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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Form 10-Q
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended June 30, 2022
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from _____ to _____

Commission file number: 001-38973

Viemed Healthcare, Inc.
(Exact name of registrant as specified in its charter)
British Columbia, Canada
  N/A
(State or other jurisdiction of
incorporation or organization)
 
(IRS Employer
Identification Number)
     
 
625 E. Kaliste Saloom Rd.
Lafayette, LA 70508
 
(Address of principal executive offices, including zip code)
 
(337) 504-3802
 
(Registrant’s telephone number, including area code)
     
Securities registered pursuant to Section 12(b) of the Act:
     
Title of each class Trading Symbol(s) Name of exchange on which registered
Common Shares, no par value VMD The Nasdaq Stock Market LLC

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  x    No  ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes  x    No  ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filer
 
Accelerated filer
  Non-Accelerated Filer ☐  
Smaller reporting company
Emerging growth company
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes  ☐    No  x

As of July 20, 2022, there were 38,221,990 common shares of the registrant outstanding.


VIEMED HEALTHCARE, INC.
TABLE OF CONTENTS
June 30, 2022 and 2021
Page
3
3
3
4
5
6
7



PART I - FINANCIAL INFORMATION

Item 1. Financial Statements
VIEMED HEALTHCARE, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(Expressed in thousands of U.S. Dollars, except outstanding shares)
Note At
June 30, 2022
At
December 31, 2021
(Unaudited) (Audited)
ASSETS
Current assets
Cash and cash equivalents $ 21,922  $ 28,408 
Accounts receivable, net of allowance for doubtful accounts of $9,383 and $7,031 at June 30, 2022 and December 31, 2021, respectively
2 14,287  12,823 
Inventory, net of inventory reserve of $0 and $1,418 at June 30, 2022 and December 31, 2021, respectively
2 2,853  2,457 
Income tax receivable 9 531  1,893 
Prepaid expenses and other assets 2,266  1,729 
Total current assets $ 41,859  $ 47,310 
Long-term assets
Property and equipment, net 3 66,685  62,846 
Equity investments 2 2,435  2,157 
Deferred tax asset 9 3,964  4,787 
Other long-term assets 8 961  862 
Total long-term assets $ 74,045  $ 70,652 
TOTAL ASSETS $ 115,904  $ 117,962 
LIABILITIES
Current liabilities
Trade payables $ 3,702  $ 3,239 
Deferred revenue 4,402  3,753 
Accrued liabilities 4 8,860  8,875 
Current portion of lease liabilities 5 283  464 
Current portion of long-term debt 5 612  1,480 
Total current liabilities $ 17,859  $ 17,811 
Long-term liabilities
Accrued liabilities 7 385  757 
Long-term lease liabilities 5 207  268 
Long-term debt 5 4,226  4,306 
Total long-term liabilities $ 4,818  $ 5,331 
TOTAL LIABILITIES $ 22,677  $ 23,142 
Commitments and Contingencies 8 —  — 
SHAREHOLDERS' EQUITY
Common stock - No par value: unlimited authorized; 38,333,089 and 39,640,388 issued and outstanding as of June 30, 2022 and December 31, 2021, respectively
7 $ 14,348  $ 14,014 
Additional paid-in capital 9,991  7,749 
Accumulated other comprehensive loss (56) (278)
Retained earnings 68,944  73,335 
TOTAL SHAREHOLDERS' EQUITY $ 93,227  $ 94,820 
TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY $ 115,904  $ 117,962 
See accompanying notes to the condensed consolidated financial statements
Page 3

VIEMED HEALTHCARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF INCOME AND COMPREHENSIVE INCOME
(Expressed in thousands of U.S. Dollars, except share and per share amounts)
(Unaudited)
Three Months Ended June 30, Six Months Ended June 30,
Note 2022 2021 2022 2021
Revenue 2 $ 33,310  $ 27,399  $ 65,565  $ 55,815 
Cost of revenue 12,920  9,774  25,432  20,448 
Gross profit $ 20,390  $ 17,625  $ 40,133  $ 35,367 
Operating expenses
Selling, general and administrative 17,536  12,884  33,312  27,393 
Research and development 672  583  1,304  922 
Stock-based compensation 7 1,271  1,236  2,576  2,543 
Depreciation 243  207  480  407 
Loss (gain) on disposal of property and equipment (110) 83  (124) 159 
     Other expense (223) (32) (664) (53)
Income from operations $ 1,001  $ 2,664  $ 3,249  $ 3,996 
Non-operating income and expenses
Income from equity method investments 446  231  769  451 
Interest expense, net of interest income 5 (59) (83) (123) (174)
Net income before taxes 1,388  2,812  3,895  4,273 
Provision for income taxes 9 421  1,246  1,166  1,023 
Net income $ 967  $ 1,566  $ 2,729  $ 3,250 
Other comprehensive income (loss)
Change in unrealized gain/loss on derivative instruments, net of tax 59  (6) 222  100 
Other comprehensive income (loss) $ 59  $ (6) $ 222  $ 100 
Comprehensive income $ 1,026  $ 1,560  $ 2,951  $ 3,350 
Net income per share
Basic 10 $ 0.02  $ 0.04  $ 0.07  $ 0.08 
Diluted 10 $ 0.02  $ 0.04  $ 0.07  $ 0.08 
Weighted average number of common shares outstanding:
Basic 10 38,773,580  39,584,064  39,195,317  39,357,992 
Diluted 10 39,752,928  41,028,742  40,056,953  40,849,311 

See accompanying notes to the condensed consolidated financial statements
Page 4


VIEMED HEALTHCARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN SHAREHOLDERS' EQUITY
(Expressed in thousands of U.S. Dollars, except share and per share amounts)
(Unaudited)
Common Stock Additional paid-in capital Accumulated other comprehensive loss Total Shareholders'
equity
Shares Amount Retained
earnings
Shareholders' equity, December 31, 2020 39,185,182 $ 9,181  $ 7,320  $ (451) $ 65,643  $ 81,693 
Stock-based compensation - options —  —  1078  —  —  1,078 
Stock-based compensation - restricted stock —  —  229  —  —  229 
Exercise of options 16,586  65  —  —  —  65 
Shares issued for vesting of restricted stock 556,840  4,403  (4,403) —  —  — 
Shares redeemed to pay income tax (181,320) —  —  —  (1,434) (1,434)
Change in accumulated other comprehensive loss, net of tax —  —  —  106  —  106 
Net income —  —  —  —  1,684  1,684 
Shareholders' equity, March 31, 2021 39,577,288  $ 13,649  $ 4,224  $ (345) $ 65,893  $ 83,421 
Stock-based compensation - options —  —  998  —  —  998 
Share-based compensation - restricted stock —  —  238  —  —  238 
Exercise of options 11,011  47  —  —  —  47 
Change in accumulated other comprehensive loss, net of tax —  —  —  (6) —  (6)
Net income —  —  —  —  1,566  1,566 
Shareholders' equity, June 30, 2021 39,588,299  $ 13,696  $ 5,460  $ (351) $ 67,459  $ 86,264 
Common Stock Additional paid-in capital Accumulated other comprehensive loss Total Shareholders'
equity
Shares Amount Retained
earnings
Shareholders' equity, December 31, 2021 39,640,388  $ 14,014  $ 7,749  $ (278) $ 73,335  $ 94,820 
Stock-based compensation - options —  —  820  —  —  820 
Stock-based compensation - restricted stock —  —  485  —  —  485 
Shares issued for vesting of restricted stock 67,010  334  (334) —  —  — 
Shares redeemed to pay income tax (23,742) —  —  —  (119) (119)
Shares repurchased under the share repurchase program (389,878) —  —  —  (1,887) (1,887)
Change in accumulated other comprehensive loss, net of tax —  —  —  163  —  163 
Net income —  —  —  —  1,762  1,762 
Shareholders' equity, March 31, 2022 39,293,778  $ 14,348  $ 8,720  $ (115) $ 73,091  $ 96,044 
Stock-based compensation - options —  —  757  —  —  757 
Stock-based compensation - restricted stock —  —  514  —  —  514 
Shares repurchased under the share repurchase program (960,689) —  —  —  (5,114) (5,114)
Change in accumulated other comprehensive loss, net of tax —  —  —  59  —  59 
Net income —  —  —  —  967  967 
Shareholders' equity, June 30, 2022 38,333,089  $ 14,348  $ 9,991  $ (56) $ 68,944  $ 93,227 











See accompanying notes to the condensed consolidated financial statements
Page 5


VIEMED HEALTHCARE, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(Expressed in thousands of U.S. Dollars)
(Unaudited)
Six Months Ended June 30,
Note 2022 2021
Cash flows from operating activities
Net income $ 2,729  $ 3,250 
Adjustments for:
Depreciation 7,136  5,325 
Provision for uncollectible accounts 2 6,300  3,402 
Change in inventory reserve (1,418) — 
Share-based compensation 7 2,576  2,543 
Distributions of earnings received from equity method investments 612  123 
Income from equity method investments (769) (451)
Loss (gain) on disposal of property and equipment (124) 159 
Deferred income tax expense 745  1,005 
Net change in working capital
Increase in accounts receivable (7,764) (3,163)
Increase in inventory 1,022  (248)
Increase (decrease) in prepaid expenses and other assets (634) 311 
Increase (decrease) in trade payables (243) 362 
Increase in deferred revenue 649  333 
Decrease in accrued liabilities (87) (3,800)
Change in income tax payable/receivable 1,362  (340)
Net cash provided by operating activities $ 12,092  $ 8,811 
Cash flows from investing activities
Purchase of property and equipment (10,989) (5,047)
Investment in equity investments (121) — 
Proceeds from sale of property and equipment 3 615  289 
Net cash used in investing activities $ (10,495) $ (4,758)
Cash flows from financing activities
Proceeds from exercise of options 7 —  112 
Principal payments on notes payable 5 (78) (73)
Principal payments on term note 5 (872) (833)
Shares redeemed to pay income tax 7 (119) (1,434)
Shares repurchased under the share repurchase program 7 (7,001) — 
Repayments of lease liabilities (13) (1,655)
Net cash used in financing activities $ (8,083) $ (3,883)
Net (decrease) increase in cash and cash equivalents (6,486) 170 
Cash and cash equivalents at beginning of year 28,408  30,981 
Cash and cash equivalents at end of period $ 21,922  $ 31,151 
Supplemental disclosures of cash flow information
Cash paid during the period for interest $ 128  $ 198 
Cash paid (received) during the period for income taxes, net of refunds $ (940) $ 358 
Supplemental disclosures of non-cash transactions
Net non-cash changes to finance leases $ —  $ 12 
Net non-cash changes to operating leases $ (8) $ 355 
See accompanying notes to the condensed consolidated financial statements
Page 6


VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021

1.    Nature of Business and Operations

Viemed Healthcare, Inc. (the "Company"), through its subsidiaries, is a provider of in-home durable medical equipment ("DME") and post-acute respiratory healthcare services in the United States. The Company’s service offerings are focused on effective in-home treatment with clinical practitioners providing therapy and counseling to patients in their homes using cutting edge technology. The Company currently serves patients in 48 states in the United States. The Company was incorporated under the Business Corporations Act (British Columbia) on December 14, 2016. The Company's registered and records office is located at Suite 2800, Park Place, 666 Burrard Street, Vancouver, British Columbia V6C 2Z7 and its corporate office is located at 625 E. Kaliste Saloom Road, Lafayette, Louisiana 70508.

The Company is an "emerging growth company," as defined in the JOBS Act, and as such, has elected to comply with certain reduced U.S. public company reporting requirements.

