0001729149-20-000019.txt : 20200505 0001729149-20-000019.hdr.sgml : 20200505 20200504185602 ACCESSION NUMBER: 0001729149-20-000019 CONFORMED SUBMISSION TYPE: 10-Q PUBLIC DOCUMENT COUNT: 80 CONFORMED PERIOD OF REPORT: 20200331 FILED AS OF DATE: 20200505 DATE AS OF CHANGE: 20200504 FILER: COMPANY DATA: COMPANY CONFORMED NAME: VIEMED HEALTHCARE, INC. CENTRAL INDEX KEY: 0001729149 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISC HEALTH & ALLIED SERVICES, NEC [8090] IRS NUMBER: 000000000 STATE OF INCORPORATION: A1 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 10-Q SEC ACT: 1934 Act SEC FILE NUMBER: 001-38973 FILM NUMBER: 20846362 BUSINESS ADDRESS: STREET 1: 202 N. LUKE STREET CITY: LAFAYETTE STATE: LA ZIP: 70506 BUSINESS PHONE: 337.504.3802 MAIL ADDRESS: STREET 1: 202 N. LUKE STREET CITY: LAFAYETTE STATE: LA ZIP: 70506 10-Q 1 q12020usgaap10-qdoc.htm 10-Q Document


UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Form 10-Q
x
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 2020
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from _____ to _____

Commission file number: 001-38973
Viemed Healthcare, Inc.
(Exact name of registrant as specified in its charter)
British Columbia, Canada
 
N/A
(State or other jurisdiction of
incorporation or organization)
 
(IRS Employer
Identification Number)
 
 
 
 
625 E. Kaliste Saloom Rd.
Lafayette, LA 70508
 
(Address of principal executive offices, including zip code)
 
 
 
 
(337) 504-3802
 
(Registrant’s telephone number, including area code)
 
 
 
Securities registered pursuant to Section 12(b) of the Act:
 
 
 
Title of each class
Trading Symbol(s)
Name of exchange on which registered
Common Shares, no par value
VMD
The Nasdaq Stock Market LLC

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  x    No  ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  x    No  ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer ☐
 
Accelerated filer ☐
 
Non-Accelerated filer ☐
 
Smaller reporting company x
Emerging growth company x
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ☐    No  x

As of April 29, 2020, there were 38,486,772 common shares of the registrant outstanding.





VIEMED HEALTHCARE, INC.
TABLE OF CONTENTS
March 31, 2020 and 2019

 
 
Page
 
 
 
 
 
 
 
 
 
 
 
 
 






PART I - FINANCIAL INFORMATION

Item 1. Financial Statements
VIEMED HEALTHCARE, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(Expressed in thousands of U.S. Dollars, except outstanding shares)
 
Note
 
At
March 31, 2020
 
At
December 31, 2019
 
 
 
(Unaudited)
 
(Audited)
ASSETS
 
 
 
 
 
Current assets
 
 
 
 
 
Cash and cash equivalents
 
 
$
8,409

 
$
13,355

Accounts receivable, net of allowance for doubtful accounts of $10,196 and $7,782 at March 31, 2020 and December 31, 2019, respectively
2
 
15,443

 
11,534

Inventory, net
2
 
1,785

 
1,360

Prepaid expenses and other assets
2
 
4,514

 
1,562

Total current assets
 
 
$
30,151

 
$
27,811

Long-term assets
 
 
 
 
 
Property and equipment
3
 
56,632

 
54,772

Equity method investment
 
 
18

 
13

Total long-term assets
 
 
$
56,650

 
$
54,785

TOTAL ASSETS
 
 
$
86,801

 
$
82,596

 
 
 
 
 
 
LIABILITIES
 
 
 
 
 
Current liabilities
 
 
 
 
 
Trade payables
 
 
$
6,380

 
$
4,700

Deferred revenue
 
 
3,394

 
3,315

Income taxes payable
 
 
281

 
86

Accrued liabilities
4
 
6,886

 
8,968

Current portion of lease liabilities
5
 
7,433

 
7,093

Current portion of long-term debt
5
 
1,772

 
1,750

Total current liabilities
 
 
$
26,146

 
$
25,912

Long-term liabilities
 
 
 
 
 
Accrued liabilities
7
 
2,350

 
2,317

Long-term lease liabilities
5
 
2,330

 
3,039

Long-term debt
5
 
7,179

 
7,629

Total long-term liabilities
 
 
$
11,859

 
$
12,985

TOTAL LIABILITIES
 
 
$
38,005

 
$
38,897

 
 
 
 
 
 
Commitments and Contingencies
 
 

 

 
 
 
 
 
 
SHAREHOLDERS' EQUITY
 
 
 
 
 
Common stock - No par value: unlimited authorized; 38,486,772 and 37,952,660 issued and outstanding as of March 31, 2020 and December 31, 2019, respectively
7
 
6,657

 
3,366

Additional paid-in capital
 
 
4,252

 
6,377

Accumulated other comprehensive loss
 
 
(469
)
 
(157
)
Retained earnings
 
 
38,356

 
34,113

TOTAL SHAREHOLDERS' EQUITY
 
 
$
48,796

 
$
43,699

 
 
 
 
 
 
TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY
 
 
$
86,801

 
$
82,596


See accompanying notes to the condensed consolidated financial statements
Page 3




VIEMED HEALTHCARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF INCOME AND COMPREHENSIVE INCOME
(Expressed in thousands of U.S. Dollars, except share and per share amounts)
(Unaudited)

 
 
 
Three Months Ended March 31,
 
Note
 
2020
 
2019
Revenue
2
 
$
23,806

 
$
18,115

 
 
 
 
 
 
Cost of revenue
 
 
8,253

 
5,041

 
 
 
 
 
 
Gross profit
 
 
$
15,553

 
$
13,074

 
 
 
 
 
 
Operating Expenses
 
 
 
 
 
Selling, general and administrative
 
 
10,577

 
9,460

Research and development
 
 
174
 
234

Stock-based compensation
7
 
1,151

 
880

Depreciation
 
 
205

 
129

(Gain) loss on disposal of property and equipment
 
 
(1,169
)
 
56

Income from operations
 
 
$
4,615

 
$
2,315

 
 
 
 
 
 
Non-operating expenses
 
 
 
 
 
Unrealized loss on warrant conversion liability
6
 

 
169
Loss from equity method investment
 
 
27
 
24
Interest expense, net of interest income
5
 
158

 
26

 
 
 
 
 
 
Net income before taxes
 
 
4,430

 
2,096

Provision for income taxes
9
 
187

 
138

 
 
 
 
 
 
Net income
 
 
$
4,243

 
$
1,958

 
 
 
 
 
 
Other Comprehensive Income
 
 
 
 
 
Change in unrealized loss on derivative instruments, net of tax
 
 
(312
)
 

Other Comprehensive Loss
 
 
$
(312
)
 
$

 
 
 
 
 
 
Comprehensive Income
 
 
$
3,931

 
$
1,958

 
 
 
 
 
 
Net income per share
 
 
 
 
 
Basic
11
 
$
0.11

 
$
0.05

Diluted
11
 
$
0.11

 
$
0.05

 
 
 
 
 
 
Weighted average number of common shares outstanding:
 
 
 
 
 
Basic
11
 
38,030,854

 
37,827,058

Diluted
11
 
39,677,983

 
39,449,123



See accompanying notes to the condensed consolidated financial statements
Page 4




VIEMED HEALTHCARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN SHAREHOLDERS' EQUITY
(Expressed in thousands of U.S. Dollars, except share and per share amounts)
(Unaudited)


 
 
Common Stock
 
Additional paid-in capital
 
Accumulated other comprehensive loss
 
 
 
Total Shareholders'
equity
 
 
Shares
 
Amount
 
 
 
Retained
earnings
 
Shareholders' equity, December 31, 2018
 
37,500,815
 
$
71

 
$
5,390

 
$

 
$
27,110

 
$
32,571

Stock-based compensation - options
 

 

 
578

 

 

 
578

Stock-based compensation - restricted stock
 

 

 
302

 

 

 
302

Options exercised
 
2,418

 
4

 

 

 

 
4

Shares issued for vesting of restricted stock units
 
539,965

 
2,202

 
(2,202
)
 

 

 

Shares repurchased and canceled under the Normal Course Issuer Bid
 
(365,100
)
 

 

 

 
(1,522
)
 
(1,522
)
Net Income
 

 

 

 

 
1,958

 
1,958

Shareholders' equity, March 31, 2019
 
37,678,098

 
$
2,277

 
$
4,068

 
$

 
$
27,546

 
$
33,891

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Common Stock
 
Additional paid-in capital
 
Accumulated other comprehensive loss
 
 
 
Total Shareholders'
equity
 
 
Shares
 
Amount
 
 
 
Retained
earnings
 
Shareholders' equity, December 31, 2019
 
37,952,660

 
$
3,366

 
$
6,377

 
$
(157
)
 
$
34,113

 
$
43,699

Stock-based compensation - options
 

 

 
891

 

 

 
891

Stock-based compensation - restricted stock
 

 

 
260

 

 

 
260

Exercise of options
 
4,737

 
15

 

 

 

 
15

Shares issued for vesting of restricted stock units
 
529,375

 
3,276

 
(3,276
)
 

 

 

Change in accumulated other comprehensive loss
 

 

 

 
(312
)
 

 
(312
)
Net Income
 

 

 

 

 
4,243

 
4,243

Shareholders' equity, March 31, 2020
 
38,486,772


$
6,657


$
4,252


$
(469
)

$
38,356


$
48,796


See accompanying notes to the condensed consolidated financial statements
Page 5




VIEMED HEALTHCARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Expressed in thousands of U.S. Dollars)
(Unaudited)


 
 
 
Three Months Ended March 31,
 
Note
 
2020
 
2019
Cash flows from operating activities
 
 
 
 
 
Net income
 
 
$
4,243

 
$
1,958

Adjustments for:
 
 
 
 
 
Depreciation

 
2,130

 
1,400

Change in allowance for doubtful accounts
2
 
2,846

 
2,125

Share-based compensation
7
 
1,151

 
880

Unrealized loss on warrant conversion liability
6
 

 
169

Loss on equity investment
 
 
27

 
24

(Gain) loss on disposal of property and equipment
 
 
(1,169
)
 
56

Net change in working capital
 
 
 
 
 
Increase in accounts receivable
 
 
(6,755
)
 
(4,952
)
Increase in inventory
 
 
(425
)
 
(728
)
Increase in prepaid expenses and other current assets
 
 
(2,952
)
 
(129
)
Increase in trade payables
 
 
3,598

 
504

Increase in deferred revenue
 
 
79

 
203

Decrease in accrued liabilities
 
 
(2,361
)
 
(856
)
Increase (decrease) in income tax payable
 
 
195

 
(4
)
Net cash provided by operating activities
 
 
$
607

 
$
650

 
 
 
 
 
 
Cash flows from investing activities
 
 
 
 
 
Purchase of property and equipment
 
 
(4,220
)
 
(116
)
Investment in equity method investment
 
 
(32
)
 

Proceeds from sale of property and equipment
 
 
2,541

 
24

Net cash used in investing activities
 
 
$
(1,711
)
 
$
(92
)
 
 
 
 
 
 
Cash flows from financing activities
 
 
 
 
 
Proceeds from exercise of options
 
 
15

 
4

Principal payments on notes payable
 
 
(33
)
 

Principal payments on term note
 
 
(395
)
 

Shares repurchased and canceled under the Normal Course Issuer Bid
 
 

 
(1,522
)
Repayments of lease liabilities, net of proceeds
 
 
(3,429
)
 
(2,043
)
Net cash used in financing activities
 
 
$
(3,842
)
 
$
(3,561
)
 
 
 
 
 
 
Net decrease in cash and cash equivalents
 
 
(4,946
)
 
(3,003
)
Cash and cash equivalents at beginning of year
 
 
13,355

 
10,413

Cash and cash equivalents at end of period
 
 
$
8,409

 
$
7,410

 
 
 
 
 
 
Supplemental disclosures of cash flow information
 
 
 
 
 
Cash paid during the period for interest
 
 
$
165

 
$
26

Cash paid during the period for income taxes, net of refunds received
 
 
$
(8
)
 
$
143

Supplemental disclosures of non-cash transactions
 
 
 
 
 
Property and equipment financed through finance leases
 
 
$
3,002

 
$
4,505

Property and equipment financed through leases under FASB ASC 842
 
 
$
31

 
$
1,267


See accompanying notes to the condensed consolidated financial statements
Page 6


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019



1.    Nature of Business and Operations

On December 21, 2017, Viemed Healthcare, Inc. (the "Company") consumated Asset and Share Purchase Agreements as well as an Arrangement Agreement ("the Arrangement") with Protech Home Medical Corp. ("PHM") (formerly Patient Home Monitoring Corp.) and was spun-out as a separate public company that owns a 100% interest in Home Sleep Delivered, L.L.C. ("HSD") and Sleep Management, L.L.C. dba Viemed ("Viemed") through the U.S. holding company Viemed Inc.

