Nov. 12, 2020 8:30 AM EST
Rob Horrar - President & CEO
David Watson - CFO
Conference Call Participants
Endri Leno - National Bank Financial
Doug Miehm - RBC Capital Markets
Chelsea Stellick - Industrial Alliance Securities
Good morning, everyone. Welcome to the Medical Facilities Corporation's 2020 Third Quarter Earnings Call. After management's remarks, this call will include a question-and-answer session, whereby qualified equity analysts will be permitted to ask questions.
Before turning the call over to management, listeners are reminded that certain statements made in today's call, including responses to questions may contain forward-looking statements within the meaning of the Safe Harbor provisions of Canadian Provincial Securities laws. Forward-looking statements involve risks and uncertainties and undue reliance should not be placed on such statements.
Certain material factors or assumptions are applied in making forward-looking statements, and actual results may differ materially from those expressed or implied in such statements. For additional information about factors that may cause actual results to differ materially from expectations and about material factors or assumptions applied in making forward-looking statements, please consult the MD&A for this quarter, the Risk Factors section of the annual information form and Medical Facilities' other filings with Canadian Securities Regulators. Medical Facilities does not undertake to update any forward-looking statements. Such statements speak only as of the date made.
Please note, that today's call is being broadcast live over the internet and the webcast will be available for replay beginning approximately one hour following the completion of the call. Details of how to access the webcast replay are available in this morning's news release announcing the company's financial results.
I would now like to turn the meeting over to Mr. Rob Horrar, President and CEO of Medical Facilities. Please go ahead, Mr. Horrar.
Good morning, everyone, and welcome to our third quarter earnings call. Joining me today is David Watson, our Chief Financial Officer. Earlier this morning, we released our third quarter results. Our news release, financial statements and MD&A are available on our website and had been filed with SEDAR.
There have been many challenges to our healthcare system this year. However, all things considered, we were pleased with our third quarter results. Today, we reported total revenue and other income of $98.8 million, which was up 2.4% from Q3 of last year. This figure includes $2.5 million of additional government stimulus income recognized by our surgical hospitals and ambulatory surgery centers during the quarter.
The relief funding had a smaller impact to our revenue and other income this quarter compared to Q2. Nevertheless, the funds were again meaningful and very much appreciated. It is important to highlight that excluding the relief funding, our third quarter adjusted EBITDA was in line with the same quarter last year. While facility service revenue was down $0.2 million compared to quarter three of last year, surgical case volume continued to rebound closer to pre-COVID levels. We also benefited from favorable changes in case and payer mix during the quarter. Contributing to our improved profitability for the quarter, our physician partners continued to manage costs to the extent possible. We also continue to benefit from the successful execution of our strategy over the past year, improving operations at our existing facilities, focusing on markets where we see the most potential for long-term growth and selling down or exiting non-strategic and underperforming assets, while at the same time strengthening our balance sheet.
We're now in what is typically our busiest time of the year, the fourth quarter. The rebound we saw in the third quarter continued through October. However, uncertainty remains around the increased COVID-19 infection rates nationally. We do not know how long the pandemic will last or what the potential material impact COVID-19 may have on our future operations and financial results. But we are certainly in a better position to withstand the impact because of the moves and decisions we made over the past year. We're also better prepared than we were at the start of the pandemic. Our facilities have robust screening and testing capabilities, and currently have access to the supplies and PPE they need to provide safe and outstanding care to patients. Our managing physicians and healthcare professionals have shared lessons learned over the past several months to ensure they're able to continue to provide our services to patients who need them.
Each of our facilities continues to take every precaution to ensure they remain safe places for physicians, staff and patients. Regardless of the challenging environment, we are focused on growing MFC and seeking opportunities to execute our ASC platform growth strategy. In September, we were pleased to announce that the St. Luke's Surgery Center of Chesterfield officially opened and completed its first cases. The new multi- specialty ASC is jointly owned by MFC, St Luke's Hospital and local physicians. While the timing was delayed due to the pandemic, we are pleased with our progress at the new ASC and look forward to ramping up over the next several months.
Finally, we continue to have a robust pipeline of acquisition targets and remain focused on adding scale to our platform. And with that, I would like to turn the call over to David to review our financial results for the quarter. David?
Thanks Rob, and good morning, everyone. As usual, a reminder that all dollar amounts expressed in today's call are in US dollars unless otherwise stated. I'll discuss our third quarter financial performance then provide an update on our balance sheet and liquidity. The pandemic did continue to affect the volume of elective surgeries in some facilities during the quarter. However, this was partly offset by the combined impact of favorable case and payor mix, as well as the recognition of additional government stimulus income of $2.5 million received by facilities during the quarter. As Rob mentioned, surgical case volumes continue to rebound in the third quarter, but were down 3.5% from the same quarter last year. The largest decrease was in inpatient cases, which declined 5.3%, while outpatient cases were down 4.4%. Observation cases on the other hand, increased by 19.3%.
Our total revenue and other income for the quarter, which includes the $2.5 million of government stimulus income was $98.8 million. This represents an increase of $2.3 million or 2.4% compared to the third quarter of 2019.
Facilities service revenue for the quarter totaled $96.3 million, down 0.2% from the same quarter last year. As a reminder, within the government stimulus income, the loan amounts received by Facilities for PPP program are eligible for forgiveness to the extent they were used for certain qualifying expenses and to maintain payroll levels and related costs. While our Facilities believe they've met the qualifications, there can be no assurances that the loans will be forgiven until applications are submitted and their review process completed.
Operating expenses for the quarter totaled $81.2 million, representing a decrease of $22.2 million, or 21.5% compared to the third quarter of last year. Almost all the decrease relates to a goodwill impairment charge taken in the third quarter of last year that was not repeated in the current quarter. As a percentage of total revenue and other income, operating expenses decreased to 82.2% from 107.2% for the comparable period. Within operating expenses, the next largest variance was in general and administrative expenses, which decreased by $2.1 million, or 13.9%. This reduction resulted primarily from a decrease in a loss from a lease termination in the prior year, lower physician recruitment costs and a gain on the sale of Two Rivers Surgical Center.
