Cautionary Statement Regarding Forward Looking Statements
The discussion contained in this Quarterly Report on Form 10-Q contains "forward-looking statements" within the meaning of Section 27A of the United States Securities Act of 1933, as amended, and Section 21E ofthe United States Securities Exchange Act of 1934, as amended. Any statements about our expectations, beliefs, plans, objectives, assumptions or future events or performance are not historical facts and may be forward-looking. These statements are often, but not always, made through the use of words or phrases like "anticipate," "estimate," "plans," "projects," "continuing," "ongoing," "target," "expects," "management believes," "we believe," "we intend," "we may," "we will," "we should," "we seek," "we plan," the negative of those terms, and similar words or phrases. We base these forward-looking statements on our expectations, assumptions, estimates and projections about our business and the industry in which we operate as of the date of this Form 10-Q. These forward-looking statements are subject to a number of risks and uncertainties that cannot be predicted, quantified or controlled and that could cause actual results to differ materially from those set forth in, contemplated by, or underlying the forward-looking statements. The "Risk Factors" section in our Annual Report on Form 10-K describes factors, among others, that could contribute to or cause these differences. Actual results may vary materially from those anticipated, estimated, projected or expected should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect. Because the factors discussed in the Risk Factors section of our Form 10-K could cause actual results or outcomes to differ materially from those expressed in any forward-looking statement made by us or on our behalf, you should not place undue reliance on any such forward-looking statement. New factors emerge from time to time, and it is not possible for us to predict which will arise. In addition, we cannot assess the impact of each factor on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statement. Except as required by law, we undertake no obligation to publicly revise our forward-looking statements to reflect events or circumstances that arise after the date of this Form 10-Q. The following discussion and analysis of our financial condition and results of operations are based upon our consolidated financial statements and the notes thereto included elsewhere in this Quarterly Report on Form 10-Q, which have been prepared in accordance with accounting principles generally accepted inthe United States . The preparation of such financial statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses. On an ongoing basis, we evaluate these estimates, including those related to useful lives of real estate assets, bad debts, impairment, contingencies and litigation. We base our estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. There can be no assurance that actual results will not differ from those estimates. The analysis set forth below is provided pursuant to applicableSEC regulations and is not intended to serve as a basis for projections of future events. Overview
Harbin Jiarun Hospital Company Limited ("Jiarun") was established inHarbin in the Province ofHeilongjiang ofthe People's Republic of China ("PRC") by the ownerJunsheng Zhang onFebruary 17, 2006 .
Harbin Jiarun Hospital Co., Ltd Nanjing Road Branch ("
Harbin Jiarun Hospital Co., Ltd Harbin New District Branch ("3rd
Jiarun is a private hospital serving patients on a municipal and county level and providing both Western and Chinese medical practices to the residents ofHarbin . Jiarun specializes in the areas of Pediatrics, Dermatology, ENT,Traditional Chinese Pharmaceuticals (TCM), Ophthalmology, Internal Pharmaceuticals Dentistry, General Surgery, Rehabilitation Science, Gynecology and General Medical Services. 2 OnNovember 20, 2013 ,Junsheng Zhang , the senior officer ofJiarun Hospital , establishedJRSIS Health Care Corporation , aFlorida corporation ("JHCC" or the "Company"). OnFebruary 25, 2013 , the officer ofJiarun Hospital establishedJRSIS Health Care Limited ("JHCL"), a wholly owned subsidiary of the Company, and onSeptember 17, 2012 , the officer ofJiarun Hospital establishedRunteng Medical Group Co., Ltd ("Runteng"), a wholly owned subsidiary of JHCL. Runteng, aHong Kong registered Investment Company, holds a 70% ownership interest inHarbin Jiarun Hospital Company Ltd , aHeilongjiang registered company. OnDecember 20, 2013 , the Company acquired 100% of the issued and outstanding capital stock ofJRSIS Health Care Limited , a privately heldLimited Liability Company registered in theBritish Virgin Islands , for 12,000,000 shares of our common stock. JHCL, through its wholly owned subsidiary,Runteng Medical Group Co., Ltd , holds majority ownership in Jiarun, a company duly incorporated, organized and validly existing under the laws ofChina . As the parent company, JHCC rely on Jiarun to conduct 100% of our businesses and operations. We have two sources of patient revenues: in-patient service revenues and out-patient service revenues. In addition to provide services to our patients, we also sell pharmaceutical pharmaceuticals to our patients. Revenues from such sales are included in either our in-patient service revenues or our out-patient service revenues. Our revenues come from individuals as well as third-party payers, including PRC government programs and insurance providers, under which the hospital is paid based upon local government established charges. Revenue from the sale of pharmaceuticals is recognized when it is both earned and realized. The Company's policy is to recognize the sale of pharmaceuticals when the title of the pharmaceuticals, ownership and risk of loss have transferred to the purchasers, and collection of the sales proceeds is reasonably assured, all of which generally occur when the patient receives the pharmaceuticals. Patient service revenue is recognized when it is both earned and realized. The Company's policy is to recognize patient service revenue when the medical service has been provided to the patient and collection of the revenue is reasonably assured.
