Document and Entity Information
Document and Entity Information - USD ($) | 12 Months Ended | ||
Dec. 31, 2021 | Apr. 15, 2022 | Jun. 30, 2021 | |
Cover [Abstract] | |||
Document Type | 10-K/A | ||
Amendment Flag | true | ||
Amendment Description | This Amendment No. 1 (“Amendment No. 1”) to the Annual Report on Form 10-K/A amends the Annual Report on Form 10-K of U.S. NeuroSurgical Holdings, Inc. (the “Company”) for the fiscal year ended December 31, 2021, as filed with the Securities and Exchange Commission (the “SEC”) on April 15 , 2022 (the “Original Filing”). The Amendment restates the Company’s previously issued consolidated financial statements as of and for the year ended December 31, 2021. See Note L, Restatement of Previously Issued Consolidated Financial Statements, in Item 8, Financial Statements and Supplementary Data, for additional information. The relevant unaudited interim financial information for each of the quarters during the year ended December 31, 2021 has also been restated. See Note M, Quarterly Results of Operations (Unaudited), in Item 8, Financial Statements and Supplementary Data, for such restated information. | ||
Document Annual Report | true | ||
Document Period End Date | Dec. 31, 2021 | ||
Current Fiscal Year End Date | --12-31 | ||
Document Fiscal Year Focus | 2021 | ||
Document Fiscal Period Focus | FY | ||
Document Transition Report | false | ||
Entity File Number | 0-15586 | ||
Entity Registrant Name | U.S. NeuroSurgical Holdings, Inc. | ||
Entity Central Index Key | 0001089815 | ||
Entity Incorporation, State or Country Code | DE | ||
Entity Tax Identification Number | 47-5370333 | ||
Entity Address, Address Line One | 2400 Research Blvd, Suite 325 | ||
Entity Address, City or Town | Rockville | ||
Entity Address, State or Province | MD | ||
Entity Address, Postal Zip Code | 20850 | ||
City Area Code | 301 | ||
Local Phone Number | 208-8998 | ||
Title of 12(g) Security | Common Stock, par value $.01 per share | ||
Entity Well-known Seasoned Issuer | No | ||
Entity Voluntary Filers | No | ||
Entity Current Reporting Status | Yes | ||
Entity Interactive Data Current | Yes | ||
Entity Filer Category | Non-accelerated Filer | ||
Entity Small Business | true | ||
Entity Emerging Growth Company | false | ||
Entity Shell Company | false | ||
ICFR Auditor Attestation Flag | false | ||
Entity Public Float | $ 1,257,000 | ||
Entity Common Stock, Shares Outstanding | 7,792,185 | ||
Auditor Name | Aronson LLC | ||
Auditor Location | Rockville, Maryland | ||
Auditor Firm ID | 517 |
CONSOLIDATED BALANCE SHEETS
CONSOLIDATED BALANCE SHEETS - USD ($) | Dec. 31, 2021 | Dec. 31, 2020 |
Current assets: | ||
Cash and cash equivalents | $ 2,178,000 | $ 2,030,000 |
Accounts receivable | 0 | 346,000 |
Investment in sales-type sublease - current | 0 | 532,000 |
Other current assets | 65,000 | 99,000 |
Total current assets | 2,243,000 | 3,007,000 |
Other assets: | ||
Due from related parties | 930,000 | 912,000 |
Investments in unconsolidated entities | 141,000 | 160,000 |
Goodwill | 315,000 | 0 |
Total other assets | 1,386,000 | 1,072,000 |
Property and equipment: | ||
Operating lease right-of-use asset | 59,000 | 94,000 |
Total property and equipment | 59,000 | 94,000 |
TOTAL ASSETS | 3,688,000 | 4,173,000 |
Current liabilities: | ||
Obligations under finance lease - current portion | 0 | 89,000 |
Operating lease right-of-use liability - current portion | 43,000 | 40,000 |
Accounts payable and accrued expenses | 169,000 | 170,000 |
Income taxes payable | 414,000 | 111,000 |
Total current liabilities | 626,000 | 410,000 |
Operating lease right-of-use liability - net of current portion | 23,000 | 66,000 |
Guarantee liability | 11,000 | 11,000 |
Total liabilities | 660,000 | 487,000 |
EQUITY | ||
Common stock - par value $.01; 25,000,000 shares authorized; 7,792,185 shares issued and outstanding at December 31, 2021 and 2020 | 78,000 | 78,000 |
Additional paid-in capital | 2,871,000 | 3,100,000 |
(Accumulated deficit) retained earnings | (373,000) | 508,000 |
U.S. Neurosurgical Holdings, Inc. stockholders' equity | 2,576,000 | 3,686,000 |
Noncontrolling interests | 452,000 | 0 |
Total equity | 3,028,000 | 3,686,000 |
TOTAL LIABILITIES AND EQUITY | $ 3,688,000 | $ 4,173,000 |
CONSOLIDATED BALANCE SHEETS (Pa
CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares | Dec. 31, 2021 | Dec. 31, 2020 |
EQUITY | ||
Common stock, par value (in dollars per share) | $ 0.01 | $ 0.01 |
Common stock, shares authorized (in shares) | 25,000,000 | 25,000,000 |
Common stock, shares issued (in shares) | 7,792,185 | 7,792,185 |
Common stock, shares outstanding (in shares) | 7,792,185 | 7,792,185 |
CONSOLIDATED STATEMENTS OF OPER
CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) | 12 Months Ended | |
Dec. 31, 2021 | Dec. 31, 2020 | |
CONSOLIDATED STATEMENTS OF OPERATIONS [Abstract] | ||
Revenue | $ 1,061,000 | $ 3,173,000 |
Costs and expenses: | ||
Patient expenses | 86,000 | 361,000 |
Selling, general and administrative | 1,063,000 | 1,197,000 |
Total | 1,149,000 | 1,558,000 |
Operating (loss) income | (88,000) | 1,615,000 |
Total other (expense) income | ||
Interest expense | (3,000) | (25,000) |
Interest income | 0 | 3,000 |
Interest income - sales-type sublease | 8,000 | 72,000 |
Loss from investments in unconsolidated entities, net | (470,000) | (809,000) |
Total other expense | (465,000) | (759,000) |
(Loss) income before income taxes | (553,000) | 856,000 |
Income tax provision | 420,000 | 323,000 |
Net (loss) income | (973,000) | 533,000 |
Net loss attributable to noncontrolling interests | 92,000 | 0 |
Net (loss) income attributable to U.S. Neurosurgical Holdings, Inc. | $ (881,000) | $ 533,000 |
Basic net (loss) income per share attributable to U.S. Neurosurgical Holdings, Inc. (in dollars per share) | $ (0.11) | $ 0.07 |
Diluted net (loss) income per share attributable to U.S. Neurosurgical Holdings, Inc. (in dollars per share) | $ (0.11) | $ 0.07 |
Weighted average common shares outstanding, basic (in shares) | 7,792,185 | 7,792,185 |
Weighted average common shares outstanding, diluted (in shares) | 7,792,185 | 7,792,185 |
CONSOLIDATED STATEMENTS OF EQUI
CONSOLIDATED STATEMENTS OF EQUITY - USD ($) | Common Stock [Member] | Additional Paid-In Capital [Member] | (Accumulated Deficit) Retained Earnings [Member] | U.S. Neurosurgical Holdings, Inc. Stockholders' Equity [Member] | Noncontrolling Interests [Member] | Total |
Balance at Dec. 31, 2019 | $ 78,000 | $ 3,100,000 | $ (25,000) | $ 3,153,000 | $ 0 | $ 3,153,000 |
Balance (in shares) at Dec. 31, 2019 | 7,792,185 | |||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Net (loss) income | $ 0 | 0 | 533,000 | 533,000 | 0 | 533,000 |
Balance at Dec. 31, 2020 | $ 78,000 | 3,100,000 | 508,000 | 3,686,000 | 0 | $ 3,686,000 |
Balance (in shares) at Dec. 31, 2020 | 7,792,185 | 7,792,185 | ||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Net (loss) income | $ 292,000 | |||||
Balance at Mar. 31, 2021 | 3,978,000 | |||||
Balance at Dec. 31, 2020 | $ 78,000 | 3,100,000 | 508,000 | 3,686,000 | 0 | $ 3,686,000 |
Balance (in shares) at Dec. 31, 2020 | 7,792,185 | 7,792,185 | ||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Net (loss) income | $ (325,000) | |||||
Balance at Jun. 30, 2021 | 3,361,000 | |||||
Balance at Dec. 31, 2020 | $ 78,000 | 3,100,000 | 508,000 | 3,686,000 | 0 | $ 3,686,000 |
Balance (in shares) at Dec. 31, 2020 | 7,792,185 | 7,792,185 | ||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Net (loss) income | $ (677,000) | |||||
Balance at Sep. 30, 2021 | 3,009,000 | |||||
Balance at Dec. 31, 2020 | $ 78,000 | 3,100,000 | 508,000 | 3,686,000 | 0 | $ 3,686,000 |
Balance (in shares) at Dec. 31, 2020 | 7,792,185 | 7,792,185 | ||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Sale of subsidiary shares to noncontrolling interests | (229,000) | (229,000) | 544,000 | $ 315,000 | ||
Net (loss) income | $ 0 | 0 | (881,000) | (881,000) | (92,000) | (973,000) |
Balance at Dec. 31, 2021 | $ 78,000 | 2,871,000 | (373,000) | 2,576,000 | 452,000 | $ 3,028,000 |
Balance (in shares) at Dec. 31, 2021 | 7,792,185 | 7,792,185 | ||||
Balance at Mar. 31, 2021 | $ 3,978,000 | |||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Net (loss) income | (617,000) | |||||
Balance at Jun. 30, 2021 | 3,361,000 | |||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Net (loss) income | (352,000) | |||||
Balance at Sep. 30, 2021 | 3,009,000 | |||||
Increase (Decrease) in Stockholders' Equity [Roll Forward] | ||||||
Net (loss) income | (296,000) | |||||
Balance at Dec. 31, 2021 | $ 78,000 | $ 2,871,000 | $ (373,000) | $ 2,576,000 | $ 452,000 | $ 3,028,000 |
Balance (in shares) at Dec. 31, 2021 | 7,792,185 | 7,792,185 |
CONSOLIDATED STATEMENTS OF CASH
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) | 12 Months Ended | |
Dec. 31, 2021 | Dec. 31, 2020 | |
Cash flows from operating activities: | ||
Net (loss) income | $ (973,000) | $ 533,000 |
Adjustments to reconcile net income to net cash provided by operating activities: | ||
Amortization of operating lease right-of-use asset | 35,000 | 34,000 |
Loss from investments in unconsolidated entities, net | 470,000 | 809,000 |
Distributed earnings from unconsolidated entities | 0 | 176,000 |
Accrued interest from notes receivable | 0 | 0 |
Deferred income taxes | 0 | 17,000 |
Changes in: | ||
Accounts receivable | 346,000 | 10,000 |
Income taxes receivable/payable | 303,000 | (109,000) |
Other current assets | 34,000 | (6,000) |
Accounts payable and accrued expenses | (1,000) | (85,000) |
Deferred revenue | 0 | (226,000) |
Operating lease right-of-use liability | (40,000) | (36,000) |
Net cash provided by operating activities | 174,000 | 1,117,000 |
Cash flows from investing activities: | ||
Advances to unconsolidated entities | (491,000) | (459,000) |
Repayments from loans to unconsolidated entities | 22,000 | 175,000 |
Capital contributions to unconsolidated entities | 0 | (125,000) |
Principal payments received under sales-type sublease | 532,000 | 888,000 |
Net cash provided by investing activities | 63,000 | 479,000 |
Cash flows from financing activities: | ||
Repayment of finance lease obligations | (89,000) | (901,000) |
Net cash used in financing activities | (89,000) | (901,000) |
Net change in cash and cash equivalents | 148,000 | 695,000 |
Cash and cash equivalents - beginning of year | 2,030,000 | 1,335,000 |
Cash and cash equivalents - end of year | 2,178,000 | 2,030,000 |
Cash paid for: | ||
Interest | 3,000 | 25,000 |
Income taxes | 213,000 | 419,000 |
Supplemental disclosure of noncash investing and financing activities: | ||
Conversion of prior advances to unconsolidated entity in lieu of cash payment for capital contribution | 0 | 121,000 |
Issuance of subsidiary shares in exchange for a controlling interest in Elite Health Plan, Inc. | $ 315,000 | $ 0 |
Organization and Business
Organization and Business | 12 Months Ended |
Dec. 31, 2021 | |
Organization and Business [Abstract] | |
Organization and Business | Note A – Organization and Business U.S. NeuroSurgical Holdings, Inc. owns and operates, through its wholly-owned subsidiaries, stereotactic radiosurgery centers, utilizing gamma knife technology, and holds other interests in radiological treatment facilities. As used herein, unless the context indicates otherwise, the term “Company”, “Registrant” and “Holdings” means U.S. NeuroSurgical Holdings, Inc. and its wholly-owned subsidiary, U.S. NeuroSurgical, Inc. (“USN”), and the wholly-owned subsidiaries of USN, U.S. NeuroSurgical Physics, Inc., USN Corona, Inc., and Elite Health Plan, Inc, from the date of acquisition. USN, a Delaware corporation, was organized in July 1993 for the purpose of owning and operating stereotactic radiosurgery centers and utilizing the gamma knife technology. USN held an interest in one gamma knife center on the premises of New York University Medical Center (“NYU”) in New York, New York, which expired during 2021. Management continues to explore opportunities to organize and participate in additional gamma knife centers. USN’s business strategy is to provide a mechanism whereby hospitals, physicians, and patients can have access to gamma knife treatment capability, a high capital cost item. USN provides the gamma knife to medical facilities on a “cost per treatment” basis. Through March 31, 2021, USN held an interest in a gamma knife unit and was reimbursed by the facility where it is housed, based on utilization. This contract ended on March 31, 2021 and currently USN does not have any customer contracts. During the fourth quarter of 2007, USN formed a wholly-owned subsidiary, USN Corona, Inc. (“USNC”), to carry investments in Corona Gamma Knife, LLC and NeuroPartners, LLC. Those investments were formed to develop and manage a gamma knife center at San Antonio Regional Hospital in Upland, California. USNC currently owns 39% of Corona Gamma Knife, LLC and 20% of NeuroPartners, LLC. (See Note C[1]) During 2010, through the formation of a joint venture, in which it has a noncontrolling interest, the Company expanded its market strategy to include opportunities to develop cancer centers featuring radiation therapy. These centers utilize linear accelerators with IMRT (Intensity Modulated Radiation Therapy) and IGRT (Image Guided Radiation Therapy) capabilities. In 2010, the Company formed Florida Oncology Partners, LLC (“FOP”) in partnership with local physicians and other investors. USNC owned a 24% interest in FOP. FOP’s first center was located in Miami, Florida and opened in the second quarter of 2011. During 2011, the Company participated in the formation of Boca Oncology Partners RE, LLC (“BOPRE”), for the purpose of acquiring an interest in Boca West, IMP, LLC, (“Boca West, IMP”) which owns a medical office building. USNC currently owns 22.51% of BOPRE. (See Note C[3]). In 2015, Medical Oncology Partners LLC (“MOP”), was formed in partnership with local physicians and other investors. MOP was established to acquire a 100% equity interest in United Oncology Medical Associates of Florida, LLC (“UOMA”). USNC was not a member of MOP at the time of its formation, as it was not able to participate in MOP’s formation due to the fact that USNC was not a physician. An application was filed for a waiver and on December 22, 2016, USNC was cleared to become a part owner of MOP. USNC currently owns 35.83% of MOP. (See Note C[4]) On September 3, 2015, pursuant to the Agreement and Plan of Reorganization (the “Merger Agreement”), dated as of September 3, 2015, by and among USN, Holdings and U.S. NeuroSurgical Merger Sub, Inc. (“Merger Sub”), the Company adopted a new holding company organizational structure whereby USN is now a wholly owned subsidiary of Holdings. This structure did not result in any changes to the assets or operations of the Company, but management believes that it will create a more flexible framework for possible future transactions and organizational and operational adjustments. The holding company organizational structure was effected by a merger (the “Merger”) conducted pursuant to Section 251(g) of the Delaware General Corporation Law (the “DGCL”), which provides for the formation of a holding company structure without a vote of the stockholders of the constituent corporations. Because the holding company organizational structure occurred at the parent company level, the remainder of the Company’s subsidiaries, operations and customers were not affected by this transaction. In order to effect the Merger, USN formed Holdings as its wholly owned subsidiary and Holdings formed Merger Sub as its wholly owned subsidiary. Under the terms of the Merger Agreement, Merger Sub merged with and into USN, with USN surviving the merger and becoming a direct, wholly owned subsidiary of Holdings. Immediately prior to the Merger, Holdings had no assets, liabilities or operations. Pursuant to the Merger Agreement, all of the outstanding capital stock of USN was converted, on a share for share basis, into capital stock of Holdings. As a result, each former stockholder of USN became the owner of an identical number of shares of capital stock of Holdings, evidencing the same proportional interests in Holdings and having the same designations, rights, powers and preferences, qualifications, limitations and restrictions, as those that the stockholder held in USN. Following the Merger, Holdings’ common stock continued to trade on the over-the-counter market and continued to be quoted on the OTC Markets under the same symbol, “USNU.” The conversion of shares of capital stock under the Merger Agreement occurred without an exchange of physical certificates. Accordingly, physical certificates formerly representing shares of outstanding capital stock of USN are deemed to represent the same number of shares of capital stock of Holdings. Pursuant to Section 251(g) of the DGCL, the provisions of the certificate of incorporation and bylaws of Holdings are substantially identical to those of USN prior to the date on which the Merger Agreement took effect. The authorized capital stock of Holdings, the designations, rights, powers and preferences of such capital stock, and the qualifications, limitations and restrictions thereof are also substantially identical to those of the capital stock of USN immediately prior to the date of the Merger. Further, the directors and executive officers of Holdings are the same individuals who were directors and executive officers, respectively, of USN immediately prior to the date of the Merger. Late in 2016, FOP took initial steps toward the development of a new radiation therapy center in Homestead, Florida. However, late in the third quarter of 2017, it was determined that the business opportunity at this new location should be pursued by a different investor group, and FOP arranged to sell the opportunity to this group. CB Oncology Partners, LLC (“CBOP”) was organized on September 1, 2017 to acquire the assets and rights in this new center from FOP. USNC owns a 28.58% interest in CBOP. (See Note C[5]). The Company, through the formation of noncontrolling interests in unconsolidated joint ventures, is currently exploring other opportunities for the establishment of cancer centers using IMRT and/or IGRT in Florida and other parts of the U.S. The recent outbreak of the novel coronavirus COVID-19 has spread across the globe and has been declared a public health emergency by the World Health Organization and a National Emergency by the President of the United States. Most states and municipalities in the U.S., including New York, California, and Florida, have taken aggressive measures to reduce the spread of the disease, including limiting non-essential gatherings of people, ceasing all non-essential travel, ordering certain businesses and government agencies to cease non-essential operations at physical locations and issuing “shelter-in-place” orders, which direct individuals to shelter at their places of residence (subject to limited exceptions). Across the healthcare industry, resources are being prioritized for the treatment and management of the outbreak. Consequently, there are delays in delivering Gamma Knife and other radiation therapy treatments. In addition, the COVID-19 pandemic poses the risk that the Company and its employees, contractors, customers, government and third party payors and others may be prevented from conducting business activities for an indefinite period of time, including due to spread of the disease within these groups or due to shutdowns that have been and may continue to be requested or mandated by governmental authorities. While the healthcare treatments that are provided by the Company are generally critical to the well-being of the patients it serves, a sustained COVID-19 pandemic, and continued measures by the government and industry to contain the pandemic, could negatively impact results for the following reasons: (i) operations at medical facilities, including those operated by the Company, could be subject to reduced operation or prolonged closure; (ii) medical facilities may defer Gamma Knife and other cancer therapy treatments for non-urgent patient cases in order to allocate resources to the care of patients with COVID-19; (iii) patients may defer or cancel treatments due to real or perceived concerns about the potential spread of COVID-19 in a medical facility setting; (iv) the outbreak could materially impact operations for a sustained period of time due to the current travel bans and restrictions, quarantines, shelter-in-place orders and shutdowns; and/or (v) members of the Company’s workforce may become ill or have family members who are ill and are absent as a result, or they may elect not to come to work due to the illness affecting others in our office or facilities. The occurrence of any of the foregoing events could have a material adverse effect on our business, financial condition and results of operations. The COVID-19 outbreak and mitigation measures have had and may continue to have an adverse impact on global economic conditions which could have an adverse effect on our business and financial condition. The extent to which the COVID-19 outbreak impacts our results will depend on future developments that are highly uncertain and cannot be predicted, including new information that may emerge concerning the severity of the virus and the actions to contain its impact. Although the Company’s contract with its only customer ended in March 2021, the Company is actively seeking new business ventures and believes that its cash reserves, which are in excess of $2 million at December 31, 2021, will allow the Company the opportunity do so. Such plans include possible new operations or extensions of its activities in Florida and California, where it has established working relationships with physician groups, hospitals and other organizations. In addition to these activities, the Company has been exploring possible combinations with other existing businesses that would create a larger operating entity that would better justify the expenses involved in continuing as an independent publicly traded company. |