As a percentage of total revenue and other income, G&A decreased to 12.9% from 15.4% a year ago. EBITDA for the quarter was $24.6 million, or 24.9% of revenue, compared to $0.4 million or 0.4% of revenue in the third quarter of last year. During the quarter, we generated cash available for distribution, totaling $12.7 million Canadian dollars, resulting in a payout ratio of 17.1%. This represents a significant improvement over the prior year payout ratio of 165.3%. We approach the end of the year with a strong balance sheet, well positioned for the opportunities and challenges that may arise. As of September 30, we had approximately $83.4 million of cash and equivalents. Of this amount $23.2 million represents advances from Medicare that will be offset against future billings. Excluding the Medicare advances, total Facilities cash was $35.6 million and MSC corporate cash was $24.6 million.
At the end of the quarter, debt outstanding on the corporate credit facility totaled $58.8 million, after reducing it by $26 million in July with proceeds from the sale of the UMASH real estate. Net debt to adjusted EBITDA leverage was 1.06 as of September 30, after netting out available cash. This concludes my review of the third quarter financial results. For additional detail, including specific results for each facility, please refer to our MD&A. We would now like to open the call for questions. Operator?
Your first question comes from Endri Leno with National Bank.
Hi, good morning, guys. Thanks for taking my questions. So a few for me actually; so I'll start at the facility level. But it appears that OSH was the only one that's not received government support. Is there any particular reason for that?
No. OSH has received government support. I just don't believe they recognized any this quarter.
Okay, so there will be some and definitely figure in -- another -- of my other questions. But how much of this government support will then be recognized in Q4, or is there any left?
No. They, unless there's additional stimulus. They recognized the stimulus they received in the second quarter.
Okay, great. Thank you. And all the other obstacles that you recognized in the quarter. I mean, can you at least provide some sort of directionality or broad breakdown of how it was distributed between the other hospitals, which funded your system or the most on facility?
Endri, we don't have that breakout handy at the moment.
Okay. But just kind of very broadly. I mean, are we to assume, for example, that ASH received the most since they performed better than everybody else, or can we make that statement?
No, no, actually. So ASH received about $0.5 million, Sioux Falls and Black Hills, both about $900,000.
Okay, thank you. And then in terms of the cases that you saw in Q3 and this trend that you're seeing continuing into October. Do you have any kind of inclination or indication of how many of these cases were scheduling from Q2 and how many are sort of your normal course procedures for Q3 and even into October?
Yes. For the most part, Endri, we have seen a little bit more -- most of our, I guess, backlog if you’ll call it has occurred in the second quarter, we did see some more in terms of rescheduling for the most part, though, those volumes have rebounded, as we said, it's new cases, the clinic volumes are rebounding. So for the most part, the majority of the volumes were generated in the quarter.
Okay, yes, great. Thank you. And I mean, still on that kind of cases and volume, but outside of the planned procedures or even the rescheduling, I mean, but can you provide any color? What would you say are some cases that would be sort of permanently lost, like, for example, cases from contact sports or fewer people driving to work and things of that nature?
Well, for the most part, if the case is medically necessary, Endri it’s going to get done. I think at this point, in terms of any type of a backlog, it would be just those patients that have less of an acute surgery that's pending, and perhaps they don't feel comfortable at this point having the procedure done in any setting. So that's certainly the minority, but for the higher acute necessary cases, and we see those continuing to come back and get done and get scheduled.
Okay, so you're still adding a few, right, you said, of the least acute ones, you're still adding a few to the quote / unquote, backlog?
I think the color on that is that are those patients particularly the higher risk age categories that are reticent. And we will probably… our estimation and the feedback we get from the markets and hospitals and clinics is that they'll see those, when there's more clarity on the COVID surge here, and when they feel more comfortable coming back. In the fourth quarter; in the first quarter next year and into the spring.
Okay, no, thanks for the color. And as far as COVID cases, South Dakota is reporting some of the highest cases and positivity rates in the country. I mean, are you seeing an impact of patients deferring procedures particularly into the hospitals in that market.
Well, Endri, you can see by the results that you continue to see a fair number of patients coming through, as I've said, they're no different than any other market, patients who don't feel comfortable, but our facilities are taking every precaution. We don't treat COVID patients; they have robust testing and screening, and are considered, very, very safe places in terms of that every facility has testing and screening capabilities, not only pre-surgically for patients, but also for staff and for physicians as well. So I think that is a very big positive for us. In fact, we've had anecdotally here recently, calls from physicians who are not a part or owners in the hospitals, to do cases in our facility as hospitals are starting to be impacted on their elective cases. So it's a good fact for us.
Okay, great. Thank you. And as a continuation to the answer you gave, Rob, I mean could that kind of be segue for you to add some of the doctors to the hospitals?
Well that would be the hope. I think in the short term, the answer is that is yes. And the long term would be remains to be seen.
Okay. Great. Thank you. The next question is on the acquisitions. I mean, you mentioned that you continue to evaluate for acquisitions out there. I mean can you do anything during the pandemic over the next two or three months? I mean can you do due diligence and is anybody active? Or is this more of a long-term target, let's say, second half of 2021 something of that nature?
Of course, COVID has presented a challenge for everyone in the industry in evaluating the impact on acquisitions. But we have seen, continued to see pipeline opportunities for us. And so it's very, it's what we just described as robust. But I'll tell you that there's a fair amount of work that we're doing and we'll continue to do around due diligence and evaluating those opportunities for the company, but they do exist in a fairly robust fashion.
Okay, great. Thank you and the last one for me. If you can talk a little bit and perhaps I missed it because I got in a bit late in the call, but the strategic rationale for selling the Two Rivers ASC and are there other divestments on the table for other ASCs?
