Graymark Healthcare 2010 net revenues increase 30% to $22.8 million

Mar 28 2011

Graymark Healthcare, Inc. (Nasdaq: GRMH), the nation's second largest provider of diagnostic sleep services and an innovator in comprehensive care for obstructive sleep apnea (OSA), reported financial results for the fiscal year ended December 31, 2010.

Net revenues in 2010 increased 30% to $22.8 million from $17.6 million in 2009 (as adjusted for the discontinued operations of the company's retail pharmacy business). The annual increase is primarily attributable to realizing a full year of operating revenue amounting to $6.7 million from the Somni and Eastern acquisitions completed in August and September of 2009, respectively.

Revenue from the company's sleep diagnostic business increased 27% to $17.2 million in 2010 from $13.5 million in 2009. The increase was primarily attributable to the 2009 acquisitions, partially offset by lower revenue from existing operations. The lower revenue was due to the company's previously announced strategy to transition from being an out-of-network provider to entering into in-network agreements with third-party payers. This transition provides Graymark the opportunity to lower administrative expenses and accelerate the receipt of reimbursement payments, resulting in improved cash flow. Additionally, the company believes that by significantly lowering patient out of pocket costs as a result of being in-network, Graymark will also be able to increase the volume of patients serviced at the company's independent sleep care centers. This transition is expected to be completed by the end of the first quarter of 2012.

Revenue from Graymark's sleep therapy business in 2010 increased 37% to $5.6 million from $4.0 million in 2009. In addition to contributions from the 2009 acquisitions, the annual increase was attributable to increases in both setup and resupply volumes, with resupply representing an important recurring revenue aspect of the company's business. Resupply volume increased 105% from 1,084 packages shipped in the first quarter of 2010 to 2,220 shipped in the fourth quarter of 2010.

Operating expenses were $31.9 million in 2010, including non-cash charges related to goodwill and intangible asset impairment, and the impairment of property and equipment of $10.8 million and $762,000, respectively. As a result of lower than expected operating results at the company's sleep centers in Oklahoma, Nevada and Texas, and forecasted cash flows in those markets, the company reassessed the carrying value of its goodwill as of December 31, 2010. The company also reassessed the value of property and equipment at certain sleep diagnostic facilities that were no longer compatible with current systems. The goodwill and property and equipment impairment charges are non-cash adjustments, which have no affect on cash flows or liquidity. Operating expenses were $18.4 million in 2009.

Net loss attributable to Graymark Healthcare was $19.1 million or $(0.66) per share in 2010, compared to a net loss of $5.2 million or $(0.18) per share in 2009.

Net loss attributable to Graymark Healthcare for the full year 2010 included non-cash charges for goodwill and intangible asset impairment of $10.8 million, impairment of property and equipment of $762,000, impairment of equity investment of $200,000, and stock-based compensation expense of $390,000. Net loss attributable to Graymark Healthcare for the full year 2009 included stock-based compensation expense of $682,000. There were no charges for goodwill and intangible asset impairment, the impairment of property and equipment, or the impairment of equity investment in 2009.

Adjusted EBITDA from continuing operations in 2010 was a loss of $3.0 million as compared to a loss of $4.6 million in 2009 (see "Reconciliation of Non-GAAP Financial Measures" below for the definition and an important discussion of this non-GAAP financial measure).

At December 31, 2010, cash and cash equivalents totaled $1.6 million, compared to $1.9 million at December 31, 2009.

2010 Operational Highlights

• Graymark performed 18,435 sleep studies in the company's standalone facilities, rural outreach sites and hospital agreements, an increase of 38% from 2009.
• Increase in sleep studies drove an increase in Continuous Positive Airway Pressure (CPAP) setups to 3,031, up 57% over 2009.
• The company signed 11 new hospital contracts for sleep medicine services in 2010, while transitioning out of five standalone facilities during the year.
• Graymark became the second largest pure-play company in the sleep management business following the sale of substantially all the assets of the pharmacy division to Walgreens for a total enterprise value of approximately $33 million.

Management Commentary

"2010 was a transformative year for Graymark as we successfully divested our pharmacy business to focus exclusively on the fast growing market of diagnosing and treating obstructive sleep apnea," said Stanton Nelson, Graymark's chairman and CEO. "With the restructuring costs associated with this divestiture behind us, we are now focused on reducing overall operating expenses through synergies realized by the combination of the Somni and Eastern acquisitions, as well as identifying additional operational efficiencies.

"We are also very much focused on bottom-line growth. In the fourth quarter of 2009, we launched a new comprehensive care model to improve the conversion rate of OSA patients into successfully using a CPAP device. The momentum generated by this new model resulted in a 37% increase in our sleep therapy business over the course of the year, and more than doubled our resupply shipment orders from Q1 to Q4."

"Our expectations for 2011 remain very positive as we further synergize our 2009 acquisitions and capitalize on the 11 hospital contracts we folded into our model in 2010. Out of the 11, six were signed in the fourth quarter and we've since signed six additional hospital agreements in the first quarter of 2011. Based upon this momentum, as well as the increasing recurring revenue stream from converting new patients into our resupply business, we expect to be EBITDA positive in the third quarter of 2011."