$IONM
Assure Holdings Corp.

2021 Q4 Form 10-Q Financial Statement

#000179827021000017 Filed on November 15, 2021

View on sec.gov

Income Statement

Concept 2021 Q4 2021 Q3 2020 Q4
Revenue $9.659M $8.546M $5.964M
YoY Change 61.96% 115.81% -227.98%
Cost Of Revenue $4.362M $4.254M $2.850M
YoY Change 53.05% 90.59% 481.63%
Gross Profit $5.297M $4.292M $3.114M
YoY Change 70.1% 147.95% -160.47%
Gross Profit Margin 54.84% 50.22% 52.21%
Selling, General & Admin $4.864M $3.427M $4.147M
YoY Change 17.29% 48.61% 11.78%
% of Gross Profit 91.83% 79.85% 133.17%
Research & Development
YoY Change
% of Gross Profit
Depreciation & Amortization $515.0K $192.0K $1.014M
YoY Change -49.21% -23.2% 382.86%
% of Gross Profit 9.72% 4.47% 32.56%
Operating Expenses $5.013M $3.720M $4.392M
YoY Change 14.14% 45.6% 12.33%
Operating Profit $284.0K $572.0K -$1.278M
YoY Change -122.22% -169.42% -85.89%
Interest Expense -$662.0K -$296.0K -$274.0K
YoY Change 141.61% -43.08% 448.0%
% of Operating Profit -233.1% -51.75%
Other Income/Expense, Net -$17.00K -$323.0K $1.250M
YoY Change -101.36% -37.88% 635.29%
Pretax Income -$395.0K $249.0K -$114.0K
YoY Change 246.49% -118.53% -98.72%
Income Tax -$86.00K $158.0K $211.0K
% Of Pretax Income 63.45%
Net Earnings -$309.0K $91.00K -$325.0K
YoY Change -4.92% -109.31% -95.09%
Net Earnings / Revenue -3.2% 1.06% -5.45%
Basic Earnings Per Share $0.01
Diluted Earnings Per Share -$25.09K $0.01 -$40.22K
COMMON SHARES
Basic Shares Outstanding 11.84M 11.84M
Diluted Shares Outstanding 15.72M

Balance Sheet

Concept 2021 Q4 2021 Q3 2020 Q4
SHORT-TERM ASSETS
Cash & Short-Term Investments $4.020M $918.0K $4.386M
YoY Change -8.34% 512.0% 7210.0%
Cash & Equivalents $4.020M $918.0K $4.386M
Short-Term Investments
Other Short-Term Assets $151.0K $104.0K $618.0K
YoY Change -75.57% -76.36% 263.53%
Inventory
Prepaid Expenses
Receivables $27.81M $22.68M $14.97M
Other Receivables $6.022M $5.884M $5.340M
Total Short-Term Assets $38.00M $29.59M $24.98M
YoY Change 52.16% 56.22% -25.91%
LONG-TERM ASSETS
Property, Plant & Equipment $85.00K $109.0K $356.0K
YoY Change -76.12% -87.02% -59.08%
Goodwill $4.448M $4.448M $2.900M
YoY Change 53.38%
Intangibles $3.649M $3.763M $4.115M
YoY Change -11.32%
Long-Term Investments $525.0K $638.0K $608.0K
YoY Change -13.65% 30.2% -74.24%
Other Assets $144.0K
YoY Change
Total Long-Term Assets $10.41M $9.979M $8.668M
YoY Change 20.05% 18.52% -18.76%
TOTAL ASSETS
Total Short-Term Assets $38.00M $29.59M $24.98M
Total Long-Term Assets $10.41M $9.979M $8.668M
Total Assets $48.41M $39.57M $33.64M
YoY Change 43.89% 44.62% -24.19%
SHORT-TERM LIABILITIES
YoY Change
Accounts Payable $2.194M $2.069M $2.870M
YoY Change -23.55% 66.85% -34.32%
Accrued Expenses $153.0K $579.0K $124.0K
YoY Change 23.39%
Deferred Revenue
YoY Change
Short-Term Debt $0.00 $0.00 $0.00
YoY Change
Long-Term Debt Due $515.0K $306.0K $4.100M
YoY Change -87.44% -96.4% -42.74%
Total Short-Term Liabilities $3.717M $2.964M $7.588M
YoY Change -51.01% -70.12% -34.59%
LONG-TERM LIABILITIES
Long-Term Debt $13.17M $10.45M $2.251M
YoY Change 485.03% 186.33% 35.6%
Other Long-Term Liabilities $864.0K $580.0K $3.224M
YoY Change -73.2% -96.5% -83.08%
Total Long-Term Liabilities $13.17M $10.45M $2.251M
YoY Change 485.03% -48.31% -89.13%
TOTAL LIABILITIES
Total Short-Term Liabilities $3.717M $2.964M $7.588M
Total Long-Term Liabilities $13.17M $10.45M $2.251M
Total Liabilities $19.45M $15.31M $14.43M
YoY Change 34.77% -49.7% -57.94%
SHAREHOLDERS EQUITY
Retained Earnings -$14.44M -$14.14M -$11.69M
YoY Change 23.58%
Common Stock $13.00K $12.00K $11.00K
YoY Change 18.18%
Preferred Stock
YoY Change
Treasury Stock (at cost)
YoY Change
Treasury Stock Shares
Shareholders Equity $28.96M $24.26M $19.21M
YoY Change
Total Liabilities & Shareholders Equity $48.41M $39.57M $33.64M
YoY Change 43.89% 44.62% -24.19%

