Document And Entity Information
Document And Entity Information - shares | 3 Months Ended | |
Mar. 31, 2016 | May. 13, 2016 | |
Entity Registrant Name | American CareSource Holdings, Inc. | |
Entity Central Index Key | 1,316,645 | |
Trading Symbol | gnow | |
Current Fiscal Year End Date | --12-31 | |
Entity Filer Category | Smaller Reporting Company | |
Entity Current Reporting Status | Yes | |
Entity Voluntary Filers | No | |
Entity Well-known Seasoned Issuer | No | |
Entity Common Stock, Shares Outstanding (in shares) | 16,597,150 | |
Document Type | 10-Q | |
Document Period End Date | Mar. 31, 2016 | |
Document Fiscal Year Focus | 2,016 | |
Document Fiscal Period Focus | Q1 | |
Amendment Flag | false |
Consolidated Balance Sheets (Cu
Consolidated Balance Sheets (Current Period Unaudited) - USD ($) | Mar. 31, 2016 | Dec. 31, 2015 |
Series A Preferred Stock [Member] | ||
Stockholders' (deficit): | ||
Preferred stock, value | $ 664,000 | $ 664,000 |
Cash and cash equivalents | 1,050,000 | 2,629,000 |
Accounts receivable, net | 1,775,000 | 1,498,000 |
Prepaid expenses and other current assets | 428,000 | 391,000 |
Assets held for sale | 2,166,000 | 2,644,000 |
Total current assets | 5,419,000 | 7,162,000 |
Property and equipment, net | 4,928,000 | 4,859,000 |
Deferred loan fees, net | 684,000 | 1,154,000 |
Other non-current assets | 118,000 | 104,000 |
Intangible assets, net | 1,828,000 | 1,885,000 |
Goodwill | 5,921,000 | 5,921,000 |
Total other assets | 8,551,000 | 9,064,000 |
Total assets | 18,898,000 | 21,085,000 |
Lines of credit | 11,800,000 | 11,100,000 |
Accounts payable | 1,477,000 | 1,609,000 |
Accrued liabilities | 1,330,000 | 1,907,000 |
Current portion of promissory notes and notes payable | 184,000 | 210,000 |
Capital lease obligations, current portion | 138,000 | 134,000 |
Liabilities held for sale | 5,127,000 | 5,435,000 |
Total current liabilities | 20,056,000 | 20,395,000 |
Promissory notes and notes payable | 522,000 | 522,000 |
Capital lease obligations | 1,595,000 | 1,630,000 |
Other long-term liabilities | 345,000 | 344,000 |
Total long term liabilities | 2,462,000 | 2,496,000 |
Total liabilities | 22,518,000 | 22,891,000 |
Preferred stock, value | 0 | 0 |
Common stock, $0.01 par value; 40,000 shares authorized; 16,608 and 16,597 shares issued and outstanding at March 31, 2016 and December 31, 2015, respectively | 166,000 | 165,000 |
Additional paid-in capital | 32,565,000 | 32,535,000 |
Accumulated (deficit) | (36,879,000) | (35,170,000) |
Stockholders' (deficit) of American CareSource Holdings, Inc. | (3,484,000) | $ (1,806,000) |
Equity of non-controlling interest | (135,000) | |
Total stockholders' (deficit) | (3,620,000) | $ (1,806,000) |
Total liabilities and stockholders' (deficit) | $ 18,898,000 | $ 21,085,000 |
Consolidated Balance Sheets (C3
Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - $ / shares | Mar. 31, 2016 | Dec. 31, 2015 |
Series A Preferred Stock [Member] | ||
Preferred stock, authorized (in shares) | 870 | 870 |
Preferred stock, issued (in shares) | 750 | 750 |
Preferred stock, outstanding (in shares) | 750 | 750 |
Preferred stock, par value (in dollars per share) | $ 0.01 | $ 0.01 |
Preferred stock, authorized (in shares) | 9,999,000 | 9,999,000 |
Common stock par value (in dollars per share) | $ 0.01 | $ 0.01 |
Common stock, shares authorized (in shares) | 40,000,000 | 40,000,000 |
Common stock, shares issued (in shares) | 16,608,000 | 16,597,000 |
Common stock, shares outstanding (in shares) | 16,608,000 | 16,597,000 |
Consolidated Statements of Oper
Consolidated Statements of Operations (Unaudited) - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | |
Mar. 31, 2016 | Mar. 31, 2015 | |
Net revenues: | ||
Urgent and primary care | $ 4,412 | $ 2,672 |
Service agreement | 594 | |
Total net revenues | 5,006 | $ 2,672 |
Operating expenses: | ||
Salaries, wages, contract medical professional fees and related expenses | 4,006 | 3,072 |
Facility expenses | 525 | 362 |
Medical supplies | 210 | 224 |
Other operating expenses | 1,603 | 2,052 |
Depreciation and amortization expense | 222 | 166 |
Total operating expenses | 6,566 | 5,876 |
Operating (loss) | (1,560) | (3,204) |
Interest expense: | ||
Interest expense | 107 | 83 |
Deferred loan fees amortization, net of loss on warrant liability | 470 | 369 |
Total other expense and interest expense | 577 | 452 |
(Loss) from continuing operations before taxes | (2,137) | (3,656) |
Income tax expense | 6 | 6 |
Net (loss) from continuing operations | (2,143) | (3,662) |
Income/(loss) from discontinued operations | 299 | (15) |
Net (loss) | (1,844) | $ (3,677) |
Net (loss) attributable to non-controlling interests | (135) | |
Net (loss) attributable to American CareSource Holdings, Inc. | $ (1,709) | $ (3,677) |
Basic net (loss) per common share, continuing operations (in dollars per share) | $ (0.11) | $ (0.54) |
Diluted net (loss) per common share, continuing operations (in dollars per share) | (0.11) | (0.55) |
Basic net income per share, discontinued operations (in dollars per share) | 0.02 | 0 |
Diluted net income per share, discontinued operations (in dollars per share) | $ 0.02 | $ 0 |
Basic weighted-average common shares outstanding (in shares) | 16,603 | 6,772 |
Diluted weighted-average common shares outstanding (in shares) | 16,603 | 6,852 |
Consolidated Statements of Stoc
Consolidated Statements of Stockholders' Equity (Deficit) (Unaudited) - 3 months ended Mar. 31, 2016 - USD ($) shares in Thousands | Preferred Stock [Member] | Common Stock [Member] | Additional Paid-in Capital [Member] | Retained Earnings [Member] | Noncontrolling Interest [Member] | Total |
Balance at December 31, 2015 (in shares) at Dec. 31, 2015 | 750 | 16,597 | ||||
Balance at December 31, 2015 at Dec. 31, 2015 | $ 664,000 | $ 165,000 | $ 32,535,000 | $ (35,170,000) | $ 0 | $ (1,806,000) |
Net (loss) | (1,709,000) | (135,000) | (1,844,000) | |||
Stock-based compensation expense | 30,000 | 30,000 | ||||
Issuance of common stock upon conversion of restricted stock (in shares) | 11 | |||||
Issuance of common stock upon conversion of restricted stock | $ 1,000 | |||||
Balance at March 31, 2016 (in shares) at Mar. 31, 2016 | 750 | 16,608 | ||||
Balance at March 31, 2016 at Mar. 31, 2016 | $ 664,000 | $ 166,000 | $ 32,565,000 | $ (36,879,000) | $ (135,000) | $ (3,620,000) |
Consolidated Statements of Cash
Consolidated Statements of Cash Flows (Unaudited) - USD ($) | 3 Months Ended | |
Mar. 31, 2016 | Mar. 31, 2015 | |
Cash flows from operating activities: | ||
Net (loss) | $ (1,844,000) | $ (3,677,000) |
Adjustments to reconcile net (loss) to net cash (used in) operating activities: | ||
Non-cash stock-based compensation expense | 30,000 | 147,000 |
Depreciation and amortization | 222,000 | 291,000 |
Deferred loan fees amortization, net of loss on warrant liability | 470,000 | 369,000 |
Change in deferred rent | 1,000 | 69,000 |
Changes in operating assets and liabilities: | ||
Accounts receivable | (277,000) | (51,000) |
Prepaid expenses and other current assets | (37,000) | (110,000) |
Accounts payable | 226,000 | (207,000) |
Accrued liabilities | (577,000) | 163,000 |
Assets held for sale | 478,000 | (204,000) |
Liabilities held for sale | (308,000) | 422,000 |
Net cash (used in) operating activities | (1,616,000) | (2,788,000) |
Cash flows from investing activities: | ||
Net change in other non-current assets | (14,000) | 8,000 |
Additions to property and equipment | (234,000) | (90,000) |
Net cash (used in) investing activities | (248,000) | (82,000) |
Cash flows from financing activities: | ||
Proceeds from borrowings under line of credit | 700,000 | 2,284,000 |
Principal payments on capital lease obligations | (31,000) | (27,000) |
Principal payments on long-term debt | (26,000) | (63,000) |
Payment of deferred offering costs | (358,000) | (22,000) |
Net cash provided by financing activities | 285,000 | 2,172,000 |
Net (decrease) in cash and cash equivalents | (1,579,000) | (698,000) |
Cash and cash equivalents at beginning of period | 2,629,000 | 1,020,000 |
Cash and cash equivalents at end of period | 1,050,000 | 322,000 |
Supplemental cash flow information: | ||
Cash paid for interest | $ 106,000 | 74,000 |
Supplemental non-cash operating and financing activity: | ||
Offering costs, deferred and unpaid | $ 7,000 | |
Offering costs, unpaid | $ 100,000 | |
Reclassified property and equipment from prepaid expenses | $ 51,000 |
Note 1 - General