Well, we will always make the best decisions for the shareholders and for the company. And we're focused on our growth. So, I'll tell you that's our first goal. The divestitures we made this year were facilities where in which circumstances changed, or they were no longer markets where we saw a lot of growth opportunity. And in the case of Unity, it made sense to sell more ownership, and that to strengthen the partnership, so those were strategic, they were -- strengthen the company going forward, and we’ll always make those decisions, but we’re focused on growing the company.
Next question comes from Doug Miehm with RBC Capital Markets.
Yes. Thank you. Just to continue on the commentary around acquisitions. First off, have you seen any change in terms of multiples during this period? And is it making it a challenge for you to get things done? And then secondly, as it relates to acquisitions; could you tell us if there's anything that the company has learned as it relates to the Unity situation, or Nueterra that is helping you guide your look for new acquisitions and how you're going to approach those?
Sure, just the first part of that, is that multiples really have not changed. I think in terms of, where acquisitions want to be and where the market is that they're, you evaluate this in terms of neutralizing the COVID impact. And so on the acquisition front, that's the case. When we do see and we talk about acquisitions, we also need to talk about development, and that is the new de novo projects like St. Luke's. And there is a great opportunity. We've talked about many times there are 5,500 ASCs in the country today. And we expect that number to double over the next decade. So significant opportunities on the new development front, which as you know take some time to develop and syndicate, but are essentially the cost of equipment and development of those centers.
So that is an important part of our growth strategy. The acquisition front lessons learned. Number one is clearly our platform will benefit from scale, in terms of circumstances changing and partnerships that happens in a smaller partnership, those with larger scale have less impact. And so scale is our number one priority for that. And I think that we've got a good platform, a lot of experience in that in evaluating both the acquisitions and the de novo opportunities for the company.
Okay, great. And then just my last question has to do with, you touched on this a little bit, but the benefit you might be seeing as a result of the severity or acuity of cases that community hospitals are seeing with respect to COVID… Is it reasonable to assume that you may be seeing over index number of patients for procedures as they try to identify hospitals, surgical hospitals that are not dealing with the cases directly?
Well, I will tell you this, that as a part of our Q3 results, we haven't really seen any of that impact from physicians or partners that are not a part of our existing partnership. I think the opportunities we mentioned, called out presents itself, as hospitals are starting to reduce their elective procedures. I think that's an opportunity. We don't know; we don't have any color in terms of what size that may be going forward. But we do know in a number of our market, several of our markets, that there is a demand for elective cases, and to the extent that cannot be done in the hospital -- acute care setting, that we've got the venue to do that. And so going forward, we see that as a potential add on.
The next question comes from Chelsea Stellick with IA Securities.
Hi, good morning, gentlemen. So I know we've kind of been talking all year about pent-up demand happening in the fourth quarter and since it's traditionally your busiest quarter, as well, I'm just wanting to see how that's going to shake out as we're seeing COVID cases rise in the US. How are you handling any additional stresses on the system and backlog potential as patients who are unable to be treated during the lockdown, combined with normal patients? What's that looking like, are you evaluating that on a center by center basis? Or is there sort of like a company-wide plan to handle any backlogs?
Well, it is clearly individual market and individual facility level. For right now, Chelsea, we're not yet to 2019 levels. We do expect that the fourth quarter will be fairly robust as it always is for us. And so hospitals are gearing up for that in terms of staffing, adequacy and PPE, but I'll tell you that the impact of COVID, that it has today and the potential for the fourth quarter is something that remains uncertain and we will continue to track going forward.
Yes. I figured that would be the answer. Also, I've had some conversations lately, just about how in the US there's been, because there's been a lot of layoffs, there's been sort of a shift in the ability to acquire good talent at a good rate. Are we seeing this in this space? Are we seeing the ability to staff up about lower expenses and what not?
That's certainly one of the challenges going forward, it's not necessarily that we don't have the staff. It will be important challenge in the fourth quarter in terms of how COVID impacts the staff in terms of family members being ill, or the need to quarantine. All of our facilities have plans around that, and very detailed plans on how to address staffing and staffing challenges with both the demand for patients in the fourth quarter. We feel they're as prepared as they can be for those challenges, as well as maintaining, again, a robust screening and testing and safe environment and having supplies necessary to take care of those patients.
Perfect, thank you. I think most of my questions have been answered previously. But I guess my last question, just in terms of the ramp up for St. Luke's. Can you give us sort of a picture of what that curve is going to look like in the fourth quarter, H1 2021 kind of deal?
I'll tell you the normal cadence for a ramp up… an ASC will do its first cases, they'll obtain its Medicare certification. And then after that, they'll receive various accreditations that they'll need, and then subsequent to that they'll be eligible and sign up for the managed care commercial plan insurance plans. So that generally that cadence is generally three to six months that's built into our pro forma and our ramp up on any de novo. We are very pleased with the progress of St. Luke's; we added four to five new physicians to that partnership above where we had anticipated opening. So our hope and our belief is that will ramp up a little quicker than we had planned. So it's a good fact for us.
And at this time, I'll turn the call over to Mr. Horrar for closing remarks.
Thank you, operator. We appreciate everyone joining the call this morning. And look forward to reporting on our progress again next quarter. Before we go, I wanted to say how proud we are of the performance of our surgical hospitals and ASCs during this pandemic. It certainly has not been easy. And I wanted to acknowledge and thank the teams at each of our facilities, including our physician partners, and all medical professionals and employees. Keep well and stay safe. Thank you.
This concludes today's conference call. You may now disconnect.
Akumin Inc. (NASDAQ: AKU) (TSX: AKU) ("Akumin" or the "Corporation") announced today its financial results for the quarter ended September 30, 2020 ("Q3 Fiscal 2020").