Cashflow Statement

Concept 2021 Q4 2021 Q3 2020 Q4
OPERATING ACTIVITIES
Net Income -$309.0K $91.00K -$325.0K
YoY Change -4.92% -109.31% -95.09%
Depreciation, Depletion And Amortization $515.0K $192.0K $1.014M
YoY Change -49.21% -23.2% 382.86%
Cash From Operating Activities -$4.021M -$3.091M -$2.533M
YoY Change 58.74% 87.33% 64.48%
INVESTING ACTIVITIES
Capital Expenditures $0.00 $0.00 -$319.0K
YoY Change -100.0% -897.5%
Acquisitions
YoY Change
Other Investing Activities -$107.0K $30.00K -$7.178M
YoY Change -98.51% -102.78% -8075.56%
Cash From Investing Activities -$107.0K $30.00K -$7.497M
YoY Change -98.57% -102.78% -15094.0%
FINANCING ACTIVITIES
Cash Dividend Paid
YoY Change
Common Stock Issuance & Retirement, Net
YoY Change
Debt Paid & Issued, Net
YoY Change
Cash From Financing Activities 7.230M 19.00K 14.36M
YoY Change -49.64% -99.27% 1254.43%
NET CHANGE
Cash From Operating Activities -4.021M -3.091M -2.533M
Cash From Investing Activities -107.0K 30.00K -7.497M
Cash From Financing Activities 7.230M 19.00K 14.36M
Net Change In Cash 3.102M -3.042M 4.327M
YoY Change -28.31% 2435.0% -1106.28%
FREE CASH FLOW
Cash From Operating Activities -$4.021M -$3.091M -$2.533M
Capital Expenditures $0.00 $0.00 -$319.0K
Free Cash Flow -$4.021M -$3.091M -$2.214M
YoY Change 81.62% 87.33% 40.13%

