The following discussion contains forward-looking statements that involve risks and uncertainties. Our actual results could differ materially from those anticipated in these forward-looking statements as a result of various factors, including those set forth previously under the caption "Risk Factors." This Management's Discussion and Analysis of Financial Condition and Results of Operations should be read in conjunction with our audited consolidated financial statements and related notes included elsewhere in this report.
The results of operations for the periods reflected herein are not necessarily indicative of results that may be expected for future periods.
References in this MD&A to "we," "us," "our," "our company," "our business" and "IMAC Holdings " are toIMAC Holdings, Inc. , aDelaware corporation and prior to the Corporate Conversion (defined below),IMAC Holdings, LLC , aKentucky limited liability company, and the following entities which are consolidated due to direct ownership of a controlling voting interest or other rights granted to us as the sole general partner or managing member of the entity:IMAC Management Services, LLC ("IMAC Management"),IMAC Regeneration Management, LLC ("IMAC Texas ") IMAC Regeneration Management ofNashville, LLC ("IMAC Nashville")IMAC Management of Illinois, LLC ("IMAC Illinois") andIMAC Management of Florida, LLC ("IMAC Florida"); the following entity which is consolidated withIMAC Regeneration Management ofNashville, LLC due to control by contract:IMAC Regeneration Center of Nashville , PC ("IMAC Nashville PC"); and the following which prior toJune 1, 2018 was held as a minority interest,IMAC Regeneration Center of St. Louis , LLC ("IMAC St. Louis"). Overview We are a provider of movement and orthopedic therapies and minimally invasive procedures performed through our regenerative and rehabilitative medical treatments to improve the physical health of our patients at our fast-growing chain of IMAC Regeneration Centers which we own or manage. Our outpatient medical clinics provide conservative, minimally invasive medical treatments to help patients with back pain, knee pain, joint pain, ligament and tendon damage, and other related soft tissue conditions. Our licensed healthcare professionals evaluate each patient and provide a custom treatment plan that integrates traditional medical procedures and innovative regenerative medicine procedures in combination with physical medicine. We do not use or offer opioid-based prescriptions as part of our treatment options in order to help our patients avoid the dangers of opioid abuse and addiction. The original IMAC RegenerationCenter opened inKentucky inAugust 2000 and remains the flagship location of our current business, which was formally organized inMarch 2015 . To date, we have opened seven, acquired eight and manage one outpatient medical clinics inKentucky ,Missouri ,Tennessee, Illinois andFlorida , and plan to further expand the reach of our facilities to other strategic locations throughoutthe United States . We have partnered with several active and former professional athletes, includingOzzie Smith ,David Price ,Tony Delk andMike Ditka , in the branding of our IMAC Regeneration Centers. Our outpatient medical clinics emphasize our focus around treating sports and orthopedic injuries as an alternative to traditional surgeries for repair or joint replacement. We own our medical clinics directly or have entered into long-term management services agreements to operate and control certain of our medical clinics by contract. Our preference is to own the clinics; however, some state laws restrict the corporate practice of medicine and require a licensed medical practitioner or own the clinic. Accordingly, our managed clinics are owned exclusively by a medical professional within a professional service corporation (formed as a limited liability company or corporation) and are under common control with us in order to comply with state laws regulating the ownership of medical practices. We are compensated under management services agreements through service fees based on the cost of the services provided, plus a specified markup percentage, and a discretionary annual bonus determined in the sole discretion of each professional service corporation. Corporate Conversion Prior toJune 1, 2018 , we were aKentucky limited liability company namedIMAC Holdings, LLC . EffectiveJune 1, 2018 , we converted into aDelaware corporation pursuant to a statutory merger (the "Corporate Conversion") and changed our name toIMAC Holdings, Inc. All of our outstanding membership interests were exchanged on a proportional basis into shares of common stock ofIMAC Holdings, Inc. 21 Following the Corporate Conversion,IMAC Holdings, Inc. continues to hold all of the property and assets ofIMAC Holdings, LLC and all of the debts and obligations ofIMAC Holdings, LLC continue as the debts and obligations ofIMAC Holdings, Inc. The purpose of the Corporate Conversion was to reorganize our corporate structure so that the top tier entity in our corporate structure is a corporation rather than a limited liability company and so that our existing owners own shares of our common stock rather than membership interests in a limited liability company. Except as otherwise noted herein, the consolidated financial statements included herein are those ofIMAC Holdings, Inc. and its consolidated subsidiaries. Initial Public Offering OnFebruary 15, 2019 , we completed our initial public offering of 850,000 units, with each unit consisting one share of our common stock and two warrants each to purchase one share of our common stock, at a combined initial public offering price of$5.125 per unit. The exercise price of the warrants is$5.00 per warrant. The units immediately and automatically separated upon issuance, and the common stock and warrants trade on The NASDAQ Capital Market under the ticker symbols "IMAC" and "IMACW," respectively. We received aggregate gross proceeds of$4,356,250 from our initial public offering, before deducting underwriting discounts, commissions and other related expenses. Proceeds from the offering have been used for financing the costs of leasing, developing and acquiring new clinic locations, funding research and new product development activities, and for working capital and general corporate purposes. In addition, upon the closing of our initial public offering, we issued unit purchase options toDawson James Securities, Inc. , as representative of the several underwriters, and its affiliates entitling them to purchase a number of our securities equal to 4% of the securities sold in the initial public offering. The unit purchase options have an exercise price equal to 120% of the public offering price of the units (or$6.15 per share and two warrants) and may be exercised on a cashless basis. The unit purchase options are not redeemable by us.