Based on the annual assessment performed on June 30, 2022, the Company meets the re-entry thresholds to qualify as a "smaller reporting company" under Rule 12b-2 of the Securities and Exchange Act of 1934, as amended (the "Exchange Act"), and, as such, has elected to comply with certain reduced U.S. public company reporting requirements.

The Company’s common shares are traded in the U.S. on the Nasdaq Capital Market under the symbol "VMD" and in Canada on the Toronto Stock Exchange under the symbol "VMD.TO".

2. Summary of Significant Accounting Policies

Principles of Presentation

The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information and pursuant to the rules and regulations of the Securities and Exchange Commission (the "SEC"). Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. The accompanying condensed consolidated financial statements are unaudited, but reflect all adjustments consisting of normal recurring accruals, which, in the opinion of management, are necessary to present fairly our Condensed Consolidated Balance Sheets, Condensed Consolidated Statements of Income and Comprehensive Income, Condensed Consolidated Statements of Changes in Shareholders’ Equity and Condensed Consolidated Statements of Cash Flows for the interim periods presented. Our fiscal year ends on December 31. The Condensed Consolidated Balance Sheet as of December 31, 2021 was derived from audited consolidated financial statements but does not include all disclosures required by GAAP. These condensed consolidated financial statements should be read in conjunction with the annual consolidated financial statements and the notes thereto and the report of our independent registered public accounting firm included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021. The nature of our business is such that the results of any interim period may not be indicative of the results to be expected for the entire year.

Basis of consolidation

These consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All intercompany transactions have been eliminated.

Use of estimates

The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting period. Management bases these estimates and assumptions upon historical experience, existing and known circumstances, authoritative accounting pronouncements and other factors that management believes to be reasonable. Significant areas requiring the use of management estimates relate to revenue recognition, accounts receivable and the related allowance for doubtful accounts, income tax provisions, and fair value of financial instruments. Actual results could differ from these estimates.


Page 7

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
Accounts receivable

Accounts receivable are regularly reviewed for collectability and an allowance is recorded to cover the estimated bad debts and billing modifications. The accounts receivable are presented on the Condensed Consolidated Balance Sheets net of the allowance for doubtful accounts. It is possible that the estimates of the allowance for doubtful accounts could change, which could have a material impact on our operations and cash flows.

The Company writes off receivables when the likelihood for collection is remote, and when the Company believes collection efforts have been fully exhausted and it does not intend to devote additional resources in attempting to collect. The write-offs are charged against the allowance for doubtful accounts.

For the six months ended June 30, 2022, the Company's evaluation takes into consideration such factors as historical bad debt experience, national and local economic trends and conditions, industry and regulatory conditions, other collection indicators and information about disaggregated receivables. The complexity of many third-party billing arrangements, patient qualification for medical necessity of equipment and the uncertainty of reimbursement amounts for certain services from certain payors may result in adjustments to amounts originally recorded.

The estimates and charge-offs for the allowance for doubtful accounts for each reporting period were as follows:
June 30, 2022 June 30, 2021
Balance, beginning of year $ 7,031  $ 9,013 
Provision for uncollectible accounts 6,300  3,402 
Amounts charged off (3,948) (5,127)
Balance, end of period $ 9,383  $ 7,288 

Included in accounts receivable at June 30, 2022 are amounts due from Medicare and Medicaid representing 37% and 12%, respectively, and 49% combined, of total outstanding receivables. As of December 31, 2021, 44% of total outstanding receivables were amounts due from Medicare and Medicaid.

Revenues from Medicare and Medicaid as percentages of the Company's traditional revenue streams, excluding COVID-19 response sales and services, for the three and six months ended June 30, 2022 and 2021 were as follows:
Three Months Ended June 30, Six Months Ended June 30,
2022 2021 2022 2021
Medicare revenues 46  % 54  % 47  % 57  %
Medicaid revenues % 10  % % %
Total Medicare and Medicaid 55  % 64  % 56  % 66  %

Inventory

Inventory represents non-serialized respiratory supplies that consist of equipment parts, consumables, and associated product supplies and is expensed at the time of sale or use. The Company values inventory at the lower of cost or net realizable value. Obsolete and unserviceable inventories are valued at estimated net realizable value. Inventory is presented net of a reserve balance of $0 and $1,418,000 at June 30, 2022 and December 31, 2021, respectively, that relates to COVID-19 response supplies. During the six months ended June 30, 2022, these supplies were determined to be unavailable for sale due to expiration. Accordingly, the previously established inventory reserves were eliminated through disposal.

Page 8

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
Property and equipment

Property and equipment is presented on the Condensed Consolidated Balance Sheets at historic cost less accumulated depreciation. Major renewals and improvements that extend the useful life of assets are capitalized to the respective property accounts, while maintenance and repairs, which do not extend the useful life of the respective assets, are expensed as incurred. Management has estimated the useful lives of equipment leased to customers. Depreciation is computed using the straight-line method over the estimated useful lives of the respective assets. Property and equipment are amortized on a straight-line basis over their estimated useful lives.

Depreciation of medical equipment commences at the date of service, which represents the date that the asset has been delivered to a patient and is put in use and continues through the useful life of the asset. Property and equipment with definite useful lives are tested for impairment whenever events or changes in circumstances indicate that their carrying amount may not be recoverable.

Equity investments

Equity investments on the Condensed Consolidated Balance Sheets are comprised of an investment accounted for under the equity method and an equity investment without a readily determinable fair value which is accounted for under the measurement alternative described in ASC 321-10-35-2.

The following table details the Company’s equity investments:
June 30, 2022 December 31, 2021
Equity method investments $ 1,116  $ 959 
Other equity investments 1,319  1,198 
Balance, end of period $ 2,435  $ 2,157 

The Company's equity method investments include a 49% equity interest in Solvet Services, LLC. Investments accounted for under the equity method are investments in unconsolidated entities over whose operating and financial policies the Company has the ability to exercise significant influence but not control. Equity method investments are initially measured at cost in the Condensed Consolidated Balance Sheets with any subsequent adjustments made to the carrying amount of the investment for the Company’s proportionate share of income or loss. Distributions received from the investee reduce the Company’s carrying value of the investment. The Company has recognized its share of income or loss on the gain (loss) from equity method investments within non-operating expenses in the Condensed Consolidated Statements of Income. Equity method investments are evaluated for impairment whenever events or changes in circumstances indicate that the carrying value of the investments may exceed the fair value. No events or changes have occurred as of June 30, 2022 that would affect the carrying value of equity method investments.

Other equity investments include an equity interest in VeruStat, Inc and an equity interest in DMEscripts, LLC. Other equity investments are investments without a readily determinable fair value which do not qualify for the practical expedient in ASC 820. For these investments, the Company has elected the measurement alternative which measures the investment at cost, less any impairment. ASU 2019-04 clarifies that if an entity identifies observable price changes in orderly transactions for the identical or a similar investment of the same issuer, it must measure its equity investment at fair value in accordance with ASC 820 as of the date that the observable transaction occurred. The Company was not aware of any impairment or observable price change adjustments that needed to be made as of June 30, 2022 on its investments in equity securities without a readily determinable fair value.

Comprehensive income

Comprehensive income reflects the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. The Company's comprehensive income represents net income adjusted for unrealized gains and losses on derivative instruments, net of tax. Accumulated other comprehensive loss is presented on the accompanying Condensed Consolidated Balance Sheets as a component of shareholders' equity.

As a result of the “backward tracing” prohibition in ASC 740, certain previously measured unrealized gains or losses have resulted in the existence of "dangling" amounts within other comprehensive income. The Company has elected the individual security approach to the release of these effects. Under the individual security approach, dangling amounts are tracked on a security-by-security basis and cleared out of the other comprehensive income balance upon sale of each individual security. During the periods presented, none of the individual securities associated with a dangling balance were sold.

Page 9

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
Revenue recognition

Revenue from a customer consists of the sale and rental of home medical equipment and medical services. Patient revenues are billed to and collections received from Medicare, Medicaid, third-party insurers, co-insurance and patient-pay. Patient revenue is recognized net of contractual adjustments and bad debt based on contractual arrangements with third-party payors, an evaluation of expected collections resulting from the analysis of current and past due accounts, past collection experience in relation to amounts billed and other relevant information. Contractual adjustments result from the differences between the rates charged for services and reimbursement rates paid by government-sponsored healthcare programs and insurance companies for such services.

The Company's contracts with customers often include multiple products and services, and the Company evaluates these arrangements to determine the unit of accounting for revenue recognition purposes based on whether the product or service is distinct from other products or services in the arrangement and should be accounted for as a separate performance obligation. A product or service is distinct if the customer can benefit from it on its own or together with other readily available resources and the Company's ability to transfer the goods or services is separately identifiable from other promises in the contractual arrangement with the customer (e.g. patient). Revenue is then allocated to each separately identifiable good or service based on the standalone price of the items underlying the performance obligations. Most of the Company’s products fall in the Medicare Fee-for-Service (“FFS”) program which is a payment model where services are unbundled and paid for separately. These services are paid based on a Medicare determined price that is publicly available on the website for the Centers for Medicare & Medicaid Services (“CMS”).

For commercial payors, DME companies must negotiate in-network pricing separately, though in general, the Company’s payors tend to benchmark their contract rates and coverage policies closely to those of Medicare.

The Company considers performance obligations for sales and rentals to be met when the customer receives the equipment, and revenue for rentals is recognized over time, over the respective rental period. For revenue associated with DME rentals, the Company recognizes revenue in accordance with ASC 842, “Leases,” (Topic 842). For any DME sales and services, the Company recognizes revenue under FASB ASU 2014-09, “Revenue from Contracts with Customers,” (Topic 606) and related amendments.

The Company recognizes equipment rental revenue over the non-cancelable lease term, which varies based on the type of equipment rental, less estimated adjustments, in accordance with Topic 842. The Company has separate contracts with each patient that are not subject to a master lease agreement with any third-party payor. The Company would first consider the lease classification issue (sales-type lease or operating lease) and then appropriately recognize or defer rental revenue over the lease term.

Under the Company’s direct commercial staffing arrangements, the Company manages all or a part of a customer’s supplemental workforce needs utilizing its own network of healthcare professionals. As a result, the Company is the principal in this arrangement for revenue recognition purposes. The Company includes the contractual gross billings in revenues with a corresponding increase to cost of revenues for worksite employee payroll costs associated with these services. Alternatively, when the Company acts as agent in the performance of workforce management, revenue is recorded based on contractually agreed upon fees based on the hourly labor of worksite employees.

The revenues from each major source are summarized in the following table:
Three Months Ended June 30, Six Months Ended June 30,
2022 2021 2022 2021
Revenue from rentals
    Ventilator rentals, non-invasive and invasive $ 22,736  $ 20,305  $ 44,254  $ 40,656 
    Other durable medical equipment rentals 4,912  3,304  9,271  6,234 
Revenue from sales and services
    Equipment and supply sales
3,245  2,076  6,282  3,844 
    COVID-19 response sales and services
183  1,136  2,278  4,091 
    Service revenues
2,234  578  3,480  990 
Total revenues $ 33,310  $ 27,399  $ 65,565  $ 55,815 
Page 10

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021

Revenue Accounting under Topic 842

The Company leases DME such as non-invasive and invasive ventilators, positive airway pressure ("PAP") machines, percussion vests, oxygen concentrator units and other small respiratory equipment to customers for a fixed monthly amount on a month-to-month basis. The customer generally has the right to cancel the lease at any time during the rental period. The Company accounts for these rentals as operating leases.

