MiMedx (MDXG) 10-Q 30 Apr 24 2024 Q1 Quarterly report Financial data

Cover

Cover - shares	3 Months Ended
	Mar. 31, 2024	Apr. 24, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2024
Document Transition Report	false
Entity File Number	001-35887
Entity Registrant Name	MIMEDX GROUP, INC.
Entity Incorporation, State or Country Code	FL
Entity Tax Identification Number	26-2792552
Entity Address, Address Line One	1775 West Oak Commons Ct NE
Entity Address, City or Town	Marietta
Entity Address, State or Province	GA
Entity Address, Postal Zip Code	30062
City Area Code	770
Local Phone Number	651-9100
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	MDXG
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		147,603,955
Entity Central Index Key	0001376339
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 48,487	$ 82,000
Accounts receivable, net	57,016	53,871
Inventory	24,454	21,021
Prepaid expenses	6,095	5,624
Other current assets	2,801	1,745
Total current assets	138,853	164,261
Property and equipment, net	7,340	6,974
Right of use asset	3,499	2,132
Deferred tax asset, net	38,747	40,777
Goodwill	19,441	19,441
Intangible assets, net	12,550	5,257
Other assets	1,251	205
Total assets	221,681	239,047
Current liabilities:
Current portion of long term debt	1,000	1,000
Accounts payable	9,697	9,048
Accrued compensation	17,913	22,353
Accrued expenses	9,196	9,361
Current liabilities of discontinued operations	344	1,352
Other current liabilities	4,071	2,894
Total current liabilities	42,221	46,008
Long term debt, net	18,453	48,099
Other liabilities	5,276	2,223
Total liabilities	65,950	96,330
Commitments and contingencies (Note 12)
Stockholders' equity
Common stock; $0.001 par value; 250,000,000 shares authorized; 147,528,596 issued and outstanding at March 31, 2024 and 146,227,639 issued and outstanding at December 31, 2023	148	146
Additional paid-in capital	280,000	276,249
Accumulated deficit	(124,417)	(133,678)
Total stockholders' equity	155,731	142,717
Total liabilities and stockholders’ equity	$ 221,681	$ 239,047

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	250,000,000	250,000,000
Common stock, shares issued (in shares)	147,528,596	146,227,639
Common stock, shares outstanding (in shares)	147,528,596	146,227,639

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Net sales	$ 84,709	$ 71,676
Cost of sales	12,987	12,419
Gross profit	71,722	59,257
Operating expenses:
Selling, general and administrative	55,129	52,250
Research and development	2,841	3,484
Investigation, restatement and related	311	3,673
Amortization of intangible assets	189	190
Impairment of intangible assets	54	0
Operating income (loss)	13,198	(340)
Other expense, net
Interest expense, net	(1,690)	(1,553)
Other (expense) income, net	(99)	2
Income (loss) from continuing operations before income tax	11,409	(1,891)
Income tax expense from continuing operations	(2,348)	(51)
Net income (loss) from continuing operations	9,061	(1,942)
Income (loss) from discontinued operations, net of tax	200	(3,041)
Net income (loss)	9,261	(4,983)
Net income (loss) from continuing operations available to common stockholders	$ 9,061	$ (3,626)
Basic net income (loss) per common share:
Continuing operations - basic (in dollars per share)	$ 0.06	$ (0.03)
Discontinued operations - basic (in dollars per share)	0	(0.03)
Basic net income (loss) per common share (in dollars per share)	0.06	(0.06)
Diluted net income (loss) per common share:
Continuing operations- diluted(in dollars per share)	0.06	(0.03)
Discontinued operations- diluted (in dollars per share)	0	(0.03)
Diluted net (loss) income per common share (in dollars per share)	$ 0.06	$ (0.06)
Weighted average common shares outstanding - basic (in shares)	146,404,587	114,398,813
Weighted average shares outstanding - diluted (in shares)	150,028,107	114,398,813

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (DEFICIT) - USD ($) $ in Thousands	Total	Common Stock Issued	Additional Paid-in Capital	Treasury Stock	Accumulated Deficit
Balance beginning of period (in shares) at Dec. 31, 2022		113,705,447
Balance, beginning of period at Dec. 31, 2022	$ (17,988)	$ 114	$ 173,804	$ 0	$ (191,906)
Treasury stock, beginning balance (in shares) at Dec. 31, 2022				0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	4,345		4,345
Issuance of restricted stock (in shares)		1,439,676		(57,770)
Issuance of restricted stock	0	$ 1	(179)	$ 178
Restricted stock shares canceled/forfeited	0		179	$ (179)
Restricted stock canceled/forfeited (in shares)				58,104
Employee stock purchase plan (in shares)		235,419
Employee stock purchase plan	680		680
Net income (loss)	(4,983)				(4,983)
Balance end of period (in shares) at Mar. 31, 2023		115,380,542
Balance, end of period at Mar. 31, 2023	$ (17,946)	$ 115	178,829	$ (1)	(196,889)
Treasury stock, ending balance (in shares) at Mar. 31, 2023				334
Balance beginning of period (in shares) at Dec. 31, 2023	146,227,639	146,227,639
Balance, beginning of period at Dec. 31, 2023	$ 142,717	$ 146	276,249	$ 0	(133,678)
Treasury stock, beginning balance (in shares) at Dec. 31, 2023				0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	4,340		4,340
Exercise of stock options (in shares)		109,920
Exercise of stock options	766		766
Employee stock purchase plan (in shares)		121,783
Employee stock purchase plan	797		797
Issuance of restricted stock, net (in shares)		1,069,254
Issuance of restricted stock, net	(2,150)	$ 2	(2,152)
Net income (loss)	$ 9,261				9,261
Balance end of period (in shares) at Mar. 31, 2024	147,528,596	147,528,596
Balance, end of period at Mar. 31, 2024	$ 155,731	$ 148	$ 280,000	$ 0	$ (124,417)
Treasury stock, ending balance (in shares) at Mar. 31, 2024				0

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Cash flows from operating activities:
Net income (loss) from continuing operations	$ 9,061	$ (1,942)
Adjustments to reconcile net income (loss) from continuing operations to net cash flows provided by (used in) operating activities from continuing operations:
Share-based compensation	4,340	3,904
Change in deferred income taxes	2,031	0
Loss on extinguishment of debt	1,401	0
Depreciation	558	714
Non-cash lease expenses	317	334
Bad debt expense	199	(60)
Amortization of intangible assets	189	190
Loss on fixed asset disposal	185	0
Accretion of asset retirement obligation	22	22
Amortization of deferred financing costs	69	121
Increase (decrease) in cash resulting from changes in:
Accounts receivable	(3,344)	(1,551)
Inventory	(2,941)	(1,474)
Prepaid expenses	(471)	934
Other assets	(1,001)	1,030
Accounts payable	283	(686)
Accrued compensation	(4,440)	(2,494)
Accrued expenses	522	1,956
Other liabilities	(195)	(398)
Net cash flows provided by operating activities from continuing operations	6,785	600
Net cash flows used in operating activities of discontinued operations	(807)	(4,648)
Net cash flows provided by (used in) operating activities	5,978	(4,048)
Cash flows from investing activities:
Consideration paid pursuant to TELA APA (Note 12)	(5,000)	0
Purchases of equipment	(1,144)	(633)
Patent application costs	120	(44)
Net cash flows used in investing activities	(6,024)	(677)
Cash flows from financing activities:
Proceeds from Citizens Revolving Credit Facility	30,000	0
Proceeds from Citizens Term Loan Facility	19,783	0
Proceeds from exercise of stock options	766	0
Principal payments on finance lease	(13)	(4)
Prepayment premium on Hayfin term loan	(500)	0
Deferred financing cost	(1,101)	0
Repayment of Hayfin term loan	(50,000)	0
Repayment of Citizens Revolving Credit Facility	(30,000)	0
Principal payments on Citizens Term Loan Facility	(250)	0
Stock repurchased for tax withholdings on vesting of restricted stock units	(2,152)	0
Net cash flows used in financing activities	(33,467)	(4)
Net change in cash	(33,513)	(4,729)
Cash and cash equivalents, beginning of period	82,000	65,950
Cash and cash equivalents, end of period	$ 48,487	$ 61,221

