Item 9A. Controls and Procedures
Item
9A. Controls and Procedures
Evaluation
of Disclosure Controls and Procedures
Our
management, with the participation of our Co-Chief Executive Officers and Interim Chief Financial Officer, based on the Internal Control-Integrated
Framework (2013 framework) issued by the Committee of Sponsoring Organizations of the Treadway Commission (“COSO”), evaluated
the effectiveness of our disclosure controls and procedures as of December 31, 2025 as required by Rules 13a-15(b) and 15d-15(b) of the
Exchange Act. The term “disclosure controls and procedures,” as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange
Act, means controls and other procedures of a company that are designed to ensure that information required to be disclosed by a company
in the reports that it files or submits under the Exchange Act is recorded, processed, summarized and reported, within the time periods
specified in the SEC’s rules and forms.
Disclosure
controls and procedures include, without limitation, controls and procedures designed to ensure that information required to be disclosed
by a company in the reports that it files or submits under the Exchange Act is accumulated and communicated to the Company’s management,
including its principal executive and principal financial officers, to allow timely decisions regarding required disclosure. Management
recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving
their objectives and management necessarily applies its judgment in evaluating the cost-benefit relationship of possible controls and
procedures.
Based
on the evaluation of our disclosure controls and procedures, as of December 31, 2025, our Co-Chief Executive Officers and Interim Chief
Financial Officer concluded that, as of such date, our disclosure controls and procedures were effective. Our management, including our
Co-Chief Executive Officers and Interim Chief Financial Officer, have concluded that the consolidated financial statements in this Annual
Report on Form 10-K fairly present, in all material respects, our consolidated financial condition, results of operations and cash flows
for the periods presented in accordance with U.S. generally accepted accounting principles.
57
Management’s
Report on Internal Control over Financial Reporting
Our
management is responsible for establishing and maintaining adequate internal control over financial reporting, as such term is defined
in Rule 13a-15(f) and 15d-15(f) of the Exchange Act. Internal control over financial reporting is a process designed to provide reasonable
assurance regarding the reliability of financial reporting and the preparation of financial statements for external reporting purposes
in accordance with generally accepted accounting principles. Internal control over financial reporting includes those policies and procedures
that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions
of our assets; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements
in accordance with generally accepted accounting principles, and that our receipts and expenditures are being made only in accordance
with authorizations of our management; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized
acquisition, use, or disposition of our assets that could have a material effect on the consolidated financial statements.
Management
is required to base its assessment on the effectiveness of our internal control over financial reporting on a suitable, recognized control
framework. Management has utilized the criteria established in COSO to evaluate the effectiveness of internal control over financial
reporting. A material weakness is a deficiency, or a combination of deficiencies, in internal control over financial reporting such that
there is a reasonable possibility that a material misstatement of the Company’s annual or interim financial statements will not
be prevented or detected on a timely basis.
Our
management has performed its assessment according to the guidelines established by COSO. Management excluded MAP App, Medsphere and RevNu
from its assessment of internal controls over financial reporting, our current year acquisitions, as it was not possible to conduct an
assessment of the acquired businesses’ internal controls over financial reporting in the period between the commencement date and
the date of management’s assessment. During 2025, the net revenue recorded by the Company for MAP App, Medsphere and RevNu was
approximately $226,000, $10.5 million and $882,000, respectively and the net assets acquired were approximately $625,000, $16.5 million
and $565,000 respectively, including goodwill. Our management concluded that as of December 31, 2025, the Company’s internal control
over financial reporting was effective.
Management
has performed analysis and procedures in preparing our consolidated financial statements. We have concluded that our consolidated financial
statements fairly present, in all material respects, our financial condition, results of operations and cash flows at and for the periods
presented.
Because
of its inherent limitations, our internal controls over financial reporting provide reasonable, not absolute, assurance that the consolidated
financial statements and notes thereto are free of material error. In addition, no internal control structure can provide absolute assurance
that all instances of fraud have been detected. Also, projections of any evaluation of effectiveness to future periods are subject to
the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies and
procedures may deteriorate.
Tanner
LLP, an independent registered public accounting firm, has audited the consolidated financial statements as of December 31, 2025 and
for the year then ended included in this Annual Report on Form 10-K and, as part of their audit, has issued their attestation report,
included herein, on the effectiveness of our internal control over financial reporting.
Changes
in Internal Control over Financial Reporting
During
the fourth quarter of 2025, there were no changes in our internal control over financial reporting (as defined in Rule 13a-15(f) of the
Exchange Act) that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
Item
9B. Other Information
During
the quarter ended December 31, 2025, none of the Company’s directors or officers (as defined in Rule 16a-1(f) of the Exchange Act)
adopted , modified or terminated a Rule 10b5-1 trading arrangement or non-Rule 10b5-1 trading arrangement (as such terms are defined in
Item 408 of Regulation S-K).
Item
9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections
Not
applicable.
58
PART
III
Item
10. Directors, Executive Officers and Corporate Governance
Information
required by this item will be included in our definitive Proxy Statement for the 2026 Meeting of Shareholders which will be filed within
120 days of the end of our fiscal year ended December 31, 2025 (“2026 Proxy Statement”) and is incorporated herein by reference.
Item
11. Executive Compensation
Information
required by this item will be included in the 2026 Proxy Statement and is incorporated herein by reference.
Item
12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
Information
required by this item will be included in the 2026 Proxy Statement and is incorporated herein by reference.
Item
13. Certain Relationships and Related Transactions, and Director Independence
Information
required by this item will be included in the 2026 Proxy Statement and is incorporated herein by reference.
Item
14. Principal Accountant Fees and Services
Information
required by this item will be included in the 2026 Proxy Statement and is incorporated herein by reference.
59
PART
IV
Item
15. Exhibits and Financial Statement Schedules
(a)
The
following documents are filed as part of this Annual Report on Form 10-K:
(1)
Financial
Statements
(i)
Consolidated
Balance Sheets as of December 31, 2025 and 2024
(ii)
Consolidated
Statements of Operations for the years ended December 31, 2025 and 2024
(iii)
Consolidated
Statements of Comprehensive Income for the years ended December 31, 2025 and 2024
(iv)
Consolidated
Statements of Shareholders’ Equity for the years ended December 31, 2025 and 2024
(v)
Consolidated
Statements of Cash Flows for the years ended December 31, 2025 and 2024
(vi)
Notes
to Consolidated Financial Statements
(2)
Financial
Statement Schedules
There
are no Financial Statement Schedules filed as part of this Annual Report on Form 10-K as the required information is not applicable or
is included in the Notes to Consolidated Financial Statements.
(b)
Exhibit
Index:
Exhibit
Number
Description
2.1
Assignment Agreement dated October 3, 2016, by and between the Company, The Prudential Insurance Company of America, and Prudential Retirement Insurance and Annuity Company (filed as Exhibit 10.1 to the Company’s Form 8-K filed on October 5, 2016, and incorporated herein by reference).
2.2
Strict Foreclosure Agreement dated October 3, 2016, by and between MTBC Acquisition, Corp., MediGain, LLC and Millennium Practice Management Associates, LLC (filed as Exhibit 10.2 to the Company’s Form 8-K filed on October 5, 2016, and incorporated herein by reference).
2.3
Transition Services Agreement dated October 3, 2016, by and between MTBC Acquisition, Corp., MediGain, LLC and Millennium Practice Management Associates, LLC (filed as Exhibit 10.3 to the Company’s Form 8-K filed on October 5, 2016, and incorporated herein by reference).
2.4
First Amendment to Assignment Agreement dated January 3, 2017, by and between the Company, The Prudential Insurance Company of America, and Prudential Retirement Insurance and Annuity Company (filed as Exhibit 2.1 to the Company’s Form 8-K filed on January 6, 2017, and incorporated herein by reference).
2.5
Second Amendment to Assignment Agreement dated January 23, 2017, by and between the Company, The Prudential Insurance Company of America, and Prudential Retirement Insurance and Annuity Company (filed as Exhibit 2.1 to the Company’s Form 8-K filed on January 24, 2017, and incorporated herein by reference).
2.6
Asset Purchase Agreement dated June 25, 2018, by and between MTBC, and Orion Healthcorp, Inc. (filed as Exhibit 10.1 to the Company’s Form 8-K filed on July 2, 2018, and incorporated herein by reference).
2.7
Transition Services Agreement dated June 25, 2018, by and between MTBC, and Orion Healthcorp, Inc. (filed as Exhibit 2.29 to the Company’s Form S-1 filed on September 25, 2018, and incorporated herein by reference).
2.8
Asset Purchase Agreement dated March 27, 2019, by and between MTBC-Med, Inc., and Etransmedia Technology, Inc., et. al. (filed as Exhibit 10.1 to the Company’s Form 8-K filed on March 28, 2019, and incorporated herein by reference).
60
2.9
Amended and Restated Asset Purchase Agreement dated April 3, 2019, by and between MTBC-Med, Inc., and Etransmedia Technology, Inc., et. al. (filed as Exhibit 10.1 to the Company’s Form 8-K filed on April 4, 2019, and incorporated herein by reference).
2.10
Agreement and Plan of Merger by and among MTBC, Inc., MTBC Merger Sub, Inc., CareCloud Corporation and Runway Growth Credit Fund Inc., as the Seller’s representative dated January 8, 2020 (filed as Exhibit 2.1 to the Company’s Form 8-K filed on January 8, 2020, and incorporated herein by reference).
2.11
Escrow Agreement dated January 8, 2020 by and among MTBC, Inc., Runway Growth Credit Fund., Inc. and TD Bank (filed as Exhibit 10.17 to the Company’s Form 10-K filed on February 28, 2020, and incorporated herein by reference).
2.12
Stock Purchase Agreement dated June 16, 2020 by and among MTBC, Inc., Origin Holdings, Inc., Meridian Billing Management Co., Origin Holdings, Inc., and GMM II Holdings, LLC, (filed as Exhibit 2.1 to the Company’s Form 8-K on June 17, 2020, and incorporated herein by reference).
2.13
Asset and Stock Purchase Agreement by and among CareCloud Acquisition. Corp., MedMatica Consulting Associates, Inc., and Jerold Howell dated June 1, 2021 (filed as Exhibit 2.1 to the Company’s Form 8-K filed on June 2, 2021, and incorporated herein by reference).
2.14
Non-Competition and Non-Solicitation Agreement by and among Santa Rosa Consulting, Inc., SureTest Holdings, LLC, Laura O’Toole, Mark Scruggs, Raleigh Brewer, Thomas Watford, and CareCloud Acquisition, Corp., dated June 1, 2021 (filed as Exhibit 2.2 to the Company’s Form 8-K filed on June 2, 2021, and incorporated herein by reference).
2.15
Transition Services Agreement by and among CareCloud Acquisition, Corp., MedMatica Consulting Associates, Inc., and Jerold Howell, dated June 1, 2021 (filed as Exhibit 2.3 to the Company’s Form 8-K filed on June 2, 2021 and incorporated herein by reference).
2.16
Asset Purchase Agreement between Medsphere Systems Corporation (“Medsphere”) and CareCloud Holdings, Inc. (“Holdings”) dated as of August 22, 2025 (filed as Exhibit 2.1 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.17
Transition Services Agreement between Medsphere and Holdings dated as of August 22, 2025 (filed as Exhibit 2.2 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.18
Security Agreement by the Company and its subsidiaries in favor of Wells Fargo Bank N.A. (“Wells Fargo”) dated as of August 22, 2025 (filed as Exhibit 2.3 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.19
Patent Security Agreement by Holdings and CareCloud Health, Inc. in favor of Wells Fargo dated as of August 22, 2025 (filed as Exhibit 2.4 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.20
Copyright Security Agreement by Holdings in favor of Wells Fargo dated as of August 22, 2025 (filed as Exhibit 2.5 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.21
Trademark Security Agreement by the Company and Holdings in favor of Wells Fargo dated as of August 22, 2025 (filed as Exhibit 2.6 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.22
Deferred Payment Agreement by and among Wells Fargo, Holdings, the Company and its other subsidiaries dated as of August 22, 2025 (filed as Exhibit 2.7 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.23
Guaranty by and among Wells Fargo as Lender and Holdings as Issuer dated as of August 22, 2025 (filed as Exhibit 2.8 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
61
2.24
Bill of Sale by and between Medsphere and Holdings dated as of August 22, 2025 (filed as Exhibit 2.9 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.25
Power of Attorney by and between Medsphere and Holdings dated as of August 22, 2025 (filed as Exhibit 2.10 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.26
Intellectual Property Assignment Agreement by and between Medsphere and Holdings dated as of August 22, 2025 (filed as Exhibit 2.11 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
2.27
Assignment and Assumption Agreement between Medsphere and Holdings dated as of August 22, 2025 (filed as Exhibit 2.12 to the Company’s Form 8-K filed on August 25, 2025, and incorporated herein by reference).
3.1
Amended and Restated Certificate of Incorporation of the Company dated April 4, 2014 (filed as Exhibit 3.1 to the Company’s Form S-1 filed on September 25, 2018 and incorporated herein by reference).
3.2
Certificate of Amendment of Certificate of Incorporation of the Company dated June 28, 2016 (filed as Exhibit 3.2 to the Company’s Form S-1 filed on September 25, 2018 and incorporated herein by reference).
3.3
Certificate of Amendment of Amended and Restated Certificate of Incorporation of the Company dated June 18, 2018 (filed as Exhibit 3.6 to the Company’s Form S-1 filed on September 25, 2018 and incorporated herein by reference).
3.4
Certificate of Amendment of Amended and Restated Certificate of Incorporation of the Company dated February 6, 2019 (filed as Exhibit 3.1 to the Company’s Form 8-K filed on February 7, 2019 and incorporated herein by reference).
3.5
Certificate of Amendment of Amended and Restated Certificate of Incorporation of the Company dated June 25, 2019 (filed as Exhibit 3.1 to the Company’s Form 8-K filed on June 25, 2019 and incorporated herein by reference).
3.6
Certificate of Amendment of Amended and Restated Certificate of Incorporation of the Company dated February 26, 2021 (filed as Exhibit 3.1 to the Company’s Form 8-K filed on March 29, 2021 and incorporated herein by reference).
3.7
Certificate of Amendment of Amended and Restated Certificate of Incorporation of the Company dated June 16, 2022 (filed as Exhibit 3.6 to the Company’s Form 8-K/A filed on June 17, 2022 and incorporated herein by reference).
3.8
Certificate of Correction to Certificate of Amendment to Amended and Restated Certificate of Incorporation (filed as Exhibit 3.1 to the Company’s Form 8-K/A filed June 17, 2022 and incorporated herein by reference).
3.9
Certificate of Amendment of Amended and Restated Certificate of Incorporation of the Company dated February 5, 2025 (filed as Exhibit 3.1 to the Company’s Form 8-K filed on February 7, 2025 and incorporated herein by reference).
3.10
Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock dated July 6, 2016 (filed as Exhibit 3.3 to the Company’s Form S-1 filed on September 25, 2018, and incorporated herein by reference).
3.11
First Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock dated September 15, 2017 (filed as Exhibit 3.4 to the Company’s Form S-1 filed on September 25, 2018, and incorporated herein by reference).
3.12
Second Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock dated March 23, 2018 (filed as Exhibit 3.5 to the Company’s Form S-1 filed on September 25, 2018, and incorporated herein by reference).
62
3.13
Third Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock dated September 25, 2018 (filed as Exhibit 3.7 to the Company’s Form S-1 filed on September 25, 2018, and incorporated herein by reference).
3.14
Fourth Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock dated January 9, 2020 (filed as Exhibit 3.1 to the Company’s Form 8-K filed on January 28, 2020, and incorporated herein by reference).
3.15
Fifth Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock dated May 19, 2020 (filed as Exhibit 3.2 to the Company’s Form 8-K filed on May 21, 2020, and incorporated herein by reference).
3.16
Sixth Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock dated July 9, 2020 (filed as Exhibit 3.1 to the Company’s Form 8-K filed on July 9, 2020, and incorporated herein by reference).
3.17
Seventh Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock (filed as exhibit 3.1 to the Company’s Form 8-K filed January 31, 2022 and incorporated herein by reference).
3.18
Certificate of Correction to Eighth Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock (filed as Exhibit 3.2 to the Company’s Form 8-K/A filed June 17, 2022 and incorporated herein by reference).
3.19
Eighth Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable Perpetual Preferred Stock dated June 15, 2022 (filed as Exhibit 3.4 to the Company’s Form 8-K/A filed June 17, 2022 and incorporated herein by reference).
3.20
Ninth
Amendment to Amended and Restated Certificate of Designations, Preferences and Rights of 11% Series A Cumulative Redeemable
Perpetual Preferred Stock dated September 11, 2024 (filed as Exhibit 3.1 to the Company’s Form 8-K filed September 16, 2024
and incorporated herein by reference).
3.21
Certificate of Designations, Preferences and Rights of 8.75% Series B Cumulative Redeemable Perpetual Preferred Stock (filed as exhibit 3.2 to the Company’s Form 8-K filed January 31, 2022 and incorporated herein by reference).
3.22
Certificate of Correction to First Amendment to Certificate of Designations, Preferences and Rights of 8.75% Series B Cumulative Redeemable Perpetual Preferred Stock (filed as Exhibit 3.3 to the Company’s Form 8-K/A filed June 17, 2022 and incorporated herein by reference).
3.23
First Amendment to Certificate of Designations, Preferences and Rights of 8.75% Series B Cumulative Redeemable Perpetual Preferred Stock dated June 15, 2022 (filed as Exhibit 3.5 to the Company’s Form 8-K/A filed June 17, 2022 and incorporated herein by reference).
3.24
Amended and Restated By-laws of the Company (filed as Exhibit 3.2 to the Company’s Amendment No. 1 to Form S-1 filed on April 7, 2014, and incorporated herein by reference).
4.1
Form of common stock certificate of the Company (filed as Exhibit 4.1 to Amendment No. 2 to the Company’s Form S-1 filed on May 7, 2014, and incorporated herein by reference).
4.2
Form of stock certificate of the 11% Series A Cumulative Redeemable Perpetual Preferred Stock (filed as Exhibit 4.2 to Amendment No. 2 to the Company’s Form S-1 on October 19, 2015, and incorporated herein by reference).
4.3
Form of stock certificate of the 8.75% Series B Cumulative Redeemable Perpetual Preferred Stock (filed as Exhibit 4.3 to the Company’s Form 8-A on January 31, 2022 and incorporated herein by reference).
63
4.4
Warrant to Purchase Stock dated as of October 13, 2017 issued by the Company to Silicon Valley Bank (filed as Exhibit 10.2 to the Company’s Form 8-K filed on October 16, 2017, and incorporated herein by reference).
4.5
Warrant to Purchase Stock issued by the Company on September 20, 2018 to Silicon Valley Bank (filed as Exhibit 10.2 to the Company’s Form 8-K filed on September 20, 2018, and incorporated herein by reference).
4.6
Warrant to Purchase Stock issued by the Company on January 8, 2020 to Runway Growth Credit Fund Inc. (filed as Exhibit 4.5 to the Company’s Form 10-K filed on February 28, 2020, and incorporated herein by reference).
4.7
Warrant to Purchase Stock issued by the Company on January 8, 2020 to Runway Growth Credit Fund Inc. (filed as Exhibit 4.6 to the Company’s Form 10-K filed on February 28, 2020, and incorporated herein by reference) .
4.8
Form of Warrant to Purchase Stock issued by the Company on June 16, 2020 with respect to the Meridian transaction (filed as Exhibit 4.7 to the Company’s Form S-1 filed on August 20, 2020, and incorporated herein by reference).