The Company, through its subsidiaries, Viemed and HSD, provides in-home durable medical equipment ("DME") and health care solutions to patients in over 30 states in the United States. Viemed offers customers requiring respiratory services and related equipment an appropriate selection of home medical products including non-invasive ventilators, positive airway pressure (“PAP”) machines and oxygen units, as well as the services of experienced respiratory therapists. HSD provides in-home sleep apnea testing, allowing a patient to determine the existence of sleep apnea at home at a fraction of the cost of the traditional sleep lab environment. The Company was incorporated under the Business Corporations Act (British Columbia) on December 14, 2016. The Company's registered and records office is located at Suite 2800, Park Place, 666 Burrard Street, Vancouver, British Columbia V6C 2Z7 and its corporate office is located at 625 E. Kaliste Saloom Road, Lafayette, Louisiana 70508.

The Company qualifies as a "foreign private issuer," as defined in Rule 12b-2 of the Securities and Exchange Act of 1934, as amended (the "Exchange Act"), for the purposes of the informational requirements of the Exchange Act. Although, as a foreign private issuer, the Company would not be required to do so, the Company will file annual reports on Form 10-K, quarterly reports on Form 10-Q, and current reports on Form 8-K with the Securities and Exchange Commission (the "SEC"), instead of filing the reporting forms available to foreign private issuers.

The Company is an "emerging growth company," as defined in the Jumpstart Our Business Startups Act (the "JOBS Act"), and as such, has elected to comply with certain reduced U.S. public company reporting requirements.

The Company’s shares are traded in Canada on the Toronto Stock Exchange under the symbol VMD.TO and in the U.S. on the Nasdaq Capital Market under the symbol VMD.

2. Summary of Significant Accounting Policies

Principles of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information and pursuant to the rules and regulations of the SEC. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. The accompanying condensed consolidated financial statements are unaudited, but reflect all adjustments consisting of normal recurring accruals, which, in the opinion of management, are necessary to present fairly our Condensed Consolidated Balance Sheets, Condensed Consolidated Statements of Income and Comprehensive Income, Condensed Consolidated Statements of Changes in Shareholders’ Equity and Condensed Consolidated Statements of Cash Flows for the interim periods presented. Our fiscal year ends on December 31. The condensed consolidated balance sheet as of December 31, 2019 was derived from audited consolidated financial statements but does not include all disclosures required by GAAP. These condensed consolidated financial statements should be read in conjunction with the annual consolidated financial statements and the notes thereto and the report of our independent registered public accounting firm included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2019. The nature of our business is such that the results of any interim period may not be indicative of the results to be expected for the entire year.

Reporting currency

All values are in U.S. dollars ($ or "USD") unless specifically indicated otherwise. Canadian dollars are indicated as CAD$.









 
 
 
Page 7


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


Functional currency

Management has exercised judgment in selecting the functional currency of each of the entities that it combines based on the primary economic environment in which the entity operates and in reference to the various indicators including the currency that primarily influences or determines the selling prices of goods and services and the cost of those services, including labor, material and other costs and the currency whose competitive forces and regulations mainly determine selling prices. The Company's functional currency was determined to be the U.S. dollar, which was determined using management’s assumption that the primary economic environment which it will derive its revenue and expenses incurred to generate those revenues is the United States.

Basis of consolidation

These consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany transactions have been eliminated.

Use of estimates

The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Management bases these estimates and assumptions upon historical experience, existing and known circumstances, authoritative accounting pronouncements and other factors that management believes to be reasonable. Significant areas requiring the use of management estimates relate to revenue recognition, accounts receivable and the related allowance for doubtful accounts, income tax provisions, and fair value of financial instruments. Actual results could differ from these estimates.

As of March 31, 2020, the COVID-19 pandemic is ongoing and the impacts of the pandemic on our business, financial condition and results of operations continue to evolve as of the date of this report. As a result, the impacts remain uncertain and difficult to predict and will depend on, among other factors, the duration and severity of the pandemic, as well as any negative economic conditions arising from the pandemic, our ability to assess potential patients in hospitals and set up and treat patients in the home, and the impacts of government actions and administrative regulations on the healthcare industry and broader economy, including through existing and any future stimulus efforts. As events continue to evolve and additional information becomes available, our estimates may change materially in future periods.

Accounts receivable

Accounts receivable are regularly reviewed for collectability and an allowance is recorded to cover the estimated bad debts and billing modifications. The accounts receivable are presented on the Condensed Consolidated Balance Sheets net of the allowance for doubtful accounts. It is possible that the estimates of the allowance for doubtful accounts could change, which could have a material impact on our operations and cash flows.

The Company writes off receivables when the likelihood for collection is remote, and when the Company believes collection efforts have been fully exhausted and it does not intend to devote additional resources in attempting to collect. The write-offs are charged against the allowance for doubtful accounts.

For the three months ended March 31, 2020, our assessment considered business and market disruptions caused by the COVID-19 pandemic and estimates of expected emerging credit and collectability trends. The continued volatility in market conditions and evolving shifts in credit trends are difficult to predict causing variability and volatility that may have a material impact on our allowance for credit losses in future periods.

The estimates and write-offs for the allowance for doubtful accounts for each reporting period were as follows:
 
 
March 31, 2020
 
March 31, 2019
Balance, beginning of year
 
$
7,782

 
$
4,266

Provision for bad debts
 
2,846

 
2,125

Amounts written off
 
(432
)
 
(502
)
Balance, end of period
 
$
10,196

 
$
5,889



 
 
 
Page 8


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


As of March 31, 2020 and 2019, no one customer represented more than 10% of outstanding accounts receivable. The Company does have receivables at March 31, 2020 from Medicare and Medicaid, representing 49% and 8%, respectively, and 57% combined, of total outstanding receivables (December 31, 2019 - 58%). As these receivables are both from government programs, there is little credit risk associated with these balances; however, these receivables are subject to billing modifications and other adjustments and estimates of the amounts of such adjustments are included in the allowance for doubtful accounts.

Revenues from Medicare and Medicaid accounted for 64% and 9%, respectively and 73% combined, of the Company's total revenues for the three months ended March 31, 2020. Revenues from Medicare and Medicaid accounted for 68% and 9%, respectively, and 77% combined, of the Company's total revenues for the three months ended March 31, 2019.

Property and equipment

Property and equipment is presented on the Condensed Consolidated Balance Sheets at historic cost less accumulated depreciation. Major renewals and improvements that extend the useful life of assets are capitalized to the respective property accounts, while maintenance and repairs, which do not extend the useful life of the respective assets, are expensed as incurred. Management has estimated the useful lives of equipment leased to customers. Depreciation is computed using the straight-line method over the estimated useful lives of the respective assets. Property and equipment are amortized on a straight-line basis over their estimated useful lives.

The estimated useful lives of the property and equipment are as follows:
Description
 
Estimated Useful Lives
Medical Equipment
 
1 - 10 Years
Computer Equipment
 
5 Years
Office Furniture & Fixtures
 
5 - 10 Years
Leasehold Improvements
 
Shorter of Useful Life or Lease
Vehicles
 
5 Years
Building
 
15 - 39 Years
Land
 
Indefinite Life

Depreciation of medical equipment commences at the date of service, which represents the date that the asset has been deployed to a patient’s address and is put in use and continues through the useful life of the asset. Property and equipment and other non-current assets with definite useful lives are tested for impairment whenever events or changes in circumstances indicate that their carrying amount may not be recoverable.

Prepaid expenses and other assets

Prepaid expenses and other current assets consists primarily of refundable deposits made for ventilators that have not been received by the Company, along with prepaid insurance, and prepaid rent.
 
Comprehensive income

Comprehensive income reflects the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Our comprehensive income represents net income adjusted for unrealized gains and losses on derivative instruments. Accumulated other comprehensive loss is presented in the accompanying balance sheets as a component of shareholders' equity.

Revenue recognition

Revenue from a customer consists of any combination of the sale and rental of DME and/or patient medical services. Revenues are billed to and collections received from Medicare, Medicaid, third-party insurers, co-insurance and patient-pay. Revenue is recognized net of contractual adjustments and bad debt based on contractual arrangements with third-party payors, an evaluation of expected collections resulting from the analysis of current and past due accounts, past collection experience in relation to amounts billed and other relevant information. Contractual adjustments result from the differences between the rates charged for services and reimbursements by government-sponsored healthcare programs and insurance companies for such services.



 
 
 
Page 9


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


The Company's contracts with customers often include multiple products and services, and the Company evaluates these arrangements to determine the unit of accounting for revenue recognition purposes based on whether the product or service is distinct from other products or services in the arrangement and should be accounted for as a separate performance obligation. A product or service is distinct if the customer can benefit from it on its own or together with other readily available resources and the Company's ability to transfer the goods or services is separately identifiable from other promises in the contractual arrangement with the customer (e.g. patient). Revenue is then allocated to each separately identifiable good or service based on the standalone price of the items underlying the performance obligations. Most of the Company’s products fall in the Medicare Fee-for-Service (“FFS”) program which is a payment model where services are unbundled and paid for separately. These services are paid based on a Medicare determined price that is publicly available on the website for the Centers for Medicare & Medicaid Services (“CMS”). For commercial payors, DME companies must negotiate in-network pricing separately, though in general, the Company’s payors tend to benchmark their contract rates and coverage policies closely to those of Medicare.

The Company considers performance obligations for sales and rentals to be met when the customer receives the equipment, and revenue for rentals is recognized over time, over the respective rental period. For revenue associated with DME rentals, the Company recognizes revenue in accordance with FASB ASC 842, “Leases,” (Topic 842). For any DME sales and services, the Company recognizes revenue under FASB ASU 2014-09, “Revenue from Contracts with Customers,” (Topic 606) and related amendments.

The Company recognizes equipment rental revenue over the non-cancelable lease term, which is one month, less estimated adjustments, in accordance with Topic 842. The Company has separate contracts with each patient that are not subject to a master lease agreement with any third-party payor. The Company would first consider the lease classification issue (sales-type lease or operating lease) and then appropriately recognize or defer rental revenue over the lease term.

The revenues from each major source are summarized in the following table:
 
 
Three Months Ended March 31,
 
 
2020
 
2019
Revenue from rentals under Topic 842
 
 
 
 
    Ventilator rentals, non-invasive and invasive
 
$
18,792

 
$
16,204

    Other durable medical equipment rentals
 
2,131

 
797

Revenue from sales and services under Topic 606
 
 
 
 
    Equipment and supply sales
 
1,533

 
778

    COVID-19 response sales(1)
 
1,040

 

    Service revenues
 
310

 
336

Total Revenues
 
$
23,806

 
$
18,115

(1) See Management's Discussion and Analysis for further discussion.

Revenue Accounting under Topic 842

The Company leases DME such as non-invasive and invasive ventilators, PAP machines, percussion vests, oxygen concentrator units and other small respiratory equipment to customers for a fixed monthly amount on a month-to-month basis. The customer generally has the right to cancel the lease at any time during the rental period. The Company considers these rentals to be operating leases.