Impacts of and Response to COVID-19 Outbreak
InMarch 2020 , federal, state and local government authorities issued orders and guidance in order to combat the spread of the COVID-19 outbreak. These actions have required or encouraged our patients to remain at home except for essential activities and may reduce patient visits to our clinics. For example, the governor ofKentucky ordered all chiropractic facilities in the state ofKentucky to close effectiveMarch 20, 2020 , which caused us to close ourKentucky chiropractic facilities until such order was lifted onMay 4, 2020 . The full extent and duration of such actions and their impacts over the longer term remain uncertain and dependent on future developments that cannot be accurately predicted at this time, such as the severity and transmission rate of the COVID-19 outbreak and the extent and effectiveness of containment actions taken.
Our response plan has multiple facets and continues to evolve as the pandemic unfolds. As a precautionary measure, we have taken steps to enhance our operational and financial flexibility to react to the risks the COVID-19 outbreak presents to our business, including the following:
? Launched telemedicine communications for remote patient engagement;
? Suspended operations in three
until we were allowed to resume operations on
? Suspended operations at one clinic in
government orders until such order is lifted. The COVID-19 outbreak appears likely to cause significant economic harm acrossthe United States , and the negative economic conditions that may result in reduced patient demand in our industry. We may experience a material loss of patients, revenue and market share as a result of the suspension of any operations. Initiatives to implement telehealth engagement with patients may not be adopted by existing and new patients. Patient habits may also be altered in the medium to long term. Negative economic conditions, a decrease in our revenue and consequent longer term trends harmful to our business may all exert pressure on our company during the pendency of emergency restrictions on our operations and beyond. Due to such conditions, we terminated the employment of 11% of our employees onMarch 20, 2020 , to reduce costs associated with non-essential personnel. Additional furloughs were conducted throughMarch 31, 2020 , resulting in a 19% reduction in staff and company-wide salary reductions of approximately 10%. 22
We cannot predict with certainty when public health and economic conditions will return to normal. A decline in patient visits and/or the possible suspension of operations mandated in response to the COVID-19 outbreak, and the consequent loss of revenue and cash flow during this period may make it difficult for us to obtain capital necessary to fund our operations.
Matters that May or Are Currently Affecting Our Business
We believe that the growth of our business and our future success depend on various opportunities, challenges, trends and other factors, including the following:
? Our ability to identify, contract with, install equipment and operate a large
number of outpatient medical clinics and attract new patients to them;
? Our need to hire additional healthcare professionals in order to operate the
large number of clinics we intend to open;
? Our ability to enhance revenue at each facility on an ongoing basis through
additional patient volume and new services;
? Our ability to obtain additional financing for the projected costs associated
with the acquisition, management and development of new clinics, and the
personnel involved, if and when needed;
? Our ability to attract competent, skilled medical and sales personnel for our
operations at acceptable prices to manage our overhead; and
? Our ability to control our operating expenses as we expand our organization
into neighboring states.
