Acquisitions | NOTE 3. ACQUISITIONS 2022 Acquisitions Steward Acquisition On November 10, 2022, the Company completed its previously announced acquisition, pursuant to the Agreement and Plan of Merger (the “Merger Agreement”), by and among (i) the Company, (ii) Sparta Merger Sub I Inc., a Delaware corporation and wholly-owned subsidiary of the Company (“Merger Sub I”), (iii) Sparta Merger Sub II Inc., a Delaware corporation and wholly-owned subsidiary of the Company (“Merger Sub II”), (iv) Sparta Merger Sub III Inc., a Delaware corporation and wholly-owned subsidiary of the Company (“Merger Sub III” and, together with Merger Sub I and Merger Sub II, “Merger Subs” and each a “Merger Sub”), (v) Sparta Merger Sub I LLC, a Delaware limited liability company and wholly-owned subsidiary of the Company (“Merger LLC I”), (vi) Sparta Merger Sub II LLC, a Delaware limited liability company and wholly-owned subsidiary of the Company (“Merger LLC II”), (vii) Sparta Merger Sub III LLC, a Delaware limited liability company and wholly-owned subsidiary of the Company (“Merger LLC III” and, together with Merger LLC I and Merger LLC II, “Merger LLCs” and each a “Merger LLC”), (viii) Sparta Sub Inc., a Delaware corporation ("SACN Holdco"), (ix) SNCN Holdco Inc. a Delaware corporation ("SNCN Holdco"), (x) SICN Holdco Inc., a Delaware corporation ("SICN Holdco" and, collectively with SACN Holdco, SNCN Holdco, Steward National Care Network, Inc. (n/k/a Steward National Care Network, LLC, “SNCN”), Steward Integrated Care Network, Inc., and Steward Accountable Care Network, Inc. (n/k/a as Steward Accountable Care Network, LLC, “SACN”), each a "target" and, collectively, the "Targets"), (xi) Sparta Holding Co. LLC, a Delaware limited liability company (the “Seller”), and (xii) Steward Health Care System LLC, a Delaware limited liability company (referred to collectively with the Seller, the “Seller Parties”), pursuant to which the Company acquired Steward Value-Based Care (such transaction, the “Steward Acquisition”). The aggregate consideration paid to the Seller under the Merger Agreement on November 10, 2022, the date of the closing of the Steward Acquisition (the “Steward Closing”), consisted of (i) a cash payment of $ 25.0 million, subject to customary adjustments (ii) 23,500,000 shares (the “Initial Share Consideration”), subject to adjustments, of the Company’s Class A common stock, par value $ 0.0001 per share (the “Class A Common Stock”) and (iii) a cash payment of $ 35.5 million, an amount equal to the value of the Targets’ accounts receivable attributable to Medicare value-based payments for the period between January 1, 2022 and the Steward Closing, minus the amount of such payments payable to the affiliate physicians of the Targets (the “Financed Net Pre-Closing Medicare AR”). In addition, the Merger Agreement provides that, following the Steward Closing, upon 100,000 Medicare lives from and/or attributable to the Seller Parties’ Medicare network participating in risk-based, value-based care arrangements contracted through the Company with a Medical Expense Ratio of less than 85 % for two consecutive calendar quarters, the Company will issue the Seller, for immediate distribution to its equity holders, a number of shares of Class A Common Stock (the “Earnout Share Consideration” and together with the Initial Share Consideration, the “Share Consideration”) that, when added to the Initial Share Consideration, would have represented 41 % of the issued and outstanding shares of the Company’s Class A Common Stock as of the Steward Closing, in each case after giving effect to issuances of Class A Common Stock between the Steward Closing and June 30, 2023 in connection with the exercise of warrants to purchase Class A Common Stock outstanding as of the Steward Closing, the potential earnout under the Company’s June 2021 Business Combination and any forfeitures, surrenders or other dispositions to the Company of Class A Common Stock outstanding as of the Steward Closing. If not previously issued, the Earnout Share Consideration will also be issuable upon a Change in Control (as defined in the Merger Agreement) of the Company. The following summarizes the consideration transferred at the closing of the Steward Acquisition ( in thousands ): Cash consideration $ 25,000 Initial Share Consideration (1) 134,420 Earnout Share Consideration (2) 212,355 Other consideration, net (3) 27,219 Total Steward Acquisition consideration $ 398,994 (1) Represents issuance of 23.5 million shares of Class A