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Nutex Health Reports Third Quarter and Year to Date September 30, 2024 Financial Results

November 07, 2024 | Last Trade: US$30.28 1.49 -4.69
  • TOTAL REVENUE OF $222.3 MILLION FOR THE FIRST NINE MONTHS OF 2024 VS. $178.0 MILLION FOR THE SAME PERIOD IN 2023, AN INCREASE OF 25%
  • HOSPITAL DIVISION VISITS OF 122,944 FOR THE FIRST NINE MONTHS OF 2024 VS. VISITS OF 102,798 FOR THE SAME PERIOD IN 2023, AN INCREASE OF 20%
  • HOSPITAL DIVISION OPERATING INCOME OF $54.7 MILLION FOR THE FIRST NINE MONTHS OF 2024 VS. $21.1 MILLION FOR THE SAME PERIOD IN 2023, AN INCREASE OF 159%
  • NET CASH FROM OPERATING ACTIVITIES OF $23.1 MILLION FOR THE FIRST NINE MONTHS OF 2024
  • COMPANY CONTINUES ITS FOCUS ON INCREASING CASH FLOW

HOUSTON, Nov. 7, 2024 /PRNewswire/ -- Nutex Health Inc. ("Nutex Health" or the "Company") (NASDAQ: NUTX), a physician-led, integrated healthcare delivery system comprised of 22 state-of-the-art micro hospitals and hospital outpatient departments (HOPDs) in ten states and primary care-centric, risk-bearing physician networks, today announced third quarter 2024 financial results for the three and nine months ended September 30, 2024.

Financial Highlights for the Three Months Ended September 30, 2024:

  • Total revenue of $78.8 million as compared to total revenue of $62.7 million for the three months ended September 30, 2023, an increase of 26%. Of this revenue growth, mature hospitals, which are hospitals opened prior to December 31, 2021, increased by 20.7% in 2024 compared to the same period in 2023.
  • Operating income (including the negative impact of a $2.0 million non-cash stock-based compensation expense) for the three months ended September 30, 2024 was $9.7 million, compared to an operating loss of approximately $0.8 million for the three months ended September 30, 2023, representing a $10.5 million improvement quarter over quarter.
  • Net loss attributable to Nutex Health of $8.8 million in the three months ended September 30, 2024 as compared to a net loss attributable to Nutex Health of $5.5 million for the three months ended September 30, 2023. This $8.8 million amount includes a $6.7 million non-cash loss on warrant liability as well as the $2.0 million non-cash stock-based compensation expense noted above.
  • EBITDA attributable to Nutex Health of $4.3 million, as compared to EBITDA attributable to Nutex Health of $1.2 million for the three months ended September 30, 2023.
  • Adjusted EBITDA attributable to Nutex Health of $13.5 million, as compared to Adjusted EBITDA attributable to Nutex Health of $1.3 million for the three months ended September 30, 2023, an increase of 938%.
  • Total visits from the Hospital Division were 41,668 for the third quarter 2024, as compared to 37,443 for the third quarter 2023, an increase of 4,225 or 11.3%. Of this visit growth, mature hospitals increased by 3.8% in 2024 compared to the same period in 2023.

Financial Highlights for the Nine Months Ended September 30, 2024:

  • Total revenue of $222.3 million as compared to total revenue of $178.0 million for the nine months ended September 30, 2023, an increase of approximately 25%. Of this revenue growth, mature hospitals, which are hospitals opened prior to December 31, 2021, increased by 13.5% in 2024 compared to 2023.
  • Operating income for the nine months ended September 30, 2024 was $16.4 million compared to an operating loss of $5.6 million for the nine months ended September 30, 2023, representing a $22.0 million improvement year over year.
  • Net loss attributable to Nutex Health of $9.5 million as compared to net loss attributable to Nutex Health of $14.2 million for the nine months ended September 30, 2023. This $9.5 million amount includes non-cash items of $10.2 million (non-cash stock-based compensation expense of $2.0 million, non-cash impairment of assets of $3.9 million, non-cash impairment of goodwill of $3.2 million and $1.1 million non-cash loss on warrant liability) in the first nine months of 2024, while the $14.2 million amount includes non-cash stock-based compensation expense of $2.2 million in the first nine months of 2023.
  • EBITDA attributable to Nutex Health of $19.9 million, as compared to EBITDA attributable to Nutex Health of $5.3 million for the nine months ended September 30, 2023.
  • Adjusted EBITDA attributable to Nutex Health of $30.1 million, as compared to Adjusted EBITDA attributable to Nutex Health of $7.7 million for the nine months ended September 30, 2023, an increase of 290%.
  • Total visits from the Hospital Division were 122,944 for the nine months ended September 30, 2024, as compared to 102,798 for the same period in 2023, an increase of 20,146 or 19.6%. Of this visit growth, mature hospitals increased by 7.7% in the nine months ended September 30, 2024 compared to the same period in 2023.
  • Net cash from operating activities of $23.1 million for the nine months ended September 30, 2024. 
  • As of September 30, 2024, the Company had total assets of $438.5 million, including cash and cash equivalents of $46.9 million and long-term debt of $26.8 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 25% revenue growth, Adjusted EBITDA attributable to Nutex Health of $13.5 million and a 209% increase in gross profit to $21.9 million in the third quarter ended September 30, 2024, showing our continued focus on top line growth, increasing cash flow as well as improving profitability," stated Jon Bates, Chief Financial Officer of Nutex Health.