4.9
Description of Securities Registered Pursuant to Section 12 of the Securities Exchange Act of 1934 (filed as Exhibit 4.9 to the Company’s Form 10-K filed on March 2, 2023, and incorporated herein by reference).
10.1
Form of Indemnification Agreement between the Company and each of its directors and executive officers (filed as Exhibit 10.1 to Amendment No. 2 to the Company’s Form S-1 filed on May 7, 2014, and incorporated herein by reference).
10.2
*
Amended and Restated Equity Incentive Plan of the Company (filed as Appendix B to the Company’s Proxy Statement on Schedule 14A filed on February 10, 2017, and incorporated herein by reference).
10.3
*
First Amendment to the Amended and Restated Equity Incentive Plan of the Company (filed as Exhibit 10.16 to the Company’s Form 10-Q filed on August 8, 2018, and incorporated herein by reference).
10.4*
Second Amendment to MTBC, Inc. Amended and Restated Equity Incentive Plan (filed as Exhibit 3.1 to the Company’s Form 8-K filed on May 21, 2020, and incorporated herein by reference).
10.5
*
Form of Restricted Stock Unit Agreement under Amended and Restated Equity Incentive Plan (filed as Exhibit 10.3 to Amendment No. 1 to the Company’s Form S-1 filed on April 7, 2014, and incorporated herein by reference).
10.6
*
Third Amendment to Amended and Restated Equity Incentive Plan (filed as Exhibit 3.1 to the Company’s Form 8-K filed on June 9, 2022, and incorporated herein by reference).
10.7
*
Form of Restricted Stock Award Agreement under the Amended and Restated Equity Incentive Plan (filed as Exhibit 10.12 to the Company’s Form 10-K filed on March 24, 2016, and incorporated herein by reference).
10.8
Lease between Company and Mahmud Haq with respect to offices located at 7 Clyde Road, Somerset, NJ 08873 (filed as Exhibit 10.4 to the Company’s Form S-1 filed on December 20, 2013, and incorporated herein by reference).
10.9
*
Employment Agreement between the Company and Mahmud Haq dated as of May 1, 2018 (filed as Exhibit 10.1 to the Company’s Form 8-K filed on May 7, 2018, and incorporated herein by reference).
10.10
*
Employment Agreement between the Company and A. Hadi Chaudhry dated as of March 23, 2021 (filed as Exhibit 10.2 to the Company’s Form 8-K filed on March 24, 2021, and incorporated herein by reference).
10.11
*
Employment Agreement between the Company and Bill Korn dated as of May 1, 2018 (filed as Exhibit 10.4 to the Company’s Form 8-K filed on May 7, 2018, and incorporated herein by reference).
64
10.12
*
Employment
Agreement and Bonus Agreement between the Company and Larry Steenvoorden each dated as of July 6, 2023 (filed as Exhibit 10.1
and 10.2 ,
respectively, to the Company’s Form 8-K filed on July 11, 2023 and incorporated herein by reference).
10.13
*
Employment Agreement between the Company and A. Hadi Chaudhry dated December 16, 2024 (filed as Exhibit 10.1 to the Company’s Form 8-K filed on December 16, 2024 and incorporated herein by reference).
10.14
*
Employment Agreement between the Company and Stephen Snyder dated December 16, 2024 (filed as Exhibit 10.2 to the Company’s Form 8-K filed on December 16, 2024 and incorporated herein by reference).
10.15
*
Employment Agreement between the Company and Crystal Williams dated December 16, 2024 (filed as Exhibit 10.3 to the Company’s Form 8-K filed on December 16, 2024 and incorporated herein by reference).
10.16 *
Employment Agreement between the Company and Mahmud Haq dated as of December 26, 2025 (filed as Exhibit 10.1 to the Company’s Form 8-K filed on December 29, 2025 and incorporated herein by reference).
10.17 *
Employment Agreement between the Company and A. Hadi Chaudhry dated December 26, 2025 (filed as Exhibit 10.2 to the Company’s Form 8-K filed on December 29, 2025 and incorporated herein by reference).
10.18 *
Employment Agreement between the Company and Stephen Snyder dated December 26, 2025 (filed as Exhibit 10.3 to the Company’s Form 8-K filed on December 29, 2025 and incorporated herein by reference).
10.19 *
Employment Agreement between the Company and Crystal Williams dated December 26, 2025 (filed as Exhibit 10.1 to the Company’s Form 8-K filed on December 29, 2025 and incorporated herein by reference).
10.20
Loan and Security Agreement dated as of October 13, 2017 between Medical Transcription Billing, Corp., MTBC Acquisition, Corp. and Silicon Valley Bank (filed as Exhibit 10.1 to the Company’s Form 8-K filed on October 16, 2017, and incorporated herein by reference).
10.21
Joinder and First Loan Modification Agreement dated as of September 20, 2018 between Medical Transcription Billing, Corp., MTBC Acquisition, Corp., MTBC Health, Inc. and MTBC Practice Management, Corp. and Silicon Valley Bank (filed as Exhibit 10.1 to the Company’s Form 8-K filed on September 20, 2018, and incorporated herein by reference).
10.22
Second Loan Modification Agreement dated November 15, 2019, by and between the Company and SVB (filed as Exhibit 1.1 to the Company’s Form 8-K filed on November 21, 2019, and incorporated herein by reference).
10.23
Joinder and Third Loan Modification Agreement dated as of February 28, 2020 between MTBC, Inc., MTBC Acquisition Corp., MTBC Health, Inc. and MTBC Practice Management Corp., MTBC-Med, Inc., CareCloud Corporation and Silicon Valley Bank (filed as Exhibit 10.16 to the Company’s Form 10-K filed on February 28, 2020, and incorporated herein by reference).
10.24
Joinder and Fourth Loan Modification Agreement dated September 21, 2020, by and between the Company and SVB (filed as Exhibit 1.1 to the Company’s Form 8-K filed on September 25, 2020, and incorporated herein by reference).
10.25
Joinder and Fifth Loan Modification Agreement dated September 21, 2021, by and between the Company and SVB (filed as Exhibit 10.1 to the Company’s Form 8-K filed on September 22, 2021 and incorporated herein by reference).
10.26
Sixth Loan Modification Agreement dated January 27, 2022, by and between the Company and SVB (filed as Exhibit 10.19 to the Company’s Form 10-Q filed on May 9, 2022 and incorporated herein by reference).
65
10.27
Seventh Loan Modification Agreement dated February 17, 2023, by and between the Company and SVB (filed as Exhibit 10.1 to the Company’s Form 8-K filed on February 21, 2023 and incorporated herein by reference).
10.28
Eighth Loan Modification Agreement dated August 31, 2023, by and between the Company and SVB (filed as Exhibit 10.1 to the Company’s Form 8-K filed on September 1, 2023 and incorporated herein by reference).
10.29
Ninth Loan Modification Agreement dated October 25, 2024, by and between the Company and SVB (filed as Exhibit 10.1 to the Company’s Form 8-K filed on October 28, 2024 and incorporated herein by reference).
10.30
Underwriting Agreement dated January 28, 2022 by and between the Company and B. Riley FBR, Inc. as representative of several underwriters named therein (filed as Exhibit 1.1 to the Company’s Form 8-K filed on January 31, 2022, and incorporated herein by reference).
10.31
At Market Issuance Sales Agreement dated February 14, 2022 by and between CareCloud, Inc. and B. Riley Securities, Inc. (filed as Exhibit 1.1 to the Company’s Form 8-K filed on February 14, 2022 and incorporated herein by reference).
10.32
Agreement dated September 3, 2025 between the Company and Provident Bank. (filed as Exhibit 10.1 to the Company’s Form 8-K filed on September 9, 2025 and incorporated herein by reference).
10.33
Commercial Line of Credit Note between the Company and Provident Bank (filed as Exhibit 10.2 to the Company’s Form 8-K filed on September 9, 2025 and incorporated herein by reference).
10.34
Consulting Agreement dated June 3, 2022 by and between the Company and Hill City Advisors, LLC (filed as Exhibit 10.22 to the Company’s Form 10-K filed on March 2, 2023, and incorporated herein by reference).
10.35
Amendment to Consulting Agreement dated February 16, 2023 by and between the Company and Hill City Advisors, LLC (filed as Exhibit 10.23 to the Company’s Form 10-K filed on March 2, 2023, and incorporated herein by reference).
10.36
Additional Statement of Work dated January 29, 2024 added as Exhibit B to the Consulting Agreement between the Company and Hill City Advisors, LLC. (filed as Exhibit 10.26 to the Company’s Form 10-K filed on March 21, 2024, and incorporated herein by reference).
10.37
Consulting Agreement dated January 9, 2024, and as amended February 12, 2024, by and between the Company and Korn Intellect, LLC (filed as Exhibit 10.27 to the Company’s Form 10-K filed on March 21, 2024, and incorporated herein by reference).
10.38
Amendment to Consulting Agreement dated September 5, 2024 between the Company and Korn Intellect, LLC. (filed as Exhibit 10.32 to the Company’s Form 10-K filed on March 13, 2025, and incorporated herein by reference).
10.39
Second Amendment to Consulting Agreement dated December 9, 2024 between the Company and Korn Intellect, LLC. (filed as Exhibit 10.33 to the Company’s Form 10-K filed on March 13, 2025, and incorporated herein by reference).
10.40
Consulting Agreement dated July 28, 2025 between the Company and Stochastic Solutions, LLC.
19.1
Insider Trading Policy dated December 1, 2024 (filed as Exhibit 19.1 to the Company’s Form 10-K filed on March 13, 2025, and incorporated herein by reference).
21.1
List of subsidiaries.
66
23.1
Consent of Tanner LLP.
23.2
Consent of Rosenberg Rich Baker Berman P.A.
31.1
Certification of the Company’s Principal Executive Officer pursuant to Exchange Act Rules 13a-14(a)/15d-14(a), of the Securities Exchange Act of 1934, as amended.
31.2
Certification of the Company’s Principal Financial Officer pursuant to Exchange Act Rules 13a-14(a)/15d-14(a), of the Securities Exchange Act of 1934, as amended.
32.1
Certification of the Company’s Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
32.2
Certification of the Company’s Interim Chief Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
97.1
Policy relating to recovery of erroneously awarded compensation, as required by applicable listing standards adopted pursuant to 17 CFR 240.10D-1 (filed as Exhibit 97.1 to the Company’s Form 10-K filed on March 21, 2024, and incorporated herein by reference).
101.INS
XBRL Instance
101.SCH
XBRL Taxonomy Extension Schema
101.CAL
XBRL Taxonomy Extension Calculation Linkbase
101.LAB
XBRL Taxonomy Extension Label Linkbase
101.PRE
XBRL Taxonomy Extension Presentation Linkbase
101.DEF
XBRL Taxonomy Extension Definition Linkbase
104
Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101).
*
Indicates management contract or compensatory plan or arrangement.
The
certifications on Exhibit 32 hereto are deemed not “filed” for purposes of Section 18 of the Securities and Exchange Act
of 1934, as amended, or otherwise subject to the liability of that Section. Such certifications will not be deemed incorporated by reference
into any filing under the Securities Act or the Exchange Act.
67
Signatures
Pursuant
to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed
on its behalf by the undersigned, thereunto duly authorized.
CareCloud, Inc.
By:
/s/
Stephen Snyder
Stephen
Snyder
Chief
Executive Officer
Date:
March
12, 2026
By:
/s/
Norman Roth
Norman
Roth
Interim
Chief Financial Officer and Corporate Controller
Date:
March
12, 2026
Pursuant
to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the
Registrant and in the capacities and on the dates indicated:
Signature
Title
Date
/s/
Mahmud Haq
March
12, 2026
Mahmud
Haq
Executive
Chairman and Director
/s/
Stephen Snyder
March
12, 2026
Stephen
Snyder
Chief
Executive Officer (Principal Executive Officer)
/s/
Norman Roth
March
12, 2026
Norman
Roth
Interim
Chief Financial Officer and Corporate Controller (Principal Financial and Accounting Officer)
/s/
Anne Busquet
March
12, 2026
Anne
Busquet
Director
/s/
Bill Korn
March
12, 2026
Bill
Korn
Director
/s/
Cameron Munter
March
12, 2026
Cameron
Munter
Director
/s/
Lawrence Sharnak
March
12, 2026
Lawrence
Sharnak
Director
68
Index
to Consolidated Financial Statements
Report
of Independent Registered Public Accounting Firm Tanner LLP (PCAOB ID Number 270 )
F-2
Report
of Independent Registered Public Accounting Firm Rosenberg Rich Baker Berman, P.A. (PCAOB ID Number 89 )
F-3
Consolidated
Balance Sheets as of December 31, 2025 and 2024
F-4
Consolidated
Statements of Operations for the years ended December 31, 2025 and 2024
F-5
Consolidated
Statements of Comprehensive Income for the years ended December 31, 2025 and 2024
F-6
Consolidated
Statements of Shareholders’ Equity for the years ended December 31, 2025 and 2024
F-7
Consolidated
Statements of Cash Flows for the years ended December 31, 2025 and 2024
F-8
Notes
to Consolidated Financial Statements
F-9
F- 1
REPORT
OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
Board
of Directors and Shareholders
CareCloud, Inc.
Opinions
on the Consolidated Financial Statements and Internal Control over Financial Reporting
We
have audited the accompanying consolidated balance sheet of CareCloud, Inc. and subsidiaries (the “Company”) as of December
31, 2025, the related consolidated statements of operations, comprehensive income, shareholders’ equity, and cash flows for the
year ended December 31, 2025, and the related notes (collectively referred to as the “financial statements”). We also have
audited the Company’s internal control over financial reporting as of December 31, 2025, based on criteria established in Internal
Control—Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).
In
our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of the Company
as of December 31, 2025, and the results of its operations and its cash flows for the year ended December 31, 2025, in conformity with
accounting principles generally accepted in the United States of America. Also, in our opinion, the Company maintained, in all material
respects, effective internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control—Integrated
Framework (2013) issued by COSO.
Basis
for Opinions
The
Company’s management is responsible for these financial statements, for maintaining effective internal control over financial reporting,
and for its assessment of the effectiveness of internal control over financial reporting included in the accompanying Management’s
Report on Internal Control Over Financial Reporting (“Management’s Report”). Our responsibility is to express an opinion
on the Company’s financial statements and an opinion on the Company’s internal control over financial reporting based on
our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and
are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules
and regulations of the Securities and Exchange Commission and the PCAOB.
We
conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain
reasonable assurance about whether the financial statements are free of material misstatement, whether due to error or fraud, and whether
effective internal control over financial reporting was maintained in all material respects.
Our
audits of the financial statements included performing procedures to assess the risks of material misstatement of the financial statements,
whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis,
evidence regarding the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting principles
used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. Our audit
of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing
the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based
on the assessed risk. Our audits also included performing such other procedures as we considered necessary in the circumstances. We believe
that our audits provide a reasonable basis for our opinions.
Our
audit of, and opinion on, the Company’s internal control over financial reporting does not include the internal control over financial
reporting of MAP App, Medsphere and RevNu, each a wholly-owned subsidiary. During the year ended December 31, 2025, the net revenue recorded
by the Company for MAP App, Medsphere and RevNu was approximately $226,000, $10,500,000 and $882,000, respectively, and the net assets
acquired were approximately $625,000, $16,500,000 and $565,000, respectively, including goodwill. As indicated in Management’s
Report, MAP App, Medsphere and RevNu were acquired during 2025. Management’s assertion on the effectiveness of the Company’s
internal control over financial reporting excluded internal control over financial reporting of MAP App, Medsphere and RevNu.
Definition
and Limitations of Internal Control over Financial Reporting
A
company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability
of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting
principles. A company’s internal control over financial reporting includes those policies and procedures that (1) pertain to the
maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the
company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in
accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance
with authorizations of management and directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection
of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.
Because
of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of
any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions,
or that the degree of compliance with the policies or procedures may deteriorate.
Critical
Audit Matters
Critical
audit matters are matters arising from the current period audit of the financial statements that were communicated or required to be
communicated to the audit committee and that (1) relate to accounts or disclosures that are material to the financial statements and
(2) involved our especially challenging, subjective, or complex judgments. We determined that there were no critical audit matters.
/s/
Tanner LLP
We
have served as the Company’s auditors since 2025.
Lehi,
Utah
March 12, 2026
F- 2
REPORT
OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
To
the Board of Directors and
Shareholders
of CareCloud, Inc.
Opinion
on the financial statements
We
have audited the accompanying balance sheet of CareCloud, Inc. as of December 31, 2024, and the related statements of operations, comprehensive
income, shareholders’ equity, cash flows, and the related notes (collectively referred to as the consolidated financial statements).
In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company
as of December 31, 2024 and the results of its operations and its cash flows for the year then ended, in conformity with accounting principles
generally accepted in the United States of America.
Basis
for opinion
These
financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s
financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board
(United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities
laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We
conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain
reasonable assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. The Company
is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits,
we are required to obtain an understanding of internal control over financial reporting, but not for the purpose of expressing an opinion
on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.
Our
audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error
or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding
the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting principles used and significant
estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audits
provide a reasonable basis for our opinion.
Critical
Audit Matters
Critical
audit matters are matters arising from the current period audit of the financial statements that were communicated or required to be
communicated to the audit committee and that (1) relate to accounts or disclosures that are material to the financial statements and
(2) involved our especially challenging, subjective, or complex judgments. We determined that there were no critical audit matters.
/s/
ROSENBERG RICH BAKER BERMAN, P.A
We
served as the Company’s auditor for 2024.
Somerset,
New Jersey
March
13, 2025
F- 3
CARECLOUD,
INC.
CONSOLIDATED
BALANCE SHEETS
AS
OF DECEMBER 31, 2025 AND 2024
($
in thousands, except share and per share amounts)
December 31,
December 31,
2025
2024
ASSETS
Current assets:
Cash
$ 3,117
$ 5,145
Restricted cash
500
-
Accounts receivable - net
15,062
12,774
Contract asset
3,664
4,334
Inventory
507
574
Current assets - related
party
16
16
Prepaid expenses and other
current assets
2,872
1,957
Total current assets
25,738
24,800
Property and equipment - net
7,775
5,290
Operating lease right-of-use assets
3,106
3,133
Intangible assets - net
18,968
18,698
Goodwill
31,442
19,186
Other assets
569
507
TOTAL ASSETS
$ 87,598
$ 71,614
LIABILITIES AND SHAREHOLDERS’ EQUITY
Current liabilities:
Accounts payable
$ 6,937
$ 4,565
Accrued compensation
4,136
1,817
Accrued expenses
5,970
4,951
Operating lease liability
(current portion)
927
1,287
Deferred revenue (current
portion)
4,148
1,212
Notes payable (current
portion)
728
310
Contingent consideration
(current portion)
909
-
Dividend payable
668
5,438
Total current liabilities
24,423
19,580
Notes payable
441
26
Contingent consideration
232
-
Operating lease liability
2,187
1,847
Deferred revenue
809
387
Total liabilities
28,092
21,840
COMMITMENTS AND CONTINGENCIES (NOTE 11)
-
-
SHAREHOLDERS’ EQUITY:
Preferred stock, $ 0.001 par value - authorized
7,000,000 shares. Series A, issued and outstanding 984,530 and 4,526,231 shares at December 31, 2025 and December 31, 2024, respectively.
Series B, issued and outstanding 1,511,372 shares at December 31, 2025 and December 31, 2024.