The Company and its Significant
The Company and its Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2021 | |
The Company and its Significant Accounting Policies [Abstract] | |
The Company and its Significant Accounting Policies | Note B - The Company and its Significant Accounting Policies [1] Basis of presentation and consolidation: The consolidated financial statements include the accounts of Holdings and its wholly-owned subsidiaries, USN, USNC and U.S. NeuroSurgical Physics, Inc., and Elite Health through from the date of acquisition. All significant intercompany balances and transactions have been eliminated in consolidation. The Company applies the provisions of Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 810, Consolidation to noncontrolling interests in consolidated financial statements. The guidance requires noncontrolling interests to be reported as a component of equity separate from the parent’s equity and purchases and sales of equity interests, that do not result in a change in control, to be accounted for as equity transactions. In addition, net (loss) income attributable to noncontrolling interests are to be included in net (loss) income and, upon a loss of control, the interest sold, as well as any interest retained, is to be recorded at fair value, with any gain or loss recognized in net (loss) income [2] Revenue recognition: The Company primarily generated revenue from a leasing arrangement with New York University, which is not within the scope of Revenue from Contracts with Customers (Topic 606), and from the sale of maintenance services with a single performance obligation The Company recognizes revenue in accordance with two different accounting standards: 1) Topic 606 and 2) Accounting Standards Codification (“ASC”) Topic 842, Leases Under Topic 606, the core principle is to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Topic 606 defines a five-step process to accomplish this objective, including identifying the contract with the customer and the performance obligations within the contract, determining the transaction price including estimates of any variable consideration, allocating the transaction price to each separate performance obligation, and recognizing revenue as the Company satisfies each performance obligation. 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 Topic 606. The Company recognizes revenue when a performance obligation is satisfied by transferring control over a product or service to a customer. The discussion below addresses our primary types of revenue as categorized by the applicable accounting standards. NYU Lease revenue: Prior to October 2018, the Company’s Gamma Knife Neuroradiosurgery Equipment Agreement with NYU (“NYU Agreement”) primarily consisted of an operating lease, and the associated patient revenue from the use of the gamma knife was primarily operating lease income. Following an amendment to the Company’s lease agreement with NYU, effective August 2016, the Company received a $30,000 minimum lease payment from NYU each month. With the exception of these fixed payments, the NYU agreement provided only for contingent rental income based on a tiered fee schedule related to the number of patient procedures and associated thresholds, with the rate per procedure decreasing as more procedures are performed. The Company recognized the contingent rental income and the fixed monthly payments on a systematic basis using an average fee per procedure calculated by estimating the expected number of procedures per contract year which runs from November 1, to the following October 31. Any amounts received in excess of the average fee were considered deferred revenue. At the end of each reporting period, the Company reviewed its estimated revenue for the contract year and adjusted revenue for any material changes in the estimate. At the end of the contract year, the revenue was adjusted to the actual amount received or receivable. In September 2017, USN and NYU entered into an additional amendment to the NYU Agreement, whereby NYU committed to purchase all of the gamma knife equipment at the NYU Medical Center for a purchase price of $2,400,000, consisting of 41 monthly installments of $50,000 commencing at the end of October 2017 and continuing through the end of February 2021, with a final payment of $350,000 on March 31, 2021. Upon receipt of final payment, title to all the equipment at the center passed to NYU. In October 2018, USN satisfied its obligation to reload the cobalt, and the NYU agreement was re-evaluated to be a sales-type sublease between USN, the lessor, and NYU, the lessee. At the inception of a sales-type sublease, the lessor recognizes its gross investment in the sublease, unearned income and sales price. The cost or carrying amount, if different, of the leased property plus any initial direct costs minus the present value of the unguaranteed residual value accruing to the benefit of the lessor, is charged by the lessor against income in the current period. Management has concluded that all fixed future minimum lease payments (“MLPs”) payable by NYU to USN should be and were included in the investment in sublease. These MLPs include fixed monthly payments of $50,000 through February 2021 and $30,000 through March 2021, as well as a final payment of $350,000 in March 2021. The present value of the MLPs was estimated to be approximately $2,447,000 and was recorded as an investment in sublease effective October 1, 2018. Until the contract renewal in October of 2020, the patient revenue under the tiered schedule had been considered contingent income under the sales type lease and was recognized on a systematic basis using an average fee per procedure. In October 2020, the Company recorded patient revenue based on procedures performed at the applicable billing rate for each procedure since the Company did not exceed the threshold at which billing rates decrease before the completed sale of the equipment on March 31, 2021. Upon termination of the NYU contract, the Company recognized a gain of $100,000 related to previously accrued expenses. The gain was included as a reduction in selling, general and administrative expenses in the accompanying Consolidated Statements of Operations in the year ended December 31, 2021. NYU Maintenance Revenue: The NYU agreement, which ended in March 2021, specified that USN was obligated to maintain the gamma knife equipment in good operating condition. This maintenance obligation was incurred through the term of the agreement while patient procedures were performed. Usage of the gamma knife machine was directly linked to the maintenance of the machine. USN billed NYU monthly for the maintenance and gamma knife services provided. The portion of the total contract consideration allocated to the maintenance services was $79,000 for 2021 and $316,000 for 2020, and was recognized ratably over each year. [3] Cash and cash equivalents: The Company considers all highly liquid debt instruments purchased with a maturity of three months or less to be cash equivalents. [4] Accounts receivable Accounts receivable only included amounts owed to the Company from the NYU Agreement. The agreement ended with the sale of the equipment to NYU on March 31, 2021. [5] Investments in unconsolidated entities: The Company accounts for its investments in unconsolidated entities by the equity method. The Company records its share of such earnings (loss) in the Consolidated Statements of Operations as “Loss from investments in unconsolidated entities, net”. The carrying value of the Company’s investments in unconsolidated entities is recorded in the Consolidated Balance Sheets. The Company records losses of the unconsolidated entities only to the extent of the Company’s interest in and advances to the entities. As such, the recorded balance of MOP and CBOP have been taken to zero. In August 2016, the FASB issued ASU 2016-15, Classification of Certain Cash Receipts and Cash Payments, which in part requires entities to assess whether distributions of cash from unconsolidated entities represent a return on the investment or a return of the investment, to appropriately classify the distributions in the statement of cash flows. Although the ASU is effective in the first quarter of 2018, we early adopted the guidance in the first quarter of 2017 due to the ongoing applicability of the new standard to the Company’s consolidated financial statements. We made an accounting policy election to use the cumulative earnings approach to determine that the distributions were returns on the investment and accordingly classified them as operating cash flows. Under the cumulative earnings approach, distributions received from the unconsolidated entity are presumed to be a return on the investment unless the distributions received by the investor, less distributions received in prior periods that were deemed to be returns of investment, exceed cumulative equity in earnings recognized by the investor. [6] Goodwill: Goodwill represents the excess of the aggregate purchase price over the fair value of the net assets acquired in a business acquisition. Goodwill is tested for impairment on an annual basis, at the anniversary of the acquisition, and between annual tests in certain circumstances, and written down when impaired. Evaluating goodwill for impairment involves the determination of the fair value of each reporting unit in which goodwill is recorded using a qualitative or quantitative analysis. A reporting unit is an operating segment or a component of an operating segment for which discrete financial information is available and reviewed by segment management on a regular basis. The qualitative impairment test includes considering various factors, including macroeconomic conditions, industry and market conditions, cost factors, a sustained share price or market capitalization decrease, and any reporting unit specific events. Goodwill was evaluated on a qualitative basis and concluded that no adjustment to the carrying value of goodwill was necessary. In addition, no qualitative indicators of impairment were identified during the fourth quarter of fiscal year ended December 31, 2021, and therefore, no interim quantitative goodwill impairment evaluation was performed. If the fair value of a reporting unit exceeds the carrying value, goodwill impairment is not indicated. If the carrying amount of a reporting unit is determined to be higher than its estimated fair value, the excess is recognized as an impairment expense. In accordance with the authoritative guidance over fair value measurements, the fair value of a reporting unit is defined as the price that would be received to sell the unit as a whole in an orderly transaction between market participants at the measurement date. The Company primarily uses the income approach methodology, which includes the discounted cash flow method and an enterprise value method, and the market approach methodology, which considers the values of comparable businesses, to estimate the fair value of the reporting unit. Management believes the methodology used to review impairment of goodwill, which includes a significant amount of judgment and estimates, provides a reasonable basis to determine whether impairment has occurred. However, many of the factors employed in determining whether goodwill is impaired are outside of the Company’s control and it is reasonably likely that assumptions and estimates will change in future periods. These changes could result in future impairments. [7] Long-lived assets: The Company reviews its long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. [8] Asset retirement obligations: The Company records liabilities for legal obligations associated with the retirement of tangible long-lived assets based on the estimated future cost of asset retirement obligations discounted to present value and records a corresponding asset and liability on its consolidated balance sheets. The values ultimately derived are based on many significant estimates, including future decommissioning costs, inflation, cost of capital, and market risk premiums. The nature of these estimates requires the Company to make judgments based on historical experience and future expectations. Revisions to the estimates may be required based on such things as changes to cost estimates or the timing of future cash outlays. Any such changes that result in upward or downward revisions in the estimated obligation will result in an adjustment to the related capitalized asset and corresponding liability on a prospective basis. [9] Capital lease obligations: Effective January 1, 2019, the Company adopted ASU 2016-02, Leases, and the Company’s leases previously classified as capital leases, were determined to be finance leases. [10] Guarantees: The Company recognizes a liability at the fair value of the obligation at the inception of a financial guarantee contract. The initial liability is subsequently reduced as the Company is released from exposure under the guarantee. If it becomes probable that the Company will have to perform on a guarantee, a separate liability is accrued if it is reasonably estimable, based on the facts and circumstances at that time. The Company reverses the fair value liability only when there is no further exposure under the guarantee. [11] Income taxes: Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets or liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Valuation allowances are established when necessary to reduce tax assets to amounts more likely than not to be realized. The Company has applied the accounting provisions for Accounting for Uncertainty in Income Taxes. (Topic 740) This accounting provision provides a comprehensive model for how the Company should recognize, measure, present, and disclose in its financial statements uncertain tax positions that the Company has taken or expects to take on its tax returns. If applicable, the Company records interest and penalties as a component of income tax expense. The Company had no uncertain material tax positions at December 31, 2021 and 2020. Tax years from January 1, 2018 to the current year remain open for examination by federal and state tax authorities. [12] Earnings per share: Earnings per share are computed by dividing earnings available to common stockholders by the weighted average shares outstanding for the period. There were no common stock equivalents during 2021 and 2020, and therefore, no potential dilution for the periods presente [13] Advertising costs: The Company follows the policy of charging the costs of advertising to expense as incurred. There were no advertising costs in 2021 and 2020. [14] Estimates and assumptions: The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. [15] Fair values of financial instruments: The estimated fair value of financial instruments has been determined based on available market information and appropriate valuation methodologies. The carrying amounts of cash and cash equivalents, accounts receivable, other current assets, due from or to related parties, and accounts payable approximate fair value at December 31, 2021 and 2020 because of the short maturity of these financial instruments. The carrying values of the notes receivable and the obligations under finance leases, approximate fair value because the interest rates on these instruments approximate the market rates at December 31, 2021 and 2020. [16] Credit risk: At times, the Company may have cash and cash equivalents at a financial institution in excess of insured limits. The Company places its cash and cash equivalents with high credit quality financial institutions whose credit ratings are monitored by management to minimize credit risk. Accounts receivable consisted of amounts due from the medical centers. Historically, credit losses on accounts receivable have not been significant. At December 31, 2020, substantially all of the Company’s accounts receivable were due from one customer, NYU. [17] Leases: In February 2016, the FASB issued ASU 2016-02, Leases (“Topic 842”) to increase transparency and comparability among organizations by requiring (1) recognition of lease assets and lease liabilities on the balance sheet and (2) disclosure of key information about leasing arrangements. Some changes to the lessor accounting guidance were made to align both of the following: (1) the lessor accounting guidance with certain changes made to the lessee accounting guidance and (2) key aspects of the lessor accounting model with revenue recognition guidance. Topic 842 was effective for fiscal years and interim periods beginning after December 15, 2018. A modified retrospective approach is required for adoption for all leases that exist at or commence after the date of initial application with an option to use certain practical expedients. The Company adopted the provisions of Topic 842, as amended, as of January 1, 2019. The adoption of Topic 842 had a material impact on the Company’s Consolidated Balance Sheets due to the recognition of certain right-of-use (“ROU”) assets and lease liabilities. Although a significant amount of revenue was accounted for under Topic 842, this guidance did not have a material impact on our Consolidated Statements of Operations or Cash Flows. The Company determines if an arrangement is a lease at its inception. The Company’s current operating lease relates to office space and is discussed in Note I. The Company’s finance lease obligations and sales-type sublease were related to the NYU gamma knife. The Company’s previously-recorded capital lease obligations addressed in Note F to the consolidated financial statements were accounted for as finance lease obligations upon adoption of Topic 842. The sales-type sublease is discussed in Note E. Under Topic 842, operating leases result in the recognition of ROU assets and lease liabilities on the consolidated balance sheets. ROU assets represent the right to use the leased asset for the lease term and lease liabilities represent the obligation to make lease payments. Under Topic 842, operating lease ROU assets and lease liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. The Company’s operating lease does not provide an implicit rate; therefore, upon adoption of Topic 842, the Company used its estimated incremental borrowing rate at the commencement date to determine the present value of lease payments. The ROU assets include any initial lease payments made and exclude lease incentives received. The lease terms may include options to extend or terminate the lease that are reasonably certain to be exercised. Lease expense under Topic 842 is recognized on a straight-line basis over the lease term. The tables below present financial information associated with our leases as of and for the years ended December 31, 2021, and 2020. Classification December 31, Assets 2021 2020 Current Finance lease assets Investment in sales-type sublease - current $ - $ 532,000 Long-term Operating lease assets Operating lease right-of-use asset 59,000 94,000 Total leased assets $ 59,000 $ 626,000 Liabilities Current Finance lease liabilities Obligations under finance lease - current portion $ - $ 89,000 Operating lease liabilities Operating lease right-of-use liability - current portion 43,000 40,000 Long-term Operating lease liabilities Operating lease right-of-use liability - net of current portion 23,000 66,000 Total lease liabilities $ 66,000 $ 195,000 Lease Cost Operating lease cost Selling, general and administrative $ 41,000 $ 42,000 Finance lease cost Interest on lease liabilities Interest expense 1,000 23,000 Sublease income Interest income - sales-type sublease 8,000 72,000 Net lease cost $ 34,000 $ (7,000 ) Maturity of lease liabilities (as of December 31, 2021) Operating lease 2022 46,000 2023 24,000 Total $ 70,000 Less amount representing interest 4,000 Present value of lease liabilities $ 66,000 Discount rate 5.850 % |
Investments in Unconsolidated E
Investments in Unconsolidated Entities | 12 Months Ended |
Dec. 31, 2021 | |
Investments in Unconsolidated Entities | |
