8-K
false00018452570001845257dei:FormerAddressMember2023-11-082023-11-0800018452572023-11-082023-11-08

 

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549

 

FORM 8-K

 

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): November 08, 2023

 

 

LifeStance Health Group, Inc.

(Exact name of Registrant as Specified in Its Charter)

 

 

Delaware

001-40478

86-1832801

(State or Other Jurisdiction
of Incorporation)

(Commission File Number)

(IRS Employer
Identification No.)

 

 

 

 

 

4800 N. Scottsdale Road

Suite 2300

 

Scottsdale, Arizona

 

85251

(Address of Principal Executive Offices)

 

(Zip Code)

 

Registrant’s Telephone Number, Including Area Code: 602 767-2100

 

 

4800 N. Scottsdale Road, Suite 6000

Scottsdale, Arizona 85251

(Former Name or Former Address, if Changed Since Last Report)

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:


Title of each class

 

Trading
Symbol(s)

 


Name of each exchange on which registered

Common Stock, par value $0.01 per share

 

LFST

 

The Nasdaq Stock Market LLC

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§ 230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§ 240.12b-2 of this chapter).

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.

 

 


Item 2.02 Results of Operations and Financial Condition.

On November 8, 2023, LifeStance Health Group, Inc. ("LifeStance Health Group", "LifeStance" or the "Company") issued a press release announcing its results of operations for the third quarter ended September 30, 2023. A copy of the press release is furnished as Exhibit 99.1.

The information furnished under Item 2.02 of this Current Report on Form 8-K, including the exhibit, shall not be deemed "filed" for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), nor shall it be deemed incorporated by reference into LifeStance Health Group's filings with the SEC under the Securities Act of 1933, as amended (the “Securities Act”), or the Exchange Act, except as shall be expressly set forth by specific reference in such a filing.

Item 7.01 Regulation FD Disclosure.

A slide presentation, which includes supplemental information related to LifeStance Health Group, is furnished as Exhibit 99.2. The information furnished under Item 7.01 of this Current Report on Form 8-K, including the exhibit, shall not be deemed "filed" for purposes of Section 18 of the Exchange Act, nor shall it be deemed incorporated by reference into LifeStance Health Group's filings with the SEC under the Securities Act or the Exchange Act, except as shall be expressly set forth by specific reference in such a filing.

Item 9.01 Financial Statements and Exhibits.

(d) Exhibits

 

Exhibit

 

Description

99.1

 

Press Release dated November 8, 2023.

99.2

 

Slide presentation providing supplemental information.

104

 

Cover Page Interactive Data File (embedded within the Inline XBRL document)

 

 


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

 

 

 

LifeStance Health Group, Inc.

 

 

 

 

Date:

November 8, 2023

By:

/s/ David Bourdon

 

 

 

David Bourdon
Chief Financial Officer and Treasurer
(principal financial and accounting officer)

 


EX-99.1

 

Exhibit 99.1

 

Investor Relations Contact

Monica Prokocki

VP of Investor Relations

602-767-2100

investor.relations@lifestance.com

 

LifeStance Reports Third Quarter 2023 Results

 

SCOTTSDALE, Ariz. – November 8, 2023 – LifeStance Health Group, Inc. (Nasdaq: LFST), one of the nation’s largest providers of outpatient mental healthcare, today announced financial results for the third quarter ended September 30, 2023.

(All results compared to prior-year comparative period, unless otherwise noted)

Q3 2023 Highlights and FY 2023 Outlook

Total revenue of $262.9 million increased $45.3 million or 21% compared to total revenue of $217.6 million
Total clinicians of 6,418 up 18%, a sequential net increase of 286 in the third quarter
Net loss of $61.6 million compared to net loss of $37.9 million, primarily driven by the preliminarily approved settlement of our shareholder class action lawsuit and stock-based compensation expenses
Adjusted EBITDA of $14.6 million compared to Adjusted EBITDA of $15.4 million
Raising the midpoints of Revenue, Center Margin, and Adjusted EBITDA guidance ranges: Now expecting full year 2023 revenue of $1.03 to $1.04 billion, Center Margin of $292 to $300 million and Adjusted EBITDA of $56 to $60 million

“We delivered another strong quarter,” said Ken Burdick, Chairman and CEO of LifeStance. “In addition to solid financial results, we continued to attract high-quality clinical talent with a record quarter of organic recruiting, growing the team by nearly 300 clinicians. As we approach the end of the year, we will continue our commitment to improving the patient and clinician experience while continuing to fortify the company’s foundation to build long-term, scalable operations.”

Financial Highlights

 

 

 

 

 

 

 

 

 

 

 

Q3 2023

 

 

Q3 2022

 

 

Y/Y

 

(in millions)

 

 

 

 

 

 

 

 

 

Total revenue

 

$

262.9

 

 

$

217.6

 

 

 

21

%

Loss from operations

 

 

(74.4

)

 

 

(38.8

)

 

 

92

%

Center Margin

 

 

76.2

 

 

 

60.3

 

 

 

26

%

Net loss

 

 

(61.6

)

 

 

(37.9

)

 

 

63

%

Adjusted EBITDA

 

 

14.6

 

 

 

15.4

 

 

 

(5

%)

As % of Total revenue:

 

 

 

 

 

 

 

 

 

Loss from operations

 

 

(28.3

%)

 

 

(17.8

%)

 

 

 

Center Margin

 

 

29.0

%

 

 

27.7

%

 

 

 

Net loss

 

 

(23.4

%)

 

 

(17.4

%)

 

 

 

Adjusted EBITDA

 

 

5.6

%

 

 

7.1

%

 

 

 

 

(All results compared to prior-year period, unless otherwise noted)

Total revenue grew 21% to $262.9 million. Strong revenue growth in the third quarter was driven primarily by net clinician growth and increased visit volumes.
Loss from operations was $74.4 million, primarily driven by stock-based compensation expense of $21.5 million and the preliminarily approved settlement of our shareholder class action lawsuit. Net loss was $61.6 million.
Center Margin grew 26% to $76.2 million, or 29% of total revenue.
Adjusted EBITDA declined 5% to $14.6 million, or 5.6% of total revenue. Adjusted EBITDA as a percentage of revenue decreased as a result of higher G&A expenses from investments in the business.

Balance Sheet, Cash Flow and Capital Allocation

For the nine months ended September 30, 2023, LifeStance used $33.7 million cash flow from operations, including $25.4 million during the third quarter of 2023. The Company ended the third quarter with cash of $42.6 million and net long-term debt of $248.4 million.

 


 

2023 Guidance

LifeStance is raising the midpoints of full year Revenue, Center Margin, and Adjusted EBITDA guidance ranges, with the following outlook for 2023:

The Company expects full year revenue of $1.03 to $1.04 billion, Center Margin of $292 to $300 million, and Adjusted EBITDA of $56 to $60 million.
For the fourth quarter of 2023, the Company expects total revenue of $255 to $265 million, Center Margin of $73 to $81 million, and Adjusted EBITDA of $17 to $21 million.