Common Stock of the Company using the closing price as of the Steward Closing of $ 5.72 per share. (2) Calculated as the 37.5 million shares of Class A Common Stock the Company estimates that it will be obligated to issue to the Seller Parties upon achievement of certain milestones as Earnout Share Consideration, multiplied by CareMax's closing stock price as of the Steward Closing of $ 5.72 per share and the estimated probability of payout of 99 %. (3) Represents funding of the Financed Net Pre-Closing Medicare AR of $ 35.5 million, offset by the Sellers' reimbursement to the Company of the interest and original issue discount of $ 6.8 million related to the Loan and Security Agreement (as defined in Note 7 of these consolidated financial statements) and by non-cash purchase price adjustment of $ 1.5 million. The acquired assets and assumed liabilities of Steward Value-Based Care were recorded at their estimated fair values. The purchase price allocation for the Steward Acquisition has not been finalized as of December 31, 2022 and is based upon the best available information at the current time. The purchase price allocation will be finalized following the settlement of the 2022 MSSP Accounts Receivable, expected to take place during the fourth quarter of 2023. The following table summarizes the consideration paid and the preliminary fair value of the assets acquired and liabilities assumed as of closing ( in thousands ): Accounts receivable $ 43,060 Other working capital adjustments ( 21,584 ) Distribution liabilities ( 7,032 ) Intangible asset - Risk contracts 37,500 Intangible asset - Provider network 42,900 Net Assets Acquired (a) 94,844 Purchase Consideration (b) 398,994 Goodwill (b) - (a) $ 304,150 The goodwill recorded as part of the acquisition included the expected synergies and other expected contribution to the Company's overall growth strategy. None of the goodwill recognized as part of the Steward Acquisition is deductible for income tax purposes. Refer to Note 5, Goodwill and Other Intangible Assets , for additional information. Operating results of Steward Value-Based Care from the date of the Steward Closing, consisting of other revenue of $ 7.0 million and cost of care of $ 1.1 million, are included in the consolidated statement of operations of the Company for the year ended December 31, 2022. Transaction Costs The Company incurred $ 13.2 million for the year ended December 31, 2022, in advisory, legal, accounting and management fees in conjunction with the Steward Acquisition, which are included in acquisition related costs in the consolidated statements of operations. As of December 31, 2022, we have accrued $ 5.0 million, payment of which is contingent upon the Company's issuance of the Earnout Share Consideration to the Seller Parties. Unaudited Pro Forma Information The financial information in the table below summarizes the combined results of operations of the Company and Steward Value-Based Care, on a pro forma basis, as if the acquisition occurred on January 1, 2021. The pro forma financial information is presented for informational purposes only and is not indicative of the results of operations that would have been achieved if the acquisition had taken place on January 1, 2021 or of results that may occur in the future. Years Ended December 31, ( in thousands ) 2022 2021 Revenue $ 669,319 $ 364,026 Net income (loss) ( 34,315 ) 3,853 These pro forma results were based on estimates and assumptions, which the Company believes are reasonable. The pro forma results include adjustments primarily related to the purchase accounting. Acquisition costs and other non-recurring charges incurred are included in the earliest period presented. Other Acquisitions During the year ended December 31, 2022, we a cquired a number of medical practices for total consideration of $ 3.3 million and recognized related goodwill in the amount of $ 2.9 million and intangible assets of $ 0.4 million. 