Critical Accounting Policies and Estimates
The preparation of our condensed consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses at the date and for the periods that the condensed consolidated financial statements are prepared. On an ongoing basis, we evaluate our estimates, including those related to insurance adjustments and provisions for doubtful accounts. We base our estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances. Actual results could materially differ from those estimates. We believe that, of the significant accounting policies discussed in our Notes to the Condensed Consolidated Financial Statements (Unaudited), the following accounting policies require our most difficult, subjective or complex judgments in the preparation of our financial statements. Intangible Assets The Company capitalizes the fair value of intangible assets acquired in business combinations. Intangible assets are amortized on a straight-line basis over their estimated economic useful lives, generally the contract term. The Company performs valuations of assets acquired and liabilities assumed on each acquisition accounted for as a business combination and allocates the purchase price of each acquired business to its respective net tangible and intangible assets. Acquired intangible assets include trade names, non-compete agreements, customer relationships and contractual agreements. 23Goodwill Our goodwill represents the excess of the purchase price over the fair value of the net identifiable assets acquired in business combinations. The goodwill generated from the business combinations is primarily related to the value placed on the employee workforce and expected synergies. Judgment is involved in determining if an indicator or change in circumstances relating to impairment has occurred. Such changes may include, among others, a significant decline in expected future cash flows, a significant adverse change in the business climate, and unforeseen competition. There was no goodwill impairment for the years presented. The Company tests goodwill for impairment on an annual basis, or when events or circumstances indicate the fair value of a reporting unit is below its carrying value. No impairments of goodwill were recorded for the three months ended
March 31, 2020 . Revenue Recognition Our patient service revenue is derived from minimally invasive procedures performed at our outpatient medical clinics and patient visits to physicians. The fees for such services are billed either to the patient or a third-party payer, including Medicare. Starting inJanuary 2020 , we implemented wellness maintenance programs on a subscription basis. There are three membership plans offered with different levels of service for each plan. We recognize patient service revenue, net of contractual adjustments, which we estimate based on the historical trend of our cash collections and contractual write-offs in the period in which services are performed. Contractual adjustments represent discounts offered for patients serviced within a negotiated third-party payer contract.
Other management service fees are derived from management services where we provide billings and collections support to the clinics and where management services are provided based on state specific regulations known as the corporate practice of medicine ("CPM"). Under the CPM, a business corporation is precluded from practicing medicine or employing a physician to provide professional medical services. In these circumstances, we provide all administrative support to the physician-owned professional corporation ("PC") through a limited liability company. The PC is consolidated due to control by contract (an "SMA" or Service Management Agreement). The fees we derive from these management arrangements are based on a percentage mark-up on the costs of the LLC. We recognize other management service revenue in the period in which services are rendered. These revenues are eliminated in consolidation. Patient Deposits Patient deposits are derived from patient payments in advance of services delivered. Our service lines include traditional and regenerative medicine. Regenerative medicine procedures are not paid by insurance carriers; therefore, we typically require up-front payment from the patient for regenerative services and any co-pays and deductibles as required by the patient specific insurance carrier. For some patients, credit is provided through an outside vendor. In this case, we are paid from the outsourced credit vendor and the risk is transferred to the credit vendor for collection from the patient. These funds are accounted for as patient deposits until the procedures are performed at which point the patient deposit is recognized as patient service revenue. Accounts Receivable Accounts receivable primarily consists of amounts due from third-party payers (non-governmental), governmental payers and private pay patients and is recorded net of allowances for doubtful accounts and contractual discounts. Our ability to collect outstanding receivables is critical to our results of operations and cash flows. Accordingly, accounts receivable reported in our consolidated financial statements are recorded at the net amount expected to be received. Our primary collection risks are (i) the risk of overestimation of net revenues at the time of billing that may result in our receiving less than the recorded receivable, (ii) the risk of non-payment as a result of commercial insurance companies' denial of claims, (iii) the risk that patients will fail to remit insurance payments to us when the commercial insurance company pays out-of-network claims directly to the patient, (iv) resource and capacity constraints that may prevent us from handling the volume of billing and collection issues in a timely manner, (v) the risk that patients do not pay us for their self-pay balances (including co-pays, deductibles and any portion of the claim not covered by insurance), and (vi) the risk of non-payment from