Under FASB Accounting Standards Codification Topic 842, the Company recognizes rental revenue on operating leases on a straight-line basis over the contractual lease term which varies based on the type of equipment rental. The lease term begins on the date products are delivered to patients, and revenues are recorded at amounts estimated to be received under reimbursement arrangements with third-party payors, including Medicare, private commercial payors, and Medicaid. Certain customer co-payments are included in revenue when considered probable of payment, which is generally when paid.

Due to the nature of the industry and the reimbursement environment in which the Company operates, certain estimates are required to record net revenue and accounts receivable at their net realizable values. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. Specifically, the complexity of many third-party billing arrangements and the uncertainty of reimbursement amounts for certain services from certain payors may result in adjustments to amounts originally recorded. Such adjustments are typically identified and recorded at the point of cash application or claim denial.




 
 
 
Page 10


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


Revenue Accounting under Topic 606

The Company sells DME, replacement parts and supplies to customers and recognizes revenue based on contractual payment rates as determined by the payors at the point in time where control of the good or service is transferred through delivery to the customer. The customer and, if applicable, the payors are generally charged at the time that the product is sold. For sales of equipment previously placed in service, proceeds associated with these sales are recorded to gain (loss) on disposal of property and equipment.

The Company also provides sleep study services to customers and recognizes revenue when the results of the sleep study are complete as that is when the performance obligation is met. The transaction price on both equipment sales and sleep studies is the amount that the Company expects to receive in exchange for the goods and services provided. Due to the nature of the DME business, gross charges are retail charges and generally do not reflect what the Company is ultimately paid. As such, the transaction price is constrained for the difference between the gross charge and what is estimated to be collected from payors and from patients. The transaction price therefore is predominantly based on contractual payment rates as determined by the payors. The Company does not generally contract with uninsured customers. The payment terms and conditions of customer contracts vary by customer type and the products and services offered.

The Company determines its estimates of contractual allowances and discounts based upon contractual agreements, its policies and historical experience. While the rates are fixed for the product or service with the customer and the payors, such amounts typically include co-payments, co-insurance and deductibles, which vary in amounts, and are due from the patient. The Company includes in the transaction price only the amount that the Company expects to be entitled, which is substantially all of the payor billings at contractual rates. The transaction price is initially constrained by the amount of customer co-payments, which are included in the transaction price when considered probable of payment and included in revenue if the product or service has already been provided to the customer.

Due to the nature of the industry and the reimbursement environment in which the Company operates, certain estimates are required to record net revenue and accounts receivable at their net realizable values. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. Specifically, the complexity of many third-party billing arrangements and the uncertainty of reimbursement amounts for certain services from certain payors may result in adjustments to amounts originally recorded. Such adjustments are typically identified and recorded at the point of cash application or claim denial.

Returns and refunds are not accepted on either equipment sales or sleep study services. The Company does not offer warranties to customers in excess of the manufacturer’s warranty. Any taxes due upon sale of the products or services are not recognized as revenue. The Company does not have any partially or unfilled performance obligations related to contracts with customers and as such, the Company has no contract liabilities as of March 31, 2020.

Stock-based compensation

The Company accounts for its stock-based compensation in accordance with ASC 718, "Compensation—Stock Compensation", which establishes accounting for share-based awards exchanged for employee services and requires companies to expense the estimated fair value of these awards over the requisite employee service period. Stock–based compensation cost for stock options are determined at the grant date using the Black-Scholes option pricing model. Stock-based compensation costs for restricted stock units are determined at the grant date based on the closing stock price. The expense of such stock-based compensation awards is recognized using the graded vesting attribution method over the vesting period and the offsetting credit is recorded as an increase in additional paid-in capital. Forfeitures are recorded as incurred. Any excess tax benefit or deficiency is recognized as a component of income taxes and within operating cash flows upon vesting of the share-based award.

Interest rate swaps

The Company utilizes an interest rate swap contract to reduce exposure to fluctuations in variable interest rates for future interest payments on the Term Note (as defined below). 

For determining the fair value of the interest rate swap contract, the Company uses significant other observable market data or assumptions (Level 2 inputs) that market participants would use in pricing similar assets or liabilities, including assumptions about counterparty risk. These fair value estimates reflect an income approach based on the terms of the interest rate swap contract and inputs corroborated by observable market data including interest rate curves. The Company includes unrealized gains in Prepaid expenses and other assets, as a component of Long-term Assets, and unrealized losses in Accrued Liabilities, as a component of Long-term Liabilities on the Condensed Consolidated Balance Sheets.


 
 
 
Page 11


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


The Company recognizes any differences between the variable interest rate payments and the fixed interest rate settlements from its swap counterparty as an adjustment to interest expense over the life of the swap. If determined to be an effective cash flow hedge, the Company will record the changes in the estimated fair value of the swaps to Accumulated other comprehensive income or loss on the Condensed Consolidated Balance Sheets. To the extent that interest rate swaps are determined to be ineffective, the Company would recognize the changes in the estimated fair value of swaps in Interest and other non-operating expenses, net in its Condensed Consolidated Statements of Income.

Net Income per Share Attributable to Common Stockholders

The Company uses the two-class method to compute net income per common share attributable to common stockholders because the Company issued securities, other than common stock, that contractually entitled the holders to participate in dividends and earnings prior to the initial listing. The two-class method requires earnings for the period to be allocated between common stock and participating securities based upon their respective rights to receive distributed and undistributed earnings.

Under the two-class method, for periods with net income, basic net income per share attributable to common stockholders is computed by dividing the net income attributable to common stockholders by the weighted-average number of shares of common stock outstanding during the period. Diluted net income per share attributable to common stockholders is computed by dividing the net income attributable to common stockholders by the weighted-average number of shares of common stock and dilutive potential shares of common stock outstanding during the period. Net income attributable to common stockholders is computed by subtracting from net income the portion of the current period's earnings that the participating securities would have been entitled to receive pursuant to their dividend rights had all of the period’s earnings been distributed. No such adjustment to earnings is made during periods with a net loss, as the holders of the participating securities have no obligation to fund losses.

See Note 11 for earnings per share computations.

Recently adopted accounting pronouncements

In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement. The new guidance modifies the disclosure requirements on fair value measurements. The Company adopted this standard on January 1, 2020 and the adoption of this standard did not have a material impact on the Company's condensed consolidated financial statements.

Recently issued accounting pronouncements

The Company is an “emerging growth company” as defined by the JOBS Act. The JOBS Act provides that an emerging growth company can take advantage of the extended transition period provided in Section 7(a)(2)(B) of the Securities Act of 1933, as amended (the “Securities Act”), for complying with new or revised accounting standards. In other words, an emerging growth company can selectively delay the adoption of all accounting standards until those standards would otherwise apply to private companies. The Company has elected to utilize this exemption and, as a result, our condensed consolidated financial statements may not be comparable to the financial statements of issuers that are required to comply with the effective dates for new or revised accounting standards that are applicable to public companies. To date, however, the Company has not delayed the adoption of any accounting standards except as noted below. Section 107 of the JOBS Act provides that the Company can elect to opt out of the extended transition period at any time, which election is irrevocable.

In June 2016, the FASB issued ASU No. 2016-13, “Financial Instruments - Credit Losses,” to require the measurement of expected credit losses for financial instruments held at the reporting date based on historical experience, current conditions and reasonable forecasts. The ASU will be effective for interim and annual periods beginning January 1, 2020 for issuers and annual periods beginning January 1, 2023 for non-issuers. The Company anticipates adopting this ASU on January 1, 2023 given its smaller reporting company status and is still evaluating the impact of adoption on the consolidated financial statements in future periods.

In November 2019, the FASB issued ASU 2019-11, Codification Improvements to Topic 326, Financial Instruments – Credit Losses. Among other things, the ASU expands the scope of the practical expedient that allows entities to exclude the accrued interest component of amortized cost from various disclosures required by ASC 326 to also include certain disclosures required by Topic 320. Entities that elect to apply the practical expedient must disclose the total amount of accrued interest that they exclude from their disclosures of amortized cost. The amendments have the same effective dates as ASU 2016-13 (Topic ASC 326) for entities that have not yet adopted that standard. For entities that early adopted ASU 2016-13 (Topic ASC 326), the amendments are effective for fiscal years beginning after December 15, 2019 and interim periods therein. Entities that early adopted ASU 2016-13 (Topic ASC 326) may early adopt the amendments.


 
 
 
Page 12


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. The new guidance simplifies the accounting for income taxes by removing certain exceptions to the general principles in Topic 740. The new guidance also improves consistent application of and simplifies U.S. GAAP for other areas of Topic 740 by clarifying and amending the existing guidance. The ASU is effective for fiscal years beginning after December 15, 2020, with early adoption permitted. The Company is currently evaluating the effect of the new guidance.

3.     Property and Equipment

The Company’s fixed assets consist of its medical equipment held for rental, furniture and equipment, real property and related improvements, and vehicles and other various small equipment. In May 2019, the Company purchased a 77,000 square foot commercial building located in Lafayette, Louisiana to utilize as its new corporate headquarters. The Building Term Note used to finance this purchase is further discussed in Note 5.

The following table details the Company’s fixed assets:
 
 
March 31, 2020
 
December 31, 2019
Medical equipment
 
$
59,169

 
$
56,202

Furniture and equipment
 
2,442

 
2,350
Land
 
2,138

 
2,138
Buildings
 
6,458

 
6,351

Leasehold improvements
 
301

 
301
Vehicles
 
1,029

 
1,110
Less: Accumulated depreciation
 
(14,905
)
 
(13,680
)
Property and equipment, net of accumulated depreciation
 
$
56,632

 
$
54,772


Depreciation in the amount of $1,925,000 and $1,166,000 is included in cost of revenue for the three months ended March 31, 2020 and 2019, respectively. Included in medical equipment above is equipment acquired under capital lease obligations whose cost and accumulated depreciation at March 31, 2020 total $14,374,000 and $1,153,000, respectively. At December 31, 2019, cost and accumulated depreciation on equipment acquired under capital lease obligations was $15,680,000 and $1,337,000, respectively. Medical equipment purchases with a cost of $899,000 and $2,817,000 was included in accounts payable at March 31, 2020 and December 31, 2019, respectively.

4.
Current Liabilities

The Company’s short-term accrued liabilities are included within current liabilities and consist of the following:
 
 
March 31, 2020
 
December 31, 2019
Accrued trade payables
 
$
775

 
$
1,023

Accrued commissions payable
 
391
 
371
Accrued bonuses payable
 
1,509
 
2,292
Accrued vacation and payroll
 
1,148
 
1,502
Current portion of phantom share liability
 
2,711
 
3,129
Accrued other liabilities
 
352
 
651

Total accrued liabilities
 
$
6,886

 
$
8,968



 
 
 
Page 13


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


5.     Debt and lease liabilities

Senior Credit Facility

On February 20, 2018, the Company entered into a two year Commercial Business Loan Agreement for Term Loans and Lines of Credit with Hancock Whitney Bank. Any amounts advanced will be secured by substantially all of the Company's assets and carried an interest rate of one month ICE LIBOR plus 3.00%, with a 4.00% interest rate floor. Advances of the line of credit initially were subject to a borrowing base as determined in accordance with the loan agreement, which was based on the value of the Company's accounts receivable balance.

On March 19, 2019, the Company entered into an amendment to the loan agreement increasing the available line of credit from $5.0 million to $10.0 million and extending the expiration date to March 19, 2021. In addition, the borrowing base restriction was removed from the loan agreement.

On September 19, 2019, in conjunction with the Term Note described below, the Company entered into a third amendment to the loan agreement, which, among other things, replaced the financial covenants in the loan agreement with the following:
Financial Covenant
 
Required Ratio
 
Ratio
Total Debt to Adjusted EBITDA (Quarterly)
 
not more than 1.50:1.00
 
0.83
Fixed Charge Coverage Ratio (Quarterly)
 
not less than 1.35:1.00
 
3.12
Loan-to-Value Ratio (Quarterly)
 
not more than 0.85
 
0.72

On May 1, 2020, the Company entered into a fourth amendment to the loan agreement extending the expiration date to May 1, 2023 and modifying the interest rate on amounts advanced to be equal to the WSJ prime rate plus a margin of 0.50%, with a 3.50% interest rate floor.