2
6
Common stock, $ 0.001 par value - authorized
85,000,000 and 35,000,000 shares at December 2025 and 2024, respectively. Issued 43,178,748 and 16,997,035 shares at December 31,
2025 and December 31, 2024, respectively. Outstanding 42,437,949 and 16,256,236 shares at December 31, 2025 and December 31, 2024,
respectively
43
17
Additional paid-in capital
119,936
121,046
Accumulated deficit
( 55,832 )
( 66,630 )
Accumulated other comprehensive loss
( 3,981 )
( 4,003 )
Less: 740,799 common shares held in treasury,
at cost at December 31, 2025 and December 31, 2024
( 662 )
( 662 )
Total shareholders’ equity
59,506
49,774
TOTAL LIABILITIES AND SHAREHOLDERS’ EQUITY
$ 87,598
$ 71,614
See
notes to consolidated financial statements.
F- 4
CARECLOUD,
INC.
CONSOLIDATED
STATEMENTS OF OPERATIONS
FOR
THE YEARS ENDED DECEMBER 31, 2025 AND 2024
($
in thousands, except share and per share amounts)
2025
2024
December
31,
2025
2024
NET REVENUE
$ 120,499
$ 110,837
OPERATING EXPENSES:
Direct operating costs
64,456
60,842
Selling and marketing
4,818
6,232
General and administrative
18,386
16,123
Research and development
6,382
3,781
Depreciation and amortization
14,960
14,142
Lease termination and restructuring
costs
154
596
Total operating expenses
109,156
101,716
OPERATING INCOME
11,343
9,121
Operating income
(loss)
OTHER:
Interest income
206
88
Interest expense
( 287 )
( 900 )
Other expense - net
( 265 )
( 298 )
INCOME BEFORE PROVISION FOR INCOME TAXES
10,997
8,011
Income tax provision
199
160
NET INCOME
$ 10,798
$ 7,851
Preferred stock dividend
6,906
12,310
NET INCOME (LOSS) ATTRIBUTABLE TO COMMON SHAREHOLDERS
$ 3,892
$ ( 4,459 )
Net income (loss) per share: basic and diluted
$ 0.10
$ ( 0.28 )
Weighted-average common
shares used to compute basic income (loss) per share
37,792,428
16,146,975
Weighted-average common
shares used to compute diluted income (loss) per share
37,953,828
16,146,975
See
notes to consolidated financial statements.
F- 5
CARECLOUD,
INC.
CONSOLIDATED
STATEMENTS OF COMPREHENSIVE INCOME
($
in thousands)
2025
2024
December
31,
2025
2024
NET INCOME
$ 10,798
$ 7,851
OTHER COMPREHENSIVE INCOME (LOSS)
Foreign currency translation adjustment (a)
22
( 134 )
COMPREHENSIVE INCOME
$ 10,820
$ 7,717
(a) No tax effect has
been recorded as the Company recorded a valuation allowance against the tax benefit from its foreign currency translation adjustments.
See
notes to consolidated financial statements.
F- 6
CARECLOUD,
INC.
CONSOLIDATED
STATEMENTS OF SHAREHOLDERS’ EQUITY
FOR
THE YEARS ENDED DECEMBER 31, 2025 AND 2024
($
in thousands, except for number of shares)
Shares
Amount
Shares
Amount
Shares
Amount
Capital
Deficit
Loss
Stock
Equity
Preferred
Stock Series A
Preferred
Stock Series B
Common
Stock
Additional
Paid-in
Accumulated
Accumulated
Other
Comprehensive
Treasury
(Common)
Total Shareholders’
Shares
Amount
Shares
Amount
Shares
Amount
Capital
Deficit
Loss
Stock
Equity
Balance - January 1, 2025
4,526,231
$ 5
1,511,372
$ 1
16,997,035
$ 17
$ 121,046
$ ( 66,630 )
$ ( 4,003 )
$ ( 662 )
$ 49,774
Net income
-
-
-
-
-
-
-
10,798
-
-
10,798
Foreign currency translation adjustment
-
-
-
-
-
-
-
-
22
-
22
Conversion of preferred stock and accrued dividends
to common stock
( 3,541,701 )
( 4 )
-
-
25,981,248
26
2,413
-
-
-
2,435
Stock issued under the equity incentive plan
-
-
-
-
200,465
-
-
-
-
-
-
Stock-based compensation, net of cash settlements
-
-
-
-
-
-
437
-
-
-
437
Preferred stock dividends
-
-
-
-
-
-
( 3,960 )
-
-
-
( 3,960 )
Balance - December 31, 2025
984,530
$ 1
1,511,372
$ 1
43,178,748
$ 43
$ 119,936
$ ( 55,832 )
$ ( 3,981 )
$ ( 662 )
$ 59,506
Balance - January 1, 2024
4,526,231
$ 5
1,468,792
$ 1
16,620,891
$ 17
$ 120,706
$ ( 74,481 )
$ ( 3,869 )
$ ( 662 )
$ 41,717
Balance
4,526,231
$ 5
1,468,792
$ 1
16,620,891
$ 17
$ 120,706
$ ( 74,481 )
$ ( 3,869 )
$ ( 662 )
$ 41,717
Net Income
-
-
-
-
-
-
-
7,851
-
-
7,851
Foreign currency translation adjustment
-
-
-
-
-
-
-
-
( 134 )
-
( 134 )
Stock issued under the equity incentive plan
-
-
42,580
-
376,144
-
-
-
-
-
-
Stock-based compensation, net of cash settlements
-
-
-
-
-
-
345
-
-
-
345
Preferred stock dividends
-
-
-
-
-
-
( 5 )
-
-
-
( 5 )
Balance - December 31, 2024
4,526,231
$ 5
1,511,372
$ 1
16,997,035
$ 17
$ 121,046
$ ( 66,630 )
$ ( 4,003 )
$ ( 662 )
$ 49,774
Balance
4,526,231
$ 5
1,511,372
$ 1
16,997,035
$ 17
$ 121,046
$ ( 66,630 )
$ ( 4,003 )
$ ( 662 )
$ 49,774
For
the year ended December 31, 2025, the Company declared twelve months of dividends and paid eleven months of dividends on the Preferred
Shares.
For
the year ended December 31, 2024, no preferred stock dividends were declared or paid.
See
notes to consolidated financial statements.
F- 7
CARECLOUD,
INC.
CONSOLIDATED
STATEMENTS OF CASH FLOWS
FOR
THE YEARS ENDED DECEMBER 31, 2025 AND 2024
($
in thousands)
2025
2024
OPERATING ACTIVITIES:
Net income
$ 10,798
$ 7,851
Adjustments to reconcile net income to net
cash provided by operating activities:
Depreciation and amortization
15,208
14,469
Lease amortization
1,767
1,994
Provision for expected
credit losses
286
334
Foreign exchange loss (gain)
109
( 130 )
Interest accretion
310
592
Stock-based compensation
expense
454
115
Changes in operating assets
and liabilities:
Accounts receivable
( 408 )
( 1,220 )
Contract asset
754
760
Inventory
67
( 109 )
Other assets
( 1,230 )
673
Accounts payable and other
liabilities
1,271
( 4,650 )
Deferred revenue
( 825 )
( 37 )
Net cash provided by operating
activities
28,561
20,642
INVESTING ACTIVITIES:
Purchases of property and
equipment
( 4,778 )
( 1,697 )
Capitalized software and
other intangible assets
( 3,249 )
( 5,709 )
Payments for acquisitions
( 16,508 )
-
Net cash used in investing
activities
( 24,535 )
( 7,406 )
FINANCING ACTIVITIES:
Preferred stock dividends
paid
( 6,295 )
-
Payment of contingent obligations
( 124 )
-
Payment of tax withholding
obligations on stock issued to employees
( 24 )
( 579 )
Proceeds from term-loan borrowings
1,452
-
Repayments of notes payable
( 620 )
( 677 )
Proceeds from line of credit
9,343
-
Repayment of line of credit
( 9,343 )
( 10,000 )
Net cash used in financing
activities
( 5,611 )
( 11,256 )
EFFECT OF EXCHANGE RATE CHANGES ON CASH AND
RESTRICTED CASH
57
( 166 )
NET (DECREASE) INCREASE IN CASH AND RESTRICTED
CASH
( 1,528 )
1,814
CASH - Beginning of the year
5,145
3,331
CASH AND RESTRICTED CASH - End of the year
$ 3,617
$ 5,145
SUPPLEMENTAL NONCASH INVESTING AND FINANCING
ACTIVITIES:
Conversion of preferred
stock and accrued dividends to common stock
$ 2,435
$ -
Dividends declared, not
paid
$ 668
$ 5
Purchase of prepaid insurance with assumption of note
-
685
Reclass of deposits for
property and equipment placed in service
$ -
$ 296
SUPPLEMENTAL INFORMATION - Cash paid during
the year for:
Income taxes
$ 246
$ 157
Interest
$ 226
$ 677
See
notes to consolidated financial statements.
F- 8
CARECLOUD,
INC.
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
AS
OF AND FOR THE YEARS ENDED DECEMBER 31, 2025 AND 2024
1. ORGANIZATION
AND BUSINESS
CareCloud,
Inc., (together with its consolidated subsidiaries, “CareCloud,” the “Company,” “we,” “us”
and/or “our”) is a healthcare information technology company that provides a full suite of proprietary cloud-based solutions,
related business services, to healthcare providers and hospitals throughout the United States. The Company’s integrated services
are designed to help customers increase revenues, streamline workflows and make better business and clinical decisions, while reducing
administrative burdens and operating costs. Our Software-as-a-Service (“SaaS”) platform includes revenue cycle management
(“RCM”), practice management (“PM”), electronic health records (“EHR”), business intelligence, telehealth,
patient experience management (“PXM”) solutions and complementary software tools and business services for high-performance
medical groups and health systems. CareCloud has its corporate offices in Somerset, New Jersey and maintains client support teams throughout
the U.S., and offshore offices in Pakistan and Azad Jammu and Kashmir, a region administered by Pakistan (the “Pakistan Offices”),
and in Sri Lanka.
CareCloud
was founded in 1999 under the name Medical Transcription Billing, Corp. and incorporated under the laws of the State of Delaware in 2001.
In 2004, the Company formed MTBC Private Limited (“MTBC Pvt. Ltd.”), a 99.9 % majority-owned subsidiary of CareCloud based
in Pakistan. The remaining 0.1 % of the shares of MTBC Pvt. Ltd. is equally owned by the founder and Executive Chairman of CareCloud and
a local employee who is also a director of this entity. In 2016, the Company formed MTBC Acquisition Corp. (“MAC”), a Delaware
corporation, in connection with its acquisition of substantially all of the assets of MediGain, LLC and its subsidiary, Millennium Practice
Management Associates, LLC (together “MediGain”). MAC had a wholly owned subsidiary in Sri Lanka, RCM MediGain Colombo, Pvt.
Ltd. Effective February 1, 2024, MAC and its wholly owned subsidiary were merged into CareCloud, Inc. In May 2018, the Company formed
CareCloud Practice Management, Corp. (“CPM”), a Delaware corporation, to operate the medical practice management business
acquired from Orion Healthcorp.
In
January 2020, the Company purchased CareCloud Corporation, a company whose name we took. That company is now known as CareCloud Health,
Inc. (“CCH”). In June 2020, the Company purchased Meridian Billing Management Co. and its affiliate Origin Holdings, Inc.
(collectively “Meridian” and sometimes referred to as “Meridian Medical Management”). Both companies were subsequently
merged and the surviving company was renamed Meridian Medical Management, Inc.
During
March 2021, the Company formed a new wholly-owned subsidiary, CareCloud Acquisition, Corp. (“CAC”). In June 2021, CAC purchased
certain assets and assumed certain liabilities of MedMatica Consulting Associates Inc. (“MedMatica”) and purchased the stock
of Santa Rosa Staffing, Inc. (“SRS”). The assets and liabilities of MedMatica were merged into SRS and the company was renamed
medSR, Inc. (“medSR”).
Effective
April 1, 2022, the Company formed MTBC Bagh Private Limited (“MTBC Bagh Pvt. Ltd.”), a 99.8 % majority-owned subsidiary of
CareCloud based in Azad Jammu and Kashmir, a region administered by Pakistan. The remaining 0.2 % of the shares of MTBC Bagh Pvt. Ltd.
is equally owned by the founder and Executive Chairman of CareCloud and the same director/employee as noted above.
During
the second quarter of 2023, the Company formed a wholly owned subsidiary, CareCloud ME Health Consultancy LLC, in the United Arab Emirates,
which has not yet begun operations.
During
August 2025, the Company formed CareCloud Holdings, Inc (“Holdings”), as an indirect subsidiary. Holdings purchased certain
assets and assumed certain liabilities of Medsphere Systems Corporation (“Medsphere”). Medsphere was in the business of providing
healthcare IT software and related services to the inpatient and ambulatory market. During October 2025, the Company formed N884AM Holdings,
Inc. to acquire an aircraft which is used primarily for sales and marketing activities.
F- 9
2. BASIS
OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES
Principles
of Consolidation — The accompanying consolidated financial statements have been prepared in accordance with accounting principles
generally accepted in the United States of America (“GAAP”) and include the operating results and financial condition of
CareCloud, and its wholly-owned subsidiaries including their wholly-owned subsidiaries and its majority-owned subsidiaries, MTBC Pvt.
Ltd and MTBC Bagh Pvt. Ltd, CCH. The non-controlling interests of MTBC Pvt. Ltd. and MTBC Bagh Pvt. Ltd. are inconsequential to the consolidated
financial statements. All intercompany accounts and transactions have been eliminated in consolidation.
Segment
Reporting — The Company views its operations as comprising two operating segments, Healthcare IT and Medical Practice Management.
The chief operating decision maker (“CODM”) monitors and reviews financial information at these segment levels for assessing
operating results and the allocation of resources.
Use
of Estimates — The preparation of consolidated financial statements in conformity with GAAP requires management to make estimates
and assumptions that affect the reported amounts of assets and liabilities at the date of the consolidated financial statements, as well
as the reported amounts of revenues and expenses during the reporting period. Significant estimates and assumptions made by management
include, but are not limited to: (1) impairment of goodwill and long-lived assets, (2) depreciable lives of assets, (3) allowance for
expected credit losses, (4) estimates of variable consideration related to the contract asset, (5) fair value of identifiable purchased
tangible and intangible assets, including determination of expected customer life, (6) stock-based compensation, (7) contingent consideration
and (8) estimating lease terms and incremental borrowing rates. Actual results could significantly differ from those estimates.
Revenue
Recognition — We derive revenue from five primary sources: (1) technology-enabled business solutions including revenue cycle
management, (2) professional services, (3) printing and mailing services, (4) group purchasing services and (5) medical practice management
services. All of our revenue arrangements are based on contracts with customers. Most of our contracts with customers contain single
performance obligations, although certain contracts do contain multiple performance obligations where we perform more than one service
for the same customer. We account for individual performance obligations separately if they are distinct within the context of the contract.
For contracts where we provide multiple services such as where we perform multiple ancillary services, each service represents its own
performance obligation. Selling or transaction prices are based on the contractual prices for each service at its stand-alone selling
price.
A
five-step approach is applied in the recognition of revenue under ASC 606: (1) identify the contract with a customer, (2) identify the
performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations
in the contract, and (5) recognize revenue when we satisfy a performance obligation.
Although
we believe that our approach to estimates and judgments is reasonable, actual results could differ, and we may be exposed to increases
or decreases in revenue that could be material. Our estimates of variable consideration may prove to be inaccurate, in which case we
may have understated or overstated the revenue recognized in a reporting period. The amount of variable consideration recognized to date
that remains subject to estimation is included within the contract asset within the consolidated balance sheet.
Payment
of invoices is due as specified in the underlying customer agreement, typically 30 days from the invoice date, which occurs on the date
of transfer of control of the services to the customer. Since payment terms are less than a year, we have elected the practical expedient
and do not assess whether a customer contract has a significant financing component.
The
Company’s revenue arrangements generally do not include a general right of refund for services provided (See Note 9, Revenue, for
additional information).
Direct
Operating Costs — Direct operating costs consist primarily of salaries and benefits related to personnel who provide services
to clients and at our managed medical practices, claims processing costs, medical supplies at our managed practices and other direct
costs related to the Company’s services. Costs associated with the implementation of new clients are expensed as incurred. The
reported amounts of direct operating costs include allocated amounts for rent expense and overhead costs.
Selling
and Marketing Expenses — Selling and marketing expenses consist primarily of compensation and benefits, travel and advertising
expenses and are expensed as incurred. The Company incurred approximately $ 2.2 million and $ 2.9 million of advertising costs for the
years ended December 31, 2025 and 2024, respectively.
F- 10
Research
and Development Expenses — Research and development expenses consist primarily of personnel-related costs incurred performing
market research, analyzing proposed products and developing new products.
Internal-Use
Software Costs — The Company capitalizes certain development costs incurred in connection with its internal-use software. Costs
incurred in the preliminary stages of development are expensed as incurred. Once an application has reached the development stage, internal
and external costs, if direct, are capitalized until the software is substantially complete and ready for its intended use. Capitalization
ceases upon completion of all substantial testing. The Company also capitalizes costs related to specific upgrades and enhancements when
it is probable that the expenditures will result in additional functionality. Capitalized costs are recorded as part of intangible assets
in the accompanying consolidated balance sheets. Maintenance and training costs are expensed as incurred. Internal use software is amortized
on a straight line basis over its estimated useful life, generally three years. Management evaluates the useful lives of these assets
on an annual basis and tests for impairment whenever events or changes in circumstances occur that could impact the recoverability of
these assets. During the years ended December 31, 2025 and 2024, the Company capitalized approximately $ 3.2 million and $ 5.7 million,
respectively, primarily consisting of salaries and payroll-related costs of employees and consultants who devoted time to the development
of internal-use software projects.
Accounts
Receivable — Accounts receivable are stated at their net realizable value. Accounts receivable are presented in the consolidated
balance sheets net of an allowance for expected credit losses, which is established based on a lifetime estimated credit loss expected
to occur for trade accounts receivable.
Property
and Equipment — Property and equipment are
stated at cost, less accumulated depreciation. Depreciation is calculated using the straight-line basis over the estimated useful lives
of the assets ranging from 3 three to five
years . Ordinary maintenance and repairs are expensed
as incurred. Depreciation for computers is calculated over three
years , while the remaining assets (except leasehold
improvements) are depreciated over five
years . The Company amortizes leasehold improvements
over the lesser of the lease term or the remaining economic life of those assets. Generally, the lease term is the base lease term plus
certain renewal option periods for which renewal is reasonably certain and for which failure to exercise the renewal option would result
in an economic penalty to the Company.
Intangible
Assets — Intangible assets include customer
relationships, covenants not-to-compete acquired in connection with acquisitions, software purchase and development costs and trademarks
acquired. Amortization for intangible assets related to revenue cycle management is recorded primarily using the 200% double declining
balance method over 3
three to four
years . Amortization for intangible assets related
to the group purchasing organization and medical practice management is recorded on a straight line basis over 4 four and twelve years ,
respectively.
Evaluation
of Long-Lived Assets — The Company reviews its long-lived assets for impairment whenever changes in circumstances indicate
that the carrying value of an asset may not be recoverable. If the sum of undiscounted expected future cash flows is less than the carrying
amount of the asset group, the Company will recognize an impairment loss based on the fair value of the asset. There was no impairment
of internal-use software costs, intangible assets, operating lease right of use assets or property and equipment during the years ended
December 31, 2025 and 2024.
Goodwill
— Goodwill consists of the excess of the purchase price over the fair value of identifiable net assets of businesses acquired.