Nature of Business

Nature of Business	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business	Nature of Business MiMedx Group, Inc. (together with its subsidiaries, except where the context otherwise requires, “MIMEDX,” or the “Company” ) is a pioneer and leader in placental biologics focused on helping humans heal. With more than a decade of helping clinicians manage chronic and other hard-to-heal wounds, MIMEDX is dedicated to providing a leading portfolio of products for applications in the wound care, burn, and surgical sectors of healthcare. The Company’s vision is to be the leading global provider of healing solutions through relentless innovation to restore quality of life. All of our products sold in the United States are regulated by the United States Food and Drug Administration ( “FDA” ). The Company’s product portfolio and product development focuses on Wound and Surgical markets. The Company’s business is focused primarily on the United States of America but the Company also has a small commercial presence in several international locations, including Japan.

Significant Accounting Policies

Significant Accounting Policies	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies Please see Note 2, Significant Accounting Policies , to the Company’s Consolidated Financial Statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 (the “ 2023 Form 10-K ”), filed with the Securities and Exchange Commission (“ SEC ”) on February 28, 2024 for a description of all significant accounting policies. Basis of Presentation The unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“ GAAP ”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three months ended March 31, 2024 and 2023 are not necessarily indicative of the results that may be expected for the full fiscal year. The balance sheet as of December 31, 2023 was derived from the audited consolidated financial statements at that date, but does not include all of the information and footnotes required by GAAP for complete financial statements. These unaudited condensed consolidated financial statements should be read in conjunction with the historical consolidated financial statements of the Company included in the 2023 Form 10-K. Reclassifications Current portion of long term debt of $1.0 million as of December 31, 2023, which was presented in other current liabilities in previously-issued financial statements, has been reclassified to be presented in a separate line item still within current liabilities in the March 31, 2024 balance sheet presentation. Principles of Consolidation The consolidated financial statements include the accounts of MiMedx Group, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation. Use of Estimates GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported consolidated statements of operations during the reporting period. Actual results could differ from those estimates. Significant estimates include estimated useful lives and potential impairment of property and equipment, estimates of impairment for goodwill and intangible assets, estimates of useful lives for intangible assets, estimates of loss for contingent liabilities, estimate of allowance for doubtful accounts, estimate of fair value and the probable achievement of share-based payments, estimates of returns and allowances, and valuation of deferred tax assets. Recently Issued Accounting Standards Not Yet Adopted In November 2023, the Financial Accounting Standards Board (“ FASB ”) issued Accounting Standards Update (“ ASU ”) 2023-07, “ Segment Reporting: Improvements to Reportable Segment Disclosures (Topic 280) ”. The standard improves disclosures about a public entity’s reportable segments and addresses requests from investors for additional, more detailed information about a reportable segment’s expenses. Additionally, ASU 2023-07 extends the disclosure requirements under Accounting Standards Codification (“ ASC ”) Topic 280 to entities with a single reportable segment. ASU 2023-07 is effective for annual reporting periods beginning after December 15, 2023, and interim periods in fiscal years beginning after December 15, 2024. As of March 31, 2024, the Company is evaluating the impact of this standard on its consolidated financial statements. In December 2023, the FASB issued ASU 2023-09, “ Improvement to Income Tax Disclosures (Topic 740) ”, which requires additional disclosures for income tax rate reconciliations, income taxes paid, and certain other tax disclosures. ASU 2023-09 is intended to enhance the transparency and decision usefulness of income tax disclosures. The amendments in ASU 2023-09 address investor requests for enhanced income tax information primarily through changes to the rate reconciliation and income taxes paid information. Adoption is required for annual periods beginning after December 15, 2024. The Company is currently evaluating the impact of this standard on its consolidated financial statements and related disclosures. All other ASUs issued and not yet effective as of March 31, 2024, and through the date of this report, were assessed and determined to be either not applicable or are expected to have minimal impact on the Company’s current and future financial position and results of operations.

Accounts Receivable, Net

Accounts Receivable, Net	3 Months Ended
	Mar. 31, 2024
Receivables [Abstract]
Accounts Receivable, Net	Accounts Receivable, Net Accounts receivable, net, consisted of the following (in thousands): March 31, 2024 December 31, 2023 Accounts receivable, gross $ 60,282 $ 57,015 Less: allowance for doubtful accounts (3,266) (3,144) Accounts receivable, net $ 57,016 $ 53,871 Activity related to the Company’s allowance for doubtful accounts for the three months ended March 31, 2024 was as follows (in thousands): Allowance for Doubtful Accounts Balance at December 31, 2023 $ 3,144 Bad debt expense 199 Write-offs (77) Balance at March 31, 2024 $ 3,266 Allowance for Doubtful Accounts Balance at December 31, 2022 $ 3,783 Bad debt expense reversal (60) Write-offs (122) Balance at March 31, 2023 $ 3,601

Inventory

Inventory	3 Months Ended
	Mar. 31, 2024
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consisted of the following (in thousands): March 31, 2024 December 31, 2023 Raw materials $ 1,136 $ 825 Work in process 8,609 8,521 Finished goods 14,709 11,675 Inventory $ 24,454 $ 21,021

Property and Equipment, Net

Property and Equipment, Net	3 Months Ended
	Mar. 31, 2024
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Property and Equipment, Net Property and equipment, net, consisted of the following (in thousands): March 31, 2024 December 31, 2023 Laboratory and clean room equipment $ 14,504 $ 13,954 Furniture and equipment 2,205 1,989 Leasehold improvements 8,141 8,141 Construction in progress 1,870 1,791 Asset retirement cost 889 938 Finance lease right-of-use asset 189 189 Property and equipment, gross 27,798 27,002 Less: accumulated depreciation and amortization (20,458) (20,028) Property and equipment, net $ 7,340 $ 6,974

Intangible Assets, Net

Intangible Assets, Net	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets, Net	Intangible Assets, Net Intangible assets, net, are summarized as follows (in thousands): March 31, 2024 December 31, 2023 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Patents and know-how $ 9,968 $ (7,949) $ 2,019 $ 10,039 $ (7,818) $ 2,221 Licenses 1,000 (67) 933 1,000 (54) $ 946 Distribution rights 7,602 — 7,602 — — — Total amortized intangible assets $ 18,570 $ (8,016) $ 10,554 $ 11,039 $ (7,872) $ 3,167 Unamortized intangible assets: Tradenames and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in Process 988 988 1,082 1,082 Total intangible assets $ 20,566 $ 12,550 $ 13,129 $ 5,257 The Company recognized $0.1 million of impairment of intangible assets during the three months ended March 31, 2024 related to patents which were abandoned. Expected future amortization of intangible assets as of March 31, 2024, is as follows (in thousands): Year ending December 31, Estimated 2024 (excluding the three months ended March 31, 2024) $ 1,708 2025 1,883 2026 1,729 2027 1,728 2028 1,726 Thereafter 1,780 Total amortized intangible assets $ 10,554

Accrued Expenses

Accrued Expenses	3 Months Ended
	Mar. 31, 2024
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consisted of the following (in thousands): March 31, 2024 December 31, 2023 Commissions to sales agents $ 2,954 $ 4,136 Accrued rebates 1,380 745 Legal and settlement costs 1,235 834 Accrued Group Purchasing Organization fees 1,235 1,338 Estimated sales returns 1,085 1,096 Accrued travel 142 433 Other 1,165 779 Accrued expenses $ 9,196 $ 9,361

