XML 20 R7.htm IDEA: XBRL DOCUMENT v3.25.3
Organization and Operations (Restated)
12 Months Ended
Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Organization and Operations (Restated) Organization and Operations (Restated)
Nutex Health Inc. (“Nutex Health” or the “Company”), is a physician-led, healthcare services and operations company with 24 hospital facilities in 11 states (hospital division), and a primary care-centric, risk-bearing population health management division. Our hospital division implements and operates different innovative health care models, including micro-hospitals, specialty hospitals and hospital outpatient departments (“HOPDs”). The population health management division owns and operates provider networks such as independent physician associations (“IPAs”).
We employ 800 full-time employees, contract 255 doctors at our facilities and partner with over 2,100 physicians within our networks. Our corporate headquarters is based in Houston, Texas. We were incorporated on April 13, 2000 in the state of Delaware.
Merger of Nutex Health Holdco LLC and Clinigence Holdings, Inc. On April 1, 2022, the merger (the “Merger”) of Nutex Health Holdco LLC and Clinigence Holdings, Inc. (“Clinigence”) was completed pursuant to the Agreement and Plan of Merger (the “Merger Agreement”) entered on November 23, 2021 between Clinigence, Nutex Acquisition LLC, a Delaware limited liability company and wholly-owned subsidiary of Clinigence, Nutex, Micro Hospital Holding LLC (solely for the purposes of certain sections of the Merger Agreement), Nutex Health Holdco LLC and Thomas Vo, M.D., solely in his capacity as the representative of the equity holders of Nutex Health Holdco LLC.
In connection with the Merger Agreement, Nutex Health Holdco LLC entered into certain Contribution Agreements with holders of equity interests, including Dr. Vo, our Chairman and CEO (“Nutex Owners”), of subsidiaries and affiliates (the “Nutex Subsidiaries”) pursuant to which such Nutex Owners agreed to contribute certain equity interests in the Nutex Subsidiaries to Nutex Health Holdco LLC in exchange for specified equity interests in Nutex Health Holdco LLC (collectively, the “Contribution Transaction”). Nutex owners having ownership interests representing approximately 84% of the agreed upon aggregate equity value of the Nutex Subsidiaries, agreed to contribute all or a portion of their equity interests, as applicable.
Pursuant to the Merger Agreement, each unit representing an equity interest in Nutex Health Holdco LLC issued and outstanding immediately prior to the effective time of the Merger but after the Contribution Transaction (collectively, the “Nutex Membership Interests”) was converted into the right to receive 3.571428575 shares of common stock of Clinigence, or an aggregate of 592,791,712 shares of common stock of Clinigence.
After completing the merger, Clinigence was renamed Nutex Health Inc.
2024 Reverse Stock Splits
1:15 Reverse stock split. The Company’s Board of Directors determined to effect a reverse stock split of the common stock at a 1-for-15 ratio (the “1:15 Reverse Stock Split”) effective as of 11:59 pm Eastern time on April 9, 2024. The stockholders of the Company at its annual meeting on June 29, 2023 had approved a reverse stock split within a range of 1:2 and 1:15 to be effected within one year of approval at the discretion of the Board. The Company’s common stock began trading on The Nasdaq Capital Market on a post-1:15 Reverse Stock Split basis under the Company’s existing trading symbol “NUTX” at the open of the market on April 10, 2024. The 1:15 Reverse Stock Split was implemented for the purpose of regaining compliance with the minimum bid price requirement for continued listing of the Company’s common stock on The Nasdaq Capital Market.
1:10 Reverse stock split. In addition, the Company’s Board of Directors determined to effect a reverse stock split of the common stock at a 1-for-10 ratio (the “1:10 Reverse Stock Split”) effective as of 11:59 pm Eastern time on July 2, 2024. The Company’s stockholders, at the annual meeting on June 17, 2024, had approved a reverse stock split within a range of 1:2 and 1:16 to be effected within one year of approval at the discretion of the Board. This 1:10 Reverse Stock Split is in addition to the Company’s previous 1:15 Reverse Stock Split as discussed above. The Company’s common stock began trading on The Nasdaq Stock Market on a post-1:10 Reverse Stock Split basis under the Company’s existing trading symbol “NUTX” at the open of the market on July 3, 2024. The 1:10 Reverse Stock Split was also implemented for the purpose of regaining compliance with the minimum bid price requirement for continued listing of the Company’s common stock on The Nasdaq Capital Market.