2021 Acquisitions Acquisition of IMC On June 8, 2021, the Company acquired 100 % of the equity interests of IMC for total purchase consideration of $ 369.7 million, subject to final closing adjustments. The purchase consideration was comprised of the following ( in thousands ): Cash consideration (1) $ 172,302 Share consideration (2) 155,347 Contingent consideration (3) 40,785 Other consideration (4) 1,271 Total consideration $ 369,705 (1) Represents cash consideration inclusive of the payment of $ 79.8 million of IMC debt simultaneous with the Closing and the reimbursement of IMC Parent's transaction costs of $ 7.3 million. (2) Represents the issuance of 10,412,023 shares of Class A Common Stock, which shares were issued at a reference price of $ 10.00 per share, but the value of which was $ 14.92 per share, the closing price on the date of the IMC Acquisition. (3) Represents the fair value of equity-classified contingent consideration. (4) Represents the fair value of cash and equity purchase consideration held in escrow pending the finalization of final closing adjustments. The IMC Acquisition was recorded as a business combination under ASC 805 with identifiable assets acquired recorded at their estimated fair values as of the acquisition date. The following table summarizes the purchase consideration and the fair value of the assets acquired and liabilities assumed, as recorded as of December 31, 2021 ( in thousands ): Cash $ 14,842 Accounts receivable 21,298 Other current assets 1,446 Property and equipment 6,198 Intangible assets 34,121 Other assets 448 Accounts payable and accrued expenses ( 8,793 ) Long term debt ( 197 ) Other long term liabilities ( 1,898 ) Net assets acquired 67,465 Excess of consideration over net assets acquired 302,240 Total consideration $ 369,705 Goodwill was recognized as the amount of consideration transferred in excess of the fair value of net assets acquired. The goodwill generated is attributable to the assembled workforce and the expected growth and cost synergies and the expected contribution to the Company’s overall strategy. The goodwill recognized that is expected to be deductible for income tax purposes is approximately $ 80.0 million. The fair value associated with definite-lived intangible assets was $ 34.1 million, comprised of $ 33.9 million in risk contracts and $ 263,000 in trademarks. The definite-lived intangible assets will be amortized ranging from one to six years . The Company’s net revenue and loss before income taxes for the year ended December 31, 2021 included revenues of $ 148.0 million and net income before taxes of $ 4.1 million related to IMC. No material measurement period adjustments related to the acquisition of IMC were identified during the years ended December 31, 2022 and 2021. Refer to Note 5, Goodwill and Other Intangible Assets , for a summary of measurement period adjustments. Acquisition of SMA Entities On June 18, 2021, the Company completed the acquisition of 100 % of the issued and outstanding equity interests of Senior Medical Associates, LLC, a Florida limited liability company (“SMA”), and Stallion Medical Management, LLC, a Florida limited liability company (“the SMA Acquisition”). The purchase consideration was comprised of the following ( in thousands ): Cash consideration (1) $ 52,000 Share consideration (2) 5,027 Total consideration $ 57,027 (1) Represents cash consideration of $ 52.0 million inclusive of $ 2.5 million held in escrow and $ 145,000 in SMA seller transaction cost. (2) Represents equity consideration of 384,615 shares of Class A Common Stock valued at $ 5.0 million based on the June 18, 2021 closing price of $ 13.07 . The SMA Acquisition was recorded as a business combination under ASC 805 with identifiable assets acquired and liabilities assumed recorded at their estimated fair values as of the acquisition date. The following table summarizes the purchase consideration and the fair value of the assets acquired and liabilities assumed, as recorded as of December 31, 2021 ( in thousands ): Cash $ 73 Accounts receivable 1,830 Property and equipment 178 Intangible assets 9,404 Other assets 29 Accounts payable and accrued expenses ( 178 ) Net assets acquired 11,336 Excess of consideration over net assets acquired 45,691 Total consideration $ 57,027 Goodwill was recognized as the amount of consideration transferred in excess of the fair value of net assets acquired. The goodwill is primarily attributed to our assembled workforce, the expected growth and cost synergies and the expected contribution to the Company’s overall strategy. The goodwill recognized that is expected to be deductible for income tax purposes is approximately $ 45.0 million. The Company incurred and expensed acquisition-related transaction costs of $ 682,000 related to the SMA Acquisition that were paid by the Company. The fair value associated with definite-lived intangible assets was $ 9.4 million, comprised of $ 8.7 million in risk contracts, $ 622,000 in non-compete agreements and $ 92,000 in tradenames. The definite-lived intangible assets will be amortized over