Critical Accounting Policies and Management Estimates
In preparing our financial statements we are required to formulate accounting policies regarding valuation of our assets and liabilities and to develop estimates of those values. In our preparation of the financial statements for the year endedDecember 31, 2020 , there were two estimates made which were (a) subject to a high degree of uncertainty and (b) material to our results, as follows:
? The determination, as set forth in Note 3 to our Financial Statements, that
the
allowance for doubtful accounts of
our review of statements from Harbin Medical Insurance Management Center.
Generally, the Center sets for each hospital an insurance claim limit, even
though the hospital is not permitted to refuse to receive patients. If the
hospital receive too many patients, it will exceed the claim limit, and record
an excess insurance claim. The Center will pay part of the excess insurance
claim from an insurance regulatory fund that is shared among all local
hospital that have excess insurance claims, but full reimbursement is not
assured. In accordance with the principle of prudence, the Company made a
determination that any excess insurance claim outstanding for more than two
years without reimbursement should be treated as a doubtful account. As of
without reimbursement was$3,338,246 , which was treated as a bad debt.
? The determination to record depreciation of our principal medical property and
equipment over an average useful life of approximately twenty years. (A
quantification of that depreciation is set forth in Note 6 to our Financial
Statements.) The determination was based primarily on our expectation that the
useful life of our hospital facilities would exceed thirty years, based on the
experience of comparable facilities in our location. 3 Results of Operations
The following table shows key components of the results of operations during
three months ended
Three Months Ended June 30, Change 2021 2020 $ % Revenue: Pharmaceuticals$ 3,197,031 $ 1,755,488 $ 1,441,543 82 % Patient services 8,543,569 5,260,883 3,282,686 62 % Total revenue 11,740,600 7,016,371 4,724,229 67 % Operating costs and expenses: Cost of pharmaceuticals sold 2,339,126 1,305,784 1,033,342 79 % Medical consumables 2,762,254 1,804,470 957,784 53 % Salaries and benefits 3,153,356 1,953,341 1,200,015 61 % Office supplies 329,885 364,583 (34,698 ) (10 )% Vehicle expenses 77,956 81,683 (3,727 ) (5 )% Utilities expenses 121,645 85,538 36,107 42 % Rentals and leases 280,523 42,978 237,545 553 % Advertising and promotion expenses 1,077 (1 ) 1,078 (107800 )% Interest expense, net 440,652 280,933 159,719 57 % Convertible notes expense
- (343,905 ) 343,905 (100 )% Warrant expense (13,818 ) 196,212 (210,030 ) (107 )% Professional fee 11,237 11,969 (732 ) (6 )% Depreciation 804,072 579,065 225,007 39 % Total operating costs and expenses 10,307,965 6,362,650 3,945,315 62 %
Earnings from operations before other income and income taxes 1,432,635 653,721 778,914
119 % Other income (32,825 ) (6,960 ) (25,865 ) 372 % Earnings from operations before income taxes 1,399,810 646,761 753,049 116 % Income tax 376,723 243,679 133,044 55 % Net income 1,023,087 403,082 620,005 154 %
Less: net income attributable to non-controlling interests 356,737 111,865 244,872
219 % Net income attributable to the Company$ 666,350 $ 291,217 $ 375,133 129 %
Comprehensive income: Foreign currency translation adjustment attributable to non-controlling interests
140,750 24,656 116,094 471 % Foreign currency translation adjustment attributable to the Company 331,105 56,685 274,420 484 % Comprehensive income$ 1,494,942 $ 484,423 $ 1,010,519 209 % 4
The following table shows key components of the results of operations during six
months ended