Investments in Unconsolidated Entities | Note C - Investments in Unconsolidated Entities [1] The Southern California Regional Gamma Knife Center During 2007, the Company, through a noncontrolling interest in joint ventures, managed the formation of the Southern California Regional Gamma Knife Center at San Antonio Regional Hospital (“SARH”) in Upland, California. Corona Gamma Knife, LLC (“CGK”) is party to a 14-year agreement with SARH to renovate space in the hospital and install and operate a Leksell PERFEXION gamma knife. CGK leases the gamma knife from NeuroPartners LLC, which holds the gamma knife equipment. In addition to returns on its ownership interests, USNC expects to receive fees for management services relating to the facility. USNC is a 20% owner of NeuroPartners LLC and owns 39% of CGK. USNC was a 20% guarantor on NeuroPartners LLC’s seven-year lease with respect to the gamma knife equipment and certain leasehold improvements at SARH. In February 2016, NeuroPartners LLC negotiated a new five-year lease to fund the reloading of cobalt and related construction services. The new lease of $1,663,000 included a balance of $668,000 from the prior lease obligations. This new lease was payable over 60 months. The first payment of $31,000 was paid on April 1, 2016, and the final payment was paid in March 2021, removing USNC’s guarantee obligation. Construction of the SARH gamma knife center was completed in December 2008 and the first patient was treated in January 2009. The project has been funded principally by outside investors. While the Company, through its joint ventures, has led the effort in organizing the business and overseeing the development and operation of the SARH center, its investment to date in the SARH center has been minimal. At December 31, 2021 and 2020, the Company’s recorded (loss) investment of NeuroPartners LLC and CGK was ($10,000) and $26,000, respectively. During the years ended December 31, 2021, and 2020, the Company’s equity in (loss) earnings of NeuroPartners LLC and CGK was ($36,000) and $124,000, respectively. At December 31, 2021 and 2020, amounts due from these related parties was $6,000 and $9,000, respectively. The following tables present the aggregation of summarized combined financial information of NeuroPartners LLC and CGK: Neuro Partners LLC and CGK Combined Condensed Income Statement Information Years Ended December 31, 2021 2020 Patient revenue $ 606,000 $ 1,141,000 Net (loss) income $ (9,000 ) $ 391,000 USNC’s equity in (loss) income of Neuro Partners LLC and CGK $ (36,000 ) $ 124,000 Neuro Partners LLC and CGK Combined Condensed Balance Sheet Information December 31, 2021 2020 Current assets $ 299,000 $ 121,000 Noncurrent assets 294,000 551,000 Total assets $ 593,000 $ 672,000 Current liabilities $ 564,000 $ 634,000 Noncurrent liabilities - - Equity 29,000 38,000 Total liabilities and equity $ 593,000 $ 672,000 [2] Florida Oncology Partners During 2010, through the formation of a joint venture, in which it has a noncontrolling interest, the Company expanded its market strategy to include opportunities to develop cancer centers featuring radiation therapy. These centers utilize linear accelerators with IMRT and IGRT capabilities. In 2010, the Company formed FOP in partnership with local physicians and other investors. USNC owned a 24% interest in the venture. FOP’s first center was located in Miami, Florida and opened in the second quarter of 2011. During 2011, FOP entered into a seven-year capital lease with Key Bank for $5,800,000. Under the terms of the capital lease, USN agreed to guarantee a maximum of $1,433,000, approximately 25% of the original lease obligation in the event of default. USN was a guarantor jointly with most of the other members of FOP. The guarantee was eliminated upon repayment of the outstanding lease balance in May 2018. In December 2015, FOP entered into an agreement with 21st Century Oncology for the sale of FOP’s Varian Rapid Arc linear accelerator and other medical equipment at the FOP location. 21st Century Oncology paid FOP $1,000,000 as a down payment for the equipment and agreed to make monthly payments of $172,000 for the equipment and all monthly payments due under the equipment lease with Key Bank. As of this date, 21st Century Oncology had not satisfied all of the terms of the agreement. In May 2017, 21st Century Oncology filed for Chapter 11 bankruptcy protection and FOP was listed as an unsecured creditor. As a result, since June 2017, FOP has not received the agreed rental payments beyond the monthly payments for the equipment lease. As noted above, the equipment lease was repaid in May 2018 and title to the equipment was transferred to 21st Century Oncology. In December 2018, FOP was awarded 10,820 shares of 21st Century Oncology Holdings Inc. common stock as part of the bankruptcy proceedings. The title to these shares was transferred to USNC during 2020. The market value of these shares is unclear at this time as there is no readily available market for them, and accordingly, no value has been recorded for these shares as of December 31, 2021. During the year ended December 31, 2020, FOP received a payment of approximately $158,000 from 21st Century Oncology. FOP used these funds to repay $155,000 of previous advances from USNC. Late in 2016, FOP took initial steps toward the development of a new radiation therapy center in Homestead, Florida. In December 2016, FOP entered into a ten-year lease agreement for office space located at 20405 Old Cutler Towne Center. FOP had to deliver an $88,000 letter of credit in conjunction with this office lease which collateral is being held in a restricted certificate of deposit. FOP began incurring architecture costs for planning/refitting the new space. During the first half of 2017, a financing agreement with BB&T Bank for the medical equipment and leasehold improvements was negotiated and then signed on August 31, 2017. In November 2017, the amounts for the equipment and leasehold improvements costs were finalized and paid under this financing agreement for a total loan of $4,106,000 to be paid over seven years. Under the terms of the financing agreement, USN agreed to guarantee the amount initially borrowed. USN was the guarantor with several other members of FOP. Effective November 15, 2019, FOP transferred this loan, along with the equipment acquired with the loan proceeds, to CBOP. The Company expects any potential liability from this guarantee to be reduced by the recoveries of the respective collateral. Late in the third quarter of 2017, it was determined that the business opportunity at this new location should be pursued by a different investor group, and FOP arranged to sell the opportunity to this group. CBOP was organized on September 1, 2017, to acquire the assets and rights in this new center from FOP. In June 2017, FOP entered into an agreement with a third-party owner of a radiation therapy center located in Miami, Florida, whereby FOP took over the operation of the center effective September 22, 2017, for a ten-year initial term, and up to three additional terms of five years each. This agreement was accounted for as a capital lease and, accordingly, FOP recorded assets and capital lease liabilities totaling $14,321,000 at September 22, 2017. The lease required monthly payments in the first year of $160,000, increasing by 2% each year; currently the payment is $170,000. FOP abandoned its operations at this radiation center on June 28, 2019 due to continued losses at the site and lack of success in good faith efforts to renegotiate the agreement after several months of discussion. Due to the circumstances, FOP derecognized the associated assets and liabilities and calculated a contingent liability equal to the net liabilities derecognized. On November 24, 2021, the third-party owner filed a Voluntary Motion to Dismiss their lawsuit against FOP, and on December 11, 2021, it was accepted and recorded by the court. There can be no guarantee the third-party owner will not reinstitute any future claims against FOP. The Company’s recorded investment in FOP prior to dissolution had been reduced to zero due to losses incurred in prior years. No equity in earnings had been recorded by the Company for the years ended December 31, 2021 and 2020 due to FOP’s deficit equity. During the year ended December 31, 2020, the Company wrote off all remaining amounts due from FOP and accrued interest thereon, resulting in a $78,000 loss. During the year ended December 31, 2020, FOP repaid $155,000 of the amounts due to the Company. On September 21, 2021, FOP filed Articles of Dissolution with the Florida Department of State that were recorded on September 22, 2021. FOP is fully dissolved. [3] Boca Oncology Partners During the quarter ended June 30, 2011, the Company, through the formation of a joint venture, in which it had a noncontrolling interest, participated in the formation of Boca Oncology Partners, LLC (“BOP”), for the purpose of owning and operating a cancer center in Boca Raton, Florida. In June 2011, BOPRE, an affiliated entity, purchased a 20% interest in Boca West IMP, owner of a medical office building in West Boca, Florida in which In June 2012, BOPRE purchased an additional 3.75% of Boca West IMP from another investor bringing its total interest to 23.75%. BOPRE accounts for this investment under the cost method since it does not exercise significant influence over Boca West, IMP. During the years ended December 31, 2018 and 2017, several investors relinquished part of their ownership interest in BOPRE, and those interests were distributed among the remaining investors in relationship to their percentages owned. During 2021 an additional member relinquished its ownership to USNC. As a result, the Company now holds a 22.5% ownership interest in BOPRE, which it accounts for under the equity method. The Company’s recorded investment in BOPRE is $151,000 and $134,000, at December 31, 2021 and 2020, respectively. USNC was a 10% guarantor of 50% of the outstanding balance of Boca West IMP’s ten-year mortgage. This mortgage had an original balance of $3,000,000 and is secured by the medical office building in which BOP operates. In April 2020, the partners of Boca West IMP refinanced the mortgage in order to recover some of the cash that was invested before the building was completely occupied and removed USNC as a guarantor. The following tables present the summarized financial information of BOPRE: BOPRE Condensed Income Statement Information Years Ended December 31, 2021 2020 Rental Income $ - $ - Net income $ 85,000 $ 63,000 USNC’s equity in income in BOPRE $ 17,000 $ 13,000 BOPRE Condensed Balance Sheet Information December 31, 2021 2020 Current assets $ 112,000 $ 27,000 Noncurrent assets 757,000 757,000 Total assets $ 869,000 $ 784,000 Current liabilities $ - $ - Noncurrent liabilities - - Equity 869,000 784,000 Total liabilities and equity $ 869,000 $ 784,000 [4] Medical Oncology Partners In April 2015, MOP, was formed in partnership with local physicians and other investors. MOP was established to acquire a 100% equity interest in UOMA. USNC was not a member of MOP at the time of formation as it was not able to participate due to the fact that USNC was not a physician. Nevertheless, USNC wished to eventually obtain an equity interest in MOP and loaned Dr. Jaime Lozano, the principal investor in MOP and a co-investor in FOP, $173,000. Dr. Lozano used these funds, along with an equal amount of his own funds (a total of $345,000), to purchase a 76.67% interest in MOP. Other investors paid a further $105,000 for the remaining equity in MOP. MOP used the $450,000 of financing to acquire a 100% equity interest in UOMA. An application was filed for a waiver to allow USNC to hold an equity interest notwithstanding the physician requirement and on December 22, 2016, USNC was cleared to become a part owner of MOP. Dr. Lozano agreed to exchange half of his membership interest to USNC in settlement of the note to USNC. USNC and Dr. Lozano also agreed to share equally in providing a 5% equity interest in MOP to an additional investor as a consulting fee for services rendered in the administration of MOP and UOMA. At December 22, 2016, USNC owned 35.83% of MOP with an initial carrying value of $161,000. The Company recorded its share of losses of $12,000 for the period from December 22, 2016 to December 31, 2016, against its investment which resulted in a reduction of its equity investment to $149,000. Due to increasing costs, continued net losses since April 2015, and reliance on related party and other debt for operating cash flows, the fair value of UOMA is less than it’s carrying amount. The Company tested its investment for impairment at December 31, 2016 and determined that the investment was impaired, and an impairment loss was recorded against the entire equity balance in MOP, as well as loans from USN and USNC to MOP and UOMA. During the year ended December 31, 2020, USNC contributed $125,000 of capital to MOP all of which was written off. For the years ended December 31, 2021 and 2020, the Company’s equity in loss of MOP was $231,000 and $450,000, respectively, but was not recorded due to prior losses. During the year ended December 31, 2020, the Company wrote off all amounts due and accrued interest thereon, from MOP and UOMA, resulting in a $686,000 loss. During the year ended December 31, 2021 the Company advanced an additional $461,000, all of which has been fully impaired. These allowances and write offs were recorded as losses from investments in unconsolidated entities. Due to loans made to MOP and UOMA, MOP and UOMA are considered to be variable interest entities of the Company. However, as the Company is not deemed to be the primary beneficiary of MOP or UOMA, since it does not have the power to direct the operating activities that most significantly affect MOP’s or UOMA’s economic performance, the entities are not consolidated, but certain disclosures are provided herein. The following table presents the summarized financial information of MOP: MOP Condensed Consolidated Income Statement Information Years Ended December 31, 2021 2020 Patient revenue $ 2,417,000 $ 2,104,000 Net loss $ (646,000 ) $ (1,256,000 ) USNC’s equity in loss in MOP $ (231,000 ) $ (450,000 ) MOP Condensed Consolidated Balance Sheet Information December 31, 2021 2020 Current assets $ 201,000 $ 204,000 Noncurrent assets 384,000 701,000 Total assets $ 585,000 $ 905,000 Current liabilities $ 3,109,000 $ 2,736,000 Noncurrent liabilities 92,000 410,000 Deficit (2,616,000 ) (2,241,000 ) Total liabilities and deficit $ 585,000 $ 905,000 [5] CB Oncology Partners CBOP was organized September 1, 2017, to acquire the rights of the new center from FOP. USNC originally had a 24% equity interest in CBOP. Beginning in October of 2017, CBOP began paying the remainder of the costs associated with opening the center. CBOP had no assets at the end of 2017. The medical center opened and treated its first patient in January of 2018. Effective November 15, 2019, FOP transferred to, and CBOP assumed, a loan with BB&T bank, that it had entered into in order to finance the purchase of equipment and build out of the new center, as well as the associated property and equipment. In addition, CBOP and BB&T agreed to reduce the monthly loan repayments for the next nine months, and to extend the term of the loan from November 2024 to July 2025. In July 2020 CBOP and BB&T further agreed to reduce the monthly payments for the life of the loan and extended the loan to July of 2027. In June 2020, CBOP made a $500,000 capital call to its members. UNSC converted previously-made advances totaling $121,000 into equity in CBOP to meet its capital requirement, and other members contributed $212,000 in cash. The remaining capital contributions are not expected to be met and, accordingly, the Company’s equity interest in CBOP increased to 28.58% in June 2020. Amounts due from CBOP at December 31, 2021, total $2,174,000 of outstanding principal, less $1,251,000 of allowances, for a net receivable of $923,000 all of which is included in due from related parties on the accompanying Consolidated Balance Sheets. Amounts due from CBOP at December 31, 2020, total $2,154,000 of outstanding principal, less $1,251,000 of allowances, for a net receivable of $903,000 all of which is included in due from related parties on the accompanying Consolidated Balance Sheets. These balances accrue interest at 6% per annum. Interest earned by the Company from the amounts owed by CBOP totaled $125,000 for both the years ended December 31, 2021 and 2020. At December 31, 2021 and 2020, total accrued interest was $398,000 and $273,000, respectively, all of which has been fully reserved for. The Company records increases in the allowance, when applicable, as a component of loss from investments in unconsolidated entities and as a deduction in interest income for interest earned. For the years ended December 31, 2021 and 2020, the Company’s equity in loss of CBOP was $91,000 and $195,000, respectively, but was not recorded due to prior losses. Due to loans made to CBOP, CBOP is considered to be a variable interest entity of the Company. However, as the Company is not deemed to be the primary beneficiary of CBOP, since it does not have the power to direct the operating activities that most significantly affect CBOP’s economic performance, the entity is not consolidated, but certain disclosures are provided herein. The following table presents the summarized financial information of CBOP: CBOP Condensed Income Statement Information Years Ended December 31, 2021 2020 Patient revenue $ 2,042,000 $ 1,795,000 Net loss $ (319,000 ) $ (730,000 ) USNC’s equity in loss of CBOP $ (91,000 ) $ (195,000 ) CBOP Condensed Balance Sheet Information December 31, 2021 2020 Current assets $ 400,000 $ 385,000 Noncurrent assets 3,667,000 4,271,000 Total assets $ 4,067,000 $ 4,656,000 Current liabilities $ 3,472,000 $ 3,181,000 Noncurrent liabilities 3,121,000 3,684,000 Deficit (2,526,000 ) (2,209,000 ) Total liabilities and deficit $ 4,067,000 $ 4,656,000 |
Agreement with New York Univers
Agreement with New York University on Behalf of New York University Medical Center | 12 Months Ended |
Dec. 31, 2021 | |
Agreement With New York University on Behalf of New York University Medical Center [Abstract] | |
Agreement with New York University on Behalf of New York University Medical Center | Note D - Agreement with New York University on Behalf of New York University Medical Center In November 1996, USN entered into a Gamma Knife Neuroradiosurgery Equipment Agreement with NYU, (the “NYU Agreement”) for a period of seven years (the “term”), with an option for NYU to extend the term for successive three-year periods or to purchase the gamma knife equipment at an appraised market value price. USN had the ability to negotiate the purchase price and upon failure of the parties to agree could request that the facility be closed. All costs associated with closing and restoring the facility to its original condition were the responsibility of USN. The NYU agreement, among other matters, required USN to provide (i) the use of the gamma knife equipment to NYU, (ii) training necessary for the proper operation of the gamma knife equipment, (iii) sufficient supplies for the equipment, (iv) the repair and maintenance of the equipment, (v) all basic hardware and software upgrades to the equipment and, (vi) an uptime guarantee. In return, NYU paid USN a scheduled fee based on the number of patient procedures performed. In 2004, the NYU agreement was extended through March 2009. In 2008, the NYU agreement was extended for an additional 12 years through March 2021. To secure this extension, USN agreed to install a new gamma knife PERFEXION model. The new equipment and certain space improvements, costing $3,742,000 in total, was financed through a seven-year lease arrangement. The amendment provided for a payment to USN of a flat fee for each patient procedure performed. The Company entered into a six-year lease of $4.7 million for the purchase of the replacement equipment and associated leasehold improvements. The Company entered into a second two-year lease of $250,000 for the cost of the construction required at the relocated site which was repaid in July 2016. In 2016, USN entered into an agreement with Elekta for the installation of new ICON imaging technology for the NYU Gamma Knife equipment with a total cost, including sales taxes, of $816,000. This ICON technology was installed during the month of July 2016 and the gamma knife center reopened on August 5, 2016. The Company entered into a four-year lease for $879,000 to finance the acquisition of the ICON technology and associated installation costs. A monthly maintenance agreement commenced a year after the installation date for $6,000 per month. The two parties also agreed for USN to receive a fixed monthly payment of $30,000 for the remaining term of the agreement through March 2021. In September 2017, USN and NYU entered into an additional amendment to the NYU Agreement, whereby NYU committed to purchase all of the gamma knife equipment at the NYU Medical Center for a purchase price of $2,400,000, with 41 monthly installments of $50,000 from October 2017 through February 2021, and a final payment of $350,000 on March 31, 2021. Previously, the NYU agreement ended on March 17, 2021, and NYU had an option to purchase the gamma knife equipment at the estimated future value of the equipment at that time. In June 2017, the Company obtained an independent estimate of $2,570,000 for the estimated future fair value of the equipment in March 2021. The Company continued to be responsible for the maintenance and insurance for the gamma knife equipment at the NYU facility through contract period and continued to be reimbursed for use of the gamma knife based on a fee per procedure performed with the equipment. NYU provided the medical and technical staff to operate the facility. With the September 2017 amendment, the Company became obligated to reload the cobalt for the gamma knife at its own expense and bear the cost of site work involved in reloading the cobalt, up to a maximum of $1,088,000. In July 2018, USN entered into an agreement with Elekta for the cobalt reload on the NYU gamma knife equipment with a cost, including sales taxes, of $925,000. This cobalt reload occurred in July 2018, and the gamma knife center reopened on August 6, 2018. The Company obtained lease financing of $833,000 to partially finance the reload of the cobalt, and paid the remaining balance directly to Elekta. In addition, the Company incurred costs of $578,000 to install the new cobalt to be paid directly to the contractor. All cobalt related costs were finalized by October 1, 2018 and totaled $1,503,000. As a result of the Company satisfying its obligation to reload the cobalt, the agreement with NYU met the criteria to be classified as a sales type lease. In addition, the Company is now no longer obligated to restore the NYU facility to its original condition. Accordingly, all related assets and the asset retirement obligation were derecognized effective October 1, 2018. All conditions of the agreement were met, and the contract expired on March 31, 2021. NYU Revenue Recognition: The Company derived patient revenue from the NYU center of $1,061,000 and $3,173,000 in 2021 and 2020, respectively, consisting of lease revenue of $982,000 and $2,857,000 and maintenance revenue of $79,000 and $316,000 for 2021 and 2020, respectively. NYU Accounts Receivable and Contract Balances: Accounts receivable presented in the Company’s Consolidated Balance Sheets represented an unconditional right to consideration from NYU. The NYU Agreement was primarily a leasing arrangement and did not have other contract assets or contract liabilities, other than associated deferred revenue. Accounts receivable totaled $0 and $346,000 at December 31, 2021 and 2020, respectively. |
