UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

FORM 10-K

 

(Mark One)

Annual Report Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934
 

For the Fiscal Year Ended June 30, 2022

or

For the Fiscal Year EndedJune 30, 2017

Transition Report Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934
For the Transition Period From ________ to ________.

For the Transition Period From  to  .

Commission File number001-34839

 

 Electromed, Inc. 
 (Exact Name of Registrant as Specified in its Charter) 

Minnesota41-1732920
(State or other jurisdiction of(IRS Employer
incorporation or organization)Identification No.)

500 Sixth Avenue NW, New Prague, MN56071

(Address of principal executive offices)offices, including zip code)

 (952) (952) 758-9299 
 (Registrant’s telephone number, including area code) 

 

Securities registered pursuant to Section 12(b) of the Act:

Common Stock, $0.01 par valueNYSE American
(Title of each class)class(Trading Symbol(s)Name of each exchange on which registered)registered
Common Stock, par value $0.01 per shareELMDNYSE American

Securities registered pursuant to Section 12(g) of the Exchange Act:None

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No ☑

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐ No ☑

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 ☑ No ☐

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Website, if any, every Interactive Data File required to be submitted and posted 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 and post such files).Yes ☑ No ☐

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§ 229.405 of this chapter) is not contained herein, and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K. ☑

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 the 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 

(Do not check if smaller reporting company)

Emerging growth company 

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 has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Ac t (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report. ☐

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

The aggregate market value of the common stock held by non-affiliates of the registrant as of December 31, 20162021 was approximately $18,767,000$91,856,000 based upon the closing price of the registrant’s common stock, as reported on the NYSE American, on such date.

There were 8,260,1678,475,438 shares of the registrant’s common stock outstanding as of September 1, 2017.August 23, 2022.

DOCUMENTS INCORPORATED BY REFERENCE

Portions of the Definitive Proxy Statement for the registrant’s Fiscal 20182023 Annual Meeting of Shareholders, to be filed within 120 days of June 30, 2017,2022, are incorporated by reference into Part III of this Annual Report on Form 10-K.

 

Electromed, Inc.

Index to Annual Report on Form 10-K

PART I1
Item 1.Business1
Item 1A.Risk Factors1213
Item 1B.Unresolved Staff Comments1213
Item 2.Properties1213
Item 3.Legal Proceedings1213
Item 4.Mine Safety Disclosures1213
   
PART II1213
Item 5.Market For Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities1213
Item 6.Selected Financial Data[Reserved]1314
Item 7.Management’s Discussion and Analysis of Financial Condition and Results of Operations1314
Item 7A.Quantitative and Qualitative Disclosures About Market Risk22
Item 8.Financial Statements and Supplementary DataF-1F-1
Item 9.Changes in and Disagreements With Accountants on Accounting and Financial Disclosure23
Item 9A.Controls and Procedures23
Item 9B.Other Information23
Item 9C.Disclosure Regarding Foreign Jurisdictions that Prevent Inspections24
   
PART III24
Item 10.Directors, Executive Officers and Corporate Governance24
Item 11.Executive Compensation2425
Item 12.Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters2425
Item 13.Certain Relationships and Related Transactions, and Director Independence2425
Item 14.Principal Accountant Fees and Services2425
PART IV25
Item 15.Exhibits and Financial Statement Schedules2425
Item 16.Form 10-K Summary2527

 

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INFORMATION REGARDING FORWARD-LOOKING STATEMENTS

Statements contained in this Annual Report on Form 10-K that are not statements of historical fact should be considered forward-looking statements within the meaning of the safe harbor provisions of Section 27A of the Securities Act of 1933, as amended, (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). Forward-looking statements include, but are not limited to, statements regardingregarding: the following:expected impact of the COVID-19 pandemic on our business; our business strategy, including our intended level of investment in research and development and marketing activities; our expectations with respect to earnings, gross margins and sales growth, industry relationships, marketing strategies and international sales; estimated sizes of markets into which our products are or may be sold; our business strengths and competitive advantages; our plans and expectations with respectability to internationalgrow additional sales growth;distribution channels; our intent to retain any earnings for use in operations rather than paying dividends; our expectation that our products will continue to qualify for reimbursement and payment under government and private insurance programs; our intellectual property plans and practices; the expected impact of applicable regulations on our business; our beliefs about our manufacturing processes; our expectations and beliefs with respect to our employees and our relationships with them; our belief that our current facilities are adequate to support our growth plans; our expectations with respect to ongoing compliance with the terms of our credit facility; our expectations regarding the ongoing availability of credit and our ability to renew our line of credit; enhancements to our products and services; expected excise tax exemption for the expansion and availability of our SmartVest Connect technology;System; and our anticipated revenues, expenses, capital requirements and liquidity. Words such as “anticipate,” “believe,” “continue,” “could,” “estimate,” “expect,” “goal,” “intend,” “may,” “ongoing,” “plan,” “potential,” “project,” “should,“goal,” “target,” “should,” “will,” “would,” and similar expressions, including the negative of these terms, are intended to identify forward-looking statements but are not the exclusive means of identifying such statements. Although we believe these forward-looking statements are reasonable, they involve risks and uncertainties that may cause actual results to differ materially from those projected by such statements. Such statements involve known and unknown risks, uncertainties and other factors that may cause our actual results or our industry’s actual results, levels of activity, performance, or achievements to be materially different from the information expressed or implied by the forward-looking statements.

Factors that could cause actual results to differ from those discussed in the forward-looking statements include, but are not limited to:to, the following:

the competitive natureduration, extent and severity of the COVID-19 pandemic, including its effects on our market;business, operations and employees as well as its impact on our customers and distribution channels and on economies and markets more generally;

changesability to obtain reimbursement from Medicare, Medicaid, or private insurance reimbursement policies;payers for our products including potential adverse impact with an expiration of the Centers for Medicare and Medicaid Services waiver for certain respiratory diseases;

component or raw material shortages, changes to health care laws;lead times or significant price increases

adverse changes affecting the medical device industry;to state and federal health care regulations;

our needability to develop new sales channels for our products such as the home care distributor channel;

our ability to maintain regulatory compliance and to gain future regulatory approvals and clearances;

entry of new competitors including new drug or pharmaceutical discoveries;

generaladverse economic and business conditions;conditions or intense competition;

wage and component price inflation;

technical problems with our research and products;

changes affecting the medical device industry;

adverse international health care regulation impacting current international business;

our ability to renew our line of credit or obtain additional credit as necessary;

our ability to protect and expand our intellectual property portfolio; and

the risks associated with expansion into international markets.cyberattacks, data breaches, computer viruses and other similar security threats; and

the risks associated with our planned sales force expansion.

This list of factors is not exhaustive, however, and these or other factors, many of which are outside of our control, could have a material adverse effect on us and our results of operations. Therefore, you should consider these risk factors with caution and form your own critical and independent conclusions about the likely effect of these risk factors on our future performance. Forward-looking statements speak only as of the date on which the statements are made, and we undertake no obligation, and expressly disclaim any such obligation, to update any forward-looking statement for any reason other than as required by law, even if new information becomes available or other events occur in the future. You should carefully review the disclosures and the risk factors described in this and other documents we file from time to time with the Securities and Exchange Commission (the “SEC”), including our Quarterly Reports on Form 10-Q and Current Reports on Form 8-K.. All forward-looking statements attributable to us or persons acting on our behalf are expressly qualified in their entirety by the cautionary statements set forth herein.

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PART I

Item 1. Business.

Overview

Electromed, Inc. (“we,” “our,” “us,” “Electromed” or the “Company”) develops, manufactures, markets and sells innovative products that provide airway clearance therapy, including the SmartVest®SmartVest® Airway Clearance System (“SmartVest System”) and related products, to patients with compromised pulmonary function with a commitment to excellence and compassionate service. Our goal is to make High Frequency Chest Wall Oscillation (“HFCWO”) treatments as effective, convenient, and comfortable as possible, so our patients in their homes, will adhere to their prescribed treatment schedule, leading tocan breathe easier and live better with improved airway clearance, enhanced respiratory function and reduced healthcare utilization. fewer exacerbations.

We employ a direct-to-patient and provider model, through which we obtain patient referrals from clinicians, manage insurance claims on behalf of our patients, and their clinicians, deliver our solutionsthe SmartVest System to patients, and traintraining them on proper use in their homes. This model allows us to directly approach patients and clinicians, whereby we disintermediate the traditional durable medical equipment (“DME”) channel and capture both the manufacturer and distributor margins. We also sell our products in the acute care setting for patients in a post-surgical or intensive care unit, or who were admitted for a lung infection brought on by compromised airway clearance. Electromed was incorporated in Minnesota in 1992. Our common stock is listed on the NYSE American (formerly the NYSE MKT) under the ticker symbol “ELMD.”

The SmartVest System features a programmable air pulse generator, a therapy garment worn over the upper body and a connecting hose, which together provide safe, comfortable, and effective airway clearance therapy. The SmartVest System generates HFCWO, also known as High Frequency Chest Wall Oscillation, a technique foran airway clearance therapy. The garment repeatedly compresses and releases the upper body at frequencies from 5 to 20 cycles per second creating a “mini cough.” Each compression (or oscillation) produces pulsations that thin and loosen secretions from the surfaces of the lung airways, propelling them toward the mouth where they can be removed by normal coughing or suction.

HFCWO facilitates airway clearance by loosening and mobilizing respiratory secretions in a patient’s lungs. One factor of respiratory health is the ability to clear secretions from airways. Impaired airway clearance, when mucus cannot be expectorated, may result in labored breathing and/or inflammatory and immune systems boosting mucus production that invites bacteria trapped in stagnant secretions to cause infections. Studies show that HFCWO therapy is as effective an airway clearance method for patients who have cystic fibrosis or other forms of compromised pulmonary function as traditional chest physical therapy (“CPT”) administered by a respiratory therapist.1 However, HFCWO can be self-administered, relieving a caregiver of participation in the therapy, and eliminating the attendant cost of an in-home care provider. We believe that HFCWO treatments are cost-effective primarily because they reduce a patient’s risk of respiratory infections and other secondary complications that are associated with impaired mucus transportairway clearance and often result in costly hospital visits.visits and repeated antibiotic use.

The SmartVest System is designed for patient comfort and ease of use which promotes compliance withadherence to prescribed treatment schedules, leading to improved airway clearance, enhanced respiratory functionpatient outcomes and quality of life, and a reduction in healthcare utilization. We offer a broad range of garments, referred to as vests and wraps, in sizes for children and adults that allow for tailored fit and function.fit. User-friendly controls allow children and the elderlypatients to administer their own daily therapy with minimal or no assistance. Our direct product support services provide patient and clinician education, training, and follow-up to ensure that the product is integrated into each patient’s daily treatment regimen. Additionally, our reimbursement and billing departments assuredepartment assures we are working on behalf of the patient by processing their physician paperwork, providing clinical support as needed and billing Medicare or the applicable insurance provider on their behalf.provider. We believe that the advantages of the SmartVest System and the Company’s customer services to the patient include:

improved quality of life;

reduction in healthcare utilization;

independence from a dedicated caregiver;

consistent treatments at home;


improved comfort during therapy; and

portability; and

eligibility for reimbursement by private insurance, federal or state government programs or combinations of the foregoing.

1Nicolini A, et al. Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis. BMC Pulmonary Medicine. 2013;13(21).

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Our Products

Since 2000, we have marketed the SmartVest System and its predecessor products to patients suffering from bronchiectasis, cystic fibrosis, and neuromuscular conditions such as cerebral palsy and amyotrophic lateral sclerosis (“ALS”). Our products are primarily sold into the home health care market for patients with chronic lung issues, including bronchiectasis, cystic fibrosis and neuromuscular disease. We also sell our products inthe acute care settings (e.g., hospitals and clinics) when the patient issetting for patients in a post-surgical or intensive care unit, or waswho were admitted for a lung infection brought on by compromised airway clearance. Accordingly, our sales points of contact include adult pulmonology clinics, cystic fibrosis centers, neuromuscular clinics pulmonary rehabilitation centers, hospitals and home health care centers.hospitals.

We have received clearance to market the SmartVest System from the U.S. Food and Drug Administration (“FDA”) to market the SmartVest System to promote airway clearance and improve bronchial drainage. In addition, Electromed is certified to apply the Conformité Européenne (“European Conformity” or “CE”) marking for HFCWO device sales in all European Union member countries and approved for HFCWO device sales in other, select international countries. The SmartVest System is available only with a physician’s prescription.

The SmartVest System is currently available in one model – SQL® – which is sold into home care and hospital markets. We will continue to support and service earlier SmartVest models pursuant to the applicable product warranty.

As part of our growth strategies, we periodically evaluate opportunities involving products and services, especially those that may provide value to the respiratory homecare and institutional market. To that end, we made meaningful progress in the development of our next generation SmartVest System during our fiscal year ended June 30, 2022 (“fiscal 2022”) and estimate launching such device and completing the corresponding FDA 510(k) clearance process in the first half of our fiscal year ending June 30, 2023 (“fiscal 2023”).

The SmartVest SQL System

The SmartVest SQL System consists of an inflatable therapy garment, a programmable air pulse generator and a patented single-hose that delivers air pulses from the generator to the garment. The SmartVest SystemSQL is currently available in two models – SV2100 and SQL® – both of which are sold into home care and institutional markets for use by patients and hospitals. Both models deliver the same clinically effective HFCWO therapy. Additionally, both systems are designed for maximum comfort and lifestyle convenience, so patients can readily fit HFCWO therapy into their daily routines:routines. The SmartVest SQL was designed to be significantly smaller, quieter, and lighter than its predecessor, and offers features that make it easier to use and enable greater patient freedom.

Patented single-hose design: When the SmartVest System is in use, aA single-hose delivers oscillations to the SmartVest garment, which we believe provides therapy in a more comfortable and unobtrusive manner than a two-hose system. Oscillations are delivered evenly from the base of the SmartVest garment, extending the forces upward and inward in strong but smooth cycles surrounding the chest.

Open system design with active inflate – active deflate: The active inflate – active deflate mechanism of the SmartVest System provides patients a more comfortable treatment experience by working in unison with patients to allowallowing them to take deep breaths and breathe more easily without feeling restricted.

Soft-fabric garment is lightweight and comfortable: The SmartVest garment is lightweight and designed to resemble an article of clothing. Quick fit Velcro®-like closures allow for a secure, comfortable fit without bulky straps and buckles. The simple design creates a broad size adjustment range to ensure a properly tailored fit. The SmartVest garment is available in a variety of colors and sizesfit to accommodate pediatric and adult patients.

Programmable generator with user-friendly device operation: The SmartVest System generator uses an internal programmable memory feature to manage air pulse frequency, air pulse pressure and treatment time to be set as prescribed by the patient’s physician. The air pulse frequency can be adjusted from 5 to 20 cycles per second and the air pulse pressure can be adjusted from 10 to 100% of a maximal pressure range.

Patented Soft Start® and 360° garment oscillation coverage:Soft Start creates an upward flow of air that gently fills the garment while initiating the squeeze/release pulse, acclimatingto acclimate the patient to therapy and minimizing “vest creep.”therapy. All SmartVest garments provide 360° oscillation coverage, which delivers simultaneous treatment to all lobes of the lungs.


The SmartVest SQL System

We designed the SmartVest SQL with an array of features that make it easier to use and enable greater patient freedom as compared to the SmartVest SV2100. In addition to incorporating the unique benefits of the SV2100, the SmartVest SQL was designed to be significantly smaller, quieter, and lighter than its predecessor, and offers advanced generator programmability, including an enhanced pause feature with save, lock and restore functionality:

Smaller, quieter and lighter:The SmartVest SQL System is 25% smaller, 5db quieter and 30% lighter than the prior SmartVest SV2100.SV2100 System, which we previously discontinued on July 1, 2021. The SmartVest SQL is the lightest and overall quietest HFCWO devicegenerator on the market, weighing less than 16 pounds, making it easier for patients to use and integrate HFCWO therapy into their daily lives.

2

Programmable ramp: The SmartVest SQL integrates fully programmable and adjustable ramp, which allows HFCWO therapy to start at a low frequency and pressure, ramp up, and then reduce the frequency and pressure during treatment. This allows clinicians greater flexibility to program patient-specific HFCWO therapy protocols.

Enhanced programmability:generator with user-friendly device operation: The SmartVest SQL features new programmabilitymultiple operating modes, including ramp, and options for saving, locking and restoring protocols, providing an extra layer of security.protocols. Further, an enhanced pause feature allows the physician to program dedicated time(s)times for the patient to clear secretions.

SmartVest Connect

In June 2017, we announced the launch oflaunched the SmartVest SQL with SmartVest Connect™Connect® wireless technology, a personalized HFCWO therapy management portal for patients with compromised pulmonary function. In March 2020, we launched the SmartVest Connect app for both the iOS and Android operating systems. The SmartVest Connect app securely connects to the SmartVest SQL with wireless technology features built-in cellular connectivity, offeringSystem through Bluetooth™ technology. This interface allows patients and healthcare teams to track therapy in real-time and patients accesscollaborate on care decisions to treatment information to better collaborate in making patient-centered care decisions.improve therapy adherence and patient outcomes. SmartVest Connect is available to pediatric and cystic fibrosis patients, using a wirelessly enabled SmartVest SQL system. We expect to expand SmartVest Connect availability toand targeted adult pulmonary clinics throughout fiscal 2018.using a Bluetooth-enabled SmartVest SQL System.

Performance insights:SmartVest Connect enables patients to track progress of their therapy plan and includes a real-time SmartVest Score and easy-to-read goal reports that provide an in-depth look at performance.

Treatment collaboration:Created to encourage patient engagement, SmartVest Connect provides feedback for patients to take an active role in their HFCWO therapy, fostering improved therapy adherence.

Engineered for simplicity:SmartVest SQL with SmartVest Connect is simple, intuitive, and designed to automatically update following completion of a therapy session.

Other Products

We market the Single Patient Use (“SPU”) SmartVest®and SmartVest Wrap® to health care providers, particularly those working in intensive care units. Hospitals issue the SPU SmartVest or SmartVest Wrap to an individual patient for the duration of the patient’s stay. Both SPU products facilitate continuity of care because they introduce the patient to our product line and may encourage use of the SmartVest System for home care, which can be provided to patients with a chronic condition upon discharge. Both SPU products also provide full coverage pulsation.


The Aerobika® Oscillating Positive Expiratory Pressure (OPEP) Device is sold in to the U.S. home care market through a distributor agreement with Monaghan Medical Corp. since early calendar year 2017. The Aerobika® OPEP device is a drug-free, easy to use, hand-held device with a proprietary pressure-oscillation dynamic that provides intermittent resistance and creates positive pressure and oscillations simultaneously. The device opens weak or collapsed airways to mobilize and assist mucociliary clearance to the upper airways where it can be coughed out. We believe that by offering this product, in addition to our SmartVest System, we can serve a broader patient population for those people with compromised pulmonary function

We market the Single Patient Use (“SPU”) SmartVest and SmartVest Wrap® to health care providers in the acute care setting. Hospitals issue the SPU SmartVest or SmartVest Wrap to an individual patient for managing airway clearance. Both SPU products provide full coverage oscillation and facilitate continuity of care because they introduce the patient to our product and may encourage use of the SmartVest System for home care, which can be provided to patients with a chronic condition upon discharge.

Our Market

We estimate the current total served U.S. market for HFCWO in the U.S. in 2016 washas returned to pre-pandemic levels and is estimated at approximately $140$220 million to $150 million.$240 million, with growth in HFCWO adoption at approximately 5% based on independent third-party market research. We believe our business modelthe market for HFCWO is supported by many market trends relatedcontinuing to expand due to an aging population, andhigher incidence of chronic lung disease, growing awareness by physicians of diseases and conditions for which patients can benefit from using HFCWO therapy.therapy, and treatments moving to lower cost home care settings. Indications for when HFCWO shouldmay be prescribed are not specific to any one disease. A physician may elect to prescribe HFCWO when he or shesuch individual believes the patient will benefit from improved airway clearance and external chest manipulation is the treatment of choice to enhance mucus transport and improve bronchial drainage.

The SmartVest System is primarily prescribed for patients with bronchiectasis, amyotrophic lateral sclerosis (“ALS”),cystic fibrosis, and neuromuscular conditions such as cerebral palsy cysticand ALS. We believe that bronchiectasis represents the fastest growing diagnostic category and greatest potential for HFCWO growth in the United States exhibiting an 8.7% increase in patients diagnosed between 2000 and 20079. Bronchiectasis is an irreversible, chronic lung condition characterized by enlarged and permanently damaged bronchi. The condition is associated with recurrent lower respiratory infections, inflammation, reduction in pulmonary function, impaired respiratory secretion clearance, increased hospitalizations and medication use, and increased morbidity and mortality.

We are driven to make life's important moments possible, one breath at a time, by leading the HFCWO therapy market in clinical evidence that supports the therapeutic imperative of clearing excess mucus from the lungs. Electromed continues to add to the body of evidence in support of HFCWO with multiple published clinical outcome studies demonstrating a significant improvement in quality of life and reduction in exacerbation rates, hospitalizations, emergency department visits, and antibiotic prescriptions in bronchiectasis patients using the SmartVest System. This includes the most recent clinical study, a 2022 publication in the American Journal of Respiratory and Critical Care Medicine reviewing outcomes among non-cystic fibrosis muscular dystrophy, quadriplegiabronchiectasis patients with HFCWO Therapy.2-6 Generating additional clinical evidence to further support the SmartVest System as a preferred treatment for bronchiectasis patients will remain a focus for us in fiscal 2023, with two clinical studies in progress. The first such clinical study is a prospective, multi-center bronchiectasis outcomes study utilizing SmartVest therapy, and the combination of emphysema and chronic bronchitis commonly known assecond is a post surveillance study with chronic obstructive pulmonary disease (“COPD”("COPD"). and bronchiectasis patients prescribed SmartVest utilizing quality of life questionnaires to measure outcomes prior to therapy and at two intervals following initiation of the therapy.

We believe that bronchiectasis is under recognized and underdiagnosed but is experiencing a surge in clinical interest and awareness, including the relationship to COPD, commonly referred to as bronchiectasis COPD overlap syndrome. The overlap of bronchiectasis and COPD increases exacerbations and hospitalizations, reduces pulmonary function, and increases mortality. Several recent studies have estimated patient populations in 2016prevalence of bronchiectasis, which we believe are helpful for diseases and conditions routinely prescribed HFCWO therapy are listed below.estimating a range of the overall market size.

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Bronchiectasis:We believe that bronchiectasis, an irreversible lung condition that is the end result of repeated episodes of pulmonary inflammation and infection leading to permanently dilated bronchial airways, represents the fastest growing diagnostic category and greatest potential for HFCWO growthWeycker (2017) projected 4.2 million adults in the United States. Two clinical studies providedStates over the analysis for this belief.age of 40 may have bronchiectasis, suggesting there is a large pool of patients with undiagnosed disease.7

Henkle (2018) confirmed a high prevalence of bronchiectasis in the United States, identifying over 600,000 unique patients with at least one bronchiectasis claim (ICD-9 claims 494.0 or 494.1). The firststudy also observed that patients with dual diagnosis of bronchiectasis and COPD were in poorer health, with more office visits, more inpatient admissions and more acute respiratory infections.8

Seitz (2012) estimated that 190,000 unique cases of bronchiectasis were diagnosed in Medicare patients in 2007 and bronchiectasis prevalence increased 8.7% annually between 2000 and 20072007.19 . Based on historic growth in prevalence and assuming a constant growth rate, the estimated number of bronchiectasis diagnoses in the Medicare population in 2016 exceeded 400,000. We estimate that approximately 15% of total bronchiectasis Medicare patients have been prescribed HFCWO therapy. See Figure 1 below.in 2021 exceeded 608,000.

Aksamit (2017) found 20% (n=350) of patients with bronchiectasis enrolled in the U.S. Bronchiectasis Research Registry between 2008 and 2014 also had COPD and 29% (n=515) also had asthma.7 Other studies have found that the overlap between bronchiectasis and COPD is observed in 27% to 57% of patients with COPD. 10-13–8

Chalmers (2017) found that prevalence of bronchiectasis in patients with COPD ranged from a low of 4% to as high as 69% with mean prevalence of 54%. In many studies in patients with COPD, the presence of bronchiectasis was associated with reduced lung function, greater sputum production, more frequent exacerbations and increased mortality versus those with COPD alone.14

The second, estimated that bronchiectasis is observed in 7% to 52% of patients with asthma or chronic obstructive pulmonary disease.2,3,4. Estimates of COPD prevalence vary considerably, suggesting that approximately 15.7 - 24 million people in the United States are affected by COPD. We believe that the conservative estimate is that approximately 7% of the total U.S. population diagnosed with asthma or COPD (15.7 million) may also have undiagnosed bronchiectasis or approximately 1.1 million people. TheThese studies indicate a wide range of potential prevalence of bronchiectasis patients from these two clinical studies is estimated to be between 400,000 to 1.1 million. See Figure 2 below.

