended March 31, 2009, 2008 and 2007, respectively. 
The increase in accounts receivable in the periods is due to 
the following factors:

•	 NextGen	 Division	 revenue	 grew	 34.7%,	 21.3%	 and	
35.5% for the years ended March 31, 2009, 2008 and 
2007, respectively;  

•	 The	NextGen	Division	constituted	a	larger	percentage	of	
our receivables at March 31, 2009 compared to March 
31, 2008. Turnover of accounts receivable in the NextGen 
Division, not including HSI and PMP, slowed partly due to 
payment terms offered by the Division;  

•	 Turnover	 of	 accounts	 receivable	 is	 also	 slower	 than	 the	
QSI Division due to the fact that the majority of the QSI 
Division’s  revenue  is  derived  from  maintenance  and  EDI 
services which typically have shorter payment terms than 
systems sales related revenue which historically have ac-
counted for a major portion of NextGen Division sales; 

•	 The	HSI	and	PMP	acquisitions	added	approximately	$4.5	
million of accounts receivable as of March 31, 2009; and

•	 We experienced an increase in the volume of undelivered 
services billed in advance by the NextGen Division which 
were unpaid as of the end of each period and included in 
accounts receivable. This resulted in an increase in both de-
ferred revenue and accounts receivable of approximately 
$1.2  million,  $4.9  million  and  $6.4  million  for  the  years 
ended March 31, 2009, 2008 and 2007, respectively.

The turnover of accounts receivable measured in terms of 
days sales outstanding (DSO) fluctuated during the year and 
decreased to 125 days from 136 days during the year ended 

March 31, 2009 compared to the prior year, primarily due 
to an increase in RCM revenue, which has a faster turnover of 
accounts receivable compared to system sales, and the above 
mentioned factors.

If amounts included in both accounts receivable and de-
ferred revenue were netted, our turnover of accounts receiv-
able expressed as DSO would be 83 days as of March 31, 
2009 and 85 days as of March 31, 2008. Provided turnover 
of accounts receivable, deferred revenue, and profitability re-
main  consistent  with  the  year  ended  March  31,  2009,  we 
anticipate being able to continue to generate cash from op-
erations during fiscal 2010 primarily from our net income. 

Cash flows from investing activities
Net cash used in investing activities for the years ended March 
31, 2009, 2008 and 2007 was $19.4 million, $30.2 mil-
lion and $8.3 million, respectively. The decrease in cash used 
in investing activities for the year ended March 31, 2009 is 
mainly due to the fact that we did not make any additional in-
vestments in marketable securities in fiscal year 2009, but rath-
er  sold  marketable  securities  for  proceeds  of  approximately 
$14.8 million. Whereas for the year ended March 31, 2008,  
we had, net of proceeds received, investments in marketable 
securities of $22.8 million. Other net cash outflows during the 
year ended March 31, 2009 include our acquisitions of HSI 
and  PMP  of  approximately  $8.2  million  and  $17.0  million, 
respectively, as well as additions to equipment and improve-
ments and capitalized software costs.

Cash flows from financing activities
Net cash used in financing activities for the year ended March 
31,  2009  was  $18.1  million  and  consisted  of  a  dividend 
paid to shareholders of approximately $30.8 million offset by 
$12.5 million of proceeds from the exercise of stock options. 
We recorded a reduction in income tax liability of $3.4 mil-
lion related to excess tax deductions received from employee 
stock option exercises. The benefit was recorded as additional 
paid in capital. 

Cash and cash equivalents and  
marketable securities
At March 31, 2009, we had cash and cash equivalents of 
$70.2 million and marketable securities of $7.4 million. We 
intend to expend some of these funds for the development of 
products complementary to our existing product line as well as 
new versions of certain of our products. These developments 
are intended to take advantage of more powerful technolo-
gies and to increase the integration of our products. We have 
no additional significant current capital commitments. 

In January 2007, our Board adopted a policy whereby 
we intend to pay a regular quarterly dividend of $0.25 per 
share  on  our  outstanding  common  stock  commencing  with 

41

conclusion of our first fiscal quarter of 2008 (June 30, 2007) 
and continuing each fiscal quarter thereafter, subject to further 
Board review and approval and establishment of record and 
distribution dates by our Board prior to the declaration of each 
such quarterly dividend. In August 2008, our Board increased 
the quarterly dividend to $0.30 per share. We anticipate that 
future quarterly dividends, if and when declared by our Board 
pursuant  to  this  policy,  would  likely  be  distributable  on  or 
about the fifth day of each of the months of October, January, 
April and July.

On  May  27,  2009,  our  Board  approved  a  quarterly 
cash dividend of $0.30 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
June 12, 2009 with an expected distribution date on or about 
July 6, 2009.

On January 28, 2009, our Board approved a quarterly 
cash dividend of $0.30 per share on our outstanding shares of 
common stock, payable to shareholders of record as of March 
11, 2009 with a distribution date on or about April 3, 2009.

On October 30, 2008, our Board approved a quarterly 
cash dividend of $0.30 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
December  15,  2008  with  a  distribution  date  on  or  about 
January 5, 2009. 

On  October  28,  2008,  we  acquired  PMP.  The  pur-
chase price consisted of approximately $19.7 million, plus up 
to  $3.0  million  in  incentives  tied  to  future  performance.  The 
$19.7 million consisted of approximately $17.0 million in cash 
and $2.75 million in shares of our common stock. 

On  August  4,  2008,  our  Board  approved  a  quarterly 
cash dividend of $0.30 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
September  15,  2008  with  a  distribution  date  on  or  about 
October 1, 2008.

On  May  29,  2008,  our  Board  approved  a  quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
June  15,  2008  with  a  distribution  date  on  or  about  July  2, 
2008. 

On  May  20,  2008,  we  acquired  HSI.  The  purchase 
price  consisted  of  approximately  $15.6  million,  plus  up  to 
approximately $1.7 million in incentives tied to future perfor-
mance.  The  $15.6  million  consisted  of  cash  and  shares  of 
common stock.

On January 30, 2008, our Board approved a quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
March 14, 2008 and was distributed to shareholders on or 
about April 7, 2008. 

42

On October 25, 2007, our Board approved a quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
December 14, 2007 and was distributed to shareholders on 
or about January 7, 2008. 

On  July  31,  2007,  our  Board  approved  a  quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
September 14, 2007 and was distributed to shareholders on 
or about October 5, 2007.

On  May  31,  2007,  our  Board  declared  a  quarterly 
cash dividend of $0.25 per share on our outstanding shares 
of  common  stock,  payable  to  shareholders  of  record  as  of 
June  15,  2007  and  was  distributed  to  shareholders  on  July 
5, 2007.

In February 2007, we paid a $1.00 per share cash divi-
dend on shares of our common stock. The record date for the 
dividend was February 13, 2007.

Management believes that its cash and cash equivalents 
on  hand  at  March  31,  2009,  together  with  its  marketable 
securities and cash flows from operations, if any, will be suf-
ficient  to  meet  its  working  capital  and  capital  expenditure 
requirements  as  well  as  any  dividends  paid  in  the  ordinary 
course of business for the balance of fiscal 2010.

Contractual Obligations. The following table summarizes our 
significant  contractual  obligations  at  March  31,  2009,  and 
the effect that such obligations are expected to have on our 
liquidity and cash in future periods: 

Non-cancelable lease obligations 

Year Ending March 31,  

2010

2011

2012

2013

2014

$  4,475

  4,311

  2,439

985

135

$ 12,345

Recent Accounting Pronouncements 
On  April  9,  2009,  the  FASB  issued  three  FSPs  intended  to 
provide additional application guidance and enhanced dis-
closures  regarding  fair  value  measurements  and  other-than-
temporary impairments of securities.

FSP  FAS  157-4,  “Determining  Fair  Value  When  the 
Volume  and  Level  of  Activity  for  the  Asset  or  Liability  Have 
Significantly  Decreased  and  Identifying  Transactions  That 
Are  Not  Orderly,”  provides  guidelines  for  making  fair  value 
measurements  more  consistent  with  the  principles  presented 
in FASB Statement No. 157, “Fair Value Measurements.” FSP 

 
 
 
 
 
 
 
 
FAS  157-4  must  be  applied  prospectively  and  retrospective 
application  is  not  permitted.  FSP  FAS  157-4  is  effective  for 
interim and annual periods ending after June 15, 2009, with 
early adoption permitted for periods ending after March 15, 
2009. An entity early adopting FSP FAS 157-4 must also early 
adopt FSP FAS 115-2 and FAS 124-2.

FSP  FAS  115-2  and  FAS  124-2.  “Recognition  and 
Presentation  of  Other-Than-Temporary  Impairments,”  provides 
additional  guidance  designed  to  create  greater  clarity  and 
consistency  in  accounting  for  and  presenting  impairment 
losses  on  debt  securities.  FSP  FAS  115-2  and  FAS  124-2  is 
effective for interim and annual periods ending after June 15, 
2009, with early adoption permitted for periods ending after 
March 15, 2009. An entity may early adopt this FSP only if it 
also elects to early adopt FSP FAS 157-4.

FSP FAS 107-1 and APB 28-1, “Interim Disclosures about 
Fair  Value  of  Financial  Instruments,”  enhances  consistency  in 
financial  reporting  by  increasing  the  frequency  of  fair  value 
disclosures.  FSP  107-1  and  APB  28-1  is  effective  for  interim 
periods ending after June 15, 2009, with early adoption per-
mitted for periods ending after March 15, 2009. However, 
an entity may early adopt these interim fair value disclosure 
requirements only if it also elects to early adopt FSP FAS 157-4 
and FSP FAS 115-2 and FAS 124-2.

We are currently evaluating the impact, if any, that the 
adoption of these FSPs will have on our consolidated financial 
statements.

On April 1, 2009, the FASB issued FASB Staff Position 
(FSP)  FAS  141(R)-1,  “Accounting  for  Assets  Acquired  and 
Liabilities  Assumed  in  a  Business  Combination  That  Arise 
from Contingencies.”  The FSP amends the guidance in FASB 
Statement No. 141 (Revised 2007), “Business Combinations,” 
to: (i) require that assets acquired and liabilities assumed in a 
business combination that arise from contingencies be recog-
nized at fair value if fair value can be reasonably estimated. 
If fair value of such an asset or liability cannot be reasonably 
estimated, the asset or liability would generally be recognized 
in accordance with FASB Statement No. 5, “Accounting for 
Contingencies,” and FASB Interpretation No. 14, “Reasonable 
Estimation of the Amount of a Loss;” (ii) eliminate the require-
ment to disclose an estimate of the range of outcomes of rec-
ognized  contingencies  at  the  acquisition  date.  For  unrecog-
nized contingencies, the FASB decided to require that entities 
include only the disclosures required by Statement No. 5 and 
that those disclosures be included in the business combination 
footnote; and (iii) require that contingent consideration arrange-
ments of an acquiree assumed by the acquirer in a business 
combination be treated as contingent consideration of the ac-
quirer and should be initially and subsequently measured at 
fair value in accordance with Statement No. 141R. This FSP 
is effective for assets or liabilities arising from contingencies in 

business combinations for which the acquisition date is on or 
after the beginning of the first annual reporting period begin-
ning on or after December 15, 2008.

 In November 2008, the FASB ratified Emerging Issues 
Task Force (EITF) Issue No. 08-6, “Equity Method Investment 
Accounting Considerations” or EITF 08-6. EITF 08-6 clarifies 
the  accounting  for  certain  transactions  and  impairment  con-
siderations involving equity method investments. EITF 08-6 is 
effective for fiscal years beginning after December 15, 2008, 
with early adoption prohibited. We do not currently have any 
investments  that  are  accounted  for  under  the  equity  method 
and therefore EITF 08-6 will not have a significant impact on 
our consolidated financial statements.

In November 2008, the FASB ratified EITF Issue No. 08-
7, “Accounting for Defensive Intangible Assets” or EITF 08-7. 
EITF 08-7 clarifies the accounting for certain separately iden-
tifiable  intangible  assets  which  an  acquirer  does  not  intend 
to actively use but intends to hold to prevent its competitors 
from obtaining access to them. EITF 08-7 requires an acquirer 
in  a  business  combination  to  account  for  a  defensive  intan-
gible asset as a separate unit of accounting which should be 
amortized to expense over the period the asset diminishes in 
value.  EITF  08-7  is  effective  for  fiscal  years  beginning  after 
December 15, 2008, with early adoption prohibited. We are 
currently in the process of evaluating the impact the new EITF 
will have on our consolidated financial statements.

In October 2008, the FASB issued FSP SFAS No. 157-3, 
“Determining  the  Fair  Value  of  a  Financial  Asset  When  The 
Market for That Asset Is Not Active,” or FSP 157-3, to clarify 
the application of the provisions of SFAS 157 in an inactive 
market and how an entity would determine fair value in an 
inactive market. FSP 157-3 was effective upon issuance. We 
have considered the FSP in our determination of estimated fair 
values of our ARS for fiscal year 2009. 

In  June  2008,  the  FASB  issued  FSP  No.  EITF  03-6-1, 
“Determining  Whether  Instruments  Granted  in  Share-Based 
Payment  Transactions  Are  Participating  Securities.”  FSP  No. 
EITF  03-6-1  concluded  that  unvested  share-based  payment 
awards that contain nonforfeitable rights to dividends or divi-
dend equivalents (whether paid or unpaid) are participating 
securities and shall be included in the computation of basic 
earnings per share (“EPS”) pursuant to the two-class method. 
This FSP becomes effective on April 1, 2009. Early adoption 
of the FSP is not permitted; however, it will apply retrospec-
tively  to  EPS  data  for  all  periods  presented  in  the  financial 
statements or in financial data. We do not currently anticipate 
that this FSP will have a material impact on our EPS data in 
fiscal year 2010 or on EPS for any prior periods presented in 
the financial data upon adoption.

43

In May 2008, the FASB issued SFAS 162 “The Hierarchy 
of Generally Accepted Accounting Principles.”  SFAS 162 de-
fines  the  order  in  which  accounting  principles  that  are  gen-
erally  accepted  should  be  followed.  SFAS  162  is  effective 
60  days  following  the  Commission’s  approval  of  the  Public 
Company  Accounting  Oversight  Board  (“PCAOB”)  amend-
ments to AU Section 411 “The Meaning of Present Fairly in 
Conformity  with  Generally  Accepted  Accounting  Principles.” 
We do not expect the adoption of SFAS 162 to have a mate-
rial impact on our consolidated financial statements.

In April 2008, the FASB finalized Staff Position (FSP) No. 
142-3,  “Determination  of  the  Useful  Life  of  Intangible  Assets.” 
The position amends the factors that should be considered in 
developing renewal or extension assumptions used to determine 
the useful life of a recognized intangible asset under FASB SFAS 
No. 142, “Goodwill and Other Intangible Assets.” The position 
applies to intangible assets that are acquired individually or with 
a group of other assets and both intangible assets acquired in 
business combinations and asset acquisitions. FSP 142-3 is ef-
fective  for  fiscal  years  beginning  after  December  15,  2008, 
and interim periods within those fiscal years. Management is 
currently evaluating the impact of the pending adoption of FSP 
142-3 on the consolidated financial statements.

In December 2007, the FASB issued SFAS 141 (Revised 
2007)  “Business  Combinations.”    SFAS  141(R)  retains  the 
fundamental  requirements  of  the  original  pronouncement  
requiring that the purchase method be used for all business 
combinations. SFAS 141(R) defines the acquirer as the entity 
that  obtains  control  of  one  or  more  businesses  in  the  busi-
ness combination, establishes the acquisition date as the date 
that  the  acquirer  achieves  control  and  requires  the  acquirer 
to recognize the assets acquired, liabilities assumed and any 
noncontrolling interest at their fair values as of the acquisition 
date.  In  addition,  SFAS  141(R)  requires  expensing  of  acqui-
sition-related  and  restructure-related  costs,  remeasurement  of 
earn out provisions at fair value, measurement of equity securi-
ties issued for purchase at the date of close of the transaction 
and non-expensing of in-process research and development 
related intangibles. SFAS 141(R) applies prospectively to busi-
ness combinations for which the acquisition date is on or after 
the beginning of the first annual reporting period beginning 
on or after December 15, 2008. An entity may not apply it 
before that date. This pronouncement will be applied by us 
when it becomes effective and when or if the we effectuate 
a business combination post adoption, otherwise there is no 
impact on our consolidated financial statements. 

ITEM 7A. Quantitative and  
Qualitative Disclosures about  
Market Risks
We maintain investments in tax exempt municipal ARS which 
are classified as current and non-current marketable securities 
on the Company’s Consolidated Balance Sheets. A small por-
tion of our portfolio is invested in closed-end funds which invest 
in tax exempt municipal ARS. At March 31, 2009, we had ap-
proximately $7.4 million of ARS on our Consolidated Balance 
Sheets.  The  ARS  are  rated  by  one  or  more  national  rating 
agencies and have contractual terms of up to thirty years, but 
generally have interest rate reset dates that occur every 7, 28 
or 35 days. 

Despite  the  underlying  long-term  maturity  of  ARS,  such 
securities were priced and subsequently traded as short-term 
investments because of the interest rate reset feature. If there 
are  insufficient  buyers,  the  auction  is  said  to  “fail”  and  the 
holders  are  unable  to  liquidate  the  investments  through  auc-
tion. A failed auction does not result in a default of the debt 
instrument. The securities will continue to accrue interest and 
be auctioned until the auction succeeds, the issuer calls the 
securities,  or  the  securities  mature.  In  February  2008,  we 
began  to  experience  failed  auctions  on  our  ARS  and  auc-
tion rate preferred securities. To determine their estimated fair 
values  at  March  31,  2009,  factors  including  credit  quality, 
the likelihood of redemption, and yields or spreads of fixed 
rate  municipal  bonds  or  other  trading  instruments  issued  by 
the same or comparable issuers were considered. Based on 
our ability to access our cash and other short-term investments, 
our expected operating cash flows, and our other sources of 
cash, we do not anticipate the current lack of liquidity on these 
investments to have a material impact on our financial condi-
tion or results of operation.

ITEM 8. Financial Statements  
and Supplementary Data
Our Consolidated Financial Statements identified in the Index 
to  Financial  Statements  appearing  under  “Item  15.  Exhibits 
and Financial Statement Schedules” of this Report are incorpo-
rated herein by reference to Item 15.

ITEM 9. Changes in and Disagreements 
with Accountants on Accounting and 
Financial Disclosure
None.

44

ITEM 9A. Controls and Procedures 

Our internal control over financial reporting is supported 

Evaluation of Disclosure Controls and  
Procedures
Our Chief Executive Officer and Chief Financial Officer (our 
principal  executive  officer  and  principal  financial  officer,  re-
spectively) have concluded, based on their evaluation as of 
March 31, 2009, that the design and operation of our “dis-
closure controls and procedures” (as defined in Rule 13a-15(e) 
under the Exchange Act) are effective to provide reasonable 
assurance that information required to be disclosed by us in 
the reports filed or submitted by us under the Exchange Act 
is recorded, processed, summarized and reported, within the 
time  periods  specified  in  the  Commission’s  rules  and  forms, 
including to ensure that information required to be disclosed 
by us in the reports we file or submit under the Exchange Act is 
accumulated and communicated to our management, includ-
ing our Chief Executive Officer and Chief Financial Officer, as 
appropriate to allow timely decisions regarding whether or not 
disclosure is required. 

Changes in Internal Control over  
Financial Reporting
During  the  quarter  ended  March  31,  2009,  there  were  no 
changes in our “internal control over financial reporting” (as 
defined in Rule 13a-15(f) under the Exchange Act) that have 
materially  affected,  or  are  reasonably  likely  to  materially  
affect, our internal control over financial reporting. 