As a result of both the 1:15 Reverse Stock Split and 1:10 Reverse Stock Split (collectively, the “2024 Reverse Stock Splits”) the number of shares of common stock outstanding was reduced to 5,511,452 shares as of December 31, 2024, inclusive of whole shares issued for fractional shares, and the number of authorized shares of common stock remains at 950,000,000.
Unless otherwise indicated, all authorized, issued, and outstanding stock and per share amounts contained in the accompanying condensed consolidated financial statements have been adjusted to reflect the 2024 Reverse Stock Splits for all prior periods presented. Proportionate adjustments for the 2024 Reverse Stock Splits were made to the exercise prices and number of shares issuable under the Company’s equity incentive plans, and the number of shares underlying outstanding equity awards, as applicable.
The impacts of the 2024 Reverse Stock Splits were applied retroactively for all periods presented in accordance with applicable guidance. Therefore, prior period amounts are different than those previously reported. Certain amounts within the following tables may not foot due to rounding.
The following table illustrates changes in equity, as previously reported prior to, and as adjusted subsequent to, the impact of the 2024 Reverse Stock Splits retroactively adjusted for the periods presented:
December 31, 2023
As Previously
Reported
Impact of 2024 Reverse
Stock Splits
As
Revised
Common Stock - Shares676,679,911(672,168,712)4,511,199
Common Stock - Amount$676,680 $(672,169)$4,511 
Additional Paid-in Capital$469,849,049 $672,169 $470,521,218 
December 31, 2022
As Previously
Reported
Impact of 2024 Reverse
Stock Splits
As
Revised
Common Stock - Shares650,223,840(645,889,015)4,334,825
Common Stock - Amount$650,224 $(645,889)$4,335 
Additional Paid-in Capital$458,498,402 $645,889 $459,144,291 
January 1, 2022
As Previously
Reported
Impact of 2024 Reverse
Stock Splits
As
Revised
Common Stock - Shares592,791,712(588,839,768)3,951,944
Common Stock - Amount$592,792 $(588,840)$3,952 
Additional Paid-in Capital$11,742,891 $588,840 $12,331,731 
The following table illustrates changes in loss per share and weighted average shares outstanding, as previously reported prior to, and as adjusted subsequent to, the impact of the 2024 Reverse Stock Splits retroactively adjusted for the periods presented:
Year Ended December 31, 2023
As Previously
Reported
Impact of 2024 Reverse
Stock Splits
As
Revised
Loss attributable to common stockholders$(45,786,614)$— $(45,786,614)
Weighted average shares used to compute basic and diluted EPS661,247,959(656,839,639)4,408,320
Loss per share - basic and diluted$(0.07)$(10.32)$(10.39)
Year Ended December 31, 2022
As Previously
Reported
Impact of 2024 Reverse
Stock Splits
As
Revised
Loss attributable to common stockholders$(424,780,446)$— $(424,780,446)
Weighted average shares used to compute basic and diluted EPS634,877,629(630,645,111)4,232,518
Loss per share - basic and diluted$(0.05)$(100.31)$(100.36)
The following outstanding stock options and warrants exercisable or issuable into shares of common stock were not included in the computation of diluted shares outstanding because the effect would be anti-dilutive:
Year ended December 31, 2023
As Previously
Reported
Impact of 2024 Reverse
Stock Splits
As
Revised
Common stock options4,137,149(4,109,568)27,581
Common stock warrants20,343,562(20,207,831)135,731
Stock options were adjusted retroactively to give effect to the 2024 Reverse Stock Splits for the year ended December 31, 2023:
As Previously ReportedImpact of the 2024 Reverse Stock SplitsRevised
Options
Outstanding
Weighted Average
Exercise Price
Options
Outstanding
Weighted Average
Exercise Price
Options
Outstanding