We believe that bronchiectasis represents the fastest growing diagnostic category and greatest potential for HFCWO growth in the United States. We also believe that it is difficult to estimate from these studies which patients will need or benefit from HFCWO. Internal company estimates derived from 2020 analysis of the IQVIA PharMetrics Plus database, one of the largest US health plan databases of adjudicated integrated medical and pharmacy claims, indicate a 15% to 20% penetration of HFCWO within the diagnosed Bronchiectasis population15. By conservatively assessing the market size in relation to the clinical studies cited above, we calculate that approximately 15%current HFCWO adoption may account for only 90,000 patients of totalthe 500 to 600 thousand currently diagnosed and treatable patients (see Figure 1 below). We believe that bronchiectasis Medicareis underdiagnosed in the U.S. based on clinical study and epidemiology evidence with an even greater number of patients have beenthat could potentially benefit from diagnosis and treatment. We believe that HFCWO is under prescribed for bronchiectasis patients resulting in a large, underpenetrated US market opportunity and growth potential for HFCWO therapy.


Figure 1

 

12Amy E. Seitz, MPH,Sievert C, et al. 2012.Using High Frequency Chest Wall Oscillation in a Bronchiectasis Patient Population: An Outcomes-Based Case Review. Respiratory Therapy Journal. 2016;11(4): 34–38.

3Sievert C, et al. Cost-Effective Analysis of Using High Frequency Chest Wall Oscillation (HFCWO) in Patients with Non-Cystic Fibrosis Bronchiectasis. Respiratory Therapy Journal. 2017;12(1): 45–49.

4Sievert C, et al. Incidence of Bronchiectasis-Related Exacerbation Rates After High Frequency Chest Wall Oscillation (HFCWO) Treatment — A Longitudinal Outcome-Based Study. Respiratory Therapy Journal. 2018;13(2): 38–41.

5Powner J, et al. Employment of an algorithm of care including chest physiotherapy results in reduced hospitalizations and stability of lung function in bronchiectasis. BMC Pulmonary Medicine. 2019;19(82).

6 DeKoven M, Mandia K, DeFabis N, Chen J, Ruscio A. Patient Characteristics, Healthcare Resource Utilization And Outcomes Among Non-Cystic Fibrosis Bronchiectasis Patients With High Frequency Chest Wall Oscillation (HFCWO) Therapy. American Journal of Respiratory and Critical Care Medicine. 2022. Vol 205:A3090

7Weycker D, Hansen G, Seifer F. Prevalence and incidence of noncystic fibrosis bronchiectasis among US adults in 2013. Chronic Respiratory Disease. 2017; 14(4):377-384.

8Henkle E, et al. Characteristics and Health-care Utilization History of Patients with Bronchiectasis in US Medicare Enrollees With Prescription Drug Plans, 2006 to 2014. Chest. 2018;154(6), 1311–1320.

9Seitz A, et al. Trends in Bronchiectasis-AmongBronchiectasis Among Medicare Beneficiaries in the United States, 2000 to 2007.Chest.CHEST. 2012;142(2): 432-439., 432–439.

10Aksamit T, et al. Bronchiectasis Research Registry C. Adult Patients With Bronchiectasis: A First Look at the US Bronchiectasis Research Registry. Chest. 2017;151:982-92.

211Patel IS, Vlahos I, Wilkinson TM,I.S., et al. Bronchiectasis, exacerbation indices, and inflammation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2004;170(4):400-407. 10.1164/rccm.200305-648OC170:400-7.

312Gono H, Fujimoto K, Kawakami S,O’Brien C, et al. EvaluationPhysiological and radiological characterization of airway wall thickness and air trapping by HRCTpatients diagnosed with chronic obstructive pulmonary disease in asymptomatic asthma. Eur Respir J 2003;22(6):965-971.primary care. Thorax. 2000;55:635-42.

413Martınez-Garcıa MA,Bafadhel M, et al. Prognostic ValueThe role of CT scanning in multidimensional phenotyping of COPD. Chest. 2011;140:634-42.

14Chalmers J. and Sethi S. Raising awareness of bronchiectasis in primary care: overview of diagnosis and management strategies in adults. NPJ Prim Care Respir Med. 2017;27:18.

15 Internal company estimates derived from IQVIA 2018 PharMetrics Plus Database

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Estimated HFCWO Market Opportunity - Bronchiectasis in Patients with Moderate-to-Severe Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2013; Vol 187, Iss. 8, pp 823–831.(U.S.) – Figure 1

Figure 2 

 The heightened awareness of bronchiectasis speaks to the growing body of clinical evidence supporting treatments to improve symptoms and manage disease progression.

NeuromuscularIn 2019, an observational comparative retrospective cohort study published in BMC Pulmonary Medicine evaluated the efficacy of a treatment algorithm in 65 patients with radiographic and neuromotor disorders: A range of neuromuscular and neuromotor disorders — including ALS, severe cerebral palsy, Duchenne muscular dystrophy, and quadriplegia — can cause respiratory muscle weakness and compromised airway clearance. Effective airway clearance therapy, including usesymptom confirmed bronchiectasis, centered on initiation of HFCWO is a critical aspect of respiratory cares for peopletherapy with neuromuscular or neuromotor disorders who lack respiratory muscle strength. Not all people with neuromuscular or neuromotor disorders will require airway clearance therapy. We estimate the total number of peopleSmartVest System.5 Patients were treated per the algorithm if they reported greater than two exacerbations in the U.S. with a neuromuscularprevious year and symptoms, including chronic cough, sputum production, or neuromotor disorderdyspnea. Results show that would benefit from airway clearanceat one-year: exacerbations requiring hospitalization and antibiotic use were significantly reduced and mean forced expiratory volume remained stable post enrollment, suggesting early initiation of HFCWO therapy is approximately 250,000.may slow the otherwise normal progression of the disease.


Cystic Fibrosis:In 2022, the U.S., approximately 30,000 people are living with cystic fibrosis,American Journal of Respiratory and an estimated 1,000 new casesCrucial Care Medicine published the results of cystic fibrosis are diagnosed each year.a third-party retrospective cohort analysis of 101 qualifying NCFBE patients who received HFCWO. Key findings revealed that patients who used HFCWO therapy experienced improved health outcomes, a reduction in healthcare resource utilization and reduction in medication usage.6

Marketing, Sales and Distribution

Our sales and marketing efforts are focused on building market awareness and acceptancedriving adoption of our products and services with physicians, clinicians, patients, and third-party payers.payers and building market awareness to the benefits of HFCWO for treatment of bronchiectasis. Because the sale of the SmartVest System requires a physician’sphysician's prescription, we market to physicians and health care providers as well as directly to patients. The vast majority of our revenue comes from domestic home care sales through a physician referral model. We have established our own domestic sales force and support network, which we believe is able to provide superior education, support and training to our customers.

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Our direct U.S. sales force works with physicians and clinicians, primarily pulmonologists, in defined territories to help them understand our products and services and the value they provide to their respective patients. As of June 30, 2017,2022, we had 4052 field sales employees, including threesix regional sales managers, 3643 clinical area managers (“CAMs”) and onethree clinical educator.educators. We also have developed a network of more thanapproximately 250 respiratory therapists and health care professionals across the U.S. to assist with in-home SmartVest System patient training on a non-exclusive, independent contractor basis. These independent contractors are credentialed by the National Board for Respiratory Care as either Certified Respiratory Therapists or Registered Respiratory Therapists.

OfTherapists and provide national coverage to an internal team of Registered Respiratory Therapists dedicated to supporting SmartVest patients. Additionally, Electromed employs a team of reimbursement specialists dedicated to managing insurance and payer relations and supporting prescribers and patients in navigating financial considerations. The availability of reimbursement is an important consideration for health care professionals and patients. Because our product has an assigned Healthcare Common Procedure Coding System (“HCPCS”) code, a claim can be billed for reimbursement using that code. We must demonstrate the $25.1 millioneffectiveness of our revenue derived from the U.S. in fiscal 2017, approximately 93% represented home careproducts to public and 7% represented institutional sales. Dueprivate insurance providers. The availability of reimbursement exists primarily due to readmission penalties associated with the Patient Protectionan established HCPCS code for HFCWO. A HCPCS code is assigned to services and Affordable Care Act, as reconciledproducts by the Health CareCenters for Medicare and Education Reconciliation Act of 2010 (collectively the “PPACA”Medicaid Services (“CMS”), for certain diseases and conditions including COPD and pneumonia, we believe opportunities for further growth exist for HFCWO therapy because the device used by a patient in an institution may influence the choice of device prescribed at discharge. We expect to achieve future sales, earnings, and overall market share growth by increasing home care referrals through building awareness of the choice patients and clinicians have of HFCWO devices..

Of the $41.7 million of our revenue derived from the U.S. in fiscal 2022, approximately 91% represented home care and 4% represented hospital sales. We expect to achieve future sales, earnings, and overall market share growth through a continued focus on product innovation, differentiation and improved patient experiences and outcomes in the home care segment. We believe that our position in the market, direct sales team and a dedication to advancing education on HFCWO awareness positions us to drive market awareness and growth to the benefits of HFCWO in treatment of bronchiectasis. We believe that dedicated service to our providers and patients is a key component of achieving future sales. Providers seek companies that are easy to work with, are responsive and care for their patients as an extension of their practices.

We generate sales leadsinterest through multiple channels that include visits to pulmonology clinics and medical centers, participation in medical conferences, maintenance of industry contacts in order to increase the visibility and acceptance of our products by physicians and health care professionals, participation with patient organizations such as the Cystic Fibrosis Foundation, direct mailings, as well as through a focus on increasing patients by word of mouth and traffic to our website. In addition, we place advertisementswebsite and social media channels. We continue to evaluate opportunities to offer the SmartVest System through selected Home Medical Equipment (“HME”) distributors. We maintain agreements with three HME distributors, one national and two regional, to distribute and sell the SmartVest System in leading medical magazines and journals.the United States home care market. We expect to continue our direct sales channel as our primary homecare revenue source.

Additionally, because the availability of reimbursement is an important consideration for health care professionals and patients, we must also demonstrate the effectiveness of our products to public and private insurance providers. The availability of reimbursement exists primarily due to an established Healthcare Common Procedure Coding System (“HCPCS”) code for HFCWO. A HCPCS code is assigned to services and products by the Centers for Medicare and Medicaid Services (“CMS”). Because our product has an assigned HCPCS code, a claim can be billed for reimbursement using that code.

International Marketing

Approximately 2.8%1.3% and 3.1%1.8% of our net revenues were from sales outside of the U.S. in our fiscal years2022 and our fiscal year ended June 30, 2017 and 20162021 (“fiscal 2017” and “fiscal 2016”2021”), respectively. We sell our products outside of the U.S. primarily through independent distributors specializing in respiratory products. Through June 30, 2017,2022, the majority of our distributors operated in exclusive territories. Our principal distributors are located in Europe, Southeast Asia, South and Central America and the Arab states of the Persian Gulf.Gulf, Southeast Asia, South America and Central America. Units are sold at a fixed contract price with payments made directly from the distributor, rather than being tied to reimbursement rates of a patient’s insurance provider as is the case for domestic sales. Our sales strategy outside of the U.S. is to focus our corporate resources on maintainingmaintain our current distributors with less emphasis on contracting with new distributors.

Third-Party Reimbursement

In the U.S., individuals who use the SmartVest System generally will rely on third-party payers, including private payers and governmental payers such as Medicare and Medicaid, to cover and reimburse all or part of the cost of using the SmartVest System. Approximately half of ourOur home care revenue iscomes from reimbursement from commercial payers, Medicare, Medicaid, Veterans Affairs and one quarter is from each of the Medicare and Medicaid programs.direct patient payments. Reimbursement for HFCWO therapy and the SmartVest System varies among public and private insurance providers.


A key strategy to grow sales is achieving world class customer service and support for our patients and clinicians.clinicians and increasing the number of covered lives across a broad payer market. We do this with an established and effective reimbursement department working on behalf of the patient by processing physician paperwork, seeking insurance authorization and processing claims. The skill and knowledge gained and offered by our reimbursement department is an important factor in building our revenue and serving patients’ financial interests. Our payment terms generally allow patients to acquire the SmartVest System over a period of 1one to 15 months, which is consistent with reimbursement procedures followed by Medicare and other third parties. The payment amount we receive for any single referral may vary based on a number of factors, including Medicare and third-party reimbursement processes and policies. The patient retains the risk of reimbursement to the Company in the event of non-payment by third-party payers. The reimbursement department includes the payer relations function working directly with all payer types to increase the covered lives for the SmartVest System with national and regional private insurers and applicable state and federal government entities as well as to maintain all of the current licenses with state and federal government and payer contracts.

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Our SmartVest System is reimbursed under HCPCS code E0483. Currently, the Medicare total allowable amount of reimbursement for this billing code is approximately $12,000.$13,000. The allowed amount for state Medicaid programs rangeranges from approximately $8,000 to $13,000, which is similar to commercial payers. Actual reimbursement from third-party payers can vary and can be significantly less than the full allowable amount. Deductions from the allowable amount, includesuch as co-payments, deductibles and/or maximums on durable medical equipment, decrease the reimbursement received from the third-party payer. Collecting a full allowable amount depends on our ability to obtain reimbursement from the patient’s secondary and/or supplemental insurance if the patient has additional coverage, or our ability to collect amounts from individual patients.

Most patients are able to qualify for reimbursement and payment from Medicare, Medicaid, private insurance or combinations of the foregoing. We expect that subsequent generations of HFCWO products also will qualify for reimbursement under Medicare Plan B and most major health plans. However, some third-party payers must also approve coverage for new or innovative devices or therapies before they will reimburse health care providers who use the medical devices or therapies. In addition, we face the risk that new or modified products could have a lower reimbursement rate, or that the levels of reimbursement currently available for our existing products could decrease, which would hamper our ability to market and sell that product. Consequently, our sales will continue to depend in part on the availability of coverage and reimbursement from third-party payers, even though our devices may have been cleared for marketing by the FDA. The manner in which reimbursement is sought and obtained varies based upon the type of payer involved and the setting in which the procedure is furnished.

In response to the COVID-19 pandemic and the U.S. federal government’s declaration of a public health emergency in March 2020, CMS implemented a number of temporary rule changes and waivers to allow prescribers to best treat patients during the period of the public health emergency. These waivers are retroactively effective to March 1, 2020. Clinical indications and documentation typically required will not be enforced for respiratory related products including the SmartVest System (solely with respect to Medicare patients). The minimum documentation now requires a valid order and documentation of a respiratory-related diagnosis. Face-to-face and in-person requirements for respiratory devices are being waived while the waiver is in place. The CMS waiver was recently extended in conjunction with the extension of the federal public health emergency for an additional 90-day period beginning July 15, 2022.

Research and Development

As of June 30, 2017, ourOur research and development staff consisted(“R&D”) capabilities consist of two full-time engineersengineering staff and several consultants. We periodically engage consultants and contract engineering employees to supplement our development initiatives. Our team has a demonstrated record of developing new products that receive the appropriate product approvals and regulatory clearances around the world.

During the fiscal years ended June 30, 20172022 and 2016,2021, we incurred research and developmentR&D expenses of approximately $597,000$1,356,000 and $380,000,$1,722,000, or 3.3% and 4.8% of our net revenues, respectively. As a percentage of sales, we expect spending on research and developmentR&D expenses to remain relatively consistent overdecrease significantly during fiscal 2023 as compared with fiscal 2022, as we conclude the design and testing of our next generation device in preparation for an anticipated product launch during the first half of fiscal 2023. Product enhancements were driven by voice of customer survey and in-person information focused on patient useability and device portability. We also estimate that the next twelve months with engineering resources focusing ongeneration product enhancements and other market opportunities.will be a lower cost of goods compared to the SmartVest SQL.

Intellectual Property

As of June 30, 2017,2022, we held 18 U.S.13 United States and 22 foreign issued43 foreign-issued patents covering the SmartVest System and its underlying technology and had 1813 pending U.S.United States and foreign patent applications. These patents and patent applications offer coverage in the field of air pressure pulse delivery to a human in support of airway clearance. One of our U.S. patents will expire during our upcoming fiscal year ending June 30, 2018.

We generally pursue patent protection for patentable subject matter in our proprietary devices in foreign countries that we have identified as key markets for our products. These markets include the European Union, Canada, Japan, and other countries.


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We also have received eight10 U.S. and 100 foreign trademark and service mark registrations: SMARTVEST®, SMARTVest®, SMARTVEST WRAP®, CREATING SUPERIOR CARE THROUGH INNOVATION®, MEDPULSE RESPIRATORY VEST SYSTEM®, SQL®, SMARTVEST SQL®, SOFT START® and MAKING LIFE’S IMPORTANT MOMENTS POSSIBLE-ONE BREATH AT A TIME®. We have one registration in Canada for SMARTVEST, one registration in Peru for SMARTVEST and have one pending international registration through the Madrid Protocol for SMARTVEST. The Statement of Grant has been issued for Japan and is pending for China and the European Union.registrations.

Manufacturing

Our headquarters in New Prague, Minnesota includes a dedicated manufacturing and engineering facility of more than 10,00014,000 square feet, and we are certified on an annual basis to be compliant with ISOInternational Organization for Standardization (“ISO”) 13485 and ISO 9001 quality system standards. Our site has been audited regularly by the FDA and ISO, in accordance with their practices, and we maintain our operations in a manner consistent with their requirements for a medical device manufacturer. While components are outsourced to meet our detailed specifications, each SmartVest System is assembled, tested, and approved for final shipment at our manufacturing site in New Prague, consistent with FDA, Underwriters Laboratory, (“UL”), and ISO standards. Many of our vendorsstrategic suppliers are located within 100 miles of our headquarters, which enables us to closely monitor our component supply chain. We maintain established inventory levels for critical components and finished goods to assure continuity of supply. During fiscal 2022 we experienced longer lead times for critical electronic components related to worldwide supply shortages due to COVID-19 and the related U.S. and global economic recovery. We did not experience any material disruptions to customer shipments in fiscal 2022.

Product Warranties

We provide a warranty on the SmartVest System that covers the cost of replacement parts and labor, or a new SmartVest System in the event we determine a full replacement is necessary. For each home care SmartVest SystemsSystem initially purchased and currently located in the U.S. and Canada, we provide a lifetime warranty to the individual patient for whom the SmartVest System is prescribed. For sales to institutions and HME distributors within the U.S., and for all international sales, except Canadian home care, we provide a three-year warranty.

Competition

The original HFCWO technology was licensed to American Biosystems, Inc. (now Advanced Respiratory, Inc. (“ARI”), part of Hill-Rom Holdings, Inc.) (“Hillrom”), which, until the introduction of our original MedPulse Respiratory Vest System® in 2000, was the only manufacturer of a product with HFCWO technology cleared for market by the FDA (ARI’s(Hillrom’s The Vest®Airway Clearance System). Recently, ARI received FDA 510(k) clearance for the Monarch™ Airway Clearance System, a mobile device that uses pulmonary oscillating discs. In 2005, Respiratory Technologies, Inc., a privately held company doing business as (now RespirTech, part of Koninklijke Phillips N.V.) received FDA clearance to market their HFCWO product, the inCourage® Airway Clearance Therapy (the “inCourage System”).in 2005. Both Hillrom and RespirTech employ a direct-to-patient model, with RespirTech additionally offering its HFCWO device through selected DME distributors.

The AffloVest® (the “AffloVest”from Tactile Systems Technology Inc. (“Tactile Medical”) from International Biophysics Corporation also competes withparticipates in the same market as our SmartVest System. The AffloVest received FDA 510(k) clearanceTactile Medical primarily sells its device through DME companies who distribute home care medical devices and supplies. Based on annual revenue, we estimate that Hillrom maintains the highest market share in 2013. Clinical and cost-effective evidence, technology innovations, including wireless connectivity, and HFCWO product features and benefits, such as size, weight offollowed by RespirTech with Electromed in the generator, reputation for patient and reimbursement services, and sales effectiveness of field personnel, have become the key drivers of HFCWO product sales.third position.

Alternative products for administering pulmonary therapy include: Positive Expiratory Pressure, (“PEP”); Oscillatory PEP; Intrapulmonary Percussive Ventilation, (“IPV”); CPT and breathing techniques. Physicians may prescribe some or all of these devices and techniques, depending upon each patient’spatient's health status, severity of disease, compliance, or personal preference.

Key drivers of HFCWO product sales continue to be clinical and cost-effective evidence, technology innovations including wireless connectivity, and HFCWO patient experience benefits such as size, weight of the generator, and product reputation. We believe our primarywe distinguish ourselves in these areas with competitive advantages over alternative treatments areultimately improving the patient comfort, ease of use, and the effectiveness of HFCWO treatment. Because HFCWO is not “technique dependent,” as compared to most other alternative pulmonary therapy products, therapy begins automatically once power is provided and remains consistent and controlled for the duration of treatment.


Governmental Regulation

Medicare and Medicaid

Recent government and private sector initiatives in the U.S. and foreign countries aim at limiting the growth of health care costs includingincluding: price regulation, competitive pricing, coverage and payment policies, comparative effectiveness of therapies, technology assessments, and managed-care arrangements, andarrangements. These initiatives are causing the marketplace to put increased emphasis on the delivery of more cost-effective medical devices that result in better clinical outcomes. Government programs, including Medicare and Medicaid, have attempted to control costs by limiting the amount of reimbursement the program will pay for particular procedures or treatments, restricting coverage for certain products or services, and implementing other mechanisms designed to constrain utilization and contain costs. Many private insurance programs look to Medicare as a guide in setting coverage policies and payment amounts. These initiatives have created an increasing level of price sensitivity among our customers.

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Home Medical Equipment Licensing

Although we do not fall under competitive bidding for Medicare, we often must satisfy the same licensing requirements as other DME providers that qualify for competitive bidding. In response to out-of-state businesses winning the competitive bidding process, which had a significant impact on small local DME businesses, many states have enacted regulations that require a DME provider to have an in-state business presence, specifically through state Home Medical Equipment (“HME”)HME licensing boards or through state Medicaid programs. In order to do business with any patients in the state or to be a provider for the state Medicaid program, a DME provider must have an in-state presence. In addition to Minnesota, the location of our corporate headquarters, we have a licensed in-state presence in fourthree other states. We also maintain an in-state presence in California in order to meet their state Medicaid requirements. In-state presence requirements are differentvary from state to state, but generally require a physical location that is staffed and open during regular business hours. We are licensed to do business in all 50 states.states except for Alaska and Hawaii.

Product Regulations

Our medical devices are subject to regulation by numerous government agencies, including the FDA and comparable foreign regulatory agencies. To varying degrees, each of these agencies requires us to comply with laws and regulations governing the development, testing, manufacturing, labeling, marketing, and distribution of our medical devices, and compliance with these laws and regulations entails significant costs for us. Our regulatory and quality assurance departments provide detailed oversight in their areas of responsibility to support required clearances and approvals to market our products.

In addition to the clearances and approvals discussed below, we obtained ISO 9001 and ISO 13485 certification in January 2005 and receive annual certification of our compliance withto the current ISO quality standards.

FDA Requirements

We have received clearance from the FDA to market our products, including the SmartVest System. We may be required to obtain additional FDA clearance before marketing a new or modified product in the U.S., either through the 510(k) clearance process or the more complex premarket approval process. The process may be time consuming and expensive, particularly if human clinical trials are required. Failure to obtain such clearances or approvals could adversely affect our ability to grow our business.

Continuing Product Regulation

In addition to its approval processes for new products, the FDA may require testing and post-market surveillance programs to monitor the safety and effectiveness of previously cleared products that have been commercialized and may prevent or limit further marketing of products based on the results of post-mark surveillance results. At any time after marketing clearance of a product, the FDA may conduct periodic inspections to determine compliance with both the FDA’s Quality System Regulation (“QSR”) requirements and/orand current medical device reporting regulations. Product approvals by the FDA can be withdrawn due to failure to comply with regulatory standards or the occurrence of unforeseen problems following initial market clearance. The failure to comply with regulatory standards or the discovery of previously unknown problems with a product or manufacturer could result in fines, delays or suspensions of regulatory clearances, seizures or recalls of products (with the attendant expenses), the banning of a particular device, an order to replace or refund the cost of any device previously manufactured or distributed, operating restrictions and criminal prosecution, as well as decreased sales as a result of negative publicity and product liability claims.


We must register annually with the FDA as a device manufacturer and, as a result, are subject to periodic FDA inspection for compliance with the FDA’s QSR requirements that require us to adhere to certain extensive regulations. In addition, the federal Medical Device Reporting regulations require us to provide information to the FDA whenever there is evidence that reasonably suggests that a device may have caused or contributed to a death or serious injury or, if a malfunction were to occur, could cause or contribute to a death or serious injury. We also must maintain certain certifications in order to sell products internationally, and we undergo periodic inspections by notified bodies to obtain and maintain these certifications.

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Advertising and marketing of medical devices, in addition to being regulated by the FDA, are also regulated by the Federal Trade Commission and by state regulatory and enforcement authorities. Recently, promotional activities for FDA-regulated products of other companies have been the subject of enforcement action brought under health care reimbursement laws and consumer protection statutes. Competitors and others also can initiate litigation relating to advertising and /orand/or marketing claims. If the FDA determines thatwere to determine our promotional or training materials constitute promotion of an unapproved or uncleared claim of use, it is possible we maywould need to modify our training or promotional materials or be subject to regulatory or enforcement actions that maycould result in civil fines or criminal penalties. Other federal, state or foreign enforcement authorities mightcould also take similar action if they were to determine that our promotional or training materials constitute promotion of an unapproved use, which could result in significant fines or penalties.