Management’s Report on Internal  
Control over Financial Reporting
Our  management  is  responsible  for  establishing  and  main-
taining  adequate  internal  control  over  financial  reporting  as 
defined in Rule 13a-15(f) under the Exchange Act. Under the 
supervision  and  with  the  participation  of  our  management, 
including our principal executive officer and principal financial 
officer, we conducted an evaluation of the effectiveness of our 
internal control over financial reporting based on the frame-
work set forth in Internal Control — Integrated Framework is-
sued by the Committee of Sponsoring Organizations of the 
Treadway  Commission.  Based  on  this  evaluation,  our  man-
agement concluded that our internal control over financial re-
porting was effective as of March 31, 2009. 

by written policies and procedures, that:

(1)  pertain to the maintenance of records that, in reasonable 
detail, accurately and fairly reflect the transactions and dis-
positions of our assets; 

(2)  provide reasonable assurance that transactions are record-
ed as necessary to permit preparation of financial state-
ments in accordance with generally accepted accounting 
principles, and that receipts and expenditures of our com-
pany are being made only in accordance with authoriza-
tions of our management and directors; and 

(3)  provide  reasonable  assurance  regarding  prevention  or 
timely detection of unauthorized acquisition, use or disposi-
tion of our assets that could have a material effect on our 
financial statements. 

Because  of  inherent  limitations  in  all  control  systems, 
no matter how well designed, no evaluation of controls can 
provide  absolute  assurance  that  all  control  issues  within  the 
Company  have  been  or  will  be  detected.  Also,  projections 
of any evaluation of effectiveness to future periods are subject 
to the risks that controls may become inadequate because of 
changes in conditions, or that the degree of compliance with 
the policies or procedures may deteriorate. 

Our  independent  registered  public  accounting  firm  has 
audited the effectiveness of our internal control over financial 
reporting as of March 31, 2009 as stated in their report that 
is included herein. 

ITEM 9B. Other Information 
We have experienced legal claims by parties asserting that 
we have infringed their intellectual property rights. We believe 
that these claims are without merit and intend to defend them 
vigorously; however, we could incur substantial costs and di-
version of management resources defending any infringement 
claim – even if we are ultimately successful in the defense of 
such matter. Litigation is inherently uncertain and always dif-
ficult to predict. We refer you to the discussion of infringement 
and litigation risks in our Risk Factors section of this Report.

45

Part III

ITEM 10. Directors, Executive Officers 
and Corporate Governance 
The  information  required  by  Item  10  is  incorporated  herein 
by reference from our definitive proxy statement for our 2009 
Annual Shareholders’ Meeting to be filed with the Commission.

ITEM 13. Certain Relationships  
and Related Transactions, and  
Director Independence
The  information  required  by  Item  13  is  incorporated  herein 
by reference from our definitive proxy statement for our 2009 
Annual Shareholders’ Meeting to be filed with the Commission.

ITEM 11. Executive Compensation 
The  information  required  by  Item  11  is  incorporated  herein 
by reference from our definitive proxy statement for our 2009 
Annual Shareholders’ Meeting to be filed with the Commission.

ITEM 12. Security Ownership of Certain 
Beneficial Owners and Management 
and Related Shareholder Matters
The  information  required  by  Item  12  is  incorporated  herein 
by reference from our definitive proxy statement for our 2009 
Annual Shareholders’ Meeting to be filed with the Commission.

ITEM 14. Principal Accountant  
Fees and Services
The  information  required  by  Item  14  is  incorporated  herein 
by reference from our definitive proxy statement for our 2009 
Annual Shareholders’ Meeting to be filed with the Commission.

Part IV

ITEM 15. Exhibits and Financial Statement Schedules 
(a) 

Index to Financial Statements: 

(1) 

•	 Report	of	Independent	Registered	Public	Accounting	Firm	

•	 Report	of	Independent	Registered	Public	Accounting	Firm	

•	 Consolidated	Balance	Sheets	as	of	March	31,	2009	and	March	31,	2008	

•	 Consolidated	Statements	of	Income	—	Years	Ended	 
  March 31, 2009, March 31, 2008 and March 31, 2007 

•	 Consolidated	Statements	of	Shareholders’	Equity	—	Years	Ended	 
  March 31, 2009, March 31, 2008 and March 31, 2007 

•	 Consolidated	Statements	of	Cash	Flows	—	Years	Ended	 
  March 31, 2009, March 31, 2008 and March 31, 2007 

•	 Notes	to	Consolidated	Financial	Statements	

  (2)  The following supplementary financial statement schedule of Quality Systems, Inc., required to  

be included in Item 15(a)(2) on Form 10-K is filed as part of this Report.

•	 Schedule	II	—	Valuation	and	Qualifying	Accounts	

Schedules other than that listed above have been omitted since they are either not required, not  
applicable, or because the information required is included in the consolidated financial statements  
or the notes thereto.

(3)  The exhibits listed in the Index to Exhibits hereof are attached hereto or incorporated herein by  

reference and filed as a part of this Report.

46

Page

51

52

53

54

55

56

58

81

	
	 	
	
	 	
	
	 	
	
	 	
   
	
	 	
   
	
	 	
   
	
	 	
 
   
	
	 	
 
   
   
   
 
 
 
Exhibit  
Number  Description

  3.1 

  3.2 

  3.3 

  3.4 

  3.5 

 10.1* 

 10.2* 

 10.3* 

 10.4* 

 10.5* 

 10.6* 

 10.7* 

 10.8* 

 10.9* 

 10.10* 

 10.11 

 10.12 

Restated  Articles  of  Incorporation  of  Quality  Systems,  Inc.  filed  with  the  Secretary  of  State  of  California  on 
September 8, 1989, are hereby incorporated by reference to Exhibit 3.1 to the registrant’s Registration Statement 
on Form S-1 (Registration No. 333-00161) filed January 11, 1996.

Certificate of Amendment to Articles of Incorporation of Quality Systems, Inc. filed with the Secretary of State of 
California effective March 4, 2005, is hereby incorporated by reference to Exhibit 3.1.1 of the registrant’s Annual 
Report on Form 10-K for the year ended March 31, 2005.

Certificate of Amendment to Articles of Incorporation of Quality Systems, Inc. filed with the Secretary of State of 
California effective October 6, 2005 is hereby incorporated by reference to Exhibit 3.01 of the registrant’s Current 
Report on Form 8-K filed October 11, 2005.

Certificate of Amendment to Articles of Incorporation of Quality Systems, Inc. filed with the Secretary of State of 
California effective March 3, 2006 is hereby incorporated by reference to Exhibit 3.1 of the registrant’s Current 
Report on Form 8-K filed March 6, 2006.

Amended and Restated Bylaws of Quality Systems, Inc., effective October 30, 2008, are hereby incorporated 
by reference to Exhibit 3.1 of the registrant’s Current Report on Form 8-K filed October 31, 2008. 

Amended and Restated 1998 Stock Option Plan is hereby incorporated by reference to Exhibit 10.10.1 of the 
registrant’s Annual Report on Form 10-K for the year ended March 31, 2005.

Form of Incentive Stock Option Agreement for Amended and Restated 1998 Stock Option Plan is hereby incorpo-
rated by reference to Exhibit 10.1 to the registrant’s Quarterly Report on Form 10-Q for the quarter ended September 
30, 2004.

Form of Non-Qualified Stock Option Agreement for Amended and Restated 1998 Stock Option Plan is hereby 
incorporated by reference to Exhibit 10.2 to the registrant’s Quarterly Report on Form 10Q for the quarter ended 
September 20, 2004.

2005 Stock Option and Incentive Plan is incorporated by reference to Exhibit 10.01 to the registrant’s Current 
Report on Form 8-K filed October 5, 2005.

Form of Nonqualified Stock Option Agreement for 2005 Stock Incentive Plan is incorporated by reference to 
Exhibit 10.2 to the registrant’s Current Report on Form 8-K filed June 5, 2007.

Form of Incentive Stock Option Agreement for 2005 Stock Incentive Plan is incorporated by reference to Exhibit 
10.3 to the registrant’s Current Report on Form 8-K filed June 5, 2007.

1993 Deferred Compensation Plan is hereby incorporated by reference to Exhibit 10.5 to the registrant’s Annual 
Report on Form 10-KSB for the year ended March 31, 1994. 

1998  Employee  Stock  Contribution  Plan  is  hereby  incorporated  by  reference  to  Exhibit  4.1  to  the  registrant’s 
Registration Statement on Form S-8 (Registration No. 333-63131).

Employment Agreement dated July 20, 2000 between Quality Systems, Inc. and Lou Silverman is hereby incor-
porated by reference to Exhibit 10.18 to the registrant’s Quarterly Report on Form 10-Q for the quarter ended 
September 30, 2000.

Form of Indemnification Agreement for directors and executive officers authorized January 27, 2005 is hereby incor-
porated by reference to Exhibit 10.6.1 of the registrant’s Annual Report on Form 10-K for the year ended March 31, 
2005.

Lease Agreement between Company and Tower Place, L.P. dated November 15, 2000, commencing February 
5, 2001 is hereby incorporated by reference to Exhibit 10.14 to the registrant’s Annual Report on Form 10-K for 
the year ended March 31, 2001. 

Fourth Amendment to lease agreement between the Company and Tower Place, L.P. dated September 22, 2005 
is incorporated by reference to Exhibit 10.24 to the registrant’s Annual Report on Form 10-K for the year ended 
March 31, 2006.

47

Exhibit  
Number  Description

Fifth Amendment to lease agreement between the Company and Tower Place, L.P. dated January 31, 2007 is 
incorporated by reference to Exhibit 10.13 to the registrant’s Annual Report on Form 10-K for the year ended March 
31, 2007.

Lease Agreement between Company and Orangewood Business Center Inc. dated April 3, 2000, amended 
February 22, 2001, is hereby incorporated by reference to Exhibit 10.15 to the registrant’s Annual Report on Form 
10-K for the year ended March 31, 2001.

Lease Agreement between the Company and HUB Properties LLC dated May 8, 2002 is hereby incorporated 
by reference to Exhibit 10.18 to the registrant’s Annual Report on Form 10-K for the year ended March 31, 2003.

Second Amendment to Office Lease agreement between the Company and HUB Properties LLC dated February 
14, 2006 is incorporated by reference to Exhibit 10.25 to the registrant’s Annual Report on Form 10-K for the year 
ended March 31, 2006.

Amended  and  Restated  Second  Amendment  to  Office  Lease  agreement  between  the  Company  and  HUB 
Properties LLC dated May 31, 2006 is incorporated by reference to Exhibit 10.17 to the registrant’s Annual Report 
on Form 10-K for the year ended March 31, 2007.

Lease Agreement between the Company and LakeShore Towers Limited Partnership Phase IV, a California limited 
partnership, dated September 15, 2004 is  hereby incorporated by reference to Exhibit 10.19 of the registrant’s 
Annual Report on Form 10-K for the year ended March 31, 2005.

Lease agreement between the Company and Von Karman Michelson Corporation dated September 6, 2005 
is incorporated by reference to Exhibit 10.23 to the registrant’s Annual Report on Form 10-K for the year ended 
March 31, 2006.

Office lease  between the Company and SLTS Grand Avenue, L.P. dated May 3, 2006 is incorporated by refer-
ence to Exhibit 10.20 to the registrant’s Annual Report on Form 10-K for the year ended March 31, 2007.

Board  Service  Agreement  between  the  Company  and  Lou  Silverman  is  incorporated  by  reference  to  Exhibit 
10.2.1 to the registrant’s Current Report on Form 8-K, dated May 31, 2005.

Board Service Agreement between the Company and Patrick Cline is incorporated by reference to Exhibit 10.2.1 
to the registrant’s Current Report on Form 8-K dated May 31, 2005.

Director Compensation Program approved May 25, 2006 is incorporated by reference to Exhibit 10.1 to the 
registrant’s Current Report on Form 8-K filed May 30, 2006.

Settlement Agreement dated as of August 8, 2006 between the registrant and Ahmed Hussein is incorporated 
by reference to Exhibit 10.1 to the registrant’s Current Report on Form 8-K filed August 9, 2006.

Description of Compensation Program for Named Executive Officers for Fiscal Year Ended March 31, 2008 is 
incorporated by reference to Exhibit 10.25 to the registrant’s Annual Report on Form 10-K for the year ended March 
31, 2007.

Description of Compensation Program for Named Executive Officers for Fiscal Year Ending March 31, 2007 is 
incorporated by reference to Exhibit 10.26 to the registrant’s Annual Report on Form 10-K for the year ended March 
31, 2007.

Agreement and Plan of Merger dated May 16, 2008 by and among Quality Systems, Inc., Bud Merger Sub, 
LLC and Lackland Acquisition II, LLC, is incorporated by reference to Exhibit 10.27 to the registrant’s Annual Report 
on Form 10-K for the year ended March 31, 2008.

Office lease between the Company and Lakeshore Towers Limited Partnership Phase II, a California limited part-
nership, dated October 18, 2007, is incorporated by reference to Exhibit 10.28 to the registrant’s Annual Report 
on Form 10-K for the year ended March 31, 2008.

10.13 

 10.14 

 10.15 

 10.16 

 10.17 

 10.18 

 10.19 

 10.20 

 10.21* 

 10.22* 

 10.23* 

 10.24 

 10.25* 

 10.26* 

 10.27 

 10.28 

48

Exhibit  
Number  Description

 10.29 

 10.30 

 10.31 

 10.32 

 10.33 

 10.34 

 10.35 

 10.36 

 10.37 

Standard Service Center Lease Agreement between the Lincoln National Life Insurance Company and Lackland 
Acquisition II, LLC, dated November 28, 2001, is incorporated by reference to Exhibit 10.29 to the registrant’s 
Annual Report on Form 10-K for the year ended March 31, 2008.

First  Amendment  to  Standard  Service  Center  Lease  Agreement  between  the  Lincoln  National  Life  Insurance 
Company and Lackland Acquisition II, LLC, dated August 17, 2005, is incorporated by reference to Exhibit 10.30 
to the registrant’s Annual Report on Form 10-K for the year ended March 31, 2008.

Standard Service Center Lease Agreement between the Lincoln National Life Insurance Company and InfoNow 
Solutions of St. Louis, LLC, dated November 28, 2001, is incorporated by reference to Exhibit 10.31 to the regis-
trant’s Annual Report on Form 10-K for the year ended March 31, 2008.

Second Amendment to Service Center Lease Agreement between the TM Properties, LLC, successor to the Lincoln 
National Life Insurance Company and Lackland Acquisition II, LLC, dated August 17, 2005, is incorporated by 
reference to Exhibit 10.32 to the registrant’s Annual Report on Form 10-K for the year ended March 31, 2008.

Assignment of Lease between InfoNow Solutions of St. Louis, Lackland Acquisition II, LLC and TM Properties, LLC 
dated August 17, 2005, is incorporated by reference to Exhibit 10.33 to the registrant’s Annual Report on Form 
10-K for the year ended March 31, 2008.

Agreement and Plan of Merger dated October 15, 2008 by and among (i) Quality Systems, Inc. (ii) NextGen 
Healthcare Information Systems, Inc. (iii) Ruth Merger Sub, Inc. (iv) Practice Management Partners, Inc. and (v) cer-
tain shareholders set forth therein, is incorporated by reference to Exhibit 10.1 to the registrant’s Quarterly Report 
on Form 10-Q for the quarter ended December 31, 2008. 

First  Amendment  to  Lease  Agreement  between  Hill  Management  Services,  Inc.  and  Practice  Management 
Partners, Inc., dated January 15, 2008, is incorporated by reference to Exhibit 10.2 to the registrant’s Quarterly 
Report on Form 10-Q for the quarter ended December 31, 2008.

First Amendment to Sublease Agreement between RehabCare Group, Inc. and Practice Management Partners 
Inc., dated January 15 2008, is incorporated by reference to Exhibit 10.3 to the registrant’s Quarterly Report on 
Form 10-Q for the quarter ended December 31, 2008.

Third Amendment to Lease Agreement between Pinecrest LLC and Practice Management Partners, Inc., dated April 
30, 2007, is incorporated by reference to Exhibit 10.4 to the registrant’s Quarterly Report on Form 10-Q for the 
quarter ended December 31, 2008.

 10.38* 

Employment Agreement dated August 11, 2008 between Quality Systems, Inc., and Steven Plochocki, is incor-
porated by reference to Exhibit 10.1 to the registrant’s Current Report on Form 8-K filed on August 12, 2008. 

  21 

  23 

 31.1 

 31.2 

 32.1 

List of subsidiaries**

Consent of Independent Registered Public Accounting Firm – Grant Thornton LLP**

Certification of Principal Executive Officer Required by Rule 13a-14(a) of the Securities Exchange Act of 1934, as 
amended, as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002**

Certification of Principal Financial Officer Required by Rule 13a-14(a) of the Securities Exchange Act of 1934, as 
amended, as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002**

Certification  of  Chief  Executive  Officer  and  Chief  Financial  Officer  Pursuant  to  18  U.S.C.  Section  1350,  as 
Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.**

*This exhibit is a management contract or a compensatory plan or arrangement.

**Filed herewith.

49

 
 
 
 
Signatures

Pursuant to the requirements of Section 13 or 15(d) 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.

Date: May 29, 2009

By: /s/ Steven Plochocki 

Steven T. Plochocki
President and Chief Executive Officer

KNOW ALL PERSONS BY THESE PRESENTS, that each of the persons whose signature appears below hereby constitutes and 
appoints Steven T. Plochocki and Paul A. Holt, each of them acting individually, as his attorney-in-fact, each with the full power 
of substitution, for him in any and all capacities, to sign any and all amendments to this Annual Report on Form 10-K, and to file 
the same, with all exhibits thereto and other documents in connection therewith, with the Securities and Exchange Commission, 
granting unto said attorneys-in-fact, and each of them, full power and authority to do and perform each and every act and 
thing requisite and necessary to be done in and about the premises as fully to all intents and purposes as he might or could do 
in person, hereby ratifying and confirming our signatures as they may be signed by our said attorney-in-fact and any and all 
amendments to this Annual Report on Form 10-K.

Pursuant to the requirement of the Securities Exchange Act of 1934, this Report has been signed by the following persons 

on our behalf in the capacities and on the dates indicated.

Signature 

Title 

Date

Chairman of the Board and Director 

May 27, 2009

President and Chief Executive Officer (Principal Executive Officer) and Director 

May 27, 2009

Chief Financial Officer (Principal Financial Officer) and Secretary 

May 27, 2009

President, NextGen Healthcare Information Systems Division, and Director 

May 27, 2009

/s/ Sheldon Razin

Sheldon Razin 

/s/ Steven Plochocki

Steven T. Plochocki 

/s/ Paul Holt

Paul A. Holt 

/s/ Patrick Cline

Patrick B. Cline 

/s/ Murray Brennan

Murray Brennan 

/s/ George Bristol

George Bristol 

/s/ 

Director 

Director 

Ahmed Hussein 

Director 

/s/ Philip Kaplan

Philip Kaplan 

/s/ Vincent Love

Vincent J. Love 

/s/ Russell Pflueger

Russell Pflueger 

50

Director 

Director 

Director 

May 27, 2009

May 27, 2009

May 27, 2009

May 27, 2009

May 27, 2009

Report Of Independent Registered Public Accounting Firm

Board of Directors and Shareholders

Quality Systems, Inc.

We have audited the accompanying consolidated balance sheets of Quality Systems, Inc. as of March 31, 2009 and 2008, 
and the related consolidated statements of income, shareholders’ equity, and cash flows for each of the three years ended 
March 31, 2009. Our audits of the basic financial statements included the financial statement Schedule II listed in the index 
appearing under Item 15 (a)(2). These consolidated financial statements and financial statement schedule are the responsibility 
of the Company’s management. Our responsibility is to express an opinion on these consolidated financial statements and 
financial statement schedule based on our audits.

We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). 
Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated 
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. An audit also includes assessing the accounting principles used and signifi-
cant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our 
audits provide a reasonable basis for our opinion.

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial posi-
tion of Quality Systems, Inc. as of March 31, 2009 and 2008 and the results of its operations and its cash flows for each of 
the three years ended March 31, 2009 in conformity with accounting principles generally accepted in the United States of 
America. Also in our opinion, the related financial statement Schedule II, when considered in relation to the basic consolidated 
financial statements taken as a whole, presents fairly, in all material respects, the information set forth therein.

