Sensus Healthcare - Earnings Call - Q1 2021

Transcript

Speaker 0

Good day, ladies and gentlemen, and welcome to the Census Healthcare First Quarter twenty twenty one Financial Results Conference Call. All lines have been placed on a listen only mode and the floor will be open for questions and comments following the presentation. If you should require assistance throughout the conference, please press 0 to reach a live operator. At this time, it is my pleasure to turn the floor over to your host, Kim Ma'am, the floor is yours.

Speaker 1

Thank you, operator. This is Kim Golodetz with LHA. Thank you all for participating in today's call. Joining me from Census Healthcare are Joe Sardano, Chief Executive Officer and Javier Rampolla, Chief Financial Officer. As a reminder, some of the matters that will be discussed during today's call contain forward looking statements within the meaning of federal securities laws.

All statements other than historical facts that address activities Census Healthcare assumes, plans, expects, believes, intends or anticipates and other similar expressions will, should or may occur in the future are forward looking statements. The forward looking statements are management's beliefs based on currently available information. Census Healthcare undertakes no obligation to update or revise any forward looking statements except as required by law. All forward looking statements are subject to risks and uncertainties, including the continuation and severity of the COVID-nineteen pandemic and its impact on sales and marketing as described in the company's Forms 10 Q and 10 ks. During today's call, there will also be reference to certain non GAAP financial measures.

Census believes these measures provide useful information for investors yet should not be considered as a substitute for GAAP nor should they be viewed as a substitute for operating results determined in accordance with GAAP. A reconciliation of non GAAP to GAAP results is included in today's financial results press release. With that said, I'd like to turn the call over to Joe Sargano. Joe?

Speaker 2

Thank you, Kim, and good afternoon, everybody. Thank you all for joining us. It's been quite a year, and I hope that you all have continued to remain healthy. Now that fully half the country has had at least one COVID-nineteen vaccine, perhaps before too long, we'll be able to move forward. Indeed, we are seeing significant improvements in economic activity, which is in stark contrast to when I spoke with you one year ago when Census was so negatively impacted by the complete shutdown of The U.

S. Economy. Our first quarter twenty twenty one revenues of $3,100,000 were significantly higher versus the prior year. More specifically, revenues were up 83% and reflect progress in our return to normalcy. Revenues featured both domestic and overseas sales.

We are cautiously optimistic that the signs of market recovery will allow continued revenue growth as the year progresses, noting our historical seasonally during seasonality during the summer months. We were delighted to ship seven SRT systems during the quarter, including six domestic direct sales and one to China. We're particularly pleased that the SRT systems installed at customer sites are operating with good volumes. This is likely reflecting not only the safety and efficacy of using SRT to treat non melanoma skin cancer, but also a fair reimbursement environment as of 01/01/2021. As of that date, the Centers for Medicare Medicaid Services or CMS revalued our main procedure and other codes following years of lobbying by census and a host of key opinion leaders who went to bat for us with CMS highlighting the efficacy and safety of SRT.

The American Cutaneous Oncology Society is particular in particular was most helpful working alongside Sensus with the American Academy of Dermatology. We have a lot of people to thank for believing in us and our technology. As we had previously indicated, Q1 has had us focused on helping the market better understand the new reimbursement coding. We stated that this will be a major part of our activities throughout the 2021. Our sales force along with our field applications team has been engaged with customers and prospects in delivering this message and will continue to do so throughout the year.

Reimbursement increased not only for the main SRT code, but also increased for the evaluation and management codes. The combination of these increased values provides SRT users as much as 50% increase over the reimbursement values of the past several years. In addition, codes were revalued upward for the ultrasound capability in our SRT-one 100 Vision systems. This has caused a greater interest in our Vision product by our existing customers and prospects alike since breakevens are improved. It has also increased interest in shared revenue programs.

To date, we have penetrated only about 2% of The U. S. Market, so clearly there's plenty of upside for growth. Customers and prospective customers alike appear to be satisfied with the new reimbursement levels, and we anticipate this acceptance will be reflected in our revenue during the second half of this year. In addition, we've developed a fair market value lease with our leasing resources, which provides another reason for our customer base and prospects to consider our higher priced SRT-one 100 Vision product.