The Company was in compliance with all covenants in effect at March 31, 2020. There were no borrowings against this line of credit at March 31, 2020 and December 31, 2019.

Commercial Term Notes

On May 30, 2019, the Company entered into a second amendment to the loan agreement providing for a term note (the “Building Term Note”) in favor of Hancock Whitney Bank in the principal amount of $4,845,000. The proceeds of the Building Term Note were used to purchase a building to utilize as a new corporate headquarters for the Company. Beginning July 1, 2019, the Company began making monthly payments towards the outstanding balance. The Building Term Note matures on May 30, 2026 and is secured by substantially all of the assets of the borrower, including the real property acquired with the proceeds of the Building Term Note. The Building Term Note bears interest at a variable rate equal to the one month ICE LIBOR index plus a margin of 2.45% per annum. The Company is required to maintain a loan to value ratio of 85% with respect to the appraised value of the real property. In connection with the Building Term Note, the Company entered into an interest rate swap transaction (the "Interest Rate Swap Transaction") with Hancock Whitney Bank effectively fixing the interest rate for the Building Term Note at 4.68%.

The Company incurred immaterial financing costs related to the real property acquired with the proceeds of the Building Term Note. These deferred financing costs are amortized over the term of the loan using the effective interest method.

On September 19, 2019, the Company entered into a third amendment to the loan agreement providing for a term note (the “Term Note") in favor of Hancock Whitney Bank in the principal amount of $5,000,000. The proceeds of the Term Note will be used for general corporate purposes. Beginning October 19, 2019, the Company started making monthly principal payments of $139,000 towards the outstanding balance. The Term Note matures on September 19, 2022 and is secured by substantially all of the assets of the borrower. The Term Note bears interest at the rate of 4.60% per annum.


 
 
 
Page 14


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


The Company has recognized these term notes, which have terms greater than twelve months, as follows:
 
 
March 31, 2020
 
December 31, 2019
Notes payable
 
$
8,951

 
$
9,379

Less:
 


 


Current portion of notes payable
 
(1,772
)
 
(1,750
)
Net long-term notes payable
 
$
7,179

 
$
7,629


Leases

The Company has recognized finance lease liabilities for medical equipment and operating leases for land and buildings that have terms greater than twelve months, as follows:
 
 
March 31, 2020
 
December 31, 2019
Lease liabilities
 
$
9,763

 
$
10,132

Less:
 
 
 
 
Current portion of lease liabilities
 
(7,433
)
 
(7,093
)
Net long-term lease liabilities
 
$
2,330

 
$
3,039


Finance lease liabilities

The Company has various finance leases for equipment with an implied interest rate at fixed rates up to 9.64%, secured by equipment, due between 2020 and 2022. The Company's weighted average interest rate was 2.22% and 0.86% for all finance lease liabilities outstanding as of March 31, 2020 and 2019, respectively. At March 31, 2020 and 2019, the weighted average lease term was approximately 0.99 years and 0.83 years, respectively. Interest expense related to these finance lease obligations for the three months ended March 31, 2020 and March 31, 2019 amounted to $52,000 and $26,000, respectively.

Operating lease liabilities

The Company has recognized operating lease liabilities that relate primarily to the lease of land and buildings. These leases contain renewal options that we have not included as part of the Company's assessment of the lease term as it is not reasonably certain that we will exercise these options. These lease liabilities are recorded at present value based on a discount rate of 5.50%, which was based on the Company's incremental borrowing rate at the time of assessment. At March 31, 2020, the weighted average lease term was approximately 3.66 years. Operating rental expenses were $184,000 for the three months ended March 31, 2020, and $90,000 for the three months ended March 31, 2019.

Included within these operating lease liabilities are real property leases for real estate from a related party. Rental payments under these related party lease agreements are $20,000 per month, plus taxes, utilities and maintenance. Total rental payments for the use of these properties were $61,000 for the three months ended March 31, 2020, and $61,000 for the three months ended March 31, 2019. The expense for these related party rents has been included within general and administrative expenses.


 
 
 
Page 15


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019



6.     Fair value measurement

Under ASC Topic 820, fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date (i.e., an exit price). ASC Topic 820 establishes a hierarchy for inputs to valuation techniques used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs that reflect assumptions market participants would use in pricing the asset or liability developed based on market data obtained from sources independent of the Company. Unobservable inputs are inputs that reflect the Company's own assumptions about the assumptions market participants would use in pricing the asset or liability developed based on the best information available in the circumstances. There are three levels to the hierarchy based on the reliability of inputs, as follows:

Level 1 - Observable inputs that reflect quoted prices (unadjusted) for identical assets or liabilities in active markets.

Level 2 - Inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs include quoted prices for similar assets or liabilities in active markets, or quoted prices for identical or similar assets and liabilities in markets that are not active.

Level 3 - Unobservable inputs for the asset or liability. The degree of judgment exercised by the Company in determining fair value is greatest for instruments categorized in Level 3.

The Company’s cash and cash equivalents are measured using Level 1 inputs and include cash on hand, deposits in banks, certificates of deposit and money market funds. Due to their short-term nature, the carrying amounts reported in the consolidated balance sheets approximate the fair value of cash and cash equivalents.

The fair value of debt is classified as Level 2 for the periods presented and approximates its carrying value.

Warrants

Pursuant to the Arrangement, PHM common share purchase warrant holders each received one tenth (1/10) of one warrant to purchase one common share of the Company. The warrants conversion feature is denominated in Canadian dollars which is different from the functional currency of the Company, which is U.S. dollars. The conversion feature is treated as a derivative financial liability and the fair value movement during the period is recognized in the Condensed Consolidated Statement of Income and Comprehensive Income. The change in the value of warrants has been recorded as an unrealized (gain) loss on derivative financial liability in the Condensed Consolidated Statements of Income and Comprehensive Income. All unexercised warrants expired during the year ended December 31, 2019.

The warrant derivative financial liability was valued using Level 3 inputs from the fair value hierarchy.

There were no warrants issued during the three month period ended March 31, 2020. There were no warrants exercised and no warrants that expired during the three months ended March 31, 2020. A summary of the change in fair value of warrant conversion liability is as follows for the period ended March 31, 2019:
Warrant Conversion Liability
 
 
Balance December 31, 2018
 
$
363

Warrants issued
 

Unrealized loss on warrant conversion liability
 
169

Balance March 31, 2019
 
$
532











 
 
 
Page 16


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


Derivative instruments and hedging activities

We currently have one interest rate swap contract in place, which became effective on May 31, 2019 and has been designated as a cash flow hedge. This swap contract matures on May 30, 2026. This swap contract converts the variable interest rate to a fixed interest rate on borrowings under the Building Term Note. As of March 31, 2020, the notional amount of the interest rate swap was $4.7 million and will be amortized over the term of the swap. The fair value was $0.5 million (determined based on Level 2 inputs) and is included in Accrued liabilities, as a component of Long-term liabilities as of March 31, 2020.

In the first three months of 2020, losses recognized as a result of ineffectiveness were immaterial.

7.
Shareholders' Equity

Authorized share capital

The Company’s authorized share capital consists of an unlimited number of common shares.

Issued and outstanding share capital

The Company has only one class of stock outstanding, common shares. The authorized stock consists of an unlimited number of common shares with no stated par value, of which 38,486,772 and 37,952,660 shares were issued and outstanding as of March 31, 2020 and December 31, 2019, respectively.

Stock-based compensation

The purpose of the Company's RSU and Option Plans (collectively, the "Plan") is to provide incentive to employees, directors, officers, management companies, and consultants who provide services to the Company or any of its subsidiaries. The Plan is a “fixed” stock plan, whereby the maximum number of the Company's shares reserved for issuance, combined with any equity securities granted under all other compensation arrangements adopted by the Company, may not exceed 7,582,000 shares (equal to 20% of the issued and outstanding shares of the Company as of the date of the adoption of the Plan). As of March 31, 2020, the Company had outstanding issuances of options of 3,638,000 and restricted stock units of 701,088 under the Plan.

The following table summarizes stock-based compensation for the three months ended March 31, 2020 and 2019 (in thousands):
 
 
Three Months Ended March 31,
 
 
2020
 
2019
Stock-based compensation - options
 
$
891
 
 
$
578
 
Stock-based compensation - restricted stock units
 
260
 
 
302
 
Total
 
$
1,151
 
 
$
880
 

At March 31, 2020, there was approximately $5,012,000 of total unrecognized pre-tax stock option expense under our equity compensation plans, which is expected to be recognized over a weighted-average period of 2.49 years. As of March 31, 2020, there was approximately $920,000 of total unrecognized pre-tax compensation expense related to outstanding time-based restricted stock units that is expected to be recognized over a weighted-average period of 0.90 years.


 
 
 
Page 17


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


Options

The following table summarizes stock option activity for the three months ended March 31, 2020:
 
 
Number of options
 (000's)
 
Weighted average exercise price (CAD$)
 
Weighted average remaining contractual life
 
Aggregate Intrinsic Value(1)
Balance December 31, 2019
 
2,683

 
$
4.36

 
6.7 years
 
$
7,790

Issued
 
964

 
7.44

 
 
 
 
Exercised
 
(5
)
 
4.16

 
 
 
 
Expired / Forfeited
 
(4
)
 
6.79

 
 
 
 
Balance March 31, 2020
 
3,638

 
$
5.17

 
7.4 years
 
$
3,684

(1) The aggregate intrinsic value of options outstanding represents the difference between the exercise price of the option and the closing stock price of our common stock on the last trading day of the period.

The aggregate intrinsic value of options outstanding was $3,684,000 and options exercisable were $3,018,000 at March 31, 2020. For the three months ended March 31, 2020, 4,737 shares of common stock were issued pursuant to the exercise of stock options.

At March 31, 2020, the Company had 1,641,000 exercisable stock options outstanding with a weighted average exercise price of CAD $4.00 and a weighted average remaining contractual life of 5.2 years. At December 31, 2019, the Company had 1,037,000 exercisable stock options outstanding with a weighted average exercise price of CAD $3.83 and a weighted average remaining contractual life of 3.5 years.

The fair value of the stock options has been charged to the Condensed Consolidated Statements of Income and Comprehensive Income and credited to additional paid-in capital over the vesting period, using the Black-Scholes option pricing model calculated using the following assumptions for issuances during the three months ended March 31, 2020:
Exercise price ($CAD)
 
$7.44 ($CAD)

Risk-free interest rate
 
1.63
%
Expected volatility
 
65.73
%
Expected life of options
 
10 Years

Expected dividend yield
 
Nil

Fair value on date of grant ($USD)
 
$4.10 ($USD)


Restricted stock units

The Company has a restricted stock unit plan ("RSU Plan"), which it uses for grants to directors, officers, and employees. The Company accounts for restricted stock units using fair value. The fair value of the restricted stock units has been charged to the consolidated statements of income and comprehensive income and credited to additional paid-in capital over the vesting period, based on the stock price on the date of grant. Restricted stock units vest generally over a one or three-year period. The Company accounts for forfeitures on restricted stock units under ASU 2016-09 and recognizes forfeitures in the period in which they occur.

The following table summarizes restricted stock unit activity for the three months ended March 31, 2020:
 
 
Number of Restricted Stock Units (000's)
 
Weighted average grant price (CAD$)
 
Weighted average remaining contractual life
 
Aggregate Intrinsic Value(1)
Balance December 31, 2019
 
1,139

 
$
2.74

 
0.55 years
 
$
7,129

Issued
 
92

 
7.44

 
 
 
 
Vested
 
(530
)
 
2.54

 
 
 
 
Expired / Forfeited
 

 

 
 
 
 
Balance March 31, 2020
 
701

 
$
3.64

 
0.90 years
 
$
3,269

(1) The aggregate intrinsic value of time-based restricted stock units outstanding was based on our closing stock price on the last trading day of the period.

