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InnovAge Announces Financial Results For The Fiscal Third Quarter Ended March 31, 2023

InnovAge
InnovAge

DENVER, Colo., May 09, 2023 (GLOBE NEWSWIRE) -- InnovAge Holding Corp. (“InnovAge” or the “Company”) (Nasdaq: INNV), an industry leader in providing comprehensive healthcare programs to frail dual-eligible seniors through the Program of All-inclusive Care for the Elderly (PACE), today announced financial results for its fiscal third quarter ended March 31, 2023.

“With our release from sanction in Sacramento on May 1st, we are excited to begin a new chapter,” said Patrick Blair, President, and CEO of InnovAge. “Our near-term performance improvement priorities will concentrate on aspiring to deliver best in class quality and participant satisfaction, which we believe will result in consistent, responsible, profitable growth.”

Financial Results

 

Three Months Ended March 31,

 

Nine Months Ended March 31,

 

 

2023

 

 

 

2022

 

 

 

2023

 

 

 

2022

 

in thousands, except percentages and per share amounts

 

 

 

 

 

Total revenues

$

172,539

 

 

$

177,359

 

 

$

511,213

 

 

$

525,780

 

Center-level Contribution Margin(1)

 

28,785

 

 

 

28,003

 

 

 

72,782

 

 

 

111,741

 

Net Income (Loss)

 

(7,310

)

 

 

(3,158

)

 

 

(31,557

)

 

 

5,572

 

Net Income (Loss) margin

(4.2)%

 

(1.8)%

 

(6.2)%

 

 

1.1

%

 

 

 

 

 

 

 

 

Net Income (Loss) Attributable to InnovAge Holding Corp.

 

(6,630

)

 

 

(2,821

)

 

 

(29,496

)

 

 

6,188

 

Net income (Loss) per share - basic and diluted

$

(0.05

)

 

$

(0.02

)

 

$

(0.22

)

 

$

0.05

 

 

 

 

 

 

 

 

 

Adjusted EBITDA(1)

$

3,789

 

 

$

1,931

 

 

$

(1,977

)

 

$

34,895

 

Adjusted EBITDA margin(1)

 

2.2

%

 

 

1.1

%

 

(0.4)%

 

 

6.6

%

Fiscal Third Quarter 2023 Financial Performance

  • Total revenue of $172.5 million, decreased approximately 2.7% compared to $177.4 million in the third quarter of fiscal 2022

  • Center-level Contribution Margin(1) of $28.8 million, increased 2.8% compared to $28.0 million in the third quarter of fiscal 2022

  • Center-level Contribution Margin(1) as a percent of revenue of 16.7%, increased 0.9 percentage points compared to 15.8% in the third quarter of fiscal 2022

  • Net loss of $7.3 million, compared to net loss of $3.2 million in the third quarter of fiscal 2022

  • Net loss margin of 4.2%, an increase of 2.4 percentage points compared to a net loss margin of 1.8% in the third quarter of fiscal year 2022

  • Net loss attributable to InnovAge Holding Corp. of $6.6 million, or a loss of $0.05 per share, compared to net loss of $2.8 million, or a loss of $0.02 per share in the third quarter of fiscal 2022

  • Adjusted EBITDA(1) of $3.8 million, an increase of $1.9 million compared to $1.9 million in the third quarter of fiscal year 2022

  • Adjusted EBITDA(1) margin of 2.2%, an increase of 1.1 percentage points compared to 1.1% in the third quarter of fiscal 2022

  • Census of approximately 6,310 participants compared to 6,800 participants in the third quarter of fiscal year 2022

  • Ended the third quarter of fiscal year 2023 with $121.7 million in cash and cash equivalents and $89.1 million in debt on the balance sheet, representing debt under the Company’s senior secured term loan, convertible term loan and finance leases

ADVERTISEMENT

(1) Management uses Center-level Contribution Margin as the measure for assessing performance of its segments. Center-level Contribution Margin is defined as total revenues less external provider costs and cost of care, excluding depreciation and amortization, which include all medical and pharmacy costs.  Adjusted EBITDA and Adjusted EBITDA margin are non-GAAP measures. For a definition and reconciliation of these non-GAAP measures to the most closely comparable GAAP measures for the periods indicated, see “Note Regarding Use of Non-GAAP Financial Measures” and “Reconciliation of GAAP and Non-GAAP Measures.”