periods ranging from one to six years . The Company’s net revenue and loss before income taxes for the year ended December 31, 2021 included revenues of $ 12.0 million and net income before taxes of $ 564,000 related to SMA. No material measurement period adjustments related to the acquisition of SMA were identified during the years ended December 31, 2022 and 2021. Refer to Note 5, Goodwill and Other Intangible Assets , for a summary of measurement period adjustments. Acquisition of DNF On September 1, 2021, the Company acquired 100 % of the assets of Unlimited Medical Services of Florida, LLC, a Florida limited liability company, dba DNF Medical Centers ("DNF"), for total purchase consideration of $ 114.2 million (the "DNF Acquisition"). The purchase consideration was comprised of the following ( in thousands ): Cash consideration (1) $ 88,118 Share consideration (2) 26,072 Total consideration $ 114,190 (1) Represents cash consideration of $ 88.1 million inclusive of $ 11.0 million held in escrow and $ 242,000 in DNF seller transaction costs. (2) Represents equity consideration of 2,741,528 shares of Class A Common Stock valued at $ 26.1 million based on the September 1, 2021 closing price of $ 9.51 . The DNF Acquisition was recorded as a business combination under ASC 805 with identifiable assets acquired recorded at their estimated fair values as of the acquisition date. The following table summarizes the purchase consideration and the fair value of the assets acquired and liabilities assumed, as recorded as of December 31, 2021 ( in thousands ): Accounts receivable $ 3,732 Property and equipment 3,520 Intangible assets 15,329 Other assets 65 Net assets acquired 22,646 Excess of consideration over net assets acquired 91,544 Total consideration $ 114,190 Goodwill was recognized as the amount of consideration transferred in excess of the fair value of net assets acquired. The goodwill generated is attributable to the assembled workforce and the expected growth and cost synergies and the expected contribution to the Company’s overall strategy. The goodwill recognized that is expected to be deductible for income tax purposes is approximately $ 90.0 million. The Company incurred and expensed acquisition-related transaction costs of $ 1,247,000 related to the DNF Acquisition that were paid by the Company. The fair value associated with definite-lived intangible assets was $ 15.3 million, comprised of $ 13.2 million in risk contracts, $ 1.5 million in non-compete agreements, and $ 638,000 in trademarks. The definite-lived intangible assets will be amortized ranging from one to six years . The Company’s net revenues and loss before income taxes for the year ended December 31, 2021 included revenue of $ 19.5 million and net loss before income taxes of $ 687,000 related to DNF. No material measurement period adjustments related to the acquisition of DNF were identified during the years ended December 31, 2022 and 2021. Refer to Note 5, Goodwill and Other Intangible Assets , for a summary of measurement period adjustments. Acquisition of Advantis On December 22, 2021, the Company acquired 100 % of the assets of Advantis Physician Alliance, LLC, dba Advantis Medical Centers ("Advantis") for total purchase consideration of $ 11.0 million (the "Advantis Acquisition"). The purchase consideration was comprised of the following ( in thousands ): Cash consideration (1) $ 9,865 Share consideration (2) 1,107 Total consideration $ 10,972 (1) Represents cash consideration of $ 9.9 million inclusive of $ 900,000 held in escrow and $ 60,000 in Advantis seller transaction costs. (2) Represents equity consideration of 145,883 shares of Class A Common Stock valued at $ 1.1 million based on the December 22, 2021 closing price of $ 7.59 . The Advantis Acquisition was recorded as a business combination under ASC 805 with identifiable assets acquired recorded at their estimated fair values as of the acquisition date. The following table summarizes the purchase consideration and the fair value of the assets acquired and liabilities assumed, as recorded as of December 31, 2021 ( in thousands ): Accounts receivable $ 242 Property and equipment 18 Intangible assets 1,064 Other assets 20 Net assets acquired 1,344 Excess of consideration over net assets acquired 9,628 Total consideration $ 10,972 Goodwill was recognized as the amount of consideration transferred in excess of the fair value of net assets acquired. The goodwill generated is attributable to the assembled workforce and the expected