uninsured patients. 24 Our accounts receivables from third-party payers are recorded net of estimated contractual adjustments and allowances from third-party payers, which are estimated based on the historical trend of our facilities' cash collections and contractual write-offs, accounts receivable aging, established fee schedules, relationships with payers and procedure statistics. While changes in estimated reimbursement from third-party payers remain a possibility, we expect that any such changes would be minimal and, therefore, would not have a material effect on our financial condition or results of operations. Our collection policies and procedures are based on the type of payor, size of claim and estimated collection percentage for each patient account. The operating systems used to manage our patient accounts provide for an aging schedule in 30-day increments, by payer, physician and patient. We analyze accounts receivable at each of the facilities to ensure the proper collection and aged category. The operating systems generate reports that assist in the collection efforts by prioritizing patient accounts. Collection efforts include direct contact with insurance carriers or patients and written correspondence. Income Taxes
IMAC Holdings was taxed as a partnership throughMay 31, 2018 . As a result, income tax liabilities were passed through to the individual members. Accordingly, no provision for income taxes were reflected in the consolidated financial statements for periods prior toMay 31, 2018 , at which time the Company converted from a limited liability company to aDelaware corporation. Subsequent to the Company converting to aDelaware corporation, IMAC Nashville, IMAC Texas, IMAC St. Louis continued as single-member limited liability companies that are disregarded entities for tax purposes and do not file separate returns. Their activity is included as part ofIMAC Holdings Inc. Advantage Therapy, IMAC Illinois and IMAC Florida are also disregarded entities for tax purposes. BioFirma was a limited liability company taxed as a partnership. EffectiveOctober 1, 2019 , BioFirma became wholly owned byIMAC Holdings and is a disregarded entity for tax purposes. IMAC Management is a C-corporation and is included in the consolidated return ofIMAC Holdings as a subsidiary. Any future benefit arising from losses have been offset by a valuation allowance. Accordingly, no provision for income taxes is reflected in the consolidated financial statements. The Company records a liability for uncertain tax positions when it is probable that a loss has been incurred and the amount can be reasonably estimated. Interest and penalties related to income tax matters, if any, would be recognized as a component of income tax expense. AtMarch 31, 2020 andDecember 31, 2019 , the Company had no liabilities for uncertain tax positions. The Company continually evaluates expiring statutes of limitations, audits, proposed settlements, changes in tax law and new authoritative rulings. Currently, the tax years subsequent to 2017 are open and subject to examination by the taxing authorities.
Results of Operations for the Three Months Ended
We own our medical clinics directly or have entered into long-term management services agreements to operate and control these medical clinics by contract. Our preference is to own the clinics; however, some state laws restrict the corporate practice of medicine and require a licensed medical practitioner to own the clinic. Accordingly, our managed clinics are owned exclusively by a medical professional within a professional service corporation (formed as a limited liability company or corporation) under common control with us or eligible members of our company in order to comply with state laws regulating the ownership of medical practices. We are compensated under management services agreements through service fees based on the cost of the services provided, plus a specified markup percentage, and a discretionary annual bonus determined in the sole discretion of each professional service corporation. 25
The following table sets forth a summary of
Three Months Ended March 31, 2020 2019 Patient revenues$ 7,151,942 $ 7,289,022 Contractual adjustments (3,842,873 ) (4,519,194 ) Total patient revenue, net 3,309,069 2,769,828 Management fees 12,487 - Total revenue 3,321,556 2,769,828 Operating expenses: Patient expenses 379,817 436,129 Salaries and benefits 2,926,150 2,064,623 Share-based compensation 81,084 3,749 Advertising and marketing 241,817 347,016 General and administrative 1,236,138 977,369
Depreciation and amortization 450,495
285,567 Total operating expenses 5,315,501 4,114,453 Operating loss (1,993,945 ) (1,344,626 ) Other expense: Other expenses - (15,955 )
Beneficial conversion interest expense -
