patient care as of december 31 , 2012 , we provided o & p patient care services through over 740 patient care clinics and over 1,300 clinicians in 45 states and the district of columbia . for the years ended december 31 , 2012 and 2011 , net sales attributable to our patient care services were $ 813.6 million and $ 753.4 million , respectively . patients are referred to our local patient care clinics directly by physicians as a result of our reputation or through our agreements with managed care providers . in our orthotics business , we design , fabricate , fit and maintain a wide range of standard and custom-made braces and other devices ( such as spinal , knee and sports-medicine braces ) that provide external support to patients suffering from musculoskeletal disorders , such as ailments of the back , extremities or joints and injuries from sports or other activities . in our prosthetics business , we design , fabricate , fit and maintain custom-made artificial limbs for patients who are without limbs as a result of traumatic injuries , vascular diseases , diabetes , 25 cancer or congenital disorders . o & p devices are increasingly technologically advanced and are custom-designed to add functionality and comfort to patients ' lives , shorten the rehabilitation process and lower the cost of rehabilitation . our clinicians are also responsible for managing and operating our patient care clinics and are compensated , in part , based on their success in managing costs and collecting accounts receivable . we provide centralized administrative , marketing and materials management services to take advantage of economies of scale and to increase the time clinicians have to provide patient care . in areas where we have multiple patient care clinics , we also utilize shared fabrication facilities where technicians fabricate devices for clinicians in that region . distribution we distribute o & p products , components , devices and supplies to our customers and to our own patient care clinics through our wholly-owned subsidiary , sps . we are also a leading fabricator and distributor of therapeutic footwear for diabetic patients in the podiatric market . for the year ended december 31 , 2012 , 35.9 % or approximately $ 107.3 million of sps distribution sales were to third-party o & p services providers , and the balance of approximately $ 191.2 million represented intercompany sales to hanger clinic 's patient care clinics . sps maintains in inventory approximately 33,000 individual skus manufactured by more than 390 different companies . sps maintains distribution facilities in california , florida , georgia , illinois , pennsylvania , and texas , which allows us to deliver products via ground shipment anywhere in the contiguous united states typically within two business days . our distribution business enables us to : centralize our purchasing and thus lower our material costs by negotiating purchasing discounts from manufacturers ; reduce our patient care clinic inventory levels and improve inventory turns ; perform inventory quality control ; encourage our patient care clinics to use clinically appropriate products that enhance our profit margins ; and coordinate new product development efforts with key vendor `` partners `` . marketing of our distribution services is conducted on a national basis through a dedicated sales force , print and e-commerce catalogues , and exhibits at industry and medical meetings and conventions . we direct specialized catalogues to segments of the healthcare industry , such as orthopedic surgeons , physical and occupational therapists , and podiatrists . therapeutic solutions we provide therapeutic solutions to the o & p market and post-acute rehabilitation market through our subsidiaries in , inc. and acp . acp is the nation 's leading provider of rehabilitation technologies and integrated clinical programs to rehabilitation providers . acp 's unique value proposition is to provide its customers with a full-service `` total solutions `` approach encompassing proven medical technology , evidence based clinical programs , and continuous onsite therapist education and training . acp 's services support increasingly advanced treatment options for a broader patient population and more medically complex conditions . acp has contracts to serve more than 4,550 skilled nursing facilities nationwide , including 21 of the 25 largest national providers . acp 's contracts contain negotiated pricing and service levels with terms ranging from one to five years . acp generally bills its customers monthly and revenue is recognized based upon the contractual terms of the agreements . 