Note 1 - General | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Basis of Presentation and Significant Accounting Policies [Text Block] | 1. General Basis of Presentation The accompanying unaudited consolidated financial statements of American CareSource Holdings, Inc. and its subsidiaries have been prepared in accordance with accounting principles generally accepted in the United States for interim financial information, with the instructions to Form 10-Q and Rule 8-03 of Regulation S-X of the rules and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, they do not include all of the information and notes required by accounting principles generally accepted in the United States for complete financial statements. In the opinion of management, these statements include all adjustments necessary to present a fair statement of our consolidated results of operations, financial position and cash flows. Operating results for any interim period are not necessarily indicative of the results that may be expected for the full year. Preparation of the Company’s financial statements in conformity with accounting principles generally accepted in the United States requires management to make estimates and assumptions that affect the reported amounts in the financial statements and notes. Actual results could differ from those estimates. This Quarterly Report on Form 10-Q should be read in conjunction with the Company’s consolidated financial statements and notes included in its Annual Report on Form 10-K for the fiscal year ended December 31, 2015. References herein to "the Company," "we," "us," or "our" refer to American CareSource Holdings, Inc. and its subsidiaries. Significant Accounting Policies Goodwill resulted from our acquisition of urgent and primary care businesses during the years ended December 31, 2015 and 2014. In accordance with the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 805, Business Combinations , Intangibles – Goodwill and Other Variable Interest Entities ("VIEs") We have determined that Medac Health Services, P.A. (“Medac”) is a VIE and that we are the primary beneficiary. The financial results of Medac, our consolidated VIE, have been included in our operations since December 15, 2015, the date we closed the acquisition of certain assets from Medac (“the Medac Asset Acquisition”). Refer to Note 4 – Acquisitions and Variable Interest Entity. For additional Significant Accounting Policies, refer to our Annual Report on Form 10-K for the fiscal year ended December 31, 2015. Recent Accounting Pronouncements In March 2016, the FASB issued ASU 2016-09 “Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting.” This standard requires the recognition of the income tax effects of awards in the income statement when the awards vest or are settled, thus eliminating additional paid in capital pools. The guidance also allows for the employer to repurchase more of an employee’s shares for tax withholding purposes without triggering liability accounting. In addition, the guidance allows for a policy election to account for forfeitures as they occur rather than on an estimated basis. The guidance is effective in 2017 with early adoption permitted. The Company is currently evaluating the impact of this guidance on its consolidated financial statements and the timing of adoption. |
Note 2 - Description of Busines
Note 2 - Description of Business | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Business Description and Basis of Presentation [Text Block] | 2. Description of Business The Company engages in two lines of business: our urgent and primary care business, which we operate under the tradenames GoNow Doctors and Medac, and our ancillary network business. These lines of business are supported by a shared services function. On November 2, 2015, we commenced efforts to sell our legacy ancillary network business to our largest client and manager of the business, HealthSmart Preferred Care II, L.P. (“HealthSmart”) in order to continue our focus on our urgent and primary care business. Assuming we reach mutually agreeable terms with HealthSmart, we anticipate closing the transaction in 2016. Accordingly, we have concluded that the ancillary network business qualifies as discontinued operations and financial results for the ancillary network business are presented as discontinued operations in our consolidated statements of operations, and the related asset and liability accounts are presented on our unaudited consolidated balance sheets as held for sale as of March 31, 2016. Amounts previously reported have been reclassified, as necessary, to conform to this presentation to allow for meaningful comparison of continuing operations. Refer to Note 5 – Discontinued Operations. In May 2014, we announced our entry into the urgent and primary care market. During the remainder of 2014, through our wholly-owned subsidiaries, we consummated five transactions resulting in our acquisition of ten urgent and primary care centers, located in Georgia (3), Florida (2), Alabama (3), and Virginia (2). In December 2015, we completed a key acquisition of urgent care assets comprising four sites in North Carolina. In January 2016, we closed one of our Georgia sites and on April 1, 2016, we sold the two Virginia centers. Our healthcare centers offer a wide array of services for non-life-threatening medical conditions. We strive to improve access to quality medical care by offering extended hours and weekend service primarily on a walk-in basis. Our centers offer a broad range of medical services that generally fall within the urgent care, primary care, family care, and occupational medicine classifications. Specifically, we offer non-life-threatening, out-patient medical care for the treatment of acute, episodic, and some chronic medical conditions. When hospitalization or specialty care is needed, referrals to appropriate providers are made. Patients typically visit our centers on a walk-in basis when their condition is not severe enough to warrant an emergency visit or when treatment by their primary care provider is inconvenient. We also attempt to capture follow-up, preventative and general primary care business after walk-in visits. The services provided at our centers include, but are not limited to, the following: · routine treatment of general medical problems, including colds, flu, ear infections, hypertension, asthma, pneumonia, urinary tract infections, and other conditions typically treated by primary care providers; · treatment of injuries, such as simple fractures, dislocations, sprains, bruises, and cuts; · minor, non-emergent surgical procedures, including suturing of lacerations and removal of foreign bodies; · diagnostic tests, such as x-rays, electrocardiograms, complete blood counts, and urinalyses; and · occupational and industrial medical services, including drug testing, workers' compensation cases, and pre-employment physical examinations. Our centers are typically equipped with digital x-ray machines, electrocardiograph machines and basic laboratory equipment, and are generally staffed with a combination of licensed physicians, nurse practitioners, physician assistants, medical support staff, and administrative support staff. Our medical support staff includes licensed nurses, certified medical assistants, laboratory technicians, and registered radiographic technologists. |
Note 3 - Liquidity and Earnings