(639,159 ) Interest expense (76,204 ) (30,671 ) Total other expenses (76,204 ) (685,785 )
Net loss before income taxes (2,070,149 )
(2,030,411 ) Income taxes - - Net loss (2,070,149 ) (2,030,411 )
Net loss attributable to the non-controlling interest 336,604
431,223
Net loss attributable to IMAC Holdings, Inc.$ (1,733,545 ) $
(1,599,188 )
Net loss per share attributable to common stockholders Basic and diluted$ (0.18 ) $
(0.27 )
Weighted average common shares outstanding Basic and diluted 9,611,252 5,919,856 Revenues
Our revenue mix is diversified between medical treatments and physiological treatments. Our medical treatments are further segmented into traditional medical and regenerative medicine practices. We are an in-network provider for traditional physical medical treatments, such as physical therapy, chiropractic services and medical evaluations, with most private health insurance carriers. Regenerative medical treatments are typically not covered by insurance, but paid by the patient. For more information on our revenue recognition policies, see "Critical Accounting Policies and Estimates - Revenue Recognition." 26 See the table below for more information regarding our revenue breakdown by service type. Three Months Ended March 31, 2020 2019 Revenues: Medical treatments 67 % 64 % Physical therapy 30 % 33 % Chiropractic care 3 % 3 % 100 % 100 %
Patient service revenues increased 19% to$3.3 million for the three months endedMarch 31, 2020 , compared to$2.8 million for the three months endedMarch 31, 2019 . These increases were primarily due to the 2019 acquisitions ofISDI Holdings II and PHR Holdings . We expect to see a negative impact on patient service revenue due to the COVID-19 outbreak in the quarter, endingJune 30, 2020 . Visits to our clinics are an indication of business activity. Visits increased 2% for the three months endedMarch 31, 2020 compared to the three months endedMarch 31, 2019 . Visits increased from 30,824 in the three months endedMarch 31, 2019 to 31,603 in the three months endedMarch 31, 2020 . Charges per visit also increased from$89.86 per visit to$109.54 per visit fromMarch 31, 2019 toMarch 31, 2020 , respectively. We expect to see a negative impact on patient service revenue due to the COVID-19 outbreak in the quarter endingJune 30, 2020 . Starting inJanuary 2020 , we implemented wellness maintenance programs on a subscription basis. As ofMarch 31, 2020 , the following markets had active memberships: 320 memberships at IMAC Management (Kentucky ), 32 memberships at IMAC Nashville, 127 memberships at IMAC St. Louis and eight memberships atIMAC Illinois . All active memberships at IMAC Management were paused inApril 2020 due to an order of the governor ofKentucky to close all elective care facilities inKentucky . Operating Expenses
Operating expenses consist of patient expenses, salaries and benefits, share based compensation, advertising and marketing, general and administrative expenses and depreciation expenses.
Patient expenses. Cost of revenues (patient expense) decreased$56,000 to$380,000 for the three months endedMarch 31, 2020 , as compared to the three months endedMarch 31, 2019 , driven by improvements in supply management and changes in the patient mix of services provided. Salaries and benefits consist of payroll, benefits and related party contracts. Salaries and benefits expenses for the three months endedMarch 31, 2020 , as compared to the three months endedMarch 31, 2019 , increased$0.9 million to$2.9 million , which was attributable to our 2019 acquisitions in theChicago andRockford, Illinois areas.
Share-based compensation. Share-based compensation increased from
Advertising and marketing. Advertising and marketing expenses decreased
General and administrative expense. General and administrative expense ("G&A") consists of all other costs other than advertising and marketing, salaries and wages, patient expenses and depreciation. G&A increased 26% from$977,000 to$1.2 million in the three months endedMarch 31, 2020 and 2019, respectively. G&A increase was primarily due to travel, rent, insurance and service fees related to theApril 2019 acquisition of the clinics managed byIMAC ofIllinois and theJanuary 2020 acquisition of CHSF. The aggregate average monthly rent of our clinics for the three months endedMarch 31, 2020 and 2019 was$111,200
and$78,200 , respectively.
Depreciation and amortization. Depreciation is related to our property and equipment purchases to use in the course of our business activities. Amortization is related to our business acquisitions. Depreciation and amortization increased from$286,000 for the three months endedMarch 31, 2019 to$450,000 for the three months endedMarch 31, 2020 . The increase in depreciation and amortization expense resulted from the 2019 acquisition of the clinics managed byIMAC ofIllinois and theJanuary 2020 acquisition of CHSF. 27 Net loss attributable to the non-controlling interest. Net loss attributable to the non-controlling interest is the amount of net income (loss) for the period allocated to non-controlling partners ofIMAC Holdings, Inc. that is included in the entity's consolidated financial statements. Analysis of Cash Flows
The primary source of our operating cash flow is the collection of accounts receivable from patients, private insurance companies, government programs, self-insured employers and other payers.
