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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
 
FORM 10-Q
 
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 20212022
 
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from                     to                     
Commission file number: 000-33001
 
NATUS MEDICAL INCORPORATED
(Exact name of registrant as specified in its charter)
 
 
Delaware 77-0154833
(State or other jurisdiction of
incorporation or organization)
 (I.R.S. Employer
Identification No.)
6701 Koll Center Parkway, Suite 120, Pleasanton, CA 945663150 Pleasant View Road, Middleton, WI 53562
(Address of principal executive offices) (Zip Code)
(925) 223-6700(608) 829-8500
(Registrant’s telephone number, including area code)

Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $0.001 par value per shareNTUSThe Nasdaq Stock Market LLC
(The Nasdaq Global Market)

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 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 every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes      No  
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” or an “emerging growth company” in Rule 12b-2 of the Exchange Act.:
Large Accelerated Filer   Accelerated Filer 
Non-accelerated Filer 
  
  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 is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes      No  
The number of issued and outstanding shares of the registrant’s Common Stock, $0.001 par value, as of April 30, 202129, 2022 was 34,078,41234,585,114.


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PART I.    FINANCIAL INFORMATION
Item 1.    Financial Statements
NATUS MEDICAL INCORPORATED AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
(unaudited)
(in thousands, except share and per share amounts)
March 31, 2021December 31, 2020March 31, 2022December 31, 2021
ASSETSASSETSASSETS
Current assets:Current assets:Current assets:
Cash and cash equivalentsCash and cash equivalents$80,549 $82,082 Cash and cash equivalents$84,285 $75,595 
Accounts receivable, net of allowance for doubtful accounts of $6,085 in 2021 and $6,213 in 202091,326 93,133 
Accounts receivable, net of allowance for doubtful accounts of $4,977 in 2022 and $5,271 in 2021Accounts receivable, net of allowance for doubtful accounts of $4,977 in 2022 and $5,271 in 2021103,714 111,760 
InventoriesInventories69,467 75,650 Inventories72,238 67,745 
Prepaid expenses and other current assetsPrepaid expenses and other current assets24,477 20,837 Prepaid expenses and other current assets26,531 22,191 
Total current assetsTotal current assets265,819 271,702 Total current assets286,768 277,291 
Property and equipment, netProperty and equipment, net23,282 24,516 Property and equipment, net21,391 21,783 
Operating lease right-of-use assetsOperating lease right-of-use assets10,776 11,669 Operating lease right-of-use assets8,027 9,288 
Intangible assets, netIntangible assets, net85,001 92,741 Intangible assets, net59,815 65,513 
GoodwillGoodwill149,761 151,299 Goodwill148,304 148,657 
Deferred income taxDeferred income tax26,321 27,563 Deferred income tax23,548 23,161 
Other assetsOther assets20,408 20,904 Other assets20,230 18,595 
Total assetsTotal assets$581,368 $600,394 Total assets$568,083 $564,288 
LIABILITIES AND STOCKHOLDERS’ EQUITYLIABILITIES AND STOCKHOLDERS’ EQUITYLIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:Current liabilities:Current liabilities:
Accounts payableAccounts payable$24,486 $23,429 Accounts payable$34,342 $36,405 
Current portion of long-term debt36,523 50,000 
Accrued liabilitiesAccrued liabilities45,792 44,236 Accrued liabilities47,185 48,135 
Deferred revenueDeferred revenue23,669 21,308 Deferred revenue26,846 25,097 
Current portion of operating lease liabilitiesCurrent portion of operating lease liabilities6,006 6,779 Current portion of operating lease liabilities4,482 4,964 
Total current liabilitiesTotal current liabilities136,476 145,752 Total current liabilities112,855 114,601 
Other liabilitiesOther liabilities17,864 18,451 Other liabilities17,128 17,237 
Operating lease liabilitiesOperating lease liabilities8,181 8,959 Operating lease liabilities5,755 6,567 
Long-term debt, net of current portion5,840 
Deferred income taxDeferred income tax9,915 10,298 Deferred income tax1,451 1,133 
Total liabilitiesTotal liabilities172,436 189,300 Total liabilities137,189 139,538 
Stockholders’ equity:Stockholders’ equity:Stockholders’ equity:
Common stock, $0.001 par value, 120,000,000 shares authorized; shares issued and outstanding 34,096,895 in 2021 and 33,911,703 in 2020344,696 342,828 
Preferred stock, $0.001 par value; 10,000,000 shares authorized; 0 shares issued and outstanding in 2021 and 2020
Common stock, $0.001 par value, 120,000,000 shares authorized; shares issued and outstanding 34,576,100 in 2022 and 34,225,682 in 2021Common stock, $0.001 par value, 120,000,000 shares authorized; shares issued and outstanding 34,576,100 in 2022 and 34,225,682 in 2021359,319 353,737 
Preferred stock, $0.001 par value; 10,000,000 shares authorized; no shares issued and outstanding in 2022 and 2021Preferred stock, $0.001 par value; 10,000,000 shares authorized; no shares issued and outstanding in 2022 and 2021— — 
Retained earningsRetained earnings73,705 71,309 Retained earnings86,389 84,486 
Accumulated other comprehensive lossAccumulated other comprehensive loss(9,469)(3,043)Accumulated other comprehensive loss(14,814)(13,473)
Total stockholders’ equityTotal stockholders’ equity408,932 411,094 Total stockholders’ equity430,894 424,750 
Total liabilities and stockholders’ equityTotal liabilities and stockholders’ equity$581,368 $600,394 Total liabilities and stockholders’ equity$568,083 $564,288 
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
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NATUS MEDICAL INCORPORATED AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(unaudited)
(in thousands, except per share amounts)
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020 20222021
RevenueRevenue$114,927 $109,383 Revenue$119,793 $114,927 
Cost of revenueCost of revenue46,688 44,933 Cost of revenue52,781 46,688 
Intangibles amortizationIntangibles amortization1,751 1,668 Intangibles amortization1,600 1,751 
Gross profitGross profit66,488 62,782 Gross profit65,412 66,488 
Operating expenses:Operating expenses:Operating expenses:
Marketing and sellingMarketing and selling28,971 30,730 Marketing and selling29,551 28,971 
Research and developmentResearch and development14,040 17,569 Research and development13,224 14,040 
General and administrativeGeneral and administrative14,855 13,182 General and administrative12,807 14,855 
Intangibles amortizationIntangibles amortization3,897 3,661 Intangibles amortization3,598 3,897 
RestructuringRestructuring205 871 Restructuring2,051 205 
Total operating expensesTotal operating expenses61,968 66,013 Total operating expenses61,231 61,968 
Income (loss) from operations4,520 (3,231)
Income from operationsIncome from operations4,181 4,520 
Other expense, netOther expense, net(1,656)(1,494)Other expense, net(807)(1,656)
Income (loss) before benefit from income tax2,864 (4,725)
Provision for (benefit from) income taxes468 (1,128)
Net income (loss)$2,396 $(3,597)
Net income (loss) per share:
Income before provision for income taxIncome before provision for income tax3,374 2,864 
Provision for income taxesProvision for income taxes1,471 468 
Net incomeNet income$1,903 $2,396 
Net income per share:Net income per share:
BasicBasic$0.07 $(0.11)Basic$0.06 $0.07 
DilutedDiluted$0.07 $(0.11)Diluted$0.06 $0.07 
Weighted average shares used in the calculation of net income (loss) per share:
Weighted average shares used in the calculation of net income per share:Weighted average shares used in the calculation of net income per share:
BasicBasic33,611 33,800 Basic34,119 33,611 
DilutedDiluted33,782 33,800 Diluted34,276 33,782 
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
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NATUS MEDICAL INCORPORATED AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS)
(unaudited)
(in thousands, except per share amounts)
 Three Months Ended
March 31,
 20212020
Net income (loss)$2,396 $(3,597)
Other comprehensive loss, net of tax:
Foreign currency translation adjustment(6,494)(4,018)
Interest rate swap designated as a cash flow hedge68 (175)
Other comprehensive loss, net of tax(6,426)(4,193)
Comprehensive loss(4,030)(7,790)
 Three Months Ended
March 31,
 20222021
Net income$1,903 $2,396 
Other comprehensive income (loss), net of tax:
Foreign currency translation adjustment(1,341)(6,494)
Interest rate swap designated as a cash flow hedge— 68 
Other comprehensive income (loss), net of tax(1,341)(6,426)
Comprehensive income (loss)$562 $(4,030)
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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NATUS MEDICAL INCORPORATED AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENT OF STOCKHOLDERS' EQUITY
(unaudited)
(in thousands, except per share amounts)
Common StockRetained
Earnings
Accumulated
Other
Comprehensive
Income (Loss)
Stockholders’
Equity
Common StockRetained
Earnings
Accumulated
Other
Comprehensive
Income (Loss)
Stockholders’
Equity
SharesAmount SharesAmount
Balances, December 31, 202033,911,703 $342,828 $71,309 $(3,043)$411,094 
Balances, December 31, 2021Balances, December 31, 202134,225,682 $353,737 $84,486 $(13,473)$424,750 
Vesting of restricted stock unitsVesting of restricted stock units19,650 — — — — Vesting of restricted stock units33,794 — — — — 
Net issuance of restricted stock awardsNet issuance of restricted stock awards222,899 — — — — Net issuance of restricted stock awards164,760 — — — — 
Stock-based compensation expenseStock-based compensation expense— 3,018 — — 3,018 Stock-based compensation expense— 2,619 — — 2,619 
Taxes paid related to net share settlement of equity awardsTaxes paid related to net share settlement of equity awards(57,357)(1,150)— — (1,150)Taxes paid related to net share settlement of equity awards(51,482)(1,228)— — (1,228)
Exercise of stock optionsExercise of stock options203,346 4,191 — — 4,191 
Other comprehensive lossOther comprehensive loss— — — (6,426)(6,426)Other comprehensive loss— — — (1,341)(1,341)
Net incomeNet income— — 2,396 — 2,396 Net income— — 1,903 — 1,903 
Balances, March 31, 202134,096,895 $344,696 $73,705 $(9,469)$408,932 
Balances, March 31, 2022Balances, March 31, 202234,576,100 $359,319 $86,389 $(14,814)$430,894 

The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

Common StockRetained
Earnings
Accumulated
Other
Comprehensive
Income (Loss)
Stockholders’
Equity
Common StockRetained
Earnings
Accumulated
Other
Comprehensive
Income (Loss)
Stockholders’
Equity
SharesAmount SharesAmount
Balances, December 31, 201934,148,700 $344,476 $87,922 $(16,275)$416,123 
Balances, December 31, 2020Balances, December 31, 202033,911,703 $342,828 $71,309 $(3,043)$411,094 
Vesting of restricted stock unitsVesting of restricted stock units14,033 — — — — Vesting of restricted stock units19,650 — — — — 
Net issuance of restricted stock awardsNet issuance of restricted stock awards162,212 — — — — Net issuance of restricted stock awards222,899 — — — — 
Stock-based compensation expenseStock-based compensation expense— 2,198 — — 2,198 Stock-based compensation expense— 3,018 — — 3,018 
Repurchase of company stock(465,117)(10,495)— — (10,495)
Taxes paid related to net share settlement of equity awardsTaxes paid related to net share settlement of equity awards(57,695)(1,883)— — (1,883)Taxes paid related to net share settlement of equity awards(57,357)(1,150)— — (1,150)
Other comprehensive lossOther comprehensive loss— — — (4,193)(4,193)Other comprehensive loss— — — (6,426)(6,426)
Net lossNet loss— — (3,597)— (3,597)Net loss— — 2,396 — 2,396 
Balances, March 31, 202033,802,133 $334,296 $84,325 $(20,468)$398,153 
Balances, March 31, 2021Balances, March 31, 202134,096,895 $344,696 $73,705 $(9,469)$408,932 
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