The FMV program offers much the same as on high line vehicles, whereby the monthly payment is much less than the capital lease, which has a dollar buyout because of the higher residuals placed on our products. We see good interest with prospects beginning in Q2. We feel this program will grow in popularity as we lower payments for our customers, while at the same time helping them achieve breakeven sooner. We were thrilled with the five hundredth installation since the formation of Sensus Healthcare a decade ago. The sale was to the Mid Atlantic Skin Surgery Institute in Maryland.

It was their second purchase of an SRT system as they expand their practice to a second location. We're looking forward to the installation of the next 500 units. And Du previously mentioned, we feel we can install our next 500 units in half the time. During the fourth quarter, we shipped an SRT system to Holy Name Hospital in Teaneck, New Jersey for the use of superficial radiation therapy treating the lungs of hospitalized COVID-nineteen patients. This hospital has been at the forefront of treating patients from the early days of the pandemic being situated adjacent to New York City, which was impacted early on.

During the 2021, Holy Name successfully treated its first patient with the patient leaving the ICU ward the day after treatment. Since then, a second patient has been treated and we will learn of the outcome soon. The hospital is developing protocols for treatment and we continue to expect data on the efficacy of our system for this indication during the second quarter. As a reminder, in evaluating this opportunity to help our frontline workers and patients, history showed a very successful approach to treating pneumonia with radiation going back nearly seventy five years. We engaged an outside physics lab to evaluate our radiation and provide us with a non biased opinion on whether or not our radiation could sufficiently penetrate the body to treat the lungs.

They published a paper that provided us the confidence that our SRT technology was capable of doing so. Our SRT systems are well suited for COVID-nineteen because they are portable and allow for bedside treatment in the ICU rather than transporting patients to a cancer treatment center for radiation therapy and possibly exposing vulnerable oncology patients to the virus. Turning now to our aesthetic lasers, we are approaching the launch of our new aesthetic lasers and the integration of the Sentinel IT Solutions software into the lasers. Phase one is complete. Sentinel provides asset management and HIPAA compliant patient data and storage capability and also contains the software necessary to support shared service models, including direct patient billing.

We expect the sale of aesthetic lasers will become a meaningful source of revenue, in particular as we roll out disruptive rental strategies. These strategies are designed to generate consistent revenue for Sensus, while providing physician customers with access to multiple lasers. We are also looking at expanding our mobile aesthetic laser business beyond Florida via strategic transactions. We will introduce our family of laser products with Sentinel, known as Smart Lasers, at the upcoming South Beach Symposium Aesthetic Laser Symposium being held in September at the Miami Diplomat Hotel. It will be a live event as over 1,000 dermatologists and plastic surgeons have already registered.

Sentinel IT has started to generate high margin recurring revenue. Although still early in its life cycle, Sentinel holds significant promise as an integrated feature not only with the new lasers, but also with the SRT-one 100 plus and the SRT-one 100 Vision. Turning now to our international efforts. Business in China looks very promising. Following the sale of three systems there during the 2020, we sold an additional system this past quarter.

We expect several more sales in the coming year. As of the start of the first quarter, we engaged a new distribution partner for China and Hong Kong. Our new VP of International Sales has developed an extensive network of prospects in China, and we're optimistic that China represents an excellent growth opportunity. In preparation for growth, we will be engaged with the Chinese health authority in renewing our license for another four years. This will be an expensive endeavor and will require almost the entire year to accomplish.

This will be our third license renewal. In addition, we are finalizing a new distributor in Taiwan and are preparing Sculptura for the regulatory process in China. Sculptura is our anisotropic radiation therapy with beam sculpting capabilities and robotic respiratory tracking for up to 17 different indications. During the first quarter, we were granted an important U. S.

Patent for Sculptura, which describes the method of beam splitting and sculpting. This patent covers 31 separate claims dealing with how our electron beam generator is able to sculpt and direct X rays precisely where they are wanted. The technology that's embedded in our Sculptura system differs from the conventional interoperative radiation therapy or brachytherapy systems in its ability to control the radiation beam and has a longer useful operating life. Ours is the first device in the world with this capability, and we believe it opens up new doors for the delivery of radiation to treat solid tumors of all kinds. In addition, there may be use for this technology in devices other than Sculptura as well providing potential licensing opportunities.