We have also audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), 
Quality Systems, Inc.’s internal control over financial reporting as of March 31, 2009, based on criteria established in Internal 
Control – Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission and our 
report dated May 27, 2009, expressed an unqualified opinion.

/s/ GRANT THORNTON LLP

Irvine, California

May 27, 2009

51

Report Of Independent Registered Public Accounting Firm

Board of Directors and Shareholders

Quality Systems, Inc.

We have audited Quality Systems, Inc.’s internal control over financial reporting as of March 31, 2009, based on criteria 
established in Internal Control – Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway 
Commission (COSO). Quality Systems, Inc.’s management is responsible for maintaining effective internal control over financial 
reporting and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying 
Quality Systems, Inc. Management’s Report on Internal Control Over Financial Reporting. Our responsibility is to express an 
opinion on Quality Systems, Inc.’s internal control over financial reporting based on our audit.

We conducted our audit in accordance with the standards of the Public Company Accounting Oversight Board (United States). 
Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal 
control over financial reporting was maintained in all material respects. Our audit included obtaining an understanding of in-
ternal control over financial reporting, assessing the risk that a material weakness exists, testing and evaluating the design and 
operating effectiveness of internal control based on the assessed risk, and performing such other procedures as we considered 
necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion. 

A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reli-
ability of financial reporting and the preparation of financial statements for external purposes in accordance with generally ac-
cepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that 
(1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions 
of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit prepara-
tion of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of 
the company are being made only in accordance with authorizations of management and directors of the company; and (3) 
provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the 
company’s assets that could have a material effect on the consolidated financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projec-
tions of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of 
changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. In our opinion, Quality 
Systems, Inc. maintained, in all material respects, effective internal control over financial reporting as of March 31, 2009, based 
on criteria established in Internal Control – Integrated Framework issued by COSO. 

We have also audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), 
the consolidated balance sheets of Quality Systems, Inc. as of March 31, 2009 and 2008, and the related consolidated 
statements of income, shareholders’ equity, and cash flows for each of the three years ended March 31, 2009, and our report 
dated May 27, 2009 expressed an unqualified opinion.

/s/ GRANT THORNTON LLP

Irvine, California

May 27, 2009

52

 
Quality Systems, Inc. 
Consolidated Balance Sheets
(in thousands, except per share data) 

ASSETS
Current assets:
   Cash and cash equivalents 
   Restricted cash 
   Marketable securities 
   Accounts receivable, net 
   Inventories, net 
   Income tax receivable 
   Net current deferred tax assets 
   Other current assets 
          Total current assets 

Marketable securities 
Equipment and improvements, net 
Capitalized software costs, net 
Intangibles, net 
Goodwill 
Other assets 
          Total assets 

LIABILITIES AND SHAREHOLDERS’ EQUITY
Current liabilities:
   Accounts payable 
   Deferred revenue 
   Accrued compensation and related benefits 
   Income taxes payable 
   Dividends payable 
   Other current liabilities 
          Total current liabilities 

Deferred revenue, net of current 
Net deferred tax liabilities 
Deferred compensation 
          Total liabilities 

Commitments and contingencies 
Shareholders’ equity:
Common stock
     $0.01 par value; authorized 50,000 shares; issued and  
     outstanding 28,447 and 27,448 shares at March 31, 2009 and  
     March 31, 2008, respectively 
Additional paid-in capital 
Retained earnings 
Accumulated other comprehensive loss, net of tax 
          Total shareholders’ equity 

March 31, 2009

March 31, 2008

$

70,180 
 1,303 
 - 

 90,070 
 1,125 
 5,605 
 3,994 
 6,312 
 178,589 

 7,395 
 6,756 
 9,552 
 8,403 
 28,731 
 2,675 
$ 242,101 

$

5,097 
 47,584 
 9,511 
 - 
 8,529 
 8,888 
 79,609 

 521 
 4,566 
 1,838 
 86,534 

$

59,046 
 - 
 2,500 
 76,585 
 1,024 
 - 
 6,397 
 4,596 
 150,148 

 20,124 
 4,773 
 8,852 
 - 
 1,840 
 2,171 
$ 187,908 

$

4,685 
 44,389 
 8,346 
 1,541 
 6,861 
 4,394 
 70,216 

 506 
 1,575 
 1,906 
 74,203 

 284 
 103,524 
 51,759 

 - 

155,567 

 274 
 75,556 
 38,071 
 (196)
113,705 

          Total liabilities and shareholders’ equity 

$ 242,101 

$ 187,908

The accompanying notes to these consolidated financial statements are an integral part of these consolidated statements.

53

Quality Systems, Inc. 
Consolidated Statements of Income
(in thousands, except per share data) 

Revenues:
   Software, hardware and supplies 
   Implementation and training services 
System sales 

   Maintenance 
   Electronic data interchange services 
   Revenue cycle management and related services
   Other services 
Maintenance, EDI, RCM and other services

        Total revenue 

Cost of revenue:
   Software, hardware and supplies 
   Implementation and training services 
        Total cost of system sales 

   Maintenance 
   Electronic data interchange services 
   Revenue cycle management and related services
   Other services 
        Total cost of maintenance, EDI, RCM and other services 

        Total cost of revenue 

   Gross profit 

Operating expenses:
   Selling, general and  administrative 
   Research and development costs 
        Total operating expenses 

   Income from operations 

Interest income 
Other (expense) income 

Income before provision for income taxes 
Provision for income taxes 
   Net income 

Net income per share:
   Basic 
   Diluted 

Weighted average shares outstanding:
   Basic 
   Diluted 
   Dividends declared per common share

Fiscal Year Ended
March 31, 2009 March 31, 2008 March 31, 2007

$

$

$
$

$

85,386 
 13,375 

 98,761 

 72,862 
 29,522 
 21,431 
 22,939 
146,754 

245,515 

13,184 
10,286 
23,470 

11,859 
21,374 
14,674 
17,513 
65,420 

88,890 

$

76,363 
 13,406 

 89,769 

 56,455 
 22,450 
 871 
 16,955 
 96,731 

$

68,871 
12,177 

81,048 

41,948 
17,049 
534 
16,586 
76,117 

 186,500 

157,165 

 10,887 
 10,341 
 21,228 

 12,446 
 15,776 
 558 
 12,493 
 41,273 

 62,501 

8,453 
8,535 
16,988 

11,834 
12,181 
341 
9,440 
33,796 

50,784 

156,625 

 123,999 

106,381 

70,445 
 13,777 
 84,222 

 53,260 
 11,350 
 64,610 

45,337 
10,166 
55,503 

 72,403 

 59,389 

50,878 

 1,203 
 (279)

 73,327 
 27,208 
46,119 

1.65 
1.62 

 28,031 
 28,396 
1.15 

 2,661 
 953 

 63,003 
 22,925 
40,078 

1.47 
1.44 

27,298 
27,770 
1.00 

$

$
$

$

3,306 
 - 

54,184 
20,952 
33,232 

1.24 
1.21 

26,882 
27,550 
1.00

$

$
$

$

The accompanying notes to these consolidated financial statements are an integral part of these consolidated statements.

54

Quality Systems, Inc. 
Consolidated Statements of Shareholders’ Equity
(in thousands)

Common Stock

Shares

 Amount

    APIC 

Retained 
Earnings

Deferred  
Compensation

Accumulated 
Other 
Comprehensive 
Loss

Total  
Shareholders’ 
Equity

Balance, March 31, 2006 

26,711  $ 267 

$ 53,675 

$ 19,151 

$  (684)

$     - 

$     72,409 

Reclass of deferred  
compensation upon adop-
tion of SFAS 123R 

Exercise of stock options 

Tax benefit resulting from 
exercise of stock options 

Stock based compensation 

Dividends declared

Net income 

 - 
 412 

 - 
 - 

 - 

 - 

 - 
 4 

 - 
 - 

 - 

 - 

Balance, March 31, 2007 

27,123 

271 

Exercise of stock options

 325 

 3 

Tax benefit resulting from 
exercise of stock options 

Stock based compensation 

Dividends declared

Net income 

Unrealized loss on market-
able securities, net of tax 

 - 
 - 

 - 

 - 

 - 

 - 
 - 

 - 

 - 

 - 

 (684)
6,058 

2,694 
3,923 

 - 

 - 

65,666 

4,757 

1,376 
3,757 

 - 

 - 

 - 

 - 
 - 

 - 
 - 

(27,074)

33,232 

25,309 

 - 

 - 
 - 

(27,316)

40,078 

 - 

Balance, March 31, 2008 

27,448 

274 

75,556 

38,071 

Exercise of stock options

 697 

 7 

12,512 

Tax benefit resulting from 
exercise of stock options 

Stock based compensation 

Common stock issued for 
acquisitions

Dividends declared

Net income 

Reclassification of unrealized 
loss on marketable securi-
ties, net of tax 

 - 
 - 

 302 
 - 

 - 

 - 

 - 
 - 

 3 
 - 

 - 

 - 

3,382 
1,977 

10,097 
 - 

 - 

 - 

 - 

 - 
 - 

 - 
(32,431)

 46,119 

 - 

684 
 - 

 - 
 - 

 - 

 - 

 - 

 - 

 - 
 - 

 - 

 - 

 - 

 - 

 - 

 - 
 - 

 - 
 - 

 - 

 - 

 - 
 - 

 - 
 - 

 - 

 - 

 - 

 - 

 - 
 - 

 - 

 - 

(196)

(196)

 - 

 - 
 - 

 - 
 - 

 - 

 - 
6,062 

 2,694 
 3,923 

(27,074)

33,232 

 91,246 

 4,760 

 1,376 
 3,757 

(27,316)

40,078 

(196)

113,705 

12,519 

3,382 
 1,977 

10,100 
(32,431)

46,119 

196 

196 

Balance, March 31, 2009 

28,447  $ 284 

$ 103,524 

$ 51,759 

$      - 

$     - 

$   155,567

The accompanying notes to these consolidated financial statements are an integral part of these consolidated statements.

55

Quality Systems, Inc. 
Consolidated Statements of Cash Flows 
(in thousands)

Fiscal Year Ended

March 31, 2009 March 31, 2008 March 31, 2007

$

46,119 

$

40,078 

$

33,232 

Cash flows from operating activities:
   Net income 
   Adjustments to reconcile net income to net cash provided by 
   operating activities:
       Depreciation 
       Amortization of capitalized software costs 
       Amortization of other intangibles 
       Gain on life insurance proceeds, net 
       Provision for bad debts 
       (Recovery)/provision for inventory obsolescense
       Share-based compensation 
       Deferred income taxes 
       Tax benefit from exercise of stock options 
       Excess tax benefit from share-based compensation 
       Loss on disposal of equipment and improvements 
   Changes in assets and liabilities:
       Accounts receivable 
       Inventories 
       Income tax receivable 
       Other current assets 
       Other assets 
       Accounts payable 
       Deferred revenue 
       Accrued compensation and related benefits 
       Income taxes payable 
       Other current liabilities 
       Deferred compensation 
Net cash provided by operating

Cash flows from investing activities:
   Additions to capitalized software costs 
   Additions to equipment and improvements 
   Proceeds from sale of marketable securities 
   Purchases of marketable securities 
   Proceeds from life insurance policy, net 
   Purchase of HSI, including direct transaction costs
   Purchase of PMP, including direct transaction costs
Net cash used in investing

Cash flows from financing activities:
   Excess tax benefit from share-based compensation 
   Proceeds from the exercise of stock options 
   Dividends paid 
   Loan repayment 
Net cash used in financing
Net increase (decrease) in cash and cash equivalents

 2,911 
 5,163 
 1,034 
 - 
 2,089 
 (13)
 1,977 
 4,462 
 3,382 
 (3,381)
 96 

 (11,369)
 (88)
 (5,433)
 (1,202)
 (448)
 (299)
 3,130 
 136 
 (1,541)
 2,055 
 (68)
 48,712 

 (5,863)
 (3,218)
 14,825 

 - 
 - 
 (8,241)
 (16,950)
 (19,447)

 3,381 
 12,519 
 (30,763)
 (3,268)
 (18,131)
 11,134 

 2,369 
 4,149 
 - 
 (755)
 1,171 
 52 
 3,757 
 (199)
 1,376 
 (1,311)
 - 

 (13,811)
 99 
 - 
 (89)
 381 
 (561)
 5,447 
 1,825 
 1,226 
 (1,232)
 (373)
 43,599 

 (6,019)
 (2,113)
 91,825 
 (114,645)
 755 
 -   
 -   

 (30,197)

 1,311 
 4,760 
 (20,455)

 -   

 (14,384)
 (982)

 1,950 
 3,231 
 - 
 - 
 1,480 
 35 
 3,923 
 (1,642)
 2,694 
 (2,527)
 - 

 (20,760)
 (649)
 1,195 
 (1,595)
 (594)
 2,312 
 3,532 
 1,031 
 315 
 1,814 
 593 
 29,570 

 (5,042)
 (3,240)
 - 
 - 
 - 
 - 
 - 
 (8,282)

 2,527 
 6,062 
 (27,074)

 - 

 (18,485)
 2,803 

 57,225 

60,028 

Cash and cash equivalents at beginning of year 

 59,046 

 60,028 

Cash and cash equivalents at end of year 

$

70,180 

$

59,046 

$

56

Quality Systems, Inc. 
Consolidated Statements of Cash Flows 
(in thousands) 

Fiscal Year Ended

March 31, 2009 March 31, 2008 March 31, 2007

Supplemental disclosures of cash flow information:
   Cash paid during the year for income taxes, net of refunds

Non-cash investing and financing activities:
   Unrealized loss on marketable securities
   Tax effect of unrealized loss on marketable securities
   Reclassification of unrealized loss on marketable securities, 
   net of tax 
   Unrealized loss on marketable securities, net of tax...

   Effective May 20, 2008, the Company acquired HSI in a 
   transaction summarized as follows:
       Fair value of net assets assumed 
       Cash paid for HSI stock 
       Common stock issued for HSI stock 
   Liabilities assumed 

   Effective October 28, 2008, the Company acquired PMP in  
   a transaction summarized as follows:
       Fair value of net assets assumed 
       Cash paid for PMP stock 
       Common stock issued for PMP stock 
   Liabilities assumed 

$

$

$

$

$

$

$

26,455 

$ 20,546 

$

18,360 

-   
-   

196 
196 

20,609 
(8,241)
(7,350)
5,018 

23,875 
(16,950)
 (2,750)
4,175 

$

$

$

$

$

$

(326)
130 

-   
(196)

-   
-   
-   
-   

-   
-   
-   
-   

$

$

$

$

$

$

-   
 -   

 -   
- 

-   
 -   
 -   
-   

-   
 -   
 -   
-  

The accompanying notes to these consolidated financial statements are an integral part of these consolidated statements.

57

Quality Systems, Inc. 
Notes to Consolidated Financial Statements

(Dollar And Share Amounts In Thousands, Except Per Share Amounts)

March 31, 2009 And 2008 

1.  Description of Business
Quality  Systems  Inc.,  comprised  of  the  QSI  Division  (“QSI 
subsidiaries,  NextGen 
Division”)  and  wholly-owned 
Healthcare  Information  Systems,  Inc.  (“NextGen  Division”), 
Lackland Acquisition II, LLC dba Healthcare Strategic Initiatives 
(“HSI”) and Practice Management Partners, Inc. (“PMP”) (col-
lectively, the Company) develops and markets healthcare infor-
mation systems that automate certain aspects of medical and 
dental practices, networks of practices such as physician hos-
pital organizations (“PHOs”) and management service organi-
zations (“MSOs”), ambulatory care centers, community health 
centers, and medical and dental schools. The Company also 
provides revenue cycle management (“RCM”) services through 
its Practice Solutions division of NextGen. Operationally, HSI 
and PMP are administered as part of the NextGen Division.

The Company, a California corporation formed in 1974, 
was founded with an early focus on providing information sys-
tems to dental group practices. In the mid-1980’s, we capital-
ized on the increasing focus on medical cost containment and 
further expanded our information processing systems to serve 
the medical market. In the mid-1990’s, we made two acquisi-
tions that accelerated our penetration of the medical market. 
These two acquisitions formed the basis for what is today the 
NextGen Division. Today, we serve the medical and dental 
markets through our two divisions. 

The two divisions operate largely as stand-alone opera-
tions  with  each  division  maintaining  its  own  distinct  product 
lines,  product  platforms,  development,  implementation  and 
support teams, sales staffing, and branding. The two divisions 
share the resources of the “corporate office” which includes 
a  variety  of  accounting  and  other  administrative  functions. 
Additionally, there are a small number of clients who are si-
multaneously utilizing software from each of our two divisions. 

The  QSI  Division,  co-located  with  our  corporate  head-
quarters in Irvine, California, currently focuses on developing, 
marketing and supporting software suites sold to dental and 
certain niche medical practices. In addition, the Division sup-
ports  a  number  of  medical  clients  that  utilize  the  Division’s 
UNIX based medical practice management software product. 

The  NextGen  Division,  with  headquarters  in  Horsham, 
Pennsylvania, and significant locations in Atlanta, Georgia, St. 
Louis, Missouri and Hunt Valley, Maryland, focuses principally 
on developing and marketing products and services for medi-
cal practices.

2.  Summary of Significant  
  Accounting Policies
Principles of Consolidation. The consolidated financial state-
ments include the accounts of the Company and its wholly-
owned  subsidiaries.  On  May  20,  2008,  the  Company 
acquired  HSI,  a  full-service  healthcare  RCM  company.  On 
October  28,  2008,  the  Company  acquired  PMP,  a  full- 
service healthcare RCM company. All significant intercompa-
ny accounts and transactions have been eliminated.

Basis of Presentation. The accompanying consolidated financial 
statements have been prepared in accordance with accounting 
principles generally accepted in the United States of America. 

Certain prior year amounts have been reclassified to con-

form with fiscal year 2009 presentation. 

References to dollar amounts in the consolidated financial 
statement  sections  are  in  thousands,  except  per  share  data, 
unless otherwise specified. 

Revenue Recognition. The Company recognizes system sales 
revenue pursuant to Statement of Position No. 97-2, “Software 
Revenue Recognition” (SOP 97-2),  as amended by Statement 
of  Position  No.  98-9  “Modification  of  SOP  97-2,  Software 
Revenue  Recognition”  (SOP  98-9).  The  Company  generates 
revenue from the sale of licensing rights to its software prod-
ucts directly to end-users and value-added resellers, or VARs. 
The Company also generates revenue from sales of hardware 
and third party software, implementation, training, EDI, post-
contract support (maintenance), and other services, including 
RCM, performed for customers who license its products. 

A typical system contract contains multiple elements of the 
above items. SOP 98-9 requires revenue earned on software 
arrangements  involving  multiple  elements  to  be  allocated  to 
each element based on the relative fair values of those ele-
ments. The fair value of an element must be based on vendor 
specific objective evidence (VSOE). The Company limits its as-
sessment of VSOE for each element to either the price charged 
when the same element is sold separately or the price estab-
lished by management having the relevant authority to do so, 
for an element not yet sold separately. VSOE calculations are 
updated  and  reviewed  quarterly  or  annually  depending  on 
the  nature  of  the  product  or  service.  The  Company  has  es-
tablished  VSOE  for  the  related  undelivered  elements  based 
on the bell-shaped curve method. Maintenance VSOE for the 
Company’s largest customers is based on stated renewal rates 
only if the rate is determined to be substantive and falls within 
the Company’s customary pricing practices. 

58

When evidence of fair value exists for the delivered and 
undelivered elements of a transaction, then discounts for indi-
vidual elements are aggregated and the total discount is allo-
cated to the individual elements in proportion to the elements’ 
fair value relative to the total contract fair value. 

When  evidence  of  fair  value  exists  for  the  undelivered 
elements only, the residual method, provided for under SOP 
98-9, is used. Under the residual method, the Company de-
fers revenue related to the undelivered elements in a system 
sale based on VSOE of fair value of each of the undelivered 
elements,  and  allocates  the  remainder  of  the  contract  price 
net of all discounts to revenue recognized from the delivered 
elements.  If  VSOE  of  fair  value  of  any  undelivered  element 
does not exist, all revenue is deferred until VSOE of fair value 
of the undelivered element is established or the element has 
been delivered.