26 in , inc. specializes in product development and commercialization of emerging products . working with the inventors under licensing and consulting agreements , in , inc. commercializes the design , obtains regulatory approvals , develops clinical protocols for the technology , and then introduces the devices to the marketplace through a variety of distribution channels . in , inc. currently has two commercial products ; the walkaide system which benefits patients with a condition referred to as foot drop and the v-hold which is active suction technology used in lower extremity prosthetic devices . the walkaide system is currently reimbursable from medicare beneficiaries with foot drop due to incomplete spinal cord injuries . in , inc. is currently conducting randomized clinical trials in an effort to gain additional coverage for stroke patients with foot drop , which represents the largest potential patient population . in , inc. fully enrolled the clinical trial in the second quarter of 2012 and completed the active phase of the clinical trial in the fourth quarter of 2012. in , inc. is currently analyzing the data , which it expects to publish and later submit to cms in late 2013. in addition to reimbursement from medicare and medicaid , in , inc. has been working with commercial insurance companies and has had limited success in receiving coverage for the walkaide . the walkaide and v-hold are sold in the united states through our patient care clinics and sps . story_separator_special_tag in addition , an entity is required to present either on the face of the statement of operations or in the notes , significant amounts reclassified out of accumulated other comprehensive income by the respective line items of net income but only if the amount reclassified is required to be reclassified to net income in its entirety in the same reporting period . for amounts not reclassified in their entirety to net income , an entity is required to cross-reference to other disclosures 31 that provide additional detail about those amounts . this asu is effective prospectively for the company fiscal years , and interim periods within those years beginning after december 15 , 2012. the company will comply with the disclosure requirements of this asu for the quarter ending march 31 , 2013. the company does not expect the impact of adopting this asu to be material to the company 's financial position , results of operations or cash flows . results of operations the following table sets forth , for the periods indicated , certain items from our consolidated statements of income and comprehensive income as a percentage of our net sales : replace_table_token_12_th year ended december 31 , 2012 compared with the year ended december 31 , 2011 net sales . net sales for the year ended december 31 , 2012 increased by $ 67.1 million , or 7.3 % , to $ 985.6 million from $ 918.5 million last year . the sales increase was principally the result of a $ 30.1 million , or 4.0 % , increase in same center sales ; a $ 30.2 million increase from acquired entities ; and a $ 6.8 million , or 6.8 % , increase in sales of the distribution segment . material costs . material costs for the year ended december 31 , 2012 were $ 296.2 million , an increase of $ 26.0 million , or 9.6 % , over $ 270.2 million for the same period in the prior year . the increase was the result of the growth in sales and change of product mix . material costs as a percentage of net sales increased to 30.1 % in 2012 from 29.4 % in 2011. personnel costs . personnel costs for the year ended december 31 , 2012 increased by $ 13.8 million to $ 335.3 million from $ 321.5 million for the year ended december 31 , 2011. the increase from prior year was primarily due to $ 10.2 million of personnel costs associated with acquired patient care clinics , and other increases in salary expense , commissions and benefits . other operating expenses . other operating expenses , which are comprised primarily of professional , office , bad debt , incentive compensation and reimbursable employee expenses , increased $ 11.0 million in 2012 to $ 188.9 million from $ 177.9 million for the year ended december 31 , 2011. the increase was attributable to $ 4.2 million related to acquisitions , $ 3.3 million in incentive compensation and $ 2.2 million in professional fees , respectively . the remainder is attributable to other operating expenses . other operating expenses as a percentage of net sales decreased slightly to 19.2 % . 32 relocation expenses . during 2011 , we completed the relocation of our corporate office from bethesda , maryland to austin , texas , which began in 2010. during the year ended december 31 , 2012 , we incurred no relocation costs compared to $ 1.2 million incurred in 2011. acquisition expenses . during 2012 , we acquired eighteen companies , consisting of 59 patient care clinics , and incurred $ 1.2 million of non-recurring costs related to these acquisitions , an increase of $ 0.4 million compared to the $ 0.8 million of acquisition related costs we incurred in 2011 to acquire eight companies that consisted of 21 patient care clinics . depreciation and amortization . depreciation and amortization for the year ended december 31 , 2012 was $ 34.7 million versus $ 31.0 million for the year ended december 31 , 2011. the increase was commensurate with the increase in capital expenditures in 2012. income from operations . income from operations increased $ 13.3 million to $ 129.3 million for the year ended december 31 , 2012 compared to $ 116.0 million in the year ended december 31 , 2011. the increase was primarily due to the patient care segment as fixed costs were leveraged over increased sales . the remaining increase was due to $ 5.9 million of additional operating income in the distribution segment resulting from