Note 3 - Liquidity and Earnings (Loss) Per Share | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Liquidity and Earnings (Loss) Per Share [Text Block] | 3. Liquidity and Earnings (Loss) Per Share Liquidity and Capital Resources As of March 31, 2016, we had cash and cash equivalents of $1.1 million and a working capital deficit of $14.6 million. As of December 31, 2015, we had cash and cash equivalents of $2.6 million and a working capital deficit of $13.2 million. Our cash needs have been funded historically from loan proceeds and equity offerings. We entered into two lines of credit in 2014. Maximum borrowings under these lines of credit is $12,000,000. As of March 31, 2016, we had no additional credit available to us under our lines of credit. Furthermore, both lines of credit are scheduled to mature in 2016 at which time the full outstanding principal balance of $11,800,000 will become due and payable. Substantially all of the borrowings under the lines of credit were used to finance acquisition activity, to fund losses, and $200,000, which is not currently available to us, was used to secure a bond required to obtain a state license for our ancillary network business. Although we intend to extend the maturity dates of the two lines of credit and raise additional capital through the incurrence of additional debt or sale of equity or assets during 2016, there is no assurance that we will be successful in completing such actions. If we are unable to obtain extensions on our lines of credit or if we are unable to raise additional funds, we will not have sufficient cash on hand to meet our cash requirements over the next 12 months. These uncertainties raise substantial doubt about our ability to continue as a going concern. Our consolidated financial statements do not include any adjustments that might be necessary if we are unable to continue as a going concern. Earnings (Loss) Per Share Basic earnings (loss) per share is computed using a two-class participating securities method. Losses have been allocated to the preferred stock, on an as-converted basis, without preference to the common stock because the dividend and liquidation rights of the preferred and common stock are equivalent on an as-converted basis. Diluted earnings (loss) per share is computed similar to basic earnings per share except for adjustments for dilutive potential common shares outstanding during the period using the treasury stock method. We computed earnings (loss) per share for both continuing and discontinued operations for the periods ended March 31, 2016, and March 31, 2015. Basic net (loss) and diluted net (loss) per share data were computed as follows (in thousands except per share amounts): Three Months Ended March 31, 2016 March 31, 2015 Numerator: (Loss) from continuing operations (2,143 ) (3,662 ) Plus loss from non-controlling interests 135 - Plus loss allocated to preferred stock 122 - (Loss) from continuing operations, common stock for basic earnings per share (1,886 ) (3,662 ) Less gain on change in fair value of warrant liability - 140 (Loss) from continuing operations, common stock for diluted earnings per share (1,886 ) (3,802 ) Income/(loss) from discontinued operations 299 (15 ) Denominator: Weighted-average basic common shares outstanding 16,603 6,772 Assumed conversion of dilutive securities: Common stock purchase warrants - 80 Denominator for dilutive earnings per share - adjusted weighted-average shares 16,603 6,852 Basic net (loss) per share, continuing operations $ (0.11 ) $ (0.54 ) Diluted net (loss) per share, continuing operations $ (0.11 ) $ (0.55 ) Basic net income per share, discontinued operations $ 0.02 $ 0.00 Diluted net income per share, discontinued operations $ 0.02 $ 0.00 The following table summarizes potentially dilutive shares outstanding as of March 31, 2016 and March 31, 2015, which were excluded from the calculation due to being anti-dilutive (in thousands): 2016 2015 Common stock purchase warrants 11,107 822 Stock options 1,644 1,334 Restricted stock units - 89 Restricted stock 50 - |
Note 4 - Acquisitions and Varia
Note 4 - Acquisitions and Variable Interest Entity | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Business Combination Disclosure [Text Block] | 4. Acquisitions and Variable Interest Entity On December 15, 2015, ACSH Medical Management, LLC (“ACSH Management”), a wholly-owned subsidiary of the Company, purchased from Medac and its shareholders, substantially all the assets used in the operation of its four urgent care centers in the greater Wilmington, North Carolina area for $4,370,000 in cash, the assumption of $768,000 in liabilities and a $560,000 note payable. Medac remains an urgent care operating entity, owned by a single physician, with which ACSH Management has entered into various agreements. ACSH Management has entered into a $1.0 million secured line of credit for the benefit of Medac to fund certain of Medac’s operating losses and to cover costs necessary to expand the Medac brand in North Carolina. ACSH Management has the power to direct certain of Medac’s significant activities and has the right to receive benefits from Medac that are significant to Medac. We have determined, therefore, that Medac is a VIE and that ACSH Management is the primary beneficiary. Consequently, we have consolidated Medac and its financial results since the date we closed the Medac Asset Acquisition. The following table provides the balance sheets of Medac (in thousands): March 31, 2016 December 31, 2015 (Unaudited) (Audited) Current assets $ 1,066 $ 779 Current liabilities 1,201 759 Stockholder's equity (135 ) 20 Total liabilities & stockholder's equity $ 1,066 $ 779 The following table provides certain pro forma financial information for the Company as if the acquisition of Medac had occurred on January 1, 2015. Three Months Ended March 31, (in thousands, except per share amounts) 2016 2015 Net revenue Urgent and primary care $ 4,412 $ 4,672 Service agreement 594 429 Total net revenue 5,006 5,101 (Loss) from continuing operations before taxes $ (2,137 ) $ (3,325 ) Basic net (loss) per common share $ (0.11 ) $ (0.49 ) Diluted net (loss) per common share $ (0.11 ) $ (0.51 ) In January 2016, we closed one of our Georgia clinics. This clinic produced net revenue of approximately $5,000 and $236,000 for the three-month periods ending March 31, 2016 and 2015, respectively. |
Note 5 - Discontinued Operation
Note 5 - Discontinued Operations | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Disposal Groups, Including Discontinued Operations, Disclosure [Text Block] | 5. Discontinued Operations We are presenting our ancillary network business as discontinued operations in our consolidated statement of operations and the related asset and liability accounts are presented as held for sale. To allow for meaningful comparison of continuing operations, amounts previously reported have been reclassified, as necessary, to conform to this presentation. The ancillary network business offers cost containment strategies, primarily through the utilization of a comprehensive national network of ancillary healthcare service providers. Services are marketed to a number of healthcare companies including third-party administrators, insurance companies, large self-funded organizations, various employer groups, and preferred provider organizations. Since October 1, 2014, HealthSmart has managed our ancillary network business under a management services agreement. Major classes of assets and liabilities of the ancillary network business held for sale are as follows (in thousands): March 31, 2016 December 31, 2015 (Unaudited) (Audited) Accounts receivable $ 1,111 $ 1,589 Prepaid expenses and other current assets 43 43 Deferred income taxes 18 18 Total current assets held for sale 1,172 1,650 Property and equipment, net 588 588 Intangible assets, net 406 406 Total other assets held for sale 994 994 Total assets held for sale $ 2,166 $ 2,644 Due to service providers $ 1,388 $ 3,225 Due to HealthSmart 3,739 2,210 Total current liabilities held for sale 5,127 5,435 Total liabilities held for sale $ 5,127 $ 5,435 Summary results of operations for the ancillary network business were as follows (in thousands): Three Months Ended March 31, 2016 2015 Net revenues $ 4,695 $ 5,743 Operating expenses: Provider payments 3,256 4,331 Administrative fees 324 330 Other operating costs 816 972 Depreciation and amortization - 125 Total operating expenses 4,396 5,758 Income/(loss) from discontinued operations $ 299 $ (15 ) We recognize revenue on the services we provide, which include (i) providing payor clients with a comprehensive network of ancillary healthcare providers; (ii) providing claims management, reporting, processing and payment services; (iii) providing network/need analysis to assess the benefits to payor clients of adding additional/different service providers to the client-specific provider networks; and (iv) providing credentialing of network service providers for inclusion in the client payor-specific provider networks. Revenue is recognized when services are delivered, which occurs after processed claims are billed to the payor clients and collections are reasonably assured. We estimate revenues and costs of revenues using average historical collection rates and average historical margins earned on claims. Revenues are adjusted periodically to reflect actual cash collections so that revenues recognized accurately reflect cash collected. We record a provision for refunds based on an estimate of historical refund amounts. Refunds are paid to payors for overpayment on claims, claims paid in error, and claims paid for non-covered services. In some instances, we will recoup payments made to the ancillary service provider if the claim has been fully resolved. The evaluation is performed periodically and is based on historical data. We present revenue net of the provision for refunds on the consolidated statement of operations. After careful evaluation of the key gross and net revenue recognition indicators, we have concluded that our circumstances are most consistent with those key indicators that support gross revenue reporting, since we are fulfilling the services of a principal versus an agent. Payments to providers is the largest component of our cost of revenues and it consists of payments for ancillary care services in accordance with contracts negotiated with providers for specific ancillary services, separately from contracts negotiated with our clients. |