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NATUS MEDICAL INCORPORATED AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(unaudited)
(in thousands)
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020 20222021
Operating activities:Operating activities:Operating activities:
Net income (loss)$2,396 $(3,597)
Adjustments to reconcile net loss to net cash provided by operating activities:
Net incomeNet income$1,903 $2,396 
Adjustments to reconcile net income to net cash provided by operating activities:Adjustments to reconcile net income to net cash provided by operating activities:
Provision for losses on accounts receivableProvision for losses on accounts receivable101 522 Provision for losses on accounts receivable87 101 
Depreciation and amortizationDepreciation and amortization7,257 6,994 Depreciation and amortization6,673 7,257 
Loss on disposal of property and equipmentLoss on disposal of property and equipment42 Loss on disposal of property and equipment30 
Warranty reserveWarranty reserve341 704 Warranty reserve1,363 341 
Share-based compensationShare-based compensation3,114 2,291 Share-based compensation2,619 3,114 
Loss on commencement of sales-type leasesLoss on commencement of sales-type leases295 Loss on commencement of sales-type leases— 
Loss on equity method investmentLoss on equity method investment136 Loss on equity method investment192 136 
Changes in operating assets and liabilities:Changes in operating assets and liabilities:Changes in operating assets and liabilities:
Accounts receivableAccounts receivable4,962 15,612 Accounts receivable8,803 4,962 
InventoriesInventories4,139 (3,443)Inventories(6,132)4,139 
Prepaid expenses and other assetsPrepaid expenses and other assets(4,028)(1,060)Prepaid expenses and other assets(4,752)(4,028)
Accounts payableAccounts payable1,303 6,038 Accounts payable(1,957)1,303 
Accrued liabilitiesAccrued liabilities1,172 (9,329)Accrued liabilities(1,762)1,172 
Deferred revenueDeferred revenue2,732 2,190 Deferred revenue1,949 2,732 
Deferred income taxDeferred income tax1,064 103 Deferred income tax(119)1,064 
Net cash provided by operating activitiesNet cash provided by operating activities24,703 17,362 Net cash provided by operating activities8,897 24,703 
Investing activities:Investing activities:Investing activities:
Purchase of property and equipmentPurchase of property and equipment(731)(3,575)Purchase of property and equipment(1,062)(731)
Purchase of equity method investmentsPurchase of equity method investments(572)— 
Net cash used in investing activitiesNet cash used in investing activities(731)(3,575)Net cash used in investing activities(1,634)(731)
Financing activities:Financing activities:Financing activities:
Proceeds from stock option exercises and Employee Stock Purchase Program purchasesProceeds from stock option exercises and Employee Stock Purchase Program purchases4,191 — 
Repurchase of common stock(10,495)
Taxes paid related to net share settlement of equity awardsTaxes paid related to net share settlement of equity awards(1,150)(1,883)Taxes paid related to net share settlement of equity awards(1,228)(1,150)
Principal payments of financing lease liabilityPrincipal payments of financing lease liability(125)(133)Principal payments of financing lease liability(447)(125)
Proceeds from borrowings60,000 
Payments on borrowingsPayments on borrowings(20,000)(15,000)Payments on borrowings— (20,000)
Net cash provided by (used in) financing activitiesNet cash provided by (used in) financing activities(21,275)32,489 Net cash provided by (used in) financing activities2,516 (21,275)
Exchange rate changes effect on cash and cash equivalentsExchange rate changes effect on cash and cash equivalents(4,230)(2,557)Exchange rate changes effect on cash and cash equivalents(1,089)(4,230)
Net increase (decrease) in cash and cash equivalentsNet increase (decrease) in cash and cash equivalents(1,533)43,719 Net increase (decrease) in cash and cash equivalents8,690 (1,533)
Cash and cash equivalents, beginning of periodCash and cash equivalents, beginning of period82,082 63,297 Cash and cash equivalents, beginning of period75,595 82,082 
Cash and cash equivalents, end of periodCash and cash equivalents, end of period$80,549 $107,016 Cash and cash equivalents, end of period$84,285 $80,549 
Supplemental disclosure of cash flow information:Supplemental disclosure of cash flow information:Supplemental disclosure of cash flow information:
Cash paid for interestCash paid for interest$513 $637 Cash paid for interest$114 $513 
Cash paid for income taxesCash paid for income taxes$(320)$3,492 Cash paid for income taxes$1,066 $(320)
Non-cash investing activities:Non-cash investing activities:Non-cash investing activities:
Property and equipment included in accounts payableProperty and equipment included in accounts payable$39 $131 Property and equipment included in accounts payable$32 $39 
Inventory transferred to property and equipmentInventory transferred to property and equipment$94 $196 Inventory transferred to property and equipment$291 $94 
Transfer of leased assets to sales-type leasesTransfer of leased assets to sales-type leases$13 $663 Transfer of leased assets to sales-type leases$— $13 
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.
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NATUS MEDICAL INCORPORATED AND SUBSIDIARIES
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (unaudited)

1 - Basis of Presentation and Significant Accounting Policies
The accompanying interim condensed consolidated financial statements of Natus Medical Incorporated (“we,” “us,” or “our”) have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”). Except where noted below within Note 1, the accounting policies followed in the preparation of the interim condensed consolidated financial statements are consistent in all material respects with those presented in Note 1 to the consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2020.2021.
Interim financial reports are prepared in accordance with the rules and regulations of the Securities and Exchange Commission; accordingly, the reports do not include all of the information and notes required by GAAP for annual financial statements. The interim financial information is unaudited, and reflects all normal adjustments that are, in the opinion of management, necessary for the fair presentation of our financial position, results of operations, and cash flows for the interim periods presented. We have made certain reclassifications to the prior period to conform to current period presentation. The consolidated balance sheet as of December 31, 20202021 was derived from audited financial statements but does not include all disclosures required by GAAP. The accompanying financial statements should be read in conjunction with the financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2020.2021.
Operating results for the three months ended March 31, 20212022 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021.2022. The accompanying condensed consolidated financial statements include our accounts and our wholly owned subsidiaries. All intercompany accounts and transactions have been eliminated in consolidation.
Impact of COVID-19 on Our Financial Statements
The global spread and unprecedented impact of COVID-19 is complex and rapidly-evolving. On March 11, 2020, the World Health Organization declared COVID-19 a global pandemic and recommended extensive containment and mitigation measures worldwide. The outbreak has reached all of the regions in which we do business, and governmental authorities around the world have implemented numerous measures attempting to contain and mitigate the effects of the virus, including travel bans and restrictions, border closings, quarantines, shelter-in-place orders, shutdowns, limitations or closures of non-essential businesses, school closures, and social distancing requirements. The global spread of COVID-19 and actions taken in response to the virus have negatively affected workforces, customers, consumer confidence, financial markets, employment rates, consumer spending, credit markets and housing demand, caused significant economic and business disruption, volatility and financial uncertainty, and led to a significant economic downturn, including in the markets where we operate.
Various government programs have been established to provide financial relief for businesses affected by COVID-19 including the Canada Emergency Wage Subsidy ("CEWS") under the COVID-19 Economic Response Plan in Canada. We received $2.9 million for payroll subsidies under CEWS during the three months ended March 31, 2021. Our policy is to account for these subsidies in the same manner as an offset to the expense they relate to in the period in which we are reasonably assured to receive payment. For the three months ended March 31, 2021 we recognized reductions of $0.4 million in cost of sales, $1.3 million in marketing and selling expense, and $1.2 million in research and development expense in the condensed consolidated statements of operations for these subsidies. No payroll subsidies were received or recognized under CEWS in prior periods. As of March 31, 2021 we have collected all amounts recorded and continue to seek additional relief as applicable.
We have assessed various accounting estimates and other matters, including those that require consideration of forecasted financial information, in context of the unknown future impacts of COVID-19 using information that is reasonably available to us at this time. The accounting estimates and other matters we assessed include, but were not limited to, our allowance for doubtful accounts, inventory and warranty reserves, stock-based compensation, goodwill and other long-lived assets, financial assets, valuation allowances for tax assets and revenue recognition. While based on our current assessment of these estimates there was not a material impact to our consolidated
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financial statements as of and for the three months ended March 31, 2021, as additional information becomes available to us, our future assessment of these estimates, including our expectations at the time regarding the duration, scope and severity of the pandemic, as well as other factors, could materially and adversely impact our consolidated financial statements in future reporting periods.

Recently Adopted Accounting Pronouncements
None.

2 - Revenue
    Unbilled accounts receivable (“AR”) for the periods presented primarily represent the difference between revenue recognized based on the relative selling price of the related performance obligations and the contractual billing terms in the arrangements. Deferred revenue for the periods presented primarily relates to extended service contracts, installation, and training, for which the service fees are billed in advance. The associated deferred revenue is generally recognized ratably over the extended service period or when installation and training are complete.
The following table summarizes the changes in the unbilled AR and deferred revenue balances for the three months ended March 31, 20212022 (in thousands):
Unbilled AR, December 31, 20202021$1,925252 
Additions691,535 
Transferred to trade receivable(8)(31)
Unbilled AR, March 31, 20212022$1,9861,756 
Deferred revenue, December 31, 20202021$25,72330,097 
Additions11,03211,844 
Revenue recognized(8,332)(9,912)
Deferred revenue, March 31, 20212022$28,42332,029 

    At March 31, 2021,2022, the short-term portion of deferred revenue of $23.7$26.8 million and the long-term portion of $4.7
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$5.2 million are included in deferred revenue and other long-term liabilities, respectively, in the consolidated balance sheet. As of March 31, 2021,2022, we expect to recognize revenue associated with deferred revenue of approximately $20.1 million in 2021, $5.5$22.8 million in 2022, $1.5$6.3 million in 2023, $0.9$1.7 million in 2024, $0.6 million in 2025, and $0.4$0.6 million thereafter.

3 - Earnings Per Share
The components of basic and diluted EPS, and shares excluded from the calculation of diluted loss per share because the effect would have been anti-dilutive, are as follows (in thousands, except per share amounts):
Three Months Ended
March 31,
Three Months Ended
March 31,
2021202020222021
Net income (loss)$2,396 $(3,597)
Net incomeNet income$1,903 $2,396 
Weighted average common sharesWeighted average common shares33,611 33,800 Weighted average common shares34,119 33,611 
Dilutive effect of stock based awardsDilutive effect of stock based awards171 Dilutive effect of stock based awards157 171 
Diluted sharesDiluted shares33,782 33,800 Diluted shares34,276 33,782 
Basic earnings per shareBasic earnings per share$0.07 $(0.11)Basic earnings per share$0.06 $0.07 
Diluted earnings per shareDiluted earnings per share$0.07 $(0.11)Diluted earnings per share$0.06 $0.07 
Shares excluded from calculation of diluted EPSShares excluded from calculation of diluted EPS85 Shares excluded from calculation of diluted EPS— — 

4 - Allowance for Doubtful Accounts
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We estimate the lifetime allowance for doubtful, potentially uncollectible, accounts receivable upon their inception based on historical collection experience within the markets in which we operate, customer-specific information such as bankruptcy filings or customer liquidity problems, current conditions, and reasonable and supportable forecasts about the future.
Our allowance for doubtful accounts is presented as a reduction to accounts receivable on our consolidated balance sheet. When all internal efforts have been exhausted to collect the receivable, it is written off and relieved from the reserve.
The details of activity in allowance for doubtful accounts are as follows (in thousands):
Three Months Ended
March 31,
20212020
Balance, beginning of period$6,213 $7,384 
Additions charged to expense101 522 
Write-offs charged against allowance(229)(614)
Balance, end of period$6,085 $7,292 
Three Months Ended
March 31,
20222021
Balance, beginning of period$5,271 $6,213 
Additions charged to expense87 101 
Write-offs charged against allowance(361)(229)
Balance, end of period$4,997 $6,085 

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5 - Inventories
Inventories consist of the following (in thousands):
March 31, 2021December 31, 2020March 31, 2022December 31, 2021
Raw materials and subassembliesRaw materials and subassemblies$18,874 $22,583 Raw materials and subassemblies$25,092 $20,750 
Work in processWork in process3,327 2,294 Work in process2,739 2,825 
Finished goodsFinished goods61,977 65,695 Finished goods59,011 57,836 
Total inventoriesTotal inventories84,178 90,572 Total inventories86,842 81,411 
Less: Non-current inventoriesLess: Non-current inventories(14,711)(14,922)Less: Non-current inventories(14,604)(13,666)
Inventories, currentInventories, current$69,467 $75,650 Inventories, current$72,238 $67,745 
As of March 31, 20212022 and December 31, 2020,2021, we have classified $14.7$14.6 million and $14.9$13.7 million, respectively, of inventories as other assets. This inventory consists primarily of service components used to repair products held by customers pursuant to warranty obligations and extended service contracts, including service components for products we no longer sell, inventory purchased for lifetime buys, and inventory that is turning over at a slow rate. We believe these inventories will be utilized for their intended purpose.