European Union and Other Regions

European Union rules require that medical products receive the right to affix the CE marking,mark, demonstrating adherence to quality standards and compliance with relevant European Union Medical Device Directives (MDD)(“MDD”). Products that bear CE markingmark can be imported to, sold or distributed within the European Union. We obtained clearance to use the CE markingmark on our products in April 2005. Renewal of CE marking is required every five years, and our notified body performs an annual audit to ensure that we are in compliance with all applicable regulations. We have maintained our CE marking in good standing since originally receiving it and most recently renewed it in January 2015.2020. The renewal of our MDD certificate will allow us to continue to CE mark and sell our SmartVest SQL device, with no substantial changes, in the European Union until the certificate expires in May 2024. We are currently working on finalizing updates to the quality system to achieve full compliance with Regulation (EU) 2017/745 (EU MDR) which came into effect in May 2021. We also require all of our distributors in the European Union and other regions to comply with their home country regulations in our distributor agreements.

The 2010 Healthcare Reform Legislation, medical device excise tax and Federal Physician Payments Sunshine Act

U.S. healthcare reform legislation, the PPACA, was enacted into law in March 2010. The PPACA imposes a 2.3% excise tax on certain domestic sales of medical devices by manufacturers. To the extent that third-party payers and institutions will not absorb increased costs represented by the tax because of reimbursement or contract limitations, we are not able to offset the tax with increased revenue.

Beginning with the third quarter of fiscal 2016, we realized a positive impact to operating profit with the adoption of the recent Consolidated Appropriations Act, 2016, which includes a two-year moratorium on the medical device excise tax effective as of January 1, 2016.

Federal Physician Payments Sunshine Act

The Federal Physician Payments Sunshine Act (Section 6002 of the PPACA, thePPACA) (the “Sunshine Act”) was adopted on February 1, 2013, to create transparency for the financial relationship between medical device companies and physicians and/or teaching hospitals.hospitals (covered recipients). In January 2021, the Sunshine Act was expanded to cover payments made to these additional covered recipients, physician assistants, nurse practitioners, clinical nurse specialists, certified nurse anesthetists, and certified nurse midwives. The Sunshine Act requires all manufacturers of drugs and medical devices to annually report to the CMS any payments or any other “transfers of value” made to physicians and teaching hospitals,any covered recipients, including but not limited to consulting fees, grants, clinical research support, royalties, honoraria, meals, and meals.value of long-term use (over 90 days) of evaluation equipment. This information is then posted on a public website so that consumers can learn how much was paid to their physician by drug and medical device companies. The Sunshine Act requires ongoing data collection and annual management and reporting by us.


us and imposes civil penalties for manufacturers that fail to report timely, accurately, or completely to CMS.

Fraud and Abuse Laws

Federal health care laws apply to the marketing of our products and when we or our customers submit claims for items or services that are reimbursed under Medicare, Medicaid or other federally-fundedfederally funded health care programs. The principal applicable federal laws include:

the False Claims Act, which prohibits the submission of false or otherwise improper claims for payment to a federally-fundedfederally funded health care program;

the Anti-Kickback Statute, which prohibits offers to pay or receive remuneration of any kind for the purpose of inducing or rewarding referrals of items or services reimbursable by a federal health care program; and

the Stark Law, which prohibits physicians from profiting (actually or potentially) from their own referrals.

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There are often similar state false claims, anti-kickback, and anti-self referralanti-self-referral and insurance laws that apply to state-funded Medicaid and other health care programs and private third-party payers. In addition, the U.S. Foreign Corrupt Practices Act can be used to prosecute companies in the U.S. for arrangements with physicians, or other parties outside the U.S. if the physician or party is a government official of another country and the arrangement violates the law of that country. Enforcement of all of these regulations has become increasingly stringent, particularly due to more prevalent use of the whistleblower provisions under the False Claims Act, which allow a private individual to bring actions on behalf of the federal government alleging that the defendant has submitted a false claim to the federal government and to share in any monetary recovery. If a governmental authority were to conclude that we are not in compliance with applicable laws and regulations, we and our officers and employees could be subject to severe criminal and civil penalties and disbarment from participation as a supplier of product to beneficiaries covered by Medicare or Medicaid.

HIPAA/HIPAA, HITECH and Other Privacy Regulations

Federal and state laws protect the confidentiality of certain patient health information, including patient records, and restrict the use and disclosure of such information. The Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (“HIPAA”) and the Health Information Technology for Economic and Clinical Health Act (“HITECH”) set forth privacy and security standards that govern the use and disclosure of protected electronic health information by “covered entities”,entities,” which include healthcare providers, health plans and healthcare clearinghouses. Because we provide our products directly to patients and bill third-party payers such as Medicare, Medicaid, and insurance companies, we are a “covered entity” and must comply with these standards. Failure to comply with HIPAA/HIPAA and HITECH or any state or foreign laws regarding personal data protection may result in significant fines or penalties and/or negative publicity. In addition to federal regulations issued under HIPAA/HIPAA and HITECH, some states have enacted privacy and security statutes or regulations that, in some cases, are more stringent than those issued under HIPAA/HIPAA and HITECH. In those cases, it may be necessary to modify our planned operations and procedures to comply with the more stringent state laws. If we fail to comply with applicable state laws and regulations, we could be subject to additional sanctions.

The HIPAA/HIPAA and HITECH health care fraud and false statement statutes also prohibit, among other things, knowingly and willfully executing, or attempting to execute, a scheme to defraud any health care benefit program, including private payers, and knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false, fictitious or fraudulent statement or representation in connection with the delivery of or payment for health care benefits, items or services.


Environmental Laws

We are subject to various environmental laws and regulations both within and outside the U.S. Like other medical device companies, our operations involve the use of substances regulated under environmental laws, primarily manufacturing, sterilization, and disposal processes. We do not expect that compliance with environmental protection laws will have a material impact on our results of operations, financial position, or cash flows.

EmployeesCybersecurity and Data Privacy

Protecting the privacy of customer and personnel information is important to us, and we maintain security protocols and processes, including ongoing training and education for all personnel, designed to combat the risk of unauthorized access or inadvertent disclosure. Our business operations involve confidential information, including patient health information subject to regulation as discussed under “HIPAA, HITECH and Other Privacy Regulations” above. Our information technology infrastructure is designed to offer reliability, scalability, performance, security and privacy for our personnel, clients and third-party contractors.

We maintain comprehensive compliance and security programs designed to help safeguard and ensure the integrity of the confidential information we possess, which includes both organizational and technical control measures. We also have programs in place to monitor the safety of confidential information as well as plans for immediate, coordinated action in the event of a potential security incident. We routinely conduct employee trainings on important information security procedures and engage with independent third-party firms to test and measure compliance on these security measures. In addition, we have maintained appropriate cyber insurance policies that limit the financial risk of any potential incident. Our cyber insurance policies include dedicated support for remediating a specific cybersecurity or data privacy incident and limit the potential financial risk associated with an actual incident.

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Even though we have implemented administrative, physical and technical safeguards designed to help protect the confidential data we possess and the integrity of our information systems and infrastructure, these safeguards may not be effective in preventing future cybersecurity incidents or data breaches.

Human Capital

We believe that our dedicated, talented employees are our most valuable resource and a key strength in accomplishing our collective mission and goals. As of June 30, 2017,2022, we had 115 employees. Eleven156 employees, an increase of 15.4% from fiscal 2021, who are located in 29 states throughout the United States. 18 of our employees arewere respiratory therapists licensed by appropriate state professional organizations, including all of the employees in our Patient Services Department.organizations. We also retain more thanhad approximately 250 respiratory therapists and health care professionals retained on a non-exclusive, independent contractor basis to provide training to our customers in the U.S. None of our employees are covered by a collective bargaining agreement. We believe our relations with our employees are good.

We are committed to attracting, retaining, and developing diverse and high-performing talent that includes a strong focus on performance and development, total rewards, diversity, inclusion and equity, and employee safety. These serve as the pillars to our human capital management framework.

We understand that our success and growth depend on attracting, retaining, and developing talent across all levels of the organization. Our recruitment strategies are continuously reviewed with leadership and partners to ensure our practices align with our mission, purpose, and values.

We believe in ensuring that employees understand our mission, purpose, and goals as well as their impact on our success. We use an annual performance review process to support development and performance discussions with employees. In addition, every employee is eligible to participate in our incentive plan, which allows for us to share the rewards of the company with the people who significantly contribute to our success.

To cultivate a learning culture that provides enhancement and growth for our people, we offer educational assistance, online training (220 courses completed during fiscal 2022), seminars, specific skill training, and participation in business and industry organizations. We are also committed to contributing our talents and resources to serve the communities in which we live and work through various charitable campaigns, employee programs and volunteerism. We believe that this commitment assists in our efforts to attract and retain employees.

We believe that sharing rewards is essential to increasing employee engagement and improving morale and creating a positive culture. We also offer our employees a competitive salary and benefits package and are committed to continuous review of these programs. These benefits include but are not limited to retirement savings, a variety of health insurance options and other benefits programs, including dental and vision, disability insurance, contributions to health savings accounts, paid maternity/paternity leave, and wellness resources. In addition, we offer opportunities for remote work and flexible schedules and location, depending on business needs and the specific role.

We are committed to ensuring a diverse workforce in a safe environment by maintaining compliance with applicable employment laws and governmental regulations. Treating employees with dignity and equality is of utmost importance in everything we do. We take pride in the fact that women represent 53% of our total managerial roles and comprise 57% of our executive leadership team. We pride ourselves on accepting, hearing, and celebrating multiple approaches and points of view and building on an inclusive and diverse culture.

Safety is a vital aspect to the success of our people and business. We are proud of our employees’ collective commitment to secure and maintain safe work practices that have resulted in zero lost time injuries within our manufacturing operations. We also provide wellbeing services to support each employee’s physical and mental health and will continue to emphasize the importance of the safety and health of our employees in all we do.

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Available Information

Our Internet address is www.smartvest.com. We have made available on our website, free of charge, our Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current Reports on Form 8-K, and, if applicable, amendments to those reports, as soon as reasonably practicable after we electronically file these materials with, or furnish them to, the SEC. Reports of beneficial ownership filed by our directors and executive officers pursuant to Section 16(a) of the Exchange Act are also available on our website. We are not including the information contained on our website as part of, or incorporating it by reference into, this Annual Report on Form 10-K. The SEC also maintains an Internet site that contains our reports, proxy and information statements, and other information we file or furnish with the SEC, available at www.sec.gov.

Item 1A.Risk Factors.

As a smaller reporting company, we are not required to provide disclosure pursuant to this item.

Item 1B.Unresolved Staff CommentsComments..

As a smaller reporting company, we are not required to provide disclosure pursuant to this item.

Item 2.Properties.

We own our principal headquarters and manufacturing facilities, consisting of approximately 24,00037,000 square feet, which are located on an approximately 2.3 acre2.3-acre parcel in New Prague, Minnesota. This owned property is subject to a mortgage (see Note 5 toAll of the Financial Statements, included in Part II, Item 8, ofCompany’s revenues, profits, and assets are associated with this Annual Report on Form 10-K for further information).We also lease approximately 20,000 square feet of warehouse and office space in a building adjacent to our manufacturing facilities.facility. We believe that our current facilities are satisfactory for our long-term growth plans.

Item 3.Legal Proceedings.

WeThe disclosure regarding legal proceedings set forth in Note 11 to our Financial Statements in Part II, Item 8 of this Annual Report on Form 10-K is incorporated herein by reference. Occasionally, we may be party to legal actions, proceedings, or claims in the ordinary course of business.business, including claims based on the assertions of patent and trademark infringement. Corresponding costs are accrued when it is probable that loss will be incurred, and the amount can be precisely or reasonably estimated. We are not aware of any undisclosed actual or threatened litigation that would have a material adverse effect on our financial condition or results of operations.

Item 4.Mine Safety Disclosures.

None.

PART II

Item 5.Market For Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities.

Market Information

Our common stock is listed on the NYSE American (formerly the NYSE MKT) under the symbol “ELMD”. The following table sets forth the high and low intra-day sale prices of our common stock by quarter during our 2017 and 2016 fiscal years.


  High Low
Fiscal Year Ended June 30, 2017:    
First Quarter (ended September 30, 2016) $6.26 $3.77
Second Quarter (ended December 31, 2016) $5.13 $3.38
Third Quarter (ended March 31, 2017) $5.47 $3.68
Fourth Quarter (ended June 30, 2017) $5.88 $4.12
     
Fiscal Year Ended June 30, 2016:    
First Quarter (ended September 30, 2015) $2.09 $1.55
Second Quarter (ended December 31, 2015) $2.21 $1.72
Third Quarter (ended March 31, 2016) $5.20 $1.55
Fourth Quarter (ended June 30, 2016) $4.99 $3.66

As of August 31, 2017,23, 2022, there were 8959 registered holders of our common stock.

Dividends

We have never paid cash dividends on any of our shares of common stock. We currently intend to retain any earnings for use in operations and do not anticipate paying cash dividends to our shareholders in the foreseeable future. Currently, theThe agreement governing our credit facility restricts our ability to pay dividends.

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Recent Sales of Unregistered Equity Securities

None.

PurchasePurchases of Equity Securities by the Company and Affiliated Purchasers

None.On May 26, 2021, our Board of Directors approved a stock repurchase authorization. Under the authorization, we were originally able to repurchase up to $3.0 million of outstanding shares of our common stock through May 26, 2022. On May 26, 2022, our Board of Directors removed the date limitation. The shares of our common stock may be repurchased on the open market or in privately negotiated transactions subject to applicable securities laws and regulations. The following table sets forth information concerning purchases of shares of our common stock for the three months ended June 30, 2022:

Period  Total Number of Shares Purchased  Average
Price Paid
per Share
  Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs  Approximate Dollar Value of Shares that May Yet be Purchased Under the Plans or Programs 
April 1 to April 30, 2022  1,253  $12.53   1,253  $898,000 
May 1 to May 31, 2022  28,126  $12.33   28,126  $551,000 
June 1 to June 30, 2022  10,799  $11.48   10,799  $427,000 
Total  40,178  $12.10   40,178     

Item 6.Selected Financial Data.[Reserved].

As a smaller reporting company, we are not required to provide disclosure pursuant to this item.

Item 7.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 our financial statements and the accompanying notes included elsewhere in this Report.Annual Report on Form 10-K. The forward-looking statements include statements that reflect management’s good faith beliefs, plans, objectives, goals, expectations, anticipations and intentions with respect to our future development plans, capital resources and requirements, results of operations, and future business performance. Our actual results could differ materially from those anticipated in the forward-looking statements included in this discussion as a result of certain factors, including, but not limited to, those discussed in the section entitled “Information Regarding Forward-Looking Statements” immediately preceding Part I of this Report.Annual Report on Form 10-K.

Overview

Electromed Inc. (“we,” “our,” “us,” “Electromed” or the “Company”) develops and provides innovative airway clearance products applying High Frequency Chest Wall Oscillation (“HFCWO”)HFCWO technologies in pulmonary care for patients of all ages.

We manufacture, market and sell products that provide HFCWO, including the SmartVest®Airway Clearance System (“SmartVest System”) that includes our newest generation SmartVest SQL®SQL® and previous generation SV2100 and related products, to patients with compromised pulmonary function. The SmartVest SQL is smaller, quieter and lighter than our previous product with enhanced programmability, and ease of use. Our products are sold in both the home health care market and the institutional market for use by patients in hospitals, which we refer to as “institutional sales.” The SmartVest SQL has been sold in the domestic home care market since the fiscal quarter ended March 31, 2014. In the fourth quarter of our fiscal 2015, we launched the SmartVest SQL into the institutional and certain international markets. In June 2017, we announced the launch of the SmartVest SQL with SmartVest Connect™ wireless technology, and entry into an agreement with Monaghan Medical Corporation to distribute and sell the Aerobika® Oscillating Positive Expiratory Pressure (OPEP) Device in the U.S. home care market. The SmartVest SQL with SmartVest Connectwhich allows data connection between physicians and patients to track therapy performance and collaborate in treatment decisions. SmartVest Connect is currently available to pediatric and cystic fibrosis patients and was made available to certain targeted adult pulmonary clinics starting in November 2017. Since 2000, we have marketed the SmartVest System and its predecessor products to patients suffering from cystic fibrosis, bronchiectasis and repeated episodes of pneumonia. Additionally, we offer our products to a patient population that includes neuromuscular disorders such as cerebral palsy, muscular dystrophies, amyotrophic lateral sclerosis (“ALS”),ALS, the combination of emphysema and chronic bronchitis commonly known as chronic obstructive pulmonary disease (“COPD”),COPD, and patients with post-surgical complications or who are ventilator dependent or have other conditions involving excess secretion and impaired mucus transport.


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The SmartVest System is often eligible for reimbursement from major private insurance providers, health maintenance organizations (“HMOs”), state Medicaid systems, and the federal Medicare system, which we believe is an important consideration for patients considering an HFCWO course of therapy. For domestic sales, the SmartVest System may be reimbursed under the Medicare-assigned billing code (E0483) for HFCWO devices if the patient has cystic fibrosis, bronchiectasis (including chronic bronchitis or COPD that has resulted in a diagnosis of bronchiectasis), or any one of certain enumerated neuromuscular diseases, and can demonstrate that another less expensive physical or mechanical treatment did not adequately mobilize retained secretions. Private payers consider a variety of sources, including Medicare, as guidelines in setting their coverage policies and payment amounts.

We employ a direct-to-patient and provider model, through which we obtain patient referrals from clinicians, manage insurance claims on behalf of our patients and their clinicians, deliver our solutions to patients and train them on proper use in their homes. This model allows us to directly approach patients and clinicians, whereby we disintermediate the traditional durable medical equipment channel and capture both the manufacturer and distributor margins. We have engaged a limited number of regional durable medical equipment distributors focused on respiratory therapies as an alternate sales channel. Revenue through this channel was 4% of our total revenues in fiscal 2022.

Our primary goals for the fiscal year ending June 30, 2018, include:

delivering profitable growth;

growing quality referrals and increasing the rate of reimbursement on referrals; and

maintaining the highest standards of integrity, respect and privacy.

Our key growth strategies for fiscal 2023 are to: accelerate our revenue growth by taking market share and expanding the fiscal year ending June 30, 2018 include:addressable population for the largest and fastest growing segments of the market: adult pulmonology/bronchiectasis. Actions to support accelerating our growth include the following:

continue to develop innovative device features that appeal to patients;Expand our sales force in targeted geographies with high potential, adding an additional five territories and direct sales reps;

enhance our superior leadership in reimbursement supportIncrease Electromed brand awareness through direct-to-consumer and customer care;physician marketing, and peer to peer education;

focus on increasing referrals in largest, fastest growing segments: adult pulmonology/bronchiectasis;Provide best-in-class customer care and support;

sales force expansion;Develop and promulgate the body of bronchiectasis clinical evidence to increase physician adoption of the SmartVest System for patients; and

maximize therapy adherence with compelling clinical and health economic outcomes;Introduce our innovative next generation device that appeals to patients.

expand third-party payer coverage; and

grow institutional market share to support home care growth.

Critical Accounting Policies and Estimates

During the preparation of our financial statements, we are required to make estimates, assumptions and judgmentsjudgment that affect reported amounts. Those estimates and assumptions affect our reported amounts of assets and liabilities, our disclosure of contingent assets and liabilities, and our reported revenues and expenses. We update these estimates, assumptions, and judgmentsjudgment as appropriate, which in most cases is at least quarterly. We use our technical accounting knowledge, cumulative business experience, judgment and other factors in the selection and applicationappropriate. Some of our accounting policies. While we believepolicies and estimates require us to exercise significant judgment in selecting the estimates,appropriate assumptions andfor calculating financial statements. Such judgments we use in preparing our financial statements are appropriate, they are subject to an inherent degree of uncertainty. Among other factors, these judgments are based upon our historical experience, known trends in our industry, terms of existing contracts and uncertainties regarding their outcome and therefore, actual results may materially differother information from these estimates.outside sources, as appropriate. The following is a summary of our primary critical accounting policies and estimates. See also Note 1 to the Financial Statements, included in Part II, Item 8, of this Report.


Annual Report on Form 10-K.

Revenue Recognition

Impacts of COVID-19 on Our Business and Allowance for Doubtful AccountsOperations

Revenues are primarily recognized upon shipment when evidence ofIn March 2020, the World Health Organization designated COVID-19 as a sales arrangement exists, delivery has occurredglobal pandemic, and the selling price is determinable with collectabilityU.S. Department of Health and Human Services designated COVID-19 as a public health emergency. The impact of the COVID-19 pandemic on our business remains uncertain, and its effects on our operational and financial performance will depend in part on future developments, which cannot be reasonably assured. Revenues from direct patient salesestimated at this time. Such future developments include, but are recorded at the amount to be received from patients under their arrangements with third-party payers, including private insurers, prepaid health plans, Medicare and Medicaid. In addition, we record an estimate for selling price adjustments that often arise from changes in a patient’s insurance coverage, changes in a patient’s state of domicile, insurance company coverage limitations or patient death. We periodically review originally billed amounts and our collection history and make changesnot limited to, the estimation process by considering any changesduration, scope and severity of the COVID-19 pandemic in recent collectiongeographic areas in which we operate or sales allowance experience, but have not made material adjustmentsin which our patients live, actions taken to previously recorded revenuescontain or mitigate its impact, the impact on governmental healthcare programs and receivables.

Other thanbudgets, the installment sales as discussed below, we expect to receive payment ondevelopment and distribution of treatments or vaccines, and the vast majorityresumption of accounts receivable within one year and therefore classify all receivables as current assets. However, in some instances, payment for direct patient sales can be delayed or interrupted resulting in a portion of collections occurring later than one year. In the event receivables are expected to be paid over longer intervals than one year, we recognize revenue under the installment method.

Certain third-party reimbursement agencies pay us on a monthly installment basis, which can span from 18 to 60 months. California and New York Medicaid constitute the majority of our installment method sales.widespread economic activity. Due to the length of time over which reimbursement is received, we believe that the inherent uncertainty of collectionthe unprecedented and evolving situation, we are unable to predict with confidence the likely impact of the COVID-19 pandemic on our future operations.

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During fiscal 2022, we experienced a reduction in the number of clinics allowing face-to-face access by our sales team although not to the extent experienced in fiscal 2021 as the number of infections relating to the Omicron variant and related subvariants of COVID-19 increased throughout most regions of the United States, and hospitals implemented additional safety protocols. Our sales team continued to utilize a hybrid sales process of virtual and face-to-face clinician interaction with strict adherence to specific clinic and healthcare system safety protocols, which we believe allowed them to drive stronger referral growth compared to fiscal 2021. During the second half of fiscal 2022, we observed an improvement in clinic access and patient flow compared to earlier in the fiscal year, which we believe is likely a result of Omicron-related case reductions throughout most of the United States, contributing to a record high number of monthly referrals for our company.

We believe that the impact of the COVID-19 pandemic on our home care and institutional business will continue during at least the beginning of fiscal 2023. Our home care revenue for fiscal 2022 has increased as compared to fiscal 2021; however, if COVID-19 infection rates increase and federal, state and local restrictions on commerce, stay-at-home orders or other restrictions on businesses are reinstated, we believe that such measures could have a material adverse effect on our business.

We observed increased changes to our supply chain timelines and increased material and shipping costs during the second half of fiscal 2022, but we did not experience any disruptions that materially impacted product availability for our customers. We anticipate that increased material and shipping costs will continue during fiscal 2023 relating to supply chain availability and inflationary trends in electronic components but may extend to other components as well. In certain instances, we have purchased key electronic materials in advance to ensure adequate future supply and mitigate the risk of supply chain disruption. It is possible that the COVID-19 pandemic could have a greater adverse impact on our supply chain in the future, including impacts associated with preventative and precautionary measures taken by other businesses and applicable governments. A reduction or interruption in any of our manufacturing processes could have a material adverse effect on our business. Any significant increases to our raw material or shipping costs could reduce our gross margins.

We have also taken measures to ensure the safety of our employees and to comply with applicable governmental orders. We consider our business to be essential under applicable governmental orders, primarily due to externalour role in manufacturing and supplying needed medical devices to patients with respiratory-related issues and have therefore continued to operate during the government restrictions put in place in response to the pandemic.

In response to the COVID-19 pandemic and the U.S. federal government’s declaration of a public health emergency, the CMS implemented a number of temporary rule changes and waivers to allow prescribers to best treat patients during the period of the public health emergency. These waivers became effective on March 1, 2020. Clinical indications and documentation typically required will not be enforced for respiratory-related products including the SmartVest System (solely with respect to Medicare patients). The minimum documentation now requires a valid order and documentation of a respiratory-related diagnosis. Face-to-face and in-person requirements for respiratory devices are being waived while the waiver is in place. The CMS waiver was recently extended in conjunction with the extension of the federal public health emergency for an additional 90-day period beginning July 15, 2022.

We did not receive any direct financial assistance from any government program during fiscal 2021 or fiscal 2022 in connection with COVID-19 relief measures.

Revenue Recognition

Revenue is measured based on consideration specified in the contract with a customer, adjusted for any applicable estimates of variable consideration and other factors noted above precludes usaffecting the transaction price, including consideration paid or payable to customers and significant financing components. Revenue from makingall customers is recognized when a reasonable estimateperformance obligation is satisfied by transferring control of revenue ata distinct good or service to a customer.