Conference Call

The Company will host a conference call this afternoon at 5:00 PM Eastern Time.  A live audio webcast of the call will be available on the Company’s website, https://investor.innovage.com/. A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for a limited time.  To access the call by phone, please go to this link (registration link), for dialing instructions and a unique access pin.  We encourage participants to dial into the call fifteen minutes ahead of the scheduled start time.

About InnovAge

InnovAge is a market leader in managing the care of high-cost, dual-eligible seniors. Our mission is to enable seniors to age independently in their own homes for as long as safely possible. Our patient-centered care model is designed to improve the quality of care our participants receive, while reducing over-utilization of high-cost care settings. InnovAge believes its healthcare model is one in which all constituencies — participants, their families, providers and government payors — “win.” As of March 31, 2023, InnovAge served approximately 6,310 participants across 17 centers in five states. https://www.innovage.com/.

Investor Contact:

Ryan Kubota
rkubota@innovage.com

Media Contact:

Lara Hazenfield
lhazenfield@innovage.com

Forward-Looking Statements - Safe Harbor

This press release may contain “forward-looking statements” within the meaning of the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements can be identified by words such as: “anticipate,” “intend,” “plan,” “believe,” “project,” “estimate,” “expect,” “may,” “should,” “will” and other words and terms of similar meaning in connection with any discussion of the timing or nature of future operating or financial performance or other events. Forward-looking statements may be identified by the fact that they do not relate strictly to historical or current facts. Examples of forward-looking statements include, among others, statements we may make regarding our expectations with respect to current audits, legal proceedings and government investigations and actions; relationships and discussions with regulatory agencies; our expectations with respect to correcting deficiencies raised in audits and other processes; our ability to effectively implement remediation measures, including creating operational excellence as a provider, expanding our payer capabilities and strengthening enterprise functions; our expectations to increase the number of participants we serve, to grow enrollment and capacity within existing centers, to build de novo centers, or execute acquisitions; quarterly or annual guidance; financial outlook, including future revenues and future earnings; reimbursement and regulatory developments; market developments; new products; integration activities; and the effects of any of the foregoing on our future results of operations or financial conditions.

Forward-looking statements are neither historical facts nor assurances of future performance. Instead, they are based only on currently available information and our current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, projections, anticipated events and trends, the economy and other future conditions. You should not place undue reliance on our forward-looking statements. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of our control. Our actual results and financial condition may differ materially from those indicated in the forward-looking statements. Important factors that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following: (i) the results of periodic inspections, reviews, audits, investigations under the federal and state government programs; (ii) our ability to sufficiently cure any deficiencies identified by federal or state government programs; (iii) the adverse impact of inspections, reviews, audits, investigations, legal proceedings, enforcement actions and litigation, including the current civil investigative demands initiated by federal and state agencies, as well as the litigation and other proceedings initiated by, or on behalf, of our stockholders; (iv) the risk that the cost of providing services will exceed our compensation under PACE; (v) the dependence of our revenues upon a limited number of government payors, particularly Medicare and Medicaid; (vi) changes in the rules governing the Medicare, Medicaid or PACE programs; (vii) the risk that our submissions to government payors may contain inaccurate or unsupportable information regarding risk adjustment scores of participants, which could cause us to overstate or understate our revenue and subjecting us to payment obligations and penalties; (viii) viability of our business strategy and our ability to realize expected results; (ix) the impact on our business of non-renewal or termination of capitation agreements with government payors; (x) the impact of state and federal efforts to reduce healthcare spending; (xi) the impact on our business from an economic downturn; (xii) the effects of a pandemic, epidemic or outbreak of an infectious disease, including the ongoing effects of COVID-19; (xiii) our dependence on our senior management team and other key employees; (xiv) the effects of sustained inflation and increased costs of labor on our business; (xv) the impact of failures by our suppliers, sustained material price increases on supplies or limitations on our ability to access new technology or medical products; (xvi) the effect of our relatively limited operating history as a for-profit company on investors’ ability to evaluate our current business and future prospects; (xvii) our ability to enroll or attract new participants and grow our revenue; (xviii) the concentration of our presence in Colorado; (xix) our ability to establish a presence in new geographic markets, especially as a result of the actions taken by certain states and us in light of our ongoing audit processes; (xx) the impact on our business of security breaches, loss of data or other disruptions causing the compromise of sensitive information or preventing us from accessing critical information; and (xxi) our existing indebtedness and access to capital markets. For a detailed discussion of the risks and uncertainties that could affect our actual results, please refer to the risk factors identified in our SEC reports, including, but not limited to our most recent Annual Report on Form 10-K and any subsequent Quarterly Report on Form 10-Q, in each case, as filed with the SEC.

