Apollo Medical Holdings, Inc. - Annual Report: 2009 (Form 10-K)
UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
10-K
(Mark
One)
x ANNUAL REPORT PURSUANT
TO SECTION 13 OR 15(D) OF THE SECURITIES
EXCHANGE
ACT OF 1934
For
the fiscal period ended January 31, 2009
o TRANSITION REPORT
PURSUANT TO SECTION 13 OR 15(D) OF THE SECURITIES
EXCHANGE
ACT
For the
transition period from ___________ to ____________
Commission
File No.
000-25809
Apollo
Medical Holdings, Inc.
(Exact
name of registrant as specified in its charter)
Delaware
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20-8046599
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State
of Incorporation
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IRS
Employer Identification No.
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1010
N. Central Avenue
Glendale,
California 91202
(Address
of principal executive offices)
(818)
507-4617
(Issuer’s
telephone number)
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in
Rule 405 of the Securities Act
Yes
o No þ
Indicate
by check mark if the registrant is not required to file reports pursuant to
Section 13 or Section 15(d) of the Exchange Act.
Yes o No þ
Check
whether the issuer (1) filed all reports required to be filed by Section 13 or
15(d) of the Exchange Act during the past 12 months (or for such shorter period
that the registrant was required to file such reports), and (2) has been subject
to such filing requirements for the past 90 days.
Yes þ No
o
Indicate
by check mark whether the registrant has submitted electronically and posted on
its corporate website, if any, every interactive data file required to be
submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding
12 months (or for such shorter period that registrant was required to submit and
post such files).
Yes o No
o
Indicate
by check mark whether the registrant is a large accelerated filer, an
accelerated filer, a non-accelerated filer, or a smaller reporting company. See
the definitions of “large accelerated filer,” “accelerated filer” and “smaller
reporting company” in Rule 12b-2 of the Exchange Act. (Check one):
Large
accelerated filer o
Accelerated filer o Non-accelerated
filer o
Smaller reporting company þ
(Do not check if a smaller reporting
company)
Indicate
by check mark whether the registrant is a shell company (as defined in
Rule 12b-2 of the Exchange Act).
Yes o No þ
The
aggregate market value of the shares of voting common stock held by
non-affiliates of the Registrant computed by reference to the closing sales
price of such shares on the OTC Bulletin Board on July 31, 2008, the last
business day of the Registrant’s most recently completed second fiscal quarter,
was $509. Solely for purposes of the foregoing calculation, all of
the registrant’s directors and officers as of July 31, 2008 are deemed to be
affiliates. This determination of affiliate status for this purpose does not
reflect a determination that any persons are affiliates for any other
purpose.
As of
April 10, 2009, there were 25,870,220 shares of Common Stock, $.001 par value
per share issued and outstanding.
APOLLO
MEDICAL HOLDINGS, INC.
FORM
10-K
FOR
THE TWELVE MONTHS ENDED JANUARY 31, 2009
TABLE
OF CONTENTS
PART
I
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Item
1
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Description
of Business
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3
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Item
1A
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Risk
Factors
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15
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Item
1B
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Unresolved
Staff Comments
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22
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Item
2
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Description
of Properties
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22
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Item
3
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Legal
Proceedings
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23
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Item
4
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Submission
of Matters to a Vote of Security Holders
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23
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PART
II
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Item
5
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Market
for Registrant’s Common Equity, Related Stockholder Matters and Issuer
Purchase of Equity Securities
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23
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Item
6
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Selected
Financial Data
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25
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Item
7
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Management’s
Discussion and Analysis of Financial Condition and Results of
Operations
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25
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Item
7A
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Quantitative
and Qualitative Disclosures about Market Risk
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29
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Item
8
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Financial
Statements and Supplementary Data
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30
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Item
9
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Changes
in and Disagreements with Accountants and Financial
Disclosures
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30
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Item
9A(T)
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Controls
and Procedures
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30
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Item
9B
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Other
Information
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32
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PART
III
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Item
10
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Directors,
Executive Officers and Corporate Governance
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32
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Item
11
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Executive
Compensation
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34
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Item
12
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Security
Ownership of Certain Beneficial Owners and Management and related
Stockholder Matters
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35
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Item
13
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Certain
Relationships and Related Transactions, and Director
Independence
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36
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Item
14
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Principal
Accounting Fees and Services
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37
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PART
IV
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Item
15
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Exhibits,
Financial Statement Schedules
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38
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Signatures
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38
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2
PART
I
ITEM
1.
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DESCRIPTION
OF BUSINESS
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Introductory
Comment
Unless
context dictates otherwise, references in this Annual Report on Form 10-K (the
“Report”) to the “Company,” “we,” “us,” “our” and similar words are to Apollo
Medical Holdings, Inc. (“Apollo”), and its wholly owned subsidiaries: (i) Apollo
Medical Management, Inc. (“AMM”); (ii) ApolloMed Hospitalists (“AMH”) and Apollo
Medical Associates (“AMA”).
The
following discussion and analysis provides information that management believes
is relevant to an assessment and understanding of our results of operations and
financial operations. This discussion should be read in conjunction with the
consolidated financial statements and notes thereto appearing elsewhere herein,
and with our prior filings with the Securities Exchange Commission (the
“SEC”).
Disclosure
Regarding Forward-Looking Statements - Cautionary Statement
We
caution readers that this Report contains “forward-looking statements” within
the meaning of the Private Securities Litigation Reform Act of 1995.
Forward-looking statements, written, oral or otherwise, are based on the
Company’s current expectations or beliefs rather than historical facts
concerning future events, and they are indicated by words or phrases such as
(but not limited to) “anticipate,” “could,” “may,” “might,” “potential,”
“predict,” “should,” “estimate,” “expect,” “project,” “believe,” “think,”
“intend,” “plan,” “envision,” “continue,” “intend,” “target,” “contemplate,”
“budgeted,” or “will” and similar words or phrases or comparable
terminology. Forward-looking statements involve risks and uncertainties. The
Company cautions that these statements are further qualified by important
economic, competitive, governmental and technological factors that could cause
the Company’s business, strategy, or actual results or events to differ
materially, or otherwise, from those in the forward-looking statements. We have
based such forward-looking statements on our current expectations, assumptions,
estimates and projections, and therefore there can be no assurance that any
forward-looking statement contained herein, or otherwise made by the Company,
will prove to be accurate. The Company assumes no obligation to update the
forward-looking statements.
The
Company has a relatively limited operating history compared to others in the
same business and is operating in a rapidly changing industry environment, and
its ability to predict results or the actual effect of future plans or
strategies, based on historical results or trends or otherwise, is inherently
uncertain. While we believe that these forward-looking statements are
reasonable, they are merely predictions or illustrations of potential outcomes,
and they involve known and unknown risks and uncertainties, many beyond our
control, that are likely to cause actual results, performance, or achievements
to be materially different from those expressed or implied by such
forward-looking statements. Factors that could have a material adverse affect on
the operations and future prospects of the Company on a condensed basis include
those factors discussed under Item 1A “Risk Factors” and Item 7, “Management’s
Discussion and Analysis or Plan of Operation” in this Report, and include, but
are not limited to, the following:
3
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Our
ability to attract and retain management, and to integrate and maintain
technical information and management information
systems;
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Our
ability to raise capital when needed and on acceptable terms and
conditions;
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The
intensity of competition; and
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General
economic conditions.
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All
written and oral forward-looking statements made in connection with this Report
that are attributable to us or persons acting on our behalf are expressly
qualified in their entirety by these cautionary statements. Given the
uncertainties that surround such statements, you are cautioned not to place
undue reliance on such forward-looking statements.
Overview
Apollo
Medical Holdings, Inc. operates as a medical management holding company that
focuses on managing the provision of hospital-based medicine through a wholly
owned subsidiary-management company, Apollo Medical Management, Inc. (“AMM”).
Through AMM, the Company manages affiliated medical groups, which presently
comprise two wholly owned subsidiaries, ApolloMed Hospitalists (“AMH”) and
Apollo Medical Associates (“AMA”). AMM operates as a Physician
Practice Management Company (PPM) and is in the business of providing management
services to Physician Practice Companies (PPC) under Management Service
Agreements.
Organizational
History
On June
13, 2008, Siclone Industries, Inc. (“Siclone”), Apollo Acquisition Co., Inc., a
wholly owned subsidiary of Siclone (“Acquisition”), Apollo Medical Management,
Inc. (“Apollo Medical”) and the shareholders of Apollo Medical entered into an
agreement and Plan of Merger (the “Merger Agreement”). Pursuant to the terms of
the Merger Agreement, Apollo Medical merged with and into Acquisition. The
former shareholders of Apollo Medical received 20,933,490 shares of Siclone’s
common stock in exchange for all the issued and outstanding shares of Apollo
Medical.
The
acquisition of Apollo Medical is accounted for as a reverse acquisition under
the purchase method of accounting since the shareholders of Apollo Medical
obtained control of the consolidated entity. Accordingly,
the reorganization of the two companies is recorded as a recapitalization
of Apollo Medical, with Apollo Medical being treated as the continuing operating
entity. The historical financial statements presented herein will be those of
Apollo Medical. The continuing entity retained January 31 as its fiscal year
end. The financial statements of the legal acquirer are not significant;
therefore, no pro forma financial information is submitted.
4
On July
1, 2008, the continuing entity (i.e., the combined entity of Acquisition and
Apollo Medical) changed its name to Apollo Medical Management, Inc.
(AMM). On July 3, 2008, Siclone changed its name to Apollo Medical
Holdings, Inc. Following the merger, the Company is
headquartered in Glendale, California.
On August
1, 2008, AMM completed negotiations and executed a formal Management Services
Agreement with ApolloMed Hospitalists (“AMH”), under which AMM will provide
management services to AMH. The Agreement is effective as of August
1, 2008 and will allow AMM, which operates as a Physician Practice Management
Company, to consolidate AMH, which operates as a Physician Practice, in
accordance with EITF 97-2, Application of FASB Statement No. 94 and APB Opinion
No. 16 to Physician Management Entities and Certain Other Entities with
Contractual Management Agreements. The Management Services Agreement was amended
on March 20, 2009, to allow for the calculation of the fee on a monthly basis
with payment of the calculated fee each month. AMH is controlled by
Dr. Hosseinion and Dr. Vazquez, the Company’s Chief Executive Officer and
President, respectively.
Hospitalist
Industry Overview
Hospitalists
are physicians who spend their professional time serving as the
physicians-of-record for inpatients. Today, many primary care
physicians/healthcare providers use hospitalists to care for their patients when
they visit emergency rooms or are admitted to the hospital. The hospitalist
handles the patient’s care during the time spent in the hospital, and
communicates often with the patient’s primary care physician about the patient’s
progress. At the time of discharge from the hospital, the hospitalists returns
the patient back to the care of their primary care providers. The number of
hospitalists has grown from a few hundred in 1996 to over 20,000 today in
response to a need for more efficient delivery of inpatient care according to
the Society of Hospital Medicine. It is anticipated that as many as 33,000
hospitalists may be currently needed for full coverage of inpatients in the
United States.
Rising
healthcare expenditures is a key motivating factor behind the utilization of
hospitalists. An aging population, advancements in medical technology, and the
rising cost of pharmaceuticals are just some of the forces driving up healthcare
costs. Hospital medicine has developed as a specialty with unique
characteristics and expertise. Hospitalists have specialized skills, knowledge,
and relationships that contribute value to hospitals, physicians, patients, and
health plans. These skills go beyond the delivery of quality patient care to
hospital inpatients and include:
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Providing
measurable quality improvement through setting standards and
compliance;
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Saving
money and resources by reducing the patient’s length of stay and achieving
better utilization;
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Improving
the efficiency of the hospital by early patient discharge, better
throughput in the emergency department (ED), and the opening up of ICU
beds;
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Creating
a seamless continuity from inpatient to outpatient care, from the ED to
the floor, and from the ICU to the
floor;
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5
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Creating
teams of healthcare professionals that make better use of the resources at
the hospital and create a better working environment for nurses and
others;
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Creating
synergies between emergency and inpatient hospital services by the
management of both areas through the Company’s strategy of acquisitions of
both ER and hospitalist groups; and
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Managing
acutely ill, complex hospitalized
patients.
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In
today’s healthcare environment, patients are generally admitted to hospitals and
cared for by primary care physicians (PCPs). The demands of modern medical
practice, however, require that PCPs spend most of their time in outpatient
practices limiting their availability to care for hospitalized patients. These
requirements and demands have led to ever-diminishing quality of inpatient care,
longer hospital stays, and higher costs to the insurance companies. Over the
past few years, hospital-based physicians, or hospitalists (i.e. those
physicians that do not have a separate outpatient practice), are becoming a
regular part of the healthcare landscape allowing PCPs to focus on outpatient
office visits. According to the Society of Hospital Medicine, a leading trade
journal, hospital medicine is the fastest growing medical specialty today
growing from a few hundred hospitalists in 1996 to approximately 20,000
hospitalists today. Generally hospital-based physicians:
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are
medical doctors that spend their time in the inpatient environment, making
them familiar with hospital systems, policies, services, departments, and
staff;
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are
in-patient experts who possess clinical credibility when addressing key
issues regarding the inpatient environment;
and
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understand
the tradeoffs involved in balancing the needs of the hospital with those
of the medical staff; they tend to have an intimate knowledge of the
issues that the hospital is facing and are invested in finding solutions
to these problems.
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Principal
Services and Markets
The
Company provides management services to medical groups that provide
comprehensive inpatient care services in the U.S. We offer a
comprehensive set of integrated medical services to hospitals, health carriers
and medical groups as well as individual physicians, through our affiliated
medical groups, as follows:
Services
for Hospitals
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Providing
care from the emergency room through hospital
discharge;
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Admission
and care of unassigned and/or uninsured
patients;
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Inpatient
internal medicine consultation
services;
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Emergency
room Clinical Decision Unit services to improve throughput and ease
overcrowding;
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Development
of hospital-based physicians programs, including pulmonary, critical care,
cardiology and nephrology;
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24/7
in-hospital inpatient coverage
services;
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6
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Development
of evidence-based medicine protocols for common
diagnoses;
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Implementation
of patient safety guidelines;
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Education
of nurses and hospital staff;
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Analysis
of statistics via the ApolloWeb (discussed further below) database,
including length of stay, bed days/1000 admissions, and readmission rates;
and
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Care
of patients at academic medical centers, including the education of
medical students, interns and
residents
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Services
for Health Carriers and Medical Groups
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Admission
and care of assigned patients;
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Consistent
communication with primary care physicians upon admission, during the
patient’s hospital stay, and upon
discharge;
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Rapid
transfer of out-of-network patients back to designated
hospitals;
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24/7
in-hospital inpatient coverage
services;
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Consistent
communication with case managers, social workers, and medical group
personnel;
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Hospital-based
physician consulting services; and
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Analysis
of statistics via the ApolloWeb database
technology.
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Services
for Individual Physicians
Hospital-based
services for physicians on weekends, holidays, or for those who do not wish to
come to the hospital; primary care physicians can benefit from this arrangement
because they have more time to focus on outpatient care.
Competition
The
healthcare industry is highly competitive, and the market for hospitalists
within this industry is highly fragmented. The Company faces
competition from numerous small hospitalist and emergency room practices as well
as large physician groups. Some of these competitors operate on a national
level, such as Emcare, Team Health and IPC and may have greater financial and
other resources available to them.
In
addition, because the market for hospitalist services is highly fragmented and
the ability of individual physicians to provide services in any hospital where
they have certain credentials and privileges, competition for growth in existing
and expanding markets is not limited to our largest competitors.
