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

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

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act:

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ~~[ ]~~☐

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

As of August ~~10, 2020,~~11, 2021, the registrant had ~~1,178,885~~29,350,000 shares of its Common Stock, $0.0001 par value, outstanding.

							June 30,			December 31,
	June 30, 2020			December 31, 2019			2021			2020
	(unaudited)							(unaudited)
ASSETS
Current assets:
Cash	$	810,848		$	16,933		$	199,632		$	25,353
Accounts receivable, net		2,596,432			3,565,447			-			499,454
Inventory		690,076			614,344			490,988			445,415
Prepaid expenses and other current assets		17,422			487			175,162			148,522
Income tax refunds receivable		1,760,988			642,503			1,139,226			1,420,251
Current assets of AMSG and HTS classified as held for sale		209,878			505,389
Current assets of discontinued operations								-			184,510
Total current assets		6,085,644			5,345,103			2,005,008			2,723,505

Property and equipment, net		7,896,467			8,231,830			7,515,703			7,814,435
Intangibles, net		509,443			509,443			259,443			259,443
Investments								8,500,000			-
Deposits		327,281			337,153			282,163			263,621
Right-of-use assets		394,281			274,747			910,541			1,000,272
Non-current assets of AMSG and HTS classified as held for sale		2,140			9,383
Non-current assets of discontinued operations								152,298			200,815

Total assets	$	15,215,256		$	14,707,659		$	19,625,156		$	12,262,091

LIABILITIES AND STOCKHOLDERS’ DEFICIT
Current liabilities:
Accounts payable (includes related parties amount of $0.6 million and $0.6 million, respectively)	$	11,766,475		$	13,691,250
Accounts payable (includes related party amounts of $0.4 million and $0.3 million, respectively)							$	15,969,902		$	14,251,851
Checks issued in excess of bank account balance		145,685			275,124			203,784			84,760
Accrued expenses (includes related parties amount of $0 million and $2.0 million, respectively)		16,269,839			14,583,954
Accrued expenses (includes related party amounts of $0.3 million and $0.2 million, respectively)								17,975,899			19,135,569
Income taxes payable		1,373,669			1,373,669			1,157,812			1,438,837
Current portion of notes payable		5,290,477			3,977,710			6,394,997			4,786,976
Current portion of note payable, related party		-			15,159,455			2,627,000			2,097,000
Current portion of finance lease obligations		349,987			1,119,418			249,985			249,985
Current portion of debentures		29,153,740			29,873,740			12,690,539			12,690,539
Current portion of right-of-use operating lease obligations		165,924			116,037			217,937			172,952
Derivative liabilities		455,336			455,336			455,336			455,336
Current liabilities of AMSG and HTS classified as held for sale		2,303,103			2,792,502
Current liabilities of discontinued operations								1,532,782			3,814,245
Total current liabilities		67,274,235			83,418,195			59,475,973			59,178,050

Other liabilities:
Note payable, net of current portion		1,402,428			-
Notes payable, net of current portion								797,007			1,196,256
Right-of-use operating lease obligations, net of current portion		228,357			158,710			692,604			827,320
Non-current liabilities of discontinued operations								-			78,217
Total liabilities		68,905,020			83,576,905			60,965,584			61,279,843

Commitments and contingencies								-			-

Redeemable Preferred Stock - Series I-1		5,835,294			5,835,294
Redeemable Preferred Stock - Series I-2		1,790,181			1,815,181

Stockholders’ deficit:
Series H preferred stock, $0.01 par value, 14,202 shares authorized, 10 shares issued and outstanding		-			-
Series F preferred stock, $0.01 par value, 1,750,000 shares authorized, 1,750,000 shares issued and outstanding		17,500			17,500
Series K preferred stock, $0.01 par value, 250,000 shares authorized, 0 and 250,000 shares issued and outstanding		-			2,500
Series L preferred stock, $0.01 par value, 250,000 shares authorized, 250,000 and 0 shares issued and outstanding		2,500			-
Series M preferred stock, $0.01 par value, 30,000 shares authorized, 22,000 and 0 shares issued and outstanding		220			-
Common stock, $0.0001 par value, 10,000,000,000 shares authorized, 989,894 and 964,894 shares issued and outstanding		99			96
Series H preferred stock, $0.01 par value, 14,202 shares authorized, 10 shares issued and outstanding								-			-
Series F preferred stock, $0.01 par value, 1,750,000 shares authorized, 1,750,000 shares issued and outstanding								17,500			17,500
Series L preferred stock, $0.01 par value, 250,000 shares authorized, 250,000 shares issued and outstanding								2,500			2,500
Series M preferred stock, $0.01 par value, 30,000 shares authorized, 21,380 and 22,000 shares issued and outstanding, respectively								214			220
Series N preferred stock, $0.01 par value, 50,000 shares authorized, 16,369 and 29,434 shares issued and outstanding, respectively								163			294
Series O preferred stock, $0.01 par value, 10,000 shares authorized, 2,750 and 0 shares issued and outstanding, respectively								28			-
Preferred stock value
Common stock, $0.0001 par value, 10,000,000,000 shares authorized, 10,000,000 and 39,648 shares issued and outstanding, respectively								1,000			4
Additional paid-in-capital		532,426,974			510,402,197			971,608,828			819,498,236
Accumulated deficit		(593,762,532	)		(586,942,014	)		(1,012,970,661	)		(868,536,506	)
Total stockholders’ deficit		(61,315,239	)		(76,519,721	)		(41,340,428	)		(49,017,752	)
Total liabilities and stockholders’ deficit	$	15,215,256		$	14,707,659		$	19,625,156		$	12,262,091

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

For the ~~Three and~~ Six Months Ended June 30, ~~2020~~2021 and ~~2019~~2020

Rennova Health, Inc. (“Rennova”), together with its subsidiaries, ~~(the~~the “Company”, “we”, “us” or “our”), is a ~~vertically integrated~~ provider of ~~healthcare related products and~~health care services. The Company owns one operating hospital in Oneida, Tennessee, a hospital located in Jamestown, Tennessee that it plans to reopen and operate, a physician’s office in Jamestown, Tennessee that it plans to reopen and a rural clinic in Kentucky. The Company’s ~~principal lines~~operations consist of only one business ~~are (i) Hospital Operations; and (ii) Clinical Laboratory Operations. The Company presents its financial results based upon these two business segments, which are more fully discussed in Note 16.~~segment.

The accompanying unaudited condensed consolidated financial statements were prepared using generally accepted accounting principles for interim financial information and the instructions to Form 10-Q and Regulation S-X. Accordingly, these financial statements do not include all information or notes required by generally accepted accounting principles for annual financial statements and should be read in conjunction with the consolidated financial statements as filed in the Company’s Annual Report on Form 10-K for the year ended December 31, ~~2019, filed with the Securities and Exchange Commission on June 29,~~ 2020. In the opinion of management, the unaudited condensed consolidated financial statements included herein contain all adjustments necessary to present fairly the Company’s consolidated financial position as of June 30, ~~2020, and~~2021, the results of its operations and changes in stockholders’ deficit ~~and cash flows~~ for the three and six months ended June 30, 2021 and 2020 and ~~2019.~~its cash flows for the six months ended June 30, 2021 and 2020. Such adjustments are of a normal recurring nature. The results of operations for the ~~three and~~ six months ended June 30, ~~2020~~2021 may not be indicative of results for the year ending December 31, ~~2020.~~2021.

The accompanying unaudited condensed consolidated financial statements, which have been prepared in accordance with accounting principles generally accepted in the United States of America (“U.S. GAAP”), include the accounts of Rennova and its wholly-owned subsidiaries. All intercompany transactions and balances have been eliminated in the consolidation.

On July 22, 2020, the Company’s Board of Directors approved an amendment to the Company’s Certificate of Incorporation to effect a 1-for-10,000 reverse stock split effective July 31, 2020 (the “Reverse Stock Split”). On May 7, 2020, the holders of a majority of the total voting power of the Company’s securities approved an amendment to the Company’s Certificate of Incorporation to effect a reverse split of all of the Company’s shares of common stock at a specific ratio within a range from 1-for-100 to 1-for-10,000, and granted authorization to the Board of Directors to determine in its discretion the specific ratio and timing of the reverse split on or prior to December 31, 2020.

As a result of the Reverse Stock Split, every 10,000 shares of the Company’s common stock was combined and automatically converted into one share of the Company’s common stock on July 31, 2020. In addition, the conversion and exercise prices of all of the Company’s outstanding preferred stock, common stock purchase warrants, stock options, equity incentive plans and convertible notes payable were proportionately adjusted at the applicable reverse split ratio in accordance with the terms of such instruments. In addition, proportionate voting rights and other rights of common stockholders were not affected by the Reverse Stock Split, other than as a result of the payment of cash in lieu of fractional shares as no fractional shares were issued in connection with the Reverse Stock Split.

All share, per share and capital stock amounts and common stock equivalents as of and for the three and six months ended June 30, 2020 and 2019 presented herein have been restated to give effect to the Reverse Stock Split.

~~Cash payment amounts related to the right-of-use liabilities for the six months ended June 30, 2019 have been reclassified on the statements of cash flows and in Note 10 for comparative purposes.~~

During the three and six months ended June 30, ~~2020~~2021 and ~~2019,~~2020, comprehensive loss was equal to the net loss amounts presented in the accompanying unaudited condensed consolidated statements of operations.

Certain items in the statement of operations for the six months ended June 30, 2021 were reclassified for comparison purposes.

The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and disclosure of contingent liabilities at the date of the ~~consolidated~~ financial statements, and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. Significant estimates and assumptions include the estimates of fair values of assets acquired and liabilities assumed in business combinations, including hospital acquisitions, the fair values of consideration received from the sale of subsidiaries, reserves and write-downs related to receivables and inventories, the recoverability of long-lived assets, ~~stock based compensation,~~ the valuation allowance relating to the Company’s deferred tax assets, the valuation of equity and derivative instruments, deemed dividends and debt discounts, among others. Actual results could differ from those estimates and would impact future results of operations and cash flows.

The Company considers all highly liquid temporary cash investments with an original maturity of three months or less to be cash equivalents.

On July 22, 2020, the Company’s Board of Directors approved an amendment to the Company’s Certificate of Incorporation to effect a 1-for-10,000 reverse stock split effective July 31, 2020 and on July 8, 2021, the Company’s Board of Directors approved an amendment to the Company’s Certificate of Incorporation to effect a 1-for-1,000 reverse stock split effective July 16, 2021 (the “Reverse Stock Splits”). The holders of a majority of the total voting power of the Company’s securities had approved these amendments to the Company’s Certificate of Incorporation on May 7, 2020 for the July 31, 2020 reverse stock split and on June 15, 2021 for the July 16, 2021 reverse stock split. In both cases, the Company’s stockholders had granted authorization to the Board of Directors to determine in its discretion the specific ratio, subject to limitations, and the timing of the reverse splits within certain specified effective dates.

As a result of the Reverse Stock Splits, every 10,000 shares of the Company’s common stock then outstanding was combined and automatically converted into one share of the Company’s common stock on July 31, 2020 and every 1,000 shares of the Company’s then outstanding common stock was combined and automatically converted into one share of the Company’s common stock on July 16, 2021. In addition, the conversion and exercise prices of all of the Company’s outstanding preferred stock, common stock purchase warrants, stock options and convertible debentures were proportionately adjusted at the applicable reverse split ratio in accordance with the terms of such instruments. In addition, proportionate voting rights and other rights of common stockholders were not affected by the Reverse Stock Splits, other than as a result of the payment of cash in lieu of fractional shares as no fractional shares were issued in connection with the Reverse Stock Splits.

The par value and other terms of the common stock were not affected by the Reverse Stock Splits. The authorized capital of the Company of 10,000,000,000 shares of common stock and 5,000,000 shares of preferred stock were also unaffected by the Reverse Stock Splits. All share, per share and capital stock amounts and common stock equivalents presented herein have been restated where appropriate to give effect to the Reverse Stock Splits.

Sale of Health Technology Solutions, Inc. and Advanced Molecular Services, Inc.

On June 25, 2021, the Company sold its subsidiaries, Health Technology Solutions, Inc. (“HTS”) and Advanced Molecular Services, Inc. (“AMSG”), including their subsidiaries, to VisualMED Clinical Solutions Corp. (“VisualMED”). HTS and AMSG held Rennova’s software and genetic testing interpretation divisions.

In consideration for the shares of HTS and AMSG and the elimination of intercompany debt among the Company and HTS and AMSG, VisualMED issued the Company 14,000 shares of its Series B Non-Voting Convertible Preferred Stock (the “VisualMED Series B Preferred Stock”). The number of shares of VisualMED Series B Preferred Stock will be subject to a post-closing adjustment. Each share of VisualMED Series B Preferred Stock has a stated value of $1,000 and is convertible into that number of shares of VisualMED common stock equal to the stated value divided by 90% of the average closing price of the VisualMED common stock during the 10 trading days immediately prior to the conversion date. Conversion of the VisualMED Series B Preferred Stock, however, is subject to the limitation that no conversion can be made to the extent the holder’s beneficial interest (as defined pursuant to the terms of the VisualMED Series B Preferred Stock) in the common stock of VisualMED would exceed 4.99%. The shares of the VisualMED Series B Preferred Stock may be redeemed by VisualMED upon payment of the stated value of the shares plus any accrued declared and unpaid dividends.

As a result of the sale, the Company has recorded the VisualMED Series B Preferred Stock as a long-term asset valued at $8.5 million at June 30, 2021 and a gain on the sale of HTS and AMSG of $10.7 million in the six months ended June 30, 2021, of which $8.5 million resulted from the value of the VisualMED Series B Preferred Stock and $2.2 million resulted from the transfer to VisualMED of the net liabilities of HTS and AMSG. See Note 14 for a discussion of the assumptions used in the valuation of the VisualMed Series B Preferred Stock.

The financial results of HTS and AMSG, including the gain on sale, are reflected as discontinued operations in the Company’s consolidated financial statements. See Note 14.

We recognize revenue in accordance with Accounting Standards Update (“ASU”) 2014-09, “Revenue ~~Recognition~~from Contracts with Customers (Topic 606),” including subsequently issued updates. This series of comprehensive guidance has replaced all existing revenue recognition guidance. There is a five-step approach outlined in the standard. In determining revenue, we first identify the contract according to the scope of ASU Topic 606 with the following criteria:

We review our calculations for the realizability of gross ~~service~~ revenues monthly to make certain that we are properly allowing for the uncollectable portion of our gross billings and that our estimates remain sensitive to variances and changes within our payer ~~groups.~~groups and within our service offerings. The contractual allowance calculation is made based on historical allowance rates for the various specific payer groups monthly with a greater weight being given to the most recent trends; this process is adjusted based on recent changes in underlying contract provisions. This calculation is routinely analyzed by us based on actual allowances issued by payers and the actual payments made to determine what adjustments, if any, are needed.

Our revenues generally relate to contracts with patients in which our performance obligations are to provide health care services to the patients. Revenues are recorded during the period our obligations to provide health care services are satisfied. Our performance obligations for inpatient services are generally satisfied over periods that average approximately five days, and revenues are recognized based on charges incurred in relation to total expected charges. Our performance obligations for outpatient services are generally satisfied over a period of less than one day. The contractual relationships with patients, in most cases, also involve a third-party payer (Medicare, Medicaid, managed care health plans and commercial insurance companies, including plans offered through the health insurance exchanges) and the ~~transaction~~ prices for the services provided are dependent upon the terms provided by (Medicare and Medicaid) or negotiated with (managed care health plans and commercial insurance companies) the third-party payers. The payment arrangements with third-party payers for the services we provide to the related patients typically specify payments at amounts less than our standard charges. Medicare generally pays for inpatient and outpatient services at prospectively determined rates based on clinical, diagnostic and other factors. Services provided to patients having Medicaid coverage are generally paid at prospectively determined rates per discharge, per identified service or per covered member. Agreements with commercial insurance carriers, managed care and preferred provider organizations generally provide for payments based upon predetermined rates per diagnosis, per diem rates or discounted fee-for-service rates. Management continually reviews the contractual estimation process to consider and incorporate updates to laws and regulations and the frequent changes in managed care contractual terms resulting from contract renegotiations and renewals. Our net revenues are based upon the estimated amounts we expect to be entitled to receive from patients and third-party payers. Estimates of contractual allowances under managed care and commercial insurance plans are based upon the payment terms specified in the related contractual agreements. ~~Revenues~~Net revenues related to uninsured patients and uninsured copayment and deductible amounts for patients who have health care coverage may have discounts applied (uninsured discounts and contractual discounts). We also record estimated implicit price concessions (based primarily on historical collection experience) related to uninsured accounts to record self-pay revenues at the estimated amounts we expect to collect.

Laws and regulations governing the Medicare and Medicaid programs are complex and subject to interpretation. Estimated reimbursement amounts are adjusted in subsequent periods as cost reports are prepared and filed and as final settlements are determined (in relation to certain government programs, primarily Medicare, this is generally referred to as the “cost report” filing and settlement process). There were no adjustments to estimated Medicare and Medicaid reimbursement amounts and disproportionate-share funds related primarily to cost reports filed during the three and six months ended June 30, ~~2020~~2021 and ~~2019.~~2020.

The Emergency Medical Treatment and Labor Act (“EMTALA”) requires any hospital participating in the Medicare program to conduct an appropriate medical screening examination of every person who presents to the hospital’s emergency room for treatment and, if the individual is suffering from an emergency medical condition, to either stabilize the condition or make an appropriate transfer of the individual to a facility able to handle the condition. The obligation to screen and stabilize emergency medical conditions exists regardless of an individual’s ability to pay for treatment. Federal and state laws and regulations require, and our commitment to providing quality patient care encourages, us to provide services to patients who are financially unable to pay for the health care services they receive. The federal poverty level is established by the federal government and is based on income and family size. The Company considers the poverty level in determining whether patients qualify for free or reduced cost of care. Because we do not pursue collection of amounts determined to qualify as charity care, they are not reported in net revenues. We provide discounts to uninsured patients who do not qualify for Medicaid or charity care. In implementing the uninsured discount policy, we may first attempt to provide assistance to uninsured patients to help determine whether they may qualify for Medicaid, other federal or state assistance, or charity care. If an uninsured patient does not qualify for these programs, the uninsured discount is applied.

The collection of outstanding receivables for Medicare, Medicaid, managed care payers, other third-party payers and patients is our primary source of cash and is critical to our operating performance. The primary collection risks relate to uninsured patient accounts, including patient accounts for which the primary insurance carrier has paid the amounts covered by the applicable agreement, but patient responsibility amounts (deductibles and copayments) remain outstanding. Implicit price concessions relate primarily to amounts due directly from patients. Estimated implicit price concessions are recorded for all uninsured accounts, regardless of the aging of those accounts. Accounts are written off when all reasonable internal and external collection efforts have been performed. The estimates for implicit price concessions are based upon management’s assessment of historical write offs and expected net collections, business and economic conditions, trends in federal, state and private employer health care coverage and other collection indicators. Management relies on the results of detailed reviews of historical write-offs and collections at facilities that represent a majority of our revenues and accounts receivable (the “hindsight analysis”) as a primary source of information in estimating the collectability of our accounts receivable. We perform the hindsight analysis quarterly, utilizing rolling ~~twelve-months~~ accounts receivable collection and write off data. We believe our quarterly updates to the estimated contractual allowance amounts and to the estimated implicit price concessions at each of our ~~hospital~~ facilities provide reasonable estimates of our net revenues and ~~valuations~~valuation of our accounts receivable. AtFor the three months ended June 30, 2021 and 2020, ~~and December 31, 2019,~~we recorded estimated contractual allowances of ~~$21.5~~$4.0 million and ~~$16.8~~$8.4 million, respectively, ~~had~~and estimated implicit price concessions of $1.3 million and $2.7 million, respectively. For the six months ended June 30, 2021 and 2020, we recorded estimated contractual allowances of $9.5 million and $18.9 million, respectively, and estimated implicit price concessions of $4.3 million and $4.0 million, respectively. These amounts have been recorded as ~~reductions to our accounts receivable balances~~ to enable us to record our net revenues and accounts receivable at the estimated amounts we expect to collect.

~~To quantify the total impact of the trends related~~ The estimated accounts receivable collection rate had been reduced to ~~uninsured accounts, we believe it is beneficial to view total uncompensated care, which is comprised of charity care, uninsured discounts and implicit price concessions. Total uncompensated care as~~ a lower percentage of gross ~~revenues was 21% and 6% for the three months ended June 30, 2020 and 2019, respectively, and 15% and 5%~~revenue for the six months ended June 30, ~~2020 and 2019, respectively.~~

~~Laboratory testing~~2021 due to serving only emergency room patients during the first four months of the period. Inpatient services for the six months ended June 30, 2019 include chemical diagnostic tests such as blood analysis and urine analysis. We did not perform any testing and analysis services for the three and six months ended June 30, 2020typically deliver higher collection rates and the ~~three months ended June 30, 2019. Laboratory service revenues are recognized at the time the testing~~absence of inpatient services are performed and billed and are reported at their estimated net realizable amounts. Net service revenues are determined utilizing gross service revenues net of contractual adjustments and discounts. Even though it is the responsibility of the patient to pay for laboratory service bills, most individuals in the U.S. have an agreement with a third-party payer such as a commercial insurance provider, Medicaid or Medicare to pay all or a portion of their healthcare expenses; most of the services provided by us in the 2019 period were to patients covered under a third-party payer contract. In most cases,meant that the Company was dependent on revenue from emergency room services, which is ~~provided the third-party billing information and seeks payment from the third party~~typically at a lower percentage of gross revenue. Inpatient services reopened in accordance with the terms and conditions of the third-party payer for health service providers like us. Each of these third-party payers may differ not only in terms of rates, but also with respect to terms and conditions of payment and providing coverage (reimbursement) for specific tests. Estimated revenues are established based on a series of procedures and judgments that require industry specific healthcare experience and an understanding of payer methods and trends.May 2021.

The Company intends to sell its clinical laboratory and, if successful, the Company would no longer own or operate clinical laboratories outside of its hospital labs, as more fully discussed under Item 2. ~~“Management’s Discussion and Analysis of Financial Condition and Results of Operations.”~~

Accounts receivable are reported at realizable value, net of contractual allowances ~~for credits~~ and estimated implicit price concessions (also referred to as doubtful ~~accounts,~~accounts), which are estimated and recorded in the period the related revenue is recorded. The Company has a standardized approach to estimating and reviewing the collectability of its receivables based on a number of factors, including the period they have been outstanding. Historical collection and payer reimbursement experience is an integral part of the estimation process related to allowances for contractual ~~credits~~allowances and doubtful accounts. In addition, the Company regularly assesses the state of its billing operations in order to identify issues which may impact the ~~collectability of these~~ receivables or reserve estimates. Receivables deemed to be uncollectible are charged against the allowance for doubtful accounts at the time such receivables are written-off. Recoveries of receivables previously written-off are recorded as credits to the allowance for doubtful accounts. Revisions to the allowances for doubtful accounts ~~estimates~~ are recorded as an adjustment to ~~provision for bad debts.~~

~~Total gross revenues for Hospital and Clinical Laboratory Operations were reduced~~revenues. As required by ~~approximately $2.7 million and $2.3 million for bad debt for the three months ended June 30, 2020 and 2019, respectively. After bad debt~~Topic 606, after estimated implicit price concessions and contractual and related allowance adjustments to revenues of ~~$11.1~~$5.3 million and ~~$31.4~~$11.1 million, respectively, for the three months ended June 30, ~~2020~~2021 and ~~2019, respectively,~~2020, we reported net revenues of ~~$2.1~~$0.9 million and ~~$4.1 million.~~

~~Total gross revenue for Hospital and Clinical Laboratory Operations were reduced by approximately $4.0~~$2.1 million, ~~and $3.9 million for bad debt for the six months ended June 30, 2020 and 2019,~~ respectively. After ~~bad debt~~estimated implicit price concessions and contractual and related allowance adjustments to revenues of ~~$22.9~~$13.8 million and ~~$64.8~~$22.9 million, respectively, for the six months ended June 30, ~~2020~~2021 and ~~2019, respectively,~~2020, we reported net revenues of ~~$3.9~~$0.3 million and ~~$9.3 million.~~$3.9 million, respectively. We continue to review the ~~provision~~provisions for ~~bad debt~~implicit price concessions and contractual ~~and related~~ allowances. See Note 4 – Accounts ~~receivable are presented~~Receivable.

~~Derivative Financial Instruments and Fair Value, Including the Adoption of ASU 2017-11~~

We account for ~~warrants issued in conjunction with the issuance of common stock and certain convertible debt instruments~~leases in accordance with ASU No. 2016-02, Leases (Topic 842) as updated, which requires leases with durations greater than 12 months to be recognized on the ~~guidance contained~~balance sheet. Upon adoption in 2019, we elected the package of transition provisions available which allowed us to carryforward our historical assessments of (1) whether contracts are or contain leases, (2) lease classification and (3) initial direct costs. We lease property and equipment under finance and operating leases. For leases with terms greater than 12 months, we record the related right-of-use assets and right-of-use obligations at the present value of lease payments over the term. We do not separate lease and non-lease components of contracts. Our operating and finance leases are more fully discussed in Note 9.

We account for the impairment or disposal of long-lived assets according to the Financial Accounting Standards Board (the “FASB”) Accounting Standards Codification (“ASC”) Topic ~~815, Derivatives~~360, Property, Plant and ~~Hedging (“~~Equipment (“ASC ~~815”) and ASC Topic 480, Distinguishing Liabilities from Equity (“ASC 480”~~360”). ~~For warrant instruments~~ASC 360 clarifies the accounting for the impairment of long-lived assets and ~~conversion options embedded~~for long-lived assets to be disposed of, including the disposal of business segments and major lines of business. Long-lived assets are reviewed when facts and circumstances indicate that the carrying value of the asset may not be recoverable. When necessary, impaired assets are written down to estimated fair value based on the best information available. Estimated fair value is generally based on either appraised value or measured by discounting estimated future cash flows. Considerable management judgment is necessary to estimate discounted future cash flows. Accordingly, actual results could vary significantly from such estimates.

The Company did not record an asset impairment charge during the three and six months ended June 30, 2021 and 2020.