Conference Call, Webcast Information, and Presentations

LifeStance will hold a conference call today, November 8, 2023, at 8:30 a.m. Eastern Time to discuss the third quarter 2023 results. Investors who wish to participate in the call should dial 1-800-715-9871, domestically, or 1-646-307-1963, internationally, approximately 10 minutes before the call begins and provide conference ID number 3827662 or ask to be joined into the LifeStance call. A real-time audio webcast can be accessed via the Events and Presentations section of the LifeStance Investor Relations website (https://investor.lifestance.com), where related materials will be posted prior to the conference call.

About LifeStance Health Group, Inc.

Founded in 2017, LifeStance (Nasdaq: LFST) is reimagining mental health. We are one of the nation’s largest providers of virtual and in-person outpatient mental health care for children, adolescents and adults experiencing a variety of mental health conditions. Our mission is to help people lead healthier, more fulfilling lives by improving access to trusted, affordable, and personalized mental healthcare. LifeStance employs approximately 6,400 psychiatrists, advanced practice nurses, psychologists and therapists and operates across 33 states and approximately 600 centers. To learn more, please visit www.LifeStance.com.

We routinely post information that may be important to investors on the “Investor Relations” section of our website at investor.lifestance.com. We encourage investors and potential investors to consult our website regularly for important information about us.

Forward-Looking Statements

Statements in this press release and on the related teleconference that express a belief, expectation or intention, as well as those that are not historical fact, are forward-looking statements. These statements include, but are not limited to, statements with respect to: full year and fourth quarter guidance and management's related assumptions; the Company’s financial position; business plans and objectives; operating results; working capital and liquidity; and other statements contained in this press release that are not historical facts. When used in this press release and on the related teleconference, words such as “may,” “will,” “should,” “could,” “intend,” “potential,” “continue,” “anticipate,” “believe,” “estimate,” “expect,” “plan,” “target,” “predict,” “project,” “seek” and similar expressions as they relate to us are intended to identify forward-looking statements. They involve a number of risks and uncertainties that may cause actual events and results to differ materially from such forward-looking statements. These risks and uncertainties include, but are not limited to: we may not grow at the rates we historically have achieved or at all, even if our key metrics may imply future growth, including if we are unable to successfully execute on our growth initiatives and business strategies; if we fail to manage our growth effectively, our expenses could increase more than expected, our revenue may not increase proportionally or at all, and we may be unable to execute on our business strategy; our ability to recruit new clinicians and retain existing clinicians; if reimbursement rates paid by third-party payors are reduced or if third-party payors otherwise restrain our ability to obtain or deliver care to patients, our business could be harmed; we conduct business in a heavily regulated industry and if we fail to comply with these laws and government regulations, we could incur penalties or be required to make significant changes to our operations or experience adverse publicity, which could have a material adverse effect on our business, results of operations and financial condition; we are dependent on our relationships with affiliated practices, which we do not own, to provide health care services, and our business would be harmed if those relationships were disrupted or if our arrangements with these entities became subject to legal challenges; we operate in a competitive industry, and if we are not able to compete effectively, our business, results of operations and financial condition would be harmed; the impact of health care reform legislation and other changes in the healthcare industry and in health care spending on us is currently unknown, but may harm our business; if our or our vendors’ security measures fail or are breached and unauthorized access to our employees’, patients’ or partners’ data is obtained, our systems may be perceived as insecure, we may incur significant liabilities, including through private litigation or regulatory action, our reputation may be harmed, and we could lose patients and partners; our business depends on our ability to effectively invest in, implement improvements to and properly maintain the uninterrupted operation and data integrity of our information technology and other business systems; actual or anticipated changes or fluctuations in our results of operations; our existing indebtedness could adversely affect our business and growth prospects; and other risks and uncertainties set forth under “Risk Factors” included in the reports we have filed or will file with the Securities and Exchange Commission, including our Annual Report on Form 10-K for the year ended December 31, 2022 and subsequent filings

 


 

made with the Securities and Exchange Commission. LifeStance does not undertake to update any forward-looking statements made in this press release to reflect any change in management's expectations or any change in the assumptions or circumstances on which such statements are based, except as otherwise required by law.

Non-GAAP Financial Information

This press release contains certain non-GAAP financial measures, including Center Margin, Adjusted EBITDA, and Adjusted EBITDA margin. Tables showing the reconciliation of these non-GAAP financial measures to the comparable GAAP measures are included at the end of this release. Management believes these non-GAAP financial measures are useful in evaluating the Company’s operating performance, and may be helpful to securities analysts, institutional investors and other interested parties in understanding the Company’s operating performance and prospects. These non-GAAP financial measures, as calculated, may not be comparable to companies in other industries or within the same industry with similarly titled measures of performance. Therefore, the Company’s non-GAAP financial measures should be considered in addition to, not as a substitute for, or in isolation from, measures prepared in accordance with GAAP, such as net loss or loss from operations.

Center Margin and Adjusted EBITDA anticipated for the fourth quarter of 2023 and full year 2023 are calculated in a manner consistent with the historical presentation of these measures at the end of this release. Reconciliation for the forward-looking fourth quarter of 2023 and full year 2023 Center Margin and Adjusted EBITDA guidance is not being provided, as LifeStance does not currently have sufficient data to accurately estimate the variables and individual adjustments for such reconciliation. As such, LifeStance management cannot estimate on a forward-looking basis without unreasonable effort the impact these variables and individual adjustments will have on its reported results.

Management acknowledges that there are many items that impact a company’s reported results and the adjustments reflected in these non-GAAP measures are not intended to present all items that may have impacted these results.

# # # #

 

Consolidated Financial Information and Reconciliations

 


 

CONSOLIDATED BALANCE SHEETS

(unaudited)

(In thousands, except for par value)

 

 

 

 

 

September 30, 2023

 

 

December 31, 2022

 

CURRENT ASSETS

 

 

 

 

 

 

Cash and cash equivalents

 

$

42,605

 

 

$

108,621

 

Patient accounts receivable, net

 

 

149,716

 

 

 

100,868

 

Prepaid expenses and other current assets

 

 

71,929

 

 

 

23,734

 

Total current assets

 

 

264,250

 

 

 

233,223

 

NONCURRENT ASSETS

 

 

 

 

 

 

Property and equipment, net

 

 

190,067

 

 

 

194,189

 

Right-of-use assets

 

 

180,685

 

 

 

199,431

 

Intangible assets, net

 

 

233,615

 

 

 

263,294

 

Goodwill

 

 

1,293,426

 

 

 

1,272,939

 

Other noncurrent assets

 

 

13,023

 

 

 

10,795

 

Total noncurrent assets

 

 

1,910,816

 

 

 

1,940,648

 

Total assets

 

$

2,175,066

 

 

$

2,173,871

 