Six Months Ended June 30, Change 2021 2020 $ % Revenue: Pharmaceuticals$ 4,961,332 $ 3,591,197 $ 1,370,135 38 % Patient services 14,105,502 9,413,173 4,692,329 50 % Total revenue 19,066,834 13,004,370 6,062,464 47 % Operating costs and expenses: Cost of pharmaceuticals sold 3,690,282 2,530,671
1,159,611 46 % Medical consumables 3,842,264 2,737,002 1,105,262 40 % Salaries and benefits 5,412,499 3,868,118 1,544,381 40 % Office supplies 577,303 560,180 17,123 3 % Vehicle expenses 119,398 127,818 (8,420 ) (7 )% Utilities expenses 347,655 305,483 42,172 14 % Rentals and leases 549,727 86,608 463,119 535 %
Advertising and promotion expenses 17,715 138
17,577 12737 % Interest expense, net 732,170 456,767 275,403 60 % Convertible notes expense - (322,363 ) 322,363 (100 )% Warrant expense 6,713 445,089 (438,376 ) (98 )% Professional fee 20,145 19,594 551 3 % Depreciation 1,612,046 1,159,012 453,034 39 %
Total operating costs and expenses 16,927,917 11,974,117 4,953,800 41 % Earnings from operations before other income and income taxes 2,138,917 1,030,253 1,108,664 108 % Other income (expenses) (36,601 ) (11,406 ) 25,195 221 % Earnings from operations before income taxes 2,102,316 1,018,847 1,083,469 106 % Income tax 583,307 300,848 282,459 94 % Net income 1,519,009 717,999 801,010 112 % Less: net income attributable to non-controlling interests 524,975 271,259 253,716 94 % Net income attributable to the Company$ 994,034 $ 446,740 $ 547,294 123 % Comprehensive income: Foreign currency translation adjustment attributable to non-controlling interests 118,160 (119,459 ) 237,619 (199 )% Foreign currency translation adjustment attributable to the Company 279,946 (287,142 ) 567,088 (197 )% Comprehensive income$ 1,917,115 $ 311,398 $ 1,605,717 516 % 5 Revenue Operating revenue for the three and six months endedJune 30, 2021 , which resulted primarily from pharmaceuticals revenue and patient services revenue, was$11,740,600 and$19,066,834 , an increase of 67% and 47% as compared with the operating revenue of$7,016,371 and$13,004,370 for the three and six months endedJune 30, 2020 . Revenue from the sale of pharmaceuticals increased by 38%, while revenue from provision of patient services increased by 50% for the six months endedJune 30, 2021 . The year-to-year increase was primarily a result of the partial alleviation of restrictions imposed by government agencies in 2020 on business operations withinHarbin City in order to control the spread of COVID-19 in 2020. These restrictions limited our ability to perform non-emergency medical services, which caused the number of treated inpatients during the first half of 2020 to fall by 41% to 5995 patients, compared with the 10229 patients treated atJiarun Hospital in the first half year of 2019. Revenue in the first half of 2020, therefore, fell by 14% compared to the first half of 2019. During the first half of 2021, however, restrictions on business operations inHarbin City were reduced, resulting in an increase in patients treated atJiarun Hospital by 17% to 7017, compared with the 5995 patients treated atJiarun Hospital in the first half year of 2020.
Operating Costs and Expenses
Total operating costs and expenses were$10,307,965 and$16,927,917 for the three and six months endedJune 30, 2021 , an increase of$3,945,315 or 62% as compared to$6,362,650 for the second quarter of 2020, and an increase of$4,953,800 or 41% as compared to$11,974,117 for the first half year of 2020. The primary reasons for the increase in costs and expenses during the six months endedJune 30, 2021 were:
?
the cost of medical consumables. These 46% and 40% increase in expenses
attributable to pharmaceuticals and medical consumables were primarily related
to the 50% increase in patient service revenue. Medical consumables mainly
consist of materials expenses, medical repair expenses and test reagents. The
largest components of the increase was the increase in materials expenses of
$406,320 .