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<p style="font-family:'Times New Roman','Times','serif';font-size:10pt;font-weight:bold;margin:0pt;"><span style="display:inline-block;text-indent:0pt;width:18pt;"><b style="font-family:'Times New Roman','Times','serif';font-size:10pt;font-style:normal;font-weight:bold;text-align:left;">1.</b></span>NATURE OF OPERATIONS</p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;"><span style="visibility:hidden;">​</span></p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;">Assure Holdings Corp. (the “Company” or “Assure”), through its two wholly-owned subsidiaries, Assure Neuromonitoring, LLC (“Neuromonitoring”) and Assure Networks, LLC (“Networks”), provides outsourced intraoperative neurophysiological monitoring (“IONM”) and is an emerging provider of remote neurology services. The Company delivers a turnkey suite of clinical and operational services to support surgeons and medical facilities during invasive procedures including spine, neurosurgery, ear, nose, and throat, cardiovascular and orthopedic. Accredited by The Joint Commission, Assure’s mission is to provide exceptional surgical care and a positive patient experience. </p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;">IONM identifies real-time changes in spinal cord, brain, and peripheral nerve functions during high-risk surgeries to prevent injuries or accidental damage to patients that could lead to strokes, heart attacks, paralysis or other serious medical issues. IONM is well established and is regarded as the standard of care in U.S healthcare. </p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;">Assure employs highly trained IONM technologists, who provide a direct point of contact in the operating room to relay critical information to the surgical team while Company physicians deliver remote neurology services in support of the surgical team. In addition, Assure offers surgeons and medical facilities a value-added platform that manages patient scheduling, billing and collections, physician relationship management and patient advocacy services. The high quality IONM support that Assure provides results in decreased hospital and surgeon liability, abbreviated patient stays, fewer readmissions, reduced hospital costs, enhanced overall patient satisfaction and the efficient achievement of better clinical outcomes.</p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;">The Company maintains operations in twelve U.S. states. Assure believes that continued geographic expansion initiatives, facility-wide outsourcing agreements with medical facilities, the acceleration of its remote neurology services platform, and selective acquisitions will combine to generate substantial growth opportunities going forward.</p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;">The Company was originally incorporated in Colorado on November 7, 2016. In conjunction with a reverse merger with Montreux Capital Corp., a British Columbia corporation, the Company was redomesticated from British Columbia to Nevada on May 16, 2017.</p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;">Neuromonitoring was formed on August 25, 2015 in Colorado and it currently has multiple wholly-owned subsidiaries. The Company’s services are sold in the United States, directly through the Company.</p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;">Networks was formed on November 7, 2016 in Colorado and holds varying ownerships interests in numerous Provider Network Entities (“PEs”), which are professional IONM entities. These entities are accounted for under the equity method of accounting. </p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;">Networks also manages other PEs that Networks does not have an ownership interest and charges those PEs a management fee which is accounted for as service revenue. </p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt 0pt 12pt 0pt;">The Company operates in the United States in one segment. </p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;font-weight:bold;padding-bottom:12pt;margin:0pt;"><i style="font-style:italic;font-weight:normal;">COVID-19</i></p><p style="background-color:#ffffff;font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt;">Our business and results of operations have been, and continues to be, adversely affected by the global COVID-19 pandemic and related events and we expect its impact to continue. The impact to date has included periods of significant volatility in various markets and industries, including the healthcare industry. The volatility has had, and we anticipate it will continue to have, an adverse effect on our customers and on our business, financial condition and results of operations, and may result in an