Note 6 - Revenue Recognition an
Note 6 - Revenue Recognition and Accounts Receivable | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Revenue Recognition, Accounts Receivable and Concentration of Credit Risk [Text Block] | 6. Revenue Recognition and Accounts Receivable In our urgent and primary care business, we have agreements with governmental and other third-party payors that provide for payments to us based on contractual adjustments to our established rates. Net revenue is reported at the time service is rendered at the estimated net realizable amounts, after giving effect to estimated contractual adjustments, payments from patients, third-party payors and others, and an estimate for bad debts. Contractual adjustments are accrued on an estimated basis in the period the related services are rendered and adjusted in future periods as final settlements are determined. We grant credit without collateral to our patients, who consist primarily of local residents insured by third-party payors. A summary of the basis of reimbursement with major third-party payors is as follows: · Commercial and HMO · Medicare In establishing our allowance for bad debts, we consider historical collection experience, the aging of the account, payor classification and patient payment patterns. We adjust this allowance prospectively. We collect payment from our uninsured patients at the time of service. With our recent acquisition of certain assets of Medac, we are recognizing service agreement revenue. Medac leases certain employees and provides administrative services to a local emergency medical business under a management services agreement in exchange for a fee. Revenue related to the agreement is recorded during the period when the services are completed. Below is a summary of accounts receivable as of March 31, 2016 and December 31, 2015, and revenues for the three month periods ended March 31, 2016 and 2015, respectively, for our urgent and primary care business. March 31, 2016 December 31, 2015 (in thousands) (Unaudited) (Audited) Accounts receivable, trade $ 3,394 $ 3,236 Accounts receivable, other 100 - Less: Estimated allowance for contractual adjustments and uncollectible amounts (1,719 ) (1,738 ) Accounts receivable, net $ 1,775 $ 1,498 Three Months Ended March 31, (in thousands) 2016 2015 Gross revenue $ 8,419 $ 5,786 Less: Provision for contractual adjustments and estimated uncollectible amounts (3,413 ) (3,114 ) Net revenue $ 5,006 $ 2,672 |
Note 7 - Capital and Operating
Note 7 - Capital and Operating Lease Obligations | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Leases of Lessee Disclosure [Text Block] | 7. Capital and Operating Lease Obligations The following reflects the scheduled, minimum required payments under our lease agreements in effect at March 31, 2016 (in thousands): Capital Leases Operating Total 2016 (remaining 9 months) $ 224 $ 915 $ 1,139 2017 288 1,001 1,289 2018 276 926 1,202 2019 273 812 1,085 2020 286 727 1,013 Thereafter 2,612 4,074 6,686 Total minimum lease payments 3,959 $ 8,455 $ 12,414 Less amount representing interest (2,226 ) Present value of net minimum obligations 1,733 Less current obligation under capital lease 138 Long-term obligation under capital lease $ 1,595 |
Note 8 - Lines of Credit, Promi
Note 8 - Lines of Credit, Promissory Notes, and Notes Payable | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Debt Disclosure [Text Block] | 8. Lines of Credit, Promissory Notes, and Notes Payable Below is a summary of our short-term and long-term debt obligations. Lines of Credit As of March 31, 2016, we had outstanding borrowings of $11,800,000 under our two credit agreements, with a weighted-average interest rate of 2.18%. Amounts outstanding under these credit agreements were recorded as a current liability on our consolidated balance sheet as of March 31, 2016, since both credit agreements mature in 2016. Substantially all of the borrowings under the credit agreements were used to finance acquisition activity, fund losses, and $200,000, which is not currently available to be borrowed by us, was used to secure a bond required to obtain a state license for our ancillary network business. The obligations under the credit agreements are secured by all the assets of the Company and its subsidiaries, and include ordinary and customary covenants related to, among other things, additional debt, further encumbrances, sales of assets, and investments and lending. Borrowings under the credit agreements are also secured by guarantees provided by certain officers and directors of the Company, among others. We issued the guarantors warrants to purchase an aggregate of 2,060,000 shares of our common stock in consideration of their guaranteeing such indebtedness. Promissory Notes and Notes Payable In 2015, as part of the Medac Asset Acquisition, the Company issued a promissory note to the seller for $560,000. The fair value of the note was subsequently adjusted for reporting purposes to $522,000. The promissory note accrues interest at 5% per annum and matures on June 15, 2017. Other acquisition notes of approximately $184,000 remain outstanding at March 31, 2016, mature in 2016 and bear interest at 5%. The following is a summary of all Company debt as of March 31, 2016 (in thousands): Revolving line of credit $ 11,800 Promissory notes, related to acquisitions 706 Total debt 12,506 Less current maturities 11,984 Long-term debt $ 522 |
Note 9 - Intangible Assets and
Note 9 - Intangible Assets and Impairment | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Goodwill and Intangible Assets Disclosure [Text Block] | 9. Intangible Assets Identifiable intangible assets acquired in the urgent and primary care transactions are comprised of relationships with patients and contracts that drive patient volume (and therefore revenue) to our centers. Identifiable intangible assets and related accumulated amortization consist of the following as of the dates presented (in thousands): March 31, 2016 December 31, 2015 (Unaudited) (Audited) Gross carrying amount of urgent and primary care intangibles: Patient relationships and contracts $ 2,074 $ 2,074 Accumulated amortization (246 ) (189 ) Total intangibles, net $ 1,828 $ 1,885 Total amortization expense related to intangibles was approximately $57,000 and $81,000 during the three months ended March 31, 2016 and 2015, respectively. We amortize patient relationships and contracts using the straight-line method over their estimated useful lives between five and ten years. Estimated future amortization expense relating to intangibles is as follows (in thousands): Years ending December 31, Urgent and Primary Care 2016 (9 months remaining) $ 172 2017 229 2018 229 2019 202 2020 167 Thereafter 829 Total $ 1,828 |
Note 10 - Warrants
Note 10 - Warrants | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Warrants [Text Block] | 10. Warrants Warrants to purchase 13,167,396 shares and 1,782,222 shares of our common stock were outstanding as of March 31, 2016 and March 31, 2015, respectively. Warrants to purchase 11,085,174 shares of common stock were issued in the 2015 Offering. Warrants to purchase 2,060,000 shares of common stock were issued in 2014 and 2015 to the guarantors of our lines of credit. The remaining warrants to purchase 22,222 shares of common stock expire on February 1, 2017 and have an exercise price of $1.50 per share. The weighted average price of the outstanding warrants to purchase an aggregate of 13,167,397 of our common stock at March 31, 2016 was $0.85. |