Individual promised goods and services in a contract are considered a performance obligation and accounted for separately if the timeindividual good or service is distinct (i.e., the product is shipped. In certain circumstances, the patient must periodically attest that the unit continues to be utilized as a prerequisite to continued reimbursement coverage. Therefore, we believe the installment method is appropriate for these sales. If the third-party reimbursement agency discontinues payment and we determine no further payments will be madecustomer can benefit from the patient,good or service on its own or with other resources that are readily available to the carrying valuecustomer and the good or service is separately identifiable from other promises in the arrangement). If an arrangement includes multiple performance obligations, the consideration is allocated between the performance obligations in proportion to their estimated standalone selling price, unless discounts or variable consideration is attributable to one or more but not all the performance obligations. Costs related to products delivered are recognized in the period incurred, unless criteria for capitalization of costs under Accounting Standards Codification (“ASC”) 340-40, “Other Assets and Deferred Costs,” or the account receivable is written off as a period adjustment against the previously recognized sales. Under the installment method, we do not record accounts receivable or revenue at the time of product shipment. We defer the revenue associated with the salerequirements under other applicable accounting guidance are met.

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The Company includes shipping and as each installment is received, that amount is recognized as revenue. Deferredhandling fees in net revenues. Shipping and handling costs associated with the saleshipment of the Company’s SmartVest System after control has transferred to a customer are amortized toaccounted for as a fulfillment cost and are included in cost of revenue ratably over the estimated period in which collections are scheduled to occur.revenues.

Accounts receivable are also net of an allowance for doubtful accounts, which are accounts from which payment is not expected to be received although product was provided and revenue was earned. Management determines the allowance for doubtful accounts by regularly evaluating individual customer receivables and considering a customer’s financial condition and credit history. Receivables are written off when deemed uncollectible. Recoveries of receivables previously written off are recorded when received.

We request that customers return previously-soldpreviously sold units that are no longer in use to us in order to limit the possibility that such units would be resold by unauthorized parties or used by individuals without a prescription. The customer is under no obligation to return the product; however, we do reclaim the majority of previously sold units upon the discontinuance of patient usage. We obtained certificationare certified to recondition and resell returned units during fiscal 2015.SmartVest System units. Returned units can now beare typically reconditioned and resold and will continue to be used for demonstration equipment and warranty replacement parts.

Inventory Valuation of Long-Lived and Intangible Assets

Long-lived assets, primarily property and equipment and finite-life intangible assets, are evaluated for impairment whenever events or changes in circumstances indicate the carrying value of an asset may not be recoverable. In evaluating recoverability, the following factors, among others, are considered: a significant change in the circumstances used to determine the amortization period, an adverse change in legal factors or in the business climate, a transition to a new product or service strategy, a significant change in customer base, and a realization of failed marketing efforts. The recoverability of an asset or asset group is measured by a comparison of the unamortized balance of the asset or asset group to future undiscounted cash flows. If we believe the unamortized balance is unrecoverable, we would recognize an impairment charge necessary to reduce the unamortized balance to the estimated fair value of the asset group. The amount of such impairment would be charged to operations at the time of determination.


Property and equipmentInventories are stated at the lower of cost less accumulated depreciation. We use(first-in, first-out method) or net realizable value. Work in process and finished goods are carried at standard cost, which approximates actual cost, and includes materials, labor and allocated overhead. The reserve for obsolescence is determined by analyzing the straight-line method for depreciating property and equipment over their estimated useful lives, which range from 3 to 39 years. Our finite-life intangibles consist of patents and trademarks and their carrying costs include the original cost of obtaining the patents, periodic renewal fees, and other costs associated with maintaining and defending patent and trademark rights. Patents and trademarks are amortized over their estimated useful lives, generally 15 and 12 years, respectively, using the straight-line method.

Allowance for Excess and Slow-Moving Inventory

An allowance for potentially slow-moving or excess inventories is made based on our analysis of inventory levels on hand and comparing it to expected future production requirements, sales forecasts and current estimated market values.

Income Taxes

We recognize deferred tax assets and liabilitiessales. Estimated inventory to be returned is based on the differences between the financial statement carrying amounts and the tax basis of assets and liabilities. We provide a valuation allowance for deferred tax assets if we determine, based on the weight of available evidence,how many devices that it is more likely than nothave shipped that some or allare expected to be returned prior to completion of the deferred tax assets will not be realized. We would reverseinsurance reimbursement process.

Warranty Reserve

The Company provides a valuation allowance if we determine, based on the weight of all available evidence, including when cumulative losses become positive income, that it is more likely than not that some or all of the deferred tax assets will be realized.

Warranty Reserve

We provide alifetime warranty on its products to the SmartVest System that covers the cost of replacement parts and labor, or a new SmartVest System in the event we determine a full replacement is necessary. For home care SmartVest Systems initially purchased and currently located inprescribed patient for sales within the U.S. and Canada, we provide a lifetimethree-year warranty to the individual patient for whom the SmartVest System is prescribed. Forall institutional sales and sales to institutions withinindividuals outside the U.S., and for all international sales, except Canadian home care, we provide a three-year warranty. We estimate, based upon a review of historical warranty claim experience, The Company estimates the costs that may be incurred under ourits warranty policies and recordrecords a liability in the amount of such estimatecosts at the time athe product is sold. The warranty cost is based upon future product performance and durability, and is estimated largely based upon historical experience. We estimate the average useful life of our products to be approximately five years.shipped. Factors that affect ourthe Company’s warranty liabilityreserve include the number of units sold,shipped, historical and anticipated rates of warranty claims, the product’s useful life and cost per claim. At our discretion, based upon the cost to either repair or replace a product, we have occasionally replaced such products covered under warranty with a new or refurbished model. WeThe Company periodically assessassesses the adequacy of ourits recorded warranty liabilityreserve and make adjustments toadjusts the accrualamounts as claims data and historical experience warrant.necessary.

Share-Based Compensation

Share-based payment awards consist of options and restrictedto purchase shares of our common stock issued to employees. Expense for share-based payment awards consist of options to purchase shares of our common stock issued to employees and directors for services. Expense for options is estimated using the Black-Scholes pricing model at the date of grant and expense for restricted stock is determined by the closing price on the day the grant is made. The portion of the award that is ultimately expected to vestExpense is recognized on a straight-line basis over the requisite service or vesting period of the award.award, or at the time services are provided for non-employee awards. In determining the fair value of our share-based payment awards,options, we make various assumptions using the Black-Scholes pricing model, including expected risk-free interest rate, stock price volatility, life and forfeitures.life. See Note 78 to the Financial Statements included in Part II, Item 8, of this Annual Report on Form 10-K for a description of these assumptions.


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Results of Operations

Fiscal Year Ended June 30, 20172022 Compared to Fiscal Year Ended June 30, 20162021

Revenues

Revenue for the twelve-month periodsfiscal years ended June 30, 2022 and 2021 are summarized in the table below (dollar amounts in thousands).

  Fiscal Years Ended June 30,   
  2022  2021  Increase (Decrease) 
Home Care Revenue $38,004,000  $32,986,000  $5,018,000   15.2%
Institutional Revenue  1,660,000   1,549,000   111,000   7.2%
Home Care Distributor Revenue  1,474,000   563,000   911,000   161.8%
International Revenue  521,000   658,000   (137,000)  (20.8%)
Total Revenue $41,659,000  $35,756,000  $5,903,000   16.5%

  Twelve Months Ended June 30,       
  2017  2016  Increase (Decrease) 
Total Revenue $25,861  $22,991  $2,870   12.5%
Home Care Revenue  23,387   20,500   2,887   14.1%
Institutional Revenue  1,758   1,778   (20)  (1.1%)
International Revenue  716   713   3   0.4%

Home Care Revenue. Our homeHome care revenue increased by 14.1%$5,018,000, or 15.2%, or approximately $2,877,000, forin fiscal year ended June 30, 2017 (“fiscal 2017”),2022 compared to the fiscal year ended June 30, 2016 (“2021. The revenue increase compared to fiscal 2016”). Home care revenue increased year-over-year2021 was primarily due to an increaseincreases in approvals and referrals and an increase in the average rate of reimbursement per approval.approvals. The increase in referrals was primarily due to growthan increase in direct sales representatives, increased sales representative productivity driven by increased clinic access and patient flow, our sales team refining their selling process and clinic targeting methodology, and benefits of the CMS waiver on the non-commercial Medicare portion of our home care revenue. Additionally, we also benefitted from a Medicare allowable rate increase that took effect on January 1, 2022. Annual Medicare rate increases for our device are linked closely to changes in the Urban Consumer Price Index.

The CMS waiver benefited the non-commercial Medicare portion of our home care revenue by increasing the number of fieldreferrals and the approval percentage for previously non-covered diagnoses. We believe that our ongoing sales employees and a higher referral per field sales employee as compared to the comparable prior year period.

During fiscal 2017, we entered into a settlement agreementteam execution, along with the Centersexpected return to pre-COVID-19 levels of patient face-to-face engagement with physicians and clinic access for Medicare and Medicaid Services with respectour sales team, has the potential to approximately 700 Medicare fee-for-service claims submitted between calendar years 2012 through 2015, resulting in approximately $703,000mitigate the impact of net recognized revenue. This benefit was partially offset by the retroactive repayment of previously collected and recognized revenue to a state Medicaid program totaling approximately $212,000. The repayment resulted from the state Medicaid program’s reinterpretation of its reimbursement process and a reduction in its allowable payments. We believe the repaymentCMS waiver expiration, which is a one-time event and is not reflective of other state Medicaid reimbursement processes. Our fiscal 2016 home care revenue benefited by approximately $250,000 from processing a backlog of referrals from the prior fiscal year in a certain state. The backlog accumulated while we reapplied for a state home medical equipment licensecurrently effective until we met a newly imposed requirement to have an approved in-state presence. The license was reinstated in October 2015.2022.

Institutional Revenue. Institutional revenue decreasedincreased by 1.1%,$111,000, or approximately $20,000,7.2%, in fiscal 20172022 compared to fiscal 2016.2021. Institutional revenue includes sales to distributors, group purchasing organization (“GPO”) members,organizations, rental companies and other institutions. The decrease in institutional revenue increase was driven by a decreasedue to increased capital purchases and stronger consumable volumes compared to fiscal 2021, as hospitals resumed utilization of HFCWO protocols after reducing utilization early in the COVID-19 pandemic.

Home Care Distributor Revenue. Home care distributor revenue increased by $911,000, or 161.8%, in fiscal 2022 compared to fiscal 2021. The revenue increase in fiscal 2022 was due to increased demand from one of our primary home care distribution partners. We began selling to a limited number of units sold compared to the priorhome medical equipment distributors during our fiscal year which was partially offset by an increaseended June 30, 2020, who in turn sell our SmartVest System in the sales of single patient use garments.U.S. home care market.

International Revenue. International revenue was approximately $716,000decreased by $137,000, or 20.8%, in fiscal 20172022 compared to $713,000fiscal 2021. International revenue growth is not currently a primary focus for us, and our corporate resources are focused on supporting and maintaining our current distributors. International sales are affected by the timing of international distributor purchases that can cause significant fluctuations in fiscal 2016.reported revenue on a quarterly basis.

Gross Profit

Gross profit increased to $20,568,000,$31,442,000 in fiscal 2022, or 79.5%75.5% of net revenues, for fiscal 2017, from approximately $17,876,000,$27,305,000, or 77.7%76.4% of net revenues, forin fiscal 2016.2021. The increase in gross profit was primarily related to increases in domestic home care revenues and arevenue including the Medicare allowable rate increase that took effect in January 2022. The decrease in our manufacturinggross profit as a percentage of net revenue was driven by higher raw material and shipping costs of the SmartVest SQL as comparedwell as patient training related expenses due to the prior year.increase in face-to-face trainings.

During fiscal years 2017 and 2016, we lowered the cost of our SmartVest SQL to a cost significantly lower than our previous products. This has shortened the time period in which we expect to phase out sales of our SV2100 product. Because of this, we recorded an additional reserve on certain SV2100 parts that may no longer be utilized in production, of $30,000 and $10,000 during fiscal 2017 and 2016, respectively.

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We believe that as we continue to grow salesrevenue, we will be able to continue to leverage manufacturing costs, and that gross margins, over the long-term, will continue to be in a range slightly above 75%, although there canmay be fluctuations on a short-term basis related to increased material and shipping costs as well as average reimbursement based on the mix of referrals during any given period. Factors such as diagnoses that are not assured of reimbursement, insurance programs with lower allowable reimbursement amounts (for example, state Medicaid programs), and whether an individual patient meets prerequisite medical criteria for reimbursement, and continuation of the Medicare waiver currently in place may have an effect on average reimbursement received on a short-term basis. We have a goal of improving our gross margin percentage over time due to lower product costs associated with our next generation product, supplier optimization, and gaining operating leverage on higher volumes.


Operating Expenses

Selling, General and Administrative Expenses. Selling, general and administrative (“SG&A”) expenses forwere $27,114,000 in fiscal 2017 were approximately $16,402,000, compared to approximately $14,387,000 for the prior year,2022, representing an increase of approximately $1,988,000,$4,671,000 or 14.0%.20.8% from $22,443,000 in fiscal 2021.

SG&A payroll and compensation-related expenses increased by approximately $1,148,000,$2,206,000, or 14.2%15.3%, to approximately $9,251,000.$16,640,000 in fiscal 2022, compared to $14,434,000 in fiscal 2021. The increase isin the current year was primarily due to additional employees ina higher average number of sales, sales support and administration, additional sales incentivesmarketing personnel, increased reimbursement personnel to process higher patient referrals, increased temporary resources to assist with systems infrastructure investments and increased incentive payments on higher revenue, higher share-based equityhome care revenue. We have also continued to provide regular merit-based increases for our employees and are regularly benchmarking our compensation expense, annual salary increasesranges for new and existing employees to ensure we can hire and retain the replacement of certain employees at a higher rate of compensationtalent needed to drive growth in our business. Field sales department,employees totaled 52, of which 43 were partially offset by lower management bonus accruals. For fiscal 2017, we had 6.3 net additional fielddirect sales, full time equivalents (“FTEs”) and 2.9 net additional general and administrative FTEs, an increaseas of 22.6% and 5.1%, respectively, asJune 30, 2022, compared to the prior fiscal year.46 as of June 30, 2021, of which 37 were direct sales.

Professional and legal fees increased by approximately $176,000$875,000, or 36.0%, to approximately $1,455,000$3,308,000 in fiscal 2017,2022, compared to approximately $1,279,000$2,433,000 in fiscal 2016. These2021. Professional fees were forinclude services related to legal costs, shareholdershareowner services and investor relations consulting, consulting fees, reporting requirements, and information technology (“IT”) securitytechnical support and backup.consulting fees. The year-over-year increase in professional feesthe current year was primarily due to increasesa shareholder activism matter, increased investment in reimbursement consulting,our system infrastructure and increased clinical study costs. Our shareholder activism matter concluded with a cooperation agreement in September 2021. We continue to make key investments in systems infrastructure including implementing a new enterprise resource planning (“ERP”) system, enhancing our customer relationship management system and investor relations servicesfurther optimizing of the revenue cycle management system that was implemented in June 2021. We expect these system infrastructure investments will result in more efficient and human resources consulting, which were partially offsetscalable operational processes and provide enhanced analytics to drive business performance. We also expect to continue investing in our on-going clinical studies in order to continue building the body of evidence around positive outcomes from bronchiectasis patients using HFCWO and SmartVest therapy.

Total discretionary marketing expenses decreased by a$238,000, or 22.4% to $824,000 in fiscal 2022, compared to $1,062,000 in fiscal 2021. The decrease in IT costs and sales consulting.the current year was primarily due to a shift to more cost-effective direct-to-consumer marketing investments.

Recruiting fees were approximately $479,000 in fiscal 2017, representing an increase of approximately $150,000, or 45.4%, as compared to the same period in the prior year. The increase in recruiting fees was due primarily to adding more employees in sales and administrative roles as compared to the prior year.

Travel, meals and entertainment expenses were approximately $1,759,000increased $734,000, or 41.2%, to $2,514,000 for fiscal 20172022 compared to $1,513,000$1,780,000 in fiscal 2021. The increase in the priorcurrent year an increaseperiod was primarily due to our sales team resuming closer-to-normal levels of approximately $247,000, or 16.2%. The increase was due primarily to additional sales personnel, which was partially offset by an overall decrease in travel expense per salesperson.

SG&A expenses included a loss on the abandonment of certain domestic and foreign patents with net values of approximately $133,000 during fiscal 2017 as compared to $18,000 recognized in fiscal 2016. The majority of the pending patents that were abandoned related to the initial development of our SQL SmartVest technology. During a review of our patent portfolio it was determined that certain patents proved redundant to a subsequent SQL patent filing and were therefore abandoned. A smaller portion of expense was related to patents that covered technology that we considered outdated and are no longer in use.

In addition, SG&A expenses did not include medical device excise tax for all of fiscal 2017, a decrease of approximately $132,000 compared to the prior year. Beginning January 1, 2016, we realized a positive impact to operating profit with the Federal Consolidated Appropriations Act, 2016, which included a two-year moratorium on the U.S. Federal medical device excise tax.

Research and Development Expenses.Research and development (“R&D”) expenses were approximately $597,000 and $380,000, or 2.3% and 1.7% of net revenues, for fiscal 2017 and 2016, respectively. During fiscal 2016, we began developing the SmartVest Connect wireless technology. We believe this innovation will strengthen our patient and clinician partnerships, leading to greater therapy adherence and improved quality of life for individuals with compromised pulmonary function. We launched this new feature during June of 2017. During fiscal 2017, we capitalized approximately $223,000 related to software developmentCOVID-19 driven travel restrictions in conjunction with this project. As a percentage of net revenues, we expect spending on R&D expenses to remain relatively consistent over the next twelve months with engineering resources focusing on product enhancements and other market opportunities. Certain expenses related to our innovation investments are not always captured in R&D expenses. These expenses may be included in cost of sales as in the case of depreciation of tooling, or for SG&A, in the case of professional fees or higher labor expense, as we improve our internal processes or enhance our customer service.


Interest Expense

Interest expense, net, decreased to approximately $50,000 in fiscal 2017, compared to $67,000 in fiscal 2016, a decrease of approximately $17,000. The decrease in interest expense during fiscal 2017 as compared to the prior year was driven by a lower effective interest rate on outstanding borrowings, a lower level of debt as compared to the prior year and an increase in regional sales meetings that were cancelled in the prior year due to COVID-19. The Company also held an in-person national sales meeting in August 2021 whereas the national sales meeting was held virtually in fiscal 2021 due to COVID-19.

Recruiting fees increased by $362,000 or 134.6% to $631,000 for fiscal 2022 compared to $269,000 in fiscal 2021. The increase in recruiting fees is primarily due to increased recruiting for senior leadership and direct sales representative positions.

Insurance expenses increased by $229,000 or 20.6% to $1,339,000 for fiscal 2022 compared to $1,110,000 in fiscal 2021. The increase in the current year is primarily due to higher health insurance, director and officer insurance costs and cyber insurance costs.

19

Research and Development Expenses

R&D expenses decreased by $366,000, or 21.3%, to $1,356,000 in fiscal 2022 compared to $1,722,000 in fiscal 2021. The decrease in the current year was primarily due to reduced professional consulting costs associated with our next generation platform development activities. R&D expenses were 3.3% of revenue in fiscal 2022 compared to 4.8% of revenue in fiscal 2021. We expect R&D spending to be between 2.0% and 3.0% of revenue during fiscal 2023, as we look to finalize our development and product testing work in preparation for an anticipated fiscal year 2023 next generation product launch.

Interest Income, net

Net interest income.income was approximately $25,000 in fiscal 2022 compared to net interest income of $39,000 in fiscal 2021. The decrease in the current year was primarily due to lower rates earned on our cash deposits and lower cash deposits in the bank compared to prior fiscal periods.

Income Tax Expense

For fiscal 2017, the Company recorded a current incomeIncome tax expense of $1,290,000. Estimated income tax expense duringin fiscal 20172022 was 692,000, which includes a current tax expense of $1,439,000,$1,181,000 and a deferred benefit of $117,000$489,000. Estimated income tax expenses include a discrete current tax benefit of approximately $37,000 related to exercised fully vested stock options and a discrete current benefit of approximately $21,000 related to the excess tax benefit of $32,000 as a result ofnon-qualified stock options that were exercised during the lapse of the statute of limitations on uncertain tax positions. For fiscal 2016, the Company recorded a current income tax expense of $830,000. period.

Income tax expense duringin fiscal 2016 includes2021 was $805,000, which included a current tax expense of $1,173,000$1,099,000 and a deferred benefit of $294,000. Estimated income tax expense included a discrete deferred tax expense of approximately $81,000 related to unexercised fully vested stock options that expired and a discrete current tax benefit of $343,000, primarily from a discreteapproximately $33,000 related to the excess tax benefit caused byof non-qualified stock options that were exercised during the Company’s release of the full valuation allowance against all of its net U.S. federal and state deferred tax assets.period.

The effective tax rates were 36.7%23.1% and 27.3%25.4% for fiscal 20172022 and 2016,2021, respectively. The effective tax rates differ from the statutory federal rate due to the effect of state income taxes, R&D tax credits, the domestic production activities deduction and other permanent items that are non-deductible for tax purposes relative to the amount of taxable income.

Net Income/LossIncome

Net income for fiscal 20172022 was approximately $2,229,000,$2,305,000, compared to net income of approximately $2,213,000$2,362,000 in fiscal 2016.2021. The year-over-year increasedecrease in current year net income was driven primarily by an increasedue to increased strategic investments in gross profit, which wasSG&A, shareholder activism costs and higher product costs partially offset by increased payrollstronger home care and compensation expenses in sales and administrative departments, increased travel, meals and entertainment driven by additional sales personnel, increased R&D costs, increased professional fees and a higher level of recruiting costs. Additionally, the prior year benefited by a discrete tax benefit of $294,000.distributor revenue growth.

Liquidity and Capital Resources

Cash Flows and Sources of Liquidity

Cash Flows from Operating Activities

For fiscal 2017, our netNet cash provided byused in operating activities in fiscal 2022 was approximately $1,191,000. Our$686,000. Cash flows from operating activities consisted of net income of approximately $2,229,000 was adjusted for$2,305,000, non-cash expenses of approximately $1,267,000,$1,115,000, a decrease in income tax receivable of $192,000, an$2,170,000 increase in income tax payable of $157,000, and a decrease in prepaid expenses and other assets of $50,000. It also was offset by increases in accounts receivable, accounts payable and accrued liabilities and inventoriesa decrease in contract assets of approximately $2,338,000, $338,000 and $28,000, respectively.

For fiscal 2016, our net$107,000. These cash provided byflows from operating activities was approximately $2,167,000. Our net income of approximately $2,213,000 was adjusted for non-cash expenses of approximately $695,000,were offset by a $4,020,000 increase in accounts receivable, an increase in other accrued liabilitiesinventory of $996,000$1,072,000, and a decrease$1,322,000 increase in prepaid expenses and other assets of $19,000. It also was offset by increasesexpenses. The increase in accounts receivable inventories andwas primarily due to an increase in the Medicare portion of our home care business, which has a 13-month payment cycle. Three distinct items have negatively impacted our operating cash flow in fiscal 2022, including tax payments on higher-than-expected fiscal 2021 net income, tax receivableincreased payments to secure adequate supply of approximately $1,093,000, $348,000 and $192,000, respectively,key raw material components, and a decreaseone-time payout of accrued vacation balances as part of an enhancement to our paid time off policy. Our cash receipt collection remains strong, with the three months ended June 30, 2022 period having the highest cash receipt collections in income taxes payable of $123,000.our company's history, building upon the prior record that was set in the previous quarter.


20

Cash Flows from Investing Activities

For fiscal 2017,Net cash used in investing activities in fiscal 2022 was approximately $687,000.$1,525,000. Cash used in investing activities primarily consisted of approximately $619,000$1,425,000 in expenditures for property and equipment, approximately $943,000 for software and $68,000$482,000 for equipment, and $100,000 in payments for patent and trademark costs.

For fiscal 2016, cash used in investing activities was approximately $580,000. Cash used in investing activities primarily consisted of approximately $535,000 in expenditures for property and equipment and $45,000 in payments for patent and trademark costs.

Cash Flows from Financing Activities

For fiscal 2017,Net cash used in financing activities in fiscal 2022 was approximately $54,000,$1,525,000, consisting of $49,000 in principal payments$1,448,000 used for our share repurchase program and $77,000 for taxes paid on long-term debt and $5,000 in payments for deferred financing fees.net share settlements of stock option exercises.

For fiscal 2016, cash used in financing activities was approximately $62,000, consisting of $49,000 in principal payments on long-term debt and $13,000 in payments for deferred financing fees.

Adequacy of Capital Resources

Our primary working capital requirements relate to adding employees to our sales force and support functions, continuing R&D efforts,infrastructure investments, and supporting general corporate needs, including financing equipment purchases and other capital expenditures incurred in the ordinary course of business. Based on our current operational performance, we believe our working capital of approximately $15,580,000$27,389,000 and available borrowings under our existing credit facility will provide adequate liquidity for our fiscal year ending June 30, 2018.2023.

Effective December 18, 2016,17, 2021, we renewed our credit facility, which provides us with a revolving line of credit and a term loan.credit. Interest on borrowings on the line of credit accrues at the prime rate (4.75% as of June 30, 2022) less 1.0% and is payable monthly. There was no outstanding principal balance on the line of credit as of June 30, 2022 or June 30, 2021. The amount eligible for borrowing on the line of credit is limited to the lesser of $2,500,000 or 57.00%57.0% of eligible accounts receivable, and the line of credit expires on December 18, 2017,2023, if not renewed. AtAs of June 30, 2017,2022, the maximum $2,500,000 was available under the line of credit and the applicable interest rate (the prime rate) was 4.25%.credit. Payment obligations under the line of credit are secured by a security interest in substantially all of our tangible and intangible assets.