We define fair value as the price that would be received from selling an asset or paid to transfer a liability in ~~promissory notes~~an orderly transaction between market participants at the measurement date. When determining the fair value measurements for assets and liabilities, which are required to be recorded at fair value, we consider the principal or most advantageous market in which we would transact and the market-based risk measurements or assumptions that market participants would use in pricing the asset or liability, such as inherent risk, transfer restrictions and credit risk. We apply the following fair value hierarchy, which prioritizes the inputs used to measure fair value into three levels and bases the categorization within the hierarchy upon the lowest level of input that is available and significant to the fair value measurement:

Level 1 – Quoted prices in active markets for identical assets or liabilities.

Level 2 – Observable inputs other than quoted prices in active markets for identical assets and liabilities, quoted prices for identical or similar assets or liabilities in inactive markets, or other inputs that are ~~not deemed to~~observable or can be ~~indexed to~~corroborated by observable market data for substantially the ~~Company’s own stock, we classified such instruments as liabilities at their fair values at~~full term of the ~~time~~assets or liabilities.

Level 3 – Inputs that are generally unobservable and typically reflect management’s estimates of ~~issuance and adjusted~~assumptions that market participants would use in pricing the ~~instruments to~~asset or liability.

We applied the Level 3 fair value ~~at each reporting period. These liabilities were subject to re-measurement at each balance sheet date until extinguished either through repayment, conversion or exercise, and any change~~hierarchy in determining the fair value ~~was recognized~~of the VisualMed Series B Preferred Stock on June 30, 2021 as more fully discussed in ~~our statement~~Note 14.

Derivative Financial Instruments, Including the Adoption of ~~operations. The fair values of these derivative and other financial instruments had been estimated using a Black-Scholes model and other valuation techniques.~~ASU 2017-11

In July 2017, the FASB issued ASU 2017-11 “Earnings Per Share (Topic 260) Distinguishing Liabilities from Equity (Topic 480) Derivatives and Hedging (Topic 815).” The amendments in Part I of this Update change the classification analysis of certain equity-linked financial instruments (or embedded features) with down round features. When determining whether certain financial instruments should be classified as liabilities or equity instruments, a down round feature no longer precludes equity classification when assessing whether the instrument is indexed to an entity’s own stock. The amendments also clarify existing disclosure requirements for equity-classified instruments. As a result, a freestanding equity-linked financial instrument (or embedded conversion option) no longer would be accounted for as a derivative liability at fair value as a result of the existence of a down round feature. For freestanding equity classified financial instruments, the amendments require entities that present earnings (loss) per share (EPS) in accordance with Topic 260 to recognize the effect of the down round feature when it is triggered. That effect is treated as a dividend and as a reduction of income available to common ~~shareholders~~stockholders in basic EPS. Convertible instruments with embedded conversion options that have down round features are now subject to the specialized guidance for contingent beneficial conversion features (in Subtopic 470-20, Debt—Debt with Conversion and Other Options), including related EPS guidance (in Topic 260).

When the down round feature is included in an equity-classified freestanding financial instrument, the value of the effect of the down round feature is treated as a dividend when it is triggered and as a numerator adjustment in the ~~basic~~ EPS calculation. This reflects the occurrence of an economic transfer of value to the holder of the instrument, while alleviating the complexity and income statement volatility associated with fair value measurement on an ongoing basis. AThe incremental value of warrants as a result of the down round provisions of $99.3 million and $149.6 million were recorded as deemed ~~dividend of $123.9 million was recorded~~dividends for the three and six months ended June 30, ~~2019~~2021, respectively. We did 0t record deemed dividends as a result of the down round ~~provision features. We did not record a deemed dividend as a result of down round provision features~~provisions during the three and six months ended June 30, 2020, ~~and 2019 and~~however, we did record a deemed dividend during the three and six months ended June 30, ~~2020.~~2020 as a result of the issuance of our Series M Convertible Preferred Stock (the “Series M Preferred Stock”) as more fully discussed in Note 11. See Note 1110 for an additional discussion of derivative financial instruments.

Income taxes are accounted for under the liability method of accounting for income taxes. Under the liability method, future tax liabilities and assets are recognized for the estimated future tax consequences attributable to differences between the amounts reported in the financial statement carrying amounts of assets and liabilities and their respective tax bases. Future tax assets and liabilities are measured using enacted or substantially enacted income tax rates expected to apply when the asset is realized or the liability settled. The effect of a change in income tax rates on future income tax liabilities and assets is recognized in income in the period that the change occurs. Future income tax assets are recognized to the extent that they are considered more likely than not to be realized. When projected future taxable income is insufficient to provide for the realization of deferred tax assets, the Company recognizes a valuation allowance.

In accordance with U.S. GAAP, the Company is required to determine whether a tax position of the Company is more likely than not to be sustained upon examination by the applicable taxing authority, including resolution of any related appeals or litigation processes, based on the technical merits of the position. The tax benefit to be recognized is measured as the largest amount of benefit that is greater than fifty percent likely of being realized upon ultimate settlement. Derecognition of a tax benefit previously recognized could result in the Company recording a tax liability that would reduce net assets. Based on its analysis, the Company has determined that it has not incurred any liability for unrecognized tax benefits as of June 30, 2021 and December 31, 2020.

The Company reports earnings (loss) ~~earnings~~ per share in accordance with ASC Topic 260, “Earnings Per Share,” which establishes standards for computing and presenting earnings (loss) per share. Basic earnings (loss) per share of common stock is calculated by dividing net earnings (loss) ~~earnings allocable~~available to common stockholders by the weighted-average shares of common stock outstanding during the period, without consideration of common stock equivalents. Diluted earnings (loss) ~~earnings~~ per share is calculated by adjusting the weighted-average shares of common stock outstanding for the dilutive effect of common stock equivalents, including stock options and warrants outstanding for the period as determined using the treasury stock method. For purposes of the diluted net loss per share calculation, common stock equivalents are excluded from the calculation when their effect would be anti-dilutive. Therefore, basic and diluted net loss per share applicable to common stockholders is the same for periods with a net ~~loss.~~loss available to common stockholders. See Note 3 for the computation of ~~(loss) earnings~~the loss per share for the three and six months ended June 30, ~~2020~~2021 and ~~2019.~~2020.

Following an inspection at Jamestown Regional Medical Center it was determined that several conditions of participation in its Medicare agreement were deficient and the hospital failed to adequately correct the deficiencies. As a result, on June 12, 2019, Jamestown Regional Medical Center’s Medicare agreement was terminated. A significant percentage of patients at Jamestown Regional Medical Center are covered by Medicare and without any ability to get paid for these services the Company suspended operations at the hospital. The Company plans to reopen the hospital upon securing adequate capital to do so. The reopening plans have also been disrupted by the coronavirus (“COVID-19”) pandemic and the timing of the reopening has been delayed and is now intended that the re-opening process will be initiated in before the end of 2021.

Effective March 5, 2019, the Company acquired certain assets related to Jellico Community Hospital. On March 1, 2021, the Company closed Jellico Community Hospital, after the city of Jellico issued a 30-day termination notice for the lease of the building. The closure reduced operating losses and the monthly cash deficit for the Company. The collections of receivables for the hospital have been negatively impacted by the closure and mean a significant shortfall in the amount required to satisfy liabilities at the facility.

~~A novel strain of coronavirus (“COVID-19”)~~COVID-19 was declared a global pandemic by the World Health Organization on March 11, 2020. We have been closely monitoring the COVID-19 pandemic and its impact on our operations and we have taken steps intended to minimize the risk to our employees and patients. These steps have increased our costs and our revenues have been significantly adversely affected. Demand for hospital services has substantially decreased. As more fully discussed in Note 7,6, we have received Paycheck Protection Program (“PPP”) loans. We have also received Health and Human Services (“HHS”) Provider Relief Funds from the federal government as more fully discussed below. If the COVID-19 pandemic continues for a further extended period, we expect to incur significant losses and additional financial assistance may be required. Going forward, the Company is unable to determine the extent to which the COVID-19 pandemic will continue to affect its business. The nature and effect of the COVID-19 pandemic on our balance sheet and results of operations will depend on the severity and length of the pandemic in our service areas; government activities to mitigate the pandemic’s effect; regulatory changes in response to the pandemic, especially those affecting rural hospitals; and existing and potential government assistance that may be provided.

The Company received Provider Relief Funds from the United States Department of ~~Health and Human Services (“HHS”)~~HHS provided to eligible healthcare providers out of the ~~$100~~ $100 billion Public Health and Social Services Emergency Fund provided for in the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”). The funds ~~are~~were allocated to eligible healthcare providers for expenses and lost revenue attributable to the COVID-19 pandemic. The funds ~~are~~were being released in tranches, and HHS partnered with UnitedHealth Group to distribute the initial ~~$30~~ $30 billion in funds by direct deposit to providers. As of ~~August 10, 2020, Company-owned~~June 30, 2021, our facilities have received approximately ~~$12.5~~ $12.4 million in relief ~~funds, $7.5 million of which we received in the three months ended June 30, 2020.~~funds. The fund payments are grants, not loans, and HHS will not require repayment, but ~~providers are restricted and~~ the funds must be used only for grant approved purposes. Based on an analysis of the compliance and reporting requirements of the Provider Relief Funds and the impact of the pandemic on our operating results through June 30, 2021,we have recognized the ~~end~~full amount of these funds as income as of June 30, 2021 of which $7.5 million and $0.5 million was recognized during the second and third quarters of 2020, respectively, and $2.5million and $1.9 million was recognized as income during the first and second quarters of 2021, respectively.

On September 19, 2020, HHS issued a Post-Payment Notice of Reporting Requirements (the “September 19, 2020 Notice”), which indicates that providers may recognize reimbursement for healthcare-related expenses, as defined therein, attributable to coronavirus that another source has not reimbursed and is not obligated to reimburse. Additionally, amounts received from HHS that are not fully expended on eligible healthcare-related expenses may be recognized as reimbursement for lost revenues, represented as a negative change in year-over-year net patient care operating income. Providers may apply payments to lost revenues up to the amount of the ~~second quarter, we~~2019 net gain from healthcare-related sources or, for entities that reported a negative net operating gain in 2019, receipts from HHS may be recognized ~~$7.5 million~~up to a net zero gain/loss in 2020. On October 22, 2020, HHS issued an updated Post-Payment Notice of ~~these~~Reporting Requirements and a Reporting Requirements Policy Update (together, the “October 22, 2020 Notice”), which includes two primary changes: (1) the definition of lost revenue is changed to refer to the negative year-over-year difference in 2019 and 2020 actual revenue from patient care related sources as opposed to the negative year-over-year change in net patient care operating income, and (2) the definition of reporting entities is broadened to include the parent of one or more subsidiary tax identification numbers that received general distribution payments, entities having providers associated with it that provide diagnoses, testing or treatment for cases of COVID-19, or entities that can otherwise attest to the terms and conditions. As codified in the October 22, 2020 Notice, the Company’s estimate of pandemic relief funds as of June 30, 2021 includes the allocation of certain general funds among subsidiaries. Regarding the amended definition of lost revenues, such change served to increase amounts eligible to be recognized as income, as compared to the September 19, 2020 Notice. As evidenced by the October 22, 2020 Notice, HHS’ interpretation of the underlying terms and conditions of such payments, including auditing and reporting requirements, continues to evolve. On January 15, 2021, the government issued “General and Targeted Distribution Post-Payment Notice of Reporting Requirements,” (the “January 15, 2021 Notice”), which again provides guidance on reporting instructions and use of funds. Additional guidance or new and amended interpretations of existing guidance on the terms and conditions of such payments may result in changes in the ~~three~~Company’s estimate of amounts for which the terms and conditions are reasonably assured of being met, and any such changes may be material. Additionally, any such changes may result in derecognition of amounts previously recognized, which may be material.

As of June 30, 2021, the Company’s estimate of the amount for which it is reasonably assured of meeting the underlying terms and conditions was updated based on, among other things, the September 19, 2020 Notice, the October 22, 2020 Notice, the January 15, 2021 Notice and the Company’s results of operations during 2020 and the six months ended June 30, ~~2020.~~2021. The Company believes that it was appropriate to recognize as income the full amount of the funds ~~have been recorded under the caption “Other income” in our unaudited condensed consolidated statements~~received, which were $12.4 million, as of ~~operations.~~June 30, 2021.

Under ASU 2014-15, Presentation of Financial Statements—Going Concern (Subtopic 205-40) (“ASC 205-40”), the Company has the responsibility to evaluate whether conditions and/or events raise substantial doubt about its ability to meet its future financial obligations as they become due within one year after the date that the financial statements are issued. As required by ASC 205-40, this evaluation shall initially not take into consideration the potential mitigating effects of plans that have not been fully implemented as of the date the financial statements are issued. Management has assessed the Company’s ability to continue as a going concern in accordance with the ~~requirement~~requirements of ASC 205-40.

As reflected in the unaudited condensed consolidated financial statements, the Company had a working capital deficit and an accumulated deficit of ~~$61.2~~$57.5 million and ~~$593.8 million,~~$1.0 billion, respectively, at June 30, ~~2020.~~2021. In addition, the Company had a loss from continuing operations before other income (expense) and income taxes of approximately ~~$3.6~~$2.6 million and ~~cash used in operating activities~~$3.2 million for the three months ended June 30, 2021 and 2020, respectively, and a loss from continuing operations before other income (expense) and income taxes of ~~$9.1~~$7.9 million and $7.1 million, for the six months ended June 30, ~~2020.~~2021 and 2020, respectively. Cash used in operating activities was $3.7 million and $9.1 million for the six months ended June 30, 2021 and 2020, respectively. As of the date of this report, our cash is deficient and payments for our operations in the ordinary course are not being made. The continued losses and other related factors, including the payment defaults under the terms of outstanding notes payable and debentures ~~for which we have received a payment demand notice,~~as more discussed in Notes 6 and 7, raise substantial doubt about the Company’s ability to continue as a going concern for twelve months from the filing date of this report.

The Company’s unaudited condensed consolidated financial statements are prepared assuming the Company can continue as a going concern, which contemplates continuity of operations through realization of assets, and the settling of liabilities in the normal course of business. ~~Initial cost savings~~As more fully discussed in Note 1, on June 25, 2021, the Company sold HTS and AMSG to VisualMED and the Company received VisualMED’s Series B Preferred Stock valued at $8.5 million as consideration for the sale (subject to post-closing adjustments). In addition, $2.2 million of net liabilities of HTS and AMSG were ~~realized by reducing the number of laboratory facilities~~transferred to ~~one for most of its toxicology diagnostics, thereby reducing the number of employees and associated operating expenses.~~VisualMED. The Company plans to separate out its Advanced Molecular Services Group (“AMSG”) and Health Technology Solutions, Inc. (“HTS”), as independent publicly traded companies in either a spin off or transaction with a publicly quoted company. The separations are subject to numerous conditions, including effectiveness of Registration Statements that may need to be filed with the Securities and Exchange Commission and consents, including under various funding agreements previously entered into by the Company. The intent of the separation of AMSG and HTS is to create separate public companies, each of which can focus on its own strengths and operational plans. In accordance with ASC 205-20 and having met the criteria for “held for sale”, the Company has reflected ~~amounts~~the assets and liabilities relating to HTS and AMSG ~~and HTS as disposal groups classified as~~ held ~~for~~prior to the sale ~~and included~~ as part of discontinued operations. AMSG and HTS are no longer included in the segment reporting following the reclassification to discontinued operations. The discontinued operations of AMSG and HTS are described further in Note 17. On June 10,In addition, during 2020, the Company ~~signed an agreement with TPT Global Tech,~~announced plans to sell its clinical laboratory, EPIC Reference Labs, Inc. ~~(OTC: TPTW)~~, and as a ~~California-based public company,~~result, EPIC Reference Labs, Inc.’s operations have been included in discontinued operations for all periods presented. The Company has been unable to ~~merge HTS~~find a buyer for EPIC Reference Labs, Inc. and, ~~AMSG into a public company (target) after TPT completes a merger of its wholly-owned subsidiary, InnovaQor, Inc. with this target. Completion of~~therefore, effective June 30, 2021, it has ceased all efforts to sell the ~~agreement is subject to a number of approvals and consents which need to be secured to complete the transaction as~~company. Discontinued operations are more fully discussed in Note ~~17.~~14.

On March 1, 2021, the Company closed Jellico Community Hospital, after the city of Jellico issued a 30-day termination notice for the lease of the building. Jellico Community Hospital had been operating at a loss since it was acquired by the Company in March 2019. The Company’s core ~~business is~~operating businesses are now a rural hospital and CarePlus Center and a hospital and physician’s office that it plans to reopen and operate. Rural hospitals ~~which is~~are a specialized marketplace with a requirement for capable and knowledgeable management. The Company’s current financial condition may make it difficult to attract and maintain adequate expertise in its management team to successfully operate ~~the Company’s hospitals.~~these businesses.

There can be no assurance that the Company will be able to achieve its business plan, which is to acquire and operate clusters of rural hospitals, raise any additional capital or secure the additional financing necessary to implement its current operating plan. The ability of the Company to continue as a going concern is dependent upon its ability to raise adequate capital to fund its operations and repay its outstanding ~~debentures~~debt and other past due obligations, fully align its operating costs, increase its revenues, and eventually regain profitable operations. The ~~accompanying~~ unaudited condensed consolidated financial statements do not include any adjustments that might be necessary if the Company is unable to continue as a going concern.

Basic loss per share is computed by dividing the loss available to common stockholders by the weighted-average number of shares of common stock outstanding during the period. Basic loss per share excludes potential dilution of securities or other contracts to issue shares of common stock. Diluted loss per share reflects the potential dilution that could occur if securities or other contracts to issue common stock were exercised or converted into common stock or resulted in the issuance of common stock that then shared in the income of the Company. For each of the three and six months ended June 30, 2021 and 2020, ~~and 2019,~~ basic ~~net~~ loss per share ~~available to common stockholders~~ is the same as diluted loss per share.

The following table sets forth the computation of the Company’s basic and diluted net loss per share available to common stockholders during the three and six months ended June 30, ~~2020~~2021 and ~~2019:~~2020:

Three Months Ended June 30, Six Months Ended June 30,
2020 2019 2020 2019
Numerator
Net income (loss) from continuing operations $ 2,105,455 $ (13,279,576 ) $ (3,646,548 ) $ (26,212,371 )
Deemed dividend (3,150,368 ) - (3,150,368 ) (123,861,587 )
Net loss available to common stockholders, continuing operations $ (1,044,913 ) $ (13,279,576 ) $ (6,796,916 ) $ (150,073,958 )
Net income (loss) from discontinued operations 16,173 (145,251 ) (23,602 ) (653,860 )
Net loss available to common stockholders $ (1,028,740 ) $ (13,424,827 ) $ (6,820,518 ) $ (150,727,818 )

Denominator
Basic and diluted weighted average common shares outstanding 989,894 528,965 985,608 335,786

Loss per share, basic and diluted
Basic and diluted, continuing operations $ (1.06 ) $ (25.11 ) $ (6.90 ) $ (446.93 )
Basic and diluted, discontinued operations $ 0.02 $ (0.27 ) $ (0.02 ) $ (1.95 )
Total basic and diluted $ (1.04 ) $ (25.38 ) $ (6.92 ) $ (448.88 )

Diluted loss per share excludes all dilutive potential shares if their effect is anti-dilutive. As of June 30, ~~2020~~2021 and ~~2019,~~2020, the following potential common stock equivalents were excluded from the calculation of diluted loss per share as their effect was anti-dilutive:

Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share

The terms of certain of the warrants, convertible preferred stock and convertible debentures issued by the Company provide for reductions in the per share exercise prices of the warrants and the per share conversion prices of the debentures and preferred stock (if applicable and subject to a floor in certain cases), in the event that the Company issues common stock or common stock equivalents (as that term is defined in the agreements) at an effective exercise/conversion price that is less than the then exercise/conversion prices of the outstanding warrants, preferred stock or debentures, as the case may be. In addition, many of these equity-based securities contain exercise or conversion prices that vary based upon the price of the Company’s common stock on the date of exercise/conversion (see Notes 7, 11 12 and ~~13)~~12). These provisions have resulted in significant dilution of the Company’s common stock.

As a result of these down round provisions, the potential common stock and ~~have given rise to reverse splits of the Company’s~~ common stock ~~including the Reverse Stock Split effected on July 31, 2020, which is~~equivalents totaled 4.7 billion at August 11, 2021, as more fully discussed in Note 1.16. See Note 11 regarding a discussion of the number of shares of the Company’s authorized common stock.

Accounts ~~receivable~~receivables at June 30, ~~2020~~2021 (unaudited) and December 31, ~~2019~~2020 consisted of the following:

The allowance for ~~discounts~~contractual obligations reflected in the table above ~~increased~~decreased as a percentage of accounts receivable to ~~79.0%~~58% at June 30, ~~2020~~2021 compared to ~~63.0%~~78% at December 31, ~~2019.~~2020. The allowance ~~for discounts varies~~is based on ~~changes in~~ historical contractual allowance rates. The decrease in the percentage of contractual obligations to accounts receivable was due to rate changes.

~~For~~Estimated implicit price concessions deducted from revenues for the three months ended June 30, 2021 and 2020 ~~and 2019, bad debt expense was $2.7~~were $1.3 million and ~~$2.3~~$2.7 million, ~~respectively. For~~respectively, and for the six months ended June 30, 2021 and 2020 ~~and 2019, bad debt expense was $4.0~~were $4.3 million and ~~$3.9~~$4.0 million, respectively. The allowance for ~~bad debts decreased by $2.8~~doubtful accounts deducted from accounts receivable was $4.1 million at June 30, ~~2020~~2021 compared to ~~the balance~~$1.5 million at December 31, ~~2019.~~2020, an increase of $2.6 million. The increase was due to updates to estimated collection rates and the closure of Jellico Community Hospital. The Company’s policy is to write off accounts receivable balances against the allowance for ~~bad debts~~implicit price concessions once an accounts receivable ages past a specified number of days.

During the year ended December 31, ~~2019,~~2020, the Company entered into ~~five~~six accounts receivable sales agreements ~~including three that were entered into during~~under which the ~~six months ended June 30, 2019. The~~Company sold an aggregate ~~amount~~of $3.3million of accounts receivable ~~sold~~ on a non-recourse basis ~~during the year ended December 31, 2019 was $3.9 million. The~~for an aggregate purchase price paid to the Company ~~was $2.7~~ of $2.2 million, less ~~$0.1~~ $0.1 million of origination fees. Accordingly, the Company recorded a loss on the sales of $1.2 million during the year ended December 31, 2020. As of June 30, 2021 and December 31, ~~2019, $1.1~~ 2020, $1.5million and $1.7 million, respectively, was outstanding and owed under ~~these~~the accounts receivable sales agreements. As of June 30, 2021, $1.3 million was recorded as a reduction of accounts receivable and $0.2million was recorded in accrued expenses. The $0.2million that was recorded in accrued expenses (see Note 5) represents the portion sold in excess of the balance of accounts receivable recorded by the Company as due on June 30, 2021.

On January 29, 2020, the Company entered into a ~~Secured Installment Promissory Note~~secured installment promissory note (the ~~“Installment~~“Ponte Note”) in the principal amount of ~~$1.2~~$1.2 million, less ~~$0.1~~$0.1 million in origination fees, the proceeds of which were used to satisfy in full the amounts due under accounts receivable sales ~~agreements.~~agreements entered into during 2019. The ~~Installment~~Ponte Note is more fully discussed in Note 7.6.

On June 26, 2020, the Company entered into an accounts receivable sales agreement under which the Company sold $0.7 million of accounts receivable on a non-recourse basis for a purchase price paid to the Company of $0.5 million, less origination fees. Accordingly, the Company recorded a loss on the sale of $0.2 million during the three and six months ended June 30, 2020. As of June 30, 2020, $0.7 million was outstanding and owed under the accounts receivable sales agreement.

As of June 30, 2021 and December 31, 2020, the Company had ~~$1.8~~$1.1 million and $1.4 million, respectively, of income tax refunds ~~receivable of which $0.6 million is more fully discussed in Note 15.~~receivable. During ~~the first quarter of~~ 2020, the U.S. Congress approved the CARES Act, which ~~allows~~allowed a five-year carryback privilege for federal net operating tax losses that arose in a tax year beginning in 2018 and through ~~the current tax year, that is,~~ 2020. As a result, during the ~~six months~~year ended ~~June 30,~~December 31, 2020, the Company recorded approximately ~~$1.1~~$1.1 million in refunds from the carryback of certain of its federal net operating losses. In addition, during the year ended December 31, 2020, the Company recorded $0.3 million in refunds related to other net operating loss carryback adjustments. During the six months ended June 30, 2021, the Company received income tax refunds of $0.3 million, which represented income tax refunds associated with the CARES Act. NaN refunds were received during the six months ended June 30, 2020. The Company used the $0.3 million of refunds that it received in the six months ended June 30, 2021 to repay a portion of the amount that it owes for federal income tax liabilities that arose from an audit of the Company’s 2015 Federal tax return as more fully discussed in Note 13. The Company’s ~~federal net operating losses~~income taxes are more fully discussed in Note 15 to the Company’s Annual Report on Form 10-K for the year ended December 31, ~~2019.~~2020.

Effective March 5, 2019, the Company acquired certain assets related to Jellico Community Hospital and CarePlus Center. Jellico Community Hospital is a fully operational 54-bed acute care facility that offers comprehensive services, including diagnostic imaging, radiology, surgery (general, gynecological and vascular), nuclear medicine, wound care and hyperbaric medicine, intensive care, emergency care and physical therapy. The CarePlus Center offers sophisticated testing capabilities and compassionate care, all in a modern, patient-friendly environment. Services include diagnostic imaging services, x-ray, mammography, bone densitometry, computed tomography (CT), ultrasound, physical therapy and laboratory services on a walk-in basis.

The purchase price for Jellico Community Hospital and CarePlus Center was $658,537. This purchase price was made available by Mr. Diamantis, a former member of the Company’s Board of Directors. The total cost of the acquisition was approximately $908,537, including $250,000 of diligence, legal and other costs associated with the acquisition. The acquisition costs were fully expensed in 2019.

The fair value of the purchase consideration paid to the sellers was allocated to the net tangible and intangible assets acquired. The Company accounted for the acquisition as a business combination under U.S. GAAP. In accordance with the acquisition method of accounting under ASC 805 the assets acquired, and liabilities assumed were recorded as of the acquisition date, at their respective fair values and consolidated with those of the Company.