Growth
Strategy, Competitive Position in Industry and Methods of
Competition
We
anticipate that we will grow our business by two primary methods, organic growth
and acquisitions.
7
Organic
Growth
The
Company has initiated a marketing plan focused on targeting hospitals, hospital
chains, health carriers/HMOs, medical groups and individual physicians. We also
plan to commence a physician recruitment campaign aimed at attracting physicians
to meet the expected increase in demand for our services. This campaign will be
driven by utilizing direct contacts with internal medicine residency programs,
advertising in professional journals, and on-line advertising programs. We
believe we have a competitive advantage in attracting highly qualified
physicians by offering recruits, through our affiliated medical groups,
competitive salary and benefits including, if appropriate, incentive-based stock
options as part of the compensation package.
We expect
to add key personnel to our business operations in order implement our growth
strategy. Management believes that this will include a marketing division,
establishing a physician recruiting division, expanding the billing department,
and establishing a case management division. We also intend to upgrade our
information technology systems to keep pace with growth. This could include: (1)
upgrading the ApolloWeb technology, (2) integration of billing and collections
functions, (3) electronic medical records, and (4) upgrading the wireless
technology system.
Acquisitions
The
Company also plans to grow through mergers/acquisitions. Targeted
mergers/acquisitions will focus on hospitalist groups, emergency room physician
groups, and other hospital-based specialty physicians. We have identified a
number of small group practices, as well as larger groups with between 40 and
200 physicians that may be potential merger/acquisition candidates. We believe
that we may have a competitive advantage in closing potential
mergers/acquisitions as a publicly-traded company, which could provide us with
access to additional capital and the ability to utilize our stock as part of the
compensation package to the stockholders of the target
companies.
Technology
AMH and
Drs. Hosseinion and Vazquez have developed, and own, a proprietary web-based,
practice management software program for hospital-based physicians. The system,
known as ApolloWeb allows a physician to enter patient information in real-time
at a patient’s bedside via a 3G broadband-enabled PDA or a desktop computer.
ApolloWeb is capable of generating:
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real-time,
comprehensive statistical data
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complete
HCFA(Health
Care Financing Administration) billing
forms
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patient
admissions and discharge summaries, including major test results and
necessary follow-ups
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faxes
or emails to primary care physicians with the aforementioned
information.
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8
It is
expected that additional features will be added to enhance the ApolloWeb
technology, several of which include an Electronic Medical Record (EMR) platform
and a quality control component in the near future. In exchange for the
Company’s management services, AMH and Drs. Hosseinion and Vazquez currently
make ApolloWeb available to the Company for its use at no charge in its business
operations. The Company is currently negotiating to acquire the rights to the
ApolloWeb technology from AMH, and Drs. Hosseinion and Vazquez.
Regulatory
Matters
Significant
Federal and State Healthcare Laws Governing Our Business
As a
healthcare company, our operations and relationships with healthcare providers
such as hospitals, other healthcare facilities, and healthcare professionals are
subject to extensive and increasing regulation by numerous federal, state, and
local government entities. These laws and regulations often are interpreted
broadly and enforced aggressively by multiple government agencies, including the
U.S. Department of Health and Human Services Office of the Inspector General, or
the OIG, the U.S. Department of Justice, and various state authorities. We have
included brief descriptions of some, but not all, of the laws and regulations
that affect our business.
Imposition
of sanctions associated with a violation of any of these healthcare laws and
regulations could have a material adverse effect on our business, financial
condition and results of operations. The Company cannot guarantee that its
arrangements or business practices will not be subject to government scrutiny or
be found to violate certain healthcare laws. Government investigations and
prosecutions, even if we are ultimately found to be without fault, can be costly
and disruptive to our business. Moreover, changes in healthcare legislation or
government regulation may restrict our existing operations, limit the expansion
of our business or impose additional compliance requirements and costs, any of
which could have a material adverse affect on its business, financial condition
and results of operations.
False
Claims Acts
The
federal civil False Claims Act imposes civil liability on individuals or
entities that submit false or fraudulent claims for payment to the federal
government. The False Claims Act provides, in part, that the federal government
may bring a lawsuit against any person whom it believes has knowingly or
recklessly presented, or caused to be presented, a false or fraudulent request
for payment from the federal government, or who has made a false statement or
used a false record to get a claim for payment approved. Private parties may
initiate qui tam
whistleblower lawsuits against any person or entity under the False Claims Act
in the name of the government and may share in the proceeds of a successful
suit.
9
The
federal government has used the False Claims Act to prosecute a wide variety of
alleged false claims and fraud allegedly perpetrated against Medicare and state
healthcare programs. By way of illustration, these prosecutions may be based
upon alleged coding errors, billing for services not rendered, billing services
at a higher payment rate than appropriate, and billing for care that is not
considered medically necessary. The government and a number of courts also have
taken the position that claims presented in violation of certain other statutes,
including the federal Anti-Kickback Statute or the Stark Law, can be considered
a violation of the False Claims Act based on the theory that a provider
impliedly certifies compliance with all applicable laws, regulations, and other
rules when submitting claims for reimbursement.
Penalties
for False Claims Act violations include fines ranging from $5,500 to $11,000 for
each false claim, plus up to three times the amount of damages sustained by the
government. A False Claims Act violation may provide the basis for the
imposition of administrative penalties as well as exclusion from participation
in governmental healthcare programs, including Medicare and Medicaid. In
addition to the provisions of the False Claims Act, which provide for civil
enforcement, the federal government also can use several criminal statutes to
prosecute persons who are alleged to have submitted false or fraudulent claims
for payment to the federal government.
A number
of states have enacted false claims acts that are similar to the federal False
Claims Act. Even more states are expected to do so in the future because
Section 6031 of the Deficit Reduction Act of 2005, or the DRA, amended the
federal law to encourage these types of changes, along with a corresponding
increase in state initiated false claims enforcement efforts. Under the DRA, if
a state enacts a false claims act that is at least as stringent as the federal
statute and that also meets certain other requirements, the state will be
eligible to receive a greater share of any monetary recovery obtained pursuant
to certain actions brought under the state’s false claims act. The OIG, in
consultation with the Attorney General of the United States, is responsible for
determining if a state’s false claims act complies with the statutory
requirements. Currently, 19 states and the District of Columbia have some form
of a state false claims acts. As of August 2007, the OIG has determined that
eight of these satisfy the DRA standards, and we anticipate this figure will
continue to increase. As of August 2007, the eight states are: Hawaii, Illinois,
Massachusetts, Nevada, New York, Tennessee, Texas and Virginia. Of the sixteen
states in which we currently operate, the following nine states have some form
of a state false claims act: California, Florida, Georgia, Illinois, Michigan,
Nevada, Oklahoma, Tennessee and Texas.
Anti-Kickback
Statutes
The
federal Anti-Kickback Statute contained in the Social Security Act prohibits the
knowing and willful offer, payment, solicitation or receipt of any form of
remuneration in return for, or to induce, (1) the referral of a beneficiary
of Medicare, Medicaid or other governmental healthcare programs, (2) the
furnishing or arranging for the furnishing of items or services reimbursable
under Medicare, Medicaid or other governmental healthcare programs or
(3) the purchase, lease, or order or arranging or recommending the
purchasing, leasing or ordering of any item or service reimbursable under
Medicare, Medicaid or other governmental healthcare programs. Some courts and
the OIG interpret the statute to cover any arrangement where even one purpose of
the remuneration is to influence referrals. A violation of the Anti-Kickback
Statute is a felony punishable by imprisonment, and criminal and civil fines of
up to $50,000 per violation and three times the amount of the unlawful
remuneration. A violation also can result in exclusion from Medicare, Medicaid
or other governmental healthcare programs.
10
Due to
the breadth of the Anti-Kickback Statute’s broad prohibition, there are a few
statutory exceptions that protect various common business transactions and
arrangements from prosecution. In addition, the OIG has published safe harbor
regulations that outline other arrangements that also are deemed protected from
prosecution under the Anti-Kickback Statute, provided all applicable criteria
are met. The failure of an activity to meet all of the applicable safe harbor
criteria does not necessarily mean that the particular arrangement violates the
Anti-Kickback Statute, but these arrangements will be subject to greater
scrutiny by enforcement agencies.
Some
states have enacted statutes and regulations similar to the Anti-Kickback
Statute, but which may be applicable regardless of the payor source of the
patient. These state laws may contain exceptions and safe harbors that are
different from those of the federal law and that may vary from state to
state.
Federal
Stark Law
The
federal Stark Law, also known as the physician self-referral law, generally
prohibits a physician from referring Medicare and Medicaid patients to an entity
(including hospitals) providing ‘‘designated health services,’’ if the physician
or a member of the physician’s immediate family has a ‘‘financial relationship’’
with the entity, unless a specific exception applies. Designated health services
include, among other services, inpatient and outpatient hospital services,
clinical laboratory services, certain imaging services, and other items or
services that our affiliated physicians may order. The prohibition applies
regardless of the reasons for the financial relationship and the referral; and
therefore, unlike the federal Anti-Kickback Statute, intent to violate the law
is not required. Like the Anti-Kickback Statute, the Stark Law contains a number
of statutory and regulatory exceptions intended to protect certain types of
transactions and business arrangements from penalty. Compliance with all
elements of the applicable Stark Law exception is mandatory.
The
penalties for violating the Stark Law include the denial of payment for services
ordered in violation of the statute, mandatory refunds of any sums paid for such
services and civil penalties of up to $15,000 for each violation, double
damages, and possible exclusion from future participation in the governmental
healthcare programs. A person who engages in a scheme to circumvent the Stark
Law’s prohibitions may be fined up to $100,000 for each applicable arrangement
or scheme.
Some
states have enacted statutes and regulations similar to the Stark Law, but which
may be applicable to the referral of patients regardless of their payor source
and which may apply to different types of services. These state laws may contain
statutory and regulatory exceptions that are different from those of the federal
law and that may vary from state to state.
11
Health
Information Privacy and Security Standards
Among
other directives, the Administrative Simplification Provisions of the Health
Insurance Portability and Accountability Act of 1996, or HIPAA, required the
Department of Health and Human Services, or the HHS, to adopt standards to
protect the privacy and security of certain health-related information. The
HIPAA privacy regulations contain detailed requirements concerning the use and
disclosure of individually identifiable health information by “HIPAA covered
entities,” which include entities like the Company, our affiliated hospitalists,
and practice groups.
In
addition to the privacy requirements, HIPAA covered entities must implement
certain administrative, physical, and technical security standards to protect
the integrity, confidentiality and availability of certain electronic health
information received, maintained, or transmitted. HIPAA also implemented the use
of standard transaction code sets and standard identifiers that covered entities
must use when submitting or receiving certain electronic healthcare
transactions, including activities associated with the billing and collection of
healthcare claims.
Violations
of the HIPAA privacy and security standards may result in civil and criminal
penalties, including: (1) civil money penalties of $100 per incident, to a
maximum of $25,000, per person, per year, per standard violated and
(2) depending upon the nature of the violation, fines of up to $250,000 and
imprisonment for up to ten years.
Many
states in which we operate also have laws that protect the privacy and security
of confidential, personal information. These laws may be similar to or even more
protective than the federal provisions. Not only may some of these state laws
impose fines and penalties upon violators but some may afford private rights of
action to individuals who believe their personal information has been
misused.
Fee-Splitting
and Corporate Practice of Medicine
Some
states have laws that prohibit business entities, such as the Company, from
practicing medicine, employing physicians to practice medicine, exercising
control over medical decisions by physicians, also known collectively as the
corporate practice of medicine, or engaging in certain arrangements, such as
fee-splitting, with physicians. In some states these prohibitions are expressly
stated in a statute or regulation, while in other states the prohibition is a
matter of judicial or regulatory interpretation. Of the sixteen states in which
we currently operate, we believe that the following nine states prohibit the
corporate practice of medicine: California, Colorado, Georgia, Illinois,
Michigan, Nevada, North Carolina, Tennessee and Texas.
The
Company operates by maintaining long-term management contracts with affiliated
professional organizations, which are each owned and operated by physicians and
which employ or contract with additional physicians to provide hospitalist
services. Under these arrangements, we perform only non-medical administrative
services, do not represent that we offer medical services, and do not exercise
influence or control over the practice of medicine by the physicians or the
affiliated professional organizations.
12
Some of
the relevant laws, regulations, and agency interpretations in the states in
which we operate have been subject to limited judicial and regulatory
interpretation. Moreover, state laws are subject to change and regulatory
authorities and other parties, including our affiliated physicians, may assert
that, despite these arrangements, we are engaged in the prohibited corporate
practice of medicine or that our arrangements constitute unlawful fee-splitting.
If this occurred, we could be subject to civil or criminal penalties, our
contracts could be found legally invalid and unenforceable (in whole or in
part), or we could be required to restructure our contractual
arrangements.
Deficit
Reduction Act of 2005
Among
other mandates, the Deficit Reduction Act of 2005, or the DRA, created a new
Medicaid Integrity Program designed to enhance federal and state efforts to
detect Medicaid fraud, waste and abuse. Additionally, section 6032 of the DRA
requires entities that make or receive annual Medicaid payments of $5.0 million
or more from any one state to provide their employees, contractors and agents
with written policies and employee handbook materials on federal and state False
Claims Acts and related statues. At this time, we are not required to comply
with section 6032 because we receive less than $5.0 million in Medicaid payments
annually from any one state. However, we will likely be required to comply in
the future as our Medicaid billings increase, but we cannot predict when that
will occur. We also cannot predict what new state statutes or enforcement
efforts may emerge from the DRA and what impact they may have on our
operations.
Other
Federal Healthcare Fraud and Abuse Laws
We are
also subject to other federal healthcare fraud and abuse laws. Under HIPAA,
there are two additional federal crimes that could have an impact on our
business: ‘‘Health Care Fraud’’ and ‘‘False Statements Relating to Health Care
Matters.’’ The Health Care Fraud statute prohibits any person from knowingly and
recklessly executing a scheme or artifice to defraud any healthcare benefit
program. Healthcare benefit programs include both government and private payers.
A violation of this statute is a felony and may result in fines, imprisonment
and/or exclusion from governmental healthcare programs.
The False
Statements Relating to Health Care Matters statute prohibits knowingly and
willfully falsifying, concealing or covering a material fact by any trick,
scheme or device or making any materially false, fictitious or fraudulent
statement in connection with the delivery of or payment for healthcare benefits,
items or services. A violation of this statute is a felony and may result in
fines and/or imprisonment.
The OIG
may impose administrative sanctions or civil monetary penalties against any
person or entity that knowingly presents or causes to be presented a claim for
payment to a governmental healthcare program for services that were not provided
as claimed, is fraudulent, is for a service by an unlicensed physician, or is
for medically unnecessary services. Violations may result in penalties of up to
$10,000 per claim, treble damages, and exclusion from governmental healthcare
funded programs, such as Medicare and Medicaid. In addition, the OIG may impose
administrative sanctions against any physician who knowingly accepts payment
from a hospital as an inducement to reduce or limit services provided to
Medicare and Medicaid program beneficiaries.
13
Other
State Fraud and Abuse Provisions
In
addition to the state laws previously described, we also are subject to other
state fraud and abuse statutes and regulations. Many of the states in which we
operate have adopted a form of anti-kickback law, self-referral prohibition, and
false claims and insurance fraud prohibition. The scope of these laws and the
interpretations of them vary from state to state and are enforced by state
courts and regulatory authorities, each with broad discretion. Generally, state
laws reach to all healthcare services and not just those covered under a
governmental healthcare program. A determination of liability under any of these
laws could result in fines and penalties and restrictions on our ability to
operate in these states. We cannot assure that our arrangements or business
practices will not be subject to government scrutiny or be found to violate
applicable fraud and abuse laws.