The  Company  bills  for  the  entire  system  sales  contract 
amount upon contract execution except for maintenance which 
is billed separately. Amounts billed in excess of the amounts 
contractually due are recorded in accounts receivable as ad-
vance billings. Amounts are contractually due when services 
are performed or in accordance with contractually specified 
payment dates. Provided the fees are fixed and determinable 
and collection is considered probable, revenue from licensing 
rights and sales of hardware and third party software is gen-
erally  recognized  upon  physical  or  electronic  shipment  and 
transfer  of  title.  In  certain  transactions  where  collections  risk 
is high, the cash basis method is used to recognize revenue. 
If the fee is not fixed or determinable, then the revenue rec-
ognized in each period (subject to application of other rev-
enue recognition criteria) will be the lesser of the aggregate of 
amounts due and payable or the amount of the arrangement 
fee that would have been recognized if the fees were being 
recognized using the residual method. Fees which are consid-
ered fixed or determinable at the inception of the Company’s 
arrangements must include the following characteristics:

•	 The	fee	must	be	negotiated	at	the	outset	of	an	arrange-
ment, and generally be based on the specific volume of 
products to be delivered without being subject to change 
based on variable pricing mechanisms such as the number 
of units copied or distributed or the expected number of 
users.

•	 Payment	terms	must	not	be	considered	extended.	If	a	sig-
nificant portion of the fee is due more than 12 months after 
delivery  or  after  the  expiration  of  the  license,  the  fee  is 
presumed not fixed and determinable.

Revenue  from  implementation  and  training  services  is 
recognized  as  the  corresponding  services  are  performed. 
Maintenance revenue is recognized ratably over the contrac-
tual maintenance period.

Contract  accounting  is  applied  where  services  include 
significant software modification, development or customiza-
tion. In such instances, the arrangement fee is accounted for in  
accordance with Statement of Position No. 81-1 “Accounting 
for Performance of Construction-Type and Certain Production-
Type  Contracts”  (SOP  81-1).  Pursuant  to  SOP  81-1,  the 
Company  uses  the  percentage  of  completion  method  pro-
vided all of the following conditions exist:

•	 The	 contract	 includes	 provisions	 that	 clearly	 specify	 the	
enforceable rights regarding goods or services to be pro-
vided and received by the parties, the consideration to be 
exchanged, and the manner and terms of settlement;

•	 The	 customer	 can	 be	 expected	 to	 satisfy	 its	 obligations	

under the contract;

•	 The	Company	can	be	expected	to	perform	its	contractual	

obligations; and

•	 Reliable  estimates  of  progress  towards  completion  can 

be made.

The  Company  measures  completion  using  labor  input 
hours. Costs of providing services, including services account-
ed for in accordance with SOP 81-1, are expensed as incurred.

If a situation occurs in which a contract is so short term 
that  the  financial  statements  would  not  vary  materially  from 
using  the  percentage-of-completion  method  or  in  which  the 
Company is unable to make reliable estimates of progress of 
completion of the contract, the completed contract method is 
utilized. 

Product  returns  are  estimated  in  accordance  with 
Statement  of  Financial  Accounting  Standards  No.  48, 
“Revenue Recognition When Right of Return Exists” (SFAS 48). 
The Company also ensures that the other criteria in SFAS 48 
have been met prior to recognition of revenue: 

•	 The	price	is	fixed	or	determinable;	

•	 The	customer	is	obligated	to	pay	and	there	are	no	contin-
gencies surrounding the obligation or the payment; 

•	 The	customer’s	obligation	would	not	change	in	the	event	of	

theft or damage to the product; 

•	 The	customer	has	economic	substance;	

•	 The	amount	of	returns	can	be	reasonably	estimated;	and	

•	 The	 Company	 does	 not	 have	 significant	 obligations	 for	
future  performance  in  order  to  bring  about  resale  of  the 
product by the customer.

The Company has historically offered short-term rights of 
return in certain sales arrangements. If the Company is able 
to  estimate  returns  for  these  types  of  arrangements,  revenue 
is  recognized  and  these  arrangements  are  recorded  in  the 

59

consolidated financial statements. If the Company is unable to 
estimate returns for these types of arrangements, revenue is not 
recognized  in  the  consolidated  financial  statements  until  the 
rights of return expire.

Revenue related to sales arrangements which include the 
right to use software stored on the Company’s hardware is ac-
counted for under the Emerging Issues Task Force Issue (EITF) 
No. 00-3 “Application of AICPA Statement of Position 97-2 to 
arrangements that include the right to use software stored on 
another  entity’s  hardware.”    EITF  No.  00-3  requires  that  for 
software licenses and related implementation services to con-
tinue to fall under SOP No. 97-2, the customer must have the 
contractual right to take possession of the software without in-
curring a significant penalty and it must be feasible for the cus-
tomer to either host the software themselves or through another 
third party. If an arrangement is not deemed to be accounted 
for under SOP 97-2, the entire arrangement is accounted for 
as a service contract in accordance with EITF Issue No. 00-21 
“Revenue  Arrangements  with  Multiple  Deliverables.”    In  that 
instance, the entire arrangement would be recognized as the 
hosting services are being performed.

From time to time, the Company offers future purchase dis-
counts on its products and services as part of its sales arrange-
ments. Pursuant to AICPA TPA 5100.50, such discounts which 
are incremental to the range of discounts reflected in the pricing 
of the other elements of the arrangement, which are incremental 
to the range of discounts typically given in comparable transac-
tions, and which are significant, are treated as an additional el-
ement of the contract to be deferred. Amounts deferred related 
to  future  purchase  options  are  not  recognized  until  either  the 
customer exercises the discount offer or the offer expires.

RCM service revenue is derived from services fees, which 
include amounts charged for ongoing billing and other related 
services, and are generally billed to the customer as a percent-
age of total collections. The Company does not recognize rev-
enue for services fees until these collections are made, as the 
services fees are not fixed and determinable until such time. 

Revenue  is  divided  into  two  categories,  “system  sales” 
and “maintenance, EDI,  RCM and other services”. Revenue 
in  the  system  sales  category  includes  software  license  fees, 
third party hardware and software, and implementation and 
training  services  related  to  purchase  of  the  Company’s  soft-
ware systems. The majority of the revenue in the system sales 
category  is  related  to  the  sale  of  software.  Revenue  in  the 
maintenance, EDI, RCM and other services category includes 
maintenance, EDI, RCM services, follow on training and im-
plementation services, annual third party license fees, hosting 
services and other revenue. 

Cash and Cash Equivalents. Cash and cash equivalents gen-
erally consist of cash, money market funds and short-term U.S. 

60

Treasury securities with original maturities of less than 90 days. 
The  Company  had  cash  deposits  at  U.S.  banks  and  finan-
cial  institutions  at  March  31,  2009  of  which  $76,364  was 
in excess of the Federal Deposit Insurance Corporation insur-
ance limit of $250 per owner. The Company is exposed to 
credit loss for amounts in excess of insured limits in the event 
of non-performance by the institutions; however, the Company 
does not anticipate non-performance by these institutions. The  
money market fund in which the Company holds a portion of 
its cash invests in only investment grade money market instru-
ments from a variety of industries, and therefore bears relatively 
low market risk. The average maturity of the investments owned 
by the money market fund is approximately two months.

Restricted Cash. Restricted cash consists of cash which is being 
held by HSI acting as agent for the disbursement of certain state 
social services programs. The Company records an offsetting 
“Care Services liability” (see also Note 9) when it initially re-
ceives such cash from the government social service programs 
and relieves both restricted cash and the Care Services liability 
when amounts are disbursed. HSI earns an administrative fee 
which is based on a percentage of funds disbursed on behalf 
of certain government social service programs.

Marketable Securities and ARS Put Option Rights. Marketable 
securities are recorded at fair value, based on quoted mar-
ket rates or valuation analysis when appropriate. In addition, 
the  Company  classifies  marketable  securities  as  current  or 
non-current based upon whether such assets are reasonably  
expected to be realized in cash or sold or consumed during 
the normal operating cycle of the business. 

The  Company’s  investments  at  March  31,  2009  and 
2008  are  in  tax  exempt  municipal  Auction  Rate  Securities 
(ARS) which are classified as either current or non-current mar-
ketable  securities  on  the  Company’s  Consolidated  Balance 
Sheets,  depending  on  the  liquidity  and  timing  of  expected 
realization of such securities. The ARS are rated by one or 
more national rating agencies and have contractual terms of 
up to thirty years, but generally have interest rate reset dates 
that  occur  every  7,  28  or  35  days.  Despite  the  underlying 
long-term  maturity  of  ARS,  such  securities  were  priced  and 
subsequently traded as short-term investments because of the 
interest rate reset feature. If there are insufficient buyers, the 
auction is said to “fail” and the holders are unable to liquidate 
the  investments  through  auction.  A  failed  auction  does  not 
result in a default of the debt instrument. Under their respec-
tive terms, the securities will continue to accrue interest and 
be auctioned until the auction succeeds, the issuer calls the 
securities or the securities mature. 

In February 2008, the Company began to experience 
failed  auctions  on  its  ARS.  To  determine  their  estimated  fair 
values  at  March  31,  2009  and  2008,  factors  including 
credit quality, assumptions about the likelihood of redemption, 

observable market data such as yields or spreads of fixed rate 
municipal bonds and other trading instruments issued by the 
same or comparable issuers were considered.

The  Company’s  ARS  are  managed  by  UBS  Financial 
Services Inc. (UBS). On November 13, 2008, the Company 
entered  into  an  Auction  Rate  Security  Rights  Agreement  (the 
Rights Agreement) with UBS, whereby the Company accepted 
UBS’ offer to purchase the Company’s ARS investments at any 
time during the period of June 30, 2010 through July 2, 2012. 
As a result, the Company has obtained an asset, ARS put op-
tion rights, whereby the Company has a right to “put” the ARS 
back to UBS. The Company expects to exercise its ARS put 
option rights and put its ARS back to UBS on June 30, 2010, 
the earliest date allowable under the Rights Agreement.

As of September 30, 2008, the Company had the in-
tent and ability to hold these securities until anticipated recov-
ery. As a result, the Company recognized the unrealized loss 
through September 30, 2008 as a temporary impairment in 
other comprehensive income within shareholders’ equity.

By  accepting  the  Rights  Agreement,  the  Company  can 
no longer assert that it has the intent to hold the auction rate 
securities until anticipated recovery and has elected to reclas-
sify its investments in ARS as trading securities, as defined by 
SFAS No. 115 “Accounting in Certain Investments in Debt and 
Equity Securities”, on the date of Company’s acceptance of 
the Rights Agreement. As trading securities, the ARS are car-
ried  at  fair  value  with  changes  recorded  through  earnings. 
At March 31, 2009, the Company held ARS with a par val-
ue of $8,125. In the fourth quarter of fiscal year 2009, the 
Company  recognized  a  pre-tax  unrealized  loss  of  approxi-
mately $730 through its earnings. The charge was measured 
as the approximate midpoint between various losses in values. 

As the Company will be permitted to put the ARS back 
to UBS at par value, the Company accounted for the ARS put 
option rights as a separate asset that was measured at its fair 
value with changes recorded through earnings. The Company 
has valued the ARS put option right as the approximate mid-
point between various fair values, measured as the difference 
between the par value of the ARS and the fair value of the 
securities, discounted by the credit risk of the broker and other 
factors  such  as  the  Company’s  historical  experience  to  sell 
ARS  at  par.  The  estimated  fair  value  of  the  ARS  put  option 
rights as of March 31, 2009 was determined to be $468. 
The  Company  is  required  to  assess  the  fair  value  of  these 
two individual assets and to record corresponding changes in 
fair value in each reporting period through the Consolidated 
Statements of Income until the ARS put option rights are exer-
cised and the ARS are redeemed or sold. The Company ex-
pects that the fair value movements in the ARS will be largely 
offset by the future changes in the fair value of the ARS put 
option rights. Since the ARS put option rights represent the right 

to sell the securities back to UBS at par, the Company will be 
required to periodically assess the economic ability of UBS to 
meet that obligation in assessing the fair value of the ARS put 
option rights. The Company will continue to classify the ARS 
as long-term investments until June 30, 2009, one year prior 
to the expected settlement. 

Allowance  for  Doubtful  Accounts.  The  Company  provides 
credit  terms  typically  ranging  from  thirty  days  to  less  than 
twelve months for most system and maintenance contract sales 
and generally does not require collateral. The Company per-
forms credit evaluations of its customers and maintains reserves 
for estimated credit losses. Reserves for potential credit losses 
are determined by establishing both specific and general re-
serves. Specific reserves are based on management’s estimate 
of the probability of collection for certain troubled accounts. 
General  reserves  are  established  based  on  the  Company’s 
historical experience of bad debt expense and the aging of 
the Company’s accounts receivable balances net of deferred 
revenues  and  specifically  reserved  accounts.  Accounts  are 
written  off  as  uncollectible  only  after  the  Company  has  ex-
pended extensive collection efforts. 

Included in accounts receivable are amounts related to 
maintenance and services which were billed, but which had 
not yet been rendered as of the end of the period. Undelivered 
maintenance and services are included on the accompanying 
Consolidated  Balance  Sheets  in  deferred  revenue  (see  also 
Note 9).

Inventories.  Inventories  consist  of  hardware  for  specific  cus-
tomer orders and spare parts, and are valued at lower of cost 
(first-in, first-out) or market. Management provides a reserve to 
reduce inventory to its net realizable value.

Equipment and Improvements. Equipment and improvements 
are stated at cost less accumulated depreciation and amorti-
zation. Depreciation and amortization of equipment and im-
provements are provided over the estimated useful lives of the 
assets, or the related lease terms if shorter, by the straight-line 
method. Useful lives range as follows:

•	 Computers	and	electronic	 

test equipment 

•	 Furniture	and	fixtures	

•	 Leasehold	improvements	

3-5 years

5-7	years

lesser	of	lease	term	or	 
estimated useful life

Software Development Costs. Development costs incurred in 
the research and development of new software products and 
enhancements to existing software products are expensed as 
incurred  until  technological  feasibility  has  been  established. 
After  technological  feasibility  is  established,  any  additional  
development costs are capitalized in accordance with SFAS 
No. 86, “Accounting for the Costs of Computer Software to 

61

 
be  Sold,  Leased  or  Otherwise  Marketed”  (SFAS  86).  Such 
capitalized costs are amortized on a straight-line basis over the 
estimated economic life of the related product of three years. 
The  Company  provides  support  services  on  the  current  and 
prior two versions of its software. Management performs an 
annual review of the estimated economic life and the recover-
ability of such capitalized software costs. If a determination is 
made that capitalized amounts are not recoverable based on 
the estimated cash flows to be generated from the applicable 
software, any remaining capitalized amounts are written off.

Goodwill and Intangible Assets. The Company follows SFAS 
No.  142,  “Goodwill  and  Other  Intangible  Assets”  (SFAS 
142).  Goodwill  is  related  to  the  NextGen  Division  and  the 
HSI and PMP acquisitions, which closed on May 20, 2008 
and  October  28,  2008,  respectively  (see  Notes  5,  6  and 
7). Under SFAS 142, management is required to perform an 
annual assessment of the implied fair value of goodwill and 
intangible assets with indefinite lives for impairment. Relating to 
NextGen Division’s goodwill, the Company compared the fair 
value of the NextGen Division with the carrying amount of its 
assets and determined that none of the goodwill recorded was 
impaired as of June 30, 2008 (the date of the Company’s last 
annual impairment test). The fair value of the NextGen Division 
was determined using an estimate of future cash flows for the 
NextGen Division over 10 years and risk adjusted discount 
rates of between 15 and 25 percent to compute a net present 
value of future cash flows. The Company will perform its initial 
impairment test on HSI and PMP as of June 30, 2009.

Long-Lived  Assets.  The  Company  follows  SFAS  No.  144, 
“Accounting  for  the  Impairment  or  Disposal  of  Long-Lived 
Assets”  (SFAS  144).  Management  periodically  reviews  the 
carrying value of long-lived assets to determine whether or not 
impairment to such value has occurred and has determined 
that there was no impairment at March 31, 2009.

Income Taxes. Income taxes are provided based on current 
taxable income and the future tax consequences of temporary 
differences between the basis of assets and liabilities for finan-
cial  and  tax  reporting.  The  deferred  income  tax  assets  and 
liabilities represent the future state and federal tax return conse-
quences of those differences, which will either be taxable or 
deductible when the assets and liabilities are recovered or set-
tled. Deferred income taxes are also recognized for operating 
losses that are available to offset future taxable income and 

 tax credits that are available to offset future income taxes. At 
each reporting period, management assesses the realizable 
value of deferred tax assets based on, among other things,  
estimates of future taxable income, and adjusts the related valu-
ation allowance as necessary. In June 2006, the FASB issued 
Interpretation No. 48, “Accounting for Uncertainty in Income 
Taxes – an Interpretation of SFAS No. 109” (FIN 48). FIN 48 
clarifies  the  accounting  for  uncertainty  in  income  taxes  rec-
ognized in an enterprise’s financial statements in accordance 
with SFAS No. 109, “Accounting for Income Taxes.” FIN 48 
prescribes a recognition threshold of more-likely-than-not and 
measurement of a tax position taken or expected to be taken 
in  an  enterprise’s  tax  return.  Management  makes  a  number 
of assumptions and estimates in determining the appropriate 
amount of expense to record for income taxes. These assump-
tions and estimates consider the taxing jurisdiction in which the 
Company operates as well as current tax regulations. Accruals 
are established for estimates of tax effects for certain transac-
tions and future projected profitability of the Company’s busi-
nesses based on management’s interpretation of existing facts 
and circumstances. The Company adopted FIN 48 effective 
April 1, 2007. See Note 12.

Advertising  Costs.  Advertising  costs  are  charged  to  opera-
tions  as  incurred.  The  Company  does  not  have  any  direct-
response advertising. Advertising costs, which includes trade 
shows and conventions, were approximately $3,459, $2,580 
and  $2,159  for  the  years  ended  March  31,  2009,  2008 
and 2007, respectively, and were included in selling, general 
and administrative expenses in the Consolidated Statements 
of Income.

Marketing Assistance Agreements. The Company has entered 
into marketing assistance agreements with certain existing us-
ers of the Company’s products which provide the opportunity 
for  those  users  to  earn  commissions  if  and  only  if  they  host 
specific site visits upon the Company’s request for prospective 
customers which directly result in a purchase of the Company’s 
software by the visiting prospects. Amounts earned by existing 
users under this program are treated as a selling expense in 
the period when earned. 

Other  Comprehensive  Income.  Comprehensive  income  in-
cludes  all  changes  in  Shareholders’  Equity  during  a  period 
except  those  resulting  from  investments  by  owners  and  dis-
tributions  to  owners.  The  components  of  accumulated  other 
comprehensive income (loss), net of income tax, consist of un-
realized losses on marketable securities of $(196) as of March 
31, 2008. There were no other comprehensive income items 
for the years ended March 31, 2009 or 2007. 

62

Net income 

Other comprehensive income:

Year Ended March 31, 

2009

2008

2007

$ 46,119 

$ 40,078 

$ 33,232 

Unrealized gain (loss) on marketable securities, net of tax 

 - 

 (196)

 - 

Comprehensive income 

$ 46,119 

$ 39,882 

$ 33,232

Earnings per Share. Pursuant to SFAS No. 128, “Earnings Per 
Share” (SFAS 128), the Company provides dual presentation 
of “basic” and “diluted” earnings per share (EPS).

common  shareholders  by  the  weighted  average  number  of 
common shares outstanding for the period. Diluted EPS reflects 
the potential dilution from common stock equivalents.

Basic  EPS  excludes  dilution  from  common  stock  equiv-
alents  and  is  computed  by  dividing  income  available  to 

The following table reconciles the weighted average shares outstanding for basic and diluted net income per share for the 

periods presented.