The Company tests goodwill for impairment annually as of October 31 st , referred to as the annual test date. The goodwill impairment
test for the Healthcare IT segment is performed using the discounted cash flow approach, the trading price of publicly traded stock and
the guideline public company method. Conditions that could trigger a more frequent impairment assessment include, but are not limited
to, a significant adverse change to the Company in certain agreements, significant underperformance relative to historical or projected
future operating results, loss of customer relationships, an economic downturn in customers’ industries, or increased competition.
Impairment testing for goodwill is performed at the reporting-unit level. The Company has determined that its business consists of two
operating segments and two reporting units. No impairment charges were recorded during the years ended December 31, 2025 and 2024.
Treasury
Stock — Treasury stock is recorded at cost and represents shares repurchased by the Company. No shares were repurchased or
issued from treasury stock during the years ended December 31, 2025 and 2024.
F- 11
Stock-Based
Compensation — The Company recognizes compensation for all share-based payments granted based on the grant date fair value.
Compensation expense is generally recognized on a straight-line basis over the vesting period. The Company does not estimate forfeitures
in recognizing the expense for share-based payments, as historical forfeiture rates have not been significant. For restricted stock units
(“RSUs”) classified as equity, the market price of our common or preferred stock on the date of grant is used in recording
the fair value of the award. For RSUs classified as a liability, the earned amount is marked to market based on the end-of-period common
stock price.
Business
Combinations — The Company accounts for business combinations under the provisions of ASC 805, Business Combinations ,
which requires that the acquisition method of accounting be used for all business combinations. Assets acquired and liabilities assumed
are recorded at the date of acquisition at their respective fair values. ASC 805 also specifies criteria that intangible assets acquired
in a business combination must be recognized and reported apart from goodwill. Goodwill represents the excess purchase price over the
fair value of the tangible net assets and intangible assets acquired in a business combination. Acquisition-related expenses are recognized
separately from the business combinations and are expensed as incurred. If the business combination provides for contingent consideration,
the Company records the contingent consideration at fair value at the acquisition date with changes in the fair value recorded through
earnings.
Income
Taxes — The Company accounts for income taxes under the asset and liability method, which requires the recognition of deferred
tax assets and liabilities for the expected future tax consequences of events that have been included in the consolidated financial statements.
Under this method, deferred tax assets and liabilities are determined based on the differences between the financial statements and tax
bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. The
effect of a change in tax rates on deferred tax assets and liabilities is recognized in operations in the period that includes the enactment
date.
The
Company records net deferred tax assets to the extent that these assets will more likely than not be realized. All available positive
and negative evidence is considered in making such a determination, including future reversals of existing taxable temporary differences,
projected future taxable income, tax planning strategies, and results of recent operations. A valuation allowance would be recorded to
reduce deferred income tax assets when it is determined that it is more likely than not that the Company would not be able to realize
its deferred income tax assets in the future in excess of their net recorded amount.
The
Company records uncertain tax positions on the basis of a two-step process whereby (1) the Company determines whether it is more likely
than not that the tax positions will be sustained based on the technical merits of the position and (2) for those tax positions that
meet the more-likely-than-not recognition threshold, the Company recognizes the largest amount of tax benefit that is greater than 50
percent likely to be realized upon ultimate settlement with the related tax authority. At December 31, 2025 and 2024, the Company did
not have any uncertain tax positions that required recognition. Interest and penalties related to uncertain tax positions are recognized
in income tax expense. For the years ended December 31, 2025 and 2024, the Company did not recognize any penalties or interest related
to unrecognized tax benefits in its consolidated financial statements.
Dividends
— Dividends are recorded when declared by the Company’s Board of Directors. At December 31, 2023, the Board of Directors
had declared monthly dividends on the Series A and Series B Preferred Stock through February 2024. However, in December 2023, the dividends
on the Preferred Stock were suspended. The dividend scheduled for payment on December 15, 2023 together with the remaining dividends
that were declared, were accrued in the consolidated balance sheet at December 31, 2024. Future monthly dividends continued to accrue
in arrears but were not recorded as a liability until they were declared by the Board of Directors. The Company resumed paying monthly
dividends in February 2025, paying one month of arrears each month for the remainder of the year. In March 2025, the Company converted
the majority of the Series A Preferred Stock into the Company’s common stock which included payment of the dividends in arrears
at that time for the shares that were converted. The dividend payments made for the remainder of 2025 included dividends for the Series
A Preferred Stock that were not converted and dividends for the Series B Preferred Stock. Preferred stock dividends are charged against
paid in capital because the Company does not have sufficient retained earnings. The dividend payable in the December 31, 2025 consolidated
balance sheet represents dividends declared, but unpaid at that date.
Deferred
Revenue — Deferred revenue primarily consists of payments received in advance of the revenue recognition criteria being met.
Deferred revenue includes certain deferred implementation services fees that are recognized as revenue ratably over the longer of the
life of the agreement or the estimated expected customer life, which is currently estimated to be three years. Deferred revenue that
will be recognized during the succeeding 12-month period is recorded as current deferred revenue and the remaining portion is recorded
as non-current. At the time of customer termination, any unrecognized service fees associated with implementation services are recognized
as revenue.
F- 12
Fair
Value Measurements — ASC 820, Fair Value Measurement , requires the disclosure of fair value information about financial
instruments, whether or not recognized in the balance sheet, for which it is practicable to estimate that value. The Company follows
a fair value measurement hierarchy to measure financial instruments. The fair value of the Company’s financial instruments is measured
using inputs from the three levels of the fair value hierarchy as follows:
Level 1 —
Inputs are unadjusted quoted market prices in active markets for identical assets or liabilities
that the Company has the ability to access at the measurement date.
Level 2 —
Inputs are directly or indirectly observable, which
include quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets or liabilities
in markets that are not active, inputs other than quoted prices that are observable for the asset or liability and inputs that are derived
principally from or corroborated by observable market data by correlation or other means.
Level 3 —
Inputs are unobservable inputs that are used to measure
fair value to the extent observable inputs are not available.
The
Company has certain financial instruments that are not measured at fair value on a recurring basis. These financial instruments are subject
to fair value adjustments only in certain circumstances and include cash, accounts receivable, accounts payable and accrued expenses,
borrowings under term loans and line of credit, and notes payable. Due to the short term nature of these financial instruments and that
the borrowings bear interest at prevailing market rates, the carrying value approximates the fair value.
Foreign
Currency Translation — The financial statements of the Company’s foreign subsidiaries are translated from their functional
currency into U.S. dollars, the Company’s functional currency. All foreign currency assets and liabilities are translated at the
period-end exchange rate, and all revenue and expenses are translated at transaction date exchange rates. The effects of translating
the financial statements of the foreign subsidiaries into U.S. dollars are reported as a cumulative translation adjustment, a separate
component of accumulated other comprehensive loss in the consolidated statements of shareholders’ equity, except for transactions
related to the intercompany receivable for which transaction adjustments are recorded in the consolidated statements of operations as
they are not deemed to be permanently reinvested. Foreign currency transaction gains/losses are reported as a component of other expense
– net in the consolidated statements of operations and amounted to a loss of approximately $ 109,000 and a gain of approximately
$ 130,000 for the years ended December 31, 2025 and 2024, respectively.
Restructuring
Costs — Restructuring costs incurred in 2025 and 2024 primarily consist of severance and separation costs associated with the
optimization of the Company’s operations and profitability improvements. (See Note 14).
Recent
Accounting Pronouncements — From time to time, new accounting pronouncements are issued by the Financial Accounting Standards
Board (“FASB”) and are adopted by us as of the specified effective date. Unless otherwise discussed, we believe that the
impact of recently adopted and recently issued accounting pronouncements will not have a material impact on our consolidated financial
position, results of operations and cash flows.
In
March 2023, the FASB issued ASU 2023-01, Leases (Topic 842): Common Control Arrangements- Issue 2. The amendments in this update
require that leasehold improvements associated with common control leases be: (1) amortized by the lessee over the useful life of the
leasehold improvements to the common control group as long as the lessee controls the use of the underlying asset through a lease and
(2) accounted for as a transfer between entities under common control through an adjustment to equity if, and when, the lessee no longer
controls the use of the underlying asset. The amendments in this update are effective for the fiscal years beginning after December 15,
2023. There was no impact on the consolidated financial statements as a result of this standard.
In
October 2023, the FASB issued ASU 2023-06, Disclosure Improvements: Codification Amendments in Response to the SEC’s Disclosure
Update and Simplification Initiative. This update amends the disclosure or presentation requirements related to various subtopics
in the FASB Accounting Standards Codification. The new guidance is intended to align U.S. GAAP requirements with those of the SEC and
to facilitate the application of U.S. GAAP for all entities. The effective date for each amendment will be the date on which the SEC’s
removal of that related disclosure requirement from Regulation S-X or Regulation S-K becomes effective, with early adoption prohibited.
If by June 30, 2027 the SEC has not removed the applicable requirement from Regulation S-X or Regulation S-K, the pending content of
the associated amendment will be removed from the Codification and will not become effective.
F- 13
In
November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280), Improvements to Reportable Disclosures . The amendments
in this update improve segment disclosure requirements, primarily through enhanced disclosures about significant segment expenses. The
amendments are effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after
December 15, 2024. The impact was only to the financial statement disclosures and has been adopted by the Company.
In
December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740), Improvements to Income Tax Disclosures. The amendments
in this update enhance the transparency and decision usefulness of income tax disclosures primarily related to rate reconciliation
and income taxes paid information. The update also includes certain other amendments to improve the effectiveness of income tax
disclosures. The amendments are effective for annual periods beginning after December 15, 2024. The impact was only to the financial
statement disclosures which has been adopted by the Company prospectively by adding such disclosures as income taxes paid by
jurisdiction and effective income tax rate percentages in the rate reconciliation table.
In
March 2024, the FASB issued ASU 2024-02, Codification Improvements- Amendments to Remove References to the Concepts Statements .
This update contains amendments to the Codification that remove references to various FASB Concepts Statements. These Codification updates
are for technical corrections such as conforming amendments, clarifications to guidance, simplifications to wording or the structure
of guidance and other minor improvements. The resulting amendments are referred to as Codification improvements. The amendments in this
update are effective for public business entities for fiscal years beginning after December 15, 2024. There was no impact on the consolidated
financial statements as a result of this standard.
In
November 2024, the FASB issued ASU 2024-03, Income Statement – Reporting Comprehensive Income – Expense Disaggregation
Disclosures (Subtopic 220-40) . This update contains amendments that require disclosure, in the notes to financial statements, of
specified information about certain costs and expenses. The amendments in this update are effective for public business entities for
annual reporting periods beginning after December 15, 2026, and interim reporting periods beginning after December 15, 2027. Early adoption
is permitted. The expected impact would only be to the financial statement disclosures.
In September 2025, the FASB issued ASU
2025-06, Intangibles – Goodwill and Other – Internal-Use Software (Subtopic 350-40) . This update makes targeted improvements
to Subtopic 350-40 to increase the operability of the recognition guidance by removing all references to software development project
stages so that the guidance is neutral to different software development methods, including methods that entities may use to develop
software in the future. The amendments in this update are effective for all entities for annual reporting periods beginning after December
15, 2027, and interim reporting periods within those annual reporting periods. Early adoption is permitted as of the beginning of an
annual reporting period. The Company is in the process of determining if this update will have a significant impact on the consolidated
financial statements.
In
December 2025, the FASB issued ASU 2025-11, Interim Reporting (Topic 270) . This update improves the guidance in Topic 270, Interim
Reporting, by improving the navigability of the required interim disclosures and clarifying when that guidance is applicable. The amendments
in this update are effective for all entities that provide interim financial statements and notes in accordance with generally accepted
accounting principles for interim reporting periods within annual reporting periods beginning after December 15, 2027. The amendments
in this update can be applied either prospectively or retrospectively to any or all prior periods presented in the financial statements.
The expected impact would only be to the financial statement disclosures.
In
December 2025, the FASB issued ASU 2025-12, Codification Improvements . This project facilitates Codification updates for a broad
range of Topics arising from technical corrections, unintended application of the Codification, clarifications, and other minor improvements.
The Board decided that the types of issues that it will consider through this project are improvements that are not expected to have
a significant effect on current accounting practice or result in significant costs to most entities. The amendments in this Update are
effective for all entities for annual reporting periods beginning after December 15, 2026, and interim reporting periods within those
annual reporting periods. The Company does not expect this update to have a material impact on the consolidated financial statements.
F- 14
3. ACQUISITIONS
Effective
October 1, 2025 (the “MAP App Closing Date”), the Company entered into an Asset Purchase Agreement (the “APA”)
with the Healthcare Financial Management Association (the “HFMA”), an Illinois not-for-profit corporation, to acquire MAP
App. The acquisition has been accounted for as a business combination. Under the APA, the Company paid $ 467,817 (the “Closing Payment”)
as consideration plus potential earnouts. The Company will pay an additional cash payment (the “Earnout Payment”) equal to
the aggregate net revenue earned by the Company during the twelve-month period beginning ninety days from the MAP App Closing Date (the
“Initial Earnout Period”) from (i) customers who were MAP App subscribers as of the MAP App Closing Date and remain active
subscribers, in good standing, throughout the Initial Earnout Period (“Acquired MAP Accounts”), (ii) prospective customers
included in the MAP App pipeline as of the MAP App Closing Date (“Pipeline MAP Accounts”) and (iii) new customers resulting
from the HFMA’s efforts that are neither Acquired MAP Accounts nor Pipeline MAP Accounts (“Ramp-up Customers”). During
the thirty-six month period beginning immediately after the Initial Earnout Period (“Post Earnout Period”), the Company will
make additional quarterly payments to the HFMA in amounts equal to 5 % of the aggregate net revenue earned during the preceding quarter
from all Acquired MAP Accounts, Pipeline MAP Accounts and Ramp-up Customers and 20 % of the aggregate net revenue earned during the preceding
quarter from all newly signed Pipeline MAP Accounts procured in connection with the agreement. The Earnout Payment will be reduced by
the sum of the Closing Payment and $ 353,000 , the deferred revenue amounts.
MAP
App is an industry-leading tool for benchmarking and measuring revenue cycle management performance, which was developed by the HFMA
and is used by top hospitals and healthcare organizations nationwide.
The
preliminary purchase price allocation of the MAP App acquisition is summarized as follows:
SCHEDULE
OF ALLOCATION OF PURCHASE PRICE
($
in thousands)
Cash
$ 468
Notes payable
Contingent escrow
Contingent consideration
157
Total purchase price
$ 625
SCHEDULE
OF ASSETS ACQUIRED AND LIABILITIES ASSUMED IN BUSINESS ACQUISITION
($
in thousands)
Accounts receivable
$ -
Contract asset
Property and equipment
Customer relationships
$ 587
Technology acquired
42
Trademark
10
Goodwill
339
Accounts payable
Accrued compensation
Deferred revenue
( 353 )
Total preliminary purchase price allocation
$ 625
The
fair value of customer relationships was based on the estimated discounted cash flows generated by these intangibles. The goodwill represents
the Company’s ability to develop software relationships with hospitals to support RCM growth. The goodwill from this acquisition
is deductible ratably for income tax purposes over fifteen years. It was estimated that the probable future payments required under the
APA will be approximately $ 157,000 which has been recorded as part of the preliminary purchase price allocation as contingent consideration.
The
Company performed the valuation of the acquired assets and the contingent consideration. The purchase price allocation is preliminary
and will be finalized by the end of the first quarter of 2026 when additional information is obtained regarding customer attrition. The
weighted-average amortization period of the acquired intangible assets is approximately three years.
Revenue
earned from the clients obtained from the MAP App acquisition was approximately $ 226,000 during the three months and year ended December
31, 2025.
The
acquisition reflects both the HFMA’s desire to partner with a leader in healthcare technology to expand MAP App’s core capabilities
and CareCloud’s strategy to expand its SaaS-based ecosystem with best-in-class tools that complement its AI-powered revenue cycle
platform.
On
August 22, 2025 (the “Medsphere Closing Date”), Holdings, a newly created, indirect subsidiary of CareCloud, executed an
Asset Purchase Agreement (the “Purchase Agreement”) with Medsphere Systems Corporation, a Delaware corporation (“Medsphere”).
The acquisition was accounted for as a business combination. Pursuant to the Purchase Agreement, Holdings acquired certain assets and
assumed certain liabilities of Medsphere, which was in the business of providing healthcare IT software and related services primarily
to the U.S. inpatient and ambulatory market.
F- 15
The
aggregate purchase price for the acquisition was $ 16,500,000 , plus the assumption of certain liabilities. The purchase price was comprised
of: (i) $ 8,250,000 in cash, subject to provisions as set forth in the Purchase Agreement and (ii) $ 8,250,000 payable by Holdings to Medsphere’s
secured bank lender Wells Fargo Bank, N.A. (“Wells Fargo”) pursuant to a Deferred Payment Agreement, bearing interest at
a rate of 12 % per year with a maturity date of February 20, 2026 . The Company and its subsidiaries were also party to the Deferred Payment
Agreement as guarantors. The obligations of the Company and its subsidiaries under the Deferred Payment Agreement were secured by their
assets pursuant to security documents executed by the Company and its subsidiaries in favor of Wells Fargo. The obligation to Well Fargo
was satisfied on September 3, 2025. (See Note 8).
The
purchase price allocation of the Medsphere acquisition is summarized as follows:
SCHEDULE
OF ALLOCATION OF PURCHASE PRICE
($
in thousands)
Cash
$ 7,750
Notes payable
8,250
Contingent escrow
500
Total purchase price
$ 16,500
SCHEDULE
OF ASSETS ACQUIRED AND LIABILITIES ASSUMED IN BUSINESS ACQUISITION
($
in thousands)
Accounts receivable
$ 2,166
Contract asset
52
Property and equipment
240
Customer relationships
6,210
Technology acquired
1,810
Trademarks
250
Goodwill
11,880
Accounts payable
( 1,734 )
Accrued compensation
( 544 )
Deferred revenue
( 3,830 )
Total purchase price allocation
$ 16,500
The
fair value of the contract asset was based on the expected revenue earned by Medsphere as of the Medsphere Closing Date. The fair value
of customer relationships was based on the estimated discounted cash flows generated by these intangibles. The goodwill represents the
Company’s ability to expand in the inpatient and ambulatory market and operational synergies that we expect to achieve that would
not be available to other market participants. The goodwill from this acquisition is deductible ratable for income tax purposes over
fifteen years. The acquired accounts receivable is recorded at fair value, which represents amounts that have been subsequently paid
or are expected to be paid by clients. The fair value of the technology is based on the present value of the expected after-tax royalty
savings. The fair value of the property and equipment, accounts payable, accrued compensation and deferred revenue were based on the
acquisition date fair values.
The
Company engaged a third-party valuation specialist to determine the fair value of the intangible assets acquired in the Medsphere acquisition.
The fair value of the remaining assets and liabilities were determined by the Company. The weighted-average amortization period of the
acquired intangible assets is approximately three years .
Revenue
earned from the clients obtained from the Medsphere acquisition was approximately $ 10.5 million during the year ended December 31, 2025.
The restricted cash balance at December 31, 2025 in the consolidated balance sheet represents the contingent escrow portion of the purchase
price allocation. The liability for the contingent consideration escrow is included in the current portion of contingent consideration
in the December 31, 2025 consolidated balance sheet.
The
Medsphere acquisition added additional clients to the Company’s customer base, allowed access to additional inpatient clients and
the clinical software market, expanded the Company’s ambulatory footprint and provided entry into certain managed services.