6 – Intangible Assets
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6 – Intangible Assets
The following table summarizes the components of gross and net intangible asset balances (in thousands):
March 31, 2021December 31, 2020 March 31, 2022December 31, 2021
Gross
Carrying
Amount
Accumulated
Impairment
Accumulated
Amortization
Net Book
Value
Gross
Carrying
Amount
Accumulated
Impairment
Accumulated
Amortization
Net Book
Value
Gross
Carrying
Amount
Accumulated
Impairment
Accumulated
Amortization
Net Book
Value
Gross
Carrying
Amount
Accumulated
Impairment
Accumulated
Amortization
Net Book
Value
Intangible assets with definite lives:Intangible assets with definite lives:Intangible assets with definite lives:
TechnologyTechnology$110,356 $(12,458)$(65,079)$32,819 $112,138 $(12,480)$(64,203)$35,455 Technology$99,288 $(6,033)$(67,934)$25,321 $99,920 $(6,039)$(66,679)$27,202 
Customer relatedCustomer related92,411 (50)(52,499)39,862 94,526 (50)(51,247)43,229 Customer related89,260 (50)(58,913)30,297 89,794 (50)(57,133)32,611 
Trade namesTrade names46,481 (3,592)(33,047)9,842 47,058 (3,677)(31,890)11,491 Trade names45,442 (3,235)(38,302)3,905 45,593 (3,260)(36,960)5,373 
Internally developed softwareInternally developed software13,281 (12,895)386 13,281 (12,845)436 Internally developed software13,281 — (13,010)271 13,281 — (12,985)296 
PatentsPatents2,748 (133)(2,615)2,810 (133)(2,677)Patents2,688 (133)(2,555)— 2,705 (133)(2,572)— 
Service agreementsService agreements1,190 (1,129)61 1,190 (1,119)71 Service agreements800 — (779)21 800 — (769)31 
Definite-lived intangible assetsDefinite-lived intangible assets$266,467 $(16,233)$(167,264)$82,970 $271,003 $(16,340)$(163,981)$90,682 Definite-lived intangible assets$250,759 $(9,451)$(181,493)$59,815 $252,093 $(9,482)$(177,098)$65,513 
Intangible assets with indefinite lives:Intangible assets with indefinite lives:Intangible assets with indefinite lives:
Intellectual PropertyIntellectual Property$2,031 $$— $2,031 $2,059 $$— $2,059 Intellectual Property$1,993 $(1,993)$— $— $2,004 $(2,004)$— $— 
Total intangible assetsTotal intangible assets$268,498 $(16,233)$(167,264)$85,001 $273,062 $(16,340)$(163,981)$92,741 Total intangible assets$252,752 $(11,444)$(181,493)$59,815 $254,097 $(11,486)$(177,098)$65,513 

Finite-lived intangible assets are amortized over their weighted average lives, which are 14 years for technology, 10 years for customer related intangibles, 7 years for trade names, 6 years for internally developed software, 13 years for patents, 2 years for service agreements and 11 years weighted average in total.
Internally developed software consists of $11.1 million relating to costs incurred for development of internal use computer software and $2.2 million for development of software to be sold.
Amortization expense related to intangible assets with definite lives was as follows (in thousands):
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020 20222021
TechnologyTechnology$1,795 $1,712 Technology$1,629 $1,795 
Customer relatedCustomer related2,360 2,140 Customer related2,116 2,360 
Trade namesTrade names1,483 1,466 Trade names1,443 1,483 
Internally developed softwareInternally developed software50 69 Internally developed software24 50 
Service agreementsService agreements$10 $10 Service agreements10 10 
Total amortizationTotal amortization$5,698 $5,397 Total amortization$5,222 $5,698 

The amortization expense amounts shown above include internally developed software not held for sale of $24 thousand and $24 thousand for the three months ended March 31, 20212022 and March 31, 2020,2021, respectively, which is recorded within our income statement as a general and administrative operating expense. The amortization expense amounts shown above include internally developed software held for sale of $26 thousandzero and $45$26 thousand for the three
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months ended March 31, 20212022 and March 31, 2020,2021, respectively, which is recorded within our income statement as cost of goods sold.
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Expected amortization expense related to definite-lived amortizable intangible assets is as follows (in thousands):
Nine months ending December 31, 2021$16,276 
202217,940 
Nine months ending December 31, 2022Nine months ending December 31, 2022$12,301 
2023202315,169 202314,748 
2024202413,233 202412,866 
2025202512,619 202512,261 
202620262,422 20262,398 
202720272,267 
ThereafterThereafter5,311 Thereafter2,974 
Total expected amortization expenseTotal expected amortization expense$82,970 Total expected amortization expense$59,815 

7 – Goodwill
The carrying amount of goodwill and the changes in the balance are as follows (in thousands):
December 31, 20202021$151,299148,657 
Foreign currency translation(1,538)(353)
March 31, 20212022$149,761148,304 

8 - Property and Equipment, net
Property and equipment, net consist of the following (in thousands):
March 31, 2021December 31, 2020
Land$1,786 $1,792 
Buildings7,144 7,365 
Leasehold improvements7,378 8,050 
Finance lease right-of-use assets2,512 2,555 
Equipment and furniture20,581 22,148 
Computer software and hardware10,257 10,246 
Demonstration and loaned equipment3,175 3,086 
52,833 55,242 
Accumulated depreciation(29,551)(30,726)
Total$23,282 $24,516 

March 31, 2022December 31, 2021
Land$1,781 $1,782 
Buildings7,209 7,238 
Leasehold improvements7,729 7,722 
Finance lease right-of-use assets2,037 2,356 
Equipment and furniture21,121 20,637 
Computer software and hardware11,566 11,308 
Demonstration and loaned equipment4,424 4,050 
55,867 55,093 
Accumulated depreciation(34,476)(33,310)
Total$21,391 $21,783 
Depreciation expense of property and equipment, net was approximately $1.6$1.5 million and $1.7$1.6 million for the three months ended March 31, 20212022 and March 31, 2020,2021, respectively.

9 - Reserve for Product Warranties
We provide a warranty for products that is generally one year in length. In some cases, regulations may require us to provide repair or remediation beyond the typical warranty period. If any of the products contain defects, we may incur additional repair and remediation costs. Service, repair and calibration services are provided by a combination of our owned facilities and vendors on a contract basis.
We accrue estimated product warranty costs at the time of sale based on historical experience. A warranty reserve is included in accrued liabilities for the expected future costs of servicing products. Additions to the reserve are based on management’s best estimate of probable liability. We consider a combination of factors including
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material and labor costs, regulatory requirements, and other judgments in determining the amount of the reserve. The reserve is reduced as costs are incurred to honor existing warranty and regulatory obligations.
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As of March 31, 2021,2022, we have accrued $4.8$6.4 million for product related warranties. Our estimate of these costs is primarily based upon the number of units outstanding that may require repair and costs associated with shipping.
The details of activity in the warranty reserve are as follows (in thousands):
 Three Months Ended
March 31,
 20212020
Balance, beginning of period$5,195 $6,404 
Additions charged to expense341 704 
Utilizations(740)(1,271)
Balance, end of period$4,796 $5,837 
 Three Months Ended
March 31,
 20222021
Balance, beginning of period$6,042 $5,195 
Additions and adjustments charged to expense1,363 341 
Utilizations(958)(740)
Balance, end of period$6,447 $4,796 

Our estimate of future product warranty costs may vary from actual product warranty costs, and any variance from estimates could impact our cost of sales, operating profits and results of operations.

10 - Share-Based Compensation
As of March 31, 2021,2022, we have 21 active share-based compensation plans,plan, the 20182021 Equity Incentive Plan and the 2011 Employee Stock Purchase Plan.
The terms of all awards granted during the three months ended March 31, 20212022 and the methods for determining grant-date fair value of the awards are consistent with those described in the consolidated financial statements included in our Annual Report on Form 10-K for the year ended December 31, 2020.2021.
Details of share-based compensation expense are as follows (in thousands):
 Three Months Ended
March 31,
 20212020
Cost of revenue$100 $75 
Marketing and selling640 469 
Research and development355 254 
General and administrative1,923 1,400 
Total$3,018 $2,198 
 Three Months Ended
March 31,
 20222021
Cost of revenue$113 $100 
Marketing and selling612 640 
Research and development195 355 
General and administrative1,699 1,923 
Total$2,619 $3,018 

As of March 31, 2021,2022, unrecognized compensation expense related to the unvested portion of stock options and other stock awards was approximately $20.2$21.9 million, which is expected to be recognized over a weighted average period of 2.62.4 years.

11 - Other Income (Expense), net
Other income (expense), net consists of (in thousands):
 Three Months Ended
March 31,
 20212020
Interest income$$24 
Interest expense(766)(717)
Foreign currency loss(731)(801)
Other expense(162)
Total other (expense), net$(1,656)$(1,494)

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11 - Other Expense, net
Other expense, net consists of (in thousands):
 Three Months Ended
March 31,
 20222021
Interest income$$
Interest expense(267)(766)
Foreign currency loss(307)(731)
Other expense(236)(162)
Total other expense, net$(807)$(1,656)

12 - Income Taxes
Our tax provision for interim periods is determined using an estimated annual effective tax rate, adjusted for discrete events arising in each respective quarter. During each interim period, we update the estimated annual effective tax rate which is subject to significant volatility due to several factors, including our ability to accurately predict the income (loss) before provision for income taxes in multiple jurisdictions, the effects of acquisitions, the integration of those acquisitions, and changes in tax law. In circumstances where we are unable to predict income (loss) in multiple jurisdictions, the actual year to date effective tax rate may be the best estimate of the annual effective tax rate for purposes of determining the interim provision for income tax.
We recorded income tax expense of $0.5$1.5 million and income tax benefit of $1.1$0.5 million for the three months ended March 31, 20212022 and March 31, 2020,2021, respectively. The effective tax rate was 16.4%43.6% and 23.9%16.4% for the three months ended March 31, 20212022 and March 31, 2020,2021, respectively. The decreaseincrease in the effective tax rate for the three months ended March 31, 20212022 compared with the three months ended March 31, 2020,2021, is primarily attributable to changesa tax law change in mixeffect from January 1, 2022 that requires the capitalization of income among jurisdictions with varyingresearch and experimental costs under IRC Section 174 and directly increased the Company's Subpart F inclusion. The approximate impact of the change in the estimated tax rates and discrete items.rate due to all impacts from IRC Section 174 resulted in a $0.01 reduction in the GAAP earnings per share. Other significant factors impacting the current period effective tax rate included the benefit of Federal and California research and development credits, offset by global intangible low taxed income inclusions (“GILTI”) that was also impacted by IRC Section 174, and non-deductible executive compensation expenses. Factors impacting the effective rate for the three months ended March 31, 2021, include the benefit of Federal and California research and development credits, favorable discrete items for the carryback of losses, partially offset by non-deductible executive compensation expenses, and other discrete events.
Under the Tax Cut and Jobs Act (the “Act”) enacted on December 22, 2017, research and experimental (“R&E”) expenditures under IRC Section 174 incurred for tax years beginning after December 31, 2021 must be capitalized and amortized ratably over five or fifteen years for tax purposes, depending on where the research activities are conducted, U.S. or foreign respectively. Although there is proposed legislation that would defer the capitalization requirement to later years, we have no assurance that IRC Section 174 will be repealed or otherwise modified.
We recorded no changeschange related to unrecognized tax benefits for the three months ended March 31, 2021.2022. Within the next twelve months, it is possible that the uncertain tax positions may change with a range of approximately 0zero to $0.2$0.8 million. Our tax returns remain open to examination as follows: U.S Federal, 2018 through 2021, U.S. states, 2017 through 2020, U.S. states, 2016 through 2020,2021, and significant foreign jurisdictions, generally 20162017 through 2020.2021.