Net income 

Basic net income per common share:

Year ended March 31,

2009

2008

2007

$ 46,119 

$ 40,078 

$ 33,232 

   Weighted average of common shares outstanding 

28,031 

27,298 

 26,882 

Basic net income per common share 

$

1.65 

$

1.47 

$

1.24 

Net income 

$ 46,119 

$ 40,078 

$ 33,232 

Diluted net income per common share:

   Weighted average of common shares outstanding 

   Effect of potentially dilutive securities (options) 

   Weighted average of common shares outstanding - diluted 

28,031 

365 

28,396 

27,298 

 472 

27,770 

26,882 

668 

27,550 

Diluted net income per common share 

$

1.62 

$

1.44 

$

1.21

The computation of diluted net income per share does 
not include 440,338, 279,752 and 92,500 options for the 
years ended March 31, 2009, 2008 and 2007, respectively, 
because their inclusion would have an anti-dilutive effect on 
earnings per share. 

Share-Based  Compensation.  On  April  1,  2006,  the 
Company adopted SFAS No. 123R, “Share-Based Payment” 
(SFAS  123R)  which  requires  the  measurement  and  recogni-
tion  of  compensation  expense  for  all  share-based  payment 
awards made to employees and directors based on estimated 
fair  values.  SFAS  123R  supersedes  the  Company’s  previous 
accounting under Accounting Principles Board Opinion (APB) 
No. 25, “Accounting for Stock Issued to Employees” (APB 25). 

The  Company  adopted  SFAS  123R  using  the  modi-
fied  prospective  transition  method,  which  requires  the  appli-
cation of the accounting standard as of April 1, 2006, the 
first day of the Company’s fiscal year 2007. The Company’s 
Consolidated  Statements  of  Income  for  the  years  ended 
March 31, 2009, 2008 and 2007 reflect the impact of SFAS 

123R. Share-based compensation expense recognized under 
SFAS 123R for the years ended March 31, 2009, 2008 and 
2007 was $1,977, $3,757 and $3,923, respectively, which 
consisted  of  stock-based  compensation  expense  related  to 
employee and director stock options and included $430 ex-
pensed under APB 25 for “in the money” options issued prior 
to the adoption of SFAS 123R. Excess tax benefits from share-
based  compensation  are  presented  as  cash  outflows  from 
operating activities and cash inflows from financing activities. 
The Company has elected to adopt the alternative transition 
method provided in FASB Staff Position No. SFAS 123R-3 (FSP 
123(R)-3) for calculating the tax effects of share-based com-
pensation  pursuant  to  SFAS  123R.  The  alternative  transition 
method includes a simplified method to establish the begin-
ning balance of the additional paid-in capital (APIC pool) re-
lated to the tax effects of employee and director stock-based 
compensation, and to determine the subsequent impact on the 
APIC pool and the consolidated statement of cash flows of the 
tax effects of employee and director share-based awards that 
were outstanding upon adoption of SFAS 123R.

63

 
SFAS 123R requires companies to estimate the fair value 
of share-based payment awards on the date of grant using 
an  option-pricing  model.  Expected  term  is  estimated  using 
historical exercise experience. Volatility is estimated by using 
the  weighted  average  historical  volatility  of  the  Company’s 
common  stock,  which  approximates  expected  volatility.  The 
risk free rate is the implied yield available on the U.S Treasury  
zero-coupon issues with remaining terms equal to the expected 

term.  The  expected  dividend  yield  is  the  average  dividend 
rate during a period equal to the expected term of the option. 
Those inputs are then entered into the Black Scholes model 
to determine the estimated fair value. The value of the portion 
of the award that is ultimately expected to vest is recognized 
ratably  as  expense  over  the  requisite  service  period  in  the 
Company’s Consolidated Statements of Income.

The following table shows total stock-based compensation expense included in the Consolidated Statements of Income for 

years ended March 31, 2009, 2008 and 2007, respectively.

Costs and expenses:

   Cost of revenue 

   Research and development 

   Selling, general and administrative 

Total share-based compensation 

Year ended March 31,

2009

2008

2007

$

195 

 242 

1,540 

$

496 

 800 

 2,461 

$

524

870

2,529

$  1,977

$  3,757

$ 3,923

Amounts capitalized in software development costs 

 (21)

 (39)

(38)

Amounts charged against earnings, before income tax benefit 

$ 1,956 

$ 3,718

$ 3,885 

Amount of related income tax benefit recognized

$

549 

$

969 

$

910

Sales Taxes. In accordance with the guidance of EITF Issue 
No.  06-3,  “How  Taxes  Collected  from  Customers  and 
Remitted to Governmental Authorities Should Be Presented in 
the Income Statement” (EITF 06-3), the Company accounts for 
sales taxes imposed on its goods and services on a net basis 
in the Consolidated Statements of Income.

Use  of  Estimates.  The  preparation  of  consolidated  financial 
statements in conformity with generally accepted accounting 
principles  in  the  United  States  of  America  (GAAP)  requires 
management to make estimates and assumptions that affect 
the reported amounts of assets and liabilities and disclosure 
of  contingent  assets  and  liabilities  at  the  date  of  the  finan-
cial  statements,  and  the  reported  amounts  of  revenue  and 
expenses during the reporting period. On an on-going basis, 
the Company evaluates its estimates, including those related to 
uncollectible receivables, vendor specific objective evidence, 
valuation of marketable securities and ARS put option rights, 
and  income  taxes  and  related  credits  and  deductions.  The 
Company bases its estimates on historical experience and on 
various other assumptions that are believed to be reasonable 
under  the  circumstances,  the  results  of  which  form  the  basis 
for making judgments about the carrying values of assets and 
liabilities  that  are  not  readily  apparent  from  other  sources. 
Actual results may differ from these estimates under different 
assumptions or conditions. 

New Accounting Pronouncements. On April 9, 2009, the 
FASB issued three FSPs intended to provide additional ap-
plication guidance and enhanced disclosures regarding fair 
value measurements and other-than-temporary impairments 
of securities.

FSP FAS 157-4, “Determining Fair Value When the Volume 
and Level of Activity for the Asset or Liability Have Significantly 
Decreased and Identifying Transactions That Are Not Orderly,” 
provides guidelines for making fair value measurements more 
consistent with the principles presented in FASB Statement No. 
157,    “Fair  Value  Measurements.”    FSP  FAS  157-4  must  be  
applied  prospectively  and  retrospective  application  is  not 
permitted. FSP FAS 157-4 is effective for interim and annual 
periods ending after June 15, 2009, with early adoption per-
mitted  for  periods  ending  after  March  15,  2009.  An  entity 
early adopting FSP FAS 157-4 must also early adopt FSP FAS 
115-2 and FAS 124-2.

FSP FAS 115-2 and FAS 124-2. “Recognition and Pres-
entation of Other-Than-Temporary Impairments,” provides ad-
ditional guidance designed to create greater clarity and con-
sistency in accounting for and presenting impairment losses on 
debt securities. FSP FAS 115-2 and FAS 124-2 is effective for 
interim and annual periods ending after June 15, 2009, with 
early adoption permitted for periods ending after March 15, 
2009. An entity may early adopt this FSP only if it also elects 
to early adopt FSP FAS 157-4.

64

 
 
 
FSP FAS 107-1 and APB 28-1, “Interim Disclosures about 
Fair  Value  of  Financial  Instruments,”  enhances  consistency  in 
financial  reporting  by  increasing  the  frequency  of  fair  value 
disclosures.  FSP  107-1  and  APB  28-1  is  effective  for  interim 
periods ending after June 15, 2009, with early adoption per-
mitted for periods ending after March 15, 2009. However, 
an entity may early adopt these interim fair value disclosure 
requirements only if it also elects to early adopt FSP FAS 157-4 
and FSP FAS 115-2 and FAS 124-2.

The Company is currently evaluating the impact, if any, 
that the adoption of these FSPs will have on its consolidated 
financial statements.

On April 1, 2009, the FASB issued FASB Staff Position 
(FSP)  FAS  141(R)-1,  “Accounting  for  Assets  Acquired  and 
Liabilities  Assumed  in  a  Business  Combination  That  Arise 
from Contingencies.”  The FSP amends the guidance in FASB 
Statement No. 141 (Revised 2007), “Business Combinations,” 
to: (i) require that assets acquired and liabilities assumed in a 
business combination that arise from contingencies be recog-
nized at fair value if fair value can be reasonably estimated. 
If fair value of such an asset or liability cannot be reasonably 
estimated, the asset or liability would generally be recognized 
in accordance with FASB Statement No. 5, “Accounting for 
Contingencies,” and FASB Interpretation No. 14, “Reasonable 
Estimation of the Amount of a Loss;” (ii) eliminate the require-
ment  to  disclose  an  estimate  of  the  range  of  outcomes  of  
recognized contingencies at the acquisition date. For unrecog-
nized contingencies, the FASB decided to require that entities 
include only the disclosures required by Statement No. 5 and 
that those disclosures be included in the business combination 
footnote; and (iii) require that contingent consideration arrange-
ments of an acquiree assumed by the acquirer in a business 
combination be treated as contingent consideration of the ac-
quirer and should be initially and subsequently measured at 
fair value in accordance with Statement No. 141R. This FSP 
is effective for assets or liabilities arising from contingencies in 
business combinations for which the acquisition date is on or 
after the beginning of the first annual reporting period begin-
ning on or after December 15, 2008.

In  November  2008,  the  FASB  ratified  EITF  Issue  No. 
08-6, “Equity Method Investment Accounting Considerations” 
(EITF 08-6). EITF 08-6 clarifies the accounting for certain trans-
actions and impairment considerations involving equity meth-
od investments. EITF 08-6 is effective for fiscal years beginning 
after  December  15,  2008,  with  early  adoption  prohibited. 
The  Company  does  not  currently  have  any  investments  that 
are accounted for under the equity method and therefore EITF 
08-6  will  not  have  a  significant  impact  on  the  Company’s 
consolidated financial statements.

08-7 clarifies the accounting for certain separately identifiable 
intangible assets which an acquirer does not intend to actively 
use but intends to hold to prevent its competitors from obtaining 
access to them. EITF 08-7 requires an acquirer in a business 
combination  to  account  for  a  defensive  intangible  asset  as 
a separate unit of accounting which should be amortized to 
expense  over  the  period  the  asset  diminishes  in  value.  EITF 
08-7  is  effective  for  fiscal  years  beginning  after  December 
15, 2008, with early adoption prohibited. The Company is 
currently in the process of evaluating the impact the new EITF 
will have on its consolidated financial statements.

In October 2008, the FASB issued Staff Position (FSP) FAS 
157-3, “Determining the Fair Value of a Financial Asset When 
The Market for That Asset Is Not Active” (FSP FAS 157-3), to 
clarify the application of the provisions of SFAS No. 157, “Fair 
Value Measurements,” in an inactive market and how an entity 
would determine fair value in an inactive market. FSP FAS 157-3 
was effective upon issuance. The Company has considered 
the FSP in its determination of estimated fair values of its ARS 
for  the  fiscal  year  2009.  The  Company  does  not  currently 
have any assets that are inactive and therefore FAS 157-3 will 
not have a significant impact on the Company’s consolidated 
financial statements.

In  June  2008,  the  FASB  issued  FSP  EITF  03-6-1, 
“Determining  Whether  Instruments  Granted  in  Share-Based 
Payment  Transactions  Are  Participating  Securities”  (FSP  EITF 
03-6-1). FSP EITF 03-6-1 concluded that unvested share-based 
payment awards that contain nonforfeitable rights to dividends 
or dividend equivalents (whether paid or unpaid) are partici-
pating  securities  and  shall  be  included  in  the  computation 
of basic earnings per share (“EPS”) pursuant to the two-class 
method. This FSP becomes effective on April 1, 2009. Early 
adoption  of  the  FSP  is  not  permitted;  however,  it  will  apply 
retrospectively  to  EPS  data  for  all  periods  presented  in  the 
financial statements or in financial data. We do not currently 
anticipate  that  this  FSP  will  have  a  material  impact  on  the 
Company’s EPS data in fiscal year 2010 or on EPS for any 
prior periods presented in the financial data upon adoption.

In  May  2008,  the  FASB  issued  SFAS  No.  162,  “The 
Hierarchy  of  Generally  Accepted  Accounting  Principles” 
(SFAS 162). SFAS 162 defines the order in which accounting 
principles  that  are  generally  accepted  should  be  followed. 
SFAS 162 is effective 60 days following the Securities and 
Exchange  Commission’s  approval  of  the  Public  Company 
Accounting  Oversight  Board  (PCAOB)  amendments  to  AU 
Section  411,  “The  Meaning  of  Present  Fairly  in  Conformity 
with Generally Accepted Accounting Principles”. We do not 
expect the adoption of SFAS 162 to have a material impact 
on the Company’s consolidated financial statements.

In November 2008, the FASB ratified EITF Issue No. 08-
7, “Accounting for Defensive Intangible Assets” (EITF 08-7). EITF 

In April 2008, the FASB finalized FSP FAS No. 142-3, 
“Determination  of  the  Useful  Life  of  Intangible  Assets”  (FSP 

65

FAS 142-3). The position amends the factors that should be 
considered  in  developing  renewal  or  extension  assumptions 
used  to  determine  the  useful  life  of  a  recognized  intangible 
asset under SFAS No. 142, “Goodwill and Other Intangible 
Assets”. The position applies to intangible assets that are ac-
quired individually or with a group of other assets and both 
intangible assets acquired in business combinations and asset 
acquisitions. FSP 142-3 is effective for fiscal years beginning 
after December 15, 2008, and interim periods within those 
fiscal years. Management is currently evaluating the impact of 
the pending adoption of FSP FAS 142-3 on the consolidated 
financial statements.

In  December  2007,  the  FASB  issued  SFAS  No.  141 
(Revised 2007), “Business Combinations” (SFAS 141(R)). SFAS 
141(R) retains the fundamental requirements of the original pro-
nouncement  requiring  that  the  purchase  method  be  used  for 
all  business  combinations.  SFAS  141(R)  defines  the  acquirer 
as the entity that obtains control of one or more businesses in 
the business combination, establishes the acquisition date as 
the  date  that  the  acquirer  achieves  control  and  requires  the 
acquirer to recognize the assets acquired, liabilities assumed 
and  any  noncontrolling  interest  at  their  fair  values  as  of  the  
acquisition date. In addition, SFAS 141(R) requires expensing of 
acquisition-related and restructure-related costs, remeasurement 
of earn out provisions at fair value, measurement of equity secu-
rities issued for purchase at the date of close of the transaction 
and  non-expensing  of  in-process  research  and  development 
related intangibles. SFAS 141(R) applies prospectively to busi-
ness combinations for which the acquisition date is on or after 
the beginning of the first annual reporting period beginning on 
or after December 15, 2008. An entity may not apply it before 
that date. This pronouncement will be applied by the Company 
when it becomes effective and when or if the Company effec-
tuates a business combination, otherwise there is no impact on 
the Company’s consolidated financial statements. 

3.  Cash and Cash Equivalents
At March 31, 2009 and 2008, the Company had cash and 
cash  equivalents  of  $70,180  and  $59,046,  respectively. 
Cash  and  cash  equivalents  consist  of  cash,  money  market 
funds  and  short-term  U.S.  Treasury  securities  with  original 
maturities  of  less  than  90  days.  The  money  market  fund  in 
which the Company holds a portion of its cash invests in only 
investment grade money market instruments from a variety of 
industries, and therefore bears relatively low market risk. The 
average maturity of the investments owned by the money mar-
ket fund is approximately two months.

4.  Fair Value Measurements
Effective  April  1,  2008,  the  Company  implemented  the  re-
quirements  of  SFAS  No.  157,  “Fair  Value  Measurements” 
(SFAS  157)  for  its  financial  assets  and  liabilities.  SFAS  157 
refines the definition of fair value, expands disclosure require-
ments about fair value measurements and establishes specific 
requirements as well as guidelines for a consistent framework 
to measure fair value. SFAS 157 defines fair value as the price 
that would be received to sell an asset, or paid to transfer a 
liability, in an orderly transaction between market participants. 
Further, SFAS 157 requires the Company to maximize the use 
of observable market inputs, minimize the use of unobservable 
market inputs and disclose in the form of an outlined hierarchy 
the details of such fair value measurements. SFAS 157 speci-
fies  a  hierarchy  of  valuation  techniques  based  on  whether 
the inputs to a fair value measurement are considered to be 
observable  or  unobservable  in  a  marketplace.  Observable 
inputs reflect market data obtained from independent sources, 
while  unobservable  inputs  reflect  the  Company’s  market  as-
sumptions. This hierarchy requires the use of observable market 
data when available. These two types of inputs have created 
the following fair value hierarchy:

Level 1  Quoted market prices in active markets for identical 

assets or liabilities;

Level 2  Observable  inputs  other  than  those  included  in 
Level 1. For example, quoted prices for similar as-
sets in active markets or quoted prices for identical 
assets in inactive markets; and

Level 3  Unobservable inputs reflecting management’s own 
assumptions about the inputs used in estimating the 
value of the asset.

The  adoption  of  SFAS  157  did  not  have  a  material  
impact on the Company’s consolidated financial position or 
results of operations.

On February 12, 2008, the FASB amended the imple-
mentation of SFAS 157 related to non-financial assets and 
liabilities until fiscal periods beginning after November 15, 
2008. As a result, the Company has not applied the above 
fair  value  procedures  to  its  goodwill  and  long-lived  asset 
impairment analyses during the current year. The Company 
believes that the adoption of SFAS 157 for non-financial as-
sets and liabilities will not have a material impact on its con-
solidated financial position or results of operations.

66

The following table summarizes the Company’s financial assets measured at fair value on a recurring basis in accordance 

with SFAS 157 as of March 31, 2009 and March 31, 2008:

Cash and cash equivalents

$ 70,180 

$ 70,180 

 $              -   

 $              -   

Balance as of 
March 31, 2009

Quoted Prices in Active 
Markets For Identical 
Assets (Level 1)

Significant Other 
Observable Inputs 
(Level 2)

Unobservable Inputs 
(Level 3)

Restricted cash

Marketable securities(1)

ARS put option rights

 1,303 

 7,395 

 468 

 1,303 

 -   

 -   

 -   

 -   

 -   

 -   

 7,395 

 468 

$ 79,346 

$ 71,483 

 $              -   

 $      7,863 

Balance as of 
March 31, 2008

Quoted Prices in Active 
Markets For Identical 
Assets (Level 1)

Significant Other 
Observable Inputs 
(Level 2)

Unobservable Inputs 
(Level 3)

Cash and cash equivalents

$ 59,046 

$ 59,046 

 $              -   

 $              -   

Restricted cash

Marketable securities(1)

(1)  Marketable securities consist of ARS.

 -   

22,624 

$ 81,670 

 -   

 -   

 -   

 -   

 -   

 22,624 

$ 59,046 

 $              -   

 $   22,624

The  fair  value  of  the  Company’s  ARS,  including  the 
Company’s  ARS  put  option  rights  has  been  estimated  by 
management based on its assumptions of what market partici-
pants would use in pricing the asset in a current transaction, or 
level 3 - unobservable inputs in accordance with SFAS 157, 
and  represents  $7,863  and  $22,624  or  9.9%  and  27.7%, 
of total financial assets measured at fair value in accordance 
with SFAS 157 at March 31, 2009 and 2008, respectively. 
Management used a model to estimate the fair value of these 
securities  that  included  certain  level  2  inputs  as  well  as  as-
sumptions, such as a liquidity discount, credit rating of the is-
suers,  based  on  management’s  judgment,  which  are  highly 
subjective and therefore considered level 3 inputs in the fair 
value hierarchy. The estimate of the fair value of the ARS could 
change based on market conditions. For additional informa-
tion on cash and cash equivalents, restricted cash or market-
able securities, see Note 2.