Long Term Debt, Net

Long Term Debt, Net	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Long Term Debt, Net	Long Term Debt, Net Citizens Credit Agreement On January 19, 2024, the Company entered into a Credit Agreement (the “ Citizens Credit Agreement ”) with certain lenders party thereto, and Citizens Bank, N.A., as administrative agent (the “ Agent ”). The Citizens Credit Agreement provides for senior secured credit facilities in an aggregate principal amount of up to $95.0 million consisting of: (i) a $75.0 million senior secured revolving credit facility (the “ Revolving Credit Facility ”) with a $10.0 million letter of credit sublimit and a $10.0 million swingline loan sublimit, and (ii) a $20.0 million senior secured term loan facility (the “ Term Loan Facility ” and, together with the Revolving Credit Facility, the “ Credit Facilities ”). All obligations are required to be paid in full on January 19, 2029 (the “ Maturity Date ”). The Company has the option to obtain one or more incremental Term Loan Facilities and/or increase the commitments under the Revolving Credit Facility in an aggregate principal amount equal to the greater of (i) $50.0 million and (ii) 1.00 times the Company’s Consolidated EBITDA (as defined therein), each subject to the existing or any new lenders’ election to extend additional term loans or revolving commitments. At the Company’s option, borrowings under the Citizens Credit Agreement (other than any swingline loan) will bear interest at a rate per annum equal to (i) the Alternate Base Rate, as defined therein, or (ii) a Term SOFR as defined therein, in each case plus an applicable margin ranging from 1.25% and 2.50% with respect to Alternate Base Rate borrowings and 2.25% and 3.50% for Term SOFR borrowings, plus a fallback provision of 0.1%. Swingline loans will bear interest at a rate per annum equal to one-month Term SOFR plus the applicable margin. The applicable margin will be determined based on the Company’s consolidated total net leverage ratio. The Company is required to pay a quarterly commitment fee on any unused portion of the Revolving Credit Facility, letter of credit fees, and other customary fees to the Agent and the Lenders. The Term Loan Facility will amortize on a quarterly basis at 1.25% (for year one and two), 1.88% (for year three and four), and 2.5% (for year five) based on the aggregate principal amount outstanding under the Term Loan Facility, with the remainder due on the Maturity Date. The Company must make mandatory prepayments in connection with certain asset dispositions and casualty events, subject in each case to customary reinvestment rights. The Company may prepay borrowings under the Credit Facilities at any time, without premium or penalty, and may, at its option, reduce the aggregate unused commitments under the Revolving Credit Facility in whole or in part, in each case subject to the terms of the Credit Agreement. The Company must also comply with certain financial covenants, including a maximum total net leverage ratio and a minimum consolidated fixed charge coverage ratio, as well as other customary restrictive covenants. On January 19, 2024, the Company borrowed $30.0 million under the Revolving Credit Facility and $20.0 million under the Term Loan Facility. Proceeds from the initial drawings under the Credit Facilities together with cash on hand were used to repay in full the $50.0 million principal amount and other outstanding obligations under the Company’s prior senior secured term loan with Hayfin (the “Hayfin Loan Agreement ”) and to pay related fees, premiums, costs and expenses (collectively with the entry into the Citizens Credit Agreement and the initial borrowings thereunder, the “ Debt Refinancing Transactions ”). The Company recorded a loss on extinguishment of debt of $1.4 million. This amount is reflected as a part of interest expense, net on the unaudited condensed consolidated statement of operations for the three months ended March 31, 2024. The composition of the loss on extinguishment of debt was as follows (amounts in thousands): January 19, 2024 Unamortized deferred financing costs $ 781 Unamortized original issue discount 120 Prepayment premium 500 Loss on extinguishment of debt $ 1,401 In addition, on February 27, 2024, the Company repaid the initial $30.0 million drawing under the Revolving Credit Facility and had no outstanding borrowings under this facility as of March 31, 2024. Deferred financing costs and original issue discount allocated to the Revolving Credit Facility are amortized straight-line through the expiration of the commitment term. The Revolving Credit Facility is currently subject to a commitment fee of 0.25% per annum of the amount undrawn, which is recognized as interest expense. Original issue discount and deferred financing costs incurred as part of the Credit Facilities were allocated between the Term Loan Facility and the Revolving Credit Facility on the basis of the maximum potential principal outstanding permitted under the Citizens Credit Agreement. The allocation of the deferred financing costs and original issue discount between the Term Loan Facility and the Revolving Credit Facility were as follows (in thousands): January 19, 2024 Term Loan Facility Revolving Credit Facility Total Long term debt Other assets Original issue discount $ 224 $ 839 $ 1,063 Deferred financing 54 202 256 The balances of the Term Loan Facility as of March 31, 2024 and the Hayfin Loan Agreement as of December 31, 2023 were as follows (in thousands): March 31, 2024 December 31, 2023 Current portion of long term debt Long term debt, net Current portion of long term debt Long term debt, net Outstanding principal $ 1,000 $ 18,750 $ 1,000 $ 49,000 Deferred financing costs — (82) — (781) Original issue discount — (215) — (120) Long term debt, net $ 1,000 $ 18,453 $ 1,000 $ 48,099 The Citizens Term Loan Facility bears interest at a rate per annum equal to (i) the Alternate Base Rate, as defined therein, or (ii) a Term SOFR as defined therein, in each case plus an applicable margin ranging from 1.25% and 2.50% with respect to Alternate Base Rate borrowings and 2.25% and 3.50% for Term SOFR borrowings, plus a fallback provision of 0.1%. The applicable margin is determined based on the Company’s consolidated total net leverage ratio. The Term Loan Facility carried an interest rate of 7.9% as of March 31, 2024. Interest expense related to the Term Loan Facility and the Hayfin Loan Agreement included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended March 31, 2024 2023 Stated interest $ 661 $ 1,436 Amortization of deferred financing costs 29 105 Accretion of original issue discount 13 16 Interest expense $ 703 $ 1,557 Interest expense related to the Revolving Credit Facility included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended March 31, 2024 Commitment fee $ 30 Amortization of deferred financing costs 16 Accretion of original issue discount 42 Interest expense $ 88 A summary of principal payments due on the Term Loan Facility, by year, from March 31, 2024 through maturity are as follows (in thousands): Year ending December 31, Principal 2024 (excluding the three months ended March 31, 2024) $ 750 2025 1,000 2026 1,500 2027 1,500 2028 2,000 Thereafter 13,000 Outstanding principal $ 19,750 As of March 31, 2024, the fair value of the Term Loan Facility was $19.3 million. This valuation was calculated based on a series of Level 2 and Level 3 inputs, including a discount rate based on the credit risk spread of debt instruments of similar risk character in reference to U.S. Treasury instruments with similar maturities, with an incremental risk premium for risk factors specific to the Company. Fair value was calculated by discounting the remaining cash flows associated with the Term Loan Facility to March 31, 2024 using this discount rate.