LIABILITIES AND STOCKHOLDERS' EQUITY

 

 

 

 

 

 

CURRENT LIABILITIES

 

 

 

 

 

 

Accounts payable

 

$

10,400

 

 

$

12,285

 

Accrued payroll expenses

 

 

83,618

 

 

 

75,650

 

Other accrued expenses

 

 

91,030

 

 

 

30,428

 

Current portion of contingent consideration

 

 

8,964

 

 

 

15,876

 

Operating lease liabilities, current

 

 

43,604

 

 

 

38,824

 

Other current liabilities

 

 

3,258

 

 

 

2,936

 

Total current liabilities

 

 

240,874

 

 

 

175,999

 

NONCURRENT LIABILITIES

 

 

 

 

 

 

Long-term debt, net

 

 

248,371

 

 

 

225,079

 

Operating lease liabilities, noncurrent

 

 

191,515

 

 

 

212,586

 

Deferred tax liability, net

 

 

38,403

 

 

 

38,701

 

Other noncurrent liabilities

 

 

855

 

 

 

2,783

 

Total noncurrent liabilities

 

 

479,144

 

 

 

479,149

 

Total liabilities

 

$

720,018

 

 

$

655,148

 

COMMITMENTS AND CONTINGENCIES

 

 

 

 

 

 

STOCKHOLDERS’ EQUITY

 

 

 

 

 

 

Preferred stock – par value $0.01 per share; 25,000 shares authorized as of
   September 30, 2023 and December 31, 2022; 0 shares issued and outstanding as
   of September 30, 2023 and December 31, 2022

 

 

 

 

 

 

Common stock – par value $0.01 per share; 800,000 shares authorized as of
   September 30, 2023 and December 31, 2022; 378,607 and 375,964 shares
   issued and outstanding as of September 30, 2023 and December 31, 2022,
   respectively

 

 

3,788

 

 

 

3,761

 

Additional paid-in capital

 

 

2,162,766

 

 

 

2,084,324

 

Accumulated other comprehensive income

 

 

4,381

 

 

 

3,274

 

Accumulated deficit

 

 

(715,887

)

 

 

(572,636

)

Total stockholders' equity

 

 

1,455,048

 

 

 

1,518,723

 

Total liabilities and stockholders’ equity

 

$

2,175,066

 

 

$

2,173,871

 

 

 


 

consolidated statements of operations and comprehensive loss

(unaudited)

(In thousands, except for Net Loss per Share)

 

 

 

Three Months Ended September 30,

 

 

Nine Months Ended September 30,

 

 

 

2023

 

 

2022

 

 

2023

 

 

2022

 

TOTAL REVENUE

 

$

262,895

 

 

$

217,560

 

 

$

775,062

 

 

$

630,182

 

OPERATING EXPENSES

 

 

 

 

 

 

 

 

 

 

 

 

Center costs, excluding depreciation and
   amortization shown separately below

 

 

186,686

 

 

 

157,267

 

 

 

556,280

 

 

 

455,857

 

General and administrative expenses

 

 

130,945

 

 

 

81,248

 

 

 

317,425

 

 

 

288,176

 

Depreciation and amortization

 

 

19,621

 

 

 

17,884

 

 

 

58,220

 

 

 

50,311

 

Total operating expenses

 

$

337,252

 

 

$

256,399

 

 

$

931,925

 

 

$

794,344

 

LOSS FROM OPERATIONS

 

$

(74,357

)

 

$

(38,839

)

 

$

(156,863

)

 

$

(164,162

)

OTHER INCOME (EXPENSE)

 

 

 

 

 

 

 

 

 

 

 

 

Gain on remeasurement of contingent consideration

 

 

1,867

 

 

 

1,176

 

 

 

4,443

 

 

 

562

 

Transaction costs

 

 

 

 

 

(210

)

 

 

(89

)

 

 

(507

)

Interest expense, net

 

 

(5,477

)

 

 

(4,189

)

 

 

(15,688

)

 

 

(14,763

)

Other expense

 

 

(1

)

 

 

(144

)

 

 

(70

)

 

 

(144

)

Total other expense

 

$

(3,611

)

 

$

(3,367

)

 

$

(11,404

)

 

$

(14,852

)

LOSS BEFORE INCOME TAXES

 

 

(77,968

)

 

 

(42,206

)

 

 

(168,267

)

 

 

(179,014

)

INCOME TAX BENEFIT

 

 

16,385

 

 

 

4,353

 

 

 

26,964

 

 

 

10,106

 

NET LOSS

 

$

(61,583

)

 

$

(37,853

)

 

$

(141,303

)

 

$

(168,908

)

NET LOSS PER SHARE, BASIC AND DILUTED

 

 

(0.17

)

 

 

(0.11

)

 

 

(0.39

)

 

 

(0.48

)

Weighted-average shares used to compute
   basic and diluted net loss per share

 

 

372,476

 

 

 

357,520

 

 

 

365,556

 

 

 

354,057

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NET LOSS

 

$

(61,583

)

 

$

(37,853

)

 

$

(141,303

)

 

$

(168,908

)

OTHER COMPREHENSIVE INCOME

 

 

 

 

 

 

 

 

 

 

 

 

Unrealized gains on cash flow hedge, net of tax

 

 

230

 

 

 

3,185

 

 

 

1,107

 

 

 

3,185

 

COMPREHENSIVE LOSS

 

$

(61,353

)

 

$

(34,668

)

 

$

(140,196

)

 

$

(165,723

)

 

 


 

CONSOLIDATED STATEMENTS OF CASH FLOWS

(unaudited)

(In thousands)

 

 

 

Nine Months Ended September 30,

 

 

 

2023

 

 

2022

 

CASH FLOWS FROM OPERATING ACTIVITIES

 

 

 

 

 

 

Net loss

 

$

(141,303

)

 

$

(168,908

)

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

 

 

 

 

 

 

Depreciation and amortization

 

 

58,220

 

 

 

50,311

 

Non-cash operating lease costs

 

 

30,225

 

 

 

 

Stock-based compensation

 

 

78,469

 

 

 

152,235

 

Loss on debt extinguishment

 

 

 

 

 

3,380

 

Amortization of discount and debt issue costs

 

 

1,592

 

 

 

1,351

 

Gain on remeasurement of contingent consideration

 

 

(4,443

)

 

 

(562

)

Other, net

 

 

5,105

 

 

 

144

 

Change in operating assets and liabilities, net of businesses acquired:

 

 

 

 

 

 

Patient accounts receivable, net

 

 

(48,484

)

 

 

(34,606

)

Prepaid expenses and other current assets

 

 

(52,293

)

 

 

(5,811

)

Accounts payable

 

 

(3,848

)

 

 

1,109

 

Accrued payroll expenses

 

 

7,622

 

 

 

(588

)

Operating lease liabilities

 

 

(30,109

)

 

 

 

Other accrued expenses

 

 

65,568

 

 