Commenting on the Q3 Fiscal 2020 financial results, Riadh Zine, President and Chief Executive Officer of the Corporation, said, "During the quarter ending September 30, 2020 we generated revenue of $67.1 million and Adjusted EBITDA of $17.8 million. On a sequential quarter basis, RVU volume increased approximately 36% versus that in Q2 Fiscal 2020, which was severely impacted by the lockdowns implemented due to the COVID-19 pandemic. This strong recovery is validation of Akumin's platform as an essential healthcare service provider.
"Akumin's volume in Q3 Fiscal 2020 was approximately 1,490,000 RVUs, compared to approximately 1,435,000 RVUs in Q3 Fiscal 2019, an increase of 4%. On an organic volume basis, RVUs decreased by 8% compared to the same prior period," Mr. Zine continued. The Corporation reports the volume of procedures performed in its diagnostic imaging centers based on relative-value units, or RVUs, instead of the number of procedures. RVUs are a standardized measure of value used in the U.S. Medicare reimbursement formula for physician services which provides weighting to distinguish the complexity of different procedures. In addition, we finished the quarter with $27.4 million cash-on-hand."
"As announced on November 2, 2020, Akumin closed its offering of $400 million in 7% senior secured notes due 2025 and a new revolving credit facility of $55 million. The proceeds of the notes were used to refinance all of Akumin's credit facilities with excess cash proceeds for general corporate purposes. Our access to the U.S. debt capital markets is another major milestone in the Company's execution of its U.S. capital markets strategy. These notes provide us with a flexible balance sheet, a platform for funding future growth, and a broadening of our investor base. We sincerely thank our Joint Book-Running Managers, Barclays, Citigroup, Morgan Stanley and BBVA for their support in this financing, as well as Co-Managers Raymond James, Craig-Hallum Capital Group and William Blair. We also take this opportunity to express our appreciation for all the lenders and institutions that have supported the capital structure of the Company to date."
Akumin is a leading provider of freestanding, fixed-site outpatient diagnostic imaging services in the United States with a network of owned and/or operated imaging centers located in Florida, Texas, Pennsylvania, Delaware, Illinois, Kansas and Georgia. By combining our clinical expertise with the latest advances in technology and information systems, our centers provide physicians with imaging capabilities to facilitate the diagnosis and treatment of diseases and disorders and may reduce unnecessary invasive procedures, minimizing the cost and amount of care for patients. Our imaging procedures include MRI, CT, positron emission tomography (PET), ultrasound, diagnostic radiology (X-ray), mammography, and other interventional procedures.
Source: Akumin Inc.
Appili Therapeutics Joins Dr. Reddy’s, Global Response Aid, and FUJIFILM in Advancing Avigan Tablets for the Potential Treatment of COVID-19
Consortium brings together world-class and globally coordinated clinical development, commercialization, cGMP manufacturing, and l logistics expertise to accelerate the deployment and availability of Avigan® tablets for the potential treatment and prevention of COVID-19
Appili Therapeutics Inc. (TSX: APLI; OTCQX: APLIF) (the “Company” or “Appili”), a biopharmaceutical company focused on anti-infective drug development, today announced that it has signed a collaboration, development and supply agreement with Dr. Reddy’s Laboratories Ltd. (BSE:500124, NSE:DRREDDY, NYSE:RDY, “Dr. Reddy’s”) and Global Response Aid (“GRA”). This agreement follows on and is harmonized with the previously announced global licensing transaction (excluding Japan, Russia, and China) between DRL, GRA and FUJIFILM Toyama Chemical Co., Ltd. (“FFTC”), the originator of Avigan® tablets. The agreements work together to coordinate and accelerate the worldwide development, commercialization, and distribution of Avigan® tablets (favipiravir) for the potential treatment and prevention of COVID-19.
In joining the global consortium to advance Avigan®, Appili will assume key responsibilities for the design and implementation of the consortium’s global clinical programs and related work, including, but not limited to, the design and implementation of multiple pivotal Phase 3 trials to enable regulatory submission, review, and, if supported by data, approvals for the use of Avigan® tablets in the treatment or prevention of COVID-19 in the US, Canada and internationally. The clinical development strategy will focus on evaluating Avigan® tablets for early treatment and post-exposure prophylaxis in the community setting.
Dr. Reddy’s and GRA will continue to be responsible for the research and development, manufacturing, commercialization, and distribution of Avigan®. FFTC is the innovator that originally developed Avigan® for use in pandemic influenza and is supplying its knowledge base, including clinical data and intellectual property, in support of the consortium’s operations. In collaboration with its partners, Appili will design and oversee Phase 3 clinical trials to support regulatory submissions worldwide. Appili will be responsible for the US and Canadian clinical trials conducted on behalf of the consortium and will receive a profit share on all US and Canadian sales for a specified term. Appili is also eligible to receive royalties on sales in Europe and Latin America for a specified term.
“To address the ongoing threat of COVID-19 we must not only identify effective agents through rigorous clinical evaluation, we must also ensure they are widely available, which is a particular challenge in COVID-19, where billions of people from every corner of the globe are at risk from this threat,” said Dr. Armand Balboni, Chief Executive Officer at Appili Therapeutics. “This consortium is designed to do just that, with world-class expertise not only in drug development but also in manufacturing and commercialization to support access. We are thrilled to join this group of industry leaders in their global effort, contributing our drug development expertise and extensive experience with Avigan® to accelerate its development on a globally coordinated basis. We look forward to the timely outcomes of our ongoing and soon-to-be initiated late-stage clinical trials to evaluate Avigan® as the first orally available anti-viral treatment option for COVID-19.”
Appili has previously announced a Phase 2 trial evaluating the use of favipiravir to control outbreaks of COVID-19 in long-term care facilities and a Phase 3 trial in the United States evaluating the use of Avigan® for the early treatment of patients with mild-to-moderate COVID-19 symptoms. Working with the consortium, Appili expects to expand its favipiravir clinical programs internationally.