Fair
Debt Collection Practices Act
Some of
our operations may be subject to compliance with certain provisions of the Fair
Debt Collection Practices Act and comparable statutes in many states. Under the
Fair Debt Collection Practices Act, a third-party collection company is
restricted in the methods it uses to contact consumer debtors and elicit
payments with respect to placed accounts. Requirements under state collection
agency statutes vary, with most requiring compliance similar to that required
under the Fair Debt Collection Practices Act.
U.S.
Sentencing Guidelines
The U.S.
Sentencing Guidelines are used by federal judges in determining sentences in
federal criminal cases. The guidelines are advisory, not mandatory. With respect
to corporations, the guidelines states that having an effective ethics and
compliance program may be a relevant mitigating factor in determining
sentencing. To comply with the guidelines, the compliance program must be
reasonably designed, implemented, and enforced such that it is generally
effective in preventing and detecting criminal conduct. The guidelines also
state that a corporation should take certain steps such as periodic monitoring
and appropriately responding to detected criminal conduct. We have yet to
develop a formal ethics and compliance program.
Licensing,
Certification, Accreditation and Related Laws and Guidelines
Clinical
personnel of our affiliated companies are subject to numerous federal, state and
local licensing laws and regulations, relating to, among other things,
professional credentialing and professional ethics. Since the Company performs
services at hospitals and other types of healthcare facilities, it may
indirectly be subject to laws applicable to those entities as well as ethical
guidelines and operating standards of professional trade associations and
private accreditation commissions, such as the American Medical Association and
the Joint Commission on Accreditation of Health Care Organizations. There are
penalties for non-compliance with these laws and standards, including loss of
professional license, civil or criminal fines and penalties, loss of hospital
admitting privileges, and exclusion from participation in various governmental
and other third-party healthcare programs.
14
Professional
Licensing Requirements
The
Company’s affiliated hospitalists must satisfy and maintain their professional
licensing in the states where they practice medicine. Activities that qualify as
professional misconduct under state law may subject them to sanctions, or to
even lose their license and could, possibly, subject us to sanctions as well.
Some state boards of medicine impose reciprocal discipline, that is, if a
physician is disciplined for having committed professional misconduct in one
state where he or she is licensed, another state where he or she is also
licensed may impose the same discipline even though the conduct occurred in
another state. Professional licensing sanctions may also result in exclusion
from participation in governmental healthcare programs, such as Medicare and
Medicaid, as well as other third-party programs.
Employees
As of
April 30, 2009, we had 3 full-time employees. None of our full-time employees is
a member of a labor union, and we have never experienced a work
stoppage.
ITEM
1A.
|
RISK
FACTORS
|
There are
a number of important factors that could cause our business, financial
condition, cash flows, and results of operations to differ materially from
historical results or those indicated by any forward-looking statements,
including the risk factors identified below and other factors about which we may
or may not yet be aware. Prospective and existing investors are strongly urged
to carefully consider the various cautionary statements and risks set forth in
this Report and our other public filings.
Risk
Relating to Our Business
The Company has a limited operating
history that makes it impossible to reliably predict future growth and operating
results.
The
Company was incorporated on October 19, 2006, and will serve as the management
company initially for two medical groups, AMH and AMA. Accordingly, we have a
limited operating history upon which you can evaluate its business prospects,
which makes it difficult to forecast Apollo’s future operating results. The
evolving nature of the current medical services industry increases these
uncertainties.
15
The Company has an unproven business
model with no assurance of significant revenues or operating
profit.
The
current business model is unproven and the profit potential, if any, is unknown
at this time. The Company is subject to all of the risks inherent in the
creation of a new business. We have not yet commenced full operations and our
ability to achieve profitability is dependent, among other things, on our
initial marketing to generate sufficient operating cash flow to fund future
expansion. There can be no assurance that our results of operations or business
strategy will achieve significant revenue or profitability.
The growth strategy of Apollo may
not prove viable and expected growth and value may not be realized.
Our
business strategy is to rapidly grow by financing the acquisition and
establishment, and managing a network, of medical groups providing certain
hospital-based services. Where permitted by local law, we may also acquire such
medical groups directly. Groups managed (or owned) by the Company are referred
to herein as “Affiliated Medical Groups.” Identifying quality acquisition
candidates is a time-consuming and costly process. There can be no assurance
that we will be successful in identifying and establishing relationships with
these and other candidates. If the Company is successful in identifying and
acquiring other businesses, there is no assurance that it will be able to manage
the growth of such businesses effectively.
The
success of our growth strategy depends on the successful identification,
completion and integration of acquisitions.
The
Company’s future success will depend on the ability to identify, complete, and
integrate the acquired businesses with its existing operations. The growth
strategy will result in additional demands on our infrastructure, and will place
further strain on limited management, administrative, operational, financial and
technical resources. Acquisitions involve numerous risks, including, but not
limited to:
·
|
the
possibility that we will not able to identify suitable acquisition
candidates or consummate acquisitions on acceptable terms, if at
all;
|
·
|
possible
decreases in capital resources or dilution to existing
stockholders;
|
·
|
difficulties
and expenses incurred in connection with an
acquisition;
|
·
|
the
diversion of management’s attention from other business
concerns;
|
·
|
the
difficulties of managing an acquired
business;
|
·
|
the
potential loss of key employees and customers of an acquired
business;
|
·
|
in
the event that the operations of an acquired business do not meet
expectations, we may be required to restructure the acquired entity or
write-off the value of some or all of the assets of the
acquisition.
|
16
Our
future growth could be harmed if we lose the services of certain key
personnel.
The
Company’s success depends upon the services of a number of key employees,
specifically Warren Hosseinion, M.D. and Adrian Vazquez, M.D., and will depend
upon certain other additional key employees. We plan to enter into employment
agreements with, and acquiring key man life insurance, for Drs. Hosseinion and
Vazquez, and other key executives hired in the future. The loss of the services
of one or more of these key employees could harm our business. The Company’s
success also depends upon its ability to attract highly skilled new employees.
Competition for such employees is intense in the industries and geographic areas
in which we operate. We may rely on our ability to grant stock options as one
mechanism for recruiting and retaining highly skilled talent. Recently proposed
accounting regulations requiring the expensing of stock options may impair our
future ability to provide these incentives without incurring significant
compensation costs. If the Company is unable to compete successfully for key
employees, its results of operations, financial condition, business and
prospects could be adversely affected.
Economic conditions or changing
consumer preferences could adversely impact our business.
A
downturn in economic conditions in one or more of the Company’s markets could
have a material adverse effect on its results of operations, financial
condition, business and prospects. Although we attempt to stay informed of
customer preferences, any sustained failure to identify and respond to trends
could have a material adverse effect on our results of operations, financial
condition, business and prospects.
We may be unable to scale its
operations successfully.
Our
growth strategy will place significant demands on our management and financial,
administrative and other resources. Operating results will depend substantially
on the ability of our officers and key employees to manage changing business
conditions and to implement and improve our financial, administrative and other
resources. If the Company is unable to respond to and manage changing business
conditions, or the scale of its operations, then the quality of its services,
its ability to retain key personnel, and its business could be
harmed.
We
may be unable to integrate new business entities and manage its
growth.
The
Company’s ability to manage its growth effectively will require it to continue
to improve its operational, financial and management controls and information
systems to accurately forecast sales demand, to manage its operating costs,
manage its marketing programs in conjunction with an emerging market, and
attract, train, motivate and manage its employees effectively. If our management
fails to manage the expected growth, our results of operations, financial
condition, business and prospects could be adversely affected. In addition, the
Company’s growth strategy may depend on effectively integrating future entities,
which requires cooperative efforts from the managers and employees of the
respective business entities. If our management is unable to effectively
integrate our various business entities, our results of operations, financial
condition, business and prospects could be adversely
affected.
17
The
Company’s success depends upon its ability to adapt to a changing market and its
continued development of additional services.
Although
we expect to provide a broad and competitive range of services, there can be no
assurance of acceptance by the marketplace. The procurement of new
contracts by the
Company’s Affiliated Medical Groups may be dependent upon the continuing results
achieved at the current facilities, upon pricing and operational
considerations, as well as the potential need for continuing improvement to
existing services. Moreover, the markets for such services may not develop as
expected nor can there be any assurance that we will be successful in its
marketing of any such services.
Changes
associated with reimbursement by third-party payers for the Company’s services
may adversely affect operating results and financial condition.
The
medical services industry is undergoing significant changes with third-party
payers that are taking measures to reduce reimbursement rates or in some cases,
denying reimbursement altogether. There is no assurance that third party payers
will continue to pay for the services provided by our Affiliated Medical Groups.
Failure of third party payers to adequately cover the medical services so
provided by the Company will have a material adverse affect on our results of
operations, financial condition, business and prospects.
The
medical services industry is highly regulated and failure to comply with laws
and regulations applicable to our business could have an adverse affect on the
Company’s financial condition.
The
medical services currently provided by our Affiliated Medical Groups and those
expected to be provided in the future are subject to stringent federal, state,
and local government health care laws and regulations. If we fail to comply with
applicable laws, we could be subject to civil or criminal penalties while also
being declined participation in Medicare, Medicaid, and other government
sponsored health care programs.
Federal
and state healthcare reform may have an adverse effect on the Company’s
financial condition and results of operations.
Federal
and state governments have continued to focus significant attention on health
care reform. A broad range of health care reform measures have been introduced
in Congress and in state legislatures. It is not clear at this time what
proposals, if any, will be adopted, or, if adopted, what effect, if any, such
proposals would have on the Company’s business.
18
Regulatory
authorities or other persons could assert that current or future relationships
with any acquired companies fail to comply with the anti-kickback law, which
could adversely affect our business operations.
The
anti-kickback provisions of the Social Security Act prohibit anyone from
knowingly and willfully (a) soliciting or receiving any remuneration in return
for referrals for items and services reimbursable under most federal health care
programs or (b) offering or paying any remunerations to induce a person to make
referrals for items and services reimbursable under most federal health care
programs, which is referred to as the “anti-kickback law”. The prohibited
remunerations may be paid directly or indirectly, overtly or covertly, in cash
or in kind. If such a claim were successfully asserted, the Company could be
subject to civil and criminal penalties and could be required to restructure or
terminate the applicable contractual arrangements. If we were subjected to
penalties or were unable to successfully restructure our relationships to comply
with the anti-kickback law, our results of operations, financial condition,
business and prospects could be adversely affected.
Regulatory
authorities could assert that acquisitions or service agreements with third
parties fail to comply with the federal Stark Law and state laws prohibiting
physicians from referring to entities in which they have a financial
interest.
The Stark
Law prohibits a physician from making a referral to an entity for the furnishing
of federally funded designated health services if the physician has a financial
relationship with the entity. Designated health services include clinical
laboratory services, physical and occupational therapy services, radiology
services such as magnetic resonance imaging (MRI) and ultrasound services,
radiation therapy services and supplies, durable medical equipment and supplies,
and others. More detailed implementing regulations have been promulgated
by the United States Department of Health and Human Services. Some states
have comparable laws restricting referrals for designated health services paid
by any payer. Unless an exception is satisfied, these laws and regulations
prevent physician investors and other physicians who have a financial
relationship with the Company from referring patients to us for designated
health services. The inability of these physicians to refer designated
health services to us may have an adverse effect on our financial condition and
results of operations. In addition, we could be required to restructure or
terminate acquisitions or service agreements to ensure compliance with the Stark
Law and applicable rules and regulations. The provisions of
the self-referral laws, like all statutes affecting the health care industry,
and the regulatory implementation and interpretation of them may change, and the
nature and timing of any such change cannot be predicted.
We
are subject to information privacy regulations, and our failure to comply with
such laws may adversely affect our business operations.
Numerous
state, federal and international laws and regulations govern the collection,
dissemination, use and confidentiality of patient-identifiable health
information, including the Federal Health Insurance Portability and
Accountability Act of 1996 (“HIPAA”) and related rules and regulations. The
HIPAA Privacy Rule restricts the use and disclosure of patient information and
requires entities to safeguard that information and to provide certain rights to
individuals with respect to that information. The HIPAA Security Rule
establishes elaborate requirements for safeguarding patient information
transmitted or stored electronically. We may be required to make costly system
purchases and modifications to comply with the HIPAA requirements that will be
imposed on us. Our failure to comply with these requirements could result in
liability and have a material adverse affect on our results of operations,
financial condition, business and prospects.
19
Our
Business may expose us to certain potential litigation, which if successful and
not covered by existing insurance could have a material adverse effect on our
profitability.
The
Company’s business may expose it to potential litigation. While we intend to
take precautions we deem appropriate, there can be no assurance that we will be
able to avoid significant liability or litigation exposure. Service liability
insurance is expensive, to the extent it is available at all. There can be no
assurance that we will be able to obtain such insurance on acceptable terms, if
at all, or that we will be able to secure increased coverage or that any
insurance policy will provide adequate protection against successful claims, if
at all. A successful claim brought against the Company in excess of its
insurance coverage would have a material adverse effect upon our results of
operations and financial condition.
We
face possible liability in connection with the proposed acquisition of a medical
management company.
In
connection with the proposed acquisition of a medical management company, the
billing company was notified approximately one month ago that Medicaid will be
auditing some of their billing practices. The audit relates to inadvertent
billing of services for which the local hospital also billed. The Medicaid audit
is expected to take 6 to 12 months. Assuming that the Company’s acquisition of
this medical management company is consummated, it is possible that the Company
will have the liability to reimburse Medicaid for these charges, along with
interest and penalties. The amount of such reimbursement, if any, cannot be
estimated at this time, but it could be material. In further negotiations with
the medical management company, management of the Company intends to seek a
mechanism whereby the Company would be able to recoup any amounts that it must
pay to Medicaid. However, no assurance can be given as to whether such
negotiations will be successful or whether the transaction will be
completed.
Risks
Relating to Our Common Stock
If
we fail to remain current in our SEC reporting obligations, we could be removed
from the OTC Bulletin Board, which would adversely affect the market liquidity
for our securities.
Companies
trading on the OTC Bulletin Board, such as us, must be reporting issuers under
Section 12 of the Securities Exchange Act of 1934, as amended, and must be
current in their reports under Section 13, in order to maintain price quotation
privileges on the OTC Bulletin Board. If we fail to remain current in our
reporting requirements, we could be removed from the OTC Bulletin Board. As a
result, the market liquidity for our securities could be severely adversely
affected by limiting the ability of broker-dealers to sell our securities and
the ability of stockholders to sell their securities in the secondary
market.
20
Our
common stock is subject to the “penny stock” rules of the SEC, and trading in
our securities is very limited, which makes transactions in our common stock
cumbersome and may reduce the value of an investment in our
securities.