The  following  table  presents  activity  in  the  Company’s 
assets measured at fair value using significant unobservable 
inputs (Level 3) as defined by SFAS 157 as of and for the year 
ended March 31, 2009:

Balance at March 31, 2008

$ 22,624 

Transfer in/(out) of Level 3

Proceeds from sales (at par)

Unrealized loss, net of tax

Recognition of ARS put option rights

-   

(14,825)

(404)

468 

Balance at March 31, 2009

$

7,863

Upon execution of the Rights Agreement (see Note 2), 
the Company elected to fair value the ARS put option rights un-
der SFAS No. 159, “The Fair Value Option for Financial Assets 
and Liabilities”. The Company fair valued the ARS put option 
rights at the inception of the Rights Agreement and is required 
to do so each reporting period, with corresponding changes 
in fair value being reported through earnings. The Company’s 
valuation resulted in an estimated fair value of $468 for the 
ARS put option rights as of March 31, 2009, which was rec-
ognized  in  other  (expense)  income  within  the  Consolidated 
Statement of Income for the year ended March 31, 2009 and 
is included in other assets on the Balance Sheet as of March 
31, 2009. 

Interest income related to cash and cash equivalents and 
marketable securities for each of the three years ended March 
31, 2009 is as follows:

Year ended March 31,

2009

2008

2007

Interest income 

 $ 1,203 

 $ 2,661 

 $ 3,306 

5.  Business Combinations
Acquisition of Healthcare Strategic Initiatives

On May 20, 2008, the Company acquired HSI, a full-service 
healthcare RCM company, resulting in HSI becoming a whol-
ly-owned subsidiary of QSI. HSI’s results of operations have 
been included in the consolidated financial statements since 
the date of acquisition. 

67

This acquisition is a part of the Company’s growth strat-
egy for NextGen Practice Solutions. HSI operates under the 
umbrella  of  NextGen  Practice  Solutions.  Founded  in  1996, 
HSI  currently  provides  RCM  services  to  providers  including 
health  systems,  hospitals,  and  physicians  in  private  practice 
with  an  in-house  team  of  employees  including  specialists  in 
medical billing, coding and compliance, payor credentialing, 
and  information  technology.  The  Company  intends  to  cross 
sell both software and RCM services to the acquired customer 
base of HSI and NextGen.

The purchase price totaled approximately $15,591 plus 
up to approximately $1,650 in incentives tied to future perfor-
mance. The purchase price consisted of cash and restricted 
QSI  common  stock,  subject  to  restrictions  on  resale  lapsing 
over  a  two  year  period,  and  transaction  related  costs.  The 
value  of  the  232,081  shares  of  common  stock  issued  was 
determined based on a formula which took the average of 
the closing price of QSI’s common shares during the 45 day 
trading period ending on May 19, 2008. The total purchase 
price for HSI is as follows:

Cash

Common stock

Direct transaction costs

   Total purchase price

$

8,000 

7,350 

241 

 $ 15,591

The acquisition of HSI was accounted for as a purchase 
business  combination  as  defined  in  Statement  of  Financial 
Accounting  Standards  No.  141,  “Business  Combinations” 
(SFAS  141).  Under  the  purchase  method  of  accounting,  the 
purchase price was allocated to HSI’s tangible and intangi-
ble  assets  acquired  and  liabilities  assumed  based  on  their 
estimated  fair  values  as  of  May  20,  2008.  The  fair  value 
of the assets acquired and liabilities assumed represent man-
agement’s estimate of fair value. The Company is amortizing 
the customer relationships intangible asset over six years and 
the  trade  name  over  four  years.  The  $10,839  assigned  to 
goodwill is expected to be deductible for tax purposes. See 
Notes 6 and 7 for a discussion of goodwill and intangibles 
acquired. As stated above, the Company has agreed to pay 
additional consideration in future periods, based upon the at-
tainment  by  the  acquired  entity  of  defined  operating  objec-
tives. In accordance with SFAS 141, the Company does not 
accrue contingent consideration obligations prior to attainment 
of these objectives. At March 31, 2009, the maximum poten-
tial future consideration pursuant to such arrangements, to be 
resolved over the following two years, is $1,650. Any such 
payments would result in increases in goodwill.

68

The following table summarizes the allocation of the pur-

chase price:

Current assets (including restricted  
cash of $1,470 and accounts receivable  
of $2,176)

Equipment and improvements and other 
long-term assets

   Total tangible assets acquired

Customer relationships

Trade name

Goodwill

Current liabilities, including long-term debt 
due within one year

Long-term debt

   Net assets acquired

 $

3,808 

342

 4,150 

 5,241 

 379 

 10,839 

 (4,369)

 (649)

 $ 15,591

The pro forma effects of this acquisition would not have 
been material to the Company’s results of operations for the 
year ended March 31, 2009 and therefore is not presented.

Acquisition of Practice Management Partners, Inc.

On October 28, 2008, the Company, through its NextGen 
subsidiary, acquired PMP, a full-service healthcare RCM com-
pany, resulting in PMP becoming a wholly-owned subsidiary 
of NextGen and, ultimately QSI. PMP’s results of operations 
have been included in the consolidated financial statements 
since the date of acquisition.

This  acquisition  is  also  part  of  the  Company’s  growth 
strategy for NextGen Practice Solutions. Similar to HSI, PMP 
operates under the umbrella of NextGen Practice Solutions. 
Founded in 2001, PMP provides physician billing and technol-
ogy management services to healthcare providers, primarily 
in the Mid-Atlantic region. The Company intends to cross sell 
both  software  and  RCM  services  to  the  acquired  customer 
base of PMP and NextGen.

The purchase price totaled approximately $19,700 plus 
up to approximately $3,000 in incentives tied to future per-
formance. The purchase price consisted of $16,950 in cash, 
including direct transaction costs and $2,750 in restricted QSI 
common stock, subject to restrictions on resale lapsing over a 
two year period, and transaction related costs. The value of 
the 67,733 shares of common stock issued was determined 
based  on  a  formula  which  took  the  average  of  the  closing 
price of QSI’s common shares during the 45 day trading pe-
riod ending on October 27, 2008. The total purchase price 
for PMP is as follows:

Cash

Common stock

Direct transaction costs

   Total purchase price

$ 16,622 

2,750

328

 $ 19,700

 
 
 
 
 
The  acquisition  of  PMP  was  accounted  for  as  a  pur-
chase business combination as defined in SFAS 141. Under 
the purchase method of accounting, the purchase price was 
allocated  to  PMP’s  tangible  and  intangible  assets  acquired 
and liabilities assumed based on their estimated fair values as 
of October 28, 2008. The fair value of the assets acquired 
and  liabilities  assumed  represent  management’s  estimate  of 
fair value. The Company is amortizing the customer relation-
ships  intangible  asset  over  nine  years  and  the  trade  name 
over four years. The $16,052 assigned to goodwill is not ex-
pected to be deductible for tax purposes. See Notes 6 and 
7 for a discussion of goodwill and intangibles acquired. As 
stated  above,  the  Company  has  agreed  to  pay  additional 
consideration in future periods, based upon the attainment by 
the acquired entity of defined operating objectives. In accor-
dance  with  SFAS  141,  the  Company  does  not  accrue  con-
tingent consideration obligations prior to attainment of these 
objectives. At March 31, 2009, the maximum potential future 
consideration pursuant to such arrangements, to be resolved 
over the following two years, is $3,000. Any such payments 
would result in increases in goodwill.

 The following table summarizes the allocation of the pur-

chase price:

Current assets (including restricted  
cash of $125 and accounts receivable  
of $2,029)

Equipment and improvements and other 
long-term assets

   Total tangible assets acquired

Customer relationships

Trade name

Goodwill

Current liabilities, including long-term debt 
due within one year

Long-term debt

   Net assets acquired

 $

2,518

1,485

 4,003 

3,559

259

16,052

 (1,882)

 (2,291)

 $ 19,700

The pro forma effects of this acquisition would not have 
been material to the Company’s results of operations for the 
year ended March 31, 2009 and therefore is not presented.

6.  Goodwill
In accordance with SFAS 142, the Company does not amor-
tize goodwill as the goodwill has been determined to have 
indefinite useful life. 

Goodwill consists of the following:

NextGen Healthcare Information Systems, Inc.

$  1,840 

March 31, 2009

Healthcare Strategic Initiatives

Practice Management Partners

   Total

 10,839 

 16,052 

$ 28,731 

7.  Intangible Assets – Customer  
   Relationships and Trade Name
The Company had the following intangible assets, other than 
capitalized  software  development  costs,  with  determinable 
lives as of March 31, 2009:

Customer  
Relationships

Trade Name

Total

Balance as of  
April 1, 2008

Acquisition

Amortization

Balance as of  
March 31, 2009

$

- 

$

- 

$

-

8,800 

(923)

637 

(111)

9,437 

(1,034)

$ 7,877 

$ 526 

$ 8,403 

The  following  table  represents  the  remaining  estimated 
amortization of intangible assets with determinable lives as of 
March 31, 2009:

Year ending March 31,

2010

2011

2012

2013

2014

2015 and beyond

Total

 $

1,428 

 1,428 

 1,428 

 1,317 

 1,269 

 1,533

$  8,403

69

 
 
8.  Capitalized Software Costs
As of March 31, 2009 and 2008, the Company had the following amounts related to capitalized software costs: 

Gross carrying amount 

Accumulated amortization 

Net capitalized software costs

Aggregate amortization expense during the year 

March 31, 2009

March 31, 2008

 $

33,508 

 $

27,645 

(23,956)

(18,793)

 $

 $

9,552 

5,163 

 $

 $

8,852 

4,149 

Activity related to net capitalized software costs for the years ended March 31, 2009 and 2008 is as follows:

Beginning of the year

Capitalization 

Amortization 

End of the year 

March 31, 2009

March 31, 2008

$

8,852

$

6,982

5,863

(5,163)

6,019

(4,149)

 $

9,552

$

8,852

The following table represents the remaining estimated amortization of capitalized software costs as of March 31, 2009:

Year ending March 31, 

2010 

2011 

2012 

Total 

$

5,165 

3,213 

1,174 

$

9,552

9.  Composition of Certain Financial Statement Captions
Accounts receivable include amounts related to maintenance and services which were billed but not yet rendered as of the end 
of the year. Undelivered maintenance and services are included on the accompanying Consolidated Balance Sheets as part 
of the deferred revenue balance.

Accounts receivable, excluding undelivered software, maintenance and services 

 $ 64,003 

 $ 50,417 

March 31, 2009

March 31, 2008

Undelivered software, maintenance and implementation services billed in 
advance, included in deferred revenue 

Accounts receivable, gross

Allowance for doubtful accounts

Accounts receivable, net

Inventories are summarized as follows:

Computer systems and components, net of reserve for obsolescence of  
$210 and $223, respectively

Miscellaneous parts and supplies

Inventories, net

29,944 

93,947 

(3,877)

28,696 

79,113 

(2,528)

 $ 90,070 

 $ 76,585

March 31, 2009

March 31, 2008

 $

1,105 

$

20 

992 

32 

 $

1,125 

$

1,024 

70

 
 
 
Equipment and improvements are summarized as follows:

Computer and electronic test equipment 

Furniture and fixtures 

Leasehold improvements 

Accumulated depreciation and amortization 

Equipment and improvements, net 

Accrued compensation and related benefits are summarized as follows:

Payroll, bonus and commission 

Vacation 

Accrued compensation and related benefits 

Short and long-term deferred revenue are summarized as follows:

Maintenance 

Implementation services 

Annual license services 

Undelivered software and other 

Deferred Revenue 

Other current liabilities are summarized as follows:

Care services liabilities 

Accrued EDI expenses 

Accrued royalties 

Deferred rent

Customer deposits 

Sales tax payable 

Professional fees 

Commission payable 

Other accrued expenses 

Other current liabilities 

March 31, 2009 March 31, 2008

 $ 15,384 

$ 11,454 

3,520

1,595 

20,499 

2,975

1,259 

15,688 

(13,743)

(10,915)

 $

6,756 

$

4,773

March 31, 2009

March 31, 2008

 $

5,768 

 $

5,443 

3,743 

2,903 

 $

9,511 

 $

8,346 

March 31, 2009

March 31, 2008

$

9,083 

 $ 10,175 

28,655 

8,176 

2,191 

25,929 

6,532 

2,259 

 $ 48,105 

 $ 44,895

March 31, 2009

March 31, 2008

 $

1,303 

 $

1,258 

 933 

782 

674 

 602 

 409 

 385 

- 

- 

216 

 607 

 621 

 765 

 600 

 346 

 2,542 

1,239 

 $

8,888 

 $

4,394

10. Other Expense
Other expense for the year ended March 31, 2009 consisted 
of impairment losses related to the fair value of the Company’s 
ARS  investments  as  well  as  gains  recorded  on  its  ARS  Put 
Option Rights. The Company recognized a pre-tax unrealized 
impairment charge on its ARS of $730. At the same time, the 
Company estimated the fair value of the ARS Put Option Rights 
at $468. See Note 2.

11. Other Income – Gain from Life  

Insurance Proceeds

On  September  26,  2007,  Mr.  Gregory  Flynn,  Executive 
Vice  President  and  General  Manager  of  the  Company’s 
QSI  Division  passed  away.  Mr.  Flynn  participated  in  the 
Company’s  deferred  compensation  plan  which  is  funded 
through  the  purchase  of  life  insurance  policies  with  the 
Company  named  as  beneficiary.  As  a  result  of  Mr.  Flynn’s 

71

 
 
 
passing, for the year ended March 31, 2008 the Company 
recorded  additional  compensation  expense  of  $198  which 
was offset by net insurance proceeds of $953. The additional 
compensation expense was recorded in Selling, General and 
Administrative Expenses and the insurance proceeds were re-
corded  as  Other  Income  in  the  Consolidated  Statement  of 
Income during fiscal year 2008. 

12. Income Taxes
During the years ended March 31, 2009, 2008 and 2007, 
the Company claimed federal research and development tax 
credits of $859, $779 and $787, respectively, and state re-
search and development tax credits of approximately $166, 
$113  and  $99,  respectively.  Due  to  the  expiration  of  the 

Internal  Revenue  Service  statute  related  to  research  and  de-
velopment  credits  on  December  31,  2007,  the  Company’s 
research and development credits for the year ended March 
31,  2008  represent  credits  for  the  nine-month  period  from 
April 1, 2007 through December 31, 2007. The Company 
also claimed the qualified production activities deduction un-
der  Section  199  of  the  Internal  Revenue  Code  for  $2,747, 
$3,069  and  $1,457  during  the  years  ended  March  31, 
2009, 2008 and 2007, respectively. The research and devel-
opment credits and the qualified production activities income 
deduction taken by the Company involve certain assumptions 
and judgments regarding qualification of expenses under the 
relevant tax code provisions.

The provision (benefit) for income taxes consists of the following components:

Current:

Federal taxes 

State taxes 

Total 

Deferred:

Federal taxes 

State taxes 

Total 

Total 

Year ended March 31,

2009

2008

2007

 $ 18,818 

 $ 18,120 

 $ 18,106 

4,992 

23,810 

4,348 

22,468 

4,488 

22,594 

2,802 

596 

3,398 

333 

124 

457 

(1,347)

(295)

(1,642)

 $ 27,208 

 $ 22,925 

 $ 20,952

The provision for income taxes differs from the amount computed at the federal statutory rate as follows:

Year ended March 31,

Current:

Federal income tax statutory rate 

Increase (decrease) resulting from:

   State income taxes, net of Federal benefit 

   Research and development tax credits 

   Qualified Production Activities Income Deduction

   Other 

Effective income tax rate 

2009

35.0%

5.2 

(1.3)

(1.4)

(0.4)

37.1%

2008

35.0%

4.8 

(1.3)

(1.8)

(0.3)

36.4%

2007

35.0%

5.0 

(1.7)

(0.9)

1.3 

38.7%

72

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The net deferred tax assets (liabilities) in the accompanying Consolidated Balance Sheets consist of the following:

March 31, 2009 March 31, 2008

Deferred tax assets:

   Deferred revenue and allowance for doubtful accounts 

 $

3,271 

$ 4,534 

   Inventory valuation 

   Purchased in-process research and development 

   Intangibles assets 

   Accrued compensation and benefits 

   Deferred compensation 

   State income taxes 

   Compensatory stock option expense 

   Unrealized loss on marketable securities 

   Other 

      Total deferred tax assets 

Deferred tax liabilities:

   Accelerated depreciation 

   Capitalized software 

   Intangibles assets 

   Prepaid expense 

       Total deferred tax liabilities 

       Deferred tax assets (liabilities), net

100 

912 

 - 

1,955 

789 

185 

125 

 - 

779 

137 

1,187 

102 

1,701 

806 

92 

1,139 

130 

801 

8,116 

10,629 

(1,114)

(4,126)

(1,412)

(2,036)

(8,688)

(545)

(3,746)

 - 

(1,516)

(5,807)

 $

(572)

 $ 4,822

The deferred tax assets and liabilities have been shown 
net in the accompanying Consolidated Balance Sheets based 
on the long-term or short-term nature of the items which give 
rise to the deferred amount. No valuation allowance has been 
made against the deferred tax assets as management expects 
to receive the full benefit of the assets recorded.

On April 1, 2007, the Company adopted the provisions 
of FASB Interpretation No. 48, “Accounting for Uncertainty in 
Income  Taxes  (FIN  48)  an  interpretation  of  FASB  Statement 
No.  109  (SFAS  109).”  The  adoption  of  the  provisions  of 
FIN 48 had no material effect on the consolidated financial 
statements. As a result, there was no cumulative effect related 
to  adopting  FIN  48.  However,  certain  amounts  have  been 
reclassified  in  the  Company’s  Consolidated  Balance  Sheets 
in  order  to  comply  with  the  requirements  of  the  statement. 
At  adoption,  the  Company  had  $394  of  unrecognized  tax 
benefits,  $89  of  which  would  affect  the  Company’s  effec-
tive tax rate if recognized in the future. A reconciliation of the 
beginning and ending amount of unrecognized tax benefits, 
which is recorded in income taxes payable in the Company’s 
Consolidated Balance Sheet, is as follows:

Balance at April 1, 2008 

Additions for prior year tax positions 

Reductions for prior year tax positions 

Balance at March 31, 2009 

 $ 613 

15 

(561)

 $

67

The total amount of unrecognized tax benefit that, if rec-

ognized, would decrease the income tax provision is $67.

The Company’s continuing practice is to recognize esti-
mated interest and/or penalties related to income tax matters 
in  general  and  administrative  expenses.  The  Company  had 
approximately $12 and $8 of accrued interest at March 31, 
2009 and 2008, respectively. No penalties were accrued.

Uncertain tax positions 
The Company’s income tax returns filed for tax years 2005 
through  2007  and  2004  through  2007  are  subject  to  ex-
amination by the federal and state taxing authorities, respec-
tively. The Company is currently not under examination by the 
Internal Revenue Service (IRS). However, the Company is un-
der routine examination by three states. The Company does 
not anticipate that total unrecognized tax benefits will signifi-
cantly change due to the settlement of audits or the expiration 
of statute of limitations within the next twelve months. 

13. Employee Benefit Plans 
The Company has a 401(k) plan available to substantially all 
of its employees. Participating employees may defer up to the 
Internal Revenue Service limit based on the Internal Revenue 
Code per year. The annual contribution is determined by a 
formula  set  by  the  Company’s  Board  of  Directors  and  may 

73

include  matching  and/or  discretionary  contributions.  The 
amount of the Company match is discretionary and subject to 
change. The retirement plans may be amended or discontin-
ued at the discretion of the Board of Directors. Contributions 
of $357, $317 and $250 were made by the Company to 
the 401(k) plan for the fiscal years ended March 31, 2009, 
2008 and 2007, respectively.

