All right, hello everyone, and thank you for continuing to join us throughout the day here at the Lytham Partners Fall 2025 Investor Conference. My name is Robert Blum, Managing Partner at Lytham, and today we have Tom Vo, the Chairman and CEO of Nutex Health, joining us to walk through the company's slide presentation. As a reminder, Nutex trades under the ticker NUTX on the NASDAQ. Tom, welcome, and I'll turn the floor over to you to get started. Excellent, excellent. Thank you, Robert, and thank you, Lytham, for inviting us to this wonderful conference. Once again, my name is Tom Vo. I'm the CEO and Chairman of Nutex Health. A little bit about my background. I've been in healthcare for about 30 years, basically my entire professional career. I started out as an emergency physician. I worked for a good 15 years in a very busy hospital in Houston. Around 15 years ago, roughly around 2010, 2011, I founded Nutex, and we've been operating as a micro-hospital company ever since. You can take a look at our management team, very deep bench, very experienced, and we have a lot of knowledge in this space that I think probably rivals probably any other company that's out there from a micro-hospital standpoint. Next, Jennifer. Mission, very important. Our mission is to provide accessibility to care to the patients, but not just accessibility. Accessibility on a concierge level, which basically means that we go the extra mile for that patient, which is kind of unusual in healthcare, where people, a lot of times, patients feel like they're treated more like a conveyor belt, more so than a patient. Our mission really is to change that, to make patients feel a lot more comfortable and a lot more well cared for. I'll talk a little bit about how we achieve that from a cultural standpoint, financial standpoint, and alignment standpoint. Our vision is definitely to be the leader in the micro-hospital industry, and we are definitely the leader in the micro-hospital industry. The reason I say that is because we get requests from all over the country to open these small hospitals. In fact, literally, as an example, today we've had requests to open something in Florida and Arkansas and Idaho, Nebraska. My point is that there's not a lack of demand out there for our services. Our values are very simple. We put patients first, and that's part of our concierge level care. Our opinion is that as long as you treat the patient fairly and well, and in a timely manner, then everything will fall into place. At a glance, our business, we essentially operate two divisions. The first division, and the much larger division, I would say 95% of our revenue comes from our micro-hospital business. I'll explain what a micro-hospital is. In essence, we have 24 locations in 11 states, and we have roughly a cadence of about four hospitals opening per year. Like I mentioned before, we get requests all over the country, and our pipeline is very, very healthy. We do have three hospitals planned to open by the end of this year. By the end of this year, we should have 24 locations, I'm sorry, 27 locations by the end of 2025, assuming that construction goes well. The other division is our population health division. The population health division, even though it's much smaller, is roughly 5% of our revenue, but it is very important. We see the population health as a very good adjunct and a symbiotic relationship to our hospital. I can explain that a little bit better. In essence, the population health is essentially a collection of primary care doctors that we put around our hospital. The whole idea is to refer those patients from those doctors to our own hospitals and vice versa, and basically set up a network of hospitals and physicians in the community. Once again, what we're doing here is very unique. There are just not a lot of companies around the country that are doing what we're doing. The next aspect of our company, once again, that is very, very unique, is that we tend to align very well with our local doctors. In other words, wherever we go around the country, we try to find great local doctors, and we align with those doctors. Not just from a strategic standpoint, but also from a financial standpoint, so that we align perfectly. This is one of the reasons why the doctors and the nurses tend to go the extra mile for the patient to provide that concierge level care. Okay, next, go ahead, Jennifer. Okay, what exactly is a micro-hospital? A micro-hospital is essentially a small licensed hospital. I think we all know what a big hospital system is, and most of these big hospital systems are sort of like the size of the Empire State Building, very, very large. Our hospital is much smaller. I would say it's analogous to the size of, say, Walgreens or CVS, roughly 20,000 sqft. The location of these hospitals is also in a very high density, high traffic area, sort of like a destination standpoint, very visible, so that we make it very convenient for the patient to go in and go out. The hospital, in essence, because it is licensed as a hospital in each of the states, has all the prerequisites of a hospital. It's got an emergency room, which is open 24/7, and we staff that with board-certified emergency physicians and emergency-trained nursing staff. We have in-house pharmacy, in-house lab, in-house radiology suites, most of the time containing CT, X-ray, ultrasound, MRI. We have inpatient beds also. When a patient comes in, we could either treat and discharge to a discharge home, or we could also admit that patient to our hospital if needed. It's a very unique model, which there's just not a lot around the country. Our aim is to build as many of these around the country as we can. Even though these hospitals have a small footprint, it is definitely a hit and a crowd pleaser wherever we put these hospitals. Wherever we put these hospitals, if you take a look at, say, our Google or Facebook reviews, you're going to see that we're four and a half to five stars, pretty much at every hospital. The point is that patients love our service. They get treated very, very well, and they're very happy after they visit us, which is very, once again, which is very unusual in healthcare. Most