Any forward-looking statement made by the Company in this press release is based only on information currently available to us and speaks only as of the date on which it is made. Except as required by law, we undertake no obligation to publicly update any forward-looking statement, whether written or oral, that may be made from time to time, whether as a result of new information, future developments or otherwise.

Note Regarding Use of Non-GAAP Financial Measures

In addition to reporting financial information in accordance with generally accepted accounting principles (“GAAP”), the Company is also reporting Adjusted EBITDA and Adjusted EBITDA margin, which are non-GAAP financial measures. Adjusted EBITDA and Adjusted EBITDA margin are supplemental measures of operating performance monitored by management that are not defined under GAAP and that do not represent, and should not be considered as, an alternative to net income (loss) and net income (loss) margin, respectively, as determined by GAAP. We believe that Adjusted EBITDA and Adjusted EBITDA margin are appropriate measures of operating performance because the metrics eliminate the impact of revenue and expenses that do not relate to our ongoing business performance, allowing us to more effectively evaluate our core operating performance and trends from period to period. We believe that Adjusted EBITDA and Adjusted EBITDA margin help investors and analysts in comparing our results across reporting periods on a consistent basis by excluding items that we do not believe are indicative of our core operating performance. These non-GAAP financial measures have limitations as analytical tools and should not be considered in isolation from, or as a substitute for, the analysis of other GAAP financial measures, including net income (loss) and net income (loss) margin. In evaluating Adjusted EBITDA, you should be aware that in the future we may incur expenses that are the same as or similar to some of the adjustments in this presentation. Our presentation of Adjusted EBITDA should not be construed to imply that our future results will be unaffected by the types of items excluded from the calculation of Adjusted EBITDA. Our use of the term Adjusted EBITDA varies from others in our industry. We define Adjusted EBITDA as net income (loss) adjusted for interest expense, depreciation and amortization, and provision (benefit) for income tax as well as addbacks for non-recurring expenses or exceptional items, including charges relating to management equity compensation, class action litigation, M&A and de novo center development, business optimization, electronic medical record (“EMR”) implementation, and facility expansion, relocation and closure. Adjusted EBITDA margin is Adjusted EBITDA expressed as a percentage of our total revenue less any exceptional, one time revenue items. For a full reconciliation of Adjusted EBITDA to the most closely comparable GAAP financial measure, please see the attachment to this earnings release.

Schedule 1

InnovAge
CONDENSED CONSOLIDATED BALANCE SHEETS
(IN THOUSANDS) (UNAUDITED)

 

March 31,
2023

 

June 30,
2022

Assets

 

 

 

Current Assets

 

 

 

Cash and cash equivalents

$

121,706

 

 

$

184,429

Short-term investments

 

45,847

 

 

 

Restricted cash

 

16

 

 

 

17

Accounts receivable, net of allowance ($3,936 – March 31, 2023 and $3,403 – June 30, 2022)

 

34,197

 

 

 

35,907

Prepaid expenses

 

13,924

 

 

 

13,842

Income tax receivable

 

254

 

 

 

6,761

  Total current assets

 

215,944

 

 

 

240,956

Noncurrent Assets

 

 

 

Property and equipment, net

 

192,911

 

 

 

176,260

Operating lease assets

 

21,906

 

 

 

Investments

 

5,493

 

 

 

5,493

Deposits and other

 

3,573

 

 

 

2,812

Goodwill

 

124,217

 

 

 

124,217

Other intangible assets, net

 

5,363

 

 

 

5,858

  Total noncurrent assets

 

353,463

 

 

 