"Nutex Health had another outstanding quarter. The strategic and operational decisions we have made over the last nine months are driving this strong performance, as demonstrated by another quarter of year-over-year growth in revenue, EBITDA and Adjusted EBITDA as well as incremental growth in cash flow. We are confident that our momentum will continue and plan on growing our hospital and population health divisions responsibly as we drive value for our shareholders," stated Warren Hosseinion, M.D., President of Nutex Health.

"The four de-novo hospitals that we opened in 2023 are ramping up nicely, resulting in strong year-over-year growth in both revenue and patient volume. Volumes and revenue continue to increase among our mature hospitals, both on the outpatient side as well as the inpatient side, which still have excess capacity. Our average payment by insurers of patient claims also increased, a trend we are optimistic will persist as we continue to work the NSA (No Surprises Act) claims through the Independent Dispute Resolution process," stated Tom Vo, M.D., MBA, Chairman and Chief Executive Officer of Nutex Health.

For more details on the Company's Third Quarter 2024 financial results, please refer to our Quarterly Report on Form 10-Q filed with the U.S. Securities & Exchange Commission and accessible at www.sec.gov.

NUTEX HEALTH INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(Unaudited)

 
  

September 30, 2024

 

December 31, 2023

Assets

      

Current assets:

      

Cash and cash equivalents

 

$

46,909,281

 

$

22,002,056

Accounts receivable

  

62,745,336

  

58,624,301

Accounts receivable - related parties

  

3,602,189

  

4,152,068

Inventories

  

2,259,168

  

3,390,584

Prepaid expenses and other current assets

  

4,279,360

  

2,679,394

Total current assets

  

119,795,334

  

90,848,403

Property and equipment, net

  

78,246,467

  

81,387,649

Operating right-of-use assets

  

11,442,369

  

11,853,082

Finance right-of-use assets

  

198,462,381

  

176,146,329

Intangible assets, net

  

15,855,392

  

20,512,636

Goodwill, net

  

13,918,719

  

17,066,263

Other assets

  

767,942

  

431,135

       

Total assets

 

$

438,488,604

 

$

398,245,497

       

Liabilities and Equity

      

Current liabilities:

      

Accounts payable

 

$

10,320,933

 

$

18,899,196

Accounts payable - related parties

  

6,342,883

  

6,382,197

Lines of credit

  

3,384,517

  

3,371,676

Current portion of long-term debt

  

10,499,532

  

10,808,721

Operating lease liabilities, current portion

  

2,060,758

  

1,579,987

Finance lease liabilities, current portion

  

5,261,458

  

4,315,979

Accrued expenses and other current liabilities

  

29,688,665

  

12,955,296

Total current liabilities

  

67,558,746

  

58,313,052

Long-term debt, net

  

26,801,811

  

26,314,733

Warrant liability

  

5,715,143

  

-

Operating lease liabilities, net

  

14,307,320

  

15,479,639

Finance lease liabilities, net

  

240,924,194

  

213,886,213

Deferred tax liabilities

  

3,402,965

  

5,145,754

Total liabilities

  

358,710,179

  

319,139,391

       

Commitments and contingencies

      
       

Equity:

      

Common stock, $0.001 par value; 950,000,000 shares authorized; 5,215,709 and 4,511,199
shares issued and outstanding as of September 30, 2024 and December 31, 2023,
respectively

  

5,216

  

4,511

Additional paid-in capital

  

479,024,452

  

470,521,218

Accumulated deficit

  

(418,588,975)

  

(409,072,539)

Nutex Health Inc. equity

  

60,440,693

  

61,453,190

Noncontrolling interests

  

19,337,732

  

17,652,916

Total equity

  

79,778,425

  

79,106,106

       

Total liabilities and equity

 

$

438,488,604

 

$

398,245,497

NUTEX HEALTH INC.