About Avigan® (favipiravir)
Avigan® (favipiravir) is a broad-spectrum antiviral in oral tablet form developed by FUJIFILM Toyama Chemical Co., Ltd. (FFTC) and approved in Japan as a treatment and stockpile countermeasure for pandemic influenza under the name Avigan®. Following promising clinical studies, Russia and India recently approved favipiravir-based antiviral medications for the emergency treatment of COVID-19.[i] [ii] FFTC recently announced positive Phase 3 data in the use of AVIGAN in hospitalized COVID-19 patients. In a previously announced agreement, Dr. Reddy’s and GRA received a license from FFTC for the manufacturing, development, and commercial rights to favipiravir outside of Japan, China, and Russia.
Additional clinical trials for favipiravir in COVID-19 are ongoing in the United States, China, India, and the United Kingdom. Unlike most other interventions that researchers are evaluating in the COVID-19 indication, favipiravir has already been thoroughly studied in human trials outside of North America and has a known safety profile, with over 3,000 subjects receiving at least one dose of the drug. Favipiravir’s oral tablet form may also provide advantages in the community setting over other COVID-19 interventions, which often require injection or intravenous administration.
Source: Appili Therapeutics Inc.
DARTMOUTH, Nova Scotia--(BUSINESS WIRE)-- IMV Inc. (Nasdaq: IMV; TSX: IMV), a clinical-stage biopharmaceutical company pioneering a novel class of cancer immunotherapies and vaccines against infectious diseases, provides further details today on the Company’s rapid progress in developing its candidate vaccine to prevent COVID-19 infection in response to the global health threat posed by the novel coronavirus.
“We are working closely with regulatory agencies and our collaborators to initiate clinical studies as quickly as possible. The design of the phase 1 clinical study, agreed with Health Canada, is a randomized controlled study, assessing the safety and immunogenicity of DPX-COVID-19, in 84 healthy adults across two age cohorts: (1) adults between 18-55 years old inclusive and (2) 56 and above. Two dose levels of DPX-COVID-19 will be tested (25μg or 50μg). We are pleased that Health Canada has welcomed the design of a phase 1 trial that includes this vulnerable population.”
The rapid progress in target selection, the vaccine formulation, manufacturing and preclinical results so far not only demonstrate the potential of our delivery platform, but also build on our previously reported clinical data from a similarly designed vaccine against RSV, the respiratory syncytial virus,” says Frederic Ors, Chief Executive Officer at IMV. “Clinical results1 have shown our DPX-based vaccine against RSV demonstrated a unique ability to generate safe and long-lasting immune responses in older adults.”
IMV’s candidate vaccine, DPX-COVID-19, is based on IMV’s first-in-class delivery platform that generates targeted and sustained immune response in vivo. Fully synthetic, the vaccine candidate is designed to focus the immune response on the weaknesses of the virus with the goal to optimize safety and efficacy:
Areas on the virus spike identified as potentially responsible for vaccine-enhanced disease4 have been excluded from our target selection to minimize safety risk.
Since the Company announced the selection of its candidate vaccine on May 21st, the Company has made significant progress.
Next milestones are anticipated as we commence phase 1 clinical trials this summer with results in the Fall of 2020. Once results are published, we plan to initiate phase 2 clinical trials in the second half of the year.
DPX-COVID-19 is IMV’s vaccine candidate against the novel strain of coronavirus that is responsible for the current pandemic. It is a DPX-based formulation of multiple peptides of the SARS-CoV-2 that generated early and strong immune responses in preclinical assays in animal models. A first-in-human Phase 1 clinical study is scheduled to initiate during summer 2020. Fully synthetic, DPX-COVID-19 has the potential for fast and large-scale manufacturing to supply a significant number of doses rapidly compared to more conventional vaccines. For more information, visit our dedicated webpage to the development of DPX-COVID-19.
IMV Inc. is a clinical stage biopharmaceutical company dedicated to making immunotherapy more effective, more broadly applicable, and more widely available to people facing cancer and other serious diseases. IMV is pioneering a new class of cancer-targeted immunotherapies and vaccines based on the Company’s proprietary drug delivery platform. This patented technology leverages a novel mechanism of action that enables the programming of immune cells in vivo, which are aimed at generating powerful new synthetic therapeutic capabilities. IMV’s lead candidate, DPX-Survivac, is a T cell-activating immunotherapy that combines the utility of the platform with a target: survivin. IMV is currently assessing DPX-Survivac as a monotherapy in advanced ovarian cancer, as well as a combination therapy in multiple clinical studies with Merck. IMV is also developing a DPX-based vaccine to fight against COVID-19.
Source: IMV Inc.
Earlier today, CareRx Corporation (TSX: CRRX) announced the launch of Pharmacy At Your Door, a new digital business providing a safe and easy alternative for Canadians to meet their pharmacy needs without leaving their homes. The initial launch is focused in Calgary, Alberta.
“We are excited to bring the future of pharmacy to the greater Calgary area today,” said David Murphy, President and Chief Executive Officer of CareRx. “Pharmacy At Your Door leverages the market-leading institutional pharmacy and technology capabilities of CareRx to deliver a convenient, safe and cost effective at-home pharmacy experience. This new business will better serve seniors and other customers who have limited time, transportation challenges, concerns about visiting retail pharmacies in light of COVID-19, or need support managing multiple medications and vitamins.”
Pharmacy At Your Door supplies all products that would be found at a retail pharmacy while providing a convenient and safe way to obtain and take prescription medications. Under the supervision of CareRx licensed pharmacists, Pharmacy At Your Door organizes and packages customer medications and vitamins by date and dose using CareRx’s state-of-the-art EasyPac technology – delivering individual pre-packed medication pouches which ensure that the right medication is taken at the right time. Free, same-day home delivery is provided in a recyclable container, with secure, real-time GPS tracking of deliveries.