13 - Debt and Credit Arrangements
    We have a Credit Agreement with JP Morgan Chase Bank ("JP Morgan"), Citibank, NA (“Citibank”), and Wells Fargo Bank, National Association (“Wells Fargo”). During the third quarter of 2020 we amended the terms of the Credit Agreement to extend the maturity date of the original agreement, reduce the aggregate value of the revolving facility, and amend certain covenants. The amended Credit Agreement provides for an aggregate $150.0 million of secured revolving credit facility. The Credit Agreement contains covenants, including covenants relating
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to maintenance of books and records, financial reporting and notification, compliance with laws, maintenance of properties and insurance, and limitations on guaranties, investments, issuance of debt, lease obligations and capital expenditures, and is secured by virtually all of our assets. The Credit Agreement provides for events of default, including failure to pay any principal or interest when due, failure to perform or observe covenants, bankruptcy or insolvency events and the occurrence of the event has a material adverse effect. We have no other significant credit facilities. As of March 31, 2022, no amounts were outstanding under the Credit Agreement.
    In addition to the customary restrictive covenants listed above, the Credit Agreement also contains financial covenants that require us to maintain a certain leverage ratio and fixed charge coverage ratio, each as defined in the Credit Agreement:
Leverage Ratio, as defined, to be no higher than 3.25 to 1.00.
Interest Coverage Ratio, as defined, to be at least 1.75 to 1.00 at all times.
    At March 31, 2021, we were in compliance with the Leverage Ratio and the Interest Coverage Ratio covenants as defined in the Credit Agreement.
    During the first quarter of 2020 we drew an additional $60.0 million on our credit line as a precaution to ensure we have the necessary capital to continue to reliably serve our customers during an extended period of uncertainty of which $43.0 million was repaid by December 31, 2020. During the first quarter of 2021, we repaid $20.0 million of our outstanding debt and at March 31, 2021, we had $37.0 million outstanding under the Credit Agreement.
    Pursuant to the terms of the Credit Agreement, the outstanding principal balance will bear interest at either (a) a fluctuating rate per annum equal to the Applicable Rate, as defined in the Credit Agreement, depending on our leverage ratio plus the higher of (i) the federal funds rate plus one-half of one percent per annum; (ii) the prime rate in effect on such a day; and (iii) the LIBOR rate plus one percent, or (b) a fluctuating rate per annum of LIBOR Rate plus the Applicable Rate, which ranges between 2.25% to 3.50%. The effective interest rate during the three
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months ended March 31, 2021 was 3.05%. The Credit Agreement matures on September 25, 2023, at which time all principal amounts outstanding under the Credit Agreement will be due and payable. As of March 31, 2021, we have classified the full outstanding debt balance of $37.0 million as short-term on our balance sheet due to our intent to repay this portion over the next twelve months.
    Long-term debt consists of (in thousands):
 March 31, 2021December 31, 2020
Revolving credit facility$37,000 $57,000 
Debt issuance costs(477)(1,160)
Less: current portion of long-term debt36,523 50,000 
Total long-term debt$$5,840 

Maturities of long-term debt as of March 31, 2021 are as follows (in thousands):
 March 31, 2021December 31, 2020
2021$$
2022
202337,000 57,000 
Thereafter
Total$37,000 $57,000 
As of March 31, 2021, the carrying value of total debt approximated fair market value.

14 - Financial Instruments and Derivatives
    We use interest rate swap derivative instruments to reduce earnings volatility and manage cash flow exposure resulting from changes in interest rates. These interest rate swaps apply a fixed interest rate on a portion of our expected LIBOR-indexed floating-rate borrowings. We held the following interest rate swaps as of March 31, 2021 (in thousands):
Hedged ItemCurrent Notional AmountDesignation DateEffective DateTermination DateFixed Interest RateFloating RateEstimated Fair Value
1-month USD LIBOR Loan$15,000 May 31, 2018June 1, 2018September 23, 20212.611%1-month USD LIBOR$187 
Total interest rate derivatives designated as cash flow hedge$15,000 $187 

    We have designated these derivative instruments as cash flow hedges. We assess the effectiveness of these derivative instruments and record the change in the fair value of a derivative instrument designated as a cash flow hedge as unrealized gains or losses in accumulated other comprehensive income (“AOCI”), net of tax. Once the hedged item affects earnings, the effective portion of any gain or loss will be reclassified to earnings. If the hedged cash flow does not occur, or if it becomes probable that it will not occur, we will reclassify the amount of any gain or loss on the related cash flow hedge to interest expense at that time.
    As of March 31, 2021, we estimate that approximately $142.0 thousand of losses associated with the cash flow hedge, net of tax, could be reclassified from AOCI into earnings within the next twelve months.

15 - Segment, Customer and Geographic Information
We operate in 1 reportable segment in which we provide medical device solutions focused onto screen, diagnose, and treat disorders affecting the diagnosisbrain, neural pathways, and treatment of centraleight sensory nervous and sensory system disorders for patients of all ages.
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systems.
End-user customer base includes hospitals, clinics, laboratories, physicians, audiologists, and governmental agencies. Most of our international sales are to distributors who resell products to end users or sub-distributors.
The following tables present revenue by end market and geographic region and long-lived asset information by geographic region. Revenue is based on the destination of the shipments and long-lived assets are based on the physical location of the assets (in thousands):
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020 20222021
Consolidated Revenue:Consolidated Revenue:Consolidated Revenue:
United StatesUnited States$67,772 $68,338 United States$69,970 $67,772 
InternationalInternational47,155 41,045 International49,823 47,155 
TotalTotal$114,927 $109,383 Total$119,793 $114,927 
 Three Months Ended
March 31,
 20212020
Revenue by End Market:
Neuro Products
Devices and Systems$53,341 $49,426 
Supplies15,714 15,924 
Total Neuro Revenue69,055 65,350 
Newborn Care Products
Devices and Systems13,772 11,124 
Supplies8,403 9,691 
Services3,764 3,417 
Total Newborn Care Revenue25,939 24,232 
Hearing & Balance Products
Devices and Systems18,771 18,560 
Supplies1,162 1,241 
Total Hearing & Balance Revenue19,933 19,801 
Total Revenue$114,927 $109,383 
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March 31, 2021December 31, 2020
Property and equipment, net:
United States$10,115 $10,998 
Ireland6,647 6,716 
Canada3,713 3,775 
Denmark1,613 1,787 
Other countries1,194 1,240 
Total$23,282 $24,516 
 Three Months Ended
March 31,
 20222021
Revenue by End Market:
Brain Products:
Devices and Systems$37,807 $37,293 
Supplies6,291 5,486 
Services7,290 5,705 
Total Brain Revenue51,388 48,484 
Neural Pathway Products:
Devices and Systems9,657 8,832 
Supplies9,531 8,751 
Services204 257 
Total Neural Pathways Revenue19,392 17,840 
Sensory Nervous Systems Products:
Devices and Systems23,342 21,292 
Supplies8,473 8,143 
Services5,858 6,097 
Total Sensory Nervous Systems Revenue37,673 35,532 
Other Products:
Devices and Systems5,025 7,067 
Supplies2,781 2,898 
Services3,534 3,106 
Total Other Revenue11,340 13,071 
Total Revenue$119,793 $114,927 
March 31, 2022December 31, 2021
Property and equipment, net:
United States$9,635 $9,642 
Ireland6,131 6,223 
Canada3,546 3,594 
Denmark1,078 1,262 
Other foreign countries1,001 1,062 
Total$21,391 $21,783 

During the three months ended March 31, 20212022 and 2020,2021, no single customer and no country outside the United States contributed more than 10% of our consolidated revenue.

1615 - Fair Value Measurements
ASC 820 defines fair value, establishes a framework for measuring fair value and expands disclosures about fair value measurements. Fair value is defined under ASC 820 as the exit price associated with the sale of an asset
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or transfer of a liability in an orderly transaction between market participants at the measurement date. ASC 820 establishes the following three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value:
Level 1 - Quoted prices (unadjusted) in active markets that are accessible at the measurement date for assets or liabilities. The fair value hierarchy gives the highest priority to Level 1 inputs.
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Level 2 - Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets and liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
Level 3 - Unobservable inputs that are used when little or no market data is available. The fair value hierarchy gives the lowest priority to Level 3 inputs.
The derivative financial instruments described in Note 14 are measured at fair value on a recurring basis and are presented on the consolidated balance sheets at fair value. We estimate the fair value of the interest rate swaps by calculating the present value of the expected future cash flows of each swap. The calculation incorporates the contractual terms of the derivatives, observable market interest rates which are considered to be Level 2 inputs, and credit risk adjustments, if any, to reflect the counterpart's as well as our nonperformance risk. As of March 31, 2021, there have been no events of default under the interest rate swap agreement. The table below presents the fair value of the derivative financial instruments as well as the classification on the consolidated balance sheet (in thousands):
December 31, 2020AdditionsPaymentsAdjustmentsMarch 31, 2021
Liabilities:
Interest rate swap$277 $$$(90)$187 
Total$277 $$$(90)$187 
The following financial instruments are not measured at fair value on our consolidated balance sheet as of March 31, 20212022 and December 31, 20202021 but require disclosure of their fair values: cash and cash equivalents, accounts receivable, and accounts payable. The carrying value of these financial instruments approximates fair values because of their relatively short maturity.

16 - Subsequent Events

As previously announced, on April 17, 2022, the Company entered into an Agreement and Plan of Merger (the “Merger Agreement”) with Prince Parent Inc., a Delaware corporation (“Parent”), and Prince Mergerco Inc., a Delaware corporation and wholly owned subsidiary of Parent (“Merger Sub”), providing for, among other things, the merger of Merger Sub with and into the Company (the “Merger”), with the Company surviving the Merger as a wholly owned subsidiary of Parent.
Subject to the terms and conditions set forth in the Merger Agreement, at the effective time of the Merger (the “Effective Time”), each share of common stock, par value $0.001 per share, of the Company (“Company Common Stock”) outstanding as of immediately prior to the Effective Time (other than any shares of Company Common Stock held in treasury, held by Parent, Merger Sub or their respective subsidiaries or as to which appraisal rights have been perfected in accordance with the Delaware General Corporation Law, but including each share of Company Restricted Stock (as defined below)) will be cancelled and extinguished and automatically converted into the right to receive cash in an amount equal to $33.50, without interest thereon (the “Per Share Price”).
Pursuant to the Merger Agreement, at the Effective Time:
except as set forth below with respect to Employee Interim Awards (as defined below), each share of Company Common Stock subject to vesting restrictions or a risk of forfeiture (“Company Restricted Stock”) outstanding as of immediately prior to the Effective Time, whether vested or unvested and whether or not granted pursuant to any of the Company’s equity plans (“Company Stock Plans”), will be cancelled and converted into and will become a right to receive an amount in cash, without interest and subject to any required tax withholding, equal to the Per Share Price;
except as set forth below with respect to Employee Interim Awards or as set forth in the CEO Retention Agreement (as defined below), each restricted stock unit in respect of shares of Company Common Stock (each, a “Company Restricted Stock Unit”) outstanding as of immediately prior to the Effective Time, whether vested or unvested and whether or not granted pursuant to any Company Stock Plan, will be cancelled and be converted into and will become a right to receive an amount in cash, without interest and subject to any required tax withholding, equal to (i) the amount of the Per Share Price; multiplied by (ii) (1) with respect to Company Restricted Stock Units that are only subject to time-vesting requirements, the total number of shares of Company Common Stock subject to such Company Restricted Stock Unit, and (2) with respect to Company Restricted Stock Units that are subject to time- and performance-vesting requirements, the total number of shares of Company Common Stock determined to be performance vested with the performance goals deemed achieved at maximum levels and with the remaining time-vesting requirements deemed satisfied;
any Company Restricted Stock and Company Restricted Stock Units granted after the date of the Merger Agreement, other than awards that may be granted to non-employee directors after the date of the Merger Agreement (such awards, “Employee Interim Awards”), that are outstanding as of immediately prior to the Effective Time, whether vested or unvested and whether or not granted pursuant to any Company Stock Plan, will be treated at the Effective Time in the manner set forth above, provided that any applicable
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performance goals will be deemed achieved at target levels, rather than at maximum, and the number of shares subject to such Employee Interim Awards that will vest at the Effective Time will be prorated to reflect the portion of the applicable vesting period that has elapsed from the date of grant until the Effective Time (rather than vesting in full), and the remaining unvested portion of any Employee Interim Awards will be forfeited at the Effective Time;
each option (or portion thereof) to purchase a share of Company Common Stock (a “Company Option”) that is outstanding as of immediately prior to the Effective Time, whether vested or unvested and whether or not granted pursuant to any Company Stock Plan, and that has an exercise price per share less than the Per Share Price (each, an “In-the-Money Company Option”) will be cancelled and converted into and will become a right to receive an amount in cash, without interest and subject to any required tax withholding, equal to (i) the amount of the Per Share Price (less the exercise price per share attributable to such Company Option), multiplied by (ii) the total number of shares of Company Common Stock that are issuable upon the full exercise of such Company Option; and
each Company Option that is not an In-the-Money Company Option will be cancelled without any cash payment being made in respect thereof.