314,640

      Total assets

$

569,407

 

 

$

555,596

Liabilities and Stockholders' Equity

 

 

 

Current Liabilities

 

 

 

Accounts payable and accrued expenses

$

48,198

 

 

$

50,562

Reported and estimated claims

 

39,095

 

 

 

38,454

Due to Medicaid and Medicare

 

11,001

 

 

 

9,130

Income tax payable

 

1,220

 

 

 

Current portion of long-term debt

 

3,795

 

 

 

3,793

Current portion of finance lease obligations

 

4,946

 

 

 

3,368

Current portion of operating lease obligations

 

3,402

 

 

 

Deferred revenue

 

26,032

 

 

 

  Total current liabilities

 

137,689

 

 

 

105,307

Noncurrent Liabilities

 

 

 

Deferred tax liability, net

 

5,714

 

 

 

17,761

Finance lease obligations

 

13,381

 

 

 

9,440

Operating lease obligations

 

20,110

 

 

 

Other noncurrent liabilities

 

1,183

 

 

 

1,134

Long-term debt, net of debt issuance costs

 

65,687

 

 

 

68,210

  Total liabilities

 

243,764

 

 

 

201,852

Commitments and Contingencies

 

 

 

Redeemable Noncontrolling Interests

 

13,461

 

 

 

15,278

Stockholders’ Equity

 

 

 

Common stock, $0.001 par value; 500,000,000 authorized as of March 31, 2023 and June 30, 2022; 135,602,464 and 135,532,811 issued shares as of March 31, 2023 and June 30, 2022, respectively

 

136

 

 

 

136

Additional paid-in capital

 

330,955

 

 

 

327,499

Retained earnings (deficit)

 

(24,767

)

 

 

4,729

  Total InnovAge Holding Corp.

 

306,324

 

 

 

332,364

Noncontrolling interests

 

5,858

 

 

 

6,102

  Total stockholders’ equity

 

312,182

 

 

 

338,466

      Total liabilities and stockholders’ equity

$

569,407

 

 

$

555,596

 

 

 

 

 

 

 

Schedule 2

InnovAge
CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
(IN THOUSANDS) (UNAUDITED)

 

Three Months Ended March 31,

 

Nine Months Ended March 31,

 

 

2023

 

 

 

2022

 

 

 

2023

 

 

 

2022

 

Revenues

 

 

 

 

 

 

 

Capitation revenue

$

172,196

 

 

$

176,988

 

 

$

510,268

 

 

$

524,507

 

Other service revenue

 

343

 

 

 

371

 

 

 

945

 

 

 

1,273

 

Total revenues

 

172,539

 

 

 

177,359

 

 

 

511,213

 

 

 

525,780

 

Expenses

 

 

 

 

 

 

 

External provider costs

 

89,805

 

 

 

103,254

 

 

 

279,550

 

 

 

284,299

 

Cost of care, excluding depreciation and amortization

 

53,949

 

 

 

46,102

 

 

 

158,881

 

 

 

129,740

 

Center-level Contribution Margin

 

28,785

 

 

 

28,003

 

 

 

72,782

 

 

 

111,741

 

Sales and marketing

 

5,314

 

 

 

6,144

 

 

 

13,502

 

 

 

19,117

 

Corporate, general and administrative

 

27,648

 

 

 

24,682

 

 

 

86,646

 

 

 

74,248

 

Depreciation and amortization

 

3,992

 

 

 

3,850

 

 

 

11,087

 

 

 

10,435

 

  Total expenses

 

180,708

 

 

 

184,032

 

 

 

549,666

 

 

 

517,839

 

Operating Income (Loss)

 

(8,169

)

 

 

(6,673

)

 

 

(38,453

)

 

 

7,941

 

 

 

 

 

 

 

 

 

Other Income (Expense)

 

 

 

 

 

 

 

Interest expense, net

 

(405

)

 

 

(709

)

 

 

(1,231

)

 

 

(1,930

)

Other expense

 

(101

)

 

 

108

 

 

 

380

 

 

 

(358

)

  Total other expense

 

(506

)

 

 

(601

)

 

 

(851

)

 

 

(2,288

)

Income (Loss) Before Income Taxes

 

(8,675

)

 

 

(7,274

)

 

 

(39,304

)

 

 

5,653

 

Provision for Income Taxes

 

(1,365

)

 

 

(4,116

)

 

 

(7,747

)

 

 

81

 

Net Income (Loss)

 

(7,310

)

 

 

(3,158

)

 

 

(31,557

)

 

 

5,572

 

  Less: net loss attributable to noncontrolling interests

 

(680

)

 

 

(337

)

 

 

(2,061

)

 

 

(616

)

Net Income (Loss) Attributable to InnovAge Holding Corp.