Under FASB ASC Topic 842, the Company recognizes rental revenue on operating leases on a straight-line basis over the contractual lease term which varies based on the type of equipment rental. The lease term begins on the date products are delivered to patients, and revenues are recorded at amounts estimated to be received under reimbursement arrangements with third-party payors, including Medicare, private commercial payors, and Medicaid. Certain customer co-payments are included in revenue when considered probable of payment, which is generally when paid.

Due to the nature of the industry and the reimbursement environment in which the Company operates, certain estimates are required to record net revenue and accounts receivable at their net realizable values. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. Specifically, the complexity of many third-party billing arrangements and the uncertainty of reimbursement amounts for certain services from certain payors may result in adjustments to amounts originally recorded. Such adjustments are typically identified and recorded at the point of cash application or claim denial.

Revenue Accounting under Topic 606

The Company sells DME, replacement parts and supplies to customers and recognizes revenue based on contractual payment rates as determined by the payors at the point in time where control of the good or service is transferred through delivery to the customer. The customer and, if applicable, the payors are generally charged at the time that the product is sold. For sales of equipment previously placed in service, proceeds associated with these sales are recorded to gain (loss) on disposal of property and equipment.

The Company also provides sleep study services to customers and recognizes revenue when the sleep study results are complete, satisfying the performance obligation. In response to the COVID-19 pandemic, the Company began offering contact and vaccine tracing services, which revenues are recognized in the period in which the service has been provided. The transaction price on equipment sales, sleep studies and contact and vaccine tracing is the amount that the Company expects to receive in exchange for the goods and services provided. Due to the nature of the DME business, gross charges are retail charges and generally do not reflect what the Company is ultimately paid. As such, the transaction price is constrained for the difference between the gross charge and what is estimated to be collected from payors and from patients. The transaction price therefore is predominantly based on contractual payment rates as determined by the payors. The Company does not generally contract with uninsured customers. The payment terms and conditions of customer contracts vary by customer type and the products and services offered.

For staffing services, performance obligations in the staffing agreements are satisfied over time when the customer simultaneously receives and consumes the benefits provided as the Company performs the services. Accordingly, revenue from staffing services is recognized as the services are rendered in both principal and agent arrangements.

The Company determines its estimates of contractual allowances and discounts based upon contractual agreements, its policies and historical experience. While the rates are fixed for the product or service with the customer and the payors, such amounts typically include co-payments, co-insurance and deductibles, which vary in amounts, and are due from the patient. The Company includes in the transaction price only the amount that the Company expects to be entitled, which is substantially all of the payor billings at contractual rates. The transaction price is initially constrained by the amount of customer co-payments, which are included in the transaction price when considered probable of payment and included in revenue if the product or service has already been provided to the customer.

Due to the nature of the industry and the reimbursement environment in which the Company operates, certain estimates are required to record net revenue and accounts receivable at their net realizable values. Inherent in these estimates is the risk that they will have to be revised or updated as additional information becomes available. Specifically, the complexity of many third-party billing arrangements and the uncertainty of reimbursement amounts for certain services from certain payors may result in adjustments to amounts originally recorded. Such adjustments are typically identified and recorded at the point of cash application or claim denial.
Page 11

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021

Returns and refunds are not accepted on equipment sales, sleep study services or contact and vaccine tracing services. The Company does not offer warranties to customers in excess of the manufacturer’s warranty. Any taxes due upon sale of the products or services are not recognized as revenue. The Company does not have any partially or unfilled performance obligations related to contracts with customers and as such, the Company has no contract liabilities as of June 30, 2022.

Stock-based compensation

The Company accounts for its stock-based compensation in accordance with ASC 718, "Compensation—Stock Compensation", which establishes accounting for share-based awards exchanged for employee services and requires companies to expense the estimated fair value of these awards over the requisite employee service period. Stock–based compensation costs for stock options are determined at the grant date using the Black-Scholes option pricing model. Stock-based compensation costs for restricted stock units ("RSUs") are determined at the grant date based on the closing stock price. The expense of such stock-based compensation awards is recognized using the graded vesting attribution method over the vesting period and the offsetting credit is recorded as an increase in additional paid-in capital. Forfeitures are recorded as incurred. Any excess tax benefit or deficiency is recognized as a component of income taxes and within operating cash flows upon vesting of the share-based award.

For the Company’s phantom share units settled in cash, the Company computes the fair value of the phantom share units using the closing price of the equivalent Company's stock value at the end of each period and records a liability based on the percentage of requisite service.

Interest rate swaps

The Company utilizes an interest rate swap contract to reduce exposure to fluctuations in variable interest rates for future interest payments on the Term Note (as defined below). 

For determining the fair value of the interest rate swap contract, the Company uses significant other observable market data or assumptions (Level 2 inputs) that market participants would use in pricing similar assets or liabilities, including assumptions about counterparty risk. These fair value estimates reflect an income approach based on the terms of the interest rate swap contract and inputs corroborated by observable market data including interest rate curves. The Company presents a positive ending period fair value of the interest rate swap contract in other long-term assets, as a component of long-term assets, and a negative ending period fair value of the interest rate swap contract in accrued liabilities, as a component of long-term liabilities on the Condensed Consolidated Balance Sheets.

The Company recognizes any differences between the variable interest rate payments and the fixed interest rate settlements from its swap counterparty as an adjustment to interest expense over the life of the swap. If determined to be an effective cash flow hedge, the Company will record the changes in the estimated fair value of the swaps to accumulated other comprehensive income or loss on the Condensed Consolidated Balance Sheets. To the extent that interest rate swaps are determined to be ineffective, the Company would recognize the changes in the estimated fair value of swaps in interest and other non-operating expenses, net in its Condensed Consolidated Statements of Income.

Income taxes

The Company is subject to income taxes in numerous jurisdictions. Significant judgment is required in determining the provision for income taxes. The Company's income tax provisions reflect management’s interpretation of country and state tax laws. There are many transactions and calculations for which the ultimate tax determination is uncertain during the ordinary course of business and may remain uncertain for several years after their occurrence. The Company recognizes assets and liabilities for taxation when it is probable that it will receive refunds from or pay taxes to the relevant tax authority. Where the final determination of tax assets and liabilities is different from the amounts that were initially recorded, such differences will impact the current and deferred income taxes provision in the period in which such a determination is made. Changes in tax law or changes in the way tax law is interpreted may also impact our effective tax rate as well as our business and operations.

Deferred income tax assets and liabilities are recognized for the future income tax consequences attributable to temporary differences between the financial statement carrying value of assets and liabilities and their respective income tax bases. Deferred income tax assets or liabilities are measured using enacted or substantively enacted income tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be settled. The calculation of current and deferred income taxes requires management to make estimates and assumptions and to exercise a certain amount of judgment concerning the carrying value of assets and liabilities. The current and deferred income tax assets and liabilities are also impacted by expectations about future operating results and the timing of reversal of temporary differences as well as possible audits of tax
Page 12

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
filings by regulatory agencies. Changes or differences in these estimates or assumptions may result in changes to the current and deferred tax assets and liabilities on the Condensed Consolidated Balance Sheets and a charge to or recovery of income tax expense.

Recently issued accounting pronouncements

The Company is an “emerging growth company” as defined by the JOBS Act. The JOBS Act provides that an emerging growth company can take advantage of the extended transition period provided in Section 7(a)(2)(B) of the Securities Act of 1933, as amended, for complying with new or revised accounting standards. In other words, an emerging growth company can selectively delay the adoption of all accounting standards until those standards would otherwise apply to private companies. The Company has elected to utilize this exemption and, as a result, the Company's condensed consolidated financial statements may not be comparable to the financial statements of issuers that are required to comply with the effective dates for new or revised accounting standards that are applicable to public companies. To date, however, the Company has not delayed the adoption of any accounting standards except as noted below. Section 107 of the JOBS Act provides that the Company can elect to opt out of the extended transition period at any time, which election is irrevocable.

In November 2019, the FASB issued ASU 2019-11, Codification Improvements to Topic 326, Financial Instruments – Credit Losses. In June 2016, the FASB issued ASU 2016-13, Financial Instruments - Credit Losses: Measurement of Credit Losses on Financial Instruments, which is intended to improve financial reporting by requiring earlier recognition of credit losses on certain financial assets. The standard replaces the current incurred loss impairment model that recognizes losses when a probable threshold is met with a requirement to recognize lifetime expected credit losses immediately when a financial asset is originated or purchased. Further, the FASB issued ASU 2019-04 and ASU 2019-05 to provide additional guidance on the credit losses standard. The standard is effective for fiscal years beginning after December 15, 2022 for smaller reporting companies based on the Company's designation as of November 2019, including interim periods within those annual periods, with early adoption permitted. The Company is currently evaluating the effect that this standard will have on its consolidated financial statements and related disclosures.

In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848), which provides optional guidance to ease the potential burden in accounting for (or recognizing the effects of) reference rate reform on financial reporting. Specifically, the guidance permits an entity, when certain criteria are met, to consider amendments to contracts made to comply with reference rate reform to meet the definition of a modification under GAAP. It further allows hedge accounting to be maintained and a one-time transfer or sale of qualifying held-to-maturity securities. The expedients and exceptions provided by the amendments are permitted to be adopted any time through December 31, 2022 and do not apply to contract modifications made and hedging relationships entered into or evaluated after December 31, 2022, except for certain optional expedients elected for certain hedging relationships existing as of December 31, 2022. The Company has a commercial term note that references LIBOR and the Company is currently evaluating how this standard may be applied to specific contract modifications through December 31, 2022.

In November 2021, the FASB issued ASU No. 2021-10, Government Assistance (Topic 832): Disclosure by Business Entities about Government Assistance, which improves the transparency of government assistance received by most business entities by requiring the disclosure of: (1) the types of government assistance received; (2) the accounting for such assistance; and (3) the effect of the assistance on a business entity's financial statements. This guidance will be effective for the annual periods beginning after December 15, 2021. The Company is currently evaluating the impact of the new guidance on its consolidated financial statements and related disclosures.

Page 13

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
3.     Property and Equipment

The Company’s fixed assets consist of its medical equipment held for rental, furniture and equipment, real property and related improvements, and vehicles and other various small equipment.

The following table details the Company’s fixed assets:
June 30, 2022 December 31, 2021
Medical equipment $ 86,055  $ 76,864 
Furniture and equipment 2,709  2,521 
Land 2,566  2,566 
Buildings 7,497  7,682 
Leasehold improvements 296  296 
Vehicles 1,052  972 
Less: Accumulated depreciation (33,490) (28,055)
Property and equipment, net of accumulated depreciation and amortization $ 66,685  $ 62,846 

Depreciation in the amount of $3,497,000 and $2,509,000 is included in cost of revenue for the three months ended June 30, 2022 and 2021, respectively, and in the amount of $6,656,000 and $4,918,000 for the six months ended June 30, 2022 and 2021, respectively. Included in medical equipment above is equipment acquired under finance lease obligations whose cost and accumulated depreciation at June 30, 2022 total $39,000 and $8,000, respectively. At December 31, 2021, cost and accumulated depreciation on equipment acquired under finance lease obligations was $47,000 and $5,000, respectively.

4.     Current Liabilities

The Company’s short-term accrued liabilities are included within current liabilities and consist of the following:
June 30, 2022 December 31, 2021
Accrued trade payables $ 2,185  $ 2,011 
Accrued commissions payable 637  452 
Accrued bonuses payable 3,015  3,405 
Accrued vacation and payroll 1,272  1,226 
Current portion of phantom share liability 841  1,118 
Accrued other liabilities 910  663 
Total accrued liabilities $ 8,860  $ 8,875 

5.     Debt and Lease Liabilities

Senior Credit Facility

On February 20, 2018, the Company entered a Commercial Business Loan Agreement (the "Senior Credit Facility") that provides for Term Loans and a Line of Credit with Hancock Whitney Bank.