Note 11 - Segment Reporting
Note 11 - Segment Reporting | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Segment Reporting Disclosure [Text Block] | 11. Segment Reporting As of March 31, 2016, we operated two segments, urgent and primary care and ancillary network. We evaluate segment performance based on several factors, the primary financial measure of which is operating income. We define segment income as income before interest expense, gain or loss on disposal of assets, income taxes, depreciation expense, non-cash amortization of intangible assets, intangible asset impairment, non-cash stock-based compensation expense, shared service expenses, severance charges and any other non-recurring costs. Shared services primarily consists of compensation costs for our executive management team, corporate headquarters costs, certain transactional costs, support services such as finance and accounting, human resources, legal, marketing and information technology and general administration. The following tables set forth a comparison of operations for the following periods presented for our segments and shared services (certain prior year amounts have been reclassified for comparability purposes). Consolidated statements of operations by segment for the respective three month periods ended March 31 are as follows (in thousands): March 31, 2016 March 31, 2015 Urgent and Ancillary Shared Total Urgent and Ancillary Shared Total Net revenues $ 5,006 $ 4,695 $ - $ 9,701 $ 2,672 $ 5,743 $ - $ 8,415 Total segment operating income (loss) 62 299 (1,285 ) (924 ) (450 ) 93 (2,011 ) (2,368 ) Additional Segment Disclosures: Interest expense 46 - 61 107 55 - 28 83 Deferred loan fees amortization, net of loss on warrant liability 353 - 117 470 277 - 92 369 Depreciation and amortization expense 194 - 28 222 149 125 17 291 Income tax expense - 6 - 6 - 6 - 6 Total asset expenditures 54 - 180 234 - - 90 90 * Presented as discontinued operations in statement of operations. The following provides a reconciliation of reportable segment operating income (loss) to the Company’s consolidated totals (in thousands): Three Months Ended March 31, 2016 2015 Total segment operating (loss) $ (924 ) $ (2,368 ) Less: Severance charges 11 - Depreciation and amortization expense 222 291 Non-cash stock-based compensation expense 30 147 Non-recurring professional fees 74 413 Operating loss, including discontinued operations (1,261 ) (3,219 ) Interest expense 107 83 Deferred loan fees amortization, net of loss on warrant liability 470 369 Loss before income taxes $ (1,838 ) $ (3,671 ) Segment assets include accounts receivable, prepaid expenses and other current assets, property and equipment, and intangibles. Shared services assets consist of cash and cash equivalents, prepaid insurance, deferred income taxes and property and equipment primarily related to information technology assets. Consolidated assets, by segment and shared services, as of the periods presented are as follows: Urgent and Primary Care Ancillary Network* Shared Services Consolidated March 31, 2016 $ 14,799 $ 2,166 $ 1,933 $ 18,898 December 31, 2015 14,920 2,644 3,521 21,085 * Presented as discontinued operations in balance sheets. |
Note 12 - Subsequent Events
Note 12 - Subsequent Events | 3 Months Ended |
Mar. 31, 2016 | |
Notes to Financial Statements | |
Subsequent Events [Text Block] | 12. Subsequent Events On April 1, 2016, we exited the Virginia urgent and primary care market by consummating the sale of our two Virginia subsidiaries to UrgeMedical Group, Inc. For the period ended March 31, 2016 and March 31 2015, our Virginia subsidiaries reported net revenues of approximately $254,000 and $275,000, respectively, and net operating loss of approximately $(151,000) and $(132,000), respectively. The sales price for the Virginia subsidiaries was $610,000, $50,000 of which was paid in cash at closing and the balance by delivery of two promissory notes. The first promissory note has an initial principal balance of $160,000 and interest accrues on the outstanding balance at 1.5% per annum. The note is payable in two installments, the first installment of $50,000 is due within 90 days after closing and the second installment of $110,000 is due within 150 days after closing. If, however, UrgeMedical pays $150,000 plus all accrued interest within 90 days, the entire note will be deemed satisfied in full. The second promissory note has an initial principal balance of $400,000 and interest accrues on the outstanding balance at 5.0% per annum. Interest-only payments are due each month beginning July 1, 2016. Principal is due in three equal installments of $133,333 on the first, second and third anniversaries of the closing date. |
Significant Accounting Policies
Significant Accounting Policies (Policies) | 3 Months Ended |
Mar. 31, 2016 | |
Accounting Policies [Abstract] | |
Basis of Accounting, Policy [Policy Text Block] | Basis of Presentation The accompanying unaudited consolidated financial statements of American CareSource Holdings, Inc. and its subsidiaries have been prepared in accordance with accounting principles generally accepted in the United States for interim financial information, with the instructions to Form 10-Q and Rule 8-03 of Regulation S-X of the rules and regulations of the Securities and Exchange Commission (“SEC”). Accordingly, they do not include all of the information and notes required by accounting principles generally accepted in the United States for complete financial statements. In the opinion of management, these statements include all adjustments necessary to present a fair statement of our consolidated results of operations, financial position and cash flows. Operating results for any interim period are not necessarily indicative of the results that may be expected for the full year. Preparation of the Company’s financial statements in conformity with accounting principles generally accepted in the United States requires management to make estimates and assumptions that affect the reported amounts in the financial statements and notes. Actual results could differ from those estimates. This Quarterly Report on Form 10-Q should be read in conjunction with the Company’s consolidated financial statements and notes included in its Annual Report on Form 10-K for the fiscal year ended December 31, 2015. References herein to "the Company," "we," "us," or "our" refer to American CareSource Holdings, Inc. and its subsidiaries. |
Goodwill and Intangible Assets, Goodwill, Policy [Policy Text Block] | Goodwill resulted from our acquisition of urgent and primary care businesses during the years ended December 31, 2015 and 2014. In accordance with the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 805, Business Combinations , Intangibles – Goodwill and Other |
Consolidation, Variable Interest Entity, Policy [Policy Text Block] | Variable Interest Entities ("VIEs") We have determined that Medac Health Services, P.A. (“Medac”) is a VIE and that we are the primary beneficiary. The financial results of Medac, our consolidated VIE, have been included in our operations since December 15, 2015, the date we closed the acquisition of certain assets from Medac (“the Medac Asset Acquisition”). Refer to Note 4 – Acquisitions and Variable Interest Entity. For additional Significant Accounting Policies, refer to our Annual Report on Form 10-K for the fiscal year ended December 31, 2015. |
New Accounting Pronouncements, Policy [Policy Text Block] | Recent Accounting Pronouncements In March 2016, the FASB issued ASU 2016-09 “Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting.” This standard requires the recognition of the income tax effects of awards in the income statement when the awards vest or are settled, thus eliminating additional paid in capital pools. The guidance also allows for the employer to repurchase more of an employee’s shares for tax withholding purposes without triggering liability accounting. In addition, the guidance allows for a policy election to account for forfeitures as they occur rather than on an estimated basis. The guidance is effective in 2017 with early adoption permitted. The Company is currently evaluating the impact of this guidance on its consolidated financial statements and the timing of adoption. |