Investment in Sublease
Investment in Sublease | 12 Months Ended |
Dec. 31, 2021 | |
Investment in Sublease [Abstract] | |
Investment in Sublease | Note E – Investment in Sublease The September 2017 amendment to the NYU Agreement provided for NYU to purchase all of the gamma knife equipment at the NYU Medical Center for a purchase price of $2,400,000, consisting of 41 monthly installments of $50,000 commencing at the end of October 2017 and continuing through the end of February 2021, with a final payment of $350,000 on March 31, 2021. Upon receipt of final payment, title to all the equipment at the center passes to NYU. This amendment also required USN to reload the cobalt in the gamma knife and to reimburse NYU for certain costs NYU incurred due to the cobalt reload. Effective October 1, 2018, USN completed the reload of the cobalt and associated costs for a total cost of $1,503,000. With the removal of the cobalt contingency, the NYU agreement was reevaluated to be a sales-type sublease between USN, the lessor, and NYU, the lessee. At the inception of a sales-type sublease, the lessor recognizes its gross investment in the sublease, unearned income and sales price. The initial sales price of $2,400,000 at September 2017 was valued at $2,447,000 at October 1, 2018, using the present value of future cash flows. The cost or carrying amount, if different, of the leased property plus any initial direct costs minus the present value of the unguaranteed residual value accruing to the benefit of the lessor, was charged by the lessor against income in 2018 The monthly fixed payments under the NYU Agreement amortized the investment in sublease until title passed to NYU on March 31, 2021. The NYU Agreement required NYU to make monthly fixed payments of $30,000 and $50,000 through February 2021 with a final fixed payment of $380,000 ($30,000 and $350,000) in March 2021. |
Obligations Under Finance Lease
Obligations Under Finance Leases | 12 Months Ended |
Dec. 31, 2021 | |
Obligations Under Finance Leases [Abstract] | |
Obligations Under Finance Leases | Note F - Obligations Under Finance Leases In 2009, the Company installed a PERFEXION model gamma knife at the NYU center with a seven-year lease from Elekta Capital. The amount financed, covering the cost of the new gamma knife equipment and certain space improvements, was approximately $3,742,000 in total. This lease became payable as a result of damage sustained at the NYU facility in October 2012, due to flooding from Hurricane Sandy, and the remainder of the balance due was paid in January 2013. In 2013, the Company entered into a modification of the above capital lease agreement to finance the new gamma knife installation, the related construction costs and the removal costs of the old equipment for approximately $4.7 million at an interest rate of 4.49% to be repaid beginning in May 2014 over 72 months with no payments for the first three months and $78,000 monthly payments thereafter through May 2020. The Company entered into another capital lease in 2014 to finance a further $250,000 of installation and construction costs, which was repaid over 24 months. In 2016, the Company entered into a capital lease in the amount of $879,000 at an interest rate of 4.45% to finance the installation of the ICON technology for the NYU Gamma Knife equipment to be repaid over 48 months with $20,000 monthly payments beginning October 2016 through September 2020. In October 2018, the Company entered into a capital lease in the amount of $833,000 at an interest rate of 5.85% to partially finance the reload of the cobalt to be repaid over 30 months with $30,000 monthly payments from October 2018 through March 2021. As discussed in Note B, the Company adopted Topic 842 on January 1, 2019. Upon adoption of Topic 842, the capital lease obligations are accounted for as finance lease obligations with no significant change to how the obligations were accounted for. The obligations under the finance leases are as follows: December 31, 2021 2020 Finance leases - Gamma Knife $ - $ 89,000 Less current portion - (89,000 ) $ - $ - |
Concentrations
Concentrations | 12 Months Ended |
Dec. 31, 2021 | |
Concentrations [Abstract] | |
Concentrations | Note G - Concentrations The Company derived substantially all of its revenue from NYU. The Company’s contract with NYU, its only customer, ended in March 2021. (See Note D) |
Taxes
Taxes | 12 Months Ended |
Dec. 31, 2021 | |
Taxes [Abstract] | |
Taxes | Note H – Taxes The components of the provision for income taxes are as follows: Years Ended December 31, 2021 2020 (As Restated) Current taxes: Federal $ 228,000 $ 211,000 State 192,000 95,000 Current taxes 420,000 306,000 Deferred taxes: Federal $ - $ 12,000 State - 5,000 Deferred taxes - 17,000 Income tax provision $ 420,000 $ 323,000 A reconciliation of the tax provision calculated at the statutory federal income tax rate with amounts reported follows: Year Ended December 31, 2021 2020 (As Restated) Income tax at the federal statutory rate $ (130,000 ) $ 180,000 State income tax, net of federal taxes (106,000 ) 52,000 Permanent differences and other (67,000 ) 16,000 Change in estimated effective state tax rate 2,000 (4,000 ) Change in valuation allowance 721,000 79,000 Income tax provision $ 420,000 $ 323,000 Items which give rise to deferred tax assets and liabilities are as follows: December 31, 2021 2020 Deferred tax asset: (As Restated) Basis differences in unconsolidated entities, including advances and loans to those entities $ 587,000 $ 561,000 Excess of book depreciation over tax depreciation - 192,000 Net intangible assets and other capitalized costs 102,000 - Net operating loss 66,000 34,000 Net effect of conversion from the accrual basis of accounting to the cash basis of accounting for tax purposes primarily related to accounts receivable, prepaid expense, deferred revenue, and accounts payable 45,000 - Valuation allowance (800,000 ) (79,000 ) - 708,000 Deferred tax liability: Deferred gain on disposal of gamma knife - (634,000 ) Net effect of conversion from the accrual basis of accounting to the cash basis of accounting for tax purposes primarily related to accounts receivable, prepaid expense, deferred revenue, and accounts payable - (74,000 ) Net deferred tax asset $ - $ - The Company files income tax returns in the U.S. federal jurisdiction, the State of Maryland, the State of Florida , the State of California, and the State of New York. With few possible exceptions, the Company is no longer subject to U.S. or state income tax examinations by tax authorities for years before 2018. As further described in Note L, management has restated the Company's 2021 Consolidated Financial Statements to record an additional tax liability as a result of the gain realized on the disposition of the Company's business at the New York University Medical Center. |
Commitments and Contingencies
Commitments and Contingencies | 12 Months Ended |
Dec. 31, 2021 | |
Commitments and Contingencies [Abstract] | |
Commitments and Contingencies | Note I – Commitments and Contingencies [1] Operating Leases: The Company leases office space under an operating lease which was renewed in February 2018 and expires June 2023. The terms of the lease include an escalation clause for a portion of certain operating expenses. As discussed in Note B, the Company adopted Topic 842 as of January 1, 2019. Upon adoption of Topic 842, the Company’s office lease remained an operating lease and a lease liability in the amount of $176,000 was recognized based on the present value of the remaining minimum lease payments, discounted using the Company’s incremental borrowing rate. The related lease ROU asset was recorded in the amount of $161,000, reflecting the present value of future minimum lease payments, adjusted for deferred rent. As of December 31, 2021 operating lease right-of-use liability and asset amounted to $66,000 and $59,000, respectively. As of December 31, 2020, the operating lease right-of-use liability and asset amounted to $106,000 and $94,000, respectively. Total operating lease expense for the years ended December 31, 2021 and 2020, was $41,000 and $42,000, respectively. The maturities of the operating lease liability as of December 31, 2021, were as follows: Year Ending December 31, 2022 46,000 2023 24,000 70,000 Less interest (4,000 ) Present value of net minimum obligation $ 66,000 [2] NYU Gamma Knife: Capital Lease Obligations (Notes D and F): In 2009, the Company installed a new gamma knife PERFEXION model at the NYU Medical Center. This new equipment and certain space improvements, costing approximately $3,742,000 in total, were financed through a seven-year lease arrangement. This PERFEXION equipment was recorded as a total loss as a result of flooding from Hurricane Sandy in October 2012. In early 2014, the Company entered into a six-year lease in the amount of $4.7 million for the purchase of the replacement equipment and associated leasehold improvements. The first payment of $78,000 was made on September 1, 2014, including $18,000 of interest, and the final payment was made in May 2020. The Company entered into a second capital lease in 2014 to finance an additional $250,000 of installation and construction costs, which was repaid in July 2016. In April 2016 the Company obtained lease financing of $879,000 to finance the acquisition of the ICON technology for the NYU Gamma Knife and associated installation costs. Monthly lease payments of $20,000 began in October 2016, and the final payment was made in September 2020. In October 2018, the Company entered into an additional capital lease in the amount of $833,000 to partially finance the reload of the cobalt to be repaid over 30 months. The final payment was made in March 2021. Maintenance Contract: The new gamma knife installed in April 2014 included a one-year warranty. The new maintenance agreement began in April of 2015. The monthly payment increased from $20,000 to $26,000 effective August 2017, due to the addition of the ICON maintenance agreement and was in effect for 5 years. The final payment of the maintenance agreement was made in March 2021. [3] Guarantees: USNC was a 20% guarantor on NeuroPartners, LLC’s lease, which terminated in March 2021, with respect to the gamma knife equipment, cobalt reload and associated construction, and certain leasehold improvements located at the Southern California Regional Gamma Knife Center at SARH in Upland, California. The outstanding balance on the lease obligations was $60,000 at December 31, 2020. The final payment of this lease was made in March of 2021, thereby releasing USNC from this guarantee. Holdings is a guarantor of the full amount of the outstanding CBOP loan with BB&T Bank entered into in 2017, as described In Note C[2]. The outstanding balance on this loan was $2,715,000 and $3,066,000 at December 31, 2021 and 2020, respectively. USNC was a 10% guarantor on 50% of the outstanding balance of Boca West IMP’s ten-year mortgage. This mortgage had an original balance of $3,000,000 and is secured by the medical office building in which BOP operates. The Company was released from this guaranty when the mortgage was refinanced in April of 2020. The Company expected any potential obligations from these guarantees to be reduced by the recoveries of the respective collateral and had recorded a liability of $11,000 at December 31, 2021 and 2020. [4] Product liability: Although USN does not directly provide medical services, it has obtained professional medical liability insurance, and has general liability insurance as well. USN’s professional medical liability and general liability policies have limits of $3 million each. The Company believes that its insurance is adequate for providing treatment facilities and non-medical services, although there can be no assurance that the coverage limits of such insurance will be adequate or that coverage will not be reduced or become unavailable in the future. |
Employees' IRA Plans
Employees' IRA Plans | 12 Months Ended |
Dec. 31, 2021 | |
Employees' IRA Plans [Abstract] | |
Employees' IRA Plans | Note J - Employees’ IRA Plans The Company has established a Company IRA covering all employees. The plan allows participants to make pre-tax contributions and the Company may, at its discretion, match certain percentages of the employee contribution. Amounts contributed to the plan are deposited into a trust fund administered by independent trustees. The Company made a discretionary matching IRA contribution of $14,000 for the year ended December 31, 2020. No such match was made for the year ended December 31, 2021. |
Acquisition
Acquisition | 12 Months Ended |
Dec. 31, 2021 | |
Acquisition [Abstract] | |
Acquisition | Note K – Acquisition The Company has been exploring opportunities to expand to other businesses that could benefit its current operations and relationships. Effective October 1, 2021, U.S. NeuroSurgical, Inc. (“USN”), acquired all of the outstanding shares of capital stock of Elite Health Plan, Inc., a California corporation (“Elite Health”.) The transaction with Elite Health was structured as an investment by Elite Health shareholders in USN, and as such did not have an immediate effect on the percentage ownership of the shareholders of the Company. However, the Company’s interest in USN, which currently holds substantially all of the interest in the Company’s businesses and operations, was effectively diluted by 15% as a result of the issuance of the new USN shares to the former holders of Elite Health. In addition, the Company agreed with the former Elite Health shareholders that if there is no trading market for the shares of USN after six months from the closing of the transaction, such holders may request that the Company take steps that would give such holders access to the public trading market, which could be accomplished at the Company’s election through an exchange of such holders’ shares for Company shares. Elite Health is a private company with a limited operating history. It was formed in 2017 with the purpose of establishing a managed care organization that will operate as a Medicare Advantage plan for seniors. It is expected that Elite Health will operate in California, initially San Bernadino, Riverside, and Orange Counties, with the objective of addressing the growing number of Medicare eligible seniors in those markets. Because of the collective experience of its founders and affiliates as physicians, software executives, and health plan administrators, management believes that Elite Health will be positioned to bring to southern California a comprehensive and cost-effective solution for these communities. Elite Health is in the process of applying for a Knox Keene license to operate a Medicare Advantage plan in California, and has taken preliminary steps toward identifying a network of providers who are well-versed in the healthcare needs of seniors in the communities in which they practice. Elite Health founders and affiliates also have considerable experience with healthcare record based software and will endeavor to utilize the latest advances in information systems, including AI and data analytics, in its processes to enhance each patient experience and control medical costs. Management and Elite Health understand that the keys to success with a managed care organization are delivering comprehensive patient care and containing costs. In addition to developing a plan to obtain necessary approvals, gaining access to a competent network of providers and enrolling a critical level of subscribers, it will be necessary for the plan to provide high quality patient care efficiently and cost effectively. There can be no assurance that the Company will be effective in doing so. The total fair value of the purchase price for the acquisition was $315,000, which included the fair value of the noncontrolling shares issued, including the acquired Company. The results of the acquisition were included in the consolidated financial statements from the closing date. The acquisition was not considered material to the consolidated financial statements. As a result, no pro forma information has been provided. The following table summarizes the changes in the carrying value of goodwill for the acquisition of Elite Health Plan, Inc.: Balance at January 1, 2020 $ - Acquisition - Balance at December 31, 2020 - Acquisition 315,000 Balance at December 31, 2021 $ 315,000 |
Restatement of Previously Issue
Restatement of Previously Issued Consolidated Financial Statements | 12 Months Ended |
Dec. 31, 2021 | |
Restatement of Previously Issued Consolidated Financial Statements [Abstract] | |
Restatement of Previously Issued Consolidated Financial Statements | Note L – Restatement of Previously Issued Consolidated Financial Statements We have restated the Company's Consolidated Financial Statements as of and for the year ended December 31, 2021, as a result of a previously unrecorded tax liability in connection with the disposition of the Company’s business at the New York University Medical Center, which resulted in the recognition of a gain on the sale and transfer of the gamma knife property on the December 31, 2021 income tax returns. The Company previously received insurance proceeds with the Gamma Knife facility, which was destroyed as a result of flooding from Hurricane Sandy. For tax purposes, the resulting gain becomes taxable when the replacement property is sold or disposed of, which occurred in 2021. The Company has corrected the accounting errors in the 2021 Consolidated Financial Statements, which have been adjusted as follows: As of December 31, 2021 Consolidated Balance Sheets: Amount Previosly Reported Amount As Restated Income taxes payable $ 114,000 $ 414,000 Total liabilities $ 361,000 $ 660,000 Total equity $ 3,327,000 $ 3,028,000 Year ended December 31, 2021 Consolidated Statements of Operations: Amount Previosly Reported Amount As Restated Income tax provision $ 120,000 $ 420,000 Net loss $ 674,000 $ 973,000 Net loss attributable to noncontrolling interest $ 47,000 $ 92,000 Net loss attributable to U.S. Neurosurgical Holdings, Inc. $ 627,000 $ 881,000 Basic and diluted net loss per share attributable to U.S. NeuroSurgical Holdings, Inc. $ (0.08 ) $ (0.11 ) The restatement corrections impact certain components within operating cash flows of the Consolidated Statements of Cash Flows. Total operating cash flows, investing activities, financing activities, and cash and cash equivalents are unchanged as a result of the restatements. |
Quarterly Results of Operations
Quarterly Results of Operations (Unaudited) | 12 Months Ended |
Dec. 31, 2021 | |
Quarterly Results of Operations (Unaudited) [Abstract] | |