F- 16
On
April 1, 2025 (the “RevNu Closing Date”), the Company entered into an Asset Purchase Agreement (the “APA”) with
Gratius Enterprises, Inc., doing business as RevNu Medical Management (“RevNu”), pursuant to which the Company acquired certain
assets of RevNu. The acquisition has been accounted for as a business combination. Under the APA, the Company is obligated to make quarterly
payments equal to twenty percent (20%) of the revenue generated from the acquired RevNu client accounts for a period of forty-two (42)
months following the RevNu Closing Date (the “RevNu Quarterly Payments”). The total purchase price is contingent upon future
revenue performance and includes the estimated fair value of the RevNu Quarterly Payments. In the event that the service agreement with
a specified customer is terminated, the Company will have no further obligation to make additional payments under the APA. For the year
ended December 31, 2025, the quarterly payments due to RevNu totaled approximately $ 53,000 .
RevNu
is in the business of providing audiology and hearing aid billing/revenue cycle IT solutions and related services to hearing healthcare
providers/practices. The total consideration for this acquisition consisted of contingent consideration of approximately $ 565,000 .
The
purchase price allocation of RevNu is summarized as follows:
SCHEDULE
OF PRELIMINARY PURCHASE PRICE ALLOCATION
($
in thousands)
Contract asset
$ 14
Customer relationships
519
Goodwill
32
Total purchase price allocation
$ 565
The
fair value of the contract asset was based on the expected revenue earned by RevNu as of the RevNu Closing Date. The fair value of customer
relationships was based on the estimated discounted cash flows generated by these intangibles. The goodwill represents the Company’s
ability to expand in the audiology and hearing aid market. The goodwill from this acquisition is deductible ratably for income tax purposes
over fifteen years. It was estimated that the probable future payments required under the APA will be approximately $ 565,000 which has
been recorded as part of the purchase price allocation as contingent consideration.
The
Company performed the valuation of the acquired assets and the contingent consideration. The weighted-average amortization period of
the acquired intangible assets is approximately three years.
Revenue
earned from the clients obtained from the RevNu acquisition was approximately $ 882,000 during the year ended December 31, 2025.
The
RevNu acquisition added additional clients in the audiology market to the Company’s customer base and, similar to previous acquisitions,
broadened the Company’s presence in the healthcare information technology industry through expansion of its customer base and by
increasing available customer relationship resources and specialized trained staff.
Pro
forma financial information (Unaudited)
The
unaudited pro forma information below represents the Company’s consolidated results of operations as if the MAP App, Medsphere,
RevNu and one other small acquisition occurred on January 1, 2024. The pro forma information has been included for comparative purposes
and is not indicative of results of operations the Company would have had if the acquisitions occurred on the above date, nor is it necessarily
indicative of future results. The unaudited pro forma information reflects material, non-recurring pro forma adjustments directly attributable
to the business combinations. The difference between the actual net revenue and the pro forma net revenue is approximately $ 22.2 million
and $ 43.2 million for the years ended December 31, 2025 and 2024, respectively and are reflected as pro forma adjustments below. These
differences primarily represent revenue recorded from the MAP App, Medsphere, RevNu and one other small acquisition. Other differences
arise primarily from amortizing purchased intangibles using the double declining balance method, depreciating acquired fixed assets,
adjusting the interest expense and reversing debt exit fees and the goodwill amortization and impairment.
SCHEDULE
OF PRO FORMA FINANCIAL INFORMATION
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands, except per share
amounts)
Net revenue
$ 142,698
$ 154,057
Net income
$ 7,195
$ 3,969
Net income (loss) attributable to common shareholders
$ 289
$ ( 8,341 )
Net income (loss) per share - basic and fully
diluted
$ 0.01
$ ( 0.52 )
F- 17
4. GOODWILL
AND INTANGIBLE ASSETS – NET
Goodwill
consists of the excess of the purchase price over the fair value of identifiable net assets of businesses acquired. At December 31, 2025,
and 2024, approximately $ 90,000 of goodwill was allocated to the Medical Practice Management segment and the balance was allocated to
the Healthcare IT segment. The following is the summary of the changes to the carrying amount of goodwill for the years ended December
31, 2025 and 2024:
SCHEDULE
OF CHANGES TO CARRYING AMOUNT OF GOODWILL
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands)
Beginning gross balance
$ 19,186
$ 19,186
Additions
12,256
-
Ending gross balance
$ 31,442
$ 19,186
Below
is a summary of intangible asset activity for the years ended December 31, 2025 and 2024:
SCHEDULE
OF INTANGIBLE ASSETS ACTIVITY
Customer
Capitalized
Other
Intangible
Relationships
Software
Assets
Total
COST
($
in thousands)
Balance, January 1, 2025
$ 47,597
$ 35,108
$ 9,653
$ 92,358
Additions
7,376
3,249
2,112
12,737
Translation loss
-
( 28 )
-
( 28 )
Balance, December 31, 2025
$ 54,973
$ 38,329
$ 11,765
$ 105,067
Useful lives
3 - 12
years
3
years
3
years
ACCUMULATED
AMORTIZATION
Balance, January 1, 2025
$ 45,947
$ 22,766
$ 4,947
$ 73,660
Amortization expense
1,833
10,320
296
12,449
Translation loss
-
( 10 )
-
( 10 )
Balance, December 31, 2025
47,780
33,076
5,243
86,099
Net book value
$ 7,193
$ 5,253
$ 6,522
$ 18,968
COST
Balance, January 1, 2024
$ 47,597
$ 29,379
$ 9,653
$ 86,629
Additions
-
5,709
-
5,709
Translation gain
-
20
-
20
Balance, December 31, 2024
$ 47,597
$ 35,108
$ 9,653
$ 92,358
Useful lives
3 - 12
years
3
years
3
years
ACCUMULATED
AMORTIZATION
Balance, January 1, 2024
$ 44,372
$ 12,237
$ 4,946
$ 61,555
Amortization expense
1,575
10,522
1
12,098
Translation gain
-
7
-
7
Balance, December 31, 2024
45,947
22,766
4,947
73,660
Net book value
$ 1,650
$ 12,342
$ 4,706
$ 18,698
We
reviewed our other long-term assets for impairment. We determined that the fair value of these assets exceeded their carrying value and
that there was no impairment. There were no triggering events during the year ended December 31, 2025.
The
amount for capitalized software represents payroll and development costs incurred for internally developed software. Other intangible
assets primarily represent non-compete agreements, purchased and acquired software and trademarks. Amortization expense was approximately
$ 12.4 million and $ 12.1 million for the years ended December 31, 2025 and 2024, respectively. The weighted-average amortization period
is three years.
F- 18
As
of December 31, 2025, future amortization expense scheduled to be expensed is as follows:
SCHEDULE
OF INTANGIBLE ASSETS, FUTURE AMORTIZATION EXPENSE
Years
ending December 31,
($
in thousands)
2026
$ 10,040
2027
5,038
2028
2,708
2029
1,032
2030
150
Total
$ 18,968
5.
PROPERTY
AND EQUIPMENT
Property
and equipment consisted of the following:
SCHEDULE
OF PROPERTY AND EQUIPMENT
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands)
Computer equipment
$ 6,843
$ 5,963
Aircraft
1,347
-
Office furniture and equipment
2,950
2,342
Transportation equipment
1,833
1,185
Leasehold improvements
8,002
6,358
Assets not placed in service
-
164
Total property and equipment
20,975
16,012
Less accumulated depreciation
( 13,200 )
( 10,722 )
Property and equipment
– net
$ 7,775
$ 5,290
Depreciation
expense was approximately $ 2.5 million and $ 2.0 million for the years ended December 31, 2025 and 2024, respectively.
We
reviewed our property and equipment for impairment. We determined that the fair value of these assets exceeded their carrying value and
that there was no impairment. There were no triggering events during the years ended December 31, 2025 and 2024.
6. CONCENTRATIONS
Financial
Risks — As of December 31, 2025 and 2024, the Company held cash of approximately $ 1.1 million and $ 119,000 , respectively, in
the name of its subsidiaries, at banks in Pakistan and Sri Lanka. The banking systems in these countries do not provide deposit insurance
coverage. Additionally, from time to time, the Company maintains cash balances at financial institutions in the United States in excess
of federal insurance limits. The Company has not experienced any losses on such accounts. The cash held by each U.S. operating company
was below the federal insurance limit at December 31, 2025.
Concentrations
of credit risk with respect to trade accounts receivable are managed by periodic credit evaluations of customers. The Company does not
require collateral for outstanding trade accounts receivable. As of December 31, 2025, two customers each individually accounted for
approximately 7 % and 5 % of accounts receivable, respectively. As of December 31, 2024, two customers each individually accounted for
approximately 7 % of accounts receivable. During the years ended December 31, 2025 and 2024, there was one customer with sales of approximately
10 % of total revenue, respectively.
Geographical
Risks — The Company’s offices in Islamabad, Karachi and Bagh, Pakistan, and Colombo, Sri Lanka conduct significant back-office
operations for the Company. The Company has no revenue earned outside of the United States. The office in Bagh is located in a different
territory of Pakistan from the Islamabad office known as Azad Jammu and Kashmir. The Bagh office was opened in 2009 for the purpose of
providing operational support and operating as a backup to the Islamabad office. The Bagh office operates as the main operational center
for the Company. The Company’s operations outside the United States are subject to special considerations and significant risks
not typically associated with companies in the United States. The Company’s business, financial condition and results of operations
may be influenced by the political, economic, and legal environment in the countries in which it operates and by the general state of
these countries’ economies. The Company’s results may be adversely affected by, among other things, changes in governmental
policies with respect to laws and regulations, changes in local countries’ telecommunications industries, regulatory rules and
policies, anti-inflationary measures, currency conversion and remittance, and rates and methods of taxation.
F- 19
Carrying
amounts of net assets located outside the United States were approximately $ 8.5 million and $ 7.0 million as of December 31, 2025 and
2024, respectively. These balances exclude net intercompany receivables of approximately $ 1.6 million and $ 2.2 million as of December
31, 2025 and 2024, respectively. The following is a summary of the net assets located outside the United States as of December 31, 2025
and 2024:
SCHEDULE
OF CONCENTRATION OF RISK, BY GEOGRAPHICAL RISKS FACTOR
2025
2024
December
31,
2025
2024
($ in thousands)
Current assets
$ 1,315
$ 211
Non-current assets
9,280
8,337
Assets
10,595
8,548
Current liabilities
( 1,839 )
( 1,336 )
Non-current liabilities
( 231 )
( 172 )
Net assets
$ 8,525
$ 7,040
7. NET INCOME (LOSS) PER COMMON SHARE
The
following table reconciles the weighted-average shares outstanding for basic and diluted net income (loss) per common share for the years
ended December 31, 2025 and 2024:
SCHEDULE
OF RECONCILIATION OF WEIGHTED-AVERAGE SHARES OUTSTANDING FOR BASIC AND DILUTED NET LOSS PER COMMON SHARE
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands, except share
and per share amounts)
Basic and Diluted:
Net income
(loss) attributable to common shareholders
$ 3,892
$ ( 4,459 )
Weighted-average common
shares used to compute basic income (loss) per share
37,792,428
16,146,975
Weighted-average common
shares used to compute diluted income (loss) per share
37,953,828
16,146,975
Net income (loss) attributable
to common shareholders per share - basic and diluted
$ 0.10
$ ( 0.28 )
The
net income (loss) attributable to common shareholders includes the preferred stock dividend amounts earned for the year ended December
31, 2025 of approximately $ 6.9 million and the preferred stock dividend amount earned, but not declared, for the year ended December
31, 2024 of approximately $ 12.3 million. The dividend payable at December 31, 2025 and 2024 in the consolidated balance sheets represents
dividends declared, but not paid, through December 31, 2025 and 2024, respectively.
At
December 31, 2025, the 161,400 unvested common stock restricted stock units (“RSUs”) as discussed in Note 16 were included
in the above earnings per share calculation but did not change the amount. At December 31, 2024, the 242,500 unvested equity RSUs were
excluded from the above earnings per share calculation as they were anti-dilutive.
8. DEBT
Silicon
Valley Bank (“SVB”) — During October 2017, the Company opened a revolving line of credit from SVB under a three-year
agreement which replaced the previous credit facility. The
SVB credit facility was secured revolving line of credit where borrowings were based on a formula of 200% of repeatable revenue adjusted
by an annualized attrition rate as defined in the credit agreement .
Effective August 31, 2023, the credit facility agreement was amended whereby the interest rate was increased from the prime rate plus
1.5 %
to the prime rate plus 2.0 % .
The requirement for the minimum liquidity ratio was slightly reduced. These amendments expired on March
31, 2024 and the credit facility reverted to its
previous terms.
F- 20
As
of December 31, 2024, there were no borrowings under the credit facility. Interest on the revolving line of credit was charged at the
prime rate plus 2.0 % for the first quarter of 2024, but decreased to the prime rate plus 1.5 % on April 1, 2024. There was also a fee
of one-half of 1% annually for the unused portion of the credit line . The debt was secured by all of the Company’s domestic assets
and 65 % of the shares in its offshore subsidiaries.
The
SVB credit agreement contained various covenants and conditions governing the revolving line of credit including an annual fee of $ 44,000 .
These covenants included a minimum level of adjusted EBITDA or a minimum liquidity ratio, one of which must be satisfied when borrowings
are outstanding. At December 31, 2024, the Company was in compliance with all covenants.
During
October 2024, the Company entered into a Ninth Loan Modification agreement with SVB whereby the Company decreased the amount available
on its revolving line of credit from $ 25 million to $ 10 million which proportionally reduced the anniversary fee and the fee on the unused
portion of the credit line. As a result of the modification, one covenant was slightly modified. During August 2025, the Company terminated
the line of credit.
On
August 22, 2025, the Company entered into a Deferred Payment Agreement with Wells Fargo for $8,250,000 pursuant to the Purchase Agreement
with Medsphere. The Deferred Payment Agreement had an interest rate of 12% per year with a maturity date of February 20, 2026 and was
secured by substantially all of the Company’s assets. The Deferred Payment Agreement was paid on September 3, 2025 . (See Note 3).
On
September 3, 2025, the Company entered into an agreement (the “Agreement”) with Provident Bank (“Provident”)
whereby Provident provided the Company with an available line of credit of $ 10
million. The
facility is secured by, among other things, a first lien security interest in substantially all of the domestic assets and other
property of the Company. The interest rate of the facility is an adjustable rate equal to the margin (300 basis points) over an
independent index which is equal to the Secured Overnight Financing Rate (“SOFR”). The cost of the Provident line of
credit, which is included in interest expense, is approximately $116,000 for the year ended December 31, 2025. The Agreement
contains various covenants and conditions governing the revolving line of credit including an initial commitment fee of $35,000 and
an annual fee of $35,000 thereafter. At December 31, 2025, the Company was in compliance with all covenants . The Agreement
terminates on September 1, 2027, but can be renewed by the parties.
Upon
entering into the Agreement, the Company borrowed approximately $ 8.3 million on its line of credit with Provident to satisfy the obligation
to Wells Fargo incurred in connection with the Medsphere acquisition. The Company repaid the borrowed amount during the year ended December
31, 2025. At December 31, 2025, the available borrowing base was $ 10.0 million.
On
November 7, 2025, the Company entered into a five-year loan agreement with Republic Bank & Trust Company
(“Republic”) for $ 1,032,000
for the purchase of an aircraft, which serves as security for the loan. The interest rate on the loan is fixed at 6.75 %
and is guaranteed by the Company. The Company plans to liquidate this loan within the next two years.
The
Company maintains cash balances at Provident in excess of the FDIC insurance coverage limits. The Company performs periodic evaluations
of the relative credit standing of Provident to ensure its credit worthiness. As of December 31, 2025 and December 31, 2024, the Company
held cash of approximately $ 1.1
million and $ 119,000 ,
respectively, in the name of its subsidiaries at banks in Pakistan and Sri Lanka. The banking systems in these countries do not provide
deposit insurance coverage. The Company has not experienced any losses on its cash accounts.
Vehicle
Financing Notes — The Company finances certain vehicle purchases both in the United States and in Pakistan. The vehicle financing
notes typically have three 3 to six year terms and are issued at current market rates.
Aircraft
Financing Note — The Company financed an aircraft purchase with a note for $ 1,032,000 with Republic.
F- 21
Maturities
of the outstanding notes payable and other obligations as of December 31, 2025 are as follows:
SCHEDULE
OF MATURITIES OF LONG-TERM DEBT
Financing
Notes
Years
ending December
31,
Vehicle
Aircraft
Total
($ in thousands)
2026
$ 86
$ 642
$ 728
2027
83
338
421
2028
20
-
20
Total
$ 189
$ 980
$ 1,169
9. REVENUE
Introduction
The
Company accounts for revenue in accordance with ASC 606, Revenue from Contracts with Customers . All revenue is recognized as our
performance obligations are satisfied. A performance obligation is a promise in a contract to transfer a distinct good or service to
a customer, and is the unit of account under ASC 606. The Company recognizes revenue when the revenue cycle management services begin
on the medical billing claims, which is generally upon receipt of the claim from the provider. For many services, the Company recognizes
revenue as a percentage of the amount the customer collects on the medical billing claims. The Company’s software is utilized at
the time the provider sees the patient, and the Company estimates the value of the consideration it will earn over the remaining contractual
period as our services are provided and recognizes the fees over the term; this estimation involves predicting the amounts our clients
will ultimately collect associated with the services they provided. Certain significant estimates, such as payment-to-charge ratios,
effective billing rates and the estimated contractual payment periods are required to measure revenue cycle management revenue under
the new standard.
Most
of our current contracts with customers contain a single performance obligation. The Company accounts for individual performance obligations
separately if they are distinct. For contracts where we provide multiple services, such as where we perform multiple ancillary services,
each service represents its own performance obligation. The transaction price is allocated to the separate performance obligations on
a relative standalone selling price (“SSP”) basis. The Company determines the SSP based on the Company’s overall pricing
objectives by reviewing the Company’s significant pricing practices, including discounting practices, geographical locations, the
size and volume of the Company’s transactions, the customer type, price lists, pricing strategy, and historical standalone sales.
The SSP is analyzed on a periodic basis to identify if the Company has experienced significant changes in selling prices.
We
apply the portfolio approach as permitted by ASC 606 as a practical expedient to contracts with similar characteristics and we use estimates
and assumptions when accounting for those portfolios. Our contracts generally include standard commercial payment terms. We have no significant
obligations for refunds, warranties or similar obligations and our revenue does not include taxes collected from our customers.
Disaggregation
of Revenue from Contracts with Customers
We
derive revenue from five primary sources: (1) Technology-enabled business solutions, (2) professional services, (3) printing and mailing
services, (4) group purchasing services and (5) medical practice management services.
F- 22
The
following table represents a disaggregation of revenue for the years ended December 31, 2025 and 2024:
SCHEDULE OF DISAGGREGATION OF REVENUE
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands)
Healthcare IT:
Technology-enabled
business solutions
$ 76,907
$ 73,672
Professional services
25,363
18,202
Printing and mailing services
3,362
3,579
Group purchasing services
934
952
Medical Practice Management:
Medical
practice management services
13,933
14,432
Total
$ 120,499
$ 110,837
Revenue
$ 120,499
$ 110,837
Technology-enabled
business solutions:
Revenue
derived on an on-going basis from our technology-enabled solutions, which typically includes revenue cycle management services, is billed
as a percentage of payments collected by our customers. The fee for our services often includes the ability to use our EHR and practice
management software as well as RCM as part of the bundled fee. The SaaS component is not a material portion of the contract compared
to the stand-alone value of RCM.
