Full Press Release Details
NUTEX HEALTH reports fourth quarter and Full YEAR 2023 financial results
HOUSTON, TX (PRNewswire) - MARCH 28, 2024 - Nutex Health Inc. ("Nutex Health" or the "Company") (NASDAQ: NUTX), a physician-led, technology-enabled integrated healthcare delivery system comprised of 20 state-of-the-art micro hospitals in eight states and primary care-centric, risk-bearing physician networks, today announced fourth quarter and fiscal year 2023 financial results for the twelve months ended December 31, 2023.
Financial Highlights for the Three Months Ended December 31, 2023:
Financial Highlights for the Year Ended December 31, 2023:
Note: EBITDA and Adjusted EBITDA are non-GAAP financial metrics. A reconciliation of non-GAAP to GAAP measures is included below in this earnings release.
"We are pleased to report 13% revenue growth, $10.8 million of Adjusted EBITDA and a 142% increase in hospital division operating income to $36.3 million in 2023," stated Jon Bates, Chief Financial Officer of Nutex Health.
"We had a solid 4th Quarter in 2023. In January of 2024, our management team and Board of Directors initiated a streamlined strategic plan that included a targeted reduction in annual cash operating expenses as well as a more focused allocation of resources and portfolio optimization. Some of these initiatives have already been executed while others are in the process of being implemented. Our goal for 2024 is to continue to be the leader and innovator in our industry, and to provide a very unique platform for selected growth opportunities," stated Tom Vo, M.D., MBA, Chairman and Chief Executive Officer of Nutex Health.
"We are intensely focused on our goal to deliver profitability on a net income basis to our investors. We believe that we are well positioned to improve our financial performance over the medium and long-term," stated Warren Hosseinion, M.D., President of Nutex Health.
For more details on the Company's Fourth Quarter and Fiscal Year 2023 financial results, please refer to our Annual Report on Form 10-K filed with the U.S. Securities & Exchange Commission and accessible at www.sec.gov.
CONSOLIDATED BALANCE SHEETS
| December 31, | ||||||
| 2023 | 2022 | |||||
| Assets | ||||||
| Current assets: | ||||||
| Cash and cash equivalents | $ | 22,002,056 | $ | 34,255,264 | ||
| Accounts receivable | 58,624,301 | 57,777,386 | ||||
| Accounts receivable - related parties | 4,152,068 | 538,183 | ||||
| Inventories | 3,390,584 | 3,533,285 | ||||
| Prepaid expenses and other current assets | 2,679,394 | 1,869,806 | ||||
| Total current assets | 90,848,403 | 97,973,924 | ||||
| Property and equipment, net | 81,387,649 | 82,094,352 | ||||
| Operating right-of-use assets | 11,853,082 | 20,466,632 | ||||
| Financing right-of-use assets | 176,146,329 | 192,591,624 | ||||
| Intangible assets, net | 20,512,636 | 21,191,390 | ||||
| Goodwill, net | 17,066,263 | 17,010,637 | ||||
| Other assets | 431,135 | 423,426 | ||||
| Total assets | $ | 398,245,497 | $ | 431,751,985 | ||
| Liabilities and Equity | ||||||
| Current liabilities: | ||||||
| Accounts payable | $ | 18,899,196 | $ | 23,614,387 | ||
| Accounts payable - related parties | 6,382,197 | 3,915,661 | ||||
| Lines of credit | 3,371,676 | 2,623,479 | ||||
| Current portion of long-term debt | 10,808,721 | 12,546,097 | ||||
| Operating lease liabilities, current portion | 1,579,987 | 1,703,014 | ||||
| Financing lease liabilities, current portion | 4,315,979 | 4,219,518 | ||||
| Accrued expenses and other current liabilities | 12,955,296 | 6,240,813 | ||||
| Total current liabilities | 58,313,052 | 54,862,969 | ||||
| Long-term debt, net | 26,314,733 | 23,051,152 | ||||