Note 3 - Liquidity and Earnin20
Note 3 - Liquidity and Earnings (Loss) Per Share (Tables) | 3 Months Ended |
Mar. 31, 2016 | |
Notes Tables | |
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block] | Three Months Ended March 31, 2016 March 31, 2015 Numerator: (Loss) from continuing operations (2,143 ) (3,662 ) Plus loss from non-controlling interests 135 - Plus loss allocated to preferred stock 122 - (Loss) from continuing operations, common stock for basic earnings per share (1,886 ) (3,662 ) Less gain on change in fair value of warrant liability - 140 (Loss) from continuing operations, common stock for diluted earnings per share (1,886 ) (3,802 ) Income/(loss) from discontinued operations 299 (15 ) Denominator: Weighted-average basic common shares outstanding 16,603 6,772 Assumed conversion of dilutive securities: Common stock purchase warrants - 80 Denominator for dilutive earnings per share - adjusted weighted-average shares 16,603 6,852 Basic net (loss) per share, continuing operations $ (0.11 ) $ (0.54 ) Diluted net (loss) per share, continuing operations $ (0.11 ) $ (0.55 ) Basic net income per share, discontinued operations $ 0.02 $ 0.00 Diluted net income per share, discontinued operations $ 0.02 $ 0.00 |
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share [Table Text Block] | 2016 2015 Common stock purchase warrants 11,107 822 Stock options 1,644 1,334 Restricted stock units - 89 Restricted stock 50 - |
Note 4 - Acquisitions and Var21
Note 4 - Acquisitions and Variable Interest Entity (Tables) | 3 Months Ended |
Mar. 31, 2016 | |
Notes Tables | |
Schedule of Variable Interest Entities [Table Text Block] | March 31, 2016 December 31, 2015 (Unaudited) (Audited) Current assets $ 1,066 $ 779 Current liabilities 1,201 759 Stockholder's equity (135 ) 20 Total liabilities & stockholder's equity $ 1,066 $ 779 |
Business Acquisition, Pro Forma Information [Table Text Block] | Three Months Ended March 31, (in thousands, except per share amounts) 2016 2015 Net revenue Urgent and primary care $ 4,412 $ 4,672 Service agreement 594 429 Total net revenue 5,006 5,101 (Loss) from continuing operations before taxes $ (2,137 ) $ (3,325 ) Basic net (loss) per common share $ (0.11 ) $ (0.49 ) Diluted net (loss) per common share $ (0.11 ) $ (0.51 ) |
Note 5 - Discontinued Operati22
Note 5 - Discontinued Operations (Tables) | 3 Months Ended |
Mar. 31, 2016 | |
Notes Tables | |
Disposal Groups, Including Discontinued Operations [Table Text Block] | March 31, 2016 December 31, 2015 (Unaudited) (Audited) Accounts receivable $ 1,111 $ 1,589 Prepaid expenses and other current assets 43 43 Deferred income taxes 18 18 Total current assets held for sale 1,172 1,650 Property and equipment, net 588 588 Intangible assets, net 406 406 Total other assets held for sale 994 994 Total assets held for sale $ 2,166 $ 2,644 Due to service providers $ 1,388 $ 3,225 Due to HealthSmart 3,739 2,210 Total current liabilities held for sale 5,127 5,435 Total liabilities held for sale $ 5,127 $ 5,435 |
Result of Operations for Ancillary Network Business [Table Text Block] | Three Months Ended March 31, 2016 2015 Net revenues $ 4,695 $ 5,743 Operating expenses: Provider payments 3,256 4,331 Administrative fees 324 330 Other operating costs 816 972 Depreciation and amortization - 125 Total operating expenses 4,396 5,758 Income/(loss) from discontinued operations $ 299 $ (15 ) |
Note 6 - Revenue Recognition 23
Note 6 - Revenue Recognition and Accounts Receivable (Tables) | 3 Months Ended |
Mar. 31, 2016 | |
Notes Tables | |
Schedule of Accounts, Notes, Loans and Financing Receivable [Table Text Block] | March 31, 2016 December 31, 2015 (in thousands) (Unaudited) (Audited) Accounts receivable, trade $ 3,394 $ 3,236 Accounts receivable, other 100 - Less: Estimated allowance for contractual adjustments and uncollectible amounts (1,719 ) (1,738 ) Accounts receivable, net $ 1,775 $ 1,498 |
Schedule of Revenue Sources, Health Care Organization [Table Text Block] | Three Months Ended March 31, (in thousands) 2016 2015 Gross revenue $ 8,419 $ 5,786 Less: Provision for contractual adjustments and estimated uncollectible amounts (3,413 ) (3,114 ) Net revenue $ 5,006 $ 2,672 |
Note 7 - Capital and Operatin24
Note 7 - Capital and Operating Lease Obligations (Tables) | 3 Months Ended |
Mar. 31, 2016 | |
Notes Tables | |
Schedule of Future Minimum Lease Payments for Capital Leases [Table Text Block] | Capital Leases Operating Total 2016 (remaining 9 months) $ 224 $ 915 $ 1,139 2017 288 1,001 1,289 2018 276 926 1,202 2019 273 812 1,085 2020 286 727 1,013 Thereafter 2,612 4,074 6,686 Total minimum lease payments 3,959 $ 8,455 $ 12,414 Less amount representing interest (2,226 ) Present value of net minimum obligations 1,733 Less current obligation under capital lease 138 Long-term obligation under capital lease $ 1,595 |
Note 8 - Lines of Credit, Pro25
Note 8 - Lines of Credit, Promissory Notes, and Notes Payable (Tables) | 3 Months Ended |
Mar. 31, 2016 | |
Notes Tables | |
Schedule of Debt [Table Text Block] | Revolving line of credit $ 11,800 Promissory notes, related to acquisitions 706 Total debt 12,506 Less current maturities 11,984 Long-term debt $ 522 |
Note 9 - Intangible Assets an26
Note 9 - Intangible Assets and Impairment (Tables) | 3 Months Ended |
Mar. 31, 2016 | |
Notes Tables | |
Schedule of Finite-Lived Intangible Assets [Table Text Block] | March 31, 2016 December 31, 2015 (Unaudited) (Audited) Gross carrying amount of urgent and primary care intangibles: Patient relationships and contracts $ 2,074 $ 2,074 Accumulated amortization (246 ) (189 ) Total intangibles, net $ 1,828 $ 1,885 |
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block] | Years ending December 31, Urgent and Primary Care 2016 (9 months remaining) $ 172 2017 229 2018 229 2019 202 2020 167 Thereafter 829 Total $ 1,828 |
Note 11 - Segment Reporting (Ta
Note 11 - Segment Reporting (Tables) | 3 Months Ended |
Mar. 31, 2016 | |
Notes Tables | |
Schedule of Segment Reporting Information, by Segment [Table Text Block] | March 31, 2016 March 31, 2015 Urgent and Ancillary Shared Total Urgent and Ancillary Shared Total Net revenues $ 5,006 $ 4,695 $ - $ 9,701 $ 2,672 $ 5,743 $ - $ 8,415 Total segment operating income (loss) 62 299 (1,285 ) (924 ) (450 ) 93 (2,011 ) (2,368 ) Additional Segment Disclosures: Interest expense 46 - 61 107 55 - 28 83 Deferred loan fees amortization, net of loss on warrant liability 353 - 117 470 277 - 92 369 Depreciation and amortization expense 194 - 28 222 149 125 17 291 Income tax expense - 6 - 6 - 6 - 6 Total asset expenditures 54 - 180 234 - - 90 90 |
Reconciliation of Revenue from Segments to Consolidated [Table Text Block] | Three Months Ended March 31, 2016 2015 Total segment operating (loss) $ (924 ) $ (2,368 ) Less: Severance charges 11 - Depreciation and amortization expense 222 291 Non-cash stock-based compensation expense 30 147 Non-recurring professional fees 74 413 Operating loss, including discontinued operations (1,261 ) (3,219 ) Interest expense 107 83 Deferred loan fees amortization, net of loss on warrant liability 470 369 Loss before income taxes $ (1,838 ) $ (3,671 ) |
Reconciliation of Assets from Segment to Consolidated [Table Text Block] | Urgent and Primary Care Ancillary Network* Shared Services Consolidated March 31, 2016 $ 14,799 $ 2,166 $ 1,933 $ 18,898 December 31, 2015 14,920 2,644 3,521 21,085 |
Note 2 - Description of Busin28
Note 2 - Description of Business (Details Textual) | Apr. 01, 2016 | Jan. 31, 2016 | Dec. 31, 2015 | Mar. 31, 2016 | Dec. 31, 2014 |
Georgia [Member] | |||||
Number of Businesses Closed | 1 | ||||
Number of Businesses Acquired | 3 | ||||
Florida [Member] | |||||
Number of Businesses Acquired | 2 | ||||
Alabama [Member] | |||||
Number of Businesses Acquired | 3 | ||||
Virginia [Member] | Subsequent Event [Member] | Two Virginia Subsidiaries [Member] | |||||
Number of Subsidiaries Sold | 2 | ||||
Virginia [Member] | |||||
Number of Businesses Acquired | 2 | ||||
North Carolina [Member] | |||||
Number of Businesses Acquired | 4 | ||||
Number of Businesses Closed | 1 | ||||
Number of Businesses Acquired | 10 |
Note 3 - Liquidity and Earnin29
Note 3 - Liquidity and Earnings (Loss) Per Share (Details Textual) | 3 Months Ended | |||
Mar. 31, 2016USD ($) | Dec. 31, 2015USD ($) | Mar. 31, 2015USD ($) | Dec. 31, 2014USD ($) | |
Revolving Credit Facility [Member] | Wells Fargo [Member] | ||||