 

18,816

 

Net cash (used in) provided by operating activities

 

$

(33,679

)

 

$

16,871

 

CASH FLOWS FROM INVESTING ACTIVITIES

 

 

 

 

 

 

Purchases of property and equipment

 

 

(29,106

)

 

 

(68,871

)

Acquisitions of businesses, net of cash acquired

 

 

(19,820

)

 

 

(40,294

)

Net cash used in investing activities

 

$

(48,926

)

 

$

(109,165

)

CASH FLOWS FROM FINANCING ACTIVITIES

 

 

 

 

 

 

Proceeds from long-term debt, net of discount

 

 

25,000

 

 

 

237,474

 

Payments of debt issue costs

 

 

(188

)

 

 

(7,266

)

Payments of long-term debt

 

 

(1,821

)

 

 

(181,230

)

Prepayment for debt paydown

 

 

 

 

 

(1,609

)

Payments of contingent consideration

 

 

(6,402

)

 

 

(12,290

)

Taxes related to net share settlement of equity awards

 

 

 

 

 

(478

)

Net cash provided by financing activities

 

$

16,589

 

 

$

34,601

 

NET DECREASE IN CASH AND CASH EQUIVALENTS

 

 

(66,016

)

 

 

(57,693

)

Cash and Cash Equivalents - Beginning of period

 

 

108,621

 

 

 

148,029

 

CASH AND CASH EQUIVALENTS – END OF PERIOD

 

$

42,605

 

 

$

90,336

 

SUPPLEMENTAL DISCLOSURE OF CASH FLOW INFORMATION

 

 

 

 

 

 

Cash paid for interest, net

 

$

15,424

 

 

$

9,518

 

Cash paid for taxes, net of refunds

 

$

416

 

 

$

1,780

 

SUPPLEMENTAL DISCLOSURES OF NON CASH INVESTING AND
   FINANCING ACTIVITIES

 

 

 

 

 

 

Equipment financed through finance leases

 

$

 

 

$

264

 

Contingent consideration incurred in acquisitions of businesses

 

$

1,985

 

 

$

7,719

 

Acquisition of property and equipment included in liabilities

 

$

5,303

 

 

$

8,607

 

 

 


 

RECONCILIATION OF loss FROM OPERATIONS TO CENTER MARGIN

(unaudited)

 

 

 

Three Months Ended September 30,

 

 

Nine Months Ended September 30,

 

 

 

2023

 

 

2022

 

 

2023

 

 

2022

 

(in thousands)

 

 

 

 

 

 

 

 

 

 

 

 

Loss from operations

 

$

(74,357

)

 

$

(38,839

)

 

$

(156,863

)

 

$

(164,162

)

Adjusted for:

 

 

 

 

 

 

 

 

 

 

 

 

Depreciation and amortization

 

 

19,621

 

 

 

17,884

 

 

 

58,220

 

 

 

50,311

 

General and administrative expenses (1)

 

 

130,945

 

 

 

81,248

 

 

 

317,425

 

 

 

288,176

 

Center Margin

 

$

76,209

 

 

$

60,293

 

 

$

218,782

 

 

$

174,325

 

(1)
Represents salaries, wages and employee benefits for our executive leadership, finance, human resources, marketing, billing and credentialing support and technology infrastructure and stock-based compensation for all employees.

 

RECONCILIATION OF NET loss TO ADJUSTED EBITDA

(unaudited)

 

 

 

Three Months Ended September 30,

 

 

Nine Months Ended September 30,

 

 

 

2023

 

 

2022

 

 

2023

 

 

2022

 

(in thousands)

 

 

 

 

 

 

 

 

 

 

 

 

Net loss

 

$

(61,583

)

 

$

(37,853

)

 

$

(141,303

)

 

$

(168,908

)

Adjusted for:

 

 

 

 

 

 

 

 

 

 

 

 

Interest expense, net

 

 

5,477

 

 

 

4,189

 

 

 

15,688

 

 

 

14,763

 

Depreciation and amortization

 

 

19,621

 

 

 

17,884

 

 

 

58,220

 

 

 

50,311

 

Income tax benefit

 

 

(16,385

)

 

 

(4,353

)

 

 

(26,964

)

 

 

(10,106

)

Gain on remeasurement of contingent
   consideration

 

 

(1,867

)

 

 

(1,176

)

 

 

(4,443

)

 

 

(562

)

Stock-based compensation expense

 

 

21,525

 

 

 

34,870

 

 

 

78,469

 

 

 

152,235

 

Loss on disposal of assets

 

 

1

 

 

 

144

 

 

 

70

 

 

 

144

 

Transaction costs (1)

 

 

 

 

 

210

 

 

 

89

 

 

 

507

 

Executive transition costs

 

 

114

 

 

 

494

 

 

 

636

 

 

 

494

 

Litigation costs (2)

 

 

45,418

 

 

 

104

 

 

 

49,267

 

 

 

104

 

Strategic initiatives (3)

 

 

790

 

 

 

 

 

 

3,242

 

 

 

 

Real estate optimization and
   restructuring charges
(4)

 

 

1,257

 

 

 

 

 

 

4,977

 

 

 

 

Other expenses (5)

 

 

214

 

 

 

866

 

 

 

803

 

 

 

3,511

 

Adjusted EBITDA

 

$

14,582

 

 

$

15,379

 

 

$

38,751

 

 

$

42,493

 

 

(1)
Primarily includes capital markets advisory, consulting, accounting and legal expenses related to our acquisitions.
(2)
Litigation costs include only those costs which are considered non-recurring and outside of the ordinary course of business based on the following considerations, which we assess regularly: (i) the frequency of similar cases that have been brought to date, or are expected to be brought within two years, (ii) the complexity of the case (e.g., complex class action litigation), (iii) the nature of the remedy(ies) sought, including the size of any monetary damages sought, (iv) the counterparty involved, and (v) our overall litigation strategy. During the three and nine months ended September 30, 2023, litigation costs included cash expenses related to three distinct litigation matters, including (x) a securities class action litigation, (y) a privacy class action litigation and (z) a compensation model class action litigation.
(3)
Strategic initiatives consist of expenses directly related to a multi-phase system upgrade in connection with our recent and significant expansion. During each of the three and nine months ended September 30, 2023, we continued a process of evaluating and adopting three critical enterprise-wide systems for (i) human resources management, (ii) clinician credentialing and onboarding process and (iii) a scalable electronic health resources system. Strategic initiatives represents costs, such as third-party consulting costs and one-time costs, that are not part of our ongoing operations related to these enterprise-wide systems. We considered the frequency and scale of this multi-part enterprise upgrade when determining that the expenses were not normal, recurring operating expenses.
(4)
Real estate optimization and restructuring charges consist of cash expenses and non-cash charges related to our real estate optimization initiative, which include certain asset impairment and disposal costs, certain gains and losses related to early lease terminations, and exit and disposal costs related to our real estate optimization initiative to consolidate our physical footprint. As the decision to close these centers was part of a significant strategic project driven by a historic shift in behavior, the magnitude of center closures has been and is expected to be greater than what would be expected as part of ordinary business operations and do not constitute normal recurring operating activities.
(5)
Primarily includes costs incurred to consummate or integrate acquired centers, certain of which are wholly-owned and certain of which are affiliated practices, in addition to the compensation paid to former owners of acquired centers and related expenses that are not reflective of the ongoing operating expenses of our centers. Acquired center integration and other are components of general and administrative expenses included in our unaudited consolidated statements of operations and comprehensive loss. Former owner fees is a component of center costs, excluding depreciation and amortization included in our unaudited consolidated statements of operations and comprehensive loss.