Quarterly Results of Operations (Unaudited) | Note M – Quarterly Results of Operations (Unaudited) In the first quarter of 2021, the disposition of the Company’s business at New York University Medical Center occurred, which resulted in the recognition of a gain on the sale and transfer of the gamma knife property at that time. A summary of the unaudited results of operations for the year ended December 31 is as follows 2021 As Restated First Quarter Second Quarter Third Quarter Fourth Quarter Revenue $ 1,061,000 $ - $ - $ - Cost and expenses: Patient expenses 86,000 - - - Selling, general and administrative 298,000 249,000 268,000 248,000 Total 384,000 249,000 268,000 248,000 Operating (loss) income 677,000 (249,000 ) (268,000 ) (248,000 ) Total other (expense) income Interest expense (2,000 ) (1,000 ) - - Other income - - 9,000 (9,000 ) Interest income - sales-type sublease 8,000 - - - Loss from investment in unconsolidated entities, net (139,000 ) (135,000 ) (77,000 ) (119,000 ) Total other expense (133,000 ) (136,000 ) (68,000 ) (128,000 ) (Loss) income before income taxes 544,000 (385,000 ) (336,000 ) (376,000 ) Income tax provision 252,000 232,000 16,000 (80,000 ) Net (loss) income 292,000 (617,000 ) (352,000 ) (296,000 ) Net loss attributable to noncontrolling interests - - - 92,000 Net (loss) income attributable to U.S. NeuroSurgical Holdings, Inc. $ 292,000 $ (617,000 ) $ (352,000 ) $ (204,000 ) Basic and diluted net (loss) income per share attributable to U.S. NeuroSurigical Holdings, Inc. $ 0.04 $ (0.08 ) $ (0.05 ) $ (0.03 ) In lieu of filing amended reports on Form 10-Q, the following tables represent the Company's restated unaudited consolidated financial statements for each of the quarters during the year ended December 31, 2021. See Note L, Restatement of Previously Issued Consolidated Financial Statements, for additional information. CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS As Restated December 31, 2021 September 30, 2021 June 30, 2021 March 31, 2021 Three Months Ended Three Months Ended Nine Months Ended Three Months Ended Six Months Ended Three Months Ended Revenue $ - $ - $ 1,061,000 $ - $ 1,061,000 $ 1,061,000 Cost and expenses: Patient expenses - - 86,000 - 86,000 86,000 Selling, general and administrative 248,000 268,000 815,000 249,000 547,000 298,000 Total 248,000 268,000 901,000 249,000 633,000 384,000 Operating (loss) income (248,000 ) (268,000 ) 160,000 (249,000 ) 428,000 677,000 Total other (expense) income Interest expense - - (3,000 ) (1,000 ) (3,000 ) (2,000 ) Other income (9,000 ) 9,000 9,000 - - - Interest income - sales-type sublease - - 8,000 - 8,000 8,000 Loss from investment in unconsolidated entities, net (119,000 ) (77,000 ) (351,000 ) (135,000 ) (274,000 ) (139,000 ) Total other expense (128,000 ) (68,000 ) (337,000 ) (136,000 ) (269,000 ) (133,000 ) (Loss) income before income taxes (376,000 ) (336,000 ) (177,000 ) (385,000 ) 159,000 544,000 Income tax provision (80,000 ) 16,000 500,000 232,000 484,000 252,000 Net (loss) income (296,000 ) (352,000 ) (677,000 ) (617,000 ) (325,000 ) 292,000 Net loss attributable to noncontrolling interests 92,000 - - - - - Net (loss) income attributable to U.S. NeuroSurgical Holdings, Inc. $ (204,000 ) $ (352,000 ) $ (677,000 ) $ (617,000 ) $ (325,000 ) $ 292,000 Basic and diluted net (loss) income per share attributable to U.S. NeuroSurigical Holdings, Inc. $ (0.03 ) $ (0.05 ) $ (0.09 ) $ (0.08 ) $ (0.04 ) $ 0.04 CONDENSED CONSOLIDATED BALANCE SHEETS As Restated September 30, 2021 June 30, 2021 March 31, 2021 ASSETS Current assets: Cash and cash equivalents $ 2,567,000 $ 2,820,000 $ 2,543,000 Accounts receivable - - 828,000 Other current assets 67,000 89,000 80,000 Total current assets 2,634,000 2,909,000 3,451,000 Other assets: Due from related parties 918,000 923,000 916,000 Investments in unconsolidated entities 152,000 164,000 161,000 Total other assets 1,070,000 1,087,000 1,077,000 Property and equipment: Operating lease right-of-use asset 68,000 77,000 86,000 Total property and equipment 68,000 77,000 86,000 TOTAL ASSETS $ 3,772,000 $ 4,073,000 $ 4,614,000 LIABILITIES Current liabilities: Operating lease right-of-use liability - current portion $ 42,000 $ 41,000 $ 40,000 Accounts payable and accrued expenses 180,000 135,000 166,000 Income taxes payable 496,000 480,000 363,000 Total current liabilities 718,000 656,000 569,000 Operating lease right-of-use liability - net of current portion 34,000 45,000 56,000 Guarantee liabliity 11,000 11,000 11,000 Total long-term liabilities 45,000 56,000 67,000 Total liabilities 763,000 712,000 636,000 EQUITY Common stock 78,000 78,000 78,000 Additional paid-in capital 3,100,000 3,100,000 3,100,000 (Accumulated deficit) retained earnings (169,000 ) 183,000 800,000 Total equity 3,009,000 3,361,000 3,978,000 TOTAL LIABILITIES AND EQUITY $ 3,772,000 $ 4,073,000 $ 4,614,000 The restatement corrections impact certain components within operating cash flows of the Consolidated Statements of Cash Flows. Total operating cash flows, investing activities, financing activities, and cash and cash equivalents are unchanged as a result of the restatements. |
The Company and its Significa_2
The Company and its Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2021 | |
The Company and its Significant Accounting Policies [Abstract] | |
Basis of presentation and consolidation | [1] Basis of presentation and consolidation: The consolidated financial statements include the accounts of Holdings and its wholly-owned subsidiaries, USN, USNC and U.S. NeuroSurgical Physics, Inc., and Elite Health through from the date of acquisition. All significant intercompany balances and transactions have been eliminated in consolidation. The Company applies the provisions of Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) Topic 810, Consolidation to noncontrolling interests in consolidated financial statements. The guidance requires noncontrolling interests to be reported as a component of equity separate from the parent’s equity and purchases and sales of equity interests, that do not result in a change in control, to be accounted for as equity transactions. In addition, net (loss) income attributable to noncontrolling interests are to be included in net (loss) income and, upon a loss of control, the interest sold, as well as any interest retained, is to be recorded at fair value, with any gain or loss recognized in net (loss) income |
Revenue recognition | [2] Revenue recognition: The Company primarily generated revenue from a leasing arrangement with New York University, which is not within the scope of Revenue from Contracts with Customers (Topic 606), and from the sale of maintenance services with a single performance obligation The Company recognizes revenue in accordance with two different accounting standards: 1) Topic 606 and 2) Accounting Standards Codification (“ASC”) Topic 842, Leases Under Topic 606, the core principle is to recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Topic 606 defines a five-step process to accomplish this objective, including identifying the contract with the customer and the performance obligations within the contract, determining the transaction price including estimates of any variable consideration, allocating the transaction price to each separate performance obligation, and recognizing revenue as the Company satisfies each performance obligation. 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 Topic 606. The Company recognizes revenue when a performance obligation is satisfied by transferring control over a product or service to a customer. The discussion below addresses our primary types of revenue as categorized by the applicable accounting standards. NYU Lease revenue: Prior to October 2018, the Company’s Gamma Knife Neuroradiosurgery Equipment Agreement with NYU (“NYU Agreement”) primarily consisted of an operating lease, and the associated patient revenue from the use of the gamma knife was primarily operating lease income. Following an amendment to the Company’s lease agreement with NYU, effective August 2016, the Company received a $30,000 minimum lease payment from NYU each month. With the exception of these fixed payments, the NYU agreement provided only for contingent rental income based on a tiered fee schedule related to the number of patient procedures and associated thresholds, with the rate per procedure decreasing as more procedures are performed. The Company recognized the contingent rental income and the fixed monthly payments on a systematic basis using an average fee per procedure calculated by estimating the expected number of procedures per contract year which runs from November 1, to the following October 31. Any amounts received in excess of the average fee were considered deferred revenue. At the end of each reporting period, the Company reviewed its estimated revenue for the contract year and adjusted revenue for any material changes in the estimate. At the end of the contract year, the revenue was adjusted to the actual amount received or receivable. In September 2017, USN and NYU entered into an additional amendment to the NYU Agreement, whereby NYU committed to purchase all of the gamma knife equipment at the NYU Medical Center for a purchase price of $2,400,000, consisting of 41 monthly installments of $50,000 commencing at the end of October 2017 and continuing through the end of February 2021, with a final payment of $350,000 on March 31, 2021. Upon receipt of final payment, title to all the equipment at the center passed to NYU. In October 2018, USN satisfied its obligation to reload the cobalt, and the NYU agreement was re-evaluated to be a sales-type sublease between USN, the lessor, and NYU, the lessee. At the inception of a sales-type sublease, the lessor recognizes its gross investment in the sublease, unearned income and sales price. The cost or carrying amount, if different, of the leased property plus any initial direct costs minus the present value of the unguaranteed residual value accruing to the benefit of the lessor, is charged by the lessor against income in the current period. Management has concluded that all fixed future minimum lease payments (“MLPs”) payable by NYU to USN should be and were included in the investment in sublease. These MLPs include fixed monthly payments of $50,000 through February 2021 and $30,000 through March 2021, as well as a final payment of $350,000 in March 2021. The present value of the MLPs was estimated to be approximately $2,447,000 and was recorded as an investment in sublease effective October 1, 2018. Until the contract renewal in October of 2020, the patient revenue under the tiered schedule had been considered contingent income under the sales type lease and was recognized on a systematic basis using an average fee per procedure. In October 2020, the Company recorded patient revenue based on procedures performed at the applicable billing rate for each procedure since the Company did not exceed the threshold at which billing rates decrease before the completed sale of the equipment on March 31, 2021. Upon termination of the NYU contract, the Company recognized a gain of $100,000 related to previously accrued expenses. The gain was included as a reduction in selling, general and administrative expenses in the accompanying Consolidated Statements of Operations in the year ended December 31, 2021. NYU Maintenance Revenue: The NYU agreement, which ended in March 2021, specified that USN was obligated to maintain the gamma knife equipment in good operating condition. This maintenance obligation was incurred through the term of the agreement while patient procedures were performed. Usage of the gamma knife machine was directly linked to the maintenance of the machine. USN billed NYU monthly for the maintenance and gamma knife services provided. The portion of the total contract consideration allocated to the maintenance services was $79,000 for 2021 and $316,000 for 2020, and was recognized ratably over each year. |
Cash and cash equivalents | [3] Cash and cash equivalents: The Company considers all highly liquid debt instruments purchased with a maturity of three months or less to be cash equivalents. |
Accounts receivable | [4] Accounts receivable Accounts receivable only included amounts owed to the Company from the NYU Agreement. The agreement ended with the sale of the equipment to NYU on March 31, 2021. |
Investments in unconsolidated entities | [5] Investments in unconsolidated entities: The Company accounts for its investments in unconsolidated entities by the equity method. The Company records its share of such earnings (loss) in the Consolidated Statements of Operations as “Loss from investments in unconsolidated entities, net”. The carrying value of the Company’s investments in unconsolidated entities is recorded in the Consolidated Balance Sheets. The Company records losses of the unconsolidated entities only to the extent of the Company’s interest in and advances to the entities. As such, the recorded balance of MOP and CBOP have been taken to zero. In August 2016, the FASB issued ASU 2016-15, Classification of Certain Cash Receipts and Cash Payments, which in part requires entities to assess whether distributions of cash from unconsolidated entities represent a return on the investment or a return of the investment, to appropriately classify the distributions in the statement of cash flows. Although the ASU is effective in the first quarter of 2018, we early adopted the guidance in the first quarter of 2017 due to the ongoing applicability of the new standard to the Company’s consolidated financial statements. We made an accounting policy election to use the cumulative earnings approach to determine that the distributions were returns on the investment and accordingly classified them as operating cash flows. Under the cumulative earnings approach, distributions received from the unconsolidated entity are presumed to be a return on the investment unless the distributions received by the investor, less distributions received in prior periods that were deemed to be returns of investment, exceed cumulative equity in earnings recognized by the investor. |
Goodwill | [6] Goodwill: Goodwill represents the excess of the aggregate purchase price over the fair value of the net assets acquired in a business acquisition. Goodwill is tested for impairment on an annual basis, at the anniversary of the acquisition, and between annual tests in certain circumstances, and written down when impaired. Evaluating goodwill for impairment involves the determination of the fair value of each reporting unit in which goodwill is recorded using a qualitative or quantitative analysis. A reporting unit is an operating segment or a component of an operating segment for which discrete financial information is available and reviewed by segment management on a regular basis. The qualitative impairment test includes considering various factors, including macroeconomic conditions, industry and market conditions, cost factors, a sustained share price or market capitalization decrease, and any reporting unit specific events. Goodwill was evaluated on a qualitative basis and concluded that no adjustment to the carrying value of goodwill was necessary. In addition, no qualitative indicators of impairment were identified during the fourth quarter of fiscal year ended December 31, 2021, and therefore, no interim quantitative goodwill impairment evaluation was performed. If the fair value of a reporting unit exceeds the carrying value, goodwill impairment is not indicated. If the carrying amount of a reporting unit is determined to be higher than its estimated fair value, the excess is recognized as an impairment expense. In accordance with the authoritative guidance over fair value measurements, the fair value of a reporting unit is defined as the price that would be received to sell the unit as a whole in an orderly transaction between market participants at the measurement date. The Company primarily uses the income approach methodology, which includes the discounted cash flow method and an enterprise value method, and the market approach methodology, which considers the values of comparable businesses, to estimate the fair value of the reporting unit. Management believes the methodology used to review impairment of goodwill, which includes a significant amount of judgment and estimates, provides a reasonable basis to determine whether impairment has occurred. However, many of the factors employed in determining whether goodwill is impaired are outside of the Company’s control and it is reasonably likely that assumptions and estimates will change in future periods. These changes could result in future impairments. |
Long-lived assets | [7] Long-lived assets: The Company reviews its long-lived assets for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. |
Asset retirement obligations | [8] Asset retirement obligations: The Company records liabilities for legal obligations associated with the retirement of tangible long-lived assets based on the estimated future cost of asset retirement obligations discounted to present value and records a corresponding asset and liability on its consolidated balance sheets. The values ultimately derived are based on many significant estimates, including future decommissioning costs, inflation, cost of capital, and market risk premiums. The nature of these estimates requires the Company to make judgments based on historical experience and future expectations. Revisions to the estimates may be required based on such things as changes to cost estimates or the timing of future cash outlays. Any such changes that result in upward or downward revisions in the estimated obligation will result in an adjustment to the related capitalized asset and corresponding liability on a prospective basis. |
Capital lease obligations | [9] Capital lease obligations: Effective January 1, 2019, the Company adopted ASU 2016-02, Leases, and the Company’s leases previously classified as capital leases, were determined to be finance leases. |
Guarantees | [10] Guarantees: The Company recognizes a liability at the fair value of the obligation at the inception of a financial guarantee contract. The initial liability is subsequently reduced as the Company is released from exposure under the guarantee. If it becomes probable that the Company will have to perform on a guarantee, a separate liability is accrued if it is reasonably estimable, based on the facts and circumstances at that time. The Company reverses the fair value liability only when there is no further exposure under the guarantee. |
Income taxes | [11] Income taxes: Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets or liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. Valuation allowances are established when necessary to reduce tax assets to amounts more likely than not to be realized. The Company has applied the accounting provisions for Accounting for Uncertainty in Income Taxes. (Topic 740) This accounting provision provides a comprehensive model for how the Company should recognize, measure, present, and disclose in its financial statements uncertain tax positions that the Company has taken or expects to take on its tax returns. If applicable, the Company records interest and penalties as a component of income tax expense. The Company had no uncertain material tax positions at December 31, 2021 and 2020. Tax years from January 1, 2018 to the current year remain open for examination by federal and state tax authorities. |
Earnings per share | [12] Earnings per share: Earnings per share are computed by dividing earnings available to common stockholders by the weighted average shares outstanding for the period. There were no common stock equivalents during 2021 and 2020, and therefore, no potential dilution for the periods presente |
Advertising costs | [13] Advertising costs: The Company follows the policy of charging the costs of advertising to expense as incurred. There were no advertising costs in 2021 and 2020. |
Estimates and assumptions | [14] Estimates and assumptions: The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates. |
Fair values of financial instruments | [15] Fair values of financial instruments: The estimated fair value of financial instruments has been determined based on available market information and appropriate valuation methodologies. The carrying amounts of cash and cash equivalents, accounts receivable, other current assets, due from or to related parties, and accounts payable approximate fair value at December 31, 2021 and 2020 because of the short maturity of these financial instruments. The carrying values of the notes receivable and the obligations under finance leases, approximate fair value because the interest rates on these instruments approximate the market rates at December 31, 2021 and 2020. |
Credit risk | [16] Credit risk: At times, the Company may have cash and cash equivalents at a financial institution in excess of insured limits. The Company places its cash and cash equivalents with high credit quality financial institutions whose credit ratings are monitored by management to minimize credit risk. Accounts receivable consisted of amounts due from the medical centers. Historically, credit losses on accounts receivable have not been significant. At December 31, 2020, substantially all of the Company’s accounts receivable were due from one customer, NYU. |
