WP CityMD Topco LLC
Notes to Condensed Consolidated Financial Statements (Unaudited)
September 30, 2022
corresponding increase of $7.5 million was recorded to goodwill. Separately, the settlement of the closing statement calculation, as defined by the agreement, resulted in a $10.0 million reduction in the total deferred cash consideration payable to the sellers on the first anniversary of the December 23, 2021 acquisition date. The deferred cash consideration was excluded from the purchase price, as it was tied to both the continued employment and services of the recipients over the one-year period. Please refer to Note 12 – Seller Obligations for additional information.
4. | Patient Service Fee Revenue and Accounts Receivable |
Contractual relationships with patients generally involve a third-party payor. As a result, the Company receives payments from healthcare payors as well as from self-pay patients who may bear some, or all of the cost of the service in the form of co-pays, coinsurance or deductible, or the entire cost when the patient does not have health insurance. As of September 30, 2022, patient and payor fees represented approximately 13% and 87%, respectively, of gross accounts receivable. Receivables from payors include patient care services covered by Medicare and Medicaid programs from the federal government, managed care plans and private insurers. Management recognizes that revenues and receivables from certain payors are significant to the Company’s operations, but it does not believe that there is significant credit risk associated with such payors. Concentration of credit risk with respect to patients is limited due to a large patient population and the value of individual patient accounts receivable.
On March 15, 2022, the Health Resources & Services Administration (“HRSA”) Uninsured Program announced that the program would stop accepting claims for payment of COVID-19 testing as of March 22, 2022, due to lack of sufficient funds. As a result of the suspension of the HRSA uninsured program, the Company wrote-off $16.6 million of receivables outstanding as of December 31, 2021 from HRSA COVID-19 testing claims during the nine months ended September 30, 2022.
5. | Variable Interest Entities |
The Company is the primary beneficiary of certain VIEs, which are included in the condensed consolidated financial statements. These VIEs include, Summit Medical Group, P.A. (“SMG”), CityMedical NY, CityMedical NJ, NJU, WestMed and a professional corporation, Bend Memorial Clinic, P.C. (“Bend”). Through the limited liability related agreements and Summit Health Management, LLC’s (“SHM”) MSAs with each of these entities, the Company, through SHM, provides comprehensive business support services to all of these entities. Accordingly, the Company has the decision-making power over the nonclinical activities that most significantly impact the economic performance of the VIEs and an obligation to absorb losses or receive benefits from the VIE that could potentially be significant to the VIE. These decisions and significant activities include, but are not limited to, the approval of operating and capital budgets, the ability to direct nonclinical activities, including the sole ability to hire and terminate nonclinical personnel, and the purchase and sale of nonclinical assets. The Company, through its wholly owned subsidiary SHM, also has certain rights and obligations to its involvement with the VIEs, including requirements over marketing efforts, nonclinical oversight of patient admissions, training, procurement, billing, collections and maintenance of medical records. In addition, the Company has related party common equity ownership and senior management influence with the equity owners of the VIEs and Topco.
Certain VIEs, including SMG, CityMedical NY, CityMedical NJ, NJU, and WestMed, have securitized their assets, which can be used to settle certain Company debt obligations in addition to their own obligations. Therefore, these entity assets and liabilities are not separately disclosed below. The terms of other VIE management agreements with SHM do not allow the Company to use their assets to satisfy the obligations of other consolidated entities. During 2022, the Company continued the execution of a phased transfer of certain assets and operations from CityMedical NJ to SMG. In addition, the Company provides overall support to the VIEs through its bank credit facilities.
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