| Operating lease liabilities, net | 15,479,639 | 19,438,497 | ||||
| Financing lease liabilities, net | 213,886,213 | 203,619,756 | ||||
| Deferred tax liabilities | 5,145,754 | 10,452,211 | ||||
| Total liabilities | 319,139,391 | 311,424,585 | ||||
| Commitments and contingencies (Note 10) | ||||||
| Equity: | ||||||
| Common stock, $0.001 par value; 950,000,000 shares authorized; 676,679,911 and 650,223,840 shares issued and outstanding as of December 31, 2023 and December 31, 2022, respectively | 676,680 | 650,224 | ||||
| Additional paid-in capital | 469,849,049 | 458,498,402 | ||||
| Accumulated deficit | (409,072,539) | (363,285,925) | ||||
| Nutex Health Inc. equity | 61,453,190 | 95,862,701 | ||||
| Noncontrolling interests | 17,652,916 | 24,464,699 | ||||
| Total equity | 79,106,106 | 120,327,400 | ||||
| Total liabilities and equity | $ | 398,245,497 | $ | 431,751,985 |
CONSOLIDATED STATEMENTS OF OPERATIONS
| Three months ended December 31 | Year ended December 31 | |||||||||||
| 2023 | 2022 | 2023 | 2022 | |||||||||
| Revenue: | ||||||||||||
| Hospital division | $ | 62,585,167 | $ | 46,532,019 | $ | 218,070,397 | $ | 198,508,245 | ||||
| Population health management division | 7,084,306 | 7,192,054 | 29,575,919 | 20,786,061 | ||||||||
| Total revenue | 69,669,473 | 53,724,073 | 247,646,316 | 219,294,306 | ||||||||
| Operating costs and expenses: | ||||||||||||
| Payroll | 28,807,419 | 26,466,650 | 108,377,938 | 111,785,110 | ||||||||
| Contract services | 14,377,128 | 9,809,286 | 42,349,982 | 35,913,441 | ||||||||
| Medical supplies | 3,402,926 | 2,791,779 | 14,151,140 | 12,118,893 | ||||||||
| Insurance expense | - | 2,284,377 | - | - | ||||||||
| Depreciation and amortization | 4,682,724 | 3,271,861 | 17,591,572 | 13,131,374 | ||||||||
| Other | 5,185,964 | 8,569,796 | 30,401,513 | 30,923,750 | ||||||||
| Total operating costs and expenses | 56,456,161 | 53,193,749 | 212,872,145 | 203,872,568 | ||||||||
| Gross profit | 13,213,312 | 530,324 | 34,774,171 | 15,421,738 | ||||||||
| Corporate and other costs: | ||||||||||||
| Facilities closing costs | - | - | 217,266 | - | ||||||||
| Acquisition costs | - | - | 43,464 | 3,885,666 | ||||||||
| Stock-based compensation | 637,159 | - | 2,835,971 | 189,581 | ||||||||
| Impairment of assets | 29,082,203 | - | 29,082,203 | - | ||||||||
| Impairment of goodwill | 1,139,297 | - | 1,139,297 | 398,135,038 | ||||||||
| General and administrative expenses | 8,499,550 | 6,309,235 | 33,229,718 | 19,810,607 | ||||||||
| Total corporate and other costs | 39,358,209 | 6,309,235 | 66,547,919 | 422,020,892 | ||||||||
| Operating income (loss) | (26,144,897) | (5,778,911) | (31,773,748) | (406,599,154) | ||||||||
| Interest expense, net | 4,236,553 | 2,862,071 | 16,317,869 | 12,490,260 | ||||||||
| Other expense (income) | 328,461 | 212,426 | 399,182 | 559,299 | ||||||||
| Income (loss) before taxes | (30,709,911) | (8,853,408) | (48,490,799) | (419,648,713) | ||||||||
| Income tax expense (benefit) | (2,998,554) | 1,805,176 | (5,067,084) | 13,090,905 | ||||||||
| Net income (loss) | (27,711,357) | (10,658,584) | (43,423,715) | (432,739,618) | ||||||||
| Less: net income (loss) attributable to noncontrolling interests | 3,906,540 | 4,093,593 | 2,362,899 | (7,959,172) | ||||||||
| Net income (loss) attributable to Nutex Health Inc. | $ | (31,617,897) | $ | (14,752,177) | $ | (45,786,614) | $ | (424,780,446) | ||||
| Earnings (loss) per common share | ||||||||||||
| Basic | (0.05) | (0.02) | (0.07) | (0.67) | ||||||||
| Diluted | (0.05) | (0.02) | (0.07) | (0.67) |
CONSOLIDATED STATEMENTS OF CASH FLOWS
| Year ended December 31, | |||||||||
| 2023 | 2022 | 2021 | |||||||
| Cash flows from operating activities: | |||||||||