Line of Credit

The Company maintains a line of credit in the amount of $10.0 million that expires May 1, 2023 under the Commercial Business Loan Agreement. Any amounts advanced on this line will be subject to an interest rate equal to the WSJ prime rate plus a margin of 0.50%, with a 3.50% interest rate floor and will be secured by substantially all of the Company's assets. There were no borrowings against this line of credit at June 30, 2022 or December 31, 2021.

Page 14

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
Commercial Term Notes

On May 30, 2019, the Company entered into a term note (the “Building Term Note”) under the Commercial Business Loan Agreement in the principal amount of $4.8 million. The proceeds of the Building Term Note were used to purchase the Company's corporate headquarters. Beginning July 1, 2019, the Company began making monthly payments towards the outstanding balance. The Building Term Note matures on May 30, 2026 and is secured by substantially all of the assets of the borrower, including the real property acquired with the proceeds of the Building Term Note. The Building Term Note bears interest at a variable rate equal to the one month ICE LIBOR index plus a margin of 2.45% per annum. The Company is required to maintain a loan to value ratio of 85% with respect to the appraised value of the real property. In connection with the Building Term Note, the Company entered into an interest rate swap transaction (the "Interest Rate Swap Transaction") with Hancock Whitney Bank effectively fixing the interest rate for the Building Term Note at 4.68%.

On September 19, 2019, the Company entered into an additional loan agreement providing for a term note (the “Term Note") under the Commercial Business Loan Agreement in the principal amount of $5.0 million. The proceeds of the Term Note were utilized for general corporate purposes. Beginning October 19, 2019, the Company started making monthly principal payments of $139,000 towards the outstanding balance. The Term Note matures on September 19, 2022 and is secured by substantially all of the assets of the borrower. The Term Note bears interest at the rate of 4.60% per annum.

The Company incurred immaterial financing costs related to the above term notes. These deferred financing costs are amortized over the term of the loans using the effective interest method.

The recorded balances associated with these term notes are as follows:
June 30, 2022 December 31, 2021
Notes payable $ 4,838  $ 5,786 
Less:
Current portion of notes payable (612) (1,480)
Net long-term notes payable $ 4,226  $ 4,306 

Under the Commercial Business Loan Agreement, the Company is subject to several restrictive covenants that, among other things, impose operating and financial restrictions on the Company. Financial covenants include a Total Debt to Adjusted EBITDA, a Loan-to-Value Ratio and a Fixed Charged Coverage Ratio, as defined in the Credit Agreement. The Credit Agreement also contains certain customary events of default, including, among other things, failure to make payments when due thereunder and failure to observe or perform certain covenants. The Company was in compliance with all covenants under the Commercial Business Term Loan Agreement in effect at June 30, 2022.

Leases

The Company has recognized finance lease liabilities for medical equipment and operating leases for land and buildings that have terms greater than twelve months, as follows:
June 30, 2022 December 31, 2021
Lease liabilities $ 490  $ 732 
Less:
Current portion of lease liabilities (283) (464)
Net long-term lease liabilities $ 207  $ 268 

Included in lease liabilities at June 30, 2022 are finance lease liabilities for medical equipment in the amount of $29,000 due between 2022 and 2024.

Operating lease liabilities

The Company has recognized operating lease liabilities that relate primarily to the lease of land and buildings. These leases contain renewal options that we have not included as part of the Company's assessment of the lease term as it is not reasonably certain that we will exercise these options. These lease liabilities are recorded at present value based on a discount rate of 5.50%, which was based on the Company's incremental borrowing rate at the time of assessment. At June 30, 2022, the weighted average
Page 15

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
lease term was approximately 2.16 years. Operating rental expenses were $124,000 and $250,000 for the three and six months ended June 30, 2022, respectively, and $190,000 and $375,000 for the three and six months ended June 30, 2021, respectively. The related assets for operating lease liabilities have been included with property and equipment on the Condensed Consolidated Balance Sheets.

6.     Fair Value Measurement

Under ASC Topic 820, fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date (i.e., an exit price). ASC Topic 820 establishes a hierarchy for inputs to valuation techniques used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. There are three levels to the hierarchy based on the reliability of inputs, as follows:

Level 1 - Observable inputs that reflect quoted prices (unadjusted) for identical assets or liabilities in active markets.

Level 2 - Inputs other than quoted prices included in Level 1 that are observable for the asset or liability, either directly or indirectly. Level 2 inputs include quoted prices for similar assets or liabilities in active markets, or quoted prices for identical or similar assets and liabilities in markets that are not active.

Level 3 - Unobservable inputs for the asset or liability. The degree of judgment exercised by the Company in determining fair value is greatest for instruments categorized in Level 3.

Assets and Liabilities Measured at Fair Value on a Recurring Basis

The Company measures certain assets and liabilities at fair value on a recurring basis. There were no transfers between fair value measurement levels during any presented period.

The following tables summarize the Company's assets and liabilities measured at fair value on a recurring basis as of June 30, 2022 and December 31, 2021:
At June 30, 2022
(In thousands) Level 1 Level 2 Level 3 Total
Recurring Fair Value Measurements:
  Money market mutual funds $ 13,460  $ —  $ —  $ 13,460 
  Interest rate swap —  99  —  99 
Total $ 13,460  $ 99  $   $ 13,559 

At December 31, 2021
(In thousands) Level 1 Level 2 Level 3 Total
Recurring Fair Value Measurements:
  Money market mutual funds $ 16,459  $ —  $ —  $ 16,459 
  Interest rate swap $ (200) $ —  $ (200)
Total $ 16,459  $ (200) $   $ 16,259 
Page 16

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021

Derivative instruments and hedging activities

The Company recognizes its interest rate swaps as either assets or liabilities in the accompanying Condensed Consolidated Balance Sheets at fair value. The valuation of these derivative instruments is determined using widely accepted valuation techniques, including discounted cash flow analysis on the expected cash flows of each derivative. This analysis reflects the contractual terms of the derivatives, including the period to maturity, and uses observable market-based inputs, including interest rate curves and implied volatilities. As of June 30, 2022, the Company holds one interest rate swap contract which matures on May 30, 2026 and has a notional amount of $4.4 million. This contract is designated as a cash flow hedge. In the first six months of 2022, ineffective portions of the hedge were immaterial. The fair value was $0.1 million (determined based on Level 2 inputs) and is included in other long-term assets as of June 30, 2022.

Assets and Liabilities Measured at Fair Value on a Nonrecurring Basis

The Company measures certain assets and liabilities at fair value on a nonrecurring basis. These assets and liabilities include equity method investments and other equity investments. Equity method investments are evaluated for impairment whenever events or changes in circumstances indicate that the carrying value of the investments may exceed the fair value. The Company's other equity investments are holdings in privately-held companies without a readily determinable market value. The Company remeasures equity securities without readily determinable fair value at fair value when an orderly transaction is identified for an identical or similar investment of the same issuer in accordance with Topic 820. ASU 2019-04 states that the measurement alternative is a nonrecurring fair value measurement. Accordingly, other equity investments without readily determinable fair value are classified within Level 3 in the fair value hierarchy because the Company estimates the value using a combination of observable and unobservable inputs, including valuation ascribed to the issuing company in subsequent financing rounds, volatility in the results of operations of the issuers and rights and obligations of the holdings the Company owns.

The Company had no material adjustments of assets and liabilities measured at fair value on a nonrecurring basis during any of the periods presented. There were no transfers between fair value measurement levels during any presented period.

7.     Shareholders' Equity

Authorized share capital

The Company’s authorized share capital consists of an unlimited number of common shares.

Issued and outstanding share capital

The Company has only one class of stock outstanding, common shares. The authorized stock consists of an unlimited number of common shares with no stated par value, of which 38,333,089 and 39,640,388 shares were issued and outstanding as of June 30, 2022 and December 31, 2021, respectively.

For the six months ended June 30, 2022, the Company repurchased and canceled 1,350,567 common shares at a cost of $7.0 million pursuant to the Share Repurchase Program authorized by the Board of Directors on March 7, 2022 (the "2022 Share Repurchase Program"). The Company also acquired and cancelled 23,742 common shares at a cost of $0.1 million to satisfy employee income tax withholding associated with RSUs vesting during the six months ended June 30, 2022. The Company’s retained earnings were reduced by the amount paid for the shares repurchased and cancelled.

Stock-based compensation

Effective June 11, 2020 (the "Effective Date"), the Company’s shareholders approved the Company's 2020 Long Term Incentive Plan (the "Omnibus Plan"). Upon approval of the Omnibus Plan, no future awards are available to be made under the Company's previous RSU and Option Plans (collectively, the "Former Plan"), and the common shares that were not settled or awarded under the Former Plan as of the Effective Date are available for awards under the Omnibus Plan. The maximum number of common shares that are available for awards under the Omnibus Plan and under any other security-based compensation arrangements adopted by the Company, including the Former Plan, may not exceed 7,758,211 shares (equal to 20% of the issued and outstanding common shares of the Company on the Effective Date). The maximum amount of the foregoing common shares that may be awarded under the Omnibus Plan as “incentive stock options” is 2,600,000 common shares. As of June 30, 2022, the Company had outstanding options of 4,532,000 and RSUs of 596,000 associated with common shares under the Omnibus Plan.

Page 17

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
The following table summarizes stock-based compensation expense for the three and six months ended June 30, 2022 and 2021 (in thousands):
Three Months Ended June 30, Six Months Ended June 30,
2022 2021 2022 2021
Stock-based compensation - options $ 757  $ 998  $ 1,577  $ 2,076 
Stock-based compensation - restricted stock units 514  238  999  467 
Total $ 1,271  $ 1,236  $ 2,576  $ 2,543 

At June 30, 2022, there was approximately $2,965,000 of total unrecognized pre-tax stock option expense under the Company's equity compensation plans, which is expected to be recognized over a weighted-average period of 1.99 years. As of June 30, 2022, there was approximately $1,973,000 of total unrecognized pre-tax compensation expense related to outstanding time-based restricted stock units that is expected to be recognized over a weighted-average period of 1.24 years.

Options

The following table summarizes stock option activity for the six months ended June 30, 2022:
Number of options
 (000's)
Weighted average exercise price(1)
Weighted average remaining contractual life
Aggregate intrinsic value(2)
Balance December 31, 2021 3,822  $ 5.22  7.4 years $ 3,722 
Issued 712  5.22 
Exercised —  — 
Expired / Forfeited (2) 5.21 
Balance June 30, 2022 4,532  $ 5.22  7.3 years $ 4,139 
(1)For presentation purposes, stock options issued with a CAD exercise price have been translated to USD based on the prevailing exchange rate on the date of grant.
(2)The aggregate intrinsic value of options outstanding represents the difference between the exercise price of the option and the closing stock price of the Company's common stock on the last trading day of the period ($5.38).

The aggregate intrinsic value of options outstanding was $4,138,673 and options exercisable were $4,023,548 at June 30, 2022. For the six months ended June 30, 2022, 0 shares of common stock were issued pursuant to the exercise of stock options.

At June 30, 2022, the Company had 2,864,000 exercisable stock options outstanding with a weighted average exercise price of $4.42 and a weighted average remaining contractual life of 6.5 years. At December 31, 2021, the Company had 1,905,744 exercisable stock options outstanding with a weighted average exercise price of $3.70 and a weighted average remaining contractual life of 6.6 years.