The consummation of the Merger (the “Closing”) is subject to certain customary closing conditions, including, but not limited to, the: (i) adoption of the Merger Agreement by the holders of a majority of the outstanding shares of Company Common Stock; (ii) expiration or termination of any waiting periods applicable to the consummation of the Merger under the Hart-Scott-Rodino Antitrust Improvements Act of 1976 and certain other applicable foreign antitrust laws and foreign direct investment laws of certain other jurisdictions; and (iii) absence of any law or order restraining, enjoining or otherwise prohibiting the Merger. The Merger is not subject to any financing condition.
The transaction is expected to close in the third quarter of 2022, although there can be no assurance that the Merger will occur by that date, subject to customary closing conditions, including approval by the Company's stockholders and receipt of regulatory approvals. If the Merger Agreement is terminated by the Company in order for the Company to enter concurrently into an alternative acquisition agreement with respect to a Superior Proposal (as defined in the Merger Agreement), (i) prior to May 22, 2022 (the “Cut-Off Date”), the Company will be obligated to pay to Parent a one-time fee equal to $19,753,676 in cash or (ii) after the Cut-Off Date, the Company will be obligated to pay Parent a one-time fee equal to $39,507,352 in cash. The Company also expects to incur costs, expenses, and fees for professional services and other transaction costs in connection with the Merger. If the transaction closes, Natus will become a private company and Natus shares will no longer be listed on any public market.
To encourage the continued retention of the Company's President and Chief Executive Officer, Thomas J. Sullivan, following the Closing, in connection with entering into the Merger Agreement, Parent required Mr. Sullivan to enter into a retention agreement, dated as of April 17, 2022, with Parent and the Company (the “CEO Retention Agreement”).
Pursuant to the CEO Retention Agreement, Mr. Sullivan agreed that, notwithstanding the treatment of Company Restricted Stock Units set forth in the Merger Agreement (as described above), he would not receive payments in respect of his Company Restricted Stock Units that are market stock units (“MSUs”) based on deemed achievement of performance goals at maximum levels. Instead, Mr. Sullivan's MSUs will be deemed attained at the level of performance actually achieved through the Closing based on the Per Share Price (which is approximately 143.4% of target, in the case of MSUs granted to Mr. Sullivan in December 2021, and 139.6% of target, in the case of MSUs granted to Mr. Sullivan in January 2022), consistent with the level of return to the Company's stockholders pursuant to the Merger Agreement. The consequence to Mr. Sullivan will be a reduction by over $3.0 million in the amount of gross proceeds that he otherwise was entitled to receive and would have received in respect of his MSUs.
Furthermore, pursuant to the CEO Retention Agreement, Mr. Sullivan agreed that an amount equal to $6.0 million (the “Retention Payment”) payable to him at the Effective Time in respect of his Company Restricted Stock Units would not become payable at the Effective Time and, instead, would become payable 50% on the six-month anniversary of the Closing and 50% on the one-year anniversary of the Closing, subject to his continued
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employment with the Company until the relevant retention date. If Mr. Sullivan's employment is terminated by the Company without cause, by Mr. Sullivan with good reason, or due to his death or disability, any then-unpaid portion of the Retention Payment shall be paid to him upon his termination (subject to, in the case of a termination by the Company without cause or by Mr. Sullivan for good reason, his execution and non-revocation of a release of claims). If Mr. Sullivan's employment terminates for any other reason prior to the relevant retention date, he will immediately forfeit all portions of the Retention Payment that relate to a future retention date. Mr. Sullivan's right to receive the Retention Payment is further subject to his continued compliance with certain restrictive covenants.
At the Effective Time, all other amounts payable to Mr. Sullivan in respect of his Company Restricted Stock and Company Restricted Stock Units will become payable in accordance with the Merger Agreement, as described above.
The CEO Retention Agreement was signed at the same time the Merger Agreement was signed, but if the Merger Agreement is terminated and the Closing does not occur, it will automatically become null and void.