Net Income (Loss) Per Common Sh

Net Income (Loss) Per Common Share	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Net Income (Loss) Per Common Share	Net Income (Loss) Per Common Share Net income (loss) per common share is calculated using two methods: basic and diluted. Basic Net Income (Loss) Per Common Share The following table provides a reconciliation of net income (loss) to net income (loss) available to common stockholders and calculation of basic net income (loss) per common share for each of the three months ended March 31, 2024 and 2023 (in thousands, except share and per share amounts): Three Months Ended March 31, 2024 2023 Net income (loss) from continuing operations $ 9,061 $ (1,942) Income (loss) from discontinued operations, net of tax $ 200 $ (3,041) Net income (loss) 9,261 (4,983) Adjustments to reconcile to income (loss) available to common stockholders: Accumulated dividend on previously converted Series B Preferred Stock — 1,684 Net income (loss) available to common stockholders from continuing operations $ 9,061 $ (3,626) Weighted average common shares outstanding 146,404,587 114,398,813 Basic net income (loss) per common share: Continuing operations $ 0.06 $ (0.03) Discontinued operations — (0.03) Basic net income (loss) per common share $ 0.06 $ (0.06) Diluted Net Income (Loss) Per Common Share The following table sets forth the computation of diluted net income (loss) per common share (in thousands, except share and per share amounts): Three Months Ended March 31, 2024 2023 Net income (loss) available to common stockholders from continuing operations $ 9,061 $ (3,626) Adjustments: Dividends on Series B Preferred Stock — 1,684 Less: antidilutive adjustments — (1,684) Total adjustments — — Numerator Net income (loss) available to common shareholders from continuing operations 9,061 (3,626) Income (loss) from discontinued operations, net of tax 200 (3,041) Weighted average shares outstanding 146,404,587 114,398,813 Adjustments: Potential common shares (a) Restricted stock unit awards 2,016,109 — Outstanding stock options 1,499,970 — Performance stock unit awards 106,802 — Employee stock purchase plan 639 — Total adjustments 3,623,520 — Weighted average shares outstanding adjusted for potential common shares 150,028,107 114,398,813 Diluted net income (loss) per common share: Continuing operations $ 0.06 $ (0.03) Discontinued operations — (0.03) Diluted net income (loss) per common share $ 0.06 $ (0.06) (a) Weighted average common shares outstanding for the calculation of diluted net income (loss) per common share does not include the following adjustments for potential common shares below because their effects were determined to be antidilutive for the periods presented. Three Months Ended March 31, 2024 2023 Series B Preferred Stock — 29,559,946 Restricted stock unit awards — 567,167 Restricted stock awards — 5,152 Employee stock purchase plan — 5,740 Performance stock unit awards — 13,133 Outstanding stock options — — Potential common shares — 30,151,138

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes On a continuing operations basis, the effective tax rates for the Company were 20.6% and (2.7)% for the three months ended March 31, 2024 and 2023, respectively. Restricted stock vestings impacted the effective tax rate for the three months ended March 31, 2024. Net operating losses generated for the three months ended March 31, 2023 were offset by a valuation allowance.

Supplemental Disclosure of Cash

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	3 Months Ended
	Mar. 31, 2024
Supplemental Cash Flow Elements [Abstract]
Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities Selected cash payments, receipts, and non-cash activities are as follows (in thousands): Three Months Ended March 31, 2024 2023 Cash paid for interest $ 1,403 $ 1,452 Cash paid for income taxes 8 — Non-cash activities: Present value of minimum earn out 2,731 — Right of use assets arising from operating lease liabilities 1,820 — Issuance of shares pursuant to employee stock purchase plan 797 680 Purchases of equipment in accounts payable 626 223 Consideration payable to TELA 366 — Unpaid deferred financing costs 149 —

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies TELA and Regenity Agreements On March 15, 2024, the Company entered into an Asset Purchase Agreement (the “ TELA APA ”) with TELA Bio, Inc. ( “TELA” ) to obtain exclusive rights to sell and market a 510(k)-cleared collagen particulate xenograft product in the United States pursuant to a preexisting Manufacturing and Supply Agreement (the “TELA-Regenity Supply Agreement” ) between TELA and Regenity Biosciences, Inc. (“ Regenity ”), which retains all intellectual property rights and regulatory clearances related to the product. Pursuant to the TELA APA, the Company paid $5.0 million of initial consideration to TELA and will be required to make future payments of $0.4 million to acquire TELA’s remaining product inventory, as well as future profit share payments (the “ Profit Share Payments ”) of between a minimum of $3.0 million and a maximum of $7.0 million based on MIMEDX’s net sales of the product over the two-years following its commercialization of the product. Simultaneously with entry into the TELA APA, the Company executed a new Manufacturing and Supply Agreement (the “ Supply Agreement ”) with Regenity, replacing the previous TELA-Regenity Supply Agreement. The Supply Agreement maintains MIMEDX’s exclusive right to sell and market the product in the United States and requires MIMEDX to purchase a minimum amount of the xenograft product from Regenity annually through December 31, 2033. Should MIMEDX fail to meet a purchasing minimum in any one period, it has the option (among others) to amend its distribution rights under the Supply Agreement to be non-exclusive. The transaction was accounted for as an acquisition of assets. The cost to acquire the assets on the transaction date was assessed to be $8.1 million, reflecting the $5.0 million of initial consideration, $0.4 million to acquire inventory, and $2.7 million, reflecting the fair value of the minimum amount of the Profit Share Payments, were allocated amongst the assets acquired. The Company assigned $7.6 million to the distribution rights acquired and $0.5 million to inventory. These amounts are reflected in the consolidated balance sheets as part of intangible assets, net and inventory, respectively, on the unaudited condensed consolidated balance sheet as of March 31, 2024. The $2.7 million fair value for the minimum amount of Profit Share Payments reflects the anticipated timing of such Profit Share Payments, discounted to present value at a discount rate approximating the Company’s borrowing rate plus a risk premium. Of the minimum Profit Share Payment, $1.1 million is reflected as part of other current liabilities in the unaudited condensed consolidated balance sheet as of March 31, 2024, reflecting the extent of the obligation that is anticipated to be repaid within twelve months of that date. The remaining balance is reflected in other liabilities. Litigation and Regulatory Matters In the ordinary course of business, the Company and its subsidiaries may be a party to pending and threatened legal, regulatory, and governmental actions and proceedings (including those described below). In view of the inherent difficulty of predicting the outcome of such matters, particularly where the plaintiffs or claimants seek very large or indeterminate damages or where the matters present novel legal theories or involve a large number of parties, the Company generally cannot predict what the eventual outcome of the pending matters will be, what the timing of the ultimate resolution of these matters will be, or what the eventual recovery, loss, fines or penalties related to each pending matter may be. The Company's unaudited condensed consolidated balance sheet as of March 31, 2024 reflects the Company's current best estimate of probable losses associated with these matters, including costs to comply with various settlement agreements, where applicable. For more information regarding the Company’s legal proceedings, refer to Note 16, “ Commitments and Contingencies ” in the 2023 Form 10-K. The Company has not accrued for any potential losses related to legal matters as of March 31, 2024. The Company made no payments toward the resolution of legal matters involving the Company during the three months ended March 31, 2024. The Company paid $0.2 million during the three months ended March 31, 2023. The following is a description of certain litigation and regulatory matters to which the Company is a party: Welker v. MiMedx, et. al. On November 4, 2022, Troy Welker and Min Turner, former optionholders of the Company, brought a lawsuit in Fulton County State Court against the Company, former directors Terry Dewberry and Charles Evans, and former officers Parker H. “Pete” Petit, William C. Taylor, and Michael Senken alleging violations of the Georgia Racketeer Influenced and Corrupt Organizations (“ RICO ”) Act against all defendants, and conspiracy to violate the Georgia RICO Act and breach of fiduciary duty against the individual defendants. On motion by the Company, the case has been moved to the Fulton County Business Court. The Company and the individual defendants filed answers and motions to dismiss, which were denied on the RICO claims, but granted with respect to the breach of fiduciary duty claims against the individual defendants. The Company is defending against the allegations and is obligated to indemnify certain of its current and former officers and directors who are party to this proceeding. Former Employee Litigation and Related Matters On January 12, 2021, the Company filed suit in the Circuit Court of the Eleventh Judicial District in and for Miami-Dade County, Florida (MiMedx Group, Inc. v. Petit, et. al.) against its former CEO, Parker H. “Pete” Petit, and its former COO, William C. Taylor, seeking a determination of its rights and obligations under indemnification agreements with Petit and Taylor following a federal jury’s guilty verdict against Petit for securities fraud and Taylor for conspiracy to commit securities fraud. On March 26, 2024, the Company filed an amended complaint against only Petit as the Company previously reached as settlement with Taylor. The Company is seeking a declaratory judgment that Petit is not entitled to indemnification in connection with certain cases and the Company is also seeking to recoup amounts previously paid on behalf of Petit in connection with such cases. As noted above, the Company and Mr. Taylor reached an agreement to settle the matter between them. Negotiations with Mr. Petit are ongoing.