Registration is easy and only requires a short phone call with a CareRx customer care specialist or an online sign-up at www.pharmacyatyourdoor.ca. New prescriptions can be sent directly to CareRx by doctors, and existing prescriptions can be refilled and delivered with ease, with automatic refill reminders. There are no extra costs for using Pharmacy At Your Door, and CareRx also works directly with insurance companies to ensure coordination of plan coverage.
Pharmacy At Your Door is initially only available in the greater Calgary area, but will be expanded to other regions in Canada as the rollout progresses.
ABOUT CARERX CORPORATION
CareRx (formerly Centric Health Corporation) is Canada’s leading provider of specialty pharmacy services to seniors. We serve more than 50,000 residents in over 850 seniors and other communities (long-term care homes, retirement homes, assisted living facilities, and group homes). We are a national organization with a large network of pharmacy fulfillment centres strategically located across the country. This allows us to deliver medications in a timely and cost-effective manner and quickly respond to routine changes in medication management. We use best-in-class technology that automates the preparation and verification of multi-dose compliance packaging of medication, providing the highest levels of safety and adherence for individuals with complex medication regimes. We take an active role in working with our home operator partners to promote resident health, staff education, and medication system quality and efficiency.
For more information, visit www.carerx.ca.
Source: CareRx Corporation
Canada COVID-19 update
Earlier this week, the number of COVID-19 cases in Canada surpassed 105,900 with Québec reporting 55,937 cases, Ontario 35,948, Alberta 8,389 and British Columbia 2,978. To date, there have been 8,693 deaths across the country.
Health Canada recently warned that it has found counterfeit N95 respirators (sold by Shanghai Lansheng Light Industrial Products) with false approval labels on them. As the masks may not provide the level of protection they claim to, Health Canada has asked the company to stop selling the product and to issue a recall while provinces were urged to review supplies to ensure they meet safety requirements.
Alberta: While the province continues to monitor several small outbreaks in Calgary and Edmonton, a more serious situation is developing in the latter city where a hospital is now closed to new admissions following 18 patients and 14 staff testing positive. The easing of restrictions continues, however, across the province with outdoor gatherings of 200 now allowed, while the province will resume distribution of non-medical face masks in mid-July.
British Columbia: B.C. continues to be largely successful in controlling the spread of the virus while most the recent fatalities have been limited to longterm care centres. Although the province has not mandated the use of facemasks out of concern for those who have difficulty wearing one, it strongly recommends their use, particularly when social distancing is not possible.
Ontario: For the first time in three months, the province reported no new C-19 related deaths (July 6). It continues to move ahead with reopening plans as Industry Note NBCFM Research | July 7, 2020 the last two municipalities in the Windsor-Essex region are expected to move into Stage 2 on July 7. Officials also announced that alongside the reopening of the economy, the province will fast-track construction of highways and transit systems throughout (with a focus in the Greater Toronto Area) via a $2.6 billion plan. While the province is seeing gradual improvements, mayors from some of the largest cities remain concerned and have requested at least $10 billion in relief funding to avoid property tax increases, user fee hikes and cutting of public services. Several municipalities, including Toronto, Ottawa, Kingston, and others, have made the use of masks mandatory in indoor public spaces.
Québec: Following a cluster in the Greater Montréal area caused by two large house parties and spread to a bar, officials announced that they will increase police presence in reopened bars, clubs and other establishments to ensure customers are properly following distancing guidelines. The government is also expected to outline fines for non-complying customers and venues later this week while closures of establishment may also be possible. Montréal plans to introduce a bylaw by the end of July requiring face coverings in enclosed public spaces.
Toronto, Ontario, June 25, 2020 – CareRx Corporation (formerly Centric Health Corporation) (“CareRx” or the “Company”) (TSX: CRRX), Canada’s leading provider of specialty pharmacy services to seniors, completed its corporate rebrand today. CareRx also launched its new website at www.carerx.ca as well as its new logo and social media accounts on LinkedIn, Twitter and Facebook (@CareRxCorp).
“I am excited about our new brand and what it represents,” said David Murphy, President and CEO of CareRx. “Our new name perfectly encapsulates the common set of values and aspirations that our team shares as it relates to “caring” for all of our stakeholders – the residents that we serve, our home operator partners and their staff, and our employees.”
The new www.carerx.ca website offers users a welcoming and refreshed look, with easy navigation to essential information about CareRx’s business and service offerings tailored towards home operator partners, residents and their families, prospective employees and investors.
Over the next few months, the Company will be working to roll out the CareRx brand across all of its pharmacy banners as it seeks to create a unified, national organization.
The rebranding follows the Company's acquisition of Remedy Holdings Inc. and the Remedy'sRx Specialty Pharmacy business back in May.
ABOUT CARERX CORPORATION
CareRx (formerly Centric Health Corporation) is Canada’s leading provider of specialty pharmacy services to seniors. We serve more than 50,000 residents in over 850 seniors and other communities (long-term care homes, retirement homes, assisted living facilities, and group homes). We are a national organization with a large network of pharmacy fulfillment centres strategically located across the country. This allows us to deliver medications in a timely and cost-effective manner and quickly respond to routine changes in medication management. We take an active role in working with our home operator partners to promote resident health, staff education, and medication system quality and efficiency.
WELL Health Completes its Seventh EMR Acquisition with the Closing of Indivica Acquisition
VANCOUVER, B.C., June 1, 2020 - WELL Health Technologies Corp. (TSX: WELL) (the “Company” or “WELL”), a company focused on consolidating and modernizing clinical and digital assets within the healthcare sector, is pleased to announce that is has closed the previously announced acquisition of Indivica Inc. (“Indivica”), whereby the Company has acquired all of the issued and outstanding shares of Indivica (the “Transaction”). With the acquisition of Indivica, WELL expands its EMR services footprint to approximately 1,900 primary health medical clinics and 10,000 physicians across Canada.