Technology-assisted
revenue cycle management services are the recurring process of submitting and following up on claims with health insurance companies
in order for the healthcare providers to receive payment for the services they rendered. The Company typically invoices customers on
a monthly basis based on the actual collections received by its customers and the agreed-upon rate in the sales contract. The fee for
these services typically includes use of practice management software and related tools (on a SaaS basis), electronic health records
(on a SaaS basis), medical billing services and use of mobile health solutions. We consider the services to be one performance obligation
since the promises are not distinct in the context of the contract. The performance obligation consists of a series of distinct services
that are substantially the same and have the same periodic pattern of transfer to our customers.
In
many cases, our clients may terminate their agreements with 90 days’ notice without cause, thereby limiting the term in which we
have enforceable rights and obligations, although this time period can vary between clients. Our payment terms are normally net 30 days.
Although our contracts typically have stated terms of one or more years, under ASC 606 our contracts are considered month-to-month and
accordingly, there is no financing component.
For
the majority of our revenue cycle management contracts, the total transaction price is variable because our obligation is to process
an unknown quantity of claims, as and when requested by our customers over the contract period. When a contract includes variable consideration,
we evaluate the estimate of the variable consideration to determine whether the estimate needs to be constrained; therefore, we include
variable consideration in the transaction price only to the extent that it is probable that a significant reversal of the amount of cumulative
revenue recognized will not occur when the uncertainty associated with variable consideration is subsequently resolved. Estimates to
determine variable consideration such as payment to charge ratios, effective billing rates, and the estimated contractual payment periods
are updated at each reporting date. Revenue is recognized over the performance period using the input method.
Our
proprietary, cloud-based practice management application automates the labor-intensive workflow of a medical office in a unified and
streamlined SaaS platform. The Company has a large number of clients who utilize the Company’s practice management, urgent care
and clinical workflow software, electronic health records software, patient experience management solutions, business intelligence software,
inventory management systems, and/or robotic process automation software on a SaaS basis, but who do not utilize the Company’s
revenue cycle management services. SaaS fees may be fixed based on the number of providers, or may be variable.
Our
digital health services, which began generating revenue in 2022, include Chronic Care Management (“CCM”), where a care manager
has remote visits with patients with one or more chronic conditions under the supervision of a physician who is our client. The performance
obligation for CCM is satisfied at a point in time once the patient receives the remote visit. The digital health services also include
Remote Patient Monitoring (“RPM”) where our system monitors recordings from FDA approved internet connected devices. These
devices record patient trends and alerts the physician to changes which might trigger the need for additional follow-up visits. The performance
obligations for remote patient monitoring are satisfied over time as the recordings are received and the patient receives the remote
visit. The revenue for CCM for the years ended December 31, 2025 and 2024 was approximately $ 2.8 million and $ 3.0 million, respectively.
The revenue for RPM for the years ended December 31, 2025 and 2024 was approximately $ 794,000 and $ 779,000 , respectively.
F- 23
The
medical billing clearinghouse service takes claim information from customers, checks the claims for errors and sends this information
electronically to insurance companies. The Company invoices customers on a monthly basis based on the number of claims submitted and
the agreed-upon rate in the agreement. This service is provided to medical practices and providers to medical practices who are not revenue
cycle management customers. The performance obligation is satisfied once the relevant submissions are completed.
Additional
services such as coding and transcription are rendered in connection with the delivery of revenue cycle management and related medical
services. The Company invoices customers monthly, based on the actual amount of services performed at the agreed-upon rate in the contract.
These services are only offered to revenue cycle management customers. These services do not represent a material right because the services
are optional to the customer and customers electing these services are charged the same price for those services as if they were on a
standalone basis. Each individual coding or transcription transaction processed represents a performance obligation, which is satisfied
over time as that individual service is rendered.
Professional
services:
Our
professional services include an extensive set of services including EHR vendor-agnostic optimization and activation, project management,
IT transformation consulting, process improvement, training, education and staffing for large healthcare organizations including health
systems and hospitals. Our professional services beginning in 2025 include managed IT services, government consulting and product development
services. The performance obligation is satisfied over time using the input method. The revenue is recorded on a monthly basis as the
professional services are rendered. Unbilled revenue at December 31, 2025 and 2024 was approximately $ 79,000 and $ 338,000 , respectively.
Printing
and mailing services:
The
Company provides printing and mailing services for both revenue cycle management customers and a non- revenue cycle management customer,
and invoices on a monthly basis based on the number of prints, the agreed-upon rate per print and the postage incurred. The performance
obligation is satisfied once the printing and mailing is completed.
Group
purchasing services:
The
Company provides group purchasing services which enable medical providers to purchase various vaccines directly from selected pharmaceutical
companies at a discounted price. Currently, there are approximately 4,000 medical providers who are members of the program. Revenue is
recognized as the vaccine shipments are made to the medical providers. Fees from the pharmaceutical companies are paid either quarterly
or annually and the Company adjusts its revenue accrual at the time of payment. The Company makes significant judgments regarding the
variable consideration which we expect to be entitled to for the group purchasing services which includes the anticipated shipments to
the members enrolled in the program, anticipated volumes of purchases made by the members, and the changes in the number of members.
The amounts recorded are constrained by estimates of decreases in shipments and loss of members to avoid a significant revenue reversal
in the subsequent period. The only performance obligation is to provide the pharmaceutical companies with the medical providers who want
to become members in order to purchase vaccines. The performance obligation is satisfied once the medical provider agrees to purchase
a specific quantity of vaccines and the medical provider’s information is forwarded to the vaccine suppliers. The Company records
a contract asset for revenue earned and not paid as the ultimate payment is conditioned on achieving certain volume thresholds.
For
all of the above revenue streams other than group purchasing services and CCM, revenue is recognized over time, which is typically one
month or less, which closely matches the point in time that the customer simultaneously receives and consumes the benefits provided by
the Company. For the group purchasing services, revenue is recognized at a point in time. Each service is substantially the same and
has the same periodic pattern of transfer to the customer. Each of the services provided above is considered a separate performance obligation.
There
were no unsatisfied performance obligations for contracts with an original duration greater than one year. The Company has elected to
utilize the practical expedient available with the guidance for contracts with an expected duration of one year or less.
F- 24
Medical
practice management services:
The
Company also provides medical practice management services under long-term management service agreements to three medical practices.
We provide the medical practices with the nurses, administrative support, facilities, supplies, equipment, marketing, RCM, accounting,
and other non-clinical services needed to efficiently operate their practices. Revenue is recognized as the services are provided to
the medical practices. Revenue recorded in the consolidated statements of operations represents the reimbursement of costs paid by the
Company for the practices and the management fee earned each month for managing the practice. The management fee is based on either a
fixed fee or a percentage of the net operating income.
The
Company assumes all financial risk for the performance of the managed medical practices. Revenue is impacted by the amount of the costs
incurred by the practices and their operating income. The gross billing of the practices is impacted by billing rates, changes in current
procedural terminology code reimbursement and collection trends which in turn impacts the management fee that the Company is entitled
to. Billing rates are reviewed at least annually and adjusted based on current insurer reimbursement practices. The performance obligation
is satisfied as the management services are provided.
Our
contracts for medical practice management services have approximately an additional 13 years remaining and are only cancellable under
very limited circumstances. The Company receives a management fee each month for managing the day-to-day business operations of each
medical group as a fixed fee or a percentage payment of the net operating income which is included in revenue in the consolidated statements
of operations.
Our
medical practice management services obligations consist of a series of distinct services that are substantially the same and have the
same periodic pattern of transfer to our customers. Revenue is recognized over time, however for reporting and convenience purposes,
the management fee is computed at each month end.
Information
about contract balances:
As
of December 31, 2025, the estimated revenue expected to be recognized in the future related to the remaining revenue cycle management
performance obligations outstanding was approximately $ 3.2 million. We expect to recognize substantially all of the revenue for the remaining
performance obligations over the next three months. Approximately $ 264,000 and $ 249,000 of the contract asset represents revenue earned,
not paid, from the group purchasing services and referral fees, respectively.
Amounts
that we are entitled to collect under the applicable contract are recorded as accounts receivable. Invoicing is performed at the end
of each month when the services have been provided. The contract asset includes our right to payment for services already transferred
to a customer when the right to payment is conditional on something other than the passage of time. For example, contracts for revenue
cycle management services where we recognize revenue over time but do not have a contractual right to payment until the customer receives
payment of their claim from the insurance provider. The contract asset also includes the revenue accrued, not received, for the group
purchasing services.
F- 25
Changes
in the contract asset are recorded as adjustments to net revenue. The changes primarily result from providing services to revenue cycle
management customers that result in additional consideration and are offset by our right to payment for services becoming unconditional
and changes in the revenue accrued for the group purchasing services. The contract asset for our group purchasing services is reduced
when we receive payments from vaccine manufacturers and is increased for revenue earned, not received. The opening and closing balances
of the Company’s accounts receivable, contract asset and deferred revenue are as follows:
SCHEDULE OF CHANGES IN ACCOUNTS RECEIVABLE, CONTRACT ASSET AND DEFERRED REVENUE
Accounts
Receivable
- Net
Contract
Asset
Deferred
Revenue
(current)
Deferred
Revenue
(long term)
($
in thousands)
Balance
as of January 1, 2025
$ 12,774
$ 4,334
$ 1,212
$ 387
Acquisitions
2,166
84
4,183
-
Increase
(decrease), net
122
( 754 )
( 1,247 )
422
Balance
as of December 31, 2025
$ 15,062
$ 3,664
$ 4,148
$ 809
Balance
as of January 1, 2024
$ 11,888
$ 5,094
$ 1,380
$ 256
Increase
(decrease), net
886
( 760 )
( 168 )
131
Balance
as of December 31, 2024
$ 12,774
$ 4,334
$ 1,212
$ 387
Deferred
revenue:
The
amount of deferred revenue that was recorded at the beginning of the year and recognized during the years ended December 31, 2025 and
2024 was approximately $ 735,000
and $ 909,000 ,
respectively.
Deferred
commissions:
Our
sales incentive plans include commissions payable to employees and third parties at the time of the initial contract execution that are
capitalized as incremental costs to obtain a contract. The capitalized commissions are amortized over the period the related services
are transferred. As we do not offer commissions on contract renewals, we have determined the amortization period to be the estimated
client life, which is three years. Deferred commissions were approximately $ 211,000 and $ 386,000 at December 31, 2025 and 2024, respectively,
and are included in the other assets amounts in the consolidated balance sheets. The amortization of deferred sales commissions during
the years ended December 31, 2025 and 2024 was approximately $ 248,000 and $ 327,000 , respectively.
Trade
Accounts Receivable – Estimate of Credit Losses:
ASU
2016-13 requires the recognition of lifetime estimated credit losses expected to occur for trade accounts receivable. The guidance also
requires we pool assets with similar risk characteristics and consider current economic conditions when estimating losses.
At
adoption, we segmented the accounts receivable population into pools based on their risk assessment. Risks related to trade accounts
receivable are a customer’s inability to pay or bankruptcy. Each pool was defined by their internal credit assessment and business
size. The pools are aligned with management’s review of financial performance. For the years ended December 31, 2025 and 2024,
no adjustment to the pools was necessary.
We
utilize a loss-rate method to measure the expected credit loss for each pool. The loss rate is calculated using a three-year lookback
period of write-offs and adjustments, divided by the revenue for each pool by aging category, net of customer payments during that period.
We consider current and future economic conditions, internal forecasts, customer collection experience and credit memos issued during
the current period when assessing loss rates. We reviewed these factors and concluded that no adjustments should be made to the historical
loss rate data for the current quarter. In addition, the Company uses specific account identification in determining the total allowance
for expected credit losses. Trade receivables are written off only after the Company has exhausted all collection efforts.
Changes
in the allowance for expected credit losses for trade accounts receivable are presented in the table below:
SCHEDULE OF TRADE ALLOWANCE FOR DOUBTFUL ACCOUNTS
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands)
Beginning balance
$ 837
$ 879
Provision
286
334
Recoveries/adjustments
-
2
Write-offs
( 269 )
( 378 )
Ending balance
$ 854
$ 837
F- 26
10. SHAREHOLDERS’ EQUITY
On
September 11, 2024, a Certificate of Amendment (the “Amendment”) to the Certificate of Designations, Preferences and Rights
of 11 % Series A Cumulative Redeemable Preferred Stock (the “Existing Certificate”) became effective, amending certain provisions
of the 11 % Series A Cumulative Redeemable Preferred Stock (the “Series A Preferred Stock”).
The
title of the Existing Certificate was amended to read “Amended and Restated Certificate of Designations, Preferences and Rights
of 8.75 % Series A Cumulative Redeemable Perpetual Preferred Stock.” Holders of Series A Preferred Stock will now receive similar
change of control protections to those afforded to holders of the Company’s Series B Preferred Stock. The dividend of Series A
Preferred Stock was amended from 11 % to 8.75 % per annum and the per annum dividend amount per share was amended from $ 2.75 to $ 2.1875
per share per annum. Also, the Company now has the right to exchange the shares of Series A Preferred Stock for common stock at the liquidation
preference value of $ 25 per share, plus accrued and unpaid dividends (See note 20).
Treasury
stock
The
Board of Directors of the Company previously approved common stock repurchase programs. The last program expired in January 2017 . As
a result of these stock repurchases, the Company has 740,799 common shares held as treasury stock at an aggregate cost of $ 662,000 .
Common
stock
Holders
of our common stock are entitled to one vote for each share held on all matters properly submitted to a vote of shareholders on which
holders of common stock are entitled to vote . Holders of common stocks are entitled to receive dividends only at times and amounts as
determined by the Board of Directors. The common stock is not entitled to pre-emptive rights, and is not subject to conversion, redemption
or sinking fund provisions. The common stock is listed on the Nasdaq Global Market under the trading symbol “CCLD.”
In
January 2025, the Company’s common stock shareholders approved an increase in the number of authorized common shares from 35 million
to 85 million. An amended certificate of incorporation was filed by the Company.
Preferred
stock
The
Company has seven million authorized shares of preferred stock of which 4,560,000 have been designated as Series A shares and the balance
have been designated as Series B shares.
Since
September 11, 2024, we have had the right, at our option, to convert the majority of the Series A Preferred Stock into common stock
at any time. If we convert shares of the Series A Preferred Stock, then subsequent to the conversion date, dividends would cease
to accrue on shares of the Series A Preferred Stock. The shares of the Series A Preferred Stock will then no longer be deemed
outstanding and all rights as a holder of those shares will terminate, except the right to receive the shares of common stock plus
accumulated and unpaid dividends, if any, payable upon the conversion.
On
March 6, 2025, the Board of Directors elected to exercise its conversion rights, which provided for the conversion of each share of Series
A Preferred Stock into 7.3358
shares of common stock, inclusive of all accumulated and unpaid
dividends (the “Conversion”). Dividends on the converted shares of Series A Preferred Stock ceased to accrue as of the conversion
date. Individual shareholders who, on the exchange date, owned at least 100,000
shares of Series A Preferred Stock did not have their shares
automatically converted to common stock so long as they were held by the Company’s transfer agent, unless they consented to the
Conversion. There were 3,541,701
shares of Series A Preferred Stock converted at that time and
984,530
shares of Series A Preferred Stock continued to be outstanding
at that time and through December 31, 2025. Due to the Conversion, the monthly cash dividends on Series A Preferred Stock were reduced
to approximately $ 455,000
per month. As a result of the Conversion, the Company delisted
the Series A Preferred Stock from the Nasdaq Global Market.
Since
November 4, 2020, the Company has the right to redeem, at its option, the Series A Preferred Stock, in whole or in part, at a cash
redemption price of $ 25.00
per share, plus all accrued and unpaid dividends to, but not including, the redemption date. This right continues for the remaining
shares of the Series A Preferred Stock still outstanding. The Series A Preferred Stock has no stated maturity, is not subject to any
sinking fund or other mandatory redemption, and is not convertible at the option of the holder into or exchangeable for any of the
Company’s other securities. Holders of the Series A Preferred Stock have no voting rights except for limited voting rights if
dividends payable on the Series A Preferred Stock are in arrears for eighteen or more consecutive or non-consecutive monthly
dividend periods, at which time they are entitled to appoint two additional directors to our Board of Directors. If the Company were
to liquidate, dissolve or wind up, the holders of the Series A Preferred Stock will have the right to receive $ 25.00
per share, plus any accumulated and unpaid dividends to, but not including, the date of payment, before any payment is made to the
holders of the common stock.
Since
February 15, 2025 and prior to February 15, 2026, we were able to redeem, at our option, the Series B Preferred Stock, in whole or in
part, at a cash redemption price of $ 25.50 per share, plus all accrued and unpaid dividends to, but not including, the redemption date.
On or after February 15, 2026 and prior to February 15, 2027, we may redeem, at our option, the Series B Preferred Stock, in whole or
in part, at a cash redemption price of $ 25.25 per share, plus all accrued and unpaid dividends to, but not including, the redemption
date. On or after February 15, 2027, we may redeem, at our option, the Series B Preferred Stock, in whole or in part, at a cash redemption
price of $ 25.00 per share, plus all accrued and unpaid dividends to, but not including, the redemption date. The Series B Preferred Stock
is listed on the Nasdaq Global Market under the trading symbol “CCLDO.”
Dividends
on the Series A Preferred Stock of $ 2.75 annually
per share (through September 11, 2024 and $ 2.19 thereafter)
and the Series B Preferred Stock at $ 2.19 annually
per share are cumulative from the date of issue and are payable each month when, as and if declared by the Company’s Board of
Directors. In October 2023, the Board of Directors declared monthly dividends on the Series A and Series B Preferred Stock payable
through February 2024. However, on December 11, 2023, the Board of Directors suspended the monthly cash dividends for Series A
Preferred Stock and Series B Preferred Stock beginning with the payment scheduled for December 15, 2023 together with the remaining
dividends that were declared. The suspension of these dividends deferred approximately $ 1.3 million
in cash dividend payments each month through September 11, 2024. Due to the above Amendment, effective on September 12, 2024, the
combined monthly cash dividends were reduced to approximately $ 1.1 million
per month.
F- 27
During
the suspension, dividends continued to accrue in arrears on the Series A and Series B Preferred Stock. The Company’s Board of Directors
declared payment of two months of dividends in January 2025 and the Company resumed payment of the dividends in February 2025, paying
one month of dividends in arrears each month during the remainder of 2025.
During
the year ended December 31, 2024, no dividends were declared by the Board of Directors. At December 31, 2024, the Company owed approximately
$ 5.4 million for dividends that had previously been declared through February 2024 (but whose payment was suspended), and also had total
undeclared dividends of approximately $ 12.3 million, which represents the accumulated (but undeclared) dividends due to Preferred Stock
shareholders of record on December 31, 2024. Dividends that have accrued in arrears but which have not been declared by the Board of
Directors are not recorded in the consolidated balance sheets but are reflected in the net loss attributable to common shareholders.
Total dividends in arrears at December 31, 2024 amounted to approximately $ 17.7 million or $ 3.04 per share for the Series A Preferred
Stock and $ 2.55 per share for the Series B Preferred Stock.
In
February 2025, the Company resumed monthly payment of the dividends on the Series A and B Preferred Stock, paying one month of dividends
in arrears and continuing through the remainder of the year and applying these amounts to the earliest payments in arrears. The payments
made starting in March 2025, which occurred after the Conversion included dividends for the shares of Series A Preferred
Stock that were not converted and dividends for the Series B Preferred Stock.