The fair value of the assets acquired, net of the liabilities assumed, was $0.9 million. The excess of the aggregate fair value of the net tangible assets acquired over the purchase price was $250,000 and has been treated as a gain on bargain purchase in accordance with ASC 805. The gain was primarily due to the value of the intangible assets acquired. In addition, after evaluation, the Company has made no material adjustments to its preliminary allocation as set forth below. The purchase price allocation was based, in part, on management’s knowledge of hospital operations.

~~The following table shows the allocation of the purchase price of Jellico Community Hospital and CarePlus Center to the acquired identifiable assets acquired, and liabilities assumed:~~

The following presents the unaudited pro-forma combined results of operations of the Company and Jellico Community Hospital and CarePlus Center as if the acquisitions had occurred on January 1, 2019. The unaudited pro-forma results of operations are presented for information purposes only. The unaudited pro-forma results of operations are not intended to present actual results that would have been attained had the acquisitions been completed as of January 1, 2019 or to project potential operating results as of any future date or for any future periods.

Accrued expenses at June 30, ~~2020~~2021 (unaudited) and December 31, ~~2019~~2020 consisted of the following:

Accrued payroll and related liabilities at June 30, 2021 and December 31, 2020 included approximately ~~$1.8~~$2.7 million and $2.5 million, respectively, for penalties associated with ~~$5.4~~ approximately $5.0 million and $4.4 million of accrued past due payroll ~~taxes. Accrued interest at~~taxes as of June 30, 2021 and December 31, 2019 included accrued interest of $1.9 million on loans made to the Company by Mr. Diamantis, a former member of our Board of Directors. The increase in accrued interest is primarily due to interest associated with outstanding debentures. Debentures are more fully discussed in 2020, respectively.

Note 8. On June 30, 2020, the Company exchanged the loans and the related accrued interest owed to Mr. Diamantis for shares of the Company’s Series M Preferred Stock as more fully discussed in Notes 7 and 13.

The Company and its subsidiaries are party to a number of loans with ~~unrelated parties.~~third parties and affiliates. At June 30, ~~2020~~2021 (unaudited) and December 31, ~~2019,~~2020, notes payable consisted of the following:

The Company did not make the required monthly principal and interest payments due under the TCA Debenture for the period from October 2016 through March 2017. On February 2, 2017, the Company made a payment to TCA in the amount of $0.4 million, which was applied to accrued and unpaid interest and fees, including default interest, as of the date of payment. On March 21, 2017, the Company made a payment to TCA in the amount of $0.75 million, of which approximately $0.1 million was applied to accrued and unpaid interest and fees under the TCA Debenture. Also on March 21, 2017, the Company entered into a letter agreement with TCA, which (i) waived any payment defaults through March 21, 2017; (ii) provided for the $0.75 million payment discussed above; (iii) set forth a revised repayment schedule whereby the remaining principal plus interest aggregating to approximately $2.6 million was to be repaid in various monthly installments from April of 2017 through September of 2017; and (iv) provided for payment of an additional service fee in the amount of $150,000, which was due on June 27, 2017, the day after the effective date of the registration statement filed by the Company; which amount was reflected in accrued expenses at June 30, 2020. In addition, TCA entered into an inter-creditor agreement with the purchasers of the convertible debentures (see Note 8)7), which sets forth rights, preferences and priorities with respect to the security interests in the Company’s assets. On September 19, 2017, the Company entered into a new agreement with TCA, which extended the repayment schedule through December 31, 2017. The remaining debt to TCA remains outstanding and TCA has made a demand for payment. In May 2020, the SEC appointed a Receiver to close down the TCA Global Master Fund, L.P. over allegations of accounting fraud. The amount recorded by the Company as being owed to TCA was based on TCA’s application of prior payments made by the Company. The Company believes that prior payments of principal and interest may have been applied to unenforceable investment banking and other fees and charges. It is the Company’s position that the amount owed to TCA is less than the amount set forth above.

The Company did not make the second annual principal payment under the Tegal Notes that was due on July 12, 2016. On November 3, 2016, the Company received a default notice from the holders of the Tegal Notes demanding immediate repayment of the outstanding principal at that time of ~~$341,612~~ $341,612 and accrued interest of ~~$43,000.~~$43,000. On December 7, 2016, the Company received a breach of contract complaint with a request for the entry of a default judgment (see Note ~~15)~~13). On April 23, 2018, the holders of the Tegal Notes received a judgment against the Company. As of June 30, ~~2020,~~2021, the Company has paid ~~$27,510~~ $50,051 of principal onamount of these notes.

On September 27, 2019, the Company issued a promissory note to a lender in the principal amount of ~~$1.9~~ $1.9 million and received proceeds of ~~$1.5~~ $1.5 million, which was net of a ~~$0.3~~ $0.3 million original issue discount and ~~$0.1~~ $0.1 million in financing fees. The first principal payment of ~~$1.0~~ $1.0 million was due on November 8, 2019and the remaining ~~$0.9~~ $0.9 million was due on December 26, ~~2019.~~2019. These payments were not made. In February 2020, the note holder sued the Company and Mr. Diamantis, as guarantor, in New York State Supreme Court for the County of New York, for approximately ~~$2.2~~ $2.2 million for non-payment of the promissory note. AsMr. Diamantis was a ~~result~~former member of the ~~payment default, the Company accrued “penalty” interest in the amount~~Company’s Board of ~~approximately $0.3 million.~~Directors. In May 2020, the Company, Mr. Diamantis, as guarantor, and the note holder entered into a Stipulation providing for a payment of a total of ~~$2.2~~ $2.2 million (which ~~includes~~included accrued ~~interest)~~“penalty” interest as of that date) in installments through November 1, 2020. As of June 30, ~~2020, $150,000~~ 2021, $450,000 has been ~~paid.~~paid in cash and $2.1 million ($1.4 million of principal and $0.6 million of accrued penalty interest), remains past due. The Stipulation is ~~also discussed in Note 15.~~

On January 29, 2020, the Company entered into the Installment Note in the principal amount of $1.2 million. The Company used the proceeds to satisfy in full the amounts due under accounts receivable sales agreements. These sales agreements are more fully discussed in Note 4. Pursuant to the Installment Note, weekly installment payments ranging from $22,500 to $34,000 are due on or before February 5, 2020 through on or before October 21, 2020, the maturity date. Accordingly, the Company made payments totaling $0.6 million during the six months ended June 30, 2020. The Installment Note, which was issued with an original issue discount in the amount of approximately $0.1 million, is non-interest bearing and subject to late-payment fees of 10%.13.

As of April 20, 2020 and through May 1, 2020, the Company and its subsidiaries received PPP loan proceeds in the form of promissory notes (the “PPP Notes”) in the aggregate amount of approximately ~~$2.4~~ $2.4 million. ~~A portion of the~~The PPP Notes and accrued interest are forgivable as long as the borrower uses the loan proceeds for eligible purposes, including payroll, benefits, rent and utilities, and maintains its payroll levels. The amount of loan forgiveness will be reduced if the borrower terminates employees or reduces salaries. No collateral or guarantees were provided in connection with the PPP Notes. The unforgiven portion of the PPP Notes ~~are~~is payable over two yearsat an interest rate of ~~1.0%~~1.0% per annum, with a deferral of payments for the first ~~six~~sixteen months. Beginning ~~seven~~sixteen months from the dates of issuance, the Company is required (if not forgiven) to make monthly payments of principal and interest to the lenders. The aggregate monthly payment of all of the PPP Notes iswould be approximately ~~$0.1~~ $0.1 million. The Company ~~intends to use~~believes that it has used the proceeds for purposes consistent with the PPP. While the Company currently believes that its use of the loan proceeds ~~will meet~~has met the conditions for forgiveness of the loans, weit cannot assure you that ~~we will~~it has not ~~take~~taken actions that could cause the Company to be ineligible for forgiveness of the loans, in whole or in part. The Company is in the process of applying for forgiveness of the PPP Notes.

On January 29, 2020, the Company entered into the Ponte Note in the principal amount of $1.2 million. Pursuant to the Ponte Note, weekly installment payments ranging from $22,500 to $34,000 were due on or before February 5, 2020 through on or before October 21, 2020, the maturity date. The Ponte Note, which was issued with an original issue discount in the amount of approximately $0.1 million, is non-interest bearing and subject to a late-payment fee of 10%. The Company did not make certain installment payments due under the note and accordingly it recorded a $9,850 late payment penalty and incurred certain legal fees in connection with the payment default. On May 5, 2021, the Company entered into a settlement agreement with the holder under which the Company agreed to pay $125,000 in full satisfaction of the note of which $75,000 was paid in the six months ended June 30, 2021. The remaining balance of $50,000 is due in two monthly payments of $25,000 in July 2021 and August 2021.

On each of February 25, 2021, April 9, 2021, April 16, 2021 and April 22, 2021, the Company entered into agreements with certain institutional investors for warrant prepayment promissory notes with an aggregate principal amount of $1.1 million. The Company received proceeds of $1.0 million from the payees and, accordingly, it recorded a total of $0.1 million in original issue discount of which, $4,795 and $27,630 was amortized in the three and six months ended June 30, 2021, respectively. The payees may at their option apply all or any portion of the principal amount outstanding to the exercise of any common stock warrants of the Company. The notes are unsecured and they mature 12 months from the date of issuance. The notes do not bear interest but an interest rate of 18% will be applied to the outstanding principal commencing five days after any event of default that results in their acceleration.

At December 31, 2019, the Company was party to loans with a related party, which were exchanged for Series M Preferred Stock on June 30, 2020 as more fully discussed below. At December 31, 2019 related party loans consisted of the following:

During the six months ended June 30, 2021 and 2020, Mr. Christopher Diamantis, a former member of our Board of Directors, loaned the Company ~~$4.6~~$0.9 million and $4.6 million, respectively, the majority of which was for working capital purposes. During the six months ended June 30, ~~2019, Mr. Diamantis advanced~~2021 and 2020, the Company ~~$9.1~~repaid $0.4 and $3.3 million ~~which was used for the settlement~~ of ~~a prepaid forward purchase contract, the purchase of Jellico Community Hospital and CarePlus Center as more fully discussed in Note 5 and working capital purposes.~~

~~During the three months ended June 30, 2020 and 2019, we accrued interest of $0.2 million and $0.6 million, respectively, on~~ the loans from Mr. Diamantis, respectively, and ~~during the six months ended~~on June 30, 2020, ~~and 2019, we accrued interest of $0.5 million and $0.7 million, respectively, on~~ the ~~loans from Mr. Diamantis. Interest accrued on loans from Mr. Diamantis at a rate of 10% on all amounts loaned.~~

~~On June 30, 2020, we~~Company exchanged the total amount owed to Mr. Diamantis on that date for outstanding loans and accrued interest, net of repayments, ofwhich totaled approximately ~~$18.8~~$18.8 million, for shares of the Company’s Series M Preferred Stock. The Series M Preferred Stock is more fully discussed in Note ~~13.~~11.

During the three months ended June 30, 2021 and 2020, the Company accrued interest of $36,000 and $0.2 million, respectively, on the loans from Mr. Diamantis and during the six months ended June 30, 2021 and 2020, it accrued interest of $0.1 million and $0.5 million, respectively, on the loans from Mr. Diamantis. As of June 30, 2021 and December 31, 2020, accrued interest on the loans from Mr. Diamantis totaled $0.3 million and $0.2 million, respectively. Interest accrues on loans from Mr. Diamantis at a rate of 10% on the majority of the amounts loaned. In addition, Mr. Diamantis incurs interest expenses as a result of borrowing money from third parties to lend to the Company. Therefore, the Company reimburses Mr. Diamantis for a certain portion of the third party interest he incurs.

The carrying amount of all outstanding debentures as of June 30, ~~2020 (unaudited), and~~2021and December 31, ~~2019~~2020 is as follows:

~~The~~Payment of all outstanding debentures totaling $12.7million, including late-payment penalties, at ~~June 30, 2020 and~~ December 31, ~~2019, which were issued during~~2020 was past due by the ~~years ending~~debentures’ original terms. The debentures bear interest at the rate of 18% per annum and are secured by a first priority lien on all of the Company’s assets. The terms of the outstanding debentures as of December 31, ~~2017, 2018 and 2019,~~2020 are more fully described in Note 9 to the Company’s ~~audited~~ consolidated financial statements included in its Annual Report on Form 10-K for the year ended December 31, ~~2019.~~2020. Certain of these debentures were issued with warrants to purchase shares of the Company’s common stock. Outstanding warrants are more fully discussed in Note ~~13.~~11.

~~Payment~~The Company accrued interest expense on ~~all~~ outstanding debentures of $29.2 million at June 30, 2020, which included non-payment penalties of $6.9 million, is past due. Approximately $0.6 million of the non-payment penalties was recorded in the six months ended June 30, 2019 and the remaining $6.0 million was recorded in the second half of 2019. In January 2020, the Company and Mr. Diamantis entered into a Forbearance Agreement with certain debenture holders under which Mr. Diamantis paid the debenture holders $50,000 for legal fees and $220,000 in principal payments on debentures that were issued in February 2019. In addition, Mr. Diamantis, who had guaranteed certain of the debentures, agreed to grant the debenture holders security interests in certain potential legal settlements funds that may become due to Mr. Diamantis. The Forbearance Agreement, which terminated on March 15, 2020, required the Company and Mr. Diamantis to repay the debenture holders a total of $4.9 million on or before the termination date, of which $4.7 million was not repaid. During May 2020, the Company repaid $0.5 million of the debentures. On June 30, 2020, the Company received a formal notice of default and demand for full payment of the $29.2 million of outstanding debentures plus accrued interest. Accrued interest on the debentures totaled $6.0 million at June 30, 2020.

During the six months ended June 30, 2019, the Company realized a total of $3.8 million in proceeds from the issuances of debentures. No debentures were issued during the six months ended June 30, 2020. At June 30, 2019, unamortized discounts were $1.4 million. These discounts represented original issue discounts, the relative fair value of the warrants issued with the debentures (and the modifications thereof) and the relative fair value of the beneficial conversion features of the debentures. During the three and six months ended June 30, 2019, the Company recorded approximately $1.5 million and $14.5 million of non-cash interest and amortization of debt discount expense primarily in connection with the debentures and warrants. The interest expense for the three and six months ended June 30, 2019 included $5.4 million and $9.5 million, respectively, of expense due to the modifications of warrants during the periods. The modifications are more fully discussed in Notes 11 and 13. These discounts were fully amortized as of December 31, 2019 and, accordingly, no amortization associated with the debentures was recorded in the three and six months ended June 30, 2020.

~~In addition to the non-cash interest expense and amortization of debt discount recorded during the three and six months ended June 30, 2019 discussed in the paragraph above,~~ during the three months ended June 30, 2021 and 2020 ~~and 2019, the Company accrued interest expense on outstanding debentures~~ of ~~$1.9~~$0.6 million and ~~$0.1~~$1.9 million, respectively, and during the six months ended June 30, 2021 and 2020 ~~and 2019, the Company accrued interest expense on outstanding debentures~~ of ~~$3.9~~$1.1 million and ~~$0.1~~$3.9 million, respectively.

On June 30, ~~2020,~~2021, as adjusted for the Reverse Stock ~~Split, $2.6~~ Splits, $2.6 million of principal amount of outstanding debentures were convertible into ~~1,517,788~~5.9 million shares of the Company’s common stock at a price of ~~$1.70~~ $0.4407 per ~~share. The remaining~~share and $5.6 million of outstanding debentures were convertible on that date into ~~27,902~~0.1 million shares of the Company’s common ~~stock.~~stock at a conversion price of $52.00. The remaining outstanding debentures of $4.5 million are non-convertible.

See Notes 3 and 1311 for a discussion of the dilutive effect of the outstanding convertible debentures and warrants as of June 30, ~~2020.~~2021 and Note 16 for the dilutive effect of outstanding convertible debentures and warrants as of August 11, 2021.

Alcimede LLC (“Alcimede”) billed ~~$0.1~~$0.1 million and ~~$0.1~~$0.1 million for consulting fees for the three months ended June 30, ~~2020~~2021 and ~~2019,~~2020, respectively, and ~~$0.2~~$0.2 million and ~~$0.2~~$0.2 million for consulting fees for the six months ended June 30, ~~2020~~2021 and ~~2019,~~2020, respectively. Seamus Lagan, the Company’s President and Chief Executive Officer, is the sole manager of Alcimede ~~(see~~(also see Note ~~13)~~11).

~~See Notes 5 and 7 for discussions of transactions between the Company and Mr. Diamantis.~~

The terms of the foregoing transaction and the transactions ~~including those~~ discussed in ~~Notes 5, 7~~Note 6 and ~~13,~~11 are not necessarily indicative of those that would have been agreed to with unrelated parties for similar transactions.

~~We adopted ASU No. 2016-02,~~ ~~Leases (Topic 842)~~, which requires leases with durations greater than 12 months to be recognized on the balance sheet, effective January 1, 2019, using the modified retrospective approach. We elected the package of transition provisions available, which allowed us to carryforward our historical assessments of (1) whether contracts are or contain leases, (2) lease classification and (3) initial direct costs. We lease property and equipment under finance and operating leases. For leases with terms greater than 12 months, we record the related right-of-use assets and right-of-use obligations at the present value of lease payments over the term. We do not separate lease and non-lease components of contracts.

Generally, we use our ~~estimated weighted average cost of capital~~most recent agreed upon borrowing interest rate at lease commencement as our interest rate, as most of our operating leases do not provide a readily determinable implicit interest rate.

The following table presents our lease-related assets and liabilities at June 30, ~~2020 (unaudited)~~2021 and December 31, ~~2019:~~2020:

The following table presents certain information related to lease expense for finance and operating leases for the three months and six months ended June 30, ~~2020~~2021 and ~~2019:~~2020:

Schedule of Information Related to Lease Expense for Finance and Operating Leases

The following table presents supplemental cash flow information for the six months ended June 30, ~~2020~~2021 and ~~2019:~~2020:

Aggregate future minimum lease payments under right-of-use operating and finance leases are as follows:

Schedule of Future Minimum Rentals Under Right-to-use Operating and Finance Leases

As of June 30, ~~2020,~~2021, the Company was in default under its finance lease obligations, therefore, the aggregate future minimum lease payments and accrued interest under this finance ~~leases in the amount of $0.4~~lease totaling approximately $0.2 million ~~are~~is deemed to be immediately due. ~~In July 2020,~~

We define fair value as the ~~Company entered~~price that would be received from selling an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. When determining the fair value measurements for assets and liabilities, which are required to be recorded at fair value, we consider the principal or most advantageous market in which we would transact and the market-based risk measurements or assumptions that market participants would use in pricing the asset or liability, such as inherent risk, transfer restrictions and credit risk.

We apply the following fair value hierarchy, which prioritizes the inputs used to measure fair value into ~~a settlement with~~three levels and bases the ~~holder~~categorization within the hierarchy upon the lowest level of ~~one~~input that is available and significant to the fair value measurement:

Level 1 – Quoted prices in active markets for identical assets or liabilities.

Level 2 – Observable inputs other than quoted prices in active markets for identical assets and liabilities, quoted prices for identical or similar assets or liabilities in inactive markets, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the ~~finance leases~~assets or liabilities.

Level 3 – Inputs that are generally unobservable and ~~paid $0.1 million as full and final settlement~~typically reflect management’s estimates of assumptions that market participants would use in pricing the ~~obligation as more fully discussed in Note 15.~~asset or liability.

The estimated fair value of financial instruments was determined by the Company using available market information and valuation methodologies considered to be appropriate. At June 30, ~~2020~~2021 and December 31, ~~2019,~~2020, the carrying value of the Company’s accounts receivable, accounts payable and accrued expenses approximated their fair values due to their short-term nature.

The following table sets forth the financial assets and liabilities carried at fair value measured on a recurring basis as of June 30, ~~2020~~2021 and December 31, ~~2019:~~2020:

The fair value of the VisualMED Series B Preferred Stock of $8.5 million as of June 30, 2021 is more fully discussed in Note 14.

The Company utilized the following ~~methods~~method to value its derivative ~~liabilities~~liability as of June 30, ~~2020~~2021 and December 31, ~~2019~~2020 for an embedded conversion ~~options that were~~option related to an outstanding debenture valued at ~~$455,336.~~$455,336. The Company determined the fair value by comparing the discounted conversion price per share ~~(85%~~(85% of market ~~price, subject to a floor in certain cases)~~price) multiplied by the number of shares issuable at the balance sheet date to the actual price per share of the Company’s common stock multiplied by the number of shares issuable at that date with the difference in value recorded as a liability.

~~During~~ There was 0 change in the value of the embedded conversion option in the three and six months ended June 30, ~~2019,~~2021 and 2020 as there was 0 change in the conversion price terms during the periods.

During the three and six months ended June 30, 2021, the conversions of preferred stock triggered a further reduction in the exercise prices of ~~any debentures and~~ warrants containing ratchet features that had not already ratcheted down to their floor. In accordance with U.S. GAAP, the incremental fair value of the debentures and warrants as a result of the decreases in the conversion/exercise prices was measured ~~ignoring the down round provision,~~ using Black Scholes. The following assumptions were utilized in the Black Scholes valuation ~~models:~~models for the three months ended June 30, 2021: risk free rates ranging from ~~2.4%~~0.06% to ~~2.6% and~~0.07%, volatility ranging from ~~189.5%~~216.72% to ~~273.1%~~253.20% and ~~weighted average life of 0.3~~terms ranging from .66 year to ~~3.2 years.~~1 year. The ~~incremental value of $123.9 million was recorded as a deemed dividend~~following assumptions were utilized in the Black Scholes valuation models for the six months ended June 30, ~~2019.~~2021: risk free rates ranging from 0.06% to 0.10%, volatility ranging from 213.25% to 253.20% and terms ranging from .66 year to 1.21 years. The incremental fair value of $99.3 million and $149.6 million was recorded as deemed dividends for the three and six months ended June 30, 2021, respectively. No deemed dividends were recorded in the three and six months ended June 30, 2020 as a result of down round provision features as no down round provisions were triggered during the periods. Deemed dividends of $3.2 million were recorded in the three and six months ended June 30, 2020 as a result of the issuance of the Series M Preferred Stock as more fully discussed in Note 11. Deemed dividends are also discussed in Notes 1 and 3.

During the three and six months ended June 30, 2019, the Company recorded interest expense of $5.4 million and $9.5 million, respectively, which represented the fair value of the modification of warrants during the periods as more fully discussed in Note 13. The Company used the Black Scholes model to calculate the fair value of the warrants as of the modification dates. Using the pre-modification terms and related assumptions of risk free rates ranging from 2.44% to 2.46%, volatility ranging from 182.9% to 204.4% and weighted average remaining lives of .24 years to .36 years, and the post-modification terms and related assumptions of risk free rates ranging from 2.23% to 2.49%, volatility ranging from 198.3% to 259.4% and weighted average remaining lives of .48 years to 2.89 years, the changes in the fair value of the warrant instruments as a result of the modifications were estimated.

The Company has 5,000,000 authorized shares of Preferred Stock at a par value of $0.01. Issuances of the Company’s Preferred Stock included as part of stockholders’ deficit are discussed in Note 13. The following is a summary of the issuances of the Company’s Redeemable Preferred Stock.

On October 30, 2017, the Company closed an offering of $4,960,000 stated value of 4,960 shares of a newly-authorized Series I-1 Convertible Preferred Stock (the “Series I-1 Preferred Stock”). Each share of Series I-1 Preferred Stock has a stated value of $1,000. The offering was pursuant to the terms of the Securities Purchase Agreement, dated as of October 30, 2017 (the “Purchase Agreement”), between the Company and certain existing institutional investors of the Company. The Company received proceeds of $4.0 million from the offering. The Purchase Agreement gives the investors the right to participate in up to 50% of any offering of common stock or common stock equivalents by the Company. In the event of any such offering, the investors may also exchange all or some of their Series I-1 Preferred Stock for such new securities on an $0.80 stated value of Series I-1 Preferred Stock for $1.00 of new subscription amount basis. Each share of Series I-1 Preferred Stock is convertible into shares of the Company’s common stock at any time at the option of the holder at a conversion price equal to 85% of the lesser of the volume weighted average market price of the common stock on the day prior to conversion or on the day of conversion. The conversion price is subject to “full ratchet” and other customary anti-dilution protections as more fully described in the Certificate of Designation of the Series I-1 Preferred Stock. Upon the occurrence of certain Triggering Events, as defined in the Certificate of Designation of the Series I-1 Preferred Stock, the holder shall, in addition to any other right it may have, have the right, at its option, to require the Company to either redeem the Series I-1 Preferred Stock in cash or in certain circumstance in shares of common stock at the redemption prices set forth in the Certificate of Designation. The definition of Triggering Events includes the Company not having enough shares of common stock available to issue upon conversion, a default on certain obligations over $150,000 resulting in their acceleration and monetary judgments in excess of $200,000 that are not satisfied after 45 days.

On October 30, 2017, the Company entered into Exchange Agreements with the holders of debentures that were issued in September 2017 (the “September Debentures”) to provide that the holders may, from time to time, exchange their September Debentures for shares of a newly-authorized Series I-2 Preferred Stock. The Exchange Agreements permitted the holders of the September Debentures to exchange specified principal amounts of the September Debentures on various closing dates starting on December 2, 2017 (debentures are more fully discussed in Note 8). At the holder’s option each holder could reduce the principal amount of September Debentures exchanged on any particular closing date, or elect not to exchange any September Debentures at all on a closing date. If a holder chose to exchange less principal amount of September Debentures, or no September Debentures at all, it could carry forward such lesser amount to a future closing date and then exchange more than the originally specified principal amount for that later closing date. For each $0.80 of principal amount of September Debenture surrendered to the Company at any closing date, the Company will issue the holder a share of Series I-2 Preferred Stock with a stated value of $1.00. From December 2, 2017 through March 1, 2018, any exchange under the Exchange Agreements was at the option of the holder. Subsequent to March 2018, any exchange is at the option of the Company. Each share of Series I-2 Preferred Stock is convertible into shares of the Company’s common stock at any time at the option of the holder at a conversion price equal to 85% of the lesser of the volume weighted average market price of the common stock on the day prior to conversion or on the day of conversion. The conversion price is subject to “full ratchet” and other customary anti-dilution protections as more fully described in the Certificate of Designation of the Series I-2 Preferred Stock.