people, when you talk to them, they're just not happy with their hospital services. In our case, they're very happy. We aim to continue with this model and take it around the country due to the high demand. Okay, next, Jennifer. What kind of things do we treat at our hospital? Remember, we have a 24/7 emergency room that opens around the clock. Anything that the patient feels is an emergency, they could come to us. We see everything from runny nose to broken bones to gunshot wounds to knife stab to major car accidents to abdominal pain. I would say that the majority of our patients are in what I would call the mid-acuity, sort of like mid-acuity spectrum. By that, I mean on the much lower acuity spectrum, and you can see there on the left there, which says non-urgent. In the U.S., there are a lot of providers that already provide sort of like this very non-urgent spectrum of care. These are like the urgent cares, the Walmart clinic, the CVS clinic, the primary care doctor's clinic. These providers already provide that service. If a patient has something that is low, very low level, unless it's like a 2:00 A.M. or something along that line, when these clinics close, they usually don't come to us for that. On the other side of the spectrum, you can see number one there on the right side, the immediate care. These are your typical hospitals, the large county hospital or the large privately-profit or nonprofit hospitals that have 500 beds, right? These hospitals are there to see pretty much anyone that walks through the door. The problem with that is that a lot of these hospitals are just very inundated with patients. You hear a lot of horror stories about how patients would have to wait eight hours, nine hours, for something that could be taken care of very, very fast. We believe that that is our niche. That's where we're coming. We specialize in sort of like the middle there, the two, three, and four, the semi-urgent, urgent, or emergent type kind of cases. These are sort of like what I would call mid-acuity cases. These are like abdominal pains, headaches, chest pain, something that can't really be treated at an urgent care. When they go to, say, a big hospital system, they would have to wait simply because they have a lot of sicker patients that take precedent over them, which is the correct way to do it at the big hospital systems. Wherever we go, we sort of like put ourselves in that mid-acuity range. In fact, we get a lot of referrals from urgent cares, right? When patients come in, when patients get sick, sometimes they don't know exactly what they have. They tend to go to the urgent care first. Afterwards, when the urgent care determines that the patient is a lot sicker than what they could handle, then they send them to us. The urgent care is actually a big referral source for us. Okay, next slide. What is the typical sort of like unit economics of a micro-hospital? The beauty with our model is that we're fairly cost-efficient. By that, I mean we really focus on maybe three or four service lines. We have the emergency room, we have the outpatient imaging, outpatient labs, and we have the inpatient side. That's basically it. It's a relatively low-cost model. We collect at a hospital rate, and our collection is basically the same as what all the other hospitals get, but yet our cost is a little bit less. I think that's where the unit economics come into play. Once again, I mentioned that the hospital is about the size of a, say, a CVS or a Walgreens space. It's about 20,000 sqf t. We typically have roughly four to ten beds, and then roughly 4- 10 inpatient beds. I mentioned before about all the necessity requirements for a hospital, so CT, X-ray, ultrasound, labs, pharmacy, and so on and so forth. Places we typically put these hospitals are more of an urban area that is sort of like away from where all the medical centers are. We typically target more of a blue-collar working-class population because we feel that that is the population that needs our service the most and that really could benefit from a fast, efficient emergency care. Right now, if we're not there, then these sort of like blue-collar type kind of works would have to go to the bigger hospitals where they would have to wait a very long time in most cases. I think that's where we can make the biggest difference. The cost to open one of these hospitals is roughly $4.5 million- $5 million. If you break it down, I would say half of that would be the equipment. We're talking CT, X-ray, ultrasound, lab equipment, tables, chairs, stretchers, things like that. The other half would be the working capital to get it from opening day up to whenever we break even and become profitable. Speaking of profitability, we typically pro forma around 12 - 15 months in order to break even. Sometimes the break-even point is a lot faster than that. Sometimes it's a little bit slower than that. In other words, another way to think about this is that let's just say we break even around, say, 20 patients a day, 20 patients a day. Some facilities, depending on the location that we pick, get up to 20 patients a day within the first couple of months, right? In those scenarios, we basically break even within a couple of months. However, other facilities may take a little bit longer, 12 - 15 months, to get up to 20 patients a day, as an example. The point is that a lot of this also depends on the need, the supply and demand, and how fast you could get up to that, say, magic break-even number, right? A lot of this also just depends on the location and the dynamics of providers and supply and demand in each of those locations. Okay, let's go to the next slide. I talked a little bit about the IPA or the population health. I'm just going to take a quick second to go over that. The way to think about population health, IPA division, is that the IPA is essentially a collection of primary care doctors around our hospital. Not only primary care doctors, but some specialists also, non-hospital-based, right? The idea is that we take the patients of these doctors, we then basically put them into an IPA, and then we contract with the insurance company. We go sort of like full risk from that