 


Slide 1

Reimagining Mental Health Q3 2023 Earnings Presentation • November 8, 2023 Exhibit 99.2


Slide 2

Forward-Looking Statements DISCLAIMERS Cautionary Note Regarding Forward-Looking Statements This presentation and related oral statements, including during any question and answer portion of the presentation, contain forward-looking statements about LifeStance Health Group, Inc. and its subsidiaries (“LifeStance”) and the industry in which LifeStance operates, including statements regarding: full-year and fourth-quarter guidance and management’s related assumptions; the Company's financial position; business plans and objectives; including capital allocation; operating results; working capital and liquidity; and other statements contained in this presentation that are not historical facts. These statements are subject to known and unknown uncertainties and contingencies outside of LifeStance's control and which are largely based on our current expectations and projections about future events and financial trends that we believe may affect LifeStance's financial condition, results of operations, business strategy, and prospects. LifeStance's actual results, events, or circumstances may differ materially from these statements. Forward-looking statements include all statements that are not historical facts. Words such as “anticipate,” “believe,” “envision,” “estimate,” “expect,” “intend,” “may,” “plan,” “predict,” “project,” “target,” “potential,” “will,” “would,” “could,” “should,” “continue,” “contemplate” and other similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. These forward-looking statements are subject to a number of risks, uncertainties, factors and assumptions, including, among other things: we may not grow at the rates we historically have achieved or at all, even if our key metrics may imply future growth, including if we are unable to successfully execute on our growth initiatives and business strategies; if we fail to manage our growth effectively, our expenses could increase more than expected, our revenue may not increase proportionally or at all, and we may be unable to execute on our business strategy; our ability to recruit new clinicians and retain existing clinicians; if reimbursement rates paid by third-party payors are reduced or if third-party payors otherwise restrain our ability to obtain or deliver care to patients, our business could be harmed; we conduct business in a heavily regulated industry and if we fail to comply with these laws and government regulations, we could incur penalties or be required to make significant changes to our operations or experience adverse publicity, which could have a material adverse effect on our business, results of operations and financial condition; we are dependent on our relationships with affiliated practices, which we do not own, to provide health care services, and our business would be harmed if those relationships were disrupted or if our arrangements with these entities became subject to legal challenges; we operate in a competitive industry, and if we are not able to compete effectively, our business, results of operations and financial condition would be harmed; the impact of health care reform legislation and other changes in the healthcare industry and in health care spending on us is currently unknown, but may harm our business; if our or our vendors' security measures fail or are breached and unauthorized access to our employees', patients' or partners' data is obtained, our systems may be perceived as insecure, we may incur significant liabilities, including through private litigation or regulatory action, our reputation may be harmed, and we could lose patients and partners; our business depends on our ability to effectively invest in, implement improvements to and properly maintain the uninterrupted operation and data integrity of our information technology and other business systems; actual or anticipated changes or fluctuations in our results of operations; our existing indebtedness could adversely affect our business and growth prospects; and the other factors set forth in our filings with the Securities and Exchange Commission. The forward-looking statements, together with statements relating to our past performance, should not be regarded as a reliable indicator of our future performance. We undertake no obligation to update any forward-looking statements made in this presentation to reflect events or circumstances after the date of this presentation or to reflect new information or the occurrence of unanticipated events, except as may be required by law. We may not actually achieve the plans, intentions, or expectations disclosed in our forward-looking statements, and you should not place undue reliance on our forward-looking statements. Our forward-looking statements do not reflect the potential impact of any future mergers, dispositions, joint ventures, or investments. Use of Non-GAAP Financial Measures In addition to financial measures presented in accordance with U.S. generally accepted accounting principles (“GAAP”), this presentation includes certain non-GAAP financial measures, including Center Margin, Adjusted EBITDA, Adjusted EBITDA Margin and Free Cash Flow. These non-GAAP measures are in addition to, and not a substitute for, or superior to, measures of financial performance prepared in accordance with U.S. GAAP. The non-GAAP financial measures used by LifeStance may differ from the non-GAAP financial measures used by other companies. A reconciliation of these measures to the most directly comparable U.S. GAAP measure is included in the Appendix to these slides or as otherwise described in these slides. Market and Industry Data This presentation also contains information regarding our market and industry that is derived from third-party research and publications. This information involves a number of assumptions and limitations. Forecasts, assumptions, expectations, beliefs, estimates and projections involve risk and uncertainties and are subject to change based on various factors.


Slide 3

LifeStance: Reimagining Mental Healthcare Note: Unless otherwise stated, data is as of September 30, 2023; (1) Trailing twelve months Building the Leading Outpatient Mental Health Platform Increasing access to trusted, affordable, and personalized mental healthcare A truly healthy society where mental and physical healthcare are unified to make lives better OUR VISION OUR MISSION Tech-enabled platform supporting hybrid model of virtual and in-person care In-network reimbursement providing affordable access to high-quality care National platform with unmatched scale Multidisciplinary clinician model composed of W-2 employed psychiatrists, APNs, psychologists & therapists 6,418 Clinicians 18% Y/Y Growth $1,005M Revenue | TTM(1) 22% Y/Y TTM(1) Growth 6.6M Visits | TTM(1) 600+ Centers in 33 States 1 2 3 4


Slide 4

Q3 2023 Highlights Q3 Revenue of $262.9 million increased 21% year-over-year Total clinicians of 6,418, +18% Y/Y; 286 net clinician adds in Q3 Q3 Center Margin of $76.2 million, or 29.0% as a percentage of revenue Q3 Adjusted EBITDA of $14.6 million, or 5.6% as a percentage of revenue Ended Q3 with a cash position of $42.6 million Note: See reconciliation of GAAP to non-GAAP measures in the Appendix to this presentation.


Slide 5

Clinicians Q3 2023 Results Adjusted EBITDA (in $M) Center Margin (in $M) Revenue (in $M) 7.1% 5.6% 27.7% 29.0% Center Margin (% of total revenue) +26% +21% +18% -5% Adj. EBITDA (% of total revenue) Note: See reconciliation of GAAP to non-GAAP measures in the Appendix to this presentation. Amounts are unaudited.