$

(6,630

)

 

$

(2,821

)

 

$

(29,496

)

 

$

6,188

 

 

 

 

 

 

 

 

 

Weighted-average number of common shares outstanding - basic

 

135,601,327

 

 

 

135,516,608

 

 

 

135,581,971

 

 

 

135,516,544

 

Weighted-average number of common shares outstanding - diluted

 

135,601,327

 

 

 

135,516,608

 

 

 

135,581,971

 

 

 

135,530,793

 

 

 

 

 

 

 

 

 

Net income (loss) per share - basic

$

(0.05

)

 

$

(0.02

)

 

$

(0.22

)

 

$

0.05

 

Net income (loss) per share - diluted

$

(0.05

)

 

$

(0.02

)

 

$

(0.22

)

 

$

0.05

 

Schedule 3

InnovAge
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(IN THOUSANDS) (UNAUDITED)

 

For the Nine Months Ended March 31,

 

 

2023

 

 

 

2022

 

Operating Activities

 

 

 

Net income (loss)

$

(31,557

)

 

$

5,572

 

Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities

 

 

 

(Gain) loss on disposal of assets

 

482

 

 

 

358

 

Provision for uncollectible accounts

 

2,319

 

 

 

4,834

 

Depreciation and amortization

 

11,087

 

 

 

10,435

 

Operating lease rentals

 

3,500

 

 

 

 

Amortization of deferred financing costs

 

322

 

 

 

322

 

Stock-based compensation

 

3,456

 

 

 

2,586

 

Deferred income taxes

 

(12,046

)

 

 

81

 

Other

 

(726

)

 

 

 

Changes in operating assets and liabilities

 

 

 

Accounts receivable, net

 

(609

)

 

 

(4,157

)

Prepaid expenses

 

(81

)

 

 

(4,323

)

Income tax receivable

 

7,727

 

 

 

(60

)

Deposits and other

 

(836

)

 

 

(1,501

)

Accounts payable and accrued expenses

 

25,161

 

 

 

4,705

 

Reported and estimated claims

 

641

 

 

 

2,778

 

Due to Medicaid and Medicare

 

1,870

 

 

 

2,429

 

Operating lease liabilities

 

(3,625

)

 

 

 

  Net cash provided (used) by operating activities

 

7,085

 

 

 

24,059

 

Investing Activities

 

 

 

Purchases of property and equipment

 

(19,329

)

 

 

(20,141

)

Purchases of short-term investments

 

(45,000

)

 

 

 

Purchases of intangible assets

 

 

 

 

(1,437

)

Purchase of cost method investment

 

 

 

 

(2,000

)

  Net cash used in investing activities

 

(64,329

)

 

 

(23,578

)

Financing Activities

 

 

 

Payments for finance lease obligations

 

(2,637

)

 

 

(1,829

)

Principal payments on long-term debt

 

(2,843

)

 

 

(2,841

)

Net cash used in financing activities

 

(5,480

)

 

 

(4,670

)

 

 

 

 

INCREASE (DECREASE) IN CASH, CASH EQUIVALENTS & RESTRICTED CASH

 

(62,724

)

 

 

(4,189

)

CASH, CASH EQUIVALENTS & RESTRICTED CASH, BEGINNING OF PERIOD

 

184,446

 

 

 

203,700

 

CASH, CASH EQUIVALENTS & RESTRICTED CASH, END OF PERIOD

$

121,722

 

 

$

199,511

 

 

 

 

 

Supplemental Cash Flows Information

 

 

 

Interest paid

$

2,826

 

 

$

1,452

 

Income taxes paid

$

13

 

 

$

84

 

Property and equipment included in accounts payable

$

1,811

 