The Company’s Board of Directors has designated up to 21,346 shares of the 5,000,000 authorized shares of preferred stock as the Series I-2 Preferred Stock and the Company has issued 3,907.67 shares of its Series I-2 Preferred Stock. Each share of Series I-2 Preferred Stock has a stated value of $1,000. Upon the occurrence of certain Triggering Events (as defined in the Certificate of Designation of the Series I-2 Preferred Stock, which is the same as the definition in the Series I-1 Preferred Stock), the holder shall, in addition to any other right it may have, have the right, at its option, to require the Company to either redeem the Series I-2 Preferred Stock in cash or in certain circumstance in shares of common stock at the redemption prices set forth in the Certificate of Designation.

During the six months ended June 30, 2020 and 2019, the holder converted 21.25 shares and 769.2276 shares of Series I-2 Preferred Stock, respectively, into 25,000 and 576,075 shares, respectively, of the Company’s common stock. As of June 30, 2020, 1,521.65 shares of the Series I-2 Preferred Stock remain outstanding.

The Company has 10,000,000,000 authorized shares of Common Stock at ~~$0.0001~~$0.0001 par value and 5,000,000 authorized shares of Preferred Stock at a par value of ~~$0.01.~~$0.01.

The Company has 5,000,000 shares, par value $0.01, of preferred stock authorized. As of June 30, ~~2020,~~2021, the Company had outstanding shares of preferred stock consisting of 1,750,000shares of its Series ~~I-1~~F Convertible Preferred Stock ~~and shares~~convertible into one share of ~~its Series I-2 Preferred Stock (both of which are more fully discussed in Note 12),~~ the Company’s common stock, 10 shares of its Series H Convertible Preferred Stock ~~(the “Series H Preferred Stock”), 1,750,000~~convertible into 0.5 million shares of ~~its Series F Convertible Preferred Stock (the “Series F Preferred Stock”),~~ the Company’s common stock, 250,000 shares of its Series L Convertible Preferred Stock ~~and 22,000~~(the “Series L Preferred Stock”), 21,380.35 shares of its Series M Preferred ~~Stock.~~

Stock, 16,368.88 shares of its Series N Convertible Redeemable Preferred Stock (the “Series N Preferred Stock”), and 2,750 shares of its Series O Convertible Redeemable Preferred Stock (the “Series O Preferred Stock”). The Series HL Preferred Stock, ~~has a stated value of $1,000 per share~~the Series M Preferred Stock, the Series N Preferred Stock and ~~is convertible into shares of~~ the ~~Company’s common stock at a conversion price of 85% of the volume weighted average price of the Company’s common stock at the time of conversion.~~Series O Preferred Stock are more fully described below.

~~In September 2017, the Company issued 1,750,000 shares of its~~ Series FL Preferred Stock valued at $174,097 in connection with the acquisition of Genomas Inc. Genomas Inc. is included in the Company’s discontinued operations, which are discussed in Note 17. As a result of the Reverse Stock Split, the maximum number of shares of common stock issuable upon the conversion of the Series F Preferred Stock is one. Any shares of Series F Preferred Stock outstanding on the fifth anniversary of the issuance date will be mandatorily converted into common stock at the applicable conversion price on such date. The Series F Preferred Stock has voting rights. Each share of Series F Preferred Stock has one vote, and the holders of the Series F Preferred Stock shall vote together with the holders of the Company’s common stock as a single class.

On December 23, 2019, the Company entered into an Exchange Agreement (the “Agreement”) with Alcimede LLC (“Alcimede”), of which Seamus Lagan, our Chief Executive Officer, is the sole manager as previously stated. Pursuant to the Agreement, the Company issued to Alcimede 250,000 shares of its Series K Convertible Preferred Stock (the “Series K Preferred Stock”) in exchange for the 250,000 shares of the Company’s Series J Convertible Preferred Stock (the “Series J Preferred Stock”) held by Alcimede. The holder of the Series J Preferred Stock was entitled to receive, when and as declared by the Board of Directors of the Company, but only out of funds that were legally available therefor, cumulative cash dividends at the rate of 8% of the stated value per annum on each share of Series J Preferred Stock. The Series J Preferred Stock had been issued to Alcimede on July 23, 2018 and upon the issuance of the Series K Preferred Stock to Alcimede, the shares of Series J Preferred Stock were cancelled. Under the Agreement, Alcimede relinquished all rights to any cumulative dividends on the Series J Preferred Stock. The terms of the Series K Preferred Stock do not provide for cumulative dividends.

On May 4, 2020, the Company filed a Certificate of Designation with the Secretary of State of the State of Delaware to authorize the issuance of up to 250,000 shares of its Series L Preferred Stock. On May 5, 2020, the Company entered into an exchange agreement with Alcimede. Pursuant to the exchange agreement, the Company issued to Alcimede 250,000 shares of its Series L Preferred Stock in exchange for the 250,000 shares of the Company’s Series K Preferred Stock held by Alcimede. Upon the issuance of the Series L Preferred Stock to Alcimede, the shares of Series K Preferred Stock were cancelled. The Series L Preferred Stock is not ~~convertible into common stock prior to December 1, 2020 and is not~~ entitled to receive any dividends. Each share of the Series L Preferred Stock is convertible into shares of the Company’s common stock at a conversion price equal to the average closing price of the Company’s common stock on the ten trading days immediately prior to the conversion date.

Series M ~~Convertible~~ Preferred Stock ~~Exchanged for Loans from Mr. Diamantis~~

~~On June 9, 2020, the Company filed a certificate~~The Company’s Board of ~~designation to authorize~~ Directors has designated 30,000 shares of ~~its~~the 5,000,000 shares of authorized preferred stock as the Series M Preferred Stock. Each share of Series M Preferred Stock ~~with~~has a stated value of ~~$1,000 per share.~~$1,000. On June 30, 2020, the Company and Mr. Diamantis entered into an exchange agreement wherein Mr. Diamantis agreed to the extinguishment of the Company’s indebtedness to Mr. Diamantis totaling ~~$18.8~~$18.8 million, including accrued interest, on that date in exchange for 22,000 shares of the Company’s Series M Preferred Stock with a par value of ~~$0.01~~$0.01 per share. As a result of the exchange, the Company recorded a deemed dividend of approximately ~~$3.2~~$3.2 million in the ~~three and six months~~year ended ~~June 30,~~December 31, 2020, which represented the difference between the ~~$18.8~~$18.8 million of debt and accrued interest exchanged and the value of the Series M Preferred Stock of ~~$22.0~~$22.0 million. See Note 76 for a discussion of the Company’s current indebtedness to Mr. Diamantis.

The terms of the Series M Preferred Stock were set forth in the Company’s Current Report on Form 8-K filed with the SEC on June 16, 2020. ~~In particular: (i) each~~

During the six months ended June 30, 2021, the holder converted 619.65 shares of ~~the~~his Series M Preferred Stock, ~~shall be entitled to vote on all matters submitted to~~with a ~~vote~~stated value of the holders of the Company’s common stock. Regardless of the number of shares of Series M Preferred Stock outstanding and so long as at least one share of Series M Preferred Stock is outstanding, the outstanding shares of Series M Preferred Stock shall have the number of votes, in the aggregate, equal to 51% of all votes entitled to be voted at any meeting of stockholders or action by written consent. Each outstanding share of the Series M Preferred Stock shall represent its proportionate share of the 51% allocated to the outstanding shares of Series M Preferred Stock in the aggregate. The Series M Preferred Stock shall vote with the common stock and any other voting securities as if they were a single class of securities; (ii) each share of the Series M Preferred Stock is convertible$0.6 million into 450,000 shares of the Company’s common stock at a conversion price equal to 90% of the average closing price of the Company’s common stock on the ten trading days immediately prior to the conversion date but in any event no less than either of the par value of the Company’s common stock or the conversion price of the Series I-1 Preferred Stock; and (iii) dividends at the rate per annum of ten percent (10%) of the stated value per share shall accrue on each outstanding share of Series M Preferred Stock from and after the date of the original issuance of such share of Series M Preferred Stock (subject to appropriate adjustment in the event of any stock dividend, stock split, combination or other similar recapitalization). The dividends shall accrue from day to day, whether or not declared, and shall be cumulative and non-compounding; ~~provided~~, ~~however~~, that such dividend shall be payable only when, as, and if declared by the Board of Directors and the Company shall be under no obligation to pay such dividends. No cash dividends shall be paid on the Company’s common stock unless the dividends are paid on the Series M Preferred Stock.stock.

On August 13, 2020, Mr. Diamantis entered into a Voting Agreement and Irrevocable Proxy with the Company, Mr. Lagan and Alcimede ~~LLC~~ (of which Mr. Lagan is the sole manager) pursuant to which Mr. Diamantis granted an ~~Irrevocable~~irrevocable proxy to Mr. Lagan to vote the Series M Preferred Stock held by Mr. Diamantis, Mr. Diamantis has retained all other rights under the Series M Preferred Stock.

On August 31, 2020, the Company and its debenture holders exchanged, under the terms of the Exchange and Redemption Agreement, certain outstanding debentures and all of the outstanding shares of the Company’s Series I-1 Convertible Preferred Stock (the “Series I-1 Preferred Stock”) and Series I-2 Convertible Preferred Stock (the “Series I-2 Preferred Stock”) for 30,435.52 shares of the Company’s Series N Preferred Stock. The terms of the Series N Preferred Stock were set forth in the Company’s Current Report on Form 8-K filed with the SEC on September 1, 2020.

During the year ended December 31, 2020, the holders converted 1,001 shares of their Series N Preferred Stock, with a stated value of $1.0 million, into 38,371 shares of the Company’s common stock. During the six months ended June 30, 2021, the holders converted 13,065.53 shares of their Series N Preferred Stock, with a stated value of $13.1 million, into 9,510,352 shares of the Company’s common stock.

On May 10, 2021, the Company closed an offering of shares of its newly-authorized Series O Preferred Stock. The offering was pursuant to the terms of the Securities Purchase Agreement, dated as of May 10, 2021 (the “Purchase Agreement”), between the Company and certain existing institutional investors of the Company. The Purchase Agreement provides for the issuance of up to 4,400 shares of Series O Preferred Stock at four closings of 1,100 shares each. If all such shares of Series O Preferred Stock are issued, the Company will receive proceeds of $4.0 million.

~~Common~~The first closing occurred on May 10, 2021, the second closing occurred on May 18, 2021 and one-half of the third closing was funded on June 29, 2021. As of June 30, 2021, Company issued an aggregate of 2,750 shares of its Series O Preferred Stock and received total proceeds of $2.5 million as a result of the closings.

The ~~Company~~Series O Preferred Stock, which has ~~authorized 10,000,000,000~~been issued for cash, does not contain mandatory redemption or other features that would require it to be presented on the balance sheet outside of equity and, therefore, it qualifies for equity accounting treatment. As a result of the equity accounting treatment, fair value accounting is not required in connection with the issuances of the stock and no gains, losses, derivative liabilities or deemed dividends have been recorded in connection with the issuances of the stock.

The terms of the Series O Preferred Stock were set forth in the Company’s Current Report on Form 8-K filed with the SEC on May 11, 2021, in particular:

General. The Company’s Board of Directors has designated 10,000 shares of the 5,000,000 authorized shares of preferred stock as the Series O Preferred Stock. Each share of the Series O Preferred Stock has a stated value of $1,000.

Voting Rights. Except as provided below or by law, the Series O Preferred Stock shall have no voting rights. However, as long as any shares of Series O Preferred Stock are outstanding, the Company shall not, without the affirmative vote of the holders of a majority of the then outstanding shares of the Series O Preferred Stock, (a) alter or change adversely the powers, preferences or rights given to the Series O Preferred Stock or alter or amend the Certificate of Designation, (b) amend its certificate of incorporation or other charter documents in any manner that adversely affects any rights of the holders, (c) increase the number of authorized shares of the Series O Preferred Stock, or (d) enter into any agreement with respect to any of the foregoing.

Dividends. Dividends at the rate per annum of 10% of the stated value per share shall accrue on each outstanding share of Series O Preferred Stock from and after the date of the original issuance of such share of Series O Preferred Stock (the “Series O Preferred Accruing Dividends”). The Series O Preferred Accruing Dividends shall accrue from day to day, whether or not declared, and shall be cumulative and non-compounding; provided, however, that such Series O Preferred Accruing Dividends shall be payable only when, as, and if declared by the Board of Directors. No cash dividends shall be paid on the common stock unless the Series O Preferred Accruing Dividends are paid.

Rank. The Series O Preferred Stock ranks with respect to dividends or a liquidation, (i) on parity with the common stock, the Company’s Series H Preferred Stock, the Company’s Series L Preferred Stock, the Company’s Series M Preferred Stock and the Company’s Series N Preferred Stock, (ii) senior to the Company’s Series F Preferred Stock, and (iii) junior to any other class or series of preferred stock of the Company afterwards created and ranking by its terms senior to the Series O Preferred Stock.

Conversion. Each share of the Series O Preferred Stock is convertible into shares of the Company’s common stock, at any time and from time to time, at the option of the holder, into that number of shares of common stock determined by dividing the stated value of such share of Series O Preferred Stock, plus any accrued declared and unpaid dividends, by the conversion price. The conversion price is equal to 90% of the lowest VWAP during the 10 trading days immediately prior to the conversion date. Holders of the Series O Preferred Stock are prohibited from converting Series O Preferred Stock into shares of common stock if, as a result of such conversion, the holder, together with its affiliates, would own more than 9.99% of the total number of shares of common stock then issued and outstanding. However, any holder may increase or decrease such percentage to any other percentage not in excess of 9.99%, provided that any increase in such percentage shall not be effective until 61 days after notice to the Company.

Liquidation Preference. Upon any liquidation, dissolution or winding up of the Company, the holders of the Series O Preferred Stock shall be entitled to receive an amount equal to the stated value of the Series O Preferred Stock, plus any accrued declared and unpaid dividends thereon and any other fees or liquidated damages then due and owing thereon, for each share of the Series O Preferred Stock before any distribution or payment shall be made on any junior securities.

Redemption. At any time the Company shall have the right to redeem all, or any part, of the Series O Preferred Stock then outstanding. The Series O Preferred Stock subject to redemption shall be redeemed by the Company in cash in an amount equal to the stated value of the shares of the Series O Preferred Stock being redeemed plus all accrued declared and unpaid dividends.

The Company had ~~989,894~~10,000,000 and ~~964,894~~39,648 shares of its common stock issued and outstanding at June 30, ~~2020~~2021 and December 31, ~~2019,~~2020, respectively. During the six months ended June 30, 2021, the Company issued 450,000 shares of its common stock upon the conversion of 619.65 shares of its Series M Preferred Stock and 9,510,352 shares of its common stock upon the conversion of 13,065.53 shares of its Series N Preferred Stock. During the six months ended June 30, 2020, the Company issued ~~25,000~~25 shares of its common stock upon the conversion of 21.25 shares of its Series I-2 Preferred Stock.

On May 7, 2020, Mr. Lagan and Alcimede LLC, the holders of 50.25% of the total voting power of the Company’s voting securities, approved by written consent in lieu of a special meeting of stockholders the following proposal, which had previously been approved and recommended to be approved by the stockholders by the Board of Directors of the Company.

~~Proposal 1~~: To approve an amendment to our Certificate of Incorporation, as amended, to effect a reverse stock split of all of the outstanding shares of our common stock, at a specific ratio from 1-for-100 to 1-for-10,000, and grant authorization to our Board of Directors to determine, in its discretion, the specific ratio and timing of the reverse split at any time on or before December 31, 2020, subject to the Board of Directors’ discretion to abandon such amendment.

The stockholder approval of the above proposal became effective on June 9, 2020. As more fully discussed in Note 1, the Company effected the Reverse Stock Split on July 31, 2020. The Reverse Stock Split did not have an effect on the par value or the number of authorized shares of the Company’s common stock.

The Company has outstanding options, warrants, convertible preferred stock and convertible debentures. Exercise of the options and warrants, and conversions of the convertible preferred stock and debentures could result in substantial dilution of ~~our~~the Company’s common stock and a decline in ~~its~~the market ~~price.~~price of the common stock. In addition, the terms of certain of the warrants, convertible preferred stock and convertible debentures issued by usthe Company provide for reductions in the per share exercise prices of the warrants and the per share conversion prices of the debentures and preferred stock (if applicable and subject to a floor in certain cases), in the event that ~~we issue~~the Company issues common stock or common stock equivalents (as that term is defined in the agreements) at an effective exercise/conversion price that is less than the then exercise/conversion prices of the outstanding warrants, preferred stock or debentures, as the case may be. These provisions, as well as the issuances of debentures and preferred stock with conversion prices that vary based upon the price of our common stock on the date of conversion, have resulted in significant dilution of ~~our~~the Company’s common stock and have given rise to reverse splits of ~~our~~its common ~~stock.~~stock, including the reverse stock split effected on July 16, 2021, which is more fully discussed in Note 1. See Note 16 for a discussion of the number of shares of the Company’s common stock and common stock equivalents outstanding as of August 11, 2021.

On August 13, 2020, Mr. Diamantis entered into the Voting Agreement with the Company, Mr. Lagan and Alcimede (of which Mr. Lagan is the sole manager) pursuant to which Mr. Diamantis granted an irrevocable proxy to Mr. Lagan to vote the Series M Preferred Stock held by Mr. Diamantis. Mr. Diamantis has retained all other rights under the Series M Preferred Stock. Regardless of the number of shares of Series M Preferred Stock outstanding and so long as at least one share of Series M Preferred Stock is outstanding, the outstanding shares of Series M Preferred Stock shall have the number of votes, in the aggregate, equal to 51% of all votes entitled to be voted at any meeting of stockholders or action by written consent. This means that the holders of Series M Preferred Stock have sufficient votes, by themselves, to approve or defeat any proposal voted on by the Company’s stockholders, unless there is a supermajority required under applicable law or by agreement. As a result of the Voting Agreement, as of the date of filing this report, the Company believes that it has the ability to ensure that it has and or can obtain sufficient authorized shares of its common stock to cover all potentially dilutive common shares outstanding.

The Company maintained and sponsored the Tegal Corporation 2007 Incentive Award Equity Plan (the “2007 Equity Plan”). Tegal Corporation ~~was~~is the prior name of the Company. The 2007 Equity Plan, as amended, provided for the issuance of stock options and other equity awards to the Company’s officers, directors, employees and consultants. The 2007 Equity Plan terminated pursuant to its terms in September 2017. As ~~a result of the Reverse Stock Split, the total number of outstanding stock options at June 30, 2020 was 30 and the exercise price was so high as to not be meaningful. All outstanding stock options as~~ of June 30, 2021, 26 options were outstanding and exercisable with a weighted average exercise price of $2,992,125 per share. No options were issued, forfeited or expired during the six months ended June 30, 2021. The remaining weighted average contractual term is 4.87 years. The intrinsic value of the options exercisable at each of June 30, 2021 and December 31, 2020 was $0. No compensation expense was recorded in the three and six months ended June 30, 2021 and 2020 as all of the options were fully vested as of December 31, 2019 and, accordingly, the Company did not incur stock option compensation expense during the six months ended June 30, 2020. The Company recognized stock option compensation expense of $17,300 for the six months ended June 30, 2019. ~~As of June 30, 2020, the weighted average remaining contractual life was 5.83 years for options outstanding and exercisable. The intrinsic value of options exercisable at June 30, 2020 was $0.~~

The Company, as part of various debt and equity financing transactions, has issued warrants to purchase shares of the Company’s common ~~stock.~~

Atstock totaling 122.4 million at June 30, ~~2020, there were 63.5 million warrants outstanding primarily~~2021. During the six months ended June 30, 2021, as a result of the anti-dilution provisions of outstanding warrants, ~~that~~the exercise prices of certain warrants decreased and they became exercisable into an additional 117.8 million shares of the Company’s common stock. Certain of these warrants were issued in connection with the issuances of ~~debentures, which~~the debentures. Debentures are more fully discussed in Note 8. 7.

Included in the warrants outstanding at June 30, 2021, were warrants issued in connection with the debentures issued in March 2017. The Company issued these warrants to purchase shares of the Company’s common stock to several accredited investors (the “March Warrants”). At June 30, 2021, these warrants were exercisable into an aggregate of approximately 108.9 million shares of the Company’s common stock. The March Warrants were issued to the investors in three tranches, Series A Warrants, Series B Warrants and Series C Warrants. At June 30, 2021, the Series A Warrants were exercisable for 40.8 million shares of the Company’s common stock. They were exercisable upon issuance and have a term of exercise equal to five years. At June 30, 2021, the Series B Warrants were exercisable for 26.1 million shares of the Company’s common stock and are exercisable until March 31, 2022. At June 30, 2021, the Series C Warrants were exercisable for 42.0 million shares of the Company’s common stock and have a term of five years provided such warrants shall only vest if, when and to the extent that the holders exercise the Series B Warrants. At June 30, 2021, the Series A, Series B and Series C Warrants each have an exercise price of $0.4407 per share, which reflects adjustments pursuant to their terms. The March Warrants are subject to “full ratchet” and other customary anti-dilution protections. During the three and six months ended June 30, 2021, reductions in the exercise prices of the March Warrants have given rise to deemed dividends as more fully discussed in Notes 1, 3 and 10.

The number of warrants issued and outstanding as well as the exercise prices of the warrants reflected in the table below have been adjusted to reflect the full ratchet and other dilutive and down round provisions pursuant to the warrant agreements. As a result of the ~~current exercise prices for~~full ratchet provisions of the majority of the outstanding warrants (subject to a floor in some cases), ~~as well as the full ratchet provisions of the majority of the outstanding warrants (again, subject to a floor in some cases), subsequent decreases in the price of the Company’s common stock and~~ subsequent issuances of the Company’s common stock or common stock equivalents at prices below the then current exercise prices of the warrants ~~will result~~have resulted in ~~(1)~~ increases in the number of shares issuable pursuant to the warrants and ~~(2)~~ decreases in the exercise prices of the warrants.

The following summarizes the information related to ~~warrants issued and~~ the ~~activity~~number of shares of common stock issuable under outstanding warrants during the six months ended June 30, ~~2020:~~2021:

~~On March 27, 2019, the expiration dates of certain warrants issued in March 2017~~See above and ~~September 2017 with convertible debentures, referred to as the March 2017 Series B Warrants~~Notes 1, 3, 10, 11 and the September 2017 Series B Warrants, were extended from June 2019 to September 2019. On May 12, 2019, the expiration date of these warrants was further extended to March 31, 2022. The Company used the Black Scholes model to calculate the fair value16 for a discussion of the ~~warrants as of~~dilutive effect on the modification date. Using the pre-modification terms and related assumptions, and the post-modification terms and related assumptions, the Company determined that the change in fair value of the warrantsCompany’s common stock as a result of the ~~March 27~~^th ~~modification was $4.1 million and the May 12~~^th modification was $5.4 million. Accordingly, the Company recorded the modification value of $5.4 and $9.5 million as interest expense in the three and six months ended June 30, 2019, respectively. See Note 11 for the assumptions used in the Black Scholes valuation models.outstanding warrants.

Credit risk with respect to accounts receivable is generally diversified due to the large number of patients comprising the ~~client base. Generally, the~~accounts receivable. The Company has receivable balances with government payers and various insurance carriers. The Company does not require collateral or other security to support customer receivables. However, the Company continually monitors and evaluates its collection procedures to minimize potential credit risks associated with its accounts receivable and establishes an allowance for uncollectible accounts and as a consequence, believes that its accounts receivable credit risk exposure beyond such allowance is not material to the financial statements.

A number of proposals for legislation continue to be under discussion which could substantially reduce Medicare and Medicaid ~~(CMS)~~ reimbursements to ~~hospitals and clinical laboratories.~~hospitals. Depending upon the nature of regulatory action, and the content of legislation, the Company could experience a significant decrease in revenues from Medicare and Medicaid, ~~(CMS),~~ which could have a material adverse effect on the Company. The Company is unable to predict, however, the extent to which such actions will be taken.

The Company maintains its cash balances in high credit quality financial institutions. The Company’s cash balances may, at times, exceed the deposit insurance limits provided by the Federal Deposit Insurance ~~Corp.~~Corporation.

From ~~time-to-time,~~time to time, the Company may be involved in a variety of claims, lawsuits, investigations and proceedings related to contractual disputes, employment matters, regulatory and compliance matters, intellectual property rights and other litigation arising in the ordinary course of business. The Company operates in a highly regulated industry which may inherently lend itself to legal matters. Management is aware that litigation has associated costs and that results of adverse litigation verdicts could have a material effect on the Company’s financial position or results of operations. The Company’s policy is to expense legal fees and expenses incurred in connection with the legal proceedings in the period in which the expense is incurred. Management, in consultation with legal counsel, has addressed known assertions and predicted unasserted claims below.

Biohealth Medical Laboratory, Inc. and PB Laboratories, LLC (the “Companies”) filed suit against CIGNA Health in 2015 alleging that CIGNA failed to pay claims for laboratory services the Companies provided to patients pursuant to CIGNA - issued and CIGNA - administered plans. In 2016, the U.S. District Court dismissed part of the Companies’ claims for lack of standing. The Companies appealed that decision to the Eleventh Circuit Court of Appeals, which in late 2017 reversed the District Court’s decision and found that the Companies have standing to raise claims arising out of traditional insurance plans as well as self-funded plans. In July 2019, the Companies and EPIC Reference Labs, Inc. filed suit against CIGNA Health for failure to pay claims for laboratory services provided. Cigna Health, in turn, sued for improper billing practices. CIGNA’s case against the Company was dismissed on June 22, ~~2020;~~2020. The suit remains ongoing but because the ~~Company’s case remains in~~Company did not have the ~~early stages.~~financial resources to see the legal action to conclusion it assigned the benefit, if any, from the suit to Christopher Diamantis for his continued financial support to the Company and assumption of all costs to carry the cost to conclusion.

The Company’s Epinex Diagnostics Laboratories, Inc. subsidiary was sued in a California state court by two former employees who alleged that they were wrongfully terminated, as well as for a variety of unpaid wage claims. The parties entered into a settlement agreement of this matter on July 29, 2016 for approximately $0.2 million, and the settlement was consummated on August 25, 2016. In October of 2016, the plaintiffs in this matter filed a motion with the court seeking payment for attorneys’ fees in the approximate amount of $0.7 million. On March 24, 2017, the court granted plaintiffs’ motion for payment of attorneys’ fees in the amount of $0.3 million, and the Company accrued this amount in its consolidated financial statements.