In connection with the credit facility, we also have a term loan, which had an outstanding principal balance of approximately $1,154,000 at June 30, 2017 and $1,200,000 as of June 30, 2016. The term loan was refinanced effective December 18, 2016, reducing the interest rate from 5.00% to 3.88%. The unamortized debt issuance cost associated with this debt was approximately $6,000 and $10,000 as of June 30, 2017 and June 30, 2016, respectively. The term loan bears interest at 3.88%, with monthly payments of principal and interest of approximately $7,900 and a final payment of principal and interest of approximately $1,085,000 due on the maturity date of December 18, 2018. Payment obligations under the term loan are secured by a mortgage on the Company’s real property.

The documents governing our line of credit and term loan contain certain financial and nonfinancial covenants that include a minimum tangible net worth of not less than $10,125,000 and restrictions on our ability to incur certain additional indebtedness or pay dividends. We were in compliance with these covenants as of June 30, 2017.

Any failure to comply with these covenants in the future may result in an event of default, which if not cured or waived, could result in the lender accelerating the maturity of our indebtedness, preventing access to additional funds under the line of credit, and/or term loan, requiring prepayment of outstanding indebtedness, under either arrangement, or refusing to renew the line of credit. If the maturity of the indebtedness is accelerated or the line of credit is not renewed, sufficient cash resources to satisfy the debt obligations may not be available and we may not be able to continue operations as planned. The indebtedness under the line of credit and term loan are secured by a security interest in substantially all of our tangible and intangible assets and a mortgage on our real property, respectively. If we are unable to repay such indebtedness, the lender could foreclose on these assets.


WeDuring fiscal 2022 and 2021, we spent approximately $619,000$1,425,000 and $535,000$287,000, respectively, on property and equipment during fiscal 2017 and 2016, respectively.equipment. We currently expect to finance planned equipment purchases with cash flows from operations or borrowings under our credit facility. We may need to incur additional debt if we have an unforeseen need for additional capital equipment or if our operating performance does not generate adequate cash flows.

Off-Balance Sheet ArrangementsWhile the impact of the COVID-19 pandemic and other factors such as inflation are difficult to predict, we believe our cash, cash equivalents and cash flows from operations will be sufficient to meet our working capital, capital expenditure, operational cash requirements for fiscal 2023.

We have no off-balance sheet arrangements.

New Accounting Pronouncements

In May 2014, the Financial Accounting Standards Board (“FASB”) issued guidance creating Accounting Standards Codification (“ASC”) Section 606, “Revenue from Contracts with Customers.” TheRecently Issued But Not Yet Adopted by the Company

See Note 1 of the Notes to our Financial Statements in this Annual Report on Form 10-K for information on new section will replace ASC Section 605, “Revenue Recognition,” and creates modifications to various other revenue accounting standards for specialized transactions and industries. The section is intended to conform revenue accounting principles with a concurrently issued International Financial Reporting Standards with previously differing treatment between U.S. practice and that of much of the rest of the world, as well as to enhance disclosures related to disaggregated revenue information. Entities will have the option to apply the standard retrospectively to all prior periods presented (“full retrospective”),adopted in fiscal 2022 or to apply it retrospectively only to contracts existing at the effective date (“modified retrospective”), with the cumulative effect of the standard recorded as an adjustment to beginning retained earnings. In August 2015, the FASB issued Accounting Standards Update (“ASU”) 2015-14, which delayed the effective date of the new revenue recognition guidance by one year. The Company is currently evaluating which of the alternative approaches it will apply and the potential impact of adoption of the revised revenue standards on its financial statements. The Company intends to complete its evaluation during its fiscal year ending June 30, 2018.pending adoption.

In April 2015, FASB issued ASU 2015-03, “Simplifying the Presentation of Debt Issuance Costs.” This standard became effective on July 1, 2016 for the Company and requires that debt issuance costs be presented as a direct deduction from the carrying amount of long-term debt on the balance sheet. The new guidance aligns the presentation of debt issuance costs with debt discounts and premiums. The Company adopted this guidance retrospectively effective as of July 1, 2016. As a result, the Company presented $10,000 of unamortized debt issuance costs that had been included in “Other assets” on its condensed balance sheet as of June 30, 2016 as a direct deduction from the carrying amounts of the related long-term debt liability.

In July 2015, FASB issued ASU 2015-11, “Inventory (Topic 330) Related to Simplifying the Measurement of Inventory,” which applies to all inventory except that which is measured using last-in, first-out (“LIFO”) or the retail inventory method. Inventory measured using first-in, first-out (“FIFO”) or average cost is within the scope of the new guidance and should be measured at the lower of cost and net realizable value. Net realizable value is the estimated selling price in the ordinary course of business, less reasonably predictable cost of completion, disposal, and transportation. Subsequent measurement is unchanged for inventory measured using LIFO or the retail inventory method. The amendments will be effective for public business entities for fiscal years beginning after December 15, 2016, including interim periods within those fiscal years. The new guidance should be applied prospectively, and earlier application is permitted as of the beginning of an interim or annual reporting period. The Company has evaluated that ASU 2015-11 will have no material impact on its consolidated financial statements or financial statement disclosures upon adoption.

In February 2016, FASB issued ASU 2016-02, “Leases.” This standard requires the recognition of all lease transactions with terms in excess of 12 months on the balance sheet as a lease liability and a right-of-use asset (as defined in the standard). ASU 2016-02 will be effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years, with earlier application permitted. Upon adoption, the lessee will apply the new standard retrospectively to all periods presented or retrospectively using a cumulative effect adjustment in the year of adoption. The Company has evaluated that ASU 2016-02 will have no material impact on its financial statements or financial statement disclosures upon adoption based on current facts and circumstances.


21

In March 2016, FASB issued ASU 2016-09, “Compensation—Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting,” which reduces complexity in accounting standards related to share-based payment transactions, including, among others, (1) accounting for income taxes, (2) classification of excess tax benefits on the statement of cash flow, (3) forfeitures, and (4) statutory tax withholding requirements. ASU 2016-09 will be effective for annual reporting periods beginning on or after December 15, 2016, and interim periods within those annual periods. The Company has evaluated that ASU 2016-09 will have no material impact on its financial statements or financial statement disclosures upon adoption.

Item 7A.Quantitative and Qualitative Disclosures About Market Risk.

As a smaller reporting company, we are not required to provide disclosure pursuant to this item.


22

Item 8.Financial Statements and Supplementary Data.

Index to Financial Statements

Report of Independent Registered Public Accounting FirmF-2
Balance SheetsF-3F-4
Statements of OperationsF-4F-5
Statements of Shareholders’ EquityF-5F-6
Statements of Cash FlowsF-6F-7
Notes to Financial StatementsF-7F-8


F-1

Report of Independent Registered Public Accounting Firm

To theShareholders and Board of Directors and Shareholders

Electromed, Inc.

Opinion on the Financial Statements

We have audited the accompanying balance sheets of Electromed, Inc. (the Company) as of June 30, 20172022 and 2016, and2021, the related statements of operations, shareholders’ equity and cash flows for the years then ended. ended, and the related notes to the financial statements. In our opinion, the financial statements present fairly, in all material respects, the financial position of the Company as of June 30, 2022 and 2021, and the results of its operations and its cash flows for the years then ended in conformity with accounting principles generally accepted in the United States of America.

Basis for Opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on thesethe Company’s financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States).PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement.misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. OurAs part of our audits, included considerationwe are required to obtain an understanding of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion. An audit also includes

Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence supportingregarding the amounts and disclosures in the financial statements, assessingstatements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statement presentation.statements. We believe that our audits provide a reasonable basis for our opinion.

In our opinion,Critical Audit Matter

The critical audit matter communicated below is a matter arising from the current period audit of the financial statements referredthat was communicated or required to above present fairly, in allbe communicated to the audit committee and that: (1) relates to accounts or disclosures that are material respects,to the financial positionstatements and (2) involved our especially challenging, subjective or complex judgments. The communication of Electromed, Inc.the critical audit matter does not alter in any way our opinion on the financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing separate opinions on the critical audit matter or on the accounts or disclosures to which it relates.

Measurement of June 30, 2017Customer Revenue Net of Adjustments

As discussed in Note 2 to the financial statements, revenues are recognized at a point in time when control passes to the customer upon product shipment or delivery. Net patient revenues (patient revenue less estimated adjustments) are recognized at the estimated net realizable amounts from third-party payers and 2016, and the results of its operations and its cash flowscustomers in exchange for the yearsproduct. The Company has agreements with third-party payers that provide for payments at amounts different from its established rates. Each quarter, the Company estimates its adjustments for each sale based on the terms of third-party payer contracts and historical collections experience, then ended,applies an estimate for an adjustment reserve percentage to the gross accounts receivable balances.

We identified the measurement of the adjustment reserve related to customer revenue as a critical audit matter due to the audit effort, degree of auditor judgment, and subjectivity involved in conformity with U.S. generally accepted accounting principles.evaluating the audit evidence related to management's estimate.

F-2

Our audit procedures related to the Company's measurement of the adjustment reserve included the following, among others.

Selected a sample of product sales to inspect and compare to the underlying source documents and final cash collections to test the reasonableness of the contractual adjustment and collection percentage assumptions used in management's estimate.

For a sample of product sales, we traced gross revenue and adjustments to net revenue recorded in the general ledger.

Evaluated the reasonableness of management’s estimate of contractual and collection reserves by:

Comparing the estimates of realization percentages to historical net collection percentages for portfolio groups.

Recalculating the contractual and collection reserve estimates and compared them to the general ledger.

Evaluating the quarterly trend analysis for portfolio groups for changes in historical realization percentages.

/s/ RSM US LLP

Duluth,We have served as the Company’s auditor since 2010.

Rochester, Minnesota

September 5, 2017August 23, 2022


F-3

Electromed, Inc.

Balance Sheets

June 30, 20172022 and 20162021

         
  June 30, 
  2022  2021 
Assets      
Current Assets        
Cash and cash equivalents $8,153,000  $11,889,000 
Accounts receivable (net of allowances for doubtful accounts of $45,000)  21,052,000   17,032,000 
Contract assets  286,000   393,000 
Inventories  3,178,000   2,114,000 
Prepaid expenses and other current assets  1,870,000   276,000 
Total current assets  34,539,000   31,704,000 
Property and equipment, net  4,568,000   3,605,000 
Finite-life intangible assets, net  599,000   663,000 
Other assets  120,000   88,000 
Deferred income taxes  1,538,000   1,049,000 
Total assets $41,364,000  $37,109,000 
         
Liabilities and Shareholders’ Equity        
Current Liabilities        
Accounts payable $1,261,000  $685,000 
Accrued compensation  2,742,000   2,474,000 
Income tax payable  51,000   288,000 
Warranty reserve  1,256,000   940,000 
Other accrued liabilities  1,840,000   252,000 
Total current liabilities  7,150,000   4,639,000 
Other long-term liabilities  41,000   54,000 
Total liabilities  7,191,000   4,693,000 
         
Commitments and Contingencies        
         
Shareholders’ Equity        
Common stock, $0.01 par value, 13,000,000 shares authorized; 8,475,438 and 8,533,209 issued and outstanding, as of June 30, 2022 and June 30, 2021, respectively  85,000   85,000 
Additional paid-in capital  18,308,000   17,409,000 
Retained earnings  15,780,000   14,922,000 
Total shareholders’ equity  34,173,000   32,416,000 
Total liabilities and shareholders’ equity $41,364,000  $37,109,000 

  June 30, 
  2017  2016 
Assets      
Current Assets        
Cash $5,573,709  $5,123,355 
Accounts receivable (net of allowances for doubtful accounts of $45,000)  9,949,759   7,611,437 
Inventories  2,559,485   2,480,443 
Prepaid expenses and other current assets  393,319   419,616 
Income tax receivable     192,685 
Total current assets  18,476,272   15,827,536 
Property and equipment, net  3,303,233   3,375,189 
Finite-life intangible assets, net  721,276   904,033 
Other assets  99,868   127,759 
Deferred income taxes  460,000   343,000 
Total assets $23,060,649  $20,577,517 
         
Liabilities and Shareholders’ Equity        
Current Liabilities        
Current maturities of long-term debt $50,703  $46,309 
Accounts payable  663,376   589,225 
Accrued compensation  946,623   1,489,798 
Income tax payable  156,524    
Warranty reserve  640,000   660,000 
Other accrued liabilities  438,748   287,194 
Total current liabilities  2,895,974   3,072,526 
Long-term debt, less current maturities and net of debt issuance costs  1,097,125   1,146,395 
Total liabilities  3,993,099   4,218,921 
         
Commitments and Contingencies        
         
Shareholders’ Equity        
Common stock, $0.01 par value; authorized: 13,000,000 shares; 8,230,167 and 8,187,112 issued and outstanding at June 30, 2017 and June 30, 2016, respectively  82,302   81,871 
Additional paid-in capital  14,028,602   13,549,551 
Retained earnings  4,956,646   2,727,174 
Total shareholders’ equity  19,067,550   16,358,596 
Total liabilities and shareholders’ equity $23,060,649  $20,577,517 

See Notes to Financial Statements.

F-3 

F-4

Electromed, Inc.

Statements of Operations

Years Ended June 30, 20172022 and 20162021

      
 Years Ended June 30,  Years Ended June 30, 
 2017  2016  2022 2021 
Net revenues $25,861,144  $22,991,999  $41,659,000  $35,756,000 
Cost of revenues  5,292,715   5,115,736   10,217,000   8,451,000 
Gross profit  20,568,429   17,876,263   31,442,000   27,305,000 
                
Operating expenses                
Selling, general and administrative  16,402,214   14,386,563   27,114,000   22,443,000 
Research and development  596,876   380,392   1,356,000   1,722,000 
Total operating expenses  16,999,090   14,766,955   28,470,000   24,165,000 
Operating income  3,569,339   3,109,308   2,972,000   3,140,000 
Interest expense, net of interest income of $17,044 and $12,658, respectively  49,867   66,806 
        
Interest income, net  25,000   27,000 
Net income before income taxes  3,519,472   3,042,502   2,997,000   3,167,000 
                
Income tax expense  (1,290,000)  (830,000)  692,000   805,000 
Net income $2,229,472  $2,212,502  $2,305,000  $2,362,000 
                
Income per share:                
Basic $0.27  $0.27  $0.27  $0.28 
Diluted $0.26  $0.27  $0.26  $0.27 
                
Weighted-average common shares outstanding:                
Basic  8,168,152   8,135,514   8,471,320   8,566,224 
Diluted  8,461,120   8,248,391   8,768,703   8,911,842 

See Notes to Financial Statements.

F-4 

F-5

Electromed, Inc.

Statements of Shareholders’ Equity

Years Ended June 30, 20172022 and 20162021

 Common Stock   Additional Paid-   
Retained
   

Total

Shareholders’

             
  Shares   Amount   in Capital  Earnings  Equity  Common Stock  Additional 
Retained
  

Total 

Shareholders’ 

 
Balance at June 30, 2015  8,133,857  $81,339  $13,327,320  $514,672  $13,923,331 
 Shares Amount  Paid-in Capital Earnings Equity 
Balance as of June 30, 2020  8,567,834  $86,000  $16,480,000  $13,684,000  $30,250,000 
Net income           2,362,000   2,362,000 
Issuance of restricted stock  37,090             
Issuance of common stock upon exercise of options  32,496      46,000      46,000 
Taxes paid on stock option exercised on a net basis        (141,000)     (141,000)
Share-based compensation expense        1,024,000      1,024,000 
Repurchase of common stock  (104,211)  (1,000)     (1,123,000)  (1,124,000)
Balance as of June 30, 2021  8,533,209   85,000   17,409,000   14,922,000   32,416,000 
                                        
Net income           2,212,502   2,212,502            2,305,000   2,305,000 
Issuance of restricted stock  53,255   532   (532)        49,400   1,000         1,000 
Issuance of common stock upon exercise of options  13,245             
Taxes paid on stock option exercised on a net basis        (77,000)     (77,000)
Share-based compensation expense        222,763      222,763         976,000      976,000 
Balance at June 30, 2016  8,187,112   81,871   13,549,551   2,727,174   16,358,596 
                    
Net income           2,229,472   2,229,472 
Issuance of restricted stock  43,055   431   (431)      
Share-based compensation expense        479,482      479,482 
Balance at June 30, 2017  8,230,167  $82,302  $14,028,602  $4,956,646  $19,067,550 
Repurchase of common stock  (120,416)  (1,000)     (1,447,000)  (1,448,000)
Balance as of June 30, 2022  8,475,438  $85,000  $18,308,000  $15,780,000  $34,173,000 

 

See Notes to Financial Statements.

 

F-5 

F-6

 


Electromed, Inc.

Statements of Cash Flows

Years Ended June 30, 20172022 and 20162021

 Years Ended June 30,       
 2017  2016  Years Ended June 30, 
Cash Flows From Operating Activities        
 2022 2021 
Cash Flows from Operating Activities        
Net income $2,229,472  $2,212,502  $2,305,000  $2,362,000 
Adjustments to reconcile net income to net cash provided by operating activities:        
Adjustments to reconcile net income to net cash (used in) provided by operating activities:        
Depreciation  636,709   616,021   503,000   477,000 
Amortization of finite-life intangible assets  118,418   122,681   125,000   133,000 
Amortization of debt issuance costs  13,067   18,016 
Share-based compensation expense  479,482   222,763   976,000   1,024,000 
Deferred income taxes  (117,000)  (343,000)  (489,000)  (294,000)
Loss on disposal of property and equipment  3,302   40,456 
Loss on disposal of intangible assets  132,724   17,706 
Changes in operating assets and liabilities:                
Accounts receivable  (2,338,322)  (1,092,621)  (4,020,000)  (4,091,000)
Contract assets  107,000   510,000 
Inventories  (28,334)  (347,623)  (1,072,000)  971,000 
Prepaid expenses and other assets  49,864   18,917 
Income tax receivable  192,685   (192,685)
Prepaid expenses and other current assets  (1,322,000)  151,000 
Income tax payable  156,524   (122,657)  (237,000)  550,000 
Accounts payable and accrued liabilities  (337,470)  996,427   2,170,000   214,000 
Net cash provided by operating activities  1,191,121   2,166,903 
Accrued compensation  268,000   1,070,000 
Net cash (used in) provided by operating activities  (686,000)  3,077,000 
                
Cash Flows From Investing Activities        
Cash Flows from Investing Activities        
Expenditures for property and equipment  (618,763)  (534,944)  (1,425,000)  (287,000)
Expenditures for finite-life intangible assets  (68,385)  (44,577)  (100,000)  (161,000)
Net cash used in investing activities  (687,148)  (579,521)  (1,525,000)  (448,000)
                
Cash Flows From Financing Activities        
Principal payments on long-term debt including capital lease obligations  (48,747)  (48,747)
Payments of deferred financing fees  (4,872)  (13,520)
Cash Flows from Financing Activities        
Issuance of common stock upon exercise of options     46,000 
Taxes paid on stock options exercised on a net basis  (77,000)  (141,000)
Repurchase of common stock  (1,448,000)  (1,124,000)
Net cash used in financing activities  (53,619)  (62,267)  (1,525,000)  (1,219,000)
Net increase in cash  450,354   1,525,115 
Cash        
Net (decrease) increase in cash  (3,736,000)  1,410,000 
Cash and cash equivalents        
Beginning of period  5,123,355   3,598,240   11,889,000   10,479,000 
End of period $5,573,709  $5,123,355  $8,153,000  $11,889,000 
                
Supplemental Disclosures of Cash Flow Information                
Cash paid for interest $59,233  $61,560 
        
Cash paid for income taxes  1,089,791   1,494,512  $1,418,000  $534,000 
        
Supplemental Disclosures of Noncash Investing and Financing Activities        
Property and equipment acquisitions in accounts payable $44,000  $10,000 
Intangible asset acquisitions in accounts payable $3,000  $42,000 
Lease assets obtained in exchange for new operating lease liabilities $117,000  $91,000 

See Notes to Financial Statements.

F-6 

F-7

Electromed, Inc.

Notes to Financial Statements

Note 1.        Nature of Business and Summary of Significant Accounting Policies

Nature of business: Electromed, Inc. (the “Company”) develops, manufactures and markets innovative airway clearance products that apply High Frequency Chest Wall Oscillation (“HFCWO”) therapy in pulmonary care for patients of all ages. The Company markets its products in the U.S. to the home health care and institutional markets for use by patients in personal residences, hospitals and clinics. The Company also sells internationally both directly and through distributors. International sales were approximately $716,000$521,000 and $713,000$658,000 for the fiscal years ended June 30, 20172022 (“fiscal 2022”) and 2016,June 30, 2021 (“fiscal 2021”), respectively. Since its inception, the Company has operated in a single industry segment: developing, manufacturing and marketing medical equipment.

Impacts of COVID-19 on the Company’s business

The Company did not receive any direct financial assistance from any government program during fiscal 2021 or fiscal 2022 in connection with COVID-19 relief measures.

In response to the COVID-19 pandemic and the U.S. federal government’s declaration of a public health emergency, the Centers for Medicare and Medicaid Services (“CMS”) implemented a number of temporary rule changes and waivers to allow prescribers to best treat patients during the period of the public health emergency. These waivers were made retroactively effective to March 1, 2020 and were in place for the duration of fiscal 2021 and fiscal 2022. Clinical indications and documentation typically required were not enforced for respiratory related products including the Company’s SmartVest® Airway Clearance System (“SmartVest System”) (solely with respect to direct Medicare covered patients) applicable for the Company’s home care prescriptions. The minimum documentation now requires a valid order and documentation of a respiratory related diagnosis. Face-to-face and in-person requirements for respiratory devices are being waived while the waiver is in place. The CMS waiver was recently extended in conjunction with the extension of the federal public health emergency for an additional 90-day period beginning July 15, 2022. A temporary suspension of a 2% tax on Medicare payments was also initiated in May 2020 and was extended through December 2021.

The impact of the COVID-19 pandemic on the Company’s business remains uncertain and its effects on operational and financial performance will depend in part on future developments, which cannot be reasonably estimated at this time. Such future developments include, but are not limited to, the duration, scope and severity of the COVID-19 pandemic in geographic areas in which the Company operates or in which its patients live, actions taken to contain or mitigate its impact, the impact on governmental healthcare programs and budgets, the deployment of treatments or vaccines, and the resumption of widespread economic activity. Due to the inherent uncertainty of the unprecedented and evolving situation, the Company is unable to predict with confidence the likely impact of the COVID-19 pandemic on its future operations.

A summary of the Company’s significant accounting policies follows:

 

Use of estimates:estimates: Management uses estimates and assumptions in preparing the financial statements in accordance with U.S. generally accepted accounting principles (“U.S. GAAP”). Those estimates and assumptions affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities, and the reported revenues and expenses. Actual results could vary from the estimates that were used. The Company believes the critical accounting policies that require the most significant assumptions and judgments in the preparation of its financial statements include revenue recognition and the related estimation of selling price adjustments, allowance for doubtful accounts,variable consideration, inventory obsolescence,valuation, share-based compensation income taxes and the warranty reserve.

Revenue recognition:recognition: The Company recognizes revenueRevenue is measured based on consideration specified in the contract with a customer, adjusted for any applicable estimates of variable consideration and other factors affecting the transaction price, including noncash consideration, consideration paid or payable to customers and significant financing components. Revenue from all customers is recognized when persuasive evidencea performance obligation is satisfied by transferring control of a sales arrangement exists, delivery of goods occurs through the transfer of title and risks and rewards of ownership, the selling price is fixeddistinct good or determinable, and collectability is reasonably assured. Revenues are primarily recognized upon shipment.service to a customer. See Note 2 for information on revenue.

Direct patient sales are recorded at amounts to be received from patients under reimbursement arrangements with third-party payers, including private insurers, prepaid health plans, Medicare and Medicaid. In addition, the Company records an estimate for selling price adjustments that often arise from changes in a patient’s insurance coverage, changes in a patient’s domicile, insurance company coverage limitations or patient death. Other than the installment sales as discussed below, the Company expects to receive payment on the vast majority of accounts receivable within one year and therefore has classified all accounts receivable as current. However, in some instances, payment for direct patient sales can be delayed or interrupted, resulting in a portion of collections occurring later than one year.

During fiscal 2017, the Company entered into a settlement agreement with the Centers for Medicare and Medicaid Services with respect to approximately 700 Medicare fee-for-service claims submitted between calendar years 2012 through 2015, resulting in approximately $703,000 of net recognized revenue.

Certain third-party reimbursement agencies pay the Company on a monthly installment basis, which can span over several years. Due to the length of time over which cash is collected and the inherent uncertainty of collectability with these installment sales, the Company cannot make a reasonable estimate of revenue at the time of sale and does not record accounts receivable or revenue at the time of product shipment. Under the installment method, the Company defers the revenue associated with the sale and, as each installment is received, that amount is recognized as revenue. Deferred costs associated with the sale are amortized to cost of revenue ratably over the estimated period in which collections are scheduled to occur.