 
 
 
Page 18


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019



During the three months ended March 31, 2020, the Company issued 92,088 restricted stock units, with a vesting term of one to three years and a fair value of $5.66 ($USD) per share.

Phantom share units

The Company has a phantom share unit plan, which it uses for grants to directors, officers, and employees. Phantom share units granted under the plan are non-assignable and are settled in cash at vesting. Phantom share units vest annually over a three-year period.

The following table summarizes phantom share unit activity for the three months ended March 31, 2020:
 
 
Number of Phantom Share Units (000's)
Balance December 31, 2019
 
1,350

Issued
 

Vested
 

Expired / Forfeited
 
(22
)
Balance March 31, 2020
 
1,328


The change in fair value of the phantom share units has been charged to the Condensed Consolidated Statements of Income and Comprehensive Income and recorded as a liability included in accrued liabilities and long-term accrued liabilities, using a valuation method with the following inputs:
 
 
Three Months Ended
 
 
March 31, 2020
Share price
 
$ 6.61 (CAD$)

Remaining life of phantom share units
 
0.11 - 2.11 Years

Calculated fair value of phantom share units
 
$
4,593


The total liability associated with phantom share units at March 31, 2020 is $4,593,000, with $1,882,000 of this balance included in long-term accrued liabilities and the remaining portion of $2,711,000 in current accrued liabilities. Accrued liability and related expense is determined at each reporting period based on the stock price at period end.

8.     Commitments

Purchase Commitments

As of March 31, 2020, the Company has non-cancellable purchase order commitments in the amount of $5.5 million for respiratory equipment.

9.
Income Taxes

At March 31, 2020 and 2019, the Company had no amounts recorded for uncertain tax positions and does not expect any material changes in uncertain tax benefits during the next 12 months. The Company recognizes interest and penalties related to income tax matters in income tax expense.

The Coronavirus Aid, Relief and Economic Security Act ("CARES Act") which was signed into law on March 27, 2020 includes various income and payroll tax provisions. As of March 31, 2020, the CARES Act has not had a material impact on our condensed consolidated financial statements, however, the Company is still analyzing these provisions of the CARES Act.
 




 
 
 
Page 19


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


The Company is subject to U.S. federal income tax as well as income tax in various states. The Company is generally not subject to examination by taxing authorities for years prior to 2016. Our annual estimated effective tax rate for 2020 is 4.20%. Our effective tax rate is based on forecasted annual results which may fluctuate significantly through the rest of the year, in particular due to the uncertainty in our annual forecasts resulting from the unpredictable impact of the COVID-19 pandemic on our operating results. The primary component of the annual effective tax rate relates to the Company's current state income taxes, as the Company continues to generate taxable losses for U.S. federal income tax purposes.

10.     Financial Risk Factors

Risk management

In the normal course of business, the Company is exposed to a number of risks that can affect its operating performance. ASC 820—Fair Value Measurements and Disclosures creates a single definition of fair value, establishes a framework for measuring fair value in GAAP and expands disclosures about fair value measurements. ASC 820 emphasizes that fair value is a market-based measurement, not an entity-specific measurement, and states that a fair value measurement is to estimate the price at which an orderly transaction to sell an asset or to transfer the liability would take place between market participants at the measurement date under current market conditions. Assets and liabilities adjusted to fair value in the balance sheet are categorized based upon the level of judgment associated with the inputs used to measure their fair value.

Credit risk

Credit risk is the risk that one party to a financial instrument will fail to discharge an obligation and cause the other party to incur a financial loss. Financial instruments that potentially subject the Company to credit risk are primarily cash and accounts receivable. Each subsidiary places its cash with one major financial institution. At times, the cash in the financial institution is temporarily in excess of the amount insured by the Federal Deposit Insurance Corporation. Substantially all accounts receivable are due under fee-for-service contracts from third party payors, such as insurance companies and government-sponsored healthcare programs, directly from patients or for rebates due from manufacturers. Receivables generally are collected within industry norms for third-party payors and from manufacturers. The Company continuously monitors collections from its clients and maintains an allowance for bad debts based upon lifetime expected credit losses.

Liquidity risk

Liquidity risk is the risk that the Company will not be able to meet its financial obligations as they become due. The Company’s approach in managing liquidity is to ensure, to the extent possible, that it will have sufficient liquidity to meet its liabilities when due by continuously monitoring actual and budgeted cash flows, and monitoring financial market conditions for signs of weakness.

As of March 31, 2020, the Company faced no material liquidity risk and is able to meet all of its current financial obligations as they become due and payable. The Company had $26,146,000 and $25,912,000 of current liabilities that are due within one year as of March 31, 2020 and December 31, 2019, respectively. The Company had $30,151,000 and $27,811,000 of current assets as of March 31, 2020 and December 31, 2019, respectively, in addition to positive cash flow from operations. The Company utilizes short term leases with a major supplier that could be extended over a longer term if there was a need for additional liquidity. Additionally, the Company maintains a $10.0 million line of credit with Hancock Whitney Bank which was fully available as of March 31, 2020, subject to compliance with certain covenants.

Interest rate risk

Interest rate risk is the risk that the future cash flows of a financial instrument will fluctuate because of changes in market interest rates. Interest rate risk is limited to potential decreases on the interest rate offered on cash and cash equivalents held with registered US financial institutions. The Company considers this risk to be immaterial. The interest on finance leases and the Term Note are not subject to cash flow interest rate risk as these instruments bear interest at fixed rates. In connection with the Building Term Note, the Company entered into an Interest Rate Swap Transaction with Hancock Whitney Bank for a fixed rate of 4.68%, thereby transforming the variable interest rate exposure into a fixed rate obligation.


 
 
 
Page 20


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
March 31, 2020 and 2019


11.     Earnings Per Share

Income per common share is calculated using earnings for the year divided by the weighted average number of shares outstanding during the year. Diluted income per share amounts are calculated giving effect to the potential dilution that would occur if securities or other contracts to issue common shares were exercised or converted to common shares by assuming the proceeds received from the exercise of stock options, restricted stock units, and warrants are used to purchase common shares at the prevailing market rate.

The following reflects the earnings and share data used in the basic and diluted earnings per share computations:
 
 
Three Months Ended March 31,
 
 
2020
 
2019
Numerator - basic and diluted:
 
 
 
 
Net income attributable to shareholders
 
$
4,243

 
$
1,958

 
 
 
 
 
Denominator:
 
 
 
 
Basic weighted-average number of common shares
 
38,030,854

 
37,827,058

Diluted weighted-average number of shares
 
39,677,983

 
39,449,123

 
 
 
 
 
Basic earnings per share
 
$
0.11

 
$
0.05

Diluted earnings per share
 
$
0.11

 
$
0.05

 
 
 
 
 
Denominator calculation from basic to diluted:
 
 
 
 
Basic weighted-average number of common shares
 
38,030,854

 
37,827,058

Stock options and other dilutive securities
 
1,647,129

 
1,622,065

Diluted weighted-average number of shares
 
39,677,983

 
39,449,123


12.
Subsequent Events


"CARES" Act Funds Received

The CARES Act created a Provider Relief Fund to support health care-related expenses or lost revenue attributable to the COVID-19 pandemic.  The Company received $3.5 million of the Provider Relief Funds in April 2020. The Department of Health and Human Services has stated that Provider Relief Fund payments are not loans and will not need to be repaid. However, as a condition to the receipt of funds, the Company and any other providers must agree to a detailed set of terms and conditions. CMS has indicated that the terms and conditions may be subject to ongoing changes and reporting. To the extent that reporting requirements and terms and conditions are modified, it may affect the Company’s ability to comply and may require the return of funds. In accordance with the terms of acceptance for the grant, we expect to utilize these funds to prevent, prepare for, and respond to the COVID-19 pandemic.


 
 
 
Page 21


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019

Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis of our financial condition and results of operations should be read in conjunction with, and is qualified entirely by, our condensed consolidated financial statements (including Notes to the Condensed Consolidated Financial Statements) and the other consolidated financial information under Item 1 of this Quarterly Report on Form 10-Q. Some of the information in this discussion and analysis includes forward-looking statements that involve risk and uncertainties. Actual results and timing of events could differ from the results described in or implied by the forward-looking statements contained in the following discussion and analysis.

On March 11, 2020, the World Health Organization declared the outbreak of the novel coronavirus ("COVID-19") a pandemic. Based on the duration and severity of the impacts of the COVID-19 pandemic, including but not limited to any negative economic conditions arising from the pandemic, our ability to assess potential patients in hospitals and set up and treat patients in the home, and the impacts of government actions and administrative regulations on the healthcare industry and broader economy, including through existing and any future stimulus efforts, we are uncertain of the ultimate impact COVID-19 could have on our business, financial condition and results of operations. The impact of COVID-19 on our financial results are discussed in more detail below.

Forward-Looking Statements

Certain statements and information in this Quarterly Report on Form 10-Q may constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995 or "forward-looking information" as such term is defined in applicable Canadian securities legislation (collectively, "forward-looking statements"). Any statements other than statements of historical information, including those that express, or involve discussions as to, expectations, beliefs, plans, objectives, assumptions or future events or performance are not historical facts and may be forward-looking and may involve estimates, assumptions and uncertainties that could cause actual results or outcomes to differ materially from those expressed in the forward-looking statements. These forward-looking statements are made as of the date hereof. We undertake no obligation to publicly update or revise any forward-looking statements after the date they are made, whether as a result of new information, future events or otherwise, except as required by applicable law.
 
Forward-looking statements relate to future events or future performance and reflect the expectations or beliefs of management regarding future events, and include, but are not limited to, statements with respect to: operating results; profitability; financial condition and resources; anticipated needs for working capital; liquidity; capital resources; capital expenditures; milestones; licensing milestones; information with respect to future growth and growth strategies; anticipated trends in our industry; our future financing plans; timelines; currency fluctuations; government regulation; unanticipated expenses; commercial disputes or claims; limitations on insurance coverage; and availability of cash flow to fund capital requirements.
 
Often, but not always, forward-looking information can be identified by the use of words such as “plans”, “expects”, “is expected”, “budget”, “potential”, “scheduled”, “estimates”, “forecasts”, “intends”, “anticipates”, “believes”, “projects”, or the negatives thereof or variations of such words and phrases or statements that certain actions, events or results “will”, “should”, “may”, “could”, “would”, “might” or “will be taken”, “occur” or “be achieved” or the negative of these terms or comparable terminology.
 
Forward-looking statements are based on the reasonable assumptions, estimates, analysis and opinions of management made in light of its experience and its perception of trends, current conditions and expected developments, as well as other factors that management believes to be relevant and reasonable in the circumstances at the date that such statements are made, but which may prove to be incorrect. We believe that the assumptions and expectations reflected in such forward-looking statements are reasonable. We cannot assure you, however, that such statements will prove to be accurate, as actual results and future events could differ materially from those anticipated in such statements. Accordingly, readers should not place undue reliance on forward-looking statements.