impairment of our long-lived assets, including goodwill, increased credit losses and impairments of investments in other companies. In particular, the healthcare industry, hospitals and providers of elective procedures have been and may continue to be impacted by the pandemic and/or other events beyond our control, and further volatility could have an additional negative impact on these industries, customers, and our business. In addition, the COVID-19 pandemic and, to a lesser extent, the impact on other industries, including automotive, electronics and real estate, </p><p style="background-color:#ffffff;font-family:'Times New Roman','Times','serif';font-size:10pt;text-align:justify;margin:0pt;">increased fuel costs, U.S. restrictions on trade, and transitory inflation have impacted and may continue to impact the financial conditions of our customers and the patients they serve.</p><p style="background-color:#ffffff;font-family:'Times New Roman','Times','serif';font-size:10pt;padding-top:10.8pt;text-align:justify;margin:0pt;">In addition, actions by United States federal, state and foreign governments to address the COVID-19 pandemic, including travel bans, stay-at-home orders and school, business and entertainment venue closures, also had and may continue to have a significant adverse effect on the markets in which we conduct our businesses. COVID-19 poses the risk that our workforce, suppliers, and other partners may be prevented from conducting normal business activities for an extended period of time, including due to shutdowns or stay-at-home orders that may be requested or mandated by governmental authorities. We have implemented policies to allow our employees to work remotely as a result of the pandemic as we reviewed processes related to workplace safety, including social distancing and sanitation practices recommended by the Centers for Disease Control and Prevention (CDC). The COVID-19 pandemic could also cause delays in acquiring new customers and executing renewals and could also impact our business as consumer behavior changes in response to the pandemic.</p><p style="background-color:#ffffff;font-family:'Times New Roman','Times','serif';font-size:10pt;padding-top:10.8pt;text-align:justify;margin:0pt;">Since the start of the second quarter of 2021, there has been increased availability and administration of vaccines against COVID-19, as well as an easing of restrictions on social, business, travel, and government activities and functions, including healthcare and elective surgeries, and we have experienced a gradual resumption of economic activities in our industries. On the other hand, infection rates continue to fluctuate in various regions and new strains of the virus, including the Delta variant, remain a risk, which may give rise to implementation of restrictions in the geographic areas that we serve. In addition, there are ongoing global impacts resulting from the pandemic, including disruption of the supply chains, product shortages, increased delivery costs, increased governmental regulation, strains on healthcare systems, and delays in shipments, product development, technology launches and facility access. </p><p style="background-color:#ffffff;font-family:'Times New Roman','Times','serif';font-size:10pt;padding-top:10.8pt;text-align:justify;margin:0pt;">We have been closely monitoring the COVID-19 pandemic and its impact on our business, including legislation to mitigate the impact of COVID-19 such as the Coronavirus Aid, Relief, and Economic Security (CARES) Act which was enacted in March 2020, and the American Rescue Plan Act of 2021 which was enacted in March 2021. Although a significant portion of our anticipated revenue for 2021 is derived from fixed-fee and minimum-guarantee arrangements, primarily from large, well-capitalized customers which we believe somewhat mitigates the risks to our business, our per-unit and variable-fee based revenue will continue to be susceptible to the volatility, supply chain disruptions, microchip shortages and potential market downturns induced by the COVID-19 pandemic.</p><p style="background-color:#ffffff;font-family:'Times New Roman','Times','serif';font-size:10pt;padding-top:10.8pt;text-align:justify;margin:0pt;">The full extent of the future impact of the COVID-19 pandemic on the Company’s operational and financial performance is uncertain and will depend on many factors outside the Company’s control, including, without limitation, the timing, extent, trajectory and duration of the pandemic; the availability, distribution and effectiveness of vaccines; the spread of new variants of COVID-19; the continued and renewed imposition of protective public safety measures; the impact of COVID-19 on integration of acquisitions, expansion plans, implementation of telemedicine, restrictions on elective procedures, delays in payor remittance and increased regulations; and the impact of the pandemic on the global economy and demand for consumer products. Although we are unable to predict the full impact and duration of the COVID-19 pandemic on our business, we are actively managing our financial expenditures in response to continued uncertainty. Further discussion of the potential impacts on our business from the COVID-19 pandemic is provided under Part I, Item 1A – Risk Factors of the Form 10-K.