Sales made under the installment method were approximately as follows:

  Years Ended June 30, 
  2017  2016 
Revenue recognized under installment sales $1,246,000  $1,555,000 
Amortized cost of revenues recognized  161,000   188,000 


F-8

 

Unrecognized installment method sales were approximately as follows:

  June 30, 
  2017  2016 
Estimated unrecognized sales, net of discounts $1,814,000  $1,977,000 
Unamortized costs of revenues included in prepaid and other current assets and other assets  209,000   263,000 

Shipping and handling expense:expense: Shipping and handling charges incurred by the Company are included in cost of goods soldrevenues and were $363,000$982,000 and $333,000$530,000 for the fiscal years ended June 30, 20172022 and 2016,2021, respectively.

Cash:Cash and cash equivalents:The Company maintains its Cash and cash equivalents consist of cash in bank deposit accounts that,deposits and money market funds with original maturities of three months or less at times, may exceed federally insured limits.the time of purchase. The Company has not experienced any losses in these accounts.

Accounts receivable:receivable: The Company’s accounts receivable balance is comprised of amounts due from individuals, institutions and distributors. Balances due from individuals are typically remitted to the Company by third-party reimbursement agencies such as Medicare, Medicaid and private insurance companies. Accounts receivable are carried at amounts estimated to be received from patients under reimbursement arrangements with third-party payers. Accounts receivable are also net of an allowance for doubtful accounts. Management determines the allowance for doubtful accounts by regularly evaluating individual customer receivables and considering a customer’s financial condition and credit history. Receivables are written off when deemed uncollectible. Recoveries of receivables previously written off are recorded when received. The allowance for doubtful accounts was approximately $45,000$45,000 as of June 30, 20172022 and 2016.2021.

Inventories:Contract assets: Contract assets include amounts recognized as revenue that are estimates of variable consideration for Medicare appeals where the final determination of the insurance coverage amount is dependent on future approval of an appeal, or when the consideration due to the Company is dependent on a future event such as the patient meeting a deductible prior to the Company’s claim being processed by the payer. Contract assets are classified as current as amounts will turn into accounts receivable and be collected during the Company’s normal business operating cycle. Contract assets are reclassified to accounts receivable when the right to receive payment is unconditional.

Inventories: Inventories are stated at the lower of cost (first-in, first-out method) or market.net realizable value. Work in process and finished goods are carried at standard cost, which approximates actual cost, and includes materials, labor and allocated overhead. Standard costs are reviewed at least quarterly by management, or more often in the event circumstances indicate a change in cost has occurred. The reserve for obsolescence is determined by analyzing the inventory on hand and comparing it to expected future sales. Estimated inventory to be returned is based on how many devices that have shipped that are expected to be returned prior to completion of the insurance reimbursement process.

Property and equipment:equipment: Property and equipment are stated at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the assets. Leasehold improvements and assets acquired under capital leases are depreciated over the shorter of their estimated useful lives or the remaining lease term. The Company retains ownership of demonstration equipment in the possession of both inside and outside sales representatives, who use the equipment in the sales process.

Finite-life intangible assets:assets: Finite-life intangible assets include patents and trademarks. These intangible assets are being amortized on a straight-line basis over their estimated useful lives, as described in Note 4.5.

Long-lived assets:assets: Long-lived assets, primarily property and equipment and finite-life intangible assets, are evaluated for impairment whenever events or changes in circumstances indicate the carrying value of an asset or asset group may not be recoverable. In evaluating recoverability, the following factors, among others, are considered: a significant change in the circumstances used to determine the amortization period, an adverse change in legal factors or in the business climate, a transition to a new product or service strategy, a significant change in customer base, and a realization of failed marketing efforts. The recoverability of an asset or asset group is measured by a comparison of the carrying value of the asset to future undiscounted cash flows.

If the Company believes the carrying value is unrecoverable, then it would recognizerecognizes an impairment charge necessary to reduce the unamortized balance to the estimated fair value of the asset or asset group. The amount of such impairment would beis charged to operations in the current period.


Warranty liability:liability: The Company provides a lifetime warranty on its products sold to patients inthe prescribed patient for sales within the U.S. and Canada and a three-year warranty for all institutional sales withinand sales to individuals outside the U.S., as well as for all international sales. The Company estimates the costs that may be incurred under its warranty and records a liability in the amount of such costs at the time the product is sold.shipped or delivered. Factors that affect the Company’s warranty liability include the number of units sold,shipped, historical and anticipated rates of warranty claims, the product’s useful life, and cost per claim. The Company periodically assesses the adequacy of its recorded warranty liability and adjusts the amounts as necessary.

F-9

Changes in the Company’s warranty liability were approximately as follows:

Schedule of changes in warranty liability

      
 Years Ended June 30,  Years Ended June 30, 
 2017  2016  2022 2021 
Beginning warranty reserve $660,000  $660,000  $940,000  $740,000 
Accrual for products sold  129,000   152,000   494,000   354,000 
Expenditures and costs incurred for warranty claims  (149,000)  (152,000)  (178,000)  (154,000)
Ending warranty reserve $640,000  $660,000  $1,256,000  $940,000 

Income taxes:taxes: Deferred taxes are provided on a liability method whereby deferred tax assets are recognized for deductible temporary differences and operating loss and tax credit carryforwards and deferred tax liabilities are recognized for taxable temporary differences. Temporary differences are the differences between the reported amounts of assets and liabilities and their tax bases. Deferred tax assets are reduced by a valuation allowance when, in the opinion of management, it is more likely than not that some portion or all of the deferred tax assets will not be realized. We would reverseThe Company reverses a valuation allowance if we determine,it determines, based on the weight of all available evidence, including when cumulative losses become positive income, that it is more likely than not that some or all of the deferred tax assets will be realized. Deferred tax assets and liabilities are adjusted for the effects of changes in tax laws and rates on the date of enactment.

The Company recognizes tax liabilities when the Company believes that certain positions may not be fully sustained upon review by tax authorities. Benefits from tax positions are measured at the largest amount of benefit that is greater than 50 percent likely of being realized upon settlement. To the extent that the final tax outcome of these matters is different than the amounts recorded, such differences impact income tax expense in the period in which such determination is made. Interest and penalties, if any, related to accrued liabilities for potential tax assessments are included in income tax expense.

Research and development:development: Research and development costs include costs of research activities as well as engineering and technical efforts required to develop new products or make improvements to existing products. Research and development costs are expensed as incurred.

Advertising costs:costs: Advertising costs are charged to expense when incurred. Advertising, marketing and trade show costs for the fiscal years ended June 30, 20172022 and 2016,2021 were approximately $380,000$936,000 and $331,000,$1,062,000, respectively.

Share-based payments:payments: Share-based payment awards consist of options to purchase shares of common stock and restricted shares of common stock issued to employees for services, and to non-employees in lieu of payment for services. Expense for options is estimated using the Black-Scholes pricing model at the date of grant and expense for restricted stock is determined by the closing price on the day the grant is made. Expense is recognized on a straight-line basis over the requisite service or vesting period of the award, or at the time services are provided for non-employee awards.

Fair value of financial instruments:instruments: The carrying values of cash and cash equivalents, accounts receivable, accounts payable and accrued expenses approximate their fair value due to the short-term nature of these instruments. The carrying value of long-term debt is the remaining amount due to debtors under borrowing arrangements. To estimate the fair value of debt, the Company estimates the interest rate necessary to secure financing to replace its debt. At June 30, 2017, the fair value of long-term debt was not significantly different than its carrying value.


Basic and diluted earningsNet income per share:common share: Net income is presented on a per share basis for both basic and diluted common shares. Basic net income per common share is computed using the weighted-average number of common shares outstanding during the period, excluding any restricted stock awards which have not vested. The diluted net income per common share calculation includes outstanding restricted stock grants and assumes that all stock options were exercised and converted into shares of common stock at the beginning of the period unless their effect is anti-dilutive. Common stock equivalents included in the calculation of 177,500diluted earnings per share were 297,383 and 345,618 shares for fiscal 2022 and 307,800 shares were2021, respectively. Common stock equivalents excluded from the calculation of diluted earnings per share for the fiscal years ended June 30, 2017 and 2016, respectively, asbecause their impact was antidilutive. See Note 7anti-dilutive were 113,646 and 48,617 shares for information on stock optionsfiscal 2022 and warrants.2021, respectively.

NewRecently Issued Accounting Pronouncements:Standards

In May 2014,June 2016, the Financial Accounting Standards Board (“FASB”) issued guidance creating Accounting Standards Codification (“ASC”) Section 606, “Revenue from Contracts with Customers.” The new section will replace ASC Section 605, “Revenue Recognition,” and creates modifications to various other revenue accounting standards for specialized transactions and industries. The section is intended to conform revenue accounting principles with a concurrently issued International Financial Reporting Standards with previously differing treatment between U.S. practice and that of much of the rest of the world, as well as to enhance disclosures related to disaggregated revenue information. Entities will have the option to apply the standard retrospectively to all prior periods presented (“full retrospective”), or to apply it retrospectively only to contracts existing at the effective date (“modified retrospective”), with the cumulative effect of the standard recorded as an adjustment to beginning retained earnings. In August 2015, the FASB issued Accounting Standards Update (“ASU”) 2015-14,2016-13, Financial Instruments -- Credit Losses: Measurement of Credit Losses on Financial Instruments, which delayed the effective date of thewas subsequently amended by ASU 2018-19, ASU 2019-04, 2019-05, 2019-10, 2019-11, and 2020-02. The standard introduces new revenue recognitionaccounting guidance by one year. The updatedfor credit losses on financial instruments within its scope, including trade receivables. This new guidance will beadds an impairment model that is based on expected losses rather than incurred losses. It is effective for public business entities for fiscal yearsinterim and annual reporting periods beginning after December 15, 2017,2022, with early adoption permitted.

F-10

Note 2. Revenues

Revenue is measured based on consideration specified in the contract with a customer, adjusted for any applicable estimates of variable consideration and interim periods withinother factors affecting the transaction price, including consideration paid or payable from customers and significant financing components. Revenue from all customers is recognized when a performance obligation is satisfied by transferring control of a distinct good or service to a customer, as further described below under Performance obligations and transaction price.

Individual promised goods and services in a contract are considered a performance obligation and accounted for separately if the individual good or service is distinct (i.e., the customer can benefit from the good or service on its own or with other resources that year. are readily available to the customer and the good or service is separately identifiable from other promises in the arrangement). If an arrangement includes multiple performance obligations, the consideration is allocated between the performance obligations in proportion to their estimated standalone selling price, unless discounts or variable consideration is attributable to one or more but not all the performance obligations. Costs related to products delivered are recognized in the period incurred, unless criteria for capitalization of costs under Accounting Standards Codification (“ASC”) 340-40, “Other Assets and Deferred Costs” (“ASC 340”), or other applicable guidance are met.

The Company is currently evaluating whichincludes shipping and handling fees in net revenues. Shipping and handling costs associated with the shipment of the alternative approaches it will applyCompany’s SmartVest® Airway Clearance System (“SmartVest System”) after control has transferred to a customer are accounted for as a fulfillment cost and are included in cost of revenues in the Statements of Operations.

The timing of revenue recognition, billings and cash collections results in accounts receivable on the Balance Sheets as further described below under Accounts receivable and Contract assets.

Disaggregation of revenues. In the following table, revenue is disaggregated by market:

Schedule of disaggregated revenue

  Years Ended June 30, 
  2022  2021 
Home care $38,004,000  $32,986,000 
Institutional  1,660,000   1,549,000 
Home care distributor  1,474,000   563,000 
International  521,000   658,000 
Total $41,659,000  $35,756,000 

F-11

In the following table, home care revenue is disaggregated by payer type:

  Years Ended June 30, 
  2022  2021 
Commercial $14,904,000  $12,530,000 
Medicare  21,144,000   19,044,000 
Medicaid  1,045,000   846,000 
Other  911,000   566,000 
Total $38,004,000  $32,986,000 

Revenues in the Company’s home care, home care distributor and international markets are recognized at a point in time when control passes to the customer upon product shipment or delivery. Revenues in the Company’s institutional market include sales recognized at a point in time upon shipment or delivery as well as revenues recognized over time under operating leases.

Performance obligations and transaction price. A performance obligation is a promise in a contract to transfer a distinct good or service to the customer and is the unit of account under ASC 606, “Revenue From Contracts With Customers” (“ASC 606”). A contract’s transaction price is allocated to each distinct performance obligation in proportion to the standalone selling price for each and recognized as revenue when, or as, the performance obligation is satisfied. The Company’s performance obligations and the potential impacttiming or method of adoptionrevenue recognition in each of the revised revenue standards onCompany’s markets are discussed below:

Home care market. In the Company’s home care market, its financial statements. customers are patients who use the SmartVest System. The various models of the SmartVest System are comprised of three main components - a generator, a vest and a connecting hose - that are sold together as an integrated unit. Accordingly, in contracts within the home care market, the Company regards the SmartVest System to be a single performance obligation.

The Company intendsmakes available to complete its evaluation during its fiscal year ending June 30, 2018.home care patients limited post-sale services that are not material in the context of the contracts, either individually or taken together, and therefore does not consider them to be performance obligations. The costs associated with the services are accrued and expensed when the related revenues are recognized. As such, transactions in the home care market consist of a single performance obligation: the SmartVest System.

In April 2015, FASB issued ASU 2015-03, “SimplifyingHome care patients generally will rely on third-party payers, including commercial payers and governmental payers such as Medicare, Medicaid and the PresentationU.S. Department of Debt Issuance Costs.” ThisVeterans Affairs to cover and reimburse all or part of the cost of the SmartVest System. The third-party payers’ reimbursement programs fall into three types, distinguished by the differences in the timing of payments from the payer, consisting of either (i) outright sale, in which payment is received from the payer based on standard became effective on July 1, 2016terms, (ii) capped installment sale, under which the SmartVest System is sold for a series of payments that are capped not to exceed a prescribed or negotiated amount over a period of time or (iii) installment sale, under which the SmartVest System is paid for over a period of several months as long as the patient continues to use the SmartVest System.

Regardless of the type of transaction, provided criteria for an enforceable contract are met, it is the Company’s long-standing business practice to regard all home care agreements as transferring control to the patient upon shipment or delivery, in spite of possible payment cancellation under government or commercial programs where the payer is controlling the payment over specified time periods. For home care sales that feature installment payments, the ultimate amount of consideration received from Medicare, Medicaid or commercial payers can be significantly less than expected if the contract is terminated due to changes in the patient’s status, including insurance coverage, hospitalization, death or otherwise becoming unable to use the SmartVest System. However, once delivered to a patient who needs the SmartVest System, the patient is under no obligation to return the SmartVest System should payments be terminated as a result of the described contingencies. As a result, the Company’s product sales qualify for point in time revenue recognition. Control transfers to the patient, and revenue is recognized, upon shipment or delivery of the SmartVest System. At this point, physical possession and the significant risks and rewards of ownership are transferred to the patient and either a current or future right to payment is triggered, as further discussed under Accounts receivable and Contract assets below.

The Company’s contractually stated transaction prices in the home care market are generally set by the terms of the contracts negotiated with insurance companies or by government programs. The transaction price for the Company’s products may be further impacted by variable consideration. ASC 606 requires the Company to adjust the transaction price at contract inception and requires that debt issuance coststhroughout the contract duration for the estimated value of payments to be presented asreceived from insurance payers based on historical experience and other available information, subject to the constraint on estimates of variable consideration. Transactions requiring estimates of variable consideration primarily include (i) capped installment payments, which are subject to the third-party payer’s termination due to changes in insurance coverage, death or the patient’s discontinued use of the SmartVest System, (ii) contracts under appeal and (iii) patient responsibility amounts for deductibles, coinsurance, copays and other similar payments.

F-12

Although estimates may be made on a direct deductioncontract-by-contract basis, whenever possible, the Company uses all available information including historical collection patterns to estimate variable consideration for portfolios of contracts. The Company’s estimates of variable consideration consist of amounts it may receive from insurance providers in excess of its initial revenue estimate due to patients meeting deductibles or coinsurance during the carryingpayment duration, changes to a patient’s insurance status, changes in an insurance allowable, claims in appeals with Medicare and amounts received directly from patients for their allowable or coinsurance. The Company believes it has representative historical information to estimate the amount of long-term debtvariable consideration in relevant portfolios considering the significant experience it has with each portfolio and the similarity of patient accounts within a portfolio. The analysis includes steps to ensure that revenue recognized on the balance sheet. The new guidance aligns the presentation of debt issuance costsa portfolio basis does not result in a material difference when compared with debt discounts and premiums.an individual contract approach. The Company adopted this guidance retrospectively effective asalso leverages its historical experience and all available relevant information for each portfolio of July 1, 2016.contracts to minimize the risk its estimates used to arrive at the transaction price will result in a significant reversal in the amount of cumulative revenue recognized when the uncertainty associated with the variable consideration is subsequently resolved. Variable consideration is included in the transaction price if, in the Company’s judgment, it is probable that a significant future reversal of cumulative revenue under the contract will not occur.

For contracts in which the Company believes the criteria for reimbursement under government or commercial payer contracts have been met but for which coverage is unconfirmed or payments are under appeal, the Company has significant observable evidence of relatively consistent claims recovery experience over the prior three to five years. The Company believes the low volatility in historical claims approval rates for populations of patients whose demographics are similar to those of current patients provides reliable predictive value in arriving at estimates of variable consideration in such contracts. Similarly, historical payment trends for recovery of claims subject to payer installments and payments from patients have remained relatively consistent over the past five years. No significant changes in patient demographics or other relevant factors have occurred that would limit the predictive value of such payment trends in estimating variable consideration for current contracts. As a result, the Company presented $10,000believes its estimates of unamortized debt issuance costsvariable consideration are generally not subject to the risk of significant revenue reversal.

For each type of variable consideration discussed above, there are a large number of contracts with similar characteristics with a wide range of possible transaction prices. For that had been included in “Other assets” on its condensed balance sheet asreason, the Company uses the probability-weighted expected value method provided under ASC 606 to estimate variable consideration.

The Company often receives payment from third-party payers for the SmartVest System sales over a period of June 30, 2016 as a direct deduction fromtime that may exceed one year. Despite these extended payment terms, no significant financing component is deemed to exist because the carrying amountspurpose of such terms is not to provide financing to the related long-term debt liability.

In July 2015, FASB issued ASU 2015-11, “Inventory (Topic 330) Related to Simplifyingpatient, the Measurementpayer or the Company. Rather, the extended payment terms are mandated by the government or commercial insurance programs, the fundamental purpose of Inventory,” which applies to all inventory except that which is measured using last-in, first-out (“LIFO”)to avoid paying the full purchase price of equipment that may potentially be used by the patient for only a short period of time.

Home care distributors. Sales to distributors, who sell direct to patients, are made at fixed contract prices and may include tiered pricing structures or volume-based rebates which offer more favorable pricing once certain volumes are achieved per the retail inventory method. Inventory measured using first-in, first-out (“FIFO”) or average cost is withinnegotiated contract. The distributor’s purchases accumulate to give the scope of the new guidance and should be measured at the lower of cost and net realizable value. Net realizable value is the estimated selling price in the ordinary course of business, less reasonably predictable cost of completion, disposal, and transportation. Subsequent measurement is unchanged for inventory measured using LIFO or the retail inventory method. The amendments will be effective for public business entities for fiscal years beginning after December 15, 2016, including interim periods within those fiscal years. The new guidance should be applied prospectively, and earlier application is permitted as of the beginning of an interim or annual reporting period. The Company has evaluated that ASU 105-11 will have no material impactdistributor a right to a higher discount on its financial statements or financial statement disclosures upon adoption.

In February 2016, FASB issued ASU 2016-02, “Leases.” This standard requires the recognition of all lease transactions with termspurchases in excess of 12 months on the balance sheet asspecified level within the contract period. As a lease liability and a right-of-use asset (as definedresult, to the extent the Company expects the distributor to exceed the specified volume of purchases in the standard). ASU 2016-02 will be effectiveannual period, it recognizes revenue at a blended rate based on estimated total annual volume and sales revenue. This effectively defers a portion of the transaction price on initial purchases below the specified volumes for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years,recognition when the higher discount is earned on purchases in excess of specified volumes. Transfer of control of the products occurs upon shipment or delivery to the distributor as applicable.

F-13

Institutional market. The Company’s institutional sales are made to hospitals and home health care centers, pulmonary rehabilitation centers and other clinics. Sales to these institutions are negotiated with earlier application permitted. Upon adoption, the lessee will applyindividual institution or with group purchasing organizations, with payments received directly from the new standard retrospectivelyinstitution. No insurance reimbursement is involved. Generators are either sold or leased to all periods presented or retrospectively usingthe institutions and associated hoses and wraps (used in institutional settings rather than vests) are sold separately. Accordingly, each product is distinct and considered a cumulative effect adjustmentseparate performance obligation in sales to institutional customers. The agreements with institutions fall into two main types, distinguished by differences in the yeartiming of adoption. transfer of control and timing of payments:

Outright sale – Under these transactions, the Company sells its products for a prescribed or negotiated price. Transfer of control of the product, and associated revenue recognition, occurs at the time of shipment and payment is made within normal credit terms, usually within 30 days.

Wrap usage agreements – Under these transactions, the Company provides a generator device at no cost to the hospital in return for a fixed annual commitment to purchase consumable wraps. These agreements are cancellable upon at least sixty days prior written notice by either party. If cancelled, the generator is returned to the Company, where it can be refurbished and used again at a later date. Revenue for the consumable wraps is recognized when control transfers to the customer.

International market. Sales to international markets are made directly to a number of independent distributors at fixed contract prices that are not subject to further adjustments for variable consideration. Transfer of control of the products occurs upon shipment or delivery to the distributor as applicable.

Product warranty. The Company has evaluated that ASU 2016-02 will have no material impactoffers warranties on its financial statementsproducts. These warranties are assurance type warranties not sold on a standalone basis or financial statement disclosures upon adoption based on current factsare otherwise considered immaterial in the context of the contract, and circumstances.


In March 2016, FASB issued ASU 2016-09, “Compensation—Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting,” which reduces complexity in accounting standards related to share-based payment transactions, including, among others, (1) accounting for income taxes, (2) classification of excess tax benefits on the statement of cash flow, (3) forfeitures, and (4) statutory tax withholding requirements. ASU 2016-09 will be effective for annual reporting periods beginning on or after December 15, 2016, and interim periods within those annual periods.therefore are not considered distinct performance obligations under ASC 606. The Company has evaluatedestimates the costs that ASU 2016-09 will have no material impactmay be incurred under its warranties and records a liability in the amount of such costs at the time the product is sold.

Accounts receivable. The Company’s accounts receivable balance is comprised of amounts due from individuals, institutions and distributors. Balances due from individuals are typically remitted to the Company by third-party reimbursement agencies such as Medicare, Medicaid and private insurance companies. Accounts receivable are carried at amounts estimated to be received from patients under reimbursement arrangements with third-party payers. Accounts receivable are also net of an allowance for doubtful accounts. Management determines the allowance for doubtful accounts by regularly evaluating individual customer receivables and considering a customer’s financial condition and credit history. Receivables are written off when deemed uncollectible.

Contract assets. Contract assets include amounts recognized as revenue that are estimates of variable consideration for Medicare appeals where the final determination of the insurance coverage amount is dependent on its financial statementsfuture approval of an appeal, or financial statement disclosures upon adoption.when the consideration due to the Company is dependent on a future event such as the patient meeting a deductible prior to the Company’s claim being processed by the payer. Contract assets are classified as current as amounts is expected to turn into accounts receivable and be collected during the Company’s normal business operating cycle. Contract assets are reclassified to accounts receivable when the right to receive payment is unconditional.

Contract balances. The following table provides information about accounts receivable and contracts assets from contracts with customers:

Schedule of contract assets

         
  June 30, 
  2022  2021 
Receivables, included in “Accounts receivable, net of allowance for doubtful accounts” $21,052,000  $17,032,000 
Contract Assets $286,000  $393,000 

F-14

Significant changes in contract assets during the period are as follows:

  

Year Ended

June 30, 2022

  

Year Ended  

June 30, 2021

 
  Increase (decrease)  Increase (decrease) 
Contract assets, beginning $393,000  $903,000 
Reclassification of contract assets to accounts receivable  (833,000)  (1,551,000)
Contract assets recognized  784,000   1,060,000 
Increase (decrease) as a result of changes in the estimate of amounts to be realized from payers, excluding amounts transferred to receivables during the period  (58,000)  (19,000)
Contract assets, ending $286,000  $393,000 

 

Reclassifications:Note 3.Certain items in the Company’s financial statements for the year ended June 30, 2016 have been reclassified to be consistent with the classifications adopted for the Company’s year ended June 30, 2017. The reclassifications are specific to the adoption of ASU 2015-03, “Simplifying the Presentation of Debt Issuance Costs” and had no impact on previously reported net income or equity.Inventories

Note 2.          Inventories

The components of inventories at June 30, 2017 and 2016inventory were approximately as follows:

Schedule of components of inventories

      
 June 30,  June 30, 
 2017  2016  2022 2021 
Parts inventory $1,789,000  $1,615,000  $2,672,000  $1,779,000 
Work in process  205,000   165,000   100,000   23,000 
Finished goods  745,000   850,000   469,000   445,000 
Estimated inventory to be returned  228,000   167,000 
Less: Reserve for obsolescence  (180,000)  (150,000)  (291,000)  (300,000)
Total $2,559,000  $2,480,000  $3,178,000  $2,114,000 

 

Note 3.          4.        Property and Equipment

Property and equipment were as follows:

Schedule of property and equipment, including assets under capital leases were approximately as follows:

  Estimated Useful Lives (Years)  June 30, 
   2017   2016 
Building and building improvements 15-39 $2,236,000  $2,236,000 
Land N/A  200,000   200,000 
Land improvements 15  166,000   166,000 
Equipment 3-7  2,982,000   2,755,000 
Demonstration and rental equipment 3  959,000   1,040,000 
     6,543,000   6,397,000 
Less: Accumulated depreciation    (3,240,000)  (3,022,000)
Net property and equipment   $3,303,000  $3,375,000 

During the fiscal years ended June 30, 2017 and 2016, the Company impaired or disposed of certain property and equipment, no longer in use, with a net value of approximately $3,000 and $40,000, respectively, which was included as an expense in cost of goods sold or selling, general and administrative expense on the statements of operations. During the year ended June 30, 2016, there was approximately $17,000 of impairment charges associated with tooling that will no longer be used to produce SmartVest SQL parts as new, more cost-effective manufacturing processes were implemented.