During the three months endedMarch 31, 2020 , net cash used in operations increased to$1.2 million compared to$0.9 million for the three months endedMarch 31, 2019 . This difference was primarily attributable to lower beneficial conversion interest expense during the three months endedMarch 31, 2019 . Net cash used in investing activities during the three months endedMarch 31, 2020 and 2019 was$207,000 and$42,000 , respectively. This was primarily driven by the acquisition of CHSF inJanuary 2020 . Net cash provided by financing activities during the three months endedMarch 31, 2020 was$2.3 million , including proceeds from notes payable, net of related fees, which totaled$1.2 million , and proceeds from the issuance of common stock of$1.1 million . Net cash provided by financing activities during the three months endedMarch 31, 2019 was$3.8 million , including proceeds from our initial public offering, net of related fees.
Reconciliation of Non-GAAP Financial Measures
This report contains certain non-GAAP financial measures, including non-GAAP net income and adjusted EBITDA, which are used by management in analyzing our financial results and ongoing operational performance.
In order to better assess the Company's financial results, management believes that net income before interest, income taxes, stock based compensation, and depreciation and amortization ("adjusted EBITDA") is a useful measure for evaluating the operating performance of the Company because adjusted EBITDA reflects net income adjusted for certain non-cash and/or non-operating items. We also believe that adjusted EBITDA is useful to many investors to assess the Company's ongoing results from current operations. Adjusted EBITDA is a non-GAAP financial measure and should not be considered a measure of financial performance under GAAP. Because adjusted EBITDA is not a measurement determined in accordance with GAAP, such non-GAAP financial measures are susceptible to varying calculations. Accordingly, adjusted EBITDA, as presented, may not be comparable to other similarly titled measures of other companies. This non-GAAP financial measure should not be considered as a substitute for, or superior to, measures of financial performance which are prepared in accordance with US GAAP and may be different from non-GAAP financial measures used by other companies and have limitations as analytical tools. A reconciliation of adjusted EBITDA to the most directly comparable GAAP measure is set forth below.March 31, 2020 March 31, 2019
GAAP loss attributable to IMAC Holdings, Inc.$ (1,733,545 ) $ (1,599,187 ) Interest expense 76,204
30,671
Beneficial conversion interest expense -
639,159
Share-based compensation expense 81,084
3,749 Depreciation and amortization 450,495 285,567 Adjusted EBITDA$ (1,125,762 ) $ (640,041 ) 28
Liquidity and Capital Resources
As ofMarch 31, 2020 , we had$1.3 million in cash and deficiency in working capital of$5.7 million . As ofDecember 31, 2019 , we had cash of$373,689 and deficiency in working capital of$3.5 million . The increase in working capital deficiency was primarily due to the increase in the current portion of notes payable for 2020.
We believe our cash at
As ofMarch 31, 2020 , we had approximately$9.2 million in current liabilities. The Iliad Note represents$935,000 of our current liabilities. Of our remaining current liabilities as ofMarch 31, 2020 , approximately$1.2 million represents a mortgage on ourLexington, Kentucky property, and$1.8 million owed under the note payable toThe Edward S. Bredniak Trust . Lastly, we have approximately$2.1 million in current liabilities outstanding to our vendors and under operating lines of credit, which we have historically paid down in the normal course
of our business.
As ofMarch 31, 2020 , we had an accumulated deficit of$11.8 million . Prior to our initial public offering, we funded our operations primarily through the sale and issuance of convertible notes, bridge loans, and the use of funds from operations. Accordingly, we anticipate that we will need to raise additional capital to fund future operations. However, we may be unable to raise additional funds or enter into such arrangements when needed or favorable terms, or at all, which would have a negative impact on our financial condition and could force us to delay, limit, reduce or terminate our development or acquisition activity. Failure to receive additional funding could also cause us to cease operations, in part or in full. Furthermore, even if we believe we have sufficient funds for our current of future operating plans, we may seek additional capital due to favorable market conditions or strategic considerations. Our independent registered public accounting firm has indicated that our financial condition raises substantial doubt as to our ability to continue as a going concern. OnJuly 15, 2019 , we signed the$10 million Purchase Agreement withLincoln Park . We also entered into a registration rights agreement (the "Registration Agreement") withLincoln Park in which we agreed to file a registration statement related to the transaction with theSEC covering the shares of our common stock that may be issued toLincoln Park under the Purchase Agreement. Pursuant to the Purchase Agreement, we have the right, in our sole discretion, over a 36-month period to sell shares of common stock toLincoln Park , subject to certain limitations contained in the Purchase