Joe Army
Analyst · Marie Thibault with BTIG
Thanks, Mark, and thank you all for joining us. On today’s call, I will review the steps we took in 2022 to set us up for success in 2023 and beyond. And John will review our fourth quarter financial performance and discuss our 2023 guidance. I will then tell you the actions we will take to achieve our guidance and drive predictable profitable growth in the future. As a result of COVID, during 2020 and 2021, we doubled our worldwide installed base and doubled the number of our gold accounts, which are the top 1,000 U.S. hospitals in terms of respiratory discharges. After two years of COVID volatility, it was difficult to predict what 2022 would look like. As COVID transitioned from a lower respiratory disease to an upper respiratory disease, COVID-related hospitalizations decreased dramatically. At the same time, we saw reduced revenue, our expenditures to meet all customer needs have left us with lower gross margins and unsustainable operating cost structure and a capital constrained balance sheet. Throughout 2022, we addressed these issues and devoted considerable effort to derisking the business and setting us up for success in 2023. One of our key focus areas throughout the year has been to return to predictable disposable revenue growth, as it represents the majority of our revenue and carries the highest gross margin. We have done this by focusing on our gold accounts. In these accounts, we have been expanding into additional care areas and delivering high quality medical education and training. As a result of these efforts, we have seen U.S. disposable turn rates, which represent disposables sold per month per box steadily recovered. In the fourth quarter, we had 70% of our pre-COVID three-year historical average due in part to flu arriving earlier than usual. Our fourth quarter U.S. disposable turn rate of 70% was up from 42% in the second quarter and 60% in the third quarter. We are also executing on the launch of the HVT 2.0. This next-generation platform represents a major upgrade over our Precision Flow Plus. First, it incorporates a built-in blower, which allows it to be used in the areas of the hospital that don’t have wall air. And second, it makes it easier to transport patients between care areas. It’s also easier to use and therefore requires less training time. There has been a lot of interest in this product since launch and we are beginning to see a number of customers replace their existing fleets with these newer devices. During the quarter, we continued our efforts to improve gross margins. I am pleased to report that our new VapoMax [ph] facility is certified. All our production lines have been moved and validated. Importantly, all of our cost assumptions are intact and we are building product and putting it into inventory. We will begin to see the impact of these lower cost products as we work through the high cost inventory that we built during COVID to meet all customer needs. Another key area of focus in 2022 was our balance sheet. The balance sheet is now in good shape and we have improved our financial flexibility. We recently completed a $23 million equity raise and expected $17 million of inventory presently on the balance sheet will convert to cash by the end of 2024. We also restructured the SLR debt facility to reset our 2023 financial covenants, reduce our minimum cash covenant and add the ability at our election to pick a portion of our 2023 interest expense, saving cash expenditures of potentially up to $9 million. Between the additional cash from our recent equity raise, the conversion of inventory to cash, the ability to pick our interest payments, our reductions in operating expenses and the gross margin improvements we expect from our relocation of manufacturing to Mexico, we believe we have the necessary capital to get us to adjusted EBITDA positive by the end of this year. During 2022, we also focused heavily on reducing cash operating expenses to pre-COVID levels or $63 million in 2019. Cash operating expenses decreased by approximately $17.2 million in 2022 versus 2021, with the stage set to deliver pre-COVID level of cash operating expenses in 2023 of $60 million to $62 million. During the year, we right-sized our worldwide commercial organization, stopped commercial investments in Vapotherm Access and RespirCare, brought R&D back in-house and won a grant from the Singaporean Government to offset a portion of our new R&D efforts in our newly established R&D center. I will now turn the call over to John who will review the financial results for this quarter.