  Estimated Useful Lives  June 30, 
  (Years)  2022  2021 
Building and building improvements  15-39  $3,420,000  $3,446,000 
Land N/A   200,000   200,000 
Land improvements 15   162,000   166,000 
Equipment 3-10   2,752,000   3,467,000 
Demonstration and rental equipment 3   1,036,000   1,060,000 
Construction in progress N/A   957,000   26,000 
      8,527,000   8,365,000 
Less: Accumulated depreciation     (3,959,000)  (4,760,000)
Net property and equipment    $4,568,000  $3,605,000 

Note 4.          5.        Finite-life Intangible Assets

The carrying value of patents and trademarks includes the original cost of obtaining the patents, periodic renewal fees, and other costs associated with maintaining and defending patent and trademark rights. Patents and trademarks are amortized over their estimated useful lives, generally 15 and 12 years, respectively. During the years ended June 30, 2017 and 2016, the Company abandoned certain domestic and foreign patents with a net value of approximately $133,000 and $18,000, respectively, which was included as an expense in selling, general and administrative expense on the statements of operations. The majority of the pending patents that were abandoned related to the initial development of the Company’s SQL SmartVest technology. During a review of the Company’s patent portfolio it was determined that certain patents proved redundant to a subsequent SQL patent filing and were therefore abandoned. A smaller portion of expense was related to patents that covered technology that management considered outdated, and was no longer in use. Accumulated amortization was approximately $790,000$433,000 and $820,000 at$1,248,000 as of June 30, 20172022 and 2016,2021, respectively.

F-15

The activity and net balances of finite-life intangible assets were as follows:

Schedule of activity and balances of finite-life intangible assets were approximately as follows:

 Years Ended June 30,  Years Ended June 30, 
 2017  2016  2022 2021 
Balance, beginning $904,000  $1,000,000  $663,000  $598,000 
Additions  68,000   45,000   61,000   198,000 
Abandonments  (133,000)  (18,000)
Amortization expense  (118,000)  (123,000)  (125,000)  (133,000)
Balance, ending $721,000  $904,000  $599,000  $663,000 

 

Based on the carrying value atas of June 30, 2017,2022, future amortization expense is expected to be approximately $112,000 annually.as follows:

Schedule of future amortization of finite-life intangible assets

     
Fiscal years ending June 30:    
2023  $46,000 
2024   42,000 
2025   40,000 
2026   39,000 
2027   38,000 
Thereafter   394,000 
Total  $599,000 

 

Note 5.          6.        Financing Arrangements

The Company has a credit facility that provides for a revolving line of credit and a term loan. Effective December 18, 2016,17, 2021, the Company renewed its $2,500,000$2,500,000 revolving line of credit. There was no outstanding principal balance on the line of credit as of June 30, 20172022 or June 30, 2016.2021. Interest on borrowings under the line of credit, if any, would accrueaccrues at the prime rate (4.25% at(4.75% as of June 30, 2017)2022) less 1.0% and is payable monthly. The amount eligible for borrowing on the line of credit is limited to the lesser of $2,500,000$2,500,000 or 57.00%57.0% of eligible accounts receivable and the line of credit expires on December 18, 2017,2023, if not renewed.renewed before such date. At June 30, 2017,2022, the maximum $2,500,000$2,500,000 was eligible for borrowing. ThePayment obligations under the line of credit, isif any, are secured by a security interest in substantially all of the tangible and intangible assets of the Company.

In connection with the credit facility, the Company also has a term loan, which had an outstanding principal balance of approximately $1,154,000 at June 30, 2017 and $1,200,000 as of June 30, 2016. The term loan was refinanced effective December 18, 2016, reducing the interest rate from 5.00% to 3.88%. The unamortized debt issuance cost associated with this debt was approximately $6,000 and $10,000 as of June 30, 2017 and June 30, 2016, respectively. The term loan bears interest at 3.88%, with monthly payments of principal and interest of approximately $7,900 and a final payment of principal and interest of approximately $1,085,000 due on the maturity date of December 18, 2018. Payment obligations under the term loan are secured by a mortgage on the Company’s real property.

The documents governing the line of credit and term loan contain certain financial and nonfinancial covenants that include a minimum tangible net worth covenant of not less than $10,125,000$10,125,000 and restrictions on the Company’s ability to incur certain additional indebtedness or pay dividends.


Long-term debt consisted of approximately the following as of June 30, 2017 and 2016:

  June 30, 
  2017  2016 
Mortgage note payable with bank, due in monthly installments of $7,932, including interest at 3.88%, remaining due December 2018, secured by land and building $1,154,000  $1,200,000 
Capital lease obligation, due in monthly installments of $648, including interest at 6.99%, to November 2016, secured by equipment     2,000 
Total  1,154,000   1,202,000 
Less: Current portion  51,000   46,000 
Less: Debt issuance costs, net  6,000   10,000 
Long-term debt $1,097,000  $1,146,000 

Approximate future maturities of long-term debt, net of debt issuance costs, as of June 30, 2017 were as follows:

Fiscal year ending June 30:   
2018 $51,000 
2019  1,097,000 
Total $1,148,000 

Capital leases: The Company has financed certain office equipment through capital leases.

At June 30, 2017 and 2016, the carrying value of assets under these capital leases was approximately as follows:

  June 30, 
  2017  2016 
Fixtures and office equipment $33,000  $33,000 
Less: Accumulated depreciation  (19,000)  (16,000)
Total $14,000  $17,000 

Depreciation expense for these assets was approximately $3,000 for each of the years ended June 30, 2017 and 2016.

Note 6.          7.       Common Stock

Authorized shares: The Company’s Articles of Incorporation, as amended, have established 15,000,000 authorized shares of capital stock consisting of 13,000,000 shares of common stock, par value $0.01$0.01 per share, and 2,000,000 shares of undesignated stock.

On May 26, 2021 the Company’s Board of Directors (the “Board”) approved a stock repurchase authorization. Under the authorization, the Company was originally able to repurchase up to $3.0 million of shares of common stock through May 26, 2022. On May 26, 2022, our Board of Directors removed the date limitation. As of June 30, 2022, a total of 120,416 shares have been repurchased and retired under this authorization for a total cost of $1,448,000, or $12.02 per share. Repurchased shares have been retired and constitute authorized but unissued shares.

Note 7.          8.        Share-Based PaymentsCompensation

Share-based compensation expense for the years ended June 30, 2017fiscal 2022 and 20162021 was approximately $479,000$976,000 and $223,000,$1,024,000, respectively, related to employee stock options and restricted stock awards. AtThis expense is included in selling, general and administrative expense in the Statements of Operations. As of June 30, 2017,2022, the Company had approximately $252,000$460,000 of unrecognized compensation expense related to non-vested equity awards, which is expected to be recognized over a weighted-average period of 0.8 years.1.5 to 2.0 years related to restricted stock awards and employee stock options, respectively.


F-16

Employee options:The Company has historically granted stock options to employees as long-term incentive compensation. Options generally expire four to ten years from the grant date and vest over a period of up to fivethree years. In November 2014,2017, the Company’s shareholders approved the 2017 Omnibus Incentive Plan (the “2017 Plan”) which supersedes the 2014 Equity Incentive Plan (the “2014 Plan”) which supersedes the Company’s 2012 Stock Incentive Plan.. The 2017 Plan allows the Board of Directors (the “Board”) to grant non-qualified stock options, orstock appreciation rights, restricted stock, to employees, directors, or consultants. The vesting schedule for options or restricted stock units and the termother stock-based awards, as well as cash incentive awards to all employees, non-employee directors, and advisors or consultants of the optionsCompany. The vesting schedule and term for each award are determined by the Board upon each grant. Upon vesting, and the Company’s determination that any necessary conditions precedent to the exercise of shares (such as satisfaction of tax withholding and compliance with applicable legal requirements) have been satisfied, shares purchased are delivered to the participant in a manner prescribed or permitted by the Board. The maximum number of shares of common stock available for issuance under the 2017 Plan is 650,000.900,000. There were 450,800248,500 options granted under the 20122014 Plan and prior plans outstanding as of June 30, 2017 and 2016.2022. There were 340,000253,584 options issued under the 20142017 Plan outstanding and 296,834 outstanding as of June 30, 2017. There were 237,251370,789 shares available for grant under the 20142017 Plan as of June 30, 2017.2022.

The Company recognizes compensation expense related to share-based payment transactions in the financial statements based on the estimated fair value of the award issued. The fair value of each option is estimated using the Black-Scholes pricing model at the time of award grant. The Company estimates the expected life of options based on the expected holding period by the option holder. The risk-free interest rate is based upon observed U.S. Treasury interest rates for the expected term of the options. The Company makes assumptions with respect to expected stock price volatility based upon the historical volatility of its stock price. Forfeitures are estimated at the time of grant and revised in subsequent periods if actual forfeitures differ from initial estimates. Forfeitures are estimated based on the percentage of awards expected to vest, taking into consideration the seniority level of the award recipient.accounted for as they occur.

The following assumptions were used to estimate the fair value of options granted:

Schedule of assumptions used to estimate fair value of options granted

 Years Ended June 30,  Years Ended June 30, 
 2017  2016  2022 2021 
Risk-free interest rate  1.14-1.27%  1.40-1.92%  0.89-2.52 %  0.31-0.59 %
Expected term (years)  6   6   6   6 
Expected volatility  100.5-105.8%  89.3-93.1%  55-64 %  283-335 %

During the year ended June 30, 2022, the Company had a change in estimate related to its expected volatility used to estimate the fair value of options granted. The change had no impact on the Financial Statements. The following table presents employee stock option activity for fiscal 2022 and 2021:

Schedule of stock option transactions

  Number of Shares  Weighted-
Average
Grant Date
Fair Value
  Weighted-
Average
Exercise Price
  

Weighted-
Average

Remaining
Contractual
Life (in Years)

 
Options outstanding as of June 30, 2020  590,780  $3.96  $4.34   6.87 
Granted  61,017  $14.13  $14.14    
Exercised  (71,150) $4.78  $5.09    
Canceled or forfeited  (112,598) $6.24  $6.50    
Options outstanding as of June 30, 2021  468,049  $4.61  $4.98   5.82 
Options exercisable as of June 30, 2021  442,437  $4.16  $4.54   5.64 
                 
Granted  81,901  $6.63  $11.52    
Exercised  (32,000) $3.70  $5.44    
Canceled or forfeited  (15,866) $6.63  $11.30    
Options outstanding as of June 30, 2022  502,084  $3.71  $5.82   5.35 
Options exercisable as of June 30, 2022  429,888  $3.16  $4.77   4.76 

The intrinsic value of a stock option is the years endedamount by which the fair value of the underlying stock exceeds its exercise price. At June 30, 20172022, the weighted average remaining contractual term for all outstanding stock options was 5.4 years and 2016:

  Number of
Shares
  Weighted-
Average
Grant Date
Fair Value
  Weighted-
Average
Exercise Price
  

Weighted-
Average

Remaining
Contractual Life
(in Years) 

 
Options outstanding at June 30, 2015  450,800  $1.74  $2.80   5.15 
Granted  163,500   1.55   2.05    
    Canceled or Forfeited  (14,500)  1.37   1.80    
Options outstanding at June 30, 2016  599,800   1.70   2.62   5.38 
                 
Granted  176,500   3.09   3.91    
Canceled or Forfeited  (28,666)  2.46   3.14    
                 
Options outstanding at June 30, 2017  747,634   2.00   2.91   5.31 
Options exercisable at June 30, 2017  584,469   1.80   2.76   4.35 

Thetheir aggregate intrinsic value was $2,244,000. Outstanding at June 30, 2022 were 502,084 stock options issued to employees, of which 429,888 were vested and exercisable and had an aggregate intrinsic value of options outstanding was $1,961,000 and options exercisable were $1,621,000 at June 30, 2017. There were no options exercised during the years ended June 30, 2017 and 2016.$2,244,000.

Options issued in conjunction with the initial public offering: In connection with the Company’s 2010 initial public offering and the exercise of the underwriter’s over-allotment option, the Company issued to the underwriter options to purchase up to 190,000 additional shares of the Company’s common stock at a price of $4.80 per share. These options became exercisable in August 2011 and expired in August 2015.

F-17


Warrants issued with convertible debt: In years prior to fiscal 2010, the Company issued convertible notes payable to certain individual creditors. In conjunction with the issuance of these convertible notes, creditors also received warrants to purchase common stock at an exercise price of $3.00 per share. The Company had approximately 44,000 warrants that were outstanding and exercisable at an exercise price of $3.00 per share which expired in September 2015. At June 30, 2017, there were no warrants outstanding and there were none exercised during the years ended June 30, 2017 and 2016.

Restricted stock: The 20142017 Plan permits the Personnel and Compensation Committee of the Board of Directors to grant other stock-based awards.awards, including shares of restricted stock. The Company makes restricted stock grants to key employees and non-employee directors that vest over six months to three years.years following the applicable grant date.

The Company issued restricted stock awards to employees totaling 30,00031,400 and 30,756 during each of the years ended June 30, 2017fiscal 2022 and 2016,2021, respectively, with a vesting term of one to three years and a fair value of $3.82$11.48 and $1.80$14.68 per share, respectively. During the years ended June 30, 2017fiscal 2022 and 2016,2021, the Company issued restricted stock awards to directors totaling 13,055 and 23,255 shares of common stock, respectively,18,000 each year, with a vesting term of six months and a fair value of $3.83$12.09 and $2.15$9.94 per share for fiscal 2022 and 2021,respectively. Restricted stock transactions during the years ended June 30, 20172022 and 20162021 are summarized as follows:

Schedule of restricted stock transactions

 Restricted Stock
Units
  Weighted-
Average Grant
Date Fair Value
per Share
   Shares of
Restricted Stock
 Weighted-Average
Grant Date Fair
Value per Share
 
Outstanding at June 30, 2015      
Outstanding as of June 30, 2020   22,499  $6.19 
Granted  53,255  $1.95    48,756  $12.93 
Vested  (33,256) $2.04    (40,752) $9.47 
Outstanding at June 30, 2016  19,999  $1.80 
Outstanding as of June 30, 2021   30,503  $12.57 
Granted  43,055  $3.82    49,400  $11.70 
Vested  (33,056) $3.21    (45,219) $11.61 
Outstanding at June 30, 2017  29,998  $3.15 
Outstanding as of June 30, 2022   34,684  $12.59 

 

Note 8.          9.        Income Taxes

Components of the provision for income taxes for the years ended June 30, 2017 and 2016 were as follows:

Schedule of components of the provision for income taxes

         
  Years Ended June 30, 
  2022  2021 
Current:        
  Current Federal $891,000  $861,000 
  Current State  290,000   238,000 
    Total Current  1,181,000   1,099,000 
Deferred:        
  Deferred Federal  (348,000)  (204,000)
  Deferred State  (141,000)  (90,000)
    Total Deferred  (489,000)  (294,000)
         
Total Income Tax Expense $692,000  $805,000 

  Years Ended June 30, 
  2017  2016 
Current $1,407,000  $1,173,000 
Deferred  (117,000)  (343,000)
Total $1,290,000  $830,000 

The total income tax expense differed from the expected tax expense, computed by applying the federal statutory rate to the Company’s pretax income, as follows:

Schedule of effective income tax reconciliation

         
  Years Ended June 30, 
  2022  2021 
Tax expense at statutory federal rate $629,000  $665,000 
State income tax expense, net of federal tax effect  105,000   110,000 
Change in valuation allowance on deferred tax assets  27,000   34,000 
Other permanent items  (69,000)  (4,000)
Income tax expense $692,000  $805,000 
         

F-18

 

  Years Ended June 30, 
  2017  2016 
Tax expense at statutory federal rate $1,197,000 $1,034,000 
State income tax expense, net of federal tax effect  131,000   114,000 
Change in valuation allowance on deferred tax assets     (308,000)
Change in uncertain tax positions  (32,000)  (6,000)
Other permanent items  (6,000)  (4,000)
Income tax expense $1,290,000 $830,000 


The effective tax rates for the years ended June 30, 2017fiscal 2022 and 20162021 were 36.7%23.1% and 27.3%25.4%, respectively.

For the year ended June 30, 2017, the Company recorded an income tax expense of $1,290,000. This amount included a current tax expense of $1,439,000, a deferred benefit of $117,000 and a discrete tax benefit of $32,000 as a result of the lapse of the statute of limitations on uncertain tax positions.

For the year ended June 30, 2016, the Company recorded an income tax expense of $830,000. This amount included a current tax expense of $1,179,000, a deferred benefit of $55,000 and a discrete tax benefit of $294,000, due primarily to the Company’s release of the full valuation allowance against all of its net U.S. net federal and state deferred tax assets during the year.

The significant components of deferred income taxes were as follows:

Schedule of significant components of deferred income taxes

         
  June 30, 
  2022  2021 
Deferred tax assets (liabilities):        
Revenue recognition and accounts receivable reserves $917,000  $655,000 
Accrued liabilities  325,000   297,000 
Property and equipment  (246,000)  (218,000)
Finite-life intangible assets  (41,000)  (15,000)
Stock options  532,000   414,000 
Tax credits  152,000   125,000 
Accounting method change     (140,000)
Valuation allowance on deferred taxes  (152,000)  (125,000)
Other  51,000   56,000 
Net deferred tax assets $1,538,000  $1,049,000 

  June 30, 
  2017  2016 
Deferred tax assets (liabilities):        
Revenue recognition and accounts receivable $143,000  $154,000 
Accrued liabilities  280,000   282,000 
Property and equipment  (534,000)  (518,000)
Finite-life intangible assets  6,000   (17,000)
Stock options  443,000   326,000 
Tax credits and net operating loss carryforwards  46,000   43,000 
Other  76,000   73,000 
Net deferred tax assets $460,000  $343,000 

As of June 30, 2017, the Company has state net operating loss carryforwards of $2,000 which, if unused, will expire in calendar 2034. The Company has state tax credit carryforwardscredits of $45,000 and$152,000, net of federal taxes, which if unused, will begin to expire in years 2027 and 2032.

calendar year 2026. The Company assesses whetherhas taken a valuation allowance should be established against its deferred tax assets based on consideration of all available evidence, using a “more likely than not” standard. In assessing the need for a valuation allowance, the Company considered both positive and negative evidence related to the likelihood of realization of deferred tax assets. In making such assessments, more weight was given to evidence that could be objectively verified. Future sources of taxable income considered in determining the amount of recorded valuation allowance included:

Taxable income in prior carryback years, if carryback is permitted under the tax law;
Future reversals of existing taxable temporary differences, excluding those related to indefinite-lived intangible assets;
Tax planning strategies; and
Future taxable income exclusive of reversing temporary differences and carryforwards.

Based on the evaluation of these factors the Companyevaluated all positive and negative evidence, as described above, in determining if the valuation allowance is fairly stated. At December 31, 2015, the Company determined that, based on the profitability it had achieved, historical cumulative profits and estimates of future income, there was sufficient positive evidence to conclude that the likelihood of realization of deferred tax assets outweigh the negative evidence. The full valuation allowance was released,against these credits which resultedrelate to research and development tax credits in Minnesota, a state in which the recognition of $288,000 in net deferred tax assets andCompany has a decrease in income tax expense for the year ended June 30, 2016.low state apportionment factor.


The Company applies the accounting standard for uncertain tax positions pursuant to which a more-likely-than-not threshold is utilized to determine the recognition and derecognition of uncertain tax positions. Once the more-likely-than-not threshold is met, the amount of benefit to be recognized is the largest amount of tax benefit that is greater than 50 percent likely of being ultimately realized upon settlement. It further requires that a change in judgment related to the expected ultimate resolution of uncertain tax positions be recognized in earnings in the period of such a change. The Company does not believe there will be significant changes to the estimates in the next 12 month period. Due to the complexityhave any uncertain tax positions as of some of these uncertainties, the ultimate settlement may result in payments that are different from The Company’s current estimate of tax liabilities, resulting in the recognition of additional charges or benefits to income tax expense.

Changes in the Company’s unrecognized tax benefits were approximately as follows:

  Years Ended June 30, 
  2017  2016 
Beginning balance of unrecognized tax benefits $32,000  $38,000 
Lapse of statute of limitations  (32,000)  (6,000)
Ending balance of unrecognized tax benefits $  $32,000 

The Company recognizes interest and penalties accrued related to unrecognized tax benefits in income tax expense. During the fiscal years ended June 30, 20172022 and 2016, the amount of recognized interest expense, net of tax benefit, and accrued interest on a gross basis was insignificant. June 30, 2021.

The Company is subject to U.S. federal income tax as well as income tax of multiple state jurisdictions. With limited exceptions, tax years prior to the Company’s fiscal 2014year ended June 30, 2019 are no longer open to federal, state and local examination by taxing authorities.

Note 9.          Commitments The Company’s examination by the Internal Revenue Service (the “IRS”) for the fiscal year ended June 30, 2020 is complete and Contingencies and Subsequent Events

Operating leases:the IRS has no findings. The Company is not under any current income tax examinations by any other state or local taxing authority. If any issues addressed in the Company’s tax audits are resolved in a manner not consistent with management’s expectations, the Company could be required to adjust its provision for income taxes in the period such resolution occurs.

Note 10.      Leases

The Company has four leases for office and warehouse space whichand office equipment that require monthly payments that include base rent and the Company’s share of common expenses, including property taxes.payments. These leases have escalating payments ranging from approximately $3,800$200 to $9,900$4,700 per month andwhich expire through July 2019. December 2025 and are recognized on a straight-line basis over the life of the lease. All leases are classified as operating leases which do not include renewal options. The Company currently does not have any short-term or variable lease costs. The Company elected the practical expedient to calculate the present value of the fixed payments without having to perform an allocation to lease and non-lease components.

The Company has a lease for office equipment that requires paymentsrecognized right of approximately $1,500 per month through December 2021. Rent expense for the years ended June 30, 2017use assets associated with its operating leases of $120,000 and 2016, was approximately $175,000 and $164,000, respectively.

Approximate future minimum operating lease payments$88,000 as of June 30, 2017,2022 and June 30, 2021, respectively, which is included in other assets on the Company’s balance sheet. Operating lease liabilities were $120,000 and $87,000 as of June 30, 2022 and June 30, 2021, respectively, which are included in other accrued liabilities and other long-term liabilities on the Company’s balance sheet.

F-19

As of June 30, 2022, the Company has a weighted-average lease term of 1.1 years for its operating leases, which have a weighted-average discount rate of 4.0%. Operating lease payments of $94,000 are included in operating cash flows in fiscal 2022.

Maturities of lease liabilities, which are included in other accrued liabilities and other long-term liabilities on the Balance Sheet, are as follows:

Schedule of maturities of lease liabilities

Fiscal years ending June 30:   
2018 $186,000 
2019  191,000 
2020  18,000 
2021  9,000 
Total $404,000 
Fiscal years ending June 30:    
2023  $81,000 
2024   17,000 
2025   17,000 
2026   9,000 
Total lease payments   124,000 
  Less: Interest   (4,000)
Present value of lease liabilities  $120,000 

 

Note 11.      Commitments and Contingencies

Litigation:The Company mayis occasionally be party to actions, proceedings,involved in claims orand disputes arising in the ordinary course of business. The Company insures itscertain business risks where possible to mitigate the financial impact of individual claims and establishes reserves for an estimate of any probable cost of settlement or other disposition.

On September 8, 2021 a state court putative class action lawsuit was filed in Minnesota against the Company asserting injury resulting from the previously announced data breach that impacted the Company’s customer protected health information and employee personal information and seeking compensatory damages, equitable relief, and attorneys’ fees and costs. On October 6, 2021, the proceeding was removed to the District of Minnesota. The Company believes the plaintiff was not injured as a result of the data privacy incident, and, as a result, the claims are without merit. Accordingly, on November 11, 2021, the Company moved to dismiss the complaint in its entirety. Prior to the hearing on the motion to dismiss, the parties agreed in principal to settle the case. The parties are continuing to negotiate the settlement agreement and expect to submit a motion to settle the class action in the near future. If the parties are unable to agree to the settlement terms or, if the Court does not grant the motion for settlement, the Company will continue to vigorously defend the lawsuit; however, at this time, the Company is unable to determine the ultimate outcome or potential exposure to loss, if any.