ITEM 2.    Management’s Discussion and Analysis of Financial Condition and Results of Operations
Overview
The following Management Discussion and Analysis of Financial Condition and Results of Operations (“MD&A”) supplements the MD&A in our Annual Report on Form 10-K for the year ended December 31, 2020.2021. MD&A should be read in conjunction with our condensed consolidated financial statements and accompanying footnotes, the risk factors referred to in Part II, Item 1A of this report, our Annual Report filed on Form 10-K for the year ended December 31, 20202021 and the cautionary information regarding forward-looking statements at the end of this section.
Our Business
We are recognized by healthcare providers as a leading providersource for solutions to screen, diagnose, and treat disorders of medical devicethe brain, neural pathways, and sensory nervous systems. Our service and education complement hardware, advanced software and algorithms, and consumables that provide stimulus, acquire and monitor physiological signals and capture how the body responds, enabling clinicians worldwide to improve patient outcomes and quality of life.
End Markets
We provide innovative healthcare solutions in four product portfolios: Brain, Neural Pathways, Sensory Nervous System and Other.
Brain - This product portfolio includes solutions focused on diagnosing, monitoring and treating disorders specific to the diagnosisbrain, which include areas of neurodiagnostics and treatment of central nervousneurocritical care. Key neurodiagnostic product lines in this portfolio include electroencephalography (EEG) used in epilepsy monitoring and sensory system disorders for patients of all ages.
End Markets
Our products address the below end markets:
Neuro - Includes products and services that provide diagnostic, therapeutic and surgical solutions in neurodiagnostics,polysomnography (PSG) used to diagnose sleep disorders. Key neurocritical care product lines provide access through the cranium to the brain, monitor intracranial pressure and neurosurgery. Neuro's comprehensive neurodiagnostic solutions include electroencephalographytemperature, and long-term monitoring, Intensive Care Unit monitoring, electromyography, sleep analysis or polysomnography, and intraoperative monitoring. These solutions enhance the diagnosisprovide therapeutic drainage of neurological conditions such as epilepsy, sleep disorders and neuromuscular diseases. Our neurocritical care solutions include managementcerebrospinal fluid in cases of traumatic brain injury, hemorrhagic stroke, and hydrocephalus. This portfolio is comprised of well-known brands in the industry, including Nicolet®, Xltek®, Olympic®, Embla®, Grass®, Natus Quantum®, Trex™ and Camino®.
Neural Pathways - Focused on nerve and muscle disorders, the Neural Pathways portfolio uses electromyography (EMG) and nerve conduction studies (NCS) testing. These product lines help diagnose neuromuscular diseases, such as myasthenia gravis, movement disorders, such as dystonia and Parkinson's disease, and peripheral neuropathies, carpal tunnel syndrome and pinched nerves. Our portfolio is comprised of well-known brands in the industry, including Nicolet®, Dantec®, UltraPro™ and Natus Elite™.
Sensory Nervous System - This product portfolio focuses on hearing and balance disorders and pediatric eye imaging. Multiple clinical needs across hearing screening and diagnosis are addressed by continuousthis portfolio, including newborn hearing screening, hearing assessment and diagnostics and hearing aid fitting. A
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monitoringcomprehensive list of intracranial pressure and cerebrospinal fluid drainage, as well as cranial access kits for entry intobalance tests helps in the cranium. Our neurosurgical solutions include itemsdiagnosis of vestibular disorders, such as valves, shuntsdizziness and related treatment solutions for procedures involving hydrocephalus.vertigo. Eye imaging is used to diagnose and monitor retinopathy of prematurity to help prevent blindness in premature babies. Natus products are sold under trusted brand names, including ALGO®, RetCam®, Aurical®, Bio-logic®, Madsen® and Otoscan®.
Newborn Care Other - IncludesThe products and servicesin this portfolio do not directly fit within the Brain, Neural Pathways or Sensory Nervous System portfolio. These solutions span eight product lines, including phototherapy for jaundice management, video streaming of newborns in the NICU, data management for newborn care including hearing screening, brain monitoring, eye imaging, jaundice management, and various disposable newborn care supplies.
Hearing & Balance - The Hearinga full range of shunts and valves for neurosurgical applications, among others. This portfolio includes products for hearing assessmentseveral well-known brands, such as neoBLUE®, NICVIEW®, Vac-Pac® and diagnostics, and hearing aid fitting, including computer-based audiological, otoneurologic and vestibular instrumentation for hearing care professionals. Our Balance portfolio provides diagnosis and assessment of vestibular and balance disorders. These solutions have a complete product and brand portfolio known for its sophisticated design technology in the hearing and balance assessment markets.Neometrics®.
Segment and Geographic Information
We operate as one operating segment and one reportable segment, which provides healthcare products, and services focused on solutions to screen, diagnose, and treat disorders affecting the diagnosisbrain, neural pathways, and treatment of centraleight sensory nervous and sensory system disorders for patients of all ages.systems. Financial information is reviewed on a consolidated basis for purposes of making operating decisions and assessing financial performance. Consolidated financial information is accompanied by disaggregated information about revenues by end market and geographic region. We do not assesassess the performance of our end markets or geographic regions on measures of profit or loss, or asset-based metrics. We have disclosed the revenues for each of our end markets and geographic regions to provide the reader of the financial statements transparency into our operations.
Information regarding our revenues and long-lived assets in the U.S. and in countries outside the U.S. is contained in Note 1514 – Segment, Customer and Geographic Information of our condensed consolidated financial statements included in this report and is incorporated in this section by reference.
Revenue by Product Category
We generate our revenue from sales of Devices and Systems, which are generally non-recurring, and from related Supplies and Services, which are generally recurring. The products that are attributable to these categories are described in our Annual Report on Form 10-K for the year ended December 31, 2020.2021. Revenue from Devices and Systems, Supplies, and Services, as a percent of total revenue for the three months ended March 31, 20212022 and 2020,2021, is as follows:
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020 20222021
Devices and SystemsDevices and Systems75 %72 %Devices and Systems63 %65 %
SuppliesSupplies22 %25 %Supplies23 %22 %
ServicesServices%%Services14 %13 %
TotalTotal100 %100 %Total100 %100 %
20212022 First Quarter Overview
Our business and operating results are driven in part by worldwide economic conditions. Our revenue is significantly dependent on both capital spending by hospitals in the United States and healthcare spending by ministries of health outside the United States. While we have no direct exposure to Russia and Ukraine, we are monitoring any broader economic impact from the current crisis, especially on commodities.
We experienced an increase in demand particularly in Asia Pacificthe United States and Europe, during the first quarter compared to the same period in the prior year as recovery from the COVID-19 pandemic continues.year. Our consolidated revenue for the first quarter ended March 31, 20212022 was $114.9$119.8 million compared to $109.4$114.9 million in the first quarter of the previous year, an increase of $5.5$4.9 million.
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Our net income was $2.4$1.9 million or $0.07$0.06 per diluted share in the three months ended March 31, 2021,2022, compared with net lossincome of $3.6$2.4 million or $0.11$0.07 per diluted share in the same period in 2020.2021. The increasedecrease in net
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income was the result of higher revenueis due to the recovery from impactlower gross margin and higher tax provision due to enactment of COVID-19, in particular in international markets for Neuro products,IRC Section 174, partly offset by increased revenue and lower expenses compared to the prior year, driven by the timing of engineering project spend and the benefit of COVID-19 payroll relief received in Canada.operating expenses.
COVID-19 Update
Healthcare providers and patients continue to depend on our products and services every day. Our team members and partners are continuing to maintain our supply chain, manufacturing and delivery of our products and services. The health and welfare of our employees, our customers and our partners remain our top priority as we continue our business operations.
We have implemented safeguards in our facilities to protect team members, including social distancing practices, work from home and other measures consistent with specific regulatory requirements and guidance from health authorities. As an essential supplier of healthcare products and services, all of our manufacturing, engineering and customer support functions remain fully operational and will continue to support customers with vital supplies, service and equipment. Supply chain delays and constraints, as well as cost increases for semiconductors, have impacted our ability to ship products in the last few quarters. We have taken actionsare working with our suppliers to reduce costs, including reducing travelconstraints by providing forecasts further into the future and discretionary expenses. We will continue to prioritize spending to allow continued investment in productsclosely monitoring and services that are key elements of our stated strategy for profitable growthcommunicating changes in the years ahead.forecast, however we remain uncertain of when the supply chain will stabilize.
Impact to our supply chain
Many of our materials are single source and require lengthy qualification periods. Disruptions in our supply chain could negatively impact our ability to produce and supply our finished products. We have made strategic investmentscontinue to experience some extended lead times and delays in inventory to help mitigate potential supply chain disruptions. These investments include increased inventoryreceiving supplies and firm purchase orders beyond our typical timeframe in order to secure capacity at our key suppliers. To date, we have not incurred any significant supply disruptions and we believe our suppliersfinished goods which impacted revenue this period. We are positioned well to provide us with the materials we need to meet our demand. Supply appears to be stable, which could allow for the reduction of inventory levels in future quarters. The health and safety of our suppliers is also a priority for us and we have transitioned collaborationworking closely with our suppliers to online technology so that we can continue our business operations.
Liquidity
In the first quarter of 2020 we drew $60.0 million on our credit line as a precaution to ensure we have the necessary capital to continue to reliably serve our customers during an extended period of uncertainty of which $43.0 million was repaid by December 31, 2020. During the third quarter of 2020 we amended our Credit Agreement which extended the maturity date of the original agreement from September 23, 2021 to September 25, 2023, reduced the aggregate revolving credit facility from $225.0 million to $150.0 million,manage orders and amended certain covenants. During the three months ended Mach 31, 2021, we repaid $20.0 million in debt, reducing the amount outstanding under the Credit Agreement to $37.0 million, and continued to maintain a strong cash position ending the period with $80.5 million in cash.
As a result of the COVID-19 pandemic, some hospitals and clinics delayed payments for products and services and we have worked with our customers to arrange mutually acceptable payment terms during this uncertain time. We have seen revenues and margins improve since the onset of the pandemic. We continue to see our customers adapting to the COVID environment, which we believe will result in increased capital spending and continue to improve our business in 2021.
While we believe that we have sufficient liquidity to operate the Company for the foreseeable future should negative economic conditions persist for an extended period of time, we are evaluating additional measures we could take to further enhance our liquidity position.
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Government Grants
Various government programs have been announced to provide financial relief for businesses affected by COVID-19 including the CEWS under the COVID-19 Economic Response Plan in Canada. We received $2.9 million for payroll subsidies under CEWS during the three months ended March 31, 2021. Our policy is to account for these subsidiesproactively resolve delays in the same manner as an offsetmaterials we require to the expense they relate to in the period in which we are reasonably assured to receive payment. For the three months ended March 31, 2021 we recognized reductions of $0.4 million of cost of sales, $1.3 million of marketing and selling expense, and $1.2 million of research and development expense in the condensed consolidated statements of operations for these subsidies. No payroll subsidies were received or recognized under CEWS in prior periods. As of March 31, 2021 we have collected all amounts recorded and continue to seek additional relief as applicable.
Impact to fair-value of intangible assets
We have reviewed the assets onmeet our balance sheet, particularly goodwill and significant intangible assets for indications of impairment related to COVID-19 and determined that there are no indicators of impairment at this time. The values of these assets are particularly sensitive to our market cap and the long-term value of their cash flows. If these conditions change significantly, we may need to record an impairment to their value. However, any impairment charges would not require the use of cash and are excluded from the calculation of our debt covenants and, therefore, would not affect our ability to borrow under our existing credit line.
Impact to our financial systems and internal controls
To date, the COVID-19 pandemic has not had a material impact to our ability to operate our accounting and financial functions. We are staffed with approximately 150 dedicated finance, accounting and IT professionals. Our accounting and IT systems are maintained with third party support agreements and we have documented disaster recovery plans in place. Our finance, accounting and IT professionals are performing their normal functions while working from home with little to no physical presence and with no changes to our internal controls. We are confident that we can operate in this manner for an extended period of time without disruption and without significant impact to our internal controls.
Travel restrictions and use of online technology
The global Natus team is geographically diverse with multiple small locations and hundreds of employees that typically work from home in normal circumstances. We use the latest collaboration technology and have been able to transition to a company-wide work from home model without major interruption. Our manufacturing, distribution and field service operations require physical presence of certain employees as their work requires them to handle our products. In these cases, we have made adjustments to shift size and schedule and limited access to these groups by non-related employees. Our field service technicians are following our customers' requirements for distancing practices but continue to provide service where needed.
Travel restrictions have forced most customer and external partner collaboration to online technology. Using this technology has enabled us to continue operations without incident. However, in-person customer engagement as well as physical presence in laboratory settings is required for the long-term success of our company and eventually, we will need to return to traditional forms of interaction.demand.
Application of Critical Accounting PoliciesEstimates
We prepare our financial statements in accordance with accounting principles generally accepted in the United States of America.America (“GAAP”). In so doing, we must often make estimates and use assumptions that can be subjective and, consequently, our actual results could differ from those estimates. For any given individual estimate or assumption we make, there may also be other estimates or assumptions that are reasonable. Our estimates are based on our historical experience and a variety of other assumptions that we believe to be reasonable under the circumstances. We evaluate our estimates, assumptions, and judgements on a regular basis.
We believe that the following critical accounting policiesestimates require the use of significant estimates, assumptions and judgments:
Revenue recognitionjudgments to have a full understanding of our financial statements:
Inventory valuation
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Income Taxes
uncertainty. The use of different estimates, assumptions, orand judgments could have a material effect on the reported amounts of assets, liabilities, revenue, expenses, and related disclosures as of the date of the financial statements and during the reporting period. These critical accounting policiesestimates are described in more detail in our Annual Report on Form 10-K10-
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K for the year ended December 31, 2020,2021, under Item 7, Management’s Discussion and Analysis of Financial Condition and Results of Operations.
Recent Developments
On April 17, 2022, we entered into an Agreement Plan of Merger (the “Merger Agreement”) with Prince Parent Inc., a Delaware corporation (“Parent”), and Prince Mergerco Inc., a Delaware corporation and wholly owned subsidiary of Parent (“Merger Sub”), providing for, among other things, the merger of Merger Sub with and into Natus (the “Merger”), with Natus surviving the Merger as a wholly owned subsidiary of Parent. Under the terms of the Merger Agreement, the Company's stockholders will receive $33.50 in cash for each share of common stock they hold on the closing date of the Merger. The transaction is expected to close in the third quarter of 2022, subject to customary closing conditions, including, but not limited to, the: (i) adoption of the Merger Agreement by the holders of a majority of the outstanding shares of Company Common Stock, (ii) expiration or termination of any waiting periods applicable to the consummation of the Merger under the Hart-Scott-Rodino Antitrust Improvements Act of 1976 and certain other applicable foreign antitrust laws and foreign direct investment laws of certain other jurisdictions; and (iii) absence of any law or order restraining, enjoining or otherwise prohibiting the Merger. The Merger is not subject to any financing condition. There can be no assurance that the proposed Merger will be consummated.
Results of Operations
The following table sets forth selected consolidated statement of operations data as a percentage of total revenue for the periods indicated:
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020 20222021
RevenueRevenue100.0 %100.0 %Revenue100.0 %100.0 %
Cost of revenueCost of revenue40.6 %41.1 %Cost of revenue44.1 %40.6 %
Intangibles amortizationIntangibles amortization1.5 %1.5 %Intangibles amortization1.3 %1.5 %
Gross profitGross profit57.9 %57.4 %Gross profit54.6 %57.9 %
Operating expenses:Operating expenses:Operating expenses:
Marketing and sellingMarketing and selling25.2 %28.1 %Marketing and selling24.7 %25.2 %
Research and developmentResearch and development12.2 %16.1 %Research and development11.0 %12.2 %
General and administrativeGeneral and administrative12.9 %12.1 %General and administrative10.7 %12.9 %
Intangibles amortizationIntangibles amortization3.4 %3.3 %Intangibles amortization3.0 %3.4 %
RestructuringRestructuring0.2 %0.8 %Restructuring1.7 %0.2 %
Total operating expensesTotal operating expenses53.9 %60.4 %Total operating expenses51.1 %53.9 %
Income (loss) from operations4.0 %(3.0)%
Income from operationsIncome from operations3.5 %4.0 %
Other expense, netOther expense, net(1.4)%(1.4)%Other expense, net(0.7)%(1.4)%
Income (loss) before provision for income tax2.6 %(4.4)%
Provision for (benefit from) income taxes0.4 %(1.0)%
Net income (loss)2.2 %(3.4)%
Income before provision for income taxIncome before provision for income tax2.8 %2.6 %
Provision for income taxesProvision for income taxes1.2 %0.4 %
Net incomeNet income1.6 %2.2 %
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Revenues
The following table shows revenue by products during the three months ended March 31, 20212022 and March 31, 20202021 (in thousands):
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020Change 20222021Change
Neuro Products
Devices and Systems$53,341 $49,426 %
Supplies15,714 15,924 (1)%
Total Neuro Revenue69,055 65,350 %
Newborn Care Products
Brain Products:Brain Products:
Devices and SystemsDevices and Systems13,772 11,124 24 %Devices and Systems$37,807 $37,293 %
SuppliesSupplies8,403 9,691 (13)%Supplies6,291 5,486 15 %
ServicesServices3,764 3,417 10 %Services7,290 5,705 28 %
Total Newborn Care Revenue25,939 24,232 %
Hearing & Balance Products
Total Brain RevenueTotal Brain Revenue51,388 48,484 %
Neural Pathway Products:Neural Pathway Products:
Devices and SystemsDevices and Systems18,771 18,560 %Devices and Systems9,657 8,832 %
SuppliesSupplies1,162 1,241 (6)%Supplies9,531 8,751 %
Total Hearing & Balance Revenue19,933 19,801 %
ServicesServices204 257 (21)%
Total Neural Pathways RevenueTotal Neural Pathways Revenue19,392 17,840 %
Sensory Nervous Systems Products:Sensory Nervous Systems Products:
Devices and SystemsDevices and Systems23,342 21,292 10 %
SuppliesSupplies8,473 8,143 %
ServicesServices5,858 6,097 (4)%
Total Sensory Nervous Systems RevenueTotal Sensory Nervous Systems Revenue37,673 35,532 %
Other Products:Other Products:
Devices and SystemsDevices and Systems5,025 7,067 (29)%
SuppliesSupplies2,781 2,898 (4)%
ServicesServices3,534 3,106 14 %
Total Other RevenueTotal Other Revenue11,340 13,071 (13)%
Total RevenueTotal Revenue$114,927 $109,383 %Total Revenue$119,793 $114,927 %
For the three months ended March 31, 2021, Neuro2022, Brain revenue increased by 6% compared to the same period last year driven by higher sales of Neuro devices and supplies, particularly in our international markets combined with strength in backlog from 2020. Revenue from Neuro supplies was down slightly from the same period last year due to lower shipments of Neurocritical Care products.EEG.
For the three months ended March 31, 2021, Newborn Care2022, Neural Pathways revenue increased by 9% compared to the same period last year due to an increase in both device and supplies revenue.
For the three months ended March 31, 2022, Sensory Nervous Systems revenue increased by 6% compared to the same period last year due mainly to the sale of NICVIEWincreased demand for our devices which had been on ship hold during the same period last year, higherand supplies, particularly in our Digital Eye Imaging & Hearing Screening device sales, and higher services revenue from our agreement with Pediatrix. These increases were partly offset by decreases in Hearing Screening supplies and Phototherapy devices due to lower births.Fitting products.
For the three months ended March 31, 2021, Hearing & Balance2022, Other revenue remained flatdecreased by 13% compared to the same period last year with an increasemostly due to a large one-time order in device sales partly offset by a slight declinethe first quarter of 2021 for our NicView products that did not repeat in supplies revenue.the first quarter of 2022.
Revenue from domestic sales decreasedincreased to $67.8$70.0 million for the three months ended March 31, 20212022 compared to $68.3$67.8 million in the three months ended March 31, 2020.2021. The decrease in domestic revenueincrease was mainly due to the impact of the COVID-19 pandemic ondriven by improved demand for supplies.our Brain, Neural Pathways and Sensory Nervous Systems products.
Revenue from international sales increased to $49.8 million for the three months ended March 31, 2022 compared to $47.2 million for the three months ended March 31, 2021 compared to $41.0 million for the three months ended March 31, 2020.2021. The increase was driven by recovery inimproved demand mainly forby our Neuro products, following the impact of the COVID-19 pandemic in the same period last year.Brain, Neural Pathways and Sensory Nervous Systems products.
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Cost of Revenue and Gross Profit
Cost of revenue and gross profit consists of (in thousands):
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020 20222021
RevenueRevenue$114,927 $109,383 Revenue$119,793 $114,927 
Cost of revenueCost of revenue46,688 44,933 Cost of revenue52,781 46,688 
Intangibles amortizationIntangibles amortization1,751 1,668 Intangibles amortization1,600 1,751 
Gross profitGross profit66,488 62,782 Gross profit65,412 66,488 
Gross profit percentageGross profit percentage57.9 %57.4 %Gross profit percentage54.6 %57.9 %
For the three months ended March 31, 2021,2022, gross profit as a percentage of revenue increased 0.5%decreased 3.3% compared to the same period in the prior year. The increasedecrease was due to higher revenue and lower operations overhead spend partly offsetmainly driven by higher supply chain costs in procuring semiconductors for our products and the costs of freight, and contract manufacturer fees.we expect this trend will continue throughout the year.
Operating Costs
Operating costs consist of (in thousands):
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020 20222021
Marketing and sellingMarketing and selling$28,971 $30,730 Marketing and selling$29,551 $28,971 
Percentage of revenuePercentage of revenue25.2 %28.1 %Percentage of revenue24.7 %25.2 %
Research and developmentResearch and development$14,040 $17,569 Research and development$13,224 $14,040 
Percentage of revenuePercentage of revenue12.2 %16.1 %Percentage of revenue11.0 %12.2 %
General and administrativeGeneral and administrative$14,855 $13,182 General and administrative$12,807 $14,855 
Percentage of revenuePercentage of revenue12.9 %12.1 %Percentage of revenue10.7 %12.9 %
Intangibles amortizationIntangibles amortization$3,897 $3,661 Intangibles amortization$3,598 $3,897 
Percentage of revenuePercentage of revenue3.4 %3.3 %Percentage of revenue3.0 %3.4 %
RestructuringRestructuring$205 $871 Restructuring$2,051 $205 
Percentage of revenuePercentage of revenue0.2 %0.8 %Percentage of revenue1.7 %0.2 %