Leases | [17] Leases: In February 2016, the FASB issued ASU 2016-02, Leases (“Topic 842”) to increase transparency and comparability among organizations by requiring (1) recognition of lease assets and lease liabilities on the balance sheet and (2) disclosure of key information about leasing arrangements. Some changes to the lessor accounting guidance were made to align both of the following: (1) the lessor accounting guidance with certain changes made to the lessee accounting guidance and (2) key aspects of the lessor accounting model with revenue recognition guidance. Topic 842 was effective for fiscal years and interim periods beginning after December 15, 2018. A modified retrospective approach is required for adoption for all leases that exist at or commence after the date of initial application with an option to use certain practical expedients. The Company adopted the provisions of Topic 842, as amended, as of January 1, 2019. The adoption of Topic 842 had a material impact on the Company’s Consolidated Balance Sheets due to the recognition of certain right-of-use (“ROU”) assets and lease liabilities. Although a significant amount of revenue was accounted for under Topic 842, this guidance did not have a material impact on our Consolidated Statements of Operations or Cash Flows. The Company determines if an arrangement is a lease at its inception. The Company’s current operating lease relates to office space and is discussed in Note I. The Company’s finance lease obligations and sales-type sublease were related to the NYU gamma knife. The Company’s previously-recorded capital lease obligations addressed in Note F to the consolidated financial statements were accounted for as finance lease obligations upon adoption of Topic 842. The sales-type sublease is discussed in Note E. Under Topic 842, operating leases result in the recognition of ROU assets and lease liabilities on the consolidated balance sheets. ROU assets represent the right to use the leased asset for the lease term and lease liabilities represent the obligation to make lease payments. Under Topic 842, operating lease ROU assets and lease liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. The Company’s operating lease does not provide an implicit rate; therefore, upon adoption of Topic 842, the Company used its estimated incremental borrowing rate at the commencement date to determine the present value of lease payments. The ROU assets include any initial lease payments made and exclude lease incentives received. The lease terms may include options to extend or terminate the lease that are reasonably certain to be exercised. Lease expense under Topic 842 is recognized on a straight-line basis over the lease term. The tables below present financial information associated with our leases as of and for the years ended December 31, 2021, and 2020. Classification December 31, Assets 2021 2020 Current Finance lease assets Investment in sales-type sublease - current $ - $ 532,000 Long-term Operating lease assets Operating lease right-of-use asset 59,000 94,000 Total leased assets $ 59,000 $ 626,000 Liabilities Current Finance lease liabilities Obligations under finance lease - current portion $ - $ 89,000 Operating lease liabilities Operating lease right-of-use liability - current portion 43,000 40,000 Long-term Operating lease liabilities Operating lease right-of-use liability - net of current portion 23,000 66,000 Total lease liabilities $ 66,000 $ 195,000 Lease Cost Operating lease cost Selling, general and administrative $ 41,000 $ 42,000 Finance lease cost Interest on lease liabilities Interest expense 1,000 23,000 Sublease income Interest income - sales-type sublease 8,000 72,000 Net lease cost $ 34,000 $ (7,000 ) Maturity of lease liabilities (as of December 31, 2021) Operating lease 2022 46,000 2023 24,000 Total $ 70,000 Less amount representing interest 4,000 Present value of lease liabilities $ 66,000 Discount rate 5.850 % |
The Company and its Significa_3
The Company and its Significant Accounting Policies (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
The Company and its Significant Accounting Policies [Abstract] | |
Financial Information Associated with our Leases | The tables below present financial information associated with our leases as of and for the years ended December 31, 2021, and 2020. Classification December 31, Assets 2021 2020 Current Finance lease assets Investment in sales-type sublease - current $ - $ 532,000 Long-term Operating lease assets Operating lease right-of-use asset 59,000 94,000 Total leased assets $ 59,000 $ 626,000 Liabilities Current Finance lease liabilities Obligations under finance lease - current portion $ - $ 89,000 Operating lease liabilities Operating lease right-of-use liability - current portion 43,000 40,000 Long-term Operating lease liabilities Operating lease right-of-use liability - net of current portion 23,000 66,000 Total lease liabilities $ 66,000 $ 195,000 Lease Cost Operating lease cost Selling, general and administrative $ 41,000 $ 42,000 Finance lease cost Interest on lease liabilities Interest expense 1,000 23,000 Sublease income Interest income - sales-type sublease 8,000 72,000 Net lease cost $ 34,000 $ (7,000 ) |
Maturity of Lease Liabilities | Maturity of lease liabilities (as of December 31, 2021) Operating lease 2022 46,000 2023 24,000 Total $ 70,000 Less amount representing interest 4,000 Present value of lease liabilities $ 66,000 Discount rate 5.850 % |
Investments in Unconsolidated_2
Investments in Unconsolidated Entities (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Neuro Partners LLC and CGK [Member] | |
Schedule of Equity Method Investments [Line Items] | |
Equity Method Investment Summarized Financial Information | The following tables present the aggregation of summarized combined financial information of NeuroPartners LLC and CGK: Neuro Partners LLC and CGK Combined Condensed Income Statement Information Years Ended December 31, 2021 2020 Patient revenue $ 606,000 $ 1,141,000 Net (loss) income $ (9,000 ) $ 391,000 USNC’s equity in (loss) income of Neuro Partners LLC and CGK $ (36,000 ) $ 124,000 Neuro Partners LLC and CGK Combined Condensed Balance Sheet Information December 31, 2021 2020 Current assets $ 299,000 $ 121,000 Noncurrent assets 294,000 551,000 Total assets $ 593,000 $ 672,000 Current liabilities $ 564,000 $ 634,000 Noncurrent liabilities - - Equity 29,000 38,000 Total liabilities and equity $ 593,000 $ 672,000 |
Boca Oncology Partners RE, LLC ("BOPRE") [Member] | |
Schedule of Equity Method Investments [Line Items] | |
Equity Method Investment Summarized Financial Information | The following tables present the summarized financial information of BOPRE: BOPRE Condensed Income Statement Information Years Ended December 31, 2021 2020 Rental Income $ - $ - Net income $ 85,000 $ 63,000 USNC’s equity in income in BOPRE $ 17,000 $ 13,000 BOPRE Condensed Balance Sheet Information December 31, 2021 2020 Current assets $ 112,000 $ 27,000 Noncurrent assets 757,000 757,000 Total assets $ 869,000 $ 784,000 Current liabilities $ - $ - Noncurrent liabilities - - Equity 869,000 784,000 Total liabilities and equity $ 869,000 $ 784,000 |
Medical Oncology Partners LLC [Member] | |
Schedule of Equity Method Investments [Line Items] | |
Equity Method Investment Summarized Financial Information | The following table presents the summarized financial information of MOP: MOP Condensed Consolidated Income Statement Information Years Ended December 31, 2021 2020 Patient revenue $ 2,417,000 $ 2,104,000 Net loss $ (646,000 ) $ (1,256,000 ) USNC’s equity in loss in MOP $ (231,000 ) $ (450,000 ) MOP Condensed Consolidated Balance Sheet Information December 31, 2021 2020 Current assets $ 201,000 $ 204,000 Noncurrent assets 384,000 701,000 Total assets $ 585,000 $ 905,000 Current liabilities $ 3,109,000 $ 2,736,000 Noncurrent liabilities 92,000 410,000 Deficit (2,616,000 ) (2,241,000 ) Total liabilities and deficit $ 585,000 $ 905,000 |
CB Oncology Partners LLC [Member] | |
Schedule of Equity Method Investments [Line Items] | |
Equity Method Investment Summarized Financial Information | The following table presents the summarized financial information of CBOP: CBOP Condensed Income Statement Information Years Ended December 31, 2021 2020 Patient revenue $ 2,042,000 $ 1,795,000 Net loss $ (319,000 ) $ (730,000 ) USNC’s equity in loss of CBOP $ (91,000 ) $ (195,000 ) CBOP Condensed Balance Sheet Information December 31, 2021 2020 Current assets $ 400,000 $ 385,000 Noncurrent assets 3,667,000 4,271,000 Total assets $ 4,067,000 $ 4,656,000 Current liabilities $ 3,472,000 $ 3,181,000 Noncurrent liabilities 3,121,000 3,684,000 Deficit (2,526,000 ) (2,209,000 ) Total liabilities and deficit $ 4,067,000 $ 4,656,000 |
Obligations Under Finance Lea_2
Obligations Under Finance Leases (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Obligations Under Finance Leases [Abstract] | |
Obligations under Finance Leases | The obligations under the finance leases are as follows: December 31, 2021 2020 Finance leases - Gamma Knife $ - $ 89,000 Less current portion - (89,000 ) $ - $ - |
Taxes (Tables)
Taxes (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Taxes [Abstract] | |
Components of Income Taxes Provision | The components of the provision for income taxes are as follows: Years Ended December 31, 2021 2020 (As Restated) Current taxes: Federal $ 228,000 $ 211,000 State 192,000 95,000 Current taxes 420,000 306,000 Deferred taxes: Federal $ - $ 12,000 State - 5,000 Deferred taxes - 17,000 Income tax provision $ 420,000 $ 323,000 |
Reconciliation of Tax Provision | A reconciliation of the tax provision calculated at the statutory federal income tax rate with amounts reported follows: Year Ended December 31, 2021 2020 (As Restated) Income tax at the federal statutory rate $ (130,000 ) $ 180,000 State income tax, net of federal taxes (106,000 ) 52,000 Permanent differences and other (67,000 ) 16,000 Change in estimated effective state tax rate 2,000 (4,000 ) Change in valuation allowance 721,000 79,000 Income tax provision $ 420,000 $ 323,000 |
Deferred Tax Assets and Liabilities | Items which give rise to deferred tax assets and liabilities are as follows: December 31, 2021 2020 Deferred tax asset: (As Restated) Basis differences in unconsolidated entities, including advances and loans to those entities $ 587,000 $ 561,000 Excess of book depreciation over tax depreciation - 192,000 Net intangible assets and other capitalized costs 102,000 - Net operating loss 66,000 34,000 Net effect of conversion from the accrual basis of accounting to the cash basis of accounting for tax purposes primarily related to accounts receivable, prepaid expense, deferred revenue, and accounts payable 45,000 - Valuation allowance (800,000 ) (79,000 ) - 708,000 Deferred tax liability: Deferred gain on disposal of gamma knife - (634,000 ) Net effect of conversion from the accrual basis of accounting to the cash basis of accounting for tax purposes primarily related to accounts receivable, prepaid expense, deferred revenue, and accounts payable - (74,000 ) Net deferred tax asset $ - $ - |
Commitments and Contingencies (
Commitments and Contingencies (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Commitments and Contingencies [Abstract] | |
Maturities of Operating Lease Liability | The maturities of the operating lease liability as of December 31, 2021, were as follows: Year Ending December 31, 2022 46,000 2023 24,000 70,000 Less interest (4,000 ) Present value of net minimum obligation $ 66,000 |
Acquisition (Tables)
Acquisition (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Acquisition [Abstract] | |
Carrying Value of Goodwill for Acquisition | The following table summarizes the changes in the carrying value of goodwill for the acquisition of Elite Health Plan, Inc.: Balance at January 1, 2020 $ - Acquisition - Balance at December 31, 2020 - Acquisition 315,000 Balance at December 31, 2021 $ 315,000 |
Restatement of Previously Iss_2
Restatement of Previously Issued Consolidated Financial Statements (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Restatement of Previously Issued Consolidated Financial Statements [Abstract] | |
Error Corrections in Consolidated Financial Statements | As of December 31, 2021 Consolidated Balance Sheets: Amount Previosly Reported Amount As Restated Income taxes payable $ 114,000 $ 414,000 Total liabilities $ 361,000 $ 660,000 Total equity $ 3,327,000 $ 3,028,000 Year ended December 31, 2021 Consolidated Statements of Operations: Amount Previosly Reported Amount As Restated Income tax provision $ 120,000 $ 420,000 Net loss $ 674,000 $ 973,000 Net loss attributable to noncontrolling interest $ 47,000 $ 92,000 Net loss attributable to U.S. Neurosurgical Holdings, Inc. $ 627,000 $ 881,000 Basic and diluted net loss per share attributable to U.S. NeuroSurgical Holdings, Inc. $ (0.08 ) $ (0.11 ) |
Quarterly Results of Operatio_2
Quarterly Results of Operations (Unaudited) (Tables) | 12 Months Ended |
Dec. 31, 2021 | |
Quarterly Results of Operations (Unaudited) [Abstract] | |
Quarterly Financial Information | A summary of the unaudited results of operations for the year ended December 31 is as follows 2021 As Restated First Quarter Second Quarter Third Quarter Fourth Quarter Revenue $ 1,061,000 $ - $ - $ - Cost and expenses: Patient expenses 86,000 - - - Selling, general and administrative 298,000 249,000 268,000 248,000 Total 384,000 249,000 268,000 248,000 Operating (loss) income 677,000 (249,000 ) (268,000 ) (248,000 ) Total other (expense) income Interest expense (2,000 ) (1,000 ) - - Other income - - 9,000 (9,000 ) Interest income - sales-type sublease 8,000 - - - Loss from investment in unconsolidated entities, net (139,000 ) (135,000 ) (77,000 ) (119,000 ) Total other expense (133,000 ) (136,000 ) (68,000 ) (128,000 ) (Loss) income before income taxes 544,000 (385,000 ) (336,000 ) (376,000 ) Income tax provision 252,000 232,000 16,000 (80,000 ) Net (loss) income 292,000 (617,000 ) (352,000 ) (296,000 ) Net loss attributable to noncontrolling interests - - - 92,000 Net (loss) income attributable to U.S. NeuroSurgical Holdings, Inc. $ 292,000 $ (617,000 ) $ (352,000 ) $ (204,000 ) Basic and diluted net (loss) income per share attributable to U.S. NeuroSurigical Holdings, Inc. $ 0.04 $ (0.08 ) $ (0.05 ) $ (0.03 ) In lieu of filing amended reports on Form 10-Q, the following tables represent the Company's restated unaudited consolidated financial statements for each of the quarters during the year ended December 31, 2021. See Note L, Restatement of Previously Issued Consolidated Financial Statements, for additional information. CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS As Restated December 31, 2021 September 30, 2021 June 30, 2021 March 31, 2021 Three Months Ended Three Months Ended Nine Months Ended Three Months Ended Six Months Ended Three Months Ended Revenue $ - $ - $ 1,061,000 $ - $ 1,061,000 $ 1,061,000 Cost and expenses: Patient expenses - - 86,000 - 86,000 86,000 Selling, general and administrative 248,000 268,000 815,000 249,000 547,000 298,000 Total 248,000 268,000 901,000 249,000 633,000 384,000 Operating (loss) income (248,000 ) (268,000 ) 160,000 (249,000 ) 428,000 677,000 Total other (expense) income Interest expense - - (3,000 ) (1,000 ) (3,000 ) (2,000 ) Other income (9,000 ) 9,000 9,000 - - - Interest income - sales-type sublease - - 8,000 - 8,000 8,000 Loss from investment in unconsolidated entities, net (119,000 ) (77,000 ) (351,000 ) (135,000 ) (274,000 ) (139,000 ) Total other expense (128,000 ) (68,000 ) (337,000 ) (136,000 ) (269,000 ) (133,000 ) (Loss) income before income taxes (376,000 ) (336,000 ) (177,000 ) (385,000 ) 159,000 544,000 Income tax provision (80,000 ) 16,000 500,000 232,000 484,000 252,000 Net (loss) income (296,000 ) (352,000 ) (677,000 ) (617,000 ) (325,000 ) 292,000 Net loss attributable to noncontrolling interests 92,000 - - - - - Net (loss) income attributable to U.S. NeuroSurgical Holdings, Inc. $ (204,000 ) $ (352,000 ) $ (677,000 ) $ (617,000 ) $ (325,000 ) $ 292,000 Basic and diluted net (loss) income per share attributable to U.S. NeuroSurigical Holdings, Inc. $ (0.03 ) $ (0.05 ) $ (0.09 ) $ (0.08 ) $ (0.04 ) $ 0.04 CONDENSED CONSOLIDATED BALANCE SHEETS As Restated September 30, 2021 June 30, 2021 March 31, 2021 ASSETS Current assets: Cash and cash equivalents $ 2,567,000 $ 2,820,000 $ 2,543,000 Accounts receivable - - 828,000 Other current assets 67,000 89,000 80,000 Total current assets 2,634,000 2,909,000 3,451,000 Other assets: Due from related parties 918,000 923,000 916,000 Investments in unconsolidated entities 152,000 164,000 161,000 Total other assets 1,070,000 1,087,000 1,077,000 Property and equipment: Operating lease right-of-use asset 68,000 77,000 86,000 Total property and equipment 68,000 77,000 86,000 TOTAL ASSETS $ 3,772,000 $ 4,073,000 $ 4,614,000 LIABILITIES Current liabilities: Operating lease right-of-use liability - current portion $ 42,000 $ 41,000 $ 40,000 Accounts payable and accrued expenses 180,000 135,000 166,000 Income taxes payable 496,000 480,000 363,000 Total current liabilities 718,000 656,000 569,000 Operating lease right-of-use liability - net of current portion 34,000 45,000 56,000 Guarantee liabliity 11,000 11,000 11,000 Total long-term liabilities 45,000 56,000 67,000 Total liabilities 763,000 712,000 636,000 EQUITY Common stock 78,000 78,000 78,000 Additional paid-in capital 3,100,000 3,100,000 3,100,000 (Accumulated deficit) retained earnings (169,000 ) 183,000 800,000 Total equity 3,009,000 3,361,000 3,978,000 TOTAL LIABILITIES AND EQUITY $ 3,772,000 $ 4,073,000 $ 4,614,000 |
Organization and Business (Deta
Organization and Business (Details) | 12 Months Ended | |||||||||
Dec. 31, 2021 USD ($) Center | Sep. 30, 2021 USD ($) | Jun. 30, 2021 USD ($) | Mar. 31, 2021 USD ($) | Dec. 31, 2020 USD ($) | Jun. 30, 2020 | Sep. 02, 2017 | Dec. 23, 2016 | Dec. 31, 2011 | Dec. 31, 2010 | |
Equity Method Investments [Abstract] | ||||||||||
Cash reserves | $ | $ 2,178,000 | $ 2,567,000 | $ 2,820,000 | $ 2,543,000 | $ 2,030,000 | |||||
Corona Gamma Knife, LLC [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 39% | |||||||||
Neuro Partners LLC [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 20% | |||||||||
Boca Oncology Partners RE, LLC ("BOPRE") [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 22.50% | |||||||||
Medical Oncology Partners LLC [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Equity interest percentage to be acquired by subsidiary | 100% | |||||||||
CB Oncology Partners LLC [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 28.58% | 24% | ||||||||
NYU [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Number of gamma knife centers owned | Center | 1 | |||||||||
USNC [Member] | Corona Gamma Knife, LLC [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 39% | |||||||||
USNC [Member] | Neuro Partners LLC [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 20% | |||||||||
USNC [Member] | Florida Oncology Partners, LLC [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 24% | |||||||||
USNC [Member] | Boca Oncology Partners RE, LLC ("BOPRE") [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 22.51% | |||||||||
USNC [Member] | Medical Oncology Partners LLC [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 35.83% | |||||||||
USNC [Member] | CB Oncology Partners LLC [Member] | ||||||||||
Equity Method Investments [Abstract] | ||||||||||
Ownership percentage | 28.58% |
The Company and its Significa_4
The Company and its Significant Accounting Policies, Revenue Recognition (Details) | 1 Months Ended | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | |||||||||
Aug. 31, 2016 USD ($) | Dec. 31, 2021 USD ($) | Sep. 30, 2021 USD ($) | Jun. 30, 2021 USD ($) | Mar. 31, 2021 USD ($) | Jun. 30, 2021 USD ($) | Sep. 30, 2021 USD ($) | Dec. 31, 2021 USD ($) Installment | Dec. 31, 2020 USD ($) | Dec. 31, 2018 USD ($) | Oct. 31, 2018 USD ($) | Sep. 30, 2018 USD ($) | Sep. 30, 2017 USD ($) | Dec. 31, 2016 USD ($) | |
Revenue recognition [Abstract] | ||||||||||||||
Present value of minimum lease payments | $ 2,447,000 | |||||||||||||
Maintenance services revenue | $ 0 | $ 0 | $ 0 | $ 1,061,000 | $ 1,061,000 | $ 1,061,000 | $ 1,061,000 | $ 3,173,000 | ||||||
Gamma Knife Cobalt Reload [Member] | ||||||||||||||
Revenue recognition [Abstract] | ||||||||||||||
Monthly lease payment | $ 30,000 | |||||||||||||
ICON Imaging Technology [Member] | ||||||||||||||
Revenue recognition [Abstract] | ||||||||||||||
Monthly lease payment | $ 20,000 | |||||||||||||
NYU [Member] | ||||||||||||||
Revenue recognition [Abstract] | ||||||||||||||
Minimum monthly operating lease payment | $ 30,000 | |||||||||||||
Purchase price of gamma knife equipment | $ 2,400,000 | |||||||||||||
Number of monthly installments | Installment | 41 | |||||||||||||
Monthly lease payment | 50,000 | |||||||||||||
Final lease payment amount | $ 350,000 | |||||||||||||
Present value of minimum lease payments | $ 2,447,000 | |||||||||||||
Gain on termination of contract | $ 100,000 | |||||||||||||
Maintenance services revenue | $ 79,000 | $ 316,000 | ||||||||||||
NYU [Member] | Gamma Knife Cobalt Reload [Member] | ||||||||||||||
Revenue recognition [Abstract] | ||||||||||||||
Monthly lease payment | $ 50,000 | |||||||||||||
NYU [Member] | ICON Imaging Technology [Member] | ||||||||||||||
Revenue recognition [Abstract] | ||||||||||||||
Monthly lease payment | 30,000 | |||||||||||||
Final lease payment amount | $ 350,000 |
The Company and its Significa_5
The Company and its Significant Accounting Policies, Investments in Unconsolidated Entities (Details) - USD ($) | Dec. 31, 2021 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Dec. 31, 2020 |
Investments in Unconsolidated Entities [Abstract] | |||||
Investments in unconsolidated entities | $ 141,000 | $ 152,000 | $ 164,000 | $ 161,000 | $ 160,000 |
Medical Oncology Partners LLC [Member] | |||||
Investments in Unconsolidated Entities [Abstract] | |||||
Investments in unconsolidated entities | 0 | ||||
CB Oncology Partners LLC [Member] | |||||
Investments in Unconsolidated Entities [Abstract] | |||||
Investments in unconsolidated entities | $ 0 |
The Company and its Significa_6
The Company and its Significant Accounting Policies, Earnings per Share (Details) - shares | 12 Months Ended | |
Dec. 31, 2021 | Dec. 31, 2020 | |