The  Company  has  a  deferred  compensation  plan  (the 
Deferral Plan) for the benefit of those officers and employees 
who qualify for inclusion. Participating employees may defer 
up to 75% of their salary and 100% of their annual bonus for 
a Deferral Plan year. In addition, the Company may, but is not 
required to, make contributions into the Deferral Plan on behalf 
of participating employees, and the amount of the Company 
match is discretionary and subject to change. Each employee’s 
deferrals together with earnings thereon are accrued as part of 
the long-term liabilities of the Company. Investment decisions 
are made by each participating employee from a family of 
mutual  funds  (“insurance  subaccounts”).  Deferred  compensa-
tion liability was $1,838 and $1,906 at March 31, 2009 and 
2008, respectively. To offset this liability, the Company has 
purchased life insurance policies on some of the participants. 
The  Company  is  the  owner  and  beneficiary  of  the  policies 
and the cash values are intended to produce cash needed 
to help make the benefit payments to employees when they 
retire or otherwise leave the Company. The Company intends 
to  hold  the  life  insurance  policy  until  the  death  of  the  plan 
participant. The net cash surrender value of the life insurance 
policies for deferred compensation was $1,715 and $1,858 
at March 31, 2009 and 2008, respectively. The values of the 
life insurance policies and the related Company obligation are 
included on the accompanying Consolidated Balance Sheets 
in  long-term  other  assets  and  long-term  deferred  compensa-
tion, respectively. The Company made contributions of $29 to 
the Deferral Plan for each of the fiscal years ended March 31, 
2009, 2008 and 2007, respectively.

The Company has a voluntary employee stock contribu-
tion  plan  for  the  benefit  of  full-time  employees.  The  plan  is 
designed to allow certain employees to acquire shares of the 
Company’s common stock through automatic payroll deduc-
tion.  Each  eligible  employee  may  authorize  the  withholding 
of  up  to  10%  of  his/her  gross  payroll  each  pay  period  to 
be  used  to  purchase  shares  on  the  open  market  by  a  bro-
ker designated by the Company. In addition, the Company 
will match 5% of each employee’s contribution and will pay 
all brokerage commissions and fees in connection with each 
purchase. The amount of the Company match is discretionary 
and  subject  to  change.  The  plan  is  not  intended  to  be  an 
employee benefit plan under the Employee Retirement Income 
Security Act of 1974, and is therefore not required to comply 

74

with that Act. Contributions of approximately $14, $28 and 
$10 were made by the Company for the fiscal years ended 
March 31, 2009, 2008 and 2007, respectively.

14. Employee Stock Option Plans
In September 1998, the Company’s shareholders approved a 
stock option plan (the “1998 Plan”) under which 4,000,000 
shares of Common Stock were reserved for the issuance of op-
tions. The 1998 Plan provides that employees, directors and 
consultants of the Company, at the discretion of the Board of 
Directors or a duly designated compensation committee, be 
granted  options  to  purchase  shares  of  Common  Stock.  The 
exercise  price  of  each  option  granted  shall  be  determined 
by the Board of Directors at the date of grant, and options 
under the 1998 Plan expire no later than ten years from the 
grant  date.  Options  granted  will  generally  become  exercis-
able in accordance with the terms of the agreement pursuant 
to  which  they  were  granted.  Certain  option  grants  to  direc-
tors became exercisable three months from the date of grant. 
Upon an acquisition of the Company by merger or asset sale, 
each outstanding option may be subject to accelerated vest-
ing  under  certain  circumstances.  The  1998  Plan  terminated 
on December 31, 2007. As of March 31, 2009, there were 
496,751 outstanding options related to this Plan.

In  October  2005,  the  Company’s  shareholders  ap-
proved a stock option and incentive plan (the “2005 Plan”) 
under which 2,400,000 shares of Common Stock have been 
reserved for the issuance of awards, including stock options, 
incentive stock options and non-qualified stock options, stock 
appreciation rights, restricted stock, unrestricted stock, restrict-
ed stock units, performance shares, performance units (includ-
ing performance options) and other share-based awards. The 
2005 Plan provides that employees, directors and consultants 
of the Company, at the discretion of the Board of Directors or a 
duly designated compensation committee, be granted awards 
to purchase shares of Common Stock. The exercise price of 
each  award  granted  shall  be  determined  by  the  Board  of 
Directors at the date of grant in accordance with the terms of 
the 2005 Plan, and under the 2005 Plan awards expire no 
later than ten years from the grant date. Options granted will 
generally become exercisable in accordance with the terms 
of the agreement pursuant to which they were granted. Upon 
an acquisition of the Company by merger or asset sale, each 
outstanding award may be subject to accelerated vesting un-
der certain circumstances. The 2005 Plan terminates on May 
25, 2015, unless terminated earlier by the Board. At March 
31, 2009, 2,076,699 shares were available for future grant 
under  the  2005  Plan.  As  of  March  31,  2009,  there  were 
323,331 outstanding options related to this Plan.

A summary of stock option transactions during the years ended March 31, 2009, 2008 and 2007 is as follows:

Number of Shares

Weighted Average 
Exercise Price

Weighted Average 
Remaining  
Contractual Life

Aggregate Intrinsic Value 
(in thousands)

Outstanding, March 31, 2006 

 1,798,372 

Granted 

Exercised 

Forfeited/Canceled 

 75,000 

 (411,414)

 (8)

Outstanding, March 31, 2007 

 1,461,950 

Granted 

Exercised 

Forfeited/Canceled 

 225,500 

 (325,266)

 (58,450)

Outstanding, March 31, 2008 

 1,303,734 

Granted 

Exercised 

Forfeited/Canceled 

 298,331 

 (697,083)

 (84,900)

Outstanding, March 31, 2009 

 820,082 

 $ 16.78 

 $  38.36

 $ 14.74 

 $

3.25 

 $ 18.46 

 $  38.78

 $ 14.64 

 $  21.12

 $ 22.81 

 $ 38.71 

 $ 17.96 

 $  25.93

 $ 32.39 

-

-

-

-

-

 4.31

 2.48 

 3.33

 3.40 

 4.62 

 2.27 

 2.89

 3.63 

-

-

$ 10,393 

-

-

-

$

4,955 

-

$ 12,220 

-

$ 17,182 

-

-

Vested and expected to vest, 
March 31, 2009 

 811,056 

 $  32.32

 3.62

 $ 10,496 

Exercisable, March 31, 2007 

Exercisable, March 31, 2008 

Exercisable, March 31, 2009 

 520,650 

 654,298 

 354,737 

 $ 20.32 

 $ 19.90 

 $ 24.25 

-

-

-

-

 2.84 

$

7,448 

The Company continues to utilize the Black-Scholes valuation model for estimating the fair value of share-based compensa-

tion after the adoption of SFAS 123R with the following assumptions: 

Expected life 

Expected volatility 

Expected dividends 

Risk-free rate 

Year Ended
March 31, 2009

4.01 years

42.00% - 46.70%

2.90% - 3.50%

1.07% - 3.40%

Year Ended
March 31, 2008

3.75 - 4.01 years

42.37% - 44.81%

2.67% - 3.38%

2.46% - 5.09%

Year Ended
March 31, 2007

3.75 - 4.75 years

47.70% - 48.50%

2.05% - 2.36%

4.53% - 5.09%

During  the  year  ended  March  31,  2009,  298,331  
options were granted under the 2005 Plan and no options 
were granted under the 1998 Plan. During the year ended 
March  31,  2008,  25,000  options  were  granted  under  the 
2005  Plan  and  200,500  were  granted  under  the  1998 
Plan. The Company issues new shares to satisfy option exer-
cises. Based on historical experience of option cancellations, 
the Company has estimated an annualized forfeiture rate of 
1.94% for employee options and 0.0% for director options for 
the year ended March 31, 2009. Based on historical expe-
rience  of  option  cancellations,  the  Company  has  estimated 
an  annualized  forfeiture  rate  ranging  of  2.0%  for  employee 
options  and  0.0%  for  director  options  for  the  year  ended 
March 31, 2008. The weighted average grant date fair value 
of stock options granted during the years ended March 31, 
2009, 2008 and 2007 was $11.22, $12.41 and $14.33 

per  share,  respectively.  The  expected  dividend  yield  is  the 
average dividend rate during a period equal to the expected 
life of the option.

On  November  5,  2008,  the  Board  of  Directors  grant-
ed  a  total  of  80,141  options  under  the  Company’s  2005 
Plan to selected employees at an exercise price equal to the 
market price of the Company’s common stock on the date of 
grant ($42.20 per share). The options vest in four equal an-
nual  installments  beginning  November  5,  2009  and  expire 
on November 5, 2013. The fair value of these options was 
$12.48 per share.

On September 9, 2008, the Board of Directors granted 
a total of 35,000 options under the Company’s 2005 Plan 
to non-management directors pursuant to the Company’s pre-
viously  announced  compensation  plan  for  non-management 

75

directors, at an exercise price equal to the market price of the 
Company’s common stock on the date of grant ($45.61 per 
share). The options vest in four equal annual installments begin-
ning September 9, 2009 and expire on September 9, 2015. 
The fair value of these options was $13.21 per share.

On August 18, 2008, the Board of Directors granted a 
total of 50,000 options under the Company’s 2005 Plan to 
an employee at an exercise price equal to the market price of 
the Company’s common stock on the date of grant ($40.08 
per share). The options vest in four equal annual installments 
beginning August 18, 2009 and expire on August 18, 2013. 
The fair value of these options was $11.72 per share.

On August 11, 2008, the Board of Directors granted a 
total of 25,000 options under the Company’s 2005 Plan to se-
lected employees at an exercise price equal to the market price 
of the Company’s common stock on the date of grant ($40.71 
per share). The options vest in four equal annual installments 
beginning August 11, 2009 and expire on August 11, 2013. 
The fair value of these options was $11.96 per share.

On  June  13,  2008,  the  Board  of  Directors  granted  a  
total of 108,190 options under the Company’s 2005 Plan to 
selected employees at an exercise price equal to the market 
price of the Company’s common stock on the date of grant 
($32.79 per share). The options vest in four equal annual in-
stallments beginning June 13, 2009 and expire on June 13, 
2013. The fair value of these options was $9.24 per share.

On May 31, 2008, the Board of Directors approved a 
performance-based  equity  incentive  program  for  employees 
to be awarded options to purchase the Company’s common 
stock based on meeting certain target increases in earnings 
per share performance and revenue growth during fiscal year 
2009. Under the program, options may also be granted as 
an incentive to prospective employees to join the Company. 
If earned, the options shall be issued pursuant to one of the 
Company’s  shareholder  approved  option  plans,  have  an 
exercise  price  equal  to  the  closing  price  of  the  Company’s 
shares on the date of grant, a term of five years, vesting in 
four  equal  installments  commencing  one  year  following  the 
date of grant. The maximum number of options available un-
der the performance-based equity incentive program plan is 
285,000, of which 20,000 is reserved for new employees 
(such new employee grants not being subject to the earnings 
and revenue criteria set forth above). Based on performance 
versus established plan targets, no expense related to the per-
formance plan was recorded for the year ended March 31, 
2009 and no options were issued under the program in fiscal 
year 2009.

On February 8, 2008, the Board of Directors granted 
25,000 options under the Company’s 2005 Plan to selected 
employees, at an exercise price equal to the market price of 
the Company’s common stock on the date of grant ($33.51 
per share). The options vest in four equal annual installments 
beginning  February  8,  2009  and  expire  on  February  8, 
2013. The fair value of these options was $9.42 per share.

On November 5, 2007, the Board of Directors granted 
6,000  options  under  the  Company’s  1998  Plan  to  an  em-
ployee, at an exercise price equal to the market price of the 
Company’s common stock on the date of grant ($33.25 per 
share). The options vest in four equal annual installments begin-
ning November 5, 2008 and expire on November 5, 2012. 
The fair value of these options was $9.69 per share.

On  August  9,  2007,  the  Board  of  Directors  granted  a 
total of 35,000 options under the Company’s 1998 Plan to 
non-management directors pursuant to the Company’s previ-
ously  announced  compensation  plan  for  non-management 
directors, at an exercise price equal to the market price of the 
Company’s common stock on the date of grant ($43.26 per 
share). The options vest in four equal annual installments begin-
ning August 9, 2008 and expire on August 9, 2012. The fair 
value of these options was $12.97 per share. 

On  June  12,  2007,  the  Board  of  Directors  granted  a  
total of 159,500 options under a previously approved perfor-
mance-based equity incentive program for selected employ-
ees based on fiscal year 2007 performance. These shares 
were issued under the Company’s 1998 Stock Option Plan at 
an exercise price equal to the market price of the Company’s 
common stock on the date of grant ($38.83 per share). The 
options vest in four equal annual installments beginning June 
12,  2008  and  expire  on  June  12,  2012.  The  fair  value  of 
these options was $12.86 per share. 

On September 20, 2006, the Board of Directors granted 
a total of 35,000 options under the Company’s 1998 Plan 
to non-management directors pursuant to the Company’s pre-
viously  announced  compensation  plan  for  non-management 
directors, at an exercise price equal to the market price of the 
Company’s common stock on the date of grant ($39.81 per 
share). The options vest in four equal annual installments be-
ginning September 20, 2007 and expire on September 20, 
2013. The fair value of these options was $15.52 per share. 

On August 11, 2006, the Board of Directors granted a 
total of 40,000 options under the Company’s 1998 Plan to 
selected employees at an exercise price equal to the market 
price  of  the  Company’s  common  stock  on  the  date  of  the 
grant ($37.09 per share). The options vest in four equal an-
nual installments beginning August 11, 2007 and expire on 
August 11, 2011. The fair value of these options was $13.29 
per share. 

76

at  various  dates  through  May  2013  with  rent  escalation 
clauses.  Rent  expense  related  to  these  leases  is  recognized 
on a straight-line basis over the lease terms. Rent expense for 
the  years  ended  March  31,  2009,  2008  and  2007  was 
$3,560,  $2,737  and  $2,329,  respectively.  Rental  commit-
ments under these agreements are as follows: 

Year Ending March 31, 

2010 

2011 

2012 

2013 

2014 

 $   4,475 

 4,311 

 2,439 

 985 

 135 

 $  12,345

Commitments and Guarantees. Software license agreements 
in  both  the  QSI  and  NextGen  Divisions  include  a  perfor-
mance guarantee that the Company’s software products will 
substantially operate as described in the applicable program 
documentation  for  a  period  of  365  days  after  delivery.  To 
date, the Company has not incurred any significant costs as-
sociated with these warranties and does not expect to incur 
significant warranty costs in the future. Therefore, no accrual 
has been made for potential costs associated with these war-
ranties. Certain arrangements also include performance guar-
antees  related  to  response  time,  availability  for  operational 
use,  and  other  performance-related  guarantees.  Certain  ar-
rangements also include penalties in the form of maintenance 
credits  should  the  performance  of  the  software  fail  to  meet 
the performance guarantees. To date, the Company has not 
incurred any significant costs associated with these warranties 
and does not expect to incur significant warranty costs in the 
future. Therefore, no accrual has been made for potential costs 
associated with these warranties.

The Company has historically offered short-term rights of 
return in certain sales arrangements. If the Company is able 
to  estimate  returns  for  these  types  of  arrangements  and  all 
other criteria for revenue recognition have been met, revenue 
is  recognized  and  these  arrangements  are  recorded  in  the 
consolidated financial statements. If the Company is unable 
to estimate returns for these types of arrangements, revenue is 
not  recognized  in  the  consolidated  financial  statements  until 
the rights of return expire, provided also, that all other criteria 
of revenue recognition have been met.

On July 25, 2006, the Board of Directors approved a 
performance-based  equity  incentive  program  for  employees 
to be awarded options to purchase the Company’s common 
stock based on meeting certain target increases in earnings 
per  share  performance  and  revenue  growth  during  fiscal 
year  2007.  The  options  shall  be  issued  pursuant  to  one  of 
the Company’s shareholder approved option plans, have an 
exercise  price  equal  to  the  closing  price  of  the  Company’s 
shares on the date of grant, a term of five years, vest in four 
equal  installments  commencing  one  year  following  the  date 
of grant. The maximum number of options originally available 
under the performance-based equity incentive program plan 
was 115,000. On January 29, 2007, a committee comprised 
of all the independent directors of the Board of Directors modi-
fied the Company’s previously approved performance based 
equity incentive program for employees. Modifications to the 
program included an increase in the maximum number of op-
tions available under the program from 115,000 to 290,000 
and  revisions  to  certain  revenue  targets.  Compensation  ex-
pense  of  $425  for  these  options  was  recorded  in  the  year 
ended  March  31,  2007.  A  total  of  159,500  options  was 
granted during the quarter ended June 30, 2007 based on 
the  achievement  of  certain  fiscal  2007  revenue  and  earn-
ings per share performance targets included in the fiscal year 
2007 equity incentive program. 

Non-vested  stock  option  award  activity,  including 
awards for the year ended March 31, 2009, is summarized 
as follows:

Weighted-
Average 
Grant Date 
Fair Value per 
Share

Non-vested 
Number of 
Shares

Non-vested, March 31, 2008 

649,436 

 $

9.57 

Granted 

Vested 

298,331 

 $ 11.22 

(397,522)

 $

8.14 

Forfeited/Canceled 

(84,900)

 $ 10.17 

Non-vested, March 31, 2009 

465,345 

 $ 11.74 

As of March 31, 2009, $5,282 of total unrecognized 
compensation  costs  related  to  stock  options  is  expected  to 
be  recognized  over  a  weighted  average  period  of  4.23 
years. This amount does not include the cost of new options 
that may be granted in future periods nor any changes in the 
Company’s forfeiture percentage. The total fair value of shares 
vested during the year ended March 31, 2009 was $3,236.

15. Commitments, Guarantees  

and Contingencies

Rental Commitments. The Company leases facilities and of-
fices under irrevocable operating lease agreements expiring 

77

 
The  Company’s  standard  sales  agreements  in  the 
NextGen  Division  contain  an  indemnification  provision  pur-
suant  to  which  it  shall  indemnify,  hold  harmless,  and  reim-
burse the indemnified party for losses suffered or incurred by 
the  indemnified  party  in  connection  with  any  United  States 
patent,  any  copyright  or  other  intellectual  property  infringe-
ment  claim  by  any  third  party  with  respect  to  its  software. 
The QSI Division arrangements occasionally utilize this type 
of language as well. As the Company has not incurred any 
significant costs to defend lawsuits or settle claims related to 
these indemnification agreements, the Company believes that 
its estimated exposure on these agreements is currently mini-
mal. Accordingly, the Company has no liabilities recorded for 
these indemnification obligations. 

From  time  to  time,  the  Company  offers  future  purchase 
discounts on its products and services as part of its sales ar-
rangements. Discounts which are incremental to the range of 
discounts reflected in the pricing of the other elements of the 
arrangement, which are incremental to the range of discounts 
typically given in comparable transactions, and which are sig-
nificant, are treated as an additional element of the contract 
to be deferred. Amounts deferred related to future purchase 
options are not recognized until either the customer exercises 
the discount offer or the offer expires.

The Company has entered into marketing assistance agree-
ments with existing users of the Company’s products which pro-
vide the opportunity for those users to earn commissions if and 
only if they host specific site visits upon the Company’s request 
for  prospective  customers  which  directly  result  in  a  purchase 
of the Company’s software by the visiting prospects. Amounts 
earned by existing users under this program are treated as a 
selling expense in the period when earned. 

Litigation. The Company has experienced certain legal claims 
by  parties  asserting  that  it  has  infringed  certain  intellectual 
property rights. The Company believes that these claims are 
without  merit  and  the  Company  has  defended  them  vigor-
ously. However, in order to avoid the further legal costs and 
diversion of management resources it is reasonably possible 
that  a  settlement  may  be  reached  which  could  result  in  a  
liability to the Company. However, at this time it is not possible 
to estimate with reasonable certainty what amount, if any, may 
be incurred as a result of a settlement. Litigation is inherently 
uncertain and always difficult to predict.

16. Operating Segment Information
The Company has prepared operating segment information in 
accordance with SFAS 131 “Disclosures About Segments of 
an Enterprise and Related Information,” to report components 
that  are  evaluated  regularly  by  its  chief  operating  decision 
maker, or decision making group in deciding how to allocate 
resources  and  in  assessing  performance.  Reportable  oper-
ating  segments  include  the  NextGen  Division  and  the  QSI 
Division. The results of operations related to the HSI and PMP 
acquisitions are included in the NextGen Division. 

The two divisions operate largely as stand-alone opera-
tions, with each division maintaining its own distinct product 
lines,  product  platforms,  development,  implementation  and 
support teams, sales staffing, and branding. The two divisions 
share the resources of the Company’s “corporate office” which 
includes a variety of accounting and other administrative func-
tions. Additionally, there are a small number of clients who are 
simultaneously utilizing software from each of the Company’s 
two divisions.