In the meantime, later this year, we expect our research partners at the University of Pennsylvania to begin supportive studies in breast and other cancers that have been on pandemic related hold. With that, I'll turn the call over to Javier Rampolo, our CFO, who will go over our Q4 and fully financial results in more detail. Javier?

Speaker 3

Thanks, Joe. It's a pleasure to be speaking with all of you this afternoon. As Joe mentioned, revenues for the 2021 were $3,100,000 and this compares with revenue of $1,700,000 for the 2020. Revenues for the twenty twenty one quarter reflect the sale of seven SRT systems, including six direct domestic sales and one system sold to China, as well as service contracts and our new mobile laser business. The twenty twenty quarter was impacted by the start of the COVID-nineteen pandemic.

Cost of sales for the 2021 was 1,500,000.0 compared with $1,000,000 for the prior year quarter. The increase was commensurate with higher sales during the 2021. Gross profit for the 2021 was $1,600,000 or 51.7% of revenue and this compares with gross profit of $700,000 or 42.2% of revenue for the prior year quarter. The increase in gross margin was primarily driven by the higher number of units sold in 2021, service revenue on installed units and the impact of COVID-nineteen on the 2020. Selling and marketing expense for the 2021 was $1,100,000 down from $1,800,000 for the 2020.

The 40% decrease was primarily attributable to lower threshold expense due to cancellations related to COVID-nineteen, reduced marketing activities including travel and lower salary and benefit expenses due to reduced headcount. General and administrative expense for the 2021 was 1,000,000 compared with $1,300,000 for the 2020. The 27% decrease primarily reflects lower salary and benefit expenses due to reduced headcount, partially offset by higher insurance premium costs. Research and development expense for the 2021 was $700,000 and this compares with $1,200,000 for the 2020. The 46% decrease was mainly due to lower expenses related to Sculptura development as Sculptura entered the production phase during 2020.

Sensors reported a net loss for the 2021 of $1,100,000 or $07 per share compared with a net loss for the 2020 of $3,600,000 or $0.22 per share. Adjusted EBITDA, which is defined as earnings before interest, taxes, depreciation, amortization and stock compensation expense was a negative $800,000 for the 2021 compared with a negative $3,300,000 for the 2020. Cash and investments were 13,700,000 as of 03/31/2021 compared with $14,900,000 as of 12/31/2020. The company had an approximately $200,000 in long term debt and no outstanding borrowings under its revolving line of credit at 03/31/2021. We're confident that with our continued attention to expenses, along with current cash and access to our existing revolving credit agreement, we continue to be financially well positioned to support our expected growth during 2021.

As a final comment, please see the table in the news release we issued earlier today for a reconciliation of GAAP to non GAAP financial measures. With that, I will turn the call back over to Joe.

Speaker 2

Thanks, Javier. I continue to voice my strong appreciation and admiration for our staff and the way they have maintained a focus on customers and patients throughout this pandemic. I believe we further strengthened those relationships and that we are poised to resume meaningful domestic growth with the worst of the pandemic behind us. We look forward to showcasing our SRT systems along with the Sentinel technology at the South Beach Symposium Aesthetic Laser Symposium in Miami and the Fall Clinical Dermatology Conference during October, which is another live show in Las Vegas. We're looking forward to that conference and especially to the prospect of seeing our industry colleagues once again in person.

I'll remind you that our products have enormous room to grow. Our SRT systems are well positioned in a large market consisting of some 14,000 dermatologists, 1,000 Mohs surgeons in The U. S, representing more than 7,500 offices and growing, not to mention a further 6,500 plastic surgeons and 5,500 radiation oncologists. Our SRT systems provide a compelling alternative to surgery for millions of patients and arguably the only solution to prevent the recurrence of keloids following surgical excision. With those comments, I'd like to thank you for your time and attention.

And now operator, we're ready to take questions.

Speaker 0

Absolutely. Thank you. Ladies and gentlemen, the floor is now open for questions. If you do have a question, please press star one on your telephone keypad at this time. If you're using a speakerphone, we ask that while posing your question, you just pick up your handset to provide favorable sound quality.