Agreement, in amounts up to 50,000 shares per regular sale, which may be increased to up to 100,000 shares depending on certain conditions as set forth in the Purchase Agreement (and subject to adjustment for any reorganization, recapitalization, non-cash dividend, stock split, reverse stock split or other similar transaction as provided in the Purchase Agreement), up to the aggregate commitment of$10 million ("Regular Purchases"). In addition to Regular Purchases and subject to the terms and conditions of the Purchase Agreement, we in our sole discretion may directLincoln Park on each purchase date to make "accelerated purchases" and "additional accelerated purchases" on the following business day as provided in the Purchase Agreement. However, in no event may we sell any number of shares that would result inLincoln Park beneficially owning more than 4.99% of our outstanding common stock. There are no upper limits on the per share priceLincoln Park may pay to purchase our common stock; however, we may not sell more than$1,000,000 in shares of common stock toLincoln Park per Regular Purchase. The purchase price of the shares related to the$10 million of future funding will be based on the prevailing market prices of our shares without any fixed discount. Furthermore, we control the timing and amount of any future sales, if any, of shares of common stock toLincoln Park . The Purchase Agreement limits our sales of shares of common stock toLincoln Park to 1,669,359 shares of common stock, representing 19.99% of the shares of common stock outstanding on the date of the Purchase Agreement unless (a) stockholder approval is obtained to issue more than such amount or (b) the average price of all applicable sales of our common stock toLincoln Park under the Purchase Agreement equals or exceeds the lower of (i) the closing price of our common stock on the Nasdaq Capital Market immediately precedingJuly 15, 2019 or (ii) the average of the closing price of our common stock on the Nasdaq Capital Market for the five Business Days immediately precedingJuly 15, 2019 . 29 The Purchase Agreement contains customary representations, warranties, covenants, closing conditions and indemnification and termination provisions by, among and for the benefit of the parties. Additionally,Lincoln Park has agreed not to cause or engage in any manner whatsoever, any direct or indirect short selling or hedging of our common stock. The Purchase Agreement does not limit our ability to raise capital from other sources at our sole discretion, provided that we have agreed not to enter into any "variable rate" transactions with any third party for the 36-month period following the execution of the Purchase Agreement.
In consideration for entering into the
As ofMarch 31, 2020 , pursuant to the Purchase Agreement, the Company sold an aggregate of 1,602,294 shares of common stock of the Company toLincoln Park for aggregate proceeds to the Company of$2,424,053 (excluding the 60,006 shares previously issued toLincoln Park as a commitment fee). OnMarch 25, 2020 , the Company entered into a note purchase agreement withIliad Research & Trading, L.P. , pursuant to which the Company agreed to issue and sell to the Holder a secured promissory note in an aggregate initial principal amount of$1,115,000 , which is payable on or before the date that is 18 months from the issuance date. The Initial Principal Amount includes an original issue discount of$100,000 and$15,000 that the Company agreed to pay to the Holder to cover the Holder's legal fees, accounting costs, due diligence and other transaction costs. In exchange for the Note, the Holder paid an aggregate purchase price of$1,000,000 . Interest on the Note accrues at a rate of 10% per annum and is payable on the Maturity Date or otherwise in accordance with the Note. The Note may be prepaid by the Company (with the payment of a premium), may be required by the Holder to be redeemed by the Company for up to$200,000 per month after the six-month anniversary of the issuance of the Note (subject to certain deferral rights), and is subject to customary events of default (with a default interest rate of up to 22%). The Note transaction documents also give the Holder a right of first refusal to future debt issuances and a right to the first$250,000 of every$1 million of proceeds from future sales of equity by the Company. The Note is secured by the assets of the Company, other than the Company's owned real property, intellectual property and accounts receivable, pursuant to a security agreement. The Company will use the proceeds of the Note for certain growth initiatives including an IND filing with the FDA. Contractual Obligations The following table summarizes our contractual obligations by period as ofMarch 31, 2020 : Payments Due by Period Less Than 1 More Than 5 Total Year 1-3 Years 4-5 Years Years Short-term obligations$ 2,440,412 $ 2,440,412 $ - $ - $ - Long-term obligations, including interest 2,637,126 - 2,581,149 46,221 9,756 Finance lease obligations, including interest 91,774 16,354 65,417 10,003 - Operating lease obligations 5,056,297 887,150 2,979,432 901,837 287,878$ 10,225,609 $ 3,343,916 $ 5,625,998 $ 958,061 $ 297,634
Off-Balance Sheet Arrangements
As of
30 Impact of Inflation
We believe that inflation has not had a material impact on our results of
operations for the three months ended
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