In February 2016, the Company received notice that the Internal Revenue Service (the “IRS”) placed a lien against Medytox Solutions, Inc. and its subsidiaries relating to unpaid 2014 taxes due, plus penalties and interest, in the amount of $5.0 million. The Company paid $0.1 million toward its 2014 tax liability in March 2016. The Company filed its 2015 Federal tax return on March 15, 2016 and the accompanying election to carryback the reported net operating losses was filed in April 2016. On August 24, 2016, the lien was released, and in September of 2016 the Company received a refund from the IRS in the amount of $1.9 million. In November of 2016, the IRS commenced an audit of the Company’s 2015 Federal tax return. Based upon the audit results, the Company ~~has~~ made provisions of approximately ~~$1.0~~$1.0 million as a liability and approximately $0.9 million as a receivable in its financial statements ~~as well as an estimated $0.6 million~~for the year ended December 31, 2018. During the first quarter of ~~receivables for an additional refund that it believes is due. The Company is also due~~2020, the U.S. Congress approved the CARES Act, which allows a ~~refund as a result of the~~ five-year carryback privilege for federal net operating tax losses ~~per~~that arose in a tax year beginning in 2018 and through 2020. As a result, during the six months ended June 30, 2020, the Company recorded approximately $1.1 million in refunds from the carryback of certain of its federal net operating losses. During the six months ended June 30, 2021, the Company received income tax refunds of $0.3 million, which represented income tax refunds associated with the CARES ~~Act, which is more fully discussed~~Act. NaN refunds were received during the six months ended June 30, 2020. The Company used the $0.3 million of refunds that it received in ~~Note 4.~~the six months ended June 30, 2021 to repay a portion of the amount that it owes for federal income tax liabilities that arose from the 2015 federal income tax audit. As of June 30, 2021, the Company had federal income tax receivables of $1.1 million and federal income tax liabilities of $0.8 million.

On September 27, 2016, a tax warrant was issued against the Company by the Florida Department of Revenue (the “DOR”) for unpaid 2014 state income taxes in the approximate amount of ~~$0.9~~$0.9 million, including penalties and interest. The Company entered into a Stipulation Agreement with the DOR allowing the Company to make monthly installments until July 2019. The Company has made payments to reduce the amount owed. The Company intends to renegotiate another Stipulation agreement. However, there can be no assurance the Company will be successful. The balance accrued of approximately ~~$0.4~~$0.4 million remained outstanding to the DOR at June 30, ~~2020.~~2021.

In December of 2016, TCS-Florida, L.P. (“Tetra”), filed suit against the Company for failure to make the required payment under an equipment leasing contract that the Company had with Tetra and received a judgment against the Company. In May 2018, Tetra and the Company agreed to dispose of certain equipment and the proceeds from the sale were applied to the outstanding balance. In July 2020, the Company entered into a settlement with Tetra and paid $100,000 as full and final settlement of all liability to Tetra. As a result of the settlement, the Company recorded a gain on settlement of approximately $0.9 million in the three and six months ended June 30, 2020.

In December of 2016, DeLage Landen Financial Services, Inc. (“DeLage”), filed suit against the Company for failure to make the required payments under an equipment leasing contract that the Company had with DeLage (see Note ~~10)~~9). On January 24, 2017, DeLage received a default judgment against the Company in the approximate amount of ~~$1.0~~$1.0 million, representing the balance owed on the lease, as well as additional interest, penalties and fees. The Company recognized this amount in its consolidated financial statements as of December 31, 2016. On February 8, 2017, a Stay of Execution was filed and under its terms the balance due was to be paid in variable monthly installments through January of 2019, with an implicit interest rate of ~~4.97%~~4.97%. The Company and DeLage ~~have now~~ disposed of certain equipment and reduced the balance owed to DeLage. A balance of ~~$0.2~~$0.2 million remained outstanding at June 30, ~~2020.~~2021.

On December 7, 2016, the holders of the Tegal Notes (see Note 7)6) filed suit against the Company seeking payment for the amounts due under the notes in the aggregate of the principal of ~~$341,612,~~$341,612, and accrued interest of ~~$43,000.~~$43,000. A request for entry of default judgment was filed on January 24, 2017. On April 23, 2018, the holders of the Tegal Notes received a judgment against the Company. As of June 30, ~~2020,~~2021, the Company has repaid ~~$27,510 of this amount.~~

~~Two former employees~~$50,051 of the Company’s CollabRx, Inc. subsidiary filed suits in a California state court in connection with amounts claimed to be owed under their respective employment agreements with the subsidiary. One former employee received a judgment in October 2018 for approximately $253,000. The other former employee received a judgment in December 2018 for approximately $173,000. While the Company has accruedprincipal amount of these ~~amounts claimed, it is considering its options to refute these matters and believes the claims against the Company to be frivolous and outside of entitlement and contractual agreements.~~notes.

The Company, as well as many of ~~our~~its subsidiaries, are defendants in a case filed in Broward County Circuit Court by TCA Global Credit Master Fund, L.P. The plaintiff alleges a breach by Medytox Solutions, Inc. of its obligations under a debenture and claims damages of approximately ~~$2,030,000~~$2,030,000 plus interest, costs and fees. The Company and the other subsidiaries are sued as alleged guarantors of the debenture. The complaint was filed on August 1, 2018. The Company has recorded the principal balance and interest owed under the debenture agreement for the period ended June 30, ~~2020~~2021 (see Note 7)6). The Company and all defendants have filed a motion to dismiss the complaint, but have not recorded any potential liability related to any further damages. In May 2020, the SEC appointed a Receiver to close down the TCA Global Master Fund, LPL.P. over allegations of accounting fraud. The amount recorded by the Company as being owed to TCA was based on TCA’s application of prior payments made by the Company. The Company believes that prior payments of principal and interest may have been applied to unenforceable investment banking and other fees and charges. It is the Company’s position that the amount owed to TCA is less than what is set forth in Note ~~7 above.~~6 and the Company intends to negotiate a settlement with the Receiver.

On September 13, 2018, Laboratory Corporation of America sued EPIC Reference Labs, Inc., a subsidiary of the Company, in Palm Beach County Circuit Court for amounts claimed to be owed. The court awarded a judgment against EPIC Reference Labs, Inc. in May 2019 for approximately ~~$155,000.~~$155,000. The Company has recorded the amount owed as a liability as of June 30, ~~2020.~~

In July 2019, Roche Diagnostics Corporation sued EPIC Reference Labs, Inc. in the Circuit Court for Palm Beach County claiming approximately $240,000 under an agreement to lease equipment and purchase supplies. The amount of the settlement in this case of $110,000 was accrued in 2019 and paid in full during the six months ended June 30, 2020.

In August 2019, EPIC Reference Labs, Inc. and Medytox Diagnostics, Inc. were sued by Beckman Coulter, Inc. in the same court under an agreement to purchase laboratory supplies. The plaintiff claims damages of approximately $124,000. The Company has disputed the amount owed, and has entered settlement discussions to settle the matter, but has recorded this liability as of June 30, 2020.

In July 2019, the landlord of Medytox Solutions, Inc. received a judgment in the amount of approximately $413,000 in connection with failure to pay under an office lease in West Palm Beach, Florida. The Company reached a settlement in May 2020 to resolve the judgment in the amount of $300,000, which is being paid under a payment plan.2021.

In February 2020, Anthony O. Killough sued the Company and Mr. Diamantis, as guarantor, in New York State Supreme Court for the County of New York, for approximately ~~$2.0~~$2.0 million relating to the promissory note issued by the Company in September 2019. In May 2020, the parties entered into a Stipulation providing for a payment of a total of ~~$2,158,168~~$2,158,168 (which includes accrued interest) in installments through November 1, ~~2020.~~2020 (See Note 7)6). As of June 30, 2021, the Company has not made the majority of the required payments and, as a result, approximately $1.5 million of principal and $0.6 million of penalty interest, which accrues at a rate of 20% per annum, are due and owing.

In February 2021, a supplier to the Company’s hospitals, Shared Medical Services, Inc., filed suit in Palm Beach County Circuit Court for approximately $90,000 by virtue of default and for breach of contract and charges totaling approximately another $100,000. The Company disputes that it has any liability or responsibility under the agreements and has filed an initial response in the matter. A mediation is being scheduled for September 2021.

Following the Company’s decision to suspend operations at Jamestown Regional Medical Center in June 2019 a number of vendors remain unpaid. A number have initiated or threatened legal actions. The Company believes it will come to satisfactory arrangements with these parties as it works toward reopening the hospital. The Company has ~~taken steps~~accrued the amounts that it expects to ~~re-enter~~owe in its financial statements. The Company is planning to reopen the ~~Medicare program and is currently planning the~~hospital upon securing adequate capital to do so. The reopening ~~of the hospital. Plans~~plans and timing thereof have also been disrupted by the current pandemic.

Two former employees of Jamestown Regional Medical Center filed suit alleging violations of the federal Worker Adjustment and Retraining Notification Act (“WARN”). The Court entered a default against the Company on August 14, 2019. The parties disagreed to the amount of damages, specifically to whether part-time employees are entitled to WARN act damages. The parties have agreed to a confidential settlement agreement, which was concluded in the second quarter of 2021. The Company has accrued the estimated settlement amount.

In June 2019, CHSPSC, the former owners of Jamestown Regional Medical Center, obtained a judgment against the Company in the amount of ~~$592,650.~~$592,650. The Company has recorded $130,000 of this judgment as a liability as of June 30, 2021, as management believes that a number of insurance payments were made to CHSPCS after the change of ownership and will likely offset the majority of the claim made by CHSPCS.

In August 2019, Morrison Management Specialists, Inc. obtained a judgment against Jamestown Regional Medical Center and the Company in Fentress County, Tennessee in the amount of ~~$194,455~~$194,455 in connection with ~~the~~ housekeeping and dietary services. The Company has recorded this liability as of June 30, ~~2020.~~2021.

In November 2019, Newstat, PLLC obtained a judgment against Big South Fork Medical Center in Knox County, Tennessee in the amount of ~~$190,600~~$190,600 in connection with the provision of medical services. The Company has recorded this liability as of June 30, ~~2020.~~2021.

~~Note 16– Segment Reporting~~On April 30 2021, Ponte Investments, LLC obtained a default judgment for $241,332 relating to a balance outstanding on a promissory note entered into on or about January 2020. In May 2021, the parties entered into a settlement agreement for $125,000 in full satisfaction of the note, of which $75,000 was paid in the six months ended June 30, 2021. The remaining balance of $50,000 is due in two monthly payments of $25,000 in July 2021 and August 2021. which as of the date of this report has been paid in full.

~~Operating segments are defined~~On June 28, 2021, Jellico Community Hospital and Big South Fork Medical Center entered into a settlement agreement with Maxim Healthcare Staffing Services, Inc. wherein Jellico Community Hospital and Big South Fork Medical Center agreed to pay Maxim $60,000 in full and final settlement of amounts owed under U.S. GAAP as components of an enterprise for which discrete financial information is available and are evaluated regularly by the enterprise’s chief operating decision maker in determining how to allocate resources and assess performance.staffing agreements. The Company ~~operates~~paid the settlement amount in ~~two reportable business segments:~~

~~The Company’s Corporate expenses reflect consolidated company-wide support services such as finance, legal counsel, human resources, and payroll.~~full on June 30, 2021.

~~Selected financial information for~~On June 30, 2021, the ~~Company’s operating segments was~~Company entered into a settlement agreement with the Tennessee Bureau of Workers’ Compensation. Per the terms of the settlement agreement, the Company has recorded a liability of $109,739 as ~~follows:~~of June 30, 2021.

In July 2021, WG Fund, Queen Funding and Diesel Funding filed legal actions in New York State Supreme Court for Kings County to recover amounts claimed to be outstanding on accounts receivable sales agreements entered into in 2020. The Company has recorded the contingent obligations (based on collections from accounts receivable) in the amount of $1.5 million under these agreements as of June 30, 2021.

In 2017, the Company announced plans to spin off ~~AMSG~~or sell its wholly-owned subsidiaries, HTS and in the third quarter 2017 our Board of Directors voted unanimously to spin off the Company’s wholly-owned subsidiary, HTS, as independent publicly traded companies by way of tax-free distributions to the Company’s stockholders.AMSG. On June ~~10, 2020,~~25, 2021, the Company ~~signed an agreement for~~sold the ~~separation~~shares of ~~these divisions into a public company. The agreement is with TPT Global Tech, Inc. (OTC: TPTW), a California-based public company, to merge~~stock of HTS and AMSG ~~into a public company after TPT completes a merger of its wholly-owned subsidiary, InnovaQor, Inc. with this public company.~~to VisualMED. HTS and AMSG held Rennova’s software and genetic testing interpretation divisions. The ~~public company will be known as InnovaQor going forward. Completion~~terms of the agreement is subject to a number of approvals and consents which need to be secured to complete the transaction. Subject to closing and the relevant SEC approvals it is intended that Rennova will receive approximately $22 million of preferred sharessale are discussed in the transaction, $5 million of which will be converted to common shares in the public company, and distributed to Rennova shareholders upon completion of the relevant registration/approvals with the SEC. The remaining approximately $17 million of preferred shares held by Rennova as an investment in InnovaQor will be convertible to common shares on achievement of certain milestones going forward. There can be no assurance that the transaction as described will be consummated or that terms including numbers or values for consideration shares will not change significantly before closing.Note 1.

During the ~~criteria for “held for sale”, as~~three months ended September 30, 2020, the Company ~~reached this~~made a decision ~~prior~~ to ~~January 1, 2019,~~sell its last clinical laboratory, EPIC Reference Labs, Inc., and it made a decision to discontinue several other non-operating subsidiaries, and as a result, EPIC Reference Labs, Inc.’s operations and the other non-operating subsidiaries have been included in discontinued operations for all periods presented. The Company has ~~reflected amounts relating~~been unable to ~~AMSG~~find a buyer for EPIC Reference Labs, Inc. and, ~~HTS as disposal groups classified as held for sale and included as part of discontinued operations. Segment operation disclosures in Note 16 no longer include amounts relating~~therefore, effective June 30, 2021, it has ceased all efforts to ~~AMSG and HTS following~~sell the ~~reclassification to discontinued operations.~~company.

Carrying amounts of major classes of assets and liabilities ~~classified as held for sale and~~sold or included as part of discontinued operations in the ~~condensed~~ consolidated balance sheets as of June 30, 2021 and December 31, 2020 consisted of the following:

Major line items constituting income (loss) from discontinued operations in the ~~unaudited condensed~~ consolidated statements of operations for the three and six months ended June 30, ~~2020~~2021 and ~~2019~~2020 consisted of the ~~following:~~following (unaudited):

EPIC Reference Labs, Inc. and Other Subsidiaries (Loss) Income ~~(Loss)~~ from Discontinued Operations:

	Three Months Ended
	June 30, 2020		June 30, 2019
	(unaudited)		(unaudited)			Three Months Ended June 30, 2021			Three Months Ended June 30, 2020			Six Months Ended June 30, 2021			Six Months Ended June 30, 2020
Revenue from services	$	103,110	$	351,380		$	-		$	-		$	-		$	442
Cost of services		2,212		31,304			-			110,257			-			-
Gross profit		100,898		320,076			-			(110,257	)		-			442
Operating expenses		52,807		406,712			(46,759	)		(22,537	)		(94,856	)		(51,653	)
Other expense		-		-
Other income (expense)							51,876			93,035			48,771			90,392
Gain on sale							-			-			-			-
Provision for income taxes		-		-			-			-			-			-
Income (loss) from discontinued operations	$	48,091	$	(86,636	)	$	5,117		$	(39,759	)	$	(46,085	)	$	39,181

Consolidated (Loss) Income ~~(Loss)~~ from Discontinued Operations:

Three Months Ended
June 30, 2020 June 30, 2019
(unaudited) (unaudited)
Revenue from services $ 103,110 $ 376,880
Cost of services 2,212 38,409
Gross profit 100,898 338,471
Operating expenses 67,431 480,720
Other expense 17,294 3,002
Provision for income taxes - -
Income (loss) from discontinued operations $ 16,173 $ (145,251 )

	Three Months Ended June 30, 2021			Three Months Ended June 30, 2020			Six Months Ended June 30, 2021			Six Months Ended June 30, 2020
Revenue from services	$	98,725		$	103,110		$	216,941		$	262,619
Cost of services		1,996			112,469			2,386			10,989
Gross profit		96,729			(9,359	)		214,555			251,630
Operating expenses		(314,555	)		(89,903	)		(646,152	)		(303,387	)
Other income (expense)		52,089			67,535			39,194			38,961
Gain on sale		10,727,152			-			10,727,152			-
Provision for income taxes		-			-			-			-
Income (loss) from discontinued operations	$	10,561,415		$	(31,727	)	$	10,334,749		$	(12,796	)

Major line items constituting income (loss) from discontinued operations in the unaudited condensed consolidated statements of operations for the six months ended June 30, 2020 and 2019 consisted of the following:

~~In August 2018, the FASB issued ASU 2018-13,~~ ~~Fair Value Measurement (Topic 820): Disclosure Framework - Changes to the Disclosure Requirements for Fair Value Measurement~~. This standard will require entities to disclose the amount of total gains or losses for the period recognized in other comprehensive income that is attributable to fair value changes in assets and liabilities held as of the balance sheet date and categorized within Level 3 of the fair value hierarchy. This ASU will be effective for us for annual and interim periods beginning after December 31, 2020. Early adoption of this standard is permitted. We have not yet determined the impact of the adoption of this ASU on our results of operations, financial position and cash flows.

In August 2018, the FASB issued ASU 2018-15, Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40): Customer’s Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract. Under this standard customers will apply the same criteria for capitalizing implementation costs as they would for an arrangement that has a software license. The adoption of this new guidance prescribes the balance sheet, income statement, and cash flow classification of the capitalized implementation costs and related amortization expense, and additional quantitative and qualitative disclosures. This ASU ~~will be~~became effective for us ~~for annual and interim periods beginning after December 30, 2020. Early~~on January 1, 2021. The adoption of this ~~standard is permitted and may be applied either prospectively to eligible costs incurred on or after the date of the new guidance or retrospectively. We~~ASU did not have ~~not yet determined the~~a material impact ~~of the adoption of this ASU~~ on our results of operations, financial position and cash flows.

In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes. The new guidance simplifies the accounting for income taxes by removing certain exceptions to the general principles and also ~~simplification of~~simplifies areas such as franchise taxes, step-up in tax basis goodwill, separate entity financial statements and interim recognition of enactment of tax laws or rate changes. This standard became effective for us on January 1, 2021. The adoption of this ASU did not have a material impact on our consolidated financial statements.

In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40).The new guidance provides accounting for convertible instruments and contracts in an entity’s own equity. The FASB issued this Update to address issues identified as a result of the complexity associated with applying U.S. GAAP for certain financial instruments with characteristics of liabilities and equity. The Board focused on amending the guidance on convertible instruments and the guidance on the derivatives scope exception for contracts in an entity’s own equity. This standard will be effective for us for annual periods beginning on January 1, ~~2021,~~2024, including interim periods within those fiscal years. Early adoption of this standard is not permitted ~~including adoption of all amendments in any interim period~~ for ~~which financial statements~~us because we have already adopted ASU 2017-11 “Earnings Per Share (Topic 260) Distinguishing Liabilities from Equity (Topic 480) Derivatives and Hedging (Topic 815).” We have not yet ~~been issued. We are evaluating~~determined the impact of adopting this new accounting guidance on our consolidated financial statements.

In May 2021, the FASB issued ASU 2021-04, Earnings Per Share (Topic 260), Debt—Modifications and Extinguishments (Subtopic 470-50), Compensation—Stock Compensation (Topic 718), and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40, Issuer’s Accounting for Certain Modifications or Exchanges of Freestanding Equity-Classified Written Call Options. The FASB issued this Update to clarify and reduce diversity in an issuer’s accounting for modifications or exchanges of freestanding equity-classified written call options (for example, warrants) that remain equity classified after modification or exchange. The guidance clarifies whether an issuer should account for a modification or an exchange of a freestanding equity-classified written call option that remains equity classified after modification or exchange as (1) an adjustment to equity and, if so, the related earnings per share (EPS) effects, if any, or (2) an expense and, if so, the manner and pattern of recognition. The amendments in this Update are effective for all entities for fiscal years beginning after December 15, 2021, including interim periods within those fiscal years. An entity should apply the amendments prospectively to modifications or exchanges occurring on or after the effective date of the amendments. Early adoption is permitted for all entities, including adoption in an interim period. If an entity elects to early adopt the amendments in this Update in an interim period, the guidance should be applied as of the beginning of the fiscal year that includes that interim period. We have not yet determined the impact of adopting this new accounting guidance on our consolidated financial statements.

Other recent accounting standards issued by the FASB, including its Emerging Issues Task Force, the American Institute of Certified Public Accountants, and the SEC did not or are not believed by management to have a material impact on the Company’s present or future consolidated financial statements.

Subsequent to June 30, ~~2020~~2021 and through August ~~10, 2020, we~~11, 2021, the Company issued 19,350,000 shares of its common stock upon conversions of 700.57 shares of its Series N Preferred Stock with a stated value of $0.7 million.

Subsequent to June 30, 2021, the Company issued 1,650 shares of its Series O Preferred Stock with a stated value of $1,650,000 and received ~~approximately $5.0~~proceeds of $1.5 million, ~~from HHS Provider Relief Funds.~~bringing the total number of outstanding shares of the Company’s Series O Preferred Stock to 4,400 shares with a stated value of $4.4 million.

On July 16, 2021, the Company effected a 1-for 1,000 reverse stock split as more fully discussed in Note 1.

The following table presents the potential dilutive effect of our various equity-linked instruments as of August 11, 2021:

On August 13, 2020, Mr. Diamantis entered into athe Voting Agreement ~~and Irrevocable Proxy~~ with the Company, Mr. Lagan and Alcimede ~~LLC~~ (of which Mr. Lagan is the sole manager) pursuant to which Mr. Diamantis granted an ~~Irrevocable~~irrevocable proxy to Mr. Lagan to vote the Series M Preferred Stock held by Mr. Diamantis, Mr. Diamantis has retained all other rights under the Series M Preferred Stock. ~~The~~Regardless of the number of shares of Series M Preferred Stock outstanding and so long as at least one share of Series M Preferred Stock is ~~described~~outstanding, the outstanding shares of Series M Preferred Stock shall have the number of votes, in ~~Note 13.~~the aggregate, equal to 51% of all votes entitled to be voted at any meeting of stockholders or action by written consent. This means that the holders of Series M Preferred Stock have sufficient votes, by themselves, to approve or defeat any proposal voted on by the Company’s stockholders, unless there is a supermajority required under applicable law or by agreement. As a result of the Voting Agreement, as of the date of filing this report, the Company believes that it has the ability to ensure that it has and or can obtain sufficient authorized shares of its common stock to cover all potentially dilutive common shares outstanding.

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

Certain statements made in this Form 10-Q are “forward-looking statements” (within the meaning of the Private Securities Litigation Reform Act of 1995) regarding the plans and objectives of management for future operations. Such statements involve known and unknown risks, uncertainties and other factors that may cause actual results, performance or achievements of the Company to be materially different from any future results, performance or achievements expressed or implied by such forward-looking statements. The forward-looking statements included herein are based on current expectations that involve numerous risks and uncertainties. The Company’s plans and objectives are based, in part, on assumptions involving its continued business operations. Assumptions related to the foregoing involve judgments with respect to, among other things, future economic, competitive and market conditions and future business decisions, all of which are difficult or impossible to predict accurately and many of which are beyond the control of the Company. Although the Company believes its assumptions underlying the forward-looking statements are reasonable, any of the assumptions could prove to be inaccurate and, therefore, there can be no assurance the forward-looking statements included in this report will prove to be accurate. In light of the significant uncertainties inherent in the forward-looking statements included herein, the inclusion of such information should not be regarded as a representation by the Company or any other person that the objectives and plans of the Company will be achieved.

The forward-looking statements included in this Form 10-Q and referred to elsewhere are related to future events or our strategies or future financial performance. In some cases, you can identify forward-looking statements by terminology such as “may,” “should,” “believe,” “anticipate,” “future,” “potential,” “estimate,” “expect,” “intend,” “plan,” or the negative of such terms or comparable terminology. All forward-looking statements included in this Form 10-Q are based on information available to us as of the filing date of this report, and the Company assumes no obligation to update any such forward-looking statements, except as required by law. Our actual results could differ materially from the forward-looking statements.

Important factors that might cause our actual results to differ materially from the results contemplated by the forward-looking statements are contained in the “Risk Factors” section of our Annual Report on Form 10-K for the fiscal year ended December 31, ~~2019~~2020 (the ~~“2019~~“2020 Form 10-K”) and in our subsequent filings with the Securities and Exchange Commission. The following discussion of our results of operations should be read in conjunction with the audited financial statements contained within the ~~2019~~2020 Form 10-K and with our unaudited condensed consolidated financial statements and related notes thereto included elsewhere in this report.

~~We operate in two business segments: Hospital Operations and Clinical Laboratory Operations.~~

~~Our Hospital Operations represented virtually all of our revenues for the three and six months ended June 30, 2020 and 2019.~~ Our hospital operations began with the opening of our Big South Fork Medical Center on August 8, 2017, following the receipt of the required licenses and regulatory approvals.

Big South Fork Medical Center is classified as a Critical Access Hospital (rural) with 25 beds, a 24/7 emergency department, operating rooms and a laboratory that provides a range of diagnostic services. On January 31, 2018, ~~the Company~~we entered into an asset purchase agreement to acquire ~~from Community Health Systems, Inc. certain assets related to~~ an acute care hospital located in Jamestown, Tennessee, referred to as Jamestown Regional Medical Center. The purchase was completed on June 1, 2018 for a purchase price of $0.7 million. The hospital was acquired by a newly formed subsidiary, Jamestown TN Medical Center, Inc., and is an 85-bed facility of approximately 90,000 square feet on over eight acres of land, which offers a 24-hour Emergency Department with two spacious trauma bays and seven private exam rooms, inpatient and outpatient medical services and a Progressive Care Unit which provides telemetry services. The acquisition also included a separate physician practice, known as Mountain View Physician Practice, Inc. Jamestown is located 38 miles west of Big South Fork Medical Center. ~~The Company has suspended operations at the Jamestown hospital but plans to reopen it upon receiving Medicare approval and securing adequate capital to do so.~~

In addition, on March 5, 2019, we closed an asset purchase agreement ~~(the “Purchase Agreement”)~~ whereby we acquired certain assets related to an acute care hospital located in Jellico, Tennessee, known as Jellico Community Hospital, and an outpatient clinic located in Williamsburg, ~~Kentucky.~~Kentucky, known as CarePlus.