?
in salaries, and
increase in our labor costs was primarily caused by the revenue increase
attributable to the hospitals, as we incurred labor costs in preparation for
full scale operations of our branch hospitals.
?
of leases for property related to our new 3rdBranch Hospital
?
because we increased the book value of our property and equipment as a result
of additional property and equipment placed in service by
2020, which led to a 39% increase in depreciation during the first half year
of 2021. Income Taxes Corporate Income Tax (CIT) is determined under the Provisional Regulations of PRC Concerning Income Tax on Enterprises promulgated by the PRC. Income tax is payable by enterprises at a rate of 25% of their taxable income. According to the PRC "Notice on Preferential Corporate Income Tax (CIT) Treatment for Eligible Equipment or Machinery (Cai Shui [2018] No. 54)", a 100% immediate tax deduction for CIT purposes is allowed for purchases of equipment on the condition that the unit price of each item of equipment or machinery is individually less thanRMB5 million . Depreciation for tax purposes is not required. Basis differences between tax and GAAP for depreciation of property and equipment exist because in the first half year of 2021 the Company purchased Eligible Equipment forRMB 4.2 million , with$8,348 deferred income tax, creating differences between the tax treatment mandated by the Chinese government and GAAP tax treatment.
Income from operations and net income
Income from Operations was$2,138,917 for the six months endedJune 30, 2021 , as compared with operating income of$1,030,253 for the six months endedJune 30, 2020 . After deducting other income and expenses as well as the provision for income tax, the Company's net income for the six months endedJune 30, 2021 was$1,519,099 , representing an increase of$801,010 or 112%, from$717,999 recorded for the six months endedJune 30, 2020 . The increase of income from operations and net income for the six months endedJune 30, 2021 were primarily due to aforementioned changes in operating revenue and expenses. Our net income was produced by Jiarun. Because we own only 70% of the equity interest in Jiarun (the other 30% being owned by our Chairman,Junsheng Zhang ), we reduced our net income for the six months period endedJune 30, 2021 and 2020 by an allocation to the "non-controlling interests" of$524,975 and$271,259 , respectively, before recognizing net income attributable to the Company. After those allocations, our net income attributable to the Company for the six months endedJune 30, 2021 and 2020 was$994,034 ($0.054 per share) and$446,740 ($0.025 per share), respectively. 6
Foreign Currency Translation Adjustment.
Our reporting currency is theU.S. dollar. Our local currency, Renminbi (RMB), is our functional currency. Results of operations and cash flows are translated at average exchange rates during the period, and assets and liabilities are translated at the unified exchange rate as quoted by thePeople's Bank of China at the end of the period. Translation adjustments resulting from this process are included in accumulated other comprehensive income in the statement of stockholders' equity. Transaction gains and losses that arise from exchange rate fluctuations on transactions denominated in a currency other than the functional currency are included in the results of operations as incurred. For the six months endedJune 30, 2021 and 2020, foreign currency translation adjustments of$398,106 (of which$118,160 was attributable to the non-controlling interest) and$(406,601) (of which$(119,459) was attributable to the non-controlling interest), respectively, have been reported as other comprehensive income in the consolidated statements of operations and comprehensive income.
Liquidity and Capital Resources
As ofJune 30, 2021 , the Company had$312,771 of cash and cash equivalents, a decrease of$532,056 from our cash balance atDecember 31, 2020 . The decrease was primarily caused by our investing activities, particularly the expansion of our facilities, which used$2,096,489 of cash during the first half year of 2021.
Our working capital deficit at
Our working capital deficit limits our ability to finance expansion. It is noteworthy, however, that our current liabilities include$99,500 in amounts due to related parties, all of which is owed to our Chairman,Junsheng Zhang , and$2,921,459 representing the current portion of our lease obligations, most of which is also owed to Chairman Zhang. We believe, therefore, that our liquidity is adequate to continue operations at our current level and fund a modest expansion program. Although our current resources and cash flows are adequate to pay our current ongoing obligations, we anticipate that our future liquidity requirements will arise from the need to fund our growth and future capital expenditures. The primary sources of funding for such growth requirements are expected to be additional funds raised from the sale of equity and/or debt financing. However, we can provide no assurances that we will be able to obtain additional financing on terms satisfactory to us.