an increase in sales prices , implementation of cost management strategies and changes in sales mix . as a percentage of sales , income from operations in 2012 increased 0.5 % from 12.6 % to 13.1 % . interest expense . interest expense for the year ended december 31 , 2012 decreased slightly to $ 31.2 million , compared to $ 31.8 million for the year ended december 31 , 2011 , primarily due to a lower average term loan balance resulting from scheduled repayments , offset by increases in seller notes resulting from the 2012 acquisitions . provision for income taxes . an income tax provision of $ 34.5 million was recognized for the year ended december 31 , 2012 , compared to $ 29.7 million for the same period of the prior year . the increase in the income tax provision was primarily due to higher pre-tax earnings . our effective tax rate was 35.1 % and 35.3 % for 2012 and 2011 , respectively . the 2012 effective tax rate benefited 2.3 % from prior period federal research and development credit claims filed in 2012 , certain deferred tax asset rate changes , the release of a portion of our valuation allowance , and other nonrecurring discrete items . the 2011 effective tax rate benefited 2.5 % from the realization of certain state tax benefits and other

cash flows our working capital at december 31 , 2012 was $ 251.5 million , compared to $ 240.6 million and $ 185.3 million for the years ended december 31 , 2011 and 2010 , respectively . the increase in working capital was primarily due to an increase in cash , inventory , and accounts receivable . days sales outstanding ( `` dso '' ) , which is the number of days between the billing for our o & p products and services and the date of our receipt of payment thereof , for the year ended december 31 , 2012 increased to 58 days , compared to 54 days in 2011 and 52 days in 2010 for the same period . the increase in dso was primarily due to the increase in fourth quarter sales and an increase in accounts receivable related to fourth quarter acquisitions . net cash provided by operating activities was $ 81.3 million for the year ended december 31 , 2012 , compared to $ 61.8 million in 2011 or $ 54.2 million in 2010. the increase in cash provided by operating activities in the current year resulted primarily from increased net income and a decrease in incentive compensation payments in 2012. net cash used in investing activities was $ 99.1 million , $ 46.9 million , and $ 186.0 million for the years ended december 31 , 2012 , 2011 , and 2010 respectively . in 2012 , 2011 , and 2010 , we invested $ 33.2 million , $ 28.7 million , and $ 30.6 million , respectively , in improvements to our patient care clinics , upgrades to our computer hardware and software , and purchases of equipment leased to third parties by our therapeutic solutions segment . in 2012 , we acquired eighteen o & p companies , operating a total of 59 patient care clinics , at an aggregate purchase price of $ 83.1 million . in 2011 , we acquired eight o & p companies , operating a total of 21 patient care clinics , at an aggregate purchase price of $ 24.9 million .


 Write a concise suspicious activity report of the following text delimited by triple backquotes. Return your response as a formal report which covers the key points highlighting the location,dates,entity names and account holder information in chronological order of the text.
     ```cash flows our working capital at december 31 , 2012 was $ 251.5 million , compared to $ 240.6 million and $ 185.3 million for the years ended december 31 , 2011 and 2010 , respectively . the increase in working capital was primarily due to an increase in cash , inventory , and accounts receivable . days sales outstanding ( `` dso '' ) , which is the number of days between the billing for our o & p products and services and the date of our receipt of payment thereof , for the year ended december 31 , 2012 increased to 58 days , compared to 54 days in 2011 and 52 days in 2010 for the same period . the increase in dso was primarily due to the increase in fourth quarter sales and an increase in accounts receivable related to fourth quarter acquisitions . net cash provided by operating activities was $ 81.3 million for the year ended december 31 , 2012 , compared to $ 61.8 million in 2011 or $ 54.2 million in 2010. the increase in cash provided by operating activities in the current year resulted primarily from increased net income and a decrease in incentive compensation payments in 2012. net cash used in investing activities was $ 99.1 million , $ 46.9 million , and $ 186.0 million for the years ended december 31 , 2012 , 2011 , and 2010 respectively . in 2012 , 2011 , and 2010 , we invested $ 33.2 million , $ 28.7 million , and $ 30.6 million , respectively , in improvements to our patient care clinics , upgrades to our computer hardware and software , and purchases of equipment leased to third parties by our therapeutic solutions segment . in 2012 , we acquired eighteen o & p companies , operating a total of 59 patient care clinics , at an aggregate purchase price of $ 83.1 million . in 2011 , we acquired eight o & p companies , operating a total of 21 patient care clinics , at an aggregate purchase price of $ 24.9 million .