Again, ladies and gentlemen, if you do have a question or comment, And our first question comes from Yi Chen from H. C. Wainwright. Please state your question.

Speaker 4

Thank you for taking my questions. My first question is, do you expect any seasonality in terms of sales of SRT systems to China?

Speaker 2

That's hard to say because of the economic condition in China. I would have to say from our own viewpoint, because we have an upcoming licensing renewal coming up in November, we might see additional activity from customers or potential customers in wanting to order prior to that happening. We don't anticipate any problems with the renewal of the license. But in this political climate, we don't know. We can't answer that.

But we're hoping to see some additional orders between now and November from the China market.

Speaker 4

Got it. And second, could you give us an update on the capacity the dermatologist office in The U. S. Are operating at currently?

Speaker 2

I'm sorry, I didn't hear the end of the question, Yi.

Speaker 4

The capacity of dermatologists office in The U. S? Are they operating at pre COVID levels?

Speaker 2

Yes. I don't think that they are operating at pre COVID levels, especially in certain states where they still might have some very strict guidelines on how they can see patients and when they can see patients. I think that, for instance, in the state of Florida and some of the other Sunbelt states, would see some very, very active conditions. So I see the market there back to what it was pre COVID. So states like Florida, Texas, Arizona, I think those are very, very strong comeback states.

I'm not seeing as much in California and in New York. So I don't think that we're 100%, but I would think that we're about eighty percent to eighty five percent, ninety percent back to where we were pre COVID.

Speaker 4

Got it. Got it. And lastly, do you expect sales of aesthetic lasers to make a significant contribution to the top line revenue this year?

Speaker 2

I don't know if it will make a significant, but it will definitely give us a percentage of sales and I think that it will have an impact for us. So we're looking forward to getting those products on the market. And when I said that we went through Phase one, we just completed Phase one with the Sentinel product being implemented into the lasers. And so we are going to go on an aggressive marketing kick in the second quarter to talk about those lasers. But as in everything else, think the biggest opportunity we're going to have is at the South Beach Symposium, which is strictly aesthetic lasers, and that's where we'll be able to display the products as well as to explain directly to customers what the Sentinel package means to them.

Speaker 4

Got it. Thank you.

Speaker 2

Thank you, Yi.

Speaker 0

Thank you. And we'll take our next question from Anthony Vendetti from Maxim Group. Please go ahead.

Speaker 5

Thanks. Good afternoon Joe. Good afternoon Javier. How are you?

Speaker 2

Good afternoon Anthony. How are you? Good afternoon.

Speaker 5

Good, good. I just wanted to see what specific steps obviously eleven etwenty one is an important day for the company. It's been many years in the process of trying to increase reimbursement to put you on a level playing field. How have you gone about educating the market? What kind of steps have you taken?

Or has that been a little bit difficult as we're trying to emerge from COVID-nineteen?

Speaker 2

Well, I mean, we're obviously got some tough road ahead in the marketing side since we don't have meetings and we don't have a lot of face to face meetings. But we have conducted two Zoom meetings where we've had a little over 100 physicians attend each time. One was an evening session around 08:00 at night on a Thursday, which is amenable to a lot of doctors working after hours versus during the day. And then on a Saturday morning at 11:00 for a couple of hours where we had ACoS, the American Cutaneous Oncology Society project or introduce the reimbursement codes as they are right now. So those are two of the events that we've had and we've had some good turnout and some good interest as a result of that.

Again, getting back to the live shows where we've regularly done extremely well is going to be really helpful and we don't see any of those coming back until the fall clinical happens towards the end of the year. But we're going to continue to do the Zoom meetings on a regular basis. I think that we'll pick that up in the second quarter. And I think the third quarter all the way through to the end of the year, we'll be doing these on a regular basis. It's a matter of getting the proper doctors on at the right time when they're able to present.

So that's going to be the main thrust. We want to do it face to face, heart to heart and doctor to doctor.

Speaker 5

Sure. Understood. Obviously, that's always the desirable and more effective way to do it. Are you looking, Joe, right now to increase the sales force? Or are you taking it slow right now as each like you said, each geographical area is a little bit different in terms of how quickly they're opening up.