Revenue

Revenue	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Revenue	Revenue Net Sales by Site of Service MIMEDX has three main sites of service for its products (1) Hospital settings and wound care clinics, which are stable reimbursement settings in which products are used for surgical applications, (2) Private offices, which generally represents doctors and practitioners with independent operations, and (3) Other, which includes federal facilities, international sales, and other sites of service. Below is a summary of net sales by site of service (in thousands): Three Months Ended March 31, 2024 2023 Hospital $ 43,757 $ 42,171 Private Office 30,332 21,487 Other 10,620 8,018 Total $ 84,709 $ 71,676 Net Sales by Product Line MIMEDX has two product lines (1) Wound, which reflects products typically used in Advanced Wound Care settings, including the treatment of chronic, non-healing wounds, and (2) Surgical, which reflects products principally used in surgical settings, including the closure of acute wounds or to protect and reinforce tissues and/or regions of interest. The Company manages its product portfolio and pipeline, based upon opportunities in each of these settings. Below is a summary of net sales by product line (in thousands): Three Months Ended March 31, 2024 2023 Wound $ 57,049 $ 45,206 Surgical 27,660 26,470 Total $ 84,709 $ 71,676 The Company did not have significant foreign operations or a single external customer from which 10% or more of revenues were derived during the three months ended March 31, 2024 or 2023. AXIOFILL The Company received a determination letter on March 25, 2024 reaffirming the FDA’s position that AXIOFILL does not meet the regulatory classification requirements of a Human Cell, Tissue or Cellular or Tissue-based Product under Section 361 of the Public Health Service Act. The Company strongly disagrees with this determination and has filed suit in the U.S. District Court for the Northern District of Georgia against the FDA on this matter.

Discontinued Operations

Discontinued Operations	3 Months Ended
	Mar. 31, 2024
Discontinued Operations and Disposal Groups [Abstract]
Discontinued Operations	Discontinued Operations Disbanding of Regenerative Medicine Business Unit On June 20, 2023, the Company announced the disbanding of its Regenerative Medicine business unit and the suspension of its Knee Osteoarthritis clinical trial program. During the fourth quarter of 2023, the Company materially completed the regulatory obligations associated with the clinical trial. Financial Statement Impact of Discontinued Operations The income and expenses of the discontinued operation have been classified as income (loss) from discontinued operations in the consolidated statements of operations for the three months ended March 31, 2024 and 2023 as follows (in thousands): Three Months Ended March 31, 2024 2023 Selling, general and administrative expense — 29 Research and development expense $ (200) 3,012 Income (loss) from discontinued operations $ 200 $ (3,041)

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 9,261	$ (4,983)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“ GAAP ”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three months ended March 31, 2024 and 2023 are not necessarily indicative of the results that may be expected for the full fiscal year. The balance sheet as of December 31, 2023 was derived from the audited consolidated financial statements at that date, but does not include all of the information and footnotes required by GAAP for complete financial statements. These unaudited condensed consolidated financial statements should be read in conjunction with the historical consolidated financial statements of the Company included in the 2023 Form 10-K.
Reclassifications	Reclassifications Current portion of long term debt of $1.0 million as of December 31, 2023, which was presented in other current liabilities in previously-issued financial statements, has been reclassified to be presented in a separate line item still within current liabilities in the March 31, 2024 balance sheet presentation.
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts of MiMedx Group, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation.
Use of Estimates	Use of Estimates GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported consolidated statements of operations during the reporting period. Actual results could differ from those estimates. Significant estimates include estimated useful lives and potential impairment of property and equipment, estimates of impairment for goodwill and intangible assets, estimates of useful lives for intangible assets, estimates of loss for contingent liabilities, estimate of allowance for doubtful accounts, estimate of fair value and the probable achievement of share-based payments, estimates of returns and allowances, and valuation of deferred tax assets.
Recently Issued Accounting Standards Not Yet Adopted	Recently Issued Accounting Standards Not Yet Adopted In November 2023, the Financial Accounting Standards Board (“ FASB ”) issued Accounting Standards Update (“ ASU ”) 2023-07, “ Segment Reporting: Improvements to Reportable Segment Disclosures (Topic 280) ”. The standard improves disclosures about a public entity’s reportable segments and addresses requests from investors for additional, more detailed information about a reportable segment’s expenses. Additionally, ASU 2023-07 extends the disclosure requirements under Accounting Standards Codification (“ ASC ”) Topic 280 to entities with a single reportable segment. ASU 2023-07 is effective for annual reporting periods beginning after December 15, 2023, and interim periods in fiscal years beginning after December 15, 2024. As of March 31, 2024, the Company is evaluating the impact of this standard on its consolidated financial statements. In December 2023, the FASB issued ASU 2023-09, “ Improvement to Income Tax Disclosures (Topic 740) ”, which requires additional disclosures for income tax rate reconciliations, income taxes paid, and certain other tax disclosures. ASU 2023-09 is intended to enhance the transparency and decision usefulness of income tax disclosures. The amendments in ASU 2023-09 address investor requests for enhanced income tax information primarily through changes to the rate reconciliation and income taxes paid information. Adoption is required for annual periods beginning after December 15, 2024. The Company is currently evaluating the impact of this standard on its consolidated financial statements and related disclosures. All other ASUs issued and not yet effective as of March 31, 2024, and through the date of this report, were assessed and determined to be either not applicable or are expected to have minimal impact on the Company’s current and future financial position and results of operations.

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	3 Months Ended
	Mar. 31, 2024
Receivables [Abstract]
Schedule of Accounts, Notes, Loans and Financing Receivable	Accounts receivable, net, consisted of the following (in thousands): March 31, 2024 December 31, 2023 Accounts receivable, gross $ 60,282 $ 57,015 Less: allowance for doubtful accounts (3,266) (3,144) Accounts receivable, net $ 57,016 $ 53,871
Schedule of Activity Related to the Allowance for Doubtful Accounts	Activity related to the Company’s allowance for doubtful accounts for the three months ended March 31, 2024 was as follows (in thousands): Allowance for Doubtful Accounts Balance at December 31, 2023 $ 3,144 Bad debt expense 199 Write-offs (77) Balance at March 31, 2024 $ 3,266 Allowance for Doubtful Accounts Balance at December 31, 2022 $ 3,783 Bad debt expense reversal (60) Write-offs (122) Balance at March 31, 2023 $ 3,601

Inventory (Tables)

Inventory (Tables)	3 Months Ended
	Mar. 31, 2024
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consisted of the following (in thousands): March 31, 2024 December 31, 2023 Raw materials $ 1,136 $ 825 Work in process 8,609 8,521 Finished goods 14,709 11,675 Inventory $ 24,454 $ 21,021

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	3 Months Ended
	Mar. 31, 2024
Property, Plant and Equipment [Abstract]
Summary of Property and Equipment	Property and equipment, net, consisted of the following (in thousands): March 31, 2024 December 31, 2023 Laboratory and clean room equipment $ 14,504 $ 13,954 Furniture and equipment 2,205 1,989 Leasehold improvements 8,141 8,141 Construction in progress 1,870 1,791 Asset retirement cost 889 938 Finance lease right-of-use asset 189 189 Property and equipment, gross 27,798 27,002 Less: accumulated depreciation and amortization (20,458) (20,028) Property and equipment, net $ 7,340 $ 6,974

Intangible Assets, Net (Tables)