 
 
 
Page 22


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019

By their nature, forward-looking statements involve numerous assumptions, inherent risks and uncertainties, both general and specific, including those identified under “Risk Factors” and elsewhere in this Quarterly Report on Form 10-Q and the other documents we file with the SEC, including under “Item 1A. Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, 2019, and with the securities regulatory authorities in certain provinces of Canada, which contribute to the possibility that the predicted outcomes may not occur or may be delayed. The risks, uncertainties and other factors, many of which are beyond our control, that could influence actual results include, but are not limited to: the general business, market and economic conditions in the regions in which the we operate; the impact of the COVID-19 pandemic and of the actions taken by governmental authorities, individuals and companies in response to the pandemic on our business, financial condition and results of operations, including on the our patient base and revenues, employees, and equipment and supplies; we may be subject to significant capital requirements and operating risks; our ability to implement business strategies and pursue business opportunities; volatility in the market price of our common shares; our novel business model; the risk that the clinical application of treatments that demonstrate positive results in a study may not be positively replicated or that such test results may not be predictive of actual treatment results or may not result in the adoption of such treatments by providers; the state of the capital markets; the availability of funds and resources to pursue operations; decline of reimbursement rates; dependence on few payors; possible new drug discoveries; dependence on key suppliers; granting of permits and licenses in a highly regulated business; competition; low profit market segments; disruptions in or attacks (including cyber-attacks) on our information technology, internet, network access or other voice or data communications systems or services; the evolution of various types of fraud or other criminal behavior to which we are exposed; the failure of third parties to comply with their obligations; difficulty integrating newly acquired businesses; the impact of new and changes to, or application of, current laws and regulations; the overall difficult litigation and regulatory environment; increased competition; changes in foreign currency rates; increased funding costs and market volatility due to market illiquidity and competition for funding; critical accounting estimates and changes to accounting standards, policies, and methods used by us; the impact of the previously disclosed restatement and correction of our previously issued financial statements; the previously disclosed identified material weakness in our internal control over financial reporting and our ability to remediate that material weakness; the initiation of legal or regulatory proceedings with respect to the restatement and corrections; the adverse effects on our business, results of operations, financial condition and stock price, as a result of the restatement and correction process; our status as an emerging growth company and a foreign private issuer; and the occurrence of natural and unnatural catastrophic events or health epidemics or concerns, such as the recent COVID-19 pandemic, and claims resulting from such events or concerns, as well as other general economic, market and business conditions; and other factors beyond our control.

General Matters

In this Quarterly Report on Form 10-Q, unless the context otherwise requires, the terms the "Company," "we," "us" and "our" refer to Viemed Healthcare, Inc. and its wholly-owned subsidiaries, Viemed Inc., Home Sleep Delivered, L.L.C. ("HSD"), and Sleep Management, L.L.C. dba Viemed ("Viemed").

We were incorporated on December 14, 2016 pursuant to the Business Corporations Act (British Columbia), and qualify as a "foreign private issuer," as defined in Rule 12b-2 of the Exchange Act, for the purposes of the informational requirements of the Exchange Act. Although, as a foreign private issuer, we would not be required to do so, we will file annual reports on Form 10-K, quarterly reports on Form 10-Q, and current reports on Form 8-K with the SEC, instead of filing the reporting forms available to foreign private issuers.

We are an "emerging growth company," as defined in the Jumpstart Our Business Startups Act (the "JOBS Act"), and as such, we have elected to comply with certain reduced U.S. public company reporting requirements.

Unless otherwise noted herein, all references to "$" or "USD" are to the currency of the United States and references to "CAD$" or "Canadian dollars" are to the currency of Canada.

Overview

We provide an array of home medical equipment, services and supplies, specializing in post-acute respiratory care services in the United States. Our primary objective is to focus on the organic growth of the business and thereby solidify our position as one of the United States’ largest providers of in home therapy for patients suffering from respiratory diseases. Our respiratory care programs are designed specifically for payors to have the ability to treat patients in the home for less total cost and with a superior quality of care. Our services include respiratory disease management (through the rental of various durable medical equipment ("DME") devices), in-home sleep testing and sleep apnea treatment, oxygen therapy, and the sale of associated supplies.

We derive the majority of our revenue through the rental of non-invasive and invasive ventilators which represented 78.9% and 89.5% of our revenue for the three months ended March 31, 2020 and 2019, respectively. We combine the benefits of home ventilation support with licensed Respiratory Therapists ("RTs") to drive improved patient outcomes and reduce costly hospital readmissions.


 
 
 
Page 23


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019

We expect to use an organic growth model whereby expansion is accomplished through existing service areas as well as in new regions through a cost efficient launch that reduces location expenses. Our licensed RTs currently serve patients in over 30 states. We expect to continue to employ more RTs in order to assure our high service model is accomplished in the home. As of March 31, 2020, we employed more than 255 licensed RTs, representing more than 54% of our company-wide employee count. By focusing overhead costs on personnel that service the patient rather than physical location costs, we anticipate efficiently scaling our business in regions that are currently not being effectively serviced.

The continued trend of servicing patients in the home rather than in hospitals is aligned with our business objective and we anticipate that this trend will continue to offer growth opportunities for us. We expect to continue to be a solution to the rising health costs in the United States by offering more cost effective, home based solutions while increasing the quality of life for patients fighting serious respiratory diseases.

Trends Affecting our Business

On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Various policies and initiatives have been implemented to reduce the transmission of COVID-19, including travel bans and restrictions, the postponement of non-essential medical surgeries, the limiting of access to medical facilities in certain areas, the promotion of social distancing and the adoption of remote working policies. Local, state and national governments continue to emphasize the importance of essential medical personnel and we remain open to meet the needs of our communities. Employee and patient safety is our first priority, and as a result, we put preparedness plans in place for our employees, especially our clinical personnel, and modified our clinical protocols to limit unnecessary patient encounters in order to ensure the safety of our employees as well as the safety of our patients. These measures do not appear to be negatively impacting our patient attrition rate at this time. In addition, our current ability to assess potential patients in hospitals varies by hospital and city, but overall our business of setting up new patients in the home is continuing. As a result, to date there has been minimal disruption to our normal operations, though it is possible that more significant disruptions could occur if the COVID-19 pandemic continues for a prolonged period of time.

The COVID-19 pandemic has resulted in a significant economic downturn in the United States and globally and has also led to significant disruptions and volatility in capital and financial markets. Broad economic factors resulting from the current COVID-19 pandemic, including high unemployment and underemployment levels and reduced consumer spending and confidence, could also affect our service mix, revenue mix, payor mix and patient base, as well as our ability to collect outstanding receivables. Business closures and layoffs in the geographic areas in which we operate may lead to increases in the uninsured and underinsured populations and adversely affect demand for our services, as well as the ability of patients and other payors to pay for services rendered. Any increase in the amount or deterioration in the collectability of patient accounts receivable will adversely affect our financial results and require an increased level of working capital. In addition, we may experience supply chain disruptions, including delays and price increases in equipment and supplies. Staffing, equipment and supplies shortages may also impact our ability to assess potential patients in hospitals and set up and treat patients in the home.

We believe we presently have sufficient liquidity to satisfy our cash needs, however, we continue to evaluate and take action, as necessary, to preserve adequate liquidity and ensure that our business can continue to operate during these uncertain times, such as limiting discretionary spending across the organization. The Coronavirus Aid, Relief, and Economic Security (“CARES”) Act, which was signed into law on March 27, 2020, provides a substantial stimulus and assistance package intended to address the impact of the COVID-19 pandemic, including tax relief and government loans, grants and investments. The legislation provides for $100 billion in relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response to support healthcare-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured Americans can get testing and treatment for COVID-19. As a result, we received a payment from the Provider Relief Fund for $3.5 million in April 2020. Payments from the Provider Relief Fund are intended to compensate healthcare providers for lost revenues and incremental expenses incurred in response to the COVID-19 pandemic and are not required to be repaid provided the recipients attest to and comply with certain terms and conditions, including limitations on balance billing and not using Provider Relief Fund funds to reimburse expenses or losses that other sources are obligated to reimburse. In accordance with the terms of acceptance for the grant, we expect to utilize these funds to prevent, prepare for, and respond to the COVID-19 pandemic.

The CARES Act also provides for a temporary suspension of the 2% payment sequestration adjustment currently applied to all Medicare fee-for-service claims. The suspension is effective for claims with dates of service from May 1, 2020 through December 31, 2020.  However, CMS and Medicare Administrative Contractors may issue guidance that affects the implementation of this provision.

As part of the CARES Act legislation, certain Payroll Protection Program ("PPP") loans were authorized for small businesses to pay their employees, subject to potential debt forgiveness. Our company evaluated the PPP extensively and after evaluation, decided not to submit a PPP loan application.
 

 
 
 
Page 24


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019

We are continuing to monitor any effects or requirements that may result from the CARES Act as many of the provisions in the CARES Act are temporary and may require us to modify our operations and compliance procedures.  CMS and other federal agencies have and are likely to issue rules and regulations to implement the CARES Act.  The impact of these rules and regulations are unknown and may affect us.  To the extent these provisions will expire as stated in the CARES Act, we will be required to unwind any changes.

While the overall impact of COVID-19 on our consolidated results of operations for the three months ended March 31, 2020 has resulted in an overall increase in revenues related to additional product sales during the period, the overall impact that COVID-19 will have on our consolidated results of operations throughout 2020 remains uncertain and difficult to predict and will depend on, among other factors, the duration and severity of the pandemic, as well as any negative economic conditions arising from the pandemic, our ability to assess potential patients in hospitals and set up and treat patients in the home and the impacts of government actions and administrative regulations on the healthcare industry and broader economy, including through existing and any future stimulus efforts. We will continue to evaluate the nature and extent of these potential impacts to our business, consolidated results of operations, liquidity and capital resources. If COVID-19 continues to spread or if the response to contain the COVID-19 pandemic is unsuccessful, we could experience a material adverse effect on our business, financial condition, and results of operations. For additional information, see Part II. Item 1A “Risk Factors.”

In 2019, CMS announced the inclusion of noninvasive ventilator products on the list of products subject to the competitive bidding program for Round 2021 which covers the period of January 1, 2021 through December 31, 2023. Rental revenue from ventilator products represents a significant portion of our revenues (approximately 86% of total revenue in 2019). At the end of 2019, approximately 19% of ventilator product-related revenue was set to be subject to the competitive bidding process under Medicare. On March 9, 2020, CMS announced that due to the COVID-19 pandemic, the President's exercise of the Defense Production Act, public concern regarding access to ventilators, and the non-invasive ventilators product category being new to the competitive bidding program, non-invasive ventilators were removed as a product category from Round 2021 and this removal from the competitive bidding process is expected to last three years. As a result of this announcement, we retain the ability to continue to furnish non-invasive ventilators for all of our Medicare accredited areas, however, we are uncertain if vents will be included in future competitive bidding programs.

The below table highlights summary financial and operational metrics for the last eight quarters.
(Tabular amounts expressed in thousands of U.S. Dollars, except vent patients)
For the quarter ended
March 31,
2020
December 31, 2019
September 30, 2019
June 30, 2019
March 31, 2019
December 31, 2018
September 30, 2018
June 30, 2018
Financial Information:
 
 
 
 
 
 
 
Revenue
$
23,806

$
21,448

$
20,368

$
20,325

$
18,115

$
18,363

$
16,930

$
15,208

Gross Profit
15,553

14,243

14,050

14,639

13,074

13,519

12,829

11,023

Gross Profit %
65
%
66
%
69
%
72
%
72
%
74
%
76
%
72
%
Net Income
4,243

2,388

2,853

1,326

1,958

2,968

2,219

2,098

Cash (As of)
8,409

13,355

12,630

7,691

7,410

10,413

10,174

8,551

Total Assets (As of)
86,801

82,596

79,981

71,014

58,718

53,653

49,240

44,256

Adjusted EBITDA(1)
7,869

5,569

4,883

4,116

4,466

4,896

4,155

3,846

Operational Information:
 
 
 
 
 
 
 
Vent Patients(2)
7,965

7,759

7,421

7,130

6,393

5,905

5,444

5,078

(1) Refer to "Non-GAAP Financial Measures" section below for definition of Adjusted EBITDA.
(2) Vent Patients represents the number of active ventilator patients on recurring billing service at the end of each calendar quarter.