Earnings Per Share [Abstract] | ||
Common stock equivalents (in shares) | 0 | 0 |
Potential dilution shares (in shares) | 0 | 0 |
The Company and its Significa_7
The Company and its Significant Accounting Policies, Advertising Costs (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2021 | Dec. 31, 2020 | |
Advertising costs [Abstract] | ||
Advertising cost | $ 0 | $ 0 |
The Company and its Significa_8
The Company and its Significant Accounting Policies, Leases (Details) - USD ($) | 12 Months Ended | ||||
Dec. 31, 2021 | Dec. 31, 2020 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | |
Current Assets [Abstract] | |||||
Investment in sales-type sublease - current | $ 0 | $ 532,000 | |||
Long-term Assets [Abstract] | |||||
Operating lease right-of-use asset | 59,000 | 94,000 | $ 68,000 | $ 77,000 | $ 86,000 |
Total leased assets | 59,000 | 626,000 | |||
Current Liabilities [Abstract] | |||||
Obligations under finance lease - current portion | 0 | 89,000 | |||
Operating lease right-of-use liability - current portion | 43,000 | 40,000 | 42,000 | 41,000 | 40,000 |
Long-term Liabilities [Abstract] | |||||
Operating lease right-of-use liability - net of current portion | 23,000 | 66,000 | $ 34,000 | $ 45,000 | $ 56,000 |
Total lease liabilities | 66,000 | 195,000 | |||
Lease Cost [Abstract] | |||||
Net lease cost | 34,000 | ||||
Net lease income | (7,000) | ||||
Operating lease [Abstract] | |||||
2022 | 46,000 | ||||
2023 | 24,000 | ||||
Total | 70,000 | ||||
Less amount representing interest | 4,000 | ||||
Present value of lease liabilities | $ 66,000 | 106,000 | |||
Discount rate | 5.85% | ||||
Selling, General and Administrative Expenses [Member] | |||||
Lease Cost [Abstract] | |||||
Operating lease cost | $ 41,000 | 42,000 | |||
Interest Expense [Member] | |||||
Lease Cost [Abstract] | |||||
Finance lease cost, interest on lease liabilities | 1,000 | 23,000 | |||
Interest Income - Sales-type Sublease [Member] | |||||
Lease Cost [Abstract] | |||||
Sublease income | $ 8,000 | $ 72,000 |
Investments in Unconsolidated_3
Investments in Unconsolidated Entities, The Southern California Regional Gamma Knife Center (Details) | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | |||||||
Apr. 01, 2016 USD ($) | Dec. 31, 2021 USD ($) | Sep. 30, 2021 USD ($) | Jun. 30, 2021 USD ($) | Mar. 31, 2021 USD ($) | Jun. 30, 2021 USD ($) | Sep. 30, 2021 USD ($) | Dec. 31, 2021 USD ($) Payment | Dec. 31, 2020 USD ($) | Dec. 31, 2019 USD ($) | Feb. 29, 2016 USD ($) | |
The Southern California Regional Gamma Knife Center [Abstract] | |||||||||||
Renovation installation and operation agreement period | 14 years | ||||||||||
Lease payment | $ 89,000 | $ 901,000 | |||||||||
Condensed Income Statement Information [Abstract] | |||||||||||
Patient revenue | $ 0 | $ 0 | $ 0 | $ 1,061,000 | $ 1,061,000 | $ 1,061,000 | 1,061,000 | 3,173,000 | |||
Net (loss) income | (296,000) | (352,000) | (617,000) | 292,000 | (325,000) | (677,000) | (973,000) | 533,000 | |||
USNC's equity in (loss) income | (119,000) | (77,000) | (135,000) | (139,000) | (274,000) | (351,000) | (470,000) | (809,000) | |||
Condensed Balance Sheet Information [Abstract] | |||||||||||
Current assets | 2,243,000 | 2,634,000 | 2,909,000 | 3,451,000 | 2,909,000 | 2,634,000 | 2,243,000 | 3,007,000 | |||
Total assets | 3,688,000 | 3,772,000 | 4,073,000 | 4,614,000 | 4,073,000 | 3,772,000 | 3,688,000 | 4,173,000 | |||
Current liabilities | 626,000 | 718,000 | 656,000 | 569,000 | 656,000 | 718,000 | 626,000 | 410,000 | |||
Noncurrent liabilities | 45,000 | 56,000 | 67,000 | 56,000 | 45,000 | ||||||
Equity | 3,028,000 | 3,009,000 | 3,361,000 | 3,978,000 | 3,361,000 | 3,009,000 | 3,028,000 | 3,686,000 | $ 3,153,000 | ||
Total liabilities and equity | 3,688,000 | $ 3,772,000 | $ 4,073,000 | $ 4,614,000 | $ 4,073,000 | $ 3,772,000 | 3,688,000 | 4,173,000 | |||
Neuro Partners LLC and CGK [Member] | |||||||||||
The Southern California Regional Gamma Knife Center [Abstract] | |||||||||||
Recorded amount of equity method income | (10,000) | 26,000 | |||||||||
Neuro Partners LLC and CGK [Member] | Investment in Unconsolidated Entity [Member] | |||||||||||
Condensed Income Statement Information [Abstract] | |||||||||||
Patient revenue | 606,000 | 1,141,000 | |||||||||
Net (loss) income | (9,000) | 391,000 | |||||||||
USNC's equity in (loss) income | (36,000) | 124,000 | |||||||||
Condensed Balance Sheet Information [Abstract] | |||||||||||
Current assets | 299,000 | 299,000 | 121,000 | ||||||||
Noncurrent assets | 294,000 | 294,000 | 551,000 | ||||||||
Total assets | 593,000 | 593,000 | 672,000 | ||||||||
Current liabilities | 564,000 | 564,000 | 634,000 | ||||||||
Noncurrent liabilities | 0 | 0 | 0 | ||||||||
Equity | 29,000 | 29,000 | 38,000 | ||||||||
Total liabilities and equity | $ 593,000 | $ 593,000 | 672,000 | ||||||||
Neuro Partners LLC [Member] | |||||||||||
The Southern California Regional Gamma Knife Center [Abstract] | |||||||||||
Ownership percentage | 20% | 20% | |||||||||
Neuro Partners LLC [Member] | Lease One [Member] | |||||||||||
The Southern California Regional Gamma Knife Center [Abstract] | |||||||||||
Share of guarantee in lease obligation | 20% | ||||||||||
Lease term | 7 years | 7 years | |||||||||
Lease obligation | $ 668,000 | ||||||||||
Neuro Partners LLC [Member] | Lease Two [Member] | |||||||||||
The Southern California Regional Gamma Knife Center [Abstract] | |||||||||||
Lease term | 5 years | 5 years | |||||||||
Lease obligation | $ 1,663,000 | ||||||||||
Number of lease payments | Payment | 60 | ||||||||||
Lease payment | $ 31,000 | ||||||||||
CGK [Member] | |||||||||||
The Southern California Regional Gamma Knife Center [Abstract] | |||||||||||
Ownership percentage | 39% | 39% | |||||||||
Due from related parties | $ 6,000 | $ 6,000 | $ 9,000 |
Investments in Unconsolidated_4
Investments in Unconsolidated Entities, Florida Oncology Partners (Details) | 1 Months Ended | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | ||||||||
Dec. 31, 2018 USD ($) shares | Dec. 31, 2021 USD ($) | Sep. 30, 2021 USD ($) | Jun. 30, 2021 USD ($) | Mar. 31, 2021 USD ($) | Jun. 30, 2021 USD ($) | Sep. 30, 2021 USD ($) | Dec. 31, 2021 USD ($) Term | Dec. 31, 2020 USD ($) | Dec. 31, 2015 USD ($) | Dec. 31, 2011 USD ($) | Nov. 30, 2017 USD ($) | Sep. 22, 2017 USD ($) | |
Florida Oncology Partners [Abstract] | |||||||||||||
Down payment of capital leases | $ 89,000 | $ 901,000 | |||||||||||
Recorded distribution | 0 | 176,000 | |||||||||||
Investments in unconsolidated entities | $ 141,000 | $ 152,000 | $ 164,000 | $ 161,000 | $ 164,000 | $ 152,000 | 141,000 | 160,000 | |||||
USNC's equity in (loss) income | $ (119,000) | $ (77,000) | $ (135,000) | $ (139,000) | $ (274,000) | $ (351,000) | $ (470,000) | (809,000) | |||||
FOP [Member] | |||||||||||||
Florida Oncology Partners [Abstract] | |||||||||||||
Lease term | 7 years | 7 years | |||||||||||
Lease obligation | $ 5,800,000 | ||||||||||||
Percentage of guarantee obligations | 25% | ||||||||||||
Down payment of capital leases | $ 1,000,000 | ||||||||||||
Monthly payments for capital leases | $ 172,000 | ||||||||||||
Common stock awarded as a part of bankruptcy proceedings (in shares) | shares | 10,820 | ||||||||||||
Recorded distribution | $ 0 | 0 | |||||||||||
Received from related party | 155,000 | ||||||||||||
Investments in unconsolidated entities | $ 0 | $ 0 | 0 | ||||||||||
USNC's equity in (loss) income | (78,000) | ||||||||||||
FOP [Member] | Maximum [Member] | |||||||||||||
Florida Oncology Partners [Abstract] | |||||||||||||
Amount of guarantee obligation | $ 1,433,000 | ||||||||||||
FOP [Member] | Office Space [Member] | |||||||||||||
Florida Oncology Partners [Abstract] | |||||||||||||
Lease term | 10 years | 10 years | |||||||||||
Loan amount | $ 4,106,000 | ||||||||||||
Debt maturity period | 7 years | ||||||||||||
FOP [Member] | Radiation Therapy Center [Member] | |||||||||||||
Florida Oncology Partners [Abstract] | |||||||||||||
Lease term | 10 years | 10 years | |||||||||||
Lease obligation | $ 14,321,000 | ||||||||||||
Monthly payments for capital leases | $ 160,000 | $ 170,000 | $ 170,000 | ||||||||||
Maximum number of additional terms extended | Term | 3 | ||||||||||||
Extension of agreement | 5 years | ||||||||||||
Percentage of increase of monthly payments each year | 2% | ||||||||||||
FOP [Member] | Letter of Credit [Member] | Office Space [Member] | |||||||||||||
Florida Oncology Partners [Abstract] | |||||||||||||
Letter of credit, amount | $ 88,000 | $ 88,000 | |||||||||||
FOP [Member] | USNC [Member] | |||||||||||||
Florida Oncology Partners [Abstract] | |||||||||||||
Ownership percentage | 24% | 24% | |||||||||||
21st Century Oncology [Member] | |||||||||||||
Florida Oncology Partners [Abstract] | |||||||||||||
Recorded distribution | $ 158,000 |
Investments in Unconsolidated_5
Investments in Unconsolidated Entities, Boca Oncology Partners (Details) | 1 Months Ended | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | ||||||
Jun. 30, 2012 | Jun. 30, 2011 USD ($) | Dec. 31, 2021 USD ($) ft² | Sep. 30, 2021 USD ($) | Jun. 30, 2021 USD ($) | Mar. 31, 2021 USD ($) | Jun. 30, 2021 USD ($) | Sep. 30, 2021 USD ($) | Dec. 31, 2021 USD ($) ft² | Dec. 31, 2020 USD ($) | Dec. 31, 2019 USD ($) | |
Boca Oncology Partners [Abstract] | |||||||||||
Investments in unconsolidated entities | $ 141,000 | $ 152,000 | $ 164,000 | $ 161,000 | $ 164,000 | $ 152,000 | $ 141,000 | $ 160,000 | |||
Condensed Income Statement Information [Abstract] | |||||||||||
Rental income | 7,000 | ||||||||||
Net (loss) income | (296,000) | (352,000) | (617,000) | 292,000 | (325,000) | (677,000) | (973,000) | 533,000 | |||
USNC's equity in (loss) income | (119,000) | (77,000) | (135,000) | (139,000) | (274,000) | (351,000) | (470,000) | (809,000) | |||
Condensed Balance Sheet Information [Abstract] | |||||||||||
Current assets | 2,243,000 | 2,634,000 | 2,909,000 | 3,451,000 | 2,909,000 | 2,634,000 | 2,243,000 | 3,007,000 | |||
Total assets | 3,688,000 | 3,772,000 | 4,073,000 | 4,614,000 | 4,073,000 | 3,772,000 | 3,688,000 | 4,173,000 | |||
Current liabilities | 626,000 | 718,000 | 656,000 | 569,000 | 656,000 | 718,000 | 626,000 | 410,000 | |||
Noncurrent liabilities | 45,000 | 56,000 | 67,000 | 56,000 | 45,000 | ||||||
Equity | 3,028,000 | 3,009,000 | 3,361,000 | 3,978,000 | 3,361,000 | 3,009,000 | 3,028,000 | 3,686,000 | $ 3,153,000 | ||
Total liabilities and equity | $ 3,688,000 | $ 3,772,000 | $ 4,073,000 | $ 4,614,000 | $ 4,073,000 | $ 3,772,000 | $ 3,688,000 | 4,173,000 | |||
USNC [Member] | Boca West IMP [Member] | |||||||||||
Boca Oncology Partners [Abstract] | |||||||||||
Share of guarantee in mortgage | 10% | 10% | |||||||||
Share of guarantee in outstanding mortgage | 50% | 50% | |||||||||
Mortgage term of guarantee | 10 years | ||||||||||
Original balance of mortgage | $ 3,000,000 | $ 3,000,000 | |||||||||
Boca Oncology Partners, LLC [Member] | |||||||||||
Boca Oncology Partners [Abstract] | |||||||||||
Area of real estate property (in square foot) | ft² | 6,000 | 6,000 | |||||||||
Boca Oncology Partners RE, LLC ("BOPRE") [Member] | |||||||||||
Boca Oncology Partners [Abstract] | |||||||||||
Ownership percentage | 22.50% | 22.50% | |||||||||
Investments in unconsolidated entities | $ 151,000 | $ 151,000 | 134,000 | ||||||||
Boca Oncology Partners RE, LLC ("BOPRE") [Member] | Boca West IMP [Member] | |||||||||||
Boca Oncology Partners [Abstract] | |||||||||||
Percentage of interest in medical office building | 20% | ||||||||||
Ownership percentage | 23.75% | ||||||||||
Additional investor purchased ownership percentage | 3.75% | ||||||||||
Boca Oncology Partners RE, LLC ("BOPRE") [Member] | Investment in Unconsolidated Entity [Member] | |||||||||||
Condensed Income Statement Information [Abstract] | |||||||||||
Rental income | 0 | 0 | |||||||||
Net (loss) income | 85,000 | 63,000 | |||||||||
USNC's equity in (loss) income | 17,000 | 13,000 | |||||||||
Condensed Balance Sheet Information [Abstract] | |||||||||||
Current assets | 112,000 | 112,000 | 27,000 | ||||||||
Noncurrent assets | 757,000 | 757,000 | 757,000 | ||||||||
Total assets | 869,000 | 869,000 | 784,000 | ||||||||
Current liabilities | 0 | 0 | 0 | ||||||||
Noncurrent liabilities | 0 | 0 | 0 | ||||||||
Equity | 869,000 | 869,000 | 784,000 | ||||||||
Total liabilities and equity | $ 869,000 | $ 869,000 | $ 784,000 | ||||||||
BOP and BOPRE [Member] | |||||||||||
Boca Oncology Partners [Abstract] | |||||||||||
Area of real estate property (in square foot) | ft² | 32,000 | 32,000 | |||||||||
Investments in unconsolidated entities | $ 225,000 | ||||||||||
Ownership percentage | 22.50% |
Investments in Unconsolidated_6
Investments in Unconsolidated Entities, Medical Oncology Partners (Details) - USD ($) | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | |||||||
Dec. 31, 2016 | Dec. 31, 2021 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2021 | Sep. 30, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 23, 2016 | |
Medical Oncology Partners [Abstract] | |||||||||||
Investments in unconsolidated entities | $ 141,000 | $ 152,000 | $ 164,000 | $ 161,000 | $ 164,000 | $ 152,000 | $ 141,000 | $ 160,000 | |||
Advances to unconsolidated entities | 491,000 | 459,000 | |||||||||
Condensed Income Statement Information [Abstract] | |||||||||||
Patient revenue | 0 | 0 | 0 | 1,061,000 | 1,061,000 | 1,061,000 | 1,061,000 | 3,173,000 | |||
Net loss | (296,000) | (352,000) | (617,000) | 292,000 | (325,000) | (677,000) | (973,000) | 533,000 | |||
USNC's equity in (loss) income | (119,000) | (77,000) | (135,000) | (139,000) | (274,000) | (351,000) | (470,000) | (809,000) | |||
Condensed Balance Sheet Information [Abstract] | |||||||||||
Current assets | 2,243,000 | 2,634,000 | 2,909,000 | 3,451,000 | 2,909,000 | 2,634,000 | 2,243,000 | 3,007,000 | |||
Total assets | 3,688,000 | 3,772,000 | 4,073,000 | 4,614,000 | 4,073,000 | 3,772,000 | 3,688,000 | 4,173,000 | |||
Current liabilities | 626,000 | 718,000 | 656,000 | 569,000 | 656,000 | 718,000 | 626,000 | 410,000 | |||
Noncurrent liabilities | 45,000 | 56,000 | 67,000 | 56,000 | 45,000 | ||||||
Deficit | 3,028,000 | 3,009,000 | 3,361,000 | 3,978,000 | 3,361,000 | 3,009,000 | 3,028,000 | 3,686,000 | $ 3,153,000 | ||
Total liabilities and deficit | 3,688,000 | $ 3,772,000 | $ 4,073,000 | $ 4,614,000 | $ 4,073,000 | $ 3,772,000 | $ 3,688,000 | 4,173,000 | |||
Medical Oncology Partners LLC [Member] | |||||||||||
Medical Oncology Partners [Abstract] | |||||||||||
Equity interest percentage to be acquired by subsidiary | 100% | ||||||||||
Investments in unconsolidated entities | $ 450,000 | ||||||||||
Investments in unconsolidated entities | 0 | 0 | |||||||||
Amount of capital contributed by company | 125,000 | ||||||||||
Advances to unconsolidated entities | 461,000 | ||||||||||
Condensed Income Statement Information [Abstract] | |||||||||||
USNC's equity in (loss) income | $ (12,000) | (686,000) | |||||||||
Medical Oncology Partners LLC [Member] | Other Investor [Member] | |||||||||||
Medical Oncology Partners [Abstract] | |||||||||||
Investments in unconsolidated entities | 105,000 | ||||||||||
Medical Oncology Partners LLC [Member] | USNC [Member] | |||||||||||
Medical Oncology Partners [Abstract] | |||||||||||
Investments in unconsolidated entities | 173,000 | ||||||||||
Ownership percentage | 35.83% | ||||||||||
Investments in unconsolidated entities | $ 149,000 | 149,000 | $ 161,000 | ||||||||
Medical Oncology Partners LLC [Member] | USNC [Member] | Dr. Jaime Lozano [Member] | |||||||||||
Medical Oncology Partners [Abstract] | |||||||||||
Investments in unconsolidated entities | $ 345,000 | ||||||||||
Percentage of equity interest to an additional investor as a consulting fee for services | 5% | ||||||||||
Ownership percentage | 76.67% | 76.67% | |||||||||
Medical Oncology Partners LLC [Member] | Investment in Unconsolidated Entity [Member] | |||||||||||
Condensed Income Statement Information [Abstract] | |||||||||||
Patient revenue | $ 2,417,000 | 2,104,000 | |||||||||
Net loss | (646,000) | (1,256,000) | |||||||||
USNC's equity in (loss) income | (231,000) | (450,000) | |||||||||
Condensed Balance Sheet Information [Abstract] | |||||||||||
Current assets | $ 201,000 | 201,000 | 204,000 | ||||||||
Noncurrent assets | 384,000 | 384,000 | 701,000 | ||||||||
Total assets | 585,000 | 585,000 | 905,000 | ||||||||
Current liabilities | 3,109,000 | 3,109,000 | 2,736,000 | ||||||||
Noncurrent liabilities | 92,000 | 92,000 | 410,000 | ||||||||
Deficit | (2,616,000) | (2,616,000) | (2,241,000) | ||||||||
Total liabilities and deficit | $ 585,000 | $ 585,000 | $ 905,000 |
Investments in Unconsolidated_7
Investments in Unconsolidated Entities, CB Oncology Partners (Details) - USD ($) | 1 Months Ended | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | ||||||
Jun. 30, 2020 | Dec. 31, 2021 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2021 | Sep. 30, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Sep. 02, 2017 | |
CB Oncology Partners [Abstract] | |||||||||||
Interest earned from the amounts owed by entity | $ 0 | $ 3,000 | |||||||||
Condensed Income Statement Information [Abstract] | |||||||||||
Patient revenue | $ 0 | $ 0 | $ 0 | $ 1,061,000 | $ 1,061,000 | $ 1,061,000 | 1,061,000 | 3,173,000 | |||
Net loss | (296,000) | (352,000) | (617,000) | 292,000 | (325,000) | (677,000) | (973,000) | 533,000 | |||
USNC's equity in (loss) income | (119,000) | (77,000) | (135,000) | (139,000) | (274,000) | (351,000) | (470,000) | (809,000) | |||
Condensed Balance Sheet Information [Abstract] | |||||||||||
Current assets | 2,243,000 | 2,634,000 | 2,909,000 | 3,451,000 | 2,909,000 | 2,634,000 | 2,243,000 | 3,007,000 | |||
Total assets | 3,688,000 | 3,772,000 | 4,073,000 | 4,614,000 | 4,073,000 | 3,772,000 | 3,688,000 | 4,173,000 | |||
Current liabilities | 626,000 | 718,000 | 656,000 | 569,000 | 656,000 | 718,000 | 626,000 | 410,000 | |||
Noncurrent liabilities | 45,000 | 56,000 | 67,000 | 56,000 | 45,000 | ||||||
Deficit | 3,028,000 | 3,009,000 | 3,361,000 | 3,978,000 | 3,361,000 | 3,009,000 | 3,028,000 | 3,686,000 | $ 3,153,000 | ||
Total liabilities and deficit | 3,688,000 | $ 3,772,000 | $ 4,073,000 | $ 4,614,000 | $ 4,073,000 | $ 3,772,000 | 3,688,000 | 4,173,000 | |||
CB Oncology Partners LLC Member [Member] | |||||||||||
CB Oncology Partners [Abstract] | |||||||||||
Ownership percentage | 28.58% | 24% | |||||||||
Capital called from members | $ 500,000 | ||||||||||
Advances converted into equity | 121,000 | ||||||||||
Contribution in cash | $ 212,000 | ||||||||||
Outstanding amount | 2,174,000 | 2,174,000 | 2,154,000 | ||||||||
Allowances on outstanding amount | 1,251,000 | 1,251,000 | 1,251,000 | ||||||||
Due from related parties | $ 923,000 | $ 923,000 | $ 903,000 | ||||||||
Note bearing interest | 6% | 6% | 6% | ||||||||
Interest earned from the amounts owed by entity | $ 125,000 | $ 125,000 | |||||||||
Accrued interest | $ 398,000 | 398,000 | 273,000 | ||||||||
CB Oncology Partners LLC Member [Member] | Investment in Unconsolidated Entity [Member] | |||||||||||
Condensed Income Statement Information [Abstract] | |||||||||||
Patient revenue | 2,042,000 | 1,795,000 | |||||||||
Net loss | (319,000) | (730,000) | |||||||||
USNC's equity in (loss) income | (91,000) | (195,000) | |||||||||
Condensed Balance Sheet Information [Abstract] | |||||||||||
Current assets | 400,000 | 400,000 | 385,000 | ||||||||
Noncurrent assets | 3,667,000 | 3,667,000 | 4,271,000 | ||||||||
Total assets | 4,067,000 | 4,067,000 | 4,656,000 | ||||||||
Current liabilities | 3,472,000 | 3,472,000 | 3,181,000 | ||||||||
Noncurrent liabilities | 3,121,000 | 3,121,000 | 3,684,000 | ||||||||
Deficit | (2,526,000) | (2,526,000) | (2,209,000) | ||||||||
Total liabilities and deficit | $ 4,067,000 | $ 4,067,000 | $ 4,656,000 |
Agreement with New York Unive_2
Agreement with New York University on Behalf of New York University Medical Center (Details) | 1 Months Ended | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | ||||||||||||||
Jul. 31, 2018 USD ($) | Sep. 30, 2017 USD ($) | Dec. 31, 2021 USD ($) | Sep. 30, 2021 USD ($) | Jun. 30, 2021 USD ($) | Mar. 31, 2021 USD ($) | Jun. 30, 2021 USD ($) | Sep. 30, 2021 USD ($) | Dec. 31, 2021 USD ($) Installment | Dec. 31, 2020 USD ($) | Dec. 31, 2018 USD ($) | Dec. 31, 2016 USD ($) Party | Dec. 31, 2009 USD ($) | Dec. 31, 2008 USD ($) | Oct. 31, 2018 USD ($) | Jun. 30, 2017 USD ($) | Apr. 30, 2016 USD ($) | Dec. 31, 2014 USD ($) | Dec. 31, 2013 USD ($) | |
NYU Revenue Recognition [Abstract] | |||||||||||||||||||
Maintenance services revenue | $ 0 | $ 0 | $ 0 | $ 1,061,000 | $ 1,061,000 | $ 1,061,000 | $ 1,061,000 | $ 3,173,000 | |||||||||||
Lease Income | 7,000 | ||||||||||||||||||
NYU Accounts Receivable and Contract Balances [Abstract] | |||||||||||||||||||
Accounts receivable | 0 | $ 0 | $ 0 | $ 828,000 | $ 0 | $ 0 | 0 | 346,000 | |||||||||||
Perfexion Gamma Knife [Member] | |||||||||||||||||||
Agreement With New York University [Abstract] | |||||||||||||||||||
Lease obligation | $ 0 | $ 0 | 89,000 | ||||||||||||||||
Monthly lease payment | $ 78,000 | ||||||||||||||||||
Maximum estimated site work cost | $ 1,088,000 | ||||||||||||||||||
ICON Imaging Technology [Member] | |||||||||||||||||||
Agreement With New York University [Abstract] | |||||||||||||||||||
Lease obligation | $ 879,000 | ||||||||||||||||||
Monthly lease payment | 20,000 | ||||||||||||||||||
Gamma Knife Cobalt Reload [Member] | |||||||||||||||||||
Agreement With New York University [Abstract] | |||||||||||||||||||
