Wall Street Signals: Assure Holdings Reports Third Quarter 2021 Financial Results

Assure Holdings Reports Third Quarter 2021 Financial Results

 


Assure Holdings Corp. (the “Company” or “Assure”) (NASDAQ: IONM; TSXV: IOM), a provider of intraoperative neuromonitoring services (“IONM”), reported financial results for the third quarter ended September 30, 2021.

Third Quarter 2021 Financial Highlights vs. Third Quarter 2020

Total revenue was $8.5 million versus $4.0 million.

Managed cases increased 86% to 4,996 versus 2,685.

General and administrative expenses were $3.2 million compared to $2.0 million, reflecting IT investments in support of automation and data analytics, adding complementary talent to the management team, and for professional fees related to financing transactions and successful Nasdaq listing.

Net income of $0.1 million compared to a net loss of ($1.0) million.

Net income per diluted share of $0.01 compared to a net loss of ($0.14) per diluted share.

Adjusted EBITDA was $1.2 million versus ($0.7) million.

The total cash collected was $5.2 million for both periods.

The Company collected $3.3 million versus $3.1 million for IONM revenue that it retains 100%.

See “Explanation of Non-GAAP Financial Measures” below

Management Commentary

“The Company generated improved revenue and profitability in the third quarter, driven by an increase in managed cases and market share capture attained while controlling expenses. We expect this trend to continue in the fourth quarter and into 2022 as we execute against our key corporate objectives: scaling our platform through both organic growth and M&A, development of an in-network revenue stream, improving the performance of Assure’s billing and collections functions, and becoming a recognized clinical care leader in the IONM industry,” said John A. Farlinger, Assure’s executive chairman and CEO. “The Company achieved a number of milestones during the period. This included listing on the NASDAQ Capital Market (“NASDAQ”). In addition, Assure secured a system-wide contract with Premier Inc., a leading healthcare improvement company, uniting an alliance of approximately 4,400 U.S. hospitals and 225,000 other providers. Over the course of the three-year agreement, Assure will serve as the sole contracted supplier of intraoperative neuromonitoring services for Premier.”

“The roll-out of Assure’s remote neurology services for IONM is advancing. We completed over 700 remote neurology cases in the third quarter. Providing this service enables the Company to reduce our cost of delivery for providing IONM, thereby driving higher profit on every case we perform. Further, remote neurology services create a new revenue stream for Assure. Importantly, the patient volume necessary to accelerate our remote neurology services has already been established by the managed cases performed by our technologists. Now, it is simply a matter of transitioning Assure patients to our remote neurology platform. The potential to scale our remote neurology offering is substantial with each of the four providers we have hired capable of providing professional oversight on 2,500 managed cases per year or more once fully ramped.”

“I am pleased with the organic growth we have generated thus far in the second half of 2021, which includes expansion into two new states, Nebraska and Nevada, as well as extending our reach in our largest market, Texas. A recently completed private placement equity offering that generated gross proceeds of $4.75 million will support Assure’s key organic growth initiatives while minimizing dilution. In addition, the Company’s deep analytical capabilities and automation is widening our competitive advantage in revenue cycle management. In the third quarter, we signed an in-network insurance agreement with the MultiPlan Network and are in active negotiations with numerous other potential partners. From a corporate expense perspective, Assure proactively took action to cut spending in the third quarter as reflected in our improved profitability and we will continue to tightly manage expenses.”

Assure will be filing its quarter-end financial statements and MD&A on SEDAR (www.sedar.com) and Form 10-Q with the SEC at www.sec.gov and the Company website.

Operational Guidance

The Company forecasts more than 17,000 total managed cases for full-year 2021, a record number representing an increase of more than 70% compared with 2020.

This projection is based on organic growth and the acquisitions of Sentry Neuromonitoring and Elevation, both completed in the second quarter of 2021. It does not account for the impact of additional M&A activity that may occur. In addition, the guidance reflects the impact to date of COVID-19, but not a substantial future disruption relating to the pandemic.