standpoint. That's basically the way that the IPA works. The other dynamics of that is that those patients from those primary care doctors need to go somewhere whenever they need a hospital visit, right? Everybody, unfortunately, will need to see a hospital sometimes or another in their life, unfortunately. When that happens, we would basically ask those doctors to send their patients to our own hospital, which is basically the same team, right? Nutex Health owns both the hospital as well as the IPA. We form essentially one sort of like network. The other benefit of that is this care is much better. It's much more coordinated so that if a patient from a primary care doctor comes to our hospital, the primary care doctor and our doctor already know each other. They already correspond. They already talk. When that patient from the clinic comes to our hospital, the doctor already knows what to do, already has a game plan in place. Whereas currently, if we don't exist, the patient from the clinic typically goes to an unknown hospital, third-party hospital, and there's no communication. These patients tend to wait a long time, and not only that, the care is not as coordinated. In addition to potential cost savings, the patient's care is much better when we're able to do this. Obviously, this is something that we want to expand on. This is certainly one of the biggest growth levers that we have because right now we have four IPAs in the country. We have Los Angeles, Houston, Miami, and Phoenix. Our goal is to put one of these IPAs around each of the hospitals because we really believe in the symbiotic relationship between these IPAs and the hospital. You could get, number one, better coordinated care, maybe a lower cost of care, and obviously it's a win-win for everybody when that happens. Okay, next. All right, this chart here basically just shows the symbiotic relationship between the hospital and the IPA clinics that we just discussed. We could skip this slide. Next. Growth opportunities. I sort of mentioned a little bit before about how we grow. Let's just start on the hospital side. On the hospital side, the primary growth lever is new construction. The reason that we have to build these from the ground up is because these micro-hospitals just don't exist. If we want to operate a hospital, we have to build it from the ground up because they're not out there. It's not like you could just take over an office space and then lease it. It doesn't work like that for us. We have to build it from the ground up if we want to operate it. There are some nuances and some construction and development issues with that, but we're definitely doing it. Like I mentioned before, we plan, we target on opening three to five hospitals per year. That is in the works. In fact, I'm looking at my board right now. We have roughly 15 projects in the works, and we're already working on the 2027 and 2028 pipeline. That's a very robust pipeline. The second way to grow a hospital is obviously to acquire an existing hospital, but like I mentioned before, these things just don't exist. Once in a while, if you see a hospital that we could acquire, then we definitely would try to acquire them. If not, then it's much easier and more cost-efficient to build it from the ground up. That's on the hospital side. On the IPA side, I mentioned before, I think there's a lot more leeway and a lot more opportunity to purchase because right now we have four IPAs, but we have 24 hospitals. If we're going to try to put an IPA around each of the hospitals, it may be easier to purchase existing IPAs so that we could sort of like put them around the hospital and not have to build it from the ground up. That's certainly one growth lever that we have. Other growth levers include joint ventures with existing hospital systems and work with them to build out their own micro-hospital system or IPA. However, we have not done that in the past, simply because we really value our independence. We have the infrastructure to build out these hospitals. We may or may not need the help of a much bigger hospital system, although we're always open to doing these types of joint ventures. Next. Okay, so I'm going to talk 10 more minutes. I'm going to talk a little bit about our financials and where we were and where we think, I think that we're going to be going in terms of our payer mix dynamics. We were a private company for about a good 10 or 12 years before we became public. Very profitable margins, like 30%, 40% every year. We became public in 2022. You can see on the graph here, 2022 and 2021. 2020, 2021, very nice, healthy margins. The one year that we became public, we were hit with what's called the No Surprises Act, which essentially is a regulation that was designed to prevent malice billing and surprise billing, which we agree with 100%. However, because of the vague language in that act, it caused our revenue to drop by about 35%, as you can see here. From 2021 to 2022, the only thing that the public investors saw was our revenue dropped by about 35%, and that went straight to the bottom line, right? From $145 million in adjusted EBITDA down to $12 million in 2022. 90%. Companies saw, they didn't know that we were operating at 30%, 40% in the past 10 years. That was a bit of a shocker to us. The good news is that we just basically put our head down and continued to operate, continued to refine that process. We actually, and because of that, and in fact, this may be the best thing that's ever happened to us, we basically put our head down and did everything we can to increase volume, increase inpatient admissions so that we could get more patients into the hospital and then find ways to get increased reimbursement from the insurance company. It took us about two years to do that. By the end of 2024, it seemed to work because we were able to get our revenue and our margins back to almost where we were before the No Surprises Act hit. The way that we did that was a combination of increased volume, increased admission to our hospital, and then most importantly, we used what's called an arbitration, which was built inside the No Surprises Act in order to force the insurance company to pay a much more