Slide 6

Quarterly Trends Clinicians Adjusted EBITDA (in $M) Adj. EBITDA (% of total revenue) Center Margin (in $M) Revenue (in $M) Center Margin (% of total revenue) 27.7% 27.3% 27.6% 28.1% 29.0% 7.1% 4.4% 4.0% 5.4% 5.6% Note: See reconciliation of GAAP to non-GAAP measures in the Appendix to this presentation. Amounts are unaudited.


Slide 7

Balance Sheet, Cash Flow, and Capital Allocation *Long-Term Debt is Net of Current Portion and Unamortized Discount and Debt Issue Costs Balance Sheet & Cash Flow Capital Allocation Evolving from purely growth mindset to balanced set of objectives that include operational excellence, profitable growth, and disciplined capital deployment $248M Net Long-term Debt* Cash & Cash Equivalents $43M ($34M) Operating Cash Flow (YTD) $29M Capital Expenditures (YTD) De Novos Selective deployment to enable clinician and market growth Opened 8 de novos in Q3 and 23 YTD Acquisitions No acquisitions in Q3 No further M&A anticipated in 2023


Slide 8

2023 Guidance (All $ in M) FY 2023 Q4 2023 Revenue $1,030 – $1,040 (Narrowed from $1,010 - $1,040; midpoint raised) $255 – $265 Center Margin $292 – $300 (Narrowed from $280 - $300; midpoint raised) $73 – $81 Adj. EBITDA $56 – $60 (Narrowed from $50 - $62; midpoint raised) $17 – $21 Note: Center Margin and Adjusted EBITDA anticipated for fourth quarter of 2023 and full year 2023 are calculated in a manner consistent with the historical presentation of these measures in the Appendix to this presentation. Reconciliation for the forward- looking fourth quarter of 2023 and full year 2023 Center Margin and Adjusted EBITDA guidance is not being provided, as LifeStance does not currently have sufficient data to accurately estimate the variables and individual adjustments for such reconciliation. LifeStance management cannot estimate on a forward-looking basis without unreasonable effort the impact these variables and individual adjustments will have on its reported results. Planning Assumptions Assumes no more than 36 de novo center openings Assumes M&A spend of ~$40M, inclusive of up to $20M in earnouts from prior years’ acquisitions Assumes no further COVID-related impacts or changes in the labor market environment


Slide 9

Appendix


Slide 10

2023 2023 2022 ($M) Q3 Q2 Q1 Q4 Q3 Q2 Q1 Total revenue $262.9 $259.6 $252.6 $229.4 $217.6  $209.5   $203.1    Operating expenses     Center costs, excluding depreciation and amortization 186.7 186.6 183.0 166.7 157.3  149.7   148.9  General and administrative expenses 130.9 101.9 84.6 89.8 81.2  103.6   103.4  Depreciation and amortization 19.6 19.5 19.1 18.9 17.9  16.7   15.7  Loss from operations (74.4) (48.4) (34.1) (46.0) (38.8)  (60.5)  (64.9) Other income (expense) Gain (loss) on remeasurement of contingent consideration 1.9 1.5 1.0 (2.2) 1.2  (0.2)  (0.4) Transaction costs — (0.0) (0.1) (0.2) (0.2)  (0.0)  (0.3) Interest expense, net (5.5) (5.1) (5.1) (5.2) (4.2)  (7.1)  (3.4) Other expense (0.0) (0.0) (0.0) (0.1) (0.1) —         — Total other expense (3.6) (3.6) (4.2) (7.7) (3.4)  (7.3)  (4.2) Loss before income taxes (78.0) (52.0) (38.3) (53.7) (42.2)  (67.8)  (69.0) Income tax benefit (provision) 16.4 6.5 4.0 7.1  4.4   (0.9)   6.7  Net loss ($61.6) ($45.5) ($34.2) ($46.7)  ($37.9)  ($68.7)  ($62.3) Other comprehensive income (loss) Unrealized gains (losses) on cash flow hedge, net of tax 0.2 2.1 (1.3) 0.1 3.2 — — Comprehensive loss ($61.4) ($43.3) ($35.5) ($46.6) ($34.7) ($68.7) ($62.3) Subtotals in the schedule above may not foot due to rounding. Amounts are unaudited. Quarterly Statements of Operations and Comprehensive Loss


Slide 11

Quarterly GAAP to Non-GAAP Reconciliations – Center Margin 2023 2023 2022 ($M) Q3 Q2 Q1 Q4 Q3 Q2 Q1 Loss from operations ($74.4) ($48.4) ($34.1) ($46.0) ($38.8) ($60.5) ($64.9)         Adjusted for:         Depreciation and amortization 19.6 19.5 19.1 18.9 17.9 16.7 15.7 General and administrative expenses (1) 130.9 101.9 84.6 89.8 81.2 103.6 103.4 Center Margin $76.2 $73.0 $69.6 $62.7 $60.3 $59.8 $54.2 Subtotals in the schedule above may not foot due to rounding. Amounts are unaudited. (1) Represents salaries, wages and employee benefits for our executive leadership, finance, human resources, marketing, billing and credentialing support and technology infrastructure and stock-based compensation for all employees. 