The Company accounts for its stock-based compensation in accordance with ASC 718 — Compensation—Stock Compensation, which establishes accounting for share-based awards exchanged for employee services and requires companies to expense the estimated fair value of these awards over the requisite employee service period. Stock–based compensation cost for stock options are determined at the grant date using the Black-Scholes option pricing model. The assumptions used to determine the grant date fair value of the stock options granted during the six months ended June 30, 2022 were as follows:
Exercise price
$5.21 - $5.41
Risk-free interest rate
1.41% - 2.75%
Expected volatility
57.91% - 57.95%
Expected term
5.49 - 5.58 years
Expected dividend yield Nil
Fair value on date of grant
$2.73 - $2.91


Page 18

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
Restricted stock units

The Company also grants RSUs to directors, officers, and employees. The Company accounts for RSUs using fair value as of the date of issuance. The fair value of the RSUs has been charged to the Condensed Consolidated Statements of Income and Comprehensive Income and credited to additional paid-in capital over the vesting period, based on the stock price on the date of grant. RSUs vest generally over a one or three-year period. The Company accounts for forfeitures on RSUs under ASU 2016-09 and recognizes forfeitures in the period in which they occur.

The following table summarizes RSU activity for the six months ended June 30, 2022:
Number of RSUs (000's)
Weighted average grant price(1)
Weighted average remaining contractual life
Aggregate intrinsic value(2)
Balance December 31, 2021 206  $ 6.61  0.68 years $ 1,074 
Issued 461  5.22 
Vested (67) 6.13 
Expired / Forfeited (4) 6.48 
Balance June 30, 2022 596  $ 5.58  1.24 years $ 3,206 
(1)All future equity grants will be awarded in USD, therefore, RSUs issued with a CAD grant price have been translated to USD based on the prevailing exchange rate on the date of grant for presentation purposes.
(2)The aggregate intrinsic value of time-based RSUs outstanding was based on the Company's closing stock price on the last trading day of the period ($5.38).

During the three months ended June 30, 2022, the Company issued 19,963 RSUs with a vesting term of three years and a fair value of $0.1 million. During the six months ended June 30, 2022, the Company issued 461,132 RSUs with a vesting term of three years and a fair value of $2.4 million.

Phantom share units

The Company has a phantom share unit plan, which it uses for grants to directors, officers, and employees. Phantom share units granted under the plan are non-assignable and are settled in cash at vesting based on the fair value of the Company's common stock on the vesting date. Phantom share units vest annually over a three-year period. The cash-settled phantom share units are accounted for as liability awards and are re-measured at fair value each reporting period until they become vested with accrued liability and related expense being recognized over the requisite service period.

The following table summarizes phantom share unit activity for the six months ended June 30, 2022:
Number of phantom share units (000's)
Value of share equivalents(1)
Balance December 31, 2021 573  $ 2,991 
Issued 238  1,213 
Vested (265) (1,389)
Expired / Forfeited (30) (164)
Balance June 30, 2022 516  $ 2,774 
(1)The value of outstanding share equivalents at the beginning of the period is based on the market price of the Company’s stock at that time, the value of issued share equivalents is based on the market price of the Company’s stock at issuance, the value of vested share equivalents is based on the cash paid at the time of vesting, the values of expired/forfeited share equivalents and outstanding share equivalents at the end of the period and are based on the market price of the Company's stock at the end of the period. The market price of the Company's stock was $5.38 on June 30, 2022.

The change in fair value of the phantom share units has been charged to the Condensed Consolidated Statements of Income and Comprehensive Income and recorded as a liability included in accrued liabilities and long-term accrued liabilities. The total liability associated with phantom share units at June 30, 2022 is $1,226,000, with $841,000 of this amount included in current accrued liabilities and the remaining portion of $385,000 included in long-term accrued liabilities.

Page 19

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
The impact associated with the fair value re-measurement of phantom share units is recorded in selling, general and administrative expenses within the unaudited Condensed Consolidated Statements of Income and Comprehensive Income. The following table summarizes expense (benefit) associated with the phantom share units for the three and six months ended June 30, 2022 and 2021 (in thousands):
Three Months Ended June 30, Six Months Ended June 30,
2022 2021 2022 2021
Selling, general, and administrative $ 538  $ (106) $ 949  $ 2,359 

The Company paid cash settlements of $1,389,000 and $6,282,000 during the six months ended June 30, 2022 and 2021, respectively, pertaining to vestings of cash-settled phantom share units.

8.     Commitments and Contingencies

The Company accrues estimates for resolution of any legal and other contingencies when losses are probable and reasonably estimable in accordance with ASC 450, Contingencies (“ASC 450”). No less than quarterly, the Company reviews the status of each significant matter underlying a legal proceeding or claim and assess our potential financial exposure. The Company accrues a liability for an estimated loss if the potential loss from any legal proceeding or claim is considered probable and the amount can be reasonably estimated. Significant judgment is required in both the determination of probability and the determination as to whether the amount of an exposure is reasonably estimable, and accruals are based only on the information available to the Company at the time the judgment is made, which may prove to be incomplete or inaccurate or unanticipated events and circumstances may occur that might cause us to change those estimates and assumptions. Furthermore, the outcome of legal proceedings is inherently uncertain, and we may incur substantial defense costs and expenses defending any of these matters.

Legal Proceedings

As previously disclosed, the Company (through its subsidiary Sleep Management LLC) submitted a purchase order (the “Purchase Order”) in March 2020 to Vyaire Medical, Inc. d/b/a CareFusion Respiratory Technologies (“Vyaire”) for respiratory equipment. The Company ultimately prepaid $1.4 million towards the delivery of such respiratory equipment. Vyaire was unable or unwilling to deliver the vast majority of the respiratory equipment referenced in the Purchase Order, and also refused to refund the prepayment amount (less the amounts paid for equipment actually received). On July 29, 2020, the Company (through its subsidiary Sleep Management LLC) filed a lawsuit against Vyaire in the United States District Court for the Western District of Louisiana (the “Court”). This lawsuit was dismissed on December 8, 2020 in connection with the commencement of the lawsuit filed by the Company (through its subsidiary Sleep Management) on November 5, 2020, against Vyaire in the 15th Judicial District Court for the Parish of Lafayette, Louisiana (the “State Court”) seeking damages for breach of contract and seeking a declaratory judgment that the Company is not required to pay any further funds to Vyaire. On December 28, 2020, Vyaire filed its Answer, Affirmative Defenses, and Reconventional Demand (“Reconventional Demand”) with the State Court alleging breach of contract and seeking damages of $4.7 million, purportedly for the improper cancellation of the Purchase Order. The Company filed its Answer to the Reconventional Demand on February 12, 2021 and the parties are currently engaged in discovery.

The Company continues to believe that it has valid legal and equitable grounds to recover its outstanding prepayment as a result of Vyaire’s failure to deliver the vast majority of the respiratory equipment referenced in the Purchase Order. The Company has determined that a loss related to the Reconventional Demand is not probable, and thus has not accrued a liability related to this claim. Although a loss may be reasonably possible, the Company does not have sufficient information to determine the amount or range of reasonably possible loss with respect to the Reconventional Demand given that the dispute is in the early stages of the legal process. As of June 30, 2022, outstanding funds in the amount of $0.9 million related to undelivered respiratory equipment are included within other long-term assets.

Governmental and Regulatory Matters

From time to time the Company is involved in various external governmental investigations, audits and reviews. Reviews, audits and investigations of this sort can lead to government actions, which can result in the assessment of recoupment of reimbursement, civil or criminal fines or penalties, or other sanctions, including restrictions or changes in the way the Company conducts business, loss of licensure or exclusion from participation in government healthcare programs.

Page 20

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
In May of 2021, a final report and recommendation (“Report”) was issued by the OIG regarding an audit by OIG of claims relating to 100 of the Company’s non-invasive ventilation at home (“NIVH”) patients. The OIG asserted that most of the sampled Medicare claims submitted for the monthly rental of non-invasive ventilators did not comply with Medicare requirements. The Company firmly believes that the Report ignores each patient’s diagnosis and supporting documentation of that diagnosis from treating and prescribing physicians and applies clinical guidelines that are contrary to CMS’s accepted standard of care. In late June of 2021, the Company received initial request letters from DME Medicare Administrative Contractors ("MACs") referencing the Report and requesting repayment of purported overpayments. The Company responded to each initial request by submitting a rebuttal and by filing a redetermination appeal as prescribed by the initial request letters and by statute. In September 2021, the MACs informed the Company of unfavorable decisions with respect to the redetermination appeals. In November 2021, the Company filed Reconsideration Appeals with CMS's designated Qualified Independent Contractor ("QIC"). Based on its review, the QIC determined that approximately 77% of the claims it reviewed were medically necessary and properly payable under Medicare rules and regulations, overturning OIG’s and the MACs' initial recommendations and determinations. As a result of the QIC's reconsideration findings, recalculated principal overpayment requests totaling $1.1 million have been issued by the MACs. The Company has filed its appeals with the Administrative Law Judge, and intends to continue to defend itself vigorously through the remaining appeals processes which include, in successive order, Administrative Law Judge, Medicare Appeals Council review, and ultimately through Federal Court, if necessary. The timing of additional appeals beyond reconsideration are subject to workload constraints of the reviewing body. Based on the current facts and circumstances as the Company understands them, and the nature of the requests, the Company has determined that a loss is not probable but may be reasonably possible. Accordingly, no related accrual has been recorded. The Company estimates that a possible loss, if any, will not exceed the amount of the recalculated overpayment requests. It is possible that the ultimate resolution of this matter, if unfavorable, could materially and adversely affect the Company’s consolidated financial position, consolidated results of operations, or consolidated cash flows.

9.     Income Taxes

For the six months ended June 30, 2022, the Company recorded income tax expense of $1.2 million. Excluding the impact of the discrete taxes, the effective rate for the six months ended June 30, 2022 is 29.4%. The effective rate differs from the amount computed by applying the statutory federal and state income tax rates to ordinary income before the provision for income taxes due to permanent non-deductible differences. The Company's effective tax rate is based on forecasted annual results which may fluctuate significantly through the rest of the year, in particular due to the uncertainty in our annual forecasts resulting from the unpredictable impact of the COVID-19 pandemic on our operating results.

At June 30, 2022 and 2021, the Company had no amounts recorded for uncertain tax positions and does not expect any material changes in uncertain tax benefits during the next 12 months. The Company recognizes interest and penalties related to income tax matters in income tax expense. The Company is subject to U.S. federal income tax as well as income tax in various states. The Company is generally not subject to examination by taxing authorities for years prior to 2018.

The Company recognizes deferred tax assets to the extent that the Company believes that these assets are more likely than not to be realized. In making such a determination, the Company considers all available positive and negative evidence, including future reversals of existing taxable temporary differences, projected future taxable income, tax-planning strategies, and results of recent operations.

10.     Earnings Per Share

Income per common share is calculated using earnings for the year divided by the weighted average number of shares outstanding during the year. Using the treasury stock method, diluted income per share amounts are calculated giving effect to the potential dilution that would occur if securities or other contracts to issue common shares were exercised or converted to common shares by assuming the proceeds received from the exercise of stock options and the vesting of RSUs are used to purchase common shares at the prevailing market rate.

Page 21

VIEMED HEALTHCARE, INC.
NOTES TO THE CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(Tabular dollar amounts expressed in thousands of U.S. Dollars, except per share amounts)
(Unaudited)
June 30, 2022 and 2021
The following reflects the earnings and share data used in the basic and diluted earnings per share computations:
Three Months Ended June 30, Six Months Ended June 30,
2022 2021 2022 2021
Numerator - basic and diluted:
Net income attributable to shareholders $ 967  $ 1,566  $ 2,729  $ 3,250 
Denominator:
Basic weighted-average number of common shares 38,773,580  39,584,064  39,195,317  39,357,992 
Diluted weighted-average number of shares 39,752,928  41,028,742  40,056,953  40,849,311 
Basic earnings per share $ 0.02  $ 0.04  $ 0.07  $ 0.08 
Diluted earnings per share $ 0.02  $ 0.04  $ 0.07  $ 0.08 
Denominator calculation from basic to diluted:
Basic weighted-average number of common shares 38,773,580  39,584,064  39,195,317  39,357,992 
Stock options and other dilutive securities 979,348  1,444,678  861,636  1,491,319 
Diluted weighted-average number of shares 39,752,928  41,028,742  40,056,953  40,849,311 

Anti-dilutive shares excluded from the calculation consisted of dilutive employee stock options and RSUs that were de minimis in all periods presented.

