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Nutex Health Reports Fourth Quarter And Full Year 2023 Financial Results

March 28, 2024 | Last Trade: US$132.85 6.12 -4.40
  • TOTAL REVENUE OF $247.6 MILLION FOR THE YEAR ENDED 2023 VS $219.3 MILLION IN 2022, AN INCREASE OF 13%
  • HOSPITAL DIVISION OPERATING INCOME OF $36.3 MILLION FOR YEAR ENDED 2023 VS $15.0 MILLION IN 2022, AN INCREASE OF 142%
  • NET CASH FROM OPERATING ACTIVITIES OF $1.3 MILLION FOR THE YEAR ENDED 2023
  • CONTINUED FOCUS ON INCREASED CASH FLOW THROUGH REDUCTION IN OPERATING EXPENSES AND PORTFOLIO OPTIMIZATION

HOUSTON, March 28, 2024 /PRNewswire/ -- 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:

  • Total revenue of $69.7 million as compared to total revenue of $53.7 million for the three months ended December 31, 2022, an increase of approximately 30%.
  • Net loss attributable to Nutex Health Inc. of $31.6 million (including a non-cash asset impairment charge of $29.1 million and a $1.1 million goodwill impairment charge for hospital closures) as compared to net loss attributable to Nutex Health Inc. of $14.8 million for the three months ended December 31, 2022.
  • Adjusted EBITDA of $3.1 million as compared to Adjusted EBITDA of negative $5.9 million for the three months ended December 31, 2022.

Financial Highlights for the Year Ended December 31, 2023:

  • Total revenue of $247.6 million as compared to total revenue of $219.3 million for the year ended December 31, 2022.
  • Net loss attributable to Nutex Health Inc. of $45.8 million (including a non-cash asset impairment charge of $29.1 million and a $1.1 million goodwill impairment charge for hospital closures) as compared to net loss attributable to Nutex Health Inc. of $424.8 million (including a non-cash goodwill impairment charge of $398.1 million) for the year ended December 31, 2022.
  • Adjusted EBITDA of $10.8 million as compared to Adjusted EBITDA of $12.6 million for the year ended December 31, 2022.
  • Net cash from operating activities of $1.3 million.
  • As of December 31, 2023, the Company had total assets of $398.2 million, including cash and cash equivalents of $22.0 million.

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.

NUTEX HEALTH INC.

CONSOLIDATED BALANCE SHEETS

(Unaudited)

  

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

NUTEX HEALTH INC.

CONSOLIDATED STATEMENTS OF OPERATIONS

(Unaudited)

 
  

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)

NUTEX HEALTH INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS

(Unaudited)

 
  

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.

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