Executive Summary

Q1 2024 revenue declined 7% year over year to $18.0M as Change Healthcare’s ransomware outage delayed claims and the footprint shrank post-restructuring; net loss widened to $14.5M (EPS $(0.32)), and regional operating loss increased to $2.5M on higher marketing and Spravato rollout costs .
Average revenue per treatment rose 14% to $238 and consultations grew 15% YoY, a leading indicator for future starts, but treatment volumes fell 18% and patient starts fell 14% amid billing disruptions and closures .
Liquidity remains tight: cash from operations was $(12.8)M in Q1, quarter-end cash was $2.65M, and management disclosed substantial doubt about going concern absent additional financing; Madryn provided multiple new loan tranches and minimum liquidity covenant waivers; shares were delisted from Nasdaq and quoted on OTCQB (GBNHF) .
Management reiterated a “path to profitability” as restructuring is largely complete and Spravato/medication-management pilots expand, but internal control weaknesses over revenue variable consideration and elevated interest expense (up 56% YoY to $4.2M) persist as headwinds .

What Went Well and What Went Wrong

What Went Well

Yield improvement and demand funnel: Average revenue per treatment increased 14% to $238; consultations rose 15% YoY, which management cites as a leading indicator for future starts .
Modalities expansion: Spravato offering expanded to 84 centers, with pilots for medication management (9 centers) and talk therapy (Florida/Missouri) to build earlier-pipeline and diversify revenue .
Management tone on positioning: “We have established a strong business foundation with the substantially completed Restructuring Plan… continue our roll-out of new treatment modalities… By becoming a comprehensive mental health provider… we will be able to provide even greater access…” — CEO Bill Leonard .

What Went Wrong

Volumes and revenue pressure: Revenue fell 7% to $18.0M; treatments declined 18% and patient starts declined 14%, hurt by Change Healthcare claims backlog and strategic closures .
Profitability deterioration: Regional operating loss rose to $2.49M (from $0.50M), driven by lower revenue and higher regional costs/marketing; interest expense climbed 56% YoY to $4.20M .
Liquidity and controls: Operating cash usage of $(12.8)M, cash of $2.65M, and ongoing covenant waivers highlight financing risk; disclosure controls/ICFR are ineffective due to a material weakness tied to variable consideration estimates .

Financial Results

P&L snapshot vs prior periods (oldest → newest)

Metric	Q1 2023	Q3 2023	Q1 2024
Revenue ($USD)	$19,304,461	$17,364,264	$18,012,190
Loss for the period ($USD)	$(10,660,136)	$(13,557,312)	$(14,540,145)
Net loss per share (basic/diluted) ($)	$(0.34)	$(0.32)	$(0.32)
Regional operating loss ($USD)	$(497,505)	$(1,118,485)	$(2,491,800)
Interest expense ($USD)	$2,692,418	$3,088,382	$4,202,402

Notes: “Prior quarter” Q4 2023 granular quarterly figures were not disclosed in reviewed filings; Q3 2023 is shown as the most recent reported quarter available.

Q1 2024 vs Wall Street Consensus

Metric	Q1 2024 Actual	Consensus (S&P Global)	Beat/Miss
Revenue ($USD)	$18,012,190	n/a	n/a
EPS (primary/diluted) ($)	$(0.32)	n/a	n/a

Consensus estimates were unavailable in S&P Global for this ticker during our query window; therefore, a beat/miss determination cannot be made.

KPIs and operating footprint

KPI	Q1 2023	Dec 31, 2023	Q1 2024
Active Treatment Centers (count)	162	130	130
Providers (count)	222	205	192
Consultations performed	7,975	34,124	9,174
Patient starts	2,854	10,401	2,448
Treatments performed	92,533	343,790	75,764
Average revenue per treatment ($)	$209	$215	$238

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
All metrics	FY2024	None provided	None provided	n/a

Management did not provide formal numeric guidance in the Q1 2024 press release or 10-Q reviewed -.

Earnings Call Themes & Trends

Earnings call transcript for Q1 2024 was not available in the document set searched; we rely on Q1 2024 10-Q/press release and prior interim filings/press releases.