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

(Unaudited)

 

 
  

Three Months Ended September 30, 

 

Nine Months Ended September 30, 

  

2024

 

2023

 

2024

 

2023

Revenue:

            

Hospital division

 

$

71,732,529

 

$

54,585,263

 

$

199,366,776

 

$

155,485,230

Population health management division

  

7,062,340

  

8,137,709

  

22,964,141

  

22,491,613

Total revenue

  

78,794,869

  

62,722,972

  

222,330,917

  

177,976,843

             

Operating costs and expenses:

            

Payroll and benefits

  

29,848,083

  

28,873,144

  

85,249,302

  

79,570,519

Contract services

  

11,657,010

  

9,035,650

  

32,481,686

  

27,972,854

Medical supplies

  

3,982,598

  

3,460,130

  

12,892,904

  

10,748,214

Depreciation and amortization

  

4,972,478

  

4,745,941

  

13,691,484

  

12,908,848

Other

  

6,417,886

  

9,541,894

  

23,380,318

  

25,215,549

Total operating costs and expenses

  

56,878,055

  

55,656,759

  

167,695,694

  

156,415,984

             

Gross profit

  

21,916,814

  

7,066,213

  

54,635,223

  

21,560,859

             

Corporate and other costs:

            

Facilities closing costs

  

-

  

-

  

-

  

217,266

Acquisition costs

  

-

  

43,464

  

-

  

43,464

Stock-based compensation expense

  

1,963,518

  

49,167

  

1,951,444

  

2,198,812

Impairment of assets

  

425,221

  

-

  

3,898,856

  

-

Impairment of goodwill

  

-

  

-

  

3,197,391

  

-

General and administrative expenses

  

9,865,330

  

7,794,808

  

29,176,130

  

24,730,168

Total corporate and other costs

  

12,254,069

  

7,887,439

  

38,223,821

  

27,189,710

             

Operating income (loss)

  

9,662,745

  

(821,226)

  

16,411,402

  

(5,628,851)

             

Interest expense, net

  

5,381,040

  

4,098,179

  

14,879,934

  

12,081,316

Loss on warrant liability

  

6,733,552

  

-

  

1,072,709

  

-

Other (income) expense

  

128,645

  

(53,206)

  

(712,049)

  

70,721

Income (loss) before taxes

  

(2,580,492)

  

(4,866,199)

  

1,170,808

  

(17,780,888)

             

Income tax expense (benefit)

  

4,584,518

  

(342,259)

  

5,868,075

  

(2,068,530)

             

Net loss

  

(7,165,010)

  

(4,523,940)

  

(4,697,267)

  

(15,712,358)

             

Less: net income (loss) attributable to
noncontrolling interests

  

1,623,303

  

1,018,451

  

4,819,169

  

(1,543,641)

             

Net loss attributable to Nutex Health Inc.

 

$

(8,788,313)

 

$

(5,542,391)

 

$

(9,516,436)

 

$

(14,168,717)

             

Loss per common share:

            

Basic

 

$

(1.72)

 

$

(1.25)

 

$

(1.91)

 

$

(3.23)

Diluted

 

$

(1.72)

 

$

(1.25)

 

$

(1.91)

 

$

(3.23)

 

NUTEX HEALTH INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(Unaudited)

 
  

Nine Months Ended September 30, 

  

2024

 

2023

Cash flows from operating activities:

      

Net income (loss)

 

$

(4,697,267)

 

$

(15,712,358)

Adjustments to reconcile net loss to net cash from operating activities:

      

Depreciation and amortization

  

13,691,484

  

12,908,848

Loss on warrant liability

  

1,072,709

  

-

Impairment of goodwill

  

3,197,391

  

-

Impairment of assets

  

3,898,856

  

-

Derecognition of goodwill

  

453,017

  

-

Stock-based compensation expense

  

1,951,444

  

2,198,812

Deferred tax benefit

  

(1,742,789)

  

(2,068,530)

Debt accretion expense

  

804,760

  

1,251,867

Loss on lease termination

  

-

  

58,210

Non-cash lease expense (income)

  

(280,835)

  

89,338

Changes in operating assets and liabilities, net of the effects of acquisitions:

      

Accounts receivable

  

(4,253,034)

  

4,444,706

Accounts receivable - related party

  

549,879

  

(949,408)

Inventories

  

1,131,416

  

850,569

Prepaid expenses and other current assets

  

(1,360,721)

  

(3,771,946)

Accounts payable

  

(7,975,067)

  

(6,015,250)

Accounts payable - related party

  

(39,314)

  

2,228,527

Accrued expenses and other current liabilities

  

16,698,416

  

7,519,285

Net cash from operating activities

  

23,100,345

  

3,032,670

       

Cash flows from investing activities:

      

Acquisitions of property and equipment

  

(1,908,651)

  

(10,322,487)

Cash related to sale of business

  

(361,325)

  

-

Payments for acquisitions of businesses, net of cash acquired

  

-

  

(743,837)

Cash related to deconsolidation of Real Estate Entities

  

-

  

(1,039,157)

Net cash from investing activities

  

(2,269,976)

  

(12,105,481)

       

Cash flows from financing activities:

      

Proceeds from lines of credit

  

1,132,168

  

2,340,911

Proceeds from notes payable

  

7,014,999

  

16,952,905

Proceeds from convertible notes

  

-

  

891,000

Repayments of lines of credit

  

(1,119,327)

  

(1,592,714)

Repayments of notes payable

  

(8,332,482)

  

(10,557,758)

Repayments of finance leases

  

(1,923,687)

  

(2,704,082)

Proceeds from common stock issuance, net issuance costs

  

9,202,500

  

-

Proceeds from exercise of warrants

  

801,000

  

-

Members' contributions

  

960,913

  

649,550

Members' distributions

  

(3,659,228)

  

(4,335,532)

Net cash from financing activities

  

4,076,856

  

1,644,280

Net change in cash and cash equivalents

  

24,907,225

  

(7,428,531)

Cash and cash equivalents - beginning of the period

  

22,002,056

  

34,255,264

Cash and cash equivalents - end of the period

 

$

46,909,281

 

$

26,826,733

 

Non-GAAP Financial Measures (Unaudited)

EBITDA and Adjusted EBITDA. EBITDA and Adjusted EBITDA are 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 EBITDA and Adjusted EBITDA are useful because it allows us to more effectively evaluate our operating performance.

We define EBITDA as net income (loss) attributable to Nutex Health Inc. plus interest expense, income taxes, depreciation and amortization.

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 an allocation to noncontrolling interests, (gain)/loss on warrant liability, stock-based compensation, certain defined items of expense, and any acquisition-related costs and impairments. A reconciliation of net income to EBITDA and Adjusted EBITDA is included below. EBITDA and Adjusted EBITDA are 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.

  

Three Months Ended September 30, 

 

Nine Months Ended September 30, 

  

2024

 

2023

 

2024

 

2023

Reconciliation of net loss attributable to Nutex Health
Inc. to Adjusted EBITDA:

            

Net loss attributable to Nutex Health Inc.

 

$

(8,788,313)

 

$

(5,542,391)

 

$

(9,516,436)

 

$

(14,168,717)

Depreciation and amortization

  

4,972,478

  

4,745,941

  

13,691,484

  

12,908,848

Interest expense, net

  

5,381,040

  

4,098,179

  

14,879,934

  

12,081,316

Income tax expense (benefit)

  

4,584,518

  

(342,259)

  

5,868,075

  

(2,068,530)

Allocation to noncontrolling interests

  

(1,808,422)

  

(1,772,908)

  

(4,980,424)

  

(3,500,873)

EBITDA attributable to Nutex Health Inc.

  

4,341,301

  

1,186,562

  

19,942,633

  

5,252,044

Facilities closing costs

  

-

  

-

  

-

  

217,266

Loss on warrant liability

  

6,733,552

  

-

  

1,072,709

  

-

Impairment of assets

  

425,221

     

3,898,856

   

Impairment of goodwill

  

-

  

-

  

3,197,391

  

-

Acquisition costs

  

-

  

43,464

  

-

  

43,464

Stock-based compensation expense

  

1,963,518

  

49,167

  

1,951,444

  

2,198,812

Adjusted EBITDA attributable to Nutex Health Inc.

 

$

13,463,592

 

$

1,279,193

 

$

30,063,033

 

$

7,711,586

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 22 facilities in ten 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.

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 and in the Quarterly Reports on Form 10-Q for the periods ending March 31, 2024 and June 30, 2024 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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