At
December 31, 2025, the Company had total undeclared dividends of approximately $ 6.8 million or $ 2.73 per share for both the Series A
and Series B Preferred Stock which represents the accumulated (but undeclared) dividends due to preferred shareholders of record on
December 31, 2025. Dividends in arrears that have not been declared by the Board of Directors are not recorded in the consolidated balance
sheets. Dividends earned during the period are reflected in the consolidated statements of operations, whether or not they were declared.
As of December 31, 2025, dividends have been declared by the Board of Directors for holders of record through that date. The Company
plans to continue declaring monthly dividends until such time as the arrearage on the Preferred Stock is satisfied. The Company has announced
that it will pay two months of dividends each month starting with the February 15, 2026 payment for the Series B Preferred Stock to satisfy
the 14 months of accumulated and unpaid dividends.
Warrants
There
were no warrants outstanding at December 31, 2025 and 2024.
11. COMMITMENTS AND CONTINGENCIES
Legal
Proceedings — On December 22, 2023, an arbitrator rendered a decision in favor of Ramapo Anesthesiologists, PC (“Ramapo”)
and granted in part and denied in part certain claims brought against Origin Healthcare Solutions, LLC, Meridian Medical Management,
Inc., and the Company for alleged breach of contract and other allegations. Ramapo was awarded mitigation related costs of $ 117,000 .
The payment for such an award was made during the first quarter of 2024. The Company’s portion of the settlement is approximately
$ 32,000 and the insurance company paid the balance. The Company’s portion was recorded in accrued expenses at December 31, 2023
in the consolidated balance sheet.
F- 28
In
March 2019, a former customer filed a complaint against the Company in New Jersey State Court to recover damages claimed to have been
caused by the mishandling of their account. Plaintiff alleged at least approximately $ 750,000 in damages which was disputed by the Company.
The parties participated in a one-day court-ordered, non-binding arbitration. At that time, the arbitrator awarded Plaintiff $ 288,750
on its contract claims, and awarded the Company $ 21,698 on its cross-claim for unpaid fees. Plaintiff filed to reject this award. The
Company previously filed a partial motion for summary judgment on the alleged punitive damages, but the court denied that motion finding
there is an issue of fact as to whether those can be awarded at trial. The Company filed an offer of judgment for $ 200,000 during April
2024 which was accepted and paid in July 2024.
In
connection with a prior acquisition, the seller had alleged that the Company owed approximately $ 800,000 in transition related costs
to them. The parties agreed to settle the claim for approximately $ 316,000 , which was paid in September 2024.
A
former customer had a dispute with the Company that was based on services before and after the account was acquired in an acquisition.
A complaint was filed in Massachusetts State Court, Essex County in February 2018. Under the terms of the purchase agreement, the Company’s
liability, if any, was solely and expressly limited to damages related to its handling of the account at issue. The parties participated
in formal mediation and at that time, Plaintiff’s starting settlement demand was over $ 2 million. The mediation was not successful.
The Company made an offer of $ 100,000 in December 2024 to settle the suit, which was accepted. The settlement amount was recorded in
accrued expenses at December 31, 2024 in the consolidated balance sheet. A settlement agreement with mutual releases was signed by the
parties in January 2025 and payment was made in February 2025.
A
dispute occurred with a former customer regarding previous services rendered and they filed a complaint in New York Supreme Court, Onondaga
County in January 2024. During settlement communications, Plaintiff’s initial settlement demand was over $ 2.5 million. During ongoing
settlement communications, the Company made an offer of $ 29,000 in March 2025, which was accepted. A settlement agreement with mutual
releases was signed by the parties in May 2025 and payment was made in June 2025.
A
dispute arose with a current customer utilizing the Company’s system and they filed a complaint in Connecticut Superior Court,
Judicial District of Middlesex in April 2025. The parties agreed to settle the claim for $ 24,000 . This amount was accrued at December
31, 2025 and was paid during January 2026.
From
time to time, we may become involved in other legal proceedings arising in the ordinary course of our business. We are not presently
a party to any legal proceedings that, in the opinion of our management, would individually or taken together have a material adverse
effect on our business, consolidated results of operations, financial position or cash flows of the Company.
12. LEASES
We
determine if an arrangement is a lease at inception. We have operating leases for office and temporary living space as well as for some
office equipment. Operating leases are included in operating lease ROU assets, current operating lease liability and non-current operating
lease liability in our consolidated balance sheets as of December 31, 2025 and 2024. The Company does not have any finance leases.
ROU
assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease
payments arising from the lease. ROU assets and liabilities are recognized at the lease commencement date based on the estimated present
value of the lease payments over the lease term.
As
most of our leases do not provide an implicit rate, we use our estimated incremental borrowing rates, which are derived from information
available at the lease commencement date, in determining the present value of lease payments. We give consideration to our bank financing
arrangements, geographical location and collateralization of assets when calculating our incremental borrowing rates.
F- 29
Our
lease terms include options to extend the lease when it is reasonably certain that we will exercise that option. Leases with a term of
less than 12 months are not recorded in the consolidated balance sheets . Our lease agreements do not contain any residual value guarantees.
For real estate leases, we account for the lease and non-lease components as a single lease component. Some leases include escalation
clauses and termination options that are factored in the determination of the lease payments when appropriate.
If
a lease is modified after the effective date, the operating lease ROU asset and liability is re-measured using the current incremental
borrowing rate. There was one lease modification during both the years ended December 31, 2025 and 2024. We review our incremental borrowing
rate for our portfolio of leases on a quarterly basis.
There
were no lease impairments recorded for the years ended December 31, 2025 and 2024.
Lease
expense is included in direct operating costs, general and administrative expense, selling and marketing expense and research and development
expense in the consolidated statements of operations based on the nature of the expense. As of December 31, 2025, we had 27 leased properties,
five in Medical Practice Management and 22 in Healthcare IT, with the remaining terms ranging from less than one year to ten years. Our
lease terms are determined taking into account lease renewal options, the Company’s anticipated operating plans and leases that
are on a month-to-month basis . We also have some related party leases – see Note 13.
The
components of lease expense were as follows:
SCHEDULE
OF LEASE EXPENSE
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands)
Operating lease cost
$ 2,142
$ 2,451
Short-term lease cost
5
4
Variable lease cost
19
28
Total - net lease cost
$ 2,166
$ 2,483
Short-term
lease cost represents leases that were not capitalized as the lease term as of the later of January 1, 2025 or the beginning of the lease
was less than 12 months. Variable lease costs include utilities, real estate taxes and common area maintenance costs.
Supplemental
balance sheet information related to leases was as follows:
SCHEDULE OF SUPPLEMENTAL BALANCE SHEET INFORMATION RELATED TO LEASES
December
31, 2025
December
31, 2024
($ in thousands)
Operating leases:
Operating lease
ROU assets, net
$ 3,106
$ 3,133
Current operating lease
liabilities
$ 927
$ 1,287
Non-current
operating lease liabilities
2,187
1,847
Total
operating lease liabilities
$ 3,114
$ 3,134
Operating leases:
ROU assets
$ 4,876
$ 5,125
Asset lease expense
( 1,767 )
( 1,994 )
Foreign
exchange (loss)/gain
( 3 )
2
ROU
assets, net
$ 3,106
$ 3,133
Weighted average remaining lease term (in years):
Operating leases
6.1
5.0
Weighted average discount rate:
Operating leases
8.5 %
14.2 %
F- 30
Supplemental
cash flow and other information related to leases was as follows:
SCHEDULE
OF SUPPLEMENTAL CASH FLOW AND OTHER INFORMATION RELATED TO LEASES
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands)
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash
flows from operating leases
$ 2,122
$ 2,467
ROU assets obtained in exchange for lease liabilities:
Operating leases, excluding
terminations
$ 1,743
$ 864
Maturities
of lease liabilities are as follows:
SCHEDULE
OF MATURITIES OF LEASE LIABILITIES
Operating leases - Years
ending December 31,
($
in thousands)
2026
$ 1,134
2027
756
2028
447
2029
238
2030
225
Thereafter
1,073
Total lease payments
3,873
Less: imputed interest
( 759 )
Total lease obligations
3,114
Less: current obligations
927
Long-term lease obligations
$ 2,187
The
Company leases certain apartments which are subleased to others. The sublease agreements are currently on a month-to-month basis and
are considered operating leases. For the years ended December 31, 2025 and 2024, the Company received sublease income of
approximately $ 31,000
and $ 94,000 ,
respectively.
13. RELATED
PARTIES
The
Company had sales to a related party, a physician who is the wife of the Executive Chairman. Revenues from this customer were approximately
$ 125,000 and $ 138,000 for the years ended December 31, 2025 and 2024, respectively. As of December 31, 2025 and 2024, the accounts receivable
balance due from this customer was approximately $ 15,000 and $ 13,000 , respectively, and is included in accounts receivable - net in the
consolidated balance sheets.
The
Company leases its corporate offices in New Jersey, its temporary housing for its foreign visitors, a storage facility, its operations
center in Bagh, Pakistan and an apartment for temporary housing in Dubai, the UAE, from the Executive Chairman. The related party rent
expense for the years ended December 31, 2025 and 2024 was approximately $ 285,000 and $ 281,000 , respectively, and is included in direct
operating costs and general and administrative expense in the consolidated statements of operations. During the years ended December
31, 2025 and 2024, the Company spent approximately $ 1.6 million and $ 979,000 , respectively, to upgrade the related party leased facilities.
The 2025 expenditures were primarily related to the expansion of the Company’s AI center. Current assets-related party in the consolidated
balance sheets includes security deposits related to the leases of the Company’s corporate offices in the amount of approximately
$ 16,000 for both the years ended December 31, 2025 and 2024. The Company also leases two facilities used for temporary housing from a
management employee for approximately $ 6,700 per month.
Included
in the ROU asset at December 31, 2025 is approximately $ 430,000 applicable to the related party leases. Included in the current and non-current
operating lease liability at December 31, 2025 is approximately $ 202,000 and $ 226,000 , respectively, applicable to the related party
leases. Included in the ROU asset at December 31, 2024 is approximately $ 550,000 applicable to the related party leases. Included in
the current and non-current operating lease liability at December 31, 2024 is approximately $ 181,000 and $ 367,000 , respectively, applicable
to the related party leases.
F- 31
During
2025, the Company employed the son of the current Chief Executive Officer. For the year ended December 31, 2025, the Company
recorded approximately $ 38,000
of salary expense.
During
July 2025, the Company entered into a month-to-month consulting agreement with an entity owned and controlled by the son of the Executive
Chairman to provide consulting services to the Company in artificial intelligence technology for $15,000 per month plus travel expenses.
The expense recorded under this agreement was approximately $ 83,000 for the year ended December 31, 2025.
Effective
January 9, 2024, and as amended February 12, 2024, the Company entered into a consulting agreement with an entity owned and controlled
by a member of its Board of Directors to provide investor relations and other services as requested for $ 8,000 per month (reduced to
$ 2,000 per month effective September 1, 2024 and reduced to an as-needed basis effective January 1, 2025). The agreement was paid at
the contractual amount plus amounts for additional services requested, and as of January 1, 2025, is paid on an hourly basis. The consulting
agreement was cancelable with ten days’ notice. This agreement was terminated by the Company effective February 22, 2026. For the
years ended December 31, 2025 and 2024, the expense recorded under this agreement was approximately $ 13,000 and $ 75,000 , respectively,
and is included in general and administrative expense in the consolidated statement of operations.
During
June 2022, the Company entered into a one-year consulting agreement with an entity owned and controlled by one of its former non-independent
directors whereby that director received 10,000 shares of the Company’s 8.75 % Series B Cumulative Redeemable Perpetual Preferred
Stock (“Series B Preferred Stock”) in exchange for assisting the Company to identify and acquire additional companies, including
performing due diligence. In addition, the Company could make additional payments under the agreement for any successful acquisitions
by the Company based on the purchase price of the transaction. No such additional payments were made in 2022. During February 2023, the
agreement was amended and extended through December 2024 whereby the former director received 14,000 shares of Series B Preferred Stock
in February 2023 and received an additional 14,000 shares in January 2024. All of the payments made were capitalized and amortized over
the service period. The amortization was recorded as stock compensation in general and administrative expense in the consolidated statement
of operations. All such shares of the Series B Preferred Stock were issued in accordance with the Company’s Amended and Restated
2014 Equity Incentive Plan. In addition to the extension of the consulting agreement, the amendment provided that any transaction fees
due will be offset against the last two above payments before any amounts are due to that former director. Effective February 1, 2024,
the Company added an additional Statement of Work (“SOW”) to the consulting agreement with the same entity. As compensation
for the SOW, the entity received $ 25,000 per month. The SOW was cancelable with ten days’ notice. The consulting agreement and
SOW, through mutual consent, were terminated as of April 30, 2024. There were no transaction fees paid through that date. Effective May
1, 2024, the former non-independent director became President of the Company and effective January 1, 2025 became Co-Chief Executive
Officer and effective January 1, 2026 became the Chief Executive Officer.
During
2020, a New Jersey corporation, talkMD Clinicians, PA (“talkMD”), was formed by the wife of the Executive Chairman, who is
a licensed physician, to provide telehealth services. talkMD was determined to be a variable interest entity (“VIE”) for
financial reporting purposes because the entity will be controlled by the Company. As of December 31, 2025, talkMD had not yet commenced
operations. Cumulatively, the Company has paid approximately $ 6,500 on behalf of talkMD for income taxes.
14. RESTRUCTURING COSTS
During
October 2023, the Company committed to effectively align resources with business priorities and improve profitability through a reduction
in the workforce for the Healthcare IT segment. The Company identified opportunities for improvements in its workforce realignment, strategy
and staffing, and increased its focus on performance management, to ensure it has the right skillsets and number of employees to execute
its long-term vision. In addition, the Company instituted certain other expense reductions.
A
majority of the impacted employees exited in the fourth quarter of 2023. The Company incurred expenses of approximately $ 1.4 million
related to the reduction in workforce of which approximately $ 154,000 and $ 606,000 were incurred in 2025 and 2024, respectively. These
restructuring expenses consisted of one-time termination benefits, including but not limited to, severance payments and healthcare benefits.
F- 32
The
following table summarizes restructuring costs for 2025 and 2024:
SCHEDULE OF RESTRUCTURING COSTS
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands)
Severance and separation costs
$ 154
$ 606
Equity awards acceleration costs associated
with severance
-
-
Other exit related costs
-
-
Total restructuring
and other costs
$ 154
$ 606
The
expense associated with the restructuring is included in restructuring costs in the consolidated statement of operations for the years
ended December 31, 2025 and 2024. The liabilities associated with restructuring costs are included in accrued expenses in the consolidated
balance sheet. The following table summarizes activity related to liabilities associated with restructuring costs:
SCHEDULE
OF LIABILITIES ASSOCIATED WITH RESTRUCTURING COSTS
Severance
and
separation costs
Other exit
related costs
Total
restructuring
and other costs
($ in thousands)
Balance as of January 1, 2025
$ -
$ -
$ -
Additions
154
-
154
Payments and other adjustments
( 154 )
-
( 154 )
Balance as of December 31, 2025
$ -
$ -
$ -
Balance as of January 1, 2024
$ 145
$ 26
$ 171
Beginning balance
$ 145
26
$ 171
Additions
606
-
606
Payments and other adjustments
( 751 )
( 26 )
( 777 )
Balance as of December 31, 2024
$ -
$ -
$ -
Ending balance
$ -
$ -
$ -
15. EMPLOYEE BENEFIT PLANS
The
Company has qualified 401(k) plans covering all U.S. employees who have completed one month of service. The plans provide for matching
contributions by the Company for employees of the Company and most U.S. subsidiaries, although there is no match for CPM employees. Employer
contributions to the plans for the years ended December 31, 2025 and 2024 were approximately $ 345,000 and $ 449,000 , respectively.
Additionally,
the Company has a defined contribution retirement plan covering all employees located in our Pakistan Offices who have completed three
months of service. The plan provides for monthly contributions by the Company which are equal to 10% of qualified employees’ basic
monthly compensation . The Company’s contributions for the years ended December 31, 2025 and 2024 were approximately $ 546,000 and
$ 438,000 , respectively.
The
Company maintains a defined contribution retirement plan covering all employees in Sri Lanka. The employee and employer contribute 8 %
and 12 %, respectively, of the employee’s gross salary. The Company’s contribution for the years ended December 31, 2025 and
2024 was approximately $ 26,000 and $ 28,000 , respectively. The contributions are required to be deposited with the Employees’ Provident
Fund Organization, a government owned entity.
16. STOCK-BASED COMPENSATION
In
April 2014, the Company adopted the Medical Transcription Billing, Corp. 2014 Equity Incentive Plan (the “Original Plan”),
reserving a total of 1,351,000 shares of common stock for grants to employees, officers, directors and consultants. On April 14, 2017,
the Original Plan was amended and restated whereby an additional 1,500,000 shares of common stock and 100,000 shares of Series A Preferred
Stock were added to the plan for future issuance (the “A&R Plan”). During 2018, an additional 200,000 shares of Series
A Preferred Stock were added to the A&R Plan for future issuance. In May 2020, an additional 2,000,000 shares of common stock and
an additional 300,000 shares of Series A Preferred Stock were added to the A&R Plan for future issuance. During 2022, an additional
1,000,000 shares of common stock and 200,000 shares of Series B Preferred Stock were added to the A&R Plan for future issuance. As
of December 31, 2025, 374,683 shares of common stock and 16,000 shares of Series B Preferred Stock are available for grant. Permissible
awards include incentive stock options, non-statutory stock options, stock appreciation rights, restricted stock, RSUs, performance stock
and cash-settled awards and other stock-based awards in the discretion of the Compensation Committee of the Board of Directors including
unrestricted stock grants.
F- 33
The
equity based RSUs contain a provision in which the units shall immediately vest and become converted into common shares at the rate of
one common share per RSU, immediately after a change in control, as defined in the award agreement.
Common
stock
During
2025, 25,000 RSUs of common stock were granted to each of the five outside members of the Board of Directors with 25 % of the shares
vesting every six months. During 2024, 226,894 RSUs of common stock were granted to employees and independent contractors to vest at
different dates during the years 2024 through 2026. Included therein were 30,000 RSUs of common stock granted over two years to each
of the five outside members of the Board of Directors with 25 % of the shares vesting every six months. In connection with the death of
one director during 2025, all such director’s unvested RSUs fully vested in accordance with the terms of the Company’s equity
incentive plan.
The
following table summarizes the RSU and restricted stock transactions related to the common and Preferred Stock under the A&R Plan
for the years ended December 31, 2025 and 2024:
DISCLOSURE OF SHARE-BASED COMPENSATION ARRANGEMENTS BY SHARE-BASED PAYMENT AWARD
Common
Stock
Series A
Preferred Stock
Series B
Preferred Stock
Outstanding and unvested shares at January 1, 2025
242,500
-
19,199
Granted
125,000
-
-
Vested
( 206,100 )
-
-
Forfeited
-
-
-
Outstanding and unvested shares at December
31, 2025
161,400
-
19,199
Outstanding and unvested shares at January 1, 2024
753,495
-
57,199
Granted
226,894
-
46,000
Vested
( 513,190 )
-
( 60,000 )
Forfeited
( 224,699 )
-
( 24,000 )
Outstanding and unvested shares at December
31, 2024
242,500
-
19,199
As
of December 31, 2025 and 2024, there was approximately $ 271,000 and $ 416,000 , respectively, of total unrecognized compensation cost related
to the common stock RSUs classified as equity that will be expensed through 2027. As of December 31, 2025 and 2024, there were no unrecognized
compensation costs related to the Series A and Series B Preferred Stock RSUs.