Page 22

VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021
Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis of our financial condition and results of operations should be read in conjunction with, and is qualified entirely by, our condensed consolidated financial statements (including Notes to the Condensed Consolidated Financial Statements) and the other consolidated financial information under Item 1 of this Quarterly Report on Form 10-Q. Some of the information in this discussion and analysis includes forward-looking statements that involve risk and uncertainties. Actual results and timing of events could differ from the results described in or implied by the forward-looking statements contained in the following discussion and analysis.

On March 11, 2020, the World Health Organization declared the outbreak of the novel coronavirus ("COVID-19") a pandemic. Based on the duration and severity of the impacts of the COVID-19 pandemic, including but not limited to any negative economic conditions arising from the pandemic, our ability to assess potential patients in hospitals and set up and treat patients in the home, and the impacts of government actions and administrative regulations on the healthcare industry and broader economy, including through existing and any future stimulus efforts, we are uncertain of the ultimate impact COVID-19 could have on our business, financial condition and results of operations.

Forward-Looking Statements

Certain statements and information in this Quarterly Report on Form 10-Q may constitute “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995 or "forward-looking information" as such term is defined in applicable Canadian securities legislation (collectively, "forward-looking statements"). Any statements other than statements of historical information, including those that express, or involve discussions as to, expectations, beliefs, plans, objectives, assumptions or future events or performance are not historical facts and may be forward-looking and may involve estimates, assumptions and uncertainties that could cause actual results or outcomes to differ materially from those expressed in the forward-looking statements. These forward-looking statements are made as of the date hereof. We undertake no obligation to publicly update or revise any forward-looking statements after the date they are made, whether as a result of new information, future events or otherwise, except as required by applicable law.
 
Forward-looking statements relate to future events or future performance and reflect the expectations or beliefs of management regarding future events, and include, but are not limited to, statements with respect to: operating results; profitability; financial condition and resources; anticipated needs for working capital; liquidity; capital resources; capital expenditures; milestones; licensing milestones; information with respect to future growth and growth strategies; anticipated trends in our industry; our future financing plans; timelines; currency fluctuations; government regulation; unanticipated expenses; commercial or governmental disputes or claims; limitations on insurance coverage or other reimbursement; and availability of cash flow to fund capital requirements.
 
Often, but not always, forward-looking information can be identified by the use of words such as “plans”, “expects”, “is expected”, “budget”, “potential”, “scheduled”, “estimates”, “forecasts”, “intends”, “anticipates”, “believes”, “projects”, or the negatives thereof or variations of such words and phrases or statements that certain actions, events or results “will”, “should”, “may”, “could”, “would”, “might” or “will be taken”, “occur” or “be achieved” or the negative of these terms or comparable terminology.
 
Forward-looking statements are based on the reasonable assumptions, estimates, analysis and opinions of management made in light of its experience and its perception of trends, current conditions and expected developments, as well as other factors that management believes to be relevant and reasonable in the circumstances at the date that such statements are made, but which may prove to be incorrect. We believe that the assumptions and expectations reflected in such forward-looking statements are reasonable. We cannot assure you, however, that such statements will prove to be accurate, as actual results and future events could differ materially from those anticipated in such statements. Accordingly, readers should not place undue reliance on forward-looking statements.

Page 23

VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021
By their nature, forward-looking statements involve numerous assumptions, inherent risks and uncertainties, both general and specific, including those identified under “Risk Factors” and elsewhere in this Quarterly Report on Form 10-Q and the other documents we file with the SEC, including under “Item 1A. Risk Factors” of our Annual Report on Form 10-K for the year ended December 31, 2021, and with the securities regulatory authorities in certain provinces of Canada, which contribute to the possibility that the predicted outcomes may not occur or may be delayed. The risks, uncertainties and other factors, many of which are beyond our control, that could influence actual results include, but are not limited to: the general business, market and economic conditions in the regions in which the we operate; the impact of the COVID-19 pandemic and of the actions taken by governmental authorities, individuals and companies in response to the pandemic on our business, financial condition and results of operations, including on our patient base, revenues, employees, and equipment and supplies; significant capital requirements and operating risks that we may be subject to; our ability to implement business strategies and pursue business opportunities; volatility in the market price of our common shares; our novel business model; the risk that the clinical application of treatments that demonstrate positive results in a study may not be positively replicated or that such test results may not be predictive of actual treatment results or may not result in the adoption of such treatments by providers; the state of the capital markets; the availability of funds and resources to pursue operations; reductions in reimbursement rates and audits of reimbursement claims by various governmental and private payor entities; dependence on few payors; possible new drug discoveries; dependence on key suppliers and the recall of certain Royal Philips BiPAP and CPAP devices and ventilators that we distribute and sell; granting of permits and licenses in a highly regulated business; competition; low profit market segments; disruptions in or attacks (including cyber-attacks) on our information technology, internet, network access or other voice or data communications systems or services; the evolution of various types of fraud or other criminal behavior to which we are exposed; the failure of third parties to comply with their obligations; difficulty integrating newly acquired businesses; the impact of new and changes to, or application of, current laws and regulations; the overall difficult litigation and regulatory environment; increased competition; changes in foreign currency rates; increased funding costs and market volatility due to market illiquidity and competition for funding; critical accounting estimates and changes to accounting standards, policies, and methods used by us; our status as an emerging growth company and a smaller reporting company; and the occurrence of natural and unnatural catastrophic events or health epidemics or concerns, such as the COVID-19 pandemic, and claims resulting from such events or concerns, as well as other general economic, market and business conditions; and other factors beyond our control.

General Matters

In this Quarterly Report on Form 10-Q, unless the context otherwise requires, the terms the "Company," "we," "us" and "our" refer to Viemed Healthcare, Inc. and its wholly-owned subsidiaries.

We were incorporated on December 14, 2016 pursuant to the Business Corporations Act (British Columbia). As of June 30, 2020, we determined that we no longer qualify as a "foreign private issuer," as defined in Rule 3b-4 of the Exchange Act, for the purposes of the informational requirements of the Exchange Act. As a result, effective January 1, 2021, we became subject to the proxy solicitation rules under Section 14 of the Exchange Act and Regulation FD, and our officers, directors, and principal shareholders became subject to the reporting and short-swing profit recovery provisions contained in Section 16 of the Exchange Act. We will continue to file annual reports on Form 10-K, quarterly reports on Form 10-Q, and current reports on Form 8-K with the SEC and with the relevant Canadian securities regulatory authorities on the System for Electronic Document Analysis and Retrieval (SEDAR).

We are an "emerging growth company," as defined in the JOBS Act and a "smaller reporting company" under Rule 12b-2 of the Exchange Act, and as such, we have elected to comply with certain reduced U.S. public company reporting requirements.

Unless otherwise noted herein, all references to "$" or "USD" are to the currency of the United States and references to "CAD$" or "Canadian dollars" are to the currency of Canada.

Overview

We provide an array of home medical equipment, services and supplies, specializing in post-acute respiratory care services in the United States. Our primary objective is to focus on the organic growth of the business and thereby solidify our position as one of the United States’ largest providers of in-home therapy for patients suffering from respiratory diseases. Our respiratory care programs are designed specifically for payors to have the ability to treat patients in the home for less total cost and with a superior quality of care. Our services include respiratory disease management (through the rental of various DME devices), in-home sleep testing and sleep apnea treatment, oxygen therapy, and the sale of associated supplies.

We derive the majority of our revenue through the rental of non-invasive and invasive ventilators which represented 68.6% and 77.3% of our traditional revenue, excluding COVID-19 response sales and services, for the three months ended June 30, 2022 and 2021, respectively, and 69.9% and 78.6% for the six months ended June 30, 2022 and 2021, respectively. We combine the benefits
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VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021
of home ventilation support with licensed Respiratory Therapists ("RTs") to drive improved patient outcomes and reduce costly hospital readmissions.

We expect to grow through expansion of existing service areas as well as in new territories through a cost efficient launch that reduces location expenses. Our licensed RTs currently serve patients in 48 states. We expect to continue to employ more RTs in order to assure our high service model is accomplished in the home. As of June 30, 2022, we employed 284 licensed RTs, representing approximately 40% of our company-wide employee count. By focusing overhead costs on personnel that service the patient rather than physical location costs, we anticipate that we will efficiently scale our business in regions that are currently not being effectively serviced.

The continued trend of servicing patients in the home rather than in hospitals is aligned with our business objective and we anticipate that this trend will continue to offer growth opportunities for us. We expect to continue to be a solution to the rising health costs in the United States by offering more cost effective, home based solutions while increasing the quality of life for patients fighting serious respiratory diseases.

Trends Affecting our Business

On March 11, 2020, the World Health Organization designated COVID-19 as a global pandemic. Various policies and initiatives have been implemented to reduce the transmission of COVID-19, including travel bans and restrictions, the postponement of non-essential medical surgeries, limiting access to medical facilities, and adoption of social distancing and remote working policies. Local, state and national governments continue to emphasize the importance of essential medical personnel and we remain open to meet the needs of our communities. Employee and patient safety is our first priority, and as a result, we put preparedness plans in place for our employees, especially our clinical personnel, and modified our clinical protocols to limit unnecessary patient encounters. These measures do not appear to be negatively impacting our patient attrition rate at this time, but we cannot assure you that future governmental policies and initiatives will not significantly disrupt our operations or adversely affect our ability to provide services to our patients in the future. In addition, our ability to assess potential patients in hospitals varies by hospital and city, but overall our business of setting up new patients in the home is continuing although at lower levels than in recent periods. While governmental and other restrictions have not had a material impact on our consolidated operating results for the six months ended June 30, 2022, it is possible that more significant disruptions could occur if the COVID-19 pandemic continues for a prolonged period of time and we cannot assure you that demand for our products and services will continue or that we will be able to maintain operations necessary to satisfy such demand, including sufficient personnel, supply chains and distributions channels.

The COVID-19 pandemic has led to significant disruptions and volatility in capital and financial markets. Broad economic factors resulting from the current COVID-19 pandemic, including high unemployment and underemployment levels and reduced consumer spending and confidence, could also affect our service mix, revenue mix, payor mix and patient base, as well as our ability to collect outstanding receivables. Business closures and layoffs in the geographic areas in which we operate may lead to increases in the uninsured and under-insured populations and adversely affect demand for our services, as well as the ability of patients and other payors to pay for services rendered. Any increase in the amount or deterioration in the collectability of patient accounts receivable will adversely affect our financial results and require an increased level of working capital. In addition, we may experience supply chain disruptions, including delays and price increases in equipment and supplies. Staffing, equipment and supplies shortages may also impact our ability to assess potential patients in hospitals and set up and treat patients in the home.