fair and reasonable number, consistent with how we were getting it prior to the No Surprises Act. I'm just going to spend maybe a minute to talk about the arbitration process. Arbitration basically is a tool that was built into the No Surprises Act. When Congress passed the No Surprises Act, they basically told providers and the insurance company to basically leave the patient alone. If there is a dispute between the provider and the payer, leave the patient out of it. The only thing that the patient has to pay is their responsibility, which we agree with. I mean, we never bill the patient anything more than that. If there's a disagreement between the providers and the payers, they're going to give us a tool so that we could sort of like negotiate among ourselves. That tool is arbitration, right? Arbitration, even though it was in the No Surprises Act in 2022, was not very refined, not very smooth, not very user-friendly. It took about two years for CMS to get it up and operational and more efficient and cost-effective. It wasn't until July of 2024 that we started using that. When we started using that, we had very good success. In fact, we were winning, I would say, 85% of the time. That basically sort of proved that insurance companies were paying very, very low. It took a third-party independent arbitrator to prove that they were paying low to begin with. Now we feel that we're getting paid fair and reasonable according to what all the other hospitals that are similar to us are getting paid. Let's go to the next slide. That trend continues from the end of 2024 into the first quarter of 2025 and into the first quarter into the second quarter of 2025. I don't have the second quarter of 2025 yet because we have not filed that, but we will. The point is that the trend continues, and we feel very confident that this is not going anywhere anytime soon. We feel that arbitration is a good tool to have simply because Congress has already told us that since the patients are not to be saddled with any bill, this is the best tool for us to negotiate. We're just basically following the rules and following the laws that are in place today so that we could get a fair and reasonable number. I could talk more about that if there's more questions on an individual investor call. In essence, we feel that we're back to where we were as a private company. Even though it looks like we're so much more profitable now, which we are compared to the past two years, we're just operating like we've been doing for the past 12 years, which is, you know, our normal sort of like cadence in terms of operating margin. Okay, next. Okay, so this is our board here. Once again, very deep bench, a lot of healthcare experience. In fact, most of the guys here have knowledge that I don't think anybody around the country has simply because we do so much work in micro-hospitals, in the arbitration process, No Surprises Act, that I think there's just not a lot of people around the country that are doing what we're doing and that have the same knowledge and expertise as we do. Next. Okay, so investment highlights. Obviously, we're very bullish on our model. It's a model that is very well received by the public. It is something that, like I mentioned, is a crowd pleaser, and we get requests to open this pretty much anywhere. Our problem is keeping up with demands and ramping up resources so that we could open these in an area where we could provide the most help as well as provide the best investment for our investors. We have a very deep bench in terms of management team. I think not to sort of tap ourselves on the back, but because we've been doing this for so long, we just know as much about this as anyone else in the country. Our long-term alignment with our physicians, I think, is a very good strategy. It is just very different. There's just not a lot of systems out there that align with the doctors, but we do. We believe that by aligning with the doctors and the nurses, we feel that we could make this a very long-term sustainable business and provide the best patient care that provides the concierge level care that is in our mission. We have a lot of ways to grow: new hospital acquisition, new Independent Physician Associations, acquisition, partnership. There are just a lot of ways for us to continue to grow. Our Independent Physician Association is, once again, a complement to our hospital. Even if they're break-even and not making money, the fact that they could refer patients to our hospital is already a big win. In terms of the cost of real estate, we do have a third-party vendor, our developers that will finance the real estate for us. All we need to do is basically sign a long-term lease from a public company standpoint. You can see that in our balance sheet. They're under the lease liabilities. We don't have to spend any money on that. We just have to sign a long-term lease. Because of all the, unfortunately, controversy surrounding the arbitration process and the No Surprises Act, this is, in my opinion, a great opportunity for any investor out there. Obviously, the longer we go and the longer that we prove our model, the better it's going to be. Because of all the noise, this is a good investment opportunity, in my opinion. We already talked about the strong management team between myself, our management team, our board, and all of our doctors out there. We have probably roughly 300 doctors that partner with us around the country. All of them are leaders in their community. Combined, we have a very strong management team. That's all I have, Robert. I think we're right on time. Look at that. Fantastic. Tom, thank you so much for the presentation. Very informative. I want to thank everybody here for watching. If there are any questions or you would like to schedule a one-on-one meeting here during the conference with management, shoot me an email. That's blum@Lythampartners.com. Learn more about Lytham. You can visit our website or make sure to follow us on LinkedIn so you can be alerted to future events like this recording here with Nutex. Again, thank you so much, Tom, for your presentation. We hope everyone has a great conference. Yep. Thank you, Robert.