Of
the total outstanding and unvested common stock RSUs at December 31, 2025 and 2024, all of 161,400 and 242,500 , respectively, are classified
as equity. For both 2025 and 2024, all of the Series B Preferred Stock RSUs are classified as equity.
F- 34
The
following table summarizes the share activity during the years ended December 31, 2025 and 2024 and the amount of common and preferred
shares available for grant at December 31, 2025 and 2024:
SCHEDULE OF SHARE-BASED COMPENSATION, RESTRICTED STOCK UNITS AWARD ACTIVITY
Common
Stock
Series
A
Preferred
Stock
Series
B
Preferred
Stock
Shares available for grant at January 1, 2025
499,683
33,769
16,000
RSUs granted
( 125,000 )
-
-
RSUs cancelled
-
( 33,769 )
-
Shares available for grant at December
31, 2025
374,683
-
16,000
Shares available for grant at January 1, 2024
493,579
33,769
38,000
RSUs granted
( 226,894 )
-
( 46,000 )
RSUs forfeited
232,998
-
24,000
Shares available for grant at December
31, 2024
499,683
33,769
16,000
At
December 31, 2025, there was no liability for taxes withheld in connection with the equity awards. The liability for the cash-settled
awards and accrued payroll taxes on equity awards was approximately $ 6,000 at December 31, 2024, and is included in accrued compensation
in the consolidated balance sheet. During the year ended December 31, 2024, approximately $ 45,000 was paid in connection with the cash-settled
awards. There were no cash-settled awards at December 31, 2025. No amounts were paid in connection with cash-settled awards during the
year ended December 31, 2025.
Preferred
Stock
In
February 2023, the Compensation Committee granted executive bonuses to be paid in 34,000 shares of Series B Preferred Stock, with the
number of shares and the amount based on specified criteria being achieved during the year 2023. During October 2023, the Compensation
Committee approved for issuance 10,000 of the above shares to one of the executives who retired. The remaining shares were not issued
and previously accrued amounts were reversed during 2024.
In
March 2024, the Compensation Committee approved executive bonuses to be paid in shares of Series B Preferred Stock with the number of
shares and the amount based on specified criteria being achieved for the year 2024. There were 34,000 shares awarded. During May 2024,
an additional executive bonus with similar terms was approved and 12,000 shares were awarded. During December 2024, the Compensation
Committee determined that the financial objectives were attained and all of the performance bonus shares were issued.
Stock-based
compensation expense
The
Company recognizes compensation expense on a straight-line basis over the total requisite service period for the entire award. For stock
awards classified as equity, the market price of our common stock or Preferred Stock on the date of grant is used to record the fair
value of the award and includes the related taxes. For stock awards classified as a liability, the earned amount is marked to market
based on the end of period common stock price. The weighted average grant date fair value of the common stock price in connection with
the RSUs classified as equity was $ 2.38 and $ 2.16 for the years ended December 31, 2025 and 2024, respectively. For the Series B Preferred
Stock, the weighted average grant date fair value was $ 6.33 for the year ended December 31, 2024.
The
following table summarizes the components of stock-based compensation expense for the years ended December 31, 2025 and 2024:
SCHEDULE OF EMPLOYEE SERVICE SHARE-BASED COMPENSATION, ALLOCATION OF RECOGNIZED PERIOD COSTS
Year
Ended December 31,
2025
2024
($
in thousands)
Direct operating costs (benefit)
$ -
$ ( 27 )
General and administrative
451
72
Research and development
3
( 4 )
Selling and marketing
-
74
Total
stock-based compensation expense
$ 454
$ 115
F- 35
17. INCOME TAXES
For
the years ended December 31, 2025 and 2024, the Company estimated its income tax provision based upon the annual pre-tax income.
Although the Company reported GAAP earnings in 2025 and 2024, it incurred tax losses historically and there is uncertainty regarding
future U.S. taxable income, to which the Company believes makes realization of a deferred tax asset difficult to support in
accordance with ASC 740. Accordingly, a valuation allowance has been recorded against all federal and state deferred tax assets as
of December 31, 2025 and 2024.
The
annual adjusted earnings and profits of our foreign affiliates pass through to the U.S. as federal and state taxable income under the
Global Intangible Low-Taxed Income (“GILTI”) regime now referred to as Net Controlled Foreign Corporation Tested Income (“NCTI”).
For the tax years ended December 31, 2025 and 2024, the net NCTI from our foreign affiliates was absorbed against our current year U.S.
consolidated loss. For state tax purposes, the Company’s foreign earnings may be taxable depending on each individual state’s
legislative stance on the recent tax reform legislation. The activity in the deferred tax valuation allowance was as follows for the
years ended December 31, 2025 and 2024:
SCHEDULE OF DEFERRED TAX VALUATION ALLOWANCE
Year
Ended December 31,
2025
2024
($ in thousands)
Beginning balance
$ 89,664
$ 87,597
Current year valuation
allowance increase
5,983
2,067
Ending balance
$ 95,647
$ 89,664
The
income before provision for income taxes for financial reporting purposes during the years ended December 31, 2025 and 2024 consisted
of the following:
SCHEDULE
OF INCOME (LOSS) BEFORE INCOME TAX, DOMESTIC AND FOREIGN
Year
Ended December 31,
2025
2024
($ in thousands)
United States
$ 10,094
$ 7,191
International
903
820
Total
$ 10,997
$ 8,011
The
provision for income taxes for the years ended December 31, 2025 and 2024 consisted of the following:
SCHEDULE
OF COMPONENTS OF INCOME TAX PROVISION
Year
Ended December 31,
2025
2024
($ in thousands)
Current:
Federal
$ -
$ -
State
150
120
International
49
40
199
160
Deferred:
Federal
-
-
State
-
-
International
-
-
-
-
Total income tax provision
$ 199
$ 160
F- 36
The
components of the Company’s deferred income taxes as of December 31, 2025 and 2024 are as follows:
SCHEDULE OF DEFERRED TAX ASSETS AND LIABILITIES
December 31,
December 31,
2025
2024 (a)
($ in thousands)
Deferred tax assets:
Allowance for
expected credit losses
$ 219
$ 213
Deferred revenue
141
103
Property and intangible
assets
4,098
3,015
State net operating loss
(“NOL”) carryforwards
30,594
20,981
Federal net operating loss
(“NOL”) carryforwards
56,836
55,569
Section 163(j) interest
limitation
-
1,669
Stock based compensation
-
( 173 )
Cumulative balance translation
adjustment
1,019
1,015
Section 267 limitation
6
6
Credit carryovers
2,498
2,498
ASC 842 - Lease liability
727
558
Accrued compensation
475
86
Section 174 costs
-
4,996
Valuation
allowance
( 95,647 )
( 89,664 )
Total deferred tax assets
966
872
Deferred tax liabilities:
Prepaid commissions
( 221 )
( 267 )
Right-of-use assets
( 731 )
( 559 )
Other
( 14 )
( 46 )
Total
deferred tax liabilities
$ ( 966 )
$ ( 872 )
(a) Certain prior period balances have been reclassified to conform to the current period presentation.
Deferred
income tax balances reflect the effects of temporary differences between the carrying amounts of assets and liabilities and their tax
bases, as well as from net operating loss carryforwards. Deferred income tax assets represent amounts available to reduce income taxes
payable on taxable income in future years. Deferred income tax liabilities represent amounts that will increase income taxes payable
in future years.
The
Company has recorded goodwill as a result of its acquisitions. Goodwill is generally not amortized for financial reporting purposes.
However, in 2023 the Company recorded a $ 42 million goodwill impairment charge, which partially reduced the basis of the tax-deductible
goodwill. For tax purposes, goodwill from asset acquisitions is tax deductible and amortized over 15 years. As such, deferred income
tax expense and a deferred tax liability arise as a result of the tax-deductibility of this indefinitely lived asset (also known as a
naked credit). Typically, the resulting deferred tax liability, which is expected to continue to increase over the amortization period,
will have an indefinite life. As a result of the Company having indefinite life net operating losses under the recent tax reform legislation,
the federal deferred tax liability resulting from the amortization of goodwill was offset against these indefinite federal operating
net losses deferred tax assets to the extent allowable prior to 2023. As a result of the goodwill impairment charge in 2023, the entire
deferred tax liability was reversed at that time and no additional deferred tax liability was recorded at December 31, 2025 and 2024.
The
income tax paid, net of refunds received, for the years ended December 31, 2025 and 2024 consisted of the following:
SCHEDULE
OF INCOME TAX PAID NET
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands)
Federal
$ -
$ -
State
152
118
Local
36
8
International
58
31
Total
$ 246
$ 157
F- 37
A
reconciliation of the provision for income taxes to the amount computed by applying the 21 % statutory U.S. federal income tax rate
to income before income taxes for the year after the adoption of ASU 2023-09 is as follows:
Schedule
of Effective Income Tax Rate Reconciliation
Year Ended December 31, 2025
Amount
Percent
($ in thousands)
Provision at U.S. federal statutory rate
$ 2,309
21.0 %
State and local income tax, net of federal income tax effect (a)
119
1.1 %
Foreign tax effects:
Pakistan
-
-
Impact of foreign operations
( 140 )
( 1.3 )%
Effect of cross-border tax laws:
Subpart F GILTI inclusion
827
7.5 %
Nontaxable or nondeductible items
( 6 )
( 0.1 )%
Changes in valuation allowance
( 2,934 )
( 26.6 )%
Deferred tax adjustment
24
0.2 %
Provision for income taxes
$ 199
1.8 %
(a)
The states and local jurisdictions that contribute to the majority (greater than 50%) of the effect in this category include New
Jersey, California, Texas and Ohio.
A reconciliation of the provision
for income taxes to the amount computed by applying the 21 % statutory U.S. federal income tax rate to income before income taxes for
the year prior to the adoption of ASU 2023-09 is as follows:
Year Ended December 31, 2024
($ in thousands)
Provision at U.S. federal statutory rate
$ 1,682
Increase (decrease) in income taxes resulting from:
State tax expense, net of federal benefit
94
Non-deductible items
30
Impact of foreign operations
( 132 )
Subpart F GILTI inclusion
1,066
Stock based compensation
( 177 )
Deferred tax adjustment
( 2,708 )
Changes in valuation allowance
305
Provision for income taxes
$ 160
At
December 31, 2025 and 2024, the Company did not record any uncertain tax positions based on the technical merits. Therefore, a
tabular roll forward was excluded and there has been no accrued interest and penalties for the years ended December 31, 2025 and
2024. The Company is subject to taxation in the United States, various states, Pakistan and Sri Lanka. As of December 31, 2025, all
tax years since 2014 remain open to examination due to the carryover of unused net operating losses and tax credits in the United
States by major taxing jurisdictions in which the
Company is subject to tax. IT companies in Pakistan are subject to a 0.25% tax deducted at the source on receipts received from
foreign sources with no further tax being due .
It is the Company’s policy that any assessed penalties and interest on uncertain tax positions would be charged to income tax
expense. As of December 31, 2025 and 2024, the Company had no unrecognized tax benefits and did not recognize any interest or
penalties.
The
Pakistan foreign receipts tax does not have a significant impact on the Company’s effective tax rate as all of its earnings in
Pakistan have been fully included in the U.S. federal tax rate reconciliation at 21 % for 2025 and 2024. The Pakistan statutory corporate
tax rate is 29 % before consideration of the aforementioned tax credit and the foreign receipts tax.
As
of December 31, 2025, the Company has a total federal NOL carry forward of approximately $ 271 million of which approximately $ 186 million
will expire between 2030 and 2037, and the balance of approximately $ 85 million has an indefinite life. At December 31, 2025, the Company
had federal research and development credit carryforwards of approximately $ 3.4 million. Out of the total federal NOL carry forward,
approximately $ 237 million is from the CareCloud and Meridian acquisitions and is subject to the federal Section 382 NOL annual usage
limitations. The Company has state NOL carry forwards of approximately $ 214 million, of which $ 87 million relates to the State of New
Jersey. These NOLs expire starting in 2026.
The
Company has a full valuation allowance on its deferred tax assets in the U.S. which results in there being no U.S. deferred tax assets
or liabilities recorded in the consolidated balance sheets at December 31, 2025 and 2024, respectively.
On
July 4, 2025, the One Big Beautiful Act (“OBBBA”) was enacted into law. The OBBBA contained several tax changes to
certain U.S. corporate tax provisions, including foreign-related tax reporting items. The Company carefully assessed all aspects of
the OBBBA and has determined that its impacts are immaterial to its income tax position.
18.
OTHER EXPENSE – NET
Other
expense - net for the years ended December 31, 2025 and 2024 consisted of the following:
SCHEDULE OF OTHER (EXPENSE) INCOME - NET
2025
2024
Year
Ended December 31,
2025
2024
($ in thousands)
Foreign exchange (losses) gains
$ ( 109 )
$ 130
Other expense
( 156 )
( 428 )
Other expense - net
$ ( 265 )
$ ( 298 )
Foreign
currency transaction gains and losses primarily result from transactions in foreign currencies other than the functional currency. These
transaction gains and losses are recorded in the consolidated statements of operations related to the recurring measurement and settlement
of such transactions. Other expense primarily represents legal settlements made by the Company.
F- 38
19.
SEGMENT
REPORTING
From
January 1, 2024 through April 30, 2024, the Chief Executive Officer (“CEO”) and Executive Chairman served as the Chief Decision
Maker (“CODM”), organizing the Company, managing resource allocations and measuring performance among two operating and reportable
segments: (i) Healthcare IT and (ii) Medical Practice Management. As of May 1, 2024, the Company’s President, CEO and Executive
Chairman served as the CODM. Effective January 1, 2025, the Executive Chairman and the two Co-CEOs served as the CODM. We report our
segment information based on the internal reporting used by management for making decisions and assessing performance as the source of
our reportable segments.
The
CODM evaluates the financial performance of the business units on the basis of revenue, certain individual and total operating
expenses and operating income (loss), as shown below, excluding unallocated amounts, which are mainly corporate overhead costs, for
assessing operating results and the allocation of resources. Our CODM does not evaluate operating segments using asset or liability
information. The CODM uses segment revenue, certain segment operating expenses and segment operating income (loss), as shown below, to manage the
segments, comparing actual results to forecasted amounts and investigating the reasons for significant variances. Currently, a focus
is being placed on reducing costs and managing global headcount. The segment revenue and segment operating income (loss) is also
used to assess the performance of personnel and in establishing their compensation.
The
Healthcare IT segment includes technology-assisted revenue cycle management, SaaS solutions and professional and other services. The
Medical Practice Management segment includes the management of three medical practices. Each segment is considered a reporting unit.
The Company does not have intra-entity sales or asset transfers, however, there are intracompany bank transfers. The accounting policies
of the segments are the same as those disclosed in the summary of significant accounting policies. The following tables present revenues,
operating expenses and operating income (loss) by reportable segment for the years ended December 31, 2025 and 2024:
SCHEDULE OF REVENUES, OPERATING EXPENSES AND OPERATING INCOME (LOSS) BY REPORTABLE SEGMENT
Healthcare
IT
Medical
Practice Management
Total
Year Ended
December 31, 2025
($
in thousands)
Healthcare
IT
Medical
Practice Management
Total
Net revenue
$ 106,566
$ 13,933 (a)
$ 120,499
Operating expenses:
Direct operating costs
53,077
11,379
64,456
Selling and marketing
4,789
29
4,818
General and administrative
9,932
2,510
12,442
Research and development
6,382
-
6,382
Depreciation and amortization
14,632
328
14,960
Restructuring
costs
154
-
154
Total
operating expenses
88,966
14,246
103,212
Segment operating income
(loss)
$ 17,600
$ ( 313 )
17,287
Reconciliation of profit
or loss (segment profit/loss):
Unallocated corporate expenses
( 5,944 )
Net interest expense
( 81 )
Other
expense
( 265 )
Income
before income taxes
$ 10,997
F- 39
Healthcare
IT
Medical
Practice Management
Total
Year Ended
December 31, 2024
($
in thousands)
Healthcare
IT
Medical
Practice Management
Total
Net revenue
$ 96,405
$ 14,432 (a)
$ 110,837
Operating expenses:
Direct operating costs
49,945
10,897
60,842
Selling and marketing
6,201
31
6,232
General and administrative
9,093
1,911
11,004
Research and development
3,781
-
3,781
Depreciation and amortization
13,813
329
14,142
Lease termination and restructuring
costs
596
-
596
Total operating expenses
83,429
13,168
96,597
Segment operating income
$ 12,976
$ 1,264
14,240
Operating income
(loss)
$ 12,976
$ 1,264
14,240
Reconciliation of profit
or loss (segment profit/loss):
Unallocated corporate expenses
( 5,119 )
Net interest expense
( 812 )
Other expense
( 298 )
Income before income taxes
$ 8,011
(a) This revenue represents fees based
on our actual costs plus a percentage of the operating profit.
20.
FAIR
VALUE OF FINANCIAL INSTRUMENTS
Fair
value measurements are based upon observable and unobservable inputs. Observable inputs reflect market data obtained from independent
sources, while unobservable inputs reflect our view of market participant assumptions in the absence of observable market information.
We utilize valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs. The fair values
of assets and liabilities required to be measured at fair value are categorized based upon the level of judgement associated with the
inputs used to measure their value in one of the following three categories:
Level
1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities. We held no Level 1 financial instruments
at December 31, 2025 or 2024.
Level
2: Quoted prices for similar instruments in active markets with inputs that are observable, either directly or indirectly. Our Level
2 financial instruments include notes payable which are carried at cost and approximate fair value since the interest rates being charged
approximate market rates.
Level
3: Unobservable inputs are significant to the fair value of the asset or liability, and include situations where there is little, if
any, market activity for the asset or liability. Our Level 3 instruments include the fair value of contingent consideration related to
completed acquisitions. The fair value at December 31, 2025 is based on a discounted cash flow analysis reflecting the likelihood of
achieving specified performance measure or events and captures the contractual nature of the contingencies, the passage of time and the
associated discount rate. There was no contingent consideration recorded at December 31, 2024.
F- 40
The
following table provides the assets and liabilities carried at fair value measured on a non-recurring basis as of December 31, 2025 and
2024. Refer to Note 2 - Basis of Presentation and Significant Accounting Policies, for a description of the valuation techniques used
to determine the fair value of the assets measured on a non-recurring basis in the table below:
FAIR
VALUE OF THE ASSETS AND LIABILITIES MEASURED ON A NON-RECURRING BASIS
Fair
Value Measurements at December 31, 2025
Expense
for the year ended
Carrying
Value
Level
1
Level
2
Level
3
December
31, 2025
($ in thousands)
Goodwill - Healthcare IT
$ 31,442
$ -
$ -
$ 31,442
$ -
Fair
Value Measurements at December 31, 2024
Expense
for the year ended
Carrying
Value
Level
1
Level
2
Level
3
December
31, 2024
($ in thousands)
Goodwill - Healthcare IT
$ 19,186
$ -
$ -
$ 19,186
$ -
The
following table provides a reconciliation of the beginning and ending balances for the contingent consideration measured at fair value
using significant unobservable inputs (Level 3):
FAIR VALUE OF THE ASSETS MEASURED ON A NON-RECURRING BASIS
2025
2024
Fair Value
Measurement at Reporting Date Using Significant Unobservable Inputs, Level 3
Year
Ended December 31,
2025
2024
($ in thousands)
Balance - January 1,
$ -
$ -
Acquisitions
1,265
-
Change in fair value
-
-
Payments
( 124 )
-
Balance - December 31,
$ 1,141
$ -
F- 41