We believe we presently have sufficient liquidity to satisfy our cash needs, however, we continue to evaluate and take action, as necessary, to preserve adequate liquidity and ensure that our business can continue to operate during these uncertain times. The CARES Act, which was signed into law on March 27, 2020, provides a substantial stimulus and assistance package intended to address the impact of the COVID-19 pandemic, including tax relief and government loans, grants and investments. The legislation provides for relief funds to hospitals and other healthcare providers on the front lines of the coronavirus response to support healthcare-related expenses or lost revenue attributable to COVID-19 and to ensure uninsured Americans can get testing and treatment for COVID-19. As a result, we received a general distribution payment from the Provider Relief Fund of $3.5 million in April 2020, a targeted distribution payment of $1.5 million in November 2021, and a general distribution payment of $0.4 million in January of 2022. Payments from the Provider Relief Fund are intended to compensate healthcare providers for lost revenues and incremental expenses incurred in response to the COVID-19 pandemic. The Department of Health and Human Services has stated that Provider Relief Fund payments are not loans and will not need to be repaid. However, as a condition to the receipt of funds, the Company and any other providers must agree to a detailed set of terms and conditions. CMS has indicated that the terms and conditions may be subject to ongoing changes and reporting. To the extent that reporting requirements and terms and conditions are modified, it may affect our ability to comply and may require the return of funds. In accordance with the terms of acceptance for the grant, we believe we have utilized these funds to prevent, prepare for, and respond to the COVID-19 pandemic.

The CARES Act also provides for a temporary suspension of the 2% payment sequestration adjustment currently applied to all Medicare fee-for-service claims. In December 2021, President Biden signed into law legislation that extended the suspension on
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VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021
the 2 percent payment sequestration through March 31, 2022. The payment sequestration adjustment was fixed at 1 percent from April 1, 2022 to June 30, 2022 and it returned to 2 percent on July 1, 2022.
 
We are continuing to monitor any effects or requirements that may result from the CARES Act as many of the provisions in the CARES Act are temporary and may require us to modify our operations and compliance procedures. CMS and other federal agencies have and are likely to issue rules and regulations to implement the CARES Act. The impact of these rules and regulations are unknown and may affect us. To the extent these provisions will expire as stated in the CARES Act, we will be required to unwind any modifications.

In 2019, CMS announced the inclusion of noninvasive ventilator products on the list of products subject to the competitive bidding program for Round 2021, which covers the period of January 1, 2021 through December 31, 2023. Rental revenue from ventilator products represents a significant portion of our revenues (approximately 69.9% of total traditional revenue, excluding COVID-19 response sales and services, for the six months ended June 30, 2022). On March 9, 2020, CMS announced that due to the COVID-19 pandemic, the United States President's exercise of the Defense Production Act, public concern regarding access to ventilators, and the non-invasive ventilators product category being new to the competitive bidding program, non-invasive ventilators were removed as a product category from Round 2021. On October 27, 2020, CMS announced that it had removed 13 of the 15 remaining product categories from Round 2021, including oxygen and PAP devices, because the payment amounts did not achieve expected savings. The next competitive bidding round is anticipated to begin no sooner than January 1, 2024. As a result of these announcements, we retain the ability to continue to furnish non-invasive ventilators and oxygen and PAP devices for all of our Medicare accredited areas, however, we are uncertain if non-invasive ventilators, oxygen, and PAP devices will be included in future competitive bidding programs.

The below table highlights summary financial and operational metrics for the last eight quarters.
(Tabular amounts expressed in thousands of U.S. Dollars, except vent patients)
For the quarter ended June 30,
2022
March 31, 2022 December 31, 2021 September 30, 2021 June 30, 2021 March 31, 2021 December 31, 2020 September 30, 2020
Financial Information:
Revenue $ 33,310  $ 32,255  $ 31,962  $ 29,285  $ 27,399  $ 28,416  $ 31,202  $ 33,447 
Gross Profit $ 20,390  $ 19,743  $ 19,662  $ 18,381  $ 17,625  $ 17,742  $ 19,178  $ 19,453 
Gross Profit % 61  % 61  % 62  % 63  % 64  % 62  % 61  % 58  %
Net Income $ 967  $ 1,762  $ 4,087  $ 1,789  $ 1,566  $ 1,684  $ 5,071  $ 2,804 
Cash (As of) $ 21,922  $ 29,248  $ 28,408  $ 26,867  $ 31,151  $ 31,097  $ 30,981  $ 32,396 
Total Assets (As of) $ 115,904  $ 119,007  $ 117,962  $ 115,486  $ 111,014  $ 113,001  $ 112,560  $ 113,969 
Adjusted EBITDA(1)
$ 6,458  $ 7,273  $ 9,549  $ 7,419  $ 6,847  $ 5,468  $ 9,458  $ 7,720 
Operational Information:
Vent Patients(2)
8,837  8,434  8,405  8,200  8,103  7,733  7,892  7,788 
(1) Refer to "Non-GAAP Financial Measures" section below for definition of Adjusted EBITDA.
(2) Vent Patients represents the number of active ventilator patients on recurring billing service at the end of each calendar quarter.
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VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021

Results of Operations

Comparison of the Three Months Ended June 30, 2022 and 2021:

The following table summarizes our results of operations for the three months ended June 30, 2022 and 2021:
Three Months Ended June 30,
2022 % of Total Revenue 2021 % of Total Revenue $
Change
%
Change
Revenue $ 33,310  100.0  % $ 27,399  100.0  % $ 5,911  21.6  %
Cost of revenue 12,920  38.8  % 9,774  35.7  % 3,146  32.2  %
Gross profit 20,390  61.2  % 17,625  64.3  % 2,765  15.7  %
Selling, general and administrative 17,536  52.6  % 12,884  47.0  % 4,652  36.1  %
Research and development 672  2.0  % 583  2.1  % 89  15.3  %
Stock-based compensation 1,271  3.8  % 1,236  4.5  % 35  2.8  %
Depreciation 243  0.7  % 207  0.8  % 36  17.4  %
Loss (gain) on disposal of property and equipment (110) (0.3) % 83  0.3  % (193) (232.5) %
Other expense (income) (223) (0.7) % (32) (0.1) % (191) 596.9  %
Income from operations 1,001  3.0  % 2,664  9.7  % (1,663) (62.4) %
Non-operating income and expenses
Income from equity method investments 446  1.3  % 231  0.8  % 215  93.1  %
Interest expense, net (59) (0.2) % (83) (0.3) % 24  (28.9) %
Net income before taxes 1,388  4.2  % 2,812  10.3  % (1,424) (50.6) %
Provision (benefit) for income taxes 421  1.3  % 1,246  4.5  % (825) (66.2) %
Net income $ 967  2.9  % $ 1,566  5.7  % $ (599) (38.3) %

Revenue

The following table summarizes our revenue for the three months ended June 30, 2022 and 2021:
Three Months Ended June 30,
2022 % of Total Revenue 2021 % of Total Revenue $
Change
%
Change
Net revenue from rentals
Ventilator rentals, non-invasive and invasive $ 22,736  68.3  % $ 20,305  74.1  % $ 2,431  12.0  %
Other durable medical equipment rentals 4,912  14.7  % 3,304  12.2  % 1,608  48.7  %
Net revenue from sales and services
Equipment and supply sales 3,245  9.7  % 2,076  7.6  % 1,169  56.3  %
COVID-19 response sales and services 183  0.5  % 1,136  4.1  % (953) (83.9) %
Service revenues 2,234  6.7  % 578  2.1  % 1,656  286.5  %
Total net revenue $ 33,310  100.0  % $ 27,399  100.0  % $ 5,911  21.6  %

For the three months ended June 30, 2022, net revenue totaled $33.3 million, an increase of $5.9 million (or 21.6%) from the comparable period in 2021. Excluding COVID-19 response sales and services revenue, net revenue increased $6.9 million (or 26.1%) from the comparable period in 2021. The net revenue increase was comprised of an increase in ventilator rental revenue of $2.4 million (or 12.0%), rental revenue from other DME of $1.6 million (or 48.7%), equipment and supply sales of $1.2 million (or 56.3%), and service revenue of $1.7 million (or 286.5%). The growth in other durable medical equipment rentals and equipment and supply sales has been primarily driven by PAP and oxygen related sales and services. The increase in service revenue is primarily due to the addition of our healthcare staffing offerings. While ventilator rentals continue to make up the majority of our revenue, the growth of PAP and oxygen related sales and services, as well as our healthcare staffing offerings, over the comparable period in 2021 is contributing significantly to the diversity of overall revenue mix.

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VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021

During the three months ended June 30, 2022, net revenue from COVID-19 response sales and services totaled $0.2 million, compared to $1.1 million during the comparable three month period in 2021. Current period COVID-19 response sales and services consist primarily of contact and vaccination tracing services. The amount of COVID-19 response sales and services revenue is expected to be lower through the end of 2022 and impact of such revenue remains uncertain and dependent on the length and intensity of the COVID-19 pandemic and the availability of such equipment, supplies, and services from other suppliers.

As we continue to expand geographically into new territories and further expand our presence in our existing territories, we expect growth in our active ventilator patient base and our other respiratory offerings, and additional revenue from our new staffing and recruitment division. While we expect growth for the remainder of the current year to exceed growth in pandemic impacted periods, the rate of growth may be impacted by residual effects of the pandemic.

Cost of revenue and gross profit

For the three months ended June 30, 2022, cost of revenue totaled $12.9 million, an increase of $3.1 million (or 32.2%) from the comparable period in 2021. Overall gross profit percentage decreased from 64.3% in the three months ended June 30, 2021 to 61.2% in the three months ended June 30, 2022. The decrease in gross profit percentage is due to migration of the revenue mix associated with product and service diversification. We expect our gross profit percentage for our normal operations to remain relatively consistent with the current quarter through the end of 2022.

Selling, general and administrative expense

For the three months ended June 30, 2022, selling, general and administrative expenses totaled $17.5 million, an increase of $4.7 million (or 36.1%) from the comparable prior period. Selling, general, and administrative expenses as a percentage of revenue increased to 52.6% for the three months ended June 30, 2022 compared to 47.0% for the three months ended June 30, 2021.

The increase in overall selling, general and administrative expense as compared to the prior period is primarily attributable to additional employee related expenses to accommodate the overall growth of the Company. Our full time employee count increased from 575 on June 30, 2021 to 715 on June 30, 2022, an increase of 24.3%. Employee compensation expenses increased $3.4 million (or 48%) as a result of the increase in our employee headcount, volume based sales commissions, and an increase in market based individual compensation rates. Included in this amount is a $0.5 million increase related to the remeasurement of phantom stock liability associated with the increase in share price. The remaining increase in selling, general, and administrative expense over the prior year period is largely due to an increase in auto and travel related expenses associated with increases in travel and in-person activities combined with increasing costs for fuel. We expect that current year selling, general and administrative expenses will decline as a percentage of revenue through the end of 2022 as costs stabilize relative to revenue growth.

Research and development

For the three months ended June 30, 2022, research and development expense totaled $0.7 million, an increase of $0.1 million (or 15.3%) from the comparable period in 2021. As we continue to invest in research and development related projects to support our technology initiatives, we expect that associated costs will continue to increase in 2022 relative to 2021 costs.

Stock-based compensation

For the three months ended June 30, 2022, stock-based compensation totaled $1.3 million, remaining consistent with the comparable period in 2021. We expect that as we continue to increase our employee count and utilize stock-based awards as an aspect of employee compensation, stock-based compensation expense will increase accordingly. Revenue growth has historically exceeded the growth in stock based compensation and stock-based compensation as a percentage of revenue is expected to continue to decline.

Interest expense, net

For the three months ended June 30, 2022 and during the comparable period in 2021, net interest expense totaled $0.1 million. As a result of low levels of interest bearing debt, we expect net interest expense to remain relatively consistent with the current quarter through the end of 2022.
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VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021

Provision for income taxes

For the three months ended June 30, 2022, the provision for income taxes was a $0.4 million expense, compared to a $1.2 million expense during the 2021 period. The decrease in income tax expense was primarily due to a decrease in non-deductible compensation expenses. Our annual estimated effective tax rate for 2022 is 29.4%.