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 Suspicious Activity Report : patient care as of december 31 , 2012 , we provided o & p patient care services through over 740 patient care clinics and over 1,300 clinicians in 45 states and the district of columbia . for the years ended december 31 , 2012 and 2011 , net sales attributable to our patient care services were $ 813.6 million and $ 753.4 million , respectively . patients are referred to our local patient care clinics directly by physicians as a result of our reputation or through our agreements with managed care providers . in our orthotics business , we design , fabricate , fit and maintain a wide range of standard and custom-made braces and other devices ( such as spinal , knee and sports-medicine braces ) that provide external support to patients suffering from musculoskeletal disorders , such as ailments of the back , extremities or joints and injuries from sports or other activities . in our prosthetics business , we design , fabricate , fit and maintain custom-made artificial limbs for patients who are without limbs as a result of traumatic injuries , vascular diseases , diabetes , 25 cancer or congenital disorders . o & p devices are increasingly technologically advanced and are custom-designed to add functionality and comfort to patients ' lives , shorten the rehabilitation process and lower the cost of rehabilitation . our clinicians are also responsible for managing and operating our patient care clinics and are compensated , in part , based on their success in managing costs and collecting accounts receivable . we provide centralized administrative , marketing and materials management services to take advantage of economies of scale and to increase the time clinicians have to provide patient care . in areas where we have multiple patient care clinics , we also utilize shared fabrication facilities where technicians fabricate devices for clinicians in that region . distribution we distribute o & p products , components , devices and supplies to our customers and to our own patient care clinics through our wholly-owned subsidiary , sps . we are also a leading fabricator and distributor of therapeutic footwear for diabetic patients in the podiatric market . for the year ended december 31 , 2012 , 35.9 % or approximately $ 107.3 million of sps distribution sales were to third-party o & p services providers , and the balance of approximately $ 191.2 million represented intercompany sales to hanger clinic 's patient care clinics . sps maintains in inventory approximately 33,000 individual skus manufactured by more than 390 different companies . sps maintains distribution facilities in california , florida , georgia , illinois , pennsylvania , and texas , which allows us to deliver products via ground shipment anywhere in the contiguous united states typically within two business days . our distribution business enables us to : centralize our purchasing and thus lower our material costs by negotiating purchasing discounts from manufacturers ; reduce our patient care clinic inventory levels and improve inventory turns ; perform inventory quality control ; encourage our patient care clinics to use clinically appropriate products that enhance our profit margins ; and coordinate new product development efforts with key vendor `` partners `` . marketing of our distribution services is conducted on a national basis through a dedicated sales force , print and e-commerce catalogues , and exhibits at industry and medical meetings and conventions . we direct specialized catalogues to segments of the healthcare industry , such as orthopedic surgeons , physical and occupational therapists , and podiatrists . therapeutic solutions we provide therapeutic solutions to the o & p market and post-acute rehabilitation market through our subsidiaries in , inc. and acp . acp is the nation 's leading provider of rehabilitation technologies and integrated clinical programs to rehabilitation providers . acp 's unique value proposition is to provide its customers with a full-service `` total solutions `` approach encompassing proven medical technology , evidence based clinical programs , and continuous onsite therapist education and training . acp 's services support increasingly advanced treatment options for a broader patient population and more medically complex conditions . acp has contracts to serve more than 4,550 skilled nursing facilities nationwide , including 21 of the 25 largest national providers . acp 's contracts contain negotiated pricing and service levels with terms ranging from one to five years . acp generally bills its customers monthly and revenue is recognized based upon the contractual terms of the agreements . 26 in , inc. specializes in product development and commercialization of emerging products . working with the inventors under licensing and consulting agreements , in , inc. commercializes the design , obtains regulatory approvals , develops clinical protocols for the technology , and then introduces the devices to the marketplace through a variety of distribution channels . in , inc. currently has two commercial products ; the walkaide system which benefits patients with a condition referred to as foot drop and the v-hold which is active suction technology used in lower extremity prosthetic devices . the walkaide system is currently reimbursable from medicare beneficiaries with foot drop due to incomplete spinal cord injuries . in , inc. is currently conducting randomized clinical trials in an effort to gain additional coverage for stroke patients with foot drop , which represents the largest potential patient population . in , inc. fully enrolled the clinical trial in the second quarter of 2012 and completed the active phase of the clinical trial in the fourth quarter of 2012. in , inc. is currently analyzing the data , which it expects to publish and later submit