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Greenbrook TMS Reports Third Quarter Operational and Financial Results

Greenbrook TMS Inc. (TSX: GTMS, NASDAQ: GBNH) (“Greenbrook” or the “Company”), today announced its third quarter 2021 (“Q3 2021”) operational and financial results. All values in this news release are in United States dollars, unless otherwise stated.

THIRD QUARTER 2021 OPERATIONAL AND FINANCIAL HIGHLIGHTS

  • Revenue for Q3 2021 increased by 9% to $13.1 million as compared to the third quarter of 2020 (“Q3 2020”) and increased by 15% to $38.2 million for the nine-month period ended September 30, 2021 (“YTD 2021”), as compared to the nine-month period ended September 30, 2020 (“YTD 2020”).
  • Quarterly treatment volumes increased by 7% to 54,525 as compared to Q3 2020 and by 16% to 164,870 in YTD 2021 as compared to YTD 2020. New patient starts increased by 3% to 1,520 as compared to Q3 2020 and by 19% to 4,762 in YTD 2021 as compared to YTD 2020.
  • Entity-wide regional operating income was $0.2 million in Q3 2021 as compared to $1.0 million in Q3 2020. YTD 2021 resulted in an entity-wide regional operating loss of $0.3 million as compared to entity-wide regional operating income of $1.5 million in YTD 2020. The loss for the period and comprehensive loss decreased by 55% in Q3 2021 to $3.5 million as compared to Q3 2020, and decreased by 17% to $18.0 million during YTD 2021 as compared to YTD 2020.
  • The Company continued the roll-out of its Spravato® (esketamine nasal spray) offering at select TMS centers (“TMS Centers”), building on the Company’s long-term business plan of utilizing its TMS Centers as platforms for the delivery of innovative treatments to patients suffering from Major Depressive Disorder and other mental health disorders. The Company expects to expand its Spravato® offering to an additional 14 TMS Centers, bringing the total to 23 TMS Centers offering Spravato® in early fiscal 2022. With this anticipated expansion, we believe that our Spravato® offering has the potential to grow to as much as 5 to 10% of our total revenue by the end of fiscal 2022.
  • The Company completed a bought deal public offering of 1,707,750 common shares (“Common Shares”) at an offering price of $7.75 per Common Share for aggregate gross proceeds of approximately $13.2 million.
  • Subsequent to quarter end, on October 1, 2021, the Company completed the acquisition of Achieve TMS East, LLC and Achieve TMS Central, LLC (the “Acquisition”), which included the acquisition of 17 active TMS Centers. The Company expects that the Acquisition will secure robust payor contracts, brand recognition, physicians with established reputations and an experienced management team. The Acquisition also serves as a platform for expansion in New England and the central United States. In addition, the Company organically added 2 new TMS Centers during Q3 2021, bringing its total TMS network to 148 TMS Centers as of the date of this press release.

Bill Leonard, President and Chief Executive Officer of Greenbrook commented:

“Q3 2021 presented specific challenges early in the quarter, with patients delaying treatment during the first open summer season since the onset of COVID-19 and a surge in the delta variant in late summer. Despite these challenges, we saw continued growth in both consolidated revenue and patient treatments in the quarter as compared to Q3 2020 as well as a strong bounce back in patient volumes in October 2021, tracking toward the record volumes that we experienced last quarter. We are also very excited about the acquisition of Achieve TMS East and Central as a foundation for future growth in New England and the central United States, and the promising prospects of the continued roll-out of our Spravato® program to more of our active TMS Centers which we believe will enhance profit margins by optimizing the utilization of our current TMS Centers. These moves build on our long-term strategy of utilizing our growing network of TMS Centers and affiliated physicians as a services platform to deliver innovative treatments to patients suffering from mental health disorders. We believe that our business fundamentals remain sound, and we are positioned better than ever to serve the need for mental health support across the country, which we believe is at an all-time high.”