Weighted Average
Exercise Price
Options outstanding at December 31, 20225,147,770$2.32 (5,113,452)$345.84 34,318$348.16 
Options exercised— — — 
Options cancelled(1,010,621)2.28 1,003,893339.72 (6,728)342.00 
Options outstanding at December 31, 20234,137,149$2.24 (4,109,559)$333.54 27,590$335.78 
Warrants were adjusted retroactively to give effect to the 2024 Reverse Stock Splits for the year ended December 31, 2023:
As Previously ReportedImpact of the 2024 Reverse Stock SplitsRevised
Warrants
Outstanding
Weighted Average
Exercise Price
Warrants
Outstanding
Weighted Average
Exercise Price
Warrants
Outstanding
Weighted Average
Exercise Price
Warrants outstanding at December 31, 202211,033,015$1.96 (10,959,462)$292.20 73,553$294.16 
Warrants issued10,770,0000.40 (10,698,286)59.60 71,71460.00 
Warrants exercised(1,456,453)1.55 1,446,743230.95 (9,710)232.50 
Warrants expired(3,000)25.00 2,9803,725.00 (20)3,750.00 
Warrants outstanding at December 31, 202320,343,562$1.16 (20,208,025)$157.00 135,537$158.16 
On July 24, 2024, the Company received written notice (the “Compliance Notice”) from The Nasdaq Stock Market LLC (“Nasdaq”) informing the Company that it has regained compliance with Nasdaq Listing Rule 5550(a)(2), which requires that companies listed on the Nasdaq Stock Market maintain a minimum bid price of $1.00 per share. Nasdaq notified the Company in the Compliance Notice that, from July 3, 2024 to July 23, 2024, the closing bid price of the Company’s common stock had been $1.00 per share or greater and, accordingly, the Company had regained compliance with Nasdaq Listing Rule 5550(a)(2) and that the matter was now closed.
Restatement of Previously Issued Consolidated Financial Statements
The Company has restated its previously issued consolidated financial statements as of and for the year ended December 31, 2024 to reclassify non-cash stock-based compensation obligations related to under-construction and ramping
hospitals as liabilities rather than equity. Further, the Company is also recording certain immaterial adjustments as described below.
The Company granted certain stock awards related to under-construction and ramping hospitals upon the merger with Clinigence discussed in Note 3. The Company corrected the classification of obligations totaling $16.4 million related to under construction and ramping hospitals from equity to liabilities in accordance with the classification criteria in ASC 718, Compensation - Stock Compensation, and ASC 480, Distinguishing Liabilities from Equity. The Company determined that these certain stock awards had no material effect on prior periods.
In addition, the Company identified certain immaterial adjustments to be made including related-party accounts payable balances amounting to $3.5 million that should be reclassified to equity, as the related-party accounts payable amounts were intended to be contribution amounts per certain of the Contribution Agreements with former owners of hospitals transferred to Nutex Health Holdco LLC effective April 1, 2022, a $2.9 million adjustment to reclassify restricted balances out of cash and cash equivalents and into restricted short-term investments, an adjustment to accrued income tax expense of $0.5 million, a change in presentation of the effective tax rate reconciliation to separately present disaggregate other items, and the deferred tax components for the right-of-use assets and liabilities in the income taxes footnote table are now presented on a gross basis. Further, the Company recorded an immaterial adjustment in the footnote on variable interest entities (Note 19) related to disclosure of consolidated balances.
These adjustments are non-cash in nature and had no effect on revenue, liquidity or operating cash flows.