Intangible Assets, Net (Tables)	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets Activity Summary - Indefinite-lived	Intangible assets, net, are summarized as follows (in thousands): March 31, 2024 December 31, 2023 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Patents and know-how $ 9,968 $ (7,949) $ 2,019 $ 10,039 $ (7,818) $ 2,221 Licenses 1,000 (67) 933 1,000 (54) $ 946 Distribution rights 7,602 — 7,602 — — — Total amortized intangible assets $ 18,570 $ (8,016) $ 10,554 $ 11,039 $ (7,872) $ 3,167 Unamortized intangible assets: Tradenames and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in Process 988 988 1,082 1,082 Total intangible assets $ 20,566 $ 12,550 $ 13,129 $ 5,257
Schedule of Estimated Future Amortization Expense for Intangible Assets	Expected future amortization of intangible assets as of March 31, 2024, is as follows (in thousands): Year ending December 31, Estimated 2024 (excluding the three months ended March 31, 2024) $ 1,708 2025 1,883 2026 1,729 2027 1,728 2028 1,726 Thereafter 1,780 Total amortized intangible assets $ 10,554

Accrued Expenses (Tables)

Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2024
Payables and Accruals [Abstract]
Schedule of Accrued Liabilities	Accrued expenses consisted of the following (in thousands): March 31, 2024 December 31, 2023 Commissions to sales agents $ 2,954 $ 4,136 Accrued rebates 1,380 745 Legal and settlement costs 1,235 834 Accrued Group Purchasing Organization fees 1,235 1,338 Estimated sales returns 1,085 1,096 Accrued travel 142 433 Other 1,165 779 Accrued expenses $ 9,196 $ 9,361

Long Term Debt, Net (Tables)

Long Term Debt, Net (Tables)	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Schedule of Extinguishment of Debt	The composition of the loss on extinguishment of debt was as follows (amounts in thousands): January 19, 2024 Unamortized deferred financing costs $ 781 Unamortized original issue discount 120 Prepayment premium 500 Loss on extinguishment of debt $ 1,401
Schedule of Original Discount and Deferred Financing Costs	Original issue discount and deferred financing costs incurred as part of the Credit Facilities were allocated between the Term Loan Facility and the Revolving Credit Facility on the basis of the maximum potential principal outstanding permitted under the Citizens Credit Agreement. The allocation of the deferred financing costs and original issue discount between the Term Loan Facility and the Revolving Credit Facility were as follows (in thousands): January 19, 2024 Term Loan Facility Revolving Credit Facility Total Long term debt Other assets Original issue discount $ 224 $ 839 $ 1,063 Deferred financing 54 202 256
Schedule of the Balances of the Loan Facility and Agreement	The balances of the Term Loan Facility as of March 31, 2024 and the Hayfin Loan Agreement as of December 31, 2023 were as follows (in thousands): March 31, 2024 December 31, 2023 Current portion of long term debt Long term debt, net Current portion of long term debt Long term debt, net Outstanding principal $ 1,000 $ 18,750 $ 1,000 $ 49,000 Deferred financing costs — (82) — (781) Original issue discount — (215) — (120) Long term debt, net $ 1,000 $ 18,453 $ 1,000 $ 48,099
Schedule of Interest Expense	Interest expense related to the Term Loan Facility and the Hayfin Loan Agreement included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended March 31, 2024 2023 Stated interest $ 661 $ 1,436 Amortization of deferred financing costs 29 105 Accretion of original issue discount 13 16 Interest expense $ 703 $ 1,557 Interest expense related to the Revolving Credit Facility included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended March 31, 2024 Commitment fee $ 30 Amortization of deferred financing costs 16 Accretion of original issue discount 42 Interest expense $ 88
Summary of Principal Payments for the Term Loan Facility	A summary of principal payments due on the Term Loan Facility, by year, from March 31, 2024 through maturity are as follows (in thousands): Year ending December 31, Principal 2024 (excluding the three months ended March 31, 2024) $ 750 2025 1,000 2026 1,500 2027 1,500 2028 2,000 Thereafter 13,000 Outstanding principal $ 19,750

Net Income (Loss) Per Common _2

Net Income (Loss) Per Common Share (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Basic Net Income (Loss) Per Common Share	The following table provides a reconciliation of net income (loss) to net income (loss) available to common stockholders and calculation of basic net income (loss) per common share for each of the three months ended March 31, 2024 and 2023 (in thousands, except share and per share amounts): Three Months Ended March 31, 2024 2023 Net income (loss) from continuing operations $ 9,061 $ (1,942) Income (loss) from discontinued operations, net of tax $ 200 $ (3,041) Net income (loss) 9,261 (4,983) Adjustments to reconcile to income (loss) available to common stockholders: Accumulated dividend on previously converted Series B Preferred Stock — 1,684 Net income (loss) available to common stockholders from continuing operations $ 9,061 $ (3,626) Weighted average common shares outstanding 146,404,587 114,398,813 Basic net income (loss) per common share: Continuing operations $ 0.06 $ (0.03) Discontinued operations — (0.03) Basic net income (loss) per common share $ 0.06 $ (0.06)
Diluted Net Income (Loss) Per Common Share	The following table sets forth the computation of diluted net income (loss) per common share (in thousands, except share and per share amounts): Three Months Ended March 31, 2024 2023 Net income (loss) available to common stockholders from continuing operations $ 9,061 $ (3,626) Adjustments: Dividends on Series B Preferred Stock — 1,684 Less: antidilutive adjustments — (1,684) Total adjustments — — Numerator Net income (loss) available to common shareholders from continuing operations 9,061 (3,626) Income (loss) from discontinued operations, net of tax 200 (3,041) Weighted average shares outstanding 146,404,587 114,398,813 Adjustments: Potential common shares (a) Restricted stock unit awards 2,016,109 — Outstanding stock options 1,499,970 — Performance stock unit awards 106,802 — Employee stock purchase plan 639 — Total adjustments 3,623,520 — Weighted average shares outstanding adjusted for potential common shares 150,028,107 114,398,813 Diluted net income (loss) per common share: Continuing operations $ 0.06 $ (0.03) Discontinued operations — (0.03) Diluted net income (loss) per common share $ 0.06 $ (0.06) (a) Weighted average common shares outstanding for the calculation of diluted net income (loss) per common share does not include the following adjustments for potential common shares below because their effects were determined to be antidilutive for the periods presented.
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	Three Months Ended March 31, 2024 2023 Series B Preferred Stock — 29,559,946 Restricted stock unit awards — 567,167 Restricted stock awards — 5,152 Employee stock purchase plan — 5,740 Performance stock unit awards — 13,133 Outstanding stock options — — Potential common shares — 30,151,138

Supplemental Disclosure of Ca_2

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities (Tables)	3 Months Ended
	Mar. 31, 2024
Supplemental Cash Flow Elements [Abstract]
Schedule of Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	Selected cash payments, receipts, and non-cash activities are as follows (in thousands): Three Months Ended March 31, 2024 2023 Cash paid for interest $ 1,403 $ 1,452 Cash paid for income taxes 8 — Non-cash activities: Present value of minimum earn out 2,731 — Right of use assets arising from operating lease liabilities 1,820 — Issuance of shares pursuant to employee stock purchase plan 797 680 Purchases of equipment in accounts payable 626 223 Consideration payable to TELA 366 — Unpaid deferred financing costs 149 —

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2024
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	Below is a summary of net sales by site of service (in thousands): Three Months Ended March 31, 2024 2023 Hospital $ 43,757 $ 42,171 Private Office 30,332 21,487 Other 10,620 8,018 Total $ 84,709 $ 71,676 Below is a summary of net sales by product line (in thousands): Three Months Ended March 31, 2024 2023 Wound $ 57,049 $ 45,206 Surgical 27,660 26,470 Total $ 84,709 $ 71,676