SELECTED THIRD QUARTER FINANCIAL AND OPERATING RESULTS (1)

Selected Financial Results

(US$) (unaudited)

Q3 2021

Q3 2020

YTD 2021

YTD 2020

Total revenue

13,130,245

12,006,570

38,150,632

33,215,627

Regional operating income (loss)

249,057

967,584

(321,722)

1,482,182

Loss before income taxes

(3,452,023)

(7,667,755)

(18,026,678)

(21,643,193)

Loss for the year and comprehensive loss

(3,452,023)

(7,667,755)

(18,026,678)

(21,643,193)

Loss attributable to the common shareholders of Greenbrook

(3,517,250)

(7,636,132)

(17,919,629)

(21,271,910)

Net loss per share (basic and diluted)(2)

(0.22)

(0.57)

(1.23)

(1.69)

Notes:

(1) Please note that additional selected consolidated financial information can be found at the end of this press release.

(2) On January 12, 2021, the shareholders of the Company approved a special resolution for an amendment to the Company’s articles and authorized a consolidation (the “Share Consolidation”) of the Company’s outstanding Common Shares on the basis of one (1) post-consolidation Common Share for every five (5) pre-consolidation Common Shares. The Share Consolidation was completed on February 1, 2021. The Company has retrospectively presented net loss per share calculations reflecting the number of Common Shares outstanding after giving effect to the Share Consolidation.

Selected Operating Results

 

As at September 30,

As at September 30,

As at December 31,

(unaudited)

 

 

2021

 

2020

 

2020

Number of active TMS Centers(1)

127

114

116

Number of TMS Centers-in-development(2)

4

11

9

Total TMS Centers

131

125

125

Number of management regions

13

13

13

Number of TMS Devices installed

214

191

198

Number of regional personnel

350

286

305

Number of shared-services / corporate personnel(3)

58

47

49

Number of TMS providers(4)

126

113

117

Number of consultations performed(5)

10,561

7,718

11,305

Number of patient starts(5)

4,762

4,017

5,445

Number of treatments performed(5)

164,870

141,584

195,992

Average revenue per treatment(5)

$231

$235

$220

Notes:

(1) Active TMS Centers represent TMS Centers that have performed billable TMS services during the applicable period.

(2) TMS Centers-in-development represents TMS Centers that have committed to a space lease agreement and the development process is substantially complete.

(3) Shared-services / corporate personnel is disclosed on a full-time equivalent basis. The Company utilizes part-time staff and consultants as a means of managing costs.

(4) Represents physician partners that are involved in the provision of TMS therapy services from our TMS Centers.

(5) Figure calculated for the applicable period ended.

For more information, please refer to the Management’s Discussion & Analysis of Financial Condition and Results of Operations (“Q3 2021 MD&A”) and the unaudited condensed interim consolidated financial statements of the Company for the three and nine months ended September 30, 2021 and 2020. These documents will be available on the Company’s website at www.greenbrooktms.com, under the Company’s SEDAR profile at www.sedar.com and under the Company’s EDGAR profile at www.sec.gov.

CONFERENCE CALL AND WEBCAST

Third Quarter Conference Call Details:

Bill Leonard, President and Chief Executive Officer, and Erns Loubser, the Chief Financial Officer, will host a conference call at 10:00 a.m. (Eastern Time) on November 10, 2021 to discuss the financial results for the quarter.

Toll Free North America: 1-866-521-4909

Toronto: 647-427-2311

Webcast:

For more information or to listen to the call via webcast, please visit: www.greenbrooktms.com/investors/events.htm

For those that plan on accessing the conference call or webcast, please allow ample time prior to the call time.

Conference Call Replay:

Toll Free (North America): 1-800-585-8367

Toronto: 416-621-4642

Passcode: 1266033

The conference call replay will be available beginning at 1:00 p.m. ET on November 10, 2021.

About Greenbrook TMS Inc.

Operating through 148 Company-operated treatment centers, Greenbrook is a leading provider of Transcranial Magnetic Stimulation (“TMS”) therapy, an FDA-cleared, non-invasive therapy for the treatment of Major Depressive Disorder and other mental health disorders, in the United States. TMS therapy provides local electromagnetic stimulation to specific brain regions known to be directly associated with mood regulation. Greenbrook has provided more than 730,000 TMS treatments to over 20,000 patients struggling with depression.