The following table summarizes the effect of the corrections on the Company's consolidated balance sheet as of December 31, 2024:
December 31, 2024December 31, 2024
As Previously ReportedAdjustmentsAs Restated
Cash and cash equivalents$43,581,412 $(2,940,796)40,640,616 
Restricted short-term investment— 2,940,796 2,940,796 
Other current assets248,897,473 — 248,897,473 
Total current assets292,478,885 — 292,478,885 
Non-current assets362,841,508 — 362,841,508 
Total assets655,320,393 — 655,320,393 
Current liabilities:
Accounts payable - related parties4,345,138 (3,539,372)805,766 
Accrued income tax expense25,989,262 543,437 26,532,699 
Accrued stock based compensation— 16,356,000 16,356,000 
Other current liabilities110,531,725 — 110,531,725 
Total current liabilities140,866,125 13,360,065 154,226,190 
Non-current liabilities312,562,391 — 312,562,391 
Total liabilities453,428,516 13,360,065 466,788,581 
Common stock, $0.001 par value; 950,000,000 shares authorized; 5,511,452 and 4,511,199 shares issued and outstanding as of December 31, 2024 and December 31, 2023, respectively
5,511 — 5,511 
Additional paid-in capital503,232,609 (13,823,628)489,408,981 
Accumulated deficit(356,893,371)(83,128)(356,976,499)
Nutex Health Inc. equity146,344,749 (13,906,756)132,437,993 
Noncontrolling interests55,547,128 546,691 56,093,819 
Total equity201,891,877 (13,360,065)188,531,812 
Total liabilities and equity$655,320,393 $— $655,320,393 
The following table summarizes the effect of the corrections on the Company's consolidated statement of operations for the year ended December 31, 2024:
December 31, 2024December 31, 2024
As Previously ReportedAdjustmentsAs Restated
Total revenue$479,948,633 $— $479,948,633 
Total operating costs and expenses283,687,356 — 283,687,356 
Gross profit196,261,277 — 196,261,277 
Corporate and other costs:
Stock-based compensation16,631,898 (77,000)16,554,898 
Other corporate and other costs49,008,579 — 49,008,579 
Total corporate and other costs65,640,477 (77,000)65,563,477 
Operating income130,620,800 77,000 130,697,800 
Other expenses20,872,058 — 20,872,058 
Income before taxes109,748,742 77,000 109,825,742 
Income tax expense14,476,821 543,437 15,020,258 
Net income95,271,921 (466,437)94,805,484 
Less: net income attributable to noncontrolling interest43,092,753 (383,309)42,709,444 
Net income attributable to Nutex Health Inc.$52,179,168 $(83,128)$52,096,040 
Earnings per common share
Basic$10.25 $(0.02)$10.23 
Diluted$9.71 $(0.02)$9.69 
The following table summarizes the effect of the corrections on the Company's statement of stockholders' equity as of December 31, 2024:
Common StockAdditional paid-in capitalAccumulated deficitNutex Health Inc. equityNoncontrolling interestsTotal equity
Balances, December 31, 2024 (as previously reported)$5,511 $503,232,609 $(356,893,371)$146,344,749 $55,547,128 $201,891,877 
Adjustment due to cumulative error correction— (13,823,628)(83,128)(13,906,756)546,691 (13,360,065)
Balances, December 31, 2024 (as restated)$5,511 $489,408,981 $(356,976,499)$132,437,993 $56,093,819 $188,531,812 
The following table summarizes the effect of the corrections on the Company's statement of cash flows for the year ended December 31, 2024:
December 31, 2024December 31, 2024
As Previously ReportedAdjustmentsAs Restated
Net income$95,271,921 $(466,437)$94,805,484 
Stock-based compensation expense16,631,898 (77,000)16,554,898 
Accrued income tax expense25,989,262 543,437 26,532,699 
Other operating activities(114,739,274)— (114,739,274)
Net cash from operating activities23,153,807 — 23,153,807 
Purchase of restricted short-term investment— (2,940,796)(2,940,796)
Other investing activities(2,665,222)— (2,665,222)
Net cash from investing activities(2,665,222)(2,940,796)(5,606,018)
Net cash from financing activities1,090,771 — 1,090,771 
Net change in cash and cash equivalents and restricted cash21,579,356 (2,940,796)18,638,560 
Cash and cash equivalents and restricted cash - beginning of the year22,002,056 — 22,002,056 
Cash and cash equivalents and restricted cash - end of the year$43,581,412 $(2,940,796)$40,640,616