growth and cost synergies and the expected contribution to the Company’s overall strategy. The goodwill recognized that is expected to be deductible for income tax purposes is approximately $ 9.5 million. The Company incurred and expensed acquisition-related transaction costs of $ 671,000 related to the Advantis Acquisition that were paid by the Company. The fair value associated with definite-lived intangible assets was $ 1.1 million, comprised of $ 345,000 in risk contracts, $ 544,000 in non-compete agreements, and $ 176,000 in trademarks. The definite-lived intangible assets will be amortized ranging from one to six years . As the acquisition was consummated on December 22, 2021, Advantis did not materially contribute net revenues or net income before income taxes during the year ended December 31, 2021. No material measurement period adjustments related to the acquisition of Advantis were identified during the years ended December 31, 2022 and 2021. Refer to Note 5, Goodwill and Other Intangible Assets , for a summary of measurement period adjustments. Acquisition of Business Intelligence & Analytics LLC ("BIX") On December 22, 2021, the Company acquired 100 % of the assets of Business Intelligence & Analytics LLC ("BIX") for total purchase consideration of $ 5.1 million, subject to final closing adjustments (the "BIX Acquisition"). The purchase consideration was comprised of the following ( in thousands ): Cash consideration (1) $ 4,000 Share consideration (2) 1,124 Total consideration $ 5,124 (1) Represents cash consideration of $ 4.0 million. (2) Represents equity consideration of 148,104 shares of Class A Common Stock valued at $ 1.1 million based on the December 22, 2021 closing price of $ 7.59 . The BIX Acquisition was recorded as a business combination under ASC 805 with identifiable assets acquired recorded at their estimated fair values as of the acquisition date. The following table summarizes the purchase consideration and the fair value of the assets acquired and liabilities assumed, as recorded as of December 31, 2021 ( in thousands ): Intangible assets $ 289 Net assets acquired 289 Excess of consideration over net assets acquired 4,835 Total consideration $ 5,124 Goodwill was recognized as the amount of consideration transferred in excess of the fair value of net assets acquired. The goodwill generated is attributable to the assembled workforce and the expected growth and cost synergies and the expected contribution to the Company’s overall strategy. The amount allocated to goodwill and intangible assets is subject to final adjustment to reflect the final valuations. The goodwill recognized that is expected to be deductible for income tax purposes is approximately $ 5.0 million. The Company did no t incur or expense material acquisition-related transaction costs that were paid by the Company. The fair value associated with definite-lived intangible assets was $ 289,000 , comprised of $ 235,000 in patents/developed technology, $ 3,000 in trademarks, and $ 35,000 in non-compete agreements. The definite-lived intangible assets will be amortized ranging from one to five years . $ 16,000 in In-Process Research and Development was classified as an indefinite lived intangible asset. As the BIX Acquisition was consummated on December 22, 2021, BIX did not materially contribute net revenues or net income before income taxes for the year ended December 31, 2021. No material measurement period adjustments related to the acquisition of BIX were identified during the year ended December 31, 2022. Refer to Note 5, Goodwill and Other Intangible Assets , for a summary of measurement period adjustments. Other Acquisitions During the year ended December 31, 2021, we acquired 100 % of three additional businesses. The acquisitions were accounted for as business combinations and the overall impact to our consolidated financial statements was not considered to be material. The fair value associated with definite-lived intangible assets from the acquisitions was $ 1.4 million. On a combined basis, the Company incurred and expensed acquisition-related transaction costs of $ 250,000 related to the acquisitions that were paid for by the Company. The total fair value of consideration paid or payable for these three acquisitions was $ 3.7 million. No material measurement period adjustments related to these acquisitions were identified during the year ended December 31, 2022. Refer to Note 5, Goodwill and Other Intangible Assets , for a summary of measurement period adjustments. |