Assure Begins Trading on Nasdaq Capital Market

In September 2021, Assure announced that its shares of common stock were approved for listing on the NASDAQ. Trading on NASDAQ commenced on September 29, 2021, under the ticker symbol “IONM.” The Company has also retained its listing on the TSX Venture Exchange (“TSXV”) under the ticker symbol “IOM.”

  • In connection with its NASDAQ application, Assure’s Board of Directors approved the following:
  • 5:1 share consolidation of its common stock to meet the share price requirements of NASDAQ which was effected on September 7, 2021.
  • Realignment of Board Committees to comply with NASDAQ requirements.
  • Adoption of new charters for its Audit Committee, Compensation Committee, and Nomination and Corporate Governance Committee to comply with NASDAQ requirements.
  • Adoption of a new Code of Business Conduct and Ethics.
  • Amendments to Bylaws.
Assure believes that trading on Nasdaq will have many benefits for the Company and represents important progress toward creating long-term shareholder value by attracting a broader, more diverse shareholder base.

Assure Signs Agreement with MultiPlan, Inc.

Assure signed an agreement with MultiPlan, Inc. (“MultiPlan”) effective August 15, 2021, to provide network access to health plan members who access MultiPlan’s national primary (PHCS) and complementary (MultiPlan) networks. More than 1 million healthcare providers participate in MultiPlan’s networks and 60 million health plan members have access to the company’s services.

Assure believes the MultiPlan agreement will improve network utilization for Assure’s IONM claims and attract a substantially higher proportion of eligible claims to our contracted rate.

Conference Call

The Company will hold a conference call today, November 15, 2021, at 4:30 p.m. Eastern Time to discuss its third quarter 2021 results.

The live webcast of the conference call and related presentation slides can be accessed at ir.assureneuromonitoring.com/news-events/ir-calendar. An audio-only option is available by following the dial-in instructions below. Investors who opt for audio-only will need to download the related slides at ir.assureneuromonitoring.com/company-information/presentations.

Date: Monday, November 15, 2021
Time: 4:30 p.m. Eastern Time (2:30 p.m. Mountain Time)
Toll-free dial-in number: 1-877-300-8521
International dial-in number: 1-412-317-6026
Conference ID: 10161977

Please call the conference telephone number 5-10 minutes prior to the start time. An operator will register your name and organization.

The conference call will be broadcast live and available for replay here.

About Assure Holdings

Assure Holdings Corp. is a Colorado-based company that works with neurosurgeons and orthopedic spine surgeons to provide a turnkey suite of services that support intraoperative neuromonitoring activities during invasive surgeries. Assure employs its own staff of technologists and uses its own state-of-the-art monitoring equipment, handles 100% of intraoperative neuromonitoring scheduling and setup, and bills for all technical services provided. Assure Neuromonitoring is recognized as providing the highest level of patient care in the industry and has earned The Joint Commission’s Gold Seal of Approval®. For more information, visit the Company’s website at www.assureneuromonitoring.com.

ASSURE HOLDINGS CORP.
CONDENSED INTERIM CONSOLIDATED STATEMENT OF FINANCIAL POSITION
(in thousands of United States Dollars)


September 30, 2021 (unaudited)

December 31, 2020

ASSETS

Current assets

Cash

$

918

$

4,386

Accounts receivable, net

22,683

14,965

Income tax receivable

150

150

Other current assets

104

618

Due from PEs

5,734

4,856

Total current assets

29,589

24,975

Equity method investments

638

608

Fixed assets

109

356

Operating lease right of use asset

124

Finance lease right of use asset

877

608

Deferred tax asset, net

144

Intangibles, net

3,763

4,115

Goodwill

4,448

2,857

Total assets

$

39,568

$

33,643

LIABILITIES AND SHAREHOLDERS' EQUITY

LIABILITIES

Current liabilities

Accounts payable and accrued liabilities

$

2,069

$

2,871

Current portion of the debt

4,100

Current portion of the lease liability

579

521

Current portion of acquisition liability

306

-

Other current liabilities

10

96

Total current liabilities

2,964

7,588

Lease liability, net of current portion

750

772

Debt, net of current portion

10,451

2,251

Acquisition liability

561

Acquisition share issuance liability

540

540

The fair value of stock option liability

40

16

Performance share issuance liability

2,668

Deferred tax liability, net

599

Total liabilities

15,306

14,434

SHAREHOLDERS' EQUITY

Common stock

12

11

Additional paid-in capital

38,385

30,886

Accumulated deficit

(14,135

)