The SEC
has adopted Rule 3a51-1 which establishes the definition of a "penny stock," for
the purposes relevant to us, as any equity security that has a market price of
less than $5.00 per share or with an exercise price of less than $5.00 per
share, subject to certain exceptions. For any transaction involving a penny
stock, unless exempt, Rule 15g-9 requires:
·
|
that
a broker or dealer approve a person's account for transactions in penny
stocks; and
|
·
|
the
broker or dealer receives from the investor a written agreement to the
transaction, setting forth the identity and quantity of the penny stock to
be purchased.
|
In order
to approve a person's account for transactions in penny stocks, the broker or
dealer must:
·
|
obtain
financial information and investment experience objectives of the person;
and
|
·
|
make
a reasonable determination that the transactions in penny stocks are
suitable for that person and the person has sufficient knowledge and
experience in financial matters to be capable of evaluating the risks of
transactions in penny stocks.
|
The
broker or dealer must also deliver, prior to any transaction in a penny stock, a
disclosure schedule prescribed by the SEC relating to the penny stock market,
which, in highlight form:
·
|
sets
forth the basis on which the broker or dealer made the suitability
determination; and
|
·
|
that
the broker or dealer received a signed, written agreement from the
investor prior to the transaction.
|
Disclosure
also has to be made about the risks of investing in penny stocks in both public
offerings and in secondary trading and about the commissions payable to both the
broker-dealer and the registered representative, current quotations for the
securities and the rights and remedies available to an investor in cases of
fraud in penny stock transactions. Finally, monthly statements have to be sent
disclosing recent price information for the penny stock held in the account and
information on the limited market in penny stocks. Generally, brokers
may be less willing to execute transactions in securities subject to the “penny
stock” rules. This may make it more difficult for investors to dispose of our
common stock and cause a decline in the market value of our
stock.
21
Efforts
to comply with recently enacted changes in federal securities laws will increase
our costs and require additional management resources.
As
directed by Section 404 of the Sarbanes-Oxley Act of 2002, the SEC adopted rules
requiring public companies to include a report of management on the Company’s
internal controls over financial reporting in their annual reports on Form 10-K.
In addition, the public accounting firm auditing the company’s financial
statements must attest to and report on management’s assessment of the
effectiveness of the company’s internal controls over financial reporting. These
requirements are not presently applicable to us but we will become subject to
these requirements by the end of our next fiscal year. If and when these
regulations become applicable to us, and if we are unable to conclude that we
have effective internal controls over financial reporting or if our independent
auditors are unable to provide us with an unqualified report as to the
effectiveness of our internal controls over financial reporting as required by
Section 404 of the Sarbanes-Oxley Act of 2002, investors could lose confidence
in the reliability of our financial statements, which could result in a decrease
in the value of our securities. We have not yet begun a formal process to
evaluate our internal controls over financial reporting. Given the status of our
efforts, coupled with the fact that guidance from regulatory authorities in the
area of internal controls continues to evolve, substantial uncertainty exists
regarding our ability to comply by applicable deadlines.
Trading
on the OTC Bulletin Board may be volatile and sporadic, which could depress the
market price of our common stock and make it difficult for our stockholders to
resell their shares.
Our
common stock is quoted on the OTC Bulletin Board service of the Financial
Industry Regulatory Authority (“FINRA”). Trading in stock quoted on the OTC
Bulletin Board is often thin and characterized by wide fluctuations in trading
prices due to many factors that may have little to do with our operations or
business prospects. This volatility could depress the market price of our common
stock for reasons unrelated to operating performance. Moreover, the OTC Bulletin
Board is not a stock exchange, and trading of securities on the OTC Bulletin
Board is often more sporadic than the trading of securities listed on a
quotation system like NASDAQ or a stock exchange like the American Stock
Exchange. Accordingly, our shareholders may have difficulty reselling any of
their shares.
ITEM 1B.
|
UNRESOLVED STAFF
COMMENTS
|
Not
applicable.
ITEM
2.
|
DESCRIPTION OF
PROPERTIES
|
The
Company’s corporate headquarters is located at 1010 N. Central Avenue, Glendale,
California. The corporate office is approximately 800 square feet and is leased
on a month-to-month basis for approximately $1,800 per month. In January 2009,
the Company exercised its right to terminate the lease and the lease was
terminated on February 28, 2009.
22
ITEM 3.
|
LEGAL PROCEEDINGS.
|
The
Company is not a party to any litigation and, to its knowledge, no action, suit
or proceeding has been threatened against the Company.
ITEM 4.
|
SUBMISSION
OF MATTERS TO A VOTE OF SECURITY
HOLDERS.
|
None.
PART
II
ITEM 5.
|
MARKET
FOR COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF
EQUITY SECURITIES.
|
The
Company’s common stock was approved for listing on the OTC Bulletin Board, under
the symbol “AMEH,” on July 13, 2008. The following table sets forth, for the
fiscal quarters indicated, high and low sale prices for the common stock on the
over-the-counter market, as reported by the National Association of Securities
Dealers, Inc. (NASD). The information below reflects inter-dealer prices,
without retail mark-up, markdown or commissions, and may not necessarily
represent actual transactions. There was little trading in our
common stock during the period(s) reflected. As of April 10, 2009, the Company
had 25,870,220 common shares outstanding, of which only 49,134 were free
trading.
High
|
Low
|
|||||||
Fiscal
Year ended January 31, 2009
|
||||||||
July
13, 2008 – July 31, 2008
|
$ | 0.0001 | $ | 0.0001 | ||||
Third
Quarter
|
$ | 4.25 | $ | 0.0001 | ||||
Fourth
Quarter
|
4.24 | 0.51 |
Stockholders
As of
April 10, 2009, as reported by the Company’s stock transfer agent, there were
318 holders of record of our common stock.
23
Dividends
To date,
we have not paid any cash dividends on our common stock and we do not
contemplate the payment of cash dividends in the foreseeable future. Our future
dividend policy will depend on our earnings, capital requirements, financial
condition, and other factors considered relevant to our ability to pay
dividends.
Stock
Option Grants
For the
twelve months ended January 31, 2009, we granted no stock options.
Equity
Compensation Plan Information
The
following table provides information, as of January 31, 2009, with respect to
all of our compensation plans under which equity securities are authorized for
issuance:
Number of securities
|
||||||
remaining available
|
||||||
Number of securities
|
for future issuance
|
|||||
to be issued upon
|
Weighted-average
|
under equity
|
||||
exercise of
|
exercise price of
|
compensation plans
|
||||
outstanding options,
|
outstanding options,
|
(excluding securities
|
||||
Plan category
|
warrants and rights
|
warrants and rights
|
reflected in column (a))
|
|||
(a)
|
(b)
|
(c)
|
||||
Equity
compensation plans approved by stockholders
|
–
|
–
|
–
|
|||
Equity
compensation plans not approved by stockholders (1)
|
322,222
|
$0.27
|
377,778
|
(1) The
amounts reported include: (i) 250,000 shares of common stock issued to A. Noel
DeWinter, the Company’s Chief Financial Officer, pursuant to an employment
agreement with the Company, dated September 10, 2008; (ii) a stock award of
50,000 shares to Kaneohe (Kyle Francis) under a consulting contract dated
October 22, 2008; and (iii) 400,000 shares of common stock issued to Suresh
Nihalani under a director agreement with the Company, dated as October 27, 2008.
The shares issued to Mr. Nihalani will vest ratably over a thirty-six month
period commencing December 2008. As of January 31, 2009, 22,222 shares had
vested under the director agreement, and 377,778 shares remained
unvested.
Recent
Sales of Unregistered Securities
We have
issued and sold securities of the Company as disclosed below within the last
three years. Unless otherwise noted, the following sales of securities were
effected in reliance on the exemption from registration contained in
Section 4(2) of the Act and Regulation D promulgated thereunder, and
such securities may not be reoffered or sold in the United States by the holders
in the absence of an effective registration statement, or valid exemption from
the registration requirements, under the Securities Act of 1933 (as amended, the
“ Act
”):
24
|
·
|
During
the period from February 1, 2007 through July 31, 2007, we sold and issued
a total of 364,000 shares of our common stock to investors for aggregate
proceeds of $182,000, at a per share price of $0.27. As part of
this issuance, we granted 91,000 warrants to purchase shares of our common
stock to such investors; and
|
|
·
|
During
the period from February 1, 2008 through July 31, 2008, we sold and issued
a total of 670,000 shares of our common stock to investors for aggregate
proceeds of $335,000, at a per share price of $0.50. As part of
this issuance, we granted 167,500 warrants to purchase shares of our
common stock to such investors.
|
ITEM 6.
|
SELECTED FINANCIAL
DATA
|
Not
applicable.
ITEM 7.
|
MANAGEMENTS’
DISCUSSION AND ANALYSIS OR PLAN OF
OPERATION.
|
Forward-Looking
Statements- Cautionary Statement
The
following discussion contains “forward-looking statements” within the meaning of
the Private Securities Litigation Reform Act of 1995. Forward-looking
statements, written, oral or otherwise, are based on the Company’s current
expectations or beliefs rather than historical facts concerning future events,
and they are indicated by words or phrases such as (but not limited to)
“anticipate,” “could,” “may,” “might,” “potential,” “predict,” “should,”
“estimate,” “expect,” “project,” “believe,” “think,” “intend,” “plan,”
“envision,” “continue,” “intend,” “target,” “contemplate,”
“budgeted,” or “will” and similar words or phrases or comparable
terminology. Forward-looking statements involve risks and uncertainties. The
Company cautions that these statements are further qualified by important
economic, competitive, governmental and technological factors that could cause
the Company’s business, strategy, or actual results or events to differ
materially, or otherwise, from those in the forward-looking statements. We have
based such forward-looking statements on our current expectations, assumptions,
estimates and projections, and therefore there can be no assurance that any
forward-looking statement contained herein, or otherwise made by the Company,
will prove to be accurate. Our actual results may differ materially from those
anticipated in these forward-looking statements as a result of certain factors,
including those set forth under Item 1A “Risk Factors,” and elsewhere in this
report. The Company assumes no obligation to update the
forward-looking statements.
25
THE
FOLLOWING DISCUSSION OF OUR FINANCIAL CONDITION AND RESULTS OF OPERATIONS SHOULD
BE READ IN CONJUNCTION WITH OUR CONSOLIDATED FINANCIAL STATEMENTS AND THE NOTES
TO THOSE STATEMENTS INCLUDED ELSEWHERE IN THIS REPORT.
Overview
and Plan of Operations
CRITICAL
ACCOUNTING POLICIES AND ESTIMATES
Our
consolidated financial statements have been prepared in accordance with
accounting principles generally accepted in the United States of America. The
preparation of these financial statements requires management to make estimates
and assumptions that affect the reported amounts of assets, liabilities,
revenues and expenses. Note 1 of Notes to Consolidated Financial Statements
describes the significant accounting policies used in the preparation of the
consolidated financial statements. Certain of these significant accounting
policies are considered to be critical accounting policies, as defined
below.
A
critical accounting policy is defined as one that is both material to the
presentation of our financial statements and requires management to make
difficult, subjective or complex judgments that could have a material effect on
our financial condition and results of operations. Specifically, critical
accounting estimates have the following attributes: (i) we are required to make
assumptions about matters that are uncertain at the time of the estimate; and
(ii) different estimates we could reasonably have used, or changes in the
estimate that are reasonably likely to occur, would have a material effect on
our financial condition or results of operations.
Estimates
and assumptions about future events and their effects cannot be determined with
certainty. We base our estimates on historical experience and on various other
assumptions believed to be applicable and reasonable under the circumstances.
These estimates may change as new events occur, as additional information is
obtained and as our operating environment changes. These changes have
historically been minor and have been included in the consolidated financial
statements as soon as they became known. Based on a critical assessment of our
accounting policies and the underlying judgments and uncertainties affecting the
application of those policies, management believes that our consolidated
financial statements are fairly stated in accordance with accounting principles
generally accepted in the United States, and meaningfully present our financial
condition and results of operations.
We
believe the following critical accounting policies reflect our more significant
estimates and assumptions used in the preparation of our consolidated financial
statements:
26
Revenue
Recognition
The
Company provides hospitalist services to numerous hospitals and other health
care providers and recognizes revenue as the services are
provided. The Company generates, and segregates, its revenue into
three categories: Case Rate, Capitation and Fee for Service. Case Rate and
Capitation revenues in each period are recorded upon completion of the services
under each contract.
Patient
Fee for Service revenues in each period is recorded at amounts reasonably
assured to be collected. The percentage of Fee for Service billings
that are assumed reasonably collectible are based on experience and are adjusted
to reflect actual collections in subsequent periods.
The
estimation and the reporting of patient responsibility revenues is highly
subjective and depends on the payer mix, contractual reimbursement rates,
collection experiences, and other factors.
Direct
Costs of Services
Direct
Costs include the direct salaries and contract payments to physicians employed
by the Company that serve as hospitalists, all employment related taxes, medical
and disability insurance costs, premiums for malpractice insurance provided to
these physicians, costs incurred for medical billing services and the costs
associated with establishing physician privileges.
Management
Fees
AMH is
charged, and pays, a monthly Management fee to AMM. The fee is calculated on a
percentage of AMH’s gross revenue that AMH receives for the performance of
medical services by AMH. The monthly percentage is established based upon the
requirements of the Management Company (AMM). Under the Management Services
Agreement dated August 1, 2008, the management fee was established at 3.5
percent of AMH’s monthly gross revenues. The Management Services Agreement was
modified on March 20, 2009 to allow for an adjustment in monthly management fees
as needed to cover costs incurred by AMM. These fees are eliminated
in consolidation.
FISCAL
YEAR ENDED JANUARY 31, 2009 COMPARED TO FISCAL YEAR ENDED JANUARY 31,
2008
Revenues
The
Company reported revenues of $1,057,354 for the twelve months ended January 31,
2009, up from revenues of $90,500 reported for the twelve months ended one year
earlier on January 31, 2008. The increase of $966,854 almost solely
reflects the consolidation of medical fees and services from AMH for the period
from August 1, 2008 through January 31, 2009, which resulted from the execution
of the Management Services Agreement signed on August 1, 2008. Revenues in
fiscal 2008 represented Management Fees earned and reported by
AMM.
27
Cost
of Services
Cost of
Services was $1,046,103 for the
twelve months ended January 2009, compared to Cost of Goods Sold of $ 63,093 for
the corresponding twelve months ended January 2008. Cost of Services includes
the payroll and consulting costs of the physicians, all payroll related costs,
costs for all medical malpractice insurance and physician
privileges.
Operating
Expenses
General
and Administrative expenses were $827,287 for the twelve months ended January
2008, compared to General and Administrative expenses of $181,069 reported in
the comparable twelve months of 2007. In fiscal 2009, the Company expensed the
$250,000 initial payment for the Siclone Merger along with legal costs of
$28,348 incurred in this transaction. . In addition, the Company recorded
compensation and consulting expenses, and financing costs of $ 306,555 and
$46,250, respectively, in 2009, all incremental to 2008.
Loss
from Operations
The
Company reported a Loss from Operations of $(835,815) for the twelve month
period ended January 31, 2009, compared to a Loss from Operations of $(153,662)
for the comparable twelve months ended January 31, 2008. The
increased loss of $(682,153) from 2008 to 2009 was due to the high costs of
service relative to the revenues generated from the Company’s contracts, as the
Company has not yet achieved economies of scale in its activities. In addition,
the loss from operations in 2009 was further impacted by costs related to the
Siclone transaction and a high level of compensation and consulting
costs. The Loss form Operations in 2008 was due to the fact that the
low level of management Fee income was insufficient to cover the costs of
services and administrative costs in this formative year.
Net
Loss
A net
loss of $(891,815) was reported for the twelve months ended January 31, 2009
verses a net loss of $(154,462) for the twelve months ended January 31,
2008. The increased loss of $(737,353) was primarily due to the cost
incurred for the Siclone Merger of $250,000, and the related legal costs of
$28,348, along with the compensation costs and financing fees.
Liquidity
and Capital Resources
At
January 31, 2009, the Company had cash and cash equivalents of $84,161, compared
to cash and cash equivalents of $44,352 at the beginning of the fiscal year at
January 31, 2008. Short-term borrowings totaled $74,782 at January 31, 2009,
compared to no short-term borrowings at January 31, 2008. Long-term borrowings
totaled $231,218 as of January 31, 2009, compared to no long-term borrowings as
of January 31, 2008.