to cms in late 2013. in addition to reimbursement from medicare and medicaid , in , inc. has been working with commercial insurance companies and has had limited success in receiving coverage for the walkaide . the walkaide and v-hold are sold in the united states through our patient care clinics and sps . story_separator_special_tag in addition , an entity is required to present either on the face of the statement of operations or in the notes , significant amounts reclassified out of accumulated other comprehensive income by the respective line items of net income but only if the amount reclassified is required to be reclassified to net income in its entirety in the same reporting period . for amounts not reclassified in their entirety to net income , an entity is required to cross-reference to other disclosures 31 that provide additional detail about those amounts . this asu is effective prospectively for the company fiscal years , and interim periods within those years beginning after december 15 , 2012. the company will comply with the disclosure requirements of this asu for the quarter ending march 31 , 2013. the company does not expect the impact of adopting this asu to be material to the company 's financial position , results of operations or cash flows . results of operations the following table sets forth , for the periods indicated , certain items from our consolidated statements of income and comprehensive income as a percentage of our net sales : replace_table_token_12_th year ended december 31 , 2012 compared with the year ended december 31 , 2011 net sales . net sales for the year ended december 31 , 2012 increased by $ 67.1 million , or 7.3 % , to $ 985.6 million from $ 918.5 million last year . the sales increase was principally the result of a $ 30.1 million , or 4.0 % , increase in same center sales ; a $ 30.2 million increase from acquired entities ; and a $ 6.8 million , or 6.8 % , increase in sales of the distribution segment . material costs . material costs for the year ended december 31 , 2012 were $ 296.2 million , an increase of $ 26.0 million , or 9.6 % , over $ 270.2 million for the same period in the prior year . the increase was the result of the growth in sales and change of product mix . material costs as a percentage of net sales increased to 30.1 % in 2012 from 29.4 % in 2011. personnel costs . personnel costs for the year ended december 31 , 2012 increased by $ 13.8 million to $ 335.3 million from $ 321.5 million for the year ended december 31 , 2011. the increase from prior year was primarily due to $ 10.2 million of personnel costs associated with acquired patient care clinics , and other increases in salary expense , commissions and benefits . other operating expenses . other operating expenses , which are comprised primarily of professional , office , bad debt , incentive compensation and reimbursable employee expenses , increased $ 11.0 million in 2012 to $ 188.9 million from $ 177.9 million for the year ended december 31 , 2011. the increase was attributable to $ 4.2 million related to acquisitions , $ 3.3 million in incentive compensation and $ 2.2 million in professional fees , respectively . the remainder is attributable to other operating expenses . other operating expenses as a percentage of net sales decreased slightly to 19.2 % . 32 relocation expenses . during 2011 , we completed the relocation of our corporate office from bethesda , maryland to austin , texas , which began in 2010. during the year ended december 31 , 2012 , we incurred no relocation costs compared to $ 1.2 million incurred in 2011. acquisition expenses . during 2012 , we acquired eighteen companies , consisting of 59 patient care clinics , and incurred $ 1.2 million of non-recurring costs related to these acquisitions , an increase of $ 0.4 million compared to the $ 0.8 million of acquisition related costs we incurred in 2011 to acquire eight companies that consisted of 21 patient care clinics . depreciation and amortization . depreciation and amortization for the year ended december 31 , 2012 was $ 34.7 million versus $ 31.0 million for the year ended december 31 , 2011. the increase was commensurate with the increase in capital expenditures in 2012. income from operations . income from operations increased $ 13.3 million to $ 129.3 million for the year ended december 31 , 2012 compared to $ 116.0 million in the year ended december 31 , 2011. the increase was primarily due to the patient care segment as fixed costs were leveraged over increased sales . the remaining increase was due to $ 5.9 million of additional operating income in the distribution segment resulting from an increase in sales prices , implementation of cost management strategies and changes in sales mix . as a percentage of sales , income from operations in 2012 increased 0.5 % from 12.6 % to 13.1 % . interest expense . interest expense for the year ended december 31 , 2012 decreased slightly to $ 31.2 million , compared to $ 31.8 million for the year ended december 31 , 2011 , primarily due to a lower average term loan balance resulting from scheduled repayments , offset by increases in seller notes resulting from the 2012 acquisitions . provision for income taxes . an income tax provision of $ 34.5 million was recognized for the year ended december 31 , 2012 , compared to $ 29.7 million for the same period of the prior year . the increase in the income tax provision was primarily due to higher pre-tax earnings . our effective tax rate was 35.1 % and 35.3 % for 2012 and 2011 , respectively . the 2012 effective tax rate benefited 2.3 % from prior period federal research and development credit claims filed in 2012 , certain deferred tax asset rate changes , the release of a portion of our valuation allowance , and other nonrecurring discrete items . the 2011 effective tax rate benefited 2.5 % from the realization of certain state tax benefits and other