Line of Credit Facility, Maximum Borrowing Capacity | $ 12,000,000 | |||
Line of Credit Facility, Remaining Borrowing Capacity | 0 | |||
Line of Credit, Current | 11,800,000 | |||
Proceeds from Line of Credit Used to Secure Bond | $ 200,000 | |||
Number of Lines of Credit | 2 | |||
Cash and Cash Equivalents, at Carrying Value | $ 1,050,000 | $ 2,629,000 | $ 322,000 | $ 1,020,000 |
Working Capital | (14,600,000) | (13,200,000) | ||
Line of Credit, Current | $ 11,800,000 | $ 11,100,000 |
Note 3 - Basic Net Loss and Dil
Note 3 - Basic Net Loss and Diluted Net Loss Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | |
Mar. 31, 2016 | Mar. 31, 2015 | |
Numerator: | ||
(Loss) from continuing operations | $ (2,143) | $ (3,662) |
Plus loss from non-controlling interests | 135 | |
Plus loss allocated to preferred stock | 122 | |
(Loss) from continuing operations, common stock for basic earnings per share | $ (1,886) | $ (3,662) |
Less gain on change in fair value of warrant liability | 140 | |
(Loss) from continuing operations, common stock for diluted earnings per share | $ (1,886) | (3,802) |
Income/(loss) from discontinued operations | $ 299 | $ (15) |
Denominator: | ||
Weighted-average basic common shares outstanding (in shares) | 16,603 | 6,772 |
Assumed conversion of dilutive securities: | ||
Common stock purchase warrants (in shares) | 80 | |
Denominator for dilutive earnings per share - adjusted weighted-average shares (in shares) | 16,603 | 6,852 |
Basic net (loss) per share, continuing operations (in dollars per share) | $ (0.11) | $ (0.54) |
Diluted net (loss) per share, continuing operations (in dollars per share) | (0.11) | (0.55) |
Basic net income per share, discontinued operations (in dollars per share) | 0.02 | 0 |
Diluted net income per share, discontinued operations (in dollars per share) | $ 0.02 | $ 0 |
Note 3 - Potentially Dilutive A
Note 3 - Potentially Dilutive Adjustments to Weighted Average Number of Common Shares (Details) - shares shares in Thousands | 3 Months Ended | 12 Months Ended |
Mar. 31, 2016 | Dec. 31, 2015 | |
Warrant [Member] | ||
Antidilutive securities (in shares) | 11,107 | 822 |
Employee Stock Option [Member] | ||
Antidilutive securities (in shares) | 1,644 | 1,334 |
Restricted Stock Units (RSUs) [Member] | ||
Antidilutive securities (in shares) | 89 | |
Restricted Stock [Member] | ||
Antidilutive securities (in shares) | 50 |
Note 4 - Acquisitions and Var32
Note 4 - Acquisitions and Variable Interest Entity (Details Textual) | 1 Months Ended | 3 Months Ended | 8 Months Ended | 12 Months Ended | |
Jan. 31, 2016 | Mar. 31, 2016USD ($) | Mar. 31, 2015USD ($) | Dec. 31, 2014 | Dec. 31, 2015USD ($) | |
Medac Health Services [Member] | |||||
Number of Businesses Acquired | 4 | ||||
Payments to Acquire Businesses, Gross | $ 4,370,000 | ||||
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Liabilities | 768,000 | ||||
Business Combination, Consideration Transferred, Liabilities Incurred | $ 560,000 | ||||
Georgia Clinic [Member] | |||||
Disposal Group, Including Discontinued Operation, Revenue | $ 5,000 | $ 236,000 | |||
Number of Businesses Acquired | 10 | ||||
Number of Businesses Closed | 1 | ||||
Disposal Group, Including Discontinued Operation, Revenue | $ 4,695,000 | $ 5,743,000 |
Note 4 - Balance Sheets of Meda
Note 4 - Balance Sheets of Medac (Details) - Variable Interest Entity, Primary Beneficiary [Member] - Medac Health Services [Member] - USD ($) $ in Thousands | Mar. 31, 2016 | Dec. 31, 2015 |
Current assets | $ 1,066 | $ 779 |
Current liabilities | 1,201 | 759 |
Stockholder's equity | (135) | 20 |
Total liabilities & stockholder's equity | $ 1,066 | $ 779 |
Note 4 - Pro Forma Financial In
Note 4 - Pro Forma Financial Information for the Company (Details) - Medac Health Services [Member] - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | |
Mar. 31, 2016 | Mar. 31, 2015 | |
Urgent and Primary Care [Member] | ||
Net revenues | $ 4,412 | $ 4,672 |
Service Agreement [Member] | ||
Net revenues | 594 | 429 |
Net revenues | 5,006 | 5,101 |
(Loss) from continuing operations before taxes | $ (2,137) | $ (3,325) |
Basic net (loss) per common share (in dollars per share) | $ (0.11) | $ (0.49) |
Diluted net (loss) per common share (in dollars per share) | $ (0.11) | $ (0.51) |
Note 5 - Major Classes of Asset
Note 5 - Major Classes of Assets and Liabilities of the Ancillary Network Business Held for Sale (Details) - USD ($) | Mar. 31, 2016 | Dec. 31, 2015 | Mar. 31, 2015 |
Due to Ancillary Network Service Providers [Member] | |||
Due to affiliate | $ 1,388,000 | $ 3,225,000 | |
Due to Healthsmart [Member] | |||
Due to affiliate | 3,739,000 | 2,210,000 | |
Accounts receivable | 1,111,000 | 1,589,000 | |
Prepaid expenses and other current assets | 43,000 | 43,000 | |
Deferred income taxes | 18,000 | 18,000 | |
Total current assets held for sale | 1,172,000 | 1,650,000 | |
Property and equipment, net | 588,000 | 588,000 | |
Intangible assets, net | 406,000 | 406,000 | |
Total other assets held for sale | 994,000 | 994,000 | |
Total assets held for sale | 2,166,000 | $ 2,644,000 | 2,644,000 |
Total current liabilities held for sale | 5,127,000 | $ 5,435,000 | 5,435,000 |
Total liabilities held for sale | $ 5,127,000 | $ 5,435,000 |
Note 5 - Results of Operations
Note 5 - Results of Operations for the Ancillary Network Business (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2016 | Mar. 31, 2015 | |
Disposal Group, Including Discontinued Operation, Revenue | $ 4,695 | $ 5,743 |
Provider payments | 3,256 | 4,331 |
Administrative fees | 324 | 330 |
Other operating costs | $ 816 | 972 |
Depreciation and amortization | 125 | |
Total operating expenses | $ 4,396 | 5,758 |
Income/(loss) from discontinued operations | $ 299 | $ (15) |
Note 6 - Accounts Receivable fr
Note 6 - Accounts Receivable from Urgent and Primary Care (Details) - Urgent and Primary Care [Member] - USD ($) $ in Thousands | Mar. 31, 2016 | Dec. 31, 2015 |
Trade Accounts Receivable [Member] | ||
Accounts receivable | $ 3,394 | $ 3,236 |
Other Accounts Receivable [Member] | ||
Accounts receivable | 100 | |
Estimated allowance for contractual adjustments and uncollectible amounts | (1,719) | $ (1,738) |
Accounts receivable, net | $ 1,775 | $ 1,498 |
Note 6 - Revenue from Urgent an
Note 6 - Revenue from Urgent and Primary Care (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2016 | Mar. 31, 2015 | Dec. 31, 2015 | |
Urgent and Primary Care [Member] | |||
Gross revenue | $ 8,419 | $ 5,786 | |
Provision for contractual adjustments and estimated uncollectible amounts | (3,413) | (3,114) | |
Net revenue | 5,006 | $ 2,672 | |
Net revenue | $ 5,006 | $ 2,672 |
Note 7 - Future Required Paymen
Note 7 - Future Required Payments under Lease Agreements (Details) - USD ($) | Mar. 31, 2016 | Dec. 31, 2015 |
2016 (remaining 9 months) | $ 224,000 | |
2016 (remaining 9 months) | 915,000 | |
2016 (remaining 9 months) | 1,139,000 | |
2,017 | 288,000 | |
2,017 | 1,001,000 | |
2,017 | 1,289,000 | |
2,018 | 276,000 | |
2,018 | 926,000 | |
2,018 | 1,202,000 | |
2,019 | 273,000 | |
2,019 | 812,000 | |
2,019 | 1,085,000 | |
2,020 | 286,000 | |
2,020 | 727,000 | |
2,020 | 1,013,000 | |
Thereafter | 2,612,000 | |
Thereafter | 4,074,000 | |
Thereafter | 6,686,000 | |
Total minimum lease payments | 3,959,000 | |
Total minimum lease payments | 8,455,000 | |
Total minimum lease payments | 12,414,000 | |
Less amount representing interest | (2,226,000) | |
Present value of net minimum obligations | 1,733,000 | |
Less current obligation under capital lease | 138,000 | $ 134,000 |
Long-term obligation under capital lease | $ 1,595,000 | $ 1,630,000 |
Note 8 - Lines of Credit, Pro40
Note 8 - Lines of Credit, Promissory Notes, and Notes Payable (Details Textual) - USD ($) | 3 Months Ended | 12 Months Ended |
Mar. 31, 2016 | Dec. 31, 2015 | |
Revolving Credit Facility [Member] | Wells Fargo [Member] | ||
Long-term Line of Credit | $ 11,800,000 | |
Debt, Weighted Average Interest Rate | 2.18% | |
Proceeds from Line of Credit Used to Secure Bond | $ 200,000 | |
March 31, 2016 Warrants [Member] | ||
Class of Warrant or Right Issued During Period | 2,060,000 | |
Medac Asset Acquisiton [Member] | ||
Business Combination, Consideration Transferred, Liabilities Incurred | $ 522,000 | $ 560,000 |
Debt Instrument, Interest Rate During Period | 5.00% | |
Other Acquisitions [Member] | ||
Debt, Long-term and Short-term, Combined Amount | $ 184,000 | |