28
Net cash
used in operating activities totaled a $(622,485) for the twelve months ended
January 31, 2009, compared to $(139,832) for the comparable twelve months ended
January 31, 2008. The significantly larger operating loss, including the
$250,000 paid and expensed on the Siclone Merger, was primarily responsible for
the increase in the negative operating cash flow.
The
Company borrowed a total of $320,000 on short-term promissory notes in the year
ended January 31, 2009. The father of the Company’s CEO loaned
$70,000 to the Company, and two individuals, each loaned the Company
$125,000.
The
$70,000 related party note was due and payable in full no later than October 1,
2008, carried no interest rate, and the Company was obligated to pay an
origination fee of $5,000 at the time of payoff. The note was
extended by verbal agreement on its expiration date with no change in terms. On
January 24, 2009, the Company formalized the note extension with the father of
the Company’s CEO. Under the terms of the new note, the $5,000
origination fee was added to the note, the due date was extended to March 31,
2011, the interest rate was set at eight (8) percent and the note is initially
convertible into 214,285 shares of common stock. The Company has the
right to redeem the note at a 105 percent premium any time prior to the due date
on March 31, 2011.
The
Company borrowed $125,000 on June 13, 2008 from a non-related
party. The note also bears no interest rate and was due and payable
in full on July 2, 2008. The note was paid off as of October 31,
2008. The Company recorded a penalty of $6,250 during the nine months
ended October 31, 2008 due to late payment.
Also,
during the third fiscal quarter, the Company borrowed $125,000 on September 24,
2008 under a note from a non-related party. This note bore an interest rate of
15 percent and was due and payable in full on October 22, 2008. The
note obligated the Company for an origination fee of $10,000 and reimbursement
of legal fees totaling $1,500 and issuance of 50,000 shares of the Company’s
common stock. The note, along with the origination fee and legal reimbursement,
was paid off in full on October 20, 2008.
During
the twelve months ended January 31, 2009, the Company also financed its
operations with the private placement of Company stock to accredited investors
totaling $335,000. These stock sales and the proceeds occurred prior to the
completion of the Siclone Merger. The Company has not sold any common stock
subsequent to the Merger in mid June 2008. During the initial six
months of 2007, the Company received $182,000 from the sale of its Common
stock.
ITEM
7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET
RISK
Not
applicable.
29
ITEM
8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA
The
Company’s financial statements for the fiscal year ended January 31, 2009 are
included in this annual report, beginning on page F-1.
ITEM
9. CHANGES IN AND DISAGREEMENTS WITH
ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE
None.
ITEM
9A. CONTROLS AND
PROCEDURES
Disclosure
Controls and Procedures
As of the
end of the period covered by this report, the Company has carried out an
evaluation under the supervision and with the participation of its management,
including its Chief Executive Officer and its Chief Financial Officer of the
effectiveness of the design and operation of its disclosure controls and
procedures as defined in Rules 13a-15(e) and 15d- 15(e) under the Securities
Exchange Act of 1934. Based upon that evaluation, the Chief Executive Officer
and Chief Financial Officer concluded that, at January 31, 2009, the
Company’s disclosure controls and procedures (as defined in Rules 13a-15(e) and
15d-15(e) under the Securities Exchange Act of 1934) were not effective, at a
reasonable assurance level, in ensuring that information required to be
disclosed in the reports the Company files and submits under the Exchange Act
are recorded, processed, summarized and reported as and when
required. For a discussion of the reasons on which this conclusion
was based, see “Management’s Annual Report on Internal Control over Financial
Reporting” below.
Management’s
Report on Internal Control Over Financial Reporting
Our
management is responsible for establishing and maintaining adequate internal
control over financial reporting, as defined in Rule 13a-15(f) and Rule
15d-15(f) under the Exchange Act. Management must evaluate its internal
controls over financial reporting, as required by Sarbanes-Oxley Act. The
Company's internal control over financial reporting is a process
designed under the supervision of the Company's management to provide
reasonable assurance regarding the reliability of financial reporting and
the preparation of the Company's financial statements for external purposes
in accordance with U.S. generally accepted accounting principles
(“GAAP”). Our management conducted an evaluation of the effectiveness
of our internal control over financial reporting based on the criteria for
effective internal control over financial reporting established in Internal
Control-Integrated Framework issued by the Committee of Sponsoring
Organizations of the Treadway Commission (“COSO”) and SEC
guidance on conducting such assessments. Based on this evaluation, our
management concluded that there were material weaknesses in our internal control
over financial reporting as of January 31, 2009.
30
A
material weakness is a control deficiency (within the meaning of the Public
Company Accounting Oversight Board (PCAOB) Auditing Standard No. 2) or
combination of control deficiencies that result in more than a remote likelihood
that a material misstatement of the annual or interim financial statements will
not be prevented or detected. Management has identified the following
three material weaknesses in our disclosure controls and procedures, and
internal controls over financial reporting:
1.
We do not have written documentation of our internal control policies and
procedures. Written documentation of key internal controls over financial
reporting is a requirement of Section 404 of the Sarbanes-Oxley Act.
Management evaluated the impact of our failure to have written documentation of
our internal controls and procedures on our assessment of our disclosure
controls and procedures, and concluded that the control deficiency that resulted
represented a material weakness.
2.
We do not have sufficient segregation of duties within accounting functions,
which is a basic internal control. Due to our size and nature, segregation
of all conflicting duties may not always be possible and may not be economically
feasible. However, to the extent possible, the initiation of transactions,
the custody of assets and the recording of transactions should be performed by
separate individuals. Management evaluated the impact of our failure to
have segregation of duties on our assessment of our disclosure controls and
procedures, and concluded that the control deficiency that resulted represented
a material weakness.
3. We
do not have review and supervision procedures for financial reporting functions.
The review and supervision function of internal control relates to the accuracy
of financial information reported. The failure to review and supervise could
allow the reporting of inaccurate or incomplete financial information. Due to
our size and nature, review and supervision may not always be possible or
economically feasible. Management evaluated the impact of our significant
number of audit adjustments, and concluded that the control deficiency that
resulted represented a material weakness.
Based on
the foregoing materials weaknesses, we have determined that, as of January 31,
2009, the effectiveness of our controls and procedures over financial accounting
and reporting are insufficient. The Company is taking steps to
improve the timeliness and accuracy of its financial information, including the
hiring of additional employees to facilitate proper segregation of
duties. It should be noted that any system of controls, however well
designed and operated, can provide only reasonable and not absolute assurance
that the objectives of the system are met. In addition, the design of any
control system is based in part upon certain assumptions about the likelihood of
certain events. Because of these and other inherent limitations of control
systems, there can be no assurance that any design will succeed in achieving its
stated goals under all potential future conditions, regardless of how
remote.
This
Annual Report on Form 10-K does not include an attestation report of our
independent registered public accounting firm regarding internal control over
financial reporting. Management’s report was not subject to attestation by our
independent registered public accounting firm pursuant to temporary rules of the
Securities and Exchange Commission that permit us to provide only management’s
report in this Annual Report on Form 10-K.
31
Changes
in Internal Controls Over Financial Reporting
There has
been no change in our internal controls over financial reporting during our most
recently completed fiscal quarter (i.e., the three-month period ended
January 31, 2009) that has materially affected, or is reasonably likely to
materially affect, our internal control over financial reporting.
ITEM
9B. OTHER INFORMATION
None.
PART
III
ITEM
10. DIRECTORS, EXECUTIVE OFFICERS AND
CORPORATE GOVERNANCE
The
following table sets forth information with respect to the Company’s directors
and executive officers, as of the date hereof. Dr. Hosseinion and Dr. Vazquez
have served as directors since the formation of the Company on July 3, 2008. Mr.
Nihalani was elected a Director on October 27, 2008.
Name
|
Age
|
Title
|
||
Warren Hosseinion, M.D.
|
36
|
Chief Executive Officer, Director
|
||
Adrian Vazquez, M.D.
|
38
|
President and Chairman of the Board
|
||
A. Noel DeWinter
|
70
|
Chief Financial Officer
|
||
Suresh Nihalani
|
56
|
Director
|
Warren Hosseinion, M.D. Dr.
Hosseinion has served as the Company’s Chief Executive Officer (“CEO”) since its
formation in July 2008, and prior to that he served as the CEO of ApolloMed
Hospitalists beginning in 2001. Dr. Hosseinion received his
medical degree from Georgetown University and is a Diplomate of the American
Board of Internal Medicine.
Adrian Vazquez, M.D. Dr.
Vazquez has served as the Company’s President and Chairman of the Board since
2008. Dr. Vazquez co-founded ApolloMed Hospitalists in 2001, and he
has served as President and Chairman of AMH since June 2001. Dr. Vazquez
received his medical degree from the University of California, Irvine and is a
Diplomate of the American Board of Internal Medicine.
A. Noel DeWinter.
Mr. DeWinter has served as the Chief Financial Officer (“CFO”) since
joining the Company in August 2008. Prior to joining the Company, Mr. DeWinter
served as Chief Financial Officer of Bridgetech Holdings International, Inc.
(“Bridgetech”), from March 2007 through April 2008. Priot to
that, Mr. DeWinter served as CFO of Retail Pilot, Inc., an affiliate
of Bridgetech, since March 2005. Mr. DeWinter holds a BA in Economics from
Carleton College and an MBA from the Wharton School at the University of
Pennsylvania.
32
Suresh Nihalani was President
and CEO of ClearMesh Network from 2005 to 2007. He also co-founded Nevis
Networks, where he served as CEO from 2002 through 2005. Prior to Nevis
Networks, he co-founded Accelerated Networks and ACT Networks. Mr. Nihalani
holds a BS in Electrical Engineering from ITT Bombay and MSEE and MBA degrees
from the Florida Institute of Technology.
Family
Relationships
There are
no familial relationships among the directors and executive offices identified
in this report.
Section
16(a) Beneficial Ownership Reporting Compliance
Section
16(a) of the Exchange Act requires our officers, directors, and persons who
beneficially own more than 10% of a registered class of our equity securities
(“10% stockholders”) to file reports of ownership and changes in ownership with
the SEC. Officers, directors, and 10% stockholders also are required to furnish
us with copies of all Section 16(a) forms they file. To our knowledge, based
solely upon a review of the copies of such reports furnished to us and written
representations provided by our officers, directors and 10%
stockholders, the Company’s directors, executive officers and
10% stockholders have complied with all Section 16(a) filing requirements,
as applicable.
Code
of Ethics
The
Company has not yet adopted a code of ethics, in part because we recently
commenced business operations and have a limited number of
employees. As the Company grows its business, and hires additional
employees, we expect to adopt a code of ethics applicable to the conduct of our
employees.
Committees
of the Board of Directors
Our
common stock is currently quoted on the OTC Bulletin Board electronic trading
platform, which does not maintain any standards requiring us to establish or
maintain an Audit, Nominating or Compensation committee. As of January 31, 2009,
our Board of Directors did not maintain an Audit Committee, Nominating Committee
or Compensation Committee.
Additionally,
the OTC Bulletin Board electronic trading platform does not maintain any
standards regarding the “independence” of the directors on our Company’s Board,
and we are not otherwise subject to the requirements of any national securities
exchange or an inter-dealer quotation system with respect to the need to have a
majority of our directors be independent. In the absence of such requirements,
we have elected to use the definition for “director independence” under the
NASDAQ stock market’s listing standards, which defines an “independent director”
as “a person other than an officer or employee of us or its subsidiaries or any
other individual having a relationship, which in the opinion of our Board, would
interfere with the exercise of independent judgment in carrying out the
responsibilities of a director.” The definition further provides that, among
others, employment of a director by us (or any parent or subsidiary of ours) at
any time during the past three years is considered a bar to independence
regardless of the determination of our Board. Based on the foregoing
standards, we have determined that Suresh Nihalani is our only “independent”
director.
33
ITEM
11. EXECUTIVE
COMPENSATION
The
following table discloses the compensation awarded to, earned by, or paid to the
our executive officers for the fiscal years ended January 31, 2009 and 2008,
respectively:
Non-Qualified
|
||||||||||||||||||||||||||||||||||
Non-Equity
|
Deferred
|
|||||||||||||||||||||||||||||||||
Name and
|
Stock
|
Option
|
Incentive Plan
|
Compensation
|
All Other
|
|||||||||||||||||||||||||||||
Principal Position
|
Year
|
Salary
|
Bonus
|
Awards
|
Awards
|
Compensation
|
Earnings
|
Compensation
|
Total
|
|||||||||||||||||||||||||
Warren
Hosseinion, M. D.
|
2009
|
$ | 239,830 | 0 | 0 | 0 | 0 | 0 | 0 | $ | 239,830 | |||||||||||||||||||||||
Chief
Executive Officer(1)
|
2008
|
$ | 0 | $ | 0 | |||||||||||||||||||||||||||||
Adrian
Vazquez, M.D.
|
2009
|
$ | 256,720 | 0 | 0 | 0 | 0 | 0 | 0 | $ | 256,720 | |||||||||||||||||||||||
President
and Chairman(1)
|
2008
|
$ | 0 | $ | 0 | |||||||||||||||||||||||||||||
A.
Noel DeWinter
|
2009
|
$ | 33,500 | 0 | $ | 67,500 | 0 | 0 | 0 | 0 | $ | 101,000 | ||||||||||||||||||||||
Chief
Financial Officer (2)
|
2008
|
$ | 0 | $ | 0 |
(1) The
reported compensation for Dr. Hosseinion and Dr. Vazquez is entirely generated
from patient care activities.
(2) Mr.
DeWinter joined the Company on August 1, 2008.
Employment
Agreements
On
September 10, 2008, the Company entered into an employment agreement with A.
Noel DeWinter pursuant to which Mr. DeWinter agreed to serve as the Chief
Financial Officer of the Company. Under the employment agreement, Mr. DeWinter
is entitled to a base salary of $7,000 per month, and reimbursement of
reasonable travel and other expenses. In addition, pursuant to the
employment agreement, the Company issued to Mr. DeWinter a stock award of
250,000 shares of common stock.
34
Outstanding
Equity Awards at Fiscal Year-End
OPTION AWARDS
|
STOCK AWARDS
|
||||||||||||||||||||||||
Name
|
Number of
Securities
Underlying
Unexercised
Options
(#)
Exercisable
|
Number of
Securities
Underlying
Unexercised
Options
(#)
Unexercisable
|
Equity
Incentive Plan
Awards:
Number of
Securities
Underlying
Unexercised
Unearned
Options
(#)
|
Option
Exercise
Price
($)
|
Option
Expiration
Date
|
Number of
Shares or
Units of
Stock That
Have Not
Vested
(#)
|
Market
Value of
Shares or
Units of
Stock That
Have Not
Vested
($)
|
Equity
Incentive
Plan Awards:
Number of
Unearned
Shares, Units
or Other
Rights That
Have Not
Vested
(#)
|
Equity
Incentive Plan
Awards:
Market or
Payout Value
of Unearned
Shares, Units
or Other
Rights That
Have Not
Vested
(#)
|
||||||||||||||||
Warren
Hosseinion,
M.D.
|
0
|
0
|
0
|
$ |
0
|
n/a
|
0
|
$ |
0
|
0
|
0
|
||||||||||||||
Adrian
Vazquez, M.D.
|
0
|
0
|
0
|
$ |
0
|
n/a
|
0
|
$ |
0
|
0
|
0
|
||||||||||||||
A.