Discontinued Operations (Tables

Discontinued Operations (Tables)	3 Months Ended
	Mar. 31, 2024
Discontinued Operations and Disposal Groups [Abstract]
Schedule of Assets And Liabilities of the Discontinued Operations	The income and expenses of the discontinued operation have been classified as income (loss) from discontinued operations in the consolidated statements of operations for the three months ended March 31, 2024 and 2023 as follows (in thousands): Three Months Ended March 31, 2024 2023 Selling, general and administrative expense — 29 Research and development expense $ (200) 3,012 Income (loss) from discontinued operations $ 200 $ (3,041)

Significant Accounting Polici_3

Significant Accounting Policies (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Other current liabilities	$ (4,071)	$ (2,894)
Current portion of long term debt	1,000	$ 1,000
Revision of Prior Period, Reclassification, Adjustment
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Other current liabilities	1,000
Current portion of long term debt	$ 1,000

Accounts Receivable, Net - Acco

Accounts Receivable, Net - Accounts Receivable (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023	Mar. 31, 2023	Dec. 31, 2022
Receivables [Abstract]
Accounts receivable, gross	$ 60,282	$ 57,015
Less: allowance for doubtful accounts	(3,266)	(3,144)	$ (3,601)	$ (3,783)
Accounts receivable, net	$ 57,016	$ 53,871

Accounts Receivable, Net - Sche

Accounts Receivable, Net - Schedule of Activity Related to the Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Allowance for Doubtful Accounts
Beginning balance	$ 3,144	$ 3,783
Bad debt expense	199	(60)
Write-offs	(77)	(122)
Ending balance	$ 3,266	$ 3,601

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Raw materials	$ 1,136	$ 825
Work in process	8,609	8,521
Finished goods	14,709	11,675
Inventory	$ 24,454	$ 21,021

Property and Equipment, Net - S

Property and Equipment, Net - Summary of Property and Equipment (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Finance lease right-of-use asset	$ 189	$ 189
Property and equipment, gross	27,798	27,002
Less: accumulated depreciation and amortization	(20,458)	(20,028)
Property and equipment, net	7,340	6,974
Laboratory and clean room equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	14,504	13,954
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	2,205	1,989
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	8,141	8,141
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,870	1,791
Asset retirement cost
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 889	$ 938

Intangible Assets, Net - Activi

Intangible Assets, Net - Activity Summary (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 18,570	$ 11,039
Accumulated Amortization	(8,016)	(7,872)
Total amortized intangible assets	10,554	3,167
Indefinite-lived Intangible Assets [Line Items]
Intangible assets, gross carrying amount	20,566	13,129
Intangible assets, net carrying amount	12,550	5,257
Tradenames and trademarks
Indefinite-lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	1,008	1,008
Patents in Process
Indefinite-lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	988	1,082
Patents and know-how
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	9,968	10,039
Accumulated Amortization	(7,949)	(7,818)
Total amortized intangible assets	2,019	2,221
Licenses
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,000	1,000
Accumulated Amortization	(67)	(54)
Total amortized intangible assets	933	946
Distribution rights
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	7,602	0
Accumulated Amortization	0	0
Total amortized intangible assets	$ 7,602	$ 0

Intangible Assets, Net - Estima

Intangible Assets, Net - Estimated Future Amortization Expense for Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Estimated future amortization expense [Abstract]
2024 (excluding the three months ended March 31, 2024)	$ 1,708
2025	1,883
2026	1,729
2027	1,728
2028	1,726
Thereafter	1,780
Total amortized intangible assets	$ 10,554	$ 3,167

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Commissions to sales agents	$ 2,954	$ 4,136
Accrued rebates	1,380	745
Legal and settlement costs	1,235	834
Accrued Group Purchasing Organization fees	1,235	1,338
Estimated sales returns	1,085	1,096
Accrued travel	142	433
Other	1,165	779
Accrued expenses	$ 9,196	$ 9,361

Long Term Debt, Net - Narrative

Long Term Debt, Net - Narrative (Details)			3 Months Ended
	Feb. 27, 2024 USD ($)	Jan. 19, 2024 USD ($)	Mar. 31, 2024 USD ($)	Mar. 31, 2023 USD ($)
Debt Instrument [Line Items]
Proceeds from revolving credit facility			$ 30,000,000	$ 0
Proceeds from term loan			19,783,000	0
Repayments of term loan			50,000,000	0
Loss on extinguishment of debt		$ 1,401,000	1,401,000	0
Repayments of initial line of credit draw			30,000,000	$ 0
Citizens Credit Agreement | Line of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 95,000,000
Citizens Credit Agreement | Line of Credit | Minimum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		1.25%
Citizens Credit Agreement | Line of Credit | Minimum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		2.25%
Citizens Credit Agreement | Line of Credit | Maximum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		2.50%
Citizens Credit Agreement | Line of Credit | Maximum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		3.50%
Citizens Credit Agreement | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 75,000,000
Line of credit facility, optional increase		$ 50,000,000
Line of credit facility, optional increase, EBITDA multiplier		1
Proceeds from revolving credit facility		$ 30,000,000
Repayments of initial line of credit draw	$ 30,000,000
Undrawn commitment fee percentage	0.25%
Citizens Credit Agreement | Line of Credit | Letter of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity		10,000,000
Citizens Credit Agreement | Line of Credit | Bridge Loan
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 10,000,000
Citizens Credit Agreement | Line of Credit | Bridge Loan | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		0.10%
Citizens Credit Agreement | Line of Credit | Term Loan
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 20,000,000
Proceeds from term loan		$ 20,000,000
Fair value of term loan			$ 19,300,000
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year One
Debt Instrument [Line Items]
Interest rate		1.25%
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year Two
Debt Instrument [Line Items]
Interest rate		1.25%
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year Three
Debt Instrument [Line Items]
Interest rate		1.88%
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year Four
Debt Instrument [Line Items]
Interest rate		1.88%
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year Five
Debt Instrument [Line Items]
Interest rate		2.50%
Citizens Credit Agreement | Line of Credit | Term Loan | Minimum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		1.25%
Citizens Credit Agreement | Line of Credit | Term Loan | Minimum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		2.25%
Interest rate, effective percentage (percent)			7.90%
Citizens Credit Agreement | Line of Credit | Term Loan | Maximum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		2.50%
Citizens Credit Agreement | Line of Credit | Term Loan | Maximum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		3.50%
Hayfin Loan Agreement Term Loan | Term loan
Debt Instrument [Line Items]
Repayments of term loan		$ 50,000,000

Long Term Debt, Net - Schedule

Long Term Debt, Net - Schedule of Extinguishment of Debt (Details) - USD ($) $ in Thousands		3 Months Ended
	Jan. 19, 2024	Mar. 31, 2024	Mar. 31, 2023
Debt Disclosure [Abstract]
Unamortized deferred financing costs	$ 781
Unamortized original issue discount	120
Prepayment premium on Hayfin term loan	500
Loss on extinguishment of debt	$ 1,401	$ 1,401	$ 0

Long Term Debt, Net - Schedul_2

Long Term Debt, Net - Schedule of Term Loan Facility Balances (Details) - Line of Credit - Citizens Credit Agreement - USD ($) $ in Thousands	Mar. 31, 2024	Jan. 19, 2024
Long term debt, net
Original issue discount		$ 1,063
Deferred financing		256
Term Loan
Long term debt, net
Original issue discount, noncurrent	$ 215	224
Deferred financing, noncurrent	82	54
Current portion of long term debt
Original issue discount, current	0
Deferred financing, current	$ 0
Revolving Credit Facility
Current portion of long term debt
Original issue discount, current		839
Deferred financing, current		$ 202