“We are very pleased to welcome the talented team at Indivica to our WELL EMR Group,” said Hamed Shahbazi, Chairman and CEO of WELL. “Indivica is a proven and well-respected OntarioMD certified EMR vendor that has developed unique intellectual property to secure and support electronic records for medical clinics across Ontario.”
Indivica, founded in 2008 and based out of Toronto, Ontario, is a provider of fully hosted EMR software and services to 390 clinics serving over 2,000 physicians and medical practitioners in Ontario. Indivica has been a true innovator developing extensive intellectual property as it relates to innovative technological solutions related to appointment notification, patient communication, patient data federation amongst disparate clinics, automated submission and retrieval of Ontario Health Insurance Plan (OHIP) billings and reports, and real-time health card and fee service code reports. In the past twelve months, Indivica generated approximately $1.8M in revenue. It is expected that Indivica will produce, at minimum, double digit percentage EBITDA margin(2) with non-speculative post-acquisition synergies. Indivica’s CEO, Neil Baimel, will assist WELL with the transition of operations for a period of time following closing of the Transaction.
“We are delighted to complete this transaction and join the WELL Health family,” said Neil Baimel, CEO of Indivica. “We feel WELL shares our vision for innovation in the EMR market in Canada, and we believe this is a win for our customers.”
The total consideration paid by the Company in connection with its acquisition of Indivica is $6,200,000, subject to certain adjustments, and consisting of the following: (i)$3,410,000 paid in cash; (ii) $1,550,000 paid in common shares in the capital of the Company at a price of $3.10 per share; and (iii) a time-based cash earn-out of $1,240,000 payable within 120 days of the close of the Transaction. The Transaction was financed with cash on hand.
Source: WELL Health Technologies Corp.
Acquisition will make Centric Health the largest Canadian provider of specialty pharmacy services to seniors communities
TORONTO, March 24, 2020 – Centric Health Corporation (“Centric Health” or the “Company”) (TSX:CHH) announced today that it has entered into a definitive agreement to acquire Remedy Holdings Inc. (“RHI”) and the Remedy’sRx Specialty Pharmacy business, a leading specialty pharmacy serving more than 18,500 residents of long-term care, assisted living and other institutional settings across Ontario and Western Canada (the “Transaction”). RHI generated revenue of approximately $60 million for the 12-month period ended September 30, 2019. The Transaction also includes a pending acquisition by RHI which will contribute an additional 800 beds serviced. Upon closing, the Company will become the leading Canadian provider of specialty pharmacy services to seniors communities, serving over 50,000 residents.
“This transaction is the culmination of our strategic transformation in the past two years, and it marks the start of an exciting new chapter for our company,” said David Murphy, President and Chief Executive Officer of Centric Health. “We look forward to welcoming the Remedy’sRx Specialty Pharmacy team and customers. Together we can build on our respective strengths and provide a best-in-class service offering to home operators that improves health outcomes for the residents we serve. The combined business will be well positioned to accelerate growth and lead the consolidation of a fragmented industry. In addition to strengthening our existing national platform, this transaction will create opportunities to realize material synergies and generate substantial shareholder value as we integrate the businesses.”
“Remedy’sRx Specialty Pharmacy was founded on the principle of providing best in class care for the residents and customers that we have the honour of servicing,” said Bruce Moody, Founder and Chief Executive Officer of RHI. “There is no better step that we could have taken than to continue our mission with Centric Health, which will drive superior shareholder value. This is a very important day for Centric Health, Remedy’sRx Specialty Pharmacy and Canadian healthcare. The very talented Remedy’sRx Specialty Pharmacy team led by Jeff May are excited to be participants in this journey along with Centric Health.”
“The combined companies will present the best of both of our businesses to deliver industry-leading partnerships with home operators to drive optimal collaborative care,” said Jeff May, Executive Vice President & General Manager of RHI.
Centric Health also announced that it has entered into binding commitment letters with Crown Capital Partners Inc. (“Crown Capital”) and Yorkville Asset Management Inc. for and on behalf of certain managed funds (“Yorkville”) pursuant to which Crown Capital and Yorkville are expected to advance indebtedness to Centric Health to refinance its existing senior and subordinated credit facilities and fund the cash closing price of the Transaction.
“On behalf of the Board of Directors of Centric, we are pleased to welcome Bruce Moody and the Remedy’sRx Specialty Pharmacy team,” said Kevin Dalton, Chairman of the Company. “We are also grateful to Yorkville Asset Management for their continued partnership and support in enabling the execution of our growth strategy.”
“When we invested in Centric Health in 2019, we believed in the company’s strategy and management team and we committed to partnering with them to create the leading Canadian specialty pharmacy,” said Ralph Desando, Managing Director of Yorkville. “We are excited to support this transformative acquisition and proud to be part of the Centric growth story.”
Summary of the RHI Acquisition
On March 23, 2020, Centric Health entered into a share purchase agreement to acquire RHI for a purchase price of up to $44 million, comprised of:
As part of the Transaction, Mr. Moody will receive the right to nominate two directors to the Company's Board of Directors under certain circumstances and will be entitled to other customary governance rights, including pre-emptive rights and registration rights. Mr. Moody, as well as his second director nominee, will be included in the slate of directors for Centric Health’s 2020 Annual General Meeting.
The Transaction is expected to close in the second quarter of 2020, subject to customary closing conditions, including the receipt of applicable regulatory approvals and the consent of Centric Health shareholders. Under applicable Toronto Stock Exchange (“TSX”) policies, the Company is required to obtain shareholder approval for the Transaction, which the Company expects to satisfy by providing the TSX with written evidence that holders of more than 50% of the Common Shares support the Transaction.
In the event the Transaction does not close in certain circumstances, a termination fee may be payable by the Company in cash or, in certain circumstances, Common Shares.
In connection with the Transaction, Origin Merchant Partners and BDO Canada LLP acted as the financial advisers to Centric Health, and NewPoint Capital Partners acted as the financial adviser to RHI.