Noel DeWinter
|
0
|
0
|
0
|
$ |
0
|
n/a
|
0
|
$ |
0
|
0
|
0
|
Director
Compensation
On
October 27, 2008, the Company entered into a Director Agreement with Suresh
Nihalani. The Company issued a stock award of 400,000 shares of
common stock to Mr. Nihalani, under the terms of the Director Agreement, which
shares will vest ratably over a thirty-six month period commencing December
2008. As of January 31, 2009, 22,222 shares had vested pursuant to the
agreement. None of our remaining directors receive any compensation
solely for their services as directors.
Option/SAR
Grants in the Last Fiscal Year
The
following table reflects option grants to our executive officers during the
fiscal year ended January 31, 2009:
% Total Options/
|
|||||||||||
# of Securities
|
SARs Granted to
|
Exercise or
|
|||||||||
Underlying Options/
|
Employees in Fiscal
|
Base
|
Expiration
|
||||||||
Name
|
SARs Granted
|
Year
|
Price ($/Share)
|
Date
|
|||||||
Warren
Hosseinion, M.D.
|
0
|
0
|
0
|
0
|
|||||||
Adrian
Vazquez, M.D.
|
0
|
0
|
0
|
0
|
|||||||
A.
Noel DeWinter
|
0
|
0
|
0
|
0
|
ITEM
12. SECURITY OWNERSHIP OF CERTAIN
BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER
MATTERS
The
following table sets forth certain information as of April 10, 2009, with
respect to (i) those persons known to us to beneficially own more than 5% of our
voting securities, (ii) each of our directors, (iii) each of our executive
officers, and (iv) all directors and executive officers as a group. The
information is determined in accordance with Rule 13d-3 promulgated under the
Exchange Act. Except as indicated below, the beneficial owners have sole voting
and dispositive power with respect to the shares beneficially
owned. As of April 10, 2009, there were 25,870,220 shares of the
Company’s common stock issued and outstanding, of which only 49,134 are free
trading shares and 25,821,086 are restricted shares.
35
Name and Address of Beneficial Owner (1)
|
Shares Beneficially
Owned (2)
|
Percent
of Class
(3)
|
||||||
Certain
Beneficial Owners:
|
||||||||
N/A
|
-
|
-
|
||||||
Directors/Named
Executive Officers:
|
||||||||
Warren
Hosseinion, M.D.
|
9,123,387
|
34.9%
|
||||||
Adrian
Vazquez, M.D
|
9,123,387
|
34.9%
|
||||||
A.
Noel DeWinter
|
250,000
(4)
|
*
|
||||||
Suresh
Nihalani
|
66,666
(5)
|
*
|
||||||
All
Named Executive Officers and Directors as a group (4
persons)
|
18,563,440
(4)(5)
|
70.9%
|
* Less
than 1%
(1)
Unless otherwise indicated, the business address of each person listed is c/o
Apollo Medical Holdings, Inc., 1010 N. Central Avenue, Glendale, California
91202.
(2) For
purposes of this table, shares are considered beneficially owned if the person
directly or indirectly has the sole or shared power to vote or direct the voting
of the securities or the sole or shared power to dispose of or direct the
disposition of the securities. Shares are also considered beneficially owned if
a person has the right to acquire beneficial ownership of the shares within 60
days of April 10, 2009.
(3) The
percentages are calculated based on the actual number of shares issued and
outstanding as of April 10, 2009, which is 25,870,220 plus the amounts
reported for Messrs. DeWinter and Nihalani, as further described in Notes 4 and
5 below.
(4) The
shares reported include 250,000 shares of common stock beneficially owned by Mr.
DeWinter under his employment agreement with the Company. However, as
of the date of this Report, such shares have not been issued to Mr. DeWinter due
to an administrative delay.
(5) The
shares reported include (i) 44,444 shares of common stock beneficially owned by
Mr. Nihalani pursuant his director agreement, as of the date of this
Report; and (ii) 22,222 shares of common stock that will vest within 60 days of
this Report. However, as of the date of this Report, the 44,444
shares have not been issued to Mr. Nihalani due to an administrative
delay.
ITEM
13. CERTAIN RELATIONSHIPS AND RELATED
TRANSACTIONS, AND DIRECTOR INDEPENDENCE
During
the twelve months ended January 31, 2009 and 2008, the Company generated revenue
of $57,344 and $90,500, respectively, by providing management services to
ApolloMed Hospitalists (AMH), an affiliated company with common ownership
interest. Commencing August 1, 2008, the management services fee income reported
by AMM was eliminated in consolidation against similar costs recorded at
AMH.
The
Company borrowed $70,000 on a short-term promissory note in the quarter ended
July 2008 from a related party of the Chief Executive officer of the
Company. The $70,000 note was due and payable in full no later than
October 1, 2008, carries no interest rate, and the Company was obligated to pay
an origination fee of $5,000 at the time of payoff. The note was
extended by verbal agreement on its expiration date with no change in terms. On
January 24, 2009, the Company formalized the note extension. Under
the terms of the new note, the $5,000 origination fee was added to the note, the
due date was extended to March 31, 2011, the interest rate was set at 8% and the
note is initially convertible into 214,285 shares of common
stock. The Company has the right to redeem the note at a 105 percent
premium prior to March 31, 2011.
36
In
addition, during the Company’s most recently completed fiscal quarter, we issued
convertible notes in amounts aggregating to $23,000 to two relatives of Warren
Hosseinion, the Company’s Chief Executive Officer.
Director
Independence
Our
common stock is quoted on the OTC Bulletin Board electronic trading platform,
which does not maintain any standards regarding the “independence” of the
directors on our Company’s Board, and we are not otherwise subject to the
requirements of any national securities exchange or an inter-dealer quotation
system with respect to the need to have a majority of our directors be
independent. In the absence of such requirements, we have elected to use the
definition for “director independence” under the NASDAQ stock market’s listing
standards, which defines an “independent director” as “a person other than an
officer or employee of us or its subsidiaries or any other individual having a
relationship, which in the opinion of our Board, would interfere with the
exercise of independent judgment in carrying out the responsibilities of a
director.” The definition further provides that, among others, employment of a
director by us (or any parent or subsidiary of ours) at any time during the past
three years is considered a bar to independence regardless of the determination
of our Board. Based on the foregoing standards, we have determined
that Suresh Nihalani is our only “independent” director.
ITEM
14. PRINCIPAL ACCOUNTING FEES AND
SERVICES
The
aggregate fees for professional services rendered by Kabani and Company to us
for the fiscal years ended January 31, 2009 and January 31, 2008 were as
follows:
Fiscal Year Ended
1/31/2009
|
Fiscal Year Ended
1/31/2008
|
|||||||
Audit
fees
|
$ | 27,000 | $ | 25,000 | ||||
Audit-related
fees
|
- | - | ||||||
Tax
fees*
|
$ | 3,000 | $ | 3,000 | ||||
All
other fees
|
- | - | ||||||
Total
|
$ | 30,000 | $ | 28,000 |
*Tax
Returns for the Company were completed by a local CPA firm and the Tax Fees in
the table above represent amounts paid to this firm.
(1)
|
Audit fees consist of services
that would normally be provided in connection with statutory and
regulatory filings or engagements, including services that generally only
the independent accountant can reasonably
provide.
|
(2)
|
Audit-related fees relate to
assurance and associated services that traditionally are performed by the
independent accountant, including: attest services that are not required
by statute or regulation; accounting consultation and audits in connection
with mergers, acquisitions and divestitures; employee benefit plans
audits; and consultation concerning financial accounting and reporting
standards.
|
(3)
|
Tax fees relate to services
performed by the tax division for tax compliance, planning, and
advice.
|
37
PART
IV
ITEM
15. EXHIBITS, FINANCIAL STATEMENT
SCHEDULES
(a)
|
Please
see the Report of our Independent Registered Public Accounting Firm, and
related financial statements for our fiscal year ended January 31, 2009,
beginning on page F-1 of this Form
10-K.
|
(b)
|
Exhibits
Index
|
Number
|
Exhibit
|
|
10.1
|
Employment
Agreement with A. Noel DeWinter (filed as an exhibit to Current Report on
Form 8-K filed on September 11, 2008, and incorporated herein by
reference).
|
|
10.2
|
Management
Services Agreement dated August 1, 2008, between Apollo Medical Management
and ApolloMed Hospitalists (filed as an exhibit on Quarterly Report on
Form 10-Q on December 22, 2008, and incorporated herein by
reference).
|
|
10.3
|
Management
Services Agreement dated March 20, 2009, between Apollo Medical Management
and ApolloMed Hospitalists*
|
|
31.1
|
Rule
13a-14(a) Certification, as adopted pursuant to Section 302 of the
Sarbanes-Oxley Act of 2002*
|
|
31.2
|
Rule
13a-14(a) Certification, as adopted pursuant to Section 302 of the
Sarbanes-Oxley Act of 2002*
|
|
32.1
|
Certification
pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of
the Sarbanes-Oxley Act of 2002*
|
|
32.2
|
Certification
pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of
the Sarbanes-Oxley Act of 2002*
|
|
* Filed
herewith.
|
SIGNATURES
In
accordance with Section 13 or 15(d) of the Exchange Act, the registrant caused
this report to be signed on its behalf by the undersigned, thereunto duly
authorized.
APOLLO MEDICAL HOLDINGS, INC.
|
||
Date: May 18, 2009
|
By:
|
/ S/ WARREN HOSSEINION, M.D
|
Warren Hosseinion, M.D., Chief
Executive Officer
|
In
accordance with the Exchange Act, this report has been signed below by the
following persons on behalf of the Company and in the capacities and on the
dates indicated.
38
SIGNATURE
|
TITLE
|
DATE
|
||
/S/ WARREN HOSSEINION, M.D.
|
Chief
Executive Officer,
|
May
18, 2009
|
||
Warren
Hosseinion, M.D.
|
||||
/S/ ADRIAN VAZQUEZ, M.D.
|
President
and Chairman of the Board
|
May
18, 2009
|
||
Adrian
Vazquez, M.D.
|
||||
/S/ A. NOEL DeWinter
|
Chief
Financial Officer
|
May
18, 2009
|
||
A.
Noel DeWinter
|
39
FINANCIAL STATEMENTS - TABLE
OF CONTENTS:
Page
|
|
Report
of independent registered public accounting firm
|
F-2
|
Financial
statements:
|
|
Consolidated
balance sheets
|
F-3
|
Consolidated
statements of operations
|
F-4
|
Consolidated
statements of changes in stockholders’ equity
|
F-5
|
Consolidated
statements of cash flows
|
F-6
|
Notes
to consolidated financial statements
|
F-7
|
F-1
Report
of Independent Registered Public Accounting Firm
Board of
Directors and Stockholders of
Apollo
Medical Holdings, Inc.
(Formerly,
Siclone Industries, Inc.)
We have
audited the accompanying consolidated balance sheets of Apollo Medical Holdings,
Inc as of January 31, 2009 and 2008 and the related consolidated statements of
operations, stockholders' equity, and cash flows for the years then ended. These
financial statements are the responsibility of the Company's management. Our
responsibility is to express an opinion on these financial statements based on
our audits.
We
conducted our audits in accordance with the standards of the Public Company
Accounting Oversight Board (United States). Those standards require that we plan
and perform the audit to obtain reasonable assurance about whether the financial
statements are free of material misstatement. An audit includes examining, on a
test basis, evidence supporting the amounts and disclosures in the financial
statements. An audit also includes assessing the accounting principles used and
significant estimates made by management, as well as evaluating the overall
financial statement presentation. We believe that our audits provide a
reasonable basis for our opinion.
In our
opinion, the consolidated financial statements referred to above present fairly,
in all material respects, the financial position of Apollo Medical Holdings, Inc
as of January 31, 2009 and 2008, and the results of their operations and their
cash flows for each of the years then ended, in conformity with U.S. generally
accepted accounting principles.
The
Company's consolidate financial statements are prepared using the generally
accepted accounting principles applicable to a going concern, which contemplates
the realization of assets and liquidation of liabilities in the normal course of
business. The Company has accumulated deficit of $1,044,951 as of January 31,
2009, negative working capital of $57,022 and cash flows used in operating
activities of $622,485. This factor, as discussed in Note 3 to the financial
statements raises substantial doubt about the Company's ability to continue as a
going concern. Management's plans in regard to the matter are also described in
Note 3. The statements do not include any adjustments that might result from the
outcome of this uncertainty.
/s/
Kabani & Company, Inc.
Certified
Public Accountants
Los
Angeles, California
May 18,
2009
F-2
PART 1 -
FINANCIAL INFORMATION
ITEM 1 -
FINANCIAL STATEMENTS
APOLLO
MEDICAL HOLDINGS, INC.
(FORMERLY,
SICLONE INDUSTRIES, INC.)
CONSOLIDATED
BALANCE SHEETS
January 31,
|
January 31,
|
|||||||
2009
|
2008
|
|||||||
ASSETS
|
||||||||
CURRENT
ASSETS
|
||||||||
Cash
and cash equivalents
|
$ | 84,161 | $ | 44,352 | ||||
Accounts
receivable, net
|
255,665 | - | ||||||
Due
from affiliate
|
2,050 | - | ||||||
Prepaid
expenses
|
25,025 | 15,719 | ||||||
Total
current assets
|
366,901 | 60,071 | ||||||
Property
and equipment - net
|
47,330 | - | ||||||
TOTAL
ASSETS
|
$ | 414,232 | $ | 60,071 | ||||
LIABILITIES
AND STOCKHOLDERS' EQUITY/(DEFICIT):
|
||||||||
CURRENT
LIABILITIES:
|
||||||||
Accounts
payable and accrued liabilities
|
$ | 349,141 | $ | 13,300 | ||||
Due
to related party
|
- | 17,907 | ||||||
Convertible
notes
|
10,000 | - | ||||||
Convertible
notes payable-related party
|
23,000 | - | ||||||
Current
portion of line of credit
|
41,782 | - | ||||||
Total
current liabilities
|
423,923 | 31,207 | ||||||
Line
of credit
|
156,218 | - | ||||||
Convertible
notes payable-related party
|
75,000 | - | ||||||
Total
liabilities
|
655,141 | 31,207 | ||||||
Minority
interest
|
228,115 | - | ||||||
Commitments
and contingency
|
||||||||
STOCKHOLDERS'
EQUITY/(DEFICIT):
|
||||||||
Preferred
stock, par value $.001 and $0.0001 per share; 5,000,000
and
|
||||||||
25,000,000
shares authorized, respectively; none issued
|
- | - | ||||||
Common
Stock, par value $.001 and $0.0001, 100,000,000 shares
authorized,
|
||||||||
25,870,220
and 20,933,490 shares issued and outstanding, respectively
|
25,870 | 20,933 | ||||||
Additional
paid-in-capital
|
550,058 | 161,067 | ||||||
Accumulated
deficit
|
(1,044,951 | ) | (153,136 | ) | ||||
Total
stockholders' equity (deficit)
|
(469,024 | ) | 28,864 | |||||
TOTAL
LIABILITIES AND STOCKHOLDERS' EQUITY (DEFICIT)
|
$ | 414,232 | $ | 60,071 |
The
accompanying notes are an integral part of these consolidated financial
statements
F-3
APOLLO
MEDICAL HOLDINGS, INC.
(FORMERLY,
SICLONE INDUSTRIES, INC.)