Slide 12

Quarterly GAAP to Non-GAAP Reconciliations – Adjusted EBITDA   2023 2023 2022 ($M) Q3 Q2 Q1 Q4 Q3 Q2 Q1 Q1   Net loss ($61.6) ($45.5) ($34.2) ($46.7) ($37.9) ($68.7) ($62.3) ($62.3)           Adjusted for:         Interest expense, net 5.5 5.1 5.1 5.2 4.2 7.1 3.4 3.4 Depreciation and amortization 19.6 19.5 19.1 18.9 17.9 16.7 15.7 15.7 Income tax (benefit) provision (16.4) (6.5) (4.0) (7.1) (4.4) 0.9 (6.7) (6.7) (Gain) loss on remeasurement of contingent consideration (1.9) (1.5) (1.0) 2.2 (1.2) 0.2 0.4 0.4 Stock-based compensation 21.5 33.1 23.9 35.2 34.9 57.5 59.9 59.9 Loss on disposal of assets 0.0 0.0 0.0 0.1 0.1 — - — Transaction costs (1) — 0.0 0.1 0.2 0.2 0.0 0.3 0.3 Executive transition costs 0.1 0.4 0.2 0.8 0.5 — - — Litigation costs (2) 45.4 3.4 0.4 0.7 0.1 — - — Strategic initiatives (3) 0.8 2.0 0.4 — — — — Real estate optimization and restructuring charges (4) 1.3 3.7 — — — — — Other expenses (5) 0.2 0.3 0.3 0.6 0.9 0.9 1.8 1.8 Adjusted EBITDA $14.6 $14.1 $10.1 $10.2 $15.4 $14.6 $12.5 $12.5     Subtotals in the schedule above may not foot due to rounding. Amounts are unaudited.   (1) Primarily includes capital markets advisory, consulting, accounting and legal expenses related to our acquisitions. (2) Litigation costs include only those costs which are considered non-recurring and outside of the ordinary course of business based on the following considerations, which we assess regularly: (i) the frequency of similar cases that have been brought to date, or are expected to be brought within two years, (ii) the complexity of the case (e.g., complex class action litigation), (iii) the nature of the remedy(ies) sought, including the size of any monetary damages sought, (iv) the counterparty involved, and (v) our overall litigation strategy. During the three and nine months ended September 30, 2023, litigation costs included cash expenses related to three distinct litigation matters, including (x) a securities class action litigation, (y) a privacy class action litigation and (z) a compensation model class action litigation. (3) Strategic initiatives consist of expenses directly related to a multi-phase system upgrade in connection with our recent and significant expansion. During each of the three and nine months ended September 30, 2023, we continued a process of evaluating and adopting three critical enterprise-wide systems for (i) human resources management, (ii) clinician credentialing and onboarding process and (iii) a scalable electronic health resources system. Strategic initiatives represents costs, such as third-party consulting costs and one-time costs, that are not part of our ongoing operations related to these enterprise-wide systems. We considered the frequency and scale of this multi-part enterprise upgrade when determining that the expenses were not normal, recurring operating expenses. (4) Real estate optimization and restructuring charges consist of cash expenses and non-cash charges related to our real estate optimization initiative, which include certain asset impairment and disposal costs, certain gains and losses related to early lease terminations, and exit and disposal costs related to our real estate optimization initiative to consolidate our physical footprint. As the decision to close these centers was part of a significant strategic project driven by a historic shift in behavior, the magnitude of center closures has been and is expected to be greater than what would be expected as part of ordinary business operations and do not constitute normal recurring operating activities. (5) Primarily includes costs incurred to consummate or integrate acquired centers, certain of which are wholly-owned and certain of which are affiliated practices, in addition to the compensation paid to former owners of acquired centers and related expenses that are not reflective of the ongoing operating expenses of our centers. Acquired center integration and other are components of general and administrative expenses included in our unaudited consolidated statements operations and comprehensive loss. Former owner fees is a component of center costs, excluding depreciation and amortization included in our unaudited consolidated statements of operations and comprehensive loss.


Slide 13

2023 2023 2022 ($M) Q3 Q2 Q1 Q4 Q3 Q2 Q1 Key Metrics Clinicians 6,418 6,132 5,961 5,631 5,431 5,226 4,989       Total Revenue $262.9 $259.6 $252.6 $229.4 $217.6 $209.5 $203.1         Center costs, excluding depreciation and amortization 186.7 186.6 183.0 166.7 157.3 149.7 148.9 Center Margin (Non-GAAP) $76.2 $73.0 $69.6 $62.7 $60.3 $59.8 $54.2 % Margin 29.0% 28.1% 27.6% 27.3% 27.7% 28.5% 26.7%       General and administrative expenses 130.9 101.9 84.6 89.8 81.2 103.6 103.4 Depreciation and amortization 19.6 19.5 19.1 18.9 17.9 16.7 15.7 Loss from operations (74.4) (48.4) (34.1) (46.0) (38.8) (60.5) (64.9)       Other income (expense)       Other income (expense) 12.8 2.9 (0.1) (0.6) 1.0 (8.3) 2.5 Net loss ($61.6) ($45.5) ($34.2) ($46.7) ($37.9) ($68.7) ($62.3)         Other comprehensive income (loss) Unrealized gains (losses) on cash flow hedge, net of tax 0.2 2.1 (1.3) 0.1 3.2 — — Comprehensive loss ($61.4) ($43.3) ($35.5) ($46.6) ($34.7) ($68.7) ($62.3) Adjusted EBITDA build       Net loss (61.6) (45.5) (34.2) (46.7) (37.9) (68.7) (62.3) Interest expense, net 5.5 5.1 5.1 5.2 4.2 7.1 3.4 Depreciation and amortization 19.6 19.5 19.1 18.9 17.9 16.7 15.7 Income tax benefit (provision) (16.4) (6.5) (4.0) (7.1) (4.4) 0.9 (6.7) (Gain) loss on remeasurement of contingent consideration (1.9) (1.5) (1.0) 2.2 (1.2) 0.2 0.4 Stock-based compensation 21.5 33.1 23.9 35.2 34.9 57.5 59.9 Loss on disposal of assets 0.0 0.0 0.0 0.1 0.1 — — Transaction costs — 0.0 0.1 0.2 0.2 0.0 0.3 Executive transition costs 0.1 0.4 0.2 0.8 0.5 — — Litigation costs 45.4 3.4 0.4 0.7 0.1 — — Strategic initiatives 0.8 2.0 0.4 — — — — Real estate optimization and restructuring charges 1.3 3.7 — — — — — Other expenses 0.2 0.3 0.3 0.6 0.9 0.9 1.8 Adjusted EBITDA (Non-GAAP) $14.6 $14.1 $10.1 $10.2 $15.4 $14.6 $12.5 % Margin 5.6% 5.4% 4.0% 4.4% 7.1% 7.0% 6.2% Subtotals in the schedule above may not foot due to rounding. Amounts are unaudited. Non-GAAP Financial Metrics


Slide 14

  2023 2023 2022 ($M)   Q3 Q2 Q1 Q4 Q3 Q2 Q1  Current assets    Cash and cash equivalents   42.6 79.6 68.3 108.6 90.3 96.7 114.0 Patient accounts receivable, net   149.7 121.8 118.4 100.9 113.3 99.7 95.0 Prepaid expenses and other current assets   71.9 36.5 25.8 23.7 49.0 47.9 54.3 Total current assets   264.3 237.9 212.5 233.2 252.6 244.3 263.3 Property and equipment, net   190.1 193.1 193.5 194.2 193.4 190.7 170.9 Right-of-use assets   180.7 191.4 196.2 199.4 — — — Intangible assets, net   233.6 243.8 254.0 263.3 272.5 282.1 291.2 Goodwill   1,293.4 1,293.5 1,293.6 1,272.9 1,249.8 1,243.7 1,229.3 Other noncurrent assets   13.0 11.2 8.8 10.8 11.4 7.9 3.7 Total noncurrent assets   1,910.8 1,933.0 1,946.1 1,940.6 1,727.1 1,724.4 1,695.1 Total assets   $2,175.1 $2,170.9 $2,158.6 $2,173.9 $1,979.7 $1,968.7 $1,958.4 Accounts payable   10.4 8.0 7.7 12.3 7.9 12.9 15.1 Accrued payroll expenses   83.6 81.1 83.7 75.7 61.6 61.2 73.2 Other accrued expenses   91.0 34.3 32.0 30.4 29.3 26.2 21.8 Current portion of contingent consideration   9.0 10.5 13.3 15.9 10.8 9.0 13.5 Operating lease liabilities, current   43.6 43.4 41.6 38.8 — — — Other current liabilities   3.3 3.3 2.8 2.9 2.6 2.2 2.0 Total current liabilities   240.9 180.9 181.1 176.0 112.3 111.5 125.6 Long-term debt, net   248.4 248.7 224.8 225.1 212.0 203.4 177.4 Operating lease liabilities, noncurrent 191.5 205.6 207.9 212.6 — — — Contingent consideration, net of current portion — — — — 1.5 3.7 1.1 Deferred tax liability, net   38.4 38.3 37.6 38.7 55.4 54.3 54.3 Other noncurrent liabilities 0.9 2.6 2.1 2.8 67.0 64.5 57.5 Total noncurrent liabilities   479.1 495.2 472.3 479.1 335.9 325.8 290.3 Total liabilities    $720.0 $676.0 $653.4 $655.1 $448.2 $437.4 $415.9 Common stock   3.8 3.8 3.8 3.8 3.8 3.8 3.7 Additional paid-in capital   2,162.8 2,141.2 2,108.2 2,084.3 2,050.5 2,015.7 1,958.2 Accumulated other comprehensive income 4.4 4.2 2.0 3.3 3.2 — — Accumulated deficit   (715.9) (654.3) (608.8) (572.6) (526.0) (488.1) (419.4) Total stockholders’ equity   1,455.0 1,494.9 1,505.1 1,518.7 1,531.5 1,531.3 1,542.5 Total liabilities and stockholders’ equity   $2,175.1 $2,170.9 $2,158.6 $2,173.9 $1,979.7 $1,968.7 $1,958.4   Subtotals in the schedule above may not foot due to rounding. Amounts are unaudited.     Quarterly Balance Sheets