| Net income (loss) | $ | (43,423,715) | $ | (432,739,618) | $ | 168,525,285 | |||
| Adjustment to reconcile net income (loss) to net cash from operating activities: | |||||||||
| Depreciation and amortization | 17,591,572 | 13,131,374 | 7,662,464 | ||||||
| Debt accretion expense | 1,209,981 | 1,952,829 | 50,273 | ||||||
| Impairment of assets | 29,082,203 | - | - | ||||||
| Impairment of goodwill | 1,139,297 | 398,135,038 | - | ||||||
| Stock-based compensation expense | 2,835,971 | 189,581 | - | ||||||
| Rescission of warrant exercise expense | - | 561,651 | - | ||||||
| Other income - gain on PPP loan forgiveness | - | - | (5,546,597) | ||||||
| Deferred tax expense (benefit) | (5,707,323) | 4,996,209 | - | ||||||
| (Gain) loss on lease termination | 58,210 | - | (109,494) | ||||||
| Non-cash lease expense | 131,582 | 64,143 | 97,578 | ||||||
| Changes in operating assets and liabilities: | |||||||||
| Accounts receivable | (969,761) | 56,622,133 | (5,392,614) | ||||||
| Accounts receivable - related party | (3,613,885) | 1,454,934 | (1,229,940) | ||||||
| Inventories | 142,701 | (719,107) | (1,088,489) | ||||||
| Prepaid expenses and other current assets | (817,297) | (1,419,139) | (233,114) | ||||||
| Accounts payable | (4,715,101) | 10,018,100 | 6,365,978 | ||||||
| Accounts payable - related party | 2,466,536 | (329,155) | (97,985) | ||||||
| Accrued expenses and other current liabilities | 5,845,481 | (1,311,865) | 4,429,141 | ||||||
| Net cash from operating activities | 1,256,452 | 50,607,108 | 173,432,486 | ||||||
| Cash flows from investing activities: | |||||||||
| Acquisitions of property and equipment | (9,496,832) | (14,632,414) | (36,926,591) | ||||||
| Acquired cash in reverse acquisition with Clinigence | - | 12,716,228 | - | ||||||
| Payments for acquisitions of businesses, net of cash acquired | (703,893) | - | - | ||||||
| Cash related to deconsolidation of Real Estate Entities | (1,039,157) | (2,421,212) | (48,853) | ||||||
| Net cash from investing activities | (11,239,882) | (4,337,398) | (36,975,444) | ||||||
| Cash flows from financing activities: | |||||||||
| Proceeds from lines of credit | 2,340,911 | 2,623,479 | - | ||||||
| Proceeds from notes payable | 16,952,905 | 815,881 | 19,614,372 | ||||||
| Proceeds from convertible notes | 4,909,864 | - | - | ||||||
| Repayments of lines of credit | (1,592,714) | (72,055) | (864,659) | ||||||
| Repayments of notes payable | (16,479,512) | (7,237,094) | (20,715,235) | ||||||
| Repayments of finance leases | (3,484,683) | (1,721,224) | (1,255,486) | ||||||
| Payment of debt issuance costs | - | - | (47,875) | ||||||
| Rescission of warrant exercise | - | (588,042) | - | ||||||
| Common stock issued for exercise of warrants | - | 4,119,141 | - | ||||||
| Common stock issued for exercise of options | - | 644,974 | - | ||||||
| Members' contributions | 298,032 | 4,513,867 | 21,753,773 | ||||||
| Members' distributions | (5,214,581) | (51,231,657) | (144,337,923) | ||||||
| Net cash from financing activities | (2,269,778) | (48,132,730) | (125,853,033) | ||||||
| Net change in cash and cash equivalents | (12,253,208) | (1,863,020) | 10,604,009 | ||||||
| Cash and cash equivalents - beginning of the year | 34,255,264 | 36,118,284 | 25,514,275 | ||||||
| Cash and cash equivalents - end of the year | $ | 22,002,056 | $ | 34,255,264 | $ | 36,118,284 |
Non-GAAP Financial Measures (Unaudited)
Adjusted EBITDA. Adjusted EBITDA is used as a supplemental non-GAAP financial measure by management and external users of our financial statements, such as industry analysts, investors, lenders and rating agencies. We believe Adjusted EBITDA is useful because it allows us to more effectively evaluate our operating performance.