Cash Flows and Capital Resources
Our cash flows for the first half year of 2021 and 2020 are summarized below: Six Months Ended June 30, 2021 2020 Net cash provided by operating activities 3,619,288 3,191,428 Net cash used in investing activities (2,096,489 ) (1,763,279 ) Net cash used in financing activities (2,004,971 ) (1,528,349 ) Effect of exchange rate fluctuation on cash and cash equivalents (49,884 ) (22,970 ) Net decrease in cash and cash equivalents (532,056 ) (123,170 ) Cash and cash equivalents, beginning of period 844,827 1,971,129 Cash and cash equivalents, ending of period$ 312,771 $ 1,847,959
As ofJune 30, 2021 , the Company had$312,771 of cash and cash equivalents, a decrease of$532,056 from our cash balance atDecember 31, 2020 . The decrease occurred because our operations during the first year of 2021 yielded$3,619,288 in cash but our investing activities and financing activities combined used
$4,101,460 in cash. 7
Net Cash Provided by Operating Activities
For the six months endedJune 30, 2021 , we had positive cash flow from operating activities of$3,619,288 , an increase of$427,860 from$3,191,428 for the six months ended Jene 30, 2020. In addition to the$1,519,009 in net income during the 2021 period, there were$1,612,046 depreciation and$732,170 interest expenses non-cash items adjustments; the major cash flow from operations increased in accounts payable by$2,123,393 while reduced inventory balance by$295,995 which offset by$1,731,422 increased in related parties prepayment and$669,494 in net accounts receivable.
Net cash used in investing activities for the six months endedJune 30, 2021 was$2,096,489 , compared to net cash used in investing activities of$1,763,279 for the six months endedJune 30, 2020 . The cash used in investing activities for the six months endedJune 30, 2021 and 2020 was mainly used for the purchase of medical equipment and payment of Construction in progress relating to the opening of our new 3rdBranch Hospital .
Net cash used in financing activities for the six months endedJune 30, 2021 was$2,004,971 , as compared to net cash used in financing activities of$1,528,349 for the six months endedJune 30, 2020 . The cash used in financing activities for the six months endedJune 30, 2021 was mainly due to accounts of finance lease and interest expenses, while for the six months endedJune 30, 2020 cash was also used to satisfy convertible notes we had sold. Although our current resources and cash flows are adequate to pay our current ongoing obligations, we anticipate that our future liquidity requirements will arise from the need to fund our growth and future capital expenditures. The primary sources of funding for such growth requirements are expected to be additional funds raised from the sale of equity and/or debt financing. However, we can provide no assurances that we will be able to obtain additional financing on terms satisfactory to us.
Trends, Events and Uncertainties
The COVID-19 pandemic has had a significant adverse impact and created many uncertainties related to our business, and we expect that it will continue to do so. The Company is experiencing challenges in sales and has suffered a significant decrease in revenues which has increased financial uncertainty. Our future business outlook and expectations are very uncertain due to the impact of the COVID-19 pandemic and are very difficult to quantify. It is difficult to assess or predict the impact of this unprecedented event on our business, financial results or financial condition.The China Ministry of Health , as well as other related agencies, may change the monetary amounts we can charge for medical services, drugs and medications. We cannot predict the impact of these proposed changes since the changes are not fully defined and we do not know whether such changes will ever be implemented or when they may take effect.
We plan to acquire other hospitals and companies involved in the healthcare industry in the PRC using cash and shares of our common stock. Substantial capital may be needed for these acquisitions and we may need to raise additional funds through the sale of our common stock, debt financing or other arrangements. We do not have any commitments or arrangements from any person to provide us with any additional capital. Additional capital may not be available to us, or if available, on acceptable terms, in which case we would not be able to acquire other hospitals or businesses in the healthcare industry. Other than the factors listed above we do not know of any trends, events or uncertainties that have had or are reasonably expected to have a material impact on our net sales or revenues or income from continuing operations. Our business is not seasonal in nature. 8
Off-Balance Sheet Arrangements
We do not have any off-balance sheet items reasonably likely to have a material effect on our financial condition.
Recent Accounting Pronouncements
Recent accounting pronouncements issued by the FASB, the AICPA and the
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