The  QSI  Division,  co-located  with  the  Company’s 
Corporate Headquarters in Irvine, California, currently focuses 
on developing, marketing and supporting software suites sold 
to  dental  and  certain  niche  medical  practices.  In  addition, 
the division supports a number of medical clients that utilize 
the division’s UNIX based medical practice management soft-
ware  product.  The  NextGen  Division,  with  headquarters  in 
Horsham,  Pennsylvania,  and  significant  locations  in  Atlanta, 
Georgia,  St.  Louis,  Missouri  and  Hunt  Valley,  Maryland,  
focuses principally on developing and marketing products and 
services for medical practices.

The accounting policies of the Company’s operating seg-
ments are the same as those described in Note 2 – Summary 
of  Significant  Accounting  Policies,  except  that  the  disaggre-
gated  financial  results  of  the  segments  reflect  allocation  of 
certain functional expense categories consistent with the basis 
and manner in which Company management internally disag-
gregates financial information for the purpose of assisting in 
making internal operating decisions. Certain corporate over-
head  costs,  such  as  executive  and  accounting  department 
personnel-related expenses, are not allocated to the individual 
segments  by  management.  Management  evaluates  perfor-
mance  based  on  stand-alone  segment  operating  income. 
Because the Company does not evaluate performance based 
on return on assets at the operating segment level, assets are 
not  tracked  internally  by  segment.  Therefore,  segment  asset 
information is not presented. All of the recorded goodwill at 
March 31, 2009 relates to the Company’s NextGen Division 
including HSI and PMP. 

78

Operating segment data for the three years ended March 31 was as follows:

2009

Revenue 

     QSI Division

 NextGen Division

Unallocated 
Corporate 
Expenses

 Consolidated

 $ 15,852 

 $ 229,663 

 $

- 

 $

245,515 

Operating income (loss) 

3,385 

83,778

(14,760)

72,403

2008

Revenue 

Operating income (loss) 

2007

Revenue 

Operating income (loss) 

  16,037

  170,463

 -

3,662 

66,558 

(10,831)

186,500

59,389

16,589 

4,391 

140,576 

 - 

56,317 

(9,830)

157,165 

50,878

17. Subsequent Events
On  May  27,  2009,  the  Board  approved  a  quarterly  cash 
dividend of $0.30 per share on the Company’s outstanding 

shares of common stock, payable to shareholders of record 
as of June 12, 2009 with an expected distribution date on or 
about July 6, 2009. 

79

 
 
 
 
18. Selected Quarterly Operating Results (unaudited)
The following table presents quarterly unaudited consolidated financial information for the eight quarters in the period ended 
March 31, 2009. Such information is presented on the same basis as the annual information presented in the accompanying 
consolidated financial statements. In management’s opinion, this information reflects all adjustments that are necessary for a fair 
presentation of the results for these periods. 

06/30/07

09/30/07

12/31/07

03/31/08

06/30/08

09/30/08

12/31/08

03/31/09

Quarter Ended (Unaudited)

Revenues:
   Software, hardware and supplies
   Implementation and training services
System sales

   Maintenance
   Electronic data interchange services
   RCM and related services
   Other services
Maintenance, EDI, RCM and other 
services

$ 16,739  $ 18,514  $ 20,591  $ 20,519  $ 21,369  $ 21,297  $ 22,336  $ 20,384 
3,629 
24,013 

 2,675 
 25,011 

3,585 
24,954 

3,115 
23,706 

3,182 
21,696 

3,486 
24,783 

3,861 
24,380 

3,248 
19,987 

12,559 
 5,024 
 134 
 4,328 

 13,442 
 5,406 
 222 
 4,380 

 14,861 
 5,739 
 256 
 3,528 

 15,593 
 6,281 
 259 
 4,719 

 17,136 
 6,670 
 1,957 
 4,507 

 17,234 
 6,985 
 4,527 
 5,452 

 19,152 
 8,008 
 6,835 
 6,473 

19,340 
7,859 
8,112 
6,507 

 22,045 

 23,450 

 24,384 

 26,852 

 30,270 

 34,198 

 40,468 

41,818 

   Total revenue

 42,032 

 45,146 

 48,090 

 51,232 

 55,224 

 58,981 

 65,479 

65,831 

Cost of revenue:
   Software, hardware and supplies

 2,488 

 2,477 

 2,984 

 2,938 

 3,486 

 3,395 

 3,030 

   Implementation and training services

 2,409 

 2,423 

 2,638 

 2,871 

 3,015 

 2,626 

 2,143 

   Total cost of system sales

 4,897 

 4,900 

 5,622 

 5,809 

 6,501 

 6,021 

 5,173 

   Maintenance
   Electronic data interchange services
   RCM and related services
   Other services
Total cost of maintenance, EDI, RCM
and other services
   Total cost of revenue
   Gross profit

Operating expenses:
   Selling, general and administrative
   Research and development costs
   Total operating expenses
Income from operations
Interest income
Other income (expense)
Income before provision for income 
taxes
Provision for income taxes
   Net income

Net income per share
   Basic*
   Diluted*

Weighted average shares outstanding:
   Basic
   Diluted
Dividends declared per common share

 3,127 
 3,509 
 98 
 2,911 

 3,033 
 3,742 
 138 
 2,962 

 3,131 
 4,162 
 166 
 3,067 

 3,155 
 4,363 
 156 
 3,553 

 3,082 
 4,891 
 1,305 
 3,448 

 2,947 
 5,256 
 3,132 
 3,866 

 2,826 
 5,541 
 4,475 
 5,085 

 9,645 
 14,542 
 27,490 

 9,875 
 14,775 
 30,371 

 10,526 
 16,148 
 31,942 

 11,227 
 17,036 
 34,196 

 12,726 
 19,227 
 35,997 

 15,201 
 21,222 
 37,759 

 17,927 
 23,100 
 42,379 

19,566 
25,341 
40,490 

 12,643 
 2,800 
 15,443 
 12,047 
 739 
 - 

 13,188 
 2,688 
 15,876 
 14,495 
 645 
 - 

 13,283 
 2,874 
 16,157 
 15,785 
 710 
 953 

 14,146 
 2,988 
 17,134 
 17,062 
 567 
 - 

 15,252 
 3,119 
 18,371 
 17,626 
 374 
 - 

 18,283 
 3,342 
 21,625 
 16,134 
 340 
 - 

 18,601 
 3,624 
 22,225 
 20,154 
 328 
 - 

18,309 
3,692 
22,001 
18,489 
161 
(279)

 12,786 
 4,846 

18,371 
7,015 
$   7,940  $   9,672  $ 11,214  $ 11,252  $ 11,114  $ 10,499  $ 13,150  $ 11,356 

 17,448 
 6,234 

 18,000 
 6,886 

 20,482 
 7,332 

 16,474 
 5,975 

 15,140 
 5,468 

 17,629 
 6,377 

$     0.29  $     0.35  $     0.41  $     0.41  $     0.40  $     0.38  $     0.46  $     0.40 
$     0.29  $     0.35  $     0.40  $     0.41  $     0.40  $     0.37  $     0.46  $     0.40 

27,134
27,657

28,393 
28,526 
$     0.25  $     0.25  $     0.25  $     0.25  $     0.25  $     0.30  $     0.30  $     0.30

27,465 
27,771 

27,930 
28,211 

27,408 
27,712 

28,340 
28,473 

27,362
27,696

27,287
27,718

3,273 

2,502 

5,775 

3,004 
5,686 
 5,762 
5,114 

*Quarterly EPS will not sum to annual EPS due to rounding

80

Schedule II

Allowance For Doubtful Accounts
(in thousands)

Balance at  
Beginning of Year

Additions Charged to 
Costs and Expenses

$

$

$

2,528 

2,438 

2,556 

$

$

$

2,089 

1,171 

1,480 

Allowance For Inventory Obsolescence
(in thousands)

Balance at  
Beginning of Year

Additions Charged to 
Costs and Expenses

$

$

$

223 

324 

304 

$

$

$

-   

52 

35 

Deductions

$

(740)

$ (1,081)

$ (1,598)

Deductions

$

(13)

$ (153)

$

(15)

Balance at  
End of Year

$

$

$

3,877 

2,528 

2,438 

Balance at  
End of Year

$

$

$

210 

223 

324

Index to Exhibits Attached to This Report

For the Year Ended

March 31, 2009

March 31, 2008

March 31, 2007

For the Year Ended

March 31, 2009

March 31, 2008

March 31, 2007

Exhibit  
Number  Description

21 

23 

31.1 

31.2 

32.1 

List of Subsidiaries

Consent of Independent Registered Public Accounting Firm – Grant Thornton LLP

Certification of Principal Executive Officer Required by Rule 13a-14(a) of the Securities Exchange Act of 1934, as amended, as 
Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 

Certification of Principal Financial Officer Required by Rule 13a-14(a) of the Securities Exchange Act of 1934, as amended, as 
Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002 

Certification of Chief Executive Officer and Chief Financial Officer Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to 
Section 906 of the Sarbanes-Oxley Act of 2002

Exhibit 21

Quality Systems, Inc. – List of Subsidiaries
1. 
2. 
3. 

NextGen Healthcare Information Systems, Inc.
Lackland Acquisition II, LLC dba Healthcare Strategic Initiatives 
Practice Management Partners, Inc.

Exhibit 23

Consent of Independent Registered Public Accounting Firm
We have issued our reports dated May 27, 2009, with respect to the consolidated financial statements, schedule, and internal 
control over financial reporting included in the Annual Report of Quality Systems, Inc. on Form 10-K for the year ended March 
31, 2009. We hereby consent to the incorporation by reference of said reports in the Registration Statements of Quality Systems, 
Inc. on (i) Forms S-8 (File No. 33-31949, effective November 6, 1989, File No. 33-63131, effective September 10, 1989, File 
No. 333-67115, effective November 12, 1998 and File No. 333-129752, effective November 16, 2005) and (ii) Form S-3 
(File No. 333-155489, effective December 4, 2008). 

/s/ GRANT THORNTON LLP

Irvine, California 
May 27, 2009

81

Exhibit 31.1

Certification of Principal Executive Officer Required by Rule 13A-14(A) of the Securities 
Exchange Act of 1934, as Amended, as Adopted Pursuant to Section 302 of the  
Sarbanes-Oxley Act Of 2002

I, Steven T. Plochocki, certify that: 

1. 

2. 

3. 

4. 

I have reviewed this Form 10-K of Quality Systems, Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material 
fact necessary to make the statements made, in light of the circumstances under which such statements were made, not 
misleading with respect to the period covered by this report; 

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in 
all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods 
presented in this report;

The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and 
procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as 
defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)  Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be de-
signed under our supervision, to ensure that material information relating to the registrant, including its consolidated 
subsidiaries, is made known to us by others within those entities, particularly during the period in which this report 
is being prepared;

(b)  Designed such internal control over financial reporting, or caused such internal control over financial reporting to be 
designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and 
the preparation of financial statements for external purposes in accordance with generally accepted accounting 
principles;

(c) 

Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our 
conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered 
by this report based on such evaluation; and 

(d)  Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during 
the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has 
materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; 
and 

5. 

The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over 
financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons 
performing the equivalent functions): 

(a)  All significant deficiencies and material weaknesses in the design or operation of internal control over financial 
reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and 
report financial information; and 

(b)  Any fraud, whether or not material, that involves management or other employees who have a significant role in the 

registrant’s internal control over financial reporting. 

Date: May 29, 2009 

82

By: /s/ Steven Plochocki 

Steven T. Plochocki, 
Chief Executive Officer 
(Principal Executive Officer)

  
 
 
 
 
 
 
Exhibit 31.2

Certification of Principal Financial Officer Required by Rule 13A-14(A) of the Securities 
Exchange Act Of 1934, as Amended, as Adopted Pursuant to Section 302 of the  
Sarbanes-Oxley Act of 2002

I, Paul A. Holt, certify that: 

1. 

2. 

3. 

4. 

I have reviewed this Form 10-K of Quality Systems, Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material 
fact necessary to make the statements made, in light of the circumstances under which such statements were made, not 
misleading with respect to the period covered by this report; 

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present 
in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the 
periods presented in this report;

The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and 
procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as 
defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)  Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be de-

signed under our supervision, to ensure that material information relating to the registrant, including its consolidated 
subsidiaries, is made known to us by others within those entities, particularly during the period in which this report 
is being prepared;

(b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be 

designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting 
and the preparation of financial statements for external purposes in accordance with generally accepted account-
ing principles;

(c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our 

conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered 
by this report based on such evaluation; and 

(d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the 

registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has 
materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial report-
ing; and 

5. 

The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control 
over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or 
persons performing the equivalent functions): 

(a)  All significant deficiencies and material weaknesses in the design or operation of internal control over financial 

reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and 
report financial information; and 

(b)  Any fraud, whether or not material, that involves management or other employees who have a significant role in 

the registrant’s internal control over financial reporting. 

Date: May 29, 2009 

By: /s/ Paul Holt 

Paul A. Holt, 
Chief Financial Officer 
(Principal Accounting Officer)

83

  
 
 
 
 
 
 
Exhibit 32.1

Certification of Chief Executive Officer and Chief Financial Officer Pursuant to 18 U.S.C. 
Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

In connection with the annual report on Form 10-K of Quality Systems, Inc. (the “Company”) for the year ended March 31, 
2009 (the “Report”), the undersigned hereby certify in their capacities as Chief Executive Officer and Chief Financial Officer 
of the Company, respectively, pursuant to 18 U.S.C. section 1350, as adopted pursuant to Section 906 of the Sarbanes-
Oxley Act of 2002, that:

1. 

2. 

the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as 
amended; and

the information contained in the Report fairly presents, in all material respects, the financial condition and results of 
operations of the Company.

Dated: May 29, 2009 

Dated: May 29, 2009 

By: /s/  Steven Plochocki

Steven T. Plochocki 
Chief Executive Officer  
(Principal Executive Officer)

By: /s/ Paul Holt 

Paul A. Holt 
Chief Financial Officer  
(Principal Accounting Officer)

84

  
 
 
 
 
 
 
  
 
 
 
 
 
 
C O M P A N Y   P R O F I L E

C O R P O R A T E   I N F O R M A T I O N

Quality Systems, Inc. (NASDAQ:QSII) and its NextGen Healthcare Information Systems 

subsidiary develop and market computer-based practice management, electronic health records 

and revenue cycle management applications as well as connectivity products and services for 

medical and dental group practices.     

F I N A N C I A L   H I G H L I G H T S

Fiscal year ended March 31,

2009  

2008 

 2007 

2006  

 2005

Revenue 

Net income 

$245,515  $186,500  $157,165  $119,287 

$88,961

46,119 

40,078 

33,232 

23,322 

16,109

Diluted earnings per share 

$1.62 

$1.44 

$1.21 

 $0.85 

$0.61

Cash dividends declared per share  

$1.15 

$1.00 

$1.00 

$0.875 

$0.75

Total shareholders’ equity 

$155,567  $113,705 

$91,246 

$72,409 

$62,731

 (in thousands, except per share amounts)

A B O U T   T H E   C O V E R

The front cover is a representation of a geometric shape known as a fractal. A fractal is divisible into parts, each of which 

is a smaller copy of the whole. Similarly, Quality Systems’ computer-based solutions for the healthcare industry, such as 

practice management, patient records and revenue cycle management applications, can be customized into parts to meet 

the specifi c needs of a medical and/or dental practice.  Currently used by more than 55,000 physicians and dentists 

nationwide, Quality Systems’ solutions have been tested, trusted and proven and can be scaled to handle the impending 

nationwide demand for a unifi ed transition to Electronic Health Records (EHR).   

B O A R D   O F   D I R E C T O R S

Sheldon Razin
Chairman of the Board

L E G A L   C O U N S E L

Rutan & Tucker, LLP
Costa Mesa, California

Steven T. Plochocki
President and Chief Executive Officer, Quality Systems, Inc. 

I N D E P E N D E N T   A U D I T O R S

Murray Brennan, MD
Emeritus Chairman, Memorial Sloan-Kettering 
Cancer Center, Department of Surgery

George Bristol
Managing Director, Crowell Weedon & Co. 

Patrick B. Cline
President, NextGen Healthcare Information Systems

Ahmed Hussein
Director
Cairo, Egypt

Philip N. Kaplan
Chief Executive Officer, Deer Valley Ventures, LLC

Vincent J. Love
Managing Director, Finance Scholars Group

Russell Pfl ueger
Chairman and CEO, Quiescence Medical, Inc.

O F F I C E R S   O F   T H E   C O M P A N Y

Steven T. Plochocki
President and Chief Executive Officer

Patrick B. Cline
President, NextGen Healthcare Information Systems

Paul A. Holt
Chief Financial Officer and Secretary

Donn Neufeld
Senior Vice President and General Manager, 
QSI Dental Division

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Grant Thornton, LLP
Irvine, California

S T O C K   T R A N S F E R   A G E N T   & 
R E G I S T R A R

Computershare
Glendale, California

A N N U A L   M E E T I N G

The annual meeting of stockholders will be held on 
Thursday, August 13, 2009 at 1:00 PM, Pacific Time at:

The Center Club 
650 Town Center Drive 
Costa Mesa, California  92626

F O R M   10 - K

A copy of the Company’s Annual Report on Form 10-K, 
as filed with the Securities and Exchange Commission, is 
available on the Company’s website at www.qsii.com or by 
contacting the Company at: 

18111 Von Karman Avenue, Suite 600

Irvine, California 92612

949.255.2600

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F O R W A R D - L O O K I N G   S T A T E M E N T S

Statements made in this Annual Report to Shareholders and in our Annual Report on Form 10-K (“Form 10-K”) contained herein (collectively, this “Report”), 
other reports and proxy statements fi led with the Securities and Exchange Commission (“Commission”), communications to shareholders, press releases 
and oral statements made by our representatives that are not historical in nature, or that state our or management’s intentions, hopes, beliefs, expectations 
or predictions of the future, may constitute “forward-looking statements” within the meaning of Section 21E of the Securities and Exchange Act of 1934, 
as amended. Forward-looking statements can often be identifi ed by the use of forward-looking terminology, such as “could,” “should,” “will,” “will be,” 
“will lead,” “will assist,” “intended,” “continue,” “believe,” “may,” “expect,” “hope,” “anticipate,” “goal,” “forecast,” “plan,” “potentially” or “estimate” or 
variations thereof or similar expressions. Forward-looking statements are not guarantees of future performance. Forward-looking statements involve risks, 
uncertainties and assumptions. It is important to note that any such performance and actual results, fi nancial condition or business, could differ materially 
from those expressed in such forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to, the risk 
factors discussed in Item 1A of our Form 10-K as well as factors discussed elsewhere in this and other reports and documents we fi le with the Commission. 
Other unforeseen factors not identifi ed herein could also have such an effect. We undertake no obligation to update or revise forward-looking statements 
to refl ect changed assumptions, the occurrence of unanticipated events or changes in future operating results, fi nancial condition or business over time 
unless required by law. Interested persons are urged to review the risks described under Item 1A, “Risk Factors” and in Item 7, “Management’s Discussion 
and Analysis of Financial Condition and Results of Operations” in our Form 10-K, as well as in our other public disclosures and fi lings with the Commission. 

 
 
 
 
 
 
 
 
 
 
 
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CORPORATE HEADQUARTERS/QSI DENTAL DIVISION LOCATION

18111 Von Karman Avenue, Suite 600

Irvine, California  92612

949.255.2600

www.qsii.com

NEXTGEN HEALTHCARE INFORMATION SYSTEMS LOCATIONS

795 Horsham Road

Horsham, Pennsylvania  19044

215.657.7010

3340 Peachtree Road NE, Suite 2700

Atlanta, Georgia  30326

404.467.1500

286 Grand Avenue

Southlake, Texas  76092

215.657.7010

1836 Lackland Hill Parkway

St. Louis, Missouri  63146

314.989.0300

11350 McCormick Road

Executive Plaza IV, Suite 600

Hunt Valley, Maryland  21031

443.933.4300

www.nextgen.com