We define Adjusted EBITDA as net income (loss) attributable to Nutex Health Inc. plus net interest expense, income taxes, depreciation and amortization, further adjusted for stock-based compensation, certain defined items of expense, any acquisition-related costs and impairments. A reconciliation of net income to Adjusted EBITDA is included below. Adjusted EBITDA is not intended to serve as an alternative to U.S. GAAP measures of performance and may not be comparable to similarly-titled measures presented by other companies.
| Year ended December 31, | |||||||||
| 2023 | 2022 | 2021 | |||||||
| Reconciliation of net income (loss) attributable to Nutex Health Inc. to Adjusted EBITDA: | |||||||||
| Net income (loss) attributable to Nutex Health Inc. | $ | (45,786,614) | $ | (424,780,446) | $ | 132,593,328 | |||
| Depreciation and amortization | 17,591,572 | 13,131,374 | 7,662,464 | ||||||
| Interest expense, net | 16,317,869 | 12,490,260 | 6,196,026 | ||||||
| Income tax expense | (5,067,084) | 13,090,905 | 965,731 | ||||||
| Allocation to noncontrolling interests | (5,546,263) | (4,837,514) | (5,751,066) | ||||||
| EBITDA | (22,490,520) | (390,905,421) | 141,666,483 | ||||||
| Facility closing costs | 217,266 | - | - | ||||||
| Acquisition costs | 43,464 | 3,885,666 | 3,553,716 | ||||||
| Stock-based compensation | 2,835,971 | 189,581 | - | ||||||
| Rescission of warrant exercise | - | 1,243,059 | - | ||||||
| Impairment of assets | 29,082,203 | - | - | ||||||
| Impairment of goodwill | 1,139,297 | 398,135,038 | - | ||||||
| Adjusted EBITDA | $ | 10,827,681 | $ | 12,547,923 | $ | 145,220,199 |
| Three months ended | Three months ended | |||||
| December 31, 2023 | December 31, 2022 | |||||
| Unaudited | Unaudited | |||||
| Reconciliation of net income (loss) attributable to Nutex Health Inc. to Adjusted EBITDA: | ||||||
| Net loss attributable to Nutex Health Inc. | $ | (31,617,897) | $ | (14,752,177) | ||
| Depreciation and amortization | 4,682,724 | 3,271,861 | ||||
| Interest expense, net | 4,236,553 | 2,862,071 | ||||
| Income tax expense | (2,998,554) | 1,805,176 | ||||
| Allocation to noncontrolling interests | (2,045,390) | (392,290) | ||||
| EBITDA | (27,742,564) | (7,205,359) | ||||
| Stock-based compensation | 637,159 | 54,166 | ||||
| Rescission of warrant exercise | - | 1,243,059 | ||||
| Impairment of assets | 29,082,203 | - | ||||
| Impairment of goodwill | 1,139,297 | - | ||||
| Adjusted EBITDA | $ | 3,116,095 | $ | (5,908,134) |
About Nutex Health Inc.
Headquartered in Houston, Texas and founded in 2011, Nutex Health Inc. (NASDAQ: NUTX) is a healthcare management and operations company with two divisions: a Hospital Division and a Population Health Management Division.
The Hospital Division owns, develops and operates innovative health care models, including micro-hospitals, specialty hospitals, and hospital outpatient departments (HOPDs). This division owns and operates 20 facilities in 8 states.
The Population Health Management division owns and operates provider networks such as Independent Physician Associations (IPAs). Through our Management Services Organization (MSO), we provide management, administrative and other support services to our affiliated hospitals and physician groups. Our cloud-based proprietary technology platform aggregates clinical and claims data across multiple settings, information systems and sources to create a holistic view of patients and providers, allowing us to deliver greater quality care more efficiently.
Forward-Looking Statements
Certain statements and information included in this press release constitute "forward-looking statements" within the meaning of the Private Securities Litigation Act of 1995. When used in this press release, the words or phrases "will", "will likely result," "expected to," "will continue," "anticipated," "estimate," "projected," "intend," "goal," or similar expressions are intended to identify "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. Such statements are subject to certain risks, known and unknown, and uncertainties, many of which are beyond the control of the Company. Such uncertainties and risks include, but are not limited to, our ability to successfully execute our growth strategy, changes in laws or regulations, including the interim final and final rules implemented under the No Surprises Act , economic conditions, dependence on management, dilution to stockholders, lack of capital, the effects of rapid growth upon the Company and the ability of management to effectively respond to the growth and demand for products and services of the Company, newly developing technologies, the Company's ability to compete, conflicts of interest in related party transactions, regulatory matters, protection of technology, lack of industry standards, the effects of competition and the ability of the Company to obtain future financing. An extensive list of factors that can affect future results are discussed in the Annual Report on Form 10-K for the year ended December 31, 2023 under the heading "Risk Factors" in Part I, Item IA thereof, and other documents filed from time to time with the Securities and Exchange Commission. Such factors could materially adversely affect the Company's financial performance and could cause the Company's actual results for future periods to differ materially from any opinions or statements expressed within this press release.
FOR ADDITIONAL INFORMATION:
Jennifer Smith Rodriguez - Investor Relations