Slide 15

Statements of Cash Flows ($M) Nine Months Ended Q3’23 Six Months Ended Q2’23 Q1’23 Nine Months Ended Q3’22 Six Months Ended Q2’22 Q1’22 CASH FLOWS FROM OPERATING ACTIVITIES Net loss (141.3) ($79.7) ($34.2) (168.9) ($131.1) ($62.3) Adjustments to reconcile net loss to net cash (used in) provided by operating activities:        Depreciation and amortization 58.2 38.6 19.1 50.3 32.4 15.7 Non-cash operating lease costs 30.2 20.3 10.1 — — — Stock-based compensation 78.5 56.9 23.9 152.2 117.4 59.9 Loss on debt extinguishment — — — 3.4 3.4 — Amortization of discount and debt issue costs 1.6 1.1 0.5 1.4 0.7 0.3 (Gain) loss on remeasurement of contingent consideration (4.4) (2.6) (1.0) (0.6) 0.6 0.4 Other, net 5.1 2.7 — — — — Loss on disposal of assets — — 0.0 0.1 — — Change in operating assets and liabilities, net of businesses acquired:     Patient accounts receivable, net (48.5) (20.6) (17.1) (34.6) (21.9) (18.1) Prepaid expenses and other current assets (52.3) (15.2) (4.5) (5.8) (5.4) (12.1) Accounts payable (3.8) (5.4) (5.5) 1.1 1.7 1.9 Accrued payroll expenses 7.6 5.2 7.7 (0.6) (0.3) 12.8 Operating lease liabilities (30.1) (16.9) (8.7) — — — Other accrued expenses 65.6 7.3 2.0 18.8 13.5 4.9 Net cash (used in) provided by operating activities ($33.7) ($8.3) ($7.9) $16.9 $11.1 $3.3 CASH FLOWS FROM INVESTING ACTIVITIES Purchases of property and equipment (29.1) (19.3) (7.7) (68.9) (53.8) (27.9) Acquisitions of businesses, net of cash acquired (19.8) (19.8) (19.8) (40.3) (35.1) (22.9) Net cash used in investing activities ($48.9) ($39.1) ($27.5) ($109.2) ($88.9) ($50.9) CASH FLOWS FROM FINANCING ACTIVITIES Proceeds from long-term debt, net of discount 25.0 25.0 — 237.5 228.0 20.0 Payments of debt issue costs (0.2) (0.2) — (7.3) (7.2) — Payments of long-term debt (1.8) (1.2) (0.6) (181.2) (181.2) (0.3) Prepayment for debt paydown — — — (1.6) (1.6) — Payments of contingent consideration (6.4) (5.2) (4.3) (12.3) (11.1) (5.7) Taxes related to net share settlement of equity awards — — — (0.5) (0.5) (0.4) Net cash provided by (used in) financing activities $16.6 $18.4 ($4.9) $34.6 $26.4 $13.5 NET DECREASE IN CASH AND CASH EQUIVALENTS ($66.0) ($29.0) ($40.3) ($57.7) ($51.3) ($34.0) Cash and Cash Equivalents - Beginning of period 108.6 108.6 108.6 148.0 148.0 148.0 CASH AND CASH EQUIVALENTS – END OF PERIOD $42.6 $79.6 $68.3 $90.3 $96.7 $114.0 Subtotals in the schedule above may not foot due to rounding. Amounts are unaudited.


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2023 2023 2022 ($M) Q3 Q2 Q1 Q4 Q3 Q2 Q1 Net cash (used in) provided by operating activities ($25.4) ($0.4) ($7.9) $36.0 $5.7 $7.8 $3.3       Purchases of property and equipment ($9.8) ($11.6) ($7.7) ($10.4) ($15.1) ($25.9) ($27.9) Free Cash Flow ($35.2) ($12.0) ($15.6) $25.6 ($9.4) ($18.1) ($24.6) We define FCF, a non-GAAP performance measure, as net cash (used in) provided by operating activities less purchases of property and equipment. We believe that FCF is a useful indicator of liquidity that provides information to management and investors about the amount of cash generated from our operations that, after investments in property and equipment, can be used for future growth. FCF is presented for supplemental informational purposes only and has limitations as an analytical tool and should not be considered in isolation or as a substitute for analysis of other GAAP financial measures, such as net cash (used in) provided by operating activities. It is important to note that other companies, including companies in our industry, may not use this metric, may calculate metrics differently, or may use other financial measures to evaluate their liquidity, all of which could reduce the usefulness of this non-GAAP metrics as a comparative measure. The above table presents a reconciliation of net cash (used in) provided by operating activities to FCF, the most directly comparable financial measure calculated in accordance with GAAP. Amounts are unaudited. Quarterly GAAP to Non-GAAP Reconciliations – Free Cash Flow (FCF)


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Quarterly Visits and Total Revenue Per Visit 2023 2023 2022 Q3 Q2 Q1 Q4 Q3 Q2 Q1 Total Revenue ($M) $262.9 $259.6 $252.6 $229.4 $217.6 $209.5 $203.1 Total Visits (000s) 1,714 1,705 1,665 1,487 1,429  1,413  1,392 Total Revenue Per Visit (TRPV) $153.4 $152.3 $151.7 $154.3 $152.3 $148.3 $145.9 Amounts are unaudited.