Topic	Previous Mentions (Q-2 and Q-1)	Current Period (Q1 2024)	Trend
Restructuring Plan	Plan announced Mar 2023; cost removal and footprint rationalization; waivers and amendment fees with Madryn; restructuring expenses recorded .	“Substantially completed”; still final steps in H1’24; path to profitability reiterated .	Executing, transitioning to growth investments.
Change Healthcare cyber incident	n/a	Incident caused claims submission backlogs and delayed cash; drove higher variable consideration adjustment; management expects normalization during 2024 .	Temporary headwind, expected to fade.
Spravato expansion	Ongoing expansion through 2023; first “buy & bill” program in Q4’23 .	84 centers offering; continued rollout of “buy & bill” and “administer/observe” programs .	Expanding modality; potential margin mix benefits.
Medication management & talk therapy	Medication management pilot initiated; talk therapy planned .	Medication management at 9 centers; talk therapy live in FL/MO .	Building earlier-funnel, cross-sell pipeline.
Liquidity/financing & covenants	Multiple Madryn amendments, PIK interest, liquidity covenant waivers; registered direct offering plans - - .	Additional loan tranches; minimum liquidity waiver extensions; operating cash burn $(12.8)M; substantial doubt about going concern -.	Elevated risk; financing reliance continues.
Listing status/SEC reporting	n/a	Nasdaq delisting; OTCQB quoting (GBNHF); Form 25 for delisting/deregistration under 12(b) .	Reduced admin burden; potential liquidity impact.
Internal controls	n/a	Material weakness in ICFR and ineffective disclosure controls tied to variable consideration estimation .	Remediation planned; risk persists.

Management Commentary

Strategic positioning: “We have established a strong business foundation with the substantially completed Restructuring Plan… continue our roll-out of new treatment modalities… By becoming a comprehensive mental health provider and expanding our continuum of care, we believe that we will be able to provide even greater access and quality of care…” — Bill Leonard, CEO .
Full-year context: “We are pleased with the successful execution of the Restructuring Plan, which we believe provides a path to profitability once we are able to resume our investment in activities to support our revenue growth… excited to continue our roll-out of new treatment modalities…” — Bill Leonard .

Q&A Highlights

No Q1 2024 earnings call transcript was available in the filings repository we searched; therefore, Q&A highlights and guidance clarifications were not observable in our document set.

Estimates Context

S&P Global consensus for Q1 2024 revenue and EPS was unavailable for this ticker at query time; consequently, we cannot assess beat/miss versus Street and recommend using company-reported actuals for model updates.
Implication: With ARPT rising and consultations improving, models should consider a potential recovery in starts as billing normalizes, offset by continued high interest costs and financing risk until liquidity stabilizes -.

Key Takeaways for Investors

Short-term: The Change Healthcare backlog depressed Q1 cash collections and recognized revenue via variable consideration; management expects claims submission normalization later in 2024, which could aid near-term cash and revenue stability .
Profitability delta: Regional operating loss expanded to $2.5M and interest expense to $4.2M; the combination of higher marketing investment and debt-service expense raises breakeven thresholds near-term .
Liquidity runway: Q1 operating cash outflow $(12.8)M and $2.65M quarter-end cash, alongside repeated covenant waivers and add-on Madryn debt, underline financing dependence and going-concern uncertainty; monitor waiver extensions and new capital actions closely - .
Mix optionality: ARPT (+14% YoY) and 84 Spravato sites, plus medication management and talk therapy pilots, support a shift toward broader care and yield improvement as volumes normalize .
Market structure: Nasdaq delisting and OTCQB quotation (GBNHF) may reduce trading liquidity; lower SEC reporting burden could modestly reduce overhead, but equity capital access may be more limited .
Execution priorities: Resolve billing normalization, sustain funnel (consultations), convert to starts, and realize restructuring efficiencies while managing debt load and interest costs; remediation of ICFR material weakness is also important for investor confidence .

Supporting Data (Detail)

Q1 2024 selected financials: Revenue $18,012,190; regional operating loss $(2,491,800); net loss $(14,540,145); EPS $(0.32); interest expense $4,202,402 .
Operating metrics Q1 2024 vs Q1 2023: Treatments 75,764 vs 92,533; patient starts 2,448 vs 2,854; consultations 9,174 vs 7,975; ARPT $238 vs $209 .
Cash flow: Net cash used in operating activities $(12,810,692) in Q1 2024; cash $2,653,197 at period end .
Financing and covenants: Additional Madryn tranches and minimum liquidity covenant temporarily reduced to $300k with extensions; further draws in April/May 2024 .
Listing/quotation: OTCQB quotation effective Mar 22, 2024 (GBNHF); previously received Nasdaq final delisting notice on Feb 22, 2024 .

Search notes: We read the Q1 2024 Form 8‑K press release and 10‑Q in full, relevant Q1 2024 corporate 8‑Ks, and prior interim statements for Q1–Q3 2023. A Q1 2024 earnings call transcript was not available in the repository searched.

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