Marketing and Selling
Marketing and selling expenses decreasedincreased for the three months ended March 31, 2021.2022. The reductionincrease was primarily driven by lowerhigher travel and tradeshow expenses dueresulting from increased commercial activity compared to the impact of COVID-19 restrictions partly offset by an increase in commissions expense related to higher revenue in the current quarter.same periods last year.
Research and Development
Research and development expenses decreased slightly during the three months ended March 31, 20212022 compared to the same periodperiods in 2020.2021. The decrease is the result of activities in 2020 which did not recur in 2021 relatedlower project spend due to remediation and projects to comply with the European Union's adoption of the Medical Device Regulation which imposes stricter requirements for the marketing and sale of medical devices, including new quality system and post-market surveillance requirements.timing.
General and Administrative
General and administrative expense during the three months ended March 31, 2021 increased2022 decreased when compared to the same periodperiods in the prior year. This increasedecrease was due to higherlower stock compensation and incentive compensation, partly offset by a reduction inlower outside service expenses.services spending.
Intangibles Amortization
Intangibles amortization remained relatively flat during the three months ended March 31, 2022 as compared to the same periods in 2021 due to currency exchange fluctuations.
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Intangibles amortization remained flatRestructuring
Restructuring expenses increased during the three months ended March 31, 2021 as2022 compared to the same periodperiods in 2020.
Restructuring
Restructuring expenses decreased during the three months ended March 31, 2021 compared to the same period in 2020.2021. The decrease in the three months ended March 31, 2021increase was primarily driven by lowerhigher severance costs and costs incurred as the result of exiting the Peloton business in 2020, which did not recur in 2021.incurred.
Other Expense, net
Other expense, net consists of investment income, interest expense, net currency exchange gains and losses, and other miscellaneous income and expense. For the three months ended March 31, 20212022 we reported $1.7$0.8 million of other expense compared to $1.5$1.7 million of other expense for the same period in 2020.2021. The increase indecrease during the three months was due to less interest expense was driven by an equity method investment adjustment.and currency exchange fluctuations.
Provision for (Benefit from) Income Tax
Our tax provision for interim periods is determined using an estimated annual effective tax rate, adjusted for discrete events arising in each respective quarter. During each interim period, we update the estimated annual effective tax rate which is subject to significant volatility due to several factors, including our ability to accurately predict the income (loss) before provision for income taxes in multiple jurisdictions, the effects of acquisitions, the integration of those acquisitions, and changes in tax law. In circumstances where we are unable to predict income (loss) in multiple jurisdictions, the actual year to date effective tax rate may be the best estimate of the annual effective tax rate for purposes of determining the interim provision for income tax.
We recorded an expense from income tax expense of $0.5$1.5 million and a benefit for income tax of $1.1$0.5 million for the three months ended March 31, 20212022 and March 31, 2020,2021, respectively. The effective tax rate was 16.4%43.6% and 23.9%16.4% for the three months ended March 31, 20212022 and March 31, 2020,2021, respectively. The decreaseincrease in the effective tax rate for the three months ended March 31, 20212022 compared with the three months ended March 31, 2020,2021, is primarily attributable to changesa tax law change in mixeffect from January 1, 2022 that requires the capitalization of income among jurisdictions with varyingresearch and experimental costs under IRC Section 174 and directly increased the Company's Subpart F inclusion. The approximate impact of the change in the estimated tax rates and discrete items.rate due to all impacts from IRC Section 174 resulted in a $0.01 reduction in the GAAP earnings per share. Other significant factors impacting the current period effective tax rate included the benefit of Federal and California research and development credits, offset by global intangible low taxed income inclusions (“GILTI”) that was also impacted by IRC Section 174, and non-deductible executive compensation expenses. Factors impacting the effective rate for the three months ended March 31, 2021, include the benefit of Federal and California research and development credits, favorable discrete items for the carryback of losses, partially offset by non-deductible executive compensation expenses, and other discrete events.
Under the Tax Cut and Jobs Act (the “Act”) enacted on December 22, 2017, research and experimental (“R&E”) expenditures under IRC Section 174 incurred for tax years beginning after December 31, 2021 must be capitalized and amortized ratably over five or fifteen years for tax purposes, depending on where the research activities are conducted, U.S. or foreign respectively. Although there is proposed legislation that would defer the capitalization requirement to later years, we have no assurance that IRC Section 174 will be repealed or otherwise modified.
We recorded no changeschange related to unrecognized tax benefits for the three months ended March 31, 2021.2022. Within the next twelve months, it is possible that the uncertain tax positions may change with a range of approximately zero to $0.2$0.8 million. Our tax returns remain open to examination as follows: U.S Federal, 2018 through 2021, U.S. states, 2017 through 2020, U.S. states, 2016 through 2020,2021, and significant foreign jurisdictions, generally 20162017 through 2020.2021.
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Liquidity and Capital Resources
Liquidity and capital resources consist of (in thousands):
March 31, 2021December 31, 2020March 31, 2022December 31, 2021
Cash and cash equivalentsCash and cash equivalents$80,549 $82,082 Cash and cash equivalents$84,285 $75,595 
Working capitalWorking capital129,343 125,950 Working capital173,913 162,690 
Three Months Ended
March 31,
Three Months Ended
March 31,
20212020 20222021
Net cash provided by operating activitiesNet cash provided by operating activities$24,703 $17,362 Net cash provided by operating activities$8,897 $24,703 
Net cash used in investing activitiesNet cash used in investing activities(731)(3,575)Net cash used in investing activities(1,634)(731)
Net cash provided by (used in) financing activitiesNet cash provided by (used in) financing activities(21,275)32,489 Net cash provided by (used in) financing activities2,516 (21,275)
We believe that our current cash and cash equivalents and any cash generated from operations will be sufficient to meet our ongoing operating requirements for the foreseeable future.
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As of March 31, 2021,2022, we had cash and cash equivalents outside the U.S. in certain of our international subsidiaries of $50.2$56.1 million, primarily in Canada and Ireland. We intend to permanently reinvest the cash held by our international subsidiaries except for Excel Tech Corporation and Natus Manufacturing Limited, which we intend to repatriate. A net deferred tax liability has been recorded for the potential future repatriation. If, however, a portion of permanently reinvested funds were needed for and distributed to our operations in the United States, we would be subject to additional U.S. income taxes and foreign withholding taxes depending on facts and circumstances at the time of distribution. The amount of taxes due would depend on the amount and manner of repatriation, as well as the country from which the funds were repatriated.
We have a Credit Agreement with JP Morgan, Citibank, and Wells Fargo. During the third quarter of 2020 we amended the terms of the Credit Agreement to extend the maturity of the original agreement, reduce the aggregate value of the revolving credit facility, and amend certain covenants. The amended Credit Agreement provides for an aggregate $150.0 million of secured revolving credit facility. The Credit Agreement contains covenants, including covenants relating to maintenance of books and records, financial reporting and notification, compliance with laws, maintenance of properties and insurance, and limitations on guaranties, investments, issuance of debt, lease obligations and capital expenditures, and is secured by virtually all of our assets. The Credit Agreement provides for events of default, including failure to pay any principal or interest when due, failure to perform or observe covenants, bankruptcy or insolvency events and the occurrence of the event has a material adverse effect. The Credit Agreement matures on September 25, 2023, at which time all principal amounts outstanding under the Credit Agreement will be due and payable. We have no other significant credit facilities. During the first quarter of 2020 we drew an additional $60.0 million on our credit line as a precaution to ensure we have the necessary capital to continue to reliably serve our customers during an extended period of uncertainty. As of March 31, 2021, we had $37.0 million2022, no amounts were outstanding under the Credit Facility.Agreement.
During the three months ended March 31, 2022 cash provided by operating activities of $8.9 million was the result of $1.9 million of net income, non-cash adjustments to net income of $11.0 million which was primarily driven by an adjustment for depreciation and amortization of $6.7 million, and net cash outflows of $4.0 million from changes in operating assets and liabilities primarily resulting from reductions in accounts receivable and increases in inventory. Cash used in investing activities during the period was $1.6 million consisting of $1.1 million to acquire other property and equipment, $0.6 million for purchase of equity method investments. Cash provided by financing activities during the three months ended March 31, 2022 was $2.5 million and consisted of $4.2 million stock option exercises offset by $1.2 million for taxes paid related to net share settlement of equity awards and $0.4 million for principal payments of financing lease liability.
During the three months ended March 31, 2021 cash provided by operating activities of $24.7 million was the result of $2.4 million of net income, non-cash adjustments to net income of $11.0 million which was primarily driven by an adjustment for depreciation and amortization of $7.3 million, and net cash inflows of $11.3 million from changes in operating assets and liabilities primarily driven by reductions in accounts receivable and inventory. Cash used in investing activities during the period was $0.7 million to acquire other property and equipment. Cash
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used in financing activities during the three months ended March 31, 2021 was $21.3 million and consisted of repayment on borrowing of $20.0 million, $1.2 million for taxes paid related to net share settlement of equity awards, and $0.1 million for principal payments of financing lease liability.
During the three months ended March 31, 2020 cash provided by operating activities of $17.4 million was the result of $3.6 million of net loss, non-cash adjustments to net loss of $10.8 million, and net cash inflows of $10.1 million from changes in operating assets and liabilities. The non-cash adjustment to net loss was primarily driven by depreciation and amortization of $7.0 million. Cash used in investing activities during the period was $3.6 million to acquire other property and equipment. Cash provided by financing activities during the three months ended March 31, 2020 was $32.5 million and consisted of proceeds from borrowing of $60.0 million offset by repayment on borrowing of $15.0 million, $10.5 million for repurchases of common stock under our share repurchase program, $1.9 million for taxes paid related to net share settlement of equity awards, and $0.1 million for principal payments of financing lease liability.
Our future liquidity and capital requirements will depend on numerous factors, including the: 
Extent to which we make acquisitions;
Amount and timing of revenue;
Length and severity of business disruptions caused by COVID-19;
Extent to which our existing and new products gain market acceptance;
Cost and timing of product development efforts and the success of these development efforts;
Cost and timing of marketing and selling activities; and
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Availability of borrowings under line of credit arrangements and the availability of other means of financing.

Contractual Obligations
Commitments and Contingencies
In the normal course of business, we enter into obligations and commitments that require future contractual payments. The commitments result primarily from firm, non-cancellable purchase orders placed with contract vendors that manufacture some of the components used in our medical devices and related disposable supply products, purchase orders placed for employee benefits and outside services, as well as commitments for leased office space, leased equipment, and bank debt. The following table summarizes our contractual obligations and commercial commitments as
As of March 31, 2021 (in thousands):
  Payments Due by Period
 TotalLess than
1 Year
1-3 Years3-5 YearsMore than
5 Years
Unconditional purchase obligations$48,682 $46,418 $2,264 $— $— 
Bank debt37,000 — 37,000 — — 
Interest payments2,137 1,224 913 — 
Repatriation tax6,552 311 2,111 4,130 — 
Total$94,371 $47,953 $42,288 $4,130 $— 

2022, we have unconditional purchase obligations of $120.7 million that payments are due within the next year and $84.9 million due within one to three years. Purchase obligations are defined as agreements to purchase goods or services that are enforceable and legally binding. Included in the purchase obligations category above are obligations related to purchase orders for inventory purchases under our standard terms and conditions and under negotiated agreements with vendors. We expect to receive consideration (products or services) for these purchase obligations. The purchase obligation amounts doamount does not represent all anticipated purchases in the future, but represent only those items for which we are contractually obligated. The table aboveThis does not include obligations under employment agreements for services rendered in the ordinary course of business.
Our Credit Agreement with JP Morgan, Citibank, and Wells Fargo matures in 2023. We have recorded this obligation in the payments due in one to three years category in the table above based on the maturity date of the Agreement. As of March 31, 2021,2022, we have classified the full outstanding debt balance of $37.0 million as short-term on our balance sheet due to our intent to repay this portion over the next twelve months.
The estimated interest payments noted aboveof $1.0 million due less than one year and $0.6 million due within one to three years. These interest payments are an estimate of expected interest payments but could vary materially based on the timing of future loan draws and payments. See Note 13 to the unaudited Condensedof our Consolidated Financial Statements for additionalfurther discussion on our debt and credit arrangements.
As of March 31, 2022, we have $5.7 million of tax obligation relating to repatriation tax. The repatriation tax is a one-time transition tax on the mandatory deemed repatriation of cumulative foreign earnings as of December 31, 2017 due to the enactment in December 2017 of the Tax Act.