Cautionary Note Regarding Forward-Looking Information

Certain information in this press release, including with respect to the Company’s future financial or operating performance, the Company’s expectations regarding the impact of the Acquisition on our business and the continued roll-out of the Spravato® offering at additional TMS Centers and its potential to enhance profit margins and diversify total revenue, constitute forward-looking information within the meaning of applicable securities laws in Canada and the United States, including the United States Private Securities Litigation Reform Act of 1995. In some cases, but not necessarily in all cases, forward-looking information can be identified by the use of forward-looking terminology such as “plans”, “targets”, “expects” or “does not expect”, “is expected”, “an opportunity exists”, “is positioned”, “estimates”, “intends”, “assumes”, “anticipates” or “does not anticipate” or “believes”, or variations of such words and phrases or state that certain actions, events or results “may”, “could”, “would”, “might”, “will” or “will be taken”, “occur” or “be achieved”. In addition, any statements that refer to expectations, projections or other characterizations of future events or circumstances contain forward-looking information. Statements containing forward-looking information are not historical facts but instead represent management’s expectations, estimates and projections regarding future events.

Forward-looking information is necessarily based on a number of opinions, assumptions and estimates that, while considered reasonable by the Company as of the date of this press release, are subject to known and unknown risks, uncertainties, assumptions and other factors that may cause the actual results, level of activity, performance or achievements to be materially different from those expressed or implied by such forward-looking information, including, but not limited to, the factors described in greater detail in the “Risk Factors” section of the Company’s current annual information form, in the “Risks and Uncertainties” section of the Company’s Q3 2021 MD&A and in the Company’s other materials filed with the Canadian securities regulatory authorities and the United States Securities and Exchange Commission from time to time, available at www.sedar.com and www.sec.gov, respectively. These factors are not intended to represent a complete list of the factors that could affect the Company; however, these factors should be considered carefully. There can be no assurance that such estimates and assumptions will prove to be correct. The forward-looking statements contained in this press release are made as of the date of this press release, and the Company expressly disclaims any obligation to update or alter statements containing any forward-looking information, or the factors or assumptions underlying them, whether as a result of new information, future events or otherwise, except as required by law.

Cautionary Note Regarding Non-IFRS Measures

This press release makes reference to certain non-IFRS measures including certain metrics specific to the industry in which we operate. These measures are not recognized measures under International Financial Reporting Standards (“IFRS”), do not have a standardized meaning prescribed by IFRS and, therefore, may not be comparable to similar measures presented by other companies. Rather, these measures are provided as additional information to complement those IFRS measures by providing further understanding of our results of operations from management’s perspective. Accordingly, these measures are not intended to represent, and should not be considered as alternatives to, loss attributable to the common shareholders of Greenbrook or other performance measures derived in accordance with IFRS as measures of operating performance or operating cash flows or as a measure of liquidity. In addition to our results determined in accordance with IFRS, we use non-IFRS measures including, “EBITDA” and “Adjusted EBITDA”. These non-IFRS measures and industry metrics are used to provide investors with supplemental measures of our operating performance and thus highlight trends in our core business that may not otherwise be apparent when relying solely on IFRS measures. See the Company’s Q3 2021 MD&A for a further discussion of these non-IFRS financial measures. Additionally, see the Company’s Q3 2021 MD&A, along with the Company’s Management’s Discussion and Analysis of Financial Condition and Results of Operations for the year ended December 31, 2020 and December 31, 2019 and the quarters ended June 30, 2021 and June 30, 2020, and March 31, 2021 and March 31, 2020, for a reconciliation of EBITDA and Adjusted EBITDA to loss attributable to the common shareholders of Greenbrook for each of the periods shown in the table below.