</p><p style="font-family:'Times New Roman','Times','serif';font-size:10pt;font-weight:bold;margin:0pt 0pt 12pt 0pt;"><span style="font-size:11pt;font-weight:normal;visibility:hidden;">​</span></p>
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us-gaap Number Of Operating Segments
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us-gaap Stockholders Equity Reverse Stock Split
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During September 2021, the Company effectuated a five-for-one reverse stock split. All share, stock option and warrant information has been retroactively adjusted to reflect the stock split. See Note 5 for additional discussion.
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0.030
us-gaap Share Based Compensation Arrangement By Share Based Payment Award Fair Value Assumptions Expected Volatility Rate
ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRate
0.91
us-gaap Share Based Compensation Arrangement By Share Based Payment Award Fair Value Assumptions Expected Volatility Rate
ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRate
1.07
CY2021Q3 us-gaap Allocated Share Based Compensation Expense
AllocatedShareBasedCompensationExpense
210000
CY2020Q3 us-gaap Allocated Share Based Compensation Expense
AllocatedShareBasedCompensationExpense
88000
us-gaap Allocated Share Based Compensation Expense
AllocatedShareBasedCompensationExpense
818000
us-gaap Allocated Share Based Compensation Expense
AllocatedShareBasedCompensationExpense
456000
CY2021Q3 us-gaap Employee Service Share Based Compensation Nonvested Awards Total Compensation Cost Not Yet Recognized Stock Options
EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedStockOptions
925000
CY2021Q3 us-gaap Sharebased Compensation Arrangement By Sharebased Payment Award Options Nonvested Number Of Shares
SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsNonvestedNumberOfShares
378092
us-gaap Employee Service Share Based Compensation Nonvested Awards Total Compensation Cost Not Yet Recognized Period For Recognition1
EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1
P2Y2M12D
CY2021Q3 us-gaap Class Of Warrant Or Right Outstanding
ClassOfWarrantOrRightOutstanding
3940006
us-gaap Net Income Loss
NetIncomeLoss
-14711000
CY2021Q3 us-gaap Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
11838032
CY2020Q4 us-gaap Class Of Warrant Or Right Outstanding
ClassOfWarrantOrRightOutstanding
3665006
ionm Debenture Warrants Issued
DebentureWarrantsIssued
275000
CY2021Q3 us-gaap Class Of Warrant Or Right Outstanding
ClassOfWarrantOrRightOutstanding
3940006
CY2021Q3 us-gaap Net Income Loss
NetIncomeLoss
91000
CY2020Q3 us-gaap Net Income Loss
NetIncomeLoss
-977000
us-gaap Net Income Loss
NetIncomeLoss
-2447000
us-gaap Net Income Loss
NetIncomeLoss
-14711000
CY2021Q3 us-gaap Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
11838032
CY2020Q3 us-gaap Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
6988058
us-gaap Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
11528371
us-gaap Weighted Average Number Of Shares Outstanding Basic
WeightedAverageNumberOfSharesOutstandingBasic
6968728
CY2021Q3 us-gaap Earnings Per Share Basic
EarningsPerShareBasic
0.01
CY2020Q3 us-gaap Earnings Per Share Basic
EarningsPerShareBasic
-0.14
us-gaap Earnings Per Share Basic
EarningsPerShareBasic
-0.21
us-gaap Earnings Per Share Basic
EarningsPerShareBasic
-2.11
CY2021Q3 us-gaap Net Income Loss
NetIncomeLoss
91000
CY2020Q3 us-gaap Net Income Loss
NetIncomeLoss
-977000
us-gaap Net Income Loss
NetIncomeLoss
-2447000
CY2021Q3 us-gaap Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
15724103
CY2020Q3 us-gaap Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
6988058
us-gaap Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
11528371
us-gaap Weighted Average Number Of Diluted Shares Outstanding
WeightedAverageNumberOfDilutedSharesOutstanding
6968728
CY2021Q3 us-gaap Earnings Per Share Diluted
EarningsPerShareDiluted
0.01
CY2020Q3 us-gaap Earnings Per Share Diluted
EarningsPerShareDiluted
-0.14
us-gaap Earnings Per Share Diluted
EarningsPerShareDiluted
-0.21
us-gaap Earnings Per Share Diluted
EarningsPerShareDiluted
-2.11

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