 

$

4,577

 

Property and equipment purchased under finance leases

$

8,157

 

 

$

8,057

 

 

 

 

 

 

 

 

 

Schedule 4

InnovAge
RECONCILIATION OF GAAP AND NON-GAAP MEASURES
(IN THOUSANDS) (UNAUDITED)

 

Three months ended March 31,

 

Nine months ended March 31,

 

 

2023

 

 

 

2022

 

 

 

2023

 

 

 

2022

 

 

 

 

 

 

 

Net income (loss)

$

(7,310

)

 

$

(3,158

)

 

$

(31,557

)

 

$

5,572

 

Interest expense, net

 

405

 

 

 

709

 

 

 

1,231

 

 

 

1,930

 

Depreciation and amortization

 

3,992

 

 

 

3,850

 

 

 

11,087

 

 

 

10,435

 

Provision (benefit) for income tax

 

(1,365

)

 

 

(4,116

)

 

 

(7,747

)

 

 

81

 

Stock-based compensation

 

1,208

 

 

 

845

 

 

 

3,721

 

 

 

2,586

 

Executive severance and recruitment(a)

 

 

 

 

 

 

 

 

 

 

4,123

 

Litigation costs and settlement(b)

 

3,274

 

 

 

377

 

 

 

7,839

 

 

 

2,820

 

M&A and de novo center development(c)

 

146

 

 

 

693

 

 

 

452

 

 

 

1,533

 

Business optimization(d)

 

1,394

 

 

 

2,329

 

 

 

8,418

 

 

 

4,720

 

EMR implementation(e)

 

2,045

 

 

 

402

 

 

 

4,579

 

 

 

1,095

 

Adjusted EBITDA

$

3,789

 

 

$

1,931

 

 

$

(1,977

)

 

$

34,895

 

 

 

 

 

 

 

 

 

Net income (loss) margin

(4.2)%

 

(1.8)%

 

(6.2)%

 

 

1.1

%

Adjusted EBITDA margin

 

2.2

%

 

 

1.1

%

 

(0.4)%

 

 

6.6

%

_______________________

(a)

Reflects charges related to executive severance and recruiting.

(b)

Reflects a $1.2 million reserve for a wage and hour class action settlement for the three and nine months ended March 31, 2023 and charges/(credits) related to litigation by stockholders, litigation related to de novo center development, and civil investigative demands. Refer to Note 9, "Commitments and Contingencies" to our condensed consolidated financial statements for more information regarding litigation by stockholders and civil investigative demands. Costs reflected consist of litigation costs considered one-time in nature and outside of the ordinary course of business based on the following considerations which we assess regularly: (i) the frequency of similar cases that have been brought to date, or are expected to be brought within two years, (ii) complexity of the case, (iii) nature of the remedies sought, (iv) litigation posture of the Company, (v) counterparty involved, and (vi) the Company's overall litigation strategy.

(c)

Reflects charges related to M&A transaction and integrations, and de novo center developments.

(d)

Reflects charges related to business optimization initiatives. Such charges related to one-time investments in projects designed to enhance our technology and compliance systems, improve and support the efficiency and effectiveness of our operations, and third party support to address efforts to remediate deficiencies in audits. For the three months ended March 31, 2023 this includes (i) $0.3 million related to consultants and contractors performing audit and other related services at sanctioned centers, (ii) $0.2 million of costs associated with third party consultants as we implement our core provider initiatives, assess our risk-bearing payor capabilities, and strengthen our enterprise capabilities, (iii) $0.6 million in the consolidation of the Germantown, Pennsylvania center, and (iv) $0.3 million related to other non-recurring projects aimed at reducing costs and improving efficiencies. For the nine months ended March 31, 2023 this includes (i) $1.5 million related to consultants and contractors performing audit and other related services at sanctioned centers, (ii) $5.3 million of costs associated with third party consultants as we implement our core provider initiatives, assess our risk-bearing payor capabilities, and strengthen our enterprise capabilities, (iii) $0.6 million in the consolidation of the Germantown center and (iv) $1.0 million related to other non-recurring projects aimed at reducing costs and improving efficiencies.

(e)

Reflects non-recurring expenses relating to the implementation of a new EMR vendor.