We are not able to reasonably estimate the timing of any potential payments for uncertain tax positions under ASCAccounting Standards Codification (“ASC”) 740, Accounting for Uncertainty in Income Taxes—an interpretation of FASB Statement 109,. As a result, the preceding table excludestherefore contractual obligations exclude any potential futuretax payments related to our ASC 740 liability for uncertain tax positions. See Note 18 in12 of our Annual Report filed on Form 10-K for the year ended December 31, 2020Consolidated Financial Statements for further discussion on income taxes and repatriation tax.taxes.
Recently Issued Accounting Pronouncements
None.
Cautionary Information Regarding Forward Looking Statements
This report contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934 about Natus Medical Incorporated. Forward-looking
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statements can be identified by the words “expects,” “anticipates,” “believes,” “intends,” “estimates,” “plans,” “will,” “outlook” and other similar expressions. Forward-looking statements are based on management's current
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plans, estimates, assumptions and projections, and speak only as of the date they are made. These forward-looking statements within Item 2 include, without limitation, statements regarding our ability to consummate the proposed Merger, and the timing, costs and any benefits of such transaction, the impact of COVID-19 pandemic on our business, the sufficiency of our current cash, cash equivalents and short-term investment balances, any cash generated from operations to meet our ongoing operating and capital requirements for the foreseeable future, outcomes of new product development, improved operations performance and profitability as the result of restructuring activities, and our intent to acquire additional technologies, products or businesses.
Forward-looking statements are not guarantees of future performance and are subject to substantial risks and uncertainties that could cause the actual results predicted in the forward-looking statements as well as our future financial condition and results of operations to differ materially from our historical results or currently anticipated results. Investors should carefully review the information contained under the caption “Risk Factors” referred to in Part II, Item 1A of this report for a description of risks and uncertainties. All forward-looking statements are based on information available to us on the date hereof, and we assume no obligation to update forward-looking statements.

ITEM 3.    Quantitative and Qualitative Disclosures about Market Risk
    We are exposed to various market risks, including changes in foreign currency exchange rates and interest rate risk onrates that could adversely affect our LIBOR-indexed floating-rate debt. We have entered into an interest rate swap agreement to effectively covert a portionresults of our floating-rate debt to a fixed-rate. The principal objective of the swap contract is to reduce the variability of future earningsoperations and cash flows associated with our floating-rate debt.financial condition. Please refer to Part II, Item 7A, "Quantitative and Qualitative Disclosures About Market Risk" included in our Annual Report on Form 10-K for the ended December 31, 20202021 for a more complete discussion on the market risks we encounter.


ITEM 4.    Controls and Procedures
Evaluation of Disclosure Controls and Procedures
Under the rules of the Securities and Exchange Commission, “disclosure controls and procedures” are controls and other procedures that are designed to ensure that information required to be disclosed in the reports that we file or submit under the Securities Exchange Act of 1934 is recorded, processed, summarized and reported within the time periods specified in the rules and forms of the Securities and Exchange Commission. Disclosure controls and procedures include, without limitation, controls and procedures designed to ensure that information required to be disclosed by us in our reports that we file or submit under the Securities Exchange Act of 1934 is accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure.
Our management, including our chief executive officer and chief financial officer, does not expect that our disclosure controls and procedures or our internal control over financial reporting will prevent all errors and all fraud due to inherent limitations of internal controls. Because of such limitations, there is a risk that material misstatements will not be prevented or detected on a timely basis by internal control over financial reporting. However, these inherent limitations are known features of the financial reporting process. Therefore, it is possible to design into the process safeguards to reduce, though not eliminate, this risk.
Our management, with the participation of our chief executive officer and our chief financial officer, has evaluated the effectiveness of our disclosure controls and procedures as of the end of the period covered by this report. Based on that evaluation, our management, including our chief executive officer and chief financial officer, has concluded that our disclosure controls and procedures were effective at a reasonable assurance level as of March 31, 2021.2022.
Changes in Internal Control over Financial Reporting
There were no changes in the Company's internal control over financial reporting during the first quarter of 2021,2022, which were identified in connection with management's evaluation required by paragraph (d) of Rules 13a-15
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and 15d-15 under the Exchange Act, that have materially affected, or are reasonablereasonably likely to materially affect, our internal control over financial reporting.
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PART II.    OTHER INFORMATION

ITEM 1.    Legal Proceedings
We currently are, and may from time to time become, a party to various other legal proceedings or claims that arise in the ordinary course of business. Our management reviews these matters if and when they arise and believes that the resolution of any such matters currently known will not have a material effect on our results of operations or financial position.

ITEM 1A.    Risk Factors
A description ofThe following updates the risks associated with our business, financial condition and results of operations is set forthrisk factors previously reported in Part 1, Item 1A “Risk Factors” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2020. 2021.
Risks Related to the Merger
The Company is subject to business uncertainties, litigation risk and contractual restrictions while the Merger is pending, which may adversely affect our business, financial condition and results of operations.
Uncertainty about the effect of the proposed Merger on our employees, customers, and other parties may have an adverse effect on our business, financial condition and results of operation regardless of whether the proposed Merger is completed. These risks to our business include the following, all of which could be exacerbated by a delay in the completion of the proposed Merger:
the impairment of our ability to attract, retain, and motivate our employees, including key personnel;
the diversion of significant management time and resources towards the completion of the proposed Merger;
difficulties maintaining relationships with customers, suppliers, and other business partners;
delays or deferments of certain business decisions by our customers, suppliers, and other business partners;
the inability to pursue alternative business opportunities or make appropriate changes to our business because the Merger Agreement requires us to use reasonable best efforts to conduct our business in the ordinary course of business and not engage in certain kinds of transactions prior to the completion of the proposed Merger;
litigation relating to the proposed Merger and the costs related thereto; and
the incurrence of significant costs, expenses, and fees for professional services and other transaction costs in connection with the proposed Merger.
Failure to consummate the proposed Merger within the expected timeframe or at all could negatively impact the price of our common stock, as well as our business, financial condition and results of operations.
There have beencan be no assurance that the proposed Merger will be consummated. The consummation of the proposed Merger is subject to certain closing conditions, including, among other things, the adoption of the Merger Agreement and the Merger by the Company's stockholders at a special meeting of stockholders convened for such purpose, the receipt of specified antitrust and foreign direct investment approvals and the absence of legal restraints and prohibitions against the Merger and the other transactions contemplated by the Merger Agreement. The obligation of each party to consummate the Merger is also conditioned upon the other party's representations and warranties being true and correct to the extent specified in the Merger Agreement and the other party having performed in all material respects its obligations under the Merger Agreement. There can be no assurance that these and other conditions to closing will be satisfied in a timely manner or at all.
The Merger Agreement also includes customary termination provisions for both the Company and Parent, subject, in certain circumstances, to the payment by the Company of a termination fee of as much as $39,507,352. If we are required to make this payment, doing so may negatively impact the price of our common stock, as well as our business, financial condition and results of operations.
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There can be no assurance that a remedy will be available to us in the event of a breach of the Merger Agreement by Parent or its affiliates or that we will wholly or partially recover for any damages incurred by us in connection with the proposed Merger. A failed transaction may result in negative publicity and a negative impression of us among our customers or in the investment community or business community generally. Further, any disruptions to our business resulting from the announcement and pendency of the proposed Merger, including any adverse changes in our relationships with our customers, partners, suppliers and employees, could continue or accelerate in the event of a failed transaction. In addition, if the proposed Merger is not completed, and there are no other parties willing and able to acquire the Company at a price of $33.50 per share or higher, on terms acceptable to us, the share price of our common stock will likely decline to the extent that the current market price of our common stock reflects an assumption that the proposed Merger will be completed. Also, we have incurred, and will continue to incur, significant costs, expenses and fees for professional services and other transaction costs in connection with the proposed Merger, for which we will have received little or no benefit if the proposed Merger is not completed. Many of these fees and costs will be payable by us even if the proposed Merger is not completed and may relate to activities that we would not have undertaken other than to complete the proposed Merger.
The Company's ability to complete the Merger is subject to certain closing conditions and the receipt of consents and approvals from government entities which may impose conditions that could adversely affect the Company or cause the Merger to be abandoned.
The Merger Agreement contains certain closing conditions, including, among others, the adoption of the Merger Agreement and the Merger by the Company's stockholders at a special meeting of stockholders convened for such purpose and the absence of legal restraints and prohibitions against the Merger and the other transactions contemplated by the Merger Agreement. The Company cannot provide any assurance that the conditions to the consummation of the Merger will be satisfied or waived, or will not result in the abandonment or delay of the Merger.
In addition, the Merger is conditioned on the expiration or termination of any waiting periods applicable to the consummation of the Merger under the Hart-Scott-Rodino Antitrust Improvements Act of 1976 and certain other applicable foreign antitrust laws and foreign direct investment laws of certain other jurisdictions. The granting of these regulatory approvals could involve the imposition of additional conditions on the closing of the Merger. The imposition of such conditions or the failure or delay to obtain regulatory approvals could have the effect of delaying completion of the Merger or of imposing additional costs or limitations on the Company or may result in the failure to close the Merger. The regulatory approvals may not be received at all, may not be received in a timely fashion, or may contain conditions on the completion of the Merger.
Risks Related to Our Business and Operations
The ongoing conflict between Russia and Ukraine has impacted our results of operations and could create or exacerbate certain risks we face to our business, financial condition and results of operations.
Russia's invasion of Ukraine and the global response, including the imposition of financial and economic sanctions by the United States and other countries, has created supply constraints that have impacted, and may continue to impact, our results of operations and could create or exacerbate risks facing our business. In addition, the uncertain nature, magnitude, and duration of hostilities stemming from such description.the conflict in Ukraine, including the potential effects of sanctions limitations, retaliatory cyberattacks on the world economy and markets, have contributed to increased market volatility and uncertainty, which could have an adverse impact on macroeconomic factors that affect our business and operations. Although we do not presently expect the impacts of the ongoing conflict on our operating results to be material, certain risks that we have identified in our Annual Report on Form 10-K for the year ended December 31, 2021 may be exacerbated. For example, a prolonged or intensified conflict could result in acute shortages of raw materials and price inflation on transportation costs, materials, and energy which in turn may adversely impact our supply chain. An escalation of geopolitical tensions due to the ongoing conflict, including increased sanctions or restrictions on global trade, could also result in further supply chain disruptions, reduced customer demand, state-sponsored cyberattacks as well as increased volatility in the financial markets, all of which could have an adverse impact on our business and operations. These and other risks are described more fully in our Annual Report on Form 10-K for the year ended December 31, 2021.

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ITEM 2.    Unregistered Sales of Equity Securities and Use of Proceeds
    None.

ITEM 5.    Other Information

    None

ITEM 6.    Exhibits
 
(a)Exhibits
      Incorporated By Reference
Exhibit
No.
  Exhibit  Filing  Exhibit
No.
  File Date  Filed
Herewith
X
          X
          X
          X
101  The following materials from Natus Medical Incorporated's Quarterly Report on Form 10-Q for the quarter ended March 31, 2021,2022, formatted in XBRL (Extensible Business Reporting Language): (i) Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations and Comprehensive Income, (iii) Condensed Consolidated Statements of Cash Flows, and (iv) Notes to Condensed Consolidated Financial Statements.        X
104The cover page from Natus Medical Incorporated's Quarterly Report on Form 10-Q for the quarter ended March 31, 2021,2022, formatted in Inline XBRL (included as Exhibit 101).X
+Indicates management contract or compensatory plan or arrangements

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SIGNATURES
Pursuant to the requirements 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.
   
NATUS MEDICAL INCORPORATED
Dated:May 7, 20216, 2022 By:/s/ Jonathan A. KennedyThomas J. Sullivan
 Jonathan A. KennedyThomas J. Sullivan
President and Chief Executive Officer
(Principal Executive Officer)
Dated:May 7, 20216, 2022 By:/s/ B. Drew Davies
 B. Drew Davies
Executive Vice President and
Chief Financial Officer
(Principal Financial and Accounting Officer)

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