Lease obligation | $ 833,000 | ||||||||||||||||||
Monthly lease payment | $ 30,000 | ||||||||||||||||||
NYU [Member] | |||||||||||||||||||
Agreement With New York University [Abstract] | |||||||||||||||||||
Term of lease agreement with NYC | 7 years | 7 years | |||||||||||||||||
Term of option | 3 years | 3 years | |||||||||||||||||
Monthly lease payment | 50,000 | ||||||||||||||||||
Purchase price of gamma knife equipment | 2,400,000 | ||||||||||||||||||
Number of monthly installments | Installment | 41 | ||||||||||||||||||
Final lease payment amount | $ 350,000 | ||||||||||||||||||
Estimated fair value of equipment | $ 2,570,000 | ||||||||||||||||||
NYU Revenue Recognition [Abstract] | |||||||||||||||||||
Maintenance services revenue | $ 1,061,000 | 3,173,000 | |||||||||||||||||
Lease Income | 982,000 | 2,857,000 | |||||||||||||||||
NYU [Member] | Maintenance [Member] | |||||||||||||||||||
NYU Revenue Recognition [Abstract] | |||||||||||||||||||
Maintenance services revenue | $ 79,000 | $ 316,000 | |||||||||||||||||
NYU [Member] | Perfexion Gamma Knife [Member] | |||||||||||||||||||
Agreement With New York University [Abstract] | |||||||||||||||||||
Term of lease agreement with NYC | 7 years | 7 years | |||||||||||||||||
Extension of agreement | 12 years | ||||||||||||||||||
Cost of new equipment installed | $ 3,742,000 | $ 3,742,000 | |||||||||||||||||
NYU [Member] | Perfexion Gamma Knife, Purchase and Replacement [Member] | |||||||||||||||||||
Agreement With New York University [Abstract] | |||||||||||||||||||
Term of lease agreement with NYC | 6 years | 6 years | |||||||||||||||||
Lease obligation | $ 4,700,000 | ||||||||||||||||||
Monthly lease payment | $ 20,000 | ||||||||||||||||||
NYU [Member] | Perfexion Gamma Knife, New Installation and Related Construction Costs [Member] | |||||||||||||||||||
Agreement With New York University [Abstract] | |||||||||||||||||||
Term of lease agreement with NYC | 2 years | 2 years | |||||||||||||||||
Lease obligation | $ 250,000 | ||||||||||||||||||
NYU [Member] | ICON Imaging Technology [Member] | |||||||||||||||||||
Agreement With New York University [Abstract] | |||||||||||||||||||
Term of lease agreement with NYC | 4 years | 4 years | |||||||||||||||||
Cost of new equipment installed | 816,000 | ||||||||||||||||||
Lease obligation | 879,000 | ||||||||||||||||||
Monthly maintenance agreement cost | $ 6,000 | ||||||||||||||||||
Number of parties agreed to receive payment | Party | 2 | ||||||||||||||||||
Monthly lease payment | $ 30,000 | $ 30,000 | |||||||||||||||||
Final lease payment amount | 350,000 | ||||||||||||||||||
NYU [Member] | Gamma Knife Cobalt Reload [Member] | |||||||||||||||||||
Agreement With New York University [Abstract] | |||||||||||||||||||
Term of lease agreement with NYC | 30 months | 30 months | |||||||||||||||||
Cost of new equipment installed | $ 925,000 | ||||||||||||||||||
Lease obligation | 833,000 | ||||||||||||||||||
Installation costs of technology | $ 578,000 | ||||||||||||||||||
Monthly lease payment | 50,000 | ||||||||||||||||||
Cobalt reload cost | $ 1,503,000 |
Investment in Sublease (Details
Investment in Sublease (Details) | 12 Months Ended | ||||||
Dec. 31, 2021 Installment | Dec. 31, 2018 USD ($) | Oct. 31, 2018 USD ($) | Sep. 30, 2018 USD ($) | Sep. 30, 2017 USD ($) | Dec. 31, 2016 USD ($) | Apr. 30, 2016 USD ($) | |
Capital Leases of Lessee [Abstract] | |||||||
Sales price | $ 2,447,000 | ||||||
Gamma Knife Cobalt Reload [Member] | |||||||
Capital Leases of Lessee [Abstract] | |||||||
Monthly lease payment | $ 30,000 | ||||||
ICON Imaging Technology [Member] | |||||||
Capital Leases of Lessee [Abstract] | |||||||
Monthly lease payment | $ 20,000 | ||||||
NYU [Member] | |||||||
Capital Leases of Lessee [Abstract] | |||||||
Purchase price of gamma knife equipment | $ 2,400,000 | ||||||
Number of monthly installments | Installment | 41 | ||||||
Monthly lease payment | 50,000 | ||||||
Final lease payment amount | $ 350,000 | ||||||
NYU [Member] | Gamma Knife Cobalt Reload [Member] | |||||||
Capital Leases of Lessee [Abstract] | |||||||
Monthly lease payment | $ 50,000 | ||||||
Cobalt reload cost | 1,503,000 | ||||||
NYU [Member] | ICON Imaging Technology [Member] | |||||||
Capital Leases of Lessee [Abstract] | |||||||
Monthly lease payment | 30,000 | $ 30,000 | |||||
Final lease payment amount | 350,000 | ||||||
Total final lease payment | $ 380,000 |
Obligations Under Finance Lea_3
Obligations Under Finance Leases (Details) - USD ($) | Dec. 31, 2021 | Dec. 31, 2020 | Oct. 31, 2018 | Dec. 31, 2016 | Dec. 31, 2014 | Dec. 31, 2013 | Mar. 31, 2009 |
Obligation under capital leases [Abstract] | |||||||
Less current portion | $ 0 | $ (89,000) | |||||
Perfexion Gamma Knife [Member] | |||||||
Capital Lease [Abstract] | |||||||
Equipment financed term | 7 years | ||||||
Capital lease asset under construction | $ 3,742,000 | ||||||
Monthly payments for capital leases | $ 78,000 | ||||||
Modified equipment capitalized cost under agreement | $ 4,700,000 | ||||||
Interest rate on lease | 4.49% | ||||||
Obligation under capital leases [Abstract] | |||||||
Present value of lease liabilities | $ 0 | 89,000 | |||||
Less current portion | 0 | (89,000) | |||||
Capital lease obligations, noncurrent | $ 0 | $ 0 | |||||
Perfexion Gamma Knife, New Installation and Related Construction Costs [Member] | |||||||
Capital Lease [Abstract] | |||||||
Equipment financed term | 72 months | ||||||
Perfexion Gamma Knife, Further Installation and Related Construction Costs [Member] | |||||||
Capital Lease [Abstract] | |||||||
Equipment financed term | 24 months | ||||||
Lease amount for cost of construction | $ 250,000 | ||||||
ICON Imaging Technology [Member] | |||||||
Capital Lease [Abstract] | |||||||
Equipment financed term | 48 months | ||||||
Monthly payments for capital leases | $ 20,000 | ||||||
Interest rate on lease | 4.45% | ||||||
Obligation under capital leases [Abstract] | |||||||
Present value of lease liabilities | $ 879,000 | ||||||
Gamma Knife, Cobalt Reload [Member] | |||||||
Capital Lease [Abstract] | |||||||
Equipment financed term | 30 months | ||||||
Monthly payments for capital leases | $ 30,000 | ||||||
Interest rate on lease | 5.85% | ||||||
Obligation under capital leases [Abstract] | |||||||
Present value of lease liabilities | $ 833,000 |
Taxes (Details)
Taxes (Details) - USD ($) | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | ||||
Dec. 31, 2021 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2021 | Sep. 30, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | |
Current taxes [Abstract] | ||||||||
Federal | $ 228,000 | $ 211,000 | ||||||
State | 192,000 | 95,000 | ||||||
Current taxes | 420,000 | 306,000 | ||||||
Deferred taxes [Abstract] | ||||||||
Federal | 0 | 12,000 | ||||||
State | 0 | 5,000 | ||||||
Deferred taxes | 0 | 17,000 | ||||||
Income tax provision | $ (80,000) | $ 16,000 | $ 232,000 | $ 252,000 | $ 484,000 | $ 500,000 | 420,000 | 323,000 |
Reconciliation of Tax Provision (Benefit) [Abstract] | ||||||||
Income tax at the federal statutory rate | (130,000) | 180,000 | ||||||
State income tax, net of federal taxes | (106,000) | 52,000 | ||||||
Permanent differences and other | (67,000) | 16,000 | ||||||
Change in estimated effective state tax rate | 2,000 | (4,000) | ||||||
Change in valuation allowance | 721,000 | 79,000 | ||||||
Income tax provision | (80,000) | $ 16,000 | $ 232,000 | $ 252,000 | $ 484,000 | $ 500,000 | 420,000 | 323,000 |
Deferred tax asset [Abstract] | ||||||||
Basis differences in unconsolidated entities, including advances and loans to those entities. | 587,000 | 587,000 | 561,000 | |||||
Excess of book depreciation over tax depreciation | 0 | 0 | 192,000 | |||||
Net intangible assets and other capitalized costs | 102,000 | 102,000 | 0 | |||||
Net operating loss | 66,000 | 66,000 | 34,000 | |||||
Net effect of conversion from the accrual basis of accounting to the cash basis of accounting for tax purposes primarily related to accounts receivable, prepaid expense, deferred revenue, and accounts payable | 45,000 | 45,000 | 0 | |||||
Valuation allowance | (800,000) | (800,000) | (79,000) | |||||
Deferred tax assets, gross | 0 | 0 | 708,000 | |||||
Deferred tax liability [Abstract] | ||||||||
Deferred gain on disposal of gamma knife | 0 | 0 | (634,000) | |||||
Net effect of conversion from the accrual basis of accounting to the cash basis of accounting for tax purposes primarily related to accounts receivable, prepaid expense, deferred revenue, and accounts payable | 0 | 0 | (74,000) | |||||
Net deferred tax asset | $ 0 | $ 0 | $ 0 |
Commitments and Contingencies,
Commitments and Contingencies, Operating Leases, Gamma Knife and Maintenance Contract (Details) - USD ($) | 1 Months Ended | 12 Months Ended | ||||||||||||||||
Sep. 01, 2014 | Jul. 31, 2018 | Aug. 31, 2017 | Apr. 30, 2015 | Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2009 | Dec. 31, 2008 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Dec. 31, 2018 | Oct. 31, 2018 | Sep. 30, 2017 | Apr. 30, 2016 | Dec. 31, 2014 | Dec. 31, 2013 | |
Operating Leases [Abstract] | ||||||||||||||||||
Operating Lease and Lease Liability | $ 176,000 | |||||||||||||||||
ROU asset | $ 161,000 | |||||||||||||||||
Operating lease right-of-use asset | $ 59,000 | $ 94,000 | $ 68,000 | $ 77,000 | $ 86,000 | |||||||||||||
Operating lease expense | 41,000 | 42,000 | ||||||||||||||||
Maturities of operating lease liability [Abstract] | ||||||||||||||||||
2022 | 46,000 | |||||||||||||||||
2023 | 24,000 | |||||||||||||||||
Total | 70,000 | |||||||||||||||||
Less interest | (4,000) | |||||||||||||||||
Present value of net minimum obligation | 66,000 | 106,000 | ||||||||||||||||
Gamma Knife [Abstract] | ||||||||||||||||||
Operating lease amount | $ 66,000 | 106,000 | ||||||||||||||||
Maintenance Contract [Abstract] | ||||||||||||||||||
Warranty term of maintenance agreement | 1 year | |||||||||||||||||
Monthly maintenance agreement cost | $ 26,000 | $ 20,000 | ||||||||||||||||
Maintenance agreement | 5 years | |||||||||||||||||
Perfexion Gamma Knife [Member] | ||||||||||||||||||
Gamma Knife [Abstract] | ||||||||||||||||||
Capital lease obligation | $ 0 | $ 0 | ||||||||||||||||
Monthly lease payment | $ 78,000 | |||||||||||||||||
Gamma Knife Cobalt Reload [Member] | ||||||||||||||||||
Gamma Knife [Abstract] | ||||||||||||||||||
Monthly lease payment | $ 30,000 | |||||||||||||||||
NYU [Member] | ||||||||||||||||||
Gamma Knife [Abstract] | ||||||||||||||||||
Equipment financed term | 7 years | |||||||||||||||||
Monthly lease payment | $ 50,000 | |||||||||||||||||
NYU [Member] | Perfexion Gamma Knife [Member] | ||||||||||||||||||
Gamma Knife [Abstract] | ||||||||||||||||||
Cost of new equipment installed | $ 3,742,000 | $ 3,742,000 | ||||||||||||||||
Equipment financed term | 7 years | |||||||||||||||||
NYU [Member] | Perfexion Gamma Knife, Purchase and Replacement [Member] | ||||||||||||||||||
Maturities of operating lease liability [Abstract] | ||||||||||||||||||
Present value of net minimum obligation | $ 4,700,000 | |||||||||||||||||
Gamma Knife [Abstract] | ||||||||||||||||||
Equipment financed term | 6 years | |||||||||||||||||
Operating lease amount | 4,700,000 | |||||||||||||||||
Capital lease obligation | $ 879,000 | |||||||||||||||||
Lease payment due | $ 78,000 | |||||||||||||||||
Interest on lease | $ 18,000 | |||||||||||||||||
Monthly lease payment | $ 20,000 | |||||||||||||||||
NYU [Member] | Perfexion Gamma Knife, Leasehold Improvements, New Installation and Related Construction Costs [Member] | ||||||||||||||||||
Maturities of operating lease liability [Abstract] | ||||||||||||||||||
Present value of net minimum obligation | 250,000 | |||||||||||||||||
Gamma Knife [Abstract] | ||||||||||||||||||
Equipment financed term | 2 years | |||||||||||||||||
Operating lease amount | $ 250,000 | |||||||||||||||||
NYU [Member] | Gamma Knife Cobalt Reload [Member] | ||||||||||||||||||
Gamma Knife [Abstract] | ||||||||||||||||||
Cost of new equipment installed | $ 925,000 | |||||||||||||||||
Equipment financed term | 30 months | |||||||||||||||||
Capital lease obligation | $ 833,000 | |||||||||||||||||
Monthly lease payment | $ 50,000 |
Commitments and Contingencies_2
Commitments and Contingencies, Guarantees and Product Liability (Details) - USD ($) | 12 Months Ended | ||||
Dec. 31, 2021 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Dec. 31, 2020 | |
Guarantees [Abstract] | |||||
Liability associated with guarantee | $ 11,000 | $ 11,000 | $ 11,000 | $ 11,000 | $ 11,000 |
Product Liability [Abstract] | |||||
Professional medical and general liability policies limits | $ 3,000,000 | ||||
Neuro Partners, LLC [Member] | Lease and Leasehold Improvements Guarantee [Member] | |||||
Guarantees [Abstract] | |||||
Percentage of guarantee obligations | 20% | ||||
Capital lease obligation | 60,000 | ||||
Boca West IMP [Member] | Mortgage Guarantee [Member] | |||||
Guarantees [Abstract] | |||||
Percentage of guarantee obligations | 10% | ||||
Percentage of outstanding balance in mortgage | 50% | ||||
Term of mortgage | 10 years | ||||
Original balance of mortgage | $ 3,000,000 | ||||
FOPRE [Member] | Lease Guarantee [Member] | |||||
Guarantees [Abstract] | |||||
Liability associated with guarantee | 11,000 | 11,000 | |||
Outstanding loan balance | $ 2,715,000 | $ 3,066,000 |
Employees' IRA Plans (Details)
Employees' IRA Plans (Details) - USD ($) | 12 Months Ended | |
Dec. 31, 2021 | Dec. 31, 2020 | |
Employees' IRA Plans [Abstract] | ||
Employer discretionary contribution amount | $ 0 | $ 14,000 |
Acquisition (Details)
Acquisition (Details) - USD ($) | 12 Months Ended | ||
Oct. 01, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | |
Goodwill [Roll Forward] | |||
Beginning balance | $ 0 | ||
Ending balance | $ 315,000 | $ 0 | |
Elite Health Plan, Inc. [Member] | |||
Acquisition [Abstract] | |||
Equity consideration, percentage of outstanding shares | 15% | ||
Period for closing of transaction | 6 months | ||
Fair value of the purchase price for acquisition | $ 315,000 | ||
Goodwill [Roll Forward] | |||
Beginning balance | $ 0 | 0 | |
Acquisition | 315,000 | 0 | |
Ending balance | $ 315,000 | $ 0 |
Restatement of Previously Iss_3
Restatement of Previously Issued Consolidated Financial Statements, Consolidated Balance Sheets (Details) - USD ($) | Dec. 31, 2021 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 |
Condensed Balance Sheets [Abstract] | ||||||
Income taxes payable | $ 414,000 | $ 496,000 | $ 480,000 | $ 363,000 | $ 111,000 | |
Total liabilities | 660,000 | 763,000 | 712,000 | 636,000 | 487,000 | |
Total equity | 3,028,000 | $ 3,009,000 | $ 3,361,000 | $ 3,978,000 | $ 3,686,000 | $ 3,153,000 |
Amount Previously Reported [Member] | ||||||
Condensed Balance Sheets [Abstract] | ||||||
Income taxes payable | 114,000 | |||||
Total liabilities | 361,000 | |||||
Total equity | $ 3,327,000 |
Restatement of Previously Iss_4
Restatement of Previously Issued Consolidated Financial Statements, Consolidated Statements of Operations (Details) - USD ($) | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | ||||
Dec. 31, 2021 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2021 | Sep. 30, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | |
Consolidated Statements of Operations: [Abstract] | ||||||||
Income tax provision | $ (80,000) | $ 16,000 | $ 232,000 | $ 252,000 | $ 484,000 | $ 500,000 | $ 420,000 | $ 323,000 |
Net loss | 296,000 | 352,000 | 617,000 | (292,000) | 325,000 | 677,000 | 973,000 | (533,000) |
Net loss attributable to noncontrolling interests | 92,000 | 0 | 0 | 0 | 0 | 0 | 92,000 | 0 |
Net loss attributable to U.S. NeuroSurgical Holdings, Inc. | $ 204,000 | $ 352,000 | $ 617,000 | $ (292,000) | $ 325,000 | $ 677,000 | $ 881,000 | $ (533,000) |
Basic net loss per share attributable to U.S. Neurosurgical Holdings, Inc. (in dollars per share) | $ (0.03) | $ (0.05) | $ (0.08) | $ 0.04 | $ (0.04) | $ (0.09) | $ (0.11) | $ 0.07 |
Diluted net loss per share attributable to U.S. Neurosurgical Holdings, Inc. (in dollars per share) | $ (0.03) | $ (0.05) | $ (0.08) | $ 0.04 | $ (0.04) | $ (0.09) | $ (0.11) | $ 0.07 |
Amount Previously Reported [Member] | ||||||||
Consolidated Statements of Operations: [Abstract] | ||||||||
Income tax provision | $ 120,000 | |||||||
Net loss | 674,000 | |||||||
Net loss attributable to noncontrolling interests | 47,000 | |||||||
Net loss attributable to U.S. NeuroSurgical Holdings, Inc. | $ 627,000 | |||||||
Basic net loss per share attributable to U.S. Neurosurgical Holdings, Inc. (in dollars per share) | $ (0.08) | |||||||
Diluted net loss per share attributable to U.S. Neurosurgical Holdings, Inc. (in dollars per share) | $ (0.08) |
Quarterly Results of Operatio_3
Quarterly Results of Operations (Unaudited), Condensed Consolidated Statements of Operations (Details) - USD ($) | 3 Months Ended | 6 Months Ended | 9 Months Ended | 12 Months Ended | ||||
Dec. 31, 2021 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Jun. 30, 2021 | Sep. 30, 2021 | Dec. 31, 2021 | Dec. 31, 2020 | |
Condensed Income Statement Information [Abstract] | ||||||||
Revenue | $ 0 | $ 0 | $ 0 | $ 1,061,000 | $ 1,061,000 | $ 1,061,000 | $ 1,061,000 | $ 3,173,000 |
Costs and expenses [Abstract] | ||||||||
Patient expenses | 0 | 0 | 0 | 86,000 | 86,000 | 86,000 | 86,000 | 361,000 |
Selling, general and administrative | 248,000 | 268,000 | 249,000 | 298,000 | 547,000 | 815,000 | 1,063,000 | 1,197,000 |
Total | 248,000 | 268,000 | 249,000 | 384,000 | 633,000 | 901,000 | 1,149,000 | 1,558,000 |
Operating (loss) income | (248,000) | (268,000) | (249,000) | 677,000 | 428,000 | 160,000 | (88,000) | 1,615,000 |
Total other (expense) income [Abstract] | ||||||||
Interest expense | 0 | 0 | (1,000) | (2,000) | (3,000) | (3,000) | (3,000) | (25,000) |
Other income | (9,000) | 9,000 | 0 | 0 | 0 | 9,000 | ||
Interest income - sales-type sublease | 0 | 0 | 0 | 8,000 | 8,000 | 8,000 | 8,000 | 72,000 |
Loss from investment in unconsolidated entities, net | (119,000) | (77,000) | (135,000) | (139,000) | (274,000) | (351,000) | (470,000) | (809,000) |
Total other expense | (128,000) | (68,000) | (136,000) | (133,000) | (269,000) | (337,000) | (465,000) | (759,000) |
(Loss) income before income taxes | (376,000) | (336,000) | (385,000) | 544,000 | 159,000 | (177,000) | (553,000) | 856,000 |
Income tax provision | (80,000) | 16,000 | 232,000 | 252,000 | 484,000 | 500,000 | 420,000 | 323,000 |
Net (loss) income | (296,000) | (352,000) | (617,000) | 292,000 | (325,000) | (677,000) | (973,000) | 533,000 |
Net loss attributable to noncontrolling interests | 92,000 | 0 | 0 | 0 | 0 | 0 | 92,000 | 0 |
Net (loss) income attributable to U.S. Neurosurgical Holdings, Inc. | $ (204,000) | $ (352,000) | $ (617,000) | $ 292,000 | $ (325,000) | $ (677,000) | $ (881,000) | $ 533,000 |
Basic net (loss) income per share attributable to U.S. Neurosurgical Holdings, Inc. (in dollars per share) | $ (0.03) | $ (0.05) | $ (0.08) | $ 0.04 | $ (0.04) | $ (0.09) | $ (0.11) | $ 0.07 |
Diluted net (loss) income per share attributable to U.S. Neurosurgical Holdings, Inc. (in dollars per share) | $ (0.03) | $ (0.05) | $ (0.08) | $ 0.04 | $ (0.04) | $ (0.09) | $ (0.11) | $ 0.07 |
Quarterly Results of Operatio_4
Quarterly Results of Operations (Unaudited), Condensed Consolidated Balance Sheets (Details) - USD ($) | Dec. 31, 2021 | Sep. 30, 2021 | Jun. 30, 2021 | Mar. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 |
Current assets [Abstract] | ||||||
Cash and cash equivalents | $ 2,178,000 | $ 2,567,000 | $ 2,820,000 | $ 2,543,000 | $ 2,030,000 | |
Accounts receivable | 0 | 0 | 0 | 828,000 | 346,000 | |
Other current assets | 65,000 | 67,000 | 89,000 | 80,000 | 99,000 | |
Total current assets | 2,243,000 | 2,634,000 | 2,909,000 | 3,451,000 | 3,007,000 | |
Other assets [Abstract] | ||||||
Due from related parties | 930,000 | 918,000 | 923,000 | 916,000 | 912,000 | |
Investments in unconsolidated entities | 141,000 | 152,000 | 164,000 | 161,000 | 160,000 | |
Total other assets | 1,386,000 | 1,070,000 | 1,087,000 | 1,077,000 | 1,072,000 | |
Property and equipment [Abstract] | ||||||
Operating lease right-of-use asset | 59,000 | 68,000 | 77,000 | 86,000 | 94,000 | |
Total property and equipment | 59,000 | 68,000 | 77,000 | 86,000 | 94,000 | |
TOTAL ASSETS | 3,688,000 | 3,772,000 | 4,073,000 | 4,614,000 | 4,173,000 | |
Current liabilities [Abstract] | ||||||
Operating lease right-of-use liability - current portion | 43,000 | 42,000 | 41,000 | 40,000 | 40,000 | |
Accounts payable and accrued expenses | 169,000 | 180,000 | 135,000 | 166,000 | 170,000 | |
Income taxes payable | 414,000 | 496,000 | 480,000 | 363,000 | 111,000 | |
Total current liabilities | 626,000 | 718,000 | 656,000 | 569,000 | 410,000 | |
Operating lease right-of-use liability - net of current portion | 23,000 | 34,000 | 45,000 | 56,000 | 66,000 | |
Guarantee liability | 11,000 | 11,000 | 11,000 | 11,000 | 11,000 | |
Total long-term liabilities | 45,000 | 56,000 | 67,000 | |||
Total liabilities | 660,000 | 763,000 | 712,000 | 636,000 | 487,000 | |
EQUITY [Abstract] | ||||||
Common stock | 78,000 | 78,000 | 78,000 | 78,000 | 78,000 | |
Additional paid-in capital | 2,871,000 | 3,100,000 | 3,100,000 | 3,100,000 | 3,100,000 | |
(Accumulated deficit) retained earnings | (373,000) | (169,000) | 183,000 | 800,000 | 508,000 | |
Total equity | 3,028,000 | 3,009,000 | 3,361,000 | 3,978,000 | 3,686,000 | $ 3,153,000 |
TOTAL LIABILITIES AND EQUITY | $ 3,688,000 | $ 3,772,000 | $ 4,073,000 | $ 4,614,000 | $ 4,173,000 |