CONSOLIDATED
STATEMENTS OF OPERATIONS
FOR
THE YEARS ENDED JANUARY 31, 2009 AND 2008
For the years ended
|
||||||||
JANUARY 31,
|
||||||||
2009
|
2008
|
|||||||
REVENUES
|
$ | 1,057,354 | $ | 90,500 | ||||
Operating
expenses:
|
||||||||
Cost
of services - physician practice salaries, benefits and
other
|
1,046,103 | 63,093 | ||||||
General
and administrative
|
827,287 | 181,069 | ||||||
Depreciation
|
19,780 | - | ||||||
Total
operating expenses
|
1,893,169 | 244,162 | ||||||
LOSS
FROM OPERATIONS
|
(835,815 | ) | (153,662 | ) | ||||
OTHER EXPENSES:
|
||||||||
Interest
expense
|
8,950 | - | ||||||
Financing
cost
|
46,250 | |||||||
Total
other expenses
|
55,200 | - | ||||||
NET
LOSS BEFORE INCOME TAXES
|
(891,015 | ) | (153,662 | ) | ||||
Provision
for Income Tax
|
800 | 800 | ||||||
NET
LOSS
|
$ | (891,815 | ) | $ | (154,462 | ) | ||
WEIGHTED
AVERAGE SHARES OF COMMON STOCK OUTSTANDING,
|
||||||||
BASIC
AND DILUTED
|
24,007,988 | 20,933,490 | ||||||
*BASIC
AND DILUTED NET LOSS PER SHARE
|
(0.04 | ) | (0.01 | ) |
*Weighted
average number of shares used to compute basic and diluted loss per share is the
same since the effect of dilutive securities is anti-dilutive.
The
accompanying notes are an integral part of these consolidated financial
statements
F-4
APOLLO
MEDICAL HOLDINGS, INC.
(FORMERLY,
SICLONE INDUSTRIES, INC.)
CONSOLIDATED
STATEMENTS OF STOCKHOLDERS' DEFICIT
FOR
THE YEARS ENDED JANUARY 31, 2009 AND 2008
Retained
|
||||||||||||||||||||
Earnings
|
||||||||||||||||||||
Common Stock
|
(Accumulated
|
Stockholder's
|
||||||||||||||||||
Shares
|
Amount
|
APIC
|
Deficit)
|
Equity (Deficit)
|
||||||||||||||||
Balance
at January 31, 2007
|
$ | 20,933,490 | $ | 20,933 | $ | 161,067 | $ | 1,326 | $ | 183,326 | ||||||||||
Net
loss
|
- | - | - | (154,462 | ) | (154,462 | ) | |||||||||||||
Balance
at January 31, 2008
|
20,933,490 | 20,933 | 161,067 | (153,136 | ) | 28,864 | ||||||||||||||
Issuance
of shares by AMM
|
- | - | 335,000 | - | 335,000 | |||||||||||||||
Recapitalization
due to reverse acquisition
|
4,606,932 | 4,607 | (35,206 | ) | - | (30,599 | ) | |||||||||||||
Shares
issued for finance charge
|
50,000 | 50 | 13,450 | - | 13,500 | |||||||||||||||
Shares
issued for service
|
279,798 | 280 | 75,266 | - | 75,545 | |||||||||||||||
Issuance
of warrants
|
- | - | 481 | - | 481 | |||||||||||||||
Net
Loss
|
- | - | - | (891,815 | ) | (891,815 | ) | |||||||||||||
Balance
at January 31, 2009
|
$ | 25,870,220 | $ | 25,870 | $ | 550,058 | $ | (1,044,951 | ) | $ | (469,024 | ) |
The
accompanying notes are an integral part of these consolidated financial
statements
F-5
APOLLO
MEDICAL HOLDINGS, INC.
(FORMERLY,
SICLONE INDUSTRIES, INC.)
CONSOLIDATED
STATEMENTS OF CASH FLOWS
FOR
THE YEARS ENDED JANUARY 31, 2009 AND 2008
Years ended January 31,
|
||||||||
2009
|
2008
|
|||||||
CASH
FLOWS FROM OPERATING ACTIVITIES:
|
||||||||
Adjustments
to reconcile net loss to net cash
|
||||||||
(used
in) operating activities:
|
||||||||
Net
loss
|
$ | (891,815 | ) | $ | (154,462 | ) | ||
Depreciation
|
19,780 | - | ||||||
Bad
debt expense
|
22,963 | - | ||||||
Issuance
of shares for services
|
75,545 | - | ||||||
Shares
issued as finance charge
|
13,500 | - | ||||||
Amortization
of debt discount
|
481 | - | ||||||
Changes
in assets and liabilities:
|
||||||||
Accounts
receivable
|
25,183 | - | ||||||
Prepaid
expenses
|
(9,306 | ) | (1,320 | ) | ||||
Due
from related party
|
13,098 | 17,707 | ||||||
Accounts
payable and accrued liabilities
|
108,087 | (1,757 | ) | |||||
Net
cash used in operating activities
|
(622,485 | ) | (139,832 | ) | ||||
CASH
FLOWS FROM INVESTING ACTIVITIES:
|
||||||||
Cash
acquired through acquisition
|
19,295 | - | ||||||
CASH
FLOWS FROM FINANCING ACTIVITIES:
|
||||||||
Proceeds
from notes payable
|
250,000 | - | ||||||
Payments
of notes payable
|
(250,000 | ) | - | |||||
Proceeds
from notes payable-affiliate
|
98,000 | - | ||||||
Proceeds
from isuance of convertible notes
|
210,000 | - | ||||||
Proceeds
from issuance of common stock for cash
|
335,000 | 182,000 | ||||||
Net
cash provided by financing activities
|
643,000 | 182,000 | ||||||
NET
INCREASE IN CASH & CASH EQUIVALENTS
|
39,810 | 42,168 | ||||||
CASH
& CASH EQUIVALENTS, BEGINNING BALANCE
|
44,352 | 2,184 | ||||||
CASH
& CASH EQUIVALENTS, ENDING BALANCE
|
84,161 | $ | 44,352 | |||||
SUPPLEMENTARY
DISCLOSURES OF CASH FLOW INFORMATION
|
||||||||
Interest
paid during the year
|
$ | 7,960 | $ | - | ||||
Taxes
paid during the year
|
$ | - | $ | - | ||||
NON-CASH
SUPPLEMENTAL DISCLOSURE
|
||||||||
Convertible
note payable due and classified in accrued liabilities
|
$ | 200,000 | - | |||||
Addition
to assets through acquisition (Note 1)
|
$ | 403,976 | - | |||||
Assumption
of liabilities through acquisition (Note 1)
|
$ | (195,155 | ) | - |
The
accompanying notes are an integral part of these consolidated financial
statements
F-6
APOLLO
MEDICAL HOLDINGS, INC.
(FORMERLY,
SICLONE INDUSTRIES, INC.)
NOTES TO
CONSOLIDATED FINANCIAL STATEMENTS
1. Organization
and Summary of Critical Accounting Policies
On June
13, 2008, Siclone Industries, Inc. (the “Company”), Apollo Acquisition Co.,
Inc., a wholly owned subsidiary of the Company (“Acquisition”), Apollo Medical
Management, Inc. (“Apollo Medical”) and the shareholders of Apollo Medical
entered into an agreement and Plan of Merger (the “Merger Agreement”). Pursuant
to the terms of the Merger Agreement, Apollo Medical merged with and into
Acquisition. The former shareholders of Apollo Medical received 20,933,490
shares of the Company’s common stock in exchange for all the issued and
outstanding shares of Apollo Medical.
The
acquisition of Apollo Medical is accounted for as a reverse acquisition under
the purchase method of accounting since the shareholders of Apollo Medical
obtained control of the consolidated entity. Accordingly,
the reorganization of the two companies is recorded as a recapitalization
of Apollo Medical, with Apollo Medical being treated as the continuing operating
entity. The historical financial statements presented herein will be those of
Apollo Medical. The continuing entity retained January 31 as its fiscal year
end. The financial statements of the legal acquirer are not significant;
therefore, no pro forma financial information is submitted.
On July
1, 2008, “Acquisition” changed its name to Apollo Medical Management, Inc.
(AMM). On July 3, 2008, the Company changed its name from Siclone
Industries, Inc. to Apollo Medical Holdings, Inc. (“Apollo or the Company”).
Following the merger, the Company is headquartered in Glendale,
California.
The
Company is a medical management holding company that focuses on managing the
provision of hospital-based medicine through a management company, Apollo
Medical Management, Inc. (“AMM”). Through AMM, the Company manages affiliated
medical groups, which presently consist of ApolloMed Hospitalists (“AMH”) and
Apollo Medical Associates (“AMA”).
AMM
operates as a Physician Practice Management Company (PPM) and is in the business
of providing management services to Physician Practice Companies (PPC) under
Management Service Agreements. The Company’s goal is to become a
leading provider of management services to medical groups that provide
comprehensive inpatient care services such as hospitalists, emergency room
physicians, and other hospital-based specialists.
On August
1, 2008, AMM completed negotiations and executed a formal management agreement
with AMH, under which AMM will provide management services to
AMH. The Agreement is effective as of August 1, 2008 and will allow
AMM, which operates as a Physician Practice Management Company, to consolidate
AMH, which operates as a Physician Practice, in accordance with EITF 97-2,
Application of FASB Statement No. 94 and APB Opinion No. 16 to Physician
Management Entities and Certain Other Entities with Contractual Management
Agreements. AMH is owned by an officer, director and major shareholder of the
Company,
F-7
2. Summary
of Significant Accounting Policies
Basis
of Consolidation
The
accompanying consolidated financial statements have been prepared by Apollo in
accordance with the rules and regulations of the Securities and Exchange
Commission for the presentation of financial information, and include all the
information and footnotes required by generally accepted accounting principles
for complete financial statements. The statements consist solely of
the management company, Apollo Medical Holdings, Inc. prior to August 1,
2008. Commencing with the Company’s third quarter on August 1, 2008,
and concurrent with the execution of the Management Services Agreement, the
statements reflect the consolidation of AMM and AMH, in accordance with EITF
97-2, Application of FASB Statement No. 94 and APB Opinion No. 16 to Physician
Management Entities and Certain Other Entities with Contractual Management
Agreements. All intercompany balances and transactions have been eliminated in
consolidation
Use
of Estimates
The
preparation of financial statements in conformity with generally accepted
accounting principles requires management to make estimates and assumptions that
affect the reported amounts of assets and liabilities and disclosure of
contingent assets and liabilities at the date of the financial statements and
the reported amounts of revenues and expenses during the reporting
period.
Concentrations
During
the twelve month period ended January 31, 2009, the Company had three major
customers, which contributed 24%, 19% and 19% of revenue. As of January 31, 2009
the total receivables from these customers amounted to $0, $75,086 and $25,056,
respectively.
Recently
Issued Accounting Pronouncements
In
December 2007, FASB issued FASB Statement No. 160, Noncontrolling Interests in
Consolidated Financial Statements—an amendment of ARB No. 51. This Statement
applies to all entities that prepare consolidated financial statements, except
not-for-profit organizations, but will affect only those entities that have an
outstanding non-controlling interest in one or more subsidiaries or that
deconsolidate a subsidiary. Not-for-profit organizations should continue to
apply the guidance in Accounting Research Bulletin No. 51, Consolidated
Financial Statements, before the amendments made by this Statement, and any
other applicable standards, until the Board issues interpretative guidance. This
Statement is effective for fiscal years, and interim periods within those fiscal
years, beginning on or after December 15, 2008 (that is, January 1, 2009, for
entities with calendar year-ends). Earlier adoption is prohibited. The effective
date of this Statement is the same as that of the related Statement 141(R). This
Statement shall be applied prospectively as of the beginning of the fiscal year
in which this Statement is initially applied, except for the presentation and
disclosure requirements. The presentation and disclosure requirements shall be
applied retrospectively for all periods presented. The Company is currently
evaluating the impact that this statement will have on its financial
reporting.
F-8
In March
2008, the FASB issued FASB Statement No. 161, “Disclosures about Derivative
Instruments and Hedging Activities”. The new standard is intended to improve
financial reporting about derivative instruments and hedging activities by
requiring enhanced disclosures to enable investors to better understand their
effects on an entity’s financial position, financial performance, and cash
flows. It is effective for financial statements issued for fiscal years and
interim periods beginning after November 15, 2008, with early application
encouraged. The new standard also improves transparency about the location and
amounts of derivative instruments in an entity’s financial statements; how
derivative instruments and related hedged items are accounted for under
Statement 133; and how derivative instruments and related hedged items affect
its financial position, financial performance, and cash flows. FASB Statement
No. 161 achieves these improvements by requiring disclosure of the fair values
of derivative instruments and their gains and losses in a tabular format. It
also provides more information about an entity’s liquidity by requiring
disclosure of derivative features that are credit risk-related. Finally, it
requires cross-referencing within footnotes to enable financial statement users
to locate important. Based on current conditions, the Company does not expect
the adoption of SFAS 161 to have a significant impact on its results of
operations or financial position.
In
December 2007, the FASB issued SFAS No. 141 (revised 2007), “Business
Combinations.” This statement replaces FASB Statement No. 141,
“Business Combinations.” This statement retains the fundamental requirements in
SFAS 141 that the acquisition method of accounting (which SFAS 141 called
the purchase method) be used for all business combinations and for an acquirer
to be identified for each business combination. This statement defines the
acquirer as the entity that obtains control of one or more businesses in the
business combination and establishes the acquisition date as the date that the
acquirer achieves control. This statement requires an acquirer to recognize the
assets acquired, the liabilities assumed, and any noncontrolling interest in the
acquiree at the acquisition date, measured at their fair values as of that date,
with limited exceptions specified in the statement. This statement applies
prospectively to business combinations for which the acquisition date is on or
after the beginning of the first annual reporting period beginning on or after
December 15, 2008. The Company does not expect the adoption of SFAS 141R to have
a significant impact on its results of operations or financial
position.
In May
2008, the FASB issued SFAS No. 162, “The Hierarchy of Generally Accepted
Accounting Principles.” This Statement identifies the sources of accounting
principles and the framework for selecting the principles to be used in the
preparation of financial statements of nongovernmental entities that are
presented in conformity with generally accepted accounting principles (GAAP) in
the United States (the GAAP hierarchy). This Statement will not have an impact
on the Company’s financial statements.
F-9
In May
2008, the FASB issued SFAS No. 163, “Accounting for Financial Guarantee
Insurance Contracts, an interpretation of FASB Statement No. 60.” The scope of
this Statement is limited to financial guarantee insurance (and reinsurance)
contracts, as described in this Statement, issued by enterprises included within
the scope of Statement 60. Accordingly, this Statement does not apply to
financial guarantee contracts issued by enterprises excluded from the scope of
Statement 60 or to some insurance contracts that seem similar to financial
guarantee insurance contracts issued by insurance enterprises (such as mortgage
guaranty insurance or credit insurance on trade receivables). This Statement
also does not apply to financial guarantee insurance contracts that are
derivative instruments included within the scope of FASB Statement No. 133,
“Accounting for Derivative Instruments and Hedging Activities.” This Statement
will not have an impact on the Company’s financial statements.
Stock-based
compensation
On
October 17, 2006 the Company adopted SFAS No. 123R, “Share-Based Payment, an
Amendment of FASB Statement No. 123.” As of the date of this report the Company
has no stock based incentive plan in effect.
Basic
and Diluted Earnings Per Share
Earnings
per share is calculated in accordance with the Statement of financial accounting
standards No. 128 (SFAS No. 128), “Earnings per share”. SFAS No. 128 superseded
Accounting Principles Board Opinion No.15 (APB 15). Net income (loss) per share
for all periods presented has been restated to reflect the adoption of SFAS No.
128. Basic net income per share is based upon the weighted average number of
common shares outstanding. Diluted net income (loss) per share is based on the
assumption that all dilutive convertible shares and stock options were converted
or exercised. Dilution is computed by applying the treasury stock method. Under
this method, options and warrants are assumed to be exercised at the beginning
of the period (or at the time of issuance, if later), and as if funds obtained
thereby were used to purchase common stock at the average market price during
the period.