401(k) Profit Sharing Plan: The Company has an employee benefit plan under Section 401(k) of the Internal Revenue Code covering all employees who are 21 years of age or older and have at least 1,000 hours of service with the Company. The Company matches each employee’s salary reduction contribution, not to exceed four percent of annual compensation. Total employer contributions to this plan for the years ended June 30, 2017fiscal 2022 and 2016,2021 were approximately $248,000$461,000 and $195,000,$399,000, respectively.

Employment Agreements:The Company has entered into formal employment agreements with its President and Chief Executive Officer, its Interim Chief Financial Officer, and its Chief Financial Officer.Commercial Officer, as amended from time to time. These agreements provide thethese officers with, among other things, one yeartwelve to eighteen months of base salary upon a termination without cause“Cause” or in the event the employee resigns for good reason“Good Reason” or within sixtwelve months of a change“Change in control.Control,” as such terms are defined in the respective employment agreements.

Note 12.      Related Parties

The Company uses a parts supplier whose founder and president was a director of the Company through November 12, 2021. The Company made payments to the supplier of $360,000 and $1,000 during fiscal year 2022 and 2021, respectively. Amounts due to the supplier at June 30, 2022 were $160,000, which were included in accounts payable on the Balance Sheets. There was no amount due to the supplier at June 30, 2021.


F-20

Note 13.      Subsequent Events

The Company evaluates, as of each reporting period, events or transactions that occur after the balance sheet date through the date the financial statements are issued for either disclosure or adjustment to the Company’s financial results. Except as described below, there have been no events subsequent to June 30, 2022 which would require recognition in the Financial Statements or Notes to the Financial Statements.

Michael J. MacCourt, the Company’s former Chief Financial Officer, Treasurer and Secretary, ceased to serve in those positions effective July 1, 2022 at which time the Company terminated its formal employment agreement with Mr. MacCourt.

F-21

Item 9.Changes in and Disagreements With Accountants on Accounting and Financial Disclosure.

Item 9. Changes in and Disagreements With Accountants on Accounting and Financial Disclosure.None.

None.

Item 9A.Controls and Procedures.

Item 9A. Controls and Procedures.

Evaluation of Disclosure Controls and Procedures

Our principal executive officer and principal financial officer evaluated the effectiveness of our disclosure controls and procedures, as defined in Rule 13a-15(e) and Rule 15d-15(e) of the Exchange Act, as of the end of the period subject to this Annual Report ifon Form 10-K. Based on this evaluation, our principal executive officer and principal financial officer concluded that our disclosure controls and procedures were effective.

Management’s Report on Internal Control over Financial Reporting

Our management is responsible for establishing and maintaining adequate internal control over financial reporting, as such term is defined in Rules 13a-15(f) and 15d-15(f) of the Exchange Act. Internal control over financial reporting refers to the process designed by, or under the supervision of, our President and Chief Executive Officer and our Chief Financial Officer, and effected by our Board of Directors, management and other personnel, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles, and includes those policies and procedures that:

(1) Pertain to the maintenance of records that in reasonable detail accurately and fairly reflect the transactions and dispositions of our assets;

(2) Provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that our receipts and expenditures are being made only in accordance with authorization of our management and directors; and

(3) Provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of our assets that could have a material effect on the financial statements.

Because of its inherent limitations, internal control over financial reporting cannot provide absolute assurance of preventing and detecting misstatements on a timely basis. It is possible to design into the process safeguards to reduce, though not eliminate, the risk that misstatements are not prevented or detected on a timely basis. Management is responsible for establishing and maintaining adequate internal control over financial reporting for the Company.

Our management conducted an evaluation of the effectiveness of our internal control over financial reporting based on the framework set forth in the report entitled Internal Control-Integrated Framework published by the Committee of Sponsoring Organizations of the Treadway Commission (“COSO”) in 1992.2013. Based on this assessment, management has concluded that, as of June 30, 2017,2022, our internal control over financial reporting was effective.

This Annual Report on Form 10-K does not include an attestation report of our independent registered public accounting firm regarding internal control over financial reporting. Management’s report was not subject to attestation by the Company’s independent registered public accounting firm pursuant to Section 989Gthe rules of the Dodd-Frank Wall Street Reform and Consumer Protection Act, which exemptsSEC that exempt smaller reporting companies from the auditor attestation requirement.

Changes in Internal Control Over Financial Reporting

There were no changes in our internal control over financial reporting that occurred during the fourth quarter of fiscal 20172022 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.


Item 9B.Other Information.

Item 9B. Other Information.None.

None.

23

Item 9C.Disclosure Regarding Foreign Jurisdictions that Prevent Inspections.

Not applicable.

PART III

Certain information required by Part III is incorporated by reference from our definitive Proxy Statement for the Fiscal 2023 Annual Meeting of Shareholders (the “Proxy Statement”). Except for those portions specifically incorporated in this Annual Report on Form 10-K by reference to the Proxy Statement, no other portions of the Proxy Statement are deemed to be filed as part of this Annual Report on Form 10-K.

Item 10.Directors, Executive Officers and Corporate Governance.

Item 10. Directors,Information about our Executive Officers

The following sets forth certain information about our current executive officers:

Kathleen S. Skarvan, age 66, joined Electromed in December 2012 as Chief Executive Officer, became a director in November 2013 and was appointed to the additional position of President in August 2015. Ms. Skarvan served as Vice President of Operations at OEM Fabricators from November 2011 until October 2012. Prior to her position with OEM Fabricators, Ms. Skarvan served in various roles at Hutchinson Technology Incorporated, most recently as the President of the Disk Drive Components Division from April 2007 until March 2011. As President of the Disk Drive Components Division, Ms. Skarvan managed a public company division with annual revenues in excess of $300 million. Ms. Skarvan also served as a Senior Vice President of Hutchinson Technology Incorporated from December 2010 to March 2011, and as Vice President of Sales & Marketing of the Disk Drive Components Division from October 2003 until April 2007. She has served on the Board of Trustees of the St. Cloud State University Foundation since June 2015. Ms. Skarvan has a bachelor’s degree from St. Cloud State University.

Michelle C. Wirtz, age 39, joined Electromed in December 2021 as the Company’s Corporate Governance.Controller and has served as Electromed’s Interim Chief Financial Officer, Treasurer and Secretary, since June 1, 2022. Prior to joining Electromed, she served as Corporate Controller at Icario, Inc. from June 2018 to December 2021. She was a senior consultant at Salo LLC from 2016 to June 2018. She began her career in accounting, serving in various roles focused on the life sciences industry at McGladrey & Pullen LLP (now RSM US LLP) and Ernst & Young Global Limited. Ms. Wirtz graduated from North Dakota State University with a degree in Accounting and holds an active Certified Public Accountant (CPA) license in the State of Minnesota.

Christopher G. Holland, age 53, joined Electromed in February 2022 as the Company’s Chief Commercial Officer. Prior to joining Electromed, Mr. Holland was the Vice President of Commercialization at Prosomnus Sleep Technologies, Inc., a Medical Device manufacturer of a mandibular advancement device for sleep apnea where he led new product introduction and revenue-growth initiatives across the enterprise, from August 2021 to February 2022. Prior to his time at Prosomnus, from 2008 to 2020, Mr. Holland served in various positions at Nonin Medical, Inc., a producer of noninvasive pulse oximeters, regional oximeters, and capnographs, including most recently as Executive Vice President, Sales & Global Development from January 2019 to July 2020, and as Chief Commercial Officer and Senior Vice President Global Sales, Marketing, Business Development from 2015 to July 2020 Earlier in his career, Holland held various leadership roles at Cisco Systems and PriceWaterhouseCoopers. Mr. Holland graduated from Minnesota State University with a degree in Computer Science/Math (minor) and obtained a Master in Business Administration (MBA) with Distinction from Jack Welch Management Institute – Strayer University.

Code of Ethics

Our Board annually reviews and approves revisions to our Code of Ethics and Business Conduct (the “Code of Ethics”) that applies to all employees, directors, and officers, including the Chief Executive Officer and the Chief Financial Officer (Principal Financial Officer and Principal Accounting Officer). The Code of Ethics was updated in May 2020 and is available in the “Investor Relations” section of our website at www.smartvest.com. We intend to disclose on our website any amendment to or waiver from any provision of the Code of Ethics that applies to our Chief Executive Officer or our Chief Financial Officer (Principal Financial Officer and Principal Accounting Officer), and that relates to any element of the Code of Ethics identified in Item 406(b) of Regulation S-K, as promulgated by the SEC. Such disclosure will be provided promptly following the date of the amendment or waiver.

24

The additional information required by this item is incorporated herein by reference to the sections labeled “Election of Directors,” “Corporate Governance,” “Compliance With“and “Security Ownership Certain Beneficial Owners and Management” and, if any, under “Delinquent Section 16(a) ofReports” in the Exchange Act,” and “Security Ownership of Principal Shareholders, Directors and Management” in our definitive proxy statement for our Fiscal 2018 Annual Meeting of Shareholders.Proxy Statement.

Item 11.Executive Compensation.

Item 11. Executive Compensation.

The information required by this item is incorporated herein by reference to the sections labeled “Executive Compensation,” “Director Compensation,” and “Corporate Governance – Personnel and Compensation Committee” in our definitive proxy statement for our Fiscal 2018 Annual Meeting of Shareholders.the Proxy Statement.

Item 12.Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters.

Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters.

The information required by this item relating to the security ownership of certain holders is incorporated herein by reference to the sections labeled “Security Ownership of Principal Shareholders, DirectorsCertain Beneficial Owners and Management” and “Equity Compensation Plan Information” in our definitive proxy statement for our Fiscal 2018 Annual Meeting of Shareholders.the Proxy Statement.

Item 13.Certain Relationships and Related Transactions, and Director Independence.

Item 13. Certain Relationships and Related Transactions, and Director Independence.

The information required by this item is incorporated herein by reference to the sections labeled “Corporate Governance–Independence” and “Certain Transactions and Business Relationships”“Related Person Transaction Approval Policy” in our definitive proxy statement for our Fiscal 2018 Annual Meeting of Shareholders.the Proxy Statement.

Item 14.Principal Accountant Fees and Services.

Item 14. Principal Accountant Fees and Services.Our independent registered public accounting firm is RSM US LLP, Rochester, MN, Auditor firm ID: 49.

The information required by this item is incorporated herein by reference to the section labeled “Ratification of the Appointment of the Company’sCompany's Independent Registered Public Accounting Firm - Audit Fees” in our definitive proxy statement for our Fiscal 2018 Annual Meeting of Shareholders.the Proxy Statement.

PART IV

Item 15.Exhibits and Financial Statement Schedules.

Item 15. Exhibits and Financial Statement Schedules.

(a)Documents filed as part of this report.

(1)Financial Statements. The following financial statements are included in Part II, Item 8 of this Annual Report on Form 10-K:

Report of Independent Registered Public Accounting Firm

Balance Sheets as of June 30, 20172022 and 20162021

Statements of Operations for the years ended June 30, 20172022 and 20162021

Statements of Shareholders’ Equity for the years ended June 30, 20172022 and 20162021

Statements of Cash Flows for the years ended June 30, 20172022 and 20162021

Notes to Financial Statements

(2)Financial Statement Schedules. No financial statement schedule is required to be included in this Annual Report on Form 10-K.


25

Exhibit Number(3)Exhibits. See theDescriptionMethod of Filing
3.1Composite Articles of Incorporation, as amended through November 8, 2010 (incorporated by reference to Exhibit Index following the signature page of this3.1 to Annual Report on Form 10-K.10-K for the fiscal year ended June 30, 2015)Incorporated by Reference
3.2Amended and Restated Bylaws, effective September 29, 2020 (incorporated by reference to Exhibit 3.1 to Current Report on Form 8-K filed September 29, 2020)Incorporated by Reference
4.1Description of Securities (incorporated by reference to Exhibit 4.1 to Annual Report on Form 10-K for the fiscal year ended June 30, 2019)Incorporated by Reference
10.1Electromed, Inc. 2012 Stock Incentive Plan (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed November 15, 2011)*Incorporated by Reference
10.2Form of Stock Option Award Agreement under the Electromed, Inc. 2012 Stock Incentive Plan (incorporated by reference to Exhibit 10.4 to Quarterly Report on Form 10-Q for the quarter ended December 31, 2011)*Incorporated by Reference
10.3Electromed, Inc. 2014 Equity Incentive Plan (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed November 25, 2014)*Incorporated by Reference
10.4Form of Incentive Stock Option Agreement under the Electromed, Inc. 2014 Equity Incentive Plan (incorporated by reference to Exhibit 10.2 to Current Report on Form 8-K filed November 25, 2014)*Incorporated by Reference
10.5Form of Nonqualified Stock Option Agreement under the Electromed, Inc. 2014 Equity Incentive Plan (incorporated by reference to Exhibit 10.3 to Current Report on Form 8-K filed November 25, 2014)*Incorporated by Reference
10.6Form of Restricted Stock Agreement under the Electromed, Inc. 2014 Equity Incentive Plan (incorporated by reference to Exhibit 10.4 to Current Report on Form 8-K filed November 25, 2014)*Incorporated by Reference
10.7Electromed, Inc. 2017 Omnibus Incentive Plan (incorporated by reference to Exhibit 99.1 to Registration Statement on Form S-8 filed December 4, 2017)*Incorporated by Reference
10.8Form of Restricted Award Agreement under the 2017 Omnibus Incentive Plan (incorporated by reference to Exhibit 10.11 to Annual Report on Form 10-K for the fiscal year ended June 30, 2018)*Incorporated by Reference
10.9Form of Non-Qualified Option Agreement under the 2017 Omnibus Incentive Plan (incorporated by reference to Exhibit 10.1 to Quarterly Report on Form 10-Q for the quarter ended March 31, 2019)*Incorporated by Reference
10.10Form of Restricted Stock Agreement (Non-Employee Directors) under the 2017 Omnibus Incentive Plan (incorporated by reference to Exhibit 10.13 to Annual Report on Form 10-K for the fiscal year ended June 30, 2018)*Incorporated by Reference
10.11Non-Competition, Non-Solicitation and Confidentiality Agreement with Kathleen S. Skarvan dated effective December 1, 2012 (incorporated by reference to Exhibit 10.2 to the Current Report on Form 8-K filed December 3, 2012)*Incorporated by Reference
10.12Non-Competition, Non-Solicitation and Confidentiality Agreement with Michelle C. Wirtz dated effective December 20, 2021*Filed electronically
10.13Non-Competition, Non-Solicitation and Confidentiality Agreement with Christopher G. Holland dated effective February 16, 2022*Filed electronically
10.14Amended and Restated Employment Agreement with Kathleen S. Skarvan dated as of December 2, 2019 (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed December 6, 2019)*Incorporated by Reference
10.15Employment Agreement with Michelle C. Wirtz dated February 21, 2022 (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed June 7, 2022)*Incorporated by Reference

26

Exhibit NumberDescriptionMethod of Filing
10.16Amendment to Employment Agreement with Michelle C. Wirtz, dated June 1, 2022 (incorporated by reference to Exhibit 10.2 to Current Report on Form 8-K filed June 7, 2022)*Incorporated by Reference
10.17Employment Agreement with Christopher G. Holland dated February 16, 2022 (incorporated by reference to Exhibit 10.1 to Quarterly Report on Form 10-Q filed May 10, 2022)*Incorporated by Reference
10.18Business Loan Agreement with Choice Financial Group, dated December 18, 2019 (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed December 17, 2019)Incorporated by Reference
10.19Rider to Business Loan Agreement (Asset Based) with Choice Financial Group, dated December 18, 2019 (incorporated by reference to Exhibit 10.2 to Current Report on Form 8-K filed December 17, 2019)Incorporated by Reference
10.20Rider to Business Loan Agreement (Asset Based) with Choice Financial Group, dated December 16, 2020 (incorporated by reference to Exhibit 10.2 to Current Report on Form 8-K filed December 17, 2020)Incorporated by Reference
10.21Rider to Business Loan Agreement (Asset Based) with Choice Financial Group, Dated December 17, 2021 (incorporated by reference to Exhibit 10. 1 to Current Report on 8-K filed December 17, 2021)Incorporated by Reference
10.22Cooperation Agreement, dated July 25, 2022, by and among Electromed, Inc. and Summers Value Partners LLC and certain of its affiliates signatory thereto (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed July 25, 2022)Incorporated by Reference
10.23Description of Fiscal Year 2022 Officer Bonus Plan (incorporated by reference to Exhibit 10.17 to Annual Report on Form 10-K for the fiscal year ended June 30, 2021)*Incorporated by Reference
10.24Description of Fiscal Year 2023 Officer Bonus Plan*Filed Electronically
23.1Consent of Independent Registered Public Accounting FirmFiled Electronically
24.1Powers of AttorneyFiled Electronically
31.1Certification Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002Filed Electronically
31.2Certification Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002Filed Electronically
32.1Certification Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002Furnished Electronically
32.2Certification Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002Furnished Electronically
101.CALXBRL Taxonomy Extension Calculation LinkbaseFiled Electronically
101.DEFXBRL Taxonomy Extension Definition LinkbaseFiled Electronically
101.INSXBRL Instance DocumentFiled Electronically
101.LABXBRL Taxonomy Extension Label LinkbaseFiled Electronically
101.PREXBRL Taxonomy Extension Presentation LinkbaseFiled Electronically
101.SCHXBRL Taxonomy Extension SchemaFiled Electronically
104Cover Page Interactive Data File (embedded within the inline XBRL Document)Filed electronically

*Management compensatory contract or arrangement.

Item 16.Form 10-K Summary.

Item 16. Form 10-K Summary.None.

27

SIGNATURES

None.


SIGNATURES

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.

ELECTROMED, INC.
Date: August 23, 2022By
Date: September 5, 2017By /s/ Kathleen S. Skarvan

Kathleen S. Skarvan

President and Chief Executive Officer

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the registrant and in the capacities and on the dates indicated. 

SignatureTitleDate
/s/ Kathleen S. SkarvanPresident, Chief Executive Officer and DirectorSeptember 5, 2017August 23, 2022
Kathleen S. Skarvan(principal executive officer)
/s/ Jeremy T. BrockMichelle C. WirtzInterim Chief Financial OfficerSeptember 5, 2017August 23, 2022
Jeremy T. BrockMichelle C. Wirtz(principal financial and accounting officer)
*Chairman and DirectorSeptember 5, 2017August 23, 2022
Stephen H. CraneyLee A. Jones
*DirectorSeptember 5, 2017August 23, 2022
William V. Eckles
*DirectorSeptember 5, 2017
Stan K. Erickson
*DirectorSeptember 5, 2017August 23, 2022
Lee A. JonesGregory J. Fluet
*Vice Chairman and DirectorSeptember 5, 2017August 23, 2022
George H. WinnJoseph L. Galatowitsch
*DirectorAugust 23, 2022
Andrea M. Walsh
*DirectorAugust 23, 2022
Kathleen A. Tune
*DirectorAugust 23, 2022
Andrew J. Summers

*The undersigned, by signing her name hereto, does hereby sign this document on behalf of each of the above-named directors of the registrant pursuant to powers of attorney duly executed by such persons.

By /s/ Kathleen S. Skarvan
Kathleen S. Skarvan
Attorney-in-Fact

EXHIBIT INDEX
ELECTROMED, INC.
FORM 10-K

Unless otherwise indicated, all documents incorporated into this Annual Report on Form 10-K by reference to a document filed with the SEC pursuant to the Exchange Act are located under SEC file number 001-34839.

Exhibit
Number
DescriptionMethod of Filing
3.1Composite Articles of Incorporation, as amended through November 8, 2010 (incorporated by reference to Exhibit 3.1 to Annual Report on Form 10-K for the fiscal year ended June 30, 2015)Incorporated by Reference
3.2Composite Bylaws, as amended through June 30, 2012 (incorporated by reference to Exhibit 3.2 to Annual Report on Form 10-K for the fiscal year ended June 30, 2015)Incorporated by Reference
10.1Form of warrant issued to investors (incorporated by reference to Exhibit 4.2 to Registration Statement on Form S-1, filed May 3, 2010 (Reg. No. 333-166470))Incorporated by Reference
10.2Form of warrant issued to employees and service providers (incorporated by reference to Exhibit 4.2 to Registration Statement on Form S-1 filed May 3, 2010 (Reg. No. 333-166470))Incorporated by Reference
10.3Form of warrant issued in connection with issuance of 7% Senior Secured Convertible Notes (incorporated by reference to Exhibit 4.4 to the Registration Statement on Form S-1 filed May 3, 2010 (Reg. No. 333-166470))Incorporated by Reference
10.4Electromed, Inc. 2012 Stock Incentive Plan (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed November 15, 2011)*Incorporated by Reference
10.5Form of Stock Option Award Agreement under the Electromed, Inc. 2012 Stock Incentive Plan (incorporated by reference to Exhibit 10.4 to Quarterly Report on Form 10-Q for the quarter ended December 31, 2011)*Incorporated by Reference
10.6Electromed, Inc. 2014 Equity Incentive Plan (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed November 24, 2014)*Incorporated by Reference
10.7Form of Incentive Stock Option Agreement under the Electromed, Inc. 2014 Equity Incentive Plan (incorporated by reference to Exhibit 10.2 to Current Report on Form 8-K filed November 24, 2014)*Incorporated by Reference
10.8Form of Nonqualified Stock Option Agreement under the Electromed, Inc. 2014 Equity Incentive Plan (incorporated by reference to Exhibit 10.3 to Current Report on Form 8-K filed November 24, 2014)*Incorporated by Reference
10.9Form of Restricted Stock Agreement under the Electromed, Inc. 2014 Equity Incentive Plan (incorporated by reference to Exhibit 10.4 to Current Report on Form 8-K filed November 24, 2014)*Incorporated by Reference
10.10Form of Restricted Stock Unit Agreement under the Electromed, Inc. 2014 Equity Incentive Plan (incorporated by reference to Exhibit 10.5 to Current Report on Form 8-K filed November 24, 2014)*Incorporated by Reference
10.11Non-Competition, Non-Solicitation and Confidentiality Agreement with Kathleen Skarvan dated effective December 1, 2012 (incorporated by reference to Exhibit 10.2 to the Current Report on Form 8-K filed December 3, 2012)*Incorporated by Reference


28

Exhibit
Number
DescriptionMethod of Filing
10.12Non-Competition, Non-Solicitation, and Confidentiality Agreement with Jeremy Brock dated as of October 18, 2011 (incorporated by reference to Exhibit 10.2 to Current Report on Form 8-K filed October 19, 2011)*Incorporated by Reference
10.13Amended and Restated Employment Agreement with Kathleen Skarvan dated as of July 1, 2014 (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed July 15, 2014)*Incorporated by Reference
10.14Amended and Restated Employment Agreement with Jeremy Brock dated as of July 1, 2014 (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed July 15, 2014)*Incorporated by Reference
10.15Mediated Settlement Agreement with Robert D. Hansen dated September 6, 2013 (incorporated by reference to Exhibit 10.46 to Annual Report on Form 10-K for the year ended June 30, 2013)Incorporated by Reference
10.16Settlement Agreement and Release with Eileen M. Manning dated September 23, 2013 (incorporated by reference to Exhibit 10.47 to Annual Report on Form 10-K for the year ended June 30, 2013)Incorporated by Reference
10.17Business Loan Agreement (Asset Based) with Venture Bank, dated December 18, 2016 (incorporated by reference to Exhibit 10.1 to Current Report on Form 8-K filed December 16, 2016)Incorporated by Reference
10.18Rider to Business Loan Agreement (Asset Based) with Venture Bank, dated December 18, 2016 (incorporated by reference to Exhibit 10.2 to Current Report on Form 8-K filed December 16, 2016)Incorporated by Reference
10.19Change in Terms Agreement with Venture Bank, dated December 18, 2016 (incorporated by reference to Exhibit 10.3 to Current Report on Form 8-K filed December 16, 2016)Incorporated by Reference
10.20Business Loan Agreement with Venture Bank, dated December 18, 2016 (incorporated by reference to Exhibit 10.4 to Current Report on Form 8-K filed December 16, 2016)Incorporated by Reference
10.21Rider to Business Loan Agreement with Venture Bank, dated December 18, 2016 (incorporated by reference to Exhibit 10.5 to Current Report on Form 8-K filed December 16, 2016)Incorporated by Reference
10.22Change in Terms Agreement with Venture Bank, dated December 18, 2016 (incorporated by reference to Exhibit 10.6 to Current Report on Form 8-K filed December 16, 2016)Incorporated by Reference
10.23Description of Fiscal Year 2016 Officer Bonus Plan (incorporated by reference to Exhibit 10.1 to Quarterly Report on Form 10-Q for the quarter ended September 30, 2015)*Incorporated by Reference
23.1Consent of Independent Registered Public Accounting FirmFiled Electronically
24.1Powers of AttorneyFiled Electronically
31.1Certification Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002Filed Electronically
31.2Certification Pursuant to Section 302of the Sarbanes-Oxley Act of 2002Filed Electronically
32.1Certification Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002Filed Electronically
32.2Certification Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002Filed Electronically
101.CALXBRL Taxonomy Extension Calculation LinkbaseFiled Electronically
101.DEFXBRL Taxonomy Extension Definition LinkbaseFiled Electronically
101.INSXBRL Instance DocumentFiled Electronically
101.LABXBRL Taxonomy Extension Label LinkbaseFiled Electronically
101.PREXBRL Taxonomy Extension Presentation LinkbaseFiled Electronically
101.SCHXBRL Taxonomy Extension SchemaFiled Electronically

*Management compensatory contract or arrangement.