(11,688

)

Total shareholders' equity

24,262

19,209

Total liabilities and shareholders' equity

$

39,568

$

33,643


ASSURE HOLDINGS CORP.
CONDENSED INTERIM CONSOLIDATED STATEMENT OF INCOME/(LOSS)
(in thousands of United States Dollars, except per share amounts)

Three Months Ended September 30,

Nine Months Ended September 30,

2021

2020

2021

2020

(unaudited)

(unaudited)

(unaudited)

(unaudited)

Revenue

Patient service fees, net

$

6,443

$

2,965

$

13,087

$

(6,342

)

Hospital, management, and other

2,103

998

6,446

3,902

Total revenue

8,546

3,963

19,533

(2,440

)

Cost of revenues

4,254

2,232

9,956

5,062

Gross margin

4,292

1,731

9,577

(7,502

)

Operating expenses

General and administrative

3,180

1,957

10,275

5,853

Sales and marketing

247

349

748

801

Depreciation and amortization

293

249

965

769

Total operating expenses

3,720

2,555

11,988

7,423

Income (loss) from operations

572

(824

)

(2,411

)

(14,925

)

Other income/(expenses)

Income (loss) from equity method investments

139

(232

)

136

(1,449

)

Other income (expense), net

(27

)

(3

)

(29

)

50

Accretion expense

(171

)

(227

)

(386

)

(619

)

Interest expense, net

(264

)

(58

)

(500

)

(164

)

Total other expense

(323

)

(520

)

(779

)

(2,182

)

Income (loss) before income taxes

249

(1,344

)

(3,190

)

(17,107

)

Income tax benefit (expense)

(158

)

367

743

2,396

Net income (loss)

$

91

$

(977

)

$

(2,447

)

$

(14,711

)

Basic income (loss) per share

$

0.01

$

(0.14

)

$

(0.21

)

$

(2.11

)

Diluted income (loss) per share

$

0.01

$

(0.14

)

$

(0.21

)

$

(2.11

)

ASSURE HOLDINGS CORP.
RECONCILIATION OF NON-GAAP ADJUSTED EBITDA TO NET LOSS
(in thousands of United States Dollars)

Three Months Ended September 30,

Nine Months Ended September 30,

2021

2020

2021

2020

(unaudited)

(unaudited)

(unaudited)

(unaudited)

Reported net income (loss)

$

91

$

(977

)

$

(2,447

)

$

(14,711

)

Interest expense, net

264

58

500

164

Accretion expense

171

227

386

619

Depreciation and amortization

293

249

672

537

Share-based compensation

210

88

818

456

Income tax expense (benefit)

158

(367

)

(743

)

(2,396

)

Provision for stock option fair value

25

3

24

(50

)

$

1,212

$

(719

)

$

(790

)

$

(15,381

)

ASSURE HOLDINGS CORP.
EARNINGS PER SHARE
(in thousands of United States Dollars, except per share amounts)

Three Months Ended September 30,

Nine Months Ended September 30,

2021

2020

2021

2020

(unaudited)

(unaudited)

(unaudited)

(unaudited)

Net income (loss)

$

91

$

(977

)

$

(2,447

)

$

(14,711

)

Basic weighted average common stock outstanding

11,838,032

6,988,058

11,528,371

6,968,728

Basic income (loss) per share

$

0.01

$

(0.14

)

$

(0.21

)

$

(2.11

)

Net income (loss)

$

91

$

(977

)

$

(2,447

)

$

(14,711

)

Basic weighted average common shares outstanding

11,838,032

6,988,058

11,528,371

6,968,728

Dilutive effect of stock options and warrants

3,886,071

Dilutive weighted average common stock outstanding

15,724,103

6,988,058

11,528,371

6,968,728

Diluted income (loss) per share

$

0.01

$

(0.14

)

$

(0.21

)

$

(2.11

)