But I was just curious, what's the sales force or territory goal by the end of the year versus where you are right now?

Speaker 2

Yes. We've been very, very aggressive in building back up our sales force. I would tell you we're back to about ninety five percent of where we were prior to COVID. And I believe that by the end of the second quarter, we'll probably be over that amount where we ended up prior to COVID. So we're aggressively adding more people on board because the more people that we have on board, the more training that they're going to get and then the more education and training that we'll be able to get out to the field face to face.

And that's where we prefer to do our business. So we want to have a very strong sales force, bigger and better than we've ever had before to launch into the second half of the year.

Speaker 5

And Joe, the know you mobile aesthetic business. You're looking to expand outside of Florida. Have you identified certain territories where that makes sense to go next? And then just a little more color on your proprietary laser aesthetic laser launch.

Speaker 2

We've identified three cities that we want to go to with the growth in that area, Dallas, Atlanta and Scottsdale, Arizona, Phoenix area, those are the big markets that we want to attack. We've even looked at various opportunities, two to three different opportunities in those areas. And I'll say we're not looking for the biggest group in those areas. We're looking for the best group, the ones that have the longest and best relationships with their customer base as well as the ones that are the best operated. So that's what we're targeting there.

And the second half of your question, I'm sorry, was?

Speaker 5

On your proprietary aesthetic lasers that you're launching?

Speaker 2

Yes. The smart laser is something that we're bringing to the market that doesn't exist any with anybody else or with any other aesthetic laser manufacturer. So we've developed a system that can provide our customers as well as ourselves an asset management program that allows us to see where this product is in its daily utilization with the number of patients, the protocols that are being used, the patient data for the customers use only because it is HIPAA compliant. It will be they'll be able to store all that data and information on the cloud. There's billing capabilities where we can direct bill the accounts of the patients or their credit card, their bank account, all of those things can be pretty put.

And one of the first steps that we have and we already have a couple of our units already in motion in Central Florida. They're in a van and they're being used to service some of the customers that we have in Central Florida with the census name on the laser. So we're adapting it one scanner at a time and we're going to implement it in that vein. And hopefully, we'll start selling them directly as well, not just on the rental side, but also on the sales side.

Speaker 5

Okay, great. And then just one last question on Sculptura. I know that sales cycle is obviously longer since the ASP is much larger than on an SRT system. But any color on how those discussions are going? Any expectation at this point of maybe selling one of those before the end of the year?

What can you say about that?

Speaker 2

I think that it's hard to say that we're disappointed, although we are, okay. But with the pandemic, the pandemic has really put a lot of our major hospitals on their backside. I mean, I don't think that we really realize how this has impacted our overall healthcare system and what it does. I know what it's done to a lot of the hospitals in the area here in the state of Florida that surrounds our offices, but I also know what the hospitals that we're dealing with are going through and how it's impacted them. So we continue to push forward.

We have good relationships. As a matter of fact, we're looking at even extending those relationships for the time being. But the protocols are being put together and we fully expect that the patients will be treated and that sometime before the end of the year, we will have a bunch of patients that have been treated with results be better known to our market and to the rest of the world. How that impacts potential opportunities? We do have a nice list of prospects that continue to that we interact with on a regular basis.

They're all involved and in contact with our installation bases wanting to know where things go. But quite frankly, they all have a great understanding of what this COVID stuff has done to those hospitals. So they're not pressing it. They understand and they're anxious to get the results as well.

Speaker 5

Okay, great. I'll hop back in the queue. Thank you. Appreciate it.

Speaker 2

Thanks, Anthony.

Speaker 0

And there appear to be no further questions at this time. I'd like to turn the floor back over to Mr. Sordano for closing remarks.

Speaker 2

Thank you, Karen. So in closing, I want to thank you once again for your time this afternoon and for your interest in Sensus. We continue to move forward on multiple fronts and are optimistic about our prospects as we drive towards a more typical business pattern and hopefully begin to put the COVID-nineteen pandemic in the rearview mirror. Please stay safe everyone and look forward to talking to you. Thank you.

Speaker 0

Thank you. Ladies and gentlemen, this does conclude today's teleconference. We thank you for your participation. You may disconnect your lines at this time and have a great day.