 
 
 
Page 25


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019

Results of Operations

Comparison of the Three Months Ended March 31, 2020 and 2019:

The following table summarizes our results of operations for the three months ended March 31, 2020 and 2019:
 
Three Months Ended March 31,
 
2020
 
% of Total Revenue
 
2019
 
% of Total Revenue
 
$
Change
 
%
Change
Revenue
$
23,806

 
100.0
 %
 
$
18,115

 
100.0
%
 
$
5,691

 
31.4
 %
Cost of revenue
8,253

 
34.7
 %
 
5,041

 
27.8
%
 
3,212

 
63.7
 %
Gross profit
15,553

 
65.3
 %
 
13,074

 
72.2
%
 
2,479

 
19.0
 %
Selling, general and administrative
10,577

 
44.4
 %
 
9,460

 
52.2
%
 
1,117

 
11.8
 %
Research and development
174

 
0.7
 %
 
234

 
1.3
%
 
(60
)
 
(25.6
)%
Stock-based compensation
1,151

 
4.8
 %
 
880

 
4.9
%
 
271

 
30.8
 %
Depreciation
205

 
0.9
 %
 
129

 
0.7
%
 
76

 
58.9
 %
Loss (gain) on disposal of property and equipment
(1,169
)
 
(4.9
)%
 
56

 
0.3
%
 
(1,225
)
 
(2,187.5
)%
Income from operations
4,615

 
19.4
 %
 
2,315

 
12.8
%
 
2,300

 
99.4
 %
Non-operating expenses
 
 
 
 
 
 
 
 
 
 
 
Unrealized (gain) loss on warrant conversion liability

 
 %
 
169

 
0.9
%
 
(169
)
 
(100.0
)%
Loss from equity investment
27

 
0.1
 %
 
24

 
0.1
%
 
3

 
12.5
 %
Interest expense, net
158

 
0.7
 %
 
26

 
0.1
%
 
132

 
507.7
 %
Net income before taxes
4,430

 
18.6
 %
 
2,096

 
11.6
%
 
2,334

 
111.4
 %
Provision for income taxes
187

 
0.8
 %
 
138

 
0.8
%
 
49

 
35.5
 %
Net income
$
4,243

 
17.8
 %
 
$
1,958

 
10.8
%
 
$
2,285

 
116.7
 %

Revenue

The following table summarizes our revenue for the three months ended March 31, 2020 and 2019:
 
Three Months Ended March 31,
 
2020
 
% of Total Revenue
 
2019
 
% of Total Revenue
 
$
Change
 
%
Change
Net revenue from rentals under Topic 842
 
 
 
 
 
 
 
 
 
 
 
Ventilator rentals, non-invasive and invasive
$
18,792

 
78.9
%
 
$
16,204

 
89.4
%
 
$
2,588

 
16.0
 %
Other durable medical equipment rentals
2,131

 
9.0
%
 
797

 
4.4
%
 
1,334

 
167.4
 %
Net revenue from sales and services under Topic 606
 
 
 
 
 
 
 
 
 
 
 
Equipment and supply sales
1,533

 
6.4
%
 
778

 
4.3
%
 
755

 
97.0
 %
COVID-19 response sales
1,040

 
4.4
%
 

 
%
 
1,040

 
100.0
 %
Service revenues
310

 
1.3
%
 
336

 
1.9
%
 
(26
)
 
(7.7
)%
Total net revenue
$
23,806

 
100.0
%
 
$
18,115

 
100.0
%
 
$
5,691

 
31.4
 %

For the three months ended March 31, 2020, revenue totaled $23.8 million, an increase of $5.7 million (or 31.4%) from the comparable period in 2019. The revenue growth was primarily driven by a $2.6 million (or 16.0%) increase in ventilator rental revenue. Our active ventilator patient base grew from 6,393 as of March 31, 2019 to 7,965 as of March 31, 2020, an increase of 25%. Rental revenue from other DME grew $1.3 million (or 167.4%) quarter over quarter. This growth was largely attributable to our percussion vests and to a lesser extent our many other respiratory-related products (PAPs, oxygen concentrators, nebulizers). As we continue to expand geographically into new states and further expand our presence in our existing territories, we expect continued growth in our active ventilator patient base and ventilator rental revenue, as well as in our other respiratory products.


 
 
 
Page 26


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019

In response to the COVID-19 pandemic, we have been working in close cooperation with state agencies and hospital systems to source urgently needed medical equipment such as ventilators, ventilator supplies and other respiratory equipment. During the three months ended March 31, 2020, we had $1.0 million of COVID-19 response related sales consisting primarily of ventilators and associated supplies. We expect further COVID-19 related sales during the remainder of 2020, but the quantity and impact of such sales remains uncertain and dependent on the length and intensity of the COVID-19 pandemic and the availability of such equipment and supplies from other suppliers. Additionally, non-COVID-19 related equipment sales grew $0.8 million (or 97.0%) year over year primarily as a result of higher supply orders for our PAP patients.

Cost of revenue and gross profit

For the three months ended March 31, 2020, cost of revenue totaled $8.3 million, an increase of $3.2 million (or 63.7%) from the comparable period in 2019. For the three months ended March 31, 2020 and 2019, gross profit percentage decreased from approximately 72.2% to approximately 65.3%. The decreased margins were primarily the result of the above mentioned COVID-19 response sales which contributed a weighted average gross profit percentage of 45.9%. Excluding the COVID-19 response sales, gross profit percentage for the three months ended March 31, 2020 was 66.2%. We expect our gross profit percentage for our normal operations (non-COVID-19 related) to remain relatively consistent with the current quarter through the end of 2020.

Selling, general & administrative expense

For the three months ended March 31, 2020, selling, general and administrative expenses totaled $10.6 million, an increase of $1.1 million (or 11.8%) from the comparable prior period. Selling, general, and administrative expenses as a percentage of revenue decreased to 44.4% for the three months ended March 31, 2020 compared to 52.2% for the three months ended March 31, 2019. Excluding the impact of the COVID-19 response sales, selling, general, and administrative expenses as a percentage of revenue was 46.4% for the three months ended March 31, 2020. The increase in overall selling, general and administrative expense as compared to the prior year period can be attributed to additional expenses to accommodate both the overall growth of the Company and an increase in associated public company expenses resulting from our August 2019 NASDAQ listing, partially offset by a decrease in employee costs, driven by the impact of our phantom stock plan. Our phantom stock plan is measured at fair value as of the reporting period and is driven primarily by our stock price. During the three months ended March 31, 2020, our stock price decreased 19%, versus an increase of 26% during the three months ended March 31, 2019, driving lower comparable expenses related to these awards in the current period. As we continue to grow into new markets and increase our employee count, we expect selling, general, and administrative expenses will trend accordingly. We expect that selling, general and administrative expenses as a percentage of revenue will remain relatively consistent with the current quarter through the end of 2020.

Loss (gain) on disposal of property and equipment

For the three months ended March 31, 2020, we recorded a gain on disposal of property and equipment of $1.2 million, compared to a loss of $0.1 million during the comparable period in 2019. As a result of our efforts for the COVID-19 response as described above, certain of our previously placed in service property and equipment was sold. As a result, during the three months ended March 31, 2020, we recorded sales proceeds on used equipment of $2.5 million which resulted in a net gain on disposal for related equipment of $1.6 million. We expect disposals of equipment to generally remain consistent with historical trends, with the exception of additional gains that could be realized from any additional COVID-19 response related sales, but the impact of such sales remains uncertain and dependent on the length and intensity of the COVID-19 pandemic and the availability of such equipment and supplies from other suppliers.

Stock-based compensation

For the three months ended March 31, 2020, stock-based compensation totaled $1.2 million, an increase of $0.3 million (or 30.8%) from the comparable period in 2019. This increase is attributable to the expense of additional stock-based awards during 2020. We expect that as we continue to increase our employee count and utilize stock-based awards as an aspect of employee compensation, stock-based compensation expense will increase accordingly. Stock-based compensation as a percentage of revenue has historically remained under 5%.

Interest expense, net

For the three months ended March 31, 2020, net interest expense totaled $158,000, an increase of $132,000 (or 507.7%) from the comparable period in 2019. We expect net interest expense to remain materially consistent through the end of 2020.

 
 
 
Page 27


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019


Provision for income taxes

For the three months ended March 31, 2020, the provision for income taxes was $187,000, compared to $138,000 during the 2019 period. The current period provision is related to state income tax liabilities. We expect to continue to benefit from the federal tax environment in the United States. Recent tax changes allow for accelerated deductions for capital expenditures and lower corporate tax rates. As we continue to incur substantial capital expenditures to acquire medical equipment to accommodate our rapid patient base growth, combined with the deferred tax assets, we expect most near-term tax payments will continue to result from state tax liabilities.

Net income

For the three months ended March 31, 2020, net income was $4.2 million, an increase of $2.3 million (or 116.7%) from the comparable period in 2019. Net income as a percentage of revenue increased from 10.8% for the three months ended March 31, 2019 to 17.8% for the three months ended March 31, 2020, primarily driven by increased revenue, increased gains on disposal of equipment and reduced selling, general and administrative expenses, as described above.

Non-GAAP Financial Measures

Our management regularly monitors certain financial measures to track the progress of our business against internal goals and targets. We believe that one of the most important measures for our company is Adjusted EBITDA. Adjusted EBITDA is a non-GAAP financial measure. We believe Adjusted EBITDA provides helpful information with respect to our operating performance as viewed by management, including a view of our business that is not dependent on the impact of our capitalization structure and items that are not part of our day-to-day operations. Management uses Adjusted EBITDA (i) to compare our operating performance on a consistent basis, (ii) to calculate incentive compensation for our employees, (iii) for planning purposes including the preparation of our internal annual operating budget, and (iv) to evaluate the performance and effectiveness of our operational strategies. Accordingly, we believe that Adjusted EBITDA provides useful information in understanding and evaluating our operating performance in the same manner as management.

In calculating Adjusted EBITDA, certain items (mostly non-cash) are excluded from net income including interest, taxes and depreciation of property and equipment. Set forth below are descriptions of the financial items that have been excluded from net income to calculate Adjusted EBITDA and the material limitations associated with using this non-GAAP financial measure as compared to net income.

Depreciation may be useful for investors to consider because it generally represents the wear and tear on the property and equipment used in our operations. However, we do not believe these charges necessarily reflect the current and ongoing cash charges related to our operating costs.

The amount of interest expense we incur or interest income we generate may be useful for investors to consider and may result in current cash inflows or outflows. However, we do not consider the amount of interest expense or interest income to be a representative component of the day-to-day operating performance of our business.

Unrealized loss on warrant conversion liability may be useful for investors to consider as it represents changes in the fair value of warrants and exchangeable shares of subsidiaries, driven predominantly by changes in our share price and exchange rates. These changes are non-cash, as is the settlement of the underlying derivative liability, which occurs upon the conversion of the derivative instrument into common shares of the Company.

Stock-based compensation may be useful for investors to consider because it is an estimate of the non-cash component of compensation received by the Company’s directors, officers, employees and consultants. However, stock-based compensation is being excluded from our operating expenses because the decisions which gave rise to these expenses were not made to increase revenue in a particular period, but were made for the Company’s long-term benefit over multiple periods. While strategic decisions, such as those to issue stock-based awards are made to further our long-term strategic objectives and do impact our earnings under GAAP, these items affect multiple periods and management is not able to change or affect these items within any period.

Income tax expense may be useful for investors to consider because it generally represents the taxes which may be payable for the period and the change in deferred income taxes and may reduce or increase the amount of funds otherwise available for use. However, we do not consider the amount of income tax expense to be a representative component of the day-to-day operating performance of our business.


 
 
 
Page 28


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019

The following table is a reconciliation of Net income, the most directly comparable GAAP measure, to Adjusted EBITDA, on a historical basis for the periods indicated:
For the quarter ended
March 31, 2020
December 31, 2019
September 30, 2019
June 30, 2019
March 31, 2019
December 31, 2018
September 30, 2018
June 30, 2018
Net Income
$
4,243

$
2,388

$
2,853

$
1,326

$
1,958

$
2,968

$
2,219

$
2,098

Add back:
 
 
 
 
 
 
 
 
Depreciation
2,130

2,003

1,659

1,444

1,295

1,177

972

893

Interest expense
158

212

56

20

26

30

37

67

Unrealized (gain) loss on warrant conversion liability


(800
)
268

169

(210
)
220

123

Stock-based compensation
1,151

908

1,064

1,034

880

804

672

665

Income tax expense
187

58

51

24

138

127

35


Adjusted EBITDA
$
7,869

$
5,569

$
4,883

$
4,116

$
4,466

$
4,896

$
4,155

$
3,846


Use of Non-GAAP Financial Measures

Adjusted EBITDA should be considered in addition to, not as a substitute for, or superior to, financial measures calculated in accordance with GAAP. It is not a measurement of our financial performance under GAAP and should not be considered as an alternative to revenue or net income, as applicable, or any other performance measures derived in accordance with GAAP and may not be comparable to other similarly titled measures of other businesses. Adjusted EBITDA has limitations as an analytical tool and you should not consider it in isolation or as a substitute for analysis of our operating results as reported under GAAP. Adjusted EBITDA does not reflect the impact of certain cash charges resulting from matters we consider not to be indicative of ongoing operations; and other companies in our industry may calculate Adjusted EBITDA differently than we do, limiting its usefulness as a comparative measure.