We suspended operations at Jamestown Regional Medical Center in June 2019, as a result of the termination of its Medicare agreement. We plan to reopen the hospital upon securing adequate capital to do so. The ~~hospital~~reopening plans have also been disrupted by the coronavirus (“COVID-19”) pandemic and the timing of the reopening has been delayed. It is ~~known as~~now intended that the re-opening process will be initiated in before the end of 2021.

On March 1, 2021, we closed Jellico Community Hospital, after the city of Jellico issued a 30-day termination notice for the lease of the building. We do not expect this closure to have an adverse effect on our business strategy as we believe it will have a positive impact from a reduced cash requirement in the immediate future.

Sale of Health Technology Solutions, Inc. and Advanced Molecular Services, Inc.

In 2017, we announced plans to spin off or sell our wholly-owned subsidiaries Advanced Molecular Services Group (“AMSG”) and Health Technology Solutions, Inc. (“HTS”). On June 25, 2021, the Company sold the shares of stock of HTS and AMSG to VisualMED Clinical Solutions Corp. (“VisualMED”). HTS and AMSG held Rennova’s software and genetic testing interpretation divisions. In consideration for the shares of HTS and AMSG and the ~~clinic~~elimination of inter-company debt between the Company and HTS and AMSG, VisualMED issued the Company 14,000 shares of its Series B Non-Voting Convertible Preferred Stock (the “VisualMED Series B Preferred Stock”). The number of shares of Series B Preferred Stock will be subject to a post-closing adjustment. Each share of Series B Preferred Stock has a stated value of $1,000 and is known as the CarePlus Center. The hospital and the clinic and their associated assets were acquired from Jellico Community Hospital, Inc. and CarePlus Rural Health Clinic, LLC, respectively. Jellico Community Hospital is a fully operational 54-bed acute care facilityconvertible into that offers comprehensive services, including diagnostic imaging, radiology, surgery (general, gynecological and vascular), nuclear medicine, wound care and hyperbaric medicine, intensive care, emergency care and physical therapy. Jellico is located 33 miles eastnumber of our Big South Fork Medical Center. The CarePlus Center offers sophisticated testing capabilities and compassionate care, all in a modern, patient-friendly environment. Services include diagnostic imaging services, x-ray, mammography, bone densitometry, computed tomography (CT), ultrasound, physical therapy and laboratory services on a walk-in basis. We refershares of VisualMED common stock equal to the ~~Jellico Community Hospital and CarePlus Center collectively as Jellico Community Hospital. The purchase~~stated value divided by 90% of the average closing price ~~was approximately $0.7 million. This purchase price was made available by Mr. Diamantis, a former member~~ of ~~our Board of Directors.~~

~~Our Hospital Operations generated revenues of approximately $2.1 million and $4.1 million~~the VisualMED common stock during the ~~three months ended~~10 trading days immediately prior to the conversion date. Conversion of the Series B Preferred Stock, however, is subject to the limitation that no conversion can be made to the extent the holder’s beneficial interest (as defined pursuant to the terms of the Series B Preferred Stock) in the common stock of VisualMED would exceed 4.99%. The shares of Series B Preferred Stock may be redeemed by VisualMED upon payment of the stated value of the shares plus any accrued declared and unpaid dividends.

As a result of the sale, the Company has recorded the Series B Preferred Stock of VisualMED as a long-term asset valued at $8.5 million at June 30, ~~2020~~2021 and 2019, respectively, and approximately $3.9 million and $9.2 million during the six months ended June 30, 2020 and 2019, respectively. Going forward, we expect our Hospital Operations to provide us with a ~~stable revenue base.~~

~~Prior to our focus on our Hospital Operations, our principal line of business had been clinical laboratory blood and urine testing services, with a particular emphasis~~gain on the ~~provision~~sale of ~~urine drug toxicology testing to physicians, clinics~~HTS and ~~rehabilitation facilities~~AMSG of $10.7 million in the United States. Our Clinical Laboratory Operations did not provide any revenue for the three months ended June 30, 2020 and provided a de minimis amount for the six months ended June 30, 2020. Clinical Laboratory Operations revenues for the three and six months ended June 30, ~~2019 were $5,415~~2021, of which $8.5 million resulted from the value of the VisualMED Series B Preferred Stock and ~~$0.1~~$2.2 million ~~respectively.~~

~~On July 12, 2017, we announced plans~~resulted from the transfer to ~~spin off our Advanced Molecular Services Group (“AMSG”) and in~~VisualMED of the ~~third quarter 2017 our Board~~net liabilities of Directors voted unanimously to spin off the Company’s wholly-owned subsidiary, Health Technology Solutions, Inc. (“HTS”), as independent publicly traded companies by way of tax-free distributions to the Company’s stockholders. On June 10, 2020, the Company signed an agreement for the separation of these divisions into a public company. The agreement is with TPT Global Tech, Inc. (OTC: TPTW), a California-based public company, to merge HTS and AMSG into a public company after TPT completes a merger of its wholly-owned subsidiary, InnovaQor, Inc. with this public company. The public company will be known as InnovaQor going forward. Completion of the agreement is subject to a number of approvals and consents which need to be secured to complete the transaction. Subject to closing and the relevant SEC approvals it is intended that Rennova will receive approximately $22 million of preferred shares in the transaction, $5 million of which will be converted to common shares in the public company, and distributed to Rennova shareholders upon completion of the relevant registration/approvals with the SEC. The remaining approximately $17 million of preferred shares held by Rennova as an investment in InnovaQor will be convertible to common shares on achievement of certain milestones going forward. There can be no assurance that the transaction as described will be consummated or that the terms, including numbers or values for consideration shares, will not change significantly before closing. The strategic goal of this transaction is to create a separate public company which can focus on its own strengths and operational plans and create value for Rennova and its shareholders. The Company hasAMSG.

We have reflected the amounts relating to HTS and AMSG, ~~and HTS~~including the gain on sale, as a disposal ~~groups~~group classified as held for sale and included in discontinued operations in ~~the Company’s~~our accompanying unaudited condensed consolidated financial statements.

~~On August 13,~~During the third quarter of 2020, ~~Mr. Diamantis entered into~~we announced that we had decided to sell EPIC Reference Labs, Inc., and as a ~~Voting Agreement~~result, EPIC Reference Labs, Inc.’s operations have been included in discontinued operations in the accompanying unaudited condensed consolidated financial statements. The Company has been unable to find a buyer for EPIC Reference Labs, Inc. and, ~~Irrevocable Proxy (the “Voting Agreement”) with~~therefore, effective June 30, 2021, it has ceased all efforts to sell the Company, Mr. Lagan and Alcimede LLC (of which Mr. Lagan is the sole manager) pursuant to which Mr. Diamantis granted an Irrevocable proxy to Mr. Lagan to vote the Series M Preferred Stock held by Mr. Diamantis, Mr. Diamantis has retained all other rights under the Series M Preferred Stock. The foregoing description of the Voting Agreement does not purport to be completes and is qualified by reference to the Voting Agreement, a copy of which is filed as an exhibit to this Quarterly Report on Form 10-Q and is incorporated herein by reference.company.

We believe that the transition of our business model from health information technology and diagnostics to ownership and operation of rural hospitals is now complete and once stabilized will create more predictable and stable revenue. Rural hospitals provide a much-needed service to their local communities and reduce our reliance on ~~commission based~~commission-based sales employees to generate sales. We currently operate ~~two hospitals~~one hospital and a rural clinic in the same general geographic location and we own another hospital and physician’s office at which operations are currently suspended. Owning a number of facilities in the same geographic location will create numerous efficiencies in purchasing and staffing and will enable the provision of additional, specialized and more valuable services that are needed by rural communities but cannot be sustained by a standalone rural hospital. While 2019 was a difficult year with unexpected disruption to revenue causing us to suspend operations at the Jamestown facility, we believe we will be successful in reopening this facility in the near future and expect to achieve more stable and predictable revenues and relative costs before the current year end. We remain confident that this is a sustainable model we can continue to grow through acquisition and development and believe that we can benefit from the compliance and IT and software capabilities we already have in place. The progress of the ~~coronavirus (“COVID-19”)~~COVID-19 pandemic, which is more fully discussed below, has severely affected our operations and may ~~however,~~ cause such expectations not to be achieved or, even if achieved, not to be done in the expected timeframe.

The COVID-19 pandemic was declared a global pandemic by the World Health Organization on March 11, 2020. We have been closely monitoring the COVID-19 pandemic and its impact on our operations and we have taken steps intended to minimize the risk to our employees and patients. These steps have increased our costs and our revenues have been significantly adversely affected. Demand for hospital services has substantially decreased. As noted in Notes 12 and 76 to the accompanying unaudited condensed consolidated financial statements, we have received Paycheck Protection Program loans (“~~PPP”~~PPP Notes”) ~~loans~~ as well as Health and Human Services (“HHS”) Provider Relief Funds from the federal government. If the COVID-19 pandemic continues for a further extended period, we expect to incur significant losses and additional financial assistance may be required. Going forward, we are unable to determine the extent to which the COVID-19 pandemic will continue to affect our business. The nature and effect of the COVID-19 pandemic on our balance sheet and results of operations will depend on the severity and length of the pandemic in our service areas; government activities to mitigate the pandemic’s effect; regulatory changes in response to the pandemic, especially those affecting rural hospitals; and existing and potential government assistance that may be provided.

The COVID-19 pandemic and the steps taken by governments to seek to reduce its spread have severely impacted the economy and the health care industry in particular. Hospitals have especially been affected. Small rural hospitals, such as ours, may be overwhelmed by patients if conditions worsen in their local areas. Staffing costs, and concerns due to the potential exposure to infections, may increase, as may the costs of needed medical supplies necessary to keep the hospitals open. Doctors and patients may defer elective procedures and other health care services. Travel bans, social distancing and quarantines may limit access to our facilities. Business closings and layoffs in our local areas may result in the loss of insurance and adversely affect demand for our services, as well as the ability of patients and other payers to pay for services as rendered.

Hospitalizations in Tennessee for COVID-19 increased throughout 2020 and appear, until recently, to have ~~decreased~~peaked in December 2020. From third party information, there have been 891,331 cases and 12,730 deaths as of July 29, 2021. Unfortunately, current indications as of the date of this report show a resurgence of COVID-19. According to a recent Tennessee state profile report from the White House, as of August 6, 2021, Tennessee saw a 78% increases in cases per 100,000 persons compared to the previous week, averaging 276 cases per 100,000 persons. Hospitalizations and deaths from COVID-19 have also jumped by 65% and 24%, respectively. One concern previously cited in the report and shared by health leaders is low vaccination rates in the state combined with a surge in cases. Tennessee is the 9th-worst in population of fully vaccinated individuals per the report and 10th in new cases per 100,000 persons.

It is hoped that the continued roll out of vaccinations will significantly ~~over~~reduce the ~~past few years. This decline in revenues has~~risk of death and reduce transmission of the virus so that a return to more normal expectations occurs throughout the remainder of 2021. These developments have had, and may continue to have, a material adverse ~~impact~~effect on us and the operations of our ~~liquidity, results of operations and financial condition.~~

~~We believe that a successful separation of AMSG and HTS will allow each~~hospitals. Our plans to focus on its own strengths and operational plans. We have agreed to terms that will combine these divisions into one publicly traded entity and believe this will provide a distinct and targeted investment opportunity. The Company believes it will be able to recognize the expenditures to date with regard to AMSG and HTS, which are in excess of $20 million, as an investment after the separation is complete.

Our loss from continuing operations before other income and (expense) and income taxes for the three months ended June 30, 2020 was $3.3 million compared to a loss of $5.1 million for the same period of a year ago. Our loss from continuing operations before other income and (expense) and income taxes for the six months ended June 30, 2020 was $7.2 million compared to a loss of $9.6 million for the same period a year ago. Our hospitals have generated losses and therefore, we attribute the decreases in the operating losses in the 2020 periods primarily to the temporary suspension of operations atreopen our Jamestown Regional Medical Center, whose operations were suspended in June 2019, have been disrupted by the pandemic and ~~a reduction in patients and services at our other hospitals.~~the timing of the reopening has been delayed.

We recorded net income from continuing operations for the three months ended June 30, 2020 of $2.1 million, as compared to a loss of $13.3 million for the same period of a year ago. The improvement was primarily due to a decrease in the loss from operations before other income (expense) and income taxes of approximately $1.8 million, other income (expense), net of approximately $6.8 million in the three months ended June 30, 2020 compared to other income (expense), net of ($0.3) million in the comparable 2019 period, a $1.2 million gain from legal settlements in the three months ended June 30, 2020 and a decrease in interest expense of $5.2 million.

We recorded a net loss from continuing operations for the six months ended June 30, 2020 of $3.6 million, as compared to a loss of $26.2 million for the same period of a year ago. The improvement was primarily due to a decrease in the loss from operations before other income (expense) and income taxes of approximately $2.4 million, other income (expense), net of approximately $6.7 million in the six months ended June 30, 2020 compared to other income (expense), net of ($1.2) million in the comparable 2019 period, a $1.2 million gain from legal settlements in the six months ended June 30, 2020 and a decrease in interest expense of $10.0 million

Three months ended June 30, ~~2020~~2021 compared to the three months ended June 30, ~~2019~~2020

The following table summarizes the results of our consolidated continuing operations for the three months ended June 30, ~~2020~~2021 and ~~2019:~~2020:

Consolidated net revenues were $0.9 million for the three months ended June 30, 2021, as compared to consolidated net revenues of $2.1 million for the three months ended June 30, 2020, ~~as compared~~a decrease of $1.2 million. Net revenues in the three months ended June 30, 2021 from Jellico Community Hospital and CarePlus Center decreased by approximately $0.8 million and from Big South Fork Medical Center decreased by approximately $0.4 million. We closed Jellico Community Hospital on March 1, 2021 after the city of Jellico issued a 30-day termination notice for the lease of the building. We attribute the decrease in net revenues from Big South Fork Medical Center to ~~$4.1~~pandemic related difficulties, including the closure of inpatient services for the first four months of 2021.

Net revenues for the three months ended June 30, 2021 and 2020 included estimated implicit price concessions of $1.3 million and $2.7 million, respectively, for doubtful accounts and $4.0 million and $8.4 million, respectively, for contractual allowances.

Direct costs of revenues decreased by $1.4 million for the three months ended June 30, 2019, a decrease of $2.0 million. The decrease in net revenues was due to a reduction in revenue from Jamestown Regional Medical Center of $0.8 million in the three months ended June 30, 2020 compared to the 2019 period. Operations at Jamestown Regional Medical Center were temporarily suspended beginning in June 2019 pending reinstatement of the hospital’s Medicare agreement, which the Company is hoping to get reinstated in the near future. The decrease in net revenues in the three months ended June 30, 2020, as compared to the 2019 period was also a result of the COVID-19 pandemic, which we attribute, in part, to decreasing net revenues from Jellico Community Hospital and CarePlus Center of $1.4 million. As a result of the COVID-19 pandemic, we believe demand for our services was reduced. Also reducing revenues at Jellico Community Hospital and CarePlus Center were staffing issues during the 2020 period, which required us to divert patients to third party facilities. Partially offsetting the decrease in Hospital Operations revenue was a $0.3 million increase in revenue at Big South Fork in the three months ended June 30, 2020 compared to the 2019 period as certain diagnostic equipment was inoperable during the 2019 period.

Net revenue for the three months ended June 30, 2020 and 2019 included bad debt expense elimination of $2.7 million and $2.3 million, respectively, for doubtful accounts and $8.4 million and $29.1 million, respectively, for contractual allowances. In a continued effort to refine our revenue recognition estimates, the Company practices the full retrospective approach, evaluating and analyzing the realizability of gross service revenues quarterly, to make certain that we are properly allowing for bad debt and contractual adjustments.

~~Direct costs of revenue decreased by $1.9 million for the three months ended June 30, 2020~~2021 compared to the three months ended June 30, ~~2019. The decrease was related to our Hospital Operations.~~2020. We attribute the decrease primarily to ~~Jamestown Regional Medical Center, which was temporarily suspended beginning in June 2019, as well as decreases in~~ the ~~number~~closure of ~~patients served at~~ Jellico Community Hospital ~~and CarePlus Center.~~on March 1, 2021. As a percentage of net revenues, direct costs increased to ~~134.3%~~136.7% in the three months ended June 30, ~~2020~~2021 compared to ~~115.2%~~129.0% in the comparable ~~2019~~2020 period. We attribute the increase in the direct costs as a percentage of net revenues to the ~~COVID-19 pandemic and~~decrease in the ~~diversion~~number of patients ~~to third party facilities due to staffing issues during the three months ended June 30, 2020.~~served. While the number of patients served decreased, certain ~~direct~~fixed costs of ~~revenue~~revenues remained.

General and administrative expenses decreased by ~~$1.9~~$0.3 million, or ~~43.6%~~12.2%, compared to the same period a year ago. ~~The~~We attribute the decrease ~~was due~~ to ~~a decrease in our Hospital Operations~~the reduction of general and administrative expenses offor our hospitals. Our corporate related expenses remained constant at approximately ~~$1.7~~$0.7 million for both the three month periods ended June 30, 2021 and ~~a decrease in our Corporate’s general and administrative expenses of approximately $0.2 million.~~2020.

Depreciation and amortization expense ~~was~~remained relatively stable at $0.2 million for both the three months ended June 30, ~~2020 as compared to $0.2 million for the same period a year ago.~~2021 and 2020.

Loss from Continuing Operations Before Other Income (Expense) and Income Taxes

Our ~~operating~~ loss ~~decreased by $1.8~~from continuing operations before other income (expense) and income taxes for the three months ended June 30, 2021 was $2.6 million compared to a loss of $3.2 million for the three months ended June 30, ~~2020, as compared to~~2020. We attribute the ~~2019 period. Our Hospital Operations~~decrease in the operating loss ~~decreased by $1.7 million and Corporate’s loss decreased by $0.2 million, partially offset by an increase~~primarily to a reduction in ~~the loss from our Clinical Laboratory Operations of $0.1 million.~~costs associated with Jellico Community Hospital.

Other income (expense), net for the three months ended June 30, 2021 of $2.0 million included $1.9 million of HHS Provider Relief Funds from the federal government. Other income (expense), net for the three months ended June 30, 2020 ~~includes $7.5~~of $6.8 million included $7.4 million of HHS Provider Relief Funds, ~~from the federal government,~~ partially offset by ~~($0.4)~~$0.4 million in penalties and interest associated with non-payment of payroll taxes and ~~($0.2)~~$0.2 million of loss on the sale of accounts receivable under a sales agreement. ~~Other income (expense), net~~

The gain from legal settlements was $31,050 and $1.1 million for the three months ended June 30, ~~2019 was due to the loss on the sale of accounts receivable under a sales agreement.~~

~~We settled several legal proceedings during the three months ended June 30,~~2021 and 2020, ~~which resulted in a gain from legal settlements of $1.2 million.~~respectively. The settlement of obligations under a financing lease for property and equipment resulted in $0.9 million of the ~~gain.~~gain for the 2020 period.

Interest expense for the three months ended June 30, ~~2020~~2021 was ~~$2.7~~$0.9 million as compared to ~~$7.9~~$2.7 million for the three months ended June 30, ~~2019.~~2020. Interest expense for the three months ended June 30, 2021 was for interest expense on debentures and notes payable and included $36,000 of interest expense on loans from Mr. Diamantis, a former member of our Board of Directors. Interest expense for the three months ended June 30, 2020 included $2.0 million for interest on ~~past due~~ debentures and note payable, $0.3 million for interest incurred by Mr. Diamantis ~~a former member of our Board of Directors,~~ on borrowings he procured in order to lend funds to the Company and $0.2 million of interest on loans from Mr. Diamantis. ~~Interest~~The decrease in interest expense ~~for~~in the three months ended June 30, ~~2019 included $0.6 million for interest on~~2021 as compared to the 2020 period was due primarily to the exchange of loans from Mr. Diamantis ~~$1.5 million~~on June 30, 2020 for preferred stock and the ~~amortization~~exchange of ~~debt discount and deferred financing costs related to~~ debentures ~~and $5.4 million~~ in ~~interest expense associated with~~ the ~~modification~~third quarter of ~~warrants.~~2020 for preferred stock.

~~We recorded~~Our net ~~income~~loss from continuing operations for the three months ended June 30, ~~2020 of $2.1~~2021 was $1.5 million as compared to ~~a loss~~net income from continuing operations of ~~$13.3~~$2.2 million for the ~~same period of a year ago.~~three months ended June 30, 2020. The ~~improvement~~change was due primarily ~~due~~ to a ~~decrease~~reduction in income of $5.5 million from HHS Provider Relief Funds and a $1.1 million gain from legal settlements in the 2020 period, partially offset by a reduction in the loss from continuing operations before other income (expense) and income taxes of ~~approximately $1.8~~$0.5 million other income (expense), net of approximately $6.8 million in the three months ended June 30, 2020 compared to other income (expense), net of ($0.3) million in the comparable 2019 period, a $1.2 million gain from legal settlements in the three months ended June 30, 2020 and a decrease in interest expense of ~~$5.2~~$1.8 million.

~~The following table presents key financial metrics for our Hospital Operations segment:~~

Our Hospital Operations have historically generated operating losses. We served less patients during the three months ended June 30, 2020 compared to the three months ended June 30, 2019 as a result of the suspension of operations at Jamestown Regional Medical Center, which did not operate during the three months ended June 30, 2020 following the termination of the Medicare program in June 2019. Also, reducing the number of patients served were the COVID-19 pandemic and staffing issues that resulted in us having to divert patients to third-party facilities during the three months ended June 30, 2020. The increase in the net revenues and direct costs per patient in the three months ended June 30, 2020 compared to the 2019 period was due to the performance of more diagnostic testing as more diagnostic machines were operational at Big South Fork during 2020.

~~The following table presents key financial and operating metrics for our Clinical Laboratory Operations segment:~~

During the three months ended June 30, 2020 and 2019, our Clinical Laboratory segment did not perform any laboratory tests. During 2019, the Company experienced a substantial decline in the volume of samples processed at its laboratories and continued difficulty in receiving reimbursement for certain diagnostics. As a result, in an effort to reduce costs, the Company is currently operating its Clinical Laboratory Operations business segment out of its EPIC Reference Labs, Inc. (“EPIC”) laboratory, and cost reduction efforts are continuing in response to the operating losses incurred. The Company intends to sell EPIC, meaning the Company would no longer own or operate clinical laboratories outside of the hospital labs.

The decrease in Corporate’s general and administrative expenses in the three months ending June 30, 2020 compared to the prior period was mainly the result of reductions in insurance expense, rent, compensation related expenses and directors fees.

Six months ended June 30, ~~2020~~2021 compared to the six months ended June 30, ~~2019~~2020

The following table summarizes the results of our consolidated continuing operations for the six months ended June 30, ~~2020~~2021 and ~~2019:~~2020:

Consolidated net revenues were $0.3 million for the six months ended June 30, 2021, as compared to $3.9 million for the six months ended June 30, 2020, ~~as compared to $9.3 million for the six months ended June 30, 2019,~~ a decrease of ~~$5.4~~$3.6 million. The decrease in net revenues was due to a reduction in revenue from Jamestown Regional Medical Center of $3.0 million in the six months ended June 30, 2020 compared to the 2019 period. Operations at Jamestown Regional Medical Center were temporarily suspended beginning in June 2019 pending reinstatement of the hospital’s Medicare agreement, which the Company is hoping to get reinstated in the near future. The decrease in netNet revenues in the six months ended June 30, ~~2020, as compared to the 2019 period was also a result of the COVID-19 pandemic, which we attribute, in part, to decreasing net revenues~~2021 from Jellico Community Hospital and CarePlus Center ~~of approximately $1.8~~decreased by $1.0 million and ~~net revenues~~ from Big South Fork Medical Center decreased by $2.6 million. We closed Jellico Community Hospital on March 1, 2021, after the city of ~~$0.5 million. As~~Jellico issued a 30-day termination notice for the lease of the building. Also, as a result of the COVID-19 pandemic, we believe the demand for our services was ~~reduced. Also reducing revenue were staffing issues and supply shortages caused by cash constraints~~reduced as we served less patients during ~~the 2020 period, which required us to divert patients to third party facilities. Clinical Laboratory Operations revenue also decreased by $0.1 million in~~ the six months ended June 30, ~~2020~~2021 compared to the ~~2019~~2020 period.

Net revenues for the six months ended June 30, 2021 and 2020 ~~and 2019 include bad debt expense elimination~~included estimated implicit price concessions of ~~$4.0~~$4.3 million and ~~$3.9~~$4.0 million, respectively, for doubtful accounts and ~~$18.9~~$9.5 million and ~~$60.9~~$18.9 million, respectively, for contractual allowances. ~~In a continued effort to refine our revenue recognition estimates, the Company practices the full retrospective approach, evaluating and analyzing the realizability~~The increase in estimated implicit price concessions of ~~gross service revenues quarterly, to make certain that we are properly allowing for bad debt and contractual adjustments.~~

~~Direct costs of revenue decreased by $3.5~~$0.3 million for the six months ended June 30, 2021 as compared to the 2020 period was due to serving only emergency room patients during the first four months of 2021. Inpatient serves typically deliver higher collection rates and the absence of inpatient services in the first four months of 2021 meant that the Company was dependent on revenue from emergency room services, which is typically at a lower percentage of gross revenue. Inpatient services reopened in May 2021.

Direct costs of revenue decreased by $2.5 million for the six months ended June 30, 2021 compared to the six months ended June 30, ~~2019. The decrease was related to our Hospital Operations.~~2020. We attribute the decrease ~~primarily~~ to ~~Jamestown Regional Medical Center, which was temporarily suspended beginning in June 2019, as well as decreases~~the reduction in the number of patients served at Jellico Community Hospital, ~~and~~ CarePlus Center and Big South Fork Medical Center. As a percentage of net revenues, direct costs increased to 136.7% in the six months ended June 30, 2020 compared to 95.6% in the comparable 2019 period. We attribute the increase in the direct costs as a percentage of net revenues to the COVID-19 pandemic and the diversion of patients to third party facilities due to staffing issues and supply shortages caused by cash constraints during the six months ended June 30, 2020. While the number of patients served decreased, certain direct costs of revenue remained.