Net income

For the three months ended June 30, 2022, net income was $1.0 million, a decrease of $0.6 million (or 38.3%) from the comparable period in 2021. Net income as a percentage of net revenue decreased from 5.7% for the three months ended June 30, 2021 to 2.9% for the three months ended June 30, 2022, primarily due to changes in the product mix as a result of diversification and increases of direct and indirect costs driven by market forces within the supply and labor environments.

Comparison of the Six Months Ended June 30, 2022 and 2021:

The following table summarizes our results of operations for the six months ended June 30, 2022 and 2021:
Six Months Ended June 30,
2022 % of Total Revenue 2021 % of Total Revenue $
Change
%
Change
Revenue $ 65,565  100.0  % $ 55,815  100.0  % $ 9,750  17.5  %
Cost of revenue 25,432  38.8  % 20,448  36.6  % 4,984  24.4  %
Gross profit 40,133  61.2  % 35,367  63.4  % 4,766  13.5  %
Selling, general and administrative 33,312  50.8  % 27,393  49.1  % 5,919  21.6  %
Research and development 1,304  2.0  % 922  1.7  % 382  41.4  %
Stock-based compensation 2,576  3.9  % 2,543  4.6  % 33  1.3  %
Depreciation 480  0.7  % 407  0.7  % 73  17.9  %
Loss (gain) on disposal of property and equipment (124) (0.2) % 159  0.3  % (283) NM
Other expense (income) (664) (1.0) % (53) (0.1) % (611) 1,152.8  %
Income from operations 3,249  5.0  % 3,996  7.2  % (747) (18.7) %
Non-operating expenses
Income from equity method investments 769  1.2  % 451  0.8  % 318  NM
Interest expense, net (123) (0.2) % (174) (0.3) % 51  (29.3) %
Net income before taxes 3,895  5.9  % 4,273  7.7  % (378) (8.8) %
Provision for income taxes 1,166  1.8  % 1,023  1.8  % 143  NM
Net income $ 2,729  4.2  % $ 3,250  5.8  % $ (521) (16.0) %

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VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021
Revenue

The following table summarizes our revenue for the six months ended June 30, 2022 and 2021:
Six Months Ended June 30,
2022 % of Total Revenue 2021 % of Total Revenue $
Change
%
Change
Net revenue from rentals
Ventilator rentals, non-invasive and invasive $ 44,254  67.5  % $ 40,656  72.8  % $ 3,598  8.8  %
Other durable medical equipment rentals 9,271  14.1  % 6,234  11.2  % 3,037  48.7  %
Net revenue from sales and services
Equipment and supply sales 6,282  9.6  % 3,844  6.9  % 2,438  63.4  %
COVID-19 response sales and services 2,278  3.5  % 4,091  7.3  % (1,813) (44.3) %
Service revenues 3,480  5.3  % 990  1.8  % 2,490  251.5  %
Total net revenue $ 65,565  100.0  % $ 55,815  100.0  % $ 9,750  17.5  %

For the six months ended June 30, 2022, revenue totaled $65.6 million, an increase of $9.8 million (or 17.5%) from the comparable period in 2021. Non-COVID-19 related net revenue increased $11.6 million (or 22.4%) from the comparable period in 2021. The net revenue increase was comprised of an increase in ventilator rental revenue of $3.6 million (or 8.8%), rental revenue from other DME of $3.0 million (or 48.7%), equipment and supply sales of $2.4 million (or 63.4%), and service revenue of $2.5 million (or 251.5%). The growth in other durable medical equipment rentals and equipment and supply sales has been primarily driven by PAP and oxygen related sales and services. The increase in service revenue is primarily due to the addition of our healthcare staffing offerings. While ventilator rentals continue to make up the majority of our revenue, the growth of PAP and oxygen related sales and services, as well as our healthcare staffing offerings, over the comparable period in 2021 is contributing significantly to the diversity of overall revenue mix.

During the six months ended June 30, 2022, net revenue from COVID-19 response sales and services totaled $2.3 million, compared to $4.1 million during the comparable six month period in 2021. Current period COVID-19 response sales and services consist primarily of contact and vaccination tracing services. The amount of COVID-19 response sales and services revenue is expected to be lower through the end of 2022 and impact of such revenue remains uncertain and dependent on the length and intensity of the COVID-19 pandemic and the availability of such equipment, supplies, and services from other suppliers.

As we continue to expand geographically into new territories and further expand our presence in our existing territories, we expect growth in our active ventilator patient base and our other respiratory offerings, and additional revenue from our new staffing and recruitment division. While we expect growth for the remainder of the current year to exceed growth in pandemic impacted periods, we anticipate that the rate of growth may be impacted by residual effects of the pandemic.

Cost of revenue and gross profit

For the six months ended June 30, 2022, cost of revenue totaled $25.4 million, an increase of $5.0 million (or 24.4%) from the comparable period in 2021. Overall gross profit percentage decreased from 63.4% for the six months ended June 30, 2021 to 61.2% for the six months ended June 30, 2022. Excluding COVID-19 response sales and services, gross profit percentage for the six months ended June 30, 2022 was 61.6%. The decrease in gross profit percentage is due to migration of the revenue mix associated with product and service diversification. We expect our gross profit percentage for our normal operations to remain relatively consistent with the current quarter through the end of 2022.

Selling, general and administrative expense

For the six months ended June 30, 2022, selling, general and administrative expenses totaled $33.3 million, an increase of $5.9 million (or 21.6%) from the comparable period in 2021. Selling, general, and administrative expenses as a percentage of revenue increased slightly to 50.8% for the six months ended June 30, 2022 compared to 49.1% for the six months ended June 30, 2021.

The increase in overall selling, general and administrative expense as compared to the prior period is primarily attributable to additional employee related expenses to accommodate the overall growth of the Company. Our full time employee count increased from 575 on June 30, 2021 to 715 on June 30, 2022, an increase of 24.3%. Employee compensation expenses increased $3.6 million (or 22%) as a result of the increase in our employee headcount, volume-based sales commissions, and an increase in
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VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021
market based individual compensation rates. Included in this amount is a $0.9 million increase related to the remeasurement of phantom stock liability associated with the increase in share price. The remaining increase in selling, general, and administrative expense over the prior year period is largely due to an increase in auto and travel related expenses associated with increases in travel and in-person activities combined with increasing costs for fuel. We expect that current year selling, general and administrative expenses will decline as a percentage of revenue through the end of 2022 as costs stabilize relative to revenue growth.

Research and development

For the six months ended June 30, 2022, research and development expense totaled $1.3 million, an increase of $0.4 million (or 41.4%) from the comparable period in 2021. As we continue to invest in research and development related projects to support our technology initiatives, we expect that associated costs will continue to increase in 2022 relative to 2021 costs.

Stock-based compensation

For the six months ended June 30, 2022, stock-based compensation totaled $2.6 million, remaining relatively unchanged from the comparable period in 2021. We expect that as we continue to increase our employee count and utilize stock-based awards as an aspect of employee compensation, stock-based compensation expense will increase accordingly. Revenue growth has historically exceeded the growth in stock based compensation and stock-based compensation as a percentage of revenue is expected to continue to decline.

Interest expense, net

For the six months ended June 30, 2022, net interest expense totaled $0.1 million. As a result of low levels of interest bearing debt, we expect net interest expense to remain relatively consistent with the current quarter through the end of 2022.

Provision for income taxes

For the six months ended June 30, 2022, the provision for income taxes was a $1.2 million expense, compared to a $1.0 million benefit during the 2021 period. The slight increase in the overall effective tax rate was due to the effect of discrete deductible compensation expenses during the prior year interim period. Our annual estimated effective tax rate for 2022 is 29.4%.

Net income

For the six months ended June 30, 2022, net income was $2.7 million, a decrease of $0.5 million (or 16.0%) from the comparable period in 2021. Net income as a percentage of revenue decreased from 5.8% for the six months ended June 30, 2021 to 4.2% for the six months ended June 30, 2022, primarily due to changes in the product mix as a result of diversification and increases of direct and indirect costs driven by market forces within the supply and labor environments.

Non-GAAP Financial Measures

The Company uses Adjusted EBITDA, which is a financial measure that is not prepared in accordance with generally accepted accounting principles in the United States ("GAAP") to analyze its financial results and believes that it is useful to investors, as a supplement to U.S. GAAP measures. Management believes Adjusted EBITDA provides helpful information with respect to the Company’s operating performance as viewed by management, including a view of the Company’s business that is not dependent on the impact of the Company’s capitalization structure and items that are not part of the Company’s day-to-day operations. Management uses Adjusted EBITDA (i) to compare the Company’s operating performance on a consistent basis, (ii) to calculate incentive compensation for the Company’s employees, (iii) for planning purposes, including the preparation of the Company’s internal annual operating budget, and (iv) to evaluate the performance and effectiveness of the Company’s operational strategies. Accordingly, management believes that Adjusted EBITDA provides useful information in understanding and evaluating the Company’s operating performance in the same manner as management.

In calculating Adjusted EBITDA, certain items (mostly non-cash) are excluded from net income including interest, taxes, stock based compensation, and depreciation of property and equipment. Set forth below are descriptions of the financial items that have been excluded from net income to calculate Adjusted EBITDA and the material limitations associated with using this non-GAAP financial measure as compared to net income.

Depreciation may be useful for investors to consider because it generally represents the wear and tear on the property and equipment used in our operations. However, we do not believe these charges necessarily reflect the current and ongoing cash charges related to our operating costs.
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VIEMED HEALTHCARE, INC.
MANAGEMENT'S DISCUSSION AND ANALYSIS
(Tabular amounts expressed in thousands of US Dollars, except per share amounts)
June 30, 2022 and 2021

The amount of interest expense we incur or interest income we generate may be useful for investors to consider and may result in current cash inflows or outflows. However, we do not consider the amount of interest expense or interest income to be a representative component of the day-to-day operating performance of our business.

Stock-based compensation may be useful for investors to consider because it is an estimate of the non-cash component of compensation received by the Company’s directors, officers, employees and consultants. However, stock-based compensation is being excluded from our operating expenses because the decisions which gave rise to these expenses were not made to increase revenue in a particular period, but were made for the Company’s long-term benefit over multiple periods. While strategic decisions, such as those to issue stock-based awards are made to further our long-term strategic objectives and do impact our earnings under GAAP, these items affect multiple periods and management is not able to change or affect these items within any period.

Income tax expense may be useful for investors to consider because it generally represents the taxes which may be payable for the period and the change in deferred income taxes and may reduce or increase the amount of funds otherwise available for use. However, we do not consider the amount of income tax expense to be a representative component of the day-to-day operating performance of our business.
The following table is a reconciliation of Net income, the most directly comparable GAAP measure, to Adjusted EBITDA, on a historical basis for the periods indicated:
For the quarter ended June 30, 2022 March 31, 2022 December 31, 2021 September 30, 2021 June 30, 2021 March 31, 2021 December 31, 2020 September 30, 2020
Net Income $ 967  $ 1,762  $ 4,087  $ 1,789  $ 1,566  $ 1,684  $ 5,071  $ 2,804 
Add back:
Depreciation 3,740  3,397  3,120  2,867  2,716  2,609  2,835  2,425 
Interest expense 59  64  69  75  83  91  100  116 
Stock-based compensation 1,271  1,305  1,305  1,302  1,236  1,307  1,301  1,234 
Income tax expense (benefit) 421  745  968  1,386  1,246  (223) 151  1,141 
Adjusted EBITDA