Long Term Debt, Net - Schedul_3

Long Term Debt, Net - Schedule of Term Loan Balances (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Jan. 19, 2024	Dec. 31, 2023
Current portion of long term debt
Long term debt, net	$ 1,000		$ 1,000
Long term debt, net
Long term debt, net	18,453		48,099
Line of Credit | Citizens Credit Agreement | Term Loan
Current portion of long term debt
Outstanding principal	1,000
Deferred financing costs	0
Original issue discount	0
Long term debt, net	1,000
Long term debt, net
Outstanding principal	18,750
Deferred financing costs	(82)	$ (54)
Original issue discount	(215)	$ (224)
Long term debt, net	$ 18,453
Term loan | Hayfin Loan Agreement Term Loan
Current portion of long term debt
Outstanding principal			1,000
Deferred financing costs			0
Original issue discount			0
Long term debt, net			1,000
Long term debt, net
Outstanding principal			49,000
Deferred financing costs			(781)
Original issue discount			(120)
Long term debt, net			$ 48,099

Long Term Debt, Net - Schedul_4

Long Term Debt, Net - Schedule of Interest Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Term Loan Facility and Hayfin Loan Agreement
Debt Instrument [Line Items]
Stated interest	$ 661	$ 1,436
Amortization of deferred financing costs	29	105
Accretion of original issue discount	13	16
Interest expense	703	$ 1,557
Line of Credit | Citizens Credit Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Amortization of deferred financing costs	16
Accretion of original issue discount	42
Commitment fee	30
Interest expense	$ 88

Long Term Debt, Net - Term Loan

Long Term Debt, Net - Term Loan Maturity (Details) - Term Loan - Citizens Credit Agreement - Line of Credit $ in Thousands	Mar. 31, 2024 USD ($)
Debt Instrument [Line Items]
2024 (excluding the three months ended March 31, 2024)	$ 750
2025	1,000
2026	1,500
2027	1,500
2028	2,000
Thereafter	13,000
Outstanding principal	$ 19,750

Net Income (Loss) Per Common _3

Net Income (Loss) Per Common Share - Schedule of Basic Net Loss Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Earnings Per Share [Abstract]
Net income (loss) from continuing operations	$ 9,061	$ (1,942)
Income (loss) from discontinued operations, net of tax	200	(3,041)
Net income (loss)	9,261	(4,983)
Adjustments to reconcile to income (loss) available to common stockholders:
Accumulated dividend on previously converted Series B Preferred Stock	0	1,684
Net income (loss) available to common stockholders from continuing operations	$ 9,061	$ (3,626)
Weighted average common shares outstanding (in shares)	146,404,587	114,398,813
Basic net income (loss) per common share:
Continuing operations - basic (in dollars per share)	$ 0.06	$ (0.03)
Discontinued operations - basic (in dollars per share)	0	(0.03)
Basic net income (loss) per common share (in dollars per share)	$ 0.06	$ (0.06)

Net Income (Loss) Per Common _4

Net Income (Loss) Per Common Share - Schedule of Diluted Net Loss Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Net income (loss) available to common stockholders from continuing operations	$ 9,061	$ (3,626)
Adjustments:
Dividends on Series B Preferred Stock	0	1,684
Less: antidilutive adjustments	0	(1,684)
Total adjustments	0	0
Numerator
Net income (loss) available to common stockholders from continuing operations	9,061	(3,626)
Income (loss) from discontinued operations, net of tax	$ 200	$ (3,041)
Weighted average shares outstanding (in shares)	146,404,587	114,398,813
Potential common shares
Total adjustments (in shares)	3,623,520	0
Weighted average shares outstanding adjusted for potential common shares (in shares)	150,028,107	114,398,813
Diluted net income (loss) per common share:
Continuing operations- diluted(in dollars per share)	$ 0.06	$ (0.03)
Discontinued operations- diluted (in dollars per share)	0	(0.03)
Diluted net (loss) income per common share (in dollars per share)	$ 0.06	$ (0.06)
RSU
Potential common shares
Stock-based awards (in shares)	2,016,109	0
Outstanding stock options
Potential common shares
Stock-based awards (in shares)	1,499,970	0
Performance stock unit awards
Potential common shares
Stock-based awards (in shares)	106,802	0
Employee stock purchase plan
Potential common shares
Stock-based awards (in shares)	639	0

Net Income (Loss) Per Common _5

Net Income (Loss) Per Common Share - Antidilutive Securities (Details) - shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares (in shares)	0	30,151,138
Series B Preferred Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares (in shares)	0	29,559,946
RSU
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares (in shares)	0	567,167
RSA
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares (in shares)	0	5,152
Employee stock purchase plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares (in shares)	0	5,740
Performance stock unit awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares (in shares)	0	13,133
Outstanding stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares (in shares)	0	0

Income Taxes (Details)

Income Taxes (Details)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Effective tax rate	20.60%	(2.70%)

Supplemental Disclosure of Ca_3

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Supplemental Cash Flow Elements [Abstract]
Cash paid for interest	$ 1,403	$ 1,452
Cash paid for income taxes	8	0
Non-cash activities:
Present value of minimum earn out	2,731	0
Right of use assets arising from operating lease liabilities	1,820	0
Issuance of shares pursuant to employee stock purchase plan	797	680
Purchases of equipment in accounts payable	626	223
Consideration payable to TELA	366	0
Unpaid deferred financing costs	$ 149	$ 0

Commitments and Contingencies (

Commitments and Contingencies (Details) - USD ($)		3 Months Ended
	Mar. 15, 2024	Mar. 31, 2024	Mar. 31, 2023
Asset Acquisition [Line Items]
Initial consideration paid		$ 5,000,000	$ 0
Fair value of minimum contingent consideration		2,731,000	0
Payments for legal settlements		0	$ 200,000
TELA APA
Asset Acquisition [Line Items]
Initial consideration paid	$ 5,000,000
Future payments for remaining product inventory	$ 400,000
Net sales over the period	2 years
Consideration transferred	$ 8,100,000
Fair value of minimum contingent consideration	2,700,000
Asset acquisition, inventory	500,000
Profit sharing payment liability, current		$ 1,100,000
TELA APA | Distribution rights
Asset Acquisition [Line Items]
Finite-lived intangible assets acquired	7,600,000
TELA APA | Minimum
Asset Acquisition [Line Items]
Contingent consideration	3,000,000
TELA APA | Maximum
Asset Acquisition [Line Items]
Contingent consideration	$ 7,000,000

Revenue - Summary of Revenue by

Revenue - Summary of Revenue by Site Of Service (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenue, Major Customer [Line Items]
Net sales	$ 84,709	$ 71,676
Hospital
Revenue, Major Customer [Line Items]
Net sales	43,757	42,171
Private Office
Revenue, Major Customer [Line Items]
Net sales	30,332	21,487
Other
Revenue, Major Customer [Line Items]
Net sales	$ 10,620	$ 8,018

Revenue - Narrative (Details)

Revenue - Narrative (Details)	3 Months Ended
	Mar. 31, 2024 service_site product_line
Revenue from Contract with Customer [Abstract]
Number of sites of service | service_site	3
Number of product lines | product_line	2

Revenue - Summary of Revenue _2

Revenue - Summary of Revenue by Product Type (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Revenue, Major Customer [Line Items]
Net sales	$ 84,709	$ 71,676
Wound
Revenue, Major Customer [Line Items]
Net sales	57,049	45,206
Surgical & Other
Revenue, Major Customer [Line Items]
Net sales	$ 27,660	$ 26,470

Discontinued Operations - Sched

Discontinued Operations - Schedule Of Disposal Groups Including Discontinued Operations Income Statement (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income (loss) from discontinued operations, net of tax	$ 200	$ (3,041)
Regenerative Medicine | Disbanded
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Selling, general and administrative expense	0	29
Research and development expense	(200)	3,012
Income (loss) from discontinued operations, net of tax	$ 200	$ (3,041)