General and administrative expenses decreased by ~~$4.2~~$0.4 million, or ~~43.7%~~8.2%, compared to the same period a year ago. ~~The~~We attribute the decrease ~~was due~~ to ~~a decrease in our Hospital Operations~~the reduction of general and administrative expenses offor our hospitals. Our corporate related expenses remained constant at approximately ~~$3.5~~$1.3 million for both the six month periods ended June 30, 2021 and ~~a decrease in our Corporate’s general and administrative expenses of approximately $0.6 million.~~2020.

Depreciation and amortization expense was $0.4 million and $0.3 million for the six months ended June 30, 2021 and 2020, ~~as compared~~respectively. The increase in the six months ended June 30, 2021 was due to ~~$0.4 million for~~depreciation expense associated with the ~~same period a year ago.~~purchases of medical equipment.

Loss from Continuing Operations Before Other Income (Expense) and Income Taxes

Our ~~operating~~ loss ~~decreased by $2.4~~from continuing operations before other income (expense) and income taxes for the six months ended June 30, 2021 was $7.9 million compared to a loss of $7.1 million for the six months ended June 30, ~~2020, as compared~~2020. We attribute the increase in the operating loss primarily to the ~~2019~~reduction in the number of patients served in the 2021 period. ~~Our Hospital Operations operating loss decreased by $1.8 million and Corporate’s loss decreased by $0.6 million.~~

Other income (expense), net of ~~$6.7~~$4.5 million for the six months ended June 30, 2021 included $4.4 million of income from HHS Provider Relief Funds. Other income (expense), net of $6.8 million for the six months ended June 30, 2020 included ~~$7.5~~$7.4 million of income from HHS Provider Relief Funds, partially offset by ~~($0.6)~~$0.6 million in penalties and interest associated with non-payment of payroll taxes and ~~($0.2)~~$0.2 million of loss on the sale of accounts receivable under a sales agreement. ~~Other income (expense), net of ($1.2)~~

The gain from legal settlements was $22,190 and $1.1 million for the six months ended June 30, ~~2019 included a ($0.6) million penalty for non-payment of a debenture that was due in March 2019~~2021 and ~~($0.7) million from the loss on sales of accounts receivable under sales agreements.~~

~~We settled several legal proceedings during the six months ended June 30,~~ 2020, ~~which resulted in a gain from legal settlements of $1.2 million.~~respectively. The settlement of obligations under a financing lease for property and equipment resulted in $0.9 million of the ~~gain.~~

~~In the six months ended June 30, 2019, we realized a $0.3 million~~ gain ~~on the bargain purchase of Jellico Community Hospital, which was acquired on March 5, 2019. The gain was associated with the intangible asset acquired in the acquisition.~~

~~The change in the fair value of derivative instruments~~ for the six months ended June 30, 2019 was $0.1 million and related to the reduction in the conversion price of an outstanding debenture. We did not incur a change in the fair value of derivative instruments during the six months ended June 30, 2020.2020 period.

Interest expense for the six months ended June 30, ~~2020~~2021 was ~~$5.5~~$1.8 million, as compared to ~~$15.6~~$5.5 million for the six months ended June 30, ~~2019.~~2020. Interest expense for the six months ended June 30, 2021 included $1.7 million for interest on debentures and notes payable and $0.1 million for interest on loans from Mr. Diamantis. Interest expense for the six months ended June 30, 2020 included $4.0 million for ~~default~~ interest on ~~past due~~ debentures and note payable, $0.7 million for interest incurred by Mr. Diamantis, ~~a former member of our Board of Directors,~~ on borrowings he procured in order to lend funds to the Company and $0.5 million of interest on loans from Mr. Diamantis. ~~Interest~~The decrease in interest expense ~~for~~in the six months ended June 30, ~~2019 included $0.7 million for interest on~~2021 as compared to the 2020 period was due primarily to the exchange of loans from Mr. Diamantis ~~$5.0 million~~on June 30, 2020 for non-interest bearing preferred stock and the ~~amortization~~exchange of ~~debt discount and deferred financing costs related to~~ debentures ~~and $9.5 million~~in the third quarter of ~~interest expense associated with the modification of warrants.~~2020 for non-interest bearing preferred stock.

During the six months ended June 30, 2020, the U.S. Congress approved the Coronavirus Aid, Relief and Economic Security Act (the “CARES Act”). The CARES Act allows a five-year carryback privilege for federal net operating tax losses that arose in a tax year beginning in 2018 and through the current tax year, that is, 2020. As a result, during the six months ended June 30, 2020, we recorded approximately $1.1 million in refunds from the carryback of certain of our federal net operating losses.

Our net loss from continuing operations ~~decreased by $22.6 million, to $3.6 million~~ for the six months ended June 30, ~~2020, as~~2021 was $5.2 million compared to a net loss from continuing operations of ~~$26.2~~$3.7 million for the six months ended June 30, ~~2019.~~2020. The ~~decrease~~increase in the net loss in the 2021 period was primarily due to ~~a decrease~~the increase in the loss from continuing operations before other income (expense)~~, net~~ and income taxes of ~~approximately $2.4~~$0.7 million, ~~other~~a reduction in income of ~~approximately $6.8~~$3.0 million from HHS Provider Relief Funds in the ~~six months ended June 30, 2020 compared to other expense of $1.2 million in~~2021 period, and the ~~comparable period, a $1.2~~$1.1 million gain from legal settlements in the 2020 period. Partially offsetting the increase in the net loss in the 2020 period was a reduction in interest expense of $3.7 million.

For the three and six months ended June 30 ~~2020, a decrease in interest expense of $10.0 million in the 2020 period and a $1.1 million income tax benefit in the six months ended June 30, 2020.~~

~~The following table presents key financial metrics for our Hospital Operations segment:~~

Our Hospital Operations have historically generated operating losses. We served less patients during the six months ended June 30, 2020 compared to the six months ended June 30, 2019 as a result of the suspension of operations at Jamestown Regional Medical Center, which did not operate during the six months ended June 30, 2020 following the termination of the Medicare program in June 2019. Also, reducing the number of patients served was the COVID-19 pandemic, as well as staffing issues and shortages of hospital supplies due to cash constraints, which required us to divert patients to third-party facilities during the six months ended June 30, 2020.

~~The following table presents key financial and operating metrics for our Clinical Laboratory Operations segment:~~

During the six months ended June 30, 2020, our Clinical Laboratory segment did not perform any laboratory tests. During 2019, the Company experienced a substantial decline in the volume of samples processed at its laboratories and continued difficulty in receiving reimbursement for certain diagnostics. As a result, in an effort to reduce costs, the Company is currently operating its Clinical Laboratory Operations business segment out of its EPIC Reference Labs, Inc. (“EPIC”) laboratory, and cost reduction efforts are continuing in response to the operating losses incurred. The Company intends to sell EPIC, meaning the Company would no longer own or operate clinical laboratories outside of the hospital labs.

The decrease in general and administrative expenses in the six months ended June 30, 2020 compared to the prior period was mainly the result of acquisition costs incurred in the 2019 period for the acquisition of Jellico Community Hospital and CarePlus Center on March 5, 2019. Also reducing general and administrative expenses in the six months ended June 30, 2020 compared to the 2019 period were reductions in insurance expense, rent, compensation related expenses and directors fees.

~~For the six months ended June 30, 2020~~2021 and the year ended December 31, ~~2019,~~2020, we financed our operations ~~primarily~~ from the issuances of equity, ~~debentures and~~ notes payable, loans from Christopher Diamantis, a ~~related party~~former member of our Board of Directors, and the sale of accounts receivable under sales agreements. Also, during the ~~six months~~year ended ~~June 30,~~December 31, 2020 we received approximately $2.4 million from PPP ~~notes payable (“PPP Notes”)~~Notes and our continuing operations received approximately ~~$7.5~~$12.4 million from HHS Provider Relief ~~Funds. On~~Funds, of which $8.0 million was recognized as other income in the second and third quarters of 2020 and $4.4 million was recognized as income in the six months ended June 30, ~~2020, we entered into an exchange agreement with~~2021. The PPP Notes and accrued interest are forgivable as long as the borrower uses the loan proceeds for eligible purposes, including payroll, benefits, rent and utilities, and maintains its payroll levels. The amount of loan forgiveness will be reduced if the borrower terminates employees or reduces salaries. The Company is in the process of applying for forgiveness for the PPP Notes and accrued interest. The HHS Provider Relief Funds are grants, not loans, and HHS will not require repayment, but providers are restricted and the funds must be used only for grant approved purposes as more fully discussed in Note 2 to the accompanying unaudited condensed consolidated financial statements. We received approximately $1.2 million in cash from the issuances of promissory notes during the six months ended June 30, 2021 and $2.5 million from the issuance of our Series O Convertible Redeemable Preferred Stock (“Series O Preferred Stock”). During the six months ended June 30, 2021, Mr. Diamantis ~~a former member of our Board of Directors, wherein we exchanged~~loaned the ~~amount owed to~~Company $0.9 million and during the year ended December 31, 2020, Mr. Diamantis loaned the Company $7.6 million, the majority of which was used for ~~principal and interest on that date, which totaled $18.8 million, for shares of the Company’s Series M Convertible Preferred Stock.~~working capital purposes. Subsequent to June 30, ~~2020~~2021 and through August ~~10, 2020,~~11, 2021, we received ~~approximately $5.0~~$0.3 million in loans from Mr. Diamantis and $1.5 million from ~~HHS Provider Relief Funds. Each~~the issuances of ~~these~~our Series O Preferred Stock. These financing transactions isare more fully discussed in Notes 1,2, 4, ~~7, 8, 13~~5, 6, 11 and 1916 to our accompanying unaudited condensed consolidated financial statements.

~~Future cash needs~~As more fully discussed above, on June 25, 2021, the Company sold HTS and AMSG to VisualMED and the Company received shares of VisualMED’s Series B Preferred Stock valued at $8.5 million as consideration for ~~working capital, capital expenditures, debt obligations~~the sale (subject to post-closing adjustments). In addition, $2.2 million of net liabilities of HTS and ~~potential acquisitions will require management~~AMSG were transferred to seek additional equity or obtain additional credit facilities. The sale/issuances of additional equity will result in additional dilution to our stockholders. A portion of our cash may be used to acquire or invest in complementary businesses or products or to obtain the right to use complementary technologies. From time-to-time, in the ordinary course of business, we evaluate potential acquisitions of such businesses, products or technologies.VisualMED.

Under ~~Accounting Standards Update, or~~ ASU 2014-15, Presentation of Financial Statements—Going Concern (Subtopic 205-40) (“ASC 205-40”), the Company has the responsibility to evaluate whether conditions and/or events raise substantial doubt about its ability to meet its future financial obligations as they become due within one year after the date that the financial statements are issued. As required by ASC 205-40, this evaluation shall initially not take into consideration the potential mitigating effects of plans that have not been fully implemented as of the date the financial statements are issued. Management has assessed the Company’s ability to continue as a going concern in accordance with the requirement of ASC 205-40.

As reflected in the accompanying unaudited condensed consolidated financial statements, ~~at June 30, 2020, we~~the Company had ~~$0.8 million cash on hand from continuing operations,~~ a working capital deficit ~~of $61.2 million,~~and an accumulated deficit of ~~$593.8~~$57.5 million and ~~a stockholders’ deficit of $61.3 million. In addition, we incurred~~$1.0 billion, respectively, at June 30, 2021. The Company had a loss from continuing operations before other income (expense) and income taxes of ~~$3.6~~approximately $2.6 million and $3.2 million for the three months ended June 30, 2021 and 2020, respectively, and a loss from continuing operations before other income (expense) and income taxes of $7.9 million and $7.1 million, for the six months ended June 30, 2021 and 2020, ~~and we~~respectively. In addition, cash used ~~cash of~~in operating activities was $3.7 million and $9.1 million ~~to fund our operations.~~for the six months ended June 30, 2021 and 2020, respectively. As of the date of this report, our cash ~~position~~ is ~~deficient;~~deficient and payments for our operations in the ordinary course are not being made. ~~In addition, we have not repaid approximately $35.1 million~~The continued losses and other related factors, including the payment defaults under the terms of outstanding ~~principal balance~~notes payable and debentures as more discussed in Notes 6 and 7 to the accompanying unaudited condensed consolidated financial statements, raise substantial doubt about the Company’s ability to continue as a going concern for 12 months from the filing date of ~~debentures, including default penalties and accrued interest, which is past due and for which we have received a payment demand notice.~~this report. Our fixed operating expenses include payroll, rent, ~~capital~~finance lease payments and other fixed expenses, as well as the costs required to operate our Hospital Operations. ~~Our fixed operating expenses were approximately $3.0~~

The Company’s accompanying unaudited condensed consolidated financial statements are prepared assuming the Company can continue as a going concern, which contemplates continuity of operations through realization of assets, and the settling of liabilities in the normal course of business. As more fully discussed in Note 1 to the accompanying unaudited condensed consolidated financial statements, on June 25, 2021, the Company sold HTS and AMSG to VisualMED and the Company received VisualMED’s Series B Preferred Stock valued at $8.5 million ~~per month~~as consideration for the ~~six months ended~~sale (subject to post-closing adjustments). In addition, $2.2 million of net liabilities of HTS and AMSG were transferred to VisualMED. The Company has reflected the assets and liabilities relating to HTS and AMSG held prior to the sale as part of discontinued operations. In addition, during 2020, the Company announced plans to sell its last clinical laboratory, EPIC Reference Labs, Inc., and as a result, EPIC Reference Labs, Inc.’s operations have been included in discontinued operations for all periods presented. The Company has been unable to find a buyer for EPIC Reference Labs, Inc. and, therefore, effective June 30, ~~2020.~~2021, it has ceased all efforts to sell the company.

On March 1, 2021, the Company closed Jellico Community Hospital, after the city of Jellico issued a 30-day termination notice for the lease of the building. Jellico Community Hospital had been operating at a loss since it was acquired by the Company in March 2019. The Company’s core operating businesses are now a rural hospital, a CarePlus Center and a hospital and physician’s office that it plans to reopen and operate. Rural hospitals are a specialized marketplace with a requirement for capable and knowledgeable management. The Company’s current financial condition may make it difficult to attract and maintain adequate expertise in its management team to successfully operate these businesses.

We need to raise additional funds immediately and will continue to do so until we begin to realize positive cash flow from operations. There can be no assurance that we will be able to achieve our business plan, which is to acquire and operate clusters of rural hospitals, raise any additional capital or secure the additional financing necessary to implement our current operating plan. Our ability to continue as a going concern is dependent upon our ability to significantly reduce our operating costs, increase our revenues and eventually achieve profitable operations. The accompanying unaudited condensed consolidated financial statements do not include any adjustments that might be necessary if we are unable to continue as a going concern.

Also, during the six months ended June 30, 2020 we received approximately $2.4 million from PPP Notes. As of August 10, 2020, Company-owned facilities have received approximately $12.5 million of HHS Provider Relief Funds, $7.5 million of which were received during the six months ended June 30, 2020. A portion of the PPP Notes and accrued interest are forgivable as long as the borrower uses the loan proceeds for eligible purposes, including payroll, benefits, rent and utilities, and maintains its payroll levels. The amount of loan forgiveness will be reduced if the borrower terminates employees or reduces salaries. The HHS Provider Relief Funds are grants, not loans, and HHS will not require repayment, but providers are restricted and the funds must be used only for grant approved purposes. We received approximately $1.1 million in cash from the issuance of a promissory note during the six months ended June 30, 2020, which was used to repay amounts due under accounts receivable sales agreements and $0.5 million from the sale of accounts receivable under a sales agreement. In addition, during the six months ended June 30, 2020, Mr. Diamantis, a former member of our Board of Directors, loaned the Company $4.6 million, the majority of which was used for working capital purposes.

As of June 30, ~~2020,~~2021, we were party to legal proceedings, which are presented in Note 1513 to the accompanying unaudited condensed consolidated financial statements.

The following table presents our capital resources as of June 30, ~~2020~~2021 and December 31, ~~2019:~~2020:

The following table presents the major sources and uses of cash for the six months ended June 30, ~~2020~~2021 and ~~2019:~~2020:

The components of cash used in operations for the six months ended June 30, ~~2020~~2021 and ~~2019~~2020 are presented in the following table:

Cash of $0.1 million and $10,435 was used by investing activities during the six months ended June 30, 2021 and 2020, respectively. The cash used in both periods was for purchases of hospital equipment.

Cash provided by financing activities for the six months ended June 30, ~~2020 was~~2021 of $4.0 million included primarily $2.5 million in proceeds from the issuance of our Series O Preferred Stock, $0.9 million in loans from a former member of our Board of Directors and $1.2 million from the issuances of notes payable, partially offset by $0.4 million in payments of loans from to ~~purchase $10,435~~a former member of ~~hospital equipment. The cash used~~our Board of Directors, $0.1 million in ~~investing activities for the six months ended June 30, 2019, was due to $0.7~~payments of notes payable and $0.2 million ~~used for the acquisition~~in payments of ~~Jellico Community Hospital and approximately $43,715 for purchases of hospital equipment.~~

accounts receivable under sales agreements. Cash provided by financing activities for the six months ended June 30, 2020 ~~totaled~~of $9.9 million ~~and~~included primarily ~~included~~ $4.6 million in loans from a ~~related party,~~former member of our Board of Directors, $2.4 million from PPP Notes, $7.5 million from HHS Provider Relief Funds, $0.5 million from the sale of accounts receivable and $1.1 million from the issuance of an installment note payable. Partially offsetting these cash receipts were $0.7 million in payments of debentures, $0.8 million of notes payable payments, $3.3 million in payments of ~~related party~~ loans from a former member of our Board of Directors and $0.1 million of finance lease obligation payments. ~~Cash provided by financing activities for~~

The Company had 10,000,000 and 39,648 shares of common stock issued and outstanding at June 30, 2021 and December 31, 2020, respectively. During the six months ended June 30, ~~2019~~2021, the Company issued an aggregate of ~~$6.6 million primarily included $9.1 million in loans from a related party, $3.8 million from the issuances~~450,000 shares of ~~debentures and $1.2 million in proceeds from the sale~~its common stock upon conversion of accounts receivable under sales agreements. Partially offsetting these cash receipts were $1.5 million in payments of related party loans, $0.8 million in payments of accounts receivable under sales agreements and $0.1$0.6 million of ~~finance lease obligation payments.~~stated value of its Series M Preferred Stock and 9,510,352 shares of its common stock upon conversions of $13.1 million of stated value of shares of its Series N Preferred Stock. During the six months ended June 30, 2020, the Company issued an aggregate of 25 shares of its common stock upon conversion of $25,000 of value of its Series I-2 Convertible Preferred Stock.

The terms of certain of the outstanding warrants, convertible preferred stock and convertible debentures issued by the Company provide for reductions in the per share exercise prices of the warrants and the per share conversion prices of the debentures and preferred stock (if applicable and subject to a floor in certain cases), in the event that the Company issues common stock or common stock equivalents (as that term is defined in the agreements) at an effective exercise/conversion price that is less than the then exercise/conversion price of the outstanding warrants, preferred stock or debentures, as the case may be. In addition, the majority of these equity-based securities contain exercise/conversion prices that vary based upon the price of the Company’s common stock on the date of exercise/conversion (see Notes ~~3, 8~~7, 11 ~~12, 13~~ and 1916 to the accompanying unaudited condensed consolidated financial statements). These provisions have resulted in significant dilution of the Company’s common stock and have given rise to reverse splits of the Company’s common stock, including a 1-for-1,000 reverse stock split effected on July ~~31,~~16, 2021. As a result of these down round provisions, the potential common stock equivalents, as adjusted for the July 16, 2021 reverse stock split, totaled 214.2 million at June 30, 2021 and 4.7 billion at August 11, 2021.

On August 13, 2020, Mr. Diamantis entered into the Voting Agreement with the Company, Mr. Lagan and Alcimede LLC (of which Mr. Lagan, the Company’s Chief Executive Officer, is ~~more fully described~~the sole manager) pursuant to which Mr. Diamantis granted an irrevocable proxy to Mr. Lagan to vote the Series M Preferred Stock held by Mr. Diamantis. Mr. Diamantis has retained all other rights under the Series M Preferred Stock. Regardless of the number of shares of Series M Preferred Stock outstanding and so long as at least one share of Series M Preferred Stock is outstanding, the outstanding shares of Series M Preferred Stock shall have the number of votes, in ~~Note 1~~the aggregate, equal to 51% of all votes entitled to be voted at any meeting of stockholders or action by written consent. This means that the ~~accompanying unaudited condensed consolidated financial statements.~~holders of Series M Preferred Stock have sufficient votes, by themselves, to approve or defeat any proposal voted on by the Company’s stockholders, unless there is a supermajority required under applicable law or by agreement. As a result of the Voting Agreement, as of the date of filing this report, the Company believes that it has the ability to ensure that it has and or can obtain sufficient authorized shares of its common stock to cover all potentially dilutive common shares outstanding.

We do not believe inflation has a significant effect on the Company’s operations at this time.

Under SEC regulations, we are required to disclose the Company’s off-balance sheet arrangements that have or are reasonably likely to have a current or future effect on the Company’s financial condition, results of operations, liquidity, capital expenditures or capital resources that are material to investors. Off-balance sheet arrangements consist of transactions, agreements or contractual arrangements to which any entity that is not consolidated with us is a party, under which we have:

As of June 30, ~~2020,~~2021, the Company had no off-balance sheet arrangements that have, or are reasonably likely to have, a current or future effect on the Company’s financial condition, results of operations, liquidity, capital expenditures or capital resources that is material to investors.

We maintain disclosure controls and procedures that are designed to ensure that material information required to be disclosed in our periodic reports filed under the Securities Exchange Act of 1934, as amended (the “Exchange Act”), is recorded, processed, summarized, and reported within the time periods specified in the SEC’s rules and forms and to ensure that such information is accumulated and communicated to our management, including our Chief Executive Officer and Interim Chief Financial Officer as appropriate, to allow timely decisions regarding required disclosure. Under the supervision and with the participation of our management, including our Chief Executive Officer, who also serves as our Interim Chief Financial Officer, we conducted an evaluation of our disclosure controls and procedures. Based on the foregoing evaluation, our management concluded that, as of June 30, ~~2020,~~2021, our disclosure controls and procedures were not effective to provide reasonable assurance that the information required to be disclosed by us in reports that we file or submit under the Exchange Act is recorded, processed, summarized, and reported within the time periods specified in SEC rules and forms, and is accumulated and communicated to our management, including our Chief Executive Officer and Interim Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure. Our management, including our Chief Executive Officer (Principal Executive Officer), who also serves as our Interim Chief Financial Officer (Principal Financial Officer), does not expect that our disclosure controls and procedures will prevent all errors and all fraud. A control system, no matter how well conceived and operated, can provide only reasonable, not absolute, assurance that the objectives of the control system are met. Further, the design of a control system must reflect the fact that there are resource constraints and the benefits of controls must be considered relative to their costs. Because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that all control issues and instances of fraud, if any, within our Company have been detected. These inherent limitations include, but are not limited to, the realities that judgments in decision-making can be faulty and that breakdowns can occur because of simple error or mistake. Additionally, controls can be circumvented by the individual acts of some persons, by collusion of two or more people, or by management override of the control. The design of any system of controls also is based in part upon certain assumptions about the likelihood of future events and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions.

In our Annual Report on Form 10-K for the year ended December 31, ~~2019,~~2020, we identified material weaknesses in our internal control over financial reporting. Insufficient staffing, accounting processes and procedures led to a lack of contemporaneous documentation supporting the accounting for certain transactions and the approval of certain cash disbursements. With the acquisitions of our hospitals, there are risks related to the timing and accuracy of the integration of information from various accounting systems whereby the Company has experienced delays in receiving information in a timely manner from its subsidiaries. Based on these material weaknesses in internal control over financial reporting, management concluded the Company did not maintain effective internal control over financial reporting as of December 31, ~~2019.~~2020. As of June 30, ~~2020,~~2021, we concluded that these material weaknesses continued to exist.

The Company expects improvements to be made on the integration of information issues during ~~2020~~2021 as we plan to move towards securing a prompt and accurate reporting system. The Company is continuing to further remediate the material weaknesses identified above as its resources permit. The Company is in the process of taking the following steps to remediate these material weaknesses: (i) increasing the staffing of its internal ~~accounting department;~~finance department, including hiring a chief financial officer; (ii) continuing the process of ~~moving towards securing~~converting to a ~~prompt and accurate~~new integrated accounting system to enhance controls and procedures for recording accounting transactions; and (iii) implementing enhanced documentation procedures to be followed by the internal ~~accounting~~finance department, including independent review of material cash disbursements.

Notwithstanding such material ~~weaknesses,~~weakness, management believes that the unaudited condensed consolidated financial statements included in this Form 10-Q fairly present in all material respects the Company’s financial condition, results of operations and cash flows for the periods and dates presented.

During the ~~three~~six months ended June 30, ~~2020,~~2021, there have been no changes in our internal control over financial reporting that have materially affected or are reasonably likely to materially affect our internal control over financial reporting except as disclosed above.

From time-to-time, the Company may be involved in a variety of claims, lawsuits, investigations and proceedings related to contractual disputes, employment matters, regulatory and compliance matters, intellectual property rights and other litigation arising in the ordinary course of business. The Company operates in a highly regulated industry which may inherently lend itself to legal matters. Management is aware that litigation has associated costs and that results of adverse litigation verdicts could have a material effect on the Company’s financial position or results of operations. Management, in consultation with legal counsel, has addressed known assertions and predicted unasserted claims, which are presented in Note 1513 to the accompanying unaudited condensed consolidated financial statements.

In addition to the other information set forth in this report, you should carefully consider the risk factors discussed in Part I, Item 1A of the ~~2019~~2020 Form 10-K which could materially affect our business, financial condition, or future results. There have been no material changes to the risk factors previously disclosed in our ~~2019~~2020 Form 10-K.

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.

Delaware		68-0370244
(State or other jurisdiction of incorporation or organization)		(IRS Employer Identification No.)