Cash
and Cash Equivalents
Cash and
cash equivalents include cash in bank representing Company’s current operating
account
Property
and Equipment
Property and Equipment is recorded at
cost and depreciated using the straight- line method over the estimated useful
lives of the respective assets. Cost and related accumulated depreciation on
assets retired or disposed of are removed from the accounts and any resulting
gains or losses are credited or charged to income. Computers and
Software are depreciated over 3 years. Furniture and Fixtures are
depreciated over 8 years. Machinery and Equipment are depreciated over 3
years.
F-10
Income
Taxes
The
Company utilizes SFAS No. 109, “Accounting for Income Taxes,” which requires the
recognition of deferred tax assets and liabilities for the expected future tax
consequences of events that have been included in the financial statements or
tax returns. Under this method, deferred income taxes are recognized for the tax
consequences in future years of differences between the tax bases of assets and
liabilities and their financial reporting amounts at each period end based on
enacted tax laws and statutory tax rates applicable to the periods in which the
differences are expected to affect taxable income. Valuation allowances are
established, when necessary, to reduce deferred tax assets to the amount
expected to be realized.
Revenue
Recognition
The
Company recognizes Case Rate and Capitation revenue when persuasive evidence of
an arrangement exists, service has been rendered, the sales price is fixed or
determinable, and collection is reasonable assured. Fee for Service
revenues are recorded at amounts reasonably assured to be collected. The
determination of reasonably assured collections is based on historical Fee for
Service collections as a percent of billings. The provisions are adjusted to
reflect actual collections in subsequent periods.
The
estimation and the reporting of patient responsibility revenues is highly
subjective and depends on the payer mix, contractual reimbursement rates,
collection experiences, judgment and other factors. The Company’s fee
arrangements are with various payers, including managed care organizations,
hospitals, insurance companies, individuals, Medicare and Medicaid.
3. Uncertainty
of ability to continue as a going concern
The
Company's financial statements are prepared using the generally accepted
accounting principles applicable to a going concern, which contemplates the
realization of assets and liquidation of liabilities in the normal course of
business. However, the Company has an accumulated deficit of $(1,044,951) as of
January 31, 2009. Cash Flows used in Operating Activities for the
twelve months ended January 31, 2009 was $(622,485).
The
financial statements do not include any adjustments relating to the
recoverability and classification of liabilities that might be necessary should
the Company be unable to continue as a going concern.
The
Company’s need for working capital is a key issue for management and necessary
for the Company to meet its goals and objectives. The Company is actively
pursuing additional capitalization opportunities. Management believes that the
above actions will allow the Company to continue operations through the next
fiscal year.
F-11
4. Accounts
Receivable
Accounts
Receivable is stated at the amount management expects to collect from
outstanding balances. An allowance for doubtful accounts is provided for those
accounts receivable considered to be uncollectible, based upon historical
experience and management's evaluation of outstanding accounts receivable at
each quarter end. Accounts Receivable totals
$255,665, net of a provision for bad debt expense of $11,465, and represents
invoiced amounts due the Company as of January 31, 2009 on amounts billed by
AMH. Accounts receivable was $0 as of January 31, 2008.
5. Due
from affiliate
Due from
affiliate totals $2,050 and represents amounts due from AMA, an unconsolidated
Affiliate of the Company. None was due from affiliate as of January 31,
2008.
6. Prepaid
expenses
Prepaid
expenses of $25,025 and $15,719 as of January 31, 2009 and January 31, 2008,
respectively, are amounts prepaid for medical malpractice insurance and
Director’s and Officer’s insurance.
7. Property
and Equipment
Property
and Equipment consists of the following as of January 31, 2009:
January 31, 2009
|
January 31,
2008
|
|||||||
Computers
|
$ | 13,912 | $ | — | ||||
Software
|
138,443 | — | ||||||
Machinery
and equipment
|
50,815 | — | ||||||
Gross
Property and Equipment
|
203,170 | — | ||||||
less
accumulated depreciation
|
(155,840 | ) | — | |||||
Net
Property and Equipment
|
$ | 47,330 | $ | — |
Depreciation
expense was $19,780 and $0 for the twelve month periods ended January 31, 2009
and 2008, respectively.
F-12
8. Accounts
Payable, and Accrued Liabilities
Accounts
payable and accrued liabilities consist of the following:
January 31,
2009
|
January 31,
2008
|
|||||||
Accounts
payable
|
$ | 30,599 | $ | |||||
Accrued
interest
|
507 | |||||||
Accrued
professional fees
|
20,267 | 12,443 | ||||||
Accrued
payroll and income taxes
|
13,768 | 857 | ||||||
Accrued
shares to be issued for note conversion
|
200,000 | - | ||||||
Accrued
shares issued for services
|
84,000 | - | ||||||
Total
|
$ | 349,141 | $ | 13,300 |
9. Convertible
Notes Payable
During the year ended January 31, 2009,
the Company received $210,000 proceeds from the issuance of convertible notes
payable. The convertible notes bear interest at 10% and are due
twelve months from the date of issuance ranging from October 7, 2008 to December
12, 2008. In connection with the convertible notes, the Company issued 140,000
warrants to the note holders with an exercise price of $1.50.
The Company recorded value of warrants
using the Black Scholes pricing model using the following assumptions: Stock
price $0.27, Expected life of 3 years, Risk free bond rate of 1.05% to 2.00% and
volatility of 44% to 61%. Based on the assumptions used the Company recorded the
fair value of warrants amounting to $379 which was fully amortized as interest
expense during year ended January 31, 2009.
As of
January 31, 2009, the Company has received the conversion notice from the note
holders to convert $200,000 of notes into shares of the Company’s common stock.
This amount is included in the Accounts Payable and Accrued Liabilities and the
remaining $10,000 is shown as Convertible Notes payable on the accompanying
financial statements.
F-13
10. Convertible
Notes Payable-Related Party
During the year ended January 31, 2008,
the Company received $23,000 proceeds from the issuance of convertible notes
payable to relatives of the CEO of the Company. The convertible notes bear
interest at 10% and are due twelve months from December 25, 2008. In connection
with the convertible notes, the Company issued 15,333 warrants to the note
holders with an exercise price of $1.50. The Company recorded value of warrants
of $ 68 using the Black Scholes pricing model using the following assumptions:
Stock price $0.27, Expected life of 3 years, Risk free bond rate of 1.14% and
volatility of 49%.
The Company received $70,000 proceeds
from the issuance of notes payable to the father of the Company’s CEO. The note
was due and payable in full no later than October 1, 2008, carried no interest
rate, and the Company was obligated to pay an origination fee of $5,000 at the
time of payoff. The note was extended by verbal agreement on its
expiration date with no change in terms. On January 24, 2009, the Company
formalized the note extension with the father of the Company’s
CEO. Under the terms of the new note, the $5,000 origination fee was
added to the note, the due date was extended to March 31, 2011, the interest
rate was set at eight 8% and the note is initially convertible into 214,285
shares of common stock. The Company has the right to redeem the note
at a 105 percent premium any time prior to the due date on March 31,
2011.
11. Notes
payable
The
Company borrowed $125,000 on June 13, 2008 from a non-related
party. The note bears no interest rate and was due and payable in
full on July 2, 2008. The note was paid off as of October 31,
2008. The Company recorded a penalty of $6,250 during the nine months
ended October 31, 2008 due to late payment.
Also,
during the third quarter, the Company borrowed $125,000 on September 24, 2008
under a note. This note bore an interest rate of 15 percent and was due and
payable in full on October 22, 2008. The note obligated the Company
for an origination fee of $10,000 and reimbursement of legal fees totaling
$1,500 and issuance of 50,000 shares of the Company’s common stock. The note,
along with the origination fee and legal reimbursement, was paid off in full on
October 20, 2008.
12. Related
Party Transactions
During
the twelve months ended January 31, 2009 and 2008, the Company generated revenue
of $57,344 and $90,500, respectively, by providing management services to
ApolloMed Hospitalists (AMH), an affiliated company with common ownership
interest. Commencing August 1, 2008, the management services fee income reported
by AMM was eliminated in consolidation against similar costs recorded at
AMH.
F-14
The
Company borrowed $70,000 on a short-term promissory note in the quarter ended
July 2008 from a related party of the Chief Executive officer of the
Company. The $70,000 note was due and payable in full no later than
October 1, 2008, carries no interest rate, and the Company was obligated to pay
an origination fee of $5,000 at the time of payoff. The note was
extended by verbal agreement on its expiration date with no change in terms. On
January 24, 2009, the Company formalized the note extension. Under
the terms of the new note, the $5,000 origination fee was added to
the note, the due date was extended to March 31, 2011, the interest rate was set
at eight (8) percent and the note is initially convertible into
214,285 shares of common stock. The Company has the right to redeem
the note at a 105 percent premium prior to March 31, 2011. (Note 9)
Also,
during the fourth quarter, the Company issued Convertible Notes in amounts
aggregating to $23,000 to two relatives of Warren Hosseinion, the Company’s CEO
(Note 9).
13. Line of
Credit
The
Company, through AMH, has a SBA line of credit with Wells Fargo Bank. The loan
was established on January 5, 2006, provided a total available credit of
$200,000 and had a final maturity date of February 10, 2009. The
interest rate is the bank’s prime rate plus 2 points. The loan is
collateralized by all machinery, equipment, furniture, accounts, inventory and
general intangibles of AMH and personally guaranteed by the CEO of the
Company.
On
February 3, 2009, the Company’s SBA line of credit with Wells Fargo Bank was, by
mutual agreement, converted into a four-year fully amortized loan. The credit
line was reduced to $198,000. The interest rate remained at the bank’s prime
rate plus 2 percentage points and the maturity date was extended to February 10,
2013 and all collateral and guarantor remained unchanged.
As of
January 31, 2008, Apollo had drawn $198,000 against this facility with $41,782
in current portion. Interest expense of $6,522 related to the SBA loan was
recorded during the year ended January 31, 2009.
The
following table represents the principal repayments of all the outstanding debt
as of January 31, 2009:
2010
|
$ | 74,782 | ||
2011
|
47,928 | |||
125,505 | ||||
2013
|
53,222
|
|||
2014
|
4,563
|
F-15
14. Minority
Interest
The
Company recorded AMH ownership interest in the accompanied financial statements
as Minority Interest amounting to $228,115.
15.
Stockholder’s Equity
During
the period from February 1, 2007 to July 31, 2007, Apollo Medical issued 364,000
shares to investors for a total cash value $182,000. As part of issuance of
shares for cash the Company granted 91,000 stock warrants to investors. During
the period from February 1, 2008 to July 31, 2008, Apollo Medical issued 670,000
shares to investors for a total cash value $335,000. As part of issuance of
shares for cash the Company granted 167,500 stock warrants to
investors.
As the
result of the merger on June 13, 2008, the former shareholders of Apollo Medical
received 20,933,490 shares of the Company’s common stock in exchange for all the
issued and outstanding shares of Apollo Medical. Certain former shareholders of
Apollo Medical received 470,470 warrants in exchange for warrants granted to
them in previous fund raising.
During
the three month period ended October 31, 2008, the Company issued 268,687 shares
for legal, accounting and investment advisory services provided to the Company.
The Company also issued 50,000 shares as financing fee on a note
payable.
On
October 27, 2008, the Company entered into a Board of Director’s Agreement with
Suresh Nihalani. The Company issued a stock award of 400,000 shares
to Mr. Nihalani, under the terms of the Director’s Agreement, which shares will
be issued ratably over a thirty-six month period commencing December 2008.
During the year ended January 2009, Mr. Nihalani was issued 11,111
shares under this agreement.
Warrants
outstanding:
Aggregate
intrinsic value
|
Number of
warrants
|
|||||||
Outstanding
at January 31, 2008
|
$ | — | 165,620 | |||||
Granted
|
460,183 | |||||||
Exercised
|
— | — | ||||||
Cancelled
|
— | — | ||||||
Outstanding
at January 31, 2009
|
625,803 |
F-16
Exercise Price
|
Warrants
outstanding
|
Weighted
average
remaining
contractual life
|
Warrants
exercisable
|
Weighted
average exercise
price
|
||||||||||||||
$ | 1.10 | 470,470 | 1.54 | 470,470 | $ | 0.89 | ||||||||||||
$ | 1.50 | 155,333 | 0.76 | 155,333 | $ | 0.29 | ||||||||||||
625,803 | 2.30 | 625,803 |
The grant
date fair value of warrants amounting to $8,190 which was calculated using the
Black-Scholes Option Pricing Model.
16.
Commitments and Contingency
On
September 4, 2008, Apollo Medical Management, Inc. executed an employment
agreement with Jilbert Issai, M.D., to provide services as Senior Vice
President . The agreement is for an initial one-year term with provision
for successive one-year periods. Under the agreement, Doctor Issai is
entitled to a nominal salary and may be granted options to purchase an aggregate
of 300,000 shares of the Company’s common stock at an exercise price of $.10 per
share when and if the Company is to adopt a stock compensation
plan.
The
Company entered into an Advisory Agreement with Stonecreek Associates, Inc. on
October 27, 2008, under which Stonecreek would provide investment advisory
services to the Company. The agreement terminated on March 31, 2009. The Company
does have a continuing obligation to pay a commission to Stone Creek if a
financing transaction occurs under specific terms and conditions as agreed to by
Stone Creek and the Company. This obligation will expire on March 31,
2010.
On
October 27, 2008, the Company entered into a Board of Director’s Agreement with
Suresh Nihalani. The Company will issue a stock award of 400,000
shares to Mr. Nihalani, under the terms of the Director’s Agreement, which
shares will be issued ratably over a thirty-six month period commencing December
2008. The shares will be released to Mr. Nihalani on a monthly basis
during his tenure as a Director. The distribution of shares will
continue as long as Mr. Nihalani serves on the Board, but
will cease when Mr. Nihalani is no longer is a Director. Mr. Nihalani was
issued 11,111 shares under this agreement in the year ended January 31, 2009. In
addition, 11,111 shares have been accrued as shares to be issued and are
included in Accounts Payable and Accrued Liabilities on the accompanying
financial statements
The
Company entered into a Consulting Agreement with Kaneohe Advisors LLC (Kyle
Francis) under which Mr. Francis would become the Company’s Executive Vice
President, Business Development and Strategy. The agreement calls for monthly
compensation of $8,000 of which $6,000 would be deferred. Mr. Francis was
awarded an initial restricted stock award of 50,000 shares which have been
accrued as shares to be issued and are included in Accounts Payable and Accrued
Liabilities on the accompanying financial statements.
F-17
The
Company has received a claim for $250,000 relating to amounts purportedly owed
by the Company as a result of the initial reverse acquisition
transaction. This dispute relates to the initial letter dated June 3,
2008. The terms of the letter of intent call for, among other things,
the payment of cash of $250,000 within 60 days of closing. The letter
of intent states, however, that it is intended to serve as a memorandum of the
Parties current discussions, and that a definitive transaction agreement will
follow. The letter of intent further states that both parties
acknowledge that all provisions of the letter of intent are non binding, and
that no contract or agreement providing for a transaction shall be deemed to
exist unless and until a final agreement has been negotiated and
executed. The final merger agreement that was executed contains a
clause that it is the “entire agreement” and thus supersedes all previous
agreements including the letter of intent; moreover, management contends that
there are no additional amounts owed under the final merger agreement. The
Company has not accrued for any amount asserted in the above claim as the
attorney of the Company has advised that the matter is in its early stage and
the outcome could not be predicted at this stage.
F-18