Summary of the Refinancing
The Company has signed a binding commitment letter with Crown Capital pursuant to which Crown Capital will advance credit facilities to the Company of up to $30 million in three tranches (the “Crown Capital Facilities”): (i) an initial tranche of $22 million, which will be used to repay the Company’s outstanding senior and subordinated debt facilities, (ii) a second tranche of $5 million, which will be used by the Company to fund a portion of the closing cash purchase price for the Transaction and (iii) a third tranche of $3 million upon the Company reaching certain financial milestones. Interest on the credit facilities will accrue at the rate of 10% per annum and will be repayable five years from closing, subject to certain prepayment rights. In addition, the Company expects to issue 7,200,000 warrants to Crown Capital, with each warrant entitling the holder thereof to acquire one Common Share at an exercise price of $0.25 per share for a period of five years.
The Company has also signed a binding commitment letter with Yorkville pursuant to which Yorkville will advance a subordinated loan to the Company of up to $12 million (the “Subordinated Loan”) in two tranches: (i) an initial tranche of $6 million, which is expected to close contemporaneously with the first tranche of the Crown Capital Facilities, and (ii) a second tranche of $2 million (which may be increased by an additional $4 million at Yorkville’s option), which is expected to close contemporaneously with the Transaction. The Subordinated Loan will rank in priority to the Company’s existing subordinated convertible debentures but subordinate to the Crown Capital Facilities. Interest on the Subordinated Loan will accrue at the rate of 12% per annum. The Subordinated Loan will mature 24 months from closing, subject to certain prepayment rights of the Company or the mutual agreement of the Company and Yorkville to extend the maturity date.
The Subordinated Loan constitutes a "related party transaction" within the meaning of Multilateral Instrument 61-101 – Protection of Minority Holders in Special Transactions (“MI 61-101”) as Yorkville is a control person of Centric and is therefore a “related party” of Centric under MI 61-101. The Company has relied on the exemption from the minority approval requirement contained in section 5.7(1)(f) of MI 61-101 in respect of the Subordinated Loan as the Subordinated Loan has been obtained from Yorkville on reasonable commercial terms that are not less advantageous to the Company than if the Subordinated Loan was obtained from a person dealing at arm’s length with the Company and is not convertible or repayable in Common Shares. A material change report in respect of the Crown Capital Facilities, Subordinated Loan and the Transaction will be filed as required, but is not expected to be filed 21 days in advance of the closing of the Subordinated Loan due to the Company’s immediate need for the proceeds of the Subordinated Loan. The disinterested members of the Company’s Board of Directors have unanimously approved the Subordinated Loan.
Source: Centric Health Corporation
This morning, Medical Facilities Corporation (TSX: DR) announced it had sold the majority of its interest in Unity Medical and Surgical Hospital ("UMASH") to a group of local investors, including leading physicians affiliated with South Bend Orthopaedics, The South Bend Clinic, and Allied Physicians of Michiana.
"After actively pursuing various strategic alternatives, our plan to improve UMASH has come together," said Robert Horrar, President and CEO of Medical Facilities. "By partnering with three of the premiere physician groups in the area, we are taking an important step in enhancing the long-term strength of both UMASH and the Corporation, as the transaction should significantly improve facility utilization and financial performance."
Medical Facilities no longer has a controlling interest in UMASH, with the Corporation's ownership interest decreasing to 31.7% from 87.6%. As a result, Medical Facilities will no longer consolidate UMASH's financial and operating results in the Corporation's consolidated financial statements. Going forward, Medical Facilities will account for its interest in UMASH under the equity method of accounting.
Medical Facilities received $1.1 million in cash consideration for its equity interests, subject to customary adjustments, which implies an equity value for UMASH of $2.0 million, and enterprise value $23.1 million. In connection with the transaction, UMASH's debt obligation to MFC was reduced by $3 million, with the remaining $20.0 million being structured on a five-year term secured by, among other things, the Buyers' equity in UMASH. The Buyers have options to acquire more of Medical Facilities' equity interest in UMASH on both the first and second anniversaries of the transaction closing for the greater of the current per share purchase price or the fair market value of the interest at the time the purchase option is exercised. In the event that Medical Facilities' ownership in UMASH falls below 25%, all of the UMASH debt owed to Medical Facilities would be required to be immediately repaid.
MFC also announced an agreement for the sale of the real estate assets underlying UMASH, consisting of land and building, for approximately $25 million, subject to adjustments for confirmatory due diligence and closing costs, to investors affiliated with the Buyers. A deposit of $750,000 was received in connection with the real estate transaction, closing of which is subject to customary closing conditions and is expected to occur in the second quarter of 2020.
"Alongside other recent initiatives, including the sale of our interest in Central Arkansas Surgical Center last month, we remain focused on strengthening our balance sheet, improving operational efficiencies, and increasing our financial flexibility to better pursue long-term value maximizing opportunities," added Mr. Horrar.
About Medical Facilities
Medical Facilities, in partnership with physicians, owns surgical facilities in the United States. Medical Facilities' portfolio includes controlling interest in four specialty surgical hospitals located in Arkansas, Oklahoma, and South Dakota, and an ambulatory surgery center located in California, as well as a non-controlling interest in one specialty surgical hospital in Indiana. In addition, through a partnership with NueHealth LLC, Medical Facilities owns controlling interest in six ambulatory surgery centers located in Michigan, Missouri, Nebraska, Ohio, Oregon, and Pennsylvania. The specialty surgical hospitals perform scheduled surgical, imaging, diagnostic and other procedures, including primary and urgent care, and derive their revenue from the fees charged for the use of their facilities. The ambulatory surgery centers specialize in outpatient surgical procedures, with patient stays of less than 24 hours. For more information, please visit www.medicalfacilitiescorp.ca.
Source: Medical Facilities Corporation