SELECTED CONSOLIDATED FINANCIAL INFORMATION

(US$)

Q3 2021

(unaudited)

Q3 2020

(unaudited)

YTD 2021

(unaudited)

YTD 2020

(unaudited)

Total revenue

13,130,245

 

12,006,570

 

38,150,632

 

33,215,627

 

 

 

 

 

 

Direct center and patient care costs

6,911,058

 

5,473,759

 

20,125,081

 

16,521,201

 

Regional employee compensation

3,115,709

 

2,569,958

 

9,170,971

 

7,419,487

 

Regional marketing expenses

1,481,272

 

1,584,426

 

4,867,188

 

3,539,227

 

Depreciation

1,373,149

 

1,410,843

 

4,309,114

 

4,253,530

 

Total direct center and regional costs

12,881,188

 

11,038,986

 

38,472,354

 

31,733,445

 

Regional operating income (loss)

249,057

 

967,584

 

(321,722

)

1,482,182

 

Center development costs

203,929

 

65,291

 

667,336

 

435,659

 

Corporate employee compensation

3,514,477

 

2,555,515

 

10,071,740

 

7,577,540

 

Corporate marketing expenses

125,306

 

202,435

 

468,139

 

806,120

 

Other corporate, general and administrative expenses

1,506,181

 

780,402

 

5,145,650

 

2,165,361

 

Share-based compensation

221,679

 

171,056

 

631,011

 

455,908

 

Amortization

115,834

 

115,832

 

347,500

 

347,498

 

Interest expense

1,145,337

 

708,665

 

3,507,436

 

2,060,707

 

Interest income

(3,067

)

(8,857

)

(5,260

)

(18,418

)

Earn-out consideration

 

4,045,000

 

 

9,295,000

 

Forgiveness of loan payable

(3,128,596

)

 

(3,128,596

)

 

Loss before income taxes

(3,452,023

)

(7,667,755

)

(18,026,678

)

(21,643,193

)

Income tax expense

 

 

 

 

Loss for the period and comprehensive loss

(3,452,023

)

(7,667,755

)

(18,026,678

)

(21,643,193

)

Loss attributable to non-controlling interest

65,227

 

(31,623

)

(107,049

)

(371,283

)

Loss attributable to the common shareholders of Greenbrook

(3,517,250

)

(7,636,132

)

(17,919,629

)

(21,271,910

)

Net loss per share (basic and diluted) (1)

(0.22

)

(0.57

)

(1.23

)

(1.69

)

Note:

(1) The Company has retrospectively presented net loss per share calculations reflecting the number of Common Shares outstanding after giving effect to the Share Consolidation.

(US$)

Q3 2021

Q2 2021

Q1 2021

Q4 2020

Q3 2020

Q2 2020

Q1 2020

Q4 2019

(unaudited)

 

 

 

 

 

 

 

 

Revenue

13,130,245

13,707,212

11,313,175

9,913,552

12,006,570

9,788,555

11,420,502

12,536,671

Regional operating income (loss)(1)

249,057

921,339

(1,492,118)

(2,050,168)

967,584

(225,198)

739,796

2,056,836

Net loss attributable to common shareholders of Greenbrook

(3,517,250)

(6,775,825)

(7,626,554)

(8,391,630)

(7,636,132)

(9,477,505)

(4,158,274)

(7,034,356)

Adjusted EBITDA(2)

(2,893,282)

(2,705,666)

(4,013,910)

(4,223,446)

(937,073)

(1,665,672)

(1,648,053)

(1,296,201)

Net loss per share – Basic(3)

(0.22)

(0.48)

(0.56)

(0.60)

(0.57)

(0.76)

(0.39)

(0.62)

Net loss per share – Diluted(3)

(0.22)

(0.48)

(0.56)

(0.60)

(0.57)

(0.76)

(0.39)

(0.62)

Notes:

(1) Regional operating income (loss) for the fourth quarter ended December 31, 2019 has been updated to exclude amortization.

(2) Adjusted EBITDA is a non-IFRS measure. See “Cautionary Note Regarding Non-IFRS Measures” above.

(3) The Company has retrospectively presented net loss per share calculations reflecting the number of Common Shares outstanding after giving effect to the Share Consolidation.

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