~~931 Village Boulevard,~~ 400 S. Australian Avenue, Suite ~~905~~800 West Palm Beach, FL		~~33409~~33401
(Address of principal executive offices)		(Zip Code)

Title of Each Class		Trading Symbol(s)		Name of each exchange on which registered
None		None		None

Large accelerated filer ~~[ ]~~☐	Accelerated filer ~~[ ]~~☐
Non-accelerated filer ~~[X]~~ ☒	Smaller reporting company ~~[X]~~☒

		Page No.
PART I – FINANCIAL INFORMATION		3

Item 1.	Financial Statements	3
	Condensed Consolidated Balance Sheets as of June 30, ~~2020~~2021 (unaudited) and December 31, ~~2019~~2020	3
	Condensed Consolidated Statements of Operations for the three and six months ended June 30, 2021 and 2020 ~~and 2019~~ (unaudited)	4
	Condensed Consolidated Statements of Changes in Stockholders’ Deficit for ~~the~~ each of the quarters in the periods ended June 30, 2021 and 2020 ~~and 2019~~ (unaudited)	~~5-6~~5
	Condensed Consolidated Statements of Cash Flows for the ~~three and~~ six months ended June 30, 2021 and 2020 ~~and 2019~~ (unaudited)	7
	Notes to Condensed Consolidated Financial Statements (unaudited)	8
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	3435
Item 3.	Quantitative and Qualitative Disclosures About Market Risk	4644
Item 4.	Controls and Procedures	4744

PART II – OTHER INFORMATION		45

Item 1.	Legal Proceedings	4745
Item 1A.	Risk Factors	4745
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	4845
Item 3.	Defaults Upon Senior Securities	4845
Item 4.	Mine Safety Disclosures	4845
Item 5.	Other Information	4845
Item 6.	Exhibits	4845

SIGNATURES		4946

	Three Months Ended						Six Months Ended
	June 30,						June 30,
	2020			2019			2020			2019

Net revenues	$	2,069,019		$	4,061,189		$	3,910,550		$	9,251,839

Operating expenses:
Direct costs of revenue		2,779,369			4,680,333			5,345,649			8,844,733
General and administrative		2,421,863			4,290,935			5,384,592			9,567,071
Depreciation and amortization		181,091			186,236			345,798			409,822
Total operating expenses		5,382,323			9,157,504			11,076,039			18,821,626

Loss from continuing operations before other income (expense) and income taxes		(3,313,304	)		(5,096,315	)		(7,165,489	)		(9,569,787	)

Other income (expense):
Other income (expense), net		6,847,209			(311,463	)		6,719,166			(1,195,742	)
Gain from legal settlements		1,230,522			-			1,230,522			-
Gain on bargain purchase		-			-			-			250,000
Change in fair value of derivative instruments		-			-			-			(105,076	)
Interest expense		(2,658,972	)		(7,871,798	)		(5,549,232	)		(15,591,766	)
Total other income (expense), net		5,418,759			(8,183,261	)		2,400,456			(16,642,584	)

Net income (loss) from continuing operations before income taxes		2,105,455			(13,279,576	)		(4,765,033	)		(26,212,371	)

Benefit from income taxes		-			-			1,118,485			-

Net income (loss) from continuing operations		2,105,455			(13,279,576	)		(3,646,548	)		(26,212,371	)

Net income (loss) from discontinued operations		16,173			(145,251	)		(23,602	)		(653,860	)
Net income (loss)		2,121,628			(13,424,827	)		(3,670,150	)		(26,866,231	)
Deemed dividend		(3,150,368	)		-			(3,150,368	)		(123,861,587	)
Net loss available to common shareholders	$	(1,028,740	)	$	(13,424,827	)	$	(6,820,518	)	$	(150,727,818	)

Net loss per common share:
Basic net loss available to common shareholders	$	(1.04	)	$	(25.38	)	$	(6.92	)	$	(448.88	)
Diluted net loss available to common shareholders	$	(1.04	)	$	(25.38	)	$	(6.92	)	$	(448.88	)
Weighted average number of common shares outstanding during the period:
Basic		989,894			528,965			985,608			335,786
Diluted		989,894			528,965			985,608			335,786

	Preferred Stock						Common Stock				Additional		Accumulated			Total Stockholders’			Shares			Amount			Shares		Amount		capital			Deficit			Deficit
	Shares			Amount			Shares		Amount		paid-in-capital		Deficit			Deficit			Preferred Stock						Common Stock				Additional paid-in-			Accumulated			Total Stockholders’
Balance at December 31, 2019		2,000,010		$	20,000			964,894	$	96	$	510,402,197	$	(586,942,014	)	$	(76,519,721	)
																			Shares			Amount			Shares		Amount		capital			Deficit			Deficit
Balance at December 31, 2020																				2,051,444		$	20,514			39,648	$	4	$	819,498,236		$	(868,536,506	)	$	(49,017,752	)
Conversion of Series N Preferred Stock into common stock																				(4,177	)		(42	)		435,082		44		(2	)		-			-
Conversion of Series M Preferred Stock into common stock
Conversion of Series M Preferred Stock into common stock, shares
Issuance of Series O Preferred Stock
Issuance of Series O Preferred stock, shares
Conversion of Series I-2 Preferred Stock into common stock		-			-			25,000		3		24,997		-			25,000
Conversion of Series I-2 Preferred stock into common stock, shares
Exchange of Series K Preferred Stock for Series L Preferred Stock
Exchange of Series K Preferred Stock for Series L Preferred Stock, shares
Issuance of Series L Preferred Stock
Issuance of Series L Preferred Stock, shares
Issuance of Series M Preferred Stock in exchange for related party loans and accrued interest
Issuance of Series M Preferred Stock in exchange for related party loans and accrued interest, shares
Deemed dividend from issuance of Series M Preferred Stock
Deemed dividend from issuance of Series M Preferred Stock, shares
Deemed dividends																														50,358,149			(50,358,149	)		-
Net loss		-			-			-		-		-		(5,791,778	)		(5,791,778	)		-			-			-		-		-			(3,893,994	)		(3,893,994	)
Balance at March 31, 2020		2,000,010		$	20,000			989,894	$	99	$	510,427,194	$	(592,733,792	)	$	(82,286,499	)
Exchange of Series K Preferred Stock for Series L Preferred Stock		(250,000	)		(2,500	)		-		-		-		-			(2,500	)
Issuance of Series L Preferred Stock		250,000			2,500			-		-		-		-			2,500
Issuance of Series M Preferred Stock in exchange for related party loans and accrued interest		22,000			220			-		-		21,999,780		-			22,000,000
Deemed dividend from issuance of Series M Preferred Stock		-			-			-		-		-		(3,150,368	)		(3,150,368	)
Balance at March 31, 2021																				2,047,267		$	20,472			474,730	$	48	$	869,856,383		$	(922,788,649	)	$	(52,911,746	)
Conversion of Series M Preferred Stock into common stock																				(620	)		(6	)		450,000		45		(39	)		-			-
Conversion of Series N Preferred Stock into common stock																				(8,888	)		(89	)		9,075,270		907		(818	)		-			-
Issuance of Series O Preferred Stock																				2,750			28			-		-		2,499,972			-			2,500,000
Deemed dividends																														99,253,330			(99,253,330	)		-
Net income		-			-			-		-		-		2,121,628			2,121,628			-			-			-		-		-			9,071,318			9,071,318
Balance at June 30, 2020		2,022,010		$	20,220			989,894	$	99	$	532,426,974	$	(593,762,532	)	$	(61,315,239	)
Balance at June 30, 2021																				2,040,509		$	20,405			10,000,000	$	1,000	$	971,608,828		$	(1,012,970,661	)	$	(41,340,428	)

															Total
	Preferred Stock				Common Stock				Additional			Accumulated			Stockholders’
	Shares		Amount		Shares		Amount		paid-in capital			Deficit			Deficit
Balance at December 31, 2018		2,000,225	$	20,002		12,857	$	1	$	375,858,739		$	(415,046,606	)	$	(39,167,864	)
Conversion of Series I-2 Preferred Stock into common stock		-		-		325,570		33		643,847			-			643,880
Common stock issued in cashless exercise of warrants		-		-		11,962		1		(1	)		-			-
Stock-based compensation		-		-		-		-		8,650			-			8,650
Deemed dividend from trigger of down round provision feature		-		-		-		-		123,861,587			(123,861,587	)		-
Modification of warrants		-		-		-		-		4,056,425			-			4,056,425
Net loss		-		-		-		-		-			(13,441,404	)		(13,441,404	)
Balance at March 31, 2019		2,000,225		20,002		350,389		35		504,429,247			(552,349,597	)		(47,900,313	)
Conversion of Series I-2 Preferred Stock into common stock		-		-		250,505		25		261,068			-			261,093
Stock-based compensation		-		-		-		-		8,650			-			8,650
Modification of warrants		-		-		-		-		5,408,566			-			5,408,566
Net loss		-		-		-		-		-			(13,424,827	)		(13,424,827	)
Balance at June 30, 2019		2,000,225	$	20,002		600,894	$	60	$	510,107,531		$	(565,774,424	)	$	(55,646,831	)

	Six Months Ended June 30,
	2020			2019

Cash flows from operating activities:
Net loss from continuing operations	$	(3,646,548	)	$	(26,212,371	)
Adjustments to reconcile net loss to net cash (used in) provided by operations:
Depreciation and amortization		345,798			409,822
Stock-based compensation		-			17,300
Amortization of debt discount		63,695			5,003,653
Modification of warrants		-			9,464,991
Gain from legal settlements		(1,230,522	)		-
HHS Provider Relief Funds		(7,483,830	)		-
Penalty for non-payment of debenture		-			595,440
Change in fair value of derivative instruments		-			105,076
Loss on sales of accounts receivable		249,500			656,949
Bargain purchase gain for hospital and medical center		-			(250,000	)
Loss from discontinued operations		(23,602	)		(653,860	)
Changes in operating assets and liabilities:
Accounts receivable		1,328,369			(2,114,913	)
Inventory		(75,732	)		35,292
Prepaid expenses and other current assets		(16,935	)		(33,353	)
Security deposits		9,872			39,227
Accounts payable and checks issued in excess of bank balance		(1,771,184	)		4,111,576
Accrued expenses		4,420,816			3,290,128
Income tax assets and liabilities		(1,118,485	)		(45,000	)
Net cash used in operating activities of continuing operations		(8,948,788	)		(5,580,043	)
Net cash (used in) provided by operating activities of discontinued operations		(122,991	)		153,483
Net cash used in operating activities		(9,071,779	)		(5,426,560	)

Cash flows from investing activities:
Purchase of hospital and medical center		-			(658,537	)
Purchase of property and equipment		(10,435	)		(43,715	)
Net cash used in investing activities of continuing operations		(10,435	)		(702,252	)
Net cash from investing activities of discontinued operations		-			-
Net cash used in investing activities		(10,435	)		(702,252	)

Cash flows from financing activities:
Proceeds from issuance of related party note payable and advances		4,595,553			9,099,126
Payments on related party note payable and advances		(3,251,387	)		(1,510,000	)
Proceeds from issuance of debentures		-			3,845,000
Proceeds from note payable		1,077,116			-
Payments on notes payable		(793,715	)		(5,005,513	)
Payments on debentures		(720,000	)		-
Proceeds from sales of accounts receivable		465,000			1,179,500
Payments on right-to-use liabilities		(133,807	)		(92,550	)
Proceeds from Paycheck Protection Program notes payable		2,368,100			-
HHS Provider Relief Funds		7,483,830			-
Payments of accounts receivable sold under sales agreements		(1,073,854	)		(818,381	)
Payments on finance lease obligations		(100,707	)		(143,926	)
Net cash provided by financing activities of continuing operations		9,916,129			6,553,256
Net cash used in financing activities of discontinued operations		(40,000	)		-
Net cash provided by financing activities		9,876,129			6,553,256

Net increase in cash		793,915			424,444

Cash at beginning of period		16,933			6,870

Cash at end of period	$	810,848		$	431,314

	●	The parties have approved the contract either in writing; orally by acknowledgement; or implicitly, based on customary business practices.
	●	Each party’s rights and the contract’s payment terms are identified.
	●	The contract has commercial substance.
	●	Collection is probable.

	Three Months Ended June 30,						Six Months Ended June 30,
	2020			2019			2020			2019
Numerator
Net income (loss) from continuing operations	$	2,105,455		$	(13,279,576	)	$	(3,646,548	)	$	(26,212,371	)
Deemed dividend		(3,150,368	)		-			(3,150,368	)		(123,861,587	)
Net loss available to common stockholders, continuing operations	$	(1,044,913	)	$	(13,279,576	)	$	(6,796,916	)	$	(150,073,958	)
Net income (loss) from discontinued operations		16,173			(145,251	)		(23,602	)		(653,860	)
Net loss available to common stockholders	$	(1,028,740	)	$	(13,424,827	)	$	(6,820,518	)	$	(150,727,818	)

Denominator
Basic and diluted weighted average common shares outstanding		989,894			528,965			985,608			335,786

Loss per share, basic and diluted
Basic and diluted, continuing operations	$	(1.06	)	$	(25.11	)	$	(6.90	)	$	(446.93	)
Basic and diluted, discontinued operations	$	0.02		$	(0.27	)	$	(0.02	)	$	(1.95	)
Total basic and diluted	$	(1.04	)	$	(25.38	)	$	(6.92	)	$	(448.88	)

Total purchase price	$	658,537
Tangible and intangible assets acquired, and liabilities assumed at estimated fair value:
Inventories	$	317,427
Property and equipment		500,000
Intangible asset- certificate of need		250,000
Accrued expenses		(158,890	)
Net tangible and intangible assets acquired	$	908,537
Gain on bargain purchase	$	250,000

	Six Months Ended
	June 30, 2019

Net revenue	$	10,969,459
Net loss from continuing operations		(26,409,730	)
Deemed dividends from trigger of down round provision feature		(123,861,587	)
Net loss from discontinued operations		(653,860	)
Net loss to common stockholders	$	(150,925,177	)

Net loss per common share:
Basic and diluted net loss from continuing operations available to common stockholders	$	(444.52	)
Basic and diluted net loss available to common stockholders	$	(449.47	)

	June 30, 2021			December 31, 2020

Loan payable to TCA Global Master Fund, L.P. (“TCA”) in the original principal amount of $3 million at 16% interest (the “TCA Debenture”). Principal and interest payments due in various installments through December 31, 2017	$	1,741,893		$	1,741,893

Notes payable to CommerceNet and Jay Tenenbaum in the original principal amount of $500,000, bearing interest at 6% per annum (the “Tegal Notes”). Principal and interest payments due annually from July 12, 2015 through July 12, 2017		291,559			297,068

Note payable to Anthony O’Killough dated September 27, 2019 in the original principal amount of $1.9 million. Interest is due only upon event of default. Issued net of $0.3 million of debt discount and $0.1 million of financing fees. Payment due in installments through November 2020.		1,450,000			1,450,000

Notes payable under the Paycheck Protection Program (“PPP) issued on April 20, 2020 through May 1, 2020 bearing interest at a rate of 1% per annum. To the extent not forgiven, principal and interest payments are due monthly beginning sixteen months from the date of issuance and the notes mature 40 months from the date of issuance.		2,385,922			2,385,921

The Ponte Note dated January 29, 2020, less original issue discount of $0.1 million, non-interest bearing, payable in weekly installment payments ranging from $22,500 to $34,000 due on or before February 5, 2020 through on or before October 21, 2020, the maturity date.		50,000			108,350

Notes payable dated January 31, 2021 and February 16, 2021 due six months from the date of issuance bearing interest at 10% for the period outstanding.		245,000			-

Warrant pre-payment promissory notes dated February 25, 2021, April 9, 2021, April 16, 2021 and April 22, 2021, non-interest bearing, $1,100,000 aggregate principal amount, issued with $100,000 of original issue discounts and payable 12 months from the date of issuance		1,027,630			-

		7,192,004			5,983,232
Less current portion		(6,394,997	)		(4,786,976	)
Notes payable - third parties, net of current portion	$	797,007		$	1,196,256

	December 31, 2019

Loan payable to Christopher Diamantis	$	15,159,455

Total note payable, related party		15,159,455

Less current portion of notes payable, related party		(15,159,455	)
Total note payable, related party, net of current portion	$	-

								Balance Sheet Classification	June 30, 2021			December 31, 2020
	Balance Sheet Classification	June 30, 2020			December 31, 2019
Assets:			(unaudited)
Operating leases	Right-of-use operating lease assets	$	394,281		$	274,747		Right-of-use operating lease assets	$	910,541		$	1,000,272
Finance leases	Property and equipment, net		349,987			1,119,418		Property and equipment, net		249,985			249,985

Total lease assets		$	744,268		$	1,394,165			$	1,160,526		$	1,250,257

Liabilities:
Current:
Operating leases	Right-of-use operating lease obligations		165,924			116,037		Right-of-use operating lease obligations	$	217,937		$	172,952
Finance leases	Current liabilities		349,987			1,119,418		Current liabilities		249,985			249,985
Noncurrent:
Operating leases	Right-of-use operating lease obligations		228,357			158,710		Right-of-use operating lease obligations		692,604			827,320
Finance leases	Long-term debt		-			-

Total lease liabilities		$	744,268		$	1,394,165			$	1,160,526		$	1,250,257

Weighted-average remaining term:
Operating leases			2.42 years			2.02 years				3.92 years			4.17 years
Finance leases			0 years			0.08 years				0 years			0 years
Weighted-average discount rate:
Operating leases(1)			13.0	%		13.0	%
Operating leases										13.0	%		13.0	%
Finance leases			10.3	%		5.1	%			4.9	%		4.9	%

	June 30,				June 30,
	2020		2019		2021		2020
Warrants		63,458,545		63,452,541		122,395,632		63,467
Convertible preferred stock		16,759,797		8,529,180		85,852,763		16,761
Convertible debentures		1,545,690		3,057,040		5,963,367		1,548
Stock options		30		34		26		26
		81,764,062		75,038,795		214,211,788		81,802

	Three Months Ended June 30, 2020		Three Months Ended June 30, 2019		Six Months Ended June 30, 2020		Six Months Ended June 30, 2019
Finance lease expense:
Depreciation/amortization of leased assets (1)	$	10,539	$	9,290	$	26,349	$	(45,069	)
Interest on lease liabilities		46,503		1,155		93,012		5,100
Operating leases:
Short-term lease expense (2)		78,502		99,927		194,238		187,401

Total lease expense	$	135,544	$	110,372	$	313,599	$	147,432

		Three Months Ended June 30, 2021		Three Months Ended June 30, 2020		Six Months Ended June 30, 2021		Six Months Ended June 30, 2020
Finance lease expense:
Finance lease expense: Depreciation/amortization of leased assets	$	-	$	10,539	$	-	$	26,349
Finance lease expense: Interest on lease liabilities		-		46,503		-		93,012
Operating leases:
Operating leases: Short-term lease expense ⁽¹⁾		34,033		69,235		106,583		169,942

Total lease expense	$	34,033	$	126,277	$	106,693	$	289,303

	Six Months Ended June 30, 2021		Six Months Ended June 30, 2020
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	102,152	$	73,812
Operating cash flows for finance leases		-		9,455
Financing cash flows for finance leases payments		-		100,707

	Six Months Ended June 30, 2020		Six Months Ended June 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	-	$	76,559
Financing cash flows for operating leases	$	133,807	$	92,550
Operating cash flows for finance leases	$	9,455	$	5,100
Financing cash flows for finance leases payments	$	100,707	$	143,926

	Right-of-Use Operating Leases			Finance Leases
July 1, 2020 to June 30, 2021	$	207,525		$	353,779
July 1, 2021 to June 30, 2022		155,687			-
July 1, 2022 to June 30, 2023		99,107			-
July 1, 2023 to June 30, 2024		-			-
July 1, 2024 to June 30, 2025		-			-
Total		462,319			353,779

Less interest		(68,038	)		(3,792	)
Present value of minimum lease payments	$	394,281		$	349,987

	Right-of-Use Operating Leases			Finance Leases
Twelve months ended June 30, 2022	$	314,807		$	253,776
Twelve months ended June 30, 2023		339,024			-
Twelve months ended June 30, 2024		216,239			-
Twelve months ended June 30, 2025		222,712			-
Twelve months ended June 30, 2026		74,598			-
Thereafter		-			-
Total		1,167,380			253,776

Less interest		(256,839	)		(3,791	)
Present value of minimum lease payments	$	910,541		$	249,985

Less current portion of lease obligations		(217,937	)		(249,985	)
Lease obligations, net of current portion	$	692,604		$	-

	Level 1		Level 2		Level 3		Total

As of December 31, 2019:
Embedded conversion options	$	-	$	-	$	455,336	$	455,336
Total	$	-	$	-	$	455,336	$	455,336

As of June 30, 2020:
Embedded conversion options	$	-	$	-	$	455,336	$	455,336
Total	$	-	$	-	$	455,336	$	455,336

	Number of warrants			Weighted average exercise price
Balance at December 31, 2019		63,458,546		$	1.44
Warrants expired		(1	)	$	(3,150.00	)
Balance at June 30, 2020		63,458,545		$	1.44

	Number of Shares of Common Stock Issuable for Warrants		Weighted average exercise price
Balance at December 31, 2020		4,571,165	$	19.99
Increase in number of shares of common stock issuable under warrants during the period as a result of down round provisions		117,824,467
Balance at June 30, 2021		122,295,632	$	0.7465

	●	~~Hospital Operations,~~ ~~which reflects the operations of Jamestown Regional Medical Center, Big South Fork Medical Center, Jellico Community Hospital and CarePlus Center.~~

	●	~~Clinical Laboratory Operations~~~~, which specializes in providing urine and blood toxicology and pain medication testing to physicians, clinics and rehabilitation facilities in the United States.~~

	As of
	June 30, 2020			December 31, 2019
Total assets
Hospital Operations	$	12,813,219		$	14,275,256
Clinical Laboratory Operations		450,212			330,381
Corporate		4,457,937			2,305,380
Assets of AMSG and HTS classified as held for sale		212,018			514,772
Eliminations		(2,718,130	)		(2,718,130	)
	$	15,215,256		$	14,707,659

	June 30, 2021		December 31, 2020
	(unaudited)
Cash	$	-	$	136
Accounts receivable, net		-		-
Prepaid expenses and other current assets		-		-
Current assets classified as held for sale	$	-	$	136

Property and equipment, net	$	-	$	-
Deposits		100,014		100,014
Right-of-use assets		52,284		100,116
Non-current assets classified as held for sale	$	152,298	$	200,130

Accounts payable and checks in excess of bank balance	$	1,144,088	$	1,185,158
Accrued expenses		336,410		334,667
Current portion of right-of-use operating lease obligation		52,284		91,166
Current portion of notes payable		-		-
Current liabilities classified as held for sale	$	1,532,782	$	1,610,991

Note payable	$	-	$	-
Right-of-use operating lease obligation		-		8,950
Non-current liabilities classified as held for sale	$	-	$	8,950

	August 11, 2021
Shares of common stock outstanding		29,350,000
Dilutive potential shares:
Convertible preferred stock		1,775,720,879
Warrants		2,657,130,516
Convertible debt		235,605,419
Stock options		26
Total dilutive potential shares of common stock, including outstanding common stock		4,697,806,840

	~~(1)~~	~~Net revenue for the three months ended June 30, 2019 related to the recovery of bad debt.~~
	~~(2)~~	~~The direct costs of revenue for the three months ended June 30, 2020 resulted from the reclassification of a previously recorded gain on legal settlement during the period.~~

~~(1)~~	~~Accumulated depreciation that was previously overstated was adjusted in the six months ended June 30, 2020.~~
~~(2)~~	Net revenue per insured test was impacted by the recovery of bad debt in the six months ended June 30, 2019. Excluding the effect of the recovery of bad debt, the net revenue per insured test was approximately $210.00 per test.

	●	Any obligation under certain guarantee contracts.

	●	Any retained or contingent interest in assets transferred to an unconsolidated entity or similar arrangement that serves as credit, liquidity or market risk support to that entity for such assets.

	●	Any obligation under a contract that would be accounted for as a derivative instrument, except that it is both indexed to the Company’s stock and classified in stockholder’s equity in the Company’s statement of financial position.

	●	Any obligation arising out of a material variable interest held by us in an unconsolidated entity that provides financing, liquidity, market risk or credit risk support to us, or engages in leasing, hedging or research and development services with us.

~~3.22~~3.26	Certificate of Designation for Series LO Convertible Redeemable Preferred Stock (incorporated by reference to Exhibit ~~3.22~~3.26 of the Company’s Current Report on Form 8-K filed with the SEC on May ~~5, 2020)~~11, 2021).

~~3.23~~10.1	~~Certificate~~Form of ~~Designation for Series M Convertible Preferred Stock (incorporated by reference to Exhibit 3.23 of the Company’s Current Report on Form 8-K filed with the SEC on June 16, 2020).~~

~~10.1~~	~~Voting Agreement and Irrevocable Proxy, dated as of August 13, 2020, by and among Rennova Health, Inc., Seamus Lagan, Alcimede LLC and Christopher Diamantis~~

~~10.92~~	~~Exchange~~Securities Purchase Agreement, dated as of May ~~5, 2020, between~~10, 2021, among Rennova Health, Inc. and ~~Alcimede LLC (incorporated by reference to Exhibit 10.178 of~~ the ~~Company’s Current Report on Form 8-K filed with the SEC on May 5, 2020).~~

~~10.93~~	~~Form of Promissory Note, with Evolve Bank & Trust~~investors signatory thereto (incorporated by reference to Exhibit 10.1 of the Company’s Current Report on Form 8-K filed with the SEC on May ~~12, 2020)~~11, 2021).

31.1	Rule 13a-14(a) Certification by the Principal Executive Officer.

31.2	Rule 13a-14(a) Certification by the Principal Financial Officer.

32.1	Certification by the Principal Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.*

32.2	Certification by the Principal Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.*

101.INS	XBRL Instance Document

101.SCH	XBRL Schema Document

101.CAL	XBRL Calculation Link base Document

101.DEF	XBRL Definition Link base Document

101.LAB	XBRL Label Link base Document

101.PRE	XBRL Presentation Link base Document

	RENNOVA HEALTH, INC.

Date: August ~~13, 2020~~16, 2021	By:	/s/ Seamus Lagan
		Seamus Lagan
		Chief Executive Officer, President and Interim Chief Financial Officer (Principal Executive Officer and Principal Financial Officer)