Liquidity and Capital Resources

Cash and cash equivalents at March 31, 2020 was $8.4 million, compared to $13.4 million at December 31, 2019. Based on our current plan of operations, including potential acquisitions, we believe this amount, when combined with expected cash flows from operations and amounts available under our line of credit will be sufficient to fund our growth strategy and to meet our anticipated operating expenses, capital expenditures, and debt service obligations for at least the next 12 months. The Company utilizes short term leases with a major supplier that could be extended over a longer term if there was a need for additional liquidity. Additionally, the Company maintains a $10.0 million line of credit with Hancock Whitney Bank which was fully undrawn as of March 31, 2020.

Cash Flows

The following table summarizes our cash flows for the periods indicated:
 
 
Three Months Ended March 31,
 
 
2020
 
2019
Net Cash provided by (used in):
 
 
 
 
Operating activities
 
$
607

 
$
650

Investing activities
 
(1,711
)
 
(92
)
Financing activities
 
(3,842
)
 
(3,561
)
Net decrease in cash and cash equivalents
 
$
(4,946
)
 
$
(3,003
)

 
 
 
Page 29


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019


Net Cash Provided by Operating Activities

Net cash provided by operating activities during the three months ended March 31, 2020 was $0.6 million, resulting from net income of $4.2 million and non-cash net income adjustments of $5.0 million, which was partially offset by an increase in net operating assets of $10.1 million. The non-cash net income adjustments primarily consisted of $2.8 million in change of allowance for doubtful accounts, $2.1 million of depreciation and $1.2 million of stock-based compensation. The uses of cash related to changes in operating assets primarily consisted of an increase in accounts receivable of $6.8 million, which was partially offset by a decrease in inventory of $0.4 million. The changes in operating liabilities primarily consisted of a decrease in accounts payable of $3.6 million and increases in accrued liabilities of $2.4 million. The increase in our operating assets was primarily driven by accounts receivable related to COVID-19 response sales occurring at the end of the quarter. Additionally, prepaid expenses and other current assets increased as a result of deposits related to ventilator supplies.

Net cash provided by operating activities during the three months ended March 31, 2019 was $0.7 million, resulting from net income of $2.0 million, non-cash net income adjustments of $4.7 million, a decrease in net operating liabilities of $0.2 million, and an increase in net operating assets of $5.8 million. The non-cash net income adjustments primarily consisted of $2.1 million of bad debt expense, $1.4 million of depreciation and $0.9 million of stock-based compensation. The uses of cash related to changes in operating assets primarily consisted of an increase in accounts receivable of $5.0 million as a result of increased revenue growth and an increase in inventory of $0.7 million. The changes in operating liabilities primarily consisted of increases in accounts payable of $0.5 million and deferred revenue of $0.2 million, partially offset by a decrease in accrued liabilities of $0.9 million.

Net Cash Used in Investing Activities

Net cash used in investing activities during the three months ended March 31, 2020 was $1.7 million, consisting of $4.2 million of purchases of property and equipment, partially offset by $2.5 million of COVID-19 response sales proceeds from the disposal of property and equipment. Purchases of property and equipment were primarily related to medical equipment rented to our patients. Combining cash purchases of property and equipment of $4.2 million and equipment financed through finance leases of $3.0 million, our total capital expenditures for the three months ended March 31, 2020 were $7.2 million. This represents a $2.6 million, or 56.3%, increase year over year, driven by our company growth.

Net cash used in investing activities during the three months ended March 31, 2019 was $92,000, consisting of $116,000 of purchases of property and equipment, partially offset by $24,000 of proceeds from the disposal of property and equipment. Purchases of property and equipment were primarily related to the medical equipment rented to patients. Combining cash purchases of property and equipment of $116,000 and equipment financed through finance leases of $4.5 million, our total capital expenditures for the three months ended March 31, 2019 was $4.6 million.

Net Cash Used in Financing Activities

Net cash used in financing activities during the three months ended March 31, 2020 was $3.8 million, consisting of $0.4 million in proceeds from the new term note, partially offset by $3.4 million in repayments of finance lease liabilities.

Net cash used in financing activities during the three months ended March 31, 2019 was $3.6 million, consisting of $2.0 million in repayments of finance lease liabilities and $1.5 million of shares repurchased and canceled under our normal course issuer bid.

Credit Agreement

On February 20, 2018, we entered into a two year commercial business loan agreement with Hancock Whitney Bank. Any amounts advanced will be secured by substantially all our assets and carried an interest rate of one month ICE LIBOR plus 3.00%, with a 4.00% interest rate floor. Advances of the line of credit initially were subject to a borrowing base as determined in accordance with the loan agreement, which was based on the value of our accounts receivable balance.

On March 19, 2019, we entered into an amendment to the loan agreement increasing the available line of credit from $5.0 million to $10.0 million and extending the expiration date to March 19, 2021. In addition, the borrowing base restriction was removed from the loan agreement.





 
 
 
Page 30


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019

On September 19, 2019, in conjunction with the Term Note described below, the Company entered into a third amendment to the loan agreement, which, among other things, replaced the financial covenants in the loan agreement with the following:
Financial Covenant
Required Ratio
Ratio
Total Debt to Adjusted EBITDA (Quarterly)
not more than 1.50:1.00
0.83
Fixed Charge Coverage Ratio (Quarterly)
not less than 1.35:1.00
3.12
Loan-to-Value Ratio (Quarterly)
not more than 0.85
0.72

On May 1, 2020, the Company entered into a fourth amendment to the loan agreement extending the expiration date to May 1, 2023 and modifying the interest rate on amounts advanced to be equal to the WSJ prime rate plus a margin of 0.50%, with a 3.50% interest rate floor.

The Company was in compliance with all covenants in effect at March 31, 2020. There were no borrowings against this line of credit at March 31, 2020 and December 31, 2019.

While we currently have no immediate plans to draw on this line of credit, the line of credit allows flexibility in funding our future operations subject to compliance with the covenants described above.

Commercial Term Notes

On May 30, 2019, the Company entered into an amendment to the loan agreement providing for a term note (the “Building Term Note”) in favor of Hancock Whitney Bank in the principal amount of $4.8 million. The proceeds of the Building Term Note were used to purchase a building to utilize as a new corporate headquarters for the Company. Beginning July 1, 2019, the Company makes monthly payments towards the outstanding balance. The Building Term Note matures on May 30, 2026 and is secured by substantially all of the assets of the borrower, including the real property acquired with the proceeds of the Building Term Note. The Building Term Note bears interest at a variable rate equal to the one month ICE LIBOR index plus a margin of 2.45% per annum. The Company is required to maintain a loan to value ratio of 85% with respect to the appraised value of the real property. In connection with the Building Term Note, the Company entered into an interest rate swap transaction (the "Interest Rate Swap Transaction") with Hancock Whitney Bank effectively fixing the interest rate for the Building Term Note at 4.68%.

On September 19, 2019, the Company entered into a third amendment to the loan agreement providing for a term note (the “Term Note") in favor of Hancock Whitney Bank in the principal amount of $5.0 million. The proceeds of the Term Note will be used for general corporate purposes. Beginning October 19, 2019, the Company makes monthly payments towards the outstanding balance. The Term Note matures on September 19, 2022 and is secured by substantially all of the assets of the borrower. The Term Note bears interest at the rate of 4.60% per annum.

Sources of funds

Our cash provided by operating activities in the three months ended March 31, 2020 was $0.6 million compared to $0.7 million in the three months ended March 31, 2019. As of March 31, 2020, we had cash and cash equivalents of $8.4 million.

Use of funds

Our principal uses of cash are funding our new rental assets and other capital purchases, operations, and other working capital requirements. Over the past two years, our revenue has increased significantly from year-to-year and, as a result, our cash provided by operating activities has increased over time and now is a significant source of capital to the business, which we expect to continue in the future.

We may need to raise additional funds to support our investing operations, and such funding may not be available to us on acceptable terms, or at all. If we are unable to raise additional funds when needed, our operations and ability to execute our business strategy could be adversely affected. We may seek to raise additional funds through equity, equity-linked or debt financings. If we raise additional funds through the incurrence of indebtedness, such indebtedness would have rights that are senior to holders of our equity securities and could contain covenants that restrict our operations. Any additional equity financing may be dilutive to our stockholders.


 
 
 
Page 31


VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
March 31, 2020 and 2019

Leases

Leases under which we assume substantially all the risks and rewards of ownership are classified as capital leases. Upon initial recognition, the leased asset is measured at an amount equal to the lesser of its fair value and the present value of the minimum lease payments. Subsequent to initial recognition, the asset is accounted for in accordance with the accounting policy applicable to the asset. The associated lease liability is drawn down over the life of the lease by allocating a portion of each lease payment to the liability with the remainder being recognized as finance charges. Leases that do not transfer the risks and rewards of ownership to the Company are treated as operating leases and are expensed as incurred.

Retirement Plan

The Company maintains a 401(k) retirement plan for employees to which eligible employees can contribute a percentage of their pre-tax compensation. Matching employer contributions to the 401(k) plan totaled $179,000 and $168,000 for the three months ended March 31, 2020 and 2019, respectively.

Off balance sheet arrangements

The Company has no material undisclosed off-balance sheet arrangements that have or are reasonably likely to have a current or future effect on its results of operations or financial condition.

Accounting and Disclosure Matters

Segment Information

We have determined that we predominantly operate in a single operating segment, which is the sleep and respiratory disorders sector of the DME industry. While we do provide some services and products outside of this operating segment, these operations, both in terms of revenue and profit, are not material to our operations and therefore have not been separately reported as a segment. 

Critical Accounting Principles and Estimates

The preparation of financial statements in conformity with GAAP requires us to make estimates and judgments that affect our reported amounts of assets and liabilities, revenues and expenses and related disclosures of contingent assets and liabilities. We evaluate our estimates on an ongoing basis, including those estimates related to allowance for doubtful accounts, inventory adjustments, impaired assets, income taxes, deferred tax valuation allowances and stock-based compensation costs.

We state these accounting policies in the notes to the consolidated financial statements and at relevant sections in the Management's Discussion and Analysis of Financial Condition and Results of Operations. The estimates are based on the information that is currently available to us and on various other assumptions that we believe to be reasonable under the circumstances. Actual results could vary from those estimates under different assumptions or conditions.

We believe that the following critical accounting policies affect the more significant judgments and estimates used in the preparation of our consolidated financial statements:

Revenue recognition

Revenue Accounting under Topic 842

We lease DME such as non-invasive and invasive ventilators, PAP machines, percussion vests, oxygen concentrator units and other small respiratory equipment to customers for a fixed monthly amount on a month-to-month basis. The customer generally has the right to cancel the lease at any time during the rental period. The Company considers these rentals to be operating leases.

Under FASB Accounting Standards Codification Topic 842, “Leases”, we recognize rental revenue on operating leases on a straight-line basis over the contractual lease term which varies based on the type of equipment rental. The lease term begins on the date products are delivered to patients, and revenues are recorded at amounts estimated to be received under reimbursement arrangements with third-party payors, including Medicare, private commercial payors, and Medicaid. Certain customer co-payments are included in revenue when considered probable of payment, which is generally when paid.