Debt Instrument, Interest Rate, Stated Percentage | 5.00% | |
Debt, Long-term and Short-term, Combined Amount | $ 12,506,000 |
Note 8 - Summary of All Debt (D
Note 8 - Summary of All Debt (Details) $ in Thousands | Mar. 31, 2016USD ($) |
Revolving Line of Credit [Member] | |
Debt, Long-term and Short-term, Combined Amount | $ 11,800 |
Promissory Notes Related to Acquistion [Member] | |
Debt, Long-term and Short-term, Combined Amount | 706 |
Debt, Long-term and Short-term, Combined Amount | 12,506 |
Less current maturities | 11,984 |
Long-term debt | $ 522 |
Note 9 - Intangible Assets an42
Note 9 - Intangible Assets and Impairment (Details Textual) - USD ($) | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2016 | Mar. 31, 2015 | Dec. 31, 2015 | |
Patient Base [Member] | Minimum [Member] | |||
Finite-Lived Intangible Asset, Useful Life | 5 years | ||
Amortization of Intangible Assets | $ 57,000 | $ 81,000 |
Note 9 - Other Intangible Asset
Note 9 - Other Intangible Assets and Related Accumulated Amortization (Details) - USD ($) $ in Thousands | Mar. 31, 2016 | Dec. 31, 2015 |
Urgent and Primary Care [Member] | Patient Relationships and Contracts [Member] | ||
Finite-lived intangible assets, gross | $ 2,074 | $ 2,074 |
Urgent and Primary Care [Member] | ||
Accumulated amortization | (246) | (189) |
Finite-lived intangible assets, net | 1,828 | |
Finite-lived intangible assets, net | $ 1,828 | $ 1,885 |
Note 9 - Finite-lived Intangibl
Note 9 - Finite-lived Intangible Assets Future Amortization Expense (Details) - USD ($) $ in Thousands | Mar. 31, 2016 | Dec. 31, 2015 |
Urgent and Primary Care [Member] | ||
2016 (9 months remaining) | $ 172 | |
2,017 | 229 | |
2,018 | 229 | |
2,019 | 202 | |
2,020 | 167 | |
Thereafter | 829 | |
Total | 1,828 | |
Total | $ 1,828 | $ 1,885 |
Note 10 - Warrants (Details Tex
Note 10 - Warrants (Details Textual) - $ / shares | Mar. 31, 2016 | Dec. 31, 2015 | Mar. 31, 2015 | Mar. 31, 2014 |
Warrants Issued to Individuals who Provided Guarantees in Connection with Lines of Credit [Member] | ||||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | 2,060,000 | 2,060,000 | ||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | 2,060,000 | 2,060,000 | ||
Warrants Expiring February 1, 2017 [Member] | ||||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | 22,222 | |||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | 22,222 | |||
Class of Warrant or Right, Exercise Price of Warrants or Rights | $ 1.50 | |||
Warrants Issued in 2015 Offering [Member] | ||||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | 11,085,174 | |||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | 11,085,174 | |||
Weighted Average [Member] | ||||
Class of Warrant or Right, Exercise Price of Warrants or Rights | $ 0.85 | |||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | 13,167,396 | 1,782,222 | ||
Class of Warrant or Right, Number of Securities Called by Warrants or Rights | 13,167,396 | 1,782,222 |
Note 11 - Segment Reporting (De
Note 11 - Segment Reporting (Details Textual) | 3 Months Ended |
Mar. 31, 2016 | |
Number of Operating Segments | 2 |
Note 11 - Consolidating Stateme
Note 11 - Consolidating Statements of Operations by Industry (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | ||
Mar. 31, 2016 | Mar. 31, 2015 | Dec. 31, 2015 | ||
Urgent and Primary Care [Member] | Operating Segments [Member] | ||||
Net revenue | $ 5,006 | $ 2,672 | ||
Total segment operating income (loss) | 62 | (450) | ||
Additional Segment Disclosures: | ||||
Interest expense | 46 | 55 | ||
Deferred loan fees amortization, net of loss on warrant liability | 353 | 277 | ||
Depreciation and amortization expense | $ 194 | $ 149 | ||
Income tax expense | ||||
Total asset expenditures | $ 54 | |||
Urgent and Primary Care [Member] | ||||
Net revenue | 5,006 | $ 2,672 | ||
Ancillary Network [Member] | Operating Segments [Member] | ||||
Net revenue | [1] | 4,695 | $ 5,743 | |
Total segment operating income (loss) | [1] | $ 299 | $ 93 | |
Additional Segment Disclosures: | ||||
Interest expense | [1] | |||
Deferred loan fees amortization, net of loss on warrant liability | [1] | |||
Depreciation and amortization expense | [1] | $ 125 | ||
Income tax expense | [1] | $ 6 | $ 6 | |
Total asset expenditures | [1] | |||
Shared Services [Member] | Operating Segments [Member] | ||||
Net revenue | ||||
Total segment operating income (loss) | $ (1,285) | $ (2,011) | ||
Additional Segment Disclosures: | ||||
Interest expense | 61 | 28 | ||
Deferred loan fees amortization, net of loss on warrant liability | 117 | 92 | ||
Depreciation and amortization expense | $ 28 | $ 17 | ||
Income tax expense | ||||
Total asset expenditures | $ 180 | $ 90 | ||
Operating Segments [Member] | ||||
Net revenue | 9,701 | 8,415 | ||
Total segment operating income (loss) | (924) | (2,368) | ||
Additional Segment Disclosures: | ||||
Interest expense | 107 | 83 | ||
Deferred loan fees amortization, net of loss on warrant liability | 470 | 369 | ||
Depreciation and amortization expense | 222 | 291 | ||
Income tax expense | 6 | 6 | ||
Total asset expenditures | 234 | 90 | ||
Net revenue | 5,006 | 2,672 | ||
Total segment operating income (loss) | (1,560) | (3,204) | ||
Interest expense | 107 | 83 | ||
Deferred loan fees amortization, net of loss on warrant liability | 470 | 369 | ||
Depreciation and amortization expense | 222 | 166 | ||
Income tax expense | $ 6 | $ 6 | ||
[1] | Presented as discontinued operations in statement of operations. |
Note 11 - Reconciliation of Rep
Note 11 - Reconciliation of Reportable Segment Operating Income (Loss) (Details) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2016 | Mar. 31, 2015 | |
Operating Segments [Member] | ||
Total segment operating income (loss) | $ (924) | $ (2,368) |
Interest expense | 107 | 83 |
Deferred loan fees amortization, net of loss on warrant liability | 470 | 369 |
Total segment operating income (loss) | (1,560) | $ (3,204) |
Severance charges | 11 | |
Depreciation and amortization expense | 222 | $ 291 |
Non-cash stock-based compensation expense | 30 | 147 |
Non-recurring professional fees | 74 | 413 |
Operating loss, including discontinued operations | (1,261) | (3,219) |
Interest expense | 107 | 83 |
Deferred loan fees amortization, net of loss on warrant liability | 470 | 369 |
Loss before income taxes | $ (1,838) | $ (3,671) |
Note 11 - Consolidating Assets,
Note 11 - Consolidating Assets, by Segment and Shared Services (Details) - USD ($) | Mar. 31, 2016 | Dec. 31, 2015 |
Urgent and Primary Care [Member] | Operating Segments [Member] | ||
Assets | $ 14,799,000 | $ 14,920,000 |
Ancillary Network [Member] | Operating Segments [Member] | ||
Assets | 2,166,000 | 2,644,000 |
Shared Services [Member] | Operating Segments [Member] | ||
Assets | 1,933,000 | 3,521,000 |
Operating Segments [Member] | ||
Assets | 18,898,000 | 21,085,000 |
Assets | $ 18,898,000 | $ 21,085,000 |
Note 12 - Subsequent Events (De
Note 12 - Subsequent Events (Details Textual) | Apr. 01, 2016USD ($) | Mar. 31, 2016USD ($) | Mar. 31, 2015USD ($) |
Virginia [Member] | Subsequent Event [Member] | Two Virginia Subsidiaries [Member] | |||
Number of Subsidiaries Sold | 2 | ||
Subsequent Event [Member] | Two Virginia Subsidiaries [Member] | Promissory Note Receivable One [Member] | |||
Promissory Notes ReceivableFaceAmount | $ 160,000 | ||
Note Receivable Interest Rate | 1.50% | ||
Number of Installments | 2 | ||
Note Receivable Installment One Due In 90 Days | $ 50,000 | ||
Note Receivable Installment Two Due in 150 Days | 110,000 | ||
Note Receivable Minimum Repayment Amount Due in 90 Days | 150,000 | ||
Subsequent Event [Member] | Two Virginia Subsidiaries [Member] | Promissory Note Receivable Two [Member] | |||
Promissory Notes ReceivableFaceAmount | $ 400,000 | ||
Note Receivable Interest Rate | 5.00% | ||
Number of Installments | 3 | ||
Note receivable Installment | $ 133,333 | ||
Subsequent Event [Member] | Two Virginia Subsidiaries [Member] | |||
Disposal Group, Including Discontinued Operation, Consideration | 610,000 | ||
Proceeds from Divestiture of Businesses | $ 50,000 | ||
Number of Promissory Notes Receivable | 2 | ||
Two Virginia Subsidiaries [Member] | |||
Disposal Group, Including Discontinued Operation, Revenue | $ 254,000 | $ 275,000 | |
Disposal Group, Including Discontinued Operation, Operating Income (Loss) | 151,000 | 132,000 | |
Disposal Group